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The Adherence Attitude Inventory is a 28-item Likert-type scaled rapid assessment instrument that consists of four distinct constructs (cognitive functioning, patient-provider communication, self-efficacy, and commitment to adherence) that are related to adherence to medication. Although the Adherence Attitude Inventory is not HIV specific, the authors created it in response to a call by the HIV community for instrument development. The focus of this article is on instrument development and pilot testing of psychometric properties.

BACKGROUND: Heavy alcohol use during pregnancy can cause considerable developmental problems for children, but effects of light-moderate drinking are uncertain. This study examined possible effects of moderate drinking in pregnancy on children's conduct problems using a Mendelian randomisation design to improve causal inference. METHODS: A prospective cohort study (ALSPAC) followed children from their mother's pregnancy to age 13 years. Analyses were based on 3,544 children whose mothers self-reported either not drinking alcohol during pregnancy or drinking up to six units per week without binge drinking. Children's conduct problem trajectories were classified as low risk, childhood-limited, adolescence-onset or early-onset-persistent, using six repeated measures of the Strengths and Difficulties Questionnaire between ages 4-13 years. Variants of alcohol-metabolising genes in children were used to create an instrumental variable for Mendelian randomisation analysis. RESULTS: Children's genotype scores were associated with early-onset-persistent conduct problems (OR = 1.29, 95% CI = 1.04-1.60, p = .020) if mothers drank moderately in pregnancy, but not if mothers abstained from drinking (OR = 0.94, CI = 0.72-1.25, p = .688). Children's genotype scores did not predict childhood-limited or adolescence-onset conduct problems. CONCLUSIONS: This quasi-experimental study suggests that moderate alcohol drinking in pregnancy contributes to increased risk for children's early-onset-persistent conduct problems, but not childhood-limited or adolescence-onset conduct problems. ; The UK Medical Research Council (MRC) and the Wellcome Trust [grant number 092731] and the University of Bristol provide core support for ALSPAC. Genotype data used in this analysis was specifically funded by the Wellcome Trust [grant number 083506]. JM [grant number 089963/Z/09/Z] and SB [grant number 100114] are supported by the Wellcome Trust. LZ is supported by the MRC [grant number G0902144], and works in a Unit that receives funding from the MRC [grant number G0600705] and the University of Bristol. MH is supported by The National Institute for Health Research School for Public Health Research, the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, which receives funding from the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council [grant number RES-590-28-0005], the MRC, the Welsh Assembly Government and the Wellcome Trust [grant number WT087640MA], under the auspices of the UK Clinical Research Collaboration, and NIH [grant number RO1 AA018333] and MRC [grant number MR/L022206/1] alcohol research grants. ; This is the final version of the article. It first appeared from Wiley via http://dx.doi.org/10.1111/jcpp.12486

Background Both active and passive cigarette smoking have previously been associated with orofacial cleft aetiology. We aimed to analyse the impact of declining active smoking prevalence and the implementation of smoke-free legislation on the incidence of children born with a cleft lip and/or palate within the United Kingdom. Methods and findings We conducted regression analysis using national administrative data in the United Kingdom between 2000–2018. The main outcome measure was orofacial cleft incidence, reported annually for England, Wales and Northern Ireland and separately for Scotland. First, we conducted an ecological study with longitudinal time-series analysis using smoking prevalence data for females over 16 years of age. Second, we used a natural experiment design with interrupted time-series analysis to assess the impact of smoke-free legislation. Over the study period, the annual incidence of orofacial cleft per 10,000 live births ranged from 14.2–16.2 in England, Wales and Northern Ireland and 13.4–18.8 in Scotland. The proportion of active smokers amongst females in the United Kingdom declined by 37% during the study period. Adjusted regression analysis did not show a correlation between the proportion of active smokers and orofacial cleft incidence in either dataset, although we were unable to exclude a modest effect of the magnitude seen in individual-level observational studies. The data in England, Wales and Northern Ireland suggested an 8% reduction in orofacial cleft incidence (RR 0.92, 95%CI 0.85 to 0.99; P = 0.024) following the implementation of smoke-free legislation. In Scotland, there was weak evidence for an increase in orofacial cleft incidence following smoke-free legislation (RR 1.16, 95%CI 0.94 to 1.44; P = 0.173). Conclusions These two ecological studies offer a novel insight into the influence of smoking in orofacial cleft aetiology, adding to the evidence base from individual-level studies. Our results suggest that smoke-free legislation may have reduced orofacial cleft ...