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While association between alcohol consumption and harm is assessed mainly by individual-level data, aggregate time series data sometimes provide a feasible alternative.
Self-harm was assessed by two questions taken from the Avon Longitudinal Study of Parents and Children (ALSPAC) study (Life of a teenager 16+ assessment; (see http://www.alspac.bris.ac.uk).ac.uk
These differences may be due to the way self-harm was assessed since single item measures tend to produce lower rates than multiple item questionnaires [ 32].
Self-harm was assessed using the Self-Harm Behavior Questionnaire (SHBQ) [ 37], which is a self-report measure to assess the lifetime prevalence of self-harming behaviours including NSSI ('Have you ever hurt yourself on purpose?
Self-harm was assessed using the following question: 'In the last [reference period], have you ever deliberately hurt yourself or done anything that you knew might have harmed you or even killed you?' The reference period was the past year for wave 3 and 4 and past 6 months for the remaining waves.
This makes clear that harms are assessed relative to some baseline.
Suicide and self-harm are assessed with the Suicide and Self-Harm Inventory (SSHI) [ 3].
Cannabis related harms are assessed using a set of questions adapted from the Adolescent Cannabis Problems Questionnaire [ 50].
For each clinical intervention under study, the balance of benefits and harms is assessed, and a grade of recommendation is classified as strong or weak.
12 Furthermore, studies reporting harms were assessed using the 15-item McMaster Quality Assessment Scale of Harms (McHarm) tool, 13 which focuses on how harms are defined, collected and reported.
Eligibility for these analyses required: 1) a valid assessment of harm avoidance without evidence of clinical dementia and 2) a valid measure of parkinsonism at the time harm avoidance was assessed and at least one or more follow-up evaluations of parkinsonism in order to assess change in parkinsonism.
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