67 research outputs found
Supplemental Material - Body mass index across adulthood and the development of airflow obstruction and emphysema
No full textSupplemental Material for Body mass index across adulthood and the development of airflow obstruction and emphysema by Ruth E Trethewey, Nicole L Spartano, Ramachandran S Vasan, Martin G Larson, George T O’Connor, Dale W Esliger, Emily S Petherick and Michael C Steiner in Chronic Respiratory Disease</p
Evaluation of ethnic disparities in detection of depression and anxiety in primary care during the maternal period:combined analysis of routine and cohort data
No full textBackgroundThere are limited data on detection disparities of common mental disorders in minority ethnic women.AimsDescribe the natural history of common mental disorders in primary care in the maternal period, characterise women with, and explore ethnic disparities in, detected and potentially missed common mental disorders.MethodSecondary analyses of linked birth cohort and primary care data involving 8991 (39.4% White British) women in Bradford. Common mental disorders were characterised through indications in the electronic medical record. Potentially missed common mental disorders were defined as an elevated General Health Questionnaire (GHQ-28) score during pregnancy with no corresponding common mental disorder markers in the medical record.ResultsEstimated prevalence of pre-birth common mental disorders was 9.5%, rising to 14.0% 3 years postnatally. Up to half of cases were potentially missed. Compared with White British women, minority ethnic women were twice as likely to have potentially missed common mental disorders and half as likely to have a marker of screening for common mental disorders.ConclusionsCommon mental disorder detection disparities exist for minority ethnic women in the maternal period
Leg ulceration: An exploration of the role of socio-economic factors in the epidemiology, access to health care and outcomes.
No full textBackground
Tackling health inequalities has been a priority policy area for the NHS since the 1990’s. To date there has been scant research addressing this area in relation to leg ulcers, despite there being some evidence of inequalities in leg ulcer prevalence. The overarching aim of this thesis is to examine the relationship between the epidemiology, management and outcomes of leg ulcers in relation and socio-economic factors.
Methods
The epidemiology and management of leg ulcers was examined using the GPRD and THIN primary care databases. Regression models were undertaken to quantify the relationship between variables and leg ulcer rates. Multilevel logistic models were undertaken to examine three aspects of guideline recommended care in the cohort of patients diagnosed with incident venous leg ulcers; initial assessment using Doppler ultrasound, provision of compression bandaging and referrals. Analysis conducted using the THIN database adjusted for Townsend deprivation fifth rank of each patient, a proxy measure of socio-economic position. Analyses of patient management using the GPRD adjusted for practice level deprivation. Second, the relationship between socio-economic position with leg ulcer outcomes including healing and adverse events was investigated using two recently completed leg ulcer treatment RCTs.
Results
Socio-economic gradients were found in rates of incident venous and prevalent venous and arterial leg ulcers. The reported management of most patients fell short of standards recommended by leg ulcer guidelines although there were wide variations between practices. Only the initial assessment of patients was found to have a relationship with deprivation. Patients living in or attending practices in the most deprived areas had reduced odds of having a record of receiving Doppler assessment of their leg. No relationship was observed between deprivation and healing or adverse outcomes in the clinical trials.
Conclusions
There are health inequalities evident in leg ulcer development and some aspects of management. The wider implementation of guideline recommendations for care may have the potential to ameliorate some of these health inequalities as results demonstrated that low socio-economic position patients were no less likely to achieve positive leg ulcer outcomes when provided with high quality care
Maternal psychological distress in primary care and association with child behavioural outcomes at age three
No full textObservational studies indicate children whose mothers have poor mental health are at increased risk of socio-emotional behavioural difficulties, but it is unknown whether these outcomes vary by the mothers' mental health recognition and treatment status. To examine this question, we analysed linked longitudinal primary care and research data from 1078 women enrolled in the Born in Bradford cohort. A latent class analysis of treatment status and self-reported distress broadly categorised women as (a) not having a common mental disorder (CMD) that persisted through pregnancy and the first 2 years after delivery (N = 756, 70.1 %), (b) treated for CMD (N = 67, 6.2 %), or (c) untreated (N = 255, 23.7 %). Compared to children of mothers without CMD, 3-year-old children with mothers classified as having untreated CMD had higher standardised factor scores on the Strengths and Difficulties Questionnaire (d = 0.32), as did children with mothers classified as having treated CMD (d = 0.27). Results were only slightly attenuated in adjusted analyses. Children of mothers with CMD may be at risk for socio-emotional and behavioural difficulties. The development of effective treatments for CMD needs to be balanced by greater attempts to identify and treat women.</p
Supplementary information files for "Non-parental Childcare During Early Childhood and Problem Behaviour Trajectories from Ages 5 to 14 Years"
No full textSupplementary files for article "Non‑parental Childcare During Early Childhood and Problem Behaviour Trajectories from Ages 5 to 14 Years"Using data from the nationally representative Millennium Cohort Study, this study examined the association between age of starting and weekly hours in formal childcare between birth and 5 years with internalising and externalising behaviour trajectories from ages 5 to 14 years in England (N=6194 children). Associations were analysed using multilevel general linear regression models, with adjustment for socio-economic position, maternal mental health, demographics, and child temperament. Later entry was associated with more internalising behaviours at age 14 years. Children who spent>40 h per week in childcare between birth and 3 years displayed more externalising behaviour at 5 years than children who did not attend childcare. Controlling for socio-economic position and parental mental health attenuated findings.© The Author(s), CC BY 4.0</p
Incidence of bone stress injury is greater in competitive female distance runners with menstrual disturbances independent of participation in plyometric training
No full textBone stress injury (BSI) is prevalent in female distance runners. Menstrual disturbances are associated with impaired bone health in endurance athletes. This study aimed to investigate the association between menstrual function and BSI and explore whether plyometric training may protect against BSI in individuals with menstrual disturbances. Competitive female distance runners (n = 183) aged 18-40 years were surveyed for training habits, menstrual function, and BSI, during the previous 12 months. Oligo/amenorrhoea during the previous 12 months (<9 menses) was deemed to indicate menstrual disturbance; hormonal contraceptive users and those previously diagnosed with a pathology that impacted menstrual function were excluded. BSI incidence rate was 2.25 (p = 0.02, 95% CI: 1.14-4.41) times greater in oligo/amenorrhoeic than eumenorrhoeic runners. BSI incidence rate was similar in oligo/amenorrhoeic and eumenorrhoeic runners that did plyometric training, but 3.78 (p = 0.001, 95% CI: 1.68-8.5) times greater in oligo/amenorrhoeic versus eumenorrhoeic runners that did not. However, the effect of plyometrics was non-significant (menstrual function × plyometric training interaction, p = 0.06; main effect, p = 0.89). Conventional plyometric training may not reduce BSI incidence in female distance runners, but menstrual disturbances and prolonged periods of low energy availability should be avoided
Spectre of jurisdiction: Supreme court of New South Wales and the British subject in Aotearoa/New Zealand 1823-41
No full textThis paper focuses on the period prior to the Treaty of Waitangi when the Supreme Court of New South Wales had jurisdiction over British subjects living in the ‘Islands of New Zealand’. It is acknowledged that there were many factors driving the colonial endeavour in New Zealand. However it was in this period that the raw materials of the colonial state were formed: namely, a people who became an imagined community, with an emerging sense of society or culture, occupying a bounded and mapped territory. One, perhaps unlikely, catalyst for this process was the unstable, partial and largely ineffectual jurisdiction of the New South Wales Supreme Court
Ambient air pollution and newborn size and adiposity at birth : differences by maternal ethnicity (the born in Bradford study cohort)
No full textExposure to ambient air pollution has been associated with reduced size of newborns; however, the modifying effect of maternal ethnicity remains little explored among South Asians.; We investigated ethnic differences in the association between ambient air pollution and newborn's size.; Pregnant women were recruited between 2007 and 2010 for the Born in Bradford cohort study, in England. Exposures to particulate matter (≤ 10 μm, PM10; ≤ 2.5 μm, PM2.5), PM2.5 absorbance, and nitrogen oxides (NOx, NO2) were estimated using land-use regressions models. Using multivariate linear regression models, we evaluated effect modification by maternal ethnicity ("white British" or "Pakistani origin," self-reported) on the associations of air pollution and birth weight, head circumference, and triceps and subscapular skinfold thickness.; A 5-μg/m3 increase in mean third trimester PM2.5 was associated with significantly lower birth weight and smaller head circumference in children of white British mothers (-43 g; 95% CI: -76, -10 and -0.28 cm; 95% CI: -0.39, -0.17, respectively), but not in children of Pakistani origin (9 g; 95% CI: -17, 35 and -0.08 cm; 95% CI: -0.17, 0.01, respectively) (pint = 0.03 and < 0.001). In contrast, PM2.5 was associated with significantly larger triceps and subscapular skinfold thicknesses in children of Pakistani origin (0.17 mm; 95% CI: 0.08, 0.25 and 0.21 mm; 95% CI: 0.12, 0.29, respectively), but not in white British children (-0.02 mm; 95% CI: -0.14, 0.01 and 0.06 mm; 95% CI: -0.06, 0.18, respectively) (pint = 0.06 and 0.11). Patterns of associations for PM10 and PM2.5 absorbance according to ethnicity were similar to those for PM2.5, but associations of the outcomes with NO2 and NOx were mostly nonsignificant in both ethnic groups.; Our results suggest that associations of ambient PM exposures with newborn size and adiposity differ between white British and Pakistani origin infants.; Schembari A, de Hoogh K, Pedersen M, Dadvand P, Martinez D, Hoek G, Petherick ES, Wright J, Nieuwenhuijsen MJ. 2015. Ambient air pollution and newborn size and adiposity at birth: differences by maternal ethnicity (the Born in Bradford study cohort). Environ Health Perspect 123:1208-1215; http://dx.doi.org/10.1289/ehp.1408675
Dealing with Under-reported Variables: An Information Theoretic Solution
No full textUnder-reporting occurs in survey data when there is a reason for participants to give a false negative response to a question, e.g. maternal smoking in epidemiological studies. Failing to correct this misreporting introduces biases and it may lead to misinformed decision making. Our work provides methods of correcting for this bias, by reinterpreting it as a missing data problem, and particularly learning from positive and unlabelled data. Focusing on information theoretic approaches we have three key contributions: (1) we provide a method to perform valid independence tests with known power by incorporating prior knowledge over misreporting; (2) we derive corrections for point/interval estimates of the mutual information that capture both relevance and redundancy; and finally, (3) we derive different ways for ranking under-reported risk factors. Furthermore, we show how to use our results in real-world problems and machine learning tasks
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