1,721,228 research outputs found
Socioeconomic gradients in smoking among young women : a British survey.
No full textMarked and increasing socioeconomic gradients in cigarette smoking are well established. Tracking these differentials among women requires appropriate measures of their socioeconomic position (SEP) which are equivalent across older and younger age groups. This study examines socioeconomic gradients in cigarette smoking by age among women aged 20-34, using a standard indicator of SEP (age left full-time education) and alternative indicators which take account of changes in women's educational levels across age cohorts. The study is based on a large cross-sectional British data set (n = 12,398), the Southampton Women's Survey, conducted 1998-2002. Poisson log-linear regression with adjusted variance was used to predict smoking status (ever smoked > or =1 cigarette a day for 1 year, currently smoking > or =1 cigarette a day, and ex-smoker - ever-smoker not currently smoking > or =1 cigarette a day) in models which controlled for SEP, age and year of interview. Socioeconomic gradients in ever-smoking were marked but stable across age groups. With quitting more prevalent in the higher than lower socioeconomic groups, gradients in current smoking steepened across age groups, with significant age/SEP interactions. The socioeconomic patterning of ever, ex and current smoking was similar using both the standard and alternative measures of education, but interactions were less pronounced with the alternative measures. Socioeconomic indicators which take account of the recent and rapid increase in women's educational participation rates may provide a more reliable indication of age-related differentials in smoking status than standard measures. Nonetheless, both conventional and alternative measures point to stable socioeconomic differentials in rates of ever-smoking and widening differentials in current smoking across age groups. Our study confirms that addressing the link between socioeconomic disadvantage and tobacco use remains a major challenge for the tobacco control community
Twenty five year mortality of a community cohort with schizophrenia
No full textBackground: people with schizophrenia have significantly raised mortality but we do not know how these mortality patterns in the UK have changed since the 1990s.Aims: to measure the 25-year mortality of people with schizophrenia with particular focus on changes over time.Method: prospective record linkage study of the mortality of a community cohort of 370 people with schizophrenia.Results: the cohort had an all-cause standardised mortality ratio of 289 (95% CI 247–337). Most deaths were from the common causes seen in the general population. Unnatural deaths were concentrated in the first 5 years of follow-up. There was an indication that cardiovascular mortality may have increased relative to the general population (P = 0.053) over the course of the study.Conclusions: people with schizophrenia have a mortality risk that is two to three times that of the general population. Most of the extra deaths are from natural causes. The apparent increase in cardiovascular mortality relative to the general population should be of concern to anyone with an interest in mental healt
Premenstrual syndrome and alcohol consumption: a systematic review and meta-analysis
No full textObjective Premenstrual syndrome (PMS) is a very common disorder worldwide which carries an important economic burden. We conducted a systematic review and a meta-analysis to assess the role of alcohol in the occurrence of PMS.Methods We searched MEDLINE, EMBASE, the five regional bibliographic databases of the WHO, the Proceedings database and the Open Access Thesis and Dissertations (OATD) from inception to May 2017. We also reviewed the references of every article retrieved and established personal contact with researchers to trace further publications or reports. We did not include any language limitations. Studies were included if: (1) they presented original data from cohort, case-control or cross-sectional studies, (2) PMS was clearly defined as the outcome of interest, (3) one of the exposure factors was alcohol consumption, (4) they provided estimates of odds ratios, relative risks, or any other effect measure and their confidence intervals, or enough data to calculate them.Results We identified 39 studies of which 19 were eligible. Intake of alcohol was associated with a moderate increase in the risk of PMS (OR=1.45, 95% CI: 1.17 to 1.79). Heavy drinking yielded a larger increase in the risk than any drinking (OR=1.79, 95% CI: 1.39 to 2.32).Discussion Our results suggest that alcohol intake presents a moderate association with PMS risk. Future studies should avoid cross-sectional designs and focus on determining whether there is a threshold of alcohol intake under which the harmful effect on PMS is non-existent
Acceptability of the FIGO Nutrition Checklist in Preconception and Early Pregnancy to Assess Nutritional Status and Prevent Excess Gestational Weight Gain: A Study of Women and Healthcare Practitioners in the UK
No full textOptimum nutrition and weight before and during pregnancy are associated with a lower risk of conditions such as pre-eclampsia and gestational diabetes. There is a lack of user-friendly tools in most clinical settings to support healthcare practitioners (HCPs) in implementing them. This study aimed to evaluate the acceptability of (1) using a nutrition checklist designed by the International Federation of Gynecology and Obstetrics (FIGO) for nutritional screening of women in the preconception and early pregnancy period and (2) routine discussion of nutrition and weight in clinical care. An online cross-sectional survey was conducted with women (aged 18–45) and HCPs (e.g., general practitioners, obstetricians, and midwives). Quantitative statistical analysis and qualitative content analysis were performed. The concept and content of the checklist were acceptable to women (n = 251) and HCPs (n = 47) (over 80% in both groups). Several barriers exist to implementation such as lack of time, training for HCPs, and the need for sensitive and non-stigmatizing communication. Routine discussion of nutrition was considered important by both groups; however, results suggest that nutrition is not regularly discussed in perinatal visits in the UK. The FIGO nutrition checklist presents a valuable resource for use in clinical practice, offering long-term and intergenerational benefits for both mother and baby
HCP’s and women’s survey data in support of the Southampton doctoral thesis 'Preconception health and the life course approach to prevention of non-communicable diseases: Implications for informing policy and practice'
No full textDataset with HCP's survey data, women's survey data and data used for qualitative content analysis (anonymised). This informed the PhD thesis entitled "Preconception Health and the Life Course Approach to Prevention of Non-Communicable Diseases: Implications for Informing Policy and Practice". The data was collected through two online surveys in 2021and contains quantitative and qualitative data.
Dataset available to bone fide researchers only - to request the data please complete the attached request form.</span
Consequences of ignoring clustering in linear regression
No full textBackground: clustering of observations is a common phenomenon in epidemiological and clinical research. Previous studies have highlighted the importance of using multilevel analysis to account for such clustering, but in practice, methods ignoring clustering are often employed. We used simulated data to explore the circumstances in which failure to account for clustering in linear regression could lead to importantly erroneous conclusions. Methods: we simulated data following the random-intercept model specification under different scenarios of clustering of a continuous outcome and a single continuous or binary explanatory variable. We fitted random-intercept (RI) and ordinary least squares (OLS) models and compared effect estimates with the “true” value that had been used in simulation. We also assessed the relative precision of effect estimates, and explored the extent to which coverage by 95% confidence intervals and Type I error rates were appropriate. Results: we found that effect estimates from both types of regression model were on average unbiased. However, deviations from the “true” value were greater when the outcome variable was more clustered. For a continuous explanatory variable, they tended also to be greater for the OLS than the RI model, and when the explanatory variable was less clustered. The precision of effect estimates from the OLS model was overestimated when the explanatory variable varied more between than within clusters, and was somewhat underestimated when the explanatory variable was less clustered. The cluster-unadjusted model gave poor coverage rates by 95% confidence intervals and high Type I error rates when the explanatory variable was continuous. With a binary explanatory variable, coverage rates by 95% confidence intervals and Type I error rates deviated from nominal values when the outcome variable was more clustered, but the direction of the deviation varied according to the overall prevalence of the explanatory variable, and the extent to which it was clustered. Conclusions: in this study we identified circumstances in which application of an OLS regression model to clustered data is more likely to mislead statistical inference. The potential for error is greatest when the explanatory variable is continuous, and the outcome variable more clustered (intraclass correlation coefficient is ≥0.01). <br/
The long-term effects of prenatal development on growth and metabolism
No full textPeople who were small at birth and had poor infant growth have an increased risk of adult cardiovascular disease, osteoporosis, and type 2 diabetes, particularly if their restricted early growth was followed by increased childhood weight gain. These relations extend across the normal range of birth size in a graded manner, so reduced size is not a prerequisite. In addition, larger birth size is associated with risks of obesity and type 2 diabetes. The associations appear to reflect developmental plastic responses made by the fetus and infant based on cues about the environment, influenced by maternal characteristics including diet, body composition, stress, and exercise levels. These responses involve epigenetic processes that modify the offspring's phenotype. Vulnerability to ill health results if the environment in infancy, childhood, and later life is mismatched to the phenotype induced in development, informed by the developmental cues. This mismatch may arise through unbalanced diet or body composition of the mother or a change in lifestyle factors between generations. These insights offer new possibilities for the early diagnosis and prevention of chronic disease.<br/
Epidemiological differences between back pain of sudden and gradual onset
No full textObjective: to explore possible differences in risk factors for low back pain according to its speed of onset.Methods: we analyzed longitudinal data from 1366 hospital nurses in England who initially had been free from low back pain for at least one month. Risk factors were ascertained from a self-administered baseline questionnaire, and outcomes from serial followup questionnaires. Hazard ratios (HR) for developing a first new episode of low back pain during followup were derived by Cox regression.Results: low back pain with gradual onset was significantly associated with psychological symptoms measured at baseline [HR 1.7 (95% CI 1.2, 2.4) and higher], but no such association was seen for sudden pain. Low back pain with sudden onset while at work was associated with exposure to specific patient-handling tasks [HR 1.8 (95% CI 1.1, 3.0) to 2.8 (95% CI 1.4, 5.5)]. However, symptoms that came on suddenly elsewhere were not related to occupational activity, and low back pain of gradual onset showed little relation to patient-handling.Conclusion: these findings suggest that a useful distinction can be made according to the speed and circumstances of onset of low back pain. If confirmed, they have important implications for the evaluation of ergonomic interventions aimed at reducing back pain
Infant sleep disturbance is associated with preconceptional psychological distress: findings from the Southampton Women's Survey
No full textStudy Objective: To determine whether preconceptional psychological distress is associated with infant sleep disturbance.Design: Prospective cohort studySetting: Southampton, UK.Participants: Acohort of women from the Southampton Women’s Survey (SWS), who were recruited between 20-34 years of age and followed through their subsequent pregnancies and beyond; a total of 874 mother-infant pairs were involved in the study.Measurements and Results: Preconceptional psychological distress was measured with the General Health Questionnaire (GHQ-12). When their infants were 6 and 12 months of age, mothers were asked to report the number of times babies woke on average between the hours of midnight and 06:00 each night during a 2-week period. Preconceptional psychological distress was a strong predictor of infant night waking at both 6 and 12 months of age, independent of the effects of postnatal depression, bedroom sharing, and other confounding factors. At 6 months, preconceptional distress was associated with a 23% increased risk of waking (prevalence ratio [PR] 1.23, 95% CI 1.06-1.44), and at 12 months with a 22% increased risk (PR 1.22, 95% confidence intervals [CI] 1.02-1.46).Conclusions: Women with preconceptional psychological distress are more likely to have babies with sleep disturbance during infancy, independent of whether they suffered from postnatal depression
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