ORCID Profile
0000-0003-4697-5156
Current Organisations
The University of Edinburgh
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University of Hull
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Publisher: BMJ
Date: 05-2018
Publisher: Public Library of Science (PLoS)
Date: 11-10-2013
Publisher: Springer Science and Business Media LLC
Date: 22-02-2012
Publisher: American Society of Mechanical Engineers
Date: 02-06-2009
DOI: 10.1115/98-GT-094
Abstract: An investigation of the aerodynamic interaction between a last gas turbine stage and an exhaust diffuser is presented. Special attention is given to the influence of the rotor tip gap on this interaction. Flow measurements downstream of a linear cascade of turbine blades with tip gap have been performed in a low speed cascade wind tunnel. The geometry of the cascade corresponds to the tip section of a gas turbine of fairly recent design. Five tip gaps lying in the typical range were investigated. The two essential results are the leakage loss and the underturning in the end wall region. The flow field of the turbine cascade supplied the inlet boundary condition for the subsequent numerical investigation of the flow field in an annular diffuser. The geometry of the annular diffuser is based on dimensions of exhaust diffusers of some heavy duty and aeroderivative gas turbines. The result of the investigation is the diffuser pressure recovery factor as a function of the gap of the upstream cascade. The results from the cascade measurements and the diffuser computations have then been coupled by means of an interaction model. For gaps of practical interest, specific work and efficiency of the last gas turbine stage followed by an exhaust diffuser are independent of the rotor gap.
Publisher: Elsevier BV
Date: 07-2021
DOI: 10.1016/J.JAIP.2021.02.052
Abstract: The impact of hormone replacement therapy (HRT) on clinical outcomes in menopausal women is uncertain. To investigate the association between use of HRT and severe asthma exacerbation in perimenopausal and postmenopausal women with asthma. We used the Optimum Patient Care Research Database, a population-based longitudinal primary care database in the United Kingdom, to construct a 17-year (January 1, 2000, to December 31, 2016) cohort of perimenopausal and postmenopausal (46-70 years, N = 31,656) women. We defined use of HRT, its subtypes, and duration of HRT use. Severe asthma exacerbation was defined as an asthma-related hospitalization, emergency department visits due to asthma, and/or prescription of oral corticosteroids. Analyses were undertaken using multilevel mixed-effects Poisson regression. At baseline, 22% of women were using any HRT, 11% combined HRT, and 11% estrogen-only HRT. Previous, but not current, use of any (incidence rate ratio [IRR]: 1.24, 95% confidence interval [CI]: 1.22-1.26), combined (IRR: 1.28, 95% CI: 1.25-1.31), and estrogen-only HRT (IRR: 1.18, 95% CI: 1.14-1.21), and longer duration (1-2 years: IRR: 1.16, 95% CI: 1.13-1.19 3-4 years: IRR: 1.43, 95% CI: 1.38-1.48 5+ years: IRR: 1.32, 95% CI: 1.28-1.36) of HRT use were associated with increased risk of severe asthma exacerbation compared with nonuse. The risk estimates were greater among lean women (body mass index [BMI] <25 kg/m Use of HRT and subtypes, particularly previous, but not current, use and use for more than 2 years, is associated with an increased risk of severe asthma exacerbation in perimenopausal ostmenopausal women with established asthma. Lean women and smokers are at greater risk than heavier women and nonsmokers, respectively.
Publisher: Elsevier BV
Date: 11-2018
Publisher: International Global Health Society
Date: 12-2017
Publisher: Hindawi Limited
Date: 17-06-2015
DOI: 10.1017/JSC.2015.12
Abstract: Electronic cigarettes (e-cigarettes) have been the subject of numerous debates in the literature. (Bullen et al., 2013 Cressey, 2014 The Lancet, 2013) So much discussion has been on it this year alone to the extent that the word vape , which means ‘to inhale and exhale the vapour produced by an e-cigarette or similar device’, has become the Oxford Dictionaries Word of the year. E-cigarettes have gained popularity amongst the youth who are smokers and want to quit as well as among children and adult non-smokers who fancy it. (Centers for Disease Control and Prevention, 2013 Dawkins, Turner, Roberts & Soar, 2013 Emery, Vera, Huang & Szczypka, 2014 News & Angeles, n.d. Serrie, 2014 US Drug and Food Administration, 2014) Even in rural communities in middle- and low-income countries, their availability in shopping centres and through multilevel marketing schemes is common (I.N.S., unpublished observation/data).
Publisher: Mary Ann Liebert Inc
Date: 11-2019
Publisher: Elsevier BV
Date: 2019
Publisher: Springer Science and Business Media LLC
Date: 06-2014
Publisher: Public Library of Science (PLoS)
Date: 02-11-2011
Publisher: Springer Science and Business Media LLC
Date: 26-05-2016
Publisher: BMJ
Date: 08-2023
DOI: 10.1136/BMJOPEN-2023-073682
Abstract: Although different educational interventions have been widely used to manage and treat hypertension, alone or in combination with other interventions, there is a significant variation in their claimed effectiveness. The objective of this umbrella review is to determine the effectiveness of educational interventions, alone or in combination with other interventions, for improving blood pressure control and self-management practices among hypertensive patients. The review question is: Do educational interventions, alone or in combination with other interventions, improve self-management practices among patients with hypertension? We will conduct a review of systematic reviews involving studies that implemented educational interventions, alone or in combination with other interventions, designed to change self-care practices among hypertensive patients who are 18 years and above, regardless of their sex and ethnicity. Following the guidelines set forth in the Preferred Reporting Items for Systematic Review and Meta-Analysis statement, a comprehensive literature search will be conducted from September to December 2023 on six electronic databases: MEDLINE, Embase, PsycINFO, CINAHL, Web of Science Core Collection and Google Scholar. Search terms will be developed using database-specific indexed terms and text words derived from the review aim. We will present the effects of the educational interventions, alone or in combination with other interventions, on hypertension self-management practices. We will report the outcome data with 95% CIs for each study. Relative risk, mean differences or ORs will be used, depending on the measuring indices in each study. Ethical approval is not required as this study will use aggregated data from previously published systematic reviews. However, we have registered the protocol in PROSPERO. We confirm that all methods will be performed following the guidelines of the Declaration of Helsinki. The findings from this study will be disseminated through presentations at academic conferences and publication in peer-reviewed international journals. CRD42022375581.
Publisher: BMJ
Date: 23-11-2020
DOI: 10.1136/THORAXJNL-2020-215540
Abstract: Longitudinal studies investigating impact of exogenous sex steroids on clinical outcomes of asthma in women are lacking. We investigated the association between use of hormonal contraceptives and risk of severe asthma exacerbation in reproductive-age women with asthma. We used the Optimum Patient Care Research Database, a population-based, longitudinal, anonymised primary care database in the UK, to construct a 17-year (1 January 2000–31 December 2016) retrospective cohort of reproductive-age (16–45 years, n=83 084) women with asthma. Using Read codes, we defined use, subtypes and duration of use of hormonal contraceptives. Severe asthma exacerbation was defined according to recommendations of the European Respiratory Society/American Thoracic Society as asthma-related hospitalisation, accident and emergency department visits due to asthma and/or oral corticosteroid prescriptions. Analyses were done using multilevel mixed-effects Poisson regression with QR decomposition. The 17-year follow-up resulted in 456 803 person-years of follow-up time. At baseline, 34% of women were using any hormonal contraceptives, 25% combined (oestrogen rogestogen) and 9% progestogen-only contraceptives. Previous (incidence rate ratio (IRR) 0.94, 95% CI 0.92 to 0.97) and current (IRR 0.96, 95% CI 0.94 to 0.98) use of any, previous (IRR 0.92, 95% CI 0.87 to 0.97) and current use of combined (IRR 0.93, 95% CI 0.91 to 0.96) and longer duration of use (3–4 years: IRR 0.94, 95% CI 0.92 to 0.97 5+ years: IRR 0.91, 95% CI 0.89 to 0.93) of hormonal contraceptives, but not progestogen-only contraceptives, were associated with reduced risk of severe asthma exacerbation compared with non-use. Use of hormonal contraceptives may reduce the risk of severe asthma exacerbation in reproductive-age women. Mechanistic studies investigating the biological basis for the influence of hormonal contraceptives on clinical outcomes of asthma in women are required. European Union electronic Register of Post-Authorisation Studies (EUPAS22967).
Publisher: BMJ
Date: 24-08-2020
DOI: 10.1136/INJURYPREV-2019-043531
Abstract: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.
Publisher: Cold Spring Harbor Laboratory
Date: 21-12-2022
DOI: 10.1101/2022.12.21.22283782
Abstract: 3. Measles is a vaccine-preventable disease whose vaccine was introduced in the United Kingdom in 1988, however, Measles outbreaks are still occurring in England. Consequently, the World Health Organization (WHO) removed the UK’s elimination status of Measles in 2019. Noticeably, MMR vaccination coverage in England is below the recommended threshold with geographical variations across local authorities (LA). The research into the effect of income disparities on MMR vaccine coverage was insufficiently examined. Therefore, an ecological study will be conducted aiming at determining whether there is a relationship between income deprivation measures and MMR vaccine coverage in upper-tier local authorities in England, using 2019 publicly available data. The effect of spatial clustering of income level on vaccination coverage will also be assessed. Vaccination coverage data will be obtained from “Cover of Vaccination Evaluated Rapidly (COVER)”. Income deprivation score, Deprivation gap, and Income Deprivation Affecting Children Index will be obtained from Office for National Statistics and Moran’s Index will be generated using RStudio. Rural/urban LA classification and mothers’ education will be included as possible confounding factors. Additionally, the live births rate per mothers’ age group will be included as a proxy for the mothers’ age variation in different LA. Multiple linear regression will be used after testing the relevant assumptions, using SPSS software. Moran’s I together with income deprivation score will be analysed through regression and mediation analysis. This study will help in determining whether income level is a determinant of MMR vaccination uptake and coverage in LA in England which would help policymakers in designing targeted c aigns, thus preventing measles outbreaks in the future.
Publisher: Elsevier BV
Date: 07-2021
Publisher: BMJ
Date: 08-01-2020
DOI: 10.1136/INJURYPREV-2019-043296
Abstract: The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates. Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm—the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate. For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced. The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum.
Publisher: BMJ
Date: 24-04-2020
DOI: 10.1136/INJURYPREV-2019-043494
Abstract: Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.
Publisher: Elsevier BV
Date: 10-2020
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.ENVINT.2017.08.009
Abstract: There is increasing policy interest in the potential for vegetation in urban areas to mitigate harmful effects of air pollution on respiratory health. We aimed to quantify relationships between tree and green space density and asthma-related hospitalisations, and explore how these varied with exposure to background air pollution concentrations. Population standardised asthma hospitalisation rates (1997-2012) for 26,455 urban residential areas of England were merged with area-level data on vegetation and background air pollutant concentrations. We fitted negative binomial regression models using maximum likelihood estimation to obtain estimates of asthma-vegetation relationships at different levels of pollutant exposure. Green space and gardens were associated with reductions in asthma hospitalisation when pollutant exposures were lower but had no significant association when pollutant exposures were higher. In contrast, tree density was associated with reduced asthma hospitalisation when pollutant exposures were higher but had no significant association when pollutant exposures were lower. We found differential effects of natural environments at high and low background pollutant concentrations. These findings can provide evidence for urban planning decisions which aim to leverage health co-benefits from environmental improvements.
Publisher: University of Illinois Libraries
Date: 06-2013
Publisher: Wiley
Date: 08-09-2017
DOI: 10.1111/PAI.12774
Publisher: Wiley
Date: 15-07-2016
DOI: 10.1111/PAI.12603
Abstract: There is increasing recognition of the importance of patient's perceptions of disease and their assessments of heathcare processes. Patient-reported outcome measures (PROMs) are therefore now regarded as at least as important as the traditional objective measures of disease. For minors, parental and, except in the very young and severally cognitively impaired, the child's perspectives are important because they provide unique and complementary information. In this review, we summarize the evidence on PROMs for allergy and asthma for use in children. Overall, there are fewer PROMs available for use in children than in adults. We were able to identify some validated pediatric PROMs that have been developed for use in atopic eczema/dermatitis, food allergy, allergic rhinitis/rhinoconjunctivitis, and asthma. There is very limited evidence on deploying these instruments out with research settings. There is therefore a pressing need to report on the experiences of using PROMs for allergy and asthma in routine clinical care. In particular, there is a need to understand how acceptable these are to children/carers, whether they can be incorporated into routine clinical assessments and if they are responsive to changes in treatment made in routine clinical practice.
Publisher: Springer Science and Business Media LLC
Date: 12-08-2013
DOI: 10.1007/S00484-012-0584-0
Abstract: Asthma is a chronic condition of great public health concern globally. The associated morbidity, mortality and healthcare utilisation place an enormous burden on healthcare infrastructure and services. This study demonstrates a multistage quantile regression approach to predicting excess demand for health care services in the form of asthma daily admissions in London, using retrospective data from the Hospital Episode Statistics, weather and air quality. Trivariate quantile regression models (QRM) of asthma daily admissions were fitted to a 14-day range of lags of environmental factors, accounting for seasonality in a hold-in s le of the data. Representative lags were pooled to form multivariate predictive models, selected through a systematic backward stepwise reduction approach. Models were cross-validated using a hold-out s le of the data, and their respective root mean square error measures, sensitivity, specificity and predictive values compared. Two of the predictive models were able to detect extreme number of daily asthma admissions at sensitivity levels of 76 % and 62 %, as well as specificities of 66 % and 76 %. Their positive predictive values were slightly higher for the hold-out s le (29 % and 28 %) than for the hold-in model development s le (16 % and 18 %). QRMs can be used in multistage to select suitable variables to forecast extreme asthma events. The associations between asthma and environmental factors, including temperature, ozone and carbon monoxide can be exploited in predicting future events using QRMs.
Publisher: Elsevier BV
Date: 08-2020
Publisher: Elsevier BV
Date: 09-2020
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.YPMED.2013.11.011
Abstract: Evidence that age of smoking initiation represents a risk factor for regular smoking in adolescence is complicated by inconsistencies in the operational definition of smoking initiation and simultaneous inclusion of age as an explanatory variable. The aim of this study was to examine the relationship between age, age of smoking initiation and subsequent regular smoking. A secondary analysis was conducted of the U.S. Youth Risk Behavior Survey 2011. A sex stratified multivariable logistic regression analysis was used to model the likelihood of regular smoking with age and age of smoking initiation as explanatory variables and race/ethnicity as a covariate. After controlling for race/ethnicity, age and age of smoking initiation were independently associated with regular smoking in males and females. Independent of age, a one year's decrease in the age of smoking initiation was associated with a 1.27 times increase in odds of regular smoking in females (95% CI: 1.192-1.348) and similar associations for males (OR: 1.28 95% CI: 1.216-1.341). While the majority of high school students do not become regular smokers after initiating smoking, earlier initiation of smoking is associated with subsequent regular smoking irrespective of sex or race/ethnicity. These findings have potentially important implications for intervention targeting.
Publisher: Informa UK Limited
Date: 08-2006
DOI: 10.1080/17290376.2006.9724872
Abstract: The HIV/AIDS epidemic in Africa has assumed a dimension raising heartbreaking anxiety among national governments and civil society groups. In Ghana for ex le, the pandemic is well-documented and has gone beyond a health problem, and now encompasses all socio-economic aspects of life. The estimated rate of infection from the mid-1980s to 2000 has more than doubled, and in spite of the control efforts by various groups and organisations, prevalence of the disease has not declined notably. This paper assesses government policy, programmes and strategies to combat the disease, using analysis of time trend sentinel data and weighting these against control efforts. The assessment revealed that 380,000 adults and 36,000 children are currently infected. There are wide spatial variations in prevalence across the country and the overall national prevalence has fluctuated over time, standing at 2.6% in 2000, 3.6% in 2002 and 3.1% in 2004. This appears relatively lower than in adjacent countries, where prevalence is around 5% and over 25% in East and Southern African countries. Although the review found a robust multipronged government intervention approach to containing the disease, we are hesitant to claim that the fairly stable or low national prevalence in Ghana compared with its immediate neighbours may have been the consequence of the effectiveness of national AIDS control programmes and impact of government interventions.
Publisher: Elsevier BV
Date: 10-2020
Publisher: Springer Science and Business Media LLC
Date: 05-10-2013
Publisher: Elsevier BV
Date: 07-2022
Publisher: Informa UK Limited
Date: 05-2012
DOI: 10.2147/IJGM.S31079
Publisher: Springer Science and Business Media LLC
Date: 16-12-2020
DOI: 10.1038/S41586-020-03043-4
Abstract: The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs) 1–4 . Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19) 5–8 . Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km 2 pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children.
Publisher: Springer Science and Business Media LLC
Date: 20-04-2020
DOI: 10.1038/S41591-020-0807-6
Abstract: A double burden of malnutrition occurs when in iduals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of % in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic.
Publisher: BMJ
Date: 11-2016
Publisher: Elsevier BV
Date: 10-2020
Publisher: Elsevier BV
Date: 10-2020
Publisher: BMJ
Date: 27-10-2017
DOI: 10.1136/TOBACCOCONTROL-2017-053801
Abstract: We investigated whether Scottish implementation of smoke-free legislation was associated with a reduction in unplanned hospitalisations or deaths (‘events’) due to respiratory tract infections (RTIs) among children. Interrupted time series (ITS). Children aged 0–12 years living in Scotland during 1996–2012. National comprehensive smoke-free legislation (March 2006). Acute RTI events in the Scottish Morbidity Record-01 and/or National Records of Scotland Death Records. 135 134 RTI events were observed over 155 million patient-months. In our prespecified negative binomial regression model accounting for underlying temporal trends, seasonality, sex, age group, region, urbanisation level, socioeconomic status and seven-valent pneumococcal vaccination status, smoke-free legislation was associated with an immediate rise in RTI events (incidence rate ratio (IRR)=1.24, 95% CI 1.20 to 1.28) and an additional gradual increase (IRR=1.05/year, 95% CI 1.05 to 1.06). Given this unanticipated finding, we conducted a number of post hoc exploratory analyses. Among these, automatic break point detection indicated that the rise in RTI events actually preceded the smoke-free law by 16 months. When accounting for this break point, smoke-free legislation was associated with a gradual decrease in acute RTI events: IRR=0.91/year, 95% CI 0.87 to 0.96. Our prespecified ITS approach suggested that implementation of smoke-free legislation in Scotland was associated with an increase in paediatric RTI events. We were concerned that this result, which contradicted published evidence, was spurious. The association was indeed reversed when accounting for an unanticipated antecedent break point in the temporal trend, suggesting that the legislation may in fact be protective. ITS analyses should be subjected to comprehensive robustness checks to assess consistency.
Publisher: Public Library of Science (PLoS)
Date: 28-06-2023
DOI: 10.1371/JOURNAL.PONE.0280008
Abstract: Measles is a vaccine-preventable disease whose vaccine was introduced in England in 1988, however, Measles outbreaks have still been occurring in the country. Consequently, the World Health Organization (WHO) removed the elimination status of Measles in 2019 from England and the whole United Kingdom. Noticeably, MMR vaccination coverage in England is below the recommended threshold with geographical variations across local authorities (LA). The research into the effect of income disparities on MMR vaccine coverage was insufficiently examined. Therefore, an ecological study will be conducted aiming at determining whether there is a relationship between income deprivation measures and MMR vaccine coverage in upper-tier local authorities in England. This study will be using 2019 publicly available vaccination data for children who were eligible for the MMR vaccine by their second and fifth birthday in 2018/2019. The effect of spatial clustering of income level on vaccination coverage will also be assessed. Vaccination coverage data will be obtained from “Cover of Vaccination Evaluated Rapidly (COVER)”. Income deprivation score, Deprivation gap, and Income Deprivation Affecting Children Index will be obtained from Office for National Statistics and Moran’s Index will be generated using RStudio. Rural/urban LA classification and mothers’ education will be included as possible confounding factors. Additionally, the live births rate per mothers’ age group will be included as a proxy for the mothers’ age variation in different LA. Multiple linear regression will be used after testing the relevant assumptions, using SPSS software. Moran’s I together with income deprivation score will be analysed through regression and mediation analysis. This study will help in determining whether income level is a determinant of MMR vaccination uptake and coverage in LA in England which would help policymakers in designing targeted c aigns, thus preventing measles outbreaks in the future.
Publisher: BMJ
Date: 06-2018
Publisher: Elsevier BV
Date: 2018
Publisher: Springer Science and Business Media LLC
Date: 25-01-2018
DOI: 10.1007/S00038-017-1072-4
Abstract: The lack of population-based evidence on the risk factors for poor glycaemic control in diabetics, particularly in resource-poor settings, is a challenge for the prevention of long-term complications. This study aimed to identify the metabolic and demographic risk factors for poor glycaemic control among diabetics in a rural community in Malaysia. A total of 1844 (780 males and 1064 females) known diabetics aged ≥ 35 years were identified from the South East Asia Community Observatory (SEACO) health and demographic surveillance site database. 41.3% of the s le had poor glycaemic control. Poor glycaemic control was associated with age and ethnicity, with older participants (65+) better controlled than younger adults (45-54), and Malaysian Indians most poorly controlled, followed by Malay and then Chinese participants. Metabolic risk factors were also highly associated with poor glycaemic control. There is a critical need for evidence for a better understanding of the mechanisms of the associations between risk factors and glycaemic control.
Publisher: Elsevier BV
Date: 08-2020
Publisher: Hindawi Limited
Date: 2015
DOI: 10.1155/2015/539212
Abstract: Background . Education is usually associated with improvement in health there is evidence that this may not be the case if education is not fully utilised at work. This study examines the relationship between education level, occupation, and health outcomes of in iduals in rural Malaysia. Results . The study finds that the incidence of chronic diseases and high blood pressure are higher for tertiary educated in iduals in agriculture and construction occupations. This brings these in iduals into more frequent contact with the health system. These occupations are marked with generally lower levels of education and contain fewer in iduals with higher levels of education. Conclusions . Education is not always associated with better health outcomes. In certain occupations, greater education seems related to increased chronic disease and contact with the health system, which is the case for workers in agriculture in rural Malaysia. Agriculture is the largest sector of employment in rural Malaysia but with relatively few educated in iduals. For the maintenance and sustainability of productivity in this key rural industry, health monitoring and job enrichment policies should be encouraged by government agencies to be part of the agenda for employers in these sectors.
Publisher: Elsevier BV
Date: 08-2022
Publisher: Springer Science and Business Media LLC
Date: 13-10-2016
Publisher: Elsevier BV
Date: 06-2020
Publisher: Elsevier BV
Date: 09-2020
Publisher: Elsevier BV
Date: 06-2021
Publisher: Elsevier BV
Date: 10-2022
Publisher: Elsevier BV
Date: 06-2020
Publisher: Springer Science and Business Media LLC
Date: 17-07-2015
Publisher: Elsevier BV
Date: 10-2021
Publisher: Oxford University Press (OUP)
Date: 26-07-2017
DOI: 10.1093/IJE/DYX113
Publisher: Elsevier BV
Date: 05-2021
Publisher: Springer International Publishing
Date: 2015
Publisher: SAGE Publications
Date: 25-04-2013
Abstract: Health forecasting can improve health service provision and in idual patient outcomes. Environmental factors are known to impact chronic respiratory conditions such as asthma, but little is known about the extent to which these factors can be used for forecasting. Using weather, air quality and hospital asthma admissions, in London (2005–2006), two related negative binomial models were developed and compared with a naive seasonal model. In the first approach, predictive forecasting models were fitted with 7-day averages of each potential predictor, and then a subsequent multivariable model is constructed. In the second strategy, an exhaustive search of the best fitting models between possible combinations of lags (0–14 days) of all the environmental effects on asthma admission was conducted. Three models were considered: a base model (seasonal effects), contrasted with a 7-day average model and a selected lags model (weather and air quality effects). Season is the best predictor of asthma admissions. The 7-day average and seasonal models were trivial to implement. The selected lags model was computationally intensive, but of no real value over much more easily implemented models. Seasonal factors can predict daily hospital asthma admissions in London, and there is a little evidence that additional weather and air quality information would add to forecast accuracy.
Publisher: Elsevier BV
Date: 10-2020
Publisher: Springer Science and Business Media LLC
Date: 19-07-2018
DOI: 10.1038/S41533-018-0094-6
Abstract: Studies have shown that a small proportion of patients have particularly high needs and are responsible for disproportionally high disease burden. Estimates suggest that 2–5% of patients are high users of healthcare for their health gain. Such patients in Scotland are referred to as high health gain (HHG) patients. We wanted to investigate if there were HHG in iduals with asthma in Scotland. We analysed data from the Scottish Health Survey (2010–11), and primary and National Health Survey (NHS) secondary healthcare and administrative data sets (2011–12). In all, 1,379,690 (26.0%) and 836,135 (15.8%) people reported to have ever had and currently have symptoms suggestive of asthma, respectively 369,868 (7.0%) people reported current symptomatic clinician-diagnosed asthma. 310,050 (5.6%) people had clinician-reported-diagnosed asthma there were 289,120 nurse consultations, 215,610 GP consultations, 9235 accident and emergency visits (0.2% people), 8263 ambulance conveyances (0.2% people), 7744 inpatient episodes (0.1% people), 3600 disability allowance claims (0.1% people), 187 intensive care unit (ICU) episodes and 94 deaths from asthma. From our study a maximum of about 9.4% of asthma patients ( n = 29,145), which is 0.5% of the Scottish population, and from the National Review of Asthma Deaths’ estimate (10% hospitalised), a minimum of nine people had severe asthma attacks that needed acute hospital attendance/admission. We found that although a high proportion of the Scottish population had symptoms suggestive of asthma and clinician diagnosed asthma, only a small proportion of asthma patients experienced exacerbations that were severe enough to warrant hospital attendance/admission in any given year. Developing risk prediction models to identify these HHG patients has the potential to both improve health outcomes while substantially reducing healthcare expenditure.
Publisher: Public Library of Science (PLoS)
Date: 31-10-2012
Publisher: Springer Science and Business Media LLC
Date: 25-12-2019
DOI: 10.1038/S41586-019-1872-1
Abstract: Educational attainment is an important social determinant of maternal, newborn, and child health 1–3 . As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting 4–6 . The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness 7,8 however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health 9–11 . Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of in iduals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but—to our knowledge—no analysis has examined the subnational proportions of in iduals who completed specific levels of education across all low- and middle-income countries 12–14 . By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations.
Publisher: Elsevier BV
Date: 06-2020
Publisher: Informa UK Limited
Date: 06-05-2014
DOI: 10.3402/GHA.V7.23176
Publisher: Informa UK Limited
Date: 08-2012
DOI: 10.2147/IJGM.S34647
Publisher: Springer Science and Business Media LLC
Date: 14-01-2017
Publisher: Springer Science and Business Media LLC
Date: 03-09-2013
Publisher: Springer Science and Business Media LLC
Date: 02-07-2020
DOI: 10.1038/S41591-020-0972-7
Abstract: An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Publisher: European Respiratory Society
Date: 07-09-2020
Publisher: Elsevier BV
Date: 07-2022
Publisher: Springer Science and Business Media LLC
Date: 28-07-2013
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2017
End Date: 2018
Funder: Natural Environment Research Council
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