ORCID Profile
0000-0002-4134-8463
Current Organisation
University of Southampton
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Publisher: Public Library of Science (PLoS)
Date: 08-03-2022
DOI: 10.1371/JOURNAL.PONE.0264331
Abstract: Long Covid is a public health concern that needs defining, quantifying, and describing. We aimed to explore the initial and ongoing symptoms of Long Covid following SARS-CoV-2 infection and describe its impact on daily life. We collected self-reported data through an online survey using convenience non-probability s ling. The survey enrolled adults who reported lab-confirmed (PCR or antibody) or suspected COVID-19 who were not hospitalised in the first two weeks of illness. This analysis was restricted to those with self-reported Long Covid. Univariate comparisons between those with and without confirmed COVID-19 infection were carried out and agglomerative hierarchical clustering was used to identify specific symptom clusters, and their demographic and functional correlates. We analysed data from 2550 participants with a median duration of illness of 7.6 months (interquartile range (IQR) 7.1–7.9). 26.5% reported lab-confirmation of infection. The mean age was 46.5 years (standard deviation 11 years) with 82.8% females and 79.9% of participants based in the UK. 89.5% described their health as good, very good or excellent before COVID-19. The most common initial symptoms that persisted were exhaustion, chest pressure/tightness, shortness of breath and headache. Cognitive dysfunction and palpitations became more prevalent later in the illness. Most participants described fluctuating (57.7%) or relapsing symptoms (17.6%). Physical activity, stress, and sleep disturbance commonly triggered symptoms. A third (32%) reported they were unable to live alone without any assistance at six weeks from start of illness. 16.9% reported being unable to work solely due to COVID-19 illness. 37.0% reported loss of income due to illness, and 64.4% said they were unable to perform usual activities/duties. Acute systems clustered broadly into two groups: a majority cluster (n = 2235, 88%) with cardiopulmonary predominant symptoms, and a minority cluster (n = 305, 12%) with multisystem symptoms. Similarly, ongoing symptoms broadly clustered in two groups a majority cluster (n = 2243, 88.8%) exhibiting mainly cardiopulmonary, cognitive symptoms and exhaustion, and a minority cluster (n = 283, 11.2%) exhibiting more multisystem symptoms. Belonging to the more severe multisystem cluster was associated with more severe functional impact, lower income, younger age, being female, worse baseline health, and inadequate rest in the first two weeks of the illness, with no major differences in the cluster patterns when restricting analysis to the lab-confirmed subgroup. This is an exploratory survey of Long Covid characteristics. Whilst this is a non-representative population s le, it highlights the heterogeneity of persistent symptoms, and the significant functional impact of prolonged illness following confirmed or suspected SARS-CoV-2 infection. To study prevalence, predictors and prognosis, research is needed in a representative population s le using standardised case definitions.
Publisher: Elsevier BV
Date: 2022
DOI: 10.2139/SSRN.4163702
Publisher: Elsevier BV
Date: 11-2021
Publisher: BMJ
Date: 02-01-2022
DOI: 10.1136/BMJ.O1
Publisher: Center for Open Science
Date: 06-03-2021
Abstract: On 22nd February, the UK government announced schools in England would fully reopen on the 8th March 2021. While returning to school as soon as possible is imperative for the education, social development, and mental and physical welfare of children, not enough has been done to make schools safer for students and staff. Multi-layered mitigations can substantially reduce the risk of transmission within schools and into households. In the Appendix we outline a set of recommendations, in line with CDC guidelines and practiced in many countries, to reduce the risk of transmission in schools and mitigate the impact of COVID-19 on children and families. Making schools safer goes hand in hand with reducing community transmission, and is essential to allow schools to safely reopen and remain open.
Publisher: Wiley
Date: 21-03-2023
Abstract: To present the first national‐level report card on the state of women's preconception health in England. Cross‐sectional population‐based study. Maternity services, England. All pregnant women in England with a first antenatal (booking) appointment recorded in the national Maternity Services Dataset (MSDS) from April 2018 to March 2019 ( n = 652 880). We analysed the prevalence of 32 preconception indicator measures in the overall population and across socio‐demographic subgroups. Ten of these indicators were prioritised for ongoing surveillance based on modifiability, prevalence, data quality and ranking by multidisciplinary UK experts. The three most prevalent indicators were the proportion of the 22.9% of women who smoked 1 year before pregnancy who did not quit smoking before pregnancy (85.0%), those who had not taken folic acid supplementation before pregnancy (72.7%) and previous pregnancy loss (38.9%). Inequalities were observed by age, ethnicity and area‐based deprivation level. The ten indicators prioritised were not taking folic acid supplementation before pregnancy, obesity, complex social factors, living in the most deprived areas, smoking around the time of conception, overweight, pre‐existing mental health condition, pre‐existing physical health condition, previous pregnancy loss and previous obstetric complication. Our findings suggest important opportunities to improve the state of preconception health and reduce socio‐demographic inequalities for women in England. In addition to MSDS data, other national data sources that record further and possibly better quality indicators could be explored and linked to build a comprehensive surveillance infrastructure.
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.VACCINE.2018.07.022
Abstract: In the UK, it is recommended that pregnant women receive the influenza and pertussis vaccination. However, uptake of these vaccinations in certain UK regions remains low. Previous studies show that pregnant women use the internet to access health information, yet it has not been previously explored whether the use of social networking sites (SNS) influences decisions about maternal vaccination uptake. The aim of this study was to determine, if the use of SNS to gain information on pregnancy vaccinations, is associated with women's uptake of the influenza and pertussis vaccines during pregnancy. This is a cross-sectional study with data collected using an online questionnaire posted on Mumsnet (an online parenting site), from 3rd to 24th August 2017. Women were included if they lived in the UK, were over 32 weeks pregnant, or had given birth in the last year. Participants were questioned about their pregnancy vaccination uptake, general SNS use and, their SNS use in relation to gathering information on vaccinations during pregnancy. The data was analysed using chi-square test, and univariable and multivariable logistic regression. Out of a s le of 308 participants, 305 (99.3%) of women reported using SNS and 64/308 (20.8%) of women reported using SNS to gather information on vaccinations during pregnancy. Women who reported using SNS to gather information on pregnancy vaccinations were 58% (adjusted odds ratio 0.42 95% CI 0.21-0.87) less likely to receive the pertussis vaccination during pregnancy. However, the association was not statistically significant for the influenza vaccination (adjusted odds ratio 0.64 95% CI 0.37-1.11). The study showed many women use SNS to gather information on pregnancy vaccinations, and this is negatively associated with their likelihood of receiving the pertussis vaccine. Future studies are needed to analyse the accuracy and quality of the vaccination information, which women find on SNS.
Publisher: BMJ
Date: 09-2014
Publisher: Royal College of General Practitioners
Date: 29-04-2021
Publisher: Cambridge University Press (CUP)
Date: 04-06-2021
DOI: 10.1017/S2040174421000258
Abstract: Initiatives to optimise preconception health are emerging following growing recognition that this may improve the health and well-being of women and men of reproductive age and optimise health in their children. To inform and evaluate such initiatives, guidance is required on indicators that describe and monitor population-level preconception health. We searched relevant databases and websites (March 2021) to identify national and international preconception guidelines, recommendations and policy reports. These were reviewed to identify preconception indicators. Indicators were aligned with a measure describing the prevalence of the indicator as recorded in national population-based data sources in England. From 22 documents reviewed, we identified 66 indicators across 12 domains. Domains included wider (social/economic) determinants of health health care reproductive health and family planning health behaviours environmental exposures cervical screening immunisation and infections mental health, physical health medication and genetic risk. Sixty-five of the 66 indicators were reported in at least one national routine health data set, survey or cohort study. A measure of preconception health assessment and care was not identified in any current national data source. Perspectives from three (healthcare) professionals described how indicator assessment and monitoring may influence patient care and inform awareness c aign development. This review forms the foundation for developing a national surveillance system for preconception health in England. The identified indicators can be assessed using national data sources to determine the population’s preconception needs, improve patient care, inform and evaluate new c aigns and interventions and enhance accountability from responsible agencies to improve preconception health.
Publisher: Cold Spring Harbor Laboratory
Date: 26-05-2022
DOI: 10.1101/2022.05.26.22275585
Abstract: Stigma can be experienced as perceived or actual disqualification from social and institutional acceptance on the basis of one or more physical, behavioural or other attributes deemed to be undesirable. Long Covid is a predominantly multisystem condition that occurs in people with a history of SARSCoV2 infection, often resulting in functional disability. To develop and validate a Long Covid Stigma Scale (LCSS) and to quantify the burden of Long Covid stigma. Follow-up of a co-produced community-based Long Covid online survey using convenience non-probability s ling. Thirteen questions on stigma were designed to develop the LCSS capturing three domains – enacted (overt experiences of discrimination), internalised (internalising negative associations with Long Covid and accepting them as self-applicable) and anticipated (expectation of bias oor treatment by others) stigma. Confirmatory factor analysis tested whether LCSS consisted of the three hypothesised domains. Model fit was assessed and prevalence was calculated. 966 UK-based participants responded (888 for stigma questions), with mean age 48 years (SD: 10.7) and 85% female. Factor loadings for enacted stigma were 0.70-0.86, internalised 0.75-0.84, anticipated 0.58-0.87, and model fit was good. The prevalence of experiencing stigma at least ‘sometimes’ and ‘often/always’ was 95% and 76% respectively. Anticipated and internalised stigma were more frequently experienced than enacted stigma. Those who reported having a clinical diagnosis of Long Covid had higher stigma prevalence than those without. This study establishes a scale to measure Long Covid stigma and highlights common experiences of stigma in people living with Long Covid.
Publisher: Elsevier BV
Date: 03-2021
Publisher: Elsevier BV
Date: 12-2020
DOI: 10.1093/AJCN/NQAA269
Publisher: Public Library of Science (PLoS)
Date: 23-11-2022
DOI: 10.1371/JOURNAL.PONE.0277317
Abstract: Stigma can be experienced as perceived or actual disqualification from social and institutional acceptance on the basis of one or more physical, behavioural or other attributes deemed to be undesirable. Long Covid is a predominantly multisystem condition that occurs in people with a history of SARSCoV2 infection, often resulting in functional disability. This study aimed to develop and validate a Long Covid Stigma Scale (LCSS) and to quantify the burden of Long Covid stigma. Data from the follow-up of a co-produced community-based Long Covid online survey using convenience non-probability s ling was used. Thirteen questions on stigma were designed to develop the LCSS capturing three domains–enacted (overt experiences of discrimination), internalised (internalising negative associations with Long Covid and accepting them as self-applicable) and anticipated (expectation of bias oor treatment by others) stigma. Confirmatory factor analysis tested whether LCSS consisted of the three hypothesised domains. Model fit was assessed and prevalence was calculated. 966 UK-based participants responded (888 for stigma questions), with mean age 48 years (SD: 10.7) and 85% female. Factor loadings for enacted stigma were 0.70–0.86, internalised 0.75–0.84, anticipated 0.58–0.87, and model fit was good. The prevalence of experiencing stigma at least ‘sometimes’ and ‘often/always’ was 95% and 76% respectively. Anticipated and internalised stigma were more frequently experienced than enacted stigma. Those who reported having a clinical diagnosis of Long Covid had higher stigma prevalence than those without. This study establishes a scale to measure Long Covid stigma and highlights common experiences of stigma in people living with Long Covid.
Publisher: MDPI AG
Date: 30-07-2018
DOI: 10.3390/NU10081000
Abstract: Obesity in pregnancy may negatively influence maternal and infant iron status. The aim of this study was to examine the association of obesity with inflammatory and iron status in both mother and infant in two prospective studies in pregnancy: UPBEAT and SCOPE. Maternal blood s les from obese (n = 245, BMI ≥ 30 kg/m2) and normal weight (n = 245, BMI 25 kg/m2) age matched pregnant women collected at approximately 15 weeks’ gestation, and umbilical cord blood s les collected at delivery, were analysed for a range of inflammatory and iron status biomarkers. Concentrations of C- reactive protein and Interleukin-6 in obese women compared to normal weight women were indicative of an inflammatory response. Soluble transferrin receptor (sTfR) concentration [18.37 nmol/L (SD 5.65) vs. 13.15 nmol/L (SD 2.33)] and the ratio of sTfR and serum ferritin [1.03 (SD 0.56) vs. 0.69 (SD 0.23)] were significantly higher in obese women compared to normal weight women (P 0.001). Women from ethnic minority groups (n = 64) had higher sTfR concentration compared with white women. There was no difference in maternal hepcidin between obese and normal weight women. Iron status determined by cord ferritin was not statistically different in neonates born to obese women compared with neonates born to normal weight women when adjusted for potential confounding variables. Obesity is negatively associated with markers of maternal iron status, with ethnic minority women having poorer iron statuses than white women.
Publisher: BMJ Publishing Group Ltd
Date: 09-2021
Publisher: Elsevier BV
Date: 10-2020
Publisher: Oxford University Press (OUP)
Date: 20-10-2017
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Nisreen Alwan.