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    ABSTRACT: 'Active ageing' has been promoted as a strategy for extending quality of life and healthy life expectancy. However, there is limited evidence from nationally representative longitudinal studies on whether engagement among older adults is associated with better outcomes and few studies have considered possible bias arising from differential study attrition. We investigate associations between the engagement of people aged 50-69 in three types of activity with self-rated health and depression 2 years later using nationally representative longitudinal data from four European countries (Denmark, France, Italy and England). Data were drawn from waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe and the English Longitudinal Study of Ageing. Multivariable analysis was used to analyse associations between baseline activity and outcomes at follow-up controlling for socioeconomic, demographic and health-related variables at baseline. Multiple imputation techniques and sensitivity analyses were undertaken to investigate possible bias arising from sample attrition. Respondents in paid work at baseline were less likely to be depressed or to report poor or fair health at follow-up than those who were 'inactive', although not in Italy. Engagement in formal and informal activities was not significantly associated with health at follow-up. Sensitivity analyses showed that assuming that those in bad health were over-represented among study attritors weakened the association between work at baseline and health at follow-up. Engagement in paid work may help maintain health in later life, although mechanisms and contextual influences need further investigation.
    Journal of epidemiology and community health 11/2013;
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    ABSTRACT: Globalization of ADHD and the rise of cognitive enhancement have raised fresh concerns about the validity of ADHD diagnosis and the ethics of stimulant drug treatment. We review the literature on these two emerging phenomena, with a focus on the corresponding social, scientific and ethical debates over the universality of ADHD and the use of stimulant drug treatments in a global population of children and adolescents. Drawing on this literature, we reflect on the importance of ethically informed, ecologically sensitive clinical practices in relation to ADHD diagnosis and treatment.
    Current Psychiatry Reports 09/2013; 15(9):385.
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    ABSTRACT: This article provides an overview of commercial pharmacogenetics and pharmacogenomics testing services offered online. The concept of 'beyond-the-clinic' (BTC) genomic testing is introduced to refer to the variety of formats in which these tests are offered and a typology of BTC models is developed. The authors review such models in relation to tests for individual drug response that are currently on offer. In conclusion, the authors argue that the evolving BTC domain provides opportunities for the pioneering of integrated data repositories, whose gatekeepers are patients or citizens. The authors anticipate that such developments will benefit pharmacogenomics sooner than other areas of medical practice.
    Pharmacogenomics 03/2013; 14(4):403-12.
  • BMJ (online) 02/2013; 346:f755.
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    ABSTRACT: Pandemic preparedness planning relies on techniques to extend epidemiological inference beyond the bounds of direct observation. Mathematical modelling and simulation techniques are used to predict the course of an outbreak or test various mitigation strategies in pre-pandemic preparedness planning. This reflects an increasing reliance on quantifiable objects and establishing regulatory and governing practices by developing numerical assessment methods. This process has been described in terms of techne; the emergence of technologies and practices of calculation in the context of governance. This article develops a narrative framework to study how modelling methods are used in the governance of pandemic outbreaks by analysing both pre-pandemic modelling practices and model-based evidence used in pandemic risk assessment at the European Disease Control Centre. It examines how the modelling methods form techne through which the efforts of governance are organised. It concludes with a critical reflection on the limits of modelling methods by studying how they accommodate uncertainties.
    Sociology of Health & Illness 12/2012;
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    ABSTRACT: Global recognition is increasing of the contribution of midwifery services to optimal outcomes for women and babies, and evidence around how to organize services and the roles of maternity providers. However, a sociological analysis can provide some insight into why the role of midwives varies so widely in different countries. Evidence is necessary, but more important is the role of the state in legalizing and financially supporting midwifery practice, how professional boundaries are negotiated in the maternity care domain, and consumer mobilization in support of midwifery and around maternity issues. (BIRTH 39:4 December 2012).
    Birth 12/2012; 39(4):323-6.
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    ABSTRACT: This article examines children's discourse about self, brain and behaviour, focusing on the dynamics of power, knowledge and responsibility articulated by children. The empirical data discussed in this article are drawn from the study of Voices on Identity, Childhood, Ethics and Stimulants, which included interviews with 151 US and UK children, a subset of whom had a diagnosis of attention deficit/hyperactivity disorder. Despite their contact with psychiatric explanations and psychotropic drugs for their behaviour, children's discursive engagements with the brain show significant evidence of agency and negotiated responsibility. These engagements suggest the limitations of current concepts that describe a collapse of the self into the brain in an age of neurocentrism. Empirical investigation is needed in order to develop agent-centred conceptual and theoretical frameworks that describe and evaluate the harms and benefits of treating children with psychotropic drugs and other brain-based technologies.
    Sociology of Health & Illness 10/2012; 35(6).
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    ABSTRACT: In this article, I examine children's reported experiences with stimulant drug treatments for attention deficit hyperactivity disorder in light of bioethical arguments about the potential threats of psychotropic drugs to authenticity and moral agency. Drawing on a study that involved over 150 families in the USA and the UK, I show that children are able to report threats to authenticity, but that the majority of children are not concerned with such threats. On balance, children report that stimulants improve their capacity for moral agency, and they associate this capacity with an ability to meet normative expectations. I argue that although under certain conditions stimulant drug treatment may increase the risk of a threat to authenticity, there are ways to minimise this risk and to maximise the benefits of stimulant drug treatment. Medical professionals in particular should help children to flourish with stimulant drug treatments, in good and in bad conditions.
    Journal of medical ethics 08/2012; 39(6).
    This article is viewable in ResearchGate's enriched format
  • Biochemical Society Transactions 12/1991; 19(4):967-71.
  • Biochemical Society Transactions 12/1991; 19(4):433S.
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