874
3,461.14
3.96
1,205

Publication History View all

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Evidence suggests that maternal and offspring smoking behaviour is correlated. Little is known about the mechanisms through which this intergenerational transfer occurs. This paper explores the role of time preferences. Although time preference is likely to be heritable and correlated with health investments, its role in the intergenerational transmission of smoking has not been explored previously. This is the first paper to empirically test this. Data (2002, 2003, 2004, 2006 and 2008) from the Household, Income and Labour Dynamics in Australia are used. Estimates by using a pooled probit model show that there is not a direct effect of maternal time preference, measured in terms of financial planning horizon, on the likelihood that their offspring is a smoker. However, there is an indirect effect of maternal time preference. Sons of mothers that are smokers and have a shorter planning horizon are 6% more likely to smoke than if their mother had a longer planning horizon, and daughters of mothers that smoke with a shorter planning horizon are 7% more likely to smoke themselves than if their mother had a longer planning horizon. Copyright © 2013 John Wiley & Sons, Ltd.
    Health Economics 12/2014; 23(12). DOI:10.1002/hec.2987
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Obesity in pregnancy is associated with macrosomia, neontatal fat mass and increased obesity and diabetes in the offspring. Physical activity during pregnancy may mediate the relationship between maternal insulin action and infant body composition. Interventions to increase physical activity might therefore improve metabolic outcomes for pregnant women and reduce the risk of obesity and diabetes in their offspring. The UK Pregnancy Better Eating and Activity Trial (UPBEAT) is a complex intervention, designed to improve pregnancy outcome through dietary change and increased physical activity. The analysis presented here includes data from 183 women recruited to the pilot phase of UPBEAT. Methods Physical activity was assessed by accelerometer at recruitment, at 27–28 weeks’ gestation and at 35–36 weeks’ gestation. The relationship between sedentary behaviour and moderate and vigorous physical activity (MVPA) and infant body composition at birth was examined using Spearman partial correlations. Results Maternal sedentary time at recruitment was inversely associated with neonatal abdominal circumference (−0.333, p = 0.016), but at 35–36ẃeeks’ gestation was positively associated with neonatal abdominal circumference (0.435, p = 0.023). Sedentary time was not associated with these outcomes at 27–28 weeks’ gestation. MVPA at 35–36 weeks’ gestation was inversely associated with neonatal abdominal circumference (−0.466, p = 0.014). No associations between physical activity and birthweight were apparent. Conclusions Our findings suggest that physical activity during pregnancy is associated with infant body composition and that maternal physical activity is an appropriate target for intervention to improve infant outcomes. UPBEAT is funded by NIHR-UK (RP-0407-10452).
    07/2014; 4(3):234. DOI:10.1016/j.preghy.2014.03.016
  • [Show abstract] [Hide abstract]
    ABSTRACT: Obesity in pregnancy is rising and is associated with severe health consequences for both the mother and the child. There is an increasing international focus on guidelines to manage the clinical risks of maternal obesity, and for pregnancy weight management. However, passive dissemination of guidelines is not effective and more active strategies are required for effective guideline implementation into practice. Implementation of guidelines is a form of healthcare professional behaviour change, and therefore implementation strategies should be based on appropriate behaviour change theory. This systematic review aimed to identify the determinants of healthcare professionals' behaviours in relation to maternal obesity and weight management. Twenty-five studies were included. Data synthesis of the existing international qualitative and quantitative evidence base used the Theoretical Domains Framework to identify the barriers and facilitators to healthcare professionals' maternal obesity and weight management practice. The domains most frequently identified included ‘knowledge’, ‘beliefs about consequences’ and ‘environmental context and resources’. Healthcare professionals' weight management practice had the most barriers compared with any other area of maternal obesity practice. The results of this review will be used to inform the development of an intervention to support healthcare professional behaviour change.
    Obesity Reviews 04/2014; 15(6). DOI:10.1111/obr.12160
  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: This prospective study evaluated swallowing outcomes prechemoradiotherapy (pre-CRT) up to 1 year post-CRT, in a substantial cohort of patients with head and neck cancer and explored factors predicting outcome. METHODS: One hundred twelve patients were assessed pretreatment and at 3, 6, and 12 months posttreatment using a questionnaire, endoscopic assessment, water swallow test, and diet score. RESULTS: Seventy-one patients were retained, the majority had oropharyngeal (53%) or hypopharyngeal cancer (20%). A marked deterioration occurred between pretreatment and 3 months posttreatment (p ≤ .01). Significant improvement between 3 and 12 months was found on 2 swallowing measures, but not self reported. Three of the 4 pretreatment assessments predicted outcomes at 1 year. CONCLUSION: CRT results in a marked deterioration on different paradigms of swallowing measurements. Improvement occurs on some clinical measures, but limited change is observed in patients' perceptions. Pretreatment measures are important indicators of long-term dysphagia. Swallowing recovery is complex, taking different courses between clinical tests and perspectives. © 2013 Wiley Periodicals, Inc. Head Neck, 2013.
    Head & Neck 03/2014; 36(3). DOI:10.1002/hed.23306
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Previously we identified space-time clustering in certain childhood cancers. The present study aimed to determine whether there was cross-space-time clustering between different diagnostic groups. A total of 32,295 cases were diagnosed during 1969-1993. Cross-space-time clustering was analysed by a second-order procedure based on Diggle's method. Locations were birth and diagnosis addresses. The following space-time combinations were examined: address and date of birth; address at birth and date of diagnosis; address and date of diagnosis. Cross-space-time clustering analyses considered clustering pairs of cases from two different diagnostic groups. Formal statistical significance was taken as P < 0.00067 and marginal significance 0.01 > P ≥ 0.00067. Based on address at birth and date of diagnosis there was statistically significant cross-clustering between cases of HL and intracranial and intraspinal embryonal tumours (IIET), both aged 0-14 years (P < 0.0001). Based on address and date of birth there was marginally significant cross-clustering between cases of lymphoid leukaemia (LL) aged 5-14 years and Hodgkin lymphoma (HL) aged 0-14 years (P = 0.0019). Based on address and date of diagnosis there was marginally significant cross-clustering between cases of LL aged 1-4 years and soft tissue sarcoma (STS) aged 0-14 years (P = 0.0041). Findings from this study are consistent with possible common aetiological factors between different diagnostic groups. They suggest a common aetiology for the following pairs of diagnostic groups: HL and IIET; older cases of LL and HL; younger cases of LL and soft tissue sarcoma. The possibility of common infectious mechanisms should be explored. © 2013 Wiley Periodicals, Inc.
    International Journal of Cancer 01/2014; 134(1). DOI:10.1002/ijc.28332
  • [Show abstract] [Hide abstract]
    ABSTRACT: The care needs of people with Parkinson's disease (PD) are poorly understood. We aimed to investigate the factors that precipitate entry to institutional care, and on-going care needs once in care, within a representative cohort of community-dwelling people with PD. All people with idiopathic PD, Parkinson's plus syndromes and vascular parkinsonism under the care of the Northumbria Healthcare NHS Foundation Trust PD service who were living in care homes on 1 January 2013 were included. Disease severity (Hoehn and Yahr stage) and demographic data were collected. Admissions to hospital over the previous 2 years and in the year before institutional care admission were documented. A total of 90 patients (51 females) with a mean age of 81.3 years were included. During care home stay, the median number of emergency department attendances, the median number of hospital admissions and the median length of stay for those admitted per year were significantly lower than before care home admission. Both before care home admission and during care home stay, falls were the most common diagnoses in people attending emergency departments, with 32 of 65 (49.2%) admissions before and 34 of 59 (57.6%) admissions during care home stay having falls recorded as a cause of attendance. Hospital attendances and admissions were relatively common, even after institutional care home placement. Events precipitating admission, such as falls, might be preventable. PD nurse specialists could be an effective way to help train staff in homes where someone is known to have PD. Geriatr Gerontol Int 2013; ●●: ●●-●●.
    Geriatrics & Gerontology International 12/2013; 14(4). DOI:10.1111/ggi.12204
  • [Show abstract] [Hide abstract]
    ABSTRACT: We investigated the association between respiratory prescribing, air quality and deprivation in primary health care. Most previous studies have used data from secondary and tertiary care to quantify air pollution effects on exacerbations of asthma and chronic obstructive pulmonary disease (COPD). However, these outcomes capture patients who suffer from relatively severe symptoms. This is a population-based ecological study. We analysed respiratory medication (salbutamol) prescribed monthly by 63 primary care practices, UK. Firstly, we captured the area-wide seasonal variation in prescribing. Then, using the area-wide variation in prescribing as an offset, we built a mixed-effects model to assess the remaining variation in relation to air quality and demographic variables. An increase of 10 μg/m(3) in ambient PM10 was associated with an increase of 1% (95% CI: 0.1-2%) in salbutamol prescribing. An increase of 1 SD in income and employment deprivation was associated with an increase of 20.5% (95% CI: 8.8-33.4%) and 14.7% (95% CI: 4.3-26.2%) in salbutamol prescribing rate, respectively. The study provides evidence that monthly respiratory prescribing in primary care is a useful indicator of the extent to which air pollution exacerbates asthma and COPD symptoms. Respiratory prescribing was higher on deprived populations.
    Journal of Public Health 12/2013; 35(4):502-9. DOI:10.1093/pubmed/fdt107
  • [Show abstract] [Hide abstract]
    ABSTRACT: Pre-existing diabetes is associated with an increased risk of stillbirth, but few studies have excluded the effect of congenital anomalies. This study used data from a long-standing population-based survey of women with pre-existing diabetes to investigate the risks of fetal and infant death and quantify the contribution of glycaemic control. All normally formed singleton offspring of women with pre-existing diabetes (1,206 with type 1 diabetes and 342 with type 2 diabetes) in the North of England during 1996-2008 were identified from the Northern Diabetes in Pregnancy Survey. RRs of fetal death (≥20 weeks of gestation) and infant death were estimated by comparison with population data from the Northern Perinatal Morbidity and Mortality Survey. Predictors of fetal and infant death in women with pre-existing diabetes were examined by logistic regression. The prevalence of fetal death in women with diabetes was over four times greater than in those without (RR 4.56 [95% CI 3.42, 6.07], p < 0.0001), and for infant death it was nearly doubled (RR 1.86 [95% CI 1.00, 3.46], p = 0.046). There was no difference in the prevalence of fetal death (p = 0.51) or infant death (p = 0.70) between women with type 1 diabetes and women with type 2 diabetes. There was no evidence that the RR of fetal and infant death had changed over time (p = 0.95). Increasing periconception HbA1c concentration above 49 mmol/mol (6.6%) (adjusted odds ratio [aOR] 1.02 [95% CI 1.00, 1.04], p = 0.01), prepregnancy retinopathy (aOR 2.05 [95% CI 1.04, 4.05], p = 0.04) and lack of prepregnancy folic acid consumption (aOR 2.52 [95% CI 1.12, 5.65], p = 0.03) were all independently associated with increased odds of fetal and infant death. Pre-existing diabetes is associated with a substantially increased risk of fetal and infant death in normally formed offspring, the effect of which is largely moderated by glycaemic control.
    Diabetologia 11/2013; DOI:10.1007/s00125-013-3108-5
  • Source
    British Journal of Cancer 11/2013; 109(11):2763-4. DOI:10.1038/bjc.2013.674
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The syndrome of cerebral palsy encompasses a large group of childhood movement and posture disorders. Severity, patterns of motor involvement, and associated impairments such as those of communication, intellectual ability, and epilepsy vary widely. Overall prevalence has remained stable in the past 40 years at 2-3·5 cases per 1000 livebirths, despite changes in antenatal and perinatal care. The few studies available from developing countries suggest prevalence of comparable magnitude. Cerebral palsy is a lifelong disorder; approaches to intervention, whether at an individual or environmental level, should recognise that quality of life and social participation throughout life are what individuals with cerebral palsy seek, not improved physical function for its own sake. In the past few years, the cerebral palsy community has learned that the evidence of benefit for the numerous drugs, surgery, and therapies used over previous decades is weak. Improved understanding of the role of multiple gestation in pathogenesis, of gene environment interaction, and how to influence brain plasticity could yield significant advances in treatment of the disorder. Reduction in the prevalence of post-neonatal cerebral palsy, especially in developing countries, should be possible through improved nutrition, infection control, and accident prevention.
    The Lancet 11/2013; 383(9924). DOI:10.1016/S0140-6736(13)61835-8
Information provided on this web page is aggregated encyclopedic and bibliographical information relating to the named institution. Information provided is not approved by the institution itself. The institution’s logo (and/or other graphical identification, such as a coat of arms) is used only to identify the institution in a nominal way. Under certain jurisdictions it may be property of the institution.