University of Leeds

Leeds, W.Yorkshire, United Kingdom

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Leeds Institute of Health Sciences (LIHS)
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School of Earth and Environment
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Institute of Psychological Sciences
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    ABSTRACT: Higher conscientiousness (C) predicts better health outcomes. Recent research suggests that stress may play an important role in explaining this relationship. The current study aimed to establish whether C moderates the relationship between daily hassle appraisals, daily affect, and physical symptoms. A daily diary design was used, where participants (N = 103) completed a baseline measure of C followed by a 14-day daily diary, providing daily details of hassles (primary and secondary appraisals) experienced as well as positive and negative affect and physical symptoms. Hierarchical linear modelling revealed that Total C (as well as two facets of C: Order and Industriousness) moderated the relationship between stress appraisals and positive affect. Specifically, the negative association between the daily appraisal of hassles as stressful (i.e., where perceived demands outweighed perceived resources) and positive affect was stronger for lower and average levels of C, Order, and Industriousness. No significant moderated effects were found for negative affect or physical symptoms. The Order facet was also found to be an important factor predicting attrition. The current study provided evidence that C and two of its facets can moderate the relationship between hassle appraisal and positive affect. C may exert part of its influence on health by modifying the effects of daily stressors. What is already known on this subject? Conscientiousness has a significant positive effect on longevity and health status. While the performance of health behaviours may partially account for this relationship, evidence suggests that it does not fully mediate the effect. Research has begun to look at stress as a possible additional explanatory variable, and there is evidence that Conscientiousness moderates the relationship between stress and health behaviours. What does this study add? Shows that Conscientiousness and two of its facets (Order and Industriousness) moderate the relationship between hassle appraisal and positive affect. Highlights the importance of studying lower order facets of personality in health research. Suggests that Conscientiousness may exert part of its influence on health by modifying the effects of daily stressors.
    British Journal of Health Psychology 11/2014; 19:311-328.
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    ABSTRACT: To determine the clinical effectiveness and cost-effectiveness of nurse-led care (NLC) for people with rheumatoid arthritis (RA). In a multicentre pragmatic randomised controlled trial, the assessment of clinical effects followed a non-inferiority design, while patient satisfaction and cost assessments followed a superiority design. Participants were 181 adults with RA randomly assigned to either NLC or rheumatologist-led care (RLC), both arms carrying out their normal practice. The primary outcome was the disease activity score (DAS28) assessed at baseline, weeks 13, 26, 39 and 52; the non-inferiority margin being DAS28 change of 0.6. Mean differences between the groups were estimated controlling for covariates following per-protocol (PP) and intention-to-treat (ITT) strategies. The economic evaluation (NHS and healthcare perspectives) estimated cost relative to change in DAS28 and quality-adjusted life-years (QALY) derived from EQ5D. Demographics and baseline characteristics of patients under NLC (n=91) were comparable to those under RLC (n=90). Overall baseline-adjusted difference in DAS28 mean change (95% CI) for RLC minus NLC was -0.31 (-0.63 to 0.02) for PP and -0.15 (-0.45 to 0.14) for ITT analyses. Mean difference in healthcare cost (RLC minus NLC) was £710 (-£352, £1773) and -£128 (-£1263, £1006) for PP and ITT analyses, respectively. NLC was more cost-effective with respect to cost and DAS28, but not in relation to QALY utility scores. In all secondary outcomes, significance was met for non-inferiority of NLC. NLC had higher 'general satisfaction' scores than RLC in week 26. The results provide robust evidence to support non-inferiority of NLC in the management of RA. ISRCTN29803766.
    Annals of the rheumatic diseases 11/2014; 73(11):1975-82.
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    ABSTRACT: The Large Low Shear Velocity Provinces (LLSVPs) in the lower mantle represent volumetrically significant thermal or chemical or thermo-chemical heterogeneities. Their structure and boundaries have been widely studied, mainly using S-waves, but much less is known about their signature in the P-wavefield. We use an extensive dataset recorded at USArray to create, for the first time, a high-resolution map of the location, shape, sharpness, and extent of the boundary of the Pacific LLSVP using P(Pdiff)P(Pdiff)-waves. We find that the northern edge of the Pacific LLSVP is shallow dipping (26° relative to the horizontal) and diffuse (∼120 km wide transition zone) whereas the eastern edge is steeper dipping (70°) and apparently sharp (∼40 km wide). We trace the LLSVP boundary up to ∼500 km above the CMB in most areas, and 700 km between 120° and 90°W at the eastern extent of the boundary. Apparent P-wave velocity drops are ∼1–3% relative to PREM, indicating a strong influence of LLSVPs on P-wave velocity, at least in the high-frequency wavefield, in contrast to previous studies. A localised patch with a greater velocity drop of ∼15–25% is detected, defined by large magnitude gradients of the travel-time residuals. We identify this as a likely location of an Ultra-Low Velocity Zone (ULVZ), matching the location of a previously detected ULVZ in this area. The boundary of a separate low velocity anomaly, of a similar height to the LLSVP, is detected in the north–west Pacific, matching tomographic images. This outlier appears to be connected to the main LLSVP through a narrow channel close to the CMB and may be in the process of joining or splitting from the main LLSVP. We also see strong velocity increases in the lower mantle to the east of the LLSVP, likely detecting subducted material beneath central America. The LLSVP P-wave boundary is similar to that determined in high-resolution S-wave studies and follows the −0.4% ΔVSΔVS iso-velocity contour in the S40RTS tomography model. Additionally, the LLSVP boundary roughly matches the shape of the −0.4% ΔVPΔVP iso-velocity contour of the P-wave model GyPSuM but defines an area more similar to that defined by the 0.0% VPVP iso-velocity contour. High resolution P-wave velocity determination allows for estimation of the ratio of P- and S-wave velocity anomalies (RS,PRS,P) which can be used to indicate dominantly thermal or chemical control of seismic velocities. Although the RS,PRS,P is found here to be approximately 2.4, which is indicative of a thermo-chemical anomaly. However, this result contains a large amount of uncertainty and the implications for the origin of LLSVPs likely remain inconclusive. Nonetheless, other observations of the Pacific LLSVP are consistent with a thermo-chemical anomaly whose shape and boundary sharpness are controlled by proximity to active and past subduction.
    Earth and Planetary Science Letters 10/2014; 403:380–392.


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    Woodhouse Lane, LS2 9JT, Leeds, W.Yorkshire, United Kingdom
  • Head of Institution
    Sir Alan Langland
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