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The Lancet 04/2013; 381(9875):1359. · 38.28 Impact Factor
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ABSTRACT: OBJECTIVE: The aim of our study was to examine cross-sectional and longitudinal associations between cigarette smoking and alcohol drinking, in a representative sample of English pupils. METHOD: Data from 13,635 school pupils in the Longitudinal Study of Young People in England (LSYPE) on usage of cigarettes from 2004 (typical age 14) to 2006 (age 16) and alcohol from 2004 to 2007 (age 17), analyzed with latent growth curve models. RESULTS: The weighted percentage of pupils drinking alcohol increased from 26% at age 14 to 71% by age 17, smoking from 12% to 27% by age 16. Pupils with lower socio-economic status were more likely to smoke but less likely to drink alcohol regularly. Both behaviors were positively correlated at age 14, adjusted for several confounding factors. The rate of increase over time was also positively correlated. CONCLUSION: Cigarette smoking and alcohol drinking are already correlated by age 14, are socio-economically patterned, and 'move together' during adolescence. Future studies and interventions should be targeted at a younger age range, to identify early smoking and potentially hazardous alcohol drinking patterns.
Preventive Medicine 02/2013; · 3.22 Impact Factor
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ABSTRACT: Conscientiousness is a strong predictor of health behaviours and better health outcomes. However, longitudinal data from representative samples of the population and from adolescents are rare. Therefore, the objective of this study was to establish whether school-related conscientiousness was associated with the onset and change in alcohol drinking and cigarette smoking frequency, in a large representative cohort of school pupils in England.
A school-related conscientiousness facet in the Longitudinal Study of Young People in England (LSYPE, N= 15,770) was identified, which had concurrent validity with conscientiousness and its facets. Latent growth curve modelling (LGCM) was used to model initial alcohol drinking and cigarette smoking frequency, over 4 years of the study.
For all pupils, higher conscientiousness predicted lower initial alcohol drinking across 4 years (from year 9 to 12). In females, higher conscientiousness was marginally associated with a slower rate of change in the move from non-drinker to drinker (linear slope), but significantly associated with a faster upturn in this change (quadratic slope). Higher conscientiousness predicted non-smoker status, greater initial cigarette smoking frequency for pupils (in smokers) but a change towards less frequent smoking (in smokers). Associations were not explained by parental educational, income, or monitoring; regularity of seeing friends; psychiatric morbidity; or birth weight.
School-related conscientiousness is an important facet, predictive of health behaviour onset and change during adolescence. The study illustrates the value of representative population samples that allow researchers to study associations between personality traits and health behaviours over time.
British Journal of Health Psychology 02/2012; 17(3):644-65. · 2.70 Impact Factor
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ABSTRACT: Alcohol impairs judgement and could be causally implicated in sexual risk taking. However, meta-analytic studies do not find an association between alcohol use and unprotected sexual intercourse at the event level, where both behaviours refer to the same point in time. Associations between personality traits and sexual risk taking have been replicated across several studies. Traits may be better conceptualized as independent risk factors, where alcohol use mediates the association between personality and condom use. The objective of our study was to determine the direct and indirect effects connecting big five personality traits with condom use, potentially mediated through alcohol use during the most recent sexual encounter.
A sample of community-dwelling adults (N= 190) completed measures of big five personality traits and a detailed assessment of event-level sexual behaviour and alcohol use.
In regression model adjusting for known confounding factors, including oral contraceptive use, partner type, and hazardous drinking patterns, one standard deviation increase in conscientiousness was associated with a 1.14-fold increase in the odds of using a condom with most recent sexual partner (p= .04). Repeating the analysis using zero-inflated regression for estimated blood alcohol concentration (eBAC) values revealed an association between conscientiousness and eBAC (p= .002). There was no association between alcohol and condom use in either analysis.
The results illustrate that personality traits are strong independent risk factors for sexual risk taking and eBAC values during sexual events, and both should be incorporated into research designs. Future research should evaluate specific facets of conscientiousness, and whether eBAC mediates the association between personality and condom use in other samples. The possibility of tailoring interventions to personality traits is discussed.
British Journal of Health Psychology 11/2011; 16(4):828-45. · 2.70 Impact Factor
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ABSTRACT: Objectives. Alcohol impairs judgement and could be causally implicated in sexual risk taking. However, meta-analytic studies do not find an association between alcohol use and unprotected sexual intercourse at the event level, where both behaviours refer to the same point in time. Associations between personality traits and sexual risk taking have been replicated across several studies. Traits may be better conceptualized as independent risk factors, where alcohol use mediates the association between personality and condom use. The objective of our study was to determine the direct and indirect effects connecting big five personality traits with condom use, potentially mediated through alcohol use during the most recent sexual encounter.Design. A sample of community-dwelling adults (N= 190) completed measures of big five personality traits and a detailed assessment of event-level sexual behaviour and alcohol use.Results. In regression model adjusting for known confounding factors, including oral contraceptive use, partner type, and hazardous drinking patterns, one standard deviation increase in conscientiousness was associated with a 1.14-fold increase in the odds of using a condom with most recent sexual partner (p= .04). Repeating the analysis using zero-inflated regression for estimated blood alcohol concentration (eBAC) values revealed an association between conscientiousness and eBAC (p= .002). There was no association between alcohol and condom use in either analysis.Conclusions. The results illustrate that personality traits are strong independent risk factors for sexual risk taking and eBAC values during sexual events, and both should be incorporated into research designs. Future research should evaluate specific facets of conscientiousness, and whether eBAC mediates the association between personality and condom use in other samples. The possibility of tailoring interventions to personality traits is discussed.
British Journal of Health Psychology 03/2011; 16(4):828 - 845. · 2.70 Impact Factor
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ABSTRACT: Many biobanks have struggled to deliver on the high expectations and claims made for them because of insufficient samples, inadequate infrastructure, cost of establishing and maintaining a large enough resource over the long term, and satisfying legal, ethics and governance requirements. Increasingly, networks have formed to help with the collection, processing, storage, advertising, and distribution of samples. However, there are also challenges to establishing and maintaining biobank networks.
To classify biobanks in order to better understand the problems faced by biobank networking.
Interviews were conducted with principal investigators and/or managers responsible for 33 biobanks in 9 countries.
Biobanks were classified into the following categories: 'storage', 'bring-and-share', 'catalogue', 'partnership', 'contribution' and 'expertise'.
It was possible to allocate all of the biobanks visited to one of the network categories although some fitted better than others. Thus, the classification may not be mutually exclusive nor encompass all types of biobanks. Many of the governance and operational problems associated with the biobanks visited were due to networking functions: either intra- or inter-biobank networks. Thus, this proposed classification system should help better understand these issues and identify solutions.
Pathobiology 01/2010; 77(4):181-90. · 1.18 Impact Factor
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Darren Shickle
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ABSTRACT: Public health practice is characterized by measuring population health, assessing needs for health care and the provision (directly or indirectly) of services to protect and promote the public's health. It is increasingly explicitly concerned with issues of equity.
Publications discussing ethical issues in public health.
Unlike the duties of clinicians, professional standards for public health practice are not well defined. An ethics framework would help the development and implementation of public health policy.
Public health strategies have been criticized for being paternalistic and restrictive of personal choice behaviours or for being too pragmatic, and appearing to endorse illegal activities.
Historically public health programmes have been delivered at a population level for large groups of people with varying capacity to benefit. Within more autonomy, consumer-orientated political environment, strategy must be more targeted to facilitate healthy choices as defined by the individual.
Debate is needed on the aims of public health, rights and responsibilities of professionals and citizens and mechanisms for developing and implementing policy.
British Medical Bulletin 07/2009; 91:7-22. · 4.54 Impact Factor
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ABSTRACT: Increases in international travel and migratory flows have enabled infectious diseases to emerge and spread more rapidly than ever before. Hence, it is increasingly easy for local infectious diseases to become global infectious diseases (GIDs). National governments must be able to react quickly and effectively to GIDs, whether naturally occurring or intentionally instigated by bioterrorism. According to the World Health Organisation, global partnerships are necessary to gather the most up-to-date information and to mobilize resources to tackle GIDs when necessary. Communicable disease control also depends upon national public health laws and policies. The containment of an infectious disease typically involves detection, notification, quarantine and isolation of actual or suspected cases; the protection and monitoring of those not infected; and possibly even treatment. Some measures are clearly contentious and raise conflicts between individual and societal interests. In Europe national policies against infectious diseases are very heterogeneous. Some countries have a more communitarian approach to public health ethics, in which the interests of individual and society are more closely intertwined and interdependent, while others take a more liberal approach and give priority to individual freedoms in communicable disease control. This paper provides an overview of the different policies around communicable disease control that exist across a select number of countries across Europe. It then proposes ethical arguments to be considered in the making of public health laws, mostly concerning their effectiveness for public health protection.
Bioethics 12/2008; 22(9):466-76. · 1.60 Impact Factor
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ABSTRACT: To understand European citizens' opinions on water fluoridation, as part of research on their attitudes to the tensions between private and public interest.
Sixty-eight focus groups held (with an average of eight people per group) in September and October 2003 in 16 countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Poland, Portugal, Spain, Sweden and the UK).
Most participants were against water fluoridation, although groups in Greece, Ireland, Poland and Sweden were more in favour. Many felt dental health was an issue to be dealt with at the level of the individual, rather than a solution to be imposed en masse. While people accepted that some children were not encouraged to brush their teeth, they proposed other solutions to addressing these needs rather than having a solution of unproved safety imposed on them by public health authorities whom they did not fully trust. They did not see why they should accept potential side effects in order that a minority may benefit. In particular, water was something that should be kept as pure as possible, even though it was recognized that it already contains many additives.
While the vast majority of people opposed water fluoridation, this may be indicative of shifts away from public support of population interventions towards private interventions, as well as reduced trust in public agencies. Thus if research were to demonstrate more clear benefits of water fluoridation over and above that which can be achieved by use of fluoride toothpaste, then the public may become more supportive. However, lobby groups are likely to remain influential.
Community Dentistry And Oral Epidemiology 05/2008; 36(2):95-102. · 1.89 Impact Factor
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ABSTRACT: As part of a larger study exploring how European citizens' balance issues of public and private interest and the extent to which they are prepared to accept State intervention on a range of public health issues, focus group participants were asked whether childhood immunisation should be a matter of parental choice or State compulsion. The question was debated in 66 (of 96) focus groups held across 16 European countries in 2003. Discussions focused on the concept of risk, trust in health professionals and the State, upholding the status quo, fears over vaccine safety and perceptions of infectious disease as a 'foreign threat'.
Vaccine 02/2008; 26(3):411-8. · 3.77 Impact Factor
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Darren Shickle
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ABSTRACT: Large prospective biobanks are being established containing DNA, lifestyle and health information in order to study the relationship between diseases, genes and environment. Informed consent is a central component of research ethics protection. Disclosure of information about the research is an essential element of seeking informed consent. Within biobanks, it is not possible at recruitment to describe in detail the information that will subsequently be collected because people will not know which disease they will develop. It will also be difficult to describe the specific research that will be performed using the biobank, other than to stipulate categories of research or diseases that are not included. Potential subjects can only be given information about the sorts of research that will be performed and by whom. Organisations responsible for biobanks usually argue that this disclosure of information is adequate when seeking informed consent, especially if coupled with a right to withdraw, as it would not be feasible or it would be too expensive to seek consent renewal on a regular basis. However, there are concerns about this 'blanket consent' approach'. Consent waivers have also been proposed in which research subjects entrust their consent with an independent third party to decide whether subsequent research using the biobank is consistent with the original consent provided by the subject.
Studies in History and Philosophy of Science Part C Studies in History and Philosophy of Biological and Biomedical Sciences 10/2006; 37(3):503-19.
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Darren Shickle
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ABSTRACT: The Mental Capacity Act 2005 covers all decisions on personal welfare including financial matters, relating to people who temporarily or permanently lack mental capacity. This paper outlines the most important provisions of the Act and describes some of the implications for healthcare professionals. For example, the Act permits advance decisions to refuse healthcare; the appointment of a person to have a Lasting Power of Attorney to act on a person's behalf at some point in the future; the appointment of a court-appointed deputy to act on behalf of a person lacking mental capacity; and research involving people who lack mental capacity in specific circumstances. The Court of Protection will now have a role in resolving difficult ethical problems in clinical cases.
Clinical medicine (London, England) 6(2):169-73. · 1.15 Impact Factor
