Hazel M Inskip

University of Southampton, Southampton, England, United Kingdom

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Publications (195)1285.79 Total impact

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    ABSTRACT: Both maternal 25-hydroxyvitamin D (25(OH)D) concentrations during pregnancy and placental amino acid transporter gene expression have been associated with development of the offspring in terms of body composition and bone structure. Several amino acid transporter genes have vitamin D response elements in their promoters suggesting the possible linkage of these two mechanisms. We aimed to establish whether maternal 25(OH)D and vitamin D-binding protein (VDBP) levels relate to expression of placental amino acid transporters. RNA was extracted from 102 placental samples collected in the Southampton Women's Survey, and gene expression was analysed using quantitative real-time PCR. Gene expression data were normalised to the geometric mean of three housekeeping genes, and related to maternal factors and childhood body composition. Maternal serum 25(OH)D and VDBP levels were measured by radioimmunoassay. Maternal 25(OH)D and VDBP levels were positively associated with placental expression of specific genes involved in amino acid transport. Maternal 25(OH)D and VDBP concentrations were correlated with the expression of specific placental amino acid transporters, and thus may be involved in the regulation of amino acid transfer to the fetus. The positive correlation of VDBP levels and placental transporter expression suggests that delivery of vitamin D to the placenta may be important. This exploratory study identifies placental amino acid transporters which may be altered in response to modifiable maternal factors and provides a basis for further studies.
    The British journal of nutrition 05/2015; DOI:10.1017/S0007114515001178 · 3.34 Impact Factor
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    ABSTRACT: Various environmental factors have been associated with the timing of eruption of primary dentition, but the evidence to date comes from small studies with limited information on potential risk factors. We aimed to investigate associations between tooth emergence patterns and pre-conception, pregnancy and postnatal influences. Dentition patterns were recorded at ages 1 and 2 years in 2915 children born to women in the Southampton Women's Survey from whom information had been collected on maternal factors before conception and during pregnancy. In mutually adjusted regression models we found that: children were more dentally advanced at ages 1 and 2 years if their mothers had smoked during pregnancy or they were longer at birth; mothers of children whose dental development was advanced at age 2 years tended to have poorer socioeconomic circumstances, and to have reported a slower walking speed pre-pregnancy; and children of mothers of Asian ethnicity had later tooth development than those of white mothers. The findings add to the evidence of environmental impacts on the timing of the eruption of primary dentition in indicating that maternal smoking during pregnancy, socio-economic status and physical activity (assessed by reported walking speed) may influence the child's primary dentition. Early life factors, including size at birth are also associated with dentition patterns, as is maternal ethnicity.
    05/2015; DOI:10.1017/S2040174415001130
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    ABSTRACT: Early life environments induce long-term changes in neurocognitive development and behaviour. In animal models, early environmental cues affect neuropsychological phenotypes via epigenetic processes but, as yet, there is little direct evidence for such mechanisms in humans. We examined the relation between DNA methylation at birth and child neuropsychological outcomes in two culturally diverse populations using a genome-wide methylation analysis and validation by pyrosequencing. Within the UK Southampton Women's Survey (SWS) we first identified 41 differentially methylated regions of interest (DMROI) at birth associated with child's full-scale IQ at age 4 years. Associations between HES1 DMROI methylation and later cognitive function were confirmed by pyrosequencing in 175 SWS children. Consistent with these findings, higher HES1 methylation was associated with higher executive memory function in a second independent group of 200 SWS 7-year-olds. Finally, we examined a pathway for this relationship within a Singaporean cohort (n = 108). Here, HES1 DMROI methylation predicted differences in early infant behaviour, known to be associated with academic success. In vitro, methylation of HES1 inhibited ETS transcription factor binding, suggesting a functional role of this site. Thus, our findings suggest that perinatal epigenetic processes mark later neurocognitive function and behaviour, providing support for a role of epigenetic processes in mediating the long-term consequences of early life environment on cognitive development. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.
    International Journal of Epidemiology 04/2015; DOI:10.1093/ije/dyv052 · 9.20 Impact Factor
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    ABSTRACT: This paper discusses the importance of promoting healthy behaviours during K-12 education and puts forward the argument that an effective and sustainable way to promote health literacy is through science education. Using socio-scientific issues as a framework for teaching about healthy behaviours at the secondary school level, we argue that health literacy and science literacy are inherently related and should be presented as such within K-12 education. Health literacy emphasises educating individuals about their health and enabling them to develop the critical and evaluative thinking skills that are required to make informed health-related decisions and develop healthy behaviours. Such critical and evaluative thinking skills and the ability to consider and weigh evidence are core practices of the scientific community, and one of the advantages that science education has to offer to the general education of young individuals. Using non-communicable diseases as the context, we propose an educational intervention that can promote both scientific and health literacy whilst engaging students in scientific practices.
    National Association for Research in Science Teaching (NARST), Chicago, IL; 04/2015
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    ABSTRACT: The FTO gene harbors variation with the strongest effect on adiposity and obesity risk. Previous data support a role for FTO variation in influencing food intake. We conducted a combined analysis of 16,094 boys and girls aged 1-18 years from 14 studies to examine: 1) the association between the FTO rs9939609 variant (or a proxy) and total energy and macronutrient intake; and 2) the interaction between the FTO variant and dietary intake on BMI. We found that the BMI-increasing allele (minor allele) of FTO variant was associated with increased total energy intake (effect per allele=14.3[5.9, 22.7] kcal/day, P=6.5×10(-4)) but not with protein, carbohydrate or fat intake. We also found that protein intake modified the association between the FTO variant and BMI (interactive effect per allele=0.08[0.03, 0.12]SDs, P for interaction=7.2×10(-4)): the association between FTO genotype and BMI was much stronger in individuals with high protein intake (effect per allele=0.10[0.07, 0.13]SDs, P=8.2×10(-10)) than in those with low intake (effect per allele=0.04[0.01, 0.07]SDs, P=0.02). Our results suggest that the FTO variant that confers a predisposition to higher BMI is associated with higher total energy intake and that lower dietary protein intake attenuates the association between FTO genotype and adiposity in children and adolescents. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
    Diabetes 02/2015; DOI:10.2337/db14-1629 · 8.47 Impact Factor
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    ABSTRACT: Rationale: Higher pulse wave velocity (PWV) reflects increased arterial stiffness and is an established cardiovascular risk marker associated with lower long-chain n-3 polyunsaturated fatty acid intake in adults. Experimentally, maternal fatty acid intake in pregnancy has lasting effects on offspring arterial stiffness. Objective: To examine the association between maternal consumption of oily fish, a source of long-chain n-3 polyunsaturated fatty acids, in pregnancy and child's aortic stiffness age 9 years. Methods and Results: In a mother-offspring study (Southampton Women's Survey) the child's descending aorta PWV was measured at age 9 years using velocity-encoded phase contrast magnetic resonance imaging and related to maternal oily fish consumption assessed prospectively during pregnancy. Higher oily fish consumption in late pregnancy was associated with lower childhood aortic PWV (sex-adjusted β=-0.084 m/s /portion/week, [95% CI -0.137 to -0.031], p=0.002, n=226). Mother's educational attainment was independently associated with child's PWV. PWV was not associated with the child's current oily fish consumption. Conclusions: Level of maternal oily fish consumption in pregnancy may influence child's large artery development, with potential long-term consequences for later cardiovascular risk.
    Circulation Research 02/2015; 116(7). DOI:10.1161/CIRCRESAHA.116.305158 · 11.09 Impact Factor
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    ABSTRACT: Studies in childhood suggest that both body composition and early postnatal growth are associated with bone mineral density (BMD). However, little is known of the relationships between longitudinal changes in fat (FM) and lean mass (LM), and bone development in pre-pubertal children. We therefore investigated these associations in a population-based mother-offspring cohort, the Southampton Women's Survey. Total FM and LM were assessed at birth and 6-7 years of age by Dual-Energy X-ray Absorptiometry (DXA). At 6-7y, total cross-sectional area (CSA) and trabecular volumetric BMD (vBMD) at the 4% site (metaphysis) of the tibia was assessed using peripheral quantitative computed tomography [pQCT (Stratec XCT-2000)]. Total CSA, cortical CSA, cortical vBMD and strength-strain index (SSI) were measured at the 38% site (diaphysis). FM, LM and bone parameters were adjusted for age and sex and standardised to create within-cohort z-scores. Change in LM (ΔLM) or FM (ΔFM) was represented by change in z-score from birth to 7y and conditioned on the birth measurement. Linear regression was used to explore the associations between ΔLM or ΔFM and standardised pQCT outcomes, before and after mutual adjustment and for linear growth. The β-coefficient represents SD change in outcome per unit SD change in predictor. DXA at birth, in addition to both DXA and pQCT scans at 6-7y, were available for 200 children (48.5% male). ΔLM adjusted for ΔFM was positively associated with tibial total CSA at both the 4% (β=0.57SD/SD, p<0.001) and 38% sites (β=0.53SD/SD, p<0.001), cortical CSA (β=0.48SD/SD, p<0.001) and trabecular vBMD (β=0.30SD/SD, p<0.001), but not with cortical vBMD. These relationships persisted after adjustment for linear growth. In contrast, ΔFM adjusted for ΔLM was only associated with 38% total and cortical CSA, which became non-significant after adjustment for linear growth. In this study, gain in childhood LM was positively associated with bone size and trabecular vBMD at 6-7 years of age. In contrast, no relationships between change in FM and bone were observed, suggesting that muscle growth, rather than accrual of fat mass, may be a more important determinant of childhood bone development. Copyright © 2015. Published by Elsevier Inc.
    Bone 02/2015; 75. DOI:10.1016/j.bone.2015.02.015 · 4.46 Impact Factor
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    ABSTRACT: Early life may be a "critical period" when appetite and regulation of energy balance are programmed, with lifelong consequences for obesity risk. Insight into the potential impact of modifying early-life risk factors on later obesity can be gained by evaluating their combined effects. The objective was to examine the relation between the number of early-life risk factors and obesity outcomes among children in a prospective birth cohort (Southampton Women's Survey). Five risk factors were defined: maternal obesity [prepregnant body mass index (BMI; in kg/m(2)) >30], excess gestational weight gain (Institute of Medicine, 2009), smoking during pregnancy, low maternal vitamin D status (<64 nmol/L), and short duration of breastfeeding (none or <1 mo). Obesity outcomes examined when the children were aged 4 and 6 y were BMI, dual-energy X-ray absorptiometry-assessed fat mass, overweight, or obesity (International Obesity Task Force). Data were available for 991 mother-child pairs, with children born between 1998 and 2003. Of the children, 148 (15%) had no early-life risk factors, 330 (33%) had 1, 296 (30%) had 2, 160 (16%) had 3, and 57 (6%) had 4 or 5. At both 4 and 6 y, there were positive graded associations between number of early-life risk factors and each obesity outcome (all P < 0.001). After taking account of confounders, the relative risk of being overweight or obese for children who had 4 or 5 risk factors was 3.99 (95% CI: 1.83, 8.67) at 4 y and 4.65 (95% CI: 2.29, 9.43) at 6 y compared with children who had none (both P < 0.001). Having a greater number of early-life risk factors was associated with large differences in adiposity and risk of overweight and obesity in later childhood. These findings suggest that early intervention to change these modifiable risk factors could make a significant contribution to the prevention of childhood obesity.
    American Journal of Clinical Nutrition 02/2015; 101(2):368-75. DOI:10.3945/ajcn.114.094268 · 6.92 Impact Factor
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    ABSTRACT: Evidence on the effect of maternal complications in pregnancy on wheezing in offspring is still insufficient. A pooled analysis was performed on individual participant data from fourteen European birth cohorts to assess the relationship between several maternal pregnancy complications and wheezing symptoms in the offspring. Exposures of interest included hypertension and preeclampsia, diabetes, as well as pre-pregnancy overweight (body mass index between 25 and 29.9) and obesity (body mass index ≥30) compared with normal weight (body mass index between 18.5 and 24.9). Outcomes included both ever and recurrent wheezing from birth up to 12-24 months of age. Cohort-specific crude and adjusted risk ratios (RR) were calculated using log-binomial regression models and then pooled using a random effects model. The study included 85 509 subjects. Cohort-specific prevalence of ever wheezing varied from 20.0% to 47.3%, and of recurrent wheezing from 3.0% to 14.3%. Adjusted pooled RR for ever and recurrent wheezing were: 1.02 (95% CI: 0.98-1.06) and 1.20 (95% CI: 0.98-1.47) for hypertensive disorders; 1.09 (95% CI: 1.01-1.18) and 1.23 (95% CI: 1.07-1.43) for preeclampsia; 1.04 (95% CI: 0.97-1.13) and 1.24 (95% CI: 0.86-1.79) for diabetes; 1.08 (95% CI: 1.05-1.11) and 1.19 (95% CI: 1.12-1.26) for overweight; 1.12 (95% CI: 1.08-1.17) and 1.16 (95% CI: 0.97-1.39) for obesity. No heterogeneity was found in RR estimates among the cohorts, except for diabetes and recurrent wheezing (P = 0.027). Preeclampsia, maternal pre-pregnancy overweight and obesity are associated with an increase risk of wheezing in the offspring. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.
    International Journal of Epidemiology 01/2015; 44(1). DOI:10.1093/ije/dyu260 · 9.20 Impact Factor
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    ABSTRACT: Epidemiological studies have shown that weaker grip strength in later life is associated with disability, morbidity, and mortality. Grip strength is a key component of the sarcopenia and frailty phenotypes and yet it is unclear how individual measurements should be interpreted. Our objective was to produce cross-sectional centile values for grip strength across the life course. A secondary objective was to examine the impact of different aspects of measurement protocol. We combined 60,803 observations from 49,964 participants (26,687 female) of 12 general population studies in Great Britain. We produced centile curves for ages 4 to 90 and investigated the prevalence of weak grip, defined as strength at least 2.5 SDs below the gender-specific peak mean. We carried out a series of sensitivity analyses to assess the impact of dynamometer type and measurement position (seated or standing). Our results suggested three overall periods: an increase to peak in early adult life, maintenance through to midlife, and decline from midlife onwards. Males were on average stronger than females from adolescence onwards: males' peak median grip was 51 kg between ages 29 and 39, compared to 31 kg in females between ages 26 and 42. Weak grip strength, defined as strength at least 2.5 SDs below the gender-specific peak mean, increased sharply with age, reaching a prevalence of 23% in males and 27% in females by age 80. Sensitivity analyses suggested our findings were robust to differences in dynamometer type and measurement position. This is the first study to provide normative data for grip strength across the life course. These centile values have the potential to inform the clinical assessment of grip strength which is recognised as an important part of the identification of people with sarcopenia and frailty.
    PLoS ONE 12/2014; 9(12):e113637. DOI:10.1371/journal.pone.0113637 · 3.53 Impact Factor
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    ABSTRACT: To test the hypothesis that maternal psychological profiles relate to children's quality of diet. Cross-sectional study. Mothers provided information on their health-related psychological factors and aspects of their child's mealtime environment. Children's diet quality was assessed using an FFQ from which weekly intakes of foods and a diet Z-score were calculated. A high score described children with a better quality diet. Cluster analysis was performed to assess grouping of mothers based on psychological factors. Mealtime characteristics, describing how often children ate while sitting at a table or in front of the television, their frequency of takeaway food consumption, maternal covert control and food security, and children's quality of diet were examined, according to mothers' cluster membership. Mother-child pairs (n 324) in the Southampton Initiative for Health. Children were aged 2-5 years. Hampshire, UK. Two main clusters were identified. Mothers in cluster 1 had significantly higher scores for all psychological factors than mothers in cluster 2 (all P<0·001). Clusters were termed 'more resilient' and 'less resilient', respectively. Children of mothers in the less resilient cluster ate meals sitting at a table less often (P=0·03) and watched more television (P=0·01). These children had significantly poorer-quality diets (β=-0·61, 95 % CI -0·82, -0·40, P≤0·001). This association was attenuated, but remained significant after controlling for confounding factors that included maternal education and home/mealtime characteristics (P=0·006). The study suggests that mothers should be offered psychological support as part of interventions to improve children's quality of diet.
    Public Health Nutrition 11/2014; DOI:10.1017/S136898001400250X · 2.48 Impact Factor
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    ABSTRACT: Patterns of body size and body composition associated with genetic obesity susceptibility inform the mechanisms that increase obesity risk.
    JAMA Pediatrics 10/2014; 168(12). DOI:10.1001/jamapediatrics.2014.1619 · 4.25 Impact Factor
  • Placenta; 09/2014
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    ABSTRACT: To assess whether changes in measures of fat distribution and body size during early life are associated with blood pressure at 36 months of age.
    BMJ Open 07/2014; 4(7):e005412. DOI:10.1136/bmjopen-2014-005412 · 2.06 Impact Factor
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    ABSTRACT: The UK government's response to the obesity epidemic calls for action in communities to improve people's health behaviour. This study evaluated the effects of a community intervention on dietary quality and levels of physical activity of women from disadvantaged backgrounds.
    BMJ Open 07/2014; 4(7):e005290. DOI:10.1136/bmjopen-2014-005290 · 2.06 Impact Factor
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    ABSTRACT: Maternal hyperglycemia in pregnancy is associated with greater adiposity in offspring. The glycemic index (GI) and glycemic load (GL) describe the glycemic response to carbohydrate ingestion. However, the influence of maternal dietary GI and GL in pregnancy on childhood adiposity is unknown.OBJECTIVE: We examined relations of maternal dietary GI and GL in early and late pregnancy with offspring body composition.DESIGN: A total of 906 mother-child pairs from the prospective cohort the Southampton Women's Survey were included. Children underwent dual-energy X-ray absorptiometry measurements of body composition at birth and 4 and 6 y of age. Log-transformed fat mass and lean mass were standardized with a mean (±SD) of 0 ± 1. Maternal dietary GI and GL were assessed at 11 and 34 wk of gestation by using an administered food-frequency questionnaire.RESULTS: After controlling for potential confounders, both maternal dietary GI and GL in early pregnancy were positively associated with fat mass at 4 and 6 y of age [fat mass SDs per 10-unit GI increase: β = 0.43 (95% CI: 0.06, 0.80), P = 0.02 at 4 y of age; β = 0.40 (95% CI: 0.10, 0.70), P = 0.01 at 6 y of age; fat mass SDs per 50-unit GL increase: β = 0.43 (95% CI: 0.19, 0.67), P < 0.001 at 4 y of age, β = 0.27 (95% CI: 0.07, 0.47), P = 0.007 at 6 y of age]. In contrast, there were no associations between maternal dietary GI or GL in late pregnancy and offspring fat mass at these ages. Maternal dietary GI and GL were not associated with fat mass at birth or offspring lean mass at any of the ages studied.CONCLUSION: Higher maternal dietary GI and GL in early pregnancy are associated with greater adiposity in childhood.
    American Journal of Clinical Nutrition 06/2014; 100(2). DOI:10.3945/ajcn.114.084905 · 6.92 Impact Factor
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    ABSTRACT: The consumer nutrition environment has been conceptualised as in-store environmental factors that influence food shopping habits. More healthful in-store environments could be characterised as those which promote healthful food choices such as selling good quality healthy foods or placing them in prominent locations to prompt purchasing. Research measuring the full-range of in-store environmental factors concurrently is limited.Purpose: To develop a summary score of 'healthfulness' composed of nine in-store factors that influence food shopping behaviour, and to assess this score by store type and neighbourhood deprivation.
    International Journal of Behavioral Nutrition and Physical Activity 05/2014; 11(1):69. DOI:10.1186/1479-5868-11-69 · 3.68 Impact Factor
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    ABSTRACT: Chronic cardiorespiratory disease is associated with low birthweight suggesting the importance of the developmental environment. Prenatal factors affecting fetal growth are believed important, but the underlying mechanisms are unknown. The influence of developmental programming on bronchial hyperreactivity is investigated in an animal model and evidence for comparable associations is sought in humans. Pregnant Wistar rats were fed either control or protein-restricted diets throughout pregnancy. Bronchoconstrictor responses were recorded from offspring bronchial segments. Morphometric analysis of paraffin-embedded lung sections was conducted. In a human mother-child cohort ultrasound measurements of fetal growth were related to bronchial hyperreactivity, measured at age six years using methacholine. Protein-restricted rats' offspring demonstrated greater bronchoconstriction than controls. Airway structure was not altered. Children with lesser abdominal circumference growth during 11-19 weeks' gestation had greater bronchial hyperreactivity than those with more rapid abdominal growth. Imbalanced maternal nutrition during pregnancy results in offspring bronchial hyperreactivity. Prenatal environmental influences might play a comparable role in humans.
    Scientific Reports 04/2014; 4:4705. DOI:10.1038/srep04705 · 5.58 Impact Factor
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    ABSTRACT: To determine adherence to nutritional guidelines by pregnant women in New Zealand and maternal characteristics associated with adherence. A cohort of the pregnant women enrolled into New Zealand's new birth cohort study, Growing Up in New Zealand. Women residing within a North Island region of New Zealand, where one-third of the national population lives. Pregnant women (n 5664) were interviewed during 2009-2010. An FFQ was administered during the face-to-face interview. The recommended daily number of servings of vegetables and fruit (≥6) were met by 25 % of the women; of breads and cereals (≥6) by 26 %; of milk and milk products (≥3) by 58 %; and of lean meat, meat alternatives and eggs (≥2) by 21 %. One in four women did not meet the recommendations for any food group. Only 3 % met all four food group recommendations. Although adherence to recommendation for the vegetables/fruit group did not vary by ethnicity (P=0·38), it did vary for the breads/cereals, milk/milk products and meat/eggs groups (all P<0·001). Adherence to recommendations for the vegetables/fruit group was higher among older women (P=0·001); for the breads/cereals group was higher for women with previous children (P<0·001) and from lower-income households (P<0·001); and for the meat/eggs group was higher for women with previous children (P=0·003) and from lower-income households (P=0·004). Most pregnant women in New Zealand do not adhere to nutritional guidelines in pregnancy, with only 3 % meeting the recommendations for all four food groups. Adherence varies more so with ethnicity than with other sociodemographic characteristics.
    Public Health Nutrition 04/2014; 17(9):1-11. DOI:10.1017/S1368980014000482 · 2.48 Impact Factor
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    ABSTRACT: A total of 148 health and social care practitioners were trained in skills to support behaviour change: creating opportunities to discuss health behaviours, using open discovery questions, listening, reflecting and goal-setting. At three time points post-training, use of the skills was evaluated and compared with use of skills by untrained practitioners. Trained practitioners demonstrated significantly greater use of these client-centred skills to support behaviour change compared to their untrained peers up to 1 year post-training. Because it uses existing services to deliver support for behaviour change, this training intervention has the potential to improve public health at relatively low cost.
    Journal of Health Psychology 04/2014; DOI:10.1177/1359105314523304 · 1.88 Impact Factor

Publication Stats

4k Citations
1,285.79 Total Impact Points

Institutions

  • 2000–2015
    • University of Southampton
      • MRC Lifecourse Epidemiology Unit
      Southampton, England, United Kingdom
  • 2013
    • University of Bristol
      Bristol, England, United Kingdom
  • 2010
    • The Bracton Centre, Oxleas NHS Trust
      Дартфорде, England, United Kingdom
  • 2005
    • University of Bergen
      Bergen, Hordaland, Norway
  • 1998
    • Poole Hospital NHS Foundation Trust
      Poole, England, United Kingdom