Publications
87 results found
Ramchandani P, O'Farrelly C, Babelis D, et al., 2017, Preventing enduring behavioural problems in young children through early psychological intervention (Healthy Start, Happy Start): study protocol for a randomized controlled trial, Trials, Vol: 18, ISSN: 1745-6215
Background: Behavioural problems are common in early childhood, and can result in enduring costs to the individualand society, including an increased risk of mental and physical illness, criminality, educational failure and drug andalcohol misuse. Most previous research has examined the impact of interventions targeting older children whendifficulties are more established and harder to change, and have rarely included fathers. We are conducting a trial of apsychological intervention delivered to families with very young children, engaging both parents where possible.Methods: This study is a two-arm, parallel group, researcher-blind, randomized controlled trial, to test the clinicaleffectiveness and cost-effectiveness of a parenting intervention, Video Feedback Intervention to Promote PositiveParenting and Sensitive Discipline (VIPP-SD) for parents of young children (12–36 months) at risk of behaviouraldifficulties. VIPP-SD is an evidence-based parenting intervention developed at Leiden University in the Netherlandswhich uses a video-feedback approach to support parents, particularly by enhancing parental sensitivity and sensitivediscipline in caring for children.The trial will involve 300 families, who will be randomly allocated into either an intervention group, who will receivethe video-feedback intervention (n = 150), or a control group, who will receive treatment as usual (n = 150). The trialwill evaluate whether VIPP-SD, compared to treatment as usual, leads to lower levels of behavioural problems in youngchildren who are at high risk of developing these difficulties. Assessments will be conducted at baseline, and 5 and24 months post-randomization. The primary outcome measure is a modified version of the Preschool Parental Accountof Child Symptoms (Pre-PACS), a structured clinical interview of behavioural symptoms. Secondary outcomes includecaregiver-reported behavioural difficulties, parenting behaviours, parental sensitivity, parental mood and anxiety a
Harris MJ, Marti J, Watt H, et al., 2017, Explicit Bias Toward High-Income Country Research: A Randomized, Blinded, Crossover Experiment Of English Clinicians, Health Affairs, Vol: 36, Pages: 1997-2004, ISSN: 0278-2715
Unconscious bias may interfere with the interpretation of research from some settings, particularly from lower-income countries. Most studies of this phenomenon have relied on indirect outcomes such as article citation counts and publication rates; few have addressed or proven the effect of unconscious bias in evidence interpretation. In this randomized, blinded crossover experiment in a sample of 347 English clinicians, we demonstrate that changing the source of a research abstract from a low- to a high-income country significantly improves how it is viewed, all else being equal. Using fixed-effects models, we measured differences in ratings for strength of evidence, relevance, and likelihood of referral to a peer. Having a high-income-country source had a significant overall impact on respondents’ ratings of relevance and recommendation to a peer. Unconscious bias can have far-reaching implications for the diffusion of knowledge and innovations from low-income countries.
Cowling TE, Laverty AA, Harris MJ, et al., 2017, Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey, Journal of the Royal Society of Medicine, Vol: 110, Pages: 440-451, ISSN: 1758-1095
Objective: To examine associations between the contractand ownership type of general practices and patient experiencein England.Design: Multilevel linear regression analysis of a nationalcross-sectional patient survey (General Practice PatientSurvey).Setting: All general practices in England in 2013–2014(n ¼ 8017).Participants: 903,357 survey respondents aged 18 years orover and registered with a general practice for six monthsor more (34.3% of 2,631,209 questionnaires sent).Main outcome measures: Patient reports of experienceacross five measures: frequency of consulting a preferreddoctor; ability to get a convenient appointment; rating ofdoctor communication skills; ease of contacting the practiceby telephone; and overall experience (measured onfour- or five-level interval scales from 0 to 100). Modelsadjusted for demographic and socioeconomic characteristicsof respondents and general practice populations and arandom intercept for each general practice.Results: Most practices had a centrally negotiated contractwith the UK government (‘General Medical Services’54.6%; 4337/7949). Few practices were limited companieswith locally negotiated ‘Alternative Provider MedicalServices’ contracts (1.2%; 98/7949); these practices providedworse overall experiences than General MedicalServices practices (adjusted mean difference 3.04, 95%CI 4.15 to 1.94). Associations were consistent in directionacross outcomes and largest in magnitude for frequencyof consulting a preferred doctor (12.78, 95% CI15.17 to 10.39). Results were similar for practicesowned by large organisations (defined as having 20 practices)which were uncommon (2.2%; 176/7949).Conclusions: Patients registered to general practicesowned by limited companies, including large organisations,reported worse experiences of their care than otherpatients in 2013–2014.
Woringer M, cecil E, watt H, et al., 2017, Evaluation of community provision of a preventive cardiovascular programme - the National Health Service Health Check in reaching the under-served groups by primary care in England: cross sectional observational study, BMC Health Services Research, Vol: 17, ISSN: 1472-6963
Background:Cardiovascular disease (CVD) is the leading cause of premature mortality and a major contributor of health inequalities in England. Compared to more affluent and white counterparts, deprived people and ethnic minorities tend to die younger due to preventable CVD associated with lifestyle. In addition, deprived, ethnic minorities and younger people are less likely to be served by CVD prevention services. This study assessed the effectiveness of community-based outreach providers in delivering England’s National Health Services (NHS) Health Check programme, a CVD preventive programme to under-served groups.Methods:Between January 2008 and October 2013, community outreach providers delivered a preventive CVD programme to 50,573 individuals, in their local communities, in a single consultation without prescheduled appointments. Community outreach providers operated on evenings and weekends as well as during regular business hours in venues accessible to the general public. After exclusion criteria, we analysed and compared socio-demographic data of 43,177 Health Check attendees with the general population across 38 local authorities (LAs). We assessed variation between local authorities in terms of age, sex, deprivation and ethnicity structures using two sample t-tests and within local authority variation in terms of ethnicity and deprivation using Chi squared tests and two sample t-tests respectively.Results:Using Index of Multiple Deprivation, the mean deprivation score of the population reached by community outreach providers was 6.01 higher (p < 0.05) than the general population. Screened populations in 29 of 38 LAs were significantly more deprived (p < 0.05). No statistically significant difference among ethnic minority groups was observed between LAs. Nonetheless some LAs – namely Leicester, Thurrock, Sutton, South Tyneside, Portsmouth and Gateshead were very successful in recruiting ethnic minority groups. The mean proportion of men s
Fayaz A, Watt HC, Langford RM, et al., 2017, The Association Between Chronic Pain and Cardiac Disease: A Cross-sectional Population Study, Clinical Journal of Pain, Vol: 32, Pages: 1062-1068, ISSN: 0749-8047
Objectives: Chronic pain may increase the risk of cardiac disease, but the extent to which confounding variables account for this association has yet to be satisfactorily established. This study aims to examine the possibility of an independent association between these 2 variables.Methods: We applied logistic regression analysis to data from 8596 adults surveyed in a population study of the health of the population of England. The association between cardiac disease (angina and/or myocardial infarction) and chronic pain (pain lasting >3 months) was explored, taking account of 10 potentially confounding variables including the regular use of nonsteroidal anti-inflammatory drugs.Results: Participants reporting chronic pain (n=3023) were more likely to experience cardiac disease than those without pain: odds ratio (OR), 1.55; 95% confidence interval (CI), 1.15-2.07. Subsets of participants fulfilling various criteria for high-intensity chronic pain demonstrated stronger associations with cardiac disease suggesting a “dose-response” element to the relationship: chronic widespread pain (OR, 3.3; 95% CI, 1.42-7.68); higher-disability chronic pain (OR, 2.35; 95% CI, 1.71-3.23); and higher average chronic pain score (OR, 1.95; 95% CI, 1.40-2.71). Adjustment for regular prescription of nonsteroidal anti-inflammatory drugs did not reduce the association of chronic pain with cardiac disease.Discussion: Patients reporting chronic pain, in particular those most severely affected, may be at significantly increased risk of cardiac disease. Future studies should focus on determining whether reducing the impact of chronic pain can improve cardiac health.
Smith TDH, Watt H, Gunn L, et al., 2016, Recommending oral probiotics to reduce winter antibiotic prescriptions in people with asthma: a pragmatic randomized controlled trial, Annals of Family Medicine, Vol: 14, Pages: 422-430, ISSN: 1544-1717
PURPOSE Evidence from studies mainly in children has shown that orally administered probiotics may prevent respiratory tract infections and associated antibiotic use. We evaluated whether advice to take daily probiotics can reduce antibiotic prescribing for winter respiratory tract infections in people with asthma.METHODS We conducted a randomized controlled, parallel-group pragmatic study for participants aged 5 years and older with asthma in a UK primary care setting. The intervention was a postal leaflet with advice to take daily probiotics from October 2013 to March 2014, compared with a standard winter advice leaflet. Primary outcome was the proportion of participants prescribed antibiotics for respiratory tract infections.RESULTS There were 1,302 participants randomly assigned to a control group (n = 650) or intervention group (n = 652). There was no significant difference in the primary outcome measure, with 27.7% receiving antibiotics in the intervention group and 26.9% receiving antibiotics in the control group (odds ratio = 1.04; 95% CI, 0.82–1.34). Uptake of probiotics was low, but outcomes were similar in those who accessed probiotics (adjusted odds ratio = 1.08; 95% CI, 0.69–1.69, compared with controls). We also found no evidence of an effect on respiratory tract infections or asthma exacerbations.CONCLUSIONS In this pragmatic community-based trial in people with asthma, we found no evidence that advising use of winter probiotics reduces antibiotic prescribing.
Nambron R, Silajdzic E, Kalliolia E, et al., 2016, A Metabolic Study of Huntington's Disease, PLOS One, Vol: 11, ISSN: 1932-6203
Background: Huntington’s disease patients have a number of peripheral manifestations suggestive of metabolic and endocrine abnormalities. We, therefore, investigated a number of metabolic factors in a 24-hour study of Huntington’s disease gene carriers (premanifest and moderate stage II/III) and controls.Methods:Control (n = 15), premanifest (n = 14) and stage II/III (n = 13) participants were studied with blood sampling over a 24-hour period. A battery of clinical tests including neurological rating and function scales were performed. Visceral and subcutaneous adipose distribution was measured using magnetic resonance imaging. We quantified fasting baseline concentrations of glucose, insulin, cholesterol, triglycerides, lipoprotein (a), fatty acids, amino acids, lactate and osteokines. Leptin and ghrelin were quantified in fasting samples and after a standardised meal. We assessed glucose, insulin, growth hormone and cortisol concentrations during a prolonged oral glucose tolerance test.Results:We found no highly significant differences in carbohydrate, protein or lipid metabolism markers between healthy controls, premanifest and stage II/III Huntington’s disease subjects. For some markers (osteoprotegerin, tyrosine, lysine, phenylalanine and arginine) there is a suggestion (p values between 0.02 and 0.05) that levels are higher in patients with premanifest HD, but not moderate HD. However, given the large number of statistical tests performed interpretation of these findings must be cautious.Conclusions:Contrary to previous studies that showed altered levels of metabolic markers in patients with Huntington’s disease, our study did not demonstrate convincing evidence of abnormalities in any of the markers examined. Our analyses were restricted to Huntington’s disease patients not taking neuroleptics, anti-depressants or other medication affecting metabolic pathways. Even with the modest sample sizes studied, the lack of highly signific
Kalliolia E, Silajdzic E, Nambron R, et al., 2015, A 24-Hour Study of the Hypothalamo-Pituitary Axes in Huntington's Disease, PLOS One, Vol: 10, ISSN: 1932-6203
Background: Huntington’s disease is an inherited neurodegenerative disorder characterised by motor, cognitive and psychiatric disturbances. Patients exhibit other symptoms including sleep and mood disturbances, muscle atrophy and weight loss which may be linked to hypothalamic pathology and dysfunction of hypothalamo-pituitary axes.Methods: We studied neuroendocrine profiles of corticotropic, somatotropic and gonadotropic hypothalamo-pituitary axes hormones over a 24-hour period in controlled environment in 15 healthy controls, 14 premanifest and 13 stage II/III Huntington’s disease subjects. We also quantified fasting levels of vasopressin, oestradiol, testosterone, dehydroepiandrosterone sulphate, thyroid stimulating hormone, free triiodothyronine, free total thyroxine, prolactin, adrenaline and noradrenaline. Somatotropic axis hormones, growth hormone releasing hormone, insulin-like growth factor-1 and insulin-like factor binding protein-3 were quantified at 06:00 (fasting), 15:00 and 23:00. A battery of clinical tests, including neurological rating and function scales were performed.Results: 24-hour concentrations of adrenocorticotropic hormone, cortisol, luteinizing hormone and follicle-stimulating hormone did not differ significantly between the Huntington’s disease group and controls. Daytime growth hormone secretion was similar in control and Huntington’s disease subjects. Stage II/III Huntington’s disease subjects had lower concentration of post-sleep growth hormone pulse and higher insulin-like growth factor-1:growth hormone ratio which did not reach significance. In Huntington’s disease subjects, baseline levels of hypothalamo-pituitary axis hormones measured did not significantly differ from those of healthy controls.Conclusions: The relatively small subject group means that the study may not detect subtle perturbations in hormone concentrations. A targeted study of the somatotropic axis in larger cohorts may be warran
Cowling TE, Harris M, Watt H, et al., 2015, Access to primary care and the route of emergency admission to hospital: retrospective analysis of national hospital administrative data, BMJ Quality & Safety, Vol: 25, Pages: 432-440, ISSN: 2044-5415
Background The UK government is pursuing policies to improve primary care access, as many patients visit accident and emergency (A and E) departments after being unable to get suitable general practice appointments. Direct admission to hospital via a general practitioner (GP) averts A and E use, and may reduce total hospital costs. It could also enhance the continuity of information between GPs and hospital doctors, possibly improving healthcare outcomes.Objective To determine whether primary care access is associated with the route of emergency admission—via a GP versus via an A and E department.Methods Retrospective analysis of national administrative data from English hospitals for 2011–2012. Adults admitted in an emergency (unscheduled) for ≥1 night via a GP or an A and E department formed the study population. The measure of primary care access—the percentage of patients able to get a general practice appointment on their last attempt—was derived from a large, nationally representative patient survey. Multilevel logistic regression was used to estimate associations, adjusting for patient and admission characteristics.Results The analysis included 2 322 112 emergency admissions (81.9% via an A and E department). With a 5 unit increase in the percentage of patients able to get a general practice appointment on their last attempt, the adjusted odds of GP admission (vs A and E admission) was estimated to increase by 15% (OR 1.15, 95% CI 1.12 to 1.17). The probability of GP admission if ≥95% of appointment attempts were successful in each general practice was estimated to be 19.6%. This probability reduced to 13.6% when <80% of appointment attempts were successful. This equates to 139 673 fewer GP admissions (456 232 vs 316 559) assuming no change in the total number of admissions. Associations were consistent in direction across geographical regions of England.Conclusions Among hospital inpatients admitted as an emergency, patients
Watt H, Harris M, Noyes J, et al., 2015, Development of a composite outcome score for a complex intervention - measuring the impact of Community Health Workers, Trials, Vol: 16, ISSN: 1745-6215
BackgroundIn health services research, composite scores to measure changes in health-seeking behaviour and uptake of services do not exist. We describe the rationale and analytical considerations for a composite primary outcome for primary care research. We simulate its use in a large hypothetical population and use it to calculate sample sizes. We apply it within the context of a proposed cluster randomised controlled trial (RCT) of a Community Health Worker (CHW) intervention.MethodsWe define the outcome as the proportion of the services (immunizations, screening tests, stop-smoking clinics) received by household members, of those that they were eligible to receive. First, we simulated a population household structure (by age and sex), based on household composition data from the 2011 England and Wales census. The ratio of eligible to received services was calculated for each simulated household based on published eligibility criteria and service uptake rates, and was used to calculate sample size scenarios for a cluster RCT of a CHW intervention. We assume varying intervention percentage effects and varying levels of clustering.ResultsAssuming no disease risk factor clustering at the household level, 11.7% of households in the hypothetical population of 20,000 households were eligible for no services, 26.4% for 1, 20.7% for 2, 15.3% for 3 and 25.8% for 4 or more. To demonstrate a small CHW intervention percentage effect (10% improvement in uptake of services out of those who would not otherwise have taken them up, and additionally assuming intra-class correlation of 0.01 between households served by different CHWs), around 4,000 households would be needed in each of the intervention and control arms. This equates to 40 CHWs (each servicing 100 households) needed in the intervention arm. If the CHWs were more effective (20%), then only 170 households would be needed in each of the intervention and control arms.ConclusionsThis is a useful first step towards a proce
Laverty AA, Elkin SL, Watt HC, et al., 2015, Impact of a COPD Discharge Care Bundle on Readmissions following Admission with Acute Exacerbation: Interrupted Time Series Analysis, PLOS ONE, Vol: 10, ISSN: 1932-6203
- Author Web Link
- Open Access Link
- Cite
- Citations: 28
Laverty AA, Diethelm P, Hopkinson NS, et al., 2015, Use and abuse of statistics in tobacco industry-funded research on standardised packaging, Tobacco Control, Vol: 24, Pages: 422-424, ISSN: 0964-4563
n this commentary we consider the validity of tobacco industry-funded research on the effects of standardised packaging in Australia. As the first country to introduce standardised packs, Australia is closely watched, and Philip Morris International has recently funded two studies into the impact of the measure on smoking prevalence. Both of these papers are flawed in conception as well as design but have nonetheless been widely publicised as cautionary tales against standardised pack legislation. Specifically, we focus on the low statistical significance of the analytical methods used and the assumption that standardised packaging should have an immediate large impact on smoking prevalence.
Koshy E, Watt H, Curcin V, et al., 2015, Tonsillectomy among children with low baseline acute throat infection consultation rates in UK general practices: a cohort study, BMJ Open, Vol: 5, ISSN: 2044-6055
Objective: To investigate the effectiveness oftonsillectomy in reducing acute throat infection (ATI)consultation rates over 6 years’ follow-up amongchildren with low baseline ATI consultation rates.Design: Retrospective cohort study.Setting: UK general practices from the ClinicalPractice Research Datalink.Participants: Children aged 4–15 years with ≤3 ATIconsultations during the 3 years prior to 2001(baseline). 450 children who underwent tonsillectomy(tonsillectomy group) and 13 442 other children withan ATI consultation (comparison group) in 2001.Main outcome measures: Mean differences in ATIconsultation rates over the first 3 years’ andsubsequent 3 years’ follow-up compared with 3 yearsprior to 2001 (baseline); odds of ≥3 ATI consultationsat the same time points.Results: Among children in the tonsillectomy group,the 3-year mean ATI consultation rate decreased from1.31 to 0.66 over the first 3 years’ follow-up andfurther declined to 0.60 over the subsequent 3 years’follow-up period. Compared with children who had nooperation, those who underwent tonsillectomyexperienced a reduction in 3-year mean ATIconsultations per child of 2.5 (95% CI 2.3 to 2.6,p<0.001) over the first 3 years’ follow-up, but only 1.2(95% CI 1.0 to 1.4, p<0.001) over the subsequent3 years’ follow-up compared with baseline,respectively. This equates to a mean reduction of 3.7ATI consultations over a 6-year period andapproximates to a mean annual reduction of 0.6 ATIconsultations per child, per year, over 6 years’ followup.Children who underwent tonsillectomy were alsomuch less likely to experience ≥3 ATI consultationsduring the first 3 years’ follow-up (adjusted OR=0.12,95% CI 0.08 to 0.17) and the subsequent 3 years’follow-up (adjusted OR=0.24, 95% CI 0.14 to 0.41).Conclusions: Among children with low baseline ATIrates, there was a statistically significant reduction inATI consultation rates over 6 years’ foll
Woringer M, Cecil E, Watt H, et al., 2015, Community Providers of the NHS Health Check CVD Prevention Programme Target Younger and More Deprived People, Publisher: UBIQUITY PRESS LTD, ISSN: 1568-4156
Hassanien AA, Majeed A, Watt H, 2014, Retrospective observational study examining indications for hospitalisation among haemodialysis patients at one of the Ministry of Health Hospitals in Makkah, Saudi Arabia., JRSM Open, Vol: 5, Pages: 1-11, ISSN: 2054-2704
OBJECTIVES: To examine the indications for hospitalisations among haemodialysis patients. DESIGN: A retrospective observational study. SETTING: Alnoor Kidney Centre in Al Noor Specialist Hospital, Makkah City, Saudi Arabia, which is a Ministry of Health hospital. PARTICIPANTS: Participants were prevalent patients with end-stage renal disease on regular haemodialysis in 2011, who had received haemodialysis for more than three months. Each patient was followed up retrospectively, from the first date of initiating haemodialysis to the end of 2011. MAIN OUTCOME MEASURES: (i) The primary reasons for hospital admissions and (ii) risk factors that increase the number of hospital admissions and which increase length of stay in hospital. RESULTS: The primary reasons for hospital admissions associated with increases in the length of stay in hospital were diseases of the circulatory system (which increased hospital bed days by 70%; 95% CI: 11-161%; p value = 0.01 compared to all other reasons). The risk factors that increased the number of hospital admissions per patient-year at risk were increasing age (incidence rate ratio [IRR] = 1.02 per 1 year of age; 95% CI: 1.01-1.03; p value = < 0.0001); receiving haemodialysis through a catheter compared to arteriovenous fistula (IRR = 2.55; 95% CI: 1.14-4.97; p value = 0.001) and diabetes as a cause of renal disease compared to hypertension (IRR = 1.84; 95% CI: 1.29-2.63; p value = 0.001). CONCLUSION: Indications for hospitalisation and consequences of practices related to hospitalisation for haemodialysis patients should be studied in further research to provide a comprehensive evidence-based management policy for haemodialysis patients in Saudi Arabia.
Kalliolia E, Silajdzic E, Nambron R, et al., 2014, Plasma Melatonin Is Reduced in Huntington's Disease, MOVEMENT DISORDERS, Vol: 29, Pages: 1511-1515, ISSN: 0885-3185
- Author Web Link
- Cite
- Citations: 71
Silajdzic E, Kalliolia E, Nambron R, et al., 2014, A STUDY OF THE HYPOTHALAMO-PITUITARY AXES IN HUNTINGTON'S DISEASE, 8th European-Huntington's-Disease-Network Plenary Meeting, Publisher: BMJ PUBLISHING GROUP, Pages: A32-A33, ISSN: 0022-3050
Cowling TE, Harris MJ, Watt HC, et al., 2014, Access to general practice and visits to accident and emergency departments in England: cross-sectional analysis of a national patient survey, British Journal of General Practice, Vol: 64, Pages: e434-e439, ISSN: 1478-5242
Laverty AA, Watt HC, Arnott D, et al., 2014, Standardised packaging and tobacco-industry-funded research, The Lancet
Adomaviciute S, Watt H, Soljak M, et al., 2014, Impact of the Integrated Care Pilot on HbA1c, cholesterol and systolic blood pressure levels in patients with diabetes, DIABETIC MEDICINE, Vol: 31, Pages: 175-175, ISSN: 0742-3071
Soljak M, Watt H, Adomaviciute S, et al., 2014, Impact of the Northwest London Integrated Care Pilot on diabetes control, INTERNATIONAL JOURNAL OF INTEGRATED CARE, Vol: 14, ISSN: 1568-4156
- Author Web Link
- Cite
- Citations: 1
Laverty AA, Elkin SL, Watt H, et al., 2013, Implementation of a COPD discharge care bundle and hospital readmissions in london, British Thoracic Society Winter Meeting 2013
Blanchard-Rohner G, Watt H, Kelly DF, et al., 2012, Baseline polysaccharide-specific antibodies may not consistently inhibit booster antibody responses in infants to a serogroup C meningococcal protein-polysaccharide conjugate vaccine., Vaccine, Vol: 30, Pages: 4153-4159
Negative correlations between baseline antibody concentrations and increases in antibody concentrations (after booster doses of vaccines) have been reported previously. Such correlation coefficients are widely reported by statisticians to be subject to mathematical coupling. Negative correlations may be attributable partly or wholly to the combination of mathematical coupling and measurement error (or other short term fluctuations in measurements) and therefore not clinically interpretable. In this study we re-analysed the serum antibody responses from five clinical trials of serogroup C meningococcal conjugate vaccine (MenCV) given to infants for priming followed by boosting with MenCV or a meningococcal A/C polysaccharide vaccine (MenA/C) at 12 months of age. Using Pearson's correlation method to assess the effect of pre-booster MenC-IgG concentration on the relative increase in MenC-IgG concentration post-booster, a significant negative correlation was observed for all the groups, indicating that high pre-booster antibody was associated with a smaller rise in antibody post-booster. We tested two additional statistical methods that account for mathematical coupling. Using Blomqvist method of adjustment to assess the plausible extent of bias, correlation coefficients were still negative providing error variance was low. The other method, a multilevel modelling specification of Oldham's method appeared not to be appropriate. In contrast, using Pearson's correlation method a consistent negative correlation between carrier protein-specific baseline antibody concentration and the increase in MenC-specific antibody concentration was only observed following booster immunisation with the protein-polysaccharide conjugate vaccine but not following the MenA/C plain polysaccharide vaccine. These findings suggest that analysis of the inhibitory effect of baseline antibody on the response to booster immunisation is challenging and should account for the possibility of mathemati
Kamaruzzaman S, Watt H, Carson C, et al., 2010, The association between orthostatic hypotension and medication use in the British Women's Heart and Health Study., Age Ageing, Vol: 39, Pages: 51-56
OBJECTIVE: to determine the prevalence of orthostatic hypotension (OH) and associations with medication use in community-dwelling older women. DESIGN: cross-sectional analysis using data from the British Women's Heart and Health Study. SETTING: general practices in 23 towns in the UK. PARTICIPANTS: 3,775 women aged 60-80 years from 1999 to 2001. MAIN OUTCOME MEASURE: orthostatic hypotension-drop of > or =20 mmHg in systolic and/or a drop of > or =10 mmHg in diastolic blood pressure on standing. RESULTS: prevalence of OH was 28% (95% confidence interval [CI] 26.6, 29.4), which increased with age and hypertension. Regardless of treatment status or diagnosed hypertension, raised blood pressure was strongly associated with OH (P < 0.001). OH was strongly associated with number of antihypertensives taken (none vs three or more: odds ratio [OR] 2.24, 95% CI 1.47-3.40, P < 0.001); the association was slightly attenuated after allowing for age and co-morbidities (OR 1.99; 95% CI 1.30, 3.05; P = 0.003). Women with multiple co-morbidities had markedly increased odds of OH independent of age, number and type of medications taken (none vs four or more diagnoses: OR 2.28, 95% CI 1.58-3.30, P = 0.005). CONCLUSION: uncontrolled hypertension, use of three or more antihypertensives and multiple co-morbidities are predictors of OH in older women. Detection or monitoring of OH in these groups may prevent women from suffering its adverse consequences.
Bowers KM, Bell D, Chiodini PL, et al., 2009, Inter-rater reliability of malaria parasite counts and comparison of methods, MALARIA JOURNAL, Vol: 8
- Author Web Link
- Cite
- Citations: 26
Rees J, Watt H, Jager HR, et al., 2009, Volumes and growth rates of untreated adult low-grade gliomas indicate risk of early malignant transformation, EUROPEAN JOURNAL OF RADIOLOGY, Vol: 72, Pages: 54-64, ISSN: 0720-048X
- Author Web Link
- Cite
- Citations: 95
Watt HC, Carson C, Lawlor DA, et al., 2009, Influence of life course socioeconomic position on older women's health behaviors: findings from the British Women's Heart and Health Study., Am J Public Health, Vol: 99, Pages: 320-327
OBJECTIVES: We examined the association between health behaviors and socioeconomic status (SES) in childhood and adult life. METHODS: Self-reported diet, smoking, and physical activity were determined among 3523 women aged 60 to 79 years recruited from general practices in 23 British towns from 1999 through 2001. RESULTS: The most affluent women reported eating more fruit, vegetables, chicken, and fish and less red or processed meat than did less affluent women. Affluent women were less likely to smoke and more likely to exercise. Life course SES did not influence the types of fat, bread, and milk consumed. Adult SES predicted consumption of all foods considered and predicted smoking and physical activity habits independently of childhood SES. Childhood SES predicted fruit and vegetable consumption independently of adult SES and, to a lesser extent, predicted physical activity. Downward social mobility over the life course was associated with poorer diets and reduced physical activity. CONCLUSIONS: Among older women, healthful eating and physical activity were associated with both current and childhood SES. Interventions designed to improve social inequalities in health behaviors should be applied during both childhood and adult life.
Andersen AF, Carson C, Watt HC, et al., 2008, Life-course socio-economic position, area deprivation and Type 2 diabetes: findings from the British Women's Heart and Health Study., Diabet Med, Vol: 25, Pages: 1462-1468
OBJECTIVES: We examined whether area deprivation influenced risk of Type 2 diabetes, fasting blood glucose and insulin resistance over and above the effect of individual socio-economic position (SEP) measured across the life course. METHODS: A cross-sectional analysis of 4286 women aged 60 to 79 years from 457 British electoral wards in 23 towns. RESULTS: Area deprivation was positively associated with diagnosed [odds ratio (OR) 1.32, 95% confidence interval (CI) 1.13, 1.53, per quintile of area deprivation, n = 2895], but not undiagnosed Type 2 diabetes after adjustment for individual life-course SEP. This association was robust to adjustment for adult health behaviours and physiological risk factors. Insulin resistance [homeostasis model assessment (HOMA) score] increased by 1.90% (95% CI 0.01, 3.82, n = 2526) per quintile of area deprivation after adjustment for individual SEP, while fasting blood glucose increased by 0.69% (95% CI 0.16, 1.22, n = 2875) after adjustment for individual SEP. CONCLUSIONS: Area level deprivation independently influences diagnosed Type 2 diabetes, insulin resistance and fasting blood glucose. Examination of more specific characteristics of places is needed to understand the mechanisms by which these effects arise.
Barnes TRE, Leeson VC, Mutsatsa SH, et al., 2008, Duration of untreated psychosis and social function: 1-year follow-up study of first-episode schizophrenia, BRITISH JOURNAL OF PSYCHIATRY, Vol: 193, Pages: 203-209, ISSN: 0007-1250
- Author Web Link
- Cite
- Citations: 105
Joyce EM, Leeson VC, Mutsatsa SH, et al., 2007, Is the effect of dup on social function mediated via negative symptoms? A one-year follow-up study of first-episode psychosis, 11th International Congress on Schizophrenia Research/8th Biennial Mt Sinai Conference on Cognition in Schizophrenia, Publisher: OXFORD UNIV PRESS, Pages: 592-593, ISSN: 0586-7614
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.