50 results found
Soukup T, Hull L, Smith EL, et al., 2019, Effectiveness-implementation hybrid type 2 trial evaluating two psychoeducational programmes for severe hypoglycaemia in type 1 diabetes: implementation study protocol., BMJ Open, Vol: 9
INTRODUCTION: Two of the most acute and feared complications in type 1 diabetes (T1D) are hypoglycaemia and severe hypoglycaemia (SH). While impaired awareness of hypoglycaemia (IAH) can lead to SH with cognitive and motivational barriers implicated, the available education does not integrate behavioural change techniques to address these. A novel Hypoglycaemia Awareness Restoration Programme despite optimised care (HARPdoc) is currently being tested against an established blood glucose awareness training (BGAT) within a parallel, two-arm, group randomised, blinded trial (with its own protocol; NCT02940873) with adults with T1D whose problems with hypoglycaemia and SH have persisted despite otherwise optimised insulin management. While both programmes are aimed at reducing hypoglycaemia, SH and IAH, it is the former that integrates behavioural change techniques.The aim of the current (implementation) study is to evaluate delivery of both HARPdoc and BGAT and explore associations between implementation outcomes and trial endpoints; as well as to develop an evidence-based implementation blueprint to guide implementation, sustainment and scale-up of the effective programmes. METHODS AND ANALYSIS: Guided by the implementation science tools, frameworks, methods and principles, the current study was designed through a series of focus groups (n=11) with the key intervention stakeholders (n=28)-including (1) individuals with lived experience of T1D, IAH and a pilot version of the HARPdoc (n=6) and (2) diabetes healthcare professionals (n=22). A mixed-methods approach will be used throughout. Stakeholder engagement has underpinned study design and materials to maximise relevance, feasibility and impact. ETHICS AND DISSEMINATION: The protocol has been reviewed and received ethical approval by the Harrow Research Ethics Committee (18/LO/1020; 240752) on 1 October 2018. The findings will be submitted to a peer-reviewed journal and presented at scientific meetings. TRIAL REGISTR
Polling C, Bakolis I, Hotopf M, et al., 2019, Differences in hospital admissions practices following self-harm and their influence on population-level comparisons of self-harm rates in South London: an observational study., BMJ Open, Vol: 9
OBJECTIVES: To compare the proportions of emergency department (ED) attendances following self-harm that result in admission between hospitals, examine whether differences are explained by severity of harm and examine the impact on spatial variation in self-harm rates of using ED attendance data versus admissions data. SETTING: A dataset of ED attendances and admissions with self-harm to four hospitals in South East London, 2009-2016 was created using linked electronic patient record data and administrative Hospital Episode Statistics. DESIGN: Proportions admitted following ED attendance and length of stay were compared. Variation and spatial patterning of age and sex standardised, spatially smoothed, self-harm rates by small area using attendance and admission data were compared and the association with distance travelled to hospital tested. RESULTS: There were 20 750 ED attendances with self-harm, 7614 (37%) resulted in admission. Proportion admitted varied substantially between hospitals with a risk ratio of 2.45 (95% CI 2.30 to 2.61) comparing most and least likely to admit. This was not altered by adjustment for patient demographics, deprivation and type of self-harm. Hospitals which admitted more had a higher proportion of admissions lasting less than 24 hours (54% of all admissions at highest admitting hospital vs 35% at lowest). A previously demonstrated pattern of lower rates of self-harm admission closer to the city centre was reduced when ED attendance rates were used to represent self-harm. This was not altered when distance travelled to hospital was adjusted for. CONCLUSIONS: Hospitals vary substantially in likelihood of admission after ED presentation with self-harm and this is likely due to the differences in hospital practices rather than in the patient population or severity of self-harm seen. Public health policy that directs resources based on self-harm admissions data could exacerbate existing health inequalities in inner-city areas
Bakolis I, Thornicroft G, Vitoratou S, et al., 2019, Development and validation of the DISCUS scale: A reliable short measure for assessing experienced discrimination in people with mental health problems on a global level, SCHIZOPHRENIA RESEARCH, Vol: 212, Pages: 213-220, ISSN: 0920-9964
Hull L, Goulding L, Khadjesari Z, et al., 2019, Designing high-quality implementation research: development, application, feasibility and preliminary evaluation of the implementation science research development (ImpRes) tool and guide, IMPLEMENTATION SCIENCE, Vol: 14, ISSN: 1748-5908
, 2019, Correction: Mental health of UK Members of Parliament in the House of Commons: a cross-sectional survey., BMJ Open, Vol: 9
Poulter D, Votruba N, Bakolis I, et al., 2019, Mental health of UK Members of Parliament in the House of Commons: a cross-sectional survey., BMJ Open, Vol: 9
OBJECTIVES: The purpose of this study was to assess (1) the overall mental health of Members of Parliament (MPs) and (2) awareness among MPs of the mental health support services available to them in Parliament. DESIGN: An anonymous self-completed online cross-sectional survey was conducted in December 2016. SETTING: 56th UK House of Commons. PARTICIPANTS: All 650 members of the 56th UK House of Commons were invited to participate; 146 MPs (23%) completed the survey. OUTCOMES: The General Health Questionnaire-12 was used to assess age- and sex-standardised prevalence of probable common mental disorders (CMD). Results were compared with a nationally representative survey, the Health Survey for England (HSE) 2014. Core demographic questions, MPs' awareness of available mental health services, their willingness to discuss mental health issues with party Whips and fellow MPs and the effects of employment outside Parliament were assessed. RESULTS: Comparison of MP respondents with HSE comparator groups found that MPs have higher rates of mental health problems (age- and sex-standardised prevalence of probable CMD in 49 surveyed MPs 34% (95% CI 27% to 42%) versus 17% (95% CI 13% to 21%) in the high-income comparison group). Survey respondents were younger, more likely to be female and more educated compared with all MPs. 77% of MPs (n=112) did not know how to access in-house mental health support. 52% (n=76) would not discuss their mental health with party Whips or other MPs (48%; n=70). CONCLUSIONS: MPs in the study sample had higher rates of mental health problems than rates seen in the whole English population or comparable occupational groups. Most surveyed MPs are unaware of mental health support services or how to access them. Our findings represent a relatively small sample of MPs. There is a need for MPs to have better awareness of, and access to, mental health support.
Amiel SA, Choudhary P, Jacob P, et al., 2019, Hypoglycaemia Awareness Restoration Programme for People with Type 1 Diabetes and Problematic Hypoglycaemia Persisting Despite Optimised Self-care (HARPdoc): protocol for a group randomised controlled trial of a novel intervention addressing cognitions., BMJ Open, Vol: 9
INTRODUCTION: Severe hypoglycaemia (SH), when blood glucose falls too low to support brain function, is the most feared acute complication of insulin therapy for type 1 diabetes mellitus (T1DM). 10% of people with T1DM contribute nearly 70% of all episodes, with impaired awareness of hypoglycaemia (IAH) a major risk factor. People with IAH may be refractory to conventional approaches to reduce SH, with evidence for cognitive barriers to hypoglycaemia avoidance. This paper describes the protocol for the Hypoglycaemia Awareness Restoration Programme for People with Type 1 Diabetes and Problematic Hypoglycaemia Persisting Despite Optimised Self-care (HARPdoc) study, a trial to assess the impact on hypoglycaemia experience of a novel intervention that addresses cognitive barriers to hypoglycaemia avoidance, compared with an existing control intervention, recommended by the National Institute of Health and Care Excellence. METHODS AND ANALYSIS: A randomised parallel two-arm trial of two group therapies: HARPdoc versus Blood Glucose Awareness Training, among 96 adults with T1DM and problematic hypoglycaemia, despite attendance at education with or without technology use, in four centres providing specialist T1DM services. The primary outcome will be the SH rate at 12 and/or 24 months after randomisation to either course. Secondary outcomes include rates of SH requiring parenteral therapy, involving unconsciousness or needing emergency services; hypoglycaemia awareness status, overall diabetes control and quality of life measures. An implementation study to evaluate how the interventions are delivered and how implementation impacts on clinical effectiveness is planned as a parallel study, with its own protocol. ETHICS AND DISSEMINATION: The protocol was approved by the London Dulwich Research Ethics Committee, the Health Research Authority, National Health Service R&D and the Institutional Review Board of the Joslin Diabetes Center in the USA. Study findings will be di
Thornicroft G, Bakolis I, Evans-Lacko S, et al., 2019, Key lessons learned from the INDIGO global network on mental health related stigma and discrimination, WORLD PSYCHIATRY, Vol: 18, Pages: 229-230, ISSN: 1723-8617
Michelini G, Jurgiel J, Bakolis I, et al., 2019, Atypical functional connectivity in adolescents and adults with persistent and remitted ADHD during a cognitive control task, TRANSLATIONAL PSYCHIATRY, Vol: 9, ISSN: 2158-3188
Deb T, Lempp H, Bakolis I, et al., 2019, Responding to experienced and anticipated discrimination (READ): anti -stigma training for medical students towards patients with mental illness - study protocol for an international multisite non-randomised controlled study, BMC Medical Education, Vol: 19, ISSN: 1472-6920
BackgroundStigma and discrimination are a significant public health concern and cause great distress to people with mental illness. Healthcare professionals have been identified as one source of this discrimination. In this article we describe the protocol of an international, multisite controlled study, evaluating the effectiveness of READ, an anti-stigma training for medical students towards patients with mental illness. READ aims to improve students’ ability to minimise perceived discriminatory behaviours and increase opportunities for patients, therefore developing the ability of future doctors to address and challenge mental illness related discrimination. READ includes components that medical education research has shown to be effective at improving attitudes, beliefs and understanding.Methods/designREAD training was developed using evidence based components associated with changes in stigma related outcomes. The study will take place in multiple international medical schools across high, middle and low income countries forming part of the INDIGO group network, with 25 sites in total. Students will be invited to participate via email from the lead researcher at each site during their psychiatry placement, and will be allocated to an intervention or a control arm according to their local teaching group at each site. READ training will be delivered solely to the intervention arm. Standardised measures will be used to assess students’ knowledge, attitudes and skills regarding discrimination in both the intervention and control groups, at baseline and at follow up immediately after the intervention. Statistical analyses of individual-level data will be conducted using random effects models accounting for clustering within sites to investigate changes in mean or percentages of each outcome, at baseline and immediately after the intervention.DiscussionThis is the first international study across high, middle and low income countries, which will evaluate
Polling C, Bakolis I, Hotopf M, et al., 2019, Spatial patterning of self-harm rates within urban areas, SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, Vol: 54, Pages: 69-79, ISSN: 0933-7954
Gazard B, Chui Z, Harber-Aschan L, et al., 2018, Barrier or stressor? The role of discrimination experiences in health service use, BMC PUBLIC HEALTH, Vol: 18, ISSN: 1471-2458
Bakolis I, Hooper R, Bachert C, et al., 2018, Dietary patterns and respiratory health in adults from nine European countries – evidence from the GA2LEN study, Clinical and Experimental Allergy, Vol: 48, Pages: 1474-1482, ISSN: 0954-7894
Background: Dietary patterns defined using Principal Component Analysis (PCA) offer an alternative to the analysis of individual foods and nutrients and have been linked with asthma and allergic disease. However, results have not been reproducible in different settings.Objective: To identify dietary patterns common to different European countries and examine their associations with asthma and allergic symptoms. Methods: In sixteen study centres in nine European countries, 3206 individuals aged 15-77 years completed a common, internationally validated, Food Frequency Questionnaire and a respiratory symptoms questionnaire. The outcomes of interest were current asthma, asthma symptoms score (derived based on responses to 5 asthma symptom-related questions), atopy (positive skin prick test). Spirometry was used to estimate forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), the FEV1/FVC, spirometric restriction (FVC below the lower limit of normal (<LLN)) and FEV1/FVC < LLN. A novel meta-analytic approach was used to identify dietary patterns using PCA and to examine associations with asthma and allergic symptoms.Results: Two dietary patterns emerged, generally correlating with the same foods in different countries: one associated with intake of animal proteins and carbohydrates; the other with fruit and vegetables. There was evidence that the former pattern was associated with a higher asthma score (RR 1.63, 95% CI: 1.33-2.01), current asthma (RR 2.03, 95% CI: 1.52-2.71), wheeze (RR 1.84, 95%CI: 1.30-2.60), atopic status (RR 1.68, 95%CI: 1.16-2.44) and with decreased lung function, including an FVC <LLN (RR 4.57, 95% CI: 2.27-9.21). Conclusions & Clinical Relevance: Our findings suggest an increase in sensitisation to common allergens, an increase in asthma symptoms and a reduction in lung function in those eating a diet rich in animal proteins and carbohydrates. We found little evidence of an association between these outcomes and
Yoshimura Y, Bakolis I, Henderson C, 2018, Psychiatric diagnosis and other predictors of experienced and anticipated workplace discrimination and concealment of mental illness among mental health service users in England, SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, Vol: 53, Pages: 1099-1109, ISSN: 0933-7954
Sadler E, Khadjesari Z, Ziemann A, et al., 2018, Case management for integrated care of frail older people in community settings, Cochrane Database of Systematic Reviews, Vol: 2018
© 2018 The Cochrane Collaboration. This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effectiveness of case management for integrated care of frail older people compared to usual care.
Barnard S, Free C, Bakolis I, et al., 2018, Comparing the characteristics of users of an online service for STI self-sampling with clinic service users: a cross-sectional analysis, SEXUALLY TRANSMITTED INFECTIONS, Vol: 94, Pages: 377-383, ISSN: 1368-4973
Garcia Larsen V, Morton V, Norat T, et al., 2018, Dietary patterns derived from Principal Component Analysis (PCA) and the risk of colorectal cancer: a systematic review and meta-analysis, European Journal of Clinical Nutrition, Vol: 73, Pages: 366-386, ISSN: 1476-5640
Background and aim: Colorectal cancer [CRC] is highly prevalent worldwide, with dietary habits being a major risk factor. We systematically reviewed and meta-analysed the observational evidence on the association between CRC and dietary patterns [DP] derived from Principal Component Analysis.Design: PRISMA guidelines were followed. Web of Science, Medline/PubMed, EMBASE, and The Cochrane Library were searched to identify all eligible papers published up to July 2017. Any pre-defined cancer in the colon was included, namely colon-rectal cancer (CRC), colon cancer (CC), rectal cancer (RC), or proximal and distal CC, if available. Western (WDP) and prudent (PDP) dietary patterns were compared as a proxy to estimate ‘unhealthy’ (Rich in meat and processed foods) and ‘healthy’ diets (containing fruits or vegetables), respectively. Meta-analyses were carried out using random effects model to calculate overall risk estimates. Relative risks (RR) and 95% confidence intervals were estimated comparing the highest versus the lowest categories of dietary patterns for any of the forms of colon cancer studied.Results: 28 studies were meta-analysed. A WDP was associated with increased risk of CRC (RR 1.25; 95% CI 1.11, 1.40), and of CC (RR 1.30; 95% CI 1.11, 1.52). A PDP was negatively associated with CRC (RR 0.81; 95% CI 0.73, 0.91). Sensitivity analyses showed that individuals from North- and South- American countries had a significantly higher risk of CRC than those from other continents. Conclusion: A PDP might reduce the risk of CRC. Conversely, a WDP is associated with a higher risk of disease.
East K, Hitchman SC, Bakolis I, et al., 2018, The Association Between Smoking and Electronic Cigarette Use in a Cohort of Young People, JOURNAL OF ADOLESCENT HEALTH, Vol: 62, Pages: 539-547, ISSN: 1054-139X
Hansell AL, Bakolis I, Cowie CT, et al., 2018, Childhood fish oil supplementation modifies associations between traffic related air pollution and allergic sensitisation, Environmental Health, Vol: 17, ISSN: 1476-069X
BackgroundStudies of potential adverse effects of traffic related air pollution (TRAP) on allergic disease have had mixed findings. Nutritional studies to examine whether fish oil supplementation may protect against development of allergic disease through their anti-inflammatory actions have also had mixed findings. Extremely few studies to date have considered whether air pollution and dietary factors such as fish oil intake may interact, which was the rationale for this study.MethodsWe conducted a secondary analysis of the Childhood Asthma Prevention Study (CAPS) birth cohort, where children were randomised to fish oil supplementation or placebo from early life to age 5 years. We examined interactions between supplementation and TRAP (using weighted road density at place of residence as our measure of traffic related air pollution exposure) with allergic disease and lung function outcomes at age 5 and 8 years.ResultsOutcome information was available on approximately 400 children (~ 70% of the original birth cohort). Statistically significant interactions between fish oil supplementation and TRAP were seen for house dust mite (HDM), inhalant and all-allergen skin prick tests (SPTs) and for HDM-specific interleukin-5 response at age 5. Adjusting for relevant confounders, relative risks (RRs) for positive HDM SPT were RR 1.74 (95% CI 1.22–2.48) per 100 m local road or 33.3 m of motorway within 50 m of the home for those randomised to the control group and 1.03 (0.76–1.41) for those randomised to receive the fish oil supplement. The risk differential was highest in an analysis restricted to those who did not change address between ages 5 and 8 years. In this sub-group, supplementation also protected against the effect of traffic exposure on pre-bronchodilator FEV1/FVC ratio.ConclusionsResults suggest that fish oil supplementation may protect against pro-allergic sensitisation effects of TRAP exposure. Strengths of this analysis are that supplementat
Bakolis I, Hammoud R, Smythe M, et al., 2018, Urban Mind: Using Smartphone Technologies to Investigate the Impact of Nature on Mental-Well-Being in Real Time, BIOSCIENCE, Vol: 68, Pages: 134-145, ISSN: 0006-3568
Carruthers S, Kinnaird E, Rudra A, et al., 2018, A cross-cultural study of autistic traits across India, Japan and the UK., Mol Autism, Vol: 9
Background: There is a global need for brief screening instruments that can identify key indicators for autism to support frontline professionals in their referral decision-making. Although a universal set of conditions, there may be subtle differences in expression, identification and reporting of autistic traits across cultures. In order to assess the potential for any measure for cross-cultural screening use, it is important to understand the relative performance of such measures in different cultures. Our study aimed to identify the items on the Autism Spectrum Quotient (AQ)-Child that are most predictive of an autism diagnosis among children aged 4-9 years across samples from India, Japan and the UK. Methods: We analysed parent-reported AQ-Child data from India (73 children with an autism diagnosis and 81 neurotypical children), Japan (116 children with autism and 190 neurotypical children) and the UK (488 children with autism and 532 neurotypical children). None of the children had a reported existing diagnosis of intellectual disability. Discrimination indices (DI) and positive predictive values (PPV) were used to identify the most predictive items in each country. Results: Sixteen items in the Indian sample, 15 items in the Japanese sample and 28 items in the UK sample demonstrated excellent discriminatory power (DI ≥ 0.5 and PPV ≥ 0.7), suggesting these items represent the strongest indicators for predicting an autism diagnosis within these countries. Across cultures, good performing items were largely overlapping, with five key indicator items appearing across all three countries (can easily keep track of several different people's conversations, enjoys social chit-chat, knows how to tell if someone listening to him/her is getting bored, good at social chit-chat, finds it difficult to work out people's intentions). Four items indicated potential cultural differences. One item was highly discriminative in Japan but poorly discrimina
Michelini G, Jurgiel J, Bakolis I, et al., 2017, Atypical functional connectivity in adolescents and adults with persistent and remitted ADHD
<jats:title>Abstract</jats:title><jats:p>We previously provided initial evidence for cognitive and event-related potential markers of persistence/remission of attention-deficit/hyperactivity disorder (ADHD) from childhood to adolescence and adulthood. In this follow-up study, using a novel brain-network connectivity approach, we aimed to examine whether functional connectivity reflects a marker of ADHD remission, or an enduring deficit unrelated to ADHD outcome. High-density EEG was recorded in 110 adolescents and young adults with childhood ADHD (87 persisters, 23 remitters) and 169 typically-developing individuals during an arrow-flanker task, eliciting cognitive control. Functional connectivity was quantified with network-based graph-theory metrics before target onset (pre-stimulus), during target processing (post-stimulus) and in the degree of change between pre-stimulus/post-stimulus. ADHD outcome was examined with parent-reported symptoms and impairment using both a categorical (DSM-IV) and a dimensional approach. Graph-theory measures converged in indicating that, compared to controls, ADHD persisters showed increased connectivity in pre-stimulus theta, alpha and beta and in post-stimulus beta (all p<.01), and reduced pre-stimulus/post-stimulus change in theta connectivity (p<.01). In the majority of indices showing ADHD persister-control differences, ADHD remitters differed from controls (all p<.05), but not from persisters. Similarly, connectivity measures were not associated with continuous outcome measures of ADHD symptoms and impairment in participants with childhood ADHD. These findings indicate that adolescents and young adults with persistent and remitted ADHD share atypical over-connectivity profiles and reduced ability to modulate connectivity patterns with task demands, compared to controls. Brain connectivity impairments may represent enduring deficits in individuals with childhood ADHD irrespective of diagno
Chamitava L, Bakolis I, Burney PGJ, et al., 2017, Respiratory health and dietary patterns in adults from ECRHS III, European-Respiratory-Society (ERS) International Congress, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Sampogna G, Bakolis I, Evans-Lacko S, et al., 2016, The impact of social marketing campaigns on reducing mental health stigma: Results from the 2009-2014 Time to Change programme., European Psychiatry, Vol: 40, Pages: 116-122, ISSN: 1778-3585
BACKGROUND: In England, during 2009-2014 the 'Time to Change' anti-stigma programme has included a social marketing campaign (SMC) using mass media channels, social media and social contact events but the efficacy of such approach has not been evaluated yet. METHODS: The target population included people aged between mid-twenties/mid-forties, from middle-income groups. Participants were recruited through an online market research panel, before and after each burst of the campaign (with a mean number of unique participants per each burst: 956.9±170.2). Participants completed an online questionnaire evaluating knowledge [Mental Health Knowledge Schedule (MAKS)]; attitudes [Community Attitudes toward Mental Illness (CAMI)]; and behaviours [Reported and Intended Behaviour Scale (RIBS)]. Socio-demographic data and level of awareness of the SMC were also collected. RESULTS: A total of 10,526 people were interviewed. An increasing usage of the SMC-media channels as well as of the level of awareness of SMC was found (P<0.001). Being aware of the SMC was found to be associated with higher score at MAKS (OR=0.95, CI=0.68 to 1.21; P<0.001), at 'tolerance and support' CAMI subscale (OR=0.12, CI=0.09 to 0.16; P<0.001), and at RIBS (OR=0.71, CI=0.51 to 0.92; P<0.001), controlling for confounders. CONCLUSION: The SMC represents an important way to effectively reduce stigma. Taking into account these positive findings, further population-based campaigns using social media may represent an effective strategy to challenge stigma.
Bartington SE, Bakolis I, Devakumar D, et al., 2016, Patterns of domestic exposure to carbon monoxide and particulate matter in households using biomass fuel in Janakpur, Nepal, Environmental Pollution, Vol: 220, Pages: 38-45, ISSN: 1873-6424
Household Air Pollution (HAP) from biomass cooking fuels is a major cause of morbidity and mortality in low-income settings worldwide. In Nepal the use of open stoves with solid biomass fuels is the primary method of domestic cooking. To assess patterns of domestic air pollution we performed continuous measurement of carbon monoxide (CO) and particulate Matter (PM2.5) in 12 biomass fuel households in Janakpur, Nepal. We measured kitchen PM2.5 and CO concentrations at one-minute intervals for an approximately 48-h period using the TSI DustTrak II 8530/SidePak AM510 (TSI Inc, St. Paul MN, USA) or EL-USB-CO data logger (Lascar Electronics, Erie PA, USA) respectively. We also obtained information regarding fuel, stove and kitchen characteristics and cooking activity patterns. Household cooking was performed in two daily sessions (median total duration 4 h) with diurnal variability in pollutant concentrations reflecting morning and evening cooking sessions and peak concentrations associated with fire-lighting. We observed a strong linear relationship between PM2.5 measurements obtained by co-located photometric and gravimetric monitoring devices, providing local calibration factors of 4.9 (DustTrak) and 2.7 (SidePak). Overall 48-h average CO and PM2.5 concentrations were 5.4 (SD 4.3) ppm (12 households) and 417.6 (SD 686.4) μg/m(3) (8 households), respectively, with higher average concentrations associated with cooking and heating activities. Overall average PM2.5 concentrations and peak 1-h CO concentrations exceeded WHO Indoor Air Quality Guidelines. Average hourly PM2.5 and CO concentrations were moderately correlated (r = 0.52), suggesting that CO has limited utility as a proxy measure for PM2.5 exposure assessment in this setting. Domestic indoor air quality levels associated with biomass fuel combustion in this region exceed WHO Indoor Air Quality standards and are in the hazardous range for human health.
Sampogna G, Bakolis I, Robinson E, et al., 2016, Experience of the Time to Change programme in England as predictor of mental health service users' stigma coping strategies, Epidemiology and Psychiatric Sciences, Vol: 26, Pages: 517-525, ISSN: 2045-7979
In the field of stigma research, an area of interest is the coping strategies that mental health service users can use in response to discriminatory experiences. As a part of the evaluation of the Time to Change (TTC) anti-stigma programme, the Viewpoint telephone survey was run annually in order to assess service users' reported levels of discrimination and selected coping strategies. The study aim is to test the extent to which experience of TTC programme is a positive predictor of selected coping strategies.Telephone interview surveys carried out by peer interviewers were conducted annually. ‘Educating others’ and ‘challenging’ coping strategies were assessed alongside anticipated and experienced discrimination.During 2011–2014, 3903 mental health service users were interviewed. Participants more often adopted the ‘educating others’ strategy (2.31 ± 0.01) than the ‘challenging’ strategy (2.15 ± 0.02) (p < 0.001). On the other hand, those who participated in campaign activities endorsed ‘challenging’ more frequently than people who were not aware of TTC (2.78 ± 1.23 v. 2.09 ± 1.08, p < 0.001). According to the multi-variate linear regression model, we found that being actively involved in TTC activities (OR = 0.74, CI: 0.29–1.19; p < 0.05), having a diagnosis of a depressive disorder (OR = 0.20, CI: 0.04–0.36; p < 0.05) or personality disorder (OR = 0.23, CI: 0.04–0.43; p < 0.05) were good predictors of endorsing a ‘challenging’ strategy even after adjusted for confounding variables.A positive relationship between participating in the TTC programme and using the ‘challenging’ strategy was found. There is still a need to disentangle the complex association between these two coping strategies and the role of anti-stigma campaigns, promoting further local activities led by service users and carers' as well as all other
Bakolis I, Kelly R, Fecht D, et al., 2016, Protective Effects of Smoke-free Legislation on Birth Outcomes in England: A Regression Discontinuity Design, Epidemiology, Vol: 27, Pages: 810-818, ISSN: 1531-5487
Background: Environmental tobacco smoke has an adverse impact on preterm birth and birthweight. England introduced a new law to make virtually all enclosed public places andworkplaces smoke free on July 1 2007. We investigated the effect of smoke-free legislation onbirth outcomes in England using Hospital Episode Statistics (HES) maternity data.Methods: We used regression discontinuity, a quasi-experimental study design, which canfacilitate valid causal inference, to analyse short-term effects of smoke-free legislation on birthweight, low birth weight, gestational age, preterm birth and small for gestational age.Results: We analysed 1,800,906 pregnancies resulting in singleton live-births in Englandbetween January 1 2005 and December 31 2009. In the one to five months following theintroduction of the smoking-free legislation, for those entering their third trimester, the risk oflow birth weight decreased by between 8% (95% CI: 4%-12%) and 14% (95% CI: 5%-23%),very low birth weight between 28% (95% CI: 19%-36%) and 32% (95% CI: 21%-41%), pretermbirth between 4% (95% CI: 1%-8%) and 9% (95% CI: 2%-16%), and small for gestational agebetween 5% (95% CI: 2%-8%) and 9% (95% CI: 2%-15%). The impact of the smoke-freelegislation varied by maternal age, deprivation, ethnicity and region.Conclusions: The introduction of smoke-free legislation in England had an immediate beneficialimpact on birth outcomes overall, although this benefit was not observed across all age, ethnic, ordeprivation groups.
Luciano M, Sampogna G, Del Vecchio V, et al., 2016, Pathways to care and duration of untreated psychosis in patients with a first episode of psychosis in Italy, International Journal of Culture and Mental Health, Vol: 9, Pages: 293-302, ISSN: 1754-2863
© 2016 Informa UK Limited, trading as Taylor & Francis Group. This study aimed to examine the pathways to care and the duration of untreated psychosis (DUP) in first-episode psychosis patients in Italy. Sociodemographic and clinical characteristics of patients were collected using an ad-hoc schedule. Pathways to care of patients were evaluated by the Nottingham Onset Schedule, administered to patients, key-relatives and key-workers. Forty patients from the Department of Psychiatry of University of Naples were recruited. Mean duration of untreated illness (DUI) was 135.9±145.9 weeks, main DUP was 27.4±26.7 weeks. First help-seeking contact, often mediated by close relatives, took place after 21.6±43.8 weeks from symptoms onset and was with general practitioners, neurologists or psychologists. Only 25% immediately referred to psychiatrists. Patients had 1.8±0.8 contacts with non-psychiatric medical professionals before referring to the mental health service, and the mean time between first contact and adequate psychiatric treatments (referral delay) was 26.6±64.1 weeks. The DUI and DUP was longer in patients with less education (p <.05) and in those with an insidious onset of symptoms (p <.01). Targeted interventions and information campaigns on at-risk populations, such as young people and their relatives, could reduce the DUP, thus improving the long-term outcome of psychotic disorders.
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