Imperial College London

DR IOANNIS BAKOLIS

Faculty of MedicineSchool of Public Health

Honorary Research Associate
 
 
 
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Contact

 

+44 (0)20 7594 3277i.bakolis Website

 
 
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Location

 

531Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

46 results found

Poulter D, Votruba N, Bakolis I, Debell F, Das-Munshi J, Thornicroft Get 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.

Journal article

Poulter D, Votruba N, Bakolis I, 2019, Correction: Mental health of UK members of parliament in the house of commons: A cross-sectional survey (BMJ Open (2019) 9 (e027892) DOI: 10.1136/bmjopen-2018-027892), BMJ Open, Vol: 9

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This article was previously published with an error. The statement 'DP and NV are joint first authors' was missing.

Journal article

Amiel SA, Choudhary P, Jacob P, Smith EL, De Zoysa N, Gonder-Frederick L, Kendall M, Heller S, Brooks A, Toschi E, Kariyawasam D, Potts L, Healy A, Rogers H, Sevdalis N, Stadler M, Qayyum M, Bakolis I, Goldsmith Ket 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

Journal article

Thornicroft G, Bakolis I, Evans-Lacko S, Gronholm P, Henderson C, Kohrt BA, Koschorke M, Milenova M, Semrau M, Votruba N, Sartorius Net 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

Journal article

Michelini G, Jurgiel J, Bakolis I, Cheung CHM, Asherson P, Loo SK, Kuntsi J, Mohammad-Rezazadeh Iet 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

Journal article

Deb T, Lempp H, Bakolis I, Vince T, Waugh W, Henderson C, Thornicroft G, Ando S, Yamaguchi S, Matsunaga A, Kondo S, Ichihashi K, Ojio Y, Ogawa M, Fujii C, Kasai K, Candelas A, Martin L, Jimenez A, Castaneda C, Hernandez C, de la Higuera J, Munoz-Negro JE, Sola M, Garcia R, Miguel Gota J, Francisco Mula J, Lopez A, Oria A, Cervilla JA, Bono A, Franco D, Gomez J, Jimenez C, Dorado R, Ingunza E, Marquez I, de la Vega D, Ga-Cubillana P, Ouali U, Jouini L, Zgueb Y, Jomli R, Nacef F, Campbell M, Stein D, Harangozo J, Ojo TM, Ogunwale A, Sowunmi AO, Awhangansi SS, Ogundapo D, Sodiya OT, Fadipe B, Olagunju AT, Erinfolami AR, Ogunnubi PO, Tomas CC, Krupchanka D, Pascucci M, Bacle SV, Colliez A, Sebbane D, Mengin A, Vidailhet P, Cazals C, Ucok A, Fiorillo A, Sampogna G, Savorani M, Del Vecchio V, Luciano M, Borriello G, Pocai B, Nwaubani P, James Y, Tocca A, Pattnaik R, Chilasagaram S, Wufang Zet 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

Journal article

Polling C, Bakolis I, Hotopf M, Hatch SLet al., 2019, Spatial patterning of self-harm rates within urban areas, SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, Vol: 54, Pages: 69-79, ISSN: 0933-7954

Journal article

Gazard B, Chui Z, Harber-Aschan L, MacCrimmon S, Bakolis I, Rimes K, Hotopf M, Hatch SLet al., 2018, Barrier or stressor? The role of discrimination experiences in health service use, BMC PUBLIC HEALTH, Vol: 18, ISSN: 1471-2458

Journal article

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

Journal article

Bitta MA, Bakolis I, Kariuki SM, Nyutu G, Mochama G, Thornicroft G, Newton CRJCet al., 2018, Suicide in a rural area of coastal Kenya, BMC PSYCHIATRY, Vol: 18, ISSN: 1471-244X

Journal article

Sadler E, Khadjesari Z, Ziemann A, Sheehan K, Whitney J, Wilson D, Bakolis I, Sevdalis N, Sandall Jet 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.

Journal article

Barnard S, Free C, Bakolis I, Turner KME, Looker KJ, Baraitser Pet 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

Journal article

Bakolis I, Hooper R, Bachert C, Lange B, Haahtela T, Keil T, Hofmaier S, Fokkens W, Rymarczyk B, Janson C, Burney PG, Garcia Larsen Vet al., Dietary patterns and respiratory health in adults from nine European countries – evidence from the GA2LEN study, Clinical and Experimental Allergy, 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

Journal article

Garcia Larsen V, Morton V, Norat T, Moreira A, Potts J, Bakolis Iet 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.

Journal article

East K, Hitchman SC, Bakolis I, Williams S, Cheeseman H, Arnott D, McNeill Aet al., 2018, When Authors Do Not Like Their Data, JOURNAL OF ADOLESCENT HEALTH, Vol: 63, Pages: 118-119, ISSN: 1054-139X

Journal article

East K, Hitchman SC, Bakolis I, Williams S, Cheeseman H, Arnott D, McNeill Aet 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

Journal article

Hansell AL, Bakolis I, Cowie CT, Belousova EG, Ng K, Weber-Chrysochoou C, Britton WJ, Leeder S, Tovey E, Webb K, Toelle B, Marks GBet 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

Journal article

Bakolis I, Hammoud R, Smythe M, Gibbons J, Davidson N, Tognin S, Mechelli Aet 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

Journal article

Carruthers S, Kinnaird E, Rudra A, Smith P, Allison C, Auyeung B, Chakrabarti B, Wakabayashi A, Baron-Cohen S, Bakolis I, Hoekstra RAet 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

Journal article

Michelini G, Jurgiel J, Bakolis I, Cheung CHM, Asherson P, Loo SK, Kuntsi J, Mohammad-Rezazadeh Iet 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&lt;.01), and reduced pre-stimulus/post-stimulus change in theta connectivity (p&lt;.01). In the majority of indices showing ADHD persister-control differences, ADHD remitters differed from controls (all p&lt;.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

Journal article

Chamitava L, Bakolis I, Burney PGJ, Zanolin ME, Jarvis D, Garcia-Larsen Vet 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

Conference paper

Sampogna G, Bakolis I, Evans-Lacko S, Robinson E, Thornicroft G, Henderson Cet 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.

Journal article

Bartington SE, Bakolis I, Devakumar D, Kurmi OP, Gulliver J, Chaube G, Manandhar DS, Saville NM, Costello A, Osrin D, Hansell AL, Ayres JGet 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.

Journal article

Sampogna G, Bakolis I, Robinson E, Corker E, Pinfold V, Thornicroft G, Henderson Cet 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

Journal article

Bakolis I, Kelly R, Fecht D, Best N, Millett C, Garwood K, Elliott P, Hansell A, Hodgson Set 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.

Journal article

Luciano M, Sampogna G, Del Vecchio V, De Rosa C, Catapano F, Fiorillo Aet 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.

Journal article

Douglas P, Bakolis I, Fecht D, Pearson C, Leal Sanchez M, Kinnersley R, de Hoogh K, Hansell Aet al., 2016, Respiratory hospital admission risk near large composting facilities, International Journal of Hygiene and Environmental Health, Vol: 219, Pages: 372-379, ISSN: 1618-131X

BackgroundLarge-scale composting can release bioaerosols in elevated quantities, but there are few studies of health effects on nearby communitiesMethodsA cross-sectional ecological small area design was used to examine risk of respiratory hospital admissions within 2500 m of all 148 English large-scale composting facilities in 2008–10. Statistical analyses used a random intercept Poisson regression model at Census Output Area (COA) level (mean population 310). Models were adjusted for age, sex, deprivation and tobacco sales.ResultsAnalysing 34,963 respiratory hospital admissions in 4656COAs within 250–2500 m of a site, there were no significant trends using pre-defined distance bands of >250m-750m, >750–1500 m and >1500-2500m. Using a continuous measure of distance, there was a small non-statistically significant (p = 0.054) association with total respiratory admissions corresponding to a 1.5% (95% CI: 0.0–2.9%) decrease in risk if moving from 251 m to 501m. There were no significant associations for subgroups of respiratory infections, asthma or chronic obstructive pulmonary disease.ConclusionThis national study does not provide evidence for increased risks of respiratory hospital admissions in those living beyond 250 m of an outdoor composting area perimeter. Further work using better measures of exposure and exploring associations with symptoms and disease prevalence, especially in vulnerable groups, is recommended to support regulatory approaches.

Journal article

Cai TY, Sullivan TR, Ayer JG, Harmer JA, Leeder SR, Toelle BG, Marks GB, Celermajer DS, Skilton MRet al., 2016, Carotid extramedial thickness is associated with local arterial stiffness in children, JOURNAL OF HYPERTENSION, Vol: 34, Pages: 109-115, ISSN: 0263-6352

Journal article

Fecht D, Anderson I, Fabbri F, Bakolis I, Hodgson Set al., Birth Outcomes And Maternal Exposure To Natural Environments In A Metropolitan Area, 27th annual meeting of the International Society for Environmental Epidemiology (ISEE)

Conference paper

Bakolis I, Heinrich J, Zock JP, Norback D, Svanes C, Chen CM, Accordini S, Verlato G, Olivieri M, Jarvis Det al., 2015, House dust-mite allergen exposure is associated with serum specific IgE but not with respiratory outcomes, INDOOR AIR, Vol: 25, Pages: 235-244, ISSN: 0905-6947

Journal article

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