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Morris D, Gillespie D, Dockrell MJ, Cook M, Horton M, Brown J, Langley TE. Potential smoke-free dividend across local areas in England: a cross-sectional analysis. Tob Control 2024:tc-2023-058264. [PMID: 38508755 DOI: 10.1136/tc-2023-058264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/09/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND The value that might be added to local economies each year through the money that people who smoke tobacco would save if everyone quit smoking is called the 'smoke-free dividend'. This study aimed to estimate the value of the smoke-free dividend across local areas in England, and how it relates to the average income in those areas. METHODS The study was a cross-sectional descriptive analysis of tobacco expenditure from the Smoking Toolkit Study (STS) matched to income and smoking prevalence data for English local authorities. The STS sample was from 2014 to 2020 and comprised 18 721 adults who smoke cigarettes. Self-reported expenditure estimates from the STS were adjusted for under-reporting. This adjustment aimed to align the total expenditure estimate with figures derived from government tax receipts and national estimates of illicit tobacco use. The smoke-free dividend is calculated as 93% of spending on legal tobacco, which is the percentage estimated to leave the local economy, plus 100% of spending on illicit tobacco. RESULTS The total dividend in England is estimated to be £10.9 billion each year, which equates to £1776 per person who smokes or £246 per adult regardless of smoking status. The estimated dividend is greater in areas with lower average income, with a correlation coefficient of -0.521 (95% CI -0.629, -0.392) between the average income of local areas and the dividend per adult. CONCLUSIONS This study has estimated that local economies could gain a substantial dividend if everybody stopped smoking, which is larger in lower income areas, meaning that geographical economic inequalities could be reduced.
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Affiliation(s)
- Damon Morris
- Sheffield Addictions Research Group, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
- SPECTRUM Consortium, UK
| | - Duncan Gillespie
- Sheffield Addictions Research Group, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
- SPECTRUM Consortium, UK
| | - Martin J Dockrell
- SPECTRUM Consortium, UK
- Office for Health Improvement and Disparities, London, UK
| | - Mark Cook
- Office for Health Improvement and Disparities, London, UK
| | - Marie Horton
- SPECTRUM Consortium, UK
- Office for Health Improvement and Disparities, London, UK
| | - Jamie Brown
- SPECTRUM Consortium, UK
- Behavioural Science and Health, University College London, London, UK
| | - Tessa Elisabeth Langley
- SPECTRUM Consortium, UK
- Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham, UK
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Woodrow N, Gillespie D, Kitchin L, O'Brien M, Chapman S, Chng NR, Passey A, Aquino MRJ, Clarke Z, Goyder E. Reintroducing face-to-face support alongside remote support to form a hybrid stop smoking service in England: a formative mixed methods evaluation. BMC Public Health 2024; 24:718. [PMID: 38448869 PMCID: PMC10916048 DOI: 10.1186/s12889-024-18235-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/29/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, United Kingdom (UK) stop smoking services had to shift to remote delivery models due to social distancing regulations, later reintroducing face-to-face provision. The "Living Well Smokefree" service in North Yorkshire County Council adopted a hybrid model offering face-to-face, remote, or a mix of both. This evaluation aimed to assess the hybrid approach's strengths and weaknesses and explore potential improvements. METHODS Conducted from September 2022 to February 2023, the evaluation consisted of three components. First, qualitative interviews involved 11 staff and 16 service users, analysed thematically. Second, quantitative data from the QuitManager system that monitored the numbers and proportions of individuals selecting and successfully completing a 4-week quit via each service option. Third, face-to-face service expenses data was used to estimate the value for money of additional face-to-face provision. The qualitative findings were used to give context to the quantitative data via an "expansion" approach and complementary analysis. RESULTS Overall, a hybrid model was seen to provide convenience and flexible options for support. In the evaluation, 733 individuals accessed the service, with 91.3% selecting remote support, 6.1% face-to-face, and 2.6% mixed provision. Remote support was valued by service users and staff for promoting openness, privacy, and reducing stigma, and was noted as removing access barriers and improving service availability. However, the absence of carbon monoxide monitoring in remote support raised accountability concerns. The trade-off in "quantity vs. quality" of quits was debated, as remote support reached more users but produced fewer carbon monoxide-validated quits. Primarily offering remote support could lead to substantial workloads, as staff often extend their roles to include social/mental health support, which was sometimes emotionally challenging. Offering service users a choice of support options was considered more important than the "cost-per-quit". Improved dissemination of information to support service users in understanding their options for support was suggested. CONCLUSIONS The hybrid approach allows smoking cessation services to evaluate which groups benefit from remote, face-to-face, or mixed options and allocate resources accordingly. Providing choice, flexible provision, non-judgmental support, and clear information about available options could improve engagement and match support to individual needs, enhancing outcomes.
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Affiliation(s)
- Nicholas Woodrow
- Sheffield Centre for Health and Related Research (SCHARR), University of Sheffield, Sheffield, UK.
| | - Duncan Gillespie
- Sheffield Centre for Health and Related Research (SCHARR), University of Sheffield, Sheffield, UK
| | - Liz Kitchin
- Sheffield Centre for Health and Related Research (SCHARR), University of Sheffield, Sheffield, UK
| | - Mark O'Brien
- Living Well Smokefree Service, North Yorkshire Council, York, UK
| | - Scott Chapman
- Living Well Smokefree Service, North Yorkshire Council, York, UK
| | - Nai Rui Chng
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Andrew Passey
- School of Health, Leeds Beckett University, LS1 3HE, Leeds, UK
| | - Maria Raisa Jessica Aquino
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Zoe Clarke
- Sheffield Centre for Health and Related Research (SCHARR), University of Sheffield, Sheffield, UK
| | - Elizabeth Goyder
- Sheffield Centre for Health and Related Research (SCHARR), University of Sheffield, Sheffield, UK
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Valiente R, Tunstall H, Kong AY, Wilson LB, Gillespie D, Angus C, Brennan A, Shortt NK, Pearce J. Geographical differences in the financial impacts of different forms of tobacco licence fees on small retailers in Scotland. Tob Control 2024:tc-2023-058342. [PMID: 38326025 DOI: 10.1136/tc-2023-058342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/02/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Retailer licencing fees are a promising avenue to regulate tobacco availability. However, they face strong opposition from retailers and the tobacco industry, who argue significant financial impacts. This study compares the impacts of different forms of tobacco licence schemes on retailers' profits in Scotland. METHODS We calculated gross profits from tobacco sales in 179 convenience stores across Scotland using 1 099 697 electronic point-of-sale records from 16 weeks between 2019 and 2022. We estimated different fees using universal, volumetric and separate urban/rural schemes. We identified the point at which 50% of retailers would no longer make a gross profit on tobacco sales for each scheme and modelled the financial impact of 10 incremental fee levels. The financial impact was assessed based on changes in retailers' tobacco gross profits. Differences by neighbourhood deprivation and urban/rural status were examined. RESULTS The gross profit from tobacco per convenience store averaged £15 859/year. Profits were 2.29 times higher in urban (vs rural) areas and 1.59 times higher in high-deprivation (vs low-deprivation) areas, attributable to higher sales volumes. Tobacco gross profit decreased proportionally with increasing fee levels. Universal and urban/rural fees had greater gross profit reductions in rural and/or less deprived areas, where profits were lower, compared with volumetric fees. CONCLUSION The introduction of tobacco licence fees offers a potential opportunity for reducing the availability of tobacco retailers. The likely impact of a tobacco licence fee is sensitive to the type of licence scheme implemented, the level at which fees are set and the retailers' location in relation to neighbourhood deprivation and rurality.
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Affiliation(s)
- Roberto Valiente
- Centre for Research on Environment, Society and Health (CRESH), School of GeoSciences, University of Edinburgh, Edinburgh, UK
- SPECTRUM Consortium, UK
| | - Helena Tunstall
- Centre for Research on Environment, Society and Health (CRESH), School of GeoSciences, University of Edinburgh, Edinburgh, UK
- SPECTRUM Consortium, UK
| | - Amanda Y Kong
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- TSET Health Promotion Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Luke B Wilson
- SPECTRUM Consortium, UK
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Duncan Gillespie
- SPECTRUM Consortium, UK
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Colin Angus
- SPECTRUM Consortium, UK
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- SPECTRUM Consortium, UK
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Niamh K Shortt
- Centre for Research on Environment, Society and Health (CRESH), School of GeoSciences, University of Edinburgh, Edinburgh, UK
- SPECTRUM Consortium, UK
| | - Jamie Pearce
- Centre for Research on Environment, Society and Health (CRESH), School of GeoSciences, University of Edinburgh, Edinburgh, UK
- SPECTRUM Consortium, UK
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Pryce R, Wilson LB, Gillespie D, Angus C, Morris D, Brennan A. Estimation of integrated price elasticities for alcohol and tobacco in the United Kingdom using the living costs and food survey 2006-2017. Drug Alcohol Rev 2024; 43:315-324. [PMID: 37952937 DOI: 10.1111/dar.13773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/26/2023] [Accepted: 10/01/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Evidence shows that price is an important policy lever in reducing consumption of alcohol and tobacco. However, there is little evidence of the cross-price effect between alcohol and tobacco. METHODS This paper uses an econometric model which estimates participation and consumption elasticities, on data from the UK Living Costs and Food Survey 2006-2017 and extends the literature by, for the first time, estimating joint price elasticities for disaggregated alcohol and tobacco products. This paper presents new price elasticities and compares them to the existing literature. RESULTS The own-price elasticity estimates are all negative for both participation and consumption. There is no pattern to the estimates of cross-price elasticities. The elasticity estimates, when used in the Sheffield Tobacco and Alcohol Policy Model, produce bigger changes in consumption for the same change in price compared to other elasticity estimates in the existing literature. DISCUSSION AND CONCLUSIONS Consumption of alcohol and tobacco are affected by the prices of one another. Policymakers should bear this in mind when devising alcohol or tobacco pricing policies.
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Affiliation(s)
- Robert Pryce
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Luke B Wilson
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Duncan Gillespie
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Damon Morris
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Hatchard J, Buykx P, Wilson L, Brennan A, Gillespie D. Mapping alcohol and tobacco tax policy interventions to inform health and economic impact analyses: A United Kingdom based qualitative framework analysis. Int J Drug Policy 2023; 122:104247. [PMID: 37939433 DOI: 10.1016/j.drugpo.2023.104247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/19/2023] [Accepted: 10/20/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Alcohol and tobacco have different policy regimes and there is little understanding of how changes to policy on each commodity might combine to affect the same outcomes or to affect people who both drink and smoke. The aim of this study was to deepen understanding of the policy objectives of UK alcohol and tobacco tax options being considered at the time of the interviews with a set of UK policy participants in 2018, and the factors affecting the implementation and outcomes of the policy options discussed. METHODS Ten tax policy experts were recruited from government arms-length organisations and advocacy groups in England and Scotland (4 alcohol, 4 tobacco, 2 alcohol and tobacco). Alcohol and tobacco experts were interviewed together in pairs and asked to discuss alcohol and tobacco tax policy objectives, options, and the mechanisms of effect. Interviews were semi-structured, supported by a briefing document and topic guide, audio-recorded, transcribed and then analysed deductively using framework analysis. RESULTS Alcohol and tobacco tax policy share objectives of health improvement and there is a common set of policy options: increasing duty rates, duty escalators, multi-rate tax structures, industry levies and the hypothecation of tax revenue for investment in societal benefits. However, participants agreed that the harms caused by alcohol and tobacco and their industries are viewed differently, and that this influences the impacts that are prioritised in tax policymaking. Working-out how alcohol and tobacco taxes could work synergistically to reduce health inequalities was seen as desirable. Participants also highlighted the importance of avoiding the combined effects of price increases on alcohol and tobacco widening economic inequalities. CONCLUSIONS Impact analyses should consider the combined effects of alcohol and tobacco tax policies on health and economic inequalities, and how the effects of changes to the tax on each commodity might trade-off.
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Affiliation(s)
- Jenny Hatchard
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Penny Buykx
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom; School of Humanities, Creative Industries and Social Science, University of Newcastle, New South Wales, Australia
| | - Luke Wilson
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom
| | - Alan Brennan
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom; SPECTRUM consortium, United Kingdom
| | - Duncan Gillespie
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom; SPECTRUM consortium, United Kingdom.
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6
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Hock ES, Franklin M, Baxter S, Clowes M, Chilcott J, Gillespie D. Covariates of success in quitting smoking: a systematic review of studies from 2008 to 2021 conducted to inform the statistical analyses of quitting outcomes of a hospital-based tobacco dependence treatment service in the United Kingdom. NIHR Open Res 2023; 3:28. [PMID: 37881466 PMCID: PMC10596416 DOI: 10.3310/nihropenres.13427.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 10/27/2023]
Abstract
Background Smoking cessation interventions are being introduced into routine secondary care in the United Kingdom (UK), but there are person and setting-related factors that could moderate their success in quitting smoking. This review was conducted as part of an evaluation of the QUIT hospital-based tobacco dependence treatment service ( https://sybics-quit.co.uk). The aim of the review was to identify a comprehensive set of variables associated with quitting success among tobacco smokers contacting secondary healthcare services in the UK who are offered support to quit smoking and subsequently set a quit date. The results would then be used to inform the development of a statistical analysis plan to investigate quitting outcomes. Methods Systematic literature review of five electronic databases. Studies eligible for inclusion investigated quitting success in one of three contexts: (a) the general population in the UK; (b) people with a mental health condition; (c) quit attempts initiated within a secondary care setting. The outcome measures were parameters from statistical analysis showing the effects of covariates on quitting success with a statistically significant (i.e., p-value <0.05) association. Results The review identified 29 relevant studies and 14 covariates of quitting success, which we grouped into four categories: demographics (age; sex; ethnicity; socio-economic conditions; relationship status, cohabitation and social network), individual health status and healthcare setting (physical health, mental health), tobacco smoking variables (current tobacco consumption, smoking history, nicotine dependence; motivation to quit; quitting history), and intervention characteristics (reduction in amount smoked prior to quitting, the nature of behavioural support, tobacco dependence treatment duration, pharmacological aids). Conclusions In total, 14 data fields were identified that should be considered for inclusion in datasets and statistical analysis plans for evaluating the quitting outcomes of smoking cessation interventions initiated in secondary care contexts in the UK. PROSPERO registration CRD42021254551 (13/05/2021).
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Affiliation(s)
- Emma S. Hock
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health School, The University of Sheffield, Sheffield, England, UK
| | - Matthew Franklin
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health School, The University of Sheffield, Sheffield, England, UK
| | - Susan Baxter
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health School, The University of Sheffield, Sheffield, England, UK
| | - Mark Clowes
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health School, The University of Sheffield, Sheffield, England, UK
| | - James Chilcott
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health School, The University of Sheffield, Sheffield, England, UK
| | - Duncan Gillespie
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health School, The University of Sheffield, Sheffield, England, UK
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7
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Hatchard J, Buykx P, Brennan A, Gillespie D. Options for modifying UK alcohol and tobacco tax: A rapid scoping review of the evidence over the period 1997-2018. NIHR Open Res 2023; 3:26. [PMID: 37881457 PMCID: PMC10593339 DOI: 10.3310/nihropenres.13379.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 10/27/2023]
Abstract
Background Increased taxation is recognised worldwide as one of the most effective interventions for decreasing tobacco and harmful alcohol use, with many variations of policy options available. This rapid scoping review was part of a NIHR-funded project ('SYNTAX' 16/105/26) and was undertaken during 2018 to inform interviews to be conducted with UK public health stakeholders with expertise in alcohol and tobacco pricing policy. Methods Objectives: To synthesise evidence and debates on current and potential alcohol and tobacco taxation options for the UK, and report on the underlying objectives, evidence of effects and mediating factors.Eligibility criteria: Peer-reviewed and grey literature; published 1997-2018; English language; UK-focused; include taxation interventions for alcohol, tobacco, or both. Sources of evidence: PubMed, Scopus, Cochrane Library, Google, stakeholder and colleague recommendations.Charting methods: Excel spreadsheet structured using PICO framework, recording source characteristics and content. Results Ninety-one sources qualified for inclusion: 49 alcohol, 36 tobacco, 6 both. Analysis identified four policy themes: changes to excise duty within existing tax structures, structural reforms, industry measures, and hypothecation of tax revenue for public benefits. For alcohol, policy options focused on raising the price of cheap, high-strength alcohol. For tobacco, policy options focused on raising the price of all tobacco products, especially the cheapest products, which are hand-rolling tobacco. For alcohol and tobacco, there were options such as levies that take money from the industries to help reduce the societal costs of their products. Due to the perceived social and economic importance of alcohol in contrast to tobacco, policy options also discussed supporting pubs and small breweries. Conclusions This review has identified a set of tax policy options for tobacco and alcohol, their objectives, evidence of effects and related mediating factors. The differences between alcohol and tobacco tax policy options and debates suggest an opportunity for cross-substance policy learning.
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Affiliation(s)
- Jenny Hatchard
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Penny Buykx
- School of Humanities and Social Science, University of Newcastle, Australia, New South Wales, Australia
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Duncan Gillespie
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
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Johnson M, Spies J, Scott K, Kato B, Mu X, Rectenwald J, White R, Khaja M, Zuckerman D, Casciani T, Gillespie D. Abstract No. 274 ▪ FEATURED ABSTRACT Predicting the Safety and Effectiveness of Inferior Vena Cava Filters (PRESERVE): Outcomes at 12 Months. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Lechner M, Liu J, Counsell N, Gillespie D, Chandrasekharan D, Ta NH, Jumani K, Gupta R, Rocke J, Williams C, Tetteh A, Amnolsingh R, Khwaja S, Batterham RL, Yan CH, Treibel TA, Moon JC, Woods J, Brunton R, Boardman J, Hatter M, Abdelwahab M, Holsinger FC, Capasso R, Nayak JV, Hwang PH, Patel ZM, Paun S, Eynon-Lewis N, Kumar BN, Jayaraj S, Hopkins C, Philpott C, Lund VJ. The burden of olfactory dysfunction during the COVID-19 pandemic in the United Kingdom. Rhinology 2023; 61:93-96. [PMID: 36286227 DOI: 10.4193/rhin22.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- M Lechner
- Division of Surgery and Interventional Science, University College London, London, UK; UCL Cancer Institute, University College London, London, UK; ENT Department, Barts Health NHS Trust, London, UK
| | - J Liu
- UCL Cancer Institute, University College London, London, UK
| | - N Counsell
- CRUK and UCL Cancer Trials Centre, University College London, London, UK
| | - D Gillespie
- UCL Cancer Institute, University College London, London, UK
| | - D Chandrasekharan
- Division of Surgery and Interventional Science, University College London, London, UK
| | - N H Ta
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - K Jumani
- Division of Surgery and Interventional Science, University College London, London, UK
| | - R Gupta
- Division of Surgery and Interventional Science, University College London, London, UK
| | - J Rocke
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - C Williams
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - A Tetteh
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - R Amnolsingh
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - S Khwaja
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - R L Batterham
- Centre for Obesity Research, University College London, London, UK; Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospitals NHS Trust, London, UK; National Institute for Health Research, UCLH Biomedical Research Centre, London, UK
| | - C H Yan
- Department of Otolaryngology, University of San Diego School of Medicine, San Diego, USA
| | - T A Treibel
- National Institute for Health Research, UCLH Biomedical Research Centre, London, UK; Barts Heart Centre, St. Bartholomew's Hospital, London, UK; Institute of Cardiovascular Sciences, University College London, UK
| | - J C Moon
- National Institute for Health Research, UCLH Biomedical Research Centre, London, UK; Barts Heart Centre, St. Bartholomew's Hospital, London, UK; Institute of Cardiovascular Sciences, University College London, UK
| | - J Woods
- The Norfolk Smell and Taste Clinic, Norfolk and Waveney ENT Service, UK
| | - R Brunton
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | | | - M Hatter
- Medical University of South Carolina, Charleston, SC, USA
| | - M Abdelwahab
- Medical University of South Carolina, Charleston, SC, USA
| | - F C Holsinger
- Medical University of South Carolina, Charleston, SC, USA
| | - R Capasso
- Medical University of South Carolina, Charleston, SC, USA
| | - J V Nayak
- Medical University of South Carolina, Charleston, SC, USA
| | - P H Hwang
- Medical University of South Carolina, Charleston, SC, USA
| | - Z M Patel
- Medical University of South Carolina, Charleston, SC, USA
| | - S Paun
- Division of Surgery and Interventional Science, University College London, London, UK
| | - N Eynon-Lewis
- Division of Surgery and Interventional Science, University College London, London, UK
| | - B N Kumar
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - S Jayaraj
- Division of Surgery and Interventional Science, University College London, London, UK
| | - C Hopkins
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK; The Norfolk Smell and Taste Clinic, Norfolk and Waveney ENT Service, UK
| | - V J Lund
- Royal National ENT Hospital, University College London Hospitals NHS Trust, London, UK
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Graham IM, Gillespie D, Gkikopoulou KC, Hastie GD, Thompson PM. Directional hydrophone clusters reveal evasive responses of small cetaceans to disturbance during construction at offshore windfarms. Biol Lett 2023; 19:20220101. [PMID: 36651028 PMCID: PMC9845968 DOI: 10.1098/rsbl.2022.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Mitigation measures to disperse marine mammals prior to pile-driving include acoustic deterrent devices and piling soft starts, but their efficacy remains uncertain. We developed a self-contained portable hydrophone cluster to detect small cetacean movements from the distributions of bearings to detections. Using an array of clusters within 10 km of foundation pile installations, we tested the hypothesis that harbour porpoises (Phocoena phocoena) respond to mitigation measures at offshore windfarm sites by moving away. During baseline periods, porpoise movements were evenly distributed in all directions. By contrast, animals showed significant directional movement away from sound sources during acoustic deterrent device use and piling soft starts. We demonstrate that porpoises respond to measures aimed to mitigate the most severe impacts of construction at offshore windfarms by swimming directly away from these sound sources. Portable directional hydrophone clusters now provide opportunities to characterize responses to disturbance sources across a broad suite of habitats and contexts.
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Affiliation(s)
- I. M. Graham
- Lighthouse Field Station, School of Biological Sciences, University of Aberdeen, Cromarty, Ross-shire IV11 8YL, Scotland
| | - D. Gillespie
- Sea Mammal Research Unit, Scottish Oceans Institute, University of St Andrews, Fife KY16 8LB, Scotland
| | - K. C. Gkikopoulou
- Sea Mammal Research Unit, Scottish Oceans Institute, University of St Andrews, Fife KY16 8LB, Scotland
| | - G. D. Hastie
- Sea Mammal Research Unit, Scottish Oceans Institute, University of St Andrews, Fife KY16 8LB, Scotland
| | - P. M. Thompson
- Lighthouse Field Station, School of Biological Sciences, University of Aberdeen, Cromarty, Ross-shire IV11 8YL, Scotland
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Longden EG, Gillespie D, Mann DA, McHugh KA, Rycyk AM, Wells RS, Tyack PL. Comparison of the marine soundscape before and during the COVID-19 pandemic in dolphin habitat in Sarasota Bay, FL. J Acoust Soc Am 2022; 152:3170. [PMID: 36586823 DOI: 10.1121/10.0015366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/06/2022] [Indexed: 06/17/2023]
Abstract
During the COVID-19 pandemic, changes in vessel activity and associated noise have been reported globally. Sarasota Bay is home to a large and increasing number of recreational vessels as well as a long-term resident community of bottlenose dolphins, Tursiops truncatus. Data were analyzed from two hydrophones to compare the soundscape during the COVID-19 pandemic to previous years (March-May 2020 and 2018/2019). Hourly metrics were calculated: vessel passes, 95th percentile sound levels [125 Hz and 16 kHz third octave bands (TOBs), and two broader bands: 88-1122 Hz and 1781-17 959 Hz], and dolphin whistle detection to understand changes in vessel activity and the effect on wildlife. Vessel activity increased during COVID-19 restrictions by almost 80% at one site and remained the same at the other site. Of the four sound level measures, only the 125 Hz TOB and 88-1122 Hz band increased with vessel activity at both sites, suggesting that these may be appropriate measures of noise from rapid pass-bys of small vessels in very shallow (<10 m) habitats. Dolphin whistle detection decreased during COVID-19 restrictions at one site but remained the same at the site that experienced increased vessel activity. The results suggest that pandemic effects on wildlife should not be viewed as homogeneous globally.
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Affiliation(s)
- E G Longden
- Sea Mammal Research Unit, Scottish Oceans Institute, University of St Andrews, St Andrews, Fife, KY16 8LB, United Kingdom
| | - D Gillespie
- Sea Mammal Research Unit, Scottish Oceans Institute, University of St Andrews, St Andrews, Fife, KY16 8LB, United Kingdom
| | - D A Mann
- Loggerhead Instruments, Inc., Sarasota, Florida 34238, USA
| | - K A McHugh
- Chicago Zoological Society's Sarasota Dolphin Research Program, c/o Mote Marine Laboratory, Sarasota, Florida 34236, USA
| | - A M Rycyk
- Division of Natural Sciences, New College of Florida, Sarasota, Florida 34243, USA
| | - R S Wells
- Chicago Zoological Society's Sarasota Dolphin Research Program, c/o Mote Marine Laboratory, Sarasota, Florida 34236, USA
| | - P L Tyack
- Sea Mammal Research Unit, Scottish Oceans Institute, University of St Andrews, St Andrews, Fife, KY16 8LB, United Kingdom
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12
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Brennan A, Angus C, Pryce R, Buykx P, Henney M, Gillespie D, Holmes J, Meier PS. Effectiveness of subnational implementation of minimum unit price for alcohol: policy appraisal modelling for local authorities in England. Addiction 2022; 118:819-833. [PMID: 36367289 DOI: 10.1111/add.16084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/21/2022] [Indexed: 11/13/2022]
Abstract
AIMS Evidence exists on the potential impact of national level minimum unit price (MUP) policies for alcohol. This study investigated the potential effectiveness of implementing MUP at regional and local levels compared with national implementation. DESIGN Evidence synthesis and computer modelling using the Sheffield Alcohol Policy Model (Local Authority version 4.0; SAPMLA). SETTING Results are produced for 23 Upper Tier Local Authorities (UTLAs) in North West England, 12 UTLAs in North East England, 15 UTLAs in Yorkshire and Humber, the nine English Government Office regions and England as a whole. CASES Health Survey for England (HSE) data 2011-13 (n = 24 685). MEASUREMENTS Alcohol consumption, consumer spending, retailers' revenues, hospitalizations, National Health Service costs, crimes and alcohol-attributable deaths and health inequalities. FINDINGS Implementing a local £0.50 MUP for alcohol in northern English regions is estimated to result in larger percentage reductions in harms than the national average. The reductions for England, North West, North East and Yorkshire and Humber regions, respectively, in annual alcohol-attributable deaths are 1024 (-10.4%), 205 (-11.4%), 121 (-17.4%) and 159 (-16.9%); for hospitalizations are 29 943 (-4.6%), 5956 (-5.5%), 3255 (-7.9%) and 4610 (-6.9%); and for crimes are 54 229 (-2.4%), 8528 (-2.5%), 4380 (-3.5%) and 8220 (-3.2%). Results vary among local authorities; for example, annual alcohol-attributable deaths estimated to change by between -8.0 and -24.8% throughout the 50 UTLAs examined. CONCLUSIONS A minimum unit price local policy for alcohol is likely to be more effective in those regions, such as the three northern regions of England, which have higher levels of alcohol consumption and higher rates of alcohol harm than for the national average. In such regions, the minimum unit price policy would achieve larger reductions in alcohol consumption, alcohol-attributable mortality, hospitalization rates, NHS costs, crime rates and health inequalities.
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Affiliation(s)
- Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Robert Pryce
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Penny Buykx
- School of Health and Related Research, University of Sheffield, Sheffield, UK.,School of Humanities and Social Science, University of Newcastle, Callaghan, NSW, Australia
| | - Madeleine Henney
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Duncan Gillespie
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Petra S Meier
- School of Health and Related Research, University of Sheffield, Sheffield, UK.,MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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13
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Milton R, Modibbo F, Gillespie D, Alkali FI, Mukaddas AS, Kassim A, Sa'ad FH, Tukur FM, Khalid RY, Muhammad MY, Bello M, Edwin CP, Ogudo E, Iregbu KC, Jones L, Hood K, Ghazal P, Sanders J, Hassan B, Belga FJ, Walsh TR. Incidence and sociodemographic, living environment and maternal health associations with stillbirth in a tertiary healthcare setting in Kano, Northern Nigeria. BMC Pregnancy Childbirth 2022; 22:692. [PMID: 36076161 PMCID: PMC9454147 DOI: 10.1186/s12884-022-04971-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/02/2022] [Indexed: 11/23/2022] Open
Abstract
Background Almost two million stillbirths occur annually, most occurring in low- and middle-income countries. Nigeria is reported to have one of the highest stillbirth rates on the African continent. The aim was to identify sociodemographic, living environment, and health status factors associated with stillbirth and determine the associations between pregnancy and birth factors and stillbirth in the Murtala Mohammed Specialist Hospital, Kano, Nigeria. Methods A three-month single-site prospective observational feasibility study. Demographic and clinical data were collected. We fitted bivariable and multivariable models for stillbirth (yes/no) and three-category livebirth/macerated stillbirth/non-macerated stillbirth outcomes to explore their association with demographic and clinical factors. Findings 1,998 neonates and 1,926 mothers were enrolled. Higher odds of stillbirth were associated with low-levels of maternal education, a further distance to travel to the hospital, living in a shack, maternal hypertension, previous stillbirth, birthing complications, increased duration of labour, antepartum haemorrhage, prolonged or obstructed labour, vaginal breech delivery, emergency caesarean-section, and signs of trauma to the neonate following birth. Interpretation This work has obtained data on some factors influencing stillbirth. This in turn will facilitate the development of improved public health interventions to reduce preventable deaths and to progress maternal health within this site. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04971-x.
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Affiliation(s)
- Rebecca Milton
- Centre for Trials Research, Cardiff University, Cardiff, UK.
| | - F Modibbo
- Murtala Mohammed Specialist Hospital (MMSH), Kano, Nigeria
| | - D Gillespie
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - F I Alkali
- Department of Biochemistry, Bayero University, Kano, Nigeria
| | - A S Mukaddas
- Department of Biological Sciences, Bayero University, Kano, Nigeria
| | - A Kassim
- Department of Biological Sciences, Bayero University, Kano, Nigeria
| | - F H Sa'ad
- Department of Medical Microbiology and Parasitology, Bayero University, Kano, Nigeria
| | - F M Tukur
- Department of Biological Sciences, Bayero University, Kano, Nigeria
| | - R Y Khalid
- Murtala Mohammed Specialist Hospital (MMSH), Kano, Nigeria
| | - M Y Muhammad
- Murtala Mohammed Specialist Hospital (MMSH), Kano, Nigeria
| | - M Bello
- Murtala Mohammed Specialist Hospital (MMSH), Kano, Nigeria
| | - C P Edwin
- Department of Microbiology, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - E Ogudo
- Murtala Mohammed Specialist Hospital (MMSH), Kano, Nigeria
| | - K C Iregbu
- Department of Medical Microbiology, National Hospital Abuja, Abuja, Nigeria
| | - L Jones
- Department of Medical Microbiology Cardiff, Public Health Wales, University Hospital of Wales, Cardiff, UK
| | - K Hood
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - P Ghazal
- Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, UK
| | - J Sanders
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - B Hassan
- Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - F J Belga
- Murtala Mohammed Specialist Hospital (MMSH), Kano, Nigeria
| | - T R Walsh
- Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK.,Department of Zoology, Ineos Institute of Antimicrobial Research, University of Oxford, Oxford, UK
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14
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Lechner M, Liu J, Counsell N, Gillespie D, Chandrasekharan D, Ta NH, Jumani K, Gupta R, Rao-Merugumala S, Rocke J, Williams C, Tetteh A, Amnolsingh R, Khwaja S, Batterham RL, Yan CH, Treibel TA, Moon JC, Woods J, Brunton R, Boardman J, Paun S, Eynon-Lewis N, Kumar BN, Jayaraj S, Hopkins C, Philpott C, Lund VJ. The COVANOS trial - insight into post-COVID olfactory dysfunction and the role of smell training. Rhinology 2022; 60:188-199. [PMID: 35901492 DOI: 10.4193/rhin21.470] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Olfactory dysfunction is a cardinal symptom of COVID-19 infection, however, studies assessing long-term olfactory dysfunction are limited and no randomised-controlled trials (RCTs) of early olfactory training have been conducted. METHODOLOGY We conducted a prospective, multi-centre study consisting of baseline psychophysical measurements of smell and taste function. Eligible participants were further recruited into a 12-week RCT of olfactory training versus control (safety information). Patient-reported outcomes were measured using an electronic survey and BSIT at baseline and 12 weeks. An additional 1-year follow-up was open to all participants. RESULTS 218 individuals with a sudden loss of sense of smell of at least 4-weeks were recruited. Psychophysical smell loss was observed in only 32.1%; 63 participants were recruited into the RCT. The absolute difference in BSIT improvement after 12 weeks was 0.45 higher in the intervention arm. 76 participants completed 1-year follow-up; 10/19 (52.6%) of participants with an abnormal baseline BSIT test scored below the normal threshold at 1-year, and 24/29 (82.8%) had persistent parosmia. CONCLUSIONS Early olfactory training may be helpful, although our findings are inconclusive. Notably, a number of individuals who completed the 1-year assessment had persistent smell loss and parosmia at 1-year. As such, both should be considered important entities of long-Covid and further studies to improve management are highly warranted.
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Affiliation(s)
- M Lechner
- ENT Department, Barts Health NHS Trust, London, UK; UCL Cancer Institute, University College London, London, UK; Division of Surgery and Interventional Science, University College London, London, UK
| | - J Liu
- UCL Cancer Institute, University College London, London, UK
| | - N Counsell
- CRUK and UCL Cancer Trials Centre, University College London, London, UK
| | - D Gillespie
- UCL Cancer Institute, University College London, London, UK
| | | | - N H Ta
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - K Jumani
- ENT Department, Barts Health NHS Trust, London, UK
| | - R Gupta
- ENT Department, Barts Health NHS Trust, London, UK
| | | | - J Rocke
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - C Williams
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - A Tetteh
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - R Amnolsingh
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - S Khwaja
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - R L Batterham
- Centre for Obesity Research, University College London, London, UK; Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospitals NHS Foundation Trust, London, UK; National Institute for Health Research, UCLH Biomedical Research Centre, London, UK
| | - C H Yan
- Department of Otolaryngology-Head and Neck Surgery, University of San Diego School of Medicine, San Diego, USA
| | - T A Treibel
- National Institute for Health Research, UCLH Biomedical Research Centre, London, UK; Barts Heart Centre, St. Bartholomew's Hospital, London, UK; Institute of Cardiovascular Sciences, University College London, UK
| | - J C Moon
- National Institute for Health Research, UCLH Biomedical Research Centre, London, UK; Barts Heart Centre, St. Bartholomew's Hospital, London, UK; Institute of Cardiovascular Sciences, University College London, UK
| | - J Woods
- The Norfolk Smell and Taste Clinic, Norfolk
| | - R Brunton
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | | | - S Paun
- ENT Department, Barts Health NHS Trust, London, UK
| | | | - B N Kumar
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - S Jayaraj
- ENT Department, Barts Health NHS Trust, London, UK
| | - C Hopkins
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK; The Norfolk Smell and Taste Clinic, Norfolk and Waveney ENT Service, UK
| | - V J Lund
- Royal National ENT Hospital, University College London Hospital NHS Foundation Trust, London, UK
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15
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Ohla K, Veldhuizen MG, Green T, Hannum ME, Bakke AJ, Moein ST, Tognetti A, Postma EM, Pellegrino R, Hwang DLD, Albayay J, Koyama S, Nolden AA, Thomas-Danguin T, Mucignat-Caretta C, Menger NS, Croijmans I, Ã-ztà Rk L, YanÄ K H, Pierron D, Pereda-Loth V, Nunez-Parra A, Martinez Pineda AM, Gillespie D, Farruggia MC, Cecchetto C, Fornazieri MA, Philpott C, Voznessenskaya V, Cooper KW, Rohlfs Dominguez P, Calcinoni O, de Groot J, Boesveldt S, Bhutani S, Weir EM, Exten C, Joseph PV, Parma V, Hayes JE, Niv MY. A follow-up on quantitative and qualitative olfactory dysfunction and other symptoms in patients recovering from COVID-19 smell loss. Rhinology 2022; 60:207-217. [PMID: 35398877 PMCID: PMC11016179 DOI: 10.4193/rhin21.415] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Sudden smell loss is a specific early symptom of COVID-19, which, prior to the emergence of Omicron, had estimated prevalence of ~40% to 75%. Chemosensory impairments affect physical and mental health, and dietary behavior. Thus, it is critical to understand the rate and time course of smell recovery. The aim of this cohort study was to characterize smell function and recovery up to 11 months post COVID-19 infection. METHODS This longitudinal survey of individuals suffering COVID-19-related smell loss assessed disease symptoms and gustatory and olfactory function. Participants (n=12,313) who completed an initial survey (S1) about respiratory symptoms, chemosensory function and COVID-19 diagnosis between April and September 2020, were invited to complete a follow-up survey (S2). Between September 2020 and February 2021, 27.5% participants responded (n=3,386), with 1,468 being diagnosed with COVID-19 and suffering co-occurring smell and taste loss at the beginning of their illness. RESULTS At follow-up (median time since COVID-19 onset ~200 days), ~60% of women and ~48% of men reported less than 80% of their pre-illness smell ability. Taste typically recovered faster than smell, and taste loss rarely persisted if smell recovered. Prevalence of parosmia and phantosmia was ~10% of participants in S1 and increased substantially in S2: ~47% for parosmia and ~25% for phantosmia. Persistent smell impairment was associated with more symptoms overall, suggesting it may be a key marker of long-COVID illness. The ability to smell during COVID-19 was rated slightly lower by those who did not eventually recover their pre-illness ability to smell at S2. CONCLUSIONS While smell ability improves for many individuals who lost it during acute COVID-19, the prevalence of parosmia and phantosmia increases substantially over time. Olfactory dysfunction is associated with broader persistent symptoms of COVID-19, and may last for many months following acute COVID-19. Taste loss in the absence of smell loss is rare. Persistent qualitative smell symptoms are emerging as common long-term sequelae; more research into treatment options is strongly warranted given that even conservative estimates suggest millions of individuals may experience parosmia following COVID-19. Healthcare providers worldwide need to be prepared to treat post COVID-19 secondary effects on physical and mental health.
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Affiliation(s)
- K Ohla
- Helmut-Schmidt-University, University of the Armed Forces Hamburg, Germany; Firmenich SA, Satigny, Switzerland; The Pennsylvania State University, USA
| | | | - T Green
- The Hebrew University of Jerusalem, Israel
| | - M E Hannum
- Monell Chemical Senses Center, Philadelphia, USA
| | - A J Bakke
- The Pennsylvania State University, USA
| | - S T Moein
- Institute for Research in Fundamental Sciences (IPM), Iran
| | - A Tognetti
- Karolinska Institutet, Stockholm, Sweden
| | - E M Postma
- Wageningen University and Research, the Netherlands
| | - R Pellegrino
- Monell Chemical Senses Center, Philadelphia, USA
| | | | | | | | - A A Nolden
- University of Massachusetts, Amherst, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - S Boesveldt
- Wageningen University and Research, the Netherlands
| | | | - E M Weir
- The Pennsylvania State University, USA
| | - C Exten
- The Pennsylvania State University, USA
| | - P V Joseph
- National Institutes of Health, NINR, NIAAA, USA
| | - V Parma
- Monell Chemical Senses Center, Philadelphia, USA
| | - J E Hayes
- The Pennsylvania State University, USA
| | - M Y Niv
- The Hebrew University of Jerusalem, Israel
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16
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Opazo Breton M, Gillespie D, Pryce R, Bogdanovica I, Angus C, Hernandez Alava M, Brennan A, Britton J. Understanding long-term trends in smoking in England, 1972-2019: an age-period-cohort approach. Addiction 2022; 117:1392-1403. [PMID: 34590368 DOI: 10.1111/add.15696] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 09/09/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIMS Smoking prevalence has been falling in England for more than 50 years, but remains a prevalent and major public health problem. This study used an age-period-cohort (APC) approach to measure lifecycle, historical and generational patterns of individual smoking behaviour. DESIGN APC analysis of repeated cross-sectional smoking prevalence data obtained from three nationally representative surveys. SETTING England (1972-2019). PARTICIPANTS Individuals aged 18-90 years. MEASUREMENTS We studied relative odds of current smoking in relation to age in single years from 18 to 90, 24 groups of 2-year survey periods (1972-73 to 2018-19) and 20 groups of 5-year birth cohorts (1907-11 to 1997-2001). Age and period rates were studied for two groups of birth cohorts: those aged 18-25 years and those aged over 25 years. FINDINGS Relative to age 18, the odds of current smoking increased with age until approximately age 25 [odds ratio (OR) = 1.48, 95% confidence interval (CI) = 1.41-1.56] and then decreased progressively to age 90 (OR = 0.06, 95% CI = 0.04-0.08). They also decreased almost linearly with period relative to 1972-73 (for 2018-19: OR = 0.30, 95% CI = 0.26-0.34) and with birth cohort relative to 1902-06, with the largest decreased observed for birth cohort 1992-96 (OR = 0.44, 95% CI = 0.35-0.46) and 1997-2001 (OR = 0.35, 95% CI = 0.74-0.88). Smoking declined in the 18-25 age group by an average of 7% over successive 2-year periods and by an average of 5% in those aged over 25. CONCLUSIONS Smoking in England appears to have declined over recent decades mainly as a result of reduced smoking uptake before age 25, and to a lesser extent to smoking cessation after age 25.
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Affiliation(s)
- Magdalena Opazo Breton
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Duncan Gillespie
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Robert Pryce
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Ilze Bogdanovica
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Monica Hernandez Alava
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - John Britton
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
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17
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Wilson LB, Pryce R, Hiscock R, Angus C, Brennan A, Gillespie D. Quantile regression of tobacco tax pass-through in the UK 2013-2019. How have manufacturers passed through tax changes for different tobacco products? Tob Control 2021; 30:e27-e32. [PMID: 33093189 PMCID: PMC8606450 DOI: 10.1136/tobaccocontrol-2020-055931] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/01/2020] [Accepted: 09/07/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND The effectiveness of tax increases relies heavily on the tobacco industry passing on such increases to smokers (also referred to as 'pass-through'). Previous research has found heterogeneous levels of tax pass-through across the market segments of tobacco products available to smokers. This study uses retail sales data to assess the extent to which recent tax changes have been passed on to smokers and whether this varies across the price distribution. METHODS We use panel data quantile regression analysis on Nielsen commercial data of tobacco price and sales in the UK from January 2013 to March 2019 combined with official UK tax rates and inflation to calculate the rate of tax pass-through for factory made (FM) cigarettes and roll your own (RYO) tobacco. RESULTS Following increases in the specific tax payable on tobacco, we find evidence of overshifting across the price distribution for both FM and RYO. The rate of the overshift in tax increased the more expensive the products were. This was consistent for FM and RYO. Additionally, our findings suggest that the introduction of standardised packaging was not followed by changes in how the tobacco industry responded to tax increases. CONCLUSIONS Following the repeated introduction of increases in specific tobacco tax as well as standardised packaging, we show that the tobacco industry applies techniques to keep the cheapest tobacco cheaper relative to the more expensive products when passing on tax increases to smokers.
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Affiliation(s)
- Luke Brian Wilson
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Robert Pryce
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Duncan Gillespie
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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18
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Langley T, Gillespie D, Lewis S, Eminson K, Brennan A, Docherty G, Young B. Developing logic models to inform public health policy outcome evaluation: an example from tobacco control. J Public Health (Oxf) 2021; 43:639-646. [PMID: 32140716 DOI: 10.1093/pubmed/fdaa032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/12/2020] [Accepted: 02/12/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The evaluation of large-scale public health policy interventions often relies on observational designs where attributing causality is challenging. Logic models-visual representations of an intervention's anticipated causal pathway-facilitate the analysis of the most relevant outcomes. We aimed to develop a set of logic models that could be widely used in tobacco policy evaluation. METHODS We developed an overarching logic model that reflected the broad categories of outcomes that would be expected following the implementation of tobacco control policies. We subsequently reviewed policy documents to identify the outcomes expected to result from the implementation of each policy and conducted a literature review of existing evaluations to identify further outcomes. The models were revised according to feedbacks from a range of stakeholders. RESULTS The final models represented expected causal pathways for each policy. The models included short-term outcomes (such as policy awareness, compliance and social cognitive outcomes), intermediate outcomes (such as changes in smoking behaviour) and long-term outcomes (such as mortality, morbidity and health service usage). CONCLUSIONS The use of logic models enables transparent and theory-based planning of evaluation analyses and should be encouraged in the evaluation of tobacco control policy, as well as other areas of public health.
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Affiliation(s)
- Tessa Langley
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham NG5 1PB, UK
- UK Centre for Tobacco and Alcohol Studies, UK
- SPECTRUM Consortium, UK
| | - Duncan Gillespie
- UK Centre for Tobacco and Alcohol Studies, UK
- SPECTRUM Consortium, UK
- School of Health and Related Research, University of Sheffield, Sheffield S1 4DA, UK
| | - Sarah Lewis
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham NG5 1PB, UK
- UK Centre for Tobacco and Alcohol Studies, UK
| | - Katie Eminson
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham NG5 1PB, UK
- UK Centre for Tobacco and Alcohol Studies, UK
| | - Alan Brennan
- UK Centre for Tobacco and Alcohol Studies, UK
- SPECTRUM Consortium, UK
- School of Health and Related Research, University of Sheffield, Sheffield S1 4DA, UK
| | - Graeme Docherty
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham NG5 1PB, UK
- UK Centre for Tobacco and Alcohol Studies, UK
| | - Ben Young
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham NG5 1PB, UK
- UK Centre for Tobacco and Alcohol Studies, UK
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Wilson LB, Angus C, Pryce R, Holmes J, Brennan A, Gillespie D. Do dual purchasers behave differently? An analysis of purchasing data for households that buy both alcohol and tobacco in the United Kingdom. Addiction 2021; 116:2538-2547. [PMID: 33565690 DOI: 10.1111/add.15430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/29/2020] [Accepted: 01/20/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Dual purchasers of alcohol and tobacco are at increased health risk from the interacting health impacts of alcohol and tobacco use. They are also at financial risk from exposure to the dual financial cost of policies that increase alcohol and tobacco prices. Understanding whose alcohol and tobacco use exposes them to these health and financial risks is important for understanding the inequality impacts of control policies. This study explores the extent to which household spending on alcohol and tobacco combined varies between socio-economic groups and compares this with results for households which purchase only one of the commodities. DESIGN Cross-sectional analysis of household-level alcohol and tobacco purchasing data. SETTING United Kingdom, 2012-17. PARTICIPANTS/CASES A total of 26 021 households. MEASUREMENTS We analysed transaction-level data from individual 14-day spending diaries in the Living Cost and Food Survey (LCFS). We used this to calculate expenditure, volumes of alcohol and tobacco purchased, and the price paid per unit of alcohol (1 unit = 8 g) and per stick of tobacco. This was compared with equivalized total expenditure and quintiles of equivalized household income. Prices were calibrated and pack sizes were imputed using empirical sales data from Nielsen/CGA to correct for reporting bias. FINDINGS Dual purchasing households spent [95% confidence interval] more on alcohol and more on tobacco than their single-purchasing counterparts. In general, lower-income households spent less on both alcohol and tobacco than higher-income households. Furthermore, dual purchasing households in the lowest income group were most exposed to potential increases in price than were other income groups, with (CI = 12.41-13.15%) of their total household budget spent on alcohol and tobacco. CONCLUSIONS Dual purchasers of alcohol and tobacco in the United Kingdom appear to be concentrated evenly among income groups. However, dual purchasers may experience particularly large effects from pricing policies, as they spend a substantially higher proportion of their overall household expenditure on alcohol and tobacco than do households that purchase only one of the commodities.
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Affiliation(s)
- Luke B Wilson
- Sheffield Alcohol Research Group, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Colin Angus
- Sheffield Alcohol Research Group, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Robert Pryce
- Sheffield Alcohol Research Group, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - John Holmes
- Sheffield Alcohol Research Group, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- Sheffield Alcohol Research Group, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Duncan Gillespie
- Sheffield Alcohol Research Group, School of Health and Related Research, University of Sheffield, Sheffield, UK
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Wilson LB, Pryce R, Angus C, Hiscock R, Brennan A, Gillespie D. The effect of alcohol tax changes on retail prices: how do on-trade alcohol retailers pass through tax changes to consumers? Eur J Health Econ 2021; 22:381-392. [PMID: 33507448 PMCID: PMC7954722 DOI: 10.1007/s10198-020-01261-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 12/18/2020] [Indexed: 06/02/2023]
Abstract
The effectiveness of alcohol duty increases relies on alcohol retailers passing the tax increase on to consumers. This study uses sales data from a market research company to investigate tax pass-through over 11 years for on-premise retailers in England and whether this varies across the price distribution, for different beverage categories and outlet types. Panel data quantile regression analysis is used to estimate the impact of 12 excise duty changes and 3 sales tax changes between 2007 and 2017 on prices. We use product-level quarterly panel data from for 777 alcoholic products. We undertake the regression at all outlets level separating products are analysed in seven broad beverage categories (Beer, Cider, RTDs, Spirits, Wine, Sparkling Wine, and Fortified Wine). We further test sensitivity by disaggregating outlets into seven outlet types. For all seven broad beverage categories, we find that there exists significant differences in tax pass-through across the price distribution. Retailers appear to "undershift" cheaper beverages (prices rise by less than the tax increase) and subsidise this loss in revenue with an "overshift" in the relatively more expensive products. Future modelling of tax change impacts on population subgroups could incorporate this evidence, and this is important because different socio-economic and drinker groups purchase alcohol at different points on the price distribution and hence are affected differently by tax changes. Governments could also potentially incorporate this evidence into future impact assessments.
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Affiliation(s)
- Luke B Wilson
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Robert Pryce
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Rosemary Hiscock
- Tobacco Control Research Group, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Duncan Gillespie
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK
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Brennan A, Angus C, Pryce R, Buykx P, Henney M, Gillespie D, Holmes J, Meier PS. Potential effects of minimum unit pricing at local authority level on alcohol-attributed harms in North West and North East England: a modelling study. Public Health Res 2021. [DOI: 10.3310/phr09040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
In 2018, Scotland implemented a 50p-per-unit minimum unit price for alcohol. Previous modelling estimated the impact of minimum unit pricing for England, Scotland, Wales and Northern Ireland. Decision-makers want to know the potential effects of minimum unit pricing for local authorities in England; the premise of this study is that estimated effects of minimum unit pricing would vary by locality.
Objective
The objective was to estimate the potential effects on mortality, hospitalisations and crime of the implementation of minimum unit pricing for alcohol at local authority level in England.
Design
This was an evidence synthesis, and used computer modelling using the Sheffield Alcohol Policy Model (local authority version 4.0). This study gathered evidence on local consumption of alcohol from the Health Survey for England, and gathered data on local prices paid from the Living Costs and Food Survey and from market research companies’ actual sales data. These data were linked with local harms in terms of both alcohol-attributable mortality (from the Office for National Statistics) and alcohol-attributable hospitalisations (from Hospital Episode Statistics) for 45 conditions defined by the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision. These data were examined for eight age–sex groups split by five Index of Multiple Deprivation quintiles. Alcohol-attributable crime data (Office for National Statistics police-recorded crimes and uplifts for unrecorded offences) were also analysed.
Setting
This study was set in 23 upper-tier local authorities in North West England, 12 upper-tier local authorities in the North East region and nine government office regions, and a national summary was conducted.
Participants
The participants were the population of England aged ≥ 18 years.
Intervention
The intervention was setting a local minimum unit price. The base case is 50p per unit of alcohol. Sensitivity analyses were undertaken using minimum unit prices of 30p, 40p, 60p and 70p per unit of alcohol.
Main outcome measures
The main outcome measures were changes in alcohol-attributable deaths, hospitalisations and crime. Savings in NHS costs, changes in alcohol purchasing and consumption, changes in revenue to off-trade and on-trade retailers and changes in the slope index of inequality between most and least deprived areas were also examined.
Results
The modelling has proved feasible at the upper-tier local authority level. The resulting estimates suggest that minimum unit pricing for alcohol at local authority level could be effective in reducing alcohol-attributable deaths, hospitalisations, NHS costs and crime. A 50p minimum unit price for alcohol at local authority level is estimated to reduce annual alcohol-related deaths in the North West region by 205, hospitalisations by 5956 (–5.5%) and crimes by 8528 (–2.5%). These estimated reductions are mostly due to the 5% of people drinking at high-risk levels (e.g. men drinking > 25 pints of beer or five bottles of wine per week, women drinking > 17 pints of beer or 3.5 bottles of wine per week, and who spend around £2500 per year currently on alcohol). Model estimates of impact are bigger in the North West and North East regions than nationally because, currently, more cheap alcohol is consumed in these regions and because there are more alcohol-related deaths and hospitalisations in these areas. A 30p minimum unit price has estimated effects that are ≈ 90% lower than those of a 50p minimum unit price, and a 40p minimum unit price has estimated effects that are ≈ 50% lower. Health inequalities are estimated to reduce with greater health gains in the deprived areas, where more cheap alcohol is purchased and where there are higher baseline harms.
Limitations
The approach requires synthesis of evidence from multiple sources on alcohol consumption; prices paid; and incidence of diseases, mortality and crime. Price elasticities used are from previous UK analysis of price responsiveness rather than specific to local areas. The study has not estimated ‘cross-border effects’, namely travelling to shops outside the region.
Conclusions
The modelling estimates suggest that minimum unit pricing for alcohol at local authority level would be an effective and well-targeted policy, reducing inequalities.
Future work
The Sheffield Alcohol Policy Model for Local Authorities framework could be further utilised to examine the local impact of national policies (e.g. tax changes) or local policies (e.g. licensing or identification and brief advice). As evidence emerges from the Scottish minimum unit price implementation, this will further inform estimates of impact in English localities. The methods used to estimate drinking and purchasing patterns in each local authority could also be used for other topics involving unhealthy products affecting public health, for example to estimate local smoking or high-fat, high-salt food consumption patterns.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 4. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Robert Pryce
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Penny Buykx
- School of Health and Related Research, University of Sheffield, Sheffield, UK
- School of Humanities and Social Science, University of Newcastle, Newcastle, NSW, Australia
| | - Madeleine Henney
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Duncan Gillespie
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Petra S Meier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Horton M, Perman-Howe PR, Angus C, Bishop J, Bogdanovica I, Brennan A, Britton J, Brose LS, Brown J, Collin J, Dockrell M, Fitzgerald N, Friel S, Gillespie D, Gilmore AB, Hill SE, Knai C, Langley T, Martin S, McNeill A, Moore G, Munafò MR, Murray RL, Opazo Breton M, Pearce J, Petticrew M, Reid G, Robson D, Rutter H, Shahab L, Shortt N, Smith K, Syrett K, Bauld L. The SPECTRUM Consortium: a new UK Prevention Research Partnership consortium focussed on the commercial determinants of health, the prevention of non-communicable diseases, and the reduction of health inequalities. Wellcome Open Res 2021; 6:6. [PMID: 33693062 PMCID: PMC7931256 DOI: 10.12688/wellcomeopenres.16318.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2020] [Indexed: 12/26/2022] Open
Abstract
The main causes of non-communicable diseases (NCDs), health inequalities and health inequity include consumption of unhealthy commodities such as tobacco, alcohol and/or foods high in fat, salt and/or sugar. These exposures are preventable, but the commodities involved are highly profitable. The economic interests of 'Unhealthy Commodity Producers' (UCPs) often conflict with health goals but their role in determining health has received insufficient attention. In order to address this gap, a new research consortium has been established. This open letter introduces the SPECTRUM ( S haping Public h Ealth poli Cies To Reduce ineq Ualities and har M)Consortium: a multi-disciplinary group comprising researchers from 10 United Kingdom (UK) universities and overseas, and partner organisations including three national public health agencies in Great Britain (GB), five multi-agency alliances and two companies providing data and analytic support. Through eight integrated work packages, the Consortium seeks to provide an understanding of the nature of the complex systems underlying the consumption of unhealthy commodities, the role of UCPs in shaping these systems and influencing health and policy, the role of systems-level interventions, and the effectiveness of existing and emerging policies. Co-production is central to the Consortium's approach to advance research and achieve meaningful impact and we will involve the public in the design and delivery of our research. We will also establish and sustain mutually beneficial relationships with policy makers, alongside our partners, to increase the visibility, credibility and impact of our evidence. The Consortium's ultimate aim is to achieve meaningful health benefits for the UK population by reducing harm and inequalities from the consumption of unhealthy commodities over the next five years and beyond.
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Affiliation(s)
- Marie Horton
- Population Health Analysis, Health Intelligence, Public Health England, London, UK
| | - Parvati R. Perman-Howe
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Julie Bishop
- Health Improvement Division, Public Health Wales, Cardiff, UK
| | - Ilze Bogdanovica
- UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - John Britton
- UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Leonie S. Brose
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, UCL, London, UK
| | - Jeff Collin
- Global Health Policy Unit, Social Policy, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Martin Dockrell
- Health Improvement Directorate, Public Health England, London, UK
| | - Niamh Fitzgerald
- Institute for Social Marketing & Health, University of Stirling, Stirling, UK
| | - Sharon Friel
- Centre for Health Governance, School of Regulation and Global Governance, Australian National University, Canberra, Australia
| | - Duncan Gillespie
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Anna B. Gilmore
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Sarah E. Hill
- Global Health Policy Unit, Social Policy, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Cecile Knai
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Tessa Langley
- UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Sancha Martin
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Ann McNeill
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Graham Moore
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - Marcus R. Munafò
- School of Psychological Science and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Rachael L. Murray
- UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | | | - Jamie Pearce
- Centre for Research on Environment, Society & Health, University of Edinburgh, Edinburgh, UK
| | - Mark Petticrew
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Garth Reid
- Public Health Science Directorate, Public Health Scotland, Edinburgh, UK
| | - Deborah Robson
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, UCL, London, UK
| | - Niamh Shortt
- Centre for Research on Environment, Society & Health, University of Edinburgh, Edinburgh, UK
| | - Katherine Smith
- School of Social Work & Social Policy, University of Strathclyde, Glasgow, UK
| | - Keith Syrett
- Centre for Health, Law, and Society, School of Law, University of Bristol, Bristol, UK
| | - Linda Bauld
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
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Gillespie D, Hatchard J, Squires H, Gilmore A, Brennan A. Conceptualising changes to tobacco and alcohol policy as affecting a single interlinked system. BMC Public Health 2021; 21:17. [PMID: 33397324 PMCID: PMC7783976 DOI: 10.1186/s12889-020-10000-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 12/02/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND To support a move towards a coordinated non-communicable disease approach in public health policy, it is important to conceptualise changes to policy on tobacco and alcohol as affecting a single interlinked system. For health economic models to effectively inform policy, the first step in their development should be to develop a conceptual understanding of the system complexity that is likely to affect the outcomes of policy change. Our aim in this study was to support the development and interpretation of health economic models of the effects of changes to tobacco and alcohol policies by developing a conceptual understanding of the main components and mechanisms in the system that links policy change to outcomes. METHODS Our study was based on a workshop from which we captured data on participant discussions on the joint tobacco-alcohol policy system. To inform these discussions, we prepared with a literature review and a survey of participants. Participants were academics and policy professionals who work in the United Kingdom. Data were analysed thematically to produce a description of the main components and mechanisms within the system. RESULTS Of the people invited, 24 completed the survey (18 academic, 6 policy); 21 attended the workshop (16 academic, 5 policy). Our analysis identified eleven mechanisms through which individuals might modify the effects of a policy change, which include mechanisms that might lead to linked effects of policy change on tobacco and alcohol consumption. We identified ten mechanisms by which the tobacco and alcohol industries might modify the effects of policy changes, grouped into two categories: Reducing policy effectiveness; Enacting counter-measures. Finally, we identified eighteen research questions that indicate potential avenues for further work to understand the potential outcomes of policy change. CONCLUSIONS Model development should carefully consider the ways in which individuals and the tobacco and alcohol industries might modify the effects of policy change, and the extent to which this results in an unequal societal distribution of outcomes. Modelled evidence should then be interpreted in the light of the conceptual understanding of the system that the modelling necessarily simplifies in order to predict the outcomes of policy change.
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Affiliation(s)
- Duncan Gillespie
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
- UK Centre for Tobacco and Alcohol Studies, Nottingham, UK.
- SPECTRUM Consortium, Edinburgh, UK.
| | - Jenny Hatchard
- UK Centre for Tobacco and Alcohol Studies, Nottingham, UK
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Hazel Squires
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
- UK Centre for Tobacco and Alcohol Studies, Nottingham, UK
| | - Anna Gilmore
- UK Centre for Tobacco and Alcohol Studies, Nottingham, UK
- SPECTRUM Consortium, Edinburgh, UK
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Alan Brennan
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
- UK Centre for Tobacco and Alcohol Studies, Nottingham, UK
- SPECTRUM Consortium, Edinburgh, UK
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Angus C, Pryce R, Holmes J, de Vocht F, Hickman M, Meier P, Brennan A, Gillespie D. Assessing the contribution of alcohol-specific causes to socio-economic inequalities in mortality in England and Wales 2001-16. Addiction 2020; 115:2268-2279. [PMID: 32237009 PMCID: PMC7687183 DOI: 10.1111/add.15037] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/02/2020] [Accepted: 02/28/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND AIMS When measuring inequalities in health, public health and addiction research has tended to focus on differences in average life-span between socio-economic groups. This does not account for the extent to which age of death varies between individuals within socio-economic groups or whether this variation differs between groups. This study assesses (1) socio-economic inequalities in both average life-span and variation in age at death, (2) the extent to which these inequalities can be attributed to alcohol-specific causes (i.e. those attributable only to alcohol) and (3) how this contribution has changed over time. DESIGN Cause-deleted life table analysis of national mortality records. SETTING England and Wales, 2001-16. CASES All-cause and alcohol-specific deaths for all adults aged 18+, stratified by sex, age and quintiles of the index of multiple deprivation (IMD). MEASUREMENTS Life expectancy at age 18 yearss and standard deviation in age at death within IMD quintiles and the contribution of alcohol to overall differences in both measures between the highest and lowest IMD quintiles by comparing observed and cause-deleted inequality 'gaps'. FINDINGS In 2016, alcohol-specific causes reduced life expectancy for men and women by 0.26 and 0.14 years, respectively, and increased the standard deviation in age at death. These causes also increased the inequality gap in life expectancy by 0.33 years for men and 0.17 years for women, and variation in age at death by 0.14 years and 0.13 years, respectively. For both measures, the contribution of alcohol to mortality inequalities rose after 2001 and subsequently fell back. For women, alcohol accounted for 3.6% of inequality in age at death and 6.0% of life-span uncertainty, suggesting that using only the former may underestimate alcohol-induced inequalities. There was no comparable difference for men. CONCLUSIONS Deaths from alcohol-specific causes increase inequalities in both life expectancy and variation in age of death between socio-economic groups. Using both measures can provide a fuller picture of overall inequalities in health.
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Affiliation(s)
- Colin Angus
- Sheffield Alcohol Research Group, School of Health and Related ResearchUniversity of SheffieldSheffieldUK,NIHR School for Public Health Research
| | - Rob Pryce
- Sheffield Alcohol Research Group, School of Health and Related ResearchUniversity of SheffieldSheffieldUK,NIHR School for Public Health Research
| | - John Holmes
- Sheffield Alcohol Research Group, School of Health and Related ResearchUniversity of SheffieldSheffieldUK,NIHR School for Public Health Research
| | - Frank de Vocht
- NIHR School for Public Health Research,School of Social and Community MedicineBristolUK
| | - Matthew Hickman
- NIHR School for Public Health Research,School of Social and Community MedicineBristolUK
| | - Petra Meier
- Sheffield Alcohol Research Group, School of Health and Related ResearchUniversity of SheffieldSheffieldUK,NIHR School for Public Health Research
| | - Alan Brennan
- Sheffield Alcohol Research Group, School of Health and Related ResearchUniversity of SheffieldSheffieldUK,NIHR School for Public Health Research
| | - Duncan Gillespie
- Sheffield Alcohol Research Group, School of Health and Related ResearchUniversity of SheffieldSheffieldUK,NIHR School for Public Health Research
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Yang F, Angus C, Duarte A, Gillespie D, Walker S, Griffin S. Impact of Socioeconomic Differences on Distributional Cost-effectiveness Analysis. Med Decis Making 2020; 40:606-618. [PMID: 32608317 PMCID: PMC7488816 DOI: 10.1177/0272989x20935883] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 05/25/2020] [Indexed: 11/17/2022]
Abstract
Public health decision makers value interventions for their effects on overall health and health inequality. Distributional cost-effectiveness analysis (DCEA) incorporates health inequality concerns into economic evaluation by accounting for how parameters, such as effectiveness, differ across population groups. A good understanding of how and when accounting for socioeconomic differences between groups affects the assessment of intervention impacts on overall health and health inequality could inform decision makers where DCEA would add most value. We interrogated 2 DCEA models of smoking and alcohol policies using first national level and then local authority level information on various socioeconomic differences in health and intervention use. Through a series of scenario analyses, we explored the impact of altering these differences on the DCEA results. When all available evidence on socioeconomic differences was incorporated, provision of a smoking cessation service was estimated to increase overall health and increase health inequality, while the screening and brief intervention for alcohol misuse was estimated to increase overall health and reduce inequality. Ignoring all or some socioeconomic differences resulted in minimal change to the estimated impact on overall health in both models; however, there were larger effects on the estimated impact on health inequality. Across the models, there were no clear patterns in how the extent and direction of socioeconomic differences in the inputs translated into the estimated impact on health inequality. Modifying use or coverage of either intervention so that each population group matched the highest level improved the impacts to a greater degree than modifying intervention effectiveness. When local level socioeconomic differences were considered, the magnitude of the impacts was altered; in some cases, the direction of impact on inequality was also altered.
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Affiliation(s)
- Fan Yang
- Centre for Health Economics, University of York, UK
| | - Colin Angus
- Sheffield Alcohol Research Group, Health Economics and Decision Science, ScHARR, University of Sheffield, UK
| | - Ana Duarte
- Centre for Health Economics, University of York, UK
| | - Duncan Gillespie
- Sheffield Alcohol Research Group, Health Economics and Decision Science, ScHARR, University of Sheffield, UK
| | - Simon Walker
- Centre for Health Economics, University of York, UK
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Pryce R, Angus C, Holmes J, Gillespie D, Buykx P, Meier P, Hickman M, de Vocht F, Brennan A. Reweighting national survey data for small area behaviour estimates: modelling alcohol consumption in Local Authorities in England. Popul Health Metr 2020; 18:1. [PMID: 31898545 PMCID: PMC6941256 DOI: 10.1186/s12963-019-0201-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 12/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are likely to be differences in alcohol consumption levels and patterns across local areas within a country, yet survey data is often collected at the national or sub-national/regional level and is not representative for small geographic areas. METHODS This paper presents a method for reweighting national survey data-the Health Survey for England-by combining survey and routine data to produce simulated locally representative survey data and provide statistics of alcohol consumption for each Local Authority in England. RESULTS We find a 2-fold difference in estimated mean alcohol consumption between the lightest and heaviest drinking Local Authorities, a 4.5-fold difference in abstention rates, and a 3.5-fold difference in harmful drinking. The method compares well to direct estimates from the data at regional level. CONCLUSIONS The results have important policy implications in itself, but the reweighted data can also be used to model local policy effects. This method can also be used for other public health small area estimation where locally representative data are not available.
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Affiliation(s)
- Robert Pryce
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA UK
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA UK
| | - Duncan Gillespie
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA UK
| | - Penny Buykx
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA UK
- School of Humanities and Social Science, Newcastle University, Newcastle, New South Wales Australia
| | - Petra Meier
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA UK
| | - Matt Hickman
- Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK
| | - Frank de Vocht
- Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA UK
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Angus C, Brown J, Beard E, Gillespie D, Buykx P, Kaner EFS, Michie S, Meier P. Socioeconomic inequalities in the delivery of brief interventions for smoking and excessive drinking: findings from a cross-sectional household survey in England. BMJ Open 2019; 9:e023448. [PMID: 31048422 PMCID: PMC6501949 DOI: 10.1136/bmjopen-2018-023448] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 01/24/2019] [Accepted: 02/18/2019] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Brief interventions (BI) for smoking and risky drinking are effective and cost-effective policy approaches to reducing alcohol harm currently used in primary care in England; however, little is known about their contribution to health inequalities. This paper aims to investigate whether self-reported receipt of BI is associated with socioeconomic position (SEP) and whether this differs for smoking or alcohol. DESIGN Population survey of 8978 smokers or risky drinkers in England aged 16+ taking part in the Alcohol and Smoking Toolkit Studies. MEASURES Survey participants answered questions regarding whether they had received advice and support to cut down their drinking or smoking from a primary healthcare professional in the past 12 months as well as their SEP, demographic details, whether they smoke and their motivation to cut down their smoking and/or drinking. Respondents also completed the Alcohol Use Disorders Identification Test (AUDIT). Smokers were defined as those reporting any smoking in the past year. Risky drinkers were defined as those scoring eight or more on the AUDIT. RESULTS After adjusting for demographic factors and patterns in smoking and drinking, BI delivery was highest in lower socioeconomic groups. Smokers in the lowest social grade had 30% (95% CI 5% to 61%) greater odds of reporting receipt of a BI than those in the highest grade. The relationship for risky drinking appeared stronger, with those in the lowest social grade having 111% (95% CI 27% to 252%) greater odds of reporting BI receipt than the highest grade. Rates of BI delivery were eight times greater among smokers than risky drinkers (48.3% vs 6.1%). CONCLUSIONS Current delivery of BI for smoking and drinking in primary care in England may be contributing to a reduction in socioeconomic inequalities in health. This effect could be increased if intervention rates, particularly for drinking, were raised.
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Affiliation(s)
- Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Jamie Brown
- Department of Psychology and Language Sciences, University College London, London, UK
| | - Emma Beard
- Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | - Duncan Gillespie
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Penelope Buykx
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Eileen F S Kaner
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Susan Michie
- Centre for Outcomes Research and Effectiveness, University College London, London, UK
| | - Petra Meier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Hastings RP, Gillespie D, Flynn S, McNamara R, Taylor Z, Knight R, Randell E, Richards L, Moody G, Mitchell A, Przybylak P, Williams B, Hunt PH. Who's challenging who training for staff empathy towards adults with challenging behaviour: cluster randomised controlled trial. J Intellect Disabil Res 2018; 62:798-813. [PMID: 30033655 DOI: 10.1111/jir.12536] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 06/21/2018] [Accepted: 06/26/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND One in five adults with intellectual disabilities (ID) known to services display challenging behaviours (CBs), and these individuals are at risk for restrictive practices and poor care. Staff attitudes may contribute to the development and/or maintenance of CBs. We investigated the effectiveness of co-produced Who's Challenging Who? training delivered by people with ID to staff. METHOD This study involved a cluster randomised controlled trial (RCT) of Who's Challenging Who? training with follow-up at six and 20 weeks post-randomisation. PARTICIPANTS two staff from each of 118 residential care settings for adults with ID at least one of whom displayed aggressive CB. PRIMARY OUTCOME Self-reported Staff Empathy for people with Challenging Behaviour Questionnaire. ANALYSIS intention to treat of all randomised settings. ISCRTN registration: ISRCTN53763600. RESULTS 118 residential settings (including 236 staff) were randomised to either receive training (59 settings) or to receive training after a delay (59 settings). The primary analysis included data from 121 staff in 76 settings (51% of staff, 64% of settings). The adjusted mean difference on the transformed (cubed) Staff Empathy for people with Challenging Behaviour Questionnaire score at the primary end point was 1073.2 (95% CI: -938.1 to 3084.5, P = 0.296) in favour of the intervention group (effect size Cohen's d = .19). CONCLUSIONS This is the first large-scale RCT of a co-produced training course delivered by people with ID. Findings indicated a small positive (but statistically non-significant) effect on increased staff empathy at 20 weeks, and small to moderate effects for staff reported secondary outcomes in favour of the intervention group.
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Affiliation(s)
- R P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, UK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia
| | - D Gillespie
- Centre for Trials Research, Cardiff University, UK
| | - S Flynn
- Centre for Educational Development, Appraisal and Research, University of Warwick, UK
| | - R McNamara
- Centre for Trials Research, Cardiff University, UK
| | - Z Taylor
- Royal Mencap Society, London, UK
| | - R Knight
- Centre for Educational Development, Appraisal and Research, University of Warwick, UK
| | - E Randell
- Centre for Trials Research, Cardiff University, UK
| | - L Richards
- Centre for Educational Development, Appraisal and Research, University of Warwick, UK
| | - G Moody
- Centre for Trials Research, Cardiff University, UK
| | - A Mitchell
- Centre for Educational Development, Appraisal and Research, University of Warwick, UK
| | - P Przybylak
- Centre for Educational Development, Appraisal and Research, University of Warwick, UK
| | - B Williams
- Centre for Educational Development, Appraisal and Research, University of Warwick, UK
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Holloway AS, Ferguson J, Landale S, Cariola L, Newbury-Birch D, Flynn A, Knight JR, Sherritt L, Harris SK, O’Donnell AJ, Kaner E, Hanratty B, Loree AM, Yonkers KA, Ondersma SJ, Gilstead-Hayden K, Martino S, Adam A, Schwartz RP, Wu LT, Subramaniam G, Sharma G, McNeely J, Berman AH, Kolaas K, Petersén E, Bendtsen P, Hedman E, Linderoth C, Müssener U, Sinadinovic K, Spak F, Gremyr I, Thurang A, Mitchell AM, Finnell D, Savage CL, Mahmoud KF, Riordan BC, Conner TS, Flett JAM, Scarf D, McRee B, Vendetti J, Gallucci KS, Robaina K, Clark BJ, Jones J, Reed KD, Hodapp RM, Douglas I, Burnham EL, Aagaard L, Cook PF, Harris BR, Yu J, Wolff M, Rogers M, Barbosa C, Wedehase BJ, Dunlap LJ, Mitchell SG, Dusek KA, Gryczynski J, Kirk AS, Oros MT, Hosler C, O’Grady KE, Brown BS, Angus C, Sherborne S, Gillespie D, Meier P, Brennan A, de Vargas D, Soares J, Castelblanco D, Doran KM, Wittman I, Shelley D, Rotrosen J, Gelberg L, Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Deng Y, Dziura J, Fiellin LE, O’Connor PG, Bedimo R, Gibert C, Marconi VC, Rimland D, Rodriguez-Barradas MC, Simberkoff MS, Justice AC, Bryant KJ, Fiellin DA, Giles EL, Coulton S, Deluca P, Drummond C, Howel D, McColl E, McGovern R, Scott S, Stamp E, Sumnall H, Vale L, Alabani V, Atkinson A, Boniface S, Frankham J, Gilvarry E, Hendrie N, Howe N, McGeechan GJ, Ramsey A, Stanley G, Clephane J, Gardiner D, Holmes J, Martin N, Shevills C, Soutar M, Chi FW, Weisner C, Ross TB, Mertens J, Sterling SA, Shorter GW, Heather N, Bray J, Cohen HA, McPherson TL, Adam C, López-Pelayo H, Gual A, Segura-Garcia L, Colom J, Ornelas IJ, Doyle S, Donovan D, Duran B, Torres V, Gaume J, Grazioli V, Fortini C, Paroz S, Bertholet N, Daeppen JB, Satterfield JM, Gregorich S, Alvarado NJ, Muñoz R, Kulieva G, Vijayaraghavan M, Adam A, Cunningham JA, Díaz E, Palacio-Vieira J, Godinho A, Kushir V, O’Brien KHM, Aguinaldo LD, Sellers CM, Spirito A, Chang G, Blake-Lamb T, LaFave LRA, Thies KM, Pepin AL, Sprangers KE, Bradley M, Jorgensen S, Catano NA, Murray AR, Schachter D, Andersen RM, Rey GN, Vahidi M, Rico MW, Baumeister SE, Johansson M, Sinadinovic C, Hermansson U, Andreasson S, O’Grady MA, Kapoor S, Akkari C, Bernal C, Pappacena K, Morley J, Auerbach M, Neighbors CJ, Kwon N, Conigliaro J, Morgenstern J, Magill M, Apodaca TR, Borsari B, Hoadley A, Scott Tonigan J, Moyers T, Fitzgerald NM, Schölin L, Barticevic N, Zuzulich S, Poblete F, Norambuena P, Sacco P, Ting L, Beaulieu M, Wallace PG, Andrews M, Daley K, Shenker D, Gallagher L, Watson R, Weaver T, Bruguera P, Oliveras C, Gavotti C, Barrio P, Braddick F, Miquel L, Suárez M, Bruguera C, Brown RL, Capell JW, Paul Moberg D, Maslowsky J, Saunders LA, McCormack RP, Scheidell J, Gonzalez M, Bauroth S, Liu W, Lindsay DL, Lincoln P, Hagle H, Wallhed Finn S, Hammarberg A, Andréasson S, King SE, Vargo R, Kameg BN, Acquavita SP, Van Loon RA, Smith R, Brehm BJ, Diers T, Kim K, Barker A, Jones AL, Skinner AC, Hinman A, Svikis DS, Thacker CL, Resnicow K, Beatty JR, Janisse J, Puder K, Bakshi AS, Milward JM, Kimergard A, Garnett CV, Crane D, Brown J, West R, Michie S, Rosendahl I, Andersson C, Gajecki M, Blankers M, Donoghue K, Lynch E, Maconochie I, Phillips C, Pockett R, Phillips T, Patton R, Russell I, Strang J, Stewart MT, Quinn AE, Brolin M, Evans B, Horgan CM, Liu J, McCree F, Kanovsky D, Oberlander T, Zhang H, Hamlin B, Saunders R, Barton MB, Scholle SH, Santora P, Bhatt C, Ahmed K, Hodgkin D, Gao W, Merrick EL, Drebing CE, Larson MJ, Sharma M, Petry NM, Saitz R, Weisner CM, Young-Wolff KC, Lu WY, Blosnich JR, Lehavot K, Glass JE, Williams EC, Bensley KM, Chan G, Dombrowski J, Fortney J, Rubinsky AD, Lapham GT, Forray A, Olmstead TA, Gilstad-Hayden K, Kershaw T, Dillon P, Weaver MF, Grekin ER, Ellis JD, McGoron L, McGoron L. Proceedings of the 14th annual conference of INEBRIA. Addict Sci Clin Pract 2017. [PMCID: PMC5606215 DOI: 10.1186/s13722-017-0087-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Sadler S, Angus C, Gavens L, Gillespie D, Holmes J, Hamilton J, Brennan A, Meier P. Understanding the alcohol harm paradox: an analysis of sex- and condition-specific hospital admissions by socio-economic group for alcohol-associated conditions in England. Addiction 2017; 112:808-817. [PMID: 27981670 DOI: 10.1111/add.13726] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/22/2016] [Accepted: 12/12/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS In many countries, conflicting gradients in alcohol consumption and alcohol-associated mortality have been observed. To understand this 'alcohol harm paradox' we analysed the socio-economic gradient in alcohol-associated hospital admissions to test whether it was greater in conditions which were: (1) chronic (associated with long-term drinking) and partially alcohol-attributable, (2) chronic and wholly alcohol-attributable, (3) acute (associated with intoxication) and partially alcohol-attributable and (4) acute and wholly alcohol-attributable. Our aim was to clarify how (1) drinking patterns (e.g. intoxication linked to acute admissions or dependence linked to chronic conditions) and (2) non-alcohol causes (e.g. smoking and poor diet which are risks for partially alcohol-attributable conditions) contribute to the paradox. DESIGN Regression analysis testing the modifying effects of condition-group (1-4 above) and sex on the relationship between area-based deprivation and admissions. SETTING England, April 2010-March 2013. PARTICIPANTS A total of 9 239 629 English hospital admissions where a primary or secondary cause was one of 36 alcohol-associated conditions. MEASUREMENTS Admissions by condition and deciles of Index of Multiple Deprivation (IMD). Socio-economic gradient measured as the relative index of inequality (RII, the slope of a linear regression of IMD on admissions adjusted for overall admission rate). Conditions were categorized by ICD-10 code. FINDINGS A socio-economic gradient in hospitalizations was seen for all conditions, except partially attributable chronic conditions. The gradient was significantly steeper for conditions which were wholly attributable to alcohol and for acute conditions than for conditions partially alcohol-attributable and for chronic conditions. Gradients were steeper for men than for women in cases of wholly alcohol attributable conditions. CONCLUSIONS There is a socio-economic gradient in English hospital admission for most alcohol-associated conditions. The greatest inequalities are in conditions associated with alcohol dependence, such as liver disease and mental and behavioural conditions, and in acute conditions, such as alcohol poisoning and assault. Socio-economic differences in harmful drinking patterns (dependence and intoxication) may contribute to the 'alcohol harm paradox'.
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Affiliation(s)
- Susannah Sadler
- School of Health and Related Research, University of Sheffield, Sheffield, UK.,University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Lucy Gavens
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Duncan Gillespie
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Jean Hamilton
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Petra Meier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Brown J, West R, Beard E, Brennan A, Drummond C, Gillespie D, Hickman M, Holmes J, Kaner E, Michie S. Are recent attempts to quit smoking associated with reduced drinking in England? A cross-sectional population survey. BMC Public Health 2016; 16:535. [PMID: 27443348 PMCID: PMC4957412 DOI: 10.1186/s12889-016-3223-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 06/27/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Alcohol consumption during attempts at smoking cessation can provoke relapse and so smokers are often advised to restrict their alcohol consumption during this time. This study assessed at a population-level whether smokers having recently initiated an attempt to stop smoking are more likely than other smokers to report i) lower alcohol consumption and ii) trying to reduce their alcohol consumption. METHOD Cross-sectional household surveys of 6287 last-year smokers who also completed the Alcohol Use Disorders Identification Test consumption questionnaire (AUDIT-C). Respondents who reported attempting to quit smoking in the last week were compared with those who did not. Those with AUDIT-C≥5 were also asked if they were currently trying to reduce the amount of alcohol they consume. RESULTS After adjustment for socio-demographic characteristics and current smoking status, smokers who reported a quit attempt within the last week had lower AUDIT-C scores compared with those who did not report an attempt in the last week (βadj = -0.56, 95 % CI = -1.08 to -0.04) and were less likely to be classified as higher risk (AUDIT-C≥5: ORadj = 0.57, 95 % CI = 0.38 to 0.85). The lower AUDIT-C scores appeared to be a result of lower scores on the frequency of 'binge' drinking item (βadj = -0.25, 95 % CI = -0.43 to -0.07), with those who reported a quit attempt within the last week compared with those who did not being less likely to binge drink at least weekly (ORadj = 0.54, 95 % CI = 0.29 to 0.999) and more likely to not binge drink at all (ORadj = 1.70, 95 % CI = 1.16 to 2.49). Among smokers with higher risk consumption (AUDIT-C≥5), those who reported an attempt to stop smoking within the last week compared with those who did not were more likely to report trying to reduce their alcohol consumption (ORadj = 2.98, 95 % CI = 1.48 to 6.01). CONCLUSION Smokers who report starting a quit attempt in the last week also report lower alcohol consumption, including less frequent binge drinking, and appear more likely to report currently attempting to reduce their alcohol consumption compared with smokers who do not report a quit attempt in the last week.
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Affiliation(s)
- Jamie Brown
- Department of Clinical, Educational and Health Psychology, University College London, London, UK.
- Cancer Research UK Health Behaviour Research Centre, University College London, London, UK.
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), Nottingham, UK.
| | - Robert West
- Cancer Research UK Health Behaviour Research Centre, University College London, London, UK
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), Nottingham, UK
- National Centre for Smoking Cessation and Training, London, UK
| | - Emma Beard
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Cancer Research UK Health Behaviour Research Centre, University College London, London, UK
| | - Alan Brennan
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), Nottingham, UK
- Sheffield Alcohol Research Group, ScHARR, The University of Sheffield, Sheffield, UK
| | - Colin Drummond
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Duncan Gillespie
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), Nottingham, UK
- Sheffield Alcohol Research Group, ScHARR, The University of Sheffield, Sheffield, UK
| | - Matthew Hickman
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - John Holmes
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), Nottingham, UK
- Sheffield Alcohol Research Group, ScHARR, The University of Sheffield, Sheffield, UK
| | - Eileen Kaner
- Institute of Health & Society, Newcastle University, Newcastle, UK
| | - Susan Michie
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), Nottingham, UK
- National Centre for Smoking Cessation and Training, London, UK
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McGill R, Anwar E, Orton L, Bromley H, Lloyd-Williams F, O'Flaherty M, Taylor-Robinson D, Guzman-Castillo M, Gillespie D, Moreira P, Allen K, Hyseni L, Calder N, Petticrew M, White M, Whitehead M, Capewell S. Erratum to: Are interventions to promote healthy eating equally effective for all? Systematic review of socioeconomic inequalities in impact. BMC Public Health 2015; 15:894. [PMID: 26373840 PMCID: PMC4571134 DOI: 10.1186/s12889-015-2162-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 08/17/2015] [Indexed: 11/20/2022] Open
Affiliation(s)
- Rory McGill
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
| | - Elspeth Anwar
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Lois Orton
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Helen Bromley
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | | | - Martin O'Flaherty
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | | | | | - Duncan Gillespie
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Patricia Moreira
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Kirk Allen
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Lirije Hyseni
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Nicola Calder
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Mark Petticrew
- Public and Environmental Health Research Unit, London School of Hygiene and Tropical Medicine, Liverpool, UK
| | - Martin White
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK.,Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Margaret Whitehead
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Simon Capewell
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
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McGill R, Anwar E, Orton L, Bromley H, Lloyd-Williams F, O'Flaherty M, Taylor-Robinson D, Guzman-Castillo M, Gillespie D, Moreira P, Allen K, Hyseni L, Calder N, Petticrew M, White M, Whitehead M, Capewell S. Are interventions to promote healthy eating equally effective for all? Systematic review of socioeconomic inequalities in impact. BMC Public Health 2015; 15:457. [PMID: 25934496 PMCID: PMC4423493 DOI: 10.1186/s12889-015-1781-7] [Citation(s) in RCA: 209] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 04/22/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Interventions to promote healthy eating make a potentially powerful contribution to the primary prevention of non communicable diseases. It is not known whether healthy eating interventions are equally effective among all sections of the population, nor whether they narrow or widen the health gap between rich and poor. We undertook a systematic review of interventions to promote healthy eating to identify whether impacts differ by socioeconomic position (SEP). METHODS We searched five bibliographic databases using a pre-piloted search strategy. Retrieved articles were screened independently by two reviewers. Healthier diets were defined as the reduced intake of salt, sugar, trans-fats, saturated fat, total fat, or total calories, or increased consumption of fruit, vegetables and wholegrain. Studies were only included if quantitative results were presented by a measure of SEP. Extracted data were categorised with a modified version of the "4Ps" marketing mix, expanded to 6 "Ps": "Price, Place, Product, Prescriptive, Promotion, and Person". RESULTS Our search identified 31,887 articles. Following screening, 36 studies were included: 18 "Price" interventions, 6 "Place" interventions, 1 "Product" intervention, zero "Prescriptive" interventions, 4 "Promotion" interventions, and 18 "Person" interventions. "Price" interventions were most effective in groups with lower SEP, and may therefore appear likely to reduce inequalities. All interventions that combined taxes and subsidies consistently decreased inequalities. Conversely, interventions categorised as "Person" had a greater impact with increasing SEP, and may therefore appear likely to reduce inequalities. All four dietary counselling interventions appear likely to widen inequalities. We did not find any "Prescriptive" interventions and only one "Product" intervention that presented differential results and had no impact by SEP. More "Place" interventions were identified and none of these interventions were judged as likely to widen inequalities. CONCLUSIONS Interventions categorised by a "6 Ps" framework show differential effects on healthy eating outcomes by SEP. "Upstream" interventions categorised as "Price" appeared to decrease inequalities, and "downstream" "Person" interventions, especially dietary counselling seemed to increase inequalities. However the vast majority of studies identified did not explore differential effects by SEP. Interventions aimed at improving population health should be routinely evaluated for differential socioeconomic impact.
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Affiliation(s)
- Rory McGill
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
| | - Elspeth Anwar
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
| | - Lois Orton
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
| | - Helen Bromley
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
| | | | - Martin O'Flaherty
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
| | | | | | - Duncan Gillespie
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
| | - Patricia Moreira
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
| | - Kirk Allen
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
| | - Lirije Hyseni
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
| | - Nicola Calder
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
| | - Mark Petticrew
- Public and Environmental Health Research Unit, London School of Hygiene and Tropical Medicine, Liverpool, UK.
| | - Martin White
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK.
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
| | - Margaret Whitehead
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
| | - Simon Capewell
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
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Gallo RC, Saxinger WC, Gallagher RE, Miller N, Gillespie D. Evolutionary nature of human reverse transcriptase and of viral-related DNA synthesized in vitro by human leukemic cells. Bibl Haematol 2015:569-76. [PMID: 51636 DOI: 10.1159/000397574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The reverse transcriptase and endogenous DNA product synthesized by virus-like particles in the cytoplasm of human leukemic cells have been studied for their genetic relatedness to homologous components obtained from several animal RNA tumor viruses. The human reverse transcriptase activity was inhibited by antibodies prepared against reverse transcriptase from some animal RNA tumor viruses. The DNA molecules synthesized endogenously by the human cytoplasmic particle in the presence of actinomycin D, using the reverse transcriptase enzyme and RNA template residing in the particle, hybridized to 70S RNA purified from certain animal RNA tumor viruses. Both the human reverse transcriptase and DNA product are closely related to homologues from primate type-C viruses, more distantly related to those from murine type-C viruses, and essentially unrelated to similar structures from feline or avian type-C viruses. They are not related to type-B RNA tumor viruses. The results demonstrate that the components from the human leukemic cells are viral (type-C) and primate in nature.
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Felce D, Cohen D, Willner P, Rose J, Kroese B, Rose N, Shead J, Jahoda A, MacMahon P, Lammie C, Stimpson A, Woodgate C, Gillespie D, Townson J, Nuttall J, Hood K. Cognitive behavioural anger management intervention for people with intellectual disabilities: costs of intervention and impact on health and social care resource use. J Intellect Disabil Res 2015; 59:68-81. [PMID: 24404992 DOI: 10.1111/jir.12112] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/25/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND Anger and aggression among adults with intellectual disability (ID) are associated with a range of adverse consequences for their well-being and that of their family or staff carers. The aims were to evaluate the effectiveness of an anger management intervention for adults with mild to moderate ID and to evaluate the costs of the intervention and its impact on health and social care resource use. This paper is concerned with the latter aim. METHODS A cluster-randomised controlled trial was conducted involving day services for adults with ID in Scotland, England and Wales. Incremental costs of delivering the intervention and its impact on subsequent total health and social care package costs were calculated. Full data comparing costs between baseline and follow-up 10 months later were collected for 67 participants in the intervention arm and 62 participants in the control arm. Cost differences between the groups at follow-up, adjusted for baseline levels, were calculated using non-parametric bootstrapping controlling for clustering. RESULTS The mean hourly excess cost of intervention over treatment as usual was £12.34. A mean adjusted cost difference of £22.46 per person per week in favour of the intervention group was found but this was not statistically significant. CONCLUSIONS The baseline-adjusted cost difference at follow-up would result in a fairly immediate compensation for the excess costs of intervention, provided the difference is not a statistical artefact. Further research is needed to clarify the extent to which it might represent a real saving in service support costs.
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Affiliation(s)
- D Felce
- Welsh Centre for Learning Disabilities, Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
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Segrott J, Rothwell H, Murphy S, Morgan-Trimmer S, Scourfield J, Holliday J, Thomas C, Gillespie D, Roberts Z, Foxcroft D, Hood K, Phillips C, Reed H, Humphreys I, Moore L. Fidelity of implementation of the Strengthening Families Programme 10-14 UK in Wales UK: a mixed-method process evaluation within a randomised controlled trial. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku163.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bandosz P, O’Flaherty M, Capewell S, Rutkowski M, Kypridemos C, Guzman-Castillo M, Gillespie D, Moreira P, Zdrojewski T. PP05 Are recent population declines in total cholesterol levels in Poland attributable to statin medications or dietary changes? Br J Soc Med 2014. [DOI: 10.1136/jech-2014-204726.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Willner P, Rose J, Jahoda A, Stenfert Kroese B, Felce D, MacMahon P, Stimpson A, Rose N, Gillespie D, Shead J, Lammie C, Woodgate C, Townson JK, Nuttall J, Cohen D, Hood K. A cluster randomised controlled trial of a manualised cognitive behavioural anger management intervention delivered by supervised lay therapists to people with intellectual disabilities. Health Technol Assess 2014; 17:1-173, v-vi. [PMID: 23701738 DOI: 10.3310/hta17210] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Anger is a frequent problem for many people with intellectual disabilities, and is often expressed as verbal and/or physical aggression. Cognitive-behaviour therapy (CBT) is the treatment of choice for common mental health problems, but CBT has only recently been adapted for people with intellectual disabilities. Anger is the main psychological presentation in which controlled trials have been used to evaluate CBT interventions for people with intellectual disabilities but these do not include rigorous randomised studies. OBJECTIVES To evaluate (1) the impact of a staff-delivered manualised CBT anger management intervention on (a) reported anger among people with mild to moderate intellectual disabilities, and (b) anger coping skills, aggression, mental health, quality of life and costs of health and social care; (2) factors that influence outcome; and (3) the experience of service users, lay therapists and service managers. DESIGN A cluster randomised controlled trial based on 30 day centres (15 intervention and 15 control). Intention-to-treat comparisons of outcomes used a two-level linear regression model to allow for clustering within centres with baseline outcome levels as a covariate. Comparison of cost data used non-parametric bootstrapping. Qualitative analysis used interpretative phenomenological analysis and thematic analysis. SETTING Recruited day centres had four-plus service users with problem anger who were prepared to participate, two-plus staff willing to be lay therapists, a supportive manager and facilities for group work, and no current anger interventions. PARTICIPANTS A total of 212 service users with problem anger were recruited. Thirty-three were deemed ineligible (30 could not complete assessments and three withdrew before randomisation). Retention at follow-up was 81%, with 17 withdrawals in each arm. Two to four staff per centre were recruited as lay therapists. Eleven service users, nine lay therapists and eight managers were interviewed. INTERVENTIONS The manualised intervention comprised 12 weekly 2-hour group sessions supplemented by 'homework'. Lay therapists received training and ongoing supervision from a clinical psychologist. Treatment fidelity, group attendance and resources used in intervention delivery were monitored. MAIN OUTCOME MEASURES The primary outcome was the service user-rated Provocation Index (PI), a measure of response to hypothetical situations that may provoke anger. Secondary trial outcomes were the key worker-rated PI; the service user- and key worker-rated Profile of Anger Coping Skills (PACS); the service user-rated PACS imaginal provocation test (PACS-IPT), a measure of response to actual situations known to provoke anger; aggression; mental health; self-esteem; quality of life; and health and social care resource use. Assessments were administered before randomisation and at 16 weeks and 10 months after randomisation. RESULTS Fourteen treatment groups were delivered, each with 12 sessions lasting an average of 114 minutes, with a mean of 4.9 service users and 2.0 lay therapists. The mean hourly cost per service user was £ 25.26. The mean hourly excess cost over treatment as usual was £ 12.34. There was no effect of intervention on the primary outcome - self-rated PI. There was a significant impact on the following secondary outcomes at the 10-month follow-up: key worker-rated PI, self-rated PACS-IPT and self- and key worker-rated PACS. Key workers and home carers reported significantly lower aggression at 16 weeks, but not at 10 months. There was no impact on mental health, self-esteem, quality of life or total cost of health and social care. Service users, key workers and service managers were uniformly positive. CONCLUSIONS The intervention was effective at changing anger coping skills and staff-rated anger. Impact on self-rated anger was equivocal. With hindsight there are reasons, from an analysis of factors influencing outcomes, to think that self-rated PI was not a well-chosen primary outcome. Widespread implementation of manualised lay therapist-led but psychologist-supervised anger management CBT for people with mild to moderate intellectual disabilities is recommended.
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Affiliation(s)
- P Willner
- Department of Psychology, Swansea University, Swansea, UK
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Adachi K, Sasaki H, Nagahisa S, Yoshida K, Hattori N, Nishiyama Y, Kawase T, Hasegawa M, Abe M, Hirose Y, Alentorn A, Marie Y, Poggioli S, Alshehhi H, Boisselier B, Carpentier C, Mokhtari K, Capelle L, Figarella-Branger D, Hoang-Xuan K, Sanson M, Delattre JY, Idbaih A, Yust-Katz S, Anderson M, Olar A, Eterovic A, Ezzeddine N, Chen K, Zhao H, Fuller G, Aldape K, de Groot J, Andor N, Harness J, Lopez SG, Fung TL, Mewes HW, Petritsch C, Arivazhagan A, Somasundaram K, Thennarasu K, Pandey P, Anandh B, Santosh V, Chandramouli B, Hegde A, Kondaiah P, Rao M, Bell R, Kang R, Hong C, Song J, Costello J, Bell R, Nagarajan R, Zhang B, Diaz A, Wang T, Song J, Costello J, Bie L, Li Y, Li Y, Liu H, Luyo WFC, Carnero MH, Iruegas MEP, Morell AR, Figueiras MC, Lopez RL, Valverde CF, Chan AKY, Pang JCS, Chung NYF, Li KKW, Poon WS, Chan DTM, Wang Y, Ng HAK, Chaumeil M, Larson P, Yoshihara H, Vigneron D, Nelson S, Pieper R, Phillips J, Ronen S, Clark V, Omay ZE, Serin A, Gunel J, Omay B, Grady C, Youngblood M, Bilguvar K, Baehring J, Piepmeier J, Gutin P, Vortmeyer A, Brennan C, Pamir MN, Kilic T, Krischek B, Simon M, Yasuno K, Gunel M, Cohen AL, Sato M, Aldape KD, Mason C, Diefes K, Heathcock L, Abegglen L, Shrieve D, Couldwell W, Schiffman JD, Colman H, D'Alessandris QG, Cenci T, Martini M, Ricci-Vitiani L, De Maria R, Larocca LM, Pallini R, de Groot J, Theeler B, Aldape K, Lang F, Rao G, Gilbert M, Sulman E, Luthra R, Eterovic K, Chen K, Routbort M, Verhaak R, Mills G, Mendelsohn J, Meric-Bernstam F, Yung A, MacArthur K, Hahn S, Kao G, Lustig R, Alonso-Basanta M, Chandrasekaran S, Wileyto EP, Reyes E, Dorsey J, Fujii K, Kurozumi K, Ichikawa T, Onishi M, Ishida J, Shimazu Y, Kaur B, Chiocca EA, Date I, Geisenberger C, Mock A, Warta R, Schwager C, Hartmann C, von Deimling A, Abdollahi A, Herold-Mende C, Gevaert O, Achrol A, Gholamin S, Mitra S, Westbroek E, Loya J, Mitchell L, Chang S, Steinberg G, Plevritis S, Cheshier S, Gevaert O, Mitchell L, Achrol A, Xu J, Steinberg G, Cheshier S, Napel S, Zaharchuk G, Plevritis S, Gevaert O, Achrol A, Chang S, Harsh G, Steinberg G, Cheshier S, Plevritis S, Gutman D, Holder C, Colen R, Dunn W, Jain R, Cooper L, Hwang S, Flanders A, Brat D, Hayes J, Droop A, Thygesen H, Boissinot M, Westhead D, Short S, Lawler S, Bady P, Kurscheid S, Delorenzi M, Hegi ME, Crosby C, Faulkner C, Smye-Rumsby T, Kurian K, Williams M, Hopkins K, Faulkner C, Palmer A, Williams H, Wragg C, Haynes HR, Williams M, Hopkins K, Kurian KM, Haynes HR, Crosby C, Williams H, White P, Hopkins K, Williams M, Kurian KM, Ishida J, Kurozumi K, Ichikawa T, Onishi M, Fujii K, Shimazu Y, Oka T, Date I, Jalbert L, Elkhaled A, Phillips J, Chang S, Nelson S, Jensen R, Salzman K, Schabel M, Gillespie D, Mumert M, Johnson B, Mazor T, Hong C, Barnes M, Yamamoto S, Ueda H, Tatsuno K, Aihara K, Jalbert L, Nelson S, Bollen A, Hirst M, Marra M, Mukasa A, Saito N, Aburatani H, Berger M, Chang S, Taylor B, Costello J, Popov S, Mackay A, Ingram W, Burford A, Jury A, Vinci M, Jones C, Jones DTW, Hovestadt V, Picelli S, Wang W, Northcott PA, Kool M, Reifenberger G, Pietsch T, Sultan M, Lehrach H, Yaspo ML, Borkhardt A, Landgraf P, Eils R, Korshunov A, Zapatka M, Radlwimmer B, Pfister SM, Lichter P, Joy A, Smirnov I, Reiser M, Shapiro W, Mills G, Kim S, Feuerstein B, Jungk C, Mock A, Geisenberger C, Warta R, Friauf S, Unterberg A, Herold-Mende C, Juratli TA, McElroy J, Meng W, Huebner A, Geiger KD, Krex D, Schackert G, Chakravarti A, Lautenschlaeger T, Kim BY, Jiang W, Beiko J, Prabhu S, DeMonte F, Lang F, Gilbert M, Aldape K, Sawaya R, Cahill D, McCutcheon I, Lau C, Wang L, Terashima K, Yamaguchi S, Burstein M, Sun J, Suzuki T, Nishikawa R, Nakamura H, Natsume A, Terasaka S, Ng HK, Muzny D, Gibbs R, Wheeler D, Lautenschlaeger T, Juratli TA, McElroy J, Meng W, Huebner A, Geiger KD, Krex D, Schackert G, Chakravarti A, Zhang XQ, Sun S, Lam KF, Kiang KMY, Pu JKS, Ho ASW, Leung GKK, Loebel F, Curry WT, Barker FG, Lelic N, Chi AS, Cahill DP, Lu D, Yin J, Teo C, McDonald K, Madhankumar A, Weston C, Slagle-Webb B, Sheehan J, Patel A, Glantz M, Connor J, Maire C, Francis J, Zhang CZ, Jung J, Manzo V, Adalsteinsson V, Homer H, Blumenstiel B, Pedamallu CS, Nickerson E, Ligon A, Love C, Meyerson M, Ligon K, Mazor T, Johnson B, Hong C, Barnes M, Jalbert LE, Nelson SJ, Bollen AW, Smirnov IV, Song JS, Olshen AB, Berger MS, Chang SM, Taylor BS, Costello JF, Mehta S, Armstrong B, Peng S, Bapat A, Berens M, Melendez B, Mollejo M, Mur P, Hernandez-Iglesias T, Fiano C, Ruiz J, Rey JA, Mock A, Stadler V, Schulte A, Lamszus K, Schichor C, Westphal M, Tonn JC, Unterberg A, Herold-Mende C, Morozova O, Katzman S, Grifford M, Salama S, Haussler D, Nagarajan R, Zhang B, Johnson B, Bell R, Olshen A, Fouse S, Diaz A, Smirnov I, Kang R, Wang T, Costello J, Nakamizo S, Sasayama T, Tanaka H, Tanaka K, Mizukawa K, Yoshida M, Kohmura E, Northcott P, Hovestadt V, Jones D, Kool M, Korshunov A, Lichter P, Pfister S, Otani R, Mukasa A, Takayanagi S, Saito K, Tanaka S, Shin M, Saito N, Ozawa T, Riester M, Cheng YK, Huse J, Helmy K, Charles N, Squatrito M, Michor F, Holland E, Perrech M, Dreher L, Rohn G, Goldbrunner R, Timmer M, Pollo B, Palumbo V, Calatozzolo C, Patane M, Nunziata R, Farinotti M, Silvani A, Lodrini S, Finocchiaro G, Lopez E, Rioscovian A, Ruiz R, Siordia G, de Leon AP, Rostomily C, Rostomily R, Silbergeld D, Kolstoe D, Chamberlain M, Silber J, Roth P, Keller A, Hoheisel J, Codo P, Bauer A, Backes C, Leidinger P, Meese E, Thiel E, Korfel A, Weller M, Saito K, Mukasa A, Nagae G, Nagane M, Aihara K, Takayanagi S, Tanaka S, Aburatani H, Saito N, Salama S, Sanborn JZ, Grifford M, Brennan C, Mikkelsen T, Jhanwar S, Chin L, Haussler D, Sasayama T, Tanaka K, Nakamizo S, Nishihara M, Tanaka H, Mizukawa K, Kohmura E, Schliesser M, Grimm C, Weiss E, Claus R, Weichenhan D, Weiler M, Hielscher T, Sahm F, Wiestler B, Klein AC, Blaes J, Weller M, Plass C, Wick W, Stragliotto G, Rahbar A, Soderberg-Naucler C, Sulman E, Won M, Ezhilarasan R, Sun P, Blumenthal D, Vogelbaum M, Colman H, Jenkins R, Chakravarti A, Jeraj R, Brown P, Jaeckle K, Schiff D, Dignam J, Atkins J, Brachman D, Werner-Wasik M, Gilbert M, Mehta M, Aldape K, Terashima K, Shen J, Luan J, Yu A, Suzuki T, Nishikawa R, Matsutani M, Liang Y, Man TK, Lau C, Trister A, Tokita M, Mikheeva S, Mikheev A, Friend S, Rostomily R, van den Bent M, Erdem L, Gorlia T, Taphoorn M, Kros J, Wesseling P, Dubbink H, Ibdaih A, Sanson M, French P, van Thuijl H, Mazor T, Johnson B, Fouse S, Heimans J, Wesseling P, Ylstra B, Reijneveld J, Taylor B, Berger M, Chang S, Costello J, Prabowo A, van Thuijl H, Scheinin I, van Essen H, Spliet W, Ferrier C, van Rijen P, Veersema T, Thom M, Meeteren ASV, Reijneveld J, Ylstra B, Wesseling P, Aronica E, Kim H, Zheng S, Mikkelsen T, Brat DJ, Virk S, Amini S, Sougnez C, Chin L, Barnholtz-Sloan J, Verhaak RGW, Watts C, Sottoriva A, Spiteri I, Piccirillo S, Touloumis A, Collins P, Marioni J, Curtis C, Tavare S, Weiss E, Grimm C, Schliesser M, Hielscher T, Claus R, Sahm F, Wiestler B, Klein AC, Blaes J, Tews B, Weiler M, Weichenhan D, Hartmann C, Weller M, Plass C, Wick W, Yeung TPC, Al-Khazraji B, Morrison L, Hoffman L, Jackson D, Lee TY, Yartsev S, Bauman G, Zheng S, Fu J, Vegesna R, Mao Y, Heathcock LE, Torres-Garcia W, Ezhilarasan R, Wang S, McKenna A, Chin L, Brennan CW, Yung WKA, Weinstein JN, Aldape KD, Sulman EP, Chen K, Koul D, Verhaak RGW. OMICS AND PROGNSTIC MARKERS. Neuro Oncol 2013; 15:iii136-iii155. [PMCID: PMC3823898 DOI: 10.1093/neuonc/not183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
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Brognaro E, Chang S, Cha J, Choi K, Choi C, DePetro J, Binding C, Blough M, Kelly J, Lawn S, Chan J, Weiss S, Cairncross G, Eisenbeis A, Goldbrunner R, Timmer M, Gabrusiewicz K, Cortes-Santiago N, Fan X, Hossain MB, Kaminska B, Heimberger A, Rao G, Yung WKA, Marini F, Fueyo J, Gomez-Manzano C, Halle B, Marcusson E, Aaberg-Jessen C, Jensen SS, Meyer M, Schulz MK, Andersen C, Bjarne, Kristensen W, Hashizume R, Ihara Y, Ozawa T, Parsa A, Clarke J, Butowski N, Prados M, Perry A, McDermott M, James D, Jensen R, Gillespie D, Martens T, Zamykal M, Westphal M, Lamszus K, Monsalves E, Jalali S, Tateno T, Ezzat S, Zadeh G, Nedergaard MK, Kristoffersen K, Poulsen HS, Stockhausen MT, Lassen U, Kjaer A, Ohka F, Natsume A, Zong H, Liu C, Hatanaka A, Katsushima K, Shinjo K, Wakabayashi T, Kondo Y, Picotte K, Li L, Westerhuis B, Zhao H, Plotkin S, James M, Kalamarides M, Zhao WN, Kim J, Stemmer-Rachamimov A, Haggarty S, Gusella J, Ramesh V, Nunes F, Rao G, Doucette T, Yang Y, Fuller G, Rao A, Schmidt NO, Humke N, Meissner H, Mueller FJ, Westphal M, Schnell O, Jaehnert I, Albrecht V, Fu P, Tonn JC, Schichor C, Shackleford G, Swanson K, Shi XH, D'Apuzzo M, Gonzalez-Gomez I, Sposto R, Seeger R, Erdreich-Epstein A, Moats R, Sirianni RW, Heffernan JM, Overstreet DJ, Sleire L, Skeie BS, Netland IA, Heggdal J, Pedersen PH, Enger PO, Stiles C, Sun Y, Mehta S, Taylor C, Alberta J, Sundstrom T, Wendelbo I, Daphu I, Hodneland E, Lundervold A, Immervoll H, Skaftnesmo KO, Babic M, Jendelova P, Sykova E, Lund-Johansen M, Bjerkvig R, Thorsen F, Synowitz M, Ku MC, Wolf SA, Respondek D, Matyash V, Pohlmann A, Waiczies S, Waiczies H, Niendorf T, Glass R, Kettenmann H, Thompson N, Elder D, Hopkins K, Iyer V, Cohen N, Tavare J, Thorsen F, Fite B, Mahakian LM, Seo JW, Qin S, Harrison V, Sundstrom T, Harter PN, Johnson S, Ingham E, Caskey C, Meade T, Skaftnesmo KO, Ferrara KW, Tschida BR, Lowy AR, Marek CA, Ringstrom T, Beadnell TJ, Wiesner SM, Largaespada DA, Wenger C, Miranda PC, Mekonnen A, Salvador R, Basser P, Yoon J, Shin H, Choi K, Choi C. TUMOR MODELS (IN VIVO/IN VITRO). Neuro Oncol 2013. [DOI: 10.1093/neuonc/not193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kabnick L, Wakefield T, Almeida J, Raffetto J, McLafferty R, Pappas P, Rectenwald J, Blebea J, Gillespie D, Onyeachom U, Kinsman R, Lal B. Use of Compression Therapy in Patients with Chronic Venous Insufficiency Undergoing Ablation Therapy: A Report from the American Venous Registry. J Vasc Surg Venous Lymphat Disord 2013; 1:107. [DOI: 10.1016/j.jvsv.2012.10.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hood K, Robling M, Ingledew D, Gillespie D, Greene G, Ivins R, Russell I, Sayers A, Shaw C, Williams J. Mode of data elicitation, acquisition and response to surveys: a systematic review. Health Technol Assess 2012; 16:1-162. [DOI: 10.3310/hta16270] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- K Hood
- School of Medicine, Cardiff University, Cardiff, UK
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Gloviczki M, Kalsi H, Heit J, Cummings E, Eklof B, Gillespie D, Gloviczki M, Henke P, Kistner R, Lurie F, Marston W, O'Donnell T, Passman M, Pounds L, Wakefield T. Venous Ulcers' Prevalence Study in Olmsted County - To Measure the Success of the Venous Ulcer Initiative. J Vasc Surg 2012. [DOI: 10.1016/j.jvs.2011.11.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Bradley H, Tsui A, Kidanu A, Gillespie D. HIV infection and contraceptive need among female Ethiopian voluntary HIV counseling and testing clients. AIDS Care 2010; 22:1295-304. [DOI: 10.1080/09540121003692227] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- H. Bradley
- a Department of Population, Family and Reproductive Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - A. Tsui
- a Department of Population, Family and Reproductive Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - A. Kidanu
- b Miz-Hasab Research Center , Addis Ababa , Ethiopia
| | - D. Gillespie
- a Department of Population, Family and Reproductive Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
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Stanton N, Hood K, Kelly MJ, Nuttall J, Gillespie D, Verheij T, Little P, Godycki-Cwirko M, Goossens H, Butler CC. Are smokers with acute cough in primary care prescribed antibiotics more often, and to what benefit? An observational study in 13 European countries. Eur Respir J 2009; 35:761-7. [PMID: 20032009 DOI: 10.1183/09031936.00168409] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Little is known about actual clinical practice regarding management of smokers compared with ex-smokers and nonsmokers presenting with acute cough in primary care, and whether a lower threshold for prescribing antibiotics benefits smokers. This was a multicentre 13-country European prospective observational study of primary care clinician management of acute cough in consecutive immunocompetent adults presenting with an acute cough of <or=28 days duration. There was complete smoking status data for 2,549 out of 3,402 participants. 28% were smokers, 24% ex-smokers and 48% nonsmokers. Smokers and ex-smokers had more chronic respiratory conditions (18.5% and 20.5% versus 12.5%). Median symptom severity scores were similar. Smokers were prescribed antibiotics more frequently (60%) than ex-smokers (51%) and nonsmokers (53%). After adjusting for clinical presentation and patient characteristics, the odds ratio of being prescribed antibiotics for smokers compared with nonsmokers was 1.44 (95% CI 1.12-1.86; p = 0.005). Patient recovery was not significantly different for smokers and nonsmokers, after adjusting for clinical presentation and patient characteristics. Smoking status was used as an independent factor to determine whether or not to prescribe an antibiotic. Being prescribed an antibiotic was not associated with recovery in smokers.
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Affiliation(s)
- N Stanton
- Dept of Primary Care and Public Health, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, UK.
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Butler CC, Hood K, Verheij T, Little P, Melbye H, Nuttall J, Kelly MJ, Mölstad S, Godycki-Cwirko M, Almirall J, Torres A, Gillespie D, Rautakorpi U, Coenen S, Goossens H. Variation in antibiotic prescribing and its impact on recovery in patients with acute cough in primary care: prospective study in 13 countries. BMJ 2009; 338:b2242. [PMID: 19549995 PMCID: PMC3272656 DOI: 10.1136/bmj.b2242] [Citation(s) in RCA: 221] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2009] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe variation in antibiotic prescribing for acute cough in contrasting European settings and the impact on recovery. DESIGN Cross sectional observational study with clinicians from 14 primary care research networks in 13 European countries who recorded symptoms on presentation and management. Patients followed up for 28 days with patient diaries. SETTING Primary care. PARTICIPANTS Adults with a new or worsening cough or clinical presentation suggestive of lower respiratory tract infection. MAIN OUTCOME MEASURES Prescribing of antibiotics by clinicians and total symptom severity scores over time. RESULTS 3402 patients were recruited (clinicians completed a case report form for 99% (3368) of participants and 80% (2714) returned a symptom diary). Mean symptom severity scores at presentation ranged from 19 (scale range 0 to 100) in networks based in Spain and Italy to 38 in the network based in Sweden. Antibiotic prescribing by networks ranged from 20% to nearly 90% (53% overall), with wide variation in classes of antibiotics prescribed. Amoxicillin was overall the most common antibiotic prescribed, but this ranged from 3% of antibiotics prescribed in the Norwegian network to 83% in the English network. While fluoroquinolones were not prescribed at all in three networks, they were prescribed for 18% in the Milan network. After adjustment for clinical presentation and demographics, considerable differences remained in antibiotic prescribing, ranging from Norway (odds ratio 0.18, 95% confidence interval 0.11 to 0.30) to Slovakia (11.2, 6.20 to 20.27) compared with the overall mean (proportion prescribed: 0.53). The rate of recovery was similar for patients who were and were not prescribed antibiotics (coefficient -0.01, P<0.01) once clinical presentation was taken into account. CONCLUSIONS Variation in clinical presentation does not explain the considerable variation in antibiotic prescribing for acute cough in Europe. Variation in antibiotic prescribing is not associated with clinically important differences in recovery. TRIAL REGISTRATION Clinicaltrials.gov NCT00353951.
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Affiliation(s)
- C C Butler
- Department of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff CF14 4XN, Wales.
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Bradley H, Bedada A, Tsui A, Brahmbhatt H, Gillespie D, Kidanu A. HIV and family planning service integration and voluntary HIV counselling and testing client composition in Ethiopia. AIDS Care 2008; 20:61-71. [DOI: 10.1080/09540120701449112] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- H. Bradley
- a Department of Population, Family and Reproductive Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , US
| | - A. Bedada
- b Family Guidance Association of Ethiopia , Addis Ababa , Ethiopia
| | - A. Tsui
- a Department of Population, Family and Reproductive Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , US
| | - H. Brahmbhatt
- a Department of Population, Family and Reproductive Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , US
| | - D. Gillespie
- a Department of Population, Family and Reproductive Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , US
| | - A. Kidanu
- c Miz-Hasab Research Center , Addis Ababa , Ethiopia
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Singer A, Gillespie D, Norbury J, Eisenberg RS. Singular perturbation analysis of the steady-state Poisson-Nernst-Planck system: Applications to ion channels. Eur J Appl Math 2008; 19:541-569. [PMID: 19809600 PMCID: PMC2756831 DOI: 10.1017/s0956792508007596] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Ion channels are proteins with a narrow hole down their middle that control a wide range of biological function by controlling the flow of spherical ions from one macroscopic region to another. Ion channels do not change their conformation on the biological time scale once they are open, so they can be described by a combination of Poisson and drift-diffusion (Nernst-Planck) equations called PNP in biophysics. We use singular perturbation techniques to analyse the steady-state PNP system for a channel with a general geometry and a piecewise constant permanent charge profile. We construct an outer solution for the case of a constant permanent charge density in three dimensions that is also a valid solution of the one-dimensional system. The asymptotical current-voltage (I-V ) characteristic curve of the device (obtained by the singular perturbation analysis) is shown to be a very good approximation of the numerical I-V curve (obtained by solving the system numerically). The physical constraint of non-negative concentrations implies a unique solution, i.e., for each given applied potential there corresponds a unique electric current (relaxing this constraint yields non-physical multiple solutions for sufficiently large voltages).
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Affiliation(s)
- A Singer
- Program in Applied Mathematics, Department of Mathematics, Yale University, 10 Hillhouse Ave., PO Box 208283, New Haven, CT 06520-8283, USA
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Abstract
The child survival revolution of the 1980s contributed to steady decreases in child mortality in some populations, but much remains to be done. More than 10 million children will die this year, almost all of whom are poor. Two-thirds of these deaths could have been prevented if effective child survival interventions had reached all children and mothers who needed them. Translation of current knowledge into effective action for child survival will require leadership, strong health systems, targeted human and financial resources, and modified health system to ensure that poor children and mothers benefit. A group of concerned scientists and policy-makers issues a call to action to leaders, governments, and citizens to translate knowledge into action for child survival.
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Parker MV, Gillespie D. Twenty-year-old man with right arm swelling. Mil Med 2001; 166:1110-2. [PMID: 11778415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Affiliation(s)
- M V Parker
- Department of Surgery, Vascular Surgery Service, Walter Reed Army Medical Center, 6900 Georgia Avenue, NW, Washington, DC 20307-5001, USA
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