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Harding S, Leishman Q, Lunceford W, Passey DJ, Pool T, Webb B. Global forecasts in reservoir computers. Chaos 2024; 34:023136. [PMID: 38407397 DOI: 10.1063/5.0181694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/24/2024] [Indexed: 02/27/2024]
Abstract
A reservoir computer is a machine learning model that can be used to predict the future state(s) of time-dependent processes, e.g., dynamical systems. In practice, data in the form of an input-signal are fed into the reservoir. The trained reservoir is then used to predict the future state of this signal. We develop a new method for not only predicting the future dynamics of the input-signal but also the future dynamics starting at an arbitrary initial condition of a system. The systems we consider are the Lorenz, Rossler, and Thomas systems restricted to their attractors. This method, which creates a global forecast, still uses only a single input-signal to train the reservoir but breaks the signal into many smaller windowed signals. We examine how well this windowed method is able to forecast the dynamics of a system starting at an arbitrary point on a system's attractor and compare this to the standard method without windows. We find that the standard method has almost no ability to forecast anything but the original input-signal while the windowed method can capture the dynamics starting at most points on an attractor with significant accuracy.
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Affiliation(s)
- S Harding
- Mathematics Department, Brigham Young University, Provo, Utah 84602, USA
| | - Q Leishman
- Mathematics Department, Brigham Young University, Provo, Utah 84602, USA
| | - W Lunceford
- Mathematics Department, Brigham Young University, Provo, Utah 84602, USA
| | - D J Passey
- Mathematics Department, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - T Pool
- The Robotics Institute, Carnegie Mellon University, Pittsburg, Pennsylvania 15289, USA
| | - B Webb
- Mathematics Department, Brigham Young University, Provo, Utah 84602, USA
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Colonetti T, Limas Carmo Teixeira D, Grande AJ, Rodrigues Uggioni ML, Generoso J, Harding S, Rodriguez-Mateos A, Rech P, Rosa Silva F, Toreti I, Ceretta L, Rosa MI. The role of intestinal microbiota on pre-eclampsia: Systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2023; 291:49-58. [PMID: 37826991 DOI: 10.1016/j.ejogrb.2023.10.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/01/2023] [Indexed: 10/14/2023]
Abstract
AIM To investigate differences between gut microbiota diversity and composition of healthy pregnant women and women with pre-eclampsia (PE). METHODS AND RESULTS This is a systematic review and meta-analysis of the literature, in which the terms "pre-eclampsia", "gastrointestinal microbiome" and "pregnant women" were used to search MEDLINE (PubMed), BVS (LILACS and others), Embase (Elsevier) and Cochrane Library, including observational studies and case-control that investigated changes in the gut microbiota during pregnancy. Six studies were included, with 479 pregnant women. A significantly lower gut microbiota alpha diversity measured as the Shannon index was found in pregnant women with PE in comparison with healthy controls (SMD: -0.47; 95 %IC: -0.77 to -0.18; P = 0.02; I2 = 0 %; three studies, 179 participants), while no significant differences were found in the relative abundance of Bacteroidetes, Firmicutes, Actinobacteria, and Proteobacteria, despite significant differences reported in the individual studies. CONCLUSION Pregnant women with PE have lower gut microbiome diversity, however, there is insufficient evidence to determine whether there are changes in gut microbiota composition. SIGNIFICANCE AND IMPACT OF THE STUDY The gut microbiota can be a new treatment target to try to prevent changes in maternal bacterial proportions, aiming to reduce complications during pregnancy.
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Affiliation(s)
- Tamy Colonetti
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.
| | - Diandra Limas Carmo Teixeira
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Antonio José Grande
- Laboratory of Evidence-based Health, Universidade Estadual de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Maria Laura Rodrigues Uggioni
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Jaqueline Generoso
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.
| | - Seeromanie Harding
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, SE1 9NH London, UK
| | - Ana Rodriguez-Mateos
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, SE1 9NH London, UK
| | - Peterson Rech
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Fabio Rosa Silva
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Indianara Toreti
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Luciane Ceretta
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Maria Inês Rosa
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
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Grande AJ, Dias IMAV, Jardim PTC, Vieira Machado AA, Soratto J, da Rosa MI, Roever L, Bisognin Ceretta L, Zourntos X, Harding S. University indigenous students' perspectives on climate change and survival of indigenous peoples in Brazil: a concept mapping study. Front Public Health 2023; 11:1236662. [PMID: 38098821 PMCID: PMC10720712 DOI: 10.3389/fpubh.2023.1236662] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/25/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction This study aimed to identify what indigenous university students in Brazil perceived to be important and feasible actions to protect the survival of indigenous peoples from climate change-related impacts. Methods Concept mapping, which is a participatory mixed methodology, was conducted virtually with 20 indigenous students at two universities in Brazil. A focus prompt was developed from consultations with indigenous stakeholders and read "To protect the survival of the Indigenous Peoples from climate change, it is necessary to…". Students brainstormed 46 statements, which they then sorted into clusters based on conceptual similarity. They rated each statement for importance and feasibility. Quantitative multivariate analyses of clusters and ratings were conducted to produce multiple visual maps of perceived actionable priorities. These analyses used the Group Wisdom TM software. Results Students agreed on 8 clusters that reflect the factors that influence the survival of indigenous peoples-preservation of lands 0.16 (SD 0.13), protection of demarcated lands 0.31 (SD 0.10), indigenous health and wellbeing 0.35 (SD 0.14), ancestral customs 0.46 (SD 0.04), global and national actions 0.61 (SD 0.13), indigenous rights 0.64 (SD 0.23), collective living 0.71 (SD 0.21), and respect 0.75 (SD 0.14). Discussion The most actionable priorities are related to the respect for their lands and customs, educational initiatives in schools about the importance of indigenous peoples to society, guarantees for basic health rights, and culturally appropriate provision of care, with specific mention of mental healthcare. The findings aligned closely with the concept of indigenous self-determination, which is rooted in autonomy and respect for cultural diversity, and the right to make decisions that impact their lives, land, and resources.
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Affiliation(s)
- Antonio Jose Grande
- Medicine School, State University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Ieda M. A. V. Dias
- Department of Public Health, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Paulo T. C. Jardim
- Medicine School, State University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Jacks Soratto
- Public Health Department, Universidade do Extremo Sul Catarinense, Criciuma, Santa Catarina, Brazil
| | - Maria Inês da Rosa
- Public Health Department, Universidade do Extremo Sul Catarinense, Criciuma, Santa Catarina, Brazil
| | - Leonardo Roever
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Luciane Bisognin Ceretta
- Public Health Department, Universidade do Extremo Sul Catarinense, Criciuma, Santa Catarina, Brazil
| | - Xanthi Zourntos
- Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Seeromanie Harding
- Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
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Grande AJ, Dias IMAV, Jardim PTC, Vieira Machado AA, Soratto J, da Rosa MI, Roever L, Bisognin Ceretta L, Zourntos X, Harding S. Climate change and mental health of Indigenous peoples living in their territory: a concept mapping study. Front Psychiatry 2023; 14:1237740. [PMID: 38025449 PMCID: PMC10657843 DOI: 10.3389/fpsyt.2023.1237740] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Background The alarming increase in annual deforestation rates has had devastating consequences in climate change, and it is affecting Indigenous people, who depend entirely on the land for survival and has also weakened the rainforest's crucial role in stabilizing the global climate. Recognizing and respecting Indigenous people's needs and social, economic, and historical conditions influence health and healthcare. This study aimed to conduct online concept mapping workshops with university students to identify perceived important and feasible actions for improving the mental health of Indigenous people living in their territory in association with climate change. Methods Concept mapping, a participatory mixed methodology, was conducted virtually with 20 Indigenous students at two universities in Brazil. A focus prompt was developed from consultations with Indigenous stakeholders and read-"To improve the mental health of Indigenous peoples in their territory during climate change crises, it is necessary to…." Results University students organized 42 unique statements in 6 clusters that cover a wide range of topics: family support, 0.68 (SD 0.19); respect and understanding, 0.37 (SD 0.08); improvement actions, 0.52 (SD 0.07); public policies in favor of Indigenous people's mental health, 0.24 (0.09); health actions, 0.15 (SD 0.08); Indigenous training in health and its importance in improving mental health 0.32 (SD 0.07). Conclusion These clusters range from community initiatives, public policies, health actions, and strengthening professional services in Indigenous communities. These all provide numerous concrete ideas for developing interventions designed to address mental health challenges associated with climate change.
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Affiliation(s)
- Antonio Jose Grande
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Campo Grande, Brazil
| | - Ieda M. A. V. Dias
- Public Health Department, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Paulo T. C. Jardim
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Campo Grande, Brazil
| | | | - Jacks Soratto
- Public Health Department, Universidade do Extremo Sul Catarinense, Santa Catarina, Criciúma, Brazil
| | - Maria Inês da Rosa
- Public Health Department, Universidade do Extremo Sul Catarinense, Santa Catarina, Criciúma, Brazil
| | - Leonardo Roever
- Department of Clinical Research, Brazilian Evidence-Based Health Network, Uberlândia, Brazil
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Luciane Bisognin Ceretta
- Public Health Department, Universidade do Extremo Sul Catarinense, Santa Catarina, Criciúma, Brazil
| | - Xanthi Zourntos
- Department of Population Health Sciences, School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Seeromanie Harding
- Department of Population Health Sciences, School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
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Zaman M, de Vale ML, Coultas C, Goff L, Mernagh-Iles A, L'Esperance V, Karamanos A, Ayis S, Ćurčin V, Durbaba S, Inyang M, Molokhia M, Harding S. Factors affecting the delivery of community-based salon interventions to prevent cardiovascular disease and breast cancer among ethnically diverse women in South London: a concept-mapping approach. Lancet 2023; 402 Suppl 1:S96. [PMID: 37997143 DOI: 10.1016/s0140-6736(23)02148-7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/17/2023] [Accepted: 09/22/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND In the UK, women from ethnically diverse and socioeconomically deprived communities are at increased risk of underdiagnosis of cardiovascular disease (CVD) and breast cancer. Promoting CVD prevention and awareness of breast cancer screening via community salons and primary health care partnerships can improve uptake of screening services and early detection. METHODS Concept mapping is a multistage mixed methods participatory approach comprised of six stages: preparation, brainstorming, structuring of statements, representing statements, interpretation and utilisation of maps using Group wisdom software. A target of 20 salons, excluding male-only salons were approached. Salons included Salons included hairdressing or hairdressing and beauty salons. Purposeful and convenience sampling (online and face to face) among UK salons (hair and beauty) was conducted. Participants were given a focus prompt "What would be some factors that can influence the ability of salons to deliver this service?" and required to generate statements, which were sorted into categories based on similarity and rated for importance and feasibility. Concept maps using multidimensional scaling and hierarchical cluster analyses were produced. FINDINGS Of 35 participants invited, 25 (71%) consented and agreed to take part in concept mapping. Reported ages were 26-35 years (n=5, 20%), 36-45 years (n=12, 48%), 46-55 years (n=3, 12%), 56-65 years (n=5, 20%), and no age reported (n=10, 40%). Around 36% (n=9) of participants were from non-White ethnic groups, with 12% (n=3) being male and 88% (n=22) female. Seven clusters emerged. Salon staff capabilities and capacities and engaging in health conversations in community salons scored average bridging values of 0·09 and 0·2 respectively, indicating good cluster homogeneity (similar meaning statements were closely sorted). Facilitating health-care access with GP practices was rated highly important to effectively promote the intervention. Engaging in health conversations in community salons and salon incentives for participation were examples of factors that were highly feasible to address. The r correlation coefficient was 0·68 between importance and feasibility to address factors affecting community health interventions. INTERPRETATION Salons are well positioned to support health promotion interventions. Actionable priorities were identified for a salon-GP surgery partnership to promote CVD prevention through lifestyle changes and health check uptake, raising breast cancer screening awareness and address issue of equity. FUNDING National Institute of Health and Care Research (NIHR), Research for Patient Benefit (RfPB) Programme NIHR202769.
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Affiliation(s)
- Maham Zaman
- School of Population Health and Life Sciences, Faculty of Life Sciences and Medicine, Kings College London, London, UK
| | - Marjorie Lima de Vale
- School of Population Health and Life Sciences, Faculty of Life Sciences and Medicine, Kings College London, London, UK
| | - Clare Coultas
- Health Service & Population Research, King's College London, London, UK
| | - Louise Goff
- Department of Nutritional Sciences, King's College London, London, UK
| | | | - Veline L'Esperance
- School of Population Health and Life Sciences, Faculty of Life Sciences and Medicine, Kings College London, London, UK
| | - Alexis Karamanos
- School of Population Health and Life Sciences, Faculty of Life Sciences and Medicine, Kings College London, London, UK
| | - Salma Ayis
- School of Population Health and Life Sciences, Faculty of Life Sciences and Medicine, Kings College London, London, UK
| | - Vasa Ćurčin
- School of Population Health and Life Sciences, Faculty of Life Sciences and Medicine, Kings College London, London, UK
| | - Stevo Durbaba
- School of Population Health and Life Sciences, Faculty of Life Sciences and Medicine, Kings College London, London, UK
| | | | - Mariam Molokhia
- School of Population Health and Life Sciences, Faculty of Life Sciences and Medicine, Kings College London, London, UK.
| | - Seeromanie Harding
- School of Population Health and Life Sciences, Faculty of Life Sciences and Medicine, Kings College London, London, UK
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Ayoub A, Akyea RK, L'Esperance V, Ayis S, Parmar D, Durbaba S, Fisher M, Patel R, Harding S, Wierzbicki AS, Qureshi N, Molokhia M. Determinants of lipid clinic referral and attendance in a multi-ethnic adult population in south London: a cross-sectional study. Lancet 2023; 402 Suppl 1:S26. [PMID: 37997066 DOI: 10.1016/s0140-6736(23)02150-5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/22/2023] [Accepted: 09/22/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Primary dyslipidaemias, including familial hypercholesterolaemia, are underdiagnosed genetic disorders that substantially increase risk for premature coronary artery disease in adults. Early identification of primary dyslipidaemias via lipid clinic referral optimises patient management and enables cascade screening of relatives. Improving the identification of primary dyslipidaemias, and understanding disparities in ascertainment and management, is an NHS priority. We aimed to assess determinants of lipid clinic referral or attendance (LCR) in ethnically diverse adults. METHODS We did a retrospective cross-sectional study using the Lambeth DataNet containing anonymised data from 41 general practitioner (GP) practices in south London. We looked at referral data for adult patients aged 18 years and older from Jan 1, 1995, until May 14, 2018. LCR was the main outcome. We used sequential multilevel logistic regression models adjusted for practice effects to estimate the odds of LCR assessed across six ethnic groups (reference group White) and patient-level factors (demographic, socioeconomic, lifestyle, comorbidities, total cholesterol [TC] >7·5mmol/L, statin prescription, and practice factors). The study was approved by NHS South East London Clinical Commissioning Group (CCG) and NHS Lambeth CCG. FINDINGS 780 (0·23%) of 332 357 adult patients were coded as referred (n=538) or seen (n=252) in a lipid clinic. 164 487 (46·49%) were women (appendix). The fully adjusted model for odds of LCR showed the following significant associations for age (odds ratio [OR] 0·96, 95% CI 0·96-0·97, p<0·001); Black, African, Caribbean, or Black-British ethnicity (0·67, 0·53-0·84, p=0·001); ex-smoker status (1·29, 1·05-1·57, p=0·014); TC higher than 7·5 mmol/L (12·18, 9·60-15·45, p<0·001); statin prescription (14·01, 10·85-18·10, p<0·001); diabetes (0·72, 0·58-0·91, p=0·005); high-frequency GP attendance at seven or more GP consultations in the past year (1·49, 1·21-1·84, p<0·001); high GP-density (0·5-0·99 full-time equivalent GPs per 1000 patients; 2·70, 1·23-5·92, p=0·013). Sensitivity analyses for LCR restricted to familial hypercholesterolaemia-coded patients (n=581) found associations with TC higher than 7·5 mmol/L (4·26, 1·89-9·62, p<0·001), statin prescription (16·96, 2·19-131·36, p=0·007), and high GP-density (5·73, 1·27-25·93, p=0·023), with no significant associations with ethnicity. The relative contribution of GP practices to LCR was 6·32% of the total variance. There were no significant interactions between ethnicity and deprivation, age, or obesity. INTERPRETATION While interpretation is limited by the accuracy and completeness of coded records, the study showed factors associated with a higher likelihood of LCR included individuals recorded as having TC higher than 7·5 mmol/L, statin prescription, ex-smoker status, high-frequency GP attendance, and registration at a GP practice with 0·5-0·99 GP density. Patients with increasing age; Black, African, Caribbean, or Black-British ethnicity patients; and patients with diabetes had lower odds of LCR. Finally, the difference in odds of LCR between Black and White patients highlights potential health inequalities. FUNDING NHS Race & Health Observatory.
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Affiliation(s)
- Aya Ayoub
- Department of Population Health Sciences, King's College London, London, UK.
| | - Ralph K Akyea
- Department of Population Health Sciences, King's College London, London, UK; Centre for Academic Primary Care, University of Nottingham, Nottingham, UK
| | - Veline L'Esperance
- Department of Population Health Sciences, King's College London, London, UK
| | - Salma Ayis
- Department of Population Health Sciences, King's College London, London, UK
| | - Divya Parmar
- Department of Population Health Sciences, King's College London, London, UK
| | - Stevo Durbaba
- Department of Population Health Sciences, King's College London, London, UK
| | - Mark Fisher
- Department of Population Health Sciences, King's College London, London, UK
| | - Riyaz Patel
- Cardiology Department, University College London Hospitals NHS Foundation Trust, London, UK
| | - Seeromanie Harding
- Department of Population Health Sciences, King's College London, London, UK
| | - Anthony S Wierzbicki
- Department of Metabolic Medicine/Chemical Pathology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Nadeem Qureshi
- Centre for Academic Primary Care, University of Nottingham, Nottingham, UK
| | - Mariam Molokhia
- Department of Population Health Sciences, King's College London, London, UK
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Breslin G, Wills W, Bontoft C, Fakoya O, Greco HA, Lloyd N, Wagner AP, Wellings A, Harding S, Brown KE. Whole systems approach to diet and healthy weight: a longitudinal process evaluation in East Scotland. Perspect Public Health 2023; 143:347-357. [PMID: 37902308 PMCID: PMC10683340 DOI: 10.1177/17579139231203858] [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] [Indexed: 10/31/2023]
Abstract
AIMS Obesity contributes to morbidity and early mortality, affecting people of all ages and sociodemographic backgrounds. Despite attempts to address obesity, efforts to date have only had limited success. Adopting a whole systems approach (WSA) may potentially address obesity and emphasise complex inter-relating factors beyond individual choice. This study aimed to assess implementation of WSA to diet and healthy weight in two council areas of Scotland, longitudinally exploring enablers and barriers. One area followed a Leeds Beckett WSA model (LBM) of implementation, while the other used a hybrid model incorporating existing working systems. METHODS To assess the process of implementing a WSA, interviews and focus groups were conducted after initiation and 1 year later. RESULTS Main enablers included: belief in WSA effectiveness; positive relationships between key personnel; buy-in at community and national levels; funding availability; the working group responsible for coordinating the system development comprising individuals with diverse expertise; good communication; and existing governance structures. Barriers included: insufficient funding; high staff turnover; inadequate training in WSA methodology; engaging all relevant stakeholders and reverting to 'old ways' of non-WSA working. The LBM provided a framework for system setup and generating an action plan. CONCLUSION This study provides the first independent longitudinal process evaluation of WSAs that have incorporated Leeds Beckett methodology, and offers insights into how a WSA can be implemented to address diet and healthy weight.
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Affiliation(s)
- G Breslin
- School of Psychology, Queen’s University Belfast, Belfast, UK
| | - W Wills
- School of Health and Social Work, University of Hertfordshire, Hatfield, UK; Applied Research Collaboration (ARC) East of England, National Institute for Health and Care Research (NIHR), London, UK
| | - C Bontoft
- Department of Psychology, Sport and Geography, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, College Lane, Hatfield AL10 9AB, UK
| | - O Fakoya
- Department of Psychology, Sport and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - H-A Greco
- Department of Psychology, Sport and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - N Lloyd
- Department of Psychology, Sport and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - AP Wagner
- Applied Research Collaboration (ARC) East of England, National Institute for Health and Care Research (NIHR), London, UK; Norwich Medical School, University of East Anglia, Norwich, UK
| | - A Wellings
- Department of Psychology, Sport and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - S Harding
- Department of Psychology, Sport and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - KE Brown
- Department of Psychology, Sport and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
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Kaneri P, Lima do Vale M, Harding S, Molokhia M. A scoping review of the evidence available for the use of salons as health promotion environments, for the prevention and management of non-communicable diseases in women from different ethnic backgrounds. Front Public Health 2023; 11:1161645. [PMID: 37529433 PMCID: PMC10390218 DOI: 10.3389/fpubh.2023.1161645] [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] [Received: 02/08/2023] [Accepted: 06/19/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction Women from different ethnic backgrounds are disproportionately affected by non-communicable diseases (NCDs). Underpinned by the community capital they harness, hairdressers have successfully delivered NCD prevention programmes, particularly for African-American women in disadvantaged areas. Integrating community organisations and networks into existing primary care pathways can provide a sustainable process to address inequalities in access to health care. This scoping review aimed to map the evidence about interventions based in beauty salons, particularly formative research phases, including co-development, community participation, theoretical or conceptual underpinnings, as well as aspects related to training and incentivisation of salon staff, evaluation and equity. Methods The methodological framework was based on the seminal guidance of Arksey and O'Malley, using the 'PCC' (participants, concept, context) structure with incorporation of other relevant materials. Studies eligible for inclusion were salon-based health interventions (concept) focused on NCDs prevention (context), targeting women (participants) from different ethnic backgrounds and published in English. The searches were conducted across PubMed, Web of Science and OVID in June 2020 and updated in January 2023, with reference lists also screened. The Reach, Effectiveness, Adoption, Implementation, and Maintenance RE-AIM framework was used to explore the potential public health impact. Results 419 titles and abstracts were screened, with eight (2%) meeting the inclusion criteria, all based in the United States of America. Two used formative phases to inform intervention development, three described evidence of co-development with key stakeholders or experts within the community and five studies referred to theoretical or conceptual frameworks. Incentivisation was provided to salon staff in five of the studies, and to clients in three of the studies. Four of the investigations collated data on socioeconomic characteristics of the target population. Discussion Formative research in the scoped studies was weakly reported upon. Community participation was implicit in each of the scoped studies, yet its application varied considerably. Theoretical and conceptual frameworks were not consistently used, and there was inadequate process evaluation to ensure equitable reach and retention of targeted groups, suggesting a more concerted effort to address health equity is needed for future interventions.
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Khan Z, Vowles Z, Fernandez Turienzo C, Barry Z, Brigante L, Downe S, Easter A, Harding S, McFadden A, Montgomery E, Page L, Rayment-Jones H, Renfrew M, Silverio SA, Spiby H, Villarroel-Williams N, Sandall J. Targeted health and social care interventions for women and infants who are disproportionately impacted by health inequalities in high-income countries: a systematic review. Int J Equity Health 2023; 22:131. [PMID: 37434187 DOI: 10.1186/s12939-023-01948-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/10/2023] [Accepted: 06/29/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Disadvantaged populations (such as women from minority ethnic groups and those with social complexity) are at an increased risk of poor outcomes and experiences. Inequalities in health outcomes include preterm birth, maternal and perinatal morbidity and mortality, and poor-quality care. The impact of interventions is unclear for this population, in high-income countries (HIC). The review aimed to identify and evaluate the current evidence related to targeted health and social care service interventions in HICs which can improve health inequalities experienced by childbearing women and infants at disproportionate risk of poor outcomes and experiences. METHODS Twelve databases searched for studies across all HICs, from any methodological design. The search concluded on 8/11/22. The inclusion criteria included interventions that targeted disadvantaged populations which provided a component of clinical care that differed from standard maternity care. RESULTS Forty six index studies were included. Countries included Australia, Canada, Chile, Hong Kong, UK and USA. A narrative synthesis was undertaken, and results showed three intervention types: midwifery models of care, interdisciplinary care, and community-centred services. These intervention types have been delivered singularly but also in combination of each other demonstrating overlapping features. Overall, results show interventions had positive associations with primary (maternal, perinatal, and infant mortality) and secondary outcomes (experiences and satisfaction, antenatal care coverage, access to care, quality of care, mode of delivery, analgesia use in labour, preterm birth, low birth weight, breastfeeding, family planning, immunisations) however significance and impact vary. Midwifery models of care took an interpersonal and holistic approach as they focused on continuity of carer, home visiting, culturally and linguistically appropriate care and accessibility. Interdisciplinary care took a structural approach, to coordinate care for women requiring multi-agency health and social services. Community-centred services took a place-based approach with interventions that suited the need of its community and their norms. CONCLUSION Targeted interventions exist in HICs, but these vary according to the context and infrastructure of standard maternity care. Multi-interventional approaches could enhance a targeted approach for at risk populations, in particular combining midwifery models of care with community-centred approaches, to enhance accessibility, earlier engagement, and increased attendance. TRIAL REGISTRATION PROSPERO Registration number: CRD42020218357.
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Affiliation(s)
- Zahra Khan
- Department of Women & Children's Health, King's College London, London, UK.
| | - Zoe Vowles
- Department of Women & Children's Health, King's College London, London, UK
| | | | - Zenab Barry
- Patient and Public Involvement and Engagement, NIHR ARC South London, London, UK
| | | | - Soo Downe
- University of Central Lancashire, Lancashire, UK
| | - Abigail Easter
- Department of Women & Children's Health, King's College London, London, UK
| | - Seeromanie Harding
- Department of Population Health Sciences, King's College London, London, UK
| | | | | | | | | | | | - Sergio A Silverio
- Department of Women & Children's Health, King's College London, London, UK
| | | | | | - Jane Sandall
- Department of Women & Children's Health, King's College London, London, UK
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10
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Ayoub A, Akyea R, L'Esperance V, Ayis S, Parmar D, Durbaba S, Fisher M, Patel R, Harding S, Wierzbicki AS, Qureshi N, Molokhia M. Determinants of lipid-lowering medication prescribing in a multi-ethnic adult population diagnosed with familial hypercholesterolaemia in South London. Br J Gen Pract 2023; 73:bjgp23X734145. [PMID: 37479297 DOI: 10.3399/bjgp23x734145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Familial hypercholesterolaemia (FH) (prevalence 1 in 250) is an inherited condition that significantly increases risk of premature cardiovascular disease. Early diagnosis can potentially normalise cardiovascular risk with lipid-lowering medicines (statins and fibrates). Only 7% of patients with FH are identified in the UK. Improving identification, and understanding disparities in ascertainment and management, is an NHS priority. AIM To assess determinants of lipid-lowering prescribing in ethnically diverse adults with an FH code. METHOD: Retrospective cross-sectional analysis of Lambeth DataNet, containing anonymised adult patient data from 41 practices in South London. Stata 17 was used to run sequential multilevel logistic regression models, adjusted for practice effects, to estimate the odds of no lipid-lowering prescription in FH-coded adults; this was assessed across 10 ethnic groups and other patient-level factors: demographic, socioeconomic, lifestyle, comorbidities, and practice factors (consultation frequency and practice list size). RESULTS One hundred and sixty-one of 801 (20%) of adults with an FH code received no lipid-lowering medication. The fully adjusted model for no lipid-lowering prescriptions showed the following associations: age (years) odds ratio (OR) 0.93 (P<0.001, 95% confidence interval [CI] = 0.91 to 0.95), male sex OR 0.47 (P = 0.002, 95% CI = 0.29 to 0.76), diabetes OR 0.26 (P = 0.04, 95% CI = 0.70 to 0.96), hypertension OR 0.30 (P<0.01, 95% CI = 0.12 to 0.72), and frequency of GP attendance OR 0.48 (P = 0.03, 95% CI = 0.24 to 0.94). Sensitivity analyses examining determinants of high-intensity statin prescribing found similar results. CONCLUSION The study suggests important determinants of lipid-lowering prescribing in an ethnically diverse adult population included older age, male sex, hypertension, and diabetes. Ethnicity showed no significant associations with lipid-lowering prescribing after adjusting for other determinants including deprivation measures.
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Affiliation(s)
- Aya Ayoub
- Department of Population Health Sciences, King's College London
| | - Ralph Akyea
- Centre for Academic Primary Care, University of Nottingham
| | | | - Salma Ayis
- Department of Population Health Sciences, King's College London
| | - Divya Parmar
- Department of Population Health Sciences, King's College London
| | - Stevo Durbaba
- Department of Population Health Sciences, King's College London
| | - Mark Fisher
- Department of Population Health Sciences, King's College London
| | - Riyaz Patel
- Cardiology Department, University College London
| | | | - Anthony S Wierzbicki
- Department of Metabolic Medicine/Chemical Pathology, Guy's & St Thomas' NHS Foundation Trust, London
| | - Nadeem Qureshi
- Centre for Academic Primary Care, University of Nottingham
| | - Mariam Molokhia
- Department of Population Health Sciences, King's College London
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11
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Zaman M, Goff L, L'Esperance V, Karamanos A, de Vale ML, Ayis S, Curcin V, Durbaba S, Molokhia M, Harding S, Mernagh-Iles A. A concept mapping approach to assess factors influencing the delivery of community-based salon interventions to prevent cardiovascular disease and breast cancer among ethnically diverse women in south London. Br J Gen Pract 2023; 73:bjgp23X733821. [PMID: 37479250 DOI: 10.3399/bjgp23x733821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND In the UK, women from ethnically diverse and socioeconomically deprived groups are at increased risk of underdiagnosis of cardiovascular disease (CVD) and low uptake for breast cancer screening. Raising awareness for CVD and breast cancer screening in partnership with salons can improve early detection, management and uptake of screening facilitating women and the NHS. AIM To explore the perceptions of hair and beauty professionals in the UK on factors that could influence the ability of salons to promote a culturally adapted educational intervention to improve CVD and breast cancer awareness and screening. METHOD Concept mapping is a multi-stage mixed methods participatory approach. Snowball sampling and dissemination of study information (online and face-to-face) among salon staff nationally was conducted. Participants were given a focus prompt 'What would be some factors that can influence the ability of salons to deliver this service?' and required to generate statements in response. Statements will be sorted into categories based on similarity and rated for importance and feasibility. Concept maps using multidimensional scaling and hierarchical cluster analyses will be produced. RESULTS A total of 19 participants participated in the first stage. We will report on statements generated by participants, statement clusters and ratings for importance and feasibility. This will be depicted in a Go-Zone map that will show statements simultaneously rated in both importance and feasibility. CONCLUSION Participatory approaches can support the development of educational community-based interventions aiming to establish partnerships between community assets and health systems for CVD and breast cancer awareness and prevention.
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Affiliation(s)
- Maham Zaman
- Department of Population Health Sciences, King's College London, UK Clare Coultas, King's College London
| | | | | | | | | | | | | | - Stevo Durbaba
- Department of Population Health Sciences, King's College London, UK
| | - Mariam Molokhia
- Department of Population Health Sciences, King's College London, UK
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12
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Kaduka L, Olale J, Karamanos A, Mutai J, Coultas C, Ahmed I, L'Esperance V, Read U, Dazzan P, Cruickshank JK, Muniu E, Harding S. Contextually appropriate communication strategies for COVID-19 prevention in Kenya border regions: evidence from a mixed methods observational study in Busia and Mandera counties. BMJ Open 2023; 13:e062686. [PMID: 37192800 PMCID: PMC10192579 DOI: 10.1136/bmjopen-2022-062686] [Citation(s) in RCA: 1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/02/2023] [Indexed: 05/18/2023] Open
Abstract
OBJECTIVES Kenya has long and porous borders with its neighbouring countries. These regions, predominantly inhabited by highly mobile rural communities with strong cross-border cultural ties, present major challenges in managing movement of people and COVID-19 preventive measures. Our study sought to assess knowledge of COVID-19 prevention behaviours, how these varied by socioeconomic (SEC) factors and the challenges of engagement and implementation, in two border counties of Kenya. METHODS We conducted a mixed methods study using a household e-survey (Busia, N=294; Mandera, N=288; 57% females, 43% males), and qualitative telephone interviews (N=73: Busia 55; Mandera 18) with policy actors, healthcare workers, truckers and traders, and community members. Interviews were transcribed, English translated and analysed using the framework method. Associations between SEC (wealth quintiles, educational level) and knowledge of COVID-19 preventive behaviours were explored using Poisson regression. RESULTS Participants were mostly educated to primary school level (54.4% Busia, 61.6% Mandera). Knowledge of COVID-19 prevention varied by behaviour: hand washing-86.5%, use of hand sanitiser-74.8%, wearing a face mask-63.1%, covering the mouth when sneezing or coughing-56.3% and social distancing-40.1%. Differences in knowledge by area, educational level and the wealth index were marked, greatest for Mandera, the less educated and the poor. Interviews with stakeholders revealed challenges in health messaging, psychosocial and socioeconomic factors, lack of preparedness for truck border crossings, language barrier, denial and livelihood insecurity as key challenges to engagement with and implementation of COVID-19 prevention behaviours in the border regions. CONCLUSION The influence of SEC disparities and border dynamics on knowledge and engagement with COVID-19 prevention behaviours calls for contextually appropriate risk communication strategies that are cognisant of community needs and local patterns of information flow. Coordinating response measures across border points is crucial in winning communities' trust and maintaining essential economic and social activities.
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Affiliation(s)
- Lydia Kaduka
- Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
- Faculty of Life Sciences & Medicine, School of Life Course Science, King's College London, London, UK
| | - Joanna Olale
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Alexis Karamanos
- Faculty of Life Sciences & Medicine, School of Life Course Science, King's College London, London, UK
| | - Joseph Mutai
- Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Clare Coultas
- School of Medical Education, King's College London, London, UK
| | - Ismail Ahmed
- Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Veline L'Esperance
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Ursula Read
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Paola Dazzan
- Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - John Kennedy Cruickshank
- Faculty of Life Sciences & Medicine, School of Life Course Science, King's College London, London, UK
| | - Erastus Muniu
- Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Seeromanie Harding
- Faculty of Life Sciences & Medicine, School of Life Course Science, King's College London, London, UK
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13
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C. Jardim PT, Dias JM, Grande AJ, Veras AB, Ferri ÉK, Quadros FAA, Peixoto C, Botelho FCS, I. M. G. Oliveira M, Dias IMAV, O’Keeffe M, Elia C, Dazzan P, Wolfe I, Harding S. Co-developing a health promotion programme for indigenous youths in Brazil: A concept mapping report. PLoS One 2023; 18:e0269653. [PMID: 36791063 PMCID: PMC9931109 DOI: 10.1371/journal.pone.0269653] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/25/2022] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Latin America and the Caribbean Region are home to about 42 million Indigenous people, with about 900,000 living in Brazil. The little routinely collected population-level data from Indigenous communities in the region available shows stark inequities in health and well-being. There are 305 Indigenous ethnic groups, speaking 274 languages, spread across the remote national territory, who have endured long-lasting inequities related to poverty, poor health, and limited access to health care. Malnutrition and mental health are key concerns for young people. Building on our Indigenous communities-academic partnerships over the last two decades, we collaborated with young people from the Terena Indigenous ethnic group, village leaders, teachers, parents, and local health practitioners from the Polo Base (community health centres) to obtain their perspectives on important and feasible actions for a youth health promotion programme. METHODS The report was conducted in the Tereré Village in Mato Grosso do Sul. Concept mapping, a participatory mixed method approach, was conducted in 7 workshops, 15 adults and 40 youths aged 9-17 years. Art-based concept mapping was used with 9 to 11 years old children (N = 20). Concept systems software was used to create concept maps, which were finalised during the workshops. Focused prompts related to factors that may influence the health and happiness of youths. The participatory method gave Terena youths a significant voice in shaping an agenda that can improve their health. RESULTS Terena youths identified priority actions that clustered under 'Family', 'School', 'Education', 'Socio-economic circumstances', 'Respect' and 'Sport' in response to protecting happiness; and 'Nutrition pattern', 'Physical activity', 'Local environment', and 'Well-being' in response to having a healthy body. Through the participatory lens of concept mapping, youths articulated the interconnectedness of priority actions across these clusters such that behaviours (e.g. Nutrition pattern, drinking water, physical activity) and aspirations (being able to read, to have a good job) were recognised to be dependent on a wider ecology of factors (e.g. loss of eco-systems, parent-child relationships, student- teacher relationships, parental unemployment). In response to developing youth health, Terena adults suggested priority actions that clustered under 'Relationships', 'Health issues', 'Prevention at Polo Base', 'Access to health care', 'Communication with young people', 'Community life', 'Raising awareness' and 'School support'. Their priorities reflected the need for structural transformative actions (e.g. Polo Base and school staff working together) and for embedding actions to protect Indigenous culture (e.g. integrating their cultural knowledge into training programmes). CONCLUSIONS Concept maps of Indigenous youths emphasised the need for a health promotion programme that engages with the structural and social determinants of health to protect their happiness and health, whilst those of adults emphasised the need to address specific health issues through preventative care via a school-Polo Base collaboration. Investment in a co-developed school-Polo-Base health promotion programme, with intersectoral engagement, has potential for making Indigenous health systems responsive to the inequalities of youth health, to yield dividends for healthy ageing trajectories as well as for the health of the next generation.
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Affiliation(s)
- Paulo T. C. Jardim
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Brazil
| | - Josiliane M. Dias
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Brazil
| | - Antonio J. Grande
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Brazil
| | - André B. Veras
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Brazil
| | - Érika K. Ferri
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Brazil
| | - Fatima A. A. Quadros
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Brazil
| | - Clayton Peixoto
- Medicine School, State University of Mato Grosso do Sul, Mato Grosso do Sul, Brazil
| | | | | | | | - Majella O’Keeffe
- Faculty of Life Sciences & Medicine, Department of Nutritional Sciences, School of Life Course Sciences, King’s College London, London, United Kingdom
| | - Christelle Elia
- Faculty of Life Sciences & Medicine, Department of Nutritional Sciences, School of Life Course Sciences, King’s College London, London, United Kingdom
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Ingrid Wolfe
- Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Seeromanie Harding
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
- Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
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Karamanos A, Lu Y, Mudway IS, Ayis S, Kelly FJ, Beevers SD, Dajnak D, Fecht D, Elia C, Tandon S, Webb AJ, Grande AJ, Molaodi OR, Maynard MJ, Cruickshank JK, Harding S. Associations between air pollutants and blood pressure in an ethnically diverse cohort of adolescents in London, England. PLoS One 2023; 18:e0279719. [PMID: 36753491 PMCID: PMC9907839 DOI: 10.1371/journal.pone.0279719] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 12/13/2022] [Indexed: 02/09/2023] Open
Abstract
Longitudinal evidence on the association between air pollution and blood pressure (BP) in adolescence is scarce. We explored this association in an ethnically diverse cohort of schoolchildren. Sex-stratified, linear random-effects modelling was used to examine how modelled residential exposure to annual average nitrogen dioxide (NO2), particulate matter (PM2.5, PM10) and ozone (O3), measures in μg/m3, associated with blood pressure. Estimates were based on 3,284 adolescents; 80% from ethnic minority groups, recruited from 51 schools, and followed up from 11-13 to 14-16 years old. Ethnic minorities were exposed to higher modelled annual average concentrations of pollution at residential postcode level than their White UK peers. A two-pollutant model (NO2 & PM2.5), adjusted for ethnicity, age, anthropometry, and pubertal status, highlighted associations with systolic, but not diastolic BP. A μg/m3 increase in NO2 was associated with a 0.30 mmHg (95% CI 0.18 to 0.40) decrease in systolic BP for girls and 0.19 mmHg (95% CI 0.07 to 0.31) decrease in systolic BP for boys. In contrast, a 1 μg/m3 increase in PM2.5 was associated with 1.34 mmHg (95% CI 0.85 to 1.82) increase in systolic BP for girls and 0.57 mmHg (95% CI 0.04 to 1.03) increase in systolic BP for boys. Associations did not vary by ethnicity, body size or socio-economic advantage. Associations were robust to adjustments for noise levels and lung function at 11-13 years. In summary, higher ambient levels of NO2 were associated with lower and PM2.5 with higher systolic BP across adolescence, with stronger associations for girls.
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Affiliation(s)
- A. Karamanos
- School of Life Course/Nutritional Sciences, King’s College London, London, United Kingdom
| | - Y. Lu
- School of Life Course/Nutritional Sciences, King’s College London, London, United Kingdom
- Clinical Research Center of The Third Xiangya Hospital, Central South University, Changsha, China
| | - I. S. Mudway
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, United Kingdom
| | - S. Ayis
- Faculty of Life Sciences & Medicine, Department of Population Health Sciences, School of Population Health & Environmental Sciences, King’s College London, London, United Kingdom
| | - F. J. Kelly
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, United Kingdom
| | - S. D. Beevers
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, United Kingdom
| | - D. Dajnak
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, United Kingdom
| | - D. Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, United Kingdom
| | - C. Elia
- School of Life Course/Nutritional Sciences, King’s College London, London, United Kingdom
| | - S. Tandon
- Faculty of Life Sciences & Medicine, Department of Population Health Sciences, School of Population Health & Environmental Sciences, King’s College London, London, United Kingdom
| | - A. J. Webb
- Faculty of Life Sciences & Medicine, Department of Clinical Pharmacology, King’s College London BHF Centre of Excellence, School of Cardiovascular Medicine and Sciences, King’s College, London, United Kingdom
| | - A. J. Grande
- Curso de Medicina, Universidade Estadual do Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - O. R. Molaodi
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | - M. J. Maynard
- School of Clinical & Applied Sciences, Leeds Beckett University, Leeds, United Kingdom
| | - J. K. Cruickshank
- School of Life Course/Nutritional Sciences, King’s College London, London, United Kingdom
| | - S. Harding
- School of Life Course/Nutritional Sciences, King’s College London, London, United Kingdom
- Faculty of Life Sciences & Medicine, Department of Population Health Sciences, School of Population Health & Environmental Sciences, King’s College London, London, United Kingdom
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15
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Emmanuel R, Read UM, Grande AJ, Harding S. Acceptability and Feasibility of Community Gardening Interventions for the Prevention of Non-Communicable Diseases among Indigenous Populations: A Scoping Review. Nutrients 2023; 15:791. [PMID: 36771495 PMCID: PMC9921708 DOI: 10.3390/nu15030791] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 02/08/2023] Open
Abstract
Compared with non-Indigenous populations, Indigenous populations experience worse health across many outcomes, including non-communicable diseases, and they are three times more likely to live in extreme poverty. The objectives were to identify (1) the content, implementation, and duration of the intervention; (2) the evaluation designs used; (3) the outcomes reported; and (4) the enablers and the challenges. Using the PRISMA-ScR guidelines, a search of research databases and grey literature was conducted. Seven studies met the inclusion criteria. Papers reported on acceptability, nutrition knowledge, fruit and vegetable intake, self-efficacy, motivation, and preference concerning fruit and vegetable, diet, and gardening. No study measured all outcomes. All papers reported on acceptability, whether implicitly or explicitly. The evaluation used mostly pre- and post-intervention assessments. The effect of gardening on nutrition and gardening knowledge and fruit and vegetable intake was inconclusive, and was related to a general lack of robust evaluations. Applying the He Pikinga Waiora Framework, however, revealed strong evidence for community engagement, cultural centeredness, integrated knowledge translation and systems thinking in increasing the acceptability and feasibility of gardening in Indigenous communities. Despite environmental challenges, the evidence signaled that gardening was an acceptable intervention for the Indigenous communities.
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Affiliation(s)
- Rosana Emmanuel
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
| | - Ursula M Read
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Antonio Jose Grande
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
- Department of Medicine, Universidade Estadual de Mato Grosso do Sul-(UEMS), P.O. Box 351, Dourados 79804-970, Brazil
| | - Seeromanie Harding
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
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Tandon S, Grande AJ, Karamanos A, Cruickshank JK, Roever L, Mudway IS, Kelly FJ, Ayis S, Harding S. Association of Ambient Air Pollution with Blood Pressure in Adolescence: A Systematic-review and Meta-analysis. Curr Probl Cardiol 2023; 48:101460. [PMID: 36265590 DOI: 10.1016/j.cpcardiol.2022.101460] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 10/13/2022] [Indexed: 01/04/2023]
Abstract
We systematically reviewed the association of ambient air pollution with blood pressure (BP) as a primary outcome in adolescents (10-19 years). Five databases (Ovid Medline, Ovid Embase, Web of Science, The Cochrane Library, and LILACS) were searched for relevant articles published up to August 2022. Meta-analyses were conducted using STATA v17 (Protocol - OSF Registries https://doi.org/10.17605/OSF.IO/96G5Q). Eight studies (5 cohort, 3 cross-sectional) with approximately 15,000 adolescents were included. Data from 6 studies were suitable for inclusion in the meta-analyses. In sub-group analyses, non-significant positive associations were observed for cohort studies assessing long-term exposure to PM10, PM2.5, and NO2 on systolic and diastolic BP. At age 12 years old (3702 adolescents), we found significant positive associations for long-term exposure to PM2.5(β=5.33 (1.56, 9.09) mmHg) and PM10 (β=2.47 (0.10, 4.85) mmHg) on diastolic BP. Significant positive associations were observed (3,592 adolescents) for long-term exposure to PM10(β=0.34 (0.19, 0.50) mmHg) and NO2 on diastolic BP (β=0.40 (0.09, 0.71) mmHg), and PM10 on systolic BP (β=0.48 (0.19, 0.77) mmHg). The overall quality of evidence analysed was graded as "low/very low." Insufficient data for short-term exposures to PM2.5, PM10, NO2, CO on BP led to their exclusion from the meta-analysis. Inconsistent associations were reported for gender-stratified results. The evidence, though of low-quality and limited, indicated that ambient air pollution was positively associated with adolescent BP. Future studies need improved measures of air pollutant exposures, consideration of gender and socio-economic circumstances on the observed pollution effects, as well as adjustment for other potential confounding factors.
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Affiliation(s)
- Saniya Tandon
- School of Life Course and Population Health, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Antonio Jose Grande
- School of Life Course and Population Health, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Curso de Medicina, Universidade Estadual do Mato Grosso do Sul, Campo Grande, Brazil
| | - Alexis Karamanos
- School of Life Course and Population Health, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - John Kennedy Cruickshank
- School of Life Course and Population Health, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Leonardo Roever
- Department of Clinical Research, Federal University of Uberlandia, Uberlândia, Brazil
| | - Ian Stanley Mudway
- MRC Centre for Environment and Health, Imperial College London, London, United Kingdom; NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, United Kingdom
| | - Frank James Kelly
- MRC Centre for Environment and Health, Imperial College London, London, United Kingdom; NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, United Kingdom
| | - Salma Ayis
- School of Life Course and Population Health, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Seeromanie Harding
- School of Life Course and Population Health, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom.
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Pollard R, Chen PJ, Mackes N, Lawrence AJ, Ma X, Matter M, Kretzer S, Morgan C, Harding S, Schumann G, Pariante C, Mehta M, Montana G, Nosarti C, Desrivieres S, Rodriguez-Mateos A, Dazzan P. The eBRAIN study: The impact of early adversity on trajectories of brain maturation and mental health in young adolescents - A prospective cohort study. Brain Behav Immun Health 2022; 26:100539. [PMID: 36388138 PMCID: PMC9640307 DOI: 10.1016/j.bbih.2022.100539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction More than 1 in 10 people are thought to experience a mental health problem during adolescence, with most adult psychopathology beginning during this time. Experiences of stress or adversity during childhood are important risk factors for poorer mental health outcomes and are also associated with alterations in neurodevelopment. There is evidence to suggest that this relationship is mediated by inflammation and the immune system. The eBRAIN study (The Impact of Early Adversity on Trajectories of Brain Maturation and Mental Health in Young Adolescents) will assess how early life adversity might affect trajectories of brain development throughout adolescence, whether these neurobiological changes are associated with psychopathology, and if they can potentially be explained by an activation of the immune system. Methods A cohort of 220 adolescents between the ages of 11-14 will be recruited into this study. Each participant will complete three study visits, each one year apart, at the Institute of Psychiatry, Psychology and Neuroscience, King's College London, London (UK). At each study visit, they will be assessed with structural and functional MRI scans, biological sample collection as well as questionnaires and interviews to collect demographic information, assess experiences of adversity, and details of psychopathology. The study will also collect information about factors such as diet and nutrition, physical exercise, and cognition. Ethics and dissemination Ethical approval for this study has been received by King's College London Research Ethics Committee (REC reference: HR-18/19-9033). Findings from the study will be published in peer-reviewed journals and disseminated at national and international conferences. Patient and public involvement (PPI) is an important component of the study, 'Study Champions' recruited from participants, their parents and teachers at collaborating schools have been invited to take an active role in study governance and dissemination.
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Affiliation(s)
- Rebecca Pollard
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Pei Jung Chen
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Nuria Mackes
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Andrew J. Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Xuemei Ma
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Maryam Matter
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Svenja Kretzer
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Craig Morgan
- Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
- ESRC Centre for Society and Mental Health, King's College London, UK
| | - Seeromanie Harding
- Department of Population Health Sciences, School of Life Course and Population Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Department of Nutritional Sciences, School of Life Course and Population Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Gunter Schumann
- Biological Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Carmine Pariante
- Biological Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Mitul Mehta
- Department of Neuroimaging & Psychopharmacology, Centre of Neuroimaging Sciences, King's College London, London, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Giovanni Montana
- Department of Statistics, University of Warwick, Coventry, UK
- WMG, University of Warwick, Coventry, UK
| | - Chiara Nosarti
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Sylvane Desrivieres
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ana Rodriguez-Mateos
- Department of Nutritional Sciences, School of Life Course and Population Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
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18
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Blackman J, Morrison H, Lloyd K, Gimson A, Banerjee L, Green S, Cousins R, Rudd S, Harding S, Coulthard E. Sleep Measurement Heterogeneity in Mild Cognitive Impairment and Early Dementia - Towards a Core Outcome Set: A Scoping Review. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.403] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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19
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Oliver C, Biswas B, Blackman J, Busse M, Butters A, Drew C, Gabb V, Harding S, Hoyos C, Kendrick A, Turner N, Coulthard E. A systematic review on adherence to continuous positive airway pressure (CPAP) treatment for obstructive sleep apnoea (OSA) in individuals with mild cognitive impairment and Alzheimer's disease dementia. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.641] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Knowles G, Gayer-Anderson C, Blakey R, Davis S, Lowis K, Stanyon D, Ofori A, Turner A, Dorn L, Beards S, Pinfold V, Reininghaus U, Harding S, Morgan C. Cohort Profile: Resilience, Ethnicity and AdolesCent mental Health (REACH). Int J Epidemiol 2022; 51:e303-e313. [PMID: 35348706 PMCID: PMC9557858 DOI: 10.1093/ije/dyac051] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 03/08/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
- Gemma Knowles
- Health Service and Population Research Department, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, London, UK
- ESRC Centre for Society and Mental Health, King’s College
London, London, UK
| | - Charlotte Gayer-Anderson
- Health Service and Population Research Department, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, London, UK
- ESRC Centre for Society and Mental Health, King’s College
London, London, UK
| | - Rachel Blakey
- Health Service and Population Research Department, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, London, UK
- ESRC Centre for Society and Mental Health, King’s College
London, London, UK
| | - Samantha Davis
- Health Service and Population Research Department, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, London, UK
- ESRC Centre for Society and Mental Health, King’s College
London, London, UK
| | - Katie Lowis
- Health Service and Population Research Department, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, London, UK
| | - Daniel Stanyon
- Health Service and Population Research Department, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, London, UK
| | - Aisha Ofori
- Health Service and Population Research Department, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, London, UK
| | - Alice Turner
- Health Service and Population Research Department, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, London, UK
- ESRC Centre for Society and Mental Health, King’s College
London, London, UK
| | - Lynsey Dorn
- Health Service and Population Research Department, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, London, UK
- ESRC Centre for Society and Mental Health, King’s College
London, London, UK
| | | | | | - Stephanie Beards
- Health Service and Population Research Department, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, London, UK
- National Children’s Bureau, London, UK
| | | | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health,
Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Seeromanie Harding
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty
of Life Sciences & Medicine, King’s College London, London, UK
| | - Craig Morgan
- Corresponding author. ESRC Centre for Society and Mental Health,
Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5
8AF, UK. E-mail:
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21
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Karamanos A, Stewart K, Harding S, Kelly Y, Lacey R. Adverse childhood experiences and adolescent drug use in the UK: The moderating role of socioeconomic position and ethnicity. SSM Popul Health 2022; 19:101142. [PMID: 35733836 PMCID: PMC9207135 DOI: 10.1016/j.ssmph.2022.101142] [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] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 05/10/2022] [Accepted: 06/05/2022] [Indexed: 11/29/2022] Open
Abstract
Rationale There is a paucity of prospective UK studies exploring the role of Adverse Childhood Experiences (ACEs) on adolescent teenage drug use and even less is known about the complex interplay between ACEs and adolescent social, demographic, and economic characteristics. To address these gaps, we use rich longitudinal data from the nationally representative Millennium Cohort Study. Methods Sex-stratified survey logistic regression modelling was applied using data from 9,476 adolescents and their parents to examine associations between ACEs between ages 3 and 14 years and drug use at ages 14 and 17 years. We a) explore the extent to which associations are robust to adjustment for ethnicity, family income, parental social class, and parental education, b) examine whether associations differ by these factors, and c) estimate the proportion of drug use at ages 14 and 17 years attributable to ACEs after controlling for these factors. Results Half of MCS cohort members had been exposed to at least one ACE and approximately 1 in 11 were exposed to 3+ ACEs. Multivariable analyses suggest that ACEs were associated with a higher likelihood of drug use at age 14 than age 17, especially for girls. No evidence was found that either advantaged socio-economic position or ethnicity acted as a buffer against the negative effects of ACEs in relation to adolescent drug use. Finally, we found that prevention of exposure to sexual violence, bullying and violence within the household (if causal) is more important for girls' drug use at age 14 than age 17. Conclusions ACEs are associated with adolescent drug use with potential consequences on wider aspects of young people's lives, regardless of their social, ethnic, or economic background, adding further urgency to the need to reduce the incidence of these negative experiences.
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Affiliation(s)
- A. Karamanos
- School of Life Course/ Nutritional Sciences, King's College London, UK
| | - K. Stewart
- Department of Social Policy and Centre for Analysis of Social Exclusion (CASE), London School of Economics and Political Science, UK
| | - S. Harding
- School of Life Course/ Nutritional Sciences, King's College London, UK
- Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Y. Kelly
- Department of Epidemiology & Public Health, University College London, UK
| | - R.E. Lacey
- Department of Epidemiology & Public Health, University College London, UK
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22
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Molokhia M, Ayis DS, Karamanos A, L'Esperance DV, Yousif S, Durbaba S, Ćurčin V, Ashworth M, Harding S. What factors influence differential uptake of NHS Health Checks, diabetes and hypertension reviews among women in ethnically diverse South London? Cross-sectional analysis of 63,000 primary care records. EClinicalMedicine 2022; 49:101471. [PMID: 35747176 PMCID: PMC9156982 DOI: 10.1016/j.eclinm.2022.101471] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Uptake of health checks among women has not been examined in relation to patient and General Practitioner (GP) practice level factors. We investigated patient and practice level factors associated with differential uptake of health checks. METHODS Primary care records from 44 practices in Lambeth for women aged 40-74 years old (N = 62,967) from 2000-2018 were analysed using multi-level logistic regression models. An odds ratio (OR) >1 indicates increased occurrence of no health check. FINDINGS The mean age (IQR) of the included female sample (aged 40-74 years) was 52.9 years (45.0-59.0). Adjusted for patient-level factors (age, ethnicity, English as first language, overweight/obesity, smoking, attendance to GP practices, and co-morbidity), the odds of non-uptake of health checks were higher for Other White (OR 1.24, 95% confidence interval 1.17-1.33), and Other ethnicity (1.20, 1.07-1.35) vs. White British. It was also higher for 50-69 year olds (1.55, 1.47-1.62), 70-74 year olds (1.60, 1.49-1.72) vs. 40-49 year olds. These ORs did not change on adjustments for practice level factors (proportion of patients living in deprived areas, proportion of patients with ≥1 chronic condition, ≥3 emergency diabetes admissions annually, GP density/1000 patients, quality outcome framework score of ≥ 95%, and patient satisfaction scores of ≥80%). Non-uptake was lower for Black Caribbeans, Bangladeshis, overweight/obese patients, frequent practice attenders and comorbid patients. INTERPRETATION Differential uptake in health checks remained after adjustment for patient and practice level factors. Better measures of social determinants of health and of practice context are needed. FUNDING NIHR Research for Patient Benefit Programme (NIHR202769).
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23
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Ma X, Biaggi A, Sacchi C, Lawrence AJ, Chen PJ, Pollard R, Matter M, Mackes N, Hazelgrove K, Morgan C, Harding S, Simonelli A, Schumann G, Pariante CM, Mehta M, Montana G, Rodriguez-Mateos A, Nosarti C, Dazzan P. Mediators and moderators in the relationship between maternal childhood adversity and children's emotional and behavioural development: a systematic review and meta-analysis. Psychol Med 2022; 52:1817-1837. [PMID: 35730541 PMCID: PMC9340854 DOI: 10.1017/s0033291722001775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/10/2021] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 11/06/2022]
Abstract
Maternal experiences of childhood adversity can increase the risk of emotional and behavioural problems in their children. This systematic review and meta-analysis provide the first narrative and quantitative synthesis of the mediators and moderators involved in the link between maternal childhood adversity and children's emotional and behavioural development. We searched EMBASE, PsycINFO, Medline, Cochrane Library, grey literature and reference lists. Studies published up to February 2021 were included if they explored mediators or moderators between maternal childhood adversity and their children's emotional and behavioural development. Data were synthesised narratively and quantitatively by meta-analytic approaches. The search yielded 781 articles, with 74 full-text articles reviewed, and 41 studies meeting inclusion criteria. Maternal mental health was a significant individual-level mediator, while child traumatic experiences and insecure maternal-child attachment were consistent family-level mediators. However, the evidence for community-level mediators was limited. A meta-analysis of nine single-mediating analyses from five studies indicated three mediating pathways: maternal depression, negative parenting practices and maternal insecure attachment, with pooled indirect standardised effects of 0.10 [95% CI (0.03-0.17)), 0.01 (95% CI (-0.02 to 0.04)] and 0.07 [95% CI (0.01-0.12)], respectively. Research studies on moderators were few and identified some individual-level factors, such as child sex (e.g. the mediating role of parenting practices being only significant in girls), biological factors (e.g. maternal cortisol level) and genetic factors (e.g. child's serotonin-transporter genotype). In conclusion, maternal depression and maternal insecure attachment are two established mediating pathways that can explain the link between maternal childhood adversity and their children's emotional and behavioural development and offer opportunities for intervention.
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Affiliation(s)
- Xuemei Ma
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Alessandra Biaggi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Chiara Sacchi
- Department of Developmental Psychology and Socialisation, University of Padova, Padua, Italy
| | - Andrew J. Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Pei-Jung Chen
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Rebecca Pollard
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Maryam Matter
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Nuria Mackes
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Katie Hazelgrove
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Craig Morgan
- Department of Health Service & Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Seeromanie Harding
- Division of Diabetes and Nutritional Sciences, King's College London, London, UK
| | - Alessandra Simonelli
- Department of Developmental Psychology and Socialisation, University of Padova, Padua, Italy
| | - Gunter Schumann
- Biological Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Carmine M. Pariante
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Biological Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mitul Mehta
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Department of Neuroimaging & Psychopharmacology, Centre of Neuroimaging Sciences, King's College London, London, UK
| | | | - Ana Rodriguez-Mateos
- Department of Nutritional Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Chiara Nosarti
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Department of Developmental Psychology and Socialisation, University of Padova, Padua, Italy
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Almughamisi M, O'Keeffe M, Harding S. Adolescent Obesity Prevention in Saudi Arabia: Co-identifying Actionable Priorities for Interventions. Front Public Health 2022; 10:863765. [PMID: 35619826 PMCID: PMC9128526 DOI: 10.3389/fpubh.2022.863765] [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: 01/27/2022] [Accepted: 03/30/2022] [Indexed: 12/05/2022] Open
Abstract
Background Childhood obesity is a serious issue in the Kingdom of Saudi Arabia, but there is no known community intervention. The aim of the study was to use a participatory approach to obtain the perspectives of students, school staff and Ministry of Education (MoE) representatives and parents on important and feasible intervention opportunities for school-based obesity prevention for adolescent girls. Method The study was conducted in two intermediate schools for girls (13–15 years old) in Jeddah that were purposefully identified with the support of the MoE. Group concept mapping, a mixed method approach, was conducted with 19 adults which included staff from the MoE and schools, school canteen suppliers and mothers. Adults generated statements in response to two prompts (P); P1 “The factors influencing adolescent obesity in Saudi are...” and P2 “The content of school-based programmes should focus on....” Photovoice-enhanced concept mapping was used with students (n = 15 students) to capture adolescent perspectives on what influences their dietary and physical activity habits. Students generated statements' using their own photographs. Stakeholders, both adult and students, sorted the statements into themes and rated each statement for relative importance and feasibility. Multidimensional scaling and hierarchical cluster analyses were used to produce concept maps with the input from students and adults. Result Adults generated 35 statements in response to P1 and identified five themes that influenced adolescent obesity including “Home Environment,” “Lifestyle,” “School Environment,” “Community,” “Biology.” They generated 42 statements in relation to P2 and identified four themes including “Ministry of Education Support,” “School Environment,” “Public health programmes” and “Wider environmental influences.” Students generated 42 statements from 39 pictures. They identified five themes that influenced their dietary and physical activity habits—“Role of Government,” “School Environment,” “Home Environment,” “Retail Environment” and “Cultural Practices.” Both groups identified several common important and feasible actions with a strong emphasis on improving the school environment, in particular food provision, with MoE support. Exemplar corresponding statements from adults were “Offer healthy foods in the canteen,” “Remove chocolates and sweets” and “Educate children about healthy foods” and from students were “Offer fruit and vegetables in the canteen,” “Remove chocolates from the canteen,” “Healthy meals should not expensive.” Lack of correspondence related to students' emphasis on access to both healthy foods and physical activity in schools and the wider environment (e.g. retail environments), while adults emphasized school-based education and food provision. After further consultations, both stakeholder groups agreed on improving access to healthy foods in the canteen. Conclusions Students and school and MoE staff jointly agreed that a canteen-based intervention was important and feasible to improve dietary habits and thus help to prevent obesity among adolescent girls. This was the first time a participatory approach was used with students for intervention development in Saudi Arabia. A co-development approach may have value to improve their school food environments.
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Affiliation(s)
- Manal Almughamisi
- Department of Nutritional Sciences, King's College London, London, United Kingdom
| | - Majella O'Keeffe
- Department of Nutritional Sciences, King's College London, London, United Kingdom.,School of Food and Nutritional Science, Biosciences Institute, University College Cork, Cork, Ireland
| | - Seeromanie Harding
- Department of Nutritional Sciences, King's College London, London, United Kingdom.,Department of Population Health Sciences and Department of Nutritional Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
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Tan K, Sakrikar D, Ashby J, North S, Ouverson L, Wallis G, Du Chateau B, Harding S, Barnidge D. M185 QIP-MS: A reliable method for detection of M-proteins traceable to the international serum standard DA470K. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.067] [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: 11/03/2022]
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26
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Tay W, Barnidge D, Sakrikar D, Harding S, Sherman M, Cheedarla N, Neish A. T042 Automated EXENT® mass spectrometry for the qualitative assessment of monoclonal immunoglobulins in urine. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.279] [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: 11/24/2022]
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Tay W, Giles H, Wright N, Afzal M, Birtwistle J, Berlanga O, North S, Drayson M, Pratt G, Wallis G, Harding S. T043 Exent mass spectrometry allows early identification of multiclonal MGUS compared to electrophoretic methods. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.280] [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: 11/24/2022]
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Tan K, Ashby J, North S, Barnidge D, Brusseau S, Patel R, Du Chateau B, Wallis G, Harding S, Sakrikar D. T032 QIP-MS: An alternative method to standard electrophoretic techniques for the identification of intact monoclonal immunoglobulins. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.269] [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: 11/29/2022]
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Harding S, MacDonald K, Nicholson S, Tageldein M, Arrowsmith C. MO-0138 cGAS localization to micronuclei is dictated by nuclear chromatin status pre-DNA damage. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02298-8] [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: 10/18/2022]
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Tan K, Lajko M, Sakrikar D, Ashby J, North S, Wallis G, Harding S, Du Chateau B, Murray D, Barnidge D. T033 QIP-MS discriminates therapeutic monoclonal antibodies from endogenous m-proteins in patients with multiple myeloma. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.270] [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: 11/30/2022]
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Grande AJ, Elia C, Peixoto C, Jardim PDTC, Dazzan P, Veras AB, Cruickshank JK, da Rosa MI, Harding S. Mental health interventions for suicide prevention among indigenous adolescents: a systematic review. SAO PAULO MED J 2022; 140:486-498. [PMID: 35508004 PMCID: PMC9671239 DOI: 10.1590/1516-3180.2021.0292.r1.22102021] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/12/2021] [Accepted: 10/22/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The legacies of colonization and of policies of forced assimilation continue to be a cause of intergenerational trauma, manifested through feelings of marginality, depression, anxiety and confusion, which place indigenous peoples at increased risk of suicide. OBJECTIVES To assess the quality, content, delivery and effectiveness of interventions for preventing suicides among indigenous adolescents. DESIGN AND SETTING Systematic review conducted with Cochrane methodology, Campo Grande, Mato Grosso do Sul, Brazil. METHODS The Cochrane library, MEDLINE, EMBASE, CINAHL, LILACS and PsycINFO databases were searched for studies published up to February 2021. The following inclusion criteria were used: published in any language; interventions that aimed to prevent suicides among indigenous adolescents; randomized or non-randomized study with a control or comparative group; and validated measurements of mental health problems. RESULTS Two studies were identified: one on adolescents in the remote Yup'ik community in south-western Alaska, and the other on Zuni adolescents in New Mexico. Both studies showed evidence of effectiveness in interventions for reducing some of the risk factors and increasing some of the protective factors associated with suicide. High levels of community engagement and culture-centeredness were key anchors of both studies, which ensured that the intervention content, delivery and outcome measurements aligned with the beliefs and practices of the communities. Both studies were judged to have a moderate risk of bias, with biases in sample selection, attrition and inadequate reporting of results. CONCLUSIONS The current evidence base is small but signaled the value of culturally appropriate interventions for prevention of suicide among indigenous adolescents. REGISTRATION DETAILS The study protocol is registered in the international prospective register of systematic reviews (PROSPERO); no. CRD42019141754.
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Affiliation(s)
- Antonio Jose Grande
- PhD. Physical Educator and Adjunct Professor, Medical Course, Universidade Estadual de Mato Grosso do Sul (UEMS), Campo Grande (MS), Brazil.
| | - Christelle Elia
- MSc. Dietitian and Research Assistant, Department of Nutrition, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, United Kingdom.
| | - Clayton Peixoto
- PhD. Psychologist and Adjunct Professor, Medical Course, Universidade Estadual de Mato Grosso do Sul (UEMS), Campo Grande (MS), Brazil.
| | - Paulo de Tarso Coelho Jardim
- PhD. Dentist and Adjunct Professor, Medical Course, Universidade Estadual de Mato Grosso do Sul (UEMS), Campo Grande (MS), Brazil.
| | - Paola Dazzan
- PhD. Physician and Professor, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, Denmark Hill Campus, London, United Kingdom.
| | - Andre Barciela Veras
- PhD. Physician and Adjunct Professor, Medical Course, Universidade Estadual de Mato Grosso do Sul (UEMS), Campo Grande (MS), Brazil.
| | - John Kennedy Cruickshank
- MBChB, MD. Physician and Professor of Cardiovascular Medicine & Diabetes, Department of Nutrition, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, United Kingdom.
| | - Maria Inês da Rosa
- PhD. Physician and Professor, Translational Psychiatry Laboratory, Postgraduate Program in Health Sciences, Universidade do Extremo Sul Catarinense (UNESC), Criciúma (SC), Brazil.
| | - Seeromanie Harding
- PhD. Professor of Social Epidemiology, Department of Population Health Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, United Kingdom.
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Chen PJ, Mackes N, Sacchi C, Lawrence AJ, Ma X, Pollard R, Matter M, Morgan C, Harding S, Schumann G, Pariante C, Mehta MA, Montana G, Nosarti C, Dazzan P. Parental education and youth suicidal behaviours: a systematic review and meta-analysis. Epidemiol Psychiatr Sci 2022; 31:e19. [PMID: 35352676 PMCID: PMC8967699 DOI: 10.1017/s204579602200004x] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 01/04/2023] Open
Abstract
AIMS Lower parental education has been linked to adverse youth mental health outcomes. However, the relationship between parental education and youth suicidal behaviours remains unclear. We explored the association between parental education and youth suicidal ideation and attempts, and examined whether sociocultural contexts moderate such associations. METHODS We conducted a systematic review and meta-analysis with a systematic literature search in PubMed, PsycINFO, Medline and Embase from 1900 to December 2020 for studies with participants aged 0-18, and provided quantitative data on the association between parental education and youth suicidal ideation and attempts (death included). Only articles published in English in peer-reviewed journals were considered. Two authors independently assessed eligibility of the articles. One author extracted data [e.g. number of cases and non-cases in each parental education level, effect sizes in forms of odds ratios (ORs) or beta coefficients]. We then calculated pooled ORs using a random-effects model and used moderator analysis to investigate heterogeneity. RESULTS We included a total of 59 articles (63 study samples, totalling 2 738 374 subjects) in the meta-analysis. Lower parental education was associated with youth suicidal attempts [OR = 1.12, 95% Confidence Interval (CI) = 1.04-1.21] but not with suicidal ideation (OR = 1.05, 95% CI = 0.98-1.12). Geographical region and country income level moderated the associations. Lower parental education was associated with an increased risk of youth suicidal attempts in Northern America (OR = 1.26, 95% CI = 1.10-1.45), but with a decreased risk in Eastern and South-Eastern Asia (OR = 0.72, 95% CI = 0.54-0.96). An association of lower parental education and increased risk of youth suicidal ideation was present in high- income countries (HICs) (OR = 1.14, 95% CI = 1.05-1.25), and absent in low- and middle-income countries (LMICs) (OR = 0.91, 95% CI = 0.77-1.08). CONCLUSIONS The association between youth suicidal behaviours and parental education seems to differ across geographical and economical contexts, suggesting that cultural, psychosocial or biological factors may play a role in explaining this association. Although there was high heterogeneity in the studies reviewed, this evidence suggests that the role of familial sociodemographic characteristics in youth suicidality may not be universal. This highlights the need to consider cultural, as well as familial factors in the clinical assessment and management of youth's suicidal behaviours in our increasingly multicultural societies, as well as in developing prevention and intervention strategies for youth suicide.
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Affiliation(s)
- P. J. Chen
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Department of Psychiatry, Chang Gung Memorial Hospital at Taoyuan and Chang Gung University, Taoyuan, Taiwan
| | - N. Mackes
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - C. Sacchi
- Department of Developmental Psychology and Socialisation, University of Padova, Padua, Italy
| | - A. J. Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - X. Ma
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - R. Pollard
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - M. Matter
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - C. Morgan
- Health Service & Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - S. Harding
- Division of Diabetes and Nutritional Sciences, King's College London, London, UK
| | - G. Schumann
- Biological Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - C. Pariante
- Biological Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M. A. Mehta
- Department of Neuroimaging & Psychopharmacology, Centre of Neuroimaging Sciences, King's College London, London, UK
| | - G. Montana
- Department of Data Science, University of Warwick, Coventry, UK
| | - C. Nosarti
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - P. Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
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Knowles G, Gayer‐Anderson C, Turner A, Dorn L, Lam J, Davis S, Blakey R, Lowis K, Pinfold V, Creary N, Dyer J, Hatch SL, Ploubidis G, Bhui K, Harding S, Morgan C. Covid-19, social restrictions, and mental distress among young people: a UK longitudinal, population-based study. J Child Psychol Psychiatry 2022; 63:1392-1404. [PMID: 35199336 PMCID: PMC9114888 DOI: 10.1111/jcpp.13586] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [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] [Accepted: 01/17/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Adolescence is a critical period for social and emotional development. We sought to examine the impacts of Covid-19 and related social restrictions and school closures on adolescent mental health, particularly among disadvantaged, marginalised, and vulnerable groups. METHODS We analysed four waves of data - 3 pre-Covid-19 (2016-2019) and 1 mid-Covid-19 (May-Aug 2020; n, 1074; 12-18 years old, >80% minority ethnic groups, 25% free school meals) from REACH (Resilience, Ethnicity, and AdolesCent Mental Health), an adolescent cohort based in inner-London, United Kingdom. Mental health was assessed using validated measures at each time point. We estimated temporal trends in mental distress and examined variations in changes in distress, pre- to mid-Covid-19, by social group, and by pre- and mid-pandemic risks. RESULTS We found no evidence of an overall increase in mental distress midpandemic (15.9%, 95% CI: 13.0, 19.4) compared with prepandemic (around 18%). However, there were variations in changes in mental distress by subgroups. There were modest variations by social group and by pre-Covid risks (e.g., a small increase in distress among girls (b [unstandardised beta coefficient] 0.42 [-0.19, 1.03]); a small decrease among boys (b - 0.59 [-1.37, 0.19]); p for interaction .007). The most notable variations were by midpandemic risks: that is, broadly, increases in distress among those reporting negative circumstances and impacts (e.g., in finances, housing, social support and relationships, and daily routines) and decreases in distress among those reporting positive impacts. CONCLUSIONS We found strong evidence that mental distress increased among young people who were most negatively impacted by Covid-19 and by related social restrictions during the first lockdown in the United Kingdom.
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Affiliation(s)
- Gemma Knowles
- Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK,ESRC Centre for Society and Mental HealthKing’s College LondonLondonUK
| | - Charlotte Gayer‐Anderson
- Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK,ESRC Centre for Society and Mental HealthKing’s College LondonLondonUK
| | - Alice Turner
- Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK,ESRC Centre for Society and Mental HealthKing’s College LondonLondonUK
| | - Lynsey Dorn
- Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK,ESRC Centre for Society and Mental HealthKing’s College LondonLondonUK
| | - Joseph Lam
- Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK,ESRC Centre for Society and Mental HealthKing’s College LondonLondonUK
| | - Samantha Davis
- Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK,ESRC Centre for Society and Mental HealthKing’s College LondonLondonUK
| | - Rachel Blakey
- Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK,ESRC Centre for Society and Mental HealthKing’s College LondonLondonUK
| | - Katie Lowis
- ESRC Centre for Society and Mental HealthKing’s College LondonLondonUK
| | | | | | | | | | | | - Stephani L. Hatch
- ESRC Centre for Society and Mental HealthKing’s College LondonLondonUK,Psychological MedicineInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
| | - George Ploubidis
- Centre for Longitudinal StudiesUniversity College LondonLondonUK
| | | | - Seeromanie Harding
- Department of Nutritional SciencesSchool of Life Course SciencesFaculty of Life Sciences and MedicineKing’s College LondonLondonUK
| | - Craig Morgan
- Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK,ESRC Centre for Society and Mental HealthKing’s College LondonLondonUK
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Goberdhan S, Gobin R, Perreira O, Sharma M, Ramdeen M, Harding S. Formative Exploration of the Feasibility of Embedding Community Assets Into Primary Health Care: Barbershop and Place of Worship Readiness in Guyana. J Prim Care Community Health 2022; 13:21501319221135949. [PMID: 36373680 PMCID: PMC9666845 DOI: 10.1177/21501319221135949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Community engagement is key to improving the quality of primary health care
(PHC), with asset-based interventions shown to have a positive impact on
equity and health outcomes. However, there tends to be a disconnect between
community-based interventions and PHC, with a lack of evidence on how to
develop sustainable community—primary care partnerships. This paper reports
on the formative phases of 2 studies exploring the feasibility of embedding
community assets, namely places of worship and barbershops, into the PHC
pathway for the prevention and control of NCDs in deprived settings. It
describes the participatory approach used to map and gather contextual
readiness information, including the enablers and constrainers for
collaborative partnerships with PHC. Methods: Grounded in community-based participatory research, we used elements of
ground-truthing and participatory mapping to locate and gather contextual
information on places of worship and barbershops in urban and rural
communities. Local knowledge, gathered from community dialogs, led to the
creation of sampling frames of these community assets. Selected places of
worship were administered a 66-item readiness questionnaire, which included
domains on governance and financing, congregation profile, and existing
health programs and collaborations. Participating barbershops were
administered a 40-item readiness questionnaire, which covered barbers’
demographic information, previous training in health promotion, and barbers’
willingness to deliver health promotion activities. Results: Fourteen barbershops were identified, of which 10 participated in the
readiness survey, while 240 places of worship were identified, of which 14
were selected and assessed for readiness. Contextual differences were found
within and between these assets regarding governance, accessibility, and
reach. Key enablers for both include training in health promotion, an
overwhelming enthusiasm for participation and recognition of the potential
benefits of a community—primary care partnership. Lack of previous
collaborations with the formal health system was common to both. Conclusion: The participatory approach extended reach within underserved communities,
while the readiness data informed intervention design and identified
opportunities for partnership development. Contextual differences between
community assets require comprehensive readiness investigations to develop
suitably tailored interventions that promote reach, acceptance, and
sustainability.
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Yiu J, Hally K, Holley A, Harding S, Larsen P. Neutrophil Count Predicts One-Year Mortality in Non-ST-Elevation Myocardial Infarction. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.357] [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: 11/28/2022]
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Blakey R, Morgan C, Gayer-Anderson C, Davis S, Beards S, Harding S, Pinfold V, Bhui K, Knowles G, Viding E. Correction to: Prevalence of conduct problems and social risk factors in ethnically diverse inner-city schools. BMC Public Health 2021; 21:2184. [PMID: 34844598 PMCID: PMC8628402 DOI: 10.1186/s12889-021-12258-7] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Rachel Blakey
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Craig Morgan
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. .,ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.
| | - Charlotte Gayer-Anderson
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Sam Davis
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Stephanie Beards
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Seeromanie Harding
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, Stand, WC2R 2LS, UK
| | - Vanessa Pinfold
- The McPin Foundation, 7-14 Great Dover Street, London, SE1 4YR, UK
| | - Kamaldeep Bhui
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London, Blakey et al. BMC Public Health (2021) 21:849 Page 12 of 13 Queen Mary University of London, Charterhouse Square Campus, Old Anatomy Building, London, EC1M 6BQ, UK
| | - Gemma Knowles
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Essi Viding
- Developmental Risk and Resilience Unit, University College London, 26 Bedford Way, London, WC1H 0AP, UK
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Goff LM, Moore AP, Harding S, Rivas C. Development of Healthy Eating and Active Lifestyles for Diabetes, a culturally tailored diabetes self-management education and support programme for Black-British adults: A participatory research approach. Diabet Med 2021; 38:e14594. [PMID: 33961307 DOI: 10.1111/dme.14594] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 01/28/2021] [Revised: 03/25/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022]
Abstract
AIMS To develop an evidence-based, culturally tailored, diabetes self-management education and support programme for Black-British adults, called Healthy Eating and Active Lifestyles for Diabetes (HEAL-D), using participatory methods to engage key stakeholders in the intervention design process. METHODS Black-British adults living with type 2 diabetes, healthcare professionals and community leaders were engaged in an intervention development study. The intervention structure, format, content and delivery were developed through three phases of participatory research: Phase 1, formative research, involved focus groups and interviews; interactive co-development workshops were conducted in Phase 2; and Phase 3 focused on materials development. RESULTS In Phase 1, focus groups and interviews identified the importance of nurturing collectivism, a reliance on informal sources of information/advice, barriers to attending appointments associated with competing priorities of work, travel and carer commitments, and a preference for directness and simple, clear advice/messages. A priority for healthcare professionals was the intervention embedding within current primary care structures and aligning with incentivised targets/metrics. Phase 2 (workshops) highlighted key requirements: avoidance of medical settings, appropriately trained and culturally knowledgeable educators, flexible appointments, preference for verbal and visual information and avoidance of technical/medical terminology. In Phase 3 (materials development), culturally sensitive videos, short films and information booklets were developed to convey educational messages, and food photography was used to provide culturally relevant dietary advice. CONCLUSIONS Participatory methods provide a means to understand the needs of specific communities. This approach enables the development of healthcare interventions that are sensitive to the needs of service users and providers.
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Affiliation(s)
- Louise M Goff
- Departments of Diabetes & Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Amanda P Moore
- Departments of Diabetes & Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Seeromanie Harding
- Departments of Diabetes & Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Carol Rivas
- Department of Social Science, University College London, London, UK
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Patel P, Mustafa S, Liu Z, Harding S, Koritzinsky M, Koch C. Strategic Training in Transdisciplinary Radiation Science for the 21st Century (STARS21): 5-Year Prospective Evaluation of an Innovative Curriculum in Radiation Science. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.696] [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: 10/20/2022]
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Karamanos A, Mudway I, Kelly F, Beevers SD, Dajnak D, Elia C, Cruickshank JK, Lu Y, Tandon S, Enayat E, Dazzan P, Maynard M, Harding S. Air pollution and trajectories of adolescent conduct problems: the roles of ethnicity and racism; evidence from the DASH longitudinal study. Soc Psychiatry Psychiatr Epidemiol 2021; 56:2029-2039. [PMID: 33929549 PMCID: PMC8519907 DOI: 10.1007/s00127-021-02097-7] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 04/23/2021] [Indexed: 01/19/2023]
Abstract
PURPOSE No known UK empirical research has investigated prospective associations between ambient air pollutants and conduct problems in adolescence. Ethnic minority children are disproportionately exposed to structural factors that could moderate any observed relationships. This prospective study examined whether exposure to PM2.5 and NO2 concentrations is associated with conduct problems in adolescence, and whether racism or ethnicity moderate such associations. METHODS Longitudinal associations between annual mean estimated PM2.5 and NO2 concentrations at the residential address and trajectories of conduct problems, and the potential influence of racism and ethnicity were examined school-based sample of 4775 participants (2002-2003 to 2005-2006) in London, using growth curve models. RESULTS Overall, in the fully adjusted model, exposure to lower concentrations of PM2.5 and NO2 was associated with a decrease in conduct problems during adolescence, while exposure to higher concentrations was associated with a flattened trajectory of conduct symptoms. Racism amplified the effect of PM2.5 (β = 0.05 (95% CI 0.01 to 0.10, p < 0.01)) on adolescent trajectories of conduct problems over time. At higher concentrations of PM2.5, there was a divergence of trajectories of adolescent conduct problems between ethnic minority groups, with White British and Black Caribbean adolescents experiencing an increase in conduct problems over time. CONCLUSION These findings suggest that the intersections between air pollution, ethnicity, and racism are important influences on the development of conduct problems in adolescence.
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Affiliation(s)
- A Karamanos
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 57 Waterloo Road, London, SE1 8WA, UK.
| | - I Mudway
- MRC Centre for Environment and Health, Imperial College London, London, UK
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
| | - F Kelly
- MRC Centre for Environment and Health, Imperial College London, London, UK
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
| | - S D Beevers
- MRC Centre for Environment and Health, Imperial College London, London, UK
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
| | - D Dajnak
- MRC Centre for Environment and Health, Imperial College London, London, UK
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
| | - C Elia
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 57 Waterloo Road, London, SE1 8WA, UK
| | - J K Cruickshank
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 57 Waterloo Road, London, SE1 8WA, UK
| | - Y Lu
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 57 Waterloo Road, London, SE1 8WA, UK
| | - S Tandon
- Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - E Enayat
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - P Dazzan
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M Maynard
- School of Clinical and Applied Sciences, Leeds Beckett University, London, UK
| | - S Harding
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 57 Waterloo Road, London, SE1 8WA, UK
- Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
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40
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Dias IMÁV, Quadros FA, Godoy MGC, Grande AJ, Jardim PDTC, Harding S. University indigenous uses social media to report the impact of COVID-19 on their communities. Rev Assoc Med Bras (1992) 2021; 67:774-776. [PMID: 34709314 DOI: 10.1590/1806-9282.20210343] [Citation(s) in RCA: 1] [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] [Received: 03/25/2021] [Accepted: 04/26/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | - Antonio Jose Grande
- Universidade do Mato Grosso do Sul, Medical Course - Campo Grande (MS), Brazil
| | | | - Seeromanie Harding
- King's College London, School of Life Course Sciences, Faculty of Life Sciences & Medicine, Department of Nutritional Science - London, England
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41
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Goff LM, Rivas C, Moore A, Beckley-Hoelscher N, Reid F, Harding S. Healthy Eating and Active Lifestyles for Diabetes (HEAL-D), a culturally tailored self-management education and support program for type 2 diabetes in black-British adults: a randomized controlled feasibility trial. BMJ Open Diabetes Res Care 2021; 9:e002438. [PMID: 34518159 PMCID: PMC8438730 DOI: 10.1136/bmjdrc-2021-002438] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/08/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Black-British communities are disproportionately affected by type 2 diabetes (T2D). Structured education programs are a core component of T2D healthcare but they are less successful in people from minority ethnic groups. Culturally tailored T2D education has demonstrated greater benefits than usual care. The aim of our study was to evaluate acceptability, fidelity and trial feasibility of the Healthy Eating and Active Lifestyles for Diabetes ('HEAL-D') culturally tailored T2D self-management education and support (DSMES) program. RESEARCH DESIGN AND METHODS A mixed-methods randomized controlled feasibility trial in black-British adults with T2D was conducted. Participants were assigned to control (usual care) or intervention (HEAL-D; 7 sessions, 14 hours of group-based culturally tailored diet and lifestyle education, behavior change support and supervised physical activity), in a ratio of 1:1. Primary outcomes were recruitment and retention rates, intervention attendance and completion. Fidelity was assessed through observations and qualitative evaluation was undertaken with participants and educators. RESULTS 102 patients responded to invitation letters (n=1335); 63 were randomized but 8 were subsequently deemed ineligible due to high baseline glycosylated hemoglogin (HbA1c) requiring intensive medical management or missing baseline HbA1c measurement. Of the remaining 55 participants (27 intervention, 28 control), 69% were female, 47% were of African and 51% were of Caribbean ethnicity. 93% completed the trial, providing end point data. Intervention attendance was high; 85% completed the program (attendance at ≥5 sessions), and 74% attended ≥6 sessions. The intervention was delivered with acceptable fidelity, although the qualitative evaluations identified some areas of structure and format in need of refinement. CONCLUSIONS We have shown it is feasible to recruit and randomize black-British adults with T2D to a trial of a culturally tailored DSMES program. We have shown the intervention is highly acceptable for both patients and healthcare providers. A future trial should assess clinical and cost-effectiveness of HEAL-D. TRIAL REGISTRATION NUMBER NCT03531177.
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Affiliation(s)
- Louise M Goff
- Department of Nutritional Sciences, King's College London, Faculty of Life Sciences and Medicine, London, UK
| | - Carol Rivas
- Social Research Institute, University College London, London, UK
| | - Amanda Moore
- Department of Nutritional Sciences, King's College London, Faculty of Life Sciences and Medicine, London, UK
| | | | - Fiona Reid
- Population Health, King's College London, Faculty of Life Sciences and Medicine, London, UK
| | - Seeromanie Harding
- Department of Nutritional Sciences, King's College London, Faculty of Life Sciences and Medicine, London, UK
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Paramlall M, Bakar I, Kandasamy R, Gadhvi A, Holloway C, Harding S, Tyagi H. #3105 How does self-report of mood symptoms compare with observer assessments after acquired brain injury. J Neurol Psychiatry 2021. [DOI: 10.1136/jnnp-2021-bnpa.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
ObjectivesPost acquired brain injury (ABI) depression has been implicated in different patient outcomes such as prospective cognition, cognitive impairment, rehabilitation outcome, and quality of life. However, there have been no studies identified in the literature, investigating post ABI insight into depression across varied cognitive abilities. Here we looked at ABI patient insight into their depression across a range of cognitive abilities and compared this to an observed or an objective measure of depression.MethodsA retrospective cohort of 24 individuals with ABI (depressed and non-depressed) seen in a neuropsychiatry outpatient clinic between 2019 and 2020 completed a Patient Health Questionnaire-9 (PHQ-9), self-reported depression scale and had a Neuropsychiatry Inventory Questionnaire(NPI-Q), an observer assessment with a depression domain. The patients also underwent a formal cognitive examination using the Montreal Cognitive Assessment (MoCA).ResultsNon-depressed ABI and depressed ABI individuals with a wide range of cognitive abilities demonstrated good insight into their depression when matched to the observer rating. Chi-Square Test showed little variation between the PHQ-9 and NPI-Q Depression data sets; Wilcoxon Signed Ranks Test: Z Test -4.08, p<0.001, Effect Size 0.87 and Spearman’s rho showed positive correlation between the two data sets (Correlation Coefficient 0.527, P<0.008). Therefore, there was a statistically significant agreement between the subjective measure (PHQ-9) and the observed (objective) measure NPIQD and that there was a positive correlation between the two measurement scales for patients with ABI regardless of cognition (as measured by MoCAz score; range -6 to 2.21, mean: -1.17)ConclusionsThese findings indicate (1) self-reported measures of depression in ABI are consistent with observed (objective measures) thus can be used to assess depression in this cohort and (2) ABI patients with a wide range of cognitive abilities would appear to have good insight into their depression.
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Cook A, Faustini S, Williams L, Cunningham A, Drayson M, Shields A, Kay D, Taylor L, Plant T, Huissoon A, Wallis G, Beck S, Jossi S, Perez-Toledo M, Newby M, Allen J, Crispin M, Harding S, Richter A. Validation of a combined ELISA to detect IgG, IgA and IgM antibody responses to SARS-CoV-2 in mild or moderate non-hospitalised patients. J Immunol Methods 2021; 494:113046. [PMID: 33775672 PMCID: PMC7997147 DOI: 10.1016/j.jim.2021.113046] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [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: 11/17/2020] [Revised: 03/18/2021] [Accepted: 03/20/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Frequently SARS-CoV-2 results in mild or moderate disease with potentially lower concentrations of antibodies compared to those that are hospitalised. Here, we validated an ELISA using SARS-CoV-2 trimeric spike glycoprotein, with targeted detection of IgG, IgA and IgM (IgGAM) using serum and dried blood spots (DBS) from adults with mild or moderate disease. METHODS Targeting the SARS-CoV-2 trimeric spike, a combined anti-IgG, IgA and IgM serology ELISA assay was developed using 62 PCR-confirmed non-hospitalised, mild or moderate COVID-19 samples, ≥14 days post symptom onset and 624 COVID-19 negative samples. The assay was validated using 73 PCR-confirmed non-hospitalised, mild or moderate COVID-19 samples, ≥14 days post symptom onset and 359 COVID-19 negative serum samples with an additional 81 DBSs. The assay was further validated in 226 PCR-confirmed non-hospitalised, mild or moderate COVID-19 samples, ≥14 days post symptom onset and 426 COVID-19 negative clinical samples. RESULTS A sensitivity and specificity of 98.6% (95% CI, 92.6-100.0), 98.3% (95% CI, 96.4-99.4), respectively, was observed following validation of the SARS-CoV-2 ELISA. No cross-reactivities with endemic coronaviruses or other human viruses were observed, and no change in results were recorded for interfering substances. The assay was stable at temperature extremes and components were stable for 15 days once opened. A matrix comparison showed DBS to correlate with serum results. Clinical validation of the assay reported a sensitivity of 94.7% (95% CI, 90.9-97.2%) and a specificity of 98.4% (95% CI, 96.6-99.3%). CONCLUSIONS The human anti-IgGAM SARS-CoV-2 ELISA provides accurate and sensitive detection of SARS-CoV-2 antibodies in non-hospitalised adults with mild or moderate disease. The use of dried blood spots makes the assay accessible to the wider community.
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Affiliation(s)
- A.M. Cook
- The Binding Site Group Ltd, 8 Calthorpe Road, Birmingham B15 1QT, UK
| | - S.E. Faustini
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham B15 2TT, UK
| | - L.J. Williams
- The Binding Site Group Ltd, 8 Calthorpe Road, Birmingham B15 1QT, UK,Corresponding author at: The Binding Site Group, 8 Calthorpe Road, Birmingham B15 1QT, UK
| | - A.F. Cunningham
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK
| | - M.T. Drayson
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham B15 2TT, UK
| | - A.M. Shields
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham B15 2TT, UK,University Hospitals Birmingham, NHS Foundation Trust, Birmingham B15 2GW, UK
| | - D. Kay
- The Binding Site Group Ltd, 8 Calthorpe Road, Birmingham B15 1QT, UK
| | - L. Taylor
- The Royal Wolverhampton NHS Trust, Wolverhampton Road, Wolverhampton, West Midlands WV10 0QP, UK
| | - T. Plant
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham B15 2TT, UK
| | - A. Huissoon
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK,University Hospitals Birmingham, NHS Foundation Trust, Birmingham B15 2GW, UK
| | - G. Wallis
- The Binding Site Group Ltd, 8 Calthorpe Road, Birmingham B15 1QT, UK
| | - S. Beck
- University Hospitals Birmingham, NHS Foundation Trust, Birmingham B15 2GW, UK
| | - S.E. Jossi
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK
| | - M. Perez-Toledo
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK
| | - M.L. Newby
- School of Biological Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - J.D. Allen
- School of Biological Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - M. Crispin
- School of Biological Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - S. Harding
- The Binding Site Group Ltd, 8 Calthorpe Road, Birmingham B15 1QT, UK
| | - A.G. Richter
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham B15 2TT, UK,University Hospitals Birmingham, NHS Foundation Trust, Birmingham B15 2GW, UK
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Blakey R, Morgan C, Gayer-Anderson C, Davis S, Beards S, Harding S, Pinfold V, Bhui K, Knowles G, Viding E. Prevalence of conduct problems and social risk factors in ethnically diverse inner-city schools. BMC Public Health 2021; 21:849. [PMID: 33941137 PMCID: PMC8091508 DOI: 10.1186/s12889-021-10834-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/29/2020] [Accepted: 04/13/2021] [Indexed: 11/10/2022] Open
Abstract
Background In the UK, around 5% of 11–16-year olds experience conduct problems of clinical importance. However, there are limited data on prevalence of conduct problems by ethnic group, and how putative social risk factors may explain any variations in prevalence. This study has two main aims: (1) to estimate the prevalence and nature of conduct problems overall, and by ethnic group and gender, among adolescents in diverse inner-city London schools; (2) to assess the extent to which putative risk factors - racial discrimination, socioeconomic status, parental control, and troublesome friends - explain any observed differences in prevalence of conduct problems between ethnic groups. Methods This study uses baseline data from REACH, an accelerated cohort study of adolescent mental health in inner-city London. Self-report questionnaire data were collected on conduct problems and a range of distinct putative social risk factors (including racial discrimination, free school meals, troublesome friends, and parental care and control). A total of 4353 pupils, 51% girls, aged 11–14 participated. We estimated prevalence of conduct problems and used multilevel logistic regression to examine differences by ethnicity and gender and associations with putative risk factors. Results Prevalence of conduct problems in inner-city schools was around three times higher than reported in national studies (i.e., 16% [95%CI: 15·2–17·5] vs. 5% [95%CI 4·6–5·9]). Compared with overall prevalence, conduct problems were lower among Indian/Pakistani/Bangladeshi (RR: 0.53 [95% CI:0.31–0.87]) and white British (RR: 0.65 [0.51–0.82]) groups, and higher among black Caribbean (RR: 1.39 [95%CI:1.19–1.62]) and mixed white and black (RR: 1.29 [95% CI: 1.02–1.60]) groups. Risk of conduct problems was higher among those who were exposed to racial discrimination compared with those who were not (RR: 1.95 [95% CI: 1.59–2.31]). Conclusions Conduct problems are markedly more common in inner-city schools, and variations in the prevalence of conduct problems are, to some extent, rooted in modifiable social contexts and experiences, such as experiences of racial discrimination. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10834-5.
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Affiliation(s)
- Rachel Blakey
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Craig Morgan
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. .,ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.
| | - Charlotte Gayer-Anderson
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Sam Davis
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Stephanie Beards
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Seeromanie Harding
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, Stand, WC2R 2LS, UK
| | - Vanessa Pinfold
- The McPin Foundation, 7-14 Great Dover Street, London, SE1 4YR, UK
| | - Kamaldeep Bhui
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London, Queen Mary University of London, Charterhouse Square Campus, Old Anatomy Building, London, EC1M 6BQ, UK
| | - Gemma Knowles
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Essi Viding
- Developmental Risk and Resilience Unit, University College London, 26 Bedford Way, London, WC1H 0AP, UK
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Knowles G, Gayer-Anderson C, Beards S, Blakey R, Davis S, Lowis K, Stanyon D, Ofori A, Turner A, Working Group S, Pinfold V, Bakolis I, Reininghaus U, Harding S, Morgan C. Mental distress among young people in inner cities: the Resilience, Ethnicity and AdolesCent Mental Health (REACH) study. J Epidemiol Community Health 2021; 75:jech-2020-214315. [PMID: 33558428 PMCID: PMC8142438 DOI: 10.1136/jech-2020-214315] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Received: 04/13/2020] [Revised: 09/09/2020] [Accepted: 10/19/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Recent estimates suggest around 14% of 11-16 years in England have a mental health problem. However, we know very little about the extent and nature of mental health problems among diverse groups in densely populated inner cities, where contexts and experiences may differ from the national average. AIMS To estimate the extent and nature of mental health problems in inner city London, overall and by social group, using data from our school-based accelerated cohort study of adolescent mental health, Resilience, Ethnicity and AdolesCent Mental Health. METHODS Self-report data on mental health (general mental health, depression, anxiety, self-harm) were analysed (n, 4353; 11-14 years, 85% minority ethnic groups). Mixed models were used to estimate weighted prevalences and adjusted risks of each type of problem, overall and by gender, cohort, ethnic group and free school meals (FSM) status. RESULTS The weighted prevalence of mental health problems was 18.6% (95% CI 16.4% to 20.8%). Each type of mental health problem was more common among girls compared with boys (adjusted risk ratios: mental health problems, 1.33, 95% CI 1.18 to 1.48; depression, 1.52, 1.30 to 1.73; anxiety, 2.09, 1.58 to 2.59, self-harm, 1.40, 1.06 to 1.75). Gender differences were more pronounced in older cohorts compared with the youngest. Mental health problems (1.28, 1.05 to 1.51) and self-harm (1.29, 1.02 to 1.56)-but not depression or anxiety-were more common among those receiving (vs not receiving) FSM. There were many similarities, with some variations, by ethnic group. CONCLUSIONS Adolescent mental health problems and self-harm are common in inner city London. Gender differences in mental health problems may emerge during early adolescence.
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Affiliation(s)
- Gemma Knowles
- Health Service and Population Research, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Charlotte Gayer-Anderson
- Health Service and Population Research, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Stephanie Beards
- Health Service and Population Research, King's College London, London, UK
- National Childrens Bureau, London, UK
| | - Rachel Blakey
- Health Service and Population Research, King's College London, London, UK
- Centre for Society and Mental Health, King's College London, London, UK
| | - Samantha Davis
- Health Service and Population Research, King's College London, London, UK
- Centre for Society and Mental Health, King's College London, London, UK
| | - Katie Lowis
- Centre for Society and Mental Health, King's College London, London, UK
| | - Daniel Stanyon
- Health Service and Population Research, King's College London, London, UK
| | - Aisha Ofori
- Health Service and Population Research, King's College London, London, UK
| | - Alice Turner
- Health Service and Population Research, King's College London, London, UK
| | | | | | - Ioannis Bakolis
- Centre for Implementation Science, Health Services and Population Research Department, King's College London, London, UK
- Department of Biostatistics and Health Informatics, King's College London, London, UK
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | - Craig Morgan
- Health Service and Population Research, King's College London, London, UK
- Centre for Society and Mental Health, King's College London, London, UK
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Tandon S, Ayis S, Hopkins D, Harding S, Stadler M. The impact of pharmacological and lifestyle interventions on body weight in people with type 1 diabetes: A systematic review and meta-analysis. Diabetes Obes Metab 2021; 23:350-362. [PMID: 33026152 DOI: 10.1111/dom.14221] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 06/23/2020] [Revised: 09/09/2020] [Accepted: 09/23/2020] [Indexed: 12/17/2022]
Abstract
AIM To systematically review the effects of pharmacological and lifestyle interventions on body weight as a secondary outcome in people with type 1 diabetes. METHODS The Ovid Medline, Embase and Cochrane Library databases were searched for relevant pharmacological (glucagon-like peptide-1 [GLP-1] receptor agonist, sodium-glucose co-transporter-2 [SGLT-2] inhibitor, dipeptidyl peptidase-4 [DPP-4] inhibitor and metformin) and lifestyle intervention studies (diet and exercise) for adults with type 1 diabetes reporting body weight change and HbA1c published from January 2000 to May 2020. Meta-analyses were performed for 16 randomized controlled trials (RCTs). RESULTS Thirty-three RCTs (n = 9344 participants), 26 pharmacological (on average 43.9 years, 83.1 kg, HbA1c 8.1%; 55.8% male) and seven lifestyle-based interventions (on average 37.0 years, 85.0 kg, HbA1c 8.1%; 84.6% male), were analysed. The GLP-1 receptor agonist liraglutide 0.6 mg (mean difference [MD]: -2.22 kg [95% CI: -2.55 to -1.90]), 1.2 mg (MD: -3.74 kg [95% CI: -4.16 to -3.33]) and 1.8 mg (MD: -4.85 kg [95% CI: -5.29 to -4.41]), and the SGLT-2 inhibitors empagliflozin 2.5 mg (MD: -1.47 kg [95% CI: -2.23 to -0.71]), 10 mg (MD: -2.77 kg [95% CI: -3.24 to -2.31]) and 25 mg (MD: -3.06 kg [95% CI: -3.57 to -2.55]) and sotagliflozin 200 mg (MD: -2.40 kg [95% CI: -2.87 to -1.94]) and 400 mg (MD: -3.23 [95% CI: -3.73 to -2.72]) were associated with significant reductions in body weight. No significant effect on body weight was found for DPP-4 inhibitors, other GLP-1-receptor agonists, metformin, or for lifestyle interventions (i.e. exercise and diet). CONCLUSIONS In people with type 1 diabetes, several adjuvant pharmacological interventions showed weight reduction as a secondary outcome. Future studies in overweight people with type 1 diabetes are needed to establish whether the lifestyle and pharmacological interventions reviewed here have potential as components of complex interventions aimed at body weight reduction as a primary outcome.
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Affiliation(s)
- Saniya Tandon
- School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Salma Ayis
- School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - David Hopkins
- Institute of Diabetes Endocrinology and Obesity, King's Health Partners, London, UK
| | - Seeromanie Harding
- School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Marietta Stadler
- Diabetes Research Group, Weston Education Centre, King's College London, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Molokhia M, Harding S. An urgent need for primary care to engage with social and structural determinants of health. Lancet Public Health 2021; 6:e137-e138. [PMID: 33516279 DOI: 10.1016/s2468-2667(21)00004-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 01/04/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Mariam Molokhia
- Department of Population Health Sciences, King's College London, London SE1 9NH, UK
| | - Seeromanie Harding
- Department of Nutritional Sciences, King's College London, London SE1 9NH, UK.
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Kristono G, Holley A, Harding S, Larsen P. Using C-reactive Protein and Cytokines to Identify Inflammatory States in Acute Myocardial Infarction. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.345] [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: 10/20/2022]
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Borrie A, Shi B, Zebrauskaite A, Ranchord A, Fairley S, Harding S. Outcomes of a New-Generation Polymer-Free Amphilimus-Eluting Stent in Complex Coronary Lesions. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.495] [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: 11/16/2022]
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Goff LM, Moore A, Harding S, Rivas C. Providing culturally sensitive diabetes self-management education and support for black African and Caribbean communities: a qualitative exploration of the challenges experienced by healthcare practitioners in inner London. BMJ Open Diabetes Res Care 2020; 8:8/2/e001818. [PMID: 33293296 PMCID: PMC7725076 DOI: 10.1136/bmjdrc-2020-001818] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/29/2020] [Accepted: 11/17/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Poor access to, and engagement with, diabetes healthcare is a significant issue for black British communities who are disproportionately burdened by type 2 diabetes (T2D). Tackling these inequalities is a healthcare priority. The purpose of this research was to explore the experiences of healthcare practitioners providing diabetes self-management education and support (DSMES) to African and Caribbean adults living with T2D to inform the development of a culturally tailored DSMES program. RESEARCH DESIGN AND METHODS Semi-structured interviews were carried out with a range of healthcare practitioners including diabetes specialist nurses, dietitians and general practitioners based in primary care in inner London. Thematic content analysis was used to identify barriers and facilitators relating to the provision of effective DSMES. RESULTS Ten interviews were conducted. There was a strong consensus among healthcare practitioners for the importance of DSMES in T2D healthcare. However, practitioners discussed this area of practice as overwhelmingly challenging and recognized a wide range of barriers that they face. Four themes were identified: (1) The tension between structural and responsive care needs, particularly with growing numbers of patients alongside incentivized targets driving a care agenda that does not meet the needs of diverse communities; (2) challenges posed by cultural beliefs and practices, particularly a distrust of conventional medicine, rejection of body mass index standards and a belief in 'God's will'; (3) building relationships through cultural understanding: insiders and outsiders, particularly the benefits of racial concordance and cultural knowledge/resources and (4) getting the messages across, particularly the need to address gaps in structured education. CONCLUSION Provision of culturally sensitive DSMES is a challenging area of practice for practitioners, who recognize the need for more training and resources to support them in developing cultural competence. Nonetheless, practitioners recognize the importance of DSMES and are striving to provide culturally sensitive care to their patients.
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Affiliation(s)
- Louise M Goff
- Department of Nutritional Sciences, King's College London, London, UK
| | - Amanda Moore
- Department of Nutritional Sciences, King's College London, London, UK
| | | | - Carol Rivas
- Department of Social Science, University College London, London, UK
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