Probabilistic linkage to enhance deterministic algorithms and reduce data linkage errors in hospital administrative data.

BACKGROUND: The pseudonymisation algorithm used to link together episodes of care belonging to the same patients in England (HESID) has never undergone any formal evaluation, to determine the extent of data linkage error. OBJECTIVE: To quantify improvements in linkage accuracy from adding probabilistic linkage to existing deterministic HESID algorithms. METHODS: Inpatient admissions to NHS hospitals in England (Hospital Episode Statistics, HES) over 17 years (1998 to 2015) for a sample of patients (born 13/28th of months in 1992/1998/2005/2012). We compared the existing deterministic algorithm with one that included an additional probabilistic step, in relation to a reference standard created using enhanced probabilistic matching with additional clinical and demographic information. Missed and false matches were quantified and the impact on estimates of hospital readmission within one year were determined. RESULTS: HESID produced a high missed match rate, improving over time (8.6% in 1998 to 0.4% in 2015). Missed matches were more common for ethnic minorities, those living in areas of high socio-economic deprivation, foreign patients and those with 'no fixed abode'. Estimates of the readmission rate were biased for several patient groups owing to missed matches, which was reduced for nearly all groups. CONCLUSION: Probabilistic linkage of HES reduced missed matches and bias in estimated readmission rates, with clear implications for commissioning, service evaluation and performance monitoring of hospitals. The existing algorithm should be modified to address data linkage error, and a retrospective update of the existing data would address existing linkage errors and their implications

Fredholmness of Toeplitz operators on the Fock space

The Fredholm property of Toeplitz operators on the $p$-Fock spaces $F_\alpha^p$ on $\mathbb{C}^n$ is studied. A general Fredholm criterion for arbitrary operators from the Toeplitz algebra $\mathcal{T}_{p,\alpha}$ on $F_\alpha^p$ in terms of the invertibility of limit operators is derived. This paper is based on previous work, which establishes corresponding results on the unit balls $\mathbb{B}^n$

Sexual orientation identity and tobacco and hazardous alcohol use: findings from a cross-sectional English population survey

Objectives: To assess the association between tobacco and hazardous alcohol use and sexual orientation and whether such an association could be explained by other sociodemographic characteristics. Design: Cross-sectional household survey conducted in 2014–2016. Setting: England, UK. Participants: Representative English population sample (pooled n=43 866). Main outcomes: Sexual orientation identity (lesbian/gay, bisexual, heterosexual, prefer-not-to-say); current tobacco and hazardous alcohol use (defined as Alcohol Use Disorders Identification Test Score ≥8). All outcomes were self-reported. Results: Due to interactions between sexual orientation and gender for substance use, analyses were stratified by gender. Tobacco use prevalence was significantly higher among lesbian/gay (women: 24.9%, 95% CI 19.2% to 32.6%; men: 25.9%, 95% CI 21.3% to 31.0%) and bisexual participants (women: 32.4%, 95% CI 25.9% to 39.6%; men: 30.7%, 95% CI 23.7% to 30.7%) and significantly lower for prefer-not-to-say participants in women (15.5%, 95% CI 13.5% to 17.8%) but not men (22.7%, 95% CI 20.3% to 25.3%) compared with heterosexual participants (women: 17.5%, 95% CI 17.0% to 18.0%; men: 20.4%, 95% CI 19.9% to 21.0%; p<0.001 for omnibus test). Similarly, hazardous alcohol use was significantly more prevalent for lesbian/gay (women: 19.0%, 95% CI 14.0% to 25.3%; men: 30.0%, 25.2%–35.3%) and bisexual participants (women: 24.4%, 95% CI 18.7% to 31.3%; men: 24.3%, 95% CI 17.9% to 32.1%) and lower for prefer-not-to-say participants (women: 4.1%, 95% CI 3.0% to 5.4%; men: 13.7%; 95% CI 11.8% to 16.0%) compared with heterosexuals (women: 8.3%, 95% CI 7.9% to 8.7%; men: 18.4%, 95% CI 17.9% to 18.9%; p<0.001 for omnibus test). However, after adjusting for sociodemographic confounders, tobacco use was similar across all sexual orientation groups among both women and men. By contrast, sexual orientation differences in hazardous alcohol use remained even after adjustment among women but not for bisexual and gay men. Conclusions: In England, higher rates of tobacco use among sexual minority men and women appear to be attributable to other sociodemographic factors. Higher rates of hazardous alcohol use among sexual minority men may also be attributable to these factors, whereas this is not the case for sexual minority women

Quantum harmonic analysis for polyanalytic Fock spaces

We develop the quantum harmonic analysis framework in the reducible setting and apply our findings to polyanalytic Fock spaces. In particular, we explain some phenomena observed in arXiv:2201.10230 and answer a few related open questions. For instance, we show that there exists a symbol such that the corresponding Toeplitz operator is unitary on the analytic Fock space but vanishes completely on one of the true polyanalytic Fock spaces. This follows directly from an explicit characterization of the kernel of the Toeplitz quantization, which we derive using quantum harmonic analysis. Moreover, we show that the Berezin transform is injective on the set of of Toeplitz operators. Finally, we provide several characterizations of the $\mathcal{C}_1$-algebra in terms of integral kernel estimates and essential commutants.Comment: 37 page

The effect of men's body attitudes and motivation for gym attendance

The current study integrates men's body attitudes with implicitly and explicitly measured motivation to investigate the role of these factors in predicting gym attendance. Male participants (N = 99) who regularly attended a gym were recruited to participate in an online questionnaire. Participants completed implicit and explicit measures of motivation, explicitly-measured men's body attitudes, and reported the average number of gym visits per week. Attitudes related to body fat and explicitly-measured autonomous motivation significantly predicted typical gym attendance. Implicitly-measured motivation significantly and negatively predicted gym attendance. Results indicate some support for a dual-systems account of gym attendance. Men's body attitudes and autonomous motivation influences gym attendance; however, implicitly-measured motivation showed antagonistic effects. While individuals may explicitly state their autonomous motivation for gym attendance, attendance may be influenced at the explicit level. Health and fitness professionals may improve gym attendance by focusing on people's reasons for attending a gym, facilitating autonomous motivation in clients, and minimising the influence of controlled reasons for exercise

Effectiveness of a motivational interviewing intervention on weight loss, physical activity and cardiovascular disease risk factors: A randomised controlled trial with a 12-month post-intervention follow-up

Background: Intensive diet and physical activity interventions have been found to reduce cardiovascular disease (CVD) risk, but are resource intensive. The American Heart Association recently recommended motivational interviewing (MI) as an effective approach for low-intensity interventions to promote health-related outcomes such as weight loss. However, there is limited research evaluating the long-term effectiveness of MI-based interventions on health-related outcomes associated with CVD risk. The current research evaluated the effectiveness of a six-month low-intensity MI intervention in a UK primary-care setting in maintaining reductions in CVD risk factors at12 months post-intervention. Methods: Primary-care patients were randomised to an intervention group that received standard exercise and nutrition information plus up to five face-to-face MI sessions, delivered by a physical activity specialist and registered dietician over a 6-month period, or to a minimal intervention comparison group that received the standard information only. Follow-up measures of behavioural (vigorous and moderate physical activity, walking, physical activity stage-of-change, fruit and vegetable intake, and dietary fat intake) and biomedical (weight, body mass index [BMI], blood pressure, cholesterol) outcomes were taken immediately post-intervention and at a 12-month follow-up occasion.Results: Intent-to-treat analyses revealed significant differences between groups for walking and cholesterol. Obese and hypercholesterolemic patients at baseline exhibited significant improvements in BMI and cholesterol respectively among those allocated to the intervention group compared to the comparison group. Post-intervention improvements in other health-related outcomes including blood pressure, weight, and BMI were not maintained. Conclusions: The present study suggests that a low-intensity MI counselling intervention is effective in bringing about long-term changes in some, but not all, health-related outcomes (walking, cholesterol levels) associated with CVD risk. The intervention was particularly effective for patients with elevated levels of CVD risk factors at baseline. Based on these findings future interventions should be conducted in a primary care setting and target patients with high risk of CVD. Future research should investigate how the long-term gains in health-related outcomes brought about by the MI-counselling intervention in the current study could be extended to a wider range of health outcomes

Athletes’ Beliefs About and Attitudes Towards Taking Banned Performance-Enhancing Substances: A Qualitative Study

Elite athletes’ beliefs about, and attitudes toward, taking banned performance enhancing substances were explored in 8 focus-group discussions with 57 athletes from 7 different sports. Discussion was initiated by 3 broad open-ended questions pertaining to 3 important themes likely to affect beliefs and attitudes toward banned performance enhancing substances. Thematic content analysis of interview transcripts revealed 9 lower-order themes emerging under the 3 global themes: personal attitudes (reputation and getting caught, health effects, and financial incentives and rewards), social influences (coaches, parents, and medical staff and sport scientists), and control beliefs (i.e., insufficiency of doping testing, resource availability, and sport level and type). Findings provide insight into the beliefs and attitudes that likely underpin motives and intentions to take banned performance-enhancing substances. Results are generally consistent with, and complement, research adopting quantitative approaches based on social– cognitive models examining the beliefs and attitudes linked to taking banned performance-enhancing substances