Diverging prevalences and different risk factors for childhood asthma and eczema: a cross-sectional study

This is the final version of the article. Available from BMJ Publishing Groupvia the DOI in this record.OBJECTIVE: To compare the prevalences of and risk factors for asthma, wheeze, hay fever and eczema in primary schoolchildren in Aberdeen in 2014. DESIGN: Cross-sectional survey. SETTING: Primary schools in Aberdeen, North-East Scotland. PARTICIPANTS: Children in Scottish school years primary 1-7 were handed a questionnaire by their class teacher to be completed by their parents and returned to the researchers by post or online. MAIN OUTCOME MEASURES: Lifetime history of asthma, eczema and hay fever, and recent history of wheeze. RESULTS: 41 schools agreed to participate (87%). 11,249 questionnaires were distributed and 3935 returned (35%). A parent-reported lifetime history of asthma, eczema and hay fever was present in 14%, 30% and 24% of children, respectively. The odds of lifetime asthma increased with age (OR 1.1 per year, 95% CI 1.1 to 1.2), male sex (OR 1.89, 95% CI 1.4 to 2.3), parental smoking (OR 1.7, 95% CI 1.2 to 2.3) and eczema (OR 6.6, 95% CI 5.2 to 8.4). Prevalence of recent wheeze was also reported to be 14% and was positively associated with male sex, parental smoking and eczema. In contrast, parental eczema was the only identified predictor of childhood eczema risk. CONCLUSIONS: The lifetime prevalence of asthma in primary schoolchildren was 14% in this survey, approximately half the prevalence of eczema. We report diverging prevalences in relation to previous studies in our locality, and different risk factors for asthma and eczema. These findings suggest that asthma and eczema are unlikely to have a common origin.This study was funded by Chest Heart and Stroke Scotland and a private donation from the family of Blanche Dawson, who conducted the initial 1964 Aberdeen Schools Asthma Survey

Reveal the viscoplastic behaviour and microstructure evolution of stainless steel 316L

Stainless steel 316L is a widely used structural material in the nuclear industry because of its excellent corrosion resistance and mechanical properties. However, very little research can be found on its viscoplastic behaviour and microstructure evolution at warm and hot deformation conditions, which hinder the possible application of advanced manufacturing technologies for producing complex parts, such as superplastic forming or hydroforming. The aims of this study are to explore stainless steel 316L’s viscoplastic behaviour, to determine its strain rate sensitivities, and to reveal its underlying microstructure evolution; this will allow appropriate manufacturing (forming) technologies and the optimal forming condition to be determined. Hence, isothermal tensile tests at 700 °C, 800 °C, 900 °C, and 1000 °C at strain rates of 0.01 s−1 and 0.001 s−1 have been conducted. Moreover, the corresponding microstructure evolution, including the grain orientation and geometrically necessary dislocation density, has been revealed by the electron backscatter diffraction method. The data show the viscoplastic behaviour of stainless steel 316L under various thermomechanical deformation conditions and how microstructure evolution influences the viscoplastic flow stress

8-Bromo­naphthalen-1-amine

The title compound, C10H8BrN, was obtained by slow addition of sodium azide to 8-bromo-1-naphthoic acid, followed by addition of aqueous ammonia. The crude product was crystallized from petroleum ether to give pink crystals. Compared to other 1,8-disubstituted naphthalene compounds, this compound exhibits less strain between the 1 and 8 substituents. Additionally, the NH protons form both intra- and inter­molecular hydrogen bonds. The naphthalene units are arranged in a herring-bone stacking motif

1,2-Bis(2-bromo­benz­yl)diselane

In the title compound, C14H12Br2Se2, the Se—Se bond length [2.3034 (9) Å] is similar to those in diphenyl diselenide [2.3066 (7) and 2.3073 (10) Å] and shorter than that in 1,8-diselenona­phthalene [2.0879 (8)Å]. The mol­ecule adopts a classical gauche conformation

Health care costs, utilization and patterns of care following Lyme disease

BACKGROUND:Lyme disease is the most frequently reported vector borne infection in the United States. The Centers for Disease Control have estimated that approximately 10% to 20% of individuals may experience Post-Treatment Lyme Disease Syndrome - a set of symptoms including fatigue, musculoskeletal pain, and neurocognitive complaints that persist after initial antibiotic treatment of Lyme disease. Little is known about the impact of Lyme disease or post-treatment Lyme disease symptoms (PTLDS) on health care costs and utilization in the United States. OBJECTIVES:1) to examine the impact of Lyme disease on health care costs and utilization, 2) to understand the relationship between Lyme disease and the probability of developing PTLDS, 3) to understand how PTLDS may impact health care costs and utilization. METHODS:This study utilizes retrospective data on medical claims and member enrollment for persons aged 0-64 years who were enrolled in commercial health insurance plans in the United States between 2006-2010. 52,795 individuals treated for Lyme disease were compared to 263,975 matched controls with no evidence of Lyme disease exposure. RESULTS:Lyme disease is associated with $2,968 higher total health care costs (95$3,798 higher total health care costs (95% CI: 3,542-4,055, p<.001) and 66% more outpatient visits (95% CI: 64%-69%, p<.001) over a 12-month period, relative to those with no PTLDS-related diagnoses. CONCLUSIONS:Lyme disease is associated with increased costs above what would be expected for an easy to treat infection. The presence of PTLDS-related diagnoses after treatment is associated with significant health care costs and utilization

Getting the strain under control: Trans-Varestraint tests for hot cracking susceptibility

A new method for conducting Trans-Varestraint tests for assessing hot cracking susceptibility is proposed. Experiments were carried out, to validate the new method, with an industrial scale rig using tungsten inert gas welding. The hot cracking susceptibility of API-5L X65 and EN3B steel was compared. The results indicated that, by using the new method, the strain applied to the welding bead and consequently to the solidification front was controlled in a repeatable and reliable way. The results also indicated that EN3B has a maximum crack length (a parameter in the test) higher than X65 and it is reached at lower augmented strain thus demonstrating it is more susceptible to hot cracking, while also indicating that there is a capability of predicting the initiation position of hot cracks during welding. By using the method proposed, the capability of setting standardized test procedures for Trans-Varestraint tests is improved. It is recommended that future tests for assessing hot cracking susceptibility should employ the proposed method in order for the results to be comparable and to also study the effect of strain rate in hot cracking of materials

Reducing drug related deaths : a pre-implementation assessment of knowledge,barriers and enablers for naloxone distribution through general practice

Peer reviewedPublisher PD

Physical activity attitudes, intentions and behaviour among 18-25 year olds: a mixed method study

Peer reviewedPublisher PD

Short stay hospital admissions for an acutely unwell child: A qualitative study of outcomes that matter to parents and professionals

This is the final version. Available from Public Library of Science via the DOI in this record. Data Availability: The qualitative data collected and analysed during this study are not publicly available due to privacy issues. We are not able to share this data as they contain potentially identifying and sensitive participant information. Moreover, participants were not informed and did not give consent for their transcripts to be shared in a public repository. Queries regarding data access may be directed to the authors or the research governance team ([email protected]).BACKGROUND: Numbers of urgent short stay admissions (SSAs) of children to UK hospitals are rising rapidly. This paper reports on experiences of SSAs from the perspective of parents accessing urgent care for their acutely unwell child and of health professionals referring, caring for, or admitting children. METHODS: A qualitative interview study was conducted by a multi-disciplinary team with patient and public involvement (PPI) to explore contextual factors relating to SSAs and better understand pre-hospital urgent care pathways. Purposive sampling of Health Board areas in Scotland, health professionals with experience of paediatric urgent care pathways and parents with experience of a SSA for their acutely unwell child was undertaken to ensure maximal variation in characteristics such as deprivation, urban-rural and hospital structure. Interviews took place between Dec 2019 and Mar 2021 and thematic framework analysis was applied. RESULTS: Twenty-one parents and forty-eight health professionals were interviewed. In the context of an urgent SSA, the themes were centred around shared outcomes of care that matter. The main outcome which was common to both parents and health professionals was the importance of preserving the child's safety. Additional shared outcomes by parents and health professionals were a desire to reduce worries and uncertainty about the illness trajectory, and provide reassurance with sufficient time, space and personnel to undertake a period of skilled observation to assess and manage the acutely unwell child. Parents wanted easy access to urgent care and, preferably, with input from paediatric-trained staff. Healthcare professionals considered that it was important to reduce the number of children admitted to hospital where safe and appropriate to do so. CONCLUSIONS: The shared outcomes of care between parents and health professionals emphasises the potential merit of adopting a partnership approach in identifying, developing and testing interventions to improve the acceptability, safety, efficiency, and cost-effectiveness of urgent care pathways between home and hospital.Chief Scientist Office (CSO) Scotlan

The EMPOWER blended digital intervention for relapse prevention in schizophrenia: a feasibility cluster randomised controlled trial in Scotland and Australia

Background: Early warning signs monitoring by service users with schizophrenia has shown promise in preventing relapse but the quality of evidence is low. We aimed to establish the feasibility of undertaking a definitive randomised controlled trial to determine the effectiveness of a blended digital intervention for relapse prevention in schizophrenia. Methods: This multicentre, feasibility, cluster randomised controlled trial aimed to compare Early signs Monitoring to Prevent relapse in psychosis and prOmote Well-being, Engagement, and Recovery (EMPOWER) with treatment as usual in community mental health services (CMHS) in Glasgow and Melbourne. CMHS were the unit of randomisation, selected on the basis of those that probably had five or more care coordinators willing to participate. Participants were eligible if they were older than 16 years, had a schizophrenia or related diagnosis confirmed via case records, were able to provide informed consent, had contact with CMHS, and had had a relapse within the previous 2 years. Participants were randomised within stratified clusters to EMPOWER or to continue their usual approach to care. EMPOWER blended a smartphone for active monitoring of early warning signs with peer support to promote self-management and clinical triage to promote access to relapse prevention. Main outcomes were feasibility, acceptability, usability, and safety, which was assessed through face-to-face interviews. App usage was assessed via the smartphone and self-report. Primary end point was 12 months. Participants, research assistants and other team members involved in delivering the intervention were not masked to treatment conditions. Assessment of relapse was done by an independent adjudication panel masked to randomisation group. The study is registered at ISRCTN (99559262). Findings: We identified and randomised eight CMHS (six in Glasgow and two in Melbourne) comprising 47 care coordinators. We recruited 86 service users between Jan 19 and Aug 8, 2018; 73 were randomised (42 [58%] to EMPOWER and 31 [42%] to treatment as usual). There were 37 (51%) men and 36 (49%) women. At 12 months, main outcomes were collected for 32 (76%) of service users in the EMPOWER group and 30 (97%) of service users in the treatment as usual group. Of those randomised to EMPOWER, 30 (71%) met our a priori criterion of more than 33% adherence to daily monitoring that assumed feasibility. Median time to discontinuation of these participants was 31·5 weeks (SD 14·5). There were 29 adverse events in the EMPOWER group and 25 adverse events in the treatment as usual group. There were 13 app-related adverse events, affecting 11 people, one of which was serious. Fear of relapse was lower in the EMPOWER group than in the treatment as usual group at 12 months (mean difference –7·53 (95% CI –14·45 to 0·60; Cohen's d –0·53). Interpretation: A trial of digital technology to monitor early warning signs blended with peer support and clinical triage to detect and prevent relapse appears to be feasible, safe, and acceptable. A further main trial is merited. Funding: UK National Institute for Health Research Health Technology Assessment programme and the Australian National Health and Medical Research Council