160 research outputs found
Is the onset of disabling chronic conditions in later childhood associated with exposure to social disadvantage in earlier childhood? A prospective cohort study using the ONS Longitudinal Study for England and Wales
Background:
The aetiology of disabling chronic conditions in childhood in high income countries is not fully understood, particularly the association with socio-economic status (SES). Very few studies have used longitudinal datasets to examine whether exposure to social disadvantage in early childhood increases the risk of developing chronic conditions in later childhood. Here we examine this association, and its temporal ordering, with onset of all-cause disabling chronic later childhood in children reported as free from disability in early childhood.
Methods:
The study comprised a prospective cohort study, using data from the Office for National Statistics Longitudinal Study (ONSLS) for England and Wales. The study sample included 52,839 children with complete data born between 1981â1991 with no disabling chronic condition/s in 1991. Index cases were children with disability recorded in 2001. Comparison cases were children with no recorded disability in 1991. A socio-economic disadvantage index (SDI) was constructed from data on social class, housing tenure and car/van access. Associations were explored with logistic regression modelling controlling sequentially for potentially confounding factors; age, gender, ethnicity and lone parenthood.
Results:
By 2001, 2049 (4%) had at least one disability. Socio-economic disadvantage, age, gender and lone parenthood but not ethnicity were significantly associated with onset of disabling chronic conditions. The SDI showed a finely graded association with onset of disabling chronic conditions in the index group (most disadvantaged OR 2·11 [CI 1·76 to 2·53]; disadvantaged in two domains OR 1·45 [CI 1·20 to 1·75]; disadvantaged in one domain OR 1·14 [CI 0·93 to 1·39] that was unaffected by age, gender and ethnicity and slightly attenuated by lone parenthood.
Conclusion:
To our knowledge, this is the first study to identify socio-economic disadvantage in earlier childhood as a predisposing factor for onset of all-cause disabling chronic conditions in later childhood. Temporal ordering and gradation of the response indicate socio-economic disadvantage may play a causal role. This suggests that targeting preventative efforts to reduce socio-economic disadvantage in early childhood is likely to be an important public health strategy to decease health inequalities in later childhood and early adulthood
Effect of strategies to reduce exposure of infants to environmental tobacco smoke in the home : cross sectional survey
Objective To examine parents' reported knowledge
and use of harm reduction strategies to protect their
infants from exposure to tobacco smoke in the home,
and the relation between reported use of strategies
and urinary cotinine to creatinine ratios in the infants.
Design Cross sectional survey.
Settings Coventry and Birmingham.
Main outcome measures Parentsâ reported
knowledge and use of harm reduction strategies and
urinary cotinine to creatinine ratios in their infants.
Participants 314 smoking households with infants.
Results 86% of parents (264/307) believed that
environmental tobacco smoke is harmful, 90%
(281/314) believed that infants can be protected from
it in the home, and 10% (32/314) were either unaware
of measures or reported using none. 65% of parents
(205/314) reported using two or more measures, but
only 18% (58/314) reported not allowing smoking in
the home. No difference was found in mean log e
transformed urinary cotinine to creatinine ratio in
infants from households that used no measures
compared with households that used less strict
measures. Mean log cotinine to creatinine ratios were
significantly different in households banning smoking
in the home compared with those using less strict or
no measures. Banning smoking in the home was
independently associated with a significant reduction
in urinary cotinine to creatinine ratio by a factor of
2.6 (1.6 to 4.2) after adjustment for average household
cigarette consumption, tenure, and overcrowding.
Conclusions Less than a fifth of parents in smoking
households ban smoking in the home. Banning
smoking was associated with a small but significant
reduction in urinary cotinine to creatinine ratio in
infants, whereas less strict measures compared with
no measures had no effect on the infantsâ exposure to
environmental tobacco smoke
Disabling chronic conditions in childhood and socioeconomic disadvantage : a systematic review and meta-analyses of observational studies
Objective To determine the association of socioeconomic disadvantage with the prevalence of childhood disabling chronic conditions in high-income countries.
Study design Systematic review and meta-analyses.
Data sources 6 electronic databases, relevant websites, reference lists and experts in the field.
Study selection 160 observational studies conducted in high-income countries with data on socioeconomic status and disabling chronic conditions in childhood, published between 1 January 1991 and 31 December 2013.
Data extraction and synthesis Abstracts were reviewed, full papers obtained, and papers identified for inclusion by 2 independent reviewers. Inclusion decisions were checked by a third reviewer. Where reported, ORs were extracted for low versus high socioeconomic status. For studies reporting raw data but not ORs, ORs were calculated. Narrative analysis was undertaken for studies without data suitable for meta-analysis.
Results 126 studies had data suitable for meta-analysis. ORs for risk estimates were: all-cause disabling chronic conditions 1.72 (95% CI 1.48 to 2.01); psychological disorders 1.88 (95% CI 1.68 to 2.10); intellectual disability 2.41 (95% CI 2.03 to 2.86); activity-limiting asthma 2.20 (95% CI 1.87 to 2.85); cerebral palsy 1.42 (95% CI 1.26 to 1.61); congenital abnormalities 1.41 (95% CI 1.24 to 1.61); epilepsy 1.38 (95% CI 1.20 to 1.59); sensory impairment 1.70 (95% CI 1.39 to 2.07). Heterogeneity was high across most estimates (I2>75%). Of the 34 studies without data suitable for meta-analysis, 26 reported results consistent with increased risk associated with low socioeconomic status.
Conclusions The findings indicate that, in high-income countries, childhood disabling chronic conditions are associated with social disadvantage. Although evidence of an association is consistent across different countries, the review provides limited evidence to explain the association; future research, using longitudinal data, will be required to distinguish low socioeconomic status as the cause or consequence of childhood disabling chronic conditions and the aetiological pathways and mechanisms
Theories or fragments?
Lake et al. argue persuasively that modelling human-like
intelligence requires flexible, compositional representations in order to
embody world knowledge. But human knowledge is too sparse and selfcontradictory
to be embedded in âintuitive theories.â We argue, instead,
that knowledge is grounded in exemplar-based learning and
generalization, combined with high flexible generalization, a viewpoint
compatible both with non-parametric Bayesian modelling and with subsymbolic
methods such as neural networks
Development and validation of a novel monitoring system for batch flocculant solids settling process
Games for topological fixpoint logic
Topological fixpoint logics are a family of logics that admits topological models and where the fixpoint operators are defined with respect to the topological interpretations. Here we consider a topological fixpoint logic for relational structures based on Stone spaces, where the fixpoint operators are interpreted via clopen sets. We develop a game-theoretic semantics for this logic. First we introduce games characterising clopen fixpoints of monotone operators on Stone spaces. These fixpoint games allow us to characterise the semantics for our topological fixpoint logic using a two-player graph game. Adequacy of this game is the main result of our paper. Finally, we define bisimulations for the topological structures under consideration and use our game semantics to prove that the truth of a formula of our topological fixpoint logic is bisimulation-invariant
Prevalence of childhood disability and the characteristics and circumstances of disabled children in the UK : secondary analysis of the Family Resources Survey
Background: Robust data on the prevalence of childhood disability and the circumstances and characteristics of
disabled children is crucial to understanding the relationship between impairment and social disadvantage. It is also
crucial for public policy development aimed at reducing the prevalence of childhood disability and providing
appropriate and timely service provision. This paper reports prevalence rates for childhood disability in the United
Kingdom (UK) and describes the social and household circumstances of disabled children, comparing these where
appropriate to those of non-disabled children.
Methods: Data were generated from secondary analysis of the Family Resources Survey, a national UK cross-sectional
survey, (2004/5) which had data on 16,012 children aged 0-18 years. Children were defined as disabled if they met the
Disability Discrimination Act (DDA) definition (1995 and 2005). Frequency distributions and cross-tabulations were run
to establish prevalence estimates, and describe the circumstances of disabled children. To establish the association
between individual social and material factors and childhood disability when other factors were controlled for, logistic
regression models were fitted on the dependent variable 'DDA defined disability'.
Results: 7.3% (CI 6.9, 7.7) of UK children were reported by as disabled according to the DDA definition. Patterns of
disability differed between sexes with boys having a higher rate overall and more likely than girls to experience
difficulties with physical coordination; memory, concentration and learning; communication. Disabled children lived in
different personal situations from their non-disabled counterparts, and were more likely to live with low-income,
deprivation, debt and poor housing. This was particularly the case for disabled children from black/minority ethnic/
mixed parentage groups and lone-parent households. Childhood disability was associated with lone parenthood and
parental disability and these associations persisted when social disadvantage was controlled for.
Conclusion: These analyses suggest that UK disabled children experience higher levels of poverty and personal and
social disadvantage than other children. Further research is required to establish accurate prevalence estimates of
childhood disability among different black and minority ethnic groups and to understand the associations between
childhood disability and lone parenthood and the higher rates of sibling and parental disability in households with
disabled children
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