Technical report on the enhancement of Millennium Cohort Study data with linked electronic health records; derivation of consent weights

This document applies to the preparation of a Standard Operating Procedure (SOP) for the Wellcome Trust Data Linkage Project regarding the definition of consent weights for linkage to electronic health records between routinely collected data and data from the Millennium Cohort Study (MCS)

Using functional data analysis to understand daily activity levels and patterns in primary school-aged children: Cross-sectional analysis of a UK-wide study

Temporal characterisation of physical activity in children is require df oreffectivs strategie sto increase physical activity(PA)

Environmental influences on children’s physical activity

This paper aims to assess whether7-year-olds’physical activity is associated with familyand area-level measures of the physical andsocioeconomic environments.MethodsWe analysed the association of environmentswith physical activity in 6497 singleton children from theUK Millennium Cohort Study with reliable accelerometerdata (≥2 days and≥10 h/day). Activity levels wereassessed as counts per minute; minutes of moderate tovigorous activity (MVPA); and whether meetingrecommended guidelines (≥60 min/day MVPA).ResultsHigher levels of children’s physical activity wereassociated with households without use of a car andwith having a television in a child’s bedroom (for countsper minute only). Aspects of the home socioeconomicenvironment that were associated with more children’sphysical activity were lone motherhood, lower maternalsocioeconomic position and education, family incomebelow 60% national median, and not owning the home.Children’s activity levels were higher when parentsperceived their neighbourhood as poor for bringing upchildren and also when families were living in the mostdeprived areas. Relationships were independent ofcharacteristics such as child’s body mass index andethnic group. When adjusted for physical andsocioeconomic correlates, the factors remainingsignificant in all outcomes were: household car usageand maternal education.ConclusionsAlthough physical and socioeconomicenvironments are associated with children’s physicalactivity, much of the variation appears to be determinedby the child’s home socioeconomic circumstances ratherthan the wider environment where they live

Linking cohort data and Welsh routine health records to investigate children at risk of delayed primary vaccination.

BACKGROUND: Delayed primary vaccination is one of the strongest predictors of subsequent incomplete immunisation. Identifying children at risk of such delay may enable targeting of interventions, thus decreasing vaccine-preventable illness. OBJECTIVES: To explore socio-demographic factors associated with delayed receipt of the Diphtheria, Tetanus and Pertussis (DTP) vaccine. METHODS: We included 1,782 children, born between 2000 and 2001, participating in the Millennium Cohort Study (MCS) and resident in Wales, whose parents gave consent for linkage to National Community Child Health Database records at the age seven years contact. We examined child, maternal, family and area characteristics associated with delayed receipt of the first dose of the DTP vaccine. RESULTS: 98.6% received the first dose of DTP. The majority, 79.6% (n = 1,429) received it on time (between 8 and 12 weeks of age), 14.2% (n = 251) received it early (prior to 8 weeks of age) and 4.8% (n = 79) were delayed (after 12 weeks of age); 1.4% (n = 23) never received it. Delayed primary vaccination was more likely among children with older natural siblings (risk ratio 3.82, 95% confidence interval (1.97, 7.38)), children admitted to special/intensive care (3.15, (1.65, 5.99)), those whose birth weight was > 4Kg (2.02, (1.09, 3.73)) and boys (1.53, (1.01, 2.31)). There was a reduced risk of delayed vaccination with increasing maternal age (0.73, (0.53, 1.00) per 5 year increase) and for babies born to graduate mothers (0.27, (0.08, 0.90)). CONCLUSIONS: Although the majority of infants were vaccinated in a timely manner, identification of infants at increased risk of early or delayed vaccination will enable targeting of interventions to facilitate timely immunisation. This is to our knowledge the first study exploring individual level socio-demographic factors associated with delayed primary vaccination in the UK and demonstrates the benefits of linking cohort data to routinely-collected child health data

Ultrafast valley-resolved carrier dynamics in group IV semiconductors

Attosecond transient absorption spectroscopy at the M4,5-edge of Ge following ultrafast photoexcitation reveals valley-resolved hot electron and hole relaxation, carrier recombination and trapping in Ge and Si-Ge alloy in unprecedented clarity and simultaneously

Are active children and young people at increased risk of injuries resulting in hospital admission or accident and emergency department attendance? Analysis of linked cohort and electronic hospital records in Wales and Scotland

Wellcome Trust (grant number 087389/B/08/Z)Health Data Research UKAsthma UK Centre for Applied Research (AUKAC-2012-01)ESRC award establishing the Administrative Data Research Centre Wales (ES/L007444/1

Are children with clinical obesity at increased risk of inpatient hospital admissions? An analysis using linked electronic health records in the UK millennium cohort study.

This is the peer reviewed version of the following article: Griffiths LJ, Cortina‐Borja M, Bandyopadhyay A, et al. Are children with clinical obesity at increased risk of inpatient hospital admissions? An analysis using linked electronic health records in the UK millennium cohort study, Pediatric Obesity. 2019;e12505. https://doi.org/10.1111/ijpo.12505., which has been published in final form at https://doi.org/10.1111/ijpo.12505. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived VersionsBACKGROUND: Few studies have examined health service utilization of children with overweight or obesity by using linked electronic health records (EHRs). OBJECTIVE/METHODS: We analysed EHRs from 3269 children (1678 boys; 51.3% [weighted]) participating in the Millennium Cohort Study, living in Wales or Scotland at age seven whose parents consented to record linkage. We used height and weight measurements at age five to categorize children as obese (>98th centile) or overweight (>91st centile) (UK1990 clinical reference standards) and linked to hospital admissions, up to age 14 years, in the Patient Episode Database for Wales and Scottish Morbidity Records. Negative binomial regression models compared rates of inpatient admissions by weight status at age five. RESULTS: At age five, 11.5% and 6.7% of children were overweight or obese, respectively; 1221 (38%) children were subsequently admitted to hospital at least once. Admissions were not increased among children with overweight or obesity (adjusted rate ratio [RR], 95% confidence interval [CI]: 0.87, 0.68-1.10 and 1.16, 0.87-1.54, respectively). CONCLUSIONS: In this nationally representative cohort of children in Wales and Scotland, those with overweight or obesity at entry to primary school did not have increased rates of hospital admissions in later childhood and early adolescence.This work was supported by the Wellcome Trust (Grant number 087389/B/08/Z). L.G., C.D., R.A.L., and A.A. are supported by Health Data Research UK, which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, National Institute for Health Research (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and Wellcome. R.A.L. is also funded by the Asthma UK Centre for Applied Research (AUK‐AC‐2012‐01) and Health Data Research UK. A.A. and K.T. are supported by an ESRC award establishing the Administrative Data Research Centre Wales (ES/L007444/1)

Analysis of factors associated with changing general practice in the first 14 years of life in Wales using linked cohort and primary care records: implications for using primary care databanks for life-course research

Background Databanks of primary care electronic health records (pcEHRs) are a valuable resource for life course research, however loss to follow up due to changing general practice has received little attention. Objective We investigated factors associated with changing general practice (GP) in early life and continuity of participation in the Secure Anonymised Information Linkage (SAIL) databank, to which approximately 80% of Welsh practices contribute. Methods We analysed linked pcEHRs for 1834 (882 girls) Millennium Cohort Study participants, resident in Wales, with consent to health record linkage. We studied time from first to next practice registration using Cox proportional hazards models, and estimated mutually-adjusted hazard ratios (aHRs) for child, household and practice factors. Findings There were 3065 Welsh GP registrations for 1834 children. By age 5 years, 25% changed practice at least once, with 1070 (58.3%), 477 (26.0%), 287 (15.7%) registered with 1, 2, or 3+ GPs respectively by age 14 years. Changing practice was related to maternal age (aHRs; 95% CI: 0.96; 0.95,0.98), living in rural areas (0.75;0.56,0.99), initial registration with a non-SAIL-practice (2.16;1.60,2.93), recent address change (1.62;1.21,2.16), and no maternal educational qualifications (1.40;1.15,1.71). Overall, 305 (16.6%) children had never registered with a SAIL practice. Of 403 children initially registered with a SAIL practice who then changed practice, 66.7% re-registered with a SAIL practice. Conclusions In a nationally representative sample of Welsh children, the majority remained registered with the same practice up to age 14 years, with change in practice varying by maternal and household factors. Continuity of participation in the Welsh SAIL databank over early life is high, reflecting the high proportion of practices contributing, and the high proportion of children registered with them. Geographically contiguous primary care databanks, such as SAIL, enable a high proportion of children to be followed over time despite changing general practice

Analysis of factors associated with changing general practice in the first 14 years of life in Wales using linked cohort and primary care records: implications for using primary care databanks for life course research

Introduction Primary care electronic health records (pcEHRs) are a valuable resource for life course research, however loss to follow up due to changing practices has received little attention. We investigated factors associated with changes in registration and record continuity in the Secure Anonymised Information Linkage (SAIL) databank, with ~80% practice coverage. Objectives and Approach We analysed linked pcEHRs for 1834 (882 girls) Millennium Cohort Study (MCS) participants, resident in Wales and with parental consent to health record linkage at the age seven MCS interview. We studied time from first to next general practice (GP) registration in Wales by fitting Cox proportional hazards models, and estimated mutually-adjusted hazard ratios (aHRs) for the following factors: child (sex, ethnicity, mode of delivery, gestation, birthweight, neonatal illness, wheeze, longstanding illness); maternal (age, education, lone parent status); household (income, housing tenure, residential mobility, urban/rural residence); GP type (SAIL-contributing/-non-contributing). Analyses were weighted for survey design (Stata: Release 15; StataCorp LP). Results There were 3065 Welsh GP registrations for 1834 children. By age 5 years, 25% of children changed GP at least once, with 1070 (58.3%), 477 (26.0%) and 287 (15.7%) registered with 1, 2, 3+ GPs respectively up to 14 years of age. Children with older mothers (aHRs; 95% CI: 0.96; 0.95, 0.98; per year) or those residing in rural areas (0.75;0.56,0.99) were less likely, and those whose first registration was not with a SAIL contributing GP (2.16;1.60,2.93), whose mothers had no educational qualifications (1.40;1.15,1.71), or had recently changed address (1.62;1.21,2.16) more likely, to change GP. 305 (16.6%) children had never registered with a SAIL-contributing GP. Of 403 children initially registered with a SAIL contributing GP who then changed GP, 66.7% re-registered with a SAIL contributing GP. Conclusion/Implications Geographically contiguous primary care databanks, such as the SAIL databank, enable a high proportion of children to be reliably followed over time despite changing GP. Similar analyses of databases based on geographically disparate volunteer GPs are needed to quality assure their suitability for life course epidemiology research