Ethnicity and prevalence of multiple sclerosis in east London

This work has been supported by a non-promotional educational grant from Novartis to Queen Mary University of London (through KS). KS has been supported by a Higher Education Funding Council for England Clinical Senior Lectureship

Are poor people healthier in rich or poor areas?: The psychosocial effects of socioeconomic incongruity in the neighbourhood

This thesis contributes to the understanding of how health is affected by the interaction between neighbourhood and individual socioeconomic status. It has been found that residents in high status neighbourhoods are healthier than those in low status neighbourhoods, controlling for individual status. Here it is hypothesised that such an association may not be found amongst low status individuals, because such individuals may have more detrimental psychosocial exposures in high status neighbourhoods than in low status neighbourhoods. For low status individuals, these detrimental psychosocial exposures, such as lacking social support and frequent status comparisons, may counteract positive material exposures in high status neighbourhoods. To test this hypothesis, three studies were conducted in this thesis. The first is an analysis of the difference in the association between neighbourhood status and health across individuals of different socioeconomic status, using a sample of mothers from England in the Millennium Cohort Study. The second study is similar and uses the same dataset, but instead of health, psychosocial factors were analysed. The third study, specific to London, uses data from the 2001 census to investigate the health impact of living in a low status city block within a wider neighbourhood of high status. In the first two studies, it was found that the positive association between neighbourhood status and health is weakest amongst the lowest status mothers, and whilst high status mothers were most likely to lack local friends and be depressed in low status neighbourhoods, there was an indication that in certain contexts the lowest status mothers were most likely to lack local friends and be depressed in high status neighbourhoods. In the third study, it was found that low status city blocks within high status neighbourhoods were more likely to have poor average health than those within low status neighbourhoods

¿Cómo se ha medido la posición social en investigación en salud?: una revisión de la literatura internacional How has social status been measured in health research?: a review of the international literature

La posición social (PS) es una variable multidimensional ampliamente utilizada en la investigación en salud. No hay una sola forma óptima de estimarla, sino que en cada caso su medición varía de acuerdo con la pregunta de investigación, la teoría considerada de base, la población de interés, el evento de interés y, en algunos casos, la información disponible. Esta revisión de literatura desarrolla los siguientes aspectos relacionados a la medición de la PS a partir de fuentes electrónicas científicas internacionales disponibles: i) identifica el rol de la PS en el contexto de la investigación epidemiológica social, ii) describe los principales indicadores y enfoques metodológicos utilizados para medir la PS en investigación en salud y iii) analiza las dificultades particulares de medir la PS en poblaciones específicas como grupos étnicos, mujeres, niños, ancianos y contextos rurales versus urbanos. La revisión permite finalmente describir algunas de las implicancias de la medición de PS en países de América Latina.Social status (SS) is a multidimensional variable that is used widely in health research. There is no single optimal method for estimating social status. Rather, in each case the measurement may vary depending on the research subject, the base theory considered, the population of interest, the event of interest and, in some cases, the available information. This literature review develops the following topics related to SS measurement, based on the international scientific sources available electronically: i) identification of the role of SS in the context of social epidemiology research, ii) description of the principal indicators and methodological approaches used to measure SS in health research, and iii) analysis of the distinct difficulties of SS measurement in specific populations such as ethnic groups, women, children, the elderly, and in rural vs. urban contexts. The review finally makes it possible to describe some of the implications of SS measurement in Latin American countries

¿Cómo se ha medido la posición social en investigación en salud?: una revisión de la literatura internacional

La posición social (PS) es una variable multidimensional ampliamente utilizada en la investigación en salud. No hay una sola forma óptima de estimarla, sino que en cada caso su medición varía de acuerdo con la pregunta de investigación, la teoría considerada de base, la población de interés, el evento de interés y, en algunos casos, la información disponible. Esta revisión de literatura desarrolla los siguientes aspectos relacionados a la medición de la PS a partir de fuentes electrónicas científicas internacionales disponibles: i) identifica el rol de la PS en el contexto de la investigación epidemiológica social, ii) describe los principales indicadores y enfoques metodológicos utilizados para medir la PS en investigación en salud y iii) analiza las dificultades particulares de medir la PS en poblaciones específicas como grupos étnicos, mujeres, niños, ancianos y contextos rurales versus urbanos. La revisión permite finalmente describir algunas de las implicancias de la medición de PS en países de América Latina

Positive impact of cladribine on quality of life in people with relapsing multiple sclerosis

BACKGROUND: A number of elements of the pivotal 'cladribine tablets treating multiple sclerosis orally' (CLARITY) trial have remained unpublished. OBJECTIVE: To report the impact of cladribine on health-related quality of life (QoL) in people with relapsing multiple sclerosis (pwRMS). METHODS: QoL data from the phase III trial of two different doses (3.5 and 5.25 mg/kg) of oral cladribine in pwRMS were acquired from the European Medicines Agency through Freedom of Information. Spearman's rank correlation was used to analyse the relationship between baseline QoL scores and baseline Expanded Disability Status Scale (EDSS) scores. Responses of the Euro Quality of Life 5 Dimensions (EQ-5D) and Multiple Sclerosis Quality of Life-54 (MSQOL-54) questionnaires were compared between treatment and control groups using univariate analyses of covariance. RESULTS: In total, n = 5148 EQ-5D responses and n = 894 MSQOL-54 physical, mental health and dimension scores were extracted. Baseline EQ-5D indices correlated with EDSS scores. After 2 years, pwRMS taking 3.5 ( p = .001) and 5.25 mg/kg ( p = .022) reported significantly improved EQ-5D index scores compared with placebo. Positive, yet non-significant, differences were detected in MSQOL-54 scores between cladribine and placebo. CONCLUSION: Analysis of the CLARITY dataset suggests that, over and above its established clinical efficacy, cladribine leads to improved QoL over 96 weeks. ClinicalTrials.gov identifier: NCT00213135

Ethnic density effects on physical morbidity, mortality, and health behaviors: a systematic review of the literature

It has been suggested that people in racial/ethnic minority groups are healthier when they live in areas with a higher concentration of people from their own ethnic group, a so-called ethnic density effect. Ethnic density effects are still contested, and the pathways by which ethnic density operates are poorly understood. The aim of this study was to systematically review the literature examining the ethnic density effect on physical health, mortality, and health behaviors. Most studies report a null association between ethnic density and health. Protective ethnic density effects are more common than adverse associations, particularly for health behaviors and among Hispanic people. Limitations of the literature include inadequate adjustment for area deprivation and limited statistical power across ethnic density measures and study samples

Classical music and social result

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