Making white spots disappear! Do minimally invasive treatments improve incisor opacities in children with molar incisor hypomineralisation?

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Dogs and the criminology of control: A case study of contemporary policy making in England and Wales

This thesis explores the nexus of criminology and public policy analysis in order to better understand and explain the policy making processes in relation to the control of dogs in society. It does this through an empirical study of policy responses to the phenomenon of ‘status’ and ‘dangerous’ dogs in England and Wales, primarily during the past three decades. An influential body of work has suggested an expanding trend in punitiveness within Western societies over the past few decades. At the forefront of sociological thinking in this field is David Garland’s Culture of Control that theorises that the advent of late-modernity, with its adjusted macro-social conditions, has ushered in this new approach to law and order. As a theoretical scaffold, grand theories such as these can be useful, but this case study also seeks to go further into the empirical particulars of policy making in order to understand how a culture of control unfolds in relation to the lesser-explored arena of dangerous dogs. The methodological elements employed were two-fold and included both an extensive documentary analysis (including academic work, policy documents and legislation) recounted via a history of the present, and a thematic analysis produced from the empirical data of key policy actors' accounts (involving a programme of semi-structured elite interviews, n=25) gained via my unique insider-researcher access as a professional member of the dog policy network. Findings suggest that widespread anxieties regarding the threat to public safety posed by dangerous dogs, have been addressed via draconian legislative measures, most notably breed specific legislation (BSL) designed to manipulate and control the dog population. Evidence that BSL and other control measures are not working, and that substitute harms are befalling dog owners and their pets, have been obscured by competition and ‘white noise’ within a chaotic policy network. Public debate, fuelled by high profile and disproportionate media stories, has intrinsically linked dangerous dogs with other risky, criminal and anti-social behaviours. This ‘othering’, coupled with expressive, symbolic and politicised policy making, has resulted in an overly-punitive culture of control for dogs and their owners in society

Poor sleep quality and progression of gait impairment in an incident Parkinson’s disease cohort

Abnormal sleep may associate with cognitive decline in Parkinson's disease (PD). Furthermore, sleep dysfunction may associate with worse motor outcome. We hypothesised that PD patients with poor quality sleep would have greater progression in gait dysfunction, due to structural and functional overlap in networks subserving sleep and gait regulation. 12 PD patients and 12 age-matched controls completed longitudinal follow-up over 36 months. Poor sleep efficiency and greater sleep fragmentation correlated significantly with progression of step-width variability, a gait characteristic mediated by postural control, providing evidence that poor sleep in PD is associated with a more rapid deterioration in gait

Health empowerment scripts : simplifying social/green prescriptions

Social prescriptions are one term commonly used to describe non-pharmaceutical approaches to healthcare and are gaining popularity in the community, with evidence highlighting psychological benefits of reduced anxiety, depression and improved mood and physiological benefits of reduced risk of cardiovascular disease and reduced hypertension. The relationship between human health benefits and planetary health benefits is also noted. There are, however, numerous barriers, such as duration and frequencies to participate in activities, access, suitability, volition and a range of unpredictable variables (such as inclement weather, shifting interests and relocating home amongst others) impeding a comprehensive approach to their use on a wider scale. From a multidisciplinary perspective, this commentary incorporates a salutogenic and nature-based approach to health, we also provide a range of recommendations that can be undertaken at the patient level to assist in shifting the acknowledged systemic barriers currently occurring. These include using simple language to explain the purpose of health empowerment scripts, ensuing personal commitment to a minimum timeframe, enabling ease of access, co-designing a script program, providing ongoing motivational support and incorporating mindfulness to counter unexpected disruptions. Copyright © 2022 Lawson, Wissing, Henderson-Wilson, Snell, Chambers, McNeil and Nuttman

Association between socioeconomic deprivation, ethnicity, and health outcomes in preschool children with recurrent wheeze in England: a retrospective cohort study

Background Preschool-aged children have amongst the highest burden of acute wheeze. We investigated differences in healthcare use, treatment, and outcomes for recurrent wheeze/asthma in pre-schoolers from different ethno-socioeconomic backgrounds. Methods Retrospective cohort study using data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics in England. We reported number of acute presentations, and hospitalisations stratified by index of multiple deprivation (IMD), and ethnicity; and factors associated with treatment non-escalation, and hospitalisation rates using multivariable logistic and Poisson regression models. Results 194,291 preschool children were included. In children not trialled on asthma preventer medications, children from the most deprived IMD quintile (adjusted OR 1.67; 95%CI 1.53-to-1.83), and South Asian (1.77; 1.64-to-1.91) children were more likely to have high reliever usage; and where specialist referral had not occurred, the odds of referral being indicated was higher in the most deprived quintile (1.39; 1.28-to-1.52), and South Asian (1.86; 1.72-to-2.01) children compared with the least deprived quintile and White children respectively. Hospitalisation rates for wheeze/asthma were significantly higher in children from the most deprived quintile (adjusted IRR 1.20; 95%CI 1.13-to-1.27) compared with the least, and in South Asian (1.57; 1.44-to-1.70) and Black (1.32; 1.22-to-1.42) compared with White children. Conclusions We identified inequalities in wheeze/asthma treatment and morbidity in preschool children from more deprived, and non-White backgrounds. A multifaceted approach to tackle health inequality at both the national and local level, which includes a more integrated and standardised approach to treatment, is needed to improve health outcomes in children with preschool wheeze/asthma.<br/

Spatial Environmental Modeling of Autoantibody Outcomes among an African American Population

In this study of autoimmunity among a population of Gullah African Americans in South Carolina, the links between environmental exposures and autoimmunity (presence of antinuclear antibodies (ANA)) have been assessed. The study population included patients with systemic lupus erythematosus (n = 10), their first degree relatives (n = 61), and unrelated controls (n = 9) where 47.5% (n = 38) were ANA positive. This paper presents the methodology used to model ANA status as a function of individual environmental influences, both self-reported and measured, while controlling for known autoimmunity risk factors. We have examined variable dimension reduction and selection methods in our approach. Following the dimension reduction and selection methods, we fit logistic spatial Bayesian models to explore the relationship between our outcome of interest and environmental exposures adjusting for personal variables. Our analysis also includes a validation “strip” where we have interpolated information from a specific geographic area for a subset of the study population that lives in that vicinity. Our results demonstrate that residential proximity to exposure site is important in this form of analysis. The use of a validation strip network demonstrated that even with small sample numbers some significant exposure-outcome relationships can be detected