The relationship between executive control, conscientiousness and health behaviour

Health is important, but the health of the nation is failing, with chronic diseases, such as cardiovascular disease, cancer and diabetes on the rise. Most of which are related to the performance of negative health behaviours. As a result, improving the health of the population through the promotion of positive health behaviours is a key aim of health professionals and Government. However, to promote positive health behaviours, first, what variables predict health behaviour must be identified. Two prominent variables of interest are cognition and personality. Recently, attention has focussed on executive control (EC) and conscientiousness as predictors of health behaviour. As such, a number of questions have emerged. Firstly, due to the conceptual overlap of these variables, are they related constructs? Secondly, do they have a direct impact on health behaviour? Finally, are they moderating variables, and do they moderate the intention-behaviour relationship? The aim of this PhD was to explore the relations between EC, conscientiousness and multiple health behaviours in healthy samples. Over four studies, participants completed an array of computer, and paper and pencil-based tasks and computer-administered questionnaires. In addition, behavioural intentions and health behaviour performance was measured over a period of 7-14 days using online daily diaries. Using multilevel modelling analysis, three main findings emerged. First, the relationship between EC and conscientiousness is dependent on the measures used. Second, some EC and conscientiousness measures have direct effects on health behaviour; and third, some EC and conscientiousness measures have indirect effects on health behaviour via moderation of the intention-behaviour relationship. The findings highlight EC and conscientiousness are significantly related to health behaviour performance, though the relationships are more complex than shown by previous research. As such, the current findings serve to highlight issues of construct complexity, ecological validity, sample diversity and measurement

Feeling misidentified : understanding migrant's readiness to engage in health care screening

National Institute for Health and Research; Research for Patient Benefit; Public Health England; The Hepatitis C Trust; South East Asian Community Leaders and participants; Muslim Council of Britain; Woking Borough Council; The Royal Surrey County Hospital NHS Trus

Variation in juvenile Chinook salmon diet composition and foraging success between two estuaries with contrasting land-use histories

The transition of juveniles from fresh water to estuarine and marine environments is a critical period in the life cycle of Pacific salmon, during which survival can be strongly size-selective. Because the amount and quality of food consumed are major determinants of juvenile salmon growth, successful acquisition of energy rich prey during estuarine residence is critical for survival. Humans have likely impacted the feeding relationships of juvenile salmon in estuaries by destroying estuarine wetlands and by altering the abundance of salmon in estuaries. While the estuarine foraging habits of juvenile salmon have been extensively examined, few studies have conducted quantitative comparisons between estuaries that have experienced different levels of human modification. However, comparisons between whole estuaries with different degrees of wetland loss and degradation may be a useful scale of analysis for the diet composition and consumption rates of mobile consumers such as juvenile salmon. To improve our understanding of the effects of wetland loss and conspecific density on juvenile Chinook salmon consumption rate and diet composition in estuaries, we assembled Chinook salmon density and diet data from two Salish Sea estuaries with dramatically different levels of wetland loss and modification. We compared juvenile Chinook salmon diet composition, diet energy density, and instantaneous ration (a proxy for consumption rate) between the two estuaries. We also evaluated the effect of conspecific density on instantaneous ration. We found significant differences in diet composition between juvenile Chinook salmon in the two estuaries, but little difference in instantaneous ration or diet energy density. However, in the highly modified estuary, conspecific density had a significant, negative effect on instantaneous ration, while in the more natural estuary there was little effect on instantaneous ration. These findings suggest that wetland loss may interact with salmon density to constrain the consumption rates of juvenile salmon in estuaries, with resulting consequences for growth and survival

Omicron infection enhances Delta antibody immunity in vaccinated persons

The extent to which Omicron infection(1–9), with or without previous vaccination, elicits protection against the previously dominant Delta (B.1.617.2) variant is unclear. Here we measured the neutralization capacity against variants of severe acute respiratory syndrome coronavirus 2 in 39 individuals in South Africa infected with the Omicron sublineage BA.1 starting at a median of 6 (interquartile range 3–9) days post symptom onset and continuing until last follow-up sample available, a median of 23 (interquartile range 19–27) days post symptoms to allow BA.1-elicited neutralizing immunity time to develop. Fifteen participants were vaccinated with Pfizer's BNT162b2 or Johnson & Johnson's Ad26.CoV2.S and had BA.1 breakthrough infections, and 24 were unvaccinated. BA.1 neutralization increased from a geometric mean 50% focus reduction neutralization test titre of 42 at enrolment to 575 at the last follow-up time point (13.6-fold) in vaccinated participants and from 46 to 272 (6.0-fold) in unvaccinated participants. Delta virus neutralization also increased, from 192 to 1,091 (5.7-fold) in vaccinated participants and from 28 to 91 (3.0-fold) in unvaccinated participants. At the last time point, unvaccinated individuals infected with BA.1 had low absolute levels of neutralization for the non-BA.1 viruses and 2.2-fold lower BA.1 neutralization, 12.0-fold lower Delta neutralization, 9.6-fold lower Beta variant neutralization, 17.9-fold lower ancestral virus neutralization and 4.8-fold lower Omicron sublineage BA.2 neutralization relative to vaccinated individuals infected with BA.1. These results indicate that hybrid immunity formed by vaccination and Omicron BA.1 infection should be protective against Delta and other variants. By contrast, infection with Omicron BA.1 alone offers limited cross-protection despite moderate enhancement

Killer-cell Immunoglobulin-like Receptor (KIR) gene profiles modify HIV disease course, not HIV acquisition in South African women.

CAPRISA, 2016.Abstract available in PDF file

Ten-year mortality, disease progression, and treatment-related side effects in men with localised prostate cancer from the ProtecT randomised controlled trial according to treatment received

Background The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy. Objective To report outcomes according to treatment received in men in randomised and treatment choice cohorts. Design, setting, and participants This study focuses on secondary care. Men with clinically localised prostate cancer at one of nine UK centres were invited to participate in the treatment trial comparing AM, radical prostatectomy, and radiotherapy. Intervention Two cohorts included 1643 men who agreed to be randomised and 997 who declined randomisation and chose treatment. Outcome measurements and statistical analysis Analysis was carried out to assess mortality, metastasis and progression and health-related quality of life impacts on urinary, bowel, and sexual function using patient-reported outcome measures. Analysis was based on comparisons between groups defined by treatment received for both randomised and treatment choice cohorts in turn, with pooled estimates of intervention effect obtained using meta-analysis. Differences were estimated with adjustment for known prognostic factors using propensity scores. Results and limitations According to treatment received, more men receiving AM died of PCa (AM 1.85%, surgery 0.67%, radiotherapy 0.73%), whilst this difference remained consistent with chance in the randomised cohort (p = 0.08); stronger evidence was found in the exploratory analyses (randomised plus choice cohort) when AM was compared with the combined radical treatment group (p = 0.003). There was also strong evidence that metastasis (AM 5.6%, surgery 2.4%, radiotherapy 2.7%) and disease progression (AM 20.35%, surgery 5.87%, radiotherapy 6.62%) were more common in the AM group. Compared with AM, there were higher risks of sexual dysfunction (95% at 6 mo) and urinary incontinence (55% at 6 mo) after surgery, and of sexual dysfunction (88% at 6 mo) and bowel dysfunction (5% at 6 mo) after radiotherapy. The key limitations are the potential for bias when comparing groups defined by treatment received and changes in the protocol for AM during the lengthy follow-up required in trials of screen-detected PCa. Conclusions Analyses according to treatment received showed increased rates of disease-related events and lower rates of patient-reported harms in men managed by AM compared with men managed by radical treatment, and stronger evidence of greater PCa mortality in the AM group. Patient summary More than 95 out of every 100 men with low or intermediate risk localised prostate cancer do not die of prostate cancer within 10 yr, irrespective of whether treatment is by means of monitoring, surgery, or radiotherapy. Side effects on sexual and bladder function are better after active monitoring, but the risks of spreading of prostate cancer are more common

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

The Salmon River estuary: restoring tidal inundation and tracking ecosystem response

Thesis (Ph. D.)--University of Washington, 2005.The Salmon River estuary offered a unique opportunity to simultaneously evaluate several estuarine restoration projects and make comparisons with a reference, undiked portion of the estuary. Dikes installed in three locations in the estuary during the early 1960s were removed in 1978, 1987 and 1996 creating a "space-for-time substitution" chronosequence. I analyzed marsh community response to assess development state of three recovering marshes and make comparisons with the reference. During spring and summer from 1998--2002, I assessed juvenile salmon habitat development by comparing wild Oncorhynchus tshawytscha (Chinook salmon) density, diet composition and modeled growth potential among marshes. I also explored differences in invertebrate abundance and composition among marshes, and determined repeatable and exclusive indicators to marsh age. In my analysis, I applied techniques, such as bioenergetics modeling and indicator analysis, to evaluate ecosystem development. A bioenergetics model was used to compare growth potential with site-specific diet composition and temperature, estuary-specific prey energy, average fish size and calculated consumption rates. Modeled growth potential was positive, ranged from 0.001--0.07 g/g/d, and was unrelated to marsh age. Growth rates approximating the reference were found in the newest restoration site with higher variability. Density and taxonomic richness of benthic macroinvertebrates was related to marsh age, but unrelated to marsh surface insects. Invertebrate communities were also compared among marshes. Benthic communities in the 1996 marsh were different from all other marshes, and insect communities were distinct by site except for several cases when no difference between the reference and the 1978 marsh was found. Using indicator analysis I determined several reliable indicators of marsh age, including Staphylinidae (rove beetles) and Chironomidae larvae (midge flies) in the 1996 marsh. Insect communities were more affected by landscape positioning than benthic communities, but tracking both, and evaluating the key indicators of community response was the most informative for describing and assessing recovery state across marsh conditions. The range of metrics I used to track ecosystem development at the Salmon River estuary provided broad indication as to the state of ecosystem re-development after restoring tidal inundation and revealed differences among the marshes related to landscape position and marsh age