The impact of Covid-19 on families, children aged 0-4 and pregnant women in Tower Hamlets: Wave One Survey Findings

Families in Tower Hamlets is an ongoing research project led by University College London into the impact of the Covid-19 pandemic on the lives of families with young children and pregnant women. This report is of initial findings from the ‘first 500’ respondents, who completed the survey between July and November 2020. We present findings in terms of seven main ethnic groups that broadly represent proportions in the local population: one third of the population identify as White British and White Irish; a further third identify as Bangladeshi; and a final third identify with a wide range of other ethnicities. There are marked differences within this group so we have used the categories: Other White; Asian Other; Somali; Black & Black Other; and Other ethnic group to illustrate the experiences of respondents. With this lens of ethnicity, combined with analysis by household income, we can see certain clear patterns arising. Here, we focus on five main areas: family livelihoods; housing and environment; supporting children at home; health and social support services; and participants’ own health and mental health. Subsequent outputs will present findings in more detail

Income, ethnic diversity and family life in East London during the first wave of the pandemic: An assets approach

Objective: This paper reports first results from a survey of 992 parents and parents to be living in an ethnically diverse and socio-economically unequal borough of East London during the coronavirus pandemic that reduced mobility, closed services and threatened public health. / Background: Little is known about the place based impacts of the pandemic on families with young children. We describe the living circumstances of families with children under five or expecting a baby living in Tower Hamlets during the Coronavirus pandemic in 2020, and then examine the relative importance of household characteristics such as ethnicity and household income for adverse impacts on survey respondents, as seen in mental health outcomes. / Method: a community survey sample recruited with support from the local council comprised 75% mothers/pregnant women, 25% fathers/partners of pregnant women. Reflecting the borough population, 35 percent were White British or Irish and 36 percent were Bangladeshi, and the remainder were from a wide range of ethnic backgrounds. Adopting an assets based approach, we describe material, familial and community assets using three household income bands and seven ethnic groups. We then use regressions to identify which assets were most important in mitigating adversity. / Results: We find that material assets (income, employment, food insecurity, housing quality) were often insecure and in decline but familial assets (home caring practices, couple relationships) were largely sustained. Community assets (informal support, service provision) were less available or means of access had changed. Our analyses find that while descriptively ethnicity structured adverse impacts of the pandemic related changes to family life, income and couple relationships were the most important assets for mitigating adversity as seen in mental health status. / Conclusion: Supporting family assets will require close attention to generating local and decent work as well as enhancing access to community assets

What Family Circumstances, During COVID-19, Impact on Parental Mental Health in an Inner City Community in London?

The introduction of lockdown due to a public health emergency in March 2020 marked the beginning of substantial changes to daily life for all families with young children. Here we report the experience of families from London Borough of Tower Hamlets with high rates of poverty and ethnic and linguistic diversity. This inner city community, like communities worldwide, has experienced a reduction or closure in access to education, support services, and in some cases, a change in or loss of income, job, and food security. Using quantitative survey items (N = 992), we examined what differences in family circumstances, for mothers and fathers of young children aged 0-5 living in Tower Hamlets, during March 2020 to November 2020, were associated with their mental health status. We measure parental mental health using symptoms of depression (self-report: Patient Health Questionnaire depression scale: PHQ-8), symptoms of anxiety levels (self-report: General Anxiety Disorder: GAD-7), and perceptions of direct loneliness. We find parental mental health difficulties are associated with low material assets (financial security, food security, and children having access to outside space), familial assets (parents time for themselves and parent status: lone vs. cohabiting), and community assets (receiving support from friends and family outside the household). South Asian parents and fathers across ethnicities were significantly more likely to experience mental health difficulties, once all other predictors were accounted for. These contributing factors should be considered for future pandemics, where restrictions on people's lives are put in place, and speak to the importance of reducing financial insecurity and food insecurity as a means of improving the mental health of parents

Interim Briefing Report. The First 500: The impact of Covid-19 on families, children aged 0-4 and pregnant women in Tower Hamlets

Families in Tower Hamlets is an ongoing research project led by University College London into the impact of the Covid-19 pandemic on the lives of families with young children and pregnant women. This report is of initial findings from the ‘first 500’ respondents, who completed the survey between July and September 2020. We present findings in terms of three main ethnic groups that broadly represent proportions in the local population: one third of the population identify as White British and White Irish; a further third identify as Bangladeshi; and a final third identify with a wide range of other ethnicities which we have had to present as ‘Other ethnicity’ in this report and we acknowledge this is unlikely to do justice to the range of experience within this group. With this lens of ethnicity, combined with analysis by household income, we can see certain clear patterns arising. Here, we focus on five main areas: family livelihoods; housing and environment; supporting children at home; health and social support services; and participants’ own health and mental health. Subsequent outputs will present findings in more detail

Magnitude of terminological bias in international health services research: a disambiguation analysis in mental health

Aims Health services research (HSR) is affected by a widespread problem related to service terminology including non-commensurability (using different units of analysis for comparisons) and terminological unclarity due to ambiguity and vagueness of terms. The aim of this study was to identify the magnitude of the terminological bias in health and social services research and health economics by applying an international classification system. Methods This study, that was part of the PECUNIA project, followed an ontoterminology approach (disambiguation of technical and scientific terms using a taxonomy and a glossary of terms). A listing of 56 types of health and social services relevant for mental health was compiled from a systematic review of the literature and feedback provided by 29 experts in six European countries. The disambiguation of terms was performed using an ontology-based classification of services (Description and Evaluation of Services and DirectoriEs – DESDE), and its glossary of terms. The analysis focused on the commensurability and the clarity of definitions according to the reference classification system. Interrater reliability was analysed using κ. Results The disambiguation revealed that only 13 terms (23%) of the 56 services selected were accurate. Six terms (11%) were confusing as they did not correspond to services as defined in the reference classification system (non-commensurability bias), 27 (48%) did not include a clear definition of the target population for which the service was intended, and the definition of types of services was unclear in 59% of the terms: 15 were ambiguous and 11 vague. The κ analyses were significant for agreements in unit of analysis and assignment of DESDE codes and very high in definition of target population. Conclusions Service terminology is a source of systematic bias in health service research, and certainly in mental healthcare. The magnitude of the problem is substantial. This finding has major implications for the international comparability of resource use in health economics, quality and equality research. The approach presented in this paper contributes to minimise differentiation between services by taking into account key features such as target population, care setting, main activities and type and number of professionals among others. This approach also contributes to support financial incentives for effective health promotion and disease prevention. A detailed analysis of services in terms of cost measurement for economic evaluations reveals the necessity and usefulness of defining services using a coding system and taxonomical criteria rather than by ‘text-based descriptions’

Conceptual and Visual Features Contribute to Visual Memory for Natural Images

We examined the role of conceptual and visual similarity in a memory task for natural images. The important novelty of our approach was that visual similarity was determined using an algorithm [1] instead of being judged subjectively. This similarity index takes colours and spatial frequencies into account. For each target, four distractors were selected that were (1) conceptually and visually similar, (2) only conceptually similar, (3) only visually similar, or (4) neither conceptually nor visually similar to the target image. Participants viewed 219 images with the instruction to memorize them. Memory for a subset of these images was tested subsequently. In Experiment 1, participants performed a two-alternative forced choice recognition task and in Experiment 2, a yes/no-recognition task. In Experiment 3, testing occurred after a delay of one week. We analyzed the distribution of errors depending on distractor type. Performance was lowest when the distractor image was conceptually and visually similar to the target image, indicating that both factors matter in such a memory task. After delayed testing, these differences disappeared. Overall performance was high, indicating a large-capacity, detailed visual long-term memory

Calcium Homeostasis in Myogenic Differentiation Factor 1 (MyoD)-Transformed, Virally-Transduced, Skin-Derived Equine Myotubes

Dysfunctional skeletal muscle calcium homeostasis plays a central role in the pathophysiology of several human and animal skeletal muscle disorders, in particular, genetic disorders associated with ryanodine receptor 1 (RYR1) mutations, such as malignant hyperthermia, central core disease, multiminicore disease and certain centronuclear myopathies. In addition, aberrant skeletal muscle calcium handling is believed to play a pivotal role in the highly prevalent disorder of Thoroughbred racehorses, known as Recurrent Exertional Rhabdomyolysis. Traditionally, such defects were studied in human and equine subjects by examining the contractile responses of biopsied muscle strips exposed to caffeine, a potent RYR1 agonist. However, this test is not widely available and, due to its invasive nature, is potentially less suitable for valuable animals in training or in the human paediatric setting. Furthermore, increasingly, RYR1 gene polymorphisms (of unknown pathogenicity and significance) are being identified through next generation sequencing projects. Consequently, we have investigated a less invasive test that can be used to study calcium homeostasis in cultured, skin-derived fibroblasts that are converted to the muscle lineage by viral transduction with a MyoD (myogenic differentiation 1) transgene. Similar models have been utilised to examine calcium homeostasis in human patient cells, however, to date, there has been no detailed assessment of the cells’ calcium homeostasis, and in particular, the responses to agonists and antagonists of RYR1. Here we describe experiments conducted to assess calcium handling of the cells and examine responses to treatment with dantrolene, a drug commonly used for prophylaxis of recurrent exertional rhabdomyolysis in horses and malignant hyperthermia in humans

Plugging a hole and lightening the burden: A process evaluation of a practice education team

Aim: To investigate the perceptions of clinical and senior managers about the role of Practice Educators employed in one acute hospital in the UK. Background: Producing nurses who are fit for practice, purpose and academic award is a key issue for nurse education partnership providers in the UK. Various new models for practice learning support structures and new roles within health care institutions have been established. To sustain funding and policy support for these models, there is a need for evaluation research. Design: A process evaluation methodology was employed to determine the current value of a practice education team and to provide information to guide future direction. Methods: Data were collected through semi-structured telephone interviews using a previously designed schedule. All senior nurse managers (N=5) and a purposive sample of clinical managers (n=13) who had personal experience of and perceptions about the role of practice educators provided the data. Interview notes were transcribed, coded and a thematic framework devised to present the results. Results: A number of key themes emerged including: qualities needed for being a successful practice educator; visibility and presence of practice educators; providing a link with the university; ‘plugging a hole’ in supporting learning needs; providing relief to practitioners in dealing with ‘the burden of students’; alleviating the ‘plight of students’; and effects on student attrition. Conclusions: Findings provided evidence for the continued funding of the practice educator role with improvements to be made in dealing with stakeholder expectations and outcomes. Relevance to clinical practice: In the UK, there still remain concerns about the fitness for practice of newly registered nurses, prompting a recent national consultation by the professional regulating body. Despite fiscal pressures, recommendations for further strengthening of all systems that will support the quality of practice learning may continue to sustain practice learning support roles