Use of record-linkage to handle non-response and improve alcohol consumption estimates in health survey data: a study protocol

<p>Introduction: Reliable estimates of health-related behaviours, such as levels of alcohol consumption in the population, are required to formulate and evaluate policies. National surveys provide such data; validity depends on generalisability, but this is threatened by declining response levels. Attempts to address bias arising from non-response are typically limited to survey weights based on sociodemographic characteristics, which do not capture differential health and related behaviours within categories. This project aims to explore and address non-response bias in health surveys with a focus on alcohol consumption.</p> <p>Methods and analysis: The Scottish Health Surveys (SHeS) aim to provide estimates representative of the Scottish population living in private households. Survey data of consenting participants (92% of the achieved sample) have been record-linked to routine hospital admission (Scottish Morbidity Records (SMR)) and mortality (from National Records of Scotland (NRS)) data for surveys conducted in 1995, 1998, 2003, 2008, 2009 and 2010 (total adult sample size around 40 000), with maximum follow-up of 16 years. Also available are census information and SMR/NRS data for the general population. Comparisons of alcohol-related mortality and hospital admission rates in the linked SHeS-SMR/NRS with those in the general population will be made. Survey data will be augmented by quantification of differences to refine alcohol consumption estimates through the application of multiple imputation or inverse probability weighting. The resulting corrected estimates of population alcohol consumption will enable superior policy evaluation. An advanced weighting procedure will be developed for wider use.</p> <p>Ethics and dissemination: Ethics approval for SHeS has been given by the National Health Service (NHS) Multi-Centre Research Ethics Committee and use of linked data has been approved by the Privacy Advisory Committee to the Board of NHS National Services Scotland and Registrar General. Funding has been granted by the MRC. The outputs will include four or five public health and statistical methodological international journal and conference papers.</p&gt

Experimental effects of mindfulness inductions on self-regulation: Systematic review and meta-analysis.

Self-regulation is the control of aspects of the self to allow pursuit of long-term goals, and it is proposed as a central pathway through which mindfulness may exert benefits on well-being. However, the effects of a single mindfulness induction on self-regulation are not clear, as there has been no comprehensive review of this evidence. The current review synthesized existing findings relating to the effect of a mindfulness induction delivered in a laboratory setting on measures of self-regulation. Twenty-seven studies were included and grouped according to 3 outcomes: regulation of experimentally induced negative affect (k = 15; meta-analysis), emotion-regulation strategies (k = 7) and executive functions (k = 9; narrative synthesis). A mindfulness induction was superior to comparison groups in enhancing the regulation of negative affect (d = -.28). Executive-function performance was enhanced only when the experimental design included an affect induction or when the outcome was sustained attention. The effect on emotion-regulation strategies was inconclusive, but with emerging evidence for an effect on rumination. Overall, the findings indicate that, in the form of an induction, mindfulness may have the most immediate effect on attention mechanisms rather than exerting cognitive changes in other domains, as are often reported outcomes of longer mindfulness training. Through effecting change in attention, emotion regulation of negative affect can be enhanced, and subsequently, executive-function performance more quickly restored. The interpretations of the findings are caveated with consideration of the low quality of many of the included study designs determined by the quality appraisal tool

Fibre-specific white matter reductions in Parkinson’s hallucinations and visual dysfunction

Objective: To investigate the microstructural and macrostructural white matter changes that accompany visual hallucinations and low visual performance in Parkinson’s disease, a risk factor for Parkinson’s dementia. Methods: We performed fixel-based analysis, a novel technique that provides metrics of specific fibre-bundle populations within a voxel (or fixel). Diffusion MRI data was acquired from patients with Parkinson’s disease (n=105, of which 34 low visual performers and 19 hallucinators) and age-matched controls (n=35). We used whole brain fixel-based analysis to compare micro-structural differences in fibre density (FD), macro-structural differences in fibre bundle cross-section (FC) and the combined fibre density and cross-section metric (FDC) across all white matter fixels. We then performed a tract of interest analysis comparing the most sensitive FDC metric across 11 tracts within the visual system. Results: Patients with Parkinson’s disease hallucinations exhibited macrostructural changes (reduced FC) within the splenium of the corpus callosum and the left posterior thalamic radiation compared to patients without hallucinations. Whilst there were no significant changes in FD, we found large reductions in the combined FDC metric in Parkinson’s hallucinators within the splenium (>50% reduction compared to non-hallucinators). Patients with Parkinson’s disease and low visual performance showed widespread microstructural and macrostructural changes within the genu and splenium of the corpus callosum, bilateral posterior thalamic radiations and the left inferior fronto-occipital fasciculus. Conclusions: We demonstrate specific white matter tract degeneration affecting posterior thalamic tracts in patients with Parkinson’s disease with hallucinations and low visual performance, providing direct mechanistic support for attentional models of visual hallucinations

Contribution of smoking-related and alcohol-related deaths to the gender gap in mortality: evidence from 30 European countries

<p>Background: Women now outlive men throughout the globe, a mortality advantage that is very established in developed European countries. Debate continues about the causes of the gender gap, although smoking is known to have been a major contributor to the difference in the past.</p> <p>Objectives: To compare the magnitude of the gender gap in all-cause mortality in 30 European countries and assess the contribution of smoking-related and alcohol-related deaths.</p> <p>Methods: Data on all-cause mortality, smoking-related mortality and alcohol-related mortality for 30 European countries were extracted from the World Health Organization Health for All database for the year closest to 2005. Rates were standardised by the direct method using the European population standard and were for all age groups. The proportion of the gender gap in all-cause mortality attributable to smoking-related and alcohol-related deaths was then calculated.</p> <p>Results: There was considerable variation in the magnitude of the male ‘excess’ of all-cause mortality across Europe, ranging from 188 per 100 000 per year in Iceland to 942 per 100 000 per year in Ukraine. Smoking-related deaths accounted for around 40% to 60% of the gender gap, while alcohol-related mortality typically accounted for 20% to 30% of the gender gap in Eastern Europe and 10% to 20% elsewhere in Europe.</p> <p>Conclusions: Smoking continues to be the most important cause of gender differences in mortality across Europe, but its importance as an explanation for this difference is often overshadowed by presumptions about other explanations. Changes in smoking patterns by gender suggest that the gender gap in mortality will diminish in the coming decades.</p&gt

Organisational and neuromodulatory underpinnings of structural-functional connectivity decoupling in patients with Parkinson's disease

Parkinson's dementia is characterised by changes in perception and thought, and preceded by visual dysfunction, making this a useful surrogate for dementia risk. Structural and functional connectivity changes are seen in humans with Parkinson's disease, but the organisational principles are not known. We used resting-state fMRI and diffusion-weighted imaging to examine changes in structural-functional connectivity coupling in patients with Parkinson's disease, and those at risk of dementia. We identified two organisational gradients to structural-functional connectivity decoupling: anterior-to-posterior and unimodal-to-transmodal, with stronger structural-functional connectivity coupling in anterior, unimodal areas and weakened towards posterior, transmodal regions. Next, we related spatial patterns of decoupling to expression of neurotransmitter receptors. We found that dopaminergic and serotonergic transmission relates to decoupling in Parkinson's overall, but instead, serotonergic, cholinergic and noradrenergic transmission relates to decoupling in patients with visual dysfunction. Our findings provide a framework to explain the specific disorders of consciousness in Parkinson's dementia, and the neurotransmitter systems that underlie these

Brain iron deposition is linked with cognitive severity in Parkinson’s disease

Background: Dementia is common in Parkinson’s disease (PD) but measures that track cognitive change in PD are lacking. Brain tissue iron accumulates with age and co-localises with pathological proteins linked to PD dementia such as amyloid. We used quantitative susceptibility mapping (QSM) to detect changes related to cognitive change in PD. Methods: We assessed 100 patients with early-stage to mid-stage PD, and 37 age-matched controls using the Montreal Cognitive Assessment (MoCA), a validated clinical algorithm for risk of cognitive decline in PD, measures of visuoperceptual function and the Movement Disorders Society Unified Parkinson’s Disease Rating Scale part 3 (UPDRS-III). We investigated the association between these measures and QSM, an MRI technique sensitive to brain tissue iron content. Results: We found QSM increases (consistent with higher brain tissue iron content) in PD compared with controls in prefrontal cortex and putamen (p<0.05 corrected for multiple comparisons). Whole brain regression analyses within the PD group identified QSM increases covarying: (1) with lower MoCA scores in the hippocampus and thalamus, (2) with poorer visual function and with higher dementia risk scores in parietal, frontal and medial occipital cortices, (3) with higher UPDRS-III scores in the putamen (all p<0.05 corrected for multiple comparisons). In contrast, atrophy, measured using voxel-based morphometry, showed no differences between groups, or in association with clinical measures. Conclusions: Brain tissue iron, measured using QSM, can track cognitive involvement in PD. This may be useful to detect signs of early cognitive change to stratify groups for clinical trials and monitor disease progression

Data Processing of Lunar Infrared Measurements at High Spatial and Radiometric Resolution to Obtain Brightness Temperatures Scientific Report No. 9

Data processing of lunar infrared measurements at high spatial and radiometric resolution to obtain brightness temperature

Assessing the Representativeness of Population-Sampled Health Surveys Through Linkage to Administrative Data on Alcohol-Related Outcomes

Health surveys are an important resource for monitoring population health, but selective nonresponse may impede valid inference. This study aimed to assess nonresponse bias in a population-sampled health survey in Scotland, with a focus on alcohol-related outcomes. Nonresponse bias was assessed by examining whether rates of alcohol-related harm (i.e., hospitalization or death) and all-cause mortality among respondents to the Scottish Health Surveys (from 1995 to 2010) were equivalent to those in the general population, and whether the extent of any bias varied according to sociodemographic attributes or over time. Data from consenting respondents (aged 20–64 years) to 6 Scottish Health Surveys were confidentially linked to death and hospitalization records and compared with general population counterparts. Directly age-standardized incidence rates of alcohol-related harm and all-cause mortality were lower among Scottish Health Survey respondents compared with the general population. For all years combined, the survey-to-population rate ratios were 0.69 (95% confidence interval: 0.61, 0.76) for the incidence of alcohol-related harm and 0.89 (95% confidence interval: 0.83, 0.96) for all-cause mortality. Bias was more pronounced among persons residing in more deprived areas; limited evidence was found for regional or temporal variation. This suggests that corresponding underestimation of population rates of alcohol consumption is likely to be socially patterne