Social class inequalities in perinatal outcomes: Scotland 1980–2000

Objective: To examine social class inequalities in adverse perinatal events in Scotland between 1980 and 2000 and how these were influenced by other maternal risk factors. Design: Population based study using routine maternity discharge data. Setting: Scotland. Participants: All women who gave birth to a live singleton baby in Scottish hospitals between 1980 and 2000 (n = 1 282 172). Main outcome measures: Low birth weight (LBW), preterm birth, and small for gestational age (SGA). Results: The distribution of social class changed over time, with the proportion of mothers with undetermined social class increasing from 3.9% in 1980–84 to 14.8% in 1995–2000. The relative index of inequality (RII) decreased during the 1980s for all outcomes. The RII then increased between the early and late 1990s (LBW from 2.09 (95%CI 1.97, 2.22) to 2.43 (2.29, 2.58), preterm from 1.52 (1.44, 1.61) to 1.75 (1.65, 1.86), and SGA from 2.28 (2.14, 2.42) to 2.49 (2.34, 2.66) respectively). Inequalities were greatest in married mothers, mothers aged over 35, mothers taller than 164 cm, and mothers with a parity of one or more. Inequalities were also greater by the end of the 1990s than at the start of the 1980s for women of parity one or more and for mothers who were not married. Conclusion: Despite decreasing during the 1980s, inequalities in adverse perinatal outcomes increased during the 1990s in all strata defined by maternal characteristics

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

Spatial clustering of mental disorders and associated characteristics of the neighbourhood context in Malmö, Sweden, in 2001

Study objective: Previous research provides preliminary evidence of spatial variations of mental disorders and associations between neighbourhood social context and mental health. This study expands past literature by (1) using spatial techniques, rather than multilevel models, to compare the spatial distributions of two groups of mental disorders (that is, disorders due to psychoactive substance use, and neurotic, stress related, and somatoform disorders); and (2) investigating the independent impact of contextual deprivation and neighbourhood social disorganisation on mental health, while assessing both the magnitude and the spatial scale of these effects. Design: Using different spatial techniques, the study investigated mental disorders due to psychoactive substance use, and neurotic disorders. Participants: All 89 285 persons aged 40–69 years residing in Malmö, Sweden, in 2001, geolocated to their place of residence. Main results: The spatial scan statistic identified a large cluster of increased prevalence in a similar location for the two mental disorders in the northern part of Malmö. However, hierarchical geostatistical models showed that the two groups of disorders exhibited a different spatial distribution, in terms of both magnitude and spatial scale. Mental disorders due to substance consumption showed larger neighbourhood variations, and varied in space on a larger scale, than neurotic disorders. After adjustment for individual factors, the risk of substance related disorders increased with neighbourhood deprivation and neighbourhood social disorganisation. The risk of neurotic disorders only increased with contextual deprivation. Measuring contextual factors across continuous space, it was found that these associations operated on a local scale. Conclusions: Taking space into account in the analyses permitted deeper insight into the contextual determinants of mental disorders

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

The influence of flow discharge variations on the morphodynamics of a diffluence-confluence unit on a large river: Impacts of discharge variation on a diffluence-confluence unit

© 2017 The Authors. Earth Surface Processes and Landforms published by John Wiley & Sons Ltd. Bifurcations are key geomorphological nodes in anabranching and braided fluvial channels, controlling local bed morphology, the routing of sediment and water, and ultimately defining the stability of their associated diffluence–confluence unit. Recently, numerical modelling of bifurcations has focused on the relationship between flow conditions and the partitioning of sediment between the bifurcate channels. Herein, we report on field observations spanning September 2013 to July 2014 of the three-dimensional flow structure, bed morphological change and partitioning of both flow discharge and suspended sediment through a large diffluence–confluence unit on the Mekong River, Cambodia, across a range of flow stages (from 13 500 to 27 000 m 3 s −1 ). Analysis of discharge and sediment load throughout the diffluence–confluence unit reveals that during the highest flows (Q = 27 000 m 3 s −1 ), the downstream island complex is a net sink of sediment (losing 2600 ± 2000 kg s −1 between the diffluence and confluence), whereas during the rising limb (Q = 19 500 m 3 s −1 ) and falling limb flows (Q = 13 500 m 3 s −1 ) the sediment balance is in quasi-equilibrium. We show that the discharge asymmetry of the bifurcation varies with discharge and highlight that the influence of upstream curvature-induced water surface slope and bed morphological change may be first-order controls on bifurcation configuration. Comparison of our field data to existing bifurcation stability diagrams reveals that during lower (rising and falling limb) flow the bifurcation may be classified as unstable, yet transitions to a stable condition at high flows. However, over the long term (1959–2013) aerial imagery reveals the diffluence–confluence unit to be fairly stable. We propose, therefore, that the long-term stability of the bifurcation, as well as the larger channel planform and morphology of the diffluence–confluence unit, may be controlled by the dominant sediment transport regime of the system. © 2017 The Authors. Earth Surface Processes and Landforms published by John Wiley & Sons Ltd

Extreme flood-driven fluvial bank erosion and sediment loads: direct process measurements using integrated Mobile Laser Scanning (MLS) and hydro-acoustic techniques: Direct measurement of flood-driven erosion using MLS and MBES

Copyright © 2016 John Wiley & Sons, Ltd. This methods paper details the first attempt at monitoring bank erosion, flow and suspended sediment at a site during flooding on the Mekong River induced by the passage of tropical cyclones. We deployed integrated mobile laser scanning (MLS) and multibeam echo sounding (MBES), alongside acoustic Doppler current profiling (aDcp), to directly measure changes in river bank and bed at high (~0.05 m) spatial resolution, in conjunction with measurements of flow and suspended sediment dynamics. We outline the methodological steps used to collect and process this complex point cloud data, and detail the procedures used to process and calibrate the aDcp flow and sediment flux data. A comparison with conventional remote sensing methods of estimating bank erosion, using aerial images and Landsat imagery, reveals that traditional techniques are error prone at the high temporal resolutions required to quantify the patterns and volumes of bank erosion induced by the passage of individual flood events. Our analysis reveals the importance of cyclone-driven flood events in causing high rates of erosion and suspended sediment transport, with a c. twofold increase in bank erosion volumes and a fourfold increase in suspended sediment volumes in the cyclone-affected wet season. Copyright © 2016 John Wiley & Sons, Ltd

Plasma radiation for atmospheric entry at Titan: Emission spectroscopy measurements and numerical rebuilding

Emission spectroscopy measurements on a plasma representative of Titan atmosphere composition were obtained in the Inductively Coupled Plasma wind tunnel facility (VKI-Minitorch) at the von Karman Institute in Belgium. Temperatures ranged from 3600 to 5000 K, pressure was fixed at 300 mbar, and the molar composition was 1.9% CH4 and 98.1% N2. The high-pressure plasma was produced to obtain conditions close to equilibrium. In conjunction, line-by-line calculations have been carried out to assess the reliability of two distinct sets of molecular electronic transition moments, recently released, by predicting the radiative signature of high-temperature N2-CH4 plasma. The radiative transfer problem was solved by considering the plasma plume at local thermodynamic equilibrium conditions in an axisymmetric configuration. Comparisons between the synthetic and experimental spectra demonstrated good agreement for the CN Violet and high-wavelength CN Red bands, while some discrepancies were observed for the C2 Swan bands and low-wavelength CN Red band

Longitudinal thalamic white and gray matter changes associated with visual hallucinations in Parkinson’s disease

Objective: Visual hallucinations are common in Parkinson’s disease (PD) and associated with worse outcomes. Large-scale network imbalance is seen in PD-associated hallucinations, but mechanisms remain unclear. As the thalamus is critical in controlling cortical networks, structural thalamic changes could underlie network dysfunction in PD hallucinations. Methods: We used whole-brain fixel-based analysis and cortical thickness measures to examine longitudinal white and grey matter changes in 76 patients with PD (15 hallucinators, 61 non-hallucinators) and 26 controls at baseline, and after 18 months. We compared white matter and cortical thickness, adjusting for age, gender, time-between-scans and intracranial volume. To assess thalamic changes, we extracted volumes for 50 thalamic subnuclei (25 each hemisphere) and mean fibre crosssection (FC) for white matter tracts originating in each subnucleus and examined longitudinal change in PDhallucinators versus non-hallucinators. Results: PD hallucinators showed white matter changes within the corpus callosum at baseline and extensive posterior tract involvement over time. Less extensive cortical thickness changes were only seen after followup. White matter connections from the right medial mediodorsal magnocellular thalamic nucleus showed reduced FC in PD hallucinators at baseline followed by volume reductions longitudinally. After follow-up, almost all thalamic subnuclei showed tract losses in PD hallucinators compared with non-hallucinators. Interpretation: PD hallucinators show white matter loss particularly in posterior connections and in thalamic nuclei, over time with relatively preserved cortical thickness. The right medial mediodorsal thalamic nucleus shows both connectivity and volume loss in PD hallucinations. Our findings provide mechanistic insights into the drivers of network imbalance in PD hallucinations and potential therapeutic targets

Visual dysfunction predicts cognitive impairment and white matter degeneration in Parkinson's disease

Visual dysfunction predicts dementia in Parkinsons disease (PD), but whether this translates to structural change is not known. We aimed to identify longitudinal white matter changes in patients with Parkinsons disease and low visual function and also in those who developed mild cognitive impairment (MCI). We used fixel-based analysis to examine longitudinal white matter change in PD. Diffusion MRI and clinical assessments were performed in 77 patients at baseline (22 low visual function /55 intact vision; and 13 MCI, 13 MCI converters /51 normal cognition) and 25 controls and again after 18 months. We compared micro-structural changes in fibre density, macro-structural changes in fibre bundle cross-section (FC) and combined fibre density and cross-section across white matter, adjusting for age, gender and intracranial volume. Patients with Parkinsons and visual dysfunction showed worse cognitive performance at follow up and were more likely to develop MCI compared with those with normal vision (p=0.008). Parkinsons with poor visual function showed diffuse micro-structural and macro-structural changes at baseline, whereas those with MCI showed fewer baseline changes. At follow-up, Parkinsons with low visual function showed widespread macrostructural changes, involving the fronto-occipital fasciculi, external capsules, and middle cerebellar peduncles bilaterally. No longitudinal change was seen in baseline MCI or in MCI converters, even when the two groups were combined. Parkinsons patients with poor visual function show increased white matter damage over time, providing further evidence for visual function as a marker of imminent cognitive decline