Effects of Neighbourhood Income on Reported Body Mass Index: An Eight Year Longitudinal Study of Canadian Children

Background: This study investigates the effects of neighbourhood income on children\u27s BodyMass Index (BMI) from childhood (ages 2–3) to early adolescence (ages 10–11) using longitudinaldata. Methods: Five cycles of data from the Canadian National Longitudinal Survey of Children andYouth are analyzed for a sub-sample of children (n = 2152) aged 2–3 at baseline (1994) and assessedat two year intervals to 2002. Body mass index percentiles are based on height/weight estimatesreported by proxy respondents (child\u27s person most knowledgeable). Family and neighbourhoodfactors were assessed at baseline. The prevalence of neighbourhood low income was obtained fromthe 1996 Census and divided into three categories from \u27most poor\u27 to \u27least poor\u27. Longitudinalmodelling techniques were applied to the data. Results: After controlling for individual/family factors (age, sex, income, education, familystructure) living in the \u27most poor\u27 neighbourhood was associated with increasing BMI percentile(1.46, 95% CI 0.16 to 2.75) over time compared to a \u27middle\u27 income neighbourhood. Living in anurban (vs. rural) neighbourhood was associated with a decreased BMI percentile (-3.57, 95% CI -6.38 to -0.76) across all time periods. Conclusion: These findings provide evidence that effects of neighbourhood disadvantage onchildren\u27s BMI occur between childhood and early adolescence and suggest that policies shouldtarget the conditions of childhood, including the neighbourhood environment

The role of urban municipal governments in reducing health inequities: A meta-narrative mapping analysis

<p>Abstract</p> <p>Background</p> <p>The 1986 Ottawa Charter for Health Promotion coincided with a preponderance of research, worldwide, on the social determinants of health and health inequities. Despite the establishment of a 'health inequities knowledge base', the precise roles for municipal governments in reducing health inequities at the local level remain poorly defined. The objective of this study was to monitor thematic trends in this knowledge base over time, and to track scholarly prescriptions for municipal government intervention on local health inequities.</p> <p>Methods</p> <p>Using meta-narrative mapping, four bodies of scholarly literature - 'health promotion', 'Healthy Cities', 'population health' and 'urban health' - that have made substantial contributions to the health inequities knowledge base were analyzed over the 1986-2006 timeframe. Article abstracts were retrieved from the four literature bodies using three electronic databases (PubMed, Sociological Abstracts, Web of Science), and coded for bibliographic characteristics, article themes and determinants of health profiles, and prescriptions for municipal government interventions on health inequities.</p> <p>Results</p> <p>1004 journal abstracts pertaining to health inequities were analyzed. The overall quantity of abstracts increased considerably over the 20 year timeframe, and emerged primarily from the 'health promotion' and 'population health' literatures. 'Healthy lifestyles' and 'healthcare' were the most commonly emphasized themes in the abstracts. Only 17% of the abstracts articulated prescriptions for municipal government interventions on local health inequities. Such interventions included public health campaigns, partnering with other governments and non-governmental organizations for health interventions, and delivering effectively on existing responsibilities to improve health outcomes and reduce inequities. Abstracts originating from Europe, and from the 'Healthy Cities' and 'urban health' literatures, were most vocal regarding potential avenues for municipal government involvement on health inequities.</p> <p>Conclusions</p> <p>This study has demonstrated a pervasiveness of 'behavioural' and 'biomedical' perspectives, and a lack of consideration afforded to the roles and responsibilities of municipal governments, among the health inequities scholarly community. Thus, despite considerable research activity over the past two decades, the 'health inequities knowledge base' inadequately reflects the complex aetiology of, and solutions to, population health inequities.</p

Using GIS-based methods of multicriteria analysis to construct socio-economic deprivation indices

<p>Abstract</p> <p>Background</p> <p>Over the past several decades researchers have produced substantial evidence of a social gradient in a variety of health outcomes, rising from systematic differences in income, education, employment conditions, and family dynamics within the population. Social gradients in health are measured using deprivation indices, which are typically constructed from aggregated socio-economic data taken from the national census – a technique which dates back at least until the early 1970's. The primary method of index construction over the last decade has been a Principal Component Analysis. Seldom are the indices constructed from survey-based data sources due to the inherent difficulty in validating the subjectivity of the response scores. We argue that this very subjectivity can uncover spatial distributions of local health outcomes. Moreover, indication of neighbourhood socio-economic status may go underrepresented when weighted without expert opinion. In this paper we propose the use of geographic information science (GIS) for constructing the index. We employ a GIS-based Order Weighted Average (OWA) Multicriteria Analysis (MCA) as a technique to validate deprivation indices that are constructed using more qualitative data sources. Both OWA and traditional MCA are well known and used methodologies in spatial analysis but have had little application in social epidemiology.</p> <p>Results</p> <p>A survey of British Columbia's Medical Health Officers (MHOs) was used to populate the MCA-based index. Seven variables were selected and weighted based on the survey results. OWA variable weights assign both local and global weights to the index variables using a sliding scale, producing a range of variable scenarios. The local weights also provide leverage for controlling the level of uncertainty in the MHO response scores. This is distinct from traditional deprivation indices in that the weighting is simultaneously dictated by the original respondent scores and the value of the variables in the dataset.</p> <p>Conclusion</p> <p>OWA-based MCA is a sensitive instrument that permits incorporation of expert opinion in quantifying socio-economic gradients in health status. OWA applies both subjective and objective weights to the index variables, thus providing a more rational means of incorporating survey results into spatial analysis.</p

Is there a north-south divide between schools in England?

The article is an opinion piece which examines the extent to which rhetoric about a north-south divide in performance between schools in England is justified. Starting with the catalyst, Sir Michael Wilshaw’s final annual Ofsted reports in 2015 and 2016, it traces how the divide rhetoric has been assimilated into popular discourse by the media and subsequent policy reports, notably in connection with the Northern Powerhouse agenda. The article uses regional school performance data to examine whether claims about the divide are convincing, focusing on the North East which has been recognised as an outlier in both primary and secondary performance. It concludes that the case for a north-south divide is not proven and with an appeal for more contextually sensitive and flexible approaches to assessing local, regional and national school performance to counter the negative effects of this divisive rhetoric

The structural role of elastic fibres in the cornea investigated using a mouse model for Marfan syndrome

Purpose: The presence of fibrillin-rich elastic fibers in the cornea has been overlooked in recent years. The aim of the current study was to elucidate their functional role using a mouse model for Marfan syndrome, defective in fibrillin-1, the major structural component of the microfibril bundles that constitute most of the elastic fibers. Methods: Mouse corneas were obtained from animals with a heterozygous fibrillin-1 mutation (Fbn1+/−) and compared to wild type controls. Corneal thickness and radius of curvature were calculated using optical coherence tomography microscopy. Elastic microfibril bundles were quantified and visualized in three-dimensions using serial block face scanning electron microscopy. Transmission electron microscopy was used to analyze stromal ultrastructure and proteoglycan distribution. Center-to-center average interfibrillar spacing was determined using x-ray scattering. Results: Fbn1+/− corneas were significantly thinner than wild types and displayed a higher radius of curvature. In the Fbn1+/− corneas, elastic microfibril bundles were significantly reduced in density and disorganized compared to wild-type controls, in addition to containing a higher average center-to-center collagen interfibrillar spacing in the center of the cornea. No other differences were detected in stromal ultrastructure or proteoglycan distribution between the two groups. Proteoglycan side chains appeared to colocalize with the microfibril bundles. Conclusions: Elastic fibers have an important, multifunctional role in the cornea as highlighted by the differences observed between Fbn1+/− and wild type animals. We contend that the presence of normal quantities of structurally organized elastic fibers are required to maintain the correct geometry of the cornea, which is disrupted in Marfan syndrome

Improving Phrap-Based Assembly of the Rat Using “Reliable” Overlaps

The assembly methods used for whole-genome shotgun (WGS) data have a major impact on the quality of resulting draft genomes. We present a novel algorithm to generate a set of “reliable” overlaps based on identifying repeat k-mers. To demonstrate the benefits of using reliable overlaps, we have created a version of the Phrap assembly program that uses only overlaps from a specific list. We call this version PhrapUMD. Integrating PhrapUMD and our “reliable-overlap” algorithm with the Baylor College of Medicine assembler, Atlas, we assemble the BACs from the Rattus norvegicus genome project. Starting with the same data as the Nov. 2002 Atlas assembly, we compare our results and the Atlas assembly to the 4.3 Mb of rat sequence in the 21 BACs that have been finished. Our version of the draft assembly of the 21 BACs increases the coverage of finished sequence from 93.4% to 96.3%, while simultaneously reducing the base error rate from 4.5 to 1.1 errors per 10,000 bases. There are a number of ways of assessing the relative merits of assemblies when the finished sequence is available. If one views the overall quality of an assembly as proportional to the inverse of the product of the error rate and sequence missed, then the assembly presented here is seven times better. The UMD Overlapper with options for reliable overlaps is available from the authors at http://www.genome.umd.edu. We also provide the changes to the Phrap source code enabling it to use only the reliable overlaps

Nonpromoter methylation of the CDKN2A gene with active transcription is associated with improved locoregional control in laryngeal squamous cell carcinoma

We previously reported a novel association between CDKN2A nonpromoter methylation and transcription (ARF/INK4a) in human papillomavirus associated oropharyngeal tumors. In this study we assessed whether nonpromoter CDKN2A methylation in laryngeal squamous cell carcinomas (LXSCC) conferred a similar association with transcription that predicted patient outcome. We compared DNA methylation and ARF/INK4a RNA expression levels for the CDKN2A locus using the Illumina HumanMethylation27 beadchip and RT-PCR in 43 LXSCC tumor samples collected from a prospective study of head and neck cancer patients treated at Montefiore Medical Center (MMC). Validation was performed using RNAseq data on 111 LXSCC tumor samples from the Cancer Genome Atlas (TCGA). The clinical relevance of combined nonpromoter CDKN2A methylation and transcription was assessed by multivariate Cox regression for locoregional recurrence on a subset of 69 LXSCC patients with complete clinicopathologic data from the MMC and TCGA cohorts. We found evidence of CDKN2A nonpromoter hypermethylation in a third of LXSCC from our MMC cohort, which was significantly associated with increased ARF and INK4a RNA expression (Wilcoxon rank-sum, P = 0.007 and 0.003, respectively). A similar association was confirmed in TCGA samples (Wilcoxon rank-sum test P < 0.0001 for ARF and INK4a). Patients with CDKN2A hypermethylation or high ARF/INK4a expression were significantly less likely to develop a locoregional recurrence compared to those with neither of the features, independent of other clinicopatholgic risk factors (adjusted hazard ratio=0.21, 95% confidence interval:0.05-0.81). These results support the conclusion that CDKN2A nonpromoter methylation is associated with increased ARF and INK4a RNA expression, and improved locoregional control in LXSCC

Newly qualified doctors' views about whether their medical school had trained them well: questionnaire surveys

A survey of newly qualified doctors in the UK in 2000/2001 found that 42% of them felt unprepared for their first year of employment in clinical posts. We report on how UK qualifiers' preparedness has changed since then, and on the impact of course changes upon preparedness. Methods Postal questionnaires were sent to all doctors who qualified from UK medical schools, in their first year of clinical work, in 2003 (n = 4257) and 2005 (n = 4784); and findings were compared with those in 2000/2001 (n = 5330). The response rates were 67% in 2000/2001, 65% in 2003, and 43% in 2005. The outcome measure was the percentage of doctors agreeing with the statement "My experience at medical school has prepared me well for the jobs I have undertaken so far". Results In the 2000/2001 survey 36.3% strongly agreed or agreed with the statement, as did 50.3% in the 2003 survey and 58.5% in 2005 (chi-squared test for linear trend: χ2 = 259.5; df = 1; p < 0.001). Substantial variation in preparedness between doctors from different medical schools, reported in the first survey, was still present in 2003 and 2005. Between 1998 and 2006 all UK medical schools updated their courses. Within each cohort a significantly higher percentage of the respondents from schools with updated courses felt well prepared. Conclusion UK medical schools are now training doctors who feel better prepared for work than in the past. Some of the improvement may be attributable to curricular change