Prevalence of psychosis in black ethnic minorities in Britain: analysis based on three national surveys

Purpose A considerable excess of psychosis in black ethnic minorities is apparent from clinical studies, in Britain, as in other developed economies with white majority populations. This excess is not so marked in population surveys. Equitable health service provision should be informed by the best estimates of the excess. We used national survey data to establish the difference in the prevalence of psychosis between black ethnic groups and the white majority in the British general population. Methods Analysis of the combined datasets (N = 26,091) from the British national mental health surveys of 1993, 2000 and 2007. Cases of psychosis were determined either by the use of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), or from a combination of screening items. We controlled for sex, age, social class, unemployment, design features and other putative confounders, using a Disease Risk Score. Results People from black ethnic minorities had an excess prevalence rate of psychosis compared with the white majority population. The OR, weighted for study design and response rate, was 2.72 (95 % CI 1.3–5.6, p = 0.002). This was marginally increased after controlling for potential confounders (OR = 2.90, 95 % CI 1.4–6.2, p = 0.006). Conclusions The excess of psychosis in black ethnic minority groups was similar to that in two previous British community surveys, and less than that based on clinical studies. Even so it confirms a considerable need for increased mental health service resources in areas with high proportions of black ethnic minority inhabitants

Influenza Vaccine Effectiveness in the Elderly Based on Administrative Databases: Change in Immunization Habit as a Marker for Bias

Administrative databases provide efficient methods to estimate influenza vaccine effectiveness (IVE) against severe outcomes in the elderly but are prone to intractable bias. This study returns to one of the linked population databases by which IVE against hospitalization and death in the elderly was first assessed. We explore IVE across six more recent influenza seasons, including periods before, during, and after peak activity to identify potential markers for bias.Acute respiratory hospitalization and all-cause mortality were compared between immunized/non-immunized community-dwelling seniors ≥65 years through administrative databases in Manitoba, Canada between 2000-01 and 2005-06. IVE was compared during pre-season/influenza/post-season periods through logistic regression with multivariable adjustment (age/sex/income/residence/prior influenza or pneumococcal immunization/medical visits/comorbidity), stratification based on prior influenza immunization history, and propensity scores. Analysis during pre-season periods assessed baseline differences between immunized and unimmunized groups. The study population included ∼140,000 seniors, of whom 50-60% were immunized annually. Adjustment for key covariates and use of propensity scores consistently increased IVE. Estimates were paradoxically higher pre-season and for all-cause mortality vs. acute respiratory hospitalization. Stratified analysis showed that those twice consecutively and currently immunized were always at significantly lower hospitalization/mortality risk with odds ratios (OR) of 0.60 [95%CI0.48-0.75] and 0.58 [0.53-0.64] pre-season and 0.77 [0.69-0.86] and 0.71 [0.66-0.77] during influenza circulation, relative to the consistently unimmunized. Conversely, those forgoing immunization when twice previously immunized were always at significantly higher hospitalization/mortality risk with OR of 1.41 [1.14-1.73] and 2.45 [2.21-2.72] pre-season and 1.21 [1.03-1.43] and 1.78 [1.61-1.96] during influenza circulation.The most pronounced IVE estimates were paradoxically observed pre-season, indicating bias tending to over-estimate vaccine protection. Change in immunization habit from that of the prior two years may be a marker for this bias in administrative data sets; however, no analytic technique explored could adjust for its influence. Improved methods to achieve valid interpretation of protection in the elderly are needed

Variations in the pre-operative status of patients coming to primary hip replacement for osteoarthritis in European orthopaedic centres.

addresses: Nuffield Department of Orthopaedic Surgery, University of Oxford, Nuffield Orthopaedic Centre, Headington, Oxford, UK. [email protected]: PMCID: PMC2654855types: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't© 2009 Dieppe et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Total hip joint replacement (THR) is a high volume, effective intervention for hip osteoarthritis (OA). However, indications and determinants of outcome remain unclear. The 'EUROHIP consortium' has undertaken a cohort study to investigate these questions. This paper describes the variations in disease severity in this cohort and the relationships between clinical and radiographic severity, and explores some of the determinants of variation

A perspective on SIDS pathogenesis. The hypotheses: plausibility and evidence

Several theories of the underlying mechanisms of Sudden Infant Death Syndrome (SIDS) have been proposed. These theories have born relatively narrow beach-head research programs attracting generous research funding sustained for many years at expense to the public purse. This perspective endeavors to critically examine the evidence and bases of these theories and determine their plausibility; and questions whether or not a safe and reasoned hypothesis lies at their foundation. The Opinion sets specific criteria by asking the following questions: 1. Does the hypothesis take into account the key pathological findings in SIDS? 2. Is the hypothesis congruent with the key epidemiological risk factors? 3. Does it link 1 and 2? Falling short of any one of these answers, by inference, would imply insufficient grounds for a sustainable hypothesis. Some of the hypotheses overlap, for instance, notional respiratory failure may encompass apnea, prone sleep position, and asphyxia which may be seen to be linked to co-sleeping. For the purposes of this paper, each element will be assessed on the above criteria

Increasing Access and Capabilities of CubeSats for Investigation of Earth Trojan Asteroids

Thesis (Ph.D.)--University of Washington, 2020This thesis develops the requirements of a low-cost spacecraft mission to the Sun-Earth Lagrange point L4 and L5 to search for Earth Trojan asteroids, and develops and demonstrates a specialized communication system needed to facilitate such a mission. Asteroids serve as time capsules into the historical past of our solar system, and have been critical components to our understanding of the formation and evolution of our solar system. A subset of Earth co-orbital asteroids, Earth Trojans, being close to our home can help us understand things like the conditions present during Earth’s initial formation or the Moon-Earth formation impact theory. Considering there is only one identified Earth Trojan asteroid, 2010 TK7, and the fact that numerical analysis and additional searches support a population of at least one hundred Trojans, a dedicated mission is well warranted. With the Earth Trojan asteroid regions particularly difficult to view when using Earth-based telescopes, an alternative approach is described herein: send a small low-cost spacecraft, called a CubeSat, directly to these regions for in-situ imaging. CubeSats present a paradigm shift in spacecraft development and are beginning to offer a new low-cost and highly accessible regime to Earth and space science. CubeSats are small, typically 1-10L and 1-10kg, and leverage the recent miniaturization of smartphones and their related technologies. The result is that in the past 10 years CubeSats have proven themselves to be invaluable for carrying out Earth-based science missions at a fraction of the cost using traditional methods. And more recently CubeSats have begun to leave Earth orbit, such as providing an auxiliary communication relay role on the latest NASA Mars mission. With ever increasing fiscal pressures limiting the development of planetary probes, developments herein lay the groundwork for an Earth Trojan prospecting mission costing less than $500,000. This mission is facilitated by the developments of a compact communication system described in this thesis that includes: (1) low-cost application of high-gain reflectarray antenna technology to the CubeSat form factor, and (2) low-cost and low-risk design technique development of radio frequency circuitry needed to interface with the antenna. Furthermore, development of a CubeSat demonstrator mission was undertaken, called the HuskySat-1, providing proof of concept implementations of these technologies as well as additional technological innovations required to support a deep space mission to the Earth Trojans. The HuskySat-1 successfully deployed into a low-Earth orbit on January 31, 2020 with operational success

Message source characteristics and employee assistance program advertising : beliefs in program effectiveness and intentions to self- refer

Research indicates that the majority of clients seeking Employee Assistance Program (EAP) services are self-referred, and that a relationship exists between self-referral and the belief that an EAP is effective. Fifty-three subjects read an advertisement proclaiming that a fictitious EAP was effective. Following the Elaboration Likelihood Model (ELM), motivation to elaborate upon the advertisement's arguments was manipulated and two message sources (EAP clients; a fictitious professional consulting firm) were used. Although motivation had no effect on subjects' belief that the EAP was effective or their intention to self-refer, participants exposed to the less expert, trustworthy, and believable source (EAP clients) experienced a greater reduction in their self-referral intention than participants exposed to the more expert, trustworthy, and believable source (consulting firm). A positive correlation between belief in the EAP and self-referral intention was found. Implications for the ELM, EAP advertising, and research are discussed.Thesis (M.A.)Department of Counseling Psychology and Guidance Service

Design in perspective: reflections on intercultural design practice in Australia

Since the 1970s, a number of Australian architects have been considering how non-Indigenous designers can work with Aboriginal and Torres Strait Islander people to achieve better built environments. A consistent message from this work has been the importance of employing inclusive, respectful, cross-cultural processes that engage the client and end-users, understand the history of the people and place, and share knowledge and expertise in the process