Type 1 diabetes incidence in Scotland between 2006 and 2019

Funding Information: We acknowledge with gratitude the contributions of people and organisations involved in providing data, setting up, maintaining and overseeing collation of data for people with diabetes in Scotland. The Scottish Diabetes Research Network is supported by National Health Service (NHS) Research Scotland, a partnership involving Scottish NHS Boards and the Chief Scientist Office of the Scottish Government. We are grateful to Professor Paul McKeigue for advice on generation and interpretation of age‐period‐cohort models. Publisher Copyright: © 2023 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.Peer reviewedPublisher PD

Educational engagement, expectation and attainment of children with disabilities : evidence from the Scottish Longitudinal Study

Funding: UK Economic and Social Research Council (ESRC) funded Census and Administrative data LongitudinaL Studies Hub (CALLS Hub) project (ref ES/K000446/1).Government statistics show that children with special educational needs and disabilities do not achieve as well academically as their peers, which impacts on later employment and socioeconomic circumstances. Addressing these inequalities is a key policy area which currently lacks a satisfactory evidence base. To explore the issue, the present study used data from the Scottish Longitudinal Study which contains data from the 1991, 2001 and 2011 censuses along with other administrative data, from a representative sample of the Scottish population. Using this large and longitudinal sample, the present study examines educational engagement, expectations and attainment for children with self-reported disability, controlling for other early childhood factors. The results show that children with mental health problems were at higher risk of leaving school early, and that children with learning difficulties were less likely to gain advanced qualifications. Neither limiting long-term illness in early childhood or disability in adolescence were significant predictors of engagement, however they did predict measures of academic expectation and attainment. Results suggest there is a critical phase for attainment, with area deprivation in early childhood but not adolescence being important for later educational inequalities.Publisher PDFPeer reviewe

Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 2: Current management

info:eu-repo/semantics/publishedVersio

Screening intervals for diabetic retinopathy and incidence of visual loss: a systematic review

Screening for diabetic retinopathy can help to prevent this complication, but evidence regarding frequency of screening is uncertain. This paper systematically reviews the published literature on the relationship between screening intervals for diabetic retinopathy and the incidence of visual loss. The PubMed and EMBASE databases were searched until December 2012. Twenty five studies fulfilled the inclusion criteria, as these assessed the incidence/prevalence of sight‐threatening diabetic retinopathy in relation to screening frequency. The included studies comprised 15 evaluations of real‐world screening programmes, three studies modelling the natural history of diabetic retinopathy and seven cost‐effectiveness studies. In evaluations of diabetic retinopathy screening programmes, the appropriate screening interval ranged from one to four years, in people with no retinopathy at baseline. Despite study heterogeneity, the overall tendency observed in these programmes was that 2‐year screening intervals among people with no diabetic retinopathy at diagnosis were not associated with high incidence of sight‐threatening diabetic retinopathy. The modelling studies (non‐economic and economic) assessed a range of screening intervals (1–5 years). The aggregated evidence from both the natural history and cost‐effectiveness models favors a screening interval >1 year, but ≤2 years. Such an interval would be appropriate, safe and cost‐effective for people with no diabetic retinopathy at diagnosis, while screening intervals ≤1 year would be preferable for people with pre‐existing diabetic retinopathy. A 2‐year screening interval for people with no sight threatening diabetic retinopathy at diagnosis may be safely adopted. For patients with pre‐existing diabetic retinopathy, a shorter interval ≤1 year is warranted.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/100323/1/dme12274.pd

Myocardial infarction incidence and survival by ethnic group:Scottish Health and Ethnicity Linkage retrospective cohort study

Peer reviewedPublisher PD

A randomised controlled trial of a patient based Diabetes recall and Management system: the DREAM trial: A study protocol [ISRCTN32042030]

BACKGROUND: Whilst there is broad agreement on what constitutes high quality health care for people with diabetes, there is little consensus on the most efficient way of delivering it. Structured recall systems can improve the quality of care but the systems evaluated to date have been of limited sophistication and the evaluations have been carried out in small numbers of relatively unrepresentative settings. Hartlepool, Easington and Stockton currently operate a computerised diabetes register which has to date produced improvements in the quality of care but performance has now plateaued leaving substantial scope for further improvement. This study will evaluate the effectiveness and efficiency of an area wide 'extended' system incorporating a full structured recall and management system, actively involving patients and including clinical management prompts to primary care clinicians based on locally-adapted evidence based guidelines. METHODS: The study design is a two-armed cluster randomised controlled trial of 61 practices incorporating evaluations of the effectiveness of the system, its economic impact and its impact on patient wellbeing and functioning

Comparing the effectiveness of a multi-component weight loss intervention in adults with and without intellectual disabilities

<p>Background: The prevalence of obesity in adults with intellectual disabilities (ID) is rising, although the evidence base for its treatment in this population group is minimal. Weight management interventions that are accessible to adults with ID will reduce the inequalities that they frequently experience in health services. This short report compared the effectiveness of weight management in those with and without ID who completed nine sessions of a multi-component weight management programme.</p> <p>Methods: TAKE 5 is a 16-week multi-component weight management intervention for adults with ID and obesity [body mass index (BMI) ≥30 kg m–2]. This intervention is an adaption of the weight management programme provided by the Glasgow & Clyde Weight Management Service (GCWMS) for adults without ID and obesity (National Health Service based). Fifty-two participants of the TAKE 5 programme were individually matched by baseline characteristics (sex, age and BMI) with two participants without ID of the GCWMS programme. Comparisons in terms of weight and BMI change and rate of weight loss were made for those who attended all nine sessions.</p> <p>Results: There were no significant differences between the groups in the amount of weight loss (median: −3.6 versus −3.8 kg, respectively, P = 0.4), change in BMI (median: −1.5 versus −1.4 kg m–2, P = 0.9), success of achieving 5% weight loss (41.3% versus 36.8%, P = 0.9) and rate of weight loss across the 16-week intervention.</p> <p>Conclusions: A multi-component weight loss intervention can be equally effective for adults with and without ID and obesity.</p&gt

Weight management interventions in adults with intellectual disabilities and obesity: a systematic review of the evidence

o evaluate the clinical effectiveness of weight management interventions in adults with intellectual disabilities (ID) and obesity using recommendations from current clinical guidelines for the first line management of obesity in adults. Full papers on lifestyle modification interventions published between 1982 to 2011 were sought by searching the Medline, Embase, PsycINFO and CINAHL databases. Studies were evaluated based on 1) intervention components, 2) methodology, 3) attrition rate 4) reported weight loss and 5) duration of follow up. Twenty two studies met the inclusion criteria. The interventions were classified according to inclusion of the following components: behaviour change alone, behaviour change plus physical activity, dietary advice or physical activity alone, dietary plus physical activity advice and multi-component (all three components). The majority of the studies had the same methodological limitations: no sample size justification, small heterogeneous samples, no information on randomisation methodologies. Eight studies were classified as multi-component interventions, of which one study used a 600 kilocalorie (2510 kilojoule) daily energy deficit diet. Study durations were mostly below the duration recommended in clinical guidelines and varied widely. No study included an exercise program promoting 225–300 minutes or more of moderate intensity physical activity per week but the majority of the studies used the same behaviour change techniques. Three studies reported clinically significant weight loss (≥ 5%) at six months post intervention. Current data indicate weight management interventions in those with ID differ from recommended practice and further studies to examine the effectiveness of multi-component weight management interventions for adults with ID and obesity are justified

Hunting and Shooting:The Ambiguities of ‘Country Sports’

An introduction to sports shooting as an aspect of animal abuse and the criminal, social and environmental harms - direct, indirect and collateral - associated with the field sports shooting industry