Socioeconomic risk, parenting during the preschool years and child health age 6 years

Parent–child relationships and parenting processes are emerging as potential life course determinants of health. Parenting is socially patterned and could be one of the factors responsible for the negative effects of social inequalities on health, both in childhood and adulthood. This study tests the hypothesis that some of the effect of socioeconomic risk on health in mid childhood is transmitted via early parenting. Methods: Prospective cohort study in 10 USA communities involving 1041 mother/ child pairs, selected at birth at random with conditional sampling. Exposures: income, maternal education, maternal age, lone parenthood, ethnic status and objective assessments of mother child interaction in the first 4 years of life covering warmth, negativity and positive control. Outcomes: mother’s report of child’s health in general at 6 years. Modelling: multiple regression analyses with statistical testing of mediational processes. Results: All five indicators of socioeconomic status (SES) were correlated with all three measures of parenting, such that low SES was associated with poor parenting. Among the measures of parenting maternal warmth was independently predictive of future health, and among the socioeconomic variables maternal education, partner presence and ‘other ethnic group’ proved predictive. Measures of parenting significantly mediated the impact of measures of SES on child health. Conclusions: Parenting mediates some, but not all of the detectable effects of socioeconomic risk on health in childhood. As part of a package of measures that address other determinants, interventions to support parenting are likely to make a useful contribution to reducing childhood inequalities in health

GlobSim (v1.0): Deriving meteorological time series for point locations from multiple global reanalyses

Simulations of land-surface processes and phenomena often require driving time series of meteorological variables. Corresponding observations, however, are unavailable in most locations, even more so, when considering the duration, continuity and data quality required. Atmospheric reanalyses provide glo

Predicting the Fine Particle Fraction of Dry Powder Inhalers Using Artificial Neural Networks

This document is the Accepted Manuscript version of a Published Work that appeared in final form in Journal of Pharmaceutical Sciences after peer review and technical editing by the publisher. Under embargo. Embargo end date: 9 November 2017. The version of record, Joanna Muddle, Stewart B. Kirton, Irene Parisini, Andrew Muddle, Darragh Murnane, Jogoth Ali, Marc Brown, Clive Page and Ben Forbes, ‘Predicting the Fine Particle Fraction of Dry Powder Inhalers Using Artificial Neural Networks’, Journal of Pharmaceutical Sciences, Vol 106(1): 313-321, first published online on 9 November 2016, is available online via doi: http://dx.doi.org/10.1016/j.xphs.2016.10.002 0022-3549/© 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.Dry powder inhalers are increasingly popular for delivering drugs to the lungs for the treatment of respiratory diseases, but are complex products with multivariate performance determinants. Heuristic product development guided by in vitro aerosol performance testing is a costly and time-consuming process. This study investigated the feasibility of using artificial neural networks (ANNs) to predict fine particle fraction (FPF) based on formulation device variables. Thirty-one ANN architectures were evaluated for their ability to predict experimentally determined FPF for a self-consistent dataset containing salmeterol xinafoate and salbutamol sulfate dry powder inhalers (237 experimental observations). Principal component analysis was used to identify inputs that significantly affected FPF. Orthogonal arrays (OAs) were used to design ANN architectures, optimized using the Taguchi method. The primary OA ANN r2 values ranged between 0.46 and 0.90 and the secondary OA increased the r2 values (0.53-0.93). The optimum ANN (9-4-1 architecture, average r2 0.92 ± 0.02) included active pharmaceutical ingredient, formulation, and device inputs identified by principal component analysis, which reflected the recognized importance and interdependency of these factors for orally inhaled product performance. The Taguchi method was effective at identifying successful architecture with the potential for development as a useful generic inhaler ANN model, although this would require much larger datasets and more variable inputs.Peer reviewe

Measuring the impact and costs of a universal group based parenting programme : protocol and implementation of a trial

Background Sub-optimal parenting is a common risk factor for a wide range of negative health, social and educational outcomes. Most parenting programmes have been developed in the USA in the context of delinquency prevention for targeted or indicated groups and the main theoretical underpinning for these programmes is behaviour management. The Family Links Nurturing Programme (FLNP) focuses on family relationships as well as behaviour management and is offered on a universal basis. As a result it may be better placed to improve health and educational outcomes. Developed in the UK voluntary sector, FLNP is popular with practitioners, has impressed policy makers throughout the UK, has been found to be effective in before/after and qualitative studies, but lacks a randomised controlled trial (RCT) evidence base. Methods/Design A multi-centre, investigator blind, randomised controlled trial of the FLNP with a target sample of 288 south Wales families who have a child aged 2-4 yrs living in or near to Flying Start/Sure Start areas. Changes in parenting, parent child relations and parent and child wellbeing are assessed with validated measures immediately and at 6 months post intervention. Economic components include cost consequences and cost utility analyses based on parental ranking of states of quality of life. Attendance and completion rates and fidelity to the FLNP course delivery are assessed. A nested qualitative study will assess reasons for participation and non-participation and the perceived value of the programme to families. By the end of May 2010, 287 families have been recruited into the trial across four areas of south Wales. Recruitment has not met the planned timescales with barriers including professional anxiety about families entering the control arm of the trial, family concern about video and audio recording, programme facilitator concern about the recording of FLNP sessions for fidelity purposes and delays due to the new UK research governance procedures. Discussion Whilst there are strong theoretical arguments to support universal provision of parenting programmes, few universal programmes have been subjected to randomised controlled trials. In this paper we describe a RCT protocol with quantitative and qualitative outcome measures and an economic evaluation designed to provide clear evidence with regard to effectiveness and costs. We describe challenges implementing the protocol and how we are addressing these

Cardiovascular disease risk profile and microvascular complications of diabetes: comparison of Indigenous cohorts with diabetes in Australia and Canada

<p>Abstract</p> <p>Background</p> <p>Indigenous populations of Australia and Canada experience disproportionately high rates of chronic disease. Our goal was to compare cardiovascular (CVD) risk profile and diabetes complications from three recent comprehensive studies of diabetes complications in different Indigenous populations in Australia and Canada.</p> <p>Methods</p> <p>We compared participants from three recent studies: remote Indigenous Australians (2002-2003, n = 37 known diabetes), urban Indigenous Australians (2003-2005, n = 99 known diabetes), and remote Aboriginal Canadians (2001-2002, n = 188 known diabetes).</p> <p>Results</p> <p>The three groups were similar for HbA1c, systolic BP, diabetes duration. Although leaner by body-mass-index criteria, remote Indigenous Australians displayed a more adverse CVD risk profile with respect to: waist-hip-ratio (1.03, 0.99, 0.94, remote Indigenous Australians, urban Indigenous Australians, remote Canadians, p < 0.001); HDL-cholesterol (0.82, 0.96, 1.17 mmol/L, p < 0.001); urine albumin-creatinine-ratio (10.3, 2.4, 4.5 mg/mmol); and C-reactive protein. With respect to diabetes complications, microalbuminuria (50%, 25%, 41%, p = 0.001) was more common among both remote groups than urban Indigenous Australians, but there were no differences for peripheral neuropathy, retinopathy or peripheral vascular disease.</p> <p>Conclusions</p> <p>Although there are many similarities in diabetes phenotype in Indigenous populations, this comparison demonstrates that CVD risk profiles and diabetes complications may differ among groups. Irrespective, management and intervention strategies are required from a young age in Indigenous populations and need to be designed in consultation with communities and tailored to community and individual needs.</p

Nuclear Shell Model Calculations of Neutralino-Nucleus Cross Sections for Silicon 29 and Germanium 73

We present the results of detailed nuclear shell model calculations of the spin-dependent elastic cross section for neutralinos scattering from \si29 and \ge73. The calculations were performed in large model spaces which adequately describe the configuration mixing in these two nuclei. As tests of the computed nuclear wave functions, we have calculated several nuclear observables and compared them with the measured values and found good agreement. In the limit of zero momentum transfer, we find scattering matrix elements in agreement with previous estimates for \si29 but significantly different than previous work for \ge73. A modest quenching, in accord with shell model studies of other heavy nuclei, has been included to bring agreement between the measured and calculated values of the magnetic moment for \ge73. Even with this quenching, the calculated scattering rate is roughly a factor of 2 higher than the best previous estimates; without quenching, the rate is a factor of 4 higher. This implies a higher sensitivity for germanium dark matter detectors. We also investigate the role of finite momentum transfer upon the scattering response for both nuclei and find that this can significantly change the expected rates. We close with a brief discussion of the effects of some of the non-nuclear uncertainties upon the matrix elements.Comment: 31 pages, figures avaiable on request, UCRL-JC-11408

Efficient Parallel Statistical Model Checking of Biochemical Networks

We consider the problem of verifying stochastic models of biochemical networks against behavioral properties expressed in temporal logic terms. Exact probabilistic verification approaches such as, for example, CSL/PCTL model checking, are undermined by a huge computational demand which rule them out for most real case studies. Less demanding approaches, such as statistical model checking, estimate the likelihood that a property is satisfied by sampling executions out of the stochastic model. We propose a methodology for efficiently estimating the likelihood that a LTL property P holds of a stochastic model of a biochemical network. As with other statistical verification techniques, the methodology we propose uses a stochastic simulation algorithm for generating execution samples, however there are three key aspects that improve the efficiency: first, the sample generation is driven by on-the-fly verification of P which results in optimal overall simulation time. Second, the confidence interval estimation for the probability of P to hold is based on an efficient variant of the Wilson method which ensures a faster convergence. Third, the whole methodology is designed according to a parallel fashion and a prototype software tool has been implemented that performs the sampling/verification process in parallel over an HPC architecture

Isolated Horizons: Hamiltonian Evolution and the First Law

A framework was recently introduced to generalize black hole mechanics by replacing stationary event horizons with isolated horizons. That framework is significantly extended. The extension is non-trivial in that not only do the boundary conditions now allow the horizon to be distorted and rotating, but also the subsequent analysis is based on several new ingredients. Specifically, although the overall strategy is closely related to that in the previous work, the dynamical variables, the action principle and the Hamiltonian framework are all quite different. More importantly, in the non-rotating case, the first law is shown to arise as a necessary and sufficient condition for the existence of a consistent Hamiltonian evolution. Somewhat surprisingly, this consistency condition in turn leads to new predictions even for static black holes. To complement the previous work, the entire discussion is presented in terms of tetrads and associated (real) Lorentz connections.Comment: 56 pages, 1 figure, Revtex; Final Version, to appear in PR

Noise storm continua: power estimates for electron acceleration

We use a generic stochastic acceleration formalism to examine the power $L_{\rm in}$ (${\rm erg s^{-1}}$) input to nonthermal electrons that cause noise storm continuum emission. The analytical approach includes the derivation of the Green's function for a general second-order Fermi process, and its application to obtain the particular solution for the nonthermal electron distribution resulting from the acceleration of a Maxwellian source in the corona. We compare $L_{\rm in}$ with the power $L_{\rm out}$ observed in noise storm radiation. Using typical values for the various parameters, we find that $L_{\rm in} \sim 10^{23-26}$ ${\rm erg s^{-1}}$, yielding an efficiency estimate $\eta \equiv L_{\rm out}/L_{\rm in}$ in the range 10^{-10} \lsim \eta \lsim 10^{-6} for this nonthermal acceleration/radiation process. These results reflect the efficiency of the overall process, starting from electron acceleration and culminating in the observed noise storm emission.Comment: Accepted for publication in Solar Physic

Pharmacists in Pharmacovigilance: Can Increased Diagnostic Opportunity in Community Settings Translate to Better Vigilance?

The pharmacy profession has undergone substantial change over the last two to three decades. Whilst medicine supply still remains a central function, pharmacist’s roles and responsibilities have become more clinic and patient focused. In the community (primary care), pharmacists have become important providers of healthcare as Western healthcare policy advocates patient self-care. This has resulted in pharmacists taking on greater responsibility in managing minor illness and the delivery of public health interventions. These roles require pharmacists to more fully use their clinical skills, and often involve diagnosis and therapeutic management. Community pharmacists are now, more than ever before, in a position to identify, record and report medication safety incidents. However, current research suggests that diagnostic ability of community pharmacists is questionable and they infrequently report to local or national schemes. The aim of this paper is to highlight current practice and suggest ways in which community pharmacy can more fully contribute to patient safety