Quantifying the Socio-Economic Benefits of Reducing Industrial Dietary Trans Fats: Modelling Study.

BACKGROUND: Coronary Heart Disease (CHD) remains a leading cause of UK mortality, generating a large and unequal burden of disease. Dietary trans fatty acids (TFA) represent a powerful CHD risk factor, yet to be addressed in the UK (approximately 1% daily energy) as successfully as in other nations. Potential outcomes of such measures, including effects upon health inequalities, have not been well quantified. We modelled the potential effects of specific reductions in TFA intake on CHD mortality, CHD related admissions, and effects upon socioeconomic inequalities. METHODS & RESULTS: We extended the previously validated IMPACTsec model, to estimate the potential effects of reductions (0.5% & 1% reductions in daily energy) in TFA intake in England and Wales, stratified by age, sex and socioeconomic circumstances. We estimated reductions in expected CHD deaths in 2030 attributable to these two specific reductions. Output measures were deaths prevented or postponed, life years gained and hospital admissions. A 1% reduction in TFA intake energy intake would generate approximately 3,900 (95% confidence interval (CI) 3,300-4,500) fewer deaths, 10,000 (8,800-10,300) (7% total) fewer hospital admissions and 37,000 (30,100-44,700) life years gained. This would also reduce health inequalities, preventing five times as many deaths and gaining six times as many life years in the most deprived quintile compared with the most affluent. A more modest reduction (0.5%) would still yield substantial health gains. CONCLUSIONS: Reducing intake of industrial TFA could substantially decrease CHD mortality and hospital admissions, and gain tens of thousands of life years. Crucially, this policy could also reduce health inequalities. UK strategies should therefore aim to minimise industrial TFA intake

Trends in morbidity and mortality in patients with diabetes in England

Diabetes Mellitus (DM) is a leading public health priority throughout the world. An estimated 463 million adults currently have DM worldwide. People with DM face an increased risk of several macro and microvascular complications and premature mortality. My thesis aims to estimate trends in hospitalisations and mortality in patients with diabetes over the past 20 years in England. Data were extracted from the Clinical Practice Research Datalink, a primary care database, for 628,811 adults from 1998 to 2018 with diagnosed DM. 313,907 of these adults had their primary care records linked to the Office for National Statistics mortality statistics and Hospital Episode Statistics inpatient admissions data. I identified age, sex matched non-DM adults at a ratio of one to one with the DM study population. I used discretised Poisson regression models, adjusted for age, year, DM status and duration, to estimate annual all-cause death and cause-specific death and hospitalisation rates in adults with and without DM over the past 20-years. I also used Logistic regression models to estimate trends in five-year risk of hospitalisation and mortality for sentinel DM complications following diagnosis. All-cause mortality has declined in adults with DM by approximately 30% from 2001-2018. There were mixed trends in cause-specific mortality with large reductions in cardiovascular disease (CVD) mortality alongside more modest declines in other conditions. This led to cancer becoming the leading cause of death in adults with DM. There were mixed trends across cause groupings in hospitalisation rates over a similar period. There were declines in DM-specific aetiological complications including CVD, amputations, and DM itself alongside increases in infections, cancers, and respiratory conditions. During this period, the 5-year risk of hospitalisation for sentinel DM-specific aetiological complications after diagnosis generally declined with the largest reductions in AMI and stroke hospitalisation risk. Changes in the composition of absolute and excess mortality and hospitalisation in adults with DM means that therapeutic, clinical and preventative programmes should be broadened to reflect the diverse set of causes driving persistent excess mortality and morbidity in this patient group.Open Acces

3D Modeling Case-Geyer: A Pilot Project Immersive Technology Summer Institute 2018

The purpose of this project is to produce a virtual 3D model of the Case-Geyer Library using the computers and 3D- modeling software available at the Ho Tung Visualization Laboratory (“VisLab”) for several potential future uses

Young adults as users of adult healthcare : experiences of young adults with complex or life-limiting conditions

Awareness is growing that young adults may have distinctive experiences of adult healthcare and that their needs may differ from those of other adult users. In addition, the role of adult health teams in supporting positive transitions from paediatrics is increasingly under discussion. This paper contributes to these debates. It reports a qualitative study of the experiences of young adults - all with complex chronic health conditions - as users of adult health services. Key findings from the study are reported, including an exploration of factors that help to explain interviewees' experiences. Study findings are discussed in the context of existing evidence from young adults in adult healthcare settings and theories of 'young adulthood'. Implications for training and practice are considered, and priorities for future research are identified

Replacing home visits with telephone calls to support parents implementing a sleep management intervention : findings from a pilot study and implications for future research

Background - Resource constraints may inhibit the provision of appropriate interventions for children with neurodisabilities presenting with behavioural sleep problems. Telephone calls (TC), as opposed to home visits (HV), may be a more resource efficient means of supporting these families. Objective - To conduct a preliminary investigation exploring the feasibility and acceptability of replacing HV with TC to support parents implementing sleep management strategies and to gather evidence to inform the design and methods of a full trial. Methods - Parents referred to a sleep management intervention routinely delivered by a community paediatric team were alternately allocated to receive implementation support via HV (n = 7) or TC (n = 8). Activity logs recorded the frequency, duration and mode of support. Parents and practitioners were interviewed about their experiences of receiving/delivering the intervention. Results - Intervention drop-out was low, the frequency, number of contacts and intervention duration appeared comparable. Parents allocated TC received less contact time. Parents valued implementation support irrespective of delivery mode and practitioners reported that despite initial reservations, implementation support via TC appeared to work well. Conclusions - TC appears an acceptable and convenient mode of delivering sleep support, valued by both parents and practitioners. We recommend a full-scale trial to investigate effectiveness

The development, testing and characterisation of a straw tracking detector and readout system for the Fermilab muon g-2 experiment

The anomalous magnetic moments of leptons can be both measured and theoretically predicted with high precision, and as such provide stringent tests of the Standard Model (SM) of particle physics. The anomalous magnetic moment of the muon, in particular offers sensitivity to new physics within the reach of current experiments. The current world’s best measurement of muon anomalous magnetic moment made at the Brookhaven National Laboratory (BNL) deviates from the SM prediction by over 3σ, providing a tantalising but inconclusive hint that contributions from new physics may be present. A new muon anomalous magnetic moment experiment is currently under construction at the Fermi National Accelerator Laboratory (Fermilab), known as the Fermilab muon g-2 experiment. Due to commence in 2017, this new experiment is expected to improve the experimental measurement precision of the muon anomalous magnetic moment by a factor of 4, and is seeking to confirm or reject the current discrepancy. The experiment, like its BNL predecessor, will measure the precession of the muon spin in a magnetic storage-ring. This new experiment has three straw tracking detectors used to measure the beam profile of the stored muons, as well as other dynamic properties of the beam. This thesis describes the design of these detectors, and the data acquisition system and subsequent data processing systems that have been developed to read them out and make their data available for physics analysis. The performance of the straw trackers and the readout systems at a number of beam tests and test stands is presented, in addition to Monte-Carlo simulations of the trackers in the final experiment

Neutrino oscillation bounds on quantum decoherence

We consider quantum-decoherence effects in neutrino oscillation data. Working in the open quantum system framework we adopt a phenomenological approach that allows to parameterize the energy dependence of the decoherence effects. We consider several phenomenological models. We analyze data from the reactor experiments RENO, Daya Bay and KamLAND and from the accelerator experiments NOvA, MINOS/MINOS+ and T2K. We obtain updated constraints on the decoherence parameters quantifying the strength of damping effects, which can be as low as $\Gamma_{ij} \lesssim 8 \times 10^{-27}$ GeV at 90% confidence level in some cases. We also present sensitivities for the future facilities DUNE and JUNO.Comment: v2: matches published version, v1: 20 pages, 9 figures, 3 table