Socioeconomic variation in the incidence of childhood coeliac disease in the UK.

BACKGROUND: Serological studies indicate that evidence of coeliac disease (CD) exists in about 1% of all children, but we lack estimates of current diagnostic patterns among children and how they vary by socioeconomic group. METHODS: We identified all children aged 0-18 years between 1993 and 2012 who were registered with general practices across the UK that contribute to a large population-based general practice database. The incidence of CD was evaluated in each quintile of the Townsend index of deprivation and stratified by age, sex, country and calendar year. RESULTS: Among 2,063,421 children, we identified 1247 CD diagnoses, corresponding to an overall CD incidence of 11.9 per 100,000 person-years, which was similar across the UK countries and higher in girls than in boys. We found a gradient of CD diagnosis across socioeconomic groups, with the rate of diagnosis being 80% higher in children from the least-deprived areas than in those from the most-deprived areas (incident rate ratio 1.80, 95% CI 1.45 to 2.22). This pattern held for both boys and girls and across all ages. Across all four countries of the UK, we found similar associations between CD and socioeconomic status. While CD incidence up to age 2 remained stable over the study period, diagnoses at older ages have almost tripled over the past 20 years. CONCLUSIONS: Children living in less socioeconomically deprived areas in the UK are more likely to be diagnosed with CD. Increased implementation of diagnostic guidelines could result in better case identification in more-deprived areas

Early recognition of coeliac disease through community pharmacies: A proof of concept study

Setting: 15 community pharmacies in the UK Objective: Proof of concept study to test the use of community pharmacies for active case finding of patients with coeliac disease. Method: Customers accessing over-the counter and prescription medicines indicated in the treatment of possible symptoms of coeliac disease over a six month period were offered a free point of care test. All patients were given advice regarding the test results and those who tested positive were advised to make an appointment with their general practitioner. Patients and pharmacists involved in service provision were asked to complete a satisfaction survey. Pharmacists were additionally invited to undertake interviews to better understand their views on the service. Main outcome measures: Feasibility of service, acceptability to stakeholders and proportion testing positive for coeliac disease. Results: Of the 551 individuals tested, 52 (9.4%) tested positive. 277 (50.3%) were tested for accessing irritable bowel syndrome treatment, 142 (25.8%) due to presenting for diarrhoea. The proportion of patients testing positive with different symptoms or for different treatments were similar. Of 43 customers who returned the satisfaction survey, all would recommend the service to others, believing the community pharmacy to be a suitable location. Community pharmacists believed that it enabled them to improve relationships with their customers and that medical practices were receptive to the service. Conclusion: This proof of concept study has shown that community pharmacies using a point of care test can effectively recognise and refer patients for confirmatory coeliac disease testing with high levels of customer and service provider satisfaction

Police legitimacy among immigrants in Europe: institutional frames and group position

Research on the antecedents of police legitimacy has begun to stress the relevance of a wide range of factors – beyond performance – in shaping public judgements of police (e.g. Jackson et al 2012; Antrobus et al 2015; Mehozay and Factor 2016; Weitzer and Tuch 2006). The ways in which people experience not just policing and but also their wider social, cultural and economic environment – and the location of both police and policed within structures of power, authority and affect – have important effects on lay judgements of police which, in turn, constitute the empirical legitimacy of this foundational state institution

The relationship between smokers' motivation to quit and intensity of tobacco control at the population level: a comparison of five European countries

Background: Smoking prevalence differs significantly across Europe. In addition, there are considerable differences in tobacco control activities across European countries. The relationship between prevalence and policy is under-researched. The present analysis examines the motivation to change smoking behaviour across 5 different European countries that differ considerably in their tobacco control activities. Methods: A population-based, representative survey of 1750 smokers, aged 16–59, from 5 different European countries (Germany, Greece, Poland, Sweden, UK) was used. Demographic variables, smoking status and the motivation to stop smoking were assessed. Motivation was assessed as, first, intending to quit (using the stages of change plus a modified stage for Precontemplation), and second, the desire to quit. Results: The majority of smokers want to stop smoking (73.5%), while only 35.0% want to stop definitely. Across countries, 10.2% definitely do not want to stop. Most of the smokers can be categorised in the Precontemplation stage (between 62.6% and 77.7% depending on the country), one of the stages of change categories. The relationship between the stages of change and the country under examination is statistically significant (chi-square = 43.466, p < 0.001). In countries with a high level of tobacco control, the proportion of people in Precontemplation is lower than in countries with low tobacco control activity. Conclusion: There are differences in the stages of change between the countries under examination. However, the categorisation of the countries into low, medium and high tobacco control activity used in this analysis does not explain these differences. Most smokers want to stop smoking, but a high proportion cannot indicate a time-frame when this is going to happen. Tobacco control efforts or other kinds of support might encourage these smokers to actually try to stop. Longitudinal studies at the population level are needed to assess, relate or monitor tobacco control activities and the intention to stop

Generating MHV super-vertices in light-cone gauge

We constructe the $\mathcal{N}=1$ SYM lagrangian in light-cone gauge using chiral superfields instead of the standard vector superfield approach and derive the MHV lagrangian. The canonical transformations of the gauge field and gaugino fields are summarised by the transformation condition of chiral superfields. We show that $\mathcal{N}=1$ MHV super-vertices can be described by a formula similar to that of the $\mathcal{N}=4$ MHV super-amplitude. In the discussions we briefly remark on how to derive Nair's formula for $\mathcal{N}=4$ SYM theory directly from light-cone lagrangian.Comment: 25 pages, 7 figures, JHEP3 style; v2: references added, some typos corrected; Clarification on the condition used to remove one Grassmann variabl

Expression profiling to predict outcome in breast cancer: the influence of sample selection

Gene expression profiling of tumors using DNA microarrays is a promising method for predicting prognosis and treatment response in cancer patients. It was recently reported that expression profiles of sporadic breast cancers could be used to predict disease recurrence better than currently available clinical and histopathological prognostic factors. Having observed an overlap in those data between the genes that predict outcome and those that predict estrogen receptor-α status, we examined their predictive power in an independent data set. We conclude that it may be important to define prognostic expression profiles separately for estrogen receptor-α-positive and estrogen receptor-α-negative tumors

Branch Mode Selection during Early Lung Development

Many organs of higher organisms, such as the vascular system, lung, kidney, pancreas, liver and glands, are heavily branched structures. The branching process during lung development has been studied in great detail and is remarkably stereotyped. The branched tree is generated by the sequential, non-random use of three geometrically simple modes of branching (domain branching, planar and orthogonal bifurcation). While many regulatory components and local interactions have been defined an integrated understanding of the regulatory network that controls the branching process is lacking. We have developed a deterministic, spatio-temporal differential-equation based model of the core signaling network that governs lung branching morphogenesis. The model focuses on the two key signaling factors that have been identified in experiments, fibroblast growth factor (FGF10) and sonic hedgehog (SHH) as well as the SHH receptor patched (Ptc). We show that the reported biochemical interactions give rise to a Schnakenberg-type Turing patterning mechanisms that allows us to reproduce experimental observations in wildtype and mutant mice. The kinetic parameters as well as the domain shape are based on experimental data where available. The developed model is robust to small absolute and large relative changes in the parameter values. At the same time there is a strong regulatory potential in that the switching between branching modes can be achieved by targeted changes in the parameter values. We note that the sequence of different branching events may also be the result of different growth speeds: fast growth triggers lateral branching while slow growth favours bifurcations in our model. We conclude that the FGF10-SHH-Ptc1 module is sufficient to generate pattern that correspond to the observed branching modesComment: Initially published at PLoS Comput Bio

Options for sampling and stratification for national forest inventories to implement REDD+ under the UNFCCC

<p>Abstract</p> <p>Background</p> <p>Developing countries that are willing to participate in the recently adopted (16^thSession of the Conference of Parties (COP) in Cancun) mitigation mechanism of Reducing emissions from Deforestation and Forest Degradation - and the role of conservation, sustainable management of forests and enhancement of forest carbon stocks (REDD+) - will have to establish a national forest monitoring system in order to assess anthropogenic forest-related greenhouse gas emissions by sources and removals by sinks. Such a system should support the Measurement, Reporting and Verification (MRV) requirement of the United Nations Framework Convention on Climate Change (UNFCCC) as the REDD+ mechanism is results-based. A national forest inventory (NFI) is one potential key component of such an MRV system. Following the Decision adopted during the 15^thSession of the COP in Copenhagen, the most recent Intergovernmental Panel on Climate Change (IPCC) Guidance and Guidelines should be used as a basis for estimating anthropogenic forest-related greenhouse gas emissions by sources and removals by sinks and changes in forest carbon stocks and area.</p> <p>Results</p> <p>First, we present the key indispensable elements of the IPCC Guidance and Guidelines that have been developed to fulfil the UNFCCC reporting requirements. This is done in order to set the framework to develop the MRV requirement in which a NFI for REDD+ implementation could be developed. Second, within this framework, we develop and propose a novel scheme for the stratification of forest land for REDD+. Finally, we present some non-exhaustive optional elements within this framework that a country could consider to successfully operationalise and implement its REDD+ NFI.</p> <p>Conclusion</p> <p>Evidently, both the methodological guidance and political decisions on REDD+ under the UNFCCC will continue to evolve. Even so, and considering that there exists decades of experience in setting up traditional NFIs, developing a NFI that a country may use to directly support REDD+ activities under the UNFCCC represents the development of a new challenge in this field. It is therefore important that both the scientific community and national implementing agencies acquaint themselves with both the context and content of this challenge so that REDD+ mitigation actions may be implemented successfully and with environmental integrity. This paper provides important contributions to the subject through our proposal of the stratification of forest land for REDD+.</p

Competition and educational quality: evidence from the Netherlands

Little evidence is available for the effect of competition on educational quality as only a few countries allow large-scale competition. In the Netherlands, free parental choice has been present since the beginning of the twentieth century and can be characterized as a full voucher program with 100 % funding. Based on micro panel data for the Netherlands, we show that there is a relation between competition and educational outcomes in secondary education, but that it is often negative and small, sometimes insignificant but never positive. This effect is larger for small and medium-sized schools and for schools that do not have a Protestant or Catholic denomination