Double trouble: the impact of multimorbidity and deprivation on preference-weighted health related quality of life - a cross sectional analysis of the Scottish Health Survey

<b>Objective</b> To investigate the association between multimorbidity and Preference_Weighted Health Related Quality of Life (PW_HRQoL), a score that combines physical and mental functioning, and how this varies by socioeconomic deprivation and age.<p></p> <b>Design</b> The Scottish Health Survey (SHeS) is a cross-sectional representative survey of the general population which included the SF-12, a survey of HRQoL, for individuals 20 years and over.<p></p> <b>Methods</b> For 7,054 participants we generated PW_HRQoL scores by running SF-12 responses through the SF-6D algorithm. The resulting scores ranged from 0.29 (worst health) to 1 (perfect health). Using ordinary least squares, we first investigated associations between scores and increasing counts of longstanding conditions, and then repeated for multimorbidity (2+ conditions). Estimates were made for the general population and quintiles of socioeconomic deprivation. For multimorbidity, the analyses were repeated stratifying the population by age group (20--44, 45--64, 65+).<p></p> <b>Results</b> 45% of participants reported a longstanding condition and 18% reported multimorbidity. The presence of 1, 2, or 3+ longstanding conditions were associated with average reductions in PW_HRQoL scores of 0.081, 0.151 and 0.212 respectively. Reduction in scores associated with multimorbidity was 33% greater in the most deprived quintile compared to the least deprived quintile, with the biggest difference (80%) in the 20--44 age groups. There were no significant gender differences.<p></p> <b>Conclusions</b> PW_HRQoL decreases markedly with multimorbidity, and is exacerbated by higher deprivation and younger age. There is a need to prioritise interventions to improve the HRQoL for (especially younger) adults with multimorbidity in deprived areas

Enhancing Export Potential for Northern Plains Mustard

International Relations/Trade,

Tonsillectomy among children with low baseline acute throat infection consultation rates in UK general practices: a cohort study.

OBJECTIVE: To investigate the effectiveness of tonsillectomy in reducing acute throat infection (ATI) consultation rates over 6 years' follow-up among children with low baseline ATI consultation rates. DESIGN: Retrospective cohort study. SETTING: UK general practices from the Clinical Practice Research Datalink. PARTICIPANTS: Children aged 4-15 years with ≤3 ATI consultations during the 3 years prior to 2001 (baseline). 450 children who underwent tonsillectomy (tonsillectomy group) and 13 442 other children with an ATI consultation (comparison group) in 2001. MAIN OUTCOME MEASURES: Mean differences in ATI consultation rates over the first 3 years' and subsequent 3 years' follow-up compared with 3 years prior to 2001 (baseline); odds of ≥3 ATI consultations at the same time points. RESULTS: Among children in the tonsillectomy group, the 3-year mean ATI consultation rate decreased from 1.31 to 0.66 over the first 3 years' follow-up and further declined to 0.60 over the subsequent 3 years' follow-up period. Compared with children who had no operation, those who underwent tonsillectomy experienced a reduction in 3-year mean ATI consultations per child of 2.5 (95% CI 2.3 to 2.6, p<0.001) over the first 3 years' follow-up, but only 1.2 (95% CI 1.0 to 1.4, p<0.001) over the subsequent 3 years' follow-up compared with baseline, respectively. This equates to a mean reduction of 3.7 ATI consultations over a 6-year period and approximates to a mean annual reduction of 0.6 ATI consultations per child, per year, over 6 years' follow-up. Children who underwent tonsillectomy were also much less likely to experience ≥3 ATI consultations during the first 3 years' follow-up (adjusted OR=0.12, 95% CI 0.08 to 0.17) and the subsequent 3 years' follow-up (adjusted OR=0.24, 95% CI 0.14 to 0.41). CONCLUSIONS: Among children with low baseline ATI rates, there was a statistically significant reduction in ATI consultation rates over 6 years' follow-up. However, the relatively modest clinical benefit needs to be weighed against the potential risks and complications associated with surgery

Stem and soil CO2 efflux responses of Pinus radiata plantations to temperature, season, age, time (day/night) and fertilization

Stem CO2 efflux is a highly variable component of the carbon budget of forest ecosystems. It reflects the balance between the CO2 respired by the living stem tissues, less the CO2 dissolved in the xylem sap moving upward in the transpiration stream, plus the CO2 transported from the roots and released at the stem. Although knowledge about such fluxes at different spatial and temporal scales has markedly increased, knowledge of the effects of silviculture treatments, such as fertilization, on stem CO2 effluxes are still limited, particularly when connecting above- and belowground processes. Using measurements obtained from twin plots (one control, one fertilized) installed in five-, 12- and 23-year-old stands of Pinus radiata, the objective of this study was to examine the influence of the temperature, stand age, fertilization, season and time of measurement (day/night) on the stem CO2 efflux, soil CO2 efflux and their ratio. There was a strong significant positive relationship between the stem CO2 efflux and temperature. The slope between these two variables declined as the stand age increased and was higher for nighttime than daytime measurements. The stem CO2 efflux was higher in the fertilized plots compared with the unfertilized (control) plots for the 5- and 12- but not the 23-year-old age classes. In contrast, the soil CO2 efflux was largely unaffected by the temperature, time of measurement (day/night), fertilization and stand age; however, significantly higher values of soil CO2 efflux were measured during spring than during the other seasons. Given the relative invariance of the soil CO2 efflux to the temperature and treatment effects, the ratio of the stem:soil CO2 effluxes was affected by the same factors as the stem CO2 effluxes. These results suggest that fertilization would increase wood production and wood CO2 efflux without changing the soil CO2 efflux, thus most likely proportionally increasing aboveground C partitioning and decrease belowground C partitioning, with this effect being enhanced at younger ages.El flujo de CO2 desde los fustes es una componente altamente variable en el balance global de carbono en ecosistemas forestales. Refleja el balance entre el CO2 respirado por los tejidos vivos del fuste, menos el CO2 disuelto en la savia del xilema que se mueve hacia arriba como resultado de la transpiración, más el CO2 transportado desde las raíces y liberado en el fuste. Aunque el conocimiento acerca de estos flujos a diferentes escalas espaciales y temporales ha aumentado marcadamente, los efectos de tratamientos silviculturales, tales como la fertilización, en la respiración de los fustes es aún limitada particularmente al conectar procesos arriba y abajo del suelo. Usando medidas en parcelas gemelas (una parcela testigo, una parcela fertilizada) instaladas en rodales de 5,12 y 23 años de edad de Pinus radiata, el objetivo del estudio fue examinar la influencia de la temperatura, edad, fertilización, temporada y tiempo del día (día/noche) en los flujos de CO2 desde los fustes, desde los suelos y la razón entre ellos. Se encontró una fuerte relación positiva entre el flujo de CO2 desde los fustes con la temperatura de los mismos. La pendiente entre estas dos variables declinó con la edad, siendo superior durante la noche que durante el día. El flujo de CO2 desde los fustes fue mayor en las parcelas fertilizadas que en las testigo en los rodales de 5 y 12 años pero no en el de 23 años. En contraste, los flujos de CO2 desde los suelos fueron mayoritariamente invariantes a la temperatura del suelo, al tiempo de medición (día/noche), fertilización y edad de los rodales; aunque dichos valores fueron significativamente mayores durante la primavera comparado con las otras temporadas. Dada la relativa invariabilidad de los flujos de CO2 de los suelos a la temperatura y a los efectos de los tratamientos (fertilización, edad, día/noche), la razón de los flujos de CO2 entre fustes y suelos fueron afectados por los mismos factores que afectaron los flujos de CO2 desde los fustes. Estos resultados sugieren que la fertilización temprana aumenta drásticamente la producción y flujos de CO2 de los fustes, sin cambiar los flujos de CO2 desde los suelos; o en otras palabras, asignando proporcionalmente más carbono arriba del suelo y menos abajo del suelo, con este efecto decreciendo con la edad de la plantación

Precise location of Sagittarius X ray sources with a rocket-borne rotating modulation collimator

Precise location of Sagittarius X ray sources with rocket-borne rotating modulation collimato

The latest FAD – Faecal antibody detection in cattle:Protocol and results from three UK beef farms naturally infected with gastrointestinal nematodes

Antibodies at gastrointestinal mucosal membranes play a vital role in immunological protection against a range of pathogens, including helminths. Gastrointestinal health is central to efficient livestock production, and such infections cause significant losses. Fecal samples were taken from 114 cattle, across three beef farms, with matched blood samples taken from 22 of those animals. To achieve fecal antibody detection, a novel fecal supernatant was extracted. Fecal supernatant and serum samples were then analysed, using adapted enzyme-linked immunosorbent assay protocols, for levels of total immunoglobulin (Ig)A, IgG, IgM, and Teladorsagia circumcincta-specific IgA, IgG, IgM and IgE (in the absence of reagents for cattle-specific nematode species). Fecal nematode egg counts were conducted on all fecal samples. Assays performed successfully and showed that IgA was the predominant antibody in fecal samples, whereas IgG was predominant in serum. Total IgA in feces and serum correlated within individuals (0.581, P = 0.005), but other Ig types did not. Results support the hypothesis that the tested protocols are an effective method for the non-invasive assessment of cattle immunology. The method could be used as part of animal health assessments, although further work is required to interpret the relationship between results and levels of infection and immunity

QCD factorization for forward hadron scattering at high energies

We consider the QCD factorization of DIS structure functions at small x and amplitudes of 2->2 -hadronic forward scattering at high energy. We show that both collinear and k_T-factorization for these processes can be obtained approximately as reductions of a more general (totally unintegrated) form of the factorization. The requirement of ultraviolet and infrared stability of the factorization convolutions allows us to obtain restrictions on the fits for the parton distributions in k_T- and collinear factorization.Comment: 18 pages, 10 figures In the present version misprints found in the prevcious version are corrected and some more details are explaine

From Navas to Kaltoft: The European Court of Justice’s evolving definition of disability and the implications for HIV-positive individuals

This article will examine the definition of disability developed by the European Court of Justice for the purposes of the Employment Equality Directive and examine whether it is sufficient for the purpose of bringing People Living with HIV/AIDS within its scope. The article will argue that in order to adequately protect People Living with HIV/AIDS within the EU from discrimination, the European Court of Justice needs to ensure that a coherent EU wide definition of disability, based fully upon the social model of disability, is adopted. This is necessary in order to ensure adequate protection not only for People Living with HIV/AIDS but for all individuals with disabilities from discrimination throughout the EU. In addition to this central argument, this paper will argue that the lack of a coherent definition of disability grounded in the social model fragments protection for People Living with HIV/AIDS across the EU leading to a number of possible unintended consequences

Fantasies of subjugation: a discourse theoretical account of British policy on the European Union

The decision by the UK government to hold a referendum on Britain’s membership of the European Union (EU) marks an important development in policy towards the EU. Policy changes of this kind must be understood in the historical and political context in which they occur. This includes the framing of the policy issues within public discourse. In the UK, policies are formed in a discursive environment which is overwhelmingly hostile towards the EU. Debates are structured by a predominantly Euroskeptic discourse which emphasizes the UK’s separation and heterogeneity from the rest of the EU. Drawing on the logics of critical explanation, this article examines the structure and affective power of Euroskeptic discourses which dictate the terms of the EU debate. It presents a case study of the recent EU treaty revision process, culminating in the Treaty of Lisbon. In so doing, it enables a deeper understanding of recent policy developments