Factors affecting psychological well-being: Evidence from two nationally representative surveys

Financial status is thought to be an important determinant of psychological well-being. We investigate this relationship, and the effect of other factors, using a parametric mixed modelling approach for panel data, controlling the problem of unobservable heterogeneity. Two nationally representative surveys, the British Household Panel Survey (BHPS) and the Understanding Society Survey (USS), were used to construct a unified data set which measured psychological well-being and associated factors using the 12-item General Health Questionnaire (GHQ-12). The GHQ-12 score for the head of the household was used as the dependant variable and its relationship with multiple independent demographic and financial status variables was investigated. Following assessment of growth curve characteristics with linear, curvilinear and higher-order polynomial modelling; several variance-covariance structures were tested to assess the error covariance structure of the longitudinal data. The random intercept and random slope were allowed to vary across participants, and methods such as natural splines and B-splines were used to improve the fit of some variables. Our final model demonstrated the most important variables affecting self-reported psychological well-being, as determined by GHQ-12, were perception and expectation of future financial situation and problems meeting household expenditure. Gender, age, marital status, number of children at home, highest qualification and job status were also significantly implicated. Unlike previous studies however we did not find that size of income was significant. These results provide further strong evidence of the impact that financial concerns have on self-reported measures of psychological well-being

An Application of the Multivariate Linear Mixed Model to the Analysis of Shoulder Complexity in Breast Cancer Patients

In this study, four major muscles acting on the scapula were investigated in patients who had been treated in the last six years for unilateral carcinoma of the breast. Muscle activity was assessed by electromyography during abduction and adduction of the affected and unaffected arms. The main principal aim of the study was to compare shoulder muscle activity in the affected and unaffected shoulder during elevation of the arm. A multivariate linear mixed model was introduced and applied to address the principal aims. The result of fitting this model to the data shows a huge improvement as compared to the alternatives

Physical activity levels in adults with intellectual disabilities: A systematic review

Despite evidence that inactivity is a major factor causing ill health in people with intellectual disabilities (pwID) there are gaps in our knowledge of their physical activity (PA). To date, there is no published systematic review of their PA levels. Therefore, we performed a systematic review from January–October 2015, comprising studies from across the globe to establish PA levels, determine how they were measured, and what factors influenced PA in adults with intellectual disabilities (awID). Five databases were searched. Studies were included if written in English, peer-reviewed, had primary research data, and measured PA levels of awID. Quality was assessed using a 19-item checklist. Meta-summary of the findings was performed and a meta-analysis of factors influencing PA using multiple regression. Fifteen studies were included consisting of 3159 awID, aged 16–81 years, 54% male and 46% female. Only 9% of participants achieved minimum PA guidelines. PA levels were measured using objective and subjective methods. ID severity, living in care, gender, and age were independently significantly correlated with the number of participants achieving PA guidelines with the strongest predictor being ID severity (Beta 0.631, p < 0.001). Findings should be in the context that most of the participants were in the mild/moderate range of ID severity and none of the studies objectively measured PA in people with profound ID. To inform measurement and intervention design for improved PA, we recommend that there is an urgent need for future PA studies in awID population to include all disability severity levels. PROSPERO registration number CRD42015016675

SARS-CoV-2 infections in migrants and the role of household overcrowding: a causal mediation analysis of Virus Watch data

Background Migrants are over-represented in SARS-CoV-2 infections globally; however, evidence is limited for migrants in England and Wales. Household overcrowding is a risk factor for SARS-CoV-2 infection, with migrants more likely to live in overcrowded households than UK-born individuals. We aimed to estimate the total effect of migration status on SARS-CoV-2 infection and to what extent household overcrowding mediated this effect. Methods We included a subcohort of individuals from the Virus Watch prospective cohort study during the second SARS-CoV-2 wave (1 September 2020–30 April 2021) who were aged ≥18 years, self-reported the number of rooms in their household and had no evidence of SARS-CoV-2 infection pre-September 2020. We estimated total, indirect and direct effects using Buis’ logistic decomposition regression controlling for age, sex, ethnicity, clinical vulnerability, occupation, income and whether they lived with children. Results In total, 23 478 individuals were included. 9.07% (187/2062) of migrants had evidence of infection during the study period vs 6.27% (1342/21 416) of UK-born individuals. Migrants had 22% higher odds of infection during the second wave (total effect; OR 1.22, 95% CI 1.01 to 1.47). Household overcrowding accounted for approximately 36% (95% CI −4% to 77%) of these increased odds (indirect effect, OR 1.07, 95% CI 1.03 to 1.12; proportion accounted for: indirect effect on log odds scale/total effect on log odds scale=0.36). Conclusion Migrants had higher odds of SARS-CoV-2 infection during the second wave compared with UK-born individuals and household overcrowding explained 36% of these increased odds. Policy interventions to reduce household overcrowding for migrants are needed as part of efforts to tackle health inequalities during the pandemic and beyond

An Application of the Multivariate Linear Mixed Model to the Analysis of Shoulder Complexity in Breast Cancer Patients

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Descriptive statistics of quantitative variables.

<p>Descriptive statistics of quantitative variables.</p

Descriptive statistics for categorical variables including participant's characteristics.

<p>Descriptive statistics for categorical variables including participant's characteristics.</p

Mixed effect model significant covariates effects.

<p>Mixed effect model significant covariates effects.</p

Biting off more than we can chew: is BMI the correct standard for bariatric surgery eligibility?

In the UK, the proportion of adults with obesity has been increasing significantly, with no signs of any reversal;1 this is despite the UK government ambitiously announcing in 2007 that England was to be the first country to reverse the trend in rising rates of obesity and the introduction of public health programmes such as Healthy Lives, Healthy People, and Change4Life. One reason why obesity has proved difficult to control is due to the limited impact of pharmacological interventions. Adverse effects such as valve disease and pulmonary hypertension (as a result of fenfluramine and dexfenfluramine treatment), psychiatric disorders (associated with rimonabant) and increased risk of myocardial infarcts or stroke (due to sibutramine) forced withdrawal of drugs by regulators or resulted in voluntary withdrawal by manufacturers. Of those drugs for obesity that remain, many are short-term and only give modest results (<4 kg weight loss) while only one (orlistat) is licensed for long-term management; all are associated with common and unpleasant side-effects.