A cross sectional study investigating the association between exposure to food outlets and childhood obesity in Leeds, UK.

Background: Current UK policy in relation to the influence of the ‘food environment’ on childhood obesity appears to be driven largely on assumptions or speculations because empirical evidence is lacking and findings from studies are inconsistent. The aim of this study was to investigate the number of food outlets and the proximity of food outlets in the same sample of children, without solely focusing on fast food. Methods: Cross sectional study over 3 years (n = 13,291 data aggregated). Body mass index (BMI) was calculated for each participant, overweight and obesity were defined as having a BMI >85th (sBMI 1.04) and 95th (sBMI 1.64) percentiles respectively (UK90 growth charts). Home and school neighbourhoods were defined as circular buffers with a 2 km Euclidean radius, centred on these locations. Commuting routes were calculated using the shortest straight line distance, with a 2 km buffer to capture varying routes. Data on food outlet locations was sourced from Leeds City Council covering the study area and mapped against postcode. Food outlets were categorised into three groups, supermarkets, takeaway and retail. Proximity to the nearest food outlet in the home and school environmental domain was also investigated. Age, gender, ethnicity and deprivation (IDACI) were included as covariates in all models. Results: There is no evidence of an association between the number of food outlets and childhood obesity in any of these environments; Home Q4 vs. Q1 OR = 1.11 (95% CI = 0.95-1.30); School Q4 vs. Q1 OR = 1.00 (95% CI 0.87 – 1.16); commute Q4 vs. Q1 OR = 0.1.00 (95% CI 0.83 – 1.20). Similarly there is no evidence of an association between the proximity to the nearest food outlet and childhood obesity in the home (OR = 0.77 [95% CI = 0.61 – 0.98]) or the school (OR = 1.01 [95% CI 0.84 – 1.23]) environment. Conclusions: This study provides little support for the notion that exposure to food outlets in the home, school and commuting neighbourhoods increase the risk of obesity in children. It seems that the evidence is not well placed to support Governmental interventions/recommendations currently being proposed and that policy makers should approach policies designed to limit food outlets with caution

Master of Science

thesisThe current study compared the efficacy of video-based social skills instruction for children with autism to traditional didactic instruction of social skills. The study consisted of two separate social skills groups. Two children with Autism Spectrum Disorder (ASD) and two typically developing same-aged peers were included in an experimental group that received video-based social skills instruction. Two other children with ASD and 2 additional typically developing same-aged peers were included in the group that received traditional didactic social skills instruction. The social skills lessons were taught twice per week for 8 weeks. Generalization probes of social interaction during free play time were conducted during analog free time intervals for each child with autism. At the end the program, effect sizes and PND were calculated to examine differences in the amount of social interaction during free time periods for the two groups, and pre- and postmeasures of social responsiveness were compared

State Trends in Premiums and Deductibles, 2003-2010: The Need for Action to Address Rising Costs

Examines the rise in employer-based insurance premiums and deductibles and as a percentage of median household income. Projects average family coverage premiums in 2020 if federal health reform is not implemented and historical rates of increase continue

Why Not the Best? Results From the National Scorecard on U.S. Health System Performance, 2011

Assesses the U.S. healthcare system's average performance in 2007-09 as measured by forty-two indicators of health outcomes, quality, access, efficiency, and equity compared with the 2006 and 2008 scorecards and with domestic and international benchmarks

Using Geographic Information Systems to measure retail food environments: discussion of methodological considerations and a proposed reporting checklist (Geo-FERN)

Geographic Information Systems (GIS) are widely used to measure retail food environments. However the methods used are hetrogeneous, limiting collation and interpretation of evidence. This problem is amplified by unclear and incomplete reporting of methods. This discussion (i) identifies common dimensions of methodological diversity across GIS-based food environment research (data sources, data extraction methods, food outlet construct definitions, geocoding methods, and access metrics), (ii) reviews the impact of different methodological choices, and (iii) highlights areas where reporting is insufficient. On the basis of this discussion, the Geo-FERN reporting checklist is proposed to support methodological reporting and interpretation

Racial and Ethnic Inequities in Health Care Coverage and Access, 20132019

In this brief, we update our 2020 report on coverage and access inequities using 2013–2019 data from the American Community Survey Public Use Microdata Sample (ACS PUMS) and the Behavioral Risk Factor Surveillance System (BRFSS). We examine trends in Black and Latinx/Hispanic disparities across the following measures, with a particular focus on the effects of Medicaid expansion on equity at the state level:adults ages 19 to 64 who are uninsuredadults ages 18 to 64 who went without care in the past 12 months because of costadults ages 18 to 64 who report having a usual health care provider