Incapacity Benefit Reforms Pilot: Findings from a longitudinal panel of clients

The Incapacity Benefit reforms were introduced in October 2003 and aim to increase the number of incapacity benefit recipients who move towards and into paid work. The package of measures that comprise the reforms is being Piloted in seven areas of England, Scotland and Wales. This report is based on research conducted by the Social Policy Research Unit, the National Centre for Social Research and the Policy Studies Institute in 2004/05 and presents findings from the first cohort of a longitudinal qualitative study of the views and experiences of incapacity benefit recipients who have taken part in the Pilots

Methods of Disease Risk Analysis in Wildlife Translocations for Conservation Purposes

Wildlife is intentionally and unintentionally translocated regularly carrying with it a range of parasites and pathogens. There are numerous examples of disease outbreaks originating from translocated animals. Managers of conservation projects, which involve translocating wildlife have a responsibility to protect humans, domestic animals, other wildlife and the ecosystem from negative effects of disease carried by the focus species. There is a significant lack of data available on the susceptibility, epidemiology and impacts of pathogens in wildlife populations making preventative actions challenging. Risk analysis has been developed to provide an objective, repeatable, transparent and documented assessment of the risks posed by a course of action. Standardised techniques have been developed and are utilised routinely to aid decision making. It is a tool used to guide policy making and disease control planning by governments and international organisations such as the OIE (World Organisation for Animal Health). Qualitative risk analysis is particularly useful in fields when quantitative data is lacking. Risk analysis has been developed for use in animal health risk management and subsequently adapted for wildlife disease management scenarios, cumulating in publication of the OIE/IUCN Manual of Procedures for Wildlife Disease Risk Analysis (2014). This paper considers further modification of risk analysis methods for wildlife translocations undertaken for conservation purposes. The challenges of these specific scenarios including hazard identification, multiple epidemiological pathways and data gaps are addressed and tools which could improve the usefulness of the technique, such as developing scenario trees and rating uncertainty are proposed

Association between change in body mass index and knee and hip replacements: a survival analysis of 7 to 10 years using multi-cohort data

Objective: To define the association between change in body mass index (BMI) and the risk of knee and hip replacement. Methods: We used data from three independent cohort studies: the Osteoarthritis Initiative (OAI), the Multicenter Osteoarthritis Study (MOST), and the Cohort Hip and Cohort Knee (CHECK) study, which collected data from adults (45 to 79 years of age) with or at risk of clinically significant knee osteoarthritis. We conducted Cox proportional hazards regression analysis with clustering of both knees and hips per person to determine the association between change in BMI (our exposure of interest) and the incidence of primary knee and hip replacement over 7 to 10 years’ follow-up. Change in BMI (in kg/m2) was calculated between baseline and the last follow-up visit before knee or hip replacement, or – for knees and hips that were not replaced – the last follow-up visit. Results: A total of 16,362 knees from 8181 participants, and 16,406 hips from 8203 participants, were eligible for inclusion in our knee and hip analyses, respectively. Change in BMI was positively associated with the risk of knee replacement (adjusted hazard ratio 1.03; 95% confidence interval [CI] 1.00 to 1.06) but not hip replacement (adjusted hazard ratio 1.00; 95% CI 0.95 to 1.04). The association between change in BMI and knee replacement was independent of participants’ BMI category at baseline (i.e., normal, overweight, or obese). Conclusion: Public health strategies incorporating weight loss interventions could reduce the burden of knee but not hip replacement surgery

Association of Change in Body Mass Index With Incidence and Progression of the Structural Defects of Hip Osteoarthritis: Data From the Osteoarthritis Initiative and the Cohort Hip and Cohort Knee study

Objective: To define the association between change in body mass index (BMI) and the incidence and progression of structural defects of hip osteoarthritis as assessed by radiography. Methods: We used data from 2 independent cohort studies: the Osteoarthritis Initiative (OAI) and the Cohort Hip and Cohort Knee (CHECK) study. Our exposure was change in BMI from baseline to 4–5 years’ follow-up. Our outcomes were the incidence and progression of structural defects of hip osteoarthritis as assessed using a modified Croft grade in OAI and the Kellgren/Lawrence grade in the CHECK study. To study incidence, we created incidence cohorts of hips without definite overall structural defects at baseline (i.e., grade <2) and then investigated the odds of hips having definite overall structural defects at follow-up (i.e., grade ≥2). To study progression, we created progression cohorts of hips with definite overall structural defects at baseline (i.e., grade ≥2) and then investigated the odds of having a grade increase of ≥1 from baseline to follow-up. Results: There was a total of 5,896 and 1,377 hips in the incidence cohorts, and 303 and 129 hips in the progression cohorts for the OAI and CHECK study, respectively. Change in BMI (decrease or increase) was not associated with any change in odds of the incidence or progression of definite structural defects of hip osteoarthritis in either the OAI or CHECK cohorts. Conclusion: Weight loss may not be an effective strategy for preventing, slowing, or delaying the structural defects of hip osteoarthritis over 4–5 years

Researchers in rheumatology should avoid categorization of continuous predictor variables

BACKGROUND: Rheumatology researchers often categorize continuous predictor variables. We aimed to show how this practice may alter results from observational studies in rheumatology. METHODS: We conducted and compared the results of two analyses of the association between our predictor variable (percentage change in body mass index [BMI] from baseline to four years) and two outcome variable domains of structure and pain in knee and hip osteoarthritis. These two outcome variable domains covered 26 different outcomes for knee and hip combined. In the first analysis (categorical analysis), percentage change in BMI was categorized as ≥ 5% decrease in BMI, < 5% change in BMI, and ≥ 5% increase in BMI, while in the second analysis (continuous analysis), it was left as a continuous variable. In both analyses (categorical and continuous), we used generalized estimating equations with a logistic link function to investigate the association between the percentage change in BMI and the outcomes. RESULTS: For eight of the 26 investigated outcomes (31%), the results from the categorical analyses were different from the results from the continuous analyses. These differences were of three types: 1) for six of these eight outcomes, while the continuous analyses revealed associations in both directions (i.e., a decrease in BMI had one effect, while an increase in BMI had the opposite effect), the categorical analyses showed associations only in one direction of BMI change, not both; 2) for another one of these eight outcomes, the categorical analyses suggested an association with change in BMI, while this association was not shown in the continuous analyses (this is potentially a false positive association); 3) for the last of the eight outcomes, the continuous analyses suggested an association of change in BMI, while this association was not shown in the categorical analyses (this is potentially a false negative association). CONCLUSIONS: Categorization of continuous predictor variables alters the results of analyses and could lead to different conclusions; therefore, researchers in rheumatology should avoid it

Risks from disease caused by Mycobacterium orygis as a consequence of Greater one-horned Rhinoceros (Rhinoceros unicornis) translocation in Nepal

The greater one‐horned rhinoceros (Rhinoceros unicornis) is listed as vulnerable by the IUCN Red List. Mycobacterium orygis–associated disease was identified in a single greater one‐horned rhino in Chitwan National Park in February 2015 prior to a planned translocation of five greater one‐horned rhinoceros from Chitwan National Park to Bardia National Park for conservation purposes. This paper describes a qualitative disease risk analysis conducted retrospectively post‐translocation for Mycobacterium orygis and this translocation, with the aim to improve the understanding of disease threats to the conservation of greater one‐horned rhino. The disease risk analysis method used was devised by Sainsbury & Vaughan‐Higgins (Conservation Biology, 26, 2017, 442) with modifications by Bobadilla Suarez et al (EcoHealth, 14, 2017, 1) and Rideout et al (EcoHealth, 14, 2017, 42) and included the use of a scenario tree and an analysis of uncertainty as recommended by Murray et al. (Handbook on import risk analysis for animals and animal products. Volume 1. Introduction and qualitative risk analysis, 2004), and the first time this combination of methods has been used to assess the risk from disease in a conservation translocation. The scenario tree and analysis of uncertainty increased the clarity and transparency of the analysis. Rideout et al.’s (EcoHealth, 14, 2017, 42) criteria were used to assess the source hazard and may be useful in comparative assessment of source hazards for future conservation translocations. The likelihood of release into the destination site of Mycobacterium orygis as a source hazard was estimated as of low risk, the risk of exposure of populations at the destination was of high risk and the likelihood of biological and environmental consequences was low. Overall, the risk from disease associated with Mycobacterium orygis as a result of this translocation was found to be low. Recommendations on disease risk management strategies could be improved with a better understanding of the epidemiology including the presence/absence of Mycobacterium orygis in greater one‐horned rhino to develop effective disease risk management strategies

The influence of risk factors associated with captive rearing on post-release survival in translocated cirl buntings Emberiza cirlus in the UK

Population decline resulting from agricultural intensification led to contraction of the range of the cirl bunting Emberiza cirlus in the UK to a small area of south Devon. As part of the UK Biodiversity Action Plan for the species, a project to re-establish a population in suitable habitat in Cornwall was undertaken during 2006–2011, in which chicks were removed from the nest in Devon, hand-reared and then delayed-released. The survival of the birds to four time points in the year after release was analysed in relation to the effect of rearing factors, using a multivariable logistic regression model. Individuals with higher body weight at capture were more likely to survive to 1 January and 1 May in the year following release, and individuals released in June and July were more likely to survive than those released in August. Individuals released in 2006 and 2011 had a higher survival rate than those released during 2007–2010. Timing of capture, time spent at each stage in captivity, medication and the detection of parasites in the brood had no significant effect. Immunosuppressive disease, weather factors and predator activity may have led to some of the observed differences in survival. This analysis provides evidence with which to plan future translocation projects for cirl buntings and other passerine birds

Association of Decrease in Body Mass Index With Reduced Incidence and Progression of the Structural Defects of Knee Osteoarthritis: A Prospective Multi-Cohort Study

Objective: To define the association between change in body mass index (BMI) and the incidence and progression of the structural defects of knee osteoarthritis as assessed by radiography. Methods: Radiographic analyses of knees at baseline and at 4–5 years of follow-up were obtained from the following 3 independent cohort studies: the Osteoarthritis Initiative (OAI) study, the Multicenter Osteoarthritis Study (MOST), and the Cohort Hip and Cohort Knee (CHECK) study. Logistic regression analyses using generalized estimating equations, with clustering of both knees within individuals, were used to investigate the association between change in BMI from baseline to 4–5 years of follow-up and the incidence and progression of knee osteoarthritis. Results: A total of 9,683 knees (from 5,774 participants) in an “incidence cohort” and 6,075 knees (from 3,988 participants) in a “progression cohort” were investigated. Change in BMI was positively associated with both the incidence and progression of the structural defects of knee osteoarthritis. The adjusted odds ratio (OR) for osteoarthritis incidence was 1.05 (95% confidence interval [95% CI] 1.02–1.09), and the adjusted OR for osteoarthritis progression was 1.05 (95% CI 1.01–1.09). Change in BMI was also positively associated with degeneration (i.e., narrowing) of the joint space and with degeneration of the femoral and tibial surfaces (as indicated by osteophytes) on the medial but not on the lateral side of the knee. Conclusion: A decrease in BMI was independently associated with lower odds of incidence and progression of the structural defects of knee osteoarthritis and could be a component in preventing the onset or worsening of knee osteoarthritis