• Understanding physician behaviour in the 6-8 weeks hip check in primary care: a qualitative study using the COM-B

      Chater, Angel M.; Milton, Sarah; Green, Judith; Gilworth, Gill; Roposch, Andreas; ; University of Bedfordshire; King's College London; University College London; Great Ormond Street Hospital for Children (BMJ Publishing Group, 2021-03-19)
      A compulsory hip check is performed on an infant at 6-8 weeks in primary care for the detection of developmental dysplasia of the hip (DDH). Missed diagnoses and infants incorrectly labelled with DDH remain an important problem. The nature of physician behaviour as a likely source of this problem has not been explored. The aims of this study were to make a behavioural diagnosis of general practitioners (GPs) who perform these hip checks, and identify potential behavioural change techniques that could make the hip checks more effective. Qualitative study with in-depth semistructured interviews of 6-8 weeks checks. We used the Capability, Opportunity, Motivation and Behaviour model in making a behavioural diagnosis and elicited factors that can be linked to improving the assessment. Primary care. 17 GPs (15 female) who had between 5 and 34 years of work experience were interviewed. Capability related to knowledge of evidence-based criteria and skill to identify DDH were important behavioural factors. Both physical (clinic time and space) and social (practice norms), opportunity were essential for optimal behaviour. Furthermore, motivation related to the importance of the 6-8 weeks check and confidence to perform the check and refer appropriately were identified in the behavioural diagnosis. Aspects of capability, opportunity and motivation affect GPs' diagnosis and referral behaviours in relation to DDH. The findings from this work extend current knowledge and will inform the development of an intervention aimed at improving the diagnosis of DDH.
    • A randomised-controlled feasibility study of the REgulate your SItting Time (RESIT) intervention for reducing sitting time in individuals with type 2 diabetes: study protocol

      Bailey, Daniel Paul; Edwardson, Charlotte L.; Pappas, Yannis; Dong, Feng; Hewson, David; Biddle, Stuart J. H.; Brierley, Marsha L.; Chater, Angel M. (BMC, 2021-03-19)
      People with type 2 diabetes mellitus (T2DM) generally spend a large amount of time sitting. This increases their risk of cardiovascular disease, premature mortality, diabetes-related complications and mental health problems. There is a paucity of research that has evaluated interventions aimed at reducing and breaking up sitting in people with T2DM. The primary aim of this study is to assess the feasibility of delivering and evaluating a tailored intervention to reduce and break up sitting in ambulatory adults with T2DM.
    • Exploring how newly qualified dentists perceive certain legal and ethical issues in view of the GDC standards

      Thakrar, Bindiya; Wassif, Hoda; Denchic Dental Spa; University of Bedfordshire (Springer Nature, 2021-03-11)
      Introduction This study focuses on how the legal and ethical requirements presented by the General Dental Council (GDC) in their Standards for the dental team (2013) document are perceived by newly qualified dentists; that is, those who have been qualified for less than five years.Aim The aim of the study was to investigate how the GDC guidance and the set standards for the dental team are perceived and understood by newly qualified dental practitioners, and how the guidance and the standards influence clinicians' decision-making. The study explored the newly qualified dentists' exposure to law and ethics, the GDC and their regulatory document, together with the clinical and non-clinical influence of this regulation on daily practice.Methods Empirical qualitative data were collected using semi-structured interviews of nine newly qualified dentists, with an average of 80 minutes for each interview. The data were analysed using thematic analysis.Results Three main themes were identified through the newly qualified dentists' perceptions of the GDC selected standards. These included sense of fear, morale and the business of dental practice, with further subthemes identified.Conclusion Results from this study present an opportunity and a challenge, as there is some fear and uncertainty among newly qualified dentists about the application of some of the GDC standards in practice. Further training in law and ethics as well as additional support for newly qualified dental practitioners is needed.
    • Effect of e-learning on health sciences education: a protocol for systematic review and meta-analysis

      Regmi, Krishna; Jones, Linda; University of Bedfordshire; University of Dundee (Routledge, 2021-02-24)
      E-learning has been widely used in higher education as it provides better access to learning resources online, utilising technology to enhance learning. Despite growing evidence claiming that e-learning is as effective as traditional means of learning, the evidence is still very limited. This protocol aims to measure the impact of e-learning as compared to traditional face-to-face learning, both measured and perceived, on health sciences education – in terms of improving students’/health professionals’ satisfaction, knowledge, skills, and behaviours and patient-related outcomes. We will conduct a systematic review and meta-analysis of both randomised controlled trials and non-randomised controlled trials. Major databases will be searched for studies, and will be reported in accordance with PRISMA. A thematic analysis will be conducted for the included studies. If sufficient data are available, the random-effects model for meta-analysis will be performed. The outcome of this study will provide a basis for developing the best methods of e-learning in health sciences education.
    • Ethnic minority women’s experiences of accessing antenatal care in high income European countries: a meta-synthesis of qualitative studies

      Sharma, Esther; Tseng, Pei-Ching; Puthussery, Shuby; Li, Leah; Harden, Angela; Griffiths, Malcolm; Bamfo, Jacqueline (2021-02-22)
      Protocol for an ongoing systematic review focussed on the following review question: What are the key themes reflected in ethnic minority women’s experiences of accessing antenatal care in European countries?
    • Evaluating ‘Enhancing Pragmatic Language skills for Young children with Social communication impairments’ (E-PLAYS): a feasibility cluster-randomised controlled trial

      Murphy, Suzanne; Joffe, Victoria; Donald, Louisa; Radley, Jessica; Sunthararajah, Sailaa; Welch, Charlie; Bell, Kerry; Messer, David J.; Crafter, Sarah; Fairhurst, Caroline; et al. (Springer Nature, 2021-01-04)
      Background This article reports the results from a feasibility study of an intervention (‘E-PLAYS’) aimed at supporting children who experience difficulties with social communication. E-PLAYS is based around a dyadic computer game, which aims to develop collaborative and communication skills. A pilot study found that when E-PLAYS was delivered by researchers, improvements on communication test scores and on collaborative behaviours were observed. The aim of this study was to ascertain the feasibility of running a full-scale trial to test the effectiveness of E-PLAYS in a National Health Service (NHS) setting with delivery by speech and language therapists and teaching assistants. Methods The study was a two-arm feasibility cluster-randomised controlled trial of the E-PLAYS intervention with a treatment as usual control arm. Data relating to recruitment and retention, treatment fidelity, acceptability to participants, suitability of outcomes and feasibility of collecting health economic measures and of determining cost-effectiveness were collected. Speech and language therapists selected suitable children (ages 4–7 years old) from their caseload. E-PLAYS intervention (experimental group) was then delivered by teaching assistants overseen by speech and language therapists. The control group received usual care. Assessments included blinded language measures and observations, non-blinded teacher-reported measures of peer relations and classroom behaviour and non-blinded parent-reported use of health and education resources and quality of life. Results Planned recruitment was for 70 children, in the event, 50 children were recruited which was sufficient for feasibility purposes. E-PLAYS was very highly rated by children, teaching assistants and speech and language therapists and treatment fidelity did not pose any issues. We were able to collect health economic data which suggests that E-PLAYS would be a low-cost intervention. Conclusion Based on recruitment, retention and adherence rates and our outcome measures, a full-scale randomised controlled trial estimated appears feasible and warranted to assess the effectiveness of E-PLAYS for use by the NHS and schools. Trial registration ISRCTN 14818949 (retrospectively registered)
    • A randomised controlled trial of energetic activity for depression in young people (READY): a multi-site feasibility trial protocol

      Howlett, Neil; Bottoms, Lindsay; Chater, Angel M.; Clark, A.B.; Clarke, T.; David, L.; Irvine, K.; Jones, A.; Jones, J.; Mengoni, S.E.; et al. (BioMed Central Ltd, 2021-01-04)
      Background: Prevalence of depression is increasing in young people, and there is a need to develop and evaluate behavioural interventions which may provide benefits equal to or greater than talking therapies or pharmacological alternatives. Exercise could be beneficial for young people living with depression, but robust, large-scale trials of effectiveness and the impact of exercise intensity are lacking. This study aims to test whether a randomised controlled trial (RCT) of an intervention targeting young people living with depression is feasible by determining whether it is possible to recruit and retain young people, develop and deliver the intervention as planned, and evaluate training and delivery. Methods: The design is a three-arm cluster randomised controlled feasibility trial with embedded process evaluation. Participants will be help-seeking young people, aged 13–17 years experiencing mild to moderate low mood or depression, referred from three counties in England. The intervention will be delivered by registered exercise professionals, supported by mental health support workers, twice a week for 12 weeks. The three arms will be high-intensity exercise, low-intensity exercise, and a social activity control. All arms will receive a ‘healthy living’ behaviour change session prior to each exercise session and the two exercise groups are energy matched. The outcomes are referral, recruitment, and retention rates; attendance at exercise sessions; adherence to and ability to reach intensity during exercise sessions; proportions of missing data; adverse events, all measured at baseline, 3, and 6 months; resource use; and reach and representativeness. Discussion: UK National Health Service (NHS) policy is to provide young people with advice about using exercise to help depression but there is no evidence-based exercise intervention to either complement or as an alternative to medication or talking therapies. UK National Institute for Health and Care Excellence (NICE) guidelines suggest that exercise can be an effective treatment, but the evidence base is relatively weak. This feasibility trial will provide evidence about whether it is feasible to recruit and retain young people to a full RCT to assess the effectiveness and cost-effectiveness of an exercise intervention for depression. Trial registration: ISRCTN, ISRCTN66452702. Registered 9 April 2020.
    • Operationalising domain 4: additional care for women and newborn infants with complications

      Madeley, Anna; University of Bedfordshire (All4Holdings Ltd, 2020-12-31)
      In this ninth article of The Practising Midwife’s education series, Domain 4 from the new Nursing and Midwifery Council (NMC) standards for proficiency is discussed. Domain 4 emphasises the midwife’s role as a coordinator of women and neonate’s care where additional care may be required. Highlighting curriculum changes at the University of Bedfordshire, Anna Madeley provides insights to how this domain has been implemented.
    • Women's experiences of living with albinism in Taiwan and perspectives on reproductive decision making: a qualitative study

      Huang, Mei-Zen; Chen, Li-Li; Hung, Shu-Ling; Puthussery, Shuby; National Tainan Junior College of Nursing; National Taipei University of Nursing and Health Sciences; University of Bedfordshire (Routledge, 2020-12-21)
      People with Albinism tend to face multiple adverse physical, psychological and social consequences. Very little is known about experiences of women with Albinism and their deliberations whilst making reproductive decisions. This study aimed to explore lived experiences of women with Albinism and to understand their perspectives on reproductive decision making. Qualitative in-depth semi-structured interviews were conducted with ten women with Albinism in Taiwan. Five key themes emerged from the accounts which were centred around the sense of discrimination that they felt whilst growing up, their strive for normality, making difficult choices in their reproductive decisions, desire to protect children from harm and reflections of parenting struggles from own experiences and the experiences of their parents. We call for global and national policy makers and practitioners to introduce explicit measures to challenge the myths, stereotypes and prejudices associated with Albinism including specific interventions towards supporting women in pregnancy decision making.
    • Analysis of routinely collected data: determining associations of maternal risk factors and infant outcomes with gestational diabetes, in Pakistani, Indian, Bangladeshi and white British pregnant women in Luton, England

      Garcia, Rebecca; Ali, Nasreen; Guppy, Andy; Griffiths, Malcolm; Randhawa, Gurch; ; Open University; University of Bedfordshire; Luton & Dunstable University Hospital NHS Foundation Trust (Elsevier, 2020-12-15)
      This study aims to compare the prevalence of gestational diabetes in Indian, Pakistani, Bangladeshi and British women in Luton, England and further examine associations in maternal risk factors (age BMI, smoking status and birth outcome), with gestational diabetes, with maternal ethnicity. A retrospective analysis using routinely collected secondary data from Ciconia Maternity information System (CMiS), between 2008 and 2013. The ethnicity of women recorded as Indian, Pakistani, Bangladeshi and white British, residing in [removed] were included in the study. The outcomes for n=15,211 cases were analysed using adjusted standardised residuals, Pearson Chi-square, frequencies and percentages of women with gestational diabetes. = 43.1 df=4, p<0.001) and an early gestational age at delivery (24-37 weeks) (χ2= 4.084 df=1, p=0.043). There are important differences in the prevalence rates of gestational diabetes which varied by maternal ethnicity. Of the women who had GDM, 48.7% were Pakistani, compared with 28.3% Bangladeshi, 16.4% white British and 6.6% Indian. It is essential policy makers and service providers target GDM screening and associated interventions and future research seeks to understand the reasons behind these differences.
    • Study protocol for evaluation of aid to diagnosis for developmental dysplasia of the hip in general practice: controlled trial randomised by practice

      Roposch, Andreas; Warsame, Kaltuun; Chater, Angel M.; Green, Judith; Hunter, Rachael; Wood, John; Freemantle, Nick; Nazareth, Irwin; ; University College London; et al. (BMJ Publishing Group, 2020-12-02)
      Introduction In the UK, a compulsory € 6-week hip check' is performed in primary care for the detection of developmental dysplasia of the hip (DDH). However, missed diagnoses and infants incorrectly labelled with DDH remain a problem, potentially leading to adverse consequences for infants, their families and the National Health Service. National policy states that infants should be referred to hospital if the 6-week check suggests DDH, though there is no available tool to aid examination or offer guidelines for referral. We developed standardised diagnostic criteria for DDH, based on international Delphi consensus, and a 9-item checklist that has the potential to enable non-experts to diagnose DDH in a manner approaching that of experts. Methods and analysis We will conduct a controlled trial randomised by practice that will compare a diagnostic aid against standard care for the hip check. The primary objective is to determine whether an aid to the diagnosis of DDH reduces the number of clinically insignificant referrals from primary care to hospital and the number of late diagnosed DDH. The trial will include a qualitative process evaluation, an assessment of professional behavioural change and a full health economic evaluation. We will recruit 152 general practitioner practices in England. These will be randomised to conduct the hip checks with useof the study diagnostic aid and/or as per usual practice. The total number of infants seen during a15-month recruitment period will be 110 per practice. Two years after the 6-week hip check, we willmeasure the number of referred infants that are (1) clinically insignificant for DDH and (2) those that constitute appropriate referrals. Ethics and dissemination This study has approval from the Health Research Authority (16/1/2020) and the Confidentiality Advisory Group (18/2/2020). Results will be published in peer-reviewed academic journals, disseminated to patient organisations and the media. Trial registration number NCT04101903; Pre-results.
    • Should we decolonise midwifery education?

      Beckford-Procyk, Chelsea; University of Bedfordshire (All4Holdings Ltd, 2020-11-30)
      This year the Black Lives Matter movement gained momentum globally and more people are having uncomfortable but necessary conversations around race. While the recent focus on racism within healthcare has largely been on outcomes because of inequality, we must also examine how the education of healthcare professionals can also play a part in dismantling racism in clinical practice. In this article, Chelsea Beckford-Procyk discusses the ways in which student midwives, birthing people and society as a whole would benefit from the decolonisation of midwifery education.
    • Development of an instrumented chair to identify the phases of the sit-to-stand movement

      Shukla, Brajesh K.; Jain, Hiteshi; Singh, Sandeep; Vijay, Vivek; Yadav, Sandeep; Hewson, David; Indian Institute of Technology Jodhpur; University of Bedfordshire (Springer Science and Business Media Deutschland GmbH, 2020-11-30)
      Instrumented versions of functional geriatric screening tests have been developed to improve clinical precision. Several different instrumented versions of the Sit-to-Stand (iSTS) test have been developed using a range of sensors such as accelerometers and cameras. An instrumented chair equipped with load cells and an ultrasound sensor was developed to detect phases of the STS (Sit to Stand). The chair was designed to be able to detect all the phases of the STS, including when the person was not in contact with the chair. Performance of the iSTS chair was compared between an RGB camera approach, and a data-fusion approach using the load-cell and ultrasound equipped chair. Ten adult subjects were tested performing the 5STS at two self-selected speeds. The accuracy of the load cell equipped chair was 70%, while the RGB camera achieved 76% accuracy. The ultrasound version of the chair and the fusion of the RGB and load cells technique both achieved significantly better accuracy at 86% and 89%, respectively. The new version of the instrumented chair obtained a high degree of accuracy in detecting the different phases of the STS and is suitable to detect STS phases without requiring additional sensors. Future work will test older subjects and aim to develop new parameters based on the phases of the STS as indicators of physical performance.
    • Health behaviour change considerations for weight loss and type 2 diabetes: nutrition, physical activity and sedentary behaviour

      Chater, Angel M.; Smith, Lindsey Rachel; Ferrandino, Louise; Wyld, Kevin; Bailey, Daniel Paul (John Wiley and Sons Ltd, 2020-11-30)
      Good nutrition, regular physical activity and low levels of sedentary behaviour are important in the prevention, management and treatment of obesity and type 2 diabetes mellitus (T2DM). Self-management requires individuals to have the capability to enact, opportunity to enable and motivation to perform relevant health behaviours. These behaviours, and the bio-psycho-social drivers of them, should be considered when working in the area of T2DM.
    • Parents' expectations and experiences of the 6-week baby check: a qualitative study in primary care

      Gilworth, Gill; Milton, Sarah; Chater, Angel M.; Nazareth, Irwin; Roposch, Andreas; Green, Judith; King's College London; University of Bedfordshire; University College London (Royal College of General Practitioners, 2020-11-18)
      Background: The Newborn and Infant Physical Examination (NIPE) programme requires all babies to have a comprehensive health check at 6-8 weeks of age. These are typically completed by GPs. Although person-centred care has achieved prominence in maternity care policy in recent years, there is limited empirical evidence on what parents and/or carers expect from the check, and how far experiences meet their needs. Aim: To explore the expectations and experiences of parents attending their GP for a baby check. Design & setting: A qualitative study was undertaken in primary care in London. Method: Content analysis was undertaken of transcripts of semi-structured interviews. Interviews were conducted with a total of 16 participants (14 mothers and two fathers) who had recently attended for a 6-week check for their baby. Results: Despite the availability of plentiful sources of general advice on infants' health and development, a thorough check by a trusted GP was an important milestone for most parents. They had few specific expectations of the check in terms of what examinations were undertaken, but even experienced parents anticipated reassurance about their baby's normal development. Many also hoped for reassurance about their own parenting. Parents appreciated GPs who explained what they were doing during the examination; space to raise any concerns; and combined mother and baby checks. Referrals to secondary care were generally experienced as reassuring rather than a source of anxiety. Conclusion: The baby check meets needs beyond those of the NIPE screening programme. Protecting the time for a thorough consultation is important for parents at what can be a vulnerable time.
    • Parents’ experiences of complementary feeding among a United Kingdom culturally diverse and deprived community

      Cook, Erica Jane; Powell, Faye; Ali, Nasreen; Penn-Jones, Catrin; Ochieng, Bertha; Randhawa, Gurch; University of Bedfordshire; DeMontfort University (Blackwell Publishing Ltd, 2020-11-09)
      Complementary feeding practices and adherence to health recommendations are influenced by a range of different and often interrelating factors such as socio-economic and cultural factors. However, the factors underlying these associations are often complex with less awareness of how complementary feeding approaches vary across the UK’s diverse population. This paper describes a qualitative investigation undertaken in a deprived and culturally diverse community in the UK which aimed to explore parents’ knowledge, beliefs and practices of complementary feeding. One hundred and ten mothers and fathers, self-identified as being White British, Pakistani, Bangladeshi, Black African/Caribbean or Polish took part in twenty-four focus group discussions, organised by age group, sex and ethnicity. The findings revealed that most parents initiated complementary feeding before the World Health Organisation (WHO) recommendation of 6 months. Early initiation was strongly influenced by breast feeding practices alongside the extent to which parents believed that their usual milk; that is, breastmilk or formula was fulfilling their infants' nutritional needs. The composition of diet and parents' approach to complementary feeding was closely aligned to traditional cultural practices; however, some contradictions were noted. The findings also acknowledge the pertinent role of the father in influencing the dietary practices of the wider household. Learning about both the common and unique cultural feeding attitudes and practices held by parents may help us to tailor healthy complementary feeding advice in the context of increasing diversity in the United Kingdom.
    • Instrumented analysis of the sit-to-stand movement for geriatric screening: a systematic review

      Shukla, Brajesh; Bassement, Jennifer; Vijay, Vivek; Yadav, Sandeep; Hewson, David; Indian Institute of Technology Jodhpur; Université Polytechnique Hauts-de-France; University of Bedfordshire (MDPI, 2020-11-06)
      The Sit-to-Stand (STS) is a widely used test of physical function to screen older people at risk of falls and frailty and is also one of the most important components of standard screening for sarcopenia. There have been many recent studies in which instrumented versions of the STS (iSTS) have been developed to provide additional parameters that could improve the accuracy of the STS test. This systematic review aimed to identify whether an iSTS is a viable alternative to a standard STS to detect older people at risk of falling, frailty, and sarcopenia. A total of 856 articles were found using the search strategy developed, with 12 articles retained in the review after screening based on PRISMA guidelines. Six studies evaluated the iSTS in fallers, five studies in frailty and only one study in both fallers and frailty. The results showed that power and velocity parameters extracted from an iSTS have the potential to improve the accuracy of screening when compared to a standard STS. Future work should focus on standardizing the segmentation of the STS into phases to enable comparison between studies and to develop devices integrated into the chair used for the test to improve usability.
    • The vital role of health psychology in the response to COVID-19

      Arden, Madelynne A.; Byrne-Davis, Lucie; Chater, Angel M.; Hart, Jo; McBride, Emily; Chilcot, Joseph (John Wiley and Sons Ltd, 2020-10-27)
      We had a huge response to our editorial and call for submissions of health psychology research related to the coronavirus pandemic (Arden & Chilcot, 2020). A total of 177 brief reports and papers have been submitted to BJHP since that call in March 2020. It has been a mammoth task for our associate editors, reviewers, and production team at Wiley to manage these papers (alongside non‐COVID submissions) in a shortened time frame, and the editors, Prof Arden and Dr Chilcot, would like to extend our sincere thanks to all who contributed their time and energies to this endeavour at what was a difficult time for everyone. This issue of BJHP includes a special section entitled COVID‐19: Health Psychology Theory and Research which includes the papers and brief reports on this topic accepted for publication to date.
    • Impact of non-pharmaceutical interventions for reducing transmission of COVID-19: a systematic review and meta-analysis protocol

      Regmi, Krishna; Lwin, Cho Mar; ; University of Bedfordshire; University of Medicine Mandalay (BMJ Open, 2020-10-22)
      Introduction Implementing non-pharmaceutical interventions (NPIs) protect the public from COVID-19. However, the impact of NPIs has been inconsistent and remains unclear. This study, therefore, aims to measure the impact of major NPIs (social distancing, social isolation and quarantine) on reducing COVID-19 transmission. Methods and analysis We will conduct a systematic review and meta-analysis research of both randomised and non-randomised controlled trials. We will undertake a systematic search of: MEDLINE, Embase, Allied & Complementary Medicine, COVID-19 Research, WHO database on COVID-19, ClinicalTrails.Gov for clinical trials on COVID-19, Cochrane Resources on Coronavirus (COVID-19), Oxford COVID-19 Evidence Service and Google Scholar for published and unpublished literatures on COVID-19 including preprint engines such as medRxiv, bioRxiv, Litcovid and SSRN for unpublished studies on COVID-19 and will be reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Outcomes of interest for impact analysis will include the reduction of COVID-19 transmission, avoiding crowds and restricting movement, isolating ill and psychological impacts. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist has been used for this protocol. For quality of included studies, we will use the Cochrane Collaboration’s tool for assessing risk of bias for randomised controlled trials and the Newcastle-Ottawa Scale for observational studies. The Grading of Recommendations Assessment, Development and Evaluation approach will grade the certainty of the evidence for all outcome measures across studies. Random-effects model for meta-analysis will measure the effect size of NPIs or the strengths of relationships. For quantitative data, risk ratio or OR, absolute risk difference (for dichotomous outcome data), or mean difference or standardised mean difference (for continuous data) and their 95% CIs will be calculated. Where statistical pooling is not possible, a narrative synthesis will be conducted for the included studies. To assess the heterogeneity of effects, I2 together with the observed effects will be evaluated to provide the true effects in the analysis. Ethics and dissemination Formal ethical approval from an institutional review board or research ethics committee is not required as primary data will not be collected. The final results of this study will be published in an open-access peer-reviewed journal, and abstract will be presented at suitable national/international conferences or workshops. We will also share important information with public health authorities as well as with the WHO. In addition, we may post the submitted manuscript under review to medRxiv, or other relevant preprint servers.
    • Childhood maternal school leaving age (level of education) and risk markers of metabolic syndrome in mid-adulthood: results from the 1958 British birth cohort

      Pappas Y; Iwundu, Chukwuma; Pang, Dong; (Dove Press, 2020-10-15)
      Purpose: The aim of this study is to investigate the relationship between childhood maternal level of education (CMLE) and changes in anthropometric and laboratory risk markers of metabolic syndrome (MetS) in mid-adulthood using results from the 1958 British Birth Cohort Study. Design: Cohort study. Participants: A total of 9376 study samples consisting of subjects that participated in the biomedical survey of the national child development study (NCDS) carried out between 2002 and 2004 were used for the analysis. Main Outcome Measures: Five risk markers of MetS: (i) HDL-cholesterol (ii) triglyceride (iii) blood pressure (BP) including systolic (SBP) and diastolic (DBP) (iv) waist circumference (WC) and (v) glycated haemoglobin (HbA1c). Methods: The NCDS or the 1958 British birth cohort data deposited in the UK data service by the centre for longitudinal studies were used for analyses. Ordinary least squares regression was used to determine unit changes in the outcome variables given CMLE. Results: The estimates for unadjusted regression analysis of individual risk markers indicated a significant relationship between CMLE and alterations in the five risk markers of MetS (HDL-cholesterol, triglyceride, WC, HbA1c, and BP) in midlife. After adjustment for birth and lifestyle characteristics/health behaviours, the relationship between CMLE and the risk markers was attenuated for HDL-cholesterol, triglycerides, and HbA1c but remained significant for WC 0.70 (95% confidence interval (CI) 0.065– 1.30, p< 0.001) and SBP 1.48 (95% CI 0.48– 2.47 p< 0.001). Conclusion: There was a positive association between lower CMLE and the risk of MetS using the NCDS data. Lifestyle characteristics may be influential determinants of MetS risk in mid-adulthood.