BackgroundIncreasing numbers of women living with chronic conditions are becoming pregnant (Jølving et al., 2016). The presence of chronic conditions can contribute to adverse outcomes in pregnancy and in later life for mother and infant (Gilmore et al., 2015; Schetter and Tanner, 2012). Over recent years, the role of increasing BMI in pregnancy has gained prominence, with risk factors for maternal obesity well documented in literature.
AimTo determine the relationship between BMI and other chronic conditions (multimorbidity) and pregnancy and birth outcomes in Northern Ireland.
MethodA cross-sectional cohort study was undertaken using data from the NIMATS database (2014-2015), accessed via the Honest Broker Service, with approval by the Office for Research Ethics Committees Northern Ireland (ORECNI) and the Honest Broker Governance Board.
ResultsRegression analyses demonstrated statistically significant relationships between increasing BMI and maternal conditions such as asthma, diabetes, epilepsy, hypertension, mental health and thyroid disease as well as a number of labour and birth outcomes. Mostly, these relationships were shown to increase with increasing BMI.
DiscussionThe findings from this study have important implications for the provision of preconception care, maternity services (including health professional training), child health services and the public health agenda.
AbstractBackgroundStudies that have systematically reviewed the psychometric properties of health‐related quality of life (HRQoL) and subjective wellbeing instruments for adolescents with intellectual disabilities narrowly focus on disease or health‐specific conditions. This review aimed to critically appraise the psychometric properties of self‐report instruments used to measure HRQoL and subjective wellbeing of adolescents with intellectual disabilities.MethodA systematic search was undertaken in four databases. The quality of the included studies and their psychometric properties was assessed according to the COnsensus‐based Standards for the selection of health Measurement Instruments Risk of Bias checklist.ResultsSeven studies reported psychometric properties of five different instruments. Only one instrument identified as having potential to be recommended for use but requires further validation research to assess its quality for this population.ConclusionsThere is insufficient evidence to support the recommendation of a self‐report instrument to assess HRQoL and subjective wellbeing of adolescents with intellectual disabilities.
In: Child abuse & neglect: the international journal ; official journal of the International Society for the Prevention of Child Abuse and Neglect, Band 77, S. 35-45
Abstract. Background: The circumstances surrounding death by suicide can give us insight into the factors affecting suicide risk in particular regions. Aims: This study examined gender and circumstances surrounding death by suicide in Northern Ireland from 2005 to 2011. Method: The study analyzed 1,671 suicides (77% male and 23% female cases) using information contained from the coroner's files on suicides and undetermined deaths. Results: Hanging was the most common method and more than one third of the deceased had prior suicide attempts. There was evidence of alcohol use in 41% of the cases. Only, 61% of cases had recorded adverse events; most had multiple and complex combinations of experiences. Relationship and interpersonal difficulties were the most common category of adverse event (40.3%). However, illness and bereavement, employment /financial crisis, and health problems were also common. One third of those who died by suicide were employed, compared with 50.3% who were not in employment. Just over half (50.1%) were known to have a mental health disorder. Conclusion: The results provide the first profile of deaths by suicide in Northern Ireland. They highlight the need to target people who have difficult life experiences in suicide prevention work, notably men, people with employment, financial and relationship crises, and those with mental disorders.
BackgroundCompared to married mothers, mothers who are not married when they register their child's birth are at increased risk of having a low birthweight baby and infant death. Having a partner protects women from poor pregnancy outcomes to some extent but those who are living with, but not married to, their partner still do less well than those who are married. As it does not appear to be marriage itself which is protective, other factors such as maternal education and smoking, and household characteristics, such as accommodation type and familial support in the household, need to be examined.
AimTo explore the individual socio-demographic and household characteristics that are associated with low birthweight and infant death among unmarried mothers.
MethodsA population based cohort study will be conducted through the Administrative Data Research Network based on all registered live births 2010-2016 to women resident in Northern Ireland (NI).
General Register Office (GRO) birth records will be linked to the NI Maternity System and GRO infant death data to identify low birth weight (primary) and infant death (secondary) outcomes. Maternal individual socio-demographic and household characteristics will be provided through linkage to the 2011 census (ethnicity, highest level of education, support from family members living in the household); Enhanced Prescribing Database (maternal mental health prescriptions); 2010 NI Multiple Deprivation Measure (area level deprivation, including income and education domains, for the mother's home address at the time of birth) and Valuation and Lands Agency Rating List (capital value of property of mother's address).
Descriptive statistics and logistic regression will be used for the analysis.
ImpactIt is anticipated the findings will reduce the public health burden of low birthweight babies by directing interventions to targeted groups of mothers.
Background: Stress-related mental ill health and its disorders are considered by the World Health Organization (WHO) to be the new world epidemic and their prevalence rates seem to be increasing worldwide. Aims: To examine and identify sub-populations at risk for psychological discomfort in Northern Ireland and map the relative impact of potential predictors. Methods: A sample of 4,638 respondents to the NIHSW-2001 survey was analysed with latent class analysis and latent class factorial analysis. Latent class multinomial logistic regression assessed the impact of a range of predictors on class membership. Results: Five sub-populations were differentiated. All subgroups at risk for anxiety and depression were characterized as being younger and female. Disability and adverse life events were strong predictors of risk. Long-standing illness and housing worries were predictors of medium and high risk membership. The effect of civil unrest was significant only for the medium-risk subgroup; marital status and income did not affect group membership. Conclusions: Because all five subgroups showed a different probability, but a similar profile of endorsing GHQ-12 items, it could be hypothesized that an underlying continuum dimension of anxiety and depression is present in the Northern Irish population.
Background: The need for structured education programmes for type 2 diabetes is a high priority for many governments around the world. One such national education programme in the United Kingdom is the DESMOND Programme, which has been shown to be robust and effective for patients in general. However, these programmesare not generally targeted to people with intellectual disabilities (ID), and robust evidence on their effects for this population is lacking. We have adapted the DESMOND Programme for people with ID and type 2 diabetes to produce an amended programme known as DESMOND-ID.This protocol is for a pilot trial to determine whether a large-scale randomised trial is feasible, to test if DESMOND-ID is more effective than usual care in adults with ID for self-management of their type 2 diabetes, in particular as a means to reduce glycated haemoglobin (Hb1Ac), improve psychological wellbeing and quality of life and promote a healthier lifestyle. This protocol describes the rationale, methods, proposed analysis plan and organisational and administrativedetails.Methods/Design: This trial is a two arm, individually randomised, pilot trial for adults with ID and type 2 diabetes, and their family and/or paid carers. It compares the DESMOND-ID programme with usual care. Approximately 36 adults with mild to moderate ID will be recruited from three countries in the United Kingdom. Family and/or paid carers may also participate in the study. Participants will be randomly assigned to one of two conditions using a secure computerised system with robust allocation concealment. A range of data will be collected from the adults with ID (biomedical,psychosocial and self-management strategies) and from their carers. Focus groups with all the participants will assess the acceptability of the intervention and the trial.Discussion: The lack of appropriate structured education programmes and educational materials for this population leads to secondary health conditions and may lead to premature deaths. There are significant ...
In: Taggart , L , Coates , V , Clarke , M , Bunting , B , Davies , M , Carey , M , Northway , R , Brown , M , Truesdale-Kennedy , M , Martin-Stacey , L , Scott , G & Karatzias , T 2015 , ' A study protocol for a pilot randomised trial of a structured education programme for the self-management of type 2 diabetes for adults with intellectual disabilities ' , Trials , vol. 16 , 148 . https://doi.org/10.1186/s13063-015-0644-y , https://doi.org/10.1186/s13063-015-0644-y
BACKGROUND: The need for structured education programmes for type 2 diabetes is a high priority for many governments around the world. One such national education programme in the United Kingdom is the DESMOND Programme, which has been shown to be robust and effective for patients in general. However, these programmes are not generally targeted to people with intellectual disabilities (ID), and robust evidence on their effects for this population is lacking. We have adapted the DESMOND Programme for people with ID and type 2 diabetes to produce an amended programme known as DESMOND-ID. This protocol is for a pilot trial to determine whether a large-scale randomised trial is feasible, to test if DESMOND-ID is more effective than usual care in adults with ID for self-management of their type 2 diabetes, in particular as a means to reduce glycated haemoglobin (Hb1Ac), improve psychological wellbeing and quality of life and promote a healthier lifestyle. This protocol describes the rationale, methods, proposed analysis plan and organisational and administrative details. METHODS/DESIGN: This trial is a two arm, individually randomised, pilot trial for adults with ID and type 2 diabetes, and their family and/or paid carers. It compares the DESMOND-ID programme with usual care. Approximately 36 adults with mild to moderate ID will be recruited from three countries in the United Kingdom. Family and/or paid carers may also participate in the study. Participants will be randomly assigned to one of two conditions using a secure computerised system with robust allocation concealment. A range of data will be collected from the adults with ID (biomedical, psychosocial and self-management strategies) and from their carers. Focus groups with all the participants will assess the acceptability of the intervention and the trial. DISCUSSION: The lack of appropriate structured education programmes and educational materials for this population leads to secondary health conditions and may lead to premature deaths. There are significant benefits to be gained globally, if structured education programmes are adapted and shown to be successful for people with ID and other cognitive impairments. TRIAL REGISTRATION: Registered with International Standard Randomised Controlled Trial (identifier: ISRCTN93185560 ) on 10 November 2014.
Background: The need for structured education programmes for type 2 diabetes is a high priority for many governments around the world. One such national education programme in the United Kingdom is the DESMOND Programme, which has been shown to be robust and effective for patients in general. However, these programmes are not generally targeted to people with intellectual disabilities (ID), and robust evidence on their effects for this population is lacking. We have adapted the DESMOND Programme for people with ID and type 2 diabetes to produce an amended programme known as DESMOND-ID. This protocol is for a pilot trial to determine whether a large-scale randomised trial is feasible, to test if DESMOND-ID is more effective than usual care in adults with ID for self-management of their type 2 diabetes, in particular as a means to reduce glycated haemoglobin (Hb1Ac), improve psychological wellbeing and quality of life and promote a healthier lifestyle. This protocol describes the rationale, methods, proposed analysis plan and organisational and administrative details. Methods/Design: This trial is a two arm, individually randomised, pilot trial for adults with ID and type 2 diabetes, and their family and/or paid carers. It compares the DESMOND-ID programme with usual care. Approximately 36 adults with mild to moderate ID will be recruited from three countries in the United Kingdom. Family and/or paid carers may also participate in the study. Participants will be randomly assigned to one of two conditions using a secure computerised system with robust allocation concealment. A range of data will be collected from the adults with ID (biomedical, psychosocial and self-management strategies) and from their carers. Focus groups with all the participants will assess the acceptability of the intervention and the trial. Discussion: The lack of appropriate structured education programmes and educational materials for this population leads to secondary health conditions and may lead to premature deaths. There are significant benefits to be gained globally, if structured education programmes are adapted and shown to be successful for people with ID and other cognitive impairments.
BACKGROUND: The World Mental Health Survey Initiative (WMHSI) has advanced our understanding of mental disorders by providing data suitable for analysis across many countries. However, these data have not yet been fully explored from a cross-national lifespan perspective. In particular, there is a shortage of research on the relationship between mood and anxiety disorders and age across countries. In this study we used multigroup methods to model the distribution of 12-month DSM-IV/CIDI mood and anxiety disorders across the adult lifespan in relation to determinants of mental health in 10 European Union (EU) countries. METHOD: Logistic regression was used to model the odds of any mood or any anxiety disorder as a function of age, gender, marital status, urbanicity and employment using a multigroup approach (n = 35500). This allowed for the testing of specific lifespan hypotheses across participating countries. RESULTS: No simple geographical pattern exists with which to describe the relationship between 12-month prevalence of mood and anxiety disorders and age. Of the adults sampled, very few aged ≥ 80 years met DSM-IV diagnostic criteria for these disorders. The associations between these disorders and key sociodemographic variables were relatively homogeneous across countries after adjusting for age. CONCLUSIONS: Further research is required to confirm that there are indeed stages in the lifespan where the reported prevalence of mental disorders is low, such as among younger adults in the East and older adults in the West. This project illustrates the difficulties in conducting research among different age groups simultaneously.
