The impact of social norms interventions on clinical behaviour change among health workers: protocol for a systematic review and meta-analysis.

Background: Health workers routinely carry out clinical behaviours, such as prescribing, test-ordering or hand-washing, which impact on patient diagnoses, care, treatment and recovery. Social norms are the implicit or explicit rules that a group uses to determine values, beliefs, attitudes and behaviours. A social norms intervention seeks to change the clinical behaviour of a target health worker by exposing them to the values, beliefs, attitudes or behaviours of a reference group or person.

C9orf72 intermediate expansions of 24-30 repeats are associated with ALS.

The expansion of a hexanucleotide repeat GGGGCC in C9orf72 is the most common known cause of ALS accounting for ~ 40% familial cases and ~ 7% sporadic cases in the European population. In most people, the repeat length is 2, but in people with ALS, hundreds to thousands of repeats may be observed. A small proportion of people have an intermediate expansion, of the order of 20 to 30 repeats in size, and it remains unknown whether intermediate expansions confer risk of ALS in the same way that massive expansions do.

India and the United Kingdom-What big data health research can do for a country.

Introduction: Big data and growth in telecommunications have increased the enormous promise of an informatics approach to health care. India and the United Kingdom are two countries facing these challenges of implementing learning health systems and big data health research.

Analysis: At present, these opportunities are more likely to be exploited in the private sector or in public-private partnerships (eg, Public Health Foundation of India [PHFI]) than public sector ventures alone.

Exercise-based cardiac rehabilitation for stable angina: systematic review and meta-analysis.

Objective: A systematic review was undertaken to assess the effects of exercise-based cardiac rehabilitation (CR) for patients with stable angina.

Methods: Databases (Cochrane Central Register of Controlled Trials, MEDLINE, Embase and CINAHL) were searched up to October 2017, without language restriction. Randomised trials comparing CR programmes with no exercise control in adults with stable angina were included.

Origins of disparities in preventable child mortality in England and Sweden: a birth cohort study.

Objective: To compare mortality in children aged <5 years from two causes amenable to healthcare prevention in England and Sweden: respiratory tract infection (RTI) and sudden unexpected death in infancy (SUDI).

Design: Birth cohort study using linked administrative health databases from England and Sweden.

Setting And Participants: Singleton live births between 2003 and 2012 in England and Sweden, followed up from age 31 days until the fifth birthday, death or 31 December 2013.

Associations Between Measures of Sarcopenic Obesity and Risk of Cardiovascular Disease and Mortality: A Cohort Study and Mendelian Randomization Analysis Using the UK Biobank.

Background The "healthy obese" hypothesis suggests the risks associated with excess adiposity are reduced in those with higher muscle quality (mass/strength). Alternative possibilities include loss of muscle quality as people become unwell (reverse causality) or unmeasured confounding. Methods and Results We conducted a cohort study using the UK Biobank (n=452 931).

Preschool developmental concerns and adjustment in the early school years: Evidence from a Scottish birth cohort.

Background: Preschool language and behavioural difficulties impact on multiple domains of the child's early life and can endure into adulthood, predicting poor educational, social, and health outcomes. Highlighting risk factors associated with poor outcomes following language and behavioural difficulties raised in early childhood may facilitate early identification and intervention.

Methods: Data from the Growing Up in Scotland national birth cohort study were used.

The effect of computerized decision support systems on cardiovascular risk factors: a systematic review and meta-analysis.

Background: Cardiovascular risk management (CVRM) is notoriously difficult because of multi-morbidity and the different phenotypes and severities of cardiovascular disease. Computerized decision support systems (CDSS) enable the clinician to integrate the latest scientific evidence and patient information into tailored strategies. The effect on cardiovascular risk factor management is yet to be confirmed.

The Translational Landscape of the Human Heart.

Gene expression in human tissue has primarily been studied on the transcriptional level, largely neglecting translational regulation. Here, we analyze the translatomes of 80 human hearts to identify new translation events and quantify the effect of translational regulation. We show extensive translational control of cardiac gene expression, which is orchestrated in a process-specific manner.

How community resources mitigate the association between household poverty and the incidence of adverse childhood experiences.

Objectives: To assess what proportion of the association between household low income and incidence of adverse childhood experiences (ACE) would be eliminated if all households had access to housing, transportation and childcare services, breastfeeding counselling, and parks.

Methods: Using Growing Up in Scotland birth cohort data (N = 2816), an inverse probability-weighted regression-based mediation technique was applied to assess associations between low-income status (< £11,000 in 2004/5), resource access, and cumulative 8-year ACE incidence (≥ 1, ≥ 3 ACEs). Resource access was measured based on households' self-reported difficulties (yes/no) in accessing housing, transportation, childcare, and breastfeeding counselling, and park proximity (within 10 min from the residence).

Life's Simple 7 Approach to Atrial Fibrillation Prevention.

Atrial fibrillation (AF) is the most commonly encountered arrhythmia in clinical practice. It constitutes a major public health problem, with total related annual expenses estimated at $6.65 billion.

How does perinatal maternal mental health explain early social inequalities in child behavioural and emotional problems? Findings from the Wirral Child Health and Development Study.

Background: This study aimed to assess how maternal mental health mediates the association between childhood socio-economic conditions at birth and subsequent child behavioural and emotional problem scores.

Methods: Analysis of the Wirral Child Health and Development Study (WCHADS), a prospective epidemiological longitudinal study of the early origins of child mental health (n = 664). Household income at 20-weeks gestation, a measure of socio-economic conditions (SECs) in pregnancy, was the main exposure.

Serum metabolic signatures of coronary and carotid atherosclerosis and subsequent cardiovascular disease.

Aims: To characterize serum metabolic signatures associated with atherosclerosis in the coronary or carotid arteries and subsequently their association with incident cardiovascular disease (CVD).

Methods And Results: We used untargeted one-dimensional (1D) serum metabolic profiling by proton nuclear magnetic resonance spectroscopy (1H NMR) among 3867 participants from the Multi-Ethnic Study of Atherosclerosis (MESA), with replication among 3569 participants from the Rotterdam and LOLIPOP studies. Atherosclerosis was assessed by coronary artery calcium (CAC) and carotid intima-media thickness (IMT).

Dynamic models to predict health outcomes: current status and methodological challenges.

Background: Disease populations, clinical practice, and healthcare systems are constantly evolving. This can result in clinical prediction models quickly becoming outdated and less accurate over time. A potential solution is to develop 'dynamic' prediction models capable of retaining accuracy by evolving over time in response to observed changes.

Liver Function and Risk of Type 2 Diabetes: Bidirectional Mendelian Randomization Study.

Liver dysfunction and type 2 diabetes (T2D) are consistently associated. However, it is currently unknown whether liver dysfunction contributes to, results from, or is merely correlated with T2D due to confounding. We used Mendelian randomization to investigate the presence and direction of any causal relation between liver function and T2D risk including up to 64,094 T2D case and 607,012 control subjects.

Understanding pathways to social inequalities in childhood unintentional injuries: findings from the UK millennium cohort study.

Background: Childhood unintentional injuries (UI) are common but continue to happen more often to children living in less advantaged socioeconomic circumstances (SEC). Our aim was to explore how early life factors mediate the association between SEC and UIs, using the UK Millennium Cohort Study.

Methods: We calculated risk ratios (RR) and 95% confidence intervals (95%CI) for parental report of UI occurring between age 3 and 5 years, using Poisson regression according to family income as a measure of SEC.

Diurnal variations in the quality of stroke care in Sweden.

Objectives: A recent study of acute stroke patients in England and Wales revealed several patterns of temporal variation in quality of care. We hypothesized that similar patterns would be present in Sweden and aimed to describe these patterns. Additionally, we aimed to investigate whether hospital type conferred resilience against temporal variation.

DNAscan: personal computer compatible NGS analysis, annotation and visualisation.

Background: Next Generation Sequencing (NGS) is a commonly used technology for studying the genetic basis of biological processes and it underpins the aspirations of precision medicine. However, there are significant challenges when dealing with NGS data. Firstly, a huge number of bioinformatics tools for a wide range of uses exist, therefore it is challenging to design an analysis pipeline.

Big Data Analytics, Infectious Diseases and Associated Ethical Impacts.

The exponential accumulation, processing and accrual of big data in healthcare are only possible through an equally rapidly evolving field of big data analytics. The latter offers the capacity to rationalize, understand and use big data to serve many different purposes, from improved services modelling to prediction of treatment outcomes, to greater patient and disease stratification. In the area of infectious diseases, the application of big data analytics has introduced a number of changes in the information accumulation models.

Expert panel process to optimise the design of a randomised controlled trial in chronic rhinosinusitis (the MACRO programme).

Background: MACRO (Defining best Management for Adults with Chronic RhinOsinusitis) is an NIHR-funded programme of work designed to establish best practice for adults with chronic rhinosinusitis (CRS). The 7-year programme comprises three consecutive workstreams, designed to explore NHS care pathways through analysis of primary and secondary data sources, and to undertake a randomised controlled trial to evaluate a longer-term course of macrolide antibiotics and endoscopic sinus surgery for patients with CRS. A number of outstanding elements still required clarification at the funding stage.

Cardiovascular Risk and Risk Factor Management in Type 2 Diabetes Mellitus: A Population-Based Cohort Study Assessing Sex Disparities.

Background: With recent changes in the United Kingdom's clinical practice for diabetes mellitus care, contemporary estimates of sex disparities in cardiovascular risk and risk factor management are needed.

Methods: In this retrospective cohort study, using the Clinical Practice Research Datalink linked to hospital and death records for people in England, we identified 79 985 patients with incident type 2 diabetes mellitus (T2DM) between 2006 to 2013 matched to 386 547 patients without diabetes mellitus. Sex-stratified Cox models were used to assess cardiovascular risk.

Control of Ebola virus disease outbreaks: Comparison of health care worker-targeted and community vaccination strategies.

Background: Health care workers (HCW) are at risk of infection during Ebola virus disease outbreaks and therefore may be targeted for vaccination before or during outbreaks. The effect of these strategies depends on the role of HCW in transmission which is understudied.

Methods: To evaluate the effect of HCW-targeted or community vaccination strategies, we used a transmission model to explore the relative contribution of HCW and the community to transmission.

Post-2000 growth trajectories in children aged 4-11 years: A review and quantitative analysis.

Children's body mass index (BMI) growth trajectories are associated with adult health outcomes, and vary by geography and epoch. Understanding these trajectories could help to identify high risk children and thus support improved health outcomes. In this review, we compare and quantitatively analyse BMI level and trajectory data published since 2010.

Supporting medication adherence for adults with cystic fibrosis: a randomised feasibility study.

Background: Preventative medication reduces hospitalisations in people with cystic fibrosis (PWCF) but adherence is poor. We assessed the feasibility of a randomised controlled trial of a complex intervention, which combines display of real time adherence data and behaviour change techniques.

Methods: Design: Pilot, open-label, parallel-group RCT with concurrent semi-structured interviews.