Age of first drinking and adult alcohol problems: systematic review of prospective cohort studies.

BACKGROUND: Alcohol policies around the world seek to delay the initiation of drinking. This is partly based on the influential idea that earlier initiation is likely to cause adult alcohol problems. This study synthesises robust evidence for this proposition. METHODS: Systematic review of prospective cohort studies in which adolescent measurement of age of first drink in general population studies was separated by at least 3 years from adult alcohol outcomes. EMBASE, Medline, PsychINFO and Social Policy and Practice were searched for eligible studies, alongside standard non-database data collection activities. Data were extracted on included study methods and findings. Risk of bias and confounding was assessed for individual studies and a narrative synthesis of findings was performed. RESULTS: The main finding was the meagre evidence base available. Only five studies were eligible for inclusion in this review. The existence of effects of age of first drink on adult drinking and related problems were supported, but not at all strongly, in some included studies, and not in others. Rigorous control for confounding markedly attenuates or eliminates any observed effects. CONCLUSIONS: There is no strong evidence that starting drinking earlier leads to adult alcohol problems and more research is needed to address this important question. Policy makers should, therefore, reconsider the justification for delaying initiation as a strategy to address levels of adult alcohol problems in the general population, while also addressing the serious acute harms produced by early drinking

The Impact of Working Beyond Traditional Retirement Ages on Mental Health: Implications for Public Health and Welfare Policy

Background: Many people now want or need to work longer due to increased life expectancy. In some countries statutory retirement ages deny older people free access to the labour market. It has been hypothesised that exclusion from employment may have negative effects on the mental health of older people. The global financial crisis has forced some countries to propose increasing the retirement age but the implications of this for population health are unclear. This paper reviews the evidence for the mental health impacts of working beyond retirement, and discusses the implications for future public health and welfare policy. Methods: A systematic literature review was conducted of studies that examined the effect of working or volunteering beyond traditional retirement ages on mental health outcomes. Results: Of the ten studies that met the inclusion criteria, none showed a negative impact of working beyond retirement age on mental health. Four studies showed that post-retirement working has a statistically significant positive effect on a range of mental health outcomes. Discussion: This review suggests that working beyond traditional retirement ages may be beneficial for mental health in some populations. The mechanisms by which this occurs are complex but are likely to be mediated by the maintenance of productive societal roles, continued income and social support. The benefits of post-retirement employment are unlikely to be universal as such factors will have varying effects depending on individual lifestyle, self-esteem and socioeconomic status. Although our research shows that allowing older people free access to the employment market may have important health benefits, flexible retirement strategies are needed to ensure that any national policy to increase statutory retirement age does not increase health and social inequalities in the elderly

Local area unemployment, individual health and workforce exit: ONS Longitudinal Study

This work was jointly funded by the Economic and Social Research Center (ESRC) and the United Kingdom’s Medical Research Council, under the Lifelong Health and Wellbeing Cross-Council Programme initiative [ES/L002892/1]. CeLSIUS is supported by the ESRC Census of Population Programme (Award Ref: ES/ K000365/1)

Autonomy, special offers and routines: a Q methodological study of industry-driven marketing influences on young people's drinking behaviour

AIM: To identify shared patterns of views in young people relating to the influence of industry-driven alcohol marketing (price, promotion, product and place of purchase/consumption) on their reported drinking behaviour. DESIGN: Q methodology harnessed qualitative and quantitative data to generate distinct clusters of opinions as follows: 39 opinion statements were derived from earlier in-depth qualitative interviews with 31 young people; by-person factor analysis was carried out on 28 participants' (six previous interviewees and 22 new recruits) rank orderings of these statements (most-to-least agreement); interpretation of the factor arrays was aided by 10-15-minute debriefing interviews held immediately following each Q-sort. SETTING: Northeast England PARTICIPANTS: Young people aged 14-17 years purposively recruited from high schools, higher education colleges, youth centres and youth offending teams. FINDINGS: Centroid factor extraction and varimax rotation of factors generated three distinct accounts: factor one ('autonomous, sophisticated consumers') illustrated a self-defined sense of individuality and autonomy in alcohol choices; factor two ('price-driven consumers') appeared price-led, choosing to drink what was most accessible or cheapest; and factor three ('context-focused consumers') described drinking practices where products were chosen to serve specific functions such as being easy to carry while dancing. CONCLUSIONS: Considering young people's views on alcohol marketing, different perspectives can be identified. These include perceived imperviousness to maketing, responsiveness to price and affordability and responsiveness to marketing focusing on youth lifestyles

The Genetics of Primary Immunodeficiency in Children

Studies of children with recurrent infection demonstrate that primary immunodeficiency (PID) has a significant genetic component. In PID, over 300 genes of high penetrance inherited mostly in autosomal recessive manner have already been identified. However, many children, including those with early onset immunodeficiency have not received a genetic diagnosis, despite use of targeted sequencing methods. I performed bioinformatic analysis in whole genome sequencing data in patients with immunodeficiency. These analyses were initially in a small cohort of affected children at Great Ormond Street in whom a genetic diagnosis was not known. I devised and utilised bioinformatic programs to identify novel genetic variants in this cohort. I evaluated the performance of whole genome sequence analyses with targeted gene panel analyses, which is the most utilised method of genetic diagnosis. To expand my analysis, I looked at a larger cohort of young people and adults with immunodeficiency as part of the large national collaborative project NIHR Bioresource Rare Diseases BRIDGE-PID project. I quantified the burden of rare coding variation in a case cohort compared to controls and used rare variant association analysis to identify potential novel candidate genes in primary immunodeficiency. The final chapter focuses on 2 novel genetic variants found in the cohort and our initial functional testing to verify genetic diagnosis. The work presented in this thesis demonstrates novel genetic causes of immunodeficiency and their functional implications. The results of my work have improved understanding of the genetic architecture of primary immunodeficiencies and has clinical utility in the diagnosis and subsequent treatment of immunodeficiency

Modelling, Simulation Methods for Intelligent Transportation Systems

Effective transportation systems lead to the efficient movement of goods and people, which significantly contribute to the quality of life in every society. In the heart of every economic and social development, there is always a transportation system. Meanwhile, traffic congestion has been increasing worldwide because of increased motorization, urbanization, population growth, and changes in population density. This threatens the social and economic prosperity of communities all over the world. Congestion reduces utilization of the transportation infrastructure and increases travel time, air pollution, and fuel consumption. Therefore, managing and controlling transportation systems becomes a high priority task for every community, as it constitutes a matter of survival and prosperity for humanity

HelioTrope: An innovative and efficient prototype for solar power production

The solar energy alternative could provide us with all the energy we need as it exist in vast quantities all around us. We only should be innovative enough in order to improve the efficiency of our systems in capturing and converting solar energy in usable forms of power. By making a case for the solar energy alternative, we identify areas where efficiency can be improved and thereby Solar Energy can become a competitive energy source. This paper suggests an innovative approach to solar energy power production, which is manifested in a prototype given the name HelioTrope. The Heliotrope Solar Energy Production prototype is tested on its' capabilities to efficiently covert solar energy to generation of electricity and other forms of energy for storage or direct use. HelioTrope involves an innovative Stirling engine design and a parabolic concentrating dish with a sun tracking system implementing a control algorithm to maximize the capturing of solar energy. Further, it utilizes a patent developed by the authors where a mechanism is designed for the transmission of reciprocating motion of variable amplitude into unidirectional circular motion. This is employed in our prototype for converting linear reciprocating motion into circular for electricity production, which gives a significant increase in efficiency and reduces maintenance costs. Preliminary calculations indicate that the Heliotrope approach constitutes a competitive solution to solar power production

Thymus transplantation for complete DiGeorge syndrome: European experience

Background: Thymus transplantation is a promising strategy for the treatment of athymic complete DiGeorge syndrome (cDGS). Methods: Twelve patients with cDGS were transplanted with allogeneic cultured thymus. Objective: To confirm and extend the results previously obtained in a single centre. Results: Two patients died of pre-existing viral infections without developing thymopoeisis and one late death occurred from autoimmune thrombocytopaenia. One infant suffered septic shock shortly after transplant resulting in graft loss and the need for a second transplant. Evidence of thymopoeisis developed from 5-6 months after transplantation in ten patients. The median (range) of circulating naïve CD4 counts (x10663 /L) were 44(11-440) and 200(5-310) at twelve and twenty-four months post-transplant and T-cell receptor excision circles were 2238 (320-8807) and 4184 (1582 -24596) per106 65 T-cells. Counts did not usually reach normal levels for age but patients were able to clear pre-existing and later acquired infections. At a median of 49 months (22-80), eight have ceased prophylactic antimicrobials and five immunoglobulin replacement. Histological confirmation of thymopoeisis was seen in seven of eleven patients undergoing biopsy of transplanted tissue including five showing full maturation through to the terminal stage of Hassall body formation. Autoimmune regulator (AIRE) expression was also demonstrated. Autoimmune complications were seen in 7/12 patients. In two, early transient autoimmune haemolysis settled after treatment and did not recur. The other five suffered ongoing autoimmune problems including: thyroiditis (3); haemolysis (1), thrombocytopaenia (4) and neutropenia (1). Conclusions: This study confirms the previous reports that thymus transplantation can reconstitute T cells in cDGS but with frequent autoimmune complications in survivors

Immunoglobulin Replacement Therapy During COVID-19 Pandemic: Practical and Psychological Impact in Patients with Antibody Deficiency

Purpose: The COVID-19 pandemic has impacted on how health services deliver care and the mental health of the population. Due to their clinical vulnerability, to reduce in-hospital attendances during the COVID-19 pandemic, modifications in immunoglobulin treatment regimens were made for patients with antibody deficiency. These patients were also likely to experience social isolation due to shielding measure that were advised. We aimed to investigate the impact of modifying immunoglobulin treatment regimen on infection and mental health burden during shielding restrictions.// Method: Patients on immunoglobulin replacement therapy (IGRT) responded to a standardised questionnaire examining self-reported infection frequency, anxiety (GAD-7), depression (PHQ-8), fatigue (FACIT), and quality of life during the pandemic. Infection frequency and immunoglobulin trough levels were compared to pre-pandemic levels.// Results: Patients who did not change treatment modality or those who received immunoglobulin replacement at home during the pandemic reported fewer infections. In patients who received less frequent hospital infusions, there was no significant increase in infections whilst immunoglobulin trough levels remained stable. There was no significant difference in anxiety, or depression scores between the treatment modality groups. Patients reported higher fatigue scores compared to the pre-COVID general population and in those discharged following hospitalisation for COVID.// Conclusion: Changing immunoglobulin treatment regimen did not negatively impact infection rates or psychological wellbeing. However, psychological welfare should be prioritised for this group particularly given uncertainties around COVID-19 vaccination responsiveness and continued social isolation for many

Letter in Response to 'Classification of Traumatic Brain Injury Severity Using Informed Data Reduction in a Series of Binary Classifier Algorithms'

This paper is a comment to the paper "Classification of Traumatic Brain Injury Severity Using Informed Data Reduction in a Series of Binary Classifier Algorithms" by Bloom et al. The authors inform the editors that they have conducted a similar study on behalf of, and funded BrainScope Company, Inc. and that the method used to acquire the QEEG data suffer from a technical fault. Same methods seem to have been used by Bloom et. al. It is noted that the authors do not refer to this technical fault even though it arose months before the publication of the papers