UMS members, Jennifer Summers, Bola Coker, Saskia Eddy, Maria Elstad, Catey Bunce, Elli Bourmpaki and Janet Peacock along with colleagues from the participating NHS hospitals, NICE and NHS England have led on a multi-centre project published in the Lancet Child and Adolescent Health.
Children with cerebral palsy will now be able to have a surgical procedure that can improve their ability to walk. Working for the National Institute for Health and Care Excellence (NICE) UMS researchers carried out an analysis that confirmed that selective dorsal rhizotomy improved outcomes for children suffering from this lifelong condition.
Selective dorsal rhizotomy, involves cutting some of the sensory nerves in order to relieve stiffness, improve mobility and reduce children’s pain levels. The operation is irreversible, and it had not previously been fully established whether it improved children’s quality of life, or whether there were any other long term effects.
The results showed the procedure benefited children by improving their movement, quality of life and levels of pain. They also found that there were no significant health risks to the children from the procedure.
This evidence was strong enough that NHS England has decided to fund the procedure for eligible children aged 3-9 years.
Janet Peacock, Professor of Medical Statistics at King’s, said: “We were commissioned to fill an evidence gap around selective dorsal rhizotomy for treating cerebral palsy – previous trials didn’t look at children’s quality of life and there was not enough evidence about how children fared in the longer term. Those were both important aspects to be considered. Our study provided convincing evidence that the procedure helped the children”
“NHS England have now decided that this procedure will be funded as a direct result of this innovative project. It’s great to get this decision so that it will make a difference to patients.”
UMS member Fiona Reid co-authored a study published in the Developmental Medicine & Child Neurology titled:
The study which has been picked up in the media, found that in patients with spina bifida, while mobility tended to decrease with age, surviving adults were more likely to live independently.
A new study led by UMS member Dr Salma Ayis has found that women are twice as likely to suffer from severe depression following a stroke than men and that long-term increased symptoms of depression are associated with higher mortality rates.
This study has attracted media coverage:
Perceptions of positive treatment and discrimination towards people with mental health problems: Findings from the 2017 Attitudes to Mental Illness survey
Rossetto A, Robinson EJ, Reavley NJ, Henderson C
This paper comes from a TTC evaluation, and focussed on the additional questions that were added to the most recent survey (n=1720). Specifically, whether the respondents knew someone with a mental health problem (30%), and if so, whether they perceived that person to be treated positively or to be discriminated against. We also found that better knowledge of mental health problems was associated with treating them positively, and lower stigma was associated with less avoidance and discrimination.
Public knowledge, attitudes, social distance and reporting contact with people with mental illness 2009–2017
Robinson EJ and Henderson C
This paper was an updated evaluation of the Time To Change (TTC) anti-stigma campaign in England, with some additional hypothesis tests. Namely, we found that the region people live in was significantly associated with mental-health stigma outcomes; London had by far the worst attitudes at baseline (2009) and has since improved to ‘catch-up’ with the rest of the country. Overall, knowledge, attitudes and behaviour towards people with mental illness is improving.
UMS member Dr Jennifer Summers has led on a article published in the New Zealand Medical Journal.
The 1918-1919 influenza pandemic has been New Zealand’s (NZ) most severe disaster event (around 9000 deaths) and while is a relatively well studied disaster event, there remain important research questions relating to this pandemic in New Zealand. This systematic review summarises all known published literature of this pandemic amongst New Zealanders and describes the epidemiological, societal and transmission characteristics of the pandemic. Nevertheless, some research gaps remain, including the apparent marked reduction in birth rates in 1918-1919. In the Centenary year of the 1918-19 Influenza Pandemic, now is the time for New Zealand to reflect on its impact and to ensure appropriate plans are in place to deal with future pandemics.
Changes in newspaper coverage of mental illness from 2008 to 2016 in England
Anderson C, Robinson EJ, Krooupa A-M, Henderson C
This paper was an evaluation of whether the type of coverage of mental illness in newspapers has changed over time, in particular, whether articles are of a neutral, stigmatising or anti-stigmatising nature. The authors found an increase in the number of articles on mental illness in general, as well as clear evidence of an increase in the proportion of anti-stigmatising articles, and a decrease in stigmatising articles. However, coverage of schizophrenia still needs improvement.
Mediators of increased self-harm and suicidal ideation in sexual minority youth: a longitudinal study
Oginni OA, Robinson EJ, Jones A, Rahman Q, Rimes KA
This paper uses the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort to investigate possible mediators (self-esteem and depression) and moderators (childhood gender nonconformity and gender) of increased suicidal ideation and self-harm in teenagers who identify as homosexual or bisexual, compared to those who identify as heterosexual. The authors found a single mediator pathway involving self-esteem and a multiple-mediated pathway involving self-esteem and depressive symptoms.
Dr Summers and co-authors in New Zealand have published a blog detailing the arrival of a ‘Death Ship’ 100 years ago into Apia, Samoa on the 7th November 1918. This ship brought with it the 1918 influenza pandemic H1N1 strain Western Samoa (along with Fiji and Tonga), and resulted in loss of 22% the adult population in Western Samoa.
The authors discuss these events and the impact on other Pacific nations, along with recommendations for the New Zealand Government to develop stronger regional pandemic controls for the Pacific.
A new study co-authored by MedStats member Dr Summers has been published in the Australian and New Zealand Journal of Public Health:
The study investigates the health impacts on both military and civilian peoples in New Zealand following WW1. Aspects of mortality and morbidity are explored, such as the injuries from conflict, psychological impacts, and health inequalities in terms of health outcomes.
Further media links include:
UMS member Professor Janet Peacock has been interviewed as part of a Podcast for the National Institute for Health Research (NIHR) Clinical Research Network (CRN) about how medical statistics and clinical medicine can work together.
UMS member Dr Salma Ayis along with colleagues has published a new study titled:
The study published in the Journal of Affective Disorders ‘examined the properties of each item of HADS [Hospital Anxiety and Depression scale] as perceived by stroke patients, and assessed the information these items convey about anxiety and depression between 3 months to 5 years after stroke’.
The authors concluded that ‘a more concise selection of items based on their properties, would provide a precise approach for screening patients and for an optimal allocation of patients into clinical trials’.
UMS member Dr Ayis, along with colleagues, publishes in Diabetes & Vascular Disease Research, a paper titled ‘Effects of aliskiren on mortality, cardiovascular outcomes and adverse events in patients with diabetes and cardiovascular disease or risk: A systematic review and meta-analysis of 13,395 patients‘.
The study aimed ‘to investigate the efficacy and safety of aliskiren in patients with diabetes and increased cardiovascular risk or established cardiovascular disease’. The systematic review and meta-analysis concluded that ‘patients with diabetes and cardiovascular disease or cardiovascular risk do not benefit from the addition of aliskiren to standard medical therapy’.
Professor Janet Peacock & colleagues investigated the relationship between unmetabolized folic acid (UFA), tetrahydrofolate and colorectal adenoma risk.
The new study published in Cancer Prevention Research was an extension of the analysis of a previously published RCT. The new study, using post hoc analysis, found that ‘during the later follow-up period in which folic acid supplementation was previously seen to increase the risk of advanced and multiple adenomas, higher serum methylated folates was associated with a higher risk of multiple and/or advanced adenomas, but no clear indication that UFA played a direct role’.
UMS member, Dr Salma Ayis along with colleagues at Kings College Hospital, Imperial College and Kings College London have recently published a study in BMJ Heart titled: ‘Drug treatment effects on outcomes in heart failure with preserved ejection fraction: a systematic review and meta-analysis’
The systematic review and meta-analysis investigated pharmacological treatments in patients with heart failure with left ventricular ejection fraction. The research concluded that ‘the efficacy of treatments in patients with heart failure and an LV ejection fraction ≥40% differ depending on the type of therapy, with beta-blockers demonstrating reductions in all-cause and cardiovascular mortality’.
UMS members Odile Sauzet (associate) and Janet Peacock have published a study titled:
The study used stimulated data on a dataset of preterm infants to investigate ‘the performance of several approaches to the analysis of binomial outcomes in the presence of some clusters of size two’. The study found ‘that the number of covariates or the level two variance do not necessarily affect the performance of the various methods used to analyse datasets containing twins but when the percentage of small clusters is too small, mixed models cannot capture the dependence between siblings’.
Janet Peacock has published, along with colleagues in London, UK, a study titled:
The study published in the European Journal of Pedicatrics aimed to ‘test the hypothesis that neurally adjusted ventilatory assist (NAVA) compared to assist control ventilation (ACV) would result in a lower OI in infants with evolving or established BPD’. The study undertaken at Kings College Hopsital London, concluded that ‘NAVA compared to ACV improved oxygenation in prematurely born infants with evolving or established bronchopulmonary dysplasia (BPD)’.
A study investigating unmetabolized folic acid (UFA), Tetrahydrofolate and Colorectal Adenoma Risk was conducted by researchers in the US, Canada and the UK, including UMS member, Professor Janet Peacock.
The study based on a earlier randomized trial concluded that ‘during the later follow-up period in which folic acid supplementation was previously seen to increase the risk of advanced and multiple adenomas, higher serum mF (methylated folates) was associated with a higher risk of multiple and/or advanced adenomas, but no clear indication that UFA played a direct role’.
UMS member, Professor Peacock along with colleagues in the UK and Netherlands have published in Acta Neurologica Scandinavica a study titled:
The study sought to ‘generate explanatory hypotheses about the co-occurrence of so- matic comorbidities and epilepsy, avoiding causal and treatment-resultant biases’. The authors concluded that ‘Somatic comorbidities do not occur randomly in relation to epilepsy; having more severe epilepsy seems to be a risk factor’.
Professor Peacock along with colleagues in the US have published a study titled:
The Randomized Control Trial concluded that ‘benefits from vitamin D3 supplementation for the prevention of advanced colorectal adenomas may vary according to vitamin D receptor genotype’.