scholarly journals 1444Housing disadvantage in childhood and health: A systematic review

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Yuxi Li ◽  
Ankur Singh ◽  
Ludmila Alfonzo ◽  
Rebecca Bentley
Keyword(s):  
Health Outcomes ◽  
Longitudinal Studies ◽  
Controlled Trial ◽  
Respiratory Illness ◽  
Social Determinant ◽  
Physical And Mental Health ◽  
Mortality And Morbidity ◽  
Study Heterogeneity ◽  
Residential Moves ◽  
Randomised Controlled

Abstract Background Housing has been recognised as one of the important determinants of health outcomes. However, little is known of the contribution of these pathways to children’s health and wellbeing and their pattern of health throughout life. This review aims to provide a synthesis of longitudinal studies linking experiences of disadvantaged housing in childhood to health outcomes. Methods A literature search was performed on four databases including Medline, EMBASE, PsycINFO, and Web of Science from 2000 to 2020. Peer-reviewed longitudinal studies assessing the association between housing disadvantage in childhood and subsequent physical and mental health were included. The methodological quality of selected studies was appraised using the ROBINS-I tool. A narrative synthesis was developed due to study heterogeneity. Results Forty-five cohort studies were included, and no randomised controlled trial met the inclusion criteria. The majority of the studies was evaluated to have a moderate risk of bias. Across the studies, while many relationships remained mixed, consistent evidence of detrimental impact was identified between: poor housing conditions and mortality; inadequate heating and respiratory illness; frequent residential moves and psychiatric mortality and morbidity. Little evidence is found between overcrowding in childhood and health outcomes. Conclusions Evidence from longitudinal studies indicates that poor housing experience in childhood may impact health later in life. Key messages The findings stressed housing as a key social determinant of child health, and interventions designed to mitigate housing disadvantage may have significant health gains across the life span

scholarly journals A 12-week low-carbohydrate, high-fat diet improves metabolic health outcomes over a control diet in a randomised controlled trial with overweight defence force personnel

2017 ◽  
Vol 42 (11) ◽  
pp. 1158-1164 ◽  
Author(s):  
Caryn Zinn ◽  
Julia McPhee ◽  
Nigel Harris ◽  
Micalla Williden ◽  
Kate Prendergast ◽  
...  
Keyword(s):  
Health Outcomes ◽  
High Fat Diet ◽  
Controlled Trial ◽  
Intervention Group ◽  
Density Lipoprotein ◽  
Metabolic Health ◽  
High Fat ◽  
Beneficial Effects ◽  
Low Carbohydrate ◽  
Randomised Controlled

Overweight, obesity, and poor health is becoming a global concern for defence force personnel. Conventional nutrition guidelines are being questioned for their efficacy in achieving optimal body composition and long-term health. This study compared the effects of a 12-week low-carbohydrate, high-fat diet with a conventional, high-carbohydrate, low-fat diet on weight reduction and metabolic health outcomes in at-risk New Zealand Defence Force personnel. In this randomised controlled trial, 41 overweight personnel were assigned to intervention and control groups. Weight, waist circumference, fasting lipids, and glycaemic control were assessed at baseline and at 12 weeks. Within-group change scores were analysed using the t statistic and interpreted using a p < 0.05 level of statistical significance. Between-group mean differences and confidence intervals were analysed using effect sizes and magnitude-based inferences. Twenty-six participants completed the trial (14 intervention, 12 control). Both groups showed statistically significant weight and waist circumference reductions; the intervention group significantly reduced triglycerides and serum glucose and significantly increased high-density lipoprotein cholesterol (HDLc). Relative to control, the intervention group showed small, possibly to likely beneficial effects for weight, triglycerides, glucose, insulin, and homeostasis model assessment of insulin resistance; moderate, likely beneficial effects for HDL cholesterol, triglyceride:HDLc ratio and HbA1c; and a small, likely harmful effect for low-density lipoprotein cholesterol. This dietary approach shows promise for short-term weight loss and improved metabolic health outcomes conditions compared with mainstream recommendations. It should be offered to defence force personnel at least as a viable alternative means to manage their weight and health.

scholarly journals Open-labelled randomised controlled trial of 12 hours versus 24 hours modified Pritchard regimen in the management of eclampsia and pre-eclampsia in Ghana (MOPEP Study): study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e032799 ◽  
Author(s):  
Titus Beyuo ◽  
Emma Lawrence ◽  
Elizabeth S Langen ◽  
Samuel A Oppong
Keyword(s):  
Randomised Controlled Trial ◽  
Health Outcomes ◽  
Magnesium Sulfate ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Control Group ◽  
University Of Michigan ◽  
Clinical Trial Registry ◽  
Randomised Controlled ◽  
Study Participants

IntroductionHypertensive disorders of pregnancy continue to be a major contributor to maternal and perinatal morbidity and mortality. Magnesium sulfate therapy is the standard of care for seizure prophylaxis and treatment for pre-eclampsia and eclampsia respectively, despite wide disparities in dosing regimens and routes of administration. This study compares the clinical efficacy of magnesium sulfate in the reduction of seizure occurrence or recurrence with the 12 hours versus 24 hours modified Pritchard regimens in the management of severe pre-eclampsia and eclampsia.Methods and analysisThis study is an open labelled randomised controlled trial. The study participants are patients admitted to the Korle Bu Teaching Hospital (KBTH) in Accra, Ghana with a diagnosis of antepartum, intrapartum or postpartum eclampsia or pre-eclampsia with severe features. All study participants will be administered a loading dose of magnesium sulfate, followed by maintenance dosing. Participants in the control group will receive magnesium sulfate for 24 hours after diagnosis, while those in the treatment group will receive magnesium sulfate for 12 hours after diagnosis. The primary outcome of this study is the occurrence of a seizure any time after the completion of treatment in the assigned group. Secondary outcome measures include maternal health outcomes, magnesium sulfate toxicities and fetal health outcomes. Data collection was started in October 2018 with a target enrolment of 1245 participants with severe pre-eclampsia and 844 participants with eclampsia with a projected study period of 2–3 years.Ethics and disseminationEthical approval was obtained from the KBTH Institutional Review Board (IRB) in Ghana. University of Michigan involvement is limited to protocol development and statistical analysis of de-identified data, and has been granted a Not Regulated Determination by the University of Michigan IRB. Results of the study will be shared at clinical forums at the KBTH and will be submitted for publication in an international peer-reviewed journal.Trial registration numberPan African Clinical Trial Registry through the South African Medical Research Council (PACTR201811515303983).

scholarly journals Pragmatic multicentre randomised controlled trial evaluating the impact of a routine molecular point-of-care ‘test-and-treat’ strategy for influenza in adults hospitalised with acute respiratory illness (FluPOC): trial protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e031674 ◽  
Author(s):  
Kate Beard ◽  
Nathan Brendish ◽  
Ahalya Malachira ◽  
Samuel Mills ◽  
Cathleen Chan ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Point Of Care ◽  
Controlled Trial ◽  
Clinical Care ◽  
Respiratory Illness ◽  
Acute Respiratory Illness ◽  
National Guidelines ◽  
South Central ◽  
Randomised Controlled ◽  
The Impact

BackgroundInfluenza infections often remain undiagnosed in patients admitted to hospital due to lack of routine testing. When tested for, the diagnosis and treatment of influenza are often delayed due to the slow turnaround times of centralised laboratory PCR testing. Newer molecular systems, have comparable accuracy to laboratory PCR testing, and can generate a result in under 1 hour, making them potentially deployable as point-of-care tests (POCTs). High-quality evidence for the impact of routine POCT for influenza on clinical outcomes is, however, currently lacking. This large pragmatic multicentre randomised controlled trial aims to address this evidence gap.Methods and analysisThe FluPOC trial is a pragmatic, multicentre, randomised controlled trial evaluating adults admitted to a large teaching hospital and a district general hospital with an acute respiratory illness, during influenza season and defined by Public Health England. Up to 840 patients will be recruited over up to three influenza seasons, and randomised (1:1) to receive either POCT using the FilmArray respiratory panel, or routine clinical care. Clinical and infection control teams will be informed of the results in real time and where influenza is detected clinical teams will be encouraged to offer neuraminidase inhibitor (NAI) treatment in accordance with national guidelines. Those allocated to standard clinical care will have a swab taken for later analysis to allow assessment of missed diagnoses. The outcomes assessment will be by retrospective case note analysis. The outcome measures include the proportion of influenza-positive patients detected and appropriately treated with NAIs, isolation facility use, antibiotic use, length of hospital stay, complications and mortality.Ethics and disseminationPrior to commencing the study, approval was obtained from the South Central Hampshire A Ethics Committee (reference 17/SC/0368, granted 7 September 2017). Results generated from this protocol will be published in peer-reviewed scientific journals and presented at national and international conferences.Trial registration numberISRCTN17197293

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