English Index Research Articles

Social Deprivation and the Association With Survival Following Fenestrated Endovascular Aneurysm Repair

Social deprivation is associated with poor clinical outcomes. It is known to have an impact on length of stay and post-operative mortality across a number of other surgical specialties. This study evaluates the impact of social deprivation on outcomes following fenestrated endovascular aneurysm repair (FEVAR). All elective FEVARs performed between 2010 and 2018 at a tertiary vascular center were analyzed. Deprivation (index of multiple deprivation [IMD]) data was sourced from the English indices of deprivation 2019, by postcode. Primary outcome was overall survival by Kaplan-Meier. Secondary outcomes included length of hospital stay (LOS) and complications. Cox-proportional hazard analyses were conducted. Some 132 FEVAR patients were followed-up for 3.7 (SD 2.2) years. Fifty-seven patients lived in areas with high levels of deprivation (IMD 1-3), 34 in areas with moderate deprivation (IMD 4-6) and 41 in areas with the lowest level (IMD 7-10) of deprivation. Groups were comparable for Age, BMI, AAA diameter and co-morbidity. A higher proportion of patients from deprived areas had renal failure (15% [26.3%] vs. 9% [11.8%] P=0.019) but no overall difference in procedure time was observed (200 min [155-250] vs. 180 min [145-240] P=0.412). Kaplan-Meier analysis demonstrated significantly poorer survival for patients living in areas with high levels of deprivation (IMD 1-3) (P=0.03). Mortality was comparable for IMD 4-6 and 7-10 groups. Patients from the most deprived areas had longer hospital stay (6 days [4-9] vs. 5 [3-7] P=0.005) and higher all-cause complication rates (21 [36.8%] vs. 14 [18.4%] P=0.02). Decreasing IMD was associated with worse survival (HR -0.85 [0.75-0.97] [P=0.02]). Social deprivation was associated with increased mortality, length of stay and all-cause complication rates in patients undergoing FEVAR for complex abdominal aortic aneurysm (AAA). These results may help direct preoptimization measures to improve outcomes in higher risk sub-groups.

Can birth outcome inequality be reduced using targeted caseload midwifery in a deprived diverse inner city population? A retrospective cohort study, London, UK

Objectives(1) To report maternal and newborn outcomes of pregnant women in areas of social deprivation in inner city London. (2) To compare the effect of caseload midwifery with standard care...

Deprivation and exposure to public activities during the COVID-19 pandemic in England and Wales

BackgroundDifferential exposure to public activities may contribute to stark deprivation-related inequalities in SARS-CoV-2 infection and outcomes but has not been directly investigated. We set out to investigate whether participants in...

The association between physical fitness, sports club participation and body mass index on health-related quality of life in primary school children from a socioeconomically deprived area of England

We examined associations between physical fitness components, body mass index (BMI) and sports club participation on health-related quality of life (HRQoL) in 8- to 11-year-old children from a socioeconomically deprived region of England. From May-October 2019, 432 children completed the HRQoL questionnaire Kidscreen-27 and Leisure Time Physical Activity Survey, and a physical fitness testing battery of 20 m shuttle run test (20mSRT), handgrip strength (Handgrip), standing broad jump (Broad Jump), and sit-and-reach. Height, body mass, BMI and somatic maturity data were collected. Comparisons with reference populations were undertaken using a quintile framework. Linear and quantile regression assessed associations between physical fitness components and HRQoL variables. Using English Indices of Multiple Deprivation, 90% of children were from the most deprived quintile and 39% were overweight or obese. More children scored poorly on the Physical Wellbeing (40%) and Psychological Wellbeing (45%) HRQoL domains than the reference population (31%). Physical fitness scores were generally classed as ‘low’-’very low’ (42–58%). 20mSRT and Broad Jump performance explained an additional 10.7% of variance in Physical Wellbeing after adjusting for BMI z-score, sex and age (total R2 21.2%). Quantile regression identified a subset of children who rated Physical Wellbeing as high regardless of 20mSRT performance. Sports club participation was associated with better 20mSRT and Broad Jump performance, and all domains of HRQoL. Our data indicate that some physical fitness components and sports club participation are positively associated with HRQoL of children from socioeconomically deprived areas, irrespective of BMI z-score. Interventions to improve HRQoL should consider both aspects.

A Small Area Estimation Method for Investigating the Relationship between Public Perception of Drug Problems with Neighborhood Prognostics: Trends in London between 2012 and 2019.

The correlation of the public’s perception of drug problems with neighborhood characteristics has rarely been studied. The aim of this study was to investigate factors that correlate with public perceptions in London boroughs using the Mayor’s Office for Policing and Crime (MOPAC) Public Attitude Survey between 2012 and 2019. A subject-specific random effect deploying a Generalized Linear Mixed Model (GLMM) using an Adaptive Gaussian Quadrature method with 10 integration points was applied. To obtain time trends across inner and outer London areas, the GLMM was fitted using a Restricted Marginal Pseudo Likelihood method. The perception of drug problems increased with statistical significance in 17 out of 32 London boroughs between 2012 and 2019. These boroughs were geographically clustered across the north of London. Levels of deprivation, as measured by the English Index of Multiple Deprivation, as well as the percentage of local population who were non-UK-born and recorded vehicle crime rates were shown to be positively associated with the public’s perception of drug problems. Conversely, recorded burglary rate was negatively associated with the public’s perception of drug problems in their area. The public are influenced in their perception of drug problems by neighborhood factors including deprivation and visible manifestations of antisocial behavior.

Kabul Koşulları Önemli midir? Hollanda ve Türkiye'de İngilizce Öğretmenliği Programı Kabul Koşulları Kıyaslaması

Qualifications of language teachers affect their students' language development and proficiency. Turkish learners' low performance in international English proficiency indices requires an investigation of the qualifications of language teachers from a critical point of view. Without doubt, one of the crucial qualifications that language teachers need to possess is a high proficiency and competency in the target language. However, graduating from different programs in high schools, students are placed in English language teaching (ELT) programs with limited English proficiency. Considering the success of the Netherlands as the top country in international English proficiency indices, this study aims to find the admission requirements of the ELT programs in the Netherlands, to compare them with the ones in Turkey, and to suggest comprehensive admission requirements for ELT programs in Turkey. In this regard, a document analysis merging a detailed analysis of information regarding the admission requirements of the ELT programs in both countries and national and international statistics was conducted. Consequently, some recommendations regarding the likely changes to be made in the admission requirements to the ELT programs in Turkey are made.

RETRACTED ARTICLE: Coastal soil pollution detection and business English teaching index construction based on deep feature fusion

This paper proposes a deep learning model, which classifies web pages based on deep feature fusion. The model has the function of using Text CNN to extract the text of important tags in the web page. It also has the function of using XL Net to extract the text of other tags in the web page. The two parts of the function in the webpage are combined together, which effectively solves the problem of feature collinearity and vector sparseness in the process of network deep feature fusion. This article discusses a deep merging mechanism that can improve the merging of the semantic features of important tags with the semantic features of other web pages. Experimental results show that this method is based on a deep fusion deep learning model and can be used for efficient and high-precision classification of website text. At the same time, the development index of an effective English language model for business research and index system is established in the study. The research is based on theoretical analysis, concept deduction, teaching reform projects, textbook drafts, teaching materials, teacher training basic knowledge, and teaching competitions. Theoretical model of English teaching development index. In addition, this article also introduces the actual soil of a certain area of China as the research object, and 16 kinds of phthalate esters were tested in the soil of this area. By determining the physical and chemical properties of soil enzymes, the effects of phthalate microbial communities, and soil microbial communities on different planting methods were analyzed. This paper uses deep functional fusion technology to detect soil pollution and display the concentration of phthalate pollutants in the soil, as well as the response of business English to the construction of teaching index.

Inequalities in incident and prevalent multimorbidity in England, 2004–19: a population-based, descriptive study

The increasing burden of multimorbidity and its socioeconomic gradient poses unique challenges to the provision and structure of health care. We aimed to describe inequalities and trends over time in multimorbidity prevalence, incidence, and case fatality among adults of all ages in England using primary care electronic health records. We used a random sample of 991 243 individuals from the Clinical Practice Research Datalink Aurum database registered at participating general practices within England between Jan 1, 2004, and Dec 31, 2019, linked to the 2015 English Index of Multiple Deprivation (IMD). We used the following two outcome measures: basic multimorbidity, comprising two or more chronic conditions; and complex multimorbidity, comprising at least three chronic conditions affecting at least three body systems. We calculated crude, age-standardised, and age-sex-standardised annual incidence, prevalence, and case fatality rates, along with median age of onset for both multimorbidity types. We calculated absolute and relative inequalities for each outcome. In 2004, 30·8% of our study population had basic multimorbidity and 15·1% had complex multimorbidity. This increased to 52·8% and 32·7%, respectively, in 2019. Although the overall incidence of basic multimorbidity remained stable over the 16-year study period, the incidence among people of working age and the incidence of complex multimorbidity increased gradually. Socioeconomic deprivation was associated with an increased incidence of both multimorbidity types in working-age adults. The median age at onset of complex multimorbidity was 7 years younger for the most deprived quintile of the IMD compared with the least deprived quintile. The burden of multimorbidity in England has increased substantially over the past 16 years with persistent inequalities, which are worse in working-age adults and for complex multimorbidity. Prevention efforts to reduce the onset and slow the progression of multimorbidity are essential to reduce the increasing impact on patients and health systems alike. University of Liverpool and UK National Institute for Health Research School for Public Health Research.

Self-harm in children 12\xa0years and younger: characteristics and outcomes based on the Multicentre Study of Self-harm in England

BackgroundVery little is known about self-harm in children. We describe the characteristics and outcomes of children under 13 years who presented following self-harm to five hospitals in England.MethodsWe included children under 13 years who presented after self-harm to hospitals in the Multicentre Study of Self-harm in England. Information on patients’ characteristics and method of self-harm was available through monitoring of self-harm in the hospitals. Area level of socioeconomic deprivation was based on the English Index of Multiple Deprivation (IMD).Results387 children aged 5–12 years presented to the study hospitals in 2000–2016, 39% of whom were 5–11 years. Boys outnumbered girls 2:1 at 5–10 years. The numbers of boys and girls were similar at age 11, while at 12 years there were 3.8 girls to every boy. The proportion of study children living in neighbourhoods ranked most deprived (43.4%) was twice the national average. 61.5% of children self-poisoned, 50.6% of them by ingesting analgesics. Of children who self-injured, 45.0% self-cut/stabbed, while 28.9% used hanging/asphyxiation. 32% of the children had a repeat hospital presentation for self-harm, 13.5% re-presented within a year.ConclusionsGender patterns of self-harm until age 11 years are different to those of adolescents, with a male preponderance, especially in 5–10 years, and hanging/suffocation being more common. The frequent use of self-poisoning in this age group highlights the need for public health messages to encourage safer household storage of medicines. Self-harm in children is strongly associated with socioeconomic deprivation; understanding the mechanisms involved could be important in effective prevention.

Exploration of the Compilation of English Learning Materials for Chinese College Students Based on Big Data under the Guidance of Complex Dynamic Theory

With the help of big data and Citespace software, this research makes a statistical analysis of the journals and dissertations on College English teaching and learning materials collected by CNKI from 2011 to 2020. This paper, based on the knowledge map drawn by the visualized analysis of literatures volume, authors, research institutions and keywords clustering, analyzes the current research status and hotspots in the compilation of China’s College English textbooks. It is found that there are six problems in the compilation. Because of the complexity of teaching and learning materials and the dynamic progress of language learning, the nature of English teaching and learning materials is bound to turn from a learning tool to learning resources. Thus, this research, from the perspective of Complex Dynamic System Theory, attempts to develop big data-based College English learning materials with digital, individual and multi-dimensional characteristics by three paths: the establishment of big data-based English learning behaviors index system, the development of big data-based College English learning materials and the application of big data-based College English learning materials. This paper will explore a new way of developing China’s College English learning materials, improve and optimize the compilation and development of College English learning materials in China.

A Study on the New Compilation of College English Learning Materials Based on Big Data in China

This paper finds that there are six problems in the compilation. Because of the complexity of teaching and learning materials and the dynamic progress of language learning, the nature of English teaching and learning materials is bound to turn from a learning tool to learning resources. Thus, this research, from the perspective of Complex Dynamic System Theory, attempts to develop big data-based College English learning materials with digital, individual and multi-dimensional characteristics by three paths: the establishment of big data-based English learning behaviors index system, the development of big data-based College English learning materials and the application of big data-based College English learning materials. This paper will explore a new way of developing China’s College English learning materials and improving and optimising the compilation and development of College English learning materials in China.

Peer review declaration

All papers published in this volume of IOP Conference Series: Materials Science and Engineering have been peer reviewed through processes administered by the Editors. Reviews were conducted by expert referees to the professional and scientific standards expected of a proceedings journal published by IOP Publishing.• Type of peer review: Double-blind • Conference submission management system: Easy Chair and our own online Submission system • Number of submissions received: 292 • Number of submissions sent for review: 280 • Number of submissions accepted: 86 • Acceptance Rate (Number of Submissions Accepted / Number of Submissions Received X 100): 30% • Average number of reviews per paper: 6 • Total number of reviewers involved: 3 • Any additional info on review process: The pre-screening process is led by the Review Committee Head and is focused on the following metrics: Conference Scope, Technical English, Paper Quality, and Similarity Index. Reviewers will be chosen based on the consistency of their analysis and their previous review experience. All of the papers obtained will be reviewed for plagiarism using the crosscheck iThenticate method. The papers will be allocated to reviewers by the technical committee, with each reviewer receiving a maximum of six papers. Acceptance will be based on the recommendations of two reviewers. • Contact person for queries: Dr. K. Geetha kgeetha.jctcet@gmail.com

Summary

English index

Tuberculosis in Solid-Organ Transplant Recipients in Turkey: Meta-Analysis From the Tuberculosis Study Group of Turkish Transplantation Society, Solid Organ Transplantation Infections.

Tuberculosis risk in solid-organ transplant recipients is more than the general population, although tuberculosis incidence has been reported to decrease 5% in the last decade in Turkey. In Turkey, solid-organ transplants started in 1975; however, routine pretransplant tuberculosis risk screening programs are still not established. Therefore, we conducted a meta-analysis of tuberculosis prevalence, clinical forms, and prognosis of tuberculosis in solid-organ transplant recipients. We searched PubMed, Web of Knowledge, Google Scholar, EBSCOhost, and Scopus databases in English and Turkish Medical Index of Turkish Academic Network and Information Center, Turkish Citation Index, Turkish Medline, Central Thesis of ULAKBIM databases in Turkish (from inception until December 2018) for national and international reference lists of all relevant papers. We used standard methodological procedures (Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009). We found 199 published studies in English and 26 in Turkish. After exclusion of noneligible studies, there were 10 retrospective research articles and 16 case reports. There were 148 (3.2%) tuberculosis cases with 4553 solid-organ transplant recipients (4031 renal, 522 liver). Of the tuberculosis cases, 50 (33.8%) were pulmonary, 21 (14.2%) were pulmonary and extrapulmonary, 13 (8.8%) were miliary, 27 (18.2%) were disseminated, and 37 (25.0%) were extra-pulmonary tuberculosis cases involving a maximum of 2 organs. There were 19 cases (12.8%) of graft lost. Of the patients with tuberculosis, 34 (19.9%) died resulting from either tuberculosis or other reasons. In this meta-analysis, most of the centers did not perform pretransplant risk evaluations; every center had different clinical procedures and follow-ups. Tuberculosis prevalence in solid-organ transplant recipients differs according to study population. Case reports were mostly about extrapulmonary tuberculosis. All such patients should be followed-up by a standard regimen during pretransplant and posttransplant periods. Prospective studies should be considered.

Impact of socio-economic deprivation on endometrial cancer survival in the North West of England: a prospective database analysis.

ObjectiveTo assess the impact of socio‐economic deprivation on endometrial cancer survival.DesignSingle‐centre prospective database study.SettingNorth West England.PopulationWomen with endometrial cancer treated between 2010 and 2015.MethodsAreal‐level socio‐economic status, using the English indices of multiple deprivation from residential postcodes, was analysed in relation to survival using Kaplan–Meier estimation and multivariable Cox regression.Main outcome measuresOverall survival, cancer‐specific survival and patterns and rates of recurrence.ResultsA total of 539 women, with a median age of 66 years (interquartile range, IQR 56–73 years) and a body mass index (BMI) of 32 kg/m2 (IQR 26–39 kg/m2), were included in the analysis. Women in the most deprived social group were younger (median 64 years, IQR 55–72 years) and more obese (median 34 kg/m2, IQR 28–42 kg/m2) than women in the least deprived group (median age 68 years, IQR 60–74 years; BMI 29 kg/m2, IQR 25–36 kg/m2; P = 0.002 and <0.001, respectively). There were no differences in endometrial cancer type, stage or grade between social groups. There was no difference in recurrence rates, however, women in the middle and most deprived social groups were more likely to present with distant/metastatic recurrence (80.6 and 79.2%, respectively) than women in the least deprived group (43.5%, P < 0.001). Women in the middle and most deprived groups had a two‐fold (adjusted hazard ratio, HR = 2.00, 95% CI 1.07–3.73, P = 0.030) and 53% (adjusted HR = 1.53, 95% CI 0.77–3.04, P = 0.221) increase in cancer‐specific mortality compared with women in the least deprived group. There were no differences in overall survival.ConclusionsWe found that socio‐economically deprived women with endometrial cancer were more likely to develop fatal recurrence. Larger studies are needed to confirm these findings and to identify modifiable contributing factors.Tweetable abstractSocio‐economic deprivation is linked to an increased risk of death from endometrial cancer in the North West of England.

Healthcare practitioner views and experiences of patients self-monitoring blood pressure: a vignette study.

BackgroundHome self-monitoring of blood pressure is widely used in primary care to assist in the diagnosis of hypertension, as well as to improve clinical outcomes and support adherence to medication. The National Institute for Health and Care Excellence (NICE) care pathways for hypertension recommend specific guidelines, although they lack detail on supporting patients to self-monitor.AimTo elicit primary care practitioners’ experiences of managing patients’ home blood pressure self-monitoring, across surgeries located in different socioeconomic areas.Design & settingA qualitative focus group study was conducted with a total of 21 primary care professionals.MethodParticipants were GPs and practice nurses (PNs), purposively recruited from surgeries in areas of low and high deprivation, according to the English indices of multiple deprivation. Six vignettes were developed featuring data from interviews with people who self-monitor and these were used in five focus groups. Results were thematically analysed.ResultsThemes derived in the thematic analysis largely reflected topics covered by the vignettes. These included: advice on purchase of a device; supporting home monitoring; mitigating patient anxiety experienced as a result of home monitoring; valuing patients’ data; and effect of socioeconomic factors.ConclusionThe work provides an account of methods used by primary care practitioners in the management of home blood pressure self-monitoring, where guidance may be lacking and primary care practitioners act on their own judgement. Findings complement recent policy documentation, which recognises the need to adopt new ways of working to empower patients (for example, additional support from healthcare assistants), but lacks detail on how this should be done.

Assessing the effectiveness of actionable nutrigenomics and lifestyle genomics interventions for weight management in clinical practice: A critical, scoping review with directions for future research.

The use of nutrigenomics and lifestyle genomics in clinical practice has the potential to optimize weight-related outcomes for patients. A scoping review was conducted to summarize and evaluate the current body of knowledge related to the effectiveness of providing DNA-based lifestyle advice on weight-related outcomes, with the aim of providing direction for future research. Primary studies were included if they were written in English, evaluated weight-related and/or body mass index and/or body composition outcomes, and provided participants with an actionable genetic-based lifestyle intervention; interventions that only provided information on genetic risk for diseases/conditions were excluded. Data was extracted from each article meeting inclusion criteria (N=3) and the studies were critically appraised for methodological limitations. Research in this area is promising, but limited. Specific limitations relate to study designs, the nature of the recommendations provided to participants, small (underpowered) sample sizes, the use of self-reported weight/BMI data and lack of consideration of important confounding factors. Therefore, the effectiveness of nutrigenomics and lifestyle genomics interventions for weight management in clinical practice cannot yet be conclusively determined. Recommendations for future research are detailed in the present manuscript.

A Novel Fuzzy Evaluation Method on Teaching Quality of College English based on Preference Selection Index

The evaluation of teaching quality is an important part of the quality management of teaching in colleges and universities. Many evaluation systems exist shortcomings, which are not suitable for the evaluation of English class. Because English subject has its own characteristics, in which the evaluation subject taken on students is more suitable than on teachers. This paper will propose a college English evaluation index system on the basis of students as the evaluation subject. Since the evaluation indicators are mainly qualitative indicators, which makes the evaluation value fuzzy, this paper proposes a new evaluation method of college English classroom teaching evaluation based on linguistic terms, triangular fuzzy numbers and preference selection index method. Finally, an algorithm case is analyzed to illustrate the effectiveness and feasibility of the proposed method.

Socioeconomic status and disease-modifying therapy prescribing patterns in people with multiple sclerosis

AimsTo examine the association between socioeconomic status (SES) and disease-modifying therapy (DMT) prescribing patterns in people with relapsing-remitting multiple sclerosis (pwRRMS). MethodsA cross-sectional analysis was conducted among pwRRMS treated with a DMT in the neuroinflammation service at The Royal London Hospital (Barts Health NHS Trust). Study data were collected between July and September 2017. SES was determined by patient income and education extracted from the English Index of Multiple Deprivation. Based on their efficacy, DMTs were categorized as moderate efficacy (Glatiramer Acetate and Beta-Interferons), high efficacy (Cladribine, Fingolimod and Dimethyl Fumarate) and very-high efficacy therapies (Natalizumab and Alemtuzumab). Multinomial logistic regressions were performed for univariate and multivariate models to assess differences between SES and DMT prescribing patterns. ResultsTreatment consisted of moderate efficacy (n = 76, 12%), high efficacy (n = 325, 51.3%) and very-high efficacy therapies (n = 232, 36.7%). Medians for income and education deciles were 4 (IQR 3–7) and 6 (IQR 4–8), respectively. After multinomial logistic regression analysis, patient income was not associated with increased odds of being treated with high efficacy (OR, 0.92; 95% CI, 0.82–1.04; p = 0.177) or very-high efficacy DMTs (OR, 0.95; 95% CI, 0.85–1.06; p = 0.371). Similarly, patient education was not associated with being treated with high efficacy (OR, 0.91; 95% CI, 0.80–1.03; p = 0.139) or very-high efficacy therapies (OR, 0.92; 95% CI, 0.81–1.04; p = 0.188). ConclusionsSES was not predictive of DMT prescribing patterns in pwRRMS. Whilst this appears reassuring within this universal health care setting, the same methodology needs to be applied to other MS services for comparison. Data could then be further interrogated to explore potential socioeconomic inequities in DMT prescribing patterns across the UK.

Socioeconomic Status and Ovarian Cancer Stage at Diagnosis: A Study Nested Within UKCTOCS.

Background: Tubo-ovarian cancer (OC) continues to be the most lethal of all gynaecological cancers. Over half of women are diagnosed with late stage (III/IV) disease, which has a five-year survival rate of 11%. Socioeconomic status (SES) has been shown to have an impact on outcomes of several cancer types, including OC. This study aims to investigate any potential association between SES and stage at diagnosis of OC. Methods: Women from the non-screening arm of the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) with a confirmed diagnosis of OC prior to 01 January 2015 and an English index of multiple deprivation (IMD) score were eligible for the study. The association between IMD and OC stage (FIGO) was analysed using an ordinal logistic regression model adjusted for age at diagnosis and BMI. Results: Four-hundred and fifty seven women were eligible for inclusion in the primary analysis. The odds of being diagnosed with the higher dichotomization of stage (I vs. II/III/IV; I/II vs. III/IV; I/II/III vs. IV) was 1.29 (p = 0.017; 95% CI: 1.048–1.592) per unit SD (standard deviation) increase in IMD. This translates to a 29% increase in odds of being diagnosed at the higher stage per each unit SD increase in IMD. Conclusion: Increased deprivation is consistently associated with a higher probability of being diagnosed with later stage OC.