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Article ; Online: Reducing the burden of knee osteoarthritis through community pharmacy: Protocol for a randomised controlled trial of the Knee Care for Arthritis through Pharmacy Service.

Darlow, Ben / Brown, Melanie / Stanley, James / Abbott, J Haxby / Briggs, Andrew M / Clark, Jane / Frew, Gareth / Grainger, Rebecca / Hood, Fiona / Hudson, Ben / Keenan, Rāwiri / Marra, Carlo / McKinlay, Eileen / Pask, Alison / Pierobon, Andrés / Simmonds, Shirley / Vincent, Loren / Wilson, Ross / Dean, Sarah

Musculoskeletal care

2023 Volume 21, Issue 4, Page(s) 1053–1067

Abstract: Introduction: Knee osteoarthritis (OA) negatively impacts the health outcomes and equity, social and employment participation, and socio-economic wellbeing of those affected. Little community-based support is offered to people with knee OA in Aotearoa ... ...

Abstract	Introduction: Knee osteoarthritis (OA) negatively impacts the health outcomes and equity, social and employment participation, and socio-economic wellbeing of those affected. Little community-based support is offered to people with knee OA in Aotearoa New Zealand. Identifying Māori and non-Māori with knee OA in community pharmacy and providing co-ordinated, evidence- and community-based care may be a scalable, sustainable, equitable, effective and cost-effective approach to improve health and wellbeing. Aim: Assess whether the Knee Care for Arthritis through Pharmacy Service (KneeCAPS) intervention improves knee-related physical function and pain (co-primary outcomes). Secondary aims assess impacts on health-related quality of life, employment participation, medication use, secondary health care utilisation, and relative effectiveness for Māori. Methods and analysis: A pragmatic randomised controlled trial will compare the KneeCAPS intervention to the Pharmaceutical Society of New Zealand Arthritis Fact Sheet and usual care (active control) at 12 months for Māori and non-Māori who have knee OA. Participants will be recruited in community pharmacies. Knee-related physical function will be measured using the function subscale of the Short Form of the Western Ontario and McMaster Universities Osteoarthritis Index. Knee-related pain will be measured using an 11-point numeric pain rating scale. Primary outcome analyses will be conducted on an intention-to-treat basis using linear mixed models. Parallel within-trial health economic analysis and process evaluation will also be conducted. Ethics and trial dissemination: Ethical approval was obtained from the Central Health and Ethics Committee (2022-EXP-11725). The trial is registered with ANZCTR (ACTRN12622000469718). Findings will be submitted for publication and shared with participants.
MeSH term(s)	Humans ; Osteoarthritis, Knee/therapy ; Pharmacies ; Quality of Life ; Maori People ; Treatment Outcome ; Pain ; Exercise Therapy/methods ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2023-05-22
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2171452-6
ISSN	1557-0681 ; 1478-2189
ISSN (online)	1557-0681
ISSN	1478-2189
DOI	10.1002/msc.1785
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Article ; Online: The Hertfordshire Cohort Study: an overview.

Syddall, Holly E / Simmonds, Shirley J / Carter, Sarah A / Robinson, Sian M / Dennison, Elaine M / Cooper, Cyrus

F1000Research

2019 Volume 8, Page(s) 82

Abstract: The Hertfordshire Cohort Study is a nationally unique study of men and women born in the English county of Hertfordshire in the early part of the ... ...

Abstract	The Hertfordshire Cohort Study is a nationally unique study of men and women born in the English county of Hertfordshire in the early part of the 20
MeSH term(s)	England ; Female ; Health Status ; Humans ; Life Style ; Longitudinal Studies ; Male
Language	English
Publishing date	2019-01-21
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2699932-8
ISSN	2046-1402 ; 2046-1402
ISSN (online)	2046-1402
ISSN	2046-1402
DOI	10.12688/f1000research.17457.1
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Article ; Online: Identification of risk factors for hospital admission using multiple-failure survival models: a toolkit for researchers.

Westbury, Leo D / Syddall, Holly E / Simmonds, Shirley J / Cooper, Cyrus / Sayer, Avan Aihie

BMC medical research methodology

2016 Volume 16, Page(s) 46

Abstract: Background: The UK population is ageing; improved understanding of risk factors for hospital admission is required. Linkage of the Hertfordshire Cohort Study (HCS) with Hospital Episode Statistics (HES) data has created a multiple-failure survival ... ...

Abstract	Background: The UK population is ageing; improved understanding of risk factors for hospital admission is required. Linkage of the Hertfordshire Cohort Study (HCS) with Hospital Episode Statistics (HES) data has created a multiple-failure survival dataset detailing the characteristics of 2,997 individuals at baseline (1998-2004, average age 66 years) and their hospital admissions (regarded as 'failure events') over a 10 year follow-up. Analysis of risk factors using logistic regression or time to first event Cox modelling wastes information as an individual's admissions after their first are disregarded. Sophisticated analysis techniques are established to examine risk factors for admission in such datasets but are not commonly implemented. Methods: We review analysis techniques for multiple-failure survival datasets (logistic regression; time to first event Cox modelling; and the Andersen and Gill [AG] and Prentice, Williams and Peterson Total Time [PWP-TT] multiple-failure models), outline their implementation in Stata, and compare their results in an analysis of housing tenure (a marker of socioeconomic position) as a risk factor for different types of hospital admission (any; emergency; elective; >7 days). The AG and PWP-TT models include full admissions histories in the analysis of risk factors for admission and account for within-subject correlation of failure times. The PWP-TT model is also stratified on the number of previous failure events, allowing an individual's baseline risk of admission to increase with their number of previous admissions. Results: All models yielded broadly similar results: not owner-occupying one's home was associated with increased risk of hospital admission. Estimated effect sizes were smaller from the PWP-TT model in comparison with other models owing to it having accounted for an increase in risk of admission with number of previous admissions. For example, hazard ratios [HR] from time to first event Cox models were 1.67(95 % CI: 1.36,2.04) and 1.63(95 % CI:1.36,1.95) for not owner-occupying one's home in relation to risk of emergency admission or death among women and men respectively; corresponding HRs from the PWP-TT model were 1.34(95 % CI:1.15,1.56) for women and 1.23(95 % CI:1.07,1.41) for men. Conclusion: The PWP-TT model may be implemented using routine statistical software and is recommended for the analysis of multiple-failure survival datasets which detail repeated hospital admissions among older people.
MeSH term(s)	Aged ; Cohort Studies ; Female ; Hospital Mortality ; Hospitalization/statistics & numerical data ; Humans ; Logistic Models ; Male ; Middle Aged ; Patient Admission/statistics & numerical data ; Patient Discharge/statistics & numerical data ; Proportional Hazards Models ; Risk Assessment/methods ; Risk Assessment/statistics & numerical data ; Risk Factors ; Survival Analysis
Language	English
Publishing date	2016-04-26
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041362-2
ISSN	1471-2288 ; 1471-2288
ISSN (online)	1471-2288
ISSN	1471-2288
DOI	10.1186/s12874-016-0147-x
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Article ; Online: Understanding poor health behaviours as predictors of different types of hospital admission in older people: findings from the Hertfordshire Cohort Study.

Syddall, Holly E / Westbury, Leo D / Simmonds, Shirley J / Robinson, Sian / Cooper, Cyrus / Sayer, Avan Aihie

Journal of epidemiology and community health

2015 Volume 70, Issue 3, Page(s) 292–298

Abstract: Background: Rates of hospital admission are increasing, particularly among older people. Poor health behaviours cluster but their combined impact on risk of hospital admission among older people in the UK is unknown.: Methods: 2997 community-dwelling ...

Abstract	Background: Rates of hospital admission are increasing, particularly among older people. Poor health behaviours cluster but their combined impact on risk of hospital admission among older people in the UK is unknown. Methods: 2997 community-dwelling men and women (aged 59-73) participated in the Hertfordshire Cohort Study (HCS). We scored (from 0 to 4) number of poor health behaviours engaged in at baseline (1998-2004) out of: current smoking, high weekly alcohol, low customary physical activity and poor diet. We linked HCS with Hospital Episode Statistics and mortality data to 31/03/2010 and analysed associations between the score and risk of different types of hospital admission: any; elective; emergency; long stay (>7 days); 30-day readmission (any, or emergency). Results: 32%, 40%, 20% and 7% of men engaged in 0, 1, 2 and 3/4 poor health behaviours; corresponding percentages for women 51%, 38%, 9%, 2%. 75% of men (69% women) experienced at least one hospital admission. Among men and women, increased number of poor health behaviours was strongly associated (p<0.01) with greater risk of long stay and emergency admissions, and 30-day emergency readmissions. Hazard ratios (HRs) for emergency admission for 3/4 poor health behaviours in comparison with none were: men, 1.37 (95% CI 1.11 to 1.69); women, 1.84 (95% CI 1.22 to 2.77). Associations were unaltered by adjustment for age, body mass index and comorbidity. Conclusions: Clustered poor health behaviours are associated with increased risk of hospital admission among older people in the UK. Lifecourse interventions to reduce number of poor health behaviours could have substantial beneficial impact on health and use of healthcare in later life.
MeSH term(s)	Aged ; Aged, 80 and over ; Alcohol Drinking/epidemiology ; Cohort Studies ; Diet ; Emergency Treatment/statistics & numerical data ; Female ; Follow-Up Studies ; Health Behavior ; Hospitalization/statistics & numerical data ; Humans ; Life Style ; Male ; Middle Aged ; Patient Admission/statistics & numerical data ; Proportional Hazards Models ; Risk Factors ; Sex Distribution ; Smoking/epidemiology ; United Kingdom/epidemiology
Language	English
Publishing date	2015-10-19
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	391868-3
ISSN	1470-2738 ; 0142-467X ; 0141-7681 ; 0143-005X
ISSN (online)	1470-2738
ISSN	0142-467X ; 0141-7681 ; 0143-005X
DOI	10.1136/jech-2015-206425
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Article ; Online: Commentary: Inequalities in cancer screening programmes.

Sarfati, Diana / Shaw, Caroline / Simmonds, Shirley

International journal of epidemiology

2010 Volume 39, Issue 3, Page(s) 766–768

MeSH term(s)	Europe ; Female ; Healthcare Disparities/statistics & numerical data ; Humans ; Mammography/statistics & numerical data ; National Health Programs/statistics & numerical data ; Social Class ; Socioeconomic Factors ; Vaginal Smears/statistics & numerical data
Language	English
Publishing date	2010-06
Publishing country	England
Document type	Comment ; Journal Article
ZDB-ID	187909-1
ISSN	1464-3685 ; 0300-5771
ISSN (online)	1464-3685
ISSN	0300-5771
DOI	10.1093/ije/dyq039
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Article ; Online: Age standardisation – an indigenous standard?

Simmonds Shirley / Cram Fiona / Purdie Gordon / Robson Bridget

Emerging Themes in Epidemiology, Vol 4, Iss 1, p

2007 Volume 3

Abstract: Abstract The study of inequities in health is a critical component of monitoring government obligations to uphold the rights of Indigenous Peoples. In Aotearoa/New Zealand the indigenous Māori population has a substantially younger age structure than the ...

Abstract	Abstract The study of inequities in health is a critical component of monitoring government obligations to uphold the rights of Indigenous Peoples. In Aotearoa/New Zealand the indigenous Māori population has a substantially younger age structure than the non-indigenous population making it necessary to account for age differences when comparing population health outcomes. An age-standardised rate is a summary measure of a rate that a population would have if it had a standard age structure. Changing age standards have stimulated interest in the potential impact of population standards on disparities data and consequently on health policy. This paper compares the age structure of the Māori and non-Māori populations with two standard populations commonly used in New Zealand: Segi's world and WHO world populations. The performance of these standards in Māori and non-Māori mortality data was then measured against the use of the Māori population as a standard. It was found that the choice of population standard affects the magnitude of mortality rates, rate ratios and rate differences, the relative ranking of causes of death, and the relative width of confidence intervals. This in turn will affect the monitoring of trends in health outcomes and health policy decision-making. It is concluded that the choice of age standard has political implications and the development and utilisation of an international indigenous population standard should be considered.
Keywords	Public aspects of medicine ; RA1-1270 ; Medicine ; R ; DOAJ:Public Health ; DOAJ:Health Sciences
Subject code	360
Language	English
Publishing date	2007-05-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Age standardisation - an indigenous standard?

Robson, Bridget / Purdie, Gordon / Cram, Fiona / Simmonds, Shirley

Emerging themes in epidemiology

2007 Volume 4, Page(s) 3

Abstract: The study of inequities in health is a critical component of monitoring government obligations to uphold the rights of Indigenous Peoples. In Aotearoa/New Zealand the indigenous Māori population has a substantially younger age structure than the non- ... ...

Abstract	The study of inequities in health is a critical component of monitoring government obligations to uphold the rights of Indigenous Peoples. In Aotearoa/New Zealand the indigenous Māori population has a substantially younger age structure than the non-indigenous population making it necessary to account for age differences when comparing population health outcomes. An age-standardised rate is a summary measure of a rate that a population would have if it had a standard age structure. Changing age standards have stimulated interest in the potential impact of population standards on disparities data and consequently on health policy. This paper compares the age structure of the Māori and non-Māori populations with two standard populations commonly used in New Zealand: Segi's world and WHO world populations. The performance of these standards in Māori and non-Māori mortality data was then measured against the use of the Māori population as a standard. It was found that the choice of population standard affects the magnitude of mortality rates, rate ratios and rate differences, the relative ranking of causes of death, and the relative width of confidence intervals. This in turn will affect the monitoring of trends in health outcomes and health policy decision-making. It is concluded that the choice of age standard has political implications and the development and utilisation of an international indigenous population standard should be considered.
Language	English
Publishing date	2007-05-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2164388-X
ISSN	1742-7622 ; 1742-7622
ISSN (online)	1742-7622
ISSN	1742-7622
DOI	10.1186/1742-7622-4-3
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Article ; Online: Grip strength among community-dwelling older people predicts hospital admission during the following decade.

Simmonds, Shirley J / Syddall, Holly E / Westbury, Leo D / Dodds, Richard M / Cooper, Cyrus / Aihie Sayer, Avan

Age and ageing

2015 Volume 44, Issue 6, Page(s) 954–959

Abstract: Background: Lower grip strength on admission to hospital is known to be associated with longer stay, but the link between customary grip and risk of future admission is less clear.: Objective: To compare grip strength with subsequent risk of hospital ...

Abstract	Background: Lower grip strength on admission to hospital is known to be associated with longer stay, but the link between customary grip and risk of future admission is less clear. Objective: To compare grip strength with subsequent risk of hospital admission among community-dwelling older people in a U.K. setting. Design: Cohort study with linked administrative data. Setting: Hertfordshire, U.K. Subjects: A total of 2,997 community-dwelling men and women aged 59-73 years at baseline. Methods: The Hertfordshire Cohort Study (HCS) participants completed a baseline assessment between 1998 and 2004, during which grip strength was measured. Hospital Episode Statistics and mortality data to March 2010 were linked with the HCS database. Statistical models were used to investigate the association of grip strength with subsequent elective, emergency and long-stay hospitalisation and readmission. Results: There was a statistically significant negative association between grip strength and all classes of admission in women [unadjusted hazard ratio per standard deviation (SD) decrease in grip strength for: any admission/death 1.10 (95% CI: 1.06, 1.14), elective admission/death 1.09 (95% CI: 1.05, 1.13), emergency admission/death 1.21 (95% CI: 1.13, 1.31), long-stay admission/death 1.22 (95% CI: 1.13, 1.32) and unadjusted relative risk per SD decrease in grip strength for 30-day readmission/death 1.30 (95% CI: 1.19, 1.43)]. These associations remained significant after adjustment for potential confounding factors (age, height, weight for height, smoking, alcohol, social class). In men, unadjusted rates for emergency admission/death, long-stay admission/death and readmission/death were significantly associated with grip strength; associations that similarly withstood adjustment. Conclusion: This study provides the first evidence that grip strength among community-dwelling men and women in the U.K. is associated with risk of hospital admission over the following decade.
MeSH term(s)	Aged ; Female ; Hand Strength/physiology ; Hospitalization/statistics & numerical data ; Humans ; Independent Living/statistics & numerical data ; Male ; Middle Aged ; Predictive Value of Tests ; Risk Factors ; United Kingdom/epidemiology
Language	English
Publishing date	2015-10-26
Publishing country	England
Document type	Journal Article
ZDB-ID	186788-x
ISSN	1468-2834 ; 0002-0729
ISSN (online)	1468-2834
ISSN	0002-0729
DOI	10.1093/ageing/afv146
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Zs.A 877: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Type of milk feeding in infancy and health behaviours in adult life: findings from the Hertfordshire Cohort Study

Robinson, Siân / Ntani, Georgia / Simmonds, Shirley / Syddall, Holly / Dennison, Elaine / Sayer, Avan Aihie / Barker, David / Cooper, Cyrus

British journal of nutrition. 2013 Mar. 28, v. 109, no. 6

2013

Abstract: A number of studies suggest that breast-feeding has beneficial effects on an individual's cardiovascular risk factors in adulthood, although the mechanisms involved are unknown. One possible explanation is that adults who were breastfed differ in their ... ...

Abstract	A number of studies suggest that breast-feeding has beneficial effects on an individual's cardiovascular risk factors in adulthood, although the mechanisms involved are unknown. One possible explanation is that adults who were breastfed differ in their health behaviours. In a historical cohort, adult health behaviours were examined in relation to type of milk feeding in infancy. From 1931 to 1939, records were kept on all infants born in Hertfordshire, UK. Their type of milk feeding was summarised as breastfed only, breast and bottle-fed, or bottle-fed only. Information about adult health behaviours was collected from 3217 of these men and women when they were aged 59–73 years. Diet was assessed using an administered FFQ; the key dietary pattern was a ‘prudent’ pattern that described compliance with ‘healthy’ eating recommendations. Of the study population, 60 % of the men and women were breastfed, 31 % were breast and bottle-fed, and 9 % were bottle-fed. Type of milk feeding did not differ according to social class at birth, and was not related to social class attained in adult life. There were no differences in smoking status, alcohol intake or reported physical activity according to type of milk feeding, but there were differences in the participants' dietary patterns. In a multivariate model that included sex and infant weight gain, there were independent associations between type of feeding and prudent diet scores in adult life (P= 0·009), such that higher scores were associated with having been breastfed. These data support experimental findings which suggest that early dietary exposures can have lifelong influences on food choice.
Keywords	adulthood ; adults ; alcohol drinking ; breast feeding ; cohort studies ; compliance ; diet ; eating habits ; food choices ; infancy ; infants ; men ; milk ; multivariate analysis ; physical activity ; risk factors ; socioeconomic status ; weight gain ; women ; United Kingdom
Language	English
Dates of publication	2013-0328
Size	p. 1114-1122.
Publishing place	Cambridge University Press
Document type	Article
ZDB-ID	280396-3
ISSN	1475-2662 ; 0007-1145
ISSN (online)	1475-2662
ISSN	0007-1145
DOI	10.1017/S000711451200267X
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Understanding NHS hospital admissions in England: linkage of Hospital Episode Statistics to the Hertfordshire Cohort Study.

Simmonds, Shirley J / Syddall, Holly E / Walsh, Bronagh / Evandrou, Maria / Dennison, Elaine M / Cooper, Cyrus / Aihie Sayer, Avan

Age and ageing

2014 Volume 43, Issue 5, Page(s) 653–660

Abstract: Background: concern over the sustainability of the National Health Service (NHS) is often focussed on rising numbers of hospital admissions, particularly among older people. Hospital admissions are enumerated routinely by the Hospital Episode Statistics ...

Abstract	Background: concern over the sustainability of the National Health Service (NHS) is often focussed on rising numbers of hospital admissions, particularly among older people. Hospital admissions are enumerated routinely by the Hospital Episode Statistics (HES) Service, but published data do not allow individual-level service use to be explored. This study linked information on Hertfordshire Cohort Study (HCS) participants with HES inpatient data, with the objective of describing patterns and predictors of admissions among individuals. Methods: 2,997 community-dwelling men and women aged 59-73 years completed a baseline HCS assessment between 1998 and 2004; HES and mortality data to 31 March 2010 were linked with the HCS database. This paper describes patterns of hospital use among the cohort at both the admission and individual person level. Results: the cohort experienced 8,741 admissions; rates were 391 per 1,000 person-years among men (95% CI: 380, 402) and 327 among women (95% CI: 316, 338), P < 0.0001 for gender difference. A total of 1,187 men (75%) and 981 women (69%) were admitted to hospital at least once; among these, median numbers of admissions were 3 in men (inter-quartile range, (IQR): 1, 6) and 2 in women (IQR: 1, 5). Forty-eight percent of those ever admitted had experienced an emergency admission and 70% had been admitted overnight. Discussion: It is possible to link routinely collected HES data with detailed information from a cohort study. Hospital admission is common among community-dwelling 'young-old' men and women. These linked datasets will facilitate research into lifecourse determinants of hospital admission and inform strategies to manage demand on the NHS.
MeSH term(s)	Aged ; Databases, Factual ; Emergency Medical Services/trends ; England/epidemiology ; Female ; Health Care Rationing/trends ; Health Resources/statistics & numerical data ; Health Resources/trends ; Health Services Needs and Demand/trends ; Health Services Research ; Humans ; Length of Stay/trends ; Male ; Medical Record Linkage ; Middle Aged ; Mortality/trends ; Patient Admission/trends ; State Medicine/trends ; Time Factors
Language	English
Publishing date	2014-03-04
Publishing country	England
Document type	Journal Article
ZDB-ID	186788-x
ISSN	1468-2834 ; 0002-0729
ISSN (online)	1468-2834
ISSN	0002-0729
DOI	10.1093/ageing/afu020
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