Mario Cortina Borja - Academia.edu (original) (raw)

Papers by Mario Cortina Borja

Journal of Epidemiology & Community Health, 2010

having pain interference (extremely, quite a bit, moderately) and having no pain interference (a ... more having pain interference (extremely, quite a bit, moderately) and having no pain interference (a little bit, not at all). Life-Course SEP Measures (1) Age left school (young adulthood SEP): those who left school at # the minimum school leaving age assigned low SEP; those who left school at > the minimum school leaving age assigned high SEP, (2) Longest job (adult working life SEP) and (3) Current/recent job (most recent adult SEP): using the National Statistics Socioeconomic Classification, Routine and manual occupations were assigned low SEP; Intermediate and Managerial and professional occupations were assigned high SEP. Life-course SEP trajectories were constructed for each respondent from the three measures. Other Measures BMI, HADS, health locus of control, adequacy of income. Analysis Confined to participants who provided data at three SEP time-points (n¼2535). Association of pain interference with each SEP trajectory (High, High, High (HHH) as reference trajectory) was calculated by logistic regression and adjusted for age, gender and BMI. Forward stepwise logistic regression was used to adjust for potential confounding psychosocial and social factors. Latent class analysis identified any clustering in SEP trajectories. Results Adjusted response to the three stages of the survey was 71e85%. The LLL SEP trajectory was significantly associated with pain interference compared to HHH (OR 2.73; 95% CI 2.16 to 3.45); this association was not altered by age or gender. Adjustment for the remaining factors reduced the association but it remained significant (OR 2.05; 95% CI 1.56 to 2.70). Latent class analysis identified two clusters of SEP trajectories: those that started Low remained Low, those starting High remained High. Conclusion In this study, adults with a consistently low SEP throughout their life-course were more likely to report pain interference in later life.

International Journal of Educational Research, 2020

Lower educational attainment contributes to cycles of disadvantage, which propagate poverty, poor... more Lower educational attainment contributes to cycles of disadvantage, which propagate poverty, poor nutritional status and lack of opportunity across generations (UNESCO, 2017). Although this linkage between education and broader human capital and health outcomes is widely recognised (UNDP, 2018), efforts have primarily focused on increasing the number of children in school. However, many who attend school may be 'silently excluded' from achieving their full learning potential because of poor attendance and low achievement (Lewin, 2007). This is a crucial issue to address because it ultimately increases the risk of early drop-out from school (

International Journal of Epidemiology, 2018

Background: The World Health organization (WHO) recommends that children engage in 60 min daily m... more Background: The World Health organization (WHO) recommends that children engage in 60 min daily moderate-to-vigorous physical activity (dMVPA). Just half of children in the UK achieve these levels (with similarly low levels in other high-income countries). Thus, the dMVPA target is a focus of national obesity strategies. However, the potential impact of increased physical activity on prevalence and inequalities in childhood overweight is unknown. Using objective data from the Millennium Cohort Study ($18 000 children born 2000-02) we simulated a series of hypothetical physical activity intervention scenarios: achievement of the target, and more realistic increases demonstrated in trials. Methods: Predicted probabilities of overweight and obesity (using measured heights and weights at age 11) were estimated in multinomial marginal structural models, adjusting for dMVPA (measured with accelerometers at age 7) and confounding. Inequalities were assessed according to household income quintiles [risk ratios (RRs) and risk differences (RDs)]. Intervention scenarios were simulated by re-estimating predicted probabilities of overweight/ obesity after manipulating (increasing) dMVPA by varying amounts, for different eligibility criteria and with varying uptake. Analyses included 6493 children with accelerometer data. Survey weights and multiple imputation addressed sampling design, attrition and item missingness. Results: In all, 27% children were overweight/obese, with relative and absolute inequalities in the expected direction; 51% children were achieving 60 min dMVPA, with those from the lowest income quintile achieving, on average, 3 min more dMVPA than those from the highest income quintile. A simulation of universal achievement of the dMVPA target reduced the prevalence of overweight/obesity to 22%, but increased relative inequalities (absolute

International Journal of Population Data Science, 2018

BackgroundHarmonisation of different data sources from various electronic health records (EHRs) a... more BackgroundHarmonisation of different data sources from various electronic health records (EHRs) across systems enhances the potential scope and granularity of data available to health data research. ObjectiveTo describe data harmonisation of routine electronic healthcare records in Wales and Scotland linked to a UK longitudinal birth cohort, the Millennium Cohort Study (MCS). MethodsComparable secondary care data was linked, with parental consent, to MCS information for 1838 and 1431 children participating in MCS and residing in Wales and Scotland, by assigning, respectively, unique Anonymised Linkage Fields to personbased records in the privacy protecting Secure Anonymised Information Linkage (SAIL) databank at Swansea University, and by the National Health Service (NHS) Information Standards Division. Survey and non-response weights were created to account for the clustered sample, sample attrition and consent to linkage. Heterogeneous variables from the Patient Episode Dataset fo...

BMJ open respiratory research, 2018

Electronic health records (EHRs) are increasingly used to estimate the prevalence of childhood as... more Electronic health records (EHRs) are increasingly used to estimate the prevalence of childhood asthma. The relation of these estimates to those obtained from parent-reported wheezing suggestive of asthma is unclear. We hypothesised that parent-reported wheezing would be more prevalent than general practitioner (GP)-recorded asthma diagnoses in preschool-aged children. 1529 of 1840 (83%) Millennium Cohort Study children registered with GPs in the Welsh Secure Anonymised Information Linkage databank were linked. Prevalences of parent-reported wheezing and GP-recorded asthma diagnoses in the previous 12 months were estimated, respectively, from parent report at ages 3, 5, 7 and 11 years, and from Read codes for asthma diagnoses and prescriptions based on GP EHRs over the same time period. Prevalences were weighted to account for clustered survey design and non-response. Cohen's kappa statistics were used to assess agreement. Parent-reported wheezing was more prevalent than GP-recor...

AIDS (London, England), Jan 31, 2017

To estimate the incidence of first pregnancy in women living with perinatally acquired HIV (PHIV)... more To estimate the incidence of first pregnancy in women living with perinatally acquired HIV (PHIV) in the United Kingdom and to compare pregnancy management and outcomes with age-matched women with behaviourally acquired HIV (BHIV). The National Study of HIV in Pregnancy and Childhood is a comprehensive, population-based surveillance study that collects demographic and clinical data on all pregnant women living with HIV, their children, and all HIV-infected children in the United Kingdom and Ireland. The incident rate ratio of first pregnancy was calculated for all women of reproductive age who had been reported to the National Study of HIV in Pregnancy and Childhood as vertically infected children. These women and their pregnancies were compared to age-matched pregnant women with BHIV. Of the 630 women with PHIV reported in the United Kingdom as children, 7% (45) went on to have at least one pregnancy, with 70 pregnancies reported. The incident rate ratio of first pregnancy was 13/1...

Public Health Nutrition, 2016

ObjectiveTo develop and validate a photographic food atlas of common foods for dietary assessment... more ObjectiveTo develop and validate a photographic food atlas of common foods for dietary assessment in southern Nepal.DesignWe created a life-sized photographic atlas of forty locally prepared foods. Between March and June 2014, data collectors weighed portion sizes that respondents consumed during one mealtime and then a different data collector revisited the household the next day to record respondents’ estimations of their previous day’s intakes using the atlas. Validity was assessed by percentage error, Cohen’s weighted kappa (κw) and Bland–Altman limits of agreement.SettingDhanusha and Mahottari districts in southern Nepal.SubjectsA random sample of ninety-five adults in forty-eight rural households with a pregnant woman.ResultsOverall, respondents underestimated their intakes (mean error =−4·5 %). Rice anddal(spiced lentil soup) intakes were underestimated (−14·1 % and −34·5 %, respectively), but vegetable curry intake was overestimated (+20·8 %). Rice and vegetable curry portio...

PLOS ONE, 2015

Background Globally, puerperal sepsis accounts for an estimated 8-12% of maternal deaths, but evi... more Background Globally, puerperal sepsis accounts for an estimated 8-12% of maternal deaths, but evidence is lacking on the extent to which clean delivery practices could improve maternal survival. We used data from the control arms of four cluster-randomised controlled trials conducted in rural India, Bangladesh and Nepal, to examine associations between clean delivery kit use and hand washing by the birth attendant with maternal mortality among home deliveries. Methods We tested associations between clean delivery practices and maternal deaths, using a pooled dataset for 40,602 home births across sites in the three countries. Cross-sectional data were analysed by fitting logistic regression models with and without multiple imputation, and confounders were selected a priori using causal directed acyclic graphs. The robustness of estimates was investigated through sensitivity analyses.

BMC Public Health, 2014

Background: Poor adherence to antiretroviral therapy (ART) is associated with HIV disease progres... more Background: Poor adherence to antiretroviral therapy (ART) is associated with HIV disease progression and, during pregnancy, increased mother-to-child transmission risk. In Ukraine, access to combination ART is expanding but data on adherence are scarce. Methods: Cross-sectional surveys of HIV-positive women were conducted i) at delivery (on antenatal ART adherence) and ii) during the first year postpartum (on ART adherence in the preceding four weeks). Factors associated with a score ≤11 on the self-report Case Adherence Support Evaluation (CASE) index or ≥1 self-reported missed dose were assessed using Fisher's exact test. Results: Of 185 antenatal participants and 102 postnatal participants, median ages were 27.5 and 29.5 years respectively: 28% (50/180) and 27% (26/98) reported an unplanned pregnancy, and 13% (24/179) and 17% (17/98) an illicit drug-use history (excluding marijuana). One quarter (49/180 antenatally, 27/101 postnatally) screened positive for depression. The proportion reporting 'low' ART-related self-efficacy (i.e. unable to do ≥1/5 ART-taking activities) was 20% (28/141) antenatally and 17% (11/66) postnatally. Antenatally, 14% (95% CI 10-21%) had a CASE score ≤11 and 35% (95% CI 28-42%) reported missing ≥1 dose. Factors associated with a CASE score ≤11 were unplanned pregnancy (25% (12/48) vs. 11% (13/120) where planned, p = 0.03) and living with extended family (23% (13/57) vs. 10% (12/125) living with partner/alone, p = 0.04). Self-report of ≥1 missed dose antenatally was additionally associated with younger age (p = 0.03) and lower self-efficacy (50% (14/28) reported ≥1 missed dose vs. 28% (30/108) of those with high self-efficacy, p = 0.04). Of 102 postnatal participants, 8% (95% CI 4-15%) had a CASE score ≤11 and 31% (95% CI 22-41%) reported ≥1 missed dose. Of 11 women with low self-efficacy, 3 (27%) had a CASE score ≤11 compared with 3/55 (5%) of those with high self-efficacy (p = 0.05). Current smokers more commonly reported ≥1 missed dose postnatally (50% (13/26) vs. 25% (18/72) of non-smokers, p = 0.03). Conclusions: Our results highlight unmet needs for counselling and support. We identify some groups at risk of poor ART adherence, including women with markers of social vulnerability and those with low ART-related self-efficacy, who may benefit from targeted interventions.

BMJ open, Jan 22, 2014

Legislation to safeguard children from maltreatment by carers or violence by others was advanced ... more Legislation to safeguard children from maltreatment by carers or violence by others was advanced in England and Scotland around 2004-2005 and resulted in different policies and services. We examined whether subsequent trends in injury admissions to hospital related to maltreatment or violence varied between the two countries. We analysed rates of all unplanned injury admission to National Health Service (NHS) hospitals in England and Scotland between 2005 and 2011 for children and adolescents aged less than 19 years. We compared incidence trends for maltreatment or violence-related (MVR) injury and adjusted rate differences between 2005 and 2011 using Poisson or negative binomial regression models to adjust for seasonal effects and secular trends in non-MVR injury. Infants, children 1-10 years and adolescents 11-18 years were analysed separately. In 2005, MVR rates were similar in England and Scotland for infants and 1-10-year-olds, but almost twice as high in Scotland for 11-18-yea...

PLoS ONE, 2013

Background: Many children can be exposed to multiple adversities in low and middle-income countri... more Background: Many children can be exposed to multiple adversities in low and middle-income countries (LMICs) placing them at potential risk of psychological problems. However, there is a paucity of research using large representative cohorts examining the psychological adjustment of children in school settings in these countries. Children's psychological adjustment has been shown to affect educational progress which is critical for their future. This study, based in a rural, socioeconomically disadvantaged area of South Africa, aimed to examine the prevalence of children's psychological problems as well as possible risk and protective factors. Methods: Rates of psychological problems in 10-12 year olds were examined using teacher-and child-report questionnaires. Data on children from 10 rural primary schools, selected by stratified random sampling, were linked to individual and household data from the Agincourt health and socio-demographic surveillance system collected from households over 15 years. Results: A total of 1,025 children were assessed. Teachers identified high levels of behavioural and emotional problems (41%). Children reported lower, but substantial rates of anxiety/depression (14%), and significant post-traumatic stress symptoms (24%); almost a quarter felt unsafe in school. Risk factors included being a second-generation former refugee and being from a large household. Protective factors highlight the importance of maternal factors, such as being more educated and in a stable partnership. Conclusion: The high levels of psychological problems identified by teachers are a serious public health concern, as they are likely to impact negatively on children's education, particularly given the large class sizes and limited resources in rural LMIC settings. Despite the high levels of risk, a proportion of children were managing well and research to understand resilience could inform interventions.

BMJ Open, 2013

Predictors of non-response in a UK-wide cohort study of children's accelerometerdetermined physic... more Predictors of non-response in a UK-wide cohort study of children's accelerometerdetermined physical activity using postal methods. BMJ Open 2013;3:e002290.

Objective: To describe levels of physical activity, sedentary time and adherence to Chief Medical... more Objective: To describe levels of physical activity, sedentary time and adherence to Chief Medical Officers (CMO) physical activity guidelines among primary school-aged children across the UK using objective accelerometer-based measurements.

Vaccine, Jan 28, 2013

Intussusception, an abdominal emergency in young children, has been linked to a previous vaccine ... more Intussusception, an abdominal emergency in young children, has been linked to a previous vaccine used to prevent rotavirus gastroenteritis. Although this vaccine was withdrawn, recent studies have suggested a potential, very small increased risk of intussusception following the administration of newly developed rotavirus vaccines. We aimed to determine the baseline incidence of intussusception among infants in the UK and Republic of Ireland - prior to the imminent introduction of the rotavirus vaccine into the UK schedule this year. Prospective, active surveillance via the established British Paediatric Surveillance Unit (BPSU) was carried out from March 2008 to March 2009. Clinicians across 101 National Health Service (and equivalent) hospitals, including 27 paediatric surgical centres, reported cases admitted for intussusception in the UK and Republic of Ireland. The standard Brighton Collaboration case definition was used with only definite cases included for incidence estimation...

PLoS Medicine, 2012

Background: Households from vulnerable groups experiencing epidemiological transitions are known ... more Background: Households from vulnerable groups experiencing epidemiological transitions are known to be affected concomitantly by under-nutrition and obesity. Yet, it is unknown to what extent this double burden affects refugee populations dependent on food assistance. We assessed the double burden of malnutrition among Western Sahara refugees living in a protracted emergency. Methods and Findings: We implemented a stratified nutrition survey in October-November 2010 in the four Western Sahara refugee camps in Algeria. We sampled 2,005 households, collecting anthropometric measurements (weight, height, and waist circumference) in 1,608 children (6-59 mo) and 1,781 women (15-49 y). We estimated the prevalence of global acute malnutrition (GAM), stunting, underweight, and overweight in children; and stunting, underweight, overweight, and central obesity in women. To assess the burden of malnutrition within households, households were first classified according to the presence of each type of malnutrition. Households were then classified as undernourished, overweight, or affected by the double burden if they presented members with under-nutrition, overweight, or both, respectively. The prevalence of GAM in children was 9.1%, 29.1% were stunted, 18.6% were underweight, and 2.4% were overweight; among the women, 14.8% were stunted, 53.7% were overweight or obese, and 71.4% had central obesity. Central obesity (47.2%) and overweight (38.8%) in women affected a higher proportion of households than did GAM (7.0%), stunting (19.5%), or underweight (13.3%) in children. Overall, households classified as overweight (31.5%) were most common, followed by undernourished (25.8%), and then double burden-affected (24.7%). Conclusions: The double burden of obesity and under-nutrition is highly prevalent in households among Western Sahara refugees. The results highlight the need to focus more attention on non-communicable diseases in this population and balance obesity prevention and management with interventions to tackle under-nutrition.

Journal of Neuroinflammation, 2009

Background: Chronic inflammation is a characteristic of Alzheimer's disease (AD). An interaction ... more Background: Chronic inflammation is a characteristic of Alzheimer's disease (AD). An interaction associated with the risk of AD has been reported between polymorphisms in the regulatory regions of the genes for the pro-inflammatory cytokine, interleukin-6 (IL-6, gene: IL6), and the antiinflammatory cytokine, interleukin-10 (IL-10, gene: IL10). Methods: We examined this interaction in the Epistasis Project, a collaboration of 7 AD research groups, contributing DNA samples from 1,757 cases of AD and 6,295 controls.

JAIDS Journal of Acquired Immune Deficiency Syndromes, 2012

Objective-To explore the pattern of repeat pregnancies among diagnosed HIV-infected women in the ... more Objective-To explore the pattern of repeat pregnancies among diagnosed HIV-infected women in the UK and Ireland, estimate the rate of these sequential pregnancies, and investigate the demographic and clinical characteristics of women experiencing them. Design-Diagnosed HIV-infected pregnant women are reported through an active confidential reporting scheme to the National Study of HIV in Pregnancy and Childhood. Methods-Pregnancies occurring during 1990-2009 were included. Multivariable analyses were conducted fitting Cox proportional hazards models. Results-There were 14,096 pregnancies in 10,568 women; 2737 (25.9%) had two or more pregnancies reported. The rate of repeat pregnancies was 6.7 (95% CI: 6.5-7.0) per 100 womanyears. The proportion of pregnancies in women who already had at least one pregnancy reported increased from 20.3% (32/158) in 1997 to 38.6% (565/1465) in 2009 (p<0.001). In multivariable analysis the probability of repeat pregnancy significantly declined with increasing age at first pregnancy. Parity was also inversely associated with repeat pregnancy. Compared with women born in the UK or Ireland, those from Europe, Eastern Africa, and Southern Africa were less likely to have a repeat pregnancy, while women from Middle Africa and Western Africa were more likely to. Maternal health at first pregnancy was not associated with repeat pregnancy. Conclusions-The number of diagnosed HIV-infected women in the UK and Ireland experiencing repeat pregnancies is increasing. Variations in the probability of repeat pregnancies, according to demographic and clinical characteristics, are an important consideration when planning reproductive health services and HIV care for people living with HIV.