Influence of neighbourhood characteristics on asthma outcomes in an asthma clinic cohort of youths
Bibliographic record
Abstract
Background Asthma is the most common chronic illness among children. We aimed to better understand the association of neighbourhood context with asthma control and the moderating effect of obesity status on this association. Methods Data were from an asthma clinic cohort (n = 4621) of Montreal youths aged 2-18 years, recruited in 2000-2007 and followed for up to 6 years. Clinical data were linked with medical records on acute care visits and hospitalizations. Neighbourhoods were defined by the 750 m buffer around youths’ postal codes. Using spatial data, neighbourhood context was described by high or low deprivation (D) and walkability (W). Asthma control was based on a composite indicator of all adverse events. The outcome was described by the event rate, i.e. total number of composite events by duration of exposure (time in neighourhood). A Poisson model was fitted to predict asthma control rates by neighbourhood context, controlling for individual covariates and an air pollution index based on spatial exposure estimates. We used the Baron-Kenny framework to test for effect modification by obesity status. Results Asthma control was independently predicted by neighbourhood context. Youth living in low D, high W areas had better asthma control compared with those living in high D low W (IRR=0.83, 95%CI 0.69,0.99, p = 0.04) and those in high D high W (IRR=0.80, 95%CI 0.67,0.95, p = 0.01) areas. Within low D areas, higher W was associated with greater asthma control (IRR=0.88, 95%CI 0.76,1.01, p = 0.07). No other associations were found and obesity did not modify the association between neighbourhood context and asthma control. Conclusions Higher deprivation is associated with lower rates of asthma control among youth; moreover, high walkability may have a protective effect in low deprivation areas. Efforts to reduce area deprivation may benefit youth suffering from poor asthma control; increasing walkability may be especially beneficial in the absence of area deprivation. Key messages: Asthma control varies according to area deprivation and walkability Obese youth do not appear to be more susceptible to adverse environments
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".