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Ruiz B, Broadbent JM, Murray Thomson W, Ramrakha S, Boden J, Horwood J, Poulton R. Is childhood oral health the 'canary in the coal mine' for poor adult general health? Findings from two New Zealand birth cohort studies. Community Dent Oral Epidemiol 2023; 51:838-846. [PMID: 36000812 DOI: 10.1111/cdoe.12772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/12/2022] [Accepted: 07/05/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES This study aimed to investigate whether childhood dental caries was associated with self-reported general health in midlife. METHODS We used data on childhood oral health (caries experience) and adult self-reported general health from two New Zealand longitudinal birth cohorts, the Dunedin Multidisciplinary Health and Development Study (n = 922 and n = 931 at ages 5 and 45 years, respectively), and the Christchurch Health and Development Study (n = 1048 and n = 904 at ages 5 and 40 years, respectively). We used generalized estimating equations to examine associations between age-5 dental caries and self-rated general health and the number of self-reported physical health conditions at ages 45/40 (diagnosed by a doctor or health professional, n = 14 conditions among both cohorts). Covariates included known risk factors for poor health (SES, IQ, perinatal complications), and personality style, which is known to affect subjective health ratings. RESULTS Incidence rate ratios for 'Excellent' self-rated health were lower among those who had high experience of dental caries as children than those who had not in both, the Dunedin (IRR, 0.76; 95% CI, 0.50, 1.14) and Christchurch studies (IRR, 0.69; 95% CI, 0.47, 1.00). Childhood dental caries was not associated with the number of self-reported physical health conditions in midlife, in either cohort. Dunedin Study members who at age 5 were not caries-free or whose parents rated their own or their child's oral health as poor were less likely to report 'Excellent' self-rated general health at age 45 than those who were caries-free and whose parents did not give a 'poor' rating (IRR, 0.69; 95% CI, 0.49, 0.97). CONCLUSIONS Five-year-olds with greater caries experience were more likely to have poorer self-rated general health by midlife. Beyond this longitudinal association, future research should examine whether childhood dental caries is associated with objective/biological markers of physical health and whether it may have utility as an early indicator for poor general health in adulthood.
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Affiliation(s)
- Begoña Ruiz
- Department of Oral Sciences, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Jonathan M Broadbent
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - William Murray Thomson
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, Division of Sciences, University of Otago, Dunedin, New Zealand
| | - Joseph Boden
- Christchurch Health and Development Study, Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - John Horwood
- Christchurch Health and Development Study, Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, Division of Sciences, University of Otago, Dunedin, New Zealand
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2
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Bolbocean C, van der Pal S, van Buuren S, Anderson PJ, Bartmann P, Baumann N, Cheong JLY, Darlow BA, Doyle LW, Evensen KAI, Horwood J, Indredavik MS, Johnson S, Marlow N, Mendonça M, Ni Y, Wolke D, Woodward L, Verrips E, Petrou S. Health-Related Quality-of-Life Outcomes of Very Preterm or Very Low Birth Weight Adults: Evidence From an Individual Participant Data Meta-Analysis. Pharmacoeconomics 2023; 41:93-105. [PMID: 36287335 PMCID: PMC9813180 DOI: 10.1007/s40273-022-01201-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 05/03/2023]
Abstract
BACKGROUND AND OBJECTIVE Assessment of health-related quality of life for individuals born very preterm and/or low birthweight (VP/VLBW) offers valuable complementary information alongside biomedical assessments. However, the impact of VP/VLBW status on health-related quality of life in adulthood is inconclusive. The objective of this study was to examine associations between VP/VLBW status and preference-based health-related quality-of-life outcomes in early adulthood. METHODS Individual participant data were obtained from five prospective cohorts of individuals born VP/VLBW and controls contributing to the 'Research on European Children and Adults Born Preterm' Consortium. The combined dataset included over 2100 adult VP/VLBW survivors with an age range of 18-29 years. The main exposure was defined as birth before 32 weeks' gestation (VP) and/or birth weight below 1500 g (VLBW). Outcome measures included multi-attribute utility scores generated by the Health Utilities Index Mark 3 and the Short Form 6D. Data were analysed using generalised linear mixed models in a one-step approach using fixed-effects and random-effects models. RESULTS VP/VLBW status was associated with a significant difference in the Health Utilities Index Mark 3 multi-attribute utility score of - 0.06 (95% confidence interval - 0.08, - 0.04) in comparison to birth at term or at normal birthweight; this was not replicated for the Short Form 6D. Impacted functional domains included vision, ambulation, dexterity and cognition. VP/VLBW status was not associated with poorer emotional or social functioning, or increased pain. CONCLUSIONS VP/VLBW status is associated with lower overall health-related quality of life in early adulthood, particularly in terms of physical and cognitive functioning. Further studies that estimate the effects of VP/VLBW status on health-related quality-of-life outcomes in mid and late adulthood are needed.
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Affiliation(s)
- Corneliu Bolbocean
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
| | - Sylvia van der Pal
- Netherlands Organisation for Applied Scientific Research, The Hague, the Netherlands
| | - Stef van Buuren
- Netherlands Organisation for Applied Scientific Research, The Hague, the Netherlands
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Peter Bartmann
- Department of Neonatology and Paediatric Intensive Care, University Hospital Bonn, Children's Hospital, Bonn, Germany
| | - Nicole Baumann
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
- Department of Health Sciences, University of Leicester, Leicester, UK
- Department of Psychology, University of Warwick, Warwick, UK
| | - Jeanie L Y Cheong
- Department of Obstetrics and Gynaecology, Clinical Sciences, Murdoch Children's Research Institute, Newborn Services, Royal Women's Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Brian A Darlow
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | - Lex W Doyle
- Department of Obstetrics and Gynaecology, Clinical Sciences, Murdoch Children's Research Institute, Newborn Services, Royal Women's Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Kari Anne I Evensen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - John Horwood
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Marit S Indredavik
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Neil Marlow
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Marina Mendonça
- Department of Obstetrics and Gynaecology, Clinical Sciences, Murdoch Children's Research Institute, Newborn Services, Royal Women's Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Yanyan Ni
- Department of Obstetrics and Gynaecology, Clinical Sciences, Murdoch Children's Research Institute, Newborn Services, Royal Women's Hospital, University of Melbourne, Melbourne, VIC, Australia
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Dieter Wolke
- Department of Psychology, Warwick Medical School, University of Warwick and Division of Health Sciences, Warwick, UK
| | - Lianne Woodward
- Faculty of Health, University of Canterbury, Christchurch, New Zealand
| | - Erik Verrips
- Netherlands Organisation for Applied Scientific Research, The Hague, the Netherlands
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
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Torkington J, Harries R, O'Connell S, Knight L, Islam S, Bashir N, Watkins A, Fegan G, Cornish J, Rees B, Cole H, Jarvis H, Jones S, Russell I, Bosanquet D, Cleves A, Sewell B, Farr A, Zbrzyzna N, Fiera N, Ellis-Owen R, Hilton Z, Parry C, Bradbury A, Wall P, Hill J, Winter D, Cocks K, Harris D, Hilton J, Vakis S, Hanratty D, Rajagopal R, Akbar F, Ben-Sassi A, Francis N, Jones L, Williamson M, Lindsey I, West R, Smart C, Ziprin P, Agarwal T, Faulkner G, Pinkney T, Vimalachandran D, Lawes D, Faiz O, Nisar P, Smart N, Wilson T, Myers A, Lund J, Smolarek S, Acheson A, Horwood J, Ansell J, Phillips S, Davies M, Davies L, Bird S, Palmer N, Williams M, Galanopoulos G, Rao PD, Jones D, Barnett R, Tate S, Wheat J, Patel N, Rahmani S, Toynton E, Smith L, Reeves N, Kealaher E, Williams G, Sekaran C, Evans M, Beynon J, Egan R, Qasem E, Khot U, Ather S, Mummigati P, Taylor G, Williamson J, Lim J, Powell A, Nageswaran H, Williams A, Padmanabhan J, Phillips K, Ford T, Edwards J, Varney N, Hicks L, Greenway C, Chesters K, Jones H, Blake P, Brown C, Roche L, Jones D, Feeney M, Shah P, Rutter C, McGrath C, Curtis N, Pippard L, Perry J, Allison J, Ockrim J, Dalton R, Allison A, Rendell J, Howard L, Beesley K, Dennison G, Burton J, Bowen G, Duberley S, Richards L, Giles J, Katebe J, Dalton S, Wood J, Courtney E, Hompes R, Poole A, Ward S, Wilkinson L, Hardstaff L, Bogden M, Al-Rashedy M, Fensom C, Lunt N, McCurrie M, Peacock R, Malik K, Burns H, Townley B, Hill P, Sadat M, Khan U, Wignall C, Murati D, Dhanaratne M, Quaid S, Gurram S, Smith D, Harris P, Pollard J, DiBenedetto G, Chadwick J, Hull R, Bach S, Morton D, Hollier K, Hardy V, Ghods M, Tyrrell D, Ashraf S, Glasbey J, Ashraf M, Garner S, Whitehouse A, Yeung D, Mohamed SN, Wilkin R, Suggett N, Lee C, Bagul A, McNeill C, Eardley N, Mahapatra R, Gabriel C, Datt P, Mahmud S, Daniels I, McDermott F, Nodolsk M, Park L, Scott H, Trickett J, Bearn P, Trivedi P, Frost V, Gray C, Croft M, Beral D, Osborne J, Pugh R, Herdman G, George R, Howell AM, Al-Shahaby S, Narendrakumar B, Mohsen Y, Ijaz S, Nasseri M, Herrod P, Brear T, Reilly JJ, Sohal A, Otieno C, Lai W, Coleman M, Platt E, Patrick A, Pitman C, Balasubramanya S, Dickson E, Warman R, Newton C, Tani S, Simpson J, Banerjee A, Siddika A, Campion D, Humes D, Randhawa N, Saunders J, Bharathan B, Hay O. Incisional hernia following colorectal cancer surgery according to suture technique: Hughes Abdominal Repair Randomized Trial (HART). Br J Surg 2022; 109:943-950. [PMID: 35979802 PMCID: PMC10364691 DOI: 10.1093/bjs/znac198] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Incisional hernias cause morbidity and may require further surgery. HART (Hughes Abdominal Repair Trial) assessed the effect of an alternative suture method on the incidence of incisional hernia following colorectal cancer surgery. METHODS A pragmatic multicentre single-blind RCT allocated patients undergoing midline incision for colorectal cancer to either Hughes closure (double far-near-near-far sutures of 1 nylon suture at 2-cm intervals along the fascia combined with conventional mass closure) or the surgeon's standard closure. The primary outcome was the incidence of incisional hernia at 1 year assessed by clinical examination. An intention-to-treat analysis was performed. RESULTS Between August 2014 and February 2018, 802 patients were randomized to either Hughes closure (401) or the standard mass closure group (401). At 1 year after surgery, 672 patients (83.7 per cent) were included in the primary outcome analysis; 50 of 339 patients (14.8 per cent) in the Hughes group and 57 of 333 (17.1 per cent) in the standard closure group had incisional hernia (OR 0.84, 95 per cent c.i. 0.55 to 1.27; P = 0.402). At 2 years, 78 patients (28.7 per cent) in the Hughes repair group and 84 (31.8 per cent) in the standard closure group had incisional hernia (OR 0.86, 0.59 to 1.25; P = 0.429). Adverse events were similar in the two groups, apart from the rate of surgical-site infection, which was higher in the Hughes group (13.2 versus 7.7 per cent; OR 1.82, 1.14 to 2.91; P = 0.011). CONCLUSION The incidence of incisional hernia after colorectal cancer surgery is high. There was no statistical difference in incidence between Hughes closure and mass closure at 1 or 2 years. REGISTRATION NUMBER ISRCTN25616490 (http://www.controlled-trials.com).
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Yang J, Epton MJ, Harris SL, Horwood J, Kingsford RA, Troughton R, Greer C, Darlow BA. Reduced Exercise Capacity in Adults Born Very Low Birth Weight: A Population-Based Cohort Study. Am J Respir Crit Care Med 2021; 205:88-98. [PMID: 34499592 DOI: 10.1164/rccm.202103-0755oc] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Population-based data regarding the consequences of very low birth weight (VLBW) and bronchopulmonary dysplasia (BPD) on adult exercise capacity is limited. OBJECTIVES To compare exercise capacity in a national VLBW cohort with term-born controls and explore factors contributing to the differences. METHODS At 26-30 years of age, 228 VLBW survivors and 100 controls underwent lung function tests, cardiopulmonary exercise testing and assessment of resting cardiac structure/function using echocardiography. Data on self-reported physical activity were collected. MEASUREMENTS AND MAIN RESULTS Compared with controls, VLBW adults demonstrated reduced oxygen uptake, work rate and oxygen pulse at peak exercise (9.3%, 10.7%, 10.8% lower, respectively) and earlier anaerobic threshold (all p<0.0001), with all mean values within normal range. VLBW survivors showed reduced physical activity, impaired lung function (reduced FEV1, FEV1/FVC, DLCO), altered left ventricular structure/function (reduced mass, size, stroke volume, cardiac output) and reduced right atrial/ventricular size. Adjustment for the combination of three sets of covariates (physical activity with BMI, lung function, cardiac structure/function) explained most of the exercise group-differences. Beyond the effects of physical activity and BMI, lung function and cardiac structure/function contributed approximately equally. BPD with other prematurity-related perinatal factors (ventilation, antenatal steroids, extremely low birth weight, extreme preterm) were not associated with a reduced exercise capacity. CONCLUSIONS Exercise capacity was significantly reduced in VLBW adults, which we speculate is from combined effects of impaired lung function, altered heart structure/function and reduced physical activity. Perinatal factors including BPD were not associated with a reduced exercise capacity.
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Affiliation(s)
- Jun Yang
- Canterbury District Health Board, 63588, Respiratory Physiology Laboratory, Christchurch Hospital, Christchurch, New Zealand;
| | - Michael J Epton
- Canterbury District Health Board, 63588, Canterbury Respiratory Research Group, Christchurch, New Zealand
| | - Sarah L Harris
- University of Otago Christchurch, 2494, Department of Pediatrics, Christchurch, New Zealand
| | - John Horwood
- University of Otago Christchurch, 2494, Department of Psychological Medicine, Christchurch, New Zealand
| | - Rachel A Kingsford
- Canterbury District Health Board, 63588, Respiratory Physiology Laboratory, Christchurch Hospital, Christchurch, New Zealand
| | - Richard Troughton
- Canterbury District Health Board, 63588, Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand.,University of Otago Christchurch, 2494, Department of Medicine, Christchurch, New Zealand
| | - Charlotte Greer
- Canterbury District Health Board, 63588, Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand
| | - Brian A Darlow
- University of Otago Christchurch, 2494, Department of Pediatrics, Christchurch, New Zealand
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5
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Yuen WS, Chan G, Clare P, Bruno R, Boland V, Aiken A, Kypri K, Horwood J, McCambridge J, Degenhardt L, Slade T, Wadolowski M, Hutchinson D, Najman J, McBride N, Mattick R, Peacock A. 962Adolescent Alcohol Use Trajectories: A Prospective Study of Risk Factors and Adulthood AUD Outcomes. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Adolescents often display heterogenous trajectories of alcohol use. Initiation and escalation of drinking may be an important predictor of later harms. Previous attempts to conceptualise these trajectories lacked adjustment for known confounders of adolescent drinking, which our study has aimed to address by modelling dynamic changes in drinking whilst adjusting for parent, child, and peer factors.
Methods
Survey data from a longitudinal cohort of Australian adolescents (n = 1813) were used to model latent class alcohol use trajectories over five annual follow-ups (Mage=13.9 and 17.8 years). Regression models determined whether child, parent, and peer factors at baseline (Mage =12.9 years) predicted trajectory membership and whether trajectories predicted self-reported symptoms of AUD in early adulthood (Mage =18.8 years).
Results
We identified a four-class solution: abstaining (n = 352); late-onset moderate drinking (n = 503); early-onset moderate drinking (n = 663); and early-onset heavy drinking (n = 295). Alcohol-specific household rules reduced risk of early-onset heavy drinking compared to late-onset moderate drinking (RRR: 0.31; 99.5% CI: 0.11, 0.83), whereas substance-using peers increased this risk (RRR: 3.43; 99.5% CI: 2.10, 5.62). Early-onset heavy drinking increased odds of meeting criteria for AUD in early adulthood (OR: 7.68; 99.5% CI: 2.41, 24.47).
Conclusions
Our study provides evidence that early initiation and heavy alcohol use throughout adolescence is associated with increased risk of alcohol-related harm compared to recommended maximum levels of consumption (late-onset, moderate drinking).
Key messages
Parenting factors and peer influences in early adolescence should be considered to reduce risk of early initiation and heavy drinking, which in turn reduces risk of later harm.
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Affiliation(s)
- Wing See Yuen
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
| | - Gary Chan
- Centre for Youth Substance Abuse Research, The University of Queensland, St Lucia, Australia
| | - Philip Clare
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
- School of Medicine, University of Tasmania, Hobart, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, The University of Newcastle, University Dr, Callaghan, Australia
| | - John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Jim McCambridge
- Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
| | - Tim Slade
- The Matilda Centre, The University of Sydney, Camperdown, Australia
| | | | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
- Centre for Social and Early Emotional Development, Deakin University, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Murdoch Childrens Research Institute, Melbourne Royal Children's Hospital, Parkville, Australia
| | - Jake Najman
- School of Public Health, The University of Queensland, St Lucia, Australia
| | | | - Richard Mattick
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University Of New South Wales, Sydney, Australia
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6
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Eves R, Mendonça M, Baumann N, Ni Y, Darlow BA, Horwood J, Woodward LJ, Doyle LW, Cheong J, Anderson PJ, Bartmann P, Marlow N, Johnson S, Kajantie E, Hovi P, Nosarti C, Indredavik MS, Evensen KAI, Räikkönen K, Heinonen K, Zeitlin J, Wolke D. Association of Very Preterm Birth or Very Low Birth Weight With Intelligence in Adulthood: An Individual Participant Data Meta-analysis. JAMA Pediatr 2021; 175:e211058. [PMID: 34047752 PMCID: PMC8329745 DOI: 10.1001/jamapediatrics.2021.1058] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE Birth before 32 weeks' gestation (very preterm [VPT]) and birth weight below 1500 g (very low birth weight [VLBW]) have been associated with lower cognitive performance in childhood. However, there are few investigations of the association of neonatal morbidities and maternal educational levels with the adult cognitive performance of individuals born VPT or VLBW (VPT/VLBW). OBJECTIVE To assess differences in adult IQ between VPT/VLBW and term-born individuals and to examine the association of adult IQ with cohort factors, neonatal morbidities, and maternal educational level among VPT/VLBW participants. DATA SOURCES Systematic review of published data from PubMed and meta-analysis of individual participant data (IPD) of cohorts from 2 consortia (Research on European Children and Adults Born Preterm [RECAP] and Adults Born Preterm International Collaboration [APIC]). STUDY SELECTION The meta-analysis included prospective longitudinal cohort studies that assessed the full-scale IQ of adults born VPT or VLBW and respective control groups comprising term-born adults. DATA EXTRACTION AND SYNTHESIS The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline for analyses of individual participant data and identified 8 studies that provided data from 2135 adults (1068 VPT/VLBW and 1067 term-born participants) born between 1978 and 1995. Meta-analyses of IPD were performed using a 1-stage approach, treating VPT birth or VLBW and cohort as random effects. MAIN OUTCOMES AND MEASURES Full-scale IQ scores were converted to z scores within each cohort using the combined SD of VPT/VLBW participants and a control group of term-born participants, with scores centered on the mean of the control group. RESULTS A total of 426 records were identified and screened. After exclusions, 13 studies were included in the aggregate meta-analysis. The IPD meta-analysis included 8 of the 9 RECAP and APIC cohorts with adult IQ data. The mean (SD) age among the 8 IPD cohorts was 24.6 (4.3) years, and 1163 participants (54.5%) were women. In unadjusted analyses, VPT/VLBW participants had mean adult IQ scores that were 0.78 SD (95% CI, -0.90 to -0.66 SD) lower than term-born participants, equivalent to a difference of 12 IQ points. Among VPT/VLBW participants, lower gestational age (score difference per week of gestation, 0.11; 95% CI, 0.07-0.14), lower birth weight z scores (score difference per 1.0 SD, 0.21; 95% CI, 0.14-0.28), the presence of neonatal bronchopulmonary dysplasia (score difference, -0.16; 95% CI, -0.30 to -0.02) or any grade of intraventricular hemorrhage (score difference, -0.19; 95% CI, -0.33 to -0.05), and lower maternal educational level (score difference, 0.26; 95% CI, 0.17-0.35) were all significantly associated with lower IQ scores in adulthood. CONCLUSIONS AND RELEVANCE In this IPD meta-analysis, lower gestational age, lower weight for gestational age, neonatal morbidities, and lower maternal educational levels were all important risk factors associated with lower IQ among young adults born VPT or VLBW.
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Affiliation(s)
- Robert Eves
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Marina Mendonça
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Yanyan Ni
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Brian A. Darlow
- Department of Paediatrics, University of Otago at Christchurch, Christchurch, New Zealand
| | - John Horwood
- Department of Psychological Medicine, University of Otago at Christchurch, Christchurch, New Zealand
| | - Lianne J. Woodward
- School of Health Sciences and Child Wellbeing Research Institute, University of Canterbury, Christchurch, New Zealand
| | - Lex W. Doyle
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia,Neonatal Services, Royal Women’s Hospital, Melbourne, Victoria, Australia,Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Jeanie Cheong
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia,Neonatal Services, Royal Women’s Hospital, Melbourne, Victoria, Australia,Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Peter J. Anderson
- Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia,Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Peter Bartmann
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Neil Marlow
- UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, United Kingdom
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, George Davies Centre, Leicester, United Kingdom
| | - Eero Kajantie
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland,PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway,Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Petteri Hovi
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland,Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Chiara Nosarti
- Institute of Psychiatry, Psychology and Neuroscience, Department of Child and Adolescent Psychiatry, King’s College London, London, United Kingdom,Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Marit S. Indredavik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kari-Anne I. Evensen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway,Unit for Physiotherapy Services, Trondheim Municipality, Torgarden, Trondheim, Norway,Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland,Psychology and Welfare Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Jennifer Zeitlin
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Paris, France
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom,Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
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7
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McLeod GF, Horwood J, Boden JM, Woodward LJ. Parental use of physical punishment in a birth cohort. N Z Med J 2021; 134:17-30. [PMID: 33927435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
AIM To document the prevalence of child physical punishment by parents and associated predictors in the Christchurch Health and Development Study (CHDS) birth cohort over a 15-year period. METHOD A cohort of 1,265 CHDS individuals were followed from birth (1977) to age 40 years. At ages 25 (n=155), 30 (n=337), 35 (n=585) and 40 years (n=636), the cohort members with dependent children (<16 years of age) were interviewed about their use of child physical punishment in the past 12 months using the Parent-Child Conflict Tactics Scale. Parent, child and family predictors were also examined. RESULTS The most common forms of physical punishment were smacking on bottom and slapping on hand, arm or leg. Rates of all forms of physical punishment declined with age, ranging from 77% reporting any physical punishment at age 25 to 42% at age 40. In multivariable models, significant predictors included parental age, numbers/ages of children in the household, childhood family socioeconomic status, parental history of adolescent mental health problems and concurrent intimate partner violence. CONCLUSION Use of physical punishment remains a relatively common form of child discipline despite the 2007 anti-smacking legislation and reduced public tolerance for physical violence towards children. Implications for prevention/intervention are discussed.
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Affiliation(s)
- Geraldine Fh McLeod
- Senior Research Fellow, Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch
| | - John Horwood
- Research Professor, Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch
| | - Joseph M Boden
- Research Professor and Director, Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch
| | - Lianne J Woodward
- Professor, School of Health Sciences & Child Wellbeing Research Institute, University of Canterbury, Christchurch
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Darlow BA, Horwood J, Dhakal B, Harris SL, McKelvey VA, Elliott JM, Yang J, Mackay RJ. Correction: Biomarkers of ageing in New Zealand VLBW young adults and controls. Pediatr Res 2021; 89:708. [PMID: 32647334 DOI: 10.1038/s41390-020-1054-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Brian A Darlow
- Department of Paediatrics, University of Otago, Christchurch, New Zealand.
| | - John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Bhubaneswor Dhakal
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Sarah L Harris
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | | | - John M Elliott
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Jun Yang
- Respiratory Physiology Laboratory, Christchurch Hospital, Christchurch, New Zealand
| | - Richard J Mackay
- Canterbury Health Laboratories, Canterbury District Health Board, Christchurch, New Zealand
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9
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Johnson EC, Demontis D, Thorgeirsson TE, Walters RK, Polimanti R, Hatoum AS, Sanchez-Roige S, Paul SE, Wendt FR, Clarke TK, Lai D, Reginsson GW, Zhou H, He J, Baranger DAA, Gudbjartsson DF, Wedow R, Adkins DE, Adkins AE, Alexander J, Bacanu SA, Bigdeli TB, Boden J, Brown SA, Bucholz KK, Bybjerg-Grauholm J, Corley RP, Degenhardt L, Dick DM, Domingue BW, Fox L, Goate AM, Gordon SD, Hack LM, Hancock DB, Hartz SM, Hickie IB, Hougaard DM, Krauter K, Lind PA, McClintick JN, McQueen MB, Meyers JL, Montgomery GW, Mors O, Mortensen PB, Nordentoft M, Pearson JF, Peterson RE, Reynolds MD, Rice JP, Runarsdottir V, Saccone NL, Sherva R, Silberg JL, Tarter RE, Tyrfingsson T, Wall TL, Webb BT, Werge T, Wetherill L, Wright MJ, Zellers S, Adams MJ, Bierut LJ, Boardman JD, Copeland WE, Farrer LA, Foroud TM, Gillespie NA, Grucza RA, Harris KM, Heath AC, Hesselbrock V, Hewitt JK, Hopfer CJ, Horwood J, Iacono WG, Johnson EO, Kendler KS, Kennedy MA, Kranzler HR, Madden PAF, Maes HH, Maher BS, Martin NG, McGue M, McIntosh AM, Medland SE, Nelson EC, Porjesz B, Riley BP, Stallings MC, Vanyukov MM, Vrieze S, Davis LK, Bogdan R, Gelernter J, Edenberg HJ, Stefansson K, Børglum AD, Agrawal A. A large-scale genome-wide association study meta-analysis of cannabis use disorder. Lancet Psychiatry 2020; 7:1032-1045. [PMID: 33096046 PMCID: PMC7674631 DOI: 10.1016/s2215-0366(20)30339-4] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Variation in liability to cannabis use disorder has a strong genetic component (estimated twin and family heritability about 50-70%) and is associated with negative outcomes, including increased risk of psychopathology. The aim of the study was to conduct a large genome-wide association study (GWAS) to identify novel genetic variants associated with cannabis use disorder. METHODS To conduct this GWAS meta-analysis of cannabis use disorder and identify associations with genetic loci, we used samples from the Psychiatric Genomics Consortium Substance Use Disorders working group, iPSYCH, and deCODE (20 916 case samples, 363 116 control samples in total), contrasting cannabis use disorder cases with controls. To examine the genetic overlap between cannabis use disorder and 22 traits of interest (chosen because of previously published phenotypic correlations [eg, psychiatric disorders] or hypothesised associations [eg, chronotype] with cannabis use disorder), we used linkage disequilibrium score regression to calculate genetic correlations. FINDINGS We identified two genome-wide significant loci: a novel chromosome 7 locus (FOXP2, lead single-nucleotide polymorphism [SNP] rs7783012; odds ratio [OR] 1·11, 95% CI 1·07-1·15, p=1·84 × 10-9) and the previously identified chromosome 8 locus (near CHRNA2 and EPHX2, lead SNP rs4732724; OR 0·89, 95% CI 0·86-0·93, p=6·46 × 10-9). Cannabis use disorder and cannabis use were genetically correlated (rg 0·50, p=1·50 × 10-21), but they showed significantly different genetic correlations with 12 of the 22 traits we tested, suggesting at least partially different genetic underpinnings of cannabis use and cannabis use disorder. Cannabis use disorder was positively genetically correlated with other psychopathology, including ADHD, major depression, and schizophrenia. INTERPRETATION These findings support the theory that cannabis use disorder has shared genetic liability with other psychopathology, and there is a distinction between genetic liability to cannabis use and cannabis use disorder. FUNDING National Institute of Mental Health; National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse; Center for Genomics and Personalized Medicine and the Centre for Integrative Sequencing; The European Commission, Horizon 2020; National Institute of Child Health and Human Development; Health Research Council of New Zealand; National Institute on Aging; Wellcome Trust Case Control Consortium; UK Research and Innovation Medical Research Council (UKRI MRC); The Brain & Behavior Research Foundation; National Institute on Deafness and Other Communication Disorders; Substance Abuse and Mental Health Services Administration (SAMHSA); National Institute of Biomedical Imaging and Bioengineering; National Health and Medical Research Council (NHMRC) Australia; Tobacco-Related Disease Research Program of the University of California; Families for Borderline Personality Disorder Research (Beth and Rob Elliott) 2018 NARSAD Young Investigator Grant; The National Child Health Research Foundation (Cure Kids); The Canterbury Medical Research Foundation; The New Zealand Lottery Grants Board; The University of Otago; The Carney Centre for Pharmacogenomics; The James Hume Bequest Fund; National Institutes of Health: Genes, Environment and Health Initiative; National Institutes of Health; National Cancer Institute; The William T Grant Foundation; Australian Research Council; The Virginia Tobacco Settlement Foundation; The VISN 1 and VISN 4 Mental Illness Research, Education, and Clinical Centers of the US Department of Veterans Affairs; The 5th Framework Programme (FP-5) GenomEUtwin Project; The Lundbeck Foundation; NIH-funded Shared Instrumentation Grant S10RR025141; Clinical Translational Sciences Award grants; National Institute of Neurological Disorders and Stroke; National Heart, Lung, and Blood Institute; National Institute of General Medical Sciences.
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Affiliation(s)
- Emma C Johnson
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA.
| | - Ditte Demontis
- Department of Biomedicine-Human Genetics and Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | | | - Raymond K Walters
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Renato Polimanti
- Division of Human Genetics, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
| | - Alexander S Hatoum
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Sandra Sanchez-Roige
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Department of Medicine, Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sarah E Paul
- Department of Psychological and Brain Sciences, Washington University in Saint Louis, St. Louis, MO, USA
| | - Frank R Wendt
- Division of Human Genetics, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
| | - Toni-Kim Clarke
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Dongbing Lai
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Hang Zhou
- Division of Human Genetics, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
| | - June He
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - David A A Baranger
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Daniel F Gudbjartsson
- Statistics Department, Reykjavik, Iceland; School of Engineering and Natural Sciences, Iceland University, Reykjavik, Iceland
| | - Robbee Wedow
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Daniel E Adkins
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA; Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA; College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Richmond, VA, USA
| | - Amy E Adkins
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA; Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA; College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Richmond, VA, USA
| | - Jeffry Alexander
- Virginia Commonwealth University Alcohol Research Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Silviu-Alin Bacanu
- Virginia Commonwealth University Alcohol Research Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Tim B Bigdeli
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Joseph Boden
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Sandra A Brown
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Department of Psychology and Office of Research Affairs, University of California San Diego, La Jolla, CA, USA
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Jonas Bybjerg-Grauholm
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Department for Congenital Disorders, Center for Neonatal Screening, Statens Serum Institut, Copenhagen, Denmark
| | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Danielle M Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA; Department of Human & Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Benjamin W Domingue
- Stanford University Graduate School of Education, Stanford University, Stanford, CA, USA
| | - Louis Fox
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Alison M Goate
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Scott D Gordon
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Laura M Hack
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Dana B Hancock
- GenOmics, Bioinformatics, and Translational Research Center, Biostatistics and Epidemiology Division, RTI International, Research Triangle Park, Durham, NC, USA
| | - Sarah M Hartz
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - David M Hougaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Department for Congenital Disorders, Center for Neonatal Screening, Statens Serum Institut, Copenhagen, Denmark
| | - Kenneth Krauter
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, CO, USA; University of Colorado Boulder, Boulder, CO, USA
| | - Penelope A Lind
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jeanette N McClintick
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Matthew B McQueen
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Jacquelyn L Meyers
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA; Henri Begleiter Neurodynamics Laboratory, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Grant W Montgomery
- Institute for Molecular Bioscience, University of Queensland, QLD, Australia
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Preben B Mortensen
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - John F Pearson
- Biostatistics and Computational Biology Unit, University of Otago, Christchurch, New Zealand; Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Roseann E Peterson
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | | | - John P Rice
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | | | - Nancy L Saccone
- Department of Genetics, Washington University School of Medicine, St Louis, MO, USA; Division of Biostatistics, Washington University School of Medicine, St Louis, MO, USA
| | - Richard Sherva
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | - Judy L Silberg
- Department of Human & Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA; Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Ralph E Tarter
- School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Tamara L Wall
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Bradley T Webb
- Virginia Commonwealth University Alcohol Research Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Thomas Werge
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
| | - Leah Wetherill
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Margaret J Wright
- Queensland Brain Institute, University of Queensland, QLD, Australia
| | - Stephanie Zellers
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Mark J Adams
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Jason D Boardman
- Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder, Boulder, CO, USA
| | - William E Copeland
- Department of Psychiatry, University of Vermont Medical Center, Burlington, VT, USA
| | - Lindsay A Farrer
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | - Tatiana M Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Nathan A Gillespie
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Richard A Grucza
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Kathleen Mullan Harris
- Department of Sociology, and The Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Andrew C Heath
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Victor Hesselbrock
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - John K Hewitt
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
| | - Christian J Hopfer
- Department of Psychiatry, University of Colorado Denver, Aurora, CO, USA
| | - John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - William G Iacono
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Eric O Johnson
- GenOmics, Bioinformatics, and Translational Research Center, Biostatistics and Epidemiology Division, RTI International, Research Triangle Park, Durham, NC, USA
| | - Kenneth S Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Martin A Kennedy
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Henry R Kranzler
- Center for Studies of Addiction, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; VISN 4 MIRECC, Crescenz VAMC, Philadelphia, PA, USA
| | - Pamela A F Madden
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Hermine H Maes
- Department of Human & Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA; Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Brion S Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Matthew McGue
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | | | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Elliot C Nelson
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Bernice Porjesz
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA; Henri Begleiter Neurodynamics Laboratory, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Brien P Riley
- Virginia Commonwealth University Alcohol Research Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Michael C Stallings
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
| | | | - Scott Vrieze
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Lea K Davis
- Department of Medicine, Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Psychiatry and Behavioral Sciences, and Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ryan Bogdan
- Department of Psychological and Brain Sciences, Washington University in Saint Louis, St. Louis, MO, USA
| | - Joel Gelernter
- Division of Human Genetics, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Genetics, and Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA; Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
| | - Howard J Edenberg
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kari Stefansson
- deCODE Genetics/Amgen, Reykjavik, Iceland; Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Anders D Børglum
- Department of Biomedicine-Human Genetics and Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
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Jones HG, Radwan RW, Sams E, Gibby M, Coomer W, Jeffries J, Codd RJ, Williams GL, Taylor G, Horwood J. Incidence and treatment of positive pelvic sidewall lymph nodes in patients with rectal cancer. Colorectal Dis 2020; 22:1560-1567. [PMID: 32506534 DOI: 10.1111/codi.15176] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/19/2020] [Indexed: 12/15/2022]
Abstract
AIM The involvement of pelvic sidewall (PSW) lymph nodes in rectal cancer is a marker of locally advanced disease and poor prognosis. Eastern countries generally advocate lateral lymph node dissection (LLND) over the Western approach of neoadjuvant chemoradiotherapy and more limited surgery. The aim of this study was to evaluate how these advanced cancers were treated in three UK Health Boards. METHODOLOGY This was a retrospective review of three colorectal multidisciplinary team meetings from 2008 to 2016. All patients with rectal cancer and suspicious PSW lymph nodes on pretreatment MRI were included. RESULTS There were 153 (6.2%) patients who met the inclusion criteria from a total of 2461 diagnosed rectal cancers. There was significant variability between the three centres with surgical intervention ranging from 59.2% to 84.4%, P = 0.015. There were 81 patients who had neoadjuvant chemoradiotherapy prior to surgery; of these 67 (82.7%) still had positive PSW nodes on the restaging MRI, but only 13 (19.4%) had LLND. There was no difference in local recurrence (15.3% vs 11.8%, P = 0.66), 5-year overall survival (69.2% vs 80.1%, P = 0.16) or 5-year disease-free survival (69.2% vs 79.4%, P = 0.72) between patients having LLND and those receiving standard neoadjuvant treatment followed by total mesorectal excision surgery. CONCLUSIONS This study has demonstrated that rectal cancer patients with PSW positive nodal disease have advanced disease, mostly of the lower rectum, and receive a highly heterogeneous spectrum of therapies, even within a relatively small geographical area. Greater accuracy in our preoperative staging is needed to select those patients who will benefit from LLND surgery.
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Affiliation(s)
- H G Jones
- Department of Colorectal Surgery, Royal Gwent Hospital, Newport, UK
| | - R W Radwan
- Department of Colorectal Surgery, Royal Gwent Hospital, Newport, UK
| | - E Sams
- Department of Colorectal Surgery, Royal Gwent Hospital, Newport, UK
| | - M Gibby
- Department of Colorectal Surgery, Royal Gwent Hospital, Newport, UK
| | - W Coomer
- Radiology Department, University Hospital of Wales, Cardiff, UK
| | - J Jeffries
- Radiology Department, University Hospital of Wales, Cardiff, UK
| | - R J Codd
- Department of Colorectal Surgery, Royal Gwent Hospital, Newport, UK
| | - G L Williams
- Department of Colorectal Surgery, Royal Gwent Hospital, Newport, UK
| | - G Taylor
- Department of Colorectal Surgery, Morriston Hospital, Swansea, UK
| | - J Horwood
- Department of Colorectal Surgery, University Hospital of Wales, Cardiff, UK
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11
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Greer C, Adamson P, Harris S, Horwood J, Troughton R, Darlow B. Very low birth weight is associated with reduced right ventricular function detected by strain imaging in early adulthood – findings from a prospective matched cohort study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Being born at very low birth weight (VLBW, <1500g) is associated with increased rates of cardiopulmonary disorders in childhood. As survivors age, late cardiac effects, including right ventricular (RV) remodelling and occult pulmonary hypertension are emerging. Strain imaging provides prognostically important information regarding RV dysfunction in diverse cardiopulmonary conditions however, these indices have not previously been described within VLBW cohorts.
Purpose
To assess differences in right heart function using strain in young adults born at VLBW, compared to normal weight term born controls.
Methods
The New Zealand Very Low Birth Weight Study has followed all infants born in 1986 with birth weight <1500g. Of 323 survivors to adulthood, 228 (71%) had echocardiograms at 26–30 years which were compared to age and sex-matched term-born, normal-weight controls (n=100). RV global longitudinal strain (GLS) was measured by speckle tracking echocardiography by an investigator blinded to group allocation. Established measures of RV function (fractional area change (FAC), tricuspid annular systolic velocity (RV S') and tricuspid regurgitation velocities) were also obtained.
Results
VLBW subjects were smaller than their peers as young adults (Table 1). Strain measurement showed reduced myocardial deformation among VLBW subjects (RV myocardial GLS: −22.4% vs −23.5%, p=0.008; RV endocardial GLS: −23.6% vs −24.9%, p=0.005; free wall myocardial GLS −25.2% vs −26.1%, p=0.039; free wall endocardial GLS −26.7% vs −27.9%, p=0.009). TR velocity was higher in VLBW: 224 cm/s v 210 cm/s (p=0.002). RV S', and FAC were not different.
Conclusion
Young adults born at VLBW have impaired myocardial strain despite preserved RV function as assessed by standard techniques. Echocardiographic strain imaging may be an important tool to detect subclinical RV dysfunction.
Graph 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- C Greer
- Christchurch Hospital, Christchurch, New Zealand
| | - P Adamson
- University of Otago Christchurch, Christchurch, New Zealand
| | - S Harris
- University of Otago Christchurch, Christchurch, New Zealand
| | - J Horwood
- University of Otago Christchurch, Christchurch, New Zealand
| | - R Troughton
- University of Otago Christchurch, Christchurch, New Zealand
| | - B Darlow
- University of Otago Christchurch, Christchurch, New Zealand
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12
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Clare PJ, Dobbins T, Bruno R, Peacock A, Boland V, Yuen WS, Aiken A, Degenhardt L, Kypri K, Slade T, Hutchinson D, Najman JM, McBride N, Horwood J, McCambridge J, Mattick RP. The overall effect of parental supply of alcohol across adolescence on alcohol-related harms in early adulthood-a prospective cohort study. Addiction 2020; 115:1833-1843. [PMID: 32034841 DOI: 10.1111/add.15005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/18/2019] [Accepted: 02/02/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND AIMS Recent research suggests that parental supply of alcohol is associated with more risky drinking and alcohol-related harm among adolescents. However, the overall effect of parental supply throughout adolescence remains unclear, because parental supply of alcohol varies during adolescence. Due to the complexity of longitudinal data, standard analytical methods can be biased. This study examined the effect of parental supply of alcohol on alcohol-related outcomes in early adulthood using robust methods to minimize risk of bias. DESIGN Prospective longitudinal cohort study. SETTING Australia PARTICIPANTS: A cohort of school students (n = 1906) recruited in the first year of secondary school (average age 12.9 years) from Australian schools in 2010-11, interviewed annually for 7 years. MEASUREMENTS The exposure variable was self-reported parental supply of alcohol (including sips/whole drinks) during 5 years of adolescence (waves 1-5). Outcome variables were self-reported binge drinking, alcohol-related harm and symptoms of alcohol use disorder, measured in the two waves after the exposure period (waves 6-7). To reduce risk of bias, we used targeted maximum likelihood estimation to assess the (counterfactual) effect of parental supply of alcohol in all five waves versus no supply on alcohol-related outcomes. FINDINGS Parental supply of alcohol throughout adolescence saw greater risk of binge drinking [risk ratios (RR) = 1.53; 95% confidence interval (CI) = 1.27-1.84] and alcohol-related harms (RR = 1.44; 95% CI = 1.22-1.69) in the year following the exposure period compared with no supply in adolescence. Earlier initiation of parental supply also increased risk of binge drinking (RR = 1.10; 95% CI = 1.05-1.14), and any alcohol-related harm (RR = 1.09; 95% CI = 1.05-1.13) for each year earlier parental supply began compared with later (or no) initiation. CONCLUSIONS Adolescents whose parents supply them with alcohol appear to have an increased risk of alcohol-related harm compared with adolescents whose parents do not supply them with alcohol. The risk appears to increase with earlier initiation of supply.
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Affiliation(s)
- Philip J Clare
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Timothy Dobbins
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.,School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.,School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Wing See Yuen
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.,Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Victoria, Australia.,Department of Paediatrics, Royal Children's Hospital, The University of Melbourne, Victoria, Australia
| | - Jackob M Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, QLD, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Jim McCambridge
- Department of Health Sciences, University of York, Heslington, York, UK
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
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13
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Yuen WS, Chan G, Bruno R, Clare P, Mattick R, Aiken A, Boland V, McBride N, McCambridge J, Slade T, Kypri K, Horwood J, Hutchinson D, Najman J, De Torres C, Peacock A. Adolescent Alcohol Use Trajectories: Risk Factors and Adult Outcomes. Pediatrics 2020; 146:peds.2020-0440. [PMID: 32968030 DOI: 10.1542/peds.2020-0440] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Adolescents often display heterogenous trajectories of alcohol use. Initiation and escalation of drinking may be important predictors of later harms, including alcohol use disorder (AUD). Previous conceptualizations of these trajectories lacked adjustment for known confounders of adolescent drinking, which we aimed to address by modeling dynamic changes in drinking throughout adolescence while adjusting for covariates. METHODS Survey data from a longitudinal cohort of Australian adolescents (n = 1813) were used to model latent class alcohol use trajectories over 5 annual follow-ups (mean age = 13.9 until 17.8 years). Regression models were used to determine whether child, parent, and peer factors at baseline (mean age = 12.9 years) predicted trajectory membership and whether trajectories predicted self-reported symptoms of AUD at the final follow-up (mean age = 18.8 years). RESULTS We identified 4 classes: abstaining (n = 352); late-onset moderate drinking (n = 503); early-onset moderate drinking (n = 663); and early-onset heavy drinking (n = 295). Having more alcohol-specific household rules reduced risk of early-onset heavy drinking compared with late-onset moderate drinking (relative risk ratio: 0.31; 99.5% confidence interval [CI]: 0.11-0.83), whereas having more substance-using peers increased this risk (relative risk ratio: 3.43; 99.5% CI: 2.10-5.62). Early-onset heavy drinking increased odds of meeting criteria for AUD in early adulthood (odds ratio: 7.68; 99.5% CI: 2.41-24.47). CONCLUSIONS Our study provides evidence that parenting factors and peer influences in early adolescence should be considered to reduce risk of later alcohol-related harm. Early initiation and heavy alcohol use throughout adolescence are associated with increased risk of alcohol-related harm compared with recommended maximum levels of consumption (late-onset, moderate drinking).
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Affiliation(s)
- Wing See Yuen
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia;
| | - Gary Chan
- National Centre for Youth Substance Use Research and
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia.,School of Psychological Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Philip Clare
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Richard Mattick
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Jim McCambridge
- Department of Health Sciences, University of York, York, United Kingdom
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
| | - John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia.,Centre for Social and Early Emotional Development, Deakin University, Geelong, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia; and.,Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Victoria, Australia
| | - Jake Najman
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Clara De Torres
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia.,School of Psychological Sciences, University of Tasmania, Hobart, Tasmania, Australia
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14
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Harris SL, Bray H, Troughton R, Elliott J, Frampton C, Horwood J, Darlow BA. Cardiovascular Outcomes in Young Adulthood in a Population-Based Very Low Birth Weight Cohort. J Pediatr 2020; 225:74-79.e3. [PMID: 32553866 DOI: 10.1016/j.jpeds.2020.06.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/03/2020] [Accepted: 06/06/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To assess differences in left heart structure and function, and endothelial function in a national cohort of very low birth weight (VLBW) young adults and term-born controls. STUDY DESIGN The New Zealand VLBW study is a prospective, population-based, longitudinal cohort study which included all infants born <1500 g in 1986. The VLBW cohort (n = 229; 71% of survivors) and term-born controls (n = 100), were assessed at age 26-30 years. Measures of left heart structure and function were evaluated by echocardiography, vascular function was assessed using blood pressure, reactive hyperemia index, and arterioventricular coupling by calculating left ventricular (LV) and arterial elastance. RESULTS Compared with controls, those born VLBW had smaller LVs, even when indexed for body surface area (mean LV mass, 89.7 ± 19.3 g/m2 vs 95.0 ± 22.3 g/m2 [P = .03]; LV end-diastolic volume, 58.3 ± 10.9 mL/m2 vs 62.4 ± 12.4 mL/m2 [P = .002]; and LV end-systolic volume, 20.8 ± 4.9 mL/m2 vs 22.6 ± 5.8 mL/m2 [P = .004]). VLBW participants had lower stroke volume (median, 37.2 mL/m2 [IQR, 33-42 mL/m2] vs median, 40.1 mL/m2 [IQR, 34-45 mL/m2]; P = .0059) and cardiac output (mean, 4.8 ± 1.2 L/min vs 5.1 ± 1.4 L/min; P = .03), but there was no difference in ejection fraction. The VLBW group had higher LV elastance (3.37 ± 0.88 mm Hg/mL vs 2.86 ± 0.75 mm Hg/mL; P < .0001) and arterial elastance (1.84 ± 0.4 vs 1.6 ± 0.4; P < .0001) and lower reactive hyperemia index (0.605 ± 0.28 vs 0.688 ± 0.31; P = .041). These measures were influenced by birth weight and sex, but we found limited associations with other perinatal factors. CONCLUSIONS Being born preterm and VLBW is associated with differences in cardiovascular structure and function in adulthood. This population may be more vulnerable to cardiovascular pathology as they age. TRIAL REGISTRATION Australian Clinical Trials Registry ACTRN12612000995875.
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Affiliation(s)
- Sarah L Harris
- Department of Pediatrics, University of Otago, Christchurch, New Zealand.
| | - Helen Bray
- Christchurch Women's Hospital, Christchurch, New Zealand
| | - Richard Troughton
- Department of Medicine, University of Otago, Christchurch, New Zealand; Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand
| | - John Elliott
- Department of Medicine, University of Otago, Christchurch, New Zealand; Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand
| | - Chris Frampton
- Department of Medicine, University of Otago, Christchurch, New Zealand; Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Brian A Darlow
- Department of Pediatrics, University of Otago, Christchurch, New Zealand
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15
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Stone TJ, Brangan E, Chappell A, Harrison V, Horwood J. Telephone outreach by community workers to improve uptake of NHS Health Checks in more deprived localities and minority ethnic groups: a qualitative investigation of implementation. J Public Health (Oxf) 2020; 42:e198-e206. [PMID: 31188440 DOI: 10.1093/pubmed/fdz063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 05/07/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND NHS Health Checks is a national cardiovascular risk assessment and management programme in England. To improve equity of uptake in more deprived, and Black, Asian and minority ethnic (BAME) communities, a novel telephone outreach intervention was developed. The outreach call included an invitation to an NHS Health Check appointment, lifestyle questions, and signposting to lifestyle services. We examined the experiences of staff delivering the intervention. METHODS Thematic analysis of semi-structured interviews with 10 community Telephone Outreach Workers (TOWs) making outreach calls, and 5 Primary Care Practice (PCP) staff they liaised with. Normalization Process Theory was used to examine intervention implementation. RESULTS Telephone outreach was perceived as effective in engaging patients in NHS Health Checks and could reduce related administration burdens on PCPs. Successful implementation was dependent on support from participating PCPs, and tensions between the intervention and other PCP priorities were identified. Some PCP staff lacked clarity regarding the intervention aim and this could reduce the potential to capitalize on TOWs' specialist skills. CONCLUSIONS To maximize the potential of telephone outreach to impact equity, purposeful recruitment and training of TOWs is vital, along with support and integration of TOWs, and the telephone outreach intervention, in participating PCPs.
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Affiliation(s)
- T J Stone
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, UK
| | - E Brangan
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, UK
| | - A Chappell
- Public Health, Bristol City Council, City Hall, Bristol, UK
| | - V Harrison
- Public Health, Bristol City Council, City Hall, Bristol, UK
| | - J Horwood
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, UK
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16
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Poulton R, Robertson K, Boden J, Horwood J, Theodore R, Potiki T, Ambler A. Patterns of recreational cannabis use in Aotearoa-New Zealand and their consequences: evidence to inform voters in the 2020 referendum. J R Soc N Z 2020. [DOI: 10.1080/03036758.2020.1750435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, Division of Sciences, University of Otago, Dunedin, New Zealand
| | - Kirsten Robertson
- Department of Marketing, Division of Commerce, University of Otago, Dunedin, New Zealand
| | - Joseph Boden
- Christchurch Health and Development Study, Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - John Horwood
- Christchurch Health and Development Study, Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Reremoana Theodore
- National Centre for Lifecourse Research, Division of Sciences, University of Otago, Dunedin, New Zealand
| | - Tuari Potiki
- Office of Maori Development, University of Otago, Dunedin, New Zealand
| | - Antony Ambler
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, Division of Sciences, University of Otago, Dunedin, New Zealand
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17
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Mowbray NG, Ansell J, Horwood J, Cornish J, Rizkallah P, Parker A, Wall P, Spinelli A, Torkington J. Safe management of surgical smoke in the age of COVID-19. Br J Surg 2020; 107:1406-1413. [PMID: 32363596 PMCID: PMC7267397 DOI: 10.1002/bjs.11679] [Citation(s) in RCA: 137] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 12/21/2022]
Abstract
Background The COVID-19 global pandemic has resulted in a plethora of guidance and opinion from surgical societies. A controversial area concerns the safety of surgically created smoke and the perceived potential higher risk in laparoscopic surgery. Methods The limited published evidence was analysed in combination with expert opinion. A review was undertaken of the novel coronavirus with regards to its hazards within surgical smoke and the procedures that could mitigate the potential risks to healthcare staff. Results Using existing knowledge of surgical smoke, a theoretical risk of virus transmission exists. Best practice should consider the operating room set-up, patient movement and operating theatre equipment when producing a COVID-19 operating protocol. The choice of energy device can affect the smoke produced, and surgeons should manage the pneumoperitoneum meticulously during laparoscopic surgery. Devices to remove surgical smoke, including extractors, filters and non-filter devices, are discussed in detail. Conclusion There is not enough evidence to quantify the risks of COVID-19 transmission in surgical smoke. However, steps can be undertaken to manage the potential hazards. The advantages of minimally invasive surgery may not need to be sacrificed in the current crisis.
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Affiliation(s)
- N G Mowbray
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
| | - J Ansell
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
| | - J Horwood
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
| | - J Cornish
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
| | - P Rizkallah
- School of Medicine, Cardiff University, Cardiff, UK
| | - A Parker
- School of Medicine, Cardiff University, Cardiff, UK
| | - P Wall
- Isca Healthcare Research, Caerleon, UK
| | - A Spinelli
- Department of General and Minimally Invasive Surgery, Istituto Clinico Humanitas, Rozzano, Italy
| | - J Torkington
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
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18
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Yang J, Kingsford RA, Horwood J, Epton MJ, Swanney MP, Stanton J, Darlow BA. Lung Function of Adults Born at Very Low Birth Weight. Pediatrics 2020; 145:peds.2019-2359. [PMID: 31900317 DOI: 10.1542/peds.2019-2359] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Much remains unknown about the consequences of very low birth weight (VLBW) and bronchopulmonary dysplasia (BPD) on adult lungs. We hypothesized that VLBW adults would have impaired lung function compared with controls, and those with a history of BPD would have worse lung function than those without. METHODS At age 26 to 30 years, 226 VLBW survivors of the New Zealand VLBW cohort and 100 term controls born in 1986 underwent lung function tests including spirometry, plethysmographic lung volumes, diffusing capacity of the lung for carbon monoxide, and single-breath nitrogen washout (SBN2). RESULTS An obstructive spirometry pattern was identified in 35% VLBW subjects versus 14% controls, with the majority showing mild obstruction. Compared with controls, VLBW survivors demonstrated significantly lower forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity (FVC) ratio (FEV1/FVC), forced expiratory flow at 25% to 75% of FVC and higher residual volume (RV), RV/total lung capacity (TLC) ratio (RV/TLC), decreased diffusing capacity of the lung for carbon monoxide, and increased phase III slope for SBN2. The differences persisted after adjustment for sex and smoking status. Within the VLBW group, subjects with BPD showed significant reduction in FEV1, FEV1/FVC, and forced expiratory flow at 25% to 75% of FVC, and increase in RV, RV/TLC, and phase III slope for SBN2, versus subjects without. The differences remained after adjustment for confounders. CONCLUSIONS Adult VLBW survivors showed a higher incidence of airflow obstruction, gas trapping, reduced gas exchange, and increased ventilatory inhomogeneity versus controls. The findings suggest pulmonary effects due to VLBW persist into adulthood, and BPD is a further insult on small airway function.
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Affiliation(s)
- Jun Yang
- Respiratory Physiology Laboratory and
| | | | | | - Michael J Epton
- Canterbury Respiratory Research Group, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand; and
| | | | | | - Brian A Darlow
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
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19
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Duncan R, Horwood J, Razvi S, Mulhern S. Psychogenic nonepileptic seizures that remit when the diagnosis is given: Just good luck? Epilepsy Behav 2020; 102:106667. [PMID: 31846898 DOI: 10.1016/j.yebeh.2019.106667] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/23/2019] [Accepted: 10/25/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Some patients with psychogenic nonepileptic seizures (PNES) remit when given the diagnosis. It is not realistically possible to test this potential therapeutic effect in an Randomized Controlled Trial (RCT) so we aim to statistically demonstrate it using the temporal relationship between the communication of the diagnosis and the timing of remission. METHOD Re-analysis of data from a study of PNES, where diagnosis was communicated, and outcomes recorded in 54 patients. Making conservative assumptions and using the binomial distribution, the Poisson distribution and the chi-squared test distribution, we calculated likelihoods of the null hypothesis: that communication of the diagnosis and remission of seizures had occurred in random temporal relationship. RESULTS Remission occurred in the week following communication of the diagnosis in 15 out of 54 patients. The χ2 test assigned this result a p value of <0.00001. Binomial and Poisson distribution calculations also indicated that remission was highly unlikely to have occurred by chance and that, in a dataset similar to ours, was unlikely to be due to chance if occurring in more than 9 patients (16.7%). CONCLUSIONS We showed that the observed remissions were highly unlikely to be due to chance. Where an intervention is 'short and sharp' and the outcome can be measured with reasonable temporal acuity, then this type of method may provide an alternative to RCT methodology when the latter is impracticable.
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Affiliation(s)
| | - John Horwood
- Department of Psychological Medicine, University of Otago Christchurch, New Zealand
| | - Saif Razvi
- Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
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20
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Greer C, Adamson P, Harris S, Horwood J, Troughton R, Darlow B. A002 Very Low Birth Weight is Associated With Reduced Right Ventricular Function Detected by Strain Imaging in Early Adulthood – Findings From a Prospective Cohort Study. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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21
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Najman JM, Plotnikova M, Horwood J, Silins E, Fergusson D, Patton GC, Olsson C, Hutchinson DM, Degenhardt L, Tait R, Youssef GJ, Borschmann R, Coffey C, Toumbourou JW, Mattick RP. Does adolescent heavier alcohol use predict young adult aggression and delinquency? Parallel analyses from four Australasian cohort studies. Aggress Behav 2019; 45:427-436. [PMID: 30887542 DOI: 10.1002/ab.21828] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 02/04/2019] [Accepted: 02/19/2019] [Indexed: 11/12/2022]
Abstract
While the association between heavy alcohol consumption and aggression has been well documented, the causal direction of this association, particularly at a population level, is disputed. A number of causal sequences have been proposed. First, that aggression leads to heavy alcohol use. Second, that heavy alcohol use leads to aggression. Third, that the association between alcohol use and aggression is due to confounding by (a) sociodemographic variables or (b) delinquency. We report here data from four Australasian prospective longitudinal studies of adolescents, to assess the temporal sequence of heavy drinking and aggression over the period from adolescence to young adulthood. The four cohort studies provide a total sample of 6,706 persons (Australian Temperament Project, n = 1701; Christchurch Health and Development Study, n = 931; Mater-University of Queensland Study of Pregnancy, n = 2437; Victorian Adolescent Health Cohort Study, n = 1637). We use multinomial logistic regression to determine whether early adolescent aggression predicts subsequent age of onset of heavy episodic drinking (HED), after adjustment for concurrent sociodemographic factors and delinquency. We then consider whether HED predicts subsequent aggression, after adjusting for past aggression, concurrent delinquency, and a range of confounders. There are broadly consistent findings across the four cohort studies. Early aggression strongly predicts subsequent HED. HED predicts later aggression after adjustment for prior aggression and other confounders. Policies that alter population levels of alcohol consumption are likely to impact on levels of aggression in societies where HED linked to aggression is more common.
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Affiliation(s)
- Jake M. Najman
- School of Public Health and School of Social ScienceThe University of Queensland Brisbane QLD Australia
| | - Maria Plotnikova
- School of Public Health and School of Social ScienceThe University of Queensland Brisbane QLD Australia
| | - John Horwood
- Christchurch Health and Development Study, Department of Psychological MedicineUniversity of Otago Christchurch New Zealand
| | - Edmund Silins
- National Drug and Alcohol Research CentreUNSW Australia Sydney Australia
| | - David Fergusson
- Christchurch Health and Development Study, Department of Psychological MedicineUniversity of Otago Christchurch New Zealand
| | - George C Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's HospitalMelbourne VIC Australia
- Department of PaediatricsUniversity of MelbourneMelbourne VIC Australia
| | - Craig Olsson
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's HospitalMelbourne VIC Australia
- Department of PaediatricsUniversity of MelbourneMelbourne VIC Australia
- Centre for Social and Early Emotional DevelopmentSchool of PsychologyDeakin UniversityGeelong VIC Australia
| | - Delyse M Hutchinson
- National Drug and Alcohol Research CentreUNSW Australia Sydney Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's HospitalMelbourne VIC Australia
- Department of PaediatricsUniversity of MelbourneMelbourne VIC Australia
- Centre for Social and Early Emotional DevelopmentSchool of PsychologyDeakin UniversityGeelong VIC Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research CentreUNSW Australia Sydney Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's HospitalMelbourne VIC Australia
- School of Population and Global HealthUniversity of MelbourneMelbourne VIC Australia
- Department of Global HealthSchool of Public Health, University of WashingtonSeattle Washington
| | - Robert Tait
- National Drug Research Institute, Faculty of Health Sciences, Curtin UniversityPerth WA Australia
| | - George J. Youssef
- Faculty of Health, School of Psychology, Deakin UniversityGeelong VIC Australia
| | - Rohan Borschmann
- School of Population and Global HealthUniversity of MelbourneMelbourne VIC Australia
| | - Carolyn Coffey
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's HospitalMelbourne VIC Australia
| | - John W Toumbourou
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's HospitalMelbourne VIC Australia
- Centre for Social and Early Emotional DevelopmentSchool of PsychologyDeakin UniversityGeelong VIC Australia
| | - Richard P. Mattick
- National Drug and Alcohol Research CentreUNSW Australia Sydney Australia
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Richards A, Horwood J, Boden J, Kennedy M, Sellers R, Riglin L, Mistry S, Jones H, Smith DJ, Zammit S, Owen M, O'Donovan MC, Harold GT. Associations between schizophrenia genetic risk, anxiety disorders and manic/hypomanic episode in a longitudinal population cohort study. Br J Psychiatry 2019; 214:96-102. [PMID: 30472973 PMCID: PMC6429243 DOI: 10.1192/bjp.2018.227] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 07/16/2018] [Accepted: 09/18/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Studies involving clinically recruited samples show that genetic liability to schizophrenia overlaps with that for several psychiatric disorders including bipolar disorder, major depression and, in a population study, anxiety disorder and negative symptoms in adolescence.AimsWe examined whether, at a population level, association between schizophrenia liability and anxiety disorders continues into adulthood, for specific anxiety disorders and as a group. We explored in an epidemiologically based cohort the nature of adult psychopathology sharing liability to schizophrenia. METHOD Schizophrenia polygenic risk scores (PRSs) were calculated for 590 European-descent individuals from the Christchurch Health and Development Study. Logistic regression was used to examine associations between schizophrenia PRS and four anxiety disorders (social phobia, specific phobia, panic disorder and generalised anxiety disorder), schizophrenia/schizophreniform disorder, manic/hypomanic episode, alcohol dependence, major depression, and - using linear regression - total number of anxiety disorders. A novel population-level association with hypomania was tested in a UK birth cohort (Avon Longitudinal Study of Parents and Children). RESULTS Schizophrenia PRS was associated with total number of anxiety disorders and with generalised anxiety disorder and panic disorder. We show a novel population-level association between schizophrenia PRS and manic/hypomanic episode. CONCLUSIONS The relationship between schizophrenia liability and anxiety disorders is not restricted to psychopathology in adolescence but is present in adulthood and specifically linked to generalised anxiety disorder and panic disorder. We suggest that the association between schizophrenia liability and hypomanic/manic episodes found in clinical samples may not be due to bias.Declarations of interestNone.
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Affiliation(s)
- Alexander Richards
- Research Associate, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - John Horwood
- Professor, Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago Christchurch, New Zealand
| | - Joseph Boden
- Associate Professor, Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago Christchurch, New Zealand
| | - Martin Kennedy
- Professor, Department of Pathology, University of Otago Christchurch, New Zealand
| | - Ruth Sellers
- Economic and Social Research Council Future Research Leader Fellow, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University and School of Psychology, University of Sussex, UK
| | - Lucy Riglin
- Research Associate, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Sumit Mistry
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Hannah Jones
- Research Associate, Population Health Sciences, Bristol Medical School and Medical Research Council Integrative Epidemiology Unit, University of Bristol, UK
| | - Daniel J. Smith
- Professor, Institute of Health and Wellbeing, University of Glasgow, UK
| | - Stanley Zammit
- Professor, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University and Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Michael Owen
- Professor, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Michael C. O'Donovan
- Professor, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Gordon T. Harold
- Professor, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University and School of Psychology, University of Sussex and School of Psychology, Trinity College, UK
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Walters RK, Polimanti R, Johnson EC, McClintick JN, Adams MJ, Adkins AE, Aliev F, Bacanu SA, Batzler A, Bertelsen S, Biernacka JM, Bigdeli TB, Chen LS, Clarke TK, Chou YL, Degenhardt F, Docherty AR, Edwards AC, Fontanillas P, Foo JC, Fox L, Frank J, Giegling I, Gordon S, Hack LM, Hartmann AM, Hartz SM, Heilmann-Heimbach S, Herms S, Hodgkinson C, Hoffmann P, Jan Hottenga J, Kennedy MA, Alanne-Kinnunen M, Konte B, Lahti J, Lahti-Pulkkinen M, Lai D, Ligthart L, Loukola A, Maher BS, Mbarek H, McIntosh AM, McQueen MB, Meyers JL, Milaneschi Y, Palviainen T, Pearson JF, Peterson RE, Ripatti S, Ryu E, Saccone NL, Salvatore JE, Sanchez-Roige S, Schwandt M, Sherva R, Streit F, Strohmaier J, Thomas N, Wang JC, Webb BT, Wedow R, Wetherill L, Wills AG, Boardman JD, Chen D, Choi DS, Copeland WE, Culverhouse RC, Dahmen N, Degenhardt L, Domingue BW, Elson SL, Frye MA, Gäbel W, Hayward C, Ising M, Keyes M, Kiefer F, Kramer J, Kuperman S, Lucae S, Lynskey MT, Maier W, Mann K, Männistö S, Müller-Myhsok B, Murray AD, Nurnberger JI, Palotie A, Preuss U, Räikkönen K, Reynolds MD, Ridinger M, Scherbaum N, Schuckit MA, Soyka M, Treutlein J, Witt S, Wodarz N, Zill P, Adkins DE, Boden JM, Boomsma DI, Bierut LJ, Brown SA, Bucholz KK, Cichon S, Costello EJ, de Wit H, Diazgranados N, Dick DM, Eriksson JG, Farrer LA, Foroud TM, Gillespie NA, Goate AM, Goldman D, Grucza RA, Hancock DB, Harris KM, Heath AC, Hesselbrock V, Hewitt JK, Hopfer CJ, Horwood J, Iacono W, Johnson EO, Kaprio JA, Karpyak VM, Kendler KS, Kranzler HR, Krauter K, Lichtenstein P, Lind PA, McGue M, MacKillop J, Madden PAF, Maes HH, Magnusson P, Martin NG, Medland SE, Montgomery GW, Nelson EC, Nöthen MM, Palmer AA, Pedersen NL, Penninx BWJH, Porjesz B, Rice JP, Rietschel M, Riley BP, Rose R, Rujescu D, Shen PH, Silberg J, Stallings MC, Tarter RE, Vanyukov MM, Vrieze S, Wall TL, Whitfield JB, Zhao H, Neale BM, Gelernter J, Edenberg HJ, Agrawal A. Transancestral GWAS of alcohol dependence reveals common genetic underpinnings with psychiatric disorders. Nat Neurosci 2018; 21:1656-1669. [PMID: 30482948 PMCID: PMC6430207 DOI: 10.1038/s41593-018-0275-1] [Citation(s) in RCA: 367] [Impact Index Per Article: 61.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 10/12/2018] [Indexed: 01/21/2023]
Abstract
Liability to alcohol dependence (AD) is heritable, but little is known about its complex polygenic architecture or its genetic relationship with other disorders. To discover loci associated with AD and characterize the relationship between AD and other psychiatric and behavioral outcomes, we carried out the largest genome-wide association study to date of DSM-IV-diagnosed AD. Genome-wide data on 14,904 individuals with AD and 37,944 controls from 28 case-control and family-based studies were meta-analyzed, stratified by genetic ancestry (European, n = 46,568; African, n = 6,280). Independent, genome-wide significant effects of different ADH1B variants were identified in European (rs1229984; P = 9.8 × 10-13) and African ancestries (rs2066702; P = 2.2 × 10-9). Significant genetic correlations were observed with 17 phenotypes, including schizophrenia, attention deficit-hyperactivity disorder, depression, and use of cigarettes and cannabis. The genetic underpinnings of AD only partially overlap with those for alcohol consumption, underscoring the genetic distinction between pathological and nonpathological drinking behaviors.
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Affiliation(s)
- Raymond K Walters
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine and Veterans Affairs Connecticut Healthcare Center, West Haven, CT, USA
| | - Emma C Johnson
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
| | - Jeanette N McClintick
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mark J Adams
- University of Edinburgh, Division of Psychiatry, Edinburgh, UK
| | - Amy E Adkins
- Department of Psychology & College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Richmond, VA, USA
| | - Fazil Aliev
- Virginia Commonwealth University, Department of Psychology, Richmond, VA, USA
| | - Silviu-Alin Bacanu
- Virginia Commonwealth University Alcohol Research Center; Virginia Institute for Psychiatric and Behavioral Genetics; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Anthony Batzler
- Mayo Clinic, Psychiatric Genomics and Pharmacogenomics Program, Rochester, MN, USA
| | - Sarah Bertelsen
- Icahn School of Medicine at Mount Sinai, Department of Neuroscience, New York, NY, USA
| | - Joanna M Biernacka
- Mayo Clinic, Department of Health Sciences Research, and Department of Psychiatry and Psychology, Rochester, MN, USA
| | - Tim B Bigdeli
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Li-Shiun Chen
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
| | - Toni-Kim Clarke
- University of Edinburgh, Division of Psychiatry, Edinburgh, UK
| | - Yi-Ling Chou
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn; and Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Anna R Docherty
- University of Utah, Department of Psychiatry, Salt Lake City, UT, USA
| | - Alexis C Edwards
- Virginia Commonwealth University, Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Richmond, VA, USA
| | | | - Jerome C Foo
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Louis Fox
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ina Giegling
- Martin-Luther-University Halle-Wittenberg, Department of Psychiatry, Psychotherapy and Psychosomatics, Halle, Germany
| | - Scott Gordon
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Laura M Hack
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Annette M Hartmann
- Martin-Luther-University Halle-Wittenberg, Department of Psychiatry, Psychotherapy and Psychosomatics, Halle, Germany
| | - Sarah M Hartz
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, University of Bonn; and Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Stefan Herms
- Institute of Human Genetics, University of Bonn; and Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
- Human Genomics Research Group, Department of Biomedicine, University of Basel Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | | | - Per Hoffmann
- Institute of Human Genetics, University of Bonn; and Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
- Human Genomics Research Group, Department of Biomedicine, University of Basel Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Jouke Jan Hottenga
- Department of Biological Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Mervi Alanne-Kinnunen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Bettina Konte
- Martin-Luther-University Halle-Wittenberg, Department of Psychiatry, Psychotherapy and Psychosomatics, Halle, Germany
| | - Jari Lahti
- Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | | | - Dongbing Lai
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lannie Ligthart
- Department of Biological Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anu Loukola
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Brion S Maher
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Hamdi Mbarek
- Department of Biological Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Andrew M McIntosh
- University of Edinburgh, Division of Psychiatry, Centre for Cognitive Ageing and Cognitive Epidemiology, Edinburgh, UK
| | - Matthew B McQueen
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Jacquelyn L Meyers
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center/GGz inGeest, Amsterdam, The Netherlands
| | - Teemu Palviainen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - John F Pearson
- Biostatistics and Computational Biology Unit, University of Otago, Christchurch, New Zealand
| | - Roseann E Peterson
- Virginia Commonwealth University, Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Richmond, VA, USA
| | - Samuli Ripatti
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Euijung Ryu
- Mayo Clinic, Department of Health Sciences Research, Rochester, MN, USA
| | - Nancy L Saccone
- Washington University School of Medicine, Department of Genetics, St. Louis, MO, USA
| | - Jessica E Salvatore
- Virginia Commonwealth University, Department of Psychology, Richmond, VA, USA
- Virginia Commonwealth University, Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Richmond, VA, USA
| | - Sandra Sanchez-Roige
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
| | | | - Richard Sherva
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jana Strohmaier
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nathaniel Thomas
- Department of Psychology & College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Richmond, VA, USA
| | - Jen-Chyong Wang
- Icahn School of Medicine at Mount Sinai, Department of Neuroscience, New York, NY, USA
| | - Bradley T Webb
- Virginia Commonwealth University Alcohol Research Center; Virginia Institute for Psychiatric and Behavioral Genetics; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Robbee Wedow
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Sociology, Harvard University, Cambridge, MA, USA
| | - Leah Wetherill
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Amanda G Wills
- University of Colorado School of Medicine, Department of Pharmacology, Aurora, CO, USA
| | - Jason D Boardman
- Institute of Behavioral Science and Department of Sociology, University of Colorado, Boulder, CO, USA
| | - Danfeng Chen
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Doo-Sup Choi
- Mayo Clinic, Department of Molecular Pharmacology and Experimental Therapeutics, Rochester, MN, USA
| | - William E Copeland
- Duke University Medical Center, Department of Psychiatry and Behavioral Sciences, Durham, NC, USA
| | - Robert C Culverhouse
- Washington University School of Medicine, Department of Medicine and Division of Biostatistics, St. Louis, MO, USA
| | - Norbert Dahmen
- Department of Psychiatry, University of Mainz, Mainz, Germany
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | - Mark A Frye
- Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN, USA
| | - Wolfgang Gäbel
- Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, Germany
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Marcus Ising
- Max-Planck-Institute of Psychiatry, Munich, Germany
| | - Margaret Keyes
- University of Minnesota, Department of Psychology, Minneapolis, MN, USA
| | - Falk Kiefer
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - John Kramer
- University of Iowa Roy J and Lucille A Carver College of Medicine, Department of Psychiatry, Iowa City, IA, USA
| | - Samuel Kuperman
- University of Iowa Roy J and Lucille A Carver College of Medicine, Department of Psychiatry, Iowa City, IA, USA
| | | | - Michael T Lynskey
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Karl Mann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | | | - Bertram Müller-Myhsok
- Department of Statistical Genetics, Max-Planck-Institute of Psychiatry, Munich, Germany
| | - Alison D Murray
- The Institute of Medical Sciences, Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, UK
| | - John I Nurnberger
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Aarno Palotie
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Medicine, Department of Neurology and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Ulrich Preuss
- Martin-Luther-University Halle-Wittenberg, Department of Psychiatry, Psychotherapy and Psychosomatics, Halle, Germany
- Vitos Hospital Herborn, Department of Psychiatry and Psychotherapy, Herborn, Germany
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | | | - Monika Ridinger
- Department of Psychiatry and Psychotherapy, University of Regensburg Psychiatric Health Care Aargau, Regensburg, Germany
| | - Norbert Scherbaum
- LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Department of Addictive Behaviour and Addiction Medicine, Medical Faculty, University of Duisburg-Essen, Duisburg, Germany
| | - Marc A Schuckit
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
| | - Michael Soyka
- Medical Park Chiemseeblick in Bernau-Felden, Chiemsee, Germany
- Psychiatric Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Jens Treutlein
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stephanie Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Norbert Wodarz
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Peter Zill
- Psychiatric Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Daniel E Adkins
- University of Utah, Department of Psychiatry, Salt Lake City, UT, USA
- University of Utah, Department of Sociology, Salt Lake City, UT, USA
| | | | - Dorret I Boomsma
- Department of Biological Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Laura J Bierut
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
| | - Sandra A Brown
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
- University of California, San Diego School of Medicine, Department of Psychology, San Diego, CA, USA
| | - Kathleen K Bucholz
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
| | - Sven Cichon
- Human Genomics Research Group, Department of Biomedicine, University of Basel Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - E Jane Costello
- Duke University Medical Center, Department of Psychiatry and Behavioral Sciences, Durham, NC, USA
| | | | | | - Danielle M Dick
- Department of Psychology & College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Richmond, VA, USA
- Department of Human & Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki, and National Institute for Health and Welfare, Helsinki, Finland
| | - Lindsay A Farrer
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
- Departments of Neurology, Ophthalmology, Epidemiology, and Biostatistics, Boston University Schools of Medicine and Public Health, Boston, MA, USA
| | - Tatiana M Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Nathan A Gillespie
- Virginia Commonwealth University, Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Richmond, VA, USA
| | - Alison M Goate
- Icahn School of Medicine at Mount Sinai, Department of Neuroscience, New York, NY, USA
| | - David Goldman
- NIH/NIAAA, Laboratory of Neurogenetics, Bethesda, MD, USA
- NIH/NIAAA, Office of the Clinical Director, Bethesda, MD, USA
| | - Richard A Grucza
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
| | - Dana B Hancock
- Center for Omics Discovery and Epidemiology, Behavioral Health Research Division, RTI International, Research Triangle Park, NC, USA
| | - Kathleen Mullan Harris
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Andrew C Heath
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
| | - Victor Hesselbrock
- University of Connecticut School of Medicine, Department of Psychiatry, Farmington, CT, USA
| | - John K Hewitt
- University of Colorado Boulder, Institute for Behavioral Genetics, Boulder, CO, USA
| | | | | | - William Iacono
- University of Minnesota, Department of Psychology, Minneapolis, MN, USA
| | - Eric O Johnson
- RTI International, Fellows Program, Research Triangle Park, NC, USA
| | - Jaakko A Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Victor M Karpyak
- Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN, USA
| | - Kenneth S Kendler
- Virginia Commonwealth University Alcohol Research Center; Virginia Institute for Psychiatric and Behavioral Genetics; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Henry R Kranzler
- University of Pennsylvania Perelman School of Medicine, Center for Studies of Addiction, Department of Psychiatry and VISN 4 MIRECC, Crescenz VAMC, Philadelphia, PA, USA
| | - Kenneth Krauter
- University of Colorado Boulder, Department of Molecular, Cellular, and Developmental Biology, Boulder, CO, USA
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Instituet, Stockholm, Sweden
| | - Penelope A Lind
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Matt McGue
- University of Minnesota, Department of Psychology, Minneapolis, MN, USA
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton; Michael G. DeGroote Centre for Medicinal Cannabis Research, Hamilton, Ontario, Canada
| | - Pamela A F Madden
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
| | - Hermine H Maes
- Virginia Commonwealth University, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
| | - Patrik Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Instituet, Stockholm, Sweden
| | - Nicholas G Martin
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Grant W Montgomery
- The Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Elliot C Nelson
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Abraham A Palmer
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
- University of California San Diego, Institute for Genomic Medicine, San Diego, CA, USA
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Instituet, Stockholm, Sweden
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center/GGz inGeest, Amsterdam, The Netherlands
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - John P Rice
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Brien P Riley
- Virginia Commonwealth University Alcohol Research Center; Virginia Institute for Psychiatric and Behavioral Genetics; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Richard Rose
- Department of Psychological & Brain Sciences, Indiana University Bloomington, Bloomington, IN, USA
| | - Dan Rujescu
- Martin-Luther-University Halle-Wittenberg, Department of Psychiatry, Psychotherapy and Psychosomatics, Halle, Germany
| | - Pei-Hong Shen
- NIH/NIAAA, Laboratory of Neurogenetics, Bethesda, MD, USA
| | - Judy Silberg
- Virginia Commonwealth University, Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Richmond, VA, USA
| | - Michael C Stallings
- University of Colorado Boulder, Institute for Behavioral Genetics, Boulder, CO, USA
| | - Ralph E Tarter
- University of Pittsburgh, School of Pharmacy, Pittsburgh, PA, USA
| | | | - Scott Vrieze
- University of Minnesota, Department of Psychology, Minneapolis, MN, USA
| | - Tamara L Wall
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
| | - John B Whitfield
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Hongyu Zhao
- Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Benjamin M Neale
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Joel Gelernter
- Departments of Psychiatry, Genetics, and Neuroscience, Yale University School of Medicine, Veterans Affairs Connecticut Healthcare System, New Haven, CT, USA.
| | - Howard J Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA.
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Arpana Agrawal
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA.
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Harris SL, More K, Dixon B, Troughton R, Pemberton C, Horwood J, Ellis N, Austin N. Factors affecting N-terminal pro-B-type natriuretic peptide levels in preterm infants and use in determination of haemodynamic significance of patent ductus arteriosus. Eur J Pediatr 2018; 177:521-532. [PMID: 29352349 DOI: 10.1007/s00431-018-3089-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 01/08/2018] [Accepted: 01/09/2018] [Indexed: 12/31/2022]
Abstract
UNLABELLED This study aimed to investigate factors affecting N-terminal pro-B-type natriuretic peptide (NTproBNP) in preterm infants and the ability of NTproBNP to predict haemodynamically significant patent ductus arteriosus (HsPDA). Prospective cohort study of 51 infants < 30 weeks gestation. Blood NTproBNP and heart ultrasound were performed on day of life 3, 10, 28 and 36 weeks corrected age. NTproBNP levels analysed for prediction of HsPDA. The effect of gestational age, ventilation, hypoxia, bronchopulmonary dysplasia (BPD), creatinine and haemoglobin levels on NTproBNP levels were investigated. Infants with HsPDA had higher mean (SD) day 3 NTproBNP (1840 pmol/L (1058) versus 178 pmol/L (140) p < 0.001). Receiver operator curves of day 3 NTproBNP for prediction of day 3 and day 10 HsPDA had an area under the curve of 0.98 and 0.94, respectively. A chosen day 3 NTproBNP value of ≥ 287 pmol/L for the prediction of day 3 HsPDA correctly classified 92% (sensitivity 92%, specificity 92%). NTproBNP demonstrated only modest ability to predict severe BPD. Chronological but not gestational age affected NTproBNP. Ventilation, hypoxia and haemoglobin levels did not influence NTproBNP but creatinine level was positively correlated. CONCLUSION Day 3 NTproBNP is a useful biomarker to predict HsPDA and may be a valuable tool in future trial design. What is Known: • NTproBNP is a cardiac hormone used to diagnose and monitor cardiac dysfunction in adults and has been shown to be higher in premature infants with haemodynamically significant ductus arteriosus (HsPDA). What is new: • NTproBNP is highly predictive of ultrasound-defined HsPDA and may be a useful tool for further triage • Early NTproBNP higher in infants who develop severe BPD and with renal impairment but not affected by gestational age, recent exposure to hypoxia or haemoglobin levels while late levels unexpectedly higher in those without BPD or HsPDA.
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Affiliation(s)
| | - Kiran More
- Neonatal Unit, Christchurch Women's Hospital, Christchurch, New Zealand
| | - Bronwyn Dixon
- Neonatal Unit, Christchurch Women's Hospital, Christchurch, New Zealand
| | - Richard Troughton
- University of Otago, Christchurch, New Zealand.,Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand
| | | | | | - Nicola Ellis
- Neonatal Unit, Christchurch Women's Hospital, Christchurch, New Zealand
| | - Nicola Austin
- Neonatal Unit, Christchurch Women's Hospital, Christchurch, New Zealand
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Mulder R, Tyrer P, Horwood J. A response to 'validating the proposed ICD-11 domains'. Personal Ment Health 2017; 11:213-214. [PMID: 28544555 DOI: 10.1002/pmh.1374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 03/21/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Roger Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Peter Tyrer
- Centre for Mental Health, Imperial College, London, UK
| | - John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Foulds J, Boden J, Horwood J, Mulder R. High novelty seeking as a predictor of antisocial behaviour in early adulthood. Personal Ment Health 2017; 11:256-265. [PMID: 28836395 DOI: 10.1002/pmh.1393] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 07/13/2017] [Accepted: 07/16/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This study aimed to examine the association between novelty seeking (NS) and antisocial behaviours (age 18-35). METHOD A New Zealand general population birth cohort was studied from 1977 to 2012. Sample sizes ranged from n = 962 (age 35) to n = 1025 (age 18). NS was measured at age 16 using the Tridimensional Personality Questionnaire. Perpetration of antisocial behaviours was ascertained by self-report at ages 18, 21, 25, 30 and 35. Generalized estimating equation models investigated the association between NS and antisocial behaviours net of individual factors and correlates of NS before age 16 and alcohol and substance use disorders at age 18-35. RESULTS Higher NS scores were associated with a higher unadjusted incidence of all forms of antisocial behaviour. Assault, theft, property damage and dishonesty offending remained associated with NS after adjustment for individual factors and correlates of NS before age 16. After further adjustment for alcohol and substance use disorders, NS was not associated with any antisocial behaviour outcomes, suggesting those disorders mediate the association between NS and antisocial behaviours. CONCLUSION Alcohol and substance use disorders mediate the association between NS and antisocial behaviours in early adulthood. NS may be a useful endophenotype for investigating the causation of externalizing behaviours. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
| | | | - John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Roger Mulder
- Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, University of Otago, PO Box 4345, Christchurch, New Zealand
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Cornish J, Harries RL, Bosanquet D, Rees B, Ansell J, Frewer N, Dhruva Rao PK, Parry C, Ellis-Owen R, Phillips SM, Morris C, Horwood J, Davies ML, Davies MM, Hargest R, Davies Z, Hilton J, Harris D, Ben-Sassi A, Rajagopal R, Hanratty D, Islam S, Watkins A, Bashir N, Jones S, Russell IR, Torkington J. Hughes Abdominal Repair Trial (HART) - Abdominal wall closure techniques to reduce the incidence of incisional hernias: study protocol for a randomised controlled trial. Trials 2016; 17:454. [PMID: 27634489 PMCID: PMC5025615 DOI: 10.1186/s13063-016-1573-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 08/14/2016] [Indexed: 01/05/2023] Open
Abstract
Background Incisional hernias are common complications of midline closure following abdominal surgery and cause significant morbidity, impaired quality of life and increased health care costs. The ‘Hughes Repair’ combines a standard mass closure with a series of horizontal and two vertical mattress sutures within a single suture. This theoretically distributes the load along the incision length as well as across it. There is evidence to suggest that this technique is as effective as mesh repair for the operative management of incisional hernias; however, no trials have compared the Hughes Repair with standard mass closure for the prevention of incisional hernia formation following a midline incision. Methods/design This is a 1:1 randomised controlled trial comparing two suture techniques for the closure of the midline abdominal wound following surgery for colorectal cancer. Full ethical approval has been gained (Wales REC 3, MREC 12/WA/0374). Eight hundred patients will be randomised from approximately 20 general surgical units within the United Kingdom. Patients undergoing open or laparoscopic (more than a 5-cm midline incision) surgery for colorectal cancer, elective or emergency, are eligible. Patients under the age of 18 years, those having mesh inserted or undergoing musculofascial flap closure of the perineal defect in abdominoperineal wound closure, and those unable to give informed consent will be excluded. Patients will be randomised intraoperatively to either the Hughes Repair or standard mass closure. The primary outcome measure is the incidence of incisional hernias at 1 year as assessed by standardised clinical examination. The secondary outcomes include quality of life patient-reported outcome measures, cost-utility analysis, incidence of complete abdominal wound dehiscence and C-POSSUM scores. The incidence of incisional hernia at 1 year, assessed by computerised tomography, will form a tertiary outcome. Discussion A feasibility phase has been completed. The results of the study will be used to inform current and future practice and potentially reduce the risk of incisional hernia formation following midline incisions. Trial registration Trial Registration Number: ISRCTN 25616490. Registered on 1 January 2012. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1573-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- J Cornish
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - R L Harries
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - D Bosanquet
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - B Rees
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - J Ansell
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - N Frewer
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - P K Dhruva Rao
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - C Parry
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - R Ellis-Owen
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - S M Phillips
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - C Morris
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - J Horwood
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - M L Davies
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - M M Davies
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - R Hargest
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - Z Davies
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - J Hilton
- Princess of Wales Hospital, Bridgend, UK
| | | | | | | | - D Hanratty
- Royal Glamorgan Hospital, Llantrisant, UK
| | - S Islam
- Swansea Clinical Trials Unit, Swansea University, Swansea, UK
| | - A Watkins
- Swansea Clinical Trials Unit, Swansea University, Swansea, UK
| | - N Bashir
- Swansea Clinical Trials Unit, Swansea University, Swansea, UK
| | - S Jones
- Involving People, Health and Care Research Wales, Cardiff, UK
| | - I R Russell
- Swansea Clinical Trials Unit, Swansea University, Swansea, UK
| | - J Torkington
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK.
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Riley R, Coghill N, Montgomery A, Feder G, Horwood J. Experiences of patients and healthcare professionals of NHS cardiovascular health checks: a qualitative study. J Public Health (Oxf) 2016; 38:543-551. [PMID: 26408822 PMCID: PMC5072162 DOI: 10.1093/pubmed/fdv121] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND NHS Health Checks are a national cardiovascular risk assessment and management programme in England and Wales. We examined the experiences of patients attending and healthcare professionals (HCPs) conducting NHS Health Checks. METHODS Interviews were conducted with a purposive sample of 28 patients and 16 HCPs recruited from eight general practices across a range of socio-economic localities. Interviews were audio recorded, transcribed, anonymized and analysed thematically. RESULTS Patients were motivated to attend an NHS Health Check because of health beliefs, the perceived value of the programme, a family history of cardiovascular and other diseases and expectations of receiving a general health assessment. Some patients reported benefits including reassurance and reinforcement of healthy lifestyles. Others experienced confusion and frustration about how results and advice were communicated, some having a poor understanding of the implications of their results. HCPs raised concerns about the skill set of some staff to competently communicate risk and lifestyle information. CONCLUSIONS To improve the satisfaction of patients attending and improve facilitation of lifestyle change, HCPs conducting the NHS Health Checks require sufficient training to equip them with appropriate skills and knowledge to deliver the service effectively.
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Affiliation(s)
- R. Riley
- School of Social and Community Medicine, University of Bristol, BristolBS8 2PS, UK
| | - N. Coghill
- School of Social and Community Medicine, University of Bristol, BristolBS8 2PS, UK
| | - A. Montgomery
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham NG7 2UH, UK
| | - G. Feder
- School of Social and Community Medicine, University of Bristol, BristolBS8 2PS, UK
| | - J. Horwood
- School of Social and Community Medicine, University of Bristol, BristolBS8 2PS, UK
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Harris SL, Austin NC, Battin M, Broadbent R, Horwood J, Keenan R, Wells S, Spencer C, Graham P, Woodward LJ, Darlow BA. In-hospital morbidity and brain metrics of preterm neonates born 1998-2009. N Z Med J 2016; 129:94-107. [PMID: 27538043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIMS To describe the survival, in-hospital morbidity, brain metrics and two-year neurodevelopmental outcomes of two extremely preterm cohorts and discuss the contribution of changes in clinical practice to these outcomes. METHODS Retrospective comparative cohort study, of two cohorts of neonates born <28 weeks gestation: 47 infants born 1998-2000 and 39 infants 2006-2009. RESULTS Comparing historical to the contemporary cohort respectively, admission temperature (35.9 degrees C, 36.5) and CRIB (Clinical Risk Index in Babies) score (5.4, 3.1) improved. Inotrope support fell significantly (55.3%, 28.2%). High frequency ventilation days fell (8.0, 2.7). CPAP days increased significantly (32.2, 47.9). Chronic lung disease at 36 weeks corrected age fell significantly (61.7%, 38.5%). Red cell transfusions decreased in number (7.1, 4.8) and volume (96.2ml/kg, 70.4ml/kg). Retinopathy of prematurity (ROP) rates dropped significantly (66.0%, 28.2%). Survival was not significantly different. Nutritional improvements included shorter days to first enteral feed (3.4, 2.0), target protein (5.4, 4.3) and lipid levels (7.1, 4.1) with better breastfeeding rates at discharge (19.2%, 38.5%). By 36 weeks z scores for weight (-0.90, -0.39) were improved but not length (-1.94, -1.26) or head circumference (-0.72, -0.69). MRI brain metrics showed a significant improvement in bifrontal (59.2, 65.9), biparietal (73.7, 79.3) and transcerebellar diameter (50.6, 52.6) with improved neurodevelopmental outcome at two years. CONCLUSION The contemporary cohort had better initial physiological stability, less chronic lung disease and retinopathy, improved body growth at 36 weeks and brain metrics at term equivalent. Improvement in neurodevelopment at two years has been seen and further analysis will be important to understand the impact of the changes in clinical care.
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Affiliation(s)
- Sarah L Harris
- Neonatologist, Neonatal Service, Christchurch Women's Hospital, Department of Pediatrics, University of Otago, Christchurch
| | - Nicola C Austin
- Neonatologist, Associate Professor, Neonatal Service, Christchurch Women's Hospital, Department of Pediatrics, University of Otago, Christchurch
| | - Malcolm Battin
- Neonatologist, Newborn Services, Auckland City Hospital, Auckland
| | | | - John Horwood
- Statistician, Associate Professor, Department of Psychological Medicine, University of Otago, Christchurch
| | - Ross Keenan
- Neuroradiologist, Canterbury Radiology Group, Christchurch
| | - Scott Wells
- Neuroradiologist, Canterbury Radiology Group, Christchurch
| | - Carole Spencer
- Research Nurse, Neonatal Service, Christchurch Women's Hospital, Christchurch
| | - Patricia Graham
- Research Nurse, Neonatal Service, Christchurch Women's Hospital, Department of Pediatrics, University of Otago, Christchurch
| | - Lianne J Woodward
- Professor of Pediatrics and Psychology, Department of Pediatric Newborn Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, US
| | - Brian A Darlow
- Neonatologist, Professor, Neonatal Service, Christchurch Women's Hospital, Department of Pediatrics, University of Otago, Christchurch
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Abstract
AIM The ICD-11 Personality Disorders Committee has proposed five personality domains: Detached, Anankastic, Negative Affective, Dissocial and Disinhibited. We attempted to validate these proposed domains in a large sample of patients with major depression. METHODS Participants from five treatment studies received a SCID assessment interview to assess DSM-5 personality disorder symptoms. Personality disorder symptoms were assigned to the five proposed domains. Confirmatory factor analysis in an exploratory framework was used to test the hypothesized domain structure. RESULTS A total of 606 patients were included in the analysis. A series of models were tested on the data set. The best fitting model produced five domains. Three domains detached, anankastic and negative affective were similar to the ICD-11 proposed domains. The Disinhibited domain did not emerge as a distinct factor but loaded onto a single Dissocial/Disinhibited factor. The model was improved by adding a separate Antisocial domain. The remaining domain incorporating borderline, histrionic and narcissistic symptoms is tentatively labelled Borderline to retain continuity with clinical practice and research. CONCLUSIONS The proposed ICD-11 personality disorder domains were partially validated. We have five domains currently labelled Detached, Anankastic, Negative Emotional, Antisocial and Borderline. The sample studied limits the generalizability of our findings. In particular, the broad domain we have called Borderline requires further study. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Roger T Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Peter Tyrer
- Centre for Mental Health, Imperial College, London, UK
| | - Janet Carter
- Psychology Department, University of Canterbury, Christchurch, New Zealand
| | - Peter R Joyce
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Palmer S, Terry R, Rimes K, Clark C, Simmonds J, Horwood J. Physiotherapy management of joint hypermobility syndrome – a focus group study of patient and health professional perspectives. Physiotherapy 2016; 102:93-102. [DOI: 10.1016/j.physio.2015.05.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 05/21/2015] [Indexed: 11/26/2022]
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Bailey K, Abrams P, Blair PS, Chapple C, Glazener C, Horwood J, Lane JA, McGrath J, Noble S, Pickard R, Taylor G, Young GJ, Drake MJ, Lewis AL. Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM) for diagnosis and management of bladder outlet obstruction in men: study protocol for a randomised controlled trial. Trials 2015; 16:567. [PMID: 26651344 PMCID: PMC4676182 DOI: 10.1186/s13063-015-1087-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 11/26/2015] [Indexed: 11/17/2022] Open
Abstract
Background Lower urinary tract symptoms (LUTS) comprise storage symptoms, voiding symptoms and post-voiding symptoms. Prevalence and severity of LUTS increase with age and the progressive increase in the aged population group has emphasised the importance to our society of appropriate and effective management of male LUTS. Identification of causal mechanisms is needed to optimise treatment and uroflowmetry is the simplest non-invasive test of voiding function. Invasive urodynamics can evaluate storage function and voiding function; however, there is currently insufficient evidence to support urodynamics becoming part of routine practice in the clinical evaluation of male LUTS. Design A 2-arm trial, set in urology departments of at least 26 National Health Service (NHS) hospitals in the United Kingdom (UK), randomising men with bothersome LUTS for whom surgeons would consider offering surgery, between a care pathway based on urodynamic tests with invasive multichannel cystometry and a care pathway based on non-invasive routine tests. The aim of the trial is to determine whether a care pathway not including invasive urodynamics is no worse for men in terms of symptom outcome than one in which it is included, at 18 months after randomisation. This primary clinical outcome will be measured with the International Prostate Symptom Score (IPSS). We will also establish whether inclusion of invasive urodynamics reduces rates of bladder outlet surgery as a main secondary outcome. Discussion The general population has an increased life-expectancy and, as men get older, their prostates enlarge and potentially cause benign prostatic obstruction (BPO) which often requires surgery. Furthermore, voiding symptoms become increasingly prevalent, some of which may not be due to BPO. Therefore, as the population ages, more operations will be considered to relieve BPO, some of which may not actually be appropriate. Hence, there is sustained interest in the diagnostic pathway and this trial could improve the chances of an accurate diagnosis and reduce overall numbers of surgical interventions for BPO in the NHS. The morbidity, and therapy costs, of testing must be weighed against the cost saving of surgery reduction. Trial registration Controlled-trials.com - ISRCTN56164274 (confirmed registration: 8 April 2014). Electronic supplementary material The online version of this article (doi:10.1186/s13063-015-1087-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- K Bailey
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. .,Bristol Randomised Trials Collaboration (BRTC), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - P Abrams
- North Bristol NHS Trust, Bristol Urological Institute, Level 3, Learning and Research Building, Southmead Hospital, Bristol, BS10 5N, UK.
| | - P S Blair
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. .,Bristol Randomised Trials Collaboration (BRTC), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. .,Bristol Randomised Trials Collaboration, University of Bristol, St. Michael's Hospital, Level D, Southwell Street, Bristol, UK.
| | - C Chapple
- Sheffield Teaching Hospitals NHS Trust, Room H26, H-Floor, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK.
| | - C Glazener
- Health Services Research Unit, University of Aberdeen, 3rd Floor, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, Scotland.
| | - J Horwood
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. .,Bristol Randomised Trials Collaboration (BRTC), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - J A Lane
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. .,Bristol Randomised Trials Collaboration (BRTC), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - J McGrath
- Exeter Surgical Health Services Research Unit - Urology, Royal Devon and Exeter Hospital, Barrack Road, Exeter, Devon, EX2 5DW, UK.
| | - S Noble
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. .,Bristol Randomised Trials Collaboration (BRTC), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - R Pickard
- Institute of Cellular Medicine, University of Newcastle, 3rd Floor, William Leech Building, Newcastle upon Tyne, NE2 4HH, UK.
| | - G Taylor
- University of Plymouth, Plymouth, Devon, PL4 8AA, UK.
| | - G J Young
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. .,Bristol Randomised Trials Collaboration (BRTC), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - M J Drake
- North Bristol NHS Trust, Bristol Urological Institute, Level 3, Learning and Research Building, Southmead Hospital, Bristol, BS10 5N, UK. .,School of Clinical Sciences, University of Bristol, 69 St Michael's Hill, BS2 8DZ, Bristol, UK.
| | - A L Lewis
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. .,Bristol Randomised Trials Collaboration (BRTC), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
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Morris RW, Taylor AE, Fluharty ME, Bjørngaard JH, Åsvold BO, Elvestad Gabrielsen M, Campbell A, Marioni R, Kumari M, Korhonen T, Männistö S, Marques-Vidal P, Kaakinen M, Cavadino A, Postmus I, Husemoen LLN, Skaaby T, Ahluwalia TVS, Treur JL, Willemsen G, Dale C, Wannamethee SG, Lahti J, Palotie A, Räikkönen K, McConnachie A, Padmanabhan S, Wong A, Dalgård C, Paternoster L, Ben-Shlomo Y, Tyrrell J, Horwood J, Fergusson DM, Kennedy MA, Nohr EA, Christiansen L, Kyvik KO, Kuh D, Watt G, Eriksson JG, Whincup PH, Vink JM, Boomsma DI, Davey Smith G, Lawlor D, Linneberg A, Ford I, Jukema JW, Power C, Hyppönen E, Jarvelin MR, Preisig M, Borodulin K, Kaprio J, Kivimaki M, Smith BH, Hayward C, Romundstad PR, Sørensen TIA, Munafò MR, Sattar N. Heavier smoking may lead to a relative increase in waist circumference: evidence for a causal relationship from a Mendelian randomisation meta-analysis. The CARTA consortium. BMJ Open 2015; 5:e008808. [PMID: 26264275 PMCID: PMC4538266 DOI: 10.1136/bmjopen-2015-008808] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To investigate, using a Mendelian randomisation approach, whether heavier smoking is associated with a range of regional adiposity phenotypes, in particular those related to abdominal adiposity. DESIGN Mendelian randomisation meta-analyses using a genetic variant (rs16969968/rs1051730 in the CHRNA5-CHRNA3-CHRNB4 gene region) as a proxy for smoking heaviness, of the associations of smoking heaviness with a range of adiposity phenotypes. PARTICIPANTS 148,731 current, former and never-smokers of European ancestry aged ≥ 16 years from 29 studies in the consortium for Causal Analysis Research in Tobacco and Alcohol (CARTA). PRIMARY OUTCOME MEASURES Waist and hip circumferences, and waist-hip ratio. RESULTS The data included up to 66,809 never-smokers, 43,009 former smokers and 38,913 current daily cigarette smokers. Among current smokers, for each extra minor allele, the geometric mean was lower for waist circumference by -0.40% (95% CI -0.57% to -0.22%), with effects on hip circumference, waist-hip ratio and body mass index (BMI) being -0.31% (95% CI -0.42% to -0.19), -0.08% (-0.19% to 0.03%) and -0.74% (-0.96% to -0.51%), respectively. In contrast, among never-smokers, these effects were higher by 0.23% (0.09% to 0.36%), 0.17% (0.08% to 0.26%), 0.07% (-0.01% to 0.15%) and 0.35% (0.18% to 0.52%), respectively. When adjusting the three central adiposity measures for BMI, the effects among current smokers changed direction and were higher by 0.14% (0.05% to 0.22%) for waist circumference, 0.02% (-0.05% to 0.08%) for hip circumference and 0.10% (0.02% to 0.19%) for waist-hip ratio, for each extra minor allele. CONCLUSIONS For a given BMI, a gene variant associated with increased cigarette consumption was associated with increased waist circumference. Smoking in an effort to control weight may lead to accumulation of central adiposity.
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Affiliation(s)
- Richard W Morris
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- Department of Primary Care and Population Health, UCL, London, UK
| | - Amy E Taylor
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies and School of Experimental Psychology, University of Bristol, Bristol, UK
| | - Meg E Fluharty
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies and School of Experimental Psychology, University of Bristol, Bristol, UK
| | - Johan H Bjørngaard
- Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Forensic Department, Research Centre Bröset, St Olav's University Hospital Trondheim, Trondheim, Norway
| | - Bjørn Olav Åsvold
- Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Maiken Elvestad Gabrielsen
- Department of Laboratory Medicine, Children's and Women's Health, The Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Archie Campbell
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Riccardo Marioni
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Meena Kumari
- Institute for Social and Economic Research, University of Essex, Colchester, UK
| | - Tellervo Korhonen
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- National Institute for Health and Welfare, Helsinki, Finland
| | - Satu Männistö
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
| | - Pedro Marques-Vidal
- Department of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Marika Kaakinen
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Alana Cavadino
- Centre for Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Population, Policy and Practice, UCL Institute of Child Health, University College London, UK
| | - Iris Postmus
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
- Netherlands Consortium of Healthy Ageing, Leiden, The Netherlands
| | | | - Tea Skaaby
- Research Centre for Prevention and Health, the Capital Region of Denmark, Denmark
| | - Tarun Veer Singh Ahluwalia
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Steno Diabetes Center, Gentofte, Denmark
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jorien L Treur
- Department of Biological Psychology, Netherlands Twin Register, VU University, Amsterdam, The Netherlands
| | - Gonneke Willemsen
- Department of Biological Psychology, Netherlands Twin Register, VU University, Amsterdam, The Netherlands
| | - Caroline Dale
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Jari Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
| | - Aarno Palotie
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, UK
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Finland
- The Medical and Population Genomics Program, The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Katri Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Alex McConnachie
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - Sandosh Padmanabhan
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Christine Dalgård
- Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lavinia Paternoster
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, University of Bristol, Bristol, UK
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Jessica Tyrrell
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, UK
| | - John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - David M Fergusson
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Martin A Kennedy
- Department of Pathology, University of Otago, Christchurch, New Zealand
| | - Ellen A Nohr
- Institute for Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lene Christiansen
- Department of Epidemiology, Biostatistics and Biodemography, Institute of Public Health, University of Southern Denmark, Denmark
| | - Kirsten Ohm Kyvik
- Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | | | - Johan G Eriksson
- National Institute for Health and Welfare, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland
- Vasa Central Hospital, Vasa, Finland
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, London, UK
| | - Jacqueline M Vink
- Department of Biological Psychology, Netherlands Twin Register, VU University, Amsterdam, The Netherlands
| | - Dorret I Boomsma
- Department of Biological Psychology, Netherlands Twin Register, VU University, Amsterdam, The Netherlands
| | - George Davey Smith
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, University of Bristol, Bristol, UK
| | - Debbie Lawlor
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, University of Bristol, Bristol, UK
| | - Allan Linneberg
- Research Centre for Prevention and Health, the Capital Region of Denmark, Denmark
- Department of Clinical Experimental Research, Glostrup University Hospital, Glostrup, Denmark.
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ian Ford
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Durrer Center for Cardiogenetic Research, Amsterdam, The Netherlands
- Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Chris Power
- Population, Policy and Practice, UCL Institute of Child Health, University College London, UK
| | - Elina Hyppönen
- Population, Policy and Practice, UCL Institute of Child Health, University College London, UK
- Centre for Population Health Research, School of Health Sciences and Sansom Institute of Health Research, University of South Australia, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Marjo-Riitta Jarvelin
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
- Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Katja Borodulin
- National Institute for Health and Welfare, Helsinki, Finland
| | - Jaakko Kaprio
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Blair H Smith
- Division of Population Health Sciences, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Caroline Hayward
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Pål R Romundstad
- Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Thorkild I A Sørensen
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, University of Bristol, Bristol, UK
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Institute of Preventive Medicine, Bispebjerg and Frederikberg Hospitals, The Capital Region, Copenhagen, Denmark
| | - Marcus R Munafò
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies and School of Experimental Psychology, University of Bristol, Bristol, UK
| | - Naveed Sattar
- Faculty of Medicine, BHF Glasgow Cardiovascular Research Centre, Glasgow, UK
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Palmer S, Terry R, Rimes K, Clark C, Simmonds J, Horwood J. Physiotherapy management of joint hypermobility syndrome—patient and therapist perspectives. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.2086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
OBJECTIVE Personality has been associated with a variety of outcomes in adulthood. Most of the literature related to mental state disorder and personality is cross sectional. METHODS Data from more than 900 participants of the Christchurch Health and Development Study (CHDS) were examined. Extroversion and neuroticism were measured at 14 years old and social outcomes at age 30. The presence of mental state disorder between 18-30 years old was identified. Multiple potential confounders in childhood were included in the analysis. RESULTS Neuroticism at fourteen was significantly correlated with multiple environmental exposures whereas extroversion had relatively few associations. Regression analysis found that neuroticism at 14 predicted depression, anxiety, suicidality and overall mental health problems at 30 as well as poor self-esteem but not relationship quality or wellbeing. Extroversion at 14 predicted alcohol and drug dependence and overall mental health problems, but also predicted improved social wellbeing, self-esteem and relationship quality at 30. CONCLUSIONS In this analysis extroversion interacts with significantly fewer environmental factors than neuroticism in predicting adult outcomes. Neuroticism at 14 years predicts poorer mental health outcomes in adulthood. Extroversion in childhood may be a protective factor in the development of mental disorder other than alcohol use disorders. Extroverted adolescents have more positive social outcomes at 30 years.
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Affiliation(s)
- Giles Newton-Howes
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand Department of Psychological Medicine, Imperial College, London, UK
| | - John Horwood
- Christchurch Health and Development Study, University of Otago, Christchurch, New Zealand
| | - Roger Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Taylor AE, Morris RW, Fluharty ME, Bjorngaard JH, Åsvold BO, Gabrielsen ME, Campbell A, Marioni R, Kumari M, Hällfors J, Männistö S, Marques-Vidal P, Kaakinen M, Cavadino A, Postmus I, Husemoen LLN, Skaaby T, Ahluwalia TS, Treur JL, Willemsen G, Dale C, Wannamethee SG, Lahti J, Palotie A, Räikkönen K, Kisialiou A, McConnachie A, Padmanabhan S, Wong A, Dalgård C, Paternoster L, Ben-Shlomo Y, Tyrrell J, Horwood J, Fergusson DM, Kennedy MA, Frayling T, Nohr EA, Christiansen L, Ohm Kyvik K, Kuh D, Watt G, Eriksson J, Whincup PH, Vink JM, Boomsma DI, Davey Smith G, Lawlor D, Linneberg A, Ford I, Jukema JW, Power C, Hyppönen E, Jarvelin MR, Preisig M, Borodulin K, Kaprio J, Kivimaki M, Smith BH, Hayward C, Romundstad PR, Sørensen TIA, Munafò MR, Sattar N. Stratification by smoking status reveals an association of CHRNA5-A3-B4 genotype with body mass index in never smokers. PLoS Genet 2014; 10:e1004799. [PMID: 25474695 PMCID: PMC4256159 DOI: 10.1371/journal.pgen.1004799] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 10/02/2014] [Indexed: 11/23/2022] Open
Abstract
We previously used a single nucleotide polymorphism (SNP) in the CHRNA5-A3-B4 gene cluster associated with heaviness of smoking within smokers to confirm the causal effect of smoking in reducing body mass index (BMI) in a Mendelian randomisation analysis. While seeking to extend these findings in a larger sample we found that this SNP is associated with 0.74% lower body mass index (BMI) per minor allele in current smokers (95% CI -0.97 to -0.51, P = 2.00×10−10), but also unexpectedly found that it was associated with 0.35% higher BMI in never smokers (95% CI +0.18 to +0.52, P = 6.38×10−5). An interaction test confirmed that these estimates differed from each other (P = 4.95×10−13). This difference in effects suggests the variant influences BMI both via pathways unrelated to smoking, and via the weight-reducing effects of smoking. It would therefore be essentially undetectable in an unstratified genome-wide association study of BMI, given the opposite association with BMI in never and current smokers. This demonstrates that novel associations may be obscured by hidden population sub-structure. Stratification on well-characterized environmental factors known to impact on health outcomes may therefore reveal novel genetic associations. We found that a single nucleotide polymorphism in the CHRNA5-A3-B4 gene cluster, which is known to influence smoking heaviness, is associated with lower body mass index (BMI) in current smokers, but higher BMI in never smokers. This difference in effects suggests that the variant influences BMI both via pathways other than smoking, and via the weight-reducing effects of smoking, in opposite directions. The overall effect on BMI would therefore be undetectable in an unstratified genome-wide association study, indicating that novel associations may be obscured by hidden population sub-structure.
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Affiliation(s)
- Amy E. Taylor
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
- UK Centre for Tobacco and Alcohol Research Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
| | - Richard W. Morris
- Department of Primary Care and Population Health, UCL, London, United Kingdom
| | - Meg E. Fluharty
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
- UK Centre for Tobacco and Alcohol Research Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
| | - Johan H. Bjorngaard
- Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bjørn Olav Åsvold
- Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Maiken E. Gabrielsen
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Archie Campbell
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Riccardo Marioni
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
- Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Meena Kumari
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
- Institute for Social and Economic Research, University of Essex, Colchester, United Kingdom
| | - Jenni Hällfors
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
| | - Satu Männistö
- National Institute for Health and Welfare, Helsinki, Finland
| | - Pedro Marques-Vidal
- Department of Internal Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Marika Kaakinen
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Alana Cavadino
- Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, United Kingdom
| | - Iris Postmus
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
- Netherlands Consortium of Healthy Ageing, Leiden, The Netherlands
| | | | - Tea Skaaby
- Research Centre for Prevention and Health, The Capital Region, Copenhagen, Denmark
| | - Tarunveer S. Ahluwalia
- Novo Nordisk Foundation Centre for Basic Metabolic Research, Metabolic Genetics Section, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Denmark
| | - Jorien L. Treur
- Netherlands Twin Register, Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - Gonneke Willemsen
- Netherlands Twin Register, Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - Caroline Dale
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - S. Goya Wannamethee
- Department of Primary Care and Population Health, UCL, London, United Kingdom
| | - Jari Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
| | - Aarno Palotie
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, United Kingdom
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- The Medical and Population Genomics Program, The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Katri Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Aliaksei Kisialiou
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom
| | - Alex McConnachie
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom
| | - Sandosh Padmanabhan
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Christine Dalgård
- Institute of Public Health, Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Lavinia Paternoster
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Jessica Tyrrell
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, United Kingdom
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, United Kingdom
| | - John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - David M. Fergusson
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Martin A. Kennedy
- Department of Pathology, University of Otago, Christchurch, New Zealand
| | - Tim Frayling
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, United Kingdom
| | - Ellen A. Nohr
- Institute for Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lene Christiansen
- Institute of Public Health, Dept. of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Denmark
| | - Kirsten Ohm Kyvik
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Graham Watt
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Johan Eriksson
- National Institute for Health and Welfare, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Helsinki University Central Hospital, Unit of General Practice, Helsinki, Finland
- Vasa Central Hospital, Vasa, Finland
| | - Peter H. Whincup
- Population Health Research Institute, St George's University of London, London, United Kingdom
| | - Jacqueline M. Vink
- Netherlands Twin Register, Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - Dorret I. Boomsma
- Netherlands Twin Register, Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - George Davey Smith
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
- Institute of Public Health, Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Debbie Lawlor
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
- Institute of Public Health, Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Allan Linneberg
- Research Centre for Prevention and Health, The Capital Region, Copenhagen, Denmark
- Department of Clinical Experimental Research, Glostrup University Hospital, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Ian Ford
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom
| | - J. Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Durrer Center for Cardiogenetic Research, Amsterdam, The Netherlands
- Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Christine Power
- Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, United Kingdom
| | - Elina Hyppönen
- Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, United Kingdom
- School of Population Health and Sansom Institute, University of South Australia, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Marjo-Riitta Jarvelin
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
- Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Katja Borodulin
- National Institute for Health and Welfare, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Blair H. Smith
- University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Caroline Hayward
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Pål R. Romundstad
- Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Thorkild I. A. Sørensen
- Novo Nordisk Foundation Centre for Basic Metabolic Research, Metabolic Genetics Section, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Institute of Preventive Medicine, Bispebrjerg and Frederikberg Hospitals, The Capital Region, Copenhagen, Denmark
| | - Marcus R. Munafò
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
- UK Centre for Tobacco and Alcohol Research Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
- * E-mail:
| | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre, Faculty of Medicine, University of Glasgow, Glasgow, United Kingdom
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Jeyadoss J, Lea R, Horwood J. A logistic challenge - use of electromyographic endotracheal tube in an extremely narrowed airway. Acta Anaesthesiol Scand 2013; 57:1083-4. [PMID: 23808918 DOI: 10.1111/aas.12145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gaysina D, Fergusson DM, Leve LD, Horwood J, Reiss D, Shaw DS, Elam KK, Natsuaki MN, Neiderhiser JM, Harold GT. Maternal smoking during pregnancy and offspring conduct problems: evidence from 3 independent genetically sensitive research designs. JAMA Psychiatry 2013; 70:956-63. [PMID: 23884431 PMCID: PMC3828999 DOI: 10.1001/jamapsychiatry.2013.127] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Several studies report an association between maternal smoking during pregnancy and offspring conduct disorder. However, past research evidences difficulty in disaggregating prenatal environmental influences from genetic and postnatal environmental influences. OBJECTIVE To examine the relationship between maternal smoking during pregnancy and offspring conduct problems among children reared by genetically related mothers and genetically unrelated mothers. DESIGN, SETTING, AND PARTICIPANTS The following 3 studies using distinct but complementary research designs were used: The Christchurch Health and Development Study (a longitudinal cohort study that includes biological and adopted children), the Early Growth and Development Study (a longitudinal adoption-at-birth study), and the Cardiff IVF (In Vitro Fertilization) Study (an adoption-at-conception study among genetically related families and genetically unrelated families). Maternal smoking during pregnancy was measured as the mean number of cigarettes per day (0, 1-9, or 10) smoked during pregnancy. Possible covariates were controlled for in the analyses, including child sex, birth weight, race/ethnicity, placement age, and breastfeeding, as well as maternal education and maternal age at birth and family breakdown, parenting practices, and family socioeconomic status. MAIN OUTCOMES AND MEASURE Offspring conduct problems (age range, 4-10 years) reported by parents or teachers using the behavior rating scales by Rutter and Conners, the Child Behavior Checklist and the Children's Behavior Questionnaire Short Form, and the Strengths and Difficulties Questionnaire. RESULTS A significant association between maternal smoking during pregnancy and offspring conduct problems was observed among children reared by genetically related mothers and genetically unrelated mothers. Results from a meta-analysis affirmed this pattern of findings across pooled study samples. CONCLUSIONS AND RELEVANCE Findings across 3 studies using a complement of genetically sensitive research designs suggest that smoking during pregnancy is a prenatal risk factor for offspring conduct problems when controlling for specific perinatal and postnatal confounding factors.
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Affiliation(s)
| | | | | | - John Horwood
- Christchurch Health & Development Study, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
| | - David Reiss
- Yale Child Study Center, New Haven, CT, USA.
| | - Daniel S. Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Kit K. Elam
- School of Psychology, College of Medicine, Biological Sciences and Psychology, University of Leicester, UK.
| | | | | | - Gordon T. Harold
- Address for correspondence/reprint requests: Prof. Gordon T Harold, School of Psychology, College of Medicine, Biological Sciences and Psychology, University of Leicester, Lancaster Road, Leicester LE19HN, UK,
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Copeland WE, Adair CE, Smetanin P, Stiff D, Briante C, Colman I, Fergusson D, Horwood J, Poulton R, Costello EJ, Angold A. Diagnostic transitions from childhood to adolescence to early adulthood. J Child Psychol Psychiatry 2013; 54:791-9. [PMID: 23451804 PMCID: PMC3674149 DOI: 10.1111/jcpp.12062] [Citation(s) in RCA: 162] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Quantifying diagnostic transitions across development is needed to estimate the long-term burden of mental illness. This study estimated patterns of diagnostic transitions from childhood to adolescence and from adolescence to early adulthood. METHODS Patterns of diagnostic transitions were estimated using data from three prospective, longitudinal studies involving close to 20,000 observations of 3,722 participants followed across multiple developmental periods covering ages 9-30. Common DSM psychiatric disorders were assessed in childhood (ages 9-12; two samples), adolescence (ages 13-18; three samples), and early adulthood (ages 19 to age 32; three samples) with structured psychiatric interviews and questionnaires. RESULTS Having a disorder at an early period was associated with at least a threefold increase in odds for having a disorder at a later period. Homotypic and heterotypic transitions were observed for every disorder category. The strongest evidence of continuity was seen for behavioral disorders (particularly ADHD) with less evidence for emotional disorders such as depression and anxiety. Limited evidence was found in adjusted models for behavioral disorders predicting later emotional disorders. Adult substance disorders were preceded by behavioral disorders, but not anxiety or depression. CONCLUSIONS Having a disorder in childhood or adolescence is a potent risk factor for a range of psychiatric problems later in development. These findings provide further support for prevention and early life intervention efforts and suggest that treatment at younger ages, while justified in its own right, may also have potential to reduce the risk for disorders later in development.
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Affiliation(s)
| | - Carol E. Adair
- Mental Health Commission of Canada,University of Calgary
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Abstract
OBJECTIVE This study aims to determine whether symptoms of post-traumatic stress disorder (PTSD) form a latent dimension reflecting responsivity to life events and whether PTSD symptoms are specific to traumatic life events. METHOD A 30-year longitudinal study of a general population sample of 987 individuals were assessed for PTSD symptoms, exposure to adverse life events, and a variety of psychosocial measures. PTSD symptoms were tested using a confirmatory factor model and a range of fitted models were used to identify significant predictors of latent PTSD symptoms. RESULTS The rate of DSM IV PTSD was 1.9%. However, subjects reported high rates of at least one significant traumatic or negative life event and PTSD symptoms. The PTSD symptoms conformed well to a single latent factor. There were strong linear associations between severity of PTSD symptoms and exposure to traumatic and non-traumatic life events. Factors contributing to latent PTSD symptoms were gender, childhood anxiety, neuroticism, self-esteem, and quality of parental care. CONCLUSION Criteria for PTSD form an underlying dimension reflecting the individual's level of responsivity to traumatic and non-traumatic stressful life events. PTSD symptoms form a continuum of severity with minor stress symptoms at one end and severe PTSD at the other.
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Affiliation(s)
- Roger Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
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Horwood J, Hanratty D, Chandran P, Billings P. Primary closure or rhomboid excision and Limberg flap for the management of primary sacrococcygeal pilonidal disease? A meta-analysis of randomized controlled trials. Colorectal Dis 2012; 14:143-51. [PMID: 20969718 DOI: 10.1111/j.1463-1318.2010.02473.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIM Sacrococcygeal pilonidal disease is a common condition afflicting the young male working and student population, resulting in considerable pain, embarrassment and loss of work days. Controversy surrounds the most appropriate surgical approach to achieve low recurrence rates whilst minimizing morbidity and permitting an early return to work. This study aims to review the published literature comparing excision followed by either primary suture or rhomboid flap repair. METHODS PubMed, EMBASE, MEDLINE and The Cochrane Library were systematically reviewed, by two independent investigators, for relevant randomized controlled trials. Keywords and MeSH terms included 'pilonidal disease', 'primary suture/repair', 'rhomboid flap' and 'limberg/modified Limberg flap'. 'Related study' function and manuscript bibliographies were searched for further relevant studies. Study quality was assessed using the Jadad score. Meta-analysis was performed on pooled data, utilizing a random effects model when heterogeneity was high and a fixed effects model when heterogeneity was low. The primary end-point assessed was disease recurrence. Secondary end-points included wound dehiscence, pain scores, hospital stay and return to work. RESULTS Six studies were eventually included for pooled analysis following exclusion of randomized controlled trials with poor methodology. Two studies compared 'off-midline' (Karydakis) primary suture with the Limberg flap repair. Six hundred and forty-one patients were included (331 flap repairs). Rhomboid flap excision demonstrated a trend towards less disease recurrence (P = 0.07), lower wound infection (P = 0.001) and dehiscence (P = 0.01). However, no significant difference was found for pain scores, hospital stay or return to work. CONCLUSION The current published literature supports the use of the rhomboid flap excision and the Limberg flap-repair procedures over primary midline suture techniques for the elective management of primary pilonidal disease. Further high-quality studies are necessary to compare flap with off-midline repairs.
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Affiliation(s)
- J Horwood
- Department of General Surgery, Wrexham Maelor Hospital, Wrexham, UK.
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Horwood J, Douthwaite A, Silva TD. Incisions for vascular clamps in minimal access aortic surgery. Ann R Coll Surg Engl 2011. [PMID: 21943478 DOI: 10.1308/003588411x582717i] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Horwood J, Douthwaite A, Da Silva T. Incisions for vascular clamps in minimal access aortic surgery. Ann R Coll Surg Engl 2011; 93:420. [DOI: 10.1308/rcsann.2011.93.5.420b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
INTRODUCTION Deciding to operate on high risk patients suffering catastrophic surgical emergencies can be problematic. Patients are frequently classed as American Society of Anesthesiologists (ASA) grade 5 and, as a result, aggressive but potentially lifesaving intervention is withheld. The aim of our study was to review the short-term outcomes in patients who were classed as ASA grade 5 but subsequently underwent surgery despite this and to compare the ASA scoring model to other predictors of surgical outcome. METHODS All patients undergoing emergency surgery with an ASA grade of 5 were identified. Patient demographics, indications for surgery, intraoperative findings and outcomes were recorded. In addition to the ASA scores, retrospective Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (P POSSUM) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were calculated and compared to the observed outcomes. RESULTS Nine patients (39%) survived to discharge. ASA grade was a poor predictor of outcome. P POSSUM and APACHE II scores correlated significantly with each other and with observed outcomes when predicting surgical mortality. The median stay for survivors in the intensive care unit was nine days. CONCLUSIONS In times of an ageing population, the number of patients suffering catastrophic surgical events will increase. Intervention, with little hope of a cure, a return to independent living or an acceptable quality of life, leads to unnecessary end-of-life suffering for patients and their relatives, and consumes sparse resources. The accuracy and reliability of ASA grade 5 as an outcome predictor has been questioned. P POSSUM and APACHE II scoring systems are significantly better predictors of outcome and should be used more frequently to aid surgical decision-making in high risk patients.
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Affiliation(s)
- J Horwood
- Department of General Surgery, Glan Clwyd Hospital, Rhyl, UK.
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Abstract
As an investigation into the feasibility of recording personality status from questionnaire data in younger people we used a three phase Delphi survey to assess items from the Christchurch Health and Development Study, administered at ages 12 to 16 years. Twelve experts took part in Phase I, and 22 in Phases II and III, 16 of whom were experts in adult personality disorder (PD), and 6 were experts who work with children. In total, 189 questions (55% of the total (238) in the questionnaires) were identified as possibly being related to personality abnormality in one or more clusters with high consensus. Experts who work with children were less likely to label features as related to personality than experts in PD (p < 0.001), and the four personality factors (equivalent to Mulder and Joyce's antisocial, asocial, asthenic, and anankastic) chosen for assessment showed variable agreement. Confirmatory factor analysis showed the best fitting model of the data was a 3 factor solution involving asocial/asthenic, antisocial, and anankastic factors. This represents the first attempt to use existing recorded data to code personality status and the results of this Delphi survey give some grounds for optimism that this approach has potential in the early identification of personality features.
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Affiliation(s)
- Tamara Elliott
- Centre for Mental Health, Imperial College, St. Dunstan's Road, London W6 8RP, UK
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Le Strat Y, Ramoz N, Horwood J, Falissard B, Hassler C, Romo L, Choquet M, Fergusson D, Gorwood P. First positive reactions to cannabis constitute a priority risk factor for cannabis dependence. Addiction 2009; 104:1710-7. [PMID: 19663900 DOI: 10.1111/j.1360-0443.2009.02680.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To assess the association between first reactions to cannabis and the risk of cannabis dependence. DESIGN A cross-sectional population-based assessment in 2007. SETTING A campus in a French region (Champagne-Ardennes). PARTICIPANTS A total of 1472 participants aged 18-21 years who reported at least one life-time cannabis consumption, of 3056 students who were screened initially [the Susceptibility Addiction Gene Environment (SAGE) study]. MEASUREMENTS Positive and negative effects of first cannabis consumptions, present cannabis dependence and related risk factors were assessed through questionnaires. FINDINGS The effects of first cannabis consumptions were associated dose-dependently with cannabis dependence at age 18-21 years, both according to the transversal approach of the SAGE study and to the prospective cohort of the Christchurch Health and Development Study (CHDS) assessed at the age of 25 years. Participants of the SAGE study who reported five positive effects of their first cannabis consumption had odds of life-time cannabis dependence that were 28.7 (95% confidence interval: 14.6-56.5) higher than those who reported no positive effects. This association remains significant after controlling for potentially confounding factors, including individual and familial variables. CONCLUSIONS This study suggests an association between positive reactions to first cannabis uses and risk of life-time cannabis dependence, this variable having a central role among, and through, other risk factors.
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Affiliation(s)
- Yann Le Strat
- INSERM U675-U894, Centre Psychiatrie et Neurosciences, Université Paris V, Paris, France.
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Zammit S, Odd D, Horwood J, Thompson A, Thomas K, Menezes P, Gunnell D, Hollis C, Wolke D, Lewis G, Harrison G. Investigating whether adverse prenatal and perinatal events are associated with non-clinical psychotic symptoms at age 12 years in the ALSPAC birth cohort. Psychol Med 2009; 39:1457-1467. [PMID: 19215630 DOI: 10.1017/s0033291708005126] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Non-clinical psychosis-like symptoms (PLIKS) occur in about 15% of the population. It is not clear whether adverse events during early development alter the risk of developing PLIKS. We aimed to examine whether maternal infection, diabetes or pre-eclampsia during pregnancy, gestational age, perinatal cardiopulmonary resuscitation or 5-min Apgar score were associated with development of psychotic symptoms during early adolescence. METHOD A longitudinal study of 6356 12-year-old adolescents who completed a semi-structured interview for psychotic symptoms in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Prenatal and perinatal data were obtained from obstetric records and maternal questionnaires completed during pregnancy. RESULTS The presence of definite psychotic symptoms was associated with maternal infection during pregnancy [adjusted odds ratio (OR) 1.44, 95% confidence interval (CI) 1.11-1.86, p=0.006], maternal diabetes (adjusted OR 3.43, 95% CI 1.14-10.36, p=0.029), need for resuscitation (adjusted OR 1.50, 95% CI 0.97-2.31, p=0.065) and 5-min Apgar score (adjusted OR per unit decrease 1.30, 95% CI 1.12-1.50, p<0.001). None of these associations were mediated by childhood IQ score. Most associations persisted, but were less strong, when including suspected symptoms as part of the outcome. There was no association between PLIKS and gestational age or pre-eclampsia. CONCLUSIONS Adverse events during early development may lead to an increased risk of developing PLIKS. Although the status of PLIKS in relation to clinical disorders such as schizophrenia is not clear, the similarity between these results and findings reported for schizophrenia indicates that future studies of PLIKS may help us to understand how psychotic experiences and clinical disorders develop throughout the life-course.
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Affiliation(s)
- S Zammit
- Academic Unit of Psychiatry, University of Bristol, UK.
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Affiliation(s)
- J Horwood
- Department of General Surgery, Glan Clwyd Hospital, Rhyl, Denbighshire, UK.
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Thomas K, Harrison G, Zammit S, Lewis G, Horwood J, Heron J, Hollis C, Wolke D, Thompson A, Gunnell D. Association of measures of fetal and childhood growth with non-clinical psychotic symptoms in 12-year-olds: the ALSPAC cohort. Br J Psychiatry 2009; 194:521-6. [PMID: 19478292 PMCID: PMC2802530 DOI: 10.1192/bjp.bp.108.051730] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Previous studies have suggested that impaired fetal and childhood growth are associated with an increased risk of schizophrenia, but the association of pre-adult growth with non-clinical psychotic symptoms (psychosis-like symptoms) in children is not known. AIMS To explore the associations of body size at birth and age 7.5 years with childhood psychosis-like symptoms. METHOD Prospective cohort of children followed up from birth to age 12: the ALSPAC cohort. RESULTS Data on 6000 singleton infants born after 37 weeks of gestation. A one standard deviation increase in birth weight was associated with an 18% reduction in the risk of definite psychosis-like symptoms after adjusting for age and gestation (Odds ratio (OR) = 0.82, 95% CI = 0.73-0.92, P = 0.001). This association was partly confounded by maternal anthropometry, smoking during pregnancy, socioeconomic status and IQ. A similar association was seen for birth length and psychosis-like symptoms, which disappeared after controlling for birth weight. There was little evidence for an association of 7-year height or adiposity with psychosis-like symptoms. CONCLUSIONS Measures of impaired fetal, but not childhood, growth are associated with an increased risk of psychosis-like symptoms in 12-year-olds.
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Affiliation(s)
- K Thomas
- Department of Social Medicine, University of Bristol, Bristol BS8 2PS, UK
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Affiliation(s)
- J Horwood
- Department of General Surgery, Glan Clwyd Hospital Rhyl, Denbighshire, UK
| | - A Maw
- Department of General Surgery, Glan Clwyd Hospital Rhyl, Denbighshire, UK
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