1
|
Walter LA, Prados M, Lloyd A, Sontheimer S, Heimann M, Rodgers JB, Hand DT, Franco R. Birth cohort-specific consideration in an Emergency Department Hepatitis C Testing Programme: A description of age-related characteristics and outcomes. J Viral Hepat 2024; 31:233-239. [PMID: 38366787 DOI: 10.1111/jvh.13930] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/15/2024] [Accepted: 02/10/2024] [Indexed: 02/18/2024]
Abstract
The emergency department (ED) has increasingly become an important public health partner in non-targeted hepatitis C virus (HCV) testing and referral to care efforts. HCV has traditionally been an infection associated with the Baby Boomer generation; however, recent exacerbation of the opioid epidemic has resulted in a growing number of younger cohorts, namely Millennials, also impacted by HCV. Examination of this age-related demographic shift, including subsequent linkage success and linkage barriers, from the perspective of an ED-based testing and linkage programme may have implications for future population and health systems interventions. A retrospective descriptive chart review was performed, inclusive of data from August 2015 through December 2020. We compared the quantity of positive HCV screening antibody (Ab) and confirmatory (RNA) tests and further considered linkage rates and correlative demographics (e.g. gender, race). Patient barriers to HCV care linkage (e.g. substance misuse, lack of health insurance, homelessness) were also evaluated. The data set was disaggregated by birth cohort to include Silent Generation (SG) (1928-45), Baby Boomer (BB) (1946-64), Generation X (Gen X) (1965-80), Millennial (1981-96) and Generation Z (1997-2012). Descriptive statistics and chi-square analysis were performed. Overall, 83,817 patients were tested for HCV (50.6% of eligible); 6187 (7.4%) were HCV Ab positive, and 2665 were HCV RNA positive (3.2%). RNA-positive individuals were more likely to be white (70.4%) and male (67.7%); generational distribution was similar (BB 33.3%, Gen X 32.0% and Millennials 32.7%). Amongst Ab-positive patients, white (45.5%), male (47.2%) and Millennial (49.7%) individuals were most likely to be RNA-positive. Overall, 28.1% of the RNA-positive cohort successfully linked to care; linkage to care rates were significantly higher in older generations (38.1% in BB vs. 17.8% in Millennials) (p < .00001). Over 90% were identified as having at least one linkage to care barrier. Younger generations (Gen X and Millennials) were disproportionately impacted by linkage barriers, including incarceration, lack of health insurance, history of mental health and substance use disorders, as well as history of or active injection drug use (IDU) (p < .00001). Older generations (SG and BB) were more likely to be impacted by competing medical comorbidities (p < .00001). The ED population represents a particularly vulnerable, at-risk cohort with a high prevalence of HCV and linkage to care barriers. While past HCV-specific recommendations and interventions have focused on Baby Boomers, this data suggests that younger generations, including Gen X and Millennials, are increasingly affected by HCV and face disparate social risk and social need factors which impede definitive care linkage and treatment.
Collapse
Affiliation(s)
- Lauren A Walter
- Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Myles Prados
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Audrey Lloyd
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sylvie Sontheimer
- Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Matthew Heimann
- Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Joel B Rodgers
- Division of Acute Care Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Delissa T Hand
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ricardo Franco
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| |
Collapse
|
2
|
Custovic A, Custovic D, Fontanella S. Understanding the heterogeneity of childhood allergic sensitization and its relationship with asthma. Curr Opin Allergy Clin Immunol 2024; 24:79-87. [PMID: 38359101 PMCID: PMC10906203 DOI: 10.1097/aci.0000000000000967] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
PURPOSE OF REVIEW To review the current state of knowledge on the relationship between allergic sensitization and asthma; to lay out a roadmap for the development of IgE biomarkers that differentiate, in individual sensitized patients, whether their sensitization is important for current or future asthma symptoms, or has little or no relevance to the disease. RECENT FINDINGS The evidence on the relationship between sensitization and asthma suggests that some subtypes of allergic sensitization are not associated with asthma symptoms, whilst others are pathologic. Interaction patterns between IgE antibodies to individual allergenic molecules on component-resolved diagnostics (CRD) multiplex arrays might be hallmarks by which different sensitization subtypes relevant to asthma can be distinguished. These different subtypes of sensitization are associated amongst sensitized individuals at all ages, with different clinical presentations (no disease, asthma as a single disease, and allergic multimorbidity); amongst sensitized preschool children with and without lower airway symptoms, with different risk of subsequent asthma development; and amongst sensitized patients with asthma, with differing levels of asthma severity. SUMMARY The use of machine learning-based methodologies on complex CRD data can help us to design better diagnostic tools to help practising physicians differentiate between benign and clinically important sensitization.
Collapse
Affiliation(s)
- Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | | |
Collapse
|
3
|
Warren CM, Bartell TR. Sociodemographic inequities in food allergy: Insights on food allergy from birth cohorts. Pediatr Allergy Immunol 2024; 35:e14125. [PMID: 38656700 DOI: 10.1111/pai.14125] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/26/2024]
Abstract
A large and growing corpus of epidemiologic studies suggests that the population-level burden of pediatric FA is not equitably distributed across major sociodemographic groups, including race, ethnicity, household income, parental educational attainment, and sex. As is the case for more extensively studied allergic disease states such as asthma and atopic dermatitis epidemiologic data suggest that FA may be more prevalent among certain populations experiencing lower socioeconomic status (SES), particularly those with specific racial and ethnic minority backgrounds living in highly urbanized regions. Emerging data also indicate that these patients may also experience more severe FA-related physical health, psychosocial, and economic outcomes relating to chronic disease management. However, many studies that have identified sociodemographic inequities in FA burden are limited by cross-sectional designs that are subject to numerous biases. Compared with cross-sectional study designs or cohorts established later in life, birth cohorts offer advantages relative to other study designs when investigators seek to understand causal relationships between exposures occurring during the prenatal or postnatal period and the atopic disease status of individuals later in life. Numerous birth cohorts have been established across recent decades, which include evaluation of food allergy-related outcomes, and a subset of these also have measured sociodemographic variables that, together, have the potential to shed light on the existence and possible etiology of sociodemographic inequities in food allergy. This manuscript reports the findings of a comprehensive survey of the current state of this birth cohort literature and draws insights into what is currently known, and what further information can potentially be gleaned from thoughtful examination and further follow-up of ongoing birth cohorts across the globe.
Collapse
Affiliation(s)
- Christopher M Warren
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Tami R Bartell
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Patrick M. Magoon Institute for Healthy Communities, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| |
Collapse
|
4
|
Regis E, Fontanella S, Curtin JA, Pinot de Moira A, Edwards MR, Murray CS, Simpson A, Johnston SL, Custovic A. Association between polymorphisms on chromosome 17q12-q21 and rhinovirus-induced interferon responses. J Allergy Clin Immunol 2024:S0091-6749(24)00269-0. [PMID: 38494094 DOI: 10.1016/j.jaci.2024.03.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/23/2024] [Accepted: 03/01/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Single nucleotide polymorphisms (SNPs) in genes on chromosome 17q12-q21 are associated with childhood-onset asthma and rhinovirus-induced wheeze. There are few mechanistic data linking chromosome 17q12-q21 to wheezing illness. OBJECTIVE We investigated whether 17q12-q21 risk alleles were associated with impaired interferon responses to rhinovirus. METHODS In a population-based birth cohort of European ancestry, we stimulated peripheral blood mononuclear cells with rhinovirus A1 (RV-A1) and rhinovirus A16 (RV-A16) and measured IFN and IFN-induced C-X-C motif chemokine ligand 10 (aka IP10) responses in supernatants. We investigated associations between virus-induced cytokines and 6 SNPs in 17q12-q21. Bayesian profile regression was applied to identify clusters of individuals with different immune response profiles and genetic variants. RESULTS Five SNPs (in high linkage disequilibrium, r2 ≥ 0.8) were significantly associated with RV-A1-induced IFN-β (rs9303277, P = .010; rs11557467, P = .012; rs2290400, P = .006; rs7216389, P = .008; rs8079416, P = .005). A reduction in RV-A1-induced IFN-β was observed among individuals with asthma risk alleles. There were no significant associations for RV-A1-induced IFN-α or CXCL10, or for any RV-A16-induced IFN/CXCL10. Bayesian profile regression analysis identified 3 clusters that differed in IFN-β induction to RV-A1 (low, medium, high). The typical genetic profile of the cluster associated with low RV-A1-induced IFN-β responses was characterized by a very high probability of being homozygous for the asthma risk allele for all SNPs. Children with persistent wheeze were almost 3 times more likely to be in clusters with reduced/average RV-A1-induced IFN-β responses than in the high immune response cluster. CONCLUSIONS Polymorphisms on chromosome 17q12-q21 are associated with rhinovirus-induced IFN-β, suggesting a novel mechanism-impaired IFN-β induction-links 17q12-q21 risk alleles with asthma/wheeze.
Collapse
Affiliation(s)
- Eteri Regis
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Sara Fontanella
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - John A Curtin
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester and University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
| | | | - Michael R Edwards
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Clare S Murray
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester and University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - Angela Simpson
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester and University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - Sebastian L Johnston
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, United Kingdom.
| |
Collapse
|
5
|
Scelo G, Zugna D, Popovic M, Strandberg-Larsen K, Richiardi L. Transporting results in an observational epidemiology setting: purposes, methods, and applied example. Front Epidemiol 2024; 4:1335241. [PMID: 38456074 PMCID: PMC10910888 DOI: 10.3389/fepid.2024.1335241] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/13/2024] [Indexed: 03/09/2024]
Abstract
In the medical domain, substantial effort has been invested in generating internally valid estimates in experimental as well as observational studies, but limited effort has been made in testing generalizability, or external validity. Testing the external validity of scientific findings is nevertheless crucial for the application of knowledge across populations. In particular, transporting estimates obtained from observational studies requires the combination of methods for causal inference and methods to transport the effect estimates in order to minimize biases inherent to observational studies and to account for differences between the study and target populations. In this paper, the conceptual framework and assumptions behind transporting results from a population-based study population to a target population is described in an observational setting. An applied example to life-course epidemiology, where internal validity was constructed for illustrative purposes, is shown by using the targeted maximum likelihood estimator.
Collapse
Affiliation(s)
- Ghislaine Scelo
- Department of Medical Sciences, University of Turin, CPO-Piemonte, Turin, Italy
| | - Daniela Zugna
- Department of Medical Sciences, University of Turin, CPO-Piemonte, Turin, Italy
| | - Maja Popovic
- Department of Medical Sciences, University of Turin, CPO-Piemonte, Turin, Italy
| | | | - Lorenzo Richiardi
- Department of Medical Sciences, University of Turin, CPO-Piemonte, Turin, Italy
| |
Collapse
|
6
|
Gimeno L, Goisis A, Dowd JB, Ploubidis GB. Generational differences in physical health and disability in the United States and Europe. medRxiv 2024:2024.01.16.24301347. [PMID: 38293226 PMCID: PMC10827238 DOI: 10.1101/2024.01.16.24301347] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Objectives Declines in mortality have typically been associated with improvements in physical health across generations. While life expectancy in most high-income countries continues to increase, there is evidence that younger generations, particularly in the United States (US), are less healthy than previous generations at the same age. We compared generational trends in physical health in the US, England, and continental Europe to explore whether other regions have experienced a similar pattern of worsening health across cohorts. Methods Using data from nationally representative studies of adults aged ≥50 years from the US (Health and Retirement Study, n=26,939), England (English Longitudinal Study of Ageing, n=14,992) and 11 continental European countries (Survey of Health, Ageing and Retirement in Europe, n=72,595), we estimated differences in the age-adjusted prevalence of self-reported chronic disease and disability and observer-measured health indicators across pseudo-birth cohorts (born <1925, 1925-1935, 1936-1945, 1946-1954, 1955-1959). Results Age-adjusted prevalence of doctor-diagnosed chronic disease increased across cohorts in all regions. Trends in disability prevalence were more regionally varied. Still, in both the US and Europe, we observed a structural break in disability trends, with declines observed in pre-war cohorts slowing, stalling, or reversing for cohorts born since 1945. Discussion In all regions, we found evidence for worsening health across cohorts, particularly for those born since 1945. While more chronic disease in younger cohorts need not necessarily translate to worse quality of life or higher rates of functional limitation, there is some suggestion that worsening chronic disease morbidity may be spilling over into worsening disability.
Collapse
Affiliation(s)
- Laura Gimeno
- Centre for Longitudinal Studies, Social Research Institute, Institute of Education, University College London
| | - Alice Goisis
- Centre for Longitudinal Studies, Social Research Institute, Institute of Education, University College London
| | - Jennifer B Dowd
- Leverhulme Centre for Demographic Science, Nuffield Department of Population Health, Nuffield College, University of Oxford
| | - George B Ploubidis
- Centre for Longitudinal Studies, Social Research Institute, Institute of Education, University College London
| |
Collapse
|
7
|
Kekäläinen T, Koivunen K, Pynnönen K, Portegijs E, Taina Rantanen. Cohort Differences in Depressive Symptoms and Life Satisfaction in 75- and 80-Year-Olds: A Comparison of Two Cohorts 28 Years Apart. J Aging Health 2024; 36:3-13. [PMID: 36947727 PMCID: PMC10693740 DOI: 10.1177/08982643231164739] [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] [Indexed: 03/24/2023]
Abstract
Objectives: To examine birth cohort differences in depressive symptoms and life satisfaction in older men and women and the mechanisms underpinning the possible cohort differences. Methods: Two independent cohorts of Finnish men and women aged 75 and 80 were assessed in 1989-1990 (n = 617) and 2017-2018 (n = 794). They reported their depressive symptoms (CES-D), current life satisfaction, and evaluation of life until now. Results: The later-born cohort reported fewer depressive symptoms (8.6 ± 7.1 vs. 13.9 ± 8.3) and the differences were similar for the subdomains of depressive symptoms. The later-born cohort was more often mostly satisfied with life until now (90 vs. 70%) but not with the current life than the earlier-born cohort. Better self-rated health and education of the later-born cohort partly explain the cohort differences. Discussion: Older people in Finland report fewer depressive symptoms and they are more satisfied with their past life compared to their counterparts assessed 28 years ago.
Collapse
Affiliation(s)
- Tiia Kekäläinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kaisa Koivunen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Katja Pynnönen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Erja Portegijs
- Human Movement Sciences, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Taina Rantanen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| |
Collapse
|
8
|
D'Ambrosio R, Piccinelli S, Beccalli B, Spinetti A, Puoti M, Fagiuoli S, Magni CF, Vavassori A, Sacchi P, Castaldi S, Bombardieri G, Farina C, Buoro S, Amorosi A, Corradin M, Cereda D, Lampertico P. A territory-wide opportunistic, hospital-based HCV screening in the general population from northern Italy: The 1969-1989 birth-cohort. Liver Int 2023; 43:2645-2656. [PMID: 37715524 DOI: 10.1111/liv.15727] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND AND AIM The World Health Organization (WHO) goal of Hepatitis C Virus (HCV) elimination by 2030 rose awareness about the need of screening plans, worldwide. In Italy, graduated screening starting from people born in 1969-1989 might be the most-effective strategy. We performed an opportunistic HCV screening study in the general population attending health facilities in Lombardy region, Northern Italy. METHODS This is a prospective, multicenter, territory-wide, opportunistic study supported by the Regional Government of Lombardy, Italy. Between June 2022 and December 2022, all subjects born in 1969-1989, hospitalized or accessing blood collection centres were offered anti-HCV and HCV-RNA tests. Patients with known anti-HCV positivity and/or previous anti-HCV treatment were excluded. Demographic features were uploaded into a regional web-based platform. RESULTS In total, 120 193 individuals were screened in 75 centres. Mean age was 44 (±6) years, 65.2% were females, 83.7% were tested at blood collection centres. Anti-HCV tested positive in 604 (0.50%) subjects: mean age 47 (±5), 51.1% females. HCV seroprevalence was higher in males (p < 0.00001), elderly (p < 0.00001) and in- vs. outpatients (p = 0.0009). HCV-RNA was detectable in 125 out of 441 (28.3%) anti-HCV positive subjects. Actively infected patients were 46 (±6) years old, mainly males (56.8%). The overall prevalence of active HCV infection was 0.10%, higher in elderly (p = 0.0003) and in in-patients (p = 0.0007). Among 93 HCV-RNA positive patients, the median age was 48 years, 58% males, 62% Italian born, median HCV-RNA levels were 6,1 log IU/mL, liver stiffness measurement (LSM) values 5.5 (3.1-29.9) kPa and ALT levels 48 U/L. CONCLUSIONS The prevalence of active HCV infection in the 1969-1989 population attending health facilities in Lombardy was low. Most viremic patients were Italian-born, with mild liver disease but high-HCV-RNA levels. Due to the higher prevalence in the elderly, the extension of such opportunistic screening programs to lower birth cohorts would be warranted.
Collapse
Affiliation(s)
- Roberta D'Ambrosio
- Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sara Piccinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Angiola Spinetti
- Division of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, AAST Spedali Civili, Brescia, Italy
| | - Massimo Puoti
- Division of Infectious Diseases, ASST GOM Niguarda, Milan, Italy
- Department of Medicine, University of Milan Bicocca, Milan, Italy
| | - Stefano Fagiuoli
- Department of Medicine, University of Milan Bicocca, Milan, Italy
- Division of Gastroenterology, Hepatology and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Paolo Sacchi
- Division of Infectious Diseases, IRCCS San Matteo di Pavia, Pavia, Italy
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Quality Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia Bombardieri
- Microbiology and Virology Laboratory, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Claudio Farina
- Microbiology and Virology Laboratory, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | | | | | | | - Pietro Lampertico
- Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, CRC "A. M. and A. Migliavacca" Centre for Liver Disease, University of Milan, Milan, Italy
| |
Collapse
|
9
|
Custovic D, Fontanella S, Custovic A. Understanding progression from pre-school wheezing to school-age asthma: Can modern data approaches help? Pediatr Allergy Immunol 2023; 34:e14062. [PMID: 38146116 DOI: 10.1111/pai.14062] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 12/27/2023]
Abstract
Preschool wheezing and childhood asthma create a heavy disease burden which is only exacerbated by the complexity of the conditions. Preschool wheezing exhibits both "curricular" and "aetiological" heterogeneity: that is, heterogeneity across patients both in the time-course of its development and in its underpinning pathological mechanisms. Since these are not fully understood, but clinical presentations across patients may nonetheless be similar, current diagnostic labels are imprecise-not mapping cleanly onto underlying disease mechanisms-and prognoses uncertain. These uncertainties also make a identifying new targets for therapeutic intervention difficult. In the past few decades, carefully designed birth cohort studies have collected "big data" on a large scale, incorporating not only a wealth of longitudinal clinical data, but also detailed information from modalities as varied as imaging, multiomics, and blood biomarkers. The profusion of big data has seen the proliferation of what we term "modern data approaches" (MDAs)-grouping together machine learning, artificial intelligence, and data science-to make sense and make use of this data. In this review, we survey applications of MDAs (with an emphasis on machine learning) in childhood wheeze and asthma, highlighting the extent of their successes in providing tools for prognosis, unpicking the curricular heterogeneity of these conditions, clarifying the limitations of current diagnostic criteria, and indicating directions of research for uncovering the etiology of the diseases underlying these conditions. Specifically, we focus on the trajectories of childhood wheeze phenotypes. Further, we provide an explainer of the nature and potential use of MDAs and emphasize the scope of what we can hope to achieve with them.
Collapse
Affiliation(s)
- Darije Custovic
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sara Fontanella
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, UK
| |
Collapse
|
10
|
Jones RP, Ponomarenko A. COVID-19-Related Age Profiles for SARS-CoV-2 Variants in England and Wales and States of the USA (2020 to 2022): Impact on All-Cause Mortality. Infect Dis Rep 2023; 15:600-634. [PMID: 37888139 PMCID: PMC10606787 DOI: 10.3390/idr15050058] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/07/2023] [Accepted: 09/07/2023] [Indexed: 10/28/2023] Open
Abstract
Since 2020, COVID-19 has caused serious mortality around the world. Given the ambiguity in establishing COVID-19 as the direct cause of death, we first investigate the effects of age and sex on all-cause mortality during 2020 and 2021 in England and Wales. Since infectious agents have their own unique age profile for death, we use a 9-year time series and several different methods to adjust single-year-of-age deaths in England and Wales during 2019 (the pre-COVID-19 base year) to a pathogen-neutral single-year-of-age baseline. This adjusted base year is then used to confirm the widely reported higher deaths in males for most ages above 43 in both 2020 and 2021. During 2020 (+COVID-19 but no vaccination), both male and female population-adjusted deaths significantly increased above age 35. A significant reduction in all-cause mortality among both males and females aged 75+ could be demonstrated in 2021 during the widespread COVID-19 vaccination period; however, deaths below age 75 progressively increased. This finding arises from a mix of vaccination coverage and year-of-age profiles of deaths for the different SARS-CoV-2 variants. In addition, specific effects of age around puberty were demonstrated, where females had higher deaths than males. There is evidence that year-of-birth cohorts may also be involved, indicating that immune priming to specific pathogen outbreaks in the past may have led to lower deaths for some birth cohorts. To specifically identify the age profile for the COVID-19 variants from 2020 to 2023, we employ the proportion of total deaths at each age that are potentially due to or 'with' COVID-19. The original Wuhan strain and the Alpha variant show somewhat limited divergence in the age profile, with the Alpha variant shifting to a moderately higher proportion of deaths below age 84. The Delta variant specifically targeted individuals below age 65. The Omicron variants showed a significantly lower proportion of overall mortality, with a markedly higher relative proportion of deaths above age 65, steeply increasing with age to a maximum around 100 years of age. A similar age profile for the variants can be seen in the age-banded deaths in US states, although they are slightly obscured by using age bands rather than single years of age. However, the US data shows that higher male deaths are greatly dependent on age and the COVID variant. Deaths assessed to be 'due to' COVID-19 (as opposed to 'involving' COVID-19) in England and Wales were especially overestimated in 2021 relative to the change in all-cause mortality. This arose as a by-product of an increase in COVID-19 testing capacity in late 2020. Potential structure-function mechanisms for the age-specificity of SARS-CoV-2 variants are discussed, along with potential roles for small noncoding RNAs (miRNAs). Using data from England, it is possible to show that the unvaccinated do indeed have a unique age profile for death from each variant and that vaccination alters the shape of the age profile in a manner dependent on age, sex, and the variant. The question is posed as to whether vaccines based on different variants carry a specific age profile.
Collapse
Affiliation(s)
| | - Andrey Ponomarenko
- Department of Biophysics, Informatics and Medical Instrumentation, Odessa National Medical University, Valikhovsky Lane 2, 65082 Odessa, Ukraine
| |
Collapse
|
11
|
Voraphani N, Stern DA, Ledford JG, Spangenberg AL, Zhai J, Wright AL, Morgan WJ, Kraft M, Sherrill DL, Curtin JA, Murray CS, Custovic A, Kull I, Hallberg J, Bergström A, Herrera-Luis E, Halonen M, Martinez FD, Simpson A, Melén E, Guerra S. Circulating CC16 and Asthma: A Population-based, Multicohort Study from Early Childhood through Adult Life. Am J Respir Crit Care Med 2023; 208:758-769. [PMID: 37523710 PMCID: PMC10563188 DOI: 10.1164/rccm.202301-0041oc] [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: 01/13/2023] [Accepted: 07/31/2023] [Indexed: 08/02/2023] Open
Abstract
Rationale: Club cell secretory protein (CC16) is an antiinflammatory protein highly expressed in the airways. CC16 deficiency has been associated with lung function deficits, but its role in asthma has not been established conclusively. Objectives: To determine 1) the longitudinal association of circulating CC16 with the presence of active asthma from early childhood through adult life and 2) whether CC16 in early childhood predicts the clinical course of childhood asthma into adult life. Methods: We assessed the association of circulating CC16 and asthma in three population-based birth cohorts: the Tucson Children's Respiratory Study (years 6-36; total participants, 814; total observations, 3,042), the Swedish Barn/Children, Allergy, Milieu, Stockholm, Epidemiological survey (years 8-24; total participants, 2,547; total observations, 3,438), and the UK Manchester Asthma and Allergy Study (years 5-18; total participants, 745; total observations, 1,626). Among 233 children who had asthma at the first survey in any of the cohorts, baseline CC16 was also tested for association with persistence of symptoms. Measurements and Main Results: After adjusting for covariates, CC16 deficits were associated with increased risk for the presence of asthma in all cohorts (meta-analyzed adjusted odds ratio per 1-SD CC16 decrease, 1.20; 95% confidence interval [CI], 1.12-1.28; P < 0.0001). The association was particularly strong for asthma with frequent symptoms (meta-analyzed adjusted relative risk ratio, 1.40; 95% CI, 1.24-1.57; P < 0.0001), was confirmed for both atopic and nonatopic asthma, and was independent of lung function impairment. After adjustment for known predictors of persistent asthma, children with asthma in the lowest CC16 tertile had a nearly fourfold increased risk for having frequent symptoms persisting into adult life compared with children with asthma in the other two CC16 tertiles (meta-analyzed adjusted odds ratio, 3.72; 95% CI, 1.78-7.76; P < 0.0001). Conclusions: Circulating CC16 deficits are associated with the presence of asthma with frequent symptoms from childhood through midadult life and predict the persistence of asthma symptoms into adulthood. These findings support a possible protective role of CC16 in asthma and its potential use for risk stratification.
Collapse
Affiliation(s)
- Nipasiri Voraphani
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| | - Debra A. Stern
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| | - Julie G. Ledford
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| | - Amber L. Spangenberg
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| | - Jing Zhai
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| | - Anne L. Wright
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| | - Wayne J. Morgan
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| | - Monica Kraft
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| | - Duane L. Sherrill
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| | - John A. Curtin
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre and National Institute for Health and Care Research Biomedical Research Centre, Manchester University Hospitals National Health Service Foundation Trust, Manchester, United Kingdom
| | - Clare S. Murray
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre and National Institute for Health and Care Research Biomedical Research Centre, Manchester University Hospitals National Health Service Foundation Trust, Manchester, United Kingdom
| | - Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Inger Kull
- Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachs’ Children and Youth Hospital, Stockholm, Sweden
| | - Jenny Hallberg
- Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachs’ Children and Youth Hospital, Stockholm, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; and
| | - Esther Herrera-Luis
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna, La Laguna, Spain
| | - Marilyn Halonen
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| | - Fernando D. Martinez
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| | - Angela Simpson
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre and National Institute for Health and Care Research Biomedical Research Centre, Manchester University Hospitals National Health Service Foundation Trust, Manchester, United Kingdom
| | - Erik Melén
- Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachs’ Children and Youth Hospital, Stockholm, Sweden
| | - Stefano Guerra
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| |
Collapse
|
12
|
Bisgaard H, Chawes B, Stokholm J, Mikkelsen M, Schoos AMM, Bønnelykke K. 25 Years of translational research in the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC). J Allergy Clin Immunol 2023; 151:619-633. [PMID: 36642652 DOI: 10.1016/j.jaci.2022.11.022] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/28/2022] [Accepted: 11/04/2022] [Indexed: 01/15/2023]
Abstract
The Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) mother-child cohorts have provided a foundation of 25 years of research on the origins, prevention, and natural history of childhood asthma and related disorders. COPSAC's approach is characterized by clinical translational research with longitudinal deep phenotyping and exposure assessments from pregnancy, in combination with multi-omic data layers and embedded randomized controlled trials. One trial showed that fish oil supplementation during pregnancy prevented childhood asthma and identified pregnant women with the highest benefits from supplementation, thereby creating the potential for personalized prevention. COPSAC revealed that airway colonization with pathogenic bacteria in early life is associated with an increased risk of asthma. Further, airway bacteria were shown to be a trigger of acute asthma-like symptoms, with benefit from antibiotic treatment. COPSAC identified an immature gut microbiome in early life as a risk factor for asthma and allergy and further demonstrated that asthma can be predicted by infant lung function. At a molecular level, COPSAC has identified novel susceptibility genes, early immune deviations, and metabolomic alterations associated with childhood asthma. Thus, the COPSAC research program has enhanced our understanding of the processes causing childhood asthma and has suggested means of personalized prevention and treatment.
Collapse
Affiliation(s)
- Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Bo Chawes
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Slagelse Hospital, Slagelse, Denmark
| | - Marianne Mikkelsen
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ann-Marie Malby Schoos
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Slagelse Hospital, Slagelse, Denmark
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
| |
Collapse
|
13
|
Fraser SDS, Stannard S, Holland E, Boniface M, Hoyle RB, Wilkinson R, Akbari A, Ashworth M, Berrington A, Chiovoloni R, Enright J, Francis NA, Giles G, Gulliford M, Macdonald S, Mair FS, Owen RK, Paranjothy S, Parsons H, Sanchez-Garcia RJ, Shiranirad M, Zlatev Z, Alwan N. Multidisciplinary ecosystem to study lifecourse determinants and prevention of early-onset burdensome multimorbidity (MELD-B) - protocol for a research collaboration. J Multimorb Comorb 2023; 13:26335565231204544. [PMID: 37766757 PMCID: PMC10521301 DOI: 10.1177/26335565231204544] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
Background Most people living with multiple long-term condition multimorbidity (MLTC-M) are under 65 (defined as 'early onset'). Earlier and greater accrual of long-term conditions (LTCs) may be influenced by the timing and nature of exposure to key risk factors, wider determinants or other LTCs at different life stages. We have established a research collaboration titled 'MELD-B' to understand how wider determinants, sentinel conditions (the first LTC in the lifecourse) and LTC accrual sequence affect risk of early-onset, burdensome MLTC-M, and to inform prevention interventions. Aim Our aim is to identify critical periods in the lifecourse for prevention of early-onset, burdensome MLTC-M, identified through the analysis of birth cohorts and electronic health records, including artificial intelligence (AI)-enhanced analyses. Design We will develop deeper understanding of 'burdensomeness' and 'complexity' through a qualitative evidence synthesis and a consensus study. Using safe data environments for analyses across large, representative routine healthcare datasets and birth cohorts, we will apply AI methods to identify early-onset, burdensome MLTC-M clusters and sentinel conditions, develop semi-supervised learning to match individuals across datasets, identify determinants of burdensome clusters, and model trajectories of LTC and burden accrual. We will characterise early-life (under 18 years) risk factors for early-onset, burdensome MLTC-M and sentinel conditions. Finally, using AI and causal inference modelling, we will model potential 'preventable moments', defined as time periods in the life course where there is an opportunity for intervention on risk factors and early determinants to prevent the development of MLTC-M. Patient and public involvement is integrated throughout.
Collapse
Affiliation(s)
- Simon DS Fraser
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, Southampton General Hospital, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton, UK
| | - Sebastian Stannard
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, Southampton General Hospital, Southampton, UK
| | - Emilia Holland
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, Southampton General Hospital, Southampton, UK
| | - Michael Boniface
- School of Electronics and Computer Science, University of Southampton, Southampton, UK
| | - Rebecca B Hoyle
- School of Mathematical Sciences, University of Southampton, Southampton, UK
| | | | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK
| | - Mark Ashworth
- School of Life Course and Population Sciences, King’s College London, London, UK
| | - Ann Berrington
- Department of Social Statistics and Demography, University of Southampton, Southampton, UK
| | - Roberta Chiovoloni
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK
| | | | - Nick A Francis
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, Southampton General Hospital, Southampton, UK
| | - Gareth Giles
- Public Policy Southampton, University of Southampton, Southampton, UK
| | - Martin Gulliford
- School of Life Course and Population Sciences, King’s College London, London, UK
| | - Sara Macdonald
- School of Health and Wellbeing, General Practice and Primary Care, University of Glasgow, Glasgow, UK
| | - Frances S Mair
- School of Health and Wellbeing, General Practice and Primary Care, University of Glasgow, Glasgow, UK
| | - Rhiannon K Owen
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK
| | - Shantini Paranjothy
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
- NHS Grampian Health Board, Aberdeen, UK
| | - Heather Parsons
- Patient and Public Involvement and Engagement, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Ruben J Sanchez-Garcia
- School of Mathematical Sciences, University of Southampton, Southampton, UK
- The Alan Turing Institute, London, UK
| | - Mozhdeh Shiranirad
- School of Mathematical Sciences, University of Southampton, Southampton, UK
| | - Zlatko Zlatev
- School of Electronics and Computer Science, University of Southampton, Southampton, UK
| | - Nisreen Alwan
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, Southampton General Hospital, Southampton, UK
- Patient and Public Involvement and Engagement, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Southampton Biomedical Research Centre, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton, UK
| |
Collapse
|
14
|
Turcotte V, Hudon C, Potvin O, Dadar M, Duchesne S. The Influence of Birth Cohorts on Future Cognitive Decline. J Alzheimers Dis 2023; 93:179-191. [PMID: 36970893 DOI: 10.3233/jad-220951] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND Slowed rates of cognitive decline have been reported in individuals with higher cognitive reserve (CR), but interindividual discrepancies remain unexplained. Few studies have reported a birth cohort effect, favoring later-born individuals, but these studies remain scarce. OBJECTIVE We aimed to predict cognitive decline in older adults using birth cohorts and CR. METHODS Within the Alzheimer's Disease Neuroimaging Initiative, 1,041 dementia-free participants were assessed on four cognitive domains (verbal episodic memory; language and semantic memory; attention; executive functions) at each follow-up visit up to 14 years. Four birth cohorts were formed according to the major historical events of the 20th century (1916-1928; 1929-1938; 1939-1945; 1946-1962). CR was operationalized by merging education, complexity of occupation, and verbal IQ. We used linear mixed-effect models to evaluate the effects of CR and birth cohorts on rate of performance change over time. Age at baseline, baseline structural brain health (total brain and total white matter hyperintensities volumes), and baseline vascular risk factors burden were used as covariates. RESULTS CR was only associated with slower decline in verbal episodic memory. However, more recent birth cohorts predicted slower annual cognitive decline in all domains, except for executive functions. This effect increased as the birth cohort became more recent. CONCLUSION We found that both CR and birth cohorts influence future cognitive decline, which has strong public policy implications.
Collapse
Affiliation(s)
- Valérie Turcotte
- École de Psychologie, Faculté des Sciences Sociales, Université Laval, Québec, QC, Canada
- CERVO Brain Research Centre, Centre Intégré Universitaire en Santé et Services Sociaux de la Capitale Nationale, Québec, QC, Canada
| | - Carol Hudon
- École de Psychologie, Faculté des Sciences Sociales, Université Laval, Québec, QC, Canada
- CERVO Brain Research Centre, Centre Intégré Universitaire en Santé et Services Sociaux de la Capitale Nationale, Québec, QC, Canada
- VITAM - Centre de Recherche en Santé Durable, Centre Intégré Universitaire en Santé et Services Sociaux de la Capitale Nationale, Québec, QC, Canada
| | - Olivier Potvin
- CERVO Brain Research Centre, Centre Intégré Universitaire en Santé et Services Sociaux de la Capitale Nationale, Québec, QC, Canada
| | - Mahsa Dadar
- Department of Psychiatry, Faculty of Medicine, McGill University, Montréal, QC, Canada
| | - Simon Duchesne
- CERVO Brain Research Centre, Centre Intégré Universitaire en Santé et Services Sociaux de la Capitale Nationale, Québec, QC, Canada
- Département de Radiologie et Médecine Nucléaire, Faculté de Médecine, Université Laval, Québec, QC, Canada
| |
Collapse
|
15
|
Haider S, Fontanella S, Ullah A, Turner S, Simpson A, Roberts G, Murray CS, Holloway JW, Curtin JA, Cullinan P, Arshad SH, Hurault G, Granell R, Custovic A. Evolution of Eczema, Wheeze, and Rhinitis from Infancy to Early Adulthood: Four Birth Cohort Studies. Am J Respir Crit Care Med 2022; 206:950-960. [PMID: 35679320 PMCID: PMC9802000 DOI: 10.1164/rccm.202110-2418oc] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [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: 10/25/2021] [Accepted: 06/09/2022] [Indexed: 01/07/2023] Open
Abstract
Rationale: The relationship between eczema, wheeze or asthma, and rhinitis is complex, and epidemiology and mechanisms of their comorbidities is unclear. Objectives: To investigate within-individual patterns of morbidity of eczema, wheeze, and rhinitis from birth to adolescence/early adulthood. Methods: We investigated onset, progression, and resolution of eczema, wheeze, and rhinitis using descriptive statistics, sequence mining, and latent Markov modeling in four population-based birth cohorts. We used logistic regression to ascertain if early-life eczema or wheeze, or genetic factors (filaggrin [FLG] mutations and 17q21 variants), increase the risk of multimorbidity. Measurements and Main Results: Single conditions, although the most prevalent, were observed significantly less frequently than by chance. There was considerable variation in the timing of onset/remission/persistence/intermittence. Multimorbidity of eczema+wheeze+rhinitis was rare but significantly overrepresented (three to six times more often than by chance). Although infantile eczema was associated with subsequent multimorbidity, most children with eczema (75.4%) did not progress to any multimorbidity pattern. FLG mutations and rs7216389 were not associated with persistence of eczema/wheeze as single conditions, but both increased the risk of multimorbidity (FLG by 2- to 3-fold, rs7216389 risk variant by 1.4- to 1.7-fold). Latent Markov modeling revealed five latent states (no disease/low risk, mainly eczema, mainly wheeze, mainly rhinitis, multimorbidity). The most likely transition to multimorbidity was from eczema state (0.21). However, although this was one of the highest transition probabilities, only one-fifth of those with eczema transitioned to multimorbidity. Conclusions: Atopic diseases fit a multimorbidity framework, with no evidence for sequential atopic march progression. The highest transition to multimorbidity was from eczema, but most children with eczema (more than three-quarters) had no comorbidities.
Collapse
Affiliation(s)
| | | | | | - Stephen Turner
- Royal Aberdeen Children’s Hospital National Health Service Grampian Aberdeen, Aberdeen, United Kingdom
- Child Health, University of Aberdeen, Aberdeen, United Kingdom
| | - Angela Simpson
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, and Manchester University National Health Service Foundation Trust, Manchester, United Kingdom
| | - Graham Roberts
- Human Development and Health and
- National Institute for Health and Care Research Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, United Kingdom
- David Hide Asthma and Allergy Research Centre, Isle of Wight, United Kingdom; and
| | - Clare S. Murray
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, and Manchester University National Health Service Foundation Trust, Manchester, United Kingdom
| | - John W. Holloway
- Human Development and Health and
- National Institute for Health and Care Research Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - John A. Curtin
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, and Manchester University National Health Service Foundation Trust, Manchester, United Kingdom
| | | | - Syed Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- National Institute for Health and Care Research Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, United Kingdom
- David Hide Asthma and Allergy Research Centre, Isle of Wight, United Kingdom; and
| | - Guillem Hurault
- Faculty of Engineering, Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Raquel Granell
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | | |
Collapse
|
16
|
Marcus E, Anders A, Per G, Karin M. Occupational differences in mortality and life expectancy persist after retirement and throughout life. Scand J Public Health 2022:14034948221081628. [PMID: 35331067 DOI: 10.1177/14034948221081628] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS There are substantial differences in remaining life expectancy at higher ages between occupational groups. These differences may be the effect of work-related exposures, lifestyle factors of workers in specific occupations, socioeconomic position or a combination of this. The scope of this paper is the extent to which occupational differences in remaining life expectancy persist after retirement, which would suggest that occupational exposures alone are not likely to explain all the difference. METHODS All individuals born between 1925 and 1939 who reported occupational information in the Census 1985 and were residents in Sweden to the end of 2020 or who died were included and followed for death until 2020. The Nordic Classification of Occupations was used to create nine occupational groups. Partial life expectancy and age-specific death rates were applied to examine mortality differentials. RESULTS This study showed substantial differences in partial life expectancy across the occupational cohorts with the biggest difference being about 2 years. The mortality differences persisted with increasing age, both when measured as absolute numbers as well as relative numbers. CONCLUSIONS The lack of convergence in mortality at high ages suggests that factors associated with lifestyle may play a larger role than occupational factors for the mortality differences between occupational groups at high ages. However, it cannot be ruled out that long-lasting effects of earlier occupational exposures also contribute. Regardless of the exact mechanism, we conclude that there is room for further reduction in mortality at high ages and, thus, for further improvement in life expectancy.
Collapse
Affiliation(s)
- Ebeling Marcus
- Unit of Epidemiology, Karolinska Institutet, Sweden.,Laboratory of Population Health, Max Planck Institute for Demographic Research, Germany
| | - Ahlbom Anders
- Unit of Epidemiology, Karolinska Institutet, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Sweden
| | - Gustavsson Per
- Centre for Occupational and Environmental Medicine, Region Stockholm, Sweden.,Unit of Occupational Medicine, Karolinska Institutet, Sweden
| | - Modig Karin
- Unit of Epidemiology, Karolinska Institutet, Sweden
| |
Collapse
|
17
|
Yang G, D'Arcy C. The changing relationship between health risk behaviors and depression among birth cohorts of Canadians 65+, 1994-2014. Front Psychiatry 2022; 13:1078161. [PMID: 36620694 PMCID: PMC9810750 DOI: 10.3389/fpsyt.2022.1078161] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The older adult residents of Canada form an increasingly larger proportion of the population and are becoming better educated and have more income. Depression is a common mental disorder, particularly among seniors. Several health risk behaviors-physical inactivity, tobacco use, and alcohol consumption-are linked to mental health problems. This study examines whether these health risk behaviors and their association with depression among Canadians 65+ born in eight cohorts between 1910-1914 and 1945-1949, have changed. METHODS Pooled data drawn from 11 nationally representative health surveys conducted by Statistics Canada between 1994 and 2014 are analyzed-88,675 survey participants met inclusion criteria. Depression was assessed by the Composite International Diagnostic Interview-Short Form. Health risk behaviors examined were physical activity/inactivity, smoking, and alcohol use. A Cochran Armitage trend test for categorical outcomes and a log-binomial modeling for binary outcomes were used to estimate the risk ratios across cohorts. RESULTS The proportions of Canadians 65+ who are physically active, regular drinkers, and regular smokers have increased; however, depression prevalence fluctuated non-significantly. Depression increased among all health risk behaviors, particularly in recent birth cohorts. Depression among physically inactive seniors, current smokers, and non-drinkers was significantly higher than among active, non-smokers, and regular drinkers (all P < 0.05). Physical inactivity and smoking-attributable depression risk showed an increasing linear trend across birth cohorts (RR = 1.67, P < 0.001; RR = 1.79, P < 0.001). For seniors born between 1915 and 1944, regular drinking was associated with a significant decrease in depression (all P < 0.001), but the protective effects of regular drinking became non-existent in the most recent 1945-1949 birth cohort (RR = 1.09, P < 0.05, after adjusting for covariates). CONCLUSION Inactivity and smoking were consistently associated with a significantly increased risk of depression among Canadian residents 65+, with smoking becoming more firmly connected to depression risk in more recent birth cohorts. In contrast, moderate alcohol use was associated with a decreased risk of depression, but that protective effect ceased in most recent birth cohort. Identifying the changing relationships between health risk behaviors and depression is meaningful for developing prevention strategies for depression and other emotional and mental health problems.
Collapse
Affiliation(s)
- Guang Yang
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
| | - Carl D'Arcy
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| |
Collapse
|
18
|
Turcotte V, Potvin O, Dadar M, Hudon C, Duchesne S. Birth Cohorts and Cognitive Reserve Influence Cognitive Performances in Older Adults. J Alzheimers Dis 2021; 85:587-604. [PMID: 34864667 DOI: 10.3233/jad-215044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 01/02/2023]
Abstract
BACKGROUND Evidence suggests birth cohort differences in cognitive performance of older adults. Proxies of cognitive reserve (CR), such as educational attainment and occupational complexity, could also partly account for these differences as they are influenced by the sociocultural environment of the birth cohorts. OBJECTIVE To predict cognitive performance using birth cohorts and CR and examine the moderating influence of CR on cognitive performance and structural brain health association. METHODS Using ADNI data (n = 1628), four birth cohorts were defined (1915-1928; 1929-1938; 1939-1945; 1946-1964). CR proxies were education, occupational complexity, and verbal IQ. We predicted baseline cognitive performances (verbal episodic memory; language and semantic memory; attention capacities; executive functions) using multiple linear regressions with CR, birth cohorts, age, structural brain health (total brain volume; total white matter hyperintensities volume) and vascular risk factors burden as predictors. Sex and CR interactions were also explored. RESULTS Recent birth cohorts, higher CR, and healthier brain structures predicted better performance in verbal episodic memory, language and semantic memory, and attention capacities, with large effect sizes. Better performance in executive functions was predicted by a higher CR and a larger total brain volume, with a small effect size. With equal score of CR, women outperformed men in verbal episodic memory and language and semantic memory in all cohorts. Higher level of CR predicted better performance in verbal episodic memory, only when total brain volume was lower. CONCLUSION Cohort differences in cognitive performance favor more recent birth cohorts and suggests that this association may be partly explained by proxies of CR.
Collapse
Affiliation(s)
- Valérie Turcotte
- École de psychologie, Faculté des SciencesSociales, Université Laval, Québec, QC, Canada.,CERVO Brain Research Centre, Centre Intégré Universitaire en Santé et Services Sociaux de laCapitale Nationale, Québec, QC, Canada
| | - Olivier Potvin
- CERVO Brain Research Centre, Centre Intégré Universitaire en Santé et Services Sociaux de laCapitale Nationale, Québec, QC, Canada
| | - Mahsa Dadar
- CERVO Brain Research Centre, Centre Intégré Universitaire en Santé et Services Sociaux de laCapitale Nationale, Québec, QC, Canada.,Département de Radiologie et MédecineNucléaire, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Carol Hudon
- École de psychologie, Faculté des SciencesSociales, Université Laval, Québec, QC, Canada.,CERVO Brain Research Centre, Centre Intégré Universitaire en Santé et Services Sociaux de laCapitale Nationale, Québec, QC, Canada
| | - Simon Duchesne
- CERVO Brain Research Centre, Centre Intégré Universitaire en Santé et Services Sociaux de laCapitale Nationale, Québec, QC, Canada.,Département de Radiologie et MédecineNucléaire, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | | |
Collapse
|
19
|
Giugliani ERJ, Gomes E, Santos IS, Matijasevich A, Camargo-Figuera FA, Barros AJD. All day-long pacifier use and intelligence quotient in childhood: A birth cohort study. Paediatr Perinat Epidemiol 2021; 35:511-518. [PMID: 33570810 DOI: 10.1111/ppe.12752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Received: 05/11/2020] [Revised: 11/23/2020] [Accepted: 12/19/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Literature on pacifier use remains controversial, but mostly suggests an inverse association with childhood intelligence. OBJECTIVES The objective of this study was to assess the association between pacifier use and intelligence quotient (IQ) in six-year-old children from a birth cohort. METHODS Data from 3532 children from the 2004 Pelotas (Brazil) Birth Cohort were analysed. Children were recruited and assessed at birth and followed up at 3 months, and 1, 2, 4, and 6 years. Data on pacifier use duration and intensity were obtained via interviews with mothers in all six follow-up visits. IQ was estimated at 6 years using the Wechsler Intelligence Scale for Children and standardised for the analyses. Crude and adjusted coefficients were calculated (linear regression) for all the data collected in follow-up assessments for pacifier use. RESULTS IQ was inversely associated with all pacifier use indicators. Children who used a pacifier all day long (ADL) at any follow-up showed an IQ 0.18 (95% confidence interval [CI] 0.11, 0.24) standard deviations below those who never used it ADL, after adjusting for confounders. The strength of association increased with number of assessments reporting ADL pacifier use, from a reduction in IQ of 0.13 (95% CI 0.06, 0.21) to 0.34 (95% CI 0.15, 0.52) standard deviations for ADL use in one and in all four follow-up visits, respectively. CONCLUSIONS We found a strong association between intense pacifier use up to 4 years of age and lower IQ at 6 years. A dose-response gradient was observed, with greater IQ deficits in children who used a ADL pacifier for longer durations. The mechanisms underlying this association need to be clarified. One hypothesis is that children using a pacifier, especially those who use it more intensely, are less stimulated.
Collapse
Affiliation(s)
- Elsa R J Giugliani
- Faculdade de Medicina, Departamento de Pediatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Erissandra Gomes
- Faculdade de Odontologia, Departamento de Cirurgia e Ortopedia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Iná S Santos
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil.,Programa de Pós-Graduação em Pediatria e Saúde da Criança, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alicia Matijasevich
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil.,Faculdade de Medicina, Departamento de Medicina Preventiva, Universidade de São Paulo, São Paulo, Brazil
| | - Fabio A Camargo-Figuera
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil.,Escuela de Enfermería, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Aluísio J D Barros
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
| |
Collapse
|
20
|
Hinojosa M, Shepard SS, Chung JR, King JP, McLean HQ, Flannery B, Belongia EA, Levine MZ. Impact of Immune Priming, Vaccination, and Infection on Influenza A(H3N2) Antibody Landscapes in Children. J Infect Dis 2020; 224:469-480. [PMID: 33090202 DOI: 10.1093/infdis/jiaa665] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 07/24/2020] [Accepted: 10/15/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Preexisting antibodies to influenza, shaped by early infection and subsequent exposures, may impact responses to influenza vaccination. METHODS We enrolled 72 children (aged 7-17 years) in 2015-2016; all received inactivated influenza vaccines. Forty-one were also vaccinated in 2014-2015, with 12 becoming infected with A(H3N2) in 2014-2015. Thirty-one children did not have documented influenza exposures in the prior 5 seasons. Sera were collected pre- and postvaccination in both seasons. We constructed antibody landscapes using hemagglutination inhibition antibody titers against 16 A(H3N2) viruses representative of major antigenic clusters that circulated between 1968 and 2015. RESULTS The breadth of the antibody landscapes increased with age. Vaccine-induced antibody responses correlated with boosting of titers to previously encountered antigens. Postvaccination titers were the highest against vaccine antigens rather than the historic A(H3N2) viruses previously encountered. Prevaccination titers to the vaccine were the strongest predictors of postvaccination titers. Responses to vaccine antigens did not differ by likely priming virus. Influenza A(H3N2)-infected children in 2014-2015 had narrower antibody landscapes than those uninfected, but prior season infection status had little effect on antibody landscapes following 2015-2016 vaccination. CONCLUSIONS A(H3N2) antibody landscapes in children were largely determined by age-related immune priming, rather than recent vaccination or infection.
Collapse
Affiliation(s)
- Michael Hinojosa
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Oak Ridge Institute for Science and Education, Atlanta, Georgia, USA
| | - Samuel S Shepard
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jessie R Chung
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer P King
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | - Huong Q McLean
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | - Brendan Flannery
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Edward A Belongia
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | - Min Z Levine
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
21
|
Abstract
BACKGROUND A growing body of literature has reported widening educational health disparities across birth cohorts or time periods in the United States, but has paid little attention to the implication of mortality selection on the cohort trend in health disparities. OBJECTIVE This study investigates how changes in the variance of unobserved frailty over time may complicate the interpretation of cohort trends in health disparities and life expectancy. METHODS We use the microsimulation method to test the effect of mortality selection and further propose a counterfactual simulation procedure to estimate its contribution. Data used in the simulations are based on Panel Studies of Income Dynamics 1968-2013, National Health and Nutrition Examination Survey data 1999-2012, and National Health Interview Survey data 1986-2011. RESULTS Simulation shows that mortality selection may generate seemingly contradictory trends in health disparities and life expectancy across birth cohorts at the group and individual level. Life expectancy can change even when individual mortality curve is fixed. In the absence of a change in the causal effect of education on mortality at the individual level, an educational life expectancy gap can change across cohorts as a result of the change in frailty variance. Empirical analysis shows that mortality selection accounts for a sizeable amount of contribution to the widening educational life expectancy gap from the 1950s to 1960s birth cohorts in the United States. CONTRIBUTION We demonstrate mortality selection can complicate the cohort trend in health disparities and life expectancy and propose a counterfactual simulation method to evaluate its contribution.
Collapse
|
22
|
Kissling E, Pozo F, Buda S, Vilcu AM, Gherasim A, Brytting M, Domegan L, Gómez V, Meijer A, Lazar M, Vučina VV, Dürrwald R, van der Werf S, Larrauri A, Enkirch T, O'Donnell J, Guiomar R, Hooiveld M, Petrović G, Stoian E, Penttinen P, Valenciano M. Low 2018/19 vaccine effectiveness against influenza A(H3N2) among 15-64-year-olds in Europe: exploration by birth cohort. ACTA ACUST UNITED AC 2020; 24. [PMID: 31796152 PMCID: PMC6891946 DOI: 10.2807/1560-7917.es.2019.24.48.1900604] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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] [Indexed: 01/10/2023]
Abstract
Introduction Influenza A(H3N2) clades 3C.2a and 3C.3a co-circulated in Europe in 2018/19. Immunological imprinting by first childhood influenza infection may induce future birth cohort differences in vaccine effectiveness (VE). Aim The I-MOVE multicentre primary care test-negative study assessed 2018/19 influenza A(H3N2) VE by age and genetic subgroups to explore VE by birth cohort. Methods We measured VE against influenza A(H3N2) and (sub)clades. We stratified VE by usual age groups (0–14, 15–64, ≥ 65-years). To assess the imprint-regulated effect of vaccine (I-REV) hypothesis, we further stratified the middle-aged group, notably including 32–54-year-olds (1964–86) sharing potential childhood imprinting to serine at haemagglutinin position 159. Results Influenza A(H3N2) VE among all ages was −1% (95% confidence interval (CI): −24 to 18) and 46% (95% CI: 8–68), −26% (95% CI: −66 to 4) and 20% (95% CI: −20 to 46) among 0–14, 15–64 and ≥ 65-year-olds, respectively. Among 15–64-year-olds, VE against clades 3C.2a1b and 3C.3a was 15% (95% CI: −34 to 50) and −74% (95% CI: −259 to 16), respectively. VE was −18% (95% CI: −140 to 41), −53% (95% CI: −131 to −2) and −12% (95% CI: −74 to 28) among 15–31-year-olds (1987–2003), 32–54-year-olds (1964–86) and 55–64-year-olds (1954–63), respectively. Discussion The lowest 2018/19 influenza A(H3N2) VE was against clade 3C.3a and among those born 1964–86, corresponding to the I-REV hypothesis. The low influenza A(H3N2) VE in 15–64-year-olds and the public health impact of the I-REV hypothesis warrant further study.
Collapse
Affiliation(s)
| | - Francisco Pozo
- National Centre for Microbiology, National Influenza Reference Laboratory, WHO-National Influenza Centre, Institute of Health Carlos III, Madrid, Spain
| | - Silke Buda
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Respiratory Infections Unit, Berlin, Germany
| | - Ana-Maria Vilcu
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Alin Gherasim
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain.,National Epidemiology Centre, Institute of Health Carlos III, Madrid, Spain
| | - Mia Brytting
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Lisa Domegan
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Health Service Executive- Health Protection Surveillance Centre, Dublin, Ireland
| | - Verónica Gómez
- Departamento de Epidemiologia, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Mihaela Lazar
- "Cantacuzino" National Military-Medical Institute for Research and Development, Bucharest, Romania
| | - Vesna Višekruna Vučina
- Croatian Institute of Public Health, Division for epidemiology of communicable diseases, Zagreb, Croatia
| | - Ralf Dürrwald
- Robert Koch Institute, National Reference Center for Influenza, Germany
| | - Sylvie van der Werf
- CNR des virus des infections respiratoires, WHO National Influenza Center, Institut Pasteur, Paris, France.,Unité de Génétique Moléculaire des Virus à ARN, Institut Pasteur, CNRS UMR3569, Université Paris Diderot SPC, France
| | - Amparo Larrauri
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain.,National Epidemiology Centre, Institute of Health Carlos III, Madrid, Spain
| | | | - Joan O'Donnell
- Health Service Executive- Health Protection Surveillance Centre, Dublin, Ireland
| | - Raquel Guiomar
- Departamento de Doenças Infeciosas, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Mariëtte Hooiveld
- Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
| | - Goranka Petrović
- Croatian Institute of Public Health, Division for epidemiology of communicable diseases, Zagreb, Croatia
| | - Elena Stoian
- "Cantacuzino" National Military-Medical Institute for Research and Development, Bucharest, Romania
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | -
- The I-MOVE primary care study team members are listed at the end of the article
| |
Collapse
|
23
|
Oluwole O, Rennie DC, Goodridge D, Blackburn D, Litzenberger T, Penz E, Lawson JA. The course of asthma: A population-based 10-year study examining asthma remission in children diagnosed with asthma in preschool. Pediatr Pulmonol 2020; 55:1924-1935. [PMID: 32478962 DOI: 10.1002/ppul.24881] [Citation(s) in RCA: 7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 05/28/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND The natural course of asthma may differ depending on the age of onset. OBJECTIVE To investigate predictors of asthma remission with a focus on the age of asthma onset. METHODS The study was a retrospective birth cohort of children with asthma in Saskatchewan, Canada. Using the Saskatchewan Ministry of Health databases, we identified children with a diagnosis of asthma in the first 6 years of life and who had at least 10 years of follow-up after diagnosis (n = 22 563). Of these, we included 6393 children either with persistent asthma (≥1 physician visit or hospitalization for asthma [PVHA] during each year of follow-up) and those who had remission (had PVHA in the first year after diagnosis but at some point during the follow-up no longer received PVHA until end of the study). We used survival analysis to examine associations between remission and age of asthma onset. RESULTS Of the study participants, 87.2% had early-onset (≤3 years) and 12.8% had late-onset (4-6 years) asthma. Over the 10-years of follow-up, the rate of asthma remission was 37 per 100 person-years. Early-onset asthma (hazard ratio [HR] = 1.10; 95%confidence interval [CI]: 1.01-1.20), being female (HR = 1.12; 95%CI: 1.07-1.18), living in a rural (HR = 1.20; 95%CI: 1.14-1.27) and medium urban (HR = 1.16; 95%CI: 1.08-1.26) location were positively associated with remission while history of atopy decreased likelihood of remission (HR = 0.73; 95%CI: 0.54-0.97). CONCLUSION Most children with asthma experienced remission, especially those with the onset of symptoms within the first 3 years of life.
Collapse
Affiliation(s)
- Oluwafemi Oluwole
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Donna C Rennie
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Donna Goodridge
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - David Blackburn
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Erika Penz
- Division of Respiratory, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Joshua A Lawson
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| |
Collapse
|
24
|
Tan Q, Jacobsen R, Nygaard M, Soerensen M, Mengel-From J, Christiansen L, Christensen K. Cohort Differences in the Associations of Selected Candidate Genes With Risk of All-Cause Mortality at Advanced Ages. Am J Epidemiol 2020; 189:708-716. [PMID: 31971580 DOI: 10.1093/aje/kwaa007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 01/09/2020] [Accepted: 01/09/2020] [Indexed: 11/13/2022] Open
Abstract
Considerable efforts have been made to identify the genetic basis of human longevity, with only limited progress. One important drawback of current genetic studies is the limited knowledge of gene-environment interaction. Using 2 cohorts of long-lived individuals born in 1905 and 1915 in Denmark, we performed survival analysis to estimate risk of mortality for major candidate genes of aging and longevity and their cohort effects. Through statistical modeling that combines individual genetic and survival information with cohort-specific survival data, we estimated the relative risks of mortality from ages 95 to 103 years associated with genetic variants in apolipoprotein E (APOE), forkhead box class O3a, clusterin, and phosphatidylinositol binding clathrin assembly protein. Our analysis estimated a decreased risk of carrying the APOE$\varepsilon $4 allele (change in risk = -0.403, 95% confidence interval (CI): -0.831, 0.021; P = 0.040) in men of the later cohort, although the allele itself was harmful to survival across sexes (relative risk = 1.161, 95% CI: 1.027, 1.345; P = 0.026). We also estimated a cohort effect of increased risk for the minor allele of rs3851179 in phosphatidylinositol binding clathrin assembly protein with borderline significance (change in risk = 0.165, 95% CI: -0.010, 0.331; P = 0.052) in women. Our estimated significant cohort effect on APOE$\varepsilon $4 is indicative of the interplay between the gene and the changing environment that modulates survival at extreme ages.
Collapse
|
25
|
Drago G, Ruggieri S, Bianchi F, Sampino S, Cibella F. Birth Cohorts in Highly Contaminated Sites: A Tool for Monitoring the Relationships Between Environmental Pollutants and Children's Health. Front Public Health 2020; 8:125. [PMID: 32411642 PMCID: PMC7198735 DOI: 10.3389/fpubh.2020.00125] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 03/27/2020] [Indexed: 12/15/2022] Open
Abstract
Industrial areas are characterized by the dispersion of environmental stressors that could possibly have long-term detrimental effects on both human health and the environment. Environmental contamination has been indicated to be one of the major risks for reproductive health. In this context, the effects of environmental pollution on pregnant women living in heavily polluted areas is of special interest. In fact, fetal development is a crucial phase due to the dynamic interaction between the maternal/external environments and the developing organs and tissues. Moreover, following Barker's postulate of the intrauterine origin of health and disease, the events occurring in this time window could affect future health. Birth cohorts provide the most suitable design for assessing the association between early-life and possible long-term health outcomes in highly contaminated sites. By providing an assessment of the early life environment throughout the collection of biological samples, birth cohorts offer the opportunity to study in-depth several possible confounders and outcomes by means of questionnaires and follow-ups based on clinical evaluations and bio-specimen samplings. The exposome comprises the totality of exposures from conception onwards; the birth cohort approach allows the integration of the exposures as a whole, including those related to socioeconomic status, with "omics" data from biological samples collected at birth and throughout life. In the characterization of the "fetal exposome," the placenta represents a highly informative and scarcely considered organ. For this purpose, the "Neonatal Environment and Health Outcomes" (NEHO) birth cohort has been established by enrolling pregnant women residing in contaminated sites and in surrounding areas.
Collapse
Affiliation(s)
- Gaspare Drago
- National Research Council of Italy, Institute for Biomedical Research and Innovation, Palermo, Italy
| | - Silvia Ruggieri
- National Research Council of Italy, Institute for Biomedical Research and Innovation, Palermo, Italy
| | - Fabrizio Bianchi
- National Research Council of Italy, Institute of Clinical Physiology, Pisa, Italy
| | - Silvestre Sampino
- Department of Experimental Embryology, Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Fabio Cibella
- National Research Council of Italy, Institute for Biomedical Research and Innovation, Palermo, Italy
| |
Collapse
|
26
|
Pizzi C, Richiardi M, Charles MA, Heude B, Lanoe JL, Lioret S, Brescianini S, Toccaceli V, Vrijheid M, Merletti F, Zugna D, Richiardi L. Measuring Child Socio-Economic Position in Birth Cohort Research: The Development of a Novel Standardized Household Income Indicator. Int J Environ Res Public Health 2020; 17:E1700. [PMID: 32150940 DOI: 10.3390/ijerph17051700] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 02/27/2020] [Accepted: 03/02/2020] [Indexed: 12/11/2022]
Abstract
The assessment of early life socioeconomic position (SEP) is essential to the tackling of social inequalities in health. Although different indicators capture different SEP dimensions, maternal education is often used as the only indicator in birth cohort research, especially in multi-cohort analyses. Household income, as a direct measure of material resources, is one of the most important indicators, but one that is underused because it is difficult to measure through questionnaires. We propose a method to construct a standardized, cross-cohort comparable income indicator, the “Equivalized Household Income Indicator (EHII)”, which measures the equivalized disposable household income, using external data from the pan-European Union Statistics on Income and Living Conditions (EUSILC) surveys, and data from the cohorts. We apply this method to four studies, Piccolipiù and NINFEA from Italy and ELFE and EDEN from France, comparing the distribution of EHII with other SEP-related variables available in the cohorts, and estimating the association between EHII and child body mass index (BMI). We found that basic parental and household characteristics may be used, with a fairly good performance, to predict the household income. We observed a strong correlation between EHII and both the self-reported income, whenever available, and other individual socioeconomic-related variables, and an inverse association with child BMI. EHII could contribute to improving research on social inequalities in health, in particular in the context of European birth cohort collaborative studies.
Collapse
|
27
|
Prescott SL, Hancock T, Bland J, van den Bosch M, Jansson JK, Johnson CC, Kondo M, Katz D, Kort R, Kozyrskyj A, Logan AC, Lowry CA, Nanan R, Poland B, Robinson J, Schroeck N, Sinkkonen A, Springmann M, Wright RO, Wegienka G. Eighth Annual Conference of inVIVO Planetary Health: From Challenges to Opportunities. Int J Environ Res Public Health 2019; 16:ijerph16214302. [PMID: 31694316 PMCID: PMC6861902 DOI: 10.3390/ijerph16214302] [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] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 10/29/2019] [Accepted: 10/29/2019] [Indexed: 11/19/2022]
Abstract
inVIVO Planetary Health (inVIVO) is a progressive scientific movement providing evidence, advocacy, and inspiration to align the interests and vitality of people, place, and planet. Our goal is to transform personal and planetary health through awareness, attitudes, and actions, and a deeper understanding of how all systems are interconnected and interdependent. Here, we present the abstracts and proceedings of our 8th annual conference, held in Detroit, Michigan in May 2019, themed “From Challenges, to Opportunities”. Our far-ranging discussions addressed the complex interdependent ecological challenges of advancing global urbanization, including the biopsychosocial interactions in our living environment on physical, mental, and spiritual wellbeing, together with the wider community and societal factors that govern these. We had a strong solutions focus, with diverse strategies spanning from urban-greening and renewal, nature-relatedness, nutritional ecology, planetary diets, and microbiome rewilding, through to initiatives for promoting resilience, positive emotional assets, traditional cultural narratives, creativity, art projects for personal and community health, and exploring ways of positively shifting mindsets and value systems. Our cross-sectoral agenda underscored the importance and global impact of local initiatives everywhere by contributing to new normative values as part of a global interconnected grass-roots movement for planetary health.
Collapse
Affiliation(s)
- Susan L. Prescott
- The ORIGINS Project, Telethon Kids Institute, University of Western Australia, Perth Childrens Hospital, Nedlands, WA 6009, Australia
- inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ 10704, USA;
- Correspondence:
| | - Trevor Hancock
- School of Public Health and Social Policy (retired), University of Victoria, Victoria, BC V8W 2Y2, Canada;
| | - Jeffrey Bland
- Personalized Lifestyle Medicine Institute, Tacoma, WA 98443, USA;
| | - Matilda van den Bosch
- Department of Forest and Conservation Sciences, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | - Janet K. Jansson
- Pacific Northwest National Laboratory, Biological Sciences Division, Richland, WA 99352, USA;
| | - Christine C. Johnson
- Henry Ford Health System and Center for Urban Responses to Environmental Stressors (CURES), Wayne State University Detroit, MI 48202, USA; (C.C.J.); (G.W.)
| | - Michelle Kondo
- USDA Forest Service, Northern Research Station, Philadelphia, PA 19103, USA;
| | - David Katz
- Yale-Griffin Prevention Research Center, Yale University, Derby, CT 06418, USA;
| | - Remco Kort
- Department of Molecular Cell Biology, VU University Amsterdam (VUA), 1081 HV Amsterdam, The Netherlands;
| | - Anita Kozyrskyj
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Alan C. Logan
- inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ 10704, USA;
| | - Christopher A. Lowry
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA;
| | - Ralph Nanan
- Charles Perkins Centre Nepean, University of Sydney, Camperdown, NSW 2006, Australia;
| | - Blake Poland
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T, Canada;
| | - Jake Robinson
- Department of Landscape, University of Sheffield, Sheffield S10 2TN, UK;
| | | | - Aki Sinkkonen
- Ecosystems and Environment Research Program, University of Helsinki, 15140 Lahti, Finland;
| | - Marco Springmann
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK;
| | - Robert O. Wright
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Ganesa Wegienka
- Henry Ford Health System and Center for Urban Responses to Environmental Stressors (CURES), Wayne State University Detroit, MI 48202, USA; (C.C.J.); (G.W.)
| |
Collapse
|
28
|
Peng C, Van Meel ER, Cardenas A, Rifas-Shiman SL, Sonawane AR, Glass KR, Gold DR, Platts-Mills TA, Lin X, Oken E, Hivert MF, Baccarelli AA, De Jong NW, Felix JF, Jaddoe VW, Duijts L, Litonjua AA, DeMeo DL. Epigenome-wide association study reveals methylation pathways associated with childhood allergic sensitization. Epigenetics 2019; 14:445-466. [PMID: 30876376 DOI: 10.1080/15592294.2019.1590085] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Epigenetic mechanisms integrate both genetic variability and environmental exposures. However, comprehensive epigenome-wide analysis has not been performed across major childhood allergic phenotypes. We examined the association of epigenome-wide DNA methylation in mid-childhood peripheral blood (Illumina HumanMethyl450K) with mid-childhood atopic sensitization, environmental/inhalant and food allergen sensitization in 739 children in two birth cohorts (Project Viva-Boston, and the Generation R Study-Rotterdam). We performed covariate-adjusted epigenome-wide association meta-analysis and employed pathway and regional analyses of results. Seven-hundred and five methylation sites (505 genes) were significantly cross-sectionally associated with mid-childhood atopic sensitization, 1411 (905 genes) for environmental and 45 (36 genes) for food allergen sensitization (FDR<0.05). We observed differential methylation across multiple genes for all three phenotypes, including genes implicated previously in innate immunity (DICER1), eosinophilic esophagitis and sinusitis (SIGLEC8), the atopic march (AP5B1) and asthma (EPX, IL4, IL5RA, PRG2, SIGLEC8, CLU). In addition, most of the associated methylation marks for all three phenotypes occur in putative transcription factor binding motifs. Pathway analysis identified multiple methylation sites associated with atopic sensitization and environmental allergen sensitization located in/near genes involved in asthma, mTOR signaling, and inositol phosphate metabolism. We identified multiple differentially methylated regions associated with atopic sensitization (8 regions) and environmental allergen sensitization (26 regions). A number of nominally significant methylation sites in the cord blood analysis were epigenome-wide significant in the mid-childhood analysis, and we observed significant methylation - time interactions among a subset of sites examined. Our findings provide insights into epigenetic regulatory pathways as markers of childhood allergic sensitization.
Collapse
Affiliation(s)
- Cheng Peng
- a Channing Division of Network Medicine, Department of Medicine , Brigham and Women's Hospital, Harvard Medical School , Boston , MA , USA
| | - Evelien R Van Meel
- b The Generation R Study Group, Erasmus MC , University Medical Center Rotterdam , Rotterdam , the Netherlands.,c Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC , University Medical Center Rotterdam , Rotterdam , the Netherlands
| | - Andres Cardenas
- d Division of Environmental Health Science , University of California, Berkeley, School of Public Health , Berkeley , CA , USA
| | - Sheryl L Rifas-Shiman
- e Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine , Harvard Medical School and Harvard Pilgrim Health Care Institute , Boston , MA , USA
| | - Abhijeet R Sonawane
- a Channing Division of Network Medicine, Department of Medicine , Brigham and Women's Hospital, Harvard Medical School , Boston , MA , USA
| | - Kimberly R Glass
- a Channing Division of Network Medicine, Department of Medicine , Brigham and Women's Hospital, Harvard Medical School , Boston , MA , USA.,f Department of Biostatistics , Harvard T.H Chan School of Public Health , Boston , MA , USA
| | - Diane R Gold
- a Channing Division of Network Medicine, Department of Medicine , Brigham and Women's Hospital, Harvard Medical School , Boston , MA , USA.,g Department of Environmental Health , Harvard T. H. Chan School of Public Health , Boston , MA , USA
| | - Thomas A Platts-Mills
- h Division of Allergy and Clinical Immunology , University of Virginia School of Medicine , Charlottesville , VA , USA
| | - Xihong Lin
- f Department of Biostatistics , Harvard T.H Chan School of Public Health , Boston , MA , USA.,i Department of Statistics , Harvard University , Cambridge , MA , USA
| | - Emily Oken
- e Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine , Harvard Medical School and Harvard Pilgrim Health Care Institute , Boston , MA , USA
| | - Marie-France Hivert
- e Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine , Harvard Medical School and Harvard Pilgrim Health Care Institute , Boston , MA , USA.,j Diabetes Unit , Massachusetts General Hospital , Boston , MA , USA
| | - Andrea A Baccarelli
- k Department of Environmental Health Sciences , Columbia University Mailman School of Public Health , New York , NY , USA
| | - Nicolette W De Jong
- l Department of Internal Medicine, Allergology, Erasmus MC , University Medical Center Rotterdam , Rotterdam , the Netherlands
| | - Janine F Felix
- b The Generation R Study Group, Erasmus MC , University Medical Center Rotterdam , Rotterdam , the Netherlands.,m Department of Epidemiology, Erasmus MC , University Medical Center Rotterdam , Rotterdam , the Netherlands.,n Department of Pediatrics, Erasmus MC , University Medical Center Rotterdam , Rotterdam , the Netherlands
| | - Vincent W Jaddoe
- b The Generation R Study Group, Erasmus MC , University Medical Center Rotterdam , Rotterdam , the Netherlands.,m Department of Epidemiology, Erasmus MC , University Medical Center Rotterdam , Rotterdam , the Netherlands.,n Department of Pediatrics, Erasmus MC , University Medical Center Rotterdam , Rotterdam , the Netherlands
| | - Liesbeth Duijts
- b The Generation R Study Group, Erasmus MC , University Medical Center Rotterdam , Rotterdam , the Netherlands.,c Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC , University Medical Center Rotterdam , Rotterdam , the Netherlands.,o Department of Pediatrics, Division of Neonatology , Erasmus MC, University Medical Center Rotterdam , Rotterdam , the Netherlands
| | - Augusto A Litonjua
- p Department of Pediatrics, Division of Pulmonary Medicine , University of Rochester Medical Center , Rochester , NY , USA
| | - Dawn L DeMeo
- a Channing Division of Network Medicine, Department of Medicine , Brigham and Women's Hospital, Harvard Medical School , Boston , MA , USA.,q Division of Pulmonary and Critical Care, Harvard Medical School , Department of Medicine, Brigham and Women's Hospital , Boston , MA , USA
| |
Collapse
|
29
|
Abstract
Previous research has shown how institutional changes, such as educational expansion, have weakened parental influence on educational attainment. We extend this analysis to occupational attainment and put forth a parental compensation hypothesis: as the origin-education (OE) association weakens, parents act to compensate for this in order to maintain their influence on the child's occupational attainment. We should see this as a strengthened origin-destination association net of education (net OD). Further, we study whether these compensatory actions are triggered by changes in educational institutions and whether the institutional changes that reduce educational inequality are the same ones that prompt parental compensation. We have linked data from five waves of the European Social Survey (2002-10) with data on educational institutions matched to birth cohorts born 1941-80 in 25 countries. We find weakened OE and strengthened net OD associations, supporting our parental compensation hypothesis. Multilevel mixed effects regression analyses reveal that reforms lengthening compulsory education, and the increased access to and the attainment of higher education have had a positive influence on parental compensation. As a conclusion, a later school leaving age seems to secure increased parental influence on children's occupational attainment, while parents seem to have reacted to a lesser extent on the changes in higher education.
Collapse
|
30
|
Abstract
OBJECTIVE To understand how to maximise recruitment of young infants with Down's syndrome (DS) into research through qualitative interviews with parents and care providers. In complex neonatal and genetic conditions such as DS, frequently diagnosed after birth, parents may go through a period of adaptation. These factors need consideration when overcoming barriers to recruitment. PARTICIPANTS AND DESIGN Participants, who were drawn from health professionals and volunteers working with families experiencing DS, were recruited using a purposive sampling strategy. Semistructured telephone interviews were completed with nine paediatricians, three research nurses and six family support workers. Five of those interviewed had a child with DS. The interviews were transcribed and analysed thematically. RESULTS A positive decision to take part in a 'from-birth' cohort study depends on factors such as the child's overall health, parent demographics (educational background and ethnicity), medical interactions that take place with the families (communication) and study logistics. The data suggest that recruitment methods need to take all these factors into consideration. Multiple recruitment methods should be considered including face to face, through parent and support groups, websites and social media. There also needs to be flexibility in the research timings to fit around the needs of the child and parents. CONCLUSION Researchers need to be aware of the variable responses elicited by families to a diagnosis of DS for their baby and be sensitive to the child's current medical status. This does not preclude recruitment into studies, but to maximise uptake good communication and flexibility is essential.
Collapse
Affiliation(s)
- Georgina M Williams
- The NIHR Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, UK,Diabetes and Metabolism, Translational Sciences, University of Bristol, Bristol, UK
| | - Patricia Neville
- Bristol Dental School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Kathleen M Gillespie
- Diabetes and Metabolism, Translational Sciences, University of Bristol, Bristol, UK
| | - Sam D Leary
- The NIHR Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, UK
| | - Julian P Hamilton-Shield
- The NIHR Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, UK
| | - Aidan J Searle
- The NIHR Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, UK
| |
Collapse
|
31
|
Bliddal M, Liew Z, Pottegård A, Kirkegaard H, Olsen J, Nohr EA. Examining Nonparticipation in the Maternal Follow-up Within the Danish National Birth Cohort. Am J Epidemiol 2018; 187:1511-1519. [PMID: 29346474 PMCID: PMC6030819 DOI: 10.1093/aje/kwy002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 07/06/2017] [Revised: 12/19/2017] [Accepted: 01/03/2018] [Indexed: 12/14/2022] Open
Abstract
A follow-up questionnaire on maternal health was distributed within the Danish National Birth Cohort (established in 1996-2002) 14 years after the index birth. Responses were obtained from 41,466 (53.2%) of 78,010 eligible mothers. To ensure the appropriate use of these data, the possibility of selection bias due to nonparticipation had to be evaluated. We estimated 4 selected exposure-outcome associations (prepregnancy weight-depression; exercise-degenerative musculoskeletal conditions; smoking-heart disease; and alcohol consumption-breast cancer). We adjusted for several factors associated with participation and applied inverse probability weighting. To estimate the degree of selection bias, we calculated relative odds ratios for the relationship between the baseline cohort and the subset participating in the Maternal Follow-up. Participating women were generally healthier, of higher social status, and older than the baseline cohort. However, selection bias in the chosen scenarios was limited; ratios of the odds ratios ranged from -14% to 5% after adjustment for age, parity, social status, and, if the variable was not the exposure variable, prepregnancy body mass index, exercise, smoking, and alcohol consumption. Applying inverse probability weighting did not further reduce bias. In conclusion, while participants differed somewhat from the baseline cohort, selection bias was limited after factors associated with participation status were accounted for.
Collapse
Affiliation(s)
| | - Zeyan Liew
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Anton Pottegård
- Research Unit of Clinical Pharmacology and Pharmacy, Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Helene Kirkegaard
- Research Unit of Gynecology and Obstetrics, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Ellen A Nohr
- Research Unit of Gynecology and Obstetrics, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
32
|
Lazarus JV, Bromberg DJ. Commentary on Trias-Llimós et al. (2017): Birth cohort research-an essential tool to guide public health interventions. Addiction 2017; 112:259-260. [PMID: 28078704 DOI: 10.1111/add.13679] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 10/24/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Jeffrey V Lazarus
- Barcelona Institute of Global Health (ISGlobal), Hospital Clinic, University of Barcelona, Barcelona, Spain.,CHIP-Centre for Health and Infectious Disease Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Daniel J Bromberg
- CHIP-Centre for Health and Infectious Disease Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
33
|
Jelenkovic A, Hur YM, Sund R, Yokoyama Y, Siribaddana SH, Hotopf M, Sumathipala A, Rijsdijk F, Tan Q, Zhang D, Pang Z, Aaltonen S, Heikkilä K, Öncel SY, Aliev F, Rebato E, Tarnoki AD, Tarnoki DL, Christensen K, Skytthe A, Kyvik KO, Silberg JL, Eaves LJ, Maes HH, Cutler TL, Hopper JL, Ordoñana JR, Sánchez-Romera JF, Colodro-Conde L, Cozen W, Hwang AE, Mack TM, Sung J, Song YM, Yang S, Lee K, Franz CE, Kremen WS, Lyons MJ, Busjahn A, Nelson TL, Whitfield KE, Kandler C, Jang KL, Gatz M, Butler DA, Stazi MA, Fagnani C, D'Ippolito C, Duncan GE, Buchwald D, Derom CA, Vlietinck RF, Loos RJ, Martin NG, Medland SE, Montgomery GW, Jeong HU, Swan GE, Krasnow R, Magnusson PK, Pedersen NL, Dahl-Aslan AK, McAdams TA, Eley TC, Gregory AM, Tynelius P, Baker LA, Tuvblad C, Bayasgalan G, Narandalai D, Lichtenstein P, Spector TD, Mangino M, Lachance G, Bartels M, van Beijsterveldt TC, Willemsen G, Burt SA, Klump KL, Harris JR, Brandt I, Nilsen TS, Krueger RF, McGue M, Pahlen S, Corley RP, Hjelmborg JVB, Goldberg JH, Iwatani Y, Watanabe M, Honda C, Inui F, Rasmussen F, Huibregtse BM, Boomsma DI, Sørensen TIA, Kaprio J, Silventoinen K. Genetic and environmental influences on adult human height across birth cohorts from 1886 to 1994. eLife 2016; 5. [PMID: 27964777 PMCID: PMC5156525 DOI: 10.7554/elife.20320] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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: 08/04/2016] [Accepted: 11/21/2016] [Indexed: 12/23/2022] Open
Abstract
Human height variation is determined by genetic and environmental factors, but it remains unclear whether their influences differ across birth-year cohorts. We conducted an individual-based pooled analysis of 40 twin cohorts including 143,390 complete twin pairs born 1886–1994. Although genetic variance showed a generally increasing trend across the birth-year cohorts, heritability estimates (0.69-0.84 in men and 0.53-0.78 in women) did not present any clear pattern of secular changes. Comparing geographic-cultural regions (Europe, North America and Australia, and East Asia), total height variance was greatest in North America and Australia and lowest in East Asia, but no clear pattern in the heritability estimates across the birth-year cohorts emerged. Our findings do not support the hypothesis that heritability of height is lower in populations with low living standards than in affluent populations, nor that heritability of height will increase within a population as living standards improve. DOI:http://dx.doi.org/10.7554/eLife.20320.001
Collapse
Affiliation(s)
- Aline Jelenkovic
- Department of Social Research, University of Helsinki, Helsinki, Finland.,Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country, Leioa, Spain
| | - Yoon-Mi Hur
- Department of Education, Mokpo National University, Jeonnam, South Korea
| | - Reijo Sund
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Yoshie Yokoyama
- Department of Public Health Nursing, Osaka City University, Osaka, Japan
| | - Sisira H Siribaddana
- Institute of Research & Development, Battaramulla, Sri Lanka.,Faculty of Medicine & Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Matthew Hotopf
- NIHR Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Athula Sumathipala
- Institute of Research & Development, Battaramulla, Sri Lanka.,Research Institute for Primary Care and Health Sciences, School for Primary Care Research, Faculty of Health, Keele University, Staffordshire, United Kingdom
| | - Fruhling Rijsdijk
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Qihua Tan
- Epidemiology, Biostatistics and Biodemography, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Dongfeng Zhang
- Department of Public Health, Qingdao University Medical College, Qingdao, China
| | - Zengchang Pang
- Department of Noncommunicable Diseases Prevention, Qingdao Centers for Disease Control and Prevention, Qingdao, China
| | - Sari Aaltonen
- Department of Social Research, University of Helsinki, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Kauko Heikkilä
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Sevgi Y Öncel
- Department of Statistics, Faculty of Arts and Sciences, Kirikkale University, Kirikkale, Turkey
| | - Fazil Aliev
- Faculty of Business, Karabuk University, Karabuk, Turkey.,Department of Psychology, Virginia Commonwealth University, Richmond, United States.,Department of African American Studies, Virginia Commonwealth University, Richmond, United States
| | - Esther Rebato
- Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country, Leioa, Spain
| | - Adam D Tarnoki
- Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary.,Hungarian Twin Registry, Budapest, Hungary
| | - David L Tarnoki
- Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary.,Hungarian Twin Registry, Budapest, Hungary
| | - Kaare Christensen
- The Danish Twin Registry, University of Southern Denmark, Odense, Denmark.,Department of Public Health, Epidemiology, Biostatistics & Biodemography, University of Southern Denmark, Odense, Denmark.,Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.,Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Axel Skytthe
- The Danish Twin Registry, University of Southern Denmark, Odense, Denmark.,Department of Public Health, Epidemiology, Biostatistics & Biodemography, University of Southern Denmark, Odense, Denmark
| | - Kirsten O Kyvik
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Judy L Silberg
- Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, United States
| | - Lindon J Eaves
- Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, United States
| | - Hermine H Maes
- Department of Human and Molecular Genetics, Psychiatry & Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, United States
| | - Tessa L Cutler
- The Australian Twin Registry, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Australia
| | - John L Hopper
- The Australian Twin Registry, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Australia.,Department of Epidemiology, School of Public Health, Seoul National University, Seoul, Korea
| | - Juan R Ordoñana
- Department of Human Anatomy and Psychobiology, University of Murcia, Murcia, Spain.,IMIB-Arrixaca, Murcia, Spain
| | - Juan F Sánchez-Romera
- IMIB-Arrixaca, Murcia, Spain.,Department of Developmental and Educational Psychology, University of Murcia, Murcia, Spain
| | - Lucia Colodro-Conde
- Department of Human Anatomy and Psychobiology, University of Murcia, Murcia, Spain.,QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Wendy Cozen
- Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, United States.,USC Norris Comprehensive Cancer Center, Los Angeles, United States
| | - Amie E Hwang
- Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, United States
| | - Thomas M Mack
- Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, United States.,USC Norris Comprehensive Cancer Center, Los Angeles, United States
| | - Joohon Sung
- Department of Epidemiology, School of Public Health, Seoul National University, Seoul, Korea.,Institute of Health and Environment, Seoul National University, Seoul, South-Korea
| | - Yun-Mi Song
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South-Korea
| | - Sarah Yang
- Department of Epidemiology, School of Public Health, Seoul National University, Seoul, Korea.,Institute of Health and Environment, Seoul National University, Seoul, South-Korea
| | - Kayoung Lee
- Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Carol E Franz
- Department of Psychiatry, University of California, San Diego, San Diego, United States
| | - William S Kremen
- Department of Psychiatry, University of California, San Diego, San Diego, United States.,VA San Diego Center of Excellence for Stress and Mental Health, La Jolla, CA, United States
| | - Michael J Lyons
- Department of Psychology, Boston University, Boston, United States
| | | | - Tracy L Nelson
- Department of Health and Exercise Sciences and Colorado School of Public Health, Colorado State University, Colorado, United States
| | | | | | - Kerry L Jang
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Margaret Gatz
- Department of Psychology, University of Southern California, Los Angeles, United States.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - David A Butler
- Health and Medicine Division, The National Academies of Sciences, Engineering, and Medicine, Washington, United States
| | - Maria A Stazi
- Istituto Superiore di Sanità - National Center for Epidemiology, Surveillance and Health Promotion, Rome, Italy
| | - Corrado Fagnani
- Istituto Superiore di Sanità - National Center for Epidemiology, Surveillance and Health Promotion, Rome, Italy
| | - Cristina D'Ippolito
- Istituto Superiore di Sanità - National Center for Epidemiology, Surveillance and Health Promotion, Rome, Italy
| | - Glen E Duncan
- Washington State Twin Registry, Washington State University - Health Sciences Spokane, Spokane, United States
| | - Dedra Buchwald
- Washington State Twin Registry, Washington State University, Seattle, United States
| | - Catherine A Derom
- Centre of Human Genetics, University Hospitals Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, Ghent University Hospitals, Ghent, Belgium
| | | | - Ruth Jf Loos
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, United States.,The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Nicholas G Martin
- Genetic Epidemiology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Sarah E Medland
- Genetic Epidemiology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Grant W Montgomery
- Molecular Epidemiology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Hoe-Uk Jeong
- Department of Education, Mokpo National University, Jeonnam, South Korea
| | - Gary E Swan
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, United States
| | - Ruth Krasnow
- Center for Health Sciences, SRI International, Menlo Park, United States
| | - Patrik Ke Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna K Dahl-Aslan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Institute of Gerontology and Aging Research Network - Jönköping (ARN-J), School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Tom A McAdams
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Thalia C Eley
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
| | - Per Tynelius
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Laura A Baker
- Department of Psychology, University of Southern California, Los Angeles, United States
| | - Catherine Tuvblad
- Department of Psychology, University of Southern California, Los Angeles, United States.,School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | | | - Danshiitsoodol Narandalai
- Healthy Twin Association of Mongolia, Ulaanbaatar, Mongolia.,Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Timothy D Spector
- Department of Twin Research and Genetic Epidemiology, King's College, London, United Kingdom
| | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology, King's College, London, United Kingdom
| | - Genevieve Lachance
- Department of Twin Research and Genetic Epidemiology, King's College, London, United Kingdom
| | - Meike Bartels
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, Netherlands
| | | | - Gonneke Willemsen
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, Netherlands
| | - S Alexandra Burt
- Michigan State University, East Lansing, Michigan, United States
| | - Kelly L Klump
- Michigan State University, East Lansing, Michigan, United States
| | | | | | | | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, United States
| | - Matt McGue
- Department of Psychology, University of Minnesota, Minneapolis, United States
| | - Shandell Pahlen
- Department of Psychology, University of Minnesota, Minneapolis, United States
| | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado, Boulder, United States
| | - Jacob V B Hjelmborg
- The Danish Twin Registry, University of Southern Denmark, Odense, Denmark.,Department of Public Health, Epidemiology, Biostatistics & Biodemography, University of Southern Denmark, Odense, Denmark
| | - Jack H Goldberg
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, United States
| | - Yoshinori Iwatani
- Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mikio Watanabe
- Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Chika Honda
- Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Fujio Inui
- Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan.,Faculty of Health Science, Kio University, Nara, Japan
| | - Finn Rasmussen
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Brooke M Huibregtse
- Institute for Behavioral Genetics, University of Colorado, Boulder, United States
| | - Dorret I Boomsma
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, Netherlands
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Centre for Basic Metabolic Research (Section on Metabolic Genetics), University of Copenhagen, Copenhagen, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, Copenhagen, Denmark
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Institute for Molecular Medicine FIMM, Helsinki, Finland
| | - Karri Silventoinen
- Department of Social Research, University of Helsinki, Helsinki, Finland.,Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan
| |
Collapse
|
34
|
Belgrave D, Henderson J, Simpson A, Buchan I, Bishop C, Custovic A. Disaggregating asthma: Big investigation versus big data. J Allergy Clin Immunol 2016; 139:400-407. [PMID: 27871876 PMCID: PMC5292995 DOI: 10.1016/j.jaci.2016.11.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 11/07/2016] [Accepted: 11/09/2016] [Indexed: 12/21/2022]
Abstract
We are facing a major challenge in bridging the gap between identifying subtypes of asthma to understand causal mechanisms and translating this knowledge into personalized prevention and management strategies. In recent years, “big data” has been sold as a panacea for generating hypotheses and driving new frontiers of health care; the idea that the data must and will speak for themselves is fast becoming a new dogma. One of the dangers of ready accessibility of health care data and computational tools for data analysis is that the process of data mining can become uncoupled from the scientific process of clinical interpretation, understanding the provenance of the data, and external validation. Although advances in computational methods can be valuable for using unexpected structure in data to generate hypotheses, there remains a need for testing hypotheses and interpreting results with scientific rigor. We argue for combining data- and hypothesis-driven methods in a careful synergy, and the importance of carefully characterized birth and patient cohorts with genetic, phenotypic, biological, and molecular data in this process cannot be overemphasized. The main challenge on the road ahead is to harness bigger health care data in ways that produce meaningful clinical interpretation and to translate this into better diagnoses and properly personalized prevention and treatment plans. There is a pressing need for cross-disciplinary research with an integrative approach to data science, whereby basic scientists, clinicians, data analysts, and epidemiologists work together to understand the heterogeneity of asthma.
Collapse
Affiliation(s)
| | - John Henderson
- School of Social and Community Medicine, Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Angela Simpson
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Iain Buchan
- Health Informatics, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | | | - Adnan Custovic
- Department of Paediatrics, Imperial College, London, United Kingdom.
| |
Collapse
|
35
|
Fuertes E, Markevych I, Bowatte G, Gruzieva O, Gehring U, Becker A, Berdel D, von Berg A, Bergström A, Brauer M, Brunekreef B, Brüske I, Carlsten C, Chan-Yeung M, Dharmage SC, Hoffmann B, Klümper C, Koppelman GH, Kozyrskyj A, Korek M, Kull I, Lodge C, Lowe A, MacIntyre E, Pershagen G, Standl M, Sugiri D, Wijga A, Heinrich J. Residential greenness is differentially associated with childhood allergic rhinitis and aeroallergen sensitization in seven birth cohorts. Allergy 2016; 71:1461-71. [PMID: 27087129 DOI: 10.1111/all.12915] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND The prevalence of allergic rhinitis is high, but the role of environmental factors remains unclear. We examined cohort-specific and combined associations of residential greenness with allergic rhinitis and aeroallergen sensitization based on individual data from Swedish (BAMSE), Australian (MACS), Dutch (PIAMA), Canadian (CAPPS and SAGE), and German (GINIplus and LISAplus) birth cohorts (n = 13 016). METHODS Allergic rhinitis (doctor diagnosis/symptoms) and aeroallergen sensitization were assessed in children aged 6-8 years in six cohorts and 10-12 years in five cohorts. Residential greenness was defined as the mean Normalized Difference Vegetation Index (NDVI) in a 500-m buffer around the home address at the time of health assessment. Cohort-specific associations per 0.2 unit increase in NDVI were assessed using logistic regression models and combined in a random-effects meta-analysis. RESULTS Greenness in a 500-m buffer was positively associated with allergic rhinitis at 6-8 years in BAMSE (odds ratio = 1.42, 95% confidence interval [1.13, 1.79]) and GINI/LISA South (1.69 [1.19, 2.41]) but inversely associated in GINI/LISA North (0.61 [0.36, 1.01]) and PIAMA (0.67 [0.47, 0.95]). Effect estimates in CAPPS and SAGE were also conflicting but not significant (0.63 [0.32, 1.24] and 1.31 [0.81, 2.12], respectively). All meta-analyses were nonsignificant. Results were similar for aeroallergen sensitization at 6-8 years and both outcomes at 10-12 years. Stratification by NO2 concentrations, population density, an urban vs rural marker, and moving did not reveal consistent trends within subgroups. CONCLUSION Although residential greenness appears to be associated with childhood allergic rhinitis and aeroallergen sensitization, the effect direction varies by location.
Collapse
|
36
|
Liu L, Yang X, Long Y, Mallhi AK, Mehta K, Veznedaroglu E, Yin X. Changes in the prevalence of hospitalization and comorbidity in US adults with stroke: A three decade cross-sectional and birth cohort analysis. Int J Stroke 2016; 11:987-998. [PMID: 27412189 DOI: 10.1177/1747493016660107] [Citation(s) in RCA: 2] [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: 11/15/2015] [Accepted: 06/09/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND PURPOSE Little attention was paid to the transition of care for stroke that may partially explain the long-term trend of stroke rates. We aimed to test the trend of hospitalization attributable to stroke in US adults. METHODS Data from National Hospital Discharge Surveys 1980-2010 in patients aged ≥18 (n = 6,527,304) were analyzed to examine the trend of patients with first-list diagnoses of stroke. Stroke comorbidities were classified in stroke patients with second- to seven-listed diagnoses of coronary heart disease, hypertension, diabetes, arrhythmias, or hyperlipidemia. Stroke trends by survey years and birth cohorts were analyzed using univariate, multivariate, and birth cohorts methods. RESULTS Of the total study sample, the prevalence of hospitalization due to stroke was 22.99%, 30.00%, and 27.03% in years of 1980-1989, 1990-1999, and 2000-2010 in males, and 17.30%, 22.04%, and 19.34% in females, respectively. Overall, hospitalization rates in stroke patients significantly increased among adults aged <65, and decreased in adults aged ≥65. There was an increase in stroke hospitalization rate in the old adults aged ≥65 in recent birth cohorts. Significant increased trends of comorbid hypertension, diabetes, arrhythmias, and hyperlipidemia were observed from 1980 to 2010. CONCLUSION A significant increase in stroke hospitalization rate was observed in adults aged <65 in the past three decades, and in old adults in recent years. Increases in stroke comorbidity rates were observed in all age groups. Findings from the study highlight that both public health and clinical practices face a serious challenge in controlling this unwelcome increased stroke trend.
Collapse
Affiliation(s)
- Longjian Liu
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, USA
| | - Xuan Yang
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, USA
| | - Yong Long
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, USA.,Department of Epidemiology, Fourth Military Medical University, Xi'an, China
| | - Arshpreet Kaur Mallhi
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, USA
| | - Kathan Mehta
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, USA.,Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, USA
| | - Erol Veznedaroglu
- Drexel Neurosciences Institute and Department of Neurosurgery, Drexel University College of Medicine, Philadelphia, USA
| | - Xiaoyan Yin
- Department of Medicine, University of Pennsylvania, Philadelphia, USA
| |
Collapse
|
37
|
Geulayov G, Metcalfe C, Gunnell D. Parental suicide attempt and offspring educational attainment during adolescence in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Psychol Med 2016; 46:2097-2107. [PMID: 27063954 DOI: 10.1017/s0033291716000556] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Few studies have investigated the impact of parental suicide attempt (SA) on offspring outcomes other than mental health. We investigated the association of parental SA with offspring educational attainment in the Avon Longitudinal Study of Parents and Children (ALSPAC). METHOD Parental SA was prospectively recorded from pregnancy until the study children were 11 years old. National school test results (ages 11-16 years) were obtained by record linkage. Multilevel regression models quantified the association between parental SA and offspring outcomes. RESULTS Data were available for 6667 mother-child and 3054 father-child pairs. Adolescents whose mothers had attempted suicide were less likely than their peers to achieve the expected educational level by age 14 years [adjusted odds ratio (aOR) 0.63, 95% confidence interval (CI) 0.41-0.95] in models controlling for relevant confounders, including parental education and depression. At age 16 years, adolescents whose mothers had attempted suicide were less likely to obtain the expected educational level (five or more qualifications at grade A*-C) (aOR 0.66, 95% CI 0.43-1.00) in models controlling for relevant confounders and parental education; however, after additionally controlling for maternal depression the results were consistent with chance (aOR 0.74, 95% CI 0.48-1.13). Findings in relation to paternal SA were consistent with those of maternal SA but power was limited due to lower response rate amongst fathers. CONCLUSIONS Maternal SA was associated with diminished educational performance at age 14 years. Educational attainment during adolescence can have substantial effect on future opportunities and well-being and these offspring may benefit from interventions.
Collapse
Affiliation(s)
- G Geulayov
- School of Social and Community Medicine,University of Bristol,Bristol,UK
| | - C Metcalfe
- School of Social and Community Medicine,University of Bristol,Bristol,UK
| | - D Gunnell
- School of Social and Community Medicine,University of Bristol,Bristol,UK
| |
Collapse
|
38
|
Prescott SL, Allen K, Armstrong K, Collins C, Dickinson H, Gardiner K, Jacka F, Jasoni C, Moore T, Moritz KM, Muhlhausler B, Siero W, Sim K, Nanan R, Saffery R, Singh G, Vickers MH, Craig JM. The establishment of DOHaD working groups in Australia and New Zealand. J Dev Orig Health Dis 2016; 7:433-9. [PMID: 27118250 DOI: 10.1017/S2040174416000167] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The evidence underpinning the developmental origins of health and disease (DOHaD) is overwhelming. As the emphasis shifts more towards interventions and the translational strategies for disease prevention, it is important to capitalize on collaboration and knowledge sharing to maximize opportunities for discovery and replication. DOHaD meetings are facilitating this interaction. However, strategies to perpetuate focussed discussions and collaborations around and between conferences are more likely to facilitate the development of DOHaD research. For this reason, the DOHaD Society of Australia and New Zealand (DOHaD ANZ) has initiated themed Working Groups, which convened at the 2014-2015 conferences. This report introduces the DOHaD ANZ Working Groups and summarizes their plans and activities. One of the first Working Groups to form was the ActEarly birth cohort group, which is moving towards more translational goals. Reflecting growing emphasis on the impact of early life biodiversity - even before birth - we also have a Working Group titled Infection, inflammation and the microbiome. We have several Working Groups exploring other major non-cancerous disease outcomes over the lifespan, including Brain, behaviour and development and Obesity, cardiovascular and metabolic health. The Epigenetics and Animal Models Working Groups cut across all these areas and seeks to ensure interaction between researchers. Finally, we have a group focussed on 'Translation, policy and communication' which focusses on how we can best take the evidence we produce into the community to effect change. By coordinating and perpetuating DOHaD discussions in this way we aim to enhance DOHaD research in our region.
Collapse
|
39
|
Abstract
This review addresses predictors of remission or persistence of wheezing and asthma from early childhood through adulthood. Early childhood wheezing is common, but predicting who will remit or have persistent childhood asthma remains difficult. By adding parental history of asthma and selected infant biomarkers to the history of recurrent wheezing, the Asthma Predictive Index and its subsequent modifications provide better predictions of persistence than simply the observation of recurrent wheeze. Sensitization, especially to multiple allergens, increases the likelihood of development of classic childhood asthma. Remission is more likely in male subjects and those with milder disease (less frequent and less severe symptoms), less atopic sensitization, a lesser degree of airway hyperresponsiveness, and no concomitant allergic disease. Conversely, persistence is linked strongly to allergic sensitization, greater frequency and severity of symptoms, abnormal lung function, and a greater degree of airway hyperresponsiveness. A genetic risk score might predict persistence more accurately than family history. Remission of established adult asthma is substantially less common than remission during childhood and adolescence. Loss of lung function can begin early in life and tracks through childhood and adolescence. Despite therapy which controls symptoms and exacerbations, the outcomes of asthma appear largely resistant to pharmacologic therapy.
Collapse
Affiliation(s)
- Malcolm R Sears
- Department of Medicine, Faculty of Health Sciences, de Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
| |
Collapse
|
40
|
Abstract
The fields of microbial surveillance, discovery, and pathogenesis are evolving rapidly with introduction of cultivation-independent molecular diagnostic assays and highly multiplexed serologic analyses, as well as the development of animal models and prospective birth cohorts that can provide insights into host and microbial determinants of health and disease. Here, past, present, and future perspectives on these fields are provided.
Collapse
Affiliation(s)
- W Ian Lipkin
- Center for Infection and Immunity, Columbia University, New York, New York
| |
Collapse
|
41
|
Canova C, Zabeo V, Pitter G, Romor P, Baldovin T, Zanotti R, Simonato L. Association of maternal education, early infections, and antibiotic use with celiac disease: a population-based birth cohort study in northeastern Italy. Am J Epidemiol 2014; 180:76-85. [PMID: 24853109 DOI: 10.1093/aje/kwu101] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
We conducted a population-based birth cohort study of approximately 203,000 babies born in northeastern Italy (1989-2012) to investigate perinatal variables, early infections leading to hospital admission, and antibiotic use in the first 12 months of life as possible risk factors for celiac disease (CD). Incident CD cases were identified from pathology reports, hospital discharge records, and exemptions from prescription charges for clinical tests. Multivariate Poisson regression models were fitted to estimate incidence rate ratios (IRRs). A total of 1,227 children had CD; CD was histopathologically confirmed in 866 (71%). Female sex, maternal age, and high maternal educational level were found to be significantly associated with CD. Gastrointestinal infections were strongly associated with a subsequent diagnosis of CD (IRR = 2.04, 95% confidence interval (CI): 1.30, 3.22). Antibiotic use was significantly associated with CD onset (IRR = 1.24, 95% CI: 1.07, 1.43), with a dose-response relationship for number of courses (P-trend < 0.01). Cephalosporin use strongly increased the risk of CD (IRR = 1.42, 95% CI: 1.18, 1.73). Use of antibiotics (supported by the dose-response relationship) and gastrointestinal infections in the first year of life may facilitate the early onset of CD by altering intestinal microflora and the gut mucosal barrier. Perinatal factors, including cesarean section, had little influence on the risk of childhood CD.
Collapse
|
42
|
Bousquet J, Gern JE, Martinez FD, Anto JM, Johnson CC, Holt PG, Lemanske RF, Le Souëf PN, Tepper RS, von Mutius ERM, Arshad SH, Bacharier LB, Becker A, Belanger K, Bergström A, Bernstein DI, Cabana MD, Carroll KN, Castro M, Cooper PJ, Gillman MW, Gold DR, Henderson J, Heinrich J, Hong SJ, Jackson DJ, Keil T, Kozyrskyj AL, Lødrup Carlsen KC, Miller RL, Momas I, Morgan WJ, Noel P, Ownby DR, Pinart M, Ryan PH, Schwaninger JM, Sears MR, Simpson A, Smit HA, Stern DA, Subbarao P, Valenta R, Wang X, Weiss ST, Wood R, Wright AL, Wright RJ, Togias A, Gergen PJ. Birth cohorts in asthma and allergic diseases: report of a NIAID/NHLBI/MeDALL joint workshop. J Allergy Clin Immunol 2014; 133:1535-46. [PMID: 24636091 DOI: 10.1016/j.jaci.2014.01.018] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 01/16/2014] [Accepted: 01/21/2014] [Indexed: 11/30/2022]
Abstract
Population-based birth cohorts on asthma and allergies increasingly provide new insights into the development and natural history of the diseases. More than 130 birth cohorts focusing on asthma and allergy have been initiated in the last 30 years. A National Institute of Allergy and Infectious Diseases; National Heart, Lung, and Blood Institute; Mechanisms of the Development of Allergy (MeDALL; Framework Programme 7 of the European Commission) joint workshop was held in Bethesda, Maryland, on September 11-12, 2012, with 3 objectives: (1) documenting the knowledge that asthma/allergy birth cohorts have provided, (2) identifying the knowledge gaps and inconsistencies, and (3) developing strategies for moving forward, including potential new study designs and the harmonization of existing asthma birth cohort data. The meeting was organized around the presentations of 5 distinct workgroups: (1) clinical phenotypes, (2) risk factors, (3) immune development of asthma and allergy, (4) pulmonary development, and (5) harmonization of existing birth cohorts. This article presents the workgroup reports and provides Web links (AsthmaBirthCohorts.niaid.nih.gov or www.medall-fp7.eu), where the reader will find tables describing the characteristics of the birth cohorts included in this report, the type of data collected at differing ages, and a selected bibliography provided by the participating birth cohorts.
Collapse
Affiliation(s)
- Jean Bousquet
- University Hospital, Montpellier and INSERM U1018, Villejuif, France.
| | - James E Gern
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | | | - Josep M Anto
- Centre for Research in Environmental Epidemiology (CREAL) and IMIM (Hospital del Mar Research Institute) and CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra, Departament de Ciències Experimentals i de la Salut, Barcelona, Spain
| | - Christine C Johnson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Mich
| | - Patrick G Holt
- Telethon Institute for Child Health Research, University of Western Australia, and Queensland Children's Medical Research Institute, University of Queensland, Brisbane, Australia
| | - Robert F Lemanske
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, Princess Margaret Hospital for Children, University of Western Australia, Perth, Australia
| | - Robert S Tepper
- Indiana University School of Medicine, James Whitcomb Riley Hospital for Children, Indianapolis, Ind
| | | | - S Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, and the David Hide Asthma and Allergy Research Centre, Isle of Wight, United Kingdom
| | | | - Allan Becker
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kathleen Belanger
- Center for Perinatal, Pediatric and Environmental Epidemiology, Yale School of Public Health, School of Medicine, New Haven, Conn
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - David I Bernstein
- Division of Immunology, Allergy and Rheumatology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Michael D Cabana
- Departments of Pediatrics, Epidemiology & Biostatistics, the University of California, San Francisco, Calif
| | - Kecia N Carroll
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn
| | - Mario Castro
- Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, Mo
| | - Philip J Cooper
- Liverpool School of Tropical Medicine, Liverpool, and Escuela de Biologia, Pontificia Universidad Catolica del Ecuador, Quito, Ecuador
| | - Matthew W Gillman
- Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Mass
| | - Diane R Gold
- Channing Division of Network Medicine, Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, and Harvard School of Public Health, Department of Environmental Health, Boston, Mass
| | - John Henderson
- School of Social & Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Joachim Heinrich
- Helmholtz Zentrum, Muenchen, German Center for Environmental Health, Institute of Epidemiology I, Munich, Germany
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Daniel J Jackson
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitaetsmedizin Berlin, Berlin, and Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Anita L Kozyrskyj
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | | | - Rachel L Miller
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University, New York, NY
| | - Isabelle Momas
- Department of Public Health and Biostatistics, Paris Descartes University, Sorbonne, and Paris Municipal Department of Social Action, Childhood, and Health, Paris, France
| | - Wayne J Morgan
- Department of Pediatrics, University of Arizona, Tucson, Ariz
| | - Patricia Noel
- Division of Lung Diseases, National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health, Bethesda, Md
| | | | - Mariona Pinart
- Centre for Research in Environmental Epidemiology (CREAL) and IMIM (Hospital del Mar Research Institute) and CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Patrick H Ryan
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Julie M Schwaninger
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Malcolm R Sears
- Department of Medicine, AstraZeneca Chair in Respiratory Epidemiology, McMaster University, Hamilton, Ontario, Canada
| | - Angela Simpson
- Centre for Respiratory and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, University of Manchester and University Hospital of South Manchester, Manchester, United Kingdom
| | - Henriette A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Debra A Stern
- Arizona Respiratory Center, University of Arizona, Tucson, Ariz
| | - Padmaja Subbarao
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Rudolf Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Xiaobin Wang
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md
| | - Scott T Weiss
- Harvard Medical School, Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Robert Wood
- Department of Pediatrics, Division of Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Anne L Wright
- Arizona Respiratory Center and the Department of Pediatrics, University of Arizona College of Medicine, Tucson, Ariz
| | - Rosalind J Wright
- Department of Pediatrics and Mindich Child Health & Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Alkis Togias
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Peter J Gergen
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| |
Collapse
|
43
|
|
44
|
Vrijheid M, Casas M, Bergström A, Carmichael A, Cordier S, Eggesbø M, Eller E, Fantini MP, Fernández MF, Fernández-Somoano A, Gehring U, Grazuleviciene R, Hohmann C, Karvonen AM, Keil T, Kogevinas M, Koppen G, Krämer U, Kuehni CE, Magnus P, Majewska R, Andersen AMN, Patelarou E, Petersen MS, Pierik FH, Polanska K, Porta D, Richiardi L, Santos AC, Slama R, Sram RJ, Thijs C, Tischer C, Toft G, Trnovec T, Vandentorren S, Vrijkotte TGM, Wilhelm M, Wright J, Nieuwenhuijsen M. European birth cohorts for environmental health research. Environ Health Perspect 2012; 120:29-37. [PMID: 21878421 PMCID: PMC3261945 DOI: 10.1289/ehp.1103823] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 08/29/2011] [Indexed: 05/03/2023]
Abstract
BACKGROUND Many pregnancy and birth cohort studies investigate the health effects of early-life environmental contaminant exposure. An overview of existing studies and their data is needed to improve collaboration, harmonization, and future project planning. OBJECTIVES Our goal was to create a comprehensive overview of European birth cohorts with environmental exposure data. METHODS Birth cohort studies were included if they a) collected data on at least one environmental exposure, b) started enrollment during pregnancy or at birth, c) included at least one follow-up point after birth, d) included at least 200 mother-child pairs, and e) were based in a European country. A questionnaire collected information on basic protocol details and exposure and health outcome assessments, including specific contaminants, methods and samples, timing, and number of subjects. A full inventory can be searched on www.birthcohortsenrieco.net. RESULTS Questionnaires were completed by 37 cohort studies of > 350,000 mother-child pairs in 19 European countries. Only three cohorts did not participate. All cohorts collected biological specimens of children or parents. Many cohorts collected information on passive smoking (n = 36), maternal occupation (n = 33), outdoor air pollution (n = 27), and allergens/biological organisms (n = 27). Fewer cohorts (n = 12-19) collected information on water contamination, ionizing or nonionizing radiation exposures, noise, metals, persistent organic pollutants, or other pollutants. All cohorts have information on birth outcomes; nearly all on asthma, allergies, childhood growth and obesity; and 26 collected information on child neurodevelopment. CONCLUSION Combining forces in this field will yield more efficient and conclusive studies and ultimately improve causal inference. This impressive resource of existing birth cohort data could form the basis for longer-term and worldwide coordination of research on environment and child health.
Collapse
Affiliation(s)
- Martine Vrijheid
- Centre for Research in Environmental Epidemiology, Doctor Aiguader 88, Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Abstract
Many studies have cited the importance of secular changes or "period effects" as causes of the U.S. obesity epidemic. Unfortunately, relatively little attention has been devoted to the possible influence of cohort-related mechanisms. To address this current gap in the scientific literature, this investigation utilized the responses from 1.7 million participants in the 1976-2002 National Health Interview Surveys to determine how birth cohorts may have contributed to the rapid increase in the prevalence of obesity. Results from hierarchical age-period-cohort (HAPC) models confirmed that period effects are principally responsible for the U.S. obesity epidemic. However, HAPC models also demonstrated that birth cohort membership is influential. Independent of age and period effects, the predicted probability of obesity at age 25 increased by 30% for cohorts born between 1955 and 1975. Our results also showed that age, period and cohort effects varied by race/gender and educational attainment. For instance, increases in the predicted probabilities of obesity were particularly sharp for recent cohorts of Black females. Our investigation successfully demonstrated that both secular change and birth cohort membership have independently contributed to elevated odds of obesity among recent generations of Americans, suggesting that cohort-specific strategies may be needed to combat disconcertingly high rates of obesity in the U.S.
Collapse
Affiliation(s)
- Eric N Reither
- Utah State University, Department of Sociology, Logan, UT 84322-0730, USA.
| | | | | |
Collapse
|
46
|
Abstract
Epidemiological studies investigating associations between early life factors and adult health are often limited to studying exposures that can be reliably recalled in adulthood or obtained from existing medical records. There are few US studies with detailed data on the pre- and postnatal environment whose study populations are now in adulthood; one exception is the Collaborative Perinatal Project (CPP). We contacted former female participants of the New York site of the CPP who were born from 1959 to 1963 and were prospectively followed for 7 years to examine whether the pre- and postnatal environment is associated with adult health in women 40 years after birth. The New York CPP cohort is particularly diverse; at enrolment, the race/ethnicity distribution of mothers was approximately 30% White, 40% Black and 30% Puerto Rican. Of the 841 eligible women, we successfully traced 375 women (45%) and enrolled 262 women (70% of those traced). Baseline data were available for all eligible women, and we compared those who participated with the remaining cohort (n = 579). Higher family socio-economic status at age 7, availability of maternal social security number, and White race/ethnicity were statistically significantly associated with a higher probability of tracing. Of those traced, race/ethnicity was associated with participation, with Blacks and Puerto Ricans less likely to participate than Whites (OR = 0.5, 95% CI 0.3, 0.8, and OR = 0.5, 95% CI 0.3, 1.0, respectively). In addition, higher weight at 7 years was associated with lower participation (OR = 0.95, 95% CI 0.92, 0.99), but this association was observed only among the non-White participants. None of the other maternal characteristics, infant or early childhood growth measures was associated with participation or with tracing, either overall or within each racial/ethnic subgroup. Daughters' recall of early life factors such as pre-eclampsia (sensitivity = 24%) and birthweight were generally poor, with the latter varying by category of birthweight with the highest sensitivity for the largest babies (81%) and the lowest sensitivity for the smallest babies (54%). These data reinforce the need to rejuvenate existing birth cohorts with prospective data for life course studies of adult health. Understanding the factors that are associated with tracing and participation in these existing cohorts will help in interpreting the validity and generalisability of the findings from these invaluable cohorts.
Collapse
Affiliation(s)
- Mary Beth Terry
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, USA.
| | - Julie Flom
- Department of Epidemiology, Columbia University, Mailman School of Public Health
| | - Parisa Tehranifar
- Department of Epidemiology, Columbia University, Mailman School of Public Health
| | - Ezra Susser
- Department of Epidemiology, Columbia University, Mailman School of Public Health,The Imprints Center for Genetic and Environmental Lifecourse Studies, Columbia University, Mailman School of Public Health,New York State Psychiatric Institute, New York, USA
| |
Collapse
|
47
|
Abstract
Evidence is accumulating that the pattern of growth in childhood is associated with development of cardiovascular disease in adulthood, but such evidence comes mostly from developed countries. We conducted a review of studies from countries undergoing the nutrition transition. Five birth cohorts with measures of child growth and outcomes through adolescence were identified, from China, India, Guatemala, Brazil and the Philippines. Across studies there are major differences in data availability and in statistical approaches to modelling child growth and its effects. Nevertheless, generally consistent associations of growth failure in early childhood and development of overweight in later childhood with the risk of elevated blood pressure, glucose, and serum lipids in adulthood were observed. As these cohorts mature they will provide a wealth of critical information on the relation between early life factors and later disease risk, and efforts should be made to ensure ongoing follow-up using standardized approaches and more comprehensive assessments.
Collapse
Affiliation(s)
- Aryeh D Stein
- Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | | | | |
Collapse
|