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Power JM, Hannigan C, Scharf T, Moynihan S, Walsh C, Johnson N, Lawlor B, Holton E, Kee F. 221 BEFRIENDING SERVICES ARE ASSOCIATED WITH LESS DECLINE IN HEALTH-RELATED QUALITY OF LIFE, BUT NOT COGNITIVE FUNCTION, OVER TIME. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Befriending services are commonly deployed in the support of older people living alone, but lack an established evidence base, particularly in relation to their association with health outcomes.
Methods
To explore the potentially therapeutic impact of befriending on Health-Related Quality-of-Life (HR-QoL) and cognitive function, we used a single case experimental design. Data were collected from 85 new users of ALONE’s befriending service between 2019 and 2021 in an AB multiple baseline design. Generalised additive modelling was then used to assess trajectories of HR-QoL and cognitive function (semantic fluency) over the course of six months, and its association with the onset of the befriending service intervention
Results
The befriending service was associated with less decline over time in HR-QoL, and with a mitigated impact of loneliness on HR-QoL too. No such effects were observed for cognitive function as an outcome, which did not change over time.
Conclusion
Befriending may exert a positive effect on health-related quality of life, and reduce the negative impact that loneliness has on this outcome.
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Affiliation(s)
- JM Power
- Maynooth University , Maynooth, Ireland
| | - C Hannigan
- National College of Ireland , Dublin, Ireland
| | - T Scharf
- Newcastle University , Newcastle, United Kingdom
| | | | - C Walsh
- University of Limerick , Limerick, Ireland
| | | | - B Lawlor
- Trinity College Dublin , Dublin, Ireland
| | - E Holton
- Maynooth University , Maynooth, Ireland
| | - F Kee
- Queen's University Belfast , Belfast, United Kingdom
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2
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Arnold N, Blaum C, Gossling A, Zeller T, Linneberg A, Soderberg S, Iacoviello L, Sans S, Leoni V, Kee F, Salomaa V, Kuulasmaa K, Blankenberg S, Koenig W, Waldeyer C. C-reactive protein as a possible modifier of Lipoprotein(a)-related risk for coronary heart disease in Europe: results from the BiomarCARE project. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Lipoprotein(a) (Lp(a)) represents a unique proatherogenic lipoprotein with potent pro-thrombotic and pro-inflammatory properties. Recent studies demonstrated that Lp(a)-associated risk for cardiovascular disease (CVD) was significantly increased only in individuals with a high inflammatory burden (i.e. hsCRP levels >2 mg/L). However, these results have been either based on a post-hoc analysis in a highly selected study population with a high/very high CVD risk, or conducted within a multi-ethnic population with significant variation in Lp(a) levels.
Purpose
The main aim was to investigate whether hsCRP concentration modulates the predictive value of Lp(a) for coronary heart disease (CHD) events in the general population across Europe.
Methods
Data of 87,760 participants from 10 European prospective population-based cohorts, participating in the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE)-project, were used for the present analysis (79,958 subjects without and 7,189 individuals with established CHD at baseline (primary/secondary prevention cohorts, respectively)). All Lp(a) measurements were performed in the central BiomarCaRE laboratory. Fine and Gray competing risk-adjusted models stratified by study cohort were calculated to assess the association between Lp(a) levels and future CHD events stratified according to hsCRP levels (<1 mg/l, ≥1–<2 mg/l and ≥2 mg/l).
Results
During a median follow-up of 11.3 years, 4,928 events occurred in the CHD-free subpopulation and 1,772 events occurred in the CHD subpopulation. In the primary prevention cohort, increased Lp(a) was significantly associated with future CHD events irrespective of hsCRP: Hazard ratios (HRs) for future CHD events (top vs bottom quintile (Q) of Lp(a) distribution) were 1.46 (95% CI: 1.21–1.78; p<0.001) in those having a hsCRP concentration <1 mg/l; 1.32 (95% CI: 1.09–1.61; p=0.0052) for a hsCRP group of ≥1-<2 mg/l and 1.40 (95% CI: 1.22–1.61; p<0.001) in subjects with a hsCRP concentration ≥2 mg/l, after multivariable adjustment for traditional CV risk factors including LDL-Ccorr and lipid-lowering medication. In contrast, in the secondary prevention, we found no association between increased Lp(a) levels and CHD events in individuals with a very low inflammatory burden (HR for hsCRP <1 mg/l 0.92 (95% CI 0.63–1.34), p=0.66, Q5 vs Q1)), whereas the association was significant among subjects with a hsCRP concentration ≥1 mg/l (HRs: 1.43 (95% CI: 1.01–2.03; p=0.045) for hsCRP group ≥1-<2 mg/l and 1.35 (95% CI: 1.07–1.71; p=0.013) for hsCRP group ≥2 mg/l (both for Q5 vs Q1)).
Conclusion
In a primary prevention setting, Lp(a) was associated with incident CHD irrespective of the inflammatory burden. In contrast, among subjects with known CHD, the association of Lp(a) and future CHD events was only present in those with hsCRP levels >1 mg/l. These findings might guide target population selection for upcoming Lp(a)-targeting compounds.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): This work was supported by the 7th Framework Programme Collaborative Project (grant agreement no. HEALTH-F2-2011-278913). The MORGAM Project has received funding from EU projects MORGAM (Biomed, BMH4-CT98-3183), GenomEUtwin (Fifth Framework Programme FP5, QLG2-CT-2002-01254), ENGAGE (FP7, HEALTH-F4-2007-201413), CHANCES (FP7, HEALTH-F3-2010-242244), BiomarCaRE (FP7, HEALTH-F2-2011-278913), euCanSHare (Horizon 2020, No. 825903) and AFFECT-EU (Horizon 2020, No. 847770); and Medical Research Council, London (G0601463, No. 80983: Biomarkers in the MORGAM Populations).
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Affiliation(s)
- N Arnold
- University Heart and Vascular Center Hamburg , Hamburg , Germany
| | - C Blaum
- University Heart and Vascular Center Hamburg , Hamburg , Germany
| | - A Gossling
- University Heart and Vascular Center Hamburg , Hamburg , Germany
| | - T Zeller
- University Heart and Vascular Center Hamburg , Hamburg , Germany
| | - A Linneberg
- Bispebjerg University Hospital, Center for Clinical Research and Prevention , Copenhagen , Denmark
| | - S Soderberg
- Umea University Hospital, Department of Public Health and Clinical Medicine , Umea , Sweden
| | - L Iacoviello
- Irccs I.N.M. Neuromed, Department of Epidemiology and Prevention , Pozzilli , Italy
| | - S Sans
- Catalan Department of Health , Barcelona , Spain
| | - V Leoni
- University of Milan Bicocca, Laboratory of Clinical Chemistry , Milan , Italy
| | - F Kee
- Queen's University of Belfast, Centre for Public Health , Belfast , United Kingdom
| | - V Salomaa
- National Institute for Health and Welfare (THL), Department of Public Health , Helsinki , Finland
| | - K Kuulasmaa
- National Institute for Health and Welfare (THL), Department of Public Health , Helsinki , Finland
| | - S Blankenberg
- University Heart and Vascular Center Hamburg , Hamburg , Germany
| | - W Koenig
- Technical University of Munich, German Heart Center , Munich , Germany
| | - C Waldeyer
- University Heart and Vascular Center Hamburg , Hamburg , Germany
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3
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Haller PM, Gossling A, Brenner H, Iacoviello L, Kee F, Linneberg A, Thorand B, Salomaa V, Soederberg S, Voelzke H, Sans S, Palmieri L, Veronesi G, Blankenberg S, Westermann D. Biomarker-based prediction of fatal and non-fatal cardiovascular outcomes in individuals of the general population with and without diabetes mellitus. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Cardiovascular biomarkers may reflect different aspects of cardiovascular disease, including myocardial tissue damage (high-sensitive cardiac troponin [hs-cTn]), hemodynamic stress (N-terminal prohormone of brain natriuretic peptide [NT-proBNP)), or inflammation (high-sensitivity C-reactive protein [hs-CRP]).
Purpose
To determine the risk for fatal and non-fatal cardiovascular events in patients with diabetes mellitus (DM), a high-risk group for cardiovascular complications, after accounting for these biomarkers and to determine the risk associated with these biomarkers.
Methods
Harmonized data of population-based studies from the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomaCaRE) and MOnica Risk, Genetics, Archiving and Monograph (MORGAM) consortia were used to calculate hazard ratios (HRs, 95% confidence intervals [CI] per standard deviation) for these biomarkers adjusted for diabetes, patient characteristics and biomarkers for their association with the primary endpoint of fatal and non-fatal cardiovascular events during a median follow-up of 9.6 years (maximum 28 years). Additionally, a years-of-life-lost analysis was conducted stratified by prevalent diabetes and specific biomarker cut-offs known to be associated with increased risk for events (hs-cTnI >5 ng/L, NTproBNP >125 ng/L, hs-CRP >5mg/L).
Results
We included 95,302 individuals, of whom 6,501 had DM (6.8%). Cox-regression analysis revealed DM to be independently associated with the primary endpoint (2.1 [95% CI 1.9, 2.3], p<0.001) despite adjustment for clinical characteristics and biomarkers. Also, all three biomarkers were independent predictors themselves: log-transformed NT-proBNP 1.3 [95% CI 1.3, 1.4] p<0.001; log-transformed hs-CRP 1.2 [95% CI 1.1, 1.2] p<0.001; third-root-transformed hs-cTnI 1.1 [95% CI 1.0, 1.1] p=0.0038). The sex-, age- and cohort-adjusted HR for the primary endpoint according to absolute biomarker concentrations derived by cox-regression models using cubic splines is provided for the three biomarkers in Figure 1. Upon dichotomization of biomarkers, individuals with diabetes and at least one elevated biomarker lost a median of 15.5 healthy years because of the primary endpoint (Kaplan-Meier plot in Figure 2, with age on the x-axis).
Conclusion
Our findings confirm that diabetes confers a residual cardiovascular risk beyond adjustment for clinical characteristics and cardiovascular biomarker. Furthermore, biomarkers may aid in the identification of patients at highest risk, which should be considered in future models of risk prediction.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- P M Haller
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - A Gossling
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - H Brenner
- German Cancer Research Center, Division of Clinical Epidemiology and Aging Research , Heidelberg , Germany
| | - L Iacoviello
- Irccs I.N.M. Neuromed, Department of Epidemiology and Prevention , Pozzilli , Italy
| | - F Kee
- Queen's University of Belfast, Centre for Public Health , Belfast , United Kingdom
| | - A Linneberg
- Bispebjerg and Frederiksberg Hospital, Center for Clinical Research and Prevention , Copenhagen , Denmark
| | - B Thorand
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Epidemiology , Neuherberg , Germany
| | - V Salomaa
- Finnish Institute for Health and Welfare, Department of Public Health and Welfare , Helsinki , Finland
| | - S Soederberg
- Umea University, Department of Public Health and Clinical Medicine , Umea , Sweden
| | - H Voelzke
- University of Greifswald, Institut für Community Medicine, Funktionsbereich SHIP/KEF , Greifswald , Germany
| | - S Sans
- Catalan Department of Health , Barcelona , Spain
| | - L Palmieri
- Istituto Superiore di Sanità, Department of Cardiovascular, Endocrine-metabolic Diseases and Aging , Rome , Italy
| | - G Veronesi
- University of Insubria, Research Center in Epidemiology and Preventive Medicine (EPIMED) , Varese , Italy
| | - S Blankenberg
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - D Westermann
- University Heart & Vascular Center Hamburg , Hamburg , Germany
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4
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Dobra R, Davies J, Elborn S, Kee F, Madge S, Boeri M. 46: A discrete choice experiment (DCE) to quantify the influence of trial features on the decision to participate in CF trials. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01471-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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5
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Camen S, Csengeri D, Geelhoed B, Gianfagna F, Soderberg S, Kee F, Blankenberg S, Lochen ML, Iacoviello L, Tunstall-Pedoe H, Joergensen T, Salomaa V, Linneberg A, Kuulasmaa K, Schnabel RB. Risk factors, subsequent disease onset and prognostic impact of myocardial infarction and atrial fibrillation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Myocardial infarction (MI) is a known risk factor for incident atrial fibrillation (AF), while AF frequently complicates acute MI. Although both diseases share common cardiovascular risk factors, the direction and strength of the association of the risk factors with disease onset, subsequent disease incidence and mortality are not completely understood.
Purpose
Our goal was to define the temporal relationship of MI and AF and the association of cardiovascular risk factors with disease incidence in order to determine whether common clinical risk factors show different associations with incident MI or AF. We further aimed to investigate predictors of subsequent disease onset and the impact of subsequent disease diagnosis on mortality.
Methods
In pooled multivariable Cox regression analyses we examined temporal relations of disease onset and identified predictors of MI, AF and subsequent all-cause mortality in 108,363 individuals (median age 46.0 years, 48.2% men) free of MI and AF at baseline from six European population-based cohorts.
Results
Over a maximum follow-up of 10.0 years 3558 (3.3%) individuals were diagnosed exclusively with MI, 1922 (1.8%) with AF but no MI, and 491 (0.5%) individuals developed both MI and AF. Association of male sex, systolic blood pressure, antihypertensive treatment and diabetes mellitus appeared to be stronger with incident MI than with AF, whereas increasing age and body mass index showed a higher risk for incident AF. Total cholesterol and daily smoking were significantly related to incident MI but not AF. The combined population attributable fraction of the cardiovascular risk factors was over 70% for incident MI, whereas it was only about one quarter for incident AF. Subsequent MI after incident AF (hazard ratio1.68, 95% CI 1.03–2.74) and subsequent AF after MI (hazard ratio 1.75, 95% CI 1.31–2.34) both significantly increased overall mortality risk.
Conclusions
Subsequent diagnosis of MI and AF was associated with a significant increase in mortality, irrespective of the first event. We found different associations of common cardiovascular risk factors with incident MI and AF indicating distinct pathophysiological pathways in disease development.
Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Union's Horizon 2020 research and innovation programme (grant agreement No 847770, AFFECT-EU) European Union's Horizon 2020 research and innovation programme (grant agreement No 648131)
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Affiliation(s)
- S Camen
- University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - D Csengeri
- University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - B Geelhoed
- University Heart & Vascular Center Hamburg, Hamburg, Germany
| | | | - S Soderberg
- Umea University, Department of Public Health and Clinical Medicine, and Heart Centre, Umea, Sweden
| | - F Kee
- Queen's University of Belfast, Belfast, United Kingdom
| | - S Blankenberg
- University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - M L Lochen
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
| | | | | | - T Joergensen
- Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - V Salomaa
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - A Linneberg
- Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - K Kuulasmaa
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - R B Schnabel
- University Heart & Vascular Center Hamburg, Hamburg, Germany
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6
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Smyth LJ, Kilner J, Nair V, Liu H, Brennan E, Kerr K, Sandholm N, Cole J, Dahlström E, Syreeni A, Salem RM, Nelson RG, Looker HC, Wooster C, Anderson K, McKay GJ, Kee F, Young I, Andrews D, Forsblom C, Hirschhorn JN, Godson C, Groop PH, Maxwell AP, Susztak K, Kretzler M, Florez JC, McKnight AJ. Assessment of differentially methylated loci in individuals with end-stage kidney disease attributed to diabetic kidney disease: an exploratory study. Clin Epigenetics 2021; 13:99. [PMID: 33933144 PMCID: PMC8088646 DOI: 10.1186/s13148-021-01081-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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] [Received: 12/08/2020] [Accepted: 04/15/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND A subset of individuals with type 1 diabetes mellitus (T1DM) are predisposed to developing diabetic kidney disease (DKD), the most common cause globally of end-stage kidney disease (ESKD). Emerging evidence suggests epigenetic changes in DNA methylation may have a causal role in both T1DM and DKD. The aim of this exploratory investigation was to assess differences in blood-derived DNA methylation patterns between individuals with T1DM-ESKD and individuals with long-duration T1DM but no evidence of kidney disease upon repeated testing to identify potential blood-based biomarkers. Blood-derived DNA from individuals (107 cases, 253 controls and 14 experimental controls) were bisulphite treated before DNA methylation patterns from both groups were generated and analysed using Illumina's Infinium MethylationEPIC BeadChip arrays (n = 862,927 sites). Differentially methylated CpG sites (dmCpGs) were identified (false discovery rate adjusted p ≤ × 10-8 and fold change ± 2) by comparing methylation levels between ESKD cases and T1DM controls at single site resolution. Gene annotation and functionality was investigated to enrich and rank methylated regions associated with ESKD in T1DM. RESULTS Top-ranked genes within which several dmCpGs were located and supported by functional data with methylation look-ups in other cohorts include: AFF3, ARID5B, CUX1, ELMO1, FKBP5, HDAC4, ITGAL, LY9, PIM1, RUNX3, SEPTIN9 and UPF3A. Top-ranked enrichment pathways included pathways in cancer, TGF-β signalling and Th17 cell differentiation. CONCLUSIONS Epigenetic alterations provide a dynamic link between an individual's genetic background and their environmental exposures. This robust evaluation of DNA methylation in carefully phenotyped individuals has identified biomarkers associated with ESKD, revealing several genes and implicated key pathways associated with ESKD in individuals with T1DM.
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Affiliation(s)
- L J Smyth
- Molecular Epidemiology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, UK.
| | - J Kilner
- Molecular Epidemiology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - V Nair
- Internal Medicine, Department of Nephrology, University of Michigan, Ann Arbor, MI, USA
| | - H Liu
- Department of Department of Medicine/ Nephrology, Department of Genetics, Institute of Diabetes, Obesity and Metabolism, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - E Brennan
- Diabetes Complications Research Centre, Conway Institute of Biomolecular and Biomedical Research, School of Medicine, University College Dublin, Dublin 4, Ireland
| | - K Kerr
- Molecular Epidemiology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - N Sandholm
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - J Cole
- Programs in Metabolism and Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Division of Endocrinology and Center for Basic and Translational Obesity Research, Boston Children's Hospital, Boston, MA, USA.,Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - E Dahlström
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - A Syreeni
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - R M Salem
- Department of Family Medicine and Public Health, UC San Diego, San Diego, CA, USA
| | - R G Nelson
- Chronic Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | - H C Looker
- Chronic Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | - C Wooster
- Molecular Epidemiology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - K Anderson
- Molecular Epidemiology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - G J McKay
- Molecular Epidemiology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - F Kee
- Molecular Epidemiology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - I Young
- Molecular Epidemiology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - D Andrews
- Diabetes Complications Research Centre, Conway Institute of Biomolecular and Biomedical Research, School of Medicine, University College Dublin, Dublin 4, Ireland
| | - C Forsblom
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - J N Hirschhorn
- Programs in Metabolism and Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Division of Endocrinology and Center for Basic and Translational Obesity Research, Boston Children's Hospital, Boston, MA, USA.,Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - C Godson
- Diabetes Complications Research Centre, Conway Institute of Biomolecular and Biomedical Research, School of Medicine, University College Dublin, Dublin 4, Ireland
| | - P H Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - A P Maxwell
- Molecular Epidemiology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, UK.,Regional Nephrology Unit, Belfast City Hospital, Belfast, Northern Ireland, UK
| | - K Susztak
- Department of Department of Medicine/ Nephrology, Department of Genetics, Institute of Diabetes, Obesity and Metabolism, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - M Kretzler
- Internal Medicine, Department of Nephrology, University of Michigan, Ann Arbor, MI, USA
| | - J C Florez
- Programs in Metabolism and Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Division of Endocrinology and Center for Basic and Translational Obesity Research, Boston Children's Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - A J McKnight
- Molecular Epidemiology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, UK
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7
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Dobra R, Elborn JS, Madge S, Allen L, Boeri M, Kee F, Goundry S, Purcell T, Saunders C, Davies JC. Guiding the rational design of patient-centred drug trials in Cystic Fibrosis: A Delphi study. J Cyst Fibros 2021; 20:986-993. [PMID: 33895096 DOI: 10.1016/j.jcf.2021.03.021] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/19/2021] [Accepted: 03/30/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Making trials more patient-centred improves recruitment and retention, patient satisfaction and makes research accessible to a more representative population. We aimed to understand the factors that influence participation and engagement in clinical trials in cystic fibrosis (CF) trials to guide the rational design and delivery of patient-centred trials. METHODS We used a Delphi process, supported by extensive literature review and 3 workshops, to determine which factors stakeholders think exert significant influence in participation and engagement in CF trials. Panellists were recruited from across the UK and the study was administered online. RESULTS We had representation from 19 CF centres; 28 people with CF (pwCF), 26 parents and 30 healthcare professionals (HCPs). Panels were presented with a shortlist of 104 factors and asked which they thought influence participation and engagement in CF trials. After 3 iterations, 43 statements met consensus for pwCF, 48 for the parents and 69 for the HCPs. CONCLUSIONS We identified many targets to make trials more patient-centred. Whilst some require an overhaul of trial delivery, many are relatively easy to implement. We outline a list of 'dos and don'ts' for sponsors and research teams including: focus on good communication; recognise that lack of time is the greatest barrier to trial participation so minimise the frequency and length of visits; help participants fit trials around busy lives; remember trial participation can be a major life-event and support participants accordingly; and don't underestimate the impact of simple strategies e.g. on-site access to Wifi and cups of tea.
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Affiliation(s)
- R Dobra
- National Heart Lung Institute, Imperial College London, London, United Kingdom; Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield Trust, London, United Kingdom.
| | - J S Elborn
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, United Kingdom
| | - S Madge
- Department of Adult Cystic Fibrosis, Royal Brompton and Harefield Trust, London, United Kingdom
| | - L Allen
- Clinical Trials Accelerator Platform, Cystic Fibrosis Trust, United Kingdom
| | - M Boeri
- RTI Health Solutions, Health Preference Assessment, Belfast, United Kingdom
| | - F Kee
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, United Kingdom
| | - S Goundry
- Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - T Purcell
- Department of Adult Cystic Fibrosis, Royal Brompton and Harefield Trust, London, United Kingdom
| | - C Saunders
- National Heart Lung Institute, Imperial College London, London, United Kingdom
| | - J C Davies
- National Heart Lung Institute, Imperial College London, London, United Kingdom; Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield Trust, London, United Kingdom
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8
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O'Neill RA, Maxwell AP, Paterson EN, Kee F, Young I, Hogg RE, Cruise S, Murphy S, McGuinness B, McKay GJ. Retinal microvascular parameters are not significantly associated with mild cognitive impairment in the Northern Ireland Cohort for the Longitudinal Study of Ageing. BMC Neurol 2021; 21:112. [PMID: 33706706 PMCID: PMC7948373 DOI: 10.1186/s12883-021-02137-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 08/23/2020] [Accepted: 03/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The retinal and cerebral microvasculature share similar embryological origins and physiological characteristics. Improved imaging technologies provide opportunistic non-invasive assessment of retinal microvascular parameters (RMPs) against cognitive outcomes. We evaluated baseline measures for associations between RMPs and mild cognitive impairment (MCI) from participants of the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA). METHODS RMPs (central retinal arteriolar / venular equivalents, arteriole to venular ratio, fractal dimension and tortuosity) were measured from optic disc centred fundus images and analysed using semi-automated software. Associations between RMPs and MCI were assessed by multivariable logistic regression with adjustment for potential confounders including age, sex, alcohol consumption, smoking status, educational attainment, physical activity, cardiovascular disease (CVD), hypertension, mean arterial blood pressure, triglycerides, diabetes, body mass index, and high density lipoprotein levels. P < 0.05 was considered statistically significant. RESULTS Data were available for 1431 participants, of which 156 (10.9%) were classified with MCI defined by a Montreal Cognitive Assessment (MoCA) score ≤ 26, with subjective cognitive decline, in the absence of depression or problems with activities of daily living. Participants had a mean age of 62.4 ± 8.5 yrs. and 52% were female. As expected, individuals with MCI had a lower MoCA score than those without (23.5 ± 2.6 versus 26.3 ± 2.7, respectively), were more likely to be female, have a lower level of educational attainment, be less physically active, more likely to have CVD, have higher levels of triglycerides and lower levels of high density lipoprotein. No significant associations between RMPs and MCI were detected in unadjusted, minimally adjusted or fully adjusted regression models or subsequent sensitivity analyses. CONCLUSION Previous studies have reported both increased retinal venular calibre and reduced fractal dimension in association with mild cognitive impairment. Our study failed to detect any associations between RMPs and those individuals at an early stage of cognitive loss in an older community-based cohort.
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Affiliation(s)
- R A O'Neill
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - A P Maxwell
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - E N Paterson
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - F Kee
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - I Young
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - R E Hogg
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - S Cruise
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - S Murphy
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - B McGuinness
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - G J McKay
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland.
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9
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O'Neill RA, Maxwell AP, Kee F, Young I, Hogg RE, Cruise S, McGuinness B, McKay GJ. Association of reduced retinal arteriolar tortuosity with depression in older participants from the Northern Ireland Cohort for the Longitudinal Study of Ageing. BMC Geriatr 2021; 21:62. [PMID: 33446119 PMCID: PMC7809811 DOI: 10.1186/s12877-021-02009-z] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/04/2021] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION The retina shares similar anatomical and physiological features with the brain and subtle variations in retinal microvascular parameters (RMPs) may reflect similar vascular variation in the brain. The aim of this study was to assess associations between RMPs and measures of depression in the Northern Ireland Cohort for the Longitudinal Study of Ageing. METHODS RMPs (arteriolar and venular caliber, fractal dimension and tortuosity) were measured from optic disc centred fundus images using semi-automated software. Depression was characterised by the Centre for Epidemiologic Studies Depression Scale (CES-D) in the absence of mild cognitive impairment or use of anti-depressive medications. Associations between depression and RMPs were assessed by regression analyses with adjustment for potential confounders. RESULTS Data were available for 1376 participants of which 113 (8.2%) and 1263 (91.8%) were classified with and without depression. Participants had a mean age of 62.0 ± 8.4 yrs., 52% were female, and 8% were smokers. Individuals with depression had a higher CES-D score than those without (22.0 ± 6.2 versus 4.4 ± 3.9). Lower values of arteriolar tortuosity were significantly associated with depression, before and after adjustment for potential confounders (odds ratio = 0.79; 95% confidence intervals: 0.65, 0.96; P = 0.02). CONCLUSION Decreased retinal arteriolar tortuosity, a measure of the complexity of the retinal microvasculature was associated with depression in older adults independent of potential confounding factors. Retinal measures may offer opportunistic assessment of microvascular health associated with outcomes of depression.
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Affiliation(s)
- R A O'Neill
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - A P Maxwell
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - F Kee
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - I Young
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - R E Hogg
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - S Cruise
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - B McGuinness
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - G J McKay
- Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland.
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10
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O'Neill RA, Maxwell AP, Kee F, Young I, McGuinness B, Hogg RE, Gj M. Association of retinal venular tortuosity with impaired renal function in the Northern Ireland Cohort for the Longitudinal Study of Ageing. BMC Nephrol 2020; 21:382. [PMID: 32883218 PMCID: PMC7469276 DOI: 10.1186/s12882-020-02031-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 08/20/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Previous studies have identified retinal microvascular features associated with renal dysfunction. Biopsies are necessary to confirm kidney microvascular damage and retinal imaging may enable evaluation of microangiopathic characteristics reflecting renal changes associated with chronic kidney disease (CKD). We evaluated retinal microvascular parameters (RMPs) for associations with renal function in a cross-sectional analysis of the Northern Ireland Cohort for the Longitudinal Study of Ageing. METHODS RMPs (central retinal arteriolar/ venular equivalents [CRAE/CRVE], arteriolar to venular ratio [AVR], fractal dimension and tortuosity) were measured from optic disc centred fundus images using semi-automated software. Associations were assessed with multivariable regression analyses between RMPs and estimated glomerular filtration rate (eGFR) defined by serum creatinine (eGFRscr) and cystatin C (eGFRcys) and also CKD status characterised by eGFR < 60 mL/min/1.73m2. Regression models were adjusted for potential confounders including age, sex, diabetes, smoking status, educational attainment, cardiovascular disease, body mass index, antihypertensive medication, systolic blood pressure, triglycerides, high- and low-density lipoprotein levels. RESULTS Data were included for 1860 participants that had measures of renal function and retinal fundus images of sufficient quality for analysis. Participants had a mean age of 62.0 ± 8.5 yrs. and 53% were female. The mean eGFR for scr and cys were 82.2 ± 14.9 mL/min/1.73m2 and 70.7 ± 18.6 mL/min/1.73m2 respectively. eGFRcys provided lower estimates than eGFRscr resulting in a greater proportion of participants categorised as having CKD stages 3-5 (eGFRcys 26.8%; eGFRscr 7.9%). Multivariable regression analyses showed that increased venular tortuosity (OR = 1.30; 95%CI: 1.10, 1.54; P < 0.01) was associated with CKD stages 3-5 characterised by eGFRscr < 60 mL/min/1.73 m2. No additional associations between CKD status characterised by eGFRscr or with eGFRcys, were detected (P > 0.05). Multivariable regression failed to detect associations between CRAE, CRVE, AVR, fractal dimension or tortuosity and eGFRscr or eGFRcys (P > 0.05). CONCLUSION Increased retinal venular tortuosity was associated with CKD stages 3-5 defined by eGFRscr < 60 mL/min/1.73 m2, in an older population independent of potential confounding factors. These retinal measures may provide non-invasive microvascular assessment of associations with CKD.
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Affiliation(s)
- R A O'Neill
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - A P Maxwell
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - F Kee
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - I Young
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - B McGuinness
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - R E Hogg
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - McKay Gj
- Centre for Public Health, Queens University Belfast, Belfast, UK.
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11
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Hicks B, Veronesi G, Ferrario M, Cesana G, Iacoviello L, Palmieri L, Kuulasmaa K, Soderberg S, Sans S, Kee F. Differential susceptibility to allostatic load and educational inequalities in coronary heart disease. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Differential exposure to lifestyle factors may mediate the association between education and cardiovascular disease (CVD). However, differential susceptibility (the effect of exposure to the same “dose” of risk factors differs across groups) may also elevate CVD risk but the causal pathways remain unclear. Allostatic Load (AL) is a marker of cumulative biological burden resulting from mal-adaptation to chronic stressors. We aimed to examine the role of differential exposure and susceptibility to AL and other factors in coronary heart disease (CHD) educational gradients in Europe.
Methods
51,328 35-74-year-old participants originally free of CVD from 21 European cohorts in the BiomarCaRE consortium were identified and followed for a median of 10 years to their first CHD event. We defined an AL score as the sum of z-scores of 8 markers from the cardiovascular, metabolic, and inflammatory systems. To investigate the mediating role of AL (and smoking, alcohol and BMI) on educational differences in CHD incidence we applied marginal structural models and three-way decomposition on gender-specific additive hazards models.
Results
AL was a significant mediator of the association between educational status and CHD. The highest proportion mediated was observed in women, with 28% (95%CI 20% to 44%) attributable to differential exposure and 8% (95%CI 0% to 16%) to differential susceptibility. In men, AL mediated 16% of the increased CHD risk in the less educated, with 2% (95%CI 0%-6%) attributable to differential susceptibility. The effects of smoking, alcohol and BMI were relatively small for men and women, with a limited role of differential susceptibility.
Conclusions
While we found evidence of differential susceptibility to AL on CHD, effects were modest and the mediating effect of AL (and other lifestyle factors) was predominately via differential exposure. Controlling disproportionate exposure to AL may help reduce CHD morbidity among those with lower education.
Key messages
Educational inequalities in coronary heart disease in Europe were predominantly driven by differential exposure rather than susceptibility to allostatic load and other lifestyle factors. Controlling disproportionate exposure to AL may help reduce coronary heart disease morbidity among those with lower education.
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Affiliation(s)
- B Hicks
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - G Veronesi
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - M Ferrario
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - G Cesana
- Research Centre on Public Health, Department of Medicine, University of Milano Bicocca, Monza, Italy
| | - L Iacoviello
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
| | - L Palmieri
- Department of Cardiovascular, Endocrine-metabolic Disease, National Institutes of Health-ISS, Rome, Italy
| | - K Kuulasmaa
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - S Soderberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - S Sans
- Catalan Department of Health, Catalan Department of Health, Barcelona, Spain
| | - F Kee
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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12
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Logan D, McEvoy CT, McKenna G, Kee F, Linden G, Woodside JV. Association between oral health status and future dietary intake and diet quality in older men: The PRIME study. J Dent 2019; 92:103265. [PMID: 31862215 DOI: 10.1016/j.jdent.2019.103265] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 11/04/2019] [Revised: 12/11/2019] [Accepted: 12/15/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES This study investigated whether oral health status, defined as number of natural teeth and subsequent prosthodontic rehabilitation, was associated with future dietary intake and diet quality in older adults in The Prospective Epidemiological Study of Myocardial Infarction (PRIME). METHODS PRIME was originally established to explore cardiovascular risk factors in 50-59 year old men in Northern Ireland (1991-1994). A rescreening phase assessed oral health (2001-2004), while diet was assessed in 2015. Diet quality was characterised by the Dietary Diversity Score and Mediterranean Diet Score. In the current analysis, associations between oral health status, dietary intake and quality were assessed using regression models in 1096 participants. RESULTS Amongst study participants, the overall mean number of teeth was 18.5, 51.5 % had ≥21 natural teeth and 49.6 % wore dentures. Oral health status was categorised into five groups: 21-28 teeth with (n = 111) and without (n = 453) dentures, 1-20 teeth with (n = 354) and without (n = 99) dentures and edentate with dentures (n = 79). After full adjustment, men with ≥21 teeth and dentures had a higher future intake of fruit, vegetables, and nuts, and diet quality scores, compared to those with <21 teeth with dentures. Edentate men with dentures were less likely to achieve the future fruit dietary recommendation. CONCLUSIONS Having ≥21 natural remaining teeth positively affected the future intake of fruit, vegetables, and nuts, as well as diet quality. Dentures may be beneficial in men with ≥21 natural remaining teeth, as they were associated with an increased future intake of fruit, vegetables, and nuts and better diet quality. CLINICAL SIGNIFICANCE Oral health status is associated with dietary intake, after an average time period of 13 years, with those with a larger number of natural teeth having a better diet quality. Further research is required to investigate this relationship in larger, diverse populations with more detailed dietary assessment.
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Affiliation(s)
- D Logan
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BA, United Kingdom
| | - C T McEvoy
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BA, United Kingdom
| | - G McKenna
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BA, United Kingdom
| | - F Kee
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BA, United Kingdom
| | - G Linden
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BA, United Kingdom
| | - J V Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BA, United Kingdom
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13
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Schrage B, Ruebsamen N, Thorand B, Koenig W, Soederberg S, Wahlin A, Mathiesen E, Njolstad I, Kee F, Linneberg A, Kuulasmaa K, Salomaa V, Blankenberg S, Zeller T, Karakas M. P6226Association of functional iron deficiency with incident cardiovascular diseases and mortality in the general population. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Functional iron deficiency (FID) has been established as a risk factor in patients with cardiovascular diseases (CVD). As opposed to absolute iron deficiency, it reflects stored iron as well as utilized iron and allows for a more accurate evaluation of individual iron status. However, evidence is scant on the relevance of FID to the incidence of CVD in the general population.
Aim
This study aimed to evaluate the association of FID with incident cardiovascular diseases and mortality endpoints in a large population-based cohort.
Methods
FID was defined as either ferritin below 100 μg/L or ferritin between 100 and 299 μg/L and transferrin saturation below 20%. Only individuals free of CVD at baseline from three population-based European cohorts were included. Multivariable-adjusted sex- and cohort-stratified Cox regression analyses were performed to evaluate the association of functional iron deficiency with incident cardiovascular diseases (coronary heart disease, cerebral infarction, heart failure and atrial fibrillation) as well as with all-cause and cardiovascular mortality. Adjustments were performed for sex (as strata), age (as time scale), smoking, total cholesterol, systolic blood pressure, diabetes, body mass index and high-sensitive C-reactive protein.
Results
In total, N=12146 individuals were included in the analysis with a median age of 59.0 years (25thpercentile 45.0, 75thpercentile 68.0), and 45.2% men. Incidence of FID was 64.3%. Median follow-up times were 12.3 to 21.8 years, with an all-cause mortality rate of 18.2% and a cardiovascular mortality rate of 6.2%. Incident coronary heart disease, cerebral infarction, heart failure and atrial fibrillation were observed in 8.7%, 6.5%, 5.9% and 11.7%, respectively.
FID was significantly associated with all-cause mortality (hazard ratio (HR) 1.12, 95% confidence interval (CI) 1.01–1.24, p=0.034), cardiovascular death (HR 1.26, 95% CI 1.03–1.54, p=0.027) and incident coronary heart disease (HR 1.23, 95% CI 1.06–1.43, p<0.01). There was no significant association with the other tested endpoints.
Conclusion
In our analysis of population-based cohorts, FID showed a significant positive association with all-cause as well as cardiovascular mortality and incident coronary heart disease. Further research is needed to validate the role of FID as a cardiovascular risk factor in the general population and to evaluate the impact of iron supplementation on gender and outcome.
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Affiliation(s)
- B Schrage
- University Heart Center Hamburg, Department for General and Interventional Cardiology, Hamburg, Germany
| | - N Ruebsamen
- University Heart Center Hamburg, Department for General and Interventional Cardiology, Hamburg, Germany
| | - B Thorand
- Helmholtz Center Munich - German Research Center for Environment and Health, Munich, Germany
| | - W Koenig
- Deutsches Herzzentrum Muenchen Technical University of Munich, Munich, Germany
| | | | | | | | | | - F Kee
- UKCRC Centre of Excellence for Public Health Northern Ireland (NI), Belfast, United Kingdom
| | - A Linneberg
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | - K Kuulasmaa
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - V Salomaa
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - S Blankenberg
- University Heart Center Hamburg, Department for General and Interventional Cardiology, Hamburg, Germany
| | - T Zeller
- University Heart Center Hamburg, Department for General and Interventional Cardiology, Hamburg, Germany
| | - M Karakas
- University Heart Center Hamburg, Department for General and Interventional Cardiology, Hamburg, Germany
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14
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Rothenbacher D, Rehm M, Iacoviello L, Tunstall-Pedoe H, Soederberg S, Salomaa V, Linneberg A, Sans S, Thorand B, Kee F, Kuulasmaa K, Waldeyer C, Zeller T, Blankenberg S, Koenig W. P3398Cystatin C based eGFR estimation compared to crea-based estimation equation for assessing risk of cardiovascular and total mortality in population-based studies and patients with manifest CVD. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Chronic kidney disease (CKD) represents a global public health problem and affects a large proportion of the adult population worldwide. Early detection, adequate risk stratification and specific treatment can prevent or delay the adverse effects of CKD.
Purpose
To assess cardiovascular risk and total mortality of subjects with CKD using cystatin C based and Crea-based estimated glomerular filtration rate (eGFR) equations (CKDEpi) in the general population, in diseased cohorts, and in specific subgroups.
Methods
The present study has been conducted within the BiomarCaRE project, with harmonized data from 21 population-based cohorts from 6 European countries and 3 cardiovascular disease (CVD) cohorts from Germany. Cox proportional hazards models were used to assess hazard ratios (HRs) for the various CKD definitions with adverse outcomes and mortality after adjustment for age, sex, cohort, smoking status, body mass index, history of diabetes, history of hypertension, and total cholesterol.
Results
21 population-based cohorts (n=76,954, median age 51 years, 52.2% men, 4.4% diabetic) and 3 diseased cohorts (n=4,982, median age 63 years, 75.6% men, 18.7% diabetic) with an average follow-up between 2.8 and 23.5 years and between 0.5 and 9.4 years, respectively, were included in the analysis. Prevalence of CKD-stage 3–5 by CKD-EPIcrea and CKD-EPIcys eGFR respectively, was 3.4% and 7.3% in the population-based cohorts and 13.9% and 14.4% in the diseased cohorts. In the population-based cohorts the incidence (per 1000 person years) of a non-fatal or fatal CVD event and total mortality respectively, was 10.0 and 11.8, whereas it was 21.2 and 17.8 in the diseased cohorts. In the population-based cohorts the HR for a CVD-event was 1.32 (95% CI 1.21–1.44) for the population with CKD-EPIcrea stage 3–5 and it was 1.47 (95% CI 1.35–1.60) based on CKD-EPIcys after adjustment for covariates. The HR for total mortality for those with CKD-EPIcrea stage 3–5 was 1.31 (1.21–1.41) and for CKD-EPIcys it was 1.86 (95% CI 1.73–2.00). Discrepancies between CKD-EPIcrea and CKD-EPIcys were even more striking across subgroups with and without diabetes or across specific age groups.
Conclusion
CKD is an important risk factor for subsequent CVD events and total mortality. However, point estimates of CKD-EPIcrea and CKD-EPIcys eGFR differ considerably between specific risk groups. Therefore, the clinical utility of both equations in different risk groups has to be considered and should be evaluated further.
Acknowledgement/Funding
7th framework programme collaborative project, grant agreement no. HEALTH-F2-2011-278913
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Affiliation(s)
- D Rothenbacher
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - M Rehm
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - L Iacoviello
- IRCCS Istituto Neurologico Mediterraneo Neuromed, Department of Epidemiology and Prevention, Laboratory of Molecular and Nutritional Epidemiology, Pozzilli, Italy
| | - H Tunstall-Pedoe
- University of Dundee, Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, Dundee, United Kingdom
| | - S Soederberg
- Umea University, Department of Public Health and Clinical Medicine, Umea, Sweden
| | - V Salomaa
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - A Linneberg
- Bispebjerg and Frederiksberg Hospital, Center for Clinical Research and Prevention, Copenhagen, Denmark
| | - S Sans
- Catalan Department of Health, Barcelona, Spain
| | - B Thorand
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
| | - F Kee
- Queens University of Belfast, UK Clinical Research Collaboration Centre of Excellence for Public Health, Belfast, United Kingdom
| | - K Kuulasmaa
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - C Waldeyer
- University Heart Center Hamburg, Clinic for General and Interventional Cardiology, Hamburg, Germany
| | - T Zeller
- University Heart Center Hamburg, Clinic for General and Interventional Cardiology, Hamburg, Germany
| | - S Blankenberg
- University Heart Center Hamburg, Clinic for General and Interventional Cardiology, Hamburg, Germany
| | - W Koenig
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
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15
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Camen S, Ojeda FM, Niiranen T, Gianfagna F, Soderberg S, Lochen ML, Kee F, Blankenberg S, Joergensen T, Zeller T, Kuulasmaa K, Linneberg A, Salomaa V, Iacoviello L, Schnabel R. P1000Temporal relations between atrial fibrillation and ischemic stroke and their prognostic impact on mortality. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p1000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Camen
- University Heart Center Hamburg, Hamburg, Germany
| | - F M Ojeda
- University Heart Center Hamburg, Hamburg, Germany
| | - T Niiranen
- Framingham Heart Study, Framingham, United States of America
| | | | | | - M L Lochen
- UiT The Arctic University of Norway, Tromso, Norway
| | - F Kee
- Queen's University of Belfast, Belfast, United Kingdom
| | | | - T Joergensen
- Bispebjerg and Frederiksberg Hospital, Center for Clinical Research and Prevention, Copenhagen, Denmark
| | - T Zeller
- University Heart Center Hamburg, Hamburg, Germany
| | - K Kuulasmaa
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - A Linneberg
- Bispebjerg and Frederiksberg Hospital, Center for Clinical Research and Prevention, Copenhagen, Denmark
| | - V Salomaa
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | | | - R Schnabel
- University Heart Center Hamburg, Hamburg, Germany
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16
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Csengeri D, Spruenker NA, Di Castelnuovo A, Niiranen T, Soederberg S, Magnussen C, Lochen MJ, Kee F, Blankenberg S, Jorgensen T, Kuulasmaa K, Zeller T, Salomaa V, Iacoviello L, Schnabel R. P4469Alcohol consumption and risk of atrial fibrillation - results from the BiomarCaRE Consortium. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Csengeri
- University Heart Center Hamburg, General and Interventional Cardiology, Hamburg, Germany
| | - N A Spruenker
- University Heart Center Hamburg, General and Interventional Cardiology, Hamburg, Germany
| | | | - T Niiranen
- Framingham Heart Study, Framingham, United States of America
| | | | - C Magnussen
- University Heart Center Hamburg, General and Interventional Cardiology, Hamburg, Germany
| | - M J Lochen
- UiT The Arctic University of Norway, Tromso, Norway
| | - F Kee
- Queen's University of Belfast, Belfast, United Kingdom
| | - S Blankenberg
- University Heart Center Hamburg, General and Interventional Cardiology, Hamburg, Germany
| | - T Jorgensen
- University of Copenhagen, Copenhagen, Denmark
| | - K Kuulasmaa
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - T Zeller
- University Heart Center Hamburg, General and Interventional Cardiology, Hamburg, Germany
| | - V Salomaa
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | | | - R Schnabel
- University Heart Center Hamburg, General and Interventional Cardiology, Hamburg, Germany
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Ordóñez-Mena JM, Walter V, Schöttker B, Jenab M, O'Doherty MG, Kee F, Bueno-de-Mesquita B, Peeters PHM, Stricker BH, Ruiter R, Hofman A, Söderberg S, Jousilahti P, Kuulasmaa K, Freedman ND, Wilsgaard T, Wolk A, Nilsson LM, Tjønneland A, Quirós JR, van Duijnhoven FJB, Siersema PD, Boffetta P, Trichopoulou A, Brenner H. Impact of prediagnostic smoking and smoking cessation on colorectal cancer prognosis: a meta-analysis of individual patient data from cohorts within the CHANCES consortium. Ann Oncol 2018; 29:472-483. [PMID: 29244072 PMCID: PMC6075220 DOI: 10.1093/annonc/mdx761] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [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: 02/07/2023] Open
Abstract
Background Smoking has been associated with colorectal cancer (CRC) incidence and mortality in previous studies and might also be associated with prognosis after CRC diagnosis. However, current evidence on smoking in association with CRC prognosis is limited. Patients and methods For this individual patient data meta-analysis, sociodemographic and smoking behavior information of 12 414 incident CRC patients (median age at diagnosis: 64.3 years), recruited within 14 prospective cohort studies among previously cancer-free adults, was collected at baseline and harmonized across studies. Vital status and causes of death were collected for a mean follow-up time of 5.1 years following cancer diagnosis. Associations of smoking behavior with overall and CRC-specific survival were evaluated using Cox regression and standard meta-analysis methodology. Results A total of 5229 participants died, 3194 from CRC. Cox regression revealed significant associations between former [hazard ratio (HR) = 1.12; 95 % confidence interval (CI) = 1.04-1.20] and current smoking (HR = 1.29; 95% CI = 1.04-1.60) and poorer overall survival compared with never smoking. Compared with current smoking, smoking cessation was associated with improved overall (HR<10 years = 0.78; 95% CI = 0.69-0.88; HR≥10 years = 0.78; 95% CI = 0.63-0.97) and CRC-specific survival (HR≥10 years = 0.76; 95% CI = 0.67-0.85). Conclusion In this large meta-analysis including primary data of incident CRC patients from 14 prospective cohort studies on the association between smoking and CRC prognosis, former and current smoking were associated with poorer CRC prognosis compared with never smoking. Smoking cessation was associated with improved survival when compared with current smokers. Future studies should further quantify the benefits of nonsmoking, both for cancer prevention and for improving survival among CRC patients, in particular also in terms of treatment response.
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Affiliation(s)
- J M Ordóñez-Mena
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research, University of Heidelberg, Heidelberg, Germany; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - V Walter
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - B Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research, University of Heidelberg, Heidelberg, Germany; Institute of Health Care and Social Sciences, FOM University, Essen, Germany
| | - M Jenab
- International Agency for Research on Cancer (IARC), Lyon, France
| | - M G O'Doherty
- UKCRC Centre of Excellence for Public Health, Queens University of Belfast, Belfast, UK
| | - F Kee
- UKCRC Centre of Excellence for Public Health, Queens University of Belfast, Belfast, UK
| | - B Bueno-de-Mesquita
- Department of Chronic Diseases, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands; Division of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK; Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - P H M Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - B H Stricker
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - R Ruiter
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - S Söderberg
- Department of Public Health and Clinical Medicine, Cardiology, and Heart Center, Umeå University, Umeå, Sweden
| | - P Jousilahti
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - K Kuulasmaa
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - N D Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, USA
| | - T Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - A Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - L M Nilsson
- Nutritional Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Arcum, Arctic Research Centre at Umeå University, Umeå, Sweden
| | - A Tjønneland
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - J R Quirós
- Public Health Directorate, Asturias, Spain
| | | | - P D Siersema
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - P Boffetta
- Hellenic Health Foundation, Athens, Greece; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - A Trichopoulou
- Hellenic Health Foundation, Athens, Greece; WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - H Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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18
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Appleton KM, Woodside JV, Arveiler D, Haas B, Amouyel P, Montaye M, Ferrieres J, Ruidavets JB, Yarnell JWG, Kee F, Evans A, Bingham A, Ducimetiere P, Patterson CC. A Role for Behavior in the Relationships Between Depression and Hostility and Cardiovascular Disease Incidence, Mortality, and All-Cause Mortality: the Prime Study. Ann Behav Med 2017; 50:582-91. [PMID: 26979997 PMCID: PMC4933737 DOI: 10.1007/s12160-016-9784-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Behavioral factors are important in disease incidence and mortality and may explain associations between mortality and various psychological traits. Purpose These analyses investigated the impact of behavioral factors on the associations between depression, hostility and cardiovascular disease(CVD) incidence, CVD mortality, and all-cause mortality. Methods Data from the PRIME Study (N = 6953 men) were analyzed using Cox proportional hazards models, following adjustment for demographic and biological CVD risk factors, and other psychological traits, including social support. Results Following initial adjustment, both depression and hostility were significantly associated with both mortality outcomes (smallest SHR = 1.24, p < 0.001). Following adjustment for behavioral factors, all relationships were attenuated both when accounting for and not accounting for other psychological variables. Associations with all-cause mortality remained significant (smallest SHR = 1.14, p = 0.04). Of the behaviors included, the most significant contribution to outcomes was found for smoking, but a role was also found for fruit and vegetable intakes and high alcohol consumption. Conclusions These findings demonstrate well-known associations between depression, hostility, and mortality and suggest the potential importance of behaviors in explaining these relationships.
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Affiliation(s)
- K M Appleton
- Department of Psychology, Bournemouth University, Poole, BH12 5BB, UK.
| | - J V Woodside
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - D Arveiler
- Department of Epidemiology and Public Health, University of Strasbourg, EA3430, Strasbourg, France
| | - B Haas
- Department of Epidemiology and Public Health, University of Strasbourg, EA3430, Strasbourg, France
| | - P Amouyel
- The Lille Monica Project, INSERM U744, Lille, France
| | - M Montaye
- The Lille Monica Project, INSERM U744, Lille, France
| | - J Ferrieres
- The Toulouse MONICA Project, INSERM UMR1027, Toulouse, France
| | - J B Ruidavets
- The Toulouse MONICA Project, INSERM UMR1027, Toulouse, France
| | - J W G Yarnell
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - F Kee
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - A Evans
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - A Bingham
- The Coordinating Center, INSERM U780, Hôpital Paul Brousse, Villejuif, France
| | - P Ducimetiere
- The Coordinating Center, INSERM U780, Hôpital Paul Brousse, Villejuif, France
| | - C C Patterson
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BJ, UK
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Moore SE, McEvoy CT, Prior L, Lawton J, Patterson CC, Kee F, Cupples M, Young IS, Appleton K, McKinley MC, Woodside JV. Barriers to adopting a Mediterranean diet in Northern European adults at high risk of developing cardiovascular disease. J Hum Nutr Diet 2017; 31:451-462. [PMID: 29159932 DOI: 10.1111/jhn.12523] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [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: 11/28/2022]
Abstract
BACKGROUND Strong evidence links the consumption of a Mediterranean diet (MD) with a reduced cardiovascular disease (CVD) risk; however, there is uncertainty as to whether non-Mediterranean regions will adopt this diet. The present qualitative research aimed to investigate attitudes towards a MD in individuals at high CVD risk in a Northern European population. This information is needed to inform development of MD interventions in non-Mediterranean high-risk populations. METHODS Focus groups (n = 12) were held with individuals at high CVD risk from Northern Europe (≥2 CVD risk factors, aged ≥50 years, no established CVD/type 2 diabetes). Attitudes to dietary change towards a MD were explored. Data were analysed using inductive thematic analysis. RESULTS Sixty-seven adults participated (60% female, mean age 64 years). There was some awareness of the term MD but limited knowledge of its composition. Barriers to general dietary change were evident, including perception of expense, concern over availability, expectation of time commitment, limited knowledge, lack of cooking skills, amount and conflicting nature of media information on diets, changing established eating habits and resistance to dietary change. Barriers specific to MD adoption were also identified, including perceived difficulty living in a colder climate, perceived impact on body weight, acceptability of a MD and cultural differences. CONCLUSIONS Knowledge of a MD was limited in this Northern European sample at high CVD risk. In addition to general barriers to dietary change, barriers specific to a MD were identified. These findings have implications for the development of interventions aiming to promote MD adoption in non-Mediterranean populations.
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Affiliation(s)
- S E Moore
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - C T McEvoy
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - L Prior
- UK Clinical Research Collaboration Centre of Excellence for Public Health, Queens University Belfast, Belfast, UK
| | - J Lawton
- Centre for Population Health Sciences, University of Edinburgh Medical School, Edinburgh, UK
| | - C C Patterson
- Centre for Public Health, Queen's University Belfast, Belfast, UK.,UK Clinical Research Collaboration Centre of Excellence for Public Health, Queens University Belfast, Belfast, UK
| | - F Kee
- Centre for Public Health, Queen's University Belfast, Belfast, UK.,UK Clinical Research Collaboration Centre of Excellence for Public Health, Queens University Belfast, Belfast, UK
| | - M Cupples
- Centre for Public Health, Queen's University Belfast, Belfast, UK.,UK Clinical Research Collaboration Centre of Excellence for Public Health, Queens University Belfast, Belfast, UK
| | - I S Young
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - K Appleton
- Department of Psychology, Bournemouth University, Bournemouth, UK
| | - M C McKinley
- Centre for Public Health, Queen's University Belfast, Belfast, UK.,UK Clinical Research Collaboration Centre of Excellence for Public Health, Queens University Belfast, Belfast, UK
| | - J V Woodside
- Centre for Public Health, Queen's University Belfast, Belfast, UK.,UK Clinical Research Collaboration Centre of Excellence for Public Health, Queens University Belfast, Belfast, UK
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20
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O’Doherty M, French D, Steptoe A, Kee F. SOCIAL CAPITAL, HEALTH BEHAVIOURS AND HEALTH: DOES REPORTING HETEROGENEITY PLAY A ROLE? Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M.G. O’Doherty
- UKCRC Centre of Excellence for Public Health for Northern Ireland, Queens University Belfast, Belfast, Ireland, United Kingdom,
| | - D. French
- Queen’s University Management School, Queens University Belfast, Belfast, Ireland, United Kingdom,
| | - A.P. Steptoe
- Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - F. Kee
- UKCRC Centre of Excellence for Public Health for Northern Ireland, Queens University Belfast, Belfast, Ireland, United Kingdom,
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21
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Neville C, McKinley M, Kee F, Young I, Cardwell C, Woodside J. VALIDITY OF FRUIT AND VEGETABLE INTAKE ASSESSED BY A FOOD FREQUENCY QUESTIONNAIRE IN OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C. Neville
- UK CRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - M.C. McKinley
- UK CRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - F. Kee
- UK CRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - I. Young
- UK CRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - C. Cardwell
- UK CRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - J. Woodside
- UK CRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
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22
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McHugh JE, Kenny RA, Lawlor BA, Steptoe A, Kee F. The discrepancy between social isolation and loneliness as a clinically meaningful metric: findings from the Irish and English longitudinal studies of ageing (TILDA and ELSA). Int J Geriatr Psychiatry 2017; 32:664-674. [PMID: 27246181 DOI: 10.1002/gps.4509] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [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: 01/30/2016] [Revised: 04/06/2016] [Accepted: 04/19/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Scant evidence is available on the discordance between loneliness and social isolation among older adults. We aimed to investigate this discordance and any health implications that it may have. METHOD Using nationally representative datasets from ageing cohorts in Ireland (TILDA) and England (ELSA), we created a metric of discordance between loneliness and social isolation, to which we refer as Social Asymmetry. This metric was the categorised difference between standardised scores on a scale of loneliness and a scale of social isolation, giving categories of: Concordantly Lonely and Isolated, Discordant: Robust to Loneliness, or Discordant: Susceptible to Loneliness. We used regression and multilevel modelling to identify potential relationships between Social Asymmetry and cognitive outcomes. RESULTS Social Asymmetry predicted cognitive outcomes cross-sectionally and at a two-year follow-up, such that Discordant: Robust to Loneliness individuals were superior performers, but we failed to find evidence for Social Asymmetry as a predictor of cognitive trajectory over time. CONCLUSIONS We present a new metric and preliminary evidence of a relationship with clinical outcomes. Further research validating this metric in different populations, and evaluating its relationship with other outcomes, is warranted. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- J E McHugh
- Institute of Neuroscience, Trinity College, Dublin 2, Ireland.,Centre for Public Health, Queen's University Belfast, BT12 6BJ, UK
| | - R A Kenny
- Institute of Neuroscience, Trinity College, Dublin 2, Ireland
| | - B A Lawlor
- Institute of Neuroscience, Trinity College, Dublin 2, Ireland
| | - A Steptoe
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK
| | - F Kee
- Centre for Public Health, Queen's University Belfast, BT12 6BJ, UK
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23
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McHugh Power JE, Lawlor BA, Kee F. Social support mediates the relationships between extraversion, neuroticism, and cognitive function in older adults. Public Health 2017; 147:144-152. [PMID: 28404490 DOI: 10.1016/j.puhe.2017.02.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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] [Received: 12/06/2016] [Revised: 02/20/2017] [Accepted: 02/24/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVES We supplement existing findings on a link between social support and cognitive function in later life by considering the role of personality as an antecedent to both, and of social support as a mediator of the link between personality and cognitive function. STUDY DESIGN An observational cohort study. METHODS We evaluated social support using the Lubben Social Network Scale, across 624 adults aged over 60 years, and investigated this measure as a mediator of the relationships between extraversion and neuroticism at baseline 2007-2009, and cognitive function at follow-up, 2 years later. A half-longitudinal mediation design, within a structural equation modelling framework, was used. RESULTS There was a direct effect of extraversion, such that lower levels were related to higher scores of cognitive function. There was no significant direct effect of neuroticism on cognitive function at follow-up. Social support partially mediated the paths between both extraversion and neuroticism and cognitive function at follow-up. Decomposing the mediation effects by using social support subscales (measuring support from friends, relatives and neighbours) showed meaningful indirect effects for both predictors. CONCLUSION Results suggest that social support may offer a target for interventions for cognitively at-risk older adults and add to the existing empirical evidence describing the link between personality and cognitive function.
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Affiliation(s)
- J E McHugh Power
- UK CRC Centre of Excellence for Public Health, Institute of Clinical Sciences Block B, Grosvenor Road, Queen's University Belfast, Royal Victoria Hospital, Belfast BT12 6BJ, UK; Institute of Neuroscience, Lloyd Institute, Trinity College, Dublin 2, Ireland.
| | - B A Lawlor
- Institute of Neuroscience, Lloyd Institute, Trinity College, Dublin 2, Ireland
| | - F Kee
- UK CRC Centre of Excellence for Public Health, Institute of Clinical Sciences Block B, Grosvenor Road, Queen's University Belfast, Royal Victoria Hospital, Belfast BT12 6BJ, UK
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24
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O'Doherty M, French D, Steptoe A, Kee F. Social capital, deprivation and self-rated health: Does reporting heterogeneity play a role? Results from the English Longitudinal Study of Ageing. Soc Sci Med 2017; 179:191-200. [DOI: 10.1016/j.socscimed.2017.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 02/28/2017] [Accepted: 03/03/2017] [Indexed: 11/16/2022]
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25
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Mohan G, Longo A, Kee F. Health and wellbeing impact of urban regeneration policy in deprived areas of Northern Ireland. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw164.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
OBJECTIVES Emergency endovascular aneurysm repair (eEVAR) may improve outcomes for patients with ruptured abdominal aortic aneurysm (RAAA). The study aim was to compare the outcomes for eEVAR with conventional open surgical repair for the treatment of RAAA. SETTING A systematic review of relevant publications was performed. Randomised controlled trials (RCTs) comparing eEVAR with open surgical repair for RAAA were included. PARTICIPANTS 3 RCTs were included, with a total of 761 patients with RAAA. INTERVENTIONS Meta-analysis was performed with fixed-effects models with ORs and 95% CIs for dichotomous data and mean differences with 95% CIs for continuous data. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome was short-term mortality. Secondary outcome measures included aneurysm-specific and general complication rates, quality of life and economic analysis. RESULTS Overall risk of bias was low. There was no difference between the 2 interventions on 30-day (or in-hospital) mortality, OR 0.91 (95% CI 0.67 to 1.22; p=0.52). 30-day complications included myocardial infarction, stroke, composite cardiac complications, renal complications, severe bowel ischaemia, spinal cord ischaemia, reoperation, amputation and respiratory failure. Reporting was incomplete, and no robust conclusion was drawn. For complication outcomes that did include at least 2 studies in the meta-analysis, there was no clear evidence to support a difference between eEVAR and open repair. Longer term outcomes and cost per patient were evaluated in only a single study, thus precluding definite conclusions. CONCLUSIONS Outcomes between eEVAR and open repair, specifically 30-day mortality, are similar. However, further high-quality trials are required, as the paucity of data currently limits the conclusions.
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Affiliation(s)
- S A Badger
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - D W Harkin
- Belfast Vascular Centre, Royal Victoria Hospital, Belfast, UK
| | - P H Blair
- Belfast Vascular Centre, Royal Victoria Hospital, Belfast, UK
| | - P K Ellis
- Belfast Vascular Centre, Royal Victoria Hospital, Belfast, UK
| | - F Kee
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - R Forster
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
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27
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Schöttker B, Rathmann W, Herder C, Thorand B, Wilsgaard T, Njølstad I, Siganos G, Mathiesen EB, Saum KU, Peasey A, Feskens E, Boffetta P, Trichopoulou A, Kuulasmaa K, Kee F, Brenner H. HbA1c levels in non-diabetic older adults - No J-shaped associations with primary cardiovascular events, cardiovascular and all-cause mortality after adjustment for confounders in a meta-analysis of individual participant data from six cohort studies. BMC Med 2016; 14:26. [PMID: 26867584 PMCID: PMC4751667 DOI: 10.1186/s12916-016-0570-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/26/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND To determine the shape of the associations of HbA1c with mortality and cardiovascular outcomes in non-diabetic individuals and explore potential explanations. METHODS The associations of HbA1c with all-cause mortality, cardiovascular mortality and primary cardiovascular events (myocardial infarction or stroke) were assessed in non-diabetic subjects ≥50 years from six population-based cohort studies from Europe and the USA and meta-analyzed. Very low, low, intermediate and increased HbA1c were defined as <5.0, 5.0 to <5.5, 5.5 to <6.0 and 6.0 to <6.5% (equals <31, 31 to <37, 37 to <42 and 42 to <48 mmol/mol), respectively, and low HbA1c was used as reference in Cox proportional hazards models. RESULTS Overall, 6,769 of 28,681 study participants died during a mean follow-up of 10.7 years, of whom 2,648 died of cardiovascular disease. Furthermore, 2,493 experienced a primary cardiovascular event. A linear association with primary cardiovascular events was observed. Adjustment for cardiovascular risk factors explained about 50% of the excess risk and attenuated hazard ratios (95 confidence interval) for increased HbA1c to 1.14 (1.03-1.27), 1.17 (1.00-1.37) and 1.19 (1.04-1.37) for all-cause mortality, cardiovascular mortality and cardiovascular events, respectively. The six cohorts yielded inconsistent results for the association of very low HbA1c levels with the mortality outcomes and the pooled effect estimates were not statistically significant. In one cohort with a pronounced J-shaped association of HbA1c levels with all-cause and cardiovascular mortality (NHANES), the following confounders of the association of very low HbA1c levels with mortality outcomes were identified: race/ethnicity; alcohol consumption; BMI; as well as biomarkers of iron deficiency anemia and liver function. Associations for very low HbA1c levels lost statistical significance in this cohort after adjusting for these confounders. CONCLUSIONS A linear association of HbA1c levels with primary cardiovascular events was observed. For cardiovascular and all-cause mortality, the observed small effect sizes at both the lower and upper end of HbA1c distribution do not support the notion of a J-shaped association of HbA1c levels because a certain degree of residual confounding needs to be considered in the interpretation of the results.
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Affiliation(s)
- Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 581, 69120, Heidelberg, Germany. .,Network Aging Research, University of Heidelberg, Bergheimer Straße 20, 69115, Heidelberg, Germany.
| | - W Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf`m Hennekamp 65, 40225, Düsseldorf, Germany
| | - C Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf`m Hennekamp 65, 40225, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764, München-Neuherberg, Germany
| | - B Thorand
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Postfach 1129, Neuherberg, Germany
| | - T Wilsgaard
- Epidemiology of Chronic Diseases Research Group, Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - I Njølstad
- Epidemiology of Chronic Diseases Research Group, Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - G Siganos
- Brain and Circulation Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - E B Mathiesen
- Brain and Circulation Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - K U Saum
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - A Peasey
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - E Feskens
- Division of Human Nutrition, Wageningen University, PO Box 8129, 6700 EV, Wageningen, The Netherlands
| | - P Boffetta
- Institute for Translational Epidemiology and The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Hellenic Health Foundation, Kaisareias 13 and Alexandroupoleos, Athens, 11527, Greece
| | - A Trichopoulou
- Hellenic Health Foundation, Kaisareias 13 and Alexandroupoleos, Athens, 11527, Greece
| | - K Kuulasmaa
- National Institute for Health and Welfare (THL), PO Box 30, FI-00271, Helsinki, Finland
| | - F Kee
- UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - H Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
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McHugh J, Kenny R, Lawlor B, Kee F. O-060: Social factors predict cognitive outcomes cross-sectionally, but not longitudinally, among older Irish adults. Eur Geriatr Med 2015. [DOI: 10.1016/s1878-7649(15)30073-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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McEvoy CT, Lawton J, Kee F, Young IS, Woodside JV, McBratney J, McKinley MC. Adolescents' views about a proposed rewards intervention to promote healthy food choice in secondary school canteens. Health Educ Res 2014; 29:799-811. [PMID: 24851865 DOI: 10.1093/her/cyu025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Using rewards may be an effective method to positively influence adolescent eating behaviour, but evidence regarding this approach is limited. The aim of this study was to explore young adolescent views about a proposed reward intervention associated with food choice in school canteens. Focus groups were held in 10 schools located in lower socioeconomic areas within Northern Ireland and involved 90 pupils aged 11-12 years (54 girls, 36 boys). Our findings indicated a high degree of acceptability for a reward scheme but there was major diversity in the type of rewards valued by pupils, largely defined by geographical area and socio-cultural differences. Pupils from rural areas tended to emphasize group-based and longer-term rewards, whereas pupils from urban-city schools tended to suggest individualistic and immediate rewards. The major factors influencing food choice were food price, value for money, taste and visual appearance. Pupils felt that factors outside of their control, such as being assigned to the second lunch sitting placed considerable constraints on their food choice. This research not only indicated a high degree of acceptability for a rewards-based intervention but also highlighted a number of socio-cultural and environmental factors that should be considered by researchers when developing such an intervention.
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Affiliation(s)
- C T McEvoy
- Centre for Public Health, Institute of Clinical Science B, Queen's University Belfast, Grosvenor Road, Belfast BT12 6BJ, UK, Public Health Sciences, University of Edinburgh Medical School, Teviot Place, Edinburgh EH8 9AG, UK and Public Health Agency for Northern Ireland, Linenhall Street, Belfast BT2 8BS, UK
| | - J Lawton
- Centre for Public Health, Institute of Clinical Science B, Queen's University Belfast, Grosvenor Road, Belfast BT12 6BJ, UK, Public Health Sciences, University of Edinburgh Medical School, Teviot Place, Edinburgh EH8 9AG, UK and Public Health Agency for Northern Ireland, Linenhall Street, Belfast BT2 8BS, UK
| | - F Kee
- Centre for Public Health, Institute of Clinical Science B, Queen's University Belfast, Grosvenor Road, Belfast BT12 6BJ, UK, Public Health Sciences, University of Edinburgh Medical School, Teviot Place, Edinburgh EH8 9AG, UK and Public Health Agency for Northern Ireland, Linenhall Street, Belfast BT2 8BS, UK
| | - I S Young
- Centre for Public Health, Institute of Clinical Science B, Queen's University Belfast, Grosvenor Road, Belfast BT12 6BJ, UK, Public Health Sciences, University of Edinburgh Medical School, Teviot Place, Edinburgh EH8 9AG, UK and Public Health Agency for Northern Ireland, Linenhall Street, Belfast BT2 8BS, UK
| | - J V Woodside
- Centre for Public Health, Institute of Clinical Science B, Queen's University Belfast, Grosvenor Road, Belfast BT12 6BJ, UK, Public Health Sciences, University of Edinburgh Medical School, Teviot Place, Edinburgh EH8 9AG, UK and Public Health Agency for Northern Ireland, Linenhall Street, Belfast BT2 8BS, UK
| | - J McBratney
- Centre for Public Health, Institute of Clinical Science B, Queen's University Belfast, Grosvenor Road, Belfast BT12 6BJ, UK, Public Health Sciences, University of Edinburgh Medical School, Teviot Place, Edinburgh EH8 9AG, UK and Public Health Agency for Northern Ireland, Linenhall Street, Belfast BT2 8BS, UK
| | - M C McKinley
- Centre for Public Health, Institute of Clinical Science B, Queen's University Belfast, Grosvenor Road, Belfast BT12 6BJ, UK, Public Health Sciences, University of Edinburgh Medical School, Teviot Place, Edinburgh EH8 9AG, UK and Public Health Agency for Northern Ireland, Linenhall Street, Belfast BT2 8BS, UK
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Cruise SM, Hughes J, Bennett K, Kouvonen A, Kee F. Understanding coronary heart disease-related disability in older adults in the Republic of Ireland and Northern Ireland in 2010/2011. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku166.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Prior L, Scott D, Hunter R, Donnelly M, Tully MA, Cupples ME, Kee F. Exploring lay views on physical activity and their implications for public health policy. A case study from East Belfast. Soc Sci Med 2014; 114:73-80. [PMID: 24911510 DOI: 10.1016/j.socscimed.2014.05.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 11/13/2013] [Revised: 05/05/2014] [Accepted: 05/09/2014] [Indexed: 10/25/2022]
Abstract
It is now recognised that inactive lifestyles underpin much of the disease burden evident in the richer nations of the world. Indeed, the WHO has identified physical inactivity as a 'global public health problem' and has established minimum physical activity (PA) targets for people at different stages of the life-course. Yet, according to WHO, just under 1/3 of working age adults across the globe meet those targets and it is not at all clear how the disjunction between the recommendations of policy makers and the behaviour of ordinary people might be surmounted. Using an opportunity to examine the impact of an urban regeneration project on community residents in East Belfast (Northern Ireland) this paper examines the views of some 113 people on how to increase rates of PA in an area of multiple deprivation. The results of the analysis suggest that lay people rarely consider PA as a discrete issue, or one that centres on individuals and their motivation, but rather as one component in a complex web of concerns, processes and events that include such things as the actions of neighbours and relatives, material and political environments, vandalism, violence, and the weather. We explore and unravel the nature of those concerns using novel methods of content analysis that generate 'issue webs'. Particular attention is paid to the ways in which lay people conceptualize 'activity' and to the manner in which they point to ways of encouraging activity that are rooted in everyday life rather than in the corpocentric, agent-centred and often sport dominated strategies favoured by local policy makers. Our results support those who argue that interventions to increase rates of PA need to move beyond behavioural approaches that focus on individuals and consider the social, political and material contexts in which 'activity' occurs.
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Affiliation(s)
- L Prior
- UKCRC Center of Excellence for Public Health Research (Northern Ireland), Queen's University, Belfast BT7 1NN, UK; School of Sociology, Social Policy & Social Work, Queen's University, Belfast BT7 1NN, UK.
| | - D Scott
- UKCRC Center of Excellence for Public Health Research (Northern Ireland), Queen's University, Belfast BT7 1NN, UK; Institute of Clinical Sciences, Block B, Queen's University Belfast, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, UK.
| | - R Hunter
- UKCRC Center of Excellence for Public Health Research (Northern Ireland), Queen's University, Belfast BT7 1NN, UK; Institute of Clinical Sciences, Block B, Queen's University Belfast, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, UK.
| | - M Donnelly
- UKCRC Center of Excellence for Public Health Research (Northern Ireland), Queen's University, Belfast BT7 1NN, UK; Institute of Clinical Sciences, Block B, Queen's University Belfast, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, UK.
| | - M A Tully
- UKCRC Center of Excellence for Public Health Research (Northern Ireland), Queen's University, Belfast BT7 1NN, UK; Institute of Clinical Sciences, Block B, Queen's University Belfast, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, UK.
| | - M E Cupples
- UKCRC Center of Excellence for Public Health Research (Northern Ireland), Queen's University, Belfast BT7 1NN, UK; Institute of Clinical Sciences, Block B, Queen's University Belfast, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, UK.
| | - F Kee
- UKCRC Center of Excellence for Public Health Research (Northern Ireland), Queen's University, Belfast BT7 1NN, UK; Institute of Clinical Sciences, Block B, Queen's University Belfast, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, UK.
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Appleton K, Woodside J, Arveiler D, Haas B, Amouyel P, Montaye M, Ferrieres J, Ruidavets J, Yarnell J, Kee F, Evans A, Bingham A, Ducimetiere P, Patterson C. EPA-0229 - Association between depression and mortality depends on methodology used. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)77683-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Appleton KM, Woodside JV, Arveiler D, Haas B, Amouyel P, Montaye M, Ferrieres J, Ruidavets JB, Yarnell JWG, Kee F, Evans A, Bingham A, Ducimetiere P, Patterson CC. Depression and mortality: artifact of measurement and analysis? J Affect Disord 2013; 151:632-638. [PMID: 23948631 DOI: 10.1016/j.jad.2013.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 07/09/2013] [Accepted: 07/10/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous research demonstrates various associations between depression, cardiovascular disease (CVD) incidence and mortality, possibly as a result of the different methodologies used to measure depression and analyse relationships. This analysis investigated the association between depression, CVD incidence (CVDI) and mortality from CVD (MCVD), smoking related conditions (MSRC), and all causes (MALL), in a sample data set, where depression was measured using items from a validated questionnaire and using items derived from the factor analysis of a larger questionnaire, and analyses were conducted based on continuous data and grouped data. METHODS Data from the PRIME Study (N=9798 men) on depression and 10-year CVD incidence and mortality were analysed using Cox proportional hazards models. RESULTS Using continuous data, both measures of depression resulted in the emergence of positive associations between depression and mortality (MCVD, MSRC, MALL). Using grouped data, however, associations between a validated measure of depression and MCVD, and between a measure of depression derived from factor analysis and all measures of mortality were lost. LIMITATIONS Low levels of depression, low numbers of individuals with high depression and low numbers of outcome events may limit these analyses, but levels are usual for the population studied. CONCLUSIONS These data demonstrate a possible association between depression and mortality but detecting this association is dependent on the measurement used and method of analysis. Different findings based on methodology present clear problems for the elucidation and determination of relationships. The differences here argue for the use of validated scales where possible and suggest against over-reduction via factor analysis and grouping.
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Affiliation(s)
- K M Appleton
- Psychology, DEC, Bournemouth University, Dorset BH12 5BB, United Kingdom.
| | - J V Woodside
- School of Medicine, Dentistry and BioMedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, United Kingdom
| | - D Arveiler
- The Strasbourg MONICA Project, Department of Epidemiology and Public Health, EA 3430, University of Strasbourg, Strasbourg, France
| | - B Haas
- The Strasbourg MONICA Project, Department of Epidemiology and Public Health, EA 3430, University of Strasbourg, Strasbourg, France
| | - P Amouyel
- The Lille Monica Project, INSERM U744, Lille, France
| | - M Montaye
- The Lille Monica Project, INSERM U744, Lille, France
| | - J Ferrieres
- The Toulouse MONICA Project, INSERM U558, Toulouse, France
| | - J B Ruidavets
- The Toulouse MONICA Project, INSERM U558, Toulouse, France
| | - J W G Yarnell
- School of Medicine, Dentistry and BioMedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, United Kingdom
| | - F Kee
- School of Medicine, Dentistry and BioMedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, United Kingdom
| | - A Evans
- School of Medicine, Dentistry and BioMedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, United Kingdom
| | - A Bingham
- The Coordinating Center, INSERM U780, Hôpital Paul Brousse, Villejuif, France
| | - P Ducimetiere
- The Coordinating Center, INSERM U780, Hôpital Paul Brousse, Villejuif, France
| | - C C Patterson
- School of Medicine, Dentistry and BioMedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, United Kingdom
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McVeigh T, Staines A, Sweeney MR, Dee AP, Perry IJ, O'Neill C, Doherty E, Callan A, Sharp L, Kearns K, O'Dwyer V, Kee F, Hughes J, Balanda K. Annual productivity losses due to co-morbidities of overweight and obesity in the Republic of Ireland. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt123.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dee AP, Perry IJ, O’Neill C, Doherty E, Callan A, Kearns K, O’Dwyer V, Staines A, McVeigh T, Sweeney MR, Sharp L, Balanda K, Hughes J, Kee F. PP47 The Cost of Overweight and Obesity on the Island of Ireland. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hughes J, Kabir Z, Hotchkiss JW, Bennett K, Kee F, Leyland AH, Davies CA, Bandosz P, Guzman-Castillo M, O’Flaherty M, Capewell S, Critchley J. OP56 Modelling Future Coronary Heart Disease Mortality to 2030 in the British Isles. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bongard V, Bodenant M, Dallongeville J, Arveiler D, Kee F, Montaye M, Ruidavets JB, Wagner A, Evans A, Ferrieres J. Comparison of coronary heart disease and stroke risks attributable to vascular risk factors: results from the PRIME study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bennett K, Hughes J, Jennings S, Kee F, Shelley E. Comparing the decline in coronary heart disease and stroke mortality in neighbouring countries with different healthcare systems. Heart 2013; 99:1179-84. [DOI: 10.1136/heartjnl-2013-303921] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Scott W, Cupples M, Prior L, Hunter R, Tully M, Kee F, Donnelly M. Physical activity in Northern Ireland-not in pole position but still on the grid. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hunter R, Tully M, Kee F. Development of an evaluation framework to measure the public health impact of a ‘natural experiment’: The PARC study. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hughes S, Spelman T, Gray O, Boz C, Trojano M, Zwanikken C, Lugaresi A, Izquierdo J, Duquette P, Girard M, Grand'Maison F, Grammond P, Oreja-Guevara C, Hupperts R, Petersen T, Bergamaschi R, Giuliani G, Lechner-Scott J, Barnett M, Edite Rio M, van Pesch V, Pia Amato M, Iuliano G, Fiol M, Slee M, Verheul F, Cristiano E, Fernández Bolaños R, Saladino D, Poehlau M, Deri N, Oleschko Arruda W, Cabrera-Gomez J, Paine M, Vella N, Herbert J, Skromne E, Savino A, Shaw C, Moore F, Vucic S, Petkovska-Boskova T, Vetere S, McDonnell G, Hawkins S, Kee F, Butzkueven H. EXPOSURE TO INTERFERON-β THERAPY IN EARLY PREGNANCY: A LITERATURE REVIEW OF PREGNANCY OUTCOMES IN WOMEN WITH MULTIPLE SCLEROSIS. J Neurol Neurosurg Psychiatry 2012. [DOI: 10.1136/jnnp-2012-304200a.64] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hughes SE, Spelman T, Gray OM, Boz C, Trojano M, McDonnell GV, Hawkins SA, Kee F, Butzkueven H. PREDICTORS OF POSTPARTUM RELAPSES IN WOMEN WITH MULTIPLE SCLEROSIS: RESULTS FROM THE MSBASE REGISTRY. J Neurol Neurosurg Psychiatry 2012. [DOI: 10.1136/jnnp-2012-304200a.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
BACKGROUND AND METHODS We conducted an all-Ireland population-based prospective epidemiological survey of motor neurone disease (MND) using the Northern Ireland and Republic of Ireland MND registers to examine the incidence and prevalence of the disease over the period 2004-2005. RESULTS AND CONCLUSIONS Incidence of MND was 1.9 per 100 000 person-years and rates were comparable in both the north and south of Ireland. Prevalence of MND was 5.0 per 100 000 population. When compared with previous published surveys of MND performed in the Republic of Ireland over the last 10 years, rates of disease have remained relatively constant. When standardized to the 1990 US population, the incidence of MND in Ireland was found to be consistent with other European prospective surveys of MND.
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Affiliation(s)
- C Donaghy
- Department of Neurology, Royal Victoria Hospital, Belfast, UK.
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Poisson T, Dallongeville J, Evans A, Ducimetierre P, Amouyel P, Yarnell J, Bingham A, Kee F, Dauchet L. Fruit and vegetable intake and smoking cessation. Eur J Clin Nutr 2012; 66:1247-53. [DOI: 10.1038/ejcn.2012.70] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Woodside JV, Yarnell JWG, Patterson CC, Arveiler D, Amouyel P, Ferrières J, Kee F, Evans A, Bingham A, Ducimetière P. Do lifestyle behaviours explain socioeconomic differences in all-cause mortality, and fatal and non-fatal cardiovascular events? Evidence from middle aged men in France and Northern Ireland in the PRIME Study. Prev Med 2012; 54:247-53. [PMID: 22306980 DOI: 10.1016/j.ypmed.2012.01.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 01/19/2012] [Accepted: 01/19/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the contribution of lifestyle behaviours to the socioeconomic gradient in all-cause mortality, and fatal and non-fatal cardiovascular events. METHOD 10,600 men aged 50-59 years examined in 1991-1994 in Northern Ireland (NI) and France and followed annually for deaths and cardiovascular events for 10 years. Baseline smoking habit, physical activity, and fruit, vegetable, and alcohol consumption were assessed. RESULTS All lifestyle behaviours showed marked socioeconomic gradients for most indicators in NI and France, with the exception of percentage of alcohol consumers in NI and frequency of alcohol consumption in NI and France. At 10 years, there were 544 deaths from any cause and 440 fatal and non-fatal cardiovascular events. After adjustment for country and age, socioeconomic gradients were further adjusted for lifestyle behaviours. For total mortality, the median residual contribution of lifestyle behaviours was 28% and for cardiovascular incidence, 41%. When cardiovascular risk factors were considered in conjunction with lifestyle behaviours these percentages increased to 38% and 67% respectively. CONCLUSION Lifestyle behaviours contribute to the gradient in mortality and cardiovascular incidence between socioeconomic groups, particularly for cardiovascular incidence, but a substantial proportion of these differentials was not explained by lifestyle behaviours and cardiovascular risk factors.
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Affiliation(s)
- J V Woodside
- Queen's University Belfast, Belfast, United Kingdom.
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Wilson JS, Sittlington JJ, McCrum-Gardner E, Kee F, Elborn JS. P210 Which symptoms prompt patients with an exacerbation of COPD to persevere, self-treat or seek care? A comparison with health professionals. Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054c.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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47
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Poisson T, Dallongeville J, Evans A, Yarnell J, Amouyel P, Kee F, Dauchet L. P031 Arrêt du tabac et consommation de fruits et légumes : une surestimation de l’association entre consommation de fruits et légumes et maladies cardiovasculaires. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70098-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Hughes J, Kee F, Bennett K, O'Flaherty M, Critchley J, Cupples M, Capewell S. Modelling coronary heart disease mortality in Northern Ireland between 1987 and 2007. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.143586.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Canouï-Poitrine F, Luc G, Mallat Z, Machez E, Bingham A, Ferrieres J, Ruidavets JB, Montaye M, Yarnell J, Haas B, Arveiler D, Morange P, Kee F, Evans A, Amouyel P, Ducimetiere P, Empana JP. Systemic chemokine levels, coronary heart disease, and ischemic stroke events: the PRIME study. Neurology 2011; 77:1165-73. [PMID: 21849651 DOI: 10.1212/wnl.0b013e31822dc7c8] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To quantify the association between systemic levels of the chemokine regulated on activation normal T-cell expressed and secreted (RANTES/CCL5), interferon-γ-inducible protein-10 (IP-10/CXCL10), monocyte chemoattractant protein-1 (MCP-1/CCL2), and eotaxin-1 (CCL11) with future coronary heart disease (CHD) and ischemic stroke events and to assess their usefulness for CHD and ischemic stroke risk prediction in the PRIME Study. METHODS After 10 years of follow-up of 9,771 men, 2 nested case-control studies were built including 621 first CHD events and 1,242 matched controls and 95 first ischemic stroke events and 190 matched controls. Standardized hazard ratios (HRs) for each log-transformed chemokine were estimated by conditional logistic regression. RESULTS None of the 4 chemokines were independent predictors of CHD, either with respect to stable angina or to acute coronary syndrome. Conversely, RANTES (HR = 1.70; 95% confidence interval [CI] 1.05-2.74), IP-10 (HR = 1.53; 95% CI 1.06-2.20), and eotaxin-1 (HR = 1.59; 95% CI 1.02-2.46), but not MCP-1 (HR = 0.99; 95% CI 0.68-1.46), were associated with ischemic stroke independently of traditional cardiovascular risk factors, hs-CRP, and fibrinogen. When the first 3 chemokines were included in the same multivariate model, RANTES and IP-10 remained predictive of ischemic stroke. Their addition to a traditional risk factor model predicting ischemic stroke substantially improved the C-statistic from 0.6756 to 0.7425 (p = 0.004). CONCLUSIONS In asymptomatic men, higher systemic levels of RANTES and IP-10 are independent predictors of ischemic stroke but not of CHD events. RANTES and IP-10 may improve the accuracy of ischemic stroke risk prediction over traditional risk factors.
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Affiliation(s)
- F Canouï-Poitrine
- INSERM U970, The Paris Cardiovascular Research Centre (PARCC), 56 rue Leblanc, Paris, F-75015, France.
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Cochrane GC, McCann JF, Kee F, Higgins K. O4-2.3 Dynamics of smoking in adolescence and influence of social networks. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976b.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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