Chronic pain is common problem in young people (occurring in up to a third) that can negatively impact their daily functioning such as attending school/work, socialising with friends, and their mental health (also known as "interference due to pain"). Intervening early by helping young people to self-manage pain, through regularly taking medication, completing exercises, and using relaxation, can improve their day to day lives. However, research shows that the long-term effects of these interventions are moderate at best, and young people (aged 10 - 18) often have difficulty taking responsibility for these complex self-management tasks. This project will help us to understand these difficulties and to better support young people's in managing their pain experiences as they mature, by exploring the role of executive functioning skills in their pain experiences and self-management. To live an independent life, young people learn how to control and organise their thoughts, behaviours, and emotions. These executive functioning skills are pivotal to the successful self-management of chronic pain. However, preliminary evidence suggests that these executive functioning skill in young people with chronic pain may develop more slowly and may be weakened further by the experience of chronic pain. We need to know more about the relationship between chronic pain and control skills to understand young people’s difficulties with self-managing their pain and improve our interventions to better support them.
To this end, the PhD project aims to find out how chronic pain, executive functioning skills and self-management difficulties are related to each other in young people. This aim will achieved through 3 related studies:
1) Using existing data on executive functioning skills and chronic pain experiences from the ALSPAC cohort to identify differences in executive functioning skills between in young people with and without chronic pain.
2) Conducting interviews with 20 young people with chronic pain to identify which self-management tasks are most important to them, and how we can best measure their engagement with these tasks.
3) Conducting a study in 100 young people (of which half have chronic pain, and the other half have not) who will complete a set of tasks, including memory tests and problem-solving tasks, and questionnaires to assess their pain and self-management experiences. Participants will complete this set of tasks and questionnaires at 2 time points (1 year apart from each other), which will allow us to compare how executive functioning skills develop over time in young people with and without chronic pain, and how these are related to their engagement with self-management tasks.

This study aims to explore the potential protective effects of an early bedtime and waking routine against depression. It also seeks to examine how factors like age and diet quality might influence this relationship. By understanding these dynamics, the research could offer insights into simple lifestyle adjustments for mitigating depression risks.

Metabolomics, defined as the measurement and study of circulating small molecules that are the substrates and products of cellular metabolism, is increasingly used by epidemiologists to provide a functional read-out of bulk cellular activity and a proxy to individual current health. This approach also provides insight into biological pathways linking exposures and disease. Nightingale Health’s nuclear magnetic resonance (NMR) spectroscopy-based metabolomic research service enables reproducible and cost-effective measurement of lipids, inflammation, dietary intake and insulin sensitivity (https://research.nightingalehealth.com/). The platform enables absolute quantification of close to 200 metabolites and includes 39 clinically validated biomarkers. This platform has already been used to generate metabolomics data from samples collected during the G1 clinics at age 7, 15, 17 and 24 years. We propose to generate NMR data from samples collected during the age 30 clinic. This work will enable us to extend the longitudinal dataset into the latter part of early adulthood. In epidemiology, this is a traditionally understudied part of the life course but one which we believe may offer important insights into the development of disease later in adulthood.

Hearing loss in children has a well-documented impact on language development, which in turn is tightly linked to cognitive development, literacy and educational outcomes. Most research has focused on the impact of moderate to severe/profound hearing loss (>40 dB in the worst hearing ear), based on clinical populations. However hearing sensitivity is a continuum, and there is developing evidence that “lesser” degrees of hearing loss, not always identified or managed through Audiology clinics, may have an impact on children’s development although much is still unknown.

This lack of evidence leads to within- and between-country differences in how hearing loss is managed in children. In the UK for example, communication and educational interventions are available as standard for those with moderate or worse bilateral hearing loss in both ears, with regional differences as to how milder hearing losses are managed, if at all. By contrast, in Canada, children with any degree of hearing loss in either ear, receive intensive communication, hearing and educational intervention from birth. There is no evidence as to which approach is best.

To develop interventions which are effective across the range of hearing losses, it is necessary to first understand the impact of hearing sensitivity (examined as a continuum) on children's development. This requires a population rather than a clinical approach. This study therefore aims to examine the impact of childhood hearing loss on language, cognitive, educational and employment outcomes through childhood and early adulthood in the ALSPAC cohort.

ALSPAC has detailed measures of hearing at ages 7, 9, 11 and 15 years on around 4-7000 of the cohort. We will conduct an in-depth statistical analysis of these hearing data to understand the range and continuum of children's hearing sensitivity in the population, how it changes with age and how it links to clinical categories of hearing loss.

We will then examine whether the continuum and range of hearing levels in childhood are associated with child development and outcomes into young adulthood. We will focus on language, cognition, literacy, education, well-being and employment outcomes. Finally if there are adverse outcomes for those with hearing loss, we will examine whether there are factors that moderate outcomes.

Blood pressure rises during exercise as a result of changes in the amount of blood the heart pumps and changes in the circulation within skeletal muscle. An exaggerated blood pressure response to exercise can indicate poor cardiovascular health but recent work suggests an exaggerated exercise BP only indicates poor cardiovascular health when cardiopulmonary fitness (aerobic fitness) is low. In this project we propose to explore the effect of fitness on exercise blood pressure and the mechanisms underlying this relationship. Sex differences in all metrics and associations will also be explored to get a better understanding of cardiovascular health in young men and women.

Blood pressure rises during exercise as a result of changes in the amount of blood the heart pumps and changes in the circulation within skeletal muscle. An exaggerated blood pressure response to exercise can indicate poor cardiovascular health but recent work suggests an exaggerated exercise BP only indicates poor cardiovascular health when cardiopulmonary fitness (aerobic fitness) is low. In this project we propose to explore the effect of fitness on exercise blood pressure and the mechanisms underlying this relationship. Sex differences in all metrics and associations will also be explored to get a better understanding of cardiovascular health in young men and women.

G1 participants of ALSPAC have had their lung function measured at the ages of 8, 15 and 24 years. This data has been used to plot trajectories of their lung function, from which four distinct patterns have been identified: persistently high, normal, below average, and persistently low. It is known that below normal lung function trajectories are associated with chronic obstructive pulmonary disease, cardiovascular disease and all-cause mortality. It is therefore important that we identify and target any modifiable risk factors. We propose using linked GP and hospital records to compare the prevalence of childhood respiratory disease in each trajectory group. By looking at hospital admissions, inhaler use and the prescription of antibiotics and steroids we can also assess the severity of respiratory disease, particularly in asthma and chest infections. Identifying conditions that increase the risk of below normal lung function gives us the opportunity to target them in childhood by optimising their clinical management.

Attachment theory suggests that when babies are born, their main aim is to connect with and stay close to their caregiver. This behaviour has developed over time to help them survive. Scientists have come up with different attachment styles, like secure, avoidant, anxious, and disorganised. Previous studies have found that how well a child bonds with their caregiver can affect things like blood pressure, stress, habits, self-esteem, wellbeing and how they form and keep stable adult relationships. The upcoming research project will investigate the strength and direction of the relationship between attachment and later health and relationship outcomes.