Proposal summaries
B236 - Average blood pressure blood pressure variability and post-exercise pressure in adolescents - 01/02/2005
(No outline received).
B222 - Lead Exposure - 01/02/2005
(No outline received).
B220 - Antibiotic resistance and pet ownership - 01/02/2005
(No outline received).
B219 - MRSA and pet ownership - 01/02/2005
(No outline received).
B218 - The use of homeopathic products in childhood data generated over 85 years - 01/02/2005
The overall aim of this project is to increase the awareness, knowledge and understanding of homeopathic product use in such a large cohort of children and to generate hypotheses for future research. Objectives included identifying the following:
* The number of children using homeopathic products and at what ages.
* The frequency of homeopathic product use at these different ages.
* The types of conditions for which homeopathy is used by children.
* The names of the actual homeopathic products used (names of remedies, creams, preparations etc).
* The source of the child's homeopathic prescription e.g. GP, Homeopathic doctor, Professional Homeopath, chemist etc.
Further objectives included:
* What are the misconceptions of homeopathic product use for children?
* What are the patterns of use? How often are children given homeopathic remedies over time, infrequently or frequently?
* What is the perceived usefulness of homeopathic medicine use and is there greater usefulness in certain indications such as glue ear, eczema and asthma?
* What are the differences in conditions treated with products/treatments prescribed by GP, Homeopathic doctor, Professional Homeopath, chemist etc.?
* Does family use determine whether children receive homeopathic medicine?
Methods
The Avon Longitudinal Study of Parents and Children (ALSPAC), is a population-based cohort study of 14,000 children recruited in Avon, South-West England during 1990-92 while their mothers were pregnant(6). The study has generated data regarding many aspects of the families' health, well being, social, demographic and environmental features. Questionnaires completed by the mother at regular time points during pregnancy and throughout the life of the child have provided a valuable data source of CAM use including use during pregnancy and over time by the children (now aged 12-14 years) and their parents. For this project, 7 time points were identified as providing available data on child homeopathic product use at 18, 54, 65, 78, 81, 91 and 103 months. These included a specific question enquiring about the child's use of homeopathic medicines asked at 18 and 81 months and also provides information on conditions treated using homeopathic products at these ages.
At 81 months the question asks about who had prescribed the homeopathic medicine, whether it was, for example, a homeopathic doctor, professional homeopath or chemist. A question enquiring about treatments for accidents and illnesses (that included a list of substances including homeopathic medicines) was asked at 54, 65, 78, 91 and 103 months. A further question dedicated to the child's use of CAM was asked at 103 months. This will provide information on the use of CAMs (including homeopathic medicines) ever taken, the age of the child when taken, the condition it was taken for and the perceived usefulness of the treatment. Table 1 summarises the above questions asked at each time point.
For the data analysed here, all questions had both a tick box response and a space for a written text description of the homeopathic products used. Tick box entries were keyed and entered into a statistical program. Text descriptions were keyed and then coded by a Homeopath using a coding frame specifically devised for the ALSPAC CAM data.
The criteria of inclusion for the written descriptions of homeopathic products were: (a) named individual remedies, (b) New Era Tissue Salt products, (c) Nelson's formulated range, (d) specific products from Weleda's range, (e) other combination remedies, (f) homeopathic creams and tinctures, and (g) Bach Flower Remedies and Essences (including Bach Flower Rescue cream). Each remedy or product was assigned an individual code.
Where written descriptions did not automatically link to any of the products listed in the inclusion criteria above (such as "remedy for...", "from my homeopath...", "constitutional remedy" etc) they were assigned a non-specific homeopathic product code (labelled as 'HPNS'). Any descriptions that were clearly non-homeopathic were coded as such and will be used in the analyses of the specific homeopathic questions at 18 and 81 months as analyses of other products confused with homeopathic ones to show misconceptions of use.
All data were analysed using SPSS v.12.0.1, frequencies of overall use and of specific homeopathic products were generated at each time point.
B216 - The effect of early childhood exposure to lead on neurodevelopment and behaviour of school age children - 01/02/2005
1) To examine whether or not an association exists between early (age 2 to 3 years) high exposure to lead as indicated by top percentile blood levels (full range at this age 0.5-30) and IQ, attention and behaviour at 8 years of age amongst the "Children in Focus" cohort group from the ALSPAC (Avon Longitudinal Study of Parents and Children) - Children of the 90s database.
2) To examine whether or not there is any association between lead level and IQ, attention and behaviour at 8 years of age and levels of early exposure below the current level of concern.
B215 - Is the use of homeopathic medicine inversely related to the use of antibiotics in pre-school children - 01/02/2005
To explore:
1) If children who take homeopathic medicine take fewer antiobiotics.
2) Socio-demographic determinants of homeopathic and antibiotic use amongst pre-school children.
B306 - DNA Banking for 1958 Cohort extension of B285 - 06/01/2005
A nationally representative set of EBV-transformed lymphocyte cultures has been established from 44-45-year-old participants in the biomedical examination of the British 1958 birth cohort. These have been used to create a renewable DNA collection for use as a reference series in genetic case-control studies. This has proved a popular resource.
There are currently 20 active users of this DNA collection, many of them funded by the Wellcome Trust. 1500 samples are currently being genotyped as a control group for the WT-funded Genetic Case-Control Consortium. Results for 1 million SNPs, on sample sizes between 1500 and 8000 DNAs, are expected during 2006.
This application requests continuity of support for the Bristol laboratory to maintain the cell line resource and to continue providing DNA arrays at no charge to users. It also proposes extension of the data management and website development activity at St George's, so that incoming genotypes can be processed in a timely and user-friendly fashion into a publicly accessible on-line reference library of genotype and allele frequencies, already piloted with over 9000 SNPs deposited to date.
Our key goal is to maximise scientific value for money from this large population-based cell line collection (WT programme grant068545/Z/02).
B213 - Parental attitudes to healthcare administration of medicinal products to children occurrence of side effects - 01/01/2005
(No outline received).
B212 - The use of complementary medicine and the implications for NHS healthcare provision in Bristol a qualitative study - 01/01/2005
The main purpose of the proposed research is to explore the use of complementary medicine among families participating in the Avon Longitudinal Study of Parents and Children (ALSPAC), in order to examine the implications of this for health care provision in Bristol.
Specific objectives to be addressed are:
* To examine why families (within ALSPAC) use complementary medicine and the implications of this for NHS patient care in Bristol.
* To investigatewhich particular complementary medicines are used by different family members and for what reasons.
- To examine where family members access complementary medicine (e.g. private complementary therapists, over-the-counter complementary medicines, complementary medicine within the NHS) and the reasons for this.
- To investigate the sources of information on complementary medicine used by family members and how they make judgements about the quality or trustworthiness of that information.
- To investigate whether families/family members disclose their complementary medicine use to NHS health professionals and the implications of this for their NHS care and professional-patient relationships.
- To explore how families/family members integrate complementary medicine use with conventional NHS healthcare.
B211 - Exposure to environmental tobacco smoke and lung function in childhood using Mendelian Randomisation in ALSPAC - 01/01/2005
Background. 1) Current research has shown that atherosclerosis starts early in life. The social patterning of coronary heart disease (CHD) in adulthood is also likely to start early in life. However, knowledge of the social patterning of the pre-clinical phases of CHD (endothelial function) and its early life determinants in childhood is scarce. 2) The role of passive smoking, a potential exposure linked to the early social patterning of disease, on CHD aetiology is controversial. Applying the principle of Mendelian randomisation will allow me to investigate whether there is a link between exposure to passive smoking in childhood and measures of early-life atherosclerosis.
Objectives.
1. To systematically review the current evidence regarding social patterning of CHD exposures and pre-clinical disease indicators occurring in early life.
2. To describe the social patterning of endothelial function in childhood.
3. To describe the social patterning of CHD risk factors in early life.
4. To investigate how the social patterning of potential CHD early-life risk factors contributes to the social patterning of endothelial function in childhood.
5. To investigate whether candidate genetic polymorphisms associated with slower detoxification of tobacco smoke are associated with endothelial dysfunction among children exposed to environmental tobacco smoke.
Methods.
Systematic reviews will establish the strongest candidate factors in early life contributing to the development of atherosclerosis and social inequalities in adulthood (Objective 1).
TheAvon Longitudinal Study of Parents and Children (ALSPAC) is a unique prospective cohort study set up to investigate the health and development of children. Vascular function measures are available from at least 6,000 children and include flow mediated dilation, arterial distensibility and pulse wave velocity. DNA for genotyping was obtained from 10,232 children. Early life CHD risk factors and detailed childhood socioeconomic circumstances data are available.This will allow establishing which exposures are likely to initiate and contribute to the social patterning of CHD risk (Objectives 2 to 4).
Polymorphisms in candidate genes related to detoxification of tobacco smoke and their association with endothelial dysfunction will be assessed in the ALSPAC cohort (Objective 5).
Scientific opportunity. The ALSPAC cohort offers a unique opportunity to answer scientific questions regarding the early life determinants of disease andseveral funders have given program support to this cohort. The analyses, proposed here for the first time, will enhance the scientific return from this investment.
Public health importance This proposal will inform interventions for public health policy by identifying the early life factors that may contribute to the adult social patterning of CHD risk. In addition, it will provide evidence regarding a potential link between passive smoking and vascular dysfunction.
B217 - The effect of COMT and other genetic polymorphisms on cognition in childhood with reference to potential intermediate phenotypes in schizophrenia and other neuro-psychiatric disorders - 01/12/2004
The study aimed to determine the cognitive effect of the Val108/158Met polymorphism in the catechol-O-methyltransferase (COMT) gene in children before and during puberty. This polymorphism affects cognitive function in healthy adults and may contribute to risk for schizophrenia. METHOD: COMT genotype was determined for 8,707 children from the Avon Longitudinal Study of Parents and Children (ALSPAC), a geographically defined general population cohort of children born between April 1, 1991, and Dec. 31, 1992, in the southwest of England.
Fourteen measures of cognitive function--including working memory, verbal and motor inhibition, attentional control, and IQ--were assessed at ages 8 and 10 years. Any pubertal development at age 9 years was reported by parents. Effects of COMT genotype on cognition and interactions with gender and puberty were assessed using general linear models. RESULTS: In boys, genotype significantly affected executive function and explained up to 10 points normal variation in verbal IQ. The effects on IQ were significantly greater in pubertal than in prepubertal boys. In girls, there were no significant effects of genotype on cognition. CONCLUSIONS: This common polymorphism may be one of the genes of small effect that contribute to normal variation in IQ. The gender-specific nature of the effect and its possible interaction with puberty may be relevant to both normal cognitive and brain development and to abnormal development in disorders such as schizophrenia.
B209 - European research collaboration - Decode - 01/12/2004
(No outline received).
B205 - Infants with initial evidence of perinatal asphyxia but rapid clinical improvement and subsequent cognitive ability - 01/12/2004
Severe intrapartum hypoxia is associated with neurodevelopmental disability, however little is known about the possible long-term effects of mild hypoxia during birth on subsequent neurodevelopment. Around one in 30 neonates have an initially low Apgar Score (less than 7) but recover by 5-10 minutes and the accepted view is such hypoxia can only cause later disability if the infant develops encephalopathy. There is evidence that perinatal hypoxia can injure areas of the brain which are more concerned with cognitive function, only becoming apparent later in life when cognitive function becomes possible to assess.
The aim of the proposed fellowship is the study the association of initially low Apgar Scores, a measure of fetal compromise, with measures of neurodevelopment age 8-10 years and in early adulthood (age 18) in two complimentary datasets. The first dataset is based on a linkage of the Swedish birth register (including 1, 5 and 10 minute Apgar Scores) with the conscription intelligence test records (age 18) of around 110,000 Swedish men. The second complementary dataset , the Bristol-based Avon Longitudinal Study of Parents and Children (ALSPAC) is a birth cohort of 14,000 intants containing more detailed measures of neurodevelopment up to age of 10 years.
B204 - Life-course determinants and longitudinal definitions of cognition emotion and social functioning orders disorders in the general population - 01/12/2004
(No outline received).
B203 - Life course exposures social determinants of oral health - 01/11/2004
(No outline received).
B202 - Can occupation influence the development of asthma and respiratory problems in partners and children - 01/11/2004
Asthma is common in childhood and, while many causes for its occurrence and increasing prevalence are known, much remains unanswered in terms of causes. In adults, 10-15% of newly diagnosed asthma is due to an occupational exposure to either low (e.g. isocyanates) or high (e.g. proteins in animal urine) molecular weight asthmagens. Lung disease in the spouses and children of workers exposed to asbestos at work is accepted and recognized. There is a report of children being sensitized to occupational sensitizers, to which their parents have been exposed at work, there is also a report of a child exposed to occupational sensitizers in the workplace developing 'occupational' asthma. In addition there are reports of asthma related to spousal occupation. The magnitude of this potential problem has not been investigated.
We wish to test the hypothesis that children are more likely to develop asthma if their parents work in occupations known to be associated with a risk of occupational asthma because parents may bring asthmagens home on their clothing, resulting in their children being exposed. In addition, we will take the opportunity to determine whether the partner of a worker exposed to occupational sensitizers is more likely to develop asthma. The hypothesis will concentrate on high molecular weight causes although potential exposure to low molecular weight agents will be analysed.
We will use existing data from the ALSPAC cohort of children to relate childhood wheezing, diagnosed asthma, and rhinitis, to parental occupation. In addition, parental occupation will also be related to objective parameters such as ventilatory function and bronchial responsiveness in later childhood (8 1/2 years) to determine if early life and/or cumulative exposure to parents in high-risk occupations are associated with physiological changes. Maternal wheeze, diagnosed asthma, and rhinitis will also be related to her partner's occupation.
Data on occupation have been obtained for both mother and father prospectively and will be coded using the CASCOT system developed by the University of Warwick. Parental occupations will be classified according to recognized associations with occupational asthma. We will also explore whether there is any relationship between the timing of childhood exposure to potential parental occupational asthmagens at 21 months of age and the likelihood of developing asthma. Risk modification by atopy and environmental tobacco smoke exposure will be investigated. The dataset will also provide the opportunity to consider parental self reported asthma or rhinitis in relation to occupation, adding to the limited population data in this area. Finally we will be able to assess the level of agreement between maternal and direct report of spouse's occupation and compare these with the codes generated by automatic and semi-automatic coding software (i.e. SOC 1990 and SOC 2000 codes from CASCOT).
If occupation is shown to increase the risk of asthma in children and partners, help and advice will need to be given to workers in at risk occupations to reduce carriage of asthmagens home on their clothes, in order to reduce the risk of their children and partner developing 'bystander occupational' asthma.
B201 - Telomere length at birth as a predictor of risk of cardiovascular disease - 01/11/2004
(No outline received).
B198 - Growth in children receiving medication for ADHD - 01/10/2004
(No outline received).
B196 - Fertility and secondary infertility - 01/10/2004
(No outline received).