Proposal summaries

These are research proposals that have been approved by the ALSPAC exec. The titles include a B number which identifies the proposal and the date on which the proposals received ALSPAC exec approval.

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B3524 - The association between different modes of delivery for childbirth and sexual health a studying using ALSPAC data - 04/05/2020

B number: 
B3524
Principal applicant name: 
Harriet Forbes | Bristol University (UK)
Co-applicants: 
Dr Abigail Fraser, Florence Martin
Title of project: 
The association between different modes of delivery for childbirth and sexual health: a studying using ALSPAC data
Proposal summary: 

Sexual health can impact upon a person’s quality of life. Being pregnant and having a child can affect a woman’s body and mind in a way that may affect their sexual health. We know that when couples have babies, their sexual activity is likely be low in the first few months after the birth. Yet what we don't know is if the mode of delivery (in other words having a vaginal or a ceasrean delivery) affects female sexual health, particularly in the medium to long-term.

Impact of research: 
With some women’s motivation for elective cesarean a perception that their sexual health will be better maintained, and elective cesarean now becoming available on maternal request, better data in this area may help to disprove the link between delivery mode and sexual function, and thereby help curb the rise of cesarean within certain women.
Date proposal received: 
Thursday, 30 April, 2020
Date proposal approved: 
Monday, 4 May, 2020
Keywords: 
Epidemiology, Pregnancy - e.g. reproductive health, postnatal depression, birth outcomes, etc., Statistical methods, Birth outcomes

B3521 - HDR-UK South West Better Care Partnership - 01/05/2020

B number: 
B3521
Principal applicant name: 
Jonathan Sterne | University of Bristol
Co-applicants: 
Prof John Macleod, Dr Rachel Denholm
Title of project: 
HDR-UK South West Better Care Partnership
Proposal summary: 

Better Care South-West Partnership is a collaboration of NHS commissioners, primary, secondary, community and mental health care providers, local authorities, and academia. They look to address real-world health problems using the Bristol, North Somerset and South Gloucestershire (BNSSG) Systemwide health and social care dataset and have an ambition to use individual-level, linked routine care and administrative data to deliver a learning, Integrated Care System for the local population.
The Partnership represents a step change in using advanced analytics to deliver Better Care Loops across a care system and benefit patients and partner organisations. Its results will be scalable across the region and nationally.
Research Projects
· P-NEWS: personalised early warning scores for preventing unplanned critical care admission
· Precision antimicrobial prescribing: safeguarding patient outcomes and preserving future efficacy
· Using operation research methods to improve flow between acute and social care: modelling the responsiveness of system-level expenditure to changes in social care capacity
· Improving hospital efficiency by forecasting demand for hospital beds
· Underpinning infrastructure to the BNSSG Systemwide dataset

Impact of research: 
Date proposal received: 
Tuesday, 28 April, 2020
Date proposal approved: 
Friday, 1 May, 2020
Keywords: 
Health Services Research/Health Systems Research

B3522 - The Healthier Together Population Data Platform - 01/05/2020

B number: 
B3522
Principal applicant name: 
Rachel Denholm | University of Bristol (UM)
Co-applicants: 
Prof. John Macleod, Dr Philip Harfield, Andrew Boyd, Prof. Nicholas Timpson
Title of project: 
The Healthier Together Population Data Platform
Proposal summary: 

Health and care services are increasingly planned and provided using patient data shared securely across multiple health-care settings. However, we know that people’s health is influenced by a wide range of things, including social, cultural, and economic factors. Unfortunately, we don’t currently have data resources that link information about these things to improve service planning, individual care and research.
Our project will fund the information technology and people to bring together information from multiple sources, including, local councils and other services such as the police, as well as the detailed data collected as part of research studies. We will do this using secure technologies and protecting patients’ confidentiality.
By combining and analysing data, we will be able to work with public services to help identify people at higher risk of a condition or disease, and deliver better, more joined up care that is both more effective and offers better value.

Impact of research: 
This application is centred on an existing partnership across NHS organisations, local government, and academia, brought together through the BNSSG Population Health Management (PHM) Steering group to support “Healthier Together” the regional ICS that will succeed the BNSSG Sustainability and Transformation Partnership (STP) over the next two years. As emphasised in the NHS Long-term Plan, the viability and value of an ICS will depend on the availability of a readily analysable person level view of the population and its interactions with the health and care system(5). The BNSSG Systemwide dataset was established for this purpose. The proposed data platform would extend available BNSSG Systemwide dataset linkages beyond the health care system, to include a view of wider determinants of health, such as social care and criminal justice, as well as research data, broadening the application of the resource. Such an integrated data resource would support: a) mapping of patients’ pathways across multiple services b) evaluation and improvement of service delivery across multiple organisations c) understanding of the efficiencies and effectiveness of a whole care system d) understanding public need across the whole system e) the effective rapid response to emerging threats f) understanding wider influences on well-being The opportunities provided with this linkage, and the availability of retrospective and prospective data, have huge potential to inform the effective system response to public health emergencies, such as the COVID-19 pandemic.
Date proposal received: 
Tuesday, 28 April, 2020
Date proposal approved: 
Friday, 1 May, 2020
Keywords: 
Health Services Research/Health Systems Research

B3523 - Fine-mapping of vascular reactivity loci using human artery multi-omics analyses - 01/05/2020

B number: 
B3523
Principal applicant name: 
Clint Miller | University of Virginia (USA)
Co-applicants: 
Title of project: 
Fine-mapping of vascular reactivity loci using human artery multi-omics analyses
Proposal summary: 

Vascular diseases such as hypertension, migraine, and atherosclerosis (hardening of arteries) involve changes in vascular cell function with reduced ability to contract and relax in response to different stresses. This results in chronic alterations in artery blood flow and maladaptive structural changes to the vascular wall leading to injury, tissue damage, and increased risk for life-threatening diseases such as stroke and heart attacks. Given that naturally occurring genetic variation contributes to changes in vascular function along with environmental risk from early life stages, it is now critical to evaluate the effects of these genetic associations at this stage using more systematic approaches. We plan to integrate these vascular phenotype data with high resolution molecular data to better understand how these genetic risk factors impact vascular disease risk at an early age.

Impact of research: 
The results of these analyses will lead to high impact publications and valuable summary datasets to enable the development of novel diagnostic, prognostic and therapeutic strategies to mitigate a range of debilitating vascular diseases.
Date proposal received: 
Tuesday, 28 April, 2020
Date proposal approved: 
Friday, 1 May, 2020
Keywords: 
Genetics, Endothelial dysfunction/artery stiffness (subclinical vascular disease) , Computer simulations/modelling/algorithms, DNA sequencing, Gene mapping, GWAS, Genetic epidemiology, Genetics, Genomics

B3518 - Using a machine learning approach to develop and validate a prediction model for the onset of hypomania - 12/05/2020

B number: 
B3518
Principal applicant name: 
Steven Marwaha | University of Birmingham
Co-applicants: 
Dr Pavan Mallikarjun, Dr Sam Leighton, Miss Danielle Hett, Professor Daniel Smith, Mr Joey Ward
Title of project: 
Using a machine learning approach to develop and validate a prediction model for the onset of hypomania
Proposal summary: 

Bipolar disorder (BD) is a debilitating mental health condition, characterised by severe shifts in mood, that can range from disabling highs (i.e., mania/hypomania) to extreme lows (i.e., depression). Approximately 1% of the population are affected by bipolar (Pini et al., 2005), with most people experiencing the onset of mood symptoms prior to their 20s (Geoffroy et al., 2013). Despite this, little is known about the predictors to bipolar disorder and hypomania symptoms, particularly among young people. Intervening early in the development of bipolar is a top clinical priority, and one that may have the potential to limit its functional and symptomatic impact on those affected. Thus, predicting the onset of bipolar/hypomania prior to its onset, may help clinicians/researchers to develop novel, tailored preventative strategies and interventions for young people.

Impact of research: 
These results will have direct clinical implications for young people who wish to know their risk of developing hypomania, a strong signal of bipolar disorder. Currently, due to the overlap in symptoms, people presenting with bipolar symptoms are often being managed within early intervention services developed for the treatment of psychosis. This could be preventing young people presenting with bipolar symptoms from receiving adequate diagnosis and appropriate treatments early on in their care. Indeed, research suggests that, compared to out-patient treatment, early intervention may be a more clinically and cost-effective tool in managing bipolar. Thus, developing a prediction model for the onset of bipolar, novel preventative/ early intervention programmes— that are tailored to young people specifically—can be developed. This research remains a key clinical priority and will ultimately help towards reducing the psychological suffering of those with bipolar disorder. A prediction model could also enable clinicians to avoid potentially harmful treatments for people at heightened risk of bipolar, such as antidepressants which are known to trigger hypomania in people who are vulnerable to the condition.
Date proposal received: 
Monday, 27 April, 2020
Date proposal approved: 
Friday, 1 May, 2020
Keywords: 
Mental health - Psychology, Psychiatry, Cognition, Mental health, Statistical methods, Statistical methods

B3519 - The impact of COVID-19 Lockdown on family interactions and infant behaviours - 30/04/2020

B number: 
B3519
Principal applicant name: 
Rebecca Pearson | Dr (United Kingdom)
Co-applicants: 
Dr Andy Skinner , Professor Paul Moran , Dr Helen Bould , Dr Iryna Culpin
Title of project: 
The impact of COVID-19 Lockdown on family interactions and infant behaviours
Proposal summary: 

The impact of the public health measures adopted to control the COVID-19 pandemic on young infants and family interactions is unknown. New information is vital to inform future policies and recovery for families and aid infant development. Infants may show more unsettled and
restless behaviours even if they are not aware of the situation, however, they may also show positive behaviours benefiting from more parental attention if parents are home. Understanding of both is important to manage further transitions in an ever changing home environment. Furthermore , young children will have been separated from wider family and friends. Online chats may provide a helpful substitute to retain attachments, but how young infants respond to such interactions is unknown . Using our existing methods to code indepeth parent and infant verbal and non-verbal behaviours we can compare parent and infant behaviours in interactions at this time to already collected and coded interactions of ALSPAC-G2 families pre-pandemic. We can also compare infant behaviours towards parents in the same room and a mimicked online interaction (where the one parent joins a chat from another room).

Impact of research: 
A secure adaptation of our current methods would a) allow us to continue to collect these valuable data and b) support the development of a platform for the collection of high-resolution data on family mental health and family interactions at this time of national crisis. The resource being requested would allow us to refine this process with professional experts in product design with whom we already had already begun to forge a successful partnership before the pandemic. The remote solution is also of benefit to our partner projects using the cameras in Africa, Chile and Brazil. Impact: Identifying key sources of changes in risk and resilient behaviours can inform strategies to support families and guide policies for future traumas, including the possibility of a second COVID-19 peak.
Date proposal received: 
Tuesday, 28 April, 2020
Date proposal approved: 
Thursday, 30 April, 2020
Keywords: 
Mental health - Psychology, Psychiatry, Cognition

B3517 - Longitudinal prevalence of covid-19 symptoms in the ALSPAC cohorts - 28/04/2020

B number: 
B3517
Principal applicant name: 
Nic Timpson | ALSPAC / University of Bristol
Co-applicants: 
Dr. Kate Northstone, Dr. Simon Haworth
Title of project: 
Longitudinal prevalence of covid-19 symptoms in the ALSPAC cohorts
Proposal summary: 

Infection by the sars-cov-2 virus (coronavirus) causes a range of flu-like symptoms which can be mild or serious. To date, testing for coronavirus in the Bristol area has focussed on people with severe symptoms. This means that existing test results do not give a full picture of how many people in the Bristol area have already had coronavirus infection.

Rather than using tests, it may be possible to track the spread of coronavirus over time by looking at how many people are experiencing flu-like symptoms. This analysis plans to divide flu-like symptoms into two groups (those which are specific to coronavirus and those which are common in many types of cold or flu) and compare how the rate of these has changed between October 2019 and June 2020. This may give more information about the posible true rate of mild infection in the Bristol area, as well as how the number of people with coronavirus is changing over time.

Impact of research: 
This research should help characterize; a) the approximate proportion of people living in the Bristol area who have reported symptoms of covid-19 and b) the timing (emergence and peak) of these symptoms
Date proposal received: 
Monday, 27 April, 2020
Date proposal approved: 
Tuesday, 28 April, 2020
Keywords: 
Epidemiology, Infection, Statistical methods, Immunity

B3520 - Host genetic effects on covid-19 susceptibility and outcomes - 01/05/2020

B number: 
B3520
Principal applicant name: 
Nic Timpson | ALSPAC / University of Bristol
Co-applicants: 
Dr. Gibran Hemani, Dr. Simon Haworth, Dr. Tom Dudding, Dr. Alex Kwong, Dr. Samuel Neaves, Dr. Kerry Pettigrew
Title of project: 
Host genetic effects on covid-19 susceptibility and outcomes
Proposal summary: 

It is not clear why some people who are exposed to sars-cov-2 (the coronavirus) only develop mild symptoms while others go on to have life-threatening infections. Age and pre-existing medical problems are important, but it is likely that genetic factors also explain why some people are more susceptible to infection. One way to identify the most relevant genetic factors is to screen millions of points across the whole human genome and see which markers are more or less common in people with infection.

This type of analysis (called a genome-wide association study) needs very large studies to generate reliable results, and it is common to run the anlaysis in multiple different studies and then combine results. A global consortium has recently been set up to co-ordinate analysis of host genetic factors and coronavirus. This proposal plans to run genome-wide analysis in ALSPAC and share the results of this anlaysis which can then be combined with other studies globally. To do this it will be necessary to re-impute (re-process) the existing ALSPAC genetic data into an updated format so the results of analysis matches other studies.

Impact of research: 
Results from genetic association anlaysis may help improve understanding of the interplay between host factors and virus which lead to infection or immunity, and lead to mild or severe symptoms during infection. This information may help inform a range of future anlaysis ranging from vaccine development to drug development for patients with severe infection.
Date proposal received: 
Tuesday, 28 April, 2020
Date proposal approved: 
Tuesday, 28 April, 2020
Keywords: 
Genetic epidemiology (including association studies and mendelian randomisation), Infection, GWAS, Genetic epidemiology, Genome wide association study

B3515 - Non-invasive Characterisation Diagnosis Prognosis of COVID-19 Respiratory Infection - 27/04/2020

B number: 
B3515
Principal applicant name: 
Dek Woolfson | University of Bristol (UK)
Co-applicants: 
Adam Finn, Dr Catherine Hyams, Professor Stephen Harper
Title of project: 
Non-invasive Characterisation (Diagnosis & Prognosis) of COVID-19 Respiratory Infection
Proposal summary: 
Impact of research: 
COVID-19 diagnostic testing
Date proposal received: 
Wednesday, 22 April, 2020
Date proposal approved: 
Monday, 27 April, 2020
Keywords: 
Immunology, Infection, COVID-19 testing Serological testing Infection Pandemic epidemiology, Biological samples -e.g. blood, cell lines, saliva, etc.

B3514 - Quantifying social contact patterns during the COVID-19 epidemic - 24/04/2020

B number: 
B3514
Principal applicant name: 
Ellen Brooks-Pollock | University of Bristol
Co-applicants: 
Dr Leon Danon, Dr Hannah Christensen, Dr Amy Thomas
Title of project: 
Quantifying social contact patterns during the COVID-19 epidemic
Proposal summary: 

Quantifying social contacts is essential for understanding how a disease will spread in a population. We have measured contact patterns using surveys that have formed the basis of predictive modelling presented at the UK Government Modelling advisory group on COVID-19. Here, we will measure social contact patterns during this unprecedented time of social distancing in the UK and compare to other studies and settings.

Impact of research: 
This work will contribute to predictive COVID-19 modelling in the UK
Date proposal received: 
Tuesday, 21 April, 2020
Date proposal approved: 
Friday, 24 April, 2020
Keywords: 
Epidemiology, COVID19, Mathematical modelling, Reproduction Number, COVID19, mathematical modelling, social contact patterns

B3516 - Exploring the associations between paternal postnatal depression aspects of involvement and parenting and child development - 24/04/2020

B number: 
B3516
Principal applicant name: 
Iryna Culpin | Centre for Academic Mental Health, Population Health Sciences, University of Bristol (United Kingdom)
Co-applicants: 
Xingyu Wang, Dr Jonathan Evans , Dr David Kessler
Title of project: 
Exploring the associations between paternal postnatal depression, aspects of involvement and parenting and child development
Proposal summary: 

There is strong epidemiological evidence to suggest that paternal postnatal depression (PPD) is associated with adverse offspring developmental outcomes in early childhood. However, few large prospective longitudinal studies have examined whether these adverse outcomes persist into later childhood (7 years of age). Furthermore, the offspring outcomes are heterogenous and effect sizes are small to moderate. Thus, it is important to elucidate putative mechanisms, i.e. mediating factors, that underly associations between PPD and offspring adverse developmental outcomes. Such insights are crucial to highlight those at greater risk and develop targeted interventions to reduce adverse outcomes in offspring of depressed fathers. A substantial body of evidence suggests that an important potential mediator is the quality of parenting. Specifically, evidence suggests that PPD disrupts paternal levels of involvement with the offspring and quality of parenting (e.g., bonding, enjoyment, confidence), which, in turn, is associated with adverse offspring outcomes, including emotional and behavioural problems. However, few population-based studies have examined potential explanatory role of fathers’ involvement and parenting in the association between PPD and offspring development using longitudinal mediation models.

Impact of research: 
The role of fathers continues to be overlooked in developmental research, thus, the impact of these findings is likely to be high across several disciplines, including public health, epidemiology and sociology. Although the link between PPD and adverse child development is now well-established, the understanding of mechanisms that underly this association is still lacking. Longitudinal population-based study examining such mechanism is likely to impactful.
Date proposal received: 
Thursday, 23 April, 2020
Date proposal approved: 
Friday, 24 April, 2020
Keywords: 
Epidemiology, Pregnancy - e.g. reproductive health, postnatal depression, birth outcomes, etc., Statistical methods, Parenting

B3512 - What are the dietary lifestyle and socio-demographic predictors of metabolically healthy obesity in adolescence - 21/04/2020

B number: 
B3512
Principal applicant name: 
Genevieve Buckland | Centre for Academic Child Health (United Kingdom)
Co-applicants: 
Dr. Caroline Taylor, Sophie Edwards, Louise Jones
Title of project: 
What are the dietary, lifestyle and socio-demographic predictors of metabolically healthy obesity in adolescence?
Proposal summary: 

The on-going childhood obesity epidemic is accompanied by dramatic increases in childhood metabolic disorders, such as paediatric type 2 diabetes and a cluster of metabolic complications. However, children with obesity are not all equally prone to developing these metabolic disorders; research has shown that there is a subset of obese children who have a more ‘favourable’ health profile, including good insulin sensitivity and normal blood pressure, glucose regulation and blood lipid levels. This has been termed metabolically healthy obesity (MHO), which contrasts with metabolically unhealthy obesity (MUO), where excess body fat is accompanied by metabolic disorders. Since most of the research to date on MHO and MUO has focused on adults, the specific determinants of MHO and MUO in paediatric groups are still not clearly understood.

The concept of metabolically unhealthy and metabolically healthy profiles can also be applied to individuals of ‘normal’ weight, since normal-weight individuals can also have the metabolic and/or inflammatory abnormalities commonly observed in obese people. This group has been termed normal-weight metabolically unhealthy (NWMU). NWMU adults are also at increased risk of cardiometabolic diseases, however, little is known about the health profile and predictive characteristics of NWMU in children.

The relatively high proportion of metabolically healthy individuals in the obese (ranging from 4-60%) and metabolically unhealthy individuals in the lean population suggests that besides from total calories, diet quality could be an important influencing factor on metabolic health. However, few studies have looked at how dietary patterns in children might influence the sub-groups of obesity. Therefore, this study aims to identify which dietary patterns, lifestyle behaviours and socio-demographic factors in children are related to MHO and MUO, as well as NWMU in adolescents. Gaining a clearer understanding of the health profile, characteristics and potential determinants of MHO and MUO in paediatric groups could be valuable in developing more efficient and targeted treatment approaches for these groups of children with obesity.

Impact of research: 
Childhood obesity is associated with increased risk of cardiometabolic disease, type II diabetes, metabolic syndrome and premature mortality. Defining the sub-group of overweight/obese children who remain metabolically healthy (and lean children who are metabolically unhealthy) is important as it can aid in understanding which factors protect against the clustering of metabolic alternations in these sub-groups. Specifically, this study should improve our understanding of the health profile, socio-demographic characteristics and dietary patterns that are associated with metabolic health status in overweight/obese and lean children. This will add to the information available when updating public health guidelines and when developing more efficient personalised approaches for interventions and treatment of obese adolescents based on metabolic health status.
Date proposal received: 
Monday, 20 April, 2020
Date proposal approved: 
Tuesday, 21 April, 2020
Keywords: 
Epidemiology, Obesity, Prospective association analysis, BMI

B3513 - Record Linkage to support Covid-19 Research in ALSPAC Immediate Covid-19 research objectives - 24/04/2020

B number: 
B3513
Principal applicant name: 
Andy Boyd | University of Bristol
Co-applicants: 
Prof. John Macleod, Prof. Nic Timpson, Dr Catherine Hyams, Dr Ashley Toye
Title of project: 
Record Linkage to support Covid-19 Research in ALSPAC & Immediate Covid-19 research objectives
Proposal summary: 

ALSPAC is well-placed to contribute to the national/international Covid-19 research effort given it has an extensive archive of data about participants health and wellbeing and circumstances prior to the Covid-19 outbreak and is now collecting data specifically related to Covid-19. These data can be used with our biobank and genetic data.

This project seeks to enhance these data with NHS and other Covid-19 records. These will bring timely information about symptoms, help-seeking and care and disease outcomes. It will allow ALSPAC to look at Covid-19 specific health (i.e. the health of those with the virus) and wider general physical and mental health (which may be impacted by stretched NHS resources during the outbreak, or due to the 'lock-down' and social distancing).

This data will sit alongside the other health records ALSPAC have collected. The same security mechanisms will be used to keep the data confidential, and ALSPAC will not extract records from participants who have objected to this use of their data.

The records will be sourced from:

1) A new NHS national (English) repository of Covid-19 data (GP records, Hospital Records, Pharmacy data, NHS 111 call records, Ambulance Records, Mortality Records, Covid-19 testing records).
2) Respiratory care records from databases at NHS University Hospital Bristol Trust and NHS North Bristol Trust hospitals.
3) Records from the 'Zoe' symptom tracker app.

ALSPAC will immediately use the data to help understand more about the factors that influence the susceptibility and severity of Covid-19. We will also examine whether Blood Group and the FUT2 gene (and other genes) are associated with Covid-19 susceptibility.

Impact of research: 
To contribute Covid-19 records to ALSPAC's research program. To help facilitate research insights to the NHS & government policy makers.
Date proposal received: 
Tuesday, 21 April, 2020
Date proposal approved: 
Tuesday, 21 April, 2020
Keywords: 
Epidemiology, Infection, Record lInkage, Linkage

B3511 - Environment DNA methylation and risk of childhood acute lymphoblastic leukaemia a novel two-sample MR study - 24/04/2020

B number: 
B3511
Principal applicant name: 
Aayah Nounu | The University of Bristol (United Kingdom)
Co-applicants: 
Title of project: 
Environment, DNA methylation and risk of childhood acute lymphoblastic leukaemia: a novel two-sample MR study
Proposal summary: 

Acute lymphoblastic leukaemia (ALL) is the most common cancer in children. Whilst a range of genetic abnormalities have been identified as crucial in disease initiation, these abnormalities alone are not sufficient for transformation. Maternal exposures during pregnancy such as smoking, or folate intake have the potential to impact on offspring DNA methylation. This epigenetic mark has also been shown to be altered in ALL. We have previously identified 5 CpG sites that have altered DNA methylation due to maternal smoking and folate intake and we aim to identify whether changes to DNA methylation at these sites affects risk of ALL.

Impact of research: 
The exact reasons and risk factors associated with childhood ALL is still not well understood. Through this analysis, we might be able to understand how maternal exposures during pregnancy may impact risk of ALL in offspring. This has the potential to be used in policy making, especially when advising mothers on smoking and folate intake during pregnancy.
Date proposal received: 
Monday, 20 April, 2020
Date proposal approved: 
Tuesday, 21 April, 2020
Keywords: 
Epidemiology, Cancer, Statistical methods, Mendelian randomisation

B3510 - Developmental Origins of Health and Disease as mediated and moderated by social determinants within the family - 28/04/2020

B number: 
B3510
Principal applicant name: 
Stefanie Pilkay | Syracuse University (United States)
Co-applicants: 
Carrie Smith, Ryan Heath, Kendra DeLoach McCutcheon, Xiafei Wang, Margaret Althea Voss, Brooks Gump, Tara Veerman, Tracy Marchese
Title of project: 
Developmental Origins of Health and Disease as mediated and moderated by social determinants within the family
Proposal summary: 

The proposed study aims to identify biomarkers (DNA methylation and measures of health) of stress and early-life adversity that indicate risk and resilience for health, and the potential mitigation of health risks by family-related social factors. We want to explore this within the child, and investigate the possible intergenerational transmission of maternal experience to child health.

Impact of research: 
We hope to identify novel targets for intervention to foster resilience in the face of adversity for at-risk families in the U.S. Moreover, we hope to provide additional insight into the epigenetic mechanisms, and the role they play, in the pathways for intergenerational transmission of adversity effects.
Date proposal received: 
Friday, 17 April, 2020
Date proposal approved: 
Monday, 20 April, 2020
Keywords: 
Social Science, Behaviour - e.g. antisocial behaviour, risk behaviour, etc., Cognitive impairment, Mental health, Obesity, Pregnancy - e.g. reproductive health, postnatal depression, birth outcomes, etc., Computer simulations/modelling/algorithms, Statistical methods, Biomarkers - e.g. cotinine, fatty acids, haemoglobin, etc., Childhood - childcare, childhood adversity, Development, Epigenetics, Expression, Parenting, Pets, Social science, Statistical methods

B3504 - The role of children and school closures in the transmission of COVID-19 - 30/04/2020

B number: 
B3504
Principal applicant name: 
Amy Thomas | University of Bristol, Bristol Veterinary School (UK)
Co-applicants: 
Dr Ellen Brooks Pollock, Professor Adam Finn , Dr Leon Danon, Dr Hannah Christensen, Dr Alice Halliday, Professor Mick Bailey, Dr Jane Metz, Dr Emily Nixon
Title of project: 
The role of children and school closures in the transmission of COVID-19
Proposal summary: 

School closures have been a central component of many countries’ response to contain COVID-19; however, we don’t know:
• What children do during unplanned school closures
• Whether children are infectious
• Whether other strategies could be equally effective.
Much of the policy is based on influenza, which does affect children more than SARS-CoV-2 [1].

Preliminary evidence suggests that children are able to become infected with SARS-CoV-2, but are either asymptomatic or show mild symptoms, with a minority of cases progressing to disease [2]. The role of healthy children in transmitting SARS-CoV-2 remains uncertain. It is of interest to define how many children do/don’t experience COVID-19 symptoms and have evidence of having had SARS-CoV-2 infection, this may have implications for transmission dynamics and policy decisions. Along with many European countries, the UK decided to close schools from March 23rd in an effort to slow SARS-CoV-2 transmission - only some vulnerable children and those of key workers remain in school. We do not know what children’s contact patterns are during this unplanned school closure, but there is evidence that contacts inside and outside the home might continue, especially for older children and where parents don’t agree with closures [3]. We propose to deploy a survey to G2 ALSPAC children to capture data on symptoms and contact patterns during the COVID-19 pandemic, as well determine evidence of SARS-CoV-2 infection through saliva antibody detection methods.

Impact of research: 
Understanding the role of children in transmission of SARS-CoV-2 is essential to inform the rapidly developing policies in response to the SARS-CoV-2 pandemic and for informing current and future policies in response to infectious disease outbreaks. Ellen Brooks-Pollock and Leon Danon are contributors to the UK Government pandemic modelling advisory group, so these results will have immediate impact. Linking antibody detection to the planned contact survey allows i) assessment of the contribution of children in transmitting SARS-CoV-2, and ii) enhances the accuracy of self-reported disease surveillance. This has immediate impact on transmission control. The adverse effects of school closures (secondary economic and societal) simply might outweigh the perceived benefit until we better understand the role of children in transmission of SARS-CoV-2. This study will offer insights into novel control strategies, possibly negating full school closures. Finally, this work is part of a larger rapid response of researchers at the University of Bristol (Bristol UNCOVER). Collection of paediatric saliva samples during the SARS-CoV-2 pandemic will be of high value to investigate the natural history of mucosal immune responses to SARS-CoV-2.
Date proposal received: 
Thursday, 9 April, 2020
Date proposal approved: 
Monday, 20 April, 2020
Keywords: 
Epidemiology, Infection, Computer simulations/modelling/algorithms, Qualitative study, Statistical methods, Biological samples -e.g. blood, cell lines, saliva, etc., Cohort studies - attrition, bias, participant engagement, ethics, Immunity

B3509 - Effects of feeding practice on childrens eating behavior and weight growth - 20/04/2020

B number: 
B3509
Principal applicant name: 
Qianling Zhou | Peking University (China)
Co-applicants: 
Meijing An
Title of project: 
Effects of feeding practice on children’s eating behavior and weight growth
Proposal summary: 

Children born with the ability of self-regulated cues of hunger and satiety. During early life, this ability is developed in a good way will facilitate healthy eating behaviours, which may be associated appropriate weight gain. In the first two years, milk feeding and complementary feeding are main feeding aspects,which could have impact on children’s self-regulation of hunger and satiety cues. Previous studies showed that breastfeeding duration and timing of solid food introduction were associated with children’s eating behaviours(eg. enjoyment of food, food fussiness, picky eating, eating slowly, overeating and so on) and weight growth. For example, Samantha L. Rogers found that breastfeeding duration was related to slower weight gain during 1 to 6 month and 1 to 12 month, and that breastfeeding duration was associated with slowness in eating at 12 m. Wang jing found that introducing complementary foods before 4 months of age compared to at 4~6 months was associated with and increased risk of being overweight and obesity during children. These findings indicated that infant feeding practice may exert an important role on development of children’s weight health However, the evidence about the relationship between concrete feeding mode such as bottle feeding, breast feeding, feeding on demand and children’s eating behaviors and weight growth were limited. Whether children’s eating behaviors and related gene variant play a mediated role on the relationship between feeding practices and weight gain also deserves exploring from a longitudinal perspective.

Impact of research: 
The finding will help researchers to understand the associations between infant feeding practices and children’s eating behaviors and growth. The results will be used to guide professional worker to propagate scientific feeding practices to parents, which will help parents nurture children’s healthy eating behaviors and promote children to grow normally.
Date proposal received: 
Friday, 17 April, 2020
Date proposal approved: 
Monday, 20 April, 2020
Keywords: 
Epidemiology, Eating disorders - anorexia, bulimia, Statistical methods, Growth

B3508 - A robust micro-assay to determine the prevalence of COVID-19 antibodies in the general population using capillary sample collect - 24/04/2020

B number: 
B3508
Principal applicant name: 
Kathleen Gillespie | University of Bristol (UK)
Co-applicants: 
Title of project: 
A robust micro-assay to determine the prevalence of COVID-19 antibodies in the general population using capillary sample collect
Proposal summary: 

The Diabetes and Metabolism Unit at Southmead has a long history of measuring antibodies. Over the last three years we have focused on a particular type of assay which works on very small samples of blood. We have also good systems for sending small tubes by post which allow people to take a small blood sample from their finger and post it safely back to the laboratory for antibody testing. Since the recent COVID-19 pandemic we do not know how many people have been infected by the virus and this is a very important question. We have been working closely with a research group in Milan who have developed a test to work out who has been infected with Covid-19 because they have antibodies to the virus. Initial tests suggest that this assay works well on very small blood samples. We are now setting up this assay in Bristol and are requesting to access some samples from ALSPAC for
1. a University of Bristol study to test different assay platforms using the same samples
2. to prospectively and safely collect low volume samples by post and use the assay to estimate the infection rate in the general population and link this to questionnaire based data regarding symptoms.
This study should allow us to work out quickly and reliably how many people in the ALSPAC population have had COVID-19.

Impact of research: 
We thick it could be very important as our assay allows samples to be safely collected and tested under lockdown conditions.
Date proposal received: 
Friday, 17 April, 2020
Date proposal approved: 
Monday, 20 April, 2020
Keywords: 
Immunology, Infection, Immunoassay , Immunity

B3505 - Maternal iodine status in pregnancy and association with social/behavioural disorders in offspring - 17/04/2020

B number: 
B3505
Principal applicant name: 
Sarah Bath | University of Surrey (UK)
Co-applicants: 
Dr Madhu Wickremaratchi
Title of project: 
Maternal iodine status in pregnancy and association with social/behavioural disorders in offspring
Proposal summary: 

Iodine is essential during pregnancy as it is required for fetal brain development. It is known that low iodine status in pregnancy is linked to lower IQ and reading ability scores. In some other cohorts mild-to-moderate deficiency or subtle impairments of maternal thyroid function has been linked to conditions such as ADHD and autism. We now want to explore the relationship between mild-to-moderate iodine deficiency in UK women with social/behavioural disorders in children.

Impact of research: 
Further evidence of the role of iodine in pregnancy in areas of mild-to-moderate deficiency, building on our previous work with ALSPAC data.
Date proposal received: 
Tuesday, 14 April, 2020
Date proposal approved: 
Friday, 17 April, 2020
Keywords: 
Mental health - Psychology, Psychiatry, Cognition, Behaviour - e.g. antisocial behaviour, risk behaviour, etc., Statistical methods, Biological samples -e.g. blood, cell lines, saliva, etc.

B3506 - Examining patterns and predictors of mental health during and in response to COVID-19 - 17/04/2020

B number: 
B3506
Principal applicant name: 
Alex Kwong | University of Bristol
Co-applicants: 
Dr Rebecca Pearson, Professor Nic Timpson, Dr Kate Northstone, Dr Simon Haworth, Professor David Gunell, Professor Paul Moran, Professor Kate Tilling
Title of project: 
Examining patterns and predictors of mental health during and in response to COVID-19
Proposal summary: 

The coronavirus (COVID-19) pandemic has had and will continue to have an unprecedented effect of daily living for the foreseeable future. Aside from the obvious effects of COVID-19 on physical health, this pandemic is also likely to have a profound effect on mental health. The knock on effects on mental health could be far reaching and long term especially if not understood and managed.

In addition, it is likely to exacerbate existing inequalities and the costs are likely to be felt disproportionately to the already most vulnerable ( those with a history of mental illness, job and housing insecurity , poor neighbourhoods , single parents and those in abusive relationships).

A number of rapid surveys have indicated an initial perceived rise in depression and anxiety symptoms. However, without pre-pandemic information, an accurate indication of the change is not possible. This is essential for modelling projected risk which needs to be taken into account when planning further policy regarding social distancing and lock down enforcements.

Longitudinal data is thus crucial. It is also important to identify at risk groups who could benefit from immediate help and planning for currently unknown policies for recovery stages. This project will use the unique data hosted by ALSPAC to examine how and why mental health changes as a result of the public health policies adopted during the COVID-19 pandemic.

Impact of research: 
This research is likely to be one the first longitudinal studies of mental health during COVID-19 and will provide evidence for public health and policy makers about how mental health is changing throughout this pandemic.
Date proposal received: 
Tuesday, 14 April, 2020
Date proposal approved: 
Friday, 17 April, 2020
Keywords: 
Mental health - Psychology, Psychiatry, Cognition, Mental health, Statistical methods

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