Locus of control is described as the way an individual perceives the outcome of events in their life as caused by their own actions (internal) or caused by outside factors uncontrolled by them (external). Research has linked locus of control, particularly external locus of control, with psychopathology, such as depressive symptoms, social anxiety symptoms, and psychotic-like experiences.

There is some evidence indicating that it may also be a risk factor for eating disorders. However, this research is mostly cross-sectional so it can't be ruled out that external locus of control is a consequence of eating disorders. To date, there is a lack of longitudinal research on this association, which limits our understanding of whether there is a causal association.

The present study aims to bridge this gap in the literature by investigating the association between external locus of control in childhood at age 8 and eating disorder symptoms in adolescence at age 16.

During the COVID-19 pandemic, vaccination efforts were crucial in controlling the spread of SARS-CoV-2. While we know from previous studies that factors including older age, immunosuppression, and obesity contribute to a reduced response to vaccination and increase the risk of breakthrough infection. Host genetic variability is increasingly appreciated to contribute to vaccination variability but contemporary studies lack power and diversity of immune measure and participant inclusion to truly understand the contribution and mechanism of genetic effects. By using statistical genetics approaches this project aims to better understand the role genetics plays in determining response to COVID-19 vaccines in different populations. This analysis may provide valuable insights into the factors influencing vaccine efficacy and inform future vaccine design and deployment strategies worldwide.

There is variation in when and how children develop speech in early
childhood. Some children experience difficulties in the process but many
of these have speech which is well developed by the time they start
school. Some children have persistent problems which continue into early
childhood. These problems can be associated with problems with
educational attainment in older childhood as well as having difficulties in
making themselves understood. Some of these children will have
problems with their speech as a result of subtle problems with the
coordination of the movements required for speech while others will
have difficulties associated with the cognitive skills involved in developing
speech. Some will have problems with both.
Genes have been identified which are associated with some types of
speech and language difficulties but it is not yet clear what part genes
may play in persistent speech sound disorder. The analysis outlined in this
proposal will enable us to determine to what extent children's problems
with speech after they have started school may be associated with
genetic factors rather than environmental factors. This information will
help us identify how best to help children who present with these
difficulties to speech and language therapists and in school.

DNA methylation (chemical marks on the DNA code) can change the activity of genes and how our cells function. There is evidence that mother’s environment can influence her baby’s DNA methylation and have lasting health consequences.

Little is known about how DNA methylation affects the genes related to the thyroid gland but it could be an important factor in thyroid disease and health.

Using large established datasets (TWINS-UK, ALSPAC), we will explore how DNA methylation at important areas of the genetic code influences thyroid hormone production in children and how the mother’s environment may contribute to these DNA methylation changes.

Atopic dermatitis (AD), also known as eczema, is a common skin disorder that is highly heritable and affects over 20% of children worldwide. AD can cause dry skin, intense itching, rash, swollen skin, and oozing, leading to sleep deprivation and social embarrassment. It can also impair the quality of life not only of patients but also of their families. Earlier childhood AD is a strong predictor for adolescence or adulthood AD. Families with AD children of patients tend to utilize healthcare services more frequently and experience greater social and economic challenges than non-ADs.
Although AD is highly heritable, some modifiable environmental exposures, such as pollution, dry skin, stress, and obesity, are also found to be related to its development since these exposures can change gene expressions, called DNA methylation (DNAm), and can result in skin disorders. Investigating what environmental exposures cause DNAm and how DNAm causes AD will enable us to understand the underlying molecular mechanisms of this disease and allow public health efforts to predict and manage environmental exposures of AD more effectively at earlier stages of life, potentially reducing the burden of AD on patients, families, and healthcare systems. To this end, this proposed study aims to identify the causal effect of DNAm level due to modifiable environmental risk factors on AD using a two-step Mendelian Randomization (MR) test. We will use the Avon Longitudinal Study of Parents and Children dataset (ALSPAC, United Kingdom) for the analyses. The MR test is an epidemiological method designed to estimate the causal relationship of exposure with a disease in observational (non-experimental) data. In the two-step MR test, we first identify the causal effect of environmental factors on the DNAm. This DNAm will then be used in the second step to investigate the causal effect on AD. We expect to find the causal relationship between DNAm and AD. To our knowledge, this is the first study using the two-step MR test to investigate the causal relationship between DNAm level due to modifiable environmental exposures and AD.

Respiratory Tract Infections (RTIs) are the most common health problem in childhood, with children suffering on average 4-8 RTIs a year. Social determinants like parental education and household income, in addition to environmental and behavioural risk factors early in life, can influence susceptibility to RTI outcomes. Children living in disadvantaged socio-economic circumstances (SECs) are more likely to suffer from severe RTI outcomes, but the pathways leading to these inequalities are complex, inter-related and poorly understood. The overall objective of this project is to understand the burden of Upper and Lower Respiratory Tract Infections in children in Europe. Using federated analyses of data from the EU Child Cohort Network, the project aims to explore the social and geographic patterns and the pathways that relate social characteristics, early-life risk factors and childhood RTIs. Understanding these patterns and pathways is vital to inform preventative policy and help reduce the unfair child health differences through effective public health interventions.

One in 5 children in the United Kingdom speak two or more languages (Department of Education, 2020). Some studies have shown that bilingual children have greater mental health issues compared to monolingual children (Guhn, et. al., 2010). However, Halle et al. (2012) found that bilingual children had fewer mental health problems than their monolingual peers. Due to mixed results in the literature, it is unclear what the consequences for children’s and adolescents’ mental health when grown-up bilinguals. Using data from the Millennium Cohort Study (MCS), we have shown that bilingualism acts as a protective factor on mental health for children between 3 to 11 years old (Salgado-Garcia, Devine, & Krott, in preparation). Compared to monolingual children, bilingual children had lower levels of internalizing and externalizing problems when sex differences, nonverbal IQ, family background (SES), school characteristics, and language proficiency were taken into account. The current project aims to investigate the cognitive mechanisms underpinning the difference between bilingual and monolingual children’s mental health, specifically focus on executive functions and theory of mind.

There has been very little previous research on the topic of public involvement (PI) in non-clinical research. The applicants work in longitudinal population and epidemiological studies and are aware of the importance and difficulty of including the public in this work, partly because these studies do not focus on a specific medical topic or procedure but collect data on a large variety of illnesses, lifestyles, and risk factors. We are also aware that the PI groups which do exist suffer from selection bias, in that the members do not reflect either the participants in observational studies or the background population from which they are drawn. These biases mean that PI groups are not ethnically or socioeconomically diverse and do not equally represent gender groups. This has important implications for the design both of longitudinal studies themselves and secondary epidemiological research using their data if we are to avoid tokenistic involvement and healthy participant bias. Our intention is to involve PI groups in all aspects of the design and conduct of observational studies and to help us to identify future research questions. An appropriate PPI groups could also provide valuable advice on how to recruit and retain certain groups of people.
There is existing evidence (Lang 2022) that although the UK is world leading in including PPI groups in its research, perhaps because of funder stipulations, only 20% of the total number (3000) of studies investigated included PI, and of these ~ only 16% were observational research and ~15% were cohort research. However, this evidence was only drawn from one journal BMJ Open. The potential important benefits of good PI use are well known, but few seem to manage it. Also, PI is seldom if ever evaluated to see what makes a difference to the quality and impact of resulting research. We would like to conduct some research to investigate which methods of recruitment and conduct of PPI are likely to be the most effective. We would then like to start to build capacity in this area and set up some kind of educational package to ensure future proofing.

Importance and need Ambient air pollution (AAP) causes 4.2 million premature deaths globally each year. It is a major contributor to non-communicable diseases, second only to cigarette smoking. In early-life, exposure to AAP influences the long-term risk of chronic disease development. Many diseases associated with AAP, such as respiratory illnesses , originate in childhood. Poor and ethnic minority children are disproportionately affected by AAP . Effective and equitable policy interventions targeting children are thus crucial. As a vulnerable group unable to control their exposures, children need to be considered and protected in policy transitions to clean air and net-zero.
Advancing current understandings and practice To tackle the inequitable health burden of AAP, we need to advance our understanding of where early-life exposures occur and how different children may be exposed differently and/or respond differently to the same exposures. This advanced understanding needs to be incorporated into decision-support tools, most notably health impact assessments (HIA), which can then assess equity impacts of clean air and net-zero transitions. I propose building a holistic program centred on the integration of multidisciplinary data, methods, tools, and networks. This integration will enable me to innovatively capture childhood exposure to AAP, estimate novel associations with chronic disease development, create and implement an equity oriented HIA, and foster enduring strategic coalitions and partnerships. The innovation in the exposure assessment can uncover fundamental insights into exposure disparities and health effects of AAP. The equity oriented HIA tool can have transformative impact on practice and policymaking. And creating a nucleus of diverse and engaged stakeholders can amplify the program’s impact. My approach will pave the way for addressing other complex and inequitable environmental health challenges.
Timeliness and trends I have been researching AAP and its health effects, primarily in children, over the past decade. The challenge of AAP is enduring. Whilst overall AAP levels have declined in some countries including the UK, levels are still considered too high to protect human health remaining above World Health Organisation (WHO) guidelines. Net-zero policies, such vehicles electrification, are expected to reduce AAP. However, these reductions will not be enough; tempered by a large, projected increase in future demand for transport leading to potential increases in non-exhaust emissions .
General AAP reductions also mask environmental injustice where there has been no progress in reducing the exposure gap between socioeconomic and racial groups . In the UK, the exposure gap between the poor and rich even increased in what has been cited as a failure of UK air quality policy . This failure is evident at locations important for children’s health. UK schools with high annual particulate matter less than 2.5 micrometres in diameter (PM2.5) levels (>12 μgm-3) had a significantly higher intake of pupils on free school meals (17.8%) and ethnic minorities (78.3%) compared to schools with low PM2.5 (<6 μgm-3, 6.5% on free school and 6.8% ethnic minorities) . Children spend about 30% of their time in schools . Commuting to school is another major contributor to exposure that is understudied. For example, AAP during commuting was 52% higher than exposures at school on average . Commuting mode and routes dictate exposures and vary between socioeconomic and racial groups complicating the understanding of equity impacts of e.g., transport policies targeting travel to school.
There is also sporadic evidence that the most exposed children might respond differently to their AAP exposures. This can be due to higher individual susceptibility or complex interactions with environmental, lifestyle and social characteristics. For example, despite controlling for a comprehensive set of confounders, I consistently observed larger associations between AAP and asthma and wheeze in children from families who struggled financially and children from Pakistani origins in Bradford, UK. So far, I do not have a satisfactory explanation of such differences but an indication of slightly higher exposure variability in the Pakistani but not the financially strained children. The question as to whether certain children respond differently to their exposures remains challenging to answer via traditional epidemiological studies which predominantly rely on a naïve assessment of exposure at the residential address only. Such studies are the norm and incapable of accurately representing exposure variability.
Impact Advancing current understandings of where exposures occur, how exposures vary across different children, and how different children might react differently to AAP has significant implications for policymaking. It can pinpoint which environments policies need to target to be most effective (e.g., at schools, on the route to school) and reveal any differential impact of policies on subgroups who may need more prioritization through a stratified approach to prevention (e.g., ethnic minorities).
But advancing understandings without a holistic approach to drive impact will not be enough. New knowledge needs translation into a new generation of equity oriented HIA, a key aspect of my program. I will use the HIA to test various clean air and net-zero policies solicited from and designed with stakeholders, focusing on climate policies which represent pathways in motion that can reduce both pollutant and greenhouse gas emissions. This focus strategically aligns with current national and global agendas on, and large investments in, net-zero and can reorient policy to better reduce inequities. As equity is also political and multi-sectoral, I acknowledge that my vision of reducing inequity extends well beyond the provision of new scientific information or adept decision-support tools. Actively engaging with policymakers and clustering influential partners to champion children’s health, prioritize equity and uptake novel science and tools is essential and at the heart of my program.