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207. How does childhood socioeconomic hardship affect reproductive strategy? Pathways of development.

Author

Sheppard, Paula, Pearce, Mark S., and Sear, Rebecca

Subjects
*REPRODUCTIVE health, *HEALTH & social status, *CHILDREN'S health, *PUBERTY, *PUBLIC health
Abstract

Objectives In high-income populations, evidence suggests that socioeconomic disadvantage early in life is correlated with reproductive strategy. Children growing up in unfavorable rearing environments tend to experience earlier sexual maturity and first births. Earlier first births may be associated with higher fertility, but links between socioeconomic disadvantage and larger family size have rarely been tested. The pathways through which early disadvantage influences reproduction are unknown. We test whether physiological factors link childhood adversity to age at first birth and total children. Methods Using data from the Newcastle Thousand Families Study, a 1947 British birth cohort, we developed path models to identify possible physiological traits linking childhood socioeconomic status, and poor housing standards, to two reproductive outcomes: age at first birth and total children. We explored birth weight, weight gain after birth, childhood illnesses, body mass index at age 9, age at menarche, and adult height as possible mediators. Results We found direct, negative effects of socioeconomic status (SES) and housing on age at first birth, and of housing on fertility. Although we found links between childhood disadvantage and menarche and height, neither of these were significantly correlated with either reproductive outcome. Age at first birth completely mediates the relationship between childhood adversity and total fertility, which we believe has not been empirically demonstrated before. Conclusions While there are some links between childhood adversity and child health, we find little evidence that physiological pathways, such as child health and growth, link early childhood adversity to reproductive outcomes in this relatively well-nourished population. Am. J. Hum. Biol. 28:356-363, 2016. © 2015 The Authors American Journal of Human Biology Published by Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Published
2016
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208. Ambulatory Blood Pressure Variability Increases Over a 10-Year Follow-Up in Community-Dwelling Older People.

Author

McDonald, Claire, Pearce, Mark S., Wincenciak, Joanna, Kerr, Simon R. J., and Newton, Julia L.

Subjects
AMBULATORY blood pressure monitoring, MEDICAL care for older people, AGE factors in disease, BLOOD pressure, HYPERTENSION
Abstract

BACKGROUND Greater ambulatory blood pressure variability (ABPV) is associated with end-organ damage and increased mortality. Age-related changes in the cardiovascular and autonomic nervous systems make age-associated increases in ABPV likely. Cross-sectional studies support this hypothesis, showing greater ABPV among older compared to younger adults. The only longitudinal study to examine changes in ABPV, however, found ABPV decreased over 5 years follow-up. This unexpected observation probably reflected the highly selected nature of the study participants. METHODS In this longitudinal study, we assessed changes in ABPV over 10 years in a community-cohort of older people. In addition, we examined the extent to which ABPV was predicted by demographics, cardiovascular risk factors, and medication. Clinical examination and 24-hour ambulatory blood pressure monitoring were carried out at baseline and at 10 years follow-up in 83 people, median age 70 years. ABPV was calculated using SD and coefficient of variation (Cv). Three time periods were examined: daytime, nighttime, and 24 hours. RESULTS Daytime and 24-hour, systolic and diastolic, SD, and Cv were significantly greater at follow-up than at baseline (P < 0.001 in all cases). Mean BP did not change. CONCLUSIONS Multilevel modeling showed follow-up interval had a significant, positive effect on SD and Cv (P < 0.004), independent of age, sex, and medication. ABPV increased over a 10-year follow-up despite stable mean BP. ABPV may therefore be an additional target for treatment in older people. Future studies should examine what degree of ABPV is harmful and if control of ABPV reduces adverse outcome. [ABSTRACT FROM AUTHOR]

Published
2016
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209. Reduction in radiation doses from paediatric CT scans in Great Britain.

Author

CHOONSIK LEE, PEARCE, MARK S., SALOTTI, JANE A., HARBRON, RICHARD W., LITTLE, MARK P., MCHUGH, KIERAN, CHAPPLE, CLAIRE-LOUISE, and BERRINGTON DE GONZALEZ, AMY

Subjects
*COMPUTED tomography, *COMPUTER-assisted image analysis (Medicine), *CANCER risk factors research, *SCANNING systems
Abstract

Objective: Although CT scans provide great medical benefits, concerns have been raised about the magnitude of possible associated cancer risk, particularly in children who are more sensitive to radiation than adults. Unnecessary high doses during CT examinations can also be delivered to children, if the scan parameters are not adjusted for patient age and size. We conducted the first survey to directly assess the trends in CT scan parameters and doses for paediatric CT scans performed in Great Britain between 1978 and 2008. Methods: We retrieved 1073 CT film sets from 36 hospitals. The patients were 0-19 years old, and CT scans were conducted between 1978 and 2008. We extracted scan parameters from each film including tube current-time product [milliampere seconds (mAs)], tube potential [peak kilovoltage (kVp)] and manufacturer and model of the CT scanner. We estimated the mean mAs for head and trunk (chest and abdomen/pelvis) scans, according to patient age (0-4, 5-9,10-14 and 15-19 years) and scan year (<1990, 1990-1994, 1995-1999 and >2000), and then derived the volumetric CT dose index and estimated organ doses. Results: For head CT scans, mean mAs decreased by about 47% on average from before 1990 to after 2000, with the decrease starting around 1990. The mean mAs for head CTs did not vary with age before 1990, whereas slightly lower mAs values were used for younger patients after 1990. Similar declines in mAs were observed for trunk CTs: a 46% decline on an average from before 1990 to after 2000. Although mean mAs for trunk CTs did not vary with age before 1990, the value varied markedly by age, from 63 mAs for age 0-4 years compared with 315 mAs for those aged >15 years after 2000. No material changes in kVp were found. Estimated brain-absorbed dose from head CT scans decreased from 62mGy before 1990 to approximately 30 mGy after 2000. For chest CT scans, the lung dose to children aged 0-4 years decreased from 28 mGy before 1990 to 4 mGy after 2000. Conclusion: We found that mAs for head and trunk CTs was approximately halved starting around 1990, and age-specific mAs was generally used for paediatric scans after this date. These changes will have substantially reduced the radiation exposure to children from CT scans in Great Britain. Advances in knowledge: The study shows that mAs and major organ doses for paediatric CT scans in Great Britain began to decrease around 1990. [ABSTRACT FROM AUTHOR]

Published
2016
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210. CT scans in childhood and risk of leukaemia and brain tumours – Authors' reply

Author

Pearce, Mark S, primary, Salotti, Jane A, additional, Little, Mark P, additional, McHugh, Kieran, additional, Lee, Choonsik, additional, Kim, Kwang Pyo, additional, Howe, Nicola L, additional, Ronckers, Cecile M, additional, Rajaraman, Preetha, additional, Craft, Alan W, additional, Parker, Louise, additional, and de González, Amy Berrington, additional

Published
2012
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212. Health Related Quality of Life and Emotional Health in Children with Chronic Granulomatous Disease: A Comparison of Those Managed Conservatively with Those That Have Undergone Haematopoietic Stem Cell Transplant

Author

Cole, Theresa, primary, McKendrick, Fiona, additional, Titman, Penny, additional, Cant, Andrew J., additional, Pearce, Mark S., additional, Cale, Catherine M., additional, Goldblatt, David, additional, and Gennery, Andrew R., additional

Published
2012
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214. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study

Author

Pearce, Mark S, primary, Salotti, Jane A, additional, Little, Mark P, additional, McHugh, Kieran, additional, Lee, Choonsik, additional, Kim, Kwang Pyo, additional, Howe, Nicola L, additional, Ronckers, Cecile M, additional, Rajaraman, Preetha, additional, Craft, Alan W, additional, Parker, Louise, additional, and Berrington de González, Amy, additional

Published
2012
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220. DNA Methylation Patterns in Cord Blood DNA and Body Size in Childhood

Author

Relton, Caroline L., primary, Groom, Alexandra, additional, St. Pourcain, Beate, additional, Sayers, Adrian E., additional, Swan, Daniel C., additional, Embleton, Nicholas D., additional, Pearce, Mark S., additional, Ring, Susan M., additional, Northstone, Kate, additional, Tobias, Jon H., additional, Trakalo, Joseph, additional, Ness, Andy R., additional, Shaheen, Seif O., additional, and Davey Smith, George, additional

Published
2012
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225. Postnatal Growth and DNA Methylation Are Associated With Differential Gene Expression of the TACSTD2 Gene and Childhood Fat Mass

Author

Groom, Alexandra, primary, Potter, Catherine, additional, Swan, Daniel C., additional, Fatemifar, Ghazaleh, additional, Evans, David M., additional, Ring, Susan M., additional, Turcot, Valerie, additional, Pearce, Mark S., additional, Embleton, Nicholas D., additional, Davey Smith, George, additional, Mathers, John C., additional, and Relton, Caroline L., additional

Published
2012
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227. Requirements for and current provision of rehabilitation services for children after severe acquired brain injury in the UK: a population-based study

Author

Hayes, Louise, Shaw, Simon, Pearce, Mark S, and Forsyth, Rob J

Abstract

ObjectivesSurvival with brain injury is an outcome of severe illness that may be becoming more common. Provision for children in this situation has received little attention. We sought to estimate rates of severe paediatric acquired brain injury (ABI) requiring rehabilitation and to describe current provision of services for these children in the UK.MethodsThis study conducted an analysis of Hospital Episode Statistics data between April 2003 and March 2012, supplemented by a UK provider survey completed in 2015. A probable severe ABI requiring rehabilitation (PSABIR) event was inferred from the co-occurrence of a medical condition likely to cause ABI (such as meningitis) and a prolonged inpatient stay (>=28 days).ResultsDuring the period studied, 4508 children aged 1–18 years in England had PSABIRs. Trauma was the most common cause (30%) followed by brain tumours (19%) and anoxia (18.3%). An excess in older males was attributable to trauma. We estimate the incidence of PSABIR to be at least 2.93 (95%CI 2.62 to 3.26) per 100 000 young people (1–18 years) pa. The provider survey confirmed marked geographic variability in the organisation of services in the UK.ConclusionsThere are at least 350 PSABIR events in children in the UK annually, a health problem of similar magnitude to that of cerebral palsy. Service provision for this population varies widely around the UK, in contrast with the nationally coordinated approach to paediatric intensive care and major trauma provision.

Published
2017
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229. Survival adjusted cancer risks attributable to radiation exposure from cardiac catheterisations in children

Author

Harbron, Richard W, Chapple, Claire-Louise, O'Sullivan, John J, Best, Kate E, Berrington de González, Amy, and Pearce, Mark S

Abstract

ObjectivesTo estimate the risk of developing cancer in relation to the typical radiation doses received from a range of X-ray guided cardiac catheterisations in children, taking variable survival into account.MethodsRadiation doses were estimated for 2749 procedures undertaken at five UK hospitals using Monte Carlo simulations. The lifetime attributable risk (LAR) of cancer incidence was estimated using models developed by the Biological Effects of Ionising Radiation committee, based on both normal life expectancy, and as a function of attained age, from 20 to 80 years, to take reduced life expectancy into account.ResultsThe radiation-related risks from these procedures are dominated by lung and breast cancer (for females). Assuming normal life expectancy, central LAR estimates for cancer incidence, based on median doses, ranged from <1 in 2000 for atrial septal defect occlusions to as high as 1 in 150 for valve replacements. For a reduced life expectancy of 50 years, estimated risks are lower by a factor of around 7. For conditions with especially poor survival (age 20 years), such as hypoplastic left heart syndrome, estimated cancer risks attributable to radiation were <1 in 20 000.ConclusionsBased on recent UK radiation dose levels, the risk of cancer following cardiac catheterisations is relatively low and strongly modified by survival and the type of procedure. The risk of breast cancer, especially following pulmonary artery angioplasty and valve replacements, is the greatest concern.

Published
2017
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230. Emotional and behavioural difficulties in chronic granulomatous disease

Author

Cole, Theresa S, primary, Jones, Laura K R, additional, McGrogan, Paraic, additional, Pearce, Mark S, additional, Flood, Terry J, additional, Cant, Andrew J, additional, Goldblatt, David, additional, Thrasher, Adrian J, additional, Gennery, Andrew R, additional, McKendrick, Fiona, additional, and Titman, Penny, additional

Published
2011
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239. Managing Radiation Use in Medical Imaging: A Multifaceted Challenge

Author

Hricak, Hedvig, primary, Brenner, David J., additional, Adelstein, S. James, additional, Frush, Donald P., additional, Hall, Eric J., additional, Howell, Roger W., additional, McCollough, Cynthia H., additional, Mettler, Fred A., additional, Pearce, Mark S., additional, Suleiman, Orhan H., additional, Thrall, James H., additional, and Wagner, Louis K., additional

Published
2011
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