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Born in Bradford John Wright YCCSA Seminar

Born in Bradford John Wright YCCSA Seminar. Growing up in Bradford. High infant mortality High rates of disability High rates of asthma Impending diabetes epidemic Childhood obesity Social change. Cohort Studies. Defined Population. N O N – R A N D O M I Z E D.

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Born in Bradford John Wright YCCSA Seminar

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  1. Born in Bradford John Wright YCCSA Seminar

  2. Growing up in Bradford • High infant mortality • High rates of disability • High rates of asthma • Impending diabetes epidemic • Childhood obesity • Social change

  3. Cohort Studies Defined Population N O N – R A N D O M I Z E D Exposed Non-exposed Disease No Disease Disease No Disease

  4. De Stavola et al 2006 AJE

  5. INFANT LIFESTYLE • Breastfeeding • Diet • Physical activity • Infant feeding/weaning • Infant care practices ADULT CHILD LIFESTYLE LIFESTYLE • Diet • Physical activity • Screen viewing ENVIRONMENT • Housing • Recreation facilities • Shops ENVIRONMENT ENVIRONMENT • Housing • Recreation facilities • Green spaces ETHNICITY ETHNICITY MEDICAL MEDICAL • Hospital/GP attendance • Infections SOCIO-CULTURAL ETHNICITY MEDICAL SOCIO-ECONOMIC GENETIC SOCIO-CULTURAL BIOLOGICAL Birth weight Anthropometry Pre-eclampsia/diabetes Congenital anomalies Kidney volume Growth Obesity/Overweight Anthropometry Immune function Growth Obesity/Overweight Allergy Well-being Education attainment CHD Diabetes Hypertension Obesity LIFE COURSE BIRTH MOTHER LIFESTYLE • Nutrition/diet • Smoking • Alcohol EXPOSURES ENVIRONMENT • Air pollution • Chemical exposures • Water ETHNICITY MEDICAL • Depression/anxiety • Diabetes • Hypertension • Infections • Obesity SOCIO-ECONOMIC • Deprivation • Social capital • Education GENETIC • Consanguinity BIOLOGICAL • Nutritional biomarkers • Metabolic biomarkers • Vitamin D OUTCOMES

  6. Data collected • Demographic/socio-economic • Family history • Lifestyle factors – smoking/drugs/alcohol • Diet • Well being – GHQ 28 • Social Capital • Clinical: antenatal and medical histories; drugs; BP; weight; U/S scans. • Blood: routine; GTT; insulin; DNA extraction

  7. BiB Database BiB Biobank

  8. Country of birth • UK born Pakistani women • Pakistani women born in Pakistani who moved to the UK aged 5 or under • Pakistani women born in Pakistani who moved to the UK aged over 5

  9. Women’s employment status

  10. Mental health 42.3% 53.7% 37.7% 29.4%

  11. Sleep-sharing by ethnicity

  12. Smoking and alcohol

  13. Exposures of interest Polycyclic hydrocarbons Heterocyclic amines Acrylamides Nitrosamines Mycotoxins (Deoxynivalenol) Organochlorins (PCBs, dioxin) DNA reactive aldehydes Alcohols

  14. Acrylamide adducts (AA-Hb, pmol/g Hb), glycidamide adducts(GA-Hb) and birth weight (grams) by country AA-Hb Birth weight GA-Hb n=238 n=216 n=244 n=189 n=217

  15. DBPs – spatial and temporal variation in the study area Fig. 1 Modelled TTHM averaged over 2006-2008 for 8 WSZs Fig.2 Modelled TTHM over 2006-2008 for each WSZ • Little spatial variation in TTHM concentrations in the Bradford region (Fig. 1) • Clear pattern of seasonal variation – TTHM concentrations peak in late summer (Fig.2)

  16. Monitoring Nitrogen Oxides • Three 2-weekly monitoring periods (summer, winter and intermediate) during 2009 • 40 NOx sites (using Ogawa badge) at Traffic, Urban Background and Rural Background sites Keighley Bingley Bradford

  17. ESCAPE NO2 predictions

  18. Cyrrillic

  19. Growth faltering v WHO 2006

  20. Vitamin D status and ethnic origin

  21. Seroprevalence of herpes virus infection

  22. Atopy • 14 schools • 155 children tested • Mean age at test: 5.3 years (range 4.6 – 6.2) • 42 children, 27% atopic (95% CI 20 – 35) • Based on 2mm weal size: 52 children, 34% atopic (95% CI 26 – 42)

  23. First 125 BradCAS cases: Consanguinity In the BradCAS cohort there is an excess of births which are the product of a consanguineous union. Consanguinity overall OR 1.98 (95% CI 1.4-2.8)

  24. Structure Process Impact of BiB Outcome Awareness raising Capacity building NHS infrastructure Communities of practice Better measurement General practice profiles Congenital anomalies register Evidence base Diabetes detection

  25. Promoting healthier lifestyles? • Has being part of the Born in Bradford project made you more aware of the health of you and your child? 71% • Has being part of Born in Bradford encouraged you to adopt a healthier life style? 61%

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