Now showing 1 - 10 of 10
  • Publication
    A Prospective Analysis of the Relationship Between Chronic Diseases and Adiposity in older adults: Findings from the Lifeways Cross-Generation Cohorts Study of a Thousand Families 2001-2014
    This study assesses the relationship between body mass index (BMI) and adult chronic diseases (diabetes mellitus type 2 [DM2], cardiovascular diseases [CVD] and cancers), in grandparents in the Lifeways Cross-Generation Cohort Study. BMI was either measured or reported, at baseline or 10-year follow-up, in 1,244 grandparents. Cumulative morbidity data were recorded at baseline, 3 and 10-year follow-up through questionnaires, General Practice note search or both. 42.4% of grandparents were overweight and 32.1% obese. In the multivariate analysis BMI showed a strong linear association with both DM2 (ptrend <0.001) and CVD (ptrend <0.001). There were no significant associations with cancers, but case numbers were small. Results were similar for waist circumference. This prospective study presents novel Irish data and confirms other recent Irish cross-sectional reports on adiposity and adult chronic disease, highlighting the need for effective health promotion interventions in older adults. 
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  • Publication
    School sociodemographic characteristics and obesity in schoolchildren: does the obesity definition matter?
    Background: Existing evidence on the role of sociodemographic variables as risk factors for overweight and obesity in school-aged children is inconsistent. Furthermore, findings seem to be influenced by the obesity definition applied. Therefore, this study aimed to investigate if school sociodemographic indicators were associated with weight status in Irish primary schoolchildren and whether this association was sensitive to different obesity classification systems. Methods: A nationally representative cross-sectional sample of 7,542 Irish children (53.9% girls), mean age 10.4 (±1.2SD) years, participating in the Childhood Obesity Surveillance Initiative in the 2010, 2012/2013 or 2015/2016 waves were included. Height, weight and waist circumference were objectively measured. Five definitions of obesity were employed using different approaches for either body mass index (BMI) or abdominal obesity. Associations between overweight and obesity and sociodemographic variables were investigated using adjusted multilevel logistic regression analyses. Results: Children attending disadvantaged schools were more likely to be overweight and obese than their peers attending non-disadvantaged schools, regardless of the obesity classification system used. Associations remained significant for the BMI-based obesity definitions when the sample was stratified by sex and age group, except for boys aged 8-10.5 years. Only boys aged ≥10.5 years in disadvantaged schools had higher odds of abdominal obesity (UK 1990 waist circumference growth charts: OR=1.56, 95%CI=1.09-2.24; waist-to-height ratio: OR=1.78, 95%CI=1.14-2.79) than those in non-disadvantaged schools. No associations were observed for school urbanisation level. Conclusions: School socioeconomic status was a strong determinant of overweight and obesity in Irish schoolchildren, and these associations were age- and sex-dependent. School location was not associated with overweight or obesity. There remains a need to intervene with school-aged children in disadvantaged schools, specifically among those approaching adolescence, to prevent a trajectory of obesity into adult life.
    Scopus© Citations 16  325
  • Publication
    Body mass index and height over three generations: evidence from the Lifeways cross-generational cohort study
    Background: Obesity and its measure of body mass index are strongly determined by parental body size. Debate continues as to whether both parents contribute equally to offspring body mass which is key to understanding the aetiology of the disease. The aim of this study was to use cohort data from three generations of one family to examine the relative maternal and paternal associations with offspring body mass index and how these associations compare with family height to demonstrate evidence of genetic or environmental cross-generational transmission. Methods: 669 of 1082 families were followed up in 2007/8 as part of the Lifeways study, a prospective observational cross-generation linkage cohort. Height and weight were measured in 529 Irish children aged 5 to 7 years and were self-reported by parents and grandparents. All adults provided information on self-rated health, education status, and indicators of income, diet and physical activity. Associations between the weight, height, and body mass index of family members were examined with mixed models and heritability estimates computed using linear regression analysis. Results: Self-rated health was associated with lower BMI for all family members, as was age for children. When these effects were accounted for evidence of familial associations of BMI from one generation to the next was more apparent in the maternal line. Heritability estimates were higher (h2 = 0.40) for mother-offspring pairs compared to father-offspring pairs (h2 = 0.22). In the previous generation, estimates were higher between mothersparents (h2 = 0.54-0.60) but not between fathers-parents (h2 = -0.04-0.17). Correlations between mother and offspring across two generations remained significant when modelled with fixed variables of socioeconomic status, health, and lifestyle. A similar analysis of height showed strong familial associations from maternal and paternal lines across each generation. Conclusions: This is the first family cohort study to report an enduring association between mother and offspring BMI over three generations. The evidence of BMI transmission over three generations through the maternal line in an observational study corroborates the findings of animal studies. A more detailed analysis of geno and phenotypic data over three generations is warranted to understand the nature of this maternal-offspring relationship.
    Scopus© Citations 88  388
  • Publication
    The determinants of self-rated health in the Republic of Ireland : further evidence and future directions
    (University College Dublin. School of Economics, 2008-04) ; ; ;
    This paper examines the determinants of self-rated health in the Republic of Ireland using data from the 2001 Quarterly National Household Survey Health Module and the 2005 ESRI Time Usage Survey. Results indicate that self-rated health is a useful proxy for self-reported chronic illness indices. Higher education, having private medical insurance cover and being married is associated with better self-rated health. The strong inverse relationship between age and self-rated health is found to be robust to the inclusion of self-reported morbidity. Caregivers display lower self-rated health, even after controlling for age, marital status and education. We find only minor effects of gender. Understanding further the causal nature of the above associations is a key issue for future research.
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  • Publication
    The determinants of self-rated health in the Republic of Ireland : further evidence and future directions
    (University College Dublin. Geary Institute, 2007-12-10) ; ; ;
    This paper examines the determinants of self-rated health in the Republic of Ireland using data from the 2001 Quarterly National Household Survey Health Module and the 2005 ESRI Time Usage Survey. Results indicate that self-rated health is a useful proxy for self-reported chronic illness indices. Higher education, having private medical insurance cover and being married is associated with better self-rated health. The strong inverse relationship between age and self-rated health is found to be robust to the inclusion of self-reported morbidity. Caregivers display lower self-rated health, even after controlling for age, marital status and education. We find only minor effects of gender. Understanding further the causal nature of the above associations is a key issue for future research.
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  • Publication
    Happy birthday? An observational study
    Background: Previous studies show contradictory findings on the relationship between birthday and deathday, in particular whether people postpone death until after their birthday. We examine the phenomenon in eight groups of famous people. Methods: Birthday and deathday for the following groups were recorded: British prime ministers, US presidents, Academy Award best actor, best female actor, best director, Nobel Prize winners, Wimbledon men’s and ladies' singles winners, all from when records began. For each group, the difference in days between the deathday and birthday was calculated. Under the hypothesis of no association, one can expect the difference to have a uniform distribution. This is assessed using goodness-of-fit tests on a circle. Results: All groups showed some departure from the uniform and it occurred around the birthday in all groups. British prime ministers, US presidents, Academy Award actors and directors, Nobel Prize winners and Wimbledon men show a ’dip' in deaths around the birthday. The length of the ’dip' varied between the groups and so they gave different p-values on different test statistics. For Academy Award female actors and Wimbledon ladies, there was rise in deaths before and after birthday. When Nobel Prize winners were subdivided into their categories, Science and Literature had a ’dip' around the birthday, but not other categories. Conclusions: We conclude ’something' happens to deathday around the birthday. Some groups of famous people show a ’dip' in death rate around the birthday while for others, particularly women, the association is in the opposite direction.
    Scopus© Citations 1  542
  • Publication
    A rapid systematic review of measures to protect older people in long-term care facilities from COVID-19
    Objectives The global COVID-19 pandemic produced large-scale health and economic complications. Older people and those with comorbidities are particularly vulnerable to this virus, with nursing homes and long term care facilities (LTCF) experiencing significant morbidity and mortality associated with COVID-19 outbreaks. The aim of this rapid systematic review was to investigate measures implemented in LTCF to reduce transmission of COVID-19 and their effect on morbidity and mortality of residents, staff and visitors. Setting Long-term care facilities. Participants Residents, staff and visitors of facilities. Primary and secondary outcome measures Databases (PubMed, EMBASE, CINAHL, Cochrane Databases and repositories and MedRXiv prepublished database) were systematically searched from inception to 27 July 2020 to identify studies reporting assessment of interventions to reduce transmission of COVID-19 in nursing homes among residents, staff or visitors. Outcome measures include facility characteristics, morbidity data, case fatalities and transmission rates. Due to study quality and heterogeneity, no meta-analysis was conducted. Results The search yielded 1414 articles, with 38 studies included. Reported interventions include mass testing, use of personal protective equipment, symptom screening, visitor restrictions, hand hygiene and droplet/contact precautions, and resident cohorting. Prevalence rates ranged from 1.2% to 85.4% in residents and 0.6% to 62.6% in staff. Mortality rates ranged from 5.3% to 55.3% in residents. Conclusions Novel evidence in this review details the impact of facility size, availability of staff and practices of operating between multiple facilities, and for-profit status of facilities as factors contributing to the size and number of COVID-19 outbreaks. No causative relationships can be determined; however, this review provides evidence of interventions that reduce transmission of COVID-19 in LTCF.
    Scopus© Citations 33  151
  • Publication
    Study Protocol: Prospective, observational, cohort study of COVID-19 in General Practice (North Dublin COVID-19 Cohort [‘ANTICIPATE’] Study)
    Background: It is accepted that COVID-19 will have considerable long-term consequences, especially on people’s mental and physical health and wellbeing. Although the impacts on local communities have been immense, there remains little data on long term outcomes among patients with COVID-19 who were managed in general practice and primary care. This study seeks to address this knowledge gap by examining how the COVID-19 pandemic has impacted the medium and long-term health and wellbeing of patients attending general practice, especially their mental health and wellbeing. Methods: The study will be conducted at 12 general practices in the catchment area of the Mater Misericordiae University Hospital, i.e. the North Dublin area, an area which has experienced an especially high COVID-19 incidence. Practices will be recruited from the professional networks of the research team. A member of the general practice team will be asked to identify patients of the practice who attended the practice after 16/3/20 with a confirmed or presumptive diagnosis of COVID-19 infection. Potential participants will be provided with information on the study by the clinical team. Data will be collected on those patients who consent to participate by means of an interviewer-administered questionnaire and review of clinical records. Data will be collected on health (especially mental health) and wellbeing, quality of life, health behaviours, health service utilisation, and wider impacts of COVID-19 at recruitment and at two follow up time points (6, 12 months). Deliverables: The project involves collaboration with Ireland’s Health Service Executive, Ireland East Hospital Group, and the Mater Misericordiae University Hospital, Dublin. The study is funded by the Health Research Board. Findings will inform health policies that attenuate the adverse impacts of COVID-19 on population mental health and health generally.
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  • Publication
    The Effect of the Great Recession on Health: A Longitudinal Study of Irish Mothers 2001-2011
    (University College Dublin. School of Economics, 2019-08) ; ;
    The relationship between recessions and health is mixed, with some evidence from the most recent financial crisis finding a positive effect on heath behaviours. This study uses longitudinal data spanning the periods before, during and after the Irish crisis of 2008, to test the impact of economic expansion and contraction on mothers physical and mental health and health behaviours. Three waves of data from the Irish Lifeways Cohort Study for the period 2001-2011, and local area employment rates from the Irish Census, are used to capture the impact of the recession on health, independent of individual employment status. The results from fixed effect linear probability models demonstrate that increases in the local unemployment rate are associated with significant increases in the probability of mothers reporting poor self-rated health and poor mental well-being. Yet the association between local area unemployment and health behaviours is mostly positive, with higher unemployment reducing the probability of being obese and tobacco consumption. The relationship with physical activity is more ambiguous. These results are largely consistent with the US literature, which is predominantly based on working men, thus demonstrating the universal impact of recessions on health.
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