what is life course epidemiology?
- a life course approach in epidemiology investigates the long term effects on chronic disease risk and ageing of physical and social hazards during gestation, childhood, adolescence, young adulthood and later adult life across generations
- it studies biological, behavioural and psychosocial pathways that operate across the life course and influence the development of chronic diseases
give some examples of factors affecting childbirth in Britain in 1946
- social class gradients affecting nutrition/diet and cost of childbirth (before NHS)
- still on rations from war affecting mother’s nutrition
- less medical knowledge + advances
- lower hygiene and sanitation (often shared bathrooms with many families and only half had running hot water
give some examples of healthcare changes since 1946
- NHS introduced
- development of vaccines
- reduction of occupational hazards
- clean air act
- shift of diseases affecting now middle and later life
- awareness and advances of diet and nutrition
- more advanced medications and treatments
give some examples of education changes since 1946
- education act forming the 11+ exam to get into secondary school
- many reports improving access to higher education
give some examples of emotional well being changes since 1946
- mother’s began to learn the importance of bonding and relationship with their child for its development
- start talking about mental health issues and normalising them
across the UK what is the general location spread of a higher proportion of people with ischemic heart disease?
- highest in wales, north west and north east
what is the link between coronary heart disease mortality and birth weight?
- as birthweight increases, risk of mortality of coronary heart disease decreases
why is fetal undernutrition/lower body weight linked to increased risk of coronary heart disease?
- undernutrition =
- adapted liver metabolism = increased LDL, cholesterol and fibrinogen
- changes in structure of heart, blood vessels and kidney = hypertension and left ventricular hypertrophy
- re-set HPA and GH-IGF axes = hypertension and left ventricular hypertrophy and non-insulin-dependent diabetes
- changes in pancreas and muscle = non-insulin-dependent diabetes
= all lead to coronary heart disease
what is the link between grip strength and birth weight?
- the higher the birth weight, the increase grip strength
why is cognitive function an important aspect of health and function?
- key determinant of everyday mastery
- highly socially and culturally patterned
- a marker of underlying physiological process
- associated with health and survival
what does this diagram show?
- the correlation coefficients between different factors affecting the national adult reading test scores
what is the correlation between birth weight and cognitive function?
- increased birth weight causes increased cognitive function
what could be some possible causes as to why a higher birthweight is linked to better cognitive function?
- Insulin-like growth factor play a critical role in determining physical growth, and have receptors located in brain areas important for cognition like the hippocampus
- thyroid hormone also has dual somatic and CNS effects and may also interact with IGF
- glucocorticoids are negatively associated with physical growth and cognition and are partly under control of thyroid hormone and also diminish IGF production
what is the association between early adversity and childhood cognition?
- the higher the severity/frequency of early adversity, the lower the childhood cognition
what are adverse childhood experiences (ACEs)?
- things that happen in a child’s life that can negatively impact them for the rest of their lives
- e.g. abuse of any form, parents’ divorce, living with someone struggling with addiction or substance abuse, witnessing domestic violence, living with someone with severe mental illness, losing a parent or close relative
what do adverse childhood experiences increase the risk of in children?
- suicide rates
- substance abuse
- early sexual experiences
- intimate partner violence
- less attendance to school
what is the correlation between cardiovascular disease risk and dementia risk?g
increased risk of cardiovascular disease is correlated with an increased risk of dementia
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CPP2003 Good medical practice5
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CPP2005 an introduction to artificial intelligence in health care11
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CPP2093 suicide awareness5
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CPP2098 Civility and patient safety6
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CPP2017 Systematic reviews spl15
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CPP2066 life course epidemiology17
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CPP2067 Interpretation of epidemiology studies20
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CPP2068 Patient visitor living with genetic disease2
