Investigating the impact of London's ultra low emission zone on children's health: children's health in London and Luton (CHILL) protocol for a prospective parallel cohort study.

BACKGROUND: Air pollution harms health across the life course. Children are at particular risk of adverse effects during development, which may impact on health in later life. Interventions that improve air quality are urgently needed both to improve public health now, and prevent longer-term increased vulnerability to chronic disease. Low Emission Zones are a public health policy intervention aimed at reducing traffic-derived contributions to urban air pollution, but evidence that they deliver health benefits is lacking. We describe a natural experiment study (CHILL: Children's Health in London and Luton) to evaluate the impacts of the introduction of London's Ultra Low Emission Zone (ULEZ) on children's health. METHODS: CHILL is a prospective two-arm parallel longitudinal cohort study recruiting children at age 6-9 years from primary schools in Central London (the focus of the first phase of the ULEZ) and Luton (a comparator site), with the primary outcome being the impact of changes in annual air pollutant exposures (nitrogen oxides [NOx], nitrogen dioxide [NO2], particulate matter with a diameter of less than 2.5micrograms [PM2.5], and less than 10 micrograms [PM10]) across the two sites on lung function growth, measured as post-bronchodilator forced expiratory volume in one second (FEV1) over five years. Secondary outcomes include physical activity, cognitive development, mental health, quality of life, health inequalities, and a range of respiratory and health economic data. DISCUSSION: CHILL's prospective parallel cohort design will enable robust conclusions to be drawn on the effectiveness of the ULEZ at improving air quality and delivering improvements in children's respiratory health. With increasing proportions of the world's population now living in large urban areas exceeding World Health Organisation air pollution limit guidelines, our study findings will have important implications for the design and implementation of Low Emission and Clean Air Zones in the UK, and worldwide. CLINICALTRIALS: GOV: NCT04695093 (05/01/2021).

Understanding lived experiences and perceptions of resilience in black and South Asian Muslim children living in East London: a qualitative study protocol.

INTRODUCTION: It is important to promote resilience in preadolescence; however, there is limited research on children's understandings and experiences of resilience. Quantitative approaches may not capture dynamic and context-specific aspects of resilience. Resilience research has historically focused on white, middle-class Western adults and adolescents, creating an evidence gap regarding diverse experiences of resilience in middle childhood which could inform interventions. East London's Muslim community represents a diverse, growing population. Despite being disproportionately affected by deprivation and racial and cultural discrimination, this population is under-represented in resilience research. Using participatory and arts-based methods, this study aims to explore lived experiences and perceptions of resilience in black and South Asian Muslim children living in East London. METHODS AND ANALYSIS: We propose a qualitative study, grounded in embodied inquiry, consisting of a participatory workshop with 6-12 children and their parents/carers to explore lived experiences and perceptions of resilience. Participants will be identified and recruited from community settings in East London. Eligible participants will be English-speaking Muslims who identify as being black or South Asian, have a child aged 8-12 years and live in East London. The workshop (approx. 3.5 hours) will take place at an Islamic community centre and will include body mapping with children and a focus group discussion with parents/carers to explore resilience perspectives and meanings. Participants will also complete a demographic survey. Workshop audio recordings will be transcribed verbatim and body maps and other paper-based activities will be photographed. Data will be analysed using systematic visuo-textual analysis which affords equal importance to visual and textual data. ETHICS AND DISSEMINATION: The Queen Mary Ethics of Research Committee at Queen Mary University of London has approved this study (approval date: 9 October 2023; ref: QME23.0042). The researchers plan to publish the results in peer-reviewed journals and present findings at academic conferences.

The effect of breastfeeding on neuro-development in infancy.

The present study examines whether breastfeeding is associated with neuro-developmental advantages at 9 months of age on a standardised measure of infant development in a large cohort study of Irish children. It is hypothesised that if breast-milk confers an independent benefit, infants who were never breastfed will have reached fewer developmental milestones than those who were partially or exclusively breastfed, after controlling for putative confounding variables. Families with infants aged 9-months were recruited as part of a nationally representative sample for the birth cohort of the Growing Up in Ireland study (n = 11,134). Information was collected from mothers on breastfeeding practices, socio-demographic characteristics and developmental progress during a household interview. Parent-report items on development covered communication, gross motor, fine motor, problem solving and personal-social skills. Analysis of pass/fail status in each developmental domain using binary logistic regression showed a positive effect of any breastfeeding on gross motor, fine motor, problem solving and personal-social skills (but not communication) and these remained after adjustment for a range of confounding variables. There was, however, little evidence of a dose-response effect or advantage of exclusive over partial breastfeeding. A clear advantage of breastfeeding on infant development was demonstrated. However, the lack of a dose-response association on pass rates suggests that the breastfeeding effect may be confounded by other unobserved factors or that there is a critical threshold during which time the effect of breast milk may be particularly salient for bolstering brain development.

Body mapping for arts-based inquiry in mental health research: a scoping review.

Traditional research methods have not yet yielded highly effective long-term mental health treatments and might not reflect diverse lived experiences. Body mapping, which is an arts-based research method, could complement the verbal data of existing approaches through its focus on visual and symbolic processes to understand subjective, embodied experiences related to mental health. We did a scoping review on the use of body mapping in research on mental health experiences and outcomes. We searched Web of Science, PubMed, Scopus, PsycINFO, Embase, Ovid Medline, and Google Scholar to retrieve peer-reviewed articles in English. In 19 articles representing 17 studies, participant numbers for body mapping ranged from three to 48, and some studies exclusively recruited women or children and young people. Study domains included primary mental health experiences and mental health in relation to physical health or social experiences. The benefits of body mapping included its exploration of difficult-to-access emotions and experiences, its focus on strength and resilience, the therapeutic effect, its participatory and collaborative nature, its empowerment and dissemination of participants' voices, and the engagement of children and young people. Body mapping holds promise for research with marginalised groups typically excluded from mental health research.

The Effect of Pandemic-Related Economic Disruption on Young Adolescents in Ireland.

The sudden health and economic crisis brought about by the COVID-19 pandemic affords an opportunity to examine the impact of economic disruption to children and families. Any negative effects on the well-being of children are important to consider in relation to both short- and long-term outcomes. Using pre-pandemic and mid-pandemic waves of the longitudinal Growing Up in Ireland study, we examined whether the impact of economic disruption was equivalent for families who were (or were not) financially vulnerable pre-pandemic. We then investigated whether economic disruption was associated with a negative effect on the emotional well-being of 12-year-olds, and if there was evidence for such a negative effect being mediated through a lack of material resources or strain on family dynamics. Our results indicated that middle-income rather than lowest-income families experienced the most economic disruption, likely reflecting the sector-specific nature of business closures in the pandemic. Families who were financially vulnerable pre-pandemic were less likely to have had suitable resources for homeschooling. Both falls in income and strain in family relationships, such as arguing more with their parents, were associated with poorer scores on a measure of the child's emotional well-being. The emergency income support payment introduced at the start of the pandemic appeared to have a protective effect on the association between family income loss and child well-being, which has wider implications for policy on child poverty.

Adaptations to a cohort study in response to the COVID-19 pandemic: insights from Growing Up in Ireland.

Growing Up in Ireland (GUI) is the national longitudinal study of children and young people in the Republic of Ireland and has followed two cohorts for over ten years to date: Cohort '98 who were recruited into the study at age nine years and Cohort '08, recruited at age nine months. The study aims to describe the lives of Irish children and young people in terms of their development, with a view to positively affecting policies and services available for them. Traditionally, data collection involved in-home visits from an interviewer who conducted face-to-face interviews, recorded physical measurements of study participants and administered cognitive assessments. However, with the onset of the COVID-19 pandemic and the associated restrictions, significant adaptations were required to these methods to ensure data collection for the pilot and main fieldwork for Cohort '08 at age 13 could continue to the expected timeline. Face-to-face interviews with participants were replaced with telephone and web-based modes, interviewer training was conducted online, online resources were made available for interviewers and participants and COVID-19 related items were added to questionnaires. In addition to the scheduled data collection, a special COVID-19 survey was also conducted on both GUI cohorts in December 2020 to explore the impact of the pandemic on participants' lives. This paper outlines the adaptations made to traditional data collection methods in GUI, highlighting the challenges that were met, but also the benefits of some changes that may be worth incorporating into future waves of GUI.

Decomposing the social gradient in children's vocabulary skills at 3 years of age: A mediation analysis using data from a large representative cohort study.

Disparities in children's expressive language by socio-economic status are evident early in childhood and impact children's development and educational attainment. This study investigated the processes by which maternal education, as a powerful indicator for socio-economic status, affects early expressive language. A nationally representative cohort study of 8,062 children resident in the Republic of Ireland were assessed on the British Ability Scales (BAS) Naming Vocabulary Test at 36 months. A significant difference of almost six points was found between the mean vocabulary test scores of children whose mothers had completed the minimum level of educational attainment compared with children whose mothers had a degree-level qualification. Mediation analysis revealed that 78% of the difference was explained by mediating variables, with differences in household income, parental practice, and material resources accounting for most of the variation. The findings support interventions which redress gaps in maternal education, income, and caregiving.

Intelligibility of dysarthric speech: perceptions of speakers and listeners.

BACKGROUND: Many factors influence listener perception of dysarthric speech. Final consensus on the role of gender and listener experience is still to be reached. The speaker's perception of his/her speech has largely been ignored. AIMS: (1) To compare speaker and listener perception of the intelligibility of dysarthric speech; (2) to explore the role of gender and listener experience in speech perception; and (3) to examine the relationship between speaker perceptions of intelligibility and formal clinical intelligibility ratings. METHODS & PROCEDURES: Study 1 examines listener perception of intelligibility of dysarthric speech. Twenty people with acquired dysarthria, ten speech language therapists (SLTs) and 20 naive listeners heard audio recordings of dysarthric speech and used direct magnitude estimation (DME) to rate perceptions of speech intelligibility. Differences in perception across gender and listener experience (SLTs versus naive listeners) were examined. Study 2 tackles the speaker's perception of his/her own speech intelligibility. Using the same groups of participants and DME, speakers rated their own speech intelligibility. SLTs and naive listeners then rated their perception of the speakers' intelligibility. Differences in perceptions between speakers and listeners were compared. Further analysis examined differences across gender and listener experience. Finally, ratings of speakers' perception of their own intelligibility were compared with intelligibility scores on the Assessment of Intelligibility of Dysarthric Speech (ASSIDS) (1981). OUTCOMES & RESULTS: Study 1 showed no statistically significant differences in perception of intelligibility across the three listener groups, although results suggest that speakers rate perceptions of intelligibility differently to SLTs and naive listeners. Despite some individual differences in ratings between speakers and listeners in Study 2, overall there are no significant group differences and methodological limitations to this section of the study are highlighted. In Studies 1 and 2 there are no statistically significant differences across gender and listener experience, although SLTs are less consistent in their ratings of speech when compared with naive listeners. There is no statistically significant relationship between formal intelligibility assessment scores and the speakers' perception of intelligibility. CONCLUSIONS: This study contributes to an understanding of perceptions of dysarthric speech. The lack of gender differences in listener perception supports earlier findings in other areas of SLT. The strong relationship between SLT and naive listeners' perceptions suggests that SLTs are not more critical of dysarthric speech. The discrepancy between formal assessment measures and speakers' perceptions of intelligibility has implications for clinical practice. The need for further research in the area is highlighted.

Nosocomial spread of Mycobacterium bovis in domestic cats.

Five domestic cats were euthanased owing to confirmed or suspected Mycobacterium bovis infection. The initial source of infection remains unclear. Cat A was presented to a veterinary clinic in County Kildare, Ireland, with a discharging submandibular lesion. The infection appears to have been transmitted to four other cats through direct (cats B and C living in the same household as cat A) and non-direct (nosocomial spread during routine operations; cats D and E) contact over a 13.5-week period. Of the five cases, two (B and D) had post-mortem examinations in which gross changes consistent with tuberculosis were seen, moderate numbers of acid-fast bacteria (AFB) were seen on microscopy and M bovis (spoligotype SB0978) was confirmed on culture. Of the remaining three cats, one had a swab taken from its draining ovariohysterectomy wound, which revealed large numbers of AFB with morphology consistent with M bovis (cat E). Two cases were euthanased without diagnostic tests; however, their history and clinical presentations were highly suggestive of tuberculosis (cats A and C). To our knowledge, this is the first documented case of nosocomial spread of M bovis in cats.

Biological risk versus socio-economic advantage: low birth-weight, multiple births and income variations among Irish infants born following fertility treatments.

The Growing Up in Ireland Infant Cohort dataset (n = 11,134) includes information on fertility treatments for over 400 infants. IVF (28.1 %) and IVF-related treatments (17.8 %) were the most frequent, but there was also a high percentage following clomiphene citrate alone (31.5 %). Infants born following fertility treatment were much more likely to be in higher income families, and this relationship was not accounted for by older mothers in wealthier families. Analysis of fertility-treatment pregnancies among Irish infants, controlling for income and maternal age, shows a greater risk of multiple birth and low birth-weight, although the latter appears to be largely related to the former especially for IVF-type treatments.