How does age affect the relationship between weight and health utility during the middle years of childhood?

Purpose: The limited literature examining weight status and preference-based health-related quality of life (HRQL) in young children is equivocal. This study aims to examine how the association between weight status and preference-based HRQL changes as children develop between the ages of 6 and 10 years old. Methods: The Child Health Utility 9D (CHU-9D) was used to determine preference-based HRQL. Height and weight data were also collected and used to calculate z-BMI adjusted for age and gender. 1467 children were recruited from 54 schools across the West Midlands. Data were collected at four time points over 5 years. Impact of weight on dimensions of HRQL was assessed via the distribution of responses to CHU-9D dimensions by weight status. Multi-level regression analysis controlling for ethnicity, deprivation and other relevant co-variates was conducted to examine the relationship between weight and HRQL. Results: There was no evidence to suggest that the weight status impacted upon the distribution of responses to CHU-9D dimensions. Correspondingly, the multi-level regression analysis found no statistically significant differences in CHU-9D scores between underweight, healthy weight, overweight and obese children. Conclusions: The evidence surrounding the link between preference-based HRQL and weight status in children is limited. This study found no association between weight status and HRQL as measured by the CHU-9D in children between the ages of 5 and 10 years in the UK. Given this, it is recommended that future studies aiming to prevent obesity in children in their middle years do not rely solely on preference-based measures for economic evaluation, and instead focus on capturing clinical or wellbeing outcomes

The Relation Between Tobacco Tax Structure and Corruption in European Union Member States

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Background: Taxing tobacco products is one of the most effective tobacco control measures, and most countries apply a combination of specific taxes, which comprise a fixed amount per cigarette or gram of hand-rolling tobacco, and ad valorem taxes, which increase in proportion to the cost of the product. Since specific taxes reduce price differentials across tobacco product ranges while ad valorem taxes amplify them, we hypothesised that tobacco companies seeking to minimise the effect of tax increases on sales across a range of products will tend to favour, and hence lobby for, ad valorem rather than specific taxes; and that relatively corrupt governments would be more susceptible to such lobbying and hence, more likely to favour ad valorem taxes. Methods: We searched for cigarette tax data and Transparency International Corruption Perceptions Index (CPI) scores for current 28 EU Member States for the years 1995 to 2017/8. Trends in cigarette tax levels and the ratio of ad valorem to specific taxes at a national and mean EU level were analysed by visual inspection, the within-country relation between the ad valorem to specific tax ratio and CPI scores over time by time-series regression analysis, and at EU level, for which complete data were available from 1995 to 2017, using a multi-level regression model. Results: Within most Member States, the ad valorem to specific cigarette tax ratio declined over the study period and was not significantly associated with corruption score. However, at an aggregate EU-level, our multi-level model indicated that reduced corruption was associated with a significant increase in the ad valorem to specific cigarette tax ratio, by 0.04 (95% confidence interval: 0.003–0.077, p < 0.036) per unit increase in CPI score. Conclusions: The ratio of ad valorem to specific taxes declined in most EU Member States over the study period, with no evidence that those with higher levels of perceived corruption tended to favour ad valorem taxes

The exposome in respiratory diseases: multiple preventable risk factors from early life to adulthood

International audienceThe increasing global burden of respiratory diseases over the last decades raises questions about the impact of environmental factors during industrialisation and urbanisation. Although the knowledge of environmental epidemiology is growing, it is still unclear what the most critical exposure windows are for respiratory health. In addition, the relationships between different environmental exposures can be complex. The exposome approach investigating all non-genetic factors on health has been developed in recent years but has been little applied in respiratory health to date. This journal club article reviews three recent publications investigating the effects of environmental exposures, considered separately or in an exposome approach with different exposure windows, on respiratory health outcomes. These three studies highlight targets for action in primary and secondary prevention. Two studies, using data from the INMA and RHINESSA cohorts, support the regulation and reduction of phthalates and air pollution, respectively. Moreover, the exposome approach conducted in the NutriNet-Santé cohort emphasises that risk reduction must involve a multi-interventional approach targeting both specific early-life risk factors and promotion of a healthy lifestyle in adulthood. These three articles also present research perspectives in environmental epidemiology

The exposome in respiratory diseases: multiple preventable risk factors from early life to adulthood

The increasing global burden of respiratory diseases over the last decades raises questions about the impact of environmental factors during industrialisation and urbanisation. Although the knowledge of environmental epidemiology is growing, it is still unclear what the most critical exposure windows are for respiratory health. In addition, the relationships between different environmental exposures can be complex. The exposome approach investigating all non-genetic factors on health has been developed in recent years but has been little applied in respiratory health to date. This journal club article reviews three recent publications investigating the effects of environmental exposures, considered separately or in an exposome approach with different exposure windows, on respiratory health outcomes. These three studies highlight targets for action in primary and secondary prevention. Two studies, using data from the INMA and RHINESSA cohorts, support the regulation and reduction of phthalates and air pollution, respectively. Moreover, the exposome approach conducted in the NutriNet-Santé cohort emphasises that risk reduction must involve a multi-interventional approach targeting both specific early-life risk factors and promotion of a healthy lifestyle in adulthood. These three articles also present research perspectives in environmental epidemiology