Psychosocial and biological determinants of ill health in relation to deprivation

Background: Despite public health campaigns and improvements in healthcare, socioeconomic gradients in health and life expectancy persist, and in many cases are becoming more marked – the gradient in coronary heart disease being a prime example. Classic cardiovascular risk factors (e.g. smoking, cholesterol and blood pressure) only partially explain the deprivation effect, and attempts to narrow the health gap by focussing on such risk factors do not appear to be succeeding. There also appear to be socioeconomic differences in uptake of healthy lifestyle advice. The work described in this thesis aimed to expand current understanding of the deprivation-based gap in health and life expectancy, focussing particularly on the socioeconomic gradient in cardiovascular risk. Methods: Using a cross-sectional, population-based study design based in the Greater Glasgow area, 666 participants were selected on the basis of area-level social deprivation (Scottish Index for Multiple Deprivation ranking). The study was designed to include approximately equal numbers from most deprived and least deprived areas; equal numbers of male and female participants and equal numbers of participants from each age group studied (35-44; 45-54 and 55-64 years). Participants completed an extensive questionnaire on health, lifestyle and early life experiences. Anthropometric measures (height, leg length, weight, waist, hip and thigh circumferences) were recorded. Blood pressure, heart rate and parameters of lung function (Forced Expiratory Volume in 1 second [FEV1] and Forced Vital Capacity [FVC]) were recorded. Psychological assessments (General Health Questionnaire-28, Generalised Self-Efficacy Scale, Sense of Coherence Scale, Beck Hopelessness Scale, Eysenck Personality Scale and Rosenberg Self-Esteem Scale) and assessments of cognitive function (Auditory Verbal Learning Test, Choice Reaction Time and Stroop Test) were undertaken. Fasting blood samples were obtained for classic and emerging cardiovascular risk factors including lipid profile, glucose, insulin, leptin, adiponectin, C-reactive protein, interleukin-6, soluble intercellular adhesion molecule-1, von Willebrand Factor, fibrinogen, D-dimer and tissue plasminogen activator antigen. Carotid ultrasound assessment of intima-media thickness (cIMT), plaque score and arterial stiffness was performed. Results: Total and low density lipoprotein cholesterol were significantly higher in the least deprived group (both p<0.0001). Triglycerides were higher and high density lipoprotein cholesterol lower in the most deprived group (both p<0.0001). Fasting glucose, insulin and leptin were higher in the most deprived group. C-reactive protein, interleukin-6 and soluble intercellular adhesion molecule-1 were higher in the most deprived group (all p<0.0001). Von Willebrand factor, fibrinogen and D-dimer were higher in the most deprived group. Age- and sex-adjusted cIMT was significantly higher in the most deprived group, but on subgroup analysis this difference was only apparent in the highest age tertile in males (>56.3 years). Plaque score showed a much more highly significant deprivation difference in the group as a whole (p<0.0001). No differences in parameters of arterial stiffness were found between the most deprived and least deprived groups. Neither adjustment for classic nor emerging cardiovascular risk factors, either alone or in combination, abolished the area-level deprivation-based difference in plaque presence or cIMT. Adjustment for early life markers of socioeconomic status in addition to classic cardiovascular risk factors abolished the deprivation-based difference in plaque presence. Further associations between early life factors and health outcomes were noted: lung function (FEV1) and cognitive performance appeared to be influenced by father’s occupation, whether the parents/guardians were owner-occupiers or tenants, and by degree of overcrowding; cIMT was modestly related to father’s occupation and carotid plaque was related strongly to father’s occupation and parental home status. Socioeconomic differences were noted in the impact of personality in determining mental wellbeing, and also in relation to the health behaviours of fruit and vegetable consumption and smoking cessation. Conclusions: The relationship between social deprivation and health is complex and multifactorial and appears to involve the interplay of early life factors, biological mediators, psychological parameters such as personality and cognitive function, health behaviours and outcomes such as atherosclerosis. Approaches aiming to narrow the deprivation gap in health will need to be designed to take into account this complexity, addressing factors such as early life experiences and personality, as well as the more classically recognised factors such as smoking, cholesterol and blood pressure, if they are to have a chance of succeeding in improving the health of those most in need.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Climate Change and the Potential Spreading of Marine Mucilage and Microbial Pathogens in the Mediterranean Sea

Background: Marine snow (small amorphous aggregates with colloidal properties) is present in all oceans of the world. Surface water warming and the consequent increase of water column stability can favour the coalescence of marine snow into marine mucilage, large marine aggregates representing an ephemeral and extreme habitat. Marine mucilage characterize aquatic systems with altered environmental conditions. Methodology/Principal Findings: We investigated, by means of molecular techniques, viruses and prokaryotes within the mucilage and in surrounding seawater to examine the potential of mucilage to host new microbial diversity and/or spread marine diseases. We found that marine mucilage contained a large and unexpectedly exclusive microbial biodiversity and hosted pathogenic species that were absent in surrounding seawater. We also investigated the relationship between climate change and the frequency of mucilage in the Mediterranean Sea over the last 200 years and found that the number of mucilage outbreaks increased almost exponentially in the last 20 years. The increasing frequency of mucilage outbreaks is closely associated with the temperature anomalies. Conclusions/Significance: We conclude that the spreading of mucilage in the Mediterranean Sea is linked to climate-driven sea surface warming. The mucilage can act as a controlling factor of microbial diversity across wide oceanic regions and could have the potential to act as a carrier of specific microorganisms, thereby increasing the spread of pathogenic bacteria

The Mediterranean Sea Regime Shift at the End of the 1980s, and Intriguing Parallelisms with Other European Basins

Background: Regime shifts are abrupt changes encompassing a multitude of physical properties and ecosystem variables, which lead to new regime conditions. Recent investigations focus on the changes in ecosystem diversity and functioning associated to such shifts. Of particular interest, because of the implication on climate drivers, are shifts that occur synchronously in separated basins. Principal Findings: In this work we analyze and review long-term records of Mediterranean ecological and hydro-climate variables and find that all point to a synchronous change in the late 1980s. A quantitative synthesis of the literature (including observed oceanic data, models and satellite analyses) shows that these years mark a major change in Mediterranean hydrographic properties, surface circulation, and deep water convection (the Eastern Mediterranean Transient). We provide novel analyses that link local, regional and basin scale hydrological properties with two major indicators of large scale climate, the North Atlantic Oscillation index and the Northern Hemisphere Temperature index, suggesting that the Mediterranean shift is part of a large scale change in the Northern Hemisphere. We provide a simplified scheme of the different effects of climate vs. temperature on pelagic ecosystems. Conclusions: Our results show that the Mediterranean Sea underwent a major change at the end of the 1980s that encompassed atmospheric, hydrological, and ecological systems, for which it can be considered a regime shift. We further provide evidence that the local hydrography is linked to the larger scale, northern hemisphere climate. These results suggest that the shifts that affected the North, Baltic, Black and Mediterranean (this work) Seas at the end of the 1980s, that have been so far only partly associated, are likely linked as part a northern hemisphere change. These findings bear wide implications for the development of climate change scenarios, as synchronous shifts may provide the key for distinguishing local (i.e., basin) anthropogenic drivers, such as eutrophication or fishing, from larger scale (hemispheric) climate drivers

Dispersal similarly shapes both population genetics and community patterns in the marine realm.

Dispersal plays a key role to connect populations and, if limited, is one of the main processes to maintain and generate regional biodiversity. According to neutral theories of molecular evolution and biodiversity, dispersal limitation of propagules and population stochasticity are integral to shaping both genetic and community structure. We conducted a parallel analysis of biological connectivity at genetic and community levels in marine groups with different dispersal traits. We compiled large data sets of population genetic structure (98 benthic macroinvertebrate and 35 planktonic species) and biogeographic data (2193 benthic macroinvertebrate and 734 planktonic species). We estimated dispersal distances from population genetic data (i.e., FST vs. geographic distance) and from β-diversity at the community level. Dispersal distances ranked the biological groups in the same order at both genetic and community levels, as predicted by organism dispersal ability and seascape connectivity: macrozoobenthic species without dispersing larvae, followed by macrozoobenthic species with dispersing larvae and plankton (phyto- and zooplankton). This ranking order is associated with constraints to the movement of macrozoobenthos within the seabed compared with the pelagic habitat. We showed that dispersal limitation similarly determines the connectivity degree of communities and populations, supporting the predictions of neutral theories in marine biodiversity patterns.RADIALES (IEO)Versión del edito

Prediction of unprecedented biological shifts in the global ocean

Impermanence is an ecological principle(1) but there are times when changes occur nonlinearly as abrupt community shifts (ACSs) that transform the ecosystem state and the goods and services it provides(2). Here, we present a model based on niche theory(3) to explain and predict ACSs at the global scale. We test our model using 14 multi-decadal time series of marine metazoans from zooplankton to fish, spanning all latitudes and the shelf to the open ocean. Predicted and observed fluctuations correspond, with both identifying ACSs at the end of the 1980s(4,5,6,7) and 1990s(5,8). We show that these ACSs coincide with changes in climate that alter local thermal regimes, which in turn interact with the thermal niche of species to trigger long-term and sometimes abrupt shifts at the community level. A large-scale ACS is predicted after 2014—unprecedented in magnitude and extent—coinciding with a strong El Niño event and major shifts in Northern Hemisphere climate. Our results underline the sensitivity of the Arctic Ocean, where unprecedented melting may reorganize biological communities(5,9) and suggest an increase in the size and consequences of ACS events in a warming world

Ecosystem exploitation and trophodynamic indicators: a comparison between the Northern Adriatic Sea and Southern New England

In an ecosystem-based resource management context, it is crucial to assess the relationships between community structure and ecosystem function and how those relationships change with resource extraction. To elucidate how changes in resource use can affect community structure and ecosystem function, we executed a comparative analysis of two different ecosystems subjected to notable fishing pressure. We contrasted the Northern Adriatic Sea (NAS) and Southern New England (SNE) ecosystems by examining outputs from comparable steady-state models. Both ecosystems have relatively high fishing pressure and a high biomass of benthic invertebrates. The basic structure of the food webs shows differences both in the number and definition of the functional groups, as described in the models. Fisheries, on the contrary, show similarities both in terms of catches and discards. Almost all statistics summarizing the structure and flows showed values three times higher in the SNE than in the NAS ecosystem, but despite this difference the two ecosystems exhibited similar, overall properties. Biomass ratios and the Mixed Trophic Impact (MTI) analysis showed that both ecosystems are dominated by the benthic compartment. Removing the biomass effect, however, shows a clear top-down effect, with a high rank achieved by fishing activities. In general terms, the low mean trophic level of catches and the high primary production required (PPR) values result in a high overexploitation level of the ecosystem, as highlighted by the L index. We conclude by exploring how comparative studies will continue to be valuable as ecosystem-based management is further implemented

A MSFD complementary approach for the assessment of pressures, knowledge and data gaps in Southern European Seas : the PERSEUS experience

PERSEUS project aims to identify the most relevant pressures exerted on the ecosystems of the Southern European Seas (SES), highlighting knowledge and data gaps that endanger the achievement of SES Good Environmental Status (GES) as mandated by the Marine Strategy Framework Directive (MSFD). A complementary approach has been adopted, by a meta-analysis of existing literature on pressure/impact/knowledge gaps summarized in tables related to the MSFD descriptors, discriminating open waters from coastal areas. A comparative assessment of the Initial Assessments (IAs) for five SES countries has been also independently performed. The comparison between meta-analysis results and IAs shows similarities for coastal areas only. Major knowledge gaps have been detected for the biodiversity, marine food web, marine litter and underwater noise descriptors. The meta-analysis also allowed the identification of additional research themes targeting research topics that are requested to the achievement of GES. 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license.peer-reviewe