Liquid array diagnostics: A novel method for rapid detection of microbial communities in single-tube multiplex reactions

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Prenatal exposure to persistent organic pollutants and child overweight/obesity at 5-year follow-up: a prospective cohort study

Source at https://doi.org/10.1186/s12940-017-0338-x .Background Prenatal exposure to persistent organic pollutants (POPs), may influence offspring weight gain. More prospective epidemiological studies are needed to compliment the growing body of evidence from animal studies. Methods Serum from 412 pregnant Norwegian and Swedish women participating in a Scandinavian prospective cohort study were collected in 1986–88, and analyses of two perfluoroalkyl substances (PFASs) and five organochlorines (OCs) were conducted. We used linear and logistic regression models with 95% confidence intervals (CIs) to evaluate the associations between maternal serum POP concentrations at 17–20 weeks of gestation and child overweight/obesity (body mass index (BMI) ≥ 85th percentile) at 5-year follow-up. Results were further stratified by country after testing for effect modification. We also assessed potential non-monotonic dose-response (NMDR) relationships. Results In adjusted linear models, we observed increased BMI-for-age-and-sex z-score (β = 0.18, 95% CI: 0.01–0.35), and increased triceps skinfold z-score (β = 0.15, 95% CI: 0.02–0.27) in children at 5-year follow-up per ln-unit increase in maternal serum perfluorooctane sulfonate (PFOS) concentrations. We observed increased odds for child overweight/obesity (BMI ≥ 85th percentile) for each ln-unit increase in maternal serum PFOS levels (adjusted OR: 2.04, 95% CI: 1.11–3.74), with stronger odds among Norwegian children (OR: 2.96, 95% CI: 1.42–6.15). We found similar associations between maternal serum perfluorooctanoate (PFOA) concentrations and child overweight/obesity. We found indications of NMDR relationships between PFOS and polychlorinated biphenyl (PCB) 153 and child overweight/obesity among Swedish children. Conclusion We found positive associations between maternal serum PFAS concentrations and child overweight/obesity at 5-year follow-up, particularly among Norwegian participants. We observed some evidence for NMDR relationships among Swedish participants

SupportPrim—a computerized clinical decision support system for stratified care for patients with musculoskeletal pain complaints in general practice: study protocol for a randomized controlled trial

BackgroundMusculoskeletal disorders represented 149 million years lived with disability world-wide in 2019 and are the main cause of years lived with disability worldwide. Current treatment recommendations are based on “one-size fits all” principle, which does not take into account the large degree of biopsychosocial heterogeneity in this group of patients. To compensate for this, we developed a stratified care computerized clinical decision support system for general practice based on patient biopsychosocial phenotypes; furthermore, we added personalized treatment recommendations based on specific patient factors to the system. In this study protocol, we describe the randomized controlled trial for evaluating the effectiveness of computerized clinical decision support system for stratified care for patients with common musculoskeletal pain complaints in general practice. The aim of this study is to test the effect of a computerized clinical decision support system for stratified care in general practice on subjective patient outcome variables compared to current care.MethodsWe will perform a cluster-randomized controlled trial with 44 general practitioners including 748 patients seeking their general practitioner due to pain in the neck, back, shoulder, hip, knee, or multisite. The intervention group will use the computerized clinical decision support system, while the control group will provide current care for their patients. The primary outcomes assessed at 3 months are global perceived effect and clinically important improvement in function measured by the Patient-Specific Function Scale (PSFS), while secondary outcomes include change in pain intensity measured by the Numeric Rating Scale (0–10), health-related quality of life (EQ-5D), general musculoskeletal health (MSK-HQ), number of treatments, use of painkillers, sick-leave grading and duration, referral to secondary care, and use of imaging.DiscussionThe use of biopsychosocial profile to stratify patients and implement it in a computerized clinical decision support system for general practitioners is a novel method of providing decision support for this patient group. The study aim to recruit patients from May 2022 to March 2023, and the first results from the study will be available late 2023.Trial registrationThe trial is registered in ISRCTN 11th of May 2022: 14,067,965

The impact of a minimal smoking cessation intervention for pregnant women and their partners on perinatal smoking behaviour in primary health care: A real-life controlled study

<p>Abstract</p> <p>Background</p> <p>There is a demand for strategies to promote smoking cessation in high-risk populations like smoking pregnant women and their partners. The objectives of this study were to investigate parental smoking behaviour during pregnancy after introduction of a prenatal, structured, multi-disciplinary smoking cessation programme in primary care, and to compare smoking behaviour among pregnant women in the city of Trondheim with Bergen and Norway.</p> <p>Methods</p> <p>Sequential birth cohorts were established to evaluate the intervention programme from September 2000 to December 2004 in primary care as a part of the Prevention of Allergy among Children in Trondheim study (PACT). The primary outcome variables were self reported smoking behaviour at inclusion and six weeks postnatal. Data from the Medical Birth Registry of Norway (MBR) were used to describe smoking cessation during pregnancy in Trondheim, Bergen and Norway 1999–2004.</p> <p>Results</p> <p>Maternal smoking prevalence at inclusion during pregnancy were 5% (CI 95% 4–6) in the intervention cohort compared to 7% (CI 95% 6–9), p = 0.03, in the control cohort. Of the pre-pregnancy maternal smokers 25% (CI 95% 20–31) and 32% (CI 95% 26–38), p = 0.17, were still smoking at inclusion in the intervention and control cohorts, respectively. Six weeks postnatal 72% (CI 95% 59–83) and 68% (CI 95% 57–77), p = 0.34 of the maternal smokers at inclusion still smoked. No significant difference in paternal smoking between the cohorts was found after the intervention period. Data from the MBR showed a significantly higher proportion of women who stopped smoking during pregnancy in Trondheim than in Bergen in 2003 and 2004, p = 0.03 and < 0.001, respectively.</p> <p>Conclusion</p> <p>No impact on parental smoking behaviour between the cohorts was observed after the smoking intervention programme. Of the women who stopped smoking during pregnancy most of them stopped smoking before the intervention. However, we observed a significantly higher quitting rate in Trondheim than in Bergen in 2003 and 2004 which may have been facilitated by the supplemental attention on smoking behaviour the PACT study initiated.</p

Family eczema-history in 2-year olds with eczema; a prospective, population-based study. The PACT-study, Norway

<p>Abstract</p> <p>Background</p> <p>A maternal line of inheritance regarding eczema has been described in several studies, whereas others find associations to both a maternal as well as a paternal line of inheritance. When studying family history of eczema symptoms, cohort studies including siblings are rare. Time point for assessing family eczema-history could be of importance when studying the associations between family eczema-history and children with eczema, as parents with unaffected children may not recall mild symptoms in other siblings or their own disease history. We therefore aimed to study the associations between reported eczema in mother, father and siblings and reported eczema in index child where information on family history was collected at two different ages of index child.</p> <p>Methods</p> <p>Parents/children participating in The Prevention of Allergy among Children in Trondheim (PACT) study were given questionnaires on reported eczema symptoms in mother, father and siblings at 6 weeks and 1 year. When index child was 2 years of age, a detailed questionnaire on different health issues with emphasize on different allergy related disorders were filled in.</p> <p>Results</p> <p>Both maternal and paternal reports on eczema were significantly associated with eczema in index child. Reporting family eczema-history at 1 year (N = 3087), "eczema sibling only" [adjusted odds ratio (aOR) = 3.13 (2.27-4.33)] as well as all other family-groups containing siblings with eczema were strongly associated with eczema 2 years. When family eczema-history was reported at 6 weeks (N = 2657), reporting of "eczema sibling only" was not associated to reported eczema at 2 years in index child [aOR = 1.31 (0.77-2.23)].</p> <p>Conclusions</p> <p>Having sibling(s) with eczema strengthened the associations between maternal and paternal reports on eczema with eczema in index child only when exposure was reported at 1 year. These findings indicate that results from questionnaires-based studies of family eczema-history depend on whether or not index child has yet developed eczema.</p> <p>Trial registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN28090297">ISRCTN28090297</a></p

A primary health-care intervention on pre- and postnatal risk factor behavior to prevent childhood allergy. The Prevention of Allergy among Children in Trondheim (PACT) study

Background: This study aimed to evaluate the impact of a primary prevention intervention program on risk behavior for allergic diseases among children up to 2 years of age. The setting was in ordinary pre- and postnatal primary health care in Trondheim, Norway. Methods: The Prevention of Allergy among Children in Trondheim, Norway (PACT) study invited all pregnant women and parents to children up to 2 years of age in the community to participate in a non-randomized, controlled, multiple life-style intervention study. Interventional topics was increased dietary intake of cod liver oil and oily fish for women during pregnancy and for infants during the first 2 years of life, reduced parental smoking and reduced indoor dampness. A control cohort was established prior to the intervention cohort with “follow up as usual”. Questionnaires were completed in pregnancy, 6 weeks after birth and at 1 and 2 years of age. Trends in exposure and behavior are described. Results: Intake of oily fish and cod liver oil increased statistically significantly among women and infants in the intervention cohort compared to the control cohort. There was a low postnatal smoking prevalence in both cohorts, with a trend towards a decreasing smoking prevalence in the control cohort. There was no change in indoor dampness or in behavior related to non- intervened life-style factors. Conclusions: The dietary intervention seemed to be successful. The observed reduced smoking behavior could not be attributed to the intervention program, and the latter had no effect on indoor dampness

Challenges in primary prevention of allergy : The Prevention of Allergy among Children in Trondheim (PACT) study

Utfordringer i primærforebygging av allergisk sykdom Barneallergistudien i Trondheim Det har vært en betydelig økning i forekomsten av allergiske sykdommer som astma, høysnue og eksem blant barn de siste 30-40 år. Forekomsten av luftveisplager og atopi blant barn i Aberdeen har blitt undersøkt med spørreskjema gjennom 35 år. Fra 1964 til 1999 økte forekomsten av astma (noen gang) fra 4% til 24%, for eksem økte forekomsten av eksem (noen gang) fra 5% til 21% og for høysnue økte forekomsten fra 3,2% til 15% for skolebarn (Devenny et al. BMJ 2004;329:489-490). Stortingsmelding nr. 118-1993-94 omhandlet denne økningen og forebygging av allergiske sykdommer ble et forskningsmessig satsningsområde. På bakgrunn av dette tok Trondheim kommune i samarbeid med SINTEF Unimed i 1997 initiativet til et prosjekt for primærforebygging av allergiske sykdommer, Barneallergistudien i Trondheim. Under forutsetning av at prosjektet var gjennomførbart og hadde nasjonal overføringsverdi ga Sosial- og Helsedirektoratet økonomisk støtte til prosjektet. NTNU ved Institutt for samfunnsmedisin fikk i oppdrag å gjennomføre evaluering av effektiviteten og effekten av intervensjonstiltakene. Hovedhensikten med PACT-studien var å studere hvor effektivt (endret deltakerne atferd) det er å intervenere på tre antatte risikofaktorer for allergisk sykdom i en uselektert populasjon av gravide kvinner og små barn. Videre å se om endret risikoatferd fører til endret forekomst av astma og allergisk sykdom ved: Økt inntak av Omega-3-fettsyrer og fet fisk Redusert eksponering for tobakksrøyk under svangerskapet og barnets 2 første leveår Redusert fukt i inneklima under svangerskapet og barnets 2 første leveår. Mål Det er mange utfordringer knyttet til gjennomføring og evaluering av et slikt prosjekt og målsettingen med denne avhandlingen var å studere om: Intervensjon mot risikofaktorer for allergisk sykdom hos små barn, innenfor rammen av ordinær primærhelsetjeneste, førte til endring i atferd og dermed eksponering. Intervensjon mot røyking under svangerskapet hadde effekt på røykeatferd. Spørsmålene brukt til å bestemme forekomsten av allergisk sykdom hos små barn var pålitelige. Inntak av tran og fet fisk under svangerskapet og i barnets første leveår forebygget foreldrerapportert eksem og legediagnostisert astma hos toåringer. Metode For å gjennomføre evalueringen ble det opprettet en hovedstudie med en kontrollkohort av gravide og barn som fikk den vanlige oppfølging og datidens råd i primærhelsetjenesten og en intervensjonskohort (tiltaksgruppe) som fikk den nye systematiserte veiledningen. Inklusjon til intervensjonskohorten startet juni 2002 og alle gravide og småbarnsforeldre i Trondheim kommune skulle får den samme rettledningen enten de deltok i studien eller ikke. Kontrollkohorten ble etablert i perioden fra høsten 2000 til mai 2002. Formålet med kontrollkohorten var å følge utvikling av prevalens av risikofaktorer og insidens av allergisk sykdom. Deltakerne besvarte spørreskjema under svangerskapet, 6 uker etter fødselen og når barnet var 1 og 2 år gammelt. Resultat Diettintervensjonen lyktes, inntaket av tran og fet fisk økte både under svangerskapet og i barnets 2 første leveår i intervensjonskohorten sammenliknet med kontrollkohorten, mens vi ikke fant noen forskjell mellom kohortene i matslag vi ikke intervenerte på. Vi observerte en betydelig redusert nedgang i røyking i intervensjonskohorten sammenliknet med kontrollkohorten. Tidstrenden for røykeslutt i studieperioden gikk i samme retning i begge kohorter, og nedgangen i røykeforekomst kunne derfor ikke tilskrives intervensjonen. Vi fant heller ingen effekt av røykeintervensjonen under svangerskapet på de kvinner som fortsatt røykte ved inklusjon i studien. Vi observerte imidlertid en betydelig høyere spontan røykeslutt ved svangerskapets start i Trondheim sammenliknet med Bergen og hele Norge når vi sammenliknet tall fra Medisinsk fødselsregister. Spørsmålene vi brukte til å bestemme forekomsten av allergisk sykdom blant 2 åringer var pålitelige, og ingen av spørsmålene overestimerte forekomsten av allergisk sykdom. Inntak av tran og fet fisk under svangerskapet viste ingen sammenheng med rapportert eksem eller legediagnostisert astma ved 2 års alder. Inntak av tran første leveår viste heller ikke sammenheng med allergisk sykdom ved 2 års alder. Inntak av fisk derimot, og spesielt inntak av feit fisk ved 1 års alder en gang i uken eller mer sammenliknet med de som spiste fisk mindre enn en gang i uken viste en sterk beskyttende effekt på rapportert eksem ved 2 års alder. Konklusjon Intervensjonstiltak for å endre atferd for å redusere risikofaktorer for allergisk sykdom i primærhelsetjenesten lar seg gjennomføre, men det er noen begrensinger. Risikofaktorer helsearbeiderne var vant til å arbeide med, som kost lot seg endre, mens et ukjent tema som fukt i boliger ikke lot seg endre. Røykeslutt ved svangerskapets start var svært vanlig, og de som ikke sluttet spontant lot seg ikke påvirke av våre intervensjonstiltak. For å få de som ikke slutter spontant å røyke ved svangerskapets start til å slutte å røyke, ser det ut til at det må utvikles nye røykesluttstrategier. Røykeintervensjonen i PACT studien kan på makroplan ha bidratt til at en høyere andel av gravide sluttet å røyke i Trondheim sammenliknet med Bergen, muligens ved at studien har forsterket de nasjonale røykesluttkampanjene. Spørreskjemaet vi utviklet for å måle forekomst av allergiske sykdommer var pålitelig. Fisk, men ikke tran gitt det første leveår beskytter mot eksem ved 2 års alder. Vår hypotese er at det kan være andre allergibeskyttende faktorer i fisk enn omega-3 fettsyrer, som enten virker alene eller sammen med fettsyrene med hensyn til å beskytte mot eksem, og våre funn rettferdiggjør søken etter slike faktorer.          The Prevention of Allergy among Children in Trondheim (PACT) stud

Crime and the transition to teenage parenthood

Age-graded social control theory suggests that parenthood can have a preventive effect on crimeamong adults, but it is unclear whether and how this applies to teenagers, as teenage parenthood and affiliation with crime can have mutual confounding causes. Using individual-level Norwegian administrative register data on the total population of fifteen to nineteen year olds, we assess the relationship between teenage parenthood and criminal activity. We find that teenage parents have an elevated risk of offending compared to non-parents, but that the transition to parenthood is nevertheless related to a within-individual decline in offending. This decline does not seem to be of permanent nature for girls, but for the boys it appears to stabilize on a lower level than before the transition to teenage fatherhood

Major faecal microbiota shifts in composition and diversity with age in a geographically restricted cohort of mothers and their children

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Diversity of vaginal microbiota increases by the time of labor onset

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