scholarly journals Recomposing persons: Scavenging and storytelling in a birth cohort archive

2021 ◽  
pp. 095269512199539
Author(s):  
Penny Tinkler ◽  
Resto Cruz ◽  
Laura Fenton
Keyword(s):  
Life Course ◽  
Cohort Studies ◽  
Birth Cohort ◽  
Quantitative Data ◽  
Population Level ◽  
Relational Embeddedness ◽  
The Life Course ◽  
Over Time

Birth cohort studies can be used not only to generate population-level quantitative data, but also to recompose persons. The crux is how we understand data and persons. Recomposition entails scavenging for various (including unrecognised) data. It foregrounds the perspective and subjectivity of survey participants, but without forgetting the partiality and incompleteness of the accounts that it may generate. Although interested in the singularity of individuals, it attends to the historical and relational embeddedness of personhood. It examines the multiple and complex temporalities that suffuse people’s lives, hence departing from linear notions of the life course. It implies involvement, as well as reflexivity, on the part of researchers. It embraces the heterogeneity and transformations over time of scientific archives and the interpretive possibilities, as well as incompleteness, of birth cohort studies data. Interested in the unfolding of lives over time, it also shines light on meaningful biographical moments.

Associations between life-course frailty and later-life heart size and function in the 1946 NSHD British birth cohort-an epidemiological study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.C Topriceanu ◽  
J.C Moon ◽  
R Hardy ◽  
A.D Hughes ◽  
N Chaturvedi ◽  
...  
Keyword(s):  
Life Course ◽  
Birth Cohort ◽  
Frailty Index ◽  
Later Life ◽  
Left Ventricular ◽  
Step Change ◽  
Deficit Accumulation ◽  
Heart Size ◽  
And Function ◽  
The Life Course

Abstract Background Cardiovascular diseases are an important component of the multi-morbidity syndrome which is associated with negative health outcomes resulting in a major societal economic burden. An objective way to assess multi-morbidity is to calculate a frailty index based on medical deficit accumulation. Late-life frailty has been validated to predict mortality, but little is known about the association between life-course frailty and cardiovascular health in later-life. Purpose To study the association between life-course frailty and later-life heart size and function using data from the world's longest running birth cohort with continuous follow-up. Methods A 45-deficit frailty index (FI) was calculated at 4 age-intervals across the life-course (0 to 16 years old, 19 to 44 years old, 45 to 54 years old and 60 to 64 years old) in participants from the UK 1946 Medical Research Council (MRC) National Survey of Heath and Development (NSHD) birth cohort. The life-course frailty indices (FI0_16, FI19_44, FI45_54 and FI60_64) reflect the cumulative medical deficits at the corresponding age-intervals. They were used to derive FImean and FIsum reflecting overall-life frailty. The step change in deficit accumulation between age-intervals was also calculated (FI2-1, FI3-1, FI4-1, FI3-2, FI4-2, FI4-3). Echocardiographic data at 60–64 years provided: E/e' ratio, ejection fraction (EF), myocardial contraction fraction index (MCFi) and left ventricular mass index (LVmassi). Generalized linear mixed models with gamma distribution and log link assessed the association between FIs and echo parameters after adjustment for sex, socio-economic position and body mass index. Results 1.805 NSHD participants were included (834 male). Accumulation of a single deficit had a significant impact (p<0.0001 to p<0.049) on LVmassi and MCFi in all the life-course FIs and overall FIs. LVmassi increased by 0.89% to 1.42% for the life-course FIs and by 0.36%/1.82% for FIsum and FImean respectively. MCFi decreased by 0.62% to 1.02% for the life-course FIs and by 0.33%/ 1.04%. for FIsum and FImean respectively. One accumulated deficit translated into higher multiplicative odds (13.2 for FI60-64, 2.1 for FI4-1, 75.4 for FI4-2 and 78.5 for FI4-3) of elevated filling pressure (defined as E/e' ratio >13, p<0.0.005 to p<0.02).A unit increase in frailty decreased LV EF (%) by 11%/12% for FI45-54 and FI60-64 respectively, by 10% to 12% for FI2-1, FI3-1, FI4-1 and FI4-2, and 4%/15% for FIsum and FImean respectively (p<0.0014 to p<0.044). Conclusion Frailty during the life-course, overall life-frailty and the step change in deficit accumulation is associated with later-life cardiac dysfunction. Frailty strain appears to have its greatest impact on pathological myocardial hypertrophy (high LVmassi and low MCFi) potentially paving the way to later-life systolic or diastolic dysfunction in susceptible individuals. Funding Acknowledgement Type of funding source: None

scholarly journals Longitudinal birth cohort study finds that life-course frailty associates with later-life heart size and function

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Constantin-Cristian Topriceanu ◽  
James C. Moon ◽  
Rebecca Hardy ◽  
Nishi Chaturvedi ◽  
Alun D. Hughes ◽  
...  
Keyword(s):  
Life Course ◽  
Birth Cohort ◽  
Left Ventricular ◽  
Step Change ◽  
Deficit Accumulation ◽  
Cardiac Phenotype ◽  
Time Period ◽  
Time Periods ◽  
The Life Course ◽  
Health Deficit

AbstractA frailty index (FI) counts health deficit accumulation. Besides traditional risk factors, it is unknown whether the health deficit burden is related to the appearance of cardiovascular disease. In order to answer this question, the same multidimensional FI looking at 45-health deficits was serially calculated per participant at 4 time periods (0–16, 19–44, 45–54 and 60–64 years) using data from the 1946 Medical Research Council (MRC) British National Survey of Health and Development (NSHD)—the world’s longest running longitudinal birth cohort with continuous follow-up. From these the mean and total FI for the life-course, and the step change in deficit accumulation from one time period to another was derived. Echocardiographic data at 60–64 years provided: ejection fraction (EF), left ventricular mass indexed to body surface area (LVmassi, BSA), myocardial contraction fraction indexed to BSA (MCFi) and E/e′. Generalized linear models assessed the association between FIs and echocardiographic parameters after adjustment for relevant covariates. 1375 participants were included. For each single new deficit accumulated at any one of the 4 time periods, LVmassi increased by 0.91–1.44% (p < 0.013), while MCFi decreased by 0.6–1.02% (p < 0.05). A unit increase in FI at age 45–54 and 60–64, decreased EF by 11–12% (p < 0.013). A single health deficit step change occurring between 60 and 64 years and one of the earlier time periods, translated into higher odds (2.1–78.5, p < 0.020) of elevated LV filling pressure. Thus, the accumulation of health deficits at any time period of the life-course associates with a maladaptive cardiac phenotype in older age, dominated by myocardial hypertrophy and poorer function.

scholarly journals Life-course burden of health deficits associates with later-life heart size and function in the 1946 British birth cohort

2020 ◽  
Author(s):  
Constantin-Cristian Topriceanu ◽  
James C Moon ◽  
Rebecca Hardy ◽  
Nishi Chaturvedi ◽  
Alun Hughes ◽  
...  
Keyword(s):  
Life Course ◽  
Birth Cohort ◽  
Later Life ◽  
Myocardial Contraction ◽  
Left Ventricular ◽  
Heart Size ◽  
Time Periods ◽  
And Function ◽  
The Life Course ◽  
Myocardial Contraction Fraction

Aim: To study the association between the life course accumulation of health deficits and later life heart size and function using data from the 1946 National Survey of Heath and Development (NSHD) British birth cohort, the longest running birth cohort with continuous follow up in the world. Methods and Results: A multidimensional health deficit index (DI) looking at 45 health deficits was serially calculated at 4 time periods of the life course in NSHD participants (0 to 16, 19 to 44, 45 to 54 and 60 to 64 years), and from these the mean and total DI for the life course was derived (DImean, DIsum). The step change in deficit accumulation from one time period to another was also calculated. Echocardiographic data at 60-64 years provided: ejection fraction (EF), left ventricular mass indexed to body surface area (LVmassi, BSA), myocardial contraction fraction indexed to BSA (MCFi) and E/e. Generalized linear models assessed the association between DIs and echocardiographic parameters after adjustment for sex, socioeconomic position and body mass index. 1,375 NSHD participants were included (46.47% male). For each single new deficit accumulated at any one of the 4 time periods of the life course, LVmassi increased by 0.91 to 1.44% (p<0.013), while MCFi decreased by 0.6 to 1.02% (p<0.05 except at 45 to 54 years). One unit increase in DI at age 45 to 54 and 60 to 64 decreased LV EF by 11 to 12% (p<0.013). A single deficit step change occurring between 60-64 years and one of the earlier time periods, translated into significantly higher odds (2.1 to 78.5, p<0.020) of elevated LV filling pressure defined as E/e>13. Conclusion: The accumulation of health deficits at any time period of the life course associates with a maladaptive cardiac phenotype in older age, dominated by myocardial hypertrophy and poorer function. The burden of health deficits appears to strain the myocardium potentially leading to future cardiac dysfunction. Keywords: frailty; cardiovascular disease; ejection fraction; left ventricular mass index; myocardial contraction fraction; E/e.

scholarly journals Time and Collective Biology: Relationships Between Individual and Societal Life Course Ideologies in Mexican Men’s Sexual Health Treatment

2021 ◽  
Vol 42 (1) ◽  
pp. 66-80
Author(s):  
Emily Wentzell
Keyword(s):  
Sexual Health ◽  
Life Course ◽  
Aging Treatment ◽  
Population Level ◽  
Well Being ◽  
Mexican Population ◽  
Medical Decisions ◽  
Race And Gender ◽  
Sexually Transmitted ◽  
Over Time

People may seek to embody cultural ideals of the life course through their use or rejection of medical interventions, including but not limited to anti-aging treatments. Here, I analyze this phenomenon via interviews with men engaging with two different forms of sexual health medicine in urban Mexico: erectile-dysfunction treatment and testing for sexually transmitted infections (STIs). I argue that, in contrast to the biomedical understanding of patients as individuals who change during their lives, my interlocutors understood themselves as components in broader “collective biologies” that change on a longer timeline. These are culturally-defined groups that people understand to be comprised of interrelated members whose behaviors concretely affect the group’s physical and social well-being over time. In both medical arenas discussed here, men used or rejected sexual health interventions in response to local narratives about the nature of the Mexican population as a collective biology, including ideas about how it should change over time away from its roots in the colonial past. They characterized predispositions to machismo and disinterest in preventative health care as embodied inheritances that the Mexican population should reject in order to achieve health-promoting modernity in the future. My analysis describes how these interlocutors sought to live out desirably modern forms of race and gender through their medical decisions in a way that they hoped would contribute to positive, embodied change in the Mexican social body over time. These findings show that, despite the assumptions of individualism generally naturalized in anti-aging treatment and biomedicine, people may make medical decisions in an effort to aid collective change over population-level timescales.

scholarly journals Socio-economic position at four time points across the life course and all-cause mortality: updated results from the Uppsala Birth Cohort Multigenerational Study

2020 ◽  
Vol 11 (1) ◽  
pp. 27-54
Author(s):  
Amy Heshmati ◽  
Gita D Mishra ◽  
Anna Goodman ◽  
Ilona Koupil
Keyword(s):  
Life Course ◽  
Birth Cohort ◽  
Later Life ◽  
University Hospital ◽  
Sensitive Period ◽  
Saturated Model ◽  
All Cause Mortality ◽  
Economic Position ◽  
The Life Course ◽  
Multigenerational Study

Socio-economic position (SEP) is associated with all-cause mortality across all stages of the life course; however, it is valuable to distinguish at what time periods SEP has the most influence on mortality. Our aim was to investigate whether the effect of SEP on all-cause mortality accumulates over the life course or if some periods of the life course are more important. Our study population were from the Uppsala Birth Cohort Multigenerational Study, born 1915–29 at Uppsala University Hospital, Sweden. We followed 3,951 men and 3,601 women who had SEP at birth available, during childhood (at age ten), in adulthood (ages 30–45) and in later life (ages 50–65) from 15 September 1980 until emigration, death or until 31 December 2010. We compared a set of nested Cox proportional regression models, each corresponding to a specific life course model (critical, sensitive and accumulation models), to a fully saturated model, to ascertain which model best describes the relationship between SEP and mortality. Analyses were stratified by gender. For both men and women the effect of SEP across the life course on all-cause mortality is best described by the sensitive period model, whereby being advantaged in later life (ages 50–65 years) provides the largest protective effect. However, the linear accumulation model also provided a good fit of the data for women suggesting that improvements in SEP at any stage of the life course corresponds to a decrease in all-cause mortality.

Environment

2013 ◽  
pp. 290-295
Author(s):  
Christopher R. Holroyd ◽  
Nicholas C. Harvey ◽  
Mark H. Edwards ◽  
Cyrus Cooper
Keyword(s):  
Rheumatoid Arthritis ◽  
Life Course ◽  
Disease Risk ◽  
Association Studies ◽  
Population Level ◽  
Environment Interaction ◽  
Disease Pattern ◽  
The Individual ◽  
The Life Course

Musculoskeletal disease covers a broad spectrum of conditions whose aetiology comprises variable genetic and environmental contributions. More recently it has become clear that, particularly early in life, the interaction of gene and environment is critical to the development of later disease. Additionally, only a small proportion of the variation in adult traits such as bone mineral density has been explained by specific genes in genome-wide association studies, suggesting that gene-environment interaction may explain a much larger part of the inheritance of disease risk than previously thought. It is therefore critically important to evaluate the environmental factors which may predispose to diseases such as osteorthritis, osteoporosis, and rheumatoid arthritis both at the individual and at the population level. In this chapter we describe the environmental contributors, across the whole life course, to osteoarthritis, osteoporosis and rheumatoid arthritis, as exemplar conditions. We consider factors such as age, gender, nutrition (including the role of vitamin D), geography, occupation, and the clues that secular changes of disease pattern may yield. We describe the accumulating evidence that conditions such as osteoporosis may be partly determined by the early interplay of environment and genotype, through aetiological mechanisms such as DNA methylation and other epigenetic phenomena. Such studies, and those examining the role of environmental influences across other stages of the life course, suggest that these issues should be addressed at all ages, starting from before conception, in order to optimally reduce the burden of musculoskeletal disorders in future generations.

Predictors of Alcohol Use Disorders Among Baby Boomers Across the Life Course

2018 ◽  
Vol 39 (8) ◽  
pp. 880-888
Author(s):  
Adam Quinn ◽  
Orion Mowbray
Keyword(s):  
Alcohol Use ◽  
Life Course ◽  
Baby Boomers ◽  
Alcohol Use Disorders ◽  
Life Course Perspective ◽  
Future Research ◽  
Older Adulthood ◽  
Use Patterns ◽  
The Life Course ◽  
Over Time

Research suggests that baby boomers entering older adulthood may possess unique alcohol use patterns over time. Using the life course perspective as a guiding framework, this empirical study sought to examine correlates of alcohol use disorders among baby boomers by examining representative data from the National Survey on Drug Use and Health at two points in time, 1998 ( N = 6,213) and 2010 ( N = 5,880). Results from logistic regression analyses suggest that predictors of alcohol use disorders evolve over time as baby boomers continue to age. Risk factors for alcohol use disorders among baby boomers may include concurrent unprescribed pain reliever use, p < .01, while protective factors such as income, p < .01, and social supports, p = .01, may be of increased importance. Based on the findings of this study, practice implications and future research are discussed.

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