New Horizons - Cognitive dysfunction associated with type 2 diabetes

The prevalence of Type 2 diabetes (T2D) and cognitive dysfunction increases with age. As society ages, clinicians will be increasingly tasked with managing older people who have both T2D and cognitive dysfunction. T2D is associated with an increased risk of cognitive dysfunction and hence there is increasing interest in whether T2D is a causal factor in the pathogenesis of cognitive decline and dementia. Recent advances in the use of sensitive measures of in-vivo brain dysfunction in life-course studies can help understand potential mechanistic pathways and also help guide recommendations for clinical practice.In this article we will describe new horizons in the understanding of cognitive dysfunction associated with T2D. Coming from a clinical perspective, we discuss potential mechanisms and pathways linking the two conditions and the contribution of multimodal neuroimaging and study designs to advancing understanding in the field. We also highlight the important issues on the horizon that will need addressing in clinical identification, management and risk reduction for people with co-existent T2D and cognitive dysfunction.

Intergenerational Commensality: A Critical Discussion on Non-Familial Age Groups Eating Together

Connecting intergenerational relationships and commensality has been a neglected area in research and conceptual development within both food and life-course studies. This has been especially true of relations beyond the family. Here, public and private settings are explored in order to examine the relationship between eating together and generationally intelligent empathy. This is to help the discovery of spaces where different generations can interact positively around food and mealtimes. Contemporary social and public health challenges include: to adapt to increased longevity and to build solidarity between generations; to repair the relations between generations arising from institutional segregation; and to increase experiences of generational connection and social inclusion. As age-based cohorts are led to see themselves as separate from each other, we must find ways of building and negotiating new complementary roles for different parts of the life-course. Commensality, eating together at the same table provides an important cultural location and opportunity around which complementary understandings between generations may be built. A new framework is proposed to help identify and critically examine the variables underpinning non-familial intergenerational commensal spaces.

Spatial Patterns of Endometriosis Incidence. A Study in Friuli Venezia Giulia (Italy) in the Period 2004–2017

Background: Diagnosis of endometriosis and evaluation of incidence data are complex tasks because the disease is identified laparoscopically and confirmed histologically. Incidence estimates reported in literature are widely inconsistent, presumably reflecting geographical variability of risk and the difficulty of obtaining reliable data. Methods: We retrieved incident cases of endometriosis in women aged 15–50 years using hospital discharge records and pathology databases of the Friuli Venezia Giulia region in the calendar period 2004–2017. We studied the spatial pattern of endometriosis incidence applying Bayesian approaches to Disease Mapping, and profiled municipalities at higher risk controlling for multiple comparisons using both q-values and a fully Bayesian approach. Results: 4125 new cases of endometriosis were identified in the age range 15 to 50 years in the period 2004–2017. The incidence rate (x100 000) is 111 (95% CI 110–112), with a maximum of 160 in the age group 31–35 years. The geographical distribution of endometriosis incidence showed a very strong north-south spatial gradient. We consistently identified a group of five neighboring municipalities at higher risk (RR 1.31 95% CI 1.13; 1.52), even accounting for ascertainment bias. Conclusions: The cluster of 5 municipalities in the industrialized and polluted south-east part of the region is suggestive. However, due to the ecologic nature of the present study, information on the patients’ characteristics and exposure histories are limited. Individual studies, including biomonitoring, and life-course studies are necessary to better evaluate our findings.

I am a survivor, keep on surviving: early-life exposure to conflict and subjective survival probabilities in adult life

Life-course studies have shown that early-life conditions predict health and socio-economic status in adult life. This study analyzes whether experiencing a traumatic event in childhood, i.e., the Second World War (WW2), affects subjective survival probabilities (SSPs). We rely on a representative sample of European adults who were differentially exposed to WW2 during childhood as a result of their date and place of birth. Results show that exposure to WW2 increases SSPs, with socio-economic and health characteristics not playing a mediating role. War exposure also counterbalances the adverse effects of health impairments on SSPs, but it does not affect health outcomes per se. This fact, jointly with low mortality rates of the cohort under investigation, suggests that selective mortality and post-traumatic stress are not the main channels. Instead, the results support the hypothesis that personal growth and life appreciation emerge after traumatic events, thereby leading to optimistic perceptions of longevity.

Recommendations for Assessment of Environmental Exposures in Longitudinal Life Course Studies Such as the National Children's Study

An important step toward understanding the relationship between the environment and child health and development is the comprehensive cataloging of external environmental factors that may modify health and development over the life course. Our understanding of the environmental influences on health is growing increasingly complex. Significant key questions exist as to what genes, environment, and life stage mean to defining normal variations and altered developmental trajectories throughout the life course and also across generations. With the rapid advances in genetic technology came large-scale genomic studies to search for the genetic etiology of complex diseases. While genome-wide association studies (GWAS) have revealed genetic factors and networks that advance our understanding to some extent, it is increasingly recognized that disease causation is largely non-genetic and reflects interactions between an individual's genetic susceptibility and his or her environment. Thus, the full promise of the human genome project to prevent or treat disease and promote good health arguably depends on a commitment to understanding the interactions between our environment and our genetic makeup and requires a design with prospective environmental data collection that considers critical windows of susceptibility that likely correspond to the expression of specific genes and gene pathways. Unlike the genome, which is static, relevant exposures as well as our response to exposures, change over time. This has fostered the complementary concept of the exposome ideally defined as the measure of all exposures of an individual over a lifetime and how those exposures relate to health. The exposome framework considers multiple external exposures (e.g., chemical, social) and behaviors that may modify exposures (e.g., diet), as well as consequences of environmental exposures indexed via biomarkers of physiological response or measures of behavioral response throughout the lifespan. The exposome concept can be applied in prospective developmental studies such as the National Children's Study (NCS) with the practical understanding that even a partial characterization will bring major advances to health. Lessons learned from the NCS provide an important opportunity to inform future studies that can leverage these evolving paradigms in elucidating the role of environment on health across the life course.

Life-course patterns of new working-class youth in Russia

PurposeThis article aims to explore the dominant normative patterns that establish the timing and order of life events, determining the desirable life strategies for working-class youth in modern Russia.Design/methodology/approachExploring the interrelationship between new working-class studies and life-course studies, this research combines the consideration of life course as a structurally organised integrity with a phenomenological perspective on the study of life strategies. The empirical basis of research consists of a survey of 1532 young working-class representatives living in the Ural Federal District of Russia and biographical in-depth interviews with 31 of them.FindingsThe study resulted in persisting significance and values of traditional life-course structures while showing that the current social conditions do not allow for this life strategy to be fulfilled. Young workers choose adaptation and survival life strategies that restrict the realisation of their professional and cultural potential. The obtained data have confirmed the presence of some worldwide tendencies, such as the dispersion of events during transition to adulthood, a combination of schooling and full-time work and an earlier career start of working-class representatives.Originality/valueThe sequencing and timing of life-course events of Russian working-class youth is an original research topic. The present study proposes and substantiates the notion of the new working class and criteria for its definition.

Housing Inequalities, Crime, and the Criminal Justice System: The Shifting Context in England and Wales since the 1980s

One of the first steps Margaret Thatcher’s government took following their election in 1979 was to introduce legislation that enabled sitting council tenants to buy their council homes. This chapter assesses the legacy of this policy on the experiences of homelessness and contact with the criminal justice system of two cohorts of UK citizens. Using longitudinal studies of people born in 1958 and 1970, the authors explore how policies intended to turn council tenants into property owners, may have also increased the risks of homelessness, and contact with the criminal justice system for others as well as subsequent generations. The authors assess how legislative changes can shape the lives of citizens, and highlight some of the unintended consequences of the ‘right to buy’ policy. Our chapter, therefore is essentially about the investigation of the outcomes of radical system deregulation. Our chapter draws upon concepts derived from life-course studies and historical institutionalist thinking in order to understand in-depth how radical policy changes may shape and alter the lives of ordinary citizens.

The male mammary gland: a novel target of endocrine disrupting chemicals

In the past several decades, the incidence of two male breast diseases, gynecomastia and male breast cancer, have increased in human populations. Whereas male breast cancer remains a rare disease, gynecomastia, a condition that arises due to abnormal development and growth of the male breast epithelium, is fairly common. In this review, we present the male mouse mammary gland as a potential model to understand human male breast diseases. Even though the male mouse typically lacks nipples, the male retains a small mammary rudiment with epithelium that is highly sensitive to estrogenic chemicals during the perinatal and peripubertal periods. In just the last few years, our understanding of the biology of the male mouse mammary gland has expanded. Researchers have characterized the complexity and size of the male mammary epithelium across the life course. Studies have documented that the male mouse mammary gland has left-right asymmetric morphologies, as well as asymmetries in the responsiveness of the left and right glands to estrogens. Recent studies have also revealed that the effect of xenoestrogens on the male mammary gland can differ based on the timing of evaluation (prior to puberty, in puberty, and in adulthood) and the administered dose. Based on the available evidence, we argue that there is a strong case that estrogenic chemicals promote the growth of the male mouse epithelium, consistent with human gynecomastia. We also argue that these outcomes should be characterized as adverse effects and should be considered in regulatory decision-making.

Consistency of data collected through online life history calendars

The collection of longitudinal data is crucial in some domains such as life course studies. However, prospective studies are considerably costly, and thus retrospective data are an appealing alternative. A life history calendar is a tool specifically conceived to collect retrospective data. However, although it is designed to enhance the recall process of the respondents, the accuracy of the data collected through this approach remains unknown, particularly when data is collected online. In this study, we conducted a secondary analysis of data collected from n = 5,181 respondents through an online survey regarding their sexual health. Because we inquired about the occurrence of certain events twice during the survey, once using a life calendar and once through a traditional questionnaire, we were able to perform three types of consistency checks: (1) reporting of single events, (2) age when the events occurred and (3) correct timing between two events. The main results indicated that it is generally more difficult to remember the exact age of occurrence of an event than the event itself, that the report of related events is generally coherent, and that women are generally more accurate in their answers than men. Based on our results, it is therefore possible to identify a subset of persons whose answers are more consistent throughout the survey. This study also shows that data obtained through an online life history calendar can be of a quality similar to that obtained through a traditional online questionnaire.<br /><br />Key messages<br /><ul><li>Online life history calendars can be used to collect accurate retrospective data.</li><br /><li>The quality of data can be very heterogeneous among participants.</li><br /><li>Data quality controls should be implemented within the life history calendar tool.</li></ul>