Concordance of Helicobacter pylori infection among children in extended-family homes

Helicobacter pylori is transmitted within households and high concordance is observed among siblings. To better understand the contributions of close interpersonal contact and family relatedness to transmission, we compared concordance of H. pylori infection among 241 sibling and non-sibling children aged 2-18 years in 68, predominantly low-income, Hispanic households with at least two nuclear families. Prevalence of H. pylori infection was 24%. Compared to children with no infected siblings or non-siblings and adjusting for age, odds of H. pylori infection were 1.2 (95% CI 0.52-2.9), 3.2 (95% CI 1.14-9.1), and 9.4 (95% CI 3.1-28.5) for children residing with at least one infected non-sibling, one infected sibling, and with at least one infected sibling and non-sibling, respectively. The study further implicates intersibling transmission as a pathway for H. pylori infection in childhood. In addition, living with a non-sibling in extended-family homes may contribute to infection risk but only in households with prevalent H. pylori infection within all family groups.     

Adult family members and their resemblance of coronary heart disease risk factors: The Cardiovascular Disease Study in Finnmark

Coronary heart disease tends to run in families, and the familial resemblance of major risk factors for the disease was examined among various types of adult family members. Family units were assembled from a total of 4,738 men and women who took part in a cross sectional health survey in four Norwegian municipalities where all inhabitants between 20 and 52 years of age were invited. After adjusting for age and other confounders, correlation coefficients were derived as a measure of the degree of resemblance. Viewed across all types of investigated familial relationships, similarity was found to be stronger for total cholesterol than for high-density lipoprotein cholesterol and triglycerides, and also stronger for systolic than for diastolic blood pressure. Between husbands and wives (3,060 subjects), correlations were small (between 0.02 and 0.06), except for 0.11 for total cholesterol. Lipid and blood pressure correlations ranged from 0.13 to 0.27 for parents and their offspring (471 subjects, p < 0.05) and from 0.11 to 0.22 among siblings (2,166 subjects, p < 0.01). Sibling correlations were consistent across age groups. Furthermore, reports from each individual on daily smoking (yes or no) revealed that husbands and wives had similar habits in 63.5% of all marriages as compared with the expected 49.4% had no smoking similarity at all been present. Smoking concordance was also demonstrated among siblings (p < 0.01). The persistent pattern of lipid and blood pressure aggregation among genetically related individuals from 20 to 52 years of age and the much weaker such similarity between husbands and wives, point towards genes or commonly shared environment at early ages as a major reason why coronary heart disease runs in families.     

Parental age, family size, and risk of multiple sclerosis

BACKGROUND: Family structure, such as having siblings, provides proxy measures for a variety of characteristics relevant to disease risk. The etiology of multiple sclerosis (MS) is not well defined and analysis of family structure may provide etiologic clues. We conducted a case-control study to examine possible associations. METHODS: Using the Swedish Inpatient Register, we identified 4443 patients with a diagnosis of MS. From the general Swedish population, using birth and death registers, we selected 24,194 controls with similar characteristics for year, county of birth, and survival until at least age at diagnosis of the matched cases. The Multi-Generation Register linked data on siblings and parents. The Census provided father's social class based on occupation. RESULTS: Having 3 or more younger siblings, compared with none, produced an adjusted odds ratio (OR) for MS (with 95% confidence interval) of 0.80 (0.70-0.92) (adjusting for number of siblings, twins, maternal and paternal age, parental MS, sex, father's social class, county and year of birth). With 3 or more older siblings, the adjusted OR was 0.83 (0.72-0.96). Different-sex twin pairs compared with singletons had an OR of 0.59 (0.37-0.95) for MS. The risk of MS increased steadily with father's age but not mother's age, up to 2.00 (1.35-2.96) for 51- to 55-year-old fathers (compared with 21- to 25-year-old fathers). CONCLUSIONS: Parents who have offspring with MS may have subtly impaired fertility. The unexpected association with paternal age may be the result of an increased risk of accumulating germ cell mutations among older men.     

Intrafamilial relations of cardiovascular disease risk factors in African-Americans: longitudinal results from DC SCAN

BACKGROUND: Few studies have examined intrafamilial patterns of cardiovascular disease (CVD) risk factors in African-American families or identified potential influences on these patterns. This study examines the effects of age and sex of child on correlations between siblings during childhood as well as between mothers and their offspring in African-American families at two points in time. METHODS: CVD risk factors were assessed in a sample of 267 pairs of African-American siblings and their mothers. One hundred nine of these families were selected for a second assessment of CVD risk factors approximately 28 months later. RESULTS: Older siblings had significantly greater correlations than younger siblings with mothers' low-density lipoproteins (r = 0.61 versus r = 0.43 for older and younger siblings, respectively), apolipoprotein A-I (r = 0. 46 versus r = 0.16), and lipoprotein (a) (r = 0.71 versus r = 0.34). Correlations between female siblings were significantly higher than between male siblings for total cholesterol (r = 0.74 versus r = 0. 18 for female versus male siblings), triglycerides (r = 0.56 versus r = 0.05), and apolipoprotein B (r = 0.72 versus r = 0.31); they were also higher between female siblings than between mixed-sex siblings for measures of adiposity (r = 0.46 versus r = 0.19) and total cholesterol (r = 0.74 versus r = 0.27). CONCLUSIONS: Significant intrafamilial correlations for African-American children were influenced by both age and sex of siblings, reflecting potential genetic and environmental influences. Assessing family patterns of CVD risk factors in high-risk populations may assist in the early identification of children who can benefit most from intervention.     

Clustering of premature mortality in 1,761 insulin-dependent diabetics and their family members

The clustering of premature mortality was investigated in 1,761 insulin-dependent diabetics and their family members from the Children's Hospital of Pittsburgh Insulin-Dependent Diabetes Mellitus Registry from 1950-1981. At follow-up, 5% of the mothers and 13% of the fathers were deceased. Life table analyses revealed that fathers of deceased diabetics were significantly more likely to die prematurely than fathers of living diabetics (18% vs. 8% at age 55 years; p = 0.02). A father-diabetic son concordance of mortality appeared to be responsible for this effect. A similar overall trend was observed for maternal mortality, although the difference was not statistically significant. Cause-specific analyses revealed that the increased paternal mortality was primarily the result of cardiovascular disease. Overall mortality rates of parents of deceased diabetics were higher than those of the general population, reaching statistical significance in the age group 35-44 years (p less than 0.05). Mortality among diabetic siblings was also examined. Diabetic siblings of deceased diabetics had a markedly increased risk of dying compared with diabetic siblings of living diabetics (p = 0.001). These findings indicate that premature mortality among both diabetic and nondiabetic relatives of diabetics clusters in families in which there is a deceased insulin-dependent diabetic, and suggest that the marked increase in mortality among persons with insulin-dependent diabetes may be partly under familial control.     

Sibship characteristics and risk of multiple sclerosis: a nationwide cohort study in Denmark

It has been hypothesized that age at infection with a common microbial agent may be associated with the risk of multiple sclerosis (MS). The authors addressed this hypothesis by using number of older siblings and other sibship characteristics as an approximation of age at exposure to common infections. Data on family characteristics and vital status from the Danish Civil Registration System were used to establish a cohort of all Danes whose mothers had been born in Denmark since 1935. Persons diagnosed with MS during the period 1968-1998 were identified through linkage with the Danish Multiple Sclerosis Register. The cohort of 1.9 million Danes was followed for 28.1 million person-years; during that time, 1,036 persons developed MS. Overall, there was no association between number of older siblings, number of younger siblings, total number of siblings, age distance from the nearest younger sibling, or exposure to younger siblings under 2 years of age and risk of MS later in life. There was no association of MS risk with multiple birth (vs. singleton birth) or with the age of the mother or father at birth. These results do not lend support to the hypothesis that number of older siblings or any of the other sibship characteristics studied is associated with risk of MS.     

Substance use and risky sexual behaviours among sexually experienced Ghanaian youth

ABSTRACT: BACKGROUND: The association between risky sexual behaviours and substance uses among Ghanaian youth were investigated. METHODS: An in-school cross-sectional representative survey was conducted among 12-18-year- old youth in Ghana in 2008 (N=1165, response rate =90%). Logistic regression analyses were employed to investigate the association between substance use (tobacco use, drunkenness, marijuana use, other drug uses) and risky sexual behaviours (sexual debut, condom use and number of sexual partners). RESULTS: Of all adolescents, 25% (28% boys and 23% girls) were sexually experienced. The mean age for first sexual intercourse was 14.8 years (14.4 years for boys and 15.1 years for girls). Among the sexually experienced, 31% had multiple sexual partners. Older age (OR=3.4, 95% CI=1.7-3.4) and rural residency (OR=1.5, 95% CI=1.1-2.1) were independently associated with sexual debut while only older age (OR=2.4, 95% CI=1.7-3.4) was associated with condom use. Additionally, smoking (OR=3.7, 95% CI=2.0-6.8), tawa use (OR=2.4, 95% CI=1.3-4.7), tobacco use (OR=2.8, 95% CI=1.7-4.7) drunkenness (OR=1.7, 95% CI=1.1-2.8) and marijuana use (OR=3.3, 95% CI=1.6-7.0) were independently associated with sexual debut. Furthermore, all substance uses studied were associated with having one or multiple sexual partners. CONCLUSION: Substance use seems to be a gateway for risky sexual behaviours among Ghanaian adolescents. Public health interventions should take into account the likelihood of substance use among sexually experienced adolescents.     

Teenage children of teenage mothers: psychological, behavioural and health outcomes from an Australian prospective longitudinal study

In many industrialised countries teenage pregnancy and teenage parenthood have in recent years been identified as social and public health problems that need to be tackled. A number of studies have looked at various outcomes for teenage mothers and their offspring, and many report a strong association with poverty for the mother both before and after having a child. Few studies, however, adequately control for socioeconomic circumstances when examining health and related outcomes. Most studies have focused on perinatal outcomes in the offspring with few looking at later health and development. In Australia, where the rate of teenage pregnancy is relatively high compared to other comparable countries, teenage pregnancy is a not prominent policy concern. As such, Australia offers the opportunity to study the outcomes of teenage parenthood in a country where there may be less stigma than in countries that portray teenage parenthood as a major health and/or social problem. This paper reports findings from the Mater-University Study of Pregnancy (MUSP) and its outcomes, a prospective study of women, and their offspring, who received antenatal care at a major public hospital (Mater Misericordiae Hospital) in South Brisbane, Australia, between 1981 and 1984. We have examined the associations of maternal age (< or =18 years (n=460) versus >18 years (n=4800)) at first antenatal visit with offspring psychological, behavioural and health characteristics when the offspring--the teenage children of teenage mothers--were aged 14 years. Multiple logistic regression was used to determine the effect of maternal and family characteristics on associations between maternal age and childhood outcomes at age 14. Results show that the 14 year old offspring of mothers who were aged 18 years and younger compared to those who were offspring of older mothers were more likely to have disturbed psychological behaviour, poorer school performance, poorer reading ability, were more likely to have been in contact with the criminal justice system and were more likely to smoke regularly and to consume alcohol. However, maternal age was not associated with health outcomes in their offspring at age 14 years. Indicators of low socioeconomic position and maternal depression were also associated with poorer psychological, cognitive and behavioural outcomes among 14 year olds. In addition children from poorer socioeconomic backgrounds and whose mothers were depressed were more likely to have self-reported poor health, asthma, to have been admitted to hospital twice or more since birth and to be bed-wetters at age 14. The associations between maternal age and psychological distress, school performance, and smoking and alcohol use were all largely explained by socioeconomic factors, maternal depression, family structure and maternal smoking. These findings confirm that not all teenage mothers and their offspring have adverse outcomes, and that many if not the majority have good outcomes.     

Number of siblings, birth order, and childhood overweight: a population-based cross-sectional study in Japan

ABSTRACT: BACKGROUND: Although several studies have investigated the relationship between the number of siblings or birth order and childhood overweight, the results are inconsistent. In addition, little is known about the impact of having older or younger siblings on overweight among elementary schoolchildren. The present population-based study investigated the relationship of the number of siblings and birth order with childhood overweight and evaluated the impact of having younger or older siblings on childhood overweight among elementary schoolchildren in Japan. METHODS: Subjects comprised fourth-grade schoolchildren (age, 9--10 years) in Ina Town during 1999--2009. Information about subjects' sex, age, birth weight, birth order, number of siblings, lifestyle, and parents' age, height, and weight was collected by a self-administered questionnaire, while measurements of subjects' height and weight were done at school. Childhood overweight was defined according to age- and sex-specific cut-off points proposed by the International Obesity Task Force. A logistic regression model was used to calculate the odds ratio (OR) and 95% confidence intervals (95% CI) of "number of siblings" or "birth order" for overweight. RESULTS: Data from 4026 children were analyzed. Only children (OR: 2.13, 95% CI: 1.45-3.14) and youngest children (1.56, 1.13-2.16) significantly increased ORs for overweight compared with middle children. A larger number of siblings decreased the OR for overweight (P for trend < 0.001). Although there was no statistically significant relationship between a larger number of older siblings and overweight, a larger number of younger siblings resulted in a lower OR for overweight (P for trend < 0.001). CONCLUSIONS: Being an only or youngest child was associated with childhood overweight, and having a larger number of younger siblings was negatively associated with overweight. The present study suggests that public health interventions to prevent childhood overweight need to focus on children from these family backgrounds.     

Mother's age and daughter's fecundity. An epidemiological analysis of late 19th to early 20th century family reconstitutions

BACKGROUND: At both ends of the female reproductive span, the risk of reproductive problems is increased. We hypothesize that this is partly explained by inadequate maturation of oocytes ('pre-ovulatory overripeness'). As this phenomenon has been shown to lead to gonadal anomalies in the offspring of animals, we tested the prediction that daughters of older and very young mothers more often suffer reproductive problems due to ovarian maldevelopment. METHODS: We analysed family reconstitutions of 1907 women born in Rotterdam, the Netherlands, between 1873 and 1902. We defined several measures of fecundity based on numbers, birth rates and fates of offspring. We made use of general estimating equations (GEE), a statistical technique that allowed simultaneous analysis of different births per woman while controlling for various time-dependent or time-independent co-variables. RESULTS: The results indicated an increased risk of childlessness (adjusted odds ratio (aOR = 2.6, 95% CI : 1.1-7.4), stillbirth (aOR = 2.5, 95% CI : 1.1-5.6) and multiple birth (aOR = 2.1, 95% CI : 0.8-5.4) for daughters of mothers of >or=40 years as compared to daughters born to mothers of intermediate age (24-30 years). Daughters of mothers of 相似文献   

Paternal age and the risk of birth defects in Norway

PURPOSE: We studied 1,869,388 births from The Medical Birth Registry of Norway to assess the effect of father's age on risks of birth defects in offspring. METHOD: Thirteen separate categories were studied including pooled categories of neural tube defects and any type of defect. We used logistic regression models to adjust for maternal age, year of birth, maternity institution, parity, and correlation between siblings. RESULTS: There was little evidence of increased risk by high paternal age for any category of defects, except for a category of "other central nervous system" where risk estimates were 2.5-fold (95% CI: 1.2-5.5) for fathers aged between 45 and 49 years compared with the reference age group (25-29 years). The risk for neural tube defects was 1.3-fold (95% CI: 1.1-1.5) when the father was aged between 20 and 24 years relative to the reference. A pattern of moderately higher risks for younger fathers was consistent for anencephaly and spina bifida. Increased risk of heart defects was also estimated among children of young fathers. CONCLUSIONS: This study does not show consistent evidence that paternal ageing is a risk for birth defects among offspring. Low paternal age, or factors associated with younger parents, may however be associated with increased risk of neural tube defects in their offspring.     

Family Meals and Substance Use: Is There a Long-Term Protective Association?

PURPOSE: To examine 5-year longitudinal associations between family meal patterns and subsequent substance use in adolescents. METHODS: A total of 806 Minnesota adolescents were surveyed in public schools in 1998-1999 (mean age, 12.8 years) and again by mail in 2003-2004 (mean age, 17.2 years) as part of a longitudinal population-based study. Logistic regression was used to estimate the odds of tobacco, alcohol, and marijuana use at follow-up for adolescents reporting regular family meals at baseline compared with those without regular family meals, adjusting for family connectedness and prior substance use. RESULTS: Family meal frequency at baseline was associated with significantly lower odds of cigarette smoking, alcohol use, and marijuana use at follow-up among female adolescents, even after adjusting for baseline substance use and additional covariates. Family meals were not associated with use of any substance at follow-up for male adolescents after adjusting for baseline use. CONCLUSIONS: Results from this study suggest that regular family meals in adolescence may have a long-term protective association with the development of substance use over 5 years among females. Parents should be encouraged to establish a pattern of regular family meals, as this activity may have long lasting benefits.     

Infant immunization and family size

BACKGROUND: To investigate whether a delay in infant immunization is associated with the number of older siblings. METHODS: A cohort analysis of cumulative immunization uptake in 616 children aged 1-4 years recruited for a case-control study of atopic dermatitis in Norwich, UK was performed. The main outcome measures were the age of third pertussis and MMR immunizations. Delayed immunization was defined as a pertussis immunization age 6 months or greater, and MMR immunization aged 16 months or greater. RESULTS: Having a larger number of older siblings was associated with a delay in pertussis immunization (6.2 per cent for children with no older siblings versus 23.3 per cent for children with two or more older siblings), but not in MMR immunization. CONCLUSION: Infants with older siblings are at greater risk of pertussis infection from intrafamilial contagion yet are less likely to be immunized on time.     

February asthma outbreaks in NSW: a case control study

OBJECTIVES: To investigate individual factors associated with an asthma outbreak among children aged one to 14 years in Sydney in February 1999. METHODS: A case control study was undertaken with cases (n=92) defined as all children admitted to Sydney Children's Hospital for asthma in February 1999. Unmatched controls (n=76) were all children admitted for asthma in the previous three months. We obtained information by a structured telephone survey of parents. Logistic regression analyses were used to determine odds ratios for risk factors for hospital admission. RESULTS: Mean age for hospital admission of 4.7 years for cases and 4.4 years for controls. The presence of one or more siblings reduced the risk of admission during an asthma outbreak (OR=0.59, 95% CI 0.37 to 0.93). Children with older siblings aged 10 to 14 years were also less likely to be admitted (OR=0.3, 95% CI 0.12 to 0.74). An age effect was observed. Other demographic, clinical and environmental characteristics, including smoking, were not associated with admission during the outbreak. CONCLUSIONS: The main findings of this study are the protective effect of siblings and an age-dependent effect in risk of hospital admission during an asthma outbreak. These findings are consistent with an infective cause of the outbreak. IMPLICATIONS: Children without siblings, particularly older siblings, appear to be at highest risk of hospital admission during an asthma outbreak. Environmental and other factors need to be examined to further explain the episodicity of such outbreaks and to determine means of predicting and preventing future episodes.     

Separating within and between effects in family studies: an application to the study of blood pressure in children

In epidemiology the analyses of family or twin studies do not always fully exploit the data, as information on differences between siblings is often used while between-families effect are not considered. We show how cross-sectional time-series linear regression analysis can be easily implemented to estimate within- and between-families effects simultaneously and how these effects can then be compared using the Hausman test. We illustrate this approach with data from the Uppsala family study on blood pressure in children with age ranging from 5.5 to 12.3 years for the younger and from 7.5 to 13.8 years for the older siblings. Comparing the effect of differences in birth weight on blood pressure within-family (in full siblings) and between-families (in unrelated children) allows us to study the contributions of fixed and pregnancy-specific maternal effects on birth weight and consequently on blood pressure. Our data showed a 0.88 mmHg decrease (95 per cent confidence interval: -1.7 to -0.03 mmHg) in systolic blood pressure for one standard deviation increase in birth weight between siblings within a family and 0.88 mmHg (95 per cent confidence interval: -1.6 to -0.2 mmHg) decrease in systolic blood pressure for one standard deviation increase in birth weight between unrelated children. These estimates were controlled for sex, age, pubertal stage, body size and pulse rate of the children at examination and for maternal body size and systolic blood pressure. The within- and between-families effects were not significantly different, p = 0.19, suggesting that fixed and pregnancy-specific factors have similar effects on childhood systolic blood pressure.     

Long-term economic costs of psychological problems during childhood

Childhood psychological conditions including depression and substance abuse are a growing concern among American children, but their long-term economic costs are unknown. This paper uses unique data from the US Panel Study of Income Dynamics (PSID) following groups of siblings and their parents for up to 40 years prospectively collecting information on education, income, work, and marriage. Following siblings offers an opportunity to control for unobserved family and neighborhood effects. A retrospective child health history designed by the author was placed into the 2007 PSID wave measuring whether respondents had any of 14 childhood physical illnesses or suffered from depression, substance abuse, or other psychological conditions.     

Psychoactive substance use disorder in youth suicide

Fifty-eight consecutive suicides committed between 1984 and 1987 by adolescents and young adults (age 15-29 years) from an urban community were the subject of retrospective investigations through interviews with survivors and analyses of registers and medical records. Psychoactive substance use disorder in accordance with DSM-III-R was present in 47% of the youth suicides investigated, predominantly as alcohol dependence. Substance use disorder often coexisted with a borderline personality disorder or schizophrenia. Secondary depression was a frequent final factor. Dependence had developed in all females and most males. The median duration of substance use was 9 years. Substance use preceded suicidal behaviour by two years. Exposure to parental substance misuse during childhood, early parental divorce and parasuicide in the family were more frequent among subjects with substance use disorder than among other subjects. The social situation was often characterized by unemployment and legal problems. Previous inpatient care was more common than among other subjects.     

Tobacco smoking among Portuguese high-school students.

The aim of this study was to evaluate the prevalence, behavioural patterns, and determinants of smoking among a large sample of high-school students from Porto, the second largest city in Portugal, information on sociodemographic characteristics and personal history of tobacco, alcohol, coffee, and illicit drug use was obtained from 2974 students, aged 12-19 years (48.7% female, 51.3% male), using an anonymous self-administered questionnaire. Crude and adjusted odds ratios (OR) were calculated by logistic regression analysis to estimate the association between smoking and the characteristics evaluated. Overall, 35.8% students had never smoked, 39.4% had tried it ("experimental" smokers) but were not smokers, 3.3% were former smokers, 6.6% occasional smokers, and 14.9% regular smokers. The mean age for starting smoking was 13.4 +/- 2.1 years for males and 13.4 +/- 1.6 years for females. The prevalence of current smoking was higher among males than females, but the difference was not significant. Male students were significantly more likely to smoke more cigarettes per day than were females. The prevalence of smoking was significantly associated with the following variables: being aged > 12 years; having parents who had attended school for < 4 years; having a mother (OR = 1.88), siblings (OR = 1.96) or friends (OR = 1.75) who smoked; low academic performance (OR = 1.74 for one or two failures and OR = 2.27 for more than two failures at school); and consumption of coffee (OR = 2.90), alcohol (OR = 3.53), or illicit drugs (OR = 6.69). The prevalence of smoking among adolescents increased with age. There is therefore a need for school-based tobacco prevention programmes which also deal with family influences on smoking.