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Background and Objectives: By age 5, 20% of British children are classed as overweight or obese, suggesting that early childhood is crucial for lifelong body mass index (BMI) trajectories. In this paper, we identify latent trajectories of early-childhood BMI from ages 3 to 11 years. Given the current context of growing socio-economic inequalities in childhood and adult overweight and obesity, we examine the socio-economic characteristics and mechanisms during pregnancy and infancy which underscore these trajectories. Subject and Methods: We use a nationally representative, prospective cohort study of 9699 children born in 2000–2002, living in the United Kingdom shortly after birth, with complete information on height and weight (measured by an interviewer) at ages 3, 5, 7 and 11. Trajectories of BMI are calculated using latent growth mixture models. Multinomial models characterize these trajectories by their socio-economic profiles and mechanisms during pregnancy and infancy. Results: Four trajectories were identified: two separate trajectories where BMI remains within a normal range (85% of the sample), an overweight trajectory (14.4%), and an obese trajectory (3.1%). No ‘declining BMI’ or late-onset groups were found. The obese group is already distinct from the other trajectories by age 3. The overweight group diverges from the normal groups around age 5. Strong socio-economic inequalities emerged; for the obese group, part of this disadvantage is mediated through early mechanisms such as pregnancy smoke and not initiating breastfeeding. Conclusions: This study provides strong evidence for the idea that childhood BMI trajectories develop early, especially for children who will follow an obese trajectory. Strong socio-economic patterns in these trajectories suggest that the observed trend in growing inequalities may be rooted in early life. Mediating mechanisms for the obese appear to be in the pregnancy and infant period, further research should explore mechanisms occurring around age 5 when the overweight trajectory diverges.

Epstein-Barr virus (EBV) is a highly prevalent herpesvirus linked to infectious mononucleosis and several malignancies. This paper aims to study the association between children's early life social environment at 9 months and EBV infection at 3 years of age.

Background Birthweight varies according to ethnic group, but it is not clear why such differences exist. We examine the contribution of socioeconomic, maternal and behavioural factors to differences in mean birthweight and the prevalence of low birthweight across ethnic groups. Methods Data from the nationally representative UK Millennium Cohort Study (n = 16 157) on White, Indian, Pakistani, Bangladeshi, Black Caribbean and Black African infants were analysed. Cohort members were born in 2000–02, and data on birthweight, maternal, infant, behavioural and socioeconomic factors were collected by home interviews. Results Indian, Pakistani and Bangladeshi infants were 280–350 g lighter, and 2.5 times more likely to be low birthweight compared with White infants. Black Caribbean infants were 150 g and Black African infants 70 g lighter compared with White infants, and Black Caribbean and Black African infants were 60% more likely to be low birthweight compared with White infants. For Black Caribbean, Black African, Bangladeshi and Pakistani infants, socioeconomic factors were important in explaining birthweight differences and, for Indian and Bangladeshi infants, maternal and infant factors were important in explaining birthweight differences. Conclusion Future policies aimed at reducing inequalities in birthweight must pay attention to the different socioeconomic and culturally-related profiles of ethnic minority groups in the UK.

BackgroundThe transcription factor FOXN1 is implicated in the differentiation of thymic and skin epithelial cells, and alterations in it are responsible for the Nude/SCID phenotype. During a genetic counselling programme offered to couples at risk in a community where a high frequency of mutated FOXN1 had been documented, the identification of a human FOXN1−/− fetus gave the unique opportunity to study T cell development in utero.ResultsTotal blockage of CD4+ T cell maturation and severe impairment of CD8+ cells were documented. Evaluation of the variable-domain β-chain (Vβ) families' usage among T lymphocytes revealed that the generation of T cell receptor (TCR) diversity occurred to some extent in the FOXN1−/− fetus, although it was impaired compared with the control. A few non-functional CD8+ cells, mostly bearing TCRγδ in the absence of CD3, were found.DiscussionFOXN1 is crucial for in utero T cell development in humans. The identification of a limited number of CD8+ cells suggests an extrathymic origin for these cells, implying FOXN1-independent lymphopoiesis.

Background Studies show a strong relationship between maternal mental health and child socio-emotional development. This literature is based on examinations of dyadic relationships, where maternal mental health is hypothesised to have a direct effect on children’s development. However, household dynamics are complex, with other household members having an effect both on the mother and the child. Furthermore, the child’s characteristics can also have a feedback effect on their career’s outcomes. Methods In this paper, we employ a multilevel structural equation model with cross lagged effects to understand the reciprocal effects of maternal mental health, child socio-emotional development, and quality of parental relationship. Analyses were conducted on longitudinal data from the Millennium Cohort Study, a prospective national birth cohort of children born in the UK 2000–2001. The Millennium Cohort Study has a wealth of information on the socioeconomic background of the household, and has collected data on the mother’s mental health (Kessler 6), the quality of the parents’ relationship (Golombok-Rust), and the children’s socio-emotional development (SDQ). Our results relate to households with two continuously partnered parents, with complete data on the three key variables, producing a sample size of 6570 households. In this work we look at data relating to age 3 and 5 years. Results Child socio-emotional development at age 3 has an influence on maternal mental health when their child is age 5 (standardised β = 0.03 [95% CI 0.001, 0.05]) and maternal mental health at age 3 has an influence on child socio-emotional development at age 5 (0.07; 0.05–0.10). Quality of the parental relationship at age 3 has an influence on maternal mental health when their child is age 5 (0.04 [0.02, 0.06]) but does not influence child socio-emotional development at age 5. Neither child socio-emotional development nor maternal mental health at age 3 influence the quality of the parental relationship when their child is age 5. Conclusion We find complex significant relationships between maternal mental health, child socio-emotional development and quality of parental relationship. This points to the need to consider all household members in order to properly capture household dynamics and to understand drivers of parental and child wellbeing.

Minority children and children from lower income families are more likely to experience the burden of oral disease. Since oral disease reduces quality of life, it is a priority to utilize preventive dental services. The research questions ask if affiliated practice increases utilization of preventive dental services by underserved children from birth to 18 years of age, and what the barriers to receiving preventive dental services are and their level of importance. A survey was administered to parents/guardians of patients from birth to 18 years of age who received preventive dental services from Catholic Healthcare West East Valley Children's Dental Clinic, an affiliated practice dental clinic in Chandler, Arizona. Thirty-four surveys were completed: 21 completed in English and 13 completed in Spanish. The data was analyzed to provide descriptive statistics and non-parametrically analyzed using the Friedman's, Kendall's W and Wilcoxon Signed Ranks Tests. The cost of preventive dental services is more important to this population than both convenience of appointment time and distance traveled. As the cost increases for preventive dental services, this population will utilize preventive dental services less frequently. The study indicated that the increase of self-reported utilization of preventive dental services by underserved children, ranging in age from birth to 18 years old, in Arizona affiliated practice dental clinics, was primarily impacted by perceived reduced costs of receiving care. Funding efforts, reimbursement mechanisms and legislative policies should support this dental care delivery model to provide care to underserved children, adults and seniors throughout the U.S.

This inter-disciplinary project investigates the relationship between family structure and early child health. The two main aims are: (1) to determine whether family structure and changes in family structure are associated with children's physical health in the Millennium Cohort Study; (2) to explore potential pathways through which these associations operate. In spite of much public debate around families, marriage, and child outcomes, UK literature on this topic remains incomplete. This thesis aims to fill two gaps: first, testing whether there is a link with children's physical health, rather than more commonly reported outcomes such as cognitive function or education achievements. Physical health outcomes included are respiratory health, childhood growth, and unintentional injuries. Second, few studies use prospective, longitudinal data and methods. Cross sectional studies cannot examine the direction of the relationship, nor capture the dynamics of changes in family structure. Here, longitudinal techniques test a complex model made up of variables ordered a priori. In unadjusted analyses, family structure presented a consistent gradient in child health: cross-sectionally, children living with married parents had better health than those living with cohabiting parents, while those living with lone parents had the worst health. Longitudinally, those who experienced changes in family structure fared worse than those living with continuously married parents, with some important exceptions, such as those living with cohabiting parents who subsequently married. Socio-economic factors were important predictors of family structure and child health. Proximal pathways through which socio-economic characteristics and family structure affected child health varied according to health outcome. Maternal mental health appeared to be important across outcomes. Concluding, this work shows the importance of using nuanced definitions of family, particularly when it comes to capturing its fluidity over time. Children who experienced changes in family structure were a heterogeneous group with diverse backgrounds and outcomes. Socio-economic factors emerged as important antecedents to both family structure and child health.

There are similarities between the clinical conditions associated with genital and oral mucosal human papillomavirus (HPV). The role of HPV infection in oral carcinogenesis is currently controversial. Also, factors underlying this infection are still unclear. The frequent location of HPV lesions in areas of trauma indicates the role of mechanical irritation as a necessary event for the penetration and/or reactivation of the virus into the epithelium. Oral mucosa is frequently exposed to mechanical irritation, as it is in constant and intimate association with hard tissues. During the oral HPV infection, favorable conditions must be generated for the infection to be successful. Some of them, associated with proliferation of basal keratinocytes, are related to the presence of external stimuli, such as chronic mechanical irritation (CMI). The objective of this work is to demonstrate, through the presentation of three clinical cases, the possible role of CMI in the pathophysiology of HPV lesions of the oral mucosa.

p53 and p185 expression in primary breast cancer with microsatellite instability (MSI) is still largely unexplored. To investigate the relationship between these oncoproteins and the pathways of genomic instability, we examined 52 primary invasive breast cancers stratified by the presence and absence of MSI. We determined the status of eight microsatellite loci using radioactive and silver staining methods, and evaluated the immunohistochemical expression of p53 and p185 in a consecutive series of Italian cancer patients characterized by clinical-pathological and biological parameters. Nineteen cases (36.5%) were MSI-positive in at least two loci. p53 was expressed in 15 cases (28.8%) and p185 in eight (15.4%). MSI-positive tumors were inversely correlated with p53 expression (p = 0.0007); in addition, the percent of p53-expressing cells decreased as the number of MSI-positive loci increased. MSI-positive tumors were correlated with a larger tumor size (p = 0.04), lymph-node metastasis (p = 0.001), and advanced clinical stage (p = 0.0006). These data demonstrate the existence of two subsets of primary breast cancers: one characterized by MSI, the other by p53 expression. MSI-positive patients had a more advanced and/or aggressive disease.