Paediatrics (RCH) - Research Publications

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    Emotional symptoms and inflammatory biomarkers in childhood: Associations in two Australian birth cohorts
    Lange, K ; Pham, C ; Fedyszyn, IE ; Cook, F ; Burgner, DP ; Olsson, CA ; Downes, M ; Priest, N ; Mansell, T ; Tang, MLK ; Ponsonby, A-L ; Symeonides, C ; Loughman, A ; Vuillermin, P ; Kerr, JA ; Gray, L ; Sly, PD ; Lycett, K ; Carlin, JB ; Saffery, R ; Wake, M ; O'Connor, M (Elsevier, 2024-01-01)
    BACKGROUND: An increasing body of evidence supports associations between inflammation and mental health difficulties, but the onset and directionality of these relationships are unclear. METHODS: Data sources: Barwon Infant Study (BIS; n = 500 4-year-olds) and Longitudinal Study of Australian Children (LSAC; n = 1099 10-13-year-olds). MEASURES: Strengths and Difficulties Questionnaire emotional symptoms at 4, 10-11 and 12-13 years, and circulating levels of two inflammatory biomarkers, high-sensitivity C-reactive protein (hsCRP) and glycoprotein acetyls (GlycA), at 4 and 11-12 years. ANALYSIS: Adjusted quantile regression models examining cross-sectional associations between emotional symptoms and inflammation in 4-year-olds (BIS), and cross-lagged associations in 10-13-year-olds (LSAC). RESULTS: We identified a small association between higher emotional symptoms at 10-11 years and higher GlycA levels a year later (standardised coefficient β = 0.09; 95%CI: 0.02 to 0.15). Sex-stratified analyses revealed this association was stronger for boys (β = 0.13; 95%CI: 0.04 to 0.21) than girls (β = 0.01; 95%CI: -0.09 to 0.11). These associations were not observed for hsCRP. There was little evidence of an association between higher GlycA or hsCRP at 11-12 years and emotional symptoms a year later, or cross-sectional associations between emotional symptoms and hsCRP or GlycA at 4 years. LIMITATIONS: A single time-point of biomarker collection in late childhood precluded adjustment for baseline inflammatory biomarkers. CONCLUSIONS: Our results support the direction of association from emotional symptoms to inflammation in late childhood, with potential sex differences. This adds to the body of evidence that addressing emotional symptoms in childhood is a major priority in optimising overall health throughout the life course.
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    Adolescent School Belonging and Mental Health Outcomes in Young Adulthood: Findings from a Multi-wave Prospective Cohort Study
    Allen, K-A ; Greenwood, CJ ; Berger, E ; Patlamazoglou, L ; Reupert, A ; Wurf, G ; May, F ; O'Connor, M ; Sanson, A ; Olsson, CA ; Letcher, P (SPRINGER, 2024-01-01)
    Abstract School belonging, sometimes referred to as school belonging or school connectedness, involves dimensions like positive affect towards school, relationships with teachers, and feeling socially valued. Previous research points to immediate benefits for students’ mental health and wellbeing; however, evidence on the potential long-term benefits of school belonging for mental health—once young people leave the school setting—is limited. This study used data on 1568 adults from the Australian Temperament Project (ATP), a 16-wave longitudinal study which has tracked participants since infancy. The short form of the Australian Council for Educational Research (ACER) School Life Questionnaire was used to assess secondary school belonging at age 15–16 years whilst young adult mental health symptoms were evaluated using the Depression, Anxiety and Stress Scales (DASS-21) at 19–20, 23–24, and 27–28 years. Generalised Estimating Equation models were used to examine the link between secondary school belonging and mental health symptoms in young adulthood. Results showed that higher levels of all aspects of school belonging were associated with lower mental health symptoms across young adulthood (β range − 0.05 to − 0.20). Associations were similar by gender. These findings underscore the importance of adolescent school belonging and in particular school status in reference to feeling socially valued, as a long-term protective factor that can mitigate against later depression, anxiety, and stress.
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    Exploring perinatal biopsychosocial factors and epigenetic age in 1-year-old offspring
    Fransquet, PD ; Macdonald, JA ; Ryan, J ; Greenwood, CJ ; Olsson, CA (FUTURE MEDICINE LTD, 2023-09)
    Background: Little is known about the determinants of epigenetic aging in pediatric populations. Methods: Epigenetic age was estimated from 258 1-year-olds, using pediatric buccal epigenetic and Horvath clocks. We explored associations between epigenetic age and maternal indicators of mental and relational health, substance use and general physical health assessed during trimester three. Results: Higher anxiety and stress, BMI and higher parent-parent relationship quality were associated with pediatric buccal epigenetic clock differences. High blood pressure during pregnancy was associated with Horvath age acceleration. Third-trimester smoking and pre-pregnancy weight were associated with acceleration and deceleration respectively, and concordant across clocks. Conclusion: A broad range of maternal factors may shape epigenetic age in infancy; further research is needed to explore the possible effects on health and development.
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    Is Neighborhood Nature an Ecological Precursor of Parenting Practices, Infant-Parent Bonding, and Infant Socioemotional Function?
    Mygind, L ; Greenwood, C ; Letcher, P ; Mavoa, S ; Lycett, K ; Wang, Y ; Flensborg-Madsen, T ; Bentsen, P ; Macdonald, JA ; Thomson, K ; Hutchinson, D ; Olsson, CA ; Enticott, PG (SAGE PUBLICATIONS INC, 2023-05)
    Nurturing relationships are crucial for adaptive child development. The objectives of the study were to investigate whether nature availability was associated with early nurturing parenting practices, mother-infant bonding, and infant socioemotional function. Data were from the Australian Temperament Project ( n = 809 infants to 515 parents residing in Victoria, Australia) and were linked cross-sectionally to residential greenness (i.e., Normalized Difference in Vegetation Index). There were no observable associations between residential greenness within a 1,600 m network radius and parenting practices, mother-infant bonding, or infant socioemotional function. The findings were largely corroborated by sensitivity analyses (i.e., NDVI within 100, 250, 500, and 1,000 m and distance to park). Shorter distances to a park were associated with less hostile parenting. More residential greenness (1,000 and 1,600 m) was associated with stronger father-infant bonding and more hostile parenting amongst the most stressed parents in exploratory analyses. Residential greenness might be a socioecological precursor for father-infant bonding.
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    Balancing friends and romance: Associations between men's investment in peer relationships and romantic relationship quality
    Marabel-Whitburn, K ; Greenwood, CJ ; Mansour, KA ; Francis, LM ; Olsson, CA ; Macdonald, JA (SAGE PUBLICATIONS LTD, 2023-12)
    Romantic and peer relationships both contribute to overall well-being; however, each demand time and emotional investment that may give rise to competition. Little is known about how men, in particular, balance these relationships. We explored the extent to which men’s investments in peer relationships are associated with romantic relationship quality. We further examined differences between fathers and non-fathers. Data were from five annual waves of the Men and Parenting Pathways cohort study ( N = 608). Participants were men in committed relationships ( n = 526) aged 28-32 years at baseline ( M = 29.91, SD = 1.3). In cross-sectional, linear regressions, estimated using Generalised Estimating Equations (GEE; to account for repeated waves), we investigated peer network investments, (1) time (hours) spent with peers, (2) close network size, and (3) extended network size, and their associations with romantic relationship quality, self-reported using the Dyadic Adjustment Scale. Inverted U-shaped associations were found for time spent with peers and close network size, whereby increases in investment were associated with improved relationship quality up to a “tipping point”, following which declines in quality are observed. For extended social networks, the association was linear, such that larger networks were linked to higher romantic relationship quality; however, this association was only evident in fathers. Investing too little or too much in peer relationships may adversely impact the quality of men’s relationships with romantic partners. Supporting men, and particularly fathers, to maintain appropriate investment in peer networks may have benefits for their romantic relationships.
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    Intervention targets for reducing mortality between mid-adolescence and mid-adulthood: a protocol for a machine-learning facilitated systematic umbrella review
    Kerr, JA ; Gillespie, AN ; O'Connor, M ; Deane, C ; Borschmann, R ; Dashti, SG ; Spry, EA ; Heerde, JA ; Moller, H ; Ivers, R ; Boden, JM ; Scott, JG ; Bucks, RS ; Glauert, R ; Kinner, SA ; Olsson, CA ; Patton, GC (BMJ PUBLISHING GROUP, 2023-10)
    INTRODUCTION: A rise in premature mortality-defined here as death during the most productive years of life, between adolescence and middle adulthood (15-60 years)-is contributing to stalling life expectancy in high-income countries. Causes of mortality vary, but often include substance misuse, suicide, unintentional injury and non-communicable disease. The development of evidence-informed policy frameworks to guide new approaches to prevention require knowledge of early targets for intervention, and interactions between higher level drivers. Here, we aim to: (1) identify systematic reviews with or without meta-analyses focused on intervention targets for premature mortality (in which intervention targets are causes of mortality that can, at least hypothetically, be modified to reduce risk); (2) evaluate the review quality and risk of bias; (3) compare and evaluate each review's, and their relevant primary studies, findings to identify existing evidence gaps. METHODS AND ANALYSIS: In May 2023, we searched electronic databases (MEDLINE, PubMed, Embase, Cochrane Library) for peer-reviewed papers published in the English language in the 12 years from 2012 to 2023 that examined intervention targets for mortality. Screening will narrow these papers to focus on systematic reviews with or without meta-analyses, and their primary papers. Our outcome is death between ages 15 and 60 years; with potential intervention targets measured prior to death. A MeaSurement Tool to Assess systematic Reviews (AMSTAR 2) will be used to assess quality and risk of bias within included systematic reviews. Results will be synthesised narratively due to anticipated heterogeneity between reviews and between primary studies contained within included reviews. ETHICS AND DISSEMINATION: This review will synthesise findings from published systematic reviews and meta-analyses, and their primary reviewed studies, meaning ethics committee approval is not required. Our findings will inform cross-cohort consortium development, be published in a peer-reviewed journal, and be presented at national and international conferences. PROSPERO REGISTRATION NUMBER: CRD42022355861.
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    Infant and preschool attachment, continuity and relationship to caregiving sensitivity: findings from a new population-based Australian cohort
    Mcintosh, JE ; Opie, J ; Greenwood, CJ ; Booth, A ; Tan, E ; Painter, F ; Messer, M ; Macdonald, JA ; Letcher, P ; Olsson, CA (WILEY, 2024-01)
    BACKGROUND: Here, we report new prevalence and temporal stability data for child attachment and parental caregiving behaviour, from infancy (1 year) to preschool (4 years). METHODS: Attachment (SSP) and caregiving data (MBQS) were from observations of parents and their infants and preschoolers, who represent the third generation of participants within an Australian longitudinal cohort. RESULTS: At 1 year (n = 314 dyads) and at 4 years (n = 368 dyads), proportions assessed secure were 59% and 71%, respectively. Proportions assessed avoidant were 15% and 11%; ambivalent 9% and 6%, and disorganised 17% and 12%, at 1 and 4 years. Continuity of attachment pattern was highest for the infant secure group. Of dyads initially classified disorganised in infancy, 36% remained so at the preschool assessment. Attachment and caregiving continuities across the infancy-preschool period were highest for the stable secure attachment group and lowest for the stable insecure attachment group. Loss of secure attachment to mother by age 4 years correlated with decreased maternal caregiving sensitivity, and acquisition of secure status by age 4 was associated with increased maternal sensitivity. We found no difference in caregiving sensitivity scores for mothers and fathers for female and male preschool children. CONCLUSIONS: The contemporary infant and preschool attachment proportions we report here closely mirror the patterns of those reported in prior decades, with an inclination towards secure base relationships. Our findings alert practitioners anew to the responsiveness of early attachment status to change in caregiving responsiveness and support ongoing investment in early identification of disorganised attachment.
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    Continuities in maternal substance use from early adolescence to parenthood: findings from the intergenerational cohort consortium
    Thomson, KC ; Greenwood, CJ ; Letcher, P ; Spry, EA ; Macdonald, JA ; McAnally, HM ; Hines, LA ; Youssef, GJ ; McIntosh, JE ; Hutchinson, D ; Hancox, RJ ; Patton, GC ; Olsson, CA (CAMBRIDGE UNIV PRESS, 2023-04-08)
    Background This study assessed the extent to which women's preconception binge drinking, tobacco use and cannabis use, reported prospectively in adolescence and young adulthood, predicted use of these substances during pregnancy and at 1 year postpartum. Methods Data were pooled from two intergenerational cohort studies: the Australian Temperament Project Generation 3 Study (395 mothers, 691 pregnancies) and the Victorian Intergenerational Health Cohort Study (398 mothers, 609 pregnancies). Alcohol, tobacco and cannabis use were assessed in adolescence (13-18 years), young adulthood (19-29 years) and at ages 29-35 years for those transitioning to parenthood. Exposures were weekly or more frequent preconception binge drinking (5 + drinks in one session), tobacco use and cannabis use. Outcomes were any alcohol, tobacco and cannabis use prior to awareness of the pregnancy, after awareness of pregnancy (up to and including the third trimester pregnancy) and at 1 year postpartum. Results Frequent preconception binge drinking, tobacco use and cannabis use across both adolescence and young adulthood were strong predictors of continued use post-conception, before and after awareness of the pregnancy and at 1 year postpartum. Substance use limited to young adulthood also predicted continued use post-conception. Conclusions Persistent alcohol, tobacco use and cannabis use that starts in adolescence has a strong continuity into parenthood. Reducing substance use in the perinatal period requires action well before pregnancy, commencing in adolescence and continuing into the years before conception and throughout the perinatal period.
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    Multilevel Impacts of the COVID-19 Pandemic: A Bioecological Systems Perspective of Parent and Child Experiences
    Painter, FL ; Booth, AT ; Letcher, P ; Olsson, CA ; McIntosh, JE (SPRINGER, 2024-04)
    Abstract Background The coronavirus (COVID-19) pandemic and associated public health restrictions created unprecedented challenges for parents and their young dependent children. While psycho-social impacts of natural disasters on families are well studied, a typography of parent specific concerns in the COVID-19 context was yet to be articulated. Objective Using a bioecological systems framework, we adopted a mixed-methods research design to examine parents’ core concerns about the impacts of the pandemic on themselves and their children, testing for differences in concern foci of mothers compared with fathers. Method Data were drawn from the Australian Temperament Project Generation 3 (ATPG3) study, a prospective study of children born to a 40-year population-based cohort. During enforced COVID-19 lockdown restrictions between May to September 2020, ATPG3 parents (n = 516) were surveyed about their own and their children’s functioning in the context of the pandemic. Subject of qualitative content analysis, parents (n = 192) experiencing wellbeing concerns offered additional free-text responses about the nature of stress impacting themselves and their child/ren. Results Parents reported far-reaching impacts for themselves and their children across multiple bioecological systems. Core concerns were for emotional rather than physical health, specifically, for parents this was represented by increased levels of anxiety and stress, and for children, these impacts were notable from a developmental perspective. Greater frequency of parenting related concern was expressed by mothers in comparison to fathers. Conclusions Findings demonstrate the complex and interrelated nature of multi-systemic and gendered stressors impacting parents during the pandemic, and importantly point to modifiable risk factors which may inform early risk detection efforts.
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    Illicit Substance Use and Harm in Young Adulthood: the Role of Substance Use in Close Relationships and Individual Social Skills
    Greenwood, CJ ; Letcher, P ; Macdonald, JA ; Hutchinson, DM ; Youssef, GJ ; Toumbourou, JW ; Spry, E ; Sanson, A ; Cleary, J ; Olsson, CA (Springer Science and Business Media LLC, 2023-01-01)
    Abstract To examine illicit substance use across young adulthood and explore the extent to which social skills moderate the relationship between use and harm. 1,404 (761 women) from the Australian Temperament Project (est. 1983) participated across young adulthood (age 19–20, 23–24, and 27–28 years). Measures included self-reported illicit substance use/harm and social skills (i.e., assertion, empathy, responsibility, and self-control). The number and type of illicit substances used changed across young adulthood. Greater illicit substance use was associated with peer (OR = 4.96) and partner use (OR = 3.60). Moderation analyses suggested the risk relationship between the number of illicit substances used and harm was lower in those with high levels of assertion/self-control (ORassertion = 2.34, ORself-control = 2.60) compared to low levels (ORassertion = 4.43, ORself-control = 3.72). Evidence based programmes designed to strengthen individual social skills for young adults may play a role in protecting against the adverse effects of illicit substance use.