Understanding early life determinants and mechanisms to preventing life course multimorbidity

了解早期生命决定因素和预防生命历程多重疾病的机制

• 批准号: MR/V004883/1
• 负责人: Niina Kolehmainen
• 金额: $ 12.65万
• 依托单位: Newcastle University
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FV004883%2F1
• 关键词: Understanding; early; life; determinants; mechanisms

The early part of life-from tiny embryo, to baby in the womb, to birth, through infancy and early childhood-is a time when many events happen that can have important, lasting effects on our lives. We want to find ways to make these early parts of our lives as good as they can be, so that we enter adulthood healthy and able to cope well with things that life may throw at us.Our research will investigate the early life events that affect our hearts, blood vessels, mental health, and metabolism (how our bodies convert food to energy and to building blocks such as proteins, and eliminate waste). We want to find ways to prevent early life events that lead us to have several health problems in later life. We call this "multi-morbidity", meaning two or more long-term conditions or disabilities.The idea of looking at health from early life into adulthood has been around for a while, but it is still fairly rare to actually link information from early life events with multimorbidity. We are a new group of people with complementary expertise in early life and adult health. For example, we have lab scientists studying hearts and blood vessels; psychologists investigating how movement and physical activity affects mothers and children; children's doctors providing front line care while also researching the best ways to help their patients; a data engineer; and public health researchers working on studies that follow people's health for decades. We know that to answer the big questions about early life events and multimorbidity we need to collaborate in new ways across our areas of expertise. We are now proposing a 6-month project to bring together what we know and our different techniques ('methods'), and to refine our bigger 4-year plan. Our bigger plan has four related parts:A. We will find and make sense of different types of existing evidence about early life drivers of multimorbidity. We will work with stakeholders (parents, carers, children, policy makers, professionals) to draw up a map that will help people to think more clearly about early life events that cause or prevent multimorbidity, see the gaps in our knowledge, and decide which questions to answer next.B. To answer these questions, we will electronically link up existing UK-based data (e.g. heel prick samples, red book questions) and use new methods, such as artificial intelligence, to explore it. We will also collect new data to fill gaps.C. As the data helps us better understand early life events and how they affect later health, we will co-design new 'interventions' to alter these events. For example, we may develop medicines, health monitors, or ways for people to do things differently. They may be for individuals or populations.D. We will involve patients and the public throughout to ensure focus on what matters and that the interventions work well in real life.In the initial 6 months, we will use three particular areas to pilot our ideas and techniques. These are areas where: early life events are already known to affect later life multimorbidity but how this happens is not clear; there is great potential for better interventions; and we have substantial expertise. The areas are:- mother's heart and blood vessel health, and influence on baby- stressful events for the mother/child, and effects on hormones and later child health- mother/child movement and physical activity, and effects on mother/child heart and blood health and stressThis research will change the way health and care is provided, moving from diagnosing and treating individual conditions as they appear to intervening on early life psychological, social and medical issues. This will prevent multiple problems later in life for large numbers of people. This will improve child and parent health, and reduce the burden on families and services. This research will also help inform what information is important for governments to collect in early life to monitor public health.

生命的早期阶段从小小的胚胎，到子宫中的婴儿，再到出生，经过婴儿期和幼儿期，是许多事件发生的时候，这些事件会对我们的生活产生重要而持久的影响。我们希望找到方法让我们生命的早期部分尽可能地好，这样我们就能健康地进入成年期，并能够很好地科普生活可能给我们带来的事情。我们的研究将调查影响我们的心脏、血管、心理健康和新陈代谢的早期生活事件（我们的身体如何将食物转化为能量和蛋白质等建筑材料，并消除废物）。我们希望找到方法来预防导致我们在晚年出现一些健康问题的早期生活事件。我们称之为“多重发病”，即两种或两种以上的长期疾病或残疾。从生命早期到成年期的健康状况来看，这一想法已经存在了一段时间，但实际上将生命早期事件的信息与多重发病联系起来仍然相当罕见。我们是一群在早期生活和成人健康方面具有互补专业知识的新成员。例如，我们有研究心脏和血管的实验室科学家;心理学家研究运动和身体活动如何影响母亲和儿童;儿童医生提供一线护理，同时也研究帮助患者的最佳方法;数据工程师;以及公共卫生研究人员从事数十年来跟踪人们健康的研究。我们知道，要回答有关早期生活事件和多莫尔的重大问题，我们需要在我们的专业领域以新的方式进行合作。我们现在提出一个为期6个月的项目，将我们所知道的和我们不同的技术（“方法”）结合起来，并完善我们更大的4年计划。我们更大的计划有四个相关的部分：A。我们将发现并理解关于多Mortocell的早期生活驱动因素的不同类型的现有证据。我们将与利益相关者（父母，照顾者，儿童，政策制定者，专业人士）合作，绘制一张地图，帮助人们更清楚地思考导致或预防多重死亡的早期生活事件，看到我们知识的差距，并决定下一步回答哪些问题。为了回答这些问题，我们将以电子方式连接现有的英国数据（例如脚跟穿刺样本，红书问题），并使用新的方法，如人工智能，来探索它。我们还将收集新的数据来填补空白。C.由于这些数据有助于我们更好地了解早期生活事件以及它们如何影响以后的健康，我们将共同设计新的“干预措施”来改变这些事件。例如，我们可能会开发药物、健康监测器或让人们以不同的方式做事的方法。它们可能是针对个人或群体的。我们将让患者和公众参与进来，以确保重点放在重要的事情上，并确保干预措施在真实的生活中发挥作用。在最初的6个月里，我们将使用三个特定领域来试点我们的想法和技术。在这些领域：我们已经知道，早期生活事件会影响晚年生活中的多发病，但这是如何发生的尚不清楚;更好的干预措施有很大的潜力;我们有大量的专门知识。这些领域是：-母亲的心脏和血管健康，以及对婴儿的影响-母亲/儿童的压力事件，以及对激素和以后儿童健康的影响-母亲/儿童运动和身体活动，以及对母亲/儿童心脏和血液健康和压力的影响这项研究将改变提供健康和护理的方式，从诊断和治疗个人疾病，因为他们似乎对早期生活的心理，社会和医疗问题进行干预。这将防止许多人在以后的生活中出现多种问题。这将改善儿童和父母的健康，减轻家庭和服务的负担。这项研究还将有助于告知政府在生命早期收集哪些信息以监测公共卫生是重要的。

项目成果

Group, The Child Routine Data (2021): Making a difference for children, young people and families' lives in the North East: Recommendations for the next steps In using routinely collected data

小组，《儿童常规数据》（2021 年）：为东北部儿童、青少年和家庭的生活带来改变：对使用常规收集数据的后续步骤的建议

• 发表时间: 2021
• 作者: Child Data Group

Identifying common health indicators from paediatric core outcome sets: a systematic review with narrative synthesis using the WHO International Classification of Functioning, Health and Disability.

• DOI: 10.1136/bmjpo-2022-001537
• 发表时间: 2022-10
• 期刊: BMJ paediatrics open
• 影响因子: 2.6

Learning through mess: Sensemaking visual communication practices in a UK multidisciplinary applied health study.

• DOI: 10.1177/14703572221092410
• 发表时间: 2022-08
• 期刊: VISUAL COMMUNICATION
• 影响因子: 1.5
• 作者: Robson, Ian