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McGrath N.,Academic Unit of Primary Care and Population science | McGrath N.,University of Southampton | McGrath N.,University of KwaZulu - Natal | Hosegood V.,University of Southampton | And 5 more authors.
The Lancet HIV | Year: 2015

Background: Increased sexual risk behaviour and HIV prevalence have been reported in migrants compared with nonmigrants in sub-Saharan Africa. We investigated the association of residential and migration patterns with sexual HIV risk behaviours and HIV prevalence in an open, general population cohort in rural KwaZulu-Natal, South Africa. Methods: In a mainly rural demographic surveillance area in northern KwaZulu-Natal, South Africa, we collected longitudinal demographic, migration, sexual behaviour, and HIV status data through household surveillance twice per year and individual surveillance once per year. All resident household members and a sample of non-resident household members (stratifi ed by sex and migration patterns) were eligible for participation. Participants reported sexual risk behaviours, including data for multiple, concurrent, and casual sexual partners and condom use, and gave a dried blood spot sample via fi ngerprick for HIV testing. We investigated population-level diff erences in sexual HIV risk behaviours and HIV prevalence with respect to migration indicators using logistic regression models. Findings: Between Jan 1, 2005, and Dec 31, 2011, the total eligible population at each surveillance round ranged between 21 129 and 22 726 women (aged 17-49 years) and between 20 399 and 22 100 men (aged 17-54 years). The number of eligible residents in any round ranged from 24 395 to 26 664 and the number of eligible non-residents ranged from 17 002 to 18 891 between rounds. The stratifi ed sample of non-residents included between 2350 and 3366 individuals each year. Sexual risk behaviours were signifi cantly more common in non-residents than in residents for both men and women. Estimated diff erences in sexual risk behaviours, but not HIV prevalence, varied between the migration indicators: recent migration, mobility, and migration type. HIV prevalence was signifi cantly increased in current residents with a recent history of migration compared with other residents in the study area in men (adjusted odds ratio 1.19, 95% CI 1.07-1.33) and in women (1.18, 1.10-1.26). Interpretation: Local information about migrants and highly mobile individuals could help to target intervention strategies that are based on the identifi cation of transmission hotspots. © McGrath et al.


Norris S.A.,University of Witwatersrand | Anuar H.,Institute of Health System Research | Matzen P.,Novo Nordisk AS | Cheah J.C.H.,Sunway University | And 2 more authors.
BMC Public Health | Year: 2014

Background: Malaysia faces burgeoning obesity and diabetes epidemics with a 250% and 88% increase respectively between 1996 and 2006. Identifying the health challenges of young adults in Malaysia, who constitute 27.5 % of the population, is critical for NCD prevention. The aim of the study was two-fold: (1) to achieve consensus amongst stakeholders on the most important challenge impacting the health of young adults, and (2) to engage with stakeholders to formulate a NCD prevention framework. Methods. The Delphi Technique was utilised to achieve group consensus around the most important life and health challenges that young adults face in Malaysia. Subsequently, the results of the consensus component were shared with the stakeholders in an engagement workshop to obtain input on a NCD prevention framework. Results: We found that life stress was a significant concern. It would seem that the apathy towards pursuing or maintaining a healthy lifestyle among young adults may be significantly influenced by the broader distal determinant of life stress. The high cost of living is suggested to be the main push factor for young working adults towards attaining better financial security to improve their livelihood. In turn, this leads to a more stressful lifestyle with less time to focus on healthier lifestyle choices. Conclusions: The findings highlight a pivotal barrier to healthier lifestyles. By assisting young adults to cope with daily living coupled with realistic opportunities to make healthier dietary choices, be more active, and less sedentary could assist in the development of NCD health promotion strategies. © 2014 Norris et al; licensee BioMed Central Ltd.


Burdge G.C.,Academic Unit of Human Development and Health | Lillycrop K.A.,University of Southampton
Current Opinion in Clinical Nutrition and Metabolic Care | Year: 2014

Purpose of review The purpose of this review is to assess the findings of recent studies on the effects of fatty acids on epigenetic process and the role of epigenetics in regulating fatty acid metabolism. Recent findings The DNA methylation status of the Fads2 promoter was increased in the liver of the offspring of mice fed an α-linolenic acid-enriched diet during pregnancy. In rats, increasing total maternal fat intake during pregnancy and lactation induced persistent hypermethylation of the Fads2 promoter in the liver and aortae of their offspring. However, increased fish oil intake in adult rats induced transient, reversible hypermethylation of Fads2. High-fat feeding in rodents also altered the levels of histone methylation in placentae and in adipose tissue. Dietary docosahexaenoic acid supplementation in pregnant women induced marginal changes in global DNA methylation in cord blood leukocytes. A high fat diet altered the DNA methylation status of specific genes in skeletal muscle in young men. Summary There are emerging findings that support the suggestion that fatty acids, in particular polyunsaturated fatty acids, can modify the epigenome. However, there is a need for rigorous investigations that assess directly the effect epigenetic modifications induced by fatty acids on gene function and metabolism. Copyright © Lippincott Williams & Wilkins.


Murray R.,Academic Unit of Human Development and Health | Godfrey K.M.,Academic Unit of Human Development and Health | Godfrey K.M.,University of Southampton | Lillycrop K.A.,University of Southampton
Current Cardiovascular Risk Reports | Year: 2015

Cardiovascular disease continues to impose a high societal and economic burden. Although it occurs primarily in later life, there is strong evidence that it originates in early life. The nutritional environment that an unborn child is exposed to can heavily influence later disease risk, with nutritional exposures altering organ development and programming metabolic changes that are then maintained during the life course. Epigenetic changes induced by the early life environment are thought to be a key mechanism by which these early life events influence subsequent disease risk. Here, we review the emerging role of epigenetics in the development of cardiovascular disease. © 2015, Springer Science+Business Media New York.


Docherty L.E.,Academic Unit of Human Development and Health | Docherty L.E.,Wessex Regional Genetics Laboratory | Rezwan F.I.,Academic Unit of Human Development and Health | Rezwan F.I.,Wessex Regional Genetics Laboratory | And 22 more authors.
Nature Communications | Year: 2015

Human-imprinting disorders are congenital disorders of growth, development and metabolism, associated with disturbance of parent of origin-specific DNA methylation at imprinted loci across the genome. Some imprinting disorders have higher than expected prevalence of monozygotic twinning, of assisted reproductive technology among parents, and of disturbance of multiple imprinted loci, for which few causative trans-acting mutations have been found. Here we report mutations in NLRP5 in five mothers of individuals affected by multilocus imprinting disturbance. Maternal-effect mutations of other human NLRP genes, NLRP7 and NLRP2, cause familial biparental hydatidiform mole and multilocus imprinting disturbance, respectively. Offspring of mothers with NLRP5 mutations have heterogenous clinical and epigenetic features, but cases include a discordant monozygotic twin pair, individuals with idiopathic developmental delay and autism, and families affected by infertility and reproductive wastage. NLRP5 mutations suggest connections between maternal reproductive fitness, early zygotic development and genomic imprinting. © 2015 Macmillan Publishers Limited. All rights reserved.

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