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This prospective cohort study aimed to investigate the associations between gestational weight gain (GWG) and long-term postpartum maternal weight gain, body mass index (BMI), waist circumference (WC), and the risk of general and abdominal obesity, beyond motherhood (some 27 y after childbirth). Participants were 1953 women enrolled in the Mater-University of Queensland Study of Pregnancy cohort study that started in the early 1980 s, with the most recent follow-up at 27 y postpartum. We examined the prospective associations of GWG in pregnancy with weight, BMI, and WC and the risk of adiposity 27 y after the index pregnancy. We used linear and multinomial logistic regressions to examine the independent effect of GWG on each outcome, adjusting for potential confounders and mediators. The average GWG during pregnancy was 14.88 kg (SD 5.24). One in four women (25.50%) gained below the Institute of Medicine (IOM) recommendations and one in three (34.00%) gained excess weight during pregnancy. Every 100 g/week increment of GWG was associated with 2.0 (95% CI: 1.5, 2.6) kg, 0.7 (0.5, 0.9) kg/m2, 1.3 (0.8, 1.8) cm greater body weight, BMI, and WC, respectively 27 y postpartum. Women who gained inadequate weight in pregnancy had significantly lower odds of general obesity (OR; 0.70, 95% CI:0.53,0.94) or abdominal obesity (0.73; 0.56,0.96), whereas those who gained excess gestational weight had much higher odds of general obesity (4.49; 3.36,6.00) and abdominal obesity (3.09; 2.29,4.16). These associations were independent of potential confounders. Maternal GWG in pregnancy independently and strongly predicted beyond motherhood weight gain trajectory. GWG within IOM recommendation may prevent long-term development of both general and central obesity. [ABSTRACT FROM AUTHOR]

Purpose: While excessive weight gain is highest during young adulthood, the extent to which specific dietary patterns are associated with changes in measures of body mass in this course of life remains unknown. We aimed to examine the associations of dietary patterns at 21 years with changes in body weight and body mass index (BMI) between 21 and 30 years. Methods: We used data on young adults from a long-running birth cohort in Australia. Western and prudent dietary patterns were identified applying principal component analysis to 33 food groups obtained by a food frequency questionnaire at 21 years. Body weight and height were measured at 21 and 30 years. Multivariable regression models, using generalized estimating equations, were adjusted for concurrent changes in sociodemographic and lifestyle variables in evaluating the effect of identified dietary patterns on changes in weight and BMI over time. Results: In the fully adjusted model, young adults in the highest tertile of the Western pattern had a mean weight gain of 9.9 (95% CI 8.5, 11.3) kg compared to those in the lowest that had a mean weight gain of 7.1 (95% CI 5.6, 8.5) kg, P-for linear trend = 0.0015. The corresponding values for mean gains in BMI were 3.1 (95% CI 2.7, 3.6) kg/m2 for young adults in the highest tertile compared to 2.4 (95% CI 1.9, 2.9) kg/m2 for those in lowest, P-for linear trend = 0.0164. There was no evidence of a significant association between the prudent pattern and mean changes in each outcome over time in this study. Conclusions: The findings of the current study show that greater adherence to the Western diet at 21 years was positively associated with increases in body weight and BMI from 21 to 30 years of age, whereas the prudent diet had no significant association with these outcomes. The findings provide evidence that the adverse effects of the Western diet on weight gain in young adulthood could partly be prevented through optimising diet in the early course of life. [ABSTRACT FROM AUTHOR]

Background: The long-term mental and physical health consequences of childhood maltreatment have been well documented. Less known are the longer-term consequences of childhood maltreatment, specifically the extent to which childhood maltreatment predicts adult life success. Objectives: To prospectively assess the extent to which childhood experiences of physical, sexual, emotional abuse and childhood neglect predict life success at 30 years of age. Participants and Setting: Data are from the Mater-University of Queensland Study of Pregnancy (MUSP), a pre-birth cohort study which follows children from conception to 30 years of age. Methods: Details of childhood maltreatment are from two sources; child safety agency notifications (and substantiations) linked to the survey data with self-reports of childhood experiences of maltreatment obtained at the 30-year follow-up using the Child Trauma Questionnaire (CTQ). Life success is a 9-item composite measure (alpha = 0.76) obtained at the 30-year follow-up. We use logistic regression models (with control for covariates) to examine the association between overall as well as specific forms of childhood maltreatment on adult life success. We further test these models using different cut-offs and propensity analyses to adjust for loss to follow-up. Results: Childhood maltreatment whether measured by agency report or self-report predicts overall low life success; agency substantiation OR = 1.88(1.14,3.08) & self-report OR = 2.60 (2.10,3.25). Self-report physical abuse, OR = 2.37(1.72,3.28); sexual abuse, OR = 2.85(2.05,3.96); emotional abuse, OR = 2.53(1.85,3.45) and neglect, OR = 2.36(1.83,3.03) all predict higher levels of low life success. Conclusions: Our findings suggest that the long-term consequences of childhood maltreatment extend to a wide range of day-to-day circumstances and extend into mid- to later life. [ABSTRACT FROM AUTHOR]

A large number of early life exposures predict child maltreatment. Using data from a 30-year birth cohort study we examine 12 early life course risk factors of four types of self-reported childhood maltreatment recalled at the 30-year follow-up. Of the 7223 children in the sample at birth, 2425 responded to the Child Trauma Questionnaire at the 30-year follow-up. On adjusted analysis being a teenage mother predicts childhood physical and sexual abuse, as well as child neglect. More numerous maternal marital partner changes in the 5 years after the birth predict offspring experiences of emotional abuse, sexual abuse and childhood neglect. Policy responses should focus on the broad social context in which children are reared as the most effective approach to reducing the high level of childhood abuse and neglect. [ABSTRACT FROM AUTHOR]

Aims: To examine the temporal association between the experience of different types of intimate partner violence (IPV) in early adulthood (21 years) and substance use disorders in young adulthood (30 years). Design Prospective birth cohort study using data from the Mater‐University of Queensland Study of Pregnancy (MUSP). Setting: Brisbane, Australia. Participants: A total of 1353 people (822 females and 531 males). Measurements IPV was measured using the Composite Abuse Scale (CAS) and alcohol, substance and nicotine use disorders were assessed using the Composite International Diagnostic Interview (CIDI). Findings In females, the experience of different forms of IPV at 21 years remained a robust risk factor for subsequent alcohol use disorder [adjusted odds ratios (aORs) ranged from 1.6 to 2.6 (all P < 0.05)], substance use disorder [aORs ranged from 2.1 to 4.0 (all P < 0.001)] and nicotine use disorder [aORs ranged from 2.0 to 2.4 (all P < 0.05)] at 30 years, even after controlling for antecedent substance disorders. However, in males only physical and emotional abuse (but not harassment) were significant in predicting alcohol use disorder [aORs ranged from 1.4 to 1.8 (all P < 0.05)] and drug use disorder [aORs ranged from 1.6 to 2.0 (all P < 0.05)] in the fully adjusted model. Conclusion: Intimate partner violence (IPV) in early adulthood is robustly associated with alcohol, substance and nicotine use disorders in women, whereas in men the association is clear for only some forms of IPV and types of disorder. [ABSTRACT FROM AUTHOR]

Aims: There is little known about the extent to which maternal alcohol consumption influences offspring's alcohol use disorder. This study aims to examine whether different maternal alcohol consumption trajectories predict gender difference in adolescent alcohol use disorder at child age 21 years. Methods: Data are from a prospective cohort, the Mater-University of Queensland Study of Pregnancy (MUSP) and its outcomes. The study involves 2531 mother-child pairs for whom data are available at the 21-year follow-up survey. Maternal alcohol consumption trajectories were determined by group-based trajectory modelling. Offspring's lifetime ever alcohol use disorder was assessed using DSM-IV diagnostic criteria. Results: Over 14 years of follow-up after the birth of a child, three distinct alcohol consumption trajectories were identified (abstainer, low-stable. and moderate-escalating drinker). A maternal trajectory of moderate-escalating alcohol consumption independently predicted offspring's lifetime ever alcohol use disorder at 21 years after adjustment for a range of potential confounders. “Cross-gender influence” is observed in the study. Conclusions: A maternal life course pattern of alcohol consumption may have an independent effect on offspring alcohol consumption, with male offspring being more vulnerable to the effects of maternal alcohol use than are female offspring. Programs intended to address alcohol consumption by adolescents and young adults need to focus on the behaviors of both parents but acknowledging that maternal patterns of alcohol consumption may be particularly important for male offspring. [ABSTRACT FROM AUTHOR]

Background: It has been widely recognized that parental dietary intake is an important and consistent factor influencing children's food intake. However, there are conflicting results with regard to the strength of the parental-child resemblance in dietary intake. Moreover, this association has rarely been investigated in young adult offspring. Objectives: The aims of this study were to describe the dietary intake and food consumption of middle-aged women and their female and male adult offspring (aged 18-23 y) and to examine the association in dietary intake between sex-specific mother-child dyads. Design: We used cross-sectional dietary data for 2017 mother-child pairs from the 21-y follow-up of the Mater-University of Queensland Study of Pregnancy, a birth cohort study. Dietary information was obtained with the use of a 74-item food-frequency questionnaire. We assessed multivariate-adjusted mother-offspring correlations in selected nutrients and food groups and performed correlational analysis while stratifying by living arrangements. Results: Both sons and daughters had a significantly lower percentage of energy from protein than did their mothers. Sons had a significantly higher percentage of energy from fat and a lower percentage of energy from carbohydrates than did their mothers, whereas there was no difference between daughters and mothers. The mother-offspring correlations were weak (r = 0.12-0.29) for most dietary factors and tended to be slightly higher in motherdaughter dyads than in mother-son dyads. Overall, correlations appeared to be stronger in offspring still living with their parents than with their counterparts not living at home, specifically the correlations for consumption of vegetables and rice. Conclusions: Mother-adult offspring dietary resemblance in this Australian cohort was only weak and varied by nutrients, food groups, and the offspring's sex and living arrangements. Factors other than parental dietary habits and home environment seem to have a stronger influence on the diets of young adults. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Relatively little is known about the consequences for women of sustained higher levels of alcohol consumption. We examine three outcomes (marital relationship, reproductive health and well-being) for women with different alcohol consumption trajectories over 21 years.Design and Methods: Data were from a prospective cohort study in Brisbane, Queensland (n = 3337). Group-based trajectory modeling measured women's alcohol consumption trajectories spanning 21 years. Outcomes were measured using a self-report questionnaire at the 27-year follow-up.Results: Four trajectories of women's alcohol consumption were identified: abstaining, low-stable drinkers, moderate-escalating drinkers and heavy-escalating drinkers. Abstaining predicts positive outcomes measured at the 27-year follow-up such as being married, never having a divorce, never having multiple partners, and fewer pregnancy terminations. Moderate and heavy-escalating trajectories predict being unmarried, having multiple partners, having fewer children, having a termination of a previous pregnancy, and reporting lower levels of well-being at the 27-year follow-up.Discussion and Conclusions: The escalating-trajectory group is of particular interest as membership of this group is associated with a wide range of adverse life course outcomes by the 27-year follow-up. The consequences of moderate and heavy-escalating alcohol trajectories in a community sample of women whose pattern of alcohol consumption do not reach clinical criteria of problem drinking have not previously been described. Women with these sustained patterns of alcohol consumption are an appropriate target group for intervention programs. programs. [TranNT, Clavarino A,WilliamsGM,Najman JM. Life course outcomes for women with different alcohol consumption trajectories: A population-based longitudinal study. Drug Alcohol Rev 2016;35:763-771]. [ABSTRACT FROM AUTHOR]

The Patient Assessment of Chronic Illness Care (PACIC) was designed to measure care congruent with several elements of the chronic care model (CCM), including self-management support and delivery system design. However, support for the a priori 5-subscale structure of the PACIC in previous research has been conflicting. Thus, we aim to investigate psychometric characteristics of the PACIC including the content and stability of its construct over time. A population-based prospective cohort study of patients with type 2 diabetes was conducted in Queensland, Australia, from 2008 (N = 3,761) to 2010 (N = 3,040). Participants completed annually the 20-item PACIC as well as measures of providers' adherence to guideline-recommended self-management support activities. We used exploratory factor analysis to determine its factor structure and examined internal consistency as well as agreement between the PACIC at baseline with repeated measurements at follow-up after 1 and 2 years. We also determined a criterion-related validity using multinomial logistic regression to explore PACIC's association with providers' self-management support. A one-factor structure was deemed optimal according to our findings. High internal consistency and moderate agreement within the scales over time were observed. Higher PACIC scores predicted better providers' self-management support. In conclusion, the PACIC is a reliable, valid, and reproducible instrument for assessment of diabetes care, and we recommend its promotion and use as a single scale rather than subscales as originally proposed. [ABSTRACT FROM AUTHOR]

Objective: Compared to the substantial body of research examining links between cannabis use and psychosis, there has been relatively little attention to the role of tobacco as a potential risk factor for psychosis. This study explored the association between age at first tobacco use and psychosis-related outcomes in a birth cohort. Method: This study is based on a large birth cohort (the Mater-University Study of Pregnancy). At approximately 21 years of age, cohort members (N = 3752) were assessed for three psychosis-related outcomes (International Classification of Diseases non-affective psychosis, the presence of any hallucination and total count of delusional-like experiences) with the Composite International Diagnostic Interview and the Peters Delusional Inventory. Associations between age at first tobacco use and psychosis-related outcomes were examined using logistic regression in a model (a) adjusted for sex and age and (b) in a second model excluding all respondents who had a history of past problematic and current cannabis use. Results: When adjusted for age and sex, those who commenced tobacco at 15 years of age or younger were significantly more likely to (a) have non-affective psychosis, (b) be in the highest quartile of total score of the Peters Delusional Inventory and (c) report hallucinations. After excluding all those with a history of a cannabis use disorder, or who were current (last month) cannabis users, a significant association between age at first tobacco use and the presence of hallucinations persisted. Conclusion: There is an association between age at first tobacco use and subsequent psychosis-related outcomes in young adults. While the findings cannot be used to deduce causality, it adds weight to the hypothesis that early tobacco use may contribute to the risk of developing psychosis-related outcomes. [ABSTRACT FROM AUTHOR]

Objective: To examine the association of the Patient Assessment of Chronic Illness Care (PACIC) with health-related quality of life (HRQoL) and the modulating effect of patient activation on this association.Design and Participants: A population-based prospective cohort study of people with Type 2 diabetes in Queensland, Australia, using data from self-report questionnaires, collected annually from 2008 (n = 3761) to 2010 (n = 3040).Main Outcome Measures: Predictors were the 20-item PACIC (dichotomized at the score of 3), and the 13-item Patient Activation Measure (PAM), dichotomized into activation Levels 1 and 2 versus Levels 3 and 4. Analyses were restricted to participants whose PACIC and PAM categories did not change over 2 years of follow-up. Outcome variables were EQ-5D index and EQ VAS dichotomized at the uppermost quartile, and EQ-5D index also dichotomized at the median.Statistical Analyses: An inverse probability weighted Poisson regression with a log-link function and a binary response variable for each outcome was used to obtain risk ratios (RRs), and the interaction between PACIC and PAM was statistically modelled, taking into consideration patient characteristics and the respective baseline outcome variable.Results: The positive association between the PACIC and EQ VAS was seen only in participants with low activation (adjusted RR: 3.91; 95% CI: 1.40-10.95; P = 0.009), and not in those with high activation, indicating the non-synergistic interaction effect of the PACIC and PAM. This association was not found with EQ-5D index.Conclusions: Chronic care received consistently over time can positively affect health status, and benefit patients with low activation. [ABSTRACT FROM AUTHOR]

Background: Previous research using cross‐sectional data has shown a positive relationship between patient activation and quality of care. The quantitative relationships in the same patients over time, however, remain undefined. Objective: To examine the relationship between changes in activation over time and patient‐assessed quality of chronic illness care. Design: Prospective cohort study. Participants: The study used data reported annually from 2008 (N = 3761) to 2010 (N = 3040), using self‐report survey questionnaires, completed by patients with type 2 diabetes in a population‐based cohort in Queensland, Australia. Main Measures: Principal measures were the 13‐item Patient Activation Measure (PAM), and the 20‐item Patient Assessment of Chronic Illness Care (PACIC) instrument. Methods: Nonparametric anova was used to determine the association between patient activation and patient‐assessed quality of care in low and high patient activation groups at baseline (2008), and in 2009 and 2010, when patients had changed group membership. The Wilcoxon signed ranks test was used to compare the PACIC scores between baseline and each follow‐up survey for the same patient activation level. Results: Patient activation was positively associated with the median PACIC score within each survey year and within each of the groups defined at baseline (high‐ and low‐activation groups; P < 0.001). Conclusions: Patient activation and the PACIC change in the same direction and should be considered together in the interpretation of patient care assessment. This can be carried out by interpreting PACIC scores within strata of PAM. [ABSTRACT FROM AUTHOR]

Background We used a novel approach to investigate early neurodevelopmental factors of later adult spectrums of mania, depression and psychosis as a means to identify etiological similarities and differences among the three constructs. Methods Participants were from the Mater University Study of Pregnancy (MUSP), a pre-birth cohort study started in Brisbane, Australia in 1981. A range of neurodevelopmental variables were ascertained at age 5, including measures of cognitive ability, developmental delay and behaviour problems. At age 21, offspring were assessed using a semi-structured psychiatric interview. We used structural equation modelling to establish three latent factors of mania, depression and psychotic symptoms. We then regressed these factors on the neurodevelopmental variables and covariates. Results In both univariate and multivariate analysis premorbid cognitive ability predicted only psychotic symptoms, developmental delay predicted only manic symptoms, while behaviour problems predicted both depressive and psychotic symptoms. In a supplementary analysis the three factors were also found to have unique relationships with a number of outcomes also measured at age 21, including anxiety and substance use. Conclusion By assessing the impact of early childhood neurodevelopment on the continuous spectrums which underlie three serious adult psychiatric disorders in a general population sample, we provide unique evidence regarding potential etiological similarities and differences. Perhaps of most interest is that our findings suggest that the manic and depressive symptoms in bipolar depression, despite often overlapping in clinical presentations, may in fact be somewhat separate entities with origins that are at least partly unique to either disorder. [ABSTRACT FROM AUTHOR]

Background and Aims Co-occurring mental health and alcohol problems appear to be associated with greater health burdens than either single disorder. This study compares familial and individual contributions to development of comorbid alcohol/mental problems and tests whether these differ from single disorders. Design Women ( n = 6703) were recruited during pregnancy to the longitudinal Mater- University of Queensland Study of Pregnancy ( MUSP). Mother/offspring dyads were followed over 21 years. Setting Mater- Misericordiae Public Hospital, Brisbane, Australia. Participants Primary offspring from the MUSP with full psychiatric information at 21 years and maternal information at age 14 ( n = 1755). Measurements Structured interviews at age 21 yielded a four-category outcome using mental health and alcohol modules of the Composite International Diagnostic Interview (no disorder, alcohol only, mental health only and comorbid alcohol/mental health). Multinomial logistic regression models were adjusted for gender, maternal mental health and substance use, family environment and adolescent behaviour. Findings Maternal smoking [odds ratio ( OR) = 1.56; 95% confidence interval ( CI) = 1.09-2.22 versus no-disorder] and low mother-offspring warmth ( OR = 3.19; 95% CI = 1.99-5.13) were associated with mental health/alcohol comorbidity in young adults, as were adolescent drinking ( OR = 2.22; 95% CI = 1.25-3.96), smoking ( OR = 2.24; 95% CI = 1.33-3.77) and attention/thought problems ( OR = 2.04; 95% CI = 1.18-3.52). Some differences were seen from single disorders. In a subsample with paternal data, fathers' drinking problems ( OR = 2.41; 95% CI = 1.10-5.29) were more associated strongly with offspring mental health/alcohol comorbidity than both single disorders ( P < 0.05). Conclusions Maternal smoking and low mother-child warmth appear to be related to alcohol, mental health and comorbid disorders at age 21, possibly via constituent alcohol and mental health disorders. Adolescent drinking and attention/thought problems appear to be associated with comorbid disorders but not with individual alcohol and mental health disorders. [ABSTRACT FROM AUTHOR]

Aims To compare the incidence, timing and risk factors for substance-related death between Indigenous and non-Indigenous ex-prisoners in Queensland, Australia. Design Retrospective cohort study. Setting All adult prisons in the state of Queensland, Australia, linked to deaths registered in Australia. Participants/cases We obtained records for all adults released from prison in Queensland, Australia from 1 January 1994 to 31 December 2007. Among this cohort of 42 015 individuals we observed 82 315 releases from prison and 2158 deaths in the community by the end of 2007, of which 661 were substance-related deaths. Measurements Incarceration data were obtained from Queensland Corrective Services and linked probabilistically with deaths recorded in the Australian National Death Index. Findings In the first year after release, Indigenous ex-prisoners were more likely to die from alcohol-related causes [hazard ratio ( HR) = 1.9, 95% confidence interval ( CI) = 1.1-3.1)] but less likely to die of drug-related causes ( HR = 0.34, 95% CI = 0.21-0.53) than were non-Indigenous ex-prisoners. Among non-Indigenous prisoners only, the risk of substance-related death was significantly higher in the first 4 weeks [relative risk ( RR) = 5.1, 95% CI = 3.7-6.9] when compared with the risk after 1 year post-release. Most evaluated risk factors for substance-related death were similar for Indigenous and non-Indigenous ex-prisoners; however, the hazard of death increased with age more for Indigenous ex-prisoners ( HR = 1.7 per decade of age, 95% CI = 1.4-2.1) than for non-Indigenous ex-prisoners ( HR = 1.3, 95% CI = 1.2-1.4). Conclusions In Australia, patterns of substance-related death in ex-prisoners differ markedly according to Indigenous status. Efforts to prevent substance-related deaths in ex-prisoners should consider heterogeneity in the target population and tailor responses accordingly. [ABSTRACT FROM AUTHOR]

BACKGROUND: Alcohol and mental health disorders are highly prevalent in the general population, with co-occurrence recognised as a major public health issue. Socio-economic factors are frequently associated with both disorders but their temporal association is unclear. This paper examines the association between prenatal socio-economic disadvantage and comorbid alcohol and mental health disorders at young adulthood. METHODS: An unselected cohort of women was enrolled during early pregnancy in the large longitudinal Mater-University of Queensland Study of Pregnancy (MUSP), at the Mater Misericordiae Public Hospital in Brisbane, Australia. The mothers and their offspring were followed over a 21 year period. Offspring from the MUSP birth cohort who provided full psychiatric information at age 21 and whose mothers provided socioeconomic information at baseline were included (n=2399). Participants were grouped into no-disorder, mental health disorder only, alcohol disorder only or comorbid alcohol and mental health disorders according to DSM-IV diagnoses at age 21 as assessed by the Composite International Diagnostic Interview. We used multivariate logistic regression analysis to compare associations of disorder group with single measures of prenatal socio-economic disadvantage including family income, parental education and employment, and then created a cumulative scale of socioeconomic disadvantage. RESULTS: Greater socio-economic disadvantage was more strongly associated with comorbidity (OR 3.36; CI95 1.37, 8.24) than with single disorders. This relationship was not fully accounted for by maternal mental health, smoking and drinking during pregnancy. CONCLUSION: Multiple domains of socio-economic disadvantage in early life are associated with comorbid alcohol and mental health disorders. [ABSTRACT FROM AUTHOR]

We have investigated the prospective association between excess gestational weight gain (GWG) and development of diabetes by 21 years post-partum using a community-based large prospective cohort study in Brisbane, Australia. There were 3386 mothers for whom complete data were available on GWG, pre-pregnancy BMI and self-reported diabetes 21 years post-partum. We used The Institute of Medicine (IOM) definition to categorize GWG as inadequate, adequate and excessive. We found 839 (25.78%) mothers gained inadequate weight, 1,353 (39.96%) had adequate weight gain and 1,194 (35.26%) had gained excessive weight during pregnancy. At 21 years post-partum, 8.40% of mothers self-reported a diagnosis of diabetes made by their doctor. In the age adjusted model, we found mothers who gained excess weight during pregnancy were 1.47(1.11,1.94) times more likely to experience diabetes at 21 years post-partum compared to the mothers who gained adequate weight. This association was not explained by the potential confounders including maternal age, parity, education, race, smoking, TV watching and exercise. However, this association was mediated by the current BMI. There was no association for the women who had normal BMI before pregnancy and gained excess weight during pregnancy. The findings of this study suggest that women who gain excess weight during pregnancy are at greater risk of being diagnosed with diabetes in later life. This relationship is likely mediated through the pathway of post-partum weight-retention and obesity. This study adds evidence to the argument that excessive GWG during pregnancy for overweight mothers has long term maternal health implications. [ABSTRACT FROM AUTHOR]

With marital breakdown and discord relatively common, we examined whether family structure and the quality of marital relationship have a long-term impact on offspring’s psychopathology in early adulthood. This study aimed to examine the association of family structure and marital discord in the family with a wide range of offspring’s mental health and problem behaviours at 21 years. Data were from the Mater-University of Queensland Study of Pregnancy, a population based birth cohort study, which commenced in Brisbane, Australia in 1981. Mothers and children were followed up at birth, 6 months and 5, 14 and 21 years after the initial interview. Marital status and marital quality were assessed at the 14 year follow-up. Young Adult Self-Report sub-scales of mental health and problem behaviours were measured at the 21-year follow-up. Type of family structure and the quality of marital relationship (at the 14-year follow-up) predicted offspring’s psychopathology at 21 years. When a selected group of confounding factors were included in the multivariate analyses, children who lived with a step-father, un-partnered mother, or in families where parents had conflict in marital relationship reported higher symptoms of psychopathology at 21 years. The association between marital problems and young adult psychopathology does not appear to be confounded by a wide range of confounding variables. Further research is needed to explore the mechanism of these associations to develop preventive programmes. [ABSTRACT FROM AUTHOR]

Introduction and Aims Early age of cannabis use predicts subsequent illicit drug abuse and other psychosocial problems. Identification of factors associated with early cannabis use may contribute to the development of preventive interventions. This study aimed to examine the early life predictors of age of initiation to cannabis. Design and Methods Data were from Mater Hospital and University of Queensland Study of Pregnancy, a population-based prospective birth cohort study. Participants were a cohort of 3488 young adults who self-reported frequency and age of onset of cannabis use at the 21 year follow up. Results Of 3488 young adults, 48.9% (51.8% men and 46.4% women) reported having ever used cannabis. For those who had ever used cannabis, age of onset had mean and median of 15.8 and 16.0 years, respectively. In multivariate analysis child's gender, change in maternal marital status, quality of marital relationship, maternal cigarette smoking and alcohol consumption and maternal depression when the child was 5 years statistically significantly predicted age of initiation to cannabis use. Discussion and Conclusions The present study explores the impact of early childhood factors associated with age of onset of cannabis use. It is suggested that the family environment within which children are reared, including factors such as parents' marital circumstances, has a major influence on initiation to cannabis use in adolescence. Research is needed to disentangle the pathways of association between these early life factors and early initiation to use of cannabis. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims To examine whether child and adolescent psychopathology predicts subsequent tobacco use at 14 and 21 years of age. Design Prospective birth cohort study. Setting Data are taken from the Mater Misericordiae Hospital and University of Queensland Study of Pregnancy and its outcomes (MUSP), a prospective longitudinal study which recruited women at their first antenatal visit in Brisbane, Australia. Participants A 5-, 14- and 21-year follow-up of children whose mother's were recruited into the MUSP birth cohort study at their first antenatal visit. Measurements Psychopathology exposure was measured using the Achenbach's Child Behaviour Checklist (CBCL) at 5 years, the Youth Self Report (YSR) at 14 years and the Young Adult Self Report (YASR) at 21 years. Outcome measures were the children's tobacco smoking status at the 14 and 21 years' follow-up and the Composite International Diagnostic Interview (CIDI) based DSM-IV nicotine dependence at 21 years' follow-up. Findings Externalizing symptoms had the strongest association with subsequent tobacco use. Children who met the criteria for CBCL aggression at 5 years were more likely to be tobacco smokers at the 14-year follow-up. YSR externalizing behaviours at the 14-year follow-up predicted tobacco smoking, but not DSM-IV nicotine dependence at the 21-year follow-up. Internalizing behaviour (anxiety/depression) was associated with a reduced rate of smoking at the 14- and 21-year follow-ups, but externalizing behaviour and attention problems at 14 and 21 years were associated separately and cumulatively with nicotine dependence at the 21-year follow-up. Conclusion Childhood and adolescent psychopathology predict tobacco smoking, but some forms of psychopathology predict increased (aggression/delinquency; attention problems) and other forms decreased (anxiety/depression) smoking. There may be some benefits in targeting children with early onset aggressive/delinquent behaviour problems with tobacco smoking prevention initiatives. [ABSTRACT FROM AUTHOR]

Evidence from longitudinal studies on the association between diet quality and change in anthropometric measures is scarce. We therefore investigated the relationship between a recently developed food-based dietary index and change in measured BMI and waist circumference (WC) in Australian adults (1992–2007). We used data from the Australian population-based Nambour Skin Cancer Study comprising 1231 adults aged 25–75 years at baseline (1992). We applied generalised estimating equations (GEE) to examine the association between diet quality and change in anthropometric measures. Dietary intake was assessed by an FFQ in 1992, 1996 and 2007. Diet quality was estimated using the dietary guideline index (DGI), developed to reflect the dietary guidelines for Australian adults; a higher score indicating increased compliance. Multivariable models, stratified by sex, were adjusted for sociodemographic and lifestyle characteristics. We show that men with higher diet quality had a lower gain in BMI as compared to those with low diet quality during the 15-year follow-up. In a multivariable adjusted model, as compared to men in quartile 1 (reference), those in the highest quartile had the lowest gain in BMI (mean (95 % CI): 0·05 (0·00, 0·09) v. 0·11 (0·06, 0·16) kg/m2 per year, P =0·01). Diet quality was inversely, but non-significantly associated with change in WC. In women, DGI score was unrelated to change in any body measure. Energy underreporting did not explain the lack of association. We conclude that adherence to a high-quality diet according to Australian dietary guidelines leads to lower gain in BMI and WC in middle-aged men, but not in women. [ABSTRACT FROM PUBLISHER]

Background: Schistosoma japonicum is a major public health concern in the Peoples' Republic of China (PRC), with about 800,000 people infected and another 50 million living in areas at risk of infection. Based on ecological, environmental, population genetic and molecular factors, schistosomiasis transmission in PRC can be categorised into four discrete ecosystems or transmission modes. It is predicted that, long-term, the Three Gorges Dam (TGD) will impact upon the transmission of schistosomiasis in the PRC, with varying degree across the four transmission modes. Methodology/Principal Findings: We undertook longitudinal surveillance from 2002 to 2006 in sentinel villages of the three transmission modes below the TGD across four provinces (Hunan, Jiangxi, Hubei and Anhui) to determine whether there was any immediate impact of the TGD on schistosomiasis transmission. Eight sentinel villages were selected to represent both province and transmission mode. The primary end point measured was human incidence. Here we present the results of this five-year longitudinal cohort study. Results showed that the incidence of human S. japonicum infection declined considerably within individual villages and overall mode over the course of the study. This is also reflected in the yearly odds ratios (adjusted) for infection risk that showed significant (P,0.01) downward trends in all modes over the follow-up period. Conclusions/Significance: The decrease in human S. japonicum incidence observed across all transmission modes in this study can probably be attributed to the annual human and bovine PZQ chemotherapy. If an increase in schistosome transmission had occurred as a result of the TGD, it would be of negligible size compared to the treatment induced decline seen here. It appears therefore that there has been virtually no immediate impact of the TGD on schistosomiasis transmission downstream of the dam. [ABSTRACT FROM AUTHOR]

Background: Women with a history of hypertensive disorders of pregnancy (HDP) are known to be at increased risk of subsequent hypertension and cardiovascular disease. Aims: In this study, we aimed to assess whether the long-term follow-up, diagnosis and treatment of hypertension in these women is adequate. Methods: Prospective study of 2112 women who were part of a Birth Cohort Study - The Mater University of Queensland Study of Pregnancy, who received antenatal care at a major public hospital in Brisbane between 1981 and 1983 and were followed up at 21 years. Results: Of the 191 women who had HDP, 62 (32.46%) were hypertensive (29 adequately treated, 33 inadequately identified or managed). Of the 1921 women without HDP, 280 (14.58%) were hypertensive (113 adequately treated, 167 inadequately identified or managed). Women with HDP were at higher risk of hypertension (OR 4.09, 95% CI 2.76, 6.07). Women with a history of HDP were more likely to have hypertension that was inadequately identified or managed (OR 3.56, 95% CI 2.06, 5.97). Conclusion: Women with HDP are at increased risk of undiagnosed or undertreated hypertension. Attention needs to be given to appropriate follow-up of women who have a pregnancy complicated by hypertensive disorders. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to examine whether maternal factors such as socioeconomic status (SES), attitudes towards the baby, and mental health at 6 months or earlier, are associated with non-penetrative and penetrative childhood sexual abuse (CSA) in her offspring. Methods: This was a prospective birth cohort study followed up to 21 years. Set in one of two obstetric hospitals in Brisbane, Australia, the Mater-University of Queensland Study of Pregnancy (MUSP) involves a prospective birth cohort from a population based sample of 7223 singletons whose mothers were enrolled between 1981 and 1984 at the first antenatal visit. The present cohort consisted of 2664 participants who provided CSA data, and whose mothers had responded to all relevant questions. Results: About 16% of young adults reported non-penetrative sexual abuse before the age of sixteen and 9% reported penetrative abuse. After adjusting for all variables in the model, an increased risk for non-penetrative CSA was associated with the child being female, unwanted pregnancy, mother being a heavy smoker, and maternal anxiety. Increased risk for penetrative CSA was associated with the child being female, the mother having failed to complete a high school level education, living in an alternative arrangement other than marriage, and being either a moderate or heavy smoker. We found no associations between maternal age and CSA after correcting for other predictors. Conclusion: CSA was not uncommon in this cohort with one in four reporting some form of sexual abuse before 16. The results suggest that several early factors may predict later CSA and that the associations are different according to type of CSA. [ABSTRACT FROM AUTHOR]

To determine if short stature at 14 or 21 years and patterns of 'catch-up' growth from 5 to 14 or 21 years are related to academic achievement in adolescents. The Mater University of Queensland Study of Pregnancy is a longitudinal study of 7223 singleton infants born between 1981 and 1984. Data were available for cross-sectional analyses of 3785 adolescents of whom 2149 were seen as young adults. Longitudinal patterns of growth were examined for 2936 subjects from 5 to 14 years and 1753 subjects from 5 to 21 years. Adolescents or young adults with height <10th centile had a lower mean Wide Range Achievement Test (WRAT) score in adolescence and at 21 years than those of normal height (2.7 and 3.0 points, respectively) and increased odds of a WRAT score <85 (1.57 and 1.87, respectively) and learning difficulties (1.61 and 1.78, respectively). For growth patterns from 5 to 14 years, adolescents short at 5 years, irrespective of height at 14 years, had a lower mean WRAT score and increased odds of WRAT score <85 and learning difficulties. However, for growth patterns from 5 to 21 years, only the group short at both ages had increased learning difficulties. Youth short at 14 years or at 21 years and those persistently short have an increased prevalence of academic difficulties. Catch-up growth by 21, although not 14 years, was associated with improved outcomes. [ABSTRACT FROM AUTHOR]

Aims: This study aims to investigate the bidirectional association between symptoms of depression and quality of marital relationship in a population-based cohort of women. Methods: The bidirectional association was examined longitudinally in over 3694 women participating in the Mater-University study of Pregnancy, Brisbane, Australia, over a 14-year period. Women were interviewed 3–5 days postdelivery and again when the child was 6 months, 5 years, and 14 years of age. A transition model was developed to examine changes in exposures and risk factors over the 14 years of follow-up. Results: Nearly 40% of the women with depressive symptoms continued to report symptoms, and a similar proportion of women who reported being in a poor quality marital relationship remained in a poor quality relationship over long periods of time. Approximately 1 in 10 women who had not reported symptoms of depression or a poor relationship in the previous phase did so at the subsequent phase. The bidirectional relationships between depressive symptoms and quality of marital relationship are both consistent and strong. Negative changes in either symptoms of depression or quality of marital relationship predicted a poor outcome. The estimated population attributable risk was similar for both depressive symptoms and quality of the marital relationship. Conclusions: The findings from this study suggest that symptoms of depression and quality of relationship are strongly associated with each other and that this association is bidirectional. Clinical intervention in poor quality marital relationships represents a logical approach to addressing symptoms of depression in women. Similarly, there needs to be a focus on family outcomes for those women with impaired mental health. [ABSTRACT FROM AUTHOR]

Background: Children of prisoners are at increased risk of impaired health, behavioural problems and substance misuse; however, the causal pathways to these problems are unclear. Under some circumstances, parental imprisonment may result in improved outcomes for the child. This study investigates the impact of paternal arrest and imprisonment on child behaviour and substance use, as a function of child gender, and in the context of known social and familial risk factors. Methods: Longitudinal analysis of an Australian birth cohort ( N = 2,399) recruited 1981–83, with child outcomes measured at age 14. Participants were recruited prenatally from a large, public hospital in Brisbane, Australia and followed up in the community. History of paternal arrest and imprisonment were based on maternal self-report, at age 14. Outcome measures included mother- and child-reported internalising and externalising behaviour (CBCL and YSR), and child self-reported alcohol and tobacco use. Results: In univariate analyses, paternal imprisonment was associated with maternal reports of increased child internalising (OR = 1.82, 95%CI 1.08–3.06) and externalising (OR = 2.24, 95%CI 1.41–3.57), and alcohol use (OR = 1.68, 95%CI 1.11–2.53) at age 14. However, controlling for socio-economic status, maternal mental health and substance use, parenting style and family adjustment, these associations became non-significant. For boys only, in the multivariate model paternal arrest but not imprisonment predicted alcohol (OR = 1.79, 95%CI 1.09–2.95) and tobacco (OR = 1.83, 95%CI 1.03–3.25) use at age 14. Conclusions: The association between paternal arrest and imprisonment and adverse outcomes in adolescence is accounted for by well-established social and familial risk factors. Paternal imprisonment may not, in itself, increase the risk for child behaviour and substance use problems. [ABSTRACT FROM AUTHOR]

An essay is presented on the aggressive and delinquent behavior of children in Australia. It offers evidence that shows source of concern and cost to the communities and identification of the pathways to the crime which guides on the prevention programs. The essay is based on a longitudinal study of Queensland children that reports age predictor of aggression and notes that among the most productive crime prevention strategy is to have effective intervention programs.

Background: Previous studies have examined the distribution of psychotic like experiences (PLE) with the aim of informing the debate concerning the categorical versus continuous nature of psychosis. We extend this research by subjecting a number of competing models of delusional ideation to validation analysis to further examine previous findings.Methods: We constructed latent variable models representing the factor structure of delusional ideation reported previously, using self-reported delusional ideation (Peter's Delusional Inventory; PDI) at age 21 in a general population prospective birth cohort study. After firstly eliminating models which exhibited poor fit we performed a longitudinal validation analyses among the competing models to investigate whether increasing levels of ideation were associated with developmental antecedents, correlates and distal indicators of psychotic disorder.Results: Four latent variable models were found to adequately represent the delusional ideation data, two comprised exclusively of continua (a multidimensional 5 factor model and a bifactor model with 1 general and 4 specific factors), and two which included both categories and continua (two factor mixture models, each with 3 classes and 1 factor per class, but with varying levels of parameter restrictions). Exclusively categorical latent models obtained poor fit and the categorical components of hybrid models failed to discriminate on psychotic illness, while among the models incorporating continuous latent factors validation analyses did not clearly identify any model as better than the others.Conclusion: We provide novel evidence of the importance of continua in adequately and validly representing delusional ideation in the general population. Beyond this, our data suggests it is not possible to further refine the structure of delusional ideation in the general population. [ABSTRACT FROM AUTHOR]

Background: The potential influence of measured body weight and height on keratinocyte skin cancer risk has scarcely been studied. Some evidence indicates melanoma risk increases as self-reported height increases, but an association with body mass index (BMI) is less certain.Methods: We measured body weight and height of 1171 Australian men and women in a community-based skin cancer study in Queensland and prospectively examined the association of BMI, body surface area (BSA) and height and incidence of basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma while accounting for skin phenotype, sun exposure, clinical/cutaneous signs of chronic photodamage and other risk factors.Results: During 16 years of follow-up, 334 and 188 participants newly developed BCC and SCC, respectively; 28 participants were diagnosed with primary melanoma. BMI and BSA were unrelated to skin cancer incidence. After full adjustment, height was significantly associated with SCC development in men (relative risk (RR)=1.66; 95% confidence interval (CI)=1.11-2.48, for ≥175cm vs ≤171cm, Ptrend=0.017), and BCC in women (Ptrend=0.043). Melanoma in men, was similarly positively associated with height (RR per 5cm increment=1.55; 95%CI 0.97-2.47, P=0.067) though not significantly.Conclusion: This study shows that after adjusting for sun exposure tall stature may be a risk factor for the most common types of skin cancer BCC, SCC, and melanoma, while body mass and surface area appear unrelated to risk. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Early onset of smoking is associated with subsequent abuse of other substances and development of negative health outcomes. This study aimed to examine early life predictors of onset of smoking in an Australian young cohort. Methods: Data were from the Mater Hospital and University of Queensland Study of Pregnancy (MUSP), a population-based prospective birth cohort study (1981–2012). The present study is based on a cohort of 3714 young adults who self-reported smoking status and age of onset of smoking at the 21-year follow-up. Of these, data were available for 3039 on early childhood factors collected between the baseline and 14-year follow-up of the study. Results: Of 3714 young adults, 49.6% (49.9% males and 49.3% females) reported having ever smoked cigarettes. For those who had ever smoked, mean and median ages at first smoke were 15.5 and 16.0years, respectively. In multivariate Cox proportional hazard analysis mother's education, change in maternal marital status, maternal cigarette smoking and alcohol consumption, maternal depression and child externalizing when the child was 5years statistically significantly predicted early onset of smoking. Conclusions: The data suggest that individuals exposed to personal and environmental risk factors during the early stage of childhood are at increased risk of initiation to cigarette smoking at an earlier age. Identification of the pathways of association between these early life factors and initiation to cigarette smoking may help reduce risk of tobacco smoking in adolescents and its adverse consequences. [Copyright &y& Elsevier]

Objectives: Longitudinal studies are a major tool for public health research, but their value can be undermined by attrition. Identification of factors associated with attrition through modeling depends on the efficient use of data and is conditional on modeling assumptions being met. The primary aim of this study was to compare the performance of four models in analyzing attrition risk. Study Design and Setting: Data from participants who were lost to follow-up from The Nambour Skin Cancer Study between 1992 and 2000 were analyzed using logistic and survival models, for all-cause and nondeath attritions. Results: During follow-up, 321 (19.8%) of 1,621 participants were lost to follow-up; 70 (4.3%) because of death and 251 (15.5%) for other reasons. Using survival models showed skin cancer diagnosis to be associated with increased all-cause attrition (hazard ratio: 2.3; 95% confi- dence interval [95% CI]: 1.5, 3.4) and nondeath attrition (subhazard ratio: 1.9; 95% CI: 1.0, 3.3). Using logistic regression resulted in inverse associations being observed for both all-cause attrition (odds ratio [OR]: 0.7; 95%CI: 0.5, 1.1) and nondeath attrition (OR: 0.5; 95%CI: 0.3, 1.0). Conclusion: These results demonstrate the relative inadequacy of a logistic as opposed to a survival approach when analyzing attrition risk in the presence of time-varying covariates and multiple timepoints [ABSTRACT FROM AUTHOR]

Abstract: Objectives: One of the possible consequences of tobacco consumption is that it contributes to an earlier age of menopause, though the causal relationship is yet to be confirmed. This study aimed to examine the prospective association between smoking and earlier age of menopause in a cohort of middle age Australian women after adjustment for a number of potential confounders. Study design: 21-Year follow-up of a cohort prospective study, Brisbane, Australia. Main outcome measures: Age of menopause measured at the 21-year follow-up. Smoking and menopausal status were assessed by self-report. Other covariates were measured prospectively in the previous follow-ups. Results: This study is based on 3545 women who provided data on their menopausal status at the 21-year follow-up of the study, and prospective as well as concurrent data on smoking. In univariate analysis tobacco smoking during the reproductive life course, socio-economic status and gravidity were significantly associated with earlier age of menopause. In multivariate analyses women who smoked cigarettes were more likely to experience earlier menopause than non-smokers. Compared to current smokers, risk of early menopause was significantly lower in those women who quit smoking in the past. Conclusions: The data suggest that the impact of smoking is independent of other covariates associated with both smoking and age of menopause. The findings raise the possibility that effective quit smoking interventions may lead to a later age of menopause, and reduce the risk of adverse health consequences of early menopause. [Copyright &y& Elsevier]

Abstract: Background: The Achenbach child behaviour checklist (CBCL/YSR) is a widely used screening tool for affective problems. Several studies report good association between the checklists and psychiatric diagnoses; although with varying degrees of agreement. Most are cross-sectional studies involving adolescents referred to mental health services. This paper aims to evaluate the performance of the youth self report (YSR) empirical and DSM-oriented internalising scales in predicting later depressive disorders in young adults. Methods: Sample was 2431 young adults from an Australian birth cohort study. The strength of association between the empirical and DSM-oriented scales assessed at 14 and 21 years and structured-interview derived depression in young adulthood (18 to 22 years) were tested using odds ratios, ROC analyses and related diagnostic efficiency tests (sensitivity, specificity, positive and negative predictive values). Results: Adolescents with internalising symptoms were twice (OR 2.3, 95%CI 1.7 to 3.1) as likely to be diagnosed with DSM-IV depression by age 21. Use of DSM-oriented depressive scales did not improve the concordance between the internalising behaviour and DSM-IV diagnosed depression at age 14 (ORs ranged from 1.9 to 2.5). Limitations: Some loss to follow-up over the 7-year gap between the two waves of follow-up. Conclusion: DSM-oriented scales perform no better than the standard internalising or anxious/depressed scales in identifying young adults with later DSM-IV depressive disorder. [Copyright &y& Elsevier]

Background: While recent decades have witnessed an increase in the use of illicit drugs in Australia, the extent to which the types of drugs used has changed over a generation of young women has not been documented.Methods: Data are from a prospective birth cohort study. Mothers were recruited in early pregnancy (1981-83) and then they and their child were followed up, with mothers interviewed 27 years (2008-2011), and daughters 30 years (2010-14), after the birth. At these most recent interviews both mothers and daughters were administered the Composite International Diagnostic Interview (CIDI III). Comparisons are for mothers and daughters separated by a 25 year period. For this study, we compare levels of lifetime use of a range of illicit drugs and drug use disorders reported by mothers and their daughters (N = 998 mother/daughter pairs) with adjustment for family income, marital status, education and occupation.Results: There has been a generational increase in the use of illicit substances and prevalence of substance use disorders experienced by Australian women. Mothers' use of illicit drugs was generally restricted to cannabis. By contrast the majority of daughters report lifetime use of an illicit drug with cannabis, club drugs and stimulants the most common. Compared to the mothers, daughters used club drugs 50 times, cocaine 19 times and inhalants 20 times more often. Daughters report experiencing 12 times the rate of cocaine use disorders, 9 times the rate of stimulant disorders and 7 times the rate of cannabis use disorders compared to their mothers.Conclusions: Mothers of the current generation of 30 year old Australian women rarely used illicit drugs and few experienced a drug use disorder. The current generation of young women report commonly using one or more illicit drugs with a substantial minority experiencing a drug use disorder. It is unlikely that the use of illicit drugs by young women in Australia will be reversed in the foreseeable future. Government policies and treatment practices need to be calibrated to the reality of the much greater contact with illicit drugs being exhibited by younger women. [ABSTRACT FROM AUTHOR]

Background: Diagnosis and duration of type 2 diabetes mellitus (DM) appear to be associated with decreased prostate cancer risk. Limitations of previous studies include methods of subject selection and accurate definition of DM diagnosis. We examined the temporal relationship between DM and prostate cancer risk exploring the period of greatest risk starting from the prediabetic to the post- diabetic period using clinical and administrative data to accurately define the date of DM diagnosis. Methods: We identified 5,813 men who developed DM between January 1, 1995 and December 31, 2009 (reference date, date of DM onset or matched date for non-diabetic cohort) and 28,019 non- diabetic men matched by age, smoking history, residence, and reference date. Prostate cancer incidence before and after the reference date was assessed using Cox regression modeling adjusted for matching variables, body mass index, insurance status, and comorbidities. Primary outcomes included hazard ratio (HR) and number needed to be exposed to DM for one additional person to be harmed (NNEH) or benefit (NNEB) with respect to prostate cancer risk. Results: After full adjustment, the HR for prostate cancer before DM diagnosis was 0.96 (95% CI 0.85-1.08; P=0.4752), and the NNEB was 974 at DM diagnosis. After the reference date, the fully- adjusted HR for prostate cancer in diabetic men was 0.84 (95% CI 0.72-0.97, P=O.OI67), and the NNEB 3 years after DM onset was 425. The NNEB continued to decrease over time, reaching 63 at 15 years after DM onset, suggesting an increasing protective effect of DM on prostate cancer risk over time. No significant difference between the diabetic and non-diabetic cohort was found prior to reference date. Conclusion: Prostate cancer risk is not reduced in pre-diabetic men but decreases after DM diagnosis and the protective effect of DM onset on prostate cancer risk increases with DM duration. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine the association between child maltreatment (abuse and neglect) and long-term cognitive outcomes within a prospective birth cohort. METHODS: A birth cohort of 7223 children was recruited. Independent reports of suspected child maltreatment were confidentially linked to the longitudinal study database. The principal predictor variable was notification to the state child-protection authority for suspected maltreatment (abuse, neglect, or both). The outcome variables were scores on the Wide Range Achievement Test (WRAT) reading test and Raven's Standard Progressive Matrices (RSPM), completed at 14 years of age. Multivariate regression analysis was used to adjust for potential confounders. RESULTS: A total of 3796 subjects completed either the WRAT or RSPM. There was a higher loss to follow-up among children who had been reported to the state as suspected victims of maltreatment. After controlling for a range of possible confounders and modifiers, notification to the state for child maltreatment (abuse, neglect, or both) was associated with a lower score on both the WRAT (mean difference: -4.4 when the SD is 15 [95% confidence interval: -6.3 to -2.51) and RSPM (mean difference: -4.8 when the SD is 15 [95% confidence interval: -6.7 to -2.91). Both reported abuse and neglect were independently associated with lower reading ability and perceptual reasoning. CONCLUSIONS: Both child abuse and child neglect are independently associated with impaired cognition and academic functioning in adolescence. These findings suggest that both abuse and neglect have independent and important adverse effects on a child's cognitive development. [ABSTRACT FROM AUTHOR]