PLERG About Us

Chronic disease management in frail elderly people; chronic disease management overseas.

Current research projects: Pragmatic trial of Calcium and Vitamin D supplementation in Primary Care; Survey of osteoporosis in care homes; Health needs assessment of diabetes in Newcastle care homes.

A systematic review of the research evidence on the relationship between air pollution and perinatal health outcomes.

Childhood disability; environmental factors affecting children with cerebral palsy. Quality of Life and Participation of Disabled Children.

Pre- and post-natal exposure to particulate matter and pregnancy outcomes (PAMPER): an historical cohort study (1961-1992). Perinatal mortality.

The role of obesity and physical inactivity in the development of diabetes and metabolic syndrome. Louise is currently involved in a project called "MENOS" [metabolically normal obesity study] which aims to identify the factors associated with not developing metabolic syndrome in very obese women.

Evaluation of services for children with disabilities and their families; understanding constraints on parent-child interaction where the child has impairments; evaluation of early intervention for children with autism spectrum disorders; neuropsychological underpinnings of repetitive behaviours in children with autism; participation of children with disabilities.

There are thought to be two main factors that lead to the development of cancer, namely genetic predisposition and environmental exposure. In those children that have genetic susceptibility there is an increased chance that certain environmental exposures may lead to onset of cancer. For most types of childhood cancer there are more boys than girls. This observation may indicate that there are differences between boys and girls in susceptibility to certain environmental agents. Alternatively (less likely) it may be due to differences in the pattern of exposure to such agents between boys and girls. The proposed study will derive separate risk estimates for males and females for particular environmental exposures. This will allow us to determine those environmental exposures which affect: (i) males, (ii) females, (iii) both males and females and will allow quantification of the size of the effects. Overall, better understanding of gender differences will enable better treatment and preventative advice.

Title of Investigation: An epidemiological study of bone tumours in children and young adults

Little is known about the possible causes of bone tumours in children and young adults. A recent study of national (UK) data has found that there is geographical variation for osteosarcomas diagnosed in children aged 0-14 years. This lends support to the possibility that certain environmental factors may be involved, particularly those that show geographical variation. Another recent study has found that bone sarcoma patients who were treated in specialist hospitals had better survival rates than patients who were treated in non-specialist hospitals. It is not known whether survival is related to socio-economic factors.

The main aim of the proposed study is to identify focused scientific hypotheses for further investigation. These hypotheses will be related to factors that may contribute to the development of bone tumours and factors that may be important for improved chance of survival after diagnosis of a bone tumour.

There are two parts to this study. The first part proposes carrying out a thorough review of what is currently known about the incidence, survival and causes of bone tumours in young people (aged 0-49 years). The second part proposes a set of analyses of population-based data from the North of England and the West Midlands.

Such analyses of population-based data are a cost-effective way of generating new hypotheses. This approach has been successfully used in studying childhood leukaemia and led to the development of plausible scientific hypotheses. Additionally factors that may affect survival will be studied.

The data analysis study will concentrate on the three regions from the North of England (the Northern Region, Yorkshire, the North West) and also the West Midlands. Data will be obtained from five sources: the Northern Region Young Persons’ Malignant Disease Registry (NRYPMDR), the Yorkshire Specialist Registry of Cancer in Children and Young People (YSRCCYP), the Northern and Yorkshire Cancer Registry and Information Service (NYCRIS), the West Midlands Regional Children’s Tumour Registry (WMRCTR)and the Manchester Children’s Tumour Registry (MCTR). All registries are population-based and are periodically cross-checked with data from regional and national cancer registries to ensure information is as accurate and complete as possible. Data for the Yorkshire and Northern regions will be available for 0-24 year olds from the NRYPMDR (from 1968 onwards) and the YSRCCYP (0-29 year olds from 1990 onwards and 0-14 year olds from 1974 onwards) and for 25-49 year olds from the NYCRIS (from 1975 onwards). Data for North West England and the West Midlands will be available for 0-14 year olds from the MCTR (from 1954 onwards) and the WMRCTR (from 1957 onwards). This novel piece of work aimed at children and uniquely young adults covers the entire age-incidence peaks for bone tumours.

Incidence patterns, trends and survival will all be described. Statistical modelling will be used to investigate the potential effect of socio-economic deprivation. Data on 0-24 year olds from the NRYPMDR will allow both the place of residence at birth and at diagnosis to be analysed. This will allow a distinction to be made between the possible effect of earlier and later exposures to environmental agents. Survival patterns will be analysed to determine whether there are differences in the survival between patients of different ages, gender and social class.

Findings from this study will be presented at scientific meetings and published in peer-reviewed journals. It is anticipated that this study will provide clues for investigation in a much larger study.

Thousand Families from Newcastle Study (study ongoing since 1947); Long-term effects of CT scans on children; Research into a number of paediatric health outcomes, including cancer, congenital malformations and infant mortality. Statistical support for other epidemiological studies.

Dr Pollard is a biological anthropologist based at the University of Durham. She has an interest in early life influences on coronary heart disease risk factors and reproductive function in women. She has worked with Dr Nigel Unwin on a study examining the effects of place of birth on reproductive hormones and features of metabolic syndrome in women of Pakistani origin in the UK and is working on publications from this study.

With Dr Mark Pearce she supervises a PhD student, Mwenza Blell, who is currently working on an MSc thesis looking at determinants of age at menarche in the Thousand Families Study.

Fetal & perinatal epidemiology including descriptive epidemiology of congenital anomaly types influence of lifestyle on the risk of congenital anomalies effect of exposure to air pollution on fetal & perinatal outcomes

North Cumbria Community Genetics Projects. The role of folate metabolism, genes and epigenetics in maternal and child health.

Survey of Langerhans Cell Histiocytosis in the UK and Ireland, in association with the British Paediatric Surveillance Unit (June 2003-06)

Record linkage study of childhood cancer among children born after assisted conception (2006-07)

Cancer risk in children and adolescents following radiation exposure from computed tomography (2006-11)

Helicobacter pylori infection in childhood; factors influencing disease outcome and nutrition.

Epidemiology and Public Health aspects of diabetes and cardiovascular disease. Particular interest in these conditions in low and middle income countries (especially Africa), and in variations in these conditions by ethnic and socioeconomic group in the UK.

The prevalence of Parkinson's Disease. Richard researched into Parkinson's Disease in North Tyneside and North Northumberland which was a population-based study of epidemiology, service-use and anticipated care needs.

Palliative care in Idiopathic Parkinson's Disease; the prevalence of Parkinson's Disease in the Hai District of Northern Tanzania;

Stroke incidence in the Hai District and Dar-es-Salaam, Tanzania; Rheumatic heart disease and Streptococcal infection in Gondar, Ethiopia.

Richard has completed an analysis of sexual and relationship dysfunction in people with Parkinson's Disease and their partners and is currently writing up and submitting papers to several journals.

Social and behavioural epidemiology; The causes of social inequalities in health and the interventions to reduce them; Development and evaluation of public health interventions.