K Tilling
Biographic Data
| ID | 1740664 |
|---|---|
| NAME | K Tilling |
| GIVEN NAMES | K |
| FAMILY NAME | Tilling |
| SIGNATURE | TILLING K |
| AFFILIATIONS | University of Bristol |
| ORCID | 0000-0002-1010-8926 |
| VERIFIED | Yes |
| TOTAL WORKS | 51 |
| TOTAL CITATIONS | 34 |
| WORKS AS AUTHOR | 51 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 1998 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 4 |
The socioeconomic trajectories followed during early adulthood contribute to inequalities in cardiometabolic health by age 24 years
The newly identified 'Part-time Employment' trajectory showed the least healthy cardiometabolic profile. Further research should focus on this group to understand the exposures contributing to poor cardiometabolic health in this sector of the population
Regression discontinuity design for the study of health effects of exposures acting early in life
Regression discontinuity design (RDD) is a quasi-experimental approach to study the causal effect of an exposure on later outcomes by exploiting the discontinuity in the exposure probability at an assignment variable cut-off. With the intent of facilitating the use of RDD in the Developmental Origins of Health and Disease (DOHaD) research, we describe the main aspects of the study design and review the studies, assignment variables and exposures …
Counterfactual Mediation Analysis with a Latent Class Exposure
Latent classes are a useful tool in developmental research, however there are challenges associated with embedding them within a counterfactual mediation model. We develop and test a new method "updated pseudo class draws (uPCD)" to examine the association between a latent class exposure and distal outcome that could easily be extended to allow the use of any counterfactual mediation method. UPCD extends an existing group of methods (based on pse…
Natural experiments for the evaluation of place-based public health interventions
Introduction Place-based public health evaluations are increasingly making use of natural experiments. This scoping review aimed to provide an overview of the design and use of natural experiment evaluations (NEEs), and an assessment of the plausibility of the as-if randomization assumption. Methods A systematic search of three bibliographic databases (Pubmed, Web of Science and Ovid-Medline) was conducted in January 2020 to capture publications …
Co‐development of attention deficit hyperactivity disorder and autistic trait trajectories from childhood to early adulthood
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) and autism, defined as traits or disorders, commonly co-occur. Developmental trajectories of ADHD and autistic traits both show heterogeneity in onset and course, but little is known about how symptom trajectories co-develop into adulthood. METHODS: Using data from a population cohort, the Avon Longitudinal Study of Parents and Children, we examined correlations between ADHD and autistic…
Relative age in the school year and risk of mental health problems in childhood, adolescence and young adulthood
PURPOSE: Relative age within the school year ('relative age') is associated with increased rates of symptoms and diagnoses of mental health disorders, including ADHD. We aimed to investigate how relative age influences mental health and behaviour before, during and after school (age range: 4-25 years). METHOD: We used a regression discontinuity design to examine the effect of relative age on risk of mental health problems using data from a large …
Time-sensitive testing pressures and Covid-19 outcomes
The association between SEP and SARS-CoV-2 testing changed over time, highlighting the potential of time-specific selection pressures to bias analyses of COVID-19. Positive and negative control analyses suggest that changes in the association between SEP and SARS-CoV-2 infection over time likely reflect true increases in socioeconomic inequalities
Mental health before and during the Covid-19 pandemic in two longitudinal UK population cohorts
Background The COVID-19 pandemic and mitigation measures are likely to have a marked effect on mental health. It is important to use longitudinal data to improve inferences. Aims To quantify the prevalence of depression, anxiety and mental well-being before and during the COVID-19 pandemic. Also, to identify groups at risk of depression and/or anxiety during the pandemic. Method Data were from the Avon Longitudinal Study of Parents and Children (…
Investigating attention‐deficit hyperactivity disorder and autism spectrum disorder traits in the general population
BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are generally considered early-onset disorders so most research has therefore tended to focus on children. Differences between ADHD/ASD in adult life and childhood have been noted, but few population-based studies have examined them in adulthood. Furthermore, the interpretation of findings is hampered by changes in measure and from parent report to self…
Polygenic risk for depression, anxiety and neuroticism are associated with the severity and rate of change in depressive symptoms across adolescence
BACKGROUND: Adolescence marks a period where depression will commonly onset. Twin studies show that genetic influences play a role in how depression develops and changes across adolescence. Recent genome-wide association studies highlight that common genetic variants - which can be combined into polygenic risk scores (PRS) - are also implicated in depression. However, the role of PRS in adolescent depression and changes in adolescent depression i…
Early adulthood socioeconomic trajectories contribute to inequalities in adult cardiovascular health, independently of childhood and adulthood socioeconomic position
BACKGROUND: Cardiovascular health shows significant socioeconomic inequalities, however there is little understanding of the role of early adulthood in generation of these inequalities. We assessed the contribution of socioeconomic trajectories during early adulthood (16-24 years) to cardiovascular health in mid-adulthood (46 years). METHODS: Participants from the 1970 British Cohort Study with socioeconomic data available in early adulthood were…
Is teachers’ mental health and wellbeing associated with students’ mental health and wellbeing?
RoB 2
Assessment of risk of bias is regarded as an essential component of a systematic review on the effects of an intervention. The most commonly used tool for randomised trials is the Cochrane risk-of-bias tool. We updated the tool to respond to developments in understanding how bias arises in randomised trials, and to address user feedback on and limitations of the original tool.
The proportion of missing data should not be used to guide decisions on multiple imputation
OBJECTIVES: Researchers are concerned whether multiple imputation (MI) or complete case analysis should be used when a large proportion of data are missing. We aimed to provide guidance for drawing conclusions from data with a large proportion of missingness. STUDY DESIGN AND SETTING: Via simulations, we investigated how the proportion of missing data, the fraction of missing information (FMI), and availability of auxiliary variables affected MI …
Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm
BACKGROUND: Suicidal thoughts and non-suicidal self-harm are common in adolescents and are strongly associated with suicide attempts. We aimed to identify predictors of future suicide attempts in these high-risk groups. METHODS: Participants were from the Avon Longitudinal Study of Parents and Children, a population-based birth cohort study in the UK. The sample included 456 adolescents who reported suicidal thoughts and 569 who reported non-suic…
Accounting for missing data in statistical analyses
BACKGROUND: Missing data are unavoidable in epidemiological research, potentially leading to bias and loss of precision. Multiple imputation (MI) is widely advocated as an improvement over complete case analysis (CCA). However, contrary to widespread belief, CCA is preferable to MI in some situations. METHODS: We provide guidance on choice of analysis when data are incomplete. Using causal diagrams to depict missingness mechanisms, we describe wh…
Is screen time associated with anxiety or depression in young people? Results from a UK birth cohort
We found associations between increased screen time, particularly computer use, and a small increased risk of anxiety and depression. Time spent alone was found to attenuate some associations, and further research should explore this
High-risk environments for eating foods surplus to requirements
Objective Interventions to reduce adolescents’ non-core food intake (i.e. foods high in fat and sugar) could target specific people or specific environments, but the relative importance of environmental contexts v . individual characteristics is unknown. Design Cross-sectional. Setting Data from 4d food diaries in the UK National Diet and Nutrition Survey (NDNS) 2008–2012 were analysed. NDNS food items were classified as ‘non-core’ based on fat a…
A discussion of statistical methods to characterise early growth and its impact on bone mineral content later in childhood
Similarities and differences in results from a variety of analytic strategies need to be understood in the context of each statistical methodology
Response to
[no abstract]
Frailty in older-age European migrants
Modelling height in adolescence
Both SITAR or the PBGM are useful models for adolescent growth and provide unbiased estimates of age at peak height velocity. Care should be taken as substantial bias and variance can occur with large measurement error
The intervention effect of local alcohol licensing policies on hospital admission and crime
BACKGROUND: Control of alcohol licensing at local government level is a key component of alcohol policy in England. There is, however, only weak evidence of any public health improvement. We used a novel natural experiment design to estimate the impact of new local alcohol licensing policies on hospital admissions and crime. METHODS: We used Home Office licensing data (2007-2012) to identify (1) interventions: local areas where both a cumulative …
Teachers' wellbeing and depressive symptoms, and associated risk factors
BACKGROUND: Teachers have been shown to have high levels of stress and common mental disorder, but few studies have examined which factors within the school environment are associated with poor teacher mental health. METHODS: Teachers (n=555) in 8 schools completed self-report questionnaires. Levels of teacher wellbeing (Warwick Edinburgh Mental Wellbeing Scale-WEMWBS) and depressive symptoms (Patient Health Questionnaire-PHQ-9) were measured and…
Protocol for a cluster randomised controlled trial of an intervention to improve the mental health support and training available to secondary school teachers – the Wise (Wellbeing in Secondary Educat…
International Standard Randomised Controlled Trial Number: ISRCTN95909211 registered 24/03/16
Socioeconomic differences in childhood growth trajectories
BACKGROUND: Socioeconomic differentials in adult height are frequently observed, but the age at which these inequalities emerge and the patterns they follow through childhood are unknown. SUBJECTS AND METHODS: Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), height trajectories from birth to 10 years (N=12366) were modelled. Individual trajectories were estimated using mixed-effects models. Differences in trajectories…
Challenges in examining area effects across the life course on physical capability in mid-life
A major limitation of past work linking area socioeconomic conditions to health in mid-life has been the reliance on single point in time measurement of area. Using the MRC National Survey of Health and Development, this study for the first time linked place of residence at three major life periods of childhood (1950), young adulthood (1972), and mid-life (1999) to area-socioeconomic data from the nearest census years. Using objective measures of…
Early adulthood socioeconomic trajectories contribute to inequalities in adult cardiovascular health, independently of childhood and adulthood socioeconomic position
BACKGROUND: Cardiovascular health shows significant socioeconomic inequalities, however there is little understanding of the role of early adulthood in generation of these inequalities. We assessed the contribution of socioeconomic trajectories during early adulthood (16-24 years) to cardiovascular health in mid-adulthood (46 years). METHODS: Participants from the 1970 British Cohort Study with socioeconomic data available in early adulthood were…
Frailty in older-age European migrants
The intervention effect of local alcohol licensing policies on hospital admission and crime
BACKGROUND: Control of alcohol licensing at local government level is a key component of alcohol policy in England. There is, however, only weak evidence of any public health improvement. We used a novel natural experiment design to estimate the impact of new local alcohol licensing policies on hospital admissions and crime. METHODS: We used Home Office licensing data (2007-2012) to identify (1) interventions: local areas where both a cumulative …
Reproducibility measures and their effect on diet–cancer associations in the Boyd Orr cohort
Objectives: To quantify measurement error in the estimation of family diet intakes using 7-day household food inventories and to investigate the effect of measurement-error adjustment on diet–disease associations. Design and setting: Historical cohort study in 16 districts in England and Scotland, between 1937 and 1939. Subjects: 4999 children from 1352 families in the Carnegie Survey of Diet and Health. 86.6% of these children were traced as adu…
Injecting drug use in Brighton, Liverpool, and London
Study objective: To estimate the prevalence of injecting drug use (IDU) in three cities in England and to measure the coverage of key public health indicators. Design: Capture-recapture techniques with covariate effects. Setting: Liverpool, Brighton, and 12 London boroughs, 2000/01. Participants: IDU collated and matched across five data sources—community recruited survey, specialist drug treatment, arrest referral, syringe exchange, and accident…
Feasibility of named antenatal HIV screening in an inner city population
The object of this study was to assess the resource use, feasibility, uptake and consumers' perspective of introducing routine named human immunodeficiency virus (HIV) testing into an inner city hospital antenatal clinic (St Thomas Hospital, part of Guy's and St Thomas Hospital Trust). Following the introduction of a new service offering routine named HIV testing at booking appointments, the length of the appointments were recorded over a three-m…
Clinical decision making, risk and occupational therapy
Little is known about the processes involved in risk taking, and complex decision making of the type encountered on acute medical wards in general hospitals. The purpose of the present study was to examine certain of these processes in the context of decisions to discharge elderly inpatients from hospital. Vignettes of hypothetical frail and disabled elderly in-patients were presented to student and qualified occupational therapists (OTs). All th…
Injecting drug use in Brighton, Liverpool, and London
Study objective: To estimate the prevalence of injecting drug use (IDU) in three cities in England and to measure the coverage of key public health indicators. Design: Capture-recapture techniques with covariate effects. Setting: Liverpool, Brighton, and 12 London boroughs, 2000/01. Participants: IDU collated and matched across five data sources—community recruited survey, specialist drug treatment, arrest referral, syringe exchange, and accident…
Objective measurement of levels and patterns of physical activity
OBJECTIVE: To measure the levels and patterns of physical activity, using accelerometers, of 11-year-old children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC). DESIGN: Cross-sectional analysis. SETTING: ALSPAC is a birth cohort study located in the former county of Avon, in the southwest of England. This study used data collected when the children were 11 years old. PARTICIPANTS: 5595 children (2662 boys, 2933 gir…
Reproducibility measures and their effect on diet–cancer associations in the Boyd Orr cohort
Objectives: To quantify measurement error in the estimation of family diet intakes using 7-day household food inventories and to investigate the effect of measurement-error adjustment on diet–disease associations. Design and setting: Historical cohort study in 16 districts in England and Scotland, between 1937 and 1939. Subjects: 4999 children from 1352 families in the Carnegie Survey of Diet and Health. 86.6% of these children were traced as adu…
Is accelerated postnatal growth associated with blood pressure in childhood
Objective: To investigate whether variations in growth patterns in early-life are associated with blood pressure at age 6.5 years by modelling detailed, individual growth trajectories between birth and 5 years of age. Design: Prospective cohort study nested in a large randomised trial. Setting: Belarus. Participants: 10 494 children from Belarus who were born in one of 31 hospitals that participated in a cluster randomised trial of breastfeeding …
Accuracy of height and weight data from child health records
MMR safety, and nearly a quarter (22.7%, n = 60) were rated as ''mixed''.In 2000, despite growing public concerns and widespread media coverage, fewer than 20 comment pieces were published.From 2001-2003 the tone of many articles was negative, mixed or neutral, thus conveying ambiguous or negative messages about MMR safety to health professionals, though from 2004 the tone changed and most comment pieces were broadly positive.Overall less than a …
Maternal and paternal smoking during pregnancy and trajectories of growth and adiposity in the offspring
Objective To explore the associations of maternal smoking during pregnancy with offspring trajectories of height, weight and adiposity and to compare these with associations with paternal smoking to determine whether any associations are driven by intrauterine mechanisms. Design Individual trajectories of height, weight and adiposity were modelled from birth to 10 years using random-effects linear-spline models. Adiposity was modelled as ponderal…
P19 Socioeconomic disparities in trajectories of adiposity across childhood
Objective Socioeconomic inequalities in obesity are consistently observed in high-income countries, with lower socioeconomic groups tending to be more adipose amongst both adults and children. The development of such inequalities across childhood, however, has not been studied using longitudinal data. Design Using longitudinal data from a prospective birth cohort study, we modelled individual trajectories of adiposity from birth to 10 years using…
Challenges in examining area effects across the life course on physical capability in mid-life
A major limitation of past work linking area socioeconomic conditions to health in mid-life has been the reliance on single point in time measurement of area. Using the MRC National Survey of Health and Development, this study for the first time linked place of residence at three major life periods of childhood (1950), young adulthood (1972), and mid-life (1999) to area-socioeconomic data from the nearest census years. Using objective measures of…
P1-427 Associations of maternal weight gain in pregnancy with offspring cognition throughout childhood and adolescence
Introduction Basic science evidence suggests that gestational weight gain (GWG) may influence offspring cognitive development. However, this relationship has not been investigated in human population studies. Methods Data from the ALSPAC, a UK prospective pregnancy cohort were used. GWG was expressed using 2009 IOM categories of GWG and estimates from random effect linear spline models (median number of measures per woman: 10 IQR: 8–11). Outcomes…
P1-285 Use of linear spline models to describe bi-ethnic differences in early childhood growth
Introduction Size at birth differs between South Asian and White European infants, but little is known about differences in growth in later infancy. We use multilevel linear spline models to describe ethnic differences in growth of infants from the Born in Bradford study (BIB). Methods Data for 1378 singleton births from BIB with follow-up visits at 6, 12 and 18 months were used (614 White and 764 Pakistani infants). Weight and length data from c…
O3-1.1 Does drop-out from cohort studies bias estimates of socioeconomic inequalities in health
Introduction Scandinavian studies exploiting record-linkage have shown that although cohort members tend to be healthy and affluent compared to the whole population, this does not bias at least certain well-established exposure-outcome associations. It is unknown whether this holds when estimating health inequalities. Individuals of lower socioeconomic position (SEP) may be less likely to consent to participation in a cohort study and more likely…
P2-449 Maternal education and height growth trajectories in childhood
Introduction The aim of this study was to explore the age at which socioeconomic inequalities in child height emerge among children from a middle-income country. Methods Using data from the 2004 Pelotas cohort study from Brazil we modelled individual height growth trajectories in 2106 boys and 1947 girls from birth to 48 months using a linear spline mixed effects model. We examined the associations of maternal education on birth length and length…
P2-166 Relationships of risk factors for pre-eclampsia with blood pressure changes during normal term pregnancy
Objective It is unclear whether established risk factors for pre-eclampsia are related to blood pressure (BP) changes across pregnancy in women who do not develop pre-eclampsia. We investigated these associations. Methods We studied routine antenatal BP measurements for 11 789 women (median 14 per woman) in ALSPAC who had a live term birth without pre-eclampsia or previous hypertension. Linear spline random effects models with knots at 18, 30 and…
P1-42 Associations of area deprivation over the lifecourse and physical capability in mid-life
Background Recent work has shown that factors across the whole of life influence physical capability in later life. Therefore, when investigating area socioeconomic effects on physical capability, area exposures should be assessed across the lifecourse to take account changes in residence and secular trends of an area. Methods Using data from the MRC National Survey of Health and Development, we examined the relationship between area low social c…
P2-34 Association of anthropometric and lifestyle factors with prostate specific antigen (PSA) trajectories in men with localised prostate cancer undergoing active monitoring
Introduction Widespread use of Prostate-specific Antigen (PSA) testing has lead to a rapid increase in the identification of low risk prostate cancer, with PSA trajectories often used to monitor tumour progression after diagnosis. Here we develop novel age-specific multi-level growth curves to assess the effects of lifestyle and anthropometric measures on PSA trajectories. Methods Serial PSA measures from 513 men aged 50–70 years with localised p…
OP25 Using Linear Spline Multilevel Models to Assess Socioeconomic Differences in Trajectories of Diet, Physical Activity and Fat Mass Across Childhood
Background Lower socioeconomic position (SEP) is a risk factor for obesity in children and adolescents in high-income countries. Since diet and physical activity are the main drivers of obesity, the socioeconomic differential in obesity is likely to arise through SEP differences in one or both of these. Methods We explored SEP differences in trajectories of fat mass, energy intake and physical activity (PA) across childhood and early adolescence,…
Socioeconomic differences in childhood growth trajectories
BACKGROUND: Socioeconomic differentials in adult height are frequently observed, but the age at which these inequalities emerge and the patterns they follow through childhood are unknown. SUBJECTS AND METHODS: Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), height trajectories from birth to 10 years (N=12366) were modelled. Individual trajectories were estimated using mixed-effects models. Differences in trajectories…
Cohort Profile
The Avon Longitudinal Study of Children and Parents (ALSPAC) was established to understand how genetic and environmental characteristics influence health and development in parents and children. All pregnant women resident in a defined area in the South West of England, with an expected date of delivery between 1st April 1991 and 31st December 1992, were eligible and 13761 women (contributing 13867 pregnancies) were recruited. These women have be…
PL01 Common Epidemiological Misconceptions
Background Each year, numerous studies relate an outcome (e.g. offspring birthweight) to several exposures (e.g. maternal characteristics) using standard multiple linear/logistic regression. The results are often reported as coefficients/odds ratios for all exposures simultaneously, described as “mutually adjusted”. As discussed recently by Westreich and Greenland, depending on the nature of the theoretical model underpinning the data, this appro…
OP17 Area Deprivation Across the Life Course and Cognitive Capability in Mid-Life
Background Recent work has shown that area conditions at single points in time have been found to be associated with cognitive capability outcomes. However, a life course perspective is required to take into account life time processes of cognitive development, changes in residence and secular trends of areas. Methods Data from the 1946 British Birth Cohort were used to estimate associations of area deprivation (indicated by % of employed people …
OP93 Common Epidemiological Errors
Background Each year numerous studies evaluate longitudinal data within a lifecourse context with later-life health status (e.g. blood pressure) analysed with respect to repeated measures of early-life experiences (e.g. body mass) using standard multiple linear/logistic regression. Although more sophisticated methods are available, some have been shown to be problematic, hence there remains confusion around which is the most appropriate analytica…
Socioeconomic differences in childhood length/height trajectories in a middle-income country
Current Controlled Trials: NCT01352247 assigned 9 Sept 2005; ClinicalTrials.gov. Identifier: NCT01561612 received 20 Mar 2012
Assessment of Offspring DNA Methylation across the Lifecourse Associated with Prenatal Maternal Smoking Using Bayesian Mixture Modelling
A growing body of research has implicated DNA methylation as a potential mediator of the effects of maternal smoking in pregnancy on offspring ill-health. Data were available from a UK birth cohort of children with DNA methylation measured at birth, age 7 and 17. One issue when analysing genome-wide DNA methylation data is the correlation of methylation levels between CpG sites, though this can be crudely bypassed using a data reduction method. I…
Medicine (45 works) · Demography (25 works) · Population (24 works) · Environmental health (19 works) · Health, Environment, Cognitive Aging (18 works) · Psychology (18 works) · Internal Medicine (16 works) · Psychiatry (16 works) · Cohort (14 works) · Cohort study (14 works)