External Publications Using GUI Data

This study reports recent trends in periconceptional folic acid use in Ireland using archived data from Growing Up in Ireland – the National Longitudinal Study of Children. Of a sample of 10,891 mothers, 6,936 (64%) reported taking folic acid before conception and 10,157 (93%) reported taking folic acid during the first trimester of pregnancy. Younger (OR=0.38, 95% CI=0.29-0.50), lower income (OR=0.59, 95% CI=0.51-0.68), lower educated (OR=0.77, 95% CI=0.66-0.89), and single mothers (OR=0.46, 95% CI=0.40-0.52) were less likely to have taken folic acid pre-conception. A similar pattern was found post-conception with younger (OR=0.58, 95% CI=0.40-0.84), lower income (OR=0.40, 95% CI=0.30-0.53), lower educated (OR=0.50, 95% CI=0.38-0.66), and single mothers (OR=0.74, 95% CI=0.60-0.91) less likely to have taken folic acid post-conception. The findings highlight an ongoing need for targeted promotional campaigns to increase supplementation rates among younger and socially disadvantaged mothers.

Importance Birth weight percentiles (BWPs) are often dichotomized at the 10th percentile and show statistically significant association with later cognitive performance, for both preterm and term-born children. However, research testing nonlinear associations between BWPs and cognitive performance is scarce.

Objective To investigate culturally invariant, nonlinear associations of BWPs and gestational age with later cognitive performance.

Design, Setting, and Participants In this cohort study, participants with valid neonatal and cognitive data were combined from 4 observational cohorts, including the Millennium Cohort Study, the National Longitudinal Survey of Youth 1979 Child and Young Adult cohort, Growing Up in Ireland, and the Longitudinal Study of Australian Children, with children born between 2000 and 2002, 1980 and 2010, 2007 and 2008, and 2003 and 2004, respectively. Neonatal data were parent reported before age 1 year. At approximately 5 years of age, multiple cognitive tests were performed. Follow-up at 5 years of age was the predominant focus. Data were analyzed July 17, 2023.

Exposure The parent-reported neonatal data were used to calculate BWPs according to the Fenton growth chart.

Main Outcome and Measure Scores for IQ were created from multiple measures of cognition, which were z standardized separately within each cohort.

Results Of 30 643 participants (50.8% male), 7.5% were born preterm (before 37 weeks gestation) and 92.5% were term born (between 37 and 42 weeks gestation). In the pooled data using multivariate adaptive regression splines, IQ linearly increased by 4.2 points as BWPs increased from the first to the 69th percentile before completely plateauing. For gestational age, IQ linearly increased by 1.3 points per week up until 32 weeks, with the association reducing to 0.3 points per week after 32 weeks. The association of BWP with IQ was not moderated by gestational age. For term-born infants, the estimated IQ score was only clinically meaningfully lower than average when birth weight was below the third percentile. Consistent results were found when instead using multivariable regression where gestational age and BWPs were categorized into groups.

Conclusions and Relevance In this cohort study, lower BWPs and gestational age were independently associated with lower IQ. For term-born infants, a cutoff of the third percentile would be more appropriate than the traditionally used 10th percentile when the aim is estimating meaningful cognitive differences.

Importance Understanding which children in the general population are at greatest risk of poor functional outcomes could improve early screening and intervention strategies.

Objective To investigate the odds of poor outcomes in emerging adulthood (ages 17 to 20 years) for children with different mental health trajectories at ages 9 to 13 years.

Design, Setting, and Participants Growing Up in Ireland is a longitudinal, nationally representative population-based cohort study. Data collection began in August 2007 and was repeated most recently in September 2018. All results were weighted to account for sampling bias and attrition and were adjusted for socioeconomic factors. Data analysis took place from October 2022 to April 2023.

Exposure Four latent classes captured variation in mental health in children aged 9 and 13 years, based on the parent-completed Strengths and Difficulties Questionnaire. Classes included no psychopathology, internalizing, externalizing, and high (comorbid) psychopathology. Those who remained in the same class from ages 9 to 13 years were included.

Main Outcomes and Measures Poor functional outcomes in emerging adulthood were measured at approximate ages 17 years (range, 16 to 18 years) and 20 years (range, 19 to 21 years). Outcomes included poor mental health, poor physical health, social isolation, heavy substance use, frequent health service use, poor subjective well-being, and adverse educational/economic outcomes.

Results Of 5141 included participants, 2618 (50.9%) were male. A total of 3726 (72.5%) were classed as having no childhood psychopathology, 1025 (19.9%) as having persistent externalizing psychopathology, 243 (4.7%) as having persistent internalizing psychopathology, and 147 (2.9%) as having persistent high psychopathology. Having any childhood psychopathology was associated with poorer functional outcomes in emerging adulthood. The internalizing group had elevated odds of most outcomes except for heavy substance use (range of odds ratios [ORs]: 1.38 [95% CI, 1.05-1.81] for frequent health service use to 3.08 [95% CI, 2.33-4.08] for poor mental health). The externalizing group had significantly elevated odds of all outcomes, albeit with relatively small effect sizes (range of ORs: 1.38 [95% CI, 1.19-1.60] for frequent health service use to 1.98 [95% CI, 1.67-2.35] for adverse educational/economic outcomes). The high psychopathology group had elevated odds of all outcomes (nonsignificantly for frequent health service use), though with wide confidence intervals (range of ORs: 1.53 [95% CI, 1.06-2.21] for poor physical health to 2.91 [95% CI, 2.05-4.12] for poor mental health). Female participants with any psychopathology had significantly higher odds of poor physical health and frequent health service use compared with male participants with any psychopathology.

Conclusions and Relevance In this longitudinal cohort study, childhood psychopathology was associated with a widespread pattern of functional impairment in emerging adulthood. Findings point to the need for a wider range of preventive interventions in child and adolescent mental health services.

Importance As young people’s mental health difficulties increase, understanding risk and resilience factors under challenging circumstances becomes critical.

Objective To explore the outcomes of the COVID-19 pandemic on secondary school students’ mental health difficulties, as well as the associations with individual, family, friendship, and school characteristics.

Design, Setting, and Participants For this cohort study, follow-up data from the My Resilience in Adolescence (MYRIAD) cluster randomized clinical trial were collected across 2 representative UK cohorts. Mainstream UK secondary schools with a strategy and structure to deliver social-emotional learning, with an appointed head teacher, and that were not rated “inadequate” in their latest official inspection were recruited. A total of 5663 schools were approached, 532 showed interest, and 84 consented. Cohort 1 included 12 schools and 864 students, and cohort 2 included 72 schools and 6386 students. COVID-19 was declared a pandemic after cohort 1 had completed all assessments (September 2018 to January 2020), but cohort 2 had not (September 2019 to June 2021).

Exposures Cohort 2 was exposed to the COVID-19 pandemic, including 3 national lockdowns. Associations of individual, family, friendship, and school characteristics with students’ mental health were explored.

Main Outcomes and Measures Changes in students’ risk for depression (Center for Epidemiological Studies-Depression scale); social, emotional, and behavioral difficulties (Strengths and Difficulties Questionnaire); and mental well-being (Warwick-Edinburgh Mental Well-Being Scale).

Results Of the 7250 participants included, the mean (SD) age was 13.7 (0.6) years, 3947 (55.4%) identified as female, and 5378 (73.1%) self-reported their race as White. Twelve schools and 769 of the 864 students (89.0%) in cohort 1 and 54 schools and 2958 of the 6386 students (46.3%) in cohort 2 provided data and were analyzed. Mental health difficulties increased in both cohorts but to a greater extent among students exposed to the pandemic, including for risk of depression (adjusted mean difference [AMD], 1.91; 95% CI, 1.07-2.76); social, emotional, and behavioral difficulties (AMD, 0.76; 95% CI, 0.33-1.18); and mental well-being (AMD, −2.08; 95% CI, −2.80 to −1.36). Positive school climate, high home connectedness, and having a friend during lockdown were protective factors during the pandemic. Female gender and initial low risk for mental health difficulties were associated with greater mental health deteriorations. Partial school attendance during lockdown was associated with better adjustment than no attendance when returning to school.

Conclusions and Relevance This cohort study of secondary school students demonstrated that to promote mental health and adjustment, policy interventions should foster home connectedness, peer friendship, and school climate; avoid full school closures; and consider individual differences.

Investigations into the wider bioecological understanding of dental problems in early childhood are limited in national surveys. Classification tree analysis (CTA) was used to explore multilevel interactions among key aspects of child and primary caregiver (PCG) psychosocial and physical health affecting dental problems in preschool children. Data were derived from the Growing Up in Ireland study, a nationally representative sample of 9-mo-olds (N = 11,134) in 2007/2008 followed up at age 3 y (N = 9,793) in 2010/2011. Analysis included PCG reports of children’s dental problems, general health, temperament, emotional and behavioral difficulties, and their own general health, stress and depression, relationship, and sociodemographic variables. Misclassification costs were specified for the model by applying a higher penalty for misclassifying those with a dental problem (minority class). Logistic regression analyses were carried out for comparison. Dental problems were reported among 302 infants (2.7%) at 9 mo of age and 493 children (5.0%) at 3 y. CTA identified infant temperament (Infant Characteristics Questionnaire unpredictable) as the primary predictor of dental problems at 9 mo and child global health at 3 y of age. First-level predictors were PCG depression score and use of a soother at 9 mo and PCG ethnicity and unscheduled hospital visits at 3 y of age. Regression analyses results supported the most important predictors at 9 mo and 3 y of age. The CTA model for 9-mo-old infants had a specificity of 90.4%, sensitivity of 31.2%, and overall accuracy of 88.8% while that for 3-y-olds had a specificity of 58.5%, sensitivity of 66%, and overall accuracy of 59%. Key aspects of infant/child and PCG health, as well as psychosocial characteristics associated with reported dental problems, should be considered in future multidisciplinary approaches to child health.

Knowledge Transfer Statement: The results of this data analysis should help raise awareness among clinicians of how primary caregiver and child psychosocial and general health factors are associated with early childhood dental problems, even before the primary dentition is complete. Classification tree analysis visually demonstrates how factors such as infant temperament (9 mo) and child global health (3 y) can interact at multiple levels and affect different subgroups of the child population. Future intervention strategies for oral health should involve consideration of the psychological and general health characteristics of the young child and PCG at both the patient and population levels. This knowledge could assist decision makers adopt an integrated multidisciplinary approach in formulating a coherent oral health policy for preschool children.

This retrospective cross-sectional paper examines the relationship between maternal smoking during pregnancy and children’s behavioural problems at 9 years of age independent of a wide range of possible confounders. The final sample comprised 7,505 nine-year-old school children participating in the first wave of the Growing Up in Ireland study. The children were selected through the Irish national school system using a 2-stage sampling method and were representative of the nine-year population. Information on maternal smoking during pregnancy was obtained retrospectively at 9 years of age via parental recall and children’s behavioural problems were assessed using the Strengths and Difficulties Questionnaire across separate parent and teacher-report instruments. A quasi-experimental approach using propensity score matching was used to create treatment (smoking) and control (non-smoking) groups which did not differ significantly in their propensity to smoke in terms of 16 observed characteristics. After matching on the propensity score, children whose mothers smoked during pregnancy were 3.5 % (p < 0.001) and 3.4 % (p < 0.001) more likely to score in the problematic range on the SDQ total difficulties index according to parent and teacher-report respectively. Maternal smoking during pregnancy was more strongly associated with externalising than internalising behavioural problems. Analysis of the dose–response relationship showed that the differential between matched treatment and control groups increased with level of maternal smoking. Given that smoking is a modifiable risk factor, the promotion of successful cessation in pregnancy may prevent potentially adverse long-term consequences.

Psychotic experiences (PEs) are common in early adolescence and are associated with nonpsychotic psychopathology. However, not all adolescents with PEs have subsequent psychopathology, and vice versa. To date, factors mediating the relationship between PEs and psychopathology have been understudied. The aims of this study were to investigate the bidirectional relationship between PEs and psychopathology in adolescence and to investigate potentially malleable mediators of these relationships. Data from 2 waves (age 13 and 17 years) of Cohort ’98 of the Growing Up in Ireland study were examined (n = 6,206). Using KHB pathway decomposition, we investigated the following as potential mediators of the relationship between psychopathology and PEs: parent-child relationship (conflict and positive), self-concept, and child-peer relationship (alienation and trust). Supplementary counterfactual mediation and sensitivity analyses were conducted. Early adolescents with psychopathology had twofold increased odds of late adolescent PEs (internalizing problems: odds ratio [OR] = 2.03, 95% confidence interval [CI; 1.56, 2.62]; externalizing problems: OR = 1.99, CI [1.51, 2.60]). Parent-child conflict explained between 23% and 34% of the associations between internalizing and externalizing problems and subsequent PEs. Early adolescents with PEs had increased odds of late adolescent psychopathology (internalizing problems: OR = 2.01, CI [1.61, 2.50]; externalizing problems: OR = 1.70, CI [1.25, 2.31]). Self-concept alone accounted for 52% of the relationship between PEs and subsequent internalizing problems. There is a bidirectional heterotypic relationship between psychopathology and PEs. Parent-child conflict and self-concept are important characteristics that mediate a proportion of the relationship between PEs and psychopathology. Interventions targeting parent-child conflict in the context of psychopathology and self-concept in the context of PEs may assist in reducing the incidence of poorer outcomes.

Introduction
Despite a growing body of research on associations between adolescent digital use and well-being, few studies have investigated these associations a) longitudinally and b) across socioeconomic status. The present study uses high-quality longitudinal data to examine how digital engagement shapes socioemotional and educational outcomes from early to late adolescence across socioeconomic status (SES).

Methods
Participants are 7685 individuals (49.0% female) from the 1998 birth cohort of the longitudinal Growing Up In Ireland (GUI) survey. The survey was administered to Irish parents and children between 2007 and 2016 (at ages 9, 13, and 17/18). Fixed-effects regression modeling was used to establish associations between digital engagement and socioemotional and educational outcomes. Further Fixed-Effects models were analyzed separately by SES, to assess how associations between digital use and adolescent outcomes differ by socioeconomic groups.

Results
Results show that digital screen time increases markedly from early to late adolescence, but to a higher extent among low-SES versus high-SES groups. Heavy levels of digital screen time (i.e., 3+ hours daily) are associated with declines in well-being, particularly for external and prosocial functioning, while engagement in learning-oriented digital activities and gaming is associated with better adolescent outcomes. Yet, low-SES adolescents are globally more harmed than high-SES adolescents by their digital engagement, and high-SES adolescents benefit more from moderate levels of digital use and from engaging in learning-oriented digital activities.

Conclusions
This study suggests that digital engagement is associated with socioeconomic inequalities in adolescents’ socioemotional well-being and, to a lesser extent, educational outcomes.

Purpose
Despite growing concerns about trends in cocaine use, there is a shortage of longitudinal research that prospectively examines risk and protective factors associated with cocaine initiation and use in general youth populations. This study addresses this gap.

Methods
Growing Up in Ireland is a nationally representative cohort. Individual, family, and socio-environmental exposures associated with incident past-year cocaine use at ages 17 (N = 5965) and 20 (n = 4549) were assessed with survey-weighted logistic regression using generalised estimating equations. Prevalent past-year cocaine use at 20 (N = 4679) was analysed using generalised estimating equations complemented by gradient-boosted decision trees and Shapley explanations.

Results
221 (3.7%) self-reported cocaine use at 17 and 1072 (22.9%) at 20. Alcohol use at 14 or younger was associated with eight times the odds of cocaine use at 17 (aOR 8.0, 95% CI 1.7–37.3) and 19 times at 20 (aOR 19.2, 95% CI 8.6–43.2). Peer cannabis use was associated with 7 times the odds of cocaine use at 17 (aOR 7.3, 95% CI 2.9–18.3) and double at 20 (aOR 2.4, 95% CI 1.8–3.2). Growing up in a neighbourhood where substance use was common doubled the odds of cocaine use at 17 (aOR 2.4, 95% CI 1.3–4.4). Shapley explanations revealed individual-specific positive or negative impacts of exposures.

Discussion
Cocaine use among 20-year-olds in Ireland is higher than reported internationally, and increases sharply between the ages of 17 and 20, suggesting a need for interventions targeting this age group. However, associations with early adolescent factors suggest that early interventions may also be important.

Background
Self-harm is a major public health concern in young people and is governed by a complex interaction of different risk factors. While many studies have identified these risk factors, less is known about how they tend to co-occur together.

Methods
A latent class analysis was conducted using risk factors for self-harm from two waves at ages 13 and 17 from the Growing Up in Ireland (GUI) study their associations with self-harm were examined longitudinally at ages 17 and 20, respectively.

Results
At age 13, there was a ‘peer problems’ group with higher probabilities of bullying, being unpopular and internalising problems and a ‘school and substance use problems’ group with higher probabilities of substance use, truancy or excessive absence from school and violence. Both of these two groups had over a two-fold risk of self-harm at age 17 in comparison to the low risk factor group. At age 17, there was a group with depression that was diagnosed by a medical professional with the highest relative risk (RR:13.9 (95 % CI 10.2–19.0)) of self-harm at age 20. Two other groups with undiagnosed depression had high probabilities of being bullied, and either high or low probabilities of substance use that had a 9.4 (95 % CI 6.8–13.1) and 7.4 (95 % CI 5.5–10.0) relative risk of self-harm at age 20, respectively.

Conclusions
Identifying hidden sub-groups using risk factors for self-harm in young people can inform potential public health interventions by clinicians and other professionals who work with young people.

Although children’s relationships with their parents and teachers contribute to their school adjustment and achievement, few studies have examined interactions between these relationships, particularly for father-child relationships. Using the Growing Up in Ireland birth cohort (N = 7507, 50.3% male), we examined child-adult relationship quality – rated by parents at age 3 and by teachers at age 5 – as predictors of teacher-rated behavioural adjustment and academic achievement at age 9 (indexed by self-reported academic self-concepts and performance on formal reading assessments). Controlling for prior levels of problem behaviours, verbal ability, and family SES, our results indicated that children’s relationships with parents and teachers showed small and comparable independent effects on school adjustment and achievement. For mothers and teachers, moderation analyses showed a cumulative risk pattern for conflictual relationships and a compensatory pattern for close relationships. Children are likely to benefit from improving closeness and reducing conflict in adult-child relationships as well as interventions that involve mothers, fathers, and teachers.

There is now fairly substantial evidence of a socioeconomic gradient in low birth weight for developed countries. The standard summary statistic for this gradient is the concentration index. Using data from the recently published Growing Up in Ireland survey, this paper calculates this index for low birth weight arising from preterm and intrauterine growth retardation. It also carries out a decomposition of this index for the different sources of low birth weight and finds that income inequality appears to be less important for the case of preterm births, while father’s education and local environmental conditions appear to be more relevant for intrauterine growth retardation. The application of the standard Blinder–Oaxaca decomposition also indicates that the socioeconomic gradient for low birth weight appears to arise owing to different characteristics between rich and poor, and not because the impact of any given characteristic on low birth weight differs between rich and poor.

The quality of the interparental relationship bears important implications for children’s socioemotional development. Given evidence that relationship satisfaction among parents tends to decline over time this study examined how change in parents’ relationship satisfaction from nine-months-old until nine-years-old related to children’s socioemotional difficulties at nine-years-old. Participants were 2074 mothers, fathers, and their child (55.1% male) recruited through random sampling of the Child Benefit Registrar by Growing Up in Ireland cohort study. Mothers ranged in age from 18 to 40 years (M = 31.06, SD = 4.70) and fathers ranged in age from 18 to 60 years (M = 33.50, SD = 5.54). Mothers and fathers completed the Dyadic Adjustment Scale at nine-months-old and at nine-years-old whereas child socioemotional development was assessed via teacher report on the Strengths and Difficulties Questionnaire at nine-years-old. Residualised change analysis indicated that both parents experienced declines in relationship satisfaction from nine-months-old until nine- years-old. However, in families where initial levels of relationship satisfaction were high, there was no significant association between decline in satisfaction and child socioemotional difficulties. Conversely, in couples where initial levels of satisfaction were low, mothers, but not fathers, who experienced further declines had female, but not male, children with more socioemotional difficulties at nine years (β = −0.22, p = 0.01; R2 = 0.15, F = 2.31, p = 0.02). These findings highlight the need for carefully tailored interventions aimed at promoting couple relationship satisfaction during transition to parenthood such that the negative impact on children of any decline experienced over time can be mitigated.

Background
Whether, and how, infant characteristics and parenting quality interact is one of developmental psychology’s key questions. However, whether specific interaction patterns replicate across cohorts or developmental outcomes is largely unknown. This study investigates whether infant characteristics and parenting quality are independent predictors (additive effects) of child outcomes or interact such that certain infants particularly suffer from poor parenting (diathesis stress), particularly benefit from good parenting (vantage sensitivity) or both (differential susceptibility).

Methods
Individual participant data from over 30,000 children from four prospective cohorts were pooled. Using a competitive-confirmatory approach of model evaluation, 16 possible permutations of infant characteristics (temperament and birthweight), parenting (maternal-reported stimulating and sensitive parenting) and later developmental outcomes (fluid and crystalised intelligence, internalising and externalising behaviour) were tested. The robustness of results was evaluated by subsequently varying analytic methods, using alternative parenting measures including observer reports and excluding covariates.

Results
AIC values in 10/16 analyses indicated infant characteristics acted independently of maternal-reported parenting for predicting developmental outcomes. Interaction patterns indicating diathesis stress (4/16), vantage sensitivity (2/16) or differential susceptibility (0/16) were rare or absent. However, diathesis-stress patterns were frequently found regarding birthweight and internalising behaviours, which were largely robust to methodological changes.

Conclusions
Developmental outcomes are more consistently explained by additive effects rather than by interaction effects.

Background
Psychotic experiences (PEs) are commonly reported in adolescence and are associated with a range of negative outcomes. Few targets for intervention for PEs have been identified. One potential target is self-concept: an individual’s beliefs about his/her personal attributes. Improvements in self-concept have been shown to reduce psychotic symptoms in patients with schizophrenia but no study has investigated the relationship between changes in self-concept and risk of PEs in the general population.

We aimed to investigate: (a) the relationship between child and adolescent self-concept and adolescent PEs; and (b) whether changes in self-concept between childhood and adolescence were associated with risk of adolescent PEs.

Method
Using data from age 9 and age 13 (n = 7,423) of the child cohort (Cohort’98) from the Growing Up in Ireland study we investigated the relationship between self-concept at age 9 and age 13 and PEs at age 13. PEs were measured using the Adolescent Psychotic Symptoms Screener and self-concept was measured using the Piers Harris-II. Using a stratified analysis, we investigated the relationship between change in self-concept between age 9 and age 13 and the risk of PEs at age 13. Additionally we investigated changes across the six self-concept subscales.

Results
Psychotic experiences were reported by 13% of participants at age 13. ‘Very low’ self-concept at age 9 was associated with an increased risk of PEs at age 13 (Adjusted-OR: 2.74, CI: 1.80–4.19), and ‘High’ self-concept at age 9 was associated with a decreased risk of PEs at age 13 (Adjusted-OR: 0.77, CI: 0.60–0.97). The stratified analysis indicated that improvements in self-concept reduced the odds of adolescent PEs and decline in self-concept increased the odds of adolescent PEs. This effect was noted across the majority of the self-concept subscales.

Conclusions
There is a strong relationship between self-concept and PEs. The antecedents of low self-concept may be a useful target for preventative psychiatry. Broad-spectrum interventions targeting self-concept in childhood may help to reduce the incidence of PEs in adolescence

Children live in a technology-mediated world, and most young people use a variety of technologies in their daily lives. However, despite intense public discourse, we have little empirical evidence on how technology use impacts on children’s development across a number of psycho-social domains. Research that has been conducted tends to be largely small-scale or cross-sectional in nature and most often focused on (young) adults rather than children. Using longitudinal data on one-in-eight Irish children, we use econometric methods to test for associations between early mobile phone ownership and two measures of children’s psycho-social development between 9 and 13 years of age. We examine the Piers Harris Self-Concept Scale, reported by children, and the Strengths and Difficulties (SDQ) score, completed by the primary caregiver. We find no generalised associations between early mobile phone ownership and psycho-social outcomes. However, there is evidence that associations differ by gender and across psycho-social sub-domains. We find no robust associations affecting boys, but girls who receive phones earlier fare less well in terms of their behavioural adjustment and academic self-concept scores at 13 years of age, all else being equal. Further research is needed to identify causal mechanisms and explore possible mediating effects of family/social context.

KEYWORDS: Mobile phone ownership; psychological adjustment; self-concept; gender; longitudinal data; Piers Harris; SDQ

Objective
Childhood chronic illness can have a high impact on the child’s quality of life. The foundations of health are established in early life, and are shaped by biological, psychosocial, spiritual and environmental processes and influences. The objectives of this presentation are twofold: firstly to describe the prevalence of chronic illness in 9-year-olds in Ireland, secondly to illustrate how chronic illness influences the psychological and social development of the children.

Methods
Analysis was based on data of 8570 9-year old children, and their families who participated in Growing Up in Ireland—the National Longitudinal Study of Children. The sample was generated through the primary school system. A representative sample of 910 schools participated; the sample of children and their families was randomly selected from within the schools. Questionnaires were administered in schools; and after completion of this phase, the project interviewers visited the families of the 9-year olds in their homes and administered core questionnaires to the Study Child and his/her carers who provided either home-based or centre-based care on a regular basis.

Results
The overall prevalence of chronic illness reported by mothers among the 9-year old cohort was 11% (gender-specific prevalence for boys: 13%, and significantly lower for girls: 10%). Respiratory illnesses accounted for almost half (46%) of all chronic illnesses, followed by mental and behavioural conditions with 19% (high gender dysbalance: reported for boys in 24%, for girls in 12%). Children with a reported chronic illness had significantly more emotional, conduct, hyperactivity, peer-based and prosocial difficulties when compared with children without a reported chronic illness. Abnormal scores, based on the Strengths and Difficulties Questionnaire were found in 20% in children with a chronic disease, and in 5.5% in children without a chronic disease. Socio-economic Status was associated with poorer health outcomes. Furthermore, primary care givers’ views and perceptions regarding the chronic illness of the child were found to be a significant factor on child strengths and difficulties in a multivariate model.

Conclusions
The majority of 9-year old children can be assessed as healthy. The most common chronic illness in this large cohort was respiratory disease and overall, chronic conditions were found to have a negative impact on the child’s emotional and social state.

Background
Globally, childhood obesity is a significant public health problem associated with adverse health and economic consequences. To tackle the problem, we need a comprehensive understanding on how the environment in which we live may influence obesity related behaviours and weight status. Thus, we explore if distance to and number of food outlets ([1] supermarkets and [2] convenience stores) in the local area impact on either dietary quality or body mass index (BMI) in 9-year-old children whilst controlling for socio-economic characteristics of the family.

Methods
Cross sectional analysis of the Growing Up in Ireland (GUI) Study, a two-stage clustered sample of 8568 nine year old children from the Republic of Ireland. Children were recruited from schools (response rate 82%) and age eligible children (response rate 57%) were invited to participate. Height and weight measurements were used to calculate BMI. Diet was assessed using a short food frequency questionnaire and a dietary quality score was generated based on Irish healthy eating guidelines. Socio-economic status was measured using parent reported household class, household net equivalised income and highest level of maternal education. Food access was measured as network distance to (in quintiles) and number of (within 1000km) convenience stores and supermarkets to each participant’s household within the local area. Separate fixed effects regression models were used to assess the impact of local area food access on (1) dietary quality and (2) BMI, stratified by gender.

Results
After controlling for socio-economic characteristics of the household, distance to the nearest supermarket was not associated with dietary quality in boys (Q5 v Q1; B = 0.84, 95% CI, –0.49 to 2.18) or girls (Q5 v Q1; B = –0.41, 95% CI, –1.60 to 0.77). Distance to the nearest convenience store was associated with dietary quality in boys (Q5 v Q1; B = 1.01, 95% CI, 0.13 to 1.89) but not in girls (Q5 v Q1; B = 0.04, 95% CI, –0.71 to 0.80). The number of convenience stores or supermarkets within 1000m of the household did not impact on dietary quality. Access to food outlets was not associated with BMI in girls or boys.

Conclusion
There was little evidence to suggest that access to food stores impact dietary quality or BMI in children. From a population health perspective, strategies tackling environmental factors associated with making poor lifestyle choices are needed. Thus, further research on the association between food access and obesity risk is needed.

Background
Poverty is associated with poor outcomes, yet exposure to distinct poverty trajectories in early childhood is not well understood.

Objective
To understand the prevalence of different trajectories of household poverty and their association with mid-childhood and mother indicators of physical health and psychopathology in Ireland.

Methods
We used a nationally representative, prospective cohort (Growing Up in Ireland–Infant Cohort). Household poverty included lowest third income decile, subjective poverty and material deprivation when children were aged 9 months, and 3, 5, 9 years. We used group-based multitrajectory cluster modelling to classify trajectories of poverty. Using multivariable logistic regression, adjusted with separate child and mother confounders, we assessed the association of poverty trajectories from 9 months to 9 years with child outcomes (overweight, any longstanding illness and psychopathology) at age 9 years and the same poverty trajectories over the same 9-year period with mother outcomes (overweight, any longstanding illness and depression).

Results
Of 11 134 participants, 4 trajectories were identified: never in poverty (43.1%), material/subjective>monetary poverty (16.1%), monetary>material poverty (25.6%) and persistent poverty (15.2%). Children in persistent poverty compared with those in never in poverty experienced higher odds of being overweight at 9 years (adjusted OR (aOR) 1.70, 95% CI 1.34, 2.16), having a longstanding illness (aOR 1.51, 95% CI 1.20, 1.91), and psychopathology (aOR 2.06, 95% CI 1.42, 2.99). The outcomes for primary parents (99.7% were mothers) were as follows: having higher odds of being overweight (aOR 1.49, 95% CI 1.16, 1.92), having a longstanding illness (aOR 2.13, 95% CI 1.63, 2.79), and depression (aOR 3.54, 95% CI 2.54, 4.94).

Conclusions
Any poverty trajectory was associated with poorer psychopathology and physical well-being in late childhood for children and their mothers in Ireland.