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Biomedical subjects

B J Milne

Publications and source records attributed to B J Milne.

At least 19 recordsLinked to original sources
PubMed2004

Association between C-reactive protein, metabolic cardiovascular risk factors, obesity and oral contraceptive use in young adults.

OBJECTIVE: This study sought to determine the relationship between levels of the inflammatory marker, C-reactive protein (CRP), cardiovascular risk factors and oral contraceptive use in young adults. DESIGN: Cross-sectional study of a community cohort. SUBJECTS: A total of 822 men and women aged 26 y. MEASUREMENTS: CRP, body mass index (BMI), blood pressure, lipid and lipoprotein levels, smoking status, socioeconomic status, health status, and hormonal contraceptive use in women. RESULTS: Multiple regression analysis showed that obesity was independently related to CRP with an increase in ratio CRP of 1.03 (95% CI 1.01, 1.05) for men and 1.07 (1.05, 1.09) for women associated with a 1 kg/m(2) increase in BMI. In women, combined oral contraceptive use was associated with a ratio change in CRP of 1.52 (1.27, 1.82) compared with nonusers. Other independent determinants of CRP in men and women were apolipoprotein B level, systolic blood pressure and apolipoprotein A1 in men. Univariate analysis showed that the relationship between CRP and BMI, systolic blood pressure and apolipoprotein B was significantly stronger in women than men. CONCLUSION: These findings suggest that obesity is associated with inflammation independent of other cardiovascular risk factors that may contribute to an increased risk for cardiovascular disease in men and women. Elevated CRP related to combined oral contraceptive use may influence the rate of cardiovascular events in young women.

Adult↗
PubMed2004

Socioeconomic inequalities in oral health in childhood and adulthood in a birth cohort.

OBJECTIVES: To determine whether adult oral health is predicted by (a) childhood socioeconomic advantage or disadvantage (controlling for childhood oral health), or (b) oral health in childhood (controlling for childhood socioeconomic advantage or disadvantage), and whether oral health in adulthood is affected by changes in socioeconomic status (SES). METHODS: Participants in a longstanding cohort study underwent systematic dental examination for dental caries and tooth loss at ages 5 and 26 years. The examination at age 26 years included the collection of data on periodontal attachment loss and plaque level. Childhood SES was determined using parental occupation, and adult SES was determined from each study member's occupation at age 26 years. Regression models were used to test the study hypotheses. RESULTS: Complete data were available for 789 individuals (47.4% female). After controlling for childhood oral health, those who were of low SES at age 5 years had substantially greater mean DFS and DS scores by age 26 years, were more likely to have lost a tooth in adulthood because of caries, and had greater prevalence and extent of periodontitis. A largely similar pattern was observed (after controlling for childhood SES) among those with greater caries experience at age 5 years. For almost all oral health indicators examined, a clear gradient was observed of greater disease at age 26 years across socioeconomic trajectory groups, in the following order of ascending disease severity and prevalence: 'high-high', 'low-high' (upwardly mobile), 'high-low' (downwardly mobile) and 'low-low'. CONCLUSION: Adult oral health is predicted by not only childhood socioeconomic advantage or disadvantage, but also by oral health in childhood. Changes in socioeconomic advantage or disadvantage are associated with differing levels of oral health in adulthood. The life-course approach appears to be a useful paradigm for understanding oral health disparities.

Adult↗
PubMed2004

Relationship between socioeconomic status and asthma: a longitudinal cohort study.

BACKGROUND: There is conflicting information about the relationship between asthma and socioeconomic status, with different studies reporting no, positive, or inverse associations. Most of these studies have been cross sectional in design and have relied on subjective markers of asthma such as symptoms of wheeze. Many have been unable to control adequately for potential confounding factors. METHODS: We report a prospective cohort study of approximately 1000 individuals born in Dunedin, New Zealand in 1972-3. This sample has been assessed regularly throughout childhood and into adulthood, with detailed information collected on asthma symptoms, lung function, airway responsiveness, and atopy. The prevalence of these in relation to measures of socioeconomic status were analysed with and without controls for potential confounding influences including parental history of asthma, smoking, breast feeding, and birth order using cross sectional time series models. RESULTS: No consistent association was found between childhood or adult socioeconomic status and asthma prevalence, lung function, or airway responsiveness at any age. Having asthma made no difference to educational attainment or socioeconomic status by age 26. There were trends to increased atopy in children from higher socioeconomic status families consistent with previous reports. CONCLUSIONS: Socioeconomic status in childhood had no significant impact on the prevalence of asthma in this New Zealand born cohort. Generalisation of these results to other societies should be done with caution, but our results suggest that the previously reported associations may be due to confounding.

Adolescent↗
PubMed2001

Persistence and perceived consequences of cannabis use and dependence among young adults: implications for policy.

AIMS: To document patterns of cannabis use and dependence from late-adolescence through to the mid-twenties; to describe perceived consequences of cannabis use among young people; and to consider policy implications of these findings. METHODS: This was a longitudinal study of the Dunedin Multidisciplinary Health and Development Study birth cohort with repeated measures of cannabis use at ages 18, 21 and 26 years. RESULTS: Twelve month prevalence rates of cannabis use (just over 50%) and dependence (just under 10%) remained stable between age 21 and 26 years, contrary to an expected decline. Cannabis dependence, as distinct from occasional use, was associated with high rates of harder drug use, selling of drugs and drug conviction. Cumulatively, almost 3/4 of our cohort had tried cannabis by age 26. Young people thought the risk of getting caught using cannabis was trivial, and that using cannabis had few negative social consequences. CONCLUSIONS: The persistent high rates of cannabis use and dependence among young New Zealand adults raises important issues for policy makers. Current laws are not particularly effective in deterring use. Whereas occasional use does not appear to present a serious problem, cannabis dependence among users is a serious public health issue that warrants immediate action.

Adolescent↗
PubMed2001

Brain drain or OE? Characteristics of young New Zealanders who leave.

AIMS: To characterise the emigration patterns of young New Zealanders. METHODS: The 980 members of the Dunedin Multidisciplinary Health and Development Study participating in the "age-26" (1998-1999) assessment provided information about emigration behaviour, qualifications, aspects of physical and mental health and personality. RESULTS: 26% of the sample had moved overseas to live between the ages of 18 and 26, with the United Kingdom and Australia being the most common destinations. Compared to non-emigrants, emigrants had higher IQ scores, were better qualified, leaner and fitter, and had happier and less stress-prone personalities. Based on their planned return date, 63% of emigrants were considered to be on their OE overseas experience (OE, return in <5 years), 18% were defined as brain-drain emigrants (return in >5 years or never) and 18% were uncertain about their return. Brain-drain emigrants were more likely than OE emigrants to leave for better work opportunities, and they were also more likely to go to Australia. However, there were no differences in terms of qualifications, intelligence and personality between OE and brain-drain emigrants. CONCLUSIONS: Most young New Zealanders in this cohort who left for overseas were embarking on their OE. Brain-drain emigrants make up a sizeable minority of emigrants, but appear to possess no more skills than those who plan or choose to return.

Adolescent↗
PubMed2001

A longitudinal study of the etiology of separation anxiety.

A longitudinal examination of the relation between separation experiences and the development of separation anxiety at age 3, 11 and 18 years was conducted. Three associative pathways were assessed. Conditioning events were not related to separation anxiety at age 3. Vicarious learning (modelling) in middle childhood (age 9 years) was the conditioning variable most strongly related to separation anxiety at age 11, accounting for 1.8% of the variance in symptoms. Separation experiences (hospitalisations) before the age of 9 were inversely correlated with separation anxiety at age 18. That is, more overnight hospital stays in childhood were related to less separation anxiety in late adolescence. However, none of these conditioning correlates remained significant predictors of separation anxiety in adjusted regression models. In contrast, certain "planned" separations in early-mid childhood were associated with lower levels of separation anxiety at later ages. Generally, the findings were consistent with predictions from the non-associative theory of fear acquisition. That vicarious learning processes appeared to modulate, albeit to a minor degree, the expression of separation anxiety during mid-late childhood suggests that there may be critical periods during which some individuals are susceptible to the interactive effects of both associative and non-associative processes. These findings serve to illustrate the complexity of fear acquisition, the relevance of developmental factors and the likely interplay between associative and non-associative processes in the etiology of fear and anxiety.

Adolescent↗
PubMed2000

Users of unconventional practitioners: a profile of 26 year old New Zealanders.

AIMS: To profile 26 year old New Zealand users of unconventional practitioners. METHODS: 977 members of the Dunedin Multidisciplinary Health and Development Study participating in the age-26 assessment (1998-1999) answered questions about twelve-month service use, education, income, recent medical history, current health status and avoidance of medical situations. RESULTS: 10% had used an unconventional practitioner in the previous twelve months. The majority (88%) had also used a conventional practitioner. Those using both types of practitioner were heavy users of health services (twelve visits/year). Compared to those who used conventional practitioners exclusively, they had significantly higher incomes and were more likely to report a serious injury, a current disability, a history of back problems, role limitations due to physical health problems, and more bodily pain (all p < 0.01). CONCLUSIONS: 26 year old New Zealand users of unconventional practitioners have a similar profile to their counterparts in other developed countries. It appears that their health needs are not fully met by conventional services, emphasising the need for more research into the aetiology and treatment of ailments (e.g. back pain) for which unconventional practitioners are commonly sought. The Medical Council of New Zealand guidelines on unconventional medicine are discussed in light of these findings.

Adult↗
PubMed1996

Cometabolic degradation of 4-chlorophenol by Alcaligenes eutrophus.

Alcaligenes eutrophus was grown in batch cultures using either phenol as a sole substrate or mixtures of phenol and 4-chlorophenol. Phenol was found to be the sole source for carbon and energy while 4-chlorophenol was utilized only as a cometabolite. Maximum growth rates on phenol reached only 0.26 h-1, significantly below the growth rates reported earlier with Pseudomonas putida. The cometabolite was found to decrease biomass yield and increase lag time before logarithmic growth occurred. Both phenol and 4-chlorophenol were found to inhibit the growth rate linearly with maximum concentrations of 1080 ppm and 69 ppm respectively, beyond which no growth occurred. The best-fit parameters are incorporated into a simple, dynamic (i.e. time-varying) model capable of predicting all the batch growth conditions presented here. It is shown that P. putida is capable of faster bioremediation when phenol is the sole carbon source or for mixed substrates with low concentrations of the cometabolite, but for high concentrations of 4-chlorophenol, A. eutrophus becomes superior because of the long lag times that occur in the Pseudomonas species.

Alcaligenes↗
PubMed1988

Post-tubal sterilization problems correlated with ovarian steroidogenesis.

Mid-luteal phase total urinary oestrogen excretion was found to be significantly reduced in women who had previously undergone tubal sterilization at least two years before assay; pregnanediol levels at or below 2.0 mg/24 hrs were significantly more frequent for the study group. These findings indicate that reduced ovarian function is associated with that procedure. The major problems declared as having been experienced subsequent to tubal sterilization were classified into three categories; some women declared problems in more than one category: (1) Abnormal uterine bleeding and/or menorrhagia, (2) Physical problems, (3) Psychological and/or psychiatric problems. Category 1 was associated with a significant fall in total oestrogen excretion, and category 2 with a significant fall in both total oestrogen and pregnanediol excretion. Analysis of category 3 will be published elsewhere. A negative correlation between total oestrogens and cholesterol was observed.

Adult↗
PubMed1986

A model to show human uterine receptivity and embryo viability following ovarian stimulation for in vitro fertilization.

A comparison of the implantation rates following in vitro fertilization (IVF) and embryo transfer (ET) for four major groups indicates differences in the implantation rates as well as in the incidence of multiple implantation. By assuming that the probability of implantation is the product of two variables, uterine receptivity (U) and embryo viability (E), estimates for U and E are derived for each of the four IVF groups using maximum likelihood methods. The UE model is tested using chi-squared goodness-of-fit methods for predicted implantation rates versus observed. The possibility that differences in U values between groups are due to different ovarian stimulation protocols is discussed, as is the value of the UE model in highlighting differences between IVF groups and its importance in predicting multiple pregnancy rates.

Embryo Implantation↗
PubMed1985

Alterations in health perception and lifestyle in treated hypertensives.

The effect of being treated for hypertension on health perception and life-style and the duration of any alterations after first diagnosis were assessed by administering a standardized interview schedule to employed treated hypertensive men and women, aged 40-64 years, who were either newly diagnosed (ND) (within 6 months of the interview) or previously diagnosed (PD) (1-3 years before the interview) and who were otherwise healthy. In both groups of 50 hypertensives, indices of health status and ability to participate in enjoyable activities were significantly lower while symptom score and index of worry about health were significantly higher compared with a group of 50 age and sex-matched normotensive controls (C) (p less than 0.001). The hypertensive groups did not differ from each other. Both hypertensive groups reported significant reductions in the time spent at work (p less than 0.005). Self-reported weight loss in the 2 months preceding the interview was significantly greater in ND hypertensives compared with PD and C individuals (p less than 0.01). Our data indicate that the diagnosis and treatment of hypertension had a significant and sustained negative impact on health perception and activities of daily living even among actively employed, relatively healthy, medicated hypertensives for whom there were no medical indications to restrict their life-style.

Absenteeism↗
PubMed1984

Influence of tumour differentiation on survival after resection for rectal cancer in a series of 1296 patients.

The influence of differentiation grade on tumour staging, local recurrence and long term survival prospects has been evaluated in a series of patients managed by resection for rectal cancer. Differentiation was known in 1095 of 1296 patients. Well-differentiated tumours were over-represented among Dukes' stage A cases and poorly differentiated among those with disseminated disease (P less than 0.001). Local recurrence was twice as common (31%) after curative resection of poorly differentiated tumours than of well (14%) or moderately (17%) differentiated. Five year cancer specific survival rates after resection (curative and palliative combined) of tumours of good, average or poor differentiation were 68%, 59% and 33%, respectively. After potentially curative resection, survival was also significantly worse in patients with poorly differentiated tumours (P less than 0.001); 5 year survival rates of patients with tumours of good, average or poor differentiation were 75%, 71% and 51%, respectively. Survival prospects beyond 5 years in patients with Dukes' stage A tumours were significantly reduced when the tumour was poorly differentiated; 5 and 10 year survival rates were 76% and 40%, respectively. However, patients with Dukes' stage C tumours of poor differentiation had an identical 5 and 10 year cancer specific survival, 26%. Patients with mucoid type tumours had worse survival prospects than those with non-mucoid type (P less than 0.02).

Adenocarcinoma↗
PubMed1983

The risk of rectal carcinoma following colectomy in ulcerative colitis.

In a series of 1439 patients with ulcerative colitis, managed by one of the authors (E.S.R.H.), surgical resection was performed on 374 patients (26 per cent): colectomy, 273 (subtotal colectomy and mucous fistula, 172, colectomy and primary ileorectal anastomosis, 101); proctocolectomy, 61; and miscellaneous procedures, 40. Of the 172 patients undergoing subtotal colectomy and mucous fistula, 93 (54 per cent) subsequently required rectal excision, 33 (19 per cent) had ileorectal anastomosis performed as a second procedure, and in 46 (27 per cent) the rectum has remained as a mucous fistula. Two hundred seventy-three patients were at risk for the development of rectal cancer after subtotal colectomy; ten patients (3.6 per cent) subsequently developed rectal cancer. The cumulative probability of developing rectal cancer after subtotal colectomy reached 17 per cent at 27 years from disease onset. The tumors were more advanced in stage and of higher grade malignancy than those of a parallel general series of patients with rectal cancer uncomplicated by inflammatory bowel disease. Colectomy and ileorectal anastomosis has been successful for most patients. However, the experience of this series highlights the danger of carcinomatous transformation in the retained rectum, the requirement for regular long-term follow-up, the need for markers of precancerous change, and the value, where relevant, of prophylactic proctectomy.

Adolescent↗
PubMed1983

The effect of patient 'familiarity' with blood pressure assessment on the accuracy of follow-up readings.

The fall in blood pressure that is commonly observed when groups of hypertensive individuals are followed without treatment is usually ascribed to two sources: regression towards the mean and increasing familiarity of the subject with the assessment process. Any effect of the latter process could bias the results of controlled studies in which one group is more frequently assessed than the other, a common situation in community trials. To assess the effect of familiarity, we randomly allocated 116 untreated, mildly hypertensive subjects to three-monthly or yearly assessments. At an independent, blind, year end assessment, both groups showed statistically significant reductions in diastolic blood pressure (P less than 0.001) of 8.4 +/- 1.2 (s.e.m.) and 7.6 +/- 1.6 mmHg respectively, but the difference between the groups was not significant (P = 0.682). We conclude that 'familiarity' does not play an important role in the reduction of blood pressure in long-term follow-up studies of hypertensive subjects.

Adult↗
PubMed1982

Influence of semen and donor factors on the success rate of artificial insemination with frozen semen.

Influence of some semen and donor factors on the success rate of artificial insemination by frozen donor semen (AID) was examined. The percentage of insemination cycles resulting in pregnancy was significantly higher for women who became pregnant within six cycles (33%) when compared with all the women in the AID programme (14%). Therefore the influence of semen and donor characteristics on the fertilizing capacity of frozen semen was studied in women who became pregnant within the first six cycles of insemination in order to minimize any influence of non-semen effects such as recipient and insemination factors. Donors less than 20 years of age appear to have a better chance of obtaining a pregnancy. Semen stored for less than six months in liquid nitrogen had a similar proportion of insemination cycles resulting in pregnancy compared with semen stored for longer than six months. Conventional semen values were not correlated with fertility, and none of these values could be used accurately to predict the fertilizing capacity of frozen semen.

Female↗