Biomedical subjects

D M Fergusson

Publications and source records attributed to D M Fergusson.

At least 127 records · Page 7Linked to original sources

PubMed1989

Medical insurance and childhood general practitioner contacts.

The relationships between the duration of medical insurance coverage and rates of general practitioner consultations for morbidity were examined for a birth cohort of children studied to ten years. This showed that children from insured families had higher consultation rates even when due allowance was made for known social and economic factors correlated with the ownership of insurance. During the period from birth to five years children who were insured throughout the period made a mean of 19.16 consultations compared to 15.38 for the uninsured (p less than 0.001); during the period from five to ten years the insured made 13.07 contacts compared to 9.38 for the uninsured (p less than 0.001). The net effects of these trends were that children whose families had been insured throughout the ten year study period made a mean of nine more general practitioner consultations by the age of ten years than children from uninsured families. It is concluded that the presence of private medical insurance encourages the development of inequalities in childhood access to health care with children from insured families having greater access to care than children from uninsured families.

Child↗

PubMed1989

Patient perceptions of general practitioner fees.

General practitioner fees were surveyed in a sample of 1033 families with eleven year old children. The median fee paid for a child consultation was $12.00 and for an adult consultation $22.00. The majority of respondents were of the opinion that these fees were too high: over half said this about child fees and over two thirds believed adult fees were too high. Patient estimates of reasonable fees were, on average, $8.00 for a child and $15.00 for an adult. There were clear and consistent dose/response relationships between the fee level charged and the likelihood that the fee would be described as too high. Comparisons of the fees paid by this cohort in 1980 with fees in 1988 indicated that child fees had increased at an average rate of 24% per annum during this period. The implications of these findings for health care delivery are discussed and the possible impact of recent increases in GMS benefits on levels of dissatisfaction with fees are examined.

Adult↗

PubMed1989

The relationships between neuroticism and depressive symptoms.

A structural equation model designed to estimate the reciprocal associations which may exist between mental state and personality trait variables is presented. This model is applied to measures of neuroticism and depression obtained for a sample of over 1000 women studied over a two year period. The fitted model suggests that while measures of neuroticism are contaminated by the effects of short term mental state on the reporting of personality, there is still a fairly substantial relationship between trait neuroticism (corrected for the effects of mental state contamination) and reports of depressive symptoms.

Depression↗

PubMed1989

The Christchurch Child Development Study: a review of epidemiological findings.

The Christchurch Child Development Study is a longitudinal study of a birth cohort of 1265 New Zealand children who have been studied over an 11-year period using data from multiple sources including parental interview, medical records, teacher questionnaires and direct testing of children. The article provides a review of the major lines of epidemiological research examined in the Study. These include: breast feeding and child health; parental smoking and child health; the effects of low level lead exposure; childhood asthma; nocturnal bladder control; the effects of early hospital admission; the distribution of child health services; and the consequences of private medical insurance. In addition a number of general topics (sample attrition, measurement error, individual differences and causal inference) relating to longitudinal designs are discussed briefly. It is concluded that the longitudinal design is a powerful and cost-effective method of gathering data for general paediatric epidemiological purposes but that research in this area would benefit from an increased use of emerging methods of statistical modelling.

Child↗

PubMed1989

Morbidity from 5 to 10 years.

The prevalence and incidence of illness was examined in a birth cohort of Christchurch children studied during the age range of 5-10 years. At this age, children had an average of 12 consultations with family doctors; 26% were admitted to hospital and 53% made one or more attendances at hospital outpatient departments. The majority of general practitioner contacts involved five groups of conditions: respiratory illness; integumental lesion; accidents; gastrointestinal conditions; and hearing problems. Hospital admissions were dominated by five types of admission: respiratory illness; accidents; gastrointestinal conditions; genito-urinary problems; musculoskeletal problems. More than two-thirds of outpatient attendances were accounted for by accidents, respiratory illness, musculoskeletal problems, vision problems, and hearing problems. Trends in rates of medical consultation for accidents and respiratory illness during the period from birth to 10 years are described and the implications of the findings are discussed.

Child↗

PubMed1989

Ketotifen in asthma.

Sixty children aged 5-13 years with moderately severe asthma took part in a double-blind, placebo-controlled trial of ketotifen. The design incorporated a 22 week study period, the addition of ketotifen or placebo to the current medication, and a controlled withdrawal of the regular therapy. Children receiving ketotifen showed significantly lower mean numbers of asthma attacks and less absence from school. The addition of ketotifen to existing treatment was associated with marginally significant changes in rates of day and night wheezing. In the second phase of study, additional therapy was withdrawn from both the ketotifen and placebo groups which resulted in a high (percentage) withdrawal. Children receiving ketotifen did not have a significantly lower failure rate than those given placebo.

Asthma↗

PubMed1989

Estimation of method and trait variance in ratings of conduct disorder.

A structural equation model designed to estimate the contributions of trait, method and error variance to maternal and teacher and child ratings of conduct disorder is presented. This model was fitted to data collected on a birth cohort of New Zealand children studied over a 3 yr period. On the basis of the fitted model it was estimated that between 28% and 40% of the variance in maternal and teacher ratings was ascribable to variations in the child's generalized behavioural tendencies and the remaining variance to either method-specific factors or random errors of measurement. The implications of these results are discussed.

Child↗

PubMed1989

A latent class model of smoking experimentation in children.

A latent class model to estimate the accuracy of reports of child smoking behaviour is presented. This model was fitted to data for a sample of 810 9-yr-old New Zealand children. The model suggested that errors of measurement in reports of child smoking largely arose from false negative responses in which children who had smoked described themselves as not smoking: false negative rates were in the region of 40%. The consequences of the high false negative rates are shown to lead to an underestimation of the prevalence of smoking experimentation and of the strength of association between maternal and child smoking.

Child↗

PubMed1988

Single dose gentamicin treatment of urinary infections in children.

Sixty-nine children with urinary tract infections were randomly allocated to single dose gentamicin therapy (n = 39) or a seven day course of an appropriate antibiotic (n = 30). During the following six weeks the response to treatments did not differ and this was not altered by the child's clinical diagnosis, past history of infection or presence of radiological abnormalities. The poorest response was in those children with a history of recurrent infections (p less than 0.01) and/or radiological abnormality (p less than 0.02). Single dose therapy had significantly less suppression upon rectal (p less than 0.001) and periurethral (p less than 0.02) flora. There was a tendency for those not cured by single dose treatment to relapse whereas those treated by conventional therapy tended to be reinfected.

Acute Disease↗

PubMed1988

A longitudinal study of dentine lead levels, intelligence, school performance and behaviour. Part I. Dentine lead levels and exposure to environmental risk factors.

Dentine lead levels were obtained for a sample of 996 children who were participants in a longitudinal study of child development. Mean dentine lead levels were just over 6 micrograms g-1 and had a log normal distribution. The relationship between dentine lead values and a number of variables (social background, residence in old weatherboard housing, residence on busy roads, pica) describing exposure to sources of lead was analysed. This showed that all factors made small but statistically significant contributions to variations in dentine lead values and that collectively these factors explained 10% of the variance in lead values. The implications of these results are discussed.

Achievement↗

PubMed1988

A longitudinal study of dentine lead levels, intelligence, school performance and behaviour. Part II. Dentine lead and cognitive ability.

The relationship between dentine lead levels and measures of cognitive ability was examined for a birth cohort of New Zealand children studied until the age of 9. There were small, consistent and stable correlations between dentine lead measures and all measures of cognitive ability including intelligence, word recognition and teacher ratings of school performance. After adjustment for the effects of confounding covariates, sample selection factors and possible reverse causal effects, the correlations between intelligence and dentine lead levels became non-significant. However, small but statistically significant correlations persisted between dentine lead values and all measures of school performance after adjustment for sources of confounding. It is concluded that the weight of the evidence from this analysis favours the hypothesis that low level lead exposure may have deleterious effects on levels of achievement in children.

Achievement↗

PubMed1988

A longitudinal study of dentine lead levels, intelligence, school performance and behaviour. Part III. Dentine lead levels and attention/activity.

The relationship between dentine lead levels and maternal/teacher ratings of inattentive/restless behaviour in children was examined for a birth cohort of New Zealand children. There were small but relatively consistent and stable correlations between dentine lead values and behaviour ratings. After correction for errors of measurement in dentine lead values and behaviour ratings it was estimated that the correlation between lead levels and inattentive/restless behaviour was in the region of +0.18. However, after control for various sources of confounding there was only a small, but statistically significant, correlation of +0.08 between lead levels and inattention/restless in children. It is concluded that the weight of the evidence favours the view that there is a very weak causal association between lead levels and attention and activity levels in children.

Achievement↗

PubMed1988

Neonatal circumcision and penile problems: an 8-year longitudinal study.

The prevalence of penile problems was examined in a birth cohort of more than 500 New Zealand children studied from birth to 8 years of age. By 8 years, circumcised children had a rate of 11.1 problems per 100 children, and uncircumcised children had a rate of 18.8 per 100. The majority of these problems were for penile inflammation including balanitis, meatitis, and inflammation of the prepuce. However, the relationship between risks of penile problems and circumcision status varied with the child's age. During infancy, circumcised children had a significantly higher risk of problems than uncircumcised children, but after infancy the rate of penile problems was significantly higher among the uncircumcised. These associations were not changed when the results were adjusted statistically for the effects of a series of potentially confounding social and perinatal factors.

Balanitis↗

PubMed1987

Vulnerability to life events exposure.

A theoretical model designed to assess the contribution of systematic factors contributing to vulnerability to life-events exposure is described. This model is applied to six-year longitudinal data on life events exposure for a sample of New Zealand women with school-aged children. The fitted model suggests that in the region of 30% of the variance in life-event reports over the six-year period was attributable to a common vulnerability factor. Modelling of this vulnerability factor suggested that two major determinants of vulnerability to life events were the level of social disadvantage of the woman and her level of neuroticism: women of socially disadvantaged backgrounds and women with high neuroticism scores showed a consistent tendency to report high life-event exposure during the six-year period. The implications of these findings are discussed.

Adaptation, Psychological↗

PubMed1987

The trait and method components of ratings of conduct disorder--Part I. Maternal and teacher evaluations of conduct disorder in young children.

A theoretical model designed to estimate the trait and method specific components of maternal and teacher ratings of childhood conduct disorder is presented. The model was applied to data collected on a birth cohort of New Zealand children. The model produced evidence to indicate that maternal and teacher ratings of childhood behaviour were contaminated by method variance. It was estimated that one-third of the variance in these scores reflected variance attributable to child behaviour traits. When the data were adjusted for the effects of method specific factors, the model suggested that conduct disorder measures were highly stable over time.

Child↗

PubMed1987

The trait and method components of ratings of conduct disorder--Part II. Factors related to the trait component of conduct disorder scores.

A theoretical model designed to estimate the associations of variables of interest with the trait component of maternal and teacher ratings of conduct disorder is outlined. This model was applied to data collected in a birth cohort of New Zealand children. The analysis showed marked differences between the correlations for various measures and observed conduct disorder scores and the corresponding correlations with the estimated trait components of these scores. In some cases correlations increased as a result of correction for measurement error whereas in other cases correlations declined as a result of correction for the effects of method factors.

Child↗

PubMed1987

Breastfeeding and subsequent social adjustment in six- to eight-year-old children.

The relationship between breastfeeding practices and measures of conduct disorder was examined, prospectively, in a birth cohort of New Zealand children studied up to the age of eight years. While there were significant associations between the duration of breastfeeding and maternal and teacher ratings of conduct disorder obtained at six, seven and eight years, these correlations appeared largely spurious arising from the effects of errors of measurement and confounding factors which were correlated with both breastfeeding and conduct disorder measures. When errors of measurement and confounding factors were accounted for the correlations between breastfeeding and measures of conduct disorder tended to become both small and statistically non-significant. The study provides no evidence to suggest that breastfeeding makes a major contribution to the subsequent social adjustment of children.

Breast Feeding↗

PubMed1986

Exposure to fluoridated public water supplies and child health and behaviour.

The relationship between duration of exposure to fluoridated public water supplies and measures of child health and behaviour was studied for a birth cohort of Christchurch children. This study showed no association between exposure to fluoridated water and a large range of measures of child health and behaviour taken during the period from birth to seven years, even when the possible effects of family social background were taken into account statistically.

Behavior↗