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Biomedical subjects

M E Wadsworth

Publications and source records attributed to M E Wadsworth.

At least 37 records · Page 2Linked to original sources
PubMed1993

Physical health status at 36 years in a British national birth cohort.

In a nationally representative British sample of over 3000 men and women aged 36 years, those in the best or worst of health were identified on the basis of measured blood pressure, lung function and body weight, self reported health problems and disability, and recent hospital admission. Serious illness in earlier life was strongly predictive of current adult health status. Even after adjusting for this and for current social circumstances and health related behaviour, those who came from poorer family backgrounds or were least well educated did not have an equal chance of being in the best of health at 36 years. Living in adverse social circumstances in adult life increased the risk of having the worst health. The analysis suggests that a number of pathways link childhood experiences to adult health and shows the need for a lifetime research perspective on health.

Adult↗
PubMed1993

Generation differences in hospital inpatient care of children aged 1 to 5 years.

STUDY OBJECTIVE: To describe differences in childhood hospital admissions at ages 1 to 5 years in two generations, and to compare the intergenerational differences in risks of admission. DESIGN: Information was taken from a longitudinal birth cohort study of a national sample and their firstborn offspring. SETTING: England, Wales, and Scotland. SUBJECTS: the 5022 birth cohort members for whom information is available from ages 1 to 5 years and their 2205 firstborn offspring. MEASUREMENTS AND MAIN RESULTS: Data comprised reports of hospital admissions, which were checked with hospitals. Mean numbers of days spent in hospital were fewer in the offspring generation than in their parents, but the proportion ever admitted fell by only 1%. Low birth weight babies (< 2500 g), who comprised 6% of cohort births and 7% of the following generation, used a high proportion of all inpatient time in the offspring population, rising from 3% to 14% of all days of admission. CONCLUSIONS: Compared with the early years of the NHS, published statistics show that the effectiveness of paediatric care has improved greatly, and that childhood mortality and the risk of serious illness have decreased significantly. This study reports intergenerational changes in the reasons for hospital admission and shows, with the benefit of good denominator data, that although there was only a small intergenerational decrease in the proportion of children treated in hospital, there was a large reduction in the time spent in hospital and an increase in admissions of children of low birth weight.

Child Health Services↗
PubMed1992

Accumulation of factors influencing respiratory illness in members of a national birth cohort and their offspring.

STUDY OBJECTIVE: The aim was to investigate predictors of childhood lower respiratory tract illness in two generations, and predictors of adult lower respiratory disorders in the first generation. DESIGN: Data on respiratory health and environmental factors from a national birth cohort study were examined from birth to 36 years. Data were also collected on the parents of the subjects and on the subjects' first born offspring from birth to eight years. Main outcome measures were: reports of lower respiratory tract illness before 2 years; lower respiratory tract illness of a week or more between age 20 and 36 years; regular phlegm production at 25 and 36 years; reports of wheeze or asthma at age 36 years; peak expiratory flow rate (PEFR) at age 36 years measured by nurses during home visits; and mothers' reports of lower respiratory illness in first born offspring before 2 years. SUBJECTS: Subjects were a sample of 5362 single, legitimate births taken from all those occurring in England, Wales, and Scotland in one week in 1946, and studied regularly from birth to age 43 years. Data on the subjects' parents and on their 1676 first offspring born while they were aged 19-25 years were also collected. MAIN RESULTS: Lower respiratory tract illness before 2 years fell from 25% in the population born in 1946 to 13% in their first born offspring. In those born in 1946, poor home environment, parental bronchitis, and atmospheric pollution were the best predictors of lower respiratory illness before 2 years, and these three factors and childhood lower respiratory illness and later smoking were the best predictors of adult lower respiratory tract problems. Risk factors for lower respiratory illness in the offspring were manual social class, parental and grandparental lower respiratory disease, and parental smoking. CONCLUSIONS: Risks for adult lower respiratory problems accumulated in childhood through illness, poor social circumstances, and atmospheric pollution. Smoking exacerbated early life risks and was an independent risk factor. In the offspring generation, parental smoking was a risk factor for early life chest illness, together with parental illness and low social class. Reduction of prevalence in the offspring generation was probably accounted for by improvement in home circumstances, reduced atmospheric pollution, and lower rates of parental lower respiratory illness, but current rates of smoking seem likely to prevent much further reduction in early life lower respiratory illness, and thus in this aspect of risk for subsequent adult lower respiratory problems. The accumulation of risk in childhood and adolescence for later adult problems implies a long time scale for the reduction of adult lower respiratory disorders.

Adult↗
PubMed1992

Loss and representativeness in a 43 year follow up of a national birth cohort.

STUDY OBJECTIVE: The aim was to describe rates of loss and assessment of representativeness during 43 years of a national birth cohort study. DESIGN: The study population is a class stratified random sample of all single, legitimate births that occurred during one single week in 1946; it has been studied at regular intervals, so far to 1989. MAIN RESULTS: Losses through death and emigration were comparable to those in the national population of the same age. Response rates from the population resident in Britain have remained high, and the responding population is in most respects representative of the native population born in the early postwar years. Response rates within some serious physical illnesses did not differ from those of the healthy population. CONCLUSIONS: The continuing high response rate and representativeness of this national birth cohort is likely to be the result of home based data collections and of the regular contact to provide feedback of information and to check addresses of the study population.

Cohort Studies↗
PubMed1989

Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease.

In national samples of 9921 10 year olds and 3259 adults in Britain systolic blood pressure was inversely related to birth weight. The association was independent of gestational age and may therefore be attributed to reduced fetal growth. This suggests that the intrauterine environment influences blood pressure during adult life. It is further evidence that the geographical differences in average blood pressure and mortality from cardiovascular disease in Britain partly reflect past differences in the intrauterine environment. Within England and Wales 10 year olds living in areas with high cardiovascular mortality were shorter and had higher resting pulse rates than those living in other areas. Their mothers were also shorter and had higher diastolic blood pressures. This suggests that there are persisting geographical differences in the childhood environment that predispose to differences in cardiovascular mortality.

Adult↗
PubMed1989

Chronic physical illness in childhood: psychological and social effects in adolescence and adult life.

A national birth cohort followed for 36 years was used to compare the life chances of individuals with chronic physical illness in childhood with those of controls. The majority of those who had been chronically physically ill in childhood were found to differ very little in social and psychological circumstances by 36 years of age, but earlier in adult life there had been signs of difficulties. However, there was a disturbing tendency for those from lower social-group families to be in significantly worse social and psychological circumstances, and by 36 years they showed signs of relatively poor life chances and of basic social support, including the death of both parents.

Activities of Daily Living↗
PubMed1989

Longterm follow-up studies; a critical overview.

The need for follow-up studies is growing as ideas about causes of chronic physical and mental illness suggest increasingly that they develop over long periods of the sufferer's life time. Follow-up studies are also necessary for collecting reliable information on the physical processes of aging and of cognitive change, in the assessment of efficacy of long-term treatments and care and in studies of quality of life in those with long-term illness. This paper illustrates the range of study designs, discusses their strengths and weaknesses and describes ways which may sometimes be used to avoid long periods of prospective data collection.

Child↗
PubMed1988

Acute appendicitis and bathrooms in three samples of British children.

The occurrence of appendicectomy in three national samples of British children was analysed in relation to household amenities, crowding in the home, and social class. The risk of having the operation depended on the amenities present in the home, in particular whether or not there was a bathroom. This risk was independent of social class. The findings support a relation between acute appendicitis and Western hygiene, which would explain the geographical distribution of the disease and its changing incidence over time. In the developing world, where children grow up in conditions of poor hygiene, there may be outbreaks of appendicitis when housing improves.

Acute Disease↗
PubMed1988

Social and regional differences in food and alcohol consumption and their measurement in a national birth cohort.

The problem of collecting detailed dietary information on a large population scattered throughout England, Wales and Scotland was resolved by use of a 7 day dietary diary, introduced at home interviews. Information on food types and quantities was coded to provide data on a wide range of nutrients. Reported levels of iron and fibre intake were found to be particularly low in relation to current recommended daily intakes, which were more often achieved by men than by women. Best dietary habits were associated with good educational attainment, whatever the social class of origin, but in women this was in some circumstances associated also with relatively high intakes of alcohol, protein and fats. Worst dietary habits were associated with low social class of family of origin and low educational attainment. Mean intakes of some nutrients varied significantly by region, in most cases independently of class and education. The implications of these findings are discussed.

Adult↗
PubMed1987

Follow-up of the first national birth cohort: findings from the Medical Research Council National Survey of Health and Development.

The medical work of a 40 year birth cohort study is described in order to show the continuing associations of childhood factors with later life health, behaviour, illness and survival. Comparisons with the health of children born at later times show the importance of a sensitive monitoring of changes in child health. A summary of work on social and psychological topics is also given, together with a complete list of publications from the study.

Cohort Studies↗
PubMed1986

Onset of obesity in a 36 year birth cohort study.

A large national cohort of children studied from birth to 36 years was used to test the predictive value of childhood obesity for obesity in adult life. Only 21% (39) of obese 36 year olds had been obese at age 11 years, and even when associated social factors were taken into account the correctly predicted percentage was much lower than the prediction rate achieved using body mass data from age 26 years. The comparatively poor predictive value of childhood obesity and the association of adult obesity with educational achievements and socioeconomic circumstances of family of origin emphasise the need for encouraging good nutritional and exercise habits rather than placing undue emphasis on the control of childhood obesity.

Adult↗
PubMed1985

Blood pressure in a national birth cohort at the age of 36 related to social and familial factors, smoking, and body mass.

Blood pressure was measured in a birth cohort of 5362 subjects at the age of 36. The prevalence of hypertension in men (blood pressure greater than 140/90 mm Hg) was almost twice that in women, although women received treatment more often. Deaths of fathers of subjects from hypertensive and ischaemic heart disease were associated with significantly higher mean systolic and diastolic pressures in both sexes. Cigarette smoking was not strongly associated with blood pressure in men and not associated at all in women. Of the social factors, low social class of family of origin was associated with high blood pressure in both sexes; but the strongest association was with current body mass, and birth weight also contributed. Differences in blood pressures between the sexes may have been related to protective biological factors, such as endogenous sex hormones, in women and also to differences in types of employment, smoking habits, and body mass. Differences in blood pressures related to the social class of family of origin may reflect long term influences of class differences on diet, exercise, and educational achievement. The importance of measuring secular trends in obesity and blood pressures is emphasised.

Adult↗
PubMed1984

Apparent doubling of frequency of undescended testis in England and Wales in 1962-81.

Examination of Hospital Inpatient Enquiry data for England and Wales for the years 1962-81 shows that the annual number of discharges with a diagnosis of undescended testicle has risen by a factor of 2.3. Cohort analysis suggests that the cumulative rate to age 15 of discharge for undescended testis has risen from 1.4% for the 1952 birth-cohort to 2.9% for the 1977 birth-cohort. Whether this is a reflection of an increase in true cryptorchidism is not known. Changes in known risk factors for cryptorchidism--exogenous oestrogen exposure, being first-born, and low birth-weight--cannot fully account for the apparent increase. With the tendency to carry out orchidopexies on apparently undescended testes at younger ages in order to preserve fertility, it is possible that a considerable number of boys with retractile testes that would have descended naturally at puberty are now being operated upon.

Adolescent↗
PubMed1984

Stigma in patients with early epilepsy: a national longitudinal study.

Forty six cases of epilepsy were identified from the National Survey of Health and Development. An index of social visibility at school was constructed from teachers' reports of survey members' behaviour at 15 years of age. For the sample as a whole this index was significantly associated with poorer educational outcomes, after adjusting for social background and measured attainment, but was not associated with poor occupational achievement. However the index did not differentiate between epileptic and non-epileptic children. Although cases with epilepsy were shown to be more at risk of psychiatric disturbance, it is concluded that their lives were less disrupted than might have been expected, and that there is no evidence from this study that stigma affects the lives of those whose epilepsy was not complicated by other pathologies.

Adolescent↗