Women's health in midlife: the influence of the menopause, social factors and health in earlier life.

Objective: To describe the health symptoms of a large representative sample of British women at age 47 years, and to examine the influence of the menopause allowing for social factors and health in earlier adult life.

Design: A national prospective birth cohort study. Information on health problems, menstrual cycle, use of hormone replacement therapy and life stress at 47 years was collected using a postal questionnaire.

Developmental precursors of affective illness in a general population birth cohort.

Background: Recent evidence suggests that neurodevelopmental impairment may be a risk factor for later affective disorder.

Methods: Associations between childhood developmental characteristics and affective disorder were examined in a prospectively studied national British birth cohort of 5362 individuals born between March 3 and March 9, 1946. Mental state examinations by trained interviewers performed at ages 36 and 43 years identified 270 case subjects with adult affective disorder (AD).

Characteristics of the low-energy reporters in a longitudinal national dietary survey.

The aim of the present study was to establish whether the characteristics of members of a large national birth cohort study who submitted diet diaries with implausibly low-energy intake differed from those whose recorded energy intake was more plausible. Survey members (n 1898) recorded their diets in a 7 d diary in household measures. Those whose reported energy intake (EI) as a fraction of their estimated BMR was less than 1.

Health inequalities in the life course perspective.

Life history approaches to the study of inequalities in health provide evidence that the biological and the social beginnings of life carry important aspects of the child's potential for adult health. Biological programming may set the operational parameters for certain organs and processes. Social factors in childhood influence the processes of biological development, and are the beginnings of socially determined pathways to health in adult life.

Childhood influences on adult health: a review of recent work from the British 1946 national birth cohort study, the MRC National Survey of Health and Development.

Research in this study has shown that growth in utero and early-life development were associated with a range of adult outcomes, including blood pressure, respiratory function and schizophrenia. It has also been shown that childhood social and educational factors are strongly associated with adult mental and physical health, and with adult health-related behaviour. It is suggested that the observed long-term effects of early-life physical development do not represent an inevitable outcome of childhood development, but one which is mediated by the chain of social factors that also begins in early life.

Health and social precursors of unemployment in young men in Great Britain.

Objective: To identify health and socioeconomic factors in childhood that are precursors of unemployment in early adult life and to examine the hypothesis that young men who become unemployed are more likely to have accumulated risks to health during childhood.

Design: Longitudinal birth cohort study. The amount of unemployment experienced in early adult life up to age 32 years was the outcome measure used.

Childhood growth and age at menarche.

Objective: To study the influence of birthweight, and weight and height at age seven years, on menarcheal age in a national sample of 1471 girls in England, Scotland and Wales.

Methods: We studied 1471 girls included in the MRC National Survey of Health and Development. During medical examinations carried out by school doctors in this cohort, born in the first week of March 1946, the mothers of girls were asked whether their daughters had started to menstruate, and if so, the month and year when this happened.

Adjustment of children and adolescents to parental cancer. Parents' and children's perspectives.

Background: Little empirical evidence exists to address the impact of a diagnosis of cancer of a father or mother on his or her children. Previous studies have found inconsistencies in the levels of distress reported for children of a parent with cancer, which may be a function of who (parent or child) was reporting on the child's symptoms and when the reports were taken (near diagnosis or months or years later).

Methods: This study examined parents' and children's reports of emotional and behavioral problems in children and adolescents from 76 patient families in which a mother or father was recently diagnosed with cancer.

The changing pattern of in-patient care.

Background: A nationally representative longitudinal study presented the opportunity to describe National Health Service (NHS) and private in-patient care used over seven years by a population of young adults in relation to known risk factors for admission and for future health.

Methods: Information on each hospital admission between ages 36 and 43 years, comprising length of admission and whether under NHS or private care, was collected from 1625 men and 1623 women, the population of the 1946 birth cohort study. Obstetric care was excluded from most analyses.

Burden of disability in a post war birth cohort in the UK.

Study Objective: To report the prevalence of physical disability in a national sample of 43 year old men and women, and examine the relationship between disability and the consumption of hospital care. To assess the contribution of childhood health and social circumstances to the risk of adult disability, and the socioeconomic consequences of disability.

Design: The assessment of disabilities of physical movement was based on criteria developed by OPCS for their national survey of disability.

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.

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.

Application of Raman spectroscopy to metal-sulfide surface analysis.

The surface products of electrochemically oxidized pyrite (FeS(2)) are investigated as a function of applied potential by using Raman spectroscopy. The parameters necessary for sulfur formation on the pyrite surface were determined. An optical multichannel apparatus, consisting of an argon laser, a triple spectrograph, and a charge-coupled-device detector, was utilized for the Raman measurements.

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.

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.

Changing disease patterns in patients with AIDS in a referral centre in the United Kingdom: the changing face of AIDS.

Objective: To study the changes in morbidity, mortality, and survival patterns in a population of patients with AIDS in the United Kingdom from 1982 to 1989.

Design: A retrospective analysis of inpatient and outpatient records of patients with AIDS.

Subjects: 347 Patients with AIDS, predominantly homosexual or bisexual men.

Children of divorced and separated parents: summary and review of findings from a long-term follow-up study in the UK.

As divorce and separation rates continue to rise it is likely that problems among the children of such parents will also continue to increase. The nature of short term problems for the children of separating parents are well known. There is now evidence of a risk of longer term difficulties which may be the result of a chain of circumstances which begins close in time to the separation and divorce.

Pertussis vaccine and severe acute neurological illnesses. Response to a recent review by members of the NCES team.

Dr. A. H.

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.

Parental height: childhood environment and subsequent adult height in a national birth cohort.

Low parental social class was associated with shorter adult stature in offspring in a national birth cohort. Since short adult stature is a risk factor for serious illness, particularly heart disease, origins of the observed class differences were sought in the childhood environment and in combined genetic and environmental factors represented by midparent height and birthweight. In addition to social class the childhood environmental factors of birth order, number of surviving younger siblings, overcrowding and mother's education were found to be significant and independent predictors of adult height, even after adjusting for parental heights and birthweight, and had therefore a long-term intragenerational effect.

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.

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.

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.

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.