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Biomedical subjects

C M Wright

Publications and source records attributed to C M Wright.

At least 19 recordsLinked to original sources
PubMed2002

Growth reference charts for use in the United Kingdom.

Since the introduction of new growth charts in the mid 1990s, there has been confusion about which charts should be used, with many districts using more than one version. Because of this uncertainty, an expert working party, the Growth Reference Review Group, was convened by the Royal College of Paediatrics and Child Health to provide guidance on the validity and comparability of the different charts currently in use. This paper describes the technical background to the construction and evaluation of growth charts and outlines the group's findings on the validity of each growth reference in relation to contemporary British children. The group concluded that for most clinical purposes the UK90 reference is superior and for many measures is the only usable reference that can be recommended, while the original Tanner-Whitehouse and the Gairdner-Pearson charts are no longer reliable for use at any age. After the age of 2 the revised Buckler-Tanner references are still suitable for assessing height. There are presently no reliable head circumference reference charts for use beyond infancy. The group propose that apart from refinements of chart design and layout, the new UK90 reference should now be "frozen", with any future revisions only undertaken after careful planning and widespread consultation.

Adolescent↗
PubMed2002

Disseminating weaning messages: an intervention trial.

This article reports a non-randomized intervention study conducted in two market towns to find out whether participant-centred health education discussions improve parents' knowledge and actions concerning infant feeding. Following an initial quiz, parents of 8-week-old infants attended a discussion on weaning (intervention) or home safety (control). They were then asked to complete a questionnaire about their knowledge and actions concerning weaning when their infants were 7-9 months old. A total of 61 parents took part in the intervention and 49 in the control. In the post-intervention questionnaire, the intervention group reported using more home-cooked foods and less commercially-prepared foods and knew the optimum time to register their infants with the dentist. These results suggest that participant-centred discussions are an effective way of disseminating public health messages concerning infant feeding.

Adult↗
PubMed2001

Implications of childhood obesity for adult health: findings from thousand families cohort study.

OBJECTIVE: To determine whether being overweight in childhood increases adult obesity and risk of disease. DESIGN: Prospective cohort study. SETTING: City of Newcastle upon Tyne. PARTICIPANTS: 932 members of thousand families 1947 birth cohort, of whom 412 attended for clinical examination age 50. MAIN OUTCOME MEASURES: Blood pressure; carotid artery intima-media thickness; fibrinogen concentration; total, low density lipoprotein, and high density lipoprotein cholesterol concentrations; triglyceride concentration; fasting insulin and 2 hour glucose concentrations; body mass index; and percentage body fat. RESULTS: Body mass index at age 9 years was significantly correlated with body mass index age 50 (r=0.24, P<0.001) but not with percentage body fat age 50 (r=0.10, P=0.07). After adult body mass index had been adjusted for, body mass index at age 9 showed a significant inverse association with measures of lipid and glucose metabolism in both sexes and with blood pressure in women. However, after adjustment for adult percentage fat instead of body mass index, only the inverse associations with triglycerides (regression coefficient= -0.21, P<0.01) and total cholesterol (-0.17, P<0.05) in women remained significant. CONCLUSIONS: Little tracking from childhood overweight to adulthood obesity was found when using a measure of fatness that was independent of build. Only children who were obese at 13 showed an increased risk of obesity as adults. No excess adult health risk from childhood or teenage overweight was found. Being thin in childhood offered no protection against adult fatness, and the thinnest children tended to have the highest adult risk at every level of adult obesity.

Adipose Tissue↗
PubMed2001

The hormone resistin links obesity to diabetes.

Diabetes mellitus is a chronic disease that leads to complications including heart disease, stroke, kidney failure, blindness and nerve damage. Type 2 diabetes, characterized by target-tissue resistance to insulin, is epidemic in industrialized societies and is strongly associated with obesity; however, the mechanism by which increased adiposity causes insulin resistance is unclear. Here we show that adipocytes secrete a unique signalling molecule, which we have named resistin (for resistance to insulin). Circulating resistin levels are decreased by the anti-diabetic drug rosiglitazone, and increased in diet-induced and genetic forms of obesity. Administration of anti-resistin antibody improves blood sugar and insulin action in mice with diet-induced obesity. Moreover, treatment of normal mice with recombinant resistin impairs glucose tolerance and insulin action. Insulin-stimulated glucose uptake by adipocytes is enhanced by neutralization of resistin and is reduced by resistin treatment. Resistin is thus a hormone that potentially links obesity to diabetes.

3T3 Cells↗
PubMed2001

A family of tissue-specific resistin-like molecules.

We have identified a family of resistin-like molecules (RELMs) in rodents and humans. Resistin is a hormone produced by fat cells. RELMalpha is a secreted protein that has a restricted tissue distribution with highest levels in adipose tissue. Another family member, RELMbeta, is a secreted protein expressed only in the gastrointestinal tract, particularly the colon, in both mouse and human. RELMbeta gene expression is highest in proliferative epithelial cells and is markedly increased in tumors, suggesting a role in intestinal proliferation. Resistin and the RELMs share a cysteine composition and other signature features. Thus, the RELMs together with resistin comprise a class of tissue-specific signaling molecules.

Amino Acid Sequence↗
PubMed2001

Accidents and resulting injuries in premobile infants: data from the ALSPAC study.

BACKGROUND AND AIMS: Little is known about injuries resulting from accidents in premobile infants. We aimed to describe the pattern of minor accidents in infants and their resulting injuries. METHODS: The ALSPAC study collected data in successive postal questionnaires. At 6 months of age, parents were asked to describe any accident since birth. The type of fall, distance fallen, resulting injury, and help sought were independently coded. Burns were similarly coded. RESULTS: A total of 11 466 responses were available. In 2554 children, 3357 falls were reported; 53% fell from beds or settees and 12% fell from arms or while being carried. Only 14% reported visible injury, of which 56% were bruises; 97% of injuries specified involved the head. Only 21 falls (<1%) resulted in concussion or fracture. A burn or scald occurred in 172 cases (1.5%). The main causes of scalds were hot drinks and water, with contact burns caused by radiators, cookers, and hot food. CONCLUSIONS: Falls in young infants are common while burns are rare. Injuries from falls are infrequent, predominantly trivial, and almost entirely confined to the head. Falls from beds and settees did not result in skull fractures. Serious injury was the result of complex accidents.

Accidental Falls↗
PubMed2000

Prognostic significance of extensive microsatellite instability in sporadic clinicopathological stage C colorectal cancer.

BACKGROUND: Colorectal cancers exhibiting microsatellite instability (MSI) appear to have unique biological behaviour. This study analyses the association between extensive MSI (MSI-H), clinicopathological features and survival in an unselected group of patients with sporadic Australian Clinico-Pathological Stage (ACPS) C (tumour node metastasis stage III) colorectal cancer. METHODS: Some 255 patients who underwent resection for sporadic ACPS C colorectal cancer between 1986 and 1992 were studied. No patient had received chemotherapy. Minimum follow-up for all patients was 5 years. Archival normal and tumour DNA was extracted and amplified by polymerase chain reaction using a radioactive labelling technique. MSI-H was defined as instability in 40 per cent or more of seven markers. RESULTS: Twenty-one patients showed MSI-H. No association was found between MSI and age or sex. Tumours exhibiting MSI-H were more commonly right sided (P<0.00001), larger (P = 0.002) and more likely to be high grade (P = 0.049). After adjustment for age, sex and other pathological variables, patients whose cancers exhibited MSI-H had improved survival (P = 0.015). CONCLUSION: Recognition of MSI-H in sporadic ACPS C tumours identifies a subset of cancers with improved prognosis. Such stratification should be considered in trials of adjuvant therapy and may be relevant to therapeutic decision making.

Adult↗
PubMed1999

The strengths and limitations of parental heights as a predictor of attained height.

Mid-parental heights are widely used to help assess an individual child's growth. However, the methods in use vary, and most make no allowance for extremes of parental height. This study aimed to examine the actual distribution of parental heights in a survey population and the relation with their children's heights. The heights of 419 representatively sampled children aged 8-9 years were compared with their reported mid-parental heights, all expressed as standard deviation scores (SDS). These confirmed previous predictions that 90% of the children's heights would fall within 1.5 SDS (approximately two centile spaces) of their mid-parental heights. However, where parents were unusually tall or short, their children were relatively less tall or short, respectively, and the mid-parental height was a poor predictor of attained height. A simple calculator for expected height centile is described that automatically adjusts for this regression to the mean. Of 13 children below the second centile for height, eight were within two centile spaces (90% range) of their mid-parental height SDS. However, when allowance was made for regression to the mean, only three of 13 were within the 90% range. Although mid-parental height provides a useful guide to expected height centile for children and parents of average stature, it can be misleading when used to assess short children.

Body Height↗
PubMed1999

Cognitive and educational attainments at school age of children who failed to thrive in infancy: a population-based study.

A 1-year cohort of children born at term in Newcastle-upon-Tyne in 1987/8 was screened for failure to thrive in infancy using a conditional longitudinal standard which identified those whose weight gain was in the lowest 5%. A group of 136 cases and 136 controls (from the same GP practice and living in a neighbourhood with the same deprivation index) was followed up at 7-9 years of age, when 79% of cases and 87% of controls were successfully studied. Cases at 7-9 were significantly shorter (mean 126.0 cm, SD 5.6) than controls (mean 130.7 cm, SD 5.9); adjusted for parental heights a difference of 4.4 cm (95% CI 2.92 to 5.90 cm) remained. They had smaller head circumferences (mean 51.9 cm, SD 1.8) than controls (mean 52.8 cm, SD 1.7), were significantly lighter (medians 23.8 kg, IR 21.5 to 26.9 in cases, and 27.9 kg, IR 25.2 to 31.6 in controls) and had a lower body mass index (median 14.9, IR 14.1 to 16.0 in cases, and 16.3, IR 15.3 to 17.8 in controls). Despite these large growth differences, no statistically significant differences in cognitive outcomes were found. Mean IQ was 87.6 (SD 17.4) in cases and 90.6 (SD 17.1) in controls; after adjustment for organic cause and mother's IQ the mean difference was 1.7 IQ points (95% CI -5.2 to 1.9). There were no statistically significant differences in the reading, spelling, or reading comprehension scores; the mean standardised reading score was 93.5 (SD 16.2) for cases and 94.5 (SD 15.6) for controls. These results show that when carefully defined by velocity-based anthropometric criteria, nonorganic failure to thrive in infancy is followed by persisting stunting and wasting, and a reduced head circumference, but is not associated with cognitive or educational disadvantages at school age.

Achievement↗
PubMed1998

Effect of community based management in failure to thrive: randomised controlled trial.

OBJECTIVE: To evaluate the effectiveness of a health visitor led intervention for failure to thrive in children under 2 years old. DESIGN: Controlled trial, randomised by primary care practice. SETTING: Newcastle upon Tyne health district. INTERVENTION: Structured health visitor management, with dietetic, paediatric, and social work input as required. SUBJECTS: 229 children (120 in intervention practices and 109 in control practices) were identified as failing to thrive by population screening during the first 2 years of life. Follow up was by home visit of a research nurse and review of the childrens' records at age 3 years. MAIN OUTCOME MEASURES: Follow up weight and height and number of routinely collected weights. RESULTS: 95 of the 97 families offered intervention completed at least the initial assessment. At follow up, 187 (82%) records were reviewed, and these suggested that 15 (16%) controls were lost to follow up immediately after the screening weight was taken compared with only one child in the intervention group. In the 134 (58%) families who consented to home visits, children in the intervention group were significantly heavier and taller and were reported to have better appetites than childen in the control group, although both groups were equally satisfied by the services they had received. When the children were last weighed, 91 (76%) in the intervention group had recovered from their failure to thrive compared with 60 (55%) in the control group (P<0.001). CONCLUSION: In failure to thrive, health visitor intervention, with limited specialist support, can significantly improve growth compared with conventional management.

Body Height↗
PubMed1998

Social and demographic characteristics of young and mature aged nursing students in Australian universities.

This national study compares the social and demographic characteristics of direct and delay entry students in a control group of 1551 students in higher education programmes in 1987 and 1990 with the national study group of 2295 students sampled in 1995. Using a specially constructed socioeconomic variable for comparison the analyses demonstrated a significant difference in the socioeconomic level of the household for the younger aged group but not for the mature aged group. There was also a significant difference between males and females in their age of entry patterns. Furthermore, there was a significant difference in the location of school attended for most of their secondary education for the younger aged group but not for the mature aged group. For both groups there was a significant difference in the number of siblings, the level of education attained by the mother and the income received by the mother in the households of the control and study groups. Logit analysis revealed that there was a significant interaction between the household variables: socioeconomic status, number of siblings, and income received by the mother of the respondents in the control and study groups for the younger age group but not for the mature age group. This interaction for the younger age group, plus the finding that nursing students were more likely to delay their Higher Education Contribution Scheme (HECS) payment than other university students suggests that politicians need to take great care in any changes to current HECS payments as such changes could upset the delicate social balance that has been achieved in nursing recruitment in Australia.

Adolescent↗
PubMed1996

Sex differences in weight in infancy and the British 1990 national growth standards.

OBJECTIVES: To determine if there is a sex difference in infancy in the new British national standards for weight (based on data from 1990). DESIGN: Weight data in a birth cohort were compared with the 1990 standards and Tanner and Whitehouse (1966) standards up to age 12 months. SETTING: Newcastle upon Tyne. SUBJECTS: 3418 term infants. RESULTS: Our cohort showed a mean difference in standard deviation scores of 0.42 between boys and girls (P < 0.0001) when compared with the 1990 standards. Two and a half times as many girls as boys had weights below the 3rd centile during the first year, with an equivalent excess of boys above the 97th centile (P < 0.0001). Similar results were found with Tanner and Whitehouse standards. CONCLUSIONS: These differences could result in substantial sex bias in the identification of poor growth in early childhood. The standards need modification.

Body Weight↗
PubMed1996

The social and gender composition of nursing students in Australia: a comparison between 1987-1990 and 1995 recruits.

This national study compares the social and gender characteristics of an earlier group of 1551 students in higher-education programs in 1987 and 1990 with the national study group of 2295 students sampled in 1995. Using a specially constructed socio-economic variable for comparison, the analyses demonstrated a significant difference in the socio-economic level of the household for the female but not the male group. There was a significant difference in the proportion of males entering nursing between the earlier and latter groups. Further, in the latter group, these males were more likely to enter nursing programs directly from school. Members of the female group in the latter sample were more likely to have attended a school in a less populated area, come from households with a reduced family size, have mothers who were earning an income and have mothers who had achieved a higher level of education than was found in the earlier group. Logic analysis revealed that there was a significant interaction between the household variables, socio-economic status, number of siblings and income received by the mother of the respondents in the early and latter groups for females but not for males. This interaction for the female group, plus the finding that members of the latter group were more likely than other university students to defer their Higher Education Contribution Scheme (HECS) payments, suggests that if politicians were to make changes to the HECS it may affect the delicate social balance currently achieved in nursing recruitment in Australia.

Australia↗