Birth placement and childhood disadvantage.
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Biomedical subjects
Publications and source records attributed to F T Shannon.
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The relationship between prenatal atopy, breast-feeding, early solid food diet and the rate of eczema was studied in a birth cohort of 2-year-old children. Rates of eczema varied significantly with parental atopy and solid feeding: children of atopic parents given solid food during the first 4 months had over two-and-a-half times the rate of eczema of children not given solid food and who had non-atopic parents. Further, rates of eczema increased in almost direct proportion to the number of different types of solid food that the child had been given during the first 4 months. Breast-feeding had no significant effect on rates of eczema. The results suggest that both parental atopy and diversity in early diet are factors which contribute towards rates of childhood eczema.
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Arteriohepatic dysplasia is a rare congenital syndrome in which attenuated peripheral pulmonary arteries are associated with liver impairment. The earliest indication is usually persistent cholestatic jaundice in the first few months after birth. Although this is invariably associated with pruritus, bile acid kinetic studies have not been reported in such patients. This report describes a girl with a particularly mild form of the syndrome who was never observed to be clinically or biochemically jaundiced. Bile acid studies indicated that there was a defect in bile acid excretion but not in uptake or conjugation.
The relationships between parental smoking and the rates of lower respiratory illness during the first three years of life were examined for a birth cohort of 1265 New Zealand children. Lower respiratory illness varied significantly with maternal smoking for the first year; there was equivocal evidence of a relationship between maternal smoking and lower respiratory illness in the second year; and by third year the relationship had clearly disappeared. Paternal smoking had no significant effect on rates of lower respiratory illness at any time. Application of logistic regression showed that for the first year rates of lower respiratory illness were approximately linearly related to maternal smoking: increases of five cigarettes a day resulted in an increase of 2.5 to 3.5 incidents of lower respiratory illness per 100 children at risk. Statistical control for maternal age, education, family size, and family living standards showed that the relationship between maternal smoking and rates of lower respiratory illness was not significantly influenced by these factors.
Over 10 percent of a group of 1180 Christchurch infants received either no immunisation, incomplete immunisation or late immunisation during the first year of life. Failure to provide the child with the recommended course of immunisation was most common amongst families of non-European ethnic origin, single parent families and families with depressed living standards.
The relationship between parental smoking and respiratory illness in a birth cohort of 1180 one-year-old children was examined. Maternal smoking was associated with an increased incidence of lower respiratory illness but there was no statistically significant association between paternal smoking and lower respiratory illness. While children of mothers who smoked suffered more lower respiratory illnesses, their overall risk of respiratory infection was similar to that for children of nonsmoking mothers. The association between maternal smoking and infantile lower respiratory illness persisted when the child's social background, perinatal history, and postnatal diet were taken into account. The findings favour the view that prolonged exposure to cigarette smoke predisposes infants to develop lower respiratory symptoms when they contract a respiratory infection.
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A prospective one year study of a birth cohort of 1262 infants indicates that the rate of infant circumcision has decreased substantially and is now about 25 percent. Most are performed at parental request and for family and traditional reasons rather than medical indications.
The paper examines the background to 210 live exnuptial births studied in the first phase of the Christ-church Child Development Study. The results show: 1. That nearly half of the children had been conceived within cohabiting situations. 2. That nearly one in five ex-nuptial children was the result of a planned pregnancy. 3. Maternal reactions to the birth and pregnancy varied with the mother's situation: cohabiting mothers reported considerably less adverse reaction to the birth than did non-cohabiting mothers. 4. Overall, mothers of ex-nuptial children had a fairly sophisticated appreciation of contraceptive methods. 5. One quarter of unplanned ex-nuptial pregnancies were the result of contraceptive failure and three-quarters were the result of contraceptive non-usage. 6. In common with previous findings for nuptial pregnancies, about 35 percent of unplanned ex-nuptial pregnancies were ascribed to a breakdown in the mother's pattern of usage of the contraceptive pill.
The paper examines smoking amongst a sample of 1248 women giving birth to live-born infants. The findings show: 1. That about 26 percent of women smoked throughout pregnancy and a further 8.0 percent smoked at some time during pregnancy. 2. Smoking during pregnancy was realted to the mother's social background: younger mothers, non-European mothers, mothers with no formal educational qualifications, mothers of low socioeconomic background and mothers of ex-nuptial infants tended to smoke more during pregnancy. 3. Smoking was associated with a decrease in birth weight, a greater risk of low birth weight (less than 2500g) infants and a greater risk of spontaneous abortion. There was no statistically significant relationship between smoking during pregnancy and: the risk of complicated labour, time to the onset of neonatal respiration, the use of active resuscitation or the risk of neonatal infection.
The pattern of illness and of health care during the first 16 weeks of life in a cohort of 1210 infants was examined. Children from families in the lower social strata had a significantly increased risk of respiratory illness and gastrointestinal disturbance and received less routine well baby care than children from more socially advantaged backgrounds. A number of policy changes which might improve the distribution of health care resources are examined.
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A patient with Paget's sarcoma of the vertebral column who developed cauda equina compression is reported. This is the first report of this condition in an aorthopaedic journal. The literature is reviewed. Palliative treatment is recommended.
Forty-two patients underwent fifty-four operations for rupture of extensor tendons in rheumatoid disease. The results are analysed and factors affecting the results discussed.