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M Woodward

Publications and source records attributed to M Woodward.

At least 91 records · Page 5Linked to original sources
PubMed1996

Enamel defects in the deciduous dentition as a potential predictor of defects in the permanent dentition of 8- and 9-year-old children in fluoridated Cheshire, England.

It is claimed that dental fluorosis in both deciduous and permanent teeth is increasing in fluoridated and non-fluoridated communities. What is unclear is whether fluoride-induced enamel opacities in the deciduous dentition are associated with the subsequent appearance of enamel defects in the permanent dentition. The aim of this study was to establish whether a relationship existed between the presence of diffuse enamel defects on the deciduous molars and permanent incisors of schoolchildren who were lifetime residents in an optimally fluoridated community in Cheshire, England. The dentitions of eight-and nine-year-old children were examined by two examiners, each unaware of the findings of the other. There was a significant increased risk of diffuse enamel defects in the permanent incisors for those children who presented with diffuse defects on their first deciduous molars (Relative Risk, 1.45; 95% confidence interval, 1.05 to 2.0) or second deciduous molars (Relative Risk, 1.86; 95% confidence interval, 1.36 to 2.54). In light of these findings, it is worth considering the potential of the presence of enamel defects in deciduous molars in children aged 1 to 3 years as a predictor of the future appearance of similar lesions in their permanent incisors.

Case-Control Studies↗
PubMed1996

Association of p53 and WAF1 expression with apoptosis in diffuse alveolar damage.

Little is known about alterations in cell cycle regulatory proteins such as p53 and WAF1 in diffuse alveolar damage (DAD). We hypothesized that up-regulation of p53 and WAF1 in type II pneumocytes in DAD is associated with underlying DNA damage and apoptosis. Twenty cases of DAD and twenty control specimens of lung adjacent to resected tumors were studied. Immunohistochemical stains with antibodies recognizing p53 and WAF1 were performed, and apoptosis was assessed in sixteen cases by the nick end-labeling method. We identified p53 expression and apoptosis in all cases of DAD but not in any of the control lungs. We detected WAF1 expression in nineteen of twenty cases of DAD and in sixteen of twenty control lungs. In general, the distribution and intensity of WAF1 staining were greater in DAD than in control lungs. Staining for both p53 and WAF1 and labeling of apoptotic cells in DAD were usually focal ( < 10% of cells) and predominantly localized in type II pneumocytes. We conclude that increased p53 and WAF1 expression in DAD reflects normal physiological up-regulation in response to cellular and DNA damage and is associated with apoptosis of type II pneumocytes. p53-dependent apoptosis may contribute to the pathogenesis of this disease.

Adolescent↗
PubMed1995

Is it necessary to transform nutrient variables prior to statistical analyses?

The distributions of the intakes of many nutrients are skewed, yet this is often overlooked when standard statistical analyses are applied to nutrient data. The nutrient intakes of 5,123 men and 5,236 women, recorded by food frequency questionnaire in the Scottish Heart Health Study, were transformed to achieve approximately symmetric distributions. Power transformations were chosen using letter value analyses. A letter value analysis uses selected order statistics and their position around the median to assess symmetry. The effect that each transformation had on a comparison of nutrient intakes between those with and without prevalent coronary heart disease was determined from t tests on the untransformed and transformed variable. The effects of the logarithm and square root transformation and of the optimum Box-Cox transformation were also determined, and the results were compared with the nonparametric Mann-Whitney test. The conclusion of whether or not to reject the null hypotheses often varied, depending on the transformation and test used. The nonparametric test usually gave a conclusion similar to that of the t test on the letter value-transformed data, the Box-Cox-transformed variable, and after either the logarithm or square root transformation of the data, but not always both. The results from the untransformed variable were sometimes very different. Failure to account for skewness in nutrient variables may thus lead to spurious conclusions.

Aged↗
PubMed1995

An investigation of the relationship between antioxidant vitamin intake and coronary heart disease in men and women using discriminant analysis.

Smoking, high blood pressure and elevated blood cholesterol are the well-established 'classical' risk factors for coronary heart disease (CHD) in men and women. However, it is also well-known that there is a considerable degree of residual variation in CHD after these factors have been taken into account. Consideration of antioxidant vitamin status may help to reduce this unexplained variation. Here, discriminant analysis is applied to the baseline cross-sectional data from the Scottish Heart Health Study. The problem of possible behavioural changes after diagnosis for CHD is addressed by analysing diagnosed and undiagnosed CHD cases separately. Results show that the combined dietary intakes of the antioxidant vitamins C, E and carotene (assessed using a food frequency questionnaire) differentiate CHD prevalence as well as do the classical risk factors. For women, stepwise discriminant analysis shows that the effect of the antioxidant vitamins on CHD is removed by adjustment for the classical risk factors and age. For men, however, the antioxidant vitamins still contribute to the discriminant function. It is concluded that dietary antioxidant vitamins appear to have a significant effect on the prevalence of CHD, especially amongst men. The benefits and problems of using discriminant analysis in this practical context are discussed, including the assumptions that need to be tested.

Adult↗
PubMed1995

An investigation of the relationship between antioxidant vitamin intake and coronary heart disease in men and women using logistic regression analysis.

Antioxidant vitamin intake (C,E and carotene) is assessed from a food frequency questionnaire applied to 10,359 middle-aged men and women participating in the Scottish Heart Health Study. Logistic regression analysis is then used to quantify the relationship between antioxidant vitamin consumption and prevalent coronary heart disease (CHD), analysing diagnosed and undiagnosed cases separately. For men, there is a protective effect of all three antioxidants, before and after adjustment for a comprehensive set of confounding variables. For women the picture is less clear, only vitamin C is negatively associated with CHD, but the effect is removed by adjustment. The logistic regression model is also used to determine classification rules for deciding whether or not an individual has CHD. The classification error rates using the antioxidants are found to be very similar to those found using smoking, blood pressure and serum total cholesterol as classification variables. Significant interactions are found for the antioxidants with smoking, cholesterol and age. It is concluded that antioxidant vitamin intake protects against CHD for men. Logistic regression analysis is compared with discriminant analysis, and is found to have important advantages as an epidemiological tool.

Adult↗
PubMed1995

Systemic absorption and activity of recombinant consensus interferons after intratracheal instillation and aerosol administration.

PURPOSE: The pulmonary pharmacokinetics and bioactivity of E. coli derived recombinant consensus interferon (CIFN) and a modified lactose-conjugated consensus interferon (LacCIFN) were evaluated in animals. METHODS: Estimated doses of 20 and 100 micrograms/kg of the interferons were administered to anesthetized rats by aerosol via ultrasonic nebulizer as well as intravenous injection. Rats also received nominal doses of 50 and 200 micrograms/kg via intratracheal instillation (IT). Hamsters were treated with interferon via various routes including IT. The effectiveness of treatment was assessed by the resistance to development of hind leg paralysis following infection with encephalomyocarditis virus. RESULTS: Significant amounts of CIFN and LacCIFN were found in rat plasma after aerosol administration. Peak plasma levels occurred approximately 25-30 minutes with estimated bioavailabilities approaching 70%. Absorption of CIFN was rate limiting and plasma levels were detectable 12 hr post-dose. The CIFN at IT doses as low as 5 micrograms/kg was effective at reducing paralysis in hamsters but protection was variable and doses of up to 100 micrograms/kg were not 100% effective. CONCLUSIONS: Despite the incomplete protection, the results demonstrate the feasibility of treating systemic viral infections with interferon administered directly to the lungs.

Absorption↗
PubMed1995

Trans fatty acids in the Scottish diet. An assessment using a semi-quantitative food-frequency questionnaire.

Trans fatty acids produced during hardening of oils have been associated with higher cholesterol levels and increased risk of heart disease. The potential risk from trans fatty acids may be greater in populations with relatively low intakes of essential fatty acids such as the Scots, who also have a high prevalence of heart disease. Means and ranges of trans fatty acid intakes are reported here for a Scottish population. A semi-quantitative food-frequency questionnaire was used to survey the diet of 10,359 Scottish men and women aged 40-59 years in 1984-6 as part of the baseline Scottish Heart Health Study. Trans fatty acid levels were calculated for each food item on the questionnaire and the total subdivided into that which is derived naturally (primarily by bacterial fermentation in ruminants) and that which is produced during industrial hydrogenation (hardening) of vegetable and fish oils. Means and ranges of intakes of each trans fatty acid variable were calculated by sex, age, smoking and social class groups. Mean total trans fatty acid intakes for men were 7.1 (SD 3.1) g/d, 2.7 (SD 2.9)% energy and for women were 6.4 (SD 2.9) g/d, 3.3 (SD 3.0)% energy. Industrially hydrogenated trans fatty acids made up nearly 58% of the total intake for men and 61% for women, with about 60% coming from cakes, biscuits and sweets, and 20% coming from the cheaper hard margarines. The main sources of the naturally derived trans fatty acids were red meat (27%), milk (20%), butter (18-19%) and cheese (13-16%). Differences between age, smoking and social class groups were apparent. However, apart from the social class differences of up to 1 g/d, these were so small that they are unlikely to be of any biological significance unless compounded by other factors such as marginal essential fatty acid adequacy. The possibility of trans fatty acid intakes up to 48 g/d and 12% total energy (compared with the Department of Health (1991) recommendations of 5 g/d or 2% energy) highlights the need for careful monitoring of the health risks at these high levels of intake.

Adult↗
PubMed1995

Sustained improvement of subjective quality of life in older community-dwelling people after treatment of urinary incontinence.

We aimed to study the impact of conservative non-pharmacological, non-surgical management on quality of life in elderly incontinent patients. Community-dwelling patients age 60 years or older were randomized to receive immediate or delayed conservative management. A number of questions relating to quality of life were administered at admission and then at 2, 4, 8 and 12 months. By 4 months, incontinence was cured in 25% and improved in 63% of patients. The frequency and severity of incontinence was reduced (p < 0.001), and deferment time was improved (p < 0.01). There were statistically significant improvements in subjective quality of life measures at 4 and 12 months involving depression (p < 0.001), isolation (p < 0.03), embarrassment (p < 0.001), laundry (p < 0.001) and smell (p < 0.02) when comparing these variables with initial assessment. This effect did not appear to be a placebo effect as evidenced by comparison with the delayed intervention group, and was sustained over 12 months. There are significant short- and long-term benefits to the quality of life of older patients with incontinence when treated by conservative measures. Intervention studies should measure and report quality of life as an outcome variable.

Activities of Daily Living↗
PubMed1995

Passive smoking by self report and serum cotinine and the prevalence of respiratory and coronary heart disease in the Scottish heart health study.

STUDY OBJECTIVE: To explore the relationship between self reported environmental tobacco smoke exposure (or passive smoking), the serum cotinine concentration, and evidence of respiratory or coronary disease in men and women who have never smoked. DESIGN: Cross sectional random population survey identifying disease markers and relating them to measures of passive smoking. Disease markers were previous medical diagnoses, response to standard symptom questionnaires, and electrocardiographic signs. SETTING: Samples of men and women aged 40-59 years drawn from general practitioner lists in 22 local government districts of Scotland, between 1984 and 1986. PARTICIPANTS: A total of 786 men and 1492 women who reported never having smoked tobacco, and who had serum cotinine concentrations below 17.5 ng/ml, the cut off point for smoking "deceivers", took part. RESULTS: Fewer than one third of never smokers reported no recent exposure to environmental tobacco smoke and the same proportion had no detectable cotinine. Women had lower cotinine values than men but reported more exposure to smoke. The correlation between the measures of exposure was poor. Self-reported exposure showed strong, statistically significant, dose response relationships with respiratory symptoms and with the coronary disease markers. These relationships were weak or absent for serum cotinine, except for diagnosed coronary heart disease. Here the dose response gradient was as strong as that for self report, with an odds ratio of 2.7 (95% CI 1.3, 5.6) for the highest v the lowest exposure group, adjusted for age, housing tenure, total cholesterol, and blood pressure, and not explained by fibrinogen. CONCLUSIONS: The validity of different measures of tobacco smoke exposure needs further investigation. The gradient of diagnosed coronary heart disease with both self reported exposure and serum cotinine was, however, surprisingly strong, statistically significant, and unexplained by other factors. These findings reinforce current policies to limit passive tobacco smoke exposure.

Adult↗
PubMed1995

Alcohol consumption, diet, coronary risk factors, and prevalent coronary heart disease in men and women in the Scottish heart health study.

STUDY OBJECTIVE: To measure the relationship between reported alcohol consumption and prevalent diagnosed and undiagnosed coronary heart disease (CHD) in men and women to see how much could be explained by covariation with diet, lifestyle, and biomedical factors. DESIGN AND SETTING: This was a cross sectional, random population survey covering 22 districts of Scotland and using general practitioner patient lists as the sampling frame. Odds ratios for prevalent CHD at different levels of alcohol consumption taken from a seven day recall were analysed. These ratios were then adjusted for lifestyle and biomedical factors. PARTICIPANTS: Male and female responders aged 40-59 years who completed the survey questionnaire and attended the survey clinic. MAIN RESULTS: The participation rate of those invited was 74%. Of the 10,359 responders, 658 were excluded because of missing alcohol data or ambiguous cardiovascular status. The questionnaire was used to designate 7058 drinkers and 2643 non-drinkers, who were then classified as having diagnosed or undiagnosed CHD, or who were controls. The prevalence of diagnosed CHD decreased with increasing alcohol consumption while undiagnosed CHD had a "U" shaped relationship. Patterns were similar in men and women if allowance was made for the lower alcohol consumption in women. Adjustment for several diet and lifestyle factors and for additional biomedical factors reduced the apparent protective effect of alcohol, leaving a modest but statistically insignificant (p > 0.05) reduction in CHD prevalence among light to moderate consumers compared with those who drank no alcohol. Wine drinkers seemed to be at lower risk than beer drinkers in both sexes. CONCLUSIONS: These results tend to confirm that intermediate alcohol consumption is a component and contributor to a low coronary risk lifestyle. Its effects are largely explained by adjusting for both confounding lifestyle associations and for biomedical effects but the remaining effect, and the lower risk with wine drinking compared with beer, are intriguing. Advice on alcohol habits should not be determined solely by the moderate apparent benefit to risk of CHD, however, as other disease risks cannot be ignored.

Adult↗
PubMed1995

Antioxidant vitamin adequacy in relation to consumption of sugars.

OBJECTIVE: To investigate the prevalence of antioxidant vitamin inadequacy and low fibre intakes according to total, intrinsic, extrinsic and milk-sugar consumption groups. DESIGN: Age- and sex-stratified cross-sectional study of coronary risk factors and diet. Based on a personal health and food frequency questionnaire with a clinic attendance for body measurements. SETTING: Ten general practitioners' surgeries from each of 22 Scottish districts (12 Mainland Health Boards) surveyed during 1984-1986. SUBJECTS: 11,626 men and women aged 25-64 years who participated in the baseline Scottish Heart Health (SHHS) and MONICA studies. Overall response rate was 69% after one reminder letter. MAIN OUTCOME MEASURES: Both the mean daily intakes of fibre and vitamins A (retinol and carotenes), C and E, and the percentage of each sex group who fall below the dietary reference values for each nutrient are reported according to fifths of dietary sugars. The percentage of the population variation in vitamin and fibre intake which can be explained by consumption of the different sugars is provided from multiple analysis of variance techniques. RESULTS: Intrinsic sugar intake is positively related to antioxidant vitamin and fibre intake (correlation coefficients, r, between 0.1 and 0.61 apart from retinol, r = -0.06), due to their mutual occurrence in fresh fruits and vegetables, while consumption of milk sugars tends to be weekly inversely related to antioxidant vitamin and fibre intake (apart from vitamin C, r = 0.02-0.06). Both low and high extrinsic sugar intake seems to be associated with poorer antioxidant vitamin and fibre-containing diets compared with a consumption of extrinsic sugar of between 6.5 and 15.6% energy for men and 4.8 and 11.6% energy for women. Intake of different sugar types is related to the antioxidant nutrient adequacy of a diet independent of age, smoking habit, total energy intake, alcohol consumption, weight and height. Fibre intake is below the recommended value at all levels of dietary sugars. CONCLUSIONS: Prevalence of antioxidant vitamin adequacy is significantly related to dietary sugar intake. However, relatively low extrinsic sugar consumption appears equally associated with a poor quality diet as does a relatively high intake. It may be concluded that the dietary reference values for sugars err on the cautions side, with respect to their effect on antioxidant nutrient adequacy.

Adult↗
PubMed1994

Sugar consumption and dental caries: evidence from 90 countries.

An examination is made of data on dental caries amongst 12-year-old children and sugar consumption of the total population for 90 countries. For the whole data set, DMFT score tends to rise with sugar consumption. The linear relationship between the logarithm of DMFT and sugar is estimated to have a slope of 0.021 per kg/year per head of population (P < 0.0001), and accounts for 28% of the variation in DMFT. In contrast, when data from 29 industrialised nations are analysed separately, there is no evidence of a sugar-caries relationship; the slope of the linear regression line is estimated to be -0.013, not significantly different from zero. This latter result is in agreement with the considerable evidence of a lack of strong relationship between the amount of sugar consumed and caries occurrence in Western countries. These results suggest that, in addition to sugar, other factors, such as other aspects of diet, exposure to fluoride and genetic effects, must be taken into account when seeking to explain variations in caries prevalence, and when making recommendations for caries control.

Australia↗
PubMed1994

Deficient health knowledge, diet, and other lifestyles in smokers: is a multifactorial approach required?

BACKGROUND: Data from the Scottish Heart Health Study, a random cross-sectional sample of middle-aged men and women, are used to compare health knowledge, behavior, and lifestyles between 4896 smokers and 4595 nonsmokers. METHODS: Smokers are identified from self-reports with biochemical validation. They are compared with nonsmokers using analysis of covariance and logistic regression, adjusting for age and social class. RESULTS: Smokers are found to have poorer dietary knowledge than nonsmokers, although both groups are well-informed on some aspects of diet. Knowledge of personal risk modifiers for coronary heart disease and recent intention to improve lifestyle are both worse among smokers. Smokers have lower intakes of the antioxidant vitamins and fiber, but higher intakes of dietary cholesterol and alcohol than nonsmokers. They also tend to have higher salt intake and eat a greater proportion of saturated fat, butter, or hard margarine, and full-fat milk. High-density lipoprotein cholesterol levels are lower, but triglycerides, fibrinogen, and, for women only, total serum cholesterol levels are higher among smokers. On the other hand, body mass index and diastolic blood pressure are lower among smokers. CONCLUSIONS: In addition to advice to give up smoking, smokers should be counseled to improve their diet. The positive message to eat more fresh fruit and vegetables would be particularly helpful.

Adult↗
PubMed1994

Coronary heart disease: prevalence and dietary sugars in Scotland.

STUDY OBJECTIVE: The aim was to investigate the effects of dietary intakes of different types of sugars (extrinsic, intrinsic, and lactose) and the dietary fat to sugar ratio on prevalent coronary heart disease (CHD). DESIGN: This was a baseline cross sectional survey of CHD risk factors. SETTING: Twenty two Scottish health districts were surveyed between 1984 and 1986. PARTICIPANTS: A total of 10,359 men and women aged 40-59 years were screened as part of the Scottish Heart Health Study, and a further 1267 men and women aged 25-39 and 60-64 years were screened as part of the Scottish MONICA (monitoring trends and determinants in cardiovascular disease) Study. The response rates were 74% and 64% respectively. METHODS: Subjects completed a questionnaire which included sociodemographic, health, and food frequency information. Medical history, response to the Rose chest pain questionnaire, and results of a 12 lead ECG recording were used to categorize subjects into CHD diagnosed, previously CHD undiagnosed, or no CHD groups. The chi 2 statistic was used to determine whether the CHD groups differed in their sugar consumption, and multiple logistic regression analysis, with adjustment for other potential coronary risk factors, was used to calculate odds ratios for prevalent CHD by intake fifths of dietary sugars. MAIN RESULTS: Men, but not women, differed in their sugar consumption by CHD group. The odds ratios showed a tendency for a U shaped relationship for extrinsic sugar intake with CHD prevalence, but no significant effect of the fat to sugar ratio (possible marker of obesity) on CHD was seen. CONCLUSIONS: The results suggest that neither extrinsic sugar, intrinsic sugar, nor the fat to sugar ratio are significant independent predictors of prevalent CHD in the Scottish population, when the other major risk factors such as cigarette smoking, blood cholesterol concentration, and antioxidant vitamins intake are accounted for. These new data for different sugar types agree with the consensus view that total sugar intake is not a major marker of coronary heart disease.

Adult↗
PubMed1994

Dietary composition and fat to sugar ratios in relation to obesity.

The aim of this work was to investigate the relationship between dietary composition and prevalent overweight and obesity in a middle-aged Scottish population. An age and sex stratified cross-sectional study was carried out of coronary risk factors and diet. This was based on a personal health and food frequency questionnaire with a clinic attendance for body measurements which included weight and height. The subjects were 11,626 men and women aged 25-64 who participated in the baseline Scottish Heart Health and MONICA studies. Those reporting to be on slimming diets were excluded. The subjects were contacted via ten general practitioners surgeries from each of 22 Scottish districts (12 Mainland Health Boards) surveyed during 1984-1986. The following were measured: (1) the prevalence of overweight (BMI 25-28.6 for women and 25-30 for men) and obesity (BMI > 28.6 for women, and > 30 for men) according to intake fifths of carbohydrates (starch, total, extrinsic, intrinsic and milk sugars) and fat to carbohydrate ratios; (2) the percentage of the variance in BMI explained by multivariate analysis models which included each of the sugar variables and total energy intake. The overall prevalence of overweight and obesity in the Scottish population were 43 and 11% for men and 38 and 14% for women respectively. Their prevalence increased from the lowest to the highest fifth of Fat:ES intake, respectively for men and women, from 5 to 18.5% and from 13 to 26%. The prevalence of overweight and obesity declined from the lowest to the highest fifth of total carbohydrate, total (TS) and extrinsic (ES) sugar intake.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Nutrient intake by duration of ex-smoking in the Scottish Heart Health Study.

Information on current-, never- and ex-smokers (including duration of cessation) was obtained in a cross-sectional survey of risk factors for coronary heart disease (CHD), the Scottish Heart Health Study. Diet was also assessed by food frequency questionnaire in a total of 4265 men and 4770 women. Nutrient intakes were computed by sex and smoking group and, according to their diet, the ex-smokers were categorized as current- or never-smokers using discriminant analysis techniques. The current- and five ex-smoking groups differed negligibly in past smoking characteristics. Energy-adjusted intake of polyunsaturated fat, fibre and the antioxidant vitamins were lowest in current-smokers, and for men, intakes increased progressively with duration of ex-smoking to reach the level of never-smokers. In a similar manner, energy, sugar and alcohol decreased with duration of ex-smoking. Fewer trends were observable for women, and the diets of ex-smokers more immediately resembled that of never-smokers. Discriminant analysis for the combined nutrients correctly categorized 72 and 69% of male, and 66 and 65% of female current- and never-smokers respectively. By 4 years of smoking cessation the general dietary pattern of ex-smokers was similar to never-smokers for both sexes. Whether this represents a change in diet over time or a cohort effect is unclear, but the results do suggest that the apparent healthier diet of ex-smokers may contribute to their reduction in CHD risk compared with life-long current-smokers.

Adult↗
PubMed1993

Self-titration of nicotine: evidence from the Scottish Heart Health Study.

Data from 2754 cigarette smokers who smoke no other forms of tobacco are extracted from the baseline cross-sectional survey of the Scottish Heart Health Study. Carbon monoxide in expired-air (CO-E), serum thiocynate and serum cotinine measurements from these smokers are compared with the carbon monoxide (CO), nicotine and tar yields of the cigarettes which they smoke, controlling for daily cigarette consumption, the sex of the smoker and the other cigarette yields. CO-E is found to increase positively with CO and tar yield, but inversely with nicotine yield. Thiocyanate increases positively with CO, is not significantly affected by tar, but increases inversely with nicotine. Cotinine is affected only by tar, in a positive direction for women. We conclude that smokers appear to self-titrate their consumption of nicotine by more aggressive smoking of lower-strength cigarettes.

Adult↗