568 research outputs found
Confidentiality of personal health information used for research
No full textMedical research has a long history in the United Kingdom and has generally enjoyed good public support. Researchers take confidentiality seriously and few breaches have been recorded. Concerns over research practices at Alder Hey hospital related to consent rather than confidentiality,1 but they tarnished the overall reputation of research. At much the same time, the Data Protection Act 1998 defined stricter criteria for handling personal data,2 supplementing the provisions in the UK common law of confidentiality. There is thus a legal and a moral impetus to ensure that research is conducted with the maximum respect for participants and their privacy, even if the research is not linked to clinical care. Many questions can be answered without the active participation of individuals, but researchers must strike a careful balance between their pursuit of health improvements for all and their obligation to maintain the privacy of individuals participating in research
The long-term effects of prenatal development on growth and metabolism
No full textPeople who were small at birth and had poor infant growth have an increased risk of adult cardiovascular disease, osteoporosis, and type 2 diabetes, particularly if their restricted early growth was followed by increased childhood weight gain. These relations extend across the normal range of birth size in a graded manner, so reduced size is not a prerequisite. In addition, larger birth size is associated with risks of obesity and type 2 diabetes. The associations appear to reflect developmental plastic responses made by the fetus and infant based on cues about the environment, influenced by maternal characteristics including diet, body composition, stress, and exercise levels. These responses involve epigenetic processes that modify the offspring's phenotype. Vulnerability to ill health results if the environment in infancy, childhood, and later life is mismatched to the phenotype induced in development, informed by the developmental cues. This mismatch may arise through unbalanced diet or body composition of the mother or a change in lifestyle factors between generations. These insights offer new possibilities for the early diagnosis and prevention of chronic disease.<br/
Infant sleep disturbance is associated with preconceptional psychological distress: findings from the Southampton Women's Survey
No full textStudy Objective: To determine whether preconceptional psychological distress is associated with infant sleep disturbance.Design: Prospective cohort studySetting: Southampton, UK.Participants: Acohort of women from the Southampton Women’s Survey (SWS), who were recruited between 20-34 years of age and followed through their subsequent pregnancies and beyond; a total of 874 mother-infant pairs were involved in the study.Measurements and Results: Preconceptional psychological distress was measured with the General Health Questionnaire (GHQ-12). When their infants were 6 and 12 months of age, mothers were asked to report the number of times babies woke on average between the hours of midnight and 06:00 each night during a 2-week period. Preconceptional psychological distress was a strong predictor of infant night waking at both 6 and 12 months of age, independent of the effects of postnatal depression, bedroom sharing, and other confounding factors. At 6 months, preconceptional distress was associated with a 23% increased risk of waking (prevalence ratio [PR] 1.23, 95% CI 1.06-1.44), and at 12 months with a 22% increased risk (PR 1.22, 95% confidence intervals [CI] 1.02-1.46).Conclusions: Women with preconceptional psychological distress are more likely to have babies with sleep disturbance during infancy, independent of whether they suffered from postnatal depression
Socioeconomic gradients in smoking among young women : a British survey.
No full textMarked and increasing socioeconomic gradients in cigarette smoking are well established. Tracking these differentials among women requires appropriate measures of their socioeconomic position (SEP) which are equivalent across older and younger age groups. This study examines socioeconomic gradients in cigarette smoking by age among women aged 20-34, using a standard indicator of SEP (age left full-time education) and alternative indicators which take account of changes in women's educational levels across age cohorts. The study is based on a large cross-sectional British data set (n = 12,398), the Southampton Women's Survey, conducted 1998-2002. Poisson log-linear regression with adjusted variance was used to predict smoking status (ever smoked > or =1 cigarette a day for 1 year, currently smoking > or =1 cigarette a day, and ex-smoker - ever-smoker not currently smoking > or =1 cigarette a day) in models which controlled for SEP, age and year of interview. Socioeconomic gradients in ever-smoking were marked but stable across age groups. With quitting more prevalent in the higher than lower socioeconomic groups, gradients in current smoking steepened across age groups, with significant age/SEP interactions. The socioeconomic patterning of ever, ex and current smoking was similar using both the standard and alternative measures of education, but interactions were less pronounced with the alternative measures. Socioeconomic indicators which take account of the recent and rapid increase in women's educational participation rates may provide a more reliable indication of age-related differentials in smoking status than standard measures. Nonetheless, both conventional and alternative measures point to stable socioeconomic differentials in rates of ever-smoking and widening differentials in current smoking across age groups. Our study confirms that addressing the link between socioeconomic disadvantage and tobacco use remains a major challenge for the tobacco control community
Women's dietary patterns change little from before to during pregnancy
No full textPrincipal component analysis (PCA) is a popular method of dietary patterns analysis, but our understanding of its use to describe changes in dietary patterns over time is limited. Using a FFQ, we assessed the diets of 12,572 nonpregnant women aged 20-34 y from Southampton, UK, of whom 2270 and 2649 became pregnant and provided complete dietary data in early and late pregnancy, respectively. Intakes of white bread, breakfast cereals, cakes and biscuits, processed meat, crisps, fruit and fruit juices, sweet spreads, confectionery, hot chocolate drinks, puddings, cream, milk, cheese, full-fat spread, cooking fats and salad oils, red meat, and soft drinks increased in pregnancy. Intakes of rice and pasta, liver and kidney, vegetables, nuts, diet cola, tea and coffee, boiled potatoes, and crackers decreased in pregnancy. PCA at each time point produced 2 consistent dietary patterns, labeled prudent and high-energy. At each time point in pregnancy, and for both the prudent and high-energy patterns, we derived 2 dietary pattern scores for each woman: a natural score, based on the pattern defined at that time point, and an applied score, based on the pattern defined before pregnancy. Applied scores are preferred to natural scores to characterize changes in dietary patterns over time because the scale of measurement remains constant. Using applied scores, there was a very small mean decrease in prudent diet score in pregnancy and a very small mean increase in high-energy diet score in late pregnancy, indicating little overall change in dietary patterns in pregnancy
Cut-off points for anthropometric indices of adiposity: differential classification in a large population of young women
No full textAnthropometric indices of adiposity include BMI, waist circumference and waist:height ratio. In the recruitment phase of a prospective cohort study carried out between 1998 and 2002 we studied a population sample of 11 786 white Caucasian non-pregnant women in Southampton, UK aged 20-34 years, and explored the extent to which proposed cut-off points for the three indices identified the same or different women and how these indices related to adiposity. Height, weight and waist circumference were measured and fat mass was estimated from skinfold thicknesses; fat mass index was calculated as fat mass/height1.65. Of the subjects, 4869 (42 %) women were overweight (BMI >/= 25 kg/m2) and 1849 (16 %) were obese (BMI >/= 30 kg/m2). A total of 890 (8 %) subjects were not overweight but had a waist circumference >/= 80 cm and 748 (6 %) subjects were overweight but had a waist circumference /= 0.5. Of the variation in fat mass index, 85 % was explained by BMI, 76 % by waist circumference and 75 % by waist:height ratio. Our findings demonstrate that many women are differentially classified depending on which index of adiposity is used. As each index captures different aspects of size in terms of adiposity, there is the need to determine how the three indices relate to function and how they can be of use in defining risk of ill health in women
Nausea and vomiting in early pregnancy: effects on food intake and diet quality
No full textExperiences of nausea and/or vomiting in pregnancy (NVP) vary greatly, but the paucity of studies with pre-pregnancy dietary data mean that little is known about the effects of NVP on diet. Using an administered food frequency questionnaire, diet was assessed before pregnancy and at 11 and 34 weeks’ gestation in 2270 participants in a UK birth cohort study (Southampton Women’s Survey). Experience of NVP in early pregnancy was graded as none, mild, moderate or severe. Participants reported their level of food consumption as more, the same or less than before pregnancy. ‘Prudent’ diet scores (derived using principal component analysis) were used to describe participants’ diet quality before, in early and late pregnancy.In early pregnancy, 89% of women were nauseous, although most commonly the NVP experienced was mild (48%) or moderate (30%); 11% had severe NVP. 39% of women reported an increase in their level of food intake in early pregnancy; 34% reported a reduction. Increasing severity of nausea was associated with changes in intake of a range of foods, most notably reduced consumption of vegetables, tea/coffee, rice/pasta, breakfast cereals, beans/pulses and citrus fruits/fruit juices and increased consumption of white bread, and soft drinks. Increasing severity of nausea was also associated with decreasing prudent diet score from before to early pregnancy, such that women with severe nausea had prudent diet scores 0.29 SDs lower than those with no nausea (P<0.001). However, this was transient as NVP was not related to change in diet quality from before to late pregnancy.<br/
Socioeconomic lifecourse influences on women's smoking status in early adulthood.
No full textStudy objective: To incorporate women’s domestic trajectories and circumstances into analyses of the socioeconomic influences on women’s smoking status (current and former smoking) in early adulthood. Design: Cross sectional survey Setting: Southampton, UK. Participants: 8437 women aged 25–34 recruited from 1998–2002 via patient lists of general practices Main results: Domestic lifecourse factors contributed to the odds of being a current smoker and former smoker in models that included conventional measures of the socioeconomic lifecourse. Early motherhood, non-cohabitation, and lone motherhood increased the odds of smoking; early motherhood and non-cohabitation reduced the odds of former smoking. For example, relative to childless women, odds ratios (OR) for women who had become mothers <20 years were 1.71 for smoking and 0.76 for former smoking. The effects of education and current SEP remained strong with the inclusion of childbearing and cohabitation variables for both outcomes. For instance, compared with women in education to age 22, the odds ratio for smoking for those leaving school 16 was 3.37 and for former smoking was 0.42. Conclusions: Both the conventionally measured socioeconomic lifecourse and the domestic lifecourse contributed separately to the odds of smoking and former smoking, suggesting that lifecourse analyses should incorporate women’s domestic circumstances as an important pathway of influence on their smoking status in early adulthood
Stability of dietary patterns in young women over a 2-year period
No full textObjective: To examine the stability of dietary patterns in young women over a two-year period and to identify factors that influence stability.Design: A food frequency questionnaire was used to assess diet. In a subgroup, this was repeated after 2 years. Questions were asked about major changes to diet over this time. Dietary patterns were identified using principal components analysis and pattern scores were compared at the two time points. The consumption of foods was also examined. The relationship between change in pattern scores and socio-demographic factors and body mass index was assessed.Setting: The Southampton Women's Survey, a prospective study of diet, health and lifestyle in young women and their influences on fetal growthSubjects: A subgroup of 94 women from a cohort of 6129 nonpregnant women aged 20–34 years.Results: Two dietary patterns, labelled ‘prudent’ and ‘high energy’, were identified. Spearman correlation coefficients between the initial and repeat scores for the prudent and high-energy patterns were 0.81 and 0.64, respectively. Average changes (repeat – initial) were 0.13 and ?0.01 SD of initial score. Change in prudent dietary pattern score was influenced by amount of strenuous exercise taken and by changes in partnership status. An increase in high-energy pattern score was associated with lower social class.Conclusions: Dietary patterns in young women are reasonably stable over a 2-year period. This suggests that dietary patterns identified in the recent past may provide useful information about current dietary patterns.Sponsorship: The study was funded by the Dunhill Medical Trust, the University of Southampton and the Medical Research Council.<br/
Dietary patterns in infancy: the importance of maternal and family influences on feeding practice
No full textIt is not known what constitutes an optimal diet in infancy. There are relatively few studies of weaning practice in the UK, and there is a need for prospective data on the effects of infant diet and nutrition on health in later life. We describe the dietary patterns, defined using principal components analysis of FFQ data, of 1434 infants aged 6 and 12 months, born between 1999 and 2003. The two most important dietary patterns identified at 6 and 12 months were very similar. The first pattern was characterised by high consumption of fruit, vegetables and home-prepared foods ('infant guidelines' pattern). The second pattern was characterised by high consumption of bread, savoury snacks, biscuits and chips ('adult foods' pattern). Dietary pattern scores were correlated at 6 and 12 months (r 0.46 'infant guidelines'; r 0.45 'adult foods'). These patterns, which reflect wide variations in weaning practice, are associated with maternal and family characteristics. A key influence on the infant diet is the quality of the maternal diet. Women who comply with dietary recommendations, and who have high intakes of fruit and vegetables, wholemeal bread and rice and pasta, are more likely to have infants who have comparable diets - with high 'infant guidelines' pattern scores. Conversely, women whose own diets are characterised by high intakes of chips, white bread, crisps and sweets are more likely to have infants who have high 'adult foods' pattern scores. The effects of these patterns on growth and development, and on long-term outcomes need to be investigated
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