Adult Circumstances Research Articles

Do childhood social circumstances affect overweight and obesity in early adulthood?

The aim of the study was to examine the association of childhood circumstances with overweight and obesity in early adulthood, to analyse whether the respondent's education and current circumstances mediate these associations, and to explore whether the respondent's health behaviour affects these associations. This was a cross-sectional study with retrospective inquiries. The study was based on a representative two-stage cluster sample (N= 1894, participation rate 79%) of young adults aged 18-29 years in Finland in 2000. The outcome measure was three-class body mass index (BMI) (normal weight, overweight, and obesity). Multinomial logistic regression was used as the main statistical tool. In women, childhood circumstances (low parental education (relative risk ratio (RRR) = 2.43), parental unemployment (RRR= 2.09) and single-parent family (RRR= 1.99)) increased the risk of overweight (25 < or = BMI<30), but the effects were largely attenuated by other childhood factors and early adult circumstances. In men, no significant childhood predictors of overweight were found. Single-parent family (RRR=2.32), parental alcohol problem (RRR= 2.71), parental mental health problems (RRR=2.28) and being bullied at school (RRR=3.13) predicted obesity (BMI > or = 30) in women in the age-adjusted models, and being bullied at school remained a significant predictor after adjusting for all childhood and current determinants. In both genders, the strong association between parental education and obesity remained significant after adjusting for all other determinants (for the lowest educational category, RRR= 3.56 in women, and RRR= 6.55 in men). Childhood factors predict overweight and obesity in early adulthood. This effect is stronger on obesity than on overweight and in women than in men, and it seems to be partly mediated by adult circumstances. The results emphasize the lasting effect of childhood socioeconomic position on adult obesity. When preventive policies are being planned, social circumstances in childhood should be addressed.

Assessment and management of psychosocial challenges in pediatric liver transplantation

Assessment and management of psychosocial challenges in pediatric liver transplantation

Status relations in school and their relevance for health in a life course perspective: Findings from the Aberdeen children of the 1950's cohort study

In the class room a hierarchical structure of social relations typically develops in which the child's position is a marker of the view of the others, i.e. the extent to which he or she is an accepted and valued member of the group. The status distribution in the school class is likely to correspond to differences in personal characteristics, including behaviours and competencies, and to generate a differential distribution of perceived expectations, treatment, resources and emotions. We argue that these phenomena constitute parts in a developmental process which, through mediators such as self-view and subsequent life choices, may affect adult health. The purpose of this paper is to study whether and how peer status is associated with self-reported health in mid-life. Data was derived from a cohort study of individuals born in Aberdeen, Scotland, between 1950 and 1956. We use information about childhood circumstances, including peer status nominations, collected in the early 1960s, and information about adult circumstances derived from a postal questionnaire carried out among more than 6000 individuals in 2001–2003. Multivariate analyses yielded a graded association between peer status and adult health problems in the form of limiting longstanding illness and less than good self-rated health. These associations could not be explained by socioeconomic circumstances or differences in individual behaviour and cognitive score in childhood. It was rather subsequent socioeconomic career that seemed to explain the association found among men. For women, a significant association remained, suggesting alternative pathways or mechanisms.

The association between cognitive ability measured at ages 18–20 and coronary heart disease in middle age among men: A prospective study using the Swedish 1969 conscription cohort

An association between childhood cognitive ability measured with IQ-tests and coronary heart disease (CHD) incidence has been reported recently. It is not clear from those studies to what extent the increased relative risk associated with lower cognitive ability may be explained by CHD risk factors. This study aims to investigate the association between cognitive ability measured at age 18–20 and incidence of CHD, acute myocardial infarction (AMI), and stroke among middle aged men adjusting for risk factors for CHD over the life course. Data on cognitive ability, and other risk factors for CHD (height, parental cardiovascular diseases (CVD) mortality, blood pressure, smoking, risky use of alcohol, BMI), were collected from 49,321 men, born in 1949–51, at conscription for compulsory military training in 1969/70 in Sweden. Information on socioeconomic factors in childhood (socioeconomic position and crowded housing) and adulthood (education, socioeconomic position, and income), as well as information on mortality and morbidity, was collected through national registers. Cognitive ability showed an inverse and graded association with CHD incidence. Adjustment for indicators of poor childhood circumstances, behavioural factors measured in late adolescence, and adult social circumstances strongly attenuated the increased risks of CHD and AMI. The contribution from adult social circumstances, after adjustment from all other factors, was very small. After adjustment for all risk factors no significantly increased relative risk was seen for stroke incidence. After adjustment for risk factors over the life course, the risk of CHD and AMI associated with cognitive ability decreased substantially, and was of borderline significance. Given the results from this study it is unlikely that cognitive ability is a risk factor on its own for CHD, AMI and stroke among men below 54 years of age.

Diabetes and Coronary Heart Disease in Filipino-American Women

To investigate associations between adult markers of childhood growth and the prevalence of diabetes and coronary heart disease (CHD) in Filipino-American women and to determine the role of social and educational differences, including the influence of social mobility between childhood and adulthood. Socioeconomic disadvantage and poor infant growth, resulting in short leg length, may contribute to the dramatically increased risk of diabetes and CHD in Filipino-American women, but this has not been investigated. This study is a cross-sectional study of 389 Filipino-American women (age 58.7 +/- 9.4 years [mean +/- SD]). Diabetes was defined by 1999 World Health Organization criteria and CHD by ischemic electrocardiogram changes, Rose angina, a history of myocardial infarction, or revascularization surgery. A score of social mobility (0-4) was calculated by summarizing childhood and adult financial circumstances. Diabetes prevalence (31.4%) was not associated with measures of growth but was significantly lower in women with greater education, childhood and adult income, or social mobility score. Compared with Filipinas who were poorest in childhood and adulthood, respective odds ratios (95% CI) for diabetes were 0.55 (0.18-1.68), 0.19 (0.06-0.62), and 0.11 (0.03-0.42), down to 0.07 (0.01-0.51) in the most advantaged women (P < 0.0001). Family history of diabetes [5.14 (2.72-9.70)] and larger waist [1.07 per cm (1.03-1.10)] were also significant predictors in multiple adjusted models. In contrast, CHD prevalence (22.4%) was most strongly associated with leg length, but not trunk length; compared with individuals with the shortest legs, respective odds ratios (95% CI) for CHD were 0.60 (0.31-1.19), 0.53 (0.26-1.05), and 0.44 (0.22-0.91) in the tallest group, in age- (P(trend) = 0.02) and multiple-adjusted models (P(trend) = 0.01). Socioeconomic disadvantage contributes to the high prevalence of diabetes in Filipinas. Factors limiting early growth of the legs may increase the risk of CHD in this comparatively short population.

Classification schemes for tumors diagnosed in adolescents and young adults

The International Classification of Diseases for Oncology (ICD‐O) is a collaborative undertaking of the International Agency for Research on Cancer and the National Cancer Institute in the U.S., under the aegis of the World Health Organization. Although the ICD‐O system generally is applicable to cancer diagnosed in childhood, it is recognized that morphology takes precedence over topography in classifying neoplasms occurring in children. Consequently, a classification scheme has been proposed that although based on the ICD‐O is tailored to the particular circumstances of adolescents and young adults with cancer.

Out of Area, Out of Sight: Review of Out‐of‐Area Placement Arrangements made by Social Services and Health for People with Learning Disabilities from the West Midlands

In 2004/2005 local partnership boards requested West Midlands South and Birmingham &amp; The Black Country Strategic Health Authorities (SHAs) to review and report back on the circumstances of adults with a learning disability placed out of area. There are currently 623 known adults with learning disability living out of area at an annual cost to commissioning services of £35 million. In 1993 the Mansell Report predicted major problems and potential consequences relating to future planning of services for people with learning disabilities and complex needs. Twelve years on this has become a reality, as more people are living in highercost services away from their original district and families. There is no evidence from this review that out‐of‐area services are any worse or any better than local services. The review does not set out to make a direct comparison of out‐of‐area placements and services provided locally, nor does it reflect on the number of people being imported into the West Midlands. With lack of monitoring and reviewing of placements, many people have been left solely to the care of provider organisations. Commissioners of services are becoming reliant on the Commission for Social Care Inspection (CSCI) to raise any concerns with them. This review calls for specific action to be taken now to reverse this trend of increasing out‐of‐area placements and to make more cost‐effective local solutions.

The Consequences of Maternal Employment During Men’s Childhood for their Adult Housework Performance

Using data from the first two waves of the National Survey of Families and Households, the author finds that married and cohabiting men exposed to maternal employment during childhood spent more time on housework as adults than did other men. By contrast, there is no such association for single men. These findings show that men’s housework performance is affected by both their childhood socialization and their adult circumstances, that is, whether they live with women. Furthermore, the positive relationship between maternal employment and adult housework for partnered men is restricted to men who grew up with their fathers present. Taken together, these results demonstrate that men’s adult housework performance is influenced by a combination of factors, namely, maternal employment, father presence, and marital status, rather than any one of them in isolation. The study suggests that we need both the socialization and the situational, or interactionist, perspectives to understand men’s adult family behavior.

Associations of childhood circumstances with physical and mental functioning in adulthood

The aim of this study was to examine the associations of parental education and specific childhood circumstances with adult physical and mental functioning. Self-reported data were collected in 2000, 2001 and 2002 among middle-aged women ( n = 7171 ) and men ( n = 1799 ) employed by the City of Helsinki. Functioning was measured by the physical and mental component summaries of the Short-Form 36 Health Survey (SF-36). The lowest quartile of the scores on each component summary was considered to indicate limited functioning. Adult socio-economic circumstances were measured by their own education. Among women parental education was inversely associated with physical functioning. The association remained after adjusting for specific childhood circumstances but disappeared after adjustment for own education. In contrast, parental education was positively associated with mental functioning among women, and the association remained after adjusting for specific childhood circumstances and the own education. Among women childhood adversities such as own chronic disease, parental mental problems, economic difficulties and having been bullied in childhood were associated with both physical and mental functioning. Parental drinking problems were associated with adult mental functioning among women. Among men, chronic disease, economic difficulties and having been bullied in childhood were associated with physical functioning. Parental mental problems, economic difficulties and having being bullied in childhood were also associated with mental functioning among men. These results suggest that the effect of parental education on physical functioning is mediated through one's own education. The association between parental education and mental functioning and the effects of several specific childhood circumstances may suggest a latency effect. Some evidence of cumulative effects of childhood and adulthood circumstances were found among women in physical functioning. Specific childhood circumstances are therefore important determinants of adult functioning. These circumstances provide detailed information on the association of childhood circumstances with adult functioning over and above parental education.

351 Childbirth and Adult Circumstances, Social Mobility and Adult Obesity: Findings from a Brazilian Birth Cohort Study

Objective: To investigate the influence of socioeconomic status at birth and during young adulthood, and social mobility, on adult central and total obesity in a developing country.Methods: 1016 men and 1087 women born in Ribeirγo Preto, Brazil in 1978/79 were followed up to age 23/25. Main outcome measures were body mass index, waist circumference and standard deviation scores of triceps and subscapular skinfold thickness. Explanatory variables were family income at birth and at young adulthood measured in minimum wages, classified into three groups: low, medium and high. Simple and multiple linear regressions were used in the analysis.Results: In the unadjusted analysis family income at birth was associated with obesity among men and women (P<0.05), with the exception of triceps skinfold among women (P=0.127) and subscapular skinfold among men (P=0.051). Current family income was associated with all measures of obesity among women (P<0.01) but not among men. After adjusting for both childbirth and current family income, childbirth income remained associated with waist circumference (P=0.023) and marginally with body mass index, triceps and subscapular skinfold (all P between 0.05 and 0.10) among men but with no measure of obesity among women. Current family income remained associated with all four measures of obesity among women (P<0.001). Only for women did upward social mobility lead to low levels of fatness. When educational level was used to measure socioeconomic position similar results were obtained.Conclusions: Fatness in young adulthood was more strongly related to childbirth circumstances for men whereas adult socioeconomic position seems to be more important for women. Upward social mobility was associated with lower obesity levels among women and did not change fatness among men. Results were fairly consistent for all measures of obesity. Influences of childbirth circumstances and social mobility on obesity seem to be predominantly socially patterned rather than biologically programmed.

Four indicators of socioeconomic position: relative ranking across causes of death

A study was undertaken to examine the relative ability of occupational class, education, household income, and housing conditions to discriminate all cause and cause-specific mortality-risk in Oslo, and to see if this relative ability is consistent across the 12 most common causes of death. Census records of inhabitants in Oslo 1990 aged 45 to 64 were linked to death records 1990-98 (n?=?88,159). All inhabitants were included except those who lacked census data on the independent variables. The relative index of inequality (RII) for each indicator was calculated. Education, occupation, and housing conditions had similar RIIs for all-cause mortality in both sexes. Household income had low RIIs, particularly in men. For the 12 most common causes of death some heterogeneity in the relative ranking between the four indicators was observed, with causes of death known to be related to early-life social circumstances (stomach cancer, cardiovascular disease, chronic obstructive pulmonary disease) being particularly strongly related to education, and causes of death which were likely to be determined by adult social circumstances (violence, sudden unexpected death) being particularly strongly related to occupation and housing conditions. Education, occupational class, and housing conditions all seemed to discriminate all-cause mortality to a similar degree. However, the cause-specific analysis revealed a heterogeneous pattern.

Childhood adversities and health variations among middle-aged men: a retrospective lifecourse study

Using a lifecourse approach, this study examines whether childhood adversities act on adult health as latent or pathway effects, and whether not only childhood ill health and material deprivation, but also an adverse psychosocial environment in terms of stressful relations with parents contribute to later ill health. Lifecourse interviews with 380 men born in 1946 were conducted. Outcome variables were perceived health, number of medical conditions, and activity limitations. Ordinal scales indicating levels of exposures as regards childhood health/growth, childhood material deprivation, stressful relations with parents, educational level, and unhealthy adult behaviours were made. Statistical analyses were performed by non-parametric correlation, logistic regression and OLS regression with dummy variables. Simple regression analyses showed a consistent pattern of more negative health outcomes with higher exposures on each of the lifecourse health determinants, but associations were relatively often not statistically significant. In multivariate analyses, the overall pattern remained with few alterations. The lifecourse determinants differed somewhat in their effects on the three health outcomes. Stressful relations with parents were significantly associated with perceived health and activity limitations. Childhood adversities influence later health to a large extent as latent effects. Stressful relations with parents were relatively important for two of the health outcomes, suggesting that not only ill health and material deprivation during childhood, but also an adverse psychosocial environment contributes to ill health among middle-aged men. The study asks whether childhood adversities influence middle-aged men's health through latent or pathway effects. Adjusted for adult circumstances, childhood health problems were associated with activity limitations and medical problems among men aged 55. Stressful relations to parents during childhood had direct negative effects on perceived overall health and activity limitations. Results indicate that childhood adversities often affect adult health as latent effects. Health promotion policies should consider that childhood psychosocial difficulties may have longterm negative health consequences.

Fetal Dermal Mesenchymal Cells Posses an Ability to Regenerate Dermis in the Reconstitution Model of Scid Mouse

Aim: We have shown that the dermal mesenchymal cells play key roles in the mouse fetal regenerative wound healing. However, the evaluation whether fetal dermal mesenchymal cells posses regenerative capacity in the adult circumstances has not been clarified yet. In the present study, we evaluated the dermal regenerative capacity of fetal dermal mesenchymal cells using reconstitution models on the back of scid mice.Method: Fetal dermal and fascial tissues were obtained from C57bl fetal mice at 17 days gestation. Tissues were dissected under microscope. Epidermis and dermis were separated with dispase. The dermis and fascia were digested with trypsin and cells from each tissue were suspended. Either dermal cells or fascial cells were mixed with epidermal cells, and transplanted in the skin defect 7 mm in diameter made on the back of scid mice. The number of cells transplanted was 1 × 107 for each type of cells. Four weeks later, the transplants were histologically examined.Results: All of the transplants constituted with dermal cells and epidermal cells regenerate almost normal dermal structures, while transplants mixed with fascial cells and epidermal cells did not regenerate dermis, and left scar like tissues.Conclusion: The regenerative capacity of fetal dermal mesenchymal cells was shown even in the adult circumstances.

From Childhood to the Later Years: Pathways of Human Development

Are family experiences early in life related to patterns of adjustment and functioning in later life? This study builds on past research with the decades-spanning Terman sample of talented children to explore this basic question. Multinomial logistic models identified three family experiences in childhood and adolescence—socio-economic status of the family of origin, early parental divorce, parent-child attachment—that predicted membership in holistic profiles of aging in the later years, as generated by cluster analysis of five social psychological factors. These associations from early to later life reflected both mediational pathways (adult experiences and current circumstances explained the observed influence of early experiences) and supplemental pathways (the significance of experiences in each stage were independent of each other).

The circumstances of adults with a psychotic disorder

This article presents some findings about adults with a psychotic disorder who were identified in the OPCS surveys of psychiatric morbidity. The main aim of the analysis was to identify characteristics associated with differences in the circumstances and health-related behaviour of adults aged 16-64 with psychosis. The analysis covers people who were identified by the various criteria used on the surveys as having a psychotic illness and who were considered to be living in private households. First we describe briefly the survey methods used and how diagnoses of psychosis were derived. We then present results from four topic areas covered in the analysis. These are: use of medication, use of health services, difficulties with activities of daily living, and social support.

More Accurate Alternatives to Serum Creatinine for Evaluating Glomerular Filtration Rate

The timely reports by Laterza et al. (1) and Filler et al. (2) in the same issue of the Journal discuss the use of serum analytes other than creatinine as surrogates for glomerular filtration rate (GFR). They describe the advantages as well as the limitations of these factors in special adult circumstances and in the pediatric age group, respectively. Recent publications by the Work Group of the National Kidney Foundation (3) also reaffirm the limitation of basing GFR only on serum creatinine. Levey et al. (4) reviewed data from 1628 patients enrolled in the Modification of Diet in Renal Disease Study (MDRD). Their stated purpose was “to develop an equation from MDRD Study data that could improve the prediction of GFR from serum creatinine”. Of the 1628 patients selected, data from 1070 were used to derive the equations, and data from 558 were used to verify the equations. They concluded that GFR calculated from serum creatinine, albumin, urea, and basic patient demographic data closely approximates the GFR determined from direct methods such as renal clearance of [125I]iodothalamate (4). Their prediction equations 6 and 7 decreased unexplained variance from measured GFR by more than one-half when compared with measured creatinine or urea clearance or the Cockcroft–Gault equation, i.e., from 19.6% to a … E-mail mscott{at}labmed.wustl.edu

Birth order and mortality: a life-long follow-up of 14,200 boys and girls born in early 20th century Sweden

The present study examines the sex-specific patterns of mortality by birth order in four stages of the life-course, using Poisson and logistic regression analysis. The main question posed is whether there is any continuing social effect of birth order when (a) biological factors at birth, (b) other social factors at birth and (c) socio-economic circumstances in adulthood are adjusted for. The analyses are based on the Uppsala Birth Cohort Study consisting of all 14,192 boys and girls who were born alive at the Uppsala Academic Hospital in Sweden during the period 1915–29. The results showed that all-cause mortality differed according to birth order in all of the four studied age intervals when birth year, mother's age, birth weight, gestational age, diseases of mother, diseases of the infant, social class and mother's marital status at the time of childbirth were adjusted for. The general tendency was for laterborn siblings, particularly girls/women, to demonstrate a higher mortality risk than firstborn children. However, in the oldest age group (55–80 years) the previously significant association between birth order and male mortality became insignificant when adult socio-economic circumstances were controlled for. This indicates that the long-term influence of childhood birth order position on mortality is partly mediated by adult social class, education and income. The concluding section of the paper notes that laterborn children, and especially girls, were a disadvantaged group in early 20th century Sweden. Thus, for the subjects in the present study, the childhood social conditions linked to birth order position seem to have had consequences for these individuals’ health and survival that extend over the whole life-course.

Sociodemographic gender differences in patients attending a community-based alcohol treatment centre.

This study included all individuals attending a community-based treatment centre during a 4-year period. Patients were referred to the treatment centre from the primary health care (17%), social insurance office (8%), social workers (19%), employers (7%), prisons and probation administration (3%), on their own initiative (25%), and by other means (21%). The participants, 355 men and 164 women, all between 18 and 64 years of age, were compared with the total population in the municipality with regards to gender differences in sociodemographic characteristics. Adult life circumstances such as legal problems, broken relationships, unemployment and lower social class, in both men and women, were clearly associated with an alcohol dependence or at least of seeking help for this problem. The study also emphasises important social consequences of alcohol dependence in women, such as legal problems and drunk driving, normally associated with male alcohol dependence. The study revealed that living with an abusing partner was associated with a higher frequency of alcohol dependence in women. The findings are important issues to address when offering treatment to women with alcohol dependence.

Lifetime risk factors for women's psychological distress in midlife

Research on the causes of psychological distress in women in midlife has focused on current adversity and hormonal changes associated with menopause and paid less attention to possible risk factors across the life course. We examined the factors in childhood, adolescence and earlier adult life that show persisting effects on psychological symptoms reported annually over a 6 year period (47–52 years) using prospective data on a cohort of 1500 British women who have been followed since their birth in 1946. Even after taking into account the powerful effect of recent life stress, this study found that women with a high level of psychological distress had different life course trajectories than those with less distress. They were more likely to have scored highly on the neuroticism scale or exhibited antisocial behaviour when they were teenagers, and to have had prior experience of mental and physical health problems in adult life. Those whose parents had divorced reported more distress in midlife, particularly if they too had experienced marital breakdown. These factors accounted for the associations between some of the adult sources of risk, particularly those to do with interpersonal difficulties or poor adult socioeconomic circumstances, and psychological distress in midlife. There was no evidence that concurrent menopausal status had any effect on the level of psychological symptoms except for those women on hormone replacement therapy who had a small and independent additional risk. More attention to a long term temporal perspective is warranted in research on the causes of psychological distress in women at midlife.

Own education, current conditions, parental material circumstances, and risk of myocardial infarction in a former communist country

OBJECTIVETo study the association between own education, adult and parental circumstances and the risk of myocardial infarction in a former communist country.DESIGNPopulation based case-control study.SETTINGGeneral population of five districts of...