West Berkshire Research Articles

Social class inequalities in childhood mortality and morbidity in an English population

The objective of this study was to examine the association between social class of the head of household at the time of birth and mortality and morbidity during the first 10 years of life in a cohort of all 117 212 children born to women who both lived, and delivered in hospital, in Oxfordshire or West Berkshire during the period 1 January 1979 to 31 December 1988. Logistic regression was used to estimate social class gradients, with odds ratios (OR), for mortality during the early neonatal period, late neonatal period, post-neonatal period, post-infancy period and throughout the first 10 years of life. Logistic regression was also used to estimate social class gradients, with ORs, for hospital admission rates for 16 broad groups of diseases during years 0-3, 4-6, 7-10 and throughout the first 10 years of life. Poisson regression was used to estimate social class gradients, with effect sizes, for overall hospital admission rates during years 0-3, 4-6, 7-10 and throughout the first 10 years of life. The study revealed a significant social class gradient in mortality during the first 10 years of life (adjusted OR for each decrement in social class category 1.08; [95% confidence interval 1.03, 1.14]). The study also revealed a significant adjusted social class gradient in hospital admission rates for 14 of the 16 groups of diseases during the first 10 years of life. For the majority of these, the social class gradients had attenuated somewhat by the later childhood years. However, the social class gradient persisted throughout the first 10 years of life for diseases of the respiratory system (1.07 [1.05, 1.08]), diseases of the digestive system (1.06 [1.04, 1.09]), and injury and poisoning (1.07 [1.06, 1.09]). In addition, a significant adjusted social class gradient was found in overall hospital admission rates for each age group studied. This study suggests that there are significant social class inequalities in a wide range of adverse child health outcomes.

Ironworking in the Bronze Age? Evidence from a 10th CenturyBCSettlement at Hartshill Copse, Upper Bucklebury, West Berkshire

Excavations at Hartshill Copse in 2003 uncovered evidence for Late Bronze Age settlement, securely dated to the 10th centuryBC, associated with long alignments of closely set posts: prehistoric landscape features with few known parallels. Extensive sampling of the settlement remains yielded quantities of burnt flint and plain Post Deverel-Rimbury potsherds, and, quite unexpectedly, a substantial quantity of iron hammerscale. This paper presents the excavation data, with supporting dating evidence, and the results of detailed analysis of the metallurgical residues. It explores the spatial distribution of artefact types within the settlement, and presents an interpretative model for settlement use. The nature of the settlement, with its carefully planned use of space and close relationship with the post alignments, is then discussed. Together, all this provides conclusive evidence for the earliest ironworking site yet recognised in Britain. The paper concludes with a comprehensive discussion of early ironworking in its British and European context.

Collaboration is the key

Sue Nicholson talks to 5to7 about why and how collaboration is being embedded at the very heart of education throughout West Berkshire

Dynamics of river–aquifer interactions along a chalk stream: the River Lambourn, UK

AbstractThis paper describes the spatial and temporal pattern of groundwater flow accretion to the River Lambourn, a 234 km2 chalk catchment of the West Berkshire Downs, UK, which has been largely unaffected by groundwater abstraction. Variations in the discharge measured at four fixed gauges in the catchment, coupled with information on the length of flowing channel over the period 1983–2001, are used to describe regional patterns in flow accretion. Mean catchment accretion generally exceeds 0·15 m3 s−1 km−1, but there are significant differences between perennial reaches indicating how the combination of local structural controls and seasonal changes in the drainage net affect flow accretion. Data from current meter surveys were used to determine the spatial variability in flow accretion: 505 paired observations along 12 reaches between 1 and 2·95 km in length indicated a consistent spatial trend in accretion. Accretion was high in upstream and downstream channel reaches, and in middle reaches where dry valleys intersected the main valley. A flow accretion index was developed to describe the relationship of flow accretion in each of the 12 study reaches to catchment discharge. The relationship varied from a strong positive correlation with catchment discharge (two reaches), a weak positive correlation (three reaches), a strong negative correlation (two reaches), to no relationship to catchment discharge (four reaches). The results highlight the need to reconsider the usual assumption of uniform, or uniformly increasing, flow accretion in chalk catchments. Moreover, they emphasize the importance of catchment topography, and illustrate how flow accretion in individual reaches may vary between high and low groundwater levels. Copyright © 2005 John Wiley & Sons, Ltd.

The economic consequences of preterm birth duringthe first 10 years of life

To examine the association between gestational age at the time of birth and long-term use and cost of hospital inpatient services. Multi-level modelling of the hospital service utilisation and cost profile of each child born in hospital during 1978-1988 in two areas covered by the Oxford Record Linkage Study. Oxfordshire and West Berkshire. 117,212 children divided into four subgroups by gestational age at birth: <28 weeks, 28-31 weeks, 32-36 weeks, 37 weeks or greater. Number and duration of hospital admissions during the first 10 years of life. Costs, expressed in pound sterling and valued at 1998-1999 prices, of hospital inpatient services. The cumulative cost of hospital inpatient admissions incurred during the first 10 years of life, including the initial birth admission, averaged 17,819.94 [22,322.87 UK pounds] for children born at <28 weeks gestation, 17,751.00 [19,055.53 UK pounds] for children born at 28-31 weeks gestation, 5,376.39 [7,393.78 UK pounds] for children born at 32-36 weeks gestation, and 1,658.63 [3,409.14 UK pounds] for children born at 37 weeks gestation or greater. The adjusted number of hospital inpatient admissions, inpatient days and costs, respectively, over the first 10 years of life was 130%, 77% and 443% higher for children born at <28 weeks gestation than for children born at term. The adverse sequelae of preterm birth are likely to have considerable long-term economic consequences for the health services and for society as a whole.

Economic implications of multiple births: inpatient hospital costs in the first 5 years of life

Objectives: To estimate long term health service costs for hospital stays associated with singleton, twin, and higher order multiple births up to 5 years of age. Design: Costs from specialty...

The association between smoking during pregnancy and hospital inpatient costs in childhood

Although the health sequelae of smoking during pregnancy are well documented, relatively little is known about its long-term economic implications. The objective of this study was to analyse individual-level data on maternal smoking behaviour and sociodemographic, perinatal and resource utilisation variables in order to estimate the association between smoking during pregnancy and hospital inpatient service utilisation and costs through the first 5 years of the infant's life. Data from the Oxford Record Linkage Study, a collection of birth registrations, death certificates and statistical abstracts of hospital inpatient and day case admissions formed the basis of the investigation. The study population comprised all infants born to women who both lived and delivered in Oxfordshire or West Berkshire during the period 1 January 1980–31 December 1989 (n=119,028). The cost of each hospital admission, including the initial birth admission, was estimated by multiplying the length of stay by the per diem cost of the respective specialty (£ 1998–1999 sterling). The effect of maternal smoking behaviour on cumulative 5-year hospital inpatient service utilisation and costs was analysed in a series of multivariate analyses, taking account of confounding clinical and sociodemographic factors. Infants born to women who reported smoking during pregnancy were hospitalised for a significantly greater number of days than infants born to women who had either never smoked or had smoked in the past (P<0.0001). Over the first 5 years of life, the adjusted mean cost difference was estimated at £462 (95%CI: £353–£571) when infants born to women who smoked at least 20 cigarettes per day were compared to infants of non-smoking mothers, and £307 (95%CI: £221–£394) when infants born to women who smoked 10–19 cigarettes per day were compared to infants of non-smoking mothers (P<0.0001). The results of this study should add an economic dimension to the importance of providing smoking cessation services for pregnant women.

The issue of consent and children: who decides?

Primary care workers have patients of all ages on their caseload and it is essential that any care or treatment delivered to them is done within the law. Consent is an essential element of the lawfulness of treatment. It provides a defence to criminal assault and the tort or civil wrong of trespass to the person (F v West Berkshire Health Authority [1990]).

The iron hat from Shaw House

The small unpublished group of armour of the mid 17th century from Shaw House in Berkshire, scene of fighting in the 2nd battle of Newbury in 1644, is preserved in the West Berkshire Museum in Newbury. The group includes an exceedingly rare form of helmet of the period, one made in the form of a broad brimmed hat. The article discusses the small group of known examples, and illustrates the closest comparable iron hat from the Scott collection in Glasgow Museums and Art Galleries.

The Wokingham &amp; West Berkshire Mind Crisis House

erceived at one level, the Wokingham Mind crisis house is the simplest of projects – both in conception and in reality. Wokingham & West Berkshire Mind was formed in July 1988 by a group of mental health service users and informal carers who were only too well aware of the local paucity of mental health services. The idea was to fill this gap with things that service users and carers actually needed. Identified as priorities were a drop-in centre, a befriending scheme and crisis beds. The service users had been on the receiving end of psychiatric oppression and the informal carers had had their needs ignored by mental health professionals. We therefore decided from the beginning that professionals would be banned. Thus we ensured that we were and always would be a user-run organisation. We sought affiliation to MIND because their stated aims and values were the same as ours and because we valued membership of the national mental health movement. Our first year’s existence was devoted entirely to the political and the philosophical. We worked out what we were and what we were not before we put any services in place and a lot of our subsequent success is due to the clarity of vision established in those early days. A year later in June 1989 we established a weekly drop-in centre in the heart of the Wokingham community. We soon had a regular attendance of 30 mental health service users and carers from whom a successful befriending scheme was derived. The hall cost £5 per morning. We passed the plate round to raise this and also started our own modest fundraising events. We heard through rumours on the grapevine that a house, Station House in Wokingham, was going to be made available to us. This house had been the headquarters of the local mental health team, which was moving to Wokingham Hospital. However, no meeting was arranged with us to discuss on what basis we were to take possession of the house. First, the P proposed date for moving was Christmas 1989. We were, of course, not ready, but we needn’t have worried. The grinding of bureaucracy was predictably slow, and we eventually got the keys to Station House at Easter 1991. I have no doubt that social services had an agenda for our development once we moved into Station House, but it was never discussed with us. At our own monthly committee meetings we had already decided to set up Station House as a crisis house as soon as we moved in. We were ready now, having established a flourishing drop-in and befriending scheme from whom crisis volunteers could be drawn. The only discussion about our occupation of Station House took place with the property department of the now defunct Berkshire County Council. They prepared a rent-free lease on two conditions. First, that we should allow a small group of service users who had attended social services groups to continue coming to our dropin and, second, that we should allow the Wokingham Volunteer Centre to continue using the premises until they found an alternative venue. Moving into Station House on Tuesday 2 April 1991, we cleaned, decorated and furnished it and immediately opened our first, and at that time, only, crisis sanctuary. A further crisis sanctuary was set up when the Volunteer Centre moved out in April 1993, a third in October 2000, and a fourth (short-term crisis bed) in April 2003. It is a service that has evolved gradually with us acquiring crisis skills and gaining confidence as we go along. The concept is simple: ‘home-spun, as mother made it’. You have a little old house in the heart of the community opposite Wokingham railway station. It is within minutes’ walk of all essential services – doctors’ surgeries, hospital, chemists, shops, job centre, housing department, and statutory mental health services. Inside, the furnishings (provided free of charge by the local community) are cosy and homelike. The house consists of four bedrooms with en-suites, two kitchens (one for the drop-in centre and

The impact of preterm birth on hospital inpatient admissions and costs during the first 5 years of life.

To compare the cumulative use and cost of hospital inpatient services to 5 years of age by individuals divided into 4 subgroups by gestational age at birth. Costs applied to the hospital service utilization profile of each infant born in 2 areas covered by the Oxford Record Linkage Study during 1970-1993. Oxfordshire and West Berkshire, southern United Kingdom. 239 694 individuals divided into 4 subgroups by gestational age at birth: <28 weeks, 28 to 31 weeks, 32 to 36 weeks, >or=37 weeks. Number and duration of hospital admissions during the first 5 years of life and costs, expressed in pound sterling and valued at 1998-1999 prices, of hospital inpatient services. The total duration of hospital admissions for infants born at <28 and at 28 to 31 gestational weeks was 85 and 16 times that for term infants, respectively, once duration of life had been taken into account. Hospital inpatient service costs were significantly higher for preterm infants than for term infants, with the cost differences persisting throughout infancy and early and mid-childhood. Over the first 5 years of life, the adjusted mean cost difference was estimated at pound 14,614 ( 22,798 US dollars) when infants born at <28 weeks gestational age were compared with term infants and pound 11,958 ( 18,654 US dollars) when infants born at 28 to 31 weeks gestational age were compared with term infants. Independent contributions to total cost came from being born: small for gestational age, a multiple, during the 1970s and early 1980s, to a woman of extreme maternal age or who was hospitalized antenatally, and from experiencing extended survival or childhood disease. However, preterm birth remained the strongest predictor of high cost. Preterm birth is a major predictor of how much an individual will cost hospital service providers during the first 5 years of life.

Hailfalls at woodlands St. Mary, West Berkshire, 13 May 2003

Hailfalls at woodlands St. Mary, West Berkshire, 13 May 2003

Hailfalls at Woodlands St. Mary, West Berkshire, 13 May 2003

Hailfalls at Woodlands St. Mary, West Berkshire, 13 May 2003

Survey of changes in the provision of vascular surgical services in the Oxford Region over 5 years.

This study aimed to examine changes in the provision of vascular services in the Oxford region over 5 years. A questionnaire was sent to all general surgeons in the region asking of their involvement in vascular surgery. Data were obtained from the Department of Health concerning vascular procedures and inpatient codes for each district in the Oxford Region from 1990-1991 to 1994-1995. Office of Population Censuses and Surveys (OPCS) data for abdominal aortic aneurysm repair and femoral artery reconstruction were validated against data collected prospectively for West Berkshire. Eighteen of 45 surgeons who replied to the questionnaire carried out elective and emergency arterial work. All were members of the Vascular Surgical Society of Great Britain and Ireland (VSS). All but one took part in the general surgical rota. Eight surgeons carried out emergency arterial surgery only; only two of these were members of the VSS. Of 19 surgeons undertaking no arterial surgery, 15 operated on primary and 11 on recurrent varicose veins. The number of arterial reconstructions rose from 20.8 per 100000 population to 28 per 100000 throughout the study. The greatest increase occurred in districts where a new vascular consultant had been appointed. Similar results were obtained with endovascular procedures. The number of major amputations remained fairly constant at approximately 11 per 100000 population. The number of inpatient episodes for arterial disease also rose, from 35.7 to 47.6 per 100000. In validating OPCS codes against prospectively collected data, discrepancies for individual years were noted but the annual trend was reflected fairly accurately by the codes. There has been an increase in vascular activity in the region, but variations still exist between different districts.

A randomized controlled trial to compare alternative strategies for preventing infant crying and sleep problems in the first 12 weeks: the COSI study

This study was designed to test the hypothesis that a behavioural programme was used preventatively to try to reduce crying and improve night sleeping in 1- to 12-week old infants compared with educational support or existing services. The objectives were to develop strategies which can be used to inform, help and support parents of new babies. The study was a three-group prospective randomized controlled trial in West Berkshire and South Oxfordshire, making a comparison between a behavioural policy, an educational intervention and existing services. The participants were 610 mothers giving birth to term healthy infants at the Royal Berkshire Hospital, Reading between March and November 1997. The main outcome measures were interruption-free nights i.e., the number of nights each week when parents reported that their baby slept for a minimum of 5 hours; babies' fuss/crying patterns; and mothers' general well-being and approach to parenthood. There were no significant differences between the groups in the amount of fuss/crying, which gradually reduced during the 12 weeks. At 12 weeks of age, more mothers in the behavioural group reported their babies to have had seven interruption-free nights (61%), compared with the educational (53%) and the control groups (50%). This was significant at the P &lt; 0.05 level. The educational and control groups did not significantly differ at any age. At 6 and 12 weeks, mothers allocated to the behavioural policy were more structured in their approach to parenting and rated it more highly for convenience. At 9 months, their babies were more likely to have a regular bedtime routine. Where mothers followed a behavioural programme, 10% more babies slept for a minimum of 5 hours at night without disturbing their parents at 12 weeks of age. This improved sleeping pattern persisted up to 9 months of age. Mothers in this group also reported a greater feeling of control and increased confidence in their ability to cope. The more widespread adoption of a behavioural approach to the management of early infant sleeping should be considered.

The incidence of childhood Leukaemia in West Berkshire*

This paper gives an overview of local work on the incidence of childhood leukaemia in West Berkshire since 1971. The most recently published figures show that between 1972–96, a total of 106 children contracted leukaemia when 81 cases would have been expected in the under 14s. Within ten kilometres of the nuclear establishments at Aldermaston and Burghfield, the risk of a child getting leukaemia, which is very small (400 children a year in the UK) is none the less doubled in under‐fives meaning that one more child a year is affected. There is also an increased incidence of all cancers in this age group and geographical area. Theories as to why this should be abound, but until the cause of cancer is fully understood, and what the part of radiation in the process could be, no firm measures can be taken to redress the balance.

Reproductive factors, subfertility, and risk of neural tube defects: a case-control study based on the Oxford Record Linkage Study Register.

Periconceptual exposure to subfertility treatments is increasingly common, raising concerns about the possibility of malformations in the offspring. The authors conducted a case-control study to determine whether subfertility or its treatment was associated with increased risk of neural tube defects (NTDs). Cases were 694 women diagnosed with an NTD-affected pregnancy in Oxfordshire or West Berkshire, England, between 1970 and 1987. Cases were individually matched on maternal year of birth and year of index pregnancy to controls randomly selected from a computerized database. Data on demographic, reproductive, and obstetric factors were abstracted from patient hospital records. Overall, the period prevalences of subfertility and of subfertility treatment were 7% and 3%, respectively, No evidence was found that the risk of NTD-affected pregnancies was increased by either subfertility (odds ratio (OR) = 1.2, 95% confidence interval (CI): 0.7, 2.1) or its treatment (OR = 0.9, 95% CI: 0.4, 2.0). After adjustment, NTD-affected pregnancies were associated with female offspring (OR = 2.3, 95% CI: 1.8, 3.1), multiple birth (OR = 4.8, 95% CI: 1.2, 18.8), and higher numbers of pregnancies (p for trend = 0.005). The findings from this large, population-based study were wholly consistent with those from smaller studies that found no increased risk of NTD associated with exposure to fertility treatments but reported associations with various pregnancy outcomes.

A cluster of intense rainfall events in West Berkshire, summer 1999

WeatherVolume 55, Issue 10 p. 356-363 A cluster of intense rainfall events in West Berkshire, summer 1999 Stephen Burt, Stephen Burt Stratfield Mortimer, West BerkshireSearch for more papers by this author Stephen Burt, Stephen Burt Stratfield Mortimer, West BerkshireSearch for more papers by this author First published: 30 April 2012 https://doi.org/10.1002/j.1477-8696.2000.tb04021.xCitations: 4AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume55, Issue10October 2000Pages 356-363 RelatedInformation

Mental incapacity and restraint for treatment: present law and proposals for reform

The House of Lords in F v West Berkshire Health Authority [1989] considered the lawfulness of providing care and treatment for a mentally incapacitated adult. They did not, however, directly...

Investigation of an Alleged Nuclear Incident at Greenham Common Airbase Using TI-mass Spectrometric Measurements of Uranium Isotopes

Uranium isotopic compositions were determined in over 500 soil samples from the Greenham Common Air Base and in surrounding west Berkshire and north Hampshire, England to detect potential contamination from an alleged 1958 nuclear incident. Owing to the large number of samples collected for the study, the short reporting time expected, and the potentially subtle nature of any contamination, a rapid and highly precise method of uranium analysis was developed. High precision 238U/235U mass spectrometric measurements are required to see slight excesses in any anthropogenic component. The reproduc ibility for measurements of uranium isotopic ratios in standards and soil samples was better than 0.26% at the 3σ uncertainty level. Despite an intensive study around the airbase no evidence was found for any contamination by uranium of anomalous isotopic composition. Plutonium measurements were also made to support the U analysis and were found to be consistent with atmospheric bomb fallout for the United Kingdom. ...