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The effects of academic achievement may extend beyond economic success to influence social functioning, including future parenting. To evaluate whether adolescent academic achievement forecasts future parenting (both positive and negative) and the family home environment of parents. We used prospectively gathered intergenerational data from a population‐based birth cohort born in 1972/1973 in Dunedin, New Zealand, including data from Generation 1 (parents of the birth cohort), the birth cohort (Generation 2; G2), and G2's children (Generation 3). Adolescent academic achievement in G2 was used to predict observed and reported parenting outcomes when offspring (G3) were aged 3 years after controlling for a range of covariates, including G2's adolescent wellbeing, early childhood socioeconomic status (collected from G1), and G2's age at child's birth. We also evaluated 2‐way interactions between academic achievement and G2 parent sex, G3 child behaviour, and G2 adolescent wellbeing. Greater G2 academic achievement, net of controls, predicted more positive and less negative parenting (for mothers only), and a more positive home environment. For the home environment outcome, the effect of adolescent academic achievement was moderated by wellbeing. Adolescent academic achievement may positively influence parenting behaviour and the quality of the home environment. [ABSTRACT FROM AUTHOR]

Elevated levels of B-type natriuretic peptides among patients with exacerbations of chronic obstructive pulmonary disease ( COPD) are associated with higher mortality. The pathophysiology is unclear. To establish if elevated levels of N-terminal pro- B-type natriuretic peptide ( NT- proBNP) are due to right or left heart dysfunction, we performed echocardiograms in 18 patients admitted to hospital with COPD. Elevated levels of NT- proBNP were associated with both right and left heart dysfunction and indicate that these patients have biventricular dysfunction rather than isolated right ventricular compromise. [ABSTRACT FROM AUTHOR]

Background: Despite the publication of several management guidelines for exacerbations of chronic obstructive pulmonary disease (COPD), there is little information on standards of care in clinical practice. The aim of this audit was to examine the assessment, management and outcome of COPD admissions to a secondary and tertiary referring New Zealand hospital during two different seasons. Compliance to current recommendations was examined and compared with the available international published work. Methods: All COPD-related admissions to Waikato Hospital during the months of May and October 2004 were reviewed. Ninety-four cases (from 84 patients) were audited. Results: General characteristics, clinical features and lung function tests were similar to that of other cohorts. Twenty-three per cent of the admissions were Maori and the mean age of Maori admissions were significantly less than that of the non-Maori admissions (57 and 72 years, respectively; P = 0.0001). The geometric mean length of stay was 3.4 days, which is significantly less than most other reported hospital lengths of stays related to exacerbations of COPD. Fifty-five per cent of the cohort was admitted more than once to the hospital for COPD in the 12 months before the index admission. Thirteen per cent of all admissions received assisted ventilation. Overall 30-day mortality was 8% and the 12-month mortality was 31%. Decreased body mass index was a risk factor for death as was an increased CURB-65 (confusion, urea, respiratory rate, blood pressure age) score – a simple bedside assessment score, which has previously been used to predict mortality in patients with community-acquired pneumonia. Conclusion: This audit documented the general characteristics, assessment, management and outcome of the COPD admissions to a secondary New Zealand hospital. Further investigations into factors contributing to shorter length of stay and predictors of mortality are needed. [ABSTRACT FROM AUTHOR]

Background: There is conflicting information about the relationship between asthma and socioeconomic status, with different studies reporting no, positive, or inverse associations. Most of these studies have been cross sectional in design and have relied on subjective markers of asthma such as symptoms of wheeze. Many have been unable to control adequately for potential confounding factors.Methods: We report a prospective cohort study of approximately 1000 individuals born in Dunedin, New Zealand in 1972-3. This sample has been assessed regularly throughout childhood and into adulthood, with detailed information collected on asthma symptoms, lung function, airway responsiveness, and atopy. The prevalence of these in relation to measures of socioeconomic status were analysed with and without controls for potential confounding influences including parental history of asthma, smoking, breast feeding, and birth order using cross sectional time series models.Results: No consistent association was found between childhood or adult socioeconomic status and asthma prevalence, lung function, or airway responsiveness at any age. Having asthma made no difference to educational attainment or socioeconomic status by age 26. There were trends to increased atopy in children from higher socioeconomic status families consistent with previous reports.Conclusions: Socioeconomic status in childhood had no significant impact on the prevalence of asthma in this New Zealand born cohort. Generalisation of these results to other societies should be done with caution, but our results suggest that the previously reported associations may be due to confounding. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of television viewing during childhood and adolescence on body mass index (BMI) in children up to the age of 15 years., Design: Unselected birth cohort, assessed at birth and every 2 years from age 3 to 15 years., Subjects: In all, 1037 individuals were assessed at age 3 years. At age 15 years, 976 (95% of living cohort) continued to participate., Measurements: Parental estimates of weekday television viewing between age 5 and 11 years. Self-reports of television viewing at age 13 and 15 years. Weight and height were measured at each age to calculate BMI., Results: BMI and prevalence of overweight at all ages were significantly associated with mean hours of television viewing reported in the assessments up to that age. These associations were stronger in girls than boys. The associations remained significant after adjusting for parental body mass indices and socio-economic status., Conclusion: Time spent watching television is a significant predictor of BMI and overweight in childhood. Although the effect size appears small, it is larger than the effect sizes commonly reported for nutritional intake and physical activity. Television viewing should be regarded as an important contributing factor to childhood obesity.

Objective: This study sought to determine the relationship between levels of the inflammatory marker, C-reactive protein (CRP), cardiovascular risk factors and oral contraceptive use in young adults., Design: Cross-sectional study of a community cohort., Subjects: A total of 822 men and women aged 26 y., Measurements: CRP, body mass index (BMI), blood pressure, lipid and lipoprotein levels, smoking status, socioeconomic status, health status, and hormonal contraceptive use in women., Results: Multiple regression analysis showed that obesity was independently related to CRP with an increase in ratio CRP of 1.03 (95% CI 1.01, 1.05) for men and 1.07 (1.05, 1.09) for women associated with a 1 kg/m(2) increase in BMI. In women, combined oral contraceptive use was associated with a ratio change in CRP of 1.52 (1.27, 1.82) compared with nonusers. Other independent determinants of CRP in men and women were apolipoprotein B level, systolic blood pressure and apolipoprotein A1 in men. Univariate analysis showed that the relationship between CRP and BMI, systolic blood pressure and apolipoprotein B was significantly stronger in women than men., Conclusion: These findings suggest that obesity is associated with inflammation independent of other cardiovascular risk factors that may contribute to an increased risk for cardiovascular disease in men and women. Elevated CRP related to combined oral contraceptive use may influence the rate of cardiovascular events in young women.

Aims: To describe the characteristics and outcomes of patients treated with domiciliary nocturnal support ventilation (NSV)., Methods: Case-note review of all patients treated with home NSV by Green Lane Hospital., Results: 111 patients received home NSV between 1990 and 1999. 59 had respiratory failure due to obesity-hypoventilation syndrome (OHS), most of whom were Maori or Pacific Island people. Their mean BMI was 53 kg/m2. They frequently presented acutely, and often in extremis. After a median duration of 22 months treatment, 37 patients continued treatment. Four have died, but none from respiratory failure. Other causes of respiratory failure included: neuromuscular disease (26), kyphoscoliosis (19) and obstructive sleep apnoea (8). Patients who did not have OHS were mostly of New Zealand European ethnicity, required lower ventilation pressures than patients with OHS, and had better arterial blood gases on treatment. After a median follow-up of 35 months, however, fourteen have died. 33 continued on treatment. Both OHS and non-OHS patients had high deprivation scores according to NZdep96. This was most apparent for patients with OHS., Conclusions: OHS is an important cause of respiratory failure in New Zealand, particularly affecting Maori and Pacific people. The prognosis of OHS treated with NSV appears to be good despite significant co-morbidity.