Finding and using inter-war maternity records

Psychiatric case notes: symptoms of mental illness and their attribution at the Maudsley Hospital, 1924-35

Case notes of patients treated at the Maudsley Hospital during the interwar period provided data about diagnosis, symptoms and beliefs about mental illness. In the absence of effective treatments, patients were investigated in detail in the hope that connections between disease processes might be revealed. We analysed a randomly-selected sample of 700 patients taken equally from 1924, 1928, 1931 and 1935. Eight groups (three representing psychosis and five indicating psychological disorders) were identified on the basis of symptom clusters. Formal diagnosis did not correlate with clusters. Although there was a measure of agreement between patients and doctors about the cause of mental illness, stigma may have inhibited discussion of some themes. Psychiatric diagnosis was informed by symptoms but not determined by them. In an era before classification systems were tested for reliability, diagnosis was fluid, reflecting changing hypotheses about causation, pathology and treatment. Attributions were associated with diagnosis rather than symptoms.

Department of Health Research Initiative on Nutrition Phase 2: overview of findings and recommendations

OBJECTIVE

The purpose of this overview is to synthesise and summarise the findings and recommendations of all 14 projects funded between 1997 and 2002 under Phase 2 of the Department of Health's Policy Research Programme Nutrition Initiative. This is aimed at end users, including policy makers, practitioners, researchers and research funding bodies.

DESIGN

The main findings and recommendations for policy and practice, as well as for future research, contained in the peer-reviewed final report of each project are summarised under headings identified as being useful for policy groups and practitioners: Maintenance of a healthy weight; Functional outcomes related to different markers of iron status; Nutritional aspects of bone health in humans; and Dietary interventions.

RESULTS

The overview draws together the key findings and recommendations for current and future policy and practice from the second phase of the research programme and identifies research gaps.

CONCLUSIONS

The findings and recommendations of the Department of Health's Nutrition Research Initiative have contributed to the scientific evidence base for policy development, policy evaluation, and will inform practitioners as well as researchers and research funding bodies.

Association between breast feeding and growth: the Boyd-Orr cohort study

OBJECTIVE

To investigate the association of breast feeding with height and body mass index in childhood and adulthood.

DESIGN

Historical cohort study, based on long term follow up of the Carnegie (Boyd-Orr) survey of diet and health in pre-war Britain (1937-1939).

SETTING

Sixteen urban and rural districts in Britain.

SUBJECTS

A total of 4999 children from 1352 families were surveyed in 1937-1939. Information on infant feeding and childhood anthropometry was available for 2995 subjects.

MAIN OUTCOME MEASURES

Mean differences in childhood and adult anthropometry between breast and bottle fed subjects.

RESULTS

Breast feeding was associated with the survey district, greater household income, and food expenditure, but not with number of children in the household, birth order, or social class. In childhood, breast fed subjects were significantly taller than bottle fed subjects after controlling for socioeconomic variables. The mean height difference among boys was 0.20 standard deviation (SD) (95% confidence interval (CI) 0.07 to 0.32), and among girls it was 0.14 SD (95% CI 0.02 to 0.27). Leg length, but not trunk length, was the component of height associated with breast feeding. In males, breast feeding was associated with greater adult height (difference: 0.34 SD, 95% CI 0.13 to 0.55); of the two components of height, leg length (0.26 SD, 95% CI 0.02 to 0.50) was more strongly related to breast feeding than trunk length (0.16 SD, 95% CI -0.04 to 0.35). Height and leg length differences were in the same direction but smaller among adult females. There was no association between breast feeding and body mass index in childhood or adulthood.

CONCLUSIONS

Compared with bottle fed infants, infants breast fed in the 1920s and 1930s were taller in childhood and adulthood. As stature is associated with health and life expectancy, the possible long term impact of infant feeding on adult mortality patterns merits further investigation.