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Biomedical subjects

A Chamberlain

Publications and source records attributed to A Chamberlain.

12 recordsLinked to original sources
PubMed1992

Evaluation of a heart disease survey and education program for general practitioners.

In 1989 we mailed a questionnaire to all 461 general practitioners (GPs) identified as currently practising in the Eastern Metropolitan Health Region of Sydney. This was the first phase of a program to assess, amplify and reassess GPs' knowledge of the risk factors for heart disease and measure their attitudes and beliefs about their role in the prevention of cardiovascular disease. The second phase was an education program designed to meet the needs identified by the first questionnaire. Phase three was a postintervention questionnaire. Fifty-six per cent (260/461) responded to the first questionnaire. This follow-up group were mailed the second questionnaire, to which 52 per cent (135/260) responded. Thirty per cent of the original sample (139/461) attended the education program and 30 per cent (79/260) of the follow-up group did so. At baseline, the respondents' level of risk factor knowledge was good, but after the education program there was still a large gap between what they said they knew and the amount of advice they said they would give to patients. The only significant increase in the amount of advice after the intervention was to 'control blood pressure'. This applied whether the GP had participated in the intervention or not. When GPs were asked how often in the last month they had actually given advice to reduce cardiovascular disease risk, program attenders reported offering it more frequently than nonattenders. We also attempted to determine whether any particular demographic characteristics could predict respondents to the questionnaires and/or the educational program.

Australia↗
PubMed1992

Home parenteral nutrition in chronic intestinal failure.

In children with severe failure of intestinal function, intravenous nutrition is at present the only treatment able to maintain adequate nutrition for prolonged periods of time. Over the last five years we have discharged 10 patients home on parenteral nutrition for a total of 25 patient years and here the outcome of these children is presented. Of the 10 patients, one has discontinued home parenteral nutrition (HPN), seven patients remain well, one patient has recently moved to the USA, and one patient has died after major abdominal surgery. All children had either normal or an accelerated rate of growth on HPN and developmentally all have progressed well. All the children over 5 years attend normal schools. The major complication of treatment was line sepsis with an overall rate of one episode in 476 days and a total of nine central lines (five patients) have required replacement giving an average line life of 680 days. For those children unfortunate enough to suffer from severe intestinal failure, HPN is preferable to prolonged hospital treatment and offers the chance of a good quality of life with prolonged survival.

Adolescent↗
PubMed1987

Targeting the smoker in an anti-smoking campaign.

Between May and September 1983, 1,661 smokers from a random sample of the populations of Sydney and Melbourne were interviewed in their homes. Of the first group, 219 were followed up 12 months later, representing a 75% response rate. Intention, measured by perceived likelihood to quit, was validated as a predictor of a later attempt to quit smoking in the cohort study. Males reported likelihood to quit more often than females. Perceived importance of smoking as a community health problem was also important in predicting attempts to change smoking status, indicating the possible importance of an agenda-setting role for the mass media in promoting change. The key finding was the interaction between health beliefs and social influence in predicting level of intention. On their own, health beliefs showed no relationship to perceived likelihood to quit, and social influence could be counterproductive. However, taken together, these two variables were strongly predictive of change. This suggests that a combination of these two messages should be used in anti-smoking campaigns.

Adolescent↗
PubMed1986

Evaluation of the Sydney "Quit. For Life" anti-smoking campaign. Part 1. Achievement of intermediate goals.

The "Quit. For Life" campaign was a media-based programme that was aimed at reducing the prevalence of smoking in Sydney. The programme committee set four intermediate goals which it felt had to be met for such a change in prevalence to occur. From households selected at random in Sydney and Melbourne, 5713 people were interviewed to assess whether the campaign attained these goals. The television commercials that were designed for the campaign, their frequency and the timing of their screening produced a higher recall of the commercial's message and the use of campaign back-up services than were specified originally in the goals. During the campaign there was a progressive increase in the number of smokers in Sydney who reported that they were likely to quit; this was significantly different from Melbourne data by the end of the campaign and thus fulfilled another campaign goal. However, shortly after the campaign ended, the proportion of smokers who intended to quit smoking was the same in the two cities. A cohort study of 949 people from the baseline study showed that, during the 12-month period of follow-up, 66% of Sydney smokers tried to stop or to reduce their smoking. In the control city, Melbourne, 60% of smokers reported making such attempts. Of the original smokers, 23% in Sydney and 9% in Melbourne quit during the follow-up period--a statistically significant difference. As well, 10% of the original ex-smokers in Sydney and 11% in Melbourne relapsed, while 4% of nonsmokers in both cities began smoking by the end of the second survey.

Adolescent↗
PubMed1985

Pulmonary epithelial permeability after inhaling saline, distilled water "fog" and cold air.

It is recognized that hyperventilation of cold air and the inhalation of fine mists of distilled water provoke significant bronchoconstriction in the asthmatic individual, yet little is known as to how these provocations affect the structural integrity of the alveolar epithelial membrane. In 11 normal subjects, the following effects have been studied: cold air hyperventilation for three minutes, inhalation of 80 L of ultrasonically nebulized distilled water "fog," and 80 L of isotonic saline "fog" on the half time clearance (T1/2) from the alveoli of technetium 99m diethylene triamine penta acetate (DTPA), inhaled as an aerosol. The DTPA T1/2 provided a measurement of pulmonary epithelial permeability.

Aerosols↗
PubMed1977

Differences in breast cancer between Japan and the United States.

Two surgically treated series of 375 Japanese and 352 American women with breast cancer were compared with respect to overall survival and recurrence-free survival rates. Recurrence-free survival rates in Japanese women were superior to those in American women. Overall survival rates were also better in Japanese women, although the difference was not nearly as great as for recurrence-free survival. This seemed due to an improved survival after metastasis in the American women. In analyzing recurrence-free survival rates by age, we found that Japanese women 40 to 54 years old had better recurrence-free survival rates than other age subgroups. This age advantage was not observed in American women. For other age groups, there was relatively little advantage in survivorship in the Japanese series.

Adult↗
PubMed1975

Adrenalectomy with radical mastectomy in the treatment of high-risk breast cancer.

Bilateral adrenalectomy with radical mastectomy has been performed in a series of 17 postmenopausal women with breast cancer having metastasis in four or more axillary lymph nodes. Results to date show that both the recurrence and mortality rates are significantly lowered in this group of "high-risk" breast cancer patients by the combined treatment. Of these 17 patients, 14 are living and well with no evidence of disease. Six are surviving without recurrence 5 or more years since their primary treatment. The study also demonstrated that adrenalectomy patients on hormone replacement therapy are able to lead full and active lives for a long time without complications. This pilot study should be considered as a guide to future clinical trials rather than as an immediate recommendation for general therapy.

Adrenalectomy↗
PubMed1975

Marital and reproductive experience in a community-wide epidemiological study of breast cancer.

The relationship of marital and reproductive experience to human breast cancer was studied using data collected during 1956-1962 by the Department of Biostatistics and Epidemiology at the Roswell Park Memorial Institute in Buffalo, New York. Information of epidemiological interest was obtained from all women with cancers of the reporductive organs in Buffalo, New York, and the adjoining township of Kenmore. For comparison, a probability sample of the same population was selected. During 1965-1967, an International Collaborative Study with similar objectives found a striking positive relationship between age at first birth and breast cancer risk. This finding can be interpreted as either indicating that an event associated with first birth at an early age protects against the development of breast cancer or that the hormonal status of a women both produces a delay in a woman becoming pregnant and increases the risk of developing breast cancer. The analysis of marital and reproductive histories in the Buffalo population study confirms previous reports of an increasing risk of breast cancer with increasing age at first birth. Attempts to distinguish the two interpretations mentioned by analyzing the interval between first marriage and time of birth in addition to age at first birth were not conclusive. This necessitated a similar analysis of data available in a larger series of 1164 breast cancer patients and 1200 non-neoplastic controls hospitalized at the Roswell Park Memorial Institute during 1957-1965. The results do not show an influence of interval between first marriage and first birth but do show an increased risk of breast cancer with increasing age at first birth. The results are thus consistent with a protective effect of an earyl age at first birth. These findings also have a bearing on recent suggestions that ovulatory failure predisposes to development of breast cancer.

Adult↗