PubMed Health⌕ Search

Biomedical subjects

D A Ansell

Publications and source records attributed to D A Ansell.

6 recordsLinked to original sources
PubMed1995

Does ethnicity influence obstetric intervention?

AIMS: To examine whether the high proportion of Polynesian women giving birth at Middlemore Hospital contributes to its low interventional delivery rate. METHODS: A study of a one-year cohort of women delivering at Middlemore Hospital. Delivery suite records were scrutinised to determine ethnicity and mode of delivery. Statistical comparisons were made. RESULTS: In Maori, Pacific Island and European women the caesarean section rates were 6.5%, 9.5% and 11.5% respectively. Maori women have a significantly lower rate of caesarean section than Pacific Island women and both groups have a significantly lower rate than European women. The spontaneous vaginal delivery rates in Maori, Pacific Island and European women were 89.0%, 87.4% and 74.8% respectively. CONCLUSION: The high proportion New Zealand Maori and Pacific Island women contributes to, but does not fully explain, the low interventional delivery rate at Middlemore Hospital.

Adult↗
PubMed1988

Breast cancer screening in an urban black population. A preliminary report.

Breast cancer is a major cause of death among black women. At Cook County Hospital in Chicago, a hospital serving a predominantly black population, only 31% of breast cancers were localized at the time of diagnosis in the years 1980-1983. A survey of patient records in the largest primary care clinic in the hospital revealed that only 2% of eligible patients had received mammograms in 1982. A nurse-run breast cancer detection program was begun in mid-1983. Since that time the proportion of women who have received periodic breast examinations has increased from 26% to 46% (P less than 0.001) and periodic mammograms have increased from 2% to 41% (P less than 0.001). The proportion of women having received breast self-examination teaching increased from 10% to 58% (P less than 0.001). The proportion of localized breast cancer was significantly greater for those women whose cancer was diagnosed through the screening program (44 of 72, 61%) compared to other clinical areas (71 of 213, 33%) in the years 1984 through 1986 (P less than 0.001). There has been a significant increase in the percentage of localized breast cancer at Cook County Hospital comparing 1980-1983 statistics (31%), before the Breast Cancer Detection Program was fully established, with 1984-1986 statistics (40%) (P less than 0.02).

Black or African American↗
PubMed1986

Transfers to a public hospital. A prospective study of 467 patients.

In recent years there has been a dramatic increase in the number of patients transferred to public hospitals in the United States. We prospectively studied 467 medical and surgical patients who were transferred from the emergency departments of other hospitals in the Chicago area to Cook County Hospital and subsequently admitted. Eighty-nine percent of the transferred patients were black or Hispanic, and 81 percent were unemployed. Most (87 percent) were transferred because they lacked adequate medical insurance. Only 6 percent of the patients had given written informed consent for transfer. Twenty-two percent required admission to an intensive care unit, usually within 24 hours of arrival. Twenty-four percent were in an unstable clinical condition at the transferring hospital. The proportion of transferred medical-service patients who died was 9.4 percent, which was significantly higher than the proportion of medical-service patients who were not transferred (3.8 percent, P less than 0.01). There was no significant difference in the proportion of deaths on the surgical service between patients who were transferred and those who were not (1.5 vs. 2.4 percent). We conclude that patients are transferred to public hospitals predominantly for economic reasons, in spite of the fact that many of them are in an unstable condition at the time of transfer.

Adult↗
PubMed1976

Geographic patterns of disease.

The preparation and use of a computerised grid for demonstrating the temporal and spatial distribution of outbreaks of infectious hepatitis is described. Methods of social area and cluster analysis are described and it is suggested that use could be made in New Zealand of these methods of analysis, taking social data obtained from the census and linking it with mortality and morbidity data obtained by geographical reference.

Computers↗
PubMedDate not supplied

HIV and syphilis seroprevalence among clients with sexually transmitted diseases attending a walk-in clinic at Cook County Hospital.

BACKGROUND AND OBJECTIVES: To determine the HIV and syphilis seroprevalence in a patients with suspected sexually transmitted diseases at an urban walk-in clinic. METHODS: Between January and November 1991, 515 patients with suspected sexually transmitted diseases were simultaneously tested for syphilis and HIV antibodies. RESULTS: The cohort studied was young (85% were < 40 years), 81% were black, 11% Hispanic, and 71% reported heterosexual contact as the primary HIV risk factor. HIV seroprevalence was 8% (41/515), (95% confidence interval [95% CI], 5.66%, 10.34%). Syphilis seroprevalence rate was 21.4% (110/515), (95% CI 17.86%, 24.94%). Syphilis seroprevalence in those who were HIV positive was 31.7% (13/41), (95% CI 17.46%, 45.94%) as compared to 5.9% (28/574), (95% CI 3.78%, 8.02%) in those who were HIV negative. CONCLUSION: The HIV seroprevalence among patients with sexually transmitted diseases who are screened for syphilis was disturbingly high. Patients who were seropositive for HIV had a significantly higher rate of syphilis than those who were HIV negative.

Adult↗