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Biomedical subjects

E A Mitchell

Publications and source records attributed to E A Mitchell.

At least 19 recordsLinked to original sources
PubMed1992

Asthma knowledge and management in primary schools in south Auckland.

AIMS: to examine the management of asthma in primary schools and the school teachers' knowledge, confidence and attitude in managing the pupils with asthma. METHODS: forty-two primary schools in south Auckland were randomly selected to participate. Questionnaires were posted out to the principals and another questionnaire was given randomly to 253 teachers from these primary schools. RESULTS: 76% of the school principals surveyed returned the questionnaire; and 66% of the school teachers surveyed returned a separate questionnaire. The average incidence of asthma reported by school principals and school teachers was 9.9% and 12.6% respectively, which suggests underreporting of the diagnosis of asthma. In 81% of the schools a questionnaire was used to identify students with asthma when they first join the school. School teachers had good basic knowledge on asthma, however 33% of teachers did not know that Ventolin (salbutamol) is for symptomatic treatment and 58% and 65% of teachers did not know that Becotide (beclomethasone) and Intal (sodium cromoglycate) are prophylactic medications. CONCLUSIONS: we suggest that primary school teachers should receive further education on asthma, especially on practical aspects of asthma management.

Albuterol↗
PubMed1992

Sudden infant death syndrome and weather temperature.

The relationship between the days on which sudden infant death syndrome (SIDS) occurred and the daily minimum temperature was examined in Auckland (1979-1984) and Christchurch (1979-1987). There was a marked winter excess of deaths in both regions. There was a significant negative correlation between the monthly mean minimum temperature and SIDS rate for both regions (r = -0.43, n = 347, P less than 0.0001). The monthly mean minimum temperature describes SIDS mortality equally as well as the three variables of daily minimum temperature, season and geographical location. There was a significant association of SIDS with minimum temperature 4 and 5 days prior to the death after adjusting for the effect of monthly mean minimum temperature. The days preceding death were on average colder than the other days, but the effect was small, especially when compared with the magnitude of the temperature differences between consecutive months.

Humans↗
PubMed1992

Postnatal depression and SIDS: a prospective study.

This study was carried out in response to reports from nurses to a post-neonatal mortality review committee that a number of mothers of infants dying from sudden infant death syndrome (SIDS) appeared to be depressed before the child's death. The New Zealand Cot Death Study was a 3 year multicentre case-control study for SIDS. There were 485 SIDS cases in the post-neonatal age group in the study regions, and these were compared with 1800 control infants. Infants of mothers with either a self-reported use of medication for psychiatric disorders, a history of hospitalization for psychiatric illness or a family history of postnatal depression had a significantly increased risk of SIDS compared with infants of mothers who were either not using medication (odds ratio (OR) = 1.45; 95% confidence interval (CI) = 1.03, 2.04) or were without a history of hospitalization for psychiatric illness (OR = 1.80; 95% CI = 1.03, 3.11) or a family history of postnatal depression (OR = 1.61; 95% CI = 1.06, 2.43). All mothers of infants born in the study areas over a 1 year period were eligible to complete a questionnaire measuring maternal depression when the infant was 4 weeks of age. Thirty-three infants subsequently died from SIDS, and they were compared with 174 controls. Fifteen (45.5%) of the mothers of cases were depressed, compared with 28 (16.1%) of the mothers of controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Case-Control Studies↗
PubMed1992

Four modifiable and other major risk factors for cot death: the New Zealand study.

New Zealand's high mortality rate from sudden infant death syndrome (SIDS) prompted the development of the New Zealand Cot Death Study. A report of the analysis of the data from the first year has been published. This report now gives the major identified risk factors from the full 3 year data set. In this case-control study there were 485 infants who died from SIDS in the post-neonatal age group, and 1800 control infants, who were a representative sample of all hospital births in the study region. Obstetric records were examined and parental interviews were completed in 97.5% and 86.9% of subjects, respectively. As expected many risk factors for SIDS were confirmed including: lower socio-economic status, unmarried mother, young mother, younger school-leaving age of mother, younger age of mother at first pregnancy, late attendance at antenatal clinic, non-attendance at antenatal classes, Maori, greater number of previous pregnancies, the further south the domicile, winter, low birthweight, short gestation, male infant and admission to a special care baby unit. In addition, however, we identified four risk factors that are potentially amenable to modification.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1992

Further evidence supporting a causal relationship between prone sleeping position and SIDS.

A 3 year case-control study identifying the risk factors for SIDS was undertaken. Preliminary analysis of the data from the first year suggested that SIDS mortality could fall by 50% if the prevalence of the prone sleeping position changed from 40 to 0%. During the 3 year study the prevalence of the prone sleeping position among infants has fallen from 43% in the first year to 20% in the third year. SIDS mortality has fallen to 3.1/1000 live births, which is very close to that predicted. When considered with other available evidence this strongly supports a causal relationship between the prone sleeping position and SIDS.

Case-Control Studies↗
PubMed1992

The national cot death prevention program in New Zealand.

A case-control study examining the risk factors for sudden infant death syndrome (SIDS) in New Zealand identified three risk factors that are potentially amenable to modification: prone sleeping position of the infant, maternal smoking and lack of breastfeeding. In total these three risk factors may account for 79 per cent of deaths from SIDS in New Zealand. We describe the planning and implementation of the cot death prevention program, which has involved a wide range of groups and different strategies. The outcome of the prevention program is being evaluated.

Health Promotion↗
PubMed1992

The New Zealand Cot Death Study: some legal and ethical issues.

The New Zealand Cot Death Study is a 3 year multicentre case-control study aimed at identifying the risk factors for sudden infant death syndrome (SIDS). The paper describes some of the legal and ethical issues which arose in the planning, implementation and analysis of the study.

Case-Control Studies↗
PubMed1991

Results from the first year of the New Zealand cot death study.

New Zealand's high mortality rate from the sudden infant death syndrome (SIDS) prompted the development of the New Zealand cot death study. This report of the preliminary analysis of the first year of the data gives the major identified risk factors. One hundred and sixty-two infants who died from SIDS were compared with 589 control infants, who were a representative sample of all hospital births in the study region. Obstetric records were examined and parental interviews were completed in 96% and 89% of subjects respectively. Data were available for all the variables in this study in 95% of those interviewed, thus 128 cases and 503 controls make up the subjects of this report. As expected we confirmed many risk factors for SIDS including: lower socioeconomic status, unmarried mother, young mother, younger school leaving age of mother, younger age of mother at first pregnancy, late attendance at antenatal clinic, nonattendant at antenatal classes, Maori, greater number of previous pregnancies, lower birth weight, shorter gestation, male infant, admission to neonatal intensive care unit. In addition, however, we identified three risk factors which are potentially amenable to modification. These were the prone sleeping position of baby (odds ratio = 3.53, 95% confidence interval 2.26, 5.54), maternal smoking (1-9 cigarettes/day OR = 1.87, 95% CI = 0.98, 3.54; 10-19/day OR = 2.64, 95% CI = 1.47, 4.74; 20+/day OR = 5.06, 95% CI = 2.86, 8.95) and breast feeding (OR = 2.93, 95% CI = 1.84, 4.67).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Neuroanatomical structures involved in the action of the 5-HT3 antagonist ondansetron: a 2-deoxyglucose autoradiographic study in the rat.

Local cerebral glucose utilization following the acute administration of the 5-HT3 receptor antagonist ondansetron (0.01-1.0 mg/kg) was determined using [14C]2-deoxyglucose quantitative autoradiography. Ondansetron effected alterations in 13 of the 66 brain areas analyzed including limbic, auditory and visual structures. In the majority of these 13 regions ondansetron was only effective at reducing glucose use compared to control values at a dose of 0.01 mg/kg. Thus in limbic and related areas (CA2 and CA3 fields of the hippocampus, lateral habenula and septal nucleus) glucose utilization was reduced by 15-21%. Similar reductions (18-20%) were apparent in primary auditory and visual areas (auditory cortex, medial geniculate and visual cortex). However, with the exception of the ventromedial thalamic nucleus (14% reduction) glucose use in extrapyramidal and sensory motor areas was unchanged. Following larger doses of ondansetron (0.1 and 1.0 mg/kg), there was no change in cerebral glucose utilization relative to control values, with the exception of the median raphe. In this structure local cerebral glucose utilization was significantly increased (P less than 0.05) following administration of 1.0 mg/kg ondansetron relative to the lower dose of 0.01 mg/kg. Changes in glucose use did not always reflect areas of high 5-HT3 receptor density. Thus, although cerebral glucose use was reduced in hippocampal layers, it was unchanged in the entorhinal cortex and the area postrema. These data suggest that under these experimental conditions ondansetron produces modest changes in glucose utilization which are primarily confined to limbic structures and those involved in sensory processing.

Animals↗
PubMed1991

A tool for measuring the asthma self-management competency of families.

A tool for measuring a family's asthma self-management behaviour has been developed for a study examining the relationships of asthma self-management behaviour, knowledge, and psychosocial factors with various indices of morbidity in children with asthma. The tool involves a structured interview which includes three typical situations of asthma self-management (scenarios). Each of the scenarios is divided into graded challenges. A scoring schedule was developed according to the critical incidents of self-management inherent in each situation. This schedule was then applied to the verbatim transcripts of the subjects' responses. These were presented to 380 asthmatic children aged 5-11 yr and their primary caregivers. Inter-rater reliability, inter-rater agreement and test-retest reliability coefficients indicate that the scores obtained are stable across raters and time. Correlations between scores on different scenarios suggest there is a common factor of self-management competency across all scenarios, but families are better at some aspects of self-management than others. The distribution of scores for each scenario is presented. The place of this tool as a means of assessing self-management behaviour is discussed.

Asthma↗
PubMed1991

Racial inequalities in childhood asthma.

Mortality and hospital admission rates for asthma are higher in Maoris and Pacific Islander children than in European children. These ethnic differences are not explained by ethnic differences in asthma prevalence, the characteristics of the disease or admission criteria. There are major ethnic differences in asthma drug management both in the community and at the time of discharge from hospital. In particular Polynesians were less likely to receive prophylactic therapy and this factor probably accounts for ethnic differences in mortality and admission rates. Possible explanations for the ethnic differences in medical management are discussed.

Adolescent↗