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Biomedical subjects

E A Nelson

Publications and source records attributed to E A Nelson.

At least 55 records · Page 3Linked to original sources
PubMed2000

Child care practices in nonindustrialized societies.

OBJECTIVE: To described child care practices associated with an increased risk of sudden infant death syndrome (SIDS) in nonindustrialized 19th and 20th century societies. METHODOLOGY: The Human Relations Area Files collection is a unique source of information on the cultures of the world. The electronic version of the Human Relations Area Files represents 200 000 pages of fully indexed cultural material on a stratified random sample of 60 nonindustrialized societies. Using various keyword combinations, texts containing information related to sleeping conditions, social interaction, temperature regulation, feeding, and smoking were identified and using structured questionnaire practices were recorded as being present, absent, or not stated. RESULTS: Relevant information was identified for 53 societies. None of 4 societies mentioning sleep position used the prone position. Swaddling and restraint were commonly practiced, often for extended periods of time. Most information was available on infant feeding and the predominant pattern was of demand breastfeeding for long periods. In many of the cultures, infants are seen as being the focus of attention, in close contact with and under the constant supervision of the mother, siblings, and other relatives. CONCLUSIONS: The study produced no clear evidence that these primarily nonindustrialized societies followed child care practices likely to protect against SIDS. Despite limitations, the information presented should be of interest to those involved in developing reduce the risks programs for SIDS prevention, because it highlights the considerable variation in child care practices and emphasizes that health education messages may not always be cross-culturally valid.

Child, Preschool↗
PubMed2000

Physician firearm ownership as a predictor of firearm injury prevention practice.

OBJECTIVES: This study explored the relation between physicians' gun ownership and their attitudes and practices regarding firearm injury prevention. METHODS: Internists and surgeons were surveyed, and logistic regression models were developed with physicians' personal involvement with firearms (in the form of a gun score) as the primary independent variable. RESULTS: Higher gun scores were associated with less agreement that firearm injury is a public health issue and that physicians should be involved in firearm injury prevention but with a greater likelihood of reporting the inclusion of firearm ownership and storage as part of patient safety counseling. CONCLUSIONS: Despite being less likely to say that doctors should participate in firearm injury prevention, physician gun owners are more likely than nonowners to report counseling patients about firearm safety.

Chi-Square Distribution↗
PubMed1999

Randomised, double blind placebo controlled trial of pentoxifylline in the treatment of venous leg ulcers.

OBJECTIVE: To determine whether pentoxifylline 400 mg (Trental 400) taken orally three times daily, in addition to ambulatory compression bandages and dressings, improves the healing rate of pure venous ulcers. DESIGN: Randomised, double blind placebo controlled trial, parallel group study of factorial design, permitting the simultaneous evaluation of alternative pharmaceutical, bandaging, and dressings materials. SETTING: Leg ulcer clinics of a teaching and a district general hospital in southern Scotland. PARTICIPANTS: 200 patients with confirmed venous ulcers and in whom other major causal factors were excluded. INTERVENTIONS: Pentoxifylline 400 mg three times daily or placebo. MAIN OUTCOME MEASURE: Complete healing (full epithelialisation) of all ulcers on the trial leg. RESULTS: Complete healing occurred in 65 of the 101 (64%) patients receiving pentoxifylline and 52 of the 99 (53%) patients receiving placebo. CONCLUSIONS: The difference in the healing rates between patients taking pentoxifylline and those taking placebo did not reach statistical significance.

Adult↗
PubMed1999

Porcine reproductive and respiratory syndrome virus infection in neonatal pigs characterised by marked neurovirulence.

Neonatal pigs from three herds of pigs were somnolent and inappetent and had microscopic lesions characterised by severe meningoencephalitis, necrotic interstitial pneumonia and gastric muscular inflammation. Porcine reproductive and respiratory syndrome virus (PRRSV) infection was diagnosed and confirmed by virus isolation, fluorescent antibody examination of frozen lung sections, serology, immunohistochemistry and in situ hybridisation. Each herd had a history of PRRSV infection and was using or had used a modified-live vaccine. The isolates from the affected pigs were genetically distinct from the modified-live vaccine strain of the virus when compared by restriction enzyme analysis and nucleotide sequencing of PRRSV open reading frames 5 and 6. The virus was identified in macrophages or microglia of brain lesions by immunohistochemical staining of brain sections with an anti-PRRSV monoclonal antibody and an anti-macrophage antibody. The replication of the virus in the brain was verified by in situ hybridisation. The meningoencephalitis induced by the virus in pigs from each of the herds was unusually severe and the brain lesions were atypical when compared with other descriptions of encephalitis induced by the virus, which should therefore be considered as a possible diagnosis for neonatal pigs with severe meningoencephalitis. In addition, field isolates of the virus which are capable of causing disease can emerge and coexist with modified-live vaccine virus in some pig herds.

Animals↗
PubMed1999

Economic and health efficiency of education funding policy.

Public spending programmes to reduce poverty, expand primary education and improve the economic status of women are recommended priorities of aid agencies and are now gradually being reflected in third world governments' policies, in response to aid conditions imposed by the World Bank and OECD countries. However outcomes fall short of aspiration. This paper shows that donors' lending policies, especially those restricting public spending on education to the primary level, (1) perpetuate poverty, (2) minimise socio-economic impact of public health programmes and (3) prevent significant improvement in the economic status of women. These effects are the result of fundamental flaws in donors' education policy model. Evidence is presented to show that health status in developing countries will be significantly enhanced by increasing the proportion of the population which has at least post-primary education. Heads of households with just primary education have much the same probability of experiencing poverty and high mortality of their children as those with no education at all. Aid donors' policies, which require governments of developing countries to limit public funding of education to the primary level, have their roots in what is contended here to be an erroneous interpretation of human capital theory. This interpretation focuses only on the declining marginal internal rates of return on public investments in successive levels of schooling and ignores the opposite message of the increasing marginal net present values of those investments. Cars do not travel fastest in their lowest gear despite its fastest acceleration, life's long journey is not most comfortable for those with only primary schooling.

Developing Countries↗
PubMed1999

International child care practices study: methods and study population.

The study set out to document child care practices in as many different countries and cultures as possible with the aim of providing baseline child care data and stimulating new hypotheses to explain persisting differences in sudden infant death syndrome (SIDS) rates between countries. The protocol, piloted in four countries in 1992, was distributed to 80 potential centres in 1995. Data from 19 centres were received. This paper describes the demographic characteristics of the data from the different centres. Comparison showed significant differences for a number of variables including mean age of completion of the study, response rate, mean gestation, mean birth weight, method of delivery and incidence of admission to neonatal intensive care units. High caesarean section rates identified in the Chinese samples (44 and 40%) were unexpected and have important public health implications. This finding warrants further study but may be related to China's one child policy. We consider that international comparison of child care practice is possible using standardised data collection methods that also allow some individual variation according to local circumstances. However, in view of the heterogeneity of the samples, it will be important to avoid over-interpreting differences identified and to view any differences within the qualitative context of each individual sample. Provided there is acknowledgement of limitations, such ecological studies have potential to produce useful information especially for hypothesis generation.

Birth Weight↗
PubMed1999

In vitro sensitivity of artemeter in Plasmodium falciparum-infected beta-thalassaemic trait erythrocytes.

Using an age-fractionated RBC model, we investigated the in vitro sensitivity of artemether in beta-thalassaemic RBC infected with the K1 and FC27 strains of Plasmodium falciparum and, to study the role of oxidant stress in modulating the sensitivity pattern, pro-oxidant (riboflavin) and antioxidant (vitamin E) agents were added to cultures in the presence of artemether. With the FC27 strain, the artemether IC50 doses in thalassaemic samples (whole blood and fractions) were significantly higher compared to equivalent normal RBC samples (P < 0.05). However, with the K1 strain, such a significant difference was not demonstrable. The addition of vitamin E reduced the antimalarial effect of artemether in both the FC27 and K1 strains (P < 0.0001). In contrast, the addition of riboflavin resulted in a significant increase in antimalarial activity (P < 0.0001). This effect of the drug combinations was not influenced by the red cell type (P < 0.0001) and there was no interaction between red cell type and drug type (P < 0.0001). These findings show that reduced sensitivity to artemether occurs in whole blood and age-fractionated beta-thalassaemic trait RBC. It appears that the RBC redox status does not influence the sensitivity to artemether.

Animals↗
PubMed1999

A systematic review of laser therapy for venous leg ulcers.

A systematic review of randomised controlled trials (RCTs) was conducted to establish the effectiveness of low-level laser therapy as a treatment for venous leg ulcers. Wound-care journals, conference proceedings and electronic databases (including Medline and Cinahl) were searched up to October 1997 for RCTs comparing low-level laser therapy with sham laser, no laser, or non-coherent light of other wavelengths. In addition, companies who manufacture or distribute therapeutic lasers were contacted for any unpublished or ongoing studies. Results from searches were scrutinised by one reviewer to identify possible RCTs and full reports of these were obtained. Details of eligible studies were extracted and summarised using a data extraction sheet. Data extraction was checked by a second reviewer. Meta-analysis was used to combine the results of trials where the interventions and outcome measures were sufficiently similar. A total of four eligible RCTs were identified. Two compared treatment with laser therapy to sham or placebo laser treatment. One study compared laser therapy with ultraviolet therapy. The fourth was a three-armed study which compared the effects of laser therapy alone, laser therapy plus infrared light, and non-coherent unpolarised red light. The comparisons of laser therapy with placebo, and laser therapy with ultraviolet therapy, showed no significant difference between treatments with regard to ulcer healing rates. The comparison of laser with red light showed a significant increase in complete healing at nine months for the combination of laser and infrared light compared to non-coherent unpolarised red light. We have not found any evidence of the benefit of low-level laser therapy per se on venous leg ulcer healing. It appears that a combination of HeNe laser and infrared light may promote the healing of venous ulcers, however more research is needed.

Evidence-Based Medicine↗
PubMed1998

Internists' and surgeons' attitudes toward guns and firearm injury prevention.

BACKGROUND: The high rates of death, injury, and long-term disability related to firearms in the United States have led to growing concern in the health care community. Medical organizations and journals are devoting increasing attention to firearm violence as a public health problem; however, few reports discuss physician attitudes toward guns and prevention of firearm-related injury. OBJECTIVE: To determine internists' and surgeons' attitudes toward guns and firearm injury prevention. DESIGN: Analysis of results of a structured telephone interview. SETTING: Internal medicine and surgical offices. PARTICIPANTS: 457 internists and 458 surgeons. MEASURES: 55 questions that covered six domains: experience with firearms, knowledge about clinical sequelae of firearm injury, knowledge about public policies on firearm violence, attitudes toward public policies on firearm violence, clinical practice behavior, and education and training. RESULTS: The interview response rate was 45.3%, with a compliance rate of 82.5% and a 95% probability (error rate, +/- 5%). Ninety-four percent of internists and 87% of surgeons believe firearm violence is a major public health issue. A majority of internists and surgeons also support community efforts to enact legislation to restrict the possession or sale of handguns (84% and 64%, respectively). Furthermore, although 84% of internists and 72% of surgeons believe that physicians should be involved with firearm injury prevention, less than 20% of respondents usually engage in some form of firearm injury prevention practice in patient care. CONCLUSION: Many internists and surgeons think that firearm injuries are a public health issue of growing importance, that physicians should incorporate firearm safety screening and counseling into their practice, that physicians should join community efforts to regulate handguns, and that specific gun regulation measures should be adopted as public policy.

Adult↗