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Biomedical subjects

E Sutcliffe

Publications and source records attributed to E Sutcliffe.

11 recordsLinked to original sources
PubMed1998

Increasing breastfeeding rates to reduce infant illness at the community level.

OBJECTIVE: Although breastfeeding is associated with lower rates of a variety of infant illnesses, skeptics have suggested that much of the association is attributable to confounding, even after appropriate statistical adjustment. This article utilizes a novel design to investigate changes in infant illness at the community level after a successful breastfeeding promotion program. METHODS: In this population-based cohort study, the medical records of all infants born in one Navajo community the year before a breastfeeding promotion program (n = 977) and the year during the intervention (n = 858) were reviewed. Outcomes assessed include changes after the intervention in: proportion breastfeeding and/or breastfeeding exclusively; incidence of common infant illnesses in the first year of life; and feeding-group specific incidence of illness. RESULTS: The proportion of women breastfeeding exclusively for any period of time increased from 16.4% to 54.6% after the intervention. The percent of children having pneumonia and gastroenteritis declined 32. 2% and 14.6%, respectively, after the intervention. Feeding-group specific rates of these illnesses were unchanged, indicating that the decline observed was attributable to the increased proportion of infants breastfeeding. In contrast, rates of croup and bronchiolitis increased after the intervention among those fed formula from birth, suggesting a viral epidemic which was limited to those never exclusively breastfed. Finally, sepsis declined in both formula-fed and breastfed infants after the intervention, suggesting that other factors affected this illness outcome after the intervention. CONCLUSIONS: Increasing the proportion of exclusively breastfed infants seems to be an effective means of reducing infant illness at the community level. The experimental design suggests that the increased incidence of illness among minimally breastfed infants is causally related to lack of breast milk, rather than being attributable to confounding.

Breast Feeding↗
PubMed1997

Using cultural knowledge in health promotion: breastfeeding among the Navajo.

Although many attempts have been made to promote breastfeeding in a variety of contexts, few programs have explicitly incorporated cultural beliefs in these efforts. This article describes a breastfeeding promotion program conducted on the Navajo reservation. This program was designed to be culturally appropriate. Background information regarding beliefs and factors affecting infant feeding practices in this setting is provided, followed by a description of the intervention. The intervention, which incorporated both social marketing and community participation techniques, consisted of three components: an intervention in the health care system, a community intervention, and an individual intervention. Based on medical records review of feeding practices of all the infants born the year before (n = 988) and the year after (n = 870) the intervention, the program was extremely successful. This combination of techniques, including qualitative and quantitative research into local definitions of the problem, collaboration with local institutions and individuals, reinforcement of traditional understandings about infant feeding, and institutional change in the health care system, is an effective way of facilitating behavioral change.

Breast Feeding↗
PubMed1993

Campylobacter bacteraemia in England and Wales, 1981-91.

Routine surveillance of infection in England and Wales detected 394 cases of campylobacter bacteraemia in 11 years. This represented an average incidence of 1.5 per 1000 intestinal campylobacter infections, with a range of 0.3/1000 in children aged 1-4 years to 5.9/1000 in patients aged 65 years or more. Definitive identification of 257 isolates showed that 89% were Campylobacter jejuni or C. coli; other species were C. fetus (8.6%), C. lari (0.8%), C. upsaliensis (0.8%), Helicobacter (Campylobacter) fennelliae (0.8%), and Helicobacter (Campylobacter) cinaedi (0.4%). Most (71%) of the C. jejuni/C. coli bacteraemias were in patients with acute enteritis. Of the patients with C. fetus bacteraemia only 27% had diarrhoea; they were older than patients with C. jejuni or C. coli bacteraemia (54.1 v. 45.9 years) and proportionally more of them were male (M:F ratio 2.7:1 v. 1.9:1); 41% had endovascular pathology or cellulitis. There was a higher proportion of C. jejuni serogroup O 4 (Penner) and O 18 strains among blood than faecal isolates, which suggests that they were unusually serum resistant and/or invasive.

Adolescent↗
PubMed1985

Diagnosing functional visual deficits with the P300 component of the visual evoked potential.

The visual evoked potential (VEP) is routinely used to assess visual function, though it occasionally does not reflect a patient's conscious experience. Reports of normal flash or pattern VEPs obtained from blind persons are extreme examples of this problem. The difficulty in interpreting VEPs in light of such findings can be partly overcome by obtaining a cognitive component of the evoked potential, P300. We obtained traditional visual acuity measurements, pattern-reversal VEPs, and VEPs containing P300s from three patients with clinically diagnosed functional visual deficits. The P300s were obtained in response to stimuli that the patients claimed they could not see, supporting the clinical conclusions that malingering or hysteria was involved. The P300 component can be helpful in assessing the subjective visual experience of patients suspected of having functional visual loss.

Clinical Trials as Topic↗
PubMed1984

Acute idiopathic corneal endotheliitis.

Seven patients presenting with acute corneal stromal edema without prior surgery, trauma, ocular disease or known exposure to noxious agents are reported. One patient had a severe iridocyclitis; two others subsequently developed herpetic keratouveitis. Four cases, however, were unassociated with other known ocular disease. All four of these patients exhibited keratic precipitates and displayed minimal or no flare and cells in the anterior chamber, although the latter was largely obscured by the corneal edema. In each of these four instances, the inflammation and corneal edema resolved following topical corticosteroid therapy. In two of the four cases, both children, antibody to Herpes simplex virus could not be identified. We suggest that, in patients without known prior corneal disease or trauma, acute diffuse corneal stroma edema may stem from severe iridocyclitis or a primary endotheliitis due either to herpetic infection, the recently described presumed autoimmune corneal endotheliopathy, or a condition which we herein designate acute idiopathic corneal endotheliitis.

Acute Disease↗