Skin replacement after burn injury.
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Biomedical subjects
Publications and source records attributed to J E Laing.
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The findings are presented of a 10-year retrospective review of burn admissions to the Wessex Regional Burn Centre, where a low volume colloid resuscitation regimen is employed. An analysis of mortality probability has been conducted using probit analysis, and the areas of burn injury associated with a 50 per cent mortality probability (LA50) were determined for four different age groups. LA50 values obtained were 0-14 years 59 per cent body surface area (BSA) burn, 15-44 years 70 per cent BSA burn, 45-64 years 38 per cent burn, 65 years and over 17 per cent BSA burn. The figures obtained parallel closely those reported from another large burn centre in the United Kingdom where a widely different fluid regimen is used. The results of this analysis suggest that wide variations in fluid resuscitation regimens, particularly with regard to volume, do little to affect the mortality associated with burn injury as assessed by probit analysis.
In a retrospective review of the 10-year period 1969-78 the intravenous plasma loads given to patients admitted to one burn centre were studied and compared with the volumes predicted by the formula used at that centre. Of 1728 patients admitted 342 (19.8%) received intravenous resuscitation with plasma. The formula appeared to be a good empirical guide to transfusion needs in the 36 h after burning. Patients with burns in excess of 45% body surface area (BSA), and particularly children, were likely to require more fluid than that indicated by the formula estimate. However, as burns in excess of 50% BSA are uncommon (50/1728 admissions) it seems reasonable to use a formula which is a guide to the probable needs of most patients while accepting the clinical response as the best means of assessing the actual fluid need of each patient, especially those with extensive injury.
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Survey data on contraceptive use-effectiveness and on the fertility of family planning acceptors can provide a useful basis for estimating the fertility effects of a family planning program. The 1974 Philippine National Acceptor Survey (NAS), a sample survey of nearly 3,000 family planning acceptors reported by clinics in 1970--72 and interviewed in 1974, provided data for such an evaluation of the Philippine family planning program. The program's effects on the fertility of acceptors were estimated utilizing a series of analytical techniques, which are described in this article. Data from the NAS on continuation, pregnancy, and fertility following acceptance, as well as estimates of fertility decline associated with acceptance and continuing use of contraception, are analyzed. Findings are presented for acceptors of the four major program methods--pills, and the IUD, rhythm, and condoms. An appendix presents special procedures employed in estimating fertility effects.
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Despite low per capita income and little evidence of economic development, the response to the government-sponsored family planning program in Bali has been remarkably favorable. After five years of government involvement, a total of 29 percent of eligible women are estimated to be using program methods, including 25 percent who have accepted IUDs, and 4 percent more are estimated to be using nonprogram methods. This level of performance is higher than in most other developing areas of the world. A number of the factors that might help to explain the success of the program in Bali are identified, and the future prospects for continued success are assessed.
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This paper presents the main survey findings from a nationally representative sample of 607 users of periodic abstinence methods in the Philippines in 1984. The survey was conducted because of the widespread popularity of periodic abstinence in the Philippines and a lack of detailed knowledge about how the method is understood and practiced in the Philippines. Findings are presented on the prevalence of the different types of periodic abstinence methods, the nature of their use, knowledge about the various periodic abstinence methods, instruction received, perceived advantages and disadvantages, the husband's role, and the use-effectiveness of periodic abstinence both with and without backup methods. The implications of these findings for program management and for future research are also discussed.