PubMed Health⌕ Search

Biomedical subjects

J F Jekel

Publications and source records attributed to J F Jekel.

At least 19 recordsLinked to original sources
PubMed1991

Screening child psychiatric inpatients for communication disorders: a pilot study.

This study was part of a project concerned with speech and language disorders among child psychiatric inpatients. Twenty-two consecutively admitted children were screened and 10 were positive. Of these, nine were diagnosed with a speech or language delay, prevalence = 40.9 (9 of 22). A chart review of the preceding 2-year period showed that 27 of 128 admissions had been referred to the speech clinic and that 25 had positive findings, for a prevalence of 19.5% (25 of 128). The difference in the observed prevalence in these two studies was significant (chi 2 = 4.89, rho = .03). Standard clinical practice may miss some children with communication disorders (estimated sensitivity = 39%), while the new screening method shows promise (estimated sensitivity = 82%).

Child↗
PubMed1991

School-age mothers: predictors of long-term educational and economic outcomes.

The long-term effects of school-age pregnancy were investigated in a 20-year follow-up of a cohort of women who were pregnant adolescents in the late 1960s. Of the 149 living young black primiparas in the original cohort, 121 (81%) were located and interviewed. At follow-up the study population ranged in age from 32 to 38 years, 68% were unmarried, 71% had finished high school, 82% were completely self-supporting, and 27% reported living in public housing. Long-term success, defined as currently employed or supported by a spouse and a high school education (62%) or its equivalent, was associated with six features: having completed more school prior to becoming pregnant (odds ratio [OR] = 18; 95% confidence interval [CI] 2.3, 139.5); participating more actively in a program intervention offered to these pregnant teenagers 20 years ago (OR = 11.11; 95% CI 1.54, 79.87); being in school with no subsequent pregnancy at 26 months postpartum (OR = 10.1; 95% CI 1.64, 62.07); feeling in control of one's life (OR = 5.4; 95% CI 1.36, 21.54) and little social isolation (OR = 8.24; 95% CI 1.56, 43.50) at 26 months postpartum; and lifetime fertility control defined as one or two children after the index child (OR = 14.19; 95% CI 3.28, 61.29). It is concluded that most former teenage mothers complete a reasonable amount of education and are economically self-sufficient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Infection control practitioners and committees in skilled nursing facilities in Connecticut.

All skilled nursing facilities (SNFs) in Connecticut were surveyed and more than 71% responded to a Centers for Disease Control-funded project, a component of which is reported herein. The study describes the infection control practitioner (ICP), assistance provided ICPs from external sources, and infection control committees. Almost all ICPs received some training in infection control and worked in the field for an average of 3 1/2 years. Both the number of hours devoted to infection control and the percentage of time spent by the ICP on infection control activities increased with the size of the facility. More than one half of the ICPs in SNFs have relationships with hospital ICPs. The majority of SNF infection control committees met quarterly. The chairperson most often was a physician, although ICPs held this office in almost one third of the reporting SNFs. We conclude that ICPs in Connecticut SNFs have increased in number and that they devote more time and effort to infection control than in previous years.

Aged↗
PubMed1990

"Rainbow reviews." IV: Recent publications of the National Center for Health Statistics.

I am always impressed at the wealth of interesting and useful information available from the NCHS, if one knows where to look. The Center tries to adapt to the changing needs of the potential users of their data, including health planners and policy analysts, and academicians. This is illustrated by the increasing emphasis on medical care utilization, especially in long term care, on disease prevention and health promotion issues and on international comparisons. Clinical investigators should be familiar with the NCHS reports, if only to avoid duplication of effort. But beyond that, the information they present can be used to develop hypotheses, estimate variances for sample size determinations, and provide useful model instruments and methods. Beyond that, the NCHS does not analyze and report exhaustively on these data, if only because of lack of resources, so that it makes most of these data available for further research at a nominal charge. Many doctoral dissertations have been based on these tapes as the primary data source for detailed content analysis and/or for methodologic innovation.

Government Publications as Topic↗
PubMed1990

Infant feeding patterns during the first year of life in Denmark: factors associated with the discontinuation of breast-feeding.

We prospectively studied 500 infants born consecutively in a university-affiliated community hospital in Copenhagen, Denmark, over the first 12 months of life using a detailed monthly mailed questionnaire (overall response rate = 73%) which focused on feeding practices and illnesses. Seventy-seven percent of respondents breast-fed their infants at 1 month of life compared to 19% at 12 months of life. Analysis of breast-feeding behavior using survival analysis showed that 50% of the mothers who breast-fed since the first month of their infant's life were still breast-feeding at 7 months of life. Also, there was a greater than two-fold increase in the rate of discontinuation of breast-feeding for infants in daycare compared to infants not attending daycare (RR = 2.08, 95% CI = 1.43, 3.01). Discontinuation of breast-feeding was not significantly associated with the number of children in the family or with social class. These results give insight into infant feeding patterns in a developed country and suggest that: (1) breast-feeding is the dominant method of feeding during the infant's first year of life, and (2) the rate of discontinuation of breast-feeding is increased by the entry of these infants into daycare.

Age Factors↗
PubMed1990

Influenza outbreaks in nursing homes: how effective is influenza vaccine in the institutionalized elderly?

During the 1984-1985 influenza season, outbreaks of influenza A (H3N2) occurred in three Connecticut nursing homes. Influenza vaccination rates were 67% (96 out of 144), 35% (30 out of 85) and 69% (332 out of 483), respectively. The relative risk of illness for vaccinated compared to unvaccinated residents was 1.8 (95% confidence interval, 0.6, 5.9), 1.6 (95% confidence interval, 0.8, 3.0) and 1.1 (95% confidence interval, 0.8, 1.7) for each of the three nursing homes, respectively. In the third outbreak, 22 vaccinated residents without clinical illness had a geometric mean titer of hemagglutination-inhibition (HI) antibody of 20. Although low, this titer was significantly higher than that of nine unvaccinated residents without clinical illness (12, p less than .05); only three (14%) vaccinated residents had HI titers of greater than or equal to 40. These results suggest that levels of HI antibody in vaccinated residents were not protective at the time of the third outbreak, four to five months after vaccination. In general, the study of vaccine effectiveness in nursing homes is limited by sample size and statistical power. Despite these limits, the retrospective investigation of influenza outbreaks in nursing homes is often the only practical way to evaluate influenza vaccine effectiveness in the elderly on a yearly basis.

Adult↗
PubMed1990

Relationship between infant feeding and infectious illness: a prospective study of infants during the first year of life.

Prior studies investigating the relationship between infant feeding and infectious illnesses in developed countries have provided conflicting data about whether breast-feeding protects against common infectious illnesses early in life. These conflicts may in part be due to the failure to consider the following methodologic issues: (1) collecting data prospectively at frequent intervals for active surveillance of the detection of infections and of feeding practices, (2) specifying what is meant by infectious illnesses and breast-feeding, (3) controlling for confounding variables such as social class or presence of siblings in the household, and (4) applying appropriate analytical strategies to a population in which both feeding and exposure to illness change over time. A total of 500 infants born consecutively in a university-affiliated community hospital in Copenhagen, Denmark, were studied prospectively for the first 12 months of life by means of a detailed, monthly, mailed questionnaire that focused on feeding practices and illnesses (overall response rate, 73%). The percentage of infants who were completely or mostly breast-fed decreased from 88% at 1 month to 20% at 12 months of age. After adjustment for major covariates, no statistically significant relationship was found between the type of infant feeding and the incidence of four categories of infectious illnesses: gastroenteritis, upper respiratory illness, otitis media, and lower respiratory illness. The adjusted incidence density ratio for gastroenteritis was 1.067 (95% confidence interval = 0.982, 1.226) and for upper respiratory illnesses 0.984 (95% confidence interval = 0.883, 1.096).(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms↗
PubMed1978

Comparison of acute-phase reactants in pediatric patients with fever.

We compared WBC count greater than or equal to 15,000/cu mm (high WBC count). Wintrobe ESR greater than or equal to 30 mm/hr (high ESR), temperature greater than or equal to 40 degrees C, and positive slide tests for C-reactive protein (CRP) at a serum dilution of 1:50 in febrile, ambulatory children. The CRP test was performed with and without heat inactivation of serum. An excellent correlation was found between noninactivated and inactivated CRP test results. Since the noninactivated CRP test can be done quickly, its results would be readily available in an outpatient setting. High ESR demonstrated the best balance of specificity and sensitivity for bacteremia, pneumonia, and other possible or proved bacterial illnesses. A positive CRP test was highly specific for these diagnoses but less sensitive than an ERS greater than or equal to 30 mm/hr. Three combinations of acute-phase reactants, high WBC count and/or high ESR, high ESR and/or positive CRP test, and high WBC count and/or high ESR and/or positive CRP test performed as well as high ESR alone. Each was less specific but more sensitive than high ESR for possible or proved bacterial illnesses. The evaluation of an ambulatory, febrile child with acute-phase reactants should include at least determination of ESR.

Bacterial Infections↗
PubMed1977

Induced abortion and sterilization among women who became mothers as adolescents.

Four cohorts of urban women who delivered a child before reaching age 18 were followed for periods ranging from 6 to 12 years to determine use of abortion and sterilization. The two more recent cohorts had been served by comprehensive service programs. About 40 per cent of each of teh groups used abortion or sterilization to control fertility. Most of the women seeking abortion had no subsequent term or near term deliveries, suggesting that such a request may signal a desire to terminate childbearing, at least for a few years. A high proportion of the young mothers obtained abortions during the second trimister, even for repeat abortion.

Abortion, Induced↗
PubMed1977

Temperature greater than or equal to 40 C in children less than 24 months of age: a prospective study.

In a prospective study, 330 consecutive children less than 24 months old coming to the emergency room of Yale-New Haven Hospital with a temperature greater than or equal to 40 C were evaluated. Nearly all patients had a white blood cell (WBC) count, erythrocyte sedimentation rate (ESR) (Wintrobe), blood culture, and chest roentgenogram. Eighty-eight percent were evaluated 24 to 48 hours later. The mean WBC count and ESR were significantly elevated in children with positive blood cultures or pneumonia. The risk of bacteremia was increased threefold and the risk of pneumonia was increased twofold in children with a WBC count greater than or equal to 15,000/cu mm or an ESR greater than or equal to 30 mm/hr compared to children without leukocytosis or elevated ESR. Sixty-one percent of children with bacteremia or pneumonia. 63% of children in whom these diagnoses were not apparent on physical examination, and 86% of children with otitis media complicated by pneumonia or bacteremia had either a WBC count greater than or equal to 15,000/cu mm or an ESR greater than or equal to 30 mm/hr. A WBC count greater than or equal to 15,000/cu mm and an ESR greater than or equal to 30 mm/hr were more effective than a polymorphonuclear leukocyte count greater than or equal to 10,000/cu mm and/or a band count greater than or equal to 500/cu mm in screening young children with high fever for bacteremia, pneumonia, or complicated otitis media.

Bacteria↗
PubMed1977

School-age parents: how permanent a relationship?

One hundred eighty school-age girls who registered for care in a prenatal clinic were studied through two years postpartum. At registration, the mean age of the pregnant girls was 15.6 and the putative fathers was 18.5 years. Many of the fathers continued to see the young mothers, to provide financial support, and to visit their children. By 26 months after delivery, however, only 23% of the mothers had married the putative fathers, 23% still were seeing them regularly, 18% saw them occasionally, and 35% either never saw them or had married someone else. Only 25% of the mothers who expected to marry the putative father did so. The study findings have significant implications for the inclusion of putative fathers in programs for school-age mothers.

Adolescent↗