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Biomedical subjects

J I Cater

Publications and source records attributed to J I Cater.

16 recordsLinked to original sources
PubMed1999

Advising parents of asthmatic children on passive smoking: randomised controlled trial.

OBJECTIVE: To investigate whether parents of asthmatic children would stop smoking or alter their smoking habits to protect their children from environmental tobacco smoke. DESIGN: Randomised controlled trial. SETTING: Tayside and Fife, Scotland. PARTICIPANTS: 501 families with an asthmatic child aged 2-12 years living with a parent who smoked. INTERVENTION: Parents were told about the impact of passive smoking on asthma and were advised to stop smoking or change their smoking habits to protect their child's health. MAIN OUTCOME MEASURES: Salivary cotinine concentrations in children, and changes in reported smoking habits of the parents 1 year after the intervention. RESULTS: At the second visit, about 1 year after the baseline visit, a small decrease in salivary cotinine concentrations was found in both groups of children: the mean decrease in the intervention group (0.70 ng/ml) was slightly smaller than that of the control group (0.88 ng/ml), but the net difference of 0.19 ng/ml had a wide 95% confidence interval (-0.86 to 0.48). Overall, 98% of parents in both groups still smoked at follow up. However, there was a non-significant tendency for parents in the intervention group to report smoking more at follow up and to having a reduced desire to stop smoking. CONCLUSIONS: A brief intervention to advise parents of asthmatic children about the risks from passive smoking was ineffective in reducing their children's exposure to environmental tobacco smoke. The intervention may have made some parents less inclined to stop smoking. If a clinician believes that a child's health is being affected by parental smoking, the parent's smoking needs to be addressed as a separate issue from the child's health.

Adult↗
PubMed1997

What determines levels of passive smoking in children with asthma?

BACKGROUND: Children with parents who smoke are often exposed to high levels of environmental tobacco smoke, and children with asthma are particularly susceptible to the detrimental effects of passive smoking. Data were collected from parents who smoke and from their asthmatic children. The families are currently taking part in a randomised controlled trial to test an intervention designed to reduce passive smoking in children with asthma. This paper reports on the baseline data. Questionnaire data and cotinine levels were compared in an attempt to assess exposure and to identify factors which influence exposure of the children. The aim of the study was to identify the scope for a reduction in passive smoking by these children. METHODS: A sample of 501 families with an asthmatic child aged 2-12 years was obtained. Factors influencing passive smoking were assessed by interviewing parents. Cotinine levels were measured from saliva samples using gas liquid chromatography with nitrogen phosphorous detection. RESULTS: Cotinine levels in children were strongly associated with the age of the child, the number of parents who smoked, contact with other smokers, the frequency of smoking in the same room as the child, and crowding within the home. Parental cotinine levels, the amount smoked in the home, and whether the home had a garden also exerted an independent effect on cotinine levels in the children. CONCLUSIONS: Many children are exposed to high levels of environmental tobacco smoke and their cotinine levels are heavily dependent upon proximity to the parent who smokes. Parents who smoke have a unique opportunity to benefit their child's health by modifying their smoking habits within the home.

Age Factors↗
PubMed1996

Nebulised antipseudomonal antibiotic therapy in cystic fibrosis: a meta-analysis of benefits and risks.

BACKGROUND: To establish the benefits and risks of nebulised antipseudomonal therapy in cystic fibrosis the results of relevant randomised controlled trials were combined. METHODS: The therapeutic end points compared were (a) number of pulmonary exacerbations requiring treatment with systemic antibiotics, (b) measurable alteration in respiratory tract pseudomonal load, (c) alteration in lung function on spirometric assessment, (d) development of resistance in respiratory tract Pseudomonas strains to the nebulised antipseudomonal used in each randomised controlled trial, and (e) renal and auditory impairment. RESULTS: Five studies were suitable for meta-analysis, eight others could not be included because of inadequate outcome description or the lack of appropriate randomisation. Meta-analysis shows benefit for nebulised antipseudomonal antibiotic therapy with no demonstrable adverse effect other than a possible increase in in vitro antibiotic resistance of Pseudomonas aeruginosa of the respiratory tract. CONCLUSIONS: Although inferences drawn from individual randomised controlled trials concerning the benefits and risks of this form of therapy are conflicting, pooled effect size establishes benefit with nebulised antipseudomonal antibiotic therapy and emphasises its relevance to the integration of information in other areas of controversy relating to the treatment of this disease.

Administration, Inhalation↗
PubMed1991

The use of the objective structured clinical examination as an audit of teaching and student performance.

A four year experience of the Objective Structured Clinical Examination in Child Health of 301 students in 18 separate examination diets was analysed to determine student competence in several clinical examinations including cardiovascular and central nervous system, developmental examination, history of asthma and in answering multiple choice questions relating to factual information. Using criterion reference assessment, student performance was related to individual knowledge, quality of teaching, examination design and teacher expectation. Variable levels of expectation and achievement were noted for different clinical items. Staff expectation of student performance was found to be higher than achieved in 39%, the same in 55% and in only 6% did students perform better than was anticipated. The value of using Criterion Reference Assessment System, based on a standard comprehensive examination, is discussed in relation to influencing examination design and efficiency of teaching medical students.

Achievement↗
PubMed1987

A once daily theophylline preparation in prevention of nocturnal symptoms in childhood asthma.

Twenty school children with chronic asthma who despite regular prophylactic therapy continued to have troublesome nocturnal wheeze or cough entered a double-blind cross-over study in which a once daily theophylline preparation was compared with placebo to assess control of these symptoms. Seventeen children completed both phases of the study. Significant improvement was noted in the day and night symptom scores, the morning dip index and daily peak flow readings with a significant reduction in rescue bronchodilator inhaler usage during the active treatment period. Satisfactory serum theophylline concentrations were obtained 11-12 h post dose in all children using a standard dose of 18 mg/kg per day at 2000 hours. Three children were withdrawn because of minor side-effects. The theophylline preparation studied in conjunction with other conventional anti-asthma therapy was thus effective in controlling nocturnal symptoms.

Adolescent↗
PubMed1987

Features of di George syndrome in a child with 45,XX,-3,-22,+der(3),t(3;22)(p25;q11).

A child with an unbalanced translocation resulting in monosomy for chromosomes 22 (q11----pter) and 3(p25----pter) is described. Although no immunological dysfunction could be demonstrated, the abnormalities found are similar to those seen in the di George syndrome which has been associated with monosomy for the same region of chromosome 22.

Chromosome Deletion↗
PubMed1984

Mother-child relationship--FIRST score.

This paper describes the use of the MCR FIRST score. The score has evolved as a method of measuring certain aspects of a mother's caring for her newborn baby. The factors included are feeding, interest, response, speech and touch, and these have been combined into a numerical score. The results for 100 mothers who were assessed on days 1, 3 and 5 postpartum are presented. The MCR FIRST score is distinguished by its simplicity of use in clinical work and may be helpful in recognizing potential impairment of mother-child relationships during the early postpartum period.

Female↗
PubMed1982

Pre-operative starvation in children. The role of alanine in blood glucose homeostasis.

Ninety-two children aged between 8 months and 8 years were fasted overnight prior to surgery. Plasma glucose and alanine concentrations were measured after the induction of anaesthesia. Of 30 children under four years, 23% had plasma glucose concentrations less than 3.3 mmol/litre. Underweight children were particularly at risk. The mean plasma alanine was low (0.17 mmol/litre) indicative of a shortfall in this essential substrate for gluconeogenesis. This probably reflects the greater obligatory glucose need of young children relative to their body protein mass.

Alanine↗
PubMed1980

Separation and other stress in child abuse.

80 children who had been abused by their parents or caretakers were examined for separation experience early in life and for other stress factors within their families. Although early separation of parent and infant was common in abusing families, combinations of other stresses and conflicts were also present. These were considered to have predisposed towards the battering.

Anxiety, Separation↗
PubMed1980

An objective undergraduate clinical examination in child health.

A new type of test used to examine medical students' clinical skills in paediatrics is described. Each student has to circulate round a number of timed stations. At each one he performs a specified clinical procedure--such as history taking, physical examination, urine analysis, and radiological interpretation--and is marked according to his performance. This type of test is objective and can be extended to cover different aspects of clinical methods; it readily informs the student about his progress, and enables the teacher to look critically at his own technique.

Clinical Competence↗
PubMed1979

Confirmation of gestational age by external physical characteristics (total maturity score).

The use of the total maturity score (TMS) as a means of estimating gestational age was assessed in a population of 76 low birthweight infants (less than or equal to 2500 g) and 80 matched controls (greater than 2500 g) all of certain gestational ages. The gestational ages, derived from the last menstrual period and from the TMS, were similar except in preterm low birthweight infants. The discrepancy in this group was attributed to the structure of the scoring system. It is concluded that the TMS is a convenient and accurate method of assessing gestational age in term babies.

Anthropometry↗
PubMed1978

Duration of breast-feeding after early initiation and frequent feeding.

111 primiparous women who had chosen to breast-feed their normal healthy term infants were assigned to one of four groups matched for age and social class. Two groups had the baby put to the breast within 10 min of delivery and the other two began breast-feeding 4--6 h after delivery. One of each pair of groups fed 2-hourly and the other 4-hourly. Follow-up over 18 months suggested that both early initiation and increased frequency of breast-feeding extended the nursing period, the former having the greater effect. 2-hourly feeding induced lactation at least 24 h earlier than did 4-hourly feeding.

Adolescent↗
PubMedDate not supplied

Correlates of low birth weight.

In order to provide a base line for long term follow-up, the background, methodology and major conclusions of a prospective study of low birth weight infants (less than or to equal to 2500 g) and their matched controls (greater than 2500 g) were studied and the results presented. The low birth weight babies were disadvantaged in respect of a number of bio-social parameters, had an excess of maternal and pregnancy disease conditions and a more unfavourable outcome in other pregnancies. The cohort was used to try and evolve a better definition of impaired fetal growth. The relative merits of using weight, head circumference, length, ratio of anthropometric measurements, relative centile position of anthropometric measurements in the same baby, cluster analysis techniques and clinical morbidity as estimates of impaired fetal growth were analysed: none defined impaired fetal growth more accurately than weight for gestational age. Methods of estimating gestational age and physical characteristics relating to growth and gestational age, as well as a number of biochemical and neonatal measurements, are described.

Anthropometry↗