Biomedical subjects
J M Stanhope
Publications and source records attributed to J M Stanhope.
The Tokelau Island migrant study: alcohol consumption in two environments.
The prevalence of alcohol consumption, the choice of beverages and the quantity of drinks used by a Polynesian society are described, both in the Tokelau atolls and among Tokelauan migrants in New Zealand. Current drinking was uncommon but increasing among women. Among men, it was more common, but both prevalence and quantity were modest compared with national alcohol consumption in New Zealand. Description of alcohol consumption in such migrant populations may provide a basis for encouraging continuing prudence regarding alcohol and ready acceptance and provision for the non-drinker of alcohol.
Rheumatic fever: clinical and laboratory manifestations in a New Zealand community.
The clinical features of acute rheumatic fever as seen in Wairoa County 1962--76 are described. The types of cases seen comprised 107 definite first attacks, 78 definite recurrences, and 117 first attacks and 34 recurrences which did not satisfy strict diagnostic criteria. The incidence of the major manifestations, carditis, polyarthritis and chorea were 53 percent, 56 percent and 11 percent in definite first attacks, and 81 percent, 26 percent and 8 percent in definite recurrences, respectively. The ratio of recurrences to first attacks was high (58 percent). The Wairoa population exhibits factors thought to contribute to a high risk of recurrence--young age distribution, non-Caucasian ethnicity, avoidance of parenteral prophylaxis and frequent carditis in the first attack.
Asthma and wheeze in New Zealand adolescents.
Two epidemiological surveys of New Zealand adolescents are reported. The prevalence of asthma was 7.5 percent in Rotorua and 7.9 percent in Wairoa. Additional questions asked in Wairoa identified 18.2 percent of subjects who had experienced wheeze but had not been labelled "asthma". The association of active asthma with nasal obstruction was confirmed. Wheeze which had not been labelled asthma was associated with the combination of subject's own and maternal cigarette smoking. The use of asthma medication was associated with easier geographic and socio-economic access to medical care, as well as with asthma activity.
Ear disease in rural New Zealand school children.
Surveys of children aged 5--17 in a predominantly rural area showed a high prevalence of inflamed ears and perforated drums in younger subjects and of perforated and scarred drums in older subjects. Abnormal drums were associated wtih lower socioeconomic status, ethnicity and low altitude and low rainfall. Maori children had both higher incidence and lower recovery rates than non-Maori children. The wider use of trained nurses for case detection and follow up is advocated, at an estimated cost of 53 cents per child examination. Further parent education and co-ordination of nurse/audiometrist surveys are necessary.
Social patterns of adolescent cigarette smoking in a rural community.
A survey of a secondary school serving a small town and rural district in New Zealand revealed that 46 percent of the students, aged 12 to 18, were current cigarette smokers. The smoking habits of elder siblings and peers were closely related to subjects' smoking. Parental opposition to smoking, beliefs that smoking was bad for health and a degree of self-esteem appeared to have protective value. The key to prevention of cigarette smoking may lie in parent and early childhood education aimed at increasing awareness of the dangers of smoking, fostering a soical climate of opposition to smoking, and increasing the child's self-confidence.
Rheumatic fever and streptococci: the Wairoa College study.
The decline in incidence of rheumatic fever seen in many countries is not evident in New Zealand. Wairoa county has the highest hospital admission rate within New Zealand, 232 per 100 000 per year, five times the national average, 43 per 100 000. Studies in Wairoa included a cross-sectional survey of the local secondary school. Throat swabbing yielded 13.6% of subjects positive for beta-haemolytic streptococcus group A. Boys had a higher rate than girls, and girls aged 14 and over had a lower rate than younger girls. Discriminant analysis failed to identify ethnic, social or geographic factors as contributing to positivity. Sibling concordance was not significant. ASO titres were high in comparison with another New Zealand study (Rotorua Lakes). There was an association between high ASO titre and throat swab positive for group A and group C streptococci. The prevalence of definite rheumatic fever and rheumatic heart disease was established as 11/715 (1.5%). A wide range of residential geographic, climatic and socioeconomic factors failed to discriminate between cases and noncases. Ethnicity alone was a significant discriminator, the cases being more Maori than noncases.
Serum levels of immunoglobulins A, G and M in New Zealand and Tokelauan children.
Serum levels of immunoglobulins A, G and M are described in a group of New Zealand (NZ) children of European descent. These findings are used as reference standards for three groups of Tokelauan children, atoll residents, migrants in NZ, and NZ-born Tokelauan children. All three Tokelauan groups had high levels of IgA, IgG, and IgM. Breast feeding was diminished and morbidity was higher in the NZ-born group. The IgG level was negatively correlated with duration of breast feeding in this group. In the atoll group IgG was related to present illness but no other consistent relationships were found between present illness status and the immunoglobulin levels. It remains unclear whether the high Tokelauan immunoglobulin levels are genetically or environmentally determined.
High-density-lipoprotein cholesterol and other serum lipids in a New Zealand biracial adolescent sample. The Wairoa College survey.
Among New Zealand adolescents, Maoris have lower serum high-density-lipoprotein cholesterol levels and higher serum triglyceride levels than non-Maoris. Boys have lower high-density-lipoprotein cholesterol and triglyceride levels than girls. Low-density-lipoprotein cholesterol levels do not show sex/race differences. These findings are reflected in an excess of hyperlipidaemia type IV in Maori girls. There may be a relation between these lipid distributions and the excess Maori mortality, especially among females, from ischaemic heart-disease.
Blood pressure and social interaction in Tokelauan migrants in New Zealand.
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The Tokelau Island migrant study: fertility and associated factors before migration.
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Delayed culture of group-A streptococci: an evaluation of variables in methods of examining throat swabs.
We studied the effects on the frequency of isolation of group-A streptococci from throat swabs of school children on three varibles: (1) plating the cultures within 4 h of collecting the swabs or after storage for 4 days at room temperature; (2) using a plain or a serum-coated cotton swab; and (3) including silica gel in the swab tube or omitting this. Under the conditions of our experiment, only delayed plating of the swab gave a statistically significant advantage. When the delayed-isolation technique was used, neither the swab type nor the presence or absence of silica gel significantly influenced the result. The least advantageous combination of variables was: plating within 4 h, a plain swab, and the absence of silica gel.
Deep vein thrombosis after femoropopliteal bypass grafting with observations on the incidence of complications following the use of dextran 70.
Radiological thrombosis was demonstrated on six occasions in the leg veins in 66 patients following the placement of 71 femoropopliteal bypass grafts. All patients received dextran 70 as prophylaxis postoperatively. The incidence was similar for grafts with the lower anastomosis either above or below the knee joint. No predisposing factors to venous thrombosis were apparent other than blood dyscrasias. A further group of patients who had arterial reconstructive procedures were examined to determine the incidence of the complications of bleeding and heart failure which might be attributed to the routine use of dextran 70. The incidence of complications in this larger group indicates that the routine use of dextran 70 is not a significant factor in their occurrence in the postoperative period.
Rheumatic fever in New Zealand: the Waiora College survey design and response rate.
The outline organisation of a health survey of a secondary school is presented. The aims of the survey were primarilary to provide population data on rheumatic fever in a high incidence area, and to further knowledge of the distribution of risk factors for coronary heart disease in New Zealand adolescents. Ninety-six and a half percent coverage of the target group was achieved; non-responders were characterised from hospital and school records as being predominantly rural with greater early childhood hospital experience than respondents. The sample was considered to be representative of the adolescent population of the area.
Some health indicators in New Zealand adolescents: The Rotorua Lakes Study 5.
This paper describes and compares health indicators in Maori and European adolescents attending a coeducational secondary school in New Zealand. No important differences were found in certain urinary constituents, haemoglobin or packed cell volume, fasting plasma glucose, serum urea nitrogen, pulse rate, age of menarche, hospital experience or tuberculin test-BCG status.
Letter: Trends in rheumatic fever.
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The Tokelau Island migrant study: prevalence of various conditions before migration.
The Tokelau Island Migrant Study has shown no important differences between those who subsequently left their home islands to migrate to New Zealand and those who remained, in key anthropometric and biochemical variables already reported. This comparison is now extended to various common diseases and conditions, and again no major difference emerges. The Tokelauans are compared with other Polynesians and shown to have less diabetes, hypertension, effort pain, chronic bronchitis and varicose veins than New Zealand Maoris, while resembling some Cook Island groups. Changes in prevalences of some conditions following migration are postulated.
Coronary risk factors in New Zealand Maori and European adolescents: The Rotoua Lakes Study 2.
A survey if 298 adolescents was carried out by questionnaire, medical examination, anthropometric and biochemical methods, to determine the prevalence of risk factors for coronary heart disease particularly those that might explain the known difference in atherosclerotic mortality between European and Maori women. Data on blood pressure, obesity and serum lipids are presented here, and are discussed together with smoking and serum uric acid. Obesity, hypertriglyceridaemia, smoking and hyperuricaemia all contributed to a higher coronary risk status for Maori subjects.