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Biomedical subjects

J Poncher

Publications and source records attributed to J Poncher.

6 recordsLinked to original sources
PubMed1994

Is there lead in the suburbs? Risk assessment in Chicago suburban pediatric practices. Pediatric Practice Research Group.

OBJECTIVE: This study was designed to determine: (1) the prevalence of elevated blood lead (BPb) levels (BPb > or = 10 micrograms/dL) in Chicago suburban children attending Pediatric Practice Research Group practices at 12 and 24 months of age, and (2) the efficacy of the Centers for Disease Control and Prevention (CDC) and Illinois lead exposure risk assessment questions. METHODS: Parents bringing their 1- and 2-year-old children for health supervision visits at pediatric practices completed questionnaires. BPb levels were drawn on children. Both questionnaire and an analyzable BPb level were obtained on 1393 subjects (79.2%). RESULTS: Only 2.1% of our sample had a venous BPb level > or = 10 micrograms/dL (0.48 mumol/L); no subjects had a level > or = 30 micrograms/dL (1.45 mumol/L). The CDC risk assessment questions had a sensitivity of .69 and specificity of .70. Due to the low prevalence of elevated BPb levels in this sample, CDC and Illinois screening strategies had high negative predictive values (.99) and low positive predictive values (.05 and .04, respectively). However, some of the subjects with BPb levels > or = 10 micrograms/dL were not at high risk by CDC and Illinois screening questions; 9 of 29 subjects with elevated lead levels (31%) did not respond affirmatively to any CDC risk assessment questions. The question best predicting an elevated BPb was the determination that the house the child lives in was built before 1960 (sensitivity = .83, specificity = .67). This question is not currently included in CDC or Illinois screening strategies. Screening based on the single question "Was your house built before 1960?" would have missed only five (17%) of the children with BPb levels > or = 10 micrograms/dL. Three of these five children were among the 17.1% of 1-year-olds and 26.3% of 2-year-olds in our sample who had moved. CONCLUSIONS: In this sample, children living in houses built before 1960 should be considered at high risk for high-dose lead exposure. Due to the high mobility of our sample, phrasing the question to include lifetime exposure (ie, Has your child ever lived in a house built before 1960?) should also be considered. Selective BPb testing of high-risk children in low-prevalence suburban areas using this question would miss few children with elevated BPb. Useful risk assessment questions in other areas and other populations may differ.

Centers for Disease Control and Prevention, U.S.↗
PubMed1988

Practice-based research: opportunities and obstacles.

Renewed interest in practice-based research reflects growing realization of the limitations of research from a hospital perspective. Practice-based pediatric research promises to broaden the range and severity of conditions commonly studied, to enhance the study of the natural history of disease and of normal development, to provide normal controls and standards, and to facilitate recruitment of adequate sample sizes. Cohort, incidence, and health services research will be promoted by the development of patients registries. The Chicago area Pediatric Practice Research Group is a research consortium of 81 practitioners in 27 office practices. Formed in 1984, it receives logistic and financial support from Children's Memorial Hospital, with which it is affiliated. The Pediatric Practice Research Group has undertaken six studies, most with outside funding. During these studies, some unifying characteristics of practice-based research have emerged. These include the need to tailor study protocols to individual practice characteristics and routines and the critical role of office staff in the conduct of research. Features can be identified that make specific studies more or less intrusive into office functioning. It has proved feasible to obtain data of high quality and reproducibility despite geographically scattered data collection sites. This review of Pediatric Practice Research Group activities and experience is intended to open an exchange of ideas with others interested in practice-based research.

Humans↗
PubMed1984

Night waking in 4- to 8-month-old infants.

Parental reports of night waking and sleep patterns were obtained for 141 normal 4- to 8-month-old infants from middle-class families. A group of infants was identified who had a past history of colic and who were perceived to have a current night waking "problem." These infants awoke more often than other infants and also had significantly briefer total sleep duration. Night waking was described as a problem in infant boys more often than in infant girls. A second group of infants who awoke frequently was reported to snore or mouth breathe when asleep. This group of infants did not have a past history of colic, was not perceived to have a night waking problem, and was not overly represented by boys. Ordinal position, father's education level, gender, and method of feeding did not affect reported sleep patterns.

Child Behavior↗
PubMed1983

Signs of airway obstruction during sleep and behavioral, developmental, and academic problems.

This case control study of healthy children utilized parents' reports to determine whether behavioral, developmental, or academic problems were associated with signs of partial airway obstruction (snoring, difficult or labored breathing, and mouth breathing) during sleep. Results suggest an association between the signs of airway obstruction during sleep and problems when awake. Children with behavioral, developmental, or academic problems had a significantly later bedtime hour, briefer duration of total sleep, longer night awakenings, and an increased latency to sleep, as compared to children without those problems.

Airway Obstruction↗