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Biomedical subjects

L Wagstaff

Publications and source records attributed to L Wagstaff.

17 recordsLinked to original sources

Prediction of illness severity and outcome of children symptomatic following kerosene ingestion.

Kerosene pneumonitis is usually self-limiting and secondary infection is rare. Long-term studies in developed countries have produced conflicting results about complications. The position in developing countries, where children are exposed to adverse environmental and nutritional factors, is unknown. The aim of the present work was to determine whether there is an increase in respiratory or other illnesses following kerosene pneumonitis and whether these changes could be related to the severity of the initial lung damage. Fifty-seven children with clinical signs of pneumonitis were examined on admission and after overnight observation. Clinical signs were assessed for their usefulness for predicting severity. Cases and matched neighbourhood controls were seen every 2 weeks for 3 months. The time to predict most reliably the severity of short-term ill effects was 12-24 hours after the initial insult. There was no significant difference in respiratory symptoms during the 3-month follow-up in cases compared with controls. However, mild diarrhoea and fever were reported significantly more often in cases than in controls. Morbidity after clinical recovery was not shown to be a problem, irrespective of the severity of the acute event.

Case-Control Studies↗

'Birth to Ten'--pilot studies to test the feasibility of a birth cohort study investigating the effects of urbanisation in South Africa.

'Birth to Ten' is a birth cohort study currently being conducted in the Johannesburg-Soweto area. This paper describes the various pilot studies that were undertaken to investigate the feasibility of a cohort study in an urban area. These studies were designed to determine the monthly birth rate, the timing, frequency and duration of maternal antenatal visits, the timing and frequency of visits to well-baby clinics and the accuracy and reliability of routinely collected growth data. In addition, a birth data collection form was tested to ascertain the appropriateness of its use in clinics within the study area.

Birth Rate↗

Birth to ten: child health in South Africa in the 1990s. Rationale and methods of a birth cohort study.

Birth to Ten is a longitudinal birth cohort study which began in April 1990 in the Johannesburg/Soweto area of Transvaal, South Africa. In this paper, the reason for the initiation of the study and its location in the current sociopolitical context is discussed. The health status of South Africa children in terms of infant mortality, morbidity (notifiable diseases) and nutritional status is described and mention is made of measures of psychological health and the importance of environmental pollution on health. The existing health service infrastructure in the study area is described and the fragmentation of health services between races, between preventive and curative services and on a geographical basis is highlighted. The study objectives, design, population, inclusion and exclusion criteria, methods of measurement and logistics are described.

Child↗

Televised paediatric consultations: a student evaluation of a multipurpose learning strategy.

Since 1984, each student in the sixth-year paediatric rotation in the Department of Paediatrics and Child Health at the University of the Witwatersrand has been videotaped while undertaking a comprehensive paediatric primary care consultation. Video replay of the consultation by each individual student was evaluated by the student together with medical and social work tutors. This incorporated psychosocial aspects, communication skills, doctor-mother-child interactions, as well as essential medical content, clinical examination techniques, and management strategies. The student was expected to provide comprehensive health care, viz. dealing with the presenting health problems, identifying any possible hidden agenda, giving due attention to nutrition, immunization, development, optimal use of available records, health surveillance and appropriate education. This teaching programme was introduced in 1984. In 1988, 68 consecutive final-year medical students completed an anonymous Likert-type evaluation form scoring their perceived learning. They affirmed that the use of television in medical education provides a unique multipurpose learning strategy and in particular enhances awareness of self and of patient/family needs. The time, cost and effort invested in this programme are considered justified.

Clinical Competence↗

Anthropometrically determined nutritional status and the school performance of black urban primary school children.

Anthropometric parameters (height and weight) were used to assess the nutritional status of 1407 black children in a Soweto lower primary school. Cross-sectional profiles were obtained in 1981 and 1983 as well as a longitudinal study of 362 pre-adolescent children who remained in the school over the 2-year period. The major proportion of the distribution of percentage weight-for-age and percentage height-for-age was less than 100 per cent of NCHS reference median. There was a small but significant increase in mean percentage weight-for-height between 1981 and 1983. Children who were stunted and those whose growth rate over a 2-year period was known to be reduced failed more frequently. Apart from these the general range of anthropometric findings did not clearly correlate with classroom achievement as assessed by end-of-year marks. The age ranges of children in the different grades exceeded 5 years. The highest failure rate occurred in the school entry grade (Substandard A). Only in this grade were the older boys found to be less adequately nourished than their age peers in higher standards. Untested adverse social, family and environmental effects may mask the real consequences of suboptimal growth. Without anthropometry the latter would frequently not be apparent because of the generally proportional reductions in weight and height for age.

Adolescent↗

Children's growth charts in theory and practice.

The many advantages accruing from the use of children's growth charts are briefly outlined. Simple small studies are described to assess how this health care tool is being utilized in Soweto. The results provide some evidence that this reputedly simple technique might be yet more effectively used.

Age Factors↗

Primary child care adapted to community needs.

Primary health care services for children should be adapted to the different and varying needs of the community. Specially trained nurses and other health workers can make an important contribution to the primary care of children.

Child↗