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Biomedical subjects

M A Belsey

Publications and source records attributed to M A Belsey.

At least 19 recordsLinked to original sources
PubMed1993

Child abuse: measuring a global problem.

Child abuse and neglect include four distinct conditions: physical abuse, neglect, emotional abuse and sexual abuse. The magnitude of the problem is not well defined. The lack of epidemiological data limits the extent to which sound public health and social welfare policies and intervention programmes could be developed, implemented and evaluated. In recent years two approaches have been developed to document the magnitude and nature of child abuse and neglect: regional or national case registers; and a screening instrument for suspected cases of child abuse and neglect (SCAN) for use in health service facilities. We are proposing an additional approach for monitoring presumed child abuse and neglect-related mortality. Applying this approach to regions or groups of countries for which there are sufficient data, the expected under-5 rate of presumed child abuse and neglect would be between 13 and 20 per 100,000 live births. These estimates are higher than those made either from community-based registers or forensic reporting systems. Differences in these estimates will need to be resolved through further research. Injury and injury-related mortality can be classified as intentional, unintentional or resulting from varying degrees of neglect. Death from physical abuse represents a willful act or series of actions. Death from neglect may arise from willful behaviour but may also arise from ignorance and irresponsible behaviour. These include failure to recognize hazardous circumstances or children's nutritional, health and developmental needs, and leaving infants and children unattended or inadequately supervised. Mortality data provide virtually no measure of sexual abuse.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Impact of hormonal contraceptives vis-à-vis non-hormonal factors on the vitamin status of malnourished women in India and Thailand. World Health Organization: Special Programme of Research, Development and Research Training in Human Reproduction. Task Force on Oral Contraceptives.

The effects of combined oral contraceptives containing 30 or 50 micrograms ethinyl oestradiol and 150 micrograms levonorgestrel or a 3-monthly injectable preparation depo-medroxyprogesterone acetate (DMPA) on the vitamin status of low-income group women from two urban centres in India (Bombay and Hyderabad) and one rural centre in Thailand (Chiang Mai) were examined in a follow-up study over a period of 1 year. The magnitude of malnutrition in the study population vis-à-vis a middle-income reference group was assessed by comparing the baseline data on the two groups. Effects of time-related variables such as lactation and season were also examined by a cross-sectional analysis of the baseline data on the study population. In all three centres the majority of the study population suffered from biochemical riboflavin and/or pyridoxine deficiency even before initiating contraception. Lactation appeared to have an effect on the vitamin status, which varied among the different populations. Seasonal effects were seen, but showed inconsistent trends in the three centres. Both the oral contraceptive pills and DMPA tended to increase serum vitamin A and blood folate. The thiamin, riboflavin and pyridoxine status of the women who were already deficient did not deteriorate further with the use of hormonal contraception, as judged by enzyme saturation tests. Some deterioration in the riboflavin status of the normal women of Hyderabad was seen with the use of oral pills. Women who were biochemically deficient prior to the use of oral contraceptives tended to show some improvement in B-vitamin status, over the 1-year period of hormonal contraception.

Adolescent↗
PubMed1982

A randomized, double-blind study of two combined and two progestogen-only oral contraceptives.

A randomized double-blind study of two combined oral contraceptives and two progestogen-only oral contraceptives was conducted using the same protocol at WHO Collaborating Centres for Clinical Research in Human Reproduction in Bombay and Ljubljana of the 518 women admitted to the trial, 123 received mestranol 50 micrograms + norethisterone 1mg (MES 50 + NET 1); 137 received ethinyl estradiol 30 micrograms + levonorgestrel 150 micrograms (EE 30 + LNG 150); 130 received norethisterone 350 micrograms/NET 350); and 128 received levonorgestrel 30 micrograms (LNG 30). At one year, between 52.6 and 61.0 percent of those recruited had discontinued oral contraceptive use for all reasons, and by two years, between 70.5 and 76.5 percent had discontinued the treatment. These rates did not differ between the four treatment groups. However, discontinuation rates for all medical reasons at one and two years, and at two years pregnancy rates and discontinuation rates for bleeding disturbances, were significantly lower in the EE/LNG preparation. The groups receiving the MES/NET, LNG and NET had similar pregnancy rates, discontinuation rates for all medical reasons and all bleeding disturbances. There were two ectopic pregnancies among the 22 pregnancies in the progestogen-only groups. Discontinuation because of headache, dizziness and other central nervous system symptoms were significantly more common in those receiving MES/NET compared to EE/LNG. In contrast, discontinuation for gastro-intestinal disturbances were significantly higher in the EE/LNG combined preparation. Bleeding disturbances in the first few cycles tended to be higher in NET than in the LNG group. The data suggest that greater consideration be given to the benefits and risks of including progestogen-only oral contraceptives in the family planning programmes of some countries.

Adolescent↗
PubMed1979

Safety of postabortion sterilisation compared with interval sterilisation. A controlled study.

406 women--about one-fifth of those requesting an induced abortion and sterilisation over a thirty-three-month period--volunteered to be allocated randomly to either a concurrent induced-abortion/sterilisation group or a group which was sterilised six weeks after abortion. The abortion-attributable and sterilisation-attributable complication rates of 3.8% and 5.2%, respectively, for the concurrent group did not differ significantly from the 6.7% and 6.9% rates for the interval group. The estimated 2%-10% of women who would have changed their minds must be set against the 4% of women who became pregnant again before being sterilised. Efforts should be made to identify women likely to regret sterilisation.

Abortion, Induced↗
PubMed1976

The epidemiology of infertility: a review with particular reference to sub-Saharan Africa.

The problem of infertility, with particular reference to Africa south of the Sahara, is reviewed. In many areas, up to 40% of women are reported to have completed their reproductive years without bearing a child. The condition is widely distributed, but also often localized in pockets corresponding to geographical or tribal units. Most available demographic data provide estimates of childlessness but it is not sufficient to define the problem in terms of primary and secondary infertility, pregnancy wastage, and infant and child mortality. The major underlying cause for the high levels of infertility appears to be the sequelae of Neisseria gonorrhoeae infection in both men and women, manifested as obstructive azoospermia and tubal occlusion. Other infections, such as those that may follow abortion or delivery, or systemic infections, may be important in some areas. The available data suggest that different patterns of infertility and pregnancy wastage, and different etiological agents and processes, contribute to the problem of infertility in the different areas. The need for a systematic, standardized research approach in several areas is clearly indicated.

Abortion, Spontaneous↗
PubMed1975

Skin infections and the epidemiology of diphtheria: acquisition and persistence of C diphtheriae infections.

Acquisition and persistence of C. diphtheriae infections of skin lesions and of the respiratory tract were observed in households exposed to C. diphtheriae carriers in a community experiencing a diphtheria outbreak and in households in two communities free of the disease. Acquisition of C. diphtheriae was more frequent in epidemic households, apparently due to a greater frequency of respiratory tract acquisition. Skin lesion acquisition was constant in both situations. The pattern of persistence appeared to be the same in both types of households, although skin lesion C. diphtheriae infections had a greater tendency to persist than respiratory tract infections. Acquisition occurred more frequently following exposure to a skin lesion C. diphtheriae carrier than following a respiratory carrier exposure.

Carrier State↗
PubMed1975

Mortality from tuberculous meningitis reduced by steroid therapy.

In this study of 99 tuberculous meningitis patients from Cali, Colombia, treatment with steroids (in conjunction with antituberculous drugs) was shown to be more effective in reducing mortality than treatment with antibacterial drugs alone. Results further suggest that low dosages of steroids (1 mg/kg of prednisone daily for r 30 days) are equally effective in treating the disease as high dosages (10 mg/kg of prednisone at the start of treatment, gradually reduced over a 30-day period). These results are band 4(-43 and -kk mg/100 ml) demonstrated cerebral release. Arterial blood hyperammonemia can be detoxified safely in the brain as long as the levels do not exceed approximately 300 mug/100 ml. Beyond that level lactic acidosis is observed, particularly in cerebral venous drainage. Arterial blood hyperammonemia was also related to the extent of alveolar hyperventilation. These findings are very similar to those seen in experimental hyperammonemia and support the concept that neurotoxicity in children with Reye's syndrome is at least partly due to impaired oxidative metabolism secondary to hyperammonemia.

Adolescent↗
PubMed1973

The epidemiology of favism.

Favism is a potential obstacle to the use of the fava bean in the development of a locally produced, inexpensive weaning food for the Middle East and North Africa. The purposes of this study were to define the epidemiology of favism, to evaluate the advisability of using the fava bean in a weaning food, and to suggest ways of avoiding or eliminating the toxic factor in the bean. Field observations, locally acquired data, and a literature review suggested that the use of the fava bean in a weaning food would be hazardous, but that the hazard might be overcome by using certain strains of the bean or, more particularly, by using old dried beans. The disease is usually directly related in time to the harvesting and availability of fresh beans, but it is also associated with fresh dried beans. On the basis of the age distribution of the disease, patterns of bean consumption, and local food taboos it appears that the toxic factor is concentrated in the skin of the bean, that it is heat-stable, that in dried beans it decreases with age, and that it crosses into the breast milk of lactating mothers. It also appears that disease expression may be a result of the interaction of several host factors, such as nutritional status and the consumption of other foods. These observations are consistent with the results of laboratory studies, which incriminate vicine, divicine, and DOPA in the etiology of favism.

Adolescent↗