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Biomedical subjects

M Malcolm

Publications and source records attributed to M Malcolm.

8 recordsLinked to original sources
PubMed2001

Mountaineering fatalities in Mt Cook National Park.

AIM: To estimate the risk of death associated with mountaineering in the Mt Cook National Park (MCNP), and to describe some characteristics of the fatal events. METHODS: Fatality data, including coroners' files, were obtained from the Mountain Safety Council and the Department of Conservation, Mt Cook field office. Data on occupancy of mountain huts were used to estimate rates. RESULTS: 33 deaths occurred among climbers using the alpine huts studied, over a period in which climbers spent 52 906 nights in the huts. The overall fatality rate was 0.62/1000 hut nights. This is estimated to equate with a fatality rate of 1.87/1000 climbing days. Fatality risk estimates varied more than 50-fold between huts serving the highest risk (6.5/1000 days) and lowest risk (0.3/1000 days) climbing areas within the MCNP. CONCLUSION: The risk of death associated with mountaineering in MCNP varies greatly with the difficulty and seriousness of the climbing undertaken. The risk associated with the more serious climbing in MCNP is very similar to that reported for climbers on expeditions to extreme altitude. Even the lower risk estimates are very high when compared with those for most other recreational activities.

Accidents↗
PubMed1996

"On the spot' vaccination: does it work?

OBJECTIVE: To trial and evaluate a system of "on the spot' vaccination for children up to the age of 15 years in the Early Childhood Centres of the Central Sydney Area Health Service, at the Royal Alexandra Hospital for Children and in a number of general practices in the area. METHODOLOGY: A brief questionnaire was used to collect data from parents and health care professionals about the child's vaccination status and vaccines given "on the spot'. RESULTS: Over an 8 week period in August-September 1993, 5162 questionnaires were completed; 71% of children were up to date with their vaccination. If Haemophilus influenzae type b vaccine, which had been introduced only 2 months before commencement of the study, was excluded, 84% of the children were up to date. A total of 441 children were given 663 vaccinations "on the spot'. Very few children were too ill to be vaccinated (6%). However, only 30% of those who needed vaccination "on the spot' actually received it (441 of 1480), and only 41% (24 of 58) of a subset of those who were not vaccinated were known to have complied 1 month later. Children attending Early Childhood Centres were younger than children attending general practices or the hospital. CONCLUSIONS: A high proportion of children who attended for routine or acute health care had vaccinations overdue (30%). If this scheme could be continued and expanded it would have an important impact on vaccination coverage, and hence on the incidence of vaccine-preventable diseases.

Child↗
PubMed1995

Lead in children from older housing areas in the Wellington region.

AIMS: To examine blood lead levels in children, aged 12 to 23 months, living in old housing areas of Wellington and Lower Hutt, and to investigate risk factors for high lead levels. METHOD: Children were selected from Plunket Society rolls. Venous blood samples were collected, and care givers were interviewed with a questionnaire. Soil samples were taken from around the children's homes. Both soil and blood samples were analysed for lead content. RESULTS: Blood samples and completed questionnaires were obtained for 143 children. The geometric mean blood lead level for all the children was 0.25 mumol/L (5.1 micrograms/dL) (95% confidence interval [95% CI]: 0.22-0.28 mumol/L). Three children had blood lead levels that exceeded the level for notification in New Zealand 1.45 mumol/L and a further 13 had blood lead levels exceeding 0.48 mumol/L. Children with elevated lead levels were likely to live in a house greater than 50 years old where paint removal had taken place in the last 2 years (risk ratio [RR] = 14.4, 95% CI: 2-107). Eating dirt, particularly for children who usually played outside within 2 metres of the house, was also a risk factor for elevated blood lead levels. Soil lead levels generally increased with the age of the house and were weakly correlated with blood lead levels (r = 0.32). CONCLUSION: Paint removal in old houses is a major risk factor for elevated blood lead levels. However, the number of study children living in houses less than 50 years old was limited. Because of this and possible participant selection bias, the results of this study require confirmation in a separate population-based study. Information about the specific paint removal procedures that cause high lead levels is also needed.

Cross-Sectional Studies↗
PubMed1995

Assessment of the risk of transmission of N meningitidis in a classroom setting.

AIM: To evaluate the risk of colonisation with N meningitidis among university classroom contacts of a student with invasive meningococcal disease. METHODS: Throat cultures were obtained from classmates and faculty exposed to a university student with meningococcal disease. Exposures to the index case were quantified using a questionnaire. RESULTS: None of the 41 students and staff from whom cultures were obtained showed evidence of colonisation with N meningitidis. The contacts had spent an average of 13.5 h in class with the index case during the 2 days prior to the onset of her illness. CONCLUSIONS: The risk of colonisation with N meningitidis among casual university classroom contacts appears to be low. This study lends support to decisions to withhold chemoprophylaxis in most instances of such contact.

Adult↗
PubMed1993

Immunisation surveillance: a comparison of four methods in Canterbury.

AIMS: To evaluate four methods of immunisation surveillance by comparing the estimates obtained for Canterbury in the National Immunisation Coverage Survey with estimates calculated using data on immunisation distribution, general practitioner immunisation benefit claims and immunisation coverage at school entry. METHODS: Estimates were calculated using existing data sources on vaccine distribution, immunisation benefit claims, school entry immunisation coverage and live births in Canterbury. The survey was conducted according to a WHO protocol. RESULTS: The estimates based on vaccine distribution were of no use. The school entry data available did not allow complete evaluation of this method, which has some potential advantages. A number of inconsistencies were found between estimates from the survey and from immunisation benefit claims, between north and south Canterbury and between the two years for which estimates were calculated using benefit claims. CONCLUSIONS: It is concluded that the most practicable option, the immunisation benefit claim system, would require careful evaluation and improvement before it could be relied upon for immunisation coverage surveillance. The feasibility of each method as a means of immunisation surveillance is discussed.

Birth Rate↗