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Biomedical subjects

P Parkin

Publications and source records attributed to P Parkin.

9 recordsLinked to original sources
PubMed2004

Community paediatricians' counseling patterns and knowledge of recommendations relating to child restraint use in motor vehicles.

BACKGROUND: Road traffic injury is the leading cause of death among Canadian children and youth. Transport Canada recommends four types of child restraint depending on the size of the child, and recent studies have demonstrated the effectiveness of recommended restraint use. OBJECTIVES: To determine community paediatricians' knowledge of Transport Canada recommendations for child restraint use in vehicles, and to examine paediatricians' counseling patterns in relation to child passenger safety. METHODS: A mailed questionnaire survey of all community paediatricians affiliated with the Hospital for Sick Children, Toronto was conducted. A 16 item questionnaire gathered information on knowledge of Transport Canada recommendations for child restraint use, general counseling patterns in relation to child passenger safety, and demographic information. RESULTS: In total, 60 community paediatricians in active practice were identified. Of these, 48 (80%) responded to the mailed questionnaire. Almost all paediatricians (92%) correctly identified the recommended weight for transition to a forward-facing car seat, whereas fewer paediatricians (63%) correctly identified the recommended weight for transition to a booster seat from a forward-facing car seat, and only one third of paediatricians correctly identified the recommended weight for transition from a booster seat to a seat belt. CONCLUSION: Community paediatricians' knowledge of Transport Canada recommendations for child restraint use in vehicles is incomplete. There is a need for such recommendations to be better disseminated to paediatricians and parents so that information on child restraint use is delivered in a clear and consistent manner.

Age Factors↗
PubMed2000

Trends in bicycling-related head injuries in children after implementation of a community-based bike helmet campaign.

BACKGROUND/PURPOSE: The aim of this study was to determine the effect of a community-based bike helmet promotion campaign on bike helmet use and related head injuries in children (0 to 14 years of age) in a large North American city. METHODS: The authors established a multifaceted, multidisciplined, community-based campaign to promote bike helmet use by children in 1989. The goals were to increase helmet use by 100% per year, to reduce fatal bike-related head injuries by 50% overall, and to explore the feasibility of legislation mandating helmet use. Helmet use was measured by standardized field observations repeated annually in a single borough within the metropolitan area. To estimate head injury incidence, the number of admissions to hospital for the treatment of bike-related head injuries in a regional trauma registry, which included all residents in the target population was used. The authors were unable to control for changes in exposure to bicycling or in the criteria for admissions to hospital for the treatment of head injuries during the study period. RESULTS: The bike helmet use rate rose from 4% in 1990 to 67% in 1996. The number of head injury admissions fell from 46 in 1990 to 24 in 1996. Legislation requiring helmet use by all children went into effect in October 1995. CONCLUSIONS: Bike helmet use increased significantly during the first 4 years of the campaign and again after the helmet law was implemented. The total number of bike-related head injury admissions declined by more than 50%. The campaign achieved all of its goals except for a 50% reduction in fatal head injuries, which were too infrequent for analysis.

Adolescent↗
PubMed1996

Folic acid and prevention of neural tube defects: a study of Canadian mothers of infants with spina bifida.

OBJECTIVES: To determine the diffusion of information about preventing neural tube defects (NTDs) through folic acid consumption by examining whether mothers of Canadian children born with spina bifida, who had become pregnant at least a year after evidence of the preventive effect of folic acid had been published, had taken sufficient amounts of folic acid in the periconceptional period and were aware of this important new information. DESIGN: Validated food-frequency questionnaire to assess folate intake. SETTING: The Hospital for Sick Children in Toronto between Jan. 4 and Aug. 16, 1994. PARTICIPANTS: Thirty mothers whose infants were being treated for spina bifida. MAIN OUTCOME MEASURES: The mothers' mean folate intake and knowledge about the protective effect of folic acid; demographic and health information. RESULTS: The mothers' mean folate intake was 0.182 mg/d (standard deviation 0.076 mg/d, range 0.02 to 0.53 mg/d), less than half the protective dose. Only 4 (13%) of the mothers had been aware of the relation between nutritional folate and NTDs when they conceived, but even they did not supplement their diets with sufficient folic acid. The medical data showed that, in addition to the failure of primary prevention of NTDs, secondary prevention through diagnostic tests during pregnancy were also inadequate. CONCLUSIONS: Our study, one of the first to be conducted after the role of folate in preventing NTDs was confirmed, reveals that, in one of the most advanced countries in the world, this new information has had no effect on patients' folate intake. Unless food is fortified with folate, the estimated 400 to 800 annual cases of NTDs in Canada will not be prevented.

Canada↗
PubMed1995

Huntington's disease: diagnosis by amplification of the CAG repeat.

AIM: To develop and validate a test for the diagnosis of Huntington's disease by the direct detection, and sizing of, expanded CAG triplet repeats within the Huntington gene of affected individuals. METHODS: A polymerase chain reaction-based test which specifically amplifies the CAG repeat was developed using an ultra heat stable polymerase and [alpha 35S] delta ATP incorporation. Amplified alleles were separated on DNA sequencing gels and sized by comparison with a known sequence. RESULTS: Analysis of 10 affected individuals showed abnormal alleles with repeat numbers ranging from 40 to 61. In one case, that had been diagnostically uncertain because there was no family history of Huntington's disease, the demonstration of an expanded allele confirmed the diagnosis. Analysis of this patient's elderly and unaffected father indicated that he had an allele at the extreme end of the normal range. In a second case with atypical neurological features the diagnosis was also established by the demonstration of an expanded allele. CONCLUSIONS: This assay allows improved diagnosis of Huntington's disease including completely accurate presymptomatic and antenatal diagnosis. Easy access to this test has implications for clinical practice but acceptable guidelines for its use will need to be developed.

Adult↗
PubMed1991

Complications of indwelling venous access lines in the pediatric hematology patient: a prospective comparison of external venous catheters and subcutaneous ports.

Since 1984, 316 subcutaneous ports (SP) and 339 external venous catheters (EC) [Roko Catheter, The Hospital for Sick Children (HSC)] have been inserted in hematology/oncology patients at HSC. During a 22-month period (July 1987 to April 1989), a committed central line nurse (J.I.) prospectively collected clinical and microbiologic data on 144 consecutive SPs and 130 consecutive ECs. Children with the SP had 0.6 infected lines and 0.7 infectious episodes per 1,000 patient days compared to 2.9 infected lines and 4.3 infectious episodes per 1,000 patient days with the EC (p less than 0.001). This lower infectious complication rate with SP was demonstrated in the entire group of unselected patients and in a cohort of children with acute lymphoblastic leukemia (ALL) receiving intensive chemotherapy, and it was evident in all age groups. In view of the other advantages of SP--normal activity, absence of the need for home maintenance, improved body image, less expense--these data suggest that SPs are the preferred device in pediatric patients and provide effective venous access with acceptable complication rates.

Adolescent↗
PubMed1989

High-versus low-dose, frequently administered, nebulized albuterol in children with severe, acute asthma.

Thirty-two 5- to 17-year-old children who had severe, acute asthma were randomly assigned to receive either high doses (0.15 mg/kg of body weight per dose) or low doses (0.05 mg/kg of body weight per dose) of nebulized albuterol every 20 minutes for six doses. Compared with the low-dose regimen, the high-dose regimen resulted in significantly greater improvement in forced expiratory volume in 1 second, forced vital capacity, and wheeze score and a lower hospitalization rate. The changes in heart rate, respiratory rate, blood pressure, white blood cell count, and serum potassium concentration did not differ significantly between the groups. The incidence of side effects, which included tremor, hyperactivity, and vomiting, was not significantly different in the two populations. Serum albuterol levels varied widely, but there was no correlation between the levels and the increase in heart rate or other side effects. high-dose, frequently administered, nebulized albuterol appears both safe and effective in treating severe, acute asthma in children.

Acute Disease↗
PubMed1974

Chemotherapy of malignant melanoma with dimethyl traizeno imidazole carboxamide (DITC) and nitrosourea derivatives (BCNU, CCNU).

Chemotherapy for metastatic melanoma was performed in 80 consecutive evaluable patients. DTIC, BCNU and CCNU produced responses in 28% of patients, alone or in combination with each other. Three of 62 patients treated with DTIC remain free of tumor, off therapy at 18-36 months following objective regression of metastases. Chemotherapy with commercially available drugs continued to be uniformly unsuccessful. DTIC was used successfully in treatment of extensive extracranial disease, including one patient with metastatic melanoma during pregnancy. Cerebral metastases were the sole or major cause of death in 8/9 patients who relapsed following control with DTIC for nine months or longer, and one patient developed a carcinoma of the breast following therapy with DTIC and BCNU. Remission was induced in two patients with intralesional BCG, after prior attempts to control metastases with DTIC and combination chemotherapy.

Adult↗
PubMedDate not supplied

Pediatric injuries: parental knowledge, attitudes and needs.

OBJECTIVE: To understand current parental knowledge, attitudes and information needs about childhood injuries. METHOD: Telephone survey of 1,516 parents in Metropolitan Toronto and Barrie. RESULTS: Over half of the parents knew that injuries were the leading cause of death and about 70% believed that injuries were the most preventable of major health disorders. However, most parents were not particularly concerned, and most had limited understanding of the major causes of injury. Traditional modes of receiving safety information by obtaining pamphlets from doctors' offices or drug stores and through media coverage were preferred. CONCLUSIONS: Although parents were aware of the risk of general childhood injury, they need to be educated about specific injury risks and effective countermeasures. A concerted and thoughtful effort is needed to market safety information for parents in Ontario.

Adolescent↗