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Biomedical subjects

S Donnan

Publications and source records attributed to S Donnan.

At least 19 recordsLinked to original sources
PubMed1999

Delphi study into planning for care of children in major incidents.

This paper describes a Delphi study used to identify and improve areas of concern in the planning of care for children in major incidents. The Delphi was conducted over three rounds and used a multidisciplinary panel of 22 experts. Experts were selected to include major incident, immediate care, emergency medicine, and paediatric specialists. This paper presents a series of consensus statements that represent the Delphi group's opinion on the management of children in major incidents. The statements cover all phases of major incident planning and response. Paediatric services may play a vital role in the preparation and response to a major incident involving children. This paper represents a consensus view on how best to plan and respond to major incidents involving children. An accompanying paper describes the practical implementation of this guidance.

Child↗
PubMed1998

Major incidents in Britain over the past 28 years: the case for the centralised reporting of major incidents.

STUDY OBJECTIVES: To describe the incidence and epidemiology of major incidents occurring in Britain over the past 28 years. METHODS: Major incidents were identified through a MEDLINE search, a hand search of journals and government reports at the Home Office Emergency Planning College, newspaper reports, a postal survey of ambulance emergency planning officers, and through requests for information posted on the internet. MAIN RESULTS: Brief incidents profiles from 108 British major incidents are presented. Most major incidents pass unreported in the medical literature. On average three to four major incidents occur in Britain each year (range 0-11). Sixty three of 108 (59.2%) of incidents involve public transportation. The next two largest groups are civil disturbance 22 of 108 (20.3%) and industrial accidents 16 of 108 (14.8%). Although incidents at sports stadiums are rare they produce large numbers of casualties. The data currently available on major incidents are difficult to find and of questionable accuracy. CONCLUSIONS: The lack of data makes planning for major incidents and exercising major incident plans difficult. Casualty incident profiles (CIPs) may assist major incidents exercises and planning. CIPs from future major incidents should be collated and made available to all major incident planners.

Accidents, Occupational↗
PubMed1993

Low prevalence of rheumatoid arthritis in the urbanized Chinese of Hong Kong.

OBJECTIVE: To establish the prevalence of rheumatoid arthritis (RA) in the urbanized Chinese of Hong Kong. METHODS: 2000 adults in 2 housing blocks were screened using a structured interview. Those who screened positive had an examination, rheumatoid factor analysis and radiographs taken. Subjects were classified using the Rome, New York and 1987 ACR criteria (modified and unmodified) for RA. RESULTS: The prevalence of RA, using the modified 1987 ACR criteria, was 0.35%. This is significantly lower than published data for European Caucasians (standardized morbidity ratio = 0.27; 95% CI 0.09-0.63). CONCLUSION: RA is rare in urbanized Chinese.

Adolescent↗
PubMed1992

Blood pressure and 40 month mortality in elderly Chinese subjects aged 70 years and over.

The association between blood pressure and 4 year mortality was examined in a cohort of 970 Chinese subjects aged 70 years and above. After adjusting for age, sex, body mass index, smoking habit, place of residence, and the presence of heart or chronic lung diseases, a U-shaped association between blood pressure and mortality was observed, the risks of mortality among subjects in the extreme quartiles being twice as high as those in the middle quartiles. Subjects with the lowest systolic blood pressure quartile also had a higher risk of developing functional limitations.

Aged↗
PubMed1990

Hong Kong strains of methicillin-resistant and methicillin-sensitive Staphylococcus aureus have similar virulence.

While most authorities agree that methicillin-resistant Staphylococcus aureus (MRSA) are as pathogenic as methicillin-sensitive strains (MSSA), some believe that MRSA are relatively avirulent opportunists, and that their importance has been exaggerated. We present evidence that Hong Kong strains of MRSA and MSSA are equally pathogenic: they have similar virulence in animal models; they are isolated in similar proportions from both deep and superficial clinical sites including blood; in patients with hospital-acquired bacteraemias mortality rates are similar when adjusted for clinical factors; and in both animals and patients with systemic MRSA infection, mortality rates are significantly reduced by vancomycin therapy. Efforts to control the spread of MRSA are justified, and in invasive sepsis early treatment with vancomycin may be life-saving.

Animals↗
PubMed1990

Hip fracture in Hong Kong and Britain.

Hip fractures in elderly people are an important public health problem in many Western populations. Little is known of their epidemiology in Oriental populations. A comparative study of hip fracture incidence in Hong Kong and Southampton showed similar incidence rates by age and sex. In the last two decades hip fracture incidence in Hong Kong has increased, particularly among men. This can be partly explained by reduction in the levels of activity among the elderly Chinese population.

Female↗
PubMed1990

Prevalence of cataract among the institutionalized elderly in Hong Kong.

The Hong Kong 1981 Census found a high prevalence of blindness in the age group aged 65 and above. Visual defects short of blindness are also a special problem among the elderly and cataract is one of the most important causes. We have studied the prevalence of cataract among 546 subjects living in homes or hostels for the aged in a New Town in Hong Kong. Cataract was defined as having a lens opacity and visual acuity worse than 20/100 in either eye. A prevalence of 45% among men and 32% among women was found. There was significant difference in prevalence between men and women aged below 75 but little sex difference was noted for the older age groups. Among the cataract cases detected on screening, about half had not had the diagnosis made previously. The results confirm the need for more epidemiological and health care studies on the visual problems among the aged.

Aged↗
PubMed1989

Repeated prevalence surveys for monitoring effectiveness of hospital infection control.

In a 1400-bedded teaching hospital single-day prevalence surveys of hospital infection were done every six months for 3 years. The prevalence of community-acquired infection remained constant; but, after the introduction of a general infection-control policy, the prevalence of hospital-acquired infection (HAI) fell linearly from 10.5% in the second survey to 5.6% in the last. After the introduction of a specific urinary catheter care policy, the prevalence of hospital-acquired urinary tract infection (HAUTI) fell from 3.2% in the first four surveys to 2.0% in the last three. These differences persisted when the results were adjusted by logistic regression for patient risk factors, which varied between surveys: the declines for HAI and HAUTI were then 9.9% to 6.0% and 2.9% to 2.2% respectively. Infection control policies, therefore, can have substantial impact on the prevalence of HAI, and their effectiveness can readily be measured by repeated prevalence surveys.

Chi-Square Distribution↗
PubMed1988

Physical activity and calcium intake in fracture of the proximal femur in Hong Kong.

In Hong Kong physical activity and calcium intake of 400 Chinese men and women with hip fractures were compared with those of 800 controls. Daily walking outdoors, upstairs, uphill, or with a load protected against fracture. This was independent of cigarette smoking and alcohol consumption. Higher levels of reported activity in middle life were also protective. Average calcium intake was around one quarter that in Britain because of the low consumption of dairy products. Differences in calcium intake depended mainly on consumption of green vegetables and small fish. High intake protected against hip fracture. These findings point to the importance of maintaining daily physical activity and calcium intake in urbanised Chinese populations.

Aged↗
PubMed1988

Nutritional correlates of blood pressure in elderly Chinese.

Dietary intakes of various nutrients, urinary electrolyte levels from a casual urine sample, and BP were determined in 425 active men and women aged 60 and above (mean age 70.6 years) living in the community. After exclusion of subjects taking Western or Chinese medicines, correlations were seen between body mass index and diastolic blood pressure (DBP, r = 0.15, P less than 0.01), between calcium intake and systolic blood pressure (SBP, r = 0.14, P less than 0.02) and retinol intake and SBP (r = -0.14, P less than 0.03). There was no significant correlation between BP and casual urinary Na/Cr, K/Cr, Na/K or Ca/Cr ratios. Fewer correlates were seen compared to younger age groups. These results suggest that dietary modification of BP based on studies in Caucasian communities of all ages may not apply to elderly Chinese populations.

Aged↗
PubMed1988

Nutritional status of the water-soluble vitamins in an active Chinese elderly population in Hong Kong.

Dietary intakes of thiamine, riboflavin, nicotinic and ascorbic acid, together with the biochemical status of thiamine, riboflavin, pyridoxine and ascorbic acid, were determined in a cluster sample of 419 healthy active elderly subjects aged 60 years and above living in the community. Nicotinic acid intake per 1000 kcal (4.18 MJ) of food energy showed an age-related decrease in men, while women had higher ascorbic acid intakes than men. Between 38 and 98 per cent of this population have intakes of thiamine, riboflavin and nicotinic acid below the UK RDA values. Intakes of ascorbic acid were below the RDA for 17 per cent of men and 9 per cent of women. The prevalence of biochemical deficiency was 8, 14, 11.5 and 24 per cent for thiamine, riboflavin, pyridoxine and ascorbic acid respectively. A significant difference in intakes between groups with blood levels within and below the reference range was seen only for riboflavin, suggesting that factors other than low intake may be more important in contributing to low blood levels for thiamine and ascorbic acid. However, inaccuracies in dietary intake estimations may contribute to the poor correlation.

Aged↗