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Biomedical subjects

S L Stewart-Brown

Publications and source records attributed to S L Stewart-Brown.

11 recordsLinked to original sources
PubMed2000

Obesity and physical and emotional well-being: associations between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire.

OBJECTIVE: To clarify the associations between obesity and health-related quality of life by exploring the associations between physical and emotional well-being in relation to obesity and the presence of other chronic illness. RESEARCH METHODS AND PROCEDURES: The study data were collected as part of a postal-survey within the old Oxford Regional Health Authority of England in 1997. Completed questionnaires were returned by 8889 of 13,800 randomly selected adults aged 18 to 64 years. The main outcome measures were body mass index in five categories (underweight, normal weight, overweight, moderately obese, morbidly obese); chronic illness status (any vs. none and number of such illnesses 0, 1 to 2, 3+); and mean SF-36 questionnaire score in two summary component measures reflecting physical and emotional well-being. RESULTS: Of the subjects, 31% were overweight and an additional 11% were obese. Body mass index was significantly associated with health status, but the pattern varied according to whether the measure reflected physical or emotional well-being. Physical, but not emotional, well-being deteriorated markedly with increasing degree of overweight and was limited in subjects who were obese but had no other chronic condition; subjects with chronic illnesses other than obesity were compromised in both dimensions. In terms of the number of chronic illnesses reported, the additional presence of obesity was associated with a significant deterioration in physical but not emotional well-being. DISCUSSION: Overweight and obesity are associated with poor levels of subjective health status, particularly in terms of physical well-being. The limitations in emotional well-being that are reported here and in other studies may be a result of confounding by the presence of accompanying chronic illness.

Adolescent↗
PubMed1999

The quality of life in acne: a comparison with general medical conditions using generic questionnaires.

Skin diseases such as acne are sometimes thought of as unimportant, even trivial, when compared with diseases of other organ systems. To address this point directly, validated generic questionnaires were used to assess morbidity in acne patients and compare it with morbidity in patients with other chronic diseases. For 111 acne patients referred to a dermatologist, quality of life was measured using the Dermatology Life Quality Index, Rosenberg's measure of self-esteem, a version of the General Health Questionnaire (GHQ-28) and the Short Form 36 (SF-36). Clinical severity was measured using the Leeds Acne Grade. Population quality of life data for the SF-36 instrument were available from a random sample of adult local residents (n = 9334) some of whom reported a variety of long-standing disabling diseases. All quality of life instruments showed substantial deficits for acne patients that correlated with each other but not with clinically assessed acne severity. The acne patients (a relatively severely affected group) reported levels of social, psychological and emotional problems that were as great as those reported by patients with chronic disabling asthma, epilepsy, diabetes, back pain or arthritis. Acne is not a trivial disease in comparison with other chronic conditions. This should be recognized in the allocation of health care resources.

Acne Vulgaris↗
PubMed1997

Preschool vision screening.

OBJECTIVES: To undertake a systematic review of the effectiveness of preschool vision screening. To provide evidence on which decisions about the future provision of this service can be made. To indicate areas for further research. STUDY SELECTION: The Centre for Reviews and Dissemination guidelines for systematic reviews were used. The research questions were formulated using the Wilson and Jungner criteria for evaluating screening programmes. They concerned prevalence, natural history, disability, treatment and screening in relation to three target conditions: amblyopia, refractive errors and squints which are not cosmetically obvious. Studies were considered for inclusion according to pre-determined criteria for the age group studied, the outcomes measured and the study design. The following types of study design were considered: cross-sectional studies of prevalence, cohort studies of natural history, any type of study (e.g., cross-sectional surveys, case-series, qualitative studies) of disability attributable to a target condition, controlled trials, observational studies and audits of screening programmes, and prospective controlled trials of treatment. DATA SOURCES: The following electronic databases were searched: Biological Abstracts, CINAHL, Embase, ERIC, IAC Health Periodicals, IAPV, Medline, Psychlit, Science Citation Index, System for Information on Grey Literature in Europe, DHSS-Data, Faculty of Public Health Medicine Database of Dissertations, Index of Scientific and Technical Proceedings, Dissertation Abstracts, Index of Theses, NHS Research Register, Public Health Information Sharing Database. A limited amount of handsearching was undertaken. Reference lists were scanned to identify other relevant studies, and requests for unpublished data were made to people working in the field. DATA EXTRACTION: Data was extracted by the first author and then checked by the second. DATA SYNTHESIS: Quantitative analysis was undertaken where possible. Qualitative analysis was performed where studies were too heterogeneous for the data to be combined, or for research questions that were not suitable for quantitative synthesis. RESEARCH FINDINGS: The electronic search yielded over 5000 references, and over 500 abstracts were downloaded from the databases for further scrutiny. A total of 85 studies were included in the main analysis. PREVALENCE: No studies were found with the primary aim of establishing the prevalence of visual defects in preschool children. Data from studies of screening programmes report a range of yields for all the target conditions combined of 2.4-6.1%. NATURAL HISTORY: No studies designed with the intention of documenting the natural history of the target conditions in children aged 3 or 4 years were found. Other studies that provide some natural history data suggest that mild degrees of amblyopia may resolve spontaneously. In the absence of information about natural history it is impossible to estimate the effect of treatment from studies without a control group that was not treated. DISABILITY: A total of 21 studies exploring disability in relation to the target conditions were included. The literature provides a reasonable basis for generating plausible hypotheses about the ways in which the target conditions might disable people, but is insufficient to draw any firm conclusions about their impact on quality of life. The research to date is not sufficient to determine appropriate outcomes for controlled trials of treatment. TREATMENT: Five randomised controlled trials of treatment and six prospective controlleld trials without randomisation were found. No studies compared treatment with no treatment. Most of the studies were methodologically flawed.(ABSTRACT TRUNCATED)

Child, Preschool↗
PubMed1991

Vision screening in preschool children: comparison of orthoptists and clinical medical officers as primary screeners.

OBJECTIVE: To see if there were differences in referral rates and abnormalities detected from two areas that were operating different preschool vision screening programmes. DESIGN: Cohort study using case notes of referrals. SETTING: Community based secondary referral centres in the county of Avon. PATIENTS: 263 referrals from a child population of 7105 in Southmead district, an area that used orthoptists as primary vision screeners; 111 referrals from a child population of 2977 in Weston-super-Mare, an area that used clinical medical officers for screening. MAIN OUTCOME MEASURES: Amblyopia and squint detection rates, together with false positive referral rates. RESULTS: The amblyopia detection rate in Southmead district was significantly higher than in Weston-super-Mare (11/1000 children v 5/1000), as was the detection rate of squint (11/1000 v 3/1000). However, the false positive referral rate from Southmead was significantly lower than that from Weston-super-Mare (9/1000 v 23/1000). CONCLUSION: Preschool vision screening using orthoptists as primary screeners offers a more effective method of detecting visual abnormalities than using clinical medical officers.

Amblyopia↗
PubMed1988

Screening of vision in school: could we do better by doing less?

Assessment of vision in schoolchildren is routinely performed, but the effectiveness of the screening programmes has not been reviewed. A survey of health district screening programmes for vision in schools was performed at the end of 1984. The response rate from districts in England and Wales was 81%. All 165 of the districts that responded screened for loss of distant visual acuity; 96% screened for loss of colour vision, 73% for squint, and 67% for loss of near visual acuity. The frequency with which districts screened varied considerably. Some districts screened yearly, and various different types of tests were used. In many districts children were screened in unsuitable places, such as corridors, assembly halls, and toilets. Criteria for referral varied from one district to another, and few districts collected data appropriate for monitoring their screening programmes. Many districts screened more intensively than could be justified on the basis of the conditions tested for and the likely benefit of remedial treatment.

Child↗
PubMed1988

Preschool vision screening: a service in need of rationalisation.

A survey of health districts in England and Wales was carried out at the end of 1984 to ascertain among other things the range of current programmes for preschool vision screening. The response rate was 81.3%. Altogether 94% of districts reported screening for both reduced visual acuity and squint; two districts screened for neither. A great variety of different types of tests were in use and screening was carried out at a variety of different ages. A high proportion of districts were screening children for reduced visual acuity in infancy, although screening tests applicable at this age have not been shown to be effective. Districts screened for squint between one and four times. Collection of routine monitoring information by districts was poor.

Child Health Services↗
PubMed1988

Partial sight and blindness in children of the 1970 birth cohort at 10 years of age.

The prevalence and causes of partial sight and blindness (best corrected distant visual acuity of 6/24 or less) have been studied in a nationally representative sample of 15,000 10-year-old children. The prevalence of blindness (acuity less than 6/60) was between 3.4 and 4.0/10,000. All these children had been registered as blind; less than half were in schools for the blind, the remainder were all in other special schools. The prevalence of partial sight (acuity less than or equal to 6/24 greater than or equal to 6/60) was between 5.4 and 8.7/10,000; less than half of these children were in schools for the visually handicapped or partially sighted; most were in ordinary schools; half were neither registered as partially sighted nor ascertained as in need of special education for visual handicap. The most common cause of partial sight or blindness in this cohort was congenital cataract; the second most common was congenital nystagmus. The study identified a number of children whose best acuity on examination was 6/24 or less who had either no ophthalmological diagnosis or who had been diagnosed as suffering from a refractive error. These children have been included in the study because at the time of the survey they had either not been prescribed spectacles or they had spectacles which they were not wearing; the functional visual level of these children was therefore equivalent to that of those defined as partially sighted.

Blindness↗
PubMed1986

The significance of minor defects of visual acuity in school children: implications for screening and treatment.

Information collected on the children of the 1970 Birth Cohort Study has been used to examine the educational performance of children who have minor defects of visual acuity. Results suggest that children with mild degrees of hypermetropia may experience difficulty learning to read but with exclusion of this group significant educational disability was not associated with minor visual defects. The significance of this finding is discussed in conjunction with information on prevalence of defects and current practice in screening and treating visual defects in school children. Some anomalies in current practice are identified.

Child↗
PubMed1985

Pubertal growth in diabetics.

Mean values for two variables of the pubertal growth spurt, peak height velocity and age at peak velocity, of children attending the diabetic clinic in Bristol are reported. The growth spurt was normal both in timing and intensity in boys, but the peak velocity was reduced and age at peak velocity more variable among girls.

Adolescent↗