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Biomedical subjects

Y D Senturia

Publications and source records attributed to Y D Senturia.

18 recordsLinked to original sources
PubMed1998

Successful techniques for retention of study participants in an inner-city population.

The purpose of this work was to describe methods of retaining participants in studies of inner-city populations, including the timing and intensity of contacts; and to describe the characteristics of participants who did not complete all follow-up interviews and/or return all peak flow diaries in the National Cooperative Inner-City Asthma Study. A cohort study design was used involving hospital emergency rooms and community clinics in seven major urban areas. Participants included 1337 4- to 9-year-old asthmatic children and their caretakers. Nearly 89% of participants completed 3-, 6-, and 9-month follow-up interviews. The 15% of participants who completed a baseline interview on the weekends were significantly more likely to complete follow-up interviews on a weekend. The percent of follow-up interviews conducted in person increased over time from 5% to 8%. The percent of participants with complete follow-up increased as the number of contact names increased (86% with zero contacts, 91% with two contracts; p = 0.03, test for trend). Participants who required at least four phone calls to complete the 3- and 6-month assessment were significantly more likely to be black, have higher participant stress, and have a smoker in the household (p < 0.05). Multiple logistic regression suggests that higher social support and lower parental stress were both predictors of completed interviews. Within our study sample of inner-city minority participants with asthmatic children, only a small proportion of participants missed any follow-up interviews. Increased caretaker stress, decreased social support, and inability to provide several alternate contacts were all predictive of retention problems. Having a flexible staff, computer tracking, and face-to-face recruitment appear essential to achieving nearly complete follow-up within a population historically difficult to follow.

Asthma↗
PubMed1997

Bicycle-riding circumstances and injuries in school-aged children. A case-control study.

OBJECTIVE: To identify bicycle-riding circumstances associated with bicycle-related injury among school-aged children. DESIGN: Case-control. SETTING: One metropolitan emergency department and 3 suburban emergency departments. SUBJECTS: Consecutive sample of children aged 7 through 18 years who experienced bicycle-related trauma and control children seen for non-bicycle-related trauma (matched for age within 1 year, sex, and area of residence [urban vs suburban]). METHODS: Parents and case children were interviewed by telephone about the bicycle ride resulting in their visit to the emergency department. Parents and control children were interviewed about their most recent bicycle ride. The survey instrument addressed the following potential risk factors: helmet use, bicycle speed, road conditions, riding location, bicycle condition, an adult presence, riding destination, bicycle style, and stunt riding. RESULTS: Interviews were completed with 47 (73%) of 64 eligible case children and 42 (69%) of 61 control children with the following age distribution: 27 (30%) of the interviews were completed with children aged 7 to 9 years, 40 (45%) of the interviews were completed with children aged 10 to 14 years, and 22 (25%) of the interviews were completed with children aged 15 to 18 years. Fourteen children (16%) were wearing helmets. There was a high degree of agreement between parent and child responses, higher for case children than for control children. In univariate analyses, injury was associated with riding with other children (vs riding alone or with adults), riding fast or slow (vs normal speed), riding a BMX-style (motocross) bicycle (vs another standard or multispeed style bicycle), playing on the bicycle (vs going to school or other purposeful or nonpurposeful trip), and riding only on the sidewalk (vs in the street). More case children than control children were farther than 3/4 mile (> 1.2 km) from home (38% vs 19%, P = .05). Multiple logistic regression identified' slow riding speed (odds ratio, 10.3;95% confidence interval, 1.6-66.8), distance from home farther than 3/4 mile (> 1.2 km) (odds ratio, 3.7;95% confidence interval, 1.1-12.5), and riding on the sidewalk (odds ratio, 6.1;95% confidence interval, 1.8-20.5) as independent risk factors for injury. CONCLUSIONS: This study identifies 3 counterintuitive but apparently strong behavioral risk factors for bicycle injuries treated in an emergency department in children aged 7 through 18 years in the Chicago (III) area. These findings will need to be confirmed in larger samples from a wider range of locales. In addition to stressing the importance of wearing a helmet when riding a bicycle, it may be desirable to include the findings of this study in anticipatory guidance discussions with school-aged children.

Adolescent↗
PubMed1996

Gun storage patterns in US homes with children. A pediatric practice-based survey. Pediatric Practice Research Group.

OBJECTIVE: To describe gun storage patterns in gun-owning families with children. DESIGN: Survey of parents attending participating offices. SETTING: Twenty-nine urban, suburban, and rural pediatric practices in Chicago, Ill; New Jersey; Houston, Tex; Utah; Georgia; Iowa; and South Carolina. SUBJECTS: Parents of children attending offices for well- or sick-child care. SELECTION PROCEDURE: Consecutive sample of families seen during the 1-week study period. MEASUREMENTS AND ANALYSES: Logistic regression models were constructed to identify sociodemographic factors associated with keeping guns loaded. RESULTS: Of 5233 surveys, 1682 (32%) indicated ownership of at least one powder firearm. Of the gun-owning families, 61% reported at least one gun unlocked, and 15% reported at least one gun loaded. Rifles were more often stored unlocked (62% rifles vs 52% handguns, P<.001, z=4.60; two-proportion z-test), but handguns were more likely to be kept loaded (3% rifles vs 27% handguns, P<.001). Seven percent of gun-owning families reported at least one gun unlocked and loaded (handguns 12 times more likely than rifles). Only 30% of households reported all guns stored unloaded and locked up. The best-fit logistic regression model for keeping a gun loaded identified four predictor variables: owning a gun for self-protection, work-related gun ownership, owning a handgun, and no men in the home. CONCLUSIONS: Because most gun-owning families store guns loaded, unlocked, or both, anticipatory guidance should address gun storage in all such families. Interventions designed to alter the way work guns are dealt with after work, and to provide safe and effective means of self-protection might affect these storage patterns.

Child↗
PubMed1996

Growth of Chicago-area infants, 1985 through 1987. Not what the reference curves predict. Pediatric Practice Research Group.

OBJECTIVE: To determine if the National Center for Health Statistics (NCHS) growth curves (including 867 white infants, born between 1929 and 1975, in the Yellow Springs, Ohio, area) reflect contemporary infant growth in pediatric practices. DESIGN: Observational cohort study of healthy term infants. Office personnel obtained standardized measurements at health maintenance visits. SETTING: Ten pediatric community practices that were members of the Chicago, III, area Pediatric Practice Research Group (PPRG). METHODS: Measurements of 1574 PPRG infants, seen on at least 5 occasions between 2 and 54 weeks of age, generated sex-specific growth curves using a 3-parameter mathematical model fitted to the serial data for each infant. Values from the computed curves were compared with NCHS growth references at 1, 3, 6, 9, and 12 months. The birth weights of PPRG and NCHS cohorts were compared. RESULTS: Mean birth weight of PPRG infants was significantly greater than a similar NCHS measure. Compared with the NCHS reference curve, PPRG infants were heavier at 1, 3, and 6 months, longer on all comparisons, and had greater head circumferences, particularly in the early months of age. CONCLUSIONS: The NCHS growth curves do not accurately reflect infant growth in this cohort. Nationally representative data are needed to revise the NCHS growth curves.

Birth Weight↗
PubMed1996

Infant and toddler feeding patterns and problems: normative data and a new direction. Pediatric Practice Research Group.

To fill information gaps, predominantly non-Hispanic white parents in five Chicago-area pediatric offices were surveyed concerning infant (n = 130) and toddler (n = 151) feeding times and behaviors. Feeding time distributions did not differ by age. Percentiles (in minutes) were: 10th, 9.4; 50th, 17.7; and 90th, 29.3. The most common infant problematic feeding behavior (PFB) was "not always hungry at mealtime" (33%). Toddler PFB included "not always hungry at mealtime" (52%), "trying to end meals after a few bites" (42%), "picky eating" (35%), and strong food preferences (33%). Toddler picky eaters ate more slowly (means 23.3 vs 19.7 minutes, p < .04). Toddlers with recalled PFB at 6 and 12 months ate most slowly (mean 37.5 minutes). We conclude that: (1) infants and toddlers who take >30 minutes to feed are slow feeders; (2) reports of behavioral feeding problems are common in toddlers and are related to slow feeding; (3) and these data can guide clinical care and future studies.

Chicago↗
PubMed1994

Children's household exposure to guns: a pediatric practice-based survey.

Guns in the home are a factor in pediatric unintentional and intentional firearm injuries, yet the patterns of ownership and use are unclear. OBJECTIVES. To describe the prevalence of firearms in households containing children who go to pediatricians, the types of firearms owned, the purposes of such ownership, the conditions of firearm storage, and the social correlates of ownership. METHODS. Survey of parents attending 29 (urban, suburban, and rural) pediatric practices in Chicago, New Jersey, Houston, Utah, Georgia, Iowa, and South Carolina for well or sick child care during a 1-week study period. The main outcome measure was ownership of rifle/shotgun and/or handgun. RESULTS. Gun ownership was reported by 37% of 5233 respondent families: rifles (26%), handguns (17%), and powder firearm (32%). Ownership varied significantly across practices and geographical locations. Thirteen percent of 823 handguns and 1% of 1327 rifles were reported both unlocked and loaded. Recreation was the most common reason for both rifle (75%) and handgun (59%) ownership; 48% of handguns were kept for self-protection versus 21% of rifles. In logistic regression models, predictor variables for firearm ownership included rural area, single family dwelling, at least one adult male, and fewer preschool children (for handgun and rifle); mother with at least 12 years education (for handgun), and white mother (for rifle). CONCLUSIONS. The data presented suggest that US pediatricians routinely see children in families that own firearms, including a worrisome number that keep loaded and unlocked handguns. Until more detailed information becomes available, it is reasonable for pediatricians to be guided by these data, and so to counsel routinely about gun exposure.

Adolescent↗
PubMed1994

Sampling issues in a regional pediatric practice-based network.

This paper explores various approaches to achieving representative and generalizable practice-based data. The data used were derived from original research conducted by the Pediatric Practice Research Group (PPRG), a research consortium including full-time staff at Children's Memorial Hospital and 132 practitioners in 35 Chicago-area practices in a variety of settings ranging from Chicago's inner city to rural northwest Indiana. Sampling issues addressed include sampling frame, source (population or practice), geographical representation, seasonal representation, survey instrument design, socioeconomic diversity, and contact and response rates.

Chicago↗
PubMed1993

Exposure corrected risk estimates for childhood product related injuries.

This study assesses the effect of exposure correction on injury risk estimates for children, using Chicago-area survey data on age-specific exposure of children to seven products: amusement park rides, sleds, bunkbeds, skateboards, fireworks, toboggans, and air guns and rifles. National Electronic Injury Surveillance System estimates for 1987 were used as numerators with two denominators: (i) uncorrected age-specific U.S. Census estimates for 1987 and (ii) these estimates corrected for exposure. Except for bunkbeds, skateboards and sleds, corrected injury risk decreased as age increased. Uncorrected population injury rates underestimated the risk posed to product-using children, especially those who are youngest and those who use skateboards.

Accidents↗
PubMed1993

In-office survey of children's hazard exposure in the Chicago area: age-specific exposure information and methodological lessons. Pediatric Practice Research Group.

Anticipatory guidance on injury prevention should reflect the risks children face, yet hazard exposure information is generally unavailable. The objectives of this study were (1) to obtain information on age-specific exposure of Chicago-area children to amusement park rides, sleds, snow discs, bunkbeds, skateboards, fireworks, toboggans, and air guns and (2) to assess methodological issues in gathering exposure information by parental survey in pediatric practices. Questionnaires were received from 679 families, including 1469 children. The proportion of families with at least one exposed child varied: amusement park rides (94%), sleds (67%), snow discs (25%), bunkbeds (24%), skateboards (22%), fireworks (17%), toboggans (15%), and air guns and rifles (6%). Use of skateboards, air guns and rifles, and bunkbeds was highest in males. Use of skateboards, air guns and rifles, and snow discs peaked among young adolescents (ages 10 to 14), whereas use of sleds, toboggans and amusement park rides peaked among young children (ages 5 to 9) and young adolescents. Use of bunkbeds peaked among young children. Log linear analyses found: the likelihood of exposure to sleds and snow discs was highest in rural communities and for families owning their own home; toboggan exposure was highest among home owners; air gun and rifle exposure was highest in rural areas; fireworks exposure decreased with increased paternal education; exposure to skateboards was highest in single family dwellings and suburban home owners. This study generates the only available current estimates for use of these products, and demonstrates that in-office parental surveys concerning exposure are feasible. The findings can help guide future hazard exposure research and may affect anticipatory guidance in some settings.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Children fathered by men treated with chemotherapy for testicular cancer.

In a study designed to assess the potential teratogenic effect of paternal chemotherapy, information was obtained on 131 children fathered by 107 men treated for metastatic testicular cancer. Of this group, first born children fathered by 96 chemotherapy patients were compared with 96 children fathered by matched controls. There was no excess of malformations (relative risk 1.0, 95% confidence intervals 0.41 and 2.40). In addition, the rates for specific malformations in the total cohort of 131 children were compared with the general population. There were no significant differences from national rates although the rate for congenital heart disease was higher than expected.

Abnormalities, Drug-Induced↗
PubMed1987

HIV infection in children: sizing up the paediatric problem.

Cases of paediatric AIDS have increased each year in the USA, as the disease has spread to the heterosexual community. In the USA the geographic distribution of perinatal AIDS cases mirrors the distribution of cases in women. To date, 503 HIV antibody positive women have been reported in the UK. It is likely that the increasing number of seropositive women will be reflected in an increase in the number of reports of perinatal HIV infection and AIDS. Although screening of blood donors and blood products has stopped further increase in infections from this route, as transfusion-infected children become symptomatic the burden on paediatric services will increase.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Children fathered by men treated for testicular cancer.

Children fathered by 27 testicular cancer patients treated with radiotherapy, 25 treated with chemotherapy, and 57 control men (46 community controls and 11 Stage I testicular cancer patients) were examined for evidence of congenital malformations. The proportion of malformations in children in the treatment group did not differ from that in children in the control group or from incidence rates for malformations in the general population. Our results suggest that treatment for testicular cancer should not constitute a reason for advising termination of pregnancy, although numbers were too few to detect a relative risk smaller than 3 X 2. More observations are needed to provide a definite answer.

Abnormalities, Drug-Induced↗
PubMed1977

Comparison of serum progesterone and endometrial biopsy for confirmation of ovulation and evaluation of luteal function.

An endometrial biopsy and a blood sample for progesterone determination obtained simultaneously in the midluteal phase of the cycles of 55 infertile women were compared for reliability for confirmation of presumptive ovulation and evaluation of luteal function. Progesterone levels of 3 ng/ml or greater were found in 90.5% of the cycles. Secretory endometrium was identified in 81% of the cycles. Thirty-three cycles yielded sufficient information to compare the two methods for evaluation of luteal function. Histology and progesterone levels were consistent with each other and the presumed time of ovulation in only 11 cycles. Histology was inconsistent with the presumed time of ovulation in 20 cycles, while progesterone was inconsistent in only two cycles. Additional samples for progesterone determinations were obtained during the biopsy cycles of 15 patients who presented adequate data for evaluation of luteal function. A single, well-timed progesterone determination appeared adequately to reflect the data obtained from serial samples in the same cycle. These results support the thesis that a single, well-timed serum progesterone determination is superior to a single endometrial biopsy as a screening method for confirmation of presumptive ovulation and for evaluation of luteal function.

Adult↗