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Biomedical subjects

A Burton

Publications and source records attributed to A Burton.

At least 73 records · Page 4Linked to original sources
PubMed1983

Cesarean section. Risk and benefits for mother and fetus.

We studied the effects of cesarean section on neonatal mortality for breech infants and low--birth weight vertex infants using data from the Georgia neonatal surveillance network on 392,241 singleton deliveries between 1974 and 1978. The risk of neonatal death for breech infants weighing 4,000 g or less delivered vaginally was significantly higher than the risk for those delivered by cesarean section. The lower the birth weight, the higher the risk for a vaginal breech delivery. For breech infants weighing 1,000 to 2,500 g, the risk was almost 21/2 times greater for a vaginal delivery v a cesarean delivery. The best outcome for high-risk vertex infants weighing 1,000 to 1,500 g was for those delivered by cesarean section in a tertiary perinatal center. An increase in the cesarean section rate may be associated with increased neonatal survival; however, the benefits must be weighed against the costs of an increased maternal mortality and morbidity.

Birth Weight↗
PubMed1983

Neonatal transport in Georgia: implications for maternal transport in high-risk pregnancies.

We analyzed population-based data from the Georgia Neonatal Surveillance Network from 1974 to 1978 to determine the effect of the hospital of delivery on the neonatal mortality rate (NMR) of infants later admitted to neonatal intensive case units (NICUs). The NMR of 3,524 infants transported from primary centers to NICUs was significantly higher [relative risk (RR) = 2.1; 95% CL = 1.9 to 2.3] than that of 10,764 infants born in tertiary centers and admitted directly to an NICU. This effect persisted even after adjustment for birth-weight differences (RR = 1.6; 95% CL = 1.5 to 1.8). The relative risk in favor of delivery in a tertiary center increased with increasing birth weight. However, the proportion of infants of less than 1,000 gm surviving was higher for transported infants and increased with distance transported. This finding suggests that, at these very low birth weights, the hardiest infants were selectively transported. A surprising finding was the very low proportion of low-birth-weight infants delivered in primary centers and transported to NICUs (eg, 32% of infants weighing between 1,001 and 1,200 gm). Our findings support previous reports that delivery in a hospital with an NICU is preferable to later neonatal transport and suggest that efforts to increase the rate of maternal transport in high-risk pregnancies can lead to a substantial reduction in infant deaths.

Adolescent↗
PubMed1982

Epidemiologic differences between sexual and physical child abuse.

Sexual and physical child abuse are assumed to differ; however, these differences have not been well characterized epidemiologically. Furthermore, despite assumed differences, these types of abuse are often analyzed as one entity. This can have significant effects on assessment of risk and recommendations for intervention. We compared 735 cases of sexual abuse and 3,486 cases of nonsexual physical abuse confirmed by the Georgia Department of Protective Services. Sexual and physical child abuse cases differed in age, sex, and relationship of perpetrators and victims; demographic and socioeconomic characteristics of families at risk; and morbidity and mortality caused by the event. The most important recommendation based on these findings is that epidemiologically distinct forms of child abuse must be analyzed separately before intervention measures are proposed.

Adolescent↗
PubMed1982

Age at onset of necrotizing enterocolitis: an epidemiologic analysis.

We studied the epidemiologic interrelationships among birth weight, gestational age, and age at onset of necrotizing enterocolitis of the newborn. As birth weight increased, the range of ages at onset and the mean age at onset both decreased. Weekly birth weight-specific attack rates for necrotizing enterocolitis declined sharply in all birth weight groups when the equivalent of 35-36 wk gestational age was reached. Our data are consistent with the hypothesis that the risk period for necrotizing enterocolitis is determined primarily by the maturity of the gastrointestinal tract of the newborn.

Age Factors↗
PubMed1981

The epidemiology of neonatal death in twins.

The epidemiology of twin pregnancies was studied with the use of data on 7,001 live-born twins from the Georgia neonatal surveillance network for the period 1974-1978. A cesarean section did not appreciably reduce the risk of neonatal death for a twin with a vertex presentation. The relative risk of such a neonatal death was 1.4 after adjustment was made for birth weight. A cesarean section did improve the outcome for breech and other presentations. Twins had a sixfold higher neonatal mortality rate than had singleton infants (p less than 0.001), which can be explained on the basis of distribution of birth weights. Twins had a weight-specific mortality rate equivalent to or significantly less than that for singletons after adjustment was made for birth weight. The relative risk of neonatal death for Twin 2 compared with Twin 1 was not significant. Breech presentation was more common in twins than in singletons, and for Twin 2 more than for Twin 1. As birth weight increased, the number of breech presentations decreased for Twin 2 but not for Twin 1. To reduce the high neonatal mortality rate for twins, the objective should be to reduce the incidence of low-birth-weight twins, rather than to increase the cesarean section rate for them.

Birth Order↗
PubMed1979

The effects of social reinforcement on dominant and dependent mildly intellectually handicapped school-leavers.

The aim of this study was to replicate Exline & Messick's (1967) study of eye-contact interview behaviour with college students on a group of mildly intellectually handicapped students. Twenty subjects (mean CA 14.02 years, SD 0.45 years, mean IQ 72.0, SD 7.6) attending a metropolitan school for the mildly mentally handicapped were classified as dominant or dependent by teacher ratings and sociogram analysis. They were given large or small amounts of reinforcement for eye-contact when interviewed by their teacher. Although the study failed to replicate some of Exline & Messick's findings, results indicated a feedback rather than reward model in explaining the effects of social reinforcement on eye-contact in interviews. Implications for communication training for such intellectually handicapped students is discussed.

Adolescent↗
PubMed1975

Natural infections of Richardson's ground squirrels with western equine encephalomyelitis virus, Saskatchewan, Canada, 1964-1973.

A survey (1964-1973) was conducted on naturally occurring western equine encephalomyelitis (WEE) virus infections of Richardson's ground squirrels (RGS) in agricultural areas of Saskatchewan. The survey included both serology and virus isolation attempts on live-trapped wild squirrels. Throughout the study, seropostive squirrels were found in the known enzootic regions of the province each summer. The infections rate was high (11.6% of 250) in the epidemic year of 1965 and low (less than 2% of 681) in the subsequent non-epidemic years. The maximal seasonal prevalence of seropositive RGS coincided with the time when the squirrel population and aedine mosquito abundance reached their seasonal peaks. Five virus isolations were obtained from the blood and brains of naturally infected squirrels. All isolations were from squirrels collected in June. The early seasonal infections in squirrels could provide a source of virus for Culex tarsalis, the epidemic vector. In view of their abundance in the enzootic agricultural areas and the high annual population turnover, the RGS may play an important role in the natural history of WEE virus in the Canadian prairies.

Animals↗