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Biomedical subjects

A Davis

Publications and source records attributed to A Davis.

456 records · Page 26Linked to original sources
PubMedDate not supplied

Relation of infant mortality to the availability of maternity care in rural Florida.

BACKGROUND: This cross-sectional study was designed to explore the impact of the availability of maternity care services on the infant mortality rates in nonmetropolitan (rural) counties in Florida. METHODS: We evaluated the sufficiency of physicians providing maternity care in each rural county. We then constructed a mathematical model to compare physician availability with the infant mortality rates for each county, while controlling for socioeconomic variables. RESULTS: Thirty-one family physicians and 974 obstetrician-gynecologists were delivering babies in Florida in 1991. Forty-seven counties were lacking in maternity care services; 45 of these counties had family physicians who practiced in the county but did not provide maternity care services. There was a negative correlation in rural counties between availability of maternity care services and infant mortality (R = -0.42, R2 = 0.176, P = 0.012), implying that 17.6 percent of the variation in rural Florida's infant mortality was explained by a ranking in physician availability. Multivariate analysis revealed that increasing infant death rates can be predicted by decreasing physician availability (P = 0.003). A multiplicative risk model developed for this study demonstrated that the loss of 1 family physician delivering babies would predict the increase of infant mortality by 2.3 percent, and the loss of 1 obstetrician-gynecologist increased infant mortality by 9.6 percent. CONCLUSIONS: Access to maternity care for women in rural Florida is a problem that could be hampering Florida's ability to reduce its infant mortality rate. Family physicians appear to be the most geographically distributed health care providers in Florida; therefore, strategies should be developed to recruit Florida's rural family physicians into maternity care.

Cross-Sectional Studies↗
PubMedDate not supplied

Long-term effectiveness of enalapril plus extended-release diltiazem in essential hypertension.

STUDY OBJECTIVE: To evaluate the efficacy and safety of a new combination product, enalapril-diltiazem ER, when administered over the long term. DESIGN: Open-label, titration to response, with treatment lasting 46 weeks after a 6-week, double-blind phase. SETTING: Medical clinics in the private and academic sectors. PATIENTS: Of 265 patients (68% men, 83% Caucasian, mean age 54.9 yrs) with essential hypertension (sitting diastolic blood pressure 95-115 mm Hg) enrolled, 167 completed the trial. INTERVENTIONS: Patients received either the dosage of enalapril-diltiazem ER that they were given during the double-blind phase, or were prescribed enalapril 5 mg-diltiazem ER 120 mg once/day. The dosage was increased until blood pressure was controlled or to a maximum of enalapril 10-diltiazem ER 360 mg/day. MEASUREMENTS AND MAIN RESULTS: Combination therapy decreased sitting blood pressures by -11.1/-10.6 mm Hg. Overall, 58% of the patients achieved a sitting diastolic blood pressure of 90 mm Hg or below at the end of the study. There was no evidence of tolerance to the agents' antihypertensive effects. The most common drug-related adverse events were cough, headache, dizziness, and asthenia or fatigue. CONCLUSION: The combination effectively managed essential hypertension when administered on a long-term basis and was generally well tolerated. It should improve both compliance and management of hypertension.

Adult↗
PubMedDate not supplied

The experience of the family of children with chronic illness at home in China.

The increasing prevalence of the nuclear family in China challenges the cultural ideal and tradition of the extended family caring for children with chronic illness at home. This study examined and documented the caregiving experiences in a sample of this population of children and their families. A descriptive survey with both quantitative and qualitative questions was developed and used to interview a total of 75 families in three urban areas of China. Factors such as the severity of illness, physical symptoms, the amount of assistance the child needed for daily living, and the emotional and social impact on the child were identified. Descriptions of the family's living circumstances, caregiving situations, and the child's experiences are illustrated through the use of three case studies.

Adaptation, Psychological↗
PubMedDate not supplied

Chlamydia: the most common sexually transmitted infection.

This article is the third in our series on sexually transmitted infections. The epidemiology and signs and symptoms of chlamydia are described and diagnostic tests, treatments, and health education and promotion are discussed.

Anti-Bacterial Agents↗
PubMedDate not supplied

Protein kinase CK2 activities in human prostatic and seminal-vesicle secretions and seminal plasma.

Human prostatic secretion and seminal plasma contain certain protein kinase activities. Protein kinases play important roles in regulating a vast variety of cellular functions. The objective of this study was to determine whether one of these protein kinase activities in human prostatic secretion and seminal plasma is due to CK2, a messenger-independent, serine/threonine protein kinase that has considerable potential as a regulatory enzyme. By employing an anti-CK2 antibody and a CK2-specific peptide substrate, we have established that CK2 is present in these secretions. Approximately 70% of the CK2 activity present in seminal plasma of normozoospermic men (n = 49) is correlated to the number of sperm originally present in the semen. Further, both the prostate gland and the seminal vesicles are sources of CK2 activity in the seminal plasma of vasectomized men (n = 38). Although there was considerable variation between individuals in CK2 activity, the variation in repeat semen samples of the same vasectomized men (n = 6) was within 21%. There was no correlation of CK2 activity in seminal plasma with age for vasectomized (27-48 years, n = 38), oligozoospermic (28-43 years, n = 24), or normozoospermic men (26-48 years, n = 49). These data suggest that the majority of CK2 activity in the seminal plasma of normozoospermic men originates from sperm but that the prostate and seminal vesicles are accessory sex-gland sources of this enzyme.

Adult↗