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Biomedical subjects

A Stewart

Publications and source records attributed to A Stewart.

At least 271 records · Page 15Linked to original sources
PubMed1989

Teenage smoking and health education.

Whilst recent OPCS surveys in 1984 and 1986 have revealed that the proportion of smokers in secondary schools is decreasing, smoking continues to remain at alarming levels. Therefore, it is of importance to identify why, when, where and what adolescents smoke in order to produce appropriate packages of health education material. Numerous studies have sought to highlight factors and features of importance. Youthscan data provides an analysis of 16-17 year-olds which will supplement information already available.

Adolescent↗
PubMed1989

Education as the key to rehabilitation.

Rehabilitation education is the key for successful transference to the home setting for the client and family. Can you picture a family at the rehabilitation facility on the day of discharge taking home a 19-year-old son with a severe head injury or a high spinal cord injury without this preparation? The client and family must be evaluated by the rehabilitation team to plan the individualized educational program. Education must start at admission and involve every member of the rehabilitation team in order to offer a complete educational program. The criteria for discharge of the client are based on an educational program successfully addressing self-care, self-direction, and self-responsibility.

Activities of Daily Living↗
PubMed1988

Prevention and control of hypertension in New Zealand: a reappraisal.

A new national policy for the prevention and control of hypertension is required in New Zealand. The first priority is the prevention of hypertension with the development of a population strategy directed at encouraging healthy nutritional and exercise habits. Pharmacological management or specific nonpharmacological treatment of individuals is the second priority and decisions about treatment levels have important logistic and cost implications. Given the limited absolute benefits of treatment to individuals, the current policy of initiating treatment at a diastolic blood pressure of greater than or equal to 95 mmHg should be revised upwards. A population approach to the prevention of hypertension is essential in New Zealand because the majority (57%) of excess deaths due to raised blood pressure occur in people with diastolic blood pressure in the range 80-94 mmHg. A fall in the population mean diastolic blood pressure of 2 mmHg would have the same effect on total mortality rates as the successful treatment of everyone with a diastolic blood pressure greater than or equal to 100 mmHg. A national multidisciplinary group should be established to formulate strategies for preventing hypertension in New Zealand and to review current treatment guidelines.

Adult↗
PubMed1988

Cardiovascular disease mortality trends in the western Pacific, 1968-1984.

Much attention has been paid in recent years to the declining cardiovascular disease mortality rates in western industrialised countries; far less attention has been paid to other countries. A comparison of 1984 age standardised mortality rates in five western Pacific countries indicates a wide variation for all cause mortality and all cardiovascular disease mortality, with Singapore having rates twice as great as Japan which has the lowest rates. New Zealand has the highest rate of coronary heart disease, and with Australia the lowest rate of stroke mortality. Mortality rates for each disease category studied were lower among women than men for each country. In the period 1968-1984 all countries experienced a decline in all cause mortality. All cardiovascular disease mortality rates have declined in all countries except Singapore; coronary heart disease mortality rates have increased in Singapore. The improvements in stroke mortality in Japan have been dramatic in comparison with the other four countries. These marked variations in absolute levels and secular trends raise intriguing research questions and indicate the potential for prevention in all countries.

Adult↗
PubMed1988

Diet, serum cholesterol and the prevention of coronary heart disease in New Zealand.

A combination of the population strategy and the high risk strategy has been recommended for the prevention and control of coronary heart disease in New Zealand. In this paper, using data from a variety of sources, we estimate the potential relative benefits of these two strategies to reduce the contribution of diet and high blood cholesterol to coronary heart disease mortality in New Zealand. It is estimated that diet is responsible, at a minimum for between 22% (1600 deaths) and 39% (2800 deaths) of the coronary heart disease mortality in New Zealand each year. Achievement of the suggested short term dietary goals for the New Zealand population would have at least the same benefit as the identification and successful treatment of all people in the top 10% of the serum cholesterol distribution. This indicates that the population strategy should have higher priority in efforts to prevent and control coronary heart disease. Decisions concerning the level at which elevated blood cholesterol levels are treated pharmacologically will have important logistic and cost implications; national guidelines are required for the management of people with high blood cholesterol levels.

Adult↗
PubMed1988

An investigation of the mineral content of barley grains and seedlings.

The Ca, Mg, K, and P content of dry barley (Hordeum vulgare) grains and seedlings was investigated using energy dispersive x-ray analysis and neutron activation analysis. Energy dispersive x-ray analysis of protein bodies in aleurone cells showed that these bodies contained very little Ca in relation to P, Mg, and K. Neutron activation analysis also showed that the endosperm contained very little Ca in relation to the other three elements. Surface sterilization and soaking treatments brought about slight loss of Ca but substantial loss of K from embryos. Over 6 days of growth the seedling plant gained minerals from the endosperm.

Journal Article↗
PubMed1988

Comparison of event rates among three MONICA centres.

Data from three MONICA centres in Auckland (New Zealand) and Newcastle and Perth (Australia) are used to explore some of the issues involved in comparing event rates and case fatality among MONICA centres. Auckland and Newcastle follow the "hot pursuit" method of identifying and interviewing patients while they are still in hospital. Perth follows the "cold pursuit" method, in which patients are identified by search of computerized hospital records after discharge and all data are abstracted retrospectively from case notes. Fatal cases are identified by the same method in the three centres. The distribution of events by MONICA diagnostic classification varied among centres, with Perth having the highest proportion of definite myocardial infarction events and the lowest proportion of possible myocardial infarction events. These differences appear to be due to the different methods of event ascertainment and data collection, and to variations in post mortem rates between centres. For comparisons among these three centres, the categories of non-fatal definite myocardial infarction and of all coronary heart disease deaths (that is those in the MONICA categories fatal definite myocardial infarction, fatal possible myocardial infarction, and fatal cases with insufficient data) appear to be the most useful.

Adult↗
PubMed1988

Prediction in very preterm infants of satisfactory neurodevelopmental progress at 12 months.

This study was performed to find out how well ultrasound brain-scanning and neurological examination of very preterm infants, together and separately, predicted normal neurodevelopmental progress at 12 months corrected age. 111 infants born at less than 33 weeks gestation were scanned at discharge from the neonatal unit, and neurological examinations were performed at a gestation-equivalent age at or near term. During the first year of life repeated neurological and developmental testing was carried out. At 12 months a diagnosis of normal progress or of major or minor neurodevelopmental disorders was made. 56 (50 per cent) infants with both a favourable ultrasound scan and normal neurological findings had a 98 per cent (90 to 99 per cent) probability of normal progress at 12 months, and a 100 per cent (93 to 100 per cent) probability of having no major disorder. Separately, ultrasound scanning and neurological examination were not such good predictors of normal outcome, although they selected larger groups of infants with high probabilities of progressing normally. Ultrasound brain-scanning and neurological examination can be used in combination to identify potentially normal preterm infants when they are discharged to their homes.

Central Nervous System↗
PubMed1988

Decreased incidence of tourniquet pain during spinal anesthesia with bupivacaine. A possible explanation.

In a previous report, the incidence of tourniquet pain was found to be 25% with bupivacaine and 60% with tetracaine (P less than 0.05) spinal anesthesia. On the other hand, tetracaine is more potent than bupivacaine in abolishing the single-compound action potential in vitro in isolated nerves. These conflicting observations may be reconciled if bupivacaine produced greater frequency-dependent conduction blockade of nerve action potentials. This hypothesis was tested in C fibers of isolated, desheathed rabbit vagus nerves. The nerves were supramaximally stimulated at frequencies of 9 or 15 Hz. After a control period, the nerves were exposed to bupivacaine (0.2 mM) or tetracaine (0.02 mM) for 30 minutes. The local anesthetics were then washed out by continuous constant-rate perfusion. The decline and recovery of the first and last action potential amplitudes of the train were measured. Bupivacaine and tetracaine produced similar depression of the first action potential of the 9-Hz and 15-Hz trains. However, bupivacaine caused a delayed recovery of the last action potential of the 15-Hz train but not of the 9-Hz train. These results show that bupivacaine produces greater frequency-dependent conduction blockade of C fibers than does tetracaine. These findings offer a possible explanation as to why spinal anesthesia with bupivacaine results in a lower incidence of tourniquet pain than tetracaine.

Action Potentials↗
PubMed1987

Assessment of function in routine clinical practice: description of the COOP Chart method and preliminary findings.

The COOP Project, a primary care research network, has begun development of a Chart method to screen function quickly. The COOP Charts, analogous to Snellen Charts, were pretested in two practices on adult patients (N = 117) to test feasibility, clinical utility, and validity. Patients completed questionnaires containing validated health status scales and sociodemographic variables. Practice staff filled out forms indicating COOP Chart scores and clinical data. We held debriefing interviews with staff who administered the Charts. The results indicate the Charts take 1-2 minutes to administer, are easy to use, and produce important clinical data. The patterns of correlations between the Charts and validity indicator variables provide evidence for both convergent and discriminant validity. We conclude that new measures are needed to assess function in a busy office practice and that the COOP Chart system represents one promising strategy.

Activities of Daily Living↗
PubMed1987

Alcohol and exercise in myocardial infarction and sudden coronary death in men and women.

The relation of alcohol consumption and regular leisure time physical activity with nonfatal myocardial infarction and sudden coronary death in men and women of Auckland, New Zealand, was examined in a large population-based case-control analysis. Within each sex, alcohol drinkers had decreased relative risks of both myocardial infarction and sudden coronary death compared with nondrinkers. Similarly, physical activity was associated with decreased relative risks of myocardial infarction and sudden coronary death in both women and men, but only in those subjects who had been exercising for five or more years. After controlling for hypertension, cigarette smoking, and alcohol consumption, 43% (95 confidence interval (CI) = 26-60) of coronary events could be explained by lack of exposure to physical activity. This compares with the per cent of coronary events in the study population attributable to hypertension (22%; 95% CI = 17-27) or cigarette smoking (31%; 95% CI = 25-38). Although the estimation of the attributable risk for a continuous variable is affected by the cut-point used to define exposure, from a public health viewpoint, regular leisure time physical activity may be as important as the above-mentioned major coronary heart disease risk factors.

Adult↗