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Biomedical subjects

B F Walker

Publications and source records attributed to B F Walker.

At least 37 records · Page 2Linked to original sources

Causes of admission of African patients to Gelukspan Hospital, North West Province, South Africa.

An enquiry has been made into the causes of admission in 1994 of African patients to Gelukspan Hospital, North West Province, South Africa. The study concerned 3791 patients of whom 3533 (93.2%) were classifiable. Two groups were not included in this number, namely, 1584 'lodgers' (e.g. mothers of infants), and 1868 females admitted for normal pregnancy. Of the 3533 patients, 940 (26.6%) were aged 14 years and younger; 545 (58.0%) these were boys and 395 (42.0%) were girls. The main causes of their admission were pneumonia, gastroenteritis, trauma, poisoning, and infections. Of the 2593 adults, 1418 (54.7%) were males and 1175 (45.3%) females. Among males, chief causes were pulmonary tuberculosis, trauma and accidents, congestive cardiac failure, psychosis, cancer and diabetes. Of the females, chief causes were pulmonary tuberculosis, trauma and accidents, pregnancy related disorders, gastroenteritis, anaemia and pneumonia. Regarding other diseases, 4.5% of adults were admitted for cancer, and 1.8% for diabetes. The general pattern of admissions is similar to that reported in other rural hospitals. The causes of admissions are discussed, regarding; (i) public health improvements occurring, and (ii) means of promoting further improvements by community self-help, and by help from State health and other services.

Adolescent↗

Is breast cancer avoidable? Could dietary changes help?

In the US, the life time odds of developing breast cancer has reached one in eight, with an incidence rate of 85 per 100,000 world population. The rate is half or less in women in some Mediterranean countries. At the extreme are rural African women whose rate is approximately 5-10 per 100,000. In African, compared with White women, protective factors include (1) reproductive behaviour, namely, slower growth before and after puberty, later age at menarche, high teenage pregnancy, high parity and long periods of lactation and amenorrhoea and (2) a diet of relatively low energy intake and of low-fat and high-fibre contents. In the Mediterranean setting, major dietary protective factors include a relatively low intake of saturated fat and high intakes of monounsaturated fat and of vegetables and fruit. Among White women, a reversion to protective reproductive behaviour is out of the question. Only in respect of diet, could significant avoiding action be taken. Adoption of an African type diet is wholly impracticable. Moreover, even conformation to a former Mediterranean diet, which is already changing, would be difficult, requiring reorientation of fat composition and large rises in intakes of vegetable and fruit. However, with resolution, were such changes made, at least by the very vulnerable, they would help, additionally, to protect against other diet-related cancers, especially colon cancer and against coronary heart disease.

Black People↗

Is the lesser growth of African schoolchildren essentially prejudicial to their present and future health?

In African and other Third World countries, 20-50% of schoolchildren lie under the 5th centile of US National Center for Health Statistics (NCHS) growth reference standards for weight- and height-for-age. Such lesser growth, orthodoxly, categorizes those affected as malnourished, at greater risk of disease, of lesser intelligence, and in need of nutritional supplementation. Questions arising include: 'Are there limitations to the application of NCHS reference standards?' In African schoolchildren, is lesser growth attributable largely, or marginally, to insufficient food intake? How powerful are the non-dietary influencing factors? What are the associated disadvantages to health? Conversely, could lesser growth around puberty even be beneficial respecting possible lessening of subsequent risk of degenerative diseases? Discussion indicates that there are numerous complexities in the whole subject of anthropometry, malnutrition and its stigmata, and interventions, dietary and non-dietary, in the youth of poor populations. In view of the invariably low health funds available in Third World countries, only intervention measures of proven significance to pupils' health warrant implementation.

Africa↗

Maximal genetic potential for adult stature: is this aim desirable?

Current nutrition theory holds that maximization of human growth and stature is a desired anthropometric outcome. However, some evidence demonstrates that lower energy intakes may actually confer a degree of future protection against degenerative processes, particularly atherosclerosis and cancer.

Adult↗

Causes of admissions of rural African patients to Murchison Hospital, Natal, South Africa.

An analysis has been made of causes of admission of black patients in 1991 to Murchison Hospital, Port Shepstone, Natal. Of 6675 total admissions, 6329 (95%) were classifiable. Of the latter, 1462 (23%) were aged 12 years and-younger, namely, 763 boys and 699 girls. Their chief causes of admission were pneumonia, gastroenteritis, trauma, acute glomerular nephritis, and malnutritional diseases. Of 4867 adults (73%), 1536 were males and 3331 females. Among men, chief causes were tuberculosis, congestive cardiac failure, hypertension and cerebral vascular accidents. Among women, apart from pregnancy, chief causes of admission were disorders of pregnancy, tuberculosis, congestive cardiac failure, pneumonia, diabetes, and hypertension. Of western diseases, 3.9% of adults were admitted for diabetes, and 2.8% for asthma. The general pattern of admissions is similar to that in other rural hospitals. The causes of admissions are discussed, regarding (1) public health improvements occurring, and (2) means of promoting further improvements by (a) community self-help, and (b) help from State health and other services.

Adult↗

Cancer patterns in three African populations compared with the United States black population.

Cancer incidence rates and patterns in three African populations in the Gambia, Mali and South Africa, have been compared with corresponding data on the Black population in Connecticut, USA. In the African populations, total rates for cancer are much lower than that of US Blacks, even allowing for under-reporting. Chief cancers are those of the oesophagus, liver and cervix. In Mali, stomach cancer is very common. As to trends, among South African Blacks, a population in transition, rates are rising, albeit slowly, of cancers of prosperity--prostate, lung, breast and colon-rectum. Salient questions are: can the number of cancers of underprivilege be lessened, and can cancers linked with rising socioeconomic states be restrained? Discussions of common risk factors, including diet, reproduction, smoking and drinking practices, indicate that for Africans as a whole, continuing poverty will prevent major changes in cancer pattern and rises in occurrence of the disease. However, should prosperity increase for Africans in big cities, rates are ultimately likely to attain those prevailing in the US Black population. Significant avoiding action seems almost impossible.

Black or African American↗