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Biomedical subjects

B Pless

Publications and source records attributed to B Pless.

22 records · Page 2Linked to original sources

Social policy as a cause of childhood accidents: the children of lone mothers.

Almost one in five British mothers is a lone mother. Their children have injury rates that are twice those of children in two parent families. In this article the link between lone parenthood and childhood injury is examined. The increased injury rates for the children of lone mothers can be explained by the poverty, poor housing conditions, and social isolation of lone mothers in Britain. The problem of reconciling the demands of paid work with the demands of the unpaid work of childrearing is particularly difficult for lone mothers, who find themselves in a benefit dependent poverty trap. Many such mothers would seek paid work if affordable day care were available. Day care would also provide a safe environment for their children, who are otherwise exposed to the environmental hazards of poor housing. Provision of day care is a social policy that would have important effects on the health and welfare of lone mothers and their children. These effects deserve to be properly evaluated.

Accidents↗

Improved low energy defibrillation efficacy in man with the use of a biphasic truncated exponential waveform.

The standard implantable defibrillator waveform is a truncated exponential of approximately 6 msec duration. This study compares the defibrillation efficacy of a standard monophasic truncated exponential to a biphasic 12 msec truncated exponential waveform in 21 patients undergoing automatic implantable cardioverter defibrillator (AICD) surgery. For the biphasic waveform, the polarity was reversed and remaining capacitor voltage was attenuated by 75% after 6 msec. Two hundred thirty episodes of VF were induced with 115 "matched pairs" of monophasic and biphasic waveforms of identical initial capacitor voltages given over a range from 70 to 600 V (0.35 to 25.7 joules). The biphasic waveform was superior to the monophasic waveform (p less than 0.006), especially for "low energy" defibrillation. For initial voltages less than 200 V, the percent successful defibrillation was 28% for the monophasic waveform versus 64% for the biphasic waveform and from 200 to 290 V (energies less than 6.4 joules) it was 45% versus 69%. There was no difference in the two waveforms in time to the first QRS complex or in the blood pressure following defibrillation. This study shows that a 12 msec biphasic truncated exponential is superior to a 6 msec monophasic waveform for defibrillation in man, especially at energies less than 6.4 joules. The waveform can be achieved in an implanted device without any increase in capacitor size or in battery energy consumption.

Electric Countershock↗

Controlled trial of social work in childhood chronic illness.

Children with chronic illnesses have a doubled risk of becoming psychosocially maladjusted, and social-work support and counselling are commonly used to reduce this secondary morbidity. A randomised controlled trial of this type of intervention was conducted in 345 children with chronic physical disorders cared for in eleven specialty clinics at a children's hospital. Four months after a six-month period of social-work services, no significant difference was found between social-work and control groups in overall prevalence of maladjustment. There was no evidence to support a preventive or therapeutic effect of social work on child behaviour disorder or social dysfunction on the principal outcome measure, the Child Behaviour Checklist. Nor was there any detectable effect on child self-esteem, on maternal psychological function, or on the impact of the child's illness on the family. Furthermore, no patient subgroup could be shown to benefit from the intervention, and restriction of the analysis to individuals who received the intervention did not alter the results.

Adolescent↗