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Biomedical subjects

E Alberman

Publications and source records attributed to E Alberman.

At least 91 records · Page 5Linked to original sources
PubMed1986

The development of performance and cost indicators for preschool immunisation.

The organisation, premises, and staffing of three child health clinics of different types in an inner city area have been studied and related to information on immunisation derived from their computerised child register and other returns, together with some simple estimates of cost. Differences were found between overall uptake of different antigens, consent rate, compliance after consent had been given, and the median age at immunisation for children allocated to each clinic. Thus consent to pertussis immunisation varied from 90% in one clinic to 69% in the other two. In the clinic with the high consent rate, however, only 66% of those whose parents had consented actually received all three doses compared with 82% and 85% in the other clinics. The median age of immunisation also showed pronounced differences between the clinics--314, 351, and 375 days, respectively, for the third dose of the triple course. There were differences in characteristics of the clientele served by each clinic and in staffing and facilities, which led to differences in costs, as well as contributing towards the variable patterns of uptake. We suggest that indicators such as these, largely available from the child health computer system, are used systematically to identify ways of improving uptake and increasing cost effectiveness.

Ambulatory Care Facilities↗
PubMed1986

The place of birth.

Explore the source record for details and available documents.

Delivery, Obstetric↗
PubMed1985

Why are stillbirth and neonatal mortality rates continuing to fall?

The Office of Population Censuses and Surveys are producing new annual tabulations including one on population birthweight distribution, and birthweight/cause-specific perinatal, neonatal and infant mortality rates. With these data it will be easier to distinguish between falls in mortality rates due to primary prevention of the causes, and those due to secondary prevention as a result of improved medical technology. Examples are given of the use of such data.

Birth Weight↗
PubMed1985

Disabilities in survivors of low birthweight.

A study of those survivors weighing 2000 g or less at birth born to residents of the South East Thames Regional Health Authority in 1970, '71, and '73 was carried out by abstracting data from health visitors' and school health records. Some postnatal information was available for 78% of the children. Prevalences of reported impairments in relation to birthweight were 20% in babies of 1500 g or less, 13% in the group weighing 1501 to 1750 g, and 11% for those of 1751 to 2000 g. Only half the impairments in the first group were likely to be seriously disabling, and only a fifth were of obvious prenatal origin. In the heaviest group, about 3% were likely to become severely disabled, but in over two fifths with impairment, this was likely to be of prenatal origin and therefore more difficult to prevent. This factor together with the larger number of survivors of birthweight 1751 to 2000 g than of 1500 g or less, indicate that an increase in impairments may be seen in the heavier group if their mortality continues to fall.

Birth Weight↗
PubMed1985

Prevalence and disabilities in 4 to 8 year olds with cerebral palsy.

A register of children born between 1970 and 1979 in the South East Thames Regional Health Authority, and diagnosed as having pre-, peri-, and postnatal cerebral palsy, was set up between 1978 and 1981. We report the 527 children born between 1970 and 1974 for whom ascertainment is virtually complete. The estimated prevalence was 2.2 per 1000, with 7.4% multiple births, and 58% boys. Birthweight distribution is as expected, with 35% weighing less than 2500 g at birth. Parental permission for release of detailed medical information was sought, and the clinicians responsible gave us data on the type of cerebral palsy; details of impairments, disabilities, and anticipated future prospects; and an opinion on the probable timing of the cause. There was a high incidence of orthopaedic defects which must represent a considerable use of resources, although the prevalence of hearing and vision defects suggested that some of these may be undetected.

Age Factors↗
PubMed1985

Morbidity and mortality in motor neuron disease: comparison with multiple sclerosis and Parkinson's disease: age and sex specific rates and cohort analyses.

The cause of motor neuron disease (MND) remains unknown although recent reports have suggested a possible rise in mortality rate. The present account describes age-specific patterns in morbidity rate and cross-sectional and cohort analyses of mortality rate, and compares these with those in multiple sclerosis and Parkinson's disease. First hospital admission rate for motor neuron disease (a proxy for incidence rates) rose steadily with age in males and females until the age of 75 years or more, but then fell, but only in females. This irregular pattern suggested the possibility of an environmental effect on certain older birth cohorts. The validity of the results was supported by a similar pattern in the two hospital regional authorities studied and the difference between this pattern and that found in multiple sclerosis and Parkinson's disease. Age-specific mortality rates of motor neuron disease between 15 and 64 years for males and females in England and Wales from 1940 to 1982 rose steadily with age. Mortality rates after the age of 65 fell in all female cohorts studied, but only in the earlier male cohorts. Unlike Parkinson's disease there was no strong birth cohort effect. However an analysis of Office of Population Censuses and Surveys (Registrar General) reports has revealed a slight increase in the age-specific mortality rate in both males and females aged 65 and over for successive birth cohorts born since 1900. Neither changes in ICD coding or in diagnostic habits could account for this pattern, which differed from that seen in Parkinson's disease. No such effect was seen in multiple sclerosis.

Adult↗
PubMed1984

Congenital abnormalities in legal abortions at 20 weeks' gestation or later.

A study of late abortions by the Royal College of Obstetricians and Gynaecologists made possible estimation of the number of abortions carried out for various types of confirmed congenital defects at or after 20 completed weeks of gestation. A reduction in the legal age of fetal viability to 24 weeks, in the absence of any other change in practice, would have stopped an estimated 26 abortions for confirmed serious fetal defects other than anencephaly in 1982; a reduction to 22 weeks would have stopped 77 such abortions.

Aborted Fetus↗
PubMed1982

Cerebral palsy and severe educational subnormality in low-birthweight children: a comparison of births in 1951-53 and 1970-73.

The prevalence at school age of cerebral palsy and severe education subnormality in children of low birthweight (less than or equal to 4 lb=1814 g) born to residents in the region served by the South East Thames Regional Health Authority in the early 1970s was compared with that in children of the same birthweight born in 1950-53. The prevalence of one or both of these defects was lower in the 1970s cohort; this was due to both a fall in the incidence of extreme gestational immaturity among children of low birthweight and a reduction in risk of defects to the gestationally immature births that occurred. The decreased risk of these defects in children of low birthweight was approximately counter-balanced by the increased likelihood of their survival; among children of all birthweights the prevalence of these defects attributable to children of very low birthweight changed little.

Cerebral Palsy↗
PubMed1982

Visual defects in children of low birthweight.

The prevalence of visual defects at ages 7 to 9 in 1485 children of birthweight 2000 g or less is reported. These children were born in 1970, 1971, and 1973 to parents resident in what is now the South East Thames Regional Health Authority area, and comprise 73.9% of all survivors of births of this weight, 81% of those whose present address is known. Only 16 (1%) children were reported to have serious visual defects; 5 had retrolental fibroplasia. For the children attending normal schools there was a significant excess of both mild and more severe visual defects compared with matched controls. A distant visual acuity of 6/6 was reported in the better eye of 89%, and in both eyes of 83% of the low birthweight group.

Cataract↗
PubMed1980

Outcome of pregnancies following the use of oral contraceptives.

The use of oral contraception by women doctors on the Medical Register for England and Wales in 1975 was studied and related to the outcome of their pregnancies. Nearly two thirds had used oral contraception at some time, but less than one third of their pregnancies had followed its use. Users tended to be younger at the time of the survey and to smoke in pregnancy more often. After allowing for these associations a poor outcome was just slightly more common in pregnancies occurring after OC use, particularly in conceptions occurring within a month or after a year of cessation. In contrast conceptions occurring in the 2nd or 3rd month after cessation had an unusually favourable outcome. It therefore seems likely that at least some of this weak association between oral contraception and poor outcome may be explained by factors that determine the length of time it takes to conceive. Overall it seems that any real risk to pregnancies conceived after cessation of oral contraception must be very small and outweighed by the undoubted advantages of its use.

Adult↗