Biomedical subjects
Publications and source records attributed to J Douglas.
A detailed account of the progress of a preschool child learning to steer a powered wheelchair via a mouth-operated joystick is described. Some problems were encountered during learning, but the positive effect on emotional, intellectual and behavioural development was noted.
The developments and considerations essential to providing microtechnological aids for a preschool severely disabled child confined to a bed in a hospital ward are described. This single case report illustrates the needs of a quadriplegic boy dependent on a ventilator via a tracheostomy. Provision of a computer, a variety of specially designed switches and software together with a self-driven powered wheelchair maximized expression of his developmental needs. The decision-making process of providing the equipment is described as well as the problems encountered. His development in language and cognitive skills is discussed in the context of his change in experience and competence as he learned to control the technological aids.
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Two cases of anaphylactic reactions that occurred in young children with clinical hypersensitivity to egg protein after their exposure to a pavlova mix (which contains powdered egg-white) are described. The exposure took place when a packet of pavlova mix was opened and its contents were transferred into a bowl by adults. Although the children were in the same room, no direct contact was made. This indicates that the exposure occurred by way of the inhalational route. Clinical sensitivity to eggs is common in infancy and early childhood. Parents of children who have experienced immediate hypersensitivity reactions to egg-protein should be aware of the potential hazard of pavlova mixes and other sources of egg-white powder.
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BACKGROUND: The cigarette smoking habit continues to be prevalent to a greater degree than would be desirable among teenagers. Innovative prevention programs are needed. This descriptive cross-sectional study sets out the behavior variables related to the cigarette smoking habit and the extracurricular activities in which teenagers are most frequently involved which are useful for setting out extracurricular prevention programs. METHODS: The data was collected by means of a questionnaire validated in a representative sample of school age youths (ages 10-11 and 13-14) from Asturias. The variables entailed in cigarette smoking were analyzed using the regression method. RESULTS: The starting smoker percentage is 14.5%-42.5%, regular smokers totaling 1.1% and 12.4%, respectively. Two models were constructed with the variables significantly related to smoking behavior, which are properly classified into smoker/non-smoker by 98.85% and 91.39% of the children, by ages. The environmental variables (availability of cigarettes and alcoholic beverages and regular visits to places entailing risk) are the major aspects comprising the model. The most common extracurricular activities are: watching TV, reading and listening to music and watching or playing sports. CONCLUSION: The findings provide keys to planning extracurricular activities tailored to fit in with the activities most popular among teens: TV commercials and ads on music media (CD's, tapes, etc.) and printed information mailed directly to teens at their homes, with messages conveyed by opinion-leaders among teens in the fields of sports, music and television.
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A randomised trial of simvastatin and enalapril in patients with chronic renal failure on dialysis: effects on serum lipoprotein concentrations and left ventricular mass. Left ventricular hypertrophy and abnormalities of lipoprotein metabolism are both possible contributors to the high risk of cardiovascular death in patients with chronic renal failure on dialysis. We investigated the effects of simvastatin on lipid and lipoprotein concentrations and the effects of enalapril on left ventricular mass in 107 patients receiving haemodialysis or continuous ambulatory peritoneal dialysis. Patients were randomised in a factorial design to receive simvastatin (10 mg daily) or placebo and enalapril (2.5-5 mg daily) or placebo. During follow-up, there was a significant excess of patients withdrawn from enalapril because of hypotension (2p = 0.002), and after 6 months only 55% of those assigned enalapril were still on treatment. From baseline to 6 months, there were no statistically significant differences in left ventricular mass or left ventricular dimensions between patients assigned enalapril and those assigned placebo. Among the patients assigned simvastatin, total cholesterol was reduced by 13% (2p = 0.001), LDL cholesterol was reduced by 17% (2p = 0.003) and apolipoprotein B was reduced by 12% (2p = 0.005) compared to patients assigned placebo. There were borderline significant (2p = 0.05 to 0.08) reductions in VLDL cholesterol, total triglyceride and VLDL triglycerides of 26%, 12% and 17% respectively. Large-scale trials are now required to determine whether reductions in lipid and lipoprotein concentrations confer a reduction in coronary heart disease morbidity and mortality in patients on dialysis.
This article traces the history of efforts to image the biliary tract, focusing on magnetic resonance cholangiopancreatography (MRCP). It examines key factors in successful MRCP, including coil selection, respiration control, pulse sequences, slice mode acquisition and post-processing. The article also presents pathological findings of MRCP and discusses the advantages and disadvantages of the procedure.
BACKGROUND: The published data on the effectiveness of programs in schools to prevent addiction to tobacco are not consistent. These programs have not been sufficiently studied, and their variables give rise to confusion. The aim of this study was to evaluate the process of educational action taken in schools. METHOD: Student leaders and teachers, who were trained and given guides, developed a socially based program. Two students selected at random from each class were interviewed, using a validated and directed questionnaire. A total of 318 children were interviewed. The Kappa Index was used to measure confidence, and the Inter-Class Coefficient of Correlation and Pearson's Coefficient were used together with analysis of individual differences to compare the data for program adjustment, as supplied by pupils and teachers. RESULTS: Mean adjustment per class was 30.07 points (48-100% adjustment). 26% of children were unable to mention any alternative to the advantages of smoking, 71.7% were unaware of the frequency of consumption amongst adults and 19.5% were unable to mention any of the tricks used in cigarette advertising. Less than half had performed psychodrama on this subject, as was required. The ICC was 0.21, Pearson's Coefficient was 0.25 (p = 0.02) and the interval of agreement between the descriptions of teachers and students was 6.93 points (-1.70 to 5.23). CONCLUSIONS: The degree to which implementation complied with the proposed model of program was insufficient. We found little agreement between the self-assessment of teachers and the score attained by pupils in compliance with the program. It is essential that this process be evaluated for its impact to be evaluated correctly.