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Biomedical subjects

J F Phillips

Publications and source records attributed to J F Phillips.

At least 37 records · Page 2Linked to original sources
PubMed1990

Impact of measles vaccination on childhood mortality in rural Bangladesh.

This study examines the impact of measles vaccination on childhood mortality, based on longitudinal data from the Matlab maternal and child health/family planning programme in rural Bangladesh. It analyses the mortality experience of 8135 vaccinated and 8135 randomly matched nonvaccinated children aged 9-60 months, who were observed from March 1982 to October 1985. The results indicate that measles vaccination had a pronounced impact on both short- and long-term survival--the mortality rates for vaccinated children were as much as 46% less than those for nonvaccinated children. Immunization of children aged up to 3 years with measles vaccine appears to improve significantly their subsequent chances of survival. The findings underscore the need to give greater priority to measles vaccination within primary health care programmes in settings such as rural Bangladesh.

Bangladesh↗
PubMed1990

Birth intervals and childhood mortality in rural Bangladesh.

This study investigates the relationship between birth intervals and childhood mortality, using longitudinal data from rural Bangladesh known to be of exceptional accuracy and completeness. Results demonstrate significant but very distinctive effects of the previous and subsequent birth intervals on mortality, with the former concentrated in the neonatal period and the latter during early childhood. The impact of short birth intervals on mortality, however, is substantially less than that found in many previous studies of this issue, particularly for the previous birth interval. The findings are discussed in terms of the potential for family planning programs to contribute to improved child survival in settings such as Bangladesh.

Bangladesh↗
PubMed1989

Biochemical and structural evidence for ethanol-induced impairment of testicular development: apparent lack of Leydig cell involvement.

The present study was conducted to provide biochemical and morphological evidence for ethanol-induced impairment of testicular development. The specific activities of testicular postmeiotic enzyme markers--sorbitol dehydrogenase (SDH), lactate dehydrogenase (LDH), and alpha-glycerophosphate dehydrogenase (GDH)--increased with age in CFW mice from ages 23 to 60 days, providing a biochemical measure of testicular development during puberty. Chronic ethanol treatment via liquid diets from ages 20 to 55 days resulted in decreased activities of SDH and LDH at ages 40 and 44 days, and of GDH at ages 34, 40, and 44 days. These decreases were consistent with an arrest in the developmental increase in SDH, LDH, and GDH at ages 31 +/- 0.6, 31 +/- 2.6, and 24 +/- 0.5 days, respectively. After 29 days of ethanol treatment (age 50 days), testicular weights, epididymal sperm content, and sperm motility were reduced, relative to controls, by 37, 83, and 60%, respectively (p less than 0.05). Epididymal weights were unaffected. Light microscopic evaluation of testes revealed disorganization of spermatogenesis, germ cell degeneration, decreased tubular luminal diameter, and vacuolation of Sertoli cells in ethanol-treated mice at age 50 days. Electron microscopic analysis showed that germ cell degeneration was not restricted to a specific cell type. Stage IX-XI tubules were observed in which spermatids had been retained and underwent phagocytosis within the Sertoli cell. Sertoli cells showed evidence of atypical nuclear invaginations. Sertoli cells underwent degenerative changes and were sloughed into the rete testis. However, relative Leydig cell size, as well as fractional volume occupied by the nucleus, mitochondria, and endoplasmic reticulum were unaffected by ethanol. The data (1) confirm previous findings suggesting ethanol-induced delayed testicular development; (2) suggest that certain aspects of testicular development are arrested relatively early in ethanol treatment (4-11 days); and (3) indicate that the Sertoli cell, rather than the Leydig cell, is the primary target with regard to the deleterious effect of chronic ethanol treatment on testicular maturation.

Administration, Oral↗
PubMed1989

Testosterone production by the prepubertal mouse testis is not depressed by ethanol.

The purpose of the present study was to evaluate the sensitivity of testicular steroidogenesis during pubertal development to inhibition by ethanol. In vivo and in vitro human chorionic gonadotropin (hCG)-stimulated steroidogenesis were examined in CFW mice as a function of age. Plasma androstenedione, testosterone, and dihydrotestosterone (DHT) increased from ages 23 to 60 days in control mice. Acute ethanol treatment (3 g/kg) yielded static levels of androstenedione (0.45 +/- 0.03 ng/mL), testosterone (6.4 +/- 0.56 ng/mL), and DHT (2.3 +/- 0.18 ng/mL) from ages 23 to 60 days, 30 to 60 days, and 35 to 60 days, respectively, resulting in reduction of plasma androstenedione, testosterone, and DHT (P less than 0.05) relative to control values, but not until ages 35, 50, and 45 days, respectively. A similar insensitivity of the prepubertal testis to ethanol was seen in vitro. Inhibition of in vitro androstenedione and testosterone accumulation was seen only after ages 26 and 45 days, respectively. The data indicate that testosterone production by the pubertal testis is relatively insensitive to direct inhibition by ethanol. Previous studies have shown that chronic ethanol treatment of adolescent mice delays testicular maturation. The present study suggests that if chronic ethanol-induced delayed testicular development were due to impaired steroidogenesis, such impairment would be secondary to reduced gonadotropin stimulation and/or due to a chronic, rather than an acute, effect of ethanol.

Aging↗
PubMed1989

Ethanol-induced delayed male puberty in mice is not due to impaired Leydig cell function.

The present study was performed to evaluate the involvement of reduced testosterone in ethanol-induced impairment of male reproductive tract development. In vivo and in vitro gonadotropin (hCG)-stimulated steroidogenesis were examined in CFW mice as a function of chronic ethanol treatment during pubertal development. Chronic ethanol treatment from ages 20 to 49 days impaired testicular growth from ages 35 days (29 +/- 2 mg vs 37 +/- 2 mg for pair-fed controls) to 50 days (42 +/- 2 mg vs 63 +/- 2 mg for pair-fed controls). Consistent with a reduction in testicular weight, testicular content of androstenedione, testosterone, and dihydrotestosterone (DHT) was depressed in ethanol-treated mice. At age 50 days, the content (expressed as pg/testis) of androstenedione, testosterone, and DHT was reduced in ethanol-treated animals by 49%, 31%, and 38%, respectively, as compared to that of their respective controls. However, no difference in plasma (ng/mL) or testicular (pg/mg protein) concentrations of steroids was observed. Except for the DHT response at ages 35 to 40 days, neither in vivo nor in vitro steroidogenesis was impaired by chronic ethanol treatment at ages 26 to 50 days; similarly, the acute ethanol effect on steroidogenesis was unaffected. However, an adaptive increase (54%-173%) in the in vivo testosterone response to hCG was seen at ages 26 to 40 days. The data indicate that 1) chronic ethanol treatment does not impair gonadotropin-stimulated steroidogenesis or result in tolerance to acute ethanol effects on steroidogenesis in older animals; and 2) ethanol-induced reduction in testosterone is not a likely mechanism for delayed sexual maturation.

Aging↗
PubMed1989

Predicting contraceptive use in Bangladesh: a logistic regression analysis.

Family planning knowledge, attitude and practice surveys typically assess respondents' reproductive attitudes and intentions to use contraception. Longitudinal observation of individual respondents nevertheless shows that such questions are not strongly predictive of subsequent behaviour. This study examines 3 years' data which show that a set of such responses to questions are nevertheless substantially superior in predicting behaviour than any single indicator. Thus statistical techniques which bring into account the apparent multidimensionality of contraceptive motivation can greatly improve upon the estimation of future practice of family planning in a population.

Adult↗
PubMed1989

Determinants of contraceptive use dynamics: research needs on decision and choice.

Because of the importance of contraceptive behaviour in most societies today a better understanding is needed of the social and behavioural factors affecting contraceptive decisions and choices of individuals and couples. This paper examines the need for longitudinal, theoretically-based studies of contraceptive use dynamics, including the timing, duration and interaction of reproductive events which may be more important than contraceptive technology in the social, cultural and economic context of fertility control. New research methods and appropriate analysis of data are relevant. Consideration of the social context is essential for the formulation and implementation of effective policies relating to the provision of contraceptive services.

Choice Behavior↗
PubMed1988

Community-based instruction with profoundly mentally retarded persons: client and public responsiveness.

Three experiments were conducted to evaluate the effects of a training program implemented in a community setting for teaching receptive language skills to profoundly mentally retarded persons. In Experiment 1, the program was implemented in a local department store and consisted of a least-to-most intrusive prompting paradigm and contingent consequences. The community-based training strategy was effective in teaching receptive identification of three objects to a profoundly mentally retarded adolescent. Additionally, generalized improvements occurred in other store locations, although cross-modal generalization in terms of changes in expressive skills did not occur. These results were replicated in Experiment 2 with two other clients in the same store, and in Experiment 3 with another client in an outdoor recreational area. Also, a questionnaire survey indicated that store employees in the first two experiments had very favorable reactions to the program. Results are discussed in regard to continued research with community-based training as a means of expanding educational opportunities for individuals who are profoundly mentally retarded.

Adolescent↗
PubMed1987

Delayed pubertal development of the male reproductive tract associated with chronic ethanol ingestion.

Little is known concerning the sensitivity of the reproductive tract to ethanol as a function of development. The present study was conducted to evaluate the action of chronic ethanol ingestion on sexual maturation of the male. Mice were given free access to liquid diets containing 5% (v/v) ethanol for either 29 or 43 days, starting at age 20 days. Controls were given liquid diets in which isocaloric sucrose replaced the ethanol. Daily diet consumption and peak blood ethanol levels were highest during the first 2 weeks of treatment, dropping thereafter to adult levels of approximately 680 ml/kg body weight and 160 mg/dl respectively. Plasma testosterone levels were depressed by ethanol throughout treatment, the reduction being somewhat greater when measured during week 6 of treatment (average = 74% inhibition) as compared to either week 2 (36%) or week 4 (25%). Average weights of testes, epididymides and seminal vesicles were depressed by 24% (P less than 0.002), 16% (P less than 0.005) and 13% (NS), respectively, after 29 days. Testicular development was also impaired in ethanol-treated animals after 29 days. Tunica albuginea thickness and seminiferous tubule diameter were decreased (by 31%, P less than 0.05; and 16%, P less than 0.01 respectively), whereas desquamation of immature germ cells and inactive tubules were increased (325 and 780% respectively; P less than 0.01). Quality of spermatogenesis was poorer in ethanol-treated animals (P less than 0.05). Also observed were decreased sperm motility (62% inhibition, P less than 0.01) and capacity to fertilize (decreased by 67%, P less than 0.01), and an increase in the incidence of morphologically abnormal spermatozoa (by 163%, P less than 0.001). Semen volume was lower (reduced by 57%, P = 0.05), as was the total number of motile ejaculated spermatozoa (reduced by 81%, P less than 0.05). After 43 days treatment, improvement was noted in all indices of fertility except for the number of motile ejaculated spermatozoa. Significant differences persisted only for dysmorphic spermatozoa and volume and sperm count of electroejaculated semen. These data suggest that ethanol ingestion during pubertal development can delay several aspects of sexual maturation in the male.

Animals↗
PubMed1987

The use effectiveness of the Copper T-200 in Matlab, Bangladesh.

Using a unique record keeping system, the use effectiveness of the Copper T-200 is examined in rural Bangladesh. In Matlab the Copper T-200 is a highly effective contraceptive modality. The adopters are typically low to medium parity women under 30 years of age. The most important cause of termination among women in the study was voluntary removal of the device. The complaint most often reported was bleeding followed by pain and weakness. The Matlab experience suggests that sustained motivation and regular resupply are the two key components of this highly successful family planning program.

Adult↗
PubMed1987

Translating pilot project success into national policy development: two projects in Bangladesh.

"This article reviews the experience of two pilot projects in Bangladesh that have addressed the question of how [operations] research can be designed to foster its utilization. In a rural field experiment [begun in 1972] in Matlab subdistrict, research has demonstrated that contraceptive services, if carefully designed and properly implemented, can influence demographic dynamics even where social and economic circumstances are not conducive to fertility change. Despite the success that Matlab represents, the project was not systematically utilized for policy until a second study [begun in 1981] was launched to address government questions concerning its replicability in the public sector programme. Results suggest that pilot projects, if fielded in conjunction with research systems for testing their replicability, can foster organizational development in contexts that are not conducive to bureaucratic change."

Asia↗
PubMed1986

Naturalistic observations of classrooms serving severely handicapped persons: establishing evaluative norms.

A naturalistic, observational analysis was conducted of 43 self-contained classrooms serving severely handicapped students. The primary focus of the observations was on levels of on-task student performance and student involvement in functional educational tasks. Results indicated that during designated instructional periods, slightly less than half of all student time was spent on-task. When students were on-task, almost two-thirds of their time involved nonfunctional instructional tasks. Results are discussed in terms of establishing norms for evaluating and improving educational services for the severely handicapped. Additionally, future research directions are noted, with a particular emphasis on investigating means of assisting educators in providing more useful teaching tasks for severely handicapped students.

Activities of Daily Living↗
PubMed1985

Providing a more appropriate education for severely handicapped persons: increasing and validating functional classroom tasks.

We evaluated a teacher training and supervision program for increasing the involvement of severely handicapped adolescents and adults in functional educational tasks. The program, consisting of a brief in-service followed by supervisory prompts and feedback, was accompanied by large increases in functional tasks in three classrooms. In addition, generalized increases occurred during nontargeted times in the classroom and the changes during both the targeted and nontargeted times were maintained over a 44-45 week period. In two subsequent experiments, surveys provided social validation for the criteria for functional versus nonfunctional tasks in that: (a) relevant individuals reliably categorized functional tasks as representing typical living, work, social, and leisure situations and (b) experienced clinicians consistently rated tasks previously categorized as functional as being more useful for severely handicapped persons than tasks categorized as nonfunctional. Results are discussed in terms of the relationship of functional classroom tasks in the overall provision of appropriate educational services for severely handicapped students.

Activities of Daily Living↗
PubMed1984

Origin of the left anterior descending coronary artery from the pulmonary artery. 3 year angiographic follow-up after saphenous vein bypass graft and proximal ligation.

A 55 year old woman had an extremely rare congenital anomaly of the coronary circulation in which the left anterior descending coronary artery arose from the pulmonary artery. Proximal ligation and saphenous vein grafting to the aberrant vessel were performed. Five month and 3 year angiographic follow-up studies demonstrated 1) a widely patent vein graft, 2) regression of large collateral vessels between the right coronary and circumflex arteries and the left anterior descending artery, and 3) marked attenuation of the distal right coronary and left circumflex arteries on the 3 year study. This report describes the clinical course of the oldest reported patient with this unique coronary artery anomaly and the only angiographic study of the effect of ligation and saphenous bypass grafting on its natural history.

Angiography↗
PubMed1984

Normalization of institutional mealtimes for profoundly retarded persons: effects and noneffects of teaching family-style dining.

Benefits have been reported for certain institutionalized populations when mealtimes are arranged under normal, family-style conditions. In this study, we evaluated a program for teaching family-style mealtime skills to institutionalized persons with skill deficits greater than those targeted in previous research--the profoundly retarded. Results showed that the program, involving forward chaining with a less-to-more intrusive prompting sequence and contingent reinforcement, successfully taught four profoundly retarded persons several family-style skills. Also, systematic measures supported the durability of the skills, social validity of the behavior changes, acceptance of the program by staff trainers, and no detrimental changes in health-related variables associated with food consumption. However, results also indicated that beneficial corollary changes (e.g., increased peer communication) previously reported with higher skilled populations did not occur. These results suggest that with more seriously handicapped populations, multiple changes should not be assumed when normalizing institutional conditions; rather, specific skill training will probably be necessary.

Adolescent↗
PubMed1982

Echocardiographic detection of left main coronary artery obstruction.

Advances in two-dimensional echocardiography have improved the prospects of using this technique to detect left main coronary artery (LMCA) obstruction. Using an echocardiograph that had digital gray scale, a 3-MHz transducer and strobe freeze-frame capability and reviewing recordings on an off-line videotape-videodisc analyzer, we retrospectively examined the LMCA in 72 patients who underwent coronary cineangiography. Angiography showed 50% or greater LMCA obstruction in seven patients. All seven had high-intensity echoes in the walls of the LMCA. The high-intensity echoes were irregularly located in the artery and partially occluded it. The LMCA could frequently be recorded proximal and distal to the obstruction. A blinded observer reviewed 28 randomly selected patients from this group and correctly identified the four patients with LMCA obstruction. There was one true and two questionable false-positive diagnoses. In a prospective study of 31 patients, two independent observers correctly identified the three patients with LMCA obstruction. There were no false negatives, and one observer had one false positive. All of the false positives were in patients with proximal left anterior descending coronary artery obstructions. Echocardiography may be a practical means of identifying patients with the LMCA obstruction.

Coronary Angiography↗