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Biomedical subjects

L M Irwig

Publications and source records attributed to L M Irwig.

15 recordsLinked to original sources
PubMed1991

Undergraduate education about cancer.

The quality, quantity and balance of undergraduate cancer teaching in Australian Medical Schools were investigated by a survey, using a self-administered questionnaire, of recent graduates from all Australian medical schools. Stratified random cluster sampling was used and a response rate of 84% (389 respondents) was achieved. The results revealed substantial differences in knowledge, experience in, and rating of teaching between the medical, surgical, radiotherapeutic and palliative components of cancer management. The proportions of graduates who had never attended radiotherapy and palliative care clinics or units (42.3% and 49.9%, respectively) were more than double the proportion who had never attended medical and surgical cancer clinics or units (17.5% and 10.9%, respectively). More than twice as many graduates rated their instruction in the palliative management of cancer as poor or very poor (29.4%) compared with those rating their instruction as poor or very poor in both cancer prevention (8.4%) and treatment for cure (14.6%). The respondents displayed a considerable lack of knowledge about radiotherapy treatment options, and reported a lack of perceived competence in doing cervical smears. Their answers to questions about 5-year survival of selected cancers, about the existence of screening tests validly shown to reduce mortality, and the ages at which breast and cervical cancers are likely to develop all revealed worrying levels of incorrect knowledge. There was some important disturbing variation in levels of knowledge, experience and rating of cancer instruction between states and between universities.

Australia↗
PubMed1979

Hypertension in urban Black outpatients. Who gets treated and for how long?

Two-thirds of all Black patients who attended the Medical Outpatient Department of the Johannesburg General Hospital for the first time during May 1975 had recorded diastolic blood pressures of 90 mmHg or above. Almost one-third of all patients were treated for hypertension. About half of the patients with diastolic blood pressures between 90 and 119 mmHg were started on treatment, a decision which was predicted by diastolic blood pressure, recorded symptoms and systolic blood pressure, but not by age. Four of the 50 patients with diastolic blood pressures of 120 mmHg or above were not treated. Less than one-third of all patients started on anti-hypertensive treatment were still returning for treatment at the end of 1 year. There was no difference in initial diastolic blood pressure between those patients who did and those who did not return for treatment. Hospital policies are required for standardizing initial decision-making and long-term treatment of hypertension. Strategies to improve compliance by altering health care delivery and changing patient behaviour must be developed and evaluated.

Adolescent↗
PubMed1979

Risk of asbestosis in crocidolite and amosite mines in South Africa.

X-rays of all while and mixed-race men employed in crocidolite and amosite mines and mills were read independently by three experienced readers according to the ILO U/C classification. Abnormality was regarded as present if reported by two or more readers. Parenchymal abnormality, defined as the presence of small irregular opacities of profusion 1/0 or greater, was found in 7.3% of the workers. Pleural thickening was found in 4.5% of the workers, costophrenic angle obliteration in 3.2%, and pleural calcification in 1.7%. The prevalences of both pleural and parenchymal abnormality were strongly related to the duration of exposure to asbestos at work. The overall prevalence of abnormality increase from 4.0% in men with exposure for 1 year or less to 47.9% in men with more than 15 years of exposure. After taking into account the effects of age and duration of asbestos exposure, the prevalence of pleural abnormality was not predicted by fiber concentration. However, white men working with amosite tended to develop a higher prevalence of pleural abnormality than did those working with crocidolite. Compared to whites, men of mixed race, who only work with crocidolite, had a high prevalence of pleural abnormality in each exposure duration category. In contrast to pleural abnormality, the prevalence of parenchymal abnormality, after taking into account the effects of age and duration of exposure, was significantly predicted by fiber concentration but not by race or asbestos type. Our results suggest that parenchymal abnormality in workers in South African asbestos mines could be largely prevented by reducing exposure to fibers visible under the light microscope. However, this may not be the case for pleural abnormality.

Adult↗
PubMed1979

The influence of availability of free school milk on the height of children in England and Scotland.

The effect is investigated of availability of free school milk on height gain in one year of six- and seven-year-old primary schoolchildren in England and Scotland, using data collected annually from 1972 to 1976. The height gain of children for whom milk was available for the whole year of observation was compared with that of children who had no milk. Out of 16 sex-country-year-specific analyses for children from manual social classes only, 13 showed no significant evidence of greater height gain in children who had milk. Comparison of children from Social Classes IV and V (semi-skilled and unskilled) showed no greater increase in height for those who had milk, nor was there a difference in height gain between manual social class children according to the number of glasses of milk they drank a day at home or at school. We concluded that, given the standard of living at the time of the survey, the drinking of free school milk did not increase the growth rate of six- and seven-year-old children.

Animals↗
PubMed1979

Lung function in sisal ropemakers.

Lung function was measured by spirometry in 66 workers in a sisal ropemaking factory, and in their matched controls. The major atmospheric contaminant was the lubricant (or a component part thereof) used to soften the fibre. The concentration of airborne matter was generally less than 1 mug m--3. There was no difference in lung function between the two groups before the start of the working shift, that is, the mixture of softening lubricant and sisal caused no long-term effects. Although there was no change in lung function over the working shift in the group making sisal rope, the control group did show a significant increase in lung function over the same period. This suggests that an effect attributable to the lubricant and sisal dust did exist. In previous studies little mention has been made of the softeners used in the processing of sisal fibre. These additives may exert a significant effect on ventilatory capacity and may act in conjunction with sisal dust.

Adult↗
PubMed1978

Lead and morbidity: A dose-response relationship.

Many laboratory tests have been recommended for monitoring factory workers exposed to lead. To select the most useful test the best predictor of selected measures of morbidity was sought. 639 lead-exposed workers in several factories were questioned about abdominal ache, constipation, and fatigue and were examined for hand tremot. Packed-cell volume, blood-lead, urinary lead, and delta-aminolaevulinic acid were estimated in 489 workers. About half of the values for the latter three tests fell into the "excessive" or "dangerous" category of lead absorption. Blood-lead was a better predictor of morbidity than any other laboratory test, and further information did not add appreciably to morbidity prediction. The findings suggest that blood-lead measurement is the most meaningful test for monitoring workers exposed to lead. The effect of lead on morbidity does not appear to depend on its action on the porphyrin metabolic pathway.

Abdomen↗
PubMed1978

Lung function and respiratory symptoms in silicotic and nonsilicotic gold miners.

In a cross-sectional sample of 1,973 white gold miners 45 to 54 years of age, symptoms of chronic bronchitis were equally common in men with radiologically diagnosed silicosis and those without silicosis; however, more silicotic miners complained of missing work during the previous 3 years because of chest illness. Whereas mean forced vital capacity did not differ between the 2 groups, both the 1-sec forced expiratory volume and the mean forced expiratory flow during the middle half of the forced vital capacity were significantly lower in those with silicosis. This difference was almost entirely accounted for by their higher exposure to dust in the mines. Men with silicosis, therefore, have the same or only slightly more airway obstruction than men without silicosis who have had similar total exposure to dust.

Dust↗
PubMed1976

Surveillance in developed countries with particular reference to child growth.

Surveillance of biological function rather than of disease events is a possible method of detecting early changes in population health. The reasons for and methods of a pilot surveillance scheme of the growth of schoolchildren in Britain are discussed. The study, started in 1972, supports the feasibility of surveillance using simple growth measurements and information provided by parents on self-administered questionnaires. Other possible applications of this type of surveillance include growth and nutrition at other stages of life as related to nutrition intervention programmes, and respiratory function as related to environmental changes or the introduction of new substances such as 'safer' cigarettes.

Child↗
PubMed1976

Influence of family factors on the incidence of lower respiratory illness during the first year of life.

In a study of a cohort of over 2000 children born between 1963 and 1965, the incidence of bronchitis and pneumonia during their first year of life was found to be associated with several family factors. The most important determinant of respiratory illness in these infants was an attack of bronchitis or pneumonia in a sibling. The age of these siblings, and their number, also contributed to this incidence. Parental respiratory symptoms, including persistent cough and phlegm, and asthma or wheezing, as well as parental smoking habits, had lesser but nevertheless important effects. Parental smoking, however, stands out from all other factors as the one most amenable to change in seeking to prevent bronchitis and pneumonia in infants.

Age Factors↗
PubMed1976

Influence of family factors on asthma and wheezing during the first five years of life.

Family factors associated with the incidence of asthma and wheezing during childhood have been studied in a cohort of over 2000 children who, together with their families, were followed-up for five years. Episodes of wheezing not regarded by the parents as asthma had a different pattern of association with family factors to that found for asthma. The outcome of the two conditions in terms of ventilatory function at the age of five years was also different, in that children with a history of asthma had a lower peak expiratory flow rate than did children with a history of non-asthmatic wheezing.

Asthma↗
PubMed1975

Deafness in middle age--how big is the problem?

Screening for hearing defect by questionnaire and audiogram was undertaken in two group practices in the South-east of England in a total of 2,278 people aged 40-64 years.The prevalence of deafness in the combined populations of these two practices as measured by audiogram was found to be 5.8 per cent (+/- 0.5 per cent; one standard error). This figure is much more than estimates derived from American data for use in Britain. The prevalence of deafness was shown to increase with lower social class and age. The questionnaire was found to be unreliable for prevalence studies, but was thought to have some use as a screening instrument.There was an incidental finding of increased hearing defects in the left ears of men. The firing of rifles was felt to be a possible explanation of this.

Adult↗
PubMedDate not supplied

A trial of the comparability of peak expiratory flow meters in schoolchildren.

In many circumstances it may not be possible to measure peak expiratory flow rate on all subjects using the same meter. A small trial was carried out to assess the variability of such meters. Five newly calibrated adult Wright peak expiratory flow meters, which gave comparable readings when rechecked on another rotameter, were compared in a trial on 160 schoolchildren. Each child blew once into each meter, and the design was balanced so that the effect of order of blow was eliminated. Statistically significant differences were found between the meters, although the difference between any pair of meters was less than 5% of the average peak flow rats. Since the meters were chosen because they were very similar it is likely that larger differences would be found in other circumstances. This could be an important source of error in multicentre studies where several meters have to be used.

Child↗