Mortality in the Democratic Republic of the Congo.
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Democratic Republic of the Congo↗
Biomedical subjects
L Roberts
Publications and source records attributed to L Roberts.
Perceptions of the effect of an impending restaurant smoking ban on dining-out experience.
BACKGROUND: The introduction of bans on smoking in restaurants is frequently marred by claims that they will lead to a loss of business. METHODS: A representative sample of 3,019 South Australians age 15+ years were asked questions about dining-out frequency and perceived effects of the ban on their dining-out enjoyment and restaurant patronage. RESULTS: Sixty-one percent thought the ban would make dining out more enjoyable, 5% thought it would be less enjoyable, and 34% thought it would make no difference. Overall, 82% thought the ban would make no difference to their likelihood of dining out, 14% would be more likely to dine out, and 4% would be less likely. CONCLUSIONS: These data suggest that the public expects bans on smoking in restaurants to result in both increased enjoyment and increased patronage of restaurants.
Adolescent↗
Extracellular and intracellular actions of azadirachtin on the electrophysiological properties of cultured rat DRG neurones.
The distinct electrophysiological actions of extracellular and intracellular azadirachtin (type A) were investigated using cultured dorsal root ganglion neurones from neonatal rats and the whole cell variant of the patch clamp technique. The cultured mammalian neurones were relatively insensitive to azadirachtin compared with some invertebrate preparations, such as insect chemosensory systems. Insect preparations have been found to respond to 1-100 nM azadirachtin. However, at concentrations of azadirachtin between 10 and 100 microM significant changes in the electrophysiological properties of cultured DRG neurones were seen. Extracellular application of azadirachtin prolonged the late repolarization phase of evoked action potentials and consistent with this produced modulation of voltage-activated K+ currents. This modulation involved an initial transient increase in K+ current followed by reversible inhibition when azadirachtin was applied at a concentration of 10 microM. Higher concentrations of azadirachtin (50 and 100 microM), had only inhibitory effects on voltage-activated K+ currents. Azadirachtin produced a degree of voltage-dependent inhibition, with a greater level of K+ current inhibition observed when neurones were held at -90 mV compared with -40 mV. Prolonged application of azadirachtin for 24 h reversibly reduced action potential amplitude. In contrast intracellular application of 100 microM azadirachtin via the patch pipette solution had no significant effects on action potentials but produced an increase in conductance. Intracellular azadirachtin activated several conductances including a TEA-sensitive K + current and an inward current that had an estimated reversal potential close to 0 mV. In conclusion, data showed that azadirachtin had different effects when it was applied inside and outside the neurones and that azadirachtin at high concentrations reversibly altered neuronal excitability mainly by modulating potassium conductances. It appears that rat cultured DRG neurones are less affected by azadirachtin than some insect sensory systems.
Action Potentials↗
Streptococcus pneumoniae antibiotic resistance in Northern Territory children in day care.
BACKGROUND: There is evidence that the rapid rise in Streptococcus pneumoniae (SP) antimicrobial resistance seen in other countries may have commenced in Australia. Streptococcus pneumoniae carriage and resistance levels are described for urban Northern Territory children in day care. METHODS: A prospective cohort study was conducted of 250 children in nine Darwin day care centres between 24 March and 15 September 1997. Each fortnight nasopharyngeal swabs were collected from children, and parents were interviewed about medications administered. RESULTS: Streptococcus pneumoniae was detected in 52% (1028/1974) of all nasopharyngeal swabs. Streptococcus pneumoniae was isolated from 92% (231/250) of children at some time. Penicillin resistance was found in 30% (312/1028) of isolates using a screening test. Of these, 256 (82%) had resistance confirmed by E-test. Two hundred and one (20% of all isolates) had intermediate penicillin resistance and 55 (5% of all isolates) had high level resistance. Ceftriaxone resistance was found in 19% of children's first isolates. Resistance to other antibiotics was also common: co-trimoxazole 45%, erythromycin 17%, tetracycline 17% and chloramphenicol 13%. A total of 17% (172/1028) of the isolates were multiresistant. The average fortnightly proportion of children given antibiotics was 16% (405/2476). CONCLUSION: Levels of intermediate and high level penicillin resistance in this day care population are consistent with previous data from the Northern Territory, and considerably higher than the rest of Australia. The national trend of increasing pencillin resistance is likely to continue.
Australia↗
Evaluating the potential for opportunistic vaccination in a Northern Territory hospital.
OBJECTIVE: To evaluate the potential for opportunistic vaccination and a simple intervention aimed at improving vaccination coverage for children in hospital. METHODS: Hospital records were reviewed for children under 7 years, discharged from paediatric wards (PW) and the emergency department (ED) for 4 weeks before and after an intervention (423 and 446 children, respectively). This comprised the education of staff and the introduction of prompts to record vaccination status. RESULTS: Documentation of vaccination status increased in the PW (63-90%) and the ED (24-46%), as did the adequacy of detail recorded (51-77% and 8-36%, respectively). Opportunistic vaccination increased from zero of 84 opportunities during the first audit to six of 139 following the intervention. All but one vaccine was given in the PW. Opportunistic vaccination improved when documentation identified a need for vaccination (P = 0. 02). CONCLUSION: There were numerous missed opportunities to vaccinate children in hospital, especially in the ED. Simple prompts improved documentation of vaccination status and the detail of information recorded. Despite improved documentation, opportunistic vaccination failed to improve in the ED. Improving documentation of vaccination status is not sufficient in itself to improve opportunistic vaccination.
Bacterial Vaccines↗
A massive epidemic of multidrug-resistant typhoid fever in Tajikistan associated with consumption of municipal water.
From 1 January through 30 June 1997, 8901 cases of typhoid fever and 95 associated deaths were reported in Dushanbe, Tajikistan. Of 29 Salmonella serotype Typhi isolates tested, 27 (93%) were resistant to ampicillin, chloramphenicol, nalidixic acid, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. In a case-control study of 45 patients and 123 controls, Salmonella Typhi infection was associated with drinking unboiled water (matched odds ratio, 7; 95% confidence interval, 3-24; P<.001). Of tap water samples, 97% showed fecal coliform contamination (mean level, 175 cfu/100 mL). Samples taken from water treatment plants revealed that fecal coliform contamination occurred both before and after treatment. Lack of chlorination, equipment failure, and back-siphonage in the water distribution system led to contamination of drinking water. After chlorination and coagulation were begun at the treatment plants and a water conservation campaign was initiated to improve water pressure, the incidence of typhoid fever declined dramatically.
Case-Control Studies↗
Comprehensive performance examination gives insights into the "hidden curriculum".
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Deception↗
Vietnamese parental perceptions of child and adolescent mental illness.
OBJECTIVES: To determine the symptoms and behaviors in children which are considered psychopathological by Vietnamese parents, to identify professionals and agencies in the community whom Vietnamese parents would consult if their child had a mental illness, and to determine Vietnamese parents' awareness of existing community mental health services. METHOD: Structured interviews were conducted with a randomized community sample of 283 Vietnamese parents in Perth, Australia. Parents were asked to identify the symptoms and behaviors they considered psychopathological in children, where they would turn for help with a mentally ill child, their knowledge of community mental health services for children, and their understanding of the causes of child psychiatric disorders. RESULTS: Vietnamese parents identified psychotic symptoms, disorientation, and suicidal thoughts and behavior as psychopathological. They preferentially endorsed Western-style treatment approaches but had little awareness of existing community mental health services for children. A biological/chemical imbalance, traumatic experiences, and a metaphysical/spiritual imbalance were identified as the most likely causes of child mental illness. CONCLUSIONS: Despite a different cultural tradition, Vietnamese parents appear open to services provided by Western-trained mental health professionals. Their very limited awareness of child and adolescent mental health services in the community, however, may severely limit their utilization of such services.
Adolescent↗
Coming up in the boogie down: the role of violence in the lives of adolescents in the South Bronx.
This article presents data gathered from young people in a poor urban community in New York City, the South Bronx. It seeks to help public health professionals better understand young people's perceptions of violence in the context of their daily lives. Sources of data include a street survey, five focus groups, interviews with incarcerated young males, and observations of several youth programs. These data suggest that violence is pervasive in the lives of both young men and women, although gender plays an important role in shaping the experience of violence. Other factors that influence the experience of violence include patterns of substance use, availability and use of weapons, and a perception that the police do not respect young people. Despite numerous challenges, many young people do take actions to reduce violence. The article suggests actions public health professionals can take to strengthen the ability of families, schools, youth organizations, and young people themselves to reduce violence in low-income urban communities.
Adaptation, Psychological↗
Creating a new framework for promoting the health of African-American female adolescents: beyond risk taking.
African-American female adolescents bear a disproportionate burden of poor health outcomes compared to young white women. The racial and gender disparities in adolescent health are readily apparent in the reported rates of human immunodeficiency virus (HIV) infection, poor nutrition, victimization and exposure to traumatic violence, incarceration, and mortality among young African-American women, especially those who are poor and living in inner cities. Risk behavior, the dominant construct explaining adolescent morbidity and mortality, is inadequate because it assumes that all adolescents develop similarly when, in fact, gender, race, and socioeconomic status force different developmental patterns and health outcomes. The author calls for interdisciplinary collaborations examining the structural inequities and combined consequences of sexism, racism, and inner-city poverty for young women of color in order to inform public health interventions to improve the health of African-American female adolescents.
Adolescent↗
Exploring the experience of type 2 diabetes in urban aboriginal people.
The experience of diabetes among urban Aboriginal people (status and non-status Indians) was explored through a qualitative study. Because researchers have focused almost exclusively on Aboriginal people living on reserves or in isolated rural communities in Canada, this study conducted face-to-face interviews with participants (n = 20) living in the city of Winnipeg, Manitoba. The data generated 3 themes: diabetes as an omnipresent and uncontrollable disease; beyond high sugar: diabetes revealed in bodily damage; and the good, the bad, and the unhelpful: interactions with health-care providers. Findings from this study and previous research support the existence of a pan-Aboriginal model of diabetes. This contemporary cultural stance appears to transcend geography and has implications for the prevention and treatment approaches used in programs and health services for Aboriginal people living with diabetes.
Adaptation, Psychological↗
Dopaminergic system does not play a major role in the precipitated cannabinoid withdrawal syndrome.
AIM: To determine the dopaminergic system involvement in precipitated cannabinoid withdrawal syndrome. METHODS: The dopamine D1 receptor antagonist SCH23390 or the dopamine D2 receptor antagonist sulpiride was administered to rats chronically treated with either delta 9-tetrahydrocannabinol (THC) or vehicle. Subjects were then injected with either SR141716A or vehicle and behavior was observed for 1 h. RESULTS: Administration of the cannabinoid receptor antagonist SR141716A to animals chronically treated with THC as described by Tsou et al (1995) produced a profound withdrawal syndrome. Treatment with dopamine antagonists did not attenuate cannabinoid precipitated withdrawal syndrome in THC tolerant animals while the agonists increased the syndrome. CONCLUSION: It is unlikely that the dopaminergic system plays a major role in mediating the behavioral aspects of the cannabinoid withdrawal syndrome.
Animals↗
Human figure drawings and house tree person drawings as indicators of self-esteem: a quantitative approach.
This study assessed the concurrent validity of Human Figure Drawings (HFD) and House-Tree-Person (HTP) drawings as measures of self-esteem. Adult subjects were requested to make HFD and HTP drawings and to complete measures of psychological adjustment which included the Coopersmith Self Esteem Inventory and Tennessee Self Concept Scale. The drawings were scored using a quantitative, composite rating scale derived from HFD and HTP empirical and theoretical literature on psychological health. Results indicated that neither the HFD nor the HTP quantitative composite ratings of psychological health related to the formal measures of self-esteem.
Adult↗
Smoking and smoking cessation among men whose partners are pregnant: a qualitative study.
Smoking among partners of non-smoking pregnant women has been linked to adverse pregnancy outcome, including low birthweight. Paternal smoking also increases the risk of infant respiratory infections and sudden infant death syndrome, irrespective of maternal smoking status. Furthermore, men's smoking habits are probably one of the strongest influences on the extent to which women are able to quit smoking in pregnancy and maintain cessation post birth. In four focus group discussions, male smokers whose partners were pregnant discussed their beliefs about passive smoking in pregnancy, the barriers they perceived to quitting in pregnancy and their preparedness to support maternal cessation. Men were largely unaware that their own smoking could pose a specific risk to the fetus, but when pregnant women are smokers, men believed their own smoking habits were unimportant. For men, barriers to quitting during their partners' pregnancy were: lack of understanding as to how passive smoking can affect the fetus, including a belief that the fetus is "protected" inside its mother; lack of motivation to quit early in pregnancy due to the baby not being "real"; and concern about stress-induced marital discord associated with cigarette withdrawal. These findings are discussed with regard to messages and strategies which may influence men to quit during their partners' pregnancy.
Female↗
Prospects for smoking cessation among people with insulin-dependent diabetes.
As part of an initiative to develop a smoking cessation resource tailored to the needs of smokers with diabetes, we undertook a survey of 223 people with insulin-dependent diabetes (IDDM) aged 15-40 years, 54 of whom were smokers. Smokers had high levels of awareness that smoking increases the risk of heart and peripheral vascular disease, but were less aware of the risk of microvascular complications. Nearly half of the smokers had other members of the household who were smokers, and 56% indicated they would expect to receive no more than a little encouragement from friends and family members to quit. Concern about weight gain and dietary adherence was a barrier to quitting smoking for approximately one-third of smokers. Seventy percent of smokers recalled advice to quit smoking from a general practitioner, but this most often had involved minimal advice to quit. There is scope for patient education with respect to microvascular complications exacerbated by smoking, and a need to consider the smoking habits of other household members and enlist their active support for smoking cessation.
Adolescent↗
Knowledge and attitudes of health-care providers toward cancer pain management: a comparison of physicians, nurses, and pharmacists in the state of New Hampshire.
The knowledge and attitudes toward cancer pain management of physicians, nurses, and pharmacists in the state of New Hampshire were examined through the use of a statewide survey. Many of the providers who completed the survey, and thus indicated that they treated patients with cancer pain on a regular basis, were not pain or oncology specialists. Most of these providers were quite well informed about the fundamentals of cancer pain management. Approximately 90% of providers in all three groups were not concerned about addiction among cancer patients. Yet, there was a small percentage of providers who responded in less than optimal ways to items dealing with opioid pharmacology, pain assessment, and the importance of pain relief. Comparison of responses among provider groups indicated that nurses were the most knowledgeable and pharmacists the least knowledgeable about pain assessment. Physicians were the most knowledgeable regarding opioid pharmacology but seemed the least committed to providing optimal pain relief. Further analysis identified a small group of physicians that included a disproportionately high percentage of family practitioners and surgeons who consistently responded in less than optimal ways to items dealing with the importance of pain relief. The results of this study indicate a continuing need for broad-based educational programs in cancer pain management and for new initiatives focused on practitioners who see relatively few cancer patients and may have difficulty accessing traditional educational programs.
Attitude of Health Personnel↗
Results of a qualitative study of smoking among pregnant adolescents.
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Adolescent↗
Combitube and percutaneous tracheostomy.
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Bronchoscopy↗