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Biomedical subjects

P Weinstein

Publications and source records attributed to P Weinstein.

At least 55 records · Page 3Linked to original sources
PubMed1996

Situation-specific child control: a visit to the dentist.

This paper describes the development of the Child Dental Control Assessment (CDCA), a situationally-specific measure of control strategies for school-age children visiting the dentist. A pilot proceeded two definitive studies. In the pilot, the instructions and a battery of items were pretested. The first study was with 180 children and gathered data in a classroom setting to establish the psychometric characteristics of the instrument. Factor analysis, accounting for over 50% of the variance, suggested five scales: Dentist-Mediated Control, Active Coping, Cognitive Withdrawal, Reassurance, and Physical Escape. Internal consistency of the scales constructed from the factors ranged from 0.5 to 0.7. The highest standardized scale scores were for Reassurance and Dentist-Mediated Control. Younger children reported a greater need for Active Coping. In the second study in a clinical setting, children completed an assessment battery and were trained to use a signalling device. Higher CDCA scores for the Active Coping scale, but not the other scales, were associated with the use by subjects of a device to signal the dentist. The proposed measure allows assessment of individual differences among children of the same age as well as developmental differences between age groupings of children.

Adaptation, Psychological↗
PubMed1996

Dentists' perceptions and management of pain experienced by children during treatment: a survey of groups of dentists in the USA and Finland.

Dentists' perceptions and management of the pain experienced by children during treatment were examined in surveys of 198 American and 230 Finnish dentists. Two pain management areas were studied: communication and the use of anaesthetics and sedation. Neither group of dentists routinely questioned children about pain, but encouraging the child to report pain during treatment was more common; the USA dentists asked about pain more often than the Finnish dentists, whereas the Finnish dentists more often encouraged children to report pain. Finnish dentists were much less likely to use local anaesthetics during restorative treatment of either primary or permanent teeth than USA dentists. Neither group of dentists routinely prescribed nitrous oxide sedation, or premedication, or post-operative pain medications. Regarding the dentists' perceptions of pain experienced by children during dental treatment, neither group rated dental treatment procedures as particularly painful or unpleasant. Most dentists found the pain reports of children credible, yet a sizeable minority (up to 67% of the USA dentists and 21% of the Finnish dentists) did not find them strongly credible. There was little relationship between the dentists' pain management behaviour and their perceptions of the pain experienced by their patients.

Adult↗
PubMed1996

Surveillance of the mosquito Aedes aegypti and its biocontrol with the copepod Mesocyclops aspericornis in Australian wells and gold mines.

A survey of the dengue vector mosquito Aedes aegypti was undertaken using funnel traps to detect immature stages (larvae and pupae) in flooded disused mine shafts and wells in Charters Towers, Queensland, Northern Australia. The town has a history of dengue fever since 1885 when goldminers were the first recorded victims. During the latest dengue epidemic in 1993, 2% of the population had laboratory-confirmed dengue virus Type 2, despite source reduction of Ae.aegypti breeding-sites at ground level or above. This led to suspicions that dengue vector Ae.aegypti breeding-sites might be below ground level. When surveyed in March 1994, Ae.aegypti immatures were found in 9/10 wells and 1/6 mine shafts. The water in wells and mines had similar characteristics-except that turbidity was higher in the mines, which more often contained predators of mosquito immatures. The copepod Mesocyclops aspericornis was collected from water in 1/10 wells and 2/6 mine shafts. Laboratory predation trials resulted in 95.5-100% predation by 25 copepods/l on Ae.aegypti first-instar larvae up to 200 larvae/l. Five wells containing Ae.aegypti in the survey were inoculated with fifty indigenous M.aspericornis, and five wells (one positive and four negative in the survey) were left untreated as controls. Nine months later, in December 1994, Ae.aegypti had been eliminated from all five treated wells but all untreated control wells contained Ae.aegypti, except for one well that contained a natural population of M.aspericornis. The role of wells and mines as winter/ dry season refuges of Ae.aegypti in northern Australia is reviewed, and we recommend the use of M.aspericornis as a cost-effective, environmentally acceptable and persistent agent for the sustainable control of Ae.aegypti, especially in inaccessible breeding sites.

Aedes↗
PubMed1996

Field epidemiology of an outbreak of dengue fever in Charters Towers, Queensland: are insect screens protective?

Between March and July 1993 a dengue virus epidemic swept through Charters Towers, a rural North Queensland mining community of 10,000. This clearly delineated outbreak provided an ideal opportunity to carry out one of the few field epidemiological studies of dengue in Australia. The epicurve was consistent with that of a point source outbreak, 18 weeks in duration and peaking at four weeks. A basic reproduction number for the dengue epidemic of 1.99 indicates a similar rate of spread to that found in dengue epidemics overseas. A female-to-male sex ratio of 1.7:1 was obtained for the 238 cases identified. An age- and sex-matched retrospective case-control study showed that cases were significantly more likely to live in unscreened houses than were controls (McNemar chi 2 = 56.1 df, P < 0.0001). Despite being generally accepted, an association between insect screens and a reduced incidence of mosquito-borne diseases has not previously been demonstrated in Australia. We speculate that unscreened housing facilitates the initial spread of a dengue epidemic.

Adolescent↗
PubMed1996

Subarachnoid injections of lysed blood induce the hsp70 stress gene and produce DNA fragmentation in focal areas of the rat brain.

BACKGROUND AND PURPOSE: Most experimental studies of subarachnoid hemorrhage have demonstrated little histological evidence of injury. In the present study we examined both the expression of the hsp70 heat-shock gene, a molecular marker of reversible neuronal injury, and DNA fragmentation, a marker of irreversible cell injury and death. METHODS: Lysed blood, whole blood, oxyhemoglobin, bovine serum albumin, and saline were injected into the cisterna magna of adult rats. The induction of hsp70 mRNA and HSP70 heat-shock protein was assessed with the use of in situ hybridization and immunocytochemistry, respectively. Fragmentation of genomic DNA was studied by DNA nick end- labeling with the use of terminal deoxynucleotidyl transferase and biotinylated dATP. RESULTS: Expression of the hsp70 gene was not induced in the brains of rats injected with whole blood, oxyhemoglobin, bovine serum albumin, or saline. Lysed blood injections, however, induced hsp70 mRNA at 6 and 24 hours in the cerebellar hemispheres and in focal regions of the basal forebrain. HSP70 protein was induced by 24 hours and persisted for at least 4 days in the same regions. HSP70 protein was localized to patches of glial cells and occasional neurons in the forebrain. In the cerebellum HSP70 was localized to Bergmann glial cells, granule cells, molecular layer stellate cells, and occasional Purkinje cells. DNA nick end-labeling showed patches of labeled cells in the basal forebrain that occurred in the same regions that hsp70 mRNA was induced. CONCLUSIONS: The results demonstrate focal stress gene induction and DNA fragmentation after subarachnoid hemorrhage. It is hypothesized that the focal areas of hsp70 induction may reflect ischemic injury due to vasospasm produced by lysed blood and/or injury mediated by direct toxic effects of the lysed blood. The hsp70 induction and DNA nick end-labeling in the same regions suggests that lysed blood produces a spectrum of injury from HSP70 protein-labeled, reversibly injured cells to dead cells with fragmented DNA. Induction of the hsp70 stress gene and DNA nick end-labeling may be useful for evaluating the causes of injury, the spectrum of injury, and potential pharmacological therapies in experimental models of subarachnoid hemorrhage.

Animals↗
PubMed1996

Assessing abuse and neglect and dental fear in women.

Little is known about how specific life stressors, such as sexual, physical and emotional abuse and neglect, might be factors in the establishment or maintenance of dental fears or might affect routine dental treatment. The authors collected data from 462 female members of a large urban health maintenance organization about their dental fear and histories of childhood and adult traumas. According to these data, a history of trauma appears to be significantly associated with elevated dental fear, although multiple factors play a major role in the establishment and maintenance of these phobias.

Adolescent↗
PubMed1996

Dengue fever with encephalopathy in Australia.

During an epidemic of dengue type 2 virus in the rural community of Charters Towers, North Queensland, Australia, in 1993, 210 cases presented to the local hospital with signs and symptoms of classic dengue fever. Two cases were noteworthy because of neurologic complications, which included drowsiness, short term memory loss, agitation, and seizure. The cases are presented in detail because they are the first cases of dengue-associated encephalopathy to be documented in Australia. An increasing number of cases of encephalopathy associated with classic dengue fever is being reported world wide, but the etiology of this clinical syndrome remains unknown.

Aged↗
PubMed1995

Origins of childhood dental fear.

This study explored Rachman's theory of fear acquisition applied to fear of the dentist in a large sample of low income American primary school children. Children and their mother/guardians were interviewed or completed questionnaires in the home about fear acquisition and related concerns. A multivariate logistic regression model was evaluated in order to explore the relationship of direct conditioning and modeling variables to fear levels. Both direct conditioning and parent modeling factors were significant independent predictors of fear level even when controlling for gender, age and other sociodemographic and attitudinal factors.

Attitude to Health↗
PubMed1995

The prevalence of dental anxiety in children from low-income families and its relationship to personality traits.

The prevalence of dental anxiety and the association between dental anxiety and personality traits were examined in a population-based sample of 895 US urban children, from 5 to 11 years of age, from low-income families. Dental anxiety was reported by the child using the Dental Subscale (DS) of the Children's Fear Survey Schedule, and behavioral problems and personality traits were evaluated by parent report on the Child Behavior Checklist (CBCL). Mean DS scores were 31.1 (SD = 10.3) for boys and 34.3 (SD = 11.0) for girls. CBCL score means were 33.3 (SD = 23.2) for boys and 28.5 (SD = 19.1) for girls. The hypothesized relationship between DS and CBCL scores in this population was not demonstrated.

Child↗
PubMed1994

Human sentinels for arbovirus surveillance and regional risk classification in South Australia.

OBJECTIVES: To assess the use of human sentinels to monitor arbovirus activity in South Australia and to use age-specific seroprevalence data from the same sentinels to classify regions according to risk from Ross River virus (RRV). METHODS: Between 1 January 1992 and 15 August 1992, 4776 serum samples were obtained from Red Cross blood donors in the State. All sera were tested for the presence of total antibody (IgA, IgG and IgM) by indirect enzyme immunoassay. To test for recent infection, positive sera were further tested for IgA and IgM specific antibody to Ross River virus with a view to initiating public health interventions if necessary. The age, sex and postcode of residence of each donor were also recorded for seroepidemiological studies. RESULTS: Of the 4776 sera, 2952 were tested to the end of May (the end of the arbovirus season in South Australia). There was evidence of RRV infection in 248 sera (8.4%) but none had serological markers consistent with recent infection. The arbovirus season was considered non-epidemic, and no reactive public health interventions were introduced. Analysis of age-specific seroprevalence by post-code in the full bank of 4776 sera indicated that the Riverland is endemic for RRV, the Murray Mallee and Upper South East epidemic for RRV, and the remaining regions of the State at variable risk, depending on their proximity to these regions. CONCLUSIONS: The ongoing use of human sentinels is a new public health surveillance system for this disease. In the first year of operation of this surveillance system, a suboptimal number of sera was collected from some areas, and sera were tested only for RRV. However, the number of sera tested could easily be increased, as could the range of arboviruses covered by the testing.

Adult↗
PubMed1994

The anxiolytic effects of intravenous sedation using midazolam alone or in multiple drug techniques.

This study examines four drug combinations (midazolam, midazolam-midazolam, fentanyl-midazolam, and fentanyl-midazolam-methohexital) in a placebo-controlled double-blind clinical trial of intravenous sedation. It tests the hypothesis that there is no difference between the anxiolytic effect of the four combinations when compared with a saline placebo. Subjects were 207 mildly anxious young adults having their third molars removed. Cognitive measures of anxiety increased from preoperative levels in the placebo and both midazolam groups (P < .05). The anxiety response remained the same in the fentanyl-midazolam and fentanyl-midazolam-methohexital groups (P > .05). The level of successful anxiolysis ranged from 24% in the placebo group to 74% in the barbiturate group. Using the log likelihood method, comparisons suggest that the drug groups (from midazolam alone to the methohexital combination) have increasingly positive anxiolytic effects even when controlling for the effects of dental fear and intraoperative pain. The fentanyl-midazolam group is 8.1 and the methohexital group is 9.0 times more likely to have had a favorable outcome than the placebo group. Additional analyses of behavioral measures of anxiety yielded parallel results. Global evaluations after surgery were related to the success of anxiolysis for subjects in the active drug conditions (P < .05).

Adult↗