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Biomedical subjects

T A Sheldon

Publications and source records attributed to T A Sheldon.

At least 109 records · Page 6Linked to original sources
PubMed1993

Investigation of factors influencing folate status in women who have had a neural tube defect-affected infant.

OBJECTIVE: To investigate folate intake and blood levels of vitamins in women with and without a history of neural tube defect (NTD)-affected infant and to explore the relation between red cell and serum folate in those women. SUBJECTS: Twenty-nine women with a history of NTD-affected infant, who had taken periconceptional vitamin supplements one year or more prior to the study and twenty-nine controls with no such history. MAIN OUTCOME MEASURES: Dietary intake of folate was assessed by questionnaire and blood levels of folate, vitamin B12 and vitamin C were measured. RESULTS: Neither dietary intake of folate nor any of the blood vitamins measured were lower in the women with a history of NTD infant. The majority of women who had received periconceptional vitamin supplementation subsequently had adequate folate intakes and red blood cell folates greater than 160 micrograms/l. Smokers had lower plasma Vitamin C levels than nonsmokers. Multiple regression analysis suggested that the relation between red blood cell (RBC) and serum folate may differ between women with and without a history of NTD. CONCLUSIONS: Women with a history of NTD-affected infants may have different folate metabolism from those who have not.

Adult↗
PubMed1993

A double blind lipase for lipase comparison of a high lipase and standard pancreatic enzyme preparation in cystic fibrosis.

A standard acid resistant microsphere pancreatic enzyme preparation was compared with identical capsules half filled with mini-tablets of a new high lipase preparation in a randomised double blind crossover study in children with cystic fibrosis. Each patient received his/her usual number of capsules and the same dose of lipase during each period of the study. Eighteen patients completed the study. There were fewer gastrointestinal symptoms when pancreatic enzyme was supplied as the high lipase preparation. There was also a significant improvement in fat absorption (17%, 95% confidence interval (CI) 6 to 27), reduction in faecal fat output (15.8 g/day, 95% CI 6.4 to 22.5), and faecal energy loss (789 kJ/day, 95% CI 211 to 1384). It is concluded that half filled capsules of the new high lipase preparation are more effective than the standard preparation and it is likely that filled capsules would allow patients to use fewer than half the number of pancreatic enzyme capsules.

Adolescent↗
PubMed1992

Discounting in health care decision-making: time for a change?

Economic appraisal is increasingly being used to inform health care decision-making. To allow comparison, costs and benefits spread over time are weighted according to when they are experienced. The further in the future, the less heavily they are weighted or the more they are discounted. Traditional economic appraisal techniques are based on the view that social decisions should reflect private preferences. The practice of discounting future streams of costs and benefits is principally justified by the fact that individuals have a positive time preference, preferring consumption sooner rather than later. Discounting weights public decision-making in favour of interventions resulting in short-term benefits and against longer-term benefits. This discriminates against preventive and other public health programmes. This paper provides a critique of the foundations of discounting. It is argued that health policy should have a longer time horizon, reflecting social values rather than individual preferences. Factors which make discounting the future rational from the individual's point of view are shown to be irrelevant to a societal perspective. Although uncertainty about the effectiveness of interventions and technological change are good reasons for weighting some future benefits less highly, the routine use of a single discount rate for economic evaluations of health programmes is not justified.

Cost-Benefit Analysis↗