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Biomedical subjects

W Feldman

Publications and source records attributed to W Feldman.

107 records · Page 6Linked to original sources
PubMedDate not supplied

How serious are the adverse effects of screening?

The adverse effects of screening are not commonly studied. False-positive tests lead to discomfort, costs, and risks from additional diagnostic and therapeutic procedures. False-negative tests lead to a sense of security and delays in seeking medical help when symptoms develop. Labeling an individual with a false-positive test, or with a true-positive test for which there is no evidence that intervention makes a difference, e.g., intervention on an 80-year-old asymptomatic woman with hypercholesterolemia, can have a markedly negative impact on the quality of life. Interpreting statistical abnormalities out of clinical context, e.g., lending importance to a multiphasic blood screen showing "high" alkaline phosphatase in a teenager, leads to unnecessary costs and anxiety. The cost of screening programs that may not have been shown to do more good than harm is already having an impact on the resources available to diagnose and treatment symptomatic persons. Premature implementation of unproved screening programs will continue to decrease physician and public confidence in prevention.

Costs and Cost Analysis↗
PubMedDate not supplied

Assessing the efficacy of a school-based asthma education program for children: a pilot study.

BACKGROUND: Asthma diminishes the health-related quality of life for many school-aged children. This study sought to explore the effect of a School-Based Asthma Education Program (SBAEP) on quality of life. METHODS: Children with asthma who attended grades 1-5 at two selected schools were requested to participate in this pilot study. Participants at one school were provided with a SBAEP, those at another school (control group) were provided with written educational material about asthma. The children completed the Paediatric Asthma Quality of Life Questionnaire (PAQLQ) before and one month after the educational interventions. RESULTS: There were clinically important improvements in the SBAEP group in quality of life, specifically in the symptom subdomain. CONCLUSIONS: The "Air Force" SBAEP appears to result in a favourable trend in quality of life for children. A larger scale trial is required following revisions to the program.

Asthma↗
PubMedDate not supplied

Infant feeding practices and socio-demographic factors in Ottawa-Carleton.

Parents of 320 infants 6-18 months of age were interviewed to determine infant feeding practices and socio-demographic factors contributing to parental choices. 76% of women breastfed initially. Social class was directly related to the incidence of breastfeeding. 50% of the women who started breastfeeding continued to do so at 6 months, a figure which is higher than that previously reported in Canada. Although social class was a major determinant in parents' choice of infant feeding, cultural factors were also very important. A higher proportion of mothers who spoke languages other than English or French in the home (including mainly Polish, Italian, Spanish, and East Indian) breastfed their infants than did mothers who spoke French, even though more of them were in the lowest socio-economic group. The reason for the relatively low incidence of breastfeeding by Francophone mothers is unclear.

Breast Feeding↗
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Assessing the effectiveness of community screening programs.

Community screening programs seek to detect disorders or risk factors in seemingly healthy persons. The following seven guidelines for determining whether a screening program is likely to be effective are proposed and discussed: (1) Has the effectiveness of the program been demonstrated in a randomized trial? (2) Are efficacious treatments available? (3) Does the burden of suffering warrant screening? (4) Is there a good screening test? (5) Does the program reach those who could benefit? (6) Can the health system cope with the program? (7) Do persons with positive screenings comply with advice and interventions?

Community Health Services↗
PubMedDate not supplied

Childhood gunshot injuries in the Ottawa area.

To determine the incidence of non-fatal firearm injuries in the Ottawa area, we retrospectively reviewed the charts of all children admitted to the Children's Hospital of Eastern Ontario for firearm injuries in the last 15 years. The Children's Hospital is the only pediatric tertiary care care centre in the Eastern Ontario and Western Quebec areas, serving a child population of 600,000. Eighteen children were admitted to our hospital for firearm injuries during this period; six suffered long-term disabilities. The low number of non-fatal firearm injuries at our institution reflects national trends in the incidence of fatal firearm injuries in Canadian children and adolescents.

Adolescent↗
PubMedDate not supplied

Hospitalization rates of children with gastroenteritis in Ontario.

PURPOSE: To calculate hospitalization rates of gastroenteritis among children in Ontario and to determine the association of hospitalization of gastroenteritis with sociodemographic indicators and the availability of hospital beds. METHODS: Ontario admission rates were calculated from hospital discharge data for fiscal year 1991/92. Small area variations, correlations between sociodemographic indicators and admission rates were studied. RESULTS: The age- and sex-adjusted admission rate in 1991/92 was 411.1/100,000 with a 14-fold variation in Ontario. The availability of paediatric beds was the only significant factor associated with high admission rates, with an estimated relative risk of 6.75 (95% confidence interval: 1.26, 36.09, p < 0.027). CONCLUSION: Since most children with gastroenteritis can be successfully managed as outpatients, high admission rates may be an indication of unnecessary hospitalization.

Adolescent↗