Preventing accidental injury to young children in the home using volunteers

Accidental injury in the home is a major cause of death andill-health among young children. Reducing home safety hazardsby the use of safety devices such as stair barriers and safetytaps has the potential to prevent home injuries. Little is knownabout levels of home safety hazards or how to encourage parentsto reduce hazards. The Safe Place Project examined parents'knowledge of home safety and the prevalence of safety hazardsin homes where there were young children. The study also evaluatedthe effectiveness of a low-cost strategy aimed at reducing homesafety hazards. The strategy used trained volunteers to providehome safety checks and tailored safety education in conjunctionwith increasing the availability of home safety devices. Onehundred and six families with young children participated inthe project. Some homes contained many hazards, with 43% ofthe sample having more than 10 home safety hazards. At follow-up,the intervention group showed a significant reduction in homehazards and a trend towards an increase in knowledge of homesafety.     

Gynopia in nursing practice: the case of urethral catheterization

• ? A pilot study of catheterized women was designed to investigate their perceptions of pain and discomfort during the procedure.
• ? The study aimed to test the feasibility of conducting a larger randomized controlled trial.
• ? Problems were encountered during the execution of the study, due to the need to conform to established principles in clinical research.
• ? Restrictions on access to patients impinged upon the opportunity to ‘cast the net wide’ in order to generate meaningful data.

     

Megaloblastic Anaemia among Indians in Britain

A high incidence of megaloblastic anaemia, approximately threetimes that in white persons, has been found in Indian immigrantsin Britain. The clinical, haematological, and biochemical featuresof 25 patients are described. All but one of these were livingin the Southall area of Middlesex. In 15 cases the presentinghaemoglobin was less than 7 g/100 ml and three of these wereteenage girls. The majority (17 cases) were nutritional anaemias;the type of deficiency was variable and this group includedsome patients with vitamin B₁₈ deficiency, some with folic aciddeficiency, and some with deficiency of both vitamins. Amongthe remaining eight patients there were cases of perniciousanaemia, tropical sprue, gluten enteropathy, post-gastrectomyanaemia, and unexplained vitamin Bla malabsorption. Some ofthese conditions have previously been considered uncommon inAsiatic Indians.     

The Heterogeneity of the High Molecular Weight B12 Binder in Serum

The binding of vitamin B₁₂ by serum proteins was studied by separatingCo⁵⁷B₁₂-enriched serum by Sephadex gel filtration, column chromatographywith DEAE-cellulose, and paper electrophoresis. Each method of separationyielded two discrete B₁₂-binding fractions. However, the analysis of each serumby all three separation technics indicated that one of the fractions was, ineach case, bipartite.

The "high" molecular weight B₁₂-binding fraction defined by Sephadex gelfiltration consisted of transcobalamin I and just part of the transcobalamin IIfraction. The remaining portion of transcobalamin II was eluted from Sephadexgel in a "low" molecular weight fraction. Thus, transcobalamin II, equivalentto the -globulin B₁₂-binder, consisted of both "high" and "low" molecularweight components.

This suggests that there are at least three serum proteins that can bindvitamin B₁₂: two -globulins, together comprising the transcobalamin II fraction and differing in molecular weight; and transcobalamin I.

Submitted on November 4, 1968 Accepted on January 28, 1969     

The cognitive effects of alcohol abuse: a controlled study

It is now well established that there is an association between excessive alcohol consumption and psychological impairment. However, there has been some difficulty in the interpretation of results as the majority of studies have relied on reporting correlations in large subject samples. It was felt therefore that if subjects were matched by variables which had been found to be confounding in previous research, a clearer picture of the effects of alcohol on cognitive functioning could be drawn. Subjects in this study were therefore divided into a ‘high’ alcohol group (over 50 units per week), and a ‘low’ alcohol group (under 20 units per week). No patients who had previously been reported as suffering from cognitive impairment were included in this study as the purpose of this research was to examine the effects of alcohol on those heavy drinkers with no obvious impairment. They were matched by age, sex, socio-economic status and educational background. Heavy drinkers showed significant deficits on a number of cognitive tests compared with their matched controls. Furthermore, the subjects in the lower educational group showed a greater decrease in scores on several sub tests than those in the higher group.     

COLON CANCER AND POLYPS IN ACROMEGALY: INCREASED RISK ASSOCIATED WITH FAMILY HISTORY OF COLON CANCER

A cohort of 52 subjects diagnosed with acromegaly in southeastern Michigan and northern Ohio between 1935 and 1985 were followed to determine the incidence of colon cancer and polyps. Medical records were reviewed, subjects or their next-of-kin were interviewed, and screening examinations of the colon were offered to the living patients who were located. Data on demographics, personal histories of cancer and colon polyps, family history of colon cancer, and cure from acromegaly were obtained for both living and deceased subjects. The risk for colon cancer compared to the general population was estimated using standardized incidence ratios (SIRs). The expected number of cases was determined utilizing age, sex and race-specific rates provided by the cancer registry in southeastern Michigan. Among the 52 subjects, one could not be located and nine were deceased, none from colon cancer, with one known to have a history of colon polyps. Of 13 (31%) who declined the screening physical, one had a history of polyps and none reported a history of colon cancer. Two of 29 screened patients were found to have right-sided adenocarcinoma of the colon. Of the entire cohort, eight people (including one deceased) had a current or previous diagnosis of polyps, with five known to be histologically adenomatous. The SIR for colon cancer was 4.7 (95% confidence interval 0.6-17.1). Seven subjects, including the two with detected adenocarcinoma and four of the six living subjects with polyps only, reported a family history of colon cancer. The SIR for the subset of subjects with a family history of colon cancer was 29.1 (95% confidence interval of 3.5-104.6).(ABSTRACT TRUNCATED AT 250 WORDS)     

Congenital anomalies in children with cerebral palsy: a population‐based record linkage study

Aim Our aim was to determine the proportion of children with cerebral palsy (CP) who have a congenital anomaly (CA) in three regions (Isère Region, French Alps; Funen County, Denmark; Northern Region, England) where population‐based CP and CA registries exist, and to classify the children according to CA subtype. Method Data for children born between 1991 and 1999 were linked using electronic matching of cases. All potential matches were checked manually by each centre and verified as true matches. Results A total of 1104 children with CP were born during the study period (663 males, 441 females). Of these, 166 (15%; 95% Confidence Interval [CI] 13.0–17.3) children with CP had a CA: 8.8% had a cerebral anomaly, 4.8% had a non‐cerebral anomaly, and 1.4% had a non‐cerebral‐related syndrome or a chromosomal/genetic anomaly. Interpretation The prevalence of cerebral anomaly was highest in children with ataxic CP (41.7%) and lowest in those with dyskinetic CP (2.1%). Cerebral anomalies were found in 8.4% and 7% of children with bilateral and unilateral spastic CP respectively. The most frequent cerebral anomalies were primary microcephaly (26.5%) and congenital hydrocephalus (17.3%). The most common non‐cerebral anomalies recorded were cardiac (12.6% of children with CP and CA), urinary (5.4%), and musculoskeletal (5.4%). The prevalence of cerebral anomalies was higher among children born at term (13%) than among those born preterm (3.8%). Associated sensorineural or intellectual impairments occurred more often in children with CP and cerebral anomalies. We concluded that cerebral and non‐cerebral CA prevalence was higher among the CP population than in the general population of live births.