ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00709.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00710.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractRare diseases in children account for disproportionate morbidity and mortality and are particularly demanding of both families and health resources. Surveillance may provide data on their epidemiology, aetiology, management and outcome and on the support requirements of affected children. Existing methods for rare disease surveillance include mandatory and voluntary notification schemes, which may be active or passive, hospital discharge databases and death certification data. The recent establishment of the Australian Paediatric Surveillance Unit has facilitated active, prospective, national case ascertainment by voluntary notification of selected rare conditions. Information obtained should enable estimation of incidence rates, evaluation of prevention and management strategies, extend data collected by existing methods and help estimate future health needs.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00711.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00712.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00713.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractAn overview of recent studies of antimicrobial factors and microbial contaminants found in human milk is presented. The incidence of gastrointestinal and respiratory infections in infants receiving human milk continues to be lower than in those not breast‐fed due to the presence of specific antibody and possibly anti‐adhesion factors in the milk. Whether the many other antimicrobial factors, which have been shown to be activein vitroor in animal model systems, have any influence on infant infections is still not clear. Microbial contaminants in human milk are rare, as are associated infant infections from the milk. However, some contaminants such as cytomegalovirus are commonly transferred to infants from the milk of seropositive mothers, fortunately without any adverse effects in the infants. Human T‐lymphotropic virus type 1 is transferred via human milk in endemic areas, human milk being the main source of mother‐to‐infant transmission. While some reports suggest human immunodeficiency virus type 1 transfer may occur through human milk, this is not the predominant mode of transmission t

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00714.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00715.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractIn order to monitor whether paediatric education has adapted to meet modern practice 91 paediatric advanced trainees were surveyed to elicit their satisfaction with developmental‐behavioural (DB) training. A response of 69% was obtained to a postal questionnaire. The traditional imbalance persists, with trainees considering themselves significantly better informed in the medical disciplines (P>0.001). Satisfaction with training in the 14 developmental disciplines surveyed is less (P>0.001) and significantly more variable compared with 11 traditional medical disciplines (P>0.01). Formal rotations in DB disciplines had been received by all respondents by the 7th year of training. However, 46–67% consider themselves ill‐informed in learning/school problems, attention‐deficit hyperactivity disorder, adolescent problems, paediatric rehabilitation and language impairment. Thirty‐seven per cent found formal postgraduate instruction unhelpful. Paediatric advanced training gives exposure to, but unsatisfactory formal education, in developmental and behavioural paediatrics. Current initiatives for mandatory DB training have serious implications for achieving adequate resources and standards to meet clinical and trainin

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00716.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractControl data from 1529 infants studied in a multicentre case‐control study of sudden infant death in New Zealand were analysed to identify factors that might hinder the establishment and duration of breast feeding. Although 1300 infants (85%) were exclusively breast‐fed at discharge from the obstetric hospital, this fell to 940 (61%) by 4 weeks. Logistic regression was used to identify factors that might adversely influence breast feeding ‘at discharge’,‘at 4 weeks’ and the overall ‘duration’ of breast feeding.When adjusted for confounding factors, not exclusive breast feeding ‘at discharge’ was significantly associated with: twin pregnancy, being a Pacific Islander, mother not bedsharing, subsequent dummy use, birthweight less than 2500g, heavy maternal smoking, not attending antenatal classes and mother less than 20 years old at first pregnancy. Mothers smoking more than 20 cigarettes a day were nearly twice as likeiy to not exclusively breast feed on discharge compared to those who did not smoke. A ‘dose response’ was apparent with the heaviest smokers having the least likelihood of establishing exclusive breast feeding.Being exclusively breast‐fed at discharge but not ‘at 4 weeks’ was associated with: twin pregnancy, admission to a neonatal intensive care unit, subsequent dummy use and not being married. A shorter overall ‘duration’ of breast feeding was associated with maternal smoking, subsequent dummy use, mother not bedsharing, twin pregnancy, mother less than 20 years old at first pregnancy, low occupational status and not attending antenatal classes. These effects persisted when social and demographic factors, including birthweight, were taken into account.This study showed that 31% of New Zealand women had smoked during their pregnancy. A concerted effort to achieve smokefree pregnancies would not only directly improve the health of mother and child but may enhance both the initiation and duration of breast feeding. The influence on the duration of breast feeding of both dummy usage and the mother sharing the bed with her infant needs to be explored further, as a causal relationship cann

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00717.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThirty‐three southern Chinese children with insulin‐dependent diabetes mellitus (IDDM) were studied. The patients had a mean follow‐up of 5.2 years (range 1.2–8.2). The mean age of onset was 8.3 years (range 1.7–13.5). The mean duration of symptoms before diagnosis was 22 days. Ten patients (30%) presented with diabetic ketoacidosis at diagnosis. Only one patient (3%) was found to have thyroid microsomal antibodies and none was found to have hypothyroidism or hyperthyroidism. Incidence and prevalence were calculated from data recorded retrospectively and prospectively in a population‐based registry of IDDM. The prevalence in 1991 and 1992 was 8.3 per 100000 children under 15 years of age. The age‐standardized incidence of IDDM was 1.7/100 000 per year with the 95% confidence interval of 1.2–2.4/100 000 per year for children under 15 years of age during the years 1986–93. The incidence for males was 1.1/100 000 per year and for females, 2.4

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00718.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY