Showing papers in "Journal of The Royal Society for The Promotion of Health in 1986"

Trends and characteristics of road traffic accidents in Nigeria

Abstract: THE TRENDS AND characteristics of road traffic accidents in Nigeria were evaluated using data from the police records. The study showed that there has been increasing trends in the case fatality ra...

Hazard Analysis Critical Control Point (HACCP) concept: application to bivalve shellfish purification systems.

Abstract: untreated sewage, has notably been associated with transmission of disease’. The filter-feeding activity of bivalve shellfish permits accumulation and concentration of faecal microorganisms thereby establishing a route for transmission of these pathogens2. Whilst the number of outbreaks attributed to bivalve shellfish consumption is relatively few, there is a potential for involving large numbers of persons through national and international trade3. Economic loss to the shellfish industry consequent upon such outbreaks of disease can be severe4. Commercially important bivalve molluscan shellfish harvested in the United Kingdom from estuarine and nearshore coastal waters are the European flat oyster (Ostrea edulis), the Pacific oyster (Crassostrea gigas), the common mussel (Mytilus edulis), the edible cockle (Cardium edule) and the hard-shell clam (Mercenaria mercenaria). Scallops (Pecten maximus) are harvested in commercial quantities but from deeper offshore waters which do not receive discharge of sewage. In the United Kingdom, cockles are cooked before sale as

Comparative trial of shampoos for treatment of head infestation.

Abstract: was 2.45% and the estimated total number of children infested in schools was 193,806’. Routine statistics on head infestation since 1975 for England and Wales have been compiled by Central Government. These do not indicate that the situation has improved, indeed it may have deteriorated. The basic problem is’that this unwanted parasite persists largely because of the late detection of cases and the inadequate tracing and treating of contacts. Non-compliance with treatment, particularly with adult contact, is related to ~ reluctance to use the lotions. There is no doubt that in practice shampoo is a more acceptable method of treatment as compared to lotions. There have been objections to this method of treatment. Maunder points out that a much greater effective dose is given to the insects by lotions rather than shampoos &dquo;nobody would dream of killing any other insect with a shampoo; nor should they with lice&dquo;2. Nevertheless, field trials with shampoos containing Malathion and Carbaryl have shown very satisfactory results3 4. However, anecdotal evidence from many school nurses suggests that this form of treatment is unsatisfactory. It is also known that the insecticide is not always released in adequate quantities from the shampoo formulation. This paper describes a trial of shampoo which has not previously been used in the U.K. which contains a pyrethroid Phenothrin which is a synthetic derivative of the naturally occurring substance pyrethrin. The shampoo is formulated as a liquid with 0.2% pyrethroid and will be sold under the trade name of Phenoderm (Napp Laboratories Ltd.). The shampoo is compared with the traditional Carylderm shampoo (Napp Laboratories Ltd.) which is 1.5% in a gel formulation. (Now available as a liquid shampoo.) BACKGROUND

Prevention and Control of Road Traffic Accidents in Nigeria

Abstract: The increasing trends of moribidity and mortality from road traffic accidents (RTAs) in Nigeria called for an evaluation of the counter measures. The evaluation of the counter measures. The evaluation showed that the main preventive measure is by safety Campaigns and that RTAs have not received the attention warranted by the magnitude of the problems. The efforts to combat RTAs in the country are uncoordinated, and inadequately evaluated for possible feed back and im provements. The situation calls for planned counter measures.

Selected factors and stroke in young adults, 15-40 years of age.

Abstract: HOSPITAL-BASED case-control study was conducted to determine the degree of association between cigarette smoking, alcohol use, drug use, and prior medical disorders and the development of stroke in young adults, 15-40 years of age. Cases consisted of 80 patients with a discharge diagnosis of stroke, excluding subarachnoid hemorrhage and transient cerebral ischemia, admitted to one of four community hospitals in northern Illinois between 1975 and 1983. Controls included 321 injury patients matched to cases by hospital and year of admission. The proportion of drug users and those with a history of medical disorders was significantly higher in cases than controls. Cigarette smoking and alcohol use did not appear to be risk factors for stroke, although the risk was obscured by the apparent association of these factors with injuries in the control group. Had community controls been selected it is possible that positive associations may have been found.

Health Manpower and Population Change in Nigeria

Abstract: HEALTH SERVICES in Nigeria were initially pro vided by traditional doctors followed by phys icians brought by Portuguese traders to care for the health of their staff. The effort to provide modern medical care for the Nigerian population was initiated by the missionaries who established hospitals by the 1850s. Government institutions which started later in the 19th Century with a unified system of health services expanded very slowly until 1952 when the system was first decentral ised. Even after decentralisation the limited economy did not permit rapid expansion until the 1970s when the economy was greatly improved by the marketing of Nigerian petroleum permitting rapid development of health manpower and establishments. The numbers of the various categories of health personnel in recent years appear to be increasing at a rate higher than that of the population growth resulting in continued higher health manpower versus population ratio but there is still the need for improvement. The present level of hea...

Family influence on incidence of intestinal parasites among Nigerian children.

Abstract: THE PREVALENCE of intestinal parasites among children of 512 families of 3 different social categories were studied. Degrees of correlations between intestinal parasites and some identified social categories were analysed and statistical evidences showed a strong association between the existence of intestinal parasites and a child's family conditions.

Goat's milk.

Abstract: This is a report of a Working Party set up by the Child Accident Prevention Trust in 1982 and was composed of experts working in many different disciplines. The terms of reference were ( 1 ) to study the incidence, types, causes and effects of burns and scalds in childhood in the overall context of children’s accidents and (2) to review existing means of their prevention and to make recommendations about their further prevention. Mortality rates for 1963 showed that burns and scalds were second only to road accidents in causing deaths of children, two thirds of these deaths involving children under four years of age, with boys being more prone to thermal accidents than girls. The greatest danger of burns came from matches, space heaters and cooking appliances, and hot liquids from cups and kettles were the commonest cause of scalds. The Working Party has made a number of recommendations in an attempt to prevent thermal ac6idents, such as safer smokers materials, use of approved fireguards, non-flammable clothing and furnishings, and review of the design of kettles and saucepans and safer thermostatic control of tap water. The role of health workers to deal with the physical and psychological problems of severe thermal injuries and the safety education of parents and children is stressed. Appendix I gives a list of hospitals in the United Kingdom with facilities for treating burns patients and Appendix 2 cites organisations, standards, and legislation concerned with fire safety and prevention of thermal injuries. A paperback book, costing £3.95 it does not deal with medical and nursing care but nevertheless a book to be read by all personnel involved in the care of these unfortunate children. GEORGE E. PICKUP

Attitudes of adults to sanitation facilities in Ibadan.

Abstract: THE AVAILABILITY of sanitation facilities throughout the world is important to the improve ment of health. A study was done in selected areas of Ibadan City, Nigeria to determine the attitudes and use of sanitation facilities by the city's residents. The findings indicate that the general attitudes are not favourable to the use of sanitation facilities and there is a prevailing belief that the facilities should be provided and maintained by the Government.

A perspective of mental handicap.

Abstract: IVE years ago MENCAP, The Royal Society for Mentally Handicapped children and adults, faced a formidable challenge. The society was asked to state its views in regard to life-giving operations, euthanasia, abortion, et al, following two widely-publicised cases at Hammersmith and Leicester crown court, one of which involved the with-holding of surgery for Duodenal Atresia in a newly-bom Down’s baby. The other was concerned with a charge of attempted murder being brought against a well-known paediatrician for prescribing nursing care only for another Down’s Neonate.

Prenatal detection and prevention of neural tube defects in South Wales.

Abstract: commonest and most tragic malformations at birth, though on the continent of Europe the incidence is less than half. This group of malformations which comprises anencephaly, encephalocele and spina bifida have a multifactorial aetiology where the genetic component is polygenic and environmental triggers are thought to set off the malformation in early development (Carter 1974). For women known to be at increased risk, prevention is, of

Improving hearing aid benefit.

Abstract: worse than the disorder itself, (iii) professional inertia: the tardiness by the first line medical services to act, possibly for the same reasons as the patients. The same article touched upon the reasons why some of those who obtained aids used them only minimally. Further information on this aspect of hearing aid use has come from a study carried out at Withington Hospital. In 1983 a review was made of the records of every adult patient issued during 1980 with a NHS post-aural aid at Withington Hospital ENT Department (N = 731). Of these 128 related to subjects who had been referred from adjacent hospitals solely for the purpose of hearing aid fitting, and for whom adequate personal and audiometric data were not available. Consequently the records of these subjects

Zinc and the fetus.

Abstract: OW BIRTHWEIGHT is a serious health problem. N In 1978, 22 million low birthweight babies were born, 21 million of which were born in developing countries where less than one third of low birthweight babies survive three years, and most are small-forgestational age (SGA) rather than preterm (premature)‘ 2, SGA babies have an increased mortality and incidence of intellectual problems, and continue to be smaller than their appropriate-for-gestational-age (AGA) counterparts34. Maternal malnutrition is thought to be a contributing factor, and certainly extremes of deprivation, as seen in the seige of Leningrad and the Dutch famine, reduce birthweight5 6. However, trials of nutritional supplementation during pregnancy have only shown a positive effect on birthweight in certain subgroups. Thus in the Sorrento study protein-energy supplementation given during the third trimester enhanced birthweight only in pregnancies that they defined from previous studies as nutritionally at risk (i.e. Indian women with minimal increase in triceps skinfold thickness), and in the Gambiag only fetuses of women who received supplementation during the wet season, when food is limited and hard work frequent, had enhanced growth. Selective nutrient deprivation, however, may be more important, and supplementation with nutrients known to be deficient and therefore better aimed at those who require it, may be more effective.

Pulmonary Tuberculosis in Nigeria

Abstract: TO DETERMINE the epidemiological significance of Mycobacterium tuberculosis with respect to the diagnosis of invasive pulmonary tuberculosis in Ile- Ife, Nigeria, the medical records of all patient...

Fluorides In The Prevention Of Dental Caries

Abstract: begins at birth and is complete by eight to ten years of age except for the third molar 2 It is a professional truism that prevention is better than cure. Optimal fluoride ingestion during this crucial stage of tooth development produces lifelong resistance to dental caries. Since most children do not see a dentist until age three, the initiation of preventive dental measures must often start with the paediatrician.

Parasites in Britain: a review:

Abstract: HE COMMONLY-HELD view that parasitic infections are rare in man in Britain is largely unjustified, -*and is based on the fact that the subject is rarely discussed either privately or in print. Furthermore, the infections in question are not included in the DHSS list of ~ ’notifiable’ infections, so the official publications rarely contain any reference to them. During the recent search for the causative organism of AIDS, a number of parasites such as Toxoplasma, Cryptosporidium and Pneumocystis

Mesothelioma in Israel (1973-1982).

Abstract: INTRODUCTION N A previous report on this subject for the period 19601972 only one mesothelioma case had a definite occupational history of exposure to asbestos. Considering that the asbestos industry in Israel was established only in the early 1950s, and that mesothelioma of occupational origin has shown to have a relatively long latent period of 20 years or more, it is possible that a significantly higher number of cases of clear occupational origin could have appeared during the 3rd decade of the asbestos industry in Israel.

Terrestrial gamma ray radiation in Cornwall.

Abstract: , INTRODUCTION UBLIC INTEREST in radiation centres on the problems likely to be caused by nuclear war or the ~ malfunction of nuclear power plant on land, sea or in the air. In the United Kingdom however only about one sixth of the annual radiation effective dose equivalent to each person comes from artificial sources with the remainder coming from natural sources. The amount of natural background radiation varies widely from place to place throughout the country but is known to be high in Cornwall. Even within Cornwall there are wide variations in the levels of natural radioactivity varying from 1020 millirads per annum at St. Ives down to 25 millirads per annum at Wadebridge2 (1 rad = 0.01 Gy). Because of this wide variation it was decided to ascertain the distribution of natural radioactivity within the county in order to determine whether sections of the population were exposed

A New Approach to Designing for the Elderly

Abstract: THE TRADITIONAL image of old people is one of slow moving or virtually immobile individuals all with similar handicaps, and all with similar simple and basic needs. The thesis that a warm environment and regular meals is all that is necessary for good care is one which our designs chose to argue with. How does one describe elderly people? We contend that they are merely individuals past the normal age of retirement. Only some are handicapped, others are able-bodied, many are without friends or relatives and lead isolated, lonely lives. Age may be the convenient categorizing factor but old age is not in itself a need for care. There are fit elderly leading full and productive lives with no disability. For the architect, elderly people in need of care might just as easily be categorized as a disabled group of people with varying combinations of disabilities.

Education and Food Habits of Bahraini Housewives

Abstract: INTRODUCTION DUCATION AND income are essential factors to ~ provide better health status of the community. There is a strong relationship between these two factors and the use of health services. In Bahrain, it is believed that -educational level has a greater influence on the dietary habits than income. This is because of the rapid industrialisation in the country which has led to a sharp increase in the income, but not in the educational level. The result is high purchasing power combined with poor information and knowledge about sound food practices. Previous studies’23 I have demonstrated that educated mothers provided better diet for their families than those who were less well educated. Delfina et all found that the incidence of malnutrition among the preschool children decreased as the educational level of their parents was raised. The present paper reports the influence of the educational level of the mothers on the dietary habits of the family in Bahrain.

Monitoring the impact of the environment on health.

Abstract: his paper discusses first the general approaches that epidemiologists utilise in order to examine a roblem, and then comments about the suitability of these approaches in relation to the task of environmental monitoring. The main component of the paper discusses the approach that has been made in the past, and emphasises the contribution that OPCS can make to this activity. The final section discusses some of the changes that might be instituted in the future to improve the approach to environmental monitoring.

Menstruation problems in Nigerian students and sex education.

Abstract: THE ONSET of menarche and subsequent menstruation problems in 420 secondary school girls in the Rivers State, Nigeria, selected on urban/rural equal representation criterion were studied. Results show that the age at which menarche occurs among the girls cluster at the range of 11 to 14 years. Girls in the urban schools attain menarche earlier than those in the rural areas. The emotional and mental preparation of the girls both in the home and school were found to be very inadequate.Six major menstrual disorders; premenstrual syndrome, prolonged flow, painful menstruation, scanty flow, ir regular cycle and vaginal itching were encountered. Personal hygiene including choice of sanitary materials for care of menstruation was equally poor. It is concluded that sex education of the girls on the growth and developmental changes about to take place in their own bodies at puberty and adolescence should be an integral aspect of school curricula, at all levels of the educational system. It is also suggested that t...

Contraception among female students in the University of Benin

Abstract: QESTIONNAIRES WERE distributed amongst a randomly selected sample of 400 female under graduates of the University of Benin, Benin City, Nigeria with the aim of finding out their degree of aware ness of, attitude to, and use of contraceptives.The mean age of the studied population was 19.6 years. 360 (90%) were single. 372 of them (93%) were aware of contraception, 192 (48%) had used one form of contracep tion or the other, and 104 (26%) had had one or more abortions at the time of the study. Of these 104, 62 (or 60.8% of them) had used no form of contraception prior to the pregnancy.The most dreaded side effect of contraception among the population studied was infertility.

Toynbee Hall: opposition and response.

Abstract: OYNBEE HALL is now a hundred years old. t During that time it has achieved a certain international renown. As the ’mother settlement’ its formal legal title is ’the Universities’ Settlement in East London’ the idea soon spread throughout London, the rest of the country, and abroad. Although there are now less settlements than before, there remain several hundred in countries as far removed from each other as Canada, Finland, Germany, Japan and the United States of America, loosely affiliated to each other through the International Federation of Settlements based at Toynbee Hall (T.H.). T.H. is unusual in that it is still a residential settlement, whereas of those that started residential many have shed this component. Despite the fame, although many have heard the name, this is not matched by accurate knowledge of the nature, purpose and scope of the settlement. Ironically T.H. may be better known to readers of Japanese texts on social welfare than it is to the local inhabitants of Spitalfields, the ward of the London Borough of Tower Hamlets in which T.H. is situated. The settlement is uncomfortably wedged between the City of London and the East End. It is a few minutes’ walk from Aldgate East underground station and near the hustle and bustle of Petticoat Lane street market.

Community health care in Kenya: what next?

Abstract: THE ALABAMA Medical Journal early this year had a lead editorial with the title: ’Doomsday: Friday, 13th 1987’. The authors decried the future uncertainty of Medical Care in the USA. By this date, they said, Doctors will be ’bursting in the seams’ trying to cope up with the crisis in Medicine and Medical Care. Are we different here in Kenya? Dr Derek Bok, President of Harvard Medical School released data showing that by 1990, USA expects a surplus of 25,000 to 50,000 doctors. And in January this year, France purpotedly had 19,600 unemployed doctors. Five years ago France had 200 doctors per 100,000 population, ie. 1:500 as against 256 doctors per 100,000 people today. In

Problems of drug treatment in the elderly.

Abstract: N 1819 THE poet Shelley’s wife gave birth to their 3rd child, one year after they had left England accompanied by Byron’s mistress and her child. Four years later Shelley and 3 of the 4 children were dead. Mortality of this order reflects the prevailing death rates of the time, a situation quite different from that in Western society today, where improvement in Public Health over the last 150 years has resulted in a greatly extended average lfie span. This fact coupled with a declining birth rate has resulted in an increasing proportion of elderly patients in the community’. Figure 1 shows the percentage of person 65 years and over from 1900 onwards in a number of countries’. In the UK although the elderly represent only 12% of the population, they were dispensed twice as many prescriptions as the national average in 19803. In the USA, where it is estimated that about 11 % of the population are over 65 years the elderly spent 25% of the national total expenditure for drugs and sundries in 19764. It is not surprising with this large volume of drug consumption among the elderly that studies from the UK 5, USA , and Sweden’ have shown that adverse drug reactions increase with increasing age. A number of factors are responsible for the high incidence of adverse drug reactions in this population and have been the subject of a recent Report from the Royal College of Physicians’. Of importance however are the problems associated with polypharmacy for patients with multiple pathology, age related pharmacokinetic and pharmacodynamic changes, and poor compliance. ’