Thursday, January 17, 2013

Photography: Tasmania & Bokeh!


© 2013 Am Ang Zhang

© 2013 Am Ang Zhang

 © 2013 Am Ang Zhang


    

       .....“Fortunately a group from Tasmania[1], of all places, decided to carry out a control study, by suggesting to prospective parents randomly how to place their babies, on their tummies or on their back.  It is amazing how under-reactive some parents really are and do not mind subjecting their precious babies to a life and death situation. Now it is considered unethical to conduct a control study in such a way.  If a drug is so obviously life-saving another way of assessing its value has to be found, rather than denying half the patients the chance of survival.”

From: The Cockroach Catcher

[1] Prospective cohort study of prone sleeping position and sudden infant death syndrome.  Dwyer. (Lancet 1991; 337: 1244-1247).  Lancet. 1985 Dec 14;2(8468):1346–1349.  The "Island State" provided a perfect source population for unbiased selection of cases and comparison samples or controls. Further, the land area and population size (around 500 000 people) made follow-up of cohorts relatively easy. Thus, Tasmania had important advantages for the two major strategies used to search for environmental and lifestyle causes of disease — case-control and cohort studies.   Terence Dwyer, MD, FAFPHM, Director.

Summary. A population-based retrospective case-control study has been conducted in Tasmania since October 1988. Study measurements pertained to the scene of death of last sleep, as well as a verbal questionnaire on relevant exposures. From 1 October 1988 to 1 October 1991, 62 cases of sudden infant death syndrome (SIDS) occurred. Case response rate for retrospective interviews was 94% (58/62). The initial control response rate was 84% (101/121). After stratification for maternal age and birthweight, there was no increase in risk associated with the usual side position (odds ratio [OR] 1.05 [0.27, 5.02]), compared with the supine position (OR 1.00, reference). The prone position was associated with increased risk [OR 5.70 (1.67,25.58)], relative to the supine position. In the final multivariable model, predictors of SIDS in this study were usual prone position (P < 0.001), maternal smoking (P = 0.008), a family history of asthma (P = 0.045) and bedroom heating during last sleep (P = 0.039). Protective factors were maternal age over 25 years (P = 0.013) and more than one child health clinic attendance (P = 0.003). The results provide further support for current health education activities which aim to inform parents of modifiable risk factors for SIDS, including the prone sleeping position, thermal stress and infant exposure to tobacco smoke.


Tasmania & SIDS: The wasted years!


Photography: Tasmania & Bokeh 2!





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