Women's preference for place of birth.
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Attitude to Health↗
Biomedical subjects
A Cartwright
Publications and source records attributed to A Cartwright.
Social class differences in health and care in the year before death.
STUDY OBJECTIVE: The aim was to identify any social class differences in health and care in the year before death emerging from a wider study of life before death. DESIGN AND SETTING: Data were collected at interviews, mainly of close relatives, with those who knew most about the people's lives in the year before they died. The sample was a random sample of adult (15 and over) deaths in 10 areas of England in 1987. SUBJECTS: Information was obtained about 639 persons, 80% of the initial sample of 800 deaths. MAIN RESULTS: While middle class people die at an older age, the symptoms and physical restrictions reported for middle class and working class people were similar, and middle class people were reported to have a better quality of life before death. More working class people were felt to be in financial need. CONCLUSIONS: Money and class contribute to the quality of life before death as well as postponing death.
Adult↗
Health services research.
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Cost-Benefit Analysis↗
Is religion a help around the time of death?
Based on reports from relatives and other associates about a random sample of adults who had recently died, the data suggest that three-fifths of the people who died were perceived as having some sort of religious faith that had been helpful to them in the time before they died. Acceptance of death was seen as more common among those thought to have had a strong religious faith, but was not related to believing or not believing in some sort of life after death. It was less frequent among those thought to be uncertain about this. The majority of relatives who said they had a religious faith felt it had been helpful to them over their bereavement, but religious faith was not related to whether or not they felt they had come to terms with the person's death. Those with a religious faith were more likely than others to describe their relationship with the person who died as having been 'very good'. The data can be interpreted in various ways and it is not possible to say with certainty that a religious faith is helpful around the time of death.
Aged↗
The role of hospitals in caring for people in the last year of their lives.
This study explored the role of hospitals in caring for people in the last year of their lives by examining hospital use and the characteristics of people admitted to hospital and changes between 1969 and 1987. Results were based on an 80% random sample of 800 adult deaths in ten areas of England in 1987. People dying when they were 85 or more were the least likely to be admitted to hospital in the last year of their lives. Results raise questions about the traditional emphasis of hospital care, the training of medical students, the adequacy of care for the very elderly in the last year of their lives and the balance of care between the hospital and the community.
Aged↗
The relationship between general practitioners, hospital consultants and community nurses when caring for people in the last year of their lives.
The general practitioners, hospital consultants and community nurses who had cared for a random sample of people who died were asked about their relationships with the other professional groups and for their views and experiences of specialist domiciliary terminal care services. Many of the general practitioners and the nurses were critical of hospital communication over discharge. The most frequent criticism made by community nurses of general practitioners was that they did not ask for nursing help early enough for people who were dying. This may be because many general practitioners regarded the community nursing services as overstretched. General practitioners were rather less enthusiastic than the other two professional groups about specialist medical or nursing domiciliary terminal care services. They were, however, more convinced of the helpfulness of these services if they had some experience of them.
Adolescent↗
Identification and characterization of the hamster polyomavirus middle T antigen.
Hamster polyomavirus (HaPV) is associated with lymphoid and hair follicle tumors in Syrian hamsters. The early region of HaPV has the potential to encode three polypeptides (which are related to the mouse polyomavirus early proteins) and can transform fibroblasts in vitro. We identified the HaPV middle T antigen (HamT) as a 45-kDa protein. Like its murine counterpart, HamT was associated with serine/threonine phosphatase, phosphatidylinositol-3 kinase, and protein tyrosine kinase activities. However, whereas mouse middle T antigen associates predominantly with pp60c-src and pp62c-yes, HamT was associated with a different tyrosine kinase, p59fyn. The ability of HaPV to cause lymphoid tumors may therefore reside in its ability to associate with p59fyn, a potentially important tyrosine kinase in lymphocytes.
Amino Acid Sequence↗
Balance of care for the dying between hospitals and the community: perceptions of general practitioners, hospital consultants, community nurses and relatives.
A survey was made of the general practitioners, hospital consultants and community nurses who had cared for a random sample of people dying in 1987. Their views and experiences of the balance of care between hospital and the community are reported. All three groups wanted more people to be looked after in their homes rather than in hospital if adequate care could be arranged at home. But they perceived inadequacies in home help and district nursing services and many wanted other community services expanded or introduced. The main shortcomings of the hospital service were seen as inadequate numbers of hospice beds, difficulty obtaining admission for people needing long term care, discharge too early and some over-treatment of people who were dying. There was some evidence from relatives that pain control was better in hospital than at home, and the district nurses also reported that pain was not controlled satisfactorily for patients dying at home as often as it could be. It is concluded that inadequacies in community services may discourage some people from taking on the care of their relatives at home.
Adult↗
Changes in life and care in the year before death 1969-1987.
Studies based on random samples of adult deaths in 1969 and 1987 show that, although more people in the recent study were living alone in the year before they die (32 per cent compared with 15 per cent in the earlier study), there had also been an increase in the proportions living in institutions and being admitted to hospital in the 12 months before their death. More of those dying in 1987 than in 1969 had had a home help, whereas the proportion receiving care from district nurses was similar for the two studies and the amount of home visiting by general practitioners had fallen. A higher proportion of those dying of cancer in 1987 than in 1969 were thought to have known that they were dying (44 per cent against 16 per cent) and that they had cancer (73 per cent compared with 29 per cent). However, the proportion of relatives and others who thought the dying person's awareness, or lack of awareness, of the prognosis was 'best as it was' was lower for people dying of cancer in the more recent study (57 per cent against 69 per cent). The symptoms reported for those dying in 1969 and 1987 were generally similar but more of those who died in 1987 had suffered from mental confusion, depression and incontinence for a year or more. This reflects the increased age at which people were dying in the later study: longer life was sometimes associated with the prolongation of unpleasant symptoms.
Adolescent↗
Collecting data about drug use by elderly people.
A random sample of 805 people aged 65 or more were interviewed in their homes in England about the drugs they were taking, and about their experiences with and views about the way drugs were prescribed. Assessments by a pharmacologist and pharmacists identified inappropriate prescribing and labelling and revealed the extent of elderly people's knowledge of their drugs. Information obtained from general practitioners, with the consent of the elderly people, showed that over a third of the elderly people were taking prescribed drugs of which their physician was unaware, but over four-fifths of the drugs reported by both patients and physicians were thought by both groups to be taken appropriately or as prescribed. The processes and problems of drug utilization and drug prescribing are demonstrated by approaching both patients and physicians and further illuminated by the expertise of pharmacologist and pharmacist.
Aged↗
Medicine taking by people aged 65 or more.
Older people consult their doctors less than younger people in relation to both their reported morbidity and their prescribed medication. Some of the large iceberg of symptoms among the elderly might respond to a modification of their current drug regimens. Assessments of medicine taking patterns among the elderly revealed various inadequacies in supervision and a substantial proportion of questionable prescribing. General practitioners were often unaware that elderly patients lived alone, or that they drank alcohol or drove--even when they were taking prescribed medicines for which drinking or driving were contraindicated. Just over a third of elderly people were taking prescribed medicines of which their general practitioners were apparently unaware. The way doctors prescribe for their elderly patients and supervise this prescribing is suggested as a suitable field for audit. The completeness of their records in relation to prescriptions, drinking, driving, and living alone is another possible area for study. So too is the home visiting of the very elderly, particularly those living alone.
Aged↗
Case finding in the elderly: do general practitioners really know enough?
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Aged↗
Identification of people attending outpatients: congruity between hospital records and response to a postal screen.
A comparison of information obtained from a postal screen of people on the electoral register about attendance at outpatient clinics with data extracted from hospital records found agreement between the two sources for 87 per cent of people. This rose to 90 per cent after an interview follow-up of those whose replies were unclear. Given the complexities of defining outpatient attendances clearly, these levels of agreement seemed good. Fewer consultations were omitted by people when a three rather than a 12-month study period was used, but the particular three-month period used (January-March) may have contributed to this difference.
Data Collection↗
Who else responds to postal questionnaires? Are those involved in the subject of the study more likely to do so?
In a postal screen to identify people who had attended hospital outpatient departments, it was predicted that attenders would be more likely to respond than non-attenders. An experiment was set up to explore this. The response rates were 76 per cent among attenders compared with 70 per cent for the others--a difference which did not reach significance at the 5 per cent level.
Data Collection↗
Unintended pregnancies that lead to babies.
Among a random sample of women giving birth to a live baby in 1984 in England, just over a quarter described the pregnancy as unintended. This, together with the ratio of legal terminations to live or still births, suggests that about two-fifths of conceptions are unintended. Data from the study suggest that babies resulting from unintended pregnancies are somewhat disadvantaged physically as well as socially, while maternity services may contribute to the disadvantages.
Adolescent↗
Interviews or postal questionnaires? Comparisons of data about women's experiences with maternity services.
Surveys by personal interview are often assumed to be superior to those conducted by mail questionnaire. An experimental study of experiences and attitudes of 800 newly delivered mothers revealed surprising advantages to postal surveys: they are cheaper, more easily repeatable, and minimize interviewer effects. While response rates differed, the quality of responses was similar, except between middle- and working-class mothers. Postal surveys can be used with considerable assurance in national studies of fairly intimate experiences of pregnancy and delivery.
Asia↗