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Biomedical subjects

H C Williams

Publications and source records attributed to H C Williams.

At least 91 records · Page 5Linked to original sources
PubMed1998

The natural history of childhood eczema: observations from the British 1958 birth cohort study.

The National Child Development Study (NCDS) is a birth cohort study whose longitudinal design makes it suitable for examining the natural history of common diseases in childhood such as atopic eczema. We have analysed the age of onset and clearance rates for examined and/or reported eczema in 6877 children born during the period 3-9 March 1958 for whom linked data were available at birth and at the ages of 7, 11, 16 and 23 years. Of the 870 cases with examined or reported eczema by the age of 16 years, 66% had age of onset by the age of 7 years. Of the 571 children with reported or examined eczema by the age of 7 years, the proportion of children who were clear in terms of examined eczema or reported eczema in the last year at ages 11 and 16 years was 65% and 74%, respectively. These 'apparent' or short-term clearance rates fell to 53% and 65%, respectively, after allowance for subsequent recurrences in adolescence and early adulthood. Age of onset of community-ascertained cases of atopic eczema may be later than that reported in hospital-based studies. The long-term prognosis of childhood eczema may be worse than some previous studies have suggested, especially when subsequent recurrences are taken into account.

Adolescent↗
PubMed1998

Focus groups in dermatology.

Focus groups have considerable potential for study of the attitudes and experiences of patients and health care providers within dermatology. This article describes the use of such groups, using specific dermatological examples.

Attitude to Health↗
PubMed1998

Quality of life measures in psoriasis: a critical appraisal of their quality.

In recent years, the importance of patient-generated evaluations in assessing the impact of healthcare has been recognized. A plethora of quality of life (QoL) instruments have been developed to measure the burden of psoriasis and its treatment on the patient. We review the QoL measures and provide a critical appraisal of their quality. There is considerable variation in how the instruments have been constructed, the categories and items included, and the methods by which their reliability and validity have been examined. In order to guide investigators in their choice of instrument, further head-to-head comparisons of measures should be undertaken. When QoL measures are compared, a Pearson or rank-order correlation coefficient is not sufficient to indicate agreement. Methods that examine agreement, rather than association, are available and should be used. In the future, we will need to demonstrate whether these measurement tools are ready for widespread implementation in clinical trials or routine patient follow-up.

Data Collection↗
PubMed1998

Spatial and temporal variation of mortality and deprivation 2: statistical modelling.

"Building on the tabular analyses exemplified in our first paper and widely used in the medical literature, we use generalised linear models to provide a formal, statistical approach to the analysis of mortality and deprivation relationships, and their change over time. Three types of fixed effects model are specified and estimated with the same ward-level data sets for Wales examined in our first paper. They are: Poisson models for analysing mortality and deprivation at a single cross section in time; repeated-measures Poisson models for analysing mortality-deprivation relations, not only at cross sections in time, but also their changes over time; and logit models focusing on temporal changes in mortality-deprivation relationships. Nonlinear effects of deprivation on mortality have been explored by using dummy variables representing deprivation categories to establish the connection between formal statistical models and the tabular approach"

Demography↗
PubMed1998

Spatial and temporal variation of mortality and deprivation. 1: widening health inequalities.

"In this paper we examine the relationship between premature mortality and material deprivation both over time (the intercensal period, 1981-91) and over space (for the population in wards and ward groups in Wales). Our focus is on the methods of analysis for small area...multiple cross-section mortality data and their application to the substantive issue of the persistent and widening inequalities in Wales.... We examine all-cause deaths and mortality by specific disease classes for groups (quintiles) of wards ranked according to standard measures of material deprivation. Although there have been reductions in premature mortality across all deprivation groups in Wales, over the decade, the gap has widened between the most and least deprived areas."

Demography↗
PubMed1997

Managing atopic eczema: the needs of children.

Atopic eczema is a common inflammatory condition of the skin. The disability and psychosocial impact of atopic eczema can be considerable. Existing dermatology clinics usually do not provide the time and the educational facilities essential for children with atopic eczema and their families.

Ambulatory Care Facilities↗
PubMed1997

Managing atopic eczema: running a specialist clinic.

Specialist management of children with atopic eczema is directed towards education, treatment and reassurance of the child and family. A specialist clinic can tailor care to the individual needs of those attending. Specialist clinics should be constantly evaluated and developed to cope with the changing demands and needs of patients with atopic eczema.

Child↗
PubMed1996

Infraorbital crease, ethnic group, and atopic dermatitis.

BACKGROUND AND DESIGN: The usefulness of a prominent infraorbital skin crease as a marker of atopic dermatitis (AD) was examined in 160 consecutive children aged 3 to 11 years in a population setting of a primary school in London, England. Infraorbital crease was recorded by two trained observers according to a strict protocol, and AD was determined by an independent dermatologist who was blinded to the study design. RESULTS: A prominent infraorbital crease was present in only four (27%) of 15 children with AD, compared with 49 (34%) of 145 children who did not have AD (P = .80). A prominent crease was a common finding in black children, even in the absence of AD, affecting 49% (34/69) of normal black children and 25% (11/44) of white children (P = .02). Interobserver agreement for the presence of infraorbital crease was low, with a kappa value of 0.38 (95% confidence interval, 0.23 to 0.53). CONCLUSIONS: While infraorbital crease may be of some use in diagnosing individual cases of AD in a hospital setting, it may be less useful in population-based studies because of its poor validity and repeatability. Studies that still use this sign as an indication of allergy need to take ethnic group differences into account.

Black People↗
PubMed1996

Dissecting cellulitis of the scalp: response to isotretinoin.

We report three patients with dissecting cellulitis of the scalp. Prolonged treatment with oral isotretinoin was highly effective in all three patients. Furthermore, long-term post-treatment follow-up in two of the patients has shown a sustained therapeutic benefit.

Adult↗
PubMed1996

Validation of the U.K. diagnostic criteria for atopic dermatitis in a population setting. U.K. Diagnostic Criteria for Atopic Dermatitis Working Party.

One reason why so little is known about the epidemiology of atopic dermatitis (AD) is lack of suitable diagnostic criteria. A simple list of diagnostic criteria for AD for use in epidemiological studies has recently been developed by a U.K. working party. These have performed well in hospital validation studies of subjects with skin diseases. This study sought to validate the newly proposed criteria for AD in a population setting by conducting a cross-sectional survey of 695 schoolchildren aged 3-11 years in three randomly selected primary schools in West Lambeth, London. As a point prevalence measure, the U.K. criteria had a sensitivity of 70%, a specificity of 93%, and a positive predictive value of 47% when compared with a dermatologist's examination findings. Subsequent analysis suggested that most children classified as false positives had suffered from AD in the last year, but were inactive at the time of examination. When adjusted for these cases, the sensitivity and specificity increased to 80 and 97%, respectively, corresponding to positive and negative predictive values of 80 and 97%, respectively. The U.K. diagnostic criteria for AD appear to work well as a 1-year period prevalence measure in London schoolchildren. Further validation in adults and other countries are needed.

Child↗
PubMed1995

Atopic eczema.

Explore the source record for details and available documents.

Dermatitis, Atopic↗
PubMed1995

London-born black Caribbean children are at increased risk of atopic dermatitis.

BACKGROUND: Previous reports suggest that atopic dermatitis is more common in black Caribbean children born in the United Kingdom than in white children. It is unclear whether these differences are caused by selection bias or variations in the use of the word "eczema" in the groups studied. OBJECTIVE: Our objective was to explore ethnic group differences in the prevalence of atopic dermatitis in London schoolchildren. METHODS: A cross-sectional prevalence survey of 693 junior school children in three schools was performed. Atopic dermatitis was defined in three ways: (1) by a dermatologist, (2) by visible flexural dermatitis as recorded by an independent observer, and (3) by a history of flexural dermatitis according to the child's parents. RESULTS: The prevalence of atopic dermatitis according to examination by a dermatologist was 16.3% in black Caribbean children and 8.7% in white children. This increased risk was present for different methods of defining of a atopic dermatitis and persisted after adjustment for potential confounders. CONCLUSION: London-born black Caribbean children appear to be at an increased risk of having atopic dermatitis.

Black or African American↗