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Biomedical subjects

J Ashton

Publications and source records attributed to J Ashton.

At least 37 records · Page 2Linked to original sources

Industrial atmospheric pollution, historical land use patterns and mortality.

BACKGROUND: The measurement of atmospheric pollution for epidemiological studies is problematic. This study presents a new proxy measure of atmospheric pollution of industrial origin and uses it to determine, at electoral ward level, the relationship between atmospheric pollution and all-cause mortality. METHODS: All-cause Standardized Mortality Ratios (SMR), all ages, and for persons under 65 years for the period 1984-1988, proportions of land in each ward utilized by industrial works (the proxy for atmospheric pollution) and levels of socioeconomic deprivation of the ward residents were compared in 104 electoral wards. RESULTS: The all-age SMR in the 22 wards containing the largest proportions of industrial land (113) was 9.7 per cent higher than the SMR (103) in the 60 wards with no industrial land. The under 65 years SMR in the 22 highly industrialized wards (120) was 22.4 per cent higher than the SMR (98) in the wards with no industrial land. After matching the levels of deprivation, the all-age SMR in the 15 wards containing over 10 per cent industrial land (116) was significantly higher than the SMR in 15 wards containing no industrial land (108); corresponding figures for the under 65 years SMR were 135 and 118. CONCLUSIONS: A greater proportion of industrial land in a ward is associated with a higher mortality of the ward residents, even after controlling for the level of socio-economic deprivation of the residents. The association between deprivation and mortality is stronger than the association between atmospheric pollution and mortality. There is an urgent need for better measures of atmospheric pollution which are usable in epidemiological studies.

Adolescent↗

The influence of exercise on the energy requirements of adult males in the UK.

Energy expenditure was measured over 10 d using the doubly-labelled water (DLW) and activity diary methods in summer and winter in subjects with 'light' occupations but leisure activities which ranged from 'non-active' to 'very active'. The basal metabolic rate (BMR) and the energy cost of activities were determined by indirect calorimetry. The Department of Health (1991) predicted BMR for the group (6.89 (SD 0.30) MJ/d; n 18) was not significantly different from the measured value (7.17 (SD 0.70) MJ/d; n 18). The range of DLW-derived expenditure values within the group was BMR x 1.41 to 2.41. The largest seasonal change within individuals was BMR x 0.5. The energy expenditure of the group as a whole was lower in winter (BMR x 1.88; SD 0.33; n 9) than summer (BMR x 2.01; SD 0.30; n 9) though the difference was not statistically significant. The average summer and winter DLW-derived expenditure was BMR x 1.96 (SD 0.31; n 17). The activity diary estimate of expenditure was BMR x 1.79 (SD 0.32; n 17). In a subset of the group who were representative of the most active 26% of all adult males in the UK, the DLW-derived expenditure was BMR x 2.08 (SD 0.24; n 11). This is higher than the highest Department of Health (1991) estimate of BMR x 1.6 for individuals in light occupations. The measured energy costs of low-intensity activities were similar to those presented in the Department of Health (1991) report but the value determined for running (BMR x 13.08; SD 2.4; n 6) was higher than the highest value in the report (BMR x 6 to 8). The results indicate that the recent Department of Health (1991) reference values for energy may underestimate the expenditure of a significant proportion of the UK population largely because the energy costs of activity used in the report to calculate expenditure do not accurately reflect those achieved during active leisure in individuals who take regular exercise.

Adult↗

[Health inequalities in Barcelona and Valencia].

BACKGROUND: Inequalities in health have been internationally recognized as an important public health problem with a reduction of 25% being the first target of WHO--Europe for the year 2000. It is, therefore, important to describe and monitor the same. METHODS: An ecological study was performed using secondary data from the statistics of mortality (years 1985-1988) and the municipal censuses from the year 1986 to describe and compare inequalities in health in the cities of Valencia and Barcelona with neighborhoods being the unit of observation and analysis. RESULTS: Although the rates of mortality in Barcelona city are slightly inferior and those of Valencia slightly higher to those of Spain, both cities demonstrate important inequalities in regard to mortality in their neighborhoods with respect to standardized mortality which ranged from 78 to 182 in Barcelona and from 63 to 147 in Valencia. The privileged zones in Barcelona are those of Pedralbes and Sant Gervasi and in Valencia in the neighborhoods of Sant Pau and Jaume Roig with the most unfavorable neighborhoods being District I in Barcelona (Gothic Quarter, City Park, Barceloneta and Raval) and the Na Rovella and Fuensanta neighborhoods of Valencia. The level of inequality in both cities is very similar. Statistically significant associations have been found in both cities between the state of health and the level of poverty in the neighborhoods according to an approximation to the Townsend et al indexes. CONCLUSIONS: The description of important inequalities in two large Spanish cities suggests the possibility of its existence in other cities and established the urgent need for a study using comparable methodologies. With the use of routine and presently available data sources it is possible to describe and posteriorly monitor the level of inequality in large cities in Spain. The development of policies to diminish the inequalities in the large cities would provide considerable gains in terms of human lives. The present results support the hypothesis that material conditions in everyday life play an important role as a condition for public health inequality.

Adolescent↗

Small area analysis: abortion statistics.

Small area analysis has developed over the last two or three decades as a useful tool in health services research, as it allows the identification of areas within health or local authority districts with high rates of morbidity and mortality, and thus provides a useful base for planning the delivery of health services. A profile was compiled for Liverpool Family Health Services Authority on planned parenthood in the Liverpool District, with the aim of identifying where resources are needed most - which parts of the City, and which groups of women, are most in need. The profile included an analysis of various outcome measures, including abortion statistics, which can be used as a guide to the apparent effectiveness of services. Using a combination of statistics on NHS abortions for electoral wards, and private abortions by postal district, it became apparent that, on the whole, areas of high NHS induced abortion rates also have high private (British Pregnancy Advisory Service; BPAS) induced abortion rates, and vice versa. The maps for NHS and BPAS abortion rates suggest that total abortion rates are high in City centre wards, and low in areas south of the City. This would suggest that there are differences in social factors, family planning provision, and other factors which are influencing abortion rates. Although available indicators would suggest that City centre wards are in greatest need of improved family planning provision, these are the wards which are relatively well provided with health authority family planning clinics.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Induced↗

Serum cortisol concentration and testosterone to cortisol ratio in elite prepubescent male gymnasts during training.

Serum cortisol concentrations and testosterone:cortisol concentration ratios of eight prepubescent elite male gymnasts (mean age 10 years 11 months) and 11 controls (mean age 11 years 1 month) were examined during 5 consecutive training days. During this period, the gymnasts trained 3 h each day with moderate intensity mobility, strength and skill exercises while the controls were relatively sedentary. Blood samples were taken from all the boys in both groups before (1630 hours) and 30 min after (2000 hours) training on 4 days. Serum cortisol concentrations of the gymnasts were not significantly different from those of the controls throughout the experiment. Serum cortisol concentrations of both groups were significantly larger (P < 0.05) at 1630 hours than at 2000 hours, indicating that cortisol secretion followed the typical adult circadian change, seemingly unaltered by training. However, there was a significant decrease (P < 0.05) in the testosterone:cortisol ratio of the gymnasts when compared with controls from day 1 to day 3. After a rest on day 4 the testosterone: cortisol ratio of the gymnasts significantly increased (P < 0.05) but the ratio of the control group also increased indicating that there may have been some day-to-day change by factor(s) other than training. The most obvious factor which may have accounted for the unresponsiveness of serum cortisol concentration to the gymnastics training was that the exercise intensity was too low. However, several days of the training seemed to reduce the anabolic to catabolic balance but further experiments are needed to confirm this finding.

Child↗

The Healthy Cities Project: a challenge for health education.

The World Health Organization Healthy Cities Project assists participating cities in developing and implementing plans to create health promoting policies, programs, and environmental conditions. The project, which has its origins in the strategy of Health for All by Year 2000, seeks to bring the rhetoric down to earth and ground it in policy and practice. So far the project has been very successful in interesting and involving people at the local level. What began as a small European project in 1986 has become part of a global movement four years later. This movement is based on a recognition of the ecological context of health and the need to reconcile human lifestyles with their environmental and planetary impact. In the process of involving many people from nonmedical sectors in urban health promotion, the continuing relevance of health education to public health is becoming apparent. The challenge to Health Education is to broaden its perspective from the individual and biological, to the social and environmental if it is to play a full part in tackling the ecological crises which confront us.

Global Health↗

Quality monitor implementation for standards of care of the mechanically ventilated patient.

Each critical care unit has a responsibility to develop a quality assurance process to evaluate nursing practice. Staff members at Shawnee Mission Medical Center (SMMC) developed a protocol, based on the Marker Model, to establish standards of care related to care of the patient requiring mechanical ventilation. The quality assurance process used to monitor implementation of the standards is described.

Critical Care↗