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Biomedical subjects

J Crofton

Publications and source records attributed to J Crofton.

At least 19 recordsLinked to original sources
PubMed1994

Drug-resistant tuberculosis: laboratory issues. World Health Organization recommendations.

There is a suggestion that drug resistance rates decreased in developing countries over the period 1962-85, while recent data suggest that resistance may be increasing. The initial decrease in resistance appears to be associated with well-functioning National Tuberculosis Control Programmes (NTP), while the recently observed increase may be due either to understaffed, resource-poor programmes or to the effect of the HIV epidemic, or to both. It is possible that the HIV epidemic may overwhelm the NTP, resulting in decreased programme efficiency and ultimately increased drug resistance. Resistance surveillance appears to be a good measure of programme efficiency. For research purposes, primary drug resistance surveys should be done on a sample of relevant patients which includes and distinguishes between HIV-positive and HIV-negative patients. At this time, there is not enough information to warrant a recommendation regarding HIV testing of TB patients for surveillance purposes. In order for resistance surveys to be relevant from the public health perspective, one must know the proportion of patients presenting for treatment having previously received treatment. The meaningful denominator for drug resistance surveys from the programme evaluation perspective should be the number of patients presenting for treatment. For initial drug resistance surveys the measurement should be the number of people never having received prior TB treatment with resistant bacilli, divided by the number of new patients presenting for treatment. For acquired resistance, one should look at all patients who begin treatment with susceptible bacilli who become resistant 6 months later.

Antitubercular Agents↗
PubMed1992

Smoking habits and attitudes of medical students towards smoking and antismoking campaigns in nine Asian countries. The Tobacco and Health Committee of the International Union Against Tuberculosis and Lung Diseases.

As part of a world survey of the habits, knowledge and attitudes of medical students regarding tobacco we report a study in 15 medical schools from nine Asian countries. Some 1646 first year and 1587 final year students were included, of whom 59% were male. The prevalence of daily smoking in males was 4% in first year and 11% in final year; of occasional smoking 18% and 24% respectively, both with considerable variations between countries. The rates were very low in women. Male exsmokers varied from 3% to 24% in different centres. Overall, 33% of smokers had made a serious attempt to quit; 44% expected to have succeeded within 5 years. Over 80% of non- or exsmokers, but only 60% of smokers, thought smoking was harmful to health. There was gross underestimation of tobacco's causal role in a number of important diseases, e.g. coronary artery disease, peripheral vascular disease, emphysema, bladder cancer and neonatal mortality. There were notable defects both in training and in motivation to counsel smoking patients. There was only partial knowledge of legislative and other measures to discourage smoking, e.g. only 44% of final year students (26% of smokers) thought increased taxation an important measure. In knowledge and attitudes there was little difference between the sexes, but in most aspects smokers had notably lower scores.

Adult↗
PubMed1991

Anti-smoking policies and practice in Scottish Health Boards: progress 1985-89. Scottish Tobacco Group.

1. The anti-smoking policies in practice of Scottish Health Boards (HBs) were surveyed in 1989, and the results compared to those of a previous survey in 1985. 2. There has been reasonable to good progress in production of a HB policy document; in smoke-free HB committee meetings; in smoke-free public offices, hospital offices, canteens, hospital outpatient areas, community clinics, health centre waiting rooms and offices: in prohibiting sale of cigarettes on NHS premises; in provision of smoking cessation services; in liaison with other organisations; and in initiatives on National No-Smoking Day. 3. On the other hand progress has been poor in providing a smoke-free environment in acute, maternity and longstay wards, and especially poor in hospital ward sitting up areas. There has been disappointingly little progress in the education of nurses and only minor improvement in that for paramedical and lay staff.

Health Education↗
PubMed1989

Smoking habits and attitudes of medical students towards smoking and antismoking campaigns in fourteen European countries.

From an ongoing global international survey we present the results for 14 European countries. The survey was carried out through a WHO-based questionnaire given to the students at the beginning of their first year and during the course of their final year. Daily smokers comprised 13.7% in first year and 21.5% in final year, with an overall variation between 3 and 33% according to country. There were already 16% of ex-smokers among first year students. More than 50% of smokers had made attempts to quit. 60% of daily smokers, and almost all others, thought that they would no longer be smoking in five years time. Knowledge of aetiology was moderate in first year. It later improved but there remained many lacunae in final year, e.g. less than 30% were aware that smoking was a cause of coronary artery disease. There was little knowledge of public health measures for smoking control. Attitudes were greatly influenced by smoking; ex-smokers were similar to non-smokers, with occasional smokers intermediate between these and daily smokers. Only 25% accepted a preventive and educative role in advising patients. As regards smoking, students were concerned with their personal health and with advising patients whom they knew to have smoking-related disease, but in general had little conception of smoking as a public health problem. The differences between countries indicate that both habits and attitudes are social and cultural problems. In most of the centres there seemed to be much room for improvement of medical education in this field.

Attitude to Health↗
PubMed1988

[French medical students and tobacco].

This is a pilot study by UICTMR on smoking habits in medical students carried out in five countries before a world study is undertaken. Smoking habits are already established for first year medical students and for fifth year medical students of both sexes. Cessation of smoking, however, is common in the young. One smoker in two hopes to stop. Knowledge of the dangers of smoking is reasonably good. However the study shows, above all, that students have not integrated into the medical field the education about and prevention of smoking, and they appear limited in their openness to the broader conceptions of Public Health.

Adolescent↗
PubMed1987

Extent and costs of alcohol problems in employment: a review of British data.

In Britain about 9% of males experience alcohol problems at work. Although heavy drinkers have a higher rate, the majority of work problems occur in light or moderate drinkers as these are more numerous. Some data are given on impairment of skills, hangover rates, alcohol-related accidents and lunchtime drinking. Due to extrapolation from the present limited data, there are great difficulties in calculating economic costs; estimates have varied from pounds 60 million to pounds 2 billion a year. In view of the human and economic costs a number of bodies are now making efforts to encourage alcohol policies in the workplace. Further research is required on many aspects of the problem.

Absenteeism↗
PubMed1985

Changes in plasma arginine vasopressin during transition from fetus to newborn following minimal trauma delivery of lambs and goats.

Vasopressin in umbilical arterial and venous blood is high at delivery and may be important in the maintenance of arterial pressure and absorption of lung liquid. We used chronically instrumented near-term fetal lambs and goats to investigate the changes in plasma vasopressin that occur during perinatal cardiovascular transition following cesarean section without labor. Plasma arginine vasopressin was more than 5 times greater 15 min following birth than immediately prior to clamping the umbilicus, and it fell progressively over the ensuing 2-5 h to levels not significantly different from before birth. Fifteen min after delivery, neither arterial pressure, blood gases, nor pH appeared to account for the increase.

Animals↗