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Biomedical subjects

J Mathers

Publications and source records attributed to J Mathers.

15 recordsLinked to original sources

Identifying 'non-medical' datasets to monitor community health and well-being.

BACKGROUND: The aim of the study was to identify 'non-medical' datasets holding routinely collected information that might be used to measure and monitor the wider determinants of community health and well-being. METHODS: An expert panel discussion, involving public health and environmental health academics and professionals with expertise in a variety of backgrounds (including environmental health, housing, transport, community safety, public health, primary and secondary care), and interrogation of the Office for National Statistics database were carried out for the West Midlands region. The aim was to identify routinely collected 'non-medical' datasets containing information on the following factors: physical environment, crime, housing and homelessness, social services, socio-economic environment including employment, lifestyles, education, leisure and culture, transport and accidents. RESULTS: Fifty-six datasets were identified. Although 43 (77 per cent) were collected at least annually, few (17; 30 per cent) held data that were disaggregated and routinely available at the sub-local authority level. CONCLUSIONS: This study has identified a number of datasets that hold information relevant to health. However, no single dataset is likely to provide information on all dimensions of health and the determinants of health, and local agencies should consider carefully the strengths and weaknesses of each. Through the development of inter-sectoral working and multi-agency involvement at the local level there is now considerable scope to improve the quality of many of these datasets and to promote their use in the measurement and monitoring of community health.

Accidents↗

Acute fuel selection in response to high-sucrose and high-starch meals in healthy men.

BACKGROUND: Despite considerable controversy over the inclusion of sucrose in the diets of people with diabetes, the acute metabolism of sucrose is not completely understood. OBJECTIVE: Our objective was to investigate the metabolism of the monomeric constituents of sucrose after a high-sucrose meal. DESIGN: Three test meals were consumed in a randomized, crossover design by 7 healthy male volunteers. Two of the meals were high in sucrose; one was supplemented with 200 mg uniformly labeled [13C]fructose and one was supplemented with 200 mg [13C]glucose. The other meal was high in starch, supplemented with 200 mg [13C]glucose. Fifty percent of energy was supplied as sucrose in the high-sucrose meals and as starch in the high-starch meal. Breath (13)CO(2) enrichment was measured at 15-min intervals and indirect calorimetry was performed for five 20-min sessions immediately before and during a 6-h postprandial period. RESULTS: Carbohydrate oxidation rates rose much faster after the high-sucrose meals than after the high-starch meal. Breath (13)CO(2) enrichment rose faster and peaked earlier and at a higher value when [13C]fructose rather than [13C]glucose was given with the high-sucrose test meal. Values for breath (13)CO(2) enrichment from [13C]glucose after the high-starch meal were intermediate. CONCLUSIONS: These results show that fructose is preferentially oxidized compared with glucose after a high-sucrose meal and that glucose is oxidized more slowly after a high-sucrose meal than after a high-starch meal.

Adult↗

Influence of volume of work on the outcome of treatment for patients with colorectal cancer.

BACKGROUND: Recent recommendations for the reorganization of cancer services emphasize the importance of a 'minimal acceptable volume of work'. The influence of both hospital and surgical workload has been examined using a population-based series of patients with colorectal cancer. METHODS: Nine hundred and twenty-seven patients with primary colorectal cancer diagnosed during the period 1 January to 30 June 1993 were identified from the North Western Regional Cancer Registry. Case notes were reviewed for information on patient age and sex, histological diagnosis, disease stage, degree of tumour differentiation, mode of admission, identity of operating surgeon, timing of operative procedure, and use of radiotherapy and/or chemotherapy. A multivariate Cox proportional hazards model was then constructed to examine, simultaneously, the effects of patient-, disease- and health service-related variables on survival. RESULTS: Age, tumour stage and differentiation, and mode of admission were revealed as significant independent prognostic variables. After adjusting for these variables, neither operator grade (consultant versus junior), consultant workload nor hospital throughput were identified as independently influencing patient survival. CONCLUSION: The results of this study do not support an association between volume of work and patient outcome.

Adult↗

Adaptive response to pneumonectomy in puppies.

When left pneumonectomy was performed on 9-week-old puppies, the right lung increased in weight, volume, surface area, and number of alveoli so that at age 20 weeks these variables were the same as those of both lungs of control animals and significantly larger than those of the right lung of control animals. The adaptive response of the right lung after pneumonectomy was greater in the lower lobe than in the middle or cardiac lobes. The number of alveoli per ml and the average interalveolar wall distance, hence the surface to volume ratio, was the same in both lungs of control animals and the same in the cardiac, middle, and lower lobes of their right lungs.

Adaptation, Physiological↗

General anesthetics and regional hypoxic pulmonary vasoconstriction.

Administration of N2O, fluroxene and isoflurane to the left lower lobe (LLL) of dogs anesthetized with pentobarbital was previously shown to inhibit LLL hypoxic pulmonary vasoconstriction (HPV). Using the same experimental model, the present study examined the effect of whole-lung administration of N2O, fluroxene, isoflurane, halothane, and enflurane on left-lower-lobe HPV. Selective ventilation of the LLL with N2 alone caused blood flow to the lobe to decrease 53.3 +/- 3.0 per cent. Responses to LLL hypoxia were remeasured during administration of inhalation anesthetics at 1 and 2 MAC to both the LLL and the rest of the lung. Isoflurane and fluroxene progressively inhibited and at 2 MAC halved lobar HPV. N2O (one third MAC) caused slight but significant inhibition, while halothane and enflurane caused slight and nonsignificant changes in lobar HPV. These effects of whole-lung administration of anesthetics on HPV were almost identical to those obtained when the administration was confined to the test lobe alone. It is concluded that N2O, isoflurane, and fluroxene locally inhibit regional HPV and via this mechanism increase total venous admixture, while halothane and enflurane do not have this effect.

Anesthesia, Endotracheal↗