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Biomedical subjects

K Judge

Publications and source records attributed to K Judge.

At least 37 records · Page 2Linked to original sources
PubMed1994

Survey of the attitudes of British physicians to pacing.

OBJECTIVES: To assess how the opinions of cardiologists, physicians, and general practitioners on the indications for permanent pacing compare with published guidelines, and to determine whether resources, pacing experience, and position influence referral practices. DESIGN: Anonymous postal survey by questionnaire from St Bartholomew's Hospital, London and the King's Fund Institute, London. The questionnaire established the respondent's position, resources, and previous pacing experience. Eleven clinical and electrocardiographic situations were described and respondents were asked to decide on whether pacing was indicated. The responses received were compared with the guidelines provided by the 1984 American College of Cardiology/American Heart Association task force. PARTICIPANTS: The 630 members of the British Cardiac Society, 1370 randomly selected general physicians, and 2000 general practitioners. RESULTS: Patients with symptoms were more likely to be referred for pacing than symptom free patients regardless of underlying aetiology. In relatively symptom free patients the frequency with which pacing was recommended was low, even when it was unequivocally indicated on prognostic grounds. Failure to recommend pacing was unrelated to diagnostic facilities or referral difficulties. Respondents with pacing experience were more likely to recommend pacing. CONCLUSIONS: The physicians surveyed had a conservative approach towards recommending pacing. Most physicians were influenced predominantly by symptoms and the prognostic indications for pacing were not well appreciated.

Attitude of Health Personnel↗
PubMed1993

Ghostbusters.

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Fees, Medical↗
PubMed1993

Tackling inequalities in health: the Australian experience.

Federal and state governments in Australia have embarked on a series of national initiatives which show a firm commitment to tackling social inequalities in health. The development of national goals and targets for health, for example, covers social and environmental conditions and sets differential targets for specific social groups with very poor health status. In a complementary initiative, a wide ranging analysis of the health care system--the National Health Strategy--has as one of its main objectives to improve the equitable impact of the health system. Where problems of access to and quality of services have been exposed, policies have been devised to deal with them. The exceptionally poor health of the Aboriginal community has elicited cross party support for action. Resources have been allocated to implement the National Aboriginal Health Strategy: to improve living and working conditions, education, and employment opportunities. Britain can glean much from the Australian experience.

Australia↗
PubMed1993

Health inequalities: new concerns about the children of single mothers.

OBJECTIVES: To show that the exclusion from conventional class based analyses of child mortality of children whose parents are classified as "unoccupied" produces a misleading picture of health inequalities. DESIGN: Reanalysis of data published in the childhood supplement of the registrar general's decennial supplement on occupational mortality in England and Wales, which compares numerator data for registrations of deaths in children over the age of 1 but below their 16th birthday in 1979, 1980, 1982, and 1983 with data about children aged 1-15 who were enumerated at the 1981 census. RESULTS: Parents who are classified as "unoccupied" largely consist of economically inactive single mothers. Their children are estimated to represent 89% of the 614,000 aged 1-15 classified as "unoccupied" in the childhood supplement. They have the worst mortality record of all social groups--an age specific death rate of 68.8/100,000 a year, 42% worse than in social class V (48.4/100,000) and worse than that of social class I (22.8) by a factor of 3. At older ages (10-15 years) these children have a relative risk of death of 4.14 relative to classes I and II; the risk is 2.58 in children 0-4 and 2.56 in those 5-9. Relative risks of child mortality in social classes I and II in comparison to classes IV and V suggests a progressive shallowing from 2.08 at ages 1-4 to 1.37 at ages 10-15. When unoccupied parents were combined with classes IV and V and compared with classes I and II, however, inequalities seemed to be pervasive throughout childhood; the relative risks were 2.21 for those aged 1-4 and 1.98 for those aged 10-15. CONCLUSION: Children classified as unoccupied are almost certainly living in poverty as well as experiencing relatively high risks of mortality. Class based analyses which exclude them therefore produce a misleading picture of inequalities in child health. The implications for health policy are profound. Strategies to promote the nation's health should acknowledge the importance of material and social deprivation more explicitly.

Adolescent↗
PubMed1991

Utilisation by homeless people of acute hospital services in London.

OBJECTIVES: To estimate the numbers and distribution of homeless people in London; to quantify the utilisation of acute inpatient services by homeless people in two health authorities; and to predict the total numbers of admissions in homeless people in district health authorities across London. DESIGN: Data were collected from various sources on the distribution of homeless people across London boroughs. All unplanned acute inpatient admissions during November 1990 to relevant hospitals were identified. SETTING: Bloomsbury and Paddington and North Kensington, two former inner London district health authorities. SUBJECTS: Homeless people in London residing in bed and breakfast and private sector leased accommodation, residing in hostels, and of no fixed abode. MAIN OUTCOME MEASURES: Number and cost of acute unplanned admissions in homeless people in two health authorities in November 1990; predicted number of such admissions each year in district health authorities in London. RESULTS: There were at least 60,000 homeless people in London in March 1990. The majority were housed in temporary accommodation (55,412). There were at least 3295 hostel dwellers and 651 people sleeping rough. Homeless people accounted for 105 (8%) of the 1256 acute unbooked admissions in residents of Bloomsbury and Paddington and North Kensington health authorities in November 1990. Considerable variations in the pattern of acute unplanned admissions in homeless people were observed in the two districts with respect to housing status and specialty of admission. The total number of acute unplanned admissions in homeless people across London each year was estimated at 7598, ranging from 38 in Bexley to 1515 in Parkside. CONCLUSIONS: The results have fundamental implications for resource allocation across London. Allocation must take better account of the heterogeneity, uneven distribution, and extra health needs of homeless people.

Adolescent↗
PubMed1991

In defense of formulae.

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Data Interpretation, Statistical↗
PubMed1983

Public opinion and the privatization of welfare: some theoretical implications.

The social policy of the Thatcher government is characterized by an abrupt shift in the direction of the private sector. To what extent does this reflect what people want? The Institute of Economic Affairs conclude from the only suitable national opinion survey that such a move is strongly supported. Our reanalysis of their data shows that this strand in public opinion can coexist with, and need not contradict, an equal public enthusiasm for state welfare. Such results have important implications for our understanding of social policy. We conclude, therefore, with a discussion of contrasting marxist and liberal accounts which seeks to show that the evidence of ambivalence in popular attitudes about the welfare state supports particular developments in theory.

Analysis of Variance↗
PubMed1982

Loss of type I procollagen gene expression in SV40-transformed human fibroblasts is accompanied by hypermethylation of these genes.

Transformation of human lung fibroblasts (WI-38) by Simian Virus 40 (SV40) resulted in a decline of 25-30% in the amount of secreted collagen. The collagen produced by the transformed fibroblasts contained no type I collagen (i.e. alpha 1(I) and alpha 2 chains), which was the major collagen component produced by untransformed fibroblasts. Measurement of the procollagen mRNA levels by dot hybridization with nick-translated procollagen-cDNA clones showed that the absence of type I collagen was due to the absence of alpha 1(I) and alpha 2 procollagen mRNAs. This result was confirmed by hybridization of cDNA to total RNA with southern blots of the procollagen clones. To clarify the mechanism by which type I procollagen gene transcription is abolished in transformed cells, the methylation patterns of the alpha 1(I) and alpha 2 procollagen genes in normal and SV40-transformed fibroblasts were compared, using the chicken alpha 1(I) and alpha 2 procollagen-cDNA clones as probes. Methylated sites were detected by means of the restriction endonuclease isoschizomers HpaII and MspI. Methylation of the procollagen alpha 1(I) and alpha 2 genes was increased in the SV40-transformed fibroblasts, concurrently with the loss of type I collagen synthesis. DNA methylation may thus contribute to altered regulation of gene expression upon cell transformation.

Cell Line↗