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Biomedical subjects

N Andersson

Publications and source records attributed to N Andersson.

At least 55 records · Page 3Linked to original sources
PubMed1989

The state, class and the allocation of health resources in southern Africa.

In Africa the literature specifically linking the state, class and the allocation of health resources is sparse, and the evidential base for health research is inadequate and difficult to interpret. This paper looks at some of the ways in which state, class and health may be related in southern Africa. The region provides useful comparisons because of the starkness of the relationships between class and race and disease patterns and health care in much of the sub-continent; the different types of state and class structure within southern Africa; and the changes in ideology and to some extent health practice which came with the political independence of some of its component parts. Using both historical and contemporary data, it pinpoints the importance of analysing the specific and changing form of the state in the different countries of the region, in order to understand the social determinants of disease and the allocation of health resources, and looks at the significance of class, race, ethnicity and gender in the incidence of health and the state's response. It highlights the specific colonial legacies, continuing imperial linkages and location of countries in the international division of labour which inhibit changes in health care. Within the region, the migrant labour system and South Africa's aggressive policies of destabilisation create particular problems for weak states and for individuals within them attempting to implement more progressive health care programmes. The paper also argues that the ideological role played by health care has to be understood, and shows the diverse uses to which it is put across the region. The paper concludes that while the position of the state in the international and regional economy, its specific form and the nature of its class relations are predictors in some sense of health and health care, a variety of micro-level political and social decisions and mediations have also to be taken into account. While most of the countries of the region are in some sense part of the 'periphery', and a product of colonialism, these labels are insufficient to explain the differences between them in terms of disease patterns and health care systems. The specificities of internal social dynamics, local class ethnic and gender struggles and political conflicts are also crucial.

Africa, Southern↗
PubMed1988

Apartheid and health in the 1980s.

The last 5 years have seen dramatic developments in South Africa, with wide-based internal political struggles and international pressure forcing the government into a well publicized if temporary series of reforms. Yet this has not been paralleled by any substantial improvement in the health conditions of the majority of the population. Apart from improvements in black infant mortality in some urban areas, the health gap remains, a material expression of the social inequality that is part of the definition of apartheid. Black children continue to die from preventible afflictions at about 10 times the rate of their white counterparts. Maternal deaths among women classified as black, coloured or Asian continue to occur, mostly due to septic abortions. At national level, blacks are nearly 30 times more at risk of being diagnosed to have tuberculosis than whites, with some age groups being at still worse risk. Black children under the age of 4 years in Cape Town in 1984 were 205 times more likely to have tuberculosis than their white counterparts. The last 5 years has also seen a revival of rhetoric echoing the international support for primary health care in the 1970s, but health care processes have not been modified to cope with the continuing racial stratification of disease and access to health care. A move towards privatization of the health services has only benefited a few.

Black People↗
PubMed1988

Exposure and response to methyl isocyanate: results of a community based survey in Bhopal.

In the two weeks immediately after the Bhopal disaster a community based survey was carried out in a series of eight exposed and two non-exposed clusters of households. The primary concern was the effect of the gas (subsequently identified as methyl isocyanate) on the eyes of the victims but data were also sought on respiratory status and the first symptoms of the exposure. No case of blindness was encountered that could be attributed to the gas. The most frequent symptoms reported were burning of the eyes, coughing, watering of the eyes, and vomiting. Among these, the frequency of cough most closely followed the rate of death in the different clusters. Although much rarer overall, the frequency of reported diarrhoea appeared to bear a stronger relation to death rates. Reports of photophobia and the clinical finding of superficial interpalpebral erosion of the cornea were more frequent where the death rates were lower. This clinical and epidemiological picture is consistent with different effects of the gas at different doses (as estimated from distance from the factory).

Accidents, Occupational↗
PubMed1987

Controlled trial of respiratory health worker visiting patients with chronic respiratory disability.

Seventy five patients with chronic respiratory disability were randomised to a group visited by a respiratory health worker (42) or control group (33). The first group was visited monthly by a respiratory nurse, who gave education and support. The effect of the intervention was assessed in terms of quality of life (by questionnaires), the number and duration of admissions to hospital, and the number of deaths. The questionnaires on quality of life showed no changes in either group during the study, but nearly all of the group visited by a respiratory health worker said that they valued the visits and wished them to continue. Their knowledge about their condition also improved compared with that of the controls. The duration of stay in hospital for respiratory reasons in the group visited by a respiratory health worker was longer than that of control patients. This was explained by their being scored as more ill than the controls on admission. Fewer patients died in the group visited by a respiratory health worker than in the control group (p = 0.11). The patients in the group visited by respiratory health workers may have survived longer because they sought help rather than dying at home. If confirmed this could have implications for the cost of their care.

Aged↗
PubMed1987

Radiological irregular opacities and coalwork exposure: a case-referent study.

Five hundred and fifteen men newly attending chest clinics in coalmining areas of England and Wales were entered into a study of the risk of irregular opacities on the chest radiograph in relation to occupation; readable radiographs were received for 489. The men completed questionnaires on occupational and smoking history and the radiographs were read for irregular opacities by the collaborating chest physicians and by a panel of three readers using the ILO 1980 classification. Older men had more irregular opacities than younger men, but coalworkers had a significant excess risk of nearly three times of having irregular opacities, which remained after stratifying for smoking and age. Lung cancer was evident on 14% of the radiographs and was significantly less common in coalworkers than non-coalworkers. The findings are consistent with a causal association between coalwork exposure and irregular opacities. Other evidence suggests that these opacities are associated with emphysema in coalworkers.

Adult↗
PubMed1985

Acute toxicity of methyl isocyanate: a preliminary study of the dose response for eye and other effects.

Acute toxic effects of methyl isocyanate in the rat were determined for two hour exposures to concentrations in the range 11 ppm (very slight effect) to 65 ppm (lethality: pulmonary oedema). Changes in the eye, lungs, and behaviour were noted. Eye changes were confined to erosions of the corneal epithelium and were most severe at intermediate levels of exposure. A comparison was made of the effects noted in rats with reported effects on survivors of the Bhopal disaster. Urinary thiocyanate concentrations in exposed rats were found to be reduced relative to control values.

Animals↗
PubMed1984

Bhopal eye.

Explore the source record for details and available documents.

Accidents, Occupational↗
PubMed1984

A special cut-off gamma camera for high-resolution SPECT of the head.

A modern system for single photon emission computerized tomography has been modified in order to optimize examinations of the head. By cutting off part of the detector housing and collimators at one edge, it is possible to rotate the camera close to the skull while still covering the entire brain and the skull base. The minimum radius of revolution used in 32 patients was thereby reduced from about 20 cm to 12.7 +/- 0.8 cm. This, combined with an adjustment of the 64 X 64 matrix to a 26- by 26-cm field of view, resulted in an improvement of the spatial resolution from about 19 mm to 12.6 +/- 0.3 mm with a low-energy, all-purpose collimator, and to 10.4 +/- 0.3 mm (FWHM) with a low-energy, high-resolution collimator. The improved spatial resolution offers several clinical advantages in studies of the brain, the cerebrospinal fluid space, and the skull base.

Adult↗
PubMed1983

Prevalence and relation to underground exposure of radiological irregular opacities in South Wales coal workers with pneumoconiosis.

A total of 124 coal workers and ex-coal workers receiving disability benefit for coal worker's pneumoconiosis and routinely reattending the Cardiff Pneumoconiosis Medical Panel during a 10-week period were studied. Those with complicated pneumoconiosis were excluded. Their current chest radiographs and their chest radiographs at the time of certification were read in random order by three readers using the 1980 ILO Classification of Radiographs. An irregularity score was derived from the readings. The x-ray findings were examined for changes since certification and for relationships with age, smoking, and underground coal work exposure. One-fifth of the current radiographs showed mainly irregular opacities, whereas nearly all of those from the time of certification showed mainly irregular opacities, whereas nearly all of those from the time of certification showed mainly rounded opacities. Irregular opacities were related to age, smoking, and underground exposure. The exposure effect remained after excluding the older men. The findings suggest that radiological irregular opacities, and their associated pathology and lung function changes, commonly develop in coal workers with pneumoconiosis and should be considered part of the condition.

Adult↗