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Biomedical subjects

R A Lyons

Publications and source records attributed to R A Lyons.

50 records · Page 3Linked to original sources
PubMed1994

Successful control of a school based measles outbreak by immunization.

In an outbreak of measles in North Wales centred on a secondary school in 1991, 74 cases occurred over a period of 51 days. Before the outbreak started, 27% pupils did not have a history of measles or immunization and were considered susceptible. Active case finding and identification and vaccination of susceptible contacts commenced after the fourth generation of cases and further reduced the pool of susceptible schoolchildren from 17%, at the onset of the vaccination campaign, to 8%. A fifth generation of cases did not occur. Delays in diagnosis (mean 2.8 days) and notification (mean 6.1 days) hampered control. There was no evidence of primary vaccine failure (observed vaccine efficacy 97%). Sixty-nine (93%) cases were considered preventable. Reasons for the apparent success of the intervention are discussed.

Adolescent↗
PubMed1994

Evidence for the validity of the Short-form 36 Questionnaire (SF-36) in an elderly population.

The objective of this study was to determine whether the Short-form 36 Health Status Questionnaire (SF-36) is suitable for use in an elderly population. The SF-36 was administered by interview to a random sample of 827 adults from West Glamorgan. Among the 216 adults aged 65 and over the data were 98.8% complete. Evidence for a high degree of internal consistency was good with Cronbach's alpha statistic exceeding 0.8 for each parameter. The evidence for construct validity was also good with the SF-36 distinguishing between those with and without markers of poorer health. The SF-36 is suitable for use with an elderly population when used in an interview setting.

Activities of Daily Living↗
PubMed1994

Comparative health status of patients with 11 common illnesses in Wales.

OBJECTIVE: To assess the health status of patients with 11 common illnesses--asthma, diabetes, arthritis, back pain, sciatica, hypertension, angina, anxiety, depression, and heart attack and stroke. DESIGN: Face to face interview using a structured questionnaire which contained the Short Form 36 questionnaire (SF-36) and questions on lifestyle, health service utilisation, and self reported conditions treated by physicians. SETTING: Patients' homes, in West Glamorgan, Wales. SUBJECTS: Twelve hundred adults, aged 20-89 years, were randomly selected from the register of the family health services authority. MAIN OUTCOME MEASURES: The eight scales within the SF-36 health profile. RESULTS: The response rate was 82%. Each illness had a distinctive profile; patients with anxiety or depression reported the worst health experience in role limitations because of emotional problems and mental health, while patients with back pain, arthritis, or sciatica registered the three highest negative scores in bodily pain and role limitations due to physical problems. For all disease groups, the general health perceptions of those with the disease was significantly worse than those without it (p < 0.01). CONCLUSIONS: The SF-36 allows comparison of the health status of patients suffering from different conditions. Data such as these can be used to inform better purchasing decisions on how resources might be more effectively deployed and as a bench mark to monitor the effects of multiple health care interventions by conducting serial surveys.

Adult↗
PubMed1992

Passive smoking and hearing loss in infants.

A cohort of infants scheduled to attend the 10 month developmental assessment were studied to determine whether hearing deficits are more common in those exposed to cigarette smoke. Hearing was assessed by the standard distraction test and those with persistent abnormalities were referred to a medical audiologist. Overall 77% of infants were exposed to cigarette smoke and 40% failed the initial hearing tests. Exposure to cigarette smoke was associated with a 4.9 times increase in the prevalence of hearing deficits and 75% of the cases of hearing loss were statistically attributable to exposure to cigarette smoke. The results of this study lend further weight to the hypothesis that exposure to cigarette smoke is a cause of hearing deficits in children.

Hearing Disorders↗
PubMed1992

General practice estimates of the prevalence of common chronic conditions.

This study measured the prevalence of chronic medical conditions in 4,549 middle aged persons attending three large general practices in Dublin over the course of a calender year. The prevalence of the following conditions were measured: coronary heart disease, hypertension, stroke, diabetes, asthma, chronic bronchitis, rheumatic disorders, dyspepsia, depression, anxiety disorders, psychoses, and cancer. In order to obtain a valid denominator for the study a second community based study was carried out in the same areas to determine what proportion of persons visit their general practitioner over the course of a year. Overall 40.5% of males and 44% of females suffered from a least one of the twelve conditions, with rheumatic disorders having the highest prevalence (14.5%) and psychotic disorders the lowest (0.75%).

Adult↗
PubMed1992

An explanation for the difference in general practitioner consultation rates between GMS and non-GMS patients.

This study compares annual consultation rates between 3,111 General Medical Services and private patients, and their family doctors in three large general practices in Dublin. Visiting rates were substantially different between practices and between GMS and private patients. However, GMS patients were older and had 50% more chronic illnesses. When the effects of age and illness were controlled in a multiple regression model, GMS status accounted for less than 5% of the variation in visiting rates. GMS patients consult their practitioners in proportion to their medical need.

Adult↗
PubMed1991

Community health service utilisation and needs in an elderly population.

This study was carried out to determine community health service utilisation and needs of an elderly population living in a geographically defined area of Dublin. A random sample of 208 persons was taken from the 11,852 elderly persons living in the area. Activities of daily living and cognitive function were assessed in the person's own home. Whilst the community health services provided were less than comprehensive, they were targeted to those most in need; the very elderly, those living alone, and persons with a mental or physical disability. Objectively assessed need for further services far outweighed the demand for such services. Studies such as this are essential if the elderly are to receive their fair share of services in a demand based health service.

Aged↗
PubMed1991

A large outbreak of salmonellosis and its economic cost.

In the summer of 1989, a large outbreak of gastroenteritis occurred in persons attending a barbeque. An investigation was carried out to determine the cause, institute control measures, and to estimate the costs involved in the outbreak. Epidemiological investigation revealed that chicken served at the barbeque was the pecant food, which was confirmed by microbiological investigation. Prompt institution of control measures resulted in early containment of secondary spread. Nevertheless, the total cost of the outbreak amounted to 77,995 pounds. The economic impact of this outbreak was therefore considerable.

Diarrhea↗
PubMed1990

Psychological distress in carers of dementia sufferers.

This study compares dementia sufferers and their carers referred to an old age psychiatry service with a non-referred group from the same community. It examines the level of stress in the carer with the age and sex of the carer, and with the degree of physical disability and cognitive impairment in the person with dementia. There was no difference between the two groups in the prevalence of stress but overall 65% of carers experienced significant levels of stress. Females and younger carers were more likely to experience stress. Stress in the carer was associated with high levels of physical disability but not with the degree of cognitive impairment. This study shows that considerable psychological distress occurs among carers of those with dementia in the community. If government policy of maintaining people with dementia in the community is to be pursued, measures to relieve carers must be included when planning services for this vulnerable group.

Adolescent↗
PubMedDate not supplied

Social class and chronic illness in Dublin.

Information on the social class distribution of illness is scarce in Ireland. The aim of this study was to document the social class distribution of 12 common chronic conditions in middle-aged persons in Dublin. Data were collected on 3,111 individuals attending three large general practices over the course of a calendar year, and 1,024 individuals living in the same areas. Ten out of the 12 conditions studied were significantly more common in those from social classes five and six, than those from social classes one and two. Persons from social classes three and four, classes five and six, had an overall excess morbidity rate of 21% and 70% respectively. The distribution of chronic illness in middle-aged residents of Dublin is social class related.

Chronic Disease↗