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Biomedical subjects

R Madeley

Publications and source records attributed to R Madeley.

17 recordsLinked to original sources
PubMed1995

How do economic status and social support influence survival after initial recovery from acute myocardial infarction?

There is much interest in the influence of psychosocial factors and social deprivation on health. This study investigates the influence of economic status (as measured by car-ownership) and social support on survival after acute myocardial infarction (AMI). In addition, the possible influence of stressful life events and satisfaction with home, social and working/retirement life is also assessed. Cases with suspected AMI were identified through the Anglo-Scandinavian Study of Early Thrombolysis (ASSET). 1701 English patients completed a questionnaire. Patients were followed for between 4.7 and 6.3 years, with the single outcome measure being death from all causes. 1283 patients surviving 7 days were included in presented statistical analyses using Cox's regression. After adjusting for a broad range of clinical variables, patients with no car were at approximately 40% higher risk of dying following AMI than car-owners (hazard ratio 1.4, P = 0.007, 95% CI 1.1-1.8). Lack of social contacts or being unmarried were not significantly associated with survival after adjusting for car-ownership and clinical variables. Economic status and survival after AMI are associated. With the dominant psychosocial prognostic indicator in this study being economic status, attention focuses on the growing gap between the socially deprived and the more affluent, and its effects on health.

Aged↗
PubMed1994

An evaluation of a new teenage clinic and its impact on teenage conceptions in Nottingham from 1986 to 1992.

A new contraceptive clinic for teenagers was developed in the centre of Nottingham from 1987 to 1992 and provided care for over 1500 young people in its first three years. Twenty-five percent of clients were aged 16 years and 32% aged 15 or younger. Sixty-seven percent were in full-time education and young unemployed people were under-represented. The majority were young women, who came for routine contraception, usually the oral contraceptive or condom. Seventeen percent came for emergency contraception and 8% for abortion counselling and referral. Over the period 1986 to 1992, data on conceptions for teenage women and women aged over 20 years, who were resident in Nottingham Health district, were compared and when corrected for the estimated population showed that there had been no reduction in teenage conception rates; reasons for this are discussed. The value of conception rates as a measure of quality of sexual health care for teenagers is questioned and other more qualitative methods suggested.

Abortion, Induced↗
PubMed1993

Characteristics associated with smoking cessation during pregnancy among working class women.

Although smoking prevalence among pregnant women is highest among those of lower socio-economic status, the factors associated with cessation in this high risk group are poorly documented. This paper reports on data from a survey of working class women in Nottingham and Coventry, who were interviewed 6 months after having delivered a baby. It compares the characteristics of the 32 women who quit smoking during their pregnancy and were still ex-smokers at the 6 month post-natal point, with 472 women who had continued to smoke during their pregnancy or had returned to smoking in the post-partum period. A logistic regression analysis revealed three variables that were independently associated with long term cessation-having previously quit for more than 1 week, having a non-smoking partner, and believing that the children of smokers are more likely to get infections. Among the most disadvantaged, an understanding of how close social ties and economic circumstances influence smoking behaviour is crucial, if we are to develop more effective smoking cessation intervention strategies for working class women.

Adolescent↗
PubMed1991

Electron microscopic reporting of gastrointestinal viruses in the United Kingdom, 1985-1987.

We examined some epidemiological features of the viruses associated with gastrointestinal illness, using national data reported by electron microscopists in the United Kingdom. During the 3 years analyzed (1985-1987), a total of 1,993 positive detections of astroviruses, caliciviruses, coronaviruses, and small round structured viruses (SRSVs) were reported. In 1 year of this period, 8,210 rotaviruses were reported. More than 90% of the astroviruses and caliciviruses were detected in children under 5 years of age, while coronaviruses and SRSVs were detected in adults as well as children. Detections of astroviruses increased in the winter and were infrequent during the summer, a seasonal pattern similar to that observed for rotaviruses. There was some variability between reporting regions in rates of detection of fecal viruses. We have attempted to identify the reasons for this. We make suggestions for improving the detection of human fecal viruses, and we recognize the need for continued surveillance of these agents.

Adolescent↗