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R Philipp

Publications and source records attributed to R Philipp.

At least 19 recordsLinked to original sources
PubMed1994

Courses in environmental and occupational epidemiology.

The results of a survey are reported in which members of WHO's Global Environmental Epidemiology Network were asked for details of free-standing environmental and occupational epidemiology courses that were offered or planned for 1991-93 with tuition in English, French or Spanish and with places for persons living outside the countries concerned. Of the 126 courses on which information was received, 72 were open to health professionals from more than one discipline.

Curriculum↗
PubMed1993

Community needlestick accident data and trends in environmental quality.

New health-based indicators of environmental quality are being sought. In this search a retrospective analysis was undertaken for all persons in England and Wales who, during 1988-91, were given Hepatitis B Immune Globulin (HBIG) in prophylaxis against Hepatitis B infection after accidental percutaneous or permucosal exposure, and for whom a surveillance form was returned to the Public Health Laboratory Service Communicable Disease Surveillance Centre, England and Wales (PHLS CDSC). Although the number of adult HBIG doses issued during 1988-90 increased annually from 1,907 to 2,850, the percentage for which completed forms were returned fell during this time from 55% (1,043/1,907) to 31% (894/2,850). In 1991, 2,049 doses were issued and completed forms returned for 32% (653/2,049). From data on the completed and returned forms for 1988-91, 51% (1,805/3,535) of accidental exposures occurred in the community and 45% (1,604/3,535) in hospitals. Of the community exposures, 958 (53%) were needlestick accidents; 16% of them occurred 'in the street', 12% from 'contact with rubbish', 6% 'in the park', and 4% 'on the beach'. The findings confirm that discarded hypodermic syringe needles in the general environment are causing new public health problems. As the percentage of completed and returned forms has declined, and because HBIG is not recommended for needlestick accidents in the community where the source of the needle is unknown, HBIG surveillance forms are thought not to be a suitable source of data for continued monitoring of environmental quality.

Adult↗
PubMed1993

Perceptions and reactions of the public to diarrhoea.

A questionnaire about diarrhoea and how people react to it was answered by 400 people aged 16-70 years, most of whom were in employment (77% of respondents). There was wide variation in perceptions and reactions. Older persons and people in skilled trades were more likely to consider any increased bowel looseness or frequency of their usual bowel habit as diarrhoea, compared to younger persons and people in professional and managerial positions. Over half the respondents rated a single soft stool as diarrhoea, and almost a third accepted likewise an increased frequency of defaecation. The most unpleasant aspect of diarrhoea was considered to be incontinence with soiling of underclothes. At the onset of diarrhoea, 16% of respondents would not wait even a day or two but would go straight to a pharmacist, and 8% would go direct to a doctor. Persons in professional and managerial positions were less likely to attend their doctor straight away than people in other occupational groups. The findings show that for improved clinical management and public health surveillance, health professionals should not accept the term when it is used by patients, but seek details of their defaecation patterns and the form of their stools. Improved public education is needed as to self-help, appropriate treatment and when to seek pharmaceutical and medical advice.

Adolescent↗
PubMed1992

Problem-management questionnaires as a student learning tool in environmental medicine.

Environmental medicine can be defined as the science and art of medicine applied to the interaction between environment and health. In support of the WHO Health for All strategy, the educational programmes encourage closer links between epidemiology, clinical practice and environmental protection, and utilize problem-based learning. For tuition, problem-management questionnaires are a worthwhile tool to assist student learning. Examples are given and a model answer for one of these is appended. Their development, use and evaluation are described. They can be readily prepared from different clinical and environmental problems, and they help to meet identified needs in community-oriented medical education.

Education, Medical↗
PubMed1992

Understanding of Weil's disease among canoeists.

Although the risks of contracting Weil's disease in the UK are small, it can be a serious illness. Recently the disease has attracted public interest. This interest has prompted confusion and anxiety among recreational water user groups such as canoeists who had not previously seen themselves as being particularly at risk. In this paper, the experience of symptoms associated with Weil's disease among canoeists, their understanding and perceptions of the disease, and their compliance with preventive advice on the British Canoe Union (BCU) warning card, have been studied. Gaps in understanding and of adherence to preventive advice were identified. Accordingly, it was concluded that health education for canoeists could be improved. Consideration is being given by the BCU to the value of preparing a canoeist instructors' training pack.

Adolescent↗
PubMed1992

Which way for housing and human settlements?

In order to clarify the housing and settlements component of the European health-for-all programme and to identify perceived priorities with a view to the preparation of training materials, members of WHO's Rural and Urban Development and Housing Network were invited to complete a questionnaire. The results are reported below. The questionnaire can be used in identifying local development priorities, comparing attitudes, and studying perceived needs. Intended as a tool for policy-makers, course organizers and public health professionals, it is available from the authors of the present article.

City Planning↗
PubMed1991

Spatial arrangement of coenzyme and substrates bound to L-3-hydroxyacyl-CoA dehydrogenase as studied by spin-labeled analogues of NAD+ and CoA.

The synthesis of nitroxide spin-labeled derivatives of S-acetoacetyl-CoA, S-acetoacetylpantetheine, and S-acetoacetylcysteamine is described. These compounds are active substrates of L-3-hydroxyacyl-CoA dehydrogenase [(S)-3-hydroxyacyl-CoA:NAD+ oxidoreductase, EC 1.1.1.35] exhibiting vmax values from 20% to 70% of S-acetoacetyl-CoA itself. S-Acetoacetylpantetheine and S-acetoacetylcysteamine form binary complexes with the enzyme and exhibit ESR spectra typical for immobilized nitroxides. In the case of spin-labeled pantetheine, the radical is more mobile. When spin-labeled substrates are bound simultaneously to each active site of this dimeric enzyme, spin-spin interactions differentiate between two alternate orientations of the substrate [Birktoft, J.J., Holden, H.M., Hamlin, R., Xuong, N.H., & Banaszak, L.J. (1987) Proc. Natl. Acad. Sci. U.S.A. 84, 8262-8266]. The fatty acid moiety is thought to be located in a cleft between two domains whereas a large part of the CoA moiety probably extends into the solution. NAD+, spin-labeled at N6 of the adenine ring, is an active coenzyme of L-3-hydroxyacyl-CoA dehydrogenase (60% vmax). Complexes with the enzyme exhibit ESR spectra typical of highly immobilized nitroxides. Binding of coenzyme NAD+ causes conformational changes of the binary enzyme/substrate complex as revealed by changes in the ESR spectrum of spin-labeled S-acetoacetylpantetheine.

3-Hydroxyacyl CoA Dehydrogenases↗
PubMed1990

Environmental health training within public health medicine.

Environmental health was reported in the UK Acheson Report to have 'become something of a backwater for public health doctors'. In this review, the background educational issues are explored, present postgraduate training opportunities are identified, and intersectoral approaches in Europe that support the WHO Health for All strategy, are outlined. It is anticipated that closer links between epidemiology, clinical practice and environmental protection in the 'new' public health will help to improve medical interest and input to environmental health.

Curriculum↗
PubMed1990

An evaluation of undergraduate occupational health teaching.

It has been reported that at present, UK medical schools do not have a uniform approach to undergraduate occupational health teaching. Consequently, a suggested educational framework for this teaching has been prepared. In this study a problem management questionnaire was used to evaluate a course based on this framework. Patterns of student understanding about hazards, risk groups, and staff responsible for occupational health in the hospital environment, were compared before and after the courses. This environment was chosen for study because after graduation all doctors work for some time in hospitals and different doctors may treat hospital staff for problems acquired at work. The findings show that although specific teaching of hospital occupational health is not given, students grasp the introductory concepts and then modify their approaches to the prevention and clinical care of health problems associated with hospital employment. In particular, they become more aware of different risk groups and the sources of professional advice. Findings from such studies before and after tuition, help tutors to identify gaps in knowledge and can be used with student groups to reinforce their interest in learning.

Curriculum↗
PubMed1990

Information needs of patients and visitors in a district general hospital.

A survey of the information needs of patients and visitors to a large District General Hospital was conducted during a one-month period in 1988 to identify sources of information used by patients and their visitors, whether these sources were perceived as adequate and what improvements were suggested. The findings indicate that of 406 respondents, 37% had wanted to know more about a particular condition within the preceding 12 months. The most frequently used sources of information were general practitioners, hospital doctors and nurses, and written material. The most frequent inquires were about disease aetiology and prevention, and the treatment and prognosis of a wide range of medical conditions. Thirty-six per cent of the inquirers had received little or none of the information that they sought. Visitors were more likely than patients to be dissatisfied with presently available sources of information, and patients over 60 years old were more likely to be satisfied than younger groups. Dissatisified persons were most often seeking improved access to doctors and nurses, more explanations from these staff, and more readily available booklets and leaflets. The results are discussed in relation to previous findings with hospital in-patients. They support a stated need in the recent Government White Paper, Working For Patients, for patient information leaflets and for clear and sensitive explanations about what is happening to them in hospital.

Adolescent↗
PubMed1989

Sick doctors.

Explore the source record for details and available documents.

Humans↗
PubMed1989

Leptospiral and hepatitis A antibodies amongst windsurfers and waterskiers in Bristol City Docks.

Previous epidemiological studies have detected a substantial risk of gastroenteritis associated with snorkel swimming events in the Bristol City Docks. The event has since been discontinued. Similar risks were not identified at that time for surface-based events. A subsequent fatality from Weil's disease (Leptospirosis) and a case of Hepatitis A associated with surface water immersion in the Bristol City Docks water prompted this study of Leptospiral and Hepatitis A immunity amongst regular windsurfers and waterskiers. Although one person showed evidence of past Leptospiral infection and several people showed evidence of previous Hepatitis A, a causal association with Docks water exposure was not established. Nevertheless, there was sufficient public concern to justify the introduction of precautions against the potential health risks associated with immersion in the City Docks. The study findings and these preventive measures are described.

Adolescent↗