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Biomedical subjects

S Openshaw

Publications and source records attributed to S Openshaw.

At least 19 recordsLinked to original sources
PubMed2001

Effect of acupuncture on nausea of pregnancy: a randomized, controlled trial.

OBJECTIVE: To compare acupuncture with sham (placebo) acupuncture for treatment of nausea of pregnancy. METHODS: In a subject- and observer-masked, randomized, controlled trial in the maternity unit at Exeter Hospital, we gave 55 women between 6 and 10 weeks' gestation genuine, traditional-style acupuncture or sham treatment with a cocktail stick on three or four occasions over 3 weeks. The main outcome measure was nausea score, as determined by subject report on a visual analogue scale in a daily diary. Anxiety and depression also were assessed. RESULTS: Nausea scores decreased from a median of 85.5 (interquartile range 71.25-89.75) to 47.5 (interquartile range 29.25-69.5) in the acupuncture group and from 87.0 (interquartile range 73.0-90.0) to 48.0 (interquartile range 14.0-80.0) in the sham treatment group. There was strong evidence of a time effect (P <.001) but no evidence of a group effect (P =.9) or a group-time interaction (P =.8). Similarly, there was evidence of time effects in scores for anxiety and depression but no group differences. The study had a power of 95% to detect significant differences in nausea scores. CONCLUSION: Acupuncture was as effective in treating nausea of pregnancy as a sham procedure.

Acupuncture Therapy↗
PubMed2000

Efficient marker-based recurrent selection for multiple quantitative trait loci.

We studied the efficiency of recurrent selection based solely on marker genotypes (marker-based selection), in order to increase favourable allele frequency at 50 previously detected quantitative trait loci (QTLs). Two selection procedures were investigated, using computer simulations: (1) Truncation Selection (MTS), in which individuals are ranked based on marker score, and best individuals are selected for recombination; and (2) QTL Complementation Selection (QCS), in which individuals are selected such that their QTL composition complements those individuals already selected. Provided QTL locations are accurate, marker-based selection with a population size of 200 was very effective in rapidly increasing frequencies of favourable QTL alleles. QCS methods were more effective than MTS for improving the mean frequency and fixation of favourable QTL alleles. Marker-based selection was not very sensitive to a reduction in population size, and appears valuable to optimize the use of molecular markers in recurrent selection programmes.

Alleles↗
PubMed1999

Teaching biomedical applications to secondary students.

Certain aspects of biomedical engineering applications lend themselves well to experimentation that can be done by high school students. This paper describes two experiments done during a six-week summer internship program in which two high school students used electrodes, circuit boards, and computers to mimic a sophisticated heart monitor and also to control a robotic car. Our experience suggests that simple illustrations of complex instrumentation can be effective in introducing adolescents to the biomedical engineering field.

Adolescent↗
PubMed1995

Geodemographic segmentation systems for screening health data.

AIM: To describe how geodemographic segmentation systems might be useful as a quick and easy way of exploring postcoded health databases for potential interesting patterns related to deprivation and other socioeconomic characteristics. DESIGN AND SETTING: This is demonstrated using GB Profiles, a freely available geodemographic classification system developed at Leeds University. It is used here to screen a database of colorectal cancer registrations as a first step in the analysis of that data. RESULTS AND CONCLUSION: Conventional geodemographics is a fairly simple technology and a number of outstanding methodological problems are identified. A solution to some problems is illustrated by using neural net based classifiers and then by reference to a more sophisticated geodemographic approach via a data optimal segmentation technique.

Cluster Analysis↗
PubMed1994

Do interventions that improve immunisation uptake also reduce social inequalities in uptake?

OBJECTIVE: To investigate whether an intervention designed to improve overall immunisation uptake affected social inequalities in uptake. DESIGN: Cross-sectional small area analyses measuring immunisation uptake in cohorts of children before and after intervention. Small areas classified into five groups, from most deprived to most affluent, with Townsend deprivation score of census enumeration districts. SETTING: County of Northumberland. SUBJECTS: All children born in country in four birth cohorts (1981-2, 1985-6, 1987-8, and 1990-1) and still resident at time of analysis. MAIN OUTCOME MEASURES: Overall uptake in each cohort of pertussis, diphtheria, and measles immunisation, difference in uptake between most deprived and most affluent areas, and odds ratio of uptake between deprived and affluent areas. RESULTS: Coverage for pertussis immunisation rose from 53.4% in first cohort to 91.1% in final cohort. Coverage in the most deprived areas was lower than in the most affluent areas by 4.7%, 8.7%, 10.2%, and 7.0% respectively in successive cohorts, corresponding to an increase in odds ratio of uptake between deprived and affluent areas from 1.2 to 1.6 to 1.9 to 2.3. Coverage for diphtheria immunisation rose from 70.0% to 93.8%; differences between deprived and affluent areas changed from 8.6% to 8.3% to 9.0% to 5.5%, corresponding to odds ratios of 1.5, 2.0, 2.5, and 2.6. Coverage for measles immunisation rose from 52.5% to 91.4%; differences between deprived and affluent areas changed from 9.1% to 5.7% to 8.2% to 3.6%, corresponding to odds ratios of 1.4, 1.4, 1.7, and 1.5. CONCLUSION: Despite substantial increase in immunisation uptake, inequalities between deprived and affluent areas persisted or became wider. Any reduction in inequality occurred only after uptake in affluent areas approached 95%. Interventions that improve overall uptake of preventive measures are unlikely to reduce social inequalities in uptake.

Cohort Studies↗
PubMed1994

Are multidimensional social classifications of areas useful in UK health service research?

OBJECTIVES: To show the advantages and disadvantages of a multi-dimensional small area classification in the analysis of child health data in order to measure social inequalities in health and to identify the types of area that have greater health needs. DESIGN: Health data on children from the district child health information system and a survey of primary school children's height were classified by the census enumeration district of residence using the Super profiles neighbourhood classification. SETTING: County of Northumberland, United Kingdom. SUBJECTS: One cohort comprised 21,702 preschool children age 0-5 years resident in Northumberland, and another cohort 9930 school children aged 5-8.5 years. MAIN OUTCOME MEASURES: Variations between types of area in the proportions of babies with birthweight less than 2.8 kg; births to mothers aged less than 20 years; pertussis immunisation uptake; child health screening uptake; and mean height of school children. RESULTS: Areas with the poorest child health measures were those which were most socially disadvantaged. The most affluent areas tended to have the best measures of health, although rural areas also had good measures. Problems in analysis included examples of the "ecological fallacy", misleading area descriptions, and the identification of the specific factors associated with poor health measures. Advantages included a wider view of social circumstances than simply "deprivation" and the ability to identify characteristic types of areas with increased child health needs. CONCLUSIONS: There is a limited place for multidimensional small area classifications in the analysis of health data for both research and health needs assessment provided the inherent drawbacks of these data are understood in interpreting the results.

Child↗
PubMed1993

Measurement of social inequalities in health and use of health services among children in Northumberland.

Social inequalities in a variety of indicators of child health were measured using a 'small area' geographical method of social classification. Cross sectional analyses of routine child health information and of a population survey of the height of primary school children were used. Social classification was by census enumeration district of residence using the Townsend deprivation score. Over 21,000 children resident in Northumberland born between January 1985 and September 1990, and 9930 children aged 5-8.6 years in Northumberland schools were studied. The following differences between the most deprived 10% of areas and the most affluent 10% of areas were used as outcome measures: the proportion of birth weights less than 2800 g; the proportion of births to teenage mothers; the proportion of 15 month old children not immunised against pertussis; the proportion of infants not screened at 6 weeks of age; the proportion of children not screened at 18 months of age; and the mean height of children in SD scores. Between the most deprived and most affluent areas birth weights less than 2800 g varied from 18 to 11%, the percentage of teenage mothers from 18 to 3%, non-immunised children from 30 to 19%, children not screened at 18 months from 21 to 14%, and mean height from -0.2 SD scores to +0.1 SD scores. The area variation in screening at 6 weeks of age was less, but still poorer in deprived areas. It is concluded that small area methods are effective in showing inequalities in child health, even in a rural area where such methods might be expected to perform less well. Social inequalities in all the aspects of child health measured remain evident.

Adolescent↗
PubMed1993

Cancer in young people in the north of England, 1968-85: analysis by census wards.

OBJECTIVE: To determine whether the seeming excess of childhood leukaemia and lymphoma identified in Seascale, Cumbria, UK, remains unusual when put into a wider context. DESIGN: Analysis of cancer incidence by geographical area. SETTING: The north of England including the Northern and North Western Regional Health Authority regions and the Southport and South Sefton districts of the Mersey Regional Health Authority. SUBJECTS: Altogether 6686 cases of malignant disease in people under 25 years old. MEASUREMENTS AND MAIN RESULTS: Cases of cancer diagnosed before their 25th birthday between January 1968 and December 1985 identified from three regional cancer registries were allocated to a census ward on the basis of 'usual place of residence'. Population data were derived from the 1971 and 1981 censuses, and the cancer incidence was calculated for each ward. Of the 6686 cases, there were 1035 cases of acute lymphoblastic leukaemia and 361 of non-Hodgkins lymphoma. Wards were ranked by cancer incidence and Poisson probability, using different population bases. Seascale ward is the most highly ranked ward for acute lymphoblastic leukaemia for the time periods 1968-85 or 1968-76. It is not the most highly ranked for non-Hodgkins lymphoma. However, combining acute lymphoblastic leukaemia and non-Hodgkins lymphoma incidence gives an even more extreme position for Seascale. The most extreme Poisson probability for any of the analyses was that for brain tumours in the electoral ward of Ashton St Michael, Tameside (p = 0.000009). CONCLUSION: The incidence of acute lymphoblastic leukaemia and non-Hodgkins lymphoma in the Seascale ward remains high when put into a wider context. For other cancers there are wards with even more extreme Poisson probability values.

Adolescent↗
PubMed1993

Do inaccuracies in small area deprivation analyses matter?

OBJECTIVE: To assess the accuracy of computerised matching of postcode to enumeration district (ED) and to determine whether any mismatching reduces the validity of methods to distinguish socioeconomic differences in "small area" deprivation studies. DESIGN: Computerised and manual matching of postcodes to EDs were compared and the census based Townsend deprivation score was compared with socioeconomic data on individual families. SETTING: County of Northumberland, England, 1989. SUBJECTS: Random sample of 301 families with a child aged less than 15 months. MAIN RESULTS: With computerised matching only 47% of postcodes were matched to the correct ED. Eighty per cent of the deprivation scores of the computer matched EDs, however, approximated (+/- 2) to the deprivation score of the actual ED. When EDs were divided into quintiles according to the deprivation score, accurate manual matching showed that 75% of families in the most deprived EDs were classed as deprived compared with 4% in the most affluent EDs. With the inaccuracies introduced by computer matching of postcodes, the corresponding figures were 56% and 12% respectively. CONCLUSIONS: Computerised matching of postcodes to EDs is highly inaccurate, but this has little effect on the allocation of deprivation scores. The socioeconomic inequalities shown by the deprivation score are blunted, but not eradicated, by this mismatching.

Computers↗
PubMed1990

Measuring child health inequalities using aggregations of Enumeration Districts.

In demonstrating health variations between different areas in a district, it is conventional to use local authority ward-to-ward variations. In rural districts, because wards have small, heterogeneous populations, this method is less useful. We have investigated alternative ways of showing variations in child health by using different aggregations of Enumeration Districts (ED) in a small, sparsely populated rural area. EDs were aggregated first by a cluster analysis based classification (Super Profiles) and second according to a material deprivation score (the Townsend score). Both methods of aggregation showed similar variations between areas in the proportion of babies with low birthweight, the proportion of teenage mothers, immunization coverage and six-week screening examination coverage. Both methods discriminated better than a straightforward ward-based analysis. Neither method was clearly superior to the other. It is concluded that for both epidemiological research and for health service information purposes, either of these methods of ED aggregation has definite advantages over ward-based analyses in rural areas.

Adolescent↗
PubMed1985

Childhood cancer in the Northern Region, 1968-82: incidence in small geographical areas.

The place of residence of all cases of childhood cancer occurring in the Northern Region from 1968 to 1982 has been analysed by electoral wards. The wards have been ranked according to rate and Poisson probability. Both rankings show a wide geographical scatter throughout the region of areas with an apparent excess incidence of cancer. These areas are not confined to the Cumbrian coast.

Adolescent↗