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PubMed2003

Mortality of migrants from the Indian subcontinent to England and Wales: effect of duration of residence.

BACKGROUND: Few studies have examined mortality of migrants by duration of residence in the country of destination. METHODS: I examined mortality of South Asian migrants by duration of residence in England and Wales. The cohort (N = 2,272, age 25-54 years in 1971) was followed from 1971 to 2000. RESULTS: All-cause mortality of South Asian migrants increased with increasing duration of residence in England and Wales. A yearly increase in duration of residence was associated with a hazard ratio of 1.07 (95% confidence interval [CI] = 1.02-1.13) among persons ages 25-34 years in 1971, 1.03 (1.00-1.07) among those ages 35-44 years, and 1.02 (1.00-1.05) among those ages 45-54. Cardiovascular disease mortality was the main component of this trend. Yearly increases in duration of residence were associated with cardiovascular disease mortality hazard ratios of 1.09 (1.03-1.16), 1.04 (1.00-1.09) and 1.02 (1.00-1.05) for the youngest, middle and oldest age groups, respectively. Comparable results were seen for coronary heart disease and for cancer mortality. Age at migration was positively related to mortality independent of duration of residence but the confidence intervals were wide. Adjusting for socioeconomic position did not alter these patterns. CONCLUSIONS: Cardiovascular and cancer mortality of South Asian migrants increased with duration of residence in England and Wales.

Adult↗
PubMed2004

Survey of dental prophylaxes rendered by pediatric dentists in New England.

BACKGROUND: The objective of this anonymous postal survey was to assess the provision of dental prophylaxis by pediatric dentists in New England. METHODS: The questionnaire survey was sent by first class mail in September, 2001 to all 217 American Academy of Pediatric Dentistry (AAPD) members in active private practice in the six New England States of Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island, and Vermont. A self-addressed, stamped envelope was provided to facilitate the returned response. RESULTS: The survey had a response rate of 70%. Most practitioners (93%) routinely recommended dental prophylaxis for their recall patients. The proportion of practitioners who considered the following indications for recommending dental prophylaxis was: plaque, stain, and/or calculus removal - 99%; caries prevention - 75%; prior to topical fluoride application - 82%; prior to sealant application - 58%; and for behavioral modification - 68%. Almost two thirds of the practitioners (62%) defined dental prophylaxis as referring to both rubber cup pumice prophylaxis as well as to toothbrush prophylaxis. However, only one in four practitioners (26%) had modified her/his clinical practice to substitute toothbrush prophylaxis in lieu of rubber cup pumice prophylaxis. CONCLUSION: Pediatric dentists in New England routinely provide dental prophylaxis to their recall patients.

Behavior Therapy↗
PubMed2003

Expanded newborn screening by tandem mass spectrometry: the Massachusetts and New England experience.

In February 1999, Massachusetts introduced expanded newborn screening for 20 rare metabolic disorders by MS/MS. Medium chain acyl-CoA dehydrogenase deficiency (MCADD) was mandated, in addition to 9 previously screened disorders, while the remaining 19 were offered as an optional pilot. Approximately 98% of parents have elected to participate in the optional program. Maine added MCAD in September 1999, and the optional disorders in July 2001. The other New England states are currently studying the benefits of adding additional testing. Expanded MS/MS screening in Massachusetts has thus far yielded a prevalence of approximately 1: 10,000 [200,000 screened--22 total cases--MCAD (7), VLCAD (1), SCAD (5), PA (2), 3-MCC (1), citrullinemia (1), ASA (1), argininemia (1), CPT11 (1) and 2 patients (argininemia and CPT11) with a severe neonatal presentation who died in the immediate newborn period]. All surviving patients have normal developmental outcomes so far. To evaluate the benefit of expanded newborn screening in the New England Region, the New England Consortium of Metabolic Centers has undertaken a prospective 3 year study, comparing the outcomes of patients identified by MS/MS with those diagnosed clinically. To date 22 screened patients (10 MCAD, 4 SCAD, 1 VLCAD, 1 CPT11, 13-MCC, 2 PA, 1 ASA, 1 citrullinemia and 1 argininemia) have been enrolled along with 24 clinically identified patients (7 MCAD, 1 SCAD, 1 VLCAD, 1 LCHAD, 1 argininemia, 1 tyrosinemia type 1, 6 PA, 3 GA 1, 2 GA 11, 1 MMA). Studies include: medical exam, neuropsychological assessment (Bayley Test and Stanford-Binet Test of Intelligence) and medical record review. Preliminary data suggest that the screened patients have an improved clinical outcome with fewer hospitalizations and so far, no neurological complications.

Algorithms↗
PubMed2005

The impact of the 2003 heat wave on daily mortality in England and Wales and the use of rapid weekly mortality estimates.

This paper describes a retrospective analysis of the impact of the 2003 heat wave on mortality in England and Wales, and compares this with rapid estimates based on the Office for National Statistics routine weekly deaths reporting system. Daily mortality data for 4 to 13 August 2003, when temperatures were much hotter than normally seen in England, were compared with averages for the same period in years 1998 to 2002. The August 2003 heat wave was associated with a large short-term increase in mortality, particularly in London. Ozone and particulate matter concentrations were also elevated during the heat wave. Overall, there were 2139 (16%) excess deaths in England and Wales. Worst affected were people over the age of 75 years. The impact was greatest in the London region where deaths in those over the age of 75 increased by 59%. Estimated excess mortality was greater than for other recent heat waves in the United Kingdom. The estimated number of deaths registered each week is reported by the Office for National Statistics. The first clear indication of a substantial increase in deaths was published on 21 August 2003. This provided a quick first estimate of the number of deaths attributable to the heat wave and reflected the pattern of daily deaths in relation to the hottest days, but underestimated the excess when compared with the later analysis.

Aged↗
PubMed2005

Geographical variations in fatal poisoning due to antidepressant drugs in England and Wales 1993-2003.

This article examines geographical variations in fatal poisoning due to antidepressant drugs in England and Wales between 1993 and 2003. The analysis looks at mortality rates for Government Office Regions and Wales and Strategic Health Authorities in England. Mortality rates were also considered in relation to antidepressant prescribing and deprivation. Throughout England and Wales, mortality rates due to antidepressant poisoning varied by area (Government Office Region and Strategic Health Authority), and were positively associated with area deprivation.

Antidepressive Agents↗
PubMed2005

Wound botulism in injectors of drugs: upsurge in cases in England during 2004.

Wound infections due to Clostridium botulinum were not recognised in the UK and Republic of Ireland before 2000. C. botulinum produces a potent neurotoxin which can cause paralysis and death. In 2000 and 2001, ten cases were clinically recognised, with a further 23 in 2002, 15 in 2003 and 40 cases in 2004. All cases occurred in heroin injectors. Seventy cases occurred in England; the remainder occurred in Scotland (12 cases), Wales (2 cases) and the Republic of Ireland (4 cases). Overall, 40 (45%) of the 88 cases were laboratory confirmed by the detection of botulinum neurotoxin in serum, or by the isolation of C. botulinum from wounds. Of the 40 cases in 2004, 36 occurred in England, and of the 12 that were laboratory confirmed, 10 were due to type A. There was some geographical clustering of the cases during 2004, with most cases occurring in London and in the Yorkshire and Humberside region of northeast England.

Botulism↗
PubMed2006

A survey of school dental screening practise in community dental services of England and Wales in 2003.

OBJECTIVE: To describe the school dental screening process in Community Dental Services across England and Wales. BASIC RESEARCH DESIGN: Cross-sectional study using a postal questionnaire. CLINICAL SETTING: Community Dental Services. PARTICIPANTS: Clinical Directors of Community Dental Services in England and Wales. MAIN OUTCOME MEASURES: Respondents answers about the objectives of school dental screening, criteria used for referring a child, methods of informing parents of screening results, and methods used to confirm subsequent dental attendance. RESULTS: The response rate for this study was 92.1%. Respondents identified dental registration (75.2%) and attendance at a dentist (82.9%) as objectives of school dental screening. Less than one third (29.5%) saw the activity as having a preventive role. Caries in the primary and secondary dentitions and soft tissue lesions were reported as key criteria for referral. Methods of follow-up of screened positive children differed and were often inadequate; approximately one third of respondents used a letter carried home by the child that did not allow parents to inform the CDS of action taken. Half of the respondents routinely collected data on the number of screened positive children who subsequently visit a dentist. CONCLUSIONS: School dental screening is delivered in a similar fashion throughout England and Wales but methods of informing parents of a positive screen and follow-up mechanisms for children with positive screens vary. Most school dental screening programmes do not collect sufficient data to evaluate the impact of their programmes on children's oral health.

Child↗
PubMed1991

[A review on mental health and psychiatric services in England].

Psychiatric care in Japan has received criticism not only within Japan but from other parts of the world. By contrast, the services for mentally ill in England is considered to be superior and is therefore presented briefly to benefit the development of better community psychiatric care in Japan. The history of psychiatric services in England is described briefly. After World War II, deinstitutionalization has been occurring and the in-patient rate per 100,000 population which was 354 in 1954 and has decreased to 120 in 1990. Despite a decrease in the in-patient rate, the admission rate per 100,000 population has been increasing gradually during this period. Deinstitutionalization process and the development of community care services are summarized. Among these are alternative services such as primary care, day care and residential services in the community which are considered to be important elements. Problems associated with deinstitutionalization process are also discussed. In developing community care services in Japan, lessons can be learned from the success and failures of England's attempt over the last 30-years to build a better, more community-based system.

Adolescent↗
PubMedDate not supplied

Report of the New England Task Force on Reducing Heart Disease and Stroke Risk.

Five years ago, a task force on reducing risk for heart disease and stroke was established by the six New England States. The task force included representatives from State public health departments, academia, the corporate sector, and voluntary organizations. This article is the final report of the task force. Heart disease and cerebrovascular disease are major causes of mortality in the New England region. Heart disease causes nearly 40 percent of all deaths in each of the six States and cerebrovascular disease, 7 percent of the deaths. Major risk factors for ischemic heart disease that have been identified--elevated serum cholesterol, high blood pressure, and cigarette smoking--are caused largely by lifestyle behaviors. Similarly, cerebrovascular disease results largely from uncontrolled high blood pressure, much of which is attributable to unhealthy lifestyle behaviors. In a series of studies evidence has accumulated that the reduction or elimination of these risk factors results in a decline in mortality rates. Many intervention programs have been mounted in the region, but there has been no population-wide effort to attack these risk factors. The task force proposed a broad range of activities for New Englanders at sites in the community and in health facilities. These activities would promote not smoking, exercising regularly, and maintaining desirable levels of serum cholesterol and blood pressure.

Adolescent↗
PubMed1989

Mortality from cardiovascular diseases in Chinese, Malays and Indians in Singapore, in comparison with England and Wales, USA and Japan.

Age-standardised death rates, for ages 35-64 years in both sexes, from ischaemic heart disease, cerebrovascular disease, and hypertensive disease for Chinese, Malays, and Indians in Singapore (1980-84) have been compared with those in England and Wales, USA and Japan (1982). For ischaemic heart disease Indians have the highest mortality, then Malays, with Chinese less than the Western countries but more than Japan. For cerebrovascular disease the Malays have highest mortality, then Indians, then Chinese, followed by Japan, England and Wales, and USA in that order. For hypertensive disease it is again Malays, then Indians, then Chinese, but followed by the different order of USA, England and Wales, and Japan. The differences are discussed in the light of declining trends in mortality from these disease in Singapore over the preceding 25 years. The special problems of ischaemic heart disease in Indians and hypertension and it's sequelae in Malays are highlighted.

Adult↗
PubMed1988

Dental health habits in Austria, England, Finland and Norway.

Individually, people can prevent dental caries by sugar restriction and periodontal disease by toothbrushing. The aim of this study was to determine the toothbrushing frequency and consumption of sweets and soft drinks in some European countries. The data were obtained during the winter of 1983-84 from schoolchildren aged 11.5, 13.5 and 15.5 in Austria, England, Finland and Norway. Except for England, the samples were nationally representative. The questionnaires were completed at school. Dental health habits apparently were best in Norway, as the toothbrushing frequency was highest and the consumption of sweets and soft drinks was lowest. The toothbrushing frequency of boys was lowest in Finland. The consumption of sweets and soft drinks was very high in Austria and England. Such international comparisons should be used when evaluating and directing national programmes of preventive dentistry.

Adolescent↗
PubMed1986

The prevalence of paratuberculosis in culled New England cattle.

The prevalence of bovine paratuberculosis in New England was determined to be 18% based on a random survey of abattoir cattle. Six tissues from each of 100 animals were examined by histologic and bacteriologic methods. The cecal lymph node and the ileocecal valve yielded positive cultures most frequently, but isolations were also made from liver, tonsil, colon, and ileum. On the basis of the prevalence data, the economic significance of paratuberculosis to the New England dairy industry was estimated in excess of +15.4 million annually. Field studies identified 25 infected herds in New England. One of the infected herds from Connecticut was sold at public auction, an act which resulted in the dissemination of 95 potentially infected cattle to 28 farms in 8 different states.

Animals↗
PubMed1986

The National Health Service and medical libraries in England.

This paper provides an overview of the National Health Service in England, including its history, its present structure, and factors that make it different from the U.S. health care system. The NHS libraries and librarians are discussed. The NHS is divided into fourteen regions in England. Three specific NHS libraries in the Wessex region are described--a hospital library, an administrative library, and a patient education library. The problems and accomplishments of NHS librarians are discussed, as well as some similarities between NHS libraries and U.S. medical libraries. Medical librarians are urged to try to understand the medical library scene in England, so that they can Learn from the unique strengths of their counterparts there.

England↗
PubMed1985

Swine trichinosis in New England slaughterhouses.

Diaphragms of 5,315 slaughter hogs from the New England states were examined for Trichinella spiralis infection between June 22 and Dec 22, 1983. Thirty-nine hogs (0.73%) were infected. The infections were light, none exceeding 30 larvae/g of tissue, with an arithmetic mean of 4.7 larvae/g. Infected hogs originated from 5 of 6 New England states. The widespread occurrence of porcine trichinosis in New England indicates that the small or part-time hog farming operations frequently found in this region may be especially vulnerable to the introduction and maintenance of the parasite.

Abattoirs↗
PubMed1984

MEDLARS utilization profile in New England.

The Northeastern Consortium for Health Information's Ad Hoc Committee on Online Statistics conducted a three-month MEDLARS utilization study in New England. Mailing lists from the New England Regional Medical Library Service and the New England Online Users Group were used to solicit participants. Seventy-four libraries submitted data on 8,899 MEDLARS searches. Each search was described by (1) type of institution; (2) occupation of requester; (3) purpose of search; (4) whether requester was a new or repeat user; (5) if the requester was from inside or outside the online center's institution; (6) fees-for-service; and (7) choice of vendor or vendors for accessing MEDLARS. Overall, patient care and research were the most frequently stated purposes of search; 44% of the searches were initiated by physicians.

Fees and Charges↗
PubMed1982

Failure to demonstrate the maintenance of leptospires by house mice (Mus musculus) in the south east of England.

A total of 272 house mice (Mus musculus) were trapped in farm buildings at four widely separated locations of south east England and examined for serological and bacteriological evidence of leptospiral infection. Only two low titres to autumnalis antigen (1:20 and 1:40) were recorded and all mice were bacteriologically negative. The absence of leptospiral infection in the house mouse in south east England is an interesting ecological finding, as this species is a maintenance host for ballum in many countries and also a common carrier of several other serovars. The source of ballum infections in domestic stock in England remains unknown.

Animals↗
PubMed1982

The geographical distribution of tuberculosis notifications in a national survey of England and Wales (1978-79). Report from the Medical Research Council Tuberculosis and Chest Diseases Unit.

A survey of tuberculosis notifications from 1 October 1978 to 31 March 1979 has provided a special opportunity to estimate annual notification rates in different ethnic groups for the 8 administrative areas of England and the 33 boroughs of Greater London. In addition it has been possible to calculate for each of the 54 counties and 403 local authorities of England and Wales the relative proportions of cases that were of White and non-White ethnic origin. Much of the considerable variation in the rates between the administrative areas of England, ranging from 5.2 per 100 000 in Anglia to 23.7 in the West Midlands, could be accounted for by the varying proportions of persons of Indian subcontinent ethnic origin for whom the notification rates were very high. Nevertheless the White rates also varied widely, from 4.2 per 100 000 in Anglia to 14.5 in the Northern area. The notification rate in Greater London was twice the national average, due in part to the fact that 40% of all non-White patients in the survey were resident there. Within the boroughs of Greater London the rates for all ethnic groups combined ranged from 7.0 in Bromley to 114.3 in Brent, a 16-fold difference. The highest rates occurred in the more densely populated areas. A large number of cases of Indian subcontinent ethnic origin was not necessarily associated with a high rate in the White population, nor vice versa.

Bangladesh↗
PubMed1994

Surveillance of HTLV infection in England and Wales: 1986-1992.

The epidemiology of infection with human T cell leukaemia/lymphoma virus (HTLV) types I and II in England and Wales between 1986 and 1992 has been studied. Two sources of data have been reviewed: reports of cases of infection received by the PHLS Communicable Disease Surveillance Centre, and information about people infected with HTLV-I and II provided on laboratory request forms sent to the Virus Reference Division of the PHLS Central Public Health Laboratory. Most patients were of Caribbean origin. The age and sex distribution of people with disease associated with HTLV-I and II in England and Wales resembles that previously recorded in the Caribbean. The data suggest that the prevalence of disease associated with HTLV infection is low in England and Wales, but case ascertainment may be incomplete.

Adult↗