Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ENGLAND”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources
PubMed2005

An outbreak of tuberculosis in the South West of England related to a public house.

There had been a continuous decline in Mycobacterium tuberculosis infection (TB) during the last century until the trend plateaued in the mid-1980's and started to increase in the early 1990's in the United Kingdom (UK). In England and Wales the incidence of TB has increased by 11% between 1993 and 1998 with an overall incidence equal to 10.9/100,000 population. In the South West (SW) of England the incidence of TB is less than the UK average (4.6/100,000). We report an outbreak of TB in the SW of England which was based around a local public house. Sixteen patients received treatment and thirteen received chemo-prophylaxis. Using a rapid IS6 110- based PCR and Restricted Fragment Length Polymorphism Method, all mycobacteria isolated were shown to be identical, and all cultures were sensitive to the usual anti-mycobacterial drugs. All patients were white Caucasians and none were from high risk groups. Despite the absence of conventional close household contacts a significant number of secondary cases were detected. Possible links between TB cases should be considered even in areas of low prevalence.

Journal Article↗
PubMed2005

Developing the public health practitioner workforce in England: lessons from theory and practice.

FOCUS: The paper focuses on public health practitioners who collectively represent one of three key workforce groups identified by England's Chief Medical Officer as critical to the successful delivery of national public health policy priorities. QUESTION: We report on two areas of work which attempt to address the following two-part question: in developing the public health practitioner workforce in England, what is needed, and how do we do it? APPROACH: First, we describe a five-component conceptual framework for developing the public health workforce which is grounded in data derived from a national Open Space event hosted by the University of the West of England in March 2005. The five components are (i) strategic support and oversight; (ii) national technical and professional support; (iii) national career building; (iv) local organisational development, and (v) sub-regional skills development. Key elements of each component are described in the paper. Second, we describe in some detail a new multidisciplinary skills development programme which illustrates one of the framework components (sub-regional skills development). The programme, established in January 2005, is aimed at three key groups of public health practitioners: health visitors (specialist community public health nurse), school nurses and environmental health officers. Its main features and some initial evaluation findings are presented. CONCLUSIONS: To be effective, activities aimed at supporting the development of the public health practitioner workforce should, where possible, aim to be congruent with core public health principles of self-determination and collective responsibility. We also conclude that leadership and vision at a national level, combined with local implementation of evidence-based training programme such as the one described could help to achieve much greater and more rapid progress in skilling up the existing public health practitioner workforce than has been possible up to now. But we note that this requires sustained investment, robust sector-wide delivery frameworks, and a group of committed local public health champions.

Humans↗
PubMed2006

Social inequalities in male mortality, and in male mortality from smoking: indirect estimation from national death rates in England and Wales, Poland, and North America.

BACKGROUND: There are substantial social inequalities in adult male mortality in many countries. Smoking is often more prevalent among men of lower social class, education, or income. The contribution of smoking to these social inequalities in mortality remains uncertain. METHODS: The contribution of smoking to adult mortality in a population can be estimated indirectly from disease-specific death rates in that population (using absolute lung cancer rates to indicate proportions due to smoking of mortality from certain other diseases). We applied these methods to 1996 death rates at ages 35-69 years in men in three different social strata in four countries, based on a total of 0.6 million deaths. The highest and lowest social strata were based on social class (professional vs unskilled manual) in England and Wales, neighbourhood income (top vs bottom quintile) in urban Canada, and completed years of education (more than vs less than 12 years) in the USA and Poland. RESULTS: In each country, there was about a two-fold difference between the highest and the lowest social strata in overall risks of dying among men aged 35-69 years (England and Wales 21%vs 43%, USA 20%vs 37%, Canada 21%vs 34%, Poland 26%vs 50%: four-country mean 22%vs 41%, four-country mean absolute difference 19%). More than half of this difference in mortality between the top and bottom social strata involved differences in risks of being killed at age 35-69 years by smoking (England and Wales 4%vs 19%, USA 4%vs 15%, Canada 6%vs 13%, Poland 5%vs 22%: four-country mean 5%vs 17%, four-country mean absolute difference 12%). Smoking-attributed mortality accounted for nearly half of total male mortality in the lowest social stratum of each country. CONCLUSION: In these populations, most, but not all, of the substantial social inequalities in adult male mortality during the 1990s were due to the effects of smoking. Widespread cessation of smoking could eventually halve the absolute differences between these social strata in the risk of premature death.

Adult↗
PubMed1997

Prescription of diamorphine, dipipanone and cocaine in England and Wales.

The vast majority of substitute prescribing to opiate addicts in England and Wales is of oral methadone. The prescription of diamorphine, dipipanone and cocaine to addicts is allowed subject to the 1971 Misuse of Drugs Act. Prescription of these drugs has aroused international interest and controversy in the United Kingdom although research is scanty. This report is a description of the current attitudes about, and practice of, prescribing diamorphine, dipipanone and cocaine by medical practitioners in the addiction field in England and Wales. A questionnaire was devised and sent to drug services in England and Wales which provided a prescribing service. Among respondents who reported that they currently hold a licence for heroin, dipipanone or cocaine, the number of patients treated by each doctor varied widely; from a handful of patients to 100 heroin patients. Dosage currently used ranged from a minimum of 10 mg to a maximum of 1000 mg daily for heroin. Doses of dipipanone were lower. More respondents thought that heroin and dipipanone were clinically justified in some situations than thought that they should never be prescribed, while the opinions were reversed in the case of cocaine.

Journal Article↗
PubMed1999

Short Form 36 (SF-36) Health Survey questionnaire: which normative data should be used? Comparisons between the norms provided by the Omnibus Survey in Britain, the Health Survey for England and the Oxford Healthy Life Survey.

BACKGROUND: Population norms for the attributes included in measurement scales are required to provide a standard with which scores from other study populations can be compared. This study aimed to obtain population norms for the Short Form 36 (SF-36) Health Survey Questionnaire, derived from a random sample of the population in Britain who were interviewed at home, and to make comparisons with other commonly used norms. METHODS: The method was a face-to-face interview survey of a random sample of 2056 adults living at home in Britain (response rate 78 per cent). Comparisons of the SF-36 scores derived from this sample were made with the Health Survey for England and the Oxford Healthy Life Survey. RESULTS: Controlling for age and sex, many of mean scores on the SF-36 dimensions differed between the three datasets. The British interview sample had better total means for Physical Functioning, Social Functioning, Mental Health, Energy/Vitality, and General Health Perceptions. The Health (interview) Survey for England had the lowest (worst) total mean scores for Physical Functioning, Social Functioning, Role Limitations (physical), Bodily Pain, and Health Perceptions. The postal sample in central England had the lowest (worst) total mean scores for Role Limitations (emotional), Mental Health and Energy/Vitality. CONCLUSION: Responses obtained from interview methods may suffer more from social desirability bias (resulting in inflated SF-36 scores) than postal surveys. Differences in SF-36 means between surveys are also likely to reflect question order and contextual effects of the questionnaires. This indicates the importance of providing mode-specific population norms for the various methods of questionnaire administration.

Adolescent↗
PubMed2005

A national survey of adult placement schemes in England: recruitment and retention of adult placement carers.

Adult placement (AP) schemes and the carers they support have been, up to now, a largely invisible part of the social care workforce. Carers in particular fail to appear in workforce statistics. They provide a unique form of care to vulnerable people, under-pinned by values of extended family ('kinship') support. Little is known about the range of current activities of AP schemes and the carers they support. This study of AP schemes in England aimed to provide baseline data about the workforce, care provision, qualification levels, training and support issues, and recruitment and retention problems. Questionnaires were sent to all known schemes in England in both statutory and independent sectors. A final database of 130 schemes was compiled and of these, 124 contributed to the survey with complete or partial information. Variables relating to carers, and recruitment and retention problems experienced by schemes were analysed in detail. Age, gender and ethnic profiles of AP carers were described. Anecdotal evidence had suggested that the current regulatory system was leading to a loss of AP carers and/or an increasingly unregulated sector. Results from analyses supported this as the major reason given by schemes for the problems they had experienced in the last 12 months. Estimates of both the current level of registration and the numbers of carers cancelling their registration in the previous 12 months were made. Recently agreed regulatory changes aim to shift the burden of regulation from individual carers to AP schemes, and thereby ensure a consistent standard of assessment, training and support across England. Evidence from the survey provided support for such a move.

Adolescent↗
PubMed1984

Periconceptional vitamin supplementation and the prevention of neural tube defects in south-east England and Northern Ireland.

A comparison has been made of the effectiveness of periconceptional vitamin supplementation for the prevention of recurrence of neural tube defects (NTD) in south-east England and Northern Ireland. These areas represent the extremes of birth prevalence of NTD (low and high respectively) within the United Kingdom. Vitamin therapy resulted in a slightly less than two-fold reduction in the recurrence risk in south-east England and a greater than three-fold reduction in Northern Ireland, when compared with unsupplemented women at the same risk from the two areas. It is probable that one of the recurrences in each area did not involve the multifactorial form of NTD and, if these are excluded, then the reduction in recurrence risk with vitamin supplementation is 2.4 times in south-east England and 5.4 times in Northern Ireland. Either way, beneficial effects of supplementation are apparent in both areas but are more marked in the high prevalence area. The implications of this for the future are discussed. Two other important findings were that all but one of the recurrences of NTD with full supplementation occurred in male fetuses, and there was a higher than expected occurrence of isolated hydrocephalus in infants or fetuses following full supplementation.

Female↗
PubMedDate not supplied

Child, adolescent and youth suicide and undetermined deaths in England and Wales compared with Australia, Canada, France, Germany, Italy, Japan and the USA for the 1974-1999 period.

Successive British Governments have aimed to reduce suicide, especially amongst younger people. Using WHO standardised data for the age bands "child" (5-14 years) and "adolescent and youth" (15-24 years) suicide rates for England and Wales were compared with the other major Western countries with end-points being average of 1974-1976 and average 1997-1999, by gender. "Undetermined deaths" were also analysed to consider any "hidden suicides". Over the period there was little change in child suicide for both genders in any country. Female "adolescent and youth" suicide rates fell in most countries, in contrast to male "adolescent and youth" rates, which rose substantially in six countries, including England & Wales. With the exception of Spain, there was little statistical significant difference between female Anglo-Welsh rates and the other countries. Apart from Spain and Australia, Anglo-Welsh youth rates were significantly worse than Canada, France, Germany and Japan. "Undetermined" deaths showed marked variation across many countries, but Anglo-Welsh rates were up substantially for both males and females [116% and 83%, respectively], whilst falling substantially in six countries. Child suicide continues to be a statistical rarity with little change in either suicide or "undetermined" deaths over the period. The dichotomy between male and female young people's suicide is a matter of concern, as the improvements in female rates are not matched in the male rates--the majority of which rose substantially. The "undetermined deaths" results continue to be problematic, especially regarding the substantial rises in England and Wales. Country-specific research is required to determine, why Anglo-Welsh adolescent and youth rates have deteriorated relative to other countries.

Adolescent↗
PubMed2002

The dental caries experience of 12-year-old children in England and Wales. Surveys coordinated by the British Association for the Study of Community Dentistry in 2000/2001.

DESIGN: This paper reports the results of standardised clinical caries examinations of 106,694 twelve-year-old children from England, Wales, the Isle of Man and Jersey. These 2000/01 coordinated surveys are the latest in a series which seek to monitor the dental health of children and to assess the delivery of dental services. METHOD: The criteria and conventions of the British Association for the Study of Community Dentistry were used. Representative samples were drawn from participating health authorities and boards, and caries was diagnosed at the caries into dentine (D3) threshold using a visual method without radiography or fibre-optic transillumination. RESULTS: Once again a wide variation in caries prevalence across the United Kingdom was demonstrated, with mean values for D3MFT for the English 'regions' (of the National Health Service) and Wales ranging from 0.63 in the West Midlands to 1.31 in Wales. The mean value for DMFT across England Wales was 0.89 (D3T=0.39, MT=0.07, FT=0.43). Overall, 38% of children had evidence of caries experience at the dentinal level of detection (D3MFT>0), although the means ranged between 30% (West Midlands) and 51% (Wales). The mean D3MFT for those with disease at this threshold was 2.35. Trends over time demonstrate an improvement of 11% in overall D3MFT since 1996/97, compared to the 15% seen over the previous four year period. FT and care index fell. The number of fillings provided in 2000/01 and thus the care index, remained low. On average across England and Wales, only 48% of the dentinal caries experience identified by survey examinations of permanent teeth was seen as fillings (range in individual districts: 30% to 78%). The use of the SiC index highlights dental health inequalities. CONCLUSION: Taken together, these findings demonstrate the continuing need for more effective preventive strategies and treatment services for this important age group.

Child↗
PubMed2005

New diagnoses of HTLV infection in England and Wales: 2002-2004.

Human T cell lymphotropic viruses (HTLV) are retroviruses transmitted through breastfeeding, sexual contact, blood transfusion and injecting drug use. HTLV is endemic in the Caribbean, and parts of Africa, Japan and South America, with isolated foci in other areas. Infection is life long. Fewer than 5% of those infected progress to one of the HTLV-related diseases, but these are debilitating and often fatal. In England and Wales, laboratory and clinical reports of new HTLV diagnoses are routinely collected, including infections identified by the blood service since the introduction of anti-HTLV testing in August 2002. Between 2002 and 2004, 273 individuals were diagnosed with HTLV: 102 (37%) were male and 169 female (sex was not reported for two). Median ages at diagnosis were 54 and 50 years respectively. Clinical reports were received for 78% (212/273) individuals. Where reported, 58% (116/199) of individuals were of black Caribbean ethnicity and 29% (57/199) white; 87% (128/147) were probably infected heterosexually or through mother-to-child transmission; 45% (66/146) were probably infected in the Caribbean and 40% (59/146) in the United Kingdom. An appreciable number of HTLV infections continue to be diagnosed within England and Wales, with increases in 2002-2003 because of anti-HTLV testing of blood donations. While most infections diagnosed are directly associated with the Caribbean, transmission of HTLV infection is occurring within England and Wales. Specialist care services for HTLV-infected individuals and their families have improved in recent years, but prevention remains limited.

Comparative Study↗
PubMed2006

The licensing of medical practitioners in Tudor England: legislation enacted by Henry VIII.

The medical profession in all developed countries requires national licensing, to identify trained medical practitioners and to proceed against quacks and mountebanks. England began this process in 1421 in the reign of Henry V, but the required legislation was enacted much later, in the reign of Henry VIII. Seven acts of parliament, directed at different elements of medical practice are described, with comments on England under Henry VIII and the persons and institutions proposing these licensing requirements. Whilst some legal aspects of medicine remained unclear, no further legislation of any significance was undertaken in England until the Medical Act of 1858.

Barber Surgeons↗
PubMed2005

Improving outcomes of cardiac surgery through cooperative efforts: the northern new England experience.

Coronary artery bypass graft (CABG) surgery is an effective procedure for relieving angina. In 1987, the Health Care Financing Administration published surgeon-specific mortality rates, prompting the formation of the Northern New England Cardiovascular Disease Study Group (NNECDSG). This regional collaborative of all medical centers performing cardiovascular procedures in northern New England began collecting data concerning patient and disease characteristics and adverse outcomes in an effort to improve the care provided to their patients. An initial quality improvement effort resulted in a 24% reduction in in-hospital mortality. Subsequent efforts have involved the development and implementation of quality improvement initiatives to redesign care to reduce further a patient's risk of mortality and other morbidities. More recently, we have adopted this model to reduce a patient's risk of neurologic injury. In this study, we are intensively monitoring patients intraoperatively with transcranial Doppler and near infrared spectroscopy as well as collecting hemodynamic data, and are synchronizing this data with a video of the surgical site. The goal of the study is to identify the association between clinical strategies and the development of the precursors of neurologic injury and use a quality improvement approach to redesign care to reduce occurrence of these precursors.

Cardiac Surgical Procedures↗
PubMed1988

The New England Maternal PKU Project: identification of at-risk women.

Young women with phenylketonuria (PKU) are at risk for bearing children with mental retardation, microcephaly, heart defects, and low birthweight. These effects may be prevented if a low phenylalanine diet is maintained prior to and throughout pregnancy. This report describes the procedures of the New England Regional Maternal PKU Project for identifying and locating this population of at-risk women. Newborn screening records, routine umbilical cord blood screening, and PKU Clinic records provided most of the identifying information. We identified 235 women with hyperphenylalaninemia, ages 12 to 44 years. Of these, 183 had PKU or atypical PKU while 52 had non-PKU mild hyperphenylalaninemia. The 235 women represent 88 per cent of the expected number of women with hyperphenylalaninemia in New England. We identified more than the expected number of those with PKU but only 57 per cent of the expected number with mild hyperphenylalaninemia. Developing a national registry, as well as screening women who utilize birth control clinics or prenatal clinics, may be helpful. Implementing routine umbilical cord blood screening programs may be beneficial in efforts to identify women with hyperphenylalaninemia who have had a child and may want more children in the future.

Adolescent↗
PubMed1964

TREATMENT IN ENGLAND OF CANADIAN PATIENTS ADDICTED TO NARCOTIC DRUGS.

The method of treatment and the results obtained from the treatment of 50 Canadian patients addicted to narcotic drugs who went to England are recorded. These patients were first stabilized on the minimal dose of narcotic drug which permitted them to work, and to acquire security and self-respect. Then, after psychiatric treatment dealing with the basic problem of their personality disorder, complete withdrawal treatment of the narcotic drug was undertaken.Nine of 10 patients aged between 20 and 30, of good social and cultural background, have been relieved of dependence on drugs for over two years.The other 40 patients came from a different background. Nearly all had been imprisoned for drug offences and they had come to England to obtain treatment and to avoid further prison sentences in Canada.The 31 patients whose prison sentences had been directly connected with drug offences are working steadily and leading an apparently normal life.The remaining nine patients had been convicted of criminal acts before becoming addicted to narcotic drugs and, with two exceptions, the results of their treatment compare unfavourably with the other patients, seven having been convicted and imprisoned in London.

Antisocial Personality Disorder↗
PubMed1998

Proximal extracranial vertebral artery disease in the New England Medical Center Posterior Circulation Registry.

OBJECTIVE: To describe the clinical features of patients with occlusive disease of the proximal (V1) segment of the vertebral artery. DESIGN AND PATIENTS: Patients with either occlusion or high-grade stenosis involving the V1 segment were chosen for study from the New England Medical Center Posterior Circulation Registry. The registry is a consecutive series of patients with signs and symptoms of posterior circulation ischemia seen at the New England Medical Center, Boston, Mass, during a 10-year period. Clinical features, radiographic findings, and patient outcome were reviewed. RESULTS: Of the 407 patients in the registry, 80 (20%) had V1 segment lesions. Patients could be classified into 5 groups: (1) V1 disease and coexistent severe intracranial occlusive disease of the posterior circulation (n=22); (2) V1 disease with evidence of artery-to-artery embolism (n=19); (3) suspected V1 disease with artery-to-artery embolism, but with other potential causes of stroke or less certain vascular diagnosis (n=20); (4) V1 disease associated with hemodynamic transient ischemic attacks (n=13); and (5) proximal vertebral arterial dissection (n=6). Hypertension, cigarette smoking, and coronary artery disease were common risk factors. Clinical features, location of infarct, and outcome differed between groups and reflected the presumed mechanisms of stroke. CONCLUSIONS: Occlusive disease involving the V1 segment of the vertebral artery is common in patients with posterior circulation ischemia, but is often associated with other potential mechanisms of stroke. However, in a series of patients seen at a tertiary referral center, occlusive disease of the V1 segment was the primary mechanism of ischemia in 9% of patients.

Academic Medical Centers↗
PubMed1988

The incidence of eye injuries in New England adults.

A population-based study examined the incidence of eye injuries among New England adults and its association with demographic characteristics and risk-taking behaviors. In 3253 random digit-dialed telephone interviews, 26 adults reported 27 eye injuries during the preceding year, yielding a rate of 9.75 eye injuries per 1000 New England adults. Fifty-nine percent of eye injuries occurred at work. Men had a risk of eye injuries 5.5 times that of women and there was a steep linear decline in eye injury rates with advancing age. Individuals who had other, noneye injuries during the preceding year and individuals who had recently driven after drinking, used marijuana, received a ticket for a moving violation, or not worn seat belts had higher rates of eye injury, but these elevated rates were not statistically significant. Educational and preventive efforts to avoid eye injuries should be directed toward young males in high-risk occupations.

Adolescent↗
PubMed1978

Screening for congenital hypothyroidism. Results in the newborn population of New England.

During the first year of operation, the New England Regional Hypothyroidism Screening Program determined the concentration of thyroxine (T4) levels in dried blood on filter paper from 129,028 infants born in Connecticut, Maine, Massachusetts, New Hampshire, and Rhode Island. Specimens from approximately 3,800 neonates were found to have levels of T4 below the lower limit of normal (less than 6.0 microgram/dl) and were assayed for thyroid-stimulating hormone (TSH) content. Levels of TSH were elevated (greater than 20 muU/ml) in 31 infants, 23 of whom eventually proved to have unequivocal hypothyroidism. Based on these figures and including two hypothyroid infants who were not tested, the incidence of congenital hypothyroidism in the New England region is approximately 1:5,200 births. The estimation of T4 values supplemented by measurement of TSH values on specimens with low T4 values has proved to be a satisfactory approach to large-scale screening for congenital hypothyroidism.

Congenital Hypothyroidism↗
PubMed1999

The most prevalent hepatitis C virus genotypes in England and Wales are 3a and 1a.

Hepatitis C virus (HCV) genotypes were assigned to 567 individuals by restriction fragment length polymorphism analysis of the 5' noncoding region of the HCV genome following reverse transcription-polymerase chain reaction. The groups of individuals in this study included hemophilia patients, injecting drug users (IDUs), blood donors, antenatal patients, those attending genitourinary medicine (GUM) clinics, and patients with chronic liver disease, all from England and Wales. The majority of HCV infections were types 1a (32%), 1b (15%), or 3a (37%). The genotype distribution in individual groups was similar to the overall genotype distribution except for hemophilia patients, in whom the frequencies were 1a (39%), 1b (23%), and 3a (21%). With the exception of hemophilia patients, subpopulations in England and Wales appear to share common modes of HCV transmission. There is a need for continued surveillance to monitor the spread of possibly more virulent or drug-resistant HCV genotypes.

5' Untranslated Regions↗