Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “WALES”

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
PubMed2000

Asthma is more prevalent in rural New South Wales than metropolitan Victoria, Australia.

OBJECTIVE: The aim of this study was to compare the prevalence of adult respiratory symptoms and conditions in a rural setting with a metropolitan setting. METHODOLOGY: We used cross-sectional population surveys of respiratory health using the European Respiratory Health Survey screening questionnaire. A random sample of 4455 eligible young adults aged 20-44 years, from electoral rolls in south-eastern metropolitan Melbourne, Victoria, and 4521 from rural south-western New South Wales were surveyed. RESULTS: Response rates of 72% (n=3194) and 69% (n=3121) were achieved in Melbourne and the Riverina, respectively. Respondents from the Riverina reported significantly higher prevalences of nocturnal dyspnoea (P<0.01), chronic bronchitis (P=0.03), an asthma attack in the previous 12 months (P<0.001), ever having had asthma (P<0.001) and doctor-diagnosed asthma (P<0.001) compared to those from Melbourne. However, among those with 'asthma attacks in the last 12 months', Melbourne respondents experienced a higher frequency of attacks (P<0.05). Riverina respondents reported a higher prevalence of smoking (P<0.05) and smoked more cigarettes on average (P<0.001) than Melbourne respondents. However, annoyance from air pollution was higher in Melbourne than in the Riverina. CONCLUSIONS: These results suggest that asthma is more prevalent in rural southern New South Wales than in Melbourne but follows a different pattern of exacerbations.

Adult↗
PubMed2000

Trends in prostate cancer incidence, mortality and survival in England and Wales 1971-1998.

OBJECTIVES: To examine trends in prostate cancer incidence and mortality in England and Wales between 1971 and 1998, using a newly developed and validated national cancer database and the national mortality database. METHODS: Age-standardized incidence and death rates were calculated directly and trends in relative survival rates among men with prostate cancer registered during 1971-1990 were examined. RESULTS: The annual number of new cases of prostate cancer registered in England and Wales increased by 179% between 1971 and 1993, from 6174 to 17 210. Directly age-standardized incidence rates increased by 104% between 1971 and 1993, from 29 to 59 per 100 000. The number of deaths from prostate cancer increased by 113% between 1971 and 1998, from 4027 to 8570. Directly age-standardized death rates increased by 49% between 1971 and 1995 and then decreased by 8% between 1995 and 1998, an overall increase of 38% (20 to 27 per 100 000) between 1971 and 1998. The relative survival rate for prostate cancer among men diagnosed during 1986-1990 was 77% at 1 year and 42% at 5 years, compared with 67% and 33%, respectively, for cases diagnosed during 1971-1975. The increase in survival rates was confined to men diagnosed with prostate cancer up to 1985 and no increase was seen for cases diagnosed after 1985. CONCLUSIONS: Prostate cancer is becoming a growing burden on the health service. The explanation for the large increase in prostate cancer incidence and mortality is unclear and needs further investigation. The lack of any improvement in survival rates in cases diagnosed after 1985 is of concern, and suggests that the current management of prostate cancer in both primary and secondary care may need to be reviewed.

Age Distribution↗
PubMed1999

Thyroid cancer in Wales 1985-1996: a cancer registry-based study.

No dedicated clinicopathological database for thyroid cancer exists in Wales to provide information about the incidence, histology, treatment and outcome of this uncommon malignancy. We have used cancer registry data to examine the epidemiology of thyroid cancer in Wales between 1985 and 1996 and have searched the database for clinically relevant data about stage, treatment and survival. A total of 699 cases were identified in this 12-year period, with no significant differences in their distribution between the five health authorities. Further analysis revealed a very wide age range (8-93 years) with a predominance of females (F:M ratio 2.8:1) and survival strongly influenced by gender, age and histological type. There were insufficient data to stage these cancers and only limited data about the surgical procedures undertaken. There was no information on non-surgical treatments (radio-iodine, radiotherapy and chemotherapy) in the database. Cancer registry data is well able to sustain an analysis of the epidemiology of thyroid cancer but further work is necessary to improve the quality of clinically relevant information about stage and treatment that could be used for audit.

Adolescent↗
PubMed2001

Current trends in colorectal cancer: site, incidence, mortality and survival in England and Wales.

The objective was to examine trends in colorectal cancer (CRC) incidence and mortality in England and Wales over the last 30 years. Age-standardized incidence, mortality and survival rates for CRC, based on data from the National Cancer Intelligence Centre at the Office for National Statistics, were calculated and trends assessed. Between 1971 and 1997 the total number of cases of CRC increased by 42%, from 20,400 to 28,900. The site distribution of CRC between 1971 and 1994 was: rectum 38%, sigmoid 29%, caecum 15%, transverse colon and flexures 10%, ascending colon 5%, and descending colon 3%. Between 1971 and 1997 the direct age-standardized incidence increased by 20% in males and by 5% in females. The direct age-standardized mortality fell by 24% in males and by 37% in females. Age-standardized relative 5-year survival in adults improved from 22%-27% for patients diagnosed during 1971-1975 to over 40% for those diagnosed during the period 1991-1993. In conclusion, the incidence of CRC in England and Wales has been steadily rising. It is more common in males and has increased more rapidly in males than in females. The reasons for these trends remain unclear. Five-year survival has improved substantially, but rates are still below those in comparable countries elsewhere in Europe and in the USA.

Adolescent↗
PubMed2001

Variation in administrators' and clinicians' attitudes toward critical elements of an infection control program and the role of the infection control practitioner in New South Wales, Australia.

BACKGROUND: Debate remains over the core activities of infection control (IC) programs. Differences in stakeholder opinions must be considered if consensus panel guidelines and recommendations are to be broadly applied. This article describes a survey of administrators and clinicians employed in hospitals in New South Wales, Australia. Respondents self-reported their levels of agreement with affirmative statements regarding the role of the infection control practitioner (ICP) and the essential requirements and infrastructure of IC programs. METHOD: The study population included administrators and clinicians in each public, private, and freestanding day hospital in New South Wales. Respondents reported the intensity of their agreement with 16 affirmative statements relating to IC program infrastructure and resources and the ICP's role and responsibilities. RESULTS: The overall response rate was 62.1% (587/945). Clinicians (349/587) and administrators (238/587) accounted for 59.5% and 40.5% of the response rate, respectively. Overall, administrators and clinicians reported greatest levels of agreement for those elements not requiring additional resources. CONCLUSION: The extent of divergence between administrators and clinicians is not so great that it can not be resolved. Our findings demonstrate the degree of administrator support that clinicians can expect for each element. We advocate better communication between clinicians and administrators in conjunction with objective strategic planning. Our findings provide a guide for ICPs to either establish or negotiate the core components of their IC program.

Attitude of Health Personnel↗
PubMed2003

Prenatal screening for Down syndrome in England and Wales and population-based birth outcomes.

OBJECTIVE: Whether the introduction of antenatal screening for Down syndrome in England and Wales with serum biochemistry or ultrasound has led to improvements in patient outcomes is unknown. The purpose of this study was to relate pregnancy outcomes to the dominant method used for prenatal Down syndrome screening. STUDY DESIGN: For the years 1989 through 1999, England and Wales were divided into geographically defined areas where specific hospitals, health authorities, and cytogenetic laboratories provided maternity care for well-defined populations. For each year from 1989 through 1999, the dominant Down syndrome screening method that was used in each area was determined. Outcomes for area-years that used serum biochemistry or ultrasound (first or second trimester) were compared with area-years that used advanced maternal age as the dominant screening method. The percent of Down syndrome cases that were diagnosed prenatally (effectiveness) and the number of invasive prenatal tests that were performed to diagnose each Down syndrome case prenatally (efficiency) were compared. RESULTS: There were 5,980,519 births and 335,184 referrals for prenatal karyotyping (amniocentesis and chorionic villus sampling) that occurred in the area-years studied, of which 12,047 pregnancies were diagnosed as Down syndrome; 5393 cases of Down syndrome (45%) were diagnosed prenatally. Invasive testing increased from 4.4% of pregnancies in 1989 to 6.4% in 1997 and declined slightly in 1999 (5.8%). Prenatal diagnosis of Down syndrome cases rose from 28% in 1989 to 53% in 1999, and the number of invasive tests that were performed to diagnose each Down syndrome case fell from 89.7 to 47.7 (P [for trend]<.0001). Areas with serum or ultrasound as the dominant screening method detected 50% more Down syndrome cases in prenatally (52% and 53% vs 36%; P<.0001) and performed fewer invasive procedures to diagnose each Down syndrome case (60.7 and 52.0 vs 88.0; P<.0001) compared with areas in which advanced maternal age screening was dominant, despite serving populations with similar mean/median maternal ages. CONCLUSION: In clinical practice, screening programs for Down syndrome that were based on maternal serum biochemistry or ultrasound were more effective and efficient than the screening programs that used advanced maternal age alone.

Amniocentesis↗
PubMed2005

Healthcare reform in New South Wales 1986-1999: using the literature to predict the impact on senior health executives.

While numerous reviews have examined the changing roles, skills, competencies, and educational needs of health service managers as the result of health care reforms, no study has focused specifically on the impact of New South Wales health reforms on the roles, responsibilities and behaviours of senior health executives in the public health sector. This paper briefly illustrates the significant changes in New South Wales health management since 1986. It also examines the forces behind these changes and predicts their impact on NSW Senior Health Executives based on national and international literature, and provides a foundation for further empirical research.

Health Care Reform↗
PubMed2000

A cross-sectional survey to analyse the risk factors associated with human cystic echinococcosis in an endemic area of mid-Wales.

In mid-Wales, the prevalence of cystic echinococcosis (hydatid disease) in humans and other animals has been well documented. A cross-sectional study was therefore undertaken to examine the associated demographic and environmental risk factors for the disease in humans, in Powys, mid-Wales. Overall, 223 fully completed questionnaires were returned from a postal survey. Eighteen of the respondents had been treated for cystic echinococcosis (CE). No significant association was found between many of the well-established risk factors, such as dog or farm ownership, and treatment for CE, although women were more likely to have been treated for the disease than men.

Agricultural Workers' Diseases↗
PubMed1992

A survey of taeniid cestodes in farm dogs in mid-Wales.

In 1983-1988, dogs on 315 farms in Powys, mid-Wales, were purged once with arecoline acetarsol and the faecal purges were examined for cestodes. A few dogs were examined by autopsy. Ninety-seven farms had at least one infected dog, and cestodes were found in 161 of the 882 dogs examined. The ovine strain of Echinococcus granulosus was found in 41 dogs on 25 farms. Taenia hydatigena, T. pisiformis, T. multiceps, T. serialis, T. ovis and Dipylidium caninum were recovered from 85, 35, 15, 3, 19 and 29 dogs respectively. The results are compared with those of previous surveys in Powys and in other regions of Wales.

Animals↗
PubMed1992

The cestodes of foxhounds and foxes in Powys, mid-Wales.

Cestodes were found in 129 of 875 foxhounds from 20 packs in Powys, mid-Wales, examined by purging in 1983-1988, in the following order of prevalence: Taenia hydatigena in 57 hounds (6.51%), Echinococcus granulosus in 27 (3.09%), Dipylidium caninum in 25 (2.86%), T. ovis in 14 (1.60%), T. pisiformis in 10 (1.14%), T. serialis in five (0.57%) and T. multiceps in four (0.46%). Of 197 foxes examined by autopsy, 22 harboured cestodes: two (1.02%) had E. granulosus, nine (4.57%) T. polyacantha, eight (4.06%) T. pisiformis, two (1.02%) T. serialis, one (0.51%) D. caninum and one (0.51%) Mesocestoides sp. This is the first definite report of T. polyacantha in British foxes. The results are compared with those of previous surveys in Powys and in other parts of Wales, and the reasons for changes in prevalence are discussed.

Animals↗
PubMed2005

Timing effects on first marriage: twentieth-century experience in England and Wales and the USA.

Recent substantial declines in first marriage in Western countries have been accompanied by increases in the average age at first marriage. Since the period proportion ever marrying, PEM, is sensitive to cohort tempo changes, the recent fall in the PEM may simply reflect cohort delays in marriage. The importance of timing factors is examined in the light of twentieth-century experience of first marriage in England and Wales and the USA. Using a variant of the Timing Index developed in research on fertility, we measure cohort timing effects for marriage and calculate an adjusted PEM. After examining twentieth-century trends in nuptiality for men and women, we find substantial tempo effects on the period PEM. Adjusted PEM values show a real decline in marriage for cohorts, but that decline is considerably smaller than the one shown by the unadjusted figures. This is especially true for England and Wales, where the decline in marriage was much greater.

Cohort Studies↗
PubMed2005

The measurement of historical trends in fetal mortality in England and Wales.

This paper critically discusses recent attempts to estimate long-term trends in the stillbirth rate for England and Wales. It assesses the available historical evidence for the level of late-fetal mortality, drawing especially on examples from Norway, Sweden, and Denmark. A theoretical fetal-infant life table for a high-mortality population is also outlined as a means of analysing the relationship between segments of the conception-to-first-birthday mortality curve. Finally, new estimates of the stillbirth rate for England and Wales are proposed, based on variations in the early neonatal and maternal mortality rates during the 1930s. These estimates are substantially lower than the earlier estimates and are more in keeping with the available evidence from northern Europe. The implications of the revised estimates for interpretations of historical changes in mortality patterns are also considered.

England↗
PubMed2004

Overseas registrars training in obstetrics and gynaecology in Wales--a questionnaire survey.

Overseas doctors have been coming to the United Kingdom for further surgical training over the past several years. In Wales, up to 50% of registrars in obstetrics and gynaecology are from overseas. It is important to address issues regarding training with a view to making changes and improvements to suit individual trainee requirements. There is very little evidence obtained from literature regarding trainees' viewpoints, satisfaction, achievements and expectations with regard to overseas registrars in obstetrics and gynaecology. We undertook a questionnaire survey assessing the training of all overseas registrars in Wales from 12 hospitals in the Deanery. The results of this survey are discussed in the article with a few suggestions for change.

Adult↗
PubMed1997

Professional ideologies and the development of syringe exchange: Wales as a case study.

This paper is derived from an evaluative study of HIV prevention programs for drug injectors across Wales. It considers how different professional territories and ideologies, concepts of drug misuse and models of HIV prevention may influence policy development. The research involved monitoring the introduction and development of agency and community based syringe exchange schemes and initiatives taken by community pharmacists. Interviews with staff, managers and administrators, and descriptions of service history, development and delivery inform the discussion. HIV prevention varied in different areas of Wales depending on the particular professional group involved, local ideologies regarding drug use treatment, and the extent to which HIV prevention was seen either as a specialist area of expertise and specific remit of drug workers or a generic health care task. Drug agencies with an abstinence policy rejected syringe exchange; instead, prevention in those areas developed in ad hoc ways as health care workers and pharmacists attempted to develop a community based service. Drug agencies with a pre-existing harm minimisation model easily integrated syringe exchange into their work and played the major part in establishing the service, but there was difficulty in extending it beyond their professional caseloads. As there were disincentives to use treatment agencies, and their catchment areas were limited, these factors influenced effective service provision.

Attitude of Health Personnel↗
PubMedDate not supplied

A spatial analysis of 100 surnames in England and Wales.

Spatial patterns are described and analysed for the 84 most common surnames in England and Wales, as well as 16 others selected for various reasons. At least three-quarters of the surname frequencies show spatial structure and are heterogeneous over the area of study. While they do not exhibit clines extending over the entire area of study, they do divide into four characteristics patterns. Spatial autocorrelation, while significant, is relatively low; similarity in surname frequency does not extend much beyond 100 km. Correlograms could be clustered to yield groups of surfaces denoting partial clines, isolation by distance, and differentiation at far distances. A method for detecting zones of rapid change found 21 such zones, mostly near the periphery of the study area. These boundaries do not indicate barriers to gene flow, but appear to be patterns brought about by historical factors. There are diffusion patterns between areas that differ greatly in surname composition, such as Wales and central England. There is little evidence of long-distance movements involving several surnames. At least three characteristic migration patterns, east-west and north-south diffusion and local dispersal, were found.

England↗
PubMed2002

Reliability of the SNAP (score of neonatal acute physiology) data collection in mechanically ventilated term babies in New South Wales, Australia.

UNLABELLED: The aim of this population-based, case-control, cohort study was to report inter-rater reliability between the New South Wales Neonatal Intensive Care Unit Data Collection (NICUS) audit nurses' collection of SNAP (OS) and a research nurse's SNAP data as the audit SNAP (AS). The study was carried out in Sydney and four large rural/urban health areas in New South Wales (NSW), Australia. The subjects--182 singleton term infants with no major congenital anomalies--were admitted to a tertiary neonatal intensive care unit (NICU) for mechanical ventilation. SNAP data were collected on the 182 case infants, born between 1 January and 31 December 1996, by clinical audit officers in the nine tertiary NICUs in NSW. The research officer conducted an audit of the original SNAP score on all infants. The data were examined using Pearson's correlation coefficient, weighted kappa, a plot of difference in SNAP against mean SNAP and Wilcoxon's signed rank sum test. Pearson's correlation coefficient between the OS and AS data was 0.80. Median (interquartile range) SNAP was 13 (9,19) for the OS and 14 (10,20) for the AS. Weighted kappa was highest for highest heart rate, paO2, temperature (degrees C), oxygenation index, haematocrit, platelet count, lowest serum sodium, lowest blood glucose and seizure. In 17 (9%) infants, OS and AS differed by > or = 10, 14 because of an original data collection error, 1 data entry error, 1 audit error and 1 for both data collection and data entry errors. CONCLUSION: If SNAP is to be incorporated into any routine NICU data collection, it should be audited regularly on a sample of records. It is important to standardize and adhere to strict definitions for parameters before the collection of SNAP data.

Case-Control Studies↗
PubMed1994

Changes in public knowledge and attitudes to HIV/AIDS in Wales, 1987 to 1992.

This paper presents information on changes in public knowledge and attitudes to HIV/AIDS in Wales between 1987 and 1992. The results indicate that throughout this period the majority of adults in Wales were aware of the high risk of infection from sexual intercourse and sharing needles with, and coming into contact with the blood of, someone with HIV. Nevertheless, the proportion who said that sexual intercourse with someone with HIV carries a high risk declined, and in 1992 confusion still remained about the nature of HIV infection amongst a substantial minority of respondents. More than one in ten of the adults in the most recent survey were of the opinion that kissing or being near someone with HIV who is coughing or sneezing carries a high risk of infection. The data also indicate that attitudes to those with HIV remained uneven in 1992. Whilst a greater proportion in 1992 than in 1987 held the view that people with HIV should be able to live normally in the community, attitudes appear to have hardened towards those perceived to be practising high risk behaviours, such as injecting drug users and homosexuals. The data also suggest that attitudes appear to be closely related to levels of knowledge. Given the apparent confusion and prejudice highlighted by the surveys, it is suggested that there is a continuing need for general campaigns to maintain public awareness of HIV-related issues, although this must also be complemented by more in-depth targeted education programmes.

Acquired Immunodeficiency Syndrome↗
PubMed2001

The law and dementia--issues in England and Wales.

This paper reviews the proposals from the Lord Chancellor's Department for new Mental Incapacity law for England and Wales as they may impact on older people with dementia. Various concerns and issues are raised, particularly from the perspective of health care professionals, and the focus is the interface between such issues and the day-to-day clinical realities for a specialist team dealing with old people with dementia. A brief overview of where problems have arisen with the law in recent times is put in the context of the political/legal structures in England and Wales

Dementia↗