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At least 433 records · Page 24Linked to original sources
PubMed2000

Patterns of prescription of PC4 by general practitioners in England and Wales.

OBJECTIVE: To study the pattern of general practitioner prescribing of PC4, the most commonly used method of hormonal emergency contraception, in England and Wales. METHOD: The UK General Practice Research Database was used to identify, from a total population of 4.2 million people on the lists of contributing practices, all women aged 10-44 years who were prescribed PC4. Rates of prescribing were calculated to produce rates over time by age group, by day of week and month of year, and by region. RESULTS: The rate for PC4 prescribing rose from about 1.5 per 1,000 women per month in 1992 to about 3.0 in 1995, then remained relatively constant until 1998. Rates were highest among 15-19-year-old women and next highest among those aged 20-24 years. Rates were higher in Wales than in each of the English regions. Excesses of prescribing took place in the summer months and between Saturdays and Mondays. CONCLUSION: Reasons for the increase in PC4 prescribing rates in the early years of the study are unclear, although increasing knowledge of the technique among the population may have contributed. There was no evidence of an increase in prescribing following the pill scare of October 1995, although there was an increase some months earlier. The concentration of requests at weekends suggests the need for weekend access to emergency contraception. The summer peak may also indicate a heightened need in holiday areas at that time.

Adolescent↗
PubMedDate not supplied

Speech and language therapy services to education in England and Wales.

Services for children with speech and language needs in England and Wales are in a period of change. The context is subject to major systemic pressures deriving from government policies. These include the development of inclusive education and encouragement of multiprofessional collaboration in policy development and practice ('joined up thinking'). In addition, structures at local level are changing with the establishment of unitary authorities and the change from Health Trusts to Primary Care Trusts. Professional practice is also changing with a shift from clinical to community settings for speech and language therapists working with children. The present study reports on a survey sponsored by the Department for Education and Employment, Department of Health and the Welsh Assembly to identify the nature of speech and language therapy (SLT) services provided to education in England and Wales. The sample comprised all SLT service managers (n = 133, response rate 74%). The results indicate that services vary greatly in size and in their SLT: child ratio, with a mean of one SLT to 4257 child population. The caseload was highest for the 5-10 age group, and service delivery was targeted at these children, with low levels of work with secondary aged pupils. Most provision in educational settings was made to mainstream schools, but the provision of SLT time per child was substantially higher in specialist language resources. Apart from the preschool phase, most SLT provision was for children with statements of special educational needs. Prioritization of service delivery was usually by severity of need. The provision of bilingual SLT services was very limited, with only 14.0 full-time equivalents SLTs fluent in a community language, other than Welsh, where proportionately availability was much greater. Most LEAs funded SLT posts, although these were usually employed as part of the SLT service, with only about 10% of LEAs employing SLTs direct. However, 55.5% of SLT managers reported that recruitment and retention were problematic, resulting in gaps in the service. These findings are discussed with respect to changes driven by professional judgements on the nature of optimal service delivery, and government policy, with particular reference to inclusion and equity of service delivery.

Adolescent↗
PubMed2005

The New South Wales Inebriates Act: going, going, gone?

OBJECTIVE: To describe how the use of psychiatric hospitals as institutions for inebriates came about in New South Wales. CONCLUSIONS: A so-called 'temporary' solution to a political problem in 1929 led to the psychiatric hospitals in New South Wales becoming repositories for inebriates for the next 75 years. This unsatisfactory situation may be about to change.

Alcohol Drinking↗
PubMed2000

Invasive pneumococcal disease in England and Wales: vaccination implications.

Knowledge of the epidemiology of invasive pneumococcal disease (IPD) will aid in planning the use of pneumococcal vaccines. A United Kingdom (UK)-based surveillance in England and Wales (1995-1997) of 11,528 individuals with IPD and a local enhanced surveillance in the Oxford (UK) area (1995-1999) have been analyzed. IPD has a high attack rate in children, with 37.1-48.1 cases per 100,000 infants <1 year old per year, and in older persons, with 21.2-36.2 cases per 100,000 persons >65 years old per year, for England, Wales, and Oxford. The 7-valent conjugate vaccine includes serotypes causing < or =79% of IPD in children <5 years old, but only 66% in adults >65 years old. The data also indicate that IPD varies by serotype, age, and country, emphasizing that the epidemiology of IPD is heterogeneous and requires continued surveillance.

Adolescent↗
PubMed2004

Characterization of group B streptococci recovered from infants with invasive disease in England and Wales.

Group B streptococci (GBS) are a major cause of invasive disease in infants, with enhanced surveillance in England and Wales showing an incidence of 0.74 cases per 1000 live births and a mortality rate of 8%. Among 353 isolates obtained during enhanced surveillance, the predominant serotypes were III (48%), Ia (27%), and V (10%), and the remainder comprised Ib, II, IV, VI, and VII; 3% were not typable. Isolates from patients with early-onset disease had serotypes III (38%), Ia (32%), and V (13%), with late-onset disease having a higher incidence of type III (67%) strains. Patients infected with serotype III strains had a higher rate of meningitis, and those with type V strains had a higher mortality rate. Isolates were susceptible to penicillin and ampicillin, but 4% were resistant to erythromycin, and 91% were resistant to tetracycline. A trivalent vaccine containing capsular polysaccharides III, Ia, and V could theoretically provide coverage against 85% of the cases of GBS disease among infants in England and Wales.

Anti-Bacterial Agents↗
PubMed2001

A survey of patient dose and image quality for computed tomography scanners in Wales.

The main aim of the study was to assess the current level of radiation dose from computed tomography scanning in the NHS in Wales and to compare these results with previous studies in Wales and the UK. In addition, the relationship between patient dose and image quality was investigated by comparing mean patient dose calculations with image noise using two quality assurance (QA) phantoms. The results show that although the introduction of spiral scanners has reduced the dose per examination, the collective dose per scanner has actually increased. The results also highlight the potential for relating dose and objective measures of image quality to assist in the selection of scanning parameters to optimise dose without compromising image quality.

Adult↗
PubMed2004

Controls on radioactivity in water supplies in England and Wales, with especial reference to radon.

This note describes the legal and administrative controls on concentrations of radioactive materials, with especial reference to radon, in drinking water in England and Wales. These controls follow the EC Drinking Water Directive and Recommendations from the European Union. The Directive relates to radioactivity in drinking water generally, while the Recommendations are specific to radon. A distinction is made between private and public supplies, with more stringent controls on the latter. In general, problems in meeting the recommended levels are not expected in England and Wales.

England↗
PubMed2003

A comparison of antimicrobial susceptibilities in nontyphoidal salmonellas from humans and food animals in England and Wales in 2000.

A joint study by the Public Health Laboratory Service and the Veterinary Laboratories Agency of resistance to antimicrobials in isolates of Salmonella enterica serotypes Enteritidis, Typhimurium, Hadar, and Virchow from humans and food-producing animals in England and Wales in 2000 has demonstrated that resistance was most common in Typhimurium, particularly in strains of definitive phage type (DT) 104. However resistance was also common in other phage types, particularly DTs 193 and 208 and phage type U302. Multiresistant strains of DT208 appeared to be predominantly associated with pigs; for the other phage types, the human/food-producing animal relationships of drug-resistant isolates were more complex. For Enteritidis, Virchow, and Hadar, there were substantial differences in the resistance spectra of isolates from humans and food-producing animals, suggesting that food-producing animals bred in England and Wales may not be the primary sources of drug-resistant strains of these serotypes causing infections in humans. Further phenotypic and molecular comparison of drug-resistant isolates of these serotypes may be required to ascertain the sources of strains responsible for infections in humans.

Animal Diseases↗
PubMed2000

Antimicrobial drug resistance in non-typhoidal salmonellas from humans in England and Wales in 1999: decrease in multiple resistance in Salmonella enterica serotypes Typhimurium, Virchow, and Hadar.

In 1999 the incidence of multiple drug resistance (to four or more antimicrobials) in non-typhoidal salmonellas from humans in England and Wales fell in isolations of Salmonella enterica serotypes Typhimurium, Virchow, and Hadar. This fall has been most noticeable in S. Typhimurium, where 59% of isolates were multiresistant compared to 81% in 1996. The main reason for this has been a 75% decline in isolations of multiply-resistant S. Typhimurium definitive phage type (DT) 104 (MR DT104) since 1996. Nevertheless MR DT104 remains second to S. Enteritidis phage type 4 as the most common strain in cases of human salmonellosis in England and Wales. Multiple resistance has also remained high in S. Hadar, with 49% of isolates resistant to four drugs or more compared to 56% in 1996. Isolates with decreased sensitivity to ciprofloxacin (minimal inhibitory concentration: 0.25-1.0 mg/L) have increased in incidence in S. Enteritidis, S. Virchow, and S. Hadar; in S. Hadar 70% of isolates were resistant to ciprofloxacin at this level. It is hoped that Codes of Practice introduced by some pharmaceutical companies, governments, professional organisations, and others to combat the unnecessary prophylactic use of fluoroquinolones in animal husbandry will not result in a reduction in the incidence of resistance to ciprofloxacin in salmonella organisms causing infections in humans.

Anti-Bacterial Agents↗
PubMed1999

A survey of social services needs assessments for elderly mentally ill people in England and Wales.

OBJECTIVE: to examine variations in the needs assessment policies and practices of social services departments in England and Wales in dealing with elderly people who have mental illness. DESIGN: postal questionnaire survey. SUBJECTS: a random sample of 61 of 119 social services departments in England and Wales. MAIN OUTCOME MEASURE: 99-item questionnaire. RESULTS: 40 responses were received (66%). There were substantial differences in the way referrals were screened before needs assessment and in the design of needs assessment procedures. Disagreements between health and social services were common and, although mechanisms existed to respond to urgent needs, almost one-third found such responses difficult to make. CONCLUSIONS: there are national variations in the way needs assessments are performed by social services, which may lead to inequalities in provision of care to individuals. The lack of a standardized approach impedes comparisons of need between areas which might aid in the distribution of resources at a national level.

Aged↗
PubMed1992

Glove use by orthodontists: results of a survey in England and Wales.

Attitudes to glove wearing during treatment of patients were tested by distribution of a questionnaire to 2000 dentists known to be practising under the National Health Service regulations in England and Wales. Of the dentists who replied, 41 specialist orthodontists, representing approximately one-sixth of all orthodontists working in the general dental services in England and Wales, were identified. Results indicate that 39 per cent of these orthodontic respondents wore gloves routinely for all patients and procedures, while 49 per cent wore gloves for some patients or procedures, with 12 per cent never wearing gloves. Reasons given by the occasional glove wearers for not wearing gloves routinely included loss of tactile sensation, perceived small risk, lack of comfort, and restriction of movement. Six per cent of those who replied had experienced skin irritation considered to be associated with glove wearing, while latex gloves were preferred by 78 per cent of respondents who wore gloves.

Attitude of Health Personnel↗
PubMed1993

Direct sequencing of the complete CFTR gene: the molecular characterisation of 99.5% of CF chromosomes in Wales.

We have performed an extensive mutation analysis on 184 CF families in Wales. In our previous study, mutations on 329/369 CF chromosomes were identified after screening for delta F508 and sixteen other mutations. To identify the mutations on the remaining 40 uncharacterized CF chromosomes, we have carried out direct DNA sequencing over the complete coding region, intron splice sites, and part of the promoter region of the CFTR gene. During this study we have designed a set of internal sequencing primers which allow clear sequencing through the aforementioned regions. Sequence analysis revealed 15 further mutations (4 of which are novel), and 10 previously described polymorphisms. In total, we have identified 29 mutations, the distribution of which provides further insight into the functional domains of the CFTR protein. We have characterised 99.5% of the CF chromosomes (365/367, one sample degraded). In order to ascertain accurate frequency data for the Welsh population, CF families with at least 3 'Welsh' grandparents were strictly regarded as 'Welsh'. Of these 91 families, delta F508 accounts for 71.6%, 621 + 1G-->T 6.6% and 1898 + 1G-->A 5.5%. The implications for CF population screening in Wales are discussed.

Base Sequence↗
PubMed1982

An analysis of cohort mortality from tongue cancer in Japan, England and Wales and the United States.

Alcohol and tobacco consumption were compared to rates of tongue cancer mortality among birth cohorts in Japan, England and Wales, and the United States for the years 1846-1975. During 1931-75 Japan had low and the US had high, stable sex, and age-specific and adjusted mortality. Rates in England and Wales, highest among the three nations, dropped dramatically, showing a classic cohort effect, which coincided with a continual rise in tobacco and a sharp decline in alcohol use since 1900. The US had a similar upsurge in smoking, but comparatively little change in drinking habits. In all countries, the alcohol but not the tobacco patterns were consistent with cohort deaths for not only tongue cancer but also other alcohol-related diseases when a dose-response time lapse was taken into account. In contrast to other studies this research suggests that alcohol may be a carcinogen even in the absence of tobacco.

Adult↗
PubMed1985

The efficiency of measles and pertussis notification in England and Wales.

This paper examines methods for estimating the efficiency of measles and pertussis notification with particular reference to England and Wales. Crude estimates are obtained from a comparison of annual numbers of births and notifications, and this approach is modified to include detailed age-specific data. Other sources of data, notably the Hospital In-Patient Enquiry, are used to give detailed estimates over time. These analyses provide evidence for a strong positive correlation between notification efficiency and incidence for both diseases and for a dramatic fall in the notification efficiency for pertussis between 1957 and 1976. This decrease is of particular interest insofar as it could explain in part the apparent fall in size of successive pertussis epidemics during that period. It is estimated that since 1976 the spotter practices of the Royal College of General Practitioners General Practice Research Unit have been approximately 1.5 times more efficient at reporting measles and 2.5 times more efficient at reporting pertussis than the national average for reporting to the Office of Population Censuses and Surveys. Finally it is noted that estimates of notification efficiency are positively correlated with the assumed level of vaccine efficacy, and that all these methods require assumptions concerning the proportion of vaccinations which are recorded, the proportion of vaccinations which are successful in immunizing the recipient, and the proportion of the population which ultimately contracts the infection. In general, measles notification in England and Wales is considerably better than that for pertussis, being of the order of 40-60% for the former and only 5-25% for the latter.

Child↗
PubMed1988

Perinatal and infant mortality in Wales: inter-district variations and associations with socio-environmental characteristics.

Stillbirth rates, perinatal death rates, early and late neonatal death rates and (post-neonatal) infant death rates are reported for Wales since local government and NHS reorganization in 1974. The time trends in these rates show declining mortality, in full weight and in low birthweight babies. Analysis of average rates for the period 1974-81 inclusive in the 37 local authority districts within Wales demonstrate wide variations, with PMRs ranging from 11.5 to 22.5 per 1000. Many highly statistically significant associations were evident between socioeconomic characteristics of the districts and stillbirth rates but few with neonatal death rates and none with infant death rates.

Environment↗
PubMed1990

Differential mortality: some comparisons between England and Wales, Finland and France, based on inequality measures.

Inequalities in mortality between social classes or socioeconomic groups were compared in three European countries, using similar sources of data from large national cohort studies. People registered at a census in 1971 (1975 for France) or a sample of them, were followed until 1980 or 1981. The Gini coefficient, a measure widely used in economics, allowed the comparison of various situations involving different numbers and group sizes. It was applied to age groups 35-44, and 45-54 for men only. According to this measure, inequalities were of the same order in England and Wales and Finland, and greater in France. Differences between the three countries concerning the principal causes of death leading to inequalities were cardiovascular diseases in England and Wales, accidents and cardiovascular diseases in Finland, and cancer and cirrhosis in France.

Accidents↗
PubMed1994

Population mixing and sudden infant death syndrome in England and Wales.

BACKGROUND: Infections may be involved in some cases of sudden infant death syndrome (SIDS). Exposure to such infections is likely to differ considerably between areas depending on rates of population mixing. It is therefore possible that the geography of SIDS will reflect that of population migration. METHODS: For 403 local authority districts in England and Wales the number of SIDS deaths in the first year of life and the number of livebirths during the period 1979-1983 were abstracted from published sources. Districts were classified by levels of in-migration using data from the 1981 Census and observed and expected numbers of SIDS deaths were compared for areas experiencing different rates of in-migration. RESULTS: A significant association (P < 0.001) was found between SIDS deaths and rates of long distance migration into districts. In the group with the highest rate of long distance in-migration the ratio of observed to expected SIDS deaths was 62% greater than in the group with the lowest rate of in-migration. This association was strengthened after adjustment for social class and illegitimacy. A weaker, but statistically significant, association was found for shorter distance in-migration. CONCLUSIONS: It is concluded that geographical variations in SIDS deaths in England and Wales are strongly associated with differences in rates of population mixing as measured by migration. The findings support the hypothesis that population mixing, by its influence on exposure to infections, may be a significant factor in the aetiology of SIDS.

Confounding Factors, Epidemiologic↗
PubMed1976

Aspects of the epidemiology of suicide in England and Wales.

This paper is concerned with the variations in suicide rates in the 161-171 local authorities in England and Wales during the 11-year period 1961-71. Analysis of the overall secular trends shows that the rates for both males and females reached a peak in 1963 and subsequently declined at a steady rate. Virtually the whole of this reduction is associated with the fall in the number of poisonings by domestic gas. Suicide rates were about 50 per cent higher in males than in females and tended to increase with increasing age and, in general, were higher in the county boroughs than in the (more rural) county authorities. There is a marked variation in terms of geographical area, with the highest rates being reported in the London and South-East Region and the lowest rates in the South-East Wales and Northern Regions. There are also systematic differences between the various conurbations, with the highest rates in London and South-East Lancashire and the lowest in Merseyside and the West Midlands. The variations between individual local authorities are then considered and it is shown that as much as 99 per cent of the total variation can be explained in terms of a small number of variables which represent the general characteristics of the the local authority and the population. The most important of these variables is the proportion of single-person housegolds, which accounts for about three-quarters of the variation in the male suicide rates and more than half of the variation in female suicide rates. The significance of these results is discussed, with particular reference to the effect of the detoxification of the domestic gas supply during the period of study.

Adolescent↗