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At least 667 records · Page 37Linked to original sources
PubMed1997

Surveillance of measles in England and Wales: implications of a national saliva testing programme.

The impact of a mass vaccination campaign against measles-rubella in England and Wales was assessed using the results of a saliva test for measles-specific IgM, which was offered to all notified cases of measles. By means of clinical data supplied by the reporting doctors, we estimated the sensitivity and specificity of various clinical case definitions in predicting a confirmed case. A saliva sample was obtained within the appropriate time period for 3442/7574 (45.4%) of notified cases; the proportion confirmed by saliva testing was low and fell from 67/681 (9.8%) at the start of the campaign to 1/373 (0.3%) after 35 weeks. The specificity of all clinical case definitions was low, but was highest at 41.1% (95% confidence interval, 39.2-43.0%) for the definition similar to that recommended in the USA. Extrapolating from cases observed during ongoing surveillance permits estimation of an annual notification rate for nonmeasles rash and fever illness. For countries with good measles control, a clinical case definition is too nonspecific for accurate surveillance. Laboratory confirmation of suspected measles cases is required and saliva testing is an acceptable method. The continued sensitivity of measles surveillance in England and Wales requires that the incidence of notified rash and fever illness and the proportion of cases in which measles infection was excluded by laboratory testing be monitored.

Adolescent↗
PubMed1998

Reference laboratory surveillance of syphilis in England and Wales, 1994 to 1996.

Routine surveillance of syphilis of public health importance (infectious, congenital, and neurosyphilis) began in England and Wales in 1994, using reports from six PHLS laboratories that undertook serological and other reference work. One hundred and thirty-one cases were reported in the first two years, including 100 cases of infectious syphilis, with all regions reporting some infectious syphilis. Reports from PHLS laboratories represented one sixth of the number of cases seen in genitourinary clinics (KC60 data), but both systems produced comparable results. Laboratory reports provided more data on risk factors, which were not available elsewhere. This study documents the risk in England and Wales from infections originating in eastern Europe, where sexually transmitted infections including syphilis have reached epidemic proportions. Forty-five per cent of cases of infectious syphilis were reported to have been acquired in the United Kingdom (UK) and 59% of people with infectious syphilis were reported to have been born in the UK. Twenty per cent of the infectious cases were associated directly or indirectly with transmission in Russia or elsewhere in eastern Europe. The majority of infectious cases were from the white ethnic group. Eighty-five per cent of cases of infectious syphilis were reported to have been acquired heterosexually; 26% of male cases were reported to have been acquired homosexually. The PHLS laboratory reporting system is now well established, and could usefully be expanded to include other, non PHLS, laboratories that undertake reference work. It has the capacity to detect changes in the national epidemiology of syphilis, including imported infections.

Adult↗
PubMed1998

General outbreaks of infectious intestinal disease in England and Wales: 1995 and 1996.

One thousand nine hundred and nineteen general outbreaks of infectious intestinal disease in England and Wales were reported to the PHLS Communicable Disease Surveillance Centre (CDSC) between 1 January 1995 and 31 December 1996, compared with 1073 in the previous two years. A minimum data set was received for 1568 (82%) of the 1919 outbreaks. Over 40,000 people were affected and about 2% of those who were ill were admitted to hospital. Seventy-one deaths were reported. The duration of outbreaks varied between less than one day and 202 days (median six days) according to the pathogen. Small round structured virus (SRSV) (43%) and salmonellas (15%) were the most commonly reported pathogens. In almost a quarter of the outbreaks (24%) the aetiology was unknown. Over half the outbreaks (64%) were reported to be transmitted from person to person, most of which were due to SRSV and occurred in residential homes and hospitals. Twenty-two per cent of outbreaks were described as mainly foodborne, 51% of which were due to salmonellas. The number of outbreaks reported in each region ranged from 52 in Wales to 512 in Northern and Yorkshire.

Caliciviridae Infections↗
PubMed1998

Results of a survey of diagnosed HIV infections prevalent in 1996 in England and Wales.

This paper describes a survey undertaken to assess the caseload of HIV infected patients who received medical care from statutory service providers in England and Wales in 1996 in order to inform health authorities about the size and composition of their resident population of such patients. A total of 13,670 HIV infected patients were identified as living in England and Wales, 70% of whom lived in the Thames NHS executive regions. Over half the total caseload received care within their health authority of residence. Regional care centres attracted patients from wider areas, however, particularly in the North West and Thames regions. This survey of prevalent diagnosed HIV infections, one of a series conducted annually, provides public health specialists with information relevant to their localities without compromising patient confidentiality. Along with other data from the surveillance of AIDS cases and HIV infections it contributes to the assessment and projection of demands on health and social services and provides evidence on which to develop and direct national and local health campaigns.

Data Collection↗
PubMed1998

Use of sentinel lambs to survey the effect of an education programme on control of transmission of Echinococcus granulosus in South Powys, Wales.

In this article the effects of an education programme (area II) on transmission of Echinococcus granulosus from dogs to sheep in Wales and of substitution of the education programme by a 6-weekly anthelmintic control programme (area I) are compared with the situation in an area where no control interventions had occurred (area III). The education programme failed to prevent transmission of E. granulosus to sentinel lambs examined at 15 months of age, 6%, 4%, and 10% of which were infected in areas I, II, and III, respectively. Educational efforts did, however, show some positive effects; for example, significantly more farmers (87-98%) in areas I, II, and III used praziquantel to treat their dogs compared with 39% of farmers in a lowland area in the east of England where E. granulosus is absent. In particular, the interval between treatments of dogs was significantly shorter in areas targeted with education programmes, and 38% of farmers in area I treated dogs at a 4-6 week interval, as did 17% in area II and 10% in area III, compared with only 3% in the lowland area. Also, more dogs in Wales (65-88%) were treated at an interval of < or = 3 months, whereas most of the dogs in the lowland area (64%) were treated at intervals of > or = 6 months. The shorter treatment intervals with praziquantel may account for the significantly fewer positive coproantigen tests among dogs in area I (6.3%) and area II (5.6%) compared with area III (23.9%).

Adolescent↗
PubMed1987

Diabetes and glucose tolerance in New South Wales coastal Aborigines: possible effects of non-Aboriginal genetic admixture.

A survey of adults living in two predominantly Aboriginal communities in eastern New South Wales revealed a crude prevalence of clinically diagnosed diabetes of 6.7% in Aboriginals. 1.4% of Aboriginal subjects investigated with 75 g oral glucose tolerance tests were found to have previously undiagnosed diabetes, and 2.8% had impaired glucose tolerance. 53% of women and 27% of men were obese as judged by body mass index. The age-sex standardised prevalence of diabetes in Aboriginals (previously diagnosed and newly detected) was 7.8%, which is substantially lower than the 15.6% prevalence found in the Aboriginal population of Bourke (central New South Wales). HLA antigen studies on these same individuals suggest approximately 60% genetic admixture from non-Aboriginal sources. Insulin response to oral glucose and mean body mass index were both related to non-Aboriginal genetic admixture with higher values in Aboriginal subjects than in their non-Aboriginal neighbours, and highest values were found in those with no detectable non-Aboriginal HLA haplotypes. The extent of genetic admixture in these communities may partly explain the lower prevalence of diabetes when compared with that found in the Aboriginal population of Bourke.

Adolescent↗
PubMed1988

Egg mass and shell thickness in dippers Cinclus cinclus in relation to stream acidity in Wales and Scotland.

The shell thickness and mass of eggs of the dipper (Cinclus cinclus) collected on streams of different pH in Wales and Scotland were measured. The aluminium, phosphorus and calcium content of their invertebrate prey were also measured. In a regression analysis, significant at p<0.05, stream pH accounted for up to 7% of the variance in shell thickness, with shells decreasing by 2.5% of the overall mean with each unit of pH decline. In the Welsh sample, differences in shell thickness due to pH were small compared with differences between years across all sites. In data pooled between Scotland and Wales, pH accounted for 17% of the variance in egg mass, but a greater proportion (25%) in Scottish eggs alone. Aluminium concentrations in invertebrates showed no relationship with stream pH, but calcium levels in two insect orders increased significantly with pH. Calcium rich prey, such as Gammarus, were found only in circumneutral streams. The importance of calcium in the diet of dippers before and during egg formation is discussed. No evidence that aluminium in prey adversely affected dipper eggs was found.

Journal Article↗
PubMed1992

Acid waters in upland Wales: causes, effects and remedies.

Although situated on the western seaboard of the UK, and hence in the path of predominantly maritime air masses arriving directly from the Atlantic, Wales receives acidic deposition when winds are from the east. In conjunction with the highly base-poor rocks and soils found in the region, significant acidification of surface waters has occurred. Extensive afforestation in the Welsh uplands in the last 40 years has exacerbated acidification effects by elevating the loading of acidic anions received by catchments, thus increasing the concentrations of aluminium in watercourses. In considering possible remedial strategies, results of liming investigations from the Llyn Brianne Project in mid-Wales are presented. These studies have mainly involved liming small streams by a variety of catchment liming techniques. The most effective catchment treatments were those where finely ground CaCO3 was applied to the hydrological source areas at rates of up to 25 tonnes ha(-1). Possible drawbacks with such liming are discussed, although it is emphasized that liming is likely to be a component of any remedial strategy in the next 30 years until emissions reductions greater than those proposed in the forthcoming EC Directive are implemented.

Journal Article↗
PubMed1994

Lead in livers and gizzards of waterfowl shot in New South Wales, Australia.

Few data exist on lead in waterfowl within New South Wales, Australia, despite global concern about lead poisoning in this group of birds. The gizzards and livers from 716 ducks (seven species) were collected from six sites within New South Wales during the 1992 duck shooting season. Six birds had ingested shot in their gizzards (<1%); four waterfowl had high concentrations of lead in their livers (>6 mg kg(-1) wet-weight (ww)) and a further three had elevated concentrations of lead in their livers (>2 mg kg(-1) ww). Mean lead concentrations in the livers of birds were low (range 0.11-0.28 mg kg(-1) ww; among six sites). Lead concentrations in livers of the herbivorous maned duck Chenonetta jubata were generally lower than in other omnivorous or carnivorous species. Low lead concentrations in tissues reflected low hunting pressure at all sites (0-0.27 hunters ha(-1) year(-1)).

Journal Article↗
PubMed2003

A survey of non-accidental injury imaging in England, Scotland and Wales.

AIM: To identify the potential national variation in non-accidental injury (NAI) imaging in England, Scotland and Wales. MATERIALS AND METHODS: A postal survey was sent to 323 hospitals with both paediatric and radiology departments. These were identified by a search through the Medical Directory. RESULTS: One hundred and thirteen of 323 postal questionnaires were returned within the study period (35%). Sixteen were excluded from the study because either no NAI imaging was performed at that institution or an incorrect address had been used. The total number of completed questionnaires was 97 (30%). Extensive variation was seen in all aspects of NAI imaging including imaging techniques used, total case numbers, follow-up imaging and those who report the NAI imaging. CONCLUSIONS: There is currently no national protocol that incorporates all aspects of NAI imaging in England, Scotland and Wales. Extensive variation in practice has been shown by this survey. Further standardization of NAI imaging practice is required. The draft BSPR skeletal survey guidelines and routine neurological imaging is recommended.

Child↗
PubMed2004

Using a linked soil model emulator and unsaturated zone leaching model to account for preferential flow when assessing the spatially distributed risk of pesticide leaching to groundwater in England and Wales.

Although macropore flow is recognized as an important process for the transport of pesticides through a wide range of soils, none of the existing spatially distributed methods for assessing the risk of pesticide leaching to groundwater account for this phenomenon. The present paper presents a spatially distributed modelling system for predicting pesticide losses to groundwater through micro- and macropore flow paths. The system combines a meta version of the mechanistic, dual porosity, preferential flow pesticide leaching model MACRO (the MACRO emulator), which describes pesticide transport and attenuation in the soil zone, to an attenuation factor leaching model for the unsaturated zone. The development of the emulator was based on the results of over 4000 MACRO model simulations. Model runs describe pesticide leaching for the range of soil types, climate regimes, pesticide properties and application patterns in England and Wales. Linking the MACRO emulator to existing spatial databases of soil, climate and compound-specific loads allowed the prediction of the concentration of pesticide leaching from the base of the soil profile (at 1 m depth) for a wide range of pesticides. Attenuation and retardation of the pesticide during transit through the unsaturated zone to the watertable was simulated using the substrate attenuation factor model AQUAT. The MACRO emulator simulated pesticide loss in 10 of 12 lysimeter soil-pesticide combinations, for which pesticide leaching was shown to occur and also successfully predicted no loss from 3 soil-pesticide combinations. Although the qualitative aspect of leaching was satisfactorily predicted, actual pesticide concentrations in leachate were relatively poorly predicted. At the national scale, the linked MACRO emulator/AQUAT system was found to predict the relative order of, and realistic regional patterns of, pesticide leaching for atrazine, isoproturon, chlorotoluron and lindane. The methodology provides a first-step assessment of the potential for pesticide leaching to groundwater in England and Wales. Further research is required to improve the modelling concept proposed. The system can be used to refine regional groundwater monitoring system designs and sampling strategies and improve the cost-effectiveness of the measures needed to achieve 'good status' of groundwater quality as required by the Water Framework Directive.

Journal Article↗
PubMed1986

Communicable disease associated with milk and dairy products in England and Wales: 1983-1984.

During the period 1983-1984 32 outbreaks of disease (II in 1983 and 21 in 1984) associated with consumption of milk and dairy products and affecting at least 714 people were reported from England and Wales. Twenty-seven of the outbreaks were attributed to raw milk, two to contaminated pasteurised milk and one each to cheese, cream and ice-cream. Twenty-two were due to salmonellas, seven to campylobacters and one each to Staphylococcus aureus, Yersinia enterocolitica and Streptococcus zooepidemicus. Two sporadic cases of Corynebacterium ulcerans infection associated with raw milk were also reported. There were eight deaths, all associated with the S. zooepidemicus outbreak. The continuing occurrence of milk-borne outbreaks, and an increasing number of incidents affecting rural communities, emphasises the urgent need for enforcing pasteurisation of milk and dairy products in England and Wales.

Aged↗
PubMed2002

Enhanced surveillance of primary measles mumps and rubella (MMR) immunisation in Wales.

In England and Wales routinely available data measure uptake of the measles mumps and rubella (MMR) vaccine at 2 years. This results in a delay in detecting change in uptake of the vaccine, which is scheduled at 12 months of age. The predictive value of uptake at 15-17 months is limited by the greater variability in uptake between quarters at the younger age. This can be overcome by presenting the data as a four-quarter annual rolling average. Uptake of the MMR vaccine at 2 years of age in Wales is predicted to stabilise at around 84% in the first three quarters of 2002.

Child, Preschool↗
PubMed2004

Radical-promoted Stone-Wales rearrangements.

The mechanism of the known Stone-Wales rearrangement of bifluorenylidene to dibenzo[g,p]chrysene is assessed with the aid of B3LYP/6-31G(d) density functional calculations, and it is shown that a radical-promoted mechanism involving a sequence of homoallyl-cyclopropylcarbinyl rearrangement steps gives a realistic activation energy and can explain experimental observations, whereas a unimolecular mechanism has an improbably high activation energy. Radical-promoted mechanisms are then applied to the hypothetical Stone-Wales rearrangements of diindeno[1,2,3,4-defg;1',2',3',4'-mnop]chrysene and C(60) itself. Severe steric constraints in these cases raise the activation energy for the radical-promoted pathways substantially, but they are still strongly preferred to uncatalyzed, unimolecular pathways

Journal Article↗
PubMed1976

Serological evidence of inter-epidemic infection of feral pigs in New South Wales with Murray Valley encephalitis virus.

The sera of 617 feral pigs, collected from three widely separated areas of northern and central New South Wales, were examined for antibody to Murray Valley encephalitis (MVE) virus and to Ross River virus. Haemagglutination-inhibition (HI) antibody was detected to MVE in 58% of sera and to Ross River virus in 15% of sera. Neutralization tests suggested that the MVE HI antibody resulted from infection with MVE virus in the summers of 1971-1972 and 1972-1973 when the virus was not known to be active in New South Wales. These same tests suggested that more than one flavivirus infected the feral pigs in the summer of 1973-1974 and that Kunjin virus was active in the summer of 1975-1976.

Animals↗
PubMed1993

Prevention of spinal cord injuries in an Australian study (New South Wales).

The Spinal Awareness and Prevention Programme presented through the Royal North Shore Hospital and the Royal Rehabilitation Centre, in Sydney, NSW, Australia has grown considerably since 1982. Ten years later it is pleasing to report that the programme has grown in response to public demand and requires a full time coordinator, secretary and five disabled lecturers (part time). This prevention message now reaches over 100,000 school students throughout New South Wales every year as well as the community in general through media advertising. Over the last 5 years the annual incidence of spinal cord injury has dropped by 20% in New South Wales for motor vehicle accidents, contact sport and water related accidents. The 'lifetime' costs for paraplegia approach AUS$1,000,000 and for quadriplegia AUS$2,000,000. The reduction of serious spinal injuries means that at least 20 families in this State, with a population of nearly 6 million, will not this year have to face the tragedy and enormous challenge of permanent paralysis. There is now commitment to the promotion of prevention of spinal cord injuries. The annual cost of this programme to each individual in the community is less than 10 cents.

Accidents, Traffic↗
PubMed1999

Vascular surgical society of great britain and ireland: deaths from ruptured abdominal aortic aneurysm in wales

BACKGROUND: The aim was to determine the true incidence and operative mortality rate of patients with ruptured abdominal aortic aneurysm (AAA) who reach hospital alive in Wales. METHODS: Patients presenting with a ruptured AAA between September 1996 and August 1997 were analysed. The data were collected prospectively by an independent body, observing strict confidentiality. RESULTS: Two hundred and thirty-three patients with confirmed ruptured AAA were identified. One hundred and thirty-three patients (57 per cent) underwent attempted operative repair. Eighty-five (64 per cent) died within 30 days. All 100 patients who received no operation died. Of the 233 patients, 92 were admitted under vascular surgeons (VSs) and 141 under non-vascular surgeons (NVSs). VSs operated on 82 patients (89 per cent) of whom 50 (61 per cent) died; NVSs operated on 51 (36 per cent) of whom 35 (69 per cent) died. CONCLUSION: This study is the only independent prospective study of death among patients with ruptured AAA who reached hospital alive. Some 57 per cent of the patients with a ruptured AAA were operated on. The operative mortality rate was 64 per cent and the overall mortality rate was 79 per cent. VSs were significantly more aggressive (89 per cent) in the management of ruptured AAA (i.e. more likely to operate) than NVSs (36 per cent) (P < 0.0001). Despite this, the operative mortality rate for VSs was 61 per cent, whereas for NVSs it was 69 per cent (P = 0.372). The overall mortality rate (including operated and non-operated patients) for NVSs (89 per cent) was significantly higher than that for VSs (65 per cent) (P < 0.0001). In Conclusion:, ruptured AAA is common in Wales and associated with a high mortality rate even when managed by VSs.

Journal Article↗
PubMed1996

Fertility in England and Wales: a fifty-year perspective.

This paper provides a detailed account of fertility levels and trends in England and Wales since 1938, with a briefer coverage of a much longer time-span. The paper is concerned both with the measurement of fertility and with understanding the observed fertility behaviour. We lament and correct the failure of demographers to apply measurement tools available since the 1950s to the analysis of fertility in England and Wales, with a particular emphasis on adjustment of period measures and period parity progression ratios and show how some of the grosser errors of analysis and interpretation might have been avoided by earlier use of these approaches. We also relate these estimates to more recent ones. Once a clearer account of trends has been established, the paper goes on to reinterpret and explain the baby boom and baby bust. The conclusion looks at future prospects for fertility.

Fertility↗