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At least 703 records · Page 39Linked to original sources
PubMed2001

Meningitis in infancy in England and Wales: follow up at age 5 years.

OBJECTIVE: To describe important sequelae occurring among a cohort of children aged 5 years who had had meningitis during the first year of life and who had been identified by a prospective national study of meningitis in infancy in England and Wales between 1985 and 1987. DESIGN: Follow up questionnaires asking about the children's health and development were sent to general practitioners and parents of the children and to parents of matched controls. The organism that caused the infection and age at infection were also recorded. SETTING: England and Wales. PARTICIPANTS: General practitioners and parents of children who had had meningitis before the age of 1 year and of matched controls. MAIN OUTCOME MEASURES: The prevalence of health and developmental problems and overall disability among children who had had meningitis compared with controls. RESULTS: Altogether, 1584 of 1717 (92.2%) children who had had meningitis and 1391 of 1485 (93.6%) controls were successfully followed up. Among children who survived to age 5 years 247 of 1584 (15.6%) had a disability; there was a 10-fold increase in the risk of severe or moderate disability at 5 years of age among children who had had meningitis (relative risk 10.3, 95% confidence interval 6.7 to 16.0, P<0.001). There was considerable variation in the rates of severe or moderate disability in children infected with different organisms. CONCLUSION: The long term consequences of having meningitis during the first year of life are significant: 32 of 1717 (1.8%) children died within five years. Not only did almost a fifth of children with meningitis have a permanent, severe or moderately severe disability, but subtle deficits were also more prevalent.

Age Factors↗
PubMed2006

Perinatal mortality and congenital anomalies in babies of women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland: population based study.

OBJECTIVE: To provide perinatal mortality and congenital anomaly rates for babies born to women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland. DESIGN: National population based pregnancy cohort. SETTING: 231 maternity units in England, Wales, and Northern Ireland. PARTICIPANTS: 2359 pregnancies to women with type 1 or type 2 diabetes who delivered between 1 March 2002 and 28 February 2003. MAIN OUTCOME MEASURES: Stillbirth rates; perinatal and neonatal mortality; prevalence of congenital anomalies. RESULTS: Of 2359 women with diabetes, 652 had type 2 diabetes and 1707 had type 1 diabetes. Women with type 2 diabetes were more likely to come from a Black, Asian, or other ethnic minority group (type 2, 48.8%; type 1, 9.1%) and from a deprived area (type 2, 46.3% in most deprived fifth; type 1, 22.8%). Perinatal mortality in babies of women with diabetes was 31.8/1000 births. Perinatal mortality was comparable in babies of women with type 1 (31.7/1000 births) and type 2 diabetes (32.3/1000) and was nearly four times higher than that in the general maternity population. 141 major congenital anomalies were confirmed in 109 offspring. The prevalence of major congenital anomaly was 46/1000 births in women with diabetes (48/1000 births for type 1 diabetes; 43/1000 for type 2 diabetes), more than double that expected. This increase was driven by anomalies of the nervous system, notably neural tube defects (4.2-fold), and congenital heart disease (3.4-fold). Anomalies in 71/109 (65%) offspring were diagnosed antenatally. Congenital heart disease was diagnosed antenatally in 23/42 (54.8%) offspring; anomalies other than congenital heart disease were diagnosed antenatally in 48/67 (71.6%) offspring. CONCLUSION: Perinatal mortality and prevalence of congenital anomalies are high in the babies of women with type 1 or type 2 diabetes. The rates do not seem to differ between the two types of diabetes.

Adolescent↗
PubMed1995

Indications, methods, and outcomes of percutaneous liver biopsy in England and Wales: an audit by the British Society of Gastroenterology and the Royal College of Physicians of London.

The liver section of the British Society of Gastroenterology and the research unit of the Royal College of Physicians collaborated to set up a nationwide audit to investigate the practice of percutaneous liver biopsy in England and Wales. Each of 189 health districts in England and Wales was approached to provide a list of 10 consecutive percutaneous biopsies performed during 1991, and details of demographic data, indications, suspected diagnosis, investigations, biopsy technique, outcome, and influence on patient management were collected. Data were retrieved on 1500 (79%). The age distribution showed 6% of biopsies were done in those over 80 years of age and as many over 90 as under 10 years of age. Suspected malignancy and chronic liver disease each contributed one third of the indications. In 34% the procedure was carried out by radiologists under ultrasound image control. The remainder were done by general physicians and gastroenterologists, with the operator in the second group being more senior and experienced. The Trucut biopsy needle accounted for two thirds of biopsies, the remainder being the Menghini type. For both needles the samples were recorded as excellent or satisfactory in 83% and inadequate in only 5%. Bleeding complicated 26 procedures (1.7%), requiring transfusion in 11, and was commoner when clotting was impaired or serum bilirubin raised. There were two definite and three possible procedure related, given an overall mortality of 0.13-0.33%. The diagnosis made before biopsy was confirmed in 63% of patients, and the clinician found the biopsy helpful in treatment in 75%. Day case biopsy and techniques to reduce the risk of bleeding were surprisingly rare in this series, which has given a unique opportunity to examine everyday practice across a wide range of hospitals.

Adolescent↗
PubMed1996

Cancer mortality among local authority pest control officers in England and Wales.

OBJECTIVE: To examine cancer mortality by tumour site among local authority pest control officers. METHODS: Prospective mortality study, and follow up to the end of 1994, of 1485 male pest control officers aged between 17 and 69 and employed in 296 local authorities in England and Wales for at least six months between January 1980 and April 1984. Observed numbers of deaths were compared with those expected on the basis of the rates for relevant calendar year, cause, sex, and age specific groups for England and Wales. RESULTS: 200 deaths occurred during the follow up period of which 65 were certified as due to malignant neoplasms. No tumour type showed significantly more deaths than expected. Total all cause, lung cancer, and respiratory disease mortality were significantly lower than expected. CONCLUSIONS: 15 year follow up of a group of men handling a wide range of pesticides did not show any significant risk of cancer. This may be partially explained by the healthy worker effect and also the limited power of the study to detect significant increases in the less common tumours. Further long term follow up of this cohort will continue. Chemical control of pests that can cause human disease and can contaminate food and water has been, and will continue to be, a major public health measure. It is important to ensure that the health of those applying pesticides is not at excess risk. Negative results are important.

Adolescent↗
PubMed2006

Factors associated with heterosexual transmission of HIV to individuals without a major risk within England, Wales, and Northern Ireland: a comparison with national probability surveys.

OBJECTIVE: To compare the prevalence of HIV risk behaviours reported by heterosexuals without major risks for HIV acquisition diagnosed with HIV in England, Wales, and Northern Ireland, with those of the heterosexual general population. METHODS: Demographic and sexual behaviour data for heterosexuals (without major risks for HIV) aged 16-44 from the British National Surveys of Sexual Attitudes and Lifestyles in 1990 and 2000 were compared to 139 HIV infected individuals without major risks for HIV aged 16+ at diagnosis, interviewed between December 1987 and March 2003. Comparisons were made overall and separately for the early and late 1990s. RESULTS: HIV infected heterosexual men without major risks were significantly more likely to report first heterosexual intercourse before age 16 (adjusted odds ratio (AOR): 2.75; 95% confidence interval (CI),1.65 to 4.57), while both HIV infected heterosexual men and women reported greater partner numbers (AOR: men 2.44; CI, 1.4 to 4.05; AOR women 2.17; CI, 1.28 to 3.66) and never using condoms (AOR: men 7.97; CI,4.78 to 13.3; AOR women 3.95; CI, 2.30 to 6.80) than the heterosexual general population. There is evidence to suggest that the two groups were more similar in their reporting of partner numbers in the late 1990s relative to the early 1990s. CONCLUSION: Heterosexual HIV infected individuals without major risks for HIV acquisition in England, Wales, and Northern Ireland are significantly more likely to report high risk sexual behaviours relative to the British heterosexual general population. However, these differences may have decreased over time, at least for the number of partners. Effective sexual health promotion, including the continued promotion of condom use, would impact on the rising rates of STI diagnoses and also prevent HIV transmission among the heterosexual general population.

Adolescent↗
PubMed2000

Changes in suicide in England and Wales, 1960-1997.

BACKGROUND: Methods of suicide and suicide rates in England and Wales have fluctuated considerably since the 1960s. AIMS: To review the changes that have occurred in suicide rates in England and Wales between 1960 and 1997. METHOD: Suicide rates, derived from total annual suicides and the estimated annual resident population, were obtained from the Office for National Statistics. RESULTS: Suicide rates decreased in both genders between the early 1960s and the mid-1970s. The rate for males then increased between 1975 and 1990, while the rate for females continued to fall. Between 1990 and 1997, the rate decreased for males and females in all age groups, particularly for those using motor vehicle exhaust gas; the latter finding is associated with increasing use of catalytic converters. CONCLUSIONS: Following the increase in suicide among males until 1990 there was a decrease for both genders between 1990 and 1997, consistent with the 'Health of the Nation' target.

Adolescent↗
PubMed2006

High quality acute care for the severely injured is not consistently available in England, Wales and Northern Ireland: report of a survey by the Trauma Committee, The Royal College of Surgeons of England.

INTRODUCTION: A survey was undertaken to determine the extent to which acute hospitals in England, Wales and Northern Ireland were meeting the acute trauma management standards published in 2000 by The Royal College of Surgeons of England and the British Orthopaedic Association. METHODS: A questionnaire comprising 72 questions in 16 categories of management was distributed in July 2003 to all eligible hospitals via the link network of the British Orthopaedic Association. Data were collected over a 3-month period. RESULTS: Of 213 eligible hospitals, 161 (76%) responded. In every category of acute care, failure to meet the standards was reported. Only 34 (21%) hospitals met all the 13 indicative standards that were considered pivotal to good trauma care, but all hospitals met at least 7 of these standards. Failures were usually in the organisation of services rather than a lack of resources, with the exception of the inadequate capacity for admission to specialist neurosurgery units. A minority of hospitals reported an inability to provide emergency airway control or insertion of chest tube. The data have not been verified and deficiencies in reporting cannot be excluded. CONCLUSIONS: The findings of this survey suggest that high quality care for the severely injured is not available consistently across England, Wales and Northern Ireland, and appear to justify concerns about the ability of the NHS to deal effectively with the current trauma workload and the consequences of a major incident.

Health Services Accessibility↗
PubMed2002

Reports from the Faculty of Family Planning and Reproductive Health Care AGM, May 2002. Assessing the quality of information leaflets about abortion methods in England and Wales.

This study assessed the quality of written information about abortion methods provided by clinics in England and Wales. Forty-four sets of leaflets were collected. The average leaflet was found to provide only half the possible information about benefits, risks and general procedures. Only half of the leaflets were of standard readability and accessible by 83% of the British population. Therefore, it seems unlikely that most women in England and Wales are in a position to make an informed decision about abortion method.

Abortion Applicants↗
PubMed1975

A health and social survey of a group of children from rural New South Wales.

Between the middle of May and middle of July, 1972, 177 children aged up to 15 years were admitted to a nursing home in Sydney on referral from their doctors in country areas of New South Wales for specialized investigation and treatment mainly of respiratory infections, congenital malformations and orthopaedic and ophthalmic conditions. Specimens of faeces from these children were examined for bacterial pathogens and parasites. These tests revealed the presence of intestinal parasites (mostly Giardia lamblia) in 91 of the children and of bacterial pathogens in 14 (a salmonella in one and shigellas in 13). The general health and development of the children and the socioeconomic status of their families were below the average for New South Wales.

Adolescent↗
PubMed1976

Infantile autism: the incidence of national groups in a New South Wales survey.

In a survey on the occurrence of infantile autism in New South Wales it was found that 21-9% of children had at least one foreign-born parent whose native language was not English. In terms of population incidence for New South Wales, Italy and Yugoslavia were under-represented while Greece and Germany were significantly over-represented. The stresses faced by migrants in a new country were discussed in terms of possible contributing agents and in particular, the cultural traditions of the Greeks and their adjustment problems were highlighted. It was suggested that the stresses of cultural change and the socioeconomic pressures borne by the parents resulted in deprivation of their children who were also exposed to a confused language environment, and that a combination of these variables could lead to decompensation into an autistic state in an already vulnerable child.

Adolescent↗
PubMed1977

The control of hydatid disease and ovine cysticercoses in the Australian Capital Territory and southern New South Wales.

A survey of human hydatid disease in New South Wales and the Australian Capital Territory over the period 1968 to 1973 was made from hospital records in Sydney and Canberra. The 162 new cases found represent an incidence, of 0-57 per 100,000 per annum, but the 20 patients living in the Central West Statistical Division of New South Wales at the time of admission to hospital represent an incidence of 12-6 per 100,000 per annum in that area. A survey of A.C.T. farms revealed dogs carrying the causative parasite Echinococcus granulosus on five out of 44 properties (11-4%). Community attitudes favoured control measures but displayed a misplaced faith in anthelmintic drugs. The high regional prevalence on the Australian mainland reveals a need to restrict availability of anthelmintics and extend the vigorous control measures employed successfully in Tasmania.

Adolescent↗
PubMed1979

Cancer mortality in selected New South Wales localities with fluoridated and non-fluoridated water supplies.

The standardized cancer mortality ratios for selected localities in New South Wales with fluoridated and non-fluoridated water supplies were examined. The cancer mortality ratios for both fluoridated and non-fluoridated localities were spread along a continuum. Two localities (one fluoridated, one non-fluoridated) had standardized mortality ratios significantly lower than the New South Wales State average. No relationship was found between cancer deaths and whether water supplies had been fluoridated or not.

Australia↗
PubMed1981

Blood lead levels of some children in New South Wales.

The venous blood lead levels of 400 children under 16 years of age who lived in Port Kembla or in Cocklecreek, and of 202 patients in several New South Wales hospitals are reported and compared with criteria announced by the National Health and Medical Research Council, the European Economic Community, and the American Environmental Protection Agency. The results of this study do not show reason for concern. The samples from hospital patients stress the importance of domestic exposure, such as to flaking paint containing lead. The findings of this study are also compared with a Victorian and a New South Wales survey of schoolchildren.

Adolescent↗
PubMed1983

Botulism in New South Wales, 1980-1981.

The isolation of Clostridium botulinum from the home environment of New South Wales patients with infant botulism is reported. Of the three cases of infant botulism type B, the bacteria were isolated from soil around the dwelling in one, and from tank rainwater in another. In one case with type A, the bacteria were present in the soil, vacuum-cleaner dust, and tank rainwater. The bacteria were not detected in the environment of two adult patients and a child with C. botulinum in their stools. The home location of the patients with infant botulism, and the frequency of isolation of the bacteria from rainwater, soil and vacuum-cleaner dust in Cobar, Nyngan, some Sydney suburbs, and at five pastoral homesteads suggest that infants in rural areas are more at risk than those in large metropolitan areas. The age of the infants with diagnosed botulism in New South Wales, compared with those reported in the United States data, strongly suggests that the disease is not being fully recognised in younger infants.

Aged↗
PubMed1998

Chronic pulmonary disease in South Wales coal mines: an eye-witness account of the MRC surveys (1937-1942).

In the mid-1930s reports were accumulating from the British coalfields, particularly from the anthracite area of South Wales, that coal face workers suffered a disabling lung condition that was not recognized as the (compensatable) silicosis of rock workers. The Second World War was threatening and discontent was rife. Government, through the Medical Research Council, initiated a medical and environmental investigation of chronic pulmonary disease in South Wales coalminers to make a systematic survey. The medical surveys, 1936-1942, were undertaken by a member of MRC staff, Dr Philip D'Arcy Hart assisted by Dr Edward Aslett of the Welsh National Memorial Association. One colliery (Ammanford) was intensively investigated; fifteen others less so; coal trimmers at the docks were added. The main observations were to confirm and describe radiographically the frequency of serious lung lesions apparently due to coal dust, and distinguishable from classical silicosis. Among recommendations accepted by Government, the lung condition became recognized for compensations, and the generic term pneumoconiosis of Coal Workers' was substituted for silicosis.

Causality↗
PubMed2000

The missing relative: the home help service in England and Wales 1918-1974 part 2.

Although recent work in social policy has illustrated how the work of home helps means that they straddle the health-social services boundary, there has been relatively little work on the earlier history of this service. In this the second of two articles, the author attempts to remedy this neglect, and considers the development of the home help service in England and Wales between 1918 and 1974, examining the overall evolution of this service. In the second article (to be published in the next issue of the journal), three themes are discussed in greater detail: the issue of training, regional variations in provision, and what home helps actually did for their clients. Although the focus is on England and Wales as a whole, in this second part the author illustrates particular themes through a case study of the Midlands city of Leicester, a local authority in which the home help service was particularly highly developed. Part one was published in the last issue of the International History of Nursing Journal (volume 5, number 1, Winter 1999 issue).

England↗
PubMed2006

Trends in premature mortality in England and Wales, 1950-2004.

Premature mortality is a major public health concern but there has been little consensus among researchers on how it should be defined and reported. In this article four means of measuring early deaths are considered using four different age thresholds to define prematurity. Using these four indicators, trends in premature mortality are reported for England and Wales from 1950 to 2004. All measures show that, however 'premature' is defined, levels of premature mortality have decreased markedly over time. This article discusses which mortality indicator and age threshold would be most appropriate for a measure of premature mortality for use in national mortality statistics for England and Wales.

Adolescent↗