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PubMed1989

Adenovirus type 7 infections in children in New South Wales, Australia.

This study describes our experience of adenovirus type 7 infection in children in New South Wales, Australia. Some aspects of the epidemiology of the infection are also recorded. A community outbreak, a hospital-ward outbreak, sporadic cases, and data from a centralised registry are described. Results of genome-type identification using restriction endonucleases are given. Adenovirus type 7b infection was associated with significant mortality and points to the need, previously expressed, for an adequate vaccine for high-risk infants. Continued surveillance of adenovirus type 7 infections worldwide is necessary to identify genome types so that appropriate vaccines can be developed.

Adenoviridae Infections↗
PubMed2001

Living circumstances of children and adults with mental retardation or developmental disabilities in the United States, Canada, England and Wales, and Australia.

The purpose of this article was to collate evidence to describe where people with mental retardation or developmental disabilities live in five developed countries: United States, Canada, England, Wales, and Australia. Family homes are important dwelling places for people with mental retardation. They are the home of the great majority of children with mental retardation and a considerable proportion of adults with mental retardation. The likelihood of placement outside the family home increases with adulthood and progressively as people age. Adults with mental retardation live in a wide variety of settings, with formal residential provision frequently dependent on the arrangements that the authorities responsible for providing service support have chosen to make. There has been a considerable move away from accommodating people in large segregated and geographically isolated institutions in the countries considered. However, the current range of accommodation includes much with a distinctively different character to the homes where other citizens live. Many people still live in larger groups than would be ordinarily found in typical homes and this may necessitate departure from the architectural norm. In all of the countries considered, there has been a recent trend towards small community settings, compatible with typical housing architecture. This appears furthest advanced in the U.S. but is discernible elsewhere. Availability of residential services at a national level varies between 100 and 155 places per 100,000 total population. Regional variation within countries is even greater. In no case is the national availability considered adequate to meet the demand arising from changing need or expectations. MRDD Research Reviews 7:115-121, 2001. (c) 2001 Wiley-Liss, Inc.

Adult↗
PubMed1983

Amniocentesis carried out for neural tube indications in South Wales 1973-1981: outcome of pregnancies and findings in the malformed abortuses.

The 2872 second trimester amniocentesis followed by amniotic alphafetoprotein (AFP) estimations carried out in South Wales between 1973 and 1981 on women known to be at increased risk for neural tube defect (NTD) and those who had a raised serum AFP level in an NTD screening programme led to the identification of 78 pregnancies of a fetus with anencephalus, 61 with 'open' spina bifida, 8 with gastroschisis, 3 with exomphalos, 2 with encephalocele and 6 with chromosome abnormality. Pregnancies of fetuses having 4 potentially identifiable NTDs were missed because of an equivocal AFP level and there were two false positive results leading to the termination of one normal fetus. It is emphasized that both the latter problems of one normal fetus. It is emphasized that both the latter problems would not have occurred had gel-electrophoresis for isoenzymes of acetyl cholinesterase been available. Follow-up of pregnancies showed that 7 children with 'closed' NTD and 3 with congenital hydrocephalus were born. The anencephalic and the 'open' spina bifida had a more florid lesion than is usual at term. Nearly all the spina bifida were associated with hydrocephalus, often severe and with an obvious Arnold-Chiari malformation. All but 13 had leg or back deformation or malformations in other systems, mostly in the renal tract.

Abnormalities, Multiple↗
PubMed1987

The impact of screening for open neural tube defects in England and Wales.

Using information derived from the voluntary system of notification of congenital malformations in England and Wales, the birth prevalence of anencephaly and spina bifida was estimated to have declined by 80 per cent from 31.5 to 6.2 per 10,000 between 1964-1972 and 1985. Over the same period, notified terminations of pregnancy with a suspected fetal central nervous system abnormality increased from less than 1 per cent to 56 per cent of neural tube defect births and central nervous system terminations combined, accounting for 31 per cent of the decline in births. Routinely collected national statistics provide a method for monitoring the impact of screening for open neural tube defects. However because they are incomplete and lack detail an alternative method of monitoring is needed. This paper includes an outline of such a method, together with the results of a pilot study designed to assess the feasibility of monitoring screening in the Oxford Region.

Amniocentesis↗
PubMed1989

Prenatal screening and diagnosis of neural tube defects in England and Wales in 1985.

A survey was carried out to determine the effect of prenatal screening and therapeutic abortion on births in 1985 with anencephaly and spina bifida in England and Wales. Maternal serum alpha-fetoprotein tests were done on 399,288 women (60 per cent of pregnant women): 4 per cent were reported as being screen-positive and 1 per cent had an amniocentesis. An estimated 534 pregnancies associated with anencephaly were terminated and an estimated 445 pregnancies associated with spina bifida (but without anencephaly) were terminated. Most (63 per cent) of the anencephalic pregnancies were first suspected from an ultrasound examination; 57 per cent of the spina bifida pregnancies were first suspected from a positive maternal serum alpha-fetoprotein test, 35 per cent by ultrasound, and the remaining 8 per cent by other means. The birth prevalence of anencephaly declined by 94 per cent between 1964-1972 and 1985, but when the terminations of pregnancy on account of having a fetus with anencephaly are added to the births the decline in prevalence was only 50 per cent. The birth prevalence of spina bifida declined by 68 per cent over the same period but when the terminations were added to the births the decline in prevalence was only 32 per cent. Among births with anencephaly 66 per cent had had no screening or diagnostic tests in early pregnancy, but in those that did nearly all were positive--usually in twin pregnancies where one fetus was affected but not the other. Among births with spina bifida, 48 per cent had no tests and in those that did the results were mainly negative.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Therapeutic↗
PubMed1991

Birth prevalence of Down's syndrome in England and Wales.

The natural birth prevalence of Down's syndrome for England and Wales in 1974-1987 (i.e., the birth prevalence in the absence of prenatal diagnosis and the induced abortion of affected pregnancies) was estimated by applying the maternal age-specific birth prevalence derived from epidemiological studies to the number of births in single-year age groups tabulated by the Office of Population Censuses and Surveys (OPCS). On average, the natural birth prevalence was 12.6 per 10,000 births and increased slightly from 12.2 to 13.2 per 10,000 births over the 14-year period. Using data on induced abortions carried out on account of Down's syndrome reported to OPCS under the statutory abortion notification scheme, 14 per cent of affected births were avoided by the induced abortion of affected pregnancies, so that the actual birth prevalence of Down's syndrome was estimated at 10.8 per 10,000 births. Using data on Down's syndrome births reported to OPCS under the voluntary congenital malformation notification scheme, the prevalence was 7.2 per 10,000 births, so only 67 per cent of the estimated number of affected births were, in fact, notified to the scheme.

Abortion, Spontaneous↗
PubMed2001

Evaluation of PCR, IEF and ELISA techniques for the detection and identification of potato cyst nematodes from field soil samples in England and Wales.

Effective management of potato cyst nematodes (PCNs) requires simple, rapid and accurate identification and quantification of field populations. Soil samples from a survey of 484 fields in potato rotations in England and Wales were used to compare the identification and quantification of PCNs using IEF, PCR, ELISA and bait plant tests. The cyst counts and bait plant test revealed that 64.3% of field samples contained PCNs. Bait plant tests increased the detection rate of PCNs in field samples by 4-6.4%. This means that some infestations are cryptic and would not normally be detected by standard counts. IEF, PCR and ELISA methods distinguished between Globodera rostochiensis and G pallida and were able to register mixed populations; however they were not in full agreement. All methods suggested that G pallida is the dominant species in the field samples tested. The PCR results indicated that 66% of field samples contained pure G pallida, 8% contained pure G rostochiensis and 26% contained mixtures of the two species. Estimates of the relative process times taken per sample in the PCR, IEF and ELISA techniques are given.

Animals↗
PubMed2001

An evaluation of the predictive performance of distributional models for flora and fauna in north-east New South Wales.

To use models of species distributions effectively in conservation planning, it is important to determine the predictive accuracy of such models. Extensive modelling of the distribution of vascular plant and vertebrate fauna species within north-east New South Wales has been undertaken by linking field survey data to environmental and geographical predictors using logistic regression. These models have been used in the development of a comprehensive and adequate reserve system within the region. We evaluate the predictive accuracy of models for 153 small reptile, arboreal marsupial, diurnal bird and vascular plant species for which independent evaluation data were available. The predictive performance of each model was evaluated using the relative operating characteristic curve to measure discrimination capacity. Good discrimination ability implies that a model's predictions provide an acceptable index of species occurrence. The discrimination capacity of 89% of the models was significantly better than random, with 70% of the models providing high levels of discrimination. Predictions generated by this type of modelling therefore provide a reasonably sound basis for regional conservation planning. The discrimination ability of models was highest for the less mobile biological groups, particularly the vascular plants and small reptiles. In the case of diurnal birds, poor performing models tended to be for species which occur mainly within specific habitats not well sampled by either the model development or evaluation data, highly mobile species, species that are locally nomadic or those that display very broad habitat requirements. Particular care needs to be exercised when employing models for these types of species in conservation planning.

Animal Population Groups↗
PubMed2002

Access rights for outdoor recreation in New Zealand: some lessons for open country in England and Wales.

Access opportunities for outdoor recreation in New Zealand and England and Wales are classified according to their conformity with collective, citizenship or exclusion rights and their degrees of permanence. Alternative criteria for the apportionment of access rights are considered in the context of this classification. Different criteria for rights apportionment are found to be appropriate according to different circumstances in the context of pluralist provision. Policy developments in New Zealand are compared with those in England. After 150 years of a dominance of collective rights in New Zealand current policy is shifting provision towards exclusionary rights. In England, there is a policy shift in the other direction, towards collective rights. Lessons for the development of collective rights in England are drawn from the New Zealand experience in relation to styles of governance, public preferences, public cost, insurance liability and the potential of markets.

Civil Rights↗
PubMed1996

Second primary cancers following cancers of the kidney and prostate in New South Wales (Australia), 1972-91.

Data from the New South Wales (NSW) (Australia) Central Cancer Registry for the period 1972-91 were examined to determine the risk of second primary cancers following an initial invasive cancer of the renal parenchyma (ICD-9 code 189.0), renal pelvis (code 189.1), or prostate (code 185). Eligible cases were restricted to those who had survived for at least two months after diagnosis of the first primary cancer. Expected numbers of cancers were obtained by assuming that subjects experienced the same cancer incidence as prevailed in the corresponding general population and applying gender-, age-, and calendar-specific rates to the appropriate person-years at risk. The relative risk (RR) of a second primary cancer was taken to be the ratio of observed to expected numbers of second cancers. Following prostatic cancer, there was an overall deficit of cancers at all sites combined (RR = 0.79, 95 percent confidence interval [CI] = 0.75-0.84), and no site had a significantly raised RR. Taking this into consideration, there appeared to be a reciprocal relationship of increased risk of prostatic cancer (RR = 1.7, CI = 1.2-2.3) following an initial cancer of the renal parenchyma and of renal parenchymal cancer (RR = 1.2, CI = 0.8-1.7) after cancer of the prostate. An increased risk of bladder cancer occurred following renal parenchymal (RR = 3.4, CI = 1.1-8.0, for women only) as well as after renal pelvic cancer (men: RR = 8.7, CI = 5.4-13; women: RR = 39, CI = 26-56). A tobacco-related pattern of excess risk was seen after renal pelvic cancer but not after cancer of the renal parenchyma. These data illustrate that an excess of second primary cancers may reflect shared etiologic factors or increased medical surveillance.

Aged↗
PubMed1992

Risk factors for kidney cancer in New South Wales, Australia. II. Urologic disease, hypertension, obesity, and hormonal factors.

In a population-based case-control study of kidney cancer in New South Wales, Australia, data from structured interviews with 489 cases of renal cell cancer (RCC) and 147 cases of renal pelvic cancer (CaRP) diagnosed in 1989 and 1990, and 523 controls from the electoral rolls, confirmed the link between obesity and RCC. In addition, regular consumption of 'diet' pills independently increased the risk for this cancer. A diagnosis of hypertension at least two years before interview raised the risk for RCC, and regular use of beta-blockers, a class of antihypertensive drug, independently increased the risk for RCC and CaRP (risk ratio = 1.5-1.8). No independent effect was found for use of diuretics. Additional information provided by this study includes increased risks associated with kidney injury (RCC, CaRP)--possibly attributed to recall bias--and kidney infection (CaRP), as well as a nonsignificantly raised risk linked with kidney stones (RCC, CaRP) and a significantly reduced risk for RCC in persons giving a history of lower urinary tract infection. No significant association of RCC was found with hormonal factors (age at menarche or menopause; child-bearing; regular use of oral contraceptives or estrogens; hysterectomy or oophorectomy).

Adult↗
PubMed1993

Respiratory illness and mortality in England and Wales. A study of the relationships between weekly data for the incidence of respiratory disease presenting to general practitioners, and registered deaths.

The possible relationship between the incidence of respiratory diseases as reported to general practitioners and numbers of registered deaths in England and Wales has been examined. Morbidity data from sentinel practices for the period 1986-1990 (population covered increased from 220,000 to 470,000) were used to calculate weekly rates of aggregated respiratory disease for persons of all ages and for elderly persons (aged 65 years and over). The elderly respiratory disease rates and numbers of deaths were aggregated into 4-week periods; secular and seasonal trends were removed from each series and the two sets of residuals were examined graphically and cross correlation coefficients calculated. There was a very strong positive association between the respiratory disease rate and number of deaths in the same 4-week period and there was also a significant but less pronounced association between respiratory disease in one 4-week period and deaths in the next. After prior separation of weeks according to temperature into four bands, weekly rates for respiratory disease were also strongly associated with the number of weekly deaths for each temperature band. The synchronisation of peaks and troughs in the two series throughout the year supports the hypothesis that a cause and effect relationship exists between respiratory disease in the elderly and number of deaths. Other climatic and meteorological variables besides temperature may play a part in determining the spread of a respiratory disease. There is a for further research to identify the micro-organisms responsible for acute respiratory infections in the elderly.

Acute Disease↗
PubMed1993

The sectorisation of psychiatric services in England and Wales.

Sectorisation is the establishment of small geographical catchment areas with dedicated mental health staff providing services to all patients living in the area. This model of care became very widespread during the 1980s in England and Wales: 81% of District Health Authorities responding to a postal questionnaire in this study were sectorised, and around three-quarters of these had become sectorised after 1980. However, this has occurred without central planning and with very little evaluation. Important questions remain to be answered about its efficacy for the severely mentally ill, about the provision of 24-h cover in a sectorised service, and about which services are appropriately provided at a sectorised and which at a centralised level.

Catchment Area, Health↗
PubMed1995

The potential effects of climate change on winter mortality in England and Wales.

In Britain death rates from several important causes, particularly circulatory and respiratory diseases, rise markedly during the colder winter months. This close association between temperature and mortality suggests that climate change as a result of global warming may lead to a future reduction in excess winter deaths. This paper gives a brief introductory review of the literature on the links between cold conditions and health, and statistical models are subsequently developed of the associations between temperature and monthly mortality rates for the years 1968 to 1988 for England and Wales. Other factors, particularly the occurrence of influenza epidemics, are also taken into account. Highly significant negative associations were found between temperature and death rates from all causes and from chronic bronchitis, pneumonia, ischaemic heart disease and cerebrovascular disease. The statistical models developed from this analysis were used to compare death rates for current conditions with those that might be expected to occur in a future warmer climate. The results indicate that the higher temperatures predicted for 2050 might result in nearly 9000 fewer winter deaths each year with the largest contribution being from mortality from ischaemic heart disease. However, these preliminary estimates might change when further research is able to make into account a number of additional factors affecting the relationship between mortality and climate.

Cerebrovascular Disorders↗
PubMed1995

Migration and social change: a longitudinal study of the social mobility of 'immigrants' in England and Wales.

"Data from the OPCS Longitudinal Study is used to examine the social mobility of 'immigrants' in England and Wales between 1971 and 1981. Three issues are raised: (i) in what respects and to what degree do 'immigrants' differ in their social mobility characteristics from the norm set by the population as a whole?; (ii) in what respects and to what degree do 'immigrants' differ amongst themselves in their social mobility characteristics according to their country of origin?; and (iii) how do 'second-generation immigrants' and recently-arrived immigrants differ in their social class locations from those who have been in the British labour market for a considerable length of time?" (SUMMARY IN FRE)

Demography↗
PubMed1993

The shape of mortality curves: an analysis of counties in England and Wales, 1911.

"Previous analysis has shown that life tables may be distinguished by two orthogonal pieces of information, the level of mortality in the population and the relative shape of the mortality curve. We show that both the regions of England and Wales in 1911, and locality types (county boroughs, other urban, and rural) differ in the shape of their mortality curves. Using data for the administrative counties, we examine the underlying correlates of this differentiation, paying particular attention to the socio-economic structure of the counties as reflected in their wealth, opportunity levels, and degree of urbanisation." (SUMMARY IN FRE)

Demography↗
PubMed1994

Cancer incidence in migrants to New South Wales (Australia) from the Middle East, 1972-91.

The incidence of cancer in migrants to New South Wales (NSW) from Cyprus, Egypt, Iran, Iraq, Israel, Lebanon, Syria, and Turkey has been compared with that in the Australian-born population using data from the NSW Central Cancer Registry for 1972-91. Age-standardized incidence rates showed overall cancer incidence to be less common in migrants from each Middle Eastern country than in the Australian-born. There was a clear pattern of generally low rates for cancers of the mouth and pharynx, esophagus, colon and rectum, lung (men only), ovary, prostate and testis, and melanoma. Cancers which tended to be more common in migrants were nasopharynx, stomach (women only), liver (men only), gallbladder (chiefly in women), bladder (men only), and thyroid. Breast cancer did not show a uniform pattern among migrant groups, rates being high in the Egyptian-born but low in Lebanese-born women. The overall low incidence of cancers related to tobacco and alcohol, and to a 'high fat, low fiber' diet, emphasizes the potential role of preventable lifestyle factors in the burden of cancer in Australia.

Age Factors↗
PubMed1989

Age, sex and suicide rates within birth cohorts in England and Wales.

The relationships between suicide rates at different ages within male and female birth cohorts in England and Wales are examined. There is a sex difference in the pattern of mean correlations of within-cohort rates for various time intervals, with females showing a significant negative correlation between rates separated by 10-15 years. The full correlation matrix of age-specific rates indicates that this negative mean interval correlation is due to negative correlations between rates at age 35-44 years and rates at other ages. This suggests that the acceleration-deceleration model of suicide may be applicable to female rates, with a reduction in suicide associated with pregnancy and motherhood and a rebound increase in rates thereafter.

Adolescent↗