Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “WALES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 775 records · Page 43Linked to original sources
PubMed1996

A survey of the management of neonatal opiate withdrawal in England and Wales.

UNLABELLED: This report details the results of a survey of 213 maternity units in England and Wales concerning the use of neonatal opiate withdrawal (NOW) charts and the drug therapy management of babies born to drug using mothers. There was a response rate of 89.6%. NOW charts were used in 36.6% of units. There were eight different charts in use in which over 35 different signs of NOW were recorded, ranging from 10 to 22 on individual charts. Nine different drugs were used to manage NOW, with chlorpromazine most commonly used. CONCLUSION: Drug misuse increasing in women of childbearing age and the management of the drug affected neonate varies widely, with inconsistent policies on determining the presence of NOW and how to treat it.

Chlorpromazine↗
PubMed1986

Mortality from Crohn's disease and ulcerative colitis in England-Wales and the U.S. from 1950 to 1983.

As the etiology of inflammatory bowel disease remains unknown, studies of its time trends may provide clues to understanding the underlying mechanisms. This study examines mortality from Crohn's disease and ulcerative colitis in England and Wales and the U.S. during the period 1950 to 1983. Mortality from Crohn's disease and ulcerative colitis changed in both countries similarly. The death rates from Crohn's disease increased until 1970 to 1974 and decreased thereafter. The death rates from ulcerative colitis decreased throughout the observation period. Similar time trends occurred in men and women, and in the U.S. in whites and nonwhites. In the U.S., the death rates from both diseases were twofold higher in whites than nonwhites. The temporal changes suggest that mortality from inflammatory bowel disease is affected by exogenous factors and that these factors are different for Crohn's disease than for ulcerative colitis. These factors seem to have changed similarly in England and in the U.S.

Adolescent↗
PubMedDate not supplied

Perinatal and postneonatal mortality in England and Wales among immigrants from the Indian subcontinent.

Perinatal and postneonatal mortality among immigrants to England and Wales from India, Pakistan and Bangladesh (Asians) for the years 1982-85 showed significant differences not only between the immigrant and indigenous populations, but also among the different groups from the Indian subcontinent. Compared with the perinatal mortality rate of 10.1 per 1000 total births in UK born mothers, rates in infants of mothers born in India, Bangladesh, and Pakistan were 12.5, 14.3 and 18.8 respectively. In contrast, postneonatal mortality in infants of Indian and Bangladeshi origin (3.9 and 2.8 per 1000 live births respectively) was lower than in the indigenous population (4.1), with Pakistani infants experiencing the highest rate (6.4). Excess perinatal mortality in infants of Asian origin was apparent at most maternal ages and parities. Pakistani infants had the highest rates of perinatal and postneonatal mortality in all age, parity and birth weight groups. The Asian groups showed higher mortality from congenital anomalies in both the perinatal and the postneonatal period, the rates in Pakistani infants being almost double those in Indian and Bangladeshi infants. A significant finding was the lower rates of sudden infant death in all the groups of Asian origin.

Bangladesh↗
PubMed2004

Suicide risk in small areas in England and Wales, 1991-1993.

BACKGROUND: There is growing evidence that areas characterised by high levels of social fragmentation have higher suicide rates. Previous ecological studies have focused on relatively large geographic areas and/or examined associations in all age groups combined. METHODS: Negative binominal regression was used to assess age- and sex-specific suicide rate ratios for a range of census-derived indicators of the social, health and economic characteristics of small areas (mean population aged > or = 15: 4500) in England and Wales. RESULTS: Indicators of social fragmentation (e. g. proportion of people living alone or population mobility) were most consistently associated with suicide risk. For example, across quartiles of wards ranked according to increasing proportions of single-person households, age- and sex-adjusted suicide rate ratios were: 1.00, 1.05 (1.00, 1.11), 1.14 (1.08, 1.19) and 1.42 (1.36, 1.49). Associations were strongest in 15 to 44 and 45 to 64 year-olds. Associations with social fragmentation persisted after controlling for the effect of other area characteristics. CONCLUSIONS: Targeted mental health promotion and social policy initiatives to reduce area-health inequalities in suicide might usefully focus on areas with high levels of social fragmentation.

Adolescent↗
PubMed1999

Polypharmacy among older men in South Wales.

OBJECTIVE: To describe the pattern of polypharmacy (PP) among older men and to relate medication use to personal, social and medical information. METHODS: Information on medication use, both prescribed and 'over the counter' (OTC), was collected from 1906 men, aged 56-75 years, observed on up to four occasions since 1979 in a community survey the Caerphilly prospective study. On each visit, a variety of questionnaires regarding personal, social and medical factors were completed, and a brief medical examination was conducted. Medication use was related to some of the questionnaire information and biological measurements collected in order to identify factors associated with PP. RESULTS: A quarter of the men (475/1906) reported using three or more prescription-only medicines (PoMs), with 9% (163) using five or more (major PP). PP was related to increasing age, lower social class, not being in employment, smoking and obesity (high body mass index). Men with a medical history, especially of high blood pressure, angina, heart attack, or hospital admission in the last 5 years, comprised a large proportion of those on major PP. Higher levels of PoM use by this group had been apparent over the previous 14 years. Men on PP reported lower levels of self-rated health and higher rates of non-PoM use. Cardiovascular and, to a lesser extent, central nervous and respiratory system drugs were the main medicines used by men on major PP. CONCLUSIONS: PP is common among men aged 56-75 years in Caerphilly, South Wales. It is related to many personal, social and medical factors, and associated with lower self-rated health status and greater use of non-PoMs. Cardiovascular medicines are the main contributor to major PP. Those on PP require regular review and, where possible, PP should be reduced as it has many potential adverse effects.

Age Factors↗
PubMed1999

Morphological and reproductive characteristics of male mosquitofish (Gambusia affinis holbrooki) inhabiting sewage-contaminated waters in New South Wales, Australia.

The potential effects of exposure of fish to reproductive endocrine disruptors (REDs) is of major concern. This study reports on the effects of sewage effluent exposure on morphology of male mosquitofish (Gambusia a. holbrooki) in a tributary of the Hawksbury-Nepean River system in New South Wales, Australia. The growth and development of the modified anal fin (the gonopodium, GP) is a secondary sexual characteristic in males, forms under the influence of testosterone, and is critical for sperm transfer. The GP was reduced in length in males sampled downstream from a sewage treatment plant discharge point compared to GP fin length in males upstream or from other comparison sites. The reduction in size of this androgen-dependent structure suggests the presence of RED substances in the water. The presence or absence of spermatozeugmata (sperm packet) was not related to a reduction in GP length, which suggests spermatogenesis may not be reduced, but other measures of fertility remain to be evaluated. These results are discussed in the context of RED contaminants associated with sewage effluent.

Analysis of Variance↗
PubMed2006

Estimating the unknown components of nutrient mass balances for forestry plantations in mine rehabilitation, upper Hunter Valley, New South Wales, Australia.

Commercial forestry plantations as a postmining land use in the Upper Hunter Valley of New South Wales, Australia are restricted by both the poor nutrient availability of mining substrates and low regional rainfall. An experiment was conducted to investigate whether municipal waste products and saline groundwater from coal mining operations could improve early tree growth without impacting on the environment through salt accumulation and/or nutrient enrichment and changes in groundwater quality. Potential impacts were investigated by quantifying the nutrient cycling dynamics within the plantation using an input-output mass balance approach for exchangeable calcium (Ca(2+)), exchangeable magnesium (Mg(2+)), exchangeable potassium (K(+)), exchangeable sodium (Na(+)), nitrogen (N), and phosphorus (P). Measured inputs to and outputs from the available nutrient pool in the 0-30 cm of the overburden subsystem were used to estimate the net effect of unmeasured inputs and outputs (termed "residuals"). Residual values in the mass balance of the irrigated treatments demonstrated large leaching losses of exchangeable Ca, Mg, K, and Na. Between 96% and 103% of Na applied in saline mine-water irrigation was leached below the 0-30-cm soil profile zone. The fate of these salts beyond 30 cm is unknown, but results suggest that irrigation with saline mine water had minimal impact on the substrate to 30 cm over the first 2 years since plantation establishment. Accumulations of N and P were detected for the substrate amendments, suggesting that organic amendments (particularly compost) retained the applied nutrients with very little associated losses, particularly through leaching.

Calcium↗
PubMed2005

Neonatal meningitis in England and Wales: sequelae at 5 years of age.

UNLABELLED: This study determined the prevalence of serious sequelae among a national cohort of 5-year old children, born in England and Wales in 1996-7, who had had neonatal meningitis. The results were compared with those from two matched control groups. In addition the results from this study were compared with those from a previous 5-year follow-up of children who had had neonatal meningitis in 1985-7. Follow-up questionnaires requesting information about the children's health and development were sent to the general practitioners (GPs) and parents of the index children and controls. Information was collected on 166 of 232 (72%) children who had had meningitis as neonates, 109 general practice controls and 191 hospital controls. At 5 years, 39/166 (23%) index children had a serious disability compared to 2% of GP controls and 7% of hospital controls. There was a 16-fold increase in risk of serious disability compared to GP-matched controls and a 4-fold increase in risk compared to hospital controls. The isolation of bacteria from the CSF was the best single predictor of serious long-term disability. Although there was a 70% fall in acute phase mortality between 1985 (22%) and 1996 (6.6%), the overall incidence of serious disability remained alarmingly high, 25.5% in 1985 compared to 23.5% in 1996. In the present study, however, fewer children had cerebral palsy or seizure disorders. CONCLUSION: Despite the dramatic improvement in acute phase survival following neonatal meningitis, the prevalence of serious sequelae remains alarmingly high.

Child↗
PubMed2005

Inter-annual rainfall variations and suicide in New South Wales, Australia, 1964-2001.

The suicide rate in New South Wales is shown to be related to annual precipitation, supporting a widespread and long-held assumption that drought in Australia increases the likelihood of suicide. The relationship, although statistically significant, is not especially strong and is confounded by strong, long-term variations in the suicide rate not related to precipitation variations. A decrease in precipitation of about 300 mm would lead to an increase in the suicide rate of approximately 8% of the long-term mean suicide rate.

Disasters↗
PubMed2004

Evaluation of a scheme to enhance palliative cancer care in rural Wales.

Since the early 1990s, the United Kingdom has seen several initiatives designed to improve the quality of cancer palliative care in the community. We report on the evaluation of a project that took place in the rural county of Powys in Wales in which a group of general practitioner clinical facilitators (GPCFs) sought to raise the overall standard of palliative care among primary health care teams (PHCTs). The evaluation was conducted over 3 years and made use of several methods: interviews with facilitators and other key stakeholders at regular intervals throughout the project; a survey of PHCT members at two time points; an analysis of patterns of opioid prescribing in the county before and during the project; monitoring of referrals to specialist palliative care services out of county; and an analysis of place of death of those dying from cancer. The evaluation found that local general practitioners (GPs) were willing to work as facilitators and that they made contact with over two thirds of those in the PHCTs. Facilitators undertook a variety of clinical, educational and service development initiatives but did report on problems of role definition and time management. There were no marked changes in patterns of referral to specialist palliative care or in place of death, but there was some evidence to suggest that the facilitators had an influence on their colleagues' opioid prescribing patterns.

Humans↗
PubMed2006

Population-based mammography screening and breast cancer incidence in New South Wales, Australia.

OBJECTIVE: To analyse breast cancer incidence trends in New South Wales (NSW), Australia, in relation to population-based mammography screening targeting women aged 50 to 69 years. METHODS: Trends in age-specific incidence of invasive breast cancers in NSW women aged > or = 40 years were examined in relation to mammography screening rates and screening cancer detection rates. RESULTS: Incidence of invasive breast cancer in NSW women increased in all age-groups over 1972 to 2002. The incidence trend for women aged 50 to 69 years showed that the steepest rise was associated with increased participation in population-based mammography screening, which was implemented from 1988 and achieved state-wide coverage in 1995. The elevated incidence of invasive cancer significantly exceeded pre-screening levels, and persisted after rates of initial screens declined. This elevated incidence was sustained by the contribution of cancers diagnosed through subsequent screening, and resulted from increased cancer detection rates in subsequent screens. CONCLUSIONS: The recent increase in invasive breast cancer incidence in NSW is associated with mammography screening, and occurred mostly in the target age-group women. Persistence of higher incidence after 1994 was not explicable by inflation of cancer incidence due to detection of prevalent screen cases, but was associated with a trend of increased cancer detection rates in subsequent screening rounds, probably consequent to quality improvements in mammography screening diagnosis.

Aged↗
PubMed1994

Drink-driving law enforcement and the legal blood alcohol limit in New South Wales.

This paper reports the results of a preliminary analysis of daily fatal crashes in New South Wales, Australia, between July 1975 and December 1986. The analysis unexpectedly uncovered a small but statistically significant decline in crashes coinciding with the introduction of a law lowering the legal blood alcohol concentration (BAC) from .08 to .05 g%. The original aim of the analysis was to develop for a larger study appropriate log-linear techniques to assess the impact of a range of government initiatives, including laws aimed at the drinking driver: increased penalties, the .05 law, and random breath testing (RBT). The analysis showed that RBT immediately reduced fatal crashes by 19.5% overall and by 30% during holiday periods, and that the .05 law, introduced two years before RBT, apparently reduced fatal crashes by 13% on Saturdays. There was no significant effect of the .05 law on any other day of the week, and there was no clear evidence that any other initiative had a statistically significant effect on accidents. Although the apparent impact of the .05 law was small, it is surprising that any effect was discernible, since the law was not extensively advertised and police enforcement was no more intense than is usual over Christmas. However, any effects of the .05 law may not have been sustained if RBT had not been introduced two years later.

Accidents, Traffic↗
PubMed1995

Factors associated with preterm birth in Cardiff, Wales. I. Univariable and multivariable analysis.

OBJECTIVE: Our purpose was to examine the associations of demographic, social, and medical factors with risk of preterm birth. STUDY DESIGN: By use of the Cardiff Births Survey, a large database of largely homogeneous (white) births in Wales, multivariable analysis by logistic regression examined the relative importance of risk variables associated with preterm birth. RESULTS: Significant independent associations with preterm birth were found (in decreasing order of magnitude) for late pregnancy bleeding, preeclampsia-proteinuria, low maternal weight, low maternal age, early pregnancy bleeding, history of previous stillbirth, smoking, high parity, low or high hemoglobin concentration, history of previous abortion, low social class, bacteriuria, and nulliparity. CONCLUSION: In this population demographic, social, and medical characteristics of the pregnancies showed significant associations with preterm birth.

Abortion, Induced↗
PubMed1993

Nonsteroidal anti-inflammatory drugs and peptic ulcer hospitalization rates in New South Wales.

BACKGROUND: Consumption of nonaspirin nonsteroidal anti-inflammatory drugs (NANSAIDS) increased substantially during the 1980s. The effects of this trend on hospitalization rates for peptic ulcer in different age groups in New South Wales, Australia, was investigated. METHODS: A population model based on sales of NANSAIDS and aspirin, age specific estimates of the relative risk of ulcer complications with these drugs, and hospitalization data for 1979 through 1988 was created. RESULTS: All age groups increased consumption of NANSAIDS. The increases were greatest in elderly subjects, with women over age 65 years increasing the prevalence of their use of the drugs from 11.9% in 1979 to 22.5% in 1988 and males over age 65 increasing use from 9.7% to 20%. Aspirin use remained relatively unchanged in all age groups. Hospitalization rates for peptic ulcer decreased in both sexes under age 64 despite increasing use of NANSAIDs. Hospitalization increased in males and females over age 65, but in females the increase was substantially greater than predicted by the computer model. In women and men over age 75 the increases in hospitalization rates predicted by the model were only 18% and 33%, respectively, of the observed rises. CONCLUSIONS: The increasing hospitalization rate for peptic ulcer among elderly subjects was only partly explained by the increasing consumption of NANSAIDS. Further research is needed.

Adult↗
PubMed1989

Preventability of death from penetrating injury in England and Wales.

A total of 1000 deaths from injury in England and Wales have been reviewed to establish the incidence and pattern of penetrating injury and the adequacy of its management. Of the 1000 deaths, 71 (7.1 per cent) were due to penetrating injury. There were 32 knife wounds and 30 firearm injuries. Most of the latter were suicides. Only 17 patients (24 per cent) reached hospital alive. Of these cases, 10 had extracranial injury and all 10 deaths were considered to have been potentially preventable when reviewed by four external assessors. One of seven patients with cranial injury was considered to have been a potentially preventable death. The median age of the 11 cases of potentially preventable death was 37 years (range: 7-61 years). Of these, three did not have any surgery for surgically treatable injuries. Seven patients underwent operation and difficulty was encountered in six of these. It appears from our figures that whilst penetrating injury is an uncommon cause of death, it is poorly managed. The implications of this finding for systems of injury care in the United Kingdom are discussed.

Adolescent↗
PubMed1996

Preventable deaths among major trauma patients in Mersey Region, North Wales and the Isle of Man.

Preventable and unexpected deaths following injury were identified from among 1088 victims of major injuries arising in a defined population and area during a 12-month period. In hospital, 44 (16 per cent) deaths from blunt injury, one death from penetrating injury and one death from drowning were preventable. In patients sustaining blunt injuries, 22 per cent of non-head-injury deaths and 13 per cent of head-injury deaths were preventable. In all preventable head-injury deaths either a delay in operation (35 per cent) or no operation for mass lesions (65 per cent) occurred, often because of misdiagnosis as alcohol intoxication (22 per cent) or CVA (22 per cent). Multiple preventable factors were more likely in non-head-injury deaths and included missed injuries (67 per cent), poor airway care (57 per cent), delayed or no operation (52 per cent), undertransfusion (38 per cent) and inadequate surgery (19 per cent). By TRISS methodology the outcome was unexpected, in 53 per cent blunt injury deaths in hospital and 2.8 per cent of survivors. Three preventable blunt injury deaths (6.8 per cent) had probabilities of survival < 50 per cent and were not, therefore, identified as unexpected by TRISS. A preventable death rate of 16 per cent for blunt injuries equates to 638 preventable blunt injury deaths each year in England and Wales.

Adolescent↗
PubMed1995

The role of the continence adviser in England and Wales.

Continence advice in England and Wales is a relatively new specialism within nursing and, over the past 20 years, the number of continence advisers has grown substantially. There are, however, no formal qualifications for the role and the service has grown up in a piecemeal fashion. A study carried out by the Social Policy Research Unit of the University of York sought to answer basic quantitative questions about: (1) the number of continence advisers in post, their professional backgrounds and so on; (2) the structures within which continence advisers work; and (3) the nature of their current practice; as well as more attitudinal and developmental questions about the history and future development of continence advisers' work.

England↗
PubMed1975

Opportunist mycobacterial pulmonary infection and occupational dust exposure: an investigation in England and Wales.

This paper reports a study in England and Wales in which the industrial and non-industrial dust exposures and smoking habits of those whose pulmonary disease was due to opportunist mycobacterial infection were compared with a control group of similar age and same sex whose infection was with M. tuberculosis. Of 70 males, 53 were found to be infected with M. kansasi, 9 with M. xenopi, 6 with M. intracellulare and 2 with other opportunist mycobacteria. Only 8 females were found, of whom, 5 were infected with M. kansasi, and 3 with M. intracellulare, Those infected with M. kansasi were on average 6.5 years younger than those infected with other opportunist mycobacteria. There was no evidence of differences between patients infected with M. kansasi and their controls in various indices of past exposure to dust. A significantly higher proportion of patients infected with M. kansasi gave a history of current dust exposure at the time of diagnosis than patients infected with M. tuberculosis. There was an apparent association between infection with M. kansasi and exposure to the dusts of the metal grinding trades, but no association with a previous history of coal mining. The study suggests that the systematic establishment of the current occupations of all new patients suffering from disease due to M. kansasi should enable the occupations with high risk to be identified.

Adult↗