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At least 793 records · Page 44Linked to original sources
PubMed1979

Infections with Mycobacterium malmoense in England and Wales.

Mycobacterium malmoense has been isolated from 11 patients in England and Wales. It was thought to be the cause of pulmonary disease in 9 of them and cervical adenitis in 2. The cultural and biochemical characters of the species are described and its position in relation to the avium-intracellulare complex and the non-chromogenicum-terrae-triviale complex determined by matching coefficients using 88 characters. Brief details are given of the 11 cases.

Aged↗
PubMed1987

National survey of tuberculosis notifications in England and Wales in 1983: characteristics of disease. Report from the Medical Research Council Tuberculosis and Chest Diseases Unit.

The number of newly notified, previously untreated patients in a survey of notifications of tuberculosis in England and Wales conducted by the MRC in 1983 was 26% lower than in the previous MRC survey in 1978/79. In both surveys the great majority of patients were of White (about half) or Indian subcontinent (Indian, Pakistani or Bangladeshi) ethnic origin (just over a third). The notification rates in the Indian subcontinent (ISC) ethnic groups were much higher than for the White group and were highest in those most recently arrived in the UK. There were a number of differences in the findings for the White and the ISC ethnic groups. Nearly two-thirds of the White patients but less than half of the ISC patients were male and the White patients were, on average, older, about half aged 55 years or more compared with 14% of the ISC patients. Respiratory disease occurred in 82% of the White patients compared with 66% of the ISC patients. Radiographically, at independent assessment, more of the White patients had pulmonary lesions, 88% compared with 63% and these were, on average, more extensive and cavitated than in the ISC patients. Isolated mediastinal lymphadenopathy, however, was more common in the ISC patients. The diagnosis was confirmed bacteriologically on culture of a respiratory specimen in a higher proportion of the White than the ISC patients (65% and 41% respectively) and more were positive on smear as well (45% and 25% respectively). The level of initial drug resistance was lower in the White patients: only 10 (1.6%) of the 623 strains tested were resistant compared to 23 (12.8%) of the 179 from ISC patients. In both White and ISC ethnic groups the commonest non-respiratory lesion was peripheral lymph node involvement, namely 37% of the 369 White and 53% of the 503 ISC patients with non-respiratory disease. The diagnosis was confirmed by bacteriological examination of the lymph node in 47% of the ISC patients compared with 29% of the White patients with a lesion. Bone or joint disease occurred in 11% of the White and 20% of the ISC patients; the commonest site in both groups was the spine. Genitourinary disease was present in 98 (27%) of White and 24 (5%) of ISC patients with a non-respiratory lesion. There were 61 patients with tuberculosis involving the central nervous system, including 55 with meningitis, the proportions being similar for the White and the ISC ethnic groups, 7% and 5% respectively.

Adult↗
PubMed1995

Uptake of organochlorines (chlorobiphenyls, dieldrin; total PCB & DDT) in bottlenose dolphins (Tursiops truncatus) from Cardigan Bay, west Wales.

High concentrations of organochlorine compounds (particularly PCB and chlorobiphenyls) have been found in three bottlenose dolphins from the vicinity of New Quay in West Wales. Although few in number, the animals ranged in age from 10 months to 23 years. The occurrence of high contaminant concentrations in all of these animals suggests that a high level of uptake of these compounds occurs in food after weaning as well as by transfer from mother to calf. In order to investigate this further we have tried to model the uptake using a bioenergetics-based approach. Using estimates of feeding rate we have calculated the concentrations of these contaminants in average prey items necessary to maintain the dolphin's body burden during the juvenile growth stage. The data available to date are too few for a rigorous test of this approach, however these preliminary studies suggest that the contaminant concentrations in local food items analysed to date are not sufficiently high to explain the high concentrations found in dolphin blubber. Further information is needed on the contaminant burdens of bottlenose dolphins in Cardigan Bay, and of their relationships and diet (including seasonal and migratory components), in order to validate this approach.

Age Factors↗
PubMed1992

Longitudinal Gompertzian analysis of ALS mortality in England and Wales, 1963-1989: estimates of susceptibility in the general population.

Mortality statistics in amyotrophic lateral sclerosis (ALS), which is more commonly and generally termed motoneurone disease (MND) in the United Kingdom, have been shown to reflect the incidence of previously diagnosed cases of the disease in a more complete way than in other conditions [1,2]. An analysis of changing patterns of mortality may therefore be a particularly appropriate way of tracing the underlying trends in the disease and is in principle a useful way of investigating the relationship between environmental and genetically controlled factors in the genesis of the condition. The majority of analyses so far have concentrated on the crude rise in reported mortality rates evident in recent decades in a number of countries [2-5], on the uneven geographical distribution [6,7] and on the complex range of plausible causes for these reported rises. Debates have centred on whether the increases represent 'real' or 'artifactual' changes, with no apparent resolution of the issue [8,3]. Recently Riggs [9] proposed a novel way of analysing this issue by using a Gompertzian model and provided evidence of the existence of an inherently susceptible subset of the US population. Riggs indicated that while the rise in ALS mortality is real, it is for the most part the result of an increase in the size of this inherently susceptible sub-population due to greater longevity. In order to examine the wider applicability of a Gompertzian model to ALS the technique has been replicated with the mortality rates for England and Wales for the 27-year period from 1963 to 1989. The technique has been developed and extended to produce an estimate of the size of the inherently susceptible sub-population (both male and female) over the entire period.

Adolescent↗
PubMed1988

The effect of reducing petrol lead on airborne lead in Wales, U.K.

Airborne lead has been measured at four urban, one semi-urban and one rural site in Wales during 1984, 1985 and 1986 to assess the effect of the reduction in lead additives in petrol which was required by an EC Directive at the beginning of 1986. The results showed a 52-61% fall in air lead in accord with the 63% reduction in petrol lead.

Air Pollutants↗
PubMed1992

Meningococcal disease in Wales: clinical features, outcome and public health management.

In Wales, in 1988, 119 patients with meningococcal disease were identified, so giving a crude annual incidence of 4.2 patients per 100,000 population. The combined classical clinical features of fever, vomiting, neck stiffness, headache and purpuric rash were identified in only 9% of patients. Fever and vomiting were the commonest symptoms, both being present in 60% of patients. A rash was noted in 77% of patients but neck stiffness in only 39%. Rash was more common in children, headache and photophobia in adults. A total of 13 patients died, the fatality rare increasing with age from 3% in infants to 20% in older teenagers and adults. Only 15% of 75 patients admitted to hospital by general practitioners were known to have received intravenous or intramuscular penicillin before admission as recommended by the Chief Medical Officers of the Health Departments in the U.K. Only 24% of patients received rifampicin to clear nasopharyngeal carriage before or at discharge from hospital. Altogether, 375 household contacts of patients were identified. At least 84% of them received chemoprophylaxis.

Acute Disease↗
PubMed1984

The housing of the disabled and non-disabled elderly in Wales.

The Welsh Housing and Dwelling Survey examined housing conditions of a sample of 45,000 households in the principality. In this paper the quality of dwellings inhabited by the disabled and non-disabled elderly throughout Wales is described. It is demonstrated that disabled elderly have a lower standard of housing than their non-disabled counterparts.

Aged↗
PubMed1985

A one-year follow-up of patients discharged from geriatrics and general medical units in Wales.

A random sample of patients aged 65 yr and over, admitted as emergencies to the specialties of geriatrics and general medicine in Wales were interviewed 3 and 12 mth after discharge using a postal questionnaire. The characteristics of patients, the preparation they received for discharge and the use made of community services were recorded as were mortality, functional capacity and rehabilitation. Overall geriatrics patients were better prepared for discharge, were given a higher level of service provision and had a more favourable outcome than the general medical patients.

Aged↗
PubMed1988

Infection control organization in hospitals in England and Wales, 1986. Report of a survey undertaken by a Hospital Infection Society working party.

Questionnaires were distributed to hospitals in order to obtain information regarding arrangements for infection control. Returns were obtained from 180 of 200 (90%) health districts in England and Wales covering 95% of 'acute' and 85% of 'other' hospital beds listed in the Hospitals Year Book. The results demonstrated that some form of infection control organization was present in all districts, 98% had control of infection officers and 92% control of infection committees. The proportion of health districts with an infection control nurse had risen from 64% in 1979 to 89%, and the regional variation seen in 1979 was no longer marked. The major commitment of medical microbiologists to infection control was underlined.

Cross Infection↗
PubMed1990

A survey of methicillin-resistant Staphylococcus aureus affecting patients in England and Wales.

For a six-month period between October 1987 and March 1988, 660 isolates of methicillin-resistant Staphylococcus aureus (MRSA) from 570 patients were sent to the Staphylococcus Reference Laboratory at Colindale to supplement the National reporting survey of MRSA in England and Wales. The isolates were characterized by phage typing, antibiotic susceptibility and by selected biochemical tests. Patient details were also surveyed. Fourteen strains affected more than one hospital and were called multi-hospital epidemic strains. One strain, EMRSA-1, accounted for more than 40% of isolates and of patients. Other epidemic strains were defined. Ten additional strains were restricted to single hospitals. Only 25 primary isolates were non-typable but 67 sporadic typable strains occurred. The patients affected were approximately equally either infected or colonized. The sexes were represented equally. Orthopaedic and geriatric wards were over-represented. Epidemic strains were clumping factor positive while some sporadic strains were weak producers. Urea alkalinization and protein A production could supplement phage typing and antibiotic resistance in strain recognition.

Adult↗
PubMed1991

Surveillance of methicillin-resistant Staphylococcus aureus in England and Wales, 1986-1990.

The incidence of methicillin-resistant Staphylococcus aureus in England and Wales was monitored by a weekly reporting scheme from early 1986 to March 1990. Potential coverage was approximately two-thirds of hospital beds. Reporting centres fell from a peak of 210 in 1986 to a low of 101 centres early in 1989 with later recovery. There were 2367 positive reports in 1986, 2174 in 1987, 1700 in 1988, 1701 in 1989 and 632 in the first quarter of 1990. Colonizations outnumbered infections by 2:1. There were marked regional differences: North-East Thames was dominant in 1986 and 1987, and then declined; South-East Thames showed a dramatic increase in 1988 which continued. Other regions showed less significant changes but there were continuing problems in the South-Western Region and in the West Midlands. Some of these changes were related to the decline of EMRSA-1, possibly due to the introduction of effective control measures, and to the emergence of EMRSA-3 in South-East Thames and its spread to Wessex.

Bacteriophage Typing↗
PubMed1991

Cancer incidence in New South Wales, Australia.

In 1972, cancer registration began in New South Wales (NSW), the most populous state in Australia. The operations of the Registry are described. By 1990, approximately 316,000 new cases of cancer had been notified from a population that had increased from 4.6 to 5.8 million. In 1981-1984, the most common sites in men were lung, prostate, colon, melanoma and bladder, and in women, breast, melanoma, colon, lung and unknown primary site. Cancers which, between 1973-1976 and 1981-1984, had increased in reported incidence by more than 25% were pharynx and kidney in both sexes, rectum, testis and melanoma in men, and lung and bladder in women; those decreasing by more than 10% were stomach in both sexes, oesophagus in men and cervix in women. Age-standardised incidence rates for melanoma (27.4 [m] and 23.8 [f] per 100,000 in 1987) and cancer of the renal pelvis in women (1.7 per 100,000 in 1989) are among the highest in the world.

Age Factors↗
PubMed1986

Analysing geographic variations in mortality using Poisson regression: the example of ischaemic heart disease in England and Wales 1969-1973.

This paper describes how Poisson regression techniques can be used to examine the relationship between mortality and possible explanatory variables over a series of areas in cases where the number of deaths involved is relatively low. As an example an analysis is carried out on deaths from ischaemic heart disease among young adults in the county boroughs of England and Wales during 1969-1973. The results of the study indicate that the number of deaths was higher for males than females and was positively related to age, the size of the 'at risk' population and crowding, but negatively associated with water hardness and the size of the New Commonwealth population. A comparison of the Poisson and log-normal regression models clearly shows that the latter provides an inferior goodness of fit and unreliable results. It is therefore concluded that when the number of deaths is small there are both theoretical and practical advantages in using Poisson regression to analyse mortality data.

Adolescent↗
PubMed1989

The demand for abortion in England and Wales.

The provision of abortion services in England and Wales is modelled with particular emphasis given to the relationship between the public and private sectors. The presence of excess demand in the public sector is established and its importance as a determinant of private demand is analysed. This study replicates the analysis and findings of one based on 1971 data with data for 1983. It is estimated that nearly one-half of the private sector demand arises as a result of excess demand in the public sector.

Abortion, Legal↗
PubMed1991

Childhood leukaemia mortality and population change in England and Wales 1969-73.

Recent evidence from new towns in Great Britain suggests that childhood leukaemia mortality is associated with rapid population growth. It has been proposed that this may reflect patterns of population mixing and exposure to infectious diseases which may predispose to the development of leukaemia in children. This study examines childhood leukaemia mortality for 1365 local authority areas of England and Wales for the period 1969 to 1973 with reference to population change between 1961 and 1971. A significantly increased risk of childhood leukaemia mortality was found for 0-14 year olds in areas which experienced more than a 50% increase in population over the decade (R. R. 1.408, 95% C. I. 1.126-1.761). A cumulative sum analysis shows a threshold at approximately 50% population growth rather than a continuous relationship. A map of the data suggests that areas of significantly raised mortality compared to the national average are concentrated in and around the major conurbations of the area studied.

Adolescent↗
PubMed1995

Socioeconomic and spatial differentials in mortality and means of committing suicide in New South Wales, Australia, 1985-91.

Analysis of suicide mortality in New South Wales, Australia is undertaken with reference to marital status and occupational status between 1986-89/90 and with reference to the principal means of committing suicide. Not currently married male manual workers were particularly at risk although marital status variations were significant with both genders and at different ages. Between 1985-91 male suicide mortality rates were significantly higher in inland non-metropolitan regions, especially among younger men, and were higher in inner areas of metropolitan Sydney. While there were no significant variations by marital status in the means of committing suicide there were variations between genders, and there were regional and social class variations in the use of guns with males. The use of guns was a factor in the elevated suicide mortality levels among inland rural youth and men, and among farmers and transport workers while the use of poisons was also significant with these occupational groups. The use of poisons was greater among persons committing suicide in the areas of elevated mortality in inner Sydney and the use of guns much lower.

Adolescent↗
PubMed1996

Regional variations in mortality rates in England and Wales: an analysis using multi-level modelling.

Mortality rates in England and Wales display a persistent regional pattern indicating generally poorer health in the North and West. Some of this is simply a reflection of regional differences in the extent of social deprivation which is known to exert a profound influence on health. Part of the pattern may also be the result of regional differences in urbanization which also affect mortality rates. However, there may be important regional differences over and above these compositional effects. This study attempts to establish the magnitude of such independent regional differences in mortality rates by using the techniques of multi-level modelling. Standardized mortality rates (SMRs) for males and females under 65 for 1989-91 in local authority districts are grouped into categories using the ACORN classification scheme. The Townsend Index is included as a measure of social deprivation. Using a cross-classified multi-level model, it is shown that region accounts for approximately four times more variation in SMRs than is explained by the ACORN classification. Analysis of diagnostic residuals show a clear North-South divide in excess mortality when both regional and socio-economic classification of districts are modelled simultaneously, a possibility allowed for by the use of a multi-level model.

Adult↗
PubMed1996

A study of the geographical distribution of suicide rates in England and Wales 1989-92 using empirical bayes estimates.

In order to achieve the suicide reduction targets proposed by the U.K. Government's The Health of the Nation document, it is necessary to determine its geographical distribution. This objective is approached using district level data for England and Wales, aggregated for 1989-92. Two techniques are used, and compared. The first is the traditional method of mapping Standardized Mortality Ratios (SMR), expressed as relative risks. The second technique employed is the relatively new method of empirical Bayes estimates (EBE). It is shown that this is a superior measure for an initial investigation of the distribution of suicide, as relative risks for this comparatively rare condition are highly dependent on the population size of the areas studied. Discernible trends of high risk are shown in high population density, urban areas for both sexes, and in economically depressed agricultural, rural areas for men. The effects of economic hardship, unemployment and social disintegration are suggested as contributing to this distribution in an initiatory or exacerbatory capacity, for those suffering from psychiatric vulnerability or existing mental illness. Suggestions are made for more detailed analyses of high risk areas.

Adolescent↗