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At least 811 records · Page 45Linked to original sources
PubMed1995

Burn injuries and characteristics of burn patients in New South Wales, Australia.

This study describes the burn injuries and characteristics of patients admitted to the major adult burn unit in New South Wales, Australia. Data were collected from the medical records of all patients admitted in the 30-month study period (184 persons, 143 (78 per cent) males, 41 (22 per cent) females). The findings identified that patients were most likely to be males, aged between 25 and 34 years, who experienced a 11-20 per cent total surface burn area flame injury whilst using an accelerant in a domestic environment. Patients were more likely to smoke tobacco, drink alcohol to hazardous levels and take prescribed psychotropic medications than the general population. Preburn morbid conditions were prevalent, especially in the females. The actions of patients who had sustained a non-intentional burn commonly indicated a lack of understanding of the danger of certain equipment or the combustibility and volatility of some materials and flame. Prevention appears to be the most effective way to reduce burn injury through education of at-risk groups. However, because of the multicausality identified in the study, other preventive measures, such as improvement in product safety design, are suggested. Some similarities and differences with studies reported from Australia and overseas are noted.

Accidents↗
PubMed1986

Period and cohort trends in mortality from cancers of the uterus in England and Wales. A new theory of changing gene frequencies.

Analysis of the age distribution of cancers of the uterus reveals three clearly distinctive types: early- and late-onset cancers of the cervix and one form of cancer of the corpus. England and Wales mortality data are available for the three types combined from 1911; cancers of the cervix and corpus have been listed separately from 1951. In the highest age groups, 60-64 yr and above, death rates fell fairly steadily from 1921-25 to 1981-82 whereas cigarette smoking - an alleged cause of cervical cancer - rose over much of that period. In the younger age groups, 55-59 yr and below, the more complicated temporal trends include two marked cohort dips. The first dip affected cohorts born around 1911; this was followed by a rise up to the 1921 central cohort, then a steep fall to the 1936 central cohort and, finally, a further rise up to the 1946 cohort (at least). The period trends are probably caused by a decline in the impact of one or more precipitators of cervical cancer, such as the papilloma virus. Cohort shifts are attributed to autoaggressive attacks on parental germ cells, the zygote, or early-stage embryo that induce gene change to affect the frequency of women genetically predisposed to early-onset cervical cancer. Attacks are also triggered by one or more precipitating agents with a temporal, and possibly a seasonal, dependence. Implications of this hypothesis of cohort shifts are discussed.

Adult↗
PubMed1989

The virulence characteristics of strains of Escherichia coli isolated from cases of bovine mastitis in England and Wales.

Of 470 Gram-negative facultative anaerobes isolated from cases of bovine mastitis in England and Wales, 422 were identified as Escherichia coli. The characteristics of 237 of these were investigated. Guinea-pig red cell haemagglutinins were possessed by 86% of strains and 12% were resistant to D-mannose. None of the strains tested invaded Vero cells. Haemolysin, Vero toxin and enterotoxin were produced by 5, 0.5 and 1% of strains, respectively. Twenty-two percent were resistant to one or more antibiotics and 4% to sodium arsenate. Transfer ability was possessed by 41% and lysogenic phage by 27% of strains; 62% possessed either one or the other and 12% possessed both. Colicin production was detected in 18% of strains; 5% produced Colicin V. Ninety-nine percent of strains were serum-resistant, while only 6% were able to grow well in bovine serum. A microscopically visible capsule was seen in 75% of strains. All strains possessed at least one of the potential virulence factors or markers studied. Several strains which possessed one characteristic only (mannose-sensitive haemagglutination or serum resistance), possessed one or more large molecular weight plasmids. None of the strains was particularly virulent for chickens following intramuscular inoculation. Of the strains which possessed one virulence characteristic, only those which were serum-resistant were re-isolated from expressed milk following intramammary inoculation of lactating cows.

Animals↗
PubMedDate not supplied

Deaths in police custody in England and Wales.

Worldwide deaths in police custody are causing public disquiet. An account is given of all the deaths occurring in police custody in England and Wales over a ten-year period from 1970-1979 with details of the causes of death and inquest verdicts.

Accidents↗
PubMed1988

Period and cohort trends for mortality and cigarette consumption in England and Wales, 1946 to 1980, with emphasis on sex ratios.

In an earlier paper (Burch P. R. J. J Chron Dis 1981; 34: 87-103) changes in sex- and age-specific mortality from all causes of death in England and Wales were studied in relation to changes in sex- and age-specific cigarette consumption. The absence of a consistent correlation between the two variables, and the general characteristics of the data, suggested that studies of sex ratios might provide a better test of the hypothesis that the association between smoking and mortality has a causal basis. In this paper temporal changes in the sex ratio of cumulative cigarette consumption by cohort, and of smoking rates by age, are considered in relation to changes in the sex ratio of mortality. Again, no consistent correlations emerge and it is evident that factors other than smoking have played a dominant part in determining recent changes in the sex ratio of mortality in all age groups from 35-39 to 80-84 years. Among these "other factors" are birth cohort effects that can be attributed, in part, to birth cohort changes in the sex ratio of mortality from bronchitis and emphysema. The present results, together with other evidence (vide supra; and Burch P. R. J. J Chron Dis 1984; 37: 148-156), show that great care needs to be exercised when attempts are made to deduce causation from epidemiologic surveys.

Adult↗
PubMed1992

Risk factors for kidney cancer in New South Wales--I. Cigarette smoking.

In a population-based case-control study of kidney cancer in New South Wales, data from structured interviews with 489 cases of renal cell cancer (RCC), 147 cases of renal pelvic cancer (CaRP) diagnosed in 1989 and 1990, and 523 controls from the electoral rolls confirmed an increased risk associated with cigarette smoking in both types of cancer. The risk among current smokers was consistently higher than among ex-smokers, and was nearly twice as great for CaRP than for RCC. Additional information provided by this study includes reduced risks following cessation of smoking within 12 years for CaRP, but only after 25 years for RCC. Starting to smoke before, rather than after, the age of 18 years is linked independently with almost twice the risk for CaRP, but does not affect the risk for RCC. No independent trend was found with number of cigarettes smoked per day.

Adult↗
PubMed1992

The follow-up care of babies discharged from special care baby units in England and Wales between 1988 and 1989.

This survey of District Health Authorities in England and Wales forms part of a wider study into the needs of babies discharged from special care baby units in South Glamorgan Health Authority. The aim of the survey was to find out what types of care were offered to babies who had been in a Special Care Baby Unit (SCBU) and their families following the babies' discharge from hospital. This in turn raised interesting issues concerning the community care of these babies and their families which are discussed in this article.

Community Health Nursing↗
PubMed2004

Environmental factors associated with crash-related mortality and injury among taxi drivers in New South Wales, Australia.

This exploratory study aims to investigate the associations between some environmental factors and the increased risk of motor vehicle crash-related injuries among taxi drivers. Information utilised in the study are obtained from police reports of all road traffic accidents that occurred on the roads between 1996 and 2000 in New South Wales (NSW), Australia. Of the 7923 taxi drivers who involved in crashes, nearly 10% (n = 750) were killed or injured. Results indicate sex, and two environmental factors are significantly associated with an increased risk of crash-related mortality and injury among taxi drivers. The adjusted relative risk of crash-related mortality and injury is increased by 60% for those who work the night shift (OR = 1.59, 95%CI = 1.35-1.88), and by 20% for those who do not carry any passenger on board (OR = 1.20, 95%CI = 1.02-1.41) should these drivers involve in a crash. The increased relative risk of crash-related mortality and injury is nearly 2.5 times for female taxi drivers (OR = 2.30, 95%CI = 1.45-3.65) when compared with their male counterparts.

Accidents, Occupational↗
PubMed2005

Exposure survey of motorcyclists in New South Wales.

This paper reports the results of an exposure survey of 794 registered motorcycle riders, with an average of 18.1 years of riding experience, in the State of New South Wales, Australia. Respondents completed two postal surveys, separated by about 6 months, that included items relating to their crash history, riding patterns, characteristics of their motorcycle, and its odometer reading. Odometer readings indicated that respondents rode a mean of 5208 km each year, and that annual exposure was related to gender, motorcycle type, and dominant riding location, time of week, and purpose. The amount of riding reported for different purposes changed with age, with older riders more likely than younger riders to ride for recreational reasons and on weekends. The mean crash rate (based on self-reported crash involvement) was 0.96 crashes/100,000 km. The crash rate declined with age, was highest in the Sydney metropolitan area, was lowest for motorcycles with large engines, and was highest for trail and dual-use motorcycles. There was a relationship between annual exposure and crash risk such that riders who rode relatively little had higher crash risks (per 100,000 km travelled) than riders who rode more often. A cluster analysis identified three groups of riders with higher-than-average risks of crash involvement.

Accidents, Traffic↗
PubMed2004

Cardiovascular risk profiles in UK-born Caribbeans and Irish living in England and Wales.

Cardiovascular disease is the leading cause of morbidity and mortality among Caribbean and Irish origin people living in England and Wales. Yet mortality from coronary heart disease (CHD) of migrant Caribbeans is lower than the national average, while stroke mortality is higher. The Irish experience higher than average mortality from both diseases. Little is known about the health of the children of these migrants. The Health Survey for England (HSE) 1999 was used to investigate for the first time cardiovascular risk factors in UK-born Caribbeans aged 35-44 and Irish aged 35-44 and 45-54 years. Caribbean men were more likely to smoke but had higher mean HDL-cholesterol than men in the general population. Caribbean women had greater body mass indices and lower mean triglyceride levels. Irish men in both age groups smoked more than men in the general population, but in the younger group had lower diastolic blood pressure (BP). At age 35-44 only, Irish women were shorter than women in the general population. These findings were independent of differences in socio-economic position. Previously, Caribbean-born migrants to Britain had generally favourable lipid profiles in line with lower CHD rates, despite obesity and diabetes. The nationally representative but small-scale data presented here suggest that UK-born Caribbeans appear to be losing this more favourable lipid pattern and among men smoking rates are now higher compared with general population men, suggesting that an increase in CHD rates can be expected. Further research should examine how improved education and specific intervention programs could be used to reduce smoking among UK-born Irish and Caribbean men, and obesity among UK-born Caribbean women. The next HSE also needs to include adequate numbers of younger people of different ethnic origins to allow time trends in these anthropometric, behavioural and metabolic risk factors to be examined reliably and fully.

Adult↗
PubMed2006

The epidemiology of hospitalised wrist fractures in older people, New South Wales, Australia.

The epidemiology and trends in wrist fracture admissions to public and private acute hospitals in New South Wales (NSW), Australia, between July 1993 and June 2003 were examined using routinely collected hospital separations statistics. During the study period, the number of hospital separations for wrist fractures increased by 71% in men, an average yearly increase of 6.5%, and by 43% in women, an average yearly increase of 3.9%. A modest, but significant, increase in age-specific and age-standardised hospitalisation rates for wrist fractures was also observed. Whilst the majority of wrist fractures were due to falls, the proportion of falls-related wrist fractures decreased significantly over time. This decrease was more pronounced in males and was accompanied by a rise in the proportion of wrist fractures resulting from high energy mechanisms such as transport, violence and machinery-related incidents. The difference in hospitalised wrist fracture rates between men and women could not be explained solely on the basis of the role played by osteoporosis, indicating the need for more research to improve our understanding of the underlying factors of this type of fracture in older people.

Age Distribution↗
PubMed2005

Technology enhancements and changes in radiotherapy throughput in New South Wales.

AIMS: To assess the effect that the age of linear accelerators and recent changes in technology have had on linear accelerator throughput in New South Wales, Australia. MATERIALS AND METHODS: Duration was measured (time of patient entry into the treatment room to time of exit) of each radiotherapy treatment fraction delivered on each linear accelerator over a 5-day period. Patient-, treatment- and equipment-based variables were collected for all treatment fractions, and assessed for their effect on fraction duration. Comparisons were made between these data and similar productivity data collected from a study carried out in 1996. Since the sample sizes for both the study periods were large enough, the distributions of the means were assumed normal (Central Limit Theorem). Specific analyses were carried out to assess the affect that new technologies, such as automatic field-sequencing (AFS) and multi-leaf collimator (MLC), have had on fraction duration. RESULTS: A total of 12 892 treatment fields and 4316 treatment fractions were delivered on 27 linear accelerators over 135 days. Comparison between the 2003 and 1996 productivity data showed an increase in the mean number of patients treated per hour by 11% and fields treated per hour by 31%. The mean number of fields treated per fraction increased by 15%. The mean fraction duration was reduced by 13% for linear accelerators of less than the median age of 7 years that were equipped with MLC/AFS, or both, compared with older linear accelerators without AFS and MLC. This reduction was more obvious for complex techniques, such as four-field breast treatments (27% decrease in fraction duration). The mean number of fields treated per hour was 43% more on the newer machines equipped with AFS and MLC. CONCLUSIONS: An increase in productivity has been observed between the 1996 and 2003 study periods, as measured by patients or fields per hour, despite an increase in treatment complexity as measured by fields per fraction. The application of AFS and MLC, and the use of newer linear accelerators, significantly shortened the mean duration per fraction for the common treatment techniques.

Hospital Departments↗
PubMed2006

Two-view mammography at the incident round has improved the rate of screen-detected breast cancer in Wales.

AIM: To investigate whether pre-invasive and invasive cancer detection rates were improved in Wales after the introduction of two views at incident screens. METHODS: The records of women attending follow-up screening for 2 years before and 2 years after the introduction of two-view incident screening were analysed. Cancer detection rates were compared before and after introduction of two view screening. RESULTS: At the incident round 98,752 women had one and 95,464 had two views. Five hundred and fifty-five cancers were detected with one view and 744 with two, an increased detection rate from 5.6 to 7.8 cancers per 1000 women screened (p=0.01). Two hundred and thirty-nine small cancers were detected with one view and 323 with two, increasing the detection rate from 2.4 to 3.4 per 1000 women screened (p=0.05). CONCLUSIONS: Two-view mammography at incident rounds detects more cancers and more favourable prognosis small cancers than single-view mammograms.

Breast Neoplasms↗
PubMed2005

A population-based study from New South Wales, Australia 1996-2001: area variation in survival from colorectal cancer.

In this study, we have investigated the impact of area of residence on survival from colon and rectal cancer. Relative survival and relative excess risk of death from cancer were calculated for each of 17 health areas in New South Wales, Australia. There were statistically significant differences in survival across areas for both cancers after adjusting for demographic factors. The variation remained for colon cancer but was reduced for rectal cancer after adjustment for spread of disease at diagnosis. This persistent variation in colon cancer survival suggests that variation in treatment contributes to it, and there is separate evidence for such variation. Of the 7186 patients whose deaths within five years were attributable to colorectal cancer, 784 could have had their survival increased to more than five years if the excess risk of death in all areas was reduced to the 20th centile of its distribution. Estimates such as this can assist in prioritizing improvements in cancer services.

Adolescent↗
PubMed2006

Survival from rectal and anal cancers in England and Wales, 1986-2001.

The aim of this study was to investigate the effects of tumour and patient characteristics on trends in the survival of patients with cancer of the anus or rectum in England and Wales. A total of 132,542 adults (15-99 years) who were diagnosed during the 14 years 1986-1999 were followed up to 2001 through the National Health Service Central Register. Relative survival up to 5 years after diagnosis was estimated, using deprivation-specific life tables. Generalised linear models were used to estimate relative excess risks of death, adjusted for patient and tumour characteristics. The results showed that 5-year relative survival was higher in women, younger patients and more affluent patients, and higher for anal cancer than rectal cancer. Survival improved by more than 10% from the late 1980s (around 38%) to the late 1990s (49%). This trend was not explained by changes in the distribution of age, anatomical site, morphology or deprivation. The trend was more marked in younger and more affluent patients, and for adenocarcinoma and epidermoid carcinoma than for tumours with other morphology. The inequality in survival between affluent and deprived patients widened. It is concluded that improvements in survival may reflect improvements in disease stage, diagnostic technique or treatment. Which of these factors contribute to the widening socioeconomic inequalities in survival remains to be elucidated.

Adolescent↗
PubMed2005

Fatal poisoning in childhood, England & Wales 1968-2000.

We analysed deaths certified as due to poisoning in England & Wales, 1968-2000, in children aged <10 years by age, sex, circumstances of death, intent, and agents involved. The number of deaths fell from 165 (20.6 per million children) in 1968 to 30 (4.6 per million) in 2000, a decrease of approximately 80%. The age-specific death rates were similar in boys and girls. The rate was initially much higher, and fell more, in those aged <5 years. Most deaths (n=1923) occurred in fires, and had been attributed to inhaling combustion products. A small number (n=104) occurred in fires resulting from motor vehicle and other transport accidents. From 1979 (use of ICD-9) the coding of some of these deaths changed from poisoning with carbon monoxide to poisoning with 'other gases, fumes or vapours'. These 'fire deaths' do not appear as poisonings in mortality statistics based on a single underlying cause of death, and cannot be tabulated as poisoning in many countries. Fire deaths and deaths coded to accidental, deliberate, or undetermined poisoning (n=702) decreased substantially with time, and by 2000 numbered 14 and 10, respectively. Accidental deaths declined from 151 in 1968 to 23 in 2000, but homicides and open verdicts varied from 5 to 20 per year, with no clear trend. Deaths attributed to carbon monoxide and to 'other gases, fumes or vapours' (mostly fire-related) totalled 2431 (84% of all poisoning deaths). Overall, 10% of these deaths were either certified as homicides or open verdicts. However, homicide or open verdict was recorded in half of the 47 fatal opiate poisonings. Opioids have now superseded antidepressants as the commonest agents encountered in fatal poisoning with drugs in children.

Accidents↗
PubMed2004

Small area variations in infant mortality in England and Wales in the inter-war period and their link with socio-economic factors.

This paper considers the changing spatial pattern of infant mortality during the inter-war years (1921-1936) at Local Government District level in England and Wales. As well as vital statistics data for these areas, also available are 1921 and 1931 Census data on unemployment, housing, occupational structure and population density, with additional data on unemployment from 1927 to 1936 for the 62 counties in which Districts are located. The statistical analysis relating changing District mortality to these characteristics derives mortality gradients across categorical forms of the social indicators, and assesses impacts of model re-specification to allow for spatio-temporal correlation. Time varying gradients across unemployment, housing and policy status are then investigated with a view to assessing whether there was a widening in mortality inequalities in the regionalized economic depression of the 1930s.

Adolescent↗
PubMed2005

Housing related difficulties, housing tenure and variations in health status: evidence from older people in Wales.

This study aimed to examine housing-related difficulties, the relationship with housing tenure and the subsequent influences on health status in a population sample of older people in Wales. Comparisons with health status normative data were undertaken to determine any geographical differences. A random sample of respondents were interviewed in their own homes (N=423). Data included demographic information, self-reported health status, housing problems, tenure and factors relating to energy efficiency. Univariate analysis found that owner occupiers reported the least housing difficulties and the best health status. Those in public rented properties experienced the most difficulties and the poorest health. The health status of the sample was generally poorer than the norms. Multivariate analysis found that housing difficulties, being cold with current heating and hours spent at home predicted poorer health status. This suggests that characteristics of the home environment may help to explain the differences between tenure and health. Considerable financial outlay may be required to meet policy initiatives that support older people remaining independent, autonomous and able to 'age in place'.

Aged↗