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At least 19 recordsLinked to original sources
PubMed1975

Psychiatric diagnosis in New South Wales compared to England and Wales.

Comparative studies of first admission rates to psychiatric hospitals have revealed significant differences in the rates of diagnoses of functional psychoses between the United Kingdom and the United States of America. The present study examined the diagnoses of indigenous patients born between 1921 and 1955 and first admitted to hospitals in New South Wales, Australia, and England and Wales. Admission rates for mania were in striking agreement. The rate in New South Wales for schizophrenia was slightly higher and for psychotic depression considerably less than in England and Wales. A similar trend in diagnostic dissonance would appear to exist between England and Wales and New South Wales as between England and Wales and the United States for schizophrenia and psychotic depression, but this is considerably less in degree.

Adjustment Disorders↗
PubMed1987

Serodiagnosis of Babesia motasi (Wales), Theileria recondita (Wales) and Cytoecetes phagocytophila infection in sheep.

The indirect fluorescent antibody test (IFAT) was used to diagnose some tick-borne infections of sheep, Babesia motasi (Wales), Theileria recondita (Wales) and Cytoecetes phagocytophila. Antigen was prepared from blood derived from splenectomised sheep except for C phagocytophila which was derived from a normal animal. A field survey was made to assess the prevalence of B motasi and T recondita in North Wales and a comparison made between the titres using the B motasi (Wales) antigen with those previously reported. IFA titres reported in the homologous system were consistently lower than those described previously. The results of the field survey suggested that B motasi (Wales) infection is more widespread than was originally thought and more widespread than the known distribution of its vector Haemaphysalis punctata. No serological cross reactions occurred between B motasi (Wales), T recondita (Wales), C phagocytophila, B divergens, Sarcocystis ovicanis and Toxoplasma gondii.

Animals↗
PubMed1998

Effects of the Heartbeat Wales programme over five years on behavioural risks for cardiovascular disease: quasi-experimental comparison of results from Wales and a matched reference area.

OBJECTIVE: To assess the net 5 year effects of intervention of a community based demonstration project, the Heartbeat Wales programme, on modifiable behavioural risks for prevention of cardiovascular disease. DESIGN AND SETTING: Quasi-experimental design comparing results from two independent cross sectional population surveys conducted in 1985 and 1990 in Wales and a matched reference area in north east England. SUBJECTS: Random, stratified samples of people aged 18-64 years (18,538 in 1985 and 13,045 in 1990) in Wales and in north east England (1483 and 4534, respectively). INTERVENTION: A coordinated range of activities for heart health promotion in Wales entailing public education campaigns along with supportive policy and infrastructure change. In the reference area no additional community heart health promotion was planned, though considerable activity did take place, "contaminating" the reference area. MAIN OUTCOME MEASURES: Fifteen self reported behavioural indicators relating to dietary choice, smoking, frequency of exercise, and weight. RESULTS: Positive changes (for health) in behavioural outcomes were observed among the population in Wales, including a reduction in reported smoking prevalence and improvements in dietary choice. There was no net intervention effect for the programme over and above observed change in the reference area. CONCLUSIONS: No definite conclusions can be drawn concerning the efficacy of the programme in terms of behavioural outcomes. With hindsight, the difficulties of evaluating such a complex multifaceted intervention were underestimated. Further debate on the most appropriate methods for assessing the effectiveness of community based health promotion programmes is called for.

Adolescent↗
PubMed1990

Cancer incidence in migrants to New South Wales from England, Wales, Scotland and Ireland.

Cancer incidence in migrants to New South Wales (NSW) from individual countries within the British Isles has been compared with that in the Australian-born population using data from the NSW Central Cancer Registry for the period 1972-84. Indirectly age-standardised incidence ratios (SIR) showed that, for cancer at all sites combined, Scottish migrants had a significantly higher, and English migrants a lower, incidence than the native-born Australians. Melanoma of skin was less common in migrants from all four countries while lung cancer was more common. In all except the Irish migrants, stomach cancer was more frequent than in the Australian-born. Raised SIRs for bladder cancer were found in men from all the countries and for breast cancer in all except the Irish women but only in the English migrants were these ratios significant. English migrants differed from those from Wales, Scotland and Ireland in that, compared with the Australian-born, they had significantly lower SIRs for cancer of the colon (both sexes), head and neck, larynx and prostate (men), gallbladder and kidney (women), and a higher SIR for ovarian cancer. Bone cancer was relatively more common in men born in Wales. 'Other genital' cancers (penis and scrotum; vulva and vagina) tended to be more frequent in migrants from each country than in the Australian-born.

England↗
PubMed1996

Comparison of cancer deaths in England and Wales and the developed world by age and gender 1973-92, and, new malignancies in England and Wales 1971-88.

Cancer deaths in England and Wales and the developed world were examined by age and gender between 1973-1992. Whilst over-all mortality levels increased, this was mainly linked to extended longevity, as the rate fell substantially for people under 55 in the majority of countries, possibly as a result of improved treatment and prevention outcomes. Whilst England and Wales had above average reductions in cancer deaths, especially for children, there were considerable rises in new malignancies, 1971-88, particularly amongst women under 35 years, and in certain selected sites. These over-all changes do not appear to be the result of improved diagnosis, thus, despite evidence of more effective therapeutic and preventative measures the incidence of new malignancies is increasing. The possible implications are briefly discussed, in the context of "medical audit', which increasing uses mortality rates as "indicators of effectiveness'.

Adolescent↗
PubMed1997

Carrier screening for cystic fibrosis in primary care: evaluation of a project in South Wales. The South Wales Cystic Fibrosis Carrier Screening Research Team.

Population carrier screening for cystic fibrosis (CF) was offered to all patients aged 16-45 in one general practice in South Wales, excluding those in couples with a current pregnancy. Out of 1553 patients in this group, 481 subjects were tested, giving an overall uptake rate of more than 30%. The rate of uptake varied with the mode of invitation. Twenty-six carriers were identified, giving a prevalence of identified carriers of 5.4% (1 in 18.5) for those with no family history of CF. A further 18 carriers were identified by cascade testing of these 26. We describe the practical difficulties encountered in setting up this programme in primary care in South Wales. Questionnaires were administered or distributed to all subjects before and after testing. The response rate for the pre-test questionnaire was 95%, and 40-50% for the post-test questionnaires. These showed that, at 3 months post-test, 1 in 4 screen-negative subjects did not appreciate that they had a residual risk of being a carrier. At the same time, 15% of this group thought that there was a 1 in 4 chance of a child being affected if one parent was screen-positive (carried an identified mutation) and the other was screen-negative, and 40% thought there was no risk. Anxiety in relation to testing did not appear to be a major problem, although individual patterns of response to carrier status varied widely and more sensitive indicators of psychosocial impact of genetic tests are required. A pilot study of couple screening showed that this approach is unlikely to be useful in primary care, although we did not assess couple testing during pregnancy. For any programme of CF carrier screening to be established in primary care, it will be necessary to involve the primary care team from the earliest planning stage, so that the opportunity costs, training needs and other costs of the programme can be fully resourced.

Adolescent↗
PubMed1998

Doctors detected self-administering opioids in New South Wales, 1985-1994: characteristics and outcomes.

OBJECTIVE: To describe the characteristics and outcomes of doctors whose drug authorities were withdrawn as a result of self-administering opioids for non-medical purposes. DESIGN: Retrospective review of New South Wales Health Department information relating to all doctors whose authorities to possess, supply, prescribe or administer drugs of addiction had been withdrawn in the period 1985 to 1994 as a result of confirmed self-administration of opioids. OUTCOME MEASURES: Age, sex, geographical location and practice category at the time of intervention; drugs used; period of opioid use before authority withdrawal; means of detection; and registration status as at August 1995. RESULTS: From 1985 to 1994, 79 doctors had their drug authorities withdrawn (0.4% of the NSW medical profession in 1994). The groups significantly over-represented were general practitioners and those aged 30-39 years. Pethidine was the main drug used (66 doctors; 84%). Drug use for more than two years before detection was reported by 34 (43%) doctors. Community pharmacists were the source of reports leading to detection of 28 (35%) doctors. As at August 1995, 27 (34%) of the study group were not practising; 10 (13%) had died. CONCLUSION: Outcomes for these doctors were poor. There was substantial attrition from practice and a high mortality rate.

Adult↗
PubMed1999

Population-based study of infants born at less than 28 weeks' gestation in New South Wales, Australia, in 1992-3. New South Wales Neonatal Intensive Care Unit Study Group.

The aims of the study were to use the population base of New South Wales (NSW) to study all births from 20 to 27 weeks' gestation in 1992-3 and to compare two data sources for perinatal deaths. The prospective population-based statewide audit (NICUS) of infants admitted to tertiary neonatal intensive care units (NICUs) in NSW was used to collect data on infants less than 28 weeks' gestation registered in 1992-3. This audit also surveyed the 160 obstetric hospitals in NSW to ascertain information on stillbirths and early neonatal deaths in the study period. The NSW midwives data collection (MDC) was the other source of information on stillbirths and labour ward deaths. Data were analysed using SAS. In 1992-3 in NSW 1170 infants were born at 20-27 weeks' gestation. There were 556 stillbirths and 614 live births, of whom 180 (29.3%) died in the labour ward and 434 (70.7%) were admitted to a tertiary NICU. Sixty-six per cent of stillbirths were identified by both data collections, 16.5% by the MDC only and 17% by NICUS only. There was a high major congenital anomaly rate (18.5%) among the stillbirths. Two-thirds of the infants admitted to NICUs survived to 1 year. Information was available on at least one follow-up parameter for 89% (255/288) of the survivors to 12 months (corrected age). Of the 244 infants who had a neurological assessment by a paediatrician, 17% were diagnosed to have cerebral palsy. Eleven per cent of the 239 who had a formal Griffiths developmental assessment had a major intellectual disability. Five (2% of 255) of the 1-year-olds were blind, and 12 (4.7% of 255) had bilateral hearing aids. Seventy-one per cent of the infants examined at 1 year did not have a major disability. For accurate perinatal death data, collection from more than one source is recommended. Infants born at 20-27 weeks' gestation contribute 40% of all stillbirths in NSW, most of the costs of neonatal intensive care as well as the costs of long-term morbidity. In Australia in the early 1990s, the survival of infants born at less than 28 weeks' gestation was best from 26 weeks gestational age onwards. Long-term morbidity did not change from that of earlier cohorts. The most common major disability was cerebral palsy.

Cerebral Palsy↗
PubMed1995

The compulsory removal of elderly people in England and Wales under Section 47 of the National Assistance Act and its 1951 Amendment: a survey of its implementation in England and Wales in 1988 and 1989.

Section 47 of the National Assistance Act 1948 and its 1951 Amendment allow for the compulsory removal from their homes of predominantly elderly people to a place of safety. The Amendment has been in use for over 40 years. Little information is available on the workings of the Acts in England and Wales. For the period 1988 to 1989 inclusive, 771 requests for compulsory removal were received by 148 'proper officers'. We examined referrals and removals under the Acts. During this time 165 people were removed. The majority of referrals were from family practitioners (46%), but social workers also played a role (18%). Of the 165 people who were actually removed from their homes, 41 were removed under Section 47 of the National Assistance Act and 124 under its 1951 Amendment. The outcome of compulsory removal was only known in 126 instances. In 34% of cases the person was transferred to residential care and 24% returned home; 18% of the detainees died during their compulsory admission. The outcome varied significantly between health regions (chi 2 = 72; p < 0.001), with for example apparently high death rates in the North West, Trent and South West regions. For a disturbing 24% of people nothing is known of their fate. A mandatory reporting system to examine the use of this legislation is required.

Activities of Daily Living↗
PubMed1988

The prevalence of antibiotic resistance in Haemophilus influenzae in Wales. Report from the Standing Specialist Advisory Group for Microbiology in Wales.

From January to April 1986 all 21 Clinical Microbiology Laboratories in Wales took part in a survey to determine the prevalence of antibiotic resistance in Haemophilus influenzae. All isolates were collected and despatched to a central laboratory where identification was confirmed and antibiotic sensitivity tests repeated. One thousand four hundred and forty strains were available for analysis. Resistance was present in 128 (8.9%) to ampicillin, 23 (1.6%) to cefaclor, 28 (1.7%) to chloramphenicol, 282 (19.6%) to erythromycin, 43 (3.0%) to tetracycline, 90 (6.2%) to sulphonamide and 66 (4.6%) to trimethoprim. One hundred and twenty-one strains (8.4%) were beta-lactamase producers. Thirteen (0.9%) were resistant to four or more antibiotics and included one type b strain isolated from cerebrospinal fluid resistant to ampicillin, chloramphenicol, tetracycline, trimethoprim and sulphonamide. The prevalence of resistance to ampicillin and trimethoprim was higher than that recorded previously in two large studies elsewhere in the United Kingdom. Ampicillin resistance was more common in strains from hospital inpatients than those from general practice.

Drug Resistance, Microbial↗
PubMed1993

Increasing importance of Trichophyton tonsurans in childhood tinea in New South Wales. The pattern of childhood tinea in New South Wales, Australia 1979-1988: the emergence of Trichophyton tonsurans as an important pathogen in tinea capitis in white children.

A retrospective study was undertaken of 192 cases of culture proven tinea capitis occurring between 1979 and 1988 in a predominantly white population of children in New South Wales (NSW). The aim of the study was to identify whether Trichophyton tonsurans was increasing in importance in the causation of this condition in Australia as it was in many other parts of the world. The results of our study were compared with those of earlier Australian studies. Our study demonstrated that Trichophyton tonsurans is now equal in importance to Microsporum canis which was previously the strongly predominant organism.

Adolescent↗
PubMedDate not supplied

Classification and evaluation of the functional results of replanted parts of the hand at the Prince of Wales Hospital and the Prince of Wales Children's Hospital: 1984 to 1988.

This paper describes a simple method of classification and evaluation of the functional results of replanted and revascularized parts in the hand. The results are presented in graphic form and have been analyzed to correlate various factors: injured part, cause, and zone (level) of injury. The type of injury, ischemic time and age have been studied in more detail to determine their influence of the final functional result. The series contains 187 amputated and devascularized parts of the hand in 119 patients who have undergone surgery at the Prince of Wales Hospital from 1984 through 1988. The length of cold or warm ischemic times, up to 16 hours in this series, while not affecting survival of the amputated part, does adversely affect the functional result. The survival rate of replanted parts in children was significantly less favorable than in adults, but the functional results were uniformly superior.

Adolescent↗
PubMed1988

Pathogenesis of infection with Theileria recondita (Wales) isolated from Haemaphysalis punctata from north Wales.

The pathogenicity of Theileria recondita infection in both splenectomised and non-splenectomised sheep was investigated. Following transmission of T. recondita to splenectomised animals both by adult ticks and blood transfusion a fever and severe macrocytic hypochromic anaemia developed which lasted the 9 days or more of patent infection. The prepatent period following tick attachment was about 8 days, but was variable following blood transfusion. Infection of normal animals caused a transient macrocytic hypochromic anaemia and slight fever which lasted throughout the period of low parasitaemia (7 days). The increase in mean cell volume was due to an increase in numbers of juvenile red cells in the peripheral blood. There was a transient neutrophilia and lymphocytopenia but no significant changes in thrombocyte or leucocyte numbers.

Animals↗