Journal of public health medicine
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J Public Health Med · Jun 1999
Developing surveillance for HIV transmission and risk behaviours among high-risk groups in a central London health district.
Our aim was to describe surveillance data on HIV transmission and risk behaviours in Camden and Islington, an inner London health district (population 360 000). This information is required to assess the effectiveness of HIV-AIDS prevention. ⋯ Population-based information on HIV is available at local level in England. It can be used for surveillance of HIV transmission and behaviour in high-risk groups, especially homosexual and bisexual men and intravenous drug users. Resources for HIV prevention are provided to all NHS districts, and surveillance is a cost-effective measure of the outcome of HIV prevention.
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J Public Health Med · Jun 1999
Management of ischaemic heart disease in primary care: towards better practice. STaRNet. South Thames Region Network.
Ischaemic heart disease is the commonest cause of mortality in the United Kingdom. The objective of this study was to assess the management of patients with ischaemic heart disease in primary care, focusing particularly on the management of hypercholesterolaemia. ⋯ Systematic searches of computerized and paper medical records can identify subgroups of patients who will benefit from continuing follow-up in primary care. The results of this study suggest that ischaemic heart disease remains an area where there is scope to improve the management of patients in primary care. Considerable effort will be required from the members of the primary health care team to achieve this objective, particularly in the areas of computerized data collection and in the identification and recall of patients.
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J Public Health Med · Mar 1999
Do social factors affect where patients die: an analysis of 10 years of cancer deaths in England.
This study investigated whether indices of social deprivation were related to the proportion of cancer patients who died at home. ⋯ There are wide variations in the percentage of cancer deaths at home in different electoral wards. Social factors are inversely correlated with home cancer death, and may explain part of this variation. Home care in deprived areas may be especially difficult to achieve.
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J Public Health Med · Dec 1998
Hospital use by an ageing cohort: an investigation into the association between biological, behavioural and social risk markers and subsequent hospital utilization.
The aims of the study were to describe the pattern of hospital utilization (acute and mental health sectors) of the Paisley-Renfrew MIDSPAN cohort and assess the influence of biological, behavioural and social 'risk factors' (established at the time of screening) on subsequent hospital admissions. ⋯ Despite the desirability of alternative settings of care for the chronically ill and dying, a high proportion of hospital bed days were required near the time of death. The absolute size of the demand for hospital services within the cohort was strikingly large and increasing over time. Strategies to address the tide of rising admissions will have to confront the increasing proportion of individuals requiring admission as well as the growth in multiple admissions. Those who were at higher risk of admission were the older members of the cohort (especially men), those with low FEV1, smokers, those who were underweight or obese, the small number with abnormal levels of blood sugar, those with high blood pressure and those who lived in the most deprived areas. Thus, programmes which affect these determinants of ill health may be useful in reducing age-specific admission rates.
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J Public Health Med · Dec 1998
Trends in intentional injury deaths in children and teenagers (1980-1995).
The aim of the study was to describe patterns and trends in intentional injury death rates in children and teenagers. ⋯ Intentional injury is responsible for an average of 335 deaths of children and teenagers each year in England and Wales. Unlike for unintentional injury, there has been no reduction in death rates from intentional injury, which now accounts for 25 per cent of all injury deaths. There is a steep social class gradient in intentional injury death rates, which has widened over the period 1980-1995.