{"title":"Communicable disease and health protection quarterly review: April to June 2003. From the Health Protection Agency Communicable Disease Surveillance Centre.","authors":"Jeremy Harker, Sarah Furrows, Sarah Anderson","doi":"10.1093/pubmed/fdg087","DOIUrl":"https://doi.org/10.1093/pubmed/fdg087","url":null,"abstract":"There were two major events that dominated this quarter. The first, on an international scale, was the threat from the emerging disease known as Severe Acute Respiratory Syndrome (SARS), which is dealt with as a feature article below. The second, on a national level, was the establishment of the new Health Protection Agency (HPA), which came into operation on 1 April 2003, bringing together the functions and expertise from: the Public Health Laboratory Service, including the Communicable Disease Surveillance Centre, the Centre for Applied Microbiology and Research, the National Focus for Chemical Incidents, the Regional Service Provider Units that support the management of chemical incidents, the National Poisons Information Service, and NHS public health staff responsible for the control of infectious disease, emergency planning and other protection support. Until new legislation is enacted the HPA, which will operate in England and Wales, will work in close partnership with the National Radiological Protection Board (NRPB). Thereafter functions currently carried out by the NRPB should transfer to the HPA. The HPA is intended to deliver 10 key gains for public health:","PeriodicalId":77224,"journal":{"name":"Journal of public health medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/pubmed/fdg087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24184173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cancer patients' awareness about their diagnosis: a population-based study.","authors":"C Nord, A Mykletun, S D Fosså","doi":"10.1093/pubmed/fdg076","DOIUrl":"https://doi.org/10.1093/pubmed/fdg076","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to evaluate Norwegian cancer patients' awareness of their prior cancer diagnosis in a general population-based study.</p><p><strong>Methods: </strong>A cross-sectional population-based study of cancer patients' responses to the index question: 'Do you have or have you had cancer?' was carried out. We assessed correctness of the response in relation to cancer site, date of diagnosis, marital status, age and education. Smoking was chosen as a marker of health awareness. A total of 65,330 persons participated in the Nord-Trøndelag Health Survey (HUNT-II), performed in 1995-1997. The database of HUNT-II was merged with the Cancer Registry of Norway (CRN), thus identifying each of the 2983 (4 percent) participants with an invasive cancer diagnosis.</p><p><strong>Results: </strong>Excluding basal cell epithelioma, a total of 20 percent of the patients denied their prior cancer diagnosis. This group consisted mainly of men (54 percent) and those who were diagnosed as very young or as elderly. More smokers than non-smokers were unaware of their prior malignancy (24 percent versus 20 percent).</p><p><strong>Conclusions: </strong>A 20 percent rate of patients who denied their former malignancy is surprisingly and unacceptably high. Disclosure of a cancer diagnosis should help the patient to develop increased health awareness. It should enable a person to report his or her former cancer diagnosis when necessary.</p>","PeriodicalId":77224,"journal":{"name":"Journal of public health medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/pubmed/fdg076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24183075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Health impact assessment and the consideration of health inequalities.","authors":"Jayne Parry, Edward Scully","doi":"10.1093/pubmed/fdg042","DOIUrl":"https://doi.org/10.1093/pubmed/fdg042","url":null,"abstract":"<p><p>Equity and the consideration of the differential impacts of public policy within populations are core values of health impact assessment. A recent paper setting out the results of the government's consultation exercise on tackling health inequalities argues for health impact assessment to be used as a mechanism to bring about reductions in health inequalities. However, we would contend that most, if not all, published health impact assessments have not considered the effects of public policies on health inequalities in a robust or reliable manner. In this paper we set out and explore some of the issues that require consideration if health impact assessment is fulfil the government's expectations.</p>","PeriodicalId":77224,"journal":{"name":"Journal of public health medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/pubmed/fdg042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24041595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G David Batty, Martin J Shipley, Michael Marmot, George Davey Smith
{"title":"Leisure time physical activity and coronary heart disease mortality in men symptomatic or asymptomatic for ischaemia: evidence from the Whitehall study.","authors":"G David Batty, Martin J Shipley, Michael Marmot, George Davey Smith","doi":"10.1093/pubmed/fdg043","DOIUrl":"https://doi.org/10.1093/pubmed/fdg043","url":null,"abstract":"<p><strong>Background: </strong>Although numerous studies have shown an association between physical activity and coronary heart disease (CHD) mortality in healthy persons, few have reported on this relation in individuals with pre-existing diseases, such as ischaemia. Further, we are unaware of any study to examine if this relationship is modified by the symptomatic nature of the ischaemia.</p><p><strong>Methods: </strong>To explore these issues, we analysed data from a 25 year follow-up of mortality for 6474 male British civil servants who underwent a resting electrocardiogram and responded to queries regarding angina at study entry.</p><p><strong>Results: </strong>Among men who had ECG abnormalities but no angina (i.e. asymptomatic), activity was associated with a higher rate of CHD mortality. Among men with both angina and ECG abnormalities (i.e. symptomatic), activity was associated with lower CHD mortality but this was not statistically significant at conventional levels.</p><p><strong>Conclusions: </strong>In the present study, there was a suggestion that the symptomatic nature of ischaemia appeared to modify the effect of physical activity on total and CHD mortality. Although these findings should be examined in other studies, they point to the need for a pre-participation medical examination in active persons or those contemplating embarking on an activity programme.</p>","PeriodicalId":77224,"journal":{"name":"Journal of public health medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/pubmed/fdg043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24040974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amanda Sacker, Richard D Wiggins, Paul Clarke, Mel Bartley
{"title":"Making sense of symptom checklists: a latent class approach to the first 9 years of the British Household Panel Survey.","authors":"Amanda Sacker, Richard D Wiggins, Paul Clarke, Mel Bartley","doi":"10.1093/pubmed/fdg056","DOIUrl":"https://doi.org/10.1093/pubmed/fdg056","url":null,"abstract":"<p><strong>Background: </strong>In health inequalities research there is a growing impetus to examine the development of inequalities in health over time. However, many of the sources of longitudinal data in Britain are not designed specifically for health research. Typically, health status is assessed by self-reported problems and the use of symptom checklists.</p><p><strong>Methods: </strong>The British Household Panel Survey (BHPS) is an annual survey of approximately 5500 private households containing 9000 men and women, which began in 1991. Each year, the BHPS contains a checklist of 13 health problems and symptoms. The findings presented here are based on adult participants aged 16 years and over in 1991. Using eight waves of data from the BHPS, we use latent class analysis (LCA) to model latent health status from a set of observed binary variables. Individuals are assigned to a latent health class on the basis of LCA estimated probabilities of class membership given their response patterns and the estimated unconditional class frequencies. The predictive value of latent health class membership is assessed for self-reported health status and functioning, health and welfare service use, and mortality 1 year later.</p><p><strong>Results: </strong>The LCA supported a suitable four-class model of health status representing good health, psychosomatic health problems, physical health problems and comorbid health problems. Members of the good latent health class were predicted to have better self-reported health and functioning, less health and welfare service use, and lower risk of mortality 1 year later than members of the three problem health classes. Those with comorbid health problems were predicted to have particularly poor outcomes.</p><p><strong>Conclusions: </strong>A latent class approach to modelling self-reported health problems and symptoms has allowed for both quantitative and qualitative dimensions of health status to be captured. This may motivate better informed models of health by users of general population surveys.</p>","PeriodicalId":77224,"journal":{"name":"Journal of public health medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/pubmed/fdg056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24040978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A preliminary study on the relation between thunderstorms and mortality of in-patients.","authors":"Qin-fang Deng, Cai-cun Zhou, Jian-fong Xu, Rui-bao Tang","doi":"10.1093/pubmed/fdg062","DOIUrl":"https://doi.org/10.1093/pubmed/fdg062","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to investigate the association between thunderstorms and mortality of in-patients.</p><p><strong>Methods: </strong>Data for in-patients and deaths in internal medicine departments from four hospitals in Shanghai were collected and grouped according to meteorological conditions.</p><p><strong>Results: </strong>Weekly mortality of in-patients was significantly higher on days with thunderstorms than on fine days. This effect was significant for patients in respiratory, cardiovascular and neurology wards but not in the wards of other specialties.</p>","PeriodicalId":77224,"journal":{"name":"Journal of public health medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/pubmed/fdg062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24041596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael J Goldacre, Marie E Duncan, Paula Cook-Mozaffari, Myfanwy Griffith
{"title":"Trends in mortality rates comparing underlying-cause and multiple-cause coding in an English population 1979-1998.","authors":"Michael J Goldacre, Marie E Duncan, Paula Cook-Mozaffari, Myfanwy Griffith","doi":"10.1093/pubmed/fdg058","DOIUrl":"https://doi.org/10.1093/pubmed/fdg058","url":null,"abstract":"<p><p>Until recently, national coding and analysis of routine mortality statistics in most countries included only underlying cause of death. There were changes in the rules for selection and coding of underlying cause in England in 1984 and 1993. We report on trends in mortality rates in an English region from 1979 to 1998, comparing multiple-cause and underlying-cause coded rates, for individual diseases that were affected by coding changes. Among many others, these include pneumonia, venous thromboembolism, heart failure, respiratory distress syndrome, tuberculosis, diabetes, dementia, alcohol and drug abuse, epilepsy, multiple sclerosis, stroke, asthma, peptic ulcer, appendicitis, and cancers of the breast, colon and prostate. Comparisons over time of mortality rates based on underlying cause alone will be misleading when the time-period crosses years in which rules changed for selecting underlying cause.</p>","PeriodicalId":77224,"journal":{"name":"Journal of public health medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/pubmed/fdg058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24041597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reducing inequalities in non-fatal accidents in England.","authors":"Mark McCarthy, Poala Primatesta","doi":"10.1093/pubmed/fdg059","DOIUrl":"https://doi.org/10.1093/pubmed/fdg059","url":null,"abstract":"<p><p>We investigated rates of non-fatal accidents recorded in the Health Survey for England. Between 1995/96 and 2001, rates fell in men although not in women. In contrast to other trends for health behaviours in the United Kingdom, for example smoking, there was no increased gap between male manual and non-manual groups.</p>","PeriodicalId":77224,"journal":{"name":"Journal of public health medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/pubmed/fdg059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24041600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cluster investigation--the importance of counting everyone.","authors":"Anna T Gavin","doi":"10.1093/pubmed/fdg057","DOIUrl":"https://doi.org/10.1093/pubmed/fdg057","url":null,"abstract":"","PeriodicalId":77224,"journal":{"name":"Journal of public health medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/pubmed/fdg057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24041601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Shining the light-public health observatories in England.","authors":"John Wilkinson","doi":"10.1093/pubmed/fdg051","DOIUrl":"https://doi.org/10.1093/pubmed/fdg051","url":null,"abstract":"","PeriodicalId":77224,"journal":{"name":"Journal of public health medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/pubmed/fdg051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24041605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}