PubMed Health⌕ Search

Biomedical subjects

A Wagstaff

Publications and source records attributed to A Wagstaff.

17 recordsLinked to original sources
PubMed1998

Early 1H magnetic resonance spectroscopy of acute head injury: four cases.

In an attempt to examine in vivo the early metabolic consequences of severe acute head injury, 1H MRS was performed in four patients from 8 to 25 h (mean 15 h) following trauma. In three of these patients, decompressive surgery was performed 4-5 h prior to the MRS. High levels of lactate (area of lactate peak >50% of the mean areas of the NAA, choline-containing, and creatine-containing compound peaks) were found at 8 h posttrauma in the one patient who was not operated on and at 10 h posttrauma in one of the patients who underwent surgery. In the other two postoperative patients, at 18 and 25 h after trauma, lactate levels were found to be low (lactate peak <20% of the mean area of the other three peaks). In the one patient who had a follow-up at 6 days and who had the largest initial lactate levels, these remained high. These findings suggest that high levels of lactate may not be an inevitable consequence of severe head injury and that similar MRS studies should be performed on each individual patient before therapies to reduce lactate are considered. There appeared to be no correlation between the relative amounts of lactate and outcome.

Acute Disease↗
PubMed1993

Equity and efficiency in Italian health care.

Health care finance and provision in Italy is unusual by international standards: public financing relies heavily on both general taxation and social insurance, and although the vast majority of expenditure is publicly financed, the majority of care is provided by the private sector. The system suffers, however, from a chronic failure to control expenditures and its record on perinatal and infant mortality is poor. Hospitals in Italy have a low bed-occupancy rate by international standards and the per diem system of reimbursing private hospitals encourages unduly long stays. Costs per inpatient day are high by international standards, but costs per admission are close to the OECD average. Ambulatory care costs are extremely low, but this appears to be due to the fact that GPs see so many patients that their role is inevitably mainly administrative. Consumption of medicines is extremely high, but because the cost per item is low, expenditure per capita is not unduly high. Despite the emphasis on social insurance, the financing system appears to be progressive. There is evidence of inequalities in health in Italy, and some evidence that health care is not provided equally to those in the same degree of need.

Ambulatory Care↗
PubMed1993

The demand for health: an empirical reformulation of the Grossman model.

Previous tests of Grossman's model of the demand for health have been based on Grossman's own empirical formulation. This paper argues that this formulation fails to capture the dynamic character of the model. It proposes an alternative formulation, which appears to be more consistent with Grossman's theoretical model and which may also explain the apparent rejections of the model by the data in the author's earlier empirical work. The paper also presents some empirical results obtained using the new formulation, which are, on the whole, consistent with the predictions of Grossman's theoretical model.

Capital Financing↗
PubMed1991

On the measurement of inequalities in health.

This paper offers a critical appraisal of the various methods employed to date to measure inequalities in health. It suggests that only two of these--the slope index of inequality and the concentration index--are likely to present an accurate picture of socioeconomic inequalities in health. The paper also presents several empirical examples to illustrate of the dangers of using other measures such as the range, the Lorenz curve and the index of dissimilarity.

Abstracting and Indexing↗
PubMed1989

Economic aspects of illicit drug markets and drug enforcement policies.

This paper reviews the economics literature on illicit drug markets and drug enforcement policies. The first part of the paper examines the problems involved in establishing the parameters of the illicit market. The second part of the paper examines the contribution economics can make to the evaluation of drug enforcement policies: the discussion covers the determination of both the appropriate level of enforcement expenditure and the appropriate mix of policy measures.

Drug and Narcotic Control↗
PubMed1986

The demand for health: theory and applications.

The concern of this paper lies with the economic theory of the "demand for health". It develops a conceptual apparatus for analysing the interaction of socioeconomic determinants of health and indicates how this can be used to shed light on a variety of topical policy issues such as socioeconomic inequalities in health and the design of prevention policies. It is written with the aim of making what has hitherto been a mathematically sophisticated literature accessible to the non-economist.

Health Services Needs and Demand↗
PubMed1985

Time series analysis of the relationship between unemployment and mortality: a survey of econometric critiques and replications of Brenner's studies.

M. Harvey Brenner's numerous time-series analyses of the relationship between population mortality rates and aggregate unemployment rates have attracted considerable attention from academics, policy-makers and the mass-media. Over the course of the last few years, however, Brenner's studies have begun to be subjected to critical scrutiny by econometricians. This paper provides a survey of these studies and concludes that--contrary to what is often claimed--Brenner's analyses do not provide convincing evidence that the social costs of unemployment include premature deaths.

Economics↗
PubMed1979

The role of cartilage canals in the formation of secondary centres of ossification.

The present studies indicate that in the growth of cartilage canals the cartilage is removed by chondroclasts which stem from the primitive connective tissue cells of the perichondrium. Besides fusing to form multinucleated chondroclasts, these cells also provide the osteoblasts which establish the secondary centre of ossification. The growing tips of the blood vessels within the canals are also fashioned from these primitive connective tissue cells as they invade the microhaemorrhages at the ends of the canals. This is an identical procedure to that found in the vascular invasion of the primary growth plate. The cartilage canals are clearly useful sites in which to study the development of osteoclasts and chondroclasts from more primitive (osteoprogenitor) cells.

Animals↗
PubMedDate not supplied

Measuring inequalities in health in the presence of multiple-category morbidity indicators.

This paper considers the problems which arise in seeking to measure socioeconomic inequalities in health when the health indicator is a categorical variable, such as self-assessed health. It shows that the standard approach--which involves dichotomizing the categorical variable--is unreliable. The degree of measured inequality is found to depend on the cut-off point chosen and the choice of cut-off point to affect the conclusions one can reach about trends in or differences in health inequality. The paper goes on to propose an alternative approach which involves constructing a latent health variable and then measuring inequalities in this latent variable by means of a variant of the health concentration curve.

Data Interpretation, Statistical↗