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Biomedical subjects

C Godfrey

Publications and source records attributed to C Godfrey.

At least 19 recordsLinked to original sources
PubMed1997

Lost productivity and costs to society.

Having a single monetary amount that provides an indicator of alcohol misuse can be a powerful instrument for those advocating policy action. Existing studies suggest that alcohol use in any year may yield costs that are equivalent to 2-5% of the gross national product. While useful, such figures do not indicate which combinations of policies could yield the greatest net benefits for their populations. There may also be interest in the effects of alcohol use on public finances or the fairness of both taxes and welfare payments across different groups of the population. Which items are identified as being relevant and how these effects are measured and valued will depend on which policy question is being addressed. There are, however, a number of common issues such as whether costing studies should be confined to the heaviest and problematic, how benefits of alcohol consumption should be measured, how future benefits in terms of health gains should be valued and whether the costs to the drinker are important or only those costs which are borne by third parties. There will not always be simple answers to these questions. However, even if costing studies are confined to third party effects and the most conservative assumptions are taken, it is clear that there is powerful evidence that many societies would be better off if action is taken to prevent alcohol problems. Research on the effects of alcohol use is becoming increasingly sophisticated and this will lead to improvements in costing studies. Productivity losses are likely to remain one of the most significant costs of alcohol misuse.

Accidents↗
PubMed1997

Costing substance misuse services.

AIMS: To develop a methodology for obtaining the detailed costs of different substance misuse services and illustrate some of the specific problems by means of a case study. DESIGN: Data on the resources required, clinical activity, and patient characteristics for one year were combined to provide detailed costs for different types of clinical events and patients. SETTING: The clinical services of a publicly funded addiction unit in a large industrial city in the UK. The unit provides for alcohol and other drug misusers mainly on an outpatient basis but with inpatient care. PARTICIPANTS: Over 1500 patients were included in the analysis with 75 per cent being male, and 80 per cent aged between 20 and 49. Nearly half of the clients had alcohol as their main drug of misuse with opiate users being the next largest group. MEASUREMENT: Detailed costing by event and patient was possible as the staff type and time taken for each event were routinely recorded. A cost for each individual event was estimated and summed for each individual patient to give a cost estimate by patient for the financial year 1992/3. FINDINGS: Core treatment outpatient events had an average cost of Pounds 48, with new assessments costing Pounds 87 but these averages hid high variations. The average cost per year for those receiving only outpatient care was Pounds 358; it was Pounds 1857 for those receiving both outpatient and inpatient care. Opiate misusers were on average more costly than alcohol misusers. The costs were skewed with 10 per cent of patients accounting for 56 per cent of the total annual costs. CONCLUSIONS: Dealing with costs of non attendance, including all resource use, and coping with large individual variations in costs across individuals and intervention types are the main problems in devising cost figures. Cost data are useful but need to be combined with outcome data if they are to be used to improve patient services.

Adult↗
PubMed1995

Counting the costs of children's smoking.

The recent publication of the 1994 OPCS survey of smoking among secondary school children confirmed that the Health of the Nation target for children's smoking (a reduction in regular smoking from 8% in 1988 to less than 6% in 1994) has not been achieved. In 1994, 12% of English schoolchildren aged 11-15 were regular smokers (as were 12% in Scotland, 9% in Wales, and 12.5% in Northern Ireland). In 1994 the government spent around 10 million pounds on initiatives to prevent smoking, but received around 8643 million pounds in tax receipts from tobacco sales, about 108 million pounds of which was tax receipts from the illegal sale of cigarettes to children under 16 years old. The tobacco industry spent an estimated 100 million pounds on promotional activities. Improving current trends in children's smoking by the year 2000 will require decisive action by the government. The government should legislate to ban tobacco advertising and should use the 108 million pounds taken each year in taxes from smoking children to fund smoking cessation and prevention initiatives.

Adolescent↗
PubMed1995

Executive leave: avoiding the pitfalls.

A leave of absence must be carefully planned to avoid any potential pitfalls. A successful transfer of power when assigning a temporary replacement requires trust, confidence and excellent communication. A director and an assistant director who work with over 300 staff share their experience.

Humans↗
PubMed1994

Alcohol policy--evaluating the options.

All policy interventions have costs and benefits and the 'harm' created by the use of alcohol can only be mitigated at a cost. The purpose of economic analysis is to measure these costs and benefits in an explicit way and to use these results to inform policy. Policy makers like to use estimates of the social costs of alcohol use but such data are of little use in identifying which interventions reduce harm at least cost: knowing alcohol use costs in local currencies $6 million in Australia, $5.8 billion in the USA, $5.7 billion in Canada and $2 billion in the UK may fuel political debate but does not identify the intervention where investment produces the greatest increase in benefit at least cost. Integrated policies to raise taxes in relation to price and income changes have significant impacts on alcohol consumption and, if complemented with advertising controls and limits on availability have even larger effects. The quantity and quality of economic evaluations of health care interventions is inadequate. What little evaluation that has been undertaken indicates that low cost minimal interventions may be cost effective for the wider population of problem drinkers. Other more intensive interventions are likely to be cost effective only if well targeted on appropriate client groups. There are many effective ways of reducing alcohol consumption. The industry will lose and oppose change but improvements in health and other aspects of life (eg civil order) will be significant.

Alcohol Drinking↗
PubMed1994

Downsizing: coping with personal pain.

A new emphasis on primary and preventive care is hailed as long overdue by many in nursing. One effect of this paradigm shift, however, is being experienced in many hospitals. Acute-care facilities are rearranging services ("restructuring"), consolidating programs and eliminating large numbers of staff ("downsizing") in an effort to position themselves securely for the future. Downsizing can be devastating to those who lose jobs, so nurse managers and administrators can play a key role in planning the downsizing process sensitively. Whenever possible, loss of a traditional job should be balanced by the offer of a new opportunity within the healthcare system.

Adaptation, Psychological↗
PubMed1993

Modelling the interactions between alcohol, crime and the criminal justice system.

Similarities in the trends of the number of offences and the level of alcohol consumption are often used as evidence as a link between alcohol and many forms of criminal activity. However, such crude correlations may be misleading as they neither take account of other factors that might be important, not assist the understanding of the causal links between alcohol and crime. In this paper, the role that economic models may play in furthering the understanding of the potential links between alcohol and crime are explored. A complete model is presented which allows for complex interactions between alcohol, crime and the criminal justice system. Results from testing this model with time series data (1960-88) for England and Wales for different types of crime are discussed in detail. Data defined by standard regions and for the years 1980 to 1988 were also compiled and a summary of the results discussed. The argument that alcohol consumption may be one of the determinants of a wide range of crimes receives some support and is also found that alcohol consumption may affect the probability of detection for some types of crime.

Alcohol Drinking↗
PubMed1992

Autosomal recessive microcephaly with severe psychomotor retardation.

Autosomal recessive microcephaly has long been recognized in association with normal early motor development and mild to severe mental retardation. We report three sibling pairs with microcephaly and severe neurological impairment. These cases and other sibling pairs reported in the literature illustrate that microcephaly with spasticity and severe mental retardation may also have autosomal recessive inheritance. Furthermore this severely affected group of patients forms a significant proportion of cases of genetic microcephaly. We looked for specific morphological features to identify these forms of genetic microcephaly for genetic counselling, but failed to find characteristic abnormalities among our group of patients.

Adolescent↗
PubMed1989

Factors influencing the consumption of alcohol and tobacco: the use and abuse of economic models.

This paper is concerned with the use of economic models in the debate about the role that tax increases and restrictions on advertising should play in reducing the health problems that arise from the consumption of alcohol and tobacco. It is argued that properly specified demand models that take account of all the important factors that influence consumption are required, otherwise inadequate modelling may lead to misleading estimates of the effects of policy changes. The ability of economics to deal with goods such as alcohol and tobacco that have addictive characteristics receives special attention. Recent advances in economic theory, estimation techniques and statistical testing are discussed, as is the problem of identifying policy recommendations from empirical results.

Alcoholism↗
PubMed1988

Economic aspects of tobacco use and taxation policy.

Tax levels have important effects on cigarette prices and tax revenues. Over 70p of every pound spent on tobacco goes to the Chancellor of the Exchequer, yielding over 5 billion pounds. But the value of tobacco tax revenues have generally fallen--by 1986 they were 10% lower than at their peak in 1965, and tobacco revenue is becoming a smaller proportion of total tax receipts. The impact of a consistent increase in tobacco taxation is important in terms of reduced consumption (and harm to health) as well as in terms of reduced employment. Revenue may, however, increase in the short term. Finally, if the findings of Townsend and Atkinson et al (see above) still apply then the distributive effects of increased taxation on the poor might be less than is sometimes feared.

Employment↗
PubMed1987

Purification and properties of formate dehydrogenase from Pseudomonas aeruginosa. Characterization of haem and iron-sulphur centres by magnetic-circular-dichroism and electron-paramagnetic-resonance spectroscopy.

The purification of formate dehydrogenase (FDH) from Pseudomonas aeruginosa after anaerobic growth on nitrate-containing medium was carried out. The separation of the FDH enzyme from nitrate reductase (NiR), which are found together in a particle fraction and constitute the short respiratory chain of this bacterium, has been followed by optical, magnetic c.d. (m.c.d.) and e.p.r. spectroscopy. These techniques have allowed the haem, iron-sulphur clusters and molybdenum components to be detected and, in part, their nature to be determined. Attempts to extract FDH anaerobically in the absence of sodium dithionite led to loss of activity. Addition of sodium dithionite maintained the activity of the enzyme, even after subsequent exposure to air, in an assay involving formate reduction with Nitro Blue Tetrazolium as reductant. Three preparations of FDH have been examined spectroscopically. The preparations vary in the amount of contaminating nitrate reductase, the amount of cytochrome c present and the concentration of oxidized [3Fe-4S] cluster. Optical spectra and low-temperature m.c.d. spectroscopy show the loss of a cytochrome-containing protohaem IX co-ordinated by methionine and histidine as NiR is separated from the preparation. In its purest state FDH contains one molecule of cytochrome co-ordinated by two histidine ligands in the oxidized state. This cytochrome has an e.p.r. spectrum with gz = 3.77, the band having the unusual ramp shape characteristic of highly anisotropic low-spin ferric haem. It also shows a charge-transfer band of high intensity in the m.c.d. spectrum at 1545 nm. It has recently been shown [Gadsby & Thomson (1986) FEBS Lett. 197, 253-257] that these spectroscopic properties are diagnostic of a bishistidine co-ordinated haem with steric constraint of the axial ligands. The e.p.r. and m.c.d. spectra of the reduced state of FDH reveal the presence of an iron-sulphur cluster of the [4Fe-4S]+ type. The g-values are 2.044, 1.943 and 1.903. An iron-sulphur cluster of the class [3Fe-4S], detected by e.p.r. spectroscopy in the oxidized state and by low-temperature m.c.d. spectroscopy in the reduced state, is purified away with the NiR. Finally, an e.p.r. signal at g = 2.0 with a narrow bandwidth which persists to 80 K is observed in the purest preparation of FDH. This may arise from an organic radical species.

Aldehyde Oxidoreductases↗
PubMed1987

Purification and properties of formate dehydrogenase from Pseudomonas aeruginosa. Electron-paramagnetic-resonance studies on the molybdenum centre.

Formate dehydrogenase from Pseudomonas aeruginosa contains molybdenum, a [4Fe-4S] cluster and cytochrome b. This paper reports the detection of molybdenum as Mo(V) by e.p.r. spectroscopy. In order to generate Mo(V) signals, addition of amounts of excess formate varying between 10- and 50-fold over enzyme, followed by 200-fold excess of sodium dithionite, were used. Two Mo(V) species were observed. One, the major component, has g1 = 2.012, g2 = 1.985 and g3 = 1.968, appeared at low concentrations of formate and increased linearly in intensity with increasing concentrations of formate up to 25-fold excess over the enzyme. At higher formate concentration this signal disappeared. The appearance and disappearance of this Mo(V) signal seems to parallel the state of reduction of the [4Fe-4S] clusters. A second, minor, Mo(V) species with g-values g1 = 1.996, g2 = 1.981 and g3 = 1.941 appears at a constant level during the formate-dithionite titration. No evidence has been obtained for nuclear hyperfine coupling to protons. The major Mo(V) species has unusual e.p.r. signals compared with other molybdenum-containing enzymes, except for that observed in the formate dehydrogenase from Methanobacterium formicicum [Barber, Siegel, Schauer, May & Ferry (1983) J. Biol. Chem. 258, 10839-10845]. The present work suggests that the enzyme is acting as a CO2 reductase, with dithionite as an electron donor to a [4Fe-4S] cluster, which in turn donates electrons to molybdenum, producing a Mo(V) species with CO2 bound to the metal.

Aldehyde Oxidoreductases↗