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Biomedical subjects

C M McKee

Publications and source records attributed to C M McKee.

At least 19 recordsLinked to original sources
PubMed1990

Micro-computers: availability to and use by trainees in public health medicine.

A survey of the availability to and use of micro-computers by public health medicine trainees was undertaken in February, 1989. Most departments have access to computers and trainees possess computing skills, but almost one in 15 trainees had no access to a micro-computer, and one trainee in eleven had no computing experience while a further one in eight had not progressed beyond word-processing. Departments of Public Health Medicine should review their computing resources and ensure that they are adequate for the challenges of the 1990s.

Computer User Training↗
PubMed1990

Effectiveness of intradermal hepatitis B immunization of hospital staff.

Three doses of hepatitis B vaccine were administered via an intradermal route to 316 health service staff. One month after the final dose, 89.9% of subjects had antibodies to hepatitis B surface antigen at levels of 10 IU/l or greater. A programme of hepatitis B immunization based upon the intradermal route is substantially less expensive than one using an intramuscular technique, and can enable health authorities to provide protection for increased numbers of staff without diverting resources from other programmes of health care.

Adult↗
PubMed1990

Accident and emergency attendance rates: variation among patients from different general practices.

As a consequence of the 1989 National Health Service review health authorities are likely to take a greater interest in patterns of use of secondary care services by patients of different general practitioners. Use of accident and emergency departments has been shown to predict subsequent use of other hospital services. If meaningful comparisons are to be made between practices it is important to identify factors other than variation in clinical practice which influence attendance at accident and emergency departments. A one in 20 sample of patients attending an accident and emergency department was studied. Patients were aggregated by general practice and by electoral ward of residence, and the influence of a range of variables was examined using multiple regression. For both groups of patients distance from an accident and emergency department was an important factor in the rate of attendance. It was possible to examine the effect of several socioeconomic variables in the analysis by electoral ward: these were not associated significantly with attendance rates. Similarly, in the analysis by practice, mean list size per partner could not explain variation in attendance rates. This study supports others which have indicated that distance from an accident and emergency department must be taken into account when interpreting attendance rates.

Accidents↗
PubMed1990

Deaths in winter in Northern Ireland: the role of low temperature.

Many European countries experience a seasonal excess in deaths each winter compared to summer. The magnitude of the excess is greater in the United Kingdom than in many other European countries. Examination of the data for Northern Ireland indicates that myocardial infarction, respiratory disease and stroke exhibit the greatest increases during winter. Excess deaths from these conditions are closely associated with low environmental temperature.

Cold Temperature↗
PubMed1989

Cold at heart.

Explore the source record for details and available documents.

Age Factors↗
PubMed1989

Deaths in winter: can Britain learn from Europe?

There is a substantial increase in the number of deaths in winter in the United Kingdom. This is also seen in some, but not all, European countries. Almost 60% of the variation among countries can be explained by the minimum average monthly temperature and the gross national product per capita. Seasonal variation is lowest in those countries with cold winters, suggesting that insulation may be important. It is also low in the more wealthy countries. The implications for health service policy of these finding are discussed. Some of the residual variation may be explained by known factors, such as low cost geo-thermal energy in Iceland, but much remains unexplained. There is a need for more research in this field.

Analysis of Variance↗
PubMed1989

Hepatitis B immunisation in northern Ireland: an epidemiological and economic analysis.

The availability of active immunisation against hepatitis B has stimulated demand for protection among health care workers. The vaccine remains expensive, and widespread immunisation will divert scarce resources from elsewhere. The arguments in favour of widespread immunisation of health care workers are based on studies from areas with prevalences of infection and carriage which are much higher than in Northern Ireland. This study was carried out to provide a rational basis for deciding who should be offered immunisation. The epidemiology of hepatitis B infection in Northern Ireland is examined. The incidence of hepatitis B in Northern Ireland is one of the lowest in the world. The evidence for an increased risk of infection among health care workers throughout the world is reviewed. The risk of infection varies widely among different countries and there is evidence that increased awareness of the hazards of sharps injuries and the introduction of safe handling techniques have substantially reduced the risk. An economic analysis suggests that a widespread programme of hepatitis B immunisation in Northern Ireland compares unfavourably with other health care interventions.

Cost-Benefit Analysis↗
PubMed1988

Attitudes to a hospital based terminal care scheme.

Two years after the establishment of a terminal care support team, the team perceived that a number of patients were not being referred to them, and many of those seen were referred at a very late stage in their illness. We sent a questionnaire to all clinicians and ward sisters in the district to elicit their knowledge of the team and attitudes to their role. Although most respondents had cared for terminal patients in the previous 6 months, over a quarter were not aware of the existence of the team. The lack of awareness was most common among junior medical staff, many of whom were spending relatively short times in the district. The study indicated a requirement for good communication between terminal care teams and other professionals and a need to inform junior staff about available facilities. A requirement for training in terminal care was also identified.

Attitude of Health Personnel↗
PubMed1988

Increasing mortality from malignant melanoma among women in Northern Ireland.

Deaths from malignant melanoma in each part of the British Isles between 1969 and 1984 have been examined. There has been a substantial increase of deaths among women in each part, and an increase of similar magnitude among men in all areas except Northern Ireland. It is suggested that this difference requires further study. The increasing number of deaths from this disease indicates a need for greater public and professional awareness of this potentially preventable and curable condition.

Female↗
PubMed1987

Diversity of autoantibodies in patients with antimitochondrial antibody and their diagnostic value.

A retrospective analysis of clinical and laboratory features of 102 patients, whose sera contained antibody to mitochondria, showed that primary biliary cirrhosis was diagnosed in 50% of them. Immunofluorescence showed that the sera of the patients with primary biliary cirrhosis all had the M2 antimitochondrial antibody staining pattern. A new staining pattern, designated M2(1), which could be mistaken for the M2 pattern, was not found in any patients with either primary biliary cirrhosis or chronic active hepatitis. Other serological variables such as antibody to mitochondria in IgM class, to multiple nuclear dots, and to the XR antigen, were associated with primary biliary cirrhosis, and taken in association with antimitochondrial antibody of M2 type, contribute to the diagnosis of the disease.

Antibodies, Antinuclear↗
PubMed1986

Acute fatty liver of pregnancy and diagnosis by computed tomography.

A 39 year old woman was admitted to a maternity unit at 34 weeks' gestation with nausea, vomiting, and jaundice. Her condition deteriorated, and she was transferred to hospital, deeply unconscious and hypotensive. The diagnosis of acute fatty liver of pregnancy was initially suggested by the typical history of prodromal malaise and vomiting and the rapid onset of hepatic encephalopathy with profound hypoglycaemia and only small increases in transaminase activities. Computed tomography was performed: there was no enlargement of the liver or spleen, but the attenuation value over the liver indicated appreciable fatty infiltration of the liver, establishing the diagnosis of acute fatty liver of pregnancy. Computed tomography is of value in the diagnosis of liver disease of late pregnancy, and this technique may become the method of choice for the investigation of acute fatty liver of pregnancy.

Acute Disease↗