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Biomedical subjects

D Simpson

Publications and source records attributed to D Simpson.

At least 235 records · Page 13Linked to original sources
PubMed1985

Inequalities in health in the city of Bristol: a preliminary review of statistical evidence.

This article compares statistical indicators of health with those of material and social deprivation for 28 wards of the city of Bristol, England. Four general indicators of health were examined-a combined rate per 1,000 live births of stillbirths and infant deaths; deaths of persons aged 15 to 64 per 1,000 of that age; deaths of persons aged 65 and over per 10,000 of that age, and numbers of babies born after 40 weeks gestation weighing less than 2,800 (and 2,500) grams per 1,000 births having that period of gestation. Measures of average and cumulative rank were used to augment tests of the significance of correlations between different indicators. The degree of rank consistency was high, and several wards at the top and the bottom of the rankings were clearly distinct on all indicators. Five indicators of deprivation were also examined-the percentages of: 1) households with fewer rooms than persons; 2) households lacking a car; 3) economically active persons seeking work; 4) children aged 5 to 15 who receive school meals free; and 5) households experiencing disconnection of electricity in the previous 12 months. Again the consistency of ranking according to the five indicators was high, with marked differences on all five indicators between the highest and lowest ranking wards. Between 1971 and 1981 some forms of deprivation increased in nearly all wards. According to some criteria, deprivation increased more in wards already most deprived in 1971 than in those least deprived. Finally, a strong association between the two sets of indicators was found. On the data available to health and planning authorities poor health is significantly correlated with deprivation. There are therefore implications for new forms of joint policy-making on the part of different departments of local and central government.

Adolescent↗
PubMed1984

Prescribing psychotropic drugs in general practice: three year study.

A three year longitudinal study of psychotropic drug prescribing in one inner city general practice showed that there was a greater use of such drugs among women and elderly men and women. Repeat prescriptions without consultation accounted for 44% of prescriptions written. We think that any attempt to reduce the volume of prescriptions for psychotropic drugs should take into account the prescribing habits and attitudes of doctors as well as the problems and needs of patients.

Adolescent↗
PubMed1984

Head injuries in country and city. A study of hospital separations in South Australia.

The incidence of head injury in South Australia was estimated from hospital separation (discharges, transfers and deaths) data for 1980 and 1981. The rate of hospital separation of patients with head injury in these years was high by international standards, and was 33% greater for country residents than for residents of the Adelaide metropolitan area. Marked differences in separation rates were observed between different age, sex and occupational groups. On the basis of indirect measures of injury severity, the injury severity threshold for admission to hospital with head injury appeared to be similar in country and city hospitals. An attempt was made to estimate the number of people seriously disabled by head injury each year. The findings raise questions about the concentration of acute surgical and long-term rehabilitation services in the city, at the expense of country areas; they also provide a starting point for further, analytical studies of head injury.

Accidents↗
PubMed1984

Fronto-ethmoidal meningoencephaloceles: morphology and treatment.

Twenty-five cases of fronto-ethmoidal meningoencephaloceles have been studied. The relationship to other sincipital meningoencephaloceles is explored. In all cases the exit holes from the anterior cranial fossa are at the site of the foramen caecum. The facial component of the defect determines the sub-classification: naso-frontal, naso-ethmoidal and naso-orbital. The cranio-facial deformity may consist of hypertelorism, orbital dystopia, elongation of the face and dental malocclusion. These reflect the distorting influence of the extruded intracranial contents on facial growth. Early removal of the meningoencephalocele by the cranio-facial route is recommended to allow normal growth forces to be re-established. In older patients with established deformities translocation of the orbits may be necessary.

Adolescent↗
PubMed1984

A nursery outbreak of multiple-aminoglycoside-resistant Escherichia coli.

In the neonatal intensive care unit (NICU) of one hospital, 16 infants became colonized or infected with multiply-resistant Escherichia coli (MR-E.coli) over an 8-month period. Isolates were obtained from blood, urine, and sputum of three patients and from rectal surveillance cultures of 13 patients. The one patient with the blood isolate died. A matched case-control study identified continuous feeding (nine of 16 cases vs. one of 16 controls, p less than or equal to 0.001) and receipt of aminoglycosides (p less than or equal to 0.03) as risk factors. For case-babies not exposed to continuous feeding, duration of bolus feeding was significantly greater than for their controls (cases, 22 days; controls, 7 days; p less than or equal to 0.02). All 16 isolates were the same serotype and were resistant to amikacin, tobramycin, kanamycin, and gentamicin. The epidemiologic investigation suggested that MR-E. coli may have spread from person-to-person on the hands of personnel and that MR-E. coli persisted in the NICU for 8 months until effective control measures were instituted.

Aminoglycosides↗
PubMed1984

Neurological injuries in South Australia: the influence of distance on management and outcome.

It has been shown that in at least two Australian states (New South Wales and South Australia), there is a disproportionately high incidence of lethal neurological injuries in country areas. To determine whether any of this increased rural mortality results from geographical remoteness from specialized hospital services, we have studied prospectively a consecutive series of 153 patients with head injuries (140) or spinal injuries (13), who were transferred to Adelaide, South Australia from country centres during a six month period. Distance appeared to be an occasional cause of delay in instituting expert primary treatment. Of 13 deaths, three resulted from potentially remediable causes (intracranial bleeding, airway obstruction), and in two others difficulties in early supportive care may have contributed to death. First aid sometimes had to be administered by lay persons, and appeared to have been occasionally inadequate. Undesirable delay in transfer from accident site to country hospital was recorded in a few cases; in some of these, private transport was used. Distance was an important cause of delay in transferring patients to Adelaide, since 77% of patients had to travel in excess of 50 km. Thirty patients were brought to Adelaide by medical retrieval teams. These teams, which are centrally co-ordinated, have been useful in extending to country areas the specialized techniques of emergency intensive care and less frequently of operative neurosurgery.

Adolescent↗
PubMed1984

Neural tube defects in Western Australia 1966-81 and a review of Australian data 1942-81.

Cases of neural tube defects born in Western Australia during the years 1966-81 were identified from hospital records and death certificates. The overall rate for the 16 year period was 1.81 cases of neural tube defects per 1000 births. The rate rose and then fell over the 16 years. The initial lower rate may have been due to underascertainment, but the recent dramatic fall is statistically significant and has been observed in other Australian states and other parts of the world. This fall was not accounted for by termination of affected pregnancies before 20 weeks' gestation nor by demographic changes in birth order, father's occupation, or parental country of birth. The birth prevalence of neural tube defects determined in previous Australian studies is reviewed in relation to the recent decline in these disorders.

Australia↗
PubMed1984

Trends in major risk factors. Cigarette smoking.

The object of this paper is to examine the role of smoking as a risk factor in coronary heart disease, starting with a brief history of smoking in the U.K. and a reminder of the epidemiological evidence linking smoking and cardiovascular disease. This is followed by a more detailed look at the trends in consumption of tobacco and the major factors influencing those trends, together with an outline of the main components of a smoking control policy designed to combat our epidemic of smoking-induced disease.

Adolescent↗
PubMed1984

Gas chromatographic screening for drugs and metabolites in plasma and urine.

There is an increasing need for sensitive and specific methods for toxicological screening. Development of a dual-column gas chromatography system for the screening of drugs and metabolites in the plasma of poisoned patients is described. The system has been evaluated using plasma from a well-documented series of patients presenting with overdose, and results obtained have been compared with results of specific assays for the groups of drugs encountered. The method has been found to be of value in the treatment of poisoned patients despite its apparent insensitivity to certain more polar drug metabolites such as nortriptyline and desmethyldiazepam.

Anti-Anxiety Agents↗
PubMed1984

Recurrent subarachnoid bleeding in association with dural substitute. Report of three cases.

Three cases of recurrent subarachnoid bleeding are reported. The hemorrhages occurred at intervals of up to 10 years after posterior fossa craniotomy with closure using grafts of Silastic dural substitute. In one case, reexploration showed that the hemorrhage had arisen from a neomembrane formed at the site of the dural substitute; in the others, circumstantial evidence suggested a similar pathology.

Adolescent↗
PubMed1984

[The group worker, a tool of power or Shh! Don't wake James Dean.].

To aid an individual or a group to express agressivity and to re-channel it < > runs the risk of being a repressive and de-mobilizing intervention. All behaviour has political and social causes which those in power have an interest in evading. To say that one is apolitical and non-directive when one has a role of authority, is to protect the social status quo. To refuse to integrate the notion of power into one's intervention, is to work to the profit of those in power and to the detriment of the dominated. We, as intervention agents, have the power to define the rules of individual or social change. To hide this renders this power unchallengeable. In the face of the potential for repression inherent in all values of the dominant, I propose tolerance of confusion, the destabilization of leadership, and the learning of power mobility.

English Abstract↗
PubMed1983

Aspirin and dipyridamole reduce platelet deposition on prosthetic femoro-popliteal grafts in man.

Platelet inhibitory drugs may be used in an attempt to reduce high failure rates in small artery bypass using prosthetic grafts. We evaluated in patients the effects of aspirin and dipyridamole (ASA/DPM) on radiolabelled platelet accumulation on femoro-popliteal grafts of Dacron, polytetrafluorethylene and saphenous vein. Forty-seven patients awaiting femoro-popliteal bypass received, at random and double blind, either ASA/DPM or placebo capsules. On the seventh postoperative day, the 42 remaining patients with patent grafts were injected with autologous 111-Indium labelled platelets. Graft platelet accumulation was expressed as the Thrombogenicity Index (TI), which was defined as the mean daily rise in the ratio of radioactivity over the graft to that over the contralateral thigh. ASA/DPM reduced mean (+/- s.e. mean) TI in Dacron grafts from 0.25 +/- 0.09 on placebo to 0.16 +/- 0.05 (p less than 0.05). Mean TI in polytetrafluorethylene grafts was also significantly lower at 0.06 +/- 0.01 on ASA/DPM compared to 0.16 +/- 0.03 on placebo. Vein grafts, however, accumulated few, if any, labelled platelets and ASA/DPM had no further influence. ASA/DPM reduces platelet accumulation in prosthetic femoro-popliteal grafts in man.

Arterial Occlusive Diseases↗