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E Renvoize

Publications and source records attributed to E Renvoize.

12 recordsLinked to original sources

Mineral fibre analysis and routes of exposure to asbestos in the development of mesothelioma in an English region.

OBJECTIVES: To compare the concentrations of inorganic fibres in the lungs in cases of mesothelioma and controls: to determine whether concentrations of retained asbestos fibres differ with the different exposures identified from interview; and to investigate the existence of a cut off point in concentrations of asbestos fibres that indicates occupational exposure. METHODS: Case-control study; 147 confirmed cases of mesothelioma and 122 controls identified from deaths occurring in four districts of Yorkshire between 1979 and 1991. Surviving relatives were interviewed to determine lifetime exposure history to asbestos. Mineral fibre analysis was carried out on lung tissue from postmortem examinations. RESULTS: Odds on high concentrations of retained asbestos fibres were greater in cases than controls. After excluding subjects with occupational and paraoccupational exposure, the odds on high concentrations were still greater in cases than controls, but only significantly so for amphiboles. There was only a weak relation between probability of occupational exposure to asbestos and concentrations of retained asbestos fibres, and no significant difference in fibre concentrations was found between subjects who had been exposed to asbestos through different routes: these comparisons were only based on small groups. There was considerable overlap in concentrations of retained asbestos fibres between cases and controls with and without histories of occupational exposure. CONCLUSIONS: The study has confirmed previous results of higher concentrations of asbestos fibres in cases than controls, and has shown that this is still found in subjects with little evidence of occupational and para-occupational exposure. The overlap in concentrations of retained asbestos for different groups of subjects did not suggest a clear cut of value.

Aged↗

Educating health educators: a survey of hospital staff completing a certificate in health education course.

Health care professionals (nurses, a midwife, a physiotherapist and an occupational therapist) working in a large NHS Trust hospital who had completed the Certificate in Health Education with the support of their employer, were interviewed. The study objectives were to seek their views on the quality of the course, to determine the extent to which participants were able to apply their new found knowledge and skills in the care they provided to patients and the level of support received to allow them to do this. Barriers that prevented staff from routinely applying health education in their work were identified. The findings indicated that the majority found the course content to be good and relevant to their clinical work but they identified lack of time due to the pressure of routine clinical work as the main barrier to the promotion of health education in their clinical area.

Allied Health Personnel↗

Patient documentation. On the records.

Documentation of patient care is frequently the Achilles heel of clinical services. The use of a multidisciplinary, semi-structured healthcare record may achieve improvements, but it needs to be coupled with appropriate strategies to overcome professional and cultural barriers to unified documentation. When implementing changes, clinical staff may overestimate their clinical information needs while underestimating the problems of its routine collection.

Documentation↗

Routes of asbestos exposure and the development of mesothelioma in an English region.

OBJECTIVES: To investigate the contribution of exposure to asbestos through different routes in the development of mesothelioma. METHODS: Case-control study. 185 confirmed cases of mesothelioma and 160 controls were identified, when death had occurred between 1979 and 1991 in four health districts in Yorkshire. The surviving relatives were interviewed to ascertain lifetime exposure to asbestos. Adjusted odds ratios (ORs) of exposure to asbestos (through occupational, paraoccupational, and residential routes) were calculated for cases and were compared with controls. RESULTS: Likely or possible occupational exposure to asbestos was more common in cases than in controls (OR 5.6, 95% confidence interval (95% CI) 3.1 to 10.1). After excluding those with likely or possible occupational exposure, likely or possible paraoccupational exposure was more common in cases than controls (OR 5.8, 95% CI 1.8 to 19.2). Only six cases of mesothelioma were identified as being solely exposed to asbestos through their residence, compared with nine controls. The OR for residential exposure to asbestos varied between 1.5 and 6.6, depending on which potential industrial sources were included, but the 95% CIs were so wide that slightly reduced or greatly increased odds comparing cases with controls could not be excluded. CONCLUSION: Study results support previous evidence that occupational and paraoccupational exposure to asbestos is associated with developing mesothelioma. Despite a rigorous search, purely residential exposure seemed to account for only 3% of identified cases. No firm conclusion can be drawn about the risks from residential exposure alone, as many of the study subjects could also have been occupationally or paraoccupationally exposed to asbestos.

Adult↗

Can the suicide rate be used as a performance indicator in mental illness?

This paper follows from an examination of death rates from suicide as a possible performance indicator in mental illness. The wide variations observed in the proportion of undetermined deaths to suicides in Yorkshire district health authorities, suggest that coroners differ in their legal definition of suicide. To counteract the problem of coroner bias it is suggested that deaths from suicide and self-inflicted injury, and deaths from injury undetermined, whether accidentally or purposely inflicted in the 15 and over age group be combined. The paper outlines the advantages of such a performance indicator and stresses that a 'poor' indicator value merely poses questions which lead to a search for reasons for the value and is not an explanation in itself.

Adolescent↗

Out-of-hours duties in public health medicine: a survey of doctors in the Yorkshire Region.

A survey of doctors involved in out-of-hours public health medicine was conducted in the Yorkshire Region. Although the majority were satisfied with their present arrangements and had received some formal training for such duties, the study revealed potential areas for improvement. A review of current responsibilities and education is indicated.

Attitude of Health Personnel↗

Deliberate self-poisoning: the need for a new approach.

New community-based preventive initiatives are required if a reduction in deliberate self-poisoning is to be achieved. Local epidemiological data can be used in a health education approach, directed at professionals who have the most contact with potential cases of deliberate self-poisoning and also to those people falling within identified high-risk groups. Such initiatives require defined outcome measures and a number are proposed. The implications for data collection on deliberate self-poisoning are discussed.

Dangerous Behavior↗

Patients' rights to access their healthcare records.

Improving communication between different healthcare disciplines and with patients is hampered by professional insecurity. In this article, the authors examine the compelling reasons for making records more accessible to patients and describe the potential benefits for patients and professionals.

Attitude to Health↗