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Biomedical subjects

E Salib

Publications and source records attributed to E Salib.

At least 19 recordsLinked to original sources
PubMed1999

Does the weather influence dementia admissions?

BACKGROUND: There is currently no literature on the relationship between weather parameters and admissions of organic brain syndromes such as dementias. In this present study we aimed to examine the effect of weather parameters such as relative humidity, sunshine hours, diurnal variations in temperature and rainfall on dementia admissions in North Cheshire. METHOD: Daily number of hospital admissions of dementias and other diagnoses in North Cheshire was analysed in relation to meteorological data, which were measured at the nearest meterological office to the study population. RESULTS: The study found no evidence of any statistically significant association between weather parameters and dementia admissions. There was a weak, lagged inverse relationship between dementia admissions and relative humidity and a positive association with diurnal variations in temperature within a week of admission. However, neither finding achieved statistical significance. CONCLUSION: The study is the first in currently available literature on the subject and may therefore provide a base reference for future studies. The interesting observation relating to relative humidity and diurnal variations in temperature is unexpected and may suggest further research.

Adolescent↗
PubMed1999

Psychiatric disorders in first-degree relatives of patients with opiate dependence.

High rates of psychiatric disorders, particularly major depression, alcoholism, drug-use disorder and antisocial personality disorder in the relatives of opiate-dependent patients compared with normal controls, have been reported in some previous studies. This study was designed to evaluate the prevalence rates of drug-use and other psychiatric disorders in the first-degree relatives of opiate-dependent patients and compare these with rates in the first-degree relatives of surgical and psychiatric patients. A case-control study was conducted to compare the prevalence of psychiatric and drug-use disorders (which were estimated by the Family History Method) in 241 biological first-degree relatives of 50 opiate-dependent patients to that in 235 and 222 first-degree relatives of 50 surgical and 50 psychiatric patients respectively. The main outcome measure was the relative risk (expressed as odds ratio) of psychiatric and drug-use disorders. First-degree relatives of opiate-dependent patients were found to have significantly higher rates of drug-use and antisocial personality disorders, compared with relatives of surgical and psychiatric probands. The odds ratio for alcoholism appeared significantly higher only in first-degree female relatives of opiate users, suggesting effect modification by sex. The study provides further evidence for the higher rate of drug-use disorder in the first-degree relatives of opiate-dependent patients. These findings suggest that familial drug-use disorder contributes to a vulnerability to opiate misuse. Implications of these findings for the classification and treatment of opiate dependence are discussed.

Adult↗
PubMed1998

Detention of in-patients under section 5(2) of the Mental Health Act 1983.

All applications of s.5(2) of the Mental Health Act 1983, allowing the emergency detention of voluntary in-patients in North Cheshire between 1985 and 1995, were reviewed to examine general trends in its use and to assess variables likely to influence its outcome. Of the 877 applications implemented (4% of all admissions), 500 (57%) were converted to longer-term detention under the Act, 396 (45%) were converted to s.2 and 104 (12%) to s.3. The other 377 (43%) detained patients under s.5(2) regained informal status. The review found that time of application of section, length of hospital stay prior to application, medical officer's grade, use of s.5(4) and clinical diagnosis are best predictors of s.5(2) outcome. The results are similar to other published studies and seem to reflect a national pattern, possibly implying that patients detained under this short-term detention order have an almost equal chance of either regaining their voluntary status or being detained under another section by the end of the 72 hours. This may raise questions about the purpose of s.5(2) as expressed by the Mental Health Act Commission.

Adolescent↗
PubMed1998

The khat users: a study of khat chewing in Liverpool's Somali men.

This study reports the demographic and social characteristics and level of psychological dysfunction in regular khat users compared with matched non-users. The results indicate that khat users resemble non-users on a number of psychosocial variables and GHQ scores, with no evidence to suggest higher morbidity amongst users. The two groups appear to differ only in the level of their use of nicotine and also in their perception of the harmful effects associated with khat use.

Adolescent↗
PubMed1998

Audit of the use of nurses' holding power under section 5(4) of the Mental Health Act 1983.

Emergency detention of psychiatric patients by doctors under s. 5(2) of the Mental Health Act 1983 is not always preceded by the use of nurses' holding power under s. 5(4). In this review of patients in North Cheshire, all applications of s. 5(4), allowing the emergency detention of voluntary in-patients by registered psychiatric nurses for a maximum period of six hours, were reviewed to examine the extent of its use and to assess its effect on s. 5(2) outcome. Of the 877 detentions under s. 5(2) implemented during the 11-year review period, 140 (16%) were preceded by s. 5(4). There was no significant difference in age, sex, clinical diagnosis, day of the week, reason for detention and length of hospital stay before section application between those who had s. 5(4) applied before 5(2) and those who did not. The latter were less likely to be converted to other sections (53%) compared to a much higher rate of 80% if s. 5(4) preceded s. 5(2). The review has also found that time of section application and length of hospital stay prior to detention may have influenced the use of nurses' holding power. It suggests that s. 5(4) may be a useful predictor of s. 5(2) outcome.

Adolescent↗
PubMed1998

Practice of seclusion: a five-year retrospective review in north Cheshire.

This study examines, retrospectively, the trends and factors associated with the use of seclusion over a five-year period in a regional secure unit located within a large psychiatric hospital that serves the population of North Cheshire. Ninety-four patients (15.3% of total admissions to the unit) spent some time in seclusion on 186 occasions. The average time spent in seclusion was 85 minutes (minimum 15 minutes and maximum 10 hours). Sixty-seven per cent of patients were secluded once, 20% secluded twice, and 13% more than three times. Patients with a clinical diagnosis of personality disorder (11.4%) accounted for 44.2% of seclusions whereas those with a defined mental disorder (55%) accounted for 35% of all seclusions. The rate of seclusion, characteristics of secluded patients, reasons, and average duration spent in seclusion, did not vary significantly over the study period, despite the significant reduction of the unit's admission rate from 150 to 63 per year. The consistent and regular occurrence of the practice over a five-year period may suggest that seclusion of some disturbed patients will inevitably continue to be used as an effective intervention and, probably at times, the only acceptable method that may ensure the safety of patients and staff.

England↗
PubMed1997

A case-control study of smoking and Alzheimer's disease.

OBJECTIVES: To study the association between Alzheimer's disease and smoking history. DESIGN: An unmatched case-control study. SETTING: Psychogeriatric unit serving an elderly population of Warrington. PERIOD: 2 years 1991-1993. SUBJECTS: 198 cases of Alzheimer's disease (ADRDA-NINCDS diagnostic criteria) were compared to two selected control groups (164 other dementias and 176 non-dementing group) with respect to their smoking history. MAIN OUTCOME MEASURE: Relative risk (odds ratio) of Alzheimer's disease. RESULTS: The odds ratio for Alzheimer's disease in patients who smoked was 0.68 (95% CI 0.47-0.98). The negative association was statistically significant only in male patients, OR 0.45 95% CI (0.23-0.87), p < 0.05. The inverse association was also only significant in patients with family history of dementia, OR 0.34 95% CI (0.12-0.92), p < 0.05. CONCLUSION: The study supports previous findings of an inverse relationship between smoking and Alzheimer's disease. This, however, does not suggest that smoking is used as a preventive measure for Alzheimer's disease.

Aged↗
PubMed1997

Head injury and the risk of Alzheimer's disease: a case control study.

OBJECTIVES: The objective of this study is to examine the association between Alzheimer's disease and head injury in elderly patients referred to an EMI unit. METHOD: An unmatched case control study comparing 198 cases of Alzheimer's disease (NINCDS-ADRDA diagnostic criteria) to selected controls (164 other dementias and 176 non-dementing group) with respect to history of head trauma, with or without loss of consciousness, prior to the onset of dementia. SETTING: EMI unit in Warrington serving an elderly population of 28,000. The subjects included all patients referred to and seen by the first author during a 2-year study period 1991-1993. MAIN OUTCOME MEASURE: Relative risk (odds ratio) of Alzheimer's disease. RESULTS: For having history of head injury, the odds ratio was 1.52 (0.98-2.35), significant only in male patients (OR 2.1 p < 0.05). For dementias other than Alzheimer's disease the odds ratio of head injury was 2.36 and 2.46 for all dementias combined (p < 0.05). CONCLUSION: The study confirms a positive association between reported head injury and Alzheimer's disease as well as non-Alzheimer type dementia. Head trauma did not appear to be a specific risk for Alzheimer's disease as previously claimed. The association was modified by sex being only significant in male patients.

Aged↗
PubMed1997

Unexpected death of psychiatric patients: suicide, misadventure, accident or unsolved mystery?

We examined the association between the psychiatric history of patients who were the subjects of a coroner's inquest and the recorded verdict, in a seven-year retrospective review. A suicide verdict was less frequently returned on patients who had inpatient psychiatric treatment compared to other unexpected deaths. History and diagnosis of an alcohol-related condition, method of death and intimation of intent were the main factors that appeared to be associated with the coroner's verdict. Age, sex, duration of illness, time and number of admissions, previous suicide attempts and treatment received did not appear to be significantly associated with the recorded verdict.

Accidents↗
PubMed1997

Weather conditions and fatal self-harm in North Cheshire 1989-1993.

BACKGROUND: We aimed to study the effect of weather conditions on the rate of all deaths due to fatal self-harm (FSH) reported in a population of 350,000. In this study the term FSH refers to all coroners' verdicts which were recorded in a specified period and included suicide, misadventure and open verdict. METHOD: Five-year data of FSH in North Cheshire was analysed in relation to meteorological data, which were measured at the nearest meteorological office to the study population. RESULTS: Small but significant positive correlations were demonstrated between occurrence of FSH and hours of sunshine (P < 0.01) and diurnal variations in daily temperature (P < 0.05). These effects were independent of gender and psychiatric history. CONCLUSIONS: Weather may influence the occurrence of FSH, probably interacting with biological and social variables. The rate of FSH death appears to be positively related to fine weather conditions, during early summer, and not to extreme weather conditions as previously reported.

Autopsy↗
PubMed1997

Coroner's verdicts in the elderly: a suicide or an open verdict?

OBJECTIVES: To identify variables, other than legal definitions, that may have influenced North Cheshire's Coroner in returning a verdict of 'suicide' or an 'open verdict' on unexpected deaths of the elderly. DESIGN: Retrospective review of all coroner's verdicts in North Cheshire during a 5-year period 1989-1993. MATERIAL: Forty-seven 'suicide' and 'open verdict' deaths in North Cheshire between 1989 and 1993 as defined in ICD classification 'E' codes E950-E959 and E980-E989, respectively, that were returned on the deceased aged 65 and above who died within North Cheshire. FINDINGS: Logistic regression analysis suggests that the Coroner's decision may be influenced by: intimation of intent, psychiatric history and method of death. Sex of the deceased, history of attempted suicide, social setting and history of alcohol problems did not appear significantly associated with coroner's verdict.

Accidents↗