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Biomedical subjects

F North

Publications and source records attributed to F North.

9 recordsLinked to original sources
PubMed2000

A randomised controlled trial of dietary energy restriction in the management of obese women with gestational diabetes.

A randomised controlled trial was designed to determine the effect of moderate 30% maternal dietary energy restriction on the requirement for maternal insulin therapy and the incidence of macrosomia in gestational diabetes. Although the control group restricted their intake to a level similar to that of the intervention group (6,845 kiloJoules (kJ) versus 6,579 kJ), the resulting cohort could not identify any adverse effect of energy restriction in pregnancy. Energy restriction did not alter the frequency of insulin therapy (17.5% in the intervention group and 16.9% in the control group). Mean birthweight (3,461 g in the intervention group and 3,267 g in the control group) was not affected. There was a trend in the intervention group towards later gestational age at commencement of insulin therapy (33 weeks versus 31 weeks) and lower maximum daily insulin dose (23 units versus 60 units) which did not reach statistical significance. Energy restriction did not cause an increase in ketonemia.

3-Hydroxybutyric Acid↗
PubMed1998

Socioeconomic and sex differentials in reason for sickness absence from the Whitehall II Study.

OBJECTIVES: Large socioeconomic differences exist in disease and mortality. This paper describes the distribution of specific medical reasons for sickness absence by grade of employment in the Whitehall II study and validates the medical reason by comparison with general practitioners' records. METHODS: Analysis of sickness absence data on 5620 male and female civil servants aged 35-55 years. Data have been collected from 12 of the 20 London based civil service departments participating in the Whitehall II study, where medical reason for absence was available. Rates and distributions of reasons for absence for short spells (< or = 7 days) and long spells (> 7 days) were analysed. RESULTS: Respiratory disorders and gastroenteritis accounted for over half of all spells of absence, with headache and migraine, musculoskeletal disorders, injury, and neurosis accounting for a further 20%-30% of absences. There was an inverse association with employment grade, the lower the grade the higher the rate of absence for both short spells (< or = 7 days) and long spells (> 7 days). In general, women had higher rates of absence than men. Comparison of reason for very long spells of absence (> 21 days) showed moderate agreement between civil service and general practitioner. CONCLUSION: There is a lack of national comprehensive data on sickness absence and medical reason for absence, in particular for women and for spells of different duration. Data from the Whitehall II study show large employment grade and sex differences in the distribution of medical reasons for absence that are similar to socioeconomic differences in morbidity documented in other studies. Possible explanations include the subjective nature of illness and disease; the work/family interface; and the influence of the absence culture. Longer term follow up will provide information on whether sickness absence relates to serious morbidity and mortality.

Absenteeism↗
PubMed1995

Sickness absence for psychiatric illness: the Whitehall II Study.

Over the past 20 years, rates of sickness absence have increased and psychiatric disorders have become an important cause of sickness absence. The socio-demographic associations for psychiatric sickness absence are reported from the Whitehall II study, a longitudinal survey of 10,308 London-based male and female civil servants between 35-55 years. Short spells (< or = 7 days), long spells (> 7 days) and very long spells (> 21 days) of sickness absence were examined in 5620 civil servants for whom reason for absence was available in civil service records. Civil service coding of reasons for absence was validated against report of general practitioners' diagnoses. Psychiatric disorder, largely neurosis and neurosis ill-defined, was the third most common cause of long spells of sickness absence in women and the fourth most common in men. For both men and women it was the second most common cause of very long spells of absence. Psychiatric sickness absence for short, long and very long spells was more frequent in lower employment grades than higher employment grades in keeping with the pattern for other illnesses. This partly explains the higher rate of sickness absence in women than men. Widowed and single men, and divorced women had high rates of psychiatric sickness absence. Comparing reason codes based on sickness certificates with general practitioners reports, there appeared to be evidence of under-reporting of psychosis on certificates.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Sickness absence as a measure of health status and functioning: from the UK Whitehall II study.

STUDY OBJECTIVE: To investigate the relationship between self reported health status and sickness absence. DESIGN: Analysis of questionnaire and sickness absence data from the first phase of the Whitehall II study--a longitudinal study set up to investigate the degree and causes of the social gradient in morbidity and mortality. SETTING: London offices of 20 civil service departments. PARTICIPANTS: Altogether 6895 male and 3413 female civil servants aged 35-55 years. Analysis was conducted on 88% of participants who had complete data for the present analysis. MAIN RESULTS: A strong inverse relation between the grade of employment (measure of socioeconomic status) and sickness absence was observed. Men in the lowest grade had rates of sickness absence six times higher than those in the highest grade. For women the corresponding differences were two to five times higher. In general, the longer the duration of absence, the more strongly did baseline health predict rates of absence. However, the health measures also predicted shorter spells, although to a lesser extent. Job satisfaction was strongly related to sickness absence with higher rates in those who reported low job satisfaction. After adjusting for health status the association remained for one to two day absences, but was greatly reduced for absences longer than three days. CONCLUSION: There was a strong association between ill health and sickness absence, particularly for longer spells. The magnitude of the association may have been underestimated because of the strength of the association between grade of employment and sickness absence. It is proposed that sickness absence be used as an integrated measure of physical, psychological, and social functioning in studies of working populations.

Absenteeism↗
PubMed1995

Flexible sigmoidoscopy or colonoscopy for colorectal screening: a randomized trial of performance and acceptability.

In a randomized clinical trail to assess acceptability, yields, costs, and unwanted effects of screening procedures, 232 subjects (137 with family history of colorectal carcinoma or adenoma, 95 without) were offered either flexible sigmoidoscopy or colonoscopy. Subjects with polyps found on sigmoidoscopy were followed up by colonoscopy. The two procedures were similar in compliance (65%) and yield (19% adenoma, 15% hyperplastic polyps). Polyps of either type were more common in those with a family history (prevalence: 41% compared with 24% without family history, p = 0.04). Costs per procedure were 60% lower for sigmoidoscopy, but follow-up colonoscopy reduced this cost advantage to 20% per subject. The subjects found the preparation for sigmoidoscopy easier, but the procedure more uncomfortable and embarrassing, as colonoscopy was performed under sedation. In this hospital-based study, colonoscopy was as acceptable to subjects, and only slightly more costly than sigmoidoscopy. Advantages of sigmoidoscopy would be greater for use outside hospitals and with less intensive follow up.

Aged↗
PubMed1993

Explaining socioeconomic differences in sickness absence: the Whitehall II Study.

OBJECTIVE: To describe and explain the socioeconomic gradient in sickness absence. DESIGN: Analysis of questionnaire and sickness absence data collected from the first phase of the Whitehall II study. Grade of employment was used as a measure of socioeconomic status. SETTING: 20 civil service departments in London. SUBJECTS: 6900 male and 3414 female civil servants aged 35-55 years. MAIN OUTCOME MEASURES: Rates of short spells (< or = 7 days) and long spells (> 7 days) of sickness absence. RESULTS: A strong inverse relation between grade of employment and sickness absence was evident. Men in the lowest grade had rates of short and long spells of absence 6.1 (95% confidence interval 5.3 to 6.9) and 6.1 (4.8 to 7.9) times higher than those in the highest grade. For women the corresponding rate ratios were 3.0 (2.3 to 3.9) and 4.2 (2.5 to 6.8) respectively. Several risk factors were identified, including health related behaviours (smoking and frequent alcohol consumption), work characteristics (low levels of control, variety and use of skills, work pace, and support at work), low levels of job satisfaction, and adverse social circumstances outside work (financial difficulties and negative support). These risk factors accounted for about one third of the grade differences in sickness absence. CONCLUSION: Large grade differences in sickness absence parallel socioeconomic differences in morbidity and mortality found in other studies. Identified risk factors accounted for a small proportion of the grade differences in sickness absence. More accurate measurement of the risk factors may explain some of the remaining differences in sickness absence but other factors, as yet unrecognised, are likely to be important.

Absenteeism↗
PubMed1993

Alcohol consumption and sickness absence: from the Whitehall II study.

Previous studies suggest that problem drinkers have markedly increased sickness absence. However, it is not clear how more moderate alcohol consumption and abstinence relate to sickness absence. As part of the Whitehall II study the relationship between different drinking patterns and sickness absence is examined. A total of 10,314 male and female civil servants completed a baseline questionnaire about their drinking habits--the amount of alcohol consumed over the past 7 days and the frequency of drinking over the past 12 months. All sickness absence has been recorded prospectively. Drinking patterns and sickness absence are examined for short spells (< or = 7 days) and long spells (> 7 days) adjusting for other causes of sickness absence: age, grade of employment, smoking, work characteristics and baseline health. Alcohol consumption was strongly related to employment grade, the lower the grade the higher proportion of men and women reporting no alcohol consumption. For men the relation of alcohol intake to short spells of sickness absence (< or = 7 days) appeared to be U-shaped, for long spells (> 7 days) increased rates of absence were found only in frequent drinkers. There was no clear relationship for women, however higher rates of sickness absence were found in non-drinkers.

Absenteeism↗
PubMed1991

Health inequalities among British civil servants: the Whitehall II study.

The Whitehall study of British civil servants begun in 1967, showed a steep inverse association between social class, as assessed by grade of employment, and mortality from a wide range of diseases. Between 1985 and 1988 we investigated the degree and causes of the social gradient in morbidity in a new cohort of 10,314 civil servants (6900 men, 3414 women) aged 35-55 (the Whitehall II study). Participants were asked to answer a self-administered questionnaire and attend a screening examination. In the 20 years separating the two studies there has been no diminution in social class difference in morbidity: we found an inverse association between employment grade and prevalence of angina, electrocardiogram evidence of ischaemia, and symptoms of chronic bronchitis. Self-perceived health status and symptoms were worse in subjects in lower status jobs. There were clear employment-grade differences in health-risk behaviours including smoking, diet, and exercise, in economic circumstances, in possible effects of early-life environment as reflected by height, in social circumstances at work (eg, monotonous work characterised by low control and low satisfaction), and in social supports. Healthy behaviours should be encouraged across the whole of society; more attention should be paid to the social environments, job design, and the consequences of income inequality.

Adult↗