Biomedical subjects

J A Giggs

Publications and source records attributed to J A Giggs.

7 recordsLinked to original sources

PubMed1992

The health of the Nottingham homeless.

This paper presents the findings of a survey of approximately 2,000 homeless individuals applying for shelter to statutory and voluntary sector agencies in Nottingham. The socio-demographic and economic characteristics of the sample are described, and are analysed in relation to reported health problems. The incidence of reported health problems amongst these homeless individuals is compared with that reported in the 1988 General Household Survey (GHS). Whilst the shelter applicants are reporting fewer health problems than the GHS population, because they are a considerably younger and thus healthier sample, subsets of the homeless with specific characteristics do indeed provide evidence of a disproportionate incidence of ill health.

Adolescent↗

PubMed1990

[Incidence and geographical distribution of acute pancreatitis in Nottingham 1969 to 1983].

During the fifteen year period 1969-1983, 493 patients with primary acute pancreatitis were admitted to Nottingham hospitals. The incidence of this disease increased from 75.1 per million per year for 1969-1976 admissions to 116.9 per million per year for 1977-1983 admissions. For both cohorts there were large statistically significant variations in the distribution of pancreatitis within the study area. The spatial distribution for both cohorts revealed that the highest incidence rates clustered in an area east of the city centre which is supplied by particularly "hard" water. The chemical composition of the domestic water supply may play a role in the manifestation of acute pancreatitis.

Acute Disease↗

PubMed1989

Managing drug use.

This study of Class A drug users in Nottingham identifies a local drug economy with specific demand and supply characteristics. With reference to demand, data are presented on users' purchasing power and purchasing behaviour, including drug re-sales and the use of credit. Crude elasticity relationships are discussed. The analysis of the supply side includes an examination of the dealing system and pricing methods. Following the integration of these two themes by way of summary the paper concludes with a discussion of the implication of its findings for public policy aimed at managing drug use.

Adult↗

PubMed1988

The epidemiology of primary acute pancreatitis in Greater Nottingham: 1969-1983.

In most countries primary acute pancreatitis is a rare disease. However, its incidence has been increasing for several decades and many patients do not survive their first attack. During the 15 years (1969-83) 493 patients with the disease were admitted to Nottingham's two District General Hospitals. The geographical distribution of the disease within the study area was determined using 62 electoral wards and two patient cohorts namely 214 1969-76 admissions (1971 census base) and 279 1977-83 admissions (1981 census base). The incidence of the disease increased from 27 per annum to 40 per annum in the two cohorts. Most of the alcohol associated patients (18 first cohort: 38 second cohort) were young or middle aged males. For gallstone and 'non-gallstone' associated groups the incidence rose sharply with increasing age for both sexes. For both cohorts there were large statistically significant variations in the distribution of pancreatitis within the study area. Moreover, the spatial distribution was very similar for both cohorts with most of the highest rate wards clustering in a U-shaped area east of the city centre. Investigation of environmental factors suggested that this high-rate area coincides with the region served by the Burton Joyce domestic drinking water supply. Examination of the residential histories of the 493 patients showed that 25.6% had moved home less than five years prior to their first attack. Analysis of these moves confirmed that many patients had moved to suburban areas from two major inner city housing renewal schemes located within the high-rate Burton Joyce water supply area. Re-calculation of incidence rates of pancreatitis by former address for the six water supply areas established that only the Burton Joyce area had significantly high numbers of cases for both cohorts.

Acute Disease↗

PubMed1987

Ecological structure and the distribution of schizophrenia and affective psychoses in Nottingham.

The 800 census enumeration districts of Nottingham were used as a basis for the production of 12 distinct 'clusters' or neighbourhood types. Plotting the place of residence of the 68 patients with 'certain' or 'very likely' diagnoses of ICD-9 schizophrenia, identified in the World Health Organization Study of Determinants of Outcome of Severe Mental Disorders, showed the expected concentration in central areas of low social status. A more varied distribution was found for 132 patients with a case-register diagnosis of affective psychosis, contacting the psychiatric services for the first time during the same two-year period as the schizophrenic patients. Some of the highest rates for affective psychosis were found in new housing estates of middle and low status at some distance from the town centre.

Adult↗

PubMed1986

Mental disorders and ecological structure in Nottingham.

This paper presents the findings of a specifically geographical investigation of the incidence, distribution and social/environmental correlates of mental disorder in Nottingham. Three diagnostic groups were examined, namely schizophrenia and paranoia, the effective psychoses (or manic depression) and the non-psychotic mental disorders. Analysis of two distinct cohorts of first contact patients for both the schizophrenia and affective psychoses diagnoses yielded markedly dissimilar incidence rates. It is therefore suggested that observed variations in the incidence of specific mental disorders between cities probably reflect such nosocomial (i.e. service related) factors as diagnostic accuracy and the levels of local psychiatric services. It is therefore dangerous to ascribe the variations solely to the contrasting social/environmental milieux found in these cities. The spatial distributions of the selected mental disorders within Nottingham were analysed in the context of a set of 12 distinct ecological areas. These areas were derived from a matrix comprising 105 sub-areas and 40 variables via principal components analysis and a non-hierarchical clustering algorithm. Marked spatial variation in the incidence of all the mental disorders was demonstrated via both traditional mapping and probability mapping techniques. Pearson product-moment analysis revealed that the distributions of the two diagnostically distinct schizophrenia and affective psychoses cohorts were virtually identical. The relationships between the inception rates for the mental disorders and social/environmental attributes were analysed. Stepwise multiple regression models for both the principal components and the individual census variables revealed strong and systematic relationships with all the mental disorders. Although such ecological analysis has limited explanatory power it nevertheless provides useful insights into mental disorder-environmental relationships. It is argued that these can be subsequently best examined at a disaggregated (i.e. behavioural) level.

Affective Disorders, Psychotic↗

PubMed1979

Variations in the incidence and the spatial distribution of patients with primary acute pancreatitis in Nottingham 1969-76.

During the eight year period 1969-76, 214 patients with primary acute pancreatitis were admitted to Nottingham hospitals from the Nottingham defined population area (the City of Nottingham and the four adjacent urban districts, which had a population of 469,720 in 1971). There was considerable variation in both the incidence and distribution of the disease within the study area and the crude average incidence rates ranged between 31.8 and 388.7 per million. Six of the eight wards with rates in excess of 200 per million were contiguous with similar wards; together these formed a U-shaped area extending from the city centre to the eastern boundary of the study area. These findings could not be accounted for by the age structure of the population or its social class structure. Although the Nottingham defined population area is relatively small (147 km2 or 57 sq. miles), it is subdivided into distinct and fixed domestic water supply areas. The distribution of patients among the six water supply areas showed that the Burton Joyce supply area, which is a particularly 'hard' water, contained significantly more patients than could have occurred by chance (P less than 0.002). This investigation of some social and geographical factors suggests that the chemical composition of the domestic water supply may affect the distribution of this disease within this particular urban area. This concentration of patients in the Burton Joyce water supply area suggests that some, as yet unidentified, property of the water supply may be an aetiological factor.

Acute Disease↗