PubMed Health⌕ Search

Biomedical subjects

Karen Hughes

Publications and source records attributed to Karen Hughes.

14 recordsLinked to original sources
PubMed2007

Thai War on Drugs: measuring changes in methamphetamine and other substance use by school students through matched cross sectional surveys.

In 2003 the Thai government announced a radical shift in drug policy with the implementation of a War on Drugs. Although consequences of this controversial measure (e.g. drug dealer deaths) have received widespread attention relatively little work has evaluated changes in substance use. We used two anonymous representative samples of secondary school students to compare drug use in Northeast Thailand before (1998; n=4217) and after (2004/5; n=3489) the War on Drugs. Results indicate that reported levels of current illicit drug use reduced significantly between 1998 and 2004/5 (for methamphetamine from 4.2% to 0.9%). By examining trends in year of first methamphetamine use we identify that observed reductions in drug initiation are temporally consistent with the War on Drugs. However, while prevalence of alcohol use has also fallen, there was a three-fold increase in daily alcohol use. We suggest that this rise, combined with other negative impacts of 'wars' on drugs, means drug control requires a public health perspective that sees eliminating drug use as part of a wider strategy that has improvement in population health, not just drug prevention, as its core objective.

Adolescent↗
PubMed2006

Sexual behaviour among casual workers in an international nightlife resort: a case control study.

BACKGROUND: Young holidaymakers report increased sexual risk-taking abroad, yet little is currently known about the sexual behaviour of those who extend time abroad through casual work. METHODS: Information on sexual behaviour was collected via an anonymous questionnaire administered to British bar and nightclub workers in Ibiza (cases, n = 92) and British people visiting Ibiza for holiday purposes only (controls, n = 868). RESULTS: Four in five (80.5%) cases who arrived in Ibiza without a partner had sex during their stay and of these two thirds (65.5%) had unprotected sex. Cases were more likely to report sexual risk-taking in Ibiza than controls and reported greater numbers of sexual partners prior to their visit. However, they had fewer sexual partners per week of stay. CONCLUSION: Casual workers in bars and nightclubs abroad are a key risk group for sexual health and a potential conduit for the international spread of sexually transmitted infections. While they are an important target group for sexual health promotion, appropriately trained they are also ideally placed to deliver sexual health interventions to other young travellers.

Adolescent↗
PubMed2005

Assessing and communicating the health and judicial impact of alcohol use.

BACKGROUND: Alcohol consumption places an increasing burden on health services, criminal justice agencies and private industry throughout the UK. Despite a national strategy to tackle alcohol-related harm, there remains a lack of epidemiology on alcohol use and related harms at local levels. Utilising national data sources and existing research studies, Regional Public Health Observatories are appropriately placed to calculate such measures and examine their relationship with deprivation. METHODS: For the North West of England, borough and health locality data were extracted from national sources. Alcohol consumption utilised lifestyle survey data and estimates of related harm were calculated by applying existing alcohol attributable fractions to deaths, hospital episodes and crime data. Contribution of alcohol to reduction in life expectancy was also calculated and all measures were correlated with deprivation. RESULTS: For the North West, the annual burden of alcohol was estimated at over 3700 deaths, 56,700 hospital episodes and 71,000 crimes. Annual alcohol-related death rates for men varied from 0.43 to 1.17 per 1000 between Local Authorities and there was a six-fold variation in alcohol-related crime rate between areas. For males, alcohol reduced life expectancy by more than five months in the area worst affected. For both sexes, more deprived areas had significantly higher levels of alcohol-related hospital episodes, crime, and contribution to reduced life expectancy. CONCLUSIONS: Alcohol-related harm requires urgent, multi-agency attention at local levels throughout the UK. Applying appropriate research methods to national data sources provides limited but valuable local measures of alcohol use and its impact on health and crime. Regional Public Health Observatories can facilitate partnership working through such provision of national intelligence tailored to support local and regional action. Application of these techniques also helps identify additional requirements for better local intelligence on health-related behaviours and the necessity for consistency across local health and behaviour surveys.

Adolescent↗
PubMed2005

Guaiac versus immunochemical tests: faecal occult blood test screening for colorectal cancer in a rural community.

OBJECTIVE: To describe patient participation and clinical performance in a colorectal cancer (CRC) screening program utilising faecal occult blood test (FOBT). METHODS: A community-based intervention was conducted in a small, rural community in north Queensland, 2000/01. One of two FOBT kits--guaiac (Hemoccult-II) or immunochemical (!nform)--was assigned by general practice and mailed to participants (3,358 patients aged 50-74 years listed with the local practices). RESULTS: Overall participation in FOBT screening was 36.3%. Participation was higher with the immunochemical kit than the guaiac kit (OR=1.9, 95% CI 1.6-2.2). Women were more likely to comply with testing than men (OR=1.4, 95% CI 1.2-1.7), and people in their 60s were less likely to participate than those 70-74 years (OR=0.8, 95% CI 0.6-0.9). The positivity rate was higher for the immunochemical (9.5%) than the guaiac (3.9%) test (chi2=9.2, p=0.002), with positive predictive values for cancer or adenoma of advanced pathology of 37.8% (95% CI 28.1-48.6) for !nform and 40.0% (95% CI 16.8-68.7) for Hemoccult-II. Colonoscopy follow-up was 94.8% with a medical complication rate of 2-3%. CONCLUSIONS: An immunochemical FOBT enhanced participation. Higher positivity rates for this kit did not translate into higher false-positive rates, and both test types resulted in a high yield of neoplasia. IMPLICATIONS: In addition to type of FOBT, the ultimate success of a population-based screening program for CRC using FOBT will depend on appropriate education of health professionals and the public as well as significant investment in medical infrastructure for colonoscopy follow-up.

Age Factors↗
PubMed2005

Measuring paternal discrepancy and its public health consequences.

Paternal discrepancy (PD) occurs when a child is identified as being biologically fathered by someone other than the man who believes he is the father. This paper examines published evidence on levels of PD and its public health consequences. Rates vary between studies from 0.8% to 30% (median 3.7%, n = 17). Using information from genetic and behavioural studies, the article identifies those who conceive younger, live in deprivation, are in long term relationships (rather than marriages), or in certain cultural groups are at higher risk. Public health consequences of PD being exposed include family break up and violence. However, leaving PD undiagnosed means cases having incorrect information on their genetics and fathers continuing to suspect that children may not be theirs. Increasing paternity testing and use of DNA techniques in clinical and judicial procedures means more cases of PD will be identified. Given developing roles for individual's genetics in decisions made by health services, private services (for example, insurance), and even in personal lifestyle decisions, the dearth of intelligence on how and when PD should be exposed urgently needs addressing.

Child↗
PubMed2004

Practical issues in using a card sort in a study of non-support and family caregiving.

The authors successfully used the card sort data collection technique with 17 female family caregivers in a large ethnographic study of non-support. In this article, they describe the practical issues they addressed. Initially, they developed strategies to construct meaningful statements that reflected key themes and were manageable in an interview. Later, to address challenges for participants, they developed approaches to assist women in moving beyond their own experience, dealing with test anxiety, and anticipating an emotional response. To facilitate effective data collection, they made detailed arrangements in advance, collected "talk aloud" data that captured women's decisions, and maintained accurate records. The women felt validated in their caregiving roles, as the card statements reflected their experience and rich data was elicited. The card sort exercise contributed information about variability in the meaning of similar interactions for different women and a beginning understanding of the criteria women used to make decisions.

Adult↗
PubMed2003

The role of an international nightlife resort in the proliferation of recreational drugs.

AIMS: The study compares types, frequencies and quantities of substances used by young people while holidaying in the international dance resort of Ibiza (Spain) with their patterns of use in the United Kingdom. It measures changes in substance use at both locations between 1999 and 2002 and examines the role of dance resorts in recruiting individuals into using new substances. DESIGN: Data were collected from visitors to Ibiza in 1999 (n = 846) and 2002 (n = 868). Information on drug use was surveyed through a short anonymous questionnaire. SETTING: Individuals were sampled at Ibiza airport just prior to returning to the UK. FINDINGS: Most individuals visiting Ibiza used illicit drugs in the United Kingdom (57.4% in 2002), with nearly all users continuing to use in Ibiza. Use of most drugs in Ibiza was characterized by binge behaviour, with many individuals using drugs 5 or more nights per week. Proportions using cocaine, ecstasy and GHB have risen significantly (1999-2002) in both locations, as have numbers of ecstasy tablets taken on a usual night. Substance use was associated positively with number of previous visits to Ibiza and new users were recruited into use while abroad (17.4 and 33.1 per 1000 people were introduced to cocaine and ecstasy use, respectively, in Ibiza). CONCLUSIONS: The emergence of international nightlife resorts increasingly links drug use abroad with that in individuals' countries of origin. Our results indicate that resorts such as Ibiza offer tourists the opportunity to increase levels of drug consumption and try different substances in an atmosphere conducive to experimentation. Patterns of recreational drug use in leading international resorts may help predict developments in drug use elsewhere and as such be an important tool in planning appropriate interventions.

Adolescent↗
PubMed2003

Knowledge, attitude and intentions related to colorectal cancer screening using faecal occult blood tests in a rural Australian population.

A telephone survey with 604 men and women without history of colorectal cancer (CRC) (age 50-74 years) explored knowledge of, attitudes toward, and intention to screen for CRC using faecal occult blood tests (FOBT) in a rural Australian population. Overall, 53% intended to participate in and 86% would follow a doctor's recommendation for FOBT screening. In contrast, only 18% had ever had a FOBT, and fewer than 60% of those with high-risk family history had undergone appropriate screening for CRC. Prior use of FOBT (OR=3.2), high perceived susceptibility to CRC (OR=2.4), belief in the importance of screening despite the absence of symptoms (OR=2.1) were positively and older age (OR = 0.5) was negatively related to screening intention in multivariate logistic regression analysis. A doctor's recommendation improved screening intention among those who never tested for CRC before but believe in the importance of early treatment. This study highlights the lack of compliance with standard CRC screening recommendations in Australia and provides evidence for the importance of continued educational efforts, with the particular emphasis on older adults and the medical community.

Aged↗
PubMed2003

Pharmacological treatment of acute coronary syndromes.

Many trials have examined the efficacy of medications used in acute coronary syndromes. This paper reviews those now recommended in patients with unstable angina and non-ST-segment elevation myocardial infarction. There are currently seven groups of drugs that are used in the management of such patients.

Adrenergic beta-Antagonists↗
PubMed2002

Faecal occult blood test: current practice in a rural Queensland community.

The findings of a recent telephone survey of 604 residents (50-74 years of age) in a rural community in Queensland are presented. The survey focused on the participants' knowledge concerning the faecal occult blood test (FOBT) and their previous testing history. Responses were analysed in terms of gender, age and education differences. More than half of all participants were aware of the FOBT, and 109 (18%) had undergone FOBT in the past. Fewer understood the importance of "health checks without symptoms" than the "advantage of early treatment". The most common reasons to use FOBT were: "prevention" and "I want to know if I have cancer". A person's gender, age and education were shown to be associated with their knowledge and beliefs. These results suggest an increase in the use of the FOBT with time (in relation to previous surveys), but a poor understanding of its place in promoting health.

Age Factors↗
PubMedDate not supplied

A surgical rat model of human Roux-en-Y gastric bypass.

Obesity affects 30% of the United States population and its detrimental effects are obesity-related metabolic diseases. For patients refractory to conventional weight loss therapy, gastric bypass surgery is one of the proven methods for inducing a sustained weight loss and reversing the metabolic sequelae of obesity. To understand the mechanisms of weight loss and the amelioration of related metabolic comorbid conditions, a reproducible animal model is needed. We report our developmental experience with rat models of sequential Roux-en-Y gastric bypass after reproducing the diet-induced obesity that characterizes the hallmarks of human obesity. Four experiments were performed to induce weight reduction through successive modifications: In Experiment 1 a 20% stapled gastric pouch with a 16 cm biliary-pancreatic limb and a 10 cm alimentary limb accomplished sufficient weight loss within 10 days to ameliorate metabolic changes associated with obesity, but the occurrence of gastrogastric fistulas prevented sustained weight loss; in Experiment 2 the model was improved by dividing the stomach to avoid gastrogastric fistula, but again sustained weight loss was not achieved; in Experiment 3 the biliary-pancreatic limb was lengthened from 16 to 30 cm, reducing the common channel to approximately 18 cm. Sustained weight loss was achieved for 28 days. In Experiment 4 the model in Experiment 3 was modified by dividing the stomach between two rows of staples. Sustained weight loss was observed for 67 days. We developed a reproducible rat model of Roux-en-Y gastric bypass. The existence of this model opens a new field of research in which to study the metabolic sequelae of obesity and the mechanisms of weight loss.

Anastomosis, Roux-en-Y↗
PubMedDate not supplied

Healthy nightclubs and recreational substance use. From a harm minimisation to a healthy settings approach.

Recent trends identify a global rise in the use of drugs such as ecstasy as part of nightlife behaviour. In order to protect young people's health, a variety of harm reduction interventions have been implemented, often focusing on the direct effects of substance use. However, the risk to health posed by substances is also related to the nightlife environmental in which they are used. A healthy settings approach to nightclubs allows environmental issues and substance use to be tackled together. Consequently, a wider range of individuals and organisations feel capable of participating in the risk reduction process. Some countries have already developed integrated approaches to nightlife health. However, growth in international travel associated with nightlife and the additional risks posed by nightclubbing in an unfamiliar country mean that both interventions and basic health and safety measures are now required on an international basis.

Adolescent↗
PubMedDate not supplied

A potent cocktail.

Explore the source record for details and available documents.

Adolescent↗