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Biomedical subjects

N J Shanks

Publications and source records attributed to N J Shanks.

At least 19 recordsLinked to original sources
PubMed2001

Environmental factors and heatstroke.

The objective of this study was to determine the extent of the influence of temperature and humidity on the number of heatstroke presentations. Three hundred and forty-five labourers presented to the Accident and Emergency Hospital in Abu Dhabi with heatstroke during a 3 month summer period. There was no significant predictive association between the maximum daily temperature and/or humidity and the presentation of heatstroke. There was no significant association with the maximum temperature on the previous day, day of the week or temperature trend. The largest statistical correlation was between the maximum temperature and humidity and the log of the number of cases. It is possible that there are other significant explanatory variables that we have not included in the model.

Adolescent↗
PubMed1995

Occupation risk of needlestick injuries among health care personnel in Saudi Arabia.

In a four-year study of penetrating injuries potentially contaminated with blood among health care personnel, the majority of cases occurred amongst nurses (65%). The wards were the commonest place for injury to occur (39%) which questions whether difficult practical procedures should be performed there. Injuries occurred most commonly during the afternoons (63%). Although needles were the most frequent implement (79%) causing injury, very few cases (7%) were related to the re-sheathing of cannulae. The commonest injured area (46%) was the palmar surface of the distal forefinger of the non-dominant hand. Western staff reported most incidents. There were no episodes of repeated needlestick injury. No staff developed any blood-borne infection (HIV, hepatitis B, treponemal infection) within a one year follow-up period after such a penetrating injury.

Accidents, Occupational↗
PubMed1995

Use of the delusions-symptoms-states inventory to detect psychiatric symptoms in a sample of homeless men.

BACKGROUND: Previous research, often using the symptom-sign inventory, had demonstrated a high prevalence of psychiatric disorder among homeless people. The delusions-symptoms-states inventory detects the presence or absence of four classes of psychiatric illness--delusions of disintegration, integrated delusions, neurotic symptoms and dysthymic states. AIM: A study was undertaken to determine the utility of the delusions-symptoms-states inventory in a sample of homeless men, and the prevalence of psychiatric symptoms in this group. METHOD: The inventory was administered to 55 homeless men in a reception centre in Sheffield. RESULTS: Nearly half of the men obtained scores on the inventory suggesting that they had psychiatric symptoms. There was an overlap of syndromes, particularly among those with severe psychiatric illness. For example, seven men had all four classes of psychiatric illness. CONCLUSION: Use of the questionnaire proved satisfactory. The findings support the contention that reception centres and similar accommodation are repositories for homeless mentally ill people.

England↗
PubMed1994

Who are the homeless?

To describe the demographic, social and medical morbidity and usage of health services of the population of single homeless individuals in Sheffield, a census was carried out over a 12-hour period at sites which homeless people frequent, as identified by those who work with the homeless. These sites included Salvation Army hostels, reception centres, probation day centres, voluntary organisation hostels, and cheap bed and breakfast accommodation. Data were collected by means of a self-administered questionnaire. A total of 340 single homeless individuals were studied, constituting 80-90% of the single homeless population of Sheffield, as estimated by field workers. The population was younger than those of earlier studies and contained a higher proportion of females (14%). One-fifth of the population had been homeless for less than six months, and 60% had been at their present lodging for less than six months. The population has a higher proportion of both ex-prisoners (49%) and ex-inmates of psychiatric hospitals (36%). Over a quarter admit to a history of alcoholism, and 9% to a history of drug abuse; 65% of the population are registered locally with a GP, and 53% of the population see their GP. Those who are more likely to use an Accident and Emergency Department are less socially integrated and more likely to be alcoholic. This study of the single homeless highlights a need for social change to reduce poverty, provide cheap available housing and provide support for disadvantaged groups.

Adult↗
PubMed1994

Road traffic accidents in Saudi Arabia.

Road traffic accidents are a major health hazard in Saudi Arabia, particularly during Ramadan. The ensuing trauma has increased in direct proportion to the increase in the number of road vehicles. An audit of RTAs over a one-year period revealed that, out of 361 victims, 16% were under 10 years and 47% between 11 and 30 years. None of those involved in accidents was wearing a seat belt. Half of the children injured were pedestrians. There was a male to female ratio of 4:1 reflecting the driving laws in Saudi Arabia. Burst tyres due to intense heat were identified as a common cause (39%) of accidents. The introduction of seat belt legislation and stricter law enforcement should lead to a rapid reduction in morbidity and mortality on the roads in Saudi Arabia.

Accidents, Traffic↗
PubMed1993

Personal immunization against hepatitis B.

Doctors represent a high risk category for contracting hepatitis B virus. We report obstacles to our vaccination programme. Thirty per cent of the doctors (mainly Middle Eastern origin) were naturally immune to hepatitis, 29% received vaccination on completion of their pre-employment medical. However, 32% did not present for vaccination despite a total of 224 letters being dispatched, an average of 5.5 letters per doctor. Three medical staff were found to be HbsAg positive. More encouragement is required for those doctors who fail to attend for immunization. Measures such as: being a pre-requisite for employment, or withholding pay could be considered in high risk areas.

Attitude to Health↗
PubMed1991

Census of single homeless people in Sheffield.

OBJECTIVE: To determine the number of single homeless people in Sheffield and to examine their demography and social and medical details. DESIGN: Census carried out between 8 am and 8 pm on one day. Participants completed a questionnaire designed to provide data relating to employment history, contact with welfare and health services, social state, prison history, medical history, and health state. SETTING: Sites in Sheffield identified by local workers as being places of residence of homeless people. SUBJECTS: 340 single homeless people. MAIN OUTCOME MEASURES: Self reported history of alcohol or drug misuse, existence of a chronic medical condition, and use of general practitioner and hospital services. RESULTS: The mean age of the population was 42.5 years and a quarter of the population were aged less than 30; there were 48 women. Significant differences were noted between men and women with respect to self reported psychiatric illness (77/266 men v 27/42 women), self reported alcoholism (83/273 v 4/44), prison history (152/255 v 8/41), and registration with a general practitioner (73/275 v 38/46). Various chronic medical conditions were reported, and the perceived health state of the population was low; 129 claimed to have been admitted to a psychiatric hospital. 220 people were registered with a general practitioner, and 179 claimed to see their doctor. Sixty five had attended or been admitted to a general hospital in the month preceding the study, 45 for accident and emergency services. CONCLUSIONS: The homeless in this population were younger than those found in previous studies. The prevalence of psychiatric illness was high in the population, and the overall health state was poor. Most subjects obtained health services from general practitioners.

Adolescent↗
PubMed1989

Previously diagnosed psychiatric illness among inhabitants of common lodging houses.

STUDY OBJECTIVE: The aim of the study was to determine the characteristics of the homeless population and their previously diagnosed psychiatric illnesses in a well defined inner city area. DESIGN: The study involved a one in 10 sequential sample collected over three years. SETTING: Hostels and day care centres for the homeless in Manchester. PARTICIPANTS: 420 homeless people were interviewed; 17 were excluded because of lack of rapport. RESULTS: The majority were single middle aged catholic males who left school early and were unemployed; 48.7% had a history of alcoholism, 38.5% of diagnosed psychiatric illness, and 22.6% of psychiatric inpatient treatment. Only 21% of those with psychiatric diagnoses were being treated or followed up at the time of study. There was a strong association between criminal behaviour and previous admission to a psychiatric unit. CONCLUSIONS: There is a high incidence of psychiatric illness among the homeless, particularly among those originating from the locality studied. They tend to be geographically stable and therefore accessible to the provision of facilities for continuing care.

Adult↗
PubMed1988

The drug treatment of depression in general practice: a comparison of nocte administration of trazodone with mianserin, dothiepin and amitriptyline.

This 6-week, double-blind, randomised, multicentre study was performed to assess the efficacy and tolerability of evening administration of 150 mg trazodone as an initial and maintenance therapy and to compare this regimen with recommended dosages of mianserin, dothiepin and amitriptyline in the treatment of depressed, adult, general practice patients. A total of 227 eligible depressed patients were recruited into the study by a panel of general practitioners. One hundred and twelve patients were randomised to receive trazodone therapy, 36 received mianserin, 35 received dothiepin and 44 received amitriptyline. Trazodone was administered as a single daily dose of 150 mg. Mianserin was given at a dose of 30 mg for the first 7 days followed by 60 mg daily for the remaining 5 weeks. Dothiepin and amitriptyline were both given at a dosage of 75 mg daily for the 1st week; this was then increased to 150 mg and 100 mg, respectively, for the final 5 weeks of the study. Efficacy of the four treatments was assessed using the modified Hamilton depression rating scale scores and by the Investigator's judgment of both the global severity and improvement of the condition. No significant differences were shown, using any measure of efficacy, between trazodone and any of the three comparator drugs. All treatments resulted in significant improvement in both Ham-D scores and global measures over the period of the study. Using a total side-effect score to assess the incidence and severity of adverse events and adjusting for baseline differences, the four treatments were found to differ.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Medical morbidity of the homeless.

A prospective study was carried out over a three year period to assess the morbidity pattern of the homeless in Manchester. A principal diagnosis was recorded for each patient consultation during the delivery of primary health care to this population. The diagnoses were grouped and analysed in comparison with expected levels in the general population, both with and without adjustment for social class. Although the total numbers of annual consultations were similar to those expected, the morbidity pattern was very different. High consultation rates in some groups (psychiatric and dermatological conditions) were balanced by low consultation rates in other groups (cardiovascular and musculoskeletal conditions). Thus the provision of primary health care to the homeless is shown to be no greater than to the general population, after adjustment for social class.

Adolescent↗
PubMed1984

Persistent tuberculous disease among inmates of common lodging houses.

The initial chest x ray films in a series of sputum positive hostel dwellers showed considerably more advanced disease than in an age matched sputum positive population living under more conventional conditions. Furthermore, the mortality rate from tuberculosis was greatly increased among hostel dwellers. All organisms were found to be sensitive to standard antituberculosis drugs.

England↗
PubMed1984

A new approach to tuberculosis notification.

A tuberculosis notification system was initiated which used several sources--the doctor, the diagnostic services of bacteriology, histopathology and radiology, and the pharmacy. The results of six months' notifications have shown that the pharmacy was by far the most complete source (74% of all new cases); doctors notified only 21% of all new cases. The combination of both doctors and the pharmacy was the most complete pair, notifying 85% of all new cases. It is suggested that consideration should be given to the use of pharmacies as a source of notification both in other settings and for other diseases.

Bacteriology↗
PubMed1984

Mortality among inmates of a common lodging house.

A retrospective study of homeless men revealed a significantly different distribution of cause of death compared with the general population. A significant relative excess mortality was shown for malignant and respiratory diseases (including tuberculosis) and a significantly reduced relative mortality was shown for heart and cerebrovascular diseases. Seasonal factors appeared to affect mortality.

Adult↗
PubMed1983

Medical provision for the homeless in Manchester.

The events leading up to the establishment of a separate primary care service for the homeless and rootless population in Manchester are described.The organization, funding and commitment of the project are outlined and an insight into the life-style of this population is provided.During the first quarter of 1981, 2,049 consultations were given. The most common causes for consultation were psychiatric, alcoholic and respiratory conditions.

Aged↗