PubMed Health⌕ Search

Biomedical subjects

S Barrow

Publications and source records attributed to S Barrow.

At least 37 records · Page 2Linked to original sources
PubMed1999

Social determinants of GHQ score by postal survey.

BACKGROUND: To develop interventions to reduce the morbidity associated with depression and anxiety, more information is needed about the social and demographic determinants of these disorders and the relative contributions of different potential predictors. METHODS: Using stratified sampling from the Family Health Services Authority (FHSA) register, postal surveys were sent to 61,000 adults across the North Western Regional Health Authority. Psychological morbidity was assessed using the 12-item General Health Questionnaire (GHQ). Nine potential predictors of morbidity were rated, including socio-demographic details and the presence of longstanding limiting physical illness and of a confidante. Logistic regression analyses were used to consider each of the nine potential predictors separately and in combination. RESULTS: A total of 38,014 questionnaires were returned (63 per cent). After adjustment for all other variables the strongest predictors of a high GHQ score were the absence of a confidante (odds ratio (OR) 3.64), longstanding limiting physical illness (OR 2.93), unemployment (OR 1.91), being a student (OR 1.78), being female (OR 1.64), single parenthood (OR 1.55) and living alone (OR 1.32). GHQ scores were highest in the 18-34 age range. Ethnicity exerted no significant effect after adjustment for other variables. CONCLUSION: In keeping with other research the data suggest that sociodemographic factors are strong predictors of depression and anxiety. The most vulnerable population groups are those with longstanding limiting physical illness and no-one to talk to. This should help in identifying high-risk individuals and informing preventive strategies.

Adolescent↗
PubMed1998

Mental health in the north west region of England: associations with deprivation.

Minor psychiatric morbidity is known to be associated with social disadvantage, but few studies have explored this association at the population level. This study reports data from a postal survey across 19 health districts in one region, with a total sample of 38,000 respondents. The percentage scoring above the General Health Questionnaire (GHQ) threshold for each health district was correlated with measures of deprivation derived from the 1991 census and standardised mortality ratios. Highly significant correlations were seen between the percentage above the GHQ threshold and the Underprivileged Area (UPA) score (r = 0.84), under 65 Standardised Mortality Ratio (SMR; r = 0.80), lack of amenities (r = 0.56), overcrowding (r = 0.54), lone-parent families (r = 0.84), unemployment (r = 0.87), unskilled workers (r = 0.77), ethnic minority composition (r = 0.58) and social mobility (r = 0.85). However, the three most deprived districts had the lowest response rates and when these were excluded from the analysis, only the correlations with under 65 SMR (r = 0.57, P < 0.05), UPA score (r = 0.52, P < 0.05) and unskilled workers (r = 0.60, P < 0.05) remained significant. There may be a threshold effect for the impact of social disadvantage on mental health, with much higher rates of psychological morbidity among markedly disadvantaged populations.

Adult↗
PubMed1998

Informal care and psychiatric morbidity.

BACKGROUND: We aimed to examine and quantify the relationship between psychiatric morbidity and the provision of informal care in the community. METHODS: The study involved a comparison of carers and non-carers in a mixed urban and rural community (Morecambe Bay Health Authority). Data were collected by postal survey for 4550 adults; 10.9 per cent of respondents were identified as carers. Subjects were selected by quasi-random methods from the Family Health Services Authority (FHSA) registers. Potential psychiatric morbidity was defined as three or more symptoms on a standardized measure, the General Health Questionnaire (12-item version). RESULTS: The prevalence of morbidity was significantly higher in people who care for others in their own homes, even after adjustment for other known risk factors for psychiatric morbidity (odds ratio 1.51, 95 per cent confidence interval 1.11-2.05). In contrast, there was no significant relationship between morbidity and care outside the home in these data. CONCLUSION: Health Authorities need to review support for carers and to consider ways to improve monitoring.

Adult↗
PubMed1997

Dengue haemorrhagic fever/dengue shock syndrome. An unwelcome arrival in Trinidad.

This is the first report of dengue haemorrhagic fever and dengue shock syndrome in Trinidad. Dengue infection was confirmed serologically or by viral isolation in five patients, aged 15 to 53 years, who presented with fever, thrombocytopenia and haemoconcentration. Three patients developed dengue shock syndrome, which was fatal; although there was no haemorrhagic tendency among these patients, bleeding occurred shortly before death in one of them. Two patients who had dengue haemorrhagic fever survived. The co-circulation of dengue virus serotypes 1, 2, and 4 in the Caribbean facilitates the development of dengue shock syndrome (DSS) or dengue haemorrhagic fever (DHF). Clinicians should therefore be aware of their clinical features, laboratory diagnosis and clinical management. Appropriate public health interventions and improved surveillance should be implemented to reduce the risk of DHF/DSS associated mortality in Trinidad and Tobago.

Adolescent↗
PubMed1996

Recent trends, future needs: management training for consultants.

Describes the results of a postal questionnaire survey of all 1,383 hospital consultants in the North Western Region of the UK in 1994; updating a similar survey conducted in 1987. In both surveys, consultants were asked to describe their current management role, management training received and any perceived future training needs. A series of open questions in the 1994 survey explored barriers and incentives to the take-up of management training. The results show that in 1994 more doctors were taking on greater management responsibility and from an earlier age. Consequently, the proportion of consultants expressing a need for management training had risen from 62 per cent in 1987 to 73 per cent in 1994. The most useful courses were local budgeting and business planning. However, many consultants described problems in accessing training. Concludes by highlighting policy implications arising from the surveys which will need to be addressed if consultants are to fulfil their management potential.

Education, Medical, Continuing↗
PubMed1995

Analysis of F2-isoprostanes as indicators of non-enzymatic lipid peroxidation in vivo by gas chromatography-mass spectrometry: development of a solid-phase extraction procedure.

Recently, it has been reported that a series of prostaglandin F2-like compounds (F2-isoprostanes) are produced in vivo during peroxidation of arachidonic acid by a mechanism independent of the cyclooxygenase pathway. Of these, 8-epi-PGF2 alpha is shown to be a potent vasoconstrictor. We describe an improved method for analysing F2-isoprostanes in biological fluids. The method involves solid-phase extraction on an octadecylsilane (C18) and an aminopropyl (NH2) cartridge. After conversion to pentafluorobenzyl ester and trimethylsilyl ether derivatives, F2-isoprostanes are analysed by negative-ion chemical ionization mass spectrometry using tetradeuterated PGF2 alpha as the internal standard. The limit of detection of the assay was 10 pg/ml, with a coefficient of variation ranging from 9.4 to 15.1%. Analysis of plasma samples from healthy volunteers (n = 7) revealed no quantifiable levels of free (unesterified) 8-epi-PGF 2 alpha. However, the plasma samples contained 58 to 166 pg/ml of 8-epi-PGF2 alpha when analyzed for the total (sum of free and esterified) F2-isoprostanes. The main advantages of the method lie in the improved recovery, gas chromatographic separation and speed compared to existing techniques.

Deuterium↗
PubMed1995

Encoding, remembering and awareness in lorazepam-induced amnesia.

The effects of lorazepam (1,2 mg) and placebo on encoding, remembering and awareness were assessed in a study with 54 healthy volunteers. All subjects studied stimulus materials in a levels of processing (L-o-p) task. Half the subjects were assessed on an explicit memory task of word recognition and the other half were given an implicit memory task of word-stem completion. Following the implicit task, awareness of retrieval was further investigated by questions and by subjects' recollective experience in recognising the actual words they had completed from stems. L-o-p effects and marked lorazepam-induced impairments were found in the implicit task of word-stem completion although the interaction between L-o-p and drug effects emerged only as a trend in the data. Lorazepam-induced impairments on stem-completion may then be explained at least in part as being due to contamination by explicit retrieval processes, but we cannot rule out the possible role of drug effects on perceptual processes at encoding. Results from responses to "awareness" questions and from analysis of subsequent recollective experience indicated that subjects were not aware of using explicit retrieval during the implicit task. Results also replicated previous findings showing that both lorazepam and L-o-p independently affect performance in an explicit memory task of word recognition. Thus drug-induced deficits at encoding persist regardless of the level at which information is initially processed.

Adult↗
PubMed1995

Factors relating to smoking and pregnancy in the North Western Region.

BACKGROUND: One of the targets for the Health of the nation is to increase the proportion of women smokers who give up smoking at the start of their pregnancy, from a quarter to at least one-third, by the year 2000. This study uses a regional lifestyle survey to look at the characteristics of pregnant women who smoke. METHODS: The lifestyle survey was based on a structured questionnaire which was sent by post to a systematic random sample of 60,000 adults across the North Western Region. A total of 513 respondents were pregnant; of these, 150 (29 per cent) reported that they smoked. The responses of pregnant smokers and non-smokers were compared to identify differences in age, demographic and social characteristics, mental distress and attitudes to lifestyle variables. RESULTS: Women in the North Western Region who smoked tended not to give up during pregnancy, but they did tend to smoke less. Smokers were more likely to be under 25 than non-smokers, less likely to be home-owners, and less likely to be living with a husband or partner. There was no difference in mental distress between smokers and ex-smokers, but they both experienced significantly greater mental distress than those who had never smoked. The difference between smokers and ex-smokers was in their type of occupation, housing tenure and whether they were living with a partner, ex-smokers being much more similar to non-smokers. CONCLUSIONS: More work needs to be done to improve the design of smoking cessation programmes, to make them more culturally appropriate for pregnant women who appear to be socially disadvantaged, have poor housing and lack a stable relationship.

Adaptation, Psychological↗
PubMed1995

Influence of physical, psychological and behavioural factors on consultations for back pain.

Over 34,000 questionnaires were used to study occurrence and consultations for back pain in the community. The 12-month period prevalence was 24% and 13% of the sample consulted a doctor. Elderly women were at greatest risk of back pain. The consultation rate increased in both sexes throughout middle age, but declined in men over the age of 55 yr. Back pain was associated with the Goldberg General Health Health Questionnaire score suggesting psychiatric morbidity [odds ratio (OR) = 2.05; confidence interval (CI) 1.89-2.23], obesity (OR = 1.59; CI 1.40-1.79), and cigarette smoking (OR = 1.52; CI 1.36-1.70). Vigorous daily activity was positively associated with back pain in men aged 18-39 yr (OR = 1.37; CI 1.02-1.85), and women aged 18-39 yr (OR = 1.50; CI 1.08-2.09), but was negatively associated with back pain in women aged over 65 yr (OR = 0.35; CI 0.16-0.76). Alcohol consumption was also negatively associated with back pain (OR = 0.72; CI 0.62-0.85). The prevalence of arthritis, constipation and respiratory disorders was increased in those who consulted for back pain corrected for the other variables. Thus back pain was substantially more common in women compared to men over 55 yr. Psychiatric morbidity, cigarette smoking and obesity were associated with back pain at all ages, but the effect of physical exercise appeared to change with age. Further studies are required to explain the sex differences and nature of the associations.

Adolescent↗
PubMed1995

Imaging strategies in the first 12 months after reduction of developmental dislocation of the hip.

We have reviewed the records of 32 infants whose developmental dislocation of the hip (DDH) was treated by reduction and immobilization in a plaster cast. We examined 50 CT scans from 22 patients. The postreduction radiological studies led to a change of cast in 10 patients and, in five of them, the subluxation shown on CT scan was not seen in an earlier radiograph. Where reduction has been undertaken at the time of arthrography or in an older child, a plain radiograph may be adequate to confirm the position in the cast. In an infant, CT scans give superior information, have acceptable risks, and should be used in association with radiation protection measures.

Arthrography↗
PubMed1995

Setting standards for cervical screening fail-safe mechanisms: a target based on an audit of cytopathology laboratory records.

OBJECTIVE: To examine the efficacy of cytopathology laboratories in monitoring action following an abnormal cervical smear. SETTING: 11 screening laboratories serving 19 districts in the former North Western region of the United Kingdom. METHOD: 944 validated cases were identified at 11 laboratories. The screening history for each abnormal smear was obtained from the screening laboratory and compared with the records from the relevant family health services authority (FHSA) database. RESULTS: Laboratories held complete follow up records in 740 (78.4%) cases; the FHSA records extended this to 910 (96.4%) cases. Poor communication was the main problem; computerisation was not necessary to improve fail-safe procedures. CONCLUSIONS: Audit of fail-safe procedures is a valuable purchasing tool, identifying weaknesses and strengths, setting and maintaining standards.

Communication↗
PubMed1995

Social deprivation and psychiatric admission rates among different diagnostic groups.

BACKGROUND: In the search for population-based indicators of need for mental health services, psychiatric admission rates have been correlated with sociodemographic variables. We explored such correlations for different diagnostic groups. METHOD: Admissions data for the 19 districts in the North West Region were derived from the Korner Episode System for 1992/93 and divided into eight broad diagnostic groups using ICD-9 codes. Admission rates per 1000 were correlated with measures of deprivation derived from the 1991 census data and with standardised mortality ratios. For the two largest diagnostic groups, correlations with age-standardised admission rates were also calculated. RESULTS: For schizophrenia/delusional disorder, eight of the 10 sociodemographic measures were significantly correlated with admission rates (Pearson's r 0.52 - 0.79). On all measures these correlations were greater than those seen for total mental illness. Significant positive correlations of a lower order were seen for organic brain syndromes and mania. Admission rates for depression, personality disorder and substance misuse were not significantly correlated with any of the sociodemographic measures. Admission rates for neurotic illness were negatively correlated with all deprivation measures, with the negative correlation statistically significant at the 5% level for ethnic composition and overcrowding. Standardising admission rates for age and repeating the analysis after removal of influential data points did not greatly alter these findings. CONCLUSIONS: The association between psychiatric admission rates and measures of deprivation varies considerably with diagnosis. Measures of social deprivation may indicate need for services for patients with psychotic disorders; admission rates for non-psychotic illnesses may reflect the availability of beds rather than need.

Adolescent↗