bluuebunny/crossref_metadata_2025 huggingface dataset:
In Vitro Antiviral Activity of a Peptide-Nucleic Acid Solution* Against the Human immunodeficiency Virus and influenza A Virus
Authors: Friedland Bernard
Published: September 2007

PEPTIDE-NUCLEIC acid solution* which had previously been reported to show in vivo efficacy in several viral infections (i.e. influenza, hepati tis, mumps, encephalitis, etc) was tested in three independent laboratories, including the US National Institutes of Health by specific in vitro methods for HIV and Influenza A. The results of these studies demonstrated significant anti-viral activity of the peptide-nucleic acid solution against the Human Immunodeficiency Virus (HIV) and the Influenza A virus.
A Survey of Dog Bites in Salisbury
Authors: Thomas Hugh F. , Voss Simon
Published: September 2007

A recent survey of patients attending an Accident and Emergency (A&E) department serving several economically depressed Thanet coastal towns found that around 3 per 1000 of the resident population attended each year for the treat ment of dog bite injuries (Thomas and Banks, 1990). We report a study of dog bite injuries treated in the A& E department serving Salisbury, a small prosperous Cathedral city, and surrounding villages. In comparison with Thanet, age specific incidence rates for dog bites show a similar pattern but only about half the overall incidence. Some reasons for these findings are suggested and extrapolations for national treatment figures are made.
5 Year Statistics of Animal and Insect Bites in Hong Kong
Authors: Yip Yu Lap
Published: September 2007

Statistics of bites of patients in a rural district hospital in Hong Kong were accumulated over a 5 year period from 1984-1989. Analysis revealed a predominance of dog bites. Seasonal variations were noted for snake and insect bites, but not for dog bites. Comparison was made with some UK data.
Dietary Habits of School-Children in Bahrain
Authors: Musaiger Abdulrahman O. , Gregory William B.
Published: September 2007

A multistage stratified sampling procedure was used to select 1673 Bahraini school children (871 boys and 802 girls) to study their food habits. The results revealed that breakfast was more often skipped than lunch and supper by both sexes. Significant differences in the food consumption between boys and girls were noticed at morning snack; beefburgers, liver and egg sandwiches were more consumed by boys, while girls preferred carbonated beverages, cheese, uncarbonated canned drinks and broad beans. The foods consumed at lunch were very similar to those of the adult population in Bahrain. However, the percentage of fresh fruits consumed at lunch was almost double by girls (31.9%) than boys (17.1%). Corn-puffs, carbonated beverages, chocolates, uncarbonated canned drinks and fruits were the main foods consumed at afternoon snack. Boys were more likely to consume tea, meat, eggs, cheese and rice at supper, while girls preferred cheese, corn-puffs and carbonated beverages. Age has also a significant influence on dietary habits. The consumption of bread at breakfast decreased with age while the consumption of carbonated beverages at morning snack increased remarkably with age. In general the meal and snack patterns of school children vary considerably with age and sex.
Suspected Synergism Between Consanguinity and Familial Aggregation in Type 2 Diabetes Mellitus in Saudi Arabia
Authors: Anokute Charles C.
Published: September 2007

A retrospective study of 210 cases of diabetes was carried out at King Khalid University Hospital diabetes clinic to delineate etiologic factors in non-insulin dependent diabetes mellitus (NIDDM).

Standardised detailed questionnaires were administered to both cases and controls and the information sought included general demographics, dietary patterns, anthropometric values, family history, consanguinity and familial aggregation of Diabetes Mellitus (DM). Familial aggregation yielded an odds ratio of 6:2 which suggests a causal association with DM. A synergistic effect of familial aggregation was observed which needs to be further explored in future studies.
Sampling in Epidemiological Research: A Case Study of the Prevalence of Brucellosis in Saudi Arabia
Authors: Al-Sekait Mohammed Abdulaziz , Bamgboye Elijah A. , Al-Nasser Abdulaziz Nasser
Published: September 2007

The superficial description in biomedical journals of sampling methods used in epidemiological studies of the prevalence of some diseases can be attributed to shallow knowledge of basic sampling techniques. The population of interest in most community surveys is usually very large and resources and time available limited, so that researchers have little or no choice but to study a sample of the population. One of the basic principles of sampling is the avoidance of bias, guaranteed by taking a random sample. But the term 'random sample' has often been misinterpreted as synonymous with 'haphazard sample', taking a sample without a definite pattern. It is re-emphasised that a random sample is a probability sample that gives every unit in the population a known probability of being selected in the sample. The procedures for taking a random sample for a nationwide study in the Kingdom of Saudi Arabia are not easy because of the structure of the population, and therefore require more complex sampling methods like the stratified cluster sampling. It is also necessary in a stratified sample to calculate estimated persons affected by a condition for each selected subgroup of the population before obtaining the overall prevalence rate. A proper understanding and use of appropriate sampling techniques is most likely to result in the most desired representative sample, and guarantees that some underlying assumptions for inferential statistics will be satisfied.
Tracking Change in the Patterns of Parental Smoking
Authors: Stanton Warren R. , Silva Phil A.
Published: September 2007

This study examined the prevalence and predictors of parental smoking in a representative sample of mothers and fathers. The results showed that in this New Zealand sample approximately 38% of mothers and 43% of fathers were smokers, and that proportionally more fathers than mothers were ex-smokers. The pattern of maternal smoking was relatively less stable, showing a rate of increase over the first 2-year period and an equivalent rate over the second period for those who started or resumed smoking compared to those who stopped smoking. Predictors of maternal smoking groups included level of educational qualifications, number of changes of residence, personality (extraversion and neuroticism scores) and being a young mother. Predictors of paternal smoking groups from a smaller range of background variables included level of educational qualifications, socio-economic status and age. The measures did not satisfactorily differentiate smokers who decreased their level of smoking from those who increased their level of smoking and those who continued to smoke or not to smoke.
A Perspective on Lead Pollution and Health 1972-1992
Authors: Harrison Roy M.
Published: September 2007

The health effects of exposure to lead from environmental sources are briefly reviewed and the likely benefits of removal of lead from petrol are evaluated. At current environmental levels of exposure, adverse effects of lead upon intellectual development of children are difficult to detect with certainty, but if present are extremely small. When viewed in the context of steadily increasing population IQ scores this effect appears almost negligible. The historical path of decision making over lead in petrol is traced and it is concluded that in the UK the present outcome is not necessarily the best practicable environmental option. The question is raised as to whether the considerable financial costs of removal oflead from petrol might have been better spent in other ways.
Sex and The Nation's Health
Authors: Drobniewski Francis
Published: September 2007

The Government's 'Health of the Nation', influenced by the WHO's 'Global Strategy for Health for All by the Year 2000', pledges a reduction in sexually transmitted diseases in general and AIDS in particular. The recommendations are clearly sensible but how do you persuade people to believe and comply with the 'sensible' advice? Failure to consider public health measures involving sexual behaviour without considering how different cultures respond and interpret the advice given is bound to fail. People are individuals and there is a danger in assuming that our values and beliefs are shared by people globally. For a message to succeed it needs to be simple and direct, and portrayed in its cultural context through an appro priate medium. An appreciation that the message however sensible may clash with individual needs (eg the economics of prostitution) and research into these aspects of sexual behaviour will ensure that the message remains effective. Changing the slogans and methods of conveying the message regularly will help to reinforce kev points and reduce apathy.
Prevalence of Brucellosis Among Abattoir Workers in Saudi Arabia
Authors: Abdulaziz Al-Sekait Mohamed
Published: September 2007

The prevalence of brucellosis among abattoir workers in Saudi Arabia was determined through a randomised multi-stage sampling of 1200 abattoir workers. Diagnosis was made by both blood culture and standard tube agglutination test. The overall prevalence of brucellosis was 4.0% among abattoir workers. Infection was more common among butchers (8.9%), veterinarians and veterinary assistants (5.4%), and administra tive personnel (1.1 %). In order to reach optimum planning for a national brucellosis control programme in Saudi Arabia, ministerial co-ordination should be established with formula tion of inter-governmental veterinary agreements between the Saudi government and the relevant authorities of animal exporting countries. A national survey on animal marketing is required.
The Growth Pattern of Saudi Arabian Pre- School Children in Riyadh Compared to NCHS/CDC Reference Population
Authors: Al Frayh Abdulrahman S. , Bamgboye Elijah A.
Published: September 2007

This study compares the growth patterns of Saudi Arabian pre-school children aged 0-5 years to a reference population of American children documented by the National Center for Health Statistics/Centers for Disease Control (NCHS/CDC). The anthropometric data of weight, height and age were collected in a cross-sectional study of Saudi Arabian children in Riyadh, the capital of Saudi Arabia. The sample selection was accomplished by a 3-stage stratified random procedure, basing the stratification on location and a socio-economic index. A total of 3,795 children comprising 55.2% males and 44.8% females had complete basic anthropometric measurements among other variables. Analyses were effected by using the WorHealth Organization/Centers for Disease Control (WHO/ CDC) standard software programme for calculating nutritional indicators. A combination of height for age (as an indicator of stunting) and weight for height (as an indicator of wasting) showed that a sizeable proportion (78.1%) have normal or slightly above normal nutritional status. A small proportion of the children (1.4%) were below -2.0 SD scores of the reference population for weight for height and for age. Overall, Saudi Arabian children are slightly shorter and thinner than their American counterparts. An important finding in weight for height was that nearly 20% of the children were below -2 SD scores of the reference population median. However, due to the very high per capita income, and the fact that food and other essential items are subsidised by the government, the deficits from this reference population may be attributed to inadequate health education nutrition programmes, genetic and other social factors including reproductive behaviour, rather than malnutrition.
Rapid Assessment of Environmental Radon Levels
Authors: Grainger C.R.
Published: September 2007

Radon is an important potential cause of cancer but this hazard is preventable. A rapid means of assessing the concentration of radon occurring in an area is described. The method requires only simple robust equipment to determine if there is a significant problem needing further detailed research. Results obtained in Cornwall by this method are shown to illustrate the potential for the procedure.
Sickness Absenteeism among Employees of a Teaching Hospital in Saudi Arabia
Authors: Al-Shammari Sulaiman A , Bamgboye Elijah A , Olubuyide IO
Published: September 2007

The sickness absence records of workers at the King Khalid University Hospital over a period of two years (1990-1991) were analysed to identify the category of workers at high risks. The records of each staff who went on 'sick-off are available at the Employee Health Clinic of the hospital. There were 861 workers with sickness absence records during the period of study and 86% are expatriates on contract. The prevalence of sickness absence is higher among contract workers than non- contract workers about 16% and 9% respectively. The sex ratio was 1:2 in favour of females among contract employees but 1.2:1 in the male's favour for the Saudis. The observed sex differential in the rate of sickness absence in each occupational group is statistically significant (P<0.01). Females have more spells of sickness than males and the duration of sickness absence is significantly higher in females. However, the average spell of sickness which is generally low is not different between contract and non-contract workers although slightly higher in the former. There was no significant occupational effect on the spells and duration of sickness absence. Respiratory infections and diseases of the digestive and musculoskeletal systems are the major diseases causing sickness absence. The implications of these findings are discussed in the paper. But for a good monitoring of sickness absence records, a health record surveil lance card for each employee is recommended.
Residency Training in Graduate Medical Education (Nine-Year View)
Authors: Al-Balla Suliman , Al-Nozha Mansour , El-Shabrawy Ali Mohamed
Published: September 2007

Assessment of the progress of residency training in graduate education after 9 years shows that the original goals established for various specialties are being effectively met.

There are now 7 approved residency programmes for diplo mas and 10 approved residency programmes for fellowships with 324 residents trained and in training, out of whom (32%) were females, and 222 (68%) were male residents.

Student interest in these programmes has remained at a high level. Only 15 candidates (4.64%) had withdrawn from the residency training programmes.

Heavy emphasis has been placed upon curriculum design, selection criteria of students and quality control mechanisms through residency committees in specialty departments and the residency board embracing residency coordinators. This paper outlines some concerns regarding the present status of various residencies and suggests some recommendations for future development of these programmes.
Causes of Admissions of Rural African Patients to Murchison Hospital, Natal, South Africa
Authors: Walker A R P , Walker B.F. , Dunn M.J. , Dunn S.E.
Published: September 2007

An analysis has been made of causes of admission of black patients in 1991 to Murchison Hospital, Port Shepstone, Natal. Of 667 5 total admissions, 6329 (95%) were classifiable. Of the latter, 1462 (23%) were aged 12 years and-younger, namely, 763 boys and 699 girls. Their chief causes of admission were pneumonia, gastroenteritis, trauma, acute glomerular nephritis, and malnutritional diseases. Of 4867 adults (73%), 1536 were males and 3331 females. Among men, chief causes were tuberculosis, congestive cardiac failure, hypertension and cerebral vascular accidents. Among women, apart from preg nancy, chief causes of admission were disorders of pregnancy, tuberculosis, congestive cardiac failure, pneumonia, diabetes, and hypertension. Of western diseases, 3.9% of adults were admitted for diabetes, and 2.8% for asthma. The general pattern of admissions is similar to that in other rural hospitals. The causes of admissions are discussed, regarding (1) public health improvements occurring, and (2) means of promoting further improvements by (a) community self-help, and (b) help from State health and other services.
Essential Food Hygiene Certificate Examination: Examination Papers Reviewed
Authors: Donaldson R.J.
Published: September 2007

One thousand papers for the Essential Food Hygiene exami nation, chosen consecutively from those being processed in RSH House on 6-7 April 1994, were reviewed.

The purpose of the review was to assess the impact of the redesigned course and the new examination papers which were introduced from 1 January 1994. The pass rate for the sample was 96.7% which was somewhat lower than the pass rate of 99.2% for the whole of 1993 when the previous examination papers were in use.

Out of 1000 papers 33 were failures. Eighteen candi dates had obtained the 70% pass mark yet still failed because one of the two questions on temperature control had been answered incorrectly. The requirement to answer both those questions correctly in order to obtain a certifi cate was introduced with the new examination papers and marked a major change.

The conclusion from this snapshot study was that the majority of Tutors and the candidates from their courses had achieved a high degree of examination success. In particular, Tutors had secured a major objective by ensu ring that trainees had a clear understanding of the concepts of temperature control. Only a minority were having diffi culty. Of the 33 individuals who failed, 18 came from just four of the 108 courses.
Psychiatric targets in 'Health of the Nation'
Authors: Pritchard C.
Published: September 2007

The psychiatric targets set in 'The Health of the Nation' reflect a fundamental change in auditing the psychiatric and social services, and it is argued that suicide levels have become 'Paradoxical indicators' of effectiveness. Based upon mortality rates between 1974-1990, inter-regional comparative league tables are presented. Changes in age and gender patterns, and the accumulative impact of unemployment 1990-1994, especially in the more affluent regions, suggest that the suicide targets may not be feasible. The implica tions for the community and psychiatric services are briefly discussed.
Children's smoking: the shopkeepers' perspective
Authors: Devine M.J. , Vickers J.E.
Published: September 2007

A self-administered postal questionnaire was sent to 216 Bolton shopkeepers to examine their knowledge and attitudes about children's smoking. The response rate was 76%. A majority of respondents (57%) were in favour of banning cigarette advertising; this option was supported by significantly more women (73%) than men (46%), (p<0.05). There was widespread recognition of the harmful consequences of children's smoking (97%), although the highly addictive nature of cigarettes was not as widely acknowledged (41%). Many of the shopkeepers perceived children's smoking as a normal part of growing up (49%); this view was held more frequently by shopkeepers who had smoked during their own childhood (62%). Challenging shopkeepers' acceptance of children's smoking as a nor mal part of growing up, and increasing their awareness about the highly addictive nature of cigarettes, may reduce their willingness to sell cigarettes to children.
Sickle cell anaemia in Saudi-Arabian children
Authors: Pejaver R.K. , Ahmad F. , Bedawi Hussein
Published: September 2007

Forty-one Saudi Arabian children aged between six months and 13 years had a total of 68 admissions for complications of sickle cell anaemia during 1992. Review of their in-patient records and the relevant out-patient notes revealed a change in the clinical profile as compared to previous years. Hand-foot syndrome is virtually non-existent and vaso occlusive crisis remains the commonest cause of admission. Introduction of pneumococcal vaccine and prophylactic oral penicillin has had no effect on the frequency of admissions and the admission rate per patient year. We have not seen any septicaemia/meningitis due to pneumococci. No death occurred during 1992.
High prevalence of smoking in young patients with acute myocardial infarction
Authors: von Eyben F.E. , Bech J. , Madsen J. Kyst , Efsen F.
Published: September 2007

Of 35 patients with acute myocardial infarction (AMI) at the age of 40 years or less, 32 (91%) smoked and only three patients were non-smokers. The age at AMI related significantly to the extent of smoking (p < 0.001, Kruskall-Wallis test). Five patients with AMI at the age < 30 years smoked more heavily than the 30 with AMI at the age of 30-40 years (p = 0.04, Mann Whitney U test). Heavy smoking men > 30 years at the AMI had a Q-wave infarction as often (11 of 13 (85%)) as those with multivessel disease or a coronary artery occlusion (8 of 9 (89% ) and 14 of 16 (88% ) respectively) on coronary arteriography after the infarction. Smoking may be the most important modifiable risk factor in young patients with AMI.
Diet in the prevention of cancer: what are the chances of avoidance?
Authors: Walker A R P
Published: September 2007

In most western populations, cancer causes about a fifth of all deaths, and in developing populations, 5-15%, with the likelihood of further rises. Diet is considered responsible for about a third of cases of cancer and smoking another third. Dietarily, for cancer avoidance, recommendations made include eat less, eat much less fat especially saturated fat, and eat more plant foods, i.e. cereals, but very particularly vegetables and fruit. However, only high consumptions of the latter are consistently associated with a lower risk of cancers, notably of the digestive and respiratory tracts. For each change urged, meaningful compliance will be very difficult, due largely to conservativeness as well as to the higher cost of a 'prudent' diet. Notwithstanding, urges to make dietary changes, particularly relating to plant foods, must be continued, especially with regard to persons familially susceptible and, additionally, with the recognition that the measures recommended also serve to lessen susceptibility to cardiovascular diseases. Compliance, even by a small proportion, could result in large numbers benefiting due to the universality of the burden from cancer.
Tackling the tobacco challenge: achieving 'healthy public policy' in tobacco control in Guernsey
Authors: Jeffs David , Hodgkinson Alan
Published: September 2007

Scientific evidence identifying smoking as the major cause of poor health and premature death in both industrialised and increasingly in developing countries is now overwhelming. Despite this, for a variety of reasons, there has been reluctance amongst many Governments including that of Britain, to take all logical action necessary to restrict and reduce smoking, especially amongst the young. The States of Guernsey in the Channel Islands has recently agreed to introduce an integrated package of measures designed specifically to make smoking less attractive and less accessible and less affordable to young people in an attempt to reduce the number of addicted adult smokers. These measures include a total ban of all public advertising of tobacco, apart from at point of sale, a substantial price rise followed by further price rises for a minimum period of five years, a raising of the minimum age for the purchase of tobacco from 16 to 18 years, an increase in the size and content of pack health warnings, and increased funding for specific non- smoking health promotion activities. The various barriers to achieving these reforms are described.
Health and Safety (Consultation with Employees) Regulations 1996
Authors: hammond Nigel
Published: September 2007

The Health and Safety Commission (HSC) introduced the Health and Safety (Consultation with Employees) Regulations 1996 (HSCER) on 1st October, 1996. The HSCER 'top up' the existing Safety Representatives and Safety Committees Regulations 1997 (SRSCR). The HSCER require employers to consult with all employees, not just those covered by representatives appointed by recognised trade unions, on matters relating to health and safety. Employers have the choice of consulting whether directly with employees or via elected representatives.
Lessons to be learned: a case study approach
Authors: Ayub Naeen , Donaldson David , Bedford Derek , Alloway Ruth , Ryalls Michael
Published: September 2007

The case report is presented of a ten-and-a-half year old boy with acute onset of confusion and visual hallucinations, subsequently confirmed to be due to hyoscine toxicity following ingestion of over-the-counter (OTC) travel sickness tablets. It is suggested that packs of such pills should carry a prominent cautionary label. A clear clinical history is very important - not only in aiding the differentiation of acute viral infections involving the central nervous system (such as acute encephalitis) from drug toxicity, but also in rationalising any further diagnostic investigations. The possible underlying reasons for drug ingestion in this case are discussed.
Nurses' evaluations of sources of information about HIV and AIDS
Authors: Irving K.L. , Ferguson E. , Cox T. , Farnsworth W.J.F. , Irving Kirstin L. , Ferguson Eamonn , Cox Tom , Farnsworth William J. F.
Published: September 2007

Reviews of the literature indicate that nurses feel ill-informed about HIV/AIDS and that poor knowledge is associated with anxiety and negative attitudes towards infected patients and their care. Although some studies have sought to identify the sources of HIV/AIDS information available to nurses, few have attempted to understand how nurses evaluate such sources.

In this study in 1992, 15 sources of HIV/AIDS information were identified during group discussions with nursing staff and nurse tutors. 277 nursing staff evaluated each of the sources in terms of perceived frequency (how often the source is used) and six items chosen to assess the 'usability' and 'usefulness' of each source (e.g. how informative the source is, how easy it is to understand). The results indicate that in-service training, basic training and professional colleagues are the sources evaluated most highly while posters and advertisements, television and radio and popular newspapers are the most frequently used sources of information. Trades unions' journals and pamphlets are the least frequently used sources of information and receive only modest evaluations. 20% of respondents report never having received any training regarding HIV and AIDS. Implications for the future provision of HIV/AIDS information and directions for further research are discussed.
The 'other' sexually transmitted diseases: a case for public health education
Authors: Osujih M.
Published: September 2007

Generally, people tend to associate the phrase 'sexually transmitted diseases' (STDs) with only gonorrhoea and syphilis. This paper highlights the prevalence of other diseases such as herpes simplex, trichomoniasis and candidiasis which are also sexually transmitted. It is shown that, although they are rarely discussed and reported, various estimates, particularly in the developed countries where statistics are available, indicate that their incidence rates are rapidly rising to epidemic proportions and, in certain instances, have surpassed the annual cases of syphilis and gonorrhoea.

Their causative organisms, mode of spread, signs and symptoms, complications, prevention and control are presented. Although knowledge of the above are important, it is emphasised that it is much more desirable to focus on prevention through public health education.

Health education strategies such as avoiding sexual exposure with infectees, personal hygiene, simulation, role-play and unemotional discussion in schools and the use of mass media in disseminating information to the public regarding prevention, control and how to seek for treatment are elaborated upon.
Antiseptics: a forgotten weapon in the control of antibiotic resistant bacteria in hospital and community settings?
Authors: Payne D.N. , Gibson S A W , Lewis R.
Published: September 2007

The aim of this study was to ascertain the activity of a selection of widely-used antiseptic/disinfectant agents against antibiotic resistant bacteria and strains isolated from patients infected with clinically significant species. Four antiseptic agents (Dettol, Dettol Hospital Concentrate, Savlon and Betadine) were tested against Staphylococcus aureus, Methicillin Resistant S. aureus (MRSA), Enterococcus hirae, Vancomicin Resistant Enterococcus sp (VRE), Escherichia coli and E. coli 0157. The antiseptics were applied at recommended use dilutions and at a half and a quarter of those concentrations in a standard suspension test (EST). Organic material was added to mimic the presence of blood, protein and other such contaminants to be found in the clinical situation. All antiseptics tested were effective against both the antibiotic sensitive and antibiotic resistant strains of S. aureus and E. hirae as well as normal and clinical strains of E. coli at recommended concentrations. All but Betadine were also effective against the antibiotic resistant bacteria at a half and a quarter of normal concentration. The iodine containing antiseptic, however, failed the test against MRSA at a half normal concentration and showed virtually no activity against MRSA at a quarter normal concentration.
Changes in the numbers of dentists and dental caries levels in 12-year-olds in the countries of the European Union and economic area
Authors: Eaton K.A. , Widstroem E.A. , Renson C.E.
Published: September 2007

This study compares numbers of dentists in the countries of the European Union (EU) from 1970 to 1994 with dentist to population ratios and dental caries levels in 12-year-olds, sets the changes which have emerged against other changing dental disease patterns (including those unconnected with caries levels) and goes on to determine the significance of the findings to the problems of dental workforce planning. Data for the numbers of dentists and dentist to population ratios were obtained from published tables. Data for past caries levels in 12-year-olds were obtained from the WHO Global Data Bank. All other data were obtained from Chief Dental Officers in all countries of the EU.

In 1994 there were 222,090 practising dentists in the EU and 12,853 other clinical workers of whom 11,493 were dental hygienists. Since 1970, the dentist: population ratios for Spain and Portugal have improved markedly, the improvement for other countries has been less marked and in Austria a small reduction has occurred. Six countries show a considerable reduction in caries levels for 12-year-olds between 1970 and the 1990s, five show smaller reductions and three show a deterioration.

As a consequence of the general improvement in caries levels in most of these countries it is probable that workloads in relation to the treatment of caries are falling, particularly for younger age groups. However, because of the overall ageing of populations in many industrialised countries the workload for older age groups is increasing, as older adults increase in number, a greater proportion retain their teeth and are afflicted by a range of problems, which include, but are not exclusive to, dental caries. There are fewer data for these older age groups than for caries levels in 12-year-olds.

It was concluded that those planning the EU dental workforce of the future should take account of reliable epidemiological data for all groups of the population and, as these are not currently available, that suitable periodic oral health surveys covering all population age groups should be carried out regularly in all EU member states.
Community care: fracturing managerial frames
Authors: Mathura E.
Published: September 2007

Managers come to their task with their frames of reference — certain assumptions — a mind set. They wish to be seen as rational and consistent; to live rent-free in their comfort zones. There is the lure of 'Social Proof'; to act like others placed in a similar situation. Deviance is seen as counter-cultural. This approach is no longer tenable; the antiquity of an error is no reason for its continuance. The entrepreneurial manager must move from the concept of 'fit' — resources to match objectives — to one of 'stretch', which argues for a misfit between strategy and resources; between funding and aspirations. One must do more with less.
Carbon Monoxide
Authors: Horner J.
Published: September 2007

Carbon monoxide (CO) is a colourless, odourless and tasteless gas. It is emitted when carbon containing compounds are incompletely combusted. This paper reports on concentrations of CO in the environment in relation to anthropogenic emission sources and assesses the extent of the health hazard from this common air pollutant. It includes the results of CO monitoring in a variety of locations in south west London. The conclusion is that indoor emission sources present a greater and more insidious health risk than do out door emission sources. Methods for reducing the dangers it poses are briefly summarised.
Health-promoting behaviours in public health: testing the Health Promotion Model
Authors: Blacconiere M.J. , Oleckno W.A.
Published: September 2007

A health-promoting lifestyle encompasses far more than preventing disease and is characterised by behaviours that lead to optimal well-being, self actualisation, and personal fulfillment. This study was undertaken to investigate the health-promoting lifestyles of employees working in local public health departments (n=602) and to test two research hypotheses suggested by the Health Promotion Model. The first hypothesis posited that public health professionals would report significantly more favourable health-promoting behaviours than support staff employed in the same departments. The second hypothesis postulated that occupational discipline in public health would be a significant predictor of health-promoting behaviours. Health- promoting behaviours were measured by the Health-Promoting Lifestyle Profile (HPLP), a psychometrically-validated measure of overall health-promoting lifestyle and six dimensions of health-promoting behaviours, which comprise the instrument subscales. The findings of the study tended to support the research hypotheses. Overall, public health professionals tended to report more favourable health-promoting behaviours than departmental support staff, and occupational discipline was a significant predictor of a health- promoting lifestyle. In general, public health nursing personnel reported the highest mean levels of health-promoting behaviours compared to the other occupational disciplines examined.
Ophthalmic care for the twenty-first century: a perspective based on a recent white paper, 'The New NHS'
Authors: Chopdar A.
Published: September 2007

A recent white paper entitled The New NHS describes the changes that the government aims to adopt in order to deliver a new truly national health service (NHS). Priority would be given to developing community services in partnership with hospital NHS trusts. This paper describes a model that could be adopted for delivering such a service in the field of ophthalmology.
Review: Genetics of the cardiometabolic syndrome: new insights and therapeutic implications
Authors: Sookoian Silvia , Pirola Carlos J.
Published: September 2007

Although the definition of the phenotype is imprecise, cardiometabolic syndrome (CMS) includes a constellation of complex diseases such as type 2 diabetes, dislipidemias, central obesity and hypertension, proinflammatory and prothrombotic states, ovarian polycystosis and fatty liver. The genetics of each disease is complex in itself and varies in spectrum from monogenic and syndromic models of inheritance, usually rare, to the most common polygenic and multifactorial forms. In addition, human studies using the candidate-gene approach indicate that common genetic variants of several genes are associated with the development of CMS. Genome-wide scans have also provided several chromosomal regions associated with some of the components of CMS. In addition, through comparative genomics animal models can generate a map for candidate loci in humans and a promising approach is offered by bioinformatic tools for gene prioritization. Lastly, the involvement of genes whose products are already the targets for approved drugs, such as SLC6A4, PPARα and PPARγ , in the development of CMS suggests new avenues for CMS pharmacological treatment.
Development of a universal measure of quadrupedal forelimb-hindlimb coordination using digital motion capture and computerised analysis
Authors: Hamilton Lindsay , Franklin Robin JM , Jeffery Nick D
Published: September 2007

Background

Clinical spinal cord injury in domestic dogs provides a model population in which to test the efficacy of putative therapeutic interventions for human spinal cord injury. To achieve this potential a robust method of functional analysis is required so that statistical comparison of numerical data derived from treated and control animals can be achieved.

Results

In this study we describe the use of digital motion capture equipment combined with mathematical analysis to derive a simple quantitative parameter – 'the mean diagonal coupling interval' – to describe coordination between forelimb and hindlimb movement. In normal dogs this parameter is independent of size, conformation, speed of walking or gait pattern. We show here that mean diagonal coupling interval is highly sensitive to alterations in forelimb-hindlimb coordination in dogs that have suffered spinal cord injury, and can be accurately quantified, but is unaffected by orthopaedic perturbations of gait.

Conclusion

Mean diagonal coupling interval is an easily derived, highly robust measurement that provides an ideal method to compare the functional effect of therapeutic interventions after spinal cord injury in quadrupeds.
Snacking behaviours of adolescents and their association with skipping meals
Authors: Savige Gayle , MacFarlane Abbie , Ball Kylie , Worsley Anthony , Crawford David
Published: September 2007

Background

Snacking is likely to play an important role in the development of overweight and obesity, yet little is known about the contexts of snacking in adolescents or how snacking may influence other dietary habits, like meal skipping. This study examines the contexts in which adolescents snack and whether these contexts are associated with demographic characteristics of adolescents and with meal skipping.

Methods

A cross-sectional, self-reported online food habits survey was administered to 3,250 secondary students in years seven and nine. The students were drawn from 37 secondary schools in Victoria, Australia during 2004–2005. Frequencies of meal skipping, and snacking in eight contexts, were compared across gender, year level and region of residence. Logistic regressions were performed to examine associations between snacking contexts and meal skipping adjusting for gender and region.

Results

The most common contexts for snacking among adolescents were after school (4.6 times per week), while watching TV (3.5 times per week) and while hanging out with friends (2.4 times per week). Adolescents were least likely to snack all day long (0.8 times per week) or in the middle of the night (0.4 times per week). Snacking contexts were variously associated with gender, year level and region. In contrast, meal skipping was associated with gender and region of residence but not year level. Adolescents who reported more frequent snacking on the run, on the way to or from school, all day long, or in the middle of the night were more likely to skip meals.

Conclusion

These data suggest adolescents snack frequently, especially in their leisure time. In addition, adolescents who snack on the run, on the way to or from school, all day long or in the middle of the night are more likely to skip meals than are adolescents who don't snack at these times. Understanding the contexts in which adolescents snack, and their associations with skipping meals, may assist those involved in the promotion of healthy food habits among adolescents.
Impact of drug classes and treatment availability on the rate of antiretroviral treatment change in the TREAT Asia HIV Observational Database (TAHOD)
Authors: Srasuebkul Preeyaporn , Calmy Alexandra , Zhou Jialun , Kumarasamy Nagalingeswaran , Law Matthew , Lim Poh Lian ,   The TREAT Asia HIV Observational Database
Published: September 2007

Background

It is critical to understand the pattern of antiretroviral treatment (ART) prescription in different regions of the world as ART procurement needs to be anticipated. We aimed at exploring rates and predictors of ART combination changes in clinical practice in Treat Asia HIV Observational Database (TAHOD).

Methods

Rates of ART changes were examined in patients who started first line triple or more ART combination in TAHOD, and had at least one follow-up visit. Rates of ART changes were summarised per follow-up year, and factors associated with changes assessed using random-effect Poisson regression. The Kaplan-Meier method was used to determine durations of patients in their first, second and third regimen.

Results

A total of 1846 patients initiated an ART combination with at least three drugs. Median follow up time for the first treatment was 3.2 years. The overall rate of ART change was 29 per 100-person-year.

In univariate analyses, rate of treatment change was significantly associated with exposure category, the country income category, the drug class combination, calendar year and the number of combinations. In multivariate analysis, compared to d4T/3TC/NVP, starting ART with another NNRTI-containing regimen, with PI only or with a triple NRTI regimen was associated with a higher risk of combination change (relative risk (RR) 1.6 (95% CI 1.64 – 1.96), p < 0.001, RR 3.39 (2.76 – 4.16) p < 0.001, RR 6.37 (4.51 – 9.00), p < 0.001). Being on a second or a third combination regimen was also associated with a decreased rate of ART change, compared with first ART combination (RR 0.82 (0.68 – 0.99), p = 0.035, RR 0.77 (0.61 – 0.97), p = 0.024). Sites with fewer than 12 drugs used had an increased rate of treatment changes (1.31 (1.13 – 1.51), p < 0.001). Injecting drug users, and other/unknown exposure was found to increase rate of treatment change (1.24 (1.00 – 1.54), p = 0.055). Percentages of patients who stopped treatment due to adverse events were 31, 27 and 32 in 1st, 2nd and 3rd treatment combinations, respectively.

Conclusion

Our study suggests that drug availability impacts on ART prescription patterns. Our data, reflecting real clinic use in Asia, suggest that around half of all patients require second combination ART by 3 years after treatment initiation.
Brief dynamic psychotherapy
Authors: Holmes Jeremy
Published: September 2007

The notion of brief dynamic psychotherapy (BDP) may seem at first sight to be a contradiction in terms. ‘Dynamic’ is a Freudian psychoanalytic term implying conflictual psychological forces — an opposition between the conscious and unconscious mind, and the use of defence mechanisms to arrive at a compromise between them. The rigidity of the obsessional person whose self-expression is traded for security, the self-reproaches of the depressive reflecting inhibited aggression, the clinging of the phobic individual who lacks an inner sense of a secure base — these would be examples of the relationship between dynamic conflict and psychiatric symptoms. But the image of psychoanalysis conjures up a picture of prolonged and intensive couch-based therapy. How can this be brief?
Liaison child and adolescent psychiatry
Authors: Cottrell David , Worrall Anne
Published: September 2007

Liaison child and adolescent psychiatry has been described as the “partnership of child psychiatrists, paediatricians and other specialities concerned with children to provide integrated medical and psychological care for children” (Blacket al, 1990). Although liaison work conjures up visions of the psychiatrist on the paediatric ward, it may also involve collaboration with community paediatric and primary care services. Indeed, the number of different professionals that may be involved with even quite mildly ill children is large (see Box 1). Much of the work is indirect (e.g. consultation with other professionals), but this and direct therapeutic work with children and families may continue long after discharge from the paediatric wards and clinics.
Lithium therapy
Authors: Ferrier I. N. , Tyrer S. P. , Bell A. J.
Published: September 2007

Since the introduction of lithium therapy 30 years ago it has become a major weapon in psychiatrists' armamentarium. It is the drug of first choice for the prevention of recurrent mood disorders, and it is estimated that about one person in every thousand people in Britain receives lithium at any one time. It therefore behoves doctors to be familiar with its use. This article is not a comprehensive account of the pharmacology of lithium (for this the reader is referred to Johnson (1987) and Peet & Pratt (1993)) but concentrates on its clinical use in practice and some less well known, but important, phenomena.
Preparing a medico-legal report
Authors: Bluglass Robert
Published: September 2007

The preparation of medico-legal reports is an increasingly important responsibility for the psychiatrist as legislation and administrative regulations become more complex and litigation increases.
Deploying a community mental health team for the effective care of individuals with schizophrenia
Authors: Strathdee Geraldine
Published: September 2007

Community mental health teams (CMHTs) have their origin in the American Community Mental Health Centre programme of the 1960s. The teams were mandated to provide services with an emphasis on the needs of the severely mentally ill (SMI). However, over time the focus of work became ‘the worried well’, to the neglect of those with severe mental illness. CMHTs are now a firm feature of British psychiatry. A Sainsbury Centre study recently identified over three hundred CMHTs across England, defining themselves as comprising at least four members, from two or more disciplines, with a caseload of individuals with mental health disorders, largely residing in the community.
Treatment of psychoses in the elderly
Authors: Phanjoo A.
Published: September 2007

Psychotic disorders in the elderly can be divided into three types: disorders that have started in earlier life and persist into old age; disorders that start de novo after the age of 60, and psychoses associated with brain disease, including the dementias. The classification of psychoses in late life has provoked controversy for nearly a century. The debate concerns whether schizophrenia can present at any stage of life or whether functional psychoses, arising for the first time in late life, represent different illnesses. The nomenclature of such disorders consists of numerous terms including late onset schizophrenia, late paraphrenia, paranoid psychosis of late life and schizophreniform psychosis. This plethora of terms has made research difficult to interpret.
Case history: psychiatric management of adult autism
Authors: O'Brien Gregory
Published: September 2007

JB is a 31-year-old man who has been described as having borderline intelligence/mild learning disability. (His overall IQ is difficult to assess, but has been estimated as around 70, or above.) Over the period of his childhood, he was assessed by numerous child psychiatrists and psychologists, all of whom agreed that he had a diagnosis of autism or some related pervasive developmental disorder, although his presentation was always described as ‘atypical’. The cause of his developmental disorder has never been established, despite the conventional extensive biological, genetic and other physical investigations (Gillberg, 1990).