bluuebunny/crossref_metadata_2025 huggingface dataset:
Seroprevalence of antibodies to herpes simplex virus types 1 and 2 among two sexually active female populations in Middlesbrough, England
Authors: Opaneye A A , Bashford J
Published: November 2005

Herpes simplex virus (HSV) infection occurs worldwide but its epidemiology varies between different countries and between groups of individuals. Seroprevalence of HSV-1 and HSV-2 antibodies is a more accurate method of determining epidemiology of this infection.

In this cross-sectional study, 467 blood samples were obtained from women attending the genitourinary medicine clinic (GUM) and antenatal clinic (ANC) in Middlesbrough, England. Analysis of their blood samples showed that 69.5% GUM patients had HSV-1 antibodies and the figure was 54.5% in the ANC patients, p<0.0001, with odds ratio 1.9 (95% CI 1.30 to 2.78) for higher prevalence in the GUM group. Also, for HSV-2 antibodies, the seroprevalence was 21.6% for GUM and 8.1% for ANC patients, p<0.0001, with an odds ratio of 3.13 (95% CI 1.70 to 6.02) for higher prevalence in the GUM group. The overall prevalence for HSV-1 is 63.2% and for HSV-2 is 15.8%. Many of these patients were asymptomatic and constitute a potential source for spreading the virus.

Knowledge of HSV seroprevalence can help in planning sexual health promotion strategies.
Health and safety of laboratory science students in Ibadan, Nigeria
Authors: Omokhodion F O
Published: November 2005

Laboratory science students are engaged in laboratory practice under supervision during the course of their training programme. They are exposed to the risk of laboratory-acquired infection and need to be adequately informed and equipped with facilities to protect their health.

A questionnaire was administered to laboratory science students to determine their perception of hazards in laboratory practice and the observance of safety codes in their work practices.

Of 128 students, 118 completed the questionnaire, a response rate of 92%. Sixty of them (51%) were males and 53 (45%) were females; five students did not indicate their sex. The results revealed that only 34 (29%) of the students use gloves for handling biological samples and 26 (22%) use gloves for handling clinical waste. Ninety-four students (80%) reported that they washed their hands after handling specimens. Eighteen of the students (15%) had been immunised against tuberculosis, 80 (68%) against tetanus, six (5%) against hepatitis B, and 18 (15%) against yellow fever. Ninety-six students (81%) thought the greatest hazard in laboratory practice was harmful biological organisms, while 13 (11%) indicated that chemical agents were the greatest hazard. Virology was thought to be the most hazardous specialty by 41 students (35%) while morbid anatomy was ranked as least hazardous by 48 (41%) of the students.

These findings indicate that whilst laboratory science students are aware of the hazards in laboratory practice, this knowledge is not translated to safe practices and students may endanger their health as a result of exposure to laboratory practice. They therefore need to be provided with adequate facilities to protect themselves and adequate supervision to ensure that they imbibe safe work practices during their training years.
Historical perspectives on health
Authors: Spirling L I , Daniels I R
Published: November 2005

As a surgeon William S Halsted’s most notable contributions were in the development of a technique for radical mastectomy, the repair of inguinal herniae and the advancement of bowel anastomoses. However, he will perhaps be best remembered for his introduction of the use of the surgical glove and his reasons were probably the least scientific of all those given. Developed by the Goodyear Rubber Company, the gaunts were made to protect the hands of his scrub nurse, Caroline Hampton, the future Mrs William S Halsted. Another of Halsted’s contributions was the development of topical anaesthesia using cocaine. A consequence of these experiments was the development of addiction to the drug and his later dependence on morphia.

The last century has seen a 360° turn in the reasons why we use gloves. Originally designed to protect the theatre staff from corrosive substances, subsequently to protect the patient from contamination by theatre staff, to today where gloves are worn to protect staff from blood-borne infection agents.

This article introduces William S Halsted, and his story of romance, drugs and the introduction of gloves to medical care.
Lessons to be learned: a case study approach
Authors: Khan A Z , Escofet X , Miles W F A , Singh K K
Published: November 2005

We present a case of Bouveret’s syndrome which is gastric outlet obstruction due to gallstone impaction in the duodenum. The paper also discusses the aetiology, presentation, methods of diagnosis and options for management of Bouveret’s syndrome.
Breast cancer information on the web
Authors: Sankar N Sai
Published: November 2005

In the UK breast cancer is one of the leading cancers in women. It is estimated that one in nine women may develop breast cancer at some time in their lives, and it is the commonest cause of death in women in the UK.

It is vital that everyone should be aware of this disease. In the 21st century, the Internet has become an important source for information and it is predicted that 75% of the UK population will use the Internet within three years.

In this article the author details various websites that provide quality information on breast cancer and breast diseases.
Identifying ‘value’ in day care provision for older people
Authors: Powell J , Roberts H
Published: November 2005

Day care can play a prominent part in the overall development of high quality health and social care provision for older people. This paper describes an approach to evaluating day care services which brings together costs and service users’ views as a means of establishing the overall ‘value’. This strategy, it is argued, underlines the purpose of day care itself as a means of promoting the independence and autonomy of older people.
Food safety awareness of older people at home: a pilot study
Authors: Hudson P K , Hartwell H J
Published: November 2005

The UK has an increasingly ageing population with the majority of older people preferring to remain independent and live in their own homes. However, during their lifetime, there have been many changes in areas such as food technology and shopping practices which have had a profound influence on the health and well-being of this vulnerable group. The aim of this pilot study, therefore, was to investigate issues surrounding food safety of older people living at home.

A focus group (n=9) was initially conducted to elucidate areas of potential concern. This was followed up by semi-structured interviews and observations (n=16) within the home.

Results show that most participants had not measured their refrigerator temperature and did not know what it should be. The majority had not adjusted the temperature control/dial and gauged the ‘correct’ temperature by the feel of goods inside.

‘Use by’ dates were generally well understood, but not always adhered to due to difficulty in reading the labels. Items were purchased near to the end of this date as they are sometimes cheaper, and although older people appreciated these dates related to food safety, items were often kept for up to a month before consumption. This has major implications, particularly if the refrigerator is not working at the correct temperature.

There is a lack of readily available educational material on this topic and most people would like to be better informed. If the Government are to encourage more independent lifestyles of older people, then awareness of food safety should be higher on the agenda. Further research to ascertain food safety needs, and awareness of this group are also required. This should also include an assessment of the impact of situations where food consumed at home is prepared elsewhere, e.g. meals-on-wheels.
Perceptions of caregivers regarding the importance of dental care for institutionalised seniors: a pilot study
Authors: Reznick S , Matear D W
Published: November 2005

The type of dental treatment that institutionalised elderly receive often depends on the decisions made by various stakeholders. These decisions may be based on a perceived need for treatment.

This study was designed to investigate the perception of primary caregivers as to the relative importance of dental care for institutionalised seniors. Seniors who lived in a long-term care institution, with a dental facility available to them on a daily basis, volunteered information regarding their primary care-givers. A total of 25 primary caregivers participated in a structured telephone interview. All (100%) of the caregivers considered emergency dental services and treatment to relieve pain as essential/important services which should be available to institutionalised seniors. The following were most commonly ranked in the top three by the primary caregivers: emergency dental services (57%); dental services to relieve pain (48%); cleanings to prevent mouth disease (45%); check-ups including X-rays (45%); dentures to replace missing teeth (33%); and fillings (24%).

The findings of this study suggest that more effort should be directed at investigating the perceived need of value of dental services for institutionalised seniors within the various stakeholders.
The willingness of general dental practitioners to treat people with handicapping conditions: the Hong Kong experience
Authors: O’Donnell D , Sheiham A , Yeung K W
Published: November 2005

A study was carried out to assess the willingness of general dental practitioners in Hong Kong to treat patients with handicaps. A questionnaire and practitioner scale were developed and circulated to 400 general dental practitioners of which 250 responded giving a response rate of 62.5%.

The majority of practitioners (59.6%) saw between one and five patients with handicaps per year; 15.6% saw none at all.

The mean score was 33.68 (SD=9.19) on a scale with a range from 0 to 60. The observed mean score, which was just over the halfway mark, indicated a slightly positive feeling for treating people with handicaps. Cronbach’s alpha for the scale was 0.67 for the raw variables. Cronbach’s alpha was sufficiently high to indicate a reliable scale for the population under investigation.

It was found that although general dental practitioners were relatively enthusiastic about treating people with handicaps they felt it was not economically viable to do so. There was also a strong feeling that government should play a more prominent role in provision of dental care for this group.
Use of folic acid supplements in the first trimester of pregnancy
Authors: Langley-Evans S C , Langley-Evans A J
Published: November 2005

Folic acid supplementation in the periconceptual period is known to reduce the risk of neural tube defects. High dose supplementation prevents a high proportion of recurrent defects, whilst low doses reduce the risk of first occurrences. The Department of Health advises all women considering pregnancy to take folate supplements for 12 weeks prior to conception and in the first trimester of pregnancy. Surveys of the British population indicate that the uptake of this advice is poor. The aim of the present study was to evaluate the uptake of advice in a group of Northampton women between January and June 2001. A total of 301 Caucasian women were recruited through an antenatal dating scan clinic. The women were aged between 16 and 42 years and completed a questionnaire concerning nutritional supplements prior to and during pregnancy and a five-day food diary, which was used to estimate dietary folate intakes. Of the women 67% consumed folate-containing supplements in the first trimester of pregnancy and 43% reported taking folate before becoming pregnant. Women under the age of 21 years were less likely to take folate supplements than women over the age of 21 years (p=0.007), as were smokers (p<0.001) and women from lower social classes. Mean folate intakes, including supplements, were 511±17μg per day and unsupplemented dietary intakes were 237±5μg per day. Of the women interviewed, 24.5% had folate intakes below the reference nutrient intake for pregnancy (300μg per day). The data supports the assertion that neural tube defects are more likely to be prevented through the fortification of staple foods than through supplementation, but highlights the fact that young women from poor social backgrounds may still require close monitoring and support.
Health behaviour among Black and White South Africans
Authors: Peltzer K
Published: November 2005

Four important health behaviours - dietary fat avoidance, regular exercise, smoking and alcohol consumption - were assessed by questionnaire, together with measures of risk awareness, health status, health benefits, subjective health and well-being. The sample included 250 Blacks and 250 Whites chosen by systematic random sampling from telephone directories in formerly White and Black urban areas in the Northern Province of South Africa. Results indicate that Blacks avoided more fat and cholesterol, smoked less and drunk less alcohol than Whites did, while Whites exercised more than Blacks did. Blacks saw more health benefits in not smoking and avoiding fat than Whites did, while Whites rated more importance to regular exercise than Blacks. Among Blacks and Whites significant gender differences were found; on average women’s behaviour was more healthy in terms of not smoking, limited or no alcohol consumption and the avoidance of fat and cholesterol, but there were no such differences for the practice of exercise. Lower socio-economic status was among Whites associated with avoidance of fat and among Blacks with non-smoking. Risk awareness in relation to disease was higher among Blacks than among Whites. The strongest predictors for various health behaviours were gender, ethnicity and age.
Quality of life: an assessment of the state of psychosocial rehabilitation of patients with schizophrenia in the community
Authors: Hasanah C I , Razali M S
Published: November 2005

The subjective quality of life (QOL) of diabetic patients on oral hypoglycaemics was compared to schizophrenic patients who were well controlled with their antipsychotic medications. This comparison was made using the generic quality of life questionnaire produced by the World Health Organization QOL (WHOQOL) group, namely the WHOQOL-100.

Statistical analysis showed that there was no significant difference in the psychological well-being and level of independence between the two groups. However, such measures revealed that the most impaired aspect of well-being in the schizophrenic group was the social relationship.

Subjective QOL assessment is able to reveal deficits or handicaps that are obscure and probably difficult to appreciate on objective social and clinical evaluation. Such findings are valuable in planning the rehabilitative need of schizophrenic patients in the community.
Historical perspectives on health
Authors: Moss G A
Published: November 2005

The Essenes were, allegedly, the authors of the Dead Sea Scrolls and were settled by the Dead Sea. An ancient source locates their sister sect, the ‘Therapeutae’, as being by the shores of Lake Mareotis in Egypt.

No scholar has previously sought to locate where exactly on Lake Mareotis they were settled. Using clues from Essene sites around the Dead Sea, an attempt is made to suggest a specific location for the Therapeutae. Since there are signs of medical activity at many of the Essene sites, a site with medical association is also sought for the location of the Essene’s sister sect in Egypt. A suitable site is found at Canopus.
Lessons to be learned: a case study approach
Authors: Mason R G , Donaldson D
Published: November 2005

In Belgium, between 1991 and 1992, seven women under the age of 50 years were admitted to a regional renal dialysis unit with progressive renal failure. All seven had been following the same slimming regimen, prescribed by the same clinic. They had an identical pattern of interstitial fibrosis on renal biopsy. Subsequently it became evident that all were at risk of developing urothelial malignant change. Could there possibly be a link to the prescribed drugs, which included Chinese herbs?
A review of social housing regeneration in the London Borough of Brent
Authors: Stewart J , Rhoden M
Published: November 2005

Council high-rise estates sprang up rapidly during the 1960s and 1970s, with cross-governmental support to resolve the nation’s housing crisis. It soon became apparent that many such new estates, designed by remote architects, and sometimes constructed rapidly and unsatisfactorily, did not provide the ideal living initially perceived. Many estates had early problems with architecture, construction and design. They proved an inhumane environment for many residents and there were frequent problems with communal features. Such estates were soon stigmatised and difficult to let as increasingly residual households were placed there, creating majority welfare-dependent estates. This created a downward spiral that traditional, and remote, housing management found difficult to address, and was too wide-scale to rectify financially within existing regimes. Prior to the 1980s, there were no specific government policies to tackle housing regeneration on high-rise estates. Problems became wider than traditional housing management and poor housing environments, encompassing social and economic exclusion.

This paper, based on historical and contemporary literature as well as estate visits, reviews regeneration policy in three council housing estates within the London Borough of Brent. It traces successive government approaches since the 1980s from one that challenged the very status of council housing - notably at Stonebridge Park and Chalkhill, to one of partnership with the local authority - at South Kilburn.

Housing policy is now concerned with more than just housing - it is about moving toward social inclusion, which requires initiative, flair, resource and commitment. It is about new accountabilities - not just numbers of bricks and mortar constructions, but about the lives, opportunities and health of those who live in an area. This fundamentally involves a partnership approach with residents at the centre of regeneration. This paper finds that sustainable estate regeneration policies are about continued improvements in both housing policy and social development.
Reducing domestic exposure to environmental tobacco smoke: a review of attitudes and behaviours
Authors: Green E , Courage C , Rushton L
Published: November 2005

This paper reviews research on attitudes and behaviours towards environmental tobacco smoke (ETS), with a special focus on child health and the indoor environment. Research needs and ways forward to encourage reductions in domestic ETS levels are discussed.

Published material was identified through online literature searches (Medline, Toxline, Cancerlit, Biosis, Embase, Enviroline, Sociological Abstracts, Social Science Citation Index, Academic Index and Psychinfo). The literature search strategy employed search terms such as “passive smoking” or “environmental tobacco smoke” with “attitude” or “awareness” and other synonyms. Additional publications were identified by citation chasing and expert advice. Focusing on the UK, studies that provided survey-derived data about attitudes and behaviours in relation to ETS exposure in the indoor environment were selected for review. Published studies from other countries were also included when they provided information pertinent to this review.

Most people are aware of the health risks associated with ETS exposure, and there is a high level of support for smoking restrictions in public places to protect non-smokers from ETS. However, although there is concern among both non-smoking and smoking parents about children and second-hand smoke, many people allow children to be exposed to ETS in the home. The review suggests that traditional health promotion campaigns have had only limited success in encouraging ETS risk reduction measures in the home. Because ETS is a public health priority, particularly in relation to child health, the barriers to the uptake of such measures need to be explored in detail to inform the future promotion of reductions in domestic levels of ETS.
Lessons to be learned: a case study approach
Authors: Maisey A , Davies G J
Published: November 2005

The drinking habits of children aged 11 to 16 years attending a comprehensive school are reported. Pupils were able to access alcoholic drinks readily despite being underage. A general awareness of the health and social risks of drinking did not act as a deterrent and, alarmingly, only less than 10% of the group reported that they did not drink. Health education and the role that schools can play are highlighted.
The application of online surveys for workplace health research
Authors: Scriven A , Smith-Ferrier S
Published: November 2005

Work has a synergistic relationship to health, and workplaces are increasingly the focus for both health promotion initiatives and health research.1 Electronic technologies are a common feature of many workplaces and as such are convenient low cost survey vehicles for the health researcher. The methods and the implications of employing Internet methods for health research are covered and a wide range of issues connected with online sampling and data collection are discussed. Because the workplace does not provide a neutral research environment, the security, anonymity and associated issues of using the two main forms of Internet surveys for workplace health research are examined and their advantages and disadvantages are debated.
Factors influencing patient choice of hospitals in Riyadh, Saudi Arabia
Authors: Al-Doghaither A H , Abdelrhman B M , Saeed A A Wahid , Magzoub M E M A
Published: November 2005

This study examined factors considered important in choosing a hospital. The sample consisted of 303 respondents selected from five randomly selected primary health care centres. The percentages of males, highly educated, high-income level, elder and private sector employees was higher in those choosing private sector hospitals, while marital status did not relate to type of hospital. The principal component analysis identified six factors accounting for 64% of the total variance. The most important component was ‘medical services’ accounting for 28% of the total variance. Stepwise discriminant analysis revealed that the main factors associated with choosing a hospital were medical services, accessibility, age, sex and education. Little importance was given to income and occupation. Future recommendations outline the need for consumers’ perceptions, attitudes, suggestions and concerns to be taken into consideration when marketing the services to be provided.
The role of culture and religion in the management of diabetes: a study of Kashmiri men in Leeds
Authors: Naeem A G
Published: November 2005

This research attempted to explore the current experience and attitude towards control of diabetes among Kashmiri men with diabetes in Leeds. The data was collected by the author by conducting interviews among a total of 106 men.

The results of this survey indicate that a large number of men with diabetes were failing to control and manage their condition. The overall attitude was to enjoy life and “leave the rest to Allah.” Data indicated the large influence of cultural values dominating the behaviour of the sample population. The data showed that although a large majority of the men had been told by health professionals that they were overweight, a majority of them did not believe themselves to be so. This belief seems to have been influenced by cultural norms in which the overweight figures tend to project prosperity and well-being in the community. Similarly, first cousin marriages are common in this community. Such cultural practices may lay foundations for future hereditary complications.

The study concluded that there is a need to change attitudes towards food and exercise, and controlling sugar level and blood pressure to avoid diabetic complications. For this, both the men as well as the women must be targeted separately in the form of open days, meetings and discussions to promote healthy food consumption, physical activity and healthy living.
Historical perspectives on health
Authors: Brimblecombe P
Published: November 2005

Sanitary reform, especially that required by the Public Health Acts (1872, 1875) needed a well trained body of Sanitary Inspectors. The Sanitary Institute and other professional organisations set about improving the qualifications and standing of the people who were charged with creating a healthier urban environment on a day-to-day basis. The structures created at that time have changed much, but we can still recognise the posts, the professional associations and the journals that were created in late Victorian times. This is a testament to the quality and flexibility of the pioneering work done a century ago.
Lessons to be learned: a case study approach
Authors: West N J , Daniels I R , Carr N D
Published: November 2005

Chronic intussusception as a cause of persistent abdominal pain in children is often an overlooked diagnosis. Here we present an eight-year-old boy, who at the age of three years had an acute intussusception reduced hydrostatically with barium and who subsequently had been extensively investigated both in Wales and in Switzerland, for persistent colicky abdominal pain. He was found to have chronic intussusception, with a Meckel’s diverticulum being the cause of his symptoms.
Relationship between maternal nutrient intakes in early and late pregnancy and infants weight and proportions at birth: prospective cohort study
Authors: Langley-Evans A J , Langley-Evans S C
Published: November 2005

Experimental studies indicate that fetal undernutrition programmes life-long physiology and disease risk. The objective of this study was to investigate relationships between maternal nutrient intakes in early and late pregnancy with birth weights, placental weights, and infant proportions at birth. A prospective cohort study set in a district general hospital in the east midlands of England considered the diets of 300 pregnant women recruited from an antenatal ultrasound dating scan clinic. Estimation of nutrient intakes utilised five-day food diaries in the first and third trimesters of pregnancy. Two hundred and four diaries were returned and analysed for trimester one and 176 for trimester three. Birth weight and infant head circumference at birth were unrelated to nutrient intakes in the first or third trimester of pregnancy. Placental weight was not related to any maternal nutrient intakes. Thinness at birth was associated with low contributions of carbohydrate to dietary energy (p=0.036). The present study shows that maternal nutrition in well-nourished populations does not exert a strong influence upon fetal growth. These data suggest that reported associations between low weight, thinness or greater head circumference at birth and disease in later life are not attributable to the effects of maternal undernutrition.
The pattern and factors associated with child spacing in eastern Saudi Arabia
Authors: Al-Almaie S M
Published: November 2005

The aim of this cross-sectional study was to determine the patterns of child spacing/birth intervals in the Eastern Province of Saudi Arabia and the socio-economic factors related to them.

The study sample comprised nine to 10-year-old Saudi school children randomly selected from 14 schools in Khobar, Thoghba and Dhahran in the Eastern Province of Saudi Arabia. A two-stage sampling technique was applied and yielded a sample of 536 children. The SPSS programme was used for data analysis.

The mean preceding and succeeding birth intervals of children in the study were 26.2 ± 13.7 and 28.2 ± 12 months respectively. The most important variables that were found to be significantly correlated with the birth intervals were maternal age, level of education, family size and breastfeeding.

This is the first time birth intervals were studied for an urban area in Saudi Arabia and the Gulf region. The figures obtained are essential for any planning of mother and child health interventions. Health team members need to know this information and the variables related to them in order to advise mothers. The figures are also essential in planning measures to reduce infant and child morbidity and mortality.
Coronary heart disease prevention in Kolkata, India
Authors: Battacharyya Madhuchanda
Published: November 2005

Studies have shown that Asian Indians, both in India and the UK, have a high prevalence of coronary heart disease (CHD). A diet rich in saturated fats and a sedentary lifestyle are contributory factors. There is published data recommending dietary change as one measure for primary prevention of CHD in India.

The aims of the study were to:

• Investigate patients’ understanding and awareness of dietary measures in the prevention of CHD • Advise patients on how to modify their diet, taking into consideration religious and financial constraints • Provide some answers to the questions which patients often have about CHD and its prevention.

The project was carried out at the R G Kar Hospital, a government hospital in north Kolkata (formally Calcutta), West Bengal, in eastern India and at a general practice six kilometres south of the hospital. Patients admitted with angina, myocardial infarction, elevated serum cholesterol or a past medical history of diabetes mellitus or ischaemic heart disease, were identified. A questionnaire was devised containing a list of foods commonly used by those on Bengali food. Patients were asked to mark on the list, or report verbally, those they felt were suitable for them to eat. They were also asked about their daily food intake and advised as to how their diet could be modified.

At the hospital, 28 subjects were interviewed. Of the responses relating to identification of suitable foods 48% were found to be correct; of the responses identifying unsuitable foods 39% were correct. In general practice, 62 subjects were interviewed; 50% of the responses identifying suitable foods were correct whereas 60% of the responses identifying unsuitable foods were correct.

The study showed that there is a need for further patient education regarding the effects of diet on the heart. The study was of greater use in the general practice setting, which caters for a middle class population; this group is at greater risk of CHD due to their food habits and lifestyle. Lower classes are, however, also at risk but are less likely to consume many of the unhealthy foods simply on account of their higher price.
The boss, the owner, the proprietor…the food hygiene manager?
Authors: MacAuslan E
Published: November 2005

The ease of opening up a small food business in the UK, combined with training regulations for food handlers, together with the requirement to demonstrate food safety management systems may be an indication that managers need management training in addition to food hygiene training.

Enforcement agencies, examination bodies and trainers could play a key part in helping managers to develop effective food safety cultures. They could encourage management, and food hygiene training and development, for small food business bosses, owners and proprietors. Some of the skills that are missing are identified and suggestions put forward that will benefit those who run small food businesses in the UK.
The experiences of older people participating in exercise referral schemes
Authors: Stathi Aphrodite , McKenna James , Fox Kenneth R
Published: November 2005

Exercise referral schemes (ERS) have become a major routeway of promoting physical activity with older adults. However, there is lack of evidence regarding the views of older people and their experience from participating in ERS. The purpose of this study was to offer insights into how physical activity (PA) is situated in notions of successful ageing of people participating in ERS and to highlight points for achieving client-based targets through ERS. Thirteen community-living, retired, older adults (five females) with ages ranging from 63 to 79 who were at various stages in their referral programme were selected from three exercise referral schemes in south west England. The respondents chose to participate in either an individual or a group semi-structured interview. Findings stress that ERS clearly disrupt a lifestyle characterised by growing purposelessness and social isolation, offer older participants better physical and mental function and feelings of accomplishment and success. The participants in this study made a range of personally valued improvements through their involvement in ERS. The success of the programmes relies on the general practitioners’ recommendations, the professional help and support from enthusiastic and experienced personnel and the attractiveness of the exercise content which needs to satisfy the multiple needs of the well-being of older adults.
Childhood obesity and the role of physical activity
Authors: Fox Kenneth R
Published: November 2005

Similar to adult obesity, childhood obesity has recently become a serious threat to public health. Children face the same environmental and lifestyle challenges that have made high energy dense food and drink increasingly available and opportunities for energy expenditure through transport and active play less likely. Governments are becoming concerned but research has been under funded, is relatively scarce in the UK and has provided little sound evidence on which to base interventions.

Physical activity seems to be declining and there is some evidence that time spent in sedentary pursuits such as TV watching is increasing and that this may be related to obesity. However, not all children are inactive and it may be more fruitful to independently examine different elements of activity such as play, walking and cycling as transport, organised sports, and active jobs so that children’s profiles of activity can be mapped on an individual and group level.

Recent research using accelerometry is providing insight into those elements which produce significant energy expenditure in a child’s daily routine. The school and the structure to the school day appear particularly important. It is also likely that attention will need to be paid to parenting - the anxieties that parents demonstrate when making decisions about the freedom of their child to be active. Furthermore, without neighbourhoods that are safe and attractive for activity it is unlikely that levels will be increased. For physical activity to contribute to reversing the trend in childhood obesity, a multi-factorial and multi-agency solution will be required that involves schools, the home, the neighbourhood and considered local planning and provision.
Some puzzling situations in the onset, occurrence and future of coronary heart disease in developed and developing populations, particularly such in sub-Saharan Africa
Authors: Walker A R P , Walker B F , Segal I
Published: November 2005

Coronary heart disease (CHD) was rare in developed populations until the early 1900s; this prevailed even among the small segments who were prosperous and who, in measure, had most of the currently recognised risk factors. However, in the 1930s, with improved circumstances from general rises in socio-economic state, there were major increases in the occurrence and mortality rate from the disease, the latter reaching a third of the total mortality in some countries, as in the United Kingdom (UK). Puzzlingly, the inter-population diversity of the increases in CHD has been such that there are as much as five fold differences in CHD mortality rates, as, for example, between Poland and Spain. Within recent years, with appropriate treatments, the mortality rate has halved in some countries, again, as in the UK. However, the incidence rate of the disease has diminished little or hardly at all. Risk factors include a familial component and, nutritionally, over-eating, a high fat intake, relatively low intakes of plant foods, especially of vegetables and fruit and, non-nutritionally, smoking, excessive alcohol consumption and a low level of everyday physical activity. On the one hand, known risk factors, broadly, are considered to be capable of explaining only about half of the variation in the occurrence of the disease. Even at present, known risk factors far from fully explain the epidemiological differences in mortality rates. Yet, on the other hand, there is abundant evidence that in population groups, among whom risk factors are low or have been reduced, CHD incidence and mortality rates are lower. Notwithstanding this knowledge, broadly, there is very little interest in the general public in taking avoiding measures. As to the situation in developing populations, in sub-Saharan Africa, in urban Africans, as in Johannesburg, South Africa, despite considerable westernisation of life style and with rises in risk factors, CHD remains of very low occurrence, the situation thereby resembling, historically, its relatively slow emergence in developed populations. In most eastern countries, mortality rates remain relatively low, as in Russia and Japan. However, in major contrast, in India, rates have risen considerably in urban dwellers. Indeed, in Indian immigrants, as in those in the UK, their rate actually exceeds that in the country’s white population. In brief, much remains to be explained in the epidemiology of the disease.
Breast cancer in black African women: a changing situation
Authors: Walker Alexander R P , Adam Fatima I , Walker Betty F
Published: November 2005

Black African women in rural South Africa have a very low incidence rate of breast cancer, 5-10 per 100,000. The rate, however, is rising in the considerably increasing urban population. During the period 1994 to 1999 in Durban, enquiries revealed an average of 57 urban patients admitted to hospital each year, from a population of about 600,000 African women, indicating an age-adjusted annual incidence rate of 15.1 per 100,000. This incidence rate is very low in comparison with those in developed populations, which range from 40 to 89 per 100,000.

In the African patients studied, the mean age on admission was relatively young, 54.1±10.9 years, almost a decade earlier than patients of developed populations. Moreover, the disease was very far advanced; 21.1% were at Stage III and 63.1% at Stage IV. As to exposure to risk factors, African women in general are characterised by certain protective factors. These factors, which closely resemble those of importance in patients in developed populations are, late menarche, early age at birth of first child, high parity (with usually prolonged lactation), and being physically active. However, with ongoing changes in the lifestyle of urban African women, the protective factors are decreasing in their intensity. Changes in these respects have been associated with rises in the disease’s incidence rate. Clearly, because of the late stage of the disease at the time of the patients’ admission to hospital, and hence their poor survival rate, intensive efforts should be made to educate women to seek help at an early stage of their disease. For its avoidance, feasible protective or restraining measures are primarily to adopt a ‘prudent’ lifestyle, in respect of both dietary and non-dietary components. However, the chances of these measures being meaningfully adopted in African urban communities, unfortunately, are negligible. In consequence, further increases in incidence rate would seem inevitable.
In-patient mental health services for young people - changing to meet new needs?
Authors: Street Cathy
Published: November 2005

There is currently considerable interest in consulting with young people and involving them in the development and delivery of mental health services - both at the local and national level. This is a welcome development since, as various studies have highlighted, young people can offer both valuable insights into the services they receive and suggestions for what they want from services.

In 2003, YoungMinds, a national charity that works to promote children’s mental health, completed a two-year, in-depth qualitative study focused on a sample of in-patient units drawn from across England and Wales. Such units, found at Tier 4 (the most severe or complex problems) within Child and Adolescent Mental Health Services (CAMHS) provide highly specialist care and treatment to some of the most seriously ill and vulnerable children and young people. A key aim of the study was to give a ‘voice’ to these young people in order to help in-patient services develop their provision in ways that are possibly more ‘young-person friendly’. Alongside this, information from staff working both within in-patient units and the community was gathered, to provide an important contrasting perspective and to build up understanding of the current pressures and challenges that face service providers in this area.

In total, data was gathered from 107 young people, 35 parents and 169 staff. Information from a number of other services was also compiled to provide case study illustrations of some new models of in-patient care now emerging. Multi-centre Research Ethics Committee approval was gained for the study, with considerable attention being paid to the design of clear ‘young person’ friendly information sheets, consent forms and questionnaires. Much attention was also paid to explaining how information would be used and confidentiality respected.

The study findings reveal a picture of considerable change - of improvements but also continuing service gaps. Most importantly, there was a high level of consistency amongst young people as to the areas of greatest concern and many highly realistic, practical suggestions and requests for how in-patient provision for young people should be improved. This article outlines some of the issues raised by young people and in particular highlights the importance of information sharing and of in-patient units being properly staffed. The need for inter-agency links and coordination between in-patient and community based mental health services is also emphasised.
Maintaining cognitive health in an ageing society
Authors: Butler Robert N , Forette Françoise , Greengross Baroness Sally
Published: November 2005

A significant concern associated with growing old is the loss of cognitive function, resulting in dementia. Fortunately, the current research on ageing indicates that cognitive decline is not an inevitable function of the ageing process. Moreover, individuals can take steps to maintain cognitive health throughout life. This paper reviews the research findings and recommendations for maintaining cognitive health that were presented at a meeting sponsored by the Alliance for Health and the Future in November 2003. The meeting, ‘Placing Cognitive Health on Europe’s Social and Economic Agenda’, reviewed the current state of knowledge about cognitive health and discussed its implications for an ageing Europe. Although the brain, for reasons that remain unclear, changes with age, a growing body of research suggests that social engagement, intellectual stimulation, and physical activity play a key role in maintaining cognitive health and preventing cognitive decline. As the number of older people increases and people live longer, developing and implementing strategies for maintaining cognitive health should be a priority for both individuals and societies.
Can watching football be a component of developing a state of mental health for men?
Authors: Pringle Alan
Published: November 2005

Football supporters, by and large, continue to have a negative image and be presented in a very destructive way by the media generally. This has been reflected academically by the fact that much of the research that has been done into football and football fans has focused on negative aspects of small numbers of supporters' behaviours such as hooliganism and racism.

This paper describes a two stage study exploring some of the more positive effects noted during studies with football fans from Mansfield Town, a team currently in the third division of the English Football League.

The study explores the perceived benefits to mental health for fans gained from the supporting experience in such areas as stress relief, catharsis and the development of good parent-child relationships.

Discussion takes place around the paradox that some of the behaviours described by supporters as beneficial and done in ‘the spirit of carnival’ may challenge liberal beliefs and be viewed as antisocial and offensive. The key feature in health promotional terms is the overwhelming view of fans that the ‘carnivalesque’ behaviours stay in the football ground where such behaviours are viewed as acceptable and socially sanctioned.
Promoting mental health in students: is there a role for sleep?
Authors: Ellis Jason , Fox Pauline
Published: November 2005

Independently both the role of being a student and reporting insufficient or unsatisfactory sleep have been shown to have deleterious consequences on mental health. However, few studies have examined the combined relationship between students’ sleep patterns specifically with mental health in mind, and how individual psychological characteristics and situational factors can influence this relationship.

The purpose of this research was to examine the relationship between sleep functioning and students’ levels of perceived stress over the course of an exam period. Additionally, the influence of perfectionism (as an individual characteristic) and daytime sleep-related intrusive thoughts (sleep catastrophising) on sleep functioning and stress were also examined. Two assumptions were tested. Firstly, that stress would increase between baseline and the morning of the exam and secondly, that this relationship would be moderated by poor sleep functioning, sleep catastrophising and levels of perfectionism.

Levels of stress, sleep functioning and sleep catastrophising were examined over a seven-day period in 48 Access to Higher Education students about to take an exam and 44 non-exam taking controls. For the exam group, levels of stress and sleep catastrophising increased between time-points. At baseline higher reported perfectionism predicted stress scores. Conversely, low perfectionism predicted high stress on the morning of the exam. Additionally, going to bed later and high levels of sleep catastrophising were also related to stress levels the morning of the exam. The results suggest an association between perfectionism and pre-exam stress, and are discussed in terms of mental health promotion for higher education students.