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6.  Percy Stocks: an appreciation. 
PMCID: PMC478893  PMID: 1102006
7.  Patient visiting and the siting of hospitals in rural areas 
For a period of one week all visitors to Shropshire patients in geriatric, psychiatric, and subnormality hospitals were asked to give details of their journey to hospital, including the addresses from which they set out. These data, together with those of the patients in hospital that week, were used to examine (1) the effect of distance of the patient's home from hospital upon the frequency of visiting; and (2) the likely consequences of adopting a policy of concentration of all resources at two district general hospitals. Whereas greater distances between home and hospital (up to 20 miles) resulted in little reduction in the frequency of visiting of short-stay (less than six months) geriatric patients and of both short and long-stay psychiatric patients, they resulted in much less frequent visiting of long-stay geriatric patients. The large majority of subnormality patients were in hospitals outside the County; relatively large distances only were involved and it was not possible to examine this issue for these patients. It was concluded that in this predominantly rural area, the provision of all hospital services at two district general hospital sites would, on the whole, greatly reduce distances travelled by visitors to psychiatric patients and to subnormal patients, and would increase distances to geriatric patients. From the point of view of patient visiting there is certainly a case for siting long-stay (over six months) geriatric patients in units near to their homes, and possibly psychiatric and subnormal patients if their homes are at inconvenient distances from the district general hospital.
PMCID: PMC478876  PMID: 4455349
8.  Accuracy of recall of histories of oral contraceptive use 
Published retrospective studies of the relationship between the use of oral contraceptives and disease have assumed that women are able to recall their oral contraceptive histories with reasonable accuracy. The validity of this assumption has been investigated by comparing oral contraceptive histories obtained from 75 women attending family planning clinics with the information contained in the clinic records. It is concluded that simple measures of oral contraceptive use, such as whether the preparations have ever or never been used, whether they are in current use, and the total duration of use, are likely to be remembered with adequate accuracy.
PMCID: PMC478875  PMID: 4455348
9.  Prevalence of gallstones in relation to differing treatment rates for biliary disease 
This paper attempts to deduce the prevalence of gallstones by the use of previously published necropsy data. These data are interpreted as suggesting that the incidence of gallstone development is similar in North America, Australia, Great Britain, and Norway and is largely independent of age between the third and eighth decades.
Data are also presented which may imply that the total mortality for gallstones or non-malignant gallbladder disease is not greatly influenced by increasing the treatment rate from the present level in the United Kingdom.
It is believed that this evidence does not support the view that widely differing treatment rates for gallstones reflect differences in the prevalence of the disease.
PMCID: PMC478874  PMID: 4455347
10.  Incidence of congenital dislocation of the hip in Hungary 
Of the 18,219 live births registered in Békés County (Hungary) in the period 1970-72, 523 infants came to treatment for congenital dislocation of the hip. The diagnosis was verified by radiography. The incidence of 28·7 per 1,000 live births is consistent with the values noted in a previous study conducted in Budapest. Differences in applying diagnostic criteria, the high proportion of first-born infants, the unhealthy swaddling customs, and the supposedly higher occurrence of genetic predisposition to congenital dislocation of the hip may account for the high incidence, which is much greater than values reported in countries of Western Europe and North America.
PMCID: PMC478873  PMID: 4455346
11.  Programmes for the prevention of rubella during pregnancy by active immunization 
United Kingdom and United States programmes of active immunization for the prevention of rubella during pregnancy are compared and their respective advantages and disadvantages discussed. The need for revaccination is more likely to arise with the United States programme in which young children are vaccinated and where, in future, immunity in adults will become increasingly vaccine-induced.
PMCID: PMC478872  PMID: 4455345
12.  Factors associated with undergraduate alcohol use 
To examine cigarette, alcohol, and drug use among undergraduates in Cork a precoded questionnaire was mailed to one in seven (458) students, chosen systematically. The response rate was 97%. Twenty per cent of males and 36% of females do not drink, whereas 52% of males and 17% of females are social drinkers or occasional drunks. Student patterns of drinking behaviour were significantly associated with sociocultural factors, such as leisure money available, belief in a God, and frequency of attendance at religious services. Current cigarette use, experience of marijuana, and attitude to future marijuana use, to the opposite sex drinking, and to the misdemeanour considered most serious also had significant associations with alcohol-related behaviour. It appears that peer group pressures, as illustrated by the proportion of close friends drinking and sibling drinking, have a greater influence on student drinking behaviour than family-related factors such as parental drinking and parental knowledge of drinking. The effect of ambivalent attitudes towards alcohol use, demonstrated by the age at introduction and the place of introduction to alcohol, may suggest that a more relaxed attitude to alcohol should be adopted.
PMCID: PMC478871  PMID: 4455344
13.  Effect of medical education on smoking behaviour 
At Manchester University medical students (n = 658) had more knowledge than law students (n = 245) about the hazards of smoking, were more convinced by the relevant evidence, and assessed the risk to health more highly. However, there was no significant difference in their smoking behaviour. Among medical students 61% were non-smokers, 10% ex-smokers, and 29% smokers, of whom three-fifths smoked regularly. During their training they were more likely to start smoking than to give it up, and more likely to increase their consumption than decrease it. Expansion of smoking occurred especially in the early years of the course, whereas the main increase in knowledge was in the clinical period. Students' knowledge and their opinion of the evidence were related to their stage of education, whereas their assessment of the risk was linked with their smoking behaviour. Expansion of smoking at medical school may be forestalled by providing information about the hazards as early as possible, although some smokers will continue the habit irrespective of knowledge.
PMCID: PMC478870  PMID: 4455343
14.  Price and consumption of cigarettes: a case for intervention? 
It is suggested that cigarette consumption can and should be reduced by tax increases. As this contradicts a recent communication, the differences of analysis and the underlying models are discussed. Straightforward curve-fitting to serial social or economic data can be very misleading. If there is random drift, it is better to analyse consecutive changes of the parameters rather than their actual values.
PMCID: PMC478869  PMID: 4455342
15.  Bladder cancer mortality in England and Wales in relation to cigarette smoking and saccharin consumption 
Cohort analyses of bladder cancer mortality rates in men and women in England and Wales have been compared with figures for the per caput consumption of saccharin and cigarette tobacco and with similar analyses of cigarette smoking habits. The increase in bladder cancer mortality rates in male cohorts born since 1870 can be attributed to cigarette smoking, and there is no evidence of any break in the continuity of the trends in either men or women which corresponds to the introduction of saccharin.
PMCID: PMC478868  PMID: 4455341
16.  Distribution of Paget's disease in England, Wales and Scotland and a possible relationship with vitamin D deficiency in childhood 
Within England, Wales, and Scotland there are regional variations in hospital discharge rates for Paget's disease (osteitis deformans). Successive cohorts born after the 1880s show a progressive fall in mortality from Paget's disease. Because of the epidemiological similarity between the disease and rickets it is suggested that vitamin D deficiency in childhood may be a predisposing influence.
PMCID: PMC478867  PMID: 4455340
17.  Obesity in schoolchildren 
In 1971 triceps skinfold thickness was measured in a sample of 6-14-year-old children attending school in Aylesbury, Buckinghamshire. The sample consisted of 1,243 boys and 1,183 girls. In both boys and girls triceps skinfolds tended to increase with age, this being most marked in the girls. If a 25 mm triceps skinfold is taken as indicating obesity, then 32·4% of the 14-year old girls and 3·6% of the 14-year-old boys would be classified as obese. Comparison with the findings of the 1959 study of London schoolchildren suggests that obesity in 14-year-old girls has become more prevalent.
PMCID: PMC478866  PMID: 4455339
18.  General practitioners and district nurses 
Variation between Aberdeen general practitioners in referral rates for home and surgery nursing care is shown to be substantial and is related to the proportion of elderly patients in the practice, inversely to list size, to the doctor's experience, and to practice attachment of nurses. There is, however, a large unexplained variation which, it is suggested, reflects differing general practitioner perception of nursing need and nursing skill, a situation that could be improved by joint training.
PMCID: PMC478860  PMID: 4413552
19.  The new chronic psychiatric population 
Data from the Camberwell Register are used to examine the accumulation of a new chronic population in three forms of psychiatric care—inpatient, day patient, and hostel care. For the period 1964-72, against the background of expanding psychiatric services, the number and characteristics of new long-stay patients in each form of care are analysed. The net accumulation of new long-stay inpatients stabilized after a few years; the population of long-stay day patients and residents in psychiatric hostels was still increasing. The epidemiological basis of the study allows the numbers to be expressed as rates per head of population.
PMCID: PMC478859  PMID: 4213460
20.  Neural tube defects in a country town 
Eighteen infants with neural tube defects occurring in 979 births over five years in a small Wiltshire town were investigated for evidence of spatial epidemicity. Applying a method not used previously in the study of these defects, clustering was confirmed, a critical distance between cases of up to 100 metres giving a highly significant result (P = 0·001), and with one exception the observed number of pairs significantly exceeds the expected number (P < 0·01) even up to 1,000 metres.
PMCID: PMC478858  PMID: 4606840
21.  An epidemiological study of oesophageal atresia 
In a retrospective study of 227 cases of oesophageal atresia born in the south-west of England, the incidence was 0·34 per 1,000 births. Taking estimated dates of conception, there were no statistically significant yearly or monthly trends. There was a statistically significant winter excess of conceptions in the offspring of primigravidae but not multigravidae. Examination of the data for clustering, using a time-interval analysis, failed to show an increased risk of a case occurring within four weeks of a previous case. It is concluded that oesophageal atresia is aetiologically heterogeneous.
PMCID: PMC478857  PMID: 4471993
22.  Sudden unexpected death in infants in the Oxford Record Linkage Area 
One-hundred-and-seventy infants resident in the Oxford Record Linkage Area and dying suddenly and unexpectedly in the five-year period 1966-70 were linked with the records concerning their delivery. For each of these cases three controls were chosen, matched for maternal age, parity, social class, legitimacy, and place and year of delivery. The files of general hospital admissions were scanned to identify admissions to the mothers during the pregnancy, and admissions to the infants, for both index cases and controls.
Significant associations were found with short gestation, low birthweight, slight growth retardation, twin delivery, `insult' during pregnancy, induction of labour, neonatal jaundice, congenital defects, subsequent hospital admission, and month of birth. There was no association with breast feeding but some evidence for contact with other cases during hospital admission.
PMCID: PMC478856  PMID: 4415983
23.  Mutually exclusive groups of bronchitics and non-bronchitics in males 
Seven mutually exclusive groups of non-bronchitics and chronic bronchitics are derived from 10,816 steel workers questioned and examined at Port Talbot. These groups are based on various combinations of responses to the Medical Research Council questionnaire on cough, phlegm, dyspnoea, increased cough and phlegm, and chest illness. The groups are formed on defined criteria of (1) a reasonable number of men in each group; (2) impairment of lung function (FEV1) related to the severity of chronic bronchitis symptoms; and (3) impairment of lung function from certain other diseases.
The ideal group of non-bronchitics (NB 0) answered `no' to every symptomatology question (46·4%). Non-bronchitics grade 1 (NB 1) were either symptom-free or had only occasional cough and phlegm with either or both increased cough and phlegm and chest illness (24·2%). Non-bronchitics grade 2 (NB 2) complained of dyspnoea in the absence of persistent cough and phlegm (4·3%). Chronic bronchitics grade 1 (CB 1) had persistent cough and phlegm in the absence of any other complaint (11·3%). Chronic bronchitics grade 2 (CB 2) had the additional impairment of increased cough and phlegm and/or chest illness (8·1%). Grade 3 (CB 3) complained of dyspnoea with or without increased cough and phlegm (2·5%). Grade 4 (CB 4) had both dyspnoea and chest illness (3·2%).
Lung function (FEV1) in three of the groups of chronic bronchitics (CB 1, CB 2, CB 3: 21·9%) was no worse than in the two groups of non-bronchitics with complaints of other respiratory disorders (NB 1, NB 2: 28·6%). An overall comparison on a binary division between non-bronchitics and bronchitics hides the severity of some of the bronchitic groups. For this reason it is recommended that epidemiological studies of chronic bronchitis should separate the suggested grades of bronchitics (CB 1, 2, 3, and 4) and compare them with the ideal group of non-bronchitics (NB 0: 46·4%) which has the lowest prevalence of heart trouble and asthma and those who have had pneumonia.
PMCID: PMC478855  PMID: 4414747
24.  A mathematical model of an integrated haemodialysis and renal transplantation programme 
A mathematical model of an integrated renal dialysis and transplantation programme is described. The three treatment areas—hospital dialysis, home dialysis, and transplantation—are represented in the model by three states and those states are subdivided into one and two substates respectively. Interstate transitions occur at either constant average rate or with constant average probability, depending on the relevant principal constraints. In estimating future numbers in the programme, interstate transition probabilities (or rates) may be adjusted for possible changes, such as an improvement in graft survival. Projection based on data of the early years of the Cardiff unit are compared with developments in later years. The model may be used for the calculation of future numbers in other centres or nationally by substituting the appropriate interstate transition probabilities or rates.
PMCID: PMC478854  PMID: 4606122
25.  Factors affecting the visiting pattern of geriatric patients in a rural area 
For a period of one week, all visitors to Shropshire patients in geriatric units were interrogated about the method, duration, and starting point of their journey to hospital. These data, together with those of the patients, were used to examine the extent to which the duration of hospital stay, and the `crow-fly' distances of patients' and visitors' homes from the hospitals, affected visiting rates. The pronounced effect of the first factor underlines the need to consider separately those patients requiring assessment and rehabilitation from those requiring mainly custodial care when the siting of hospitals for geriatric patients is being planned. The visiting pattern for the former type of patient was not materially affected by the distance of the patient's home from hospital (within a range of 0-32 kilometres), whereas visiting rates for long-stay patients decreased rapidly as distance increased beyond 16 kilometres (10 miles).
PMCID: PMC478851  PMID: 4852001

Results 1-25 (640)