To assess the usefulness of a centralised injury database in monitoring progress towards nationally set health targets for the reduction of childhood injuries.West Glamorgan County, Wales.Analysis was undertaken of data held in the West Glamorgan injury database which amalgamates population data with data from the three hospital units covering a population of 370,000. All first attendances due to a new injury in children aged 0-14 occurring in 1993 were analysed, with subgroup analysis for injuries occurring in the home and injuries resulting in fractures. Standardised injury ratios were compared with the distance travelled, car ownership, and Townsend index of deprivation at the ward level, using multiple linear regression.A total of 10,117 first time visits due to injuries were recorded, representing a rate of 182 injuries/1000 children aged 0-14 in West Glamorgan County. Distance from home to the accident and emergency departments was inversely correlated with total injury attendances, and injuries occurring at home, but not with injuries resulting in fractures. Visit rates for any type of injury were not associated with local car ownership rates or deprivation indices.Proximity to accident and emergency departments is a strong determinant of the use of the service by children with overall injuries, and injuries occurring at home. The lack of a significant association between travel distance and injuries resulting in fractures suggests that it is more meaningful to use a centralised database of accident and emergency department attendances to monitor the more severe spectrum of childhood injuries in assessing progress towards national targets for their reduction. The absence of an association between severe injuries and local socioeconomic factors suggests that national targets for the reduction of socioeconomic differentials in childhood injuries may need to be reassessed. These databases are also useful in generating information to direct preventive strategies and to target resources to areas of greatest need.
Correspondence to : Dr RA Lyons, Consultant in Public Health Medicine, West Glamorgan Health Authority, 36 Orchard Street, Swansea SAI 5AQ, South Wales, UK Abstract Objective To assess the health status of ever-smokers and never-smokers. Design Person-to-person interview us ing structured questionnaire which con tained the SF-36 and a variety of ques tions on lifestyle. Setting Participants' homes, in West Glamorgan, South Wales, UK. Subjects Twelve hundred adults, aged 20-89 years, were randomly selected from the register of the Family Health Services Authority. Main outcome measures -The eight scales within the SF-36 health profile. Results -The response rate was 82%. Only 53.2% had ever smoked. Ever smokers reported a significantly worse health experience in four of the eight parameters measured by the SF-36; in other words, they perceived themselves to be less physically active, experienced more bodily pain, had less vitality, and in general, considered themselves to be less healthy. There was no difference in role limitations due to physical problems, social functioning, role limitations due to emotional problems, or mental health between the two groups. Conclusions Studies which measure the general health effects, rather than disease effects, of smoking may be more mean ingful to the general public and might be expected to have a greater impact on those who smoke or who are considering whether to smoke.
OBJECTIVE--To assess the health status of patients with 11 common illnesses--asthma, diabetes, arthritis, back pain, sciatica, hypertension, angina, anxiety, depression, and heart attack and stroke. DESIGN--Face to face interview using a structured questionnaire which contained the Short Form 36 questionnaire (SF-36) and questions on lifestyle, health service utilisation, and self reported conditions treated by physicians. SETTING--Patients9 homes, in West Glamorgan, Wales. SUBJECTS--Twelve hundred adults, aged 20-89 years, were randomly selected from the register of the family health services authority. MAIN OUTCOME MEASURES--The eight scales within the SF-36 health profile. RESULTS--The response rate was 82%. Each illness had a distinctive profile; patients with anxiety or depression reported the worst health experience in role limitations because of emotional problems and mental health, while patients with back pain, arthritis, or sciatica registered the three highest negative scores in bodily pain and role limitations due to physical problems. For all disease groups, the general health perceptions of those with the disease was significantly worse than those without it (p < 0.01). CONCLUSIONS--The SF-36 allows comparison of the health status of patients suffering from different conditions. Data such as these can be used to inform better purchasing decisions on how resources might be more effectively deployed and as a bench mark to monitor the effects of multiple health care interventions by conducting serial surveys.
A common source outbreak of small round structure virus (SRSV) gastroenteritis affected 81 patients and 114 staff in four hospitals served by one central hospital kitchen. Eating salad items was found to be significantly associated with illness. In a cohort study of a staff buffet function eating turkey salad sandwiches was associated with illness (relative risk = 2.4; 95% CI = 1.4-4.1; P = 0.003), and a case control study of patients in one hospital showed an odds ratio of 6.6 (95% CI = 1.0-71.6; P = 0.04) for eating tuna salad and becoming ill. One of two food handlers who prepared the salads became ill the day following food preparation; she also had a young child at home who had been ill with a gastrointestinal illness during the previous two days. Contamination of food by mechanical transmission of the virus from the child via clothes and hands of the mother, or pre-symptomatic faecal excretion in the mother are possible explanations of contamination of food.
Background: We tested 14,766 sera collected during the first wave of pandemic influenza H1N1 (pdmH1N1) in Hong Kong using viral microneutralization (MN). Each serum specimen was tested for seropositivity at MN titers of 1:20 and 1:40. Combining these serologic data with clinical surveillance data, we estimated the transmission and severity parameters using an age-structured SIR model with four age groups: 0-12, 13-19, 20-29, and 30-59. Methods: Combining data from serological study and clinical surveillance data obtained from E-Flu database in Hong Kong, we use an age-structured SIR transmission model to estimate transmission and severity parameters of pdmH1N1, such as basic reproductive number and case hospitalization probability. Results: We estimated that the basic reproductive number was 1.49. Older age groups were more likely to possess immunity before the pandemic and were less susceptible to pdmH1N1 infections if they did not have pre-pandemic immunity. School closure reduced within-age-group transmission by 75% among the 0-12 year olds but only 26% among the 13-19 year olds. The mean delay between symptoms onset and seropositivity at MN titers 1:20 and 1:40 were around 3 and 10 days, respectively. Conclusion: Serial cross-sectional serologic data together with clinical surveillance data can be used to completely characterize the transmission dynamics and severity of an influenza pandemic. Serologic monitoring should be considered in pandemic surveillance.
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