RESUMEN
BACKGROUND: Several studies, mainly non-UK based, have reported higher than expected mortality for individuals with mental illness. This investigation in Salford (England) was undertaken to determine local experiences. METHOD: An historical cohort design was employed with record linkage to determine status at study end: maximum follow-up was 18 years. All 6952 individuals with schizophrenia, neuroses, affective or personality disorders, enrolled on the psychiatric case register between 1 January 1968 and 31 December 1975 were recruited: there were 199 exclusions. Death was the study end-point. RESULTS: Observed mortality was 65% higher than expected and elevated throughout the whole of follow-up. Mortality was higher in younger ages, females and subjects born locally. Circulatory disorders, injury and poisoning each caused approximately one-third of the excess deaths. CONCLUSIONS: Documenting mortality risk has important applications for prioritisation, resource allocation, developing control programmes, evaluating service effectiveness, disease forecasting and future research.
Asunto(s)
Causas de Muerte , Trastornos Mentales/mortalidad , Sistema de Registros/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Estudios Transversales , Inglaterra/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Trastornos del Humor/mortalidad , Trastornos Neuróticos/mortalidad , Trastornos de la Personalidad/mortalidad , Factores de Riesgo , Esquizofrenia/mortalidadRESUMEN
This study investigated the use of measles vaccine in children with a history of egg protein hypersensitivity, referred between 1987 and 1993 to a specialist immunization facility. Two hundred children were seen of whom 199 were immunized without any adverse effect; one child had an anaphylactic reaction. The proportion experiencing an anaphylactic reaction was 0.5% (95% CI 0.01-2.75%). It is believed that a history of egg protein allergy should no longer be regarded as a contra-indication to vaccination. Skin testing prior to measles immunization should, however, continue.
Asunto(s)
Proteínas Dietéticas del Huevo/efectos adversos , Hipersensibilidad a los Alimentos/inmunología , Vacuna Antisarampión/efectos adversos , Vacuna Antisarampión/inmunología , Anafilaxia/etiología , Niño , Preescolar , Femenino , Humanos , Masculino , Sarampión/prevención & control , Pruebas CutáneasRESUMEN
HIV-related behaviour was studied in a sample of 187 injecting drug users in Stockport, most of whom were not regular users of health services. 174 of the group had shared needles, most of them within the last 4 weeks. Among the 174, more than a quarter were under 20 years of age; most had had multiple sexual partners, and only a minority ever used condoms. Most perceived themselves to be at low or no risk of HIV infection. Perception of risk was related to changes in reported sexual behaviour, but not to needle-sharing. Implications for existing control programmes are considered.
Asunto(s)
Infecciones por VIH/transmisión , Conductas Relacionadas con la Salud , Aceptación de la Atención de Salud , Abuso de Sustancias por Vía Intravenosa/psicología , Adolescente , Adulto , Femenino , Humanos , Masculino , Factores de Riesgo , Conducta SexualRESUMEN
Reasons for the non-uptake of vaccination are discussed and proposals to remedy them are considered. It is believed that the proposals outlined in the paper will be as effective in improving vaccine uptake as legislation which has worked well in other countries (e.g. Hungary and the USA).
Asunto(s)
Inmunización/estadística & datos numéricos , Aceptación de la Atención de Salud , Actitud del Personal de Salud , Educación en Salud/normas , Empleos en Salud/educación , Accesibilidad a los Servicios de Salud/normas , Humanos , Padres/educación , Reino UnidoAsunto(s)
Infección Hospitalaria/epidemiología , Brotes de Enfermedades , Gastroenteritis/epidemiología , Infecciones por Salmonella/epidemiología , Adulto , Inglaterra , Femenino , Hospitales de Distrito , Humanos , Recién Nacido , Servicio de Ginecología y Obstetricia en Hospital , Embarazo , Infecciones por Salmonella/transmisiónRESUMEN
Although an effective whooping cough vaccine has been available in the UK since the 1950s, its current association with neurotoxicity has resulted in poor uptake: as a consequence major epidemics (with significant morbidity and mortality) are still being experienced. Component (sub-unit) vaccines, which incorporate those antigens thought to be concerned with generating a protective effect, have been developed and are now available for field testing. This paper addresses how such a vaccine might be evaluated, the organization of a trial and the difficulties to be expected.
Asunto(s)
Vacuna contra la Tos Ferina/normas , Tos Ferina/prevención & control , Factores de Edad , Ensayos Clínicos como Asunto , Método Doble Ciego , Estudios de Seguimiento , Humanos , Matemática , Vacuna contra la Tos Ferina/efectos adversos , Vacuna contra la Tos Ferina/inmunología , Estudios Prospectivos , Distribución Aleatoria , VacunaciónRESUMEN
In Jamaica, an average of about 20,000 primary rubella infections is estimated to occur each year, but very few of these are notified. The true prevalence of congenital rubella syndrome (CRS) is unknown, but 207 suspected cases born during the period 1972-1981 are known to institutions for the handicaped. Better methods of surveillance, including an improved rubella notification system and a CRS Register, are needed, Although Jamaica's approach to the prevention of CRS is by selective vaccination of girls at 10 or 11 years of age, many parishes only achieve a 60-70 percent uptake in the target group. A case is made for improving uptake by extending the age range to 10-14 years (AU)