Abstract:
STUDY OBJECTIVE:To determine the extent of intrapartum intervention received by primigravidas. DESIGN:Cross sectional survey of NHS hospitals in the UK. SETTING:One hundred and one randomly selected hospital maternity units. PARTICIPANTS:Forty consecutive primigravid women, judged to be at low risk at the start of labour, in each hospital. MAIN OUTCOME MEASURES:Seven groups of interventions or monitoring procedures were identified from the first, second, and third stages of labour: fetal monitoring, vaginal examinations, artificial rupture of membranes, augmentation of labour, pain relief, type of delivery, and episiotomy. Data were collected during 1993. MAIN RESULTS:Ninety eight hospitals took part in the study and data were collected on 3160 low risk primigravidas. Seventy four per cent of these women had continuous cardiotocography. The proportion of women having restrictive or invasive fetal monitoring showed appreciable geographical variation for both the first and second stages of labour. Using the criterion of a vaginal examination every four hours and allowing for the length of each woman's labour, 72% had more vaginal examinations than expected; there was a significant geographical variation in the number of women receiving more than five examinations. Fifty three per cent had artificial rupture of membranes; the procedure was performed over a wide range of cervical dilatations (0 cm-10 cm). Thirty eight per cent of labours were augmented, most commonly by intravenous syntocinon; the procedure showed significant geographical variation. Twenty eight per cent had a spinal block or epidural analgesia for the relief of pain; this intervention varied by geographical region only for the second stage of labour. Over one quarter of the women required instrumental delivery. Forty six per cent had an episiotomy; the frequency of this intervention varied substantially by region. There were no infant deaths. Twelve babies were recorded at birth as having a congenital anomaly. CONCLUSIONS:The rates of several interventions seem high for this low risk group and there was substantial geographical variation in the use of six interventions. Clinical trials are needed to evaluate the optimum criteria for using these interventions from which guidelines should be drawn up by local groups and the Royal College.
journal_name
J Epidemiol Community Healthjournal_title
Journal of epidemiology and community healthauthors
Williams FL,Florey CV,Ogston SA,Patel NB,Howie PW,Tindall VRdoi
10.1136/jech.52.8.494subject
Has Abstractpub_date
1998-08-01 00:00:00pages
494-500issue
8eissn
0143-005Xissn
1470-2738journal_volume
52pub_type
杂志文章,多中心研究abstract:BACKGROUND:There are substantial socioeconomic inequalities in functional limitations in old age. Resilience may offer new insights into these inequalities by identifying constellations of factors that protect some individuals from developing functional limitations despite socioeconomic adversity. METHODS:Data from 19...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2018-211736
更新日期:2019-06-01 00:00:00
abstract:STUDY OBJECTIVE:Analyses of causes of mortality in people with diabetes using data form death certificates mentioning diabetes provide unreliable estimates of mortality. Under-recording of diabetes as a cause on death certificates has been widely reported, ranging from 15-60%. Using a population based register on peopl...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.49.6.570
更新日期:1995-12-01 00:00:00
abstract::In a study of selenium status in 391 apparently healthy subjects resident in the south of England statistical examination of the data showed a significant effect with regard to age, smoking, alcohol, and oral contraceptives. The most important of these factors seems to be a combination of alcohol and smoking habits in...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.37.3.213
更新日期:1983-09-01 00:00:00
abstract::A cohort of 6168 schizophrenic patients was followed from 1957 to 1984 to determine the incidence of cancer in these patients. In the male schizophrenic patients the incidence of cancer was found to be significantly reduced in comparison with the general Danish population. This reduction was especially marked for canc...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.43.1.43
更新日期:1989-03-01 00:00:00
abstract:STUDY OBJECTIVE:To examine the effect of deprivation, crowding, maternal smoking, and breast feeding on morbidity from wheeze and diarrhoea in the first six months after birth. DESIGN:A geographically located population survey using maternal responses on self completion questionnaires. SETTING:The three health distri...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.52.7.451
更新日期:1998-07-01 00:00:00
abstract:STUDY OBJECTIVES:To compare in-hospital mortality for acute myocardial infarction (AMI) between metropolitan and non-metropolitan hospitals after adjustment for patients' severity; to examine the role of the use of effective cardiac medications in the possible mortality difference between these types of hospital. DESI...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.54.8.590
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:Even though persistent organic pollutants (POPs) are well-known neurotoxicants, there is no previous study, even cross-sectional, on the association between background exposure to POPs and clinically significant developmental disorders, such as learning disability (LD) or attention deficit disorder (ADD), amo...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2006.054700
更新日期:2007-07-01 00:00:00
abstract:STUDY OBJECTIVE:It is increasingly recognised that different dimensions of social inequality may be linked to health by different pathways. Furthermore, factors operating at the individual level such as employment conditions may affect health in a different way from household level factors. The paper examines the assoc...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.57.1.56
更新日期:2003-01-01 00:00:00
abstract:STUDY OBJECTIVE:The aim was to assess the interrelationship between alcohol intake, cigarette smoking, body weight, and blood lipid concentrations. DESIGN:This was the cross sectional (screening) phase of a prospective study. The main outcome measure was the blood lipids (serum total cholesterol, HDL cholesterol, and ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.46.3.197
更新日期:1992-06-01 00:00:00
abstract:BACKGROUND:Children have a social status position of their own, apart from that of the family, that may have an impact on short-term and long-term health. The aim of the present study was to analyse the associations between childhood social status in school (ie, peer status) and disease-specific morbidity in adulthood....
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2009.088377
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVES:Using common alcohol consumption categories, to conduct a pooled analysis of six ongoing large-scale cohort studies in Japan in order to produce concrete estimates of the quantitative contribution of alcohol consumption to all-cause and major causes of mortality in the Japanese population. METHODS:Of the 30...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2010.121830
更新日期:2012-05-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate whether cognitive performance in childhood is an early determinant of adult illness. DESIGN:Prospective cohort study covering over 30 years. SETTING:Providence, Rhode Island, USA. PARTICIPANTS:633 people ages 30-39 followed up since birth as part of the Providence cohort of the national c...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2003.016444
更新日期:2004-08-01 00:00:00
abstract::Health equity is increasingly present as an overarching goal in public health policy frameworks across the globe. Public health actions to support health equity are challenging because solutions to the root causes of health inequities often lie outside of the health sector, and a specific role for environmental public...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2018-210843
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:The effects of six income types (household post-government income, Organisation for Economic Cooperation and Development-weighted household post-government income, individual net income, corrected monthly household income and household net income from wages) on subjective health were compared in order to exa...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2009.103390
更新日期:2011-06-01 00:00:00
abstract::An ecological perspective on health emphasises both individual and contextual systems and the interdependent relations between the two. Origins of this approach have emanated from multiple disciplines over the past century or more. This article provides a glossary of perspectives, processes, and settings that pertain ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2003.018044
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Innovative strategies beyond the health system are required to reduce the prevalence of smoking. Early child development interventions are examples of interventions that can help set children on positive social and educational trajectories, which in turn may also reduce the prevalence of smoking. The aim of ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2009.101840
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Children are particularly vulnerable to the effects of extreme temperatures. OBJECTIVE:To examine the relationship between extreme temperatures and paediatric emergency department admissions (EDAs) in Brisbane, Australia, during 2003-2009. METHODS:A quasi-Poisson generalised linear model combined with a di...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2013-202725
更新日期:2014-04-01 00:00:00
abstract::Growing concern about the global burden of child mental health disorders has generated an increased interest in population-level efforts to improve child mental health. This in turn has led to a shift in emphasis away from treatment of established disorders and towards prevention and promotion. Prevention efforts are ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2013-203712
更新日期:2014-10-01 00:00:00
abstract::Delay in the presentation of symptoms and in referral of patients for surgical opinion remains an important problem in colorectal cancer. Factors influencing patients to consult early include advice from close family or other associates and abdominal pain or vomiting, or both, as one of the early symptoms. More locali...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.38.2.122
更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:Childhood mortality is a well-known public health issue, particularly in the low and middle income countries. The overarching aim of this study was to examine whether neighbourhood socioeconomic disadvantage is associated with childhood mortality beyond individual-level measures of socioeconomic status in Ni...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2015-205457
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:Differences in health, lifestyles, and use of health care between groups of varying ethnic origin can have important implications for preventive and curative health care. This paper studies whether socioeconomic factors explain ethnic differences in these outcomes. DESIGN:Data on health status, lifestyles, a...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.52.5.298
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:Identifying children at risk of poor developmental outcomes remains a challenge, but is important for better targeting children who may benefit from additional support. We explored whether data routinely collected in early life predict which children will have language disability, overweight/obesity or behav...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2018-211028
更新日期:2018-12-01 00:00:00
abstract::It is not a point of debate that the Stockholm Convention for the prevention of further accumulation of persistent organic pollutants (POPs) should be ratified and implemented by all countries. However, in their article, Schafer and Kegley present an unbalanced "worst case scenario". Approximately 20% of the food supp...
journal_title:Journal of epidemiology and community health
pub_type: 评论,杂志文章
doi:10.1136/jech.56.11.824
更新日期:2002-11-01 00:00:00
abstract:STUDY OBJECTIVE:The aims were (1) to assess whether termination of pregnancy after prenatal screening by ultrasound affected the prevalence of congenital anomalies at birth, and (2) to examine the trend of this pattern over time. DESIGN:This study deals with congenital anomalies, possibly detectable prenatally or at b...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.48.3.290
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVES:To describe the situation of the influenza in Portugal through the estimates of the incidence rates and the identification of the viral strains implicated on it during the period 1990-1996. DESIGN:The integrated clinical and laboratory surveillance system for influenza in Portugal is based on the Portuguese...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:
更新日期:1998-04-01 00:00:00
abstract::A case-control study of cancers of the upper alimentary tract was conducted in a hospital to assess the role of several risk factors, including alcohol consumption, which is reported here. Male patients from one community with cancers of the oral cavity (n = 278), pharynx (n = 225), and oesophagus (n = 236) formed the...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.42.2.187
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVES:To examine the relationship between residential change and a woman's subsequent risk of intimate partner violence (IPV), whether by a past or a new offender, a relationship that has not been prospectively examined to date. DESIGN:A dynamic cohort of women who recently changed residence (movers) was compared...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2006.047084
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:The prevalence of diagnosed diabetes among different ethnic groups and the influence of deprivation on the prevalence of diabetes among Māori and New Zealand Europeans was investigated. METHODS:This was a cross-sectional survey on all patients registered with 10 practices in the Rotorua General Practice Gro...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2008.078873
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Polychlorinated biphenyls (PCBs) are complex mixtures of persistent contaminants that are widespread in the environment. Newborns are exposed across the placenta and through breast feeding. Experimental animal studies have indicated that PCBs are neurotoxic. The neurological effects of these compounds on chi...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech.55.8.537
更新日期:2001-08-01 00:00:00
abstract:STUDY OBJECTIVE:To examine the impact of non-fatal war related injuries on physical disability in a group of war wounded civilians and to assess their needs. DESIGN:Cross sectional study. Home interviews were conducted using a structured interview schedule around one month after the injury, to assess impairments, disa...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.54.1.35
更新日期:2000-01-01 00:00:00