Jacky Chambers - Academia.edu (original) (raw)
Papers by Jacky Chambers
BMJ, Oct 19, 1991
Any government that is seriously committed to improving the health of its population must have a ... more Any government that is seriously committed to improving the health of its population must have a strategy for controlling the use of tobacco and reducing the number of people who smoke. It is therefore encouraging that The Health of the Nation recognises smoking as a key area for action and suggests a fairly ambitious target that by the year 2000 around four out of five people should be non-smokers (box).' Our discussion focuses on the relation between smoking and the prevention of disease and, drawing on experience from other countries, whether the measures outlined in the consultation document are likely to be adequate to achieve the smoking target.
PubMed, Apr 1, 1985
A survey of 2599 general practitioners was undertaken to assess personal participation, attitudes... more A survey of 2599 general practitioners was undertaken to assess personal participation, attitudes and facilities for the promotion of exercise and health. The majority of the 1049 respondents took part in two or more vigorous physical activities during an average week and believed in the importance of exercise for health and wellbeing. Most respondents accepted the importance of fitness assessments in the management of certain diseases but were unable to undertake tests, other than taking a simple history, through lack of time, equipment, staff and space.It is suggested that health authorities might do more to support the growing interest and enthusiasm for exercise promotion among general practitioners by sponsoring more postgraduate training in the physiology of exercise and practical methods of fitness testing. The provision of additional staff, equipment and facilities to support these promotion initiatives should also be encouraged.
The Journal of Trauma: Injury, Infection, and Critical Care, 1996
Moderate or severe traumatic brain injury (TBI) resulting from cranial trauma is usually easily r... more Moderate or severe traumatic brain injury (TBI) resulting from cranial trauma is usually easily recognizable. Mild TBI (MTBI), however, may escape detection at presentation because of delayed symptoms and the absence of radiographic abnormalities. Despite its subtle or delayed presentation, the spectrum of symptoms often experienced after MTBI, collectively referred to as "postconcussive syndrome," may cause serious psychosocial dysfunction. To assess the sensitivity of emergency department screening for MTBI, a prospective follow-up study was conducted on a group of patients (N = 129) who had been evaluated at a regional trauma center after blunt trauma. None had symptoms or signs of TBI at presentation, nor any history of direct cranial trauma. All were discharged to home from the emergency department without a diagnosis of TBI. At 1 month after injury, 41 of 129 (32%) patients described an increase in symptoms consistent with MTBI. The most common symptoms were insomnia (62%), headaches (58%), irritability (56%) and fatigue (56%). At 2 months, most symptoms had decreased significantly, and none had increased in severity. Despite improvement in their symptoms over that time period, 11% of those with persistent symptoms remained unable to resume their premorbid daily activities. These data, obtained from a population of patients considered to be at extremely low risk for TBI, indicate that MTBI occurs more often among blunt trauma patients than is commonly appreciated, even in busy trauma centers. Because early recognition of MTBI may expedite referral of these patients for appropriate outpatient follow-up care, thereby avoiding potentially serious social and financial repercussions, emergency department personnel should have a high index of suspicion for MTBI in any patient sustaining blunt systemic trauma. Current measures that screen for MTBI appear to be inadequate; follow-up protocols may prove to be more sensitive screening tools.
Journal of Infection, 2007
Journal of Chemical Ecology, 1983
A laboratory method has been devised for testing the attractancy of vapors to adult Oryzaephilus ... more A laboratory method has been devised for testing the attractancy of vapors to adult Oryzaephilus surinamensis (L.). Of four solvent extracts prepared from pods of the carob tree [ Ceratonia siliqua (L.)], all attracted O. surinamensis, but the least polar extract was the most active. Subdivision of extracts yielded a series of fractions, the most attractive of which contained a mixture of triglycerides with three or more double bonds per molecule. Twelve authentic triglycerides, either synthesized or purchased, elicited responses ranging from high to very low attractancy in a way which appeared to be related to the number, position, and geometrical shape of the double bonds in the molecules. By studying the response of the insects to five glyceride acids, three aldehydes, and three volatile fatty acids, it has been shown that it may be possible to explain the attractancy attributed to the triglycerides, which are involatile, in terms of the response to their volatile breakdown products.
The American Journal of Medicine, 1985
In three patients with pulmonary embolism, two-dimensional echocardiography demonstrated thrombi ... more In three patients with pulmonary embolism, two-dimensional echocardiography demonstrated thrombi within the right heart chambers. These thrombi, suspected of embolizing into the pulmonary circulation, showed varied morphology and mobility. Of the two patients undergoing embolectomy, only one survived. The third patient improved with anticoagulation therapy. Two-dimensional echocardiography is useful in evaluating patients suspected of having pulmonary thromboembolism because it may demonstrate evolution of the thrombus.
Tobacco Control, Sep 1, 1992
Journal of Public Health, 2000
Evidence-based Healthcare, 2000
BMJ, 1985
an initial plasma sodium concentration of 140 mmol(mEq)/l, a fall to 115 mmol/l would have had to... more an initial plasma sodium concentration of 140 mmol(mEq)/l, a fall to 115 mmol/l would have had to have been associated with an initial haemoglobin concentration of 16-3 g/dl, which would be unusually high in the fourth month of pregnancy. In case 2 a total fluid intake of 2-7 1 and a urinary loss of 2 02 1 also does not indicate significant water retention. An initial value for the patient's haemoglobin concentration of 15 9 g/dl (derived as in case 1) would again be unusually high. Some evidence exists that oxytocin may affect renal sodium excretion directly,l 2 and we suggest that the data and clinical features described were due not to water intoxication but to acute hyponatraemia.
Journal of Health Organization and Management, 2007
PurposeThe purpose of this paper is to evaluate the views of stove users in Ulaanbaatar, Mongolia... more PurposeThe purpose of this paper is to evaluate the views of stove users in Ulaanbaatar, Mongolia on how stoves affect their health.Design/methodology/approachIn this paper focus groups were conducted with improved stove users; traditional stove users; and a mix of traditional and improved stove users. Individual interviews were also held with various types of stove users. A translator moderated all discussions with a questioning route. All discussions were fully transcribed and translated. The transcripts were analysed by identifying common themes in responses to form an emerging theory.FindingsThe findings in the paper are that all stove users recognised respiratory symptoms caused by stove smoke and other health effects such as warmth, dirt and workload, which they perceived to be important. Stove users had a lack of knowledge about the diseases caused by the smoke. Public health was a key driver for the improved stove project, yet has been neglected in improved stove marketing.R...
Public Health, 2002
Super Profiles have been used as alternative methods of characterising the deprivation of an area... more Super Profiles have been used as alternative methods of characterising the deprivation of an area. Some reports suggest that Super Profiles are as accurate as established indices such as the Townsend score (TS). This was a test of this assertion. A total of 138 696 live born singleton births to Birmingham residents born between 1986 and 1996 (inclusive) were allocated to enumeration districts (EDs) by linkage from the postcode. We allocated the TS of the individual's ED. We allocated a Lifestyle and Target Market (TM) from Super Profiles by linkage to the ED. We examined the gradient between mean birth weight and the 10 Super Profile Lifestyles and compared this to the gradient between 10 Townsend groups and mean birth weight. We repeated this approach using the 40 TMs and 40 Townsend groups. We used both the median income and a census-derived deprivation measure to rank Lifestyles and TMs. The gradient between mean birth weight and area deprivation was linear for Townsend groups but not linear using either Lifestyles or TMs whichever method of ranking Lifestyles or TMs was used. Where Lifestyles or TMs were out of line with their neighbours, the TS of that group mostly explained this. As Super Profiles are generated using nationally representative data, applying the affluence ranking to small areas can lead to inaccuracies, as shown in this data. We conclude that Super Profiles are probably unsuitable as measures of deprivation of small areas.
2015 IEEE Eindhoven PowerTech, 2015
This paper presents experiences in applying electromechanical oscillation damping estimation meth... more This paper presents experiences in applying electromechanical oscillation damping estimation methods in real-time use from the transmission system operator's perspective. A wavelet based method and a method based on the multivariate autoregressive model are used for real-time monitoring of electromechanical oscillations. The paper analyzes the performance of these methods both under transient and ambient conditions. In the paper, real-time ambient data measured from the Nordic power system are analyzed. For transient analysis, also simulated data are used. Based on the results, recommendations regarding the use of modal analysis methods for monitoring of real power systems are given.
IET Generation, Transmission & Distribution, 2015
This study discusses the use of time-delayed remote signals available through phasor measuring un... more This study discusses the use of time-delayed remote signals available through phasor measuring units (PMUs) for low-order controller design in order to stabilise the power oscillations in the range of 0.3-0.42 Hz between two areas. In the proposed approach, first synchronisation measures are determined among the group of generators located in two areas. Then, an index that characterises the joint observability and controllability property in terms of Hankel singular values is defined as a criterion to preselect the remote feedback signal. Following this, a low-order controller design based on minimisation of H ∞ norm is considered. The measurement redundancy is taken into account in controller design using rotor angle, power flow or speed deviation as feedback signal from one of the generators. Additionally, if some specific PMU fails to provide measurements from a chosen generator, then controller effectiveness is guaranteed using signal from other generator in the same area. The performance of controller is verified considering single-step and multi-step disturbances applied to the reference voltage of exciter system. The comparison with design functions such as H 2 norm, complex stability radius and spectral abscissa are also presented. The analytical results confirm using H ∞ design algorithm provides better dynamic performance.
BMJ, Oct 19, 1991
Any government that is seriously committed to improving the health of its population must have a ... more Any government that is seriously committed to improving the health of its population must have a strategy for controlling the use of tobacco and reducing the number of people who smoke. It is therefore encouraging that The Health of the Nation recognises smoking as a key area for action and suggests a fairly ambitious target that by the year 2000 around four out of five people should be non-smokers (box).' Our discussion focuses on the relation between smoking and the prevention of disease and, drawing on experience from other countries, whether the measures outlined in the consultation document are likely to be adequate to achieve the smoking target.
PubMed, Apr 1, 1985
A survey of 2599 general practitioners was undertaken to assess personal participation, attitudes... more A survey of 2599 general practitioners was undertaken to assess personal participation, attitudes and facilities for the promotion of exercise and health. The majority of the 1049 respondents took part in two or more vigorous physical activities during an average week and believed in the importance of exercise for health and wellbeing. Most respondents accepted the importance of fitness assessments in the management of certain diseases but were unable to undertake tests, other than taking a simple history, through lack of time, equipment, staff and space.It is suggested that health authorities might do more to support the growing interest and enthusiasm for exercise promotion among general practitioners by sponsoring more postgraduate training in the physiology of exercise and practical methods of fitness testing. The provision of additional staff, equipment and facilities to support these promotion initiatives should also be encouraged.
The Journal of Trauma: Injury, Infection, and Critical Care, 1996
Moderate or severe traumatic brain injury (TBI) resulting from cranial trauma is usually easily r... more Moderate or severe traumatic brain injury (TBI) resulting from cranial trauma is usually easily recognizable. Mild TBI (MTBI), however, may escape detection at presentation because of delayed symptoms and the absence of radiographic abnormalities. Despite its subtle or delayed presentation, the spectrum of symptoms often experienced after MTBI, collectively referred to as "postconcussive syndrome," may cause serious psychosocial dysfunction. To assess the sensitivity of emergency department screening for MTBI, a prospective follow-up study was conducted on a group of patients (N = 129) who had been evaluated at a regional trauma center after blunt trauma. None had symptoms or signs of TBI at presentation, nor any history of direct cranial trauma. All were discharged to home from the emergency department without a diagnosis of TBI. At 1 month after injury, 41 of 129 (32%) patients described an increase in symptoms consistent with MTBI. The most common symptoms were insomnia (62%), headaches (58%), irritability (56%) and fatigue (56%). At 2 months, most symptoms had decreased significantly, and none had increased in severity. Despite improvement in their symptoms over that time period, 11% of those with persistent symptoms remained unable to resume their premorbid daily activities. These data, obtained from a population of patients considered to be at extremely low risk for TBI, indicate that MTBI occurs more often among blunt trauma patients than is commonly appreciated, even in busy trauma centers. Because early recognition of MTBI may expedite referral of these patients for appropriate outpatient follow-up care, thereby avoiding potentially serious social and financial repercussions, emergency department personnel should have a high index of suspicion for MTBI in any patient sustaining blunt systemic trauma. Current measures that screen for MTBI appear to be inadequate; follow-up protocols may prove to be more sensitive screening tools.
Journal of Infection, 2007
Journal of Chemical Ecology, 1983
A laboratory method has been devised for testing the attractancy of vapors to adult Oryzaephilus ... more A laboratory method has been devised for testing the attractancy of vapors to adult Oryzaephilus surinamensis (L.). Of four solvent extracts prepared from pods of the carob tree [ Ceratonia siliqua (L.)], all attracted O. surinamensis, but the least polar extract was the most active. Subdivision of extracts yielded a series of fractions, the most attractive of which contained a mixture of triglycerides with three or more double bonds per molecule. Twelve authentic triglycerides, either synthesized or purchased, elicited responses ranging from high to very low attractancy in a way which appeared to be related to the number, position, and geometrical shape of the double bonds in the molecules. By studying the response of the insects to five glyceride acids, three aldehydes, and three volatile fatty acids, it has been shown that it may be possible to explain the attractancy attributed to the triglycerides, which are involatile, in terms of the response to their volatile breakdown products.
The American Journal of Medicine, 1985
In three patients with pulmonary embolism, two-dimensional echocardiography demonstrated thrombi ... more In three patients with pulmonary embolism, two-dimensional echocardiography demonstrated thrombi within the right heart chambers. These thrombi, suspected of embolizing into the pulmonary circulation, showed varied morphology and mobility. Of the two patients undergoing embolectomy, only one survived. The third patient improved with anticoagulation therapy. Two-dimensional echocardiography is useful in evaluating patients suspected of having pulmonary thromboembolism because it may demonstrate evolution of the thrombus.
Tobacco Control, Sep 1, 1992
Journal of Public Health, 2000
Evidence-based Healthcare, 2000
BMJ, 1985
an initial plasma sodium concentration of 140 mmol(mEq)/l, a fall to 115 mmol/l would have had to... more an initial plasma sodium concentration of 140 mmol(mEq)/l, a fall to 115 mmol/l would have had to have been associated with an initial haemoglobin concentration of 16-3 g/dl, which would be unusually high in the fourth month of pregnancy. In case 2 a total fluid intake of 2-7 1 and a urinary loss of 2 02 1 also does not indicate significant water retention. An initial value for the patient's haemoglobin concentration of 15 9 g/dl (derived as in case 1) would again be unusually high. Some evidence exists that oxytocin may affect renal sodium excretion directly,l 2 and we suggest that the data and clinical features described were due not to water intoxication but to acute hyponatraemia.
Journal of Health Organization and Management, 2007
PurposeThe purpose of this paper is to evaluate the views of stove users in Ulaanbaatar, Mongolia... more PurposeThe purpose of this paper is to evaluate the views of stove users in Ulaanbaatar, Mongolia on how stoves affect their health.Design/methodology/approachIn this paper focus groups were conducted with improved stove users; traditional stove users; and a mix of traditional and improved stove users. Individual interviews were also held with various types of stove users. A translator moderated all discussions with a questioning route. All discussions were fully transcribed and translated. The transcripts were analysed by identifying common themes in responses to form an emerging theory.FindingsThe findings in the paper are that all stove users recognised respiratory symptoms caused by stove smoke and other health effects such as warmth, dirt and workload, which they perceived to be important. Stove users had a lack of knowledge about the diseases caused by the smoke. Public health was a key driver for the improved stove project, yet has been neglected in improved stove marketing.R...
Public Health, 2002
Super Profiles have been used as alternative methods of characterising the deprivation of an area... more Super Profiles have been used as alternative methods of characterising the deprivation of an area. Some reports suggest that Super Profiles are as accurate as established indices such as the Townsend score (TS). This was a test of this assertion. A total of 138 696 live born singleton births to Birmingham residents born between 1986 and 1996 (inclusive) were allocated to enumeration districts (EDs) by linkage from the postcode. We allocated the TS of the individual's ED. We allocated a Lifestyle and Target Market (TM) from Super Profiles by linkage to the ED. We examined the gradient between mean birth weight and the 10 Super Profile Lifestyles and compared this to the gradient between 10 Townsend groups and mean birth weight. We repeated this approach using the 40 TMs and 40 Townsend groups. We used both the median income and a census-derived deprivation measure to rank Lifestyles and TMs. The gradient between mean birth weight and area deprivation was linear for Townsend groups but not linear using either Lifestyles or TMs whichever method of ranking Lifestyles or TMs was used. Where Lifestyles or TMs were out of line with their neighbours, the TS of that group mostly explained this. As Super Profiles are generated using nationally representative data, applying the affluence ranking to small areas can lead to inaccuracies, as shown in this data. We conclude that Super Profiles are probably unsuitable as measures of deprivation of small areas.
2015 IEEE Eindhoven PowerTech, 2015
This paper presents experiences in applying electromechanical oscillation damping estimation meth... more This paper presents experiences in applying electromechanical oscillation damping estimation methods in real-time use from the transmission system operator's perspective. A wavelet based method and a method based on the multivariate autoregressive model are used for real-time monitoring of electromechanical oscillations. The paper analyzes the performance of these methods both under transient and ambient conditions. In the paper, real-time ambient data measured from the Nordic power system are analyzed. For transient analysis, also simulated data are used. Based on the results, recommendations regarding the use of modal analysis methods for monitoring of real power systems are given.
IET Generation, Transmission & Distribution, 2015
This study discusses the use of time-delayed remote signals available through phasor measuring un... more This study discusses the use of time-delayed remote signals available through phasor measuring units (PMUs) for low-order controller design in order to stabilise the power oscillations in the range of 0.3-0.42 Hz between two areas. In the proposed approach, first synchronisation measures are determined among the group of generators located in two areas. Then, an index that characterises the joint observability and controllability property in terms of Hankel singular values is defined as a criterion to preselect the remote feedback signal. Following this, a low-order controller design based on minimisation of H ∞ norm is considered. The measurement redundancy is taken into account in controller design using rotor angle, power flow or speed deviation as feedback signal from one of the generators. Additionally, if some specific PMU fails to provide measurements from a chosen generator, then controller effectiveness is guaranteed using signal from other generator in the same area. The performance of controller is verified considering single-step and multi-step disturbances applied to the reference voltage of exciter system. The comparison with design functions such as H 2 norm, complex stability radius and spectral abscissa are also presented. The analytical results confirm using H ∞ design algorithm provides better dynamic performance.