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Articles by A Tookman
Total Records ( 2 ) for A Tookman
  A. J Rodger , N Brecker , S Bhagani , T Fernandez , M Johnson , A Tookman and A. Bartley

Background Unemployment in the human immunodeficiency virus (HIV) population remains a major issue. Recent changes in the benefits system have triggered concerns about (re)integration into work for adults with HIV.

Aims To examine attitudes and barriers to employment in HIV patients.

Methods We undertook a cross-sectional study in the Royal Free HIV outpatient department from December 2008 to February 2009. The questionnaire collected data on demographics, date of HIV diagnosis, combination antiretroviral therapy, CD4 count, employment status, attitudes to work, psychological health and perception of barriers to employment. Logistic regression analyses were used to assess factors associated with not working.

Results Five hundred and forty-five HIV patients took part. Overall, 26% were not working and of these, half (53%) had been unemployed for >5 years. Associations with not working were having been diagnosed with HIV >10 years before, poor psychological health and poor attitudes to employment. There was no association between objective measures of health (CD4 count) and employment status. Those not working were less likely to agree with that ‘work is good for physical and mental health’ (90 versus 97%: P < 0.01) and more likely to agree that ‘should only work if 100% fit and well’ (76 versus 51%: P < 0.001) compared to workers. Those currently not working had negative perceptions of their abilities to gain employment and to remain in work.

Conclusions There are opportunities for HIV services to provide psychological support around attitudes associated with unemployment and to help HIV-positive men in particular obtain and remain in work.

  E. L Sampson , M. R Blanchard , L Jones , A Tookman and M. King


Increasing numbers of people will die with dementia, many in the acute hospital. It is often not perceived to be a life-limiting illness.


To investigate the prevalence of dementia in older people undergoing emergency medical admission and its effect on outcomes.


Longitudinal cohort study of 617 people (aged over 70). The main outcome was mortality risk during admission.


Of the cohort, 42.4% had dementia (only half diagnosed prior to admission). In men aged 70–79, dementia prevalence was 16.4%, rising to 48.8% of those over 90. In women, 29.6% aged 70–79 had dementia, rising to 75.0% aged over 90. Urinary tract infection or pneumonia was the principal cause of admission in 41.3% of the people with dementia. These individuals had markedly higher mortality; 24.0% of those with severe cognitive impairment died during admission (adjusted mortality risk 4.02, 95% CI 2.24–7.36).


The rising prevalence of dementia will have an impact on acute hospitals. Extra resources will be required for intermediate and palliative care and mental health liaison services.

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