Coral studied for sunscreen abilities

Coral studied for sunscreen abilities – Health News – NHS Choices.

NHS Choices looks at the science behind the headlines.

Links to the headlines

 

Sunscreen pill could be available within five years, scientists say. The Guardian, August 31 2011

 

Pill to prevent sunburn ‘within five years’. The Daily Telegraph, August 31 2011

 

Coral could hold key to sunscreen pill. BBC News, August 31 2011

 

Sunscreen pill that’s made from coral: One tablet could give weeks of protection. Daily Mail, August 31 2011

 

Sunblock tablet ‘just five years away’. Daily Mirror, August 31 2011

 

Pill that stops you getting sunburn. Daily Express, August 31 2011

 

Links to the science

 

Tropical coral could be used to create novel sunscreens for human use, say scientists. Press release, August 30 2011

Integrated systems and continuity in health care: a navigation through the concepts and models

Integrated systems and continuity in health care: a navigation through the concepts and models — Di Stanislao et al. 15 (3): 82 — International Journal of Care Pathways.

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This paper aims to share with readers some points on the matterof integration/continuity that we have reached thanks to ourprofessional experience in health-care planning and organization.These points have been confirmed by our experience in the fieldand by cross-fertilization with other branches of knowledge(sociology, epistemology, management science, education theory,etc.). They represent a difficult process of de-structuringof knowledge, but at the same time opened a path to research,discovery and learning that deeply influenced our way of understandinginstitutional organizations and has conditioned our operationalchoices and decisions.

The ‘how’ and ‘why’ of cost-effectiveness analysis for care pathways

The ‘how’ and ‘why’ of cost-effectiveness analysis for care pathways — Broughton 15 (3): 76 — International Journal of Care Pathways.

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Health service improvement interventions such as care pathwaysshould be evaluated for cost-effectiveness the same way otherhealth interventions are. I describe what cost-effectivenessanalyses (CEAs) for care pathways are, how they are conductedand how their results are interpreted. CEAs should clearly statewhat perspective they are taking, what time frame is being consideredand what research question is being addressed. Effectivenessmeasured by tangible patient outcomes (deaths averted, bed-dayssaved or QALYs [quality-adjusted life-years] gained) are preferableto process measures because they are easier for non-specialiststo understand. Having a control group is highly desirable toenhance the case for attributability. Costs include explicitand opportunity costs of implementing the care pathway. Costconsequences include the change in expenditures attributableto changes associated with the care pathway. Dividing incrementalcost by incremental effects gives an incremental cost-effectivenessratio, the common measure of relative cost-effectiveness. Carepathways that decrease cost and improve outcomes should be implementedunequivocally. Those that improve outcomes but increase costsneed to be considered according to the funder’s willingnessto pay for improved outcomes. CEAs for care pathways are asimportant as for any other health intervention and are necessaryto provide information for decision makers.

The ‘how’ and ‘why’ of cost-effectiveness analysis for care pathways

The ‘how’ and ‘why’ of cost-effectiveness analysis for care pathways — Broughton 15 (3): 76 — International Journal of Care Pathways.

An NHS Athens account may be required to view this article in full text.

Health service improvement interventions such as care pathwaysshould be evaluated for cost-effectiveness the same way otherhealth interventions are. I describe what cost-effectivenessanalyses (CEAs) for care pathways are, how they are conductedand how their results are interpreted. CEAs should clearly statewhat perspective they are taking, what time frame is being consideredand what research question is being addressed. Effectivenessmeasured by tangible patient outcomes (deaths averted, bed-dayssaved or QALYs [quality-adjusted life-years] gained) are preferableto process measures because they are easier for non-specialiststo understand. Having a control group is highly desirable toenhance the case for attributability. Costs include explicitand opportunity costs of implementing the care pathway. Costconsequences include the change in expenditures attributableto changes associated with the care pathway. Dividing incrementalcost by incremental effects gives an incremental cost-effectivenessratio, the common measure of relative cost-effectiveness. Carepathways that decrease cost and improve outcomes should be implementedunequivocally. Those that improve outcomes but increase costsneed to be considered according to the funder’s willingnessto pay for improved outcomes. CEAs for care pathways are asimportant as for any other health intervention and are necessaryto provide information for decision makers.

Multiplicity of data in trial reports and the reliability of meta-analyses: empirical study

Multiplicity of data in trial reports and the reliability of meta-analyses: empirical study — Tendal et al. 343 — bmj.com.

This article is available via Open Access. Please click on the link above.

Abstract

Objectives To examine the extent of multiplicity of data in trial reports and to assess the impact of multiplicity on meta-analysis results.

Design Empirical study on a cohort of Cochrane systematic reviews.

Data sources All Cochrane systematic reviews published from issue 3 in 2006 to issue 2 in 2007 that presented a result as a standardised mean difference (SMD). We retrieved trial reports contributing to the first SMD result in each review, and downloaded review protocols. We used these SMDs to identify a specific outcome for each meta-analysis from its protocol.

Review methods Reviews were eligible if SMD results were based on two to ten randomised trials and if protocols described the outcome. We excluded reviews if they only presented results of subgroup analyses. Based on review protocols and index outcomes, two observers independently extracted the data necessary to calculate SMDs from the original trial reports for any intervention group, time point, or outcome measure compatible with the protocol. From the extracted data, we used Monte Carlo simulations to calculate all possible SMDs for every meta-analysis.

Results We identified 19 eligible meta-analyses (including 83 trials). Published review protocols often lacked information about which data to choose. Twenty-four (29%) trials reported data for multiple intervention groups, 30 (36%) reported data for multiple time points, and 29 (35%) reported the index outcome measured on multiple scales. In 18 meta-analyses, we found multiplicity of data in at least one trial report; the median difference between the smallest and largest SMD results within a meta-analysis was 0.40 standard deviation units (range 0.04 to 0.91).

Conclusions Multiplicity of data can affect the findings of systematic reviews and meta-analyses. To reduce the risk of bias, reviews and meta-analyses should comply with prespecified protocols that clearly identify time points, intervention groups, and scales of interest.

Footnotes

• Contributors: All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. BT and EN contributed to the study equally. BT, EN, and PCG contributed to the study concept and design. BT and EN contributed to the acquisition of data and drafted the manuscript. JPTH, EN, and BT contributed to the analysis and interpretation of data. All the authors critically reviewed the manuscript for publication. PCG provided administrative, technical, and material support, and was the study supervisor and guarantor.

• Funding: This study was part of a PhD (BT) funded by IMK Charitable Fund. The funding source had no role in the design and conduct of the study; data collection, management, analysis, and interpretation; preparation, review, and approval of the manuscript; or the decision to submit the paper for publication.

• Competing interests: All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: this study is part of a PhD funded by IMK Charitable Fund; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.

• Data sharing: No additional data available.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

Roles of pathway-based models and their contribution to the redesign of health-care systems

Roles of pathway-based models and their contribution to the redesign of health-care systems — Mould and Bowers 15 (3): 90 — International Journal of Care Pathways.

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Care pathways provide a practical analytical tool that encompassesboth organizational efficiency and individual patients’ care.In the UK, constructing the care pathway has been a recommendedstarting point for the redesign of health-care systems. Thispaper examines the redesign cycle for health-care systems andlooks at the role of pathway-based models in the design andoperation phases of the cycle. In addition, the models providefurther benefits for communicating recommended practice andaudit of care and outcomes. The models span the classic carepathway with extensions to simulation modelling. An exampleof the use of care pathways in the redesign of an emergencydepartment is used for illustration. This study shows the roleof pathway models as: a tool for redesign, a catalyst for enhancingcommunication and as a repository for audit information. Thefinal role of a tool for modelling contingencies was not implemented.From the example it can be concluded that sophisticated modelscan be useful, in some applications; however, the simpler approachesmay often be the best, offering rapid, transparent recommendationsbased on a multidisciplinary approach.

The Map of Medicine and student nurses’ information-seeking behaviour

The Map of Medicine and student nurses’ information-seeking behaviour — Paget and Dundon 15 (3): 55 — International Journal of Care Pathways.

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The Map of Medicine provides access to around 400 care pathwaysfor clinicians. Its primary function is to support clinicaldecision-making and increase clinical effectiveness. It alsohas the potential to act as an educational tool. This paperseeks to explore that function and to evaluate how student nursestake advantage of this facility. Two student nursing cohortsat a single college in Wales were asked to complete two questionnaires;one at the point where the Map of Medicine was first introducedto them, and subsequently six months later. The results showthat the expressed initial enthusiasm for the Map waned overthe six months, but that most students recognized the benefitsof the online resource compared with paper-based alternatives.Traditional resources remain important and there were indicationsthat access to other resources or forgetting about using italongside the lack of IT access in a clinical setting may havepresented a barrier.

Global fall in neonatal deaths over past 20 years is too slow, says study

via Global fall in neonatal deaths over past 20 years is too slow, says study — Zarocostas 343 — bmj.com

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Despite a 29% global fall in the number of babies dying in their first month of life over the past 20 years, progress on improving neonatal mortality rates has been too slow, particularly in Africa, says a study published in PLoS Medicine

 

Patients’ experiences with patient-centred care are associated with documented outcome of care indicators for diabetes: findings from the Leuven Diabetes Project

Patients’ experiences with patient-centred care are associated with documented outcome of care indicators for diabetes: findings from the Leuven Diabetes Project — Borgermans et al. 15 (3): 65 — International Journal of Care Pathways.

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Summary: Assessment of diabetes care quality increasingly integratesmeasurements of patient perceptions. With escalating demandfor diabetic services, it is critical to evaluate patients’experiences with patient-centred care and their associationwith outcome of care indicators. Global satisfaction and experienceswith patient-centred care were evaluated in patients with type2 diabetes. Patients participated in a quality improvement programmeset-up as a two-arm clustered randomized trial. The Usual QualityImprovement Programme (UQIP) targeted clinical inertia in primarycare physicians. The Advanced Quality Improvement Programme(AQIP) aimed to reduce the rate of clinical inertia and improvethe provision of patient-centred care. Objective measures ofpatient-centred care, including overall satisfaction with careand measures related to health promotion, were associated withmean levels of glycosylated haemoglobin (HbA1c), low-densitylipoprotein cholesterol (LDLc) and systolic blood pressure (SBP),measured after 18 months of intervention. The patient responserate was 55.4%. Fifty-nine per cent of patients were very satisfiedwith quality of care. Overall satisfaction scores and patients’experiences with patient-centred care, did not significantlydiffer between AQIP and UQIP. The association between overallsatisfaction with care and HbA1c levels significantly differedbetween AQIP and UQIP (P = 0.048). Overall satisfaction withcare and LDLc levels did not significantly differ between AQIPand UQIP, or among all patients. The association between overallsatisfaction with care and SBP levels, significantly differedbetween AQIP and UQIP (P = 0.004). Positive experiences withsupport in the use of oral antidiabetic agents were associatedwith significantly lower levels of HbA1c in all patients (P= 0.006). Positive experiences with information provision ondiabetes mellitus were associated with significantly lower levelsof LDLc and SBP (P = 0.036 and 0.010, respectively), as wereexperiences with information provision on medical treatment(LDLc, P = 0.005; SBP, P = 0.003). In conclusion, results showrelatively good performance in both overall satisfaction withquality of care and in all patient-centredness measures examined.Overall satisfaction and measures of patient-centred care areassociated with improved outcomes of care, although not consistently.