Commissioning groups ‘concerned’ about size and budgets

A survey of the groups due to take over commissioning NHS care is highlighting fears about their size and budgets

via BBC News – Commissioning groups ‘concerned’ about size and budgets.

Alcohol Concern Cymru: End pub energy drinks promotion

An alcohol campaign group wants pubs and clubs to stop promoting caffeine energy drinks as mixers for spirits.

via BBC News – Alcohol Concern Cymru: End pub energy drinks promotion.

The effects of hourly differences in air pollution on the risk of myocardial infarction: case crossover analysis of the MINAP database

Source: The effects of hourly differences in air pollution on the risk of myocardial infarction: case crossover analysis of the MINAP database — Bhaskaran et al. 343 — bmj.com.

This article is available freely via Open Access. Please click on the above link to view it fully.

Abstract

Objectives To investigate associations between air pollution levels and myocardial infarction (MI) on short timescales, with data at an hourly temporal resolution.

Design Time stratified case crossover study linking clinical data from the Myocardial Ischaemia National Audit Project (MINAP) with PM₁₀, ozone, CO, NO₂, and SO₂ data from the UK National Air Quality Archive. Pollution effects were investigated with delays (lags) of 1–6, 7–12, 13–18, 19–24, and 25–72 hours in both single and multi-pollutant models, adjusted for ambient temperature, relative humidity, circulating levels of influenza and respiratory syncytial virus, day of week, holidays, and residual seasonality within calendar month strata.

Setting Population based study in 15 conurbations in England and Wales.

Subjects 79 288 diagnoses of myocardial infarction recorded over the period 2003–6.

Main outcome measures Excess risk of myocardial infarction per 10 µg/m³ increase in pollutant level.

Results In single pollutant models, PM₁₀ and NO₂ levels were associated with a very short term increase in risk of myocardial infarction 1–6 hours later (excess risks 1.2% (95% confidence interval 0.3 to 2.1) and 1.1% (0.3 to 1.8) respectively per 10 μg/m³ increase); the effects persisted in multi-pollutant models, though with only weak evidence of an independent PM₁₀ effect (P=0.05). The immediate risk increases were followed by reductions in risk at longer lags: we found no evidence of any net excess risk associated with the five pollutants studied over a 72 hour period after exposure.

Conclusions Higher levels of PM₁₀ and NO₂, which are typically markers of traffic related pollution, seem to be associated with transiently increased risk of myocardial infarction 1–6 hours after exposure, but later reductions in risk suggest that air pollution may be associated with bringing events forward in time (“short-term displacement”) rather than increasing overall risk. The well established effect of air pollution on cardiorespiratory mortality may not be mediated through increasing the acute risk of myocardial infarction, but through another mechanism.

Vulnerable adult protection to be improved – Burstow

Source: Vulnerable adult protection to be improved – Burstow | News | Health Service Journal.

This article is solely the work of the HSJ. For a full copy of the article please contact the library.

Vulnerable adults will be protected in the same way as children by the next general election, the Liberal Democrat social care minister Paul Burstow has said.

 

Polio strain spreads to China from Pakistan

Polio has spread to China for the first time since 1999 after being imported from Pakistan, the World Health Organization (WHO) has confirmed.

via BBC News – Polio strain spreads to China from Pakistan.

Food and agriculture sectors are not adequately represented at UN health summit, says report

Source: Food and agriculture sectors are not adequately represented at UN health summit, says report — Arie 343 — bmj.com.

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

The agriculture and food sectors have a vital role in halting the rise in disease related to bad diet but are barely represented at this week’s UN conference on non-communicable diseases, warns the Chicago Council on Global Affairs in its report on the links between people’s health and what they eat.

 

The cost-effectiveness of public health interventions

Source: The cost-effectiveness of public health interventions.

Abstract

Background The need to make best use of limited resources in the English National Health Service is now greater than ever. This paper contributes to this endeavour by synthesizing data from cost-effectiveness evidence produced to support the development of public health guidance at the National Institute of Health and Clinical Excellence (NICE). No comprehensive list of cost-effectiveness estimates for public health interventions has previously been published in England.

Methods Cost-effectiveness estimates using English cost data were collected and analysed from 21 (of 26) economic analyses underpinning public health guidance published by NICE between 2006 and 2010.

Results Two hundred base-case cost-effectiveness estimates were analysed, 15% were cost saving (i.e. the intervention was more effective and cheaper than comparator). Eighty-five per cent were cost-effective at a threshold of £20 000 per quality-adjusted life year and 89% at the higher threshold of £30 000. A further 5.5% were above £30 000 and 5.5% of the interventions were dominated (i.e. the intervention was more costly and less effective than comparator).

Conclusions The majority of public health interventions assessed are highly cost-effective. The next challenge is to provide commissioners with a framework that allows information from economic analyses to be combined with other criteria that supports making better investment decisions at a local level.

 

Lessons from the past: celebrating the 75th anniversary of Poverty and Public Health

Source: Lessons from the past: celebrating the 75th anniversary of Poverty and Public Health.

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

Introduction: 2011 marks the 75th anniversary of the publication of George Cuthbert Mura M’Gonigle and John Kirkby’s groundbreaking study Poverty and Public Health (1936). 1, 2 It was one of the first major texts to reflect the emerging ideas of social medicine 3 and a forerunner of post-war investigations into health and social conditions such as the Black Report…

 

Risk factors and prognosis of young stroke.The FUTURE study: a prospective cohort study. Study rationale and protocol

Abstract | Risk factors and prognosis of young stroke.The FUTURE study: a prospective cohort study. Study rationale and protocol.

This article is available freely via Open Access. Please click on the above link to view it fully.

 

Abstract (provisional)

 

Background

Young stroke can have devastating consequences with respect to quality of life, the ability to work, plan or run a family, and participate in social life. Better insight into risk factors and the long-term prognosis is extremely important, especially in young stroke patients with a life expectancy of decades. To date, detailed information on risk factors and the long-term prognosis in young stroke patients, and more specific risk of mortality or recurrent vascular events, remains scarce.

Methods

The FUTURE study is a prospective cohort study on risk factors and prognosis of young ischemic and hemorrhagic stroke among 1008 patients, aged 18-50 years, included in our study database between 1-1-1980 and 1-11-2010. Follow-up visits at our research centre take place from the end of 2009 until the end of 2011. Control subjects will be recruited among the patients’ spouses, relatives or social environment. Information on mortality and incident vascular events will be retrieved via structured questionnaires. In addition, participants are invited to the research centre to undergo an extensive sub study including MRI.

Discussion

The FUTURE study has the potential to make an important contribution to increase the knowledge on risk factors and long-term prognosis in young stroke patients. Our study differs from previous studies by having a maximal follow-up of more than 30 years, including not only TIA and ischemic stroke but also hemorrhagic stroke, the addition of healthy controls and prospectively collect data during an extensive follow-up visit. Completion of the FUTURE study may provide better information for treating physicians and patients with respect to the prognosis of young stroke