Source:Predicting babies’ risk of obesity — Rudolf 96 (11): 995 — Archives of Disease in Childhood.
An NHS Athens account may be required to view this in full.
One in 10 children starting school in the UK are already obese, 1 yet a recent government poll indicated that parents worry more about their children being murdered than they do about their health. 2 How do we begin to raise awareness about the considerable risks that accompany obesity?
via Plans for information collection from NHS put doctors in “impossible position” — Cross 343 — bmj.com.
An NHS Athens account may be required to view this in full.
Provisions in the Health and Social Care Bill to improve the collection of information in the NHS in England could harm the confidentiality of GP-patient relationships, doctors have warned.
via NICE guidelines on multiple sclerosis are being ignored — Hawkes 343 — bmj.com.
An NHS Athens account may be required to view this in full.
Services for patients with multiple sclerosis have failed to show any real improvement over the past five years and guidelines are no nearer being met than when they were issued in 2003, a national audit has shown.
via Do personal health budgets lead to better care choices? — White 343 — bmj.com.
An NHS Athens account may be required to view this in full.
NHS patients are to get personal health budgets. Does this mean more money will be spent on non-evidence based treatments and private sector services? Or does giving patients responsibility for care choices improve outcomes? Caroline White reports
via Organ donors’ funeral costs should be paid, report says — Hawkes 343 — bmj.com.
An NHS Athens account may be required to view this in full.
Organ donation rates might be boosted if donors’ funeral costs were to be paid by the NHS, the Nuffield Council on Bioethics suggests in a new report.
Source: Lansley identifies 20 ‘unsustainable’ trusts | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
The government has identified 20 trusts whose “clinical and financial stability is at risk” because of “cash-flow shortages” and legacy debt
Source: Stafford Hospital receives formal warning from regulator — Dyer 343 — bmj.com.
An NHS Athens account may be required to view this in full.
Stafford Hospital, found to have “appalling” standards of care by a Healthcare Commission investigation in 2009, has received a formal warning from regulators that staff shortages could still be endangering the safety and welfare of patients in the accident and emergency department.
An NHS Athens account may be required to view this in full.
Background Although increasing participation in physical activities has significant health benefits, there are no guidelines to help professionals decide when it is safe to return to activity after injury.
Objective To examine the specific criteria (eg, strength, pain) that expert sport medicine clinicians use for return to activity decisions in children with musculoskeletal injuries.
Methods The authors conducted an online cross-sectional survey of certified Canadian sport medicine doctors (MDs) and sport rehabilitation specialists (physiotherapists (PTs) or athletic therapists (ATs)). The authors asked how they would measure each of the following signs in the context of a knee injury: sport-specific skills, pain, swelling, strength, range of motion (ROM) and balance. Clinicians also ranked the importance of each sign with respect to influencing their recommendations for each of five clinical vignettes.
Results The overall response rate was 33.6% (464/1380) with similar rates for each profession. For each clinical sign, all three professions preferred the same measure to determine readiness to return to play: standardised testing for sport-specific skills, impact on function for pain, palpation for swelling, manual muscle testing for strength, visual inspection for ROM and standing on one leg with eyes closed for balance. Regarding importance of specific signs for return to activity, all professions had similar responses for one vignette, but MDs differed from PTs and ATs for the remaining four. Finally, pain was ranked as the no 1 or 2 most important sign in all five vignettes by 41.0% of MDs, 18.1% of ATs and 11.3% of PTs, whereas sport-specific skills was chosen by 9.6% MDs, 12.0% ATs and 16.1% PTs.
Conclusion Our results provide the foundation for future work leading towards the development of interdisciplinary consensus guidelines.
An NHS Athens account may be required to view this in full.
Background Proximity to walkable destinations or amenities is thought to influence physical activity behaviour. Previous efforts attempting to calculate neighbourhood walkability have relied on self-report or time-intensive and costly measures. Walk Score is a novel and publicly available website that estimates neighbourhood walkability based on proximity to 13 amenity categories (eg, grocery stores, coffee shops, restaurants, bars, movie theatres, schools, parks, libraries, book stores, fitness centres, drug stores, hardware stores, clothing/music stores).
Objective The purpose of this study is to test the validity and reliability of Walk Score for estimating access to objectively measured walkable amenities.
Methods Walk Scores of 379 residential/non-residential addresses in Rhode Island were manually calculated. Geographic information systems (GIS) was used to objectively measure 4194 walkable amenities in the 13 Walk Score categories. GIS data were aggregated from publicly available data sources. Sums of amenities within each category were matched to address data, and Pearson correlations were calculated between the category sums and address Walk Scores.
Results Significant correlations were identified between Walk Score and all categories of aggregated walkable destinations within a 1-mile buffer of the 379 residential and non-residential addresses. Test–retest reliability correlation coefficients for a subsample of 100 addresses were 1.0.
Conclusion These results support Walk Score as a reliable and valid measure of estimating access to walkable amenities. Walk Score may be a convenient and inexpensive option for researchers interested in exploring the relationship between access to walkable amenities and health behaviours such as physical activity.
Source: Uneaten meals costing trusts £20m a year | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
Nearly eight per cent of hospital meals are returned uneaten at a cost to the NHS of more than £22m a year, according to trusts’ figures.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
A motion to enable greater scrutiny of key sections of the Health and Social Care Bill has been changed at the last minute following discussions between ministers and crossbench peers.
via Medics’ calls to scrap reforms backed by high profile figures | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
Ministers are facing demands from more than 60 leading medical professionals to scrap or substantially rewrite the coalition government’s proposed NHS reforms.
This article is available freely via Open Access. Please click on the above link to view it fully.
Measures of premature mortality have been used to guide debates on future health priorities and to monitor the population health status. Standard expected years of life lost (SEYLL) is one of the methods used to assess the time lost due to premature death. This article affords an overview of premature mortality in Spain for the year 2008.
A population-based study was conducted estimating SEYLL by sex and age groups. SEYLL, a key component of the disability-adjusted life years measure of disease burden, was calculated using Princeton West standard life tables with life expectancy at birth fixed at 80 years for males and 82.5 years for females. Population data and specific death records were obtained from the official registers of the National Institute of Statistics. All data were analysed and prepared in GesMor and Epidat software packages.
The burden of premature mortality was estimated at 2.1 million SEYLL when age at death is taken into account. Males lost 60.9% and females lost 39.1% of total SEYLL. Malignant tumors (34.5%) and cardiovascular diseases (24.0%) were the leading categories in terms of SEYLL. Ischaemic heart disease (8.5%) and lung cancers (8.0%) were the most common specific causes of SEYLL followed by cerebrovascular diseases (5.9%), colorectal cancer (4.1%), road traffic accidents (3.5%), Alzheimer and other dementias (2.9%), chronic obstructive pulmonary disease (2.8%), breast cancer (2.8%) and suicides (2.6%).
In Spain, premature mortality was essentially due to chronic non-communicable diseases. Data provided in this study are relevant for a more balanced health agenda aimed at reducing the burden of premature mortality. This study also represents a first step in estimating the overall burden of disease in terms of premature death and disability.
|
|
This article is available freely via Open Access. Please click on the above link to view it fully.
In cancer research the selection and definitions of survival endpoints are important and yet they are not used consistently. The aim of this study was to compare different survival endpoints in patients with primary colorectal cancer (CRC) and to understand the effect of second primary other cancer on disease-free survival (DFS) calculations.
A population-based cohort of 415 patients with CRC, 332 of whom were treated with curative intention between the years 2000-2003, was analysed. Events such as locoregional recurrence, distant metastases, second primary cancers, death, cause of death and loss to follow-up were recorded. Different survival endpoints, including DFS, overall survival, cancer-specific survival, relapse-free survival, time to treatment failure and time to recurrence were compared and DFS was calculated with and without inclusion of second primary other cancers.
The events that occurred most often in patients treated with curative intention were non-cancer-related death (n=74), distant metastases (n=66) and death from CRC (n=59). DFS was the survival endpoint with most events (n=170) followed by overall survival (n=144) and relapse-free survival (n=139). Fewer events were seen for time to treatment failure (n=80), time to recurrence (n=68) and cancer-specific survival (n=59). Second primary other cancer occurred in 26 patients and its inclusion as an event in DFS calculations had a detrimental effect on the survival. The DFS for patients with stage I-III disease was 62% after 5 years if second primary other cancer was not included as an event, compared with 58% if it was. However, the difference was larger for stage II (68 vs 60%) than for stage III (49 vs 47%).
The inclusion of second primary other cancer as an endpoint in DFS analyses significantly alters the DFS for patients with CRC. Researchers and journals must clearly define survival endpoints in all trial protocols and published manuscripts.
This article is available freely via Open Access. Please click on the above link to view it fully.
Cigarette smoking is a tough addiction to break. Therefore, improved approaches to smoking cessation are necessary. The electronic-cigarette (e-Cigarette), a battery-powered electronic nicotine delivery device (ENDD) resembling a cigarette, may help smokers to remain abstinent during their quit attempt or to reduce cigarette consumption. Efficacy and safety of these devices in long-term smoking cessation and/or smoking reduction studies have never been investigated.
In this prospective proof-of-concept study we monitored possible modifications in smoking habits of 40 regular smokers (unwilling to quit) experimenting the ‘Categoria’ e-Cigarette with a focus on smoking reduction and smoking abstinence. Study participants were invited to attend a total of five study visits: at baseline, week-4, week-8, week-12 and week-24. Product use, number of cigarettes smoked, and exhaled carbon monoxide (eCO) levels were measured at each visit. Smoking reduction and abstinence rates were calculated. Adverse events and product preferences were also reviewed.
Sustained 50% reduction in the number of cig/day at week-24 was shown in 13/40(32.5%) participants; their median of 25 cigs/day decreasing to 6 cigs/day (p<0.001). Sustained 80% reduction was shown in 5/40(12.5%) participants; their median of 30 cigs/day decreasing to 3 cigs/day (p=0.043). Sustained smoking abstinence at week-24 was observed in 9/40(22.5%) participants, with 6/9 still using the e-Cigarette by the end of the study. Combined sustained 50% reduction and smoking abstinence was shown in 22/40 (55%) participants, with an overall 88% fall in cigs/day. Mouth (20.6%) and throat (32.4%) irritation, and dry cough (32.4%) were common, but diminished substantially by week-24. Overall, 2 to 3 cartridges/day were used throughout the study. Participants’ perception and acceptance of the product was good.
The use of e-Cigarette substantially decreased cigarette consumption without causing significant side effects in smokers not intending to quit (ClinicalTrials.gov number NCT01195597).
