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Peter Ueda, Thomas Wai-Chun Lung, Yuan Lu, Joshua A Salomon, Kazem Rahimi, Philip Clarke, Goodarz Danaei
BACKGROUND: The updated national guidelines for cardiovascular risk assessment and lipid modification in the UK and US expand the indications for statin therapy in primary prevention to adults with moderate risk of cardiovascular disease (CVD) but many adults at high CVD risk remain untreated in both countries. We set out to identify treatment gaps in English and American adults at moderate and high risk of cardiovascular disease (CVD), and to estimate the number of CVD events that would be prevented from expanding statin therapy to those who are currently untreated...
2018: PloS One
Nicholas Z Muller, Peter Hans Matthews, Virginia Wiltshire-Gordon
This paper calculates the distribution of an adjusted measure of income that deducts damages due to exposure to air pollution from reported market income in the United States from 2011 to 2014. The Gini coefficient for this measure of adjusted income is 0.682 in 2011, as compared to 0.482 for market income. By 2014, we estimate that the Gini for adjusted income fell to 0.646, while the market income Gini did not appreciably change. The inclusion of air pollution damage acts like a regressive tax: with air pollution, the bottom 20% of households lose roughly 10% of the share of income, while the top 20% of households gain 10%...
2018: PloS One
John Tingle
John Tingle discusses the latest Care Quality Commission annual report on how health services in England are applying the Mental Health Act 1983, which reveals with some worrying findings.
March 22, 2018: British Journal of Nursing: BJN
Kate R Weinberger, Kipruto Kirwa, Melissa N Eliot, Julia Gold, Helen H Suh, Gregory A Wellenius
BACKGROUND: Climate change is expected to result in more heat-related, but potentially fewer cold-related, emergency department visits and deaths. The net effect of projected changes in temperature on morbidity and mortality remain incompletely understood. We estimated the change in temperature-related morbidity and mortality at two sites in southern New England, USA through the end of the 21st century. METHODS: We used distributed lag Poisson regression models to estimate the present-day associations between daily mean temperature and all-cause emergency department visits and deaths in Rhode Island and in Boston, Massachusetts...
March 16, 2018: Epidemiology
Allicia Imada, Nathaniel Nelms, David Halsey, Michael Blankstein
Background: Following total knee and hip arthroplasty, patient progress can be assessed with patient-reported outcome measures (PROMs) and performance-based outcome measures (PBOMs). The American Joint Replacement Registry 2016 guide recommends collecting several measures, including Patient Reported Outcome Measure Information System Global, Knee Injury and Osteoarthritis Outcome Score Jr, and Hip Injury and Osteoarthritis Outcome Score Jr. This study aimed to assess the current and anticipated use of PROMs and PBOMs by New England physical therapists...
March 2018: Arthroplasty Today
Abi Rimmer
No abstract text is available yet for this article.
March 20, 2018: BMJ: British Medical Journal
D'Andrea K Joseph, Daniel Daman, Rae Lynne Kinler, Karyl Burns, Lenworth Jacobs
The aim of this study was to describe the management of severe blunt renal injuries at a Level I trauma hospital. Data were collected through a record review of patients admitted from January 1, 2000, to December 31, 2011. These data were compiled as part of our hospital's participation in the Nonoperative Management of Grade IV and V Blunt Renal Injuries: A Research Consortium of New England Centers for Trauma Study. Thirty-six patients with severe blunt renal injuries were identified. Twenty-nine (80.6%) underwent nonoperative management (NOM) for their injuries...
March 1, 2018: American Surgeon
Alexandra Pitman
Analyses of population-based registers provide evidence to support an increased risk of suicide and mental illness after the suicide of a relative or partner. This editorial explores the implications of this work for progressing recommendations made in suicide prevention strategies regarding the specific support provided to people bereaved by suicide. Declaration of interest A.P. served on the Public Health England expert reference committee contributing to local guidance on commissioning and delivering postvention support (Public Health England, 2016...
April 2018: British Journal of Psychiatry: the Journal of Mental Science
Vik Veer, Henry Zhang, Jolien Beyers, Olivier Vanderveken, Bhik Kotecha
PURPOSE: The purpose of this international survey is to ascertain the current practice of drug-induced sleep endoscopy (DISE) for patients with sleep-disordered breathing (SDB) by Otolaryngologists in the United Kingdom and Belgium. We compare the results with recommendations from the European Position Paper on drug-induced sleep endoscopy. METHODS: An online questionnaire was circulated to Consultant Otolaryngologists, independent practitioners, and trainees across the two countries...
March 19, 2018: European Archives of Oto-rhino-laryngology
Christopher Vernazza, Lauren Anderson, Andrew Ian Hunter, Helen Christine Leck, Stephen Daniel O'Connor, Gillian Rose Smith, Richard Joseph Stokes, Sarah Rolland
Introduction: Given the limited evidence about the benefits of orthodontic treatment, many health care systems have rationed access to orthodontic care with the Index of Orthodontic Treatment Need (IOTN) being one tool used to attempt to allocate resources based on need. However, it is not clear whether patient and public valuations of different levels of need (as described by the IOTN) reflect the resource allocation decisions. The aim of this project was therefore to determine the values parents placed on correction of malocclusions at different IOTN levels using the willingness to pay (WTP) technique...
April 1, 2018: JDR Clinical and Translational Research
Evangelos Kontopantelis, Mamas A Mamas, Harm van Marwijk, Iain Buchan, Andrew M Ryan, Tim Doran
BACKGROUND: At a low geographical level, little is known about the associations between population characteristics and deprivation, and their trends, which would be directly affected by the house market, labour pressures and government policies. We describe temporal trends in health and overall deprivation in England by age, sex, urbanity and ethnicity. METHODS: Repeated cross-sectional whole population study for England, 2004-2015, at a low geographical level (average 1500 residents)...
March 19, 2018: Journal of Epidemiology and Community Health
Michelle Farr, Jonathan Banks, Hannah B Edwards, Kate Northstone, Elly Bernard, Chris Salisbury, Jeremy Horwood
OBJECTIVES: To examine patient and staff views, experiences and acceptability of a UK primary care online consultation system and ask how the system and its implementation may be improved. DESIGN: Mixed-method evaluation of a primary care e-consultation system. SETTING: Primary care practices in South West England. METHODS: Qualitative interviews with 23 practice staff in six practices. Patient survey data for 756 e-consultations from 36 practices, with free-text survey comments from 512 patients, were analysed thematically...
March 19, 2018: BMJ Open
Esther T van der Werf, Lorna J Duncan, Paschen von Flotow, Erik W Baars
OBJECTIVE: To determine differences in antibiotic prescription rates between conventional General Practice (GP) surgeries and GP surgeries employing general practitioners (GPs) additionally trained in integrative medicine (IM) or complementary and alternative medicine (CAM) (referred to as IM GPs) working within National Health Service (NHS) England. DESIGN: Retrospective study on antibiotic prescription rates per STAR-PU (Specific Therapeutic group Age-sex weighting Related Prescribing Unit) using NHS Digital data over 2016...
March 5, 2018: BMJ Open
Sherlly Xie, Md Jobayer Hossain
BACKGROUND: Acute myeloid leukemia (AML) is a serious disease with complex etiology and marked variation in survival. Known prognostic factors include AML subtypes, age at diagnosis and sex. However, survival outcomes may vary across healthcare systems. In this study, we evaluated the survival patterns in individuals diagnosed with AML at ages 0-24 years in the US and England between prognostic features and across countries. METHODS: We obtained data on 4387 and 2194 subjects from the US Surveillance Epidemiology and End Result registries and UK National Cancer Data Repository...
March 16, 2018: Cancer Epidemiology
Mads Gilbert
BACKGROUND: The atrocities in Syria have been covered in the four general medical weekly journals in the USA and the UK. Medical journal articles addressing political determinants of public health have rightly described and criticised the international community's failure to enforce humanitarian law while urging global bodies of power to ensure protection of civilians and civilian infrastructure and medical services. Discussions of the political influences on health of people in the occupied Palestinian territory (West Bank and Gaza Strip) seem to be considered politically out-of-bounds by some medical journals...
February 21, 2018: Lancet
Abi McNiven
The popular characterisation of acne as a mundane and insignificant feature of adolescence sits at odds with academic studies showing the detrimental impacts of the condition on people of various ages. Drawing from in-depth qualitative interviews with 13- to 25-year olds living in England, this article will consider some of the tensions between two messages about acne through the ambiguities in young people's narratives. Consistent with existing literature on skin conditions and visual differences more broadly, participants in the study recounted ways in which acne negatively shaped their lives socially and emotionally...
March 1, 2018: Health (London)
Peter Greaves
The aim of this study was to examine the impact of regional diets on the health of the poor in mid-Victorian Britain. Contemporary surveys of regional diets and living condition were reviewed. This information was compared with mortality data from Britain over the same period. Although there was an overall improvement in life expectancy during the latter part of the 19th century, there were large regional differences in lifestyle, diet and mortality rates. Dietary surveys showed that the poor labouring population in isolated rural areas of England, in the mainland and islands of Scotland and in the west of Ireland enjoyed the most nutritious diets...
March 2018: JRSM Open
Michael E Reschen, Andrea Mazzella, Edward Sharples
Background and aims: Dysfunction of a kidney transplant often requires histological sampling by percutaneous ultrasound-guided core needle biopsy. Transplant biopsy is more specialized than native kidney biopsy, the indications and complications are less well defined and in England are performed mainly by nephrologists. The aims of the study were to evaluate the adequacy and complication rate in living and deceased donor recipients according to training status of the nephrologist, assess the accuracy of physicians in predicting rejection, the threshold creatinine rise for biopsy, and the change in drug management post-biopsy...
April 2018: Annals of Medicine and Surgery
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