A history of Guy’s, King’s and St. Thomas’ hospitals from 1649 to 2009: 360 Years of innovation in science and surgery

AbstractMuch has been achieved in the scientific and surgical fields over the last 360 years. Some institutions have contributed disproportionately to these advances. The medical schools and hospitals of Guy’s (est. 1721), King’s (est. 1840) and St. Thomas’ (est. 1173) seem to provide a focus and a catalyst for much innovation and creativity dating back to 1608. This review sets to provide an overview of the major contributors to surgical advances at these institutions over the last 360 years and what factors affected unique to these institutions contributed to the climate of discovery. It is based on a lecture given to the Osler Club of London (est. 1928) at the Royal College of Physicians in London on 4 November 2010. It is the author’s premise that the people and the discoveries they made within these institutions within three square miles of London changed the practice and understanding of science and healthcare as we know it today

Exploring Breast Cancer Patients’ Experiences of Struggle against Socio-Economic and Geographical Barriers in Rural Pakistan

This study offers insights into the barriers experienced by Breast Cancer (BC) patients from less privileged rural areas of Pakistan. We conducted in-depth interviews with 42 BC survivors, from the northern Sindh in southern Pakistan, to explore and analyse knowledge, geographical and financial barriers and how these barriers intersect and complicate BC patients’ lives. Results indicate that most of the women in this study were poor and their families’ health seeking behaviour was influenced by their socio-economic background; their knowledge about the disease was limited and they were unable to appropriately assess the symptoms for months, which caused delay. Based on the results, we underscore the need for increasing health education as who had a sound academic background, awareness about health as well as better social standing, accessed the treatment facility in time, approached quality healthcare services and were in a better position to cope with the aftermath of cancer. Extending the fold of quality healthcare services to less privileged areas and enabling women easy and inexpensive access to healthcare services will help in early diagnosis when treatment is affordable and chances of survival are better

A Design Exploration of Health-Related Community Displays

The global population is ageing, leading to shifts in healthcare needs. It is well established that increased physical activity can improve the health and wellbeing of many older adults. However, motivation remains a prime concern. We report findings from a series of focus groups where we explored the concept of using community displays to promote physical activity to a local neighborhood. In doing so, we contribute both an understanding of the design space for community displays, as well as a discussion of the implications of our work for the broader CSCW community. We conclude that our work demonstrates the potential for developing community displays for increasing physical activity amongst older adults

Interventions to reduce and prevent obesity in pre-conceptual and pregnant women:a systematic review and meta-analysis

BACKGROUND: The increasing prevalence of obesity in pregnant women is associated with adverse maternal and neonatal outcomes, and increased costs to healthcare, the economy and broader society. OBJECTIVES: To assess the efficacy of behavioural interventions for managing gestational weight gain (GWG) in the pre-conceptual and pregnancy period in overweight, obese and morbidly obese women. SEARCH METHODS: A search was performed for published studies in the English language, from date? 2000-31 December 2012 in five electronic databases; PubMed, Scopus, Cochrane Library, CINAHL and PsycINFO. SELECTION CRITERIA: Studies were included if they compared the efficacy or effectiveness of a particular behavioural intervention in pregnant or pre-conceptual women with standard maternity care. Studies that included women with co-morbid conditions such as diabetes mellitus and polycystic ovarian syndrome were excluded to help isolate the effect of the intervention. RESULTS: Fifteen studies involving 3,426 participants were included. One study (n = 692) focused on the pre-conceptual period and the remaining 14 (n = 2,734) in the pregnancy period. Pooled mean difference for GWG indicated a lower GWG in the intervention groups when compared to standard maternity care groups (n = 1771, mean difference (MD) -1.66 kg, 95% CI -3.12 to -0.21 kg). With respect to the types of participants, considerable heterogeneity between studies was shown in the obese subgroup [Tau(2) = 15.61; Chi(2) = 40.80, df = 3 (P<0.00001); I(2) = 93%]. CONCLUSIONS: Behavioural interventions in pregnancy may be effective in reducing GWG in obese women without comorbid conditions, but not overweight or morbidly obese women. Behavioural interventions had no effect on postpartum weight loss or retention, gestation week of delivery and infant birth weight in overweight, obese and morbidly obese women

Summary of baseline characteristics.

<p>*Mean ± Standard Deviation; N/A  =  Not applicable or Not reported; CBA  =  Control before and after; RCT  =  Randomised controlled trial; CCT  =  Controlled clinical trial.</p

Forest plot comparing gestational weight gain (kg) between those with behaviour change interventions during pregnancy and those with standard maternity care.

<p>Forest plot comparing gestational weight gain (kg) between those with behaviour change interventions during pregnancy and those with standard maternity care.</p

Summary of subgroup analysis of gestational weight gain.

<p>Summary of subgroup analysis of gestational weight gain.</p

Summary of participants.

<p>N/A  =  Not applicable or Not reported; UW  =  underweight; NW  =  normal weight; OW  =  overweight; OB  =  obese.</p

Forest plot comparing gestational weight gain (standardised mean difference in kg) between behaviour change interventions during pregnancy versus standard maternity care – sensitivity analysis.

<p>Forest plot comparing gestational weight gain (standardised mean difference in kg) between behaviour change interventions during pregnancy versus standard maternity care – sensitivity analysis.</p

Funnel plot comparing gestational weight gain (kg) between those with behaviour change interventions during pregnancy and those with standard maternity care.

<p>Funnel plot comparing gestational weight gain (kg) between those with behaviour change interventions during pregnancy and those with standard maternity care.</p