Public Health in the 1980s and 1990s: Decline and rise?

Annotated and edited transcript of a Witness Seminar held on 12 October 2004. Introduction by Professor Virginia Berridge, London School of Hygiene and Tropical Medicine.First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2006.©The Trustee of the Wellcome Trust, London, 2006.All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 12 October 2004. Introduction by Professor Virginia Berridge, London School of Hygiene and Tropical Medicine.Annotated and edited transcript of a Witness Seminar held on 12 October 2004. Introduction by Professor Virginia Berridge, London School of Hygiene and Tropical Medicine.Annotated and edited transcript of a Witness Seminar held on 12 October 2004. Introduction by Professor Virginia Berridge, London School of Hygiene and Tropical Medicine.Annotated and edited transcript of a Witness Seminar held on 12 October 2004. Introduction by Professor Virginia Berridge, London School of Hygiene and Tropical Medicine.Annotated and edited transcript of a Witness Seminar held on 12 October 2004. Introduction by Professor Virginia Berridge, London School of Hygiene and Tropical Medicine.Annotated and edited transcript of a Witness Seminar held on 12 October 2004. Introduction by Professor Virginia Berridge, London School of Hygiene and Tropical Medicine.The 1974 reorganization of the National Health Service was largely seen as a disaster for the public health profession. The post of Medical Officer of Health, with its links to local government, was replaced by the community physician, located within health services. The technician-manager rather than the activist role predominated: community medicine doctors carried little weight by comparison with their clinical colleagues. Chaired by Professor Virginia Berridge this Witness Seminar examined the decline and rise of 'public health' both nationally and internationally in the 1980s and 1990s: the impact of the 1988 Acheson Report on public health medicine on a demoralized profession; the role of new ideas about health promotion imported from the international scene; the rise of evidence-based medicine and health services research, and their impact on public health; and the movement for multidisciplinary public health (MDPH) as a new avenue for public health from the 1990s. Participants included Professor Sir Donald Acheson, Professor John Ashton, Professor Nick Black, Professor David Blane, Dr Tim Carter, Sir Iain Chalmers, Dr Aileen Clarke, Dr June Crown, Dr Jeff French, Professor Alan Glynn, Ms Shirley Goodwin, Professor Rod Griffiths, Professor Walter Holland, Professor Klim McPherson, Dr Ornella Moscucci, Dr Geoffrey Rivett, Professor Alwyn Smith and Professor Ann Taket. Berridge V, Christie D A, Tansey E M. (eds) (2006) Public health in the 1980s and 1990s: Decline and rise? Wellcome Witnesses to Twentieth Century Medicine, vol. 26. London: The Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Addiction through the Ages: a review of the development of concepts and ideas about addiction in European countries since the nineteenth century and the role of international organisations in the process

The work on addiction through the ages proceeded through 4 interlinked studies: The emergence of concepts of addiction across Europe at the national level, 1860-1980 The framing of the alcohol question at the international alcohol conferences The role of the World Health Organisation (WHO) and its expert committees in defining addiction from the 1940s to the early twenty first century The role of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) in defining concepts of addiction The long view of addiction concepts at the country level over time points to continuities and changes across countries. They have also played a significant role in international organisations, the pre World War Two alcohol conferences and the World Health Organisation (WHO) after that war. The European level through the European Monitoring Centre on Drugs and Drug Addiction has also come into the picture in more recent times with discussion of a different set of concepts. Although a degree of stability has been achieved around addiction concepts, these still encapsulate a variety of meanings which translate into different treatment and policy approaches and traditions within Europe. By understanding the history of such concepts and how and why they came in and out of use, we can better understand addiction terminology and substance use policy today

Search for Free Decay of Negative Pions in Water and Light Materials

We report on a search for the free decay component of pi- stopped in water and light materials. A non-zero value of this would be an indication of anomalous nu_e contamination to the nu_e and nu_mu_bar production at stopped-pion neutrino facilities. No free decay component of pi- was observed in water, Beryllium, and Aluminum, for which upper limits were established at 8.2E-4, 3.2E-3, and 7.7E-3, respectively

Reusable, set-based selection algorithm for matched control groups

ABSTRACT Aims The wealth of data available in linked administrative datasets offers great potential for research, but researchers face methodological and computational challenges in data preparation, due to the size and complexity of the data. The creation of matched control groups in the Secure Anonymised Information Linkage (SAIL) Databank illustrates this point: SAIL contains multiple health datasets describing millions of individuals in Wales. The volume of data creates the potential for more precise matching, but only if an appropriate algorithm can be applied. We aimed to create such an algorithm for reuse by many research projects. Methods We developed set-based code in SQL that efficiently selects matches from millions of potential combinations in a relational database environment. It is parameterized to allow different matching criteria to be employed as needed, including follow-up time around an index event. A combinatorial optimisation problem occurs when a potential control could match more than one subject, which we solved by ranking potential match pairs first by subject with the fewest potential matches, then by closeness of the match. Results One example of the algorithm’s use was the Suicide Information Database Cymru, an electronic case-control study on suicide in Wales between 2003 and 2011. Subjects who had a cause of death recorded as self-harm were each matched to twenty controls who were alive at the subject’s date of death and had the same gender and similar birth week. The rate of matching success was >99.9%, with all subjects but one matching the full twenty controls. >99.99% of the matched controls had a week of birth that was identical to the subject. The second example was a matched cohort study looking at hospital admissions and type 1 diabetes, using the Brecon register of childhood diabetes in Wales, with matching based on week of birth within two weeks, gender, county of residence, deprivation quintile, and residence in Wales at time of diagnosis. This study had a matching rate of 98.9%; 97.5% of subjects matched to five controls, and 69.8% of matches had the same week of birth. Conclusions This algorithm provides good matching performance while executing efficiently and scalably on large datasets. Its implementation as reusable code will facilitate more efficient, high-quality research in SAIL. Instead of spending many hours developing a custom solution, analysts can execute parameterized code in a few minutes. We hope it to be useful more widely beyond SAIL as well

Giant Alcohol: A Worthy Opponent for the Children of the Band of Hope

From its foundation in 1847, the temperance organisation the Band of Hope addressed its young members as consumers, victims, and agents. In the first two roles they encountered the effects of drink of necessity, but in the third role they were encouraged to seek it out, attempting to influence individuals and wider society against 'Giant Alcohol'. With an estimated membership of half the school-age population by the early twentieth century, well over three million, the Band of Hope also acted more directly to influence policy, and encouraged young people to consider issues of policy and politics. With its wide range of activities and material to educate, entertain and empower millions of children, and its radical view of the place of the child, the Band of Hope not only mobilised its child members to lobby for legal change, including prohibition, but took an active part in pointing out the cost of alcohol to society, particularly during the 14-18 war. The organisation began to decline post 1918, and this paper focuses on the address made to children by the Band of Hope in the late nineteenth and early twentieth centuries, at a time when its innovative view of children as able to understand and influence policy decisions reflected developments in the construction of childhood. This article draws on the archive of the British National Temperance League, over 50,000 items located in the Livesey Collection, University of Central Lancashire

The experience of long-term opiate maintenance treatment and reported barriers to recovery: A qualitative systematic review

Background/Aim: To inform understanding of the experience of long-term opiate maintenance and identify barriers to recovery. Methods: A qualitative systematic review. Results: 14 studies in 17 papers, mainly from the USA (65%), met inclusion criteria, involving 1,088 participants. Studies focused on methadone prescribing. Participants reported stability; however, many disliked methadone. Barriers to full recovery were primarily ‘inward focused'. Conclusion: This is the first review of qualitative literature on long-term maintenance, finding that universal service improvements could be made to address reported barriers to recovery, including involving ex-users as positive role models, and increasing access to psychological support. Treatment policies combining harm minimisation and abstinence-orientated approaches may best support individualised recovery