Detection and Management of Diabetes in England: Results from the Health Survey for England

<p><strong>Article full text</strong></p> <p><br> The full text of this article can be found <a href="https://link.springer.com/article/10.1007/s13300-017-0300-5"><b>here</b>.</a><br> <br> <strong>Provide enhanced content for this article</strong><br> If you are an author of this publication and would like to provide additional enhanced content for your article then please contact <u>[email protected]</u>.<br> <br> The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.<br> <br> Other enhanced features include, but are not limited to:<br> • Slide decks<br> • Videos and animations<br> • Audio abstracts<br> • Audio slides</p> <p> </p

Rule etonia : educating the Irish Catholic elite 1850-1900

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Inpatient care utilisation and expenditure associated with objective physical activity:econometric analysis of the UK Biobank

BACKGROUND Physical inactivity increases the risk of chronic disease and mortality. The high prevalence of physical inactivity in the UK is likely to increase financial pressure on the National Health Service. The UK Biobank Study offered an opportunity to assess the impact of physical inactivity on healthcare use and spending using individual-level data and objective measures of physical activity. The objective of this study was to assess the associations between objectively measured physical activity levels and future inpatient days and costs in adults in the UK Biobank study. METHODS We conducted an econometric analysis of the UK Biobank study, a large prospective cohort study. The participants (n = 86,066) were UK adults aged 43-79 who had provided sufficient valid accelerometer data. Hospital inpatient days and costs were discounted and standardised to mean monthly values per person to adjust for the variation in follow-up times. Econometric models adjusted for BMI, long-standing illness, and other sociodemographic factors. RESULTS Mean follow-up time for the sample was 28.11 (SD 7.65) months. Adults in the most active group experienced 0.037 fewer days per month (0.059-0.016) and 14.1% lower inpatient costs ( - £3.81 [ - £6.71 to  - £0.91] monthly inpatient costs) compared to adults in the least active group. The relationship between physical activity and inpatient costs was stronger in women compared to men and amongst those in the lowest income group compared to others. The findings remained significant across various sensitivity analyses. CONCLUSIONS Increasing physical activity levels in the UK may reduce inpatient hospitalisations and costs, especially in women and lower-income groups

Developing composite indices of geographical access and need for nursing home care in Ireland using multiple criteria decision analysis.

Background: Spatial accessibility has consistently been shown to influence utilisation of care and health outcomes, compared against local population needs. We sought to identify how appropriately nursing homes (NHs) are distributed in Ireland, as its NH market lacks central planning. Methods: We used multiple criteria decision analysis (MCDA) approaches to develop composite indices of both access (incorporating measures of availability, choice, quality and affordability) and local NH need for over 65s (relating to the proportion living alone, with cognitive disabilities or with low self-rated health, estimated scores for activities of daily living and instrumental activities of daily living, the average number of disabilities per person and the average age of this group). Data for need were derived from census data. Results were mapped to better understand underlying geographical patterns. Results: By comparing local accessibility and need, underserved areas could be identified, which were clustered particularly in the country's northwest. Suburbs, particularly around Dublin, were by this measure relatively overserved. Conclusions: We have developed multi-dimensional indices of both accessibility to, and need for, nursing home care. This was carried out by combining granular, open data sources and elicited expert/stakeholder opinion from practitioners. Mapping these data helped to highlight clear evidence of inequitable variation in nursing home distribution

Examining the transnational health preferences of a group of Eastern European migrants relative to a European host population using the EQ-5D-5L.

The concept of transnationalism may provide an alternative rationale to observed differences in patterns of migrant healthcare use and health-related behaviours. In this study, we examined the health preferences of Eastern European migrants residing in another European state relative to comparable natives through the prism of transnationalism. For the analysis, we focused on the health preferences of 87 Polish migrants living full-time in Ireland compared to 87 Irish natives. We used EQ-5D-5L composite Time Trade-Off (cTTO) utility data collected as part of the Irish value set during 2015/2016 to examine the health preferences of both groups. Propensity score matching was utilised to match comparable Irish respondents to Polish migrants with 1:1 matching. Since cTTO utility data is censored, a random effects Tobit model was used to explore differences in utility valuations, and in a secondary analysis, we examined the likelihood of applying a negative utility valuation using a random effects logit model. The results from this study demonstrate that on average Polish migrants apply a significantly greater disutility valuation to health states and are more likely to apply a negative utility valuation to a given health state when compared to comparable natives. Differences in utility valuations can be seen as indicative of time preference with a greater disutility valuation being associated with a higher rate of time preference. This finding may be suggestive of health-related behaviours, such as a greater likelihood of not engaging with preventive service use in as far as those with high rates of time preference have low uptake. Transnationalism can underpin the observed differences in health preferences between the Polish migrants and comparable Irish natives. Transnational ties shape health-related behaviours of migrants from the use of healthcare services to health preferences. The results of this study will be of interest to policymakers in Ireland and Europe

Factors driving inequality in prostate cancer survival: a population based study

As cancer control strategies have become more successful, issues around survival have become increasingly important to researchers and policy makers. The aim of this study was to examine the role of a range of clinical and socio-demographic variables in explaining variations in survival after a prostate cancer diagnosis, paying particular attention to the role of healthcare provider(s) i.e. private versus public status. Data were extracted from the National Cancer Registry Ireland, for patients diagnosed with prostate cancer from 1998-2009 (N = 26,183). A series of multivariate Cox and logistic regression models were used to examine the role of healthcare provider and socio-economic status (area-based deprivation) on survival, controlling for age, stage, Gleason grade, marital status and region of residence. Survival was based on all-cause mortality. Older individuals who were treated in a private care setting were more likely to have survived than those who had not, when other factors were controlled for. Differences were evident with respect to marital status, region of residence, clinical stage and Gleason grade. The effect of socio-economic status was modified by healthcare provider, such that risk of death was higher in those men of lower socio-economic status treated by public, but not private providers in the Cox models. The logistic models revealed a socio-economic gradient in risk of death overall; the gradient was larger for those treated by public providers compared to those treated by private providers when controlling for a range of other confounding factors. The role of healthcare provider and socio-economic status in survival of men with prostate cancer may give rise to concerns that warrant further investigation

Debunked: How to Tell Fact from Fiction

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