An evaluation of Birmingham Own Health telephone care management service among patients with poorly controlled diabetes. A retrospective comparison with the General Practice Research Database.

Abstract Background Telephone-based care management programmes have been shown to improve health outcomes in some chronic diseases. Birmingham Own Health® is a telephone-based care service (nurse-delivered motivational coaching and support for self-management and lifestyle change) for patients with poorly controlled diabetes, delivered in Birmingham, UK. We used a novel method to evaluate its effectiveness in a real-life setting. Methods Retrospective cohort study in the UK. 473 patients aged ≥ 18 years with diabetes enrolled onto Birmingham Own Health® (intervention cohort) and with > 90 days follow-up, were each matched by age and sex to up to 50 patients with diabetes registered with the General Practice Research Database (GPRD) to create a pool of 21,052 controls (control cohort). Controls were further selected from the main control cohort, matching as close as possible to the cases for baseline test levels, followed by as close as possible length of follow-up (within +/-30 days limits) and within +/-90 days baseline test date. The aim was to identify a control group with as similar distribution of prognostic factors to the cases as possible. Effect sizes were computed using linear regression analysis adjusting for age, sex, deprivation quintile, length of follow-up and baseline test levels. Results After adjusting for baseline values and other potential confounders, the intervention showed significant mean reductions among people with diabetes of 0.3% (95%CI 0.1, 0.4%) in HbA1c; 3.5 mmHg (1.5, 5.5) in systolic blood pressure, 1.6 mmHg (0.4, 2.7) in diastolic blood pressure and 0.7 unit reduction (0.3, 1.0) in BMI, over a mean follow-up of around 10 months. Only small effects were seen on average on serum cholesterol levels (0.1 mmol/l reduction (0.1, 0.2)). More marked effects were seen for each clinical outcome among patients with worse baseline levels. Conclusions Despite the limitations of the study design, the results are consistent with the Birmingham Own Health® telephone care management intervention being effective in reducing HbA1c levels, blood pressure and BMI in people with diabetes, to a degree comparable with randomised controlled trials of similar interventions and clinically important. The effects appear to be greater in patients with poorer baseline levels and the intervention is effective in the most deprived populations.</p

FlaME: Flash Molecular Editor - a 2D structure input tool for the web

<p>Abstract</p> <p>Background</p> <p>So far, there have been no Flash-based web tools available for chemical structure input. The authors herein present a feasibility study, aiming at the development of a compact and easy-to-use 2D structure editor, using Adobe's Flash technology and its programming language, ActionScript. As a reference model application from the Java world, we selected the Java Molecular Editor (JME). In this feasibility study, we made an attempt to realize a subset of JME's functionality in the Flash Molecular Editor (FlaME) utility. These basic capabilities are: structure input, editing and depiction of single molecules, data import and export in molfile format.</p> <p>Implementation</p> <p>The result of molecular diagram sketching in FlaME is accessible in V2000 molfile format. By integrating the molecular editor into a web page, its communication with the HTML elements on this page is established using the two JavaScript functions, <it>getMol() </it>and <it>setMol()</it>. In addition, structures can be copied to the <it>system clipboard</it>.</p> <p>Conclusion</p> <p>A first attempt was made to create a compact single-file application for 2D molecular structure input/editing on the web, based on Flash technology. With the application examples presented in this article, it could be demonstrated that the Flash methods are principally well-suited to provide the requisite communication between the Flash object (application) and the HTML elements on a web page, using JavaScript functions.</p

Parental cigarette smoking and childhood risks of hepatoblastoma: OSCC data

Historically health care data and especially health care cost data were not collected by disease. This is due on one side to a lack of readily available information on the diagnosis that led to the health care given and on the other side to the diversity of actors and organizations taking charge of patients. This results in a major difficulty of linking together incompatible and separate data. A few countries have tried to desagregate their global health cost data in a top-down approach. The limits of such undertakings appeared however quickly, not the least because of the difficulties in allocating the expenditures by sector and disease. Other approaches, probably more fecund in the long run, such as the one used by the SEER-Medicare database in the U.S. favour the linkage of individual patient clinical and cost data in a bottom-up approach. However one should not ignore the potential bias problems raised by the use of even large databases such as this one. A major advantage of clinical trials for costing purposes is that they include homogeneous groups of patients randomly allocated to several treatments for comparative purposes. They are therefore potentially better adapted for comparing new treatments with standard reference care

IUPAC specification for the FAIR management of spectroscopic data in chemistry (IUPAC FAIRSpec) - guiding principles

set of guiding principles for the development of a standard for FAIR management of spectroscopic data are outlined and discussed. The principles form the basis for future recommendations of IUPAC Project 2019-031-1-024 specifying a detailed data model and metadata schema for describing the contents of an “IUPAC FAIRData Collection” and the organization of digital objects within that collection. Foremost among the recommendations will be a specification for an “IUPAC FAIRData Finding Aid” that describes the collection in such a way as to optimize the findability, accessibility, interoperability, and reusability of its contents. Results of an analysis of data provided by an American Chemical Society Publications pilot study are discussed in relation to potential workflows that might be used in implementing the “IUPAC FAIRSpec” standard based on these principles

Breastfeeding and risk of childhood CNS tumours

We investigated infant feeding habits in relation to risk of childhood central nervous system tumours among 633 cases in the UK Childhood Cancer Study (UKCCS). No significant effect of breastfeeding was detected overall (odds ratio 1.01, confidence interval: 0.85–1.21) nor in any morphological subgroup. Similarly, no effect for the duration of breastfeeding or any other feeding practices was observed