Nottingham Study of Food Choice in Later Life, 1994-1996

Abstract copyright UK Data Service and data collection copyright owner.The combined ESRC/MAFF food choice project identified seven research objectives: to assess and compare the influence of taste preference factors; microeconomic factors; personal and health status factors, practical considerations, and the accessibility of retail outlets on the selection and purchase of foods within two cohorts of elderly people; to assess and compare the influence of these factors on the amount purchased and consumed by retired and elderly people living at home; to estimate the nutritional and economic 'efficiency' of food choices in this age group; to identify components in, and influences on, the purchase consumption sequence where the estimated nutritional and economic 'efficiency' of choices could be improved by changes in retail practices, transport, health education, or pensions policy, or any other area of public policy; to generate a comprehensive database describing the 'social ecology' of food choices in later life for use both in future longitudinal studies and possible secondary analyses; to compare findings for the rural communities with those of the urban communities; to identify factors influencing the consumption of vegetables, fruit, and dietary supplements in both urban and rural communities.Main Topics:The study comprised three population survey instruments: The health and diet questionnaire, which covered socio-economic circumstances, physical health, psychological well-being, mobility, use of social and health services, dentition, storage and cooking facilities, smoking, alcohol consumption, dietary restrictions, appetite, cooking skills, access to and choice of food retailers, supplement usage. The dietary diary and food frequency questionnaire, which covered food eaten and bought, cost of the food, where the food was eaten, with whom the food was eaten, frequency with which named foods were eaten, types of products eaten. The follow-up interview, which covered attitudes to food and eating, food labelling, influences on choices of foods, brands and retailers, the influence of food on health, nutritional knowledge, concerns about food risks, resistance to change, locus of control, sources of information. Standard Measures The health and diet questionnaire included the following scales: The Brief Assessment of Social Engagement (BASE) scale, and the Nottingham Life Satisfaction Index, source Morgan, K. et al (1987) <i>British Journal of Psychiatry</i>, 150, pp.801-807; The NLSAA Health Index, source Bassey, E.J.B. et al (1989) <i>European Journal of Applied Physiology</i>, 58, pp.353-360; Demi-span, source Bassey, E.J.B. (1986) <i>Annals of Human Biology</i>, 13(5), pp.499-502. Demiquet and Mindex, source Lehmann, A.B. et al (1991) <i>Clinical Nutrition</i>, 10, p.18-22. Clifton Assessment Procedures for the Elderly (CAPE), source Pattie, A.H. et al (1979) <i>Manual for the Clifton Assessment Procedures for the Elderly (CAPE)</i>, Sevenoaks: Hodder and Stoughton Educational

The cost-effectiveness of exenatide twice daily (BID) vs insulin lispro three times daily (TID) as add-on therapy to titrated insulin glargine in patients with type 2 diabetes

Objective: To evaluate the cost-effectiveness of exenatide twice daily (BID) vs bolus insulin lispro three times daily (TID) as add-on therapy when glycemic control is sub-optimal with titrated basal insulin glargine and metformin. Methods: The analysis was based on the recent 4B Study, which compared exenatide BID and lispro TID as add-on therapies in subjects with type 2 diabetes insufficiently controlled, despite titrated insulin glargine. The Cardiff Diabetes Model was used to simulate patient costs and health benefits beyond the 4B Study. The Swedish healthcare perspective was adopted for this analysis; costs are reported in €EUR to aid interpretation. The main outcome measure was the cost per quality-adjusted life-year (QALY) gained with exenatide BID compared to lispro TID. Results: Exenatide BID was associated with an incremental cost of €1,270 and a QALY increase of +0.64 compared with lispro TID over 40 years. The cost per QALY gained with exenatide BID compared with lispro TID was €1,971, which is within conventional limits of cost-effectiveness. Cost-effectiveness results were generally robust to alternative assumptions and values for key model parameters. Limitations: Extrapolation of trial data over the longer term can be influenced by modeling and parameter uncertainty. Cost-effectiveness results were generally insensitive to alternative values of key model input parameters and across scenarios. Conclusions: The addition of exenatide BID rather than insulin lispro to basal insulin is associated with similar or better clinical outcomes. Illustrated from the Swedish healthcare perspective, analysis with the Cardiff Diabetes Model demonstrated that exenatide BID represents a cost-effective treatment alternative to lispro TID as add-on therapy in type 2 diabetes patients insufficiently controlled on basal insulin

Fourth European stroke science workshop

Lake Eibsee, Garmisch-Partenkirchen, 16 to 18 November, 2017: The European Stroke Organisation convened >120 stroke experts from 21 countries to discuss latest results and hot topics in clinical, translational and basic stroke research. Since its inception in 2011, the European Stroke Science Workshop has become a cornerstone of European Stroke Organisation’s academic activities and a major highlight for researchers in the field. Participants include stroke researchers at all career stages and with different backgrounds, who convene for plenary lectures and discussions. The workshop was organised in seven scientific sessions focusing on the following topics: (1) acute stroke treatment and endovascular therapy; (2) small vessel disease; (3) opportunities for stroke research in the omics era; (4) vascular cognitive impairment; (5) intracerebral and subarachnoid haemorrhage; (6) alternative treatment concepts and (7) neural circuits, recovery and rehabilitation. All sessions started with a keynote lecture providing an overview on current developments, followed by focused talks on a timely topic with the most recent findings, including unpublished data. In the following, we summarise the key contents of the meeting. The program is provided in the online only Data Supplement. The workshop started with a key note lecture on how to improve the efficiency of clinical trial endpoints in stroke, which was delivered by Craig Anderson (Sydney, Australia) and set the scene for the following discussions