Publications

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global origin of mycobacterium tuberculosis in the midlands, uk.dna fingerprinting data for 4,207 mycobacterium tuberculosis isolates were combined with data from a computer program (origins). largest population groups were from england (n = 1,031) and india (n = 912), and most prevalent strains were the euro-american (45%) and east african-indian (34%) lineages. combining geographic and molecular data can enhance cluster investigation.201020202442
the epidemiology of attempted suicide in the oxford area, england (1989-1992).the epidemiological and clinical characteristics of attempted suicide in oxford, united kingdom, between 1989 and 1992 are reported on the basis of data collected as part of the who/euro multicentre study of parasuicide in europe. some further findings for the period 1976-1992 are also described. rates of attempted suicide were particularly high among females aged 15-19 years. there was a very marked association in males and females between attempted suicide and both lower socioeconomic status a ...19947859480
breast cancer screening; cost-effective in practice?the main aim of national breast screening is a reduction in breast cancer mortality. the data on the reduction in breast cancer mortality from three (of the five) swedish trials in particular gave rise to the expectation that the dutch programme of 2-yearly screening for women aged 50-70 would produce a 16% reduction in the total population. in all likelihood, many of the years of life gained as a result of screening are enjoyed in good health. according to its critics the actual benefit that ca ...200010674787
reduction in hospitalization rates following cardiac resynchronisation therapy in cardiac failure: experience from a single centre.frequent, lengthy hospital admissions for congestive cardiac failure (ccf) result in excessive health care costs. cardiac resynchronisation therapy (crt) is a novel treatment option for patients with ccf and associated cardiac conduction defects. we investigated whether crt resulted in significant improvements in new york heart association (nyha) symptom class, exercise tolerance, and hospitalization rates in such patients.200415519262
the effectiveness and cost effectiveness of a national lay-led self care support programme for patients with long-term conditions: a pragmatic randomised controlled trial.supporting patients' self care could have a major effect on the management of long-term conditions, which has led to worldwide interest in effective self care interventions. in england, self care support is being developed through the "expert patients programme", which provides lay-led generic courses to improve patients' self care skills. however, the clinical and cost effectiveness of such courses remains unclear.200717325405
[economic impact of healthcare-associated infections].healthcare-associated infections are not only an important public health problem but also have a relevant socioeconomic impact. the overall estimated yearly costs vary between 3.5 billion euros in the united states to 1.3 billion euros in england. in italy estimated costs are 2.5-5.0 billion euros/year with the cost of a single case ranging from 9,000 to 10,500 euros. the present study aimed to describe the type and distribution of hospital costs for healthcare-associated infections, the economi ...200919188940
estimated cost of a health visitor-led protocol for perinatal mental health.anecdotally, protocols, care pathways and clinical guidelines are time consuming to develop and sustain, but there is little research about the actual costs of their development, use and audit.this is a notable gap considering the pervasiveness of such documents that are intended to reduce unacceptable variations in practice by standardising care processes. a case study research design was used to calculate the resource use costs of a protocol for perinatal mental health, part of the core progra ...201020586374
the london low emission zone baseline study.on february 4, 2008, the world's largest low emission zone (lez) was established. at 2644 km2, the zone encompasses most of greater london. it restricts the entry of the oldest and most polluting diesel vehicles, including heavy-goods vehicles (haulage trucks), buses and coaches, larger vans, and minibuses. it does not apply to cars or motorcycles. the lez scheme will introduce increasingly stringent euro emissions standards over time. the creation of this zone presented a unique opportunity to ...201122315924
a comparison of english and french approaches to providing patients access to summary care records: scope, consent, cost.online access to records is part of the process of empowering patients. national health services in both france and england have introduced systems to provide online access to summary health data. the english system was called the "summary care record (scr)," made accessible to patients through "healthspace". the french system dossier médical personnel (dmp) is a patient controlled record clinicians enter data into. the objective was to compare the programmes and lessons from the introduction of ...201323542968
imaging at london 2012 summer olympic games: analysis of demand and distribution of workload.very little data on the provision of imaging services at the summer olympic games have been published before. with 7.9 million euros (£6.6 million, us$11 million) invested into setting up the imaging equipment at the purpose-built polyclinics for london 2012 summer olympics, an ideal opportunity was presented to study the demand and distribution of workload on imaging services at the games.201323881896
imaging services at the paralympic games london 2012: analysis of demand and distribution of workload.very little data have been published on medical imaging services at disability games. 7.9 million euros (£6.6 million, us$11 million) were invested in setting up radiology facilities within purpose built polyclinics at the london 2012 olympic and paralympic games. this paper details imaging services at the 2012 paralympic games. data analysis on imaging at 2012 olympics has been published in a separate paper.201524705230
epidemic of severe streptococcus pyogenes infections in injecting drug users in the uk, 2003-2004.during the late 1990s, increases in referrals to the national reference laboratory of streptococcus pyogenes isolates from injecting drug users (idus) with severe soft tissue infection indicated an emerging problem in the uk, later confirmed during the 2003-2004 european enhanced surveillance (strep-euro) programme. in light of these findings, further analyses were undertaken in an attempt to understand the reasons behind this increase in referrals. single and multivariable analyses were underta ...200819040471
foodborne infectious risks: do we need a wide system of data collection and survey? the lessons learned from the study of infectious intestinal disease in england.in 2000, the united kingdom government's food standards agency published "a report of the study of infectious intestinal disease in england". this report was the result of over a decade's endeavour and cost well in excess of 2 million pound sterling (approximately 3.3 million euros). the study originated in 1989. in response to national epidemics of foodborne infection with salmonella enteritidis phage type 4 and listeria monocytogenes, the government set up the committee on the microbiological ...200211938120
[comparison of the emergency medical services systems of birmingham and bonn: process efficacy and cost effectiveness].due to rising health care costs there is a need to verify that the treatment by emergency medical services (ems) systems is efficient and cost effective. the integration of emergency physicians is inherent part of out-of-hospital emergency care and regulated by law in germany but not in england and the united states of america. aim of this study therefore was to conduct a cost performance analysis by evaluating the underlying structure, the costs incurred and the achieved performance in two ems ...200314508702
measuring burden of disease in two inner london boroughs using disability adjusted life years.this paper uses the disability adjusted life year (daly) to estimate disease burden at a local level and relates this to programme budget (pb) data.200818400697
orthognathic treatment: how much does it cost?the aim of this multi-centre retrospective study was to assess the cost, and factors influencing the cost, of combined orthodontic and surgical treatment for dentofacial deformity. the sample, from the south-west of england, comprised 352 subjects (109 males and 243 females) with an age range of 14 to 57 years treated in 11 hospital orthodontic units. treatment costs were calculated for each subject by combining consumable costs with staff overhead and capital costs. the median total treatment c ...200617041085
trials and tribulations of an african-led research and capacity development programme: the case for edctp investments.we describe the initiation and establishment of the university of zambia - university college london medical school (unza-uclms) research and training project, an entirely african scientist-led, south-north partnership. in its 16 year existence, the project, by successfully obtaining competitive grant funding, has transformed itself into one of africa's most productive african-led r&d programmes with training and visible research outputs. the project serves as a role model and now networks r&d a ...201020180932
litigation following groin hernia repair in england.since 1995, litigation following surgical procedures has cost the national health service (nhs) over 1.3 billion gbp (great british pounds)/2.1 billion usd (united states dollars)/1.4 billion euros. despite it being the most commonly undertaken general surgical operation, no study has examined clinical negligence claims in england following groin hernia repairs.201020012456
measurement of no(x) fluxes from a tall tower in central london, uk and comparison with emissions inventories.direct measurements of nox concentration and flux were made from a tall tower in central london, uk as part of the clean air for london (clearflo) project. fast time resolution (10 hz) no and no2 concentrations were measured and combined with fast vertical wind measurements to provide top-down flux estimates using the eddy covariance technique. measured nox fluxes were usually positive and ranged from close to zero at night to 2000-8000 ng m(-2) s(-1) during the day. peak fluxes were usually obs ...201525494849
utilizing community and voluntary sector partnerships to survey and compare the health outcomes of hard-to- reach groups to the wider community-the euro- urhis 2 hard-to-reach project.this article describes the hard-to-reach (htr) project that was developed to capture health and lifestyle data from groups who are htr by postal surveys within the larger euro-urhis 2 project. by collaborating with partner organizations, data were collected using standard survey tools, allowing for comparison with the wider population. following a scoping exercise to determine which groups were htr in greater manchester, black and minority ethnic (bme) groups and students were selected. bme grou ...201726420845
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