There is growing evidence of the effectiveness of early childhood interventions to improve the growth and development of children. Although, historically, nutrition and stimulation interventions may have been delivered separately, they are increasingly being tested as a package of early childhood interventions that synergistically improve outcomes over the life course. However, implementation a...

OBJECTIVES The objectives of this study are to develop a discrete-event simulation (DES) model for the Singapore Emergency Medical Services (EMS), and to demonstrate the utility of this DES model for the evaluation of different policy alternatives to improve ambulance response times. METHODS A DES model was developed based on retrospective emergency call data over a continuous 6-month period ...

BACKGROUND We conducted a wait-list control randomised trial of an outpatient rehabilitation service for people living with and beyond cancer, delivered in a hospice day care unit. We report the results of an economic evaluation undertaken using the trial data. METHODS Forty-one participants were recruited into the study. A within-trial stochastic cost-utility analysis was undertaken using Mo...

We read with interest the paper in the May issue on the theme of performance indicator scoring by Houghton and Rouse.1 We were surprised that they did not refer to a conceptually similar attempt we made to develop a composite performance indicator — the National Health Service Practice Performance Index (NHSPPI) — in three areas of England (including their own) and one in Scotland.2 As Houghton...

STUDY OBJECTIVE To demonstrate the effect of exclusion of data on delays in scheduling operations in calculating difference in admission rates between two enrolment periods. DESIGN A prospective cohort study; outcome measure-waiting time for elective admission; study variables-enrolment periods, before 31 March 1997 and after that date; the time of scheduling delay; gender; age; urgency, and ...

INTRODUCTION The aim of this study was to look at the different claims made about hip resurfacing arthroplasty in the popular UK print media and how this relates to findings in the scientific literature. METHODS A review of UK popular print media from January 1992 to June 2011 was performed using the Lexis(®) Library online news database. Only articles discussing the clinical results of hip ...

Black women in the Deep South experience excess morbidity/mortality from obesity-related diseases, which may be partially attributable to poor diet. One reason for poor dietary intake may be high stress, which has been associated with unhealthy diets in other groups. Limited data are available regarding dietary patterns of black women in the Deep South and to our knowledge no studies have been ...

OBJECTIVE To evaluate the effectiveness of quality improvement collaboratives in improving the quality of care. DATA SOURCES Relevant studies through Medline, Embase, PsycINFO, CINAHL, and Cochrane databases. STUDY SELECTION Two reviewers independently extracted data on topics, participants, setting, study design, and outcomes. DATA SYNTHESIS Of 1104 articles identified, 72 were included ...

The closer progressive multiple sclerosis (MS) is approached, the more awkward it is to define and the more slippery it is to measure. Of course on one level it is easy – if 5 years previously a person affected by MS can walk or see or balance normally, but now they walk with a stick or have a visual acuity of 6/60 or are falling over, then it is clear (to anyone) that progression has occurred,...

................................................................................................................... 5 LIST OF PAPERS ........................................................................................................... 7 ABBREVIATIONS ......................................................................................................... 8 INTRODUCTION ......................