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Objectives To explore similarities and differences in policy content and the political context of the three main English government reports on health inequalities: the Black Report (1980), the Acheson Enquiry (1998), and the Marmot Review (2010). Methods Thematic policy and context analysis of the Black Report (1980), the Acheson Enquiry (1998), and the Marmot Review (2010) in terms of: (i) underpinningtheoretical principles; (ii) policy recommendations; (iii) the political contexts in which each was released; and (iv) their actual or potential influence on research and policy. Results There were great similarities and very few differences in terms of both the theoretical principles guiding the recommendations of these reports and the focus of the recommendations themselves. However, there were clear differences in terms of the political contexts of each report, as well as their subsequent impacts on research and policy. Conclusion The paper calls into question the progress of health inequalities research, the use of evidence and of the links between research, politics and policy. [ABSTRACT FROM AUTHOR]

Objective: To identify if the educational trajectories of preterm infants differ from those of their term peers.Design: This work is based on the Avon Longitudinal Study of Parents and Children (ALSPAC). Educational measures were categorised into 10 deciles to allow comparison of measures across time periods. Gestational age was categorised as preterm (23-36 weeks) or term (37-42 weeks). Multilevel mixed-effects linear regression models were derived to examine the trajectories of decile scores across the study period. Gestational group was added as an interaction term to assess if the trajectory between educational measures varied between preterm and term infants. Adjustment for possible confounders was performed.Subjects: The final dataset contained information on 12 586 infants born alive at between 23 weeks and 42 weeks of gestation.Main Outcome Measures: UK mandatory educational assessments (SATs) scores throughout educational journal (including final GCSE results at 16 years of age).Results: Preterm infants had on average lower Key Stage (KS) scores than term children (-0.46 (-0.84 to -0.07)). However, on average, they gained on their term peers in each progressive measure (0.10 (0.01 to 0.19)), suggesting 'catch up' during the first few years at school. Preterm infants appeared to exhibit the increase in decile scores mostly between KS1 and KS2 (p=0.005) and little between KS2 and KS3 (p=0.182) or KS3 and KS4 (p=0.149).Conclusions: This work further emphasises the importance of early schooling and environment in these infants and suggests that support, long after the premature birth, may have additional benefits. [ABSTRACT FROM AUTHOR]

Background Teamwork training and system standardisation have both been proposed to reduce error and harm in surgery. Since the approaches differ markedly, there is potential for synergy between them. Methods Design: Controlled interrupted time series with a 3 month intervention and observation phases before and after. Setting: Operating theatres conducting elective orthopaedic surgery in a single hospital system (UK Hospital Trust). Intervention: Teamwork training based on crew resource management plus training and follow-up support in developing standardised operating procedures. Focus of subsequent standardisation efforts decided by theatre staff. Measures: Paired observers watched whole procedures together. We assessed non-technical skills using NOTECHS II, technical performance using glitch rate and compliance with WHO checklist using a simple quality tool. We measured complication and readmission rates and hospital stay using hospital administrative records. Before/after change was compared in the active and control groups using two-way ANOVA and regression models. Results 1121 patients were operated on before and 1100 after intervention. 44 operations were observed before and 50 afterwards. Nontechnical skills (p=0.002) and WHO compliance (p<0.001) improved significantly after the intervention in the active versus the control group. Glitch count improved in both groups and there was no significant effect on clinical outcomes. Discussion Combined training in teamwork and system improvement causes marked improvements in team behaviour and WHO performance, but not technical performance or outcome. These findings are consistent with the synergistic hypothesis, but larger controlled studies with a strong implementation strategy are required to test potential outcome effects. [ABSTRACT FROM AUTHOR]

Aims: To review the process and outcome of education and training visits to paediatric departments by the RCPCH.Methods: Retrospective audit of visits reports (1997-2001) against the RCPCH criteria for general professional training. Hospital and/or community child health departments who were responsible for training paediatric senior house officers were visited to assess whether RCPCH criteria of education were being met. Follow up visits were undertaken where limited education and training approval was given. Reports were received from 214 of 242 (88%) hospital and/or community based departments in England, Wales, and Northern Ireland.Results: Satisfactory achievement of the 12 training criteria by departments varied widely: 39-95% (median 66%) achieved. Follow up visits reported significant improvements in most departments. Criteria which departments struggled to achieve reasonable standards were: (1) ensuring SHOs were performing educationally appropriate duties (39% achieved); and (2) satisfactory outpatient experience (41% achieved). Twenty four per cent of hospital based departments did not have a paediatrician with 12 months or more experience of paediatrics resident on call.Conclusions: The visiting process highlighted areas of good practice, encouraged change to meet the criteria, and recommended increased resources and staffing where necessary to improve training and hence the service. The need for continuing approval for education and training in these departments encouraged significant efforts on the part of trainers and managers to meet the requirements, and consequently the quality of service to children has been enhanced. [ABSTRACT FROM AUTHOR]