7 results
Search Results
2. One to one interventions to reduce sexually transmitted infections and under the age of 18 conceptions: a systematic review of the economic evaluations.
- Author
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Barham, L., Lewis, D., and Latimer, N.
- Subjects
TEENAGE pregnancy ,SEXUALLY transmitted diseases ,COMMUNICABLE diseases ,MEDICAL care costs ,MEDICAL economics ,PREVENTION of sexually transmitted diseases ,PREVENTION of teenage pregnancy ,EPIDEMIOLOGY of sexually transmitted diseases ,DATABASES ,FERRANS & Powers Quality of Life Index ,COUNSELING ,MEDICAL care for teenagers ,BENCHMARKING (Management) ,COST effectiveness ,QUALITY-adjusted life years - Abstract
Objective: To systematically review and critically appraise the economic evaluations of one to one interventions to reduce sexually transmitted infections (STIs) and teenage conceptions.Design: Systematic review.Data Sources: Search of four electronic bibliographic databases from 1990 to January 2006. Search keywords included teenage, pregnancy, adolescent, unplanned, unwanted, cost benefit, cost utility, economic evaluation, cost effectiveness and all terms for STIs, including specific diseases.Review Methods: We included studies that evaluated a broad range of one to one interventions to reduce STIs. Outcomes included major outcomes averted, life years and quality adjusted life years (QALY). All studies were assessed against quality criteria.Results: Of 3,190 identified papers, 55 were included. The majority of studies found one to one interventions to be either cost saving or cost effective, although one highlighted the need to target the population to receive post-exposure prophylaxis to reduce transmission of HIV. Most studies used a static approach that ignores the potential re-infection of treated patients.Conclusion: One to one interventions have been shown to be cost saving or cost effective but there are some limitations in applying this evidence to the UK policy context. More UK research using dynamic modelling approaches and QALYs would provide improved evidence, enabling more robust policy recommendations to be made about which one to one interventions are cost effective in reducing STIs in the UK setting. The results of this review can be used by policy makers, health economists and researchers considering further research in this area. [ABSTRACT FROM AUTHOR]- Published
- 2007
- Full Text
- View/download PDF
3. Supply of medicines: paternalism, autonomy and reality.
- Author
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Prayle, David, Brazier, Margaret, Prayle, D, and Brazier, M
- Subjects
DRUGS ,CLASSIFICATION ,DRUG laws ,AUTONOMY (Psychology) ,BENEVOLENCE ,COMMUNICATION ,CULTURE ,HEALTH services accessibility ,PHILOSOPHY of medicine ,PATERNALISM ,PHARMACOLOGY ,RISK assessment ,GOVERNMENT regulation ,OCCUPATIONAL roles - Abstract
Radical changes are taking place in the United Kingdom in relation to the classification of, and access to, medicines. More and more medicines are being made available over the counter both in local pharmacies and in supermarkets. The provision of more open access to medicines may be hailed as a triumph for patient autonomy. This paper examines whether such a claim is real or illusory. It explores the ethical and legal implications of deregulating medicines. Do patients benefit? What is the impact on pharmacists? Are the true beneficiaries of change largely the pharmaceutical industries? [ABSTRACT FROM AUTHOR]
- Published
- 1998
- Full Text
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4. Impact of national smoke-free legislation on home smoking bans: findings from the International Tobacco Control Policy Evaluation Project Europe Surveys.
- Author
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Mons, Ute, Nagelhout, Gera E., Allwright, Shane, Guignard, Romain, Van Den Putte, Bas, Willemsen, Marc C., Fong, Geoffrey T., Brenner, Hermann, Pötschke-Langer, Martina, and Breitling, Lutz P.
- Subjects
SMOKING laws ,SMOKING prevention ,CONFIDENCE intervals ,EPIDEMIOLOGY ,LONGITUDINAL method ,RESEARCH methodology ,SMOKING cessation ,T-test (Statistics) ,DATA analysis ,HOME environment ,MULTIPLE regression analysis ,SECONDARY analysis ,DESCRIPTIVE statistics - Abstract
Objectives To measure changes in prevalence and predictors of home smoking bans (HSBs) among smokers in four European countries after the implementation of national smoke-free legislation. Design Two waves of the International Tobacco Control Policy Evaluation Project Europe Surveys, which is a prospective panel study. Pre- and post-legislation data were used from Ireland, France, Germany and the Netherlands. Two pre-legislation waves from the UK were used as control. Participants 4634 respondents from the intervention countries and 1080 from the control country completed both baseline and follow-up and were included in the present analyses. Methods Multiple logistic regression models to identify predictors of having or of adopting a total HSB, and Generalised Estimating Equation models to compare patterns of change after implementation of smoke-free legislation to a control country without such legislation. Results Most smokers had at least partial smoking restrictions in their home, but the proportions varied significantly between countries. After implementation of national smoke-free legislation, the proportion of smokers with a total HSB increased significantly in all four countries. Among continuing smokers, the number of cigarettes smoked per day either remained stable or decreased significantly. Multiple logistic regression models indicated that having a young child in the household and supporting smoking bans in bars were important correlates of having a pre-legislation HSB. Prospective predictors of imposing a HSB between survey waves were planning to quit smoking, supporting a total smoking ban in bars and the birth of a child. Generalised Estimating Equation models indicated that the change in total HSB in the intervention countries was greater than that in the control country. Conclusions The findings suggest that smoke-free legislation does not lead to more smoking in smokers' homes. On the contrary, our findings demonstrate that smoke-free legislation may stimulate smokers to establish total smoking bans in their homes. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
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5. Developing a multi-disciplinary public health specialist workforce: training implications of current UK policy.
- Author
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Evans, D. and Dowling, S.
- Subjects
TRAINING of public health personnel ,PUBLIC health ,HEALTH care reform ,MEDICAL education - Abstract
The article presents developments in multi-disciplinary public health training in Great Britain. It mentions that public health doctors have put emphasis on maintaining and developing a high quality specialist public health training scheme after the establishment of the Faculty in 1972. It states that the Calman reforms followed directives of the European Community to assure that postgraduate medical education was compatible throughout Europe.
- Published
- 2002
6. Ethics briefings.
- Author
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English, Veronica, Heath, Lucy, Romano-Critchley, Gillian, and Sommerville, Ann
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MEDICAL ethics ,MEDICINE ,ANIMALS ,BIOETHICS ,DEVELOPING countries ,LEGISLATION ,MEDICAL protocols ,MEDICAL research ,PREIMPLANTATION genetic diagnosis ,PSYCHOTHERAPY patients ,RESEARCH ethics ,SOCIAL control ,TRANSPLANTATION of organs, tissues, etc. ,XENOGRAFTS ,ADVANCE directives (Medical care) ,GOVERNMENT policy ,GOVERNMENT regulation ,INVOLUNTARY hospitalization - Abstract
Presents news briefs related to medical ethics as of April 2000. Publication of a parliamentary bill entitled Medical Treatment by the Great Britain government on January 18, 2000; Joint consultation document on preimplantation genetic diagnosis issued by the Human Fertilisation and Embryology and Advisory Committee on Genetic Testing on November 1999; Revision of the World Medical Association's Declaration of Helsinki for the ethics of medical research on humans.
- Published
- 2000
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7. The aim is vaccine uptake.
- Author
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Puliyel, Jacob
- Subjects
HEPATITIS B vaccines - Abstract
A letter to the editor commenting on the focus of the British government on hepatitis B vaccine uptake rather than disease mitigation.
- Published
- 2013
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