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Objectives: To construct UK ethnicity birth weight centiles (UK-EBWC) for gestational age and cut-offs for small for gestational age (SGA) for England and Wales and to evaluate the SGA misclassification using the UK centiles.Design: Analysis of national birth data.Participants: All live singleton births in England and Wales in 2006-2012, as recorded by the Office for National Statistics and birth registrations, linked with National Health Service into numbers for babies.Main Outcome Measures: Both sex-specific and ethnicity-sex-specific birth weight centiles for gestational age, and ethnicity-sex-specific SGA cut-offs. Centiles were computed using the generalised additive model for location, scale and shape.Results: Our sex-specific centiles performed well and showed an agreement between the expected and observed number of births below the centiles. The ethnicity-sex-specific centiles for Black and Asian presented lower values compared with the White centiles. Comparisons of sex-specific and ethnicity-sex-specific centiles shows that use of sex-specific centiles increases the SGA diagnosed cases by 50% for Asian, 30% for South Asian (Indian, Pakistani and Bangladeshi) and 20% for Black ethnicity.Conclusions: The centiles show important differences between ethnic groups, in particular the 10th centile used to define SGA. To account for these differences and to minimise misclassification of SGA, we recommend the use of customised birth weight centiles. [ABSTRACT FROM AUTHOR]

The article reports on the Royal College of Surgeons' consultation paper "Delivering High-Quality Surgical Services for the Future." The group recommended that surgeons in England and Wales form a network and work as teams in a specific area, rather than for the individual NHS hospital trusts. The consultation paper also focused on surgical training standards. The College's president, Bernard Ribeiro, comments on health service policy.

The article analyses British Health Secretary Andrew Lansley's privatisation plans for National Health Service (NHS). In a white paper presented by Lansley on July 12, 2001, the health secrerary noted that any willing healthcare provider will be allowed to deliver services to NHS patients as long as they provide high quality standards of care. Information is presented on the failure of Hinchingbrooke, a 369 bed complex in Cambridgeshire, England, which could be the first to be privatised under the initiative.

Aims Uveal melanoma is the commonest primary intraocular malignancy in adults, and leads to death in approximately half of patients. The aim was to report on trends over time and geographical variation in rates of uveal melanoma in England. Methods Analysis of admissions for uveal melanoma, using linked English national hospital episode statistics, available from 1999 to 2010, and the Oxford record linkage study (ORLS), before that, from 1979 to 1998. Results The annual rate of people admitted in England with a new record of uveal melanoma remained stable at approximately 1.0 people per 100 000 population from 1999 to 2010. Annual ORLS incidence rates were also stable from 1979 to 1998. Proportions of new uveal malignancies in adults for 2006-10 were 88% (382 people/year) choroidal and 12% (52) ciliary body/iris. Incidence rates increased with increasing age and were higher in men than women. Geographical analysis showed variation across local authorities (LA) in incidence rates, from 0.1 to 1.9 people per 100 000 population per year. Incidence rates at the LA level were inversely correlated with the proportion of black (r=-0.18) or Indian individuals (r=-0.13) in each LA, were weakly correlated with LA levels of social deprivation (r=0.08) and were not correlated with southerly latitude. Conclusions The annual incidence of uveal melanoma in England has remained stable over the past decade. This contrasts with the rising incidence of cutaneous melanoma. Our data do not support the possibility that ultraviolet light exposure contributes to the pathogenesis of uveal melanoma. [ABSTRACT FROM AUTHOR]

Objectives: To identify ethical dilemmas experienced by occupational and physical therapists working in the UK National Health Service (NHS). To compare ethical contexts, themes and principles across the two groups.Design: A structured questionnaire was circulated to the managers of occupational and physical therapy services in England and Wales.Subjects: The questionnaires were given to 238 occupational and 249 physical therapists who conformed to set criteria.Results: Ethical dilemmas experienced during the previous six months were reported by 118 occupational and 107 physical therapists. The two groups were similar in age, grade, and years of experience. Fifty of the occupational therapy dilemmas occurred in mental health settings but no equivalent setting emerged for physical therapy. Different ethical themes emerged between the two groups, with the most common in occupational therapy being difficult/dangerous behaviour in patients and unprofessional staff behaviour, and for physical therapists resource limitations and treatment effectiveness. No differences were found in the ethical principles used.Conclusion: The ethical dilemmas reported by the therapists were primarily concerned with health care ethics, rather than the more dramatic ethics reported in much of the biomedical ethics literature. Differences were found between the two professional groups when ethical contexts and themes were compared but not when ethical principles were compared. This suggests that educators and researchers need to be aware of work settings and the interdisciplinary nature of employment as well as ethical principles held by individual therapists. [ABSTRACT FROM AUTHOR]