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Introduction: An observational study examining 1-year follow-up of clients of two National Health Service smoking cessation services in Glasgow was used to inform a cost-effectiveness analysis. One service involved 7 weeks of group-based support (n = 411) and the other consisted of up to 12 weeks of one-to-one counseling with pharmacists (n = 1,374). Pharmacological aids to quitting (e.g., nicotine replacement therapy) were available to all clients. Methods: Quit rates were calculated for each service at 52 weeks after the quit date, and these were used for an economic evaluation of both the annual and the lifetime cost-effectiveness of the pharmacy- and group-based interventions in comparison with a baseline “self-quit” scenario. The annual cost-effectiveness model established the incremental cost per 52-week quitter, while a Markov model was developed for the lifetime analysis to estimate the potential lifetime outcomes in terms of cost per quality-adjusted life years (QALY) gained, to account for the benefits quitters will receive in terms of extended life years and improvements in quality of life from smoking cessation. Results: The proportion of carbon monoxide–validated quitters from both services combined fell from 22.5% at 4-week follow-up to 3.6% at 52 weeks. The group service achieved a higher quit rate (6.3%) than the pharmacy service (2.8%) but was more intensive and required greater overhead costs. The lifetime analysis resulted in an incremental cost per QALY of £4,800 for the group support and £2,600 for pharmacy one-to-one counseling. Conclusions: Despite disappointing 1-year quit rates, both services were considered to be highly cost-effective. [ABSTRACT FROM AUTHOR]

Background Studies show that the well-prepared traveller is less likely to suffer travel related illness. This study is designed to examine trekkers’ knowledge of altitude sickness in an attempt to see whether knowledge can protect against acute mountain sickness (AMS) and high altitude pulmonary or cerebral oedema (HAPE/HACE). [ABSTRACT FROM PUBLISHER]

Background One of the successes of the National Health Service is that the distribution of general practitioners(GPs) corresponds much more closely to the size of the local communities than it did before 1948. However, more should be done to reflect the fact that different populations have variable needs for GPs. The aim of this paper is to estimate the relative need for GPs by linking evidence from individual utilization data to the characteristics of small areas. Methods Statistical models of GP utilization were developed from household survey data on 12 729 adults representative of the English population. The odds ratios derived from the models were combined with Census information for Family Health Services Authorities (FHSAs) to calculate a need indicator, which was used to estimate the number of GPs ‘needed’ in an area for comparison with the actual distribution. Results The utilization of GPs is associated with morbidity, demographic and socioeconomic variables. The needs indicator derived from the model of GP utilization varies from 1⋅66 to 2⋅40 with a mean of 2. Substantial changes in the distribution of GPs are required to reflect the relative need for them. For example, in relative terms, Cornwall and the Isles of Scilly has an excess of GPs of almost one-fifth whereas Rotherham has a shortfall of more than one-third. Conclusions The findings in this paper suggest that there are still considerable inequalities in access to GP services in England in relation to need. [ABSTRACT FROM PUBLISHER]

The article discusses the Health Action Zone (HAZ) in England. HAZ focuses on community-based activities aimed to tackle health inequalities both nationally and internationally. Among the strategic objectives of HAZ include the addressing of public health needs, increase in the efficiency of medical services and the development of partnerships for improving public health.

The article reports that policy design and implementation in public health are more neglected than political values. It states that the change of government leadership in England helps to explain why health inequality policies are being refreshed. A broad territory must be covered by any serious consideration of the impact of political science on public health. Much of politics is about values which do not bring themselves easily to scientific examination. According to the author, politics and government is vital to public health and it is time to focus more effort on the improvement of service delivery and performance.