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The number of deaths in England and Wales associated with gastrointestinal pathogens, norovirus in particular, in persons ≥65 years was estimated for 2001-2006. Regression analysis was used to model monthly counts of gastrointestinal pathogens in fecal samples from infected patients against monthly counts of deaths from infectious and noninfectious intestinal diseases. Data came from the Office of National Statistics (death registrations from local registrars) and from the Health Protection Agency (laboratory results). Model results suggest that 20% (13.3%-26.8%) of deaths in persons >65 years of age caused by infectious intestinal disease other than Clostridium difficile were associated with norovirus infection in this period and that 13% (7.5%-18.5%) of deaths caused by noninfectious intestinal disease were associated with norovirus. An estimated 80 deaths each year in this age group may be associated with norovirus infection. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence, nature and distribution of person-perceived participation restriction, in community-dwelling older adults.Method: Population based cross-sectional postal survey of 11,055 adults aged 50 years and over in North Staffordshire, United Kingdom. Person-perceived participation restriction was measured using the Keele Assessment of Participation which covers 11 different aspects of life mapped to the World Health Organization's International Classification of Functioning. Four-week period prevalence was calculated for restriction in any, multiple and for each aspect separately. Prevalence estimates were calculated for the total sample, and for each age and gender stratum.Results: A total of 7,878 subjects responded (adjusted response--71.3%). The 4-week period prevalence of any participation restriction was 51.8%; 3.3% had substantial restriction. Participation restriction increased with age (p<0.001) and, for moderate and substantial restriction, was more frequent in women. The prevalence of restricted participation in individual aspects of life ranged from 3.8% (work) to 25.9% (mobility outside the home).Conclusion: Some restriction of participation 'as and when we want it' is common in the general population and increases with age, although severe restriction only affects a minority. The distribution of person-perceived participation restriction is similar to that of impairments and activity limitation in community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Introduction: although often a last resort, urinary catheterisation is a relatively common management option for bladder dysfunction in older people and others cared for in community settings. Catheter-associated urinary tract infection (CAUTI) is a well-recognised source of increased morbidity and economic burden in acute care services, but much less is known about the prevalence and impact of CAUTI in primary and community care. Objectives: the aim of this study was to examine the criteria and outcome measures used in reporting CAUTI, to identify sources and quality of data recorded on CAUTI and to determine a base-line prevalence rate for CAUTI in community settings. Methods: (i) a mapping exercise to identify local, national and international sources of data on CAUTI and (ii) a retrospective prevalence survey of CAUTIs, recorded within three Primary Care Trusts in England during 1 month (October 2004). Results: published or other recorded data on CAUTI in community settings were very limited. Criteria and outcome measures were variable and commonly failed to distinguish between symptomatic and asymptomatic CAUTI. A prevalence rate of 8.5% was determined by retrospective survey of patient records. Conclusions: limitations in the quality and consistency of catheter-related information collected by healthcare services present a major obstacle to robust epidemiological analysis of risk and impact of CAUTI in primary and community care. Standardised routine data collection is essential to determine the magnitude of risk associated with CAUTI, to enable the development of a longitudinal database of long-term catheterised patients and to provide base-line data against which infection-control initiatives in primary and community care can be evaluated. [ABSTRACT FROM AUTHOR]

Examines the effects of treatments in hypertensive patients in England to produce an estimate of the number of medication hypertensive patients aged 35 to 74 years might be expected to need to achieve a target systolic blood pressure of under 140 mmHg and a target diastolic blood pressure of under 90 mmHg. Effects of a single antihypertensive drug on systolic and diastolic blood pressures; Effects of increasing the dose.