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10. Canada

Author

Snowdon, Anne W., primary, Alessi, Charles, additional, Van Aerde, John, additional, and Schnarr, Karin, additional

Published
2018
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12. Reducing the Risk of Cognitive Decline and Dementia: WHO Recommendations

Author

Chowdhary, Neerja, primary, Barbui, Corrado, additional, Anstey, Kaarin J., additional, Kivipelto, Miia, additional, Barbera, Mariagnese, additional, Peters, Ruth, additional, Zheng, Lidan, additional, Kulmala, Jenni, additional, Stephen, Ruth, additional, Ferri, Cleusa P., additional, Joanette, Yves, additional, Wang, Huali, additional, Comas-Herrera, Adelina, additional, Alessi, Charles, additional, Suharya (Dy), Kusumadewi, additional, Mwangi, Kibachio J., additional, Petersen, Ronald C., additional, Motala, Ayesha A., additional, Mendis, Shanthi, additional, Prabhakaran, Dorairaj, additional, Bibi Mia Sorefan, Ameenah, additional, Dias, Amit, additional, Gouider, Riadh, additional, Shahar, Suzana, additional, Ashby-Mitchell, Kimberly, additional, Prince, Martin, additional, and Dua, Tarun, additional

Published
2022
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15. Brain health: Key to health, productivity, and well‐being.

Author

Avan, Abolfazl, Hachinski, Vladimir, Aamodt, Anne‐Hege, Alessi, Charles, Ali, Shehzad, Alladi, Suvarna, Andersen, Robert, Anderson, Kelly K., Azarpazhooh, M. Reza, Bassetti, Claudio L. A., Brainin, Michael, Brodtmann, Amy, Buchan, Alastair M., Charway‐Felli, Augustina, Cipriano, Lauren E., Endres, Matthias, Evans, Timothy G., Federico, Antonio, Feigin, Valery L., and Ferro, José M.

Abstract

Brain health is essential for physical and mental health, social well‐being, productivity, and creativity. Current neurological research focuses mainly on treating a diseased brain and preventing further deterioration rather than on developing and maintaining brain health. The pandemic has forced a shift toward virtual working environments that accelerated opportunities for transdisciplinary collaboration for fostering brain health among neurologists, psychiatrists, psychologists, neuro and socio‐behavioral scientists, scholars in arts and humanities, policymakers, and citizens. This could shed light on the interconnectedness of physical, mental, environmental, and socioeconomic determinants of brain disease and health. We advocate making brain health the top priority worldwide, developing common measures and definitions to enhance research and policy, and finding the cause of the decline of incidence of stroke and dementia in some countries and then applying comprehensive customized cost‐effective prevention solutions in actionable implementation units. Life cycle brain health offers the best single individual, communal, and global investment. [ABSTRACT FROM AUTHOR]

Published
2022
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16. Preface

Author

Alessi, Charles, primary, Chambers, Larry W., additional, and Gray, Muir, additional

Published
2021
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17. Copyright Page

Author

Alessi, Charles, primary, Chambers, Larry W., additional, and Gray, Muir, additional

Published
2021
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18. New dimensions for hospital services and early detection of disease: a Review from the Lancet Commission into liver disease in the UK

Author

Williams, Roger, primary, Alessi, Charles, additional, Alexander, Graeme, additional, Allison, Michael, additional, Aspinall, Richard, additional, Batterham, Rachel L, additional, Bhala, Neeraj, additional, Day, Natalie, additional, Dhawan, Anil, additional, Drummond, Colin, additional, Ferguson, James, additional, Foster, Graham, additional, Gilmore, Ian, additional, Goldacre, Raphael, additional, Gordon, Harriet, additional, Henn, Clive, additional, Kelly, Deirdre, additional, MacGilchrist, Alastair, additional, McCorry, Roger, additional, McDougall, Neil, additional, Mirza, Zulfiquar, additional, Moriarty, Kieran, additional, Newsome, Philip, additional, Pinder, Richard, additional, Roberts, Stephen, additional, Rutter, Harry, additional, Ryder, Stephen, additional, Samyn, Marianne, additional, Severi, Katherine, additional, Sheron, Nick, additional, Thorburn, Douglas, additional, Verne, Julia, additional, Williams, John, additional, and Yeoman, Andrew, additional

Published
2021
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19. Effective interventions for potentially modifiable late-onset dementia risk factors: a costs and cost-effectiveness modelling study

Author

Mukadam, Naaheed, Anderson, Robert, Knapp, Martin, Wittenberg, Raphael, Karagiannidou, Maria, Costafreda, Sergi G., Tutton, Madison, Alessi, Charles, and Livingston, Gill

Subjects
RA0421 Public health. Hygiene. Preventive Medicine, RC Internal medicine
Abstract

Background The potential economic value of interventions to prevent late-onset dementia is unknown. We modelled this for potentially modifiable dementia risk factors. Methods We searched PubMed and Web of Science from inception to March 2020 and included interventions that (a) successfully targeted any of nine pre-specified potentially modifiable risk factors (hypertension, diabetes, hearing loss, obesity, physical inactivity, social isolation, depression, cigarette smoking and less childhood education), (b) had robust evidence that the intervention improved risk or risk behaviour and (c) are feasible in an adult population. We established when in the life-course each intervention would be delivered. We calculated dementia incidence reduction from: annual incidence of dementia in people with each risk factor; population attributable fraction for each risk, corrected for risk factor clustering, and how effectively the intervention controls the risk factor. We calculated the discounted value of lifetime health gain and impact on cost (including NHS, social care and carer costs) per person eligible for treatment. We estimated annual total expenditure on the fully operational intervention programme in England. Findings We found effective treatments for hypertension, stopping smoking, diabetes prevention and hearing loss. Treatments for stopping smoking and provision of hearing aids reduced cost. Treatment of hypertension was cost-effective by reference to standard UK thresholds. The three interventions when fully implemented would save £1·863 billion annually in England, reduce dementia prevalence by 8·5% and produce QALY gains. The intervention for diabetes was unlikely to be cost-effective in terms of impact on dementia alone. Interpretation There is a strong case for implementing the three effective interventions on grounds of cost-effectiveness and quality of life gains, as well as for improvements in general health. There is considerable room for the interventions to remain cost-saving or cost-effective even with variations in dementia incidence and costs and effectiveness of interventions.

Published
2020

21. Mild Cognitive Impairment: the Manchester consensus

Author

Dunne, Ross A, primary, Aarsland, Dag, additional, O’Brien, John T, additional, Ballard, Clive, additional, Banerjee, Sube, additional, Fox, Nick C, additional, Isaacs, Jeremy D, additional, Underwood, Benjamin R, additional, Perry, Richard J, additional, Chan, Dennis, additional, Dening, Tom, additional, Thomas, Alan J, additional, Schryer, Jeffrey, additional, Jones, Anne-Marie, additional, Evans, Alison R, additional, Alessi, Charles, additional, Coulthard, Elizabeth J, additional, Pickett, James, additional, Elton, Peter, additional, Jones, Roy W, additional, Mitchell, Susan, additional, Hooper, Nigel, additional, Kalafatis, Chris, additional, Rasmussen, Jill G C, additional, Martin, Helen, additional, Schott, Jonathan M, additional, and Burns, Alistair, additional

Published
2020
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24. Mild Cognitive Impairment: the Manchester consensus.

Author

Dunne, Ross A, Aarsland, Dag, O'Brien, John T, Ballard, Clive, Banerjee, Sube, Fox, Nick C, Isaacs, Jeremy D, Underwood, Benjamin R, Perry, Richard J, Chan, Dennis, Dening, Tom, Thomas, Alan J, Schryer, Jeffrey, Jones, Anne-Marie, Evans, Alison R, Alessi, Charles, Coulthard, Elizabeth J, Pickett, James, Elton, Peter, and Jones, Roy W

Subjects
AMYLOID beta-protein precursor, BIOMARKERS, CEREBRAL circulation, CONSENSUS (Social sciences), NEURORADIOLOGY, MILD cognitive impairment
Abstract

Given considerable variation in diagnostic and therapeutic practice, there is a need for national guidance on the use of neuroimaging, fluid biomarkers, cognitive testing, follow-up and diagnostic terminology in mild cognitive impairment (MCI). MCI is a heterogenous clinical syndrome reflecting a change in cognitive function and deficits on neuropsychological testing but relatively intact activities of daily living. MCI is a risk state for further cognitive and functional decline with 5–15% of people developing dementia per year. However, ~50% remain stable at 5 years and in a minority, symptoms resolve over time. There is considerable debate about whether MCI is a useful clinical diagnosis, or whether the use of the term prevents proper inquiry (by history, examination and investigations) into underlying causes of cognitive symptoms, which can include prodromal neurodegenerative disease, other physical or psychiatric illness, or combinations thereof. Cognitive testing, neuroimaging and fluid biomarkers can improve the sensitivity and specificity of aetiological diagnosis, with growing evidence that these may also help guide prognosis. Diagnostic criteria allow for a diagnosis of Alzheimer's disease to be made where MCI is accompanied by appropriate biomarker changes, but in practice, such biomarkers are not available in routine clinical practice in the UK. This would change if disease-modifying therapies became available and required a definitive diagnosis but would present major challenges to the National Health Service and similar health systems. Significantly increased investment would be required in training, infrastructure and provision of fluid biomarkers and neuroimaging. Statistical techniques combining markers may provide greater sensitivity and specificity than any single disease marker but their practical usefulness will depend on large-scale studies to ensure ecological validity and that multiple measures, e.g. both cognitive tests and biomarkers, are widely available for clinical use. To perform such large studies, we must increase research participation amongst those with MCI. [ABSTRACT FROM AUTHOR]

Published
2021
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25. New dimensions for hospital services and early detection of disease: a Review from the LancetCommission into liver disease in the UK

Author

Williams, Roger, Alessi, Charles, Alexander, Graeme, Allison, Michael, Aspinall, Richard, Batterham, Rachel L, Bhala, Neeraj, Day, Natalie, Dhawan, Anil, Drummond, Colin, Ferguson, James, Foster, Graham, Gilmore, Ian, Goldacre, Raphael, Gordon, Harriet, Henn, Clive, Kelly, Deirdre, MacGilchrist, Alastair, McCorry, Roger, McDougall, Neil, Mirza, Zulfiquar, Moriarty, Kieran, Newsome, Philip, Pinder, Richard, Roberts, Stephen, Rutter, Harry, Ryder, Stephen, Samyn, Marianne, Severi, Katherine, Sheron, Nick, Thorburn, Douglas, Verne, Julia, Williams, John, and Yeoman, Andrew

Abstract

This Review, in addressing the unacceptably high mortality of patients with liver disease admitted to acute hospitals, reinforces the need for integrated clinical services. The masterplan described is based on regional, geographically sited liver centres, each linked to four to six surrounding district general hospitals—a pattern of care similar to that successfully introduced for stroke services. The plan includes the establishment of a lead and deputy lead clinician in each acute hospital, preferably a hepatologist or gastroenterologist with a special interest in liver disease, who will have prime responsibility for organising the care of admitted patients with liver disease on a 24/7 basis. Essential for the plan is greater access to intensive care units and high-dependency units, in line with the reconfiguration of emergency care due to the COVID-19 pandemic. This Review strongly recommends full implementation of alcohol care teams in hospitals and improved working links with acute medical services. We also endorse recommendations from paediatric liver services to improve overall survival figures by diagnosing biliary atresia earlier based on stool colour charts and better caring for patients with impaired cognitive ability and developmental mental health problems. Pilot studies of earlier diagnosis have shown encouraging progress, with 5–6% of previously undiagnosed cases of severe fibrosis or cirrhosis identified through use of a portable FibroScan in primary care. Similar approaches to the detection of early asymptomatic disease are described in accounts from the devolved nations, and the potential of digital technology in improving the value of clinical consultation and screening programmes in primary care is highlighted. The striking contribution of comorbidities, particularly obesity and diabetes (with excess alcohol consumption known to be a major factor in obesity), to mortality in COVID-19 reinforces the need for fiscal and other long delayed regulatory measures to reduce the prevalence of obesity. These measures include the food sugar levy and the introduction of the minimum unit price policy to reduce alcohol consumption. Improving public health, this Review emphasises, will not only mitigate the severity of further waves of COVID-19, but is crucial to reducing the unacceptable burden from liver disease in the UK.

Published
2021
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30. The Blackfriars Consensus on brain health and dementia

Author

Lincoln, Paul, primary, Fenton, Kevin, additional, Alessi, Charles, additional, Prince, Martin, additional, Brayne, Carol, additional, Wortmann, Marc, additional, Patel, Kiran, additional, Deanfield, John, additional, and Mwatsama, Modi, additional

Published
2014
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34. Get involved in the new commissioning agenda

Author

Howie, Katie and Alessi, Charles

Subjects
Nurses -- Practice, Health care reform, Health, National Association of Primary Care -- Conferences, meetings and seminars
Published
2010

35. Commissioning: back on the front line

Author

Alessi, Charles

Subjects
United Kingdom. National Health Service, Physicians (General practice) -- Practice, Patients -- Care and treatment, Patients -- Evaluation, Health
Published
2010

36. How we'll stamp out overcharging by acute trusts

Author

Alessi, Charles

Subjects
Hospitals -- Central service department, Hospital administrators -- Vocational guidance, Physicians (General practice) -- Vocational guidance, Health, Health care industry
Abstract

GPs need to watch hospital activity like a hawk to prevent miscoding and overpayment. Here, Dr Charles Alessi explains how his commissioning group is doing it There is a perverse [...]

Published
2011

37. PulseFinance: How we make extended hours work for us

Author

Alessi, Charles

Subjects
Medical personnel and patient, Work hours, Medical care -- United Kingdom, Physicians (General practice) -- Practice, Health, Health care industry
Abstract

A practice near London extended its opening hours so successfully Prime Minister Gordon Brown and health secretary Alan Johnson looked in to see how things are done. Dr Charles Alessi [...]

Published
2007

39. How we'll stamp out overcharging acute trusts.

Author

Alessi, Charles

Subjects
*COLLECTING of accounts, *OVERPAYMENT, *MEDICAL audit, *MEDICAL records, *GENERAL practitioners
Abstract

The article explains how general practitioners (GPs) are watching hospital activity to prevent miscoding and overpayment. It explores the proposal of two-stage process for monitoring activity that aims to establish automated systems to highlight anomalies, and then introduce a system of clinical audit to ensure providers are coding correctly. It also investigates the proposal to audit the medical records to examine the correlation between what was requested by the GP.

Published
2011

40. Will polyclinics benefit patients?

Author

Alessi, Charles

Subjects
*CONCEPTS, *HEALTH services administration, *MEDICAL quality control
Abstract

The article focuses on the views of several people on the effect of the proposed polyclinics among patients. Dr. Charles Alessi points out that such scheme promotes a wide variety of services to patients without losing the personal touch. Further, Dr. Mark Levy reveals that the proposed polyclinic threatens the principle of personalized care among patients.

Published
2008

42. Commissioning: Referral Management - How armed forces GPs refer patients.

Author

Macleod, Jeff and Alessi, Charles

Abstract

The article reports that general practitioners (GPs) in British Forces Germany Health Service (BFGHS) are aspiring to Great Britain accepted best practice as well as referring patients into a contracted German secondary care health service. As stated, the secondary care health service is the system of funding and operation which is different from England's. It also discusses whether commissioners in England can learn from work in Germany.

Published
2011

43. Commissioning to reduce costs.

Author

Alessi, Charles

Subjects
*CONSORTIA, *PUBLIC service commissions, *COST structure, *SUCCESS, *MEDICAL care costs
Abstract

The article offers tips from Dr. Charles Alessi that help commissioning consortium kept within the budget and generate efficiency savings. It highlights the significance to set clinical priorities and have to live within one's limitations and on areas that are more important. It also mentions the need to learn from one's successes and mistakes and to aim for a small yet achievable change.

Published
2011

44. How our children's clinic cut A&E visits by 40%.

Author

Alessi, Charles

Subjects
*PHYSICIANS, *MEDICAL practice
Abstract

A personal narrative is presented which explores the author's experience for the success of his practice.

Published
2010

45. Are fixed-share partnerships a fair way of employing GPs?

Author

Alessi, Charles and Canning, John

Subjects
*PARTNERSHIP agreements, *GENERAL practitioners, *FAMILY medicine, *MEDICAL practice
Abstract

The article discusses the issue whether fixed-share partnerships are fair way of employing general practitioners (GPs) in Great Britain. It notes that this fixed-share partnerships can be sensible to GPs' flexible contracts as long as they are not substandard. They make it easier to employ doctors under various contractual arrangements. It notes that the general practice faces uncertainty financially and structurally.

Published
2008

48. NHS England chief executive: welcome back, Simon. Here's your to-do list.

Author

Appleby J, Charles A, Maynard A, Kar P, Gerada C, Prabhu U, O'Riordan D, Wood J, Alessi C, Doyle A, Dixon M, Kell S, Bell A, Dalton S, Rodrigues L, Coghill Y, Kline R, Morgan B, Farrington-Douglas J, Foster A, Humphries R, Keene S, and Koczan P

Subjects
Administrative Personnel, Cost Control methods, Cost Control standards, England, Healthcare Disparities economics, Humans, Mental Health Services economics, Primary Health Care economics, Social Work economics, State Medicine economics, State Medicine organization & administration, Healthcare Disparities standards, Mental Health Services standards, Primary Health Care standards, Social Work standards, State Medicine standards
Published
2014

49. Ten steps to realise personalised healthcare.

Author

Alessi C, Snowdon A, and Schnarr K

Subjects
Humans, Medical Informatics trends, Patient Access to Records, Patient-Centered Care trends, Professional-Patient Relations, State Medicine trends, United Kingdom, Medical Informatics organization & administration, Patient-Centered Care standards, State Medicine standards
Published
2014

50. Target transformation over hospital closures. The 1962 hospital plan provides inspiration for solving the financial and sustainability dilemmas facing acute care.

Author

Myatt J, Philip I, Randall J, and Alessi C

Subjects
Catchment Area, Health economics, Cost Control methods, Health Facility Size economics, Health Facility Size standards, Health Facility Size trends, Hospitals, General organization & administration, Hospitals, General trends, Hospitals, Special organization & administration, Hospitals, Special standards, Humans, Models, Organizational, Program Evaluation economics, State Medicine organization & administration, State Medicine trends, United Kingdom, Health Facility Closure economics, Hospital Planning economics, Hospitals, General economics, Hospitals, Special economics, State Medicine economics
Published
2013

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