Journal of epidemiology and community health
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J Epidemiol Community Health · Mar 2007
Review Comparative StudyElective surgery for aortic abdominal aneurysm: comparison of English outcomes with those elsewhere.
The aim of this study was to quantify mortality after elective repair of abdominal aortic aneurysm (AAA) in England, and to compare English case fatality rates (CFRs) with those reported in the literature. ⋯ The CFR after elective surgical repair in England within 30 days of operation (6.8%) was higher than expected from the literature. Differences between England and other countries in quality of care is one possible explanation for the findings, but other explanations are possible and are discussed.
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J Epidemiol Community Health · Mar 2007
Randomized Controlled Trial Multicenter StudyThe effectiveness and cost effectiveness of a national lay-led self care support programme for patients with long-term conditions: a pragmatic randomised controlled trial.
Supporting patients' self care could have a major effect on the management of long-term conditions, which has led to worldwide interest in effective self care interventions. In England, self care support is being developed through the "Expert Patients Programme", which provides lay-led generic courses to improve patients' self care skills. However, the clinical and cost effectiveness of such courses remains unclear. ⋯ Lay-led self care support groups are effective in improving self-efficacy and energy levels among patients with long-term conditions, and are likely to be cost effective over 6 months at conventional values of a decision-maker's willingness to pay. They may be a useful addition to current services in the management of long-term conditions.
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J Epidemiol Community Health · Mar 2007
Charcoal burning suicides in Hong Kong and urban Taiwan: an illustration of the impact of a novel suicide method on overall regional rates.
Following the first case in Hong Kong in 1998, the method of committing suicide by charcoal burning has spread to other communities. This aim of this study was to examine the impact of charcoal burning suicides on both overall suicide rates and older-method suicide rates in Hong Kong and urban Taiwan. ⋯ The lack of parallel decreases in the suicides rates of older methods with the rise of charcoal burning suicides suggests limited substitution between the methods. The preponderance of the rise in suicide deaths associated with charcoal burning suggests that its invention, followed by wide media dissemination, may have specifically contributed to the increase in suicides in both regions. As a similar increase was found in urban Taiwan as in Hong Kong, charcoal burning suicide should not be viewed as merely a local health problem and has the potential to become a major public health threat in other countries.