Medical Centre

I recently attended the Middle East and North Africa (MENA) Diabetes Forum , which was held in Dubai in December 2010. The countries in the MENA region have amongst the world's highest prevalence of diabetes, driven by rapid changes in income, lifestyle, diet and physical activity. The forum covered a range of issues, from prevention, early diagnosis, and effective treatment. There were also sessions in which policies from other countries, such as the UK, USA and Italy, were discussed so that these policies from other health systems could be examined to see what lessons they might offer the countries of the MENA region. Amongst the speaker were Professor Tawfik Khoja , Professor Jean-Claude Mbanya , Professor Salman Rawaf , Professor Ala Alwan and former US President William (Bill) Clinton. I spoke about the UK experience of implementing screening programmes for diabetes and the UK pay for performance framework that encourages primary care physicians to provide high-quality car...

A recent paper in the journal Thorax by Amaia Calderón-Larrañaga annd colleagues examined the association between hospital admissions for chronic obstructive pulmonary diseases (COPD) and population and primary health care factors. Hospital admission rates for COPD are known to be strongly associated with population factors. Primary care services may also affect admission rates, but there is little direct supporting evidence. The study examined admission rates in 8,064 general practices in 152 English PCTs. Admission rates for COPD were strongly associated with population deprivation and smoking prevalence, whereas  healthcare factors such as influenza immunisation, patient-reported access to consultations within two days, and primary care staffing, were protective.

About one million people worldwide die each year from suicide. Hence, strategies to reduce deaths from suicide are a key public health priority in many countries. A recent study by Dennis Ougrin and colleagues published in the Journal of Public Health aimed to collate relevant data from local and national sources, which will demonstrate the incidence of death from suicide and undetermined injury in the London Borough of Brent. The study also aimed to determine the characteristics of the subjects dying of suicide and undetermined injury in the locality and to identify what structures and processes are in place for recognizing, monitoring and sharing information about suicide between primary care, secondary care and public health. The authors identified all deaths by suicides and open verdicts in the residents of Brent between February 2005 and February 2008. Health records of the identified subjects were analysed by two researchers. The annual rate of su...

Cardiovascular diseases remain the main cause of morbidity and mortality in the UK. Strategies to reduce the burden of cardiovascular disease UK, such as the Quality & Outcomes Framework for general practitioners, have often emphasized improved management of high-risk individuals, rather than more population-based approaches to prevention. A recent study published in the  Journal of Public Health Medicine  by  Anthony Laverty  and colleagues from  Imperial College London  examined blood pressure monitoring and control among patients with and without cardiovascular disease in general practices in Wandsworth, London between 1998 and 2007. Logistic regression was used to assess associations among age, gender, ethnicity, deprivation and blood pressure control. Laverty and colleagues found that the percentage of patients with elevated blood pressure (>140/90 mm Hg) decreased at a significantly slower rate in patients without cardiovascular disease (from ...