The potential for reducing greenhouse gas emissions through disease prevention: a secondary analysis of data from the CREDENCE trial.

Background: The health-care sector is responsible for 5·2% of global emissions, however, little data exist regarding the environmental impact of disease management strategies. SGLT2 inhibitors are now widely used to reduce the risk of hospital admission and kidney failure in people with type 2 diabetes and chronic kidney disease. This study aimed to estimate the impact of SGLT2 inhibitors on greenhouse gas emissions using data from the CREDENCE trial.

Assessing the environmental impact of an anastomotic leak care pathway.

Background: The healthcare sector faces increasing pressure to improve environmental sustainability whilst continuing to meet the needs of patients. One strategy is to lower the avoidable demand on healthcare services, by reducing the number of surgical complications, such as anastomotic leak (AL). The aim of this study was to assess the environmental impact associated with the care pathway of AL.

Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries.

National health systems need strengthening if they are to meet the growing challenge of chronic diseases in low-income and middle-income countries. By application of an accepted health-systems framework to the evidence, we report that the factors that limit countries' capacity to implement proven strategies for chronic diseases relate to the way in which health systems are designed and function. Substantial constraints are apparent across each of the six key health-systems components of health financing, governance, health workforce, health information, medical products and technologies, and health-service delivery.

Health inequalities in England: advocacy, articulation and action.

There is a long history of people expressing concern about the health, lifestyle and well-being of our population--and of proposals for action to address the inequitable experiences between groups within this population. Over time, our understanding of both the problem and its causal connections has changed considerably. This is reflected within an increasingly explicit articulation of the issues and a progressively more sophisticated and determined cross-sectoral approach to tackling health inequalities.

Creating Europe-wide health policies: a case study.

Many local-level issues have direct parallels within broader transnational and global trends. Using practical examples, this article will share the learning from policy development for England within the broader European context, focusing particularly on the changing partnership dynamics and the opportunities afforded for policy development by the new communications technologies.

The three domains of public health: an internationally relevant basis for public health education?

By focusing on the Masters of Public Health course, this study took a pragmatic approach to exploring the interface between public health education and public health practice. The commonly utilized 'three domains of practice' framework could provide a robust and explicit link between educational provision and practice for public health. This model provides the workforce, the university, the students and the potential funders of the course with an easily comprehensible framework for understanding how the modules of an MSc can support the development of competency within the context of practice.

The role of the Government in public health: a national perspective.

The main challenges today are complex systems problems, with equally complex solutions; there are problems that have the potential to affect all individuals at different levels, affecting health, the sustainability of health services, and potentially the long-term economic prosperity of the country. The evidence shows that unless people themselves are engaged, releasing their potential for action, supporting a cultural shift towards a health promoting society, it is unlikely that the necessary sustainable impact on obesity, diabetes and other chronic diseases will be achieved. By reflecting on experience in England, this article will provide an insight into the potential for change that can be generated by rebalancing the relationship between the state, the individual and civil society.

Sustainable development and public health: a national perspective.

The increasing policy focus on sustainable development offers new opportunities to align the public health narrative with that of sustainable development to promote both sustainable health for the population, and a sustainable health care system for England. This paper provides some insights into ways in which potential linkages between the two areas can be made meaningful across a wide range of policies at a national level.

Better than a cure.

A brief glance through the national papers and medical press shows the depth of concern with the cost of delivering high quality, free at the point of access healthcare to the population. However, at a time of increasingly greater demands being placed on public health systems across the globe, the question of how we can make health and healthcare both accessible to everyone and sustainable in the long term is being posed. In this paper we provide an insight into how England is responding to these challenges.

Evidence into practice: a theory based study of achieving national health targets in primary care.

Rationale, Aims And Objectives: This study investigates reasons why general practices achieve nationally set milestones to different extents. It compares the beliefs, self-reported behaviours and organizational context of general practitioners (GPs) who have been successful in achieving milestones set out in the UK's National Service Framework (NSF) for Coronary Heart Disease (CHD) with those who have been less successful.

Methods: Sixteen London GPs were interviewed, eight 'high implementers' (having met five or more of six CHD NSF milestones) and eight 'low implementers' (having met one or two milestones).

Postgraduate training in public health medicine: St George's Hospital Medical School Library public health information service.

This article examines the development of the St George's Hospital Medical School Library public health information service. Begun in 1997 as a pilot project to support Public Health Specialist Registrars in South Thames West, it is now an established part of postgraduate training in the region. An outline of the service is described, including the evolution of the post of Public Health Librarian.

Fibrinogen and factor VII levels are related to adiposity but not to fetal growth or social class in children aged 10-11 years.

Factors operating in fetal life or during childhood may be important in determining fibrinogen and factor VII concentrations in adult life, and particularly in explaining social gradients in cardiovascular disease risk. In 1994, the authors measured fibrinogen and factor VIIc levels in 641 children aged 10-11 years (61% response rate) from schools in five towns in England and Wales. Birth weight was obtained by maternal recall, and other data on measures of fetal growth were obtained from birth records.