Barriers to a software reminder system for risk assessment of stroke in atrial fibrillation: a process evaluation of a cluster randomised trial in general practice.

Background: Oral anticoagulants reduce the risk of stroke in patients with atrial fibrillation (AF), but are underused. AURAS-AF (AUtomated Risk Assessment for Stroke in AF) is a software tool designed to identify eligible patients and promote discussions within consultations about initiating anticoagulants.

Aim: To investigate the implementation of the software in UK general practice.

Impact of the Prevalence of Concordant and Discordant Conditions on the Quality of Diabetes Care in Family Practices in England.

Purpose: The purpose of this study was to examine the association between the prevalence of both diabetes-concordant and diabetes-discordant conditions and the quality of diabetes care at the family practice level in England. We hypothesized that the prevalence of concordant (or discordant) conditions would be associated with better (or worse) quality of diabetes care.

Methods: We conducted a cross-sectional study using practice-level data (7,884 practices).

Polarization spectroscopy of a velocity-selected molecular sample.

This Letter demonstrates polarization spectroscopy of a velocity selected and vibrationally excited molecular sample. Specifically, the anisotropy induced by a circularly polarized IR pump beam tuned to the R(14.5)(1/2)v=1←v=0 transition of nitric oxide is observed using an IR probe resonant with the R(15.

Pump and probe spectroscopy with continuous wave quantum cascade lasers.

This paper details infra-red pump and probe studies on nitric oxide conducted with two continuous wave quantum cascade lasers both operating around 5 μm. The pump laser prepares a velocity selected population in a chosen rotational quantum state of the v = 1 level which is subsequently probed using a second laser tuned to a rotational transition within the v = 2 ← v = 1 hot band. The rapid frequency scan of the probe (with respect to the molecular collision rate) in combination with the velocity selective pumping allows observation of marked rapid passage signatures in the transient absorption profiles from the polarized vibrationally excited sample.

Impact of universal health insurance coverage on hypertension management: a cross-national study in the United States and England.

Background: The Patient Protection and Affordable Care Act (ACA) galvanised debate in the United States (US) over universal health coverage. Comparison with countries providing universal coverage may illustrate whether the ACA can improve health outcomes and reduce disparities. We aimed to compare quality and disparities in hypertension management by socio-economic position in the US and England, the latter of which has universal health care.

Do-it-yourself healthcare: the current landscape, prospects and consequences.

The wider availability and increasing use of mHealth tools - covering health applications, smartphone plug-ins and gadgets is significant for healthcare. This trend epitomises broader trajectories in access to and delivery of healthcare, with greater consumer involvement and decentralisation. This shift may be conceptualised as 'do-it-yourself Healthcare' - allowing consumers to monitor and manage their health, and guide their healthcare consumption.

The English North-South divide: risk factors for cardiovascular disease accounting for cross-sectional socio-economic position.

Aims: Given a North-South divide in mortality in England, we aimed to assess the extent of a North-South divide in risk factors for cardiovascular disease (CVD), controlling for markers of socio-economic position (SEP).

Methods: We undertook cross-sectional analyses using respondents from the 2006 Health Survey for England. We assessed mean systolic blood pressure, total cholesterol, body mass index (BMI) and smoking prevalence in the two regions.

Effectiveness of a national cardiovascular disease risk assessment program (NHS Health Check): results after one year.

Objective: We aimed to assess whether the National Health Service (NHS) Health Check, a systematic cardiovascular disease (CVD) risk assessment and management program, was associated with reduction in CVD risk in attendees after one year.

Methods: We extracted data from patients aged 40-74 years, with high estimated CVD risk, who were registered with general practices in a deprived, culturally diverse setting in England. We included 4748 patients at baseline (July 2008-November 2009), with 3712 at follow-up (December 2009-March 2011).

Ethnic group differences in cardiovascular risk assessment scores: national cross-sectional study.

Objectives: There are marked inequalities in cardiovascular disease (CVD) incidence and outcomes between ethnic groups. CVD risk scores are increasingly used in preventive medicine and should aim to accurately reflect differences between ethnic groups. Ethnicity, as an independent risk factor for CVD, can be accounted for in CVD risk scores primarily using two methods, either directly incorporating it as a risk factor in the algorithm or through a post hoc adjustment of risk.

The nationwide systematic prevention of cardiovascular disease: the UK's health check programme.

High-income countries have witnessed marked reductions in cardiovascular disease (CVD) in recent years. Aging populations, however, maintain CVD as a major threat to public health and health system's financial stability. England has commenced on a population-wide screening and prevention program for CVD, the NHS Health Check program, the first national program of its type.

Assessment of cardiovascular risk factors prior to NHS Health Checks in an urban setting: cross-sectional study.

Objectives: To assess the completeness of cardiovascular disease (CVD) risk factor recording and levels of risk factors in patients eligible for the NHS Health Check.

Design: Cross-sectional study.

Setting: Twenty-eight general practices located in Hammersmith and Fulham, London, UK.

Prevalence of cardiovascular disease risk amongst the population eligible for the NHS Health Check Programme.

Background: The National Health Service (NHS) Health Check Programme aims to identify and manage patients in England aged 40-74 years with a 10-year cardiovascular disease (CVD) risk score over 20%. We aimed to assess the prevalence of high CVD risk in the English population, using the two CVD risk scores and the 20% cut off mandated in national policy, and the prevalence of risk factors within this population.

Design: Modelling study using patients registered in general practice in England.

Uptake of the NHS Health Checks programme in a deprived, culturally diverse setting: cross-sectional study.

Background: The UK is embarking on a national cardiovascular risk assessment programme called NHS Health Checks; in order to be effective, high and equitable uptake is paramount.

Methods: A cross-sectional study, using data extracted from electronic medical records of persons aged 35-74 years estimated to be at a high risk of developing cardiovascular disease, to examine the uptake of the Health Checks using logistic regression and statin prescribing.

Results: A total of 44.

The comparison of cardiovascular risk scores using two methods of substituting missing risk factor data in patient medical records.

Background: Targeted screening for cardiovascular disease (CVD) can be carried out using existing data from patient medical records. However, electronic medical records in UK general practice contain missing risk factor data for which values must be estimated to produce risk scores.

Objective: To compare two methods of substituting missing risk factor data; multiple imputation and the use of default National Health Survey values.

Implementation of the NHS Health Checks programme: baseline assessment of risk factor recording in an urban culturally diverse setting.

Background: National Health Service (NHS) Health Checks, a population-wide prevention programme introduced during 2009, aims to measure and manage cardiovascular disease (CVD) risk factors among all persons aged 40-74 years in England. The potential workload implications of the programme for general practice are considerable, particularly in deprived culturally diverse settings.

Objective: To examine the baseline levels of CVD risk factor recording in general practices located in Ealing, North West London.