Effectiveness-implementation hybrid type 2 study evaluating an intervention to support 'information work' in dementia care: an implementation study protocol.

Introduction: Patients with long-term conditions consistently report a lack of information around services and support available to them. This unmet need for information is significant among people with dementia and family carers. A quality improvement intervention is being carried out to tackle this issue as part of a co-creation initiative in the North East of England (UK).

A need-based, multi-level, cross-sectoral framework to explain variations in satisfaction of care needs among people living with dementia.

Background: Provision of care and support for people with dementia and family carers is complex, given variation in how dementia manifests, progresses and affects people, co-morbidities associated with ageing, as well as individual preferences, needs, and circumstances. The traditional service-led approach, where individual needs are assessed against current service provision, has been recognised as unfit to meet such complexity. As a result, people with dementia and family members often fail to receive adequate support, with needs remaining unmet.

Preventing type 2 diabetes: systematic review of studies of cost-effectiveness of lifestyle programmes and metformin, with and without screening, for pre-diabetes.

Objective: Explore the cost-effectiveness of lifestyle interventions and metformin in reducing subsequent incidence of type 2 diabetes, both alone and in combination with a screening programme to identify high-risk individuals.

Design: Systematic review of economic evaluations.

Data Sources And Eligibility Criteria: Database searches (Embase, Medline, PreMedline, NHS EED) and citation tracking identified economic evaluations of lifestyle interventions or metformin alone or in combination with screening programmes in people at high risk of developing diabetes.

STAR--people-powered prioritization: a 21st-century solution to allocation headaches.

The aim of cost effectiveness analysis (CEA) is to inform the allocation of scarce resources. CEA is routinely used in assessing the cost-effectiveness of specific health technologies by agencies such as the National Institute for Health and Clinical Excellence (NICE) in England and Wales. But there is extensive evidence that because of barriers of accessibility and acceptability, CEA has not been used by local health planners in their annual task of allocating fixed budgets to a wide range of types of health care.

Using an epidemiological model to investigate unwarranted variation: the case of ventilation tubes for otitis media with effusion in England.

Objectives: To investigate unwarranted variation in ventilation tube insertions for otitis media with effusion in children in England. This procedure is known to be 'overused' from clinical audits, as only one in three ventilation tube insertions conforms to the appropriateness criteria of the National Institute for Health and Care Excellence (NICE); but audits cannot identify the scale of 'underuse' - i.e.

Disinvestments in practice: overcoming resistance to change through a sociotechnical approach with local stakeholders.

For health care, economists have developed cost-effectiveness analysis (CEA) as a "rational," analytic tool to set priorities. Attempts to use CEA to decide how to cut expenditures, however, have been met with stakeholders' resistance. This article presents an illustrative case study of the application of an approach explicitly designed to engage stakeholders with conflicting objectives in confronting tightening budgets.

Four days later in Cincinnati: longitudinal tests of hyperbolic discounting.

Hyperbolic discounting of delayed rewards has been proposed as an underlying cause of the failure to stick to plans to forego one's immediate desires, such as the plan to diet, wake up early, or quit taking heroin. We conducted two tests of inconsistent planning in which respondents made at least two choices between a smaller-sooner (SS) and larger-later (LL) amount of money, one several weeks before SS would be received, and one immediately before. Hyperbolic discounting predicts that there would be more choices of SS as it became more proximate-and, equivalently, that among those who change their mind, "impatient shifts" (LL-to-SS) will be more common than "patient shifts" (SS-to-LL).

Modelling the impact on avoidable cardiovascular disease burden and costs of interventions to lower SBP in the England population.

Background: The burden of disease from cardiovascular disease (CVD) remains significant in England. Blood pressure remains an important risk factor. Health gain through public health measures and improving treatment compliance are potentially likely to be high.

Nuclear risk management on stage: a decision analysis perspective on the UK's Committee on Radioactive Waste Management.

In 2003, the UK government set up a broad-based Committee on radioactive waste management (CoRWM) to look at the UK's policy on radioactive waste management with a view to jumpstarting a stalled policy process. The committee's brief was to come up with a set of recommendations that would protect the public and the environment, and be capable of inspiring public confidence. After consulting widely with the public and stakeholders, and drawing on advice from scientists and other experts, CoRWM arrived at a remarkably well-received set of recommendations.

Adjusting life for quality or disability: stylistic difference or substantial dispute?

This paper focuses on the contrast between describing the benefit of a healthcare intervention as gain in health (QALY-type ideas) or a disability reduction (DALY-type ideas). The background is an apparent convergence in practice of the work conducted under both traditions. In the light of these methodological developments, we contrast a health planner who wants to maximise health and one who wants to minimise disability.

Exploring the healthcare journey of patients with rheumatoid arthritis: a mapping project - implications for practice.

Objective: Consumers of healthcare can reveal important insights into the personal challenges they experience when negotiating their health needs. The National Rheumatoid Arthritis Society (NRAS) wanted to explore the experiences of those with rheumatoid arthritis (RA) in order to understand the impact on the individual and on healthcare resources and benchmark care against published standards and guidelines.

Methods: A project was designed to explore the experiences of individuals with sero-positive RA who had been diagnosed for three years or less.

Requisite models for strategic commissioning: the example of type 1 diabetes.

A developing emphasis of health care reforms has been creating organisations with responsibilities for strategic commissioning of services for defined populations. Such organisations must set priorities in aiming to meet their populations' needs subject to a budget constraint. This requires estimates of the health benefits and costs of different interventions for their populations.