Coronary heart disease risk screening: the community pharmacy Healthy Heart Assessment Service

Objectives We examined the characteristics and CHD risks of people who accessed the free Healthy Heart Assessment (HHA) service operated by a large UK pharmacy chain from August 2004 to April 2006. Methods Associations between participants’ gender, age, and socioeconomics were explored in relation to calculated 10-year CHD risks by cross-tabulation of the data. Specific associations were tested by forming contingency tables and using Pearson chi-square (χ2). Results Data from 8,287 records were analysable; 5,377 were at low and 2,910 at moderate-to-high CHD risk. The likelihood of moderate-to-high risk for a male versus female participant was significantly higher with a relative risk ratio (RRR) 1.72 (P < 0.001). A higher percentage of those in socioeconomic categories ‘constrained by circumstances’ (RRR 1.15; P < 0.05) and ‘blue collar communities’ (RRR 1.13; P < 0.05) were assessed with moderate-to-high risk compared to those in ‘prospering suburbs’. Conclusions People from ‘hard-to-reach’ sectors of the population, men and people from less advantaged communities, accessed the HHA service and were more likely to return moderate-to-high CHD risk. Pharmacists prioritised provision of lifestyle information above the sale of a product. Our study supports the notion that pharmacies can serve as suitable environments for the delivery of similar screening services.

Post War land reform and the impact on planning in Japan

One feature of Japanese urban areas in the 21st century that is bound to strike any Western visitor is the extensive spread of its suburbs with their varied mixing of land-uses. It is almost impossible to pinpoint precisely where the city begins and where it ends. During the post-War period, this characteristic pattern of land-use sprawled over the countryside, seemingly unimpeded by planning restrictions. The number of studies that highlight the problems of Japanese planning outweighs the research that explores its underlying causes. This paper aims to partly redress this imbalance by describing a case study of the failed implementation of the green belt around Tokyo and to link this with the Allied Occupation’s postwar land reforms and drafting of a new constitution in the period 1946-1951. Overall, we aim to highlight how the ostensible benefits and aims of a land reform programme can entail substantial disbenefits or unforeseen outcomes in terms of land-use planning..

Venues on the verges: London's theater government between 1594 and 1614

In 1594, major decisions were made by the governors of London and the country about plays and playing. We need to learn what lay behind these events, such as what led James Burbage to build his Blackfriars theater in 1596. That initial fiasco might tell us much about what lay behind Shakespeare’s decision to join the new Chamberlain’s Men in 1594 and his subsequent commitment to them as a full-time playwright. When the Globe burned down in 1613, a majority of the shareholders decided to rebuild it at great cost, but Shakespeare withdrew. The rebuilding was old-fashioned thinking, reverting to the company’s desire, asserted in 1594, to play indoors in winter, which helps to clarify their decisions and Shakespeare’s own—to write plays rather than more long poems. The few surviving papers of the Privy Council and the London mayoralty from the time suggest that one of the two new companies of 1594 preferred to play indoors during the winter instead of at their allocated open playhouses in the suburbs. They tried to renew this traditional practice, first in 1594 and again in 1596 when James Burbage built the indoor Blackfriars playhouse for them. The renewal of the Globe in 1614 was part of the same thinking, although Shakespeare evidently opted out of the decision.