The Public Health Observatory Handbook of Health Inequalities Measurement (2005)

This SEPHO handbook primarily focuses on the measurement and interpretation of health inequalities. Written by Roy Carr-Hill and Paul Chalmers-Dixon of York University, it provides a comprehensive collection of material for those concerned to document and understand health inequalities.

National Child Measurement Programme: Detailed Analysis of the 2006/07 National Dataset

The National Child Measurement Programme (NCMP) weighs and measures children in Reception (typically aged 4 - 5 years) and (aged 10 - 11 years) annually. The report highlights the usefulness of the NCMP Dataset in furthering our understanding of underweight, overweight and obesity in children, as well as highlighting some areas where improvements can be made in the programme, or where further analysis and investigation is required. The purpose of this report is not to provide specific local results, but an understanding from national-level analysis that can be used to inform local uses and analysis of NCMP data.

Supporting Healthy Lifestyles: The Natioanl Child Measurement Programme - Guidance for 2006 - 07 school year

The Department of Health is providing a central data store for child obesity data collected by PCTs to be available for live implementation by the end of June 2006. The central data store will be accessible by PCTs via Unify, the DH performance management system.

The national child measurement programme guidance for PCTs: 2007-08 school year

This guidance has been developed following wide consultation with primary care trusts (PCTs) and schools. It provides advice to PCTs on: arrangements for measuring the height and weight of primary and middle school children as part of the National Child Measurement Programme; and upload of this information to the Information Centre for health and social care (IC). refer to the resource

National Child Measurement Programme Guidance for 2007-08: Summary points

The guidance on the National Child Measurement Programme was published on 26 September 2007. This paper summarises the main points relevant to PCTs, SHAs and PHOs. The department of health website (see link at the end of the briefing) also includes specimen letters that can be customised for local use.

National Child Measurement Programme: detailed analysis of the 2007/08 dataset

The report provides analysis of PCT participation levels and investigates data quality issues in the collection of the 2007/08 NCMP dataset.

North West Child Height & Weight Measurement 2007

This analysis of child overweight and obesity data has been produced by the North West Public Health Observatory on behalf of PCTs in the region in order to look at inequalities across deprivation quintiles and to produce Local Authority District measures of child obesity.

National Child Measurement Programme. Detailed Analysis of the 2006/07 Dataset

The National Child Measurement Programme (NCMP) weighs and measures children in Reception (typically aged 4 - 5 years) and (aged 10 - years) annually. The report highlights the usefulness of the NCMP Dataset in furthering our understanding of underweight, overweight and obesity in children, as well as highlighting some areas where improvements can be made in the programme, or where further analysis and investigation is required. The purpose of this report is not to provide specific local results, but an understanding from national-level analysis that can be used to inform local uses and analysis of NCMP data.

National Child Measurement Programme: Detailed Analysis of the 2006/07 National Dataset

The National Obesity Observatory has produced a new report - National Child Measurement Programme: Detailed Analysis of the 2006/07 National Dataset. The report highlights the usefulness of the NCMP for advancing our understanding of underweight, overweight and obesity in children. The report looks at the effects of socio-demographic and other factors on the reported prevalence of childhood obesity. It also identifies areas where improvements can be made, and where further analysis and investigation are required.

Family doctors' consultations with people suffering from chronic pain without objective findings: Which protective practices might they develop in these challenging medical encounters?

Introduction: Consultations with patients suffering from chronic pain without objective findings represent a challenge fo r family doctors (FDs). A mutual lack of understanding may arise, which threatens the doctor-patient relationship and may lead to dissatisfaction of both patient and doctor and to a breakdown of the therapeutic alliance. Objectives: This study aims to investigate FDs' potential protective practices to preserve the doctor-patient relationship during this type of consultation. Method: In the first step of this qualitative research, I carried out a range of 10 se- mi-structured interviews with FDs to explore their reported practices and repre- sentations during consultations with people suffering from chronic pain without objective findings. The interviews' transcripts were integrally analysed with computer-assisted thematic content analysis (QSR NVivo ® ) to highlight the main themes related to the topic in the participants' talk. Results: At this point of the research, two types of FDs' protective practices can be identified: first the use of complementary sources of knowledge in addition to the medical model to provide explanations to patients, second the collaboration with multidisciplinary teams or support gr oups that allow them to share profes- sional expertise and emotional experiences. Conclusion: The findings could be useful to develop ways to improve the follow- up of patients suffering from chronic pain without objective findings and conse- quently the FDs' work satisfaction.

p.L1612P, a novel voltage-gated sodium channel Nav1.7 mutation inducing a cold sensitive paroxysmal extreme pain disorder.

BACKGROUND: Mutations in the SCN9A gene cause chronic pain and pain insensitivity syndromes. We aimed to study clinical, genetic, and electrophysiological features of paroxysmal extreme pain disorder (PEPD) caused by a novel SCN9A mutation. METHODS: Description of a 4-generation family suffering from PEPD with clinical, genetic and electrophysiological studies including patch clamp experiments assessing response to drug and temperature. RESULTS: The family was clinically comparable to those reported previously with the exception of a favorable effect of cold exposure and a lack of drug efficacy including with carbamazepine, a proposed treatment for PEPD. A novel p.L1612P mutation in the Nav1.7 voltage-gated sodium channel was found in the four affected family members tested. Electrophysiologically the mutation substantially depolarized the steady-state inactivation curve (V1/2 from -61.8 ± 4.5 mV to -30.9 ± 2.2 mV, n = 4 and 7, P < 0.001), significantly increased ramp current (from 1.8% to 3.4%, n = 10 and 12) and shortened recovery from inactivation (from 7.2 ± 5.6 ms to 2.2 ± 1.5 ms, n = 11 and 10). However, there was no persistent current. Cold exposure reduced peak current and prolonged recovery from inactivation in wild-type and mutated channels. Amitriptyline only slightly corrected the steady-state inactivation shift of the mutated channel, which is consistent with the lack of clinical benefit. CONCLUSIONS: The novel p.L1612P Nav1.7 mutation expands the PEPD spectrum with a unique combination of clinical symptoms and electrophysiological properties. Symptoms are partially responsive to temperature but not to drug therapy. In vitro trials of sodium channel blockers or temperature dependence might help predict treatment efficacy in PEPD.

An analysis of the components of pain, function, and health-related quality of life in patients with failed back surgery syndrome treated with spinal cord stimulation or conventional medical management

Objectives: Failed back surgery syndrome (FBSS) patients experience pain, functional disability, and reduced health-related quality of life (HRQoL) despite anatomically successful surgery. Examining sub-dimensions of health outcomes measures provides insight into patient well-being. Materials and Methods: The international multicenter PROCESS trial collected detailed HRQoL (EuroQol-5D; Short-Form 36) and function (Oswestry Disability Index) information on 100 FBSS patients. Results: At baseline, patients reported moderate-to-severe leg and back pain adversely affecting all dimensions of function and HRQoL. Compared with conventional medical management alone, patients also receiving spinal cord stimulation (SCS) reported superior pain relief, function, and HRQoL at six months on overall and most sub-component scores. The majority of these improvements with SCS were sustained at 24 months. Nonetheless, 36-40% of patients experienced ongoing marked disability (standing, lifting) and HRQoL problems (pain/discomfort). Conclusions: Longer-term patient management and research must focus on these refractory FBSS patients with persisting poor function and HRQoL outcomes.

Douleurs neuropathiques : quelques pistes pour une évaluation structurée et une prise en charge spécifique et globale [Neuropathic pain: tips and tools for specific and comprehensive pain management]

Les syndromes neuropathiques sont caractérisés par une douleur d'intensité élevée, de longue durée et résistante aux analgésiques classiques. De fait, il existe un risque important de répercussions sur la vie et le bien-être des patients. A travers une vignette clinique, cet article abordera le diagnostic, le traitement spécifique et l'impact de la douleur neuropathique sur la qualité de vie et les conséquences psychologiques associées, comme la dépression et l'anxiété. Nous présenterons des outils validés qui permettent d'objectiver la composante neuropathique aux douleurs et les comorbidités psychiatriques associées. Cette évaluation globale favorise un meilleur dialogue avec les patients ainsi que l'élaboration de stratégies thérapeutiques, notamment par le biais d'antidépresseurs, dont l'efficacité sera discutée en fin d'article. Neuropathic pain syndromes are characterized by intense and long lasting pain that is resistant to usual analgesics. Patients are therefore at high risk of decreased quality of life and impaired well-being. Using a case report, we will consider in this article the diagnosis and treatment of neuropathic pain as well as its impact on the quality of life including psychological consequences such as depression and anxiety. We will present simple and reliable scales that can help the general practitioner evaluate the neuropathic component of the pain syndrome and its related psychiatric co-morbidities. This comprehensive approach to pain management should facilitate communication with the patient and help the practitioner select the most appropriate therapeutic strategy, notably the prescription of antidepressants, the efficacy of which we will discuss at the end of the article.