Abstracts
Short abstracts for each oral and poster presentation are given below, along with copies of the presentations given where available.
Jump to: Assessing and commissioning local services for health (oral) | 'Lifestyle' risk factors in public health (oral) | Improving management of communicable diseases (poster) | Education and training in public health (poster)
Good maternal health results in improved outcomes for both the parent and the newborn. Maternal health is also an area which highlights the inequalities caused by deprivation and ethnic status - Infant and maternal mortality are higher in the more deprived populations. The NSF for children spoke of developing a service that was flexible and responsive to the needs of the individual while promoting as far as possible a normal birth experience. Four 'national choice' guarantees were proposed as the means to improving the quality and accessibility of maternity services with the underlying principle that pregnancy and child birth are natural events to be supported by a midwife. The challenge to commissioners is to provide the 'choice' to the population they serve in the face of demographic and lifestyle changes, EWTD and the challenge of ensuring continuity of care in the community. This needs assessment seeks to take the first steps in the future commissioning process for Oxfordshire.
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the presentation (MS PowerPoint, 98kb)
Aims/Objectives: This review was undertaken and led by the public health team at Milton Keynes PCT and aimed to review evidence of best practice in maternity care, determine the needs of the MK population, and derive optimal models of maternity care for MK. Methodology: Evidence was collated of what should be provided; what currently exists; and how MK compares with elsewhere. Conclusion: Many factors pointing towards provision of less than optimal care for pregnant women in Milton Keynes were identified; recommendations have been made to the providers, commissioners and also to the local Maternity Services Liaison Committee, resulting in changes to contract monitoring and increased funds for recruiting midwives.
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Within Oxfordshire Primary Care Trust, the Department of Public Health has been leading on a Mental Health Needs Assessment for older people which aims to raise the profile of mental illness amongst older people in the county, and influence the commissioning agenda for older peoples’ health services. Data was extracted from the computer systems of all 82 GP practices in Oxfordshire using MIQUEST on 31st August 2007. Information relating to the common psychiatric diagnosis and the prescription psychiatric drugs was queried. We found that the prevalence of schizophrenia in general practice in Oxfordshire was roughly equal to that expected. The prevalence of depression/ anxiety was less than expected and the prevalence of dementia was more than expected. Information on management of mental illness in older people within Oxfordshire showed that for older patients with severe mental illness or dementia there were issues with the recording of information during follow-up, whilst for patients with depression there were important issues around the discrepancy in those who were prescribed psychiatric medications and those with a diagnosis. This study has helped to update our knowledge of the burden of mental health morbidity amongst the elderly in primary care in Oxfordshire and allowed us to identify where efforts should be focused to improve mental health care provision for older people within general practice. The results of this study are being taken forward as part of the review of older people’s health services in Oxfordshire and will form the basis of conversations between the PCT and PBC consortia locally.
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Uy Hoang or
Suzanne Jones
An Equality Impact Assessment (EqIA) is a relatively new process intended to finding out whether or not an existing or proposed function or policy affects people from certain groups differently or disproportionately for good or ill. The South East England health strategy provides a regional framework for improving health and well being and reducing health inequalities The aim of EqIA was to identify whether this strategy has an adverse impact (unlawful discrimination, lack of equality of opportunity, harassment or victimisation, lack of good relations between different groups, lack of positive attitudes, lack of reasonable adjustments with regard to disability etc) and also to make recommendations to address impact (if any) identified.
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Milton Keynes Council and the Office of the Deputy Prime Minister made a Local Public Service Agreement (LPSA) covering the period 1st April 2005 to 31st March 2008. The LPSA suggested specific enhanced performance targets that would improve the health and social well-being for the population of Milton Keynes. Target 10 described improvements in the health of 5-year-old children as a result of improved oral health, as measured by the mean number of decayed, missing and filled teeth (dmft), from a mean of 1.23 to 1 and in those children with decay experience from 3.13 to 2.62.During the period of the project specific evidence-based interventions were: guidance regarding diet (including sugar intake); toothbrushing with a family toothpaste (>1000ppm) and oral hygiene; access to primary dental care.
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The role of Primary Care Trusts in commissioning has recently been increased, and expectations of quality raised with the introduction of the World Class Commissioning programme. In England there are 152 PCTs which all need to commission cost-effective and evidence-based services, but currently the appraisal of new and existing health technologies and services occurs independently in the majority of PCTs, with massive duplication of effort. Therefore in October 2007 a project was begun to develop a formal network of public health commissioners in England, to encourage sharing of high quality work in commissioning, and specialisation in commissioning topics. See www.nks.nhs.uk/commissioningnet for more information.
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Background: Smoking is one of the biggest avoidable cause of morbidity and mortality in the United Kingdom (UK) and imposes a huge economic burden on the UK National Health Service (NHS). Methods: A systematic literature review to identify previous estimates of NHS costs attributable to smoking was undertaken. PAFs for smoking related disease from the WHO’s GBD project were applied to NHS cost and national mortality data. Results: Previous studies estimated that smoking related conditions cost the NHS about £1.5 – 1.7billion in 1991 and is responsible for 106,100 (17.2%;1998–2002). The estimated that number of deaths attributable to smoking was 109,164 (18.6%) in 2005 and the direct cost to the NHS was £5.2 billion in 2005-06. Smoking was directly responsible for 12% of DALYs in 2002.
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the presentation (MS PowerPoint, 519kb)
Objective: To predict income group differentials in economic and health effects of targeted food taxes in the UK. Method: model based on consumption data and demand elasticity constructed to predict effects of food tax ± subsidy. Fiscal regimens examined: (1) taxing major sources of dietary saturated fat; (2) taxing ‘less healthy’ foods (defined by WXYfm nutrient profiling model); (3) combining “2” with 17.5% subsidy to fruits/vegetables; and (4) modelling a tax-neutral scenario. Data: Expenditure and Food Survey of Great Britain 2003-2006 and previous meta-analytical studies. Results: Scenario 1 likely to increase deaths from CVD/cancer. Scenario 2 has uncertain effects. Scenarios 3 and 4 avert CVD/cancer and few obesity deaths in the UK. Conclusions: Targeted food tax with subsidy on fruits/vegetables will reduce CVD/cancer deaths. Though economically regressive, such tax will produce positive health effects most significant in lower income groups.
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Getting Ahead of the Curve: A report by the Chief Medical Officer highlighted the need for improved action in prevention, diagnosis and treatment of many infectious diseases - including viral hepatitis. In particular, since 2002 the importance of hepatitis C infection as a major infectious disease priority for the UK has been reflected in a series of documents, culminating with the Hepatitis C Action Plan for England (Hepatitis C in England: An update 2007. London: Health Protection Agency Centre for Infections, December 2007). The prevention and management of viral hepatitis infections in Milton Keynes is an important and complex issue for the Primary Care Trust. Milton Keynes has a younger population than the UK average and is one of the fastest growing in the country. Milton Keynes has become, and is likely to become, increasingly ethnically diverse and multi-cultural. Within Milton Keynes there are still areas of deprivation and poverty. These factors can have a profound influence on health. If services for people with viral hepatitis infection are to be commissioned effectively at the local level, then it is essential to have an accurate estimate of the numbers of individuals infected; vulnerable groups; and likely healthcare resources required. A local needs assessment, focusing on viral hepatitis types A, B and C, was undertaken to inform stakeholders of current viral hepatitis epidemiology in Milton Keynes and to assist the development of hepatitis services to meet the needs of the population.
A retrospective review of notifications of meningitis and meningococcal infections in Thames Valley during the period of January 2006 - December 2007 was conducted by reviewing the NOIDS data, electronic records and paper notes held in TVHPU office. The relevant details were entered on to a excel spreadsheet and analysed using pivot charts. 235 cases were notified during this period with Oxfordshire reporting the highest number of cases (101 cases) followed by Berkshire (78 cases) and Buckinghamshire (56 cases). Of the 190 cases for which data as readily available, 108 (56.8%) were males and 82 (43.4%) were females. Out of Hours notification rate was approximately 21%. Laboratory results were available in 156 cases, of which, Neisseria meningitidis was confirmed in 80 cases. Enterovirus was confirmed in 33 cases and Strepococcus pneumoniae in 15 cases. The study also highlights the variable quality of documentation of case records, which has significant clinical governance implications and consequently, the need for an urgent review of current practices. Further analysis of data is ongoing and more results will be presented at the mini-conference.
Within the Thames Valley there exist multiple protocols for the management of accidental exposure to Bloodborne Viruses. These protocols vary with regard to patient management, patient care pathways, those included in such care pathways, and their roles and responsibilities. Furthermore, key players vary in-hours and out-of-hours. There is still uncertainty as to what role is played by the public health specialist/CCDC/CHP on-call in individual patients risk assessment and management. This project puts forward a possible template for a single protocol, puts the case for using this and clarifies roles and responsibilities of health care providers.
A chemical incident is an event in which an exposure arising from the release of a chemical substance has the potential to cause illness or where one or more individual suffer from an illness which is attributed to such an exposure. Chemical incidents can result in severe adverse health effects, it is essential therefore that an incident is clearly defined in order to ensure easy identification and for a response to be carried out in a timely and appropriate manner. This poster outlines the steps taken in response to a chemical incident involving chlorine. An automated Chlorine dosing machine malfunctioned, allowing excess Chlorine to be released into a school swimming pool. A total of twelve people were exposed.
Milton Keynes is a high haemoglobinopathy prevalence area. The Universal newborn bloodspot and antenatal screening started in July 2006 and March 2007 respectively. The performance of this programme locally was audited against the National Screening Committee’s standards. This audit showed that the screening process is working well and areas for improvement identified were - to improve the proportion of women offered screening before 10 weeks, to improve partner testing. To avoid delay in informing patents about screening results – timely sample dispatch to laboratory is needed.
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The purpose of this investigation was to explore the approaches to learning employed by a sample of nine Oxford University students from three different disciplines. Structured interviews were conducted and attempts were made to determine factors influencing learning as well as student approaches to learning. The methodology and findings of the investigation were framed within the context of the evidence base on higher education.
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