This new edition of Ann Bowling's well-known and highly respected text has been thoroughly revised and updated to reflect key methodological developments in health research. It is a comprehensive, easy to read, guide to the range of methods used to study and evaluate health and health services. It describes the concepts and methods used by the main disciplines involved in health research, including: demography, epidemiology, health economics, psychology and sociology.The research methods described cover the assessment of health needs, morbidity and mortality trends and rates, costing health services, sampling for survey research, cross-sectional and longitudinal survey design, experimental methods and techniques of group assignment, questionnaire design, interviewing techniques, coding and analysis of quantitative data, methods and analysis of qualitative observational studies, and types of unstructured interviewing. With new material on topics such as cluster randomization, utility analyses, patients' preferences, and perception of risk, the text is aimed at students and researchers of health and health services. It has also been designed for health professionals and policy makers who have responsibility for applying research findings in practice, and who need to know how to judge the value of that research.

Research Methods in Health. Investigating health and health services

This study, which is a part of the initiative 'Lifting The Burden: The Global Campaign to Reduce the Burden of Headache Worldwide', assesses and presents all existing evidence of the world prevalence and burden of headache disorders. Population-based studies applying International Headache Society criteria for migraine and tension-type headache, and also studies on headache in general and 'chronic daily headache', have been included. Globally, the percentages of the adult population with an active headache disorder are 46% for headache in general, 11% for migraine, 42% for tension-type headache and 3% for chronic daily headache. Our calculations indicate that the disability attributable to tension-type headache is larger worldwide than that due to migraine. On the World Health Organization's ranking of causes of disability, this would bring headache disorders into the 10 most disabling conditions for the two genders, and into the five most disabling for women.

https://www.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1468-2982.2007.01288.x

The Global Burden of Headache: A Documentation of Headache Prevalence and Disability Worldwide:

Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies.

4 CLINICAL PARTICULARS 4.1 Therapeutic Indications Trimetazidine is indicated in adults as add-on therapy for the symptomatic treatment of patients with stable angina pectoris who are inadequately controlled by or intolerant to first-line antianginal therapies. 4.2 Posology and method of administration Oral administration. Posology The dose is one tablet of 35mg of trimetazidine twice daily during meals. Special populations Renal impairment In patients with moderate renal impairment (creatinine clearance [30-60] ml/min) (see sections 4.4 and 5.2), the recommended dose is 1 tablet of 35mg in the morning during breakfast. Elderly Elderly patients may have increased trimetazidine exposure due to age-related decrease in renal function (see section 5.2). In patients with moderate renal impairment (creatinine clearance [30-60] ml/min), the recommended dose is 1 tablet of 35mg in the morning during breakfast. Dose titration in elderly patients should be exercised with caution (see section 4.4). Health Products Regulatory Authority

Summary of product characteristics

QUITE apart from the academic consideration that vital and medical statistics now form an obligatory part of the education of students seeking the University of London's diploma in public health, the demand for information about the methods of vital and medical statistics is increasing. The most casual reader of the newspapers is now aware that population problems are of serious practical importance and that the publications of the General Register Office cannot be ignored. It is scarcely an exaggeration to say that the recently issued preliminary report on the census of 1931 is one of the most sensational documents which has appeared for years, and that he who reads it intelligently will understand what is meant by saying that civilisation is in the melting pot. An Introduction to Medical Statistics. By Hilda M. Woods William T. Russell. Pp. x + 125. (London: P. S. King and Son, Ltd., 1931.) 7s. 6d.

/pdf/an-introduction-to-medical-statistics-58gm2cuxfv.pdf

An Introduction to Medical Statistics

Study objectives To investigate the incidence, persistence, and consequences of insomnia and their associations with psychological health and pain. Design A population based, longitudinal, cohort study using postal questionnaires at baseline and 12-month follow-up. Sleep problems in the past month were assessed using 4 questions: insomnia was defined as having at least 1 of the sleep problems "on most nights." Questions about psychological health, presence of pain at different sites, and demographic details were included in the questionnaire. Setting Five general practices in Staffordshire, UK. Participants The questionnaire was mailed to a random sample of 4885 adults aged 18 years and over registered with these practices. There were 2662 questionnaires returned. Results Of the responders, 2363 completed all 4 sleep questions at baseline: 870 (37%) had insomnia and 1493 (63%) did not have insomnia. Of those without insomnia at baseline, the incidence of insomnia at 12 months was 15%, and this was significantly associated with baseline anxiety, depression, and pain. Of those who did have insomnia at baseline, 69% had insomnia at 12-month follow-up; persistence of insomnia was significantly associated with older age. Insomnia at baseline was significantly associated with incidence of anxiety, depression, and widespread pain at 12-month follow-up. Conclusions Insomnia is common and often persistent. Older people appear more vulnerable to persistent symptoms. Our results provide evidence that the common problems of insomnia, pain, and psychological distress are intertwined and suggest that combined approaches to treatment may be needed to reduce the onset and persistence of these problems in the community.

/pdf/epidemiology-of-insomnia-a-longitudinal-study-in-a-uk-20yvvaq2m2.pdf

Epidemiology of insomnia: a longitudinal study in a UK population.

Objective.—To investigate the associations of headache occurrence, severity, and frequency with psychological, sleep, and lifestyle characteristics, and comorbid conditions.



Background.—Whilst associations for individual headache types, particularly migraine, have been investigated, possible associations between headache of all types and general health characteristics have not been explored.



Methods.—Cross-sectional postal survey in an adult general population sample registered at five general practices in North Staffordshire, UK.



Results.—Headache occurrence was associated with anxiety (odds ratio 4.09, 95% confidence interval 3.0, 5.6) and sleep problems (moderate sleep problems OR 3.60, 95% CI 2.5, 5.0), and the strength of the associations increased with higher levels of anxiety and sleep problem. Whilst depression showed an association with headache, this was not seen in respondents with depression in the absence of anxiety. Headache occurrence was also associated with comorbid pain anywhere in the body (OR 2.12, 95% CI 1.7, 2.6), with the strongest associations being for the neck and upper body areas compared with other areas. There was no overall link with alcohol or caffeine consumption. Increasing severity and frequency of headache resulted in stronger associations, and there were strong associations between the occurrence, severity, and frequency of headache, and both sleep problems and psychological distress.



Conclusion.—Poor sleep and anxiety appear to make a substantial contribution to the impact of headache on sufferers' lives in the general population.

Psychological, sleep, lifestyle, and comorbid associations with headache.

Headache prevalence, characteristics and impact in adults were measured using a cross-sectional general population survey in North Staffordshire, UK. A postal survey was mailed out to 4885 adults (aged ≥ 18 years) with an adjusted response rate of 56% (n = 2662). Of respondents 93% reported headache ever and 70% in the last 3 months. Women and younger people reported higher headache prevalences. Of those reporting headache in the last 3 months, 23% experienced headache at least weekly and 16% experienced severe headache pain. Headaches affected work, home or social activities in 43% of sufferers and 20% reported at least moderate headache-related disability. Higher levels of disability were associated with higher levels of pain, 61% with severe disability reporting severe pain compared with 13% who had mild or moderate disability. In the total adult population sample headache affected more than two-thirds in the last 3 months and 14% of all adults reported headache-related disability of at least moderate ...

Epidemiology of headache in an English district

https://cyberleninka.org/article/n/238982.pdf

The contribution of the Medicines Use Review (MUR) consultation to counseling practice in community pharmacies

Objective of the study Medicines use review and prescription intervention (‘MUR services’) is the first advanced service within the NHS community pharmacy contract and is a structured review that is undertaken by a pharmacists with patients on multiple medicines. The objective of this study was to investigate factors that influence the number of Medicines use reviews (MURs) performed by community pharmacists and to explore community pharmacists’ attitudes towards the service. Setting This study was conducted with pharmacists who were employed by one UK community pharmacy chain. Method A questionnaire was developed to investigate factors that influence the number of MURs performed and pharmacists’ attitudes towards MURs. It consisted of a series of attitudinal statements together with brief demographic data. Questionnaires were distributed to a sample of 280 pharmacists accredited to provide the service during April and May 2006. Main outcome measure Factors affecting the number of MURs performed and community pharmacists’ attitudes towards MURs. Results Sixty per cent (167/280) of pharmacists returned a completed questionnaire. Twenty-seven per cent of respondents had not performed any MURs, 43% had conducted one to 14 reviews and 31% had conducted 15 or more. Job title affected the number of reviews performed; respondents categorised as ‘Store based’ pharmacists performed significantly more MURs than those working as ‘Locums’ but not significantly more than ‘Managing’ pharmacists. Pharmacists reporting access to an accredited consultation area performed significantly more MURs than those who did not. Those working more than 20 h per week performed significantly more MURs than those working less. Gender, time since qualification, the pharmacy size and those having or currently undertaking a clinical diploma were not found to be associated with the number of MURs performed. Most respondents reported that MURs were an opportunity for pharmacist to use their professional skills in an extended role and patients would benefit from the service. However they reported concerns about GPs opinion of the service, lack of time and support staff to conduct MURs and were unhappy about consultation areas. Conclusion This study demonstrates that pharmacists perceive MURs to be an opportunity for an extended role and of value to patients. However, this study has identified perceived barriers, including the availability of a consultation area suitable for performing MURs, time to perform MURs and support staff. The number of MURs performed by pharmacists appears to be affected by the pharmacists’ job title, their working hours and the presence of a consultation area. Additional support for ‘locum’ pharmacists was also highlighted and may be needed.

Helen F. Boardman

Papers

Epidemiology of insomnia: a longitudinal study in a UK population.

Psychological, sleep, lifestyle, and comorbid associations with headache.

Epidemiology of headache in an English district

The contribution of the Medicines Use Review (MUR) consultation to counseling practice in community pharmacies

Community pharmacists' attitudes towards medicines use reviews and factors affecting the numbers performed.