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Logo of jepicomhJournal of Epidemiology and Community HealthVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
 
J Epidemiol Community Health. 2007 September; 61(9): 840.
PMCID: PMC2660014

Hygieia

Prognosis of women with gestational diabetes in the UK

A study to assess the glucose tolerance of South Asian and white women with previous gestational diabetes mellitus (GDM) found that GDM represents a significant risk factor for future DM development regardless of ethnicity. In a retrospective follow‐up of 178 women in Leicester (115 South Asian and 63 white) diagnosed with GDM between 1995 and 2001, glucose tolerance was reassessed a mean of 4.38 years after pregnancy. Diabetes developed in 36.9%, affecting more women of South Asian extraction (48.6%) than white (25.0%) women. Women who developed diabetes were older at follow‐up, weighed more, were more hyperglycaemic, and were more likely to need insulin during pregnancy. The study showed that glycated haemoglobin values at GDM diagnosis have worth in predicting future diabetes mellitus. (Postgrad Med J 2007;83:426–30)

Case ascertainment in childhood blindness in Bangladesh

Local volunteers recruited to ascertain severely visually impaired and blind children provided a more representative population sample than traditional methods of examining children in special education and community based rehabilitation programmes. Approximately 800 volunteers, who live and/or work in their local community, were trained to act as key informants (KIs). A total of 1935 children with severe visual impairment (SVI) or who were blind (BL) were recruited in all 64 districts of Bangladesh. Children identified by KIs were more likely to be female, of pre‐school age, from rural areas, multiply impaired, and with treatable eye diseases compared to those recruited from schools for the blind. Overall, a child with avoidable causes of SVI/BL had 40% and 30% higher odds of being ascertained using KIs than using special education and community based rehabilitation programmes, respectively. This innovative approach has resulted in one of the largest studies of children with SVI/BL to date. The findings indicate that KIs can recruit large numbers of children quickly, and that the children they recruit are more likely to be representative of all blind children in the community. (Br J Ophthalmol 2007 published online first 12 April 2007; doi: 10.1136/bjo.2006.108027)

Glenys Hughes ghughes@btinternet.com

Cataract surgery rates in England

In the 1990s there was a national deficit in the provision of cataract surgery. An increasing backlog of unoperated cataracts, exacerbated by an ageing population, was predicted. Since then, changes in practice and government initiatives have led to significantly increased capacity. Hospital episode statistics (HES), the hospital inpatient enquiry (HIPE), and the Oxford record linkage study (ORLS) were analysed for cataract admissions between the 1960s and 2003. Annual rates of admission for cataract surgery in England rose from 62 episodes per 100 000 population in 1968 to 637 episodes per 100 000 population in 2004. This increase was reflected in every age group for both men and women. This huge increase in cataract surgery raises the possibility of overcapacity for cataract surgery. Geographical analysis showed a wide variation across local authority areas, ranging from 172 to 548 people per 100 000 population in 1998–2003. The rate of surgery by local authority was positively correlated with the index of multiple deprivation. High levels of social deprivation are associated with high rates of cataract surgery; this may be caused by an increased prevalence of cataract or differences in referral patterns. (Br J Ophthalmol 2007 published online first 31 May 2007; doi: 10.1136/bjo.2006.108977)

Tuberculosis in London

In the developed world tuberculosis is increasingly concentrated in subgroups of the population in large urban centres. Tuberculosis is a major public health problem in London, with an 11% increase in new reported cases between 2004 and 2005 accounting for 45% of all cases reported in England. Tuberculosis control is founded on early detection and complete treatment of disease. A cohort study of all tuberculosis patients in Greater London was conducted to determine the prevalence of the disease in different groups and to examine the risk factors for smear positivity, drug resistance, treatment adherence, loss to follow‐up, and use of directly observed therapy (DOT). Data were collected on 1941 of 1995 eligible patients. The overall prevalence of tuberculosis was 27 per 100 000 population; extremely high prevalence was seen in homeless people living on the streets or in hostels (788/100 000), problem drug users (354/100 000), and prisoners (208/100 000). In London these populations collectively comprise 17% of tuberculosis cases, 44% of smear positive drug resistant cases, 38% of poorly compliant cases, and 44% of cases lost to follow‐up; 15% of these patients start treatment on DOT but 46% end up on DOT. These findings indicate that tuberculosis is not being effectively controlled among homeless people, problem drug users and prisoners in London. (Thorax 2007 published online first 8 February 2007; doi: 10.1136/thx.2006.065409)

Drinking social norms and drinking behaviours in US

Alcohol related diseases represent 4% of the global health burden, and in the United States the economic costs of alcohol misuse were over $18 billion in 1998, a 25% increase from 1992. Concerns over the role of workplaces as alcohol stimulating environments led to the 1988 Drug‐free Workplace Act reinforcing the importance of employee assistance programmes in managing substance abuse. A study of 5338 workers to examine whether restrictive drinking social norms shared by workgroup membership are associated with decreased heavy drinking, frequent drinking and drinking at work was carried out at 16 US worksites. It showed participants working in the most discouraging drinking norms quartile were 45% less likely to be heavy drinkers, 54% less likely to be frequent drinkers and 69% less likely to drink at work than their counterparts in the most encouraging quartile. Strong associations between workgroup level restrictive drinking social norms and drinking outcomes suggest public health efforts at reducing drinking and alcohol related injuries, illnesses and diseases should target social interventions at worksites. (Occup Environ Med 2007 published online first 24 May 2007; doi: 10.1136/oem.2006.031765)


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