Is the future in the cards?

Smart cards have yet to catch on in health care. Applications for data security and marketing, however, could boost their use.     

How about the uncertainty in the haplotypes in the population-based KORA studies?

In the KORA surveys, numerous candidate genes in the context of type 2 diabetes, myocardial infarction, atherosclerosis or obesity are under investigation. Current focus is on genotyping single nucleotide polymorphism (SNPs). Haplotypes are also of increasing interest: haplotypes are combinations of alleles within a certain section of one chromosome. Analysing haplotypes in genetic association studies is often more efficient than studying the SNPs separately. A statistical problem in this context is the reconstruction of the phase: genotyping the SNPs determines the alleles of an individual at one particular locus of the DNA, but does not reveal which allele is located on which one of the two chromosomes. This information is required when talking about haplotypes. There are statistical approaches to identify the most likely two haplotypes of an individual given the genotypes. However, a certain error in prognosis is unavoidable. There are also errors in the genotypes. These errors are assumed to be small for one SNP but can accumulate over the SNPs involved in one haplotype and thus can induce further uncertainty in the haplotype. It is therefore the aim of our project to quantify the uncertainties in the haplotypes particularly for genes investigated in the KORA surveys. We conduct computer simulations based on the haplotypes and their frequencies observed in the KORA individuals and compare the results with simulations based on mathematical modelling of the evolutionary process ("coalescent models"). The uncertainties in the haplotypes have an impact on the search for association between genes and disease: an association may not be detected as the haplotype uncertainty obscures the haplotype frequency differences between cases and controls. It is a further aim of our project to elucidate the extent of this problem and to develop strategies for reducing it.     

Cafeteria benefits in the NHS?

Choice of benefits in addition to (or as an alternative to part of) base pay. Lessons from the USA. How much applies to the NHS in the UK? Discusses some examples and describes a process of devising such a scheme. Concludes that there is a need to consider such a scheme in relation to an organizations's labour market and culture. Is it appropriate? Or are there better ways to the same results?     

Is the self of the infant preserved in the adult?

Medicine, Health Care and Philosophy - What does a confrontation between philosophy and psychoanalysis look like? My task is a philosophical investigation of a psychoanalytic concept. Thus, I offer...     

Whither career development in the NHS?

Observes that changes in the nature of employment and career development in the private sector have also affected the National Health Service in a similar way. Highlights how economic pressures have forced organizations to rationalize their workforces, and with this has come an end to the psychological contract which has existed between employers and employees. Outlines the nature of those changes, and their effect on individuals who need to take responsibility for their own career development. Suggests that there is now a need to develop a new moral contract between employers and employees. In return for job security, employers can offer a range of developmental opportunities to enable employees to become more employable when new employment is required.     

Does the Heartbeat Award scheme in England result in change in dietary behaviour in the workplace?

The Heartbeat Award (HBA) scheme is a national nutrition labelling scheme that operates throughout England. The aim of this study was to assess whether the implementation of the HBA scheme in the workplace results in an improvement in eating habits at work. A longitudinal survey of employees using a structured questionnaire pre- and post-HBA intervention in six workplaces in Leicestershire, England, was conducted. A qualitative food frequency questionnaire was used to assess dietary behaviour 6 months before the scheme was implemented and 6 months afterwards. Four HBA workplaces (n = 453 employees) were compared with two comparison workplaces (n = 124 employees). The outcome measures for dietary change were consumption of 20 food items, i.e. 16 food-frequency and four food-type items. Changes in pre-intervention data compared with post-intervention data evaluated the impact of the HBA on eating habits. Differences were considered statistically different at the p < 0.05 level. Crude and adjusted odds ratios were used to assess differences in change in dietary behaviour between the intervention and comparison workplaces. The results showed that there was significantly more positive change in intervention workplaces only (i.e. the changes were not detected in the comparison workplaces) for four of the 20 food items tested: increase in consumption of fruit (p = 0.029); reduction in consumption of fried foods (p = 0.044) and sweet puddings (p = 0.042); and change to lower fat milks (p = 0.034). In conclusion, the HBA had a modest impact on dietary intake, resulting in a significant positive change in four out of 20 foods consumed by employees in HBA-holding premises.     

Homelessness--on the health agenda in Wales?

Building a sustainable and inclusive future for Wales is at the heart of the constitution of the National Assembly for Wales, which means forging a crosscutting approach to social policy. Improving health is a strategic priority within this agenda, and homelessness and housing appear to be at the center of the Assembly Government's vision of developing sustainable and cohesive communities and promoting social inclusion. This article considers the links between homelessness and mental and physical ill health and the importance of combating homelessness and poor housing within the health agenda in Wales. The article cites the links between homelessness and health identified in the United Kingdom and in international research and highlights the growth in homelessness witnessed during the late 1990s and beginning of the 21st Century. The paper considers the significant increase of homelessness and assesses whether, in reality, sufficient practical measures are being taken to combat homelessness as a means of tackling ill health in Wales. The authors conclude that although Wales is making progress toward an integrated approach to health and well-being and that the need to tackle broader health determinants has gained recognition, investment in effectively tackling homelessness and exclusion is needed. Integrating the broader housing, homelessness, and health agendas could contribute to health gains in Wales.