Do single-handed practices offer poorer care?:
Researchers compared the performance of single-handed practices and group practices in the United Kingdom, using information on hospital admissions and achievement of clinical targets within the practice.
They found important differences for three types of hospital admission, but after taking other practice characteristics into account, such as level of deprivation, the percentage of black and Asian residents and the proportion of patients over 75 years old, there were no substantial differences.
The authors are quoted in this week's British Medical Journal as saying: "we have found no evidence in this study that single-handed general practitioners are underperforming clinically. Despite some important limitations, the results offer insight into the structural differences between the two types of practice and underline the importance of other practice characteristics, such as deprivation."
Chest pain:
Researchers have developed a test to assess chest pain in UK emergency departments. It can rule out the possibility of heart damage within six hours, allowing safe discharge of patients and reducing unnecessary admissions. The current approach requires admission to hospital for a minimum of 24 hours.
Over a 12-month period, researchers at Manchester Royal Infirmary identified patients aged over 25 years who were attending the emergency department with chest pain. The new test was compared with the current gold standard for diagnosing heart damage in 292 patients. Patients with a positive result were admitted to hospital. All other patients were discharged to the care of their general practitioners.
Its accuracy has important clinical and economic implications, as it would allow early discharge of patients who were shown not to be at risk of heart attack and facilitate early treatment of those who required it, the authors conclude in the British Medical Journal.
Passive smoking:
Non-smokers forced to breathe their colleagues' cigarette smoke at work may significantly compromise the ability of their lungs to function properly, according to recent research. The study involved more than 300 randomly selected from general-practitioner records in Glasgow, Scotland. All non-smokers, their ages ranged between 25 and 64.
Each person completed a health record, detailing levels and location of exposure to environmental tobacco smoke. They were also given a physical examination and lung-function tests. Lung function decreases with age and is affected by height and gender.
After taking these factors into account, and adjusting for socioeconomic status, the results showed that lung function was adversely affected by the amount of environmental tobacco smoke. But workplace smoke had the greatest impact.
Workers exposed to the highest levels were up to three times as likely to have decreased lung function as those exposed to the lowest levels. At the highest level of exposure, there was a 5 to 10 per cent reduction in lung function.
Heart-attack time:
Weekends are the peak time for heart attacks in young and middle-aged men, a study in France has revealed.
Mondays have often been cited as the critical day for heart attacks, with the impending stress of the working week sometimes suggested as a precipitating factor.
The researchers looked at data on heart-attack patterns and death rates from registers used for monitoring coronary heart disease, as well as national statistical databases on causes and date of death, for the 10 years between 1987 and 1997.
The findings showed that deaths from heart disease in men aged between 25 and 44 peaked on Saturdays and Sundays. In men aged 45 to 54, death from heart disease peaked on Sundays. For older men, Monday seemed to be the critical day.
There is no obvious explanation for these findings, say the authors. It could be that young men engage in strenuous activity at the weekends, so increasing the risk of a heart attack in those who are susceptible.
Fighting blindness:
The prevalence of trachoma, the bacterial eye infection that can result in blindness, has been halved in a population of two million in Tanzania and Morocco over the course of a year. Trachoma is the leading cause of preventable blindness, with 150 million people currently infected.
A combination of curative medicine - single-dose antibiotics - and community-based public-hygiene programmes carried out by the International Trachoma Initiative has resulted in the dramatic drop in numbers infected by the disease in Tanzania and Morocco.
The initiative, which is part sponsored by the pharmaceutical company Pfizer, also works with non-governmental organisations in Ghana, Mali, Vietnam and Sudan.
Back-to-school tips:
Parents anxious about their little ones starting back to school - or indeed, starting school - will find some very sensible tips at www.rollercoaster.ie, a parenting website.
These include using positive language about school routines, ensuring your child goes to bed early enough so as not to be too tired at the beginning of term, dressing your child in clothes that are comfortable and easily managed and following your child's lead regarding how much they want to talk about school. And, for the parents, avoiding being too emotional at the school gate, as this upsets your child.
Lighten up:
Depression Awareness Week runs from September 10th to 15th. This annual consciousness-raising event, organised by the depression support group Aware, coincides with Daisy Days (September 13th-15th), one of the charity's fund-raising initiatives.
Statistical reports show time and again that half of women and a quarter of men will suffer from depression at some stage in their lives.
Aware also co-ordinates a series of free public lectures one Wednesday a month, at 7.15 p.m. in the Dean Swift Centre at St Patrick's Hospital in Dublin. Dr Frank O'Donoghue, a consultant psychiatrist at the hospital, will speak on panic attacks on Wednesday, September 12th as part of this series.
For more information on events around the Republic, call 01-6766166. To help with Daisy Days collections, call 01-6617211.
Fancy volunteering?:
Comhlβmh, the voluntary group for global development, is the organiser of a volunteer festival in Dublin next Saturday. Those thinking of volunteering can visit some of the 66 groups taking part. Start your tour (and get a map) at the Volunteer Resource Centre, Coleraine Street, Dublin 1 or Comhlβmh, 10 Upper Camden Street, Dublin 2, between 1.30 p.m. and 5 p.m. No fee or registration necessary. More details from 01-4783490.
lifelines@irish-times.ie