Patterns of coronary heart disease mortality over the 20th century in England and Wales: Possible plateaus in the rate of decline

Allender, Steven; Scarborough, Peter; O'Flaherty, Martin; Capewell, Simon
January 2008
BMC Public Health;2008, Vol. 8 Issue 1, p148
Academic Journal
Background: We report a patient-centered intervention study in 9 municipalities of rural Nicaragua aiming at a reduction of internalized social stigma in new AFB positive tuberculosis (TB) patients diagnosed between March 2004 and July 2005. Methods: Five out of 9 municipal teams were coached to tailor and introduce patient-centered package. New TB patients were assigned to the intervention group when diagnosed in municipalities implementing effectively at least TB clubs and home visits. We compared the changes in internalized stigma and TB treatment outcome in intervention and control groups. The internalized stigma was measured through score computed at 15 days and at 2 months of treatment. The treatment results were evaluated through classical TB program indicators. In all municipalities, we emphasized process monitoring to capture contextual factors that could influence package implementation, including stakeholders. Results: TB clubs and home visits were effectively implemented in 2 municipalities after June 2004 and in 3 municipalities after January 2005. Therefore, 122 patients were included in the intervention group and 146 in the control group. After 15 days, internalized stigma scores were equivalent in both groups. After 2 months, difference between scores was statistically significant, revealing a decreased internalized stigma in the intervention group and not in the control group. Conclusion: This study provides initial evidences that it is possible to act on TB patients' internalized stigma, in contexts where at least patient centered home visits and TB clubs are successfully implemented. This is important as, indeed, TB care should also focus on the TB patient's wellbeing and not solely on TB epidemics control.


Related Articles

  • Changing mortality from ischaemic heart disease in Great Britain 1968-76. du V Florey, C.; Melia, R.J.W.; Darby, S.C. // British Medical Journal;3/11/1978, Vol. 1 Issue 6113, p635 

    Reports the increase in mortality rates caused by ischemic heart disease (IHD) in Great Britain. Relation between tobacco consumption and IHD death rates; Influence of diet on the incidence of IHD; Significance of changing life styles in preventing IHD.

  • Seasonality of coronary artery deaths in New South Wales, Australia. Weerasinghe, D.P.; MacIntyre, C.R.; Rubin, G.L. // Heart;Jul2002, Vol. 88 Issue 1, p30 

    Background: Complex temporal variations in coronary deaths, including diurnal, weekly, and seasonal trends, have been reported worldwide.Objective: To describe the magnitude of seasonal changes in coronary artery deaths in New South Wales, Australia.Design:...

  • Prediction of mortality from coronary heart disease among diverse populations: is there a common predictive function?  // Heart;Sep2002, Vol. 88 Issue 3, p222 

    Objectives: To examine the generalisability of multivariate risk functions from diverse populations in three contexts: ordering risk, magnitude of relative risks, and estimation of absolute risk. Design: Meta-analysis of prospective cohort studies. Patients: Participants from various...

  • Omega-6 linoleic acid supplements may be harmful in heart disease.  // Endocrine Today;Mar2013, Vol. 11 Issue 3, p42 

    The article reports on study published in the "British Medical Journal," which suggests an increased risk for all-cause mortality, cardiovascular death and death related to coronary heart disease for those who suffered a coronary event.

  • Ischemic heart disease deaths are still falling, but at a slower pace.  // Modern Medicine;May97, Vol. 65 Issue 5, p56 

    Presents an abstract of the study `Trends in Ischemic Heart Disease Deaths--United States, 1990-1995,' from the US Centers for Disease Control and Prevention,' published in the February 21, 1997 issue of `MMWR.'

  • Homocysteine predicts mortality in CAD. Alexander, Sidney // Modern Medicine;Jan98, Vol. 66 Issue 1, p55 

    Discusses the abstract of the article `Plasma homocysteine levels and mortality in patients with coronary artery disease,' by O. Nygard, J.E. Nordrehaug et al, which appeared in the July 24, 1997 issue of `National English Journal of Medicine.'

  • A (small) dent in ischemic heart disease.  // Patient Care;4/15/1997, Vol. 31 Issue 7, p23 

    Examines the death rate from coronary heart disease or ischemic heart disease in the United States from 1990-1994. Demographic profile of coronary heart disease fatalities; Risk factors.

  • Let's not take credit for drop in CHD. Smith, Russell; P.F.C. // Cortlandt Forum;4/25/96, Vol. 9 Issue 4, p94 

    Answers a question concerning reductions in the coronary heart disease (CHD) death rate. Reasons for the decline in mortality rate; Credit for the medical industry.

  • Coffee consumption and death from coronary heart disease in middle aged Norwegian men and women. Tverdal, Aage; Stensvold, Inger; Solvoll, Kari; Foss, Olav P.; Lund-Larsen, Per; Bjartveit, Kjell // BMJ: British Medical Journal (International Edition);3/3/90, Vol. 300 Issue 6724, p566 

    Examines the association between coffee consumption and death from coronary heart disease in middle aged men and women in Norway. Performance of a cardiovascular survey; Increase in cholesterol concentrations; Use of the generalized linear interactive modelling.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics