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Background: Health literacy (HL) is an important public health issue. Current measures have drawbacks in length and/or acceptability. The US-developed Newest Vital Sign (NVS) health literacy instrument measures both reading comprehension and numeracy skills using a nutrition label, takes 3 minutes to administer, and has proven to be acceptable to research subjects. This study aimed to amend and validate it for the UK population. Methods: We used a three-stage process; (1) a Delphi study with academic and clinical experts to amend the NVS label to reflect UK nutrition labeling (2) community-based cognitive testing to assess and improve ease of understanding and acceptability of the test (3) validation of the NVS-UK against an accepted standard test of health literacy, the Test of Functional Health Literacy in Adults (TOFHLA) (Pearson's r and the area under the Receiver Operating Characteristic (ROC) curve) and participant educational level. A sample size calculation indicated that 250 participants would be required. Inclusion criteria were age 18-75 years and ability to converse in English. We excluded people working in the health field and those with impaired vision or inability to undertake the interview due to cognitive impairment or inability to converse in English. Results: In the Delphi study, 28 experts reached consensus (3 cycles). Cognitive testing (80 participants) yielded an instrument that needed no further refinement. Validation testing (337 participants) showed high internal consistency (Cronbach's Alpha = 0.74). Validation against the TOFHLA demonstrated a Pearson's r of 0.49 and an area under the ROC curve of 0.81. Conclusions: The NVS-UK is a valid measure of HL. Its acceptability and ease of application makes it an ideal tool for use in the UK. It has potential uses in public health research including epidemiological surveys and randomized controlled trials, and in enabling practitioners to tailor care to patient need. [ABSTRACT FROM AUTHOR]

This article reports a survey and a subsequent intervention study. The survey was conducted in two psychogeriatric day hospitals to establish the extent of day-by-day non-attendance. In 1991, 23% of allocated places were not taken up and the reasons for 98% of these episodes are reported. Little attention has been paid to non-attendance rates in the literature. Their importance is discussed. The prospective intervention study was then conducted using information from the survey year. Administrative interventions, which sought to raise the awareness of patient non-attendance within the multidisciplinary team, were put into place in the two-day hospitals. Non-attendance rates in a third day hospital, where no intervention was made, were used for comparative purposes. After second year, non-attendance in the day hospital with no interventions had fallen 3%. The other two had each reduced non-attendance rates by 18%. These reduction have clinical relevance, representing 380 patient days over the whole year in the two day hospitals. [ABSTRACT FROM AUTHOR]

Discusses the mechanics of the inflation process and the underlying causes of the inflation in Great Britain. Overview of the structuralist model of inflation; Distinction between the permissive and causative factors in the inflation process; Limitations of the structural factors used in analyzing British price history; Policy implications of separating inflationary stimuli into causative and secondary factors.

The article offers information on cost effective evaluation of how screening combined with desalinization strategies in an intensive care unit (ICU) to control meticillin resistant Staphylococcus. It mentions that universal desalinization strategy was used for reducing costs and improving health outcomes. It also informs that cost effective analysis was designed on the basis of dynamic transmission model.

This Commentary focuses on the landmark paper about hypoxia in radiotherapy by Gray, Scott et al published in 1953. By then, it was known that hypoxic regions in tumours could make them resistant to radiation treatment and that this was a possible cause of failure. The paper proposed that oxygen breathing could substantially decrease this resistance without incurring significant additional damage to normal tissues, thus reducing the likelihood of recurrence. Although the paper's supporting data were in some respects incomplete, the case it made was convincing and it prompted pilot clinical trials that combined radiotherapy with oxygen breathing, including under elevated pressure. Research into tumour hypoxia and strategies to overcome its adverse effects soon expanded and entered full clinical trials. Meta-analysis of their results showed improved outcomes in accord with the original proposals of Gray, Scott et al. A secondary result of their 1953 work was the founding at Mount Vernon Hospital of what later became Cancer Research UK's Gray Cancer Institute. This project was initiated by Oliver Scott and construction of the new laboratories was funded by a donation that he provided.