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BACKGROUND Cholinesterase inhibitors produce small improvements in cognitive and global assessments in Alzheimer's disease. We aimed to determine whether donepezil produces worthwhile improvements in disability, dependency, behavioural and psychological symptoms, carers' psychological wellbeing, or delay in institutionalisation. If so, which patients(More)
BACKGROUND Cardiovascular risk factors and a history of vascular disease can increase the risk of Alzheimer's disease (AD). AD is less common in aspirin users than non-users, and there are plausible biological mechanisms whereby aspirin might slow the progression of either vascular or Alzheimer-type pathology. We assessed the benefits of aspirin in patients(More)
OBJECTIVES To consider how the impact of the NHS Health Technology Assessment (HTA) Programme should be measured. To determine what models are available and their strengths and weaknesses. To assess the impact of the first 10 years of the NHS HTA programme from its inception in 1993 to June 2003 and to identify the factors associated with HTA research that(More)
This paper examines the development of contracting within the NHS on the basis of the data collected as part of a national survey of English District Health Authorities carried out in late 1994. The paper starts with a discussion of the background to contracting and its evolution during the first 4 years of the NHS internal market. The second section(More)
A randomized trial of acute psychiatric care was conducted to compare home-based interventions with standard care. The setting of the study was a comprehensive urban psychiatric service in London. Sixteen of the 172 patients in the study had schizophrenia--11 in standard care (SC) and 5 in community care (CC). Care for patients with schizophrenia was, on(More)
OBJECTIVES To evaluate the effect of purchaser mix, market competition, and trust status on hospital productivity within the NHS internal market. METHODS Hospital cost and activity data were taken from routinely collected data for acute NHS hospitals in England for 1991-2 to 1993-4. Cross sectional and longitudinal regression methods were used to estimate(More)
The Irish have generally been ignored in studies of the health needs of ethnic groups in the U.K. despite being the largest immigrant group and having the highest Standardised Mortality Ratio of all first generation immigrants. Using the OPCS Longitudinal Study, the present paper shows that this excess mortality persists into the second generation Irish in(More)