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Increasing duration of tamoxifen therapy improves survival in women with breast cancer but the impact of adherence to tamoxifen on mortality is unclear. This study investigated whether women prescribed tamoxifen after surgery for breast cancer adhered to their prescription and whether adherence influenced survival. A retrospective cohort study of all women(More)
OBJECTIVES The increased risk of cardiovascular (CV) disease associated with rheumatoid arthritis (RA) is partly attributable to chronic inflammation, but traditional CV risk factors such as physical inactivity are also likely to be important. This study assessed the cross-sectional relationship between physical activity (PA) and arterial dysfunction in(More)
BACKGROUND Previous research suggests that women admitted to hospital with acute myocardial infarction (MI) are managed less intensively than men. Chronic stable angina is the commonest clinical manifestation of coronary heart disease in the community, but little information is available concerning its contemporary clinical management. The aim of this study(More)
Pulse wave analysis (PWA) using applanation tonometry is a non-invasive technique for assessing cardiovascular function. It produces three important indices: ejection duration index (ED%), augmentation index adjusted for heart rate (AIX@75), and subendocardial viability ratio (SEVR%). The aim of this study was to assess within- and between-observer(More)
BACKGROUND Non-adherence with medication prescribed for chronic disease is ubiquitous and undermines the benefits of effective therapy. AIM To evaluate the influence of an educational booklet on thyroxine adherence and health in patients with primary hypothyroidism. DESIGN OF STUDY Unblinded randomised clinical trial of individual patients (by(More)
OBJECTIVE To quantify the relationship between arterial stiffness and cumulative inflammatory burden in patients with RA. METHODS We recruited RA patients without overt arterial disease aged 40-65 years, attending hospital rheumatology outpatient clinics. Standardized research nurse assessment included blood pressure (BP), pulse wave analysis (PWA,(More)
Journal of Family Planning and Reproductive Health Care 2004: 30(1) The gap between evidence and practice Clinical research continually produces new findings that can contribute to better patient care. However, such research cannot benefit patients unless doctors (and other health care professionals) adopt them in practice. A well-recognised time lag occurs(More)
BACKGROUND The evidence-based medicine (EBM) approach to clinical practice has been incorporated into medical training around the world. Whilst EBM is a component of the 'foundation years' (FY) programme, it appears to lack a firm foundation in the UK undergraduate curriculum. AIM To identify whether the teaching of EBM is adequately supported by the(More)
BACKGROUND Woman with heart disease may receive lower levels of clinical care than men. We assessed whether the Yentl syndrome (women receive equivalent care to men only when they demonstrate that they are like men by having a heart attack) operates in the management of angina pectoris in primary care. METHODS The study design is a cross-sectional survey(More)