Crisp gives NHS a year to halve PCTs in 250m pounds sterling savings drive.
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Biomedical subjects
Publications and source records attributed to Alastair McLellan.
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The independent sector's contribution to NHS patient choice is to be significantly extended through an invitation to bid for inclusion on PCT choice menus. In an exclusive interview, NHS chief executive Sir Nigel Crisp reveals that 'the BUPAs of this world' will be encouraged to supply care in all areas of elective care where choice is to be offered.
Osteoporosis is a common disease with a strong genetic component, characterized by reduced bone mass and an increased risk of fracture. Bone mineral density (BMD) is a highly heritable trait and a key determinant of osteoporotic fracture risk, but the genes responsible are incompletely defined. Here, we identified quantitative trait loci (QTL) for regulation of BMD by a genome wide scan involving 3691 individuals from 715 families, who were selected because of reduced BMD values at the lumbar spine (LS-BMD) or femoral neck (FN-BMD) in probands. Linkage analysis was conducted in the study group as a whole with correction for age, gender, weight and height. Further analyses were conducted for men and women separately to identify gender-specific QTL and for those under and over the age of 50 years to distinguish QTL for peak bone mass from those that influence bone mass in older people. No regions of suggestive or significant linkage were identified when data from all subjects were analyzed together. On subgroup analysis, however, we identified a significant QTL for FN-BMD on chromosome 10q21 (LOD score +4.42; men < or =50 years) and two suggestive QTL for LS-BMD on chromosomes 18p11 (LOD score +2.83; women >50 years) and 20q13 (LOD score +3.20; women < or =50 years). We identified five other QTL for BMD with LOD scores of greater than +2.20 on chromosomes 3q25, 4q25, 7p14, 16p13 and 16q23. This study provides evidence for gender-specific, site-specific and age-specific QTL, which regulate BMD in humans, and illustrates the importance of conducting subgroup analysis to detect these loci.
The detail behind the Conservatives' proposed redirection of NHS reform was revealed to HSJ by health spokesman Andrew Lansley (pictured) this week. But the manifesto--analysed on these pages--has come under attack from policy players and managers alike. Professor Chris Ham of Birmingham University commented: 'If that's not micro-management then what is?'.
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