Improving vitamin D status through dietary supplementation is unlikely to reduce CVD risk factors. Confounding of seasonality should be recognized and addressed in future studies of vitamin D.

Few year-long vitamin D supplementation trials exist that match seasonal changes. The aim of this study was to determine whether daily oral vitamin D 3 at 400 IU or 1000 IU compared with placebo affects annual bone mineral density (BMD) change in postmenopausal women in a 1-year double-blind placebo controlled trial in Scotland. White women aged 60 to 70 years (n ¼ 305) were randomized to one of two doses of vitamin D or placebo. Mean BMD loss at the hip was significantly less for the 1000 IU vitamin D group (0.05% AE 1.46%) compared with the 400 IU vitamin D or placebo groups (0.57% AE 1.33% and 0.60% AE 1.67%, respectively) (p < 0.05). Mean (AE SD) baseline 25(OH)D was 33.8 AE 14.6 nmol/L; comparative 25(OH) D change for the placebo, 400 IU, and 1000 IU vitamin D groups was À4.1 AE 11.5 nmol/L, þ31.6 AE 19.8 nmol/L, and þ42.6 AE 18.9 nmol/L, respectively. Treatment did not change markers of bone metabolism, except for a small reduction in PTH and an increase in serum calcium (latter with 1000 IU dose only). The discordance between the incremental increase in 25(OH)D between the 400 IU and 1000 IU vitamin D and effect on BMD suggests that 25(OH)D may not accurately reflect clinical outcome, nor how much vitamin D is being stored.

We found no evidence of an improvement in physical function following vitamin D3 supplementation for 1 year.

The Scottish Public Health Network (ScotPHN) was tasked by the Scottish Government to update the previous Needs Assessment Report (2002) to take account of the current epidemiology and recent advances in the understanding, treatment and care of people with rheumatoid arthritis. The aim of the updated health care needs assessment (HCNA) is to (1) review the epidemiology of rheumatoid arthritis in Scotland (including future trends), (2) identify the views of stakeholders on current and future service provision and (3) identify gaps in service provision and highlight priority areas for change and make recommendations that will assist NHS boards to plan and develop services for those with rheumatoid arthritis (RA) in their local area. This HCNA has used elements of the following three approaches to needs assessment: epidemiological needs assessment: describing the incidence and prevalence of the disease and baseline service activity; corporate needs assessment: reporting the views of interested parties and stakeholders (including professionals and service users and their carers); and comparative needs assessment: comparing and contrasting current RA services in Scotland with those provided elsewhere. The following key issues were identified: (1) the need to shift practice towards early diagnosis and treatment; (2) ensuring the appropriate management of chronic disease; (3) access to the multidisciplinary team; (4) managing the cost pressures associated with RA drug prescribing; (5) reducing work disability due to RA; (6) meeting training and staffing needs; and (7) auditing and improving outcomes. There are 30 recommendations that have been Abstract Background: Rheumatoid arthritis is an inflammatory condition that results in joint damage. Sharp-van der Heidje is one of the most widely used scoring method in assessing damage in RA. The aim of this project was to compare scoring of hand radiographs manually with a semi-automated workflow tool in development. Method and results: Twenty-one sets of bilateral hand radiographs from patients with RA of variable duration were scored both manually and with the semi-automated Abstracts e33

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