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Objective-To evaluate the eVectiveness of a nurse led shared care programme to improve coronary heart disease risk factor levels and general health status and to reduce anxiety and depression in patients awaiting coronary artery bypass grafting (CABG). Design-Randomised controlled trial. Setting-Community, January 1997 to March 1998. Study groups-98 (75 male) consecutive patients were recruited to the study within one month of joining the waiting list for elective CABG at Glasgow Royal Infirmary University NHS Trust. Patients were randomly assigned to usual care (control; n = 49) or a nurse led intervention programme (n = 49). Intervention-A shared care programme consisting of health education and motivational interviews, according to individual need, was carried out monthly. Care was provided in the patients' own homes by the community based cardiac liaison nurse alternating with the general practice nurse at the practice clinic. Outcome measures-Smoking status, obesity, physical activity, anxiety and depression, general health status, and proportion of patients exceeding target values for blood pressure, plasma cholesterol, and alcohol intake. Results-Compared with patients who received usual care, those participating in the nurse led programme were more likely to stop smoking (25% v 2%, p = 0.001) and to reduce obesity (body mass index > 30 kg/m 2 ) (16.3% v 8.1%, p = 0.01). Target systolic blood pressure improved by 19.8% compared with a 10.7% decrease in the control group (p = 0.001) and target diastolic blood pressure improved by 21.5% compared with 10.2% in the control group (p = 0.000). However, there was no significant diVerence between groups in the proportion of patients with cholesterol concentrations exceeding target values. There was a significant improvement in general health status scores across all eight domains of the 36 item short form health survey with changes in diVerence in mean scores between the groups ranging from 8.1 (p = 0.005) to 36.1 (p < 0.000). Levels of anxiety and depression improved (p < 0.000) and there was improvement in time spent being physically active (p < 0.000). Conclusions-This nurse led shared care intervention was shown to be eVective for improving care for patients on the waiting list for CABG. (Heart 2001;86:317-323) Keywords: coronary artery bypass grafting; coronary heart disease risk; nurse led shared care; risk reduction Coronary artery bypass graft (CABG) surgery has been shown to be a highly eVective intervention for the relief of angina, improving quality of life and for some patients prolonging life. [1][2][3][4] There has been a 10-fold increase in CABG surgery procedures in the UK, from approximately 3000 a year in 1977, either as a single procedure or together with another cardiac procedure, to almost 25 000 operations in 1995.5 In Scotland, rates of CABG are among the highest in the UK, at 448 operations per million of the population in 1995. The national guaranteed maximum waiting time is one year with a mean waiting time on National Health ...

Objective To assess the effects of major multi-sport events on health and socioeconomic determinants of health in the population of the city hosting the event. Design Systematic review.

For each n and k, let ∏¯(i,k) denote the poset of all partitions of n having every block size congruent to i mod k. Attach to ∏¯n(i,k) a unique maximal or minimal element if it does not already have one, and denote the resulting poset ∏n(i,k) Results of Björner, Sagan, and Wachs show that ∏n(0,k) and ∏n(1,k) are lexicographically shellable, and hence Cohen–Macaulay. Let βn(0,k) and βn(1,k) denote the characters of Sn acting on the unique non‐vanishing reduced homology groups of ∏n(0,k) and ∏n(1,k). This paper is divided into three parts. In the first part, we use combinatorial methods to derive defining equations for the generating functions of the character values of the βn(i,k) The most elegant of these states that the generating function for the characters βn1+1(1,k) (t = 0, 1,…) is the inverse in the composition ring (or plethysm ring) to the generating function for the corresponding trivial characters ɛnt$1. In the second part, we use these cycle index sum equations to examine the values of the characters βn(1,2) and βn(0,2). We show that the values of βn(0,2) are simple multiples of the tangent numbers and that the restrictions of the βn(0,2) to Sn−1 are the skew characters examined by Foulkes (whose values are always plus or minus a tangent number). In the case βn(1,2) a number of remarkable results arise. First it is shown that a series of polynomials {Pα(λ): σ € Sn} which are connected with our cycle index sum equations satisfy βn(1,2)(σ) = pσ(0) or pσ(1) depending on whether n is odd or even. Next it is shown that the pσ(λ) have integer roots which obey a simple recursion. Lastly it is shown that the pσ(λ) have a combinatorial interpretation. If the rank function of ∏n(1,2) is naturally modified to depend on σ then the polynomials pσ(λ) are the Birkhoff polynomials of the fixed point posets (∏n(1,2))σ. In the last part we prove a conjecture of R. P. Stanley which indentifies the restriction of βn(0,2) to Sn−1 as a skew character. A consequence of this result is a simple combinatorial method for decomposing βn(0,k) into irreducibles.