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Articles by S Saxena
Total Records ( 3 ) for S Saxena
  J Murray , S Saxena , C Millett , V Curcin , S de Lusignan and A. Majeed
 

Objectives. To explore trends by ethnicity in clinical risk factor recording and control among patients with coronary heart disease (CHD), during a period of major investment in quality improvement initiatives in general practice in England.

Design. Longitudinal study from 1998 to 2007, using general practice data extracted from electronic patient records of all adult patients (n = 177 412) registered in 2007.

Setting. Twenty-nine general practices in Wandsworth south-west London.

Subjects. Three thousand two hundred registered patients with a recorded diagnosis of CHD, in 2007.

Main outcome measures. Mean systolic and diastolic blood pressure and mean cholesterol of patients with CHD, for each calendar year.

Results. From 1998 to 2007, the proportion of patients with CHD who had their blood pressure recorded rose from 33.2% to 93.9% and cholesterol from 21.7% to 83.5%. Over this period, mean blood pressure decreased from 140/80 to 133/74 mmHg (P < 0.001). There was a reduction in mean cholesterol from 5.2 to 4.3 mmol/l (P < 0.001). Reductions in mean blood pressure and cholesterol occurred across all ethnic groups.

Conclusions. From 1998 to 2007, risk factor control among patients with CHD improved, with reductions in their mean blood pressure and cholesterol across all ethnic groups. Widespread policy change has helped to improve the quality and equity of primary care for heart disease patients. Health improvements predated implementation of the Quality and Outcomes Framework and have since continued. Our findings illustrate how a national health care system with universal coverage can significantly reduce inequalities and improve chronic disease care for all ethnic groups.

  A Verma , R Birger , H Bhatt , J Murray , C Millett , S Saxena , R Banarsee , S Gnani and A. Majeed
  Background

There has been little research on the impact of quality improvement initiatives on ethnic disparities in diabetes management in the UK.

Methods

Population-based, repeated cross-sectional survey of recorded measurements, prescribing and achievement of treatment targets among 4309 patients with diabetes mellitus using electronic medical records from 26 general practices in North-West London from 1997 to 2006.

Results

Proportions of patients having their blood pressure (BP), cholesterol and HbA1c measured and recorded increased over the study period [from 50.6% to 87.0% (P < 0.0001), 17.0% to 76.7% (P < 0.0001) and 32.9% to 74.1% (P < 0.0001), respectively]. However, some ethnic differences remained. Black patients with diabetes were less likely to achieve target BP (<140/80 mmHg) than the white group [2006 age-sex adjusted odds ratio (AOR), 0.65; 95% confidence interval (CI), 0.51–0.83]. South Asians were found to have better lipid target control (2006 AOR, 1.57; CI, 1.23–2.00), were more likely to receive oral hypoglycaemic agents (2006 AOR, 2.27; CI, 1.79–2.86) but less likely to receive insulin (2006 AOR, 0.54; CI, 0.42–0.69) than the white group.

Conclusions

Although ethnic disparities persist in diabetes management in this study population, these are starting to be addressed, particularly in the South Asian group. All ethnic groups have benefited from recent quality initiatives in the UK.

  P Sharan , C Gallo , O Gureje , E Lamberte , J. J Mari , G Mazzotti , V Patel , L Swartz , S Olifson , I Levav , A de Francisco , S Saxena and the World Health Organization Global Forum for Health Research Mental Health Research Mapping Pro
 

Background

Studies suggest a paucity of and lack of prioritisation in mental health research from low- and middle-income (LAMI) countries.

Aims

To investigate research priorities in mental health among researchers and other stakeholders in LAMI countries.

Method

We used a two-stage design that included identification, through literature searches and snowball technique, of researchers and stakeholders in 114 countries of Africa, Asia, Latin America and the Caribbean; and a mail survey on priorities in research.

Results

The study identified broad agreement between researchers and stakeholders and across regions regarding research priorities. Epidemiology (burden and risk factors), health systems and social science ranked highest for type of research. Depression/anxiety, substance use disorders and psychoses; and children and adolescents, women, and people exposed to violence/trauma were prioritised among the disorders and population groups respectively. Important criteria for prioritising research were burden of disease, social justice, and availability of funds. Stakeholder groups differed in the importance they gave to the personal interest of researchers as a criterion for prioritising research. Researchers’ and stakeholders’ priorities were consistent with burden of disease estimates, however suicide was underprioritised compared with its burden. Researchers’ and stakeholders’ priorities were also largely congruent with the researchers’ projects.

Conclusions

The results of this first ever conducted survey of researchers and stakeholders regarding research priorities in mental health suggest that it should be possible to develop consensus at regional and international levels regarding the research agenda that is necessary to support health system objectives in LAMI countries.

 
 
 
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