Health bulletin最新文献

{"title":"A qualitative study of general practitioners' and practice nurses' attitudes to obesity management in primary care.","authors":"S W Mercer,&nbsp;S Tessier","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To examine general practitioners' (GPs) and practice nurses' (PNs) perceptions of obesity, their strategies and attitudes towards weight management, and their views on the major obstacles to (and need for) better weight management in primary care.</p><p><strong>Method: </strong>A qualitative study was carried out using semi-structured interviews with GPs and PNS within the Greater Glasgow Healthboard area.</p><p><strong>Results: </strong>GPs and PNs understood the problem of obesity but generally had little enthusiasm for weight management. Most of the GPs felt it was an inappropriate use of their time and passed obese patients onto the PNs; the PNs felt that obese patients were \"off-loaded\" onto them. Stated management objectives were aimed at \"healthy lifestyle\" rather than \"unrealistic\" weight loss, yet frustration at \"lack of success\" was a major theme. Lack of motivation on the part of the patient was seen as the major problem. GPs were keener to be directly involved when a concomitant disease was present. Suggested requirements to improve weight management at the level of primary care included more time, better facilities, community dieticians and more training courses. However, many felt that Government, media and public health had to take a leading role in order to deal with the problem effectively.</p><p><strong>Conclusions: </strong>A comprehensive and integrative primary care-led approach to weight management may be possible but will need substantial shifts of resources, organisation, training and attitudes in order to maximise its potential impact.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 4","pages":"248-53"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colorectal cancer in Orkney.","authors":"H A Elmusharaf,&nbsp;A Almakhtar","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 4","pages":"276-7"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What do we know about the voluntary healthcare sector in Scotland?","authors":"D R Coid,&nbsp;I K Crombie","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To document sources of information available to the National Health Service in Scotland (NHSiS) which relate to the health voluntary sector.</p><p><strong>Design: </strong>Interrogation of the databases of the Charities Register in Scotland (CRIS) and Health Education Board for Scotland (HEBS) for information on health voluntary organisations and a retrospective review of information held on health voluntary organisations recently funded by health boards.</p><p><strong>Setting: </strong>National Health Service in Scotland and the Scottish Council for Voluntary Organisations</p><p><strong>Results: </strong>Nine hundred and fifty six health voluntary organisations in Scotland were registered with the CRIS database. Five hundred and forty five (57%) of these had annual incomes of less than 100,000 Pounds and two thirds of them (630) operated at a local level. Information on 3,106 health and support organisations was present on the HEBS database. In 1997-98 Scottish Health Boards grant funded 278 voluntary organisations. Eighty seven (31%) of these had information held on the CRIS database and another 87 (31%) with the HEBS database. Funding was much more likely to be given to organisations dealing with adult physical health and alcohol problems. Organisations dealing with specific diseases were less likely to be funded. Of the 87 funded organisations registered with CRIS, health boards typically contributed less than 10% of annual funding.</p><p><strong>Conclusions: </strong>Health planning decisions are made difficult by a deficiency of useful information on the existence, activities and financial positions of voluntary organisations. Construction of accurate and comprehensive national databases to inform these decisions would be expensive. However, the development of appropriate local databases by health boards and the voluntary sector would facilitate the development of a constructive partnership.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 4","pages":"224-7"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Web-based questionnaires regarding osteoporosis prevention in young British women.","authors":"J Marsden,&nbsp;R B Jones","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>The aim was to assess the content, validity and reproducibility of web-based questionnaires, for a study on osteoporosis prevention among young British women. Twenty-two questionnaires to assess knowledge, self-efficacy, physical activity, calcium intake, health beliefs and stages of change relevant to osteoporosis prevention were identified. Nine were selected and modified to compensate for cultural differences, to suit young women, for completion on the Web.</p><p><strong>Design: </strong>Subjects were recruited by e-mail and asked to complete the web-based questionnaires. Subjects completed the questionnaires again, on paper and were asked to assess the content validity, at least seven days later.</p><p><strong>Setting: </strong>University of Glasgow, Scotland.</p><p><strong>Subjects: </strong>Sixteen female students and staff aged 19-49.</p><p><strong>Results: </strong>The questionnaires' reproducibility, as measured by the intraclass correlation coefficient was significant at p < 0.01 and acceptable, i.e. above 0.70 for knowledge, 0.85; for self-efficacy, 0.72; for exercise stage of change, 0.79; for exercise benefits, 0.89 and for exercise barriers, 0.82. The intraclass correlation coefficient was significant at p < 0.01 for health belief, 0.43, for weight-bearing physical activity, 0.67, for calcium barriers, 0.48, for 'others around you', 0.65, for calcium stage of change, 0.50 and for calcium intake, 0.56. The intraclass correlation coefficient was not significant for calcium benefits.</p><p><strong>Conclusions: </strong>Assessing content validity was valuable in ensuring questionnaires were relevant and interpreted correctly by the sample population. Nine web-based questionnaires suitable for, and validated with, young British women are now available for use as outcome measures in studies of health education to prevent osteoporosis.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 4","pages":"254-62"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The national health demonstration projects.","authors":"J McVea,&nbsp;M K Ross,&nbsp;L de Caestecker,&nbsp;D Milne,&nbsp;A McEwen,&nbsp;N Rees,&nbsp;L Wilkie,&nbsp;C Morton","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The White Paper Towards a Healthier Scotland pledged 15 million Pounds to support four national health demonstration projects to lead the way in achieving sustained improvement in child health, young people's sexual health, coronary heart disease and cancer. The Starting Well project aims to demonstrate that child health in Glasgow can be improved by a programme of activities which both supports families and provides them with access to enhanced community-based resources. The Healthy Respect project aims to help young people in Lothian develop a positive attitude to their own sexuality and that of others, and a healthy respect for their partners, in order to reduce unplanned teenage pregnancies and sexually transmitted infections. The Have a Heart Paisley project is targeting coronary heart disease among the population of Scotland's largest town. The Cancer Challenge project is piloting a screening programme in the North East of Scotland for the detection of colorectal cancer. Though each project has specific objectives, appropriate to its own topic, all share underlying principles. The projects will act as test beds for action and a learning resource for the rest of Scotland.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 4","pages":"268-75"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A complete audit cycle of intrapartum group B streptococcus prophylaxis.","authors":"N McCord,&nbsp;P Owen,&nbsp;A Powls,&nbsp;B Lunan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Group B Streptococcus (GBS) colonises the intestines of approximately one third of women and can result in intermittent colonisation of the vagina. The principal route of neonatal infection is from the vagina during delivery which can cause morbidity and mortality in the neonate. We recently introduced a protocol of intrapartum prophylaxis based on recognised risk factors.</p><p><strong>Objective: </strong>To complete an audit cycle to determine the adequacy of intrapartum antibiotic prophylaxis for women with recognised risk factors for neonatal GBS infection, to make changes to the indications for prophylaxis and to highlight and rectify any deficiencies in practice.</p><p><strong>Methods: </strong>Women identified with risk factors for neonatal GBS were treated with a regimen of intravenous benzylpenicillin or clindamycin. Adequate prophylaxis was achieved if the women received antibiotics more than four hours prior to delivery. The case notes of all deliveries over a four-week period were reviewed in both the initial audit and the re-audit.</p><p><strong>Results: </strong>Three hundred and fifty nine deliveries occurred during the initial study period. Thirty seven (10.3%) women were identified with risk factors but adequate prophylaxis was provided to only 32%. Difficulty in providing adequate prophylaxis to women with intrapartum maternal pyrexia due to time constraints and an unanticipated increase in the number of neonates of 35 to 37 weeks gestation receiving postnatal intravenous antibiotics necessitated changes to the indications for prophylaxis. During the re-audit there were 378 deliveries with 49 (13%) women identified with risk factors and adequate prophylaxis was achieved in 42% of women.</p><p><strong>Conclusion: </strong>Despite changes to the protocol and circulation of the results to medical and midwifery staff, the percentage of women receiving adequate prophylaxis is low. Areas for further improvement include greater awareness of the indications for prophylaxis through education and better documentation of risk factors present before labour. Despite the benefits of adopting a protocol of intrapartum prophylaxis it is important to recognise its practical limitations and to continue to be vigilant in identifying and treating neonates whose mothers have not received adequate treatment.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 4","pages":"263-7"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A unitary patient record improves admission documentation in a medical assessment unit in a major teaching hospital.","authors":"L G Morrison,&nbsp;S Lam,&nbsp;M Sutherland,&nbsp;K Kefala,&nbsp;T Morse,&nbsp;D Bell","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To ascertain the impact of the introduction of a unitary patient record (UPR) on clerking documentation of emergency medical admissions.</p><p><strong>Design: </strong>Retrospective casenote audit.</p><p><strong>Subjects and setting: </strong>Random sample of 100 unselected admissions to the medical assessment unit of a major teaching hospital, comprising two groups pre- and post-introduction of the UPR.</p><p><strong>Results: </strong>Statistically significant improvements in the documentation of several items were achieved; function before episode, ethnic origin, chest pain, breathlessness, ankle oedema, cough, bowel habit and locomotor symptoms and recording of blood pressure and peripheral pulses. There were trends towards improvement in other areas and there were no areas in which the UPR performed less well than standard documentation.</p><p><strong>Conclusions: </strong>Introduction of the UPR represents the successful application of multidisciplinary principles to over 10,000 acute general medical admissions. It has improved some, but not all, aspects of documentation. Revision of the design of the UPR should lead to further progress, as part of an ongoing process of development and re-audit.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 4","pages":"218-23"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A second survey of Scottish emergency psychiatry.","authors":"I M Pullen,&nbsp;E Nisbet","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To survey NHS services providing emergency psychiatric assessment in Scotland and to compare the findings with those of the survey conducted 8 years ago.</p><p><strong>Design: </strong>Postal and telephone questionnaire of all primary care trusts, the one integrated trust and three Island Health Boards in Scotland.</p><p><strong>Results: </strong>All parts of Scotland provide a 24 hour service for the assessment of psychiatric emergencies. There is a range of multidisciplinary responses during office hours with a total of 75 multidisciplinary Community Mental Health Teams, 18 Community Psychiatric Nursing Teams, 11 liaison psychiatry teams and one dedicated emergency team. However, for most of the week, the service is provided by a duty basic grade doctor in each area with the exception of Orkney.</p><p><strong>Conclusions: </strong>Planning the most appropriate emergency and crisis service for any population depends on suitable data being available. Eight years after the first survey there is still no systematic collection of data on emergency contacts in Scotland. The systematic collection of National data is required for effective audit, planning and development of these services. The working definitions proposed in the first survey would be suitable for coding.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 4","pages":"228-32"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GDP referrals for orthodontic treatment.","authors":"B S Thind,&nbsp;S Hewage,&nbsp;C J Larmour","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To assess the accuracy of the information provided by General Dental Practitioners (GDPs) in referral letters for orthodontic treatment.</p><p><strong>Design: </strong>An audit.</p><p><strong>Setting: </strong>Orthodontic Department, Royal Aberdeen Children's Hospital, Aberdeen. METHOD (SUBJECTS): Prospective assessment of GDP referrals over a two month period. Information provided by referrals compared with British Orthodontic Society guidelines.</p><p><strong>Results: </strong>A total of 103 new referrals were assessed. Only 25 (24%) patients knew why they were referred. Nineteen (18%) patients were keen on treatment before being explained what treatment was indicated. Nine (8%) patients declined treatment after being explained the risk/benefit of the treatment. Approximately one third of the patients examined had inadequate oral hygiene. Five (4%) patients had more than two active carious lesions. Forty two (41%) referrals provided no information or missed important malocclusion features. None of the letters provided details of patient's general medical practitioner.</p><p><strong>Conclusions: </strong>The present audit has highlighted a number of recurring problems with GDP referrals to a hospital orthodontic department. It has indicated a need to inform referring GDPs about the minimum information required in their referral letters. It is suggested that referring dentists should follow the recommendations of the British Orthodontic Society.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 4","pages":"244-7"},"PeriodicalIF":0.0,"publicationDate":"2001-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An audit of the investigation and use of anti-D immunoglobulin prophylaxis in Tayside.","authors":"I Rennie,&nbsp;A Smith,&nbsp;R Smith,&nbsp;P S Rawlinson,&nbsp;P Clark","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To audit the implementation of national guidelines on the investigation and management of RhD disease in Tayside.</p><p><strong>Setting: </strong>Tayside region.</p><p><strong>Design: </strong>An eight month retrospective audit.</p><p><strong>Results: </strong>Two hundred and eighty eight completed pregnancies in RhD negative women were observed from a total of 1879 deliveries. Of these, 120 RhD negative and 169 RhD positive babies were delivered from women who had not previously been sensitised. At delivery, anti-D was used appropriately in all cases. Of those assessed to require anti-D (n = 168), 91% received it within 24 hours of delivery. In 59 RhD negative subjects, 75 potential sensitising events occurred antenatally. In 45 of these, the event occurred after 20 weeks gestation and 44 received appropriate anti-D. In 11 (23.7%) of these, no foetomaternal haemorrhage assessment was carried out.</p><p><strong>Conclusion: </strong>Despite a significant increase in awareness of antenatal prophylaxis since a previous audit in the region, there is still a significant failure to request FMH assessments following potential antenatal sensitising episodes and after delivery. During the audit period, an EDTA plasma gell-based antibody detection system was commissioned in the region. This has allowed the introduction of internal laboratory referral for FMH assessment. This has allowed accurate knowledge on the possible occurrence of FMH at delivery, but has not had a significant impact on antenatal events.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 3","pages":"150-4"},"PeriodicalIF":0.0,"publicationDate":"2001-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}