Health bulletin最新文献

{"title":"General practitioners and the Internet--a questionnaire survey of Internet connectivity and use in Lothian.","authors":"M O Moffat,&nbsp;K J Moffat,&nbsp;V Cano","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To determine the extent of Internet connectivity and use by GPs in the Lothian Health Board area and to investigate which Internet medical information resources GPs find most useful for work related purposes.</p><p><strong>Design: </strong>Postal questionnaire.</p><p><strong>Setting: </strong>General Practice.</p><p><strong>Subjects: </strong>Postal questionnaires were sent to all GPs listed in the Lothian Health Primary Care mailing list. In total 546 questionnaires were sent to 126 practices during April/May 1999.</p><p><strong>Results: </strong>At least one response was received from 86% of practices and overall 56% of questionnaires were returned. Ninety two percent of practices that responded indicated that an Internet connection was available with 86% reporting that access was restricted to one computer. Sixty seven percent of responding GPs indicated that they had used the Internet, with more time being spent using the Web than Email. Of the Internet users 54%, rated the Internet as useful or very useful for work related purposes. Accessibility and immediacy of access to information were among the most useful aspects of Internet use, with locating specific resources and lack of time being highlighted as commonly reported difficulties. Popular medical Internet resources included Medline/Pubmed, the eBMJ/BMA site and a range of other resources produced by authoritative medical bodies.</p><p><strong>Conclusion: </strong>This study indicates high Internet connectivity in Lothian general practices, with increased levels of use by GPs compared with previous benchmark studies and high levels of perceived usefulness of the Internet in relation to GPs work. Training and education of GPs is clearly required if they are to take best advantage of improved Internet accessibility.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 2","pages":"120-6"},"PeriodicalIF":0.0,"publicationDate":"2001-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314030","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 survey of information given by health professionals, about bottle feeding, to first-time mothers in a Scottish population.","authors":"P A Cairney,&nbsp;E M Alder","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To assess mothers' perception of information given to them about bottle feeding.</p><p><strong>Design: </strong>Survey, as part of a longitudinal study of professional support given to infant feeding mothers. Data were analysed from postal questionnaires completed at 34 weeks gestation and one month postnatally.</p><p><strong>Subjects: </strong>Every woman over 16 years expecting her first baby in an uncomplicated pregnancy, in two Scottish regions, was sent an antenatal questionnaire over an eight month period during 1998. This report considers respondents over 23 years of age, of whom there were 365 (51% response rate). Of these, 296 (81%) completed the subsequent questionnaire at one month postnatally.</p><p><strong>Results: </strong>Fewer than 50% of women reported being given information about sterilising equipment, making feeds and offering the right quantities, before the birth of their baby. Of women considering bottle feeding only 42% had been given any information on sterilising equipment before their baby's birth. Of women who had begun to breastfeed but were giving bottle feeds at one month postnatally, fewer than 40% had been given information on bottle feeding antenatally, and less than 56% postnatally.</p><p><strong>Conclusion: </strong>In a study of 365 mothers of 23 years and over most women reported having little or no information about bottle feeding. Women who intended to bottle feed reported receiving more information than those intending to breastfeed. Those giving bottle feeds at one month reported that they received more information than those exclusively breastfeeding, but low levels of information giving were recalled overall.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 2","pages":"97-101"},"PeriodicalIF":0.0,"publicationDate":"2001-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22312918","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":"Prison admission health screening as a measure of health needs.","authors":"D S Morrison,&nbsp;G Gilchrist","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To assess the validity of routine prison screening admission data for measuring health needs and planning health services.</p><p><strong>Design: </strong>Retrospective descriptive study of routinely collected admission data.</p><p><strong>Setting: </strong>The largest Scottish men's prison with an annual throughput of around 20,000 men.</p><p><strong>Subjects: </strong>All adult male (> or = 21 years) prisoners admitted during January 1998.</p><p><strong>Results: </strong>Nine hundred and six men were screened in January 1998. Thirty-eight per cent of men entering prison said they currently or had previously used illegal drugs and 22% of all admissions gave a history of intravenous drug use. Six men (0.7%) reported hepatitis C infection and two (0.2%) reported hepatitis B infection. A history of major mental illness was reported by 10% of all prisoners, 7% of drug users and 15% of problem drinkers. Deliberate self-harm was reported by 10% of all prisoners, 9% of drug users and 17% of problem drinkers.</p><p><strong>Conclusion: </strong>There is a high prevalence of reported substance misuse and its sequelae and mental illness in prisoners. However, mental illness, substance use and some infectious diseases (such as HIV, hepatitis B and hepatitis C) may be under-reported, possibly because of social stigma or low expectations of treatment in prison. Health screening on admission to prison presents a unique opportunity to identify health needs at an early stage. However, there is a need to improve detection of some stigmatized conditions if individual care and health service planning are to be improved.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 2","pages":"114-9"},"PeriodicalIF":0.0,"publicationDate":"2001-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22312920","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 evaluation of community learning disability services for children with a learning disability.","authors":"K Mckenzie,&nbsp;D Paxton,&nbsp;G C Murray","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study outlines the results of a survey carried out with parents of children with a learning disability, general practitioners and community learning disability teams as to the health service needs for this client group. Overall, 40% of parents were very dissatisfied or dissatisfied with the services they received. A number of gaps in service provision were identified. In particular, psychological and behavioural difficulties of children were of major concern to all those involved, but needs in relation to these areas were often unmet or inadequately dealt with. Of greater concern was that some families in the area studied were paying privately for child learning disability clinical psychology services because they had such difficulty in accessing NHS services. Implications for service provision are discussed.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 2","pages":"91-6"},"PeriodicalIF":0.0,"publicationDate":"2001-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22312917","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":"Acceptability and uptake of a community-based flu immunisation programme.","authors":"J Farmer,&nbsp;L Iversen,&nbsp;G Peterkin,&nbsp;P Strachan,&nbsp;H Kelman,&nbsp;K Proctor,&nbsp;M Emslie","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate a community based influenza immunisation programme in terms of patients' and primary care professionals' satisfaction and uptake of immunisation.</p><p><strong>Design: </strong>Surveys were conducted which compared the experiences and opinions of groups of staff and patients who had experienced the programme with groups where general practice was responsible for immunisation arrangements.</p><p><strong>Setting: </strong>Primary care.</p><p><strong>Subjects: </strong>Patients eligible for influenza immunisation and general practice staff involved in providing immunisation.</p><p><strong>Results: </strong>A good response was obtained from patients (82.2%:2,900) and general practices (83.3%:55). Patients from both programme and comparison groups reported high levels of satisfaction with flu immunisation arrangements. Preferences expressed tended to coincide with patients' experiences of arrangements. Around 40% of both groups desired information. A minority of unvaccinated patients (more programme patients than comparators) expressed difficulties in accessing clinics. There were both advantages and disadvantages for general practices involved in the programme. Although time consumed in giving injections was less for programme staff, they reported substantial time spent on programme-related administration and dealing with patients' queries. Programme figures indicate uptake of 53.8% (not including those vaccinated elsewhere). Survey results show that 58.5% of programme patients who responded were vaccinated.</p><p><strong>Conclusions: </strong>In light of recent Scottish Executive Health Department guidance, experiences of this programme may be of interest to those contemplating Local Development Schemes for flu immunisation. Findings highlight the dilemma between potential economies of scale and continuity of care for patients.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 2","pages":"127-35"},"PeriodicalIF":0.0,"publicationDate":"2001-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314031","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":"Breastfeeding rates are increasing in Scotland.","authors":"D M Tappin,&nbsp;J M Mackenzie,&nbsp;A J Brown,&nbsp;R W Girdwood,&nbsp;J Britten,&nbsp;M Broadfoot,&nbsp;J Warren","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To measure the change in prevalence of breastfeeding between 1990/1991 and 1997/1998 in Scotland, using information collected on Guthrie cards when newborn infants are about seven days old.</p><p><strong>Design: </strong>Analysis, by geographic postcode area, health board and maternity unit, for babies born in 1990/1991 and 1997/1998. For 1997, maternity unit and health board breastfeeding rates were also compared after standardisation for maternal age, deprivation and age of infant.</p><p><strong>Setting: </strong>Scotland.</p><p><strong>Subjects: </strong>131,759 babies born in 1990/1991 and 118,055 in 1997/1998.</p><p><strong>Results: </strong>In 1990/1991, 46,949 (35.6%) were breastfed as were 49,615 (42.0%) in 1997/1998, an increase of 6.4% (95% CI 6.0, 6.8) over eight years. A 3.8% increase remained after adjustment for change in maternal age. Maternity units with the Baby Friendly award improved 8.1% (95% CI 7.0, 9.2) compared with those with a certificate of commitment 6.1% (95% CI 5.2, 7.0). Other units improved 2.2% (95% C1 1.6, 2.8) no more than estimates due to increase in maternal age. Standardised rates were higher on the East Coast of Scotland 111 (109, 112) than the West or Central Regions 97 (96, 99).</p><p><strong>Conclusion: </strong>Breastfeeding has increased over eight years in Scotland. Less than half can be explained by demographic change in maternal age. However present breastfeeding targets are unlikely to be met. Maternity units should be urged to participate fully in the UNICEF U.K. Baby Friendly Initiative. Effective interventions prior to pregnancy are required so that more young men and women want their babies to be breastfed.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 2","pages":"102-13"},"PeriodicalIF":0.0,"publicationDate":"2001-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22312919","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 controlled study of children born at gestation 28 weeks or less: psychological characteristics at seven to ten years of age.","authors":"L Harding,&nbsp;L G Walker,&nbsp;D Lloyd,&nbsp;P Duffty","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Forty seven children aged between seven and ten years who were born at 28 weeks gestation or less were followed up and assessed using psychometric tests, questionnaires and a parental interview. Birth and post-birth medical details were also collected. A control group of 47 normal gestation/birth weight children, matched with the children in the low gestation (LG) cohort on nine other criteria, were assessed using the same procedures. Children in the LG cohort were of average intelligence and attainment, but differed from the control group in that they had significantly lower scores on the WISC-R (VIQ, PIQ and FSIQ, Freedom from Distractibility), information processing, visual motor memory, speech and auditory discrimination, mathematics, spelling and restlessness. Handedness was related to birth weight. In addition to birth weight, centile score (weight in relation to gestation) was found to predict later FSIQ, VIQ and reading, spelling and mathematics. Neurological factors such as the absence of suspected intracranial haemorrhage or seizures were predictors of PIQ and Freedom from Distractibility, respectively. Although children in the LG cohort scored significantly lower than control children on various cognitive tests, only two had Full Scale IQs below 70 and most functioned at least at the normal range of intelligence.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 2","pages":"81-90"},"PeriodicalIF":0.0,"publicationDate":"2001-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22312916","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 effect of introducing a dedicated emergency theatre and altering consultant on-call commitments in a large children's hospital.","authors":"G Haddock,&nbsp;S J O'Toole,&nbsp;P A Raine,&nbsp;C Davis,&nbsp;G M Walker","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Two recommendations of NCEPOD were the introduction of dedicated emergency theatres and a higher level of consultant involvement in emergency cases. In May 1998 a dedicated emergency theatre was introduced in the Royal Hospital for Sick Children, Glasgow. At the same time the on-call rota of the Consultant Paediatric Surgeons was changed from days on-call to a period of one week, during which elective commitments were cancelled.</p><p><strong>Method: </strong>A retrospective audit was conducted for the 12-month periods before and after these changes. Start times of emergency cases and grades of surgeons were obtained from the theatre database.</p><p><strong>Results: </strong>The proportion of emergency operations carried out during on call periods (weekends and weekdays after 5 pm) decreased for general paediatric and neonatal surgery (OR = 0.7, p < 0.01). There was an increase in the proportion of daytime emergency cases performed before 1 pm (OR = 0.28, p < 0.01). The Consultant Paediatric Surgeons were involved in more emergency cases (OR = 0.60, p < 0.01).</p><p><strong>Conclusions: </strong>The provision of a dedicated emergency theatre increased the proportion of emergency cases performed during normal working hours, particularly before 1 pm. Cancelling elective commitments for Consultant Paediatric Surgeons ensured higher levels of consultant input into daytime emergency cases.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 2","pages":"77-80"},"PeriodicalIF":0.0,"publicationDate":"2001-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22312915","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":"Referral of children to a general anaesthetic dental service in Tayside.","authors":"J Foley,&nbsp;D J Evans,&nbsp;A Blackwell","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To determine the adequacy of child referral for dental general anaesthesia (DGA) by local dental practitioners, given the recent guidance document to dentists from the General Dental Council and in addition, to determine the subsequent treatment and factors which influence treatment selection.</p><p><strong>Design: </strong>A prospective study.</p><p><strong>Setting: </strong>Department of Paediatric Dentistry, Dundee Dental Hospital, Dundee.</p><p><strong>Subjects: </strong>Children [n = 84] who were referred for dental extractions under general anaesthetic over a three month period.</p><p><strong>Results: </strong>Non-surgical dental extractions under general anaesthetic were requested in nearly 90% of referrals. In the majority of cases, the referral was deemed inadequate; e.g. the medical history was not mentioned in the majority of cases (85.7%) despite nearly one-fifth of patients having a relevant medical history. In general, referring practitioners under-estimated the extent of disease, requiring treatment plans to be changed in 76% of cases; all changes represented an increase in the number of dental extractions undertaken. The most common reasons for general anaesthetic use were: multiple dental extractions (73.8%); the patient's anxiety (63.1%); and patient's age (41.7%). As an alternative to general anaesthesia, treatment was undertaken successfully using inhalation sedation in nearly 15% of cases.</p><p><strong>Conclusion: </strong>Dental extractions under general anaesthetic are still a common reason for referral. Referring practitioners frequently provide inadequate information, in addition to under-estimating the treatment required. Alternative forms of anxiety management are available and should be considered for children requiring dental extractions.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 2","pages":"136-9"},"PeriodicalIF":0.0,"publicationDate":"2001-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314032","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":"Independent nursing practice: a national survey of attitudes of practice employed nurses in Scotland.","authors":"J L Caldow,&nbsp;C M Bond,&nbsp;E M Russell","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>During the last decade, the number of practice nurses has increased dramatically and their role has evolved according to demand rather than through planning and design. Consequently, many nursing roles have become extended and nurses now perform many of the tasks previously performed by doctors. With increasing emphasis on primary care, their new role has become widely accepted and continues to develop. There is now a real question as to whether, with suitable training, it is timely to consider a formal extension to independent practice for at least some practice nurses.</p><p><strong>Objective: </strong>The aim was to describe the characteristics of practice nurses and to explore their attitudes to independent practice. For the purpose of this study, independent practice was taken to mean specialised autonomous practice.</p><p><strong>Design: </strong>This was a descriptive, cross-sectional study undertaken by postal questionnaire. A two stage sampling process was used.</p><p><strong>Setting: </strong>Firstly a 1/2 sample of all general practices in Scotland (n = 625) was asked for the names of all practice employed nurses. Secondly, one practice nurse from each practice was sent a postal questionnaire.</p><p><strong>Results: </strong>Five hundred and thirty eight general practices responded. Eighty six practices had no practice employed nurse. Four hundred and thirty three practices (96%; 433/452) were willing to allow their practice nurses to be approached to take part in the study. Four hundred practice nurses returned questionnaires (92%; 400/433). Fifteen were excluded because the nurses were not fully practice employed. Three hundred and eighty five were suitable for inclusion in the study (85%; 385/452). Most practice nurses were over 35 years of age and had been in post for more than three years. Almost half had at least one other nursing qualification in addition to registration. Eighty six percent thought that there should be independent practice for some nurses within the profession and 65% would, themselves, be happy to practise independently.</p><p><strong>Conclusion: </strong>Most practice nurses throughout Scotland think that there should be independent practice for some nurses.</p>","PeriodicalId":75896,"journal":{"name":"Health bulletin","volume":"59 1","pages":"21-8"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22441184","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}