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Midlands Region (Midland + region)

Distribution by Scientific Domains
Medical Sciences85%

Kinds of Midlands Region

  • west Midland region
    		•

    Selected Abstracts

    Report on accreditation learning sets in the West Midlands Region of the NHS

    HEALTH INFORMATION & LIBRARIES JOURNAL, Issue 4 2000
    Gwen Giles
    This article reports on the evaluation of the first year of a project, which utilized learning sets to support librarians undergoing the accreditation process, in the health libraries in the West Midlands region of the NHS. The West Midlands Health region is divided up into education consortia patches. Each group of patch librarians was allocated a local accreditation facilitator. The groups met regularly to discuss problems and progress relating to their library's accreditation. The results of the evaluation suggest that this is a valuable approach to use. The recommendations state that regular, frequent meetings are needed. Extra training and guidance would help the facilitators to be more effective in their role. [source]

    Use of over-the-counter medicines in children

    INTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 4 2003
    John McIntyre senior lecturer in child health
    ABSTRACT Objective To assess the reasons for over-the-counter (OTC) medicine use in children and the sociodemographic factors influencing this choice of self-care rather than GP consultation. Method Questionnaires were sent to the home address of a randomly generated list of children under 12 years of age from three GP practices in the East Midlands selected to represent bottom, middle and top tertiles of deprivation on the basis of the Jarman score. Analysis using chi-square and Mann-Whitney tests was used to identify associated factors (number of carers in the home, number of children, deprivation score, parent/carer's age, age and number of children in the house) of the responses. Setting Primary care setting in the East Midlands region of England. Key findings From 424 completed questionnaires returned (response rate 61%), 413 parents/carers had purchased OTC medicines. Fifty-one different products had been purchased, with analgesic/antipyretic and cough/cold remedies the most frequently bought. The most commonly reported reasons for parent/carer initiated medication were to avoid troubling the GP with minor childhood ailments (79% of respondents) and to have medicines available in case of future need (74%). Cost was a barrier to buying OTC medicines for the more deprived. Advice-seeking behaviour was associated with the symptom, the number of children, affluence and the age of the child. Conclusion Parent/carer initiated use of OTC medication is widespread, particularly for analgesic/antipyretic and cough/cold remedies. Differences in advice-seeking behaviour are associated with the presenting symptom and a variety of sociodemographic factors. [source]

    Explaining bird species composition and richness in eucalypt-dominated remnants in subhumid Tasmania

    JOURNAL OF BIOGEOGRAPHY, Issue 9 2003
    Michael A. MacDonald
    Abstract Aim To determine the factors influencing the distribution of birds in remnants in a fragmented agricultural landscape. Location Forty-seven eucalypt remnants and six sites in continuous forest in the subhumid Midlands region of Tasmania, Australia. Methods Sites were censused over a two-year period, and environmental data were collected for remnants. The avifauna of the sites was classified and ordinated. The abundances of bird species, and bird species composition, richness, abundance and diversity were related to environmental variables, using simple correlation and modelling. Results There were two distinct groups of sample sites, which sharply differed in species composition, richness, diversity and bird abundance, separated on the presence/absence of noisy miner (Manorina melanocephala Latham) colonies, remnant size, vegetation structural attributes and variables that reflected disturbance history. The approximate remnant size threshold for the change from one group to another was 20,30 ha. Remnant species richness and diversity were most strongly explained by remnant area and noisy miner abundance, with contributions from structural and isolation attributes in the second case. Segment richness was explained by precipitation, logging history and noisy miner abundance. Bird abundance was positively related to precipitation and negatively related to tree dieback. The 28 individual bird species models were highly individualistic, with vegetation structural variables, noisy miner abundance, climatic variables, variables related to isolation, area, variables related to floristics, disturbance variables, the nature of the matrix and remnant shape all being components in declining order of incidence. Age of the remnant did not relate to any of the dependent variables. Main conclusions Degraded and small remnants may have become more distinct in their avifaunal characteristics than might otherwise be the case, as a result of the establishment of colonies of an aggressive native bird, the noisy miner. The area, isolation and shape of remnants directly relate to the abundance of relatively few species, compared to vegetation attributes, climate and the abundance of the noisy miner. The nature of the matrix is important in the response of some species to fragmentation. [source]

    Paediatric training for family doctors: principals and practice

    MEDICAL EDUCATION, Issue 5 2002
    C Melville
    Background There is controversy as to how best to train general practitioners for the paediatric challenges they will meet in practice, in particular what should be included in training, what should be left out and how long should it last? Subjects and methods All 615 general practice principals referring to 6 hospitals were surveyed (40% response rate). Setting West Midlands region of England. Study design Postal questionnaire. Statistics Quantitative and qualitative assessment of responses. Quantitative responses were analysed by hospital, decade of qualification, and duration of paediatric training. Qualitative responses were analysed using grounded theory. Results Satisfaction with training was directly related to its duration, with low levels of satisfaction for less than 6 months paediatrics, moderate levels for 6,11 months, and high levels with 12 months or more. The most important item of training was recognition of the sick child. Acute and chronic paediatrics was generally well covered. Psychosocial aspects, public health and immunisation were poorly addressed. Neonatal resuscitation and first day checks were seen as relevant, but neonatal intensive care was not. Conclusions At least 6 months of paediatrics is necessary for GPs in training, but longer paediatric exposure further increases their satisfaction with training. GPs have a biopsychosocial rather than biomedical approach to their child patients, suggesting potential benefits from a greater emphasis on psychosocial and public health aspects at the expense of neonatal intensive care. Recognition of the sick child is essential, and acute and chronic organic illness should be covered in breadth. Possible future models for GP training in paediatrics are discussed. [source]

    Variations in prescribing atypical antipsychotic drugs in primary care: cross-sectional study

    PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2002
    Darren M. Ashcroft
    Abstract Background Side-effects from conventional antipsychotic drugs, in particular extrapyramidal side-effects, limit their use for some patients, lead to non-compliance and may adversely affect the quality of life of others. Newer, more expensive, ,atypical' antipsychotics have been developed in attempts to address these problems, although debate about the most appropriate role for these medications remains. Objectives To examine variations in prescribing of the ,atypical' antipsychotics in primary care, over a 5-year period. Setting All 13 health authorities within the West Midlands region. Method Cross-sectional analysis of prescribing analysis and cost (PACT) data for atypical antipsychotic drugs (amisulpride, clozapine, olanzapine, risperidone, sertindole, and zotepine) was performed using one-way analysis of variance. To test whether the differences reflected variation in local population need, the prescribing data were adjusted using Mental Illness Needs Index scores. Regression analysis was used to examine the relationship between the overall levels of prescribing and local population need. Results The total volume of prescribing of atypical antipsychotic drugs in primary care increased nearly six-fold from 1996/97 to 2000/01 in the West Midlands region. Olanzapine was the most commonly prescribed drug during 1999/2000, accounting for 45% of defined daily doses, while risperidone accounted for 38% of the total. In 1996/97, a four-fold variation in rates of atypical antipsychotic prescribing between health authorities was found, compared with a three-fold variation in 2000/01, after adjusting for measures of local population need. Conclusions There has been a substantial increase in the prescription of atypical antipsychotics in primary care over the last 5 years, but the rate of increase has varied widely between health authorities. Further studies are needed to determine the factors that have led to these differences in uptake, and the likely impact of national guidance on future prescribing patterns. Copyright © 2002 John Wiley & Sons, Ltd. [source]

    Surgical workload and outcome after resection for carcinoma of the oesophagus and cardia,

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2002
    E. W. Gillison
    Background: Performing cancer surgery in high-volume centres may lead to improved outcomes. This study explored the relationship between annual workload and outcome following resection for carcinoma of the oesophagus and cardia. Methods: The study was a retrospective case-note review of 1125 patients who had surgery for cardio-oesophageal cancer in the West Midlands region of England. Outcome measures were 30-day mortality and long-term survival. Results: The overall 30-day mortality rate was 10·0 per cent with a median survival of 14 months and a 5-year survival rate of 17·2 per cent. Increasing age, advanced stage of disease and emergency resection independently affected outcome adversely. Forty-one infrequent operators (fewer than four resections per year) performed 146 resections (13·0 per cent), 18 intermediate operators (between four and 11 resections per year) performed 488 resections (43·4 per cent) and five frequent operators (12 or more resections per year) performed 491 resections (43·6 per cent). The 30-day mortality rate was greatest in the infrequent group (15·1 per cent) compared with both the intermediate group (6·6 per cent; adjusted odds 0·40, P = 0·004) and the frequent group (11·8 per cent; odds 0·73, P = 0·28). There were no differences in survival rates between the groups, and no difference in outcome between high- and low-volume hospitals. Conclusion: In this unselected population-based series there was little evidence of a trend of improving 30-day mortality rate with increasing workload, or between workload and long-term survival. © 2002 British Journal of Surgery Society Ltd [source]