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This service aimed to improve patient access to treatment for urinary tract infections (UTI), impetigo and exacerbation of chronic obstructive pulmonary disease (COPD) and relieve pressure on general practice and out of hours services.
In 2016, a service (Pharmacy First) was introduced in Forth Valley for the management of UTI, impetigo and exacerbation of COPD using patient group directions in community pharmacies. Trained pharmacists supplied a limited range of prescription medicines. Pathways for GP referral were defined. After 5 months of implementation, the service was evaluated.
A quantitative evaluation was undertaken. Feedback was sought from patients, GPs, pharmacists and GP reception staff, using structured questionnaires. Pharmacy records were used to assess referrals and pharmacy data summarised the number and type of consultations. Basic cost data was obtained from the Health Board.
In all, 75 pharmacies (of 76), and all 55 GP practices in the area, participated in the service. Over a 5-month period, 1189 cases were managed, the majority being for UTI (75.4%) followed by impetigo (15.2%), then COPD (9.3%). Of all cases, 77.9% were prescribed medication by the pharmacist, 9.1% were given advice only and 16.7% were referred to the GP. Independent clinical assessment of a random sample of 30 GP referrals considered all to be ‘appropriate’. Feedback was received from 69 pharmacists, 34 GPs, 54 reception staff and 73 patients. Patients were very satisfied with the service, most frequently citing the ‘quick and efficient’ access to treatment, and a ‘professional service’. Two thirds of GPs (67%) and 59% of reception staff found the service useful, mainly because it reduced pressure on GP appointments. A further cost benefit evaluation would allow objective assessment of the value of this service.
To prioritise policy actions for government to improve the food environment and contribute to reduced obesity and related diseases.
Cross-sectional study applying the Food Environment Policy Index (Food EPI) in two stages. First, the evidence on all relevant policies was compiled, through an Internet search of government documents, and reviewed for accuracy and completeness by government officials. Second, independent experts were brought together to identify critical gaps and prioritise actions to fill those gaps, through a two-stage rating process.
A total of seventy-three independent experts from forty-one organisations were involved in the exercise.
The top priority policy actions for government identified were: (i) control the advertising of unhealthy foods to children; (ii) implement the levy on sugary drinks; (iii) reduce the sugar, fat and salt content in processed foods (leading to an energy reduction); (iv) monitor school and nursery food standards; (v) prioritise health and the environment in the 25-year Food and Farming Plan; (vi) adopt a national food action plan; (vii) monitor the food environment; (viii) apply buying standards to all public institutions; (ix) strengthen planning laws to discourage less healthy food offers; and (x) evaluate food-related programmes and policies.
Applying the Food EPI resulted in agreement on the ten priority actions required to improve the food environment. The Food EPI has proved to be a useful tool in developing consensus for action to address the obesity epidemic among a broad group of experts in a complex legislative environment.
This book provides an overview of the research related to psychological assessment across South Africa. The thirty-six chapters provide a combination of psychometric theory and practical assessment applications in order to combine the currently disparate research that has been conducted locally in this field. Existing South African texts on psychological assessment are predominantly academic textbooks that explain psychometric theory and provide brief descriptions of a few testing instruments. Psychological Assessment in South Africa provides in-depth coverage of a range of areas within the broad field of psychological assessment, including research conducted with various psychological instruments. The chapters critically interrogate the current Eurocentric and Western cultural hegemonic practices that dominate the field of psychological assessment. The book therefore has the potential to function both as an academic text for graduate students, as well as a specialist resource for professionals, including psychologists, psychometrists, remedial teachers and human resource practitioners.
To determine which interventions can reduce linear growth retardation (stunting) in children aged 6–36 months over a 5-year period in a food-insecure population in Ethiopia.
We used data collected through an operations research project run by Save the Children UK: the Child Caring Practices (CCP) project. Eleven neighbouring villages were purposefully selected to receive one of four interventions: (i) health; (iii) nutrition education; (iii) water, sanitation and hygiene (WASH); or (iv) integrated comprising all interventions. A comparison group of three villages did not receive any interventions. Cross-sectional surveys were conducted at baseline (2004) and for impact evaluation (2009) using the same quantitative and qualitative tools. The primary outcome was stunted growth in children aged 6–36 months measured as height (or length)-for-age Z-scores (mean and prevalence). Secondary outcomes were knowledge of health seeking, infant and young child feeding and preventive practices.
Children aged 6–36 months.
The WASH intervention group was the only group to show a significant increase in mean height-for-age Z-score (+0·33, P = 0·02), with a 12·1 % decrease in the prevalence of stunting, compared with the baseline group. This group also showed significant improvements in mothers’ knowledge of causes of diarrhoea and hygiene practices. The other intervention groups saw non-significant impacts for childhood stunting but improvements in knowledge relating to specific intervention education messages given.
The study suggests that an improvement in hygiene practices had a significant impact on stunting levels. However, there may be alternative explanations for this and further evidence is required.
The authors review the significance of bracers by undertaking a detailed examination of their morphology, fragmentation, manufacture and wear. The results have a number of implications regarding their use and value and this is supported by the use of petrographic and geochemical analyses which suggest discrete patterns of raw material acquisition. A description of the technical methodology and appropriate data tables are available at http://www.antiquity.ac.uk/projgall/woodward.
Cerebral palsy (CP) can occur in term infants with or without preceding newborn encephalopathy. We compared the type and severity of CP and associated disability in these two groups. Participants from a population-based case-control study of term newborn encephalopathy were followed up for 6 years and linked to the Western Australian Cerebral Palsy Register. The remaining term infants with CP for the same period were also identified from the Cerebral Palsy Register. 13% of neonatal survivors of term newborn encephalopathy had CP, a rate of 116 per 1000 term live births. Overall, 24% of term infants with CP followed newborn encephalopathy. CP following newborn encephalopathy was more likely to: affect males (72% vs 56%); be severe (47% vs 25%); and be of spastic quadriplegia or dyskinetic types. Cognitive impairment was more common (75% vs 43%) and severe (41% vs 16%), as was epilepsy (53% vs 29%) in survivors of encephalopathy. These children were also more likely to: be non-verbal (47% vs 22%); have a severe composite disability score (47% vs 26%); and die between time of diagnosis of CP and age 6 years (5-year cumulative mortality 19% vs 5%). Children born at term who develop CP following newborn encephalopathy have a poorer prognosis than those with CP who were not encephalopathic in the first week of life.
There are twelve chapters in this treatise. The first concerns the purpose of the narrative. The second shows how the Roman Empire had remained based through the reigns of thirty-three emperors and for 345 years and five months invariably at Rome. The third demonstrates how the peoples of the East, namely, the Persians, Arabs, Chaldeans and other bordering nations, fell from the control of the Roman Empire. The fourth identifies the principal peoples who in the circumstances already described raised rebellion of this kind. The fifth treats the beginning and ordering of the transfer of the control of the Empire from the Greeks to the Franks. The sixth explains how Pepin was elevated, in the time of Zacharias, the Pope at Rome, from master of the palace to King of the Franks. The seventh relates how Pepin, King of the Franks, at the petitioning of the Roman church, marched to Italy against Astulphus, King of the Lombards, defeated him, and restored the temporal possessions of the Roman church. The eighth, how in the time of Pope Adrian, Charlemagne was made Patrician of the city and was granted the administration of the apostolic seat at Rome. The ninth, how the transfer of control of the Roman Empire from the Greeks to the Franks was effected. The tenth, how control of the Roman Empire was transferred from the Franks or Gauls to the Germans.
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