P55 The neurosurgical physician: a new role in the UK

2019 ◽  
Vol 90 (3) ◽  
pp. e38.1-e38
Author(s):  
PJ Stewart ◽  
J Martin ◽  
J Thomas ◽  
C Hayhurst
Keyword(s):  
Patient Care ◽  
Nurse Practitioners ◽  
Qualitative Assessment ◽  
Junior Doctors ◽  
The North ◽  
Qualitative Descriptive ◽  
Ward Rounds ◽  
Physician Role ◽  
The Uk ◽  
The Impact

ObjectivesWith reduction in numbers of junior doctors and strict deanery requirements for training opportunities, the provision of ward cover and continuity has consistently fallen. Various methods of addressing this have been implemented in the UK, including increased nurse practitioners and physician associates. We introduced a new position of GP with a specialist neuroscience interest in line with the North American model of hospitalist and review the impact on patients and trainees.DesignQualitative descriptive study.Subjects14 core and speciality trainees.MethodsRetrospective review of the impact of a permanent neurosurgical physician on ward care and provision of training with a qualitative study of trainee experience. Saturation was reached at 14 interviews.ResultsA neurosurgical physician role was instituted in 2013, enabling a formal training rota to fulfil deanery requirements for core training and provide continuity of care at senior medical level, reducing medical ward consults to zero, improved communication with relatives and reduced the need for ST ward rounds. Qualitative assessment revealed a senior medical presence aided trainees own knowledge, resulted in better rapport and communication with patients and improved patient care through knowledge of best medical practice guidelines.ConclusionsThe addition of the neurosurgical physician role has positively impacted on the quality of patient care and junior doctor training. Senior medical care is provided with continuity, in contrast to other models.

scholarly journals Evaluating the efficacy of technical measures: a case study of selection device legislation in the UK Crangon crangon (brown shrimp) fishery

2008 ◽  
Vol 65 (2) ◽  
pp. 267-275 ◽  
Author(s):  
Tom L. Catchpole ◽  
Andrew S. Revill ◽  
James Innes ◽  
Sean Pascoe
Keyword(s):  
Brown Shrimp ◽  
Crangon Crangon ◽  
Shrimp Fishery ◽  
The North ◽  
Ex Post ◽  
Wide Range ◽  
The Uk ◽  
The Impact ◽  
Technical Measures

Abstract Catchpole, T. L., Revill, A. S., Innes, J., and Pascoe, S. 2008. Evaluating the efficacy of technical measures: a case study of selection device legislation in the UK Crangon crangon (brown shrimp) fishery. – ICES Journal of Marine Science, 65: 267–275. Bycatch reduction devices are being introduced into a wide range of fisheries, with shrimp and prawn fisheries particularly targeted owing to the heavy discarding common in these fisheries. Although studies are often undertaken to estimate the impact of a technical measure on the fishery before implementation, rarely have the impacts been assessed ex post. Here, the efficacy of the UK legislation pertaining to the use of sievenets in the North Sea Crangon crangon fishery is assessed. Three impacts were evaluated: on fisher behaviour (social), on the level of bycatch (biological), and on vessel profitability (economic). An apparent high level of compliance by skippers was identified despite a low level of enforcement. The estimated reduction in fleet productivity following the introduction of the legislation was 14%, equalling the mean loss of Crangon landings when using sievenets calculated from catch comparison trawls. Sievenets did reduce the unnecessary capture of unwanted marine organisms, but were least effective at reducing 0-group plaice, which make up the largest component of the bycatch. Clearly the legislation has had an effect in the desired direction, but it does not address sufficiently the bycatch issue in the Crangon fishery.

scholarly journals Does eating local food reduce the environmental impact of food production and enhance consumer health?

2010 ◽  
Vol 69 (4) ◽  
pp. 582-591 ◽  
Author(s):  
Gareth Edwards-Jones
Keyword(s):  
Food System ◽  
Local Food ◽  
Local Level ◽  
Qualitative Assessment ◽  
Small Scale ◽  
Quantitative Evidence ◽  
Self Sufficiency ◽  
Non Local ◽  
The Uk ◽  
The Impact

The concept of local food has gained traction in the media, engaged consumers and offered farmers a new marketing tool. Positive claims about the benefits of local food are probably not harmful when made by small-scale producers at the local level; however, greater concern would arise should such claims be echoed in policy circles. This review examines the evidence base supporting claims about the environmental and health benefits of local food. The results do not offer any support for claims that local food is universally superior to non-local food in terms of its impact on the climate or the health of consumers. Indeed several examples are presented that demonstrate that local food can on occasions be inferior to non-local food. The analysis also considers the impact on greenhouse gas emissions of moving the UK towards self-sufficiency. Quantitative evidence is absent on the changes in overall emissions that would occur if the UK switched to self-sufficiency. A qualitative assessment suggests the emissions per item of food would probably be greater under a scenario of self-sufficiency than under the current food system. The review does not identify any generalisable or systematic benefits to the environment or human health that arise from the consumption of local food in preference to non-local food.

scholarly journals 'Greenfields' and 'Brownfields': automotive industrial development in the UK and in Portugal

Finisterra ◽  
2012 ◽  
Vol 31 (62) ◽  
Author(s):  
Andrew Pike ◽  
Mário Vale
Keyword(s):  
Industrial Policy ◽  
Automobile Industry ◽  
Industrial Development ◽  
Development Strategies ◽  
North West ◽  
Demonstration Effect ◽  
North East ◽  
The North ◽  
The Uk ◽  
The Impact

The industrial policy in the UK and in Portugal, as in most EU countries, seeks to attract new investment capacity, to create jobs and to promote the impact of the so-called "demonstration efect" of "greenfield" development strategies pursued in the new plants of inward investors on existing or "brownfield" plants. This industrial policy focus is particularly evident in the automobile industry.This paper compares the industrial policy oriented towards the automobile industry in the UK and in Portugal. Two recent "greenfield" investments are analised: Nissan in the North-East region (UK) and Ford/VW in the Setúbal Peninsula (Portugal), as well as three "brownfield" plants: Ford Halewood and GM Vauxhall Ellesmere Port in the North-West region (UK) and Renault in Setúbal (Portugal). The first part starts with a discussion of industrial policy in the automobile sector, the role of "greenfield" development strategies and the "demonstration effect" on "brownfield" plants. Then, the limits of new inward investment are pointed out, basically their problems and restrictions. Afterwards, the structural barriers to the "demonstration effect" within "brownfield" plants are outlined and some possabilities for alternative "brownfield" development strategies are presented.

scholarly journals The EWTD: friend or foe to quality patient care?

2006 ◽  
Vol 88 (9) ◽  
pp. 318-319
Author(s):  
MBS Brewster ◽  
R Potter ◽  
D Power ◽  
V Rajaratnam ◽  
PB Pynsent
Keyword(s):  
Patient Care ◽  
Medical Staff ◽  
Junior Doctor ◽  
European Working Time Directive ◽  
Junior Doctors ◽  
Out Of Hours ◽  
Quality Patient Care ◽  
European Working ◽  
The Uk ◽  
Working Time Directive

For the last few years all the hospitals in the UK have been changing junior doctors' rotas to become compliant with the European Working Time Directive (EWTD). The first stage, requiring a junior doctor to work a maximum of 58 hours per week averaged over a 6-month period, became law in August 2004. In addition to new posts for junior doctors there have been schemes to facilitate the transition, such as the Hospital at Night programme. This was designed to use the minimum safe number of doctors from appropriate specialties with supporting medical staff to cover the hospital out of hours. It was required to make the most efficient use of this team and allow the junior doctor rotas to be compliant with the appointment of as few new posts as possible.

Inequalities in awareness and availability of bereavement services in North-East England

2020 ◽  
pp. bmjspcare-2020-002422
Author(s):  
Donna Wakefield ◽  
Elizabeth Fleming ◽  
Kate Howorth ◽  
Kerry Waterfield ◽  
Emily Kavanagh ◽  
...  
Keyword(s):  
Phase 1 ◽  
Waiting Times ◽  
Financial Strain ◽  
Web Based ◽  
North East ◽  
The North ◽  
Referral Criteria ◽  
National Guidance ◽  
The Uk ◽  
The Impact

ObjectivesNational guidance recommends equality in access to bereavement services; despite this, awareness and availability appears inconsistent. The aim of this study was to explore availability and accessibility of bereavement services across the North-East of England and to highlight issues potentially applicable across the UK, at a time of unprecedented need due to the impact of COVID-19.MethodsPhase 1: an eight item, web-based survey was produced. A survey link was cascaded to all GP practices (General Practitioners) in the region. Phase 2: an email was sent to all services identified in phase 1, requesting details such as referral criteria and waiting times.ResultsAll 392 GP practices in the region were invited to participate. The response rate was 22% (85/392). Twenty-one per cent (18/85) of respondents reported that they do not refer patients, comments included ‘not aware of any services locally’. A total of 36 services were contacted with 72% responding with further information. Most bereavement specific support was reliant on charity-funded services including hospices, this sometimes required a pre-existing link with the hospice. Waiting times were up to 4 months.ConclusionsAlthough multiple different, usually charity-funded services were identified, awareness and accessibility were variable. This survey was conducted prior to the COVID-19 pandemic, where complex situations surrounding death is likely to impact on the usual grieving process and increase the need for bereavement support. Meanwhile, charities providing this support are under severe financial strain. There is an urgent need to bridge the gap between need and access to bereavement services.

scholarly journals Reducing pressure ulcers across multiple care settings using a collaborative approach

2019 ◽  
Vol 8 (3) ◽  
pp. e000409 ◽  
Author(s):  
Julia Wood ◽  
Bob Brown ◽  
Annette Bartley ◽  
Andreia Margarida Batista Custódio Cavaco ◽  
Anthony Paul Roberts ◽  
...  
Keyword(s):  
Pressure Ulcers ◽  
Length Of Hospital Stay ◽  
Community Services ◽  
Care Community ◽  
North East ◽  
The North ◽  
Healthcare Improvement ◽  
The Uk ◽  
Breakthrough Series Collaborative ◽  
The Impact

In the UK, over 700 000 patients are affected by pressure ulcers each year, and 180 000 of those are newly acquired each year. The occurrence of pressure ulcers costs the National Health Service (NHS) more than 3.8 million every day. In 2004, pressure ulcers were estimated to cost the NHS £1.4–£2.4 billion per year, which was 4% of the total NHS expenditure.The impact on patients can be considerable, due to increased pain, length of hospital stay and decreased quality of life. However, it is acknowledged that a significant number of these are avoidable.In early 2015, it was identified that for the North East and North Cumbria region the incidence of pressure ulcers was higher than the national average. Because of this, a 2-year Pressure Ulcer Collaborative was implemented, involving secondary care, community services, care homes and the ambulance service, with the aim of reducing the percentage of pressure ulcers developed by patients within their care.The Breakthrough Series Collaborative Model from the Institute for Healthcare Improvement provided the framework for this Collaborative.In year 1, pressure ulcers were reduced by 36%, and in year 2 by 33%, demonstrating an estimated cost saving during the lifespan of the Collaborative of £513 000, and a reduction in the number of bed days between 220 and 352.

Current innovations in otolaryngology medical education in the UK: a systematic literature review

2020 ◽  
Vol 134 (4) ◽  
pp. 284-292
Author(s):  
H M Yip ◽  
T C F Soh ◽  
Z Z Lim
Keyword(s):  
Medical Education ◽  
Objective Assessment ◽  
Final Analysis ◽  
Subjective Assessment ◽  
Junior Doctors ◽  
Synthesis Methods ◽  
Qualitative Synthesis ◽  
Educational Innovations ◽  
The Uk ◽  
The Impact

AbstractObjectiveRecent studies have indicated a lack of ENT training at the undergraduate and post-graduate levels. This study aimed to review the impact of recent educational innovations in improving ENT training for medical students and junior doctors in the UK.MethodsThree independent investigators conducted a literature search of published articles on ENT education. Included studies were analysed using qualitative synthesis methods.ResultsAn initial search yielded 2008 articles; 44 underwent full-text evaluation and 5 were included for final analysis. Most included studies demonstrated benefits for students when compared to existing teaching standards in terms of objective assessment (knowledge and skills gained) or subjective assessment (confidence and preference) following implemented educational innovations.ConclusionThis study identified educational innovations developed in the past 15 years to enhance the teaching of core ENT competencies. More research is needed to establish their impact on the state of ENT medical education in the UK.

scholarly journals Effects of halogens on European air-quality

2017 ◽  
Vol 200 ◽  
pp. 75-100 ◽  
Author(s):  
T. Sherwen ◽  
M. J. Evans ◽  
R. Sommariva ◽  
L. D. J. Hollis ◽  
S. M. Ball ◽  
...  
Keyword(s):  
Air Quality ◽  
Stratospheric Ozone ◽  
Mixing Ratios ◽  
The North ◽  
Halogen Chemistry ◽  
The North Sea ◽  
Regional Air Quality ◽  
The Uk ◽  
The Impact ◽  
Quality Policy

Halogens (Cl, Br) have a profound influence on stratospheric ozone (O3). They (Cl, Br and I) have recently also been shown to impact the troposphere, notably by reducing the mixing ratios of O3 and OH. Their potential for impacting regional air-quality is less well understood. We explore the impact of halogens on regional pollutants (focussing on O3) with the European grid of the GEOS-Chem model (0.25° × 0.3125°). It has recently been updated to include a representation of halogen chemistry. We focus on the summer of 2015 during the ICOZA campaign at the Weybourne Atmospheric Observatory on the North Sea coast of the UK. Comparisons between these observations together with those from the UK air-quality network show that the model has some skill in representing the mixing ratios/concentration of pollutants during this period. Although the model has some success in simulating the Weybourne ClNO2 observations, it significantly underestimates ClNO2 observations reported at inland locations. It also underestimates mixing ratios of IO, OIO, I2 and BrO, but this may reflect the coastal nature of these observations. Model simulations, with and without halogens, highlight the processes by which halogens can impact O3. Throughout the domain O3 mixing ratios are reduced by halogens. In northern Europe this is due to a change in the background O3 advected into the region, whereas in southern Europe this is due to local chemistry driven by Mediterranean emissions. The proportion of hourly O3 above 50 nmol mol−1 in Europe is reduced from 46% to 18% by halogens. ClNO2 from N2O5 uptake onto sea-salt leads to increases in O3 mixing ratio, but these are smaller than the decreases caused by the bromine and iodine. 12% of ethane and 16% of acetone within the boundary layer is oxidised by Cl. Aerosol response to halogens is complex with small (∼10%) reductions in PM2.5 in most locations. A lack of observational constraints coupled to large uncertainties in emissions and chemical processing of halogens make these conclusions tentative at best. However, the results here point to the potential for halogen chemistry to influence air quality policy in Europe and other parts of the world.

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