PubMed · 16953535
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Michael Gross. 2006-08-08. Crystal clear.. https://doi.org/10.1016/j.cub.2006.07.038
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INTRODUCTION: Many changes have been made to the staffing and organisation of neonatal care in the UK in the past 10 years. This study assessed the extent to which these changes had affected the transfer of babies between different parts of the service. METHODS: Data from the Trent Neonatal Survey, an ongoing study of neonatal intensive care activity in the former Trent Health Region of the UK, were used to evaluate neonatal inter-hospital transfers over a 10-year period, from 1 January 1995 to 31 December 2004. The number of transfers and the types of transfer were analysed and trends in gestation and disease severity over the study period were assessed. Rates of "inappropriate transfer" were also identified. RESULTS: 8105 babies were transferred over the period; 2294 babies underwent urgent postnatal transfer and this equates to approximately two such transfers every three days. The maximum number of journeys by any one baby was eight. Intensive care activity rose during the 10 years but the number of inappropriate transfers remained persistently high. CONCLUSIONS: Organisational changes in neonatal care during the 10-year period have been insufficient to deal with the rising demand, as reflected by the persistently high rate of inappropriate transfers.
The incidence of infection by mycobacteria, other than tubercle bacilli (MOTT) is increasing in the United Kingdom, Europe and the United States. These diseases increase morbidity and are an increasing public health concern. However, the epidemiology of disease due to these species is not well characterized. We used space-time clustering approaches and Generalized Linear Modelling to investigate the potential predictors of disease in cases of infection by organisms of the Mycobacterium avium complex (MAC) and M. malmoense recorded in the north of England during 2000-2005. There was significant spatial and temporal clustering in juvenile cases of infection by MAC but not for cases of infection in adults by either species. There were no significant predictors of infection by M. malmoense or juvenile cases of M. avium. Incidence of disease caused by M. avium in adults was significantly related to health deprivation and weakly related to rainfall. We consider possible reasons for the difference in epidemiology in infection by M. avium in adults and juveniles.
BACKGROUND: Surveys of occupational stress were undertaken in 1999 and 2004. OBJECTIVE: To measure the prevalence of psychological strain and exposure to work-related stressors in personnel. METHOD: A cross-sectional survey using a validated, reliable questionnaire was undertaken in 1999 and was replicated in 2004. The data were combined and models of stress-strain were developed for male and female personnel in the Royal Navy (RN) and males in the Royal Marines (RM). RESULTS: The response rates were 78% in 1999 and 67% in 2004. Strain prevalence was 32% in 1999 and 33.5% in 2004. Strain rates were higher in females than in males and in personnel serving at sea. Reduced organizational commitment was associated with strain in males and females. Dissatisfaction with the physical work environment was associated with strain in RN females and RM. Role conflict was associated with strain in all groups. Work-family conflict was associated with strain in males, but not in females. The models accounted for 20-30% of the variance in strain. CONCLUSION: The strain rate in the Naval Service appeared to be similar to that in the other service occupations such as the UK Police, as did the sex difference in strain. The strain rate and stressor exposure ratings were remarkably stable over the period. Role conflict was found to be a generic stressor associated with strain.