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At least 73 records · Page 4Linked to original sources

Clinical management special: mental health. One to chew over.

Eating disorders have the highest mortality rate of any psychiatric condition, yet a 2001 study showed that half of health authorities had no specialist eating disorder service. This postcode lottery of provision means many people end up without effective treatment or have to travel long distances. New NICE guidelines set the standard for effective treatment for eating disorders, but will significant funding and training implications.

Adolescent↗

Career opportunities in public health: one veterinarian's experience.

The veterinary profession is rich in opportunities that are ignored. The veterinary profession should evolve to a new level--to more broadly include all aspects of public health. Veterinary education, even in its current classical mode, provides a rich base for multiple careers. With expansion, there will be a wealth of opportunities for veterinarians to be leaders in many phases of business and society.

Animals↗

Study of urinary tract infection in children in one health district.

OBJECTIVES: To determine the number of children who had urine specimens sent for culture, who had infections or sterile pyuria, and who were investigated further. To relate the laboratory findings to the results of imaging. DESIGN: One year survey of urine specimens submitted to a laboratory; review of previous and subsequent laboratory reports; review of the findings of imaging of the urinary tract. SETTING: Portsmouth and South East Hampshire health district. SUBJECTS: An estimated population of 89,086 children aged 12 years or under. MAIN OUTCOME MEASURES: Urine bacterial count and results of imaging. RESULTS: 12,551 urine specimens were submitted from 7450 children, 3138 boys and 4312 girls. 2238 children had infection or sterile pyuria at least once during the study (13.9/1000 boys, 37/1000 girls). 996 (45%) of the children with infection or sterile pyuria underwent some form of imaging. 128 children who had infection or sterile pyuria were already known to have urinary tract abnormalities and 114 children had newly identified abnormalities (1.0/1000 boys, 1.5/1000 girls). 50 (44%) of the children with newly detected abnormalities had no pyuria and 48 (42%) had bacterial counts below 10(8)/l. Eight children who had sterile pyuria on presentation were found to have abnormalities on imaging. CONCLUSIONS: Urinary tract infection is much commoner in children than is widely believed. Low bacterial counts, the absence of pyuria, or a finding of sterile pyuria should not be disregarded.

Age Distribution↗

How good are the data? Reliability of one health care data bank.

This study investigates the reliability of the Manitoba Health Services Commission data bank from a variety of perspectives. Emphasizing diagnostic and surgical procedures, the research focuses on those areas in which problems exist and in which the data can be relied upon. Computerized comparisons are stressed, since they can provide cost-effective checks on data quality. One key to performing reliability studies inexpensively is finding information recorded independently: by separate individuals or organizations, at two different times, or in two or more data files. When a particular event has certain logical implications vis-à-vis another, inconsistencies can be located. Face sheet information and data on the performance of major surgical procedures were found to be reliably recorded in the Manitoba data bank. Collapsing ICD-8 diagnosis from medical claims into several categories proved much better than relying upon individual diagnoses. Problems in working with the data included difficulty in distinguishing between closely related surgical procedures and the underreporting of inhospital consultations and nonsurgical procedures.

Computers↗

Out-patient follow-up after total hip replacement in one health region.

A postal survey was carried out of all orthopaedic surgeons in the West Yorkshire Health region enquiring about out-patient follow-up practices after total hip replacement. Follow-up is advised to detect problems that can more effectively be resolved if detected early. A huge variation in the number, timing and nature of appointments following discharge was demonstrated. The total length of follow-up varied between 3 months and indefinite follow-up. The number of visits in the first post-operative year varied between one and four. The considerable variation in post surgery follow-up of these patients has important cost implications. Some patients will have unnecessary appointments whereas others will be inadequately reviewed. Guidance is required on the appropriate review of these patients which will allow early detection of joint failure in a way that is efficient in terms of the time and cost of out-patient follow-up.

Arthroplasty, Replacement, Hip↗

Are malaria films requested appropriately? A study of all film requests in one health district.

In a 12-month period 238 patients had blood films examined for malaria parasites in a London district general hospital. All the available medical records of these patients were studied. The ethnic origin and country from which the patients had travelled were typical of an area with a large immigrant population. 27 of the films were positive. 39 were judged to have been requested inappropriately, usually because an adequate travel history had not been taken. Imported malaria is an important problem in this health district and contributes significantly to the laboratory workload.

Clinical Laboratory Techniques↗