scholarly journals Systemic glucocorticoid usage in dogs under primary veterinary care in the UK: prevalence and risk factors

2019 ◽  
Vol 185 (4) ◽  
pp. 108-108 ◽  
Author(s):  
Doaa A Elkholly ◽  
Dan O’Neill ◽  
Andrea K Wright ◽  
Kennedy Mwacalimba ◽  
Laura S Nolan ◽  
...  
Keyword(s):  
Primary Care ◽  
Medium Size ◽  
Age Group ◽  
Systemic Glucocorticoid ◽  
Oral Preparation ◽  
Systemic Glucocorticoids ◽  
Study Population ◽  
Long Acting ◽  
The Uk ◽  
To Receive

Glucocorticoids are widely used in primary care veterinary practices. The study aimed to quantify the usage of systemic glucocorticoids (SGC) in dogs in the UK using primary care treatment records recorded during 2013 in the VetCompass Programme. From a study population of 455 557 dogs, 28 472 dogs (6.2 per cent, 95 per cent CI 6.2 to 6.3) received a total of 50 971 SGC therapy events in 2013. Prednisolone represented the most frequently used oral preparation (27 362 events, 90.0 per cent of oral events). Dexamethasone sodium phosphate was the most commonly used injectable agent (12 796 events, 62.7 per cent of injectable events). The most common breed treated was Staffordshire Bull Terriers (2236/28 472 dogs, 7.9 per cent, 95 per cent CI 7.5 to 8.2) and within-breed prevalence of SGC usage was 2236/32 635, 6.9 per cent, 95 per cent CI 6.6 to 7.1. The most commonly treated age group was dogs older than eight years (8931/28472, 31.4 per cent) and the most commonly treated bodyweight group was 10.01–20.0 kg (7918/28 472, 27.8 per cent). Dexamethasone and prednisolone were the most commonly prescribed SGC. Short-acting and intermediate-acting injectable SGC were more commonly used compared with long-acting injectable SGC. Older and medium size dogs were most likely to receive SGC and certain breeds appeared predisposed. These data can provide a useful benchmark for glucocorticoid usage and highlight the benefits from ‘Big Data’ analyses.

scholarly journals Paramedic independent prescribing in primary care: seven steps to success

2020 ◽  
Vol 2 (6) ◽  
pp. 292-299 ◽  
Author(s):  
Judith Edwards ◽  
Melaine Coward ◽  
Nicola Carey
Keyword(s):  
Primary Care ◽  
Scope Of Practice ◽  
Service Development ◽  
Potential Barriers ◽  
Independent Prescribing ◽  
Early Adoption ◽  
Independent Case ◽  
The Uk ◽  
To Receive ◽  
Significant Milestone

Paramedic practice is evolving and the number of advanced paramedics in primary care roles in the UK has risen dramatically. Recent legislation granting paramedics independent prescribing rights means UK paramedics are the first worldwide to receive this extension in scope of practice – a significant milestone for the paramedic profession. Paramedic prescribing capability is expected to increase autonomy for independent case management and enhance capacity for service development. However, local and national success is likely to depend on skilful implementation and avoidance of historical barriers. This article aims to raise awareness of potential barriers to early adoption of paramedic independent prescribing in primary care. It identifies common pitfalls prior to training and provides seven practical steps for paramedics considering pursuing non-medical prescribing training.

scholarly journals Choice of temporary contraception based on client’s demographic status and parity

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Benju Pandit
Keyword(s):  
Retrospective Study ◽  
Contraceptive Method ◽  
Descriptive Analysis ◽  
Tertiary Hospital ◽  
Age Group ◽  
Hospital Record ◽  
Contraceptive Methods ◽  
Contraceptive Service ◽  
Long Acting ◽  
To Receive

Aim: To analyse the demographic factors and parity in women influencing choice of contraceptive methods. Methods: This is a hospital record based retrospective study at Bhaktapur hospital, a tertiary hospital in a span of 6 months from October 2020 to March 2021. Data were collected from medical record and descriptive analysis was done. Results: There were 142 women taking contraceptive service in six months.Implant was the most commonly used method of contraception (48%), followed by the IUCD (26%), Injectable (16%) and OCP (10%). Age group of 20-39 had more acceptance of contraception as compared to adolescent and women above 40. More the parity more usage of long acting reversible contraception was found. Conclusion: The most common contraceptive method used among women was implant. Client having two or more children are more to receive long acting contraception.

Amoxicillin or Myringotomy or Both for Acute Otitis Media: Results of a Randomized Clinical Trial

PEDIATRICS ◽  
1991 ◽  
Vol 87 (4) ◽  
pp. 466-474
Author(s):  
Phillip H. Kaleida ◽  
Mark M. Blatter ◽  
Keith S. Reisinger ◽  
Ellen R. Wald ◽  
Margaretha L. Casselbrant ◽  
...  
Keyword(s):  
Otitis Media ◽  
Initial Treatment ◽  
Acute Otitis Media ◽  
Placebo Treatment ◽  
Age Group ◽  
Middle Ear Effusion ◽  
Recurrence Rates ◽  
Study Population ◽  
To Receive ◽  
Ear Effusion

A total of 536 infants and children with acute otitis media were randomly assigned to one of six consistent year-long regimens involving the treatment of nonsevere episodes with either amoxicillin or placebo, and severe episodes with either amoxicillin, amoxicillin and myringotomy, or, in children aged 2 years or older, placebo and myringotomy. Nonsevere episodes had more favorable outcomes in subjects assigned to treatment with amoxicillin than with placebo, as measured by the proportions that resulted in initial treatment failure (3.9% vs 7.7%, P = .009) and the proportions in which middle-ear effusion was present at 2 and 6 weeks after onset (46.9% vs 62.5%, P < .001; and 45.9% vs 51.5%, P = .09, respectively). In subjects whose entry episode was nonsevere, those assigned to amoxicillin treatment had less average time with effusion during the succeeding year than those assigned to placebo treatment (36.0% vs 44.4%, P = .004), but recurrence rates of acute otitis media in the two groups were similar. In the 2-year-and-older age group, severe episodes resulted in more initial treatment failures in subjects assigned to receive myringotomy alone than in subjects assigned to receive amoxicillin with, or without, myringotomy (23.5% vs 3.1% vs 4.1%, P = .006). In the study population as a whole, severe episodes in subjects assigned to receive amoxicillin alone, and amoxicillin with myringotomy, had comparable outcomes. It is concluded that children with acute otitis media should routinely be treated with amoxicillin (or an equivalent antimicrobial drug). The data provide no support for the routine use of myringotomy either alone or adjunctively.

Graduate Employment and Training in SMEs in Northern Ireland

2005 ◽  
Vol 19 (1) ◽  
pp. 55-63 ◽  
Author(s):  
Richard Harris ◽  
Renee S. Reid
Keyword(s):  
Northern Ireland ◽  
Labour Force ◽  
Policy Implications ◽  
Medium Size ◽  
Multivariate Approach ◽  
Graduate Employment ◽  
Size Firm ◽  
The Uk ◽  
To Receive ◽  
And Training

Using the UK Labour Force Survey, this paper considers whether graduate employment is more important in the small and medium-size enterprise (SME) sector in Northern Ireland than in other regions of the UK. The authors disaggregate their analysis by gender, occupation and industry to provide a detailed breakdown. The issue of whether graduates are more or less likely to receive on-the-job training is also considered, both by comparison with non-graduates (matched by industry and occupation groups) and graduates in other UK regions. Finally, given that company size, firm location, industry and occupation groups are all related to the proportion of graduates employed in the labour market, the authors use a multivariate approach to disentangle the extent to which there are differences associated with graduate employment in the Northern Ireland SME sector (having controlled for other factors). The policy implications of their findings for graduate employment are then considered.

scholarly journals P01 Incidence of juvenile idiopathic arthritis in the United Kingdom: estimates from a national primary care dataset

Rheumatology ◽  
2019 ◽  
Vol 58 (Supplement_4) ◽  
Author(s):  
Ruth Costello ◽  
Janet McDonagh ◽  
Will Dixon ◽  
Kimme Hyrich ◽  
Jenny Humphreys
Keyword(s):  
Primary Care ◽  
Juvenile Idiopathic Arthritis ◽  
Conflicts Of Interest ◽  
Incidence Rates ◽  
Age Group ◽  
The Uk ◽  
Incident Cases ◽  
Over Time ◽  
Adolescent Rheumatology ◽  
Direct Standardisation

Poster presentation Tuesday 8 October Background Juvenile idiopathic arthritis (JIA) is the most common childhood onset inflammatory arthritis. The last estimates of incidence of JIA in the UK are from nearly 30 years ago, prior to international classification consensus and the emergence of paediatric and adolescent rheumatology as a specialty. The aim of this study was to estimate incidence of JIA from primary care records in the UK since 2000. Methods The study used data from the Clinical Practice Research Datalink (CPRD), a database of UK primary care records broadly representative of the UK in terms of age, gender and ethnicity. A pre-defined list of JIA Read codes were used to identify incident cases annually from 2000-2018. Incidence rates (IR) with 95% confidence intervals(CI) were calculated and stratified by age and gender. The denominator was the population of CPRD <16 years old on the 31st December each year. Direct standardisation, applying Office for National Statistics population data, was used to estimate the UK IR. IRs in 5-year groupings were calculated 2000-2015 to identify change over time. Results Between 2000-2018, there were 1927 incident cases of JIA, from a total of 23,328,676 children <16 years old in CPRD. The total IR (95% CI) was 8.26 (7.90-8.64) per 100,000 population; for females and males respectively it was 9.83 (9.27-10.43) and 6.78 (6.33-7.27) per 100,000. Age-adjusted direct standardisation to the UK population estimated a total IR of 9.66 per 100,000 person-years. By age group, there appeared to be a lower incidence in middle childhood compared to early childhood and adolescents, as well as infancy where lower rates may be due to difficulties recognising the disease (Table 1). IRs over time did not appear to change. P01 Table 1: Incidence rates by age group Age (years) Denominator Cases IR (95% CI) Per 100,000 0-2 1739417 113 6.5 (5.40-7.81) >2-6 5763003 534 9.27 (8.51 – 10.08) >6-12 9464988 693 7.32 (6.80-7.90) >12-15 6361268 587 9.22 (8.51-10.01) Conclusion This is the first study to provide contemporary UK estimates of the incidence of JIA for nearly 30 years. JIA was more common in females compared to males, and in early childhood and adolescence compared to other age groups. Incidence appeared to be stable over fifteen years. These data provide important information for patients, their families and healthcare providers; in addition, they are vital for appropriate resource planning and service provision in paediatric and adolescent rheumatology. Conflicts of Interest The authors declare no conflicts of interest.

scholarly journals Comparison of long-acting testosterone undecanoate formulation versus testosterone enanthate on sexual function and mood in hypogonadal men

2009 ◽  
Vol 160 (5) ◽  
pp. 815-819 ◽  
Author(s):  
F Jockenhövel ◽  
T Minnemann ◽  
M Schubert ◽  
S Freude ◽  
D Hübler ◽  
...  
Keyword(s):  
Sexual Functioning ◽  
Sexual Interest ◽  
Treatment Modalities ◽  
Testosterone Enanthate ◽  
Testosterone Undecanoate ◽  
Desire Satisfaction ◽  
Study Population ◽  
Baseline Values ◽  
Long Acting ◽  
To Receive

ObjectiveTo compare the effects of two treatment modalities of testosterone on sexual functioning and mood.DesignForty men were randomized to receive either parenteral testosterone enanthate (TE) or long-acting parenteral testosterone undecanoate (TU) over a period of 30 weeks. Thereafter, 20 men who had received TU and 16 men who had received TE continued with TU and completed another 65 weeks to study longer-term effects of TU.MethodsThe following variables of sexual functioning were studied: sexual thoughts and fantasy, sexual interest and desire, satisfaction with sex life, number of erections and ejaculations per week, and number of spontaneous morning erections per week. Also variables related to mood were analyzed.ResultsImprovements in these variables were significant and were of a similar magnitude in the group treated with TU and TE for 30 weeks. Improvements were maintained at the same levels over a period of another 65 weeks when all men received TU. Effects on mood were recorded for 30 weeks, but were more difficult to establish in the study population. There were significant differences in baseline values between the two groups and scores showed wide s.d.ConclusionsBoth TE and TU were effective in improving sexual functions in hypogonadal men. An advantage of TU over TE is its lower frequency of administration and its better tolerability and safety profile.

scholarly journals Inaccurate diagnosis of COPD: the Welsh National COPD Audit

2018 ◽  
Vol 69 (678) ◽  
pp. e1-e7 ◽  
Author(s):  
Marie Fisk ◽  
Viktoria McMillan ◽  
James Brown ◽  
Juliana Holzhauer-Barrie ◽  
Muhammad S Khan ◽  
...  
Keyword(s):  
Primary Care ◽  
Correct Diagnosis ◽  
Airflow Obstruction ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Beta Agonists ◽  
Quality And Outcomes ◽  
Never Smokers ◽  
Long Acting ◽  
To Receive

BackgroundThe diagnosis of chronic obstructive pulmonary disease (COPD) is confirmed with spirometry demonstrating persistent airflow obstruction.AimTo evaluate the clinical characteristics and management of patients in primary care on COPD registers with spirometry incompatible with COPD.Design and settingA primary care audit of Welsh COPD Read-Coded patient data from the Quality and Outcomes Framework (QOF) COPD register in Wales.MethodPatients on the QOF COPD register with incompatible spirometry (post-bronchodilator forced expiratory lung volume in 1 second/forced vital capacity [FEV1/FVC] ratio ≥0.70) were compared with those with compatible spirometry (FEV1/FVC <0.70).ResultsThis audit included 63% of Welsh practices contributing 48 105 patients. Only 19% (n = 8957) of patients were post-bronchodilator FEV1/FVC Read-Coded and were included in this study. Of these, 75% (n = 6702) had compatible spirometry and 25% (n = 2255) did not. Patients with incompatible spirometry were more likely female (P = 0.009), never-smokers (P<0.001), had higher body mass index (P<0.001), and better mean FEV1 (P<0.001). Medical Research Council (MRC) breathlessness scores, exacerbation frequency, and asthma co-diagnosis were similar between groups. Patients in both groups were just as likely to receive inhaled corticosteroid (ICS) and long-acting beta-agonists (LABAs), but patients with incompatible spirometry were less likely to receive long-acting muscarinic antagonists (LAMAs) (P<0.001) or LABA/ICS (P = 0.002) combinations.ConclusionPatients on the COPD QOF register with spirometry incompatible with COPD are symptomatic and managed using significant resources. If quality of care and effective resource use are to be improved, focus must be given to correct diagnosis in this group.

scholarly journals Self-harm presentation across healthcare settings by sex in young people: an e-cohort study using routinely collected linked healthcare data in Wales, UK

2019 ◽  
Vol 105 (4) ◽  
pp. 347-354 ◽  
Author(s):  
Amanda Marchant ◽  
Samantha Turner ◽  
Lloyd Balbuena ◽  
Evyn Peters ◽  
Dave Williams ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Hospital Admissions ◽  
Population Based ◽  
Age Group ◽  
Individual Level ◽  
Healthcare Data ◽  
Self Harm ◽  
The Uk ◽  
Over Time

BackgroundThis study used individual-level linked data across general practice, emergency departments (EDs), outpatients and hospital admissions to examine contacts across settings and time by sex for self-harm in individuals aged 10–24 years old in Wales, UK.MethodsA whole population-based e-cohort study of routinely collected healthcare data was conducted. Rates of self-harm across settings over time by sex were examined. Individuals were categorised based on the service(s) to which they presented.ResultsA total of 937 697 individuals aged 10–24 years contributed 5 369 794 person years of data from 1 January 2003 to 30 September 2015. Self-harm incidence was highest in primary care but remained stable over time (incident rate ratio (IRR)=1.0; 95% CI 0.9 to 1.1). Incidence of ED attendance increased over time (IRR=1.3; 95% CI 1.2 to 1.5) as did hospital admissions (IRR=1.4; 95% CI 1.1 to 1.6). Incidence in the 15–19 years age group was the highest across all settings. The largest increases were seen in the youngest age group. There were increases in ED attendances for both sexes; however, females are more likely than males to be admitted following this. This was most evident in individuals 10–15 years old, where 76% of females were admitted compared with just 49% of males. The majority of associated outpatient appointments were under a mental health specialty.ConclusionsThis is the first study to compare self-harm in people aged 10–24 years across primary care, EDs and hospital settings in the UK. The high rates of self-harm in primary care and for young men in EDs highlight these as important settings for intervention.

Menstruation Among Adolescent Girls Living in Rural Border Areas

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Ritu Gupta ◽  
Ravinder K Gupta ◽  
Vallabh Dogra ◽  
Himani Badyal
Keyword(s):  
Abdominal Pain ◽  
Menstrual Cycle ◽  
Blood Loss ◽  
Prospective Study ◽  
Adolescent Girls ◽  
Common Side Effect ◽  
Age Group ◽  
Different Types ◽  
Study Population ◽  
Border Areas

Objective: To study the various beliefs and problems regarding menstruation among adolescent girls living in rural border areas. Design- Prospective study. Setting- Pediatric outpatient clinic. Materials and methods- About 200 adolescent girls (11-19 years) living in rural border areas were enrolled for the study. These girls were asked about menarche, duration of the cycle, amount of blood loss and the various menstrual problems. They were also asked about the various beliefs and myths regarding menstruation. The girls having any illness affecting the menstrual cycle or those suffering from neuropsychiatric disorders were excluded from this study. Results- About 51% of the study population was in the age group 17-18 years. About 43.5% of girls attained menarche at the age of 10-12 years. About 51% of girls did not know about menstruation before menarche. Abdominal pain was the most common side effect seen in 41% of girls during menstruation. About 61% of girls considered themselves unclean during menstruation.  Twenty percent avoided schools, 20% avoided kitchen, 12% avoided temples while 10% stayed away from friends/ relatives. Only 33% of girls knew that menstruation stops temporarily after becoming pregnant. Twenty-two percent girls were using sanitary napkins while the rest used different types of clothes during the menstrual cycle. Conclusion- There is a dire need to educate girls regarding menstruation before menarche in the rural border areas. Every mother should discuss in a friendly way regarding various aspects of menstruation.

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