Patient removals from general practitioner lists in Northern Ireland:1987-1996

Being struck off a general practitioner's list is a major event for patients and a subject for much media attention. However, it has not hitherto received much research attention.

Change in the use of and attitude to peak flow measurement among general practitioners in Northern Ireland between 1989 and 1994

In 1994 we repeated a study first performed in 1989 to assess the change in general practitioners' use of and attitudes to peak flow measurement. Of 232 general practitioners surveyed, 199 (86%) and 192 (83%) responded in 1989 and 1994 respectively. The percentage who reported having patients using domiciliary peak flow monitoring rose form 58.3 (95% confidence limits 51.4 to 65.2)% to 97.9 (95.9 to 99.9)%. The percentage who reported 'usually' using peak flow measurements for the diagnosis and management of asthma rose from 81.9 (76.5 to 87.3)% to 93.2 (89.6 to 96.8)% and from 83.3 (78.1 to 88.5)% to 95.8 (92.9 to 98.7)% respectively. An unchanged proportion took peak flow meters on house calls. General practitioners have become more aware of the potential of peak flow measurements but are still unlikely to have a meter available to assess patients seen at home. They are therefore likely to be ill-equipped to manage acute exacerbations of asthma in this setting.

Renal replacement treatment for diabetic nephropathy in Northern Ireland 1979-1987

Twenty-three patients with end-stage renal failure due to diabetic nephropathy received renal replacement treatment. All patients had insulin-dependent diabetes mellitus. Nineteen transplants were performed in seventeen patients. Two-year graft survival for all transplants was 74% with a two-year patient survival post-transplantation of 81%. Overall two-year patient survival was 73%, compared with 82% in non-diabetic patients receiving renal replacement treatment. In diabetic patients accepted for treatment there was a high incidence of non-renal complications, particularly vascular disease. An aggressive approach to the treatment of vascular disease in these patients may improve overall survival rates.

Persistent and consistent poverty in the 1994 and 1995 waves of the European Community Household Panel Survey

This paper focuses on the mismatch between income and deprivation measures of poverty. Using the first two waves of the European Community Household Panel Survey, a measure of relative deprivation is constructed and the overlap between the relative income poor and relatively deprived is examined, There is very limited overlap with the lowest relative income threshold. The overlap increases as the income threshold is raised, but it remains true that less than half those below the 60 percent relative income line are among the most deprived. Relative deprivation is shown to be related to the persistence of income poverty, but also to a range of other resource and need factors. Income and deprivation measures each contain information that can profitably be employed to enhance our understanding of poverty and a range of other social phenomena. This is illustrated by the manner in which both income poverty and relative deprivation are associated with self-reported difficulty making ends meet.

Targeting poverty: Lessons from monitoring Ireland's national anti-poverty strategy

In 1997 the Irish government adopted the National Anti-Poverty Strategy (NAPS), a global target for the reduction of poverty which illuminates a range of issues relating to official poverty targets. The Irish target is framed in terms of a relative poverty measure incorporating both relative income and direct measures of deprivation based on data on the extent of poverty from 1994. Since 1994 Ireland has experienced an unprecedented period of economic growth that makes it particularly important to assess whether the target has been achieved, but in doing so we cannot avoid asking some underlying questions about how poverty should be measured and monitored over time. After briefly outlining the nature of the NAPS measure, this article examines trends in poverty in Ireland between 1987 and 1997, Results show that the relative income and deprivation components of the NAPS measure reveal differential trends with increasing relative income poverty, but decreasing deprivation. However, this differential could be due to the fact that the direct measures of deprivation upon which NAPS is based have not been updated to take account of changes in real living standards and increasing expectations. To test whether this is so, we examine the extent to which expectations about living standards and the structure of deprivation have changed over time using confirmatory factor analysis and tests of criterion validity using different definitions of deprivation. Results show that the combined income and deprivation measure, as originally constituted, continues to identify a set of households experiencing generalised deprivation resulting from a lack of resources.

Social mobility in Ireland in the 1990s: Evidence from the 1994 living in Ireland survey

In this paper we seek to update findings relating to class mobility outcomes and processes in the Republic of Ireland employing data from the Living in Ireland Survey which was carried out in 1994. We also provide an evaluation of a measured variable model of the mobility process developed on an earlier data set. Our findings confirm that transformation of the class structure has been associated with substantial levels of social mobility. At the same time inequalities of opportunity as reflected in the underlying patterns of social fluidity remain substantial and are constant across cohorts. Gender differences are almost entirely a consequence of occupational segregation and there is no evidence that the underlying processes of class disadvantage operate differently for men and women.

Trends in the use of psychotropic medications among adolescents, 1994 to 2001

Objectives: Few psychotropic medications are approved for use among children younger than 18 years. Yet previous studies have shown an increase in the use of psychotropic medications among school-age children and adolescents. Most previous studies examined data only up to 1997; therefore, the results predate any impact of changing federal policies and newly marketed medications. This study examined trends in the prescription of psychotropic medications to adolescents aged 14 to 18 years in office-based care in the United States from 1994 to 2001. Methods: Data from the National Ambulatory Medical Care Survey (NAMCS) were used to determine visit rates and prescribing patterns from 1994 to 2001 for psychotropics that were prescribed in office-based treatment settings to adolescents aged 14 to 18 years. Rates of visits that resulted in a prescription for psychotropic medication were calculated for two-year periods. Analyses were conducted by type of medication, gender, and the prescribing physician's specialty. Results: Rates of visits that resulted in a psychotropic prescription increased from 3.4 percent in 1994-1995 to 8.3 percent in 2000-2001. These trends were evident for males and females. The average annual growth rates for psychotropic prescriptions were much higher after 1999. Trends were also significant across drug classes. By 2001, one out of ten office visits by adolescent males resulted in a prescription for a psychotropic medication. Conclusions: Average annual growth rates for the prescription of psychotropics to adolescents increased from 1994 to 2001, with especially rapid acceleration after 1999. This increase may be associated with changing thresholds of diagnosis and treatment, availability of new medications, and changes in federal regulatory policies concerning promotion of medications by the pharmaceutical industry.

L'accord sujet-verbe en français contemporain: une étude de variation sociolinguistique

Cette communication a pour objectif de présenter et d’analyser les résultats d’une enquête portant sur l’accord sujet-verbe en français contemporain. Dans le domaine de l’accord sujet-verbe, bien que dans la plupart des cas le locuteur n’ait pas le choix de l’accord – c’est–à-dire qu’il n’y a qu’un accord possible – il existe néanmoins des contextes dans lesquels on peut trouver une variation entre l’accord singulier et le pluriel (cf. Corbett 2006 ; Grevisse 1993 ; Riegel et al 1994). Cette variation est souvent liée à une discordance entre le nombre syntaxique et le nombre sémantique. C’est le cas de certaines expressions de quantité, comme dans les exemples suivants : Singulier : « On a affaire à une minorité qui fait la loi à l’université » (Ouest France, 23-24 mai 2009, p.13) Pluriel : « Un petit millier de producteurs allemands, français et belges se sont déplacés, hier, à Bruxelles […] » (Ouest France, 26 mai 2009, p.3) Cette variation nous offre plusieurs pistes de recherche : dans une perspective linguistique, elle peut nous aider à mieux comprendre comment interagissent les différents facteurs linguistiques qui ont une influence sur l’accord, et dans une perspective sociolinguistique, elle représente un nouveau domaine à explorer pour l’étude sociolinguistique de la variation grammaticale en français, ce qui reste jusqu’à présent relativement peu étudiée. Nous traitons dans cette communication de la perspective sociolinguistique, c'est-à-dire les facteurs externes tels que l’âge, le sexe, et le niveau d’éducation du locuteur qui jouent un rôle dans l’accord sujet-verbe avec les expressions de quantité. Nous considérons en particulier la variation sexolectale : dans un premier temps, nous examinons les résultats de quelques études précédentes de la variation morphosyntaxique en français contemporain par rapport à l’influence du sexe du locuteur. Nous en concluons que les Principes élaborés par Labov (1990) pour décrire la variation sexolectale en anglais semblent être moins valables pour le cas du français de la France ; ou bien, qu’ils ne s’appliquent pas de façon simpliste. Dans un deuxième temps, nous présentons les résultats de nôtre étude, et nous voyons que pour nôtre projet aussi, les résultats pour la variation sexolectale ne s’expliquent pas facilement dans le cadre des Principes de Labov (1990).

A review of glaucoma treatment in Scotland 1994-2004

Objective: This study evaluated the changing trends in glaucoma management in Scotland between 1994 and 2004. Methods: A retrospective analysis of national health statistics in Scotland from 1994 to 2004. The Scottish morbidity record was used to collect information on all episodes of trabeculectomy. Data on number of prescriptions were gathered for individual drugs and also for groups of active ingredient. The population likely to have glaucoma (PLG) was calculated from estimates of prevalence in individuals aged 40 years and older, based on published epidemiological studies. The outcome measures were trabeculectomy rates, corrected for population likely to be at risk of glaucoma (PLG), and prescribing volume and cost for glaucoma medications. Results: Trabeculectomy rates have fallen by 67% from 46 per 1000 PLG in 1994 to 15.4 per 1000 PLG in 2004. Over the same time period, the population likely to be at risk of glaucoma (PLG) increased by 16.6%. The cost of prescribing has increased by 122% over 11 years compared with an increase in number of items per 1000 PLG by 27.5%. In 1994, ß-blockers accounted for 65.2% of prescribed drugs but by 2004 this had dropped to 33%. Since their introduction, the prescribing of prostaglandin analogues has increased rapidly and in 2004, they accounted for 39.4% of prescribed drugs. Conclusion: The increasing useof prostaglandin analogues has led to an increase in prescribing rates and a rapid increase in cost. At the same time, prescribing of ß-blockers has declined and trabeculectomy rates have fallen.

Provisional report. 1987 Season. Gubbio Project

Stoddart, S.K.F. and C. Malone,. Xerox circulation to sponsors. 1987.

1987-1991. Joint Archaeological Project of the National Museum of Malta and the Universities of Bristol, Cambridge and Malta.

Malone, C.A.T. and S.K.F. Stoddart, Five Year Statement.1991: Cambridge University.