Epidemiology of community-acquired meticillin-resistant Staphylococcus aureus obtained from the UK West Midlands region

Between January 2005 and December 2005, 199 meticillin-resistant Staphylococcus aureus (MRSA) isolates were obtained from nonhospitalised patients presenting skin and soft tissue infections to local general practitioners. The study area incorporated 57 surgeries from three Primary Care Trusts in the Lichfield, Tamworth, Burntwood, North and East Birmingham regions of Central England, UK. Following antibiotic susceptibility testing, pulsed-field gel electrophoresis, Panton-Valentine leukocidin gene detection and SCCmec element assignment, 95% of the isolates were shown to be related to hospital epidemic strains EMRSA-15 and EMRSA-16. In total 87% of the isolate population harboured SCCmec IV, 9% had SCCmec II and 4% were identified as carrying novel SCCmec IIIa-mecI. When mapped to patient home postcode, a diverse distribution of isolates harbouring SCCmec II and SCCmec IV was observed; however, the majority of isolates harbouring SCCmec IIIa-mecI were from patients residing in the north-west of the study region, highlighting a possible localised clonal group. Transmission of MRSA from the hospital setting into the surrounding community population, as demonstrated by this study, warrants the need for targeted patient screening and decolonisation in both the clinical and community environments.

Between a rock and a hard place:exploring women's experience of participation and progress in managerial careers

Purpose – The growth of women in management has been argued to offer a route to reduce organizational and social inequality. The purpose of this paper is to explore the careers and experiences of female managers from a variety of organizations operating in the West Midlands region of the UK. Design/methodology/approach – This study is based on 56 interviews conducted with women managers within various sectors. The interviewees also completed pictorial careers maps, which along with interview recordings were analyzed. Findings – The key themes to emerge from this research centre upon the factors that draw women into management (which we term seductive elements) as well as some of the hindering practices that prevent women from progressing. Significantly, we find that managerial careers are associated with gendered assumptions and practices (e.g. facilitating and developing people) which contribute to construct management (done by women) as bounded-up characteristically with “feminized” behaviours. Research limitations/implications – The research is based upon a relatively small sample that is multi-sectorial. Wider studies that increase population size, together with deeper studies that hold sectorial variables constant would further add weight to the findings presented here. Practical implications – The paper draws attention to the “lived reality” of doing management, which, we argue often, for women in particular involves the reconciliation of contradictions and conflicting pressures. We draw attention to the lack of “alternative models” of organization and highlight the potential for gender-focus mentoring and management education. Originality/value – The paper is of value in giving voice to a selection of women managers by allowing them to reflect upon and explore their experience of management. The paper also documents the day-to-day reality of women's managerial careers that require the re-enactment and reproduction of stereotypical gender norms.

Thermochemical characterisation of agricultural wastes from West Africa

Thermochemical characterisation of agricultural biomass wastes from West African region has been carried out and their potential use as feedstock in thermochemical conversion processes determined. Proximate, ultimate, structural compositions, calorific values, thermogravimetry (TGA) and derivative thermogravimetry (DTG) analyses were carried out on corn straw and cobs, rice straw and husks, cocoa pod, jatropha curcas and moringa olifiera seed cakes, parinari polyandra fruit shell and sugarcane bagasse. Moringa olifiera seed cakes and cocoa pods were found to contain the highest moisture contents. Rice straw was found to contain a high ash content of 45.76. wt.%. The level of nitrogen and sulphur in all the samples were very low. Rice husk was found to have the highest lignin contents while corn cob low lignin contents indicate a potential feedstock source for quality bio-oil production using thermochemical process. © 2013.

High sensitivity sensors utilising characteristics of dispersion-turning-point of long-period gratings in B/Ge co-doped fibre

Systematically investigated the waveguide dispersion characteristics of LPFGs. It has been revealed that the coupled cladding modes resonating in the dispersion-turning-point region are intrinsically sensitive to the external perturbation. Thus, LPFG-based application devices requiring good stability should avoid this region. On the other hand, this mode ultra-sensitive-zone can be explored to realise sensors and tuneable filters of high efficiency.

Prevalence of the use of cancer related self-tests by members of the public:A community survey

Background: Self-tests are those where an individual can obtain a result without recourse to a health professional, by getting a result immediately or by sending a sample to a laboratory that returns the result directly. Self-tests can be diagnostic, for disease monitoring, or both. There are currently tests for more than 20 different conditions available to the UK public, and self-testing is marketed as a way of alerting people to serious health problems so they can seek medical help. Almost nothing is known about the extent to which people self-test for cancer or why they do this. Self-tests for cancer could alter perceptions of risk and health behaviour, cause psychological morbidity and have a significant impact on the demand for healthcare. This study aims to gain an understanding of the frequency of self-testing for cancer and characteristics of users. Methods: Cross-sectional survey. Adults registered in participating general practices in the West Midlands Region, will be asked to complete a questionnaire that will collect socio-demographic information and basic data regarding previous and potential future use of self-test kits. The only exclusions will be people who the GP feels it would be inappropriate to send a questionnaire, for example because they are unable to give informed consent. Freepost envelopes will be included and non-responders will receive one reminder. Standardised prevalence rates will be estimated. Discussion: Cancer related self-tests, currently available from pharmacies or over the Internet, include faecal occult blood tests (related to bowel cancer), prostate specific antigen tests (related to prostate cancer), breast cancer kits (self examination guide) and haematuria tests (related to urinary tract cancers). The effect of an increase in self-testing for cancer is unknown but may be considerable: it may affect the delivery of population based screening programmes; empower patients or cause unnecessary anxiety; reduce costs on existing healthcare services or increase demand to investigate patients with positive test results. It is important that more is known about the characteristics of those who are using self-tests if we are to determine the potential impact on health services and the public. © 2006 Wilson et al; licensee BioMed Central Ltd.

Technological and organisational change in small- to medium-sized manufacturing companies:a learning organisation perspective

This paper examines the extent to which a learning organisation perspective is attainable in small- to medium-sized manufacturing companies. An audit tool is developed from the literature on organisational learning and recognised processes that lead towards becoming a learning organisation. The paper focuses on the application of the audit tool in three UK automotive component suppliers which are all experiencing pressures for change imposed by the major vehicle manufacturers. The main changes are concerned with tiering of the supply chain and substantial delegation of responsibilities to component suppliers including an increasing emphasis on innovation and continuous improvement. The companies presented in the paper are taken from a research project into the impact of changes in supply chain relationships on the operation of small- and medium-sized manufacturing firms in the West Midlands region of the UK. The ways in which the companies are responding to change are presented together with the results of a self-assessment using the developed audit tool. These results suggest that companies of this type tend to focus on change in those areas that involve least challenge to the established power and authority of management.

Correlates of spontaneous reporting of adverse drug reactions within primary care: the paradox of low prescribers who are high reporters

AIM(S) To examine Primary Care Trust (PCT) demographics influencing general practitioner (GP) involvement in pharmacovigilance. METHODS PCT adverse drug reaction (ADR) reports to the Yellow Card scheme between April 2004 and March 2006 were obtained for the UK West Midlands region. Reports were analysed by all drugs, and most commonly reported drugs (‘top drugs’). PCT data, adjusted for population size, were aggregated. Prescribing statistics and other characteristics were obtained for each PCT, and associations between these characteristics and ADR reporting rates were examined. RESULTS During 2004–06, 1175 reports were received from PCTs. Two hundred and eighty (24%) of these reports were for 14 ‘top drugs’. The mean rate of reporting for PCTs was 213 reports per million population. A total of 153 million items were prescribed during 2004–06, of which 33% were ‘top drugs’. Reports for all drugs and ‘top drugs’ were inversely correlated with the number of prescriptions issued per thousand population (rs = -0.413, 95% CI -0.673, -0.062, P < 0.05, and r = -0.420, 95% CI -0.678, -0.071, P < 0.05, respectively). Reporting was significantly negatively correlated with the percentages of male GPs within a PCT, GPs over 55 years of age, single-handed GPs within a PCT, the average list size of a GP within a PCT, the overall deprivation scores and average QOF total points. ADR reports did not correlate significantly with the proportion of the population over 65 years old. CONCLUSIONS Some PCT characteristics appear to be associated with low levels of ADR reporting. The association of low prescribing areas with high ADR reporting rates replicates previous findings.

An examination of adverse drug reaction reporting to the yellow card scheme

Chief pharmacists in 209 hospitals were surveyed about ADR reporting schemes, the priority given to ADR reporting, and attitudes towards ADR reporting. ADR reporting had a low managerial priority. Local reporting schemes were found to be operating in 37% trusts, but there were few plans to start new schemes. Few problems were discovered by the introduction of pharmacist ADR reporting. Chief pharmacists had concerns about the competence of hospital pharmacists to detect ADRs and were in favour of increased training. Lack of time on wards, and recruitment difficulties were suggested as reasons for hospital pharmacist under-reporting. Teaching hospitals appeared to have an increased interest in ADR reporting. A retrospective analysis of reporting trends within the West Midlands region from 1994, showed increasing or stable reporting rates for most sectors of reporters, except for general practitioners (GPs). The West Midlands region maintained higher ADR reporting rates than the rest of the UK. National reporting figures showed a worrying decline in ADR reports from healthcare professionals. Variation was found in the ADR reporting rates of Acute NHS Hospital Trusts and Primary Care Trusts (PCTs) in the West Midlands region, including correlations with prescribing rates and other PCT characteristics. Qualitative research into attitudes of GPs towards the Yellow Card scheme was undertaken. A series of qualitative interviews with GPs discovered barriers and positive motivators for their involvement in the Yellow Card scheme. A grounded theory of GP involvement in the Yellow Card scheme was developed to explain GP behaviour, and which could be used to inform potential solutions to halt declining rates of reporting. Under-reporting of ADRs continues to be a major concern to those who administer spontaneous reporting schemes.

Migration and mobility of new Polish migrants in England:narratives of lived experience

This thesis sets out to understand the act of migrating in a period of growing movement of people. It captures the subjective experience of individual migrants, as narrated in the migration stories of 32 “new” Polish migrants in the West Midlands region of England. Since the enlargement of the European Union in 2004, over half a million Poles have arrived and registered to work in the UK, constituting one of the largest migration movements in contemporary Britain and Europe. This influx of predominantly young migrants opened up public and academic debates regarding the social relations between the Polish migrants and the host society, their duration of stay, and the impact on the economy and social services. While a substantial amount of research has now been undertaken on this migration, this thesis highlights some of the significant features of migration to Britain and Europe today, namely its dynamic, fluid, complex and varied character. Through four themes of lived experience of migration, migration and mobility, gender, and return migration, this thesis uncovers and explores the phenomenon of post-2004 EU migration from the perspective of migrants themselves. Migrant stories in this thesis are linked with experiences and meanings of migration, but also migrants’ emotions, perceptions, views and opinions. By exploring individual journeys of migration and deliberating over the determinants and consequences of migration, this thesis asks how the processes of migration and mobility come into play in the everyday lives of migrant people, and how this impacts on questions of identity, home, belonging, gender, as well as return.

Conflicting pressures and seductive contradictions:women’s participation and progress in management

Organisations operating in the West Midlands region of the UK. Based on over fifty interviews, the key themes to emerge from this research centre upon some of the factors that draw women into management (which we term seductive elements) as well as some of the hindering practices that prevent women from progressing. Significantly, managerial careers are associated with gendered assumptions and practices (e.g. facilitating and developing people) which might contribute to construct management (as done by women) as focused on feminine aspects. However, in terms of the lived reality of doing management, such women experience contradictions and conflicting pressures.

'Er's from off:the indexicalization and enregisterment of Black Country dialect

This article considers how conscious use of dialect in writing is an intentional act and can be accounted for through the notion of enregisterment. It does this by exploring the value of dialect in social and ideological contexts in relation to a regional dialect of British speech, that of the Black Country in the West Midlands region of England. The article provides a summary of recent directions in sociolinguistic research and an overview of the Black Country speech community, including a summary of its distinctive linguistic variables. This description is then used as an external evaluation of the authenticity of written representations of Black Country speech and the items enregistered in writing. Analysis of three written texts taken from three different genres across a time span of 30 years reveals the extent to which identified linguistic features are drawn upon in each one of the three texts and the extent to which any one is enregisterd across all three. The article discusses the social and linguistic contexts within which the writing occurs by way of accounting for their enregisterment as markers of identity linked to region and place. It also considers the ways in which the texts juxtapose norms and values of those "within" the community with those from "outside" the community in ways that subvert traditional notions of linguistic hierarchy.

Dynamics and topographic organization of recursive self-organizing maps

Recently there has been an outburst of interest in extending topographic maps of vectorial data to more general data structures, such as sequences or trees. However, there is no general consensus as to how best to process sequences using topographicmaps, and this topic remains an active focus of neurocomputational research. The representational capabilities and internal representations of the models are not well understood. Here, we rigorously analyze a generalization of the self-organizingmap (SOM) for processing sequential data, recursive SOM (RecSOM) (Voegtlin, 2002), as a nonautonomous dynamical system consisting of a set of fixed input maps. We argue that contractive fixed-input maps are likely to produce Markovian organizations of receptive fields on the RecSOM map. We derive bounds on parameter β (weighting the importance of importing past information when processing sequences) under which contractiveness of the fixed-input maps is guaranteed. Some generalizations of SOM contain a dynamic module responsible for processing temporal contexts as an integral part of the model. We show that Markovian topographic maps of sequential data can be produced using a simple fixed (nonadaptable) dynamic module externally feeding a standard topographic model designed to process static vectorial data of fixed dimensionality (e.g., SOM). However, by allowing trainable feedback connections, one can obtain Markovian maps with superior memory depth and topography preservation. We elaborate on the importance of non-Markovian organizations in topographic maps of sequential data. © 2006 Massachusetts Institute of Technology.

Changing policies for the automotive industry in an 'old' industrial region:an open innovation model for the UK West Midlands?

Automobile manufacture in the UK West Midlands peaked during the 1950s and early 1960s but, with overseas competition, declined thereafter. Successive policies, such as government supported mergers to form the British Motor Corporation in the 1950s, green-field development away from the region in the 1960s, nationalisation of the (then) British Leyland in the 1970s, Japanese FDI in the 1980s and the Rover-centric Accelerate Project in the 1990s have failed to halt the decline. Since early 2000, regional policy has been the responsibility of the Regional Development Agency, Advantage West Midlands. The RDA has moved away from traditional support based on the needs of big companies or ‘champions’ and adopted an approach centred on a mix of small and large businesses and high level research, and – arguably – an ‘open innovation’ model. Here, we examine these new policies and their potential to create an innovative and competitive regional environment.