An evaluation of quinolone prescribing in a group of acute hospitals:Development of an objective measure of usage

Objectives: To develop an objective measure to enable hospital Trusts to compare their use of antibiotics. Design: Self-completion, postal questionnaire with telephone follow up. Sample: 4 hospital trusts in the English Midlands. Results: The survey showed that it was possible to collect data concerning the number of Defined Daily Doses (DDD's) of quinolone antibiotic dispensed per Finished Consultant Episode (FCE) in each Trust.. In the 4 trusts studied the mean DDD/FCE was 0.197 (range 0.117 to 0.258). This indicates that based on a typical course length of 5 days, 3.9% of patient episodes resulted in the prescription of a quinolone antibiotic. Antibiotic prescribing control measures in each Trust were found to be comparable. Conclusion: The measure will enable Trusts to objectively compare their usage of quinolone antibiotics and use this information to carry out clinical audit should differences be recorded. This is likely to be applicable to other groups of antibiotics.

Control of antibiotic prescribing in UK NHS hosptials. Available in 2 volumes.

This thesis is an evaluation of practices to control antibiotic prescribing in UK NHS hospitals. Within the past ten years there has been increasing international concern about escalating antibiotic resistance, and the UK has issued several policy documents for pmdent antibiotic prescribing. Chief Pharmacists in 253 UK NHS hospitals were surveyed about the availability and nature of documents to control antibiotic prescribing (formularies, policies and guidelines), and the role of pharmacists and medical microbiologists in monitoring prescribers' compliance with the recommendations of such documents. Although 235 hospitals had at least one document, only 60% had both an antibiotic formulary and guidelines, and only about one-half planned an annual revision of document(s). Pharmacists were reported as mostly checking antibiotic prescribing on every ward whilst medical microbiologists mostly visited selected units only. Response to a similar questionnaire was obtained from the Chief Medical Microbiologists in 131 UK NHS hospitals. Comparisons of the questionnaires indicated areas of apparent disagreement about the roles of pharmacists and medical microbiologists. Eighty three paired-responses received from pharmacists and medical microbiologists in the same hospital revealed poor agreement and awareness about controls. A total of 205 institutional prescribing guidelines were analysed for recommendations for the empirical antibiotic prescribing of Community-Acquired Pneumonia (CAP). Variation was observed in recommendations and agreement with national guidance from the British Thoracic Society (BTS). A questionnaire was subsequently sent to 235 Chief Pharmacists to investigate their awareness of this new guidance from the BTS, and subsequent revision of institutional guidelines. Documents had been revised in only about one-half of hospitals where pharmacists were aware of the new guidance. An audit of empirical antibiotic prescribing practices for CAP was performed at one hospital. Although problems were experienced with retrieval of medical records, diagnostic criteria were poorly recorded, and only 57% of prescribing for non-severe CAP was compliant with institutional guidelines. A survey of clinicians at the same hospital identified that almost one-half used the institutional guidelines and most found them useful. However, areas for improvement concernmg awareness of the guidelines and ease of access were identified. It is important that hospitals are equipped to react to changes in the hospital environment including frequent movement of junior doctors between institutions, the employment of specialist "infectious diseases pharmacists" and the increasing benefits offered by information technology. Recommendations for policy have been suggested.

Spatio-temporal analyses of West Nile virus transmission in Culex mosquitoes in northern Illinois, USA, 2004

After a severe outbreak of West Nile virus (WNV) in Cook County, Illinois, in 2002, detections of WNV in mosquitoes were frequent across the state in the following years despite small numbers of human cases. We conducted a spatio-temporal analysis of Culex (subgenus Culex) mosquitoes collected in 2004 in three mosquito abatement districts (MAD) in Cook County by calculating monthly estimates of mosquito density, prevalence of infected mosquitoes, and exposure intensity, which in turn is a product of mosquito density and infection rates. Mosquito infections were detected early at three sites in late May and were widely detected throughout the three MADs in the summer with infection rates as high as 13 per 1000 in August. Exposure intensities were higher at sites adjacent to the Des Plaines River, especially in August and September. The aggregated pattern of WNV transmission along the river might be related to the existence of substantial forest preserves and wetlands that might produce ecological conditions favorable for mosquito proliferation and interactions between mosquitoes and birds.

Religion, politics and law in the European Union: an introduction

EU enlargement - to countries in Central and Eastern Europe in 2004, the inclusion of Bulgaria and Romania in 2007, and increasing debates on Turkey’s membership - has dramatically transformed the European Union into a multi-religious space. Religious communities are not only shaping identities but are also influential factors in political discourse. This edited volume examines the activities of religious actors in the context of supranational European institutions and the ways in which they have responded to the idea of Europe at local and international levels. By bringing together scholars working in political science, history, law and sociology, this volume analyses key religious factors in contemporary EU architecture, such as the transformation of religious identities, the role of political and religious leaders, EU legislation on religion, and, the activities of religious lobbies. This book was published as a special issue of Religion, State and Society.

Die Sprache der Auricher Juden. Zur Rekonstruktion westjiddischer Sprachreste in Ostfriesland:to reconstruct westjiddischer language residues in Ostfriesland

Western Yiddish, the spoken language of the traditional Jewish society in the German- and Dutch-speaking countries, was abandoned by its speakers at the end of the 18th in favour of the emerging standard varieties: Dutch and German, respectively. Remnants of Western Yiddish varieties, however, remained a medium of discourse in remote provinces and could be found well into the 19th and sometimes the 20th century in some South-western areas of Germany and Switzerland, the Alsace, some areas of the Netherlands and in parts of the German province of Westphalia. It appears that rural Jewish communities sometimes preserved in-group vernaculars, which were based on Western Yiddish. Sources discovered in 2004 in the town of Aurich prove that Jews living in East Frisia, a Low-German speaking peninsula in the North-west of Germany, used a variety based on Western Yiddish until the Second World War. It appears that until the Holocaust a number of small, close-knit Jewish communities East Frisia, which depended economically mainly on cattle-trading and butchery, kept certain specific cultural features, among them the vernacular which they spoke alongside Low German and Standard German. The sources consist of two amateur theatre plays, a memoir and two word lists written in 1902, 1928 and the 1980s, respectively. In the monograph these sources are documented and annotated as well as analyzed linguistically against the background of rural Jewish life in Northern Germany. The study focuses on traces of language contact with Low German, processes of language change and on the question of the function of the variety in day-to-day life in a rural Jewish community.

In search of a sustainable success strategy in the Chinese chemical industry

The Chinese chemical industry is facing fierce competition and changing market dynamics due to the change in the country's economic policy. Its government has applied administr.ttive actions rather than simply relying on the market to address the changing dynamics. It has attempted to privatise government-owned enterprises by corporatisation coupled with industrial restructuring. This paper uses a case study of Peony Printing Ink Co Ltd, a state-owned chemical enterprise, to illustrate the effectiveness of developing internal competences to improve long-term operational performance rather than the adoption of a privatisation approach.

What are the practical implications for treating diabetes in light of recent evidence? Updated recommendations from the Global Partnership for Effective Diabetes Management

The Global Partnership for Effective Diabetes Management was established in 2004 to provide practical guidance to improving glycaemic control for people with type 2 diabetes. Those recommendations have been updated to take account of recent trials assessing the effects of intensive glucose control. We continue to emphasis the importance of early and sustained glycaemic control, aiming for HbA( 1c) 6.5-7% wherever safe and appropriate. Individualisation of targets and the management process is strongly encouraged to accommodate patient circumstances and to avoid hypoglycaemia. Prompt introduction of combinations of agents is suggested when monotherapy is inadequate.Treatments will preferably address the underlying pathophysiology of type 2 diabetes and integrate within a wider programme of care which also aims to reduce modifiable cardiovascular risk factors and better equip patients in the self-management of their condition.

Transforming the eastern neighbourhood: the security implications of European Union Activity in Ukraine 2000-2006

This thesis examines the external activities of the European Union conducted in the wider Europe against the backdrop of eastern enlargement. It focuses on the technical aspects of EU diplomacy, using qualitative research methodology to study the programmes and initiatives launched since the year 2000 in the countries lying along the Union’s new border to the east. Drawing on evidence from Ukraine, it hypothesises that the EU is an agent of transformation in the eastern neighbourhood and that this transformation has important implications for the regional order in the post-Soviet space. The thesis constitutes an investigation into the transformational activities engaged by the EU in Ukraine conducted with an eye to their strategic implications. It documents and analyses three instances of EU intervention in Ukraine’s internal processes that relate to management of cross-border traffic in the Ukrainian-Russian borderland, restructuring of the country’s energy sector, and conduct of its contentious presidential election in 2004. It is argued that while these interventions have explicitly sought to advance the Union’s security with respect to certain twenty-first century transnational threats, they have at the same time served to confer important strategic advantages on the EU that include giving the bloc greater knowledge and control over developments in Ukraine and that contribute to the dismantling of infrastructural, institutional and other ties between Kiev and the other Soviet successor states, notably Russia. The effect of the European Union’s actions in the region, whether intended or not, has thus been to undermine any competing regional initiatives that cut across its own functions, and thereby to assert itself as the primary integration project in Europe. By showing how technical interventions in the politics, economics and administration of Ukraine can yield important geopolitical dividends, this thesis demonstrates that, in the context of EU external relations, high and low politics are interlinked.

Religion, politics and law in the European Union

EU enlargement - to countries in Central and Eastern Europe in 2004, the inclusion of Bulgaria and Romania in 2007, and increasing debates on Turkey’s membership - has dramatically transformed the European Union into a multi-religious space. Religious communities are not only shaping identities but are also influential factors in political discourse. This edited volume examines the activities of religious actors in the context of supranational European institutions and the ways in which they have responded to the idea of Europe at local and international levels. By bringing together scholars working in political science, history, law and sociology, this volume analyses key religious factors in contemporary EU architecture, such as the transformation of religious identities, the role of political and religious leaders, EU legislation on religion, and, the activities of religious lobbies.

An assessment of factors affecting performance and growth of new technology based firms in the UK

New Technology Based Firms (NTBF) are considered to be important for the economic development of a country in regards to both employment growth and innovative activity. The latter is believed to contribute significantly to the increase in productivity and therefore the competitiveness of UK’s economy. This study contributes to the above literature by investigating two of the factors believed to limit the growth of such firms in the UK. The first concerns the existence of a ‘knowledge gap’ while the second the existence of a ‘financial gap’. These themes are developed along three main research lines. Firstly, based upon the human capital theory initially proposed by Backer (1964) new evidence is provided on the human capital characteristics (experience and education) of the current UK NTBF entrepreneurs. Secondly, the causal relationship between general and specific human capital (as well as their interactions) upon the company performance and growth is investigated via its traditional direct effect as well as via its indirect effect upon the access to external finance. Finally, more light is shed on the financial structure and the type of financial constraints that high-tech firms face at start-up. In particular, whether a financial gap exists is explored by distinguishing between the demand and the supply of external finance as well as by type of external source of financing. The empirical testing of the various research hypotheses has been obtained by carrying out an original survey of new technology based firms defined as independent companies, established in the past 25 years in R&D intensive sectors. The resulting dataset contains information for 412 companies on a number of general company characteristics and the characteristics of their entrepreneurs in 2004. Policy and practical implications for future and current entrepreneurs and also providers of external finance are provided.

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.

Medicines management strategies to improve antibiotic prescribing

A systematic review was conducted to explicitly identify interventions that alone, or in combination, were effective in improving antibiotic prescribing. The citation search strategy used in the present review provided a database of 365077 studies, of which only twenty-five were included in the final review (“review studies”). Analysis of the interventions used within the review studies indicated that a combination of “guidelines” and “pharmacy” interventions have the greatest potential to improve antibiotic prescribing. Two types of qualitative research were conducted, semi-structured interviews and the collection of naturally occurring data. Semi-structured interviews were conducted in order to determine NHS managers? perceptions of current policies used to improve antibiotic prescribing within selected Primary Care Trusts and highlighted the importance of pharmacy intervention, formularies or guidelines and improved prescribing analysis (IT based intervention) on improving antibiotic prescribing. This was supported by the collection of naturally occurring data, which was used to provide further insight into interventions used to improve antibiotic prescribing. The Specialist Antibiotic Pharmacist (HD) produced and implemented an innovative electronic antibiotic prescribing analysis tool (the Antibiotic Database) to analyse and improve antibiotic prescribing in a consistent manner. The key advantage of the Antibiotic Database was the time and money saved on producing visual electronic outputs containing an inaccurate outcome measure or time period for analysis. The results concluded that an IT based intervention, such as the Antibiotic Database should be used, in addition to the use of antibiotic guidelines and pharmacy intervention, within all sectors of the NHS in order to improve antibiotic prescribing and its analysis.

The influence of newer member states in the European Union:the case of Poland and the Eastern partnership

This article seeks to examine and assess the role of Poland in the early stages of the making of the Eastern Partnership of the European Union. First, it briefly reviews Poland's aims and ambitions with regard to the European Union's policy towards its eastern neighbours, both before and since it joined the European Union in 2004. Second, it describes and analyses the Eastern Partnership, including its added value for the European Neighbourhood Policy. Third, it draws on a range of interviews carried out by the authors in Brussels and Warsaw on Poland's role in the initial formation of the Eastern Partnership, as seen by its partners in the other member states and European institutions. In addition, it seeks to unpack some of the early stage lessons learnt by the Polish government about how best to achieve its ambitions in the European Union, and notes the remaining weaknesses of the Polish administration, particularly in the area of administrative capacity. © 2013 University of Glasgow.