Health bulletin
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A position paper to enhance understanding of:- the range of role developments within nursing in Scotland; the educational and managerial preparation planned and undertaken for the introduction of new nursing roles; the implications of new roles with regard to working practices, career development and organisational issues; the perceived benefits and drawbacks of new roles; the nature of role evaluations; plans for future development. ⋯ New roles for nurses were considered to be beneficial for patients, nurses and the organisation. Protocol usage and educational input into the new roles was variable. Formal evaluation was not well established at the time of the survey.
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Injuries are an important cause of morbidity and mortality in childhood. Injuries at school account for up to 30% of accident and emergency department attendances in school age children in England and Wales. Routine school reports are a possible source of information on these injuries, but work in other countries indicates that schools under-report injuries to children, making it difficult to estimate incidence. ⋯ At this rate, the cost of hospital treatment for school accidents for Argyll and Clyde Health Board is estimated at Pounds 134,760 per year. Applied to the Scottish population, costs would be over Pounds 1.8 million per year. These figures supply the first UK estimates of health care costs of school accidents, and hence assist services in deciding the priority to accord school accident prevention.
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To quantify the association between dental decay in Scottish Schoolchildren & social deprivation as measured by the Carstairs Index from the 1991 census. ⋯ Tooth decay was confirmed as a disease associated with social deprivation in Scotland. The increasing polarisation of decay to socio-economically deprived groups of the population, suggests a 'whole population' approach such as water fluoridation would prevent tooth decay in these deprived groups most effectively. Nevertheless all evidence-based interventions should be used to try to narrow the "Dental Health Divide' by improving the dental health of deprived individuals.
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A study was undertaken in 1988 to examine various aspects of administering diamorphine subcutaneously by syringe driver at the time when its use had recently been introduced into the community. The results of this study and of a comparative study undertaken in 1994 are reported. It was found that in both studies the syringe driver was used mainly for patients who were unable to take oral medication or who were vomiting. ⋯ The syringe driver was used for longer than 14 days in most patients (56%) in the first study and the dose of diamorphine was increased in 54% of patients. In the second study, the driver was used mainly in the last week of life (69%) and the dose was more stable, remaining unchanged in 69% of patients. The incidence of site complications (5%) was the same in both groups, but other problems occurred with the use of the driver in the first group.
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One of the strategies identified by the NHS to achieve improvements in the health status of the Scottish population is to implement health promotion programmes through the general medical practitioner service. Grampian Local Health Council undertook a survey of Grampian residents to identify factors which might encourage greater public participation in such programmes. The results which are analysed and discussed in this paper show that factors identified by the public include: a preference for doctors to carry out health checks; the need for public education on the roles of different health professionals; the need for information on health checks and their benefits to be supplied in advance; a choice of appointment times and the offer of a follow-up appointment to discuss test results. These results are of interest to health professionals as they are likely to contribute to higher levels of patient involvement in health promotion programmes.