Partnership work between Public Health and Health Psychology: introduction to a novel training programme.

Background: Public health services implement individual, community and population level interventions to change health behaviours, improve healthy life expectancy and reduce health inequalities. Understanding and changing health behaviour is complex. Integrating behaviour change theory and evidence into interventions has the potential to improve services.

Effect of gender, age and deprivation on key performance indicators in a FOBT-based colorectal screening programme.

Objectives: To assess the effect of gender, age and deprivation on key performance indicators in a colorectal cancer screening programme.

Setting: Between March 2000 and May 2006 a demonstration pilot of biennial guaiac faecal occult blood test (gFOBT) colorectal screening was carried out in North-East Scotland for all individuals aged 50-69 years.

Methods: The relevant populations were subdivided, by gender, into four age groups and into five deprivation categories according to the Scottish Index of Multiple Deprivation (SIMD), and key performance indicators analysed within these groups.

Green-coloured results on guaiac-based faecal occult blood testing should be considered positive.

Background: In guaiac-based faecal occult blood tests (FOBT), blue colours are considered positive. Blue-green colours should also be considered positive. Distinct green colours are said to be due to bile and it is stated that these should be interpreted as negative.

Clinical record keeping in patients receiving antibiotics in hospital.

Background: Antibiotic prescribing is associated with the growth of antibiotic resistance in micro-organisms. Prescribing therefore needs to be restricted by well-designed antibiotic protocols. Audit of such protocols is only possible if clinical information about infection is properly recorded.

Out-patient and home-parenteral antibiotic therapy (OHPAT): evaluation of the impact of one year's experience in Tayside.

Objective: An out-patient and home parenteral antibiotic therapy programme for the treatment of suitable infections was developed over a four year period. This paper describes the impact of one year's experience of its implementation on various measures of outcome.

Design: Each patient treatment has a full integrated care pathway (ICP) and patient satisfaction questionnaire completed.

The ascertainment and management of tuberculosis in Tayside, Scotland during 1993-94.

Objective: To evaluate whether utilising a database of dispensed prescriptions for anti-tuberculous chemotherapy could improve case ascertainment compared to standard methods. A further objective was to assess whether cases were managed according to standard guidelines.

Design: Retrospective case note audit.

Sequential antibiotic therapy.

Antimicrobials are an important source of hospital expenditure. Traditionally, severe bacterial infections have been treated initially with intravenous antibiotics, followed by physician-directed switch to oral therapy. Unfortunately this approach results in unnecessary prolongation of intravenous treatment, with all its inherent disadvantages.

The use of adult isolation facilities in a UK infectious diseases unit.

The emergence and re-emergence of communicable infections, especially those due to antibiotic resistant nosocomial pathogens, is likely to increase the burden on the limited isolation facilities of the UK. It was our perception, however, that isolation beds are not always used optimally; with patients requiring isolation sometimes being housed in open-bay beds, whilst other non-communicable patients are unnecessarily isolated. The main aim of this study was to test this hypothesis in a regional infectious diseases (ID) unit.

Lymphangioleiomyomatosis. A series of three case reports illustrating the link with high oestrogen states.

Lymphangioleiornyomatosis is a rare lung disorder characterised by cystic air spaces and smooth muscle proliferation. The condition, which most commonly presents with dyspnoea, pneumothoraces or cough, is only described in females and is most commonly diagnosed during childbearing years. Three cases are presented which illustrate typical features of the disease and the association with high oestrogen levels.

Cost and dosing issues.

Twice-daily dosing is recommended for ciprofloxacin for most indications. Trovafloxacin and grepafloxacin can be administered once-daily. Levofloxacin should probably be administered twice daily in serious, life-threatening infections.

An outbreak of skin sepsis in abattoir workers caused by an 'unusual' strain of Streptococcus pyogenes.

An outbreak of indolent skin infections due to an 'unusual' serological type of Streptococcus pyogenes that lasted for 3 months and affected eight workers in an abattoir is described. The group A streptococcal (GAS) isolates were serotyped as M-type 59; however, they possessed a T-protein pattern (T5/27/44) that is not commonly associated with M-type 59. Further genotypic characterisation studies revealed that all eight isolates were indistinguishable by pulsed-field gel electrophoresis (PFGE) and possessed the emm gene encoding for the M-type 59.

Acute meningococcaemia complicated by late onset gastrointestinal vasculitis.

Extra-meningeal and non-cutaneous manifestations of meningococcal infection are well recognized but rare. Herein we report a little recognized complication of meningococcaemia, namely late-onset gastrointestinal vasculitis. In the case presented, the prostacycline analogue iloprost was used in an attempt to minimize incipient digital gangrene ina patient with evidence of protracted immunological phenomena.

Community antibiotic therapy, hospitalization and subsequent respiratory tract isolation of Haemophilus influenzae resistant to amoxycillin: a nested case-control study.

The study objective was to determine whether recent community antibiotic prescribing and hospitalization are associated with beta-lactam resistance in respiratory isolates of Haemophilus influenzae. Data obtained for hospitalization and community prescribing (in the previous 3 months) from 412 adults (>15 years) in whom an episode of respiratory tract infection had been described, during which H. influenzae was isolated, were analysed.

Place of parenteral cephalosporins in the ambulatory setting: clinical evidence.

During the last decade, 6 parenteral third generation cephalosporins have been introduced into clinical practice. The three most frequently used agents are cefotaxime, ceftazidime and ceftriaxone. Although primarily used in hospitals, these agents are increasingly employed in the ambulatory setting.

Assessing smoking prevalence amongst school children in a health board region.

The objective of the study was to provide baseline data for Tayside in 1995 on the prevalence of smoking cigarettes in school children, aged 11 to 15 years. The design was a cross-sectional survey of 4675 children, obtained using a random cluster sample of 79 schools, stratified by school year and deprivation category. The main outcomes measures using a structured questionnaire, were the prevalence and level of smoking, by age and gender.

Feasibility of an outpatient and home parenteral antibiotic therapy (OHPAT) programme in Tayside, Scotland.

Outpatient and home parenteral antibiotic therapy (OHPAT) is under-utilized in the U.K. We performed a feasibility study over a 5-month period in a regional U.

Recurrent aseptic meningitis following non- steroidal anti-inflammatory drugs--a reminder.

Non-steroidal anti-inflammatory drugs (NSAIDs) are rarely associated with side-effects affecting the central nervous system. A case of NSAID-induced recurrent aseptic meningitis is presented. Seven episodes of aseptic meningitis were documented in the patient's life-time (up to the age of 30).

Strategies to rationalize sepsis management--a review of 4 years' experience in Dundee.

Hospitals worldwide are facing an unprecedented crisis of rising cost of antibacterials due to the increasing rapid emergence and dissemination of antibiotic-resistant organisms, improper use of antibiotics and the use of broad spectrum parenteral agents. The last 25 years has seen the introduction of many measures to improve the quality of sepsis management, and specifically antimicrobial use. The present paper reviews the development, implementation and evaluation of some of the key strategies employed within the Dundee Teaching Hospitals NHS Trust (DTHT) to enhance recognition and assessment of sepsis and to rationalize the early and often empiric antibiotic treatment of patients in hospital with infection.

Acute Herpes zoster in Tayside: demographic and treatment details in immunocompetent patients 1989-1992.

Medical records of 105 patients admitted to Tayside hospitals with acute Herpes zoster without underlying immunosuppression were examined retrospectively for the period 1984-1992. In this elderly population (median age: 79 years) there was a female preponderance (70.5%), most admissions were for trigeminal zoster (49.

Review by a local medical research ethics committee of the conduct of approved research projects, by examination of patients' case notes, consent forms, and research records and by interview.

Objective: To monitor the conduct of medical research projects that have already been approved by the local medical research ethics committee.

Design: Follow up study of ethically approved studies (randomly selected from all the studies approved in the previous year) by examination of patients' case notes, consent forms, and research records and by interview of the researchers at their workplace.

Setting: Tayside, Scotland (mixed rural and urban population).