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Ashton-under-Lyne, United Kingdom

Bidwai A.S.,Mersey Deanery
Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand | Year: 2013

Trapeziectomy and Weilby ligament reconstruction is a recognized treatment for osteoarthritis of the trapeziometacarpal joint. Studies published using this procedure have limited follow-up post-surgery. In this series of 24 cases assessed objectively and 36 subjectively with a minimum follow-up of five years, patients continue to have pain relief and function comparable to the opposite non-operated hand. Patient satisfaction is high at 92% and the rate of complications is low. Despite these encouraging results the need for interposition arthroplasty and/or ligament reconstruction in addition to trapeziectomy alone is discussed. Source

Horsburgh B.,Mersey Deanery | Singh G.,Southport and Ormskirk Hospital NHS Trust
BMJ Case Reports | Year: 2014

A 62-year-old woman presented 3 weeks following vaginal hysterectomy and anterior repair with exquisite urethral pain, incontinence and complete urethral prolapse. Following examination under anaesthesia and cystoscopy, anterior vaginal repair sutures were removed with spontaneous reduction of the prolapse. At a 5-week follow-up appointment, the patient was asymptomatic with resolution of the urethral prolapse. Copyright 2014 BMJ Publishing Group. All rights reserved. Source

Rutherford M.E.,University of Otago | Hill P.C.,University of Otago | Triasih R.,Gadjah Mada University | Sinfield R.,Mersey Deanery | And 2 more authors.
Tropical Medicine and International Health | Year: 2012

Young children living with a tuberculosis patient are at high risk of Mycobacterium tuberculosis infection and disease. WHO guidelines promote active screening and isoniazid (INH) preventive therapy (PT) for such children under 5years, yet this well-established intervention is seldom used in endemic countries. We review the literature regarding barriers to implementation of PT and find that they are multifactorial, including difficulties in screening, poor adherence, fear of increasing INH resistance and poor acceptability among primary caregivers and healthcare workers. These barriers are largely resolvable, and proposed solutions such as the adoption of symptom-based screening and shorter drug regimens are discussed. Integrated multicomponent and site-specific solutions need to be developed and evaluated within a public health framework to overcome the policy-practice gapand provide functional PT programmes for children in endemic settings. © 2012 Blackwell Publishing Ltd. Source

Moreton A.,Health Education North West | Jackson E.,Health Education North West | Ahmed-Little Y.,Mersey Deanery
Journal of Health, Organisation and Management | Year: 2014

Purpose: Designing and running robust junior doctor rotas is a challenging task and much previous advice has been based on consensus or anecdote. This paper aims to discern the most frequently occurring problems with trainee working patterns and produce evidence-based guidance for implementing and running contract-compliant rotas. Design/methodology/approach: A total of 35 secondary care trusts in North West England were invited to supply information on pay banding appeals requested under the New Deal junior doctor contract. Of these, 15 (43 per cent) participated with data from 35 appeals between 2004 and 2012. A thematic analysis was undertaken to discern the commonly occurring causes of contractual breaches. Findings: A total of 83 per cent (n=29/35) of appeals were based on data showing the rota to be non-compliant with the contract (band 3), with the remainder being compliant with the contract but not in keeping with the pay banding currently assigned. Inability to take adequate natural breaks was the most frequently cited cause of rota non-compliance. Where underlying reasons were given for breaches of hours/rest limits they clustered around 20 themes, the top four being poor or absent dialogue between HR and doctors, excessive workload, inappropriately timed ward rounds, and inadequate or non-existent bleep policies. Originality/value: This is the first analysis of banding appeals under the UK junior doctor contract. The findings show that problems with rotas cluster around specific themes. The authors provide recommendations to target these so as to avoid financially detrimental contract breaches and trainee dissatisfaction. © Emerald Group Publishing Limited. Source

This research aimed to define and agree a consensus on the overall aims, educational objectives and assessments for extended GP training. It used a modified Delphi technique to achieve a consensus of opinions from a representative group of stakeholders and assessment content experts. Existing curriculum gaps that could be developed further in a period of extended training were defined. The study showed a very strong consensus for a 'gateway' assessment-to-a-standard1 at the current ST3 endpoint before progression to extended GP training with those years of extended training giving 'added value'. The current MRCGP summative components of the applied knowledge test (AKT) and clinical skills assessment (CSA) are considered fit for purpose as an appropriate 'gateway' standard; with more robust workplace-based assessments to demonstrate continued progression during extended training. The results informed and provided the evidence base for the development of a proposed programmatic assessment model, which has been critically appraised.2 This paper reports in detail on the Delphi study and comments on the importance of further work developing assessments. © 2013 Radcliffe Publishing Limited. Source

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