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Coventry, United Kingdom

Fowler T.,University of Birmingham | Edeghere O.,Public Health England | Inglis N.,NHS Coventry | Bradshaw S.,University of Birmingham
International Journal of STD and AIDS

Advances in technology have raised the possibility of including gonorrhoea testing as part of chlamydia screening. In England this is recommended only where the positive predictive value (PPV) of the test is ≥90%. This study assessed the PPV for gonorrhoea testing using routine testing data. Routine data (including gonorrhoea testing) from the Greater Manchester Chlamydia Screening Programme (GMCSP) in 2009/2010, were used to estimate the PPV for gonorrhoea testing. Of those screened, 0.3% (59/18044) of men and 0.4% (174/41873) of women tested positive for gonorrhoea. The PPV was 82.3% in women and 73.6% in men, in those who also tested positive for chlamydia. For women and men testing negative for chlamydia the PPV for a positive gonorrhoea test was incalculable. The low PPV observed in most groups suggests that where population testing for gonorrhoea occurs there is a need for further confirmatory testing of positive results before treatment decisions are made. Clinicians should be aware of screening test result limitations in this context. Source

Ratcliffe T.,Wharfedale | Ratcliffe T.,University of Bristol | Dabin S.,University of Southampton | Barker P.,NHS Coventry
Clinical Governance

Purpose - This paper aims to design and implement an audit of physical health monitoring for patients with schizophrenia or bipolar disorder in primary care. Design/methodology/approach - Evidence-based criteria for physical health monitoring were developed from current clinical guidelines. Physical health monitoring of 128 patients with a diagnosis of either schizophrenia or bipolar disorder was audited against these criteria in two urban GP practices. Findings - The number of patients whose smoking history, alcohol consumption history, blood pressure and body mass index had been recorded in the preceding 15 months varied significantly by practice, whilst recording of blood cholesterol and diabetes status did not. Patients with a diagnosis of schizophrenia were significantly more likely to have had a diabetes status recorded in the preceding 15 months compared to patients with bipolar disorder. Research limitations/implications - Standards for compliance with audit criteria need to be debated and agreed with stakeholders. Further research is needed into how physical healthcare services can effectively engage patients with serious mental illness. Practical implications - Audit of physical health monitoring in primary care is feasible and could be used to identify shortcomings in physical healthcare for people with serious mental illness. Inviting patients on practices' mental health registers for cardiovascular risk screening should be considered. Social implications - Regular audit of physical health monitoring in people with schizophrenia or bipolar disorder may help ensure equitable healthcare delivery for patients with serious mental illness. Originality/value - This paper presents an audit methodology that primary care trusts and general practitioners can use to assess how effectively the physical health of people with serious mental illness is being monitored. © 2011 Emerald Group Publishing Limited. Source

Bush K.,ST5 Ophthalmology | Thomas R.,Retinal Screening Unit | Raymond N.T.,University of Warwick | Sankar S.,University of Warwick | And 2 more authors.
Diabetes and Vascular Disease Research

Attendance at diabetic retinopathy screening in minority ethnic groups, including the South Asian population, is known to be poor. We describe a cluster randomised controlled trial conducted in 10 general practitioner (GP) surgeries in Coventry, UK, during 2007 which aimed to evaluate the use of a Link Worker-delivered intervention to improve attendance. The intervention consisted of a simple telephone reminder with the main outcome measure being attendance at diabetic retinopathy screening. We found a statistically significant difference between mean attendance proportions for intervention (0.89) and control (0.74) practices: difference (95% confidence interval (CI)) 0.15 (0.04-0.27), t = 3.03, p = 0.0162; this difference remained significant when adjusted for previous year's proportions. In this proof-of-concept study, in inner city Coventry, we demonstrated increased attendance at diabetic retinopathy screening by use of a simple Link Worker-implemented telephone call intervention. The use of Link Worker phone calls may be a useful tool to increase attendance for diabetic retinopathy screening in a group with high did-not-attend (DNA) rates and a high prevalence of diabetic retinopathy and visual impairment. © The Author(s) 2014. Source

Harrell R.,NHS Coventry | Caley M.,NHS Warwickshire | Fowler T.,University of Birmingham
Journal of Public Health

Background The UK government has proposed major changes to the Public Health system in England. This study aims quantify increasing anecdotal concern that the number of Public Health consultant posts advertised has plummeted since the publication of these plans. Methods The archives of BMJ careers were interrogated for hospital and Public Health consultant posts advertised October 2008 and May 2011. Statistical process control charts were used to compare differences in recruitment over time and the ratio of Public Health:hospital consultant posts. Results We found a highly significant reduction in the mean number of advertisements for Public Health consultant posts from 27.9 posts per month in the period October 2008-Novermber 2009 to 6.3 posts per month between December 2009 and May 2010 (P< 0.005). The ratio of Public Health:hospital consultant posts fell from 3.3 to 0.9 Public Health consultant posts per 100 hospital consultant posts (P< 0.005). Conclusions This study confirms the anecdotal concern that there has been a significant reduction in the advertisement, and by extrapolation, recruitment to Public Health consultants posts in England around the time of the publication of the governments reform plans. Public Health consultant posts have been disproportionately affected by this reduction compared to hospital consultant posts. © The Author 2011, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. Source

Towey M.,Health and Physical Activity Team | Harrell R.,NHS Coventry | Lee B.,NHS Coventry
Journal of Obesity

Service evaluation of a community-based healthy lifestyle programme, designed for families aimed at preventing obesity. Physiological and behaviour measures were recorded at the beginning and end of the programme. Out of a total of 454 participants, 358 (79%) completed. From these completers 293 (64%) were analysed as there was sufficient data. The use of "high visibility recruitment" led to 77% of completers being from Coventry's two most deprived population quintiles. Ethnic minorities were also well represented. There were statistically significant self-reported behaviour changes, with improvements in fruit and vegetables eaten and decrease in consumption of crisps, snacks, and take away foods. There were also significant increases in physical activity. There were small but statistically significant improvements in BMI/BMI percentile for adults and children who started the programme overweight/obese. These results demonstrate the programmes' effectiveness in enabling behaviour change, and attracting participants from deprived communities. © 2011 Marsha Towey et al. Source

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