Managing the multiple demands of a chronic condition whilst negotiating the developmental tasks of adolescence and young adulthood is a process that is neither well described nor understood, particularly in relation to providing developmentally appropriate health care for young people. The importance of this issue is starting to be reflected within the literature, and although research into models of service delivery is emerging, a lack of user involvement in service development is apparent. This qualitative, user involvement study aimed to describe and understand the considered opinions of 19 young adults with diabetes who were receiving secondary care services about the provision of diabetes services for young people. The findings, gathered using semistructured interview and focus group methods, have potentially wide-reaching implications across primary and secondary health care, and across agencies providing services to children and young people, in terms of facilitating a person's transition through adolescence and into young adult life. Participants suggested key issues to address when developing services for young people, including staff consistency, civility, clinic structures which help a person navigate the health care system, provision of age-specific information, and support in relation to a range of health, emotional, social and developmental needs. Health care professionals can help young people to meet the expectations upon them as autonomous service users by modelling appropriate relationships, helping them to acquire skills and knowledge, and overcome barriers to them becoming active participants in their health care and achieving social participation in a fuller sense. It is somewhat arbitrary to delineate between adolescence and young adulthood in terms of age alone, but in this paper, 'adolescence' refers to the period between 11 and 15 years of age, and 'young adulthood' between 16 and 25 years of age. The phrase 'young people' will also be used to refer to people between 11 and 25 years.
There has traditionally been a low level of engagement of primary care practitioners with research. In the UK, primary care trusts (PCTs) now have some responsibility for the encouragement of research and development in primary care. The aim of this study was to assess the current level of research activity and capacity for research within a PCT. A questionnaire, incorporating a recently developed and validated research and development culture index, was sent to all 572 health care professionals and staff under the auspices of North Tyneside Research PCT. Data analysis used nonparametric tests of association including chi-squared, MannÀWhitney U and Spearman's rank order correlation. There was a 50.3 per cent response rate to the questionnaire. Groups more likely to show an increased capacity for research included those with postgraduate qualifications and those in post for the least time. General practitioners were less likely than other professional groupings to declare personal skills or aptitude for research. The two most important factors thought to contribute towards the development of a culture of R&D were having access to people to support development and changes in professional practice and having access to training and development opportunities. The use of the R&D culture index enabled groups to be identified that may be more research interested and can therefore be targeted to increase research capacity. The R&D culture index could be used by other PCTs wishing to define and develop research capacity in primary care.
An investigation has been made on the changes in the haemoglobin index with age in four breeds of indigenous African and two breeds of European cattle.1. Support is given to previous findings that the haemoglobin index was high and variable at birth and fell to an individual more stable adult level at between 2 and 3 years of age.2. The haemoglobin levels for mature animals of the four tropical breeds are higher than mean figures quoted for other tropical cattle, but still fall within the ranges quoted.3. The haemoglobin levels for the Friesian agreed with those quoted from temperate regions, but those for the Jersey were higher, agreeing most nearly with Jamaican figures. A reason for this is advanced.4. The haemoglobin levels of the tropical breeds were significantly higher than those of the two temperate breeds examined.5. Confirmation was given to the association of a high haemoglobin index with a high heat toleration coefficient.
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