This study provides evidence that the use of specialist nurses to perform educational outreach to improve target adherence to patients with diabetes in primary care is not effective.

Processes of care indicators are similar in diabetic patients of South Asian and European origin, irrespective of SES. However, there are worrying differences in improvements over time in the intermediate outcomes, and glycaemic control remained poorer among patients of South Asian origin patients throughout.

Aims/hypothesis. Our aim was to investigate trends in provision and outcomes of care by socio-economic status among patients with diabetes in Salford, United Kingdom. Methods. Salford is a deprived urban area in North West England. Data for people with diabetes who were younger than 20 years of age (4034 patients in the year 1993 and 5671 by the year 2000) were extracted from the Diabetes Information System. Agestandardised means, proportions and attainment of targets were calculated for: processes of care indicators, intermediate outcomes and prescribing of preventive drug treatments in 1993 to 1994 and in 2000 to 2001 by quintiles of Townsend deprivation score. We did comparisons of means and proportions using ageadjusted linear regression and of trends using generalised estimating equations. Rate ratios for first microvascular and first macrovascular complication were estimated from proportional hazards models. Results. Marked improvements occurred in all indicators. For patients managed in primary care, blood pressure and cholesterol measurement increased from 53% to 64% (p<0.001) and 27% to 61% (p<0.001) respectively; whilst mean systolic blood pressure decreased from 147 to 140 mmHg (p<0.001) and cholesterol concentrations from 6.0 to 5.1 mmol/l (p<0.001 Most studies suggest that the prevalence of risk factors for diabetic complications, intermediate outcomes of diabetes care, and diabetic complication rates vary inversely with socio-economic status (SES). For example, risk factors for cardio-vascular diseases, particularly cigarette smoking, are more prevalent among people with diabetes with lower SES in community and hospital-based studies [1,2,3,4,5]. Patients of lower SES have an increased incidence of retinopathy and nephropathy [1,2,4,5].All cause mortality is higher in people with diabetes of lower SES [6] or from more deprived communi-

The Divisions Diabetes and Cardiovascular Disease Quality Improvement Project (DDCQIP) is a national project that aims to promote quality improvement initiatives among Divisions of General Practice. DDCQIP has investigated the growth of Division-based diabetes and cardiovascular disease register-recall systems and the role they play in promoting evidence-based structured care within general practice. In the period [2000][2001][2002], an increase in the number of GPs using register-recall systems and the rise in the number of active registered patients have made it possible to monitor quality of care and health outcome indicators, and contributed to the growth of a Division-based population health program.

This study looks at the reactions shown by a group of premature and low-birthweight babies to a programme of sequenced stroking, called TAC-TIC. It also sets out to ascertain whether mothers, as compared to fathers, elicit different behavioural reactions while stroking their baby and whether they enjoy interacting with their babies using TAC-TIC.