Black Country Research Articles

Medical prescription and nursing administration of medication in learning disabilities in-patient settings

AimsThe aim of this re-audit was to review whether inpatientprescription cards are completed correctly by doctors and administered by nurses, and to compare the results with the previous audit.BackgroundWe carried out a re-audit of Medical Prescription and Nursing Administration of Medication in Learning Disabilities In-patient Settings. Black Country Partnership NHS Foundation Trust is committed to managing medicines safely, efficiently and effectively as a key part of delivering high quality patient centred care. In BCPFT medications are recorded by doctors on paper prescription cards and administered by registered nurses.MethodThis audit compared results against the standards for prescribing medication in BCPFT Medicines Policy.Prescription charts were retrospectively reviewed against 22 standards for all LD inpatients as outlined in the LD trust policy across all 3 of the Learning Disabilities in-patient units during May 2019 as long as they were still inpatients during this month. 27 prescription cards were reviewed in total.Result100% of prescription cards had patients full names , address , ward name, were fully legible , written in black ink, route of administration, approved abbreviation for route, date of prescription, signature of prescriber , prescription labelled as 1of 1 /2, frequency of prn meds and indication . Whereas only 96% had generic drug names, clearly documented doses and time of administration along with acceptable abbreviation and appropriate code for omission. 85% drugs had a stop date once drug was stopped and 85% had allergies recorded in red and had a line drawn through once drug was omitted.ConclusionThe re- audit was highlighted to inpatient managers, nursing staff, The Medicines Management Committee (MMC) anddoctors in the Learning Disability division. Prescribers werereminded of the importance of documenting a stop date for the prescriptions and signing off once drug is crossed out. It was discussed in MMC to consider removing the standard for recording allergies in red ink as the box is already red in colour. The PRN section for medication does not have an area to sign when the drug is cancelled and this in particular is the case when PRN medication is re-written. It was discussed to limit this standard to regular medication and to be taken in consideration if the current drug chart requires redesigning in the future. We also recommended a re- audit in 2 years’ time.

Experience of tele-psychiatry during COVID-19 amongst doctors working in a mental health trust: A survey

AimsThere is paucity of information about perspectives of psychiatrists about telemedicine practice during COVID-19 pandemic. It was intended to explore the experience of doctors using tele-psychiatry for provision of clinical care during the COVID-19 pandemic in a Mental Health Trust covering four cities in West Midlands, UK.MethodThe study was conducted as an anonymized questionnaire survey. A 10-item questionnaire was designed with items related to the clinical outcomes, challenges and provider satisfaction when using tele-psychiatry. It had mostly yes/no dichotomous responses along with the scope for making additional comments for each question. An online link of the questionnaire was sent via email to doctors of all grades working across the Black Country Healthcare NHS foundation Trust, in the West Midlands. The survey was open between July and October 2020; and monthly reminders were sent.ResultThe questionnaire was sent out to 159 doctors and 34 responded (response rate of 21.3%). Just over 50% had used both telephone and video consultations, whereas 47.1% responders had used telephone only. More than half (55.8%) reported that the tele-psychiatry affected clinical outcomes; and it was considered positive in around half (52.9%). Most (73.5%) of the responders found that limitations or challenges of using technology impacted on delivery of care remotely. However 64.7% psychiatrists were satisfied with the process overall; and 79.4% reported that they would like to use tele-psychiatry in the future as well.Survey captured many observations from the psychiatrists. Positive comments from the psychiatrists included expedited delivery of care, reduced non-attendance rates, as well as successful multidisciplinary meetings. Challenges in specific sub-specialties such as Child and Adolescent Psychiatry or Older Adult psychiatry were reported where complete assessments were not achieved successfully. The process was felt to be appropriate in general for stable or follow-up patients in comparison to new or acutely unwell patients. There was some worry expressed about missing out non-verbal cues which assist with mental state examination.ConclusionInspite of a low response rate, the survey provided some understanding about the experience of doctors practicing tele-psychiatry during pandemic. While technological challenges were acknowledged, tele-psychiatry seemed to have been accepted by a majority of doctors who are also willing to continue it in their future clinical practice. There is a need to explore in a larger sample involving both patients and clinicians about the beneficial effects of tele-psychiatry that can be incorporated in the usual psychiatric practice.

Physical health monitoring before commencing regular antipsychotics in a Psychiatric Intensive Care Unit (PICU) - A Quality Improvement project

AimsTo compare the practice in a PICU setting against the standard practicing guidelines before commencing antipsychotics with regards to: 1.Physical examination2.ECG3.Baseline blood investigations4.Physical health conditions5.Family history of medical conditions.MethodData were collected from the PICU, Black Country Healthcare NHS Foundation Trust which covers four different hospital sites. 37 patients were admitted in PICU from 1st March 2020 to 30th September 2020, out of which 30 were included. 6 case notes were not available and one patient was admitted twice, thus case notes for only one admission was included in data collection.The standard guidelines for PICU outline that each admitted patient should have physical examination, vitals monitoring and baseline investigations including routine blood tests and ECG within first 24 hours. The data were collected as per standards retrospectively within two weeks from case notes in health records. Investigations were accessed through electronic information system for current inpatient admission and 12 months prior to the admission to the PICU.ResultMean age of the sample (n = 30) was 34.26 years. 37% of patients had physical comorbidities and a family history of medical conditions was documented for only 3% of cases. A large proportion of inpatients (53%) refused to have blood investigations before treatment and only 13% of blood investigations were completed before commencing treatment. Only 7% of patients consented to an ECG prior to commencing treatment. 27% of patients had a physical examination, including vitals, before starting treatment, a further 37% had just their vitals taken within 24 hours of admission and 20% refused any form of physical examination during their inpatient admission. 7% of cases had complications due to a lack of investigation.ConclusionAlthough there are standard guidelines for the PICU setting, it has been noted that these guidelines aren't always implemented. Multiple factors have a role to play such as: non-consenting patients, inaccessibility of previous records, initial assessment forms being incomplete including assessment of mental capacity and lack of follow-up with physical investigations by both primary care and secondary mental health services. As per findings, a few recommendations were proposed to meet the standards.

Coercion in the Cradle

Important recent research highlights the role of forced labor in the expansion of neoliberal capitalism in the global South. In this article I make the case that coerced labor was central to the first industrial revolution, the classical case of Great Britain. I demonstrate that in an area known as the Black Country for its coal, steel, and related industries, master and servant laws allowed criminal prosecution of workers deemed problematic, to insure labor control in the workplace. Employers relied on these laws when they were unable to use machinery to embed control in the labor process, and when they had recourse to reliable local courts (or petty sessions), in which many were magistrates, so they could rely on convictions under summary jurisdictions for fines, damage payment, and incarceration. I conclude by suggesting that this particular historical case can reorient our perspective on labor coercion and the law across the long arc of modern capitalism.

Punjabi Migration to the Black Country: A Photographic Journey through History, Cultures and Digital Technology

Indian migrant workers have been present in the United Kingdom’s county of the West Midlands since the 1930s. Initially, they were mostly men. However, by the 1960s, many of them had married Indian...

LONG TERM CONDITIONS AND MENTAL HEALTH: AN AUDIT OF LOCAL DATA

Objective: Studies have shown that mental health is affected by poor physical health, with people living in the deprived area are the most affected. Community Pharmacists potentially have a new role in supporting people with mental illness and dementia to manage their medications. The aim of this local audit was to compare the local population to the national and global population, to inform the development and provision of local pharmacy mental health screening services, to support patients diagnosed with long-term conditions.
 Methods: This project was designed as an audit of anonymised local data, to inform the development of services offered by community pharmacies to improve adherence to therapy amongst patients diagnosed with long-term conditions in the Black Country, UK. It forms part of a larger study granted ethical approval by the Health Research Authority in 2018. It was carried out against the background of the Covid-19 epidemic. A total of 652 patients pharmacy records were reviewed between March and April 2020. No patient identifiers were included in the reviewed data.
 Results: This means that the results of this analysis might not be applicable to the entire local population outside the 31-90 y of age range.
 Conclusion: It is was demonstrated during COVID-19 that pharmacists are well-positioned as easily accessible health care facilities to support patients, especially when the other NHS facilities are stretched or closed. Community pharmacies are in a position to offer large-scale screening programs such as self-completed anxiety, depression and cognitive function screening surveys and refer to general practitioners for further investigations. It is also recommended that the New Medicines Service include mental health disorder patients prescribed pharmacological therapy and to allow the pharmacists appropriate access to medical records to facilitate safe, integrated and effective patient care.

‘A lock so tallying in all its parts, that any part of one lock may fit another’: exploring the standardisation and interchangeable manufacturing of New Land Pattern Musket Locks

A Select Committee Report of 1817 states that the New Land Pattern Musket has ‘a lock so tallying in all its parts, that any part of one lock may fit another’. This is the earliest claim of interchangeability to have been found for Board of Ordnance firearms. It has focussed the authors’ attention on understanding the British efforts in the interchangeable manufacturing of firearms in the early 19th century, and more specifically on the manufacture of the lock of the New Land Pattern Muskets. This has also necessitated and included some work to unravel the story of the development of the New Land Pattern Musket and its variants, and to appreciate the contemporary use of lock jiggers by the East India Company (EIC) and others. Our approach has blended multiple iterations of archival research, object study, analysis of musket lock ‘Types’, and experimental evaluations of interchangeability. The methods used have allowed a comparison with contemporary American achievements at the Springfield and Harpers Ferry National Armories. This paper reports our results, including those of a close study of 35 New Land Pattern Muskets; the generation of a typology identifying three distinct variants of New Land Pattern Musket locks and a chronology of key aspects of their design, manufacture and supply; a five-lock component exchange experiment with 20 potential interchanges and other supplementary interchange tests; and an experimental evaluation of the use of two surviving EIC lock jiggers (i.e. gauges). These demonstrate that Great Britain had made significant strides in the interchangeable manufacturing of musket locks by 1817, but that these achievements, based upon the use of gauges and other similar tooling, were limited by their use of manual methods, chiefly filing by hand. They also show that Henry Nock, Ezekiel Baker and others contributed to the design of the variants of the musket, the lock and the tooling. The work also indicates that Britain was attempting interchangeable lock manufacturing in more than one geographical location, at the workshops of key suppliers in Birmingham and the Black Country (the metal working district to the West and North West of Birmingham), the London trade and the new Royal Manufactory in Lewisham. This multiple site approach would have been particularly challenging, and it is also important to note that much of this work was carried out in time of war. These British innovations may have influenced others through the transfer of technology by former Ordnance artificers, including at the Imperial Manufactory at Tula in Russia via John Jones, father and son. The experimental comparison with contemporary American achievements shows that the British were realising levels of interchangeability at least equivalent to those at US National Armories, but that whilst the dimensional control sought in Britain may have been less demanding it was being attempted at many more sites.

Fieldwork, Theory and Layers in the Black Country

Fieldwork, Theory and Layers in the Black Country

The Introduction of Brownfield Land Registers in England

ABSTRACT This review examines recent planning policy and legislation regarding the regeneration of brownfield land in England. The study is centred on housing and England’s West Midlands region with a focus on the Black Country. The Housing and Planning Act 2016 introduced provisions to grant permission in principle for housing-led development in England and mandated the assembly of brownfield planning registers. The Brownfield Land Register Regulations 2017 requirements and their implementation is explored. The review concludes that of almost 18,000 brownfield sites have been mapped and capacity for 1.3 million homes on 21,000 sites covering 25,000 hectares has been identified on brownfield registers.

Effect of surfactant dose on outcomes in preterm infants with respiratory distress syndrome: the OPTI-SURF study protocol

IntroductionRespiratory distress syndrome is a condition seen in preterm infants primarily due to surfactant insufficiency. European guidelines recommend the dose and method of surfactant administration. However, in routine practice, clinicians...

OS CORPOS NEGROS: QUESTÕES ÉTNICO-RACIAIS, DE GÊNERO E SUAS INTERSECÇÕES NA FÍSICA E NA ASTRONOMIA BRASILEIRA

In a metaphorical reference to the classical “black-body’s question” in the 19th century Physics, I problematize, in this essay, the reality of black people in the areas of Physics and Astronomy in contemporary Brazil, undertaking a theoretical-critical reading of the reality of these people in these areas of knowledge. I disentangle not only ethnic-racial and gender issues, but also historical and philosophical elements of science. I discuss how the historical construction of the contemporary concept of science, technology, development, innovation, race, scientific, institutional and structural racism can help us answer fundamental questions: why are there so few black people in Physics and Astronomy in a mostly black country? Are these areas of knowledge “affirmative actions” for whites? Why does scientific racism, a pseudoscience, not have the same status (concern) in science education and dissemination programs in Physics and Astronomy as other pseudosciences such as astrology, flat earth or quantum healing?  

Adopter quand on a une descendance biologique

Why adopt when you have biological descendants, and why adopt ostensibly by choosing a child from a black African country? This is the question we address in this article from a doctoral thesis in psychology supported in 2017 at the University of Lorraine. Although adoption has been the subject of much research, the scientific literature on “international adoption”, which will occupy us here, and which, at least in France, has tended to dry up in recent years, is very little provided. That is why, in order to open up avenues of research, we wanted to engage in an exploratory study of the appropriation that couples give in the after-the-fact to this adventure in which they engaged. Five couples were therefore interviewed in non-directive research interviews (Blanchet, 2003) conducted by the clinical psychologist involved in this thesis. This style of adoption is basically a “couple affair”, each couple being heard in three separate meetings in about a week. The first interview took place with the couple, the next two involving just the wife and then the husband. The interviews were recorded, then transcribed verbatim, finally analyzed thematically, through a relatively informal content analysis, and then pragmatically, using tools for analysis of the dialogue relating to enunciation (for example on people's deixis [Benveniste, 1966]) and dialogue management (e.g. the management of alternation and dialogical sequences (Trognon and Brassac, 1993; Trognon and Coulon, 2001; Trognon and Batt, 2010). This approach has identified many traits specific to those involved in the adventure of “international adoption”. Related, for example, to the individual and interindividual history of the members of the couple, the place that is devolved to the adopted child in the couple's imagination, and the commitment that both parents make in the common project. Their knowledge should prove to be useful to any professional who meets families who have experienced an international adoption.

Meniscal tear outcome Study (METRO Study): a study protocol for a multicentre prospective cohort study exploring the factors which affect outcomes in patients with a meniscal tear

IntroductionThis study is designed to explore the baseline characteristics of patients under 55 years of age with a meniscal tear, and to describe the relationship between the baseline characteristics and...

P033: Histological features and outcome of breast cancer of non-caucasian women - A single institution experience

Introduction: Breast cancer in females of Non-Caucasian origin remains poorly understood and management strategies are derived from the Caucasian disease. Our previous work showed differences at miRNA-level in breast cancer of four ethnic groups and a predominance of the triple negative phenotype (TNBC) in African breast cancer. Ethnic groups comprise nearly 30% of the population in Birmingham and Black Country.

‘A General Description’: Incorporating Battery Into a Generic Charge of Common Assault: R (on the application of Ward) v Black Country Magistrates’ Court [2020] EWHC 680 (Admin)

‘A General Description’: Incorporating Battery Into a Generic Charge of Common Assault: <i>R (on the application of Ward) v Black Country Magistrates’ Court</i> [2020] EWHC 680 (Admin)

Influence of combined vitamin D3 supplementation and resistance exercise training on musculoskeletal health in older men and women (EXVITD): protocol for a randomised controlled trial

IntroductionSarcopenia is a progressive loss in muscle mass, strength and function, the adverse consequences of which are severe, affecting quality of life and placing an increasing burden on social and...

BCLM: Forging Ahead: building a new urban history of the Black Country

AbstractThe recreation of urban historical space in museums is inevitably a complex, large-scale endeavour bridging the worlds of academic and public history. BCLM: Forging Ahead at the Black Country Living Museum is a £23m project recreating a typical Black Country town post-World War II. This article uses case-studies of three buildings – a Civic Restaurant, a record shop and a pub – to argue that urban-historical research methodology and community engagement can both create a vivid sense of the past, and challenge pervasive prejudices. It also argues that such a collaborative and public project reveals much about the urban and regional nature of industrial areas like the Black Country in this pivotal historical moment.

Prognostic Insight to Breast Cancer Markers in Nigeria

Nigeria is the most populous black country on earth with over 152 million people, it is located in the African continent at the western coast....

Heart failure with preserved ejection fraction (HFpEF) pathophysiology study (IDENTIFY-HF): does increased arterial stiffness associate with HFpEF, in addition to ageing and vascular effects of comorbidities? Rationale and design

AimsThere has been a paradigm shift proposing that comorbidities are a major contributor towards the heart failure with preserved ejection fraction (HFpEF) syndrome. Furthermore, HFpEF patients have abnormal macrovascular and...

Rationale and design of a cross-sectional study to investigate and describe the chronotype of patients with type 2 diabetes and the effect on glycaemic control: the CODEC study

IntroductionA person’s chronotype is their entrained preference for sleep time within the 24 hours clock. It is described by the well-known concept of the ‘lark’ (early riser) and ‘owl’ (late...