Wales North Research Articles

PWE-295 Colorectal cancer management in the very elderly

<h3>Introduction</h3> With an increasing elderly population we are more frequently having to address treatment of colorectal cancer in those over 80. Despite this, there is relatively little published UK data for these patients. North Wales has a significantly higher than average elderly population and our aim was to evaluate the treatment of colorectal cancer in those 80 years and older. <h3>Method</h3> This was a retrospective observational study. Data from the north wales cancer registry was used to identify all patients with a diagnosis of colorectal cancer from January 2009–July 2014. Patient case details were then cross referenced with local coding data, clinical/histopathological records and imaging records. We analysed diagnosis, treatment including operation (open versus laparoscopic and elective versus emergency). For those operated on we include 30 day mortality and length of hospital stay. Data for those aged 80 or over was compared to those under 80 using SPSS software. <h3>Results</h3> There were 942 total patients, of which 243 were over the age of 80(26%). 102 of 243(42%) were female. Age range was 80–110(Mean = 85). Significantly less of those over 80 underwent cancer resection (64% vs. 80% p = 0.0000). This was despite no significant difference in disease severity at diagnosis (p = 0.198). Overall 30 day mortality post surgery in the elderly resection group was worse when compared to the under 80 group (12.8% vs. 3% p = 0.0000). Of elderly patients undergoing elective surgical resection, 46% were laparoscopic compared to 52% in the under 80 group. 30 day mortality of the elderly laparoscopic group was significantly worse when compared to the under 80 group (10% vs. 2.6%) p = 0.015, however this difference was less sizeable than in open surgery category. Significantly more of the over 80s presented as an emergency (16% vs. 12% p = 0.008). Three quarters of the elderly emergency patients underwent surgery, for which the 30 day mortality was 23% compared to 6% of the under 80s (p = 0.0001). Length of stay was significantly higher in the over 80 group (p = 0.0001) with the average length of stay at (18.2 days vs. 13.1 days). Postoperative stay in elderly group was significantly more in open procedure than laparoscopic (Mean no days 21.0 vs. 14.4 P = 0.001). <h3>Conclusion</h3> Patients over 80 years old form a quarter of our colorectal cancer burden, and are more likely to present as emergencies and require longer hospital stays post operatively. Despite the perceived increased risks in this age group our data demonstrates we are performing resection surgery for a significant proportion with acceptable outcomes. Our data also supports the benefits of laparoscopic surgery in this age group. <h3>Disclosure of interest</h3> None Declared.

How do physiotherapists assess and treat patellofemoral pain syndrome in North Wales? A mixed method study

Background/Aim: Little is known about how individual physiotherapists assess, treat and measure outcomes for patients with patellofemoral pain syndrome (PFPS) in the clinic. Previous research has revealed no gold standard methods. This study therefore set out to explore beliefs and practices of physiotherapists working in a non-academic health community in North Wales (NW). Methods: Methodology involved a mixed-method approach. 4 quantitative questionnaire exploring how physiotherapists assess, treat, and measure outcomes in PFPS, was emailed to physiotherapists working in NW. Thirty responded (62.5%) and eleven were then interviewed (qualitative). Interviews were recorded, transcribed, and organised into categories. Number and frequency of the different assessments, treatments, and outcome measures were triangulated against the quantitative survey data. Findings were then synthesised. Findings: Physiotherapists are aware of the different types of presentation of PFPS; however, individual clinical practice differs. Although the questionnaire reported a large number of outcome measures, interviews reported mainly only the visual analogue pain scale and subjective functional tasks. Moreover, physiotherapists treat function, not syndromes. Home exercises aim for simplicity and function rather than complex muscle group specific exercises. Peers were reported to be the most important source of knowledge and influence on their practice. Conclusion: There is a need to develop an evidence-based assessment and outcome measurement protocol for routine clinical practice.

Meeting research governance requirements by developing a joint research and development strategy between NHS and higher education partners

The Research Governance Framework (DoH, 2001) requires health and social care organisations to promote a research culture in their organisation and ensure that staff are supported in, and held accountable for, the professional conduct of research. In Wales, recent policy documents also necessitate the building of research capacity in health and social care in order to develop a high-quality workforce (WAG, 2002: 31) and deal with recruitment and retention problems by supporting initiatives and developments (NAfW, 2001). A literature search revealed that, although such strategies exist, none were reported to use an action research framework. This paper, therefore, reports on the progress of an action research project to develop, implement and evaluate a Joint Research and Development Strategy between North East Wales NHS Trust and North East Wales Institute of Higher Education. The strategy reported on in this paper used action research as a means of empowering stakeholders to become involved in research, whilst ensuring that the strategy continues to be implemented and evaluated. The paper reports on progress made in the first cycle of this action research process and outlines plans for future cycles.

Severe motorcycle injury in mersey region and north wales

Ninety-three patients were involved in serious motorcycle accidents (death or Injury Severity Score more than 15) during a 1-year period among a total of 554 victims of serious road traffic accidents studied at 16 district general and teaching hospitals. There were 91 males and two females. The average age was 29 years (range 15–81 years). Of these, 32 per cent died at the scene of the accident or in transil; 68 per cent arrived alive at the above hospitals. Of the latter, 30 per cent died in hospital. The commonest cause of death was multiple injuries. The Injury Severity Score of patients admitted to hospital was a mean of 32.1. The Glasgow Coma Score was below 9 in 33.8 per cent. Of those admitted to hospital, the average length of stay was 38.7 days. 67 per cent were admitted to intensive therapy unit of whom 41.3 per cent had to be ventilated for an average of 3.55 days. There were four preventable deaths among the patients who died after being admitted to hospital. Many body areas are frequently injured in motorcycle accidents which occur usually in fit males. Careful assessment along with vigorous and aggressive treatment is particularly important for this group. Access to a specialized trauma centre would be beneficial.

THE FISHERIES SOCIEIY OF THE BRITISH ISLES FACTORS AFFECTING THE DISTRIBUTION OF FISH

Journal of Fish BiologyVolume 42, Issue 2 p. 320-320 THE FISHERIES SOCIEIY OF THE BRITISH ISLES FACTORS AFFECTING THE DISTRIBUTION OF FISH ANNUAL SYMPOSIUM, 5–9 JULY 1993 CONWY, NORTH WALES First published: February 1993 https://doi.org/10.1111/j.1095-8649.1993.tb00335.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume42, Issue2February 1993Pages 320-320 RelatedInformation

Patterns of parental language use in wales

This paper reports the language use of some 400 mothers in North Wales and their partners. The sample was divided into five types of couple, both mainly Welsh speaking, only father Welsh speaking, only mother Welsh speaking, both mainly English speaking, and couples where both have always used a mixture of Welsh and English. Factors associated with language use are examined, and these include cross‐language partnerships, past educational medium, and situation. Thinking in Welsh most clearly differentiates the groups, with the majority of the Welsh speaking couples and or the Welsh speaking partners in cross‐language marriages thinking in Welsh. Those in the mixed language background group tend to think in English. Language choice for reading and viewing is also examined. Finally, consideration of the effect of gender on language use/choice in the home indicates that the father may have the greater influence.

Chadian faunas and flora from dyserth: Depositional environments and palaeogeographic setting of Viséan strata in northeast wales

AbstractNew floral and faunal data from the oldest Dinantian limestones (Foel Formation) in the Dyserth area, suggest that these sediments are of Chadian age, rather than the Asbian age concluded by earlier workers. The basal late Chadian limestones rest conformably on Dinantian Basement Beds of ?Chadian age or older.The initial inundation of St. George's Land occurred during Chadian times, when shallow‐water marine limestones accumulated in the Dyserth area and further to the south, together with terrestrially derived siliciclastics, containing drifted plant fragments. Periodically, a restricted hypersaline lagoonal environment was established but an open marine, neritic environment with abundant stenohaline fauna prevailed in this area.These Chadian sediments accumulated on the proximal part of a carbonate ramp and are presumed to have passed laterally downslope into deeper water basinal facies with Waulsortian buildups of the Irish Sea Basin. In the later Arundian, a carbonate ramp–to–platform transition occurred, with widespread deposition of shallow‐water carbonates. In the Asbian this platform developed a rimmed margin, with buildups forming a linear belt between platform and basin.An almost complete Chadian to Brigantian Lower Carboniferous sequence can now be recognized in North Wales. This succession is comparable with the shelf succession in south Cumbria on the northern margin of the Irish Sea Basin.

Language and Reality: An Introduction to the Philosophy of Language By MICHAEL DEVITT and KIM STERELNY Basil Blackwell, 1987. xii + 274 pp. £27.50 cloth, £8.95 paper

Philosophical BooksVolume 29, Issue 2 p. 88-91 Language and Reality: An Introduction to the Philosophy of Language By MICHAEL DEVITT and KIM STERELNY Basil Blackwell, 1987. xii + 274 pp. £27.50 cloth, £8.95 paper GEOFFREY HUNTER, GEOFFREY HUNTER UNIVERSITY COLLEGE OF NORTH WALES, BANGORSearch for more papers by this author GEOFFREY HUNTER, GEOFFREY HUNTER UNIVERSITY COLLEGE OF NORTH WALES, BANGORSearch for more papers by this author First published: April 1988 https://doi.org/10.1111/j.1468-0149.1988.tb02019.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume29, Issue2April 1988Pages 88-91 RelatedInformation

Providing a placement service an experiment in north wales

Abstract The article describes an experiment in North Wales involving a CQSW course sub-contracting the organisation and support of its students' placements to a separate project jointly managed by the college concerned and other local educational institutions and agencies. On the basis of an evaluation of this experience some tentative conclusions are offered about such matters as the utility of jointly managed projects in addressing basic structural deficits in qualifying training currently, such as the shortage of suitable, well-found practice placements, and the extent to which the tutorial role in social work education can be effectively divided into academic and practice related functions. It is suggested that QDSW (if and when it comes) may shortly raise these and other related issues with particular force and urgency and that pertinent lessons already learned in the context of CQSW provision could usefully inform that debate.

PRECIPITATION ACIDITY AT A RURAL SITE IN NORTH WALES

WeatherVolume 42, Issue 8 p. 236-241 PRECIPITATION ACIDITY AT A RURAL SITE IN NORTH WALES B. Reynolds, B. Reynolds Institute of Terrestrial Ecology, Bangor, GwyneddSearch for more papers by this author B. Reynolds, B. Reynolds Institute of Terrestrial Ecology, Bangor, GwyneddSearch for more papers by this author First published: August 1987 https://doi.org/10.1002/j.1477-8696.1987.tb04898.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume42, Issue8August 1987Pages 236-241 RelatedInformation

SIR GAWAIN'S TRAVELS IN NORTH WALES

SIR GAWAIN'S TRAVELS IN NORTH WALES Get access J. EADIE J. EADIE Search for other works by this author on: Oxford Academic Google Scholar The Review of English Studies, Volume XXXIV, Issue 134, May 1983, Pages 191–195, https://doi.org/10.1093/res/XXXIV.134.191 Published: 01 May 1983

The ashgill rocks of the glyn ceiriog district. North wales

AbstractThe Ashgill rocks of the Glyn Ceiriog district comprise a relatively thick sequence of mudstones and siltstones with subordinate sandstones and locally developed limestone members. Closely related deposits are found in the inliers of Cym‐y‐brain and Mynydd Cricor to the north. Correlation with other areas of Ashgill rocks suggests that the Dolhir Formation, of the Glyn Ceiriog district, can be dated as mid‐Cautlcyan to Rawtheyan while the overlying Glyn Formation is high Rawtheyan to Himantian. In the inliers to the north, that part of the Cyrn‐y‐brain Formation which is exposed is dated as Rawtheyan and both the Plas Uchaf Formation (Cym‐y‐brain) and Cricor Formation (Mynydd Cricor) are taken to be Hirnantian.The succession is interpreted as a transgressive‐regressive sequence in which shallow shelf mud‐stones and siltstones with storm‐sand and coquinid layers are overlain by shallow water shoreline deposits.Although the base of the Ashgill is not exposed in the inliers to the north, in the Glyn Ceiriog district it is seen to rest unconformably on older Ordovician strata; in all three areas the Ashgill is apparently conformably overlain by Lower Llandovery shales and sandstones.

The geology of the Llanuwchllyn to Llanymawddwy area, south gwynedd, north wales

AbstractA geological map of the Caradoc rocks of the Llanuwchllyn to Llanymawddwy area is presented and the geology of the area described in detail. Hitherto unrecorded outcrops provide important stratigraphical evidence which is used to redraw the Caradoc‐Ashgill Series boundary and many of the formational boundaries within the Caradoc Series.The stratigraphy of the area is revised to conform with the standard classification of the Caradoc Series in the Bala region. The only modifications are as follows: the Llaethnant Siltstone is proposed as a formational name for a group of beds which are broadly equivalent to the Glyn Gower Formation but which represent a distinct facies. The greater part of the Nod Glas Formation north of Dinas Mawddwy is shown to be laterally equivalent to the upper part of the Gelli‐grin Formation; it is also subdivided into two members, the Dyfi Mudstone and the Corris Shale, differentiated on lithological and faunal grounds. The stratigraphy of the Dinas Mawddwy area is also amended.Faunal elements (genera) new to the Caradoc Series of this area, and to Wales, are noted.

The caradocian rocks of the north and west berwyn hills, north wales

AbstractThe Caradoc of the Berwyn Hills is a thick sequence of marine mudstones and siltstones with interstratified sub‐aerial tuff formations. Near the top of the succession there is a sharp facies change to graptolitic shales. The sequence has been re‐mapped and two new formations (the Pen‐plaenau Siltstone Formation and Cwm Rhiwarth Siltstone Formation) and one new member are proposed. Assemblage zones can be traced round the outcrop in the lower part of the sequence (Soudleyan) but higher in the succession (Longvillian) there are differences between the faunal assemblages of the north and west. The northern faunas are referred to Dalmanella community which is believed to have occupied a shallower environment than the Nicolella community to the west. In spite of the presumed environmental control of the faunas, the sequence can be fairly precisely correlated with the classic sections in Shropshire and Bala.The Caradoc sedimentary sequence represents a mainly shallow sub‐tidal environment with periodic episodes of local emergence. The area deepened during the Longvillian, particularly in the west. There followed a period of non‐deposition with probably some erosion at the base of the Nod Glas which itself represents a period of reduced sediment.There is a well‐known stratigraphic break at the base of the Ashgill which rests on rocks of Onnian age and on different horizons of the Longvillian.

QUOTATIONS IN JOSEPH HUCKS'S A PEDESTRIAN TOUR THROUGH NORTH WALES

QUOTATIONS IN JOSEPH HUCKS'S A PEDESTRIAN TOUR THROUGH NORTH WALES Get access Notes and Queries, Volume 23, Issue 11, November 1976, Pages 510-b–510, https://doi.org/10.1093/nq/23-11-510b Published: 01 November 1976

FIELD SOIL ASSESSMENT FOR CLUB ROOT IN NORTH WALES

Annals of Applied BiologyVolume 47, Issue 2 p. 361-363 FIELD SOIL ASSESSMENT FOR CLUB ROOT IN NORTH WALES D. C. Gwynne, D. C. Gwynne National Agricultural Advisory Service, BangorSearch for more papers by this author D. C. Gwynne, D. C. Gwynne National Agricultural Advisory Service, BangorSearch for more papers by this author First published: June 1959 https://doi.org/10.1111/j.1744-7348.1959.tb02551.xCitations: 3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume47, Issue2June 1959Pages 361-363 RelatedInformation

Chemical studies on upland peat in north wales

AbstractVarious layers from profiles from upland acid peat area containing both untouched and reclaimed sites were chemically examined for inorganic and organic changes as a result of treatments. Low phosphorus and high aluminium and lead contents were found and a layer of copper accumulation was noted in the undisturbed site. Lanthanum content was also found to be high. The amino‐acid distribution in hydrolysates of soil water, as well as pyrophosphate‐extracted humic acid and the pyrophosphate‐insoluble soil residue containing organic matter, was examined. The surface layers are characterised by the presence of non‐protein amino‐acids of plant and microbiological origin. The basic amino‐acids appeared to be in greater strength in the soil water samples from treated sites than those from untreated sites. The soil residue appears to be a reservoir of amino‐sugar‐containing compounds. The relative distribution of certain “non‐protein” amino‐acids found in small amounts in the humic acids isolated from samples from different depths in the profile, may possibly be explained if the humic acid is considered as a cation‐exchanger being eluted in the hydrogen cycle.

The structural evolution of north wales

AbstractThe Caledonian structures of North Wales were foreshadowed by Pre‐Cambrian structures. A feature of the Caledonian pattern is a deflection of cleavage and fold trends from north‐south, as in Merionethshire, to east‐west, as in Denbighshire. The axis of this deflection trends northwest—southeast from Shropshire to Anglesey; it appears to be wrenched sinistrally along the Bala fault. The vergence of cleavage and folds is generally towards the east and south. Intensity of deformation increases from the foreland (Shropshire) to Anglesey. Late‐Caledonian granite and dolerites are discussed in relation to deformation. Post‐Caledonian events are briefly reviewed.

The alleged subaqueous sliding of large sheets of sediment in the silurian rocks of north wales

AbstractSince reference is made from time to time to examples of supposed subaqueous sliding on a large scale in the Silurian rocks (Salopian Series) of Denbighshire, North Wales, for the purpose of supporting inferences about the mode of origin of certain intraformational disturbances, the stratigraphical evidence in Denbighshire is reviewed. On the basis of zoning by means of graptolites (or shelly faunas where available), the boundaries of the alleged sheets of slipped material prove to be transgressive. In particular, the largest ‘contemporaneously‐disturbed’ sheet includes parts of the undisturbed succession ranging in age from the nilssoni zone to the tumescens zone. Its supposed base would have to cross its supposed surface, so that it would appear to have a negative thickness—of minus 1,000 feet or more. Acceptance of the hypothesis of large‐scale sliding on the sea‐floor in this area is thus incompatible with a belief in the value of graptolites as zonal indices in the Salopian rocks.

Q FEVER IN NORTH WALES

Q FEVER IN NORTH WALES