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Concept: South West England


To identify factors influencing general practitioners' (GPs') decisions about whether or not to remain in direct patient care in general practice and what might help to retain them in that role.

Concepts: Physician, General practitioner, West Country, South West England


Evaluation of a pilot study of an online consultation system in primary care. We describe who used the system, when and why, and the National Health Service costs associated with its use.

Concepts: Health care, West Country, South West England


We conducted a cross-sectional survey including specialist trainees in obstetrics and gynaecology in the Health Education West Midlands region, UK, to capture their views and assess training opportunities on the use of Kielland’s forceps. Half of the trainees in the region completed the survey (87/172, 50%). Only 31% of our trainees worked in units that supported the training on these forceps (27/87, 31%). The majority reported that they did not get enough exposure to using Kielland’s forceps (53/87, 60.9%). Only a minority (5.7%, 5/87) felt confident to perform a Kielland’s rotational delivery independently. The majority (64.3%, 56/87) were keen to continue using Kielland’s forceps in the future if competent. More than two-thirds (86.2%, 75/87) felt that simulation could aid their training. There was large enthusiasm for training on the safe use of Kielland’s forceps among trainees in obstetrics and gynaecology in the West Midlands region. A national assessment of training resources is needed to better plan training recourses on this complex skill.

Concepts: Skill, Training, England, Obstetrics and gynaecology, West Midlands, Coventry, Solihull, South West England


To implement parent-oriented discharge planning (Train-to-Home) for preterm infants in neonatal care.

Concepts: West Country, South West England


To determine the proportion of Salmonella cases in children aged <5 years that were reptile-associated salmonellosis (RAS) and to compare the severity of illness.

Concepts: West Country, South West England


Dry weight concentrations of lead in paints on a variety of structures in the urban and suburban environs of a British city (Plymouth, south west England) were determined in situ and ex situ by field-portable X-ray fluorescence spectrometry. Lead was detected in 221 out of 272 analyses, with overall median and mean concentrations of 4180μgg(-1) and 29,300μgg(-1), respectively, and a maximum concentration of 390,000μgg(-1). Highest concentrations were observed in extant paints on poorly maintained, metallic structures, including railings, gates, telephone kiosks and bridges, in various yellow road line paints, and in paints of varying condition on public playground facilities (ramps, climbing frames, monkey bars). Occupants of households in the vicinity of structures that are shedding leaded paint are at potential risk of exposure from paint particles being tracked in on shoes and clothing while children in contact with leaded paints in playgrounds and recreational areas are at potential risk from the direct ingestion of paint flakes. Since the issues highlighted in the present study are neither likely to be restricted to this city, nor to the UK, a greater, general awareness and understanding of the sources and routes of exposure of exterior leaded paint is called for.

Concepts: Playground, Risk aversion, Cornwall, Plymouth, Devon, Lead paint, South West England, Playscape


Several aspects of school life are thought to be associated with increased risk of self-harm in adolescence, but these have rarely been investigated in prospective studies.

Concepts: Cohort study, Cohort, Study design, Native Americans in the United States, West Country, Bristol, South West England, West of England


We have previously reported that there is little evidence of population ‘cure’ amongst two populations of women diagnosed with invasive breast cancer. ‘Cure’ has not yet been examined in the context of screen-detection.

Concepts: Cancer, Breast cancer, England, United States Census Bureau, Regions of England, West Midlands, Coventry, South West England


In the West Midlands region of the UK, the delivery of prehospital trauma care has recently been remodelled through the introduction of a regionalised major trauma network (MTN). Helicopter emergency medical services (HEMS) are integral to the network, providing means of delivering highly skilled specialist teams to scenes of trauma and rapid transfer of patients to major trauma centres. This study reviews the impact of introducing the West Midlands MTN on the operation of one its regional HEMS units.

Concepts: Birmingham, England, Ambulance, Emergency medical services, Emergency medicine, Colorado, West Midlands, South West England


The aim of this study was to evaluate the prevalence of diabetic foot ulcer and its related risk factors.

Concepts: Epidemiology, Medical statistics, Risk, The Canon of Medicine, Avicenna, Iran, Ahvaz, South West England