Access to and utilisation of GP services among Burmese migrants in London: a cross-sectional descriptive study

ABSTRACT: BACKGROUND: An estimated 10,000 Burmese migrants are currently living in London. No studies have been conducted on their access to health services. Furthermore, most studies on migrants in the United Kingdom (UK) have been conducted at the point of service provision, carrying the risk of selection bias. Our cross-sectional study explored access to and utilisation of General Practice (GP) services by Burmese migrants residing in London. METHODS: We used a mixed-method approach: a quantitative survey using self-administered questionnaires was complemented by qualitative in-depth interviews for developing the questionnaire and triangulating the findings of the survey. Overall, 137 questionnaires were received (a response rate of 57%) and 11 in-depth interviews conducted. The main outcome variables of the study included GP registration, barriers towards registration, GP consultations, barriers towards consultations, and knowledge on entitlements to health care. Quantitative data were analysed using descriptive statistics, association tests, and a multivariate analysis using logistic regression. The qualitative information was analysed using content analysis. RESULTS: The respondents were young, of roughly equal gender (51.5% female), well educated, and had a fair level of knowledge on health services in the UK. Although the GP registration rate was relatively high (80%, 109 out of 136), GP service utilisation during the last episode of illness, at 56.8% (54 out of 95), was low. The statistical analysis showed that age being younger than 35 years, lacking prior overseas experience, having an unstable immigration status, having a shorter duration of stay, and resorting to self-medication were the main barriers hindering Burmese migrants from accessing primary health care services. These findings were corroborated by the in-depth interviews. CONCLUSIONS: Our study found that having formal access to primary health care was not sufficient to ensure GP registration and health care utilisation. Some respondents faced difficulties in registering with GP practices. Many of those who have registered prefer to forego GP services in favour of self-medication, partly due to long waiting times and language barriers. To ensure that migrants enjoy the health services they need and to which they are entitled, more proactive steps are required, including those that make health services culturally responsiv

Does Deep Tectonic Tremor Occur in the Central‐Eastern Mediterranean Basin?

Tectonic tremor has been observed at the roots of many fault systems around the Pacific rim, including convergent and transform plate boundaries. The extent to which deep tremor signals are prevalent along fault systems elsewhere, including the Mediterranean basin, has not yet been documented in detail. A body of evidence suggests that tremor triggered during the surface waves of teleseismic events may commonly occur where ambient tremor during episodic tremor and slip episodes occur, suggesting triggered tremor provides a useful tool to identify regions with ambient tremor. We perform a systematic search of triggered tremor associated with large teleseismic events between 2010 and 2020 at four major fault systems within the central-eastern Mediterranean basin, namely the Hellenic and Calabrian subduction zones, and the North Anatolian and Kefalonia transform faults. In addition, we search for ambient tremor during a slow slip event in the eastern Sea of Marmara along a secondary branch of the North Anatolian Fault, and two slow slip events beneath western Peloponnese (Hellenic Subduction Zone). We find no unambiguous evidence for deep triggered tremor, nor ambient tremor. The absence of triggered tremor at the Hellenic and Calabrian subduction zones supports an interpretation of less favorable conditions for tremorgenesis in the presence of old and cold slabs. The absence of tremor along the transform faults may be due to an absence of the conditions commonly promoting tremorgenesis in such settings, including high-fluid pressures and low-differential stresses between the down-dip limit of the seismogenic layer and the continental Moho

Salaries and Fringe Benefits in Computing 1984 report

SIGLEAvailable from British Library Lending Division - LD:8070.5685(1984) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Management of dyslipidaemia in patients with coronary heart disease : Results from the ESC-EORP EUROASPIRE V survey in 27 countries

Background and aims: One of the objectives of the ESC-EORP EUROASPIRE V survey is to determine how well European guidelines on the management of dyslipidaemias are implemented in coronary patients. Methods: Standardized methods were used by trained technicians to collect information on 7824 patients from 130 centers in 27 countries, from the medical records and at a visit at least 6 months after hospitalization for a coronary event. All lipid measurements were performed in one central laboratory. Patients were divided into three groups: on high-intensity LDL-C-lowering-drug therapy (LLT), on low or moderate-intensity LLT and on no LLT. Results: At the time of the visit, almost half of the patients were on a high-intensity LLT. Between hospital discharge and the visit, LLT had been reduced in intensity or interrupted in 20.8% of the patients and had been started or increased in intensity in 11.7%. In those who had interrupted LLT or had reduced the intensity, intolerance to LLT and the advice of their physician were reported as the reason why in 15.8 and 36.8% of the cases, respectively. LDL-C control was better in those on a high-intensity LLT compared to those on low or moderate intensity LLT. LDL-C control was better in men than women and in patients with self-reported diabetes. Conclusions: The results of the EUROASPIRE V survey show that most coronary patients have a less than optimal management of LDL-C. More professional strategies are needed, aiming at lifestyle changes and LLT adapted to the need of the individual patient

Upper Mantle Shear Wave Velocity Structure of Southeastern China: Seismic Evidence for Magma Activities in the Late Mesozoic to the Cenozoic

Abstract The Fujian‐Taiwan Strait‐Taiwan region, as the active eastern margin of Eurasia since the Mesozoic, has experienced the subduction and retreat of the Paleo‐Pacific plate from the Middle Mesozoic, the breakup of the continental margin in the early Cenozoic, and then the collision with the Philippine Sea plate in the late Cenozoic. To better understand the tectonic evolution process, a high‐resolution 3‐D shear wave velocity model of the crust and upper mantle was obtained from surface wave tomography through a direct inversion method. Intermediate‐ to long‐period Rayleigh wave dispersion curves, extracted from teleseismic surface wave with the traditional two‐station method, were combined with the short‐period dispersion curves obtained from ambient noise cross correlation to obtain broader band surface wave data. Two groups of large‐scale low‐velocity bodies are found to be located in the upper mantle of Fujian and the Taiwan Strait and are inferred to be closely related to the magmatic activities caused by the Mesozoic subduction and Cenozoic extension, respectively. The low‐velocity anomalies in Fujian are concentrated in the west Cathaysia block in deep regions and split into small bodies in the uppermost mantle, while the low‐velocity body in the strait is divided into northern and southern parts, corresponding to the two‐stage Cenozoic extension. The velocity gradient was also calculated to estimate the lithospheric thickness, which is only 60–80 km, and the lithosphere‐asthenosphere boundary also features strongly horizontal variations and discontinuities. Our results provide important seismological constraints to investigate the geological and tectonic processes of this region