Search

The article focuses on some of the ways in which the study of Scotland's place-names can inform understanding of the early vocabulary of the Scots and English languages. It also attempts to draw attention to some of the questions regarding the relationship between the Scots lexicon and onomasticon. The author hopes to illustrate the need for greater recognition of the Scottish toponymicon as a national resource for early linguistic history. It cites examples of influential reference works on English place-name vocabulary. It discusses the Germanic toponymicon of Southern Scotland.

The article discusses a prospective assessment of a temporary stroke and transient ischaemic attack clinic in Lothian, Scotland as part of the Scottish Stroke Care Audit. It states that in February 2007, a 24-hour telephone hotline was provided to a medical consultant who gave immediate recommendation on diagnosis, emergency treatment, and investigation for patients suffering from ischaemic attack. It says that the launch of the hotline resulted to a sustained and immediate decrease in delays to treatment and assessment. It adds that the hotline decreased delays to carotid surgery. It notes that the hotline is an effective and feasible way of decreasing delays to treatment and assessment of patients suffering from stroke or ischaemic attack.

Problem: Patients with transient ischaemic attack or stroke benefit from early diagnosis, specialist assessment, and treatment with thrombolysis, and from stroke unit care and secondary prevention. The challenge with such patients is to minimise delays and ensure that treatment is appropriate, and to provide this care with the available resources., Design: An ongoing prospective audit of a transient ischaemic attack and stroke clinic (1 January 2005 to 30 September 2009), as part of the Scottish Stroke Care Audit, and a three month targeted audit of immediate telephone access to a specialist stroke consultant (1 February 2009 to 30 April 2009)., Setting: Stroke and transient ischaemic attack services in Lothian, a region of Scotland with a population of 810,000., Key Measures for Improvement: Delays to assessment at a rapid access transient ischaemic attack and stroke clinic; delays to appropriate treatment., Strategy for Change: In February 2007 we introduced a 24 hours a day, seven days a week hotline to a consultant, who provided immediate advice on diagnosis, investigation, and emergency treatment for patients with transient ischaemic attack or stroke, and suggested the most appropriate care pathway, which might include an early appointment in a transient ischaemic attack and stroke clinic., Effects of Change: The introduction of the hotline was associated with an immediate and sustained reduction in delays to assessment (from 13 to three days) and treatment. The proportion of participants taking statins at the time of visiting the clinic increased from 40% before the introduction of the hotline to 60% after the hotline was in place. Also, the hotline contributed to a reduction in the delay from last event to carotid surgery, from 58 days to 21.5 days. A total of 376 calls were received during the three month audit. Of the 273 (88%) referrers who responded to our questionnaire, 257 (94%) were very satisfied with the advice given over the hotline., Lessons Learnt: Although associated with some disruption to the activities of the consultants, a 24 hours a day, seven days a week telephone hotline to a consultant is a feasible and effective means of reducing delays to specialist assessment and treatment of patients with transient ischaemic attack or stroke.