Training in clinical forensic medicine in the UK--perceptions of current regulatory standards.

PubMed

Stark, Margaret M; Norfolk, Guy A

2011-08-01

As clinical forensic medicine (CFM) is not currently recognised as a speciality in the UK there are no nationally agreed mandatory standards for training forensic physicians in either general forensic (GFM) or sexual offence medicine (SOM). The General Medical Council (GMC), the medical regulator in the UK, has issued clear standards for training in all specialities recommending that "trainees must be supported to acquire the necessary skills and experience through induction, effective educational supervision, an appropriate workload and time to learn". In order to evaluate the current situation in the field of clinical forensic medicine, doctors who have recently (within the last two years) started working in the field "trainees" (n = 38), and trainers (n = 61) with responsibility for clinical and educational supervision of new trainees, were surveyed by questionnaire to gather their perceptions of how the relevant GMC standards are being met in initial on-the-job training. Telephone interviews were performed with eleven doctors working as clinical or medical directors to determine their views. It is clear that currently the quality of training in CFM is sub-standard and inconsistent and that the published standards, as to the minimum requirement for training that must be met by post-graduate medical and training providers at all levels, are not being met. The Faculty of Forensic and Legal Medicine (FFLM) needs to set explicit minimum standards which will comply with the regulator and work to pilot credentialing for forensic physicians. A number of recommendations are made for urgent FFLM development. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

An Investigation of Operational Decision Making in Situ: Incident Command in the U.K. Fire and Rescue Service.

PubMed

Cohen-Hatton, Sabrina R; Butler, Philip C; Honey, Robert C

2015-08-01

The aim of this study was to better understand the nature of decision making at operational incidents in order to inform operational guidance and training. Normative models of decision making have been adopted in the guidance and training for emergency services. In these models, it is assumed that decision makers assess the current situation, formulate plans, and then execute the plans. However, our understanding of how decision making unfolds at operational incidents remains limited. Incident commanders, attending 33 incidents across six U.K. Fire and Rescue Services, were fitted with helmet-mounted cameras, and the resulting video footage was later independently coded and used to prompt participants to provide a running commentary concerning their decisions. The analysis revealed that assessment of the operational situation was most often followed by plan execution rather than plan formulation, and there was little evidence of prospection about the potential consequences of actions. This pattern of results was consistent across different types of incident, characterized by level of risk and time pressure, but was affected by the operational experience of the participants. Decision making did not follow the sequence of phases assumed by normative models and conveyed in current operational guidance but instead was influenced by both reflective and reflexive processes. These results have clear implications for understanding operational decision making as it occurs in situ and suggest a need for future guidance and training to acknowledge the role of reflexive processes. © 2015, Human Factors and Ergonomics Society.

International Students of Speech and Language Therapy in the UK: Do We Meet Their Needs?

ERIC Educational Resources Information Center

Marshall, Julie; Goldbart, Juliet; Evans, Ruth

2004-01-01

Background: Informal evidence suggests that many Speech and Language Therapy (SLT) students from outside of the UK and/or Republic of Ireland who come to the UK either do not return to their home country on qualification or do not practise as SLTs in the public sector. Many factors may contribute to this situation. Concern that it may result in…

A comparison of complication rates based on published haemovigilance data.

PubMed

Flesland, O

2007-06-01

Haemovigilance is defined as the collection of information on complications of transfusion, the analysis of the data, and suggestions for improvement in the transfusion service. A national haemovigilance system is of value in identifying possible areas in need of improvement in the national transfusion system. Haemovigilance becomes even more important if the system is used to compare the situation in one country with the situation in other countries, e.g. if the countries differ significantly in products used. The current study focuses on immunological transfusion complications, especially TRALI, as published in haemovigilance reports from Denmark, Norway, Sweden and the UK. In Norway immunological transfusion reactions occurred 96.7 times per 100 000 red cell (RBC) transfusion, 231.1 times per 100 000 thrombocyte (Trc) concentrate transfusion and five times per 100.000 transfusions of solvent detergent treated plasma (SD plasma). Denmark and the UK have similar rates of transfusion reactions to RBC and fresh frozen plasma (FFP), but quite different for Trc (0.5 vs. 4.9 per 100 000). In 49% of reported TRALI the causative product is FFP, but no case of TRALI after SD plasma transfusion has been reported. When considering all reports for immunological complications in Norway, the most striking is the very small number of reports related to SD plasma. Comparing data from Denmark and the UK shows a big difference in reactions caused by thrombocyte concentrates that may reflect different production methods in the two countries. TRALI is most often caused by FFP, but has never been reported after SD plasma transfusion. Heamovigilance data can be valuable in choosing the safest products available.

Leading Change in Higher Education

ERIC Educational Resources Information Center

McRoy, Ian; Gibbs, Paul

2009-01-01

This article considers the situation in the UK higher education system and investigates specifically the leadership practice in a cluster of UK institutions as they changed their status. The research goes further to advocate a form of contextualized leadership that is relevant to higher institutions under change. (Contains 1 figure.)

Pediatric Drowning: A Standard Operating Procedure to Aid the Prehospital Management of Pediatric Cardiac Arrest Resulting From Submersion.

PubMed

Best, Rebecca R; Harris, Benjamin H L; Walsh, Jason L; Manfield, Timothy

2017-05-08

Drowning is one of the leading causes of death in children. Resuscitating a child following submersion is a high-pressure situation, and standard operating procedures can reduce error. Currently, the Resuscitation Council UK guidance does not include a standard operating procedure on pediatric drowning. The objective of this project was to design a standard operating procedure to improve outcomes of drowned children. A literature review on the management of pediatric drowning was conducted. Relevant publications were used to develop a standard operating procedure for management of pediatric drowning. A concise standard operating procedure was developed for resuscitation following pediatric submersion. Specific recommendations include the following: the Heimlich maneuver should not be used in this context; however, prolonged resuscitation and therapeutic hypothermia are recommended. This standard operating procedure is a potentially useful adjunct to the Resuscitation Council UK guidance and should be considered for incorporation into its next iteration.

Strategic Reflections: Operation Iraqi Freedom, July 2004-February 2007

DTIC Science & Technology

2012-10-01

not pan out. We knew that our mission was ultimately to hand over security responsibility to the Iraqi government, but we had not yet developed a...were “ chicken -egg” discus- sions about whether the security situation had to improve before the political track could begin. I strongly argued that...2005 Lt Gen Nick Houghton (UK), October 2005–February 2006 Lt Gen Rob Fry (UK), March 2006–September 2006 Lt Gen Graham Lamb (UK), September 2006

Questions raised over future of UK research council

NASA Astrophysics Data System (ADS)

Banks, Michael

2010-02-01

Five senior physicists have written to the UK science minister, Lord Drayson, about the "dismal future" for researchers in the country in the wake of a £40m shortfall in the budget of the Science and Technology Facilities Council (STFC). The physicists, who chair the STFC's five advisory panels, have also called for structural reforms to be made to the council. They warn that unless the government takes action to reverse the situation, the UK will be "perceived as an untrustworthy partner in global projects" and predict that a brain drain of the best UK scientists to positions overseas will ensue.

Augmentation of UK Space Debris Observing Capabilities Using Univiersity Optical Telescopes

NASA Astrophysics Data System (ADS)

Herridge, Philip; Brown, David; Crowther, Richard

2013-08-01

The study of space debris requires a range of different sensors. Debris population monitoring requires survey, follow-on and characterisation capable sensors. In order to fully participate in space debris measurement the range of sensors available to the UK Space Agency needs to be augmented with additional capability. One source of untapped resource resides within the UK university sector. This paper discusses investigation into extending the optical sensor diversity available to the UK for participation in study of the debris environment through a collaboration between Space Insight Limited, a commercial company providing Space Situational Awareness (SSA) services to the UK Space Agency, and the Astronomy Group at the University of St Andrews.

The ISB model (infrastructure, service, behaviour): a tool for waste practitioners.

PubMed

Timlett, R; Williams, I D

2011-06-01

In response to the EU Landfill Directive and the challenge of mitigating climate change, the UK government (nationally and locally) must develop strategies and policies to reduce, recycle, compost and recover waste. Best practice services that yield high recycling rates, such as alternate weekly collections, are now largely mainstream in suitable areas. However, national recycling performance is short of what is needed; policy makers must look for innovative ways to meet challenging recycling targets. Increasingly, local authorities are using behaviour change interventions to encourage the public to recycle; these tend to be based on the premise that an individuals' behaviour is predetermined by their values. In practice, this has led to a host of initiatives that attempt to change individuals' behaviour without addressing situational barriers. In this paper, we argue that that a behaviour-centric approach has limited effectiveness. Using an analysis of the literature and studies that investigated recycling participation in the city of Portsmouth, we have identified three significant clusters that can facilitate effective recycling: infrastructure, service and behaviour (ISB). We present the ISB model - a tool that can be used by waste practitioners when planning interventions to maximise recycling to better understand the situation and context for behaviour. Analysis using the ISB model suggests that current best practice, "business as usual" interventions could realistically achieve a national recycling rate of 50%. If the UK is to move towards zero waste, policy makers must look "upstream" for interventions that change the situational landscape. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Education of Asylum Seekers: Some UK Case Studies

ERIC Educational Resources Information Center

Reakes, Angharad

2007-01-01

The body of literature examining the educational needs of asylum-seeker children is limited. Extending the body of knowledge has become increasingly important because of the increasing number of asylum seekers in the UK, with significant implications for local education authorities and schools. The main focus of the research was the situation in…

Corporatisation, Competitiveness, Commercialisation: New Logics in the Globalising of UK Higher Education

ERIC Educational Resources Information Center

Robertson, Susan L.

2010-01-01

This paper examines the changing form and scope of higher education in the UK with a specific focus on contemporary "globalising" developments within the sector and beyond. Situated within an analysis of transformations under way in the wider global and regional economy, and drawing on Jessop's strategic relational approach (SRA), I…

The use of digital imaging, video conferencing, and telepathology in histopathology: a national survey.

PubMed

Dennis, T; Start, R D; Cross, S S

2005-03-01

To undertake a large scale survey of histopathologists in the UK to determine the current infrastructure, training, and attitudes to digital pathology. A postal questionnaire was sent to 500 consultant histopathologists randomly selected from the membership of the Royal College of Pathologists in the UK. There was a response rate of 47%. Sixty four per cent of respondents had a digital camera mounted on their microscope, but only 12% had any sort of telepathology equipment. Thirty per cent used digital images in electronic presentations at meetings at least once a year and only 24% had ever used telepathology in a diagnostic situation. Fifty nine per cent had received no training in digital imaging. Fifty eight per cent felt that the medicolegal implications of duty of care were a barrier to its use. A large proportion of pathologists (69%) were interested in using video conferencing for remote attendance at multidisciplinary team meetings. There is a reasonable level of equipment and communications infrastructure among histopathologists in the UK but a very low level of training. There is resistance to the use of telepathology in the diagnostic context but enthusiasm for the use of video conferencing in multidisciplinary team meetings.

Clinical librarianship in the UK: temporary trend or permanent profession? Part I: a review of the role of the clinical librarian.

PubMed

Sargeant, Sally J E; Harrison, Janet

2004-09-01

This paper is the first of a two-part series of articles presenting the role of the clinical librarian (CL) in the UK today. It situates the CL concept historically, and specifically reports the findings from a study in 2002 (Skinner, The Role of the Clinical Librarian in the UK. MSc Dissertation. Loughborough University: Department of Information Science). The impetus for the 2002 study was the awareness of an increase in job advertisements within the NHS for roles seeking to enhance the practice of evidence-based medicine, which included elements of clinical librarianship. Therefore the research was undertaken to establish whether this increase was coincidental, or the beginning of a new professional role for librarians. A content analysis of CL job advertisements, examining job titles and duties was undertaken. Twenty-three advertisements were scrutinized, and these results are presented here. As a complementary investigation, a postal questionnaire was sent to a sample of practising CLs in the UK. Several duties can be classified as core to the role of the CL. However there is a great diversity of duties attached to this core, reflecting an absence of nationally accepted practice. Further work was necessary to assess current practice and how clinical librarianship can continue to grow at local and national levels. This is addressed in Part Two of this series.

Reframing sociologies of ethnicity and migration in encounters with Chinese London.

PubMed

Knowles, Caroline

2017-09-01

In this paper I argue that the intersecting sociologies of ethnicity and migration work from a series of interconnected blind spots hindering effective analysis of the current UK situation. Both operate analytically within the limitations of an 'immigrant problem' framework; are overinvested in state agendas; privilege a nation state analysis; are narrowly focused on distributions of migrant bodies, and on receiving, at the expense of sending, contexts. Exploring these limitations with data derived from a modest small-scale qualitative study of young Chinese migrants in London, I argue for a reframing along four dimensions. Firstly, in an era of elite migration, sociology could reach beyond its immigrant problem framework and open up to a broader range of UK migrant ethnicities and circumstances. Secondly, a stronger focus on cities as the scale on which lives are lived, and through which diverse streams of translocal activity are routed, would open new avenues of sociological exploration. Thirdly, including translocal activities connected with distributions of ethnic migrant bodies, such as capital transfers, would broaden its focus, taking migration and ethnicity more centrally into the analysis of globalization as one of its constituting practices. Finally, paying attention to sending, as well as arrival cities, reveals migrants' thinking and shapes the ways in which they live, as my data shows. The Chinese are both one of the UK's neglected minorities, and one of its fastest growing populations. They are a good example of new UK migrants and they bring globalization's realignment with the rising significance of China to the UK. © London School of Economics and Political Science 2017.

An Investigation into Dental Local Anaesthesia Teaching in United Kingdom Dental Schools.

PubMed

Oliver, Graham; DavidD, Ailsa; Bell, Christopher; Robb, Nigel

2016-01-01

To review the current teaching of the use and administration of local anaesthesia in United Kingdom dental schools, along with their local guidelines and protocols. A qualitative and quantitative questionnaire was sent to sixteen UK dental schools to probe the methods of local anaesthetic teaching within each school. 14 of the 16 schools replied and the responses show a variety of practices being taught in the dental schools. 2% Lidocaine 1:80,000 Adrenaline is the first choice local anaesthetic solution for the majority of clinical situations. 2% Lidocaine with 1:80,000 Adrenaline remains the gold standard dental local anaesthetic with teaching about its safety and uses in all but a few situations. Most are taught the use of additional aids such as safety syringes and topical anaesthesia. There is variation with regards to the use of alternative anaesthetic agents.

Investigating the sustainability of careers in academic primary care in the United Kingdom.

PubMed

Adams, Ann; Lester, Helen; Reeve, Joanne; Roberts, Jane; Wilson, Andrew

2014-07-01

The UK Society for Academic Primary Care (SAPC) is re-examining the sustainability of careers in academic primary care (APC). The motivation for this is a number of significant changes within the context of APC since the last such investigation (SAPC, 2003). It is now timely to review the current situation. As a first phase, semi-structured interviews were undertaken with 15 SAPC members from different disciplines and career stages. Findings show that lack of clarity about APC career pathways persist, but important factors linked with sustainability were identified at individual and organisational levels. These include being proactive, developing resilience, mentorship and a positive organisational culture with a strong shared vision about why APC is important. FURTHER RESEARCH: Sustainability is undermined by funding difficulties, lack of integration of members of different APC disciplines, leading to disparities in career progression and lack of clarity about what APC is. Phase 2 will comprise a UK-wide survey.

"Right Nutrition, Right Values": The Construction of Food, Youth and Morality in the UK Government 2010-2014

ERIC Educational Resources Information Center

Elliott, Victoria; Hore, Beth

2016-01-01

This paper presents a critical discourse analysis, situated within a broad Foucauldian framework, focusing on the construction of food and eating within the context of youth, schools and education, drawing on speeches, documents and public texts produced or sponsored by members of the UK Coalition Government (2010-2014). Michael Gove, the then…

Homesickness among students in two cultures: antecedents and consequences.

PubMed

Stroebe, Margaret; van Vliet, Tony; Hewstone, Miles; Willis, Hazel

2002-05-01

Review of the theoretical and empirical literature on homesickness showed that despite recent advances, scientific understanding of the impact on students of leaving home for college is still limited. Further empirical investigation using standardized measures, structural equation models and including additional mediating/moderating variables is needed. Two studies were thus conducted, one in the Netherlands, and one in the UK. Homesickness was investigated among recent-intake students, using a newly developed instrument, the Utrecht Homesickness Scale. Variables investigated in relationship to homesickness included depression, personality factors (self-liking, competence, self-esteem) and family situation (attachment to family). Homesickness was found to be a common though differentially prevalent phenomenon (approximately 50% in the Netherlands; 80% in the UK). Structural equation models showed that students missed family and friends and had difficulties adjusting to college life. These difficulties were associated with ruminations about home and loneliness, which themselves were associated with depression. There were differences in intensity (UK students were more homesick) and there were gender differences (UK females experienced more homesickness). Both the personality and family situation factors had an impact on homesickness. The results supported the conceptualization of homesickness as a 'mini-grief', to be viewed from theoretical perspectives in the field of loss and bereavement.

Could situational judgement tests be used for selection into dental foundation training?

PubMed

Patterson, F; Ashworth, V; Mehra, S; Falcon, H

2012-07-13

To pilot and evaluate a machine-markable situational judgement test (SJT) designed to select candidates into UK dental foundation training. Single centre pilot study. UK postgraduate deanery in 2010. Seventy-four candidates attending interview for dental foundation training in Oxford and Wessex Deaneries volunteered to complete the situational judgement test. The situational judgement test was developed to assess relevant professional attributes for dentistry (for example, empathy and integrity) in a machine-markable format. Test content was developed by subject matter experts working with experienced psychometricians. Evaluation of psychometric properties of the pilot situational judgement test (for example, reliability, validity and fairness). Scores in the dental foundation training selection process (short-listing and interviews) were used to examine criterion-related validity. Candidates completed an evaluation questionnaire to examine candidate reactions and face validity of the new test. Forty-six candidates were female and 28 male; mean age was 23.5-years-old (range 22-32). Situational judgement test scores were normally distributed and the test showed good internal reliability when corrected for test length (α = 0.74). Situational judgement test scores positively correlated with the management, leadership and professionalism interview (N = 50; r = 0.43, p <0.01) but not with the clinical skills interview, providing initial evidence of criterion-related validity as the situational judgement test is designed to test non-cognitive professional attributes beyond clinical knowledge. Most candidates perceived the situational judgement test as relevant to dentistry, appropriate for their training level, and fair. This initial pilot study suggests that a situational judgement test is an appropriate and innovative method to measure professional attributes (eg empathy and integrity) for selection into foundation training. Further research will explore the long-term predictive validity of the situational judgement test once candidates have entered training.

Estimating National-scale Emissions using Dense Monitoring Networks

NASA Astrophysics Data System (ADS)

Ganesan, A.; Manning, A.; Grant, A.; Young, D.; Oram, D.; Sturges, W. T.; Moncrieff, J. B.; O'Doherty, S.

2014-12-01

The UK's DECC (Deriving Emissions linked to Climate Change) network consists of four greenhouse gas measurement stations that are situated to constrain emissions from the UK and Northwest Europe. These four stations are located in Mace Head (West Coast of Ireland), and on telecommunication towers at Ridge Hill (Western England), Tacolneston (Eastern England) and Angus (Eastern Scotland). With the exception of Angus, which currently only measures carbon dioxide (CO2) and methane (CH4), the remaining sites are additionally equipped to monitor nitrous oxide (N2O). We present an analysis of the network's CH4 and N2O observations from 2011-2013 and compare derived top-down regional emissions with bottom-up inventories, including a recently produced high-resolution inventory (UK National Atmospheric Emissions Inventory). As countries are moving toward national-level emissions estimation, we also address some of the considerations that need to be made when designing these national networks. One of the novel aspects of this work is that we use a hierarchical Bayesian inversion framework. This methodology, which has newly been applied to greenhouse gas emissions estimation, is designed to estimate temporally and spatially varying model-measurement uncertainties and correlation scales, in addition to fluxes. Through this analysis, we demonstrate the importance of characterizing these covariance parameters in order to properly use data from high-density monitoring networks. This UK case study highlights the ways in which this new inverse framework can be used to address some of the limitations of traditional Bayesian inverse methods.

The use of digital imaging, video conferencing, and telepathology in histopathology: a national survey

PubMed Central

Dennis, T; Start, R D; Cross, S S

2005-01-01

Aims: To undertake a large scale survey of histopathologists in the UK to determine the current infrastructure, training, and attitudes to digital pathology. Methods: A postal questionnaire was sent to 500 consultant histopathologists randomly selected from the membership of the Royal College of Pathologists in the UK. Results: There was a response rate of 47%. Sixty four per cent of respondents had a digital camera mounted on their microscope, but only 12% had any sort of telepathology equipment. Thirty per cent used digital images in electronic presentations at meetings at least once a year and only 24% had ever used telepathology in a diagnostic situation. Fifty nine per cent had received no training in digital imaging. Fifty eight per cent felt that the medicolegal implications of duty of care were a barrier to its use. A large proportion of pathologists (69%) were interested in using video conferencing for remote attendance at multidisciplinary team meetings. Conclusions: There is a reasonable level of equipment and communications infrastructure among histopathologists in the UK but a very low level of training. There is resistance to the use of telepathology in the diagnostic context but enthusiasm for the use of video conferencing in multidisciplinary team meetings. PMID:15735155

Time to ditch non-SI units in physics teaching?

NASA Astrophysics Data System (ADS)

Atkin, Keith

2015-08-01

The current use of two sets of units in the UK continues to be a source of muddle and confusion. Young people are taught metric (SI) units in school but, in the outside world, still have to contend with units such as inches, feet, pounds, stones and miles. Specialist teachers and practitioners of the sciences are not blameless. This paper considers the fact that some units commonly used in physics, astronomy, and physics education are unnecessary, involve time-wasting conversions and frequently lead to confusion or even error. This unsatisfactory situation is illustrated by examples, and suggestions are made for a radical improvement.

Applicant Reactions to a Situational Judgment Test Used for Selection into Initial Teacher Training

ERIC Educational Resources Information Center

Klassen, Robert M.; Durksen, Tracy L.; Rowett, Emma; Patterson, Fiona

2014-01-01

We considered applicants' perceptions of the use of a pilot situational judgment test (SJT) designed for selection into primary and secondary teacher training programs in the UK. Quantitative and qualitative data were collected from 304 applicants (73% female) to two postgraduate (PGCE) training programs in the 2013-2014 application cycle.…

Cross-cultural sex differences in situational triggers of aggressive responses.

PubMed

Zajenkowska, Anna; Mylonas, Kostas; Lawrence, Claire; Konopka, Karolina; Rajchert, Joanna

2014-10-01

This paper examines male and female individual differences in situational triggers of aggressive responses (STAR) in three countries as well as cross-cultural sex differences in trait aggression (aggression questionnaire, AQ). Convenience sampling was employed (university students) for the descriptive correlational study (Poland N = 300, 63% female, mean age 21.86, SD = 2.12; UK N = 196, 60% female, mean age 20.48, SD = 3.79; Greece N = 299, 57% female, mean age 20.71, SD = 4.42). The results showed that the STAR scale is an equivalent construct across all three countries. Overall, females were more sensitive to both provocation (SP) and frustration (SF) than males. When controlling for trait aggression, Polish and Greek females scored similarly in SP and higher than UK females. No sex differences in SP or SF were found in the UK sample. Additionally, Polish participants scored the highest in SP. Furthermore, when trait aggression was removed, the Greek participants were most sensitive to frustration, whereas Polish and English participants' SF did not differ. We discuss the results with regard to intercultural differences between investigated countries. © 2014 International Union of Psychological Science.

Pre-market version of a commercially available hearing instrument with a tinnitus sound generator: feasibility of evaluation in a clinical trial.

PubMed

Sereda, Magdalena; Davies, Jeff; Hall, Deborah A

2017-04-01

This report considers feasibility of conducting a UK trial of combination devices for tinnitus, using data from the study which evaluated different listener programmes available within the pre-market version of Oticon Alta with Tinnitus Sound Generator. Open and closed questions addressed the following feasibility issues: (1) Participant recruitment; (2) Device acceptability; (3) Programme preferences in different self-nominated listening situations; (4) Usability; (5) Compliance; (6) Adverse events. Eight current combination hearing aid users (all males) aged between 62-72 years (mean age 67.25 years, SD = 3.8). All eight participants reported the physical aspects and noise options on the experimental device to be acceptable. Programmes with amplification and masking features were equally preferred over the basic amplification-only programme. Individual preferences for the different programme options varied widely, both across participants and across listening situations. A set of recommendations for future trials were formulated which calls for more "real world" trial design rather than tightly controlling the fitting procedure.

Human Computer Collaboration at the Edge: Enhancing Collective Situation Understanding with Controlled Natural Language

DTIC Science & Technology

2016-09-06

settled all but question 36 which was: ‘What sport does Capt Falcon play?’ and answers conflicted because some players used the name ‘soccer’ while others...email: PreeceAD@cardiff.ac.uk †Emerging Technology Services, IBM United Kingdom Ltd, Hursley Park, Winchester, UK ‡US Army Research Laboratory, Human... Research and Engineering Directorate, Aberdeen Proving Ground, USA Abstract—Effective coalition operations require support for dynamic information

Equality of Opportunity and Vocational Training. Creation and Management of Enterprises by Women. The Situation in the United Kingdom. Rapport National Royaume-Uni. Synthesis Report.

ERIC Educational Resources Information Center

May, Annie

This document contains three reports: (1) a report on women entrepreneurs in the United Kingdom (UK) in English; (2) the same report in French; and (3) a synthesis report of 12 national reports and 4 related reports. The report on women entrepreneurs in the UK includes an introduction, a description of the methodology, five sections of findings,…

Current trends, examples of regulations and practical approaches to occupational health services in the United Kingdom.

PubMed

Aw, T C

2001-01-01

Occupational health services in the United Kingdom are evolving from the traditional approach using doctor and nurses to provide clinical care at the worksite for any medical ailment, to multidisciplinary occupational health practitioners focussing on the prevention of ill-health from workplace factors. Nevertheless, there continues to be an artificial divide between safety departments and occupational health departments within the same organisation. Many occupational health services focus on the need to comply with the requirements of health and safety legislation. In the UK, these include the Health and Safety at Work, etc. Act of 1974, the Control of Substances Hazardous to Health, the 1994 regulations, and a newer legislation based on the European Union Directives. A practical approach to providing occupational health cover has been the development of occupational health departments within the public healthcare sector, private occupational health service providers, and independent consultants. These are some similarities between the UK situation and other countries in the models used for providing occupational health care. The appropriate model for any country would depend on their perceived needs, resources, industries and hazards.

The need for leadership and vision in dentistry. A personal view.

PubMed

Holt, Vernon P

2008-07-01

This paper considers how dentistry has developed in the United Kingdom (UK) over the last 60 years and concludes that dentists have failed to be proactive and to shape the systems for the delivery of an optimal level of care to the population. It suggests that there is a need for far better leadership and for dentists, as individuals and as a profession, to rediscover the sense of vision that they once had and to shape their destinies, rather than accepting the current situation. The author goes on to explain how this might be done. Since the inception of the National Health Service (NHS), the dental profession in the UK has, to a large extent, been dominated by the politics of the NHS, by changing fee structures and contracts, by reports from the Review Body on Doctors' and Dentists' Remuneration (DDRB), and by strategies adopted by successive governments, especially during the last two decades. These strategies have resulted in cohorts of disillusioned dental practitioners reducing their commitment to, or opting out of, NHS contracts and committing themselves, to a greater or lesser extent, to private practice. It is now over three years since, for the first time, the proportion of dentistry provided under private contact in the UK, as measured by gross fees, exceeded that provided under NHS contract. The profession has shown a remarkable lack of imagination in organising itself to provide the best kind of care for patients. Instead of being proactive and visionary, it has allowed itself to become a political football. This has led to the progressive deskilling of many practitioners, and a manifest failure to secure the long-term oral health of patients. This paper considers how the situation could be improved and looks at four aspects, which are: 1. 21st century dentistry: state of the art versus reality? The contrast between what is clinically possible and what the profession currently delivers. 2. What are we here for? The need for a new vision for dentistry, the profession and the future, and the need for a new sense of mission. 3. A responsibility for the profession. The responsibility of the profession for providing patients (and funding bodies) with advice. 4. Leading the way: a new-look personal development plan. The personal development needs of dentists, with much more emphasis on interpersonal and leadership skills.

Awareness and attitudes towards organ donation and transplantation among the asian population. A preliminary survey in Luton, UK.

PubMed

Darr, A; Randhawa, G

1999-01-01

Currently the demand for transplant organs, particularly kidneys, far outstrips the supply in the UK. This problem is particularly severe for the Asian population, which has been shown to have a disproportionately large representation on kidney-transplant waiting lists in some regions of the UK. The situation is clear: there is an urgent need to address the number of Asians requiring a kidney transplant, otherwise the human and economic costs will be very high. An exploratory qualitative study was therefore undertaken with the aim of assessing current awareness of organ donation and transplantation and to explore attitudes towards these issues in a cross section of the Asian population in Luton. It was found that nearly half of the respondents in this survey did not know what a donor card was used for, and approximately half of these had never seen one; only 6 of the 64 people interviewed had heard of the National Donor Register. Of the three people who carried a donor card, two had an immediate family member who had received a transplant. This suggests that media campaigns aimed at attracting donors from the Asian population have had limited success thus far. It appears that the vast majority of the Asian population is at the initial stage of the process of making a decision about donating their organs, that of simply knowing that transplantation takes place. Very little debate of pertinent issues seems to have taken place, which is essential for reaching a decision on whether or not to donate an organ. The study should be seen as exploratory but is nonetheless an important initial step towards the establishment of a greater knowledge and understanding of the issues affecting the low donation rate in the Asian population.

Magnetic Moments in the Past: developing archaeomagnetic dating in the UK

NASA Astrophysics Data System (ADS)

Outram, Zoe; Batt, Catherine M.; Linford, Paul

2010-05-01

Magnetic studies of archaeological materials have a long history of development in the UK and the data produced by these studies is a key component of global models of the geomagnetic field. However, archaeomagnetic dating is not a widely used dating technique in UK archaeology, despite the potential to produce archaeologically significant information that directly relates to human activity. This often means that opportunities to improve our understanding of the past geomagnetic field are lost, because archaeologists are unaware of the potential of the method. This presentation discusses a project by the University of Bradford, UK and English Heritage to demonstrate and communicate the potential of archaeomagnetic dating of archaeological materials for routine use within the UK. The aims of the project were achieved through the production of a website and a database for all current and past archaeomagnetic studies carried out in the UK. The website provides archaeologists with the information required to consider the use of archaeomagnetic dating; including a general introduction to the technique, the features that can be sampled, the precision that can be expected from the dates and how much it costs. In addition, all archaeomagnetic studies carried out in the UK have been collated into a database, allowing similar studies to be identified on the basis of the location of the sites, the archaeological period and type of feature sampled. This clearly demonstrates how effective archaeomagnetic dating has been in different archaeological situations. The locations of the sites have been mapped using Google Earth so that studies carried out in a particular region, or from a specific time period can be easily identified. The database supports the continued development of archaeomagnetic dating in the UK, as the data required to construct the secular variation curves can be extracted easily. This allows the curves to be regularly updated following the production of new magnetic measurements. The information collated within the database will also be added to the global databases, such as MaGIC, contributing the improvement of the global models of the geomagnetic field. This project demonstrates the benefits that the presentation of clear, accessible information and increased communication with archaeologists can have on the study of the geomagnetic field. It is also hoped that similar approaches will beintroduced on a wider geographical scale in the future.

Training Metacognitive Skills for Situation Assessment

DTIC Science & Technology

1994-06-01

see Toulmin , 1978). The initial recognitional response to a cue provides its normal meaning. For example, the absence of enemy artillery within...Holland. Toulmin , S. (1958). The uses of argument. Cambridge, UK: Cambridge University Press.

How midwives' discursive practices contribute to the maintenance of the status quo in English maternity care.

PubMed

Pollard, Katherine C

2011-10-01

poor relationships between maternity care professionals still contribute to poor outcomes for childbearing women, although issues concerning power, gender, professionalism and the medicalisation of birth have been identified and discussed as germane to this situation for nearly three decades. Although power relationships and communication issues are known to affect the way maternity care professionals in the UK work together, there has been no study of the interplay between these factors, or of how semiotic aspects of professionals' communication relate to it. to explore how National Health Service midwives' discursive practices relate to the status quo; that is, how they contribute either to maintaining or challenging traditional discourses concerning power, gender, professionalism and the medicalisation of birth. in a qualitative study within a critical discourse analysis framework, data were collected from maternity care professionals and women within one English maternity unit, through semi-structured interviews and observation of physical behaviour and naturally occurring conversation. midwives in the unit revealed an inconsistent professional identity, sometimes challenging established hierarchies and power relationships, but often reinforcing traditional notions of gender, professionalism and the medicalisation of birth through their discursive practices. given the known effect of wider social factors on maternity care, it is not surprising that the status quo persists, and that problems linked to these factors are still commonplace. This situation is compounded by the conflicting obligations under which UK midwives are forced to practice. These findings may have implications for midwives' capacity to respond to current challenges facing the profession. Copyright © 2010 Elsevier Ltd. All rights reserved.

Assessment of the risk of introduction of H5N1 HPAI virus from affected countries to the U.K.

PubMed

Sabirovic, M; Hall, S; Wilesmith, J; Grimley, P; Coulson, N; Landeg, F

2007-03-01

The Department for Environment, Food and Rural Affairs (Defra) has monitored epidemiologic developments following outbreaks of H5N1 in Asia since the beginning of 2004 and publishes risk assessments as the situation evolves. The U.K. applies safeguard measures that reflect EU rules to enable imports to continue when they present negligible risk. Defra risk assessments (RA) identify possible pathways by which the H5N1 virus may be introduced to the U.K. These assessments provide a basis for identifying appropriate surveillance activities to ensure early detection, should the virus be introduced, and disease control measures to be taken, should the virus be detected in the U.K. Nevertheless, these assessments have highlighted that many fundamental uncertainties still remain. These uncertainties center on the geographic and species distribution of infection outside Asia and the means of dissemination of the virus. However, the evolving developments demonstrated that regulatory decisions had to be made despite these uncertainties. Improvements in our current RA abilities would greatly benefit from systematic studies to provide more information on the species susceptibility, dynamics of infection, pathogenesis, and ecology of the virus along with possible pathways by which the H5N1 virus may be disseminated. Such an approach would assist in reducing uncertainties and ensuring that regulatory risk management measures are regularly reviewed by taking into account the most recent scientific evidence. The likelihood of the persistence of H5N1 outside Asia in the coming years and the effects of control programs in Asia and other affected regions to reduce the prevalence of infection are also important factors.

Verifying the UK N_{2}O emission inventory with tall tower measurements

NASA Astrophysics Data System (ADS)

Carnell, Ed; Meneguz, Elena; Skiba, Ute; Misselbrook, Tom; Cardenas, Laura; Arnold, Tim; Manning, Alistair; Dragosits, Ulli

2016-04-01

Nitrous oxide (N2O) is a key greenhouse gas (GHG), with a global warming potential ˜300 times greater than that of CO2. N2O is emitted from a variety of sources, predominantly from agriculture. Annual UK emission estimates are reported, to comply with government commitments under the United Nations Framework Convention on Climate Change (UNFCCC). The UK N2O inventory follows internationally agreed protocols and emission estimates are derived by applying emission factors to estimates of (anthropogenic) emission sources. This approach is useful for comparing anthropogenic emissions from different countries, but does not capture regional differences and inter-annual variability associated with environmental factors (such as climate and soils) and agricultural management. In recent years, the UK inventory approach has been refined to include regional information into its emissions estimates (e.g. agricultural management data), in an attempt to reduce uncertainty. This study attempts to assess the difference between current published inventory methodology (default IPCC methodology) and a revised approach, which incorporates the latest thinking, using data from recent work. For 2013, emission estimates made using the revised approach were 30 % lower than those made using default IPCC methodology, due to the use of lower emission factors suggested by recent projects (www.ghgplatform.org.uk, Defra projects: AC0116, AC0213 and MinNO). The 2013 emissions estimates were disaggregated on a monthly basis using agricultural management (e.g. sowing dates), climate data and soil properties. The temporally disaggregated emission maps were used as input to the Met Office atmospheric dispersion model NAME, for comparison with measured N2O concentrations, at three observation stations (Tacolneston, E England; Ridge Hill, W England; Mace Head, W Ireland) in the UK DECC network (Deriving Emissions linked to Climate Change). The Mace Head site, situated on the west coast of Ireland, was used to establish baseline concentrations. The trends in the modelled data were found to fit with the observational data trends, with concentration peaks coinciding with periods of fertiliser application and land spreading of manures. The model run using the 'experimental' approach was found to give a closer agreement with the observed data.

Potential for long-term, high-frequency, high-precision methane isotope measurements to improve UK emissions estimates

NASA Astrophysics Data System (ADS)

Rennick, Chris; Bausi, Francesco; Arnold, Tim

2017-04-01

On the global scale methane (CH4) concentrations have more than doubled over the last 150 years, and the contribution to the enhanced greenhouse effect is almost half of that due to the increase in carbon dioxide (CO2) over the same period. Microbial, fossil fuel, biomass burning and landfill are dominant methane sources with differing annual variabilities; however, in the UK for example, mixing ratio measurements from a tall tower network and regional scale inversion modelling have thus far been unable to disaggregate emissions from specific source categories with any significant certainty. Measurement of the methane isotopologue ratios will provide the additional information needed for more robust sector attribution, which will be important for directing policy action Here we explore the potential for isotope ratio measurements to improve the interpretation of atmospheric mixing ratios beyond calculation of total UK emissions, and describe current analytical work at the National Physical Laboratory that will realise deployment of such measurements. We simulate isotopic variations at the four UK greenhouse gas tall tower network sites to understand where deployment of the first isotope analyser would be best situated. We calculate the levels of precision needed in both δ-13C and δ-D in order to detect particular scenarios of emissions. Spectroscopic measurement in the infrared by quantum cascade laser (QCL) absorption is a well-established technique to quantify the mixing ratios of trace species in atmospheric samples and, as has been demonstrated in 2016, if coupled to a suitable preconcentrator then high-precision measurements are possible. The current preconcentration system under development at NPL is designed to make the highest precision measurements yet of the standard isotope ratios via a new large-volume cryogenic trap design and controlled thermal desorption into a QCL spectrometer. Finally we explore the potential for the measurement of clumped isotopes at high frequency and precision. The doubly-substituted 13CH3D isotopologue is a tracer for methane formed at geological temperatures, and will provide additional information for identification of these sources.

Representing situation awareness in collaborative systems: a case study in the energy distribution domain.

PubMed

Salmon, P M; Stanton, N A; Walker, G H; Jenkins, D; Baber, C; McMaster, R

2008-03-01

The concept of distributed situation awareness (DSA) is currently receiving increasing attention from the human factors community. This article investigates DSA in a collaborative real-world industrial setting by discussing the results derived from a recent naturalistic study undertaken within the UK energy distribution domain. The results describe the DSA-related information used by the networks of agents involved in the scenarios analysed, the sharing of this information between the agents and the salience of different information elements used. Thus, the structure, quality and content of each network's DSA is discussed, along with the implications for DSA theory. The findings reinforce the notion that when viewing situation awareness (SA) in collaborative systems, it is useful to focus on the coordinated behaviour of the system itself, rather than on the individual as the unit of analysis and suggest that the findings from such assessments can potentially be used to inform system, procedure and training design. SA is a critical commodity for teams working in industrial systems and systems, procedures and training programmes should be designed to facilitate efficient system SA acquisition and maintenance. This article presents approaches for describing and understanding SA during real-world collaborative tasks, the outputs from which can potentially be used to inform system, training programmes and procedure design.

Synthetic biology in the view of European public funding organisations

PubMed Central

Pei, Lei; Gaisser, Sibylle; Schmidt, Markus

2012-01-01

We analysed the decisions of major European public funding organisations to fund or not to fund synthetic biology (SB) and related ethical, legal and social implication (ELSI) studies. We investigated the reaction of public organisations in six countries (Austria, France, Germany, the Netherlands, Switzerland and the UK) towards SB that may influence SB’s further development in Europe. We examined R&D and ELSI communities and their particular funding situation. Our results show that the funding situation for SB varies considerably among the analysed countries, with the UK as the only country with an established funding scheme for R&D and ELSI that successfully integrates these research communities. Elsewhere, we determined a general lack of funding (France), difficulties in funding ELSI work (Switzerland), lack of an R&D community (Austria), too small ELSI communities (France, Switzerland, Netherlands), or difficulties in linking existing communities with available funding sources (Germany), partly due to an unclear SB definition. PMID:22586841

Synthetic biology in the view of European public funding organisations.

PubMed

Pei, Lei; Gaisser, Sibylle; Schmidt, Markus

2012-02-01

We analysed the decisions of major European public funding organisations to fund or not to fund synthetic biology (SB) and related ethical, legal and social implication (ELSI) studies. We investigated the reaction of public organisations in six countries (Austria, France, Germany, the Netherlands, Switzerland and the U.K.) towards SB that may influence SB's further development in Europe. We examined R&D and ELSI communities and their particular funding situation. Our results show that the funding situation for SB varies considerably among the analysed countries, with the U.K. as the only country with an established funding scheme for R&D and ELSI that successfully integrates these research communities. Elsewhere, we determined a general lack of funding (France), difficulties in funding ELSI work (Switzerland), lack of an R&D community (Austria), too small ELSI communities (France, Switzerland, Netherlands), or difficulties in linking existing communities with available funding sources (Germany), partly due to an unclear SB definition.

Implications of genetic testing for the insurance industry: the UK example.

PubMed

Raeburn, Sandy

2002-01-01

This report summarises the controversy of genetic tests and insurance, with a focus on the UK situation during the past decade. UK experience provides insight for future strategies to help people with genetic disadvantages make insurance provision for themselves and their families. Non-disclosure of genetic test results (already carried out for clinical purposes) may not benefit people at risk of genetic disorders or with positive genetic tests. The pressure of geneticists over a decade to prevent disclosure to insurers may have masked opportunities to use insurance to provide help for people with genetic disadvantages. To seize the opportunities now, there must be collaboration, not conflict. Politicians, geneticists, social scientists and all elements of the insurance industry can contribute to wise solutions.

Scheduling terminology for oral and maxillofacial surgery. Are we speaking a universal language?

PubMed

Howe, T E; Varley, I; Allen, J E; Glossop, A; McKechnie, A

2017-05-01

Use of a universal vocabulary to assist with the scheduling of operations has been shown to considerably reduce delays and improve the use of theatre resources. Within the UK the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) has established a classification to assist with the triage of both emergency and non-emergency operating lists. We completed a survey to assess the uptake and understanding of this classification when scheduling maxillofacial operations. From a list of eight scheduling terms, respondents had to choose one each for 20 different clinical situations (that represented equally) immediate, urgent, expedited, and elective operations as defined by them. A total of 50 surveys were collated. Only 65% of answers selected represented NCPOD terms. 25% of answers represented a term higher and 18% a term lower, on the scale of intervention for the same category of situation. Current NCEPOD terms do not seem to be used universally and are poorly understood. Considerable variation in terminology exists when scheduling maxillofacial operations. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Western Australian school students' understanding of biotechnology

NASA Astrophysics Data System (ADS)

Dawson, Vaille; Schibeci, Renato

2003-01-01

Are science educators providing secondary school students with the background to understand the science behind recent controversies such as the recently introduced compulsory labelling of genetically modified foods? Research from the UK suggests that many secondary school students do not understand the processes or implications of modern biotechnology. The situation in Australia is unclear. In this study, 1116 15-year-old students from eleven Western Australian schools were surveyed to determine their understanding of, and attitude towards, recent advances in modern biotechnology. The results indicate that approximately one third of students have little or no understanding of biotechnology. Many students over-estimate the use of biotechnology in our society by confusing current uses with possible future applications. The results provide a rationale for the inclusion of biotechnology, a cutting edge science, in the school science curriculum

Assessment Is for Learning: Supporting Feedback

ERIC Educational Resources Information Center

McLaren, Susan V.

2012-01-01

This paper describes an action research, school situated project conducted with partnership funding from Learning and Teaching Scotland, Scottish Qualifications Authority and Becta, the UK government's agency for communications technology in education. Based on "e-scape" (e-solutions for creative assessment in portfolio environments),…

Natural flood management in Southwell (Nottinghamshire, UK): an interdisciplinary approach in a rural-urban catchment

NASA Astrophysics Data System (ADS)

Wells, Josh; Labadz, Jillian; Islam, Mofa; Smith, Amanda; Disney, Andrew; Thorne, Colin

2017-04-01

The town of Southwell (Nottinghamshire, UK) is situated within a rural catchment and has experienced multiple flood events. In summer 2013 an extreme event occurred in which 107.6mm of rain fell within two hours, flooding up to 300 homes. As a result, a voluntary flood action group was established in the community (Southwell Flood Forum). An experimental natural flood management research project has been developed within the Potwell Dyke catchment (above Southwell). This has led to the creation of a catchment partnership of relevant stakeholders (academics, community, statutory bodies, local government and conservation organisations). Prior to intervention, water level monitoring was installed at five locations and flows were gauged for approximately one year. Rainfall data are available from the university weather station within the catchment. Ten large woody debris dams were installed on two of the streams within the catchment in summer 2016. In November, a stream restoration took place to reinstate historic meanders and create online storage in a previously ditched channel reach, together with the construction of five earth bunds in the corners of the fields. These interventions are designed to store and slow water whilst promoting ecological gains. The research takes an interdisciplinary approach. The aims are to assess the extent to which natural food management (NFM) can reduce fluvial flood occurrence but also identify and analyse current barriers to NFM uptake. Interviews with landowners in the catchment have taken place. Practitioners have also been interviewed in order to discuss the barriers to current uptake from an industry perspective. This study therefore not only addresses the evidence gap but also draws upon current barriers to advise future NFM projects. This paper will present preliminary findings from the hydrological monitoring and summarise barriers identified and lessons learned from stakeholder engagement activities.

Environmental & economic life cycle assessment of current & future sewage sludge to energy technologies.

PubMed

Mills, N; Pearce, P; Farrow, J; Thorpe, R B; Kirkby, N F

2014-01-01

The UK Water Industry currently generates approximately 800GWh pa of electrical energy from sewage sludge. Traditionally energy recovery from sewage sludge features Anaerobic Digestion (AD) with biogas utilisation in combined heat and power (CHP) systems. However, the industry is evolving and a number of developments that extract more energy from sludge are either being implemented or are nearing full scale demonstration. This study compared five technology configurations: 1 - conventional AD with CHP, 2 - Thermal Hydrolysis Process (THP) AD with CHP, 3 - THP AD with bio-methane grid injection, 4 - THP AD with CHP followed by drying of digested sludge for solid fuel production, 5 - THP AD followed by drying, pyrolysis of the digested sludge and use of the both the biogas and the pyrolysis gas in a CHP. The economic and environmental Life Cycle Assessment (LCA) found that both the post AD drying options performed well but the option used to create a solid fuel to displace coal (configuration 4) was the most sustainable solution economically and environmentally, closely followed by the pyrolysis configuration (5). Application of THP improves the financial and environmental performance compared with conventional AD. Producing bio-methane for grid injection (configuration 3) is attractive financially but has the worst environmental impact of all the scenarios, suggesting that the current UK financial incentive policy for bio-methane is not driving best environmental practice. It is clear that new and improving processes and technologies are enabling significant opportunities for further energy recovery from sludge; LCA provides tools for determining the best overall options for particular situations and allows innovation resources and investment to be focused accordingly. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Use of non‐invasive ventilation in UK emergency departments

PubMed Central

Browning, J; Atwood, B; Gray, A

2006-01-01

Aim To describe the current use of non‐invasive ventilation in UK emergency departments. Methods A structured questionnaire was sent to all UK emergency departments assessing 25,000 new patients annually. Results 222 of 233 departments completed the questionnaire. 148 currently use non‐invasive ventilation (NIV). Most used NIV for either cardiogenic pulmonary oedema (n = 128) or chronic obstructive pulmonary disease (n = 115). Only 49 departments have protocols for NIV use and 23 audited practice. Conclusion NIV is commonly used in UK emergency departments. Practices vary significantly. One solution would be the development of guidelines on when and how to use NIV in emergency medicine practice. PMID:17130599

Application of the Commission's recommendations: the 2013-2017 Committee 4 programme of work.

PubMed

Lochard, J

2015-06-01

Committee 4 of the International Commission on Radiological Protection (ICRP) is responsible for developing principles, recommendations, and guidance on the protection of people against radiation exposure, and to consider their practical application in all exposure situations. Currently, the Committee's efforts are focused on the completion of a series of future ICRP publications on the implementation of its 2007 Recommendations to the various existing exposure situations. A report on protection against radon exposure was published recently (ICRP Publication 126), and two documents on protection against cosmic radiation in aviation, and naturally occurring radioactive material are under development. The programme of work for the forthcoming 2013-2017 period comprises the update of ICRP Publication 109 on protection of people in emergency exposure situations, and the update of ICRP Publication 111 on protection of people living in long-term contaminated areas after a nuclear accident, as well as the development of a future ICRP publication on the ethics of radiological protection. It also includes the preparation of task groups on the application of the Commission's recommendations for contaminated sites from past activities and for surface and near-surface disposal of radioactive waste. Another important task for Committee 4 will be to develop a reflection on the tolerability of risk from radiation. © The International Society for Prosthetics and Orthotics Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Combining dispersion modelling with synoptic patterns to understand the wind-borne transport into the UK of the bluetongue disease vector

NASA Astrophysics Data System (ADS)

Burgin, Laura; Ekström, Marie; Dessai, Suraje

2017-07-01

Bluetongue, an economically important animal disease, can be spread over long distances by carriage of insect vectors ( Culicoides biting midges) on the wind. The weather conditions which influence the midge's flight are controlled by synoptic scale atmospheric circulations. A method is proposed that links wind-borne dispersion of the insects to synoptic circulation through the use of a dispersion model in combination with principal component analysis (PCA) and cluster analysis. We illustrate how to identify the main synoptic situations present during times of midge incursions into the UK from the European continent. A PCA was conducted on high-pass-filtered mean sea-level pressure data for a domain centred over north-west Europe from 2005 to 2007. A clustering algorithm applied to the PCA scores indicated the data should be divided into five classes for which averages were calculated, providing a classification of the main synoptic types present. Midge incursion events were found to mainly occur in two synoptic categories; 64.8% were associated with a pattern displaying a pressure gradient over the North Atlantic leading to moderate south-westerly flow over the UK and 17.9% of the events occurred when high pressure dominated the region leading to south-easterly or easterly winds. The winds indicated by the pressure maps generally compared well against observations from a surface station and analysis charts. This technique could be used to assess frequency and timings of incursions of virus into new areas on seasonal and decadal timescales, currently not possible with other dispersion or biological modelling methods.

Verifying the UK agricultural N2O emission inventory with tall tower measurements

NASA Astrophysics Data System (ADS)

Carnell, E. J.; Meneguz, E.; Skiba, U. M.; Misselbrook, T. H.; Cardenas, L. M.; Arnold, T.; Manning, A.; Dragosits, U.

2016-12-01

Nitrous oxide (N2O) is a key greenhouse gas (GHG), with a global warming potential 300 times greater than that of CO2. N2O is emitted from a variety of sources, predominantly from agriculture. Annual UK emission estimates are reported, to comply with government commitments under the United Nations Framework Convention on Climate Change (UNFCCC). The UK N2O inventory follows internationally agreed protocols and emission estimates are derived by applying emission factors to estimates of (anthropogenic) emission sources. This approach is useful for comparing anthropogenic emissions from different countries, but does not capture regional differences and inter-annual variability associated with environmental factors (such as climate and soils) and agricultural management. In recent years, the UK inventory approach has been refined to include regional information into its emissions estimates, in an attempt to reduce uncertainty. This study attempts to assess the difference between current published inventory methodology (default IPCC methodology) and an alternative approach, which incorporates the latest thinking, using data from recent work. For 2013, emission estimates made using the alternative approach were 30 % lower than those made using default IPCC methodology, due to the use of lower emission factors suggested by recent projects (Defra projects: AC0116, AC0213 and MinNO). The 2013 emissions estimates were disaggregated on a monthly basis using agricultural management (e.g. sowing dates), climate data and soil properties. The temporally disaggregated emission maps were used as input to the Met Office atmospheric dispersion model NAME, for comparison with measured N2O concentrations, at three observation stations (Tacolneston, E. England; Ridge Hill, W. England; Mace Head, W. Ireland) in the UK DECC network (Deriving Emissions linked to Climate Change). The Mace Head site, situated on the west coast of Ireland, was used to establish baseline concentrations. The trends in the modelled data were found to correspond with the observational data trends, with concentration peaks coinciding with periods of land spreading of manures and fertiliser application. The model run using the default IPCC methodology was found to correspond with the observed data more closely than the alternative approach.

UK Schools, CCTV and the Data Protection Act 1998

ERIC Educational Resources Information Center

Taylor, Emmeline

2011-01-01

The use of CCTV in schools is now commonplace in the UK. It is estimated that 85% of all UK secondary schools currently have CCTV systems in operation. The introduction of the Data Protection Act 1998 (DPA) (enacted in March 2000) meant that for the first time CCTV had direct legislation governing its use in the UK. This paper attempts to apply…

Psycho-Cultural Analysis of Disaster Risk Attitudes in Situation Awareness

DTIC Science & Technology

2013-09-01

the American Geophysical Union called for greater resilience in facing such hazards which would curb damages and economic losses (Lewis, 2012). Most of...Reduction and Climate Change Adaptation. Rugby , UK: Practical Action Publishing, ISBN 978-1-85339-786-8. UNISDR (2009). Terminology on Disaster Risk

Reaching across Continents: Engaging Students through Virtual Collaborations

ERIC Educational Resources Information Center

Wilmot, Natalie Victoria; Rushton, Diane; Zandona Hofmann, Anelise Seleme

2016-01-01

Business schools have the responsibility of preparing students for work in multicultural organisations and global markets. This paper examines a situated learning experience for undergraduates through a virtual collaboration between a UK university and a Brazilian university. This facilitated remote communication using social media and smart…

Can the UK's birth registration system better serve the interests of those born following collaborative assisted reproduction?

PubMed

Crawshaw, Marilyn A; Blyth, Eric D; Feast, Julia

2017-06-01

Current birth registration systems fail to serve adequately the interests of those born as a result of gamete and embryo donation and surrogacy. In the UK, changes to the birth registration system have been piecemeal, reactive and situation-specific and no information is recorded about gamete donors. Birth registration has thereby become a statement of legal parentage and citizenship only, without debate as to whether it should serve any wider functions. This sits uneasily with the increasingly accepted human right to know one's genetic and gestational as well as legal parents, and the duty of the State to facilitate that right. This commentary sets out one possible model for reform to better ensure that those affected become aware of, and/or have access to, knowledge about their origins and that such information is stored and released effectively without compromising individual privacy. Among other features, our proposal links the birth registration system and the information stored in the Human Fertilization and Embryology Authority's Register of Information, although further work than we have been able to undertake here is necessary to ensure a better fit where cross-border treatment services or informal arrangements have been involved. The time for debate and reform is well overdue.

Women from Africa living with HIV in London: a descriptive study.

PubMed

Anderson, J; Doyal, L

2004-01-01

There are no studies that have examined the particular needs and experiences of African women living with HIV in the UK at a time when they represent an increasingly large proportion of the UK HIV epidemic. This study explores the illness biographies and daily lives of HIV-positive African women receiving treatment in London. Sixty-two women from 11 African countries attending HIV specialist clinics in five London hospitals participated in self-completion questionnaires and in depth semi-structured interviews. Using a narrative approach, women were asked to talk about their HIV status in the broader context of their life history. Important differences exist within this group based mainly on nationality, income, education level and legal status in the UK. However, marked similarities also emerged which were related in part to their situation as migrants and were compounded by their illness. Stigma, both actual and perceived, had a profound impact on women's lives, making control of information about their situation a matter of acute concern. This had an effect on how women accessed health services and voluntary sector agencies. The resilience of women in dealing with difficulties in their lives was strengthened by religious belief. Such similarities and differences need to be properly understood by health and social care professionals if they are to offer the most appropriate care for this growing population of patients.

Measuring Care-Related Quality of Life of Caregivers for Use in Economic Evaluations: CarerQol Tariffs for Australia, Germany, Sweden, UK, and US.

PubMed

Hoefman, Renske J; van Exel, Job; Brouwer, Werner B F

2017-04-01

Informal care is often not included in economic evaluations in healthcare, while the impact of caregiving can be relevant for cost-effectiveness recommendations from a societal perspective. The impact of informal care can be measured and valued with the CarerQol instrument, which measures the impact of informal care on seven important burden dimensions (CarerQol-7D) and values this in terms of general quality of life (CarerQol-VAS). The CarerQol can be included at the effect side of multi-criteria analyses of patient interventions or in cost-effectiveness or utility analysis of interventions targeted at caregivers. At present, utility scores based on relative utility weights for the CarerQol-7D are only available for the Netherlands. This study calculates CarerQol-7D tariffs for Australia, Germany, Sweden, UK, and US. Data were collected among the general population in Australia, Germany, Sweden, UK, and US by an Internet survey. Utility weights were collected with a discrete choice experiment with two unlabeled alternatives described in terms of the seven CarerQol-7D dimensions. An efficient experimental design with priors obtained from the Netherlands was used to create the choice sets. Data was analyzed with a panel mixed multinomial logit model with random parameters. In all five countries, the CarerQol-7D dimensions were significantly associated with the utility of informal care situations. Physical health problems were most strongly associated with the utility for informal care situations. The tariff was constructed by adding up the relative utility weights per category of all CarerQol-7D dimensions for each country separately. The CarerQol tariffs for Australia, Germany, Sweden, UK, and US facilitate the inclusion of informal care in economic evaluations.

Findings from the UK and Canadian Space Situational Awareness (SSA) Experimentation during the Relocation of SKYNET 5A Satellite

NASA Astrophysics Data System (ADS)

Ash, A.; Scott, L.; Feline, W.

2016-09-01

This paper describes the planning, execution, analysis and lessons identified from a collaborative Space Situational Awareness (SSA) experiment to observe the SKYNET 5A satellite during a series of orbital maneuvers that occurred in the summer of 2015. In March 2015 Airbus Defence and Space (Airbus DS) announced its intention to relocate the SKYNET 5A satellite from the Atlantic to the Asia Pacific region to increase its global coverage; this provided an opportunity to observe this high value asset to explore the challenges and technical solutions related to deep space SSA. Within the UK the Defence Science and Technology Laboratory (Dstl, part of the UK Ministry of Defence) were established as the lead agency to plan the observation campaign utilising operational and emerging experimental SSA capabilities. The campaign was then expanded to involve Canada, the United States and Australia under the auspices of the Combined Space Operations (CSpO) Memorandum of Understanding (MOU) to further explore the coordination of observations between operational systems and potential fusion of data collected using experimental SSA assets. The focus for this paper is the collaborative work between Dstl and Defence Research and Development Canada (DRDC) that featured a period of experimentation to explore methods that enable cross cueing between ground-based and space-based SSA sensors, namely the UK Starbrook facility (located on the island of Cyprus), and NEOSSat/ Sapphire space surveillance satellites located in low-Earth orbit. A number of conclusions and lessons are identified in this paper that seek to inform the wider SSA community on the challenges, potential solutions and benefits of operating a distributed SSA architecture such as the one utilized during this experiment.

Current status of teaching on spirituality in UK medical schools.

PubMed

Neely, David; Minford, Eunice J

2008-02-01

To investigate the current status of teaching on spirituality in medicine in UK medical schools and to establish if and how medical schools are preparing future doctors to identify patients' spiritual needs. We carried out a national questionnaire survey using a 2-part questionnaire. Section A contained questions relating to the quantity of teaching on spirituality and the topics covered. Section B contained questions relating to teaching on alternative health practices. Medical educators from each of the 32 medical schools in the UK were invited to participate. A response rate of 53% (n = 17) was achieved. A total of 59% (n = 10) of respondents stated that there is teaching on spirituality in medicine in their curricula. On extrapolation, at least 31% and a maximum of 78% of UK medical schools currently provide some form of teaching on spirituality. Of the respondents that teach spirituality, 50% (n = 5) stated that their schools include compulsory teaching on spirituality in medicine, 80% (n = 8) include optional components, and 88% stated that teaching on complementary and alternative medicine is included in the curriculum. Although 59% (n = 10) of respondent medical schools (the actual UK figure lies between 31% and 78%) currently provide some form of teaching on spirituality, there is significant room for improvement. There is little uniformity between medical schools with regard to content, form, amount or type of staff member delivering the teaching. It would be beneficial to introduce a standardised curriculum on spirituality across all UK medical schools.

Commercial satellite broadcasting for Europe

NASA Astrophysics Data System (ADS)

Forrest, J. R.

1988-12-01

A review is presented of the current television broadcasting situation in European countries, which involves a varied mix of terrestrial VHF or UHF systems and cable networks. A small market has emerged in Europe for receivers using the low-power telecommunications satellite transmission between the program providers and cable network companies. This is expected to change with the launch of medium-power pan-European telecommunication satellites (e.g. ASTRA, EUTELSAT II), which are now directly addressing the market of home reception. DBS (direct broadcast satellite) in the UK, using the D-MAC transmission standard, will offer three additional television channels, data broadcasting services, and a planned evolution to compatible forms of wide-screen, high-definition television. Comments are given on receiver and conditional access system standardization. Some views are expressed on satellite broadcasting as part of an overall broadcasting framework for the future.

[Clinical drug trials in Germany--an assessment of current status from the viewpoint of industry].

PubMed

Baumbauer, E

1996-01-01

Drug development today is a highly professional and costly affair, whereby quality and speed are decisive competitive factors in a global setting. Germany is in the process of losing its attractiveness for clinical drug research as evidenced by a significant decrease in funding of clinical drug research which at the moment amounts to about 1.5 billion DM/year. This decrease is due to an adverse environment created by a certain anxiety in public opinion regarding technological advances, an overburden of regulations, lack of an infrastructure in hospitals to work according to GCP and a regulatory agency which has to compete with momentarily more effective agencies in Europe (UK, France). A joint effort between industry and the medical profession is called for to change this situation for the better.

Practical Steps for Using Interdisciplinary Educational Research to Enhance Cultural Awareness

ERIC Educational Resources Information Center

CohenMiller, A. S.; Faucher, Carole; Hernández-Torrano, Daniel; Brown Hajdukova, Eva

2017-01-01

This article adds to the dialogue on multidisciplinary and interdisciplinary research, providing definitions and practical steps for using interdisciplinary educational research to enhance cultural awareness. Informed by a research study conducted by seven primary researchers situated in the U.K. and Kazakhstan, along with local partners, we…

Professional Development for Teachers Working with International Students

ERIC Educational Resources Information Center

Tran, Ly Thi; Pasura, Rinos

2018-01-01

The commercialisation of education and the massive recruitment of international students across different vocational education and training (VET) systems including the US, UK, Canada and Australia have led to significant changes in the VET teaching and learning landscape. This situation compels the VET sector to design and develop new professional…

Training Outdoor Educators: Integrating Academic and Professional Demands.

ERIC Educational Resources Information Center

Higgins, Peter; Morgan, Alastair

In the United Kingdom, outdoor educators have varied backgrounds in terms of academic versus professional outdoor training, and the profession has not agreed upon required qualifications. Multiple influences in the historical development of outdoor education have contributed to this situation. Since the 1970s, several U.K. colleges and…

Situated Legitimacy: Deliberative Arenas and the New Rural Governance

ERIC Educational Resources Information Center

Connelly, Steve; Richardson, Tim; Miles, Tim

2006-01-01

Rural governance in the UK and elsewhere has undergone far-reaching changes, as partnerships and other collaborative approaches have emerged to address the challenges of rural sustainable development. The legitimacy of this "new rural governance" is purportedly grounded in deliberation between stakeholders, but this is problematic--it is…

Current optometric practices and attitudes in keratoconus patient management.

PubMed

Ortiz-Toquero, Sara; Martin, Raul

2017-08-01

To compare the current optometric practices and attitudes in the management of keratoconus patients in the UK and Spain. An online survey (adapted to optometric practices) was distributed via a newsletter emailed by various professional organizations in the UK and Spain. Four hundred and sixty-four practitioners (126 in the UK; 338 in Spain) who prescribed gas permeable GP contact lenses (CLs) more than once per month (54.8% of UK practitioners and 28.1% of practitioners in Spain; p<0.01) responded to the questionnaire. A combination of multiple factors is considered necessary in the keratoconus detection (79.4% in the UK, 75% in Spain; p=0.68), and the use of classification criteria is considered relevant (67.5% in the UK, 70.7% in Spain; p=0.49). There is a high consensus on the consideration that GP CL fitting is more difficult in keratoconus (79.4% in the UK, 80.5% in Spain; p=0.79) requiring more diagnostic lenses (3.2±1.4 and 3.4±1.2 in the UK and Spain, respectively; p=0.72) than are necessary for healthy eyes. Using corneal topography is uncommon from both countries (38.1% in the UK, 59.8% in Spain; p<0.01), with a similar ophthalmologist referral pattern (at initial diagnosis, 50% in both the UK and Spain; p=1.00). Few cases of co-management with ophthalmologists were noted (no co-management reported by 60.3% in the UK and 72.8% in Spain, p=0.01). This study provides initial observations and evidence regarding keratoconus management by optometrists in the UK and Spain and shows similarity in the professional practices and attitudes of practitioners in these two countries. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

What is the prognosis of nitrogen losses from UK soils?

NASA Astrophysics Data System (ADS)

Burt, T. P.; Worrall, F.; Whelan, M.; Howden, N. J.

2009-12-01

The UK’s high population density, intensive agriculture and relative short, unimpeded rivers mean that the UK is a known “hotspot” of fluvial nitrogen flux. Furthermore, it is known that the fluvial flux of nitrogen from the UK is increasing. This study estimates the release of nitrate from the UK terrestrial biosphere to understand this rising fluvial flux and i to assess the in-stream losses of nitrate, thusgiving an assessment of the fluvial component of the total nitrogen budget of UK. The approach taken by the study is to use an export coefficient model coupled with a description of mineralisation and immobilisation of nitrogen within soil reserves. The study applies the modelling approach to the whole of the UK from 1925 to 2007 using long term records of: land use (including - agricultural, forestry and urban uses); livestock; human population and atmospheric deposition. The study shows that: i) The flux of nitrate from the UK soils varied from 420 to 1463 Ktonnes N/yr with two peaks in the period since 1925, one in 1944 and one in 1967, the first is caused by mineralisation of soil organic matter following large-scale land use change in the Second World War, and the second is a multifactorial response to land use change and intensification. ii) The current trend in the release from soils is downward whilst the current fluvial flux at the tidal limit is upwards. With the current trends fluvial flux at the tidal limit will be greater than release from the soils of the UK, i.e. there will be net gain across the fluvial network. This apparent gain can be explained by the breakthrough of high nitrate groundwater into surface waters.

Universities UK Submission to the 2010 Spending Review

ERIC Educational Resources Information Center

Universities UK, 2010

2010-01-01

This document represents the submission of Universities UK to the 2010 Spending Review. It sets out why the authors believe universities are critical to the UK's future economic growth, what the impact of cuts to the budget for higher education would be, and the activities which universities are currently pursuing to secure national economic…

From Graduate Employability to Employment: Policy and Practice in UK Higher Education

ERIC Educational Resources Information Center

Minocha, Sonal; Hristov, Dean; Reynolds, Martin

2017-01-01

The purpose of this paper is to enrich the current conceptualization of graduate employability and employment through the lens of policy, academia and practice in UK higher education. We examine the UK policy context that is shaping graduate employability and employment debates before enriching this conceptualization through a discussion of key…

Lost in Translation: Cross-Cultural Experiences in Teaching Geo-Genealogy

ERIC Educational Resources Information Center

Longley, Paul A.; Singleton, Alex D.; Yano, Keiji; Nakaya, Tomoki

2010-01-01

This paper reports on a cross-cultural outreach activity of the current UK "Spatial Literacy in Teaching" (SPLINT) Centre of Excellence in Teaching and Learning (CETL), a past UK Economic and Social Research Council (ESRC) grant, and shared interests in family names between Japanese and UK academics. It describes a pedagogic programme…

E-cigarettes, a safer alternative for teenagers? A UK focus group study of teenagers' views.

PubMed

Hilton, Shona; Weishaar, Heide; Sweeting, Helen; Trevisan, Filippo; Katikireddi, Srinivasa Vittal

2016-11-16

Concerns exist that e-cigarettes may be a gateway to traditional cigarettes and/or (re)normalise teenage smoking. This qualitative study explores how teenagers in the UK currently perceive e-cigarettes and how and why they do or do not use them. 16 focus groups were conducted across the UK between November 2014 and February 2015, with 83 teenagers aged 14-17. All discussions were digitally recorded, transcribed verbatim, imported into NVivo 10 and thematically analysed. Teenagers generally agreed that e-cigarettes are useful products for smokers, including teenage smokers, to quit or reduce traditional cigarette use. Concerns were expressed about lack of information on their precise ingredients and any unknown risks for users and bystanders. However, teenagers typically viewed e-cigarettes as substantially less harmful than traditional cigarettes. They perceived e-cigarettes as attractive, with products described as 'fun' and having 'great flavourings'. Seeing websites or social media featuring e-cigarettes, especially YouTube 'vaping tricks', prompted some experimentation and imitation. E-cigarettes were used in a variety of situations, including at parties or when they could not smoke traditional cigarettes. A very few participants suggested covert use was a possibility and that e-cigarettes might help maintain a fledgling nicotine habit. Teenagers support the use of e-cigarettes as smoking cessation aids for established adult smokers. However, they engage with these products differently from adults, with the novel hypothesis that covert use could potentially reinforce traditional cigarette smoking requiring further investigation. Policy responses should more clearly meet the needs of young people, as well as helping established adult smokers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

E-cigarettes, a safer alternative for teenagers? A UK focus group study of teenagers' views

PubMed Central

Weishaar, Heide; Sweeting, Helen; Trevisan, Filippo; Katikireddi, Srinivasa Vittal

2016-01-01

Objective Concerns exist that e-cigarettes may be a gateway to traditional cigarettes and/or (re)normalise teenage smoking. This qualitative study explores how teenagers in the UK currently perceive e-cigarettes and how and why they do or do not use them. Design 16 focus groups were conducted across the UK between November 2014 and February 2015, with 83 teenagers aged 14–17. All discussions were digitally recorded, transcribed verbatim, imported into NVivo 10 and thematically analysed. Results Teenagers generally agreed that e-cigarettes are useful products for smokers, including teenage smokers, to quit or reduce traditional cigarette use. Concerns were expressed about lack of information on their precise ingredients and any unknown risks for users and bystanders. However, teenagers typically viewed e-cigarettes as substantially less harmful than traditional cigarettes. They perceived e-cigarettes as attractive, with products described as ‘fun’ and having ‘great flavourings’. Seeing websites or social media featuring e-cigarettes, especially YouTube ‘vaping tricks’, prompted some experimentation and imitation. E-cigarettes were used in a variety of situations, including at parties or when they could not smoke traditional cigarettes. A very few participants suggested covert use was a possibility and that e-cigarettes might help maintain a fledgling nicotine habit. Conclusions Teenagers support the use of e-cigarettes as smoking cessation aids for established adult smokers. However, they engage with these products differently from adults, with the novel hypothesis that covert use could potentially reinforce traditional cigarette smoking requiring further investigation. Policy responses should more clearly meet the needs of young people, as well as helping established adult smokers. PMID:27852721

Village Schools in England: At the Heart of Their Community?

ERIC Educational Resources Information Center

Bagley, Carl; Hillyard, Sam

2011-01-01

Recent debates within UK rural studies have stressed the shifting interplay of economic, social, political and cultural forces, with a concomitant blurring as to what constitutes rural living, rural spaces and even rural occupations. This article situates the rural school within this social, cultural and political landscape and attends to the…

Collaborative Production of Learning Objects on French Literary Works Using the LOC Software

ERIC Educational Resources Information Center

Penman, Christine

2015-01-01

This case study situates the collaborative design of learning objects (interactive online learning material) using the LOC (Learning Object Creator) software in the context of language activities external to the core learning activities of language students at a UK university. It describes the creative and pedagogical processes leading to the…

"Novice Teachers" Views of an Introductory Workshop about Teaching in the Biosciences

ERIC Educational Resources Information Center

Gartland, Kevan M. A.; Perkins, Joy; Shearer, Morven C.; Tierney, Anne M.; Wilson, Jackie J.

2013-01-01

Seven regional networking events, aimed at supporting and developing "early stage" novice university bioscience teachers were held across the UK. These workshops allowed 230 participants to reflect on teaching styles, learn about Higher Education Academy resources and discuss strategies to deal with a range of teaching situations.…

Delivering Communication Strategy Training for People with Aphasia: What Is Current Clinical Practice?

ERIC Educational Resources Information Center

Beckley, Firle; Best, Wendy; Beeke, Suzanne

2017-01-01

Background: Communication strategy training (CST) is a recognized part of UK speech and language therapists' (SLTs) role when working with a person with aphasia. Multiple CST interventions have been published but, to date, there are no published studies exploring clinical practice in this area. Aims: To investigate UK SLTs' current CST practices.…

Children's views on research without prior consent in emergency situations: a UK qualitative study.

PubMed

Roper, Louise; Sherratt, Frances C; Young, Bridget; McNamara, Paul; Dawson, Angus; Appleton, Richard; Crawley, Esther; Frith, Lucy; Gamble, Carrol; Woolfall, Kerry

2018-06-09

We explored children's views on research without prior consent (RWPC) and sought to identify ways of involving children in research discussions. Qualitative interview study. Participants were recruited through a UK children's hospital and online advertising. 16 children aged 7-15 years with a diagnosis of asthma (n=14) or anaphylaxis (n=2) with recent (<12 months) experience of emergency care. Children were keen to be included in medical research and viewed RWPC as acceptable in emergency situations if trial interventions were judged safe. Children trusted that doctors would know about their trial participation and act in their best interests. All felt that children should be informed about the research following their recovery and involved in discussions with a clinician or their parent(s) about the use of data already collected as well as continued participation in the trial (if applicable). Participants suggested methods to inform children about their trial participation including an animation. Children supported, and were keen to be involved in, clinical trials in emergency situations. We present guidance and an animation that practitioners and parents might use to involve children in trial discussions following their recovery. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The UK Human Genome Mapping Project online computing service.

PubMed

Rysavy, F R; Bishop, M J; Gibbs, G P; Williams, G W

1992-04-01

This paper presents an overview of computing and networking facilities developed by the Medical Research Council to provide online computing support to the Human Genome Mapping Project (HGMP) in the UK. The facility is connected to a number of other computing facilities in various centres of genetics and molecular biology research excellence, either directly via high-speed links or through national and international wide-area networks. The paper describes the design and implementation of the current system, a 'client/server' network of Sun, IBM, DEC and Apple servers, gateways and workstations. A short outline of online computing services currently delivered by this system to the UK human genetics research community is also provided. More information about the services and their availability could be obtained by a direct approach to the UK HGMP-RC.

Students and Sex Work in the UK: Providers and Purchasers

ERIC Educational Resources Information Center

Roberts, Ron; Jones, Amy; Sanders, Teela

2013-01-01

Available evidence suggests that changes in the funding of UK higher education in recent years have been accompanied by an increased student presence in the sex industry, ostensibly for financial reasons and to make ends meet. The current study comprises a sample of students ("N" = 200) drawn from several universities in the UK. Data…

Large-Scale Innovation and Change in UK Higher Education

ERIC Educational Resources Information Center

Brown, Stephen

2013-01-01

This paper reflects on challenges universities face as they respond to change. It reviews current theories and models of change management, discusses why universities are particularly difficult environments in which to achieve large scale, lasting change and reports on a recent attempt by the UK JISC to enable a range of UK universities to employ…

Faculty Development in Teaching and Learning: The UK Framework and Current Debates

ERIC Educational Resources Information Center

Hibbert, Paul; Semler, Mirko

2016-01-01

Following the publication of a recent report, commissioned by the Higher Education Academy (HEA) and conducted by Staff and Educational Developers Association, this short paper considers the HEA UK Professional Standards Framework in the UK Higher Education Sector, in the context of recent and continuing debates about how best to support faculty…

An Exploration of the Relationship between Training Grants and Profitability of UK Construction Companies

ERIC Educational Resources Information Center

Abdel-Wahab, Mohamed; Dainty, Andrew R. J.; Ison, Stephen G.; Hazlehurst, Guy

2008-01-01

A levy/grant system exists in the UK construction industry to provide financial support for companies undertaking training activities. With the current UK government skills policy, there is an emphasis on ensuring that training support provided to employers is aimed at enhancing companies' profitability. This paper explores the profitability of…

Visual Access in Interpreter-Mediated Learning Situations for Deaf and Hard-of-Hearing High School Students Where an Artifact Is in Use

PubMed Central

Thomassen, Gøril

2016-01-01

This article highlights interpreter-mediated learning situations for deaf high school students where such mediated artifacts as technical machines, models, and computer graphics are used by the teacher to illustrate his or her teaching. In these situations, the teacher’s situated gestures and utterances, and the artifacts will contribute independent pieces of information. However, the deaf student can only have his or her visual attention focused on one source at a time. The problem to be addressed is how the interpreter coordinates the mediation when it comes to deaf students’ visual orientation. The presented discourse analysis is based on authentic video recordings from inclusive learning situations in Norway. The theoretical framework consists of concepts of role, footing, and face-work (Goffman, E. (1959). The presentation of self in everyday life. London, UK: Penguin Books). The findings point out dialogical impediments to visual access in interpreter-mediated learning situations, and the article discusses the roles and responsibilities of teachers and educational interpreters. PMID:26681267

Smokers' rights to health care.

PubMed Central

Persaud, R

1995-01-01

The question whether rights to health care should be altered by smoking behaviour involves wideranging implications for all who indulge in hazardous behaviours, and involves complex economic utilitarian arguments. This paper examines current debate in the UK and suggest the major significance of the controversy has been ignored. That this discussion exists at all implies increasing division over the scope and purpose of a nationalised health service, bestowing health rights on all. When individuals bear the cost of their own health care, they appear to take responsibility for health implications of personal behaviour, but when the state bears the cost, moral obligations of the community and its doctors to care for those who do not value health are called into question. The debate has far-reaching implications as ethical problems of smokers' rights to health care are common to situations where health as a value comes into conflict with other values, such as pleasure or wealth. PMID:8558542

Class in contemporary Britain: comparing the Cultural Capital and Social Exclusion (CCSE) project and the Great British Class Survey (GBCS)

PubMed Central

Silva, Elizabeth B

2015-01-01

The paper discusses the salience of class in Britain in relation to the experiment of the BBC–academic partnership of the Great British Class Survey (GBCS). It addresses the claimed inauguration of a third phase in class analysis in the UK sparked by the experiment. This is done by considering three main issues. First, the GBCS experiment is situated in the context of various explorations of cultural class analyses, and chiefly in relation to the Cultural Capital and Social Exclusion (CCSE) project (ESRC funded 2003–6). Secondly, the focus is on the influence of the academic turn to big data for the procedures and claims of the project, and some implications of the methodological choices. Thirdly, attention is turned to the deleterious effects of commercial and institutional pressures on the current research culture in which the experiment exists. PMID:26640302

Research report appraisal: how much understanding is enough?

PubMed

Lipscomb, Martin

2014-07-01

When appraising research papers, how much understanding is enough? More specifically, in deciding whether research results can inform practice, do appraisers need to substantively understand how findings are derived or is it sufficient simply to grasp that suitable analytic techniques were chosen and used by researchers? The degree or depth of understanding that research appraisers need to attain before findings can legitimately/sensibly inform practice is underexplored. In this paper it is argued that, where knowledge/justified beliefs derived from research evidence prompt actions that materially affect patient care, appraisers have an epistemic duty to demand high (maximal) rather than low (minimal) levels of understanding regards finding derivation (i.e. appraisers have a duty to seek a superior epistemic situation). If this argument holds assumptions about appraiser competence/ability and the feasibility of current UK conceptions of evidence based practice are destabilized. © 2014 John Wiley & Sons Ltd.

Flood risk and insurance loss potential in the Thames Gateway

NASA Astrophysics Data System (ADS)

Eldridge, J.; Horn, D.

2009-04-01

The Thames Gateway, currently Europe's largest regeneration project, is an area of redevelopment located in the South East of England, with Government plans to create up to 160,000 new homes and 180,000 new jobs by 2016. Although the new development is intended to contribute £12bn annually to the economy, the potential flood risk is high, with much of the area situated on Thames tidal floodplain and vulnerable to both storm surges and peak river flows. This poses significant hazard to those inhabiting the area and has raised concern amongst the UK insurance industry, who would be liable for significant financial claims if a large flood event were to occur, particularly with respect to the number of new homes and businesses being built in flood risk areas. Flood risk and the potential damage to both lives and assets in vulnerable areas have gained substantial recognition, in light of recent flooding events, from both governmental agencies and in the public's awareness of flood hazard. This has resulted in a change in UK policy with planning policy for flood risk (PPS25, Planning Policy Statement 25) adopting a more strategic approach to development, as well as a new Flooding and Water Bill which is due for consultation in 2009. The Government and the Association of British Insurers, who represent the UK insurance industry, have also recently changed their Statement of Principles which guides provision of flood insurance in the future. This PhD research project aims to quantify flood risk in the Thames Gateway area with a view to evaluating the insurance loss potential under different insurance and planning scenarios. Using current sources of inundation extent, and incorporating varying insurance penetration rates and degrees of adoption of planning policy and guidance, it focuses on estimating flood risk under these different scenarios. This presentation introduces the development of the project and the theory and methodology which will be used to address the research problem, and presents the initial findings, including an overview of the major developments going ahead in the area and an indication of areas of high asset value and potential for inundation based on topography and standard of protection of defences.

Fieldwork Skills in Virtual Worlds

NASA Astrophysics Data System (ADS)

Craven, Benjamin; Lloyd, Geoffrey; Gordon, Clare; Houghton, Jacqueline; Morgan, Daniel

2017-04-01

Virtual reality has an increasingly significant role to play in teaching and research, but for geological applications realistic landscapes are required that contain sufficient detail to prove viable for investigation by both inquisitive students and critical researchers. To create such virtual landscapes, we combine DTM data with digitally modelled outcrops in the game engine Unity. Our current landscapes are fictional worlds, invented to focus on generation techniques and the strategic and spatial immersion within a digital environment. These have proved very successful in undergraduate teaching; however, we are now moving onto recreating real landscapes for more advanced teaching and research. The first of these is focussed on Rhoscolyn, situated within the Ynys Mon Geopark on Anglesey, UK. It is a popular area for both teaching and research in structural geology so has a wide usage demographic. The base of the model is created from DTM data, both 1 m LiDAR and 5 m GPS point data, and manipulated with QGIS before import to Unity. Substance is added to the world via models of architectural elements (e.g. walls and buildings) and appropriate flora and fauna, including sounds. Texturing of these models is performed using 25 cm aerial imagery and field photographs. Whilst such elements enhance immersion, it is the use of digital outcrop models that fully completes the experience. From fieldwork, we have a library of photogrammetric outcrops that can be modelled into 3D features using free (VisualSFM and MeshLab) and non-free (AgiSoft Photoscan) tools. These models are then refined and converted in Maya to create models for better insertion into the Unity environment. The finished product is a virtual landscape; a Rhoscolyn `world' that is sufficiently detailed to provide a base not only for geological teaching and training but also for geological research. Additionally, the `Rhoscolyn World' represents a significant tool for those students who are unable to attend conventional field classes and really enhances their learning experience. This project is part of the larger Virtual Landscapes project, which is a collaboration between The University of Leeds and Leeds College of Art, UK. All our current virtual landscapes are freely available online at www.see.leeds.ac.uk/virtual-landscapes/.

Basic Blue Skies Research in the UK: Are we losing out?

PubMed Central

Linden, Belinda

2008-01-01

Background The term blue skies research implies a freedom to carry out flexible, curiosity-driven research that leads to outcomes not envisaged at the outset. This research often challenges accepted thinking and introduces new fields of study. Science policy in the UK has given growing support for short-term goal-oriented scientific research projects, with pressure being applied on researchers to demonstrate the future application of their work. These policies carry the risk of restricting freedom, curbing research direction, and stifling rather than stimulating the creativity needed for scientific discovery. Methods This study tracks the tortuous routes that led to three major discoveries in cardiology. It then investigates the constraints in current research, and opportunities that may be lost with existing funding processes, by interviewing selected scientists and fund providers for their views on curiosity-driven research and the freedom needed to allow science to flourish. The transcripts were analysed using a grounded theory approach to gather recurrent themes from the interviews. Results The results from these interviews suggest that scientists often cannot predict the future applications of research. Constraints such as lack of scientific freedom, and a narrow focus on relevance and accountability were believed to stifle the discovery process. Although it was acknowledged that some research projects do need a clear and measurable framework, the interviewees saw a need for inquisitive, blue skies research to be managed in a different way. They provided examples of situations where money allocated to 'safe' funding was used for more innovative research. Conclusion This sample of key UK scientists and grant providers acknowledge the importance of basic blue skies research. Yet the current evaluation process often requires that scientists predict their likely findings and estimate short-term impact, which does not permit freedom of research direction. There is a vital need for prominent scientists and for universities to help the media, the public, and policy makers to understand the importance of innovative thought along with the need for scientists to have the freedom to challenge accepted thinking. Encouraging an avenue for blue skies research could have immense influence over future scientific discoveries. PMID:18312612

Basic Blue Skies Research in the UK: Are we losing out?

PubMed

Linden, Belinda

2008-02-29

The term blue skies research implies a freedom to carry out flexible, curiosity-driven research that leads to outcomes not envisaged at the outset. This research often challenges accepted thinking and introduces new fields of study. Science policy in the UK has given growing support for short-term goal-oriented scientific research projects, with pressure being applied on researchers to demonstrate the future application of their work. These policies carry the risk of restricting freedom, curbing research direction, and stifling rather than stimulating the creativity needed for scientific discovery. This study tracks the tortuous routes that led to three major discoveries in cardiology. It then investigates the constraints in current research, and opportunities that may be lost with existing funding processes, by interviewing selected scientists and fund providers for their views on curiosity-driven research and the freedom needed to allow science to flourish. The transcripts were analysed using a grounded theory approach to gather recurrent themes from the interviews. The results from these interviews suggest that scientists often cannot predict the future applications of research. Constraints such as lack of scientific freedom, and a narrow focus on relevance and accountability were believed to stifle the discovery process. Although it was acknowledged that some research projects do need a clear and measurable framework, the interviewees saw a need for inquisitive, blue skies research to be managed in a different way. They provided examples of situations where money allocated to 'safe' funding was used for more innovative research. This sample of key UK scientists and grant providers acknowledge the importance of basic blue skies research. Yet the current evaluation process often requires that scientists predict their likely findings and estimate short-term impact, which does not permit freedom of research direction. There is a vital need for prominent scientists and for universities to help the media, the public, and policy makers to understand the importance of innovative thought along with the need for scientists to have the freedom to challenge accepted thinking. Encouraging an avenue for blue skies research could have immense influence over future scientific discoveries.

Co-operation of employers in the area of personal monitoring: a commentary on BIR guidance on the UK regulatory situation.

PubMed

Rogers, Andy

2017-11-01

The requirement for organizations to co-operate regarding doses to staff who work across organizational boundaries is well established. However, in the field of personal dosimetry there is little guidance as to how to actually achieve legal compliance. Following improvement action in the UK by the regulator, The Health & Safety Executive, a guidance document was developed by the leading professional bodies in this area. This guidance was also commented on by the Health & Safety Executive Specialist Inspectorate (Radiation) enabling the published guidance to represent a compliant standard. This commentary describes the guidance and discusses the issues involved with developing systems for compliance in this area.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lang, J.

The report identifies, compares, and evaluates the major methods developed in Europe and North America to predict noise levels resulting from urban-development projects. Hopefully, it will guide countries that have not yet developed their own noise-prediction models to choose the model most appropriate for their particular situation. It covers prediction methods for road traffic noise and railroad traffic noise in Austria, Czecheslovakia, France, both Germany's Hungary, Netherlands, Scandinavia, Switzerland, U.K. and USA, as well as the Commission of the European Communities, and a comparison of methods. It also covers prediction methods for industrial noise from Austria, both Germany's Netherlands, Scandinavia,more » and U.K., and discusses calculation methods for aircraft noise around airports.« less

Current status of kilovoltage (kV) radiotherapy in the UK: installed equipment, clinical workload, physics quality control and radiation dosimetry.

PubMed

Palmer, Antony L; Pearson, Michael; Whittard, Paul; McHugh, Katie E; Eaton, David J

2016-12-01

To assess the status and practice of kilovoltage (kV) radiotherapy in the UK. 96% of the radiotherapy centres in the UK responded to a comprehensive survey. An analysis of the installed equipment base, patient numbers, clinical treatment sites, quality control (QC) testing and radiation dosimetry processes were undertaken. 73% of UK centres have at least one kV treatment unit, with 58 units installed across the UK. Although 35% of units are over 10 years old, 39% units have been installed in the last 5 years. Approximately 6000 patients are treated with kV units in the UK each year, the most common site (44%) being basal cell carcinoma. A benchmark of QC practice in the UK is presented, against which individual centres can compare their procedures, frequency of testing and acceptable tolerance values. We propose the use of internal "notification" and "suspension" levels for analysis. All surveyed centres were using recommended Codes of Practice for kV dosimetry in the UK; approximately the same number using in-air and in-water methodologies for medium energy, with two-thirds of all centres citing "clinical relevance" as the reason for choice of code. 64% of centres had hosted an external dosimetry audit within the last 3 years, with only one centre never being independently audited. The majority of centres use locally measured applicator factors and published backscatter factors for treatments. Monitor unit calculations are performed using software in only 36% of centres. A comprehensive review of current kV practice in the UK is presented. Advances in knowledge: Data and discussion on contemporary kV radiotherapy in the UK, with a particular focus on physics aspects.

Current status of kilovoltage (kV) radiotherapy in the UK: installed equipment, clinical workload, physics quality control and radiation dosimetry

PubMed Central

Pearson, Michael; Whittard, Paul; McHugh, Katie E; Eaton, David J

2016-01-01

Objective: To assess the status and practice of kilovoltage (kV) radiotherapy in the UK. Methods: 96% of the radiotherapy centres in the UK responded to a comprehensive survey. An analysis of the installed equipment base, patient numbers, clinical treatment sites, quality control (QC) testing and radiation dosimetry processes were undertaken. Results: 73% of UK centres have at least one kV treatment unit, with 58 units installed across the UK. Although 35% of units are over 10 years old, 39% units have been installed in the last 5 years. Approximately 6000 patients are treated with kV units in the UK each year, the most common site (44%) being basal cell carcinoma. A benchmark of QC practice in the UK is presented, against which individual centres can compare their procedures, frequency of testing and acceptable tolerance values. We propose the use of internal “notification” and “suspension” levels for analysis. All surveyed centres were using recommended Codes of Practice for kV dosimetry in the UK; approximately the same number using in-air and in-water methodologies for medium energy, with two-thirds of all centres citing “clinical relevance” as the reason for choice of code. 64% of centres had hosted an external dosimetry audit within the last 3 years, with only one centre never being independently audited. The majority of centres use locally measured applicator factors and published backscatter factors for treatments. Monitor unit calculations are performed using software in only 36% of centres. Conclusion: A comprehensive review of current kV practice in the UK is presented. Advances in knowledge: Data and discussion on contemporary kV radiotherapy in the UK, with a particular focus on physics aspects. PMID:27730839

Situation Venice: Towards a Performative "Ex-Planation" of a City

ERIC Educational Resources Information Center

Whybrow, Nicolas

2011-01-01

The article's main concern is to analyse theoretical and artistic factors influencing the attempt by a group of undergraduate students (at the University of Warwick, UK) to produce a "performative mapping" of the city of Venice. In other words, it asks what kind of performance-based strategies might usefully be applied in the process of…

Hierarchies and Learning in the Conservatoire: Exploring What Students Learn through the Lens of Bourdieu

ERIC Educational Resources Information Center

Perkins, Rosie

2013-01-01

This article explores the intersection between institutional hierarchies and learning at a UK conservatoire. Conceptualizing learning as a social practice situated in a hierarchical social space, the article draws on the theorization of Bourdieu to understand how students are positioned in the conservatoire field and what this means in terms of…

Transactions in Primary Physical Education in the UK: A Smorgasbord of Looks-Like-Sport

ERIC Educational Resources Information Center

Ward, Gavin; Quennerstedt, Mikael

2016-01-01

Background: Crum proposes the term "movement culture" as a means to best understand the relationships between PE and wider movement practices. Learning within movement culture is practical and embodied, and integral to the cultural and institutional contexts within which PE is situated. Purpose: Using visual data gathered from PE lessons…

Policy Space and the Governance of Education: Transnational Influences on Institutions and Identities in the Netherlands and the UK

ERIC Educational Resources Information Center

Alexiadou, Nafsika; van de Bunt-Kokhuis, Sylvia

2013-01-01

This article presents a comparative analysis of two country-specific cases. The comparative analysis is situated within the broad domain of the changing knowledge economy landscape for educational policy. The two cases examine the transfer, embedding and enactment of policies during the interactions between supranational, national, institutional…

Dyslexia and Learning Disabilities in Canada and the UK: The Impact of Its Disability Employment Laws

ERIC Educational Resources Information Center

Gerber, Paul J.; Batalo, Cecilia G.; Achola, Edwin O.

2012-01-01

The impact of employment laws pertaining to individuals with learning disabilities in Canada and dyslexia in the UK were investigated via the extant research literature. Currently, there is very little research in this area despite Canada and the UK having laws in effect for decades. Surprisingly, their laws have been revamped despite an absence…

Knowledge Exchange between Universities and the Creative Industries in the UK: A Case Study of Current Practice

ERIC Educational Resources Information Center

Ferguson, Morag

2014-01-01

The importance to the economy of knowledge exchange between universities and industry has long been recognized, and in the UK a number of initiatives are in place to support such activities. These initiatives have helped to stimulate engagement between universities and the creative industries, a sector of increasing importance to the UK economy.…

Exploring the training and scope of practice of GPs in England, Germany and Spain.

PubMed

Glonti, Ketevan; Struckmann, Verena; Alconada, Alvaro; Pettigrew, Luisa M; Hernandez-Santiago, Virginia; Minue, Sergio; Risso-Gill, Isabelle; McKee, Martin; Legido-Quigley, Helena

2018-03-22

To explore general practitioner (GP) training, continuing professional development, scope of practice, ethical issues and challenges in the working environment in three European countries. Qualitative study of 35 GPs from England, Germany and Spain working in urban primary care practices. Participants were recruited using convenience and snowball sampling techniques. Semi-structured interviews were recorded, transcribed and analysed by four independent researchers adopting a thematic approach. Entrance to and length of GP training differ between the three countries, while continuing professional development is required in all three, although with different characteristics. Key variations in the scope of practice include whether there is a gatekeeping role, whether GPs work in multidisciplinary teams or singlehandedly, the existence of appraisal processes, and the balance between administrative and clinical tasks. However, similar challenges, including the need to adapt to an ageing population, end-of-life care, ethical dilemmas, the impact of austerity measures, limited time for patients and gaps in coordination between primary and secondary care are experienced by GPs in all three countries. Primary health care variations have strong historical roots, derived from the different national experiences and the range of clinical services delivered by GPs. There is a need for an accessible source of information for GPs themselves and those responsible for safety and quality standards of the healthcare workforce. This paper maps out the current situation before Brexit is being implemented in the UK which could see many of the current EU arrangements and legislation to assure professional mobility between the UK and the rest of Europe dismantled. Copyright © 2017. Publicado por Elsevier España, S.L.U.

[Introduction of British guidelines in perinatal mental healthcare--towards enhancing the function of perinatal mental healthcare in Japan].

PubMed

Suzuki, Toshihito

2014-01-01

Professionals in many different occupations, from psychiatrists, obstetricians, and pediatricians to nurses, midwives, pharmacists, clinical psychologists, public health nurses, and psychiatric social workers, are involved in perinatal mental healthcare. In order to enhance the function of such healthcare, it is necessary both to provide specialized training in each occupation and form a system and to smoothly conduct medical collaboration between different occupations. A deficiency in the medical function of perinatal mental healthcare greatly influences the mother and child's health, mental hygiene, and social life later in life. Therefore, a demand is seen for specialized staff and system formation capable of the following: 1) responding with appropriate perinatal management of female patients taking psychotropic drugs; 2) providing support and pregnancy consultation to female patients who wish to have children; and 3) properly handling postpartum mental disorder management, possibility of breastfeeding, and various issues that arise in mother-child relationships during upbringing. In the UK, the clinical guideline (NICE Clinical Guideline 45) for perinatal mental healthcare, which was created by the National Institute for Clinical Excellence (NICE), provides important guidelines on how to handle perinatal mental health. Aside from the NICE guideline, the Maudsley Prescribing Guidelines in Psychiatry indicates basic guidelines on prescribing perinatal drug therapy. In Japan, however, the current situation of perinatal mental healthcare is such that it has yet to be systemically developed. In this paper, we introduce the basic content in these British guidelines that should be noted. In addition, we consider the current status and future disposition of Japan's perinatal mental healthcare, with consideration for the differences in healthcare circumstances between Japan and the UK.

Review article: liver transplantation for hepatocellular carcinoma - a critical appraisal of the current worldwide listing criteria.

PubMed

Menon, K V; Hakeem, A R; Heaton, N D

2014-10-01

Liver transplantation (LT) plays an important role in the management of patients with hepatocellular carcinoma (HCC). Although early results following LT for HCC were poor, since the introduction of the Milan criteria in 1996 morphological criteria have since been well established. Thereafter, various expansions of the Milan criteria were introduced worldwide. Listing criteria for LT for HCC in the United Kingdom (UK) initially conformed to the Milan criteria but were re-defined in 2009 by expansion of the Milan criteria. To look at the evidence in literature on listing criteria and management of HCC worldwide in comparison with the UK. Secondly, we aim to review worldwide vs. UK literature on prioritisation models, loco-regional therapy protocols and role of alpha-fetoprotein (AFP) in LT for HCC. An electronic literature search with Medline was carried out to identify articles related to LT for HCC. Although various expansions of the Milan criteria have been described, they remain the gold standard against which other criteria are measured. The UK criteria are an expansion of the Milan criteria that go beyond Milan and University of California, San Francisco (UCSF) criteria. The current UK listing criteria for LT for HCC when compared to the worldwide criteria have a worse survival benefit (projected 5-year survival between 35-50%) when plotted on the metroticket calculator. In keeping with most transplant centres worldwide, the UK have adopted expansions to Milan to allow more patients to benefit from LT. However, currently, as it stands the UK criteria when plotted in the modification of the Metroticket model project worse survival that would seem unjustified. © 2014 John Wiley & Sons Ltd.

Inferring population history with DIY ABC: a user-friendly approach to approximate Bayesian computation

PubMed Central

Cornuet, Jean-Marie; Santos, Filipe; Beaumont, Mark A.; Robert, Christian P.; Marin, Jean-Michel; Balding, David J.; Guillemaud, Thomas; Estoup, Arnaud

2008-01-01

Summary: Genetic data obtained on population samples convey information about their evolutionary history. Inference methods can extract part of this information but they require sophisticated statistical techniques that have been made available to the biologist community (through computer programs) only for simple and standard situations typically involving a small number of samples. We propose here a computer program (DIY ABC) for inference based on approximate Bayesian computation (ABC), in which scenarios can be customized by the user to fit many complex situations involving any number of populations and samples. Such scenarios involve any combination of population divergences, admixtures and population size changes. DIY ABC can be used to compare competing scenarios, estimate parameters for one or more scenarios and compute bias and precision measures for a given scenario and known values of parameters (the current version applies to unlinked microsatellite data). This article describes key methods used in the program and provides its main features. The analysis of one simulated and one real dataset, both with complex evolutionary scenarios, illustrates the main possibilities of DIY ABC. Availability: The software DIY ABC is freely available at http://www.montpellier.inra.fr/CBGP/diyabc. Contact: j.cornuet@imperial.ac.uk Supplementary information: Supplementary data are also available at http://www.montpellier.inra.fr/CBGP/diyabc PMID:18842597

Soil-related geohazard assessments for maintaining the UK's minor road network

NASA Astrophysics Data System (ADS)

Pritchard, Oliver; Hallett, Stephen; Farewell, Timothy

2015-04-01

The minor road network of the UK (United Kingdom) encompasses 98% of the overall road network. In recent years the UK's roads have been deteriorating, currently rated 26th in the world and considered at risk and declining by the Institution of Civil Engineers (ICE). Many factors contribute to the degradation and ultimately, to the failure of particular road sections. However, several UK local authorities have identified that during drought conditions, road sections founded upon clay soils which are susceptible to volumetric shrinkage and swelling undergo significant deterioration compared to those sections on non-susceptible soils. Droughts in East Anglia recently resulted in estimated damages of £26 million, leading several local authorities to apply to Central Government for emergency funding. The minor or evolved road network is most at risk due to them having often little, if any, structural foundations. This paper addresses the use of soil-related geohazard assessments and GIS (Geographical Information Systems) in helping to provide a soil-informed maintenance strategy for the asset management of the important (both socially and commercially) local road network of the UK. Furthermore, to establish future subsidence risk, UKCP09 climate projections have been used to model the likely potential soil moisture deficit (PSMD) for baseline (1961-1990), 2030 (2020-2049) and 2050 (2040-2069) scenarios. The incorporation of probabilistic PSMD data into clay-related subsidence models has allowed an assessment of potential subsidence risk, with a range of uncertainties, for these scenarios. Intersection of road networks with future projections of subsidence risk has enabled metrics of potential vulnerability to be established. This will aid prioritisation of areas which require further maintenance to make them more climate resilient, avoiding emergency funding situations. Subsequently, this approach can then be extrapolated to the entire UK minor road network, on a local authority level, to provide a series of regional risk assessments. Case studies are drawn from the UK administrative counties of Lincolnshire and Worcestershire. Data from observed road assessments, obtained from the respective local authorities have been analysed and intersected with clay-related subsidence risk. Lincolnshire County Council have already implemented this research to prioritise approximately £600,000 of road maintenance fund to their minor road network. Further appreciation of the spatial distribution and understanding of soil-related hazards has also led Lincolnshire County Council to trial new resurfacing strategies; these new techniques helping to reduce carbon outputs in the form of materials and transport. A reduction in the amount of potential hazardous (bituminous) waste to landfill is also being achieved through re-inclusion of waste material back into the road foundation where areas are particularly prone to soil shrinkage. Our research shows that soil-related geohazard assessments have a part to play in the asset management of the UK's local highways network. The study supports the ICE's recommendation for a regime which moves towards planned, preventative maintenance and achieving Defra's (Department for Environment, Food and Rural Affairs) aim of a climate resilient UK infrastructure. The methodology introduced here also has applicability to other countries, where appropriate soils and infrastructure data are available.

Visual function and fitness to drive.

PubMed

Kotecha, Aachal; Spratt, Alexander; Viswanathan, Ananth

2008-01-01

Driving is recognized to be a visually intensive task and accordingly there is a legal minimum standard of vision required for all motorists. The purpose of this paper is to review the current United Kingdom (UK) visual requirements for driving and discuss the evidence base behind these legal rules. The role of newer, alternative tests of visual function that may be better indicators of driving safety will also be considered. Finally, the implications of ageing on driving ability are discussed. A search of Medline and PubMed databases was performed using the following keywords: driving, vision, visual function, fitness to drive and ageing. In addition, papers from the Department of Transport website and UK Royal College of Ophthalmologists guidelines were studied. Current UK visual standards for driving are based upon historical concepts, but recent advances in technology have brought about more sophisticated methods for assessing the status of the binocular visual field and examining visual attention. These tests appear to be better predictors of driving performance. Further work is required to establish whether these newer tests should be incorporated in the current UK visual standards when examining an individual's fitness to drive.

Moving towards Inclusion? The First-Degree Results of Students with and without Disabilities in Higher Education in the UK: 1998-2005

ERIC Educational Resources Information Center

Pumfrey, Peter

2008-01-01

Is the currently selective UK higher education (HE) system becoming more inclusive? Between 1998/99 and 2004/05, in relation to talented students with disabilities, has the UK government's HE policy implementation moved HE towards achieving two of the government's key HE objectives for 2010? These objectives are: (a) increasing HE participation…

Arts Entrepreneurship Education in the UK and Germany: An Empirical Survey among Lecturers in Fine Art

ERIC Educational Resources Information Center

Thom, Marco

2017-01-01

Purpose: The purpose of this paper is to report on the current state of arts entrepreneurship education at higher educational institutions (HEIs) in the UK and Germany. It is based on findings from questionnaire surveys among 210 lecturers in fine art at 89 HEIs in the UK and Germany. Design/methodology/approach: This paper explores issues related…

The Impact of Peer Mentoring on Levels of Student Wellbeing, Integration and Retention: A Controlled Comparative Evaluation of Residential Students in UK Higher Education

ERIC Educational Resources Information Center

Collings, R.; Swanson, V.; Watkins, R.

2014-01-01

Peer mentoring is becoming increasingly popular in UK higher education, however, there remains little good quality, theoretically driven and evaluative research. The current study aims to bridge the gap between theory, practice and evaluation by providing a controlled evaluation of a peer mentoring scheme within UK universities. 109 first year…

Retrospection and Reflection: The Emerging Influence of an Institutional Professional Recognition Scheme on Professional Development and Academic Practice in a UK University

ERIC Educational Resources Information Center

van der Sluis, Hendrik; Burden, Penny; Huet, Isabel

2017-01-01

Raising the quality and profile of teaching and student learning is something universities across the UK are aspiring to achieve in order to maintain reputations. Currently, the UK Professional Standards Framework (UKPSF) provides a standard by which academic staff can gain professional recognition for their academic practice and many UK…

Fit for the frontline? A focus group exploration of auditory tasks carried out by infantry and combat support personnel.

PubMed

Bevis, Zoe L; Semeraro, Hannah D; van Besouw, Rachel M; Rowan, Daniel; Lineton, Ben; Allsopp, Adrian J

2014-01-01

In order to preserve their operational effectiveness and ultimately their survival, military personnel must be able to detect important acoustic signals and maintain situational awareness. The possession of sufficient hearing ability to perform job-specific auditory tasks is defined as auditory fitness for duty (AFFD). Pure tone audiometry (PTA) is used to assess AFFD in the UK military; however, it is unclear whether PTA is able to accurately predict performance on job-specific auditory tasks. The aim of the current study was to gather information about auditory tasks carried out by infantry personnel on the frontline and the environment these tasks are performed in. The study consisted of 16 focus group interviews with an average of five participants per group. Eighty British army personnel were recruited from five infantry regiments. The focus group guideline included seven open-ended questions designed to elicit information about the auditory tasks performed on operational duty. Content analysis of the data resulted in two main themes: (1) the auditory tasks personnel are expected to perform and (2) situations where personnel felt their hearing ability was reduced. Auditory tasks were divided into subthemes of sound detection, speech communication and sound localization. Reasons for reduced performance included background noise, hearing protection and attention difficulties. The current study provided an important and novel insight to the complex auditory environment experienced by British infantry personnel and identified 17 auditory tasks carried out by personnel on operational duties. These auditory tasks will be used to inform the development of a functional AFFD test for infantry personnel.

What lessons can operational planners infer from the NATO Partnership for Peace Program for the execution of contemporary US Regionally Aligned Force and UK Adaptable Force Security Cooperation missions

DTIC Science & Technology

2016-05-26

research questions consist of three groups . The first group addresses an analysis of PfP. The second group determines contemporary US and UK strategy...The second group of research questions focuses upon current US, UK security cooperation initiatives and the specific policy objectives they...Ambition, Austerity and the Case for Rethinking UK Military Spending.” Oxford Research Group . Last modified May 13, 2015. Accessed September 17, 2015

Towards a measurement-based national verification system for GHG emissions: UK emission estimates of CO2 from the GAUGE experiment

NASA Astrophysics Data System (ADS)

Gonzi, Siegfried; Palmer, Paul; O'Doherty, Simon; Young, Dickon; Stanley, Kieran; Stavert, Ann; Grant, Aoife; Helfter, Carole; Mullinger, Neil; Nemitz, Eiko; Allen, Grant; Pitt, Joseph; Le Breton, Michael; Bösch, Hartmut; Sembhi, Harjinder; Sonderfeld, Hannah; Parker, Robert; Bauguitte, Stephane

2016-04-01

Robust quantification of emissions of greenhouse gases (GHG) is central to the success of ongoing international efforts to slow current emissions and mitigate future climate change. The Greenhouse gAs Uk and Global Emissions (GAUGE) project aims to quantify the magnitude and uncertainty of country-scale emissions of carbon dioxide (CO2), methane (CH4) and nitrous oxide (N2O) using concentration measurements from a network of tall towers and mobile platforms (aircraft and ferry) distributed across the UK. The GAUGE measurement programme includes: (a) GHG measurements on a regular ferry route down the North Sea aimed at sampling UK outflow; (b) campaign deployment of the UK BAe-146 research aircraft to provide vertical profile measurements of GHG over and around the UK; (c) a high-density GHG measurement network over East Anglia that is primarily focused on the agricultural sector; and (d) regular measurements of CO2 and CH4 isotopologues used for GHG source attribution. We also use satellite observations from the Japanese Greenhouse gases Observing SATellite (GOSAT) to provide continental-scale constraints on GHG flux estimates. We present CO2 flux estimates for the UK inferred from GAUGE measurements using a nested, high-resolution (25 km) version of the GEOS-Chem global atmospheric chemistry and transport model and an ensemble Kalman filter. We will present our current best estimate for CO2 fluxes and a preliminary assessment of the efficacy of individual GAUGE data sources to spatially resolve CO2 flux estimates over the UK. We will also discuss how flux estimates inferred from the different models used within GAUGE can help to assess the role of transport model error and to determine an ensemble CO2 flux estimate for the UK.

Organising, Educating, and Training: Varieties of Activist Learning in Left Social Movements in Sheffield (UK)

ERIC Educational Resources Information Center

Grayson, John

2011-01-01

The article is based on activist research working in an anti-deportation social movement, and on sixteen interviews with both experienced and less experienced activists between 2009 and 2011. The anti deportation social movement made up of a range of organisations, is identified as a left social movement situated in an historic producer…

"The Chinese Approach to Learning": Cultural Trait or Situated Response? The Case of a Self-Directed Learning Programme

ERIC Educational Resources Information Center

Gieve, Simon; Clark, Rose

2005-01-01

This paper raises the question of how flexible approaches to learning are to contextual factors, as opposed to being culturally determined, with specific reference to autonomy in Chinese students studying in the UK. We describe the outcome of a research project which investigated Chinese undergraduates studying English language as part of their UK…

A. S. Hornby and 50 Years of the Hornby Trust

ERIC Educational Resources Information Center

Smith, Richard; Bowers, Roger

2012-01-01

A. S. Hornby can justly be considered the "father" of UK-based ELT. He was the founder and first Editor of English Language Teaching (now known as ELT Journal); he established the ground rules for situational language teaching, the dominant ELT methodology in the United Kingdom up until the 1970s; he was the chief originator of the…

Overactive, Overwrought or Overdrawn? The Role of Personality in Undergraduate Financial Knowledge, Decision-Making and Debt

ERIC Educational Resources Information Center

Harrison, Neil; Chudry, Farooq

2011-01-01

The financial situation of undergraduate students remains a high-profile issue within the UK higher education sector, not least due to its perceived relationship with retention, well-being and success. This article probes this question from a new direction, using concepts and approaches from the field of applied psychology to examine how students…

Parental Experiences of Dealing with Disputes in Additional Support Needs in Scotland: Why Are Parents Not Engaging with Mediation?

ERIC Educational Resources Information Center

Wright, Kevin; Stead, Joan; Riddell, Sheila; Weedon, Elisabet

2012-01-01

Partnerships with parents, particularly in the field of education, have featured prominently in policy rhetoric for many years, but routes of redress have not had much attention until relatively recently. The development of Alternative Dispute Resolution in the UK reflects the situation in several jurisdictions (e.g. Norway, Germany, the…

Letting Go and Letting the Angels Grow: Using Etienne Wenger's Community of Practice Theory to Facilitate Teacher Education

ERIC Educational Resources Information Center

Breen, Paul

2015-01-01

This paper describes a small-scale qualitative research study conducted within a community of English Language teachers, and explores how teacher development workshops can be used to foster or cultivate Communities of Practice. The study was situated in a Language Centre within the domain of UK Higher Education where there was an institutional…

An Audit Learning Experience: A Pilot Project through Cooperation with a Third Sector Organization

ERIC Educational Resources Information Center

Tonge, Richard; Willett, Caroline

2012-01-01

This paper is a critical evaluation of a pilot cooperative education project conducted with a charitable organization in the UK. An action research approach was adopted. Final level students who are studying auditing have had the opportunity to apply the knowledge and skills they are developing through their studies to a real-life situation in the…

The Impact of the Economic Downturn on Libraries: With Special Reference to University Libraries

ERIC Educational Resources Information Center

Nicholas, David; Rowlands, Ian; Jubb, Michael; Jamali, Hamid R.

2010-01-01

Evidence is presented of the extent to which libraries from around the world are experiencing financial hardship as a result of the world-wide economic downturn. Comparative analyses are provides on the grounds of country, sector and size of institution. The article concentrates on the situation of UK and US university libraries and is based on…

Languages: The Next Generation. The Final Report and Recommendations of the Nuffield Languages Inquiry.

ERIC Educational Resources Information Center

Nuffield Foundation, London (England).

This report examines the United Kingdom's (UK) capability in foreign languages and reports on what the nation should do to improve the situation. It is argued that despite the fact that English is rapidly becoming an even more dominant language in the world--it is clearly the international language of science, law, banking, business,…

The case for particle therapy.

PubMed

Jones, B

2006-01-01

Among the most important decisions facing the British Government regarding the treatment of cancer in the National Health Service (NHS) is the purchase of charged particle therapy (CPT) centres. CPT is different from conventional radiotherapy: the dose is deposited far more selectively in Bragg Peaks by either protons or "heavy" ions, such as carbon. In this way, it is possible to "dose paint" targets, voxel by voxel, with far less dose to surrounding tissues than with X-ray techniques. At present the UK possesses a 62 MeV cyclotron proton facility at Clatterbridge (Wirral), which provides therapy for intraocular cancers such as melanoma; for deeper situated cancers in the pelvis, chest etc., much higher energies, over 200 MeV are required from a synchrotron facility. There is an impressive expansion in particle beam therapy (PBT) centres worldwide, since they offer good prospects of improved quality of life with enhanced cancer cures in situations where conventional therapy is limited due to radioresistance or by the close proximity of critical normal tissues. There is a threat to UK Oncology, since it is anticipated that several thousand British patients may require referral abroad for therapy; this would severely disrupt their multidisciplinary management and require demanding logistical support.

Visual Access in Interpreter-Mediated Learning Situations for Deaf and Hard-of-Hearing High School Students Where an Artifact Is in Use.

PubMed

Berge, Sigrid Slettebakk; Thomassen, Gøril

2016-04-01

This article highlights interpreter-mediated learning situations for deaf high school students where such mediated artifacts as technical machines, models, and computer graphics are used by the teacher to illustrate his or her teaching. In these situations, the teacher's situated gestures and utterances, and the artifacts will contribute independent pieces of information. However, the deaf student can only have his or her visual attention focused on one source at a time. The problem to be addressed is how the interpreter coordinates the mediation when it comes to deaf students' visual orientation. The presented discourse analysis is based on authentic video recordings from inclusive learning situations in Norway. The theoretical framework consists of concepts of role, footing, and face-work (Goffman, E. (1959). The presentation of self in everyday life. London, UK: Penguin Books). The findings point out dialogical impediments to visual access in interpreter-mediated learning situations, and the article discusses the roles and responsibilities of teachers and educational interpreters. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Vision Too Far? Mapping the Space for a High Skills Project in the UK

ERIC Educational Resources Information Center

Lloyd, Caroline; Payne, Jonathan

2005-01-01

Although the current Labour government is committed to developing the UK as a high skills society, there is much confusion as what such a society might look like and from where it might draw its inspiration. Some academic commentators have also expressed the need for a clearer vision of the kind of society to which the UK might choose to head for…

Undergraduate teaching on biological weapons and bioterrorism at medical schools in the UK and the Republic of Ireland: results of a cross-sectional study.

PubMed

Green, Stephen T; Cladi, Lorenzo; Morris, Paul; Forde, Donall

2013-06-20

To determine if individual undergraduate schools of medicine in the UK and the Republic of Ireland provide any teaching to medical students about biological weapons, bioterrorism, chemical weapons and weaponised radiation, if they perceive them to be relevant issues and if they figure them in their future plans. A cross-sectional study utilising an internet-based questionnaire sent to key figures responsible for leading on the planning and delivery of undergraduate medical teaching at all schools of medicine in the UK and Ireland. All identified undergraduate schools of medicine in the UK and Ireland between August 2012 and December 2012. Numerical data and free text feedback about relevant aspects of undergraduate teaching. Of the 38 medical schools approached, 34 (28 in UK, 6 in Ireland) completed the questionnaire (89.47%). 4 (all in UK) chose not to complete it. 6/34 (17.65%) included some specific teaching on biological weapons and bioterrorism. 7/34 (20.59%) had staff with bioterrorism expertise (mainly in microbiological and syndromic aspects). 4/34 (11.76%) had plans to introduce some specific teaching on bioterrorism. Free text responses revealed that some felt that because key bodies (eg, UK's General Medical Council) did not request teaching on bioterrorism, then it should not be included, while others regarded this field of study as a postgraduate subject and not appropriate for undergraduates, or argued that the curriculum was too congested already. 4/34 (11.76%) included some specific teaching on chemical weapons, and 3/34 (8.82%) on weaponised radiation. This study provides evidence that at the present time there is little teaching at the undergraduate level in the UK and Ireland on the subjects of biological weapons and bioterrorism, chemical weapons and weaponised radiation and signals that this situation is unlikely to change unless there were to be high-level policy guidance.

Undergraduate teaching on biological weapons and bioterrorism at medical schools in the UK and the Republic of Ireland: results of a cross-sectional study

PubMed Central

Green, Stephen T; Cladi, Lorenzo; Morris, Paul; Forde, Donall

2013-01-01

Objective To determine if individual undergraduate schools of medicine in the UK and the Republic of Ireland provide any teaching to medical students about biological weapons, bioterrorism, chemical weapons and weaponised radiation, if they perceive them to be relevant issues and if they figure them in their future plans. Design A cross-sectional study utilising an internet-based questionnaire sent to key figures responsible for leading on the planning and delivery of undergraduate medical teaching at all schools of medicine in the UK and Ireland. Setting All identified undergraduate schools of medicine in the UK and Ireland between August 2012 and December 2012. Outcome measures Numerical data and free text feedback about relevant aspects of undergraduate teaching. Results Of the 38 medical schools approached, 34 (28 in UK, 6 in Ireland) completed the questionnaire (89.47%). 4 (all in UK) chose not to complete it. 6/34 (17.65%) included some specific teaching on biological weapons and bioterrorism. 7/34 (20.59%) had staff with bioterrorism expertise (mainly in microbiological and syndromic aspects). 4/34 (11.76%) had plans to introduce some specific teaching on bioterrorism. Free text responses revealed that some felt that because key bodies (eg, UK's General Medical Council) did not request teaching on bioterrorism, then it should not be included, while others regarded this field of study as a postgraduate subject and not appropriate for undergraduates, or argued that the curriculum was too congested already. 4/34 (11.76%) included some specific teaching on chemical weapons, and 3/34 (8.82%) on weaponised radiation. Conclusions This study provides evidence that at the present time there is little teaching at the undergraduate level in the UK and Ireland on the subjects of biological weapons and bioterrorism, chemical weapons and weaponised radiation and signals that this situation is unlikely to change unless there were to be high-level policy guidance. PMID:23794539

The Legal Implications of Student Use of Social Networking Sites in the UK and US: Current Concerns and Lessons for the Future

ERIC Educational Resources Information Center

Davies, Mark R.; Lee, Barbara A.

2008-01-01

This paper provides a comparative snapshot of the current state of the law in the US and UK with respect to potential liability of university and college students for use (and misuse) of social networking sites. It reviews the limited case law on this topic, highlights the differences in the two nations' laws of defamation and the various possible…

Incorporation of UK Met Office's radiation scheme into CPTEC's global model

NASA Astrophysics Data System (ADS)

Chagas, Júlio C. S.; Barbosa, Henrique M. J.

2009-03-01

Current parameterization of radiation in the CPTEC's (Center for Weather Forecast and Climate Studies, Cachoeira Paulista, SP, Brazil) operational AGCM has its origins in the work of Harshvardhan et al. (1987) and uses the formulation of Ramaswamy and Freidenreich (1992) for the short-wave absorption by water vapor. The UK Met Office's radiation code (Edwards and Slingo, 1996) was incorporated into CPTEC's global model, initially for short-wave only, and some impacts of that were shown by Chagas and Barbosa (2006). Current paper presents some impacts of the complete incorporation (both short-wave and long-wave) of UK Met Office's scheme. Selected results from off-line comparisons with line-by-line benchmark calculations are shown. Impacts on the AGCM's climate are assessed by comparing output of climate runs of current and modified AGCM with products from GEWEX/SRB (Surface Radiation Budget) project.

Tackling Health Inequalities in the United Kingdom: The Progress and Pitfalls of Policy

PubMed Central

Exworthy, Mark; Blane, David; Marmot, Michael

2003-01-01

Goal Assess the progress and pitfalls of current United Kingdom (U.K.) policies to reduce health inequalities. Objectives (1) Describe the context enabling health inequalities to get onto the policy agenda in the United Kingdom. (2) Categorize and assess selected current U.K. policies that may affect health inequalities. (3) Apply the “policy windows” model to understand the issues faced in formulating and implementing such policies. (4) Examine the emerging policy challenges in the U.K. and elsewhere. Data Sources Official documents, secondary analyses, and interviews with policymakers. Study Design Qualitative, policy analysis. Data Collection 2001–2002. The methods were divided into two stages. The first identified policies which were connected with individual inquiry recommendations. The second involved case-studies of three policies areas which were thought to be crucial in tackling health inequalities. Both stages involved interviews with policy-makers and documentary analysis. Principal Findings (1) The current U.K. government stated a commitment to reducing health inequalities. (2) The government has begun to implement policies that address the wider determinants. (3) Some progress is evident but many indicators remain stubborn. (4) Difficulties remain in terms of coordinating policies across government and measuring progress. (5) The “policy windows” model explains the limited extent of progress and highlights current and possible future pitfalls. (6) The U.K.'s experience has lessons for other governments involved in tackling health inequalities. Conclusions Health inequalities are on the agenda of U.K. government policy and steps have been made to address them. There are some signs of progress but much remains to be done including overcoming some of the perverse incentives at the national level, improving joint working, ensuring appropriate measures of performance/progress, and improving monitoring arrangements. A conceptual policy model aids understanding and points to ways of sustaining and extending the recent progress and overcoming pitfalls. PMID:14727803

Eatwell Guide: modelling the dietary and cost implications of incorporating new sugar and fibre guidelines.

PubMed

Scarborough, Peter; Kaur, Asha; Cobiac, Linda; Owens, Paul; Parlesak, Alexandr; Sweeney, Kate; Rayner, Mike

2016-12-21

To model food group consumption and price of diet associated with achieving UK dietary recommendations while deviating as little as possible from the current UK diet, in order to support the redevelopment of the UK food-based dietary guidelines (now called the Eatwell Guide). Optimisation modelling, minimising an objective function of the difference between population mean modelled and current consumption of 125 food groups, and constraints of nutrient and food-based recommendations. The UK. Adults aged 19 years and above from the National Diet and Nutrition Survey 2008-2011. Proportion of diet consisting of major foods groups and price of the optimised diet. The optimised diet has an increase in consumption of 'potatoes, bread, rice, pasta and other starchy carbohydrates' (+69%) and 'fruit and vegetables' (+54%) and reductions in consumption of 'beans, pulses, fish, eggs, meat and other proteins' (-24%), 'dairy and alternatives' (-21%) and 'foods high in fat and sugar' (-53%). Results within food groups show considerable variety (eg, +90% for beans and pulses, -78% for red meat). The modelled diet would cost £5.99 (£5.93 to £6.05) per adult per day, very similar to the cost of the current diet: £6.02 (£5.96 to £6.08). The optimised diet would result in increased consumption of n-3 fatty acids and most micronutrients (including iron and folate), but decreased consumption of zinc and small decreases in consumption of calcium and riboflavin. To achieve the UK dietary recommendations would require large changes in the average diet of UK adults, including in food groups where current average consumption is well within the recommended range (eg, processed meat) or where there are no current recommendations (eg, dairy). These large changes in the diet will not lead to significant changes in the price of the diet. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

International rescue? Managing the dental tourist.

PubMed

Iqbal, Junaid; Shah, Shilpa; Ashley, Martin

2014-01-01

The concept of dental tourism can be considered two-fold. On one side it is a term used to describe non-UK residing patients who visit, requesting NHS dental care whilst here in the U.K. Alternatively, it also encompasses patients who travel to destinations outside their residing countries to receive care. The latter has become an ever-growing issue in the U.K.; one that warrants appropriate management and knowledge of current legislation amongst dental professionals. Clarity and guidance on who is eligible for care under the NHS when visiting the U.K. and who, if anyone, is ultimately responsible when treatment abroad fails.

Laboratory Diagnosis and Characterization of Fungal Disease in Patients with Cystic Fibrosis (CF): A Survey of Current UK Practice in a Cohort of Clinical Microbiology Laboratories.

PubMed

Boyle, Maeve; Moore, John E; Whitehouse, Joanna L; Bilton, Diana; Downey, Damian G

2018-03-02

There is much uncertainty as to how fungal disease is diagnosed and characterized in patients with cystic fibrosis (CF). A 19-question anonymous electronic questionnaire was developed and distributed to ascertain current practice in clinical microbiology laboratories providing a fungal laboratory service to CF centres in the UK. Analyses of responses identified the following: (1) current UK laboratory practice, in general, follows the current guidelines, but the scope and diversity of what is currently being delivered by laboratories far exceeds what is detailed in the guidelines; (2) there is a lack of standardization of fungal tests amongst laboratories, outside of the current guidelines; (3) both the UK CF Trust Laboratory Standards for Processing Microbiological Samples from People with Cystic Fibrosis and the US Cumulative Techniques and Procedures in Clinical Microbiology (Cumitech) Guidelines 43 Cystic Fibrosis Microbiology need to be updated to reflect both new methodological innovations, as well as better knowledge of fungal disease pathophysiology in CF; (4) there is a need for clinical medicine to decide upon a stratification strategy for the provision of new fungal assays that will add value to the physician in the optimal management of CF patients; (5) there is also a need to rationale what assays should be performed at local laboratory level and those which are best served at National Mycology Reference Laboratory level; and (6) further research is required in developing laboratory assays, which will help ascertain the clinical importance of 'old' fungal pathogens, as well as 'emerging' fungal pathogens.

German EstSmoke: estimating adult smoking-related costs and consequences of smoking cessation for Germany.

PubMed

Sonntag, Diana; Gilbody, Simon; Winkler, Volker; Ali, Shehzad

2018-01-01

We compared predicted life-time health-care costs for current, never and ex-smokers in Germany under the current set of tobacco control polices. We compared these economic consequences of the current situation with an alternative in which Germany were to implement more comprehensive tobacco control policies consistent with the World Health Organization (WHO) Framework Convention for Tobacco Control (FCTC) guidelines. German EstSmoke, an adapted version of the UK EstSmoke simulation model, applies the Markov modelling approach. Transition probabilities for (re-)currence of smoking-related diseases were calculated from large German disease-specific registries and the German Health Update (GEDA 2010). Estimations of both health-care costs and effect sizes of smoking cessation policies were taken from recent German studies and discounted at 3.5%/year. Germany. German population of prevalent current, never and ex-smokers in 2009. Life-time cost and outcomes in current, never and ex-smokers. If tobacco control policies are not strengthened, the German smoking population will incur €41.56 billion life-time excess costs compared with never smokers. Implementing tobacco control policies consistent with WHO FCTC guidelines would reduce the difference of life-time costs between current smokers and ex-smokers by at least €1.7 billion. Modelling suggests that the life-time healthcare costs of people in Germany who smoke are substantially greater than those of people who have never smoked. However, more comprehensive tobacco control policies could reduce health-care expenditures for current smokers by at least 4%. © 2017 Society for the Study of Addiction.

Community occupational therapy for people with dementia and family carers (COTiD-UK) versus treatment as usual (Valuing Active Life in Dementia [VALID] programme): study protocol for a randomised controlled trial.

PubMed

Wenborn, Jennifer; Hynes, Sinéad; Moniz-Cook, Esme; Mountain, Gail; Poland, Fiona; King, Michael; Omar, Rumana; Morris, Steven; Vernooij-Dassen, Myrra; Challis, David; Michie, Susan; Russell, Ian; Sackley, Catherine; Graff, Maud; O'Keeffe, Aidan; Crellin, Nadia; Orrell, Martin

2016-02-03

A community-based occupational therapy intervention for people with mild to moderate dementia and their family carers (Community Occupational Therapy in Dementia (COTiD)) was found clinically and cost effective in the Netherlands but not in Germany. This highlights the need to adapt and implement complex interventions to specific national contexts. The current trial aims to evaluate the United Kingdom-adapted occupational therapy intervention for people with mild to moderate dementia and their family carers living in the community (COTiD-UK) compared with treatment as usual. This study is a multi-centre, parallel-group, pragmatic randomised trial with internal pilot. We aim to allocate 480 pairs, with each pair comprising a person with mild to moderate dementia and a family carer, who provides at least 4 hours of practical support per week, at random between COTiD-UK and treatment as usual. We shall assess participants at baseline, 12 and 26 weeks, and by telephone at 52 and 78 weeks (first 40% of recruits only) after randomisation. The primary outcome measure is the Bristol Activities of Daily Living Scale (BADLS) at 26 weeks. Secondary outcome measures will include quality of life, mood, and resource use. To assess intervention delivery, and client experience, we shall collect qualitative data via audio recordings of COTiD-UK sessions and conduct semi-structured interviews with pairs and occupational therapists. COTiD-UK is an evidence-based person-centred intervention that reflects the current priority to enable people with dementia to remain in their own homes by improving their capabilities whilst reducing carer burden. If COTiD-UK is clinically and cost effective, this has major implications for the future delivery of dementia services across the UK. Current Controlled Trials ISRCTN10748953 Date of registration: 18 September 2014.

JPRS Report, Epidemiology.

DTIC Science & Technology

1989-09-28

Market Bans Export of UK Cows To Combat Disease [Godfrey Brown; London THE DAILY TELEGRAPH, 27 Jul 89] 28 JPRS-TEP-89-016 28 SEPTEMBER 1989 SUB...educational, legal, ethical and media reporting aspects. More than 80 delegates from Thailand, Indonesia, Malaysia , Singapore, Japan, Australia, Canada...gathered that ’Stebatin’ injection used to cure kalaazar has been scanty in the market . Taking advan- tage of this situation some dishonest druggists

Underachievement, Failing Youth and Moral Panics

ERIC Educational Resources Information Center

Smith, Emma

2010-01-01

This paper considers contemporary "moral panics" around the underachievement of boys in school examinations in the UK and America. In the UK, in particular, the underachievement of boys is central to current "crisis accounts" about falling standards and failing pupils. "Underachievement" is a familiar word to those…

CHP -- A revolution in the making

DOE Office of Scientific and Technical Information (OSTI.GOV)

Green, D.

1999-07-01

Liberalization, globalization, and particularly climate change are changing energy thinking. In the future, climate change will be tackled by improved energy efficiency and carbon neutral sources of energy, but much more could be done today by the more widespread use of CHP. CHP has made reasonably good progress in the UK and Europe, due to energy industry liberalization and the widespread availability of gas. But the pursuit of sustainability objectives requires government intervention into liberalized markets. While the current UK Government is a strong supporter of CHP, major opportunities to develop CHP were missed in favor of less efficient CCGTmore » power stations over the last decade. The two critical policy issues in the UK now are the proposed tax on the business use of energy and the current reform of electricity trading arrangements. Both could impact favorably on the development of CHP. The UK CHP Association, COGEN Europe and the International Cogeneration Alliance continue to press the case for CHP.« less

Prevalence of markers for HIV, hepatitis B and hepatitis C infection in UK military recruits.

PubMed

Brown, A E; Ross, D A; Simpson, A J H; Erskine, R S; Murphy, G; Parry, J V; Gill, O N

2011-08-01

An unlinked anonymous survey was conducted to measure the prevalence of selected markers for HIV, hepatitis B and C infection in recruits to the UK Armed Forces to inform future screening and hepatitis B vaccination policies. During 2007, nearly 14 000 left-over samples taken from new recruits for blood typing were collected, unlinked from identifiers and anonymously tested for HIV, hepatitis C and current and past cleared hepatitis B infection. Overall, serological evidence of HIV and hepatitis C was found in 0·06% and 0·06% of recruits, respectively. Evidence of past cleared and current hepatitis B infection was found in 3·63% and 0·37% of recruits, respectively. Overall, prevalence rates were broadly consistent with UK population estimates of infection. However, HIV and hepatitis B prevalence was higher in recruits of African origin than in those from the UK (P<0·0001). Screening for these infections is an option that could be considered for those entering Services from high-prevalence countries.

National audit of cerebrospinal fluid testing.

PubMed

Holbrook, Ian; Beetham, Robert; Cruickshank, Anne; Egner, William; Fahie-Wilson, Mike; Keir, Geoff; Patel, Dina; Watson, Ian; White, Peter

2007-09-01

UK National External Quality Assessment Service (NEQAS) Specialist Advisory Group for EQA of CSF Proteins and Biochemistry was interested in current practice for the biochemical investigation of cerebrospinal fluid (CSF) in the UK. A questionnaire was sent to laboratories via regional audit committees and the results collated. Most laboratories were analysing CSF in a satisfactory manner. There was some variation in the reference ranges used for glucose, protein and lactate. There was concern about the rejection policies of some laboratories on these unrepeatable samples and the wavelengths used to measure bilirubin. The survey revealed the lack of spectrophotometric scanning for haem pigments and bilirubin in some hospitals. The current practice for the measurement of CSF samples in the UK is satisfactory in most laboratories responding to the questionnaire. National agreement on reference ranges for glucose, protein and lactate should be achievable. Those performing spectrophotometric scanning of the CSF were doing so in concordance with the national guidelines. Some hospitals in the UK may not have responded to the questionnaire because they did not offer spectrophotometric scanning.

Lessons from UK Digitization research

NASA Astrophysics Data System (ADS)

Ross, Eamon T.

2002-08-01

The paper describes the findings and approach of Ex NEAR HORIZONS, which as part of a series of trials, aimed to explore the performance characteristics and potential operational benefits of a number of technology inserts for the UK Digitization Programme. Although the exercise contained 5 discrete options (hypotheses) for improvement in Command, Control, Communications, Computing and Information (C4I) this paper explores only two of these: a web-based approach and the provision of technology to support distributed and co-located collaborative team working. Despite the commercial world moving towards an information exchange model based on publish and subscribe, the trial found that, although the concept was well received, the implications for changes in organsiation and process were substantial. When working collaboratively in a distributed environment, the findings indicate difficulties in gaining an initial shared understanding of the situation and to exercise command. The participants were a wide range of regular British Army Officers, not only to provide broad views on current military benefits but also to move away from the traditional trials, which tend to expose a single HQ, with prescriptive processes and organizations to the technology. The innovative trial was considered to have been very successful, gathering a considerable body of valuable data and identifying clear paths for exploitation of information technologies to support the military decision- maker. The paper extrapolates the findings of the trial to provide comment on the potential difficulties facing the concept of Network Centric Warfare.

Impact of extreme weather events and climate change for health and social care systems.

PubMed

Curtis, Sarah; Fair, Alistair; Wistow, Jonathan; Val, Dimitri V; Oven, Katie

2017-12-05

This review, commissioned by the Research Councils UK Living With Environmental Change (LWEC) programme, concerns research on the impacts on health and social care systems in the United Kingdom of extreme weather events, under conditions of climate change. Extreme weather events considered include heatwaves, coldwaves and flooding. Using a structured review method, we consider evidence regarding the currently observed and anticipated future impacts of extreme weather on health and social care systems and the potential of preparedness and adaptation measures that may enhance resilience. We highlight a number of general conclusions which are likely to be of international relevance, although the review focussed on the situation in the UK. Extreme weather events impact the operation of health services through the effects on built, social and institutional infrastructures which support health and health care, and also because of changes in service demand as extreme weather impacts on human health. Strategic planning for extreme weather and impacts on the care system should be sensitive to within country variations. Adaptation will require changes to built infrastructure systems (including transport and utilities as well as individual care facilities) and also to institutional and social infrastructure supporting the health care system. Care sector organisations, communities and individuals need to adapt their practices to improve resilience of health and health care to extreme weather. Preparedness and emergency response strategies call for action extending beyond the emergency response services, to include health and social care providers more generally.

Approaches to the vaccination of pregnant women: experience from Stockport, UK, with prenatal influenza.

PubMed

Baxter, David

2013-06-01

For the 2010/11 influenza season the prenatal vaccination program was extended to all women in England and Wales irrespective of gestational age--this was a considerable shift in practice for both pregnant women and healthcare providers where the emphasis previously had been only on targeted vaccination for pregnant women with adverse risk factors for influenza infection. This paper will describe the program's operation in Stockport, UK during this season when uptake was among the highest in the England and Wales. Stockport is situated in the south east of Greater Manchester. It is a generally affluent area with a population of 295,000. Health indicators are generally higher than the regional average. The target population for influenza is just under 50,000 residents (excluding pregnant women).

The complexity of patient safety reporting systems in UK dentistry.

PubMed

Renton, T; Master, S

2016-10-21

Since the 'Francis Report', UK regulation focusing on patient safety has significantly changed. Healthcare workers are increasingly involved in NHS England patient safety initiatives aimed at improving reporting and learning from patient safety incidents (PSIs). Unfortunately, dentistry remains 'isolated' from these main events and continues to have a poor record for reporting and learning from PSIs and other events, thus limiting improvement of patient safety in dentistry. The reasons for this situation are complex.This paper provides a review of the complexities of the existing systems and procedures in relation to patient safety in dentistry. It highlights the conflicting advice which is available and which further complicates an overly burdensome process. Recommendations are made to address these problems with systems and procedures supporting patient safety development in dentistry.

Aspects of deceased organ donation in paediatrics.

PubMed

Brierley, J; Hasan, A

2012-01-01

Organ transplantation offers children in acute or chronic severe organ failure similar opportunities to adults. However, while the number who might benefit is relatively low, significantly fewer cadaveric donors exist for any given child compared with an adult. Incompatible organ size and relatively low donation rates mean that despite living parental donation and innovations to reduce donated organ size, children die before organs become available. The severity of the UK situation is compounded by restrictions on paediatric living donation, uncertainties over the application of brain death criteria, and ethical concerns about the use of donation after circulatory death. The UK Department of Health's Organ Donation Task Force suggested the means by which the adult donor pool might be increased, recommending that outstanding ethical and legal issues be resolved, but made no specific recommendations about children.

Quest for certainty regarding early discharge in paediatric low-risk febrile neutropenia: a multicentre qualitative focus group discussion study involving patients, parents and healthcare professionals in the UK

PubMed Central

Phillips, Bob; Stewart, Lesley A; Atkin, Karl

2018-01-01

Objectives A systematic review of paediatric low-risk febrile neutropenia found that outpatient care is safe, with low rates of treatment failure. However, this review, and a subsequent meta-ethnography, suggested that early discharge of these patients may not be acceptable to key stakeholders. This study aimed to explore experiences and perceptions of patients, parents and healthcare professionals involved in paediatric febrile neutropenia care in the UK. Setting Three different centres within the UK, purposively selected from a national survey on the basis of differences in their service structure and febrile neutropenia management. Participants Thirty-two participants were included in eight focus group discussions. Primary outcomes Experiences and perceptions of paediatric febrile neutropenia care, including possible future reductions in therapy. Results Participants described a quest for certainty, in which they attempted to balance the uncertainty involved in understanding, expressing and negotiating risk with the illusion of certainty provided by strict protocols. Participants assessed risk using both formal and informal stratification tools, overlaid with emotional reactions to risk and experiences of risk within other situations. The benefits of certainty provided by protocols were counterbalanced by frustration at their strict constraints. The perceived benefits and harms of previous inpatient care informed participants’ appraisals of future treatment strategies. Conclusions This study highlighted the previously underestimated harms of admission for febrile neutropenia and the paternalistic nature of decision making, along with the frustrations and challenges for all parties involved in febrile neutropenia care. It demonstrates how the same statistics, generated by systematic reviews, can be used by key stakeholders to interpret risk differently, and how families in particular can view the harms of therapeutic options as different from the outcomes used within the literature. It justifies a reassessment of current treatment strategies for these children and further exploration of the potential to introduce shared decision making. PMID:29764879

Do Universities Have "Successful" Brands?

ERIC Educational Resources Information Center

Chapleo, Chris

2005-01-01

Branding in universities is a topical issue, but arguably few UK universities have fully developed "successful" brands in the manner of commercial organizations. This qualitative paper explores the opinions of 40 opinion formers on which UK universities have successful brands and the associations these brands have. Current literature on…

Current and future climate- and air pollution-mediated impacts on human health.

PubMed

Doherty, Ruth M; Heal, Mathew R; Wilkinson, Paul; Pattenden, Sam; Vieno, Massimo; Armstrong, Ben; Atkinson, Richard; Chalabi, Zaid; Kovats, Sari; Milojevic, Ai; Stevenson, David S

2009-12-21

We describe a project to quantify the burden of heat and ozone on mortality in the UK, both for the present-day and under future emission scenarios. Mortality burdens attributable to heat and ozone exposure are estimated by combination of climate-chemistry modelling and epidemiological risk assessment. Weather forecasting models (WRF) are used to simulate the driving meteorology for the EMEP4UK chemistry transport model at 5 km by 5 km horizontal resolution across the UK; the coupled WRF-EMEP4UK model is used to simulate daily surface temperature and ozone concentrations for the years 2003, 2005 and 2006, and for future emission scenarios. The outputs of these models are combined with evidence on the ozone-mortality and heat-mortality relationships derived from epidemiological analyses (time series regressions) of daily mortality in 15 UK conurbations, 1993-2003, to quantify present-day health burdens. During the August 2003 heatwave period, elevated ozone concentrations > 200 microg m-3 were measured at sites in London and elsewhere. This and other ozone photochemical episodes cause breaches of the UK air quality objective for ozone. Simulations performed with WRF-EMEP4UK reproduce the August 2003 heatwave temperatures and ozone concentrations. There remains day-to-day variability in the high ozone concentrations during the heatwave period, which on some days may be explained by ozone import from the European continent.Preliminary calculations using extended time series of spatially-resolved WRF-EMEP4UK model output suggest that in the summers (May to September) of 2003, 2005 & 2006 over 6000 deaths were attributable to ozone and around 5000 to heat in England and Wales. The regional variation in these deaths appears greater for heat-related than for ozone-related burdens.Changes in UK health burdens due to a range of future emission scenarios will be quantified. These future emissions scenarios span a range of possible futures from assuming current air quality legislation is fully implemented, to a more optimistic case with maximum feasible reductions, through to a more pessimistic case with continued strong economic growth and minimal implementation of air quality legislation. Elevated surface ozone concentrations during the 2003 heatwave period led to exceedences of the current UK air quality objective standards. A coupled climate-chemistry model is able to reproduce these temperature and ozone extremes. By combining model simulations of surface temperature and ozone with ozone-heat-mortality relationships derived from an epidemiological regression model, we estimate present-day and future health burdens across the UK. Future air quality legislation may need to consider the risk of increases in future heatwaves.

PREFACE: XI Conference on Beauty, Charm, Hyperons in Hadronic Interactions BEACH

NASA Astrophysics Data System (ADS)

Bozzo, Marco

2014-11-01

This volume contains the invited and contributed papers presented at the 11th International Conference on Hyperons, Charm and Beauty Hadrons, currently known as the BEACH Conferences. The BEACH conferences cover a broad range of physics topics in the field of Hyperon and heavy-flavor physics. This conference continues the BEACH series, which began with a meeting in Strasbourg in 1995 and since then offers a biennial opportunity for both theorists and experimentalists from the high-energy physics community to discuss all aspects of flavour physics. The 11th Conference took place in the Lecture Theatre of the Physics West Building of the University of Birmingham (United Kingdom) from July 22nd to July 26th and was attended by 107 participants. All of the sessions were plenary sessions accommodating review talks and shorter contributions discussing both theory and recent experiments. At the end of the conference Valerie Gibson (Cavendish Laboratory, University of Cambridge, UK) and Sebastian Jaeger (School of Physics and Astronomy, University of Sussex, UK) summarized and put in context all the presentations of the conference giving two very interesting Summary talks. These Conference Proceedings are particularly interesting since, due to the long shutdown of the LHC in Geneva (CH), most of the data presented were from the entire data set available. This volume in fact offers an interesting panorama of the present situation and allows a comparison of the experimental data and the theory in a field that is always in continuous evolution. The conference was impeccably organized by the Local Organizing Committee chaired by Cristina Lazzeroni (Birmingham Univeristy, Birmingham, UK) that I want to thank particularly here. Many from the University Staff have contributed to the smooth running of the conference. We would like to thank the Local Scientific Secretariat for their invaluable help in making the conference a truly enjoyable and unforgettable event; a special thanks goes also to Maria Hobbs, our local secretary, who worked tirelessly in the organization of every detail. Finally we would like thank the European Organization for Nuclear Research, the European Research Council, the UK Science and Technology Facility Council, the UK Institute of Particle Physics Phenomenology and the University of Birmingham for their generous support. The next BEACH Conference will be held at George Mason University, George Mason University Fairfax, Virginia (USA) at the beginning of summer 2016 and I hope that we will all meet again there.

The predictive validity of a situational judgement test, a clinical problem solving test and the core medical training selection methods for performance in specialty training .

PubMed

Patterson, Fiona; Lopes, Safiatu; Harding, Stephen; Vaux, Emma; Berkin, Liz; Black, David

2017-02-01

The aim of this study was to follow up a sample of physicians who began core medical training (CMT) in 2009. This paper examines the long-term validity of CMT and GP selection methods in predicting performance in the Membership of Royal College of Physicians (MRCP(UK)) examinations. We performed a longitudinal study, examining the extent to which the GP and CMT selection methods (T1) predict performance in the MRCP(UK) examinations (T2). A total of 2,569 applicants from 2008-09 who completed CMT and GP selection methods were included in the study. Looking at MRCP(UK) part 1, part 2 written and PACES scores, both CMT and GP selection methods show evidence of predictive validity for the outcome variables, and hierarchical regressions show the GP methods add significant value to the CMT selection process. CMT selection methods predict performance in important outcomes and have good evidence of validity; the GP methods may have an additional role alongside the CMT selection methods. © Royal College of Physicians 2017. All rights reserved.

Air quality management: evolution of policy and practice in the UK as exemplified by the experience of English local government

NASA Astrophysics Data System (ADS)

Beattie, C. I.; Longhurst, J. W. S.; Woodfield, N. K.

The air quality management (AQM) framework in the UK is designed to be an effects-based solution to air pollutants currently affecting human health. The AQM process has been legislated through The Environment Act 1995, which required the National Air Quality Strategy (NAQS) to be published. AQM practice and capability within local authorities has flourished since the publication of the NAQS in March 1997. This paper outlines the policy framework within which the UK operates, both at a domestic and European level, and reviews the air quality management process relating to current UK policy and EU policy. Data from questionnaire surveys are used to indicate the involvement of various sectors of local government in the air quality management process. These data indicate an increasing use of monitoring, and use of air dispersion modelling by English local authorities. Data relating to the management of air quality, for example, the existence and work of air quality groups, dissemination of information to the public and policy measures in place on a local scale to improve air quality, have also been reported. The UK NAQS has been reviewed in 1999 to reflect developments in European legislation, technological and scientific advances, improved air pollution modelling techniques and an increasingly better understanding of the socio-economic issues involved. The AQM process, as implemented by UK local authorities, provides an effective model for other European member states with regards to the implementation of the Air Quality Framework Directive. The future direction of air quality policy in the UK is also discussed.

What determines patient preferences for treating low risk basal cell carcinoma when comparing surgery vs imiquimod? A discrete choice experiment survey from the SINS trial.

PubMed

Tinelli, Michela; Ozolins, Mara; Bath-Hextall, Fiona; Williams, Hywel C

2012-10-04

The SINS trial (Controlled Clinical Trials ISRCTN48755084; Eudract No. 2004-004506-24) is a randomised controlled trial evaluating long term success of excisional surgery vs. imiquimod 5% cream for low risk nodular and superficial basal cell carcinoma (BCC). The trial included a discrete choice experiment questionnaire to explore patient preferences of a cream versus surgery for the treatment of their skin cancer. The self-completed questionnaire was administered at baseline to 183 participants, measuring patients' strength of preferences when choosing either alternative 'surgery' or 'imiquimod cream' instead of a fixed 'current situation' option (of surgical excision as standard practice in UK). The treatments were described according to: cost, chance of complete clearance, side effects and appearance. Participants had to choose between various scenarios. Analysis was performed using a mixed logit model, which took into account the impact of previous BCC treatment and sample preference variability. The analysis showed that respondents preferred 'imiquimod cream' to their 'current situation' or 'surgery', regardless of previous experience of BCC symptoms and treatment. Respondents were more likely to be worried about their cosmetic outcomes and side effects they might experience over and above their chance of clearance and cost. Those with no experience of surgery (compared with experience) valued more the choice of 'imiquimod cream' (£1013 vs £781). All treatment characteristics were significant determinants of treatment choice, and there was significant variability in the population preferences for all of them. Patients with BCC valued more 'imiquimod cream' than alternative 'surgery' options, and all treatment characteristics were important for their choice of care. Understanding how people with a BCC value alternative interventions may better inform the development of health care interventions.

REIMBURSEMENT OF CELL-BASED REGENERATIVE THERAPY IN THE UK AND FRANCE

PubMed Central

Mahalatchimy, Aurélie

2016-01-01

Cell-based regenerative therapies are presented as being able to cure the diseases of the twenty-first century, especially those coming from the degeneration of the aging human body. But their specific nature based on biological materials raises particular challenging issues on how regulation should frame biomedical innovation for society's benefit regarding public health. The European Union (EU) supports the development of cell-based regenerative therapies that are medicinal products with a specific regulation providing their wide access to the European market for European patients. However, once these medicinal products have obtained a European marketing authorisation, they are still far away from being fully accessible to European patients in all EU Member States. Whereas there is much written on the EU regulatory system for new biotechnologies, there is no systematic legal study comparing the insurance provisions in two EU countries. Focussing on the situation in the UK and France that are based on two different healthcare systems, this paper is based on a comparative methodological approach. It raises the question of regulatory reimbursement mechanisms that determine access to innovative treatments and their consequences for social protection systems in the general context of public health. After having compared the French and English regulations of cell-based regenerative therapy regarding pricing and reimbursement, this papers analyses how England and France are addressing two main challenges of cell-based regenerative therapy, to take into account their long-term benefit through their potential curative nature and their high upfront cost, towards their adoption within the English and French healthcare systems. It concludes that England and France have different general legal frameworks that are not specific to the reimbursement of cell-based regenerative therapy, although their two current and respective trends would bring more convergence between the two systems while addressing the main challenges for the reimbursement of these therapies. Nevertheless, despite their current differences, neither the English nor the French national healthcare system has yet approved the reimbursement of cell-based regenerative therapies. The paper highlights where both systems could be learning from each others' experiences to favour the adoption of cell-based regenerative therapies through the adaptation of their reimbursement methodologies. It also emphasises the gap between market access and patients’ access, and it calls for research and discussions through reflexive agencies such as the Regenerative Medicine Expert Group in the UK. PMID:27083495

Public Health England's Migrant Health Guide: an online resource for primary care practitioners.

PubMed

Crawshaw, A F; Kirkbride, H

2018-05-01

Approximately 13% of the UK population in 2015 was born overseas. Most migrants have come to the UK to work or study although there has been a small increase in the number of asylum applications in the UK in recent years, reflective of the ongoing humanitarian situation across Europe. Migrants in the UK tend to be young and healthy, but some may face unique health needs as a result of their experiences before, during and after migration. For these needs to be appropriately recognised and addressed, evidence-based advice is needed for UK professionals. The Migrant Health Guide is a free online tool for healthcare professionals. It was launched in 2011 and is widely used in the UK and internationally. It has four sections: 1) Migrants and the NHS-information on access and entitlements to the National Health Service (NHS); 2) Assessing patients-includes a checklist for initial healthcare assessments and advice for patients travelling abroad to visit friends and relatives; 3) Countries-country-specific advice on infectious diseases, women's health and nutritional and metabolic concerns; and 4) Health topics-information about communicable and non-communicable diseases and other health issues. The guide has undergone an extensive update in 2017. In particular, the pages on mental health and human trafficking have been expanded. A formal evaluation will obtain feedback on the guide and measure changes in awareness, knowledge, opinions, attitudes and behaviour of end users. Findings will inform future revisions and updates to the guide. Public Health England's Migrant Health Guide is a valuable resource for healthcare professionals. The relaunched guide builds on the previous version in raising awareness of key issues and providing evidence-based advice to improve the health of migrants and refugees internationally and in the UK. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

Assessment of the footprint and carrying capacity of oil and gas well sites: the implications for limiting hydrocarbon resources.

NASA Astrophysics Data System (ADS)

Clancy, Sarah; Worrall, Fred; Davies, Richard; Gluyas, Jon

2017-04-01

The rapid growth of shale gas developments within the United States and the possibility of developments within Europe have raised concerns about the impact and potential environmental cost. In this study we estimated the likely physical footprint of well pads if shale gas or oil developments were to go forward in Europe and used these estimates to understand the impact upon existing infrastructure; the carrying capacity of the environment and how this may limit the proportion of resources that are accessible estimates. Conventional well pads in UK, The Netherlands and Poland were examined. For the existing UK conventional well pads the current minimum setback from a building for a currently producing well was measured. To assess the carrying capacity of the land surface, well pads, of the average well pad footprint, with recommended setbacks, were randomly placed into the licensed blocks covering the Bowland Shale, UK, and the extent to which they would interact or disrupt existing infrastructure assessed. The average conventional well site footprints were: 10800 m2 (1.08 ha) in the UK; 44600 m2 (4.46 ha) in The Netherlands; and 3000 m2 (0.30 ha) in Poland. The average area per well was: 541 m^2/well (0.05 ha/well) for the UK; 2870 m^2/well (0.29 ha/well) for Poland; and 6370 m^2/well (0.64 ha/well) for The Netherlands. Average access road lengths were: 230 m in the UK; 250 m in Poland; and 310 m in The Netherlands. The minimum setback from a building for a currently producing well was 21 m and 46 m from a house, though the mean setback was 329 and 447 m, respectively. When the surface and sub-surface footprints were considered our approach found that the carrying capacity of the sites and the restrictions from infrastructure over the currently licensed blocks covering the Bowland Shale (UK) was between 5 and 42%, with a mean of 26%. Using Cuadrilla's predicted recoverable reserves estimate of 8.5 x 10^11 m3 for the Bowland Basin, the carrying capacity of the surface and the likely maximum accessible gas reserves would be limited by the surface carrying capacity to 2.21 x 10^11 m^3.

Ethical and legal issues in caring for asylum seekers and refugees in the UK.

PubMed

Hamill, M; McDonald, L; Brook, G; Murphy, S

2004-11-01

Inward migration to the UK remains topical and controversial as numbers continue to increase. Many immigrants have specific health care needs and may shoulder a large burden of infectious disease. Imposition of legal constraints can have a huge impact on the medical care afforded to immigrants. Currently UK policy is to treat, free of charge and with NHS resources, those who fulfil specific criteria. However an increasing number are being asked to pay for their treatment. Many health care professionals are confused as to current legal restrictions and require guidance on the associated ethical issues. We concentrate on provision of care to HIV positive individuals and use cases to illustrate some of the issues. However these issues are equally pertinent to practitioners in all branches of medicine.

Teaching Astronomy in UK Schools

ERIC Educational Resources Information Center

Roche, Paul; Roberts, Sarah; Newsam, Andy; Barclay, Charles

2012-01-01

This article attempts to summarise the good, bad and (occasionally) ugly aspects of teaching astronomy in UK schools. It covers the most common problems reported by teachers when asked about covering the astronomy/space topics in school. Particular focus is given to the GCSE Astronomy qualification offered by Edexcel (which is currently the…

Strategies of Higher Education Institutions Development in Great Britain

ERIC Educational Resources Information Center

Komochkova, Olga

2015-01-01

The current stage of higher education sector transformation in Ukraine has been indicated. The study of foreign experience, namely of Great Britain, and the use of positive aspects of such experience have been justified. Information sources of Universities UK (Universities UK Strategic Plan 2013-2018; Efficiency and Effectiveness in Higher…

Internationalization of U.K. University Business Schools: A Survey of Current Practice

ERIC Educational Resources Information Center

Bennett, Roger; Kane, Suzanne

2011-01-01

A questionnaire was sent to the heads of internationalization in the business schools of all U.K. universities. Sixty-five replies were received. The document covered, inter alia, the internationalization activities undertaken by the respondents' schools, the intensities with which internationalization had been implemented, motives for…

Childhood in Crisis? Perceptions of 7-11-Year-Olds on Being a Child and the Implications for Education's Well-Being Agenda

ERIC Educational Resources Information Center

Adams, Kate

2013-01-01

Notions of a good childhood are inextricably linked with well-being. Both concepts are central to a contentious debate about the quality of childhood in the UK, which is partly situated within the "childhood in crisis" discourse which opponents claim is overstated. This study contributes to the debate by hearing the voices of children as…

JPRS Report, Science & Technology, Europe & Latin America

DTIC Science & Technology

1987-12-21

situated among these lattice components. The substitution of trivalent lanthanium with bivalent barium or strontium leads to a charge deficit which can...Engineering, Ferranti, J.K. Lasers, Welding Institute, and UK AEA Culham; the French firms Cilas (CGE Group) and Crouzet, the French Ministry of Research...uses lasers for cutting and welding processes and for heat and photochemical processing. 8615 CSO: 3698/MO15 42 METALLURGICAL INDUSTRIES WEST EUROPE

The Situated Aspect of Creativity in Communicative Events: How Do Children Design Web Pages Together?

ERIC Educational Resources Information Center

Fernandez-Cardenas, Juan Manuel

2008-01-01

This paper looks at the collaborative construction of web pages in History by a Year-4 group of children in a primary school in the UK. The aim of this paper is to find out: (a) How did children interpret their involvement in this literacy practice? (b) How the construction of web pages was interactionally accomplished? and (c) How can creativity…

Using a situational judgement test for selection into dental core training: a preliminary analysis.

PubMed

Rowett, E; Patterson, F; Cousans, F; Elley, K

2017-05-12

Objective and setting This paper describes the evaluation of a pilot situational judgement test (SJT) for selection into UK Dental Core Training (DCT). The SJT's psychometric properties, group differences based on gender and ethnicity, and candidate reactions were assessed.Methods The SJT targets four non-academic attributes important for success in DCT. Data were collected alongside live selection processes from five Health Education England local teams in the UK (N = 386). Candidates completed the pilot SJT and an evaluation questionnaire to examine their reactions to the test.Results SJT scores were relatively normally distributed and showed acceptable levels of internal reliability (α = 0.68). Difficulty level and partial correlations between scenarios and SJT total score were in the expected ranges (64.61% to 90.03% and r = 0.06 to 0.41, respectively). No group differences were found for gender, and group differences between White and BME candidates were minimal. Most candidates perceived the SJT as relevant to the target role, appropriate and fair.Conclusions This study demonstrated the potential suitability of an SJT for use in DCT selection. Future research should replicate these preliminary findings in other cohorts, and assess the predictive validity of the SJT for predicting key training and practice-based outcomes.

European cardiovascular nurses' experiences of and attitudes towards having family members present in the resuscitation room.

PubMed

Axelsson, Asa B; Fridlund, Bengt; Moons, Philip; Mårtensson, Jan; Op Reimer, Wilma Scholte; Smith, Karen; Strömberg, Anna; Thompson, David R; Norekvål, Tone M

2010-03-01

To investigate cardiovascular nurses' experiences of and attitudes towards the presence of family members during resuscitation of adult patients. A 36-item questionnaire exploring the experiences of and attitudes towards family members being present in the resuscitation room was distributed to a convenience sample of nurses attending three national and one international cardiovascular nursing conferences held in Europe during 2007. Of 820 questionnaires distributed, 411(50%) completed ones were returned. Of these 411 respondents, 178 (44%) had experienced at least one situation of families being present. Positive (23%) and negative (21%) experiences of family presence were equally distributed. Only 28 (7%) respondents stated that their unit had a protocol covering family presence. Nurses in Ireland (n=30; 59%) and the UK (n=18; 55%) were most likely to have experienced family presence and protocols relating to this were most commonly found in the UK (n=4; 14%). Less than half of the included European cardiovascular nurses had experienced a situation of families being present during resuscitation and protocols pertaining to this were rare. There was no clear attitude towards family presence, though experience in nursing made nurses more favourable towards it. Copyright (c) 2009 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.

Understanding the psychosocial experiences of adults with mild-moderate hearing loss: An application of Leventhal’s self-regulatory model

PubMed Central

Heffernan, Eithne; Coulson, Neil S.; Henshaw, Helen; Barry, Johanna G.; Ferguson, Melanie A

2017-01-01

Objective This study explored the psychosocial experiences of adults with hearing loss using the self-regulatory model as a theoretical framework. The primary components of the model, namely cognitive representations, emotional representations, and coping responses, were examined. Design Individual semi-structured interviews were conducted. The data were analysed using an established thematic analysis procedure. Study sample Twenty-five adults with mild-moderate hearing loss from the UK and nine hearing healthcare professionals from the UK, USA, and Canada were recruited via maximum variation sampling. Results Cognitive representations: Most participants described their hearing loss as having negative connotations and consequences, although they were not particularly concerned about the progression or controllability/curability of the condition. Opinions differed regarding the benefits of understanding the causes of one’s hearing loss in detail. Emotional representations: negative emotions dominated, although some experienced positive emotions or muted emotions. Coping responses: engaged coping (e.g. hearing aids, communication tactics) and disengaged coping (e.g. withdrawal from situations, withdrawal within situations): both had perceived advantages and disadvantages. Conclusions This novel application of the self-regulatory model demonstrates that it can be used to capture the key psychosocial experiences (i.e. perceptions, emotions, and coping responses) of adults with mild-moderate hearing loss within a single, unifying framework. PMID:26754550

Development and application of a mechanistic model to estimate emission of nitrous oxide from UK agriculture

NASA Astrophysics Data System (ADS)

Brown, L.; Syed, B.; Jarvis, S. C.; Sneath, R. W.; Phillips, V. R.; Goulding, K. W. T.; Li, C.

A mechanistic model of N 2O emission from agricultural soil (DeNitrification-DeComposition—DNDC) was modified for application to the UK, and was used as the basis of an inventory of N 2O emission from UK agriculture in 1990. UK-specific input data were added to DNDC's database and the ability to simulate daily C and N inputs from grazing animals and applied animal waste was added to the model. The UK version of the model, UK-DNDC, simulated emissions from 18 different crop types on the 3 areally dominant soils in each county. Validation of the model at the field scale showed that predictions matched observations well. Emission factors for the inventory were calculated from estimates of N 2O emission from UK-DNDC, in order to maintain direct comparability with the IPCC approach. These, along with activity data, were included in a transparent spreadsheet format. Using UK-DNDC, the estimate of N 2O-N emission from UK current agricultural practice in 1990 was 50.9 Gg. This total comprised 31.7 Gg from the soil sector, 5.9 Gg from animals and 13.2 Gg from the indirect sector. The range of this estimate (using the range of soil organic C for each soil used) was 30.5-62.5 Gg N. Estimates of emissions in each sector were compared to those calculated using the IPCC default methodology. Emissions from the soil and indirect sectors were smaller with the UK-DNDC approach than with the IPCC methodology, while emissions from the animal sector were larger. The model runs suggested a relatively large emission from agricultural land that was not attributable to current agricultural practices (33.8 Gg in total, 27.4 Gg from the soil sector). This 'background' component is partly the result of historical agricultural land use. It is not normally included in inventories of emission, but would increase the total emission of N 2O-N from agricultural land in 1990 to 78.3 Gg.

The future of flood insurance in the UK

NASA Astrophysics Data System (ADS)

Horn, Diane

2013-04-01

Approximately one in seven properties in the UK (3.6 million homes and businesses) are at risk of flooding. The Adaptation Sub-Committee of the UK Committee on Climate Change reported in 2012 that development on the floodplain grew at a faster rate than elsewhere in England over the past ten years, with one in five properties in the floodplain in areas of significant risk. They concluded that current levels of investment will not keep pace with the increasing risk, noting that without additional action, climate change could almost double the number of properties at significant risk by 2035. Flood insurance can contribute to risk reduction by using pricing or restrictions on availability of cover to discourage new development in flood risk areas, or to encourage the uptake of flood resilience measures. The UK insurance market currently offers flood cover as a standard feature of domestic and small business policies, with central government providing physical protection backed up by financial protection provided by the insurance industry. This approach is unusual in not passing all or part of the flood risk to government schemes. At present, flood insurance in the UK is conducted under a series of informal agreements established between the insurance industry and the Government known as the Statement of Principles. Members of the Association of British Insurers (ABI) currently agree to cover homes at risk of flooding in return for government commitment to manage flood risk. However, this arrangement is now under threat, as the insurance industry is increasingly reluctant to bear the financial burden of flooding alone. The current Statement of Principles ends on 30 June 2013 and will not be renewed. High-risk properties may be unable to obtain insurance after the Statement of Principles expires. Unusually, insurers are arguing against a free market solution, arguing that no country in the world provides universal flood cover without some form of government-led support. The UK insurance industry prefers a risk-pooling approach, while to date the government has not taken a position on the future of flood insurance after 2013.

Development of a parent version of the Manchester-Minneapolis quality of life survey for use by parents and carers of UK children: MMQL-UK (PF)

PubMed Central

Hutchings, Hayley A; Upton, Penney; Cheung, Wai-Yee; Maddocks, Alison; Eiser, Christine; Williams, John G; Russell, Ian T; Jackson, Sonia; Jenney, Meriel EM

2008-01-01

Background Although it is now widely endorsed that children should as far as possible rate their own health related quality of life (HRQL), there are situations where proxy information on child HRQL may be useful, especially where a child is too ill or young to provide their own HRQL assessment. There is limited availability of generic HRQL scales that have a parallel child and parent version and that are reliable, valid, brief, comprehensible and suitable for use in UK populations. The aims of this study were therefore to develop and validate a parent version of the anglicised Manchester-Minneapolis Quality of Life child form (MMQL-UK (CF)) and to determine the level of association between the child and parent versions of this form. Methods This study was undertaken concurrently with the anglicisation and validation of the MMQL, a measure of HRQL developed for use with children in North America. At that time, no parent version existed, so the MMQL form for children (MMQL-UK (CF)) was used as the basis for the development of the MMQL-UK parent form (PF). The sample included a control group of healthy children and their parents and five exemplar groups; children diagnosed with asthma, diabetes or inflammatory bowel disease and their parents, children in remission from cancer and their parents and children in public care and their carers. Consistency of the MMQL-UK (PF) components were assessed by calculating Cronbach's alpha. Validation of the parent questionnaire was undertaken by comparing MMQL-UK (PF) component scores with comparable components on the proxy PedsQL™ quality of life scales, comparing MMQL-UK (PF) component scores between parents of healthy and chronic disease children and by comparison of component scores from children and their parents or carers. Reproducibility and responsiveness were assessed by retesting parents by follow-up questionnaires. Results A total of 874 children (completing MMQL-UK (CF)) and 572 parents or carers (completing MMQL-UK (PF)) took part in the study. The internal consistency of all the MMQL-UK (PF) components exceeding the accepted criterion of 0.70 and the construct validity was good with moderate correlations being evident between comparable components of the MMQL-UK (PF) and the proxy PedsQL™. Discriminant validity was demonstrated with significant differences being identified between parents of healthy children and those with chronic conditions. Intra-class correlations exceeded 0.65 for all MMQL-UK (PF) components demonstrating good reproducibility. Weak to moderate levels of responsiveness were demonstrated for all but social functioning. The MMQL-UK (PF) showed moderate parent-child correlation with the MMQL-UK (CF) for all components. The best correlations were seen for those components measuring the same construct (Pearson's r ranged from 0.31 to 0.61, p < 0.01 for equivalent components). Conclusion The MMQL-UK (PF) showed moderate to good correlations with the MMQL-UK (CF) component scores. The MMQL-UK (PF) will be of use when comparing child and parent/carer perception of the impact of a child's condition on their HRQL or where the child is too ill or young to provide their own report. PMID:18307771

Practice patterns for the radical treatment of nasopharyngeal cancer by head and neck oncologists in the United Kingdom.

PubMed

Petkar, Imran; Bhide, Shreerang; Newbold, Kate; Harrington, Kevin; Nutting, Chris

2018-05-01

Advances in radiation delivery, imaging techniques, and chemotherapy have significantly improved treatment options for non-metastatic nasopharyngeal cancers (NPC). However, their impact on the practice in the United Kingdom (UK), where this tumour is rare, is unknown. This study examined the current attitudes of UK head and neck oncologists to the treatment of NPC. UK head and neck oncologists representing 19/23 cancer networks were sent an invitation email with a personalised link to a web-based survey designed to identify the influence of tumour and nodal staging on current NPC management practices. 26/42 (61%) of clinicians responded. Induction chemotherapy followed by concomitant chemoradiation was the treatment of choice for Stage III (69%) and IVa/b (96%), with cisplatin and 5-fluorouracil combination being the most commonly used induction chemotherapy regimen (88%). 16 centres (61%) used a geometric approach, adding variable margins of 0-10 mm to the gross tumour volume to define their therapeutic dose clinical target volume. 54% of respondents used 3 radiotherapy (RT) prescription doses to treat NPC. Retropharyngeal nodal region irradiation policy was inconsistent, with nearly one-quarter treating the entire group to a radical dose. Significant heterogeneity currently exists in the RT practice of NPC in the UK. A consensus regarding the optimal curative, function-sparing treatment paradigm for NPC is necessary to ensure cancer survivors have satisfactory long-term health-related quality of life. Advances in knowledge: This is the first study to highlight the significant variation in RT practice of NPC in the UK.

Provision of cellular blood components to CMV-seronegative patients undergoing allogeneic stem cell transplantation in the UK: survey of UK transplant centres.

PubMed

Morton, S; Peniket, A; Malladi, R; Murphy, M F

2017-12-01

To identify current UK practice with regards to provision of blood components for cytomegalovirus (CMV)-seronegative, potential, allogeneic stem cell recipients of seronegative grafts. Infection with CMV remains a major cause of morbidity and mortality after allogeneic stem cell transplantation (aSCT). CMV transmission has been a risk associated with the transfusion of blood components from previously exposed donors, but leucocyte reduction has been demonstrated to minimise this risk. In 2012, the UK Advisory Committee for the Safety of Tissues and Organs (SaBTO) recommended that CMV-unselected components could be safely transfused without increased risk of CMV transmission. We surveyed UK aSCT centres to establish current practice. Fifteen adult and seven paediatric centres (75%) responded; 22·7% continue to provide components from CMV-seronegative donors. Reasons cited include the continued perceived risk of CMV transmission by blood transfusion, its associated morbidity and concerns regarding potential for ambiguous CMV serostatus in seronegative potential transplant recipients due to passive antibody transfer from CMV-seropositive blood donors, leading to erroneous donor/recipient CMV matching at transplant. The survey demonstrated a surprisingly high rate (22.7%) of centres continuing to provide blood components from CMV-seronegative donors despite SaBTO guidance. © 2017 British Blood Transfusion Society.

Metastasis Research Society VII International Congress (Part II). 7-10 October 1998, San Diego, CA, USA.

PubMed

Chambers, A F

1999-02-01

The Metastasis Research Society (MRS) has held its International Congress every two years since 1986, and alternates between European and North American meeting venues. The next MRS International Congress will be held in London, UK in the year 2000, and will be hosted by the current MRS President, Dr. Suzanne Eccles (Institute of Cancer Research, Sutton, UK). Dr. Eccles took over from the out-going President, Dr. William Stetler-Stevenson (National Institutes of Health, Bethesda, MD, USA), at the San Diego meeting. Information on joining the Metastasis Research Society, which includes a subscription to the Society's journal, Clinical and Experimental Metastasis, can be obtained from Dr. Eccles (suzan@icr.ac.uk) or from the newly-elected Secretary/Treasurer Dr. Danny Welch (Hershey, PA, USA; drw9@psu.edu). The meeting was organized by Darwin Medical Communications Ltd (Gill Heaton, Oxford, UK), who have placed the full program on the meeting web site (http:@www.sparks.co.uk/mrs). It is envisaged that full abstracts of all the presentations will be placed on the Metastasis Research Society web site, which is currently under construction. Corporate sponsors for the San Diego meeting included Agouron Pharmaceuticals, Becton Dickinson & Co, Zeneca Pharma SA, Schering AG, AntiCancer Inc, Oncogene Research Products, Daiichi Seiyaku Co Ltd and Novartis Pharma AG.

Through the back door: nurse migration to the UK from Malawi and Nepal, a policy critique.

PubMed

Adhikari, Radha; Grigulis, Astrida

2014-03-01

The UK National Health Service has a long history of recruiting overseas nurses to meet nursing shortages in the UK. However, recruitment patterns regularly fluctuate in response to political and economic changes. Typically, the UK government gives little consideration of how these unstable recruitment practices affect overseas nurses. In this article, we present findings from two independent research studies from Malawi and Nepal, which aimed to examine how overseas nurses encountered and overcame the challenges linked to recent recruitment and migration restrictions. We show how current UK immigration policy has had a negative impact on overseas nurses' lives. It has led them to explore alternative entry routes into the UK, affecting both the quality of their working lives and their future decisions about whether to stay or return to their home country. We conclude that the shifting forces of nursing workforce demand and supply, leading to abrupt policy changes, have significant implications on overseas nurses' lives, and can leave nurses 'trapped' in the UK. We make recommendations for UK policy-makers to work with key stakeholders in nurse-sending countries to minimize the negative consequences of unstable nurse recruitment, and we highlight the benefits of promoting circular migration.

Leonardo (formerly Selex ES) infrared sensors for astronomy: present and future

NASA Astrophysics Data System (ADS)

Baker, Ian; Maxey, Chris; Hipwood, Les; Barnes, Keith

2016-07-01

Many branches of science require infrared detectors sensitive to individual photons. Applications range from low background astronomy to high speed imaging. Leonardo in Southampton, UK, has been developing HgCdTe avalanche photodiode (APD) sensors for astronomy in collaboration with European Southern Observatory (ESO) since 2008 and more recently the University of Hawaii. The devices utilise Metal Organic Vapour Phase Epitaxy, MOVPE, grown on low-cost GaAs substrates and in combination with a mesa device structure achieve very low dark current and near-ideal MTF. MOVPE provides the ability to grow complex HgCdTe heterostructures and these have proved crucial to suppress breakdown currents and allow high avalanche gain in low background situations. A custom device called Saphira (320x256/24μm) has been developed for wavefront sensors, interferometry and transient event imaging. This device has achieved read noise as low as 0.26 electrons rms and single photon imaging with avalanche gain up to x450. It is used in the ESO Gravity program for adaptive optics and fringe tracking and has been successfully trialled on the 3m NASA IRTF, 8.2m Subaru and 60 inch Mt Palomar for lucky imaging and wavefront sensing. In future the technology offers much shorter observation times for read-noise limited instruments, particularly spectroscopy. The paper will describe the MOVPE APD technology and current performance status.

Committee on air pollution effects research: 40 years of UK air pollution.

PubMed

Fowler, David; Dise, Nancy; Sheppard, Lucy

2016-01-01

The UK Committee on Air Pollution Effects Research (CAPER) was established 40 years ago. This special section was compiled to mark this anniversary. During this time there have been dramatic changes in the composition of the air over the UK. The four papers in this special section of Environmental Pollution represent the current air pollution effects research focus on ozone and nitrogen deposition, two related issues and are proving from a policy perspective to be quite intractable issues. The UK CAPER research community continues to advance the underpinning science and engages closely with the user community in government departments. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Environmental aspects of large-scale wind-power systems in the UK

NASA Astrophysics Data System (ADS)

Robson, A.

1983-12-01

Environmental issues relating to the introduction of large, MW-scale wind turbines at land-based sites in the U.K. are discussed. Areas of interest include noise, television interference, hazards to bird life and visual effects. A number of areas of uncertainty are identified, but enough is known from experience elsewhere in the world to enable the first U.K. machines to be introduced in a safe and environmentally acceptable manner. Research currently under way will serve to establish siting criteria more clearly, and could significantly increase the potential wind-energy resource. Certain studies of the comparative risk of energy systems are shown to be overpessimistic for U.K. wind turbines.

Legionella pneumonia cases over a five-year period: a descriptive, retrospective study of outcomes in a UK district hospital.

PubMed

Wingfield, Tom; Rowell, Sam; Peel, Alex; Puli, Deeksha; Guleri, Achyut; Sharma, Rashmi

2013-04-01

As the recent outbreaks in Edinburgh and Camarthen, UK, have shown, Legionella pneumonia (LP) remains a significant public health problem, which is not only confined to those who have travelled abroad. In both outbreaks and sporadic cases, diagnosis can go unrecognised. We reviewed the demographics, comorbidities, diagnosis, treatment and clinical outcome of LP cases over five years in a district general hospital in northwest England. Over half of LP cases were UK acquired and 'classic' clinical features were common. Clinical criteria for diagnosing LP were confirmed, but few sputum samples were sent to reference laboratories, limiting further essential epidemiological mapping of UK cases. Following current UK community-acquired pneumonia guidance would have missed nearly one quarter of LP cases in our series, potentially leading to further morbidity and mortality.

The soiling of materials in the ambient atmosphere

NASA Astrophysics Data System (ADS)

Hamilton, R. S.; Mansfield, T. A.

Models describing the rate of soiling of exposed surfaces due to the deposition and accumulation of particulate matter from the atmosphere are reviewed. Samples of white painted wood were exposed for 110 days in the ambient atmosphere. Separate samples were sheltered and unsheltered from rainfall. Reflectance was measured daily. Results are compared with recently published studies in the U.S.A. (samples in the ambient atmosphere) and the U.K. (samples in a road tunnel). Experimental soiling rates were compared with predicted values. Existing models were satisfactory for predicting soiling in a tunnel but underestimated soiling in an ambient situation; a revised formulation is proposed for this situation. Rainfall generally produced a cleaning effect but redistribution of washed-off material could produce enhanced soiling.

Abandoned babies and absent policies.

PubMed

Mueller, Joanne; Sherr, Lorraine

2009-12-01

Although infant abandonment is a historical problem, we know remarkably little about the conditions or effects of abandonment to guide evidence driven policies. This paper briefly reviews the existing international evidence base with reference to potential mental health considerations before mapping current UK guidelines and procedures, and available incidence data. Limitations arising from these findings are discussed with reference to international practice, and interpreted in terms of future pathways for UK policy. A systematic approach was utilized to gather available data on policy information and statistics on abandoned babies in the UK. A review of the limited literature indicates that baby abandonment continues to occur, with potentially wide-ranging mental health ramifications for those involved. However, research into such consequences is lacking, and evidence with which to understand risk factors or motives for abandonment is scarce. International approaches to the issue remain controversial with outcomes unclear. Our systematic search identified that no specific UK policy relating to baby abandonment exists, either nationally or institutionally. This is compounded by a lack of accurate of UK abandonment statistics. Data that does exist is not comprehensive and sources are incompatible, resulting in an ambiguous picture of UK baby abandonment. Available literature indicates an absence of clear provision, policy and research on baby abandonment. Based on current understanding of maternal and child mental health issues likely to be involved in abandonment, existing UK strategy could be easily adapted to avoid the 'learning from scratch' approach. National policies on recording and handling of baby abandonments are urgently needed, and future efforts should be concentrated on establishing clear data collection frameworks to inform understanding, guide competent practice and enable successfully targeted interventions.

Determination of beryllium concentrations in UK ambient air

NASA Astrophysics Data System (ADS)

Goddard, Sharon L.; Brown, Richard J. C.; Ghatora, Baljit K.

2016-12-01

Air quality monitoring of ambient air is essential to minimise the exposure of the general population to toxic substances such as heavy metals, and thus the health risks associated with them. In the UK, ambient air is already monitored under the UK Heavy Metals Monitoring Network for a number of heavy metals, including nickel (Ni), arsenic (As), cadmium (Cd) and lead (Pb) to ensure compliance with legislative limits. However, the UK Expert Panel on Air Quality Standards (EPAQS) has highlighted a need to limit concentrations of beryllium (Be) in air, which is not currently monitored, because of its toxicity. The aim of this work was to analyse airborne particulate matter (PM) sampled onto filter papers from the UK Heavy Metals Monitoring Network for quantitative, trace level beryllium determination and compare the results to the guideline concentration specified by EPAQS. Samples were prepared by microwave acid digestion in a matrix of 2% sulphuric acid and 14% nitric acid, verified by the use of Certified Reference Materials (CRMs). The digested samples were then analysed by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The filters from the UK Heavy Metals Monitoring Network were tested using this procedure and the average beryllium concentration across the network for the duration of the study period was 7.87 pg m-3. The highest site average concentration was 32.0 pg m-3 at Scunthorpe Low Santon, which is significantly lower than levels that are thought to cause harm. However the highest levels were observed at sites monitoring industrial point sources, indicating that beryllium is being used and emitted, albeit at very low levels, from these point sources. Comparison with other metals concentrations and data from the UK National Atmospheric Emissions Inventory suggests that current emissions of beryllium may be significantly overestimated.

Surrogacy: donor conception regulation in Japan.

PubMed

Semba, Yukari; Chang, Chiungfang; Hong, Hyunsoo; Kamisato, Ayako; Kokado, Minori; Muto, Kaori

2010-09-01

As of 2008, surrogacy is legal and openly practised in various places; Japan, however, has no regulations or laws regarding surrogacy. This paper reports the situation of surrogacy in Japan and in five other regions (the USA, the UK, Taiwan, Korea and France) to clarify the pros and cons of prohibiting surrogacy, along with the problems and issues relating to surrogacy compensation. Not only in a country such as France that completely prohibits surrogacy within the country, but also in a country such as the UK that allows non-commercial surrogacy, infertile couples travel overseas for the purpose of surrogacy. In addition, some couples might seek underground surrogacy if the government prohibits surrogacy. If an intended parent couple and a surrogate make an agreement among themselves and then a problem occurs, they cannot ask for support from professionals or bring a case to court, as can be observed in South Korea and Taiwan. We also conclude that there is little difference between commercial surrogacy and non-commercial surrogacy in the absence of a clear definition of 'reasonable expenses.' In the UK, the law does not allow surrogates to receive compensation. However, in reality, there may be little difference between the amounts paid to surrogates for profit in the US and those paid to surrogates for reasonable expenses in the UK. We conclude that the issue of surrogacy demands further discussion in Japan.

Impact of U.K. and Australian Transnational Higher Education in Malaysia

ERIC Educational Resources Information Center

Arunasalam, Nirmala Devi

2016-01-01

This study investigated outcomes of the provision, by one Australian and two U.K. universities, of bridging programs that allow registered Malaysian nurses to upgrade their diploma qualifications to degree level. The study was informed by current literature on Transnational Higher Education (TNHE) programs. Not sufficiently explored in the…

Education and Training in Psychiatry in the U.K.

ERIC Educational Resources Information Center

Carney, Stuart; Bhugra, Dinesh K.

2013-01-01

Background/Objective: Recent training and education changes have raised important issues in delivery of psychiatric education at all levels. In this article, the authors describe the current status of mental health education in the training of all doctors and postgraduate training and education in psychiatry in the U.K. Method: The authors explore…

Engaging Children: Research Issues around Participation and Environmental Learning

ERIC Educational Resources Information Center

Hacking, Elisabeth Barratt; Barratt, Robert; Scott, William

2007-01-01

In this article we explore a number of issues arising from the papers in this special issue of "Environmental Education Research." The papers focus on current examples of childhood environment research in the UK together with research reviews from the UK, the US and Australia. In order to provide a framework for considering and…

Creating Cultures of Integrity: Ethics Education in UK Business Schools

ERIC Educational Resources Information Center

Bell, Emma; Caulfield, Paul; Hibbert, Paul; Jennings, Paul

2014-01-01

Recent corporate scandals and responses by regulators have created an environment in which there is a heightened awareness of business ethics. This report presents a series of case studies exploring how the current curricula in UK business schools could be scoped differently to give new business leaders the tools required for strong ethical…

Day One Sustainability

ERIC Educational Resources Information Center

Orr, John; Ibell, Timothy; Evernden, Mark; Darby, Antony

2015-01-01

Emissions reductions targets for the UK set out in the Climate Change Act for the period to 2050 will only be achieved with significant changes to the built environment, which is currently estimated to account for 50% of the UK's carbon emissions. The socio-technological nature of Civil Engineering means that this field is uniquely placed to lead…

Technology and Special Needs Provision in the UK: Is Current Law Satisfactory?

ERIC Educational Resources Information Center

Kariyawasam, Rohan

2007-01-01

Recently, the government has issued legislation on disability discrimination (the UK "Disability Discrimination Act" 2005) that is silent on the issue of access to technology for those adults and minors with special needs/disabilities either in the classroom or out of the classroom. At the same time, commercial legislation from Europe…

Diagnostic Testing at UK Universities: An E-Mail Survey

ERIC Educational Resources Information Center

Gillard, Jonathan; Levi, Margaret; Wilson, Robert

2010-01-01

In July 2009, an e-mail survey was sent to various UK universities to gain information regarding current practices concerning mathematics diagnostic testing, and to provide an update from the review "Diagnostic Testing for Mathematics" published by the LTSN MathsTEAM Project in 2003. A total of 38 university departments were contacted…

Exploring the Current Position of ESD in UK Higher Education Institutions

ERIC Educational Resources Information Center

Fiselier, Evelien S.; Longhurst, James W. S.; Gough, Georgina K.

2018-01-01

Purpose: The purpose of this paper is to consider the position of education for sustainable development in the UK Higher Education (HE) sector with respect to the Quality Assurance Agency (QAA) and Higher Education Academy (HEA) Guidance for education for sustainable development (ESD). Design/methodology/approach: By means of a mixed-method…

Do health-related labour costs weaken the competitiveness of the economy?

PubMed

Häussler, Bertram; Ecker, Thomas; Schneider, Markus

2006-12-01

At least in Germany, it is widely assumed that healthcare-related labour costs weaken the competitiveness of national industries. However, there is a lack of knowledge about the amount of employers' financial burden in Germany and in other competing countries, as well as the impact on market prices of German goods. To quantify the health-related labour costs for employers in seven countries and different industries, and identify the effects of current reforms in Germany on the financial burden of employers. We calculated the spending on health in Germany and the burden on German employers (by branch of production). We then compared the total burden with that of six other countries. A univariate analysis was then conducted to examine the connection between health-related labour costs and employment. In 2000, employers paid 41.2% of the total of 283.3 billion spent on health matters in Germany. These total costs account for 3.2% of the gross output (UK: 1.8%, Switzerland: 1.9%, Poland: 2.1%, US: 3.2%, France: 3.6%, The Netherlands: 3.7%). Health-related labour costs account for 10.6% of the total labour costs. The health-related labour costs per employee are on average 3013 (from 2752 to 4793 in healthcare and the chemical industry, respectively). In the UK and the US there are corresponding labour costs of 1836 and 4256 per employee, respectively. The current health reform (2003) would reduce the labour costs by only 0.7% after 4 years (based on 2000, with all factors remaining constant). Employment increased by 3.7% from 1995 to 2000 (textile industry: -26.8%, vehicle manufacture: +18.3%). There is no empirical connection between employment and health-related labour costs. Labour costs increased by a higher amount than the health-related labour costs. The burden on German employers is moderate when compared internationally. The current reform of the German health system is not expected to improve companies' financial situation or German competitiveness. Restrictions on the range of medical services would provide a relatively small amount of relief for employers.

Preserving The UK-US Special Relationship: A Tactically Capable And Interoperable Royal Air Force In 2036

DTIC Science & Technology

2016-06-01

discussed. Finally, the paper provides a brief survey of doctrinal deficiencies, highlights the importance of enhancing distributed synthetic training...adversaries, such as China , have increasingly modern AU/ACSC/Radley J/AY16 4 and capable military capabilities that, in the event of a conflict, will...is that Blue Forces, despite superb situational awareness, will quickly run short of fuel and missiles against a large- force aggressor. Having

eMontage: An Architecture for Rapid Integration of Situational Awareness Data at the Edge

DTIC Science & Technology

2013-05-01

Request Response Interaction Android Client Dispatcher Servlet Spring MVC Controller Camel Producer Template Camel Route Remote Data Service - REST...8SATURN 2013© 2013 Carnegie Mellon University Publish Subscribe Interaction Android Client Dispatcher Servlet Spring MVC Controller Remote Data...set ..., "’"C oUkRelw•b J’- - ’ ~ ’~------’ ~-------- ’-------~ , Parse XML into a single Java XML Document object. -=--:=’ Software Engineering

British Army Units under US Army Control: Interoperability Issues

DTIC Science & Technology

2001-03-01

DISTRIBUTION/AVAILABILITY STATEMENT A PUBLIC RELEASE , 13. SUPPLEMENTARY NOTES 14. ABSTRACT World War II laid the foundations for a ?special...relationship? between the UK and US, with security being its primary purpose. Since the end of that war , the threat of Soviet expansion caused it to deepen...under US control during both the Korean and Gulf Wars . This monograph initially looks at the relationship to see if this situation could reoccur. As

Quantitative risk assessment to compare the risk of rabies entering the UK from Turkey via quarantine, the Pet Travel Scheme and the EU Pet Movement Policy.

PubMed

Ramnial, V; Kosmider, R; Aylan, O; Freuling, C; Müller, T; Fooks, A R

2010-08-01

Rabies was eradicated from the UK in 1922 through strict controls of dog movement and investigation of every incident of disease. Amendments were made to the UK quarantine laws and the Pet Travel Scheme (PETS) was subsequently introduced in 2000 for animals entering the UK from qualifying listed countries. European Regulation 998/2003 on the non-commercial movement of pet animals initiated the European Union Pet Movement Policy (EUPMP) in July 2004. The introduction of EUPMP harmonized the movement of pet animals within the EU (EUPMP(listed)) but raised the possibility of domestic animals entering the UK from a non-EU state where rabies is endemic (EUPMP(unlisted)). A quantitative risk assessment was developed to estimate the risk of rabies entering the UK from Turkey via companion animals that are incubating the disease and enter through PETS or EUPMP compared to quarantine. Specifically, the risk was assessed by estimating the annual probability of rabies entering the UK and the number of years between rabies entries for each scheme. The model identified that the probability of rabies entering the UK via the three schemes is highly dependent on compliance. If 100% compliance is assumed, PETS and EUPMP(unlisted) (at the current level of importation) present a lower risk than quarantine, i.e. the number of years between rabies entry is more than 170 721 years for PETS and 60 163 years for EUPMP(unlisted) compared to 41 851 years for quarantine (with 95% certainty). If less than 100% compliance is assumed, PETS and EUPMP(unlisted) (at the current level of importation) present a higher risk. In addition, EUPMP(listed) and EUPMP(unlisted) (at an increased level of importation) present a higher risk than quarantine or PETS at 100% compliance and at an uncertain level of compliance.

UK medical selection: lottery or meritocracy?

PubMed

Harris, Benjamin H L; Walsh, Jason L; Lammy, Simon

2015-02-01

From senior school through to consultancy, a plethora of assessments shape medical careers. Multiple methods of assessment are used to discriminate between applicants. Medical selection in the UK appears to be moving increasingly towards non-knowledge-based testing at all career stages. We review the evidence for non-knowledge-based tests and discuss their perceived benefits. We raise the question: is the current use of non-knowledge-based tests within the UK at risk of undermining more robust measures of medical school and postgraduate performance? © 2015 Royal College of Physicians.

Clinical pharmacology and therapeutics in undergraduate medical education in the UK: current status.

PubMed Central

Walley, T; Bligh, J; Orme, M; Breckenridge, A

1994-01-01

1. Medical undergraduate education is currently undergoing major changes in the UK in response to calls for the development of a core curriculum. Teaching in clinical pharmacology and therapeutics will also change to meet these demands. A postal survey was conducted to assess the current status of teaching in these subjects. 2. A questionnaire based on previous similar surveys conducted elsewhere was sent to departments or individuals in 27 medical schools in the UK; 22 (81%) replied. 3. Departmental priorities were defined as (in order): clinical research, undergraduate teaching, basic scientific research and clinical service provision. No change in these priorities in the future was foreseen by respondents. 4. Teaching methods were for the most part traditional, with the lecture as the most widely used and important technique. Specific clinical teaching was conducted by some and was considered very important by them. Teaching by problem solving was much less common. 5. Respondents were asked for free text comments; many of the remarks suggested dissatisfaction with the resources and time currently available for teaching in clinical pharmacology and therapeutics. Some expressed significant concerns that their teaching commitment would be reduced further by the development of the core curriculum. PMID:8186059

The Farm Credit Situation: Implications for Agricultural Policy.

ERIC Educational Resources Information Center

Bullock, J. Bruce

1986-01-01

Examines issues regarding current farm finance situation from a public policy perspective: origins and causes of current situation, available policy options for dealing with the problems, and impacts of policy options. (NEC)

Progress in the Assessment of Waste-forms for the Immobilisation of UK Civil Plutonium

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harrison, M.T.; Scales, C.R.; Maddrell, E.R.

The alternatives for the disposition of the UK's civil plutonium stocks are currently being investigated by Nexia Solutions Ltd. on behalf of the Nuclear Decommissioning Authority (NDA). A number of scenarios are currently being considered depending on the strategic requirements of the UK. The two main disposition options are: re-use as MOX (Mixed Oxide) fuel in reactors, or immobilisation in the event of any material being declared surplus to requirements. The amount of Pu which will require immobilisation will depend on future UK nuclear strategy, along with the extent of any stocks deemed unsuitable for re-use. However, it is likelymore » that some portion will have to be immobilised and therefore three credible waste-forms are under consideration; ceramic, glass and 'immobilisation' MOX. These are currently being developed and assessed in a systematic programme that involves periodic evaluation against a range of criteria. In this way, by down-selecting on the basis of robust and technical review, the most appropriate option for immobilising surplus civil plutonium in the UK can be recommended. The latest results from the immobilisation experimental programme are presented following the de-selection of the least favourable glass and ceramic candidates. The main criteria for this decision were waste loading, durability, processability, criticality and proliferation resistance. In addition, the durability of unirradiated MOX fuel is being examined to determine its potential as a wasteform for Pu, and recent leach test data is discussed. The current evaluation comprises not only a comparison of the relevant physical properties of the various waste-forms, but also key processing parameters, e.g. glass viscosity and melter technology, ceramic fabrication routes, and criticality issues. Other important aspects of the long-term behaviour of the waste-forms under consideration in a potential repository environment, such as radiation damage, criticality control and the properties of any neutron poisons present, are also included. (authors)« less

An Autonomous Data Reduction Pipeline for Wide Angle EO Systems

NASA Astrophysics Data System (ADS)

Privett, G.; George, S.; Feline, W.; Ash, A.; Routledge, G.

The UK’s National Space and Security Policy states that the identification of potential on-orbit collisions and re-entry warning over the UK is of high importance, and is driving requirements for indigenous Space Situational Awareness (SSA) systems. To meet these requirements options are being examined, including the creation of a distributed network of simple, low cost commercial–off-the-shelf electro-optical sensors to support survey work and catalogue maintenance. This paper outlines work at Dstl examining whether data obtained using readily-deployable equipment could significantly enhance UK SSA capability and support cross-cueing between multiple deployed systems. To effectively exploit data from this distributed sensor architecture, a data handling system is required to autonomously detect satellite trails in a manner that pragmatically handles highly variable target intensities, periodicity and rates of apparent motion. The processing and collection strategies must be tailored to specific mission sets to ensure effective detections of platforms as diverse as stable geostationary satellites and low altitude CubeSats. Data captured during the Automated Transfer Vehicle-5 (ATV-5) de-orbit trial and images captured of a rocket body break up and a deployed deorbit sail have been employed to inform the development of a prototype processing pipeline for autonomous on-site processing. The approach taken employs tools such as Astrometry.Net and DAOPHOT from the astronomical community, together with image processing and orbit determination software developed inhouse by Dstl. Interim results from the automated analysis of data collected from wide angle sensors are described, together with the current perceived limitations of the proposed system and our plans for future development.

Availability and use of capnography for in-hospital cardiac arrests in the United Kingdom.

PubMed

Turle, Sarah; Sherren, Peter B; Nicholson, Stuart; Callaghan, Thomas; Shepherd, Stephen J

2015-09-01

Airway complications occur more frequently outside the operating theatre and in emergency situations. Capnography remains the gold standard for confirming correct endotracheal tube placement, retaining high sensitivity and specificity in cardiac arrest. The 2010 European Resuscitation Council guidelines for adult advanced life support recommended waveform capnography in this setting. We investigated current UK practice relating to the availability and use of this technology during cardiac arrest. Between June and November 2014, a study was conducted of all UK acute hospitals with both a level three adult intensive care unit (ICU) and an emergency department (ED). A telephone questionnaire was administered examining intubation practice and utilisation of capnography within the ED, ICU and general wards. Two hundred and eleven hospitals met the inclusion criteria. The response rate was 100%. Arrests were mainly attended by anaesthesia (48%) and ICU physicians (38%) of registrar grade (56%). The ability to measure end tidal carbon dioxide (ETCO2) was available in all but 4 EDs; most used in waveform devices. Most ICUs were similar. However, in 67% of hospitals surveyed, it was not possible to measure ETCO2 in general wards. Where available, 87% used capnography to confirm ETT placement with less than 50% using ETCO2 to determine CPR effectiveness and 8% to prognosticate. We believe this is the first study of its kind to fully investigate the availability and use of capnography during cardiac arrest throughout the hospital. Whilst equipment provision appears adequate in critical care areas, it is insufficient in general wards. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Rethinking the "Third Mission": UK Universities and Regional Engagement in Challenging Times

ERIC Educational Resources Information Center

Lebeau, Yann; Cochrane, Allan

2015-01-01

Drawing on the experiences and statements of two universities, this article sets out to relate current trends and discourses of engagement of UK higher education (HE) institutions with their regional environment in the context of major policy shifts in HE and in regional governance. The "third mission" is considered as an aspect of what…

Knowledge of School Nurses in the U.K. regarding Sexual Health Education

ERIC Educational Resources Information Center

Westwood, Jo; Mullan, Barbara

2006-01-01

In the U.K., a current government health strategy indicates that school nurses should be key contributors to sexual health education because they have access to the school-age population. However, there appears to be little research that investigates whether school nurses are the most appropriate health care professionals or indeed have sufficient…

Power and Control: Managing Agents for International Student Recruitment in Higher Education

ERIC Educational Resources Information Center

Huang, Iona Yuelu; Raimo, Vincenzo; Humfrey, Christine

2016-01-01

This multiple case-based study investigates the relationship between recruiting agents and the UK universities who act as their principals. The current extensive use of agents in UK higher education may be seen as an indicator of the financial impact made by international students. The study analyses the practice of agent management and explores…

International Student Policies in UK Higher Education from Colonialism to the Coalition: Developments and Consequences

ERIC Educational Resources Information Center

Walker, Patricia

2014-01-01

The internationalization of tertiary education has given rise to student mobility of industrial proportions and affects and is affected by, national economies. Currently British universities are host to the second highest number of international students in the world; the proportionality of international students in the student body in UK higher…

The Future of Bioscience Fieldwork in UK Higher Education

ERIC Educational Resources Information Center

Mauchline, Alice L.; Peacock, Julie; Park, Julian R.

2013-01-01

Fieldwork is an important and often enjoyable part of learning in Bioscience degree courses, however it is unclear how the recent reforms to Higher Education (HE) may impact the future funding of outdoor learning. This paper reports on the findings from a recent survey of 30 HE Bioscience practitioners from across the UK. Their current level of…

Student Experiences and Perceptions of Digital Literacy Skills Development: Engaging Learners by Design?

ERIC Educational Resources Information Center

Hall, Marion; Nix, Ingrid; Baker, Kirsty

2013-01-01

In the current digital environment, it is vital for learners to develop digital literacy skills. The UK's Quality Assurance Agency for Higher Education (HE) requires graduates to demonstrate digital literacy. Employers consider these skills essential. With the high cost of HE in the UK, learners themselves also expect university courses to…

Mediating Science and Society in the EU and UK: From Information-Transmission to Deliberative Democracy?

ERIC Educational Resources Information Center

Tlili, Anwar; Dawson, Emily

2010-01-01

In this paper we critically review recent developments in policies, practices and philosophies pertaining to the mediation between science and the public within the EU and the UK, focusing in particular on the current paradigm of Public Understanding of Science and Technology (PEST) which seeks to depart from the science information-transmission…

Advances in SELEX ES infrared detectors for space and astronomy

NASA Astrophysics Data System (ADS)

Knowles, P.; Hipwood, L.; Baker, I.; Weller, H.

2017-11-01

Selex ES produces a wide range of infrared detectors from mercury cadmium telluride (MCT) and triglycine sulfate (TGS), and has supplied both materials into space programmes spanning a period of over 40 years. Current development activities that underpin potential future space missions include large format arrays for near- and short-wave infrared (NIR and SWIR) incorporating radiation-hard designs and suppression of glow. Improved heterostructures are aimed at the reduction of dark currents and avalanche photodiodes (APDs), and parallel studies have been undertaken for low-stress MCT array mounts. Much of this development work has been supported by ESA, UK Space, and ESO, and some has been performed in collaboration with the UK Astronomy Technology Centre and E2V. This paper focuses on MCT heterostructure developments and novel design elements in silicon read-out chips (ROICs). The 2048 x 2048 element, 17um pitch ROIC for ESA's SWIR array development forms the basis for the largest cooled infrared detector manufactured in Europe. Selex ES MCT is grown by metal organic vapour phase epitaxy (MOVPE), currently on 75mm diameter GaAs substrates. The MCT die size of the SWIR array is 35mm square and only a single array can be printed on the 75mm diameter wafer, utilising only 28% of the wafer area. The situation for 100mm substrates is little better, allowing only 2 arrays and 31% utilisation. However, low cost GaAs substrates are readily available in 150mm diameter and the MCT growth is scalable to this size, offering the real possibility of 6 arrays per wafer with 42% utilisation. A similar 2k x 2k ROIC is the goal of ESA's NIR programme, which is currently in phase 2 with a 1k x 1k demonstrator, and a smaller 320 x 256 ROIC (SAPHIRA) has been designed for ESO for the adaptive optics application in the VLT Gravity instrument. All 3 chips have low noise source-follower architecture and are enabled for MCT APD arrays, which have been demonstrated by ESO to be capable of single photon detection. The possibility therefore exists in the near future of demonstrating a photon counting, 2k x 2k SWIR MCT detector manufactured on an affordable wafer scale of 6 arrays per wafer.

Modelling the monetary value of a QALY: a new approach based on UK data.

PubMed

Mason, Helen; Jones-Lee, Michael; Donaldson, Cam

2009-08-01

Debate about the monetary value of a quality-adjusted life year (QALY) has existed in the health economics literature for some time. More recently, concern about such a value has arisen in UK health policy. This paper reports on an attempt to 'model' a willingness-to-pay-based value of a QALY from the existing value of preventing a statistical fatality (VPF) currently used in UK public sector decision making. Two methods of deriving the value of a QALY from the existing UK VPF are outlined: one conventional and one new. The advantages and disadvantages of each of the approaches are discussed as well as the implications of the results for policy and health economic evaluation methodology.

Tackling fuel poverty through facilitating energy tariff switching: a participatory action research study in vulnerable groups.

PubMed

Lorenc, A; Pedro, L; Badesha, B; Dize, C; Fernow, I; Dias, L

2013-10-01

A fifth of UK households live in fuel poverty, with significant health risks. Recent government strategy integrates public health with local government. This study examined barriers to switching energy tariffs and the impact of an energy tariff switching 'intervention' on vulnerable peoples' likelihood to, success in, switching tariffs. Participatory Action Research (PAR), conducted in West London. Community researchers from three voluntary/community organisations (VCOs) collaborated in recruitment, study design, data collection and analysis. VCOs recruited 151 participants from existing service users in three groups: Black and Minority Ethnic (BME) communities, older people (>75 yrs) and families with young children. Researchers conducted two semi-structured interviews with each participant, a week apart. The first interview asked about demographics, current energy supplier, financial situation, previous experience of tariff-switching and barriers to switching. Researchers then provided the 'intervention' - advice on tariff-switching, printed materials, access to websites. The second interview explored usefulness of the 'intervention', other information used, remaining barriers and information needs. Researchers kept case notes and a reflective log. Data was analysed thematically and collaboratively between the research coordinator and researchers. Quantitative data was analysed using SPSS, with descriptive statistics and Chi-squared tests. A total of 151 people were interviewed: 47 older people over 75 years, 51 families with young children, 51 BME (two were missing demographics). The majority were not White British or UK-born. Average household weekly income was £230. Around half described 'difficult' financial situations, 94% were receiving state benefits and 62% were in debt. Less than a third had tried to find a better energy deal; knowledge was the main barrier. After the intervention 19 people tried to switch, 13 did. Young families were most likely to switch, older people least. The main reasons for not switching were apathy ('can't be bothered'), lack of time, fear or scepticism and loyalty. Older people were particularly affected by apathy and scepticism. The personalized advice and help with websites was especially valued. Low-income consumers appear to have considerable apathy to switching energy tariffs, despite potential savings and health benefits, in part due to their complex lives in which switching is not a priority. An independent, one-on-one, personalized 'intervention' encouraged switching, particularly for young families. However, older people still experience significant barriers to switching with specific interventions needed, which take account of their status quo bias, energy use habits and scepticism. The recent integration of public health and local government in the UK may provide the ideal environment for providing similar services which are desperately needed to reduce fuel poverty in these groups in line with the new Public Health Strategy. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Present and future of the undergraduate ophthalmology curriculum: a survey of UK medical schools

PubMed Central

Hill, Sophie; Dennick, Reg

2017-01-01

Objectives To investigate the current undergraduate ophthalmology curricula provided by the UK medical schools, evaluate how they compare with the guidelines of the Royal College of Ophthalmologists (RCOphth) and International Council for Ophthalmology (ICO), and determine the views of the UK ophthalmology teaching leads on the future direction of the curriculum. Methods A cross-sectional questionnaire was sent to teaching leads in 31 medical schools across the UK. The questionnaire evaluated eight themes of the curriculum: content and learning outcomes, communication of learning outcomes, organisation of the curriculum, assessment, educational resources, teaching methods used, and the educational environment. The ophthalmology teaching leads were also asked their opinion on the current and future management of the curriculum. These were compared with RCOphth and ICO guidelines and descriptive statistical analysis performed. Results A response rate of 93% (n=29/31) was achieved. The knowledge and clinical skills taught by the UK medical schools match the  RCOphth guidelines, but fail to meet the ICO recommendations. A diverse range of assessment methods are used by UK medical schools during ophthalmology rotations. Variation was also observed in the organisation and methods of ophthalmology teaching.  However, a significant consensus about the future direction of the curriculum was reported by teaching leads. Conclusions Comprehensive RCOphth guidance, and resource sharing between medical schools could help to ensure ophthalmology’s continuing presence in the medical curriculum and improve the effectiveness of undergraduate ophthalmology teaching, while reducing the workload of local teaching departments and medical schools.  PMID:29103017

[Involving patients, the insured and the general public in healthcare decision making].

PubMed

Mühlbacher, Axel C; Juhnke, Christin

2016-01-01

No doubt, the public should be involved in healthcare decision making, especially when decision makers from politics and self-government agencies are faced with the difficult task of setting priorities. There is a general consensus on the need for a stronger patient centeredness, even in HTA processes, and internationally different ways of public participation are discussed and tested in decision making processes. This paper describes how the public can be involved in different decision situations, and it shows how preference measurement methods are currently being used in an international context to support decision making. It distinguishes between different levels of decision making on health technologies: approval, assessment, pricing, and finally utilization. The range of participation efforts extends from qualitative surveys of patients' needs (Citizen Councils of NICE in the UK) to science-based documentation of quantitative patient preferences, such as in the current pilot projects of the FDA in the US and the EMA at the European level. Possible approaches for the elicitation and documentation of preference structures and trade-offs in relation to alternate health technologies are decision aids, such as multi-criteria decision analysis (MCDA), that provide the necessary information for weighting and prioritizing decision criteria. Copyright © 2015. Published by Elsevier GmbH.

[100 years of drinking water regulation. Retrospective review, current situation and prospects].

PubMed

Rakhmanin, Yu A; Krasovsky, G N; Egorova, N A; Mikhailova, R I

2014-01-01

There is considered the history of the development of legislative requirements to the regulation of the quality of drinking water in different countries and international organizations during the period from 1912 to the present time. In terms of comparative analysis there is analyzed the current state of regulatory frameworks of the Russian Federation, WHO, EU, Finland, the UK, Singapore, Australia, Japan, China, Nigeria, the United States and Canada in the field of providing favorable conditions of population drinking water use. There has been noted the significant progress in standardization of the content of the biogenic elements and chemical pollution of drinking water in the absence of uniform requirements to the composition and properties of drinking water globally, that is bound to the need to take into account the national peculiarities of drinking water supply within the separate countries. As promising directions for improving regulation of drinking water quality there are noted: the development of new standards for prioritized water pollution, periodic review ofstandards after appearance of the new scientific data on the biological action of substances, the use of the concept of risk, the harmonization of the normative values and the assessment of the possibility of introduction into the practice the one more criterion of profitableness of population water use--the bioenergetic state of the water.

Aspirin desensitization in patients undergoing percutaneous coronary intervention: a survey of current practice.

PubMed

Chapman, Andrew R; Rushworth, Gordon F; Leslie, Stephen J

2013-01-01

Aspirin remains the mainstay of anti-platelet therapy in cardiac patients. However, if a patient is allergic to aspirin and dual anti-platelet therapy is indicated - such as with percutaneous coronary intervention (PCI), then there is no clear guidance. One possibility is aspirin desensitization. A variety of protocols exist for the rapid desensitization of patients with aspirin allergy. The aim of this survey was to assess current knowledge and practice regarding aspirin desensitization in the UK. We conducted a UK wide survey of all UK 116 PCI centers and obtained complete responses from 40 (35.4%) centers. Of these, just 7 (17.5%) centers had previously desensitised patients; 29 (87.9%) centers suggested a lack of a local protocol prevented them from desensitizing, with 10 (30.3%) unsure of how to conduct desensitization. Only 5 (12.5%) centers had a local policy for aspirin desensitization although 25 (64.1%) units had a clinical strategy for dealing with aspirin allergy; the majority (72%) giving higher doses of thienopyridine class drugs. In the UK, there appears to be no consistent approach to patients with aspirin allergy. Patients undergoing PCI benefit from dual anti-platelet therapy (including aspirin), and aspirin desensitization in those with known allergy may facilitate this. Sustained effort should be placed on encouraging UK centers to use desensitization as a treatment modality prior to PCI rather than avoiding aspirin altogether.

A qualitative exploration of psychosocial specialists' experiences of providing support in UK burn care services.

PubMed

Guest, Ella; Griffiths, Catrin; Harcourt, Diana

2018-01-01

A burn can have a significant and long-lasting psychosocial impact on a patient and their family. The National Burn Care Standards (2013) recommend psychosocial support should be available in all UK burn services; however, little is known about how it is provided. The current study aimed to explore experiences of psychosocial specialists working in UK burn care, with a focus on the challenges they experience in their role. Semi-structured telephone interviews with eight psychosocial specialists (two psychotherapists and six clinical psychologists) who worked within UK burn care explored their experiences of providing support to patients and their families. Thematic analysis revealed two main themes: burn service-related experiences and challenges reflected health professionals having little time and resources to support all patients; reduced patient attendance due to them living large distances from service; psychosocial appointments being prioritised below wound-related treatments; and difficulties detecting patient needs with current outcome measures. Therapy-related experiences and challenges outlined the sociocultural and familial factors affecting engagement with support, difficulties treating patients with pre-existing mental health conditions within the burn service and individual differences in the stage at which patients are amenable to support. Findings provide an insight into the experiences of psychosocial specialists working in UK burn care and suggest a number of ways in which psychosocial provision in the NHS burn service could be developed.

Prehospital airway management on rescue helicopters in the United Kingdom.

PubMed

Schmid, M; Mang, H; Ey, K; Schüttler, J

2009-06-01

Adequate equipment is one prerequisite for advanced, out of hospital, airway management. There are no data on current availability of airway equipment on UK rescue helicopters. An internet search revealed all UK rescue helicopters, and a questionnaire was sent to the bases asking for available airway management items. We identified 27 helicopter bases and 26 (96%) sent the questionnaire back. Twenty-four bases (92%) had at least one supraglottic airway device; 16 (62%) helicopters had material for establishing a surgical airway (e.g. a cricothyroidotomy set); 88% of the helicopters had CO(2) detection; 25 (96%) helicopters carried automatic ventilators; among these, four (15%) had sophisticated ventilators and seven (27%) helicopters carried special face masks suitable for non-invasive ventilation. We found a wide variation in the advanced airway management equipment that was carried routinely on air ambulances. Current guidelines for airway management are not met by all UK air ambulances.

The hospital microbiome project: meeting report for the UK science and innovation network UK-USA workshop ‘beating the superbugs: hospital microbiome studies for tackling antimicrobial resistance’, October 14th 2013

PubMed Central

2014-01-01

The UK Science and Innovation Network UK-USA workshop ‘Beating the Superbugs: Hospital Microbiome Studies for tackling Antimicrobial Resistance’ was held on October 14th 2013 at the UK Department of Health, London. The workshop was designed to promote US-UK collaboration on hospital microbiome studies to add a new facet to our collective understanding of antimicrobial resistance. The assembled researchers debated the importance of the hospital microbial community in transmission of disease and as a reservoir for antimicrobial resistance genes, and discussed methodologies, hypotheses, and priorities. A number of complementary approaches were explored, although the importance of the built environment microbiome in disease transmission was not universally accepted. Current whole genome epidemiological methods are being pioneered in the UK and the benefits of moving to community analysis are not necessarily obvious to the pioneers; however, rapid progress in other areas of microbiology suggest to some researchers that hospital microbiome studies will be exceptionally fruitful even in the short term. Collaborative studies will recombine different strengths to tackle the international problems of antimicrobial resistance and hospital and healthcare associated infections.

The Problem of “Just for Fun”: Patterns of Use Situations among Active Club Drug Users

PubMed Central

Starks, Tyrel J.; Golub, Sarit; Kelly, Brian C.; Parsons, Jeffrey T.

2010-01-01

Existing research has demonstrated the significance of situational antecedents to substance use. The current study used a cluster analytic approach to identify groups of club drug users who report using substances in similar situations (assessed by the Inventory of Drug Taking Situations) with longitudinal data from 400 active drug users. A three-cluster solution emerged in baseline data and was replicated in 12-month follow-up data. Groups were identified as Situationally Restricted, Pleasure Driven, and Situationally Broad users. Group differences were observed on measures of mental health, attitudes towards substance use, amount of substance use, and rates of substance dependence. Cluster membership predicted substance dependence after controlling for past dependence, current use, and current depression/anxiety. PMID:20696530

Does the UKCAT predict performance on exit from medical school? A national cohort study

PubMed Central

Cleland, J A; Ayansina, D; Nicholson, S

2016-01-01

Objectives Most UK medical programmes use aptitude tests during student selection, but large-scale studies of predictive validity are rare. This study assesses the UK Clinical Aptitude Test (UKCAT: http://www.ukcat.ac.uk), and 4 of its subscales, along with individual and contextual socioeconomic background factors, as predictors of performance during, and on exit from, medical school. Methods This was an observational study of 6294 medical students from 30 UK medical programmes who took the UKCAT from 2006 to 2008, for whom selection data from the UK Foundation Programme (UKFPO), the next stage of UK medical education training, were available in 2013. We included candidate demographics, UKCAT (cognitive domains; total scores), UKFPO Educational Performance Measure (EPM) and national exit situational judgement test (SJT). Multilevel modelling was used to assess relationships between variables, adjusting for confounders. Results The UKCAT—as a total score and in terms of the subtest scores—has significant predictive validity for performance on the UKFPO EPM and SJT. UKFPO performance was also affected positively by female gender, maturity, white ethnicity and coming from a higher social class area at the time of application to medical school An inverse pattern was seen for a contextual measure of school, with those attending fee-paying schools performing significantly more weakly on the EPM decile, the EPM total and the total UKFPO score, but not the SJT, than those attending other types of school. Conclusions This large-scale study, the first to link 2 national databases—UKCAT and UKFPO, has shown that UKCAT is a predictor of medical school outcome. The data provide modest supportive evidence for the UKCAT's role in student selection. The conflicting relationships of socioeconomic contextual measures (area and school) with outcome adds to wider debates about the limitations of these measures, and indicates the need for further research. PMID:27855088

Social gradients in health for Pakistani and White British women and infants in two UK birth cohorts.

PubMed

Uphoff, Eleonora P; Pickett, Kate E; Wright, John

2016-10-01

This study aims to examine social gradients in low birth weight (LBW), preterm birth, smoking during pregnancy and maternal health for women and infants of Pakistani origin and White British women and infants in the UK. The sample included women and singleton infants from the Born in Bradford (BiB) study (n = 8181) and the first sweep of the Millennium Cohort Study (MCS) (n = 8980). Social gradients in health for four measures of socioeconomic status (SES): maternal education, means-tested benefits, financial situation, and occupation of the father were analysed in multivariate regression models adjusting for maternal age and parity. For White British mothers and infants in the MCS sample, social gradients in health were observed for at least three out of four measures of SES for each health outcome (p for trend <.01). Similar trends were found for White British mothers and infants in the BiB sample, although these were less likely to be significant. There were few associations between measures of SES and outcomes in the Pakistani samples. The strongest evidence of a social gradient in health for Pakistani women was demonstrated with the self-reported measure of financial situation, in relation to mental health (p for trend <.001 in both cohorts). This study describes a lack of social gradients in health for Pakistani women and infants and discusses potential explanations for this finding.

The composition of precarity: 'emerging' composers' experiences of opportunity culture in contemporary classical music.

PubMed

Smith, Neil Thomas; Thwaites, Rachel

2018-02-28

This paper examines the precarious working lives of 'emerging' composers attempting to build a career in the world of new classical music in the UK. This topic is approached by considering the 'composition opportunity', success in which is seen as an important element in 'making it' in this sphere. We argue that such schemes in fact manifest a crucial tension in the nature of artistic labour, and are, at the very least, problematic in their function as conduits towards full professional identity. They may instead act to maintain the precarious working situation of composers in a neoliberal age. The working lives of artists are all too rarely illuminated, and new music composers are no exception; this survey of 47 emerging composers is the largest study of such individuals in the UK. © London School of Economics and Political Science 2018.

Acting discursively: the development of UK organic food and farming policy networks.

PubMed

TOMLINSON, Isobel Jane

2010-01-01

This paper documents the early evolution of UK organic food and farming policy networks and locates this empirical focus in a theoretical context concerned with understanding the contemporary policy-making process. While policy networks have emerged as a widely acknowledged empirical manifestation of governance, debate continues as to the concept's explanatory utility and usefulness in situations of network and policy transformation since, historically, policy networks have been applied to "static" circumstances. Recognizing this criticism, and in drawing on an interpretivist perspective, this paper sees policy networks as enacted by individual actors whose beliefs and actions construct the nature of the network. It seeks to make links between the characteristics of the policy network and the policy outcomes through the identification of discursively constructed "storylines" that form a tool for consensus building in networks. This study analyses the functioning of the organic policy networks through the discursive actions of policy-network actors.

An example of the teacher expectation effect in mixed ability teaching

NASA Astrophysics Data System (ADS)

Matthews, G. P.

Much interest has been shown recently in teacher expectation or self-fulfilling prophecy effects, despite the difficulty of making objective observations of the phenomenon. The present case study concerns a population of twelve mixed-ability chemistry classes in a comprehensive school in the U.K. The poor behavior of one of the groups led to a stigma being attached to it by staff, and for various doubtful reasons, this became associated with another class as well. A statistical analysis of examination marks shows that neither reputation was justified in terms of academic achievement, and quantifies possible teacher expectation effects arising from the situation. The findings demonstrate the ease with which academic achievements can be hampered unwittingly by the prejudices of a teacher even in a well-structured learning situation.

Current Capabilities, Requirements and a Proposed Strategy for Interdependency Analysis in the UK

NASA Astrophysics Data System (ADS)

Bloomfield, Robin; Chozos, Nick; Salako, Kizito

The UK government recently commissioned a research study to identify the state-of-the-art in Critical Infrastructure modelling and analysis, and the government/industry requirements for such tools and services. This study (Cetifs) concluded with a strategy aiming to bridge the gaps between the capabilities and requirements, which would establish interdependency analysis as a commercially viable service in the near future. This paper presents the findings of this study that was carried out by CSR, City University London, Adelard LLP, a safety/security consultancy and Cranfield University, defense academy of the UK.

Discussing Terrorism: A Pupil-Inspired Guide to UK Counter-Terrorism Policy Implementation in Religious Education Classrooms in England

ERIC Educational Resources Information Center

Quartermaine, Angela

2016-01-01

My research into pupils' perceptions of terrorism and current UK counter-terrorism policy highlights the need for more detailed and accurate discussions about the implementation of the educational aims, in particular those laid out by the Prevent Strategy. Religious education (RE) in England is affected by these aims, specifically the challenging…

Resources for Teaching Astronomy in UK Schools

ERIC Educational Resources Information Center

Roche, Paul; Newsam, Andy; Roberts, Sarah; Mason, Tom; Baruch, John

2012-01-01

This article looks at a selection of resources currently available for use in the teaching of astronomy in UK schools. It is by no means an exhaustive list but it highlights a variety of free resources that can be used in the classroom to help engage students of all ages with astronomy and space science. It also lists several facilities with a…

What Major Search Engines Like Google, Yahoo and Bing Need to Know about Teachers in the UK?

ERIC Educational Resources Information Center

Seyedarabi, Faezeh

2014-01-01

This article briefly outlines the current major search engines' approach to teachers' web searching. The aim of this article is to make Web searching easier for teachers when searching for relevant online teaching materials, in general, and UK teacher practitioners at primary, secondary and post-compulsory levels, in particular. Therefore, major…

From Sustainable Community to Big Society: 10 Years Learning with the Imagine Approach

ERIC Educational Resources Information Center

Bell, Simon

2011-01-01

Community is a key word in the current UK political vocabulary. As part of Big Society or as a sustainable means to develop social coherence, community has been an area of focus that has attained UK political party interest since 2003. In 1999, the Imagine method was first hinted at in the Earthscan book: "Sustainability Indicators: measuring…

Restrictive and Expansive Policy Learning--Challenges and Strategies for Knowledge Exchange in Upper Secondary Education across the Four Countries of the UK

ERIC Educational Resources Information Center

Hodgson, Ann; Spours, Ken

2016-01-01

This article examines the challenges and possibilities for UK policy learning in relation to upper secondary education (USE) across England, Scotland, Wales and Northern Ireland (NI) within current national and global policy contexts. Drawing on a range of international literature, the article explores the concepts of "restrictive" and…

A new tree improvement programme for black walnut in the United Kingdom

Treesearch

Karen Russell; Gabriel E. Hemery

2004-01-01

Black walnut is an introduced species in the United Kingdom (UK) and economically one of the more productive broadleaved species. Currently it is not widely planted in the UK as there is insufficient knowledge about the species among foresters and very little, if any, improved material is available. A research programme was initiated in 2001 to address both these...

Is It Because of Partners or Partnerships?: An Investigation into the Main Obstacles of Developing International Partnerships in Four UK Universities

ERIC Educational Resources Information Center

Ayoubi, Rami M.; Massoud, Hiba

2012-01-01

Purpose: The main aim of the current study is to explore and model the major obstacles that UK universities encounter when developing international partnerships with overseas universities. Design/methodology/approach: Focusing on the obstacles to developing international partnerships, the study results are developed from 24 interviews with senior…

Peer Mentoring during the Transition to University: Assessing the Usage of a Formal Scheme within the UK

ERIC Educational Resources Information Center

Collings, Rosalyn; Swanson, Vivien; Watkins, Ruth

2016-01-01

Although mentoring has become increasingly popular within UK higher education, there is little evaluative research. The current longitudinal study aimed to evaluate the usage of a peer mentoring scheme during a first semester at university amongst 124 students. Results indicate that during the first week at university the majority accessed the…

Re-Visiting the Role of Disability Coordinators: The Changing Needs of Disabled Students and Current Support Strategies from a UK University

ERIC Educational Resources Information Center

Koca-Atabey, Mujde

2017-01-01

This study aimed to investigate the system designed to support disabled university students from the perspective of disability coordinators. The research on this topic specifically is limited. Disability coordinators from a particular UK university were interviewed to better understand the support system from their own perspective. Interpretative…

Responding to Schoolgirl Pregnancy: The Recognition and Non-Recognition of Difference

ERIC Educational Resources Information Center

Vincent, Kerry

2009-01-01

Teenage mothers in the UK have been found to be at risk of early school leaving, low levels of educational achievement and low levels of post-compulsory educational participation. Current policy in the UK emphasizes the importance of education as a way of improving the life chances of those who become pregnant while young and, as part of that,…

Securing World-Class Research in UK Universities: Exploring the Impact of Block Grant Funding

ERIC Educational Resources Information Center

Universities UK, 2009

2009-01-01

The UK research base is world class. It is second only to the USA on leading scientific indicators and crucially, during the current economic climate, ranks first on publication productivity and citations in relation to research and development public spend. Commonly known as quality-related (QR) funding because it is allocated selectively on the…

Contribution of the SPEED Programme to the Enhancement of an Enterprise Culture in a UK University

ERIC Educational Resources Information Center

Clements, Mike

2012-01-01

When the current UK coalition government came to power in 2010, it sought amongst other things to stimulate a dormant economy and deal with the national budget deficit. One of its first acts was to charge universities to become the bedrock for entrepreneurial activity, and to deliver challenging enterprise education to all their students, so…

Does Education Improve Citizenship? Evidence from the U.S. and the U.K. Working Paper.

ERIC Educational Resources Information Center

Milligan, Kevin; Moretti, Enrico; Oreopoulos, Philip

This paper explores the effect of extra schooling, induced through compulsory schooling laws, on the likelihood of becoming politically involved in the United States and the United Kingdom. U.S. data come from the annual National Elections Studies and the November Current Population Surveys. U.K. data come from the British General Election Studies…

UK and Twenty Comparable Countries GDP-Expenditure-on-Health 1980-2013: The Historic and Continued Low Priority of UK Health-Related Expenditure.

PubMed

Harding, Andrew J E; Pritchard, Colin

2016-07-10

It is well-established that for a considerable period the United Kingdom has spent proportionally less of its gross domestic product (GDP) on health-related services than almost any other comparable country. Average European spending on health (as a % of GDP) in the period 1980 to 2013 has been 19% higher than the United Kingdom, indicating that comparable countries give far greater fiscal priority to its health services, irrespective of its actual fiscal value or configuration. While the UK National Health Service (NHS) is a comparatively lean healthcare system, it is often regarded to be at a 'crisis' point on account of low levels of funding. Indeed, many state that currently the NHS has a sizeable funding gap, in part due to its recently reduced GDP devoted to health but mainly the challenges around increases in longevity, expectation and new medical costs. The right level of health funding is a political value judgement. As the data in this paper outline, if the UK 'afforded' the same proportional level of funding as the mean average European country, total expenditure would currently increase by one-fifth. © 2016 by Kerman University of Medical Sciences.

Implications of shale gas exploitation for UK climate change targets under a production-based accounting system.

NASA Astrophysics Data System (ADS)

Turk, J.; Reay, D.; Haszeldine, S.

2017-12-01

The shale gas boom in the USA has seemingly decreased the greenhouse gas intensity of electricity generation in the USA over the last decade. The United Kingdom is supporting its own shale gas industry to increase its own domestic energy supply. The UK's climate change policy is underpinned by defined national carbon budgets periods. The UK has met Carbon Budget 1 (2008 - 2012) and is likely to meet the second and third carbon budgets (2013 - 2022). There is a projected shortcoming in the fourth carbon budget (2023 - 2027). This shortfall may be increased as the UK pursues a domestic shale gas industry. Under the current production-based GHG accounting system, the UK is incentivized to import natural gas rather than produce it domestically. If the projected gas supply were to be met by UK shale gas, we project additional greenhouse gas emissions which would need to be accommodated during Carbon Budget periods 3 - 6. Additionally, natural gas electricity generation will contribute to sustaining grid electricity emissions during the same time period within the traded European Union emissions cap.

Long term care financing in four OECD countries: fiscal burden and distributive effects.

PubMed

Karlsson, Martin; Mayhew, Les; Rickayzen, Ben

2007-01-01

This paper compares long term care (LTC) systems in four OECD countries (UK, Japan, Sweden and Germany). In the UK, provision is means tested, so that out of pocket payments depend on levels of income, savings and assets. In Sweden, where the system is wholly tax-financed, provision is essentially free at the point of use. In Germany and Japan, provision is financed from recently introduced compulsory insurance schemes, although the details of how each scheme operates and the distributive consequences differ somewhat. The paper analyses the effects of importing the other three countries' systems for financing LTC into the UK, focussing on both the distributive consequences and the tax burden. It finds that the German system would not be an improvement on the current UK system, because it uses a regressive method of financing. Therefore, the discussion of possible alternatives to the present UK system could be restricted to a general tax-based system as used in Sweden or the compulsory insurance system as used in Japan. The results suggest that all three systems would imply increased taxes in the UK.

The current status of diabetes professional educational standards and competencies in the UK--a position statement from the Diabetes UK Healthcare Professional Education Competency Framework Task and Finish Group.

PubMed

Walsh, N; George, S; Priest, L; Deakin, T; Vanterpool, G; Karet, B; Simmons, D

2011-12-01

Diabetes is a significant health concern, both in the UK and globally. Management can be complex, often requiring high levels of knowledge and skills in order to provide high-quality and safe care. The provision of good, safe, quality care lies within the foundations of healthcare education, continuing professional development and evidence-based practice, which are inseparable and part of a continuum during the career of any health professional. Sound education provides the launch pad for effective clinical management and positive patient experiences. This position paper reviews and discusses work undertaken by a Working Group under the auspices of Diabetes UK with the remit of considering all health professional educational issues for people delivering care to people with diabetes. This work has scoped the availability of education for those within the healthcare system who may directly or indirectly encounter people with diabetes and reviews alignment to existing competency frameworks within the UK's National Health Service. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

What do preservice teachers from the USA and the UK know about dyslexia?

PubMed

Washburn, Erin K; Binks-Cantrell, Emily S; Joshi, R Malatesha

2014-02-01

The purpose of the study was to examine the knowledge base of preservice teachers from the USA and the UK of dyslexia as a language-based learning disability. A survey (both US and UK versions) was constructed using current research-based understandings of dyslexia as a language-based learning disability. One hundred and one preservice teachers from the USA and 70 preservice teachers from the UK were administered the survey. Results indicated that participants in the two groups demonstrated some similar accurate knowledge about dyslexia as well as displaying some common misunderstandings about dyslexia. Recommendations concerning preservice teacher preparation and professional development for in-service teachers about dyslexia as well as future research directions are discussed. Copyright © 2013 John Wiley & Sons, Ltd.

New undergraduate curricula in the UK and Australia.

PubMed

Lumsden, M A; Symonds, I M

2010-12-01

There are many challenges facing undergraduate education in the smaller specialities such as obstetrics and gynaecology (O&G). These are similar throughout the world, although the emphasis may vary according to geography and the approach of those involved in medical education in general. The number of medical students has increased because of the greater number of doctors required, the gender balance and also because it provides revenue for the universities. This means that strategies must be developed to include more teaching units in both primary and secondary care as well as those at a distance from the main teaching provider. Australia and the UK both have this problem but, obviously, the distances involved in Australia are much greater. One of the drivers for the change in undergraduate medical education in the UK was factual overload and the need to teach basic competencies to the students. National curricula that take this into account are being developed and that in the UK has been taken up by a majority of the medical schools. The opportunities offered by O&G to provide basic skills and competencies difficult to find elsewhere in the curriculum are unparalleled. These include issues such as communication in situations where great sensitivity is required and also the impact of cultural beliefs and ethnicity on clinical practice. However, factual knowledge of medical science is also essential and ways of achieving a balance are discussed. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

Quantifying the uncertainties in life cycle greenhouse gas emissions for UK wheat ethanol

NASA Astrophysics Data System (ADS)

Yan, Xiaoyu; Boies, Adam M.

2013-03-01

Biofuels are increasingly promoted worldwide as a means for reducing greenhouse gas (GHG) emissions from transport. However, current regulatory frameworks and most academic life cycle analyses adopt a deterministic approach in determining the GHG intensities of biofuels and thus ignore the inherent risk associated with biofuel production. This study aims to develop a transparent stochastic method for evaluating UK biofuels that determines both the magnitude and uncertainty of GHG intensity on the basis of current industry practices. Using wheat ethanol as a case study, we show that the GHG intensity could span a range of 40-110 gCO2e MJ-1 when land use change (LUC) emissions and various sources of uncertainty are taken into account, as compared with a regulatory default value of 44 gCO2e MJ-1. This suggests that the current deterministic regulatory framework underestimates wheat ethanol GHG intensity and thus may not be effective in evaluating transport fuels. Uncertainties in determining the GHG intensity of UK wheat ethanol include limitations of available data at a localized scale, and significant scientific uncertainty of parameters such as soil N2O and LUC emissions. Biofuel polices should be robust enough to incorporate the currently irreducible uncertainties and flexible enough to be readily revised when better science is available.

Experiences of refugees and asylum seekers in general practice: a qualitative study

PubMed Central

Bhatia, Ravi; Wallace, Paul

2007-01-01

Background There has been much debate regarding the refugee health situation in the UK. However most of the existing literature fails to take account of the opinions of refugees themselves. This study was established to determine the views of asylum seekers and refugees on their overall experiences in primary care and to suggest improvements to their care. Methods Qualitative study of adult asylum seekers and refugees who had entered the UK in the last 10 years. The study was set in Barnet Refugee Walk in Service, London. 11 Semi structured interviews were conducted and analysed using framework analysis. Results Access to GPs may be more difficult for failed asylum seekers and those without support from refugee agencies or family. There may be concerns amongst some in the refugee community regarding the access to and confidentiality of professional interpreters. Most participants stated their preference for GPs who offered advice rather than prescriptions. The stigma associated with refugee status in the UK may have led to some refugees altering their help seeking behaviour. Conclusion The problem of poor access for those with inadequate support may be improved by better education and support for GPs in how to provide for refugees. Primary Care Trusts could also supply information to newly arrived refugees on how to access services. GPs should be aware that, in some situations, professional interpreters may not always be desired and that instead, it may be advisable to reach a consensus as to who should be used as an interpreter. A better doctor-patient experience resulting from improvements in access and communication may help to reduce the stigma associated with refugee status and lead to more appropriate help seeking behaviour. Given the small nature of our investigation, larger studies need to be conducted to confirm and to quantify these results. PMID:17711587

Falls and confidence related quality of life outcome measures in an older British cohort

PubMed Central

Parry, S; Steen, N; Galloway, S; Kenny, R; Bond, J

2001-01-01

Falls are common in older subjects and result in loss of confidence and independence. The Falls Efficacy Scale (FES) and the Activities-specific Balance Confidence scale (ABC) were developed in North America to quantify these entities, but contain idiom unfamiliar to an older British population. Neither has been validated in the UK. The FES and the ABC were modified for use within British culture and the internal consistency and test-retest reliability of the modified scales (FES-UK and ABC-UK) assessed. A total of 193 consecutive, ambulant, new, and return patients (n=119; 62%) and their friends and relatives ("visitors", n=74; 38%) were tested on both scales, while the last 60 subjects were retested within one week. Internal reliability was excellent for both scales (Cronbach's alpha 0.97 (FES-UK), and 0.98 (ABC-UK)). Test-retest reliability was good for both scales, though superior for the ABC-UK (intraclass correlation coefficient 0.58 (FES-UK), 0.89 (ABC-UK)). There was evidence to suggest that the ABC-UK was better than the FES-UK at distinguishing between older patients and younger patients (|tABC| = 4.4; |tFES| = 2.3); and between fallers and non-fallers (|tABC| = 8.7; |tFES| = 5.0) where the t statistics are based on the comparison of two independent samples. The ABC-UK and FES-UK are both reliable and valid measures for the assessment of falls and balance related confidence in older adults. However, better test-retest reliability and more robust differentiation of subgroups in whom falls related quality of life would be expected to be different make the ABC-UK the current instrument of choice in assessing this entity in older British subjects.


Keywords: quality of life; falls; elderly; health status measurement PMID:11161077

Public health approaches to end-of-life care in the UK: an online survey of palliative care services.

PubMed

Paul, Sally; Sallnow, Libby

2013-06-01

The public health approach to end-of-life care has gained recognition over the past decade regarding its contribution to palliative care services. Terms, such as health-promoting palliative care, and compassionate communities, have entered the discourse of palliative care and practice; examples exist in the UK and globally. This scoping study aimed to determine if such initiatives were priorities for hospices in the UK and, if so, provide baseline data on the types of initiatives undertaken. An online survey was designed, piloted and emailed to 220 palliative care providers across the four UK countries. It included a total of six questions. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed thematically. There was a 66% response rate. Of those providers, 60% indicated that public health approaches to death, dying and loss were a current priority for their organisation. Respondents identified a range of work being undertaken currently in this area. The most successful were felt to be working with schools and working directly with local community groups. The findings demonstrate the relevance of a public health approach for palliative care services and how they are currently engaging with the communities they serve. Although the approach was endorsed by the majority of respondents, various challenges were highlighted. These related to the need to balance this against service provision, and the need for more training and resources to support these initiatives, at both national and community levels.

Current management strategies for patellofemoral pain: an online survey of 99 practising UK physiotherapists.

PubMed

Smith, Benjamin E; Hendrick, Paul; Bateman, Marcus; Moffatt, Fiona; Rathleff, Michael Skovdal; Selfe, James; Smith, Toby O; Logan, Pip

2017-05-08

Patellofemoral pain (PFP) is considered one of the commonest forms of knee pain. This study aimed to identify how physiotherapists in the United Kingdom (UK) currently manage patellofemoral pain (PFP), particularly in relation to exercise prescription, and response to pain. An anonymous survey was designed with reference to previous surveys and recent systematic reviews. Practising UK physiotherapists who treat patients with PFP were invited to take part via an invitation email sent through professional networks, the 'interactive Chartered Society of Physiotherapy (iCSP)' message board, and social media (Twitter). Descriptive statistics were used to analyse the data. A total of 99 surveys were completed. Responders reported a wide range of management strategies, including a broad selection of type and dose of exercise prescription. The five most common management strategies chosen were: closed chain strengthening exercises (98%); education and advice (96%); open chain strengthening exercises (76%); taping (70%) and stretches (65%). Physiotherapists with a special interest in treating PFP were statistically more likely to manage patients with orthotics (P = 0.02) and bracing (P = 0.01) compared to physiotherapists without a special interest. Approximately 55% would not prescribe an exercise if it was painful. Thirty-one percent of physiotherapists would advise patients not to continue with leisure and/or sporting activity if they experienced any pain. Current UK practice in the management strategies of PFP is variable. Further high quality research on which to inform physiotherapy practice is warranted for this troublesome musculoskeletal condition.

Current Status of Infant Mental Health in Day-Care Centres in Japan: An Investigation of Okinawa and Aomori Prefectures

ERIC Educational Resources Information Center

Takizawa, Tohru; Kondo, Tsuyoshi; Tanaka, Osamu; Wake, Norie; Naka, Kuoichi; Todoriki, Hidemi; Ishizu, Hiroshi

2009-01-01

Grasping both the extent and the actual situation of psychosomatic disorders, neurotic habits and developmental disorders of infancy and childhood is vital for their prevention and for taking appropriate measures to deal with the current situation. The purpose of this study is to explore the current situation of infant mental health in Japanese…

The politics of accountability for school curriculum: An Australian case study

NASA Astrophysics Data System (ADS)

Smithson, Alan

1987-03-01

This normative-descriptive case study of accountability for state school curriculum in South Australia has the following objectives. First, to seek to draw a distinction between accountability and responsibility: terms which have been confused by two South Australian Directors-General of Education (position akin to C.E.O. in the U.K. and Superintendent in the U.S.A.) with important consequences. Second, to present a model of accountability for state school curriculum, by which accountability for such curriculum may be judged democratic or non-democratic, and against which accountability for curriculum in South Australian state schools will be gauged. Third, to show that whilst the South Australian school system exhibits a large measure of bureaucratic or technocratic accountability for curriculum, there is no effective democratic accountability for curriculum, and to indicate a remedy for this situation. Finally, to point out the wider significance of the South Australian case study, and suggest that democracies currently re-structuring their educational systems would do well to keep the need for democratic accountability foremost in mind.

SequenceLDhot: detecting recombination hotspots.

PubMed

Fearnhead, Paul

2006-12-15

There is much local variation in recombination rates across the human genome--with the majority of recombination occurring in recombination hotspots--short regions of around approximately 2 kb in length that have much higher recombination rates than neighbouring regions. Knowledge of this local variation is important, e.g. in the design and analysis of association studies for disease genes. Population genetic data, such as that generated by the HapMap project, can be used to infer the location of these hotspots. We present a new, efficient and powerful method for detecting recombination hotspots from population data. We compare our method with four current methods for detecting hotspots. It is orders of magnitude quicker, and has greater power, than two related approaches. It appears to be more powerful than HotspotFisher, though less accurate at inferring the precise positions of the hotspot. It was also more powerful than LDhot in some situations: particularly for weaker hotspots (10-40 times the background rate) when SNP density is lower (< 1/kb). Program, data sets, and full details of results are available at: http://www.maths.lancs.ac.uk/~fearnhea/Hotspot.

Delivering accessible fieldwork: preliminary findings from a collaborative international study

NASA Astrophysics Data System (ADS)

Stokes, Alison; Atchison, Christopher; Feig, Anthony; Gilley, Brett

2017-04-01

Students with disabilities are commonly excluded from full participation in geoscience programs, and encounter significant barriers when accessing field-learning experiences. In order to increase talent and diversity in the geoscience workforce, more inclusive learning experiences must be developed that will enable all students to complete the requirements of undergraduate degree programs, including fieldwork. We discuss the outcomes of a completely accessible field course developed through the collaborative effort of geoscience education practitioners from the US, Canada and the UK. This unique field workshop has brought together current geoscience academics and students with disabilities to share perspectives on commonly-encountered barriers to learning in the field, and explore methods and techniques for overcoming them. While the student participants had the opportunity to learn about Earth processes while situated in the natural environment, participating geoscience instructors began to identify how to improve the design of field courses, making them fully inclusive of learners with disabilities. The outcomes from this experience will be used to develop guidelines to facilitate future development and delivery of accessible geoscience fieldwork.

38 CFR 36.4326 - Subrogation and indemnity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the obligor's current financial situation and prospective earning potential and obligations indicates... situation will consider all of the following: (i) The obligor's current and anticipated family income based... financial situation. Such actions would include termination of the loan by means of a deed-in-lieu of...

[Variant Creutzfeldt-Jakob disease in France: estimating the number of cases related to travel to the United Kingdom between 1980 and 1995].

PubMed

Chadeau-Hyam, M; Alpérovitch, A

2005-02-01

The outbreak of variant Creutzfeldt-Jakob disease (vCJD) cases rose serious concerns about secondary transmission of the disease, particularly through blood transfusion. Protective measures leading to the exclusion of potentially infectious blood donors were settled: in France, donors who had stayed more than one year in the UK were excluded. In this work, which was part of a larger study aiming to estimate the French epidemic of vCJD, the number of vCJD cases who were infected during a trip to the UK was estimated. Those estimates may notably enable the assessment of such exclusion measures. The particular age-related structure in vCJD cases is taken into account in our simulations considering birth cohorts in the population. The total French exposure is simulated assuming the main source of infection to be dietary through consumption of mechanically recovered meat (MRM) manufactured from British bovine carcasses. Then, using a "back calculation" algorithm, all infected individuals required to produce a consistent epidemic (6 vCJD cases in 2003) was simulated. This study was exclusively focused on the part of the exposure linked to trips (beef MRM consumed in the UK while traveling) and on cases resulting from this exposure. The influence of exposure linked to trips to the UK was greater in the youngest cohort (6.3% of the total exposure) while it only accounted for 3.3% and 1% in the 1939-69 and in the pre-1939 birth cohorts respectively. Overall, exposure resulting from trips in the UK can be neglected with regards to the exposure linked to the consumption of MRM produced in France from British bovine carcasses. Consequently, French vCJD cases that would have been infected in the UK are very unlikely to occur (median: 0 case, IC 95%: (0-2)). Nevertheless, if such cases occur, they would probably occur in subjects born after 1969 and their onset would take place before 2010. Thus, unlike the situation in BSE-free countries, the causal relationship between travel in the UK and occurrence of vCJD cases cannot be underlined in France, as trips only account for a small part of the French exposure. Since trips in the UK slightly contribute to the overall French exposure, excluding people who travelled in the UK from blood donation would not influence the risk of secondary transmission.

The Development of Program for Enhancing Learning Management Competency of Teachers in Non-Formal and Informal Education Centers

ERIC Educational Resources Information Center

Jutasong, Chanokpon; Sirisuthi, Chaiyut; Phusri-on, Songsak

2016-01-01

The objectives of this research are: 1) to study factors and indicators, 2) to study current situations, desirable situations and techniques, 3) to develop the Program, and 4) to study the effect of Program. It comprised 4 phases: (1) studying the factors and indicators; (2) studying the current situations, desirable situations and techniques; (3)…

REIMBURSEMENT OF CELL-BASED REGENERATIVE THERAPY IN THE UK AND FRANCE.

PubMed

Mahalatchimy, Aurélie

2016-01-01

Cell-based regenerative therapies are presented as being able to cure the diseases of the twenty-first century, especially those coming from the degeneration of the aging human body. But their specific nature based on biological materials raises particular challenging issues on how regulation should frame biomedical innovation for society's benefit regarding public health. The European Union (EU) supports the development of cell-based regenerative therapies that are medicinal products with a specific regulation providing their wide access to the European market for European patients. However, once these medicinal products have obtained a European marketing authorisation, they are still far away from being fully accessible to European patients in all EU Member States. Whereas there is much written on the EU regulatory system for new biotechnologies, there is no systematic legal study comparing the insurance provisions in two EU countries. Focussing on the situation in the UK and France that are based on two different healthcare systems, this paper is based on a comparative methodological approach. It raises the question of regulatory reimbursement mechanisms that determine access to innovative treatments and their consequences for social protection systems in the general context of public health. After having compared the French and English regulations of cell-based regenerative therapy regarding pricing and reimbursement, this papers analyses how England and France are addressing two main challenges of cell-based regenerative therapy, to take into account their long-term benefit through their potential curative nature and their high upfront cost, towards their adoption within the English and French healthcare systems. It concludes that England and France have different general legal frameworks that are not specific to the reimbursement of cell-based regenerative therapy, although their two current and respective trends would bring more convergence between the two systems while addressing the main challenges for the reimbursement of these therapies. Nevertheless, despite their current differences, neither the English nor the French national healthcare system has yet approved the reimbursement of cell-based regenerative therapies. The paper highlights where both systems could be learning from each others' experiences to favour the adoption of cell-based regenerative therapies through the adaptation of their reimbursement methodologies. It also emphasises the gap between market access and patients' access, and it calls for research and discussions through reflexive agencies such as the Regenerative Medicine Expert Group in the UK. © The Author 2016. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

Modelling the long-range transport of secondary PM 10 to the UK

NASA Astrophysics Data System (ADS)

Malcolm, A. L.; Derwent, R. G.; Maryon, R. H.

The fine fraction of airborne particulate matter (PM 10) is known to be harmful to human health. In order to establish how current air quality standards can best be met now and in the future, it is necessary to understand the cause of PM 10 episodes. The UK Met Office's dispersion model, NAME, has been used to model hourly concentrations of sulphate aerosol for 1996 at a number of UK locations. The model output has been compared with measured values of PM 10 or sulphate aerosol at these sites and used to provide attribution information. In particular two large PM 10 episodes in March and July 1996 have been studied. The March episode has been shown to be the result of imported pollution from outside the UK, whereas the July case was dominated by UK emissions. This work highlights the need to consider trans-boundary pollution when setting air quality standards and when making policy decisions on emissions.

Implementing a successful data-management framework: the UK10K managed access model

PubMed Central

2013-01-01

This paper outlines the history behind open access principles and describes the development of a managed access data-sharing process for the UK10K Project, currently Britain’s largest genomic sequencing consortium (2010 to 2013). Funded by the Wellcome Trust, the purpose of UK10K was two-fold: to investigate how low-frequency and rare genetic variants contribute to human disease, and to provide an enduring data resource for future research into human genetics. In this paper, we discuss the challenge of reconciling data-sharing principles with the practicalities of delivering a sequencing project of UK10K’s scope and magnitude. We describe the development of a sustainable, easy-to-use managed access system that allowed rapid access to UK10K data, while protecting the interests of participants and data generators alike. Specifically, we focus in depth on the three key issues that emerge in the data pipeline: study recruitment, data release and data access. PMID:24229443

Screening for Diabetic Retinopathy in Adults with Learning Disability: Current Uptake and Adjustments to Facilitate Equality of Access

ERIC Educational Resources Information Center

Pilling, Rachel F.

2015-01-01

Equality of access to health care for adults with learning disability has been in the spotlight in the UK in recent years due to publication of several reports. Adults with learning disability are thought to account for a significant proportion of the diabetic population in the UK. A list of adults known to the learning disability health…

The Architecture and the Plumbing: What Features Do the Higher Education Systems in the UK and Australia Have in Common?

ERIC Educational Resources Information Center

Wellings, Paul

2015-01-01

The recent period can only be seen as one of rapid and substantial churn as UK governments have attempted to widen participation, strengthen the national system of innovation and control the direct public costs of higher education. Very similar issues have dominated the debate in Australia. This paper compares the current position of two higher…

The making of a nutrition professional: the Association for Nutrition register.

PubMed

Cade, J E; Eccles, E; Hartwell, H; Radford, S; Douglas, A; Milliner, L

2012-11-01

Nutritionists in the UK are at the start of an exciting time of professional development. The establishment of the Association for Nutrition in 2010 has presented an opportunity to review, revitalize and expand the UK Voluntary Register of Nutritionists. In the UK and elsewhere, there is a need for a specialist register of nutritionists with title protection as a public safeguard. The new structure will base professional registration on demonstration of knowledge and application in five core competencies. Initially, there will be five specialist areas: animal; public health; nutritional scientist; food; sports and exercise. The wording and requirements linking the specialist areas to the competencies have been carefully defined by leading individuals currently on the existing register in these specialist areas. These have been evaluated by a random sample of existing registrants to check for accuracy of definitions and examples. Other work aims to establish a clear quality assurance framework in nutrition for workers in the health and social care sectors (UK Public Health Skills and Career Framework Levels 1-4) who contribute to nutrition activity, such as community food workers, nutrition assistants and pharmacists. Students, co-professional affiliates and senior fellows will also find a place in the new Association. The title 'nutritionist' is not currently legally protected in the UK and it is used freely to cover a range of unregulated practice. The establishment of a professional register to protect the public and to provide a clear identity for nutritionists is a vital step forward.

Nursing shortages and international nurse migration.

PubMed

Ross, S J; Polsky, D; Sochalski, J

2005-12-01

The United Kingdom and the United States are among several developed countries currently experiencing nursing shortages. While the USA has not yet implemented policies to encourage nurse immigration, nursing shortages will likely result in the growth of foreign nurse immigration to the USA. Understanding the factors that drive the migration of nurses is critical as the USA exerts more pull on the foreign nurse workforce. To predict the international migration of nurses to the UK using widely available data on country characteristics. The Nursing and Midwifery Council serves as the source of data on foreign nurse registrations in the UK between 1998 and 2002. We develop and test a regression model that predicts the number of foreign nurse registrants in the UK based on source country characteristics. We collect country-level data from sources such as the World Bank and the World Health Organization. The shortage of nurses in the UK has been accompanied by massive and disproportionate growth in the number of foreign nurses from poor countries. Low-income, English-speaking countries that engage in high levels of bilateral trade experience greater losses of nurses to the UK. Poor countries seeking economic growth through international trade expose themselves to the emigration of skilled labour. This tendency is currently exacerbated by nursing shortages in developed countries. Countries at risk for nurse emigration should adjust health sector planning to account for expected losses in personnel. Moreover, policy makers in host countries should address the impact of recruitment on source country health service delivery.

Predicted shortage of vascular surgeons in the United Kingdom: A matter for debate?

PubMed

Harkin, D W; Beard, J D; Shearman, C P; Wyatt, M G

2016-10-01

Vascular surgery became a new independent surgical specialty in the United Kingdom (UK) in 2013. In this matter for debate we discuss the question, is there a "shortage of vascular surgeons in the United Kingdom?" We used data derived from the "Vascular Surgery United Kingdom Workforce Survey 2014", NHS Employers Electronic Staff Records (ESR), and the National Vascular Registry (NVR) surgeon-level public report to estimate current and predict future workforce requirements. We estimate there are approximately 458 Consultant Vascular Surgeons for the current UK population of 63 million, or 1 per 137,000 population. In several UK Regions there are a large number of relatively small teams (3 or less) of vascular surgeons working in separate NHS Trusts in close geographical proximity. In developed countries, both the number and complexity of vascular surgery procedures (open and endovascular) per capita population is increasing, and concerns have been raised that demand cannot be met without a significant expansion in numbers of vascular surgeons. Additional workforce demand arises from the impact of population growth and changes in surgical work-patterns with respect to gender, working-life-balance and 7-day services. We predict a future shortage of Consultant Vascular Surgeons in the UK and recommend an increase in training numbers and an expansion in the UK Consultant Vascular Surgeon workforce to accommodate population growth, facilitate changes in work-patterns and to create safe sustainable services. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Gas-fired power in the UK: Bridging supply gaps and implications of domestic shale gas exploitation for UK climate change targets.

PubMed

Turk, Jeremy K; Reay, David S; Haszeldine, R Stuart

2018-03-01

There is a projected shortcoming in the fourth carbon budget of 7.5%. This shortfall may be increased if the UK pursues a domestic shale gas industry to offset projected decreases in traditional gas supply. Here we estimate that, if the project domestic gas supply gap for power generation were to be met by UK shale gas with low fugitive emissions (0.08%), an additional 20.4MtCO 2 e 1 would need to be accommodated during carbon budget periods 3-6. We find that a modest fugitive emissions rate (1%) for UK shale gas would increase global emissions compared to importing an equal quantity of Qatari liquefied natural gas. Additionally, we estimate that natural gas electricity generation would emit 420-466MtCO 2 e (460 central estimate) during the same time period within the traded EU emissions cap. We conclude that domestic shale gas production with even a modest 1% fugitive emissions rate would risk exceedance of UK carbon budgets. We also highlight that, under the current production-based greenhouse gas accounting system, the UK is incentivized to import natural gas rather than produce it domestically. Copyright © 2017 Elsevier B.V. All rights reserved.

Investigating the sustainability of careers in academic primary care: a UK survey.

PubMed

Calitri, Raff; Adams, Ann; Atherton, Helen; Reeve, Joanne; Hill, Nathan R

2014-12-14

The UK National Health Service (NHS) is undergoing institutional reorganisation due to the Health and Social Care Act-2012 with a continued restriction on funding within the NHS and clinically focused academic institutions. The UK Society for Academic Primary Care (SAPC) is examining the sustainability of academic primary care careers within this climate and preliminary qualitative work has highlighted individual and organisational barriers. This study seeks to quantify the current situation for academics within primary care. A survey of academic primary care staff was undertaken. Fifty-three academic primary care departments were selected. Members were invited to complete a survey which contained questions about an individual's career, clarity of career pathways, organisational culture, and general experience of working within the area. Data were analysed descriptively with cross-tabulations between survey responses and career position (early, mid-level, senior), disciplinary background (medical, scientist), and gender. Pearson chi-square test was used to determine likelihood that any observed difference between the sets arose by chance. Responses were received from 217 people. Career pathways were unclear for the majority of people (64%) and 43% of the workforce felt that the next step in their career was unclear. This was higher in women (52% vs. men 25%; χ(2)(3) = 14.76; p = 0.002) and higher in those in early career (50% vs. senior career, 25%) and mid-career(45%; vs. senior career; χ(2)(6) = 29.19, p < 0.001). The workforce appeared geographically static but unstable with only 50% of people having their contract renewed or extended. The majority of people (59%) have never been promoted by their institution. There were perceptions of gender equality even in the context of females being underrepresented in senior positions (19% vs. males 39%; χ(2)(3) = 8.43, p = 0.015). Despite these findings, the majority of the workforce reported positive organisational and cultural experiences. Sustainability of a academic primary care career is undermined by unclear pathways and a lack of promotion. If the discipline is to thrive, there is a need to support early and mid-career individuals via greater transparency of career pathways. Despite these findings staff remained positive about their careers.

Perceptions of diabetes control among people with type 2 diabetes treated with basal insulin in Sweden, Switzerland, and the United Kingdom.

PubMed

Brod, Meryl; Pfeiffer, Kathryn M; Barnett, Anthony H; Berntorp, Kerstin; Vilsbøll, Tina; Weissenberger, Benno

2016-07-11

To investigate perceptions of control among people with uncontrolled and well controlled type 2 diabetes (T2D) treated with basal insulin, as well as differences in perceptions and diabetes management practices between the two groups. Web surveys of 1012 people with uncontrolled T2D (HbA 1c >8.0% or 64 mmol/mol) on basal insulin in Sweden, Switzerland, and the UK and 295 people with well controlled T2D (HbA 1c <7.5% or 58 mmol/mol) on basal insulin in the UK were conducted. People with uncontrolled T2D perceived a wide range of factors as very/extremely important for deciding whether they are well controlled, including diet (80.7%), HbA 1c value (78.9%), times per day insulin taken (78.8%), insulin units taken per day (77.6%), and energy levels (74.5%). Fifty-one percent of uncontrolled respondents considered the past week or more recently when thinking about control. Perceived major obstacles to control included stress (75.4%), other health issues (70.8%), medicine side effects (69.9%), food cravings (69.8%), doctor not understanding individual situation (67.6%), and life crises (66.9%). Many uncontrolled respondents reported that diabetes was very/extremely interfering with their lives, including energy level (71.0%), performance at work (70.0%), general health (69.9%), and doing what one wants (69.3%). Analyses showed significant differences between well controlled and uncontrolled UK respondents. Compared to the uncontrolled, people with well controlled T2D were significantly more likely to consider the last 24 hours/current time when thinking about control (50% vs. 21%, p < 0.001) and reported greater healthcare contact related to diabetes and more frequent glucose measurement. Study limits include potential selection bias of web surveys and possible recall bias in patient-reported data. The results illuminate how people with T2D treated with basal insulin perceive control and show important differences between the well controlled and uncontrolled. Findings may have implications for improving patient and physician education and diabetes management.

BALKANS SECURITY. Current and Projected Factors Affecting Regional Stability

DTIC Science & Technology

2000-04-01

Security Briefing Section II Current Situation in Kosovo and Bosnia primary responsibility for public security in Kosovo. 6 According to a senior KFOR...Integrity * Reliability GAO/NSIAD-00-125BR „.c-miBUTION STATEMENT A ApSwed for Public Release Contents Letter Briefing Section Appendixes Tables...Figures Briefing Section I: Background Briefing Section II: Current Situation in Kosovo and Bosnia Briefing Section III: Projected Security Situation

Evolving PBPK applications in regulatory risk assessment: current situation and future goals

EPA Science Inventory

The presentation includes current applications of PBPK modeling in regulatory risk assessment and discussions on conflicts between assuring consistency with experimental data in current situation and the desire for animal-free model development.

Workshop Report UK Food Standards Agency Workshop Report: carbohydrate and cardiovascular risk

PubMed Central

Peacock, Emma; Stanley, John; Calder, Philip C.; Jebb, Susan A.; Thies, Frank; Seal, Chris J.; Woodside, Jayne V.; Sanders, Tom A. B.

2012-01-01

This report summarises a workshop convened by the UK Food Standards Agency (FSA) on 14 October 2008 to discuss current FSA-funded research on carbohydrates and cardiovascular health. The objective of this workshop was to discuss the results of recent research and to identify any areas which could inform future FSA research calls. This workshop highlighted that the FSA is currently funding some of the largest, well-powered intervention trials investigating the type of fat and carbohydrate, whole grains and fruit and vegetables, on various CVD risk factors. Results of these trials will make a substantive contribution to the evidence on diet and cardiovascular risk. PMID:20236556

The 40 and 50 GHz propagation experiments at the Rutherford Appleton Laboratory, UK, using the ITALSAT beacons

NASA Technical Reports Server (NTRS)

Woodroffe, J. M.; Davies, P. G.; Ladd, D. N.; Norbury, John R.

1994-01-01

This paper describes the current experimental program and future plans for the reception of transmissions from the 18.7, 39.6, and 49.5 GHz beacons from the ITALSAT satellite by the Radio Communications Research Unit at Rutherford Appleton Laboratory, UK. The Radio Communications Research Unit, which has had considerable experience in developing experimental millimetric equipment for propagation studies, has initiated the development of a single-channel receiver and a triple-channel receiver to measure propagation effects at 49.5 GHz and 39.6 GHz respectively. The initial location of the receivers will be at Chilbolton, Hampshire, UK.

The prospects for solar energy use in industry within the United Kingdom

NASA Astrophysics Data System (ADS)

Lewis, C. W.

1980-01-01

An assessment of the potential for solar energy applications within U.K. industry has been made, using a disaggregated breakdown of energy consumption in the eight industrial sectors by fuel and end-use, and taking account of solar collector performance under U.K. climatic conditions. Solar contributions of 35 per cent of process boiler heat up to a temperature of 80 C and 10 per cent in the 80-120 C range are considered feasible, along with 35 per cent of non-industrial water heating. After employing energy conservation techniques currently more cost-effective than solar systems, an additional 3.5 per cent of U.K. primary energy expended in manufacturing industry (excluding iron and steel production) could be contributed by solar. This represents 1 per cent of the U.K. national primary energy demand.

Two Stages Cooperative Learning by Ability Indicators

ERIC Educational Resources Information Center

Wu, YuLung

2013-01-01

The teaching system in Taiwan is currently based on large classes where teachers cannot control student situations totally. In E-Learning System, a teacher who reviews a student's learning situation must examine the students' learning records according to different items, and further organize and define the students' current learning situations,…

Enhancement of the thrombolytic efficacy of prourokinase by lys-plasminogen in a dog model of arterial thrombosis.

PubMed

Badylak, S F; Voytik, S L; Henkin, J; Burke, S E; Sasahara, A A; Simmons, A

1991-05-01

Current findings suggest that the efficacy of thrombolytic therapy may be limited by the availability of active forms of plasminogen at the thrombus site. The purpose of this study was to determine if the systemic administration of 0.5 mg kg-1 glu-plasminogen (glu-plg) or 0.5 mg kg-1 lys-plasminogen (lys-plg) could safely increase the efficacy of a single intravenous bolus injection of 50,000 U kg-1 prourokinase (proUK) in a dog model of arterial thrombosis. Thrombolysis was measured by monitoring the continuous decrement of 125I-gamma emissions from a radiolabeled thrombus. Reflow was evaluated by direct visual examination. Forty dogs (mean wt 10.3 +/- 2 kg) were randomly sorted into 4 groups of 10 each. The dogs in each group were given either saline plus saline, saline plus proUK, glu-plg plus proUK, or lys-plg plus proUK 60 minutes after formation of an occlusive arterial thrombus. Ninety minutes after drug administration the dogs receiving saline plus proUK, glu-plg plus proUK, and the lys-plg plus proUK showed greater thrombolysis (41%, 43%, and 66%, respectively) than the control (saline plus saline) group (15%, P less than 0.01). The lys-plg plus proUK treatment caused greater lysis than the saline plus proUK or the glu-plg plus proUK treatment (P less than 0.05). All of the dogs (10/10) receiving lys-plg plus proUK had patent vessels at the end of the 90 minute monitoring period, whereas only 4/10 and 5/10 vessels were patent in the saline plus proUK and glu-plg plus proUK groups, respectively. None of the dogs in the saline plus saline group had patent vessels. No significant changes were observed in the various coagulation parameters tested for any of the 4 treatment groups. The results show that lys-plg can safely increase the thrombolytic efficacy of proUK.

Poverty and child health in the UK: using evidence for action

PubMed Central

Wickham, Sophie; Anwar, Elspeth; Barr, Ben; Law, Catherine; Taylor-Robinson, David

2016-01-01

There are currently high levels of child poverty in the UK, and for the first time in almost two decades child poverty has started to rise in absolute terms. Child poverty is associated with a wide range of health-damaging impacts, negative educational outcomes and adverse long-term social and psychological outcomes. The poor health associated with child poverty limits children's potential and development, leading to poor health and life chances in adulthood. This article outlines some key definitions with regard to child poverty, reviews the links between child poverty and a range of health, developmental, behavioural and social outcomes for children, describes gaps in the evidence base and provides an overview of current policies relevant to child poverty in the UK. Finally, the article outlines how child health professionals can take action by (1) supporting policies to reduce child poverty, (2) providing services that reduce the health consequences of child poverty and (3) measuring and understanding the problem and assessing the impact of action. PMID:26857824

Current management practices and interventions prioritised as part of a nationwide mastitis control plan

PubMed Central

Bradley, A. J.; Breen, J. E.; Hudson, C. D.; Green, M. J.

2016-01-01

The objectives of this study were to report performance and management data taken from a sample of UK dairy farms that have participated in the Agriculture and Horticulture Development Board Dairy Mastitis Control Plan (DMCP) and to identify important mastitis prevention practices that are not currently widely implemented. A total of 234 UK dairy herds were included in the study from which farm management and udder health data were collected. Herds were grouped according to their mastitis epidemiology and could be classed as (i) environmental dry period (EDP) (i.e. environmental pathogen with majority of infections being acquired during the dry period), (ii) environmental lactation (EL), (iii) contagious dry period (CDP) or (iv) contagious lactation (CL). The results of this study showed that many mastitis-related management practices that are generally considered to be important were not widely performed. A better understanding of those practices not widely adopted by UK dairy farmers at present may aid practitioners in identifying and overcoming potential barriers to improved mastitis control. PMID:26966249

Evaluation of the status of canine hydrotherapy in the UK.

PubMed

Waining, M; Young, I S; Williams, S B

2011-04-16

To establish the current status of canine hydrotherapy in the UK and to ascertain information regarding the current use of hydrotherapy, a questionnaire was sent to 152 hydrotherapy centres throughout the UK, from which 89 responded. Hydrotherapy was found to be a rapidly growing business. Stand-alone centres were in existence; however, many centres were connected to other businesses, including boarding kennels and general practice veterinary surgeries. The dogs using the facility were mainly pedigree breeds, particularly labrador retrievers (30 per cent), and the most commonly encountered conditions were rupture of the cranial cruciate ligament (25 per cent), hip dysplasia (24 per cent) and osteoarthritis (18 per cent). The proportion of qualified versus unqualified staff varied between centres, highlighting a need for improved regulation of this aspect of the industry. However, all the dogs treated by the hydrotherapy centres surveyed were direct veterinary referrals, suggesting a good degree of professionalism in the field and a high regard for the benefits of hydrotherapy.

Quantifying UK emissions of carbon dioxide using an integrative measurement strategy

NASA Astrophysics Data System (ADS)

Gonzi, S.; Palmer, P.

2015-12-01

The main objective of the Greenhouse gAs Uk and Global Emissions (GAUGE) programme is to quantify the magnitude and uncertainty of CO2, CH4 and N2O fluxes from the UK. GAUGE builds on the tall tower network established by the UK Government to estimate fluxes from England, Northern Ireland, Scotland, and Wales. The GAUGE measurement programme includes two additional tall tower sites (one in North Yorkshire and one downwind of London); regular measurements of CO2 and CH4 isotopologues; instrumentation installed on a ferry that travels daily along the eastern coast of the UK from Scotland to Belgium; a research aircraft that has been deployed on a campaign basis; and a high-density network over East Anglia that is primarily focused on the agricultural sector. We have also included satellite observations from the Japanese Greenhouse gases Observing SATellite (GOSAT) through ongoing activities within the UK National Centre for Earth Observation. In this presentation, we will present new CO2 flux estimates for the UK inferred from GAUGE measurements using a nested, high-resolution (25 km) version of the GEOS-Chem atmospheric transport model and an ensemble Kalman filter. We will present our current best estimate for CO2 fluxes and a preliminary assessment of the efficacy of individual GAUGE data sources to spatially resolve CO2 flux estimates over the UK. We will also discuss how flux estimates inferred from the different models used within GAUGE can help to assess the role of transport model error and to determine an ensemble CO2 flux estimate for the UK.

Transitional care in clinical networks for young people with juvenile idiopathic arthritis: current situation and challenges.

PubMed

Cruikshank, Mary; Foster, Helen E; Stewart, Jane; Davidson, Joyce E; Rapley, Tim

2016-04-01

Clinical networks for paediatric and adolescent rheumatology are evolving, and their effect and role in the transition process between paediatric and adult services are unknown. We therefore explored the experiences of those involved to try and understand this further. Health professionals, young people with juvenile idiopathic arthritis and their families were recruited via five national health service paediatric and adolescent rheumatology specialist centres and networks across the UK. Seventy participants took part in focus groups and one-to-one interviews. Data was analysed using coding, memoing and mapping techniques to identify features of transitional services across the sector. Variation and inequities in transitional care exist. Although transition services in networks are evolving, development has lagged behind other areas with network establishment focusing more on access to paediatric rheumatology multidisciplinary teams. Challenges include workforce shortfalls, differences in service priorities, standards and healthcare infrastructures, and managing the legacy of historic encounters. Providing equitable high-quality clinically effective services for transition across the UK has a long way to go. There is a call from within the sector for more protected time, staff and resources to develop transition roles and services, as well as streamlining of local referral pathways between paediatric and adult healthcare services. In addition, there is a need to support professionals in developing their understanding of transitional care in clinical networks, particularly around service design, organisational change and the interpersonal skills required for collaborative working. Key messages • Transitional care in clinical networks requires collaborative working and an effective interface with paediatric and adult rheumatology.• Professional centrism and historic encounters may affect collaborative relationships within clinical networks.• Education programmes need to support the development of interpersonal skills and change management, to facilitate professionals in networks delivering transitional care.

Have restricted working hours reduced junior doctors' experience of fatigue? A focus group and telephone interview study.

PubMed

Morrow, Gill; Burford, Bryan; Carter, Madeline; Illing, Jan

2014-03-06

To explore the effects of the UK Working Time Regulations (WTR) on trainee doctors' experience of fatigue. Qualitative study involving focus groups and telephone interviews, conducted in Spring 2012 with doctors purposively selected from Foundation and specialty training. Final compliance with a 48 h/week limit had been required for trainee doctors since August 2009. Framework analysis of data. 9 deaneries in all four UK nations; secondary care. 82 doctors: 53 Foundation trainees and 29 specialty trainees. 36 participants were male and 46 female. Specialty trainees were from a wide range of medical and surgical specialties, and psychiatry. Implementation of the WTR, while acknowledged as an improvement to the earlier situation of prolonged excessive hours, has not wholly overcome experience of long working hours and fatigue. Fatigue did not only arise from the hours that were scheduled, but also from an unpredictable mixture of shifts, work intensity (which often resulted in educational tasks being taken home) and inadequate rest. Fatigue was also caused by trainees working beyond their scheduled hours, for reasons such as task completion, accessing additional educational opportunities beyond scheduled hours and staffing shortages. There were also organisational, professional and cultural drivers, such as a sense of responsibility to patients and colleagues and the expectations of seniors. Fatigue was perceived to affect efficiency of skills and judgement, mood and learning capacity. Long-term risks of continued stress and fatigue, for doctors and for the effective delivery of a healthcare service, should not be ignored. Current monitoring processes do not reflect doctors' true working patterns. The effectiveness of the WTR cannot be considered in isolation from the culture and context of the workplace. On-going attention needs to be paid to broader cultural issues, including the relationship between trainees and seniors.

Collaboration in the UK on time transfer using the GLONASS system

NASA Astrophysics Data System (ADS)

Daly, P.; Knight, D. J. E.; Jefferies, R.; Swabey, B. R.

1992-06-01

Collaboration in the UK (United Kingdom) on the use of the GLONASS (Russian Global Space Navigation System) satellite navigation system for time transfer, and the main results obtained, are reported. The GLONASS clock stability and GLONASS system time has been monitored since 1988 within an accuracy of about +/- 50 ns. Current news of the GLONASS system is given, and measures towards improving accuracy are discussed.

The Long and Winding Road: A Review of the Policy, Practice and Development of the Internationalisation of Higher Education in the UK

ERIC Educational Resources Information Center

Humfrey, Christine

2011-01-01

Internationalisation is a key element in the evolving role and function of the UK higher education (HE) sector. Its perceived benefits are promoted widely and sought assiduously. It has come to be believed by many practitioners that internationalisation and the quest for quality and status in HE are synonymous. In the current phase of…

Provision and practice of specialist preterm labour clinics: a UK survey of practice.

PubMed

Sharp, A N; Alfirevic, Z

2014-03-01

To identify the current status of specialist preterm labour (PTL) clinic provision and management within the UK. Postal survey of clinical practice. All consultant-led obstetric units within the UK. A questionnaire was sent by post to all 210 NHS consultant-led obstetric units within the UK. Units that had a specialist PTL clinic were asked to complete a further 20 questions defining their protocol for risk stratification and management. Current practice in specialist preterm labour clinics. We have identified 23 specialist clinics; the most common indications for attendance were previous PTL (100%), preterm prelabour rupture of membranes (95%), two large loop excisions of the transformation zone (95%) or cone biopsy (95%). There was significant heterogeneity in the indications for and method of primary treatment for short cervix, with cervical cerclage used in 45% of units, progesterone in 18% of units and Arabin cervical pessary in 5%. A further 23% used multiple treatment modalities in combination. A significant heterogeneity in all topics surveyed suggests an urgent need for networking, more evidence-based guidelines and prospective comparative audits to ascertain the real impact of specialist PTL clinics on the reduction in preterm birth and its sequelae. © 2013 Royal College of Obstetricians and Gynaecologists.

A survey of UK fertility clinics' approach to surrogacy arrangements.

PubMed

Norton, Wendy; Crawshaw, Marilyn; Hudson, Nicky; Culley, Lorraine; Law, Caroline

2015-09-01

This paper draws on the findings of the first survey of surrogacy arrangements in Human Fertilisation and Embryology Authority (HFEA) licensed fertility clinics since 1998. Given the complex social, ethical and legal issues involved, surrogacy continues to raise debate worldwide and fuel calls for increased domestic provision in developed countries. However, little is known about how recent changes have affected HFEA licensed clinics. A 24-item online survey was undertaken between August and October 2013, designed to improve understanding of recent trends and current practices associated with UK-based surrogacy, and consider the implications for future policy and practice in UK and cross-border surrogacy arrangements. The response rate was 51.4%, comprising 54 clinics. Quantitative data were analysed using descriptive statistics, and open-ended qualitative responses analysed for extending understanding. Of the participating clinics, 42.6% offered surrogacy (mostly gestational surrogacy). Heterosexual couples using gestational surrogacy were the largest group currently using services followed by male same-sex couples. Most clinics reported having encountered problems with surrogacy treatments, suggesting barriers still exist to expanding the UK provision of surrogacy arrangements. It is important that professionals are well informed about the legal implications of surrogacy and that clinics have consistent and appropriate operational protocols for surrogacy arrangements. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Development of a New Branded UK Food Composition Database for an Online Dietary Assessment Tool

PubMed Central

Carter, Michelle C.; Hancock, Neil; Albar, Salwa A.; Brown, Helen; Greenwood, Darren C.; Hardie, Laura J.; Frost, Gary S.; Wark, Petra A.; Cade, Janet E.

2016-01-01

The current UK food composition tables are limited, containing ~3300 mostly generic food and drink items. To reflect the wide range of food products available to British consumers and to potentially improve accuracy of dietary assessment, a large UK specific electronic food composition database (FCDB) has been developed. A mapping exercise has been conducted that matched micronutrient data from generic food codes to “Back of Pack” data from branded food products using a semi-automated process. After cleaning and processing, version 1.0 of the new FCDB contains 40,274 generic and branded items with associated 120 macronutrient and micronutrient data and 5669 items with portion images. Over 50% of food and drink items were individually mapped to within 10% agreement with the generic food item for energy. Several quality checking procedures were applied after mapping including; identifying foods above and below the expected range for a particular nutrient within that food group and cross-checking the mapping of items such as concentrated and raw/dried products. The new electronic FCDB has substantially increased the size of the current, publically available, UK food tables. The FCDB has been incorporated into myfood24, a new fully automated online dietary assessment tool and, a smartphone application for weight loss. PMID:27527214

Development of a New Branded UK Food Composition Database for an Online Dietary Assessment Tool.

PubMed

Carter, Michelle C; Hancock, Neil; Albar, Salwa A; Brown, Helen; Greenwood, Darren C; Hardie, Laura J; Frost, Gary S; Wark, Petra A; Cade, Janet E

2016-08-05

The current UK food composition tables are limited, containing ~3300 mostly generic food and drink items. To reflect the wide range of food products available to British consumers and to potentially improve accuracy of dietary assessment, a large UK specific electronic food composition database (FCDB) has been developed. A mapping exercise has been conducted that matched micronutrient data from generic food codes to "Back of Pack" data from branded food products using a semi-automated process. After cleaning and processing, version 1.0 of the new FCDB contains 40,274 generic and branded items with associated 120 macronutrient and micronutrient data and 5669 items with portion images. Over 50% of food and drink items were individually mapped to within 10% agreement with the generic food item for energy. Several quality checking procedures were applied after mapping including; identifying foods above and below the expected range for a particular nutrient within that food group and cross-checking the mapping of items such as concentrated and raw/dried products. The new electronic FCDB has substantially increased the size of the current, publically available, UK food tables. The FCDB has been incorporated into myfood24, a new fully automated online dietary assessment tool and, a smartphone application for weight loss.

RCR audit of compliance with UK guidelines for the prevention and detection of acute kidney injury in adult patients undergoing iodinated contrast media injections for CT.

PubMed

Cope, L H; Drinkwater, K J; Howlett, D C

2017-12-01

To determine radiology departmental compliance with current UK guidance on contrast-induced acute kidney injury (CI-AKI) and to provide data on the incidence of clinically significant post-contrast AKI (PC-AKI) in computed tomography (CT) practice. A questionnaire was sent to all UK acute National Health Service (NHS) providers (NHS boards in Scotland, local health boards in Wales, NHS trusts in England and health and social care trusts in Northern Ireland) to assess compliance of provider protocols with current UK guidelines for the prevention, recognition, and management of CI-AKI. Audit data were collected for 40 consecutive fit outpatients and 40 consecutive acutely unwell patients/inpatients from hospitals within each participating provider to assess clinical compliance. Eighty-nine of 172 (52%) health service providers responded, and data on 7,159 contrast-enhanced CT examinations were provided. Compliance with guidelines was poor with wide variation in clinical practice. The observed incidence of clinically significant (requiring treatment or resulting in death) PC-AKI was zero in 3,590 outpatients, although two patients developed AKI due to other causes (sepsis and progressive malignancy). Fourteen out of 3,569 (0.4%) patients in the inpatient group developed clinically significant PC-AKI, and a further 17 patients were identified who met the Kidney Disease Improving Global Outcomes (KDIGO) definition of AKI (Electronic Supplementary Material Appendix S1), but did not require active treatment, giving an overall incidence of AKI of 0.9%. In patients at high risk due to impaired renal function prior to the scan, there was no difference in the median serum creatinine (SCr) before and after contrast medium administration in either group. Health service provider protocols and clinical practice demonstrate poor compliance with current UK guidance on CI-AKI. A very low incidence of PC- AKI was demonstrated. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

United Nations and human cloning: a slender and fortunate defence for biomedical research.

PubMed

Edwards, R G

2003-12-01

Numerous biomedical scientists have contributed to the wide knowledge on the growth of preimplantation human embryos in vitro, now improving every aspect of the form of clinical care. These data were gained ethically in many countries, to open new vistas including the alleviation of infertility, preimplantation genetic diagnosis and stem cells, combined with some recent reports on human reproductive cloning. After detailed consultations with scientists, clinicians, ethicists and lawyers, many governments passed legislation permitting research under their own particular socially-defined conditions. Virtually all of them rejected reproductive cloning; a few have accepted therapeutic cloning. These legislatures saluted the many biomedical scientists striving to improve IVF and its derivatives, recognizing their immense medical potential. A motion recently placed before the United Nations then recommended a worldwide ban on all forms of human cloning. Proponents included the Vatican and many Roman Catholic countries, the USA and others. Opponents included Belgium, China, Japan, Brazil, UK, Germany and France. Mediation was achieved by Iran and other Muslim nations, and led to a motion passed by single vote for a two-year delay. This may be the first-ever proposal to ban worldwide a particular form of research. It sounds the alarm bells for further research. It raises questions about the UN being an appropriate forum for ethical decisions affecting the entire world and its future medicine. Large blocs of nations committed to particular religions and outlooks confronted each other, a situation in total contrast to the detailed and widespread consultations made by individual governments when deciding their own individual ethics. This event was clearly a narrow escape for free research as defined by each country's own jurisprudence. It also places research on human embryology and reproductive biomedicine into a more critical situation than before. Current liberalism in studies on assisted conception, clearly threatened by powerful adversaries, will have to be fortified to maintain the current impetus into newer forms of clinical care.

Views of senior UK doctors about working in medicine: questionnaire survey

PubMed Central

Lambert, Trevor W; Goldacre, Michael J

2014-01-01

Summary Objectives We surveyed the UK medical qualifiers of 1993. We asked closed questions about their careers; and invited them to give us comments, if they wished, about any aspect of their work. Our aim in this paper is to report on the topics that this senior cohort of UK-trained doctors who work in UK medicine raised with us. Design Questionnaire survey Participants 3479 contactable UK-trained medical graduates of 1993. Setting UK. Main outcome measures Comments made by doctors about their work, and their views about medical careers and training in the UK. Method Postal and email questionnaires. Results Response rate was 72% (2507); 2252 were working in UK medicine, 816 (36%) of whom provided comments. Positive comments outweighed negative in the areas of their own job satisfaction and satisfaction with their training. However, 23% of doctors who commented expressed dissatisfaction with aspects of junior doctors’ training, the impact of working time regulations, and with the requirement for doctors to make earlier career decisions than in the past about their choice of specialty. Some doctors were concerned about government health service policy; others were dissatisfied with the availability of family-friendly/part-time work, and we are concerned about attitudes to gender and work-life balance. Conclusions Though satisfied with their own training and their current position, many senior doctors felt that changes to working hours and postgraduate training had reduced the level of experience gained by newer graduates. They were also concerned about government policy interventions. PMID:25408920

Views of senior UK doctors about working in medicine: questionnaire survey.

PubMed

Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

2014-11-01

We surveyed the UK medical qualifiers of 1993. We asked closed questions about their careers; and invited them to give us comments, if they wished, about any aspect of their work. Our aim in this paper is to report on the topics that this senior cohort of UK-trained doctors who work in UK medicine raised with us. Questionnaire survey. 3479 contactable UK-trained medical graduates of 1993. UK. Comments made by doctors about their work, and their views about medical careers and training in the UK. Postal and email questionnaires. Response rate was 72% (2507); 2252 were working in UK medicine, 816 (36%) of whom provided comments. Positive comments outweighed negative in the areas of their own job satisfaction and satisfaction with their training. However, 23% of doctors who commented expressed dissatisfaction with aspects of junior doctors' training, the impact of working time regulations, and with the requirement for doctors to make earlier career decisions than in the past about their choice of specialty. Some doctors were concerned about government health service policy; others were dissatisfied with the availability of family-friendly/part-time work, and we are concerned about attitudes to gender and work-life balance. Though satisfied with their own training and their current position, many senior doctors felt that changes to working hours and postgraduate training had reduced the level of experience gained by newer graduates. They were also concerned about government policy interventions.

The Vocational Education and Training System in Bulgaria. Current Situation, Challenges and Reform Needs.

ERIC Educational Resources Information Center

Pantaleev, Tzako; Kalandarova, Natalia; Dineva, Nedka; Panev, Georgi; Petrova, Iskra

This report reviews the current situation of Bulgaria's vocational education and training (VET) system to identify challenges facing the system and areas needing reform. Section 1 explores the following five aspects of Bulgaria's political and socioeconomic situation: (1) demography; (2) economic developments (privatization of state enterprises,…

Impact of current and scaled-up levels of hepatitis C prevention and treatment interventions for people who inject drugs in three UK settings-what is required to achieve the WHO's HCV elimination targets?

PubMed

Ward, Zoe; Platt, Lucy; Sweeney, Sedona; Hope, Vivian D; Maher, Lisa; Hutchinson, Sharon; Palmateer, Norah; Smith, Josie; Craine, Noel; Taylor, Avril; Martin, Natasha; Ayres, Rachel; Dillon, John; Hickman, Matthew; Vickerman, Peter

2018-05-17

To estimate the impact of existing high-coverage needle and syringe provision (HCNSP, defined as obtaining more than one sterile needle and syringe per injection reported) and opioid substitution therapy (OST) on hepatitis C virus (HCV) transmission among people who inject drugs (PWID) in three UK settings and to determine required scale-up of interventions, including HCV treatment, needed to reach the World Health Organization (WHO) target of reducing HCV incidence by 90% by 2030. HCV transmission modelling using UK empirical estimates for effect of OST and/or HCNSP on individual risk of HCV acquisition. Three UK cities with varying chronic HCV prevalence (Bristol 45%, Dundee 26%, Walsall 19%), OST (72-81%) and HCNSP coverage (28-56%). Relative change in new HCV infections throughout 2016-30 if current interventions were stopped. Scale-up of HCNSP, OST and HCV treatment required to achieve the WHO elimination target. Removing HCNSP or OST would increase the number of new HCV infections throughout 2016 to 2030 by 23-64 and 92-483%, respectively. Conversely, scaling-up these interventions to 80% coverage could achieve a 29 or 49% reduction in Bristol and Walsall, respectively, whereas Dundee may achieve a 90% decrease in incidence with current levels of intervention because of existing high levels of HCV treatment (47-58 treatments per 1000 PWID). If OST and HCNSP are scaled-up, Walsall and Bristol can achieve the same impact by treating 14 or 40 per 1000 PWID annually, respectively (currently two and nine treatments per 1000 PWID), while 18 and 43 treatments per 1000 PWID would be required if OST and HCNSP are not scaled-up. Current opioid substitution therapy and high-coverage needle and syringe provision coverage is averting substantial hepatitis C transmission in the United Kingdom. Maintaining this coverage while getting current drug injectors onto treatment can reduce incidence by 90% by 2030. © 2018 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

A survey of doctors at a UK teaching hospital to assess understanding of recent changes to consent law.

PubMed

O'Brien, J W; Natarajan, M; Shaikh, I

2017-06-01

The UK Supreme Court recently ruled that when consenting patients for treatments or procedures, clinicians must also discuss any associated material risks. We surveyed medical staff at a large UK teaching hospital in order to ascertain knowledge of consent law and current understanding of this change. Email survey sent to medical staff in all specialities at Norfolk and Norwich University Hospital in February 2016. 245 responses (141 Consultants and 104 junior doctors, response rate 32%). 82% consent patients for procedures at least monthly and 23% daily. 31% were not familiar with the concept of material risk. 35% were familiar with the recent change in consent law, 41% were not. 18% were "very uncertain" and 64% "a little uncertain" that their consenting process meets current legal requirements. >92% think that landmark cases and changes in law should be discussed through professional bodies and circulated better locally. The majority were not familiar with the concept of material risk and recent legal changes. A majority were not confident that their practice meets current requirements, suggesting that recent changes in consent law may not be widely understood at this hospital. We suggest more guidance and education may be necessary than is currently available. Increased understanding of recent changes to consent law will reduce the risk taken by NHS trusts and offer patients a service compliant with Supreme Court guidance.

Use of atropine penalization to treat amblyopia in UK orthoptic practice.

PubMed

Piano, Marianne; O'Connor, Anna R; Newsham, David

2014-01-01

To compare clinical practice patterns regarding atropine penalization use by UK orthoptists to the current evidence base and identify any existing barriers against use of AP as first-line treatment. An online survey was designed to assess current practice patterns of UK orthoptists using atropine penalization. They were asked to identify issues limiting their use of atropine penalization and give opinions on its effectiveness compared to occlusion. Descriptive statistics and content analysis were applied to the results. Responses were obtained from 151 orthoptists throughout the United Kingdom. The main perceived barriers to use of atropine penalization were inability to prescribe atropine and supply difficulties. However, respondents also did not consider atropine penalization as effective as occlusion in treating amblyopia, contrary to recent research findings. Patient selection criteria and treatment administration largely follow current evidence. More orthoptists use atropine penalization as first-line treatment than previously reported. Practitioners tend to closely follow the current evidence base when using atropine penalization, but reluctance in offering it as first-line treatment or providing a choice for parents between occlusion and atropine still remains. This may result from concerns regarding atropine's general efficacy, side effects, and risk of reverse amblyopia. Alternatively, as demonstrated in other areas of medicine, it may reflect the inherent delay of research findings translating to clinical practice changes. Copyright 2014, SLACK Incorporated.

Evaluation of 2 possible further developments of the UK in-flight radiation warning meter for SSTS

NASA Technical Reports Server (NTRS)

Wilson, I. J.; Eustace, R. C.

1972-01-01

A mass reduction of the moderator and the response to the nucleon flux, responsible for the tissue-star component of the total-dose equivalent rate using a high atomic number material, are discussed. Radiation situations at SST cruising altitudes (approximately 20 km) due to solar proton flares were simulated in the stratosphere and on the ground. Actual stratospheric situations due to galactic cosmic radiation with a limited range of quality factor values (2-4) were encountered during slow ascents by balloons to 36 km. Synthetic situations obtained from high and low energy acclerator radiations were used to obtain radiation distributions having a larger range of quality factor values (11/2-9) than experienced in the stratosphere. The measurements made in these simulations related to the directly ionizing, neutron and tissue-star components of dose-equivalent rate. Due to the restricted range of neutron spectra encountered in the stratosphere, a significant mass reduction of the moderator by 4 kg was made, with the moderator clad with cadmium or some other slow neutron absorber.

GDPs' self-perceived confidence and anxiety in their clinical and communication skills used when screening for oral cancer: UK variations.

PubMed

Farrand, Paul; Clover, Henry; Hutchison, Iain L

2003-07-01

To compare anxieties of general dental practitioners (GDPs) across the UK in communicating with patients about oral cancer and confidence in clinical skills required to perform soft tissue screening for oral cancer. A questionnaire was sent to 2200 randomly selected GDPs from across the UK. Responses to the questionnaires were analysed using 95% confidence intervals. Dental practitioners in general practice within England, Northern Ireland, Scotland and Wales. The response rate varied between 57% in England and 65% in Northern Ireland. A high percentage of dental practitioners across all UK regions reported performing soft tissue examinations (range 78% to 88%). The number of soft tissue examinations per month varied between 129 (95% CI 109, 148) and 162 (95% CI 154, 170) indicating criteria when selecting patients for screening. Using a nine-point rating scale (1 = not at all, 9 = extremely), confidence in the clinical skills required during oral cancer screening was generally good (ratings varying between 5.4 and 6.7). With the exception of reporting positive findings to patients (rating 4.5 to 5.2), anxiety in communication skills used during oral cancer screening was generally low (ratings varying between 1.8 and 3.9). While concerns over generalizing the results exist, the situation with respect to the clinical and communication skills required by GDPs during oral cancer screening is generally encouraging. An area of concern is discussing positive findings with patients. This may be overcome by developing specialist courses on breaking bad news within undergraduate dental curricula and programmes of continuing professional development.

Monitoring and reporting of preanalytical errors in laboratory medicine: the UK situation.

PubMed

Cornes, Michael P; Atherton, Jennifer; Pourmahram, Ghazaleh; Borthwick, Hazel; Kyle, Betty; West, Jamie; Costelloe, Seán J

2016-03-01

Most errors in the clinical laboratory occur in the preanalytical phase. This study aimed to comprehensively describe the prevalence and nature of preanalytical quality monitoring practices in UK clinical laboratories. A survey was sent on behalf of the Association for Clinical Biochemistry and Laboratory Medicine Preanalytical Working Group (ACB-WG-PA) to all heads of department of clinical laboratories in the UK. The survey captured data on the analytical platform and Laboratory Information Management System in use; which preanalytical errors were recorded and how they were classified and gauged interest in an external quality assurance scheme for preanalytical errors. Of the 157 laboratories asked to participate, responses were received from 104 (66.2%). Laboratory error rates were recorded per number of specimens, rather than per number of requests in 51% of respondents. Aside from serum indices for haemolysis, icterus and lipaemia, which were measured in 80% of laboratories, the most common errors recorded were booking-in errors (70.1%) and sample mislabelling (56.9%) in laboratories who record preanalytical errors. Of the laboratories surveyed, 95.9% expressed an interest in guidance on recording preanalytical error and 91.8% expressed interest in an external quality assurance scheme. This survey observes a wide variation in the definition, repertoire and collection methods for preanalytical errors in the UK. Data indicate there is a lot of interest in improving preanalytical data collection. The ACB-WG-PA aims to produce guidance and support for laboratories to standardize preanalytical data collection and to help establish and validate an external quality assurance scheme for interlaboratory comparison. © The Author(s) 2015.

Dyslexia and learning disabilities in Canada and the UK: the impact of its disability employment laws.

PubMed

Gerber, Paul J; Batalo, Cecilia G; Achola, Edwin O

2012-08-01

The impact of employment laws pertaining to individuals with learning disabilities in Canada and dyslexia in the UK were investigated via the extant research literature. Currently, there is very little research in this area despite Canada and the UK having laws in effect for decades. Surprisingly, their laws have been revamped despite an absence of data that measures impact and effectiveness. This finding is not unlike the Americans with Disabilities Act, reauthorized as the Americans with Disabilities Act Amendments in 2008, without substantive research to guide legal policies and practices going forward. Investigation in this area is needed to seek the positive and negative effects of legislation on those with learning disabilities in Canada and dyslexia in the UK, a high incidence population that finds most employment opportunities in competitive employment. Copyright © 2012 John Wiley & Sons, Ltd.

Composition, concentration and deprivation: exploring their association with social cohesion among different ethnic groups in the UK.

PubMed

Bécares, Laia; Stafford, Mai; Laurence, James; Nazroo, James

2011-01-01

Although studies in the US have shown an association between the ethnic residential composition of an area and reports of decreased social cohesion among its residents, this association is not clear in the UK, and particularly for ethnic minority groups. The current study analyses a merged dataset from the 2005 and 2007 Citizenship Survey to assess the evidence for an association between social cohesion and ethnic residential concentration, composition and area deprivation across different ethnic groups in the UK. Results of the multilevel regression models show that, after adjusting for area deprivation, increased levels of social cohesion are found in areas of greater ethnic residential heterogeneity. Although different patterns emerge across ethnic groups and the measure of social cohesion used, findings consistently show that it is area deprivation, and not ethnic residential heterogeneity, which erodes social cohesion in the UK.

Impact of climate change on ozone-related mortality and morbidity in Europe.

PubMed

Orru, Hans; Andersson, Camilla; Ebi, Kristie L; Langner, Joakim; Aström, Christofer; Forsberg, Bertil

2013-02-01

Ozone is a highly oxidative pollutant formed from precursors in the presence of sunlight, associated with respiratory morbidity and mortality. All else being equal, concentrations of ground-level ozone are expected to increase due to climate change. Ozone-related health impacts under a changing climate are projected using emission scenarios, models and epidemiological data. European ozone concentrations are modelled with the model of atmospheric transport and chemistry (MATCH)-RCA3 (50×50 km). Projections from two climate models, ECHAM4 and HadCM3, are applied under greenhouse gas emission scenarios A2 and A1B, respectively. We applied a European-wide exposure-response function to gridded population data and country-specific baseline mortality and morbidity. Comparing the current situation (1990-2009) with the baseline period (1961-1990), the largest increase in ozone-associated mortality and morbidity due to climate change (4-5%) have occurred in Belgium, Ireland, the Netherlands and the UK. Comparing the baseline period and the future periods (2021-2050 and 2041-2060), much larger increases in ozone-related mortality and morbidity are projected for Belgium, France, Spain and Portugal, with the impact being stronger using the climate projection from ECHAM4 (A2). However, in Nordic and Baltic countries the same magnitude of decrease is projected. The current study suggests that projected effects of climate change on ozone concentrations could differentially influence mortality and morbidity across Europe.

Coordination and relationships between organisations during the civil-military international response against Ebola in Sierra Leone: an observational discussion.

PubMed

Forestier, Colleen; Cox, A T; Horne, S

2016-06-01

The Ebola virus disease (EVD) crisis in West Africa began in March 2014. At the beginning of the outbreak, no one could have predicted just how far-reaching its effects would be. The EVD epidemic proved to be a unique and unusual humanitarian and public health crisis. It caused worldwide fear that impeded the rapid response required to contain it early. The situation in Sierra Leone (SL) forced the formation of a unique series of civil-military interagency relationships to be formed in order to halt the epidemic. Civil-military cooperation in humanitarian situations is not unique to this crisis; however, the slow response, the unusual nature of the battle itself and the uncertainty of the framework required to fight this deadly virus created a situation that forced civilian and military organisations to form distinct, cooperative relationships. The unique nature of the Ebola virus necessitated a steering away from normal civil-military relationships and standard pillar responses. National and international non-governmental organisations (NGOs), Department for International Development (DFID) and the SL and UK militaries were required to disable this deadly virus (as of 7 November 2015, SL was declared EVD free). This paper draws on personal experiences and preliminary distillation of information gathered in formal interviews. It discusses some of the interesting features of the interagency relationships, particularly between the military, the UK's DFID, international organisations, NGOs and departments of the SL government. The focus is on how these relationships were key to achieving a coordinated solution to EVD in SL both on the ground and within the larger organisational structure. It also discusses how these relationships needed to rapidly evolve and change along with the epidemiological curve. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Teaching of clinical pharmacology and therapeutics in UK medical schools: current status in 2009.

PubMed

O'Shaughnessy, Lelia; Haq, Inam; Maxwell, Simon; Llewelyn, Martin

2010-07-01

Junior doctors feel poorly prepared by their training in Clinical Pharmacology and Therapeutics and commonly make prescribing errors. Since 1993 the General Medical Council's guidance on undergraduate medical education 'Tomorrow's Doctors' has emphasized the integration of Clinical Pharmacology and Therapeutics teaching within the medical curriculum. With the publication of a new version of Tomorrow's Doctors in 2009, medical schools will be further revising their Clinical Pharmacology and Therapeutics teaching. Although we know what the recommendations for undergraduate teaching of Clinical Pharmacology and Therapeutics teaching are, there are no published data describing what is currently happening in UK medical schools. This paper describes the course structures, volume and range of teaching and assessment of Clinical Pharmacology and Therapeutics in the UK in 2009. Our data provide a foundation for schools looking to revise the Clinical Pharmacology and Therapeutics Teaching in the light of Tomorrow's Doctors 2009. To describe the current structure, delivery and assessment of Clinical Pharmacology and Therapeutics (CPT) teaching in UK medical schools. An online questionnaire was distributed to the person with overall responsibility for CPT teaching at all UK medical schools in June 2009. Thirty of the 32 UK medical schools responded. 60% of schools have a CPT course although in 72% this was an integrated vertical theme. At 70% of schools pharmacologists have overall responsibility for CPT teaching (clinical 67%, non-clinical 33%); at 20% teaching is run by a non-specialist clinician and at 7% by a pharmacist. Teaching is commonly delivered by NHS clinicians (87%) and clinical pharmacists (80%) using lectures (90%) but additionally 50% of schools use e-Learning and 63% have a student formulary. CPT is assessed throughout the curriculum at many schools through written, practical examinations and course work. 90% of schools have specific CPT content in their written examinations. 90% of respondents believed that their students were 'fairly' to 'well' prepared for the foundation year but only 37% of schools gather data on the competence of their graduates. CPT teaching in UK medical schools is very diverse. Most schools do not assess the performance of their graduates as prescribers and there is a lack of evidence that many of the teaching approaches employed are suitable for the development of prescribing skills. It is vital that developments in CPT teaching are driven by validated, real-world assessments of the prescribing skills of medical students and newly qualified doctors.

SUDEP revisited - a decade on: have circumstances changed?

PubMed

Beran, Roy G

2015-04-01

A paper, published a decade ago, endorsed doctors' right to avoid discussing Sudden Unexpected Death in Epilepsy (SUDEP). It did not negate discussion, advocating same where appropriate. This paper investigates the current situation to identify any changes. The tort of negligence includes a duty to discuss "material risks" and adhere to accepted practice. Within the last decade, "material risks" for SUDEP have not altered significantly and international practice discusses SUDEP with those patients who seek advice or in whom such discussion is designed to improve patient compliance. Doctors are unlikely to be found negligent for not discussing SUDEP, acknowledging a push encouraging same, despite it being contrary to routine practice in the US, Italy, UK and elsewhere. Doctors should continue to practice the "art of medicine", discuss SUDEP when warranted and with patients seeking such advice. They must warn about risks, such as bathing alone, avoiding accident and injuries and possibly SUDEP in non-compliant patients and also consider the impact of such discussion. With no 'material' changes in the last decade, doctors must recognise when to discuss SUDEP, with which patients and in what context, accepting it may have a negative psychosocial impact on family dynamics unless discussed in a culturally competent fashion, to avoid causing additional stress for families where accepting the diagnosis of epilepsy may already prove difficult. Having formed a therapeutic relationship with the patient, discussion of SUDEP should be considered within that context, acknowledging the "art of medicine" and the implications of such discussion, similar to the situation a decade ago. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Are we failing to provide adequate rescue medication to children at risk of prolonged convulsive seizures in schools?

PubMed Central

Cross, J Helen; Wait, Suzanne; Arzimanoglou, Alexis; Beghi, Ettore; Bennett, Christine; Lagae, Lieven; Mifsud, Janet; Schmidt, Dieter; Harvey, Gordon

2013-01-01

Objective This paper explores the issues that arise from the discussion of administering rescue medication to children who experience prolonged convulsive seizures in mainstream schools in the UK. Situation analysis Current guidelines recommend immediate treatment of children with such seizures (defined as seizures lasting more than 5 min) to prevent progression to status epilepticus and neurological morbidity. As children are unconscious during prolonged convulsive seizures, whether or not they receive their treatment in time depends on the presence of a teacher or other member of staff trained and able to administer rescue medication. However, it is thought that the situation varies between schools and depends mainly on the goodwill and resources available locally. Recommendations A more systematic response is needed to ensure that children receive rescue medication regardless of where their seizure occurs. Possible ways forward include: greater use of training resources for schools available from epilepsy voluntary sector organisations; consistent, practical information to schools; transparent guidance outlining a clear care pathway from the hospital to the school; and implementation and adherence to each child's individual healthcare plan. Implications Children requiring emergency treatment for prolonged convulsive seizures during school hours test the goals of integrated, person-centred care as well as joined-up working to which the National Health Service (NHS) aspires. As changes to the NHS come into play and local services become reconfigured, every effort should be made to take account of the particular needs of this vulnerable group of children within broader efforts to improve the quality of paediatric epilepsy services overall. PMID:23899921

Outbreak column 21: Tuberculosis (TB): Still a nosocomial threat.

PubMed

Curran, Evonne T

2018-05-01

This outbreak column explores the epidemiology and infection prevention guidance on tuberculosis (TB) in the UK. The column finds that, at present, national guidance leaves UK hospitals ill-prepared to prevent nosocomial TB transmission. Reasons for this conclusion are as follows: (1) while TB is predominantly a disease that affects people with 'social ills', it has the potential to infect anyone who is sufficiently exposed; (2) nosocomial transmission is documented throughout history; (3) future nosocomial exposures may involve less treatable disease; and (4) current UK guidance is insufficient to prevent nosocomial transmission and is less than that advocated by the World Health Organization and the Centers for Disease Control and Prevention.

Arts, health & wellbeing: reflections on a national seminar series and building a UK research network

PubMed Central

Stickley, Theo; Parr, Hester; Atkinson, Sarah; Daykin, Norma; Clift, Stephen; De Nora, Tia; Hacking, Sue; Camic, Paul M; Joss, Tim; White, Mike; Hogan, Susan J

2017-01-01

Abstract An account is provided of a UK national seminar series on Arts, Health and Wellbeing funded by the Economic and Social Research Council during 2012–13. Four seminars were organised addressing current issues and challenges facing the field. Details of the programme and its outputs are available online. A central concern of the seminar programme was to provide a foundation for creating a UK national network for researchers in the field to help promote evidence-based policy and practice. With funding from Lankelly Chase Foundation, and the support of the Royal Society for Public Health, a Special interest Group for Arts, Health and Wellbeing was launched in 2015. PMID:28163778

The UK Earth System Model project

NASA Astrophysics Data System (ADS)

Tang, Yongming

2016-04-01

In this talk we will describe the development and current status of the UK Earth System Model (UKESM). This project is a NERC/Met Office collaboration and has two objectives; to develop and apply a world-leading Earth System Model, and to grow a community of UK Earth System Model scientists. We are building numerical models that include all the key components of the global climate system, and contain the important process interactions between global biogeochemistry, atmospheric chemistry and the physical climate system. UKESM will be used to make key CMIP6 simulations as well as long-time (e.g. millennium) simulations, large ensemble experiments and investigating a range of future carbon emission scenarios.

Utilisation of inorganic salts in fungal crop disease management in the U.K.

PubMed

Deliopoulos, T; Kettlewell, P S; Hare, M C

2009-01-01

The overaLl aim of the study described in this communication was to utilise the findings of a global scientific and technical literature survey on the use of inorganic salts against crop fungal diseases in order to assess the potential of using these substances to reduce the reliance of UK growers on conventional fungicides. A summary of the main findings of the Literature survey is provided followed by information on the current commercial use of inorganic salt-based products in fungal disease management. Finally, the scope of potential use of inorganic salts on high disease risk crops in the UK is assessed and specific crop/pathogen combinations are prioritised for further research.

Insufficient evidence to support separate BMI definitions for obesity in children and adolescents from south Asian ethnic groups in the UK.

PubMed

Viner, R M; Cole, Tim J; Fry, T; Gupta, S; Kinra, S; McCarthy, D; Saxena, S; Taylor, S; Wells, J C K; Whincup, P; Zaman, M J S

2010-04-01

Re-evaluation of adult obesity thresholds in some ethnic groups has led to the questioning of childhood obesity thresholds. An expert group was convened to examine the representativeness of childhood obesity definitions, evidence for ethnic differences in body composition in UK children and the extent of misclassification of adiposity by current body mass index (BMI) thresholds in south Asian and black groups. The group concluded that the current International Obesity Task Force (IOTF) definitions remained the most appropriate for use in the United Kingdom, but further research was needed on the relationship of body shape, fat mass, metabolic markers and ethnicity in children and adolescents.

The introduction of anti-HTLV testing of blood donations and the risk of transfusion-transmitted HTLV, UK: 2002-2006.

PubMed

Davison, K L; Dow, B; Barbara, J A; Hewitt, P E; Eglin, R

2009-02-01

The objectives of the study were to describe the introduction of testing blood donations for antibodies to human T-cell lymphotropic virus (anti-HTLV) and to determine the risk of HTLV potentially infectious donations entering the UK blood supply. The rationale for testing was based on (i) evidence of transmission through transfusion in the UK, (ii) the serious nature of HTLV I-associated morbidity and (iii) evidence of infection in UK blood donors. From mid-2002, all blood donations made at UK blood centres were tested in pooled samples using Abbott-Murex HTLV I/II GE 80/81 enzyme immunoassay (EIA). Surveillance data were used to calculate the incidence and prevalence of anti-HTLV and derive estimates of risk. Between August 2002 and December 2006, 106 donations were confirmed positive for anti-HTLV (95 anti-HTLV I and 11 anti-HTLV II). Prevalence was 10-fold higher among donations from new donors than repeat (4.0 and 0.42 per 100 000 donations), and only one repeat donor had evidence of seroconversion. The risk of an HTLV I potentially infectious donation entering the UK blood supply was estimated at 0.11 per million donations (95% confidence interval 0.06 to 0.18). The current very low observed incidence and prevalence among blood donors reflect the very low estimated risk of an HTLV I-positive donation entering the UK blood supply. A change in either the epidemiology of HTLV in UK blood donors or the length of the window period of the test should prompt further review of the risk and a reassessment of anti-HTLV testing in the UK.

Economics of alternative energy sources.

PubMed

Ryle, M

1977-05-12

An important part of the oil and natural gas at present consumed in the UK is used for the heating of buildings, a demand which shows large diurnal, day-to-day and annual fluctuations. The replacement of this energy by nuclear-generated electricity, as at present envisaged, would require the construction of some 250 GW of additional capacity by the end of the century, a progamme which does not seem feasible. By incorporating relatively cheap, short term storage in the form of low-grade heat, the generating capacity required to fulfil peak demand could be reduced by more than 50%. As soon as such storage is provided, however, other sources of energy become viable and attractive alternatives, and the UK is well situated to make use of wind, wave, and tidal power. It seems likely that the value of North Sea oil/gas reserves as feedstock to the chemical industry will rise sufficiently to make an early reduction in their consumption as fuel of great economic importance.

Using cognitive behaviour therapy to explore resilience in the life-stories of 16 UK centenarians.

PubMed

Hutnik, Nimmi; Smith, Pam; Koch, Tina

2016-04-01

In 2010, we interviewed 16 UK centenarians about their lives and later published a paper on the socio-emotional aspects of positive ageing. We were struck by their ability to 'move on' from difficult situations which we recognized conceptually as 'resilience'. In the effort to understand aspects of resilience as portrayed in their stories, we re-examined their data. In the original study, we used participatory action research (PAR) for its storytelling and group process components. Here, we re-examine data from the centenarians' life stories using a cognitive behavioural therapy (CBT) lens. We focused on the notion of resilience in the centenarians' stories guided by CBT insights to analyse and develop psychosocial interpretations. Resilience comprised the ability to frame difficult life events in positive terms, accept what cannot be changed, manage worry and anxiety effectively, develop psychological flexibility in the face of change and continually seek opportunities for growth and development. We suggest that these resilient behaviours may have contributed to positive ageing.

Do children with reading delay benefit from the use of personal FM systems in the classroom?

PubMed

Purdy, Suzanne C; Smart, Jennifer L; Baily, Melissa; Sharma, Mridula

2009-12-01

FM systems have been used to compensate for poor signal-to-noise ratios in classrooms. This study evaluates benefits of a 6-week trial of personal FM systems used during the school day for children with reading delay aged 6-11 years, using a randomized control design. Teachers and children completed the LIFE-UK questionnaire. Test-retest reliability of the LIFE-UK children's version was confirmed in a separate group of 18 children from the same school. The 23 children in the FM group had significantly improved teacher ratings, and the children's ratings of classroom listening for difficult situations were significantly better after the trial. These changes did not occur for the 23 control-group children. Most children (92%) commented positively about the FM after the trial. It is likely that a longer FM trial or a specific reading intervention combined with FM will be required for the benefits of enhanced listening to affect performance on standardized reading tests.

A randomised trial of peer review: the UK National Chronic Obstructive Pulmonary Disease Resources and Outcomes Project.

PubMed

Roberts, C M; Stone, R A; Buckingham, R J; Pursey, N A; Harrison, B D W; Lowe, D; Potter, J M

2010-06-01

Peer review has been widely employed within the NHS to facilitate health quality improvement but has not been rigorously evaluated. This article reports the largest randomised trial of peer review ever conducted in the UK. The peer review intervention was a reciprocal supportive exercise that included clinicians, hospital management, commissioners and patients which focused on the quality of the provision of four specific evidence-based aspects of chronic obstructive pulmonary disease care. Follow up at 12 months demonstrated few quantitative differences in the number or quality of services offered in the two groups. Qualitative data in contrast suggested many benefits of peer review in most but not all intervention units and some control teams. Findings suggest peer review in this format is a positive experience for most participants but is ineffective in some situations. Its longer term benefits and cost effectiveness require further study. The generic findings of this study have potential implications for the application of peer review throughout the NHS.

Molecular variation in the potato cyst nematode, Globodera pallida, in relation to virulence.

PubMed

Blok, V C; Pylypenko, L; Phillips, M S

2006-01-01

The potato cyst nematode Globodera pallida poses a challenge for potato growers. The potato cyst nematodes (PCN) Globodera rostochiensis and G. pallida cause damage valued at over pounds 50m per annum in the U.K. and problems in controlling PCN are growing due to the increase in populations and spread of G. pallida, the lack of many commercially attractive cultivars with resistance to this species and the pressure to reduce nematicide use. Over 60% of potato fields in the U.K. are infected with G. pallida (Minnis et al. 2000). The Scottish Agricultural Science Agency (SASA) figures show that the incidence of both species of PCN on Scottish seed potato land, though low, has been increasing. The proportion of potato land in ware production in Scotland is also increasing and now represents 50% of the potato growing area. This situation potentially increases the risk of the spread of PCN unless it is very carefully monitored and managed.

Video occupant detection and classification

DOEpatents

Krumm, John C.

1999-01-01

A system for determining when it is not safe to arm a vehicle airbag by storing representations of known situations as observed by a camera at a passenger seat; and comparing a representation of a camera output of the current situation to the stored representations to determine the known situation most closely represented by the current situation. In the preferred embodiment, the stored representations include the presence or absence of a person or infant seat in the front passenger seat of an automobile.

The design and content of orthodontic practise websites in the UK is suboptimal and does not correlate with search ranking.

PubMed

Patel, Annika; Cobourne, Martyn T

2015-08-01

This study investigated standards of ethical advertising; design and content; and information quality associated with UK dental practice websites offering orthodontic treatment. The World Wide Web was searched from a UK-based computer using the Google search engine combined with the term 'orthodontic braces'. The first 100 UK-based dental practice websites were pooled and saved following duplicate removal. Websites were evaluated for compliance with current General Dental Council ethical advertising guidelines; accessibility, usability, and reliability using the LIDA instrument (a validated outcome tool for healthcare website design and content evaluation); and quality of information using the DISCERN toolkit (a validated method of quality assessment for online written patient information). Nine per cent of websites demonstrated full compliance with current guidelines on ethical advertising. Mean total LIDA score was 110/144 (76%) [range: 51-135; 35-94%]. Eleven websites reached a gold standard of 90% or more for total LIDA score. Mean total DISCERN score was 48/75 (64%) [range: 19-73; 25-97%]. Five websites achieved a total DISCERN score above 90%. Spearman's rank correlation coefficients demonstrated no significant correlations between LIDA (0.1669; P = 0.4252, confidence interval [CI]: -0.2560 to 0.5362) or DISCERN (0.3572; P = 0.0796, CI: -0.0565 to 0.663) score and ranking amongst the 25 highest ranked websites. Most UK websites offering orthodontic services are not fully compliant with national guidelines relating to ethical advertising. Validated measures of website design (LIDA) and information quality (DISCERN) showed wide variation amongst sites. No correlation existed between ranking amongst the highest 25 sites and either of these measures. This investigation was limited to a subsample of UK-only websites; and whilst not representative of European-wide sites, it does suggest that in the UK at least website quality can be improved. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

High-intensity interval training versus moderate-intensity steady-state training in UK cardiac rehabilitation programmes (HIIT or MISS UK): study protocol for a multicentre randomised controlled trial and economic evaluation.

PubMed

McGregor, Gordon; Nichols, Simon; Hamborg, Thomas; Bryning, Lucy; Tudor-Edwards, Rhiannon; Markland, David; Mercer, Jenny; Birkett, Stefan; Ennis, Stuart; Powell, Richard; Begg, Brian; Haykowsky, Mark J; Banerjee, Prithwish; Ingle, Lee; Shave, Rob; Backx, Karianne

2016-11-16

Current international guidelines for cardiac rehabilitation (CR) advocate moderate-intensity exercise training (MISS, moderate-intensity steady state). This recommendation predates significant advances in medical therapy for coronary heart disease (CHD) and may not be the most appropriate strategy for the 'modern' patient with CHD. High-intensity interval training (HIIT) appears to be a safe and effective alternative, resulting in greater improvements in peak oxygen uptake (VO 2 peak ). To date, HIIT trials have predominantly been proof-of-concept studies in the laboratory setting and conducted outside the UK. The purpose of this multicentre randomised controlled trial is to compare the effects of HIIT and MISS training in patients with CHD attending UK CR programmes. This pragmatic study will randomly allocate 510 patients with CHD to 8 weeks of twice weekly HIIT or MISS training at 3 centres in the UK. HIIT will consist of 10 high-intensity (85-90% peak power output (PPO)) and 10 low-intensity (20-25% PPO) intervals, each lasting 1 min. MISS training will follow usual care recommendations, adhering to currently accepted UK guidelines (ie, >20 min continuous exercise at 40-70% heart rate reserve). Outcome measures will be assessed at baseline, 8 weeks and 12 months. The primary outcome for the trial will be change in VO 2 peak as determined by maximal cardiopulmonary exercise testing. Secondary measures will assess physiological, psychosocial and economic outcomes. The study protocol V.1.0, dated 1 February 2016, was approved by the NHS Health Research Authority, East Midlands-Leicester South Research Ethics Committee (16/EM/0079). Recruitment will start in August 2016 and will be completed in June 2018. Results will be published in peer-reviewed journals, presented at national and international scientific meetings and are expected to inform future national guidelines for exercise training in UK CR. NCT02784873; pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

High-intensity interval training versus moderate-intensity steady-state training in UK cardiac rehabilitation programmes (HIIT or MISS UK): study protocol for a multicentre randomised controlled trial and economic evaluation

PubMed Central

McGregor, Gordon; Nichols, Simon; Hamborg, Thomas; Bryning, Lucy; Tudor-Edwards, Rhiannon; Markland, David; Mercer, Jenny; Birkett, Stefan; Ennis, Stuart; Powell, Richard; Begg, Brian; Haykowsky, Mark J; Banerjee, Prithwish; Ingle, Lee; Shave, Rob; Backx, Karianne

2016-01-01

Introduction Current international guidelines for cardiac rehabilitation (CR) advocate moderate-intensity exercise training (MISS, moderate-intensity steady state). This recommendation predates significant advances in medical therapy for coronary heart disease (CHD) and may not be the most appropriate strategy for the ‘modern’ patient with CHD. High-intensity interval training (HIIT) appears to be a safe and effective alternative, resulting in greater improvements in peak oxygen uptake (VO2 peak). To date, HIIT trials have predominantly been proof-of-concept studies in the laboratory setting and conducted outside the UK. The purpose of this multicentre randomised controlled trial is to compare the effects of HIIT and MISS training in patients with CHD attending UK CR programmes. Methods and analysis This pragmatic study will randomly allocate 510 patients with CHD to 8 weeks of twice weekly HIIT or MISS training at 3 centres in the UK. HIIT will consist of 10 high-intensity (85–90% peak power output (PPO)) and 10 low-intensity (20–25% PPO) intervals, each lasting 1 min. MISS training will follow usual care recommendations, adhering to currently accepted UK guidelines (ie, >20 min continuous exercise at 40–70% heart rate reserve). Outcome measures will be assessed at baseline, 8 weeks and 12 months. The primary outcome for the trial will be change in VO2 peak as determined by maximal cardiopulmonary exercise testing. Secondary measures will assess physiological, psychosocial and economic outcomes. Ethics and dissemination The study protocol V.1.0, dated 1 February 2016, was approved by the NHS Health Research Authority, East Midlands—Leicester South Research Ethics Committee (16/EM/0079). Recruitment will start in August 2016 and will be completed in June 2018. Results will be published in peer-reviewed journals, presented at national and international scientific meetings and are expected to inform future national guidelines for exercise training in UK CR. Trial registration number NCT02784873; pre-results. PMID:27852718

An inventory of nitrous oxide emissions from agriculture in the UK using the IPCC methodology: emission estimate, uncertainty and sensitivity analysis

NASA Astrophysics Data System (ADS)

Brown, L.; Armstrong Brown, S.; Jarvis, S. C.; Syed, B.; Goulding, K. W. T.; Phillips, V. R.; Sneath, R. W.; Pain, B. F.

Nitrous oxide emission from UK agriculture was estimated, using the IPCC default values of all emission factors and parameters, to be 87 Gg N 2O-N in both 1990 and 1995. This estimate was shown, however, to have an overall uncertainty of 62%. The largest component of the emission (54%) was from the direct (soil) sector. Two of the three emission factors applied within the soil sector, EF1 (direct emission from soil) and EF3 PRP (emission from pasture range and paddock) were amongst the most influential on the total estimate, producing a ±31 and +11% to -17% change in emissions, respectively, when varied through the IPCC range from the default value. The indirect sector (from leached N and deposited ammonia) contributed 29% of the total emission, and had the largest uncertainty (126%). The factors determining the fraction of N leached (Frac LEACH) and emissions from it (EF5), were the two most influential. These parameters are poorly specified and there is great potential to improve the emission estimate for this component. Use of mathematical models (NCYCLE and SUNDIAL) to predict Frac LEACH suggested that the IPCC default value for this parameter may be too high for most situations in the UK. Comparison with other UK-derived inventories suggests that the IPCC methodology may overestimate emission. Although the IPCC approach includes additional components to the other inventories (most notably emission from indirect sources), estimates for the common components (i.e. fertiliser and animals), and emission factors used, are higher than those of other inventories. Whilst it is recognised that the IPCC approach is generalised in order to allow widespread applicability, sufficient data are available to specify at least two of the most influential parameters, i.e. EF1 and Frac LEACH, more accurately, and so provide an improved estimate of nitrous oxide emissions from UK agriculture.

Predictors of quality of life for autistic adults.

PubMed

Mason, David; McConachie, Helen; Garland, Deborah; Petrou, Alex; Rodgers, Jacqui; Parr, Jeremy R

2018-05-07

Research with adults on the autism spectrum is as yet limited in scope and quality. The present study describes quality of life (QoL) of a large sample of autistic adults in the UK and investigates characteristics that may be predictive of QoL. A total of 370 autistic adults from the Adult Autism Spectrum Cohort-UK (ASC-UK) completed the WHOQoL-BREF, and the Social Responsiveness Scale (SRS, autism symptom severity), along with the ASC-UK registration questionnaire giving information on mental health and their life situation. QoL for autistic adults was lower than for the general population for each WHOQoL domain. Younger participants reported higher QoL than older participants in psychological and environment domains. Males reported higher physical QoL than females, and females reported higher social QoL than males. Significant positive predictors of QoL were: being employed (physical QoL), receiving support (social and environment QoL), and being in a relationship (social QoL). Having a mental health condition and higher SRS total score were negative predictors of QoL across all four domains. Autistic adults require access to effective mental health interventions, and informal and formal support for their social difficulties, to improve their quality of life. Autism Res 2018. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. There has been limited research into the lived experience of autistic adults. Using the World Health Organization quality of life measure, we found that autistic people (370) in the UK reported their quality of life to be lower than that of the general population. Better quality of life was associated with being in a relationship; those with a mental health condition had poorer quality of life. This research suggests some ways in which autistic people can be helped to improve their quality of life. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc.

Smoking habits and attitudes toward tobacco bans among United Kingdom hospital staff and students.

PubMed

Lewis, K E; Shin, D; Davies, G

2011-08-01

A group of United Kingdom (UK) hospitals. To estimate the current smoking habits of health care professionals (HCPs) in a country with active tobacco control measures, and to record their attitudes to national and hospital tobacco bans. A cross-sectional survey of 500 HCPs. HCPs reported a lower rate of current smoking (7%) than the general population (24%). Doctors (2.6%) and medical students (3.8%) were less likely to be current smokers than both nurses (8.7%) and allied health professionals (10.9%, P < 0.001). The vast majority felt national legislation had been effective (88%) and well complied with (82%). Around a third of respondents believed the ban had led to a reduction in admissions for acute coronary syndrome. Almost all respondents were in favour of restrictions on smoking in health care premises. A higher proportion of UK doctors (69%) than nurses (52%) favoured a complete ban (odds ratio 2.01, 95% confidence interval 1.14-3.56). Self-reported smoking patterns in UK health professionals are lower than previously and compared to other industrialised and developing countries. Support for bans is very high, but differences remain in behaviour and especially attitudes to local bans according to professional status, although this gap is also narrowing.

The impact of European Union law on individuals as patients.

PubMed

Hodgson, John

This article considers how the EU affects individuals as patients. This can arise in several separate situations - where the person concerned is living in a host state, where treatment becomes necessary during a temporary visit or where a patient wishes to travel to another country for planned treatment. The situation is complicated by the fact that each member state has its own system of health-care and social security, which operate on very different principles and which have not been harmonized, as this is not within the remit of the EU. For example, in many systems the health-care provider will charge the patient a fee covering the whole or part of the cost of treatment and medication, which is then recovered from the patient's health insurance provider. A 'monolithic' national health service offering a comprehensive service 'free at the point of delivery', as in the UK, is the exception rather than the rule.

Fighting fires?--emergency hospital admission and the concept of prevention.

PubMed

Glasby, J; Littlechild, R

2000-01-01

Although the UK's health and social care system has always been geared towards dealing with crises, evidence suggests that this is becoming increasingly the case. Changes in health care and the prioritisation of scarce resources have resulted in a situation where those with low level needs are often left unsupported until they experience a major life crisis. To rectify this situation, the government has introduced a range of policies designed to emphasise the need for preventive work. Against this background, this paper focuses on the issue of emergency hospital admissions, critiquing the research methodologies that have been used to investigate the scope for preventive work in this area. Despite the use of more sophisticated and objective research tools, there is a need to develop new ways of researching emergency admissions which build on the strengths of existing approaches while at the same time incorporating more of a user perspective.

The Current Situation of Field Experience in a Five-Year Science Teacher Education Program in Thailand

ERIC Educational Resources Information Center

Faikhamta, Chatree; Jantarakantee, Ekgapoom; Roadrangka, Vantipa

2011-01-01

This research explored the current situation in managing the field experience of a five-year science teacher education program in one university in Thailand. A number of methods were used to assess field experience situation: (1) a questionnaire on the perceptions of pre-service science teachers of field experience management; (2) participant…

The current provision of community-based teaching in UK medical schools: an online survey and systematic review.

PubMed

Lee, Sandra W W; Clement, Naomi; Tang, Natalie; Atiomo, William

2014-12-01

To evaluate the current provision and outcome of community-based education (CBE) in UK medical schools. An online survey of UK medical school websites and course prospectuses and a systematic review of articles from PubMed and Web of Science were conducted. Articles in the systematic review were assessed using Rossi, Lipsey and Freeman's approach to programme evaluation. Publications from November 1998 to 2013 containing information related to community teaching in undergraduate medical courses were included. Out of the 32 undergraduate UK medical schools, one was excluded due to the lack of course specifications available online. Analysis of the remaining 31 medical schools showed that a variety of CBE models are utilised in medical schools across the UK. Twenty-eight medical schools (90.3%) provide CBE in some form by the end of the first year of undergraduate training, and 29 medical schools (93.5%) by the end of the second year. From the 1378 references identified, 29 papers met the inclusion criteria for assessment. It was found that CBE mostly provided advantages to students as well as other participants, including GP tutors and patients. However, there were a few concerns regarding the lack of GP tutors' knowledge in specialty areas, the negative impact that CBE may have on the delivery of health service in education settings and the cost of CBE. Despite the wide variations in implementation, community teaching was found to be mostly beneficial. To ensure the relevance of CBE for 'Tomorrow's Doctors', a national framework should be established, and solutions sought to reduce the impact of the challenges within CBE. This is the first study to review how community-based education is currently provided throughout Medical Schools in the UK. The use of Rossi, Lipsey and Freeman's method of programme evaluation means that the literature was analysed in a consistent and comprehensive way. However, a weakness is that data from the online survey was obtained from online medical school prospectuses. This means the data may be incomplete or out of date. Data in the literature review may also be skewed by publication bias. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The current provision of community-based teaching in UK medical schools: an online survey and systematic review

PubMed Central

Lee, Sandra W W; Clement, Naomi; Tang, Natalie; Atiomo, William

2014-01-01

Objective To evaluate the current provision and outcome of community-based education (CBE) in UK medical schools. Design and data sources An online survey of UK medical school websites and course prospectuses and a systematic review of articles from PubMed and Web of Science were conducted. Articles in the systematic review were assessed using Rossi, Lipsey and Freeman's approach to programme evaluation. Study selection Publications from November 1998 to 2013 containing information related to community teaching in undergraduate medical courses were included. Results Out of the 32 undergraduate UK medical schools, one was excluded due to the lack of course specifications available online. Analysis of the remaining 31 medical schools showed that a variety of CBE models are utilised in medical schools across the UK. Twenty-eight medical schools (90.3%) provide CBE in some form by the end of the first year of undergraduate training, and 29 medical schools (93.5%) by the end of the second year. From the 1378 references identified, 29 papers met the inclusion criteria for assessment. It was found that CBE mostly provided advantages to students as well as other participants, including GP tutors and patients. However, there were a few concerns regarding the lack of GP tutors’ knowledge in specialty areas, the negative impact that CBE may have on the delivery of health service in education settings and the cost of CBE. Conclusions Despite the wide variations in implementation, community teaching was found to be mostly beneficial. To ensure the relevance of CBE for ‘Tomorrow's Doctors’, a national framework should be established, and solutions sought to reduce the impact of the challenges within CBE. Strengths and limitations of this study This is the first study to review how community-based education is currently provided throughout Medical Schools in the UK. The use of Rossi, Lipsey and Freeman's method of programme evaluation means that the literature was analysed in a consistent and comprehensive way. However, a weakness is that data from the online survey was obtained from online medical school prospectuses. This means the data may be incomplete or out of date. Data in the literature review may also be skewed by publication bias. PMID:25448625

International survey on willingness-to-pay (WTP) for one additional QALY gained: what is the threshold of cost effectiveness?

PubMed

Shiroiwa, Takeru; Sung, Yoon-Kyoung; Fukuda, Takashi; Lang, Hui-Chu; Bae, Sang-Cheol; Tsutani, Kiichiro

2010-04-01

Although the threshold of cost effectiveness of medical interventions is thought to be 20 000- 30 000 UK pounds in the UK, and $50 000-$100 000 in the US, it is well known that these values are unjustified, due to lack of explicit scientific evidence. We measured willingness-to-pay (WTP) for one additional quality-adjusted life-year gained to determine the threshold of the incremental cost-effectiveness ratio. Our study used the Internet to compare WTP for the additional year of survival in a perfect status of health in Japan, the Republic of Korea (ROK), Taiwan, Australia, the UK, and the US. The research utilized a double-bound dichotomous choice, and analysis by the nonparametric Turnbull method. WTP values were JPY 5 million (Japan), KWN 68 million (ROK), NT$ 2.1 million (Taiwan), 23 000 UK pounds (UK), AU$ 64 000 (Australia), and US$ 62 000 (US). The discount rates of outcome were estimated at 6.8% (Japan), 3.7% (ROK), 1.6% (Taiwan), 2.8% (UK), 1.9% (Australia), and 3.2% (US). Based on the current study, we suggest new classification of cost-effectiveness plane and methodology for decision making. Copyright (c) 2009 John Wiley & Sons, Ltd.

Public health impacts of combustion emissions in the United Kingdom.

PubMed

Yim, Steve H L; Barrett, Steven R H

2012-04-17

Combustion emissions are a major contributor to degradation of air quality and pose a risk to human health. We evaluate and apply a multiscale air quality modeling system to assess the impact of combustion emissions on UK air quality. Epidemiological evidence is used to quantitatively relate PM(2.5) exposure to risk of early death. We find that UK combustion emissions cause ∼13,000 premature deaths in the UK per year, while an additional ∼6000 deaths in the UK are caused by non-UK European Union (EU) combustion emissions. The leading domestic contributor is transport, which causes ∼7500 early deaths per year, while power generation and industrial emissions result in ∼2500 and ∼830 early deaths per year, respectively. We estimate the uncertainty in premature mortality calculations at -80% to +50%, where results have been corrected by a low modeling bias of 28%. The total monetized life loss in the UK is estimated at £6-62bn/year or 0.4-3.5% of gross domestic product. In Greater London, where PM concentrations are highest and are currently in exceedance of EU standards, we estimate that non-UK EU emissions account for 30% of the ∼3200 air quality-related deaths per year. In the context of the European Commission having launched infringement proceedings against the UK Government over exceedances of EU PM air quality standards in London, these results indicate that further policy measures should be coordinated at an EU-level because of the strength of the transboundary component of PM pollution.

Effects of climate change on water abstraction restrictions for irrigation during droughts - The UK case

NASA Astrophysics Data System (ADS)

Rey Vicario, D.; Holman, I.

2016-12-01

The use of water for irrigation and on-farm reservoir filling is globally important for agricultural production. In humid climates, like the UK, supplemental irrigation can be critical to buffer the effects of rainfall variability and to achieve high quality crops. Given regulatory efforts to secure sufficient environmental river flows and meet rising water demands due to population growth and climate change, increasing water scarcity is likely to compound the drought challenges faced by irrigated agriculture in this region. Currently, water abstraction from surface waters for agricultural irrigation can be restricted by the Environment Agency during droughts under Section 57 of the Water Resources Act (1991), based on abnormally low river flow levels and rainfall forecast, causing significant economic impacts on irrigated agricultural production. The aim of this study is to assess the impact that climate change may have on agricultural abstraction in the UK within the context of the abstraction restriction triggers currently in place. These triggers have been applied to the `Future Flows hydrology' database to assess the likelihood of increasing restrictions on agricultural abstraction in the future by comparing the probability of voluntary and compulsory restrictions in the baseline (1961-1990) and future period (2071-2098) for 282 catchments throughout the whole of the UK. The results of this study show a general increase in the probability of future agricultural irrigation abstraction restrictions in the UK in the summer, particularly in the South West, although there is significant variability between the 11 ensemble members. The results also indicate that UK winters are likely to become wetter in the future, although in some catchments the probability of abstraction restriction in the reservoir refilling winter months (November-February) could increase slightly. An increasing frequency of drought events due to climate change is therefore likely to lead to more water abstraction restrictions, increasing the need for irrigators to adapt their businesses to increase drought resilience and hence food security.

Translating the WHO 25×25 goals into a UK context: the PROMISE modelling study

PubMed Central

Cobiac, Linda J; Scarborough, Peter

2017-01-01

Objective Model the impact of targets for obesity, diabetes, raised blood pressure, tobacco use, salt intake, physical inactivity and harmful alcohol use, as outlined in the Global Non-Communicable Disease Action Plan 2013–2020, on mortality and morbidity in the UK population. Design Dynamic population modelling study. Setting UK population. Participants Not available. Main outcome measures Mortality and morbidity (years lived with disability) from non-communicable diseases (NCDs) that are averted or delayed. Probability of achieving a 25% reduction in premature mortality from NCDs by 2025 (current WHO target) and a 33% reduction by 2030 (proposed target). Results The largest improvements in mortality would be achieved by meeting the obesity target and the largest improvements in morbidity would be achieved by meeting the diabetes target. The UK could achieve the 2025 and 2030 targets for reducing premature mortality with only a little additional preventive effort compared with current practice. Achieving all 7 risk targets could avert a total of 300 000 deaths (95% uncertainty interval 250 000 to 350 000) and 1.3 million years lived with disability (1.2–1.4 million) from NCDs by 2025, with the majority of health gains due to reduced mortality and morbidity from heart disease and stroke, and reduced morbidity from diabetes. Potential reductions in morbidity from depression and in morbidity and mortality from dementia at older ages are also substantial. Conclusions The global premature mortality targets are a potentially achievable goal for countries such as the UK that can capitalise on many decades of effort in prevention and treatment. High morbidity diseases and diseases in later life are not addressed in the Global NCD Action Plan and targets, but must also be considered a priority for prevention in the UK where the population is ageing and the costs of health and social care are rising. PMID:28377390

HCV treatment rates and sustained viral response among people who inject drugs in seven UK sites: real world results and modelling of treatment impact.

PubMed

Martin, N K; Foster, G R; Vilar, J; Ryder, S; Cramp, M E; Gordon, F; Dillon, J F; Craine, N; Busse, H; Clements, A; Hutchinson, S J; Ustianowski, A; Ramsay, M; Goldberg, D J; Irving, W; Hope, V; De Angelis, D; Lyons, M; Vickerman, P; Hickman, M

2015-04-01

Hepatitis C virus (HCV) antiviral treatment for people who inject drugs (PWID) could prevent onwards transmission and reduce chronic prevalence. We assessed current PWID treatment rates in seven UK settings and projected the potential impact of current and scaled-up treatment on HCV chronic prevalence. Data on number of PWID treated and sustained viral response rates (SVR) were collected from seven UK settings: Bristol (37-48% HCV chronic prevalence among PWID), East London (37-48%), Manchester (48-56%), Nottingham (37-44%), Plymouth (30-37%), Dundee (20-27%) and North Wales (27-33%). A model of HCV transmission among PWID projected the 10-year impact of (i) current treatment rates and SVR (ii) scale-up with interferon-free direct acting antivirals (IFN-free DAAs) with 90% SVR. Treatment rates varied from <5 to over 25 per 1000 PWID. Pooled intention-to-treat SVR for PWID were 45% genotypes 1/4 [95%CI 33-57%] and 61% genotypes 2/3 [95%CI 47-76%]. Projections of chronic HCV prevalence among PWID after 10 years of current levels of treatment overlapped substantially with current HCV prevalence estimates. Scaling-up treatment to 26/1000 PWID annually (achieved already in two sites) with IFN-free DAAs could achieve an observable absolute reduction in HCV chronic prevalence of at least 15% among PWID in all sites and greater than a halving in chronic HCV in Plymouth, Dundee and North Wales within a decade. Current treatment rates among PWID are unlikely to achieve observable reductions in HCV chronic prevalence over the next 10 years. Achievable scale-up, however, could lead to substantial reductions in HCV chronic prevalence. © 2014 The Authors Journal of Viral Hepatitis Published by John Wiley & Sons Ltd.

HCV treatment rates and sustained viral response among people who inject drugs in seven UK sites: real world results and modelling of treatment impact

PubMed Central

Martin, N K; Foster, G R; Vilar, J; Ryder, S; E Cramp, M; Gordon, F; Dillon, J F; Craine, N; Busse, H; Clements, A; Hutchinson, S J; Ustianowski, A; Ramsay, M; Goldberg, D J; Irving, W; Hope, V; De Angelis, D; Lyons, M; Vickerman, P; Hickman, M

2015-01-01

Hepatitis C virus (HCV) antiviral treatment for people who inject drugs (PWID) could prevent onwards transmission and reduce chronic prevalence. We assessed current PWID treatment rates in seven UK settings and projected the potential impact of current and scaled-up treatment on HCV chronic prevalence. Data on number of PWID treated and sustained viral response rates (SVR) were collected from seven UK settings: Bristol (37–48% HCV chronic prevalence among PWID), East London (37–48%), Manchester (48–56%), Nottingham (37–44%), Plymouth (30–37%), Dundee (20–27%) and North Wales (27–33%). A model of HCV transmission among PWID projected the 10-year impact of (i) current treatment rates and SVR (ii) scale-up with interferon-free direct acting antivirals (IFN-free DAAs) with 90% SVR. Treatment rates varied from <5 to over 25 per 1000 PWID. Pooled intention-to-treat SVR for PWID were 45% genotypes 1/4 [95%CI 33–57%] and 61% genotypes 2/3 [95%CI 47–76%]. Projections of chronic HCV prevalence among PWID after 10 years of current levels of treatment overlapped substantially with current HCV prevalence estimates. Scaling-up treatment to 26/1000 PWID annually (achieved already in two sites) with IFN-free DAAs could achieve an observable absolute reduction in HCV chronic prevalence of at least 15% among PWID in all sites and greater than a halving in chronic HCV in Plymouth, Dundee and North Wales within a decade. Current treatment rates among PWID are unlikely to achieve observable reductions in HCV chronic prevalence over the next 10 years. Achievable scale-up, however, could lead to substantial reductions in HCV chronic prevalence. PMID:25288193

Current situations and discussions in Japan in relation to the new occupational equivalent dose limit for the lens of the eye.

PubMed

Yokoyama, Sumi; Hamada, Nobuyuki; Hayashida, Toshiyuki; Tsujimura, Norio; Tatsuzaki, Hideo; Kurosawa, Tadahiro; Nabatame, Kuniaki; Ohguchi, Hiroyuki; Ohno, Kazuko; Yamauchi-Kawaura, Chiyo; Iimoto, Takeshi; Ichiji, Takeshi; Hotta, Yutaka; Iwai, Satoshi; Akahane, Keiichi

2017-09-25

Since the International Commission on Radiological Protection recommended reducing the occupational equivalent dose limit for the lens of the eye in 2011, there have been extensive discussions in various countries. This paper reviews the current situation in radiation protection of the ocular lens and the discussions on the potential impact of the new lens dose limit in Japan. Topics include historical changes to the lens dose limit, the current situation with occupational lens exposures (e.g., in medical workers, nuclear workers, and Fukushima nuclear power plant workers) and measurements, and the current status of biological studies and epidemiological studies on radiation cataracts. Our focus is on the situation in Japan, but we believe such information sharing will be useful in many other countries.

The value of carbon sequestration and storage in coastal habitats

NASA Astrophysics Data System (ADS)

Beaumont, N. J.; Jones, L.; Garbutt, A.; Hansom, J. D.; Toberman, M.

2014-01-01

Coastal margin habitats are globally significant in terms of their capacity to sequester and store carbon, but their continuing decline, due to environmental change and human land use decisions, is reducing their capacity to provide this ecosystem service. In this paper the UK is used as a case study area to develop methodologies to quantify and value the ecosystem service of blue carbon sequestration and storage in coastal margin habitats. Changes in UK coastal habitat area between 1900 and 2060 are documented, the long term stocks of carbon stored by these habitats are calculated, and the capacity of these habitats to sequester CO2 is detailed. Changes in value of the carbon sequestration service of coastal habitats are then projected for 2000-2060 under two scenarios, the maintenance of the current state of the habitat and the continuation of current trends of habitat loss. If coastal habitats are maintained at their current extent, their sequestration capacity over the period 2000-2060 is valued to be in the region of £1 billion UK sterling (3.5% discount rate). However, if current trends of habitat loss continue, the capacity of the coastal habitats both to sequester and store CO2 will be significantly reduced, with a reduction in value of around £0.25 billion UK sterling (2000-2060; 3.5% discount rate). If loss-trends due to sea level rise or land reclamation worsen, this loss in value will be greater. This case study provides valuable site specific information, but also highlights global issues regarding the quantification and valuation of carbon sequestration and storage. Whilst our ability to value ecosystem services is improving, considerable uncertainty remains. If such ecosystem valuations are to be incorporated with confidence into national and global policy and legislative frameworks, it is necessary to address this uncertainty. Recommendations to achieve this are outlined.

"It's Quite Liberating Turning up to a Classroom without a Pile of Papers and Equipment." Pedagogic Bungee Jumping: A Strategy to Rethink Teaching in a Technology-Rich Age?

ERIC Educational Resources Information Center

Hughes, Julie

2012-01-01

Initial Teacher Education (ITE) for the post-compulsory sector (PCE) in the UK is currently under review. Despite earlier plans to substantially increase the use of technology in ITE the Lifelong Learning UK (LLUK) consultation findings recommend that "we will expect that teachers do develop their skills in this area to a limited extent on a…

Proceedings of the Rank Forum on Vitamin D

PubMed Central

Lanham-New, S. A.; Buttriss, J. L.; Miles, L. M.; Ashwell, M.; Berry, J. L.; Boucher, B. J.; Cashman, K. D.; Cooper, C.; Darling, A. L.; Francis, R. M.; Fraser, W. D.; de Groot, C. P. G. M.; Hyppönen, E.; Kiely, M.; Lamberg-Allardt, C.; Macdonald, H. M.; Martineau, A. R.; Masud, T.; Mavroeidi, A.; Nowson, C.; Prentice, A.; Stone, E. M.; Reddy, S.; Vieth, R.; Williams, C. M.

2012-01-01

The Rank Forum on Vitamin D was held on 2nd and 3rd July 2009 at the University of Surrey, Guildford, UK. The workshop consisted of a series of scene-setting presentations to address the current issues and challenges concerning vitamin D and health, and included an open discussion focusing on the identification of the concentrations of serum 25-hydroxyvitamin D (25(OH)D) (a marker of vitamin D status) that may be regarded as optimal, and the implications this process may have in the setting of future dietary reference values for vitamin D in the UK. The Forum was in agreement with the fact that it is desirable for all of the population to have a serum 25(OH)D concentration above 25 nmol/l, but it discussed some uncertainty about the strength of evidence for the need to aim for substantially higher concentrations (25(OH)D concentrations > 75 nmol/l). Any discussion of ‘optimal’ concentration of serum 25(OH)D needs to define ‘optimal’ with care since it is important to consider the normal distribution of requirements and the vitamin D needs for a wide range of outcomes. Current UK reference values concentrate on the requirements of particular subgroups of the population; this differs from the approaches used in other European countries where a wider range of age groups tend to be covered. With the re-emergence of rickets and the public health burden of low vitamin D status being already apparent, there is a need for urgent action from policy makers and risk managers. The Forum highlighted concerns regarding the failure of implementation of existing strategies in the UK for achieving current vitamin D recommendations. PMID:21134331

What does the general public in the UK know about the risk to a developing foetus if exposed to alcohol in pregnancy? Findings from a UK mixed methodology study.

PubMed

Mukherjee, R; Wray, E; Hollins, S; Curfs, L

2015-05-01

Foetal alcohol spectrum disorders (FASD) are a set of preventable conditions where the foetus is exposed to alcohol in utero and as a result suffers adverse consequences. To develop a public health strategy related to FASD, it is important to first establish what is known by the public about this condition. This study aimed to assess the current level of knowledge about FASD in the UK general population. A mixed methodology study was conducted using a 17-item questionnaire and focus group sessions. Four focus groups were held with an average of 10 people in each group. Semi-structured questions and thematic analysis of interviews alongside quantitative analysis of the questionnaire data was completed. The research was approved by an National Health service (NHS) research ethical committee. A total of 674 people responded to the questionnaire and a majority (86.7%) had heard about FASD, with most receiving their information from the media (26.2%) or from their work (27.7%). Four broad themes emerged. Overall these were: a general lack of knowledge about the subject; information about the subject needed to be personally relevant; there was a need for further education; and there was a lack of clarity in the current guidance on alcohol use in pregnancy. Currently there appears to be a superficial level of knowledge about FASD in the UK general public. More detailed work in subgroups, such as young women, to identify their specific needs may be necessary before targeted public health and educational interventions can be developed to meet the needs of the general public. © 2014 John Wiley & Sons Ltd.

Is the current standard of care leading to cost-effective outcomes for patients with type 2 diabetes requiring insulin? A long-term health economic analysis for the UK.

PubMed

Valentine, W J; Curtis, B H; Pollock, R F; Van Brunt, K; Paczkowski, R; Brändle, M; Boye, K S; Kendall, D M

2015-07-01

The aim of the analysis was to investigate whether insulin intensification, based on the use of intensive insulin regimens as recommended by the current standard of care in routine clinical practice, would be cost-effective for patients with type 2 diabetes in the UK. Clinical data were derived from a retrospective analysis of 3185 patients with type 2 diabetes on basal insulin in The Health Improvement Network (THIN) general practice database. In total, 48% (614 patients) intensified insulin therapy, defined by adding bolus or premix insulin to a basal regimen, which was associated with a reduction in HbA1c and an increase in body mass index. Projections of clinical outcomes and costs (2011 GBP) over patients' lifetimes were made using a recently validated type 2 diabetes model. Immediate insulin intensification was associated with improvements in life expectancy, quality-adjusted life expectancy and time to onset of complications versus no intensification or delaying intensification by 2, 4, 6, or 8 years. Direct costs were higher with the insulin intensification strategy (due to the acquisition costs of insulin). Incremental cost-effectiveness ratios for insulin intensification were GBP 32,560, GBP 35,187, GBP 40,006, GBP 48,187 and GBP 55,431 per QALY gained versus delaying intensification 2, 4, 6 and 8 years, and no intensification, respectively. Although associated with improved clinical outcomes, insulin intensification as practiced in the UK has a relatively high cost per QALY and may not lead to cost-effective outcomes for patients with type 2 diabetes as currently defined by UK cost-effectiveness thresholds. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

UK Renal Registry 16th annual report: chapter 9 adequacy of haemodialysis in UK adult patients in 2012: national and centre-specific analyses.

PubMed

Shaw, Catriona; Steenkamp, Retha; Davenport, Andrew

2013-01-01

Outcomes in patients treated with haemodialysis (HD) are influenced by the delivered dose of dialysis. The UK Renal Association (RA) publishes clinical practice guidelines which include recommendations for dialysis dose. The urea reduction ratio (URR) is a widely used measure of dialysis dose and has historically been the measure of adequacy reported by the UKRR. This chapter aims to determine the extent to which patients achieved the recommended UK target. All 71 UK renal centres submitted data to the UK Renal Registry (UKRR). Two groups of patients were included in the analyses: the prevalent HD patient population on 30st September 2012 and the incident HD patient population for 2011. Centres returning data on <50% of their patient population or centres with <20 patients were excluded from centrespecific comparisons. Data regarding URR were available from 63 renal centres in the UK. Forty nine centres provided URR data on more than 90% of prevalent HD patients. The proportion of patients in the UK who met the UK clinical practice guideline for URR (>65%) increased from 69% in 2000 to 88% in 2012. There was persistent variation observed between centres, with 21 centres attaining the RA clinical practice guideline in >90% of patients, 38 centres attaining the guideline in 70-90% of patients and one centre in less than 70% of patients. The overall proportion of prevalent HD patients with a URR >65% has continued to improve over time. The delivered dose of HD, as measured by URR for patients with established renal failure, has increased over the last decade. Whilst the majority of UK patients achieved the target URR there was considerable variation between centres in the percentage of patients achieving the current guideline. © 2014 S. Karger AG, Basel.

IS INCREASED HCV CASE-FINDING COMBINED WITH CURRENT OR 8–12 WEEK DAA THERAPY COST-EFFECTIVE IN UK PRISONS? A PREVENTION BENEFIT ANALYSIS

PubMed Central

Martin, Natasha K; Vickerman, Peter; Brew, Iain F; Williamson, Joan; Miners, Alec; Irving, William L; Saksena, Sushma; Hutchinson, Sharon J; Mandal, Sema; O’Moore, Eamonn; Hickman, Matthew

2016-01-01

Background Prisoners have a high prevalence of Hepatitis C virus (HCV), but case-finding may not have been cost-effective because treatment often exceeded average prison stay combined with a lack of continuity-of-care. We assess the cost-effectiveness of increased HCV case-finding and treatment in UK prisons using short-course therapies. Methods A dynamic HCV transmission model assesses the cost-effectiveness of doubling HCV case-finding (achieved through introducing opt-out HCV testing in UK pilot prisons) and increasing treatment in UK prisons, compared to status-quo voluntary risk-based testing (6% prison entrants/year), using currently recommended therapies (8–24 weeks) or IFN-free DAAs (8–12 weeks, 95% SVR, £3300/wk). Costs (GBP£) and health utilities (quality-adjusted life-years, QALYs) were used to calculate mean incremental cost-effectiveness ratios (ICERs). We assume 56% referral and 2.5%/25% of referred people who inject drugs (PWID)/exPWID treated within 2 months of diagnosis in prison. PWID and ex/nonPWID are in prison an average 4/8 months, respectively. Results Doubling prison testing rates with existing treatments produces a mean ICER of £19,850/QALY gained compared to current testing/treatment, and is 45% likely to be cost-effective under a £20,000 willingness-to-pay (WTP) threshold. Switching to 8–12 week IFN-free DAAs in prisons could increase cost-effectiveness (ICER £15,090/QALY gained). Excluding prevention benefit decreases cost-effectiveness. If >10% referred PWID are treated in prison (2.5% base-case), either treatment could be highly cost-effective (ICER<£13,000). HCV case-finding and IFN-free DAAs could be highly cost-effective if DAA cost is 10% lower or 8 weeks duration. Conclusions Increased HCV testing in UK prisons (such as through opt-out testing) is borderline cost-effective compared to status-quo voluntary risk-based testing under a £20,000 WTP with current treatments, but likely to be cost-effective if short-course IFN-free DAAs are used, and could be highly cost-effective if PWID treatment rates were increased. PMID:26864802

Why don't Practitioners use Reservoir Optimization Methods? Results from a Survey of UK Water Managers

NASA Astrophysics Data System (ADS)

Dobson, B.; Pianosi, F.; Wagener, T.

2016-12-01

Extensive scientific literature exists on the study of how operation decisions in water resource systems can be made more effectively through the use of optimization methods. However, to the best of the authors' knowledge, there is little in the literature on the implementation of these optimization methods by practitioners. We have performed a survey among UK reservoir operators to assess the current state of method implementation in practice. We also ask questions to assess the potential for implementation of operation optimization. This will help academics to target industry in their current research, identify any misconceptions in industry about the area and open new branches of research for which there is an unsatisfied demand. The UK is a good case study because the regulatory framework is changing to impose "no build" solutions for supply issues, as well as planning across entire water resource systems rather than individual components. Additionally there is a high appetite for efficiency due to the water industry's privatization and most operators are part of companies that control multiple water resources, increasing the potential for cooperation and coordination.

A survey of current consultant practice of treatment of severe ankle sprains in emergency departments in the United Kingdom

PubMed Central

Cooke, M; Lamb, S; Marsh, J; Dale, J

2003-01-01

Objective: To determine current consultant practice in larger UK emergency departments in the management of severe ankle sprains. Design: Questionnaire study to all UK emergency departments seeing more than 50 000 new patients per year. Results: 70% response rate. Most popular treatment was ice, elevation, Tubigrip, and exercise, each of which was reported as used in most cases by over 70% of respondents. Crutches, early weight bearing, and non-steroidal anti-inflammatory drugs were each reported as used in most cases at over half of responding departments. Physiotherapy was usually only used in selected cases. Rest was usually advised for one to three days (35%). Follow up was only recommended for selected patients. Conclusions: The results of this survey suggest that there is considerable variation in some aspects of the clinical approach (including drug treatment, walking aids, periods of rest) taken to the management of severe ankle sprains in the UK, although in some areas (for example, not routinely immobilising, early weight bearing as pain permits, use of physiotherapy, use of rest, ice, and elevation) there was concordance. PMID:14623832

A streamlined software environment for situated skills

NASA Technical Reports Server (NTRS)

Yu, Sophia T.; Slack, Marc G.; Miller, David P.

1994-01-01

This paper documents a powerful set of software tools used for developing situated skills. These situated skills form the reactive level of a three-tiered intelligent agent architecture. The architecture is designed to allow these skills to be manipulated by a task level engine which is monitoring the current situation and selecting skills necessary for the current task. The idea is to coordinate the dynamic activations and deactivations of these situated skills in order to configure the reactive layer for the task at hand. The heart of the skills environment is a data flow mechanism which pipelines the currently active skills for execution. A front end graphical interface serves as a debugging facility during skill development and testing. We are able to integrate skills developed in different languages into the skills environment. The power of the skills environment lies in the amount of time it saves for the programmer to develop code for the reactive layer of a robot.

Qualitative risk analysis of introducing Batrachochytrium dendrobatidis to the UK through the importation of live amphibians.

PubMed

Peel, Alison J; Hartley, Matt; Cunningham, Andrew A

2012-03-20

The international amphibian trade is implicated in the emergence and spread of the amphibian fungal disease chytridiomycosis, which has resulted in amphibian declines and extinctions globally. The establishment of the causal pathogen, Batrachochytrium dendrobatidis (Bd), in the UK could negatively affect the survival of native amphibian populations. In recognition of the ongoing threat that it poses to amphibians, Bd was recently included in the World Organisation for Animal Health Aquatic Animal Health Code, and therefore is in the list of international notifiable diseases. Using standardised risk analysis guidelines, we investigated the likelihood that Bd would be introduced to and become established in wild amphibians in the UK through the importation of live amphibians. We obtained data on the volume and origin of the amphibian trade entering the UK and detected Bd infection in amphibians being imported for the pet and private collection trade and also in amphibians already held in captive pet, laboratory and zoological collections. We found that current systems for recording amphibian trade into the UK underestimate the volume of non-European Union trade by almost 10-fold. We identified high likelihoods of entry, establishment and spread of Bd in the UK and the resulting major overall impact. Despite uncertainties, we determined that the overall risk estimation for the introduction of Bd to the UK through the importation of live amphibians is high and that risk management measures are required, whilst ensuring that negative effects on legal trade are minimised.

The Medical Boomerang: will it come back?

PubMed

McDermott, Cian; Sheridan, Michael; Moore, Katie; Gosbell, Andrew

2015-04-01

To explore the increasing numbers of emergency medicine (EM) registrars that obtained their primary medical degree from UK or Irish universities, who work in emergency departments (ED) throughout Australia and New Zealand. The Victorian Emergency Registrar Study was published at the Australasian College for Emergency Medicine (ACEM) annual scientific meeting in Adelaide in November 2013. As a follow on, ACEM provided the authors with data regarding country of primary degree for international medical graduates (IMG) working as registrars in Australasian EDs. UK and Irish EM registrars make up the largest proportion of IMGs working in Australian and New Zealand EDs. These figures have increased from 34% in 2008 to 45% in 2013. In 2013, there was the highest yearly intake of UK and Irish ED IMG registrars, representing 41% of registrars joining the Australasian EM training programme. Current data show that >25% of all ED registrars working in Australasian EDs studied for their primary medical degree in a university either in Ireland or the UK. While there have been anecdotal reports of increased outflow of junior EM doctors from the UK and Ireland, we provide quantitative data on the extent of the recent (5-year trend data) emigration of UK/Irish EM trainees to Australia and New Zealand and discuss the impact of this on both the UK/Irish and Australasian health systems. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Teaching cultural diversity: current status in U.K., U.S., and Canadian medical schools.

PubMed

Dogra, Nisha; Reitmanova, Sylvia; Carter-Pokras, Olivia

2010-05-01

In this paper we present the current state of cultural diversity education for undergraduate medical students in three English-speaking countries: the United Kingdom (U.K.), United States (U.S.) and Canada. We review key documents that have shaped cultural diversity education in each country and compare and contrast current issues. It is beyond the scope of this paper to discuss the varied terminology that is immediately evident. Suffice it to say that there are many terms (e.g. cultural awareness, competence, sensitivity, sensibility, diversity and critical cultural diversity) used in different contexts with different meanings. The major issues that all three countries face include a lack of conceptual clarity, and fragmented and variable programs to teach cultural diversity. Faculty and staff support and development, and ambivalence from both staff and students continue to be a challenge. We suggest that greater international collaboration may help provide some solutions.

Integrating Radiology and Anatomy Teaching in Medical Education in the UK--The Evidence, Current Trends, and Future Scope.

PubMed

Heptonstall, N B; Ali, T; Mankad, K

2016-04-01

This review article presents the current evidence of the importance of integrating radiology and anatomy in medical education in the UK, a recommendation by a number of key anatomy, education, and radiology organizations. Current evidence highlights that on average only 5% of total teaching time in medical education is dedicated to radiology. Often, radiology teaching does not adequately fulfill students' learning needs and potentially leaves them underprepared for medical practice. Benefits of integrating radiology and anatomy include improved clinical application of anatomy, an increase in student's interest in anatomy, and ultimately improved radiological interpretation. Various modalities exist for the integration of radiology and anatomy, facilitated by the vast portability of radiological images. It appears that combining radiological resources with traditional anatomy teaching methodology in a blended approach is most beneficial. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Current provision of care for older persons in A & E units in the UK.

PubMed

Howe, C A

1998-10-01

This study investigates the state of care for older persons within Accident and Emergency (A & E) units in the UK. As the proportion of older persons in the population continues to inexorably increase, A & E units will be expected to cope with a greater number of older people than ever before. Are they prepared for this increase, and do they possess the skills, knowledge and environment to care adequately for older people and the many special problems they present? One hundred A & E units were surveyed by a postal questionnaire consisting of a benchmark of best practice deemed by literature search and expert opinion to be important in caring for older persons in A & E. The data produced gives an overall picture of the current provision of care for older persons in A & E units, and indicates to fellow A & E nursing professionals where current performance may be improved.

Advice and guidance on the admissions process to UK dental schools.

PubMed

McAndrew, Robert; Salem-Rahemi, Morva

2013-03-01

Students looking to read dentistry can be overwhelmed by the information and requirements presented to them by dental schools, career advisors and the printed literature. In the UK, there are currently 16 dental schools which provide a dentistry degree. While there are variations in the specific aspects of the dental courses at each school, there are common principles and generic application requirements that apply. This paper provides a guide to facilitate applications and inform potential students, career advisors and dentists. The information presented has been gathered from UK dental school websites and university prospectuses and corroborated through contact with university admissions offices. This paper is relevant to dental practitioners who are often asked to provide advice on applications to dental schools by potential students.

Long-term impact of sewage sludge application on soil microbial biomass: An evaluation using meta-analysis.

PubMed

Charlton, Alex; Sakrabani, Ruben; Tyrrel, Sean; Rivas Casado, Monica; McGrath, Steve P; Crooks, Bill; Cooper, Pat; Campbell, Colin D

2016-12-01

The Long-Term Sludge Experiments (LTSE) began in 1994 as part of continuing research into the effects of sludge-borne heavy metals on soil fertility. The long-term effects of Zn, Cu, and Cd on soil microbial biomass carbon (C mic ) were monitored for 8 years (1997-2005) in sludge amended soils at nine UK field sites. To assess the statutory limits set by the UK Sludge (Use in Agriculture) Regulations the experimental data has been reviewed using the statistical methods of meta-analysis. Previous LTSE studies have focused predominantly on statistical significance rather than effect size, whereas meta-analysis focuses on the magnitude and direction of an effect, i.e. the practical significance, rather than its statistical significance. The results presented here show that significant decreases in C mic have occurred in soils where the total concentrations of Zn and Cu fall below the current UK statutory limits. For soils receiving sewage sludge predominantly contaminated with Zn, decreases of approximately 7-11% were observed at concentrations below the UK statutory limit. The effect of Zn appeared to increase over time, with increasingly greater decreases in C mic observed over a period of 8 years. This may be due to an interactive effect between Zn and confounding Cu contamination which has augmented the bioavailability of these metals over time. Similar decreases (7-12%) in C mic were observed in soils receiving sewage sludge predominantly contaminated with Cu; however, C mic appeared to show signs of recovery after a period of 6 years. Application of sewage sludge predominantly contaminated with Cd appeared to have no effect on C mic at concentrations below the current UK statutory limit. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The impact of CFS/ME on employment and productivity in the UK: a cross-sectional study based on the CFS/ME national outcomes database.

PubMed

Collin, Simon M; Crawley, Esther; May, Margaret T; Sterne, Jonathan A C; Hollingworth, William

2011-09-15

Few studies have investigated factors associated with discontinuation of employment in patients with CFS/ME or quantified its impact on productivity. We used patient-level data from five NHS CFS/ME services during the period 01/04/2006-31/03/2010 collated in the UK CFS/ME National Outcomes Database. We used logistic regression to identify factors associated with discontinuation of employment. We estimated UK-wide productivity costs using patient-level data on duration of illness before assessment by a CFS/ME service, duration of unemployment, age, sex and numbers of patients, in conjunction with Office for National Statistics income and population data. Data were available for 2,170 patients, of whom 1,669 (76.9%) were women. Current employment status was recorded for 1,991 patients (91.8%), of whom 811 patients (40.7%) were currently employed and 998 (50.1%) had discontinued their employment "because of fatigue-related symptoms". Older age, male sex, disability, fatigue, pain, and duration of illness were associated with cessation of employment. In a multivariable model, age, male sex, and disability remained as independent predictors. Total productivity costs among the 2,170 patients due to discontinuation of employment in the years preceding assessment by a specialist CFS/ME service (median duration of illness=36 months) were £49.2 million. Our sample was equivalent to 4,424 UK adults accessing specialist services each year, representing productivity costs to the UK economy of £102.2 million. Sensitivity analyses suggested a range between £75.5-£128.9 million. CFS/ME incurs huge productivity costs amongst the small fraction of adults with CFS/ME who access specialist services.

In vivo dosimetry in UK external beam radiotherapy: current and future usage.

PubMed

MacDougall, Niall D; Graveling, Michael; Hansen, Vibeke N; Brownsword, Kevin; Morgan, Andrew

2017-04-01

Towards Safer Radiotherapy recommended that radiotherapy (RT) centres should have protocols in place for in vivo dosimetry (IVD) monitoring at the beginning of patient treatment courses (Donaldson S. Towards safer radiotherapy. R Coll Radiol 2008). This report determines IVD implementation in the UK in 2014, the methods used and makes recommendations on future use. Evidence from peer-reviewed journals was used in conjunction with the first survey of UK RT centre IVD practice since the publication of Towards Safer Radiotherapy. In March 2014, profession-specific questionnaires were sent to radiographer, clinical oncologist and physics staff groups in each of the 66 UK RT centres. Response rates from each group were 74%, 45% and 74%, respectively. 73% of RT centres indicated that they performed IVD. Diodes are the most popular IVD device. Thermoluminescent dosimeter (TLD) is still in use in a number of centres but not as a sole modality, being used in conjunction with diodes and/or electronic portal imaging device (EPID). The use of EPID dosimetry is increasing and is considered of most potential value for both geometric and dosimetric verification. Owing to technological advances, such as electronic data transfer, independent monitor unit checking and daily image-guided radiotherapy, the overall risk of adverse treatment events in RT has been substantially reduced. However, the use of IVD may prevent a serious radiation incident. Point dose IVD is not considered suited to the requirements of verifying advanced RT techniques, leaving EPID dosimetry as the current modality likely to be developed as a future standard. Advances in knowledge: An updated perspective on UK IVD use and provision of professional guidelines for future implementation.

Digital pathology access and usage in the UK: results from a national survey on behalf of the National Cancer Research Institute's CM-Path initiative.

PubMed

Williams, Bethany Jill; Lee, Jessica; Oien, Karin A; Treanor, Darren

2018-05-01

To canvass the UK pathology community to ascertain current levels of digital pathology usage in clinical and academic histopathology departments, and prevalent attitudes to digital pathology. A 15-item survey was circulated to National Health Service and academic pathology departments across the UK using the SurveyMonkey online survey tool. Responses were sought at a departmental or institutional level. Where possible, departmental heads were approached and asked to complete the survey, or forward it to the most relevant individual in their department. Data were collected over a 6-month period from February to July 2017. 41 institutes from across the UK responded to the survey. 60% (23/39) of institutions had access to a digital pathology scanner, and 60% (24/40) had access to a digital pathology workstation. The most popular applications of digital pathology in current use were undergraduate and postgraduate teaching, research and quality assurance. Investigating the deployment of digital pathology in their department was identified as a high or highest priority by 58.5% of institutions, with improvements in efficiency, turnaround times, reporting times and collaboration in their institution anticipated by the respondents. Access to funding for initial hardware, software and staff outlay, pathologist training and guidance from the Royal College of Pathologists were identified as factors that could enable respondent institutions to increase their digital pathology usage. Interest in digital pathology adoption in the UK is high, with usage likely to increase in the coming years. In light of this, pathologists are seeking more guidance on safe usage. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

In vivo dosimetry in UK external beam radiotherapy: current and future usage

PubMed Central

Graveling, Michael; Hansen, Vibeke N; Brownsword, Kevin; Morgan, Andrew

2017-01-01

Objective: Towards Safer Radiotherapy recommended that radiotherapy (RT) centres should have protocols in place for in vivo dosimetry (IVD) monitoring at the beginning of patient treatment courses (Donaldson S. Towards safer radiotherapy. R Coll Radiol 2008). This report determines IVD implementation in the UK in 2014, the methods used and makes recommendations on future use. Methods: Evidence from peer-reviewed journals was used in conjunction with the first survey of UK RT centre IVD practice since the publication of Towards Safer Radiotherapy. In March 2014, profession-specific questionnaires were sent to radiographer, clinical oncologist and physics staff groups in each of the 66 UK RT centres. Results: Response rates from each group were 74%, 45% and 74%, respectively. 73% of RT centres indicated that they performed IVD. Diodes are the most popular IVD device. Thermoluminescent dosimeter (TLD) is still in use in a number of centres but not as a sole modality, being used in conjunction with diodes and/or electronic portal imaging device (EPID). The use of EPID dosimetry is increasing and is considered of most potential value for both geometric and dosimetric verification. Conclusion: Owing to technological advances, such as electronic data transfer, independent monitor unit checking and daily image-guided radiotherapy, the overall risk of adverse treatment events in RT has been substantially reduced. However, the use of IVD may prevent a serious radiation incident. Point dose IVD is not considered suited to the requirements of verifying advanced RT techniques, leaving EPID dosimetry as the current modality likely to be developed as a future standard. Advances in knowledge: An updated perspective on UK IVD use and provision of professional guidelines for future implementation. PMID:28205452

Digital pathology access and usage in the UK: results from a national survey on behalf of the National Cancer Research Institute’s CM-Path initiative

PubMed Central

Williams, Bethany Jill; Lee, Jessica; Oien, Karin A; Treanor, Darren

2018-01-01

Aim To canvass the UK pathology community to ascertain current levels of digital pathology usage in clinical and academic histopathology departments, and prevalent attitudes to digital pathology. Methods A 15-item survey was circulated to National Health Service and academic pathology departments across the UK using the SurveyMonkey online survey tool. Responses were sought at a departmental or institutional level. Where possible, departmental heads were approached and asked to complete the survey, or forward it to the most relevant individual in their department. Data were collected over a 6-month period from February to July 2017. Results 41 institutes from across the UK responded to the survey. 60% (23/39) of institutions had access to a digital pathology scanner, and 60% (24/40) had access to a digital pathology workstation. The most popular applications of digital pathology in current use were undergraduate and postgraduate teaching, research and quality assurance. Investigating the deployment of digital pathology in their department was identified as a high or highest priority by 58.5% of institutions, with improvements in efficiency, turnaround times, reporting times and collaboration in their institution anticipated by the respondents. Access to funding for initial hardware, software and staff outlay, pathologist training and guidance from the Royal College of Pathologists were identified as factors that could enable respondent institutions to increase their digital pathology usage. Conclusion Interest in digital pathology adoption in the UK is high, with usage likely to increase in the coming years. In light of this, pathologists are seeking more guidance on safe usage. PMID:29317516

Do personality traits assessed on medical school admission predict exit performance? A UK-wide longitudinal cohort study.

PubMed

MacKenzie, R K; Dowell, J; Ayansina, D; Cleland, J A

2017-05-01

Traditional methods of assessing personality traits in medical school selection have been heavily criticised. To address this at the point of selection, "non-cognitive" tests were included in the UK Clinical Aptitude Test, the most widely-used aptitude test in UK medical education (UKCAT: http://www.ukcat.ac.uk/ ). We examined the predictive validity of these non-cognitive traits with performance during and on exit from medical school. We sampled all students graduating in 2013 from the 30 UKCAT consortium medical schools. Analysis included: candidate demographics, UKCAT non-cognitive scores, medical school performance data-the Educational Performance Measure (EPM) and national exit situational judgement test (SJT) outcomes. We examined the relationships between these variables and SJT and EPM scores. Multilevel modelling was used to assess the relationships adjusting for confounders. The 3343 students who had taken the UKCAT non-cognitive tests and had both EPM and SJT data were entered into the analysis. There were four types of non-cognitive test: (1) libertariancommunitarian, (2) NACE-narcissism, aloofness, confidence and empathy, (3) MEARS-self-esteem, optimism, control, self-discipline, emotional-nondefensiveness (END) and faking, (4) an abridged version of 1 and 2 combined. Multilevel regression showed that, after correcting for demographic factors, END predicted SJT and EPM decile. Aloofness and empathy in NACE were predictive of SJT score. This is the first large-scale study examining the relationship between performance on non-cognitive selection tests and medical school exit assessments. The predictive validity of these tests was limited, and the relationships revealed do not fit neatly with theoretical expectations. This study does not support their use in selection.

Embodiment of discrimination and overseas nurses' career progression.

PubMed

Larsen, John Aggergaard

2007-12-01

To examine empirically and in-depth how discriminatory attitudes and practices are experienced by overseas nurses and how the discrimination may affect their well-being and career progression and, furthermore, to apply the theoretical perspective of embodiment in understanding these processes. The UK healthcare sector has, in recent years, relied on overseas-trained professionals to fill up vacancies in nursing and other professions. Research shows that overseas nurses claim that their UK colleagues, managers and patients express discriminatory, racist and xenophobic attitudes. The paper provides an existential phenomenological analysis of in-depth interviews with two overseas nurses. The data are drawn from a study of overseas-trained healthcare workers' experiences working and living in the UK. The two cases have been purposively selected to provide an illumination and discussion of personal experiences with discrimination, how individuals may respond to these and how their professional career is affected. Discrimination towards migrant workers may, at times, be experienced as 'blatant racism' or, in more subtle forms, as 'aversive racism'. It is demonstrated how such discrimination may impact on the afflicted person's sense of self, suggesting a theoretical model of the embodiment of discrimination. Discrimination not only works at an interpersonal and institutional level, but is a form of 'symbolic violence' that may be internalized to affect the person's 'habitus'; it can be resisted through meaning-making activity that explains and hence objectifies and embodies the experience in a way that allows individuals to positively influence their situation through agency. This article details how social and institutionalized discrimination in the UK healthcare sector may be internalized by overseas workers and affects their professional careers. The study allows a theoretical reflection on the damage inflicted by discrimination, and it may contribute to the eradication of discriminatory practices and the development of necessary support and monitoring mechanisms.

Long-term measurements of atmospheric trace gases (CO2, CH4, N2O, SF6, CO, H2), O2, and δ13CH4 isotopes at Weybourne Atmospheric Observatory, UK: past, present and future

NASA Astrophysics Data System (ADS)

Manning, Andrew C.; Forster, Grant L.; Oram, David E.; Reeves, Claire E.; Pickers, Penelope A.; Barningham, S. Thomas; Sturges, William T.; Bandy, Brian; Nisbet, Euan G.; Lowry, David; Fisher, Rebecca; Fleming, Zoe

2016-04-01

The Weybourne Atmospheric Observatory (WAO) is situated on the north Norfolk Coast (52.95°N, 1.13°E) in the United Kingdom and is run by the University of East Anglia (UEA), with support from the UK National Centre for Atmospheric Science (NCAS). In 2016, the WAO became a UK-ICOS (Integrated Carbon Observing System) monitoring station. Since 2008, we have been collecting high-precision long-term in situ measurements of atmospheric carbon dioxide (CO2), oxygen (O2), carbon monoxide (CO) and molecular hydrogen (H2), as well as regular bag sampling for δ13CH4. In early 2013, the measurement of atmospheric methane (CH4) commenced, and nitrous oxide (N2O) and sulphur hexafluoride (SF6) began in 2014. We summarise the CO2, O2, CH4, N2O, SF6, CO, H2 and δ13CH4 measurements made to date and highlight some key features observed (e.g. seasonal cycles, long-term trends, pollution events and deposition events). We summarise how the long-term measurements fit into other broader projects which have helped to support the long term time-series at WAO over the years, and highlight how we contribute to broader global atmospheric observation networks.

The interference of paid work with household demands in different social policy contexts: perceived work-household conflict in Sweden, the UK, the Netherlands, Hungary, and the Czech Republic.

PubMed

Strandh, Mattias; Nordenmark, Mikael

2006-12-01

The article explores whether people experiences a lower level of work-household conflict in a context that is characterized by extensive family policies (Sweden and to some extent Hungary and Czech Republic) aimed at facilitating participation in the labour market. This is done by studying perceived work-household conflict among women and men living in Sweden, the UK, the Netherlands, Hungary, and the Czech Republic. The analyses are based on the answers to a questionnaire distributed to nearly 6,000 randomly selected individuals within the framework of the European Union financed 'Household, Work, and Flexibility' (HWF) study. The results show that women in Sweden experience conflicts between work and household demands to a higher degree than any other category in all five countries. The differences between Swedish women and women living in the Netherlands and the UK are explained by variables indicating qualifications and workload in the main job, but the lower degree of work-household conflict among Czech and Hungarian women is still significant when controlling for household composition and working conditions. Data indicate that a possible explanation for this can be found in the interplay between men's and women's attitudes toward gender roles and the actual situation in terms of division of labour.

Support needs and experiences of family members of wounded, injured or sick UK service personnel.

PubMed

Verey, Anna; Keeling, M; Thandi, G; Stevelink, S; Fear, N

2017-12-01

When a service person has been wounded, injured or sick (WIS), family members may provide care during their recovery in an unpaid capacity. This may occur in diverse environments including hospitals, inpatient rehabilitation centres, in the community and at home. Thirty-seven family members of WIS personnel were interviewed regarding their support needs, family relationships and use of UK support services. Semistructured, in-depth telephone interviews were used, with data analysis undertaken using a thematic approach. 'Family member involvement' was the main theme under which four subthemes were situated: 'continuity of support', 'proactive signposting and initiating contact', 'psychoeducation and counselling' and 'higher risk groups'. Family members felt they might benefit from direct, consistent and continuous care regardless of the WIS person's injury or engagement type, and whether the WIS person was being treated in a hospital, rehabilitative centre or at home. The findings of this study suggest that family members of WIS personnel value proactive, direct and sustained communication from support service providers. We suggest that families of UK service personnel may benefit from family care coordinators, who could provide continuous and consistent care to family members of WIS personnel. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Current Situation and Prospects of Emergency Medical Equipment in Our Country].

PubMed

Qi, Lijing; Cheng, Feng

2016-03-01

This article analyzes the new demand of emergency medical equipment in the current development trend based on the analysis of the development and current situation of emergency medicine in our country. At the same time it introduces the current industrial characteristics of our country. Finally it analyzes the development trend of this kind of equipment in the new emergency medicine field.

Think tank (1) - Its definition and the overseas situation

NASA Astrophysics Data System (ADS)

Obara, Michio

The definition as organization is that 1) the think tank should be policy oriented and propose the current issues, 2) it should be interdisciplinary and future oriented, and 3) it should be independent without any outside interference upon it. It is divided into three types in terms of business activity; 1) policy proposing, 2) R&D undertaking and 3) business consulting think tanks. Historically the U.S. has been leading the world because the first think tank was born in this country, and three types of think tanks have brought out the mature business undertakings there. Most of the countries other than the U.S. has held policy proposing type think tanks. The notable think tanks are Brookings Research Institute, Rand Research Institute, Battelle Memorial Institute, Arthur D. Little Co. Ltd. SRI International in the U.S.A., IFO Economic Research Institute, German Economic Research Institute in Germany, France International Relations Research Institute in France, Royal International Relations Research institute, International Strategic Matters Research Institute in the U.K., and Korean Development Research Institute, Korean industrial Research Institute in Korea. All of these have been active in the areas of politics, economics, industry and technology.

Substitute decision-making for adults with intellectual disabilities living in residential care: learning through experience.

PubMed

Dunn, Michael C; Clare, Isabel C H; Holland, Anthony J

2008-03-01

In the UK, current policies and services for people with mental disorders, including those with intellectual disabilities (ID), presume that these men and women can, do, and should, make decisions for themselves. The new Mental Capacity Act (England and Wales) 2005 (MCA) sets this presumption into statute, and codifies how decisions relating to health and welfare should be made for those adults judged unable to make one or more such decisions autonomously. The MCA uses a procedural checklist to guide this process of substitute decision-making. The personal experiences of providing direct support to seven men and women with ID living in residential care, however, showed that substitute decision-making took two forms, depending on the type of decision to be made. The first process, 'strategic substitute decision-making', paralleled the MCA's legal and ethical framework, whilst the second process, 'relational substitute decision-making', was markedly different from these statutory procedures. In this setting, 'relational substitute decision-making' underpinned everyday personal and social interventions connected with residents' daily living, and was situated within a framework of interpersonal and interdependent care relationships. The implications of these findings for residential services and the implementation of the MCA are discussed.

Marginalization and symbolic violence in a world of differences: war and parallels to nursing practice.

PubMed

Hall, Joanne M

2004-04-01

Marginalization has been used as a guiding concept for nursing research, theory and practice. Its properties have been identified and updated in 1994 and 1999, respectively. This article re-examines marginalization, considering it to be a concept that changes with pivotal historical events. The events of September 11, 2001, and the war between the US/UK and Iraq are such pivotal events. The notion of the linguistic habitus and symbolic violence as outlined by Bourdieu provide new insights about the dynamics of marginalization. Specifically noted is the marginalization of persons and cultures based on their designation by the current US administration, and as interpreted through mainstream media, as actual or potential 'terrorists'. A parallel situation in nursing is discussed, beginning with nursing's own marginality, related to the dynamics of symbolic violence. Nursing is argued to be vulnerable to having essential words and practices co-opted by dominant institutions and altered in meaning, that is, made incongruent with the discipline's emphasis on core values of confidentiality, equity and care. In response to marginalization and exteriorization those affected can use voice and testimony to 'recreate the centre'. Suggestions for protecting our practices and philosophy are included.

OFT, VBP: QED?

PubMed

Claxton, Karl

2007-06-01

The report by the Office of Fair Trading (OFT) on the UK pharmaceutical price regulation scheme (PPRS) recommends the reform of the current scheme, which is a combination of profit and price controls, to one where price is based on the health benefits offered by a pharmaceutical. On closer examination some of the more commonly expressed concerns about these proposals do not seem to be well founded. In principle, the OFT's recommendations may contribute to allocative and dynamic efficiency in the NHS. However, there are some dangers and the details of how it will be implemented are crucial. For example, value-based pricing with an inappropriate threshold for cost-effectiveness, or an inappropriate pricing structure, could lead to technologies being adopted at prices where their benefits, in terms of health outcome, do not offset the health displaced elsewhere in the NHS, a situation in which the NHS is damaged rather than improved by innovation. A failure to account for uncertainty and the value of evidence in negotiating prices and coverage could also undermine the evidence base for future NHS practice. Whatever view is taken, the OFT report will inevitably shape the scope of future policy debates about value, guidance, price and innovation.

Re-visioning evidence: Reflections on the recent controversy around gender selective abortion in the UK.

PubMed

Unnithan, Maya; Dubuc, Sylvie

2018-06-01

Reports in the British media over the last 4 years have highlighted the schisms and contestations that have accompanied the reports of gender selective abortions amongst British Asian families. The position that sex-selection may be within the terms of the 1967 Abortion Act has particularly sparked controversy amongst abortion campaigners and politicians but equally among medical practitioners and the British Pregnancy Advisory Service who have hitherto tended to stay clear of such debates. In what ways has the controversy around gender-based abortion led to new framings of the entitlement to service provision and new ways of thinking about evidence in the context of reproductive rights? We reflect on these issues drawing on critiques of what constitutes best evidence, contested notions of reproductive rights and reproductive governance, comparative work in India and China as well as our involvement with different groups of campaigners including British South Asian NGOs. The aim of the paper is to situate the medical and legal provision of abortion services in Britain within current discursive practices around gender equality, ethnicity, reproductive autonomy, probable and plausible evidence, and policies of health reform.

The legal framework for end-of-life decisions in the UK.

PubMed

Rennie, Janet M; Leigh, Bertie

2008-10-01

We have reviewed the current UK guidance regarding withholding and withdrawing life-prolonging treatment in the infant and termination of pregnancy for fetal malformation. We provide summaries of the key cases. The framework provided by professional bodies and the law in this difficult area stresses the importance of good and frequent communication between different professional groups and parents with early recourse to second opinions if a difference of view emerges. Legal proceedings should be used only as a last resort.

F-35 Joint Strike Fighter (JSF) Program: Background and Issues for Congress

DTIC Science & Technology

2011-04-26

bulkheads on the F-22.”28 Third, the driveshaft, lift-fan clutch, and actuator for the F-35B’s roll-post nozzles will be redesigned following...levels of participation in the program. International partners are also assisting with Initial Operational Test and Evaluation ( IOT &E), a subset of...Week/Ares blog, March 15, 2010. 59 Currently, the UK, Italy, and the Netherlands have agreed to participate in the IOT &E program. UK, the senior F

Implications for the UK of solar-power satellites /s.p.s/ as an energy source

NASA Technical Reports Server (NTRS)

Shelton, R. M.

1980-01-01

The solar power satellite concept which would make the sun's radiation available on earth as a source of energy, is discussed. Attention is given to the concept currently under evaluation in the USA, and also in Europe, though to a lesser extent. The advantages and problems associated with its adoption by the UK as a major source of electrical energy are discussed. The discussion covers topics such as sizing, reference system, and construction, costs, and problem areas.

Health effects of adopting low greenhouse gas emission diets in the UK

PubMed Central

Milner, James; Green, Rosemary; Dangour, Alan D; Haines, Andy; Chalabi, Zaid; Spadaro, Joseph; Markandya, Anil; Wilkinson, Paul

2015-01-01

Objective Dietary changes which improve health are also likely to be beneficial for the environment by reducing emissions of greenhouse gases (GHG). However, previous analyses have not accounted for the potential acceptability of low GHG diets to the general public. This study attempted to quantify the health effects associated with adopting low GHG emission diets in the UK. Design Epidemiological modelling study. Setting UK. Participants UK population. Intervention Adoption of diets optimised to achieve the WHO nutritional recommendations and reduce GHG emissions while remaining as close as possible to existing dietary patterns. Main outcome Changes in years of life lost due to coronary heart disease, stroke, several cancers and type II diabetes, quantified using life tables. Results If the average UK dietary intake were optimised to comply with the WHO recommendations, we estimate an incidental reduction of 17% in GHG emissions. Such a dietary pattern would be broadly similar to the current UK average. Our model suggests that it would save almost 7 million years of life lost prematurely in the UK over the next 30 years and increase average life expectancy by over 8 months. Diets that result in additional GHG emission reductions could achieve further net health benefits. For emission reductions greater than 40%, improvements in some health outcomes may decrease and acceptability will diminish. Conclusions There are large potential benefits to health from adopting diets with lower associated GHG emissions in the UK. Most of these benefits can be achieved without drastic changes to existing dietary patterns. However, to reduce emissions by more than 40%, major dietary changes that limit both acceptability and the benefits to health are required. PMID:25929258

UK medical education on human trafficking: assessing uptake of the opportunity to shape awareness, safeguarding and referral in the curriculum.

PubMed

Arulrajah, Poojani; Steele, Sarah

2018-06-13

Human trafficking is a serious violation of human rights, with numerous consequences for health and wellbeing. Recent law and policy reforms mean that clinicians now hold a crucial role in national strategies. 2015 research, however, indicates a serious shortfall in knowledge and confidence among healthcare professionals in the UK, leading potentially to failures in safeguarding and appropriate referral. Medical education is a central point for trafficking training. We ascertain the extent of such training in UK Medical Schools, and current curricular design. We sent Freedom of Information requests to the 34 public UK medical schools, which included a preliminary question on education provision, supplemented with follow-up questions exploring the nature, delivery and format of any education, as well as future curriculum development. There was a response rate of 97%. A majority (72%) of the schools did not provide trafficking education. 13% of these did, however, offer opportunities outside the formal curriculum. 70% had no plans to implement any education opportunities. Among the 28% of schools providing teaching, 56% integrated this within the core curriculum. 56% only delivered this within a single year of the degree. 67% provided some form of teaching in-person, while 78% used a combination of methods. Medical education on trafficking in the UK is variable and often absent. To produce future clinicians who are competent and capable, there is a need for expanded education on trafficking and research into optimal curriculum design. The UK's new Independent Anti-Slavery Commissioner should work with medical schools to develop an educational strategy urgently to fulfil the UK Government's plans and commitments. Both in the UK and around the world, human trafficking education presents a critical opportunity to address human rights and safeguarding to a generation of new doctors.

A comparative analysis of drug safety withdrawals in the UK and the US (1971-1992): implications for current regulatory thinking and policy.

PubMed

Abraham, John; Davis, Courtney

2005-09-01

By going beyond individual case studies and solely quantitative surveys, this paper systematically examines why there were over twice as many new prescription drugs withdrawn from the market on grounds of safety in the UK as there were in the US between 1971 and 1992. Drawing on interviews with regulators, industry scientists and others involved, and on regulatory data never before accessed outside governments and companies, five key hypotheses which might explain this difference in drug safety withdrawals are analysed. These are: (1) simply because the UK approved more new drugs than the US; (2) because of an industrial corporate strategy to seek approval of 'less safe' drugs in the UK earlier; (3) because British regulators were more vigilant at spotting post-marketing safety problems than their US counterparts; (4) because the slowness of the US in approving new drugs enabled regulators there to learn from, and avoid, safety problems that had already emerged in the UK or European market; and (5) because more stringent regulation in the US meant that they approved fewer unsafe drugs on to the market in the first place. It is concluded that the main explanation for fewer drug safety withdrawals in the US is that the regulatory agency there applied more stringent pre-market review and/or standards, which took longer than UK regulatory checks, but prevented unsafe drugs marketed in the UK from entering the US market. Contrary to the claims frequently made by the pharmaceutical industry and regulatory agencies on both sides of the Atlantic, these results imply that it is likely that acceleration of regulatory review times in the US and the UK since the early 1990s is compromising drug safety.

Contemporary management of acute coronary syndromes: does the practice match the evidence? The global registry of acute coronary events (GRACE).

PubMed

Carruthers, K F; Dabbous, O H; Flather, M D; Starkey, I; Jacob, A; Macleod, D; Fox, K A A

2005-03-01

To determine to what extent evidence based guidelines are followed in the management of acute coronary syndromes (ACS) in the UK, elsewhere in Europe, and multinationally, and what the outcomes are. Multinational, prospective, observational registry (GRACE, global registry of acute coronary events) with six months' follow up. Patients presenting to a cluster of hospitals. The study was designed to collect data representative of the full spectrum of ACS in specific geographic populations. Patients admitted with a working diagnosis of unstable angina or suspected myocardial infarction (MI). Death during hospitalisation and at six months' follow up (adjusted for baseline risks). In ST elevation MI, reperfusion was applied more often in the UK (71%) than in Europe (65%) and multinationally (59%) (p < 0.01). However, this was almost entirely by lytic treatment, in contrast with elsewhere (primary percutaneous coronary intervention 1%, 29%, 16%, respectively). Statins were applied more frequently in the UK for all classes of patients with ACS (p < 0.0001). In contrast there was lower use of revascularisation procedures in non-ST MI (20% v 37% v 28%, respectively) and glycoprotein IIb/IIIa antagonists (6% v 25% v 26%, respectively). In-hospital death rates, adjusted for baseline risk, were not significantly different but six month death rates were higher in the UK for ST elevation MI (7.2% UK, 4.3% Europe, 5.3% multinationally; p < 0.0001) and non-ST elevation MI (7.5%, 6.2%, and 6.7%, respectively; p = 0.012, UK v Europe). Current management of ACS in the UK more closely follows the recommendations of the National Service Framework than British or European guidelines. Differences in practice may account for the observed higher event rates in the UK after hospital discharge.

Health effects of adopting low greenhouse gas emission diets in the UK.

PubMed

Milner, James; Green, Rosemary; Dangour, Alan D; Haines, Andy; Chalabi, Zaid; Spadaro, Joseph; Markandya, Anil; Wilkinson, Paul

2015-04-30

Dietary changes which improve health are also likely to be beneficial for the environment by reducing emissions of greenhouse gases (GHG). However, previous analyses have not accounted for the potential acceptability of low GHG diets to the general public. This study attempted to quantify the health effects associated with adopting low GHG emission diets in the UK. Epidemiological modelling study. UK. UK population. Adoption of diets optimised to achieve the WHO nutritional recommendations and reduce GHG emissions while remaining as close as possible to existing dietary patterns. Changes in years of life lost due to coronary heart disease, stroke, several cancers and type II diabetes, quantified using life tables. If the average UK dietary intake were optimised to comply with the WHO recommendations, we estimate an incidental reduction of 17% in GHG emissions. Such a dietary pattern would be broadly similar to the current UK average. Our model suggests that it would save almost 7 million years of life lost prematurely in the UK over the next 30 years and increase average life expectancy by over 8 months. Diets that result in additional GHG emission reductions could achieve further net health benefits. For emission reductions greater than 40%, improvements in some health outcomes may decrease and acceptability will diminish. There are large potential benefits to health from adopting diets with lower associated GHG emissions in the UK. Most of these benefits can be achieved without drastic changes to existing dietary patterns. However, to reduce emissions by more than 40%, major dietary changes that limit both acceptability and the benefits to health are required. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Sharing the British National Health Service around the world: a self-interested perspective

PubMed Central

2013-01-01

As the UK reiterates its commitment to protecting and growing its development aid budget amidst an adverse economic environment for the UK and Europe, we discuss the potential to use the country’s National Health Service (NHS) model as a vehicle for promoting the country’s economic as well as global health diplomacy and development priorities, through a coordinated cross-government plan of action. With the country’s Prime Minister serving as a co-chair of the UN post-2015 development agenda panel,a this is a unique opportunity for the UK to put forward its health system architecture as a highly applicable and well-tested model for providing access to efficient and cost-effective care, with minimal financial hardship. Arguably, such a model tailored to the needs of specific countries could consequently lead to commercial opportunities for UK plc. in areas such as consulting, training, education and healthcare products. Finally, this approach would be consistent with the current thinking on the evolving role of UK aid, especially in the case of emerging powers such as India, where the focus has shifted from aid to investment in technical assistance and cooperation as a means of boosting bilateral business and trade. PMID:24160168

Synergy between medicinal chemistry and biological research.

PubMed

Moncada, Salvador; Coaker, Hannah

2014-09-01

Salvador Moncada studied medicine at the University of El Salvador (El Salvador) before coming to the UK in 1971 to work on a PhD with Professor John Vane at the Institute of Basic Medical Sciences, Royal College of Surgeons (UK). After a short period of research at the University of Honduras (Honduras), he joined the Wellcome Research Laboratories (UK) where he became Head of the Department of Prostaglandin Research and later, Director of Research. He returned to academic life in 1996 as founder and director of the Wolfson Institute for Biomedical Research at University College London (UK). Moncada played a role in the discovery of the mechanism of action of aspirin-like drugs and later led the teams which discover prostacyclin and identified nitric oxide as a biological mediator. In his role as a Director of Research of the Wellcome Laboratories, he oversaw the discovery and development of medicines for epilepsy, migraine, malaria and cancer. Currently, he is working on the regulation of cell proliferation as Director of the Institute of Cancer Sciences at the University of Manchester (UK). Moncada has won numerous awards from the international scientific community and in 2010, he received a knighthood from Her Majesty Queen Elizabeth II for his services to science.

Sharing the British National Health Service around the world: a self-interested perspective.

PubMed

Chalkidou, Kalipso; Vega, Jeanette

2013-10-25

As the UK reiterates its commitment to protecting and growing its development aid budget amidst an adverse economic environment for the UK and Europe, we discuss the potential to use the country's National Health Service (NHS) model as a vehicle for promoting the country's economic as well as global health diplomacy and development priorities, through a coordinated cross-government plan of action. With the country's Prime Minister serving as a co-chair of the UN post-2015 development agenda panel,a this is a unique opportunity for the UK to put forward its health system architecture as a highly applicable and well-tested model for providing access to efficient and cost-effective care, with minimal financial hardship. Arguably, such a model tailored to the needs of specific countries could consequently lead to commercial opportunities for UK plc. in areas such as consulting, training, education and healthcare products. Finally, this approach would be consistent with the current thinking on the evolving role of UK aid, especially in the case of emerging powers such as India, where the focus has shifted from aid to investment in technical assistance and cooperation as a means of boosting bilateral business and trade.

Lessons from 150 years of UK maternal hemorrhage deaths.

PubMed

Kerr, Robert Stuart; Weeks, Andrew David

2015-06-01

We have reviewed maternal hemorrhage death rates in the UK over the past 150 years in order to draw lessons from this material for current attempts to reduce global maternal mortality. Mortality rates from data in the UK Annual Reports from the Registrar General were entered into a database. Charts were created to display trends in hemorrhage mortality, allowing comparison with historical medical advances. Hemorrhage death rates fell steadily before the 1930s; between 1874 and 1926 they fell by 56%. In contrast, there was no consistent reduction in overall maternal mortality rates until the 1930s; from 1932 to 1952 they fell by 85%, primarily due to a reduction in sepsis deaths. In conclusion the majority of maternal hemorrhage mortality reductions in the UK occurred prior to the availability of effective oxytocics, antibiotics, and blood transfusion. Improving access to and standards of maternal care is key to addressing global maternal mortality today. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

Problematising the `Career Academic' in UK construction and engineering education: does the system want what the system gets?

NASA Astrophysics Data System (ADS)

Pilcher, Nick; Forster, Alan; Tennant, Stuart; Murray, Mike; Craig, Nigel

2017-11-01

'Career Academics' are principally research-led, entering academia with limited or no industrial or practical experience. UK Higher Education Institutions welcome them for their potential to attain research grant funding and publish world-leading journal papers, ultimately enhancing institutional reputation. This polemical paper problematises the Career Academic around three areas: their institutional appeal; their impact on the student experience, team dynamics and broader academic functions; and current strategic policy to employ them. We also argue that recent UK Government teaching-focused initiatives will not address needs to employ practical academics, or 'Pracademics' in predominantly vocational Construction and Engineering Education. We generate questions for policy-makers, institutions and those implementing strategy. We argue that research is key, but partial rebalancing will achieve a diverse academic skill base to achieve contextualised construction and engineering education. In wider European contexts, the paper resonates with issues of academic 'drift' and provides reflection for others on the UK context.

The nutritional content of supermarket beverages: a cross-sectional analysis of New Zealand, Australia, Canada and the UK.

PubMed

Chepulis, Lynne; Mearns, Gael; Hill, Shaunie; Wu, Jason Hy; Crino, Michelle; Alderton, Sarah; Jenner, Katharine

2018-02-07

To compare the nutritional content, serving size and taxation potential of supermarket beverages from four different Western countries. Cross-sectional analysis. Multivariate regression analysis and χ 2 comparisons were used to detect differences between countries. Supermarkets in New Zealand (NZ), Australia, Canada and the UK. Supermarket beverages in the following categories: fruit juices, fruit-based drinks, carbonated soda, waters and sports/energy drinks. A total of 4157 products were analysed, including 749 from NZ, 1738 from Australia, 740 from Canada and 930 from the UK. NZ had the highest percentage of beverages with sugar added to them (52 %), while the UK had the lowest (9 %, P8 % sugar) categories. There is substantial difference between countries in the mean energy, serving size and proportion of products eligible for fiscal sugar taxation. Current self-regulatory approaches used in these countries may not be effective to reduce the availability, marketing and consumption of sugar-sweetened beverages and subsequent intake of free sugars.

Members of the YjgF/YER057c/UK114 family of proteins inhibit phosphoribosylamine synthesis in vitro.

PubMed

Lambrecht, Jennifer A; Browne, Beth Ann; Downs, Diana M

2010-11-05

The YjgF/YER057c/UK114 family of proteins is highly conserved across all three domains of life and currently lacks a consensus biochemical function. Analysis of Salmonella enterica strains lacking yjgF has led to a working model in which YjgF functions to remove potentially toxic secondary products of cellular enzymes. Strains lacking yjgF synthesize the thiamine precursor phosphoribosylamine (PRA) by a TrpD-dependent mechanism that is not present in wild-type strains. Here, PRA synthesis was reconstituted in vitro with anthranilate phosphoribosyltransferase (TrpD), threonine dehydratase (IlvA), threonine, and phosphoribosyl pyrophosphate. TrpD-dependent PRA formation in vitro was inhibited by S. enterica YjgF and the human homolog UK114. Thus, the work herein describes the first biochemical assay for diverse members of the highly conserved YjgF/YER057c/UK114 family of proteins and provides a means to dissect the cellular functions of these proteins.

Interprofessional care co-ordinators: the benefits and tensions associated with a new role in UK acute health care.

PubMed

Bridges, Jackie; Meyer, Julienne; Glynn, Michael; Bentley, Jane; Reeves, Scott

2003-08-01

While more flexible models of service delivery are being introduced in UK health and social care, little is known about the impact of new roles, particularly support worker roles, on the work of existing practitioners. This action research study aimed to explore the impact of one such new role, that of interprofessional care co-ordinators (IPCCs). The general (internal) medical service of a UK hospital uses IPCCs to provide support to the interprofessional team and, in doing so, promote efficiency of acute bed use. Using a range of methods, mainly qualitative, this action research study sought to explore the characteristics and impact of the role on interprofessional team working. While the role's flexibility, autonomy and informality contributed to success in meeting its intended objectives, these characteristics also caused some tensions with interprofessional colleagues. These benefits and tensions mirror wider issues associated with the current modernisation agenda in UK health care.

A novel approach to evaluating the UK childhood immunisation schedule: estimating the effective coverage vector across the entire vaccine programme.

PubMed

Crowe, Sonya; Utley, Martin; Walker, Guy; Panovska-Griffiths, Jasmina; Grove, Peter; Pagel, Christina

2015-12-29

The availability of new vaccines can prompt policy makers to consider changes to the routine childhood immunisation programme in the UK. Alterations to one aspect of the schedule may have implications for other areas of the programme (e.g. adding more injections could reduce uptake of vaccines featuring later in the schedule). Colleagues at the Department of Health (DH) in the UK therefore wanted to know whether assessing the impact across the entire programme of a proposed change to the UK schedule could lead to different decisions than those made on the current case-by-case basis. This work is a first step towards addressing this question. A novel framework for estimating the effective coverage against all of the diseases within a vaccination programme was developed. The framework was applied to the current (August 2015) UK childhood immunisation programme, plausible extensions to it in the foreseeable future (introducing vaccination against Meningitis B and/or Hepatitis B) and a "what-if" scenario regarding a Hepatitis B vaccine scare that was developed in close collaboration with DH. Our applications of the framework demonstrate that a programme-view of hypothetical changes to the schedule is important. For example, we show how introducing Hepatitis B vaccination could negatively impact aspects of the current programme by reducing uptake of vaccines featuring later in the schedule, and illustrate that the potential benefits of introducing any new vaccine are susceptible to behaviour changes affecting uptake (e.g. a vaccine scare). We show how it may be useful to consider the potential benefits and scheduling needs of all vaccinations on the horizon of interest rather than those of an individual vaccine in isolation, e.g. how introducing Meningitis B vaccination could saturate the early (2-month) visit, thereby potentially restricting scheduling options for Hepatitis B immunisation should it be introduced to the programme in the future. Our results demonstrate the potential benefit of considering the programme-wide impact of changes to an immunisation schedule, and our framework is an important step in the development of a means for systematically doing so.

Prehospital critical care for out-of-hospital cardiac arrest: An observational study examining survival and a stakeholder-focused cost analysis.

PubMed

von Vopelius-Feldt, Johannes; Powell, Jane; Morris, Richard; Benger, Jonathan

2016-12-07

Survival rates from out-of-hospital cardiac arrest (OHCA) remain low, despite remarkable efforts to improve care. A number of ambulance services in the United Kingdom (UK) have developed prehospital critical care teams (CCTs) which attend critically ill patients, including OHCA. However, current scientific evidence describing CCTs attending OHCA is sparse and research to date has not demonstrated clear benefits from this model of care. This prospective, observational study will describe the effect of CCTs on survival from OHCA, when compared to advanced-life-support (ALS), the current standard of prehospital care in the UK. In addition, we will describe the association between individual critical care interventions and survival, and also the costs of CCTs for OHCA. To examine the effect of CCTs on survival from OHCA, we will use routine Utstein variables data already collected in a number of UK ambulance trusts. We will use propensity score matching to adjust for imbalances between the CCT and ALS groups. The primary outcome will be survival to hospital discharge, with the secondary outcome of survival to hospital admission. We will record the critical care interventions delivered during CCT attendance at OHCA. We will describe frequencies and aim to use multiple logistic regression to examine possible associations with survival. Finally, we will undertake a stakeholder-focused cost analysis of CCTs for OHCA. This will utilise a previously published Emergency Medical Services (EMS) cost analysis toolkit and will take into account the costs incurred from use of a helicopter and the proportion of these costs currently covered by charities in the UK. Prehospital critical care for OHCA is not universally available in many EMS. In the UK, it is variable and largely funded through public donations to charities. If this study demonstrates benefit from CCTs at an acceptable cost to the public or EMS commissioners, it will provide a rationale to increase funding and service provision. If no clinical benefit is found, the public and charities providing these services can consider concentrating their efforts on other areas of prehospital care. ISRCTN registry ID ISRCTN18375201 .

The Current Use of Online Services in U.K. Academic Libraries.

ERIC Educational Resources Information Center

Foster, Allan; Akeroyd, John

This update of a survey taken by the authors in April 1978 on the use of online services in British academic libraries (Online Review; v3 n2 p195-204 1979) concentrates on the following areas: (1) general pattern of use; (2) current arguments for charging users for online services; (3) current academic library practice on charging; (4) specific…

The Problematic Relationship Between Knowing How and Knowing That in Secondary Art Education

ERIC Educational Resources Information Center

Cunliffe, Leslie

2005-01-01

This article explores and attempts to rectify current conceptual confusion found in secondary art education in the UK between procedural knowledge or "knowing how" and declarative knowledge or "knowing that". The paper argues that current practice confuses procedural knowledge with declarative knowledge. A corollary is that…

Assessing metaldehyde concentrations in surface water catchments and implications for drinking water abstraction

NASA Astrophysics Data System (ADS)

Asfaw, Alemayehu; Shucksmith, James; Smith, Andrea; Cherry, Katherine

2015-04-01

Metaldehyde is an active ingredient in agricultural pesticides such as slug pellets, which are heavily applied to UK farmland during the autumn application season. There is current concern that existing drinking water treatment processes may be inadequate in reducing potentially high levels of metaldehyde in surface waters to below the UK drinking water quality regulation limit of 0.1 µg/l. In addition, current water quality monitoring methods can miss short term fluctuations in metaldehyde concentration caused by rainfall driven runoff, hampering prediction of the potential risk of exposure. Datasets describing levels, fate and transport of metaldehyde in river catchments are currently very scarce. This work presents results from an ongoing study to quantify the presence of metaldehyde in surface waters within a UK catchment used for drinking water abstraction. High resolution water quality data from auto-samplers installed in rivers are coupled with radar rainfall, catchment characteristics and land use data to i) understand which hydro-meteorological characteristics of the catchment trigger the peak migration of metaldehyde to surface waters; ii) assess the relationship between measured metaldehyde levels and catchment characteristics such as land use, topographic index, proximity to water bodies and runoff generation area; iii) describe the current risks to drinking water supply and discuss mitigation options based on modelling and real-time control of water abstraction. Identifying the correlation between catchment attributes and metaldehyde generation will help in the development of effective catchment management strategies, which can help to significantly reduce the amount of metaldehyde finding its way into river water. Furthermore, the effectiveness of current water quality monitoring strategy in accurately quantifying the generation of metaldehyde from the catchment and its ability to benefit the development of effective catchment management practices has also been investigated.

Electronic Nicotine Delivery Systems

PubMed Central

Adkison, Sarah E.; O’Connor, Richard J.; Bansal-Travers, Maansi; Hyland, Andrew; Borland, Ron; Yong, Hua-Hie; Cummings, K. Michael; McNeill, Ann; Thrasher, James F.; Hammond, David; Fong, Geoffrey T.

2013-01-01

Background Electronic nicotine delivery systems (ENDS) initially emerged in 2003 and have since become widely available globally, particularly over the Internet. Purpose Data on ENDS usage patterns are limited. The current paper examines patterns of ENDS awareness, use, and product-associated beliefs among current and former smokers in four countries. Methods Data come from Wave 8 of the International Tobacco Control Four-Country Survey, collected July 2010 to June 2011 and analyzed through June 2012. Respondents included 5939 current and former smokers in Canada (n=1581); the U.S. (n=1520); the United Kingdom (UK; n=1325); and Australia (n=1513). Results Overall, 46.6% were aware of ENDS (U.S.: 73%, UK: 54%, Canada: 40%, Australia: 20%); 7.6% had tried ENDS (16% of those aware of ENDS); and 2.9% were current users (39% of triers). Awareness of ENDS was higher among younger, non-minority smokers with higher incomes who were heavier smokers. Prevalence of trying ENDS was higher among younger, nondaily smokers with a high income and among those who perceived ENDS as less harmful than traditional cigarettes. Current use was higher among both nondaily and heavy (≥20 cigarettes per day) smokers. In all, 79.8% reported using ENDS because they were considered less harmful than traditional cigarettes; 75.4% stated that they used ENDS to help them reduce their smoking; and 85.1% reported using ENDS to help them quit smoking. Conclusions Awareness of ENDS is high, especially in countries where they are legal (i.e., the U.S. and UK). Because trial was associated with nondaily smoking and a desire to quit smoking, ENDS may have potential to serve as a cessation aid. PMID:23415116

Electronic nicotine delivery systems: international tobacco control four-country survey.

PubMed

Adkison, Sarah E; O'Connor, Richard J; Bansal-Travers, Maansi; Hyland, Andrew; Borland, Ron; Yong, Hua-Hie; Cummings, K Michael; McNeill, Ann; Thrasher, James F; Hammond, David; Fong, Geoffrey T

2013-03-01

Electronic nicotine delivery systems (ENDS) initially emerged in 2003 and have since become widely available globally, particularly over the Internet. Data on ENDS usage patterns are limited. The current paper examines patterns of ENDS awareness, use, and product-associated beliefs among current and former smokers in four countries. Data come from Wave 8 of the International Tobacco Control Four-Country Survey, collected July 2010 to June 2011 and analyzed through June 2012. Respondents included 5939 current and former smokers in Canada (n=1581); the U.S. (n=1520); the United Kingdom (UK; n=1325); and Australia (n=1513). Overall, 46.6% were aware of ENDS (U.S.: 73%, UK: 54%, Canada: 40%, Australia: 20%); 7.6% had tried ENDS (16% of those aware of ENDS); and 2.9% were current users (39% of triers). Awareness of ENDS was higher among younger, non-minority smokers with higher incomes who were heavier smokers. Prevalence of trying ENDS was higher among younger, nondaily smokers with a high income and among those who perceived ENDS as less harmful than traditional cigarettes. Current use was higher among both nondaily and heavy (≥20 cigarettes per day) smokers. In all, 79.8% reported using ENDS because they were considered less harmful than traditional cigarettes; 75.4% stated that they used ENDS to help them reduce their smoking; and 85.1% reported using ENDS to help them quit smoking. Awareness of ENDS is high, especially in countries where they are legal (i.e., the U.S. and UK). Because trial was associated with nondaily smoking and a desire to quit smoking, ENDS may have the potential to serve as a cessation aid. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

How the UK Can Lead the Terrestrial Translation of Biomedical Advances Arising from Lunar Exploration Activities

NASA Astrophysics Data System (ADS)

Green, David A.

2010-12-01

Terrestrial translation of biomedical advances is insufficient justification for lunar exploration. However, terrestrial translation should be viewed as a critical part of the cycle of mission planning, execution and review, both in terms of the progress of space exploration, but also of sustained life on Earth. Thus, both the mission and its potential to benefit mankind are increased by the adoption of human-based exploration of the lunar surface. Whilst European biomedical sciences have grown in stature, there remains a gap between space biomedical science and terrestrial medical application. As such, an opportunity for the UK to take a sustainable leadership role exists by utilising its biomedical science community, socialised health care system (National Health Service) and defined mechanisms to determine the clinical efficacy and cost-effectiveness upon health and wellbeing (i.e. National Institute Clinical Excellence), aiding the difficult process of health care rationing. By focusing upon exploitation of the more scientifically rewarding, potentially long-term and more terrestrially analogous challenge of lunar habitation, the UK would circumnavigate the current impediments to International Space Station utilisation. Early engagement in lunar exploration would promote the UK, and its adoption of a leadership role incorporating a considered approach to the development of space biomedicine with an eye to its terrestrial value. For instance, prolonged lunar habitation could provide an `ideal controlled environment' for investigation of medical interventions, in particular multiple interactions (e.g. between exercise and nutrition), a model of accelerated aging and a number of chronic pathologies, including those related to disuse. Lunar advances could provide a springboard for individualized medicine, insights into occupational and de-centralised medicine (e.g. telemedicine) and act as a stimulus for biomedical innovation and understanding. Leadership in biomedical science activities would retain mission critically (and thus avoid obsolesce) so long as a human is involved (irrespective of specific mission architecture) and could be used to leverage opportunities for UK-based institutions, companies and individuals, most notably current ESA astronaut candidate Major Tim Peake. A combination of ESA engagement and national support for space biomedical sciences via research councils (e.g. Medical Research Council) could facilitate a virtuous circle of investment, advancement and socio-economic return invigorating the NHS, education, and key research initiatives such as ESA Harwell, UK Centre for Medical Research and Innovation, and the newly instigated Academic Health Science Centres. Such a strategy could also boost private space enterprise within the UK including the creation of a space port and could help retain the UK's position as a European aerospace transportation, services and legislative hub. By focusing upon its biomedical strength within a multi-faceted but co-ordinated strategy of engagement, the UK could reap significant socio-economic benefits for the UK and its citizens, be they on the Moon, or the Earth.

The use of adjustable gastric bands for management of severe and complex obesity

PubMed Central

Hopkins, James C. A.; Blazeby, Jane M.; Rogers, Chris A.; Welbourn, Richard

2016-01-01

Background Obesity levels in the UK have reached a sustained high and ∼4% of the population would be candidates for bariatric surgery based upon current UK NICE guidelines, which has important implications for Clinical Commissioning Groups. Sources of data Summary data from Cochrane systematic reviews, randomized controlled trials (RCTs) and cohort studies. Areas of agreement Currently, the only treatment that offers significant and durable weight loss for those with severe and complex obesity is surgery. Three operations account for 95% of all bariatric surgery in the UK, but the NHS offers surgery to only a small fraction of those who could benefit. Laparoscopic adjustable gastric banding (gastric banding) has potentially the lowest risk and up-front costs of the three procedures. Areas of controversy Reliable Level 1 evidence of the relative effectiveness of the operations is lacking. Growing points As a point intervention, weight loss surgery together with the chronic disease management strategy for obesity can prevent significant future disease and mortality, and the NHS should embrace both. Areas timely for developing research Better RCT evidence is needed including clinical effectiveness and economic analysis to answer the important question ‘which is the best of the three operations most frequently performed?’ This review considers the current evidence for gastric banding for the treatment of severe and complex obesity. PMID:27034443

Family building using donated gametes and embryos in the UK: recommendations for policy and practice on behalf of the British Infertility Counselling Association and the British Fertility Society in collaboration with the Association of Clinical Embryologists and the Royal College of Nurses Fertility Nurses Forum.

PubMed

Wilde, Ruth; McTavish, Alison; Crawshaw, Marilyn

2014-03-01

The UK Department of Health's consultation on the future of the Human Fertilisation and Embryology Authority (HFEA) presented an opportunity to review current practice in relation to donor conception (DC) and make recommendations for improving services to those seeking fertility treatment, to families with donor conceived children and those of donors, and to those seeking later information. The year 2023 marks the start of post-2005 donor conceived adults having statutory access to identifying information about their donor(s); some adults with pre-2005 donors will have access sooner if the donor(s) re-registers as 'willing to be identified'. This paper examines current practice in UK licensed treatment centres in collecting and disseminating donor information and in supporting donors and prospective parents. Further, it considers current HFEA functions concerning DC including its responsibilities for the Register of Information and Donor Sibling Link and its approach to policy making, regulation and the release of information from these Registers to applicants. Proposals for how these functions could be carried out in the future are set out together with recommendations for national support and intermediary services. The key evidence available to support these recommendations is outlined.

A Week Is a Long Time in Politics: The Health Implications of Jeremy Corbyn's UK Labour Party Leadership Victory.

PubMed

Scott-Samuel, Alex; Bambra, Clare

2016-01-01

For more than 30 years, socialism within the UK Labour Party - which was in government from 1997 to 2010 and is currently the main UK parliamentary opposition - has been in decline. Despite its origins as a party of and for the working class, Labour has become at best a social democratic party with strong neoliberal leanings. However, in the recent leadership election that followed Labour's general election defeat in May 2015, the socialist Jeremy Corbyn confounded all expectations by winning Labour's leadership with a substantial majority. We describe the political context of Corbyn's controversial victory and discuss its potential short- and medium-term impact on England's troubled National Health Service and on the public health. © The Author(s) 2015.

Indoor Tanning within UK Young Adults: An Extended Theory of Planned Behaviour Approach.

PubMed

Dodd, Lorna J; Forshaw, Mark J; Williams, Stella

2013-01-01

The indoor tanning industry poses a long-term public health risk. Despite the adverse health effects, indoor tanning seems to be gaining considerable popularity. The study examined indoor tanning intentions and behaviour within UK young adults using an extended theory of planned behaviour model, which included variables on "appearance reasons to tan," "perceived susceptibility to damaging appearance," "perceived susceptibility to health consequences," and "tanning knowledge." The model was successful in predicting indoor tanning intentions and behaviour (explained 17% and 71%, resp.). An interesting outcome was the magnitude of the variable "appearance reasons to tan." A current tanned appearance therefore seemed to outweigh any adverse future appearance or health consequences caused by indoor tanning. Appearance-focused interventions to reduce such behaviour may now prove to be efficacious within a UK sample.

UK role 4 military infection services: past, present and future.

PubMed

Dufty, Ngozi E; Bailey, M S

2013-09-01

NATO describes 'Role 4' military medical services as those provided for the definitive care of patients who cannot be treated within a theatre of operations and these are usually located in a military force's country of origin and may include the involvement of civilian medical services. The UK Defence Medical Services have a proud history of developing and providing clinical services in infectious diseases and tropical medicine, sexual health and HIV medicine, and medical microbiology and virology. These UK Role 4 Military Infection Services have adapted well to recent overseas deployments, but new challenges will arise due to current military cutbacks and a greater diversity of contingency operations in the future. Further evidence-based development of these services will require leadership by military clinicians and improved communication and support for 'reach-back' services.

Undergraduate teaching in UK general practice: a geographical snapshot.

PubMed

Derbyshire, Helen; Rees, Eliot; Gay, Simon P; McKinley, Robert K

2014-06-01

Learning in general practice is an essential component of undergraduate medical education; currently, on average, 13% of clinical placements in the UK are in general practice. However, whether general practice can sustainably deliver more undergraduate placements is uncertain. To identify the geographical distribution of undergraduate teaching practices and their distance from the host medical school. National survey of all medical schools in the UK. All 33 UK medical schools were invited to provide the postcodes of their undergraduate teaching practices. These were collated, de-duplicated, and mapped. The distance in kilometres and journey times by car and public transport between each medical school and its teaching practices was estimated using Transport Direct (www.transportdirect.info). The postcodes of every practice in the UK were obtained from the UK's health departments. All 33 UK medical schools responded; 4392 practices contributed to teaching, with a median (minimum-maximum) of 142 (17-385) practices per school. The median (minimum-maximum) distance between a school and a teaching practice was 28 km (0-1421 km), 41 (0:00-23:26) minutes' travel by car and 1 hour 12 (0:00-17:29) minutes' travel by public transport. All teaching practices were accessible by public transport in one school and 90-99% were in a further four schools; 24 schools had >20% of practices that were inaccessible by public transport. The 4392 undergraduate teaching general practices are widely distributed and potentially any practice, no matter how isolated, could contribute to undergraduate education. However, this is, at the price of a considerable travel burden. © British Journal of General Practice 2014.

Maintaining quality in the UK breast screening program

NASA Astrophysics Data System (ADS)

Gale, Alastair

2010-02-01

Breast screening in the UK has been implemented for over 20 years and annually nearly two million women are now screened with an estimated 1,400 lives saved. Nationally, some 700 individuals interpret screening mammograms in almost 110 screening centres. Currently, women aged 50 to 70 are invited for screening every three years and by 2012 this age range will increase to 47 - 73 years. There is a rapid ongoing transition from using film mammograms to full field digital mammography such that in 2010 every screening centre will be partly digital. An early, and long running, concern has been how to ensure the highest quality of imaging interpretation across the UK, an issue enhanced by the use of a three year screening interval. To partly address this question a self assessment scheme was developed in 1988 and subsequently implemented nationally in the UK as a virtually mandatory activity. The scheme is detailed from its beginnings, through its various developments to current incarnation and future plans. This encompasses both radiological (single view screening, two view screening, mammographic film and full field digital mammography) as well as design changes (cases reported by means of: form filling; PDA; tablet PC; iPhone, and the internet). The scheme provides a rich data source which is regularly studied to examine different aspects of radiological performance. Overall it aids screening radiologists by giving them regular access to a range of difficult exemplar cases together with feedback on their performance as compared to their peers.

The cost effectiveness of licensed oromucosal midazolam (Buccolam(®)) for the treatment of children experiencing acute epileptic seizures: an approach when trial evidence is limited.

PubMed

Lee, Dawn; Gladwell, Daniel; Batty, Anthony J; Brereton, Nic; Tate, Elaine

2013-04-01

In the UK, two treatment options are used for acute epileptic seizures in the community-rectal diazepam and unlicensed buccal midazolam. In practice, the former is rarely used, with unlicensed buccal midazolam being widely recommended and prescribed by physicians. In September 2011, Buccolam(®) (licensed midazolam oromucosal solution) became the first medicine to receive a Paediatric-Use Marketing Authorization (PUMA) and it is indicated for the treatment of prolonged, acute, convulsive seizures by caregivers in the community for children (aged 6 months to <18 years) diagnosed with epilepsy. The approval process for a PUMA product differs from other marketing authorization processes and may be based upon small population subsets and may not, in some cases, require new safety or efficacy data to be generated; a similar situation to that seen for orphan drugs. This can lead to challenges when conducting economic evaluations. The aim of this study was to assess the cost effectiveness of Buccolam(®) for children with a diagnosis of epilepsy suffering prolonged, acute, convulsive seizures occurring in the UK community setting. DESIGN AND PERSPECTIVE: A hybrid model was developed according to a UK payer perspective. The model included a time-to-event simulation for the frequency and location of occurrence of seizures, along with a decision-tree model that assessed the treatment pathway when a seizure occured. The model compared treatment with Buccolam(®) with standard care in the community (95 % unlicensed buccal midazolam and 5 % rectal diazepam) or either treatment alone. The model was informed by data from a variety of sources, including clinical effectiveness estimates, and costs based on published UK data, using 2012-13 prices, where possible. To determine current practice and real-world effectiveness, a Delphi panel and a survey of parents of children with epilepsy were conducted. Buccolam(®) showed a reduction in costs of £2,939 compared with standard care, £14,269 compared with rectal diazepam alone and £886 compared with unlicensed buccal midazolam alone. Increases of 0.025, 0.082 and 0.013 quality-adjusted life-years, respectively, were also seen. Buccolam(®) remained dominant across a range of scenario analyses. This model demonstrates the possibility of constructing a thorough economic case when trial or real-world data are not available. The results of the model show Buccolam(®) to be cost saving compared with rectal diazepam due to a reduction in the need for ambulance callouts and hospital stays, and compared with unlicensed buccal midazolam, through reduced drug costs and wastage.

Recognition and the Fleeting Glimpse of Intimacy: Tracing the Chaplain's Response to Ungrieved Death.

PubMed

Coble, Richard

2015-03-01

The article traces the response of the hospital chaplain witnessing ungrieved death. Linking grief with cultural recognition, the article analyzes the absence of grief on the occasion of death within outcast social spheres. It then outlines the ways chaplains both participate in the cultural norms that render lives ungrievable and, conversely, in the solidarity of God, who cares for every life and death. The article closes by situating the chaplain as a liminal figure and proposing liminality itself as an opportunity for solidarity. © The Author(s) 2015 Reprints and permissions:sagepub.co.uk/journalsPermissions.nav.

Exploring perinatal shift-to-shift handover communication and process: an observational study.

PubMed

Poot, Else P; de Bruijne, Martine C; Wouters, Maurice G A J; de Groot, Christianne J M; Wagner, Cordula

2014-04-01

Loss of situation awareness (SA) by health professionals during handover is a major threat to patient safety in perinatal care. SA refers to knowing what is going on around. Adequate handover communication and process may support situation assessment, a precursor of SA. This study describes current practices and opinions of perinatal handover to identify potential improvements. Structured direct observations of shift-to-shift patient handovers (n = 70) in an academic perinatal setting were used to measure handover communication (presence and order of levels of SA: current situation, background, assessment and recommendation) and process (duration, interruptions/distractions, eye contact, active inquiry and reading information back). Afterwards, receivers' opinions of handover communication (n = 51) were measured by means of a questionnaire. All levels of SA were present in 7% of handovers, the current situation in 86%, the background in 99%, an assessment in 24% and a recommendation in 46%. In 77% of handovers the background was mentioned first, followed by the current situation. Forty-four per cent of handovers took 2 minutes or more per patient. In 52% distractions occurred, in 43% there was no active inquiry, in 32% no eye contact and in 97% information was not read back. The overall mean of the receivers' opinions of handover communication was 4.1 (standard deviation ± 0.7; scale 1-5, where 5 is excellent). Perinatal handovers are currently at risk for inadequate situation assessment because of variability and limitations in handover communication and process. However, receivers' opinions of handover communication were very positive, indicating a lack of awareness of patient safety threats during handover. Therefore, the staff's awareness of current limitations should be raised, for example through video reflection or simulation training. © 2013 John Wiley & Sons, Ltd.

Aircraft Wake Vortices : An Assessment of the Current Situation

DOT National Transportation Integrated Search

1991-01-01

The state of knowledge about aircraft wake vortices in the summer of 1990 is summarized. With the advent of a new FAA wake vortex program, the current situation was assessed by answering five questions: (1) What do we know about wake vortices, (2) wh...

An analysis of stress, burnout, and work commitment among disability support staff in the UK.

PubMed

Smyth, Emmett; Healy, Olive; Lydon, Sinėad

2015-12-01

Previous research has suggested that challenging behaviour emitted by persons with intellectual and developmental disabilities negatively impacts upon the levels of stress and burnout of those who support and care for them. In the current study a sample of disability support workers in the UK (N=138) reported their levels of perceived stress, burnout, and commitment to their work. The relationship between the frequency and severity of aggressive/destructive behaviours to which they were exposed, and these three measures were examined. Results showed that participants scored lower on measures of burnout in the current study than has been reported by similar research studies in the UK and North America. The results revealed an association between challenging behaviours experienced and participants' perceived stress and emotional exhaustion. Perceived stress and burnout were also associated with participants' commitment to their work. Finally, a series of regression analyses identified a number of predictors of emotional exhaustion, depersonalization, and personal accomplishment among disability support workers. The results and their implications for the consideration of disability support worker wellbeing and future research in this area are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

The clinical profile of employees with mental health problems working in social firms in the UK.

PubMed

Milton, Alyssa; Parsons, Nicholas; Morant, Nicola; Gilbert, Eleanor; Johnson, Sonia; Fisher, Adrian; Singh, Swaran; Cunliffe, Di; Marwaha, Steven

2015-08-01

UK social firms are under-researched but are a potentially important vocational option for people with mental health problems. To describe the clinical profile, satisfaction levels and experiences of social firms employees with mental health problems. Clinical, work and service use characteristics were collected from social firms' employees with mental health problems in England and Wales. Workplace experience and satisfaction were explored qualitatively. Predominantly, social firms' employees (N = 80) report that they have a diagnosis of depression (56%) and anxiety (41%). People with schizophrenia (20%) or bipolar disorder (5%) were a minority. Respondents had low symptom and disability levels, high quality of life and job satisfaction and experienced reductions in secondary mental health service use over time. High-workplace satisfaction was related to flexibility, manager and colleague support and workplace accommodations. The clinical profile, quality of life and job satisfaction level of employees with mental health problems suggest social firms could be a useful addition to UK vocational services for some people. Current employees mainly have common mental disorders, and social firms will need to shift their focus if they are to form a substantial pathway for the vocational recovery of people currently using community mental health teams.

Poverty and child health in the UK: using evidence for action.

PubMed

Wickham, Sophie; Anwar, Elspeth; Barr, Ben; Law, Catherine; Taylor-Robinson, David

2016-08-01

There are currently high levels of child poverty in the UK, and for the first time in almost two decades child poverty has started to rise in absolute terms. Child poverty is associated with a wide range of health-damaging impacts, negative educational outcomes and adverse long-term social and psychological outcomes. The poor health associated with child poverty limits children's potential and development, leading to poor health and life chances in adulthood. This article outlines some key definitions with regard to child poverty, reviews the links between child poverty and a range of health, developmental, behavioural and social outcomes for children, describes gaps in the evidence base and provides an overview of current policies relevant to child poverty in the UK. Finally, the article outlines how child health professionals can take action by (1) supporting policies to reduce child poverty, (2) providing services that reduce the health consequences of child poverty and (3) measuring and understanding the problem and assessing the impact of action. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Cross-situational statistical word learning in young children.

PubMed

Suanda, Sumarga H; Mugwanya, Nassali; Namy, Laura L

2014-10-01

Recent empirical work has highlighted the potential role of cross-situational statistical word learning in children's early vocabulary development. In the current study, we tested 5- to 7-year-old children's cross-situational learning by presenting children with a series of ambiguous naming events containing multiple words and multiple referents. Children rapidly learned word-to-object mappings by attending to the co-occurrence regularities across these ambiguous naming events. The current study begins to address the mechanisms underlying children's learning by demonstrating that the diversity of learning contexts affects performance. The implications of the current findings for the role of cross-situational word learning at different points in development are discussed along with the methodological implications of employing school-aged children to test hypotheses regarding the mechanisms supporting early word learning. Copyright © 2014 Elsevier Inc. All rights reserved.

Strategic model of national rabies control in Korea.

PubMed

Cheong, Yeotaek; Kim, Bongjun; Lee, Ki Joong; Park, Donghwa; Kim, Sooyeon; Kim, Hyeoncheol; Park, Eunyeon; Lee, Hyeongchan; Bae, Chaewun; Oh, Changin; Park, Seung-Yong; Song, Chang-Seon; Lee, Sang-Won; Choi, In-Soo; Lee, Joong-Bok

2014-01-01

Rabies is an important zoonosis in the public and veterinary healthy arenas. This article provides information on the situation of current rabies outbreak, analyzes the current national rabies control system, reviews the weaknesses of the national rabies control strategy, and identifies an appropriate solution to manage the current situation. Current rabies outbreak was shown to be present from rural areas to urban regions. Moreover, the situation worldwide demonstrates that each nation struggles to prevent or control rabies. Proper application and execution of the rabies control program require the overcoming of existing weaknesses. Bait vaccines and other complex programs are suggested to prevent rabies transmission or infection. Acceleration of the rabies control strategy also requires supplementation of current policy and of public information. In addition, these prevention strategies should be executed over a mid- to long-term period to control rabies.

Gender and Sexuality: The Discursive Limits of "Equality" in Higher Education

ERIC Educational Resources Information Center

Morrish, Liz; Sauntson, Helen

2010-01-01

This special issue sets out to investigate a number of areas of concern, regarding gender and sexuality, which are identifiable in the current British higher education environment. We argue that current dominant "neoliberal" discourses, which emphasise the commodification of higher education in the U.K., function to set limits upon…

The Current State of Sustainability in Bioscience Laboratories: A Statistical Examination of a UK Tertiary Institute

ERIC Educational Resources Information Center

Wright, Hazel A.; Ironside, Joseph E.; Gwynn-Jones, Dylan

2008-01-01

Purpose: This study aims to identify the current barriers to sustainability in the bioscience laboratory setting and to determine which mechanisms are likely to increase sustainable behaviours in this specialised environment. Design/methodology/approach: The study gathers qualitative data from a sample of laboratory researchers presently…

Computer Programming in the UK Undergraduate Mathematics Curriculum

ERIC Educational Resources Information Center

Sangwin, Christopher J.; O'Toole, Claire

2017-01-01

This paper reports a study which investigated the extent to which undergraduate mathematics students in the United Kingdom are currently taught to programme a computer as a core part of their mathematics degree programme. We undertook an online survey, with significant follow-up correspondence, to gather data on current curricula and received…

The mental health of the UK Armed Forces: where facts meet fiction

PubMed Central

Hunt, Elizabeth J. F.; Wessely, Simon; Jones, Norman; Rona, Roberto J.; Greenberg, Neil

2014-01-01

A substantial amount of research has been conducted into the mental health of the UK military in recent years. This article summarises the results of the various studies and offers possible explanations for differences in findings between the UK and other allied nations. Post-traumatic stress disorder (PTSD) rates are perhaps surprisingly low amongst British forces, with prevalence rates of around 4% in personnel who have deployed, rising to 6% in combat troops, despite the high tempo of operations in recent years. The rates in personnel currently on operations are consistently lower than these. Explanations for the lower PTSD prevalence in British troops include variations in combat exposures, demographic differences, higher leader to enlisted soldier ratios, shorter operational tour lengths and differences in access to long-term health care between countries. Delayed-onset PTSD was recently found to be more common than previously supposed, accounting for nearly half of all PTSD cases; however, many of these had sub-syndromal PTSD predating the onset of the full disorder. Rates of common mental health disorders in UK troops are similar or higher to those of the general population, and overall operational deployments are not associated with an increase in mental health problems in UK regular forces. However, there does appear to be a correlation between both deployment and increased alcohol misuse and post-deployment violence in combat troops. Unlike for regular forces, there is an overall association between deployment and mental health problems in Reservists. There have been growing concerns regarding mild traumatic brain injury, though this appears to be low in British troops with an overall prevalence of 4.4% in comparison with 15% in the US military. The current strategies for detection and treatment of mental health problems in British forces are also described. The stance of the UK military is that psychological welfare of troops is primarily a chain of command responsibility, aided by medical advice when necessary, and to this end uses third location decompression, stress briefings, and Trauma Risk Management approaches. Outpatient treatment is provided by Field Mental Health Teams and military Departments of Community Mental Health, whilst inpatient care is given in specific NHS hospitals. PMID:25206948

The (sexual) politics of evolution: popular controversy in the late 20th-century United Kingdom.

PubMed

Cassidy, Angela

2007-05-01

This article outlines the major threads of controversy around the emerging subject of evolutionary psychology in the U.K. mass media during the 1990s. Much of this controversy centered on the role of evolution in shaping human gender roles and sexualities, contributing to the subject's mass appeal. This case is used to illustrate the argument that in theorizing about evolution and humans, "human nature" and "human origins" both provide a flexible resource for making arguments about how people do and should relate to one another and that such theorizing is therefore reflective of how power is held (and contested) in society. In the case of popular evolutionary psychology, shifts in the U.K. political landscape during the 1990s combined with changes in gender and sexual politics to create a situation where evolutionary theorizing about humans became more acceptable than it had been in the past. This was particularly true in left-liberal media, where a newfound compatibility between certain aspects of Darwinism and feminism created a very different space for debating gender, sexuality, and the role of human nature in today's society.

Oil spill treatment products approval: the UK approach and potential application to the Gulf region.

PubMed

Kirby, Mark F; Law, Robin J

2008-07-01

The environmental threat from oil spills remains significant across the globe and particularly in regions of high oil production and transport such as the Gulf. The ultimate damage caused can be limited by mitigation actions that responders deploy. The responsible and appropriate use of oil spill treatment products (e.g. dispersants, sorbents etc.) can offer response options that can result in substantial net environmental benefit. However, the approval and choice of what products to use needs careful consideration. The United Kingdom has had in place a statutory approval scheme for oil spill treatment products for 30 years. It is based on measures of efficiency and environmental acceptability. Two toxicity tests form an integral part of the assessment, the Sea test and the Rocky Shore test, and work on the premise that approved products will not make the situation significantly worse when added to spilled oil. This paper outlines the UK approach and how its rationale might be applied to the approval of products specific for the Gulf region. Issues such as species choice, higher temperatures and salinity and regional environmental conditions are considered.

Inside 'bed management': ethnographic insights from the vantage point of UK hospital nurses.

PubMed

Allen, Davina

2015-03-01

In the face of unprecedented financial and demographic challenges, optimising acute bed utilisation by the proactive management of patient flows is a pressing policy concern in high-income countries. Despite the growing literature on this topic, bed management has received scant sociological attention. Drawing on practice-based approaches, this article deploys ethnographic data to examine bed management from the perspective of UK hospital nurses. While the nursing contribution to bed management is recognised formally in their widespread employment in patient access and discharge liaison roles, nurses at all levels in the study site were enrolled in this organisational priority. Rather than the rational, centrally controlled processes promulgated by policymakers, bed management emerges as a predominantly distributed activity, described here as match-making. An example of micro-level rationing, for the most part, match-making was not informed by explicit criteria nor did it hinge on clearly identifiable decisions to grant or deny access. Rather it was embedded in the everyday practices and situated rationalities through which nurses accomplished the accommodations necessary to balance demand with resources. © 2014 Foundation for the Sociology of Health & Illness.

The geostatistic-based spatial distribution variations of soil salts under long-term wastewater irrigation.

PubMed

Wu, Wenyong; Yin, Shiyang; Liu, Honglu; Niu, Yong; Bao, Zhe

2014-10-01

The purpose of this study was to determine and evaluate the spatial changes in soil salinity by using geostatistical methods. The study focused on the suburb area of Beijing, where urban development led to water shortage and accelerated wastewater reuse to farm irrigation for more than 30 years. The data were then processed by GIS using three different interpolation techniques of ordinary kriging (OK), disjunctive kriging (DK), and universal kriging (UK). The normality test and overall trend analysis were applied for each interpolation technique to select the best fitted model for soil parameters. Results showed that OK was suitable for soil sodium adsorption ratio (SAR) and Na(+) interpolation; UK was suitable for soil Cl(-) and pH; DK was suitable for soil Ca(2+). The nugget-to-sill ratio was applied to evaluate the effects of structural and stochastic factors. The maps showed that the areas of non-saline soil and slight salinity soil accounted for 6.39 and 93.61%, respectively. The spatial distribution and accumulation of soil salt were significantly affected by the irrigation probabilities and drainage situation under long-term wastewater irrigation.

The role of food in the Polish migrant adjustment journey.

PubMed

Brown, Lorraine; Paszkiewicz, Irena

2017-02-01

In 2015, there were 916,000 Poles living in the UK, making them the largest group of non-UK nationals at 16.5 percent of the population. Though increasingly research has focused on the consequences of this migration for both migrants themselves and the receiving country, little research has looked at food habits. This paper will explore the role of food in the Polish migrant adjustment journey. A qualitative approach was adopted, involving semi-structured interviews with nine Polish migrants. In this study, Polish migrants described the move to a new culture as a time of stress and loneliness. Due to a lack of money, they were forced to eat local food, which exacerbated their unease, as they found it to be tasteless and unhealthy. As soon as their financial situation improved, they reverted to a Polish diet, relying on ingredients brought from home, from London, or more recently, purchased from local Polish shops. This gave them comfort, and all participants acknowledged the vital role of food in their adjustment to life in a new culture. Copyright © 2016 Elsevier Ltd. All rights reserved.

Soil geochemical analyses as an indication of metal working at the excavation of a house in the Roman City at Silchester (UK)

NASA Astrophysics Data System (ADS)

Cook, S. R.; Fulford, M.; Ciarke, A.; Pearson, C.

2003-05-01

Silchesteris the site of a major late Iron Age and Roman town (Calleva Atrebatum), situated in northern Hampshire (England (UK)) and occupied between the late first century BC and the fifth or sixth century AD. Extensive evidence of the nature of the buildings and the plan of the town was obtained from excavations undertaken between 1890 and 1909. The purpose of this study was to use soil geochemical analyses to reinforce the archaeological evidence particularly with reference to potential metal working at the site Soil analysis has been used previously to distinguish different functions or land use activity over a site and to aid identification and interpretation of settlement features (Entwistle et al., 2000). Samples were taken from two areas of the excavation on a l-metre grid. Firstly from an area of some 500 square metres from contexts of late first/early second century AD date throughout the entirety of a large “town house” (House 1) from which there was prima facie evidence of metalworking.

'Every breath we take: the lifelong impact of air pollution' - a call for action.

PubMed

Holgate, Stephen T

2017-02-01

Air pollution has become one of the major risks to human health because of the progressive increase in the use of vehicles powered by fossil fuels. While the risks of air pollution to health were thought to have been brought under control by the Clean Air Acts of the 1950s and 1960s, the situation of air pollution in the UK has now deteriorated to a point where it is contributing to 40,000 excess deaths each year. Here the findings of the RCP/RCPCH's 2015/16 Working Party on Air Pollution and Health are described and what actions now need to be taken. The UK needs to take a lead and introduce a new Clean Air Act that deals with the vehicle sources of pollution recognising that the toxic particles and gases emitted are effecting individuals from conception to death. This mandates urgent action by government both central and local, but also by all of us who have now become so dependent on road transport. © Royal College of Physicians 2017. All rights reserved.

Model-based analysis of costs and outcomes of non-invasive prenatal testing for Down's syndrome using cell free fetal DNA in the UK National Health Service.

PubMed

Morris, Stephen; Karlsen, Saffron; Chung, Nancy; Hill, Melissa; Chitty, Lyn S

2014-01-01

Non-invasive prenatal testing (NIPT) for Down's syndrome (DS) using cell free fetal DNA in maternal blood has the potential to dramatically alter the way prenatal screening and diagnosis is delivered. Before NIPT can be implemented into routine practice, information is required on its costs and benefits. We investigated the costs and outcomes of NIPT for DS as contingent testing and as first-line testing compared with the current DS screening programme in the UK National Health Service. We used a pre-existing model to evaluate the costs and outcomes associated with NIPT compared with the current DS screening programme. The analysis was based on a hypothetical screening population of 10,000 pregnant women. Model inputs were taken from published sources. The main outcome measures were number of DS cases detected, number of procedure-related miscarriages and total cost. At a screening risk cut-off of 1∶150 NIPT as contingent testing detects slightly fewer DS cases, has fewer procedure-related miscarriages, and costs the same as current DS screening (around UK£280,000) at a cost of £500 per NIPT. As first-line testing NIPT detects more DS cases, has fewer procedure-related miscarriages, and is more expensive than current screening at a cost of £50 per NIPT. When NIPT uptake increases, NIPT detects more DS cases with a small increase in procedure-related miscarriages and costs. NIPT is currently available in the private sector in the UK at a price of £400-£900. If the NHS cost was at the lower end of this range then at a screening risk cut-off of 1∶150 NIPT as contingent testing would be cost neutral or cost saving compared with current DS screening. As first-line testing NIPT is likely to produce more favourable outcomes but at greater cost. Further research is needed to evaluate NIPT under real world conditions.

New strategies for lowering the costs of antiretroviral treatment and care for people with HIV/AIDS in the United Kingdom

PubMed Central

Gazzard, Brian; Moecklinghoff, Christiane; Hill, Andrew

2012-01-01

In the UK, the annual cost of treatment and care for people with human immunodeficiency virus (HIV)/acquired immune deficiency virus (AIDS) rose by over 600% from £104 million in 1997 to £762 million in 2010; approximately two-thirds of the £762 million cost of treatment and care in 2010 was for the procurement of antiretrovirals and other related drugs. The number of people accessing care for HIV/AIDS rose from 22,000 in 2000 to 65,000 in 2009. Adoption of “test and treat” guidelines for treating all HIV-infected people with antiretrovirals would further increase the burden of costs. Given the current economic situation, there is now a new focus on strategies for treatment and care of people with HIV-1 infection which can maintain efficacy but at a lower cost. In this review, we propose three strategies which could potentially lower the costs of treatment and care, ie, stopping testing CD4 counts for patients with full HIV RNA suppression on antiretroviral treatment and recent CD4 counts above 350 cells/μL; more widespread use of generic antiretrovirals as replacements for patients currently taking patented versions; and use of darunavir-ritonavir monotherapy as a switch option for patients with full HIV RNA suppression on other antiretrovirals and no history of virological failure. However, it is important that high standards of clinical care are maintained despite cost-saving measures. Antiretrovirals with generic alternatives may have toxicity issues, eg, zidovudine and nevirapine. There could be ethical issues in starting patients on these drugs if they are currently tolerating other treatments. The use of darunavir-ritonavir monotherapy is not consistently recommended in international HIV treatment guidelines. PMID:22888265

Global cropland and greenhouse gas impacts of UK food supply are increasingly located overseas

PubMed Central

Macdiarmid, Jennie I.

2016-01-01

Producing sufficient, healthy food for a growing world population amid a changing climate is a major challenge for the twenty-first century. Agricultural trade could help alleviate this challenge by using comparative productivity advantages between countries. However, agricultural trade has implications for national food security and could displace environmental impacts from developed to developing countries. This study illustrates the global effects resulting from the agricultural trade of a single country, by analysing the global cropland and greenhouse gas impacts of the UK's food and feed supply. The global cropland footprint associated with the UK food and feed supply increased by 2022 kha (+23%) from 1986 to 2009. Greenhouse gas emissions (GHGE) associated with fertilizer and manure application, and rice cultivation remained relatively constant at 7.9 Mt CO2e between 1987 and 2008. Including GHGE from land-use change, however, leads to an increase from 19.1 in 1987 to 21.9 Mt CO2e in 2008. The UK is currently importing over 50% of its food and feed, whereas 70% and 64% of the associated cropland and GHGE impacts, respectively, are located abroad. These results imply that the UK is increasingly reliant on external resources and that the environmental impact of its food supply is increasingly displaced overseas. PMID:26740576

Review of the scientific evidence to support environmental risk assessment of shale gas development in the UK.

PubMed

Prpich, George; Coulon, Frédéric; Anthony, Edward J

2016-09-01

Interest in the development of shale gas resources using hydraulic fracturing techniques is increasing worldwide despite concerns about the environmental risks associated with this activity. In the United Kingdom (UK), early attempts to hydraulically fracture a shale gas well resulted in a seismic event that led to the suspension of all hydraulic fracturing operations. In response to this occurrence, UK regulators have requested that future shale gas operations that use hydraulic fracturing should be accompanied by a high-level environmental risk assessment (ERA). Completion of an ERA can demonstrate competency, communicate understanding, and ultimately build trust that environmental risks are being managed properly, however, this assessment requires a scientific evidence base. In this paper we discuss how the ERA became a preferred assessment technique to understand the risks related to shale gas development in the UK, and how it can be used to communicate information between stakeholders. We also provide a review of the evidence base that describes the environmental risks related to shale gas operations, which could be used to support an ERA. Finally, we conclude with an update of the current environmental risks associated with shale gas development in the UK and present recommendations for further research. Copyright © 2015 Elsevier B.V. All rights reserved.

SmARTest regulation? Comparing the regulatory structures for ART in the UK and Australia.

PubMed

Petersen, Kerry; Johnson, Martin H

2007-08-01

Assisted reproductive technologies are regulated in both the UK and Australia, thereby curtailing both reproductive and professional autonomy. Different regulatory models have developed in each jurisdiction, despite the similar legal, scientific and cultural histories of the two jurisdictions. In the UK the regulatory structures are under review, largely in the absence of empirical research on the costs and benefits of regulation. The regulatory structures in each jurisdiction are compared and some key differences identified. The UK regulatory structure governing assisted reproductive technologies is currently simpler, more accountable and more transparent than that in Australia. On the other hand, despite administrative and legislative restrictions (particularly in Victoria), the medical scientists and clinicians in Australia generally have more control than their British counterparts over the technical aspects of their work in the provision of IVF and other treatment services, and to a lesser extent in embryo research. Recent proposals appear to move the UK regulatory structure towards a less accountable and less transparent model, but with no evident increase in reproductive or professional autonomy. It is suggested that this change is not in the interests of patients, doctors and the public, and a different model is outlined for devolution of both authority and accountability to the professions.

Modelling future impacts of air pollution using the multi-scale UK Integrated Assessment Model (UKIAM).

PubMed

Oxley, Tim; Dore, Anthony J; ApSimon, Helen; Hall, Jane; Kryza, Maciej

2013-11-01

Integrated assessment modelling has evolved to support policy development in relation to air pollutants and greenhouse gases by providing integrated simulation tools able to produce quick and realistic representations of emission scenarios and their environmental impacts without the need to re-run complex atmospheric dispersion models. The UK Integrated Assessment Model (UKIAM) has been developed to investigate strategies for reducing UK emissions by bringing together information on projected UK emissions of SO2, NOx, NH3, PM10 and PM2.5, atmospheric dispersion, criteria for protection of ecosystems, urban air quality and human health, and data on potential abatement measures to reduce emissions, which may subsequently be linked to associated analyses of costs and benefits. We describe the multi-scale model structure ranging from continental to roadside, UK emission sources, atmospheric dispersion of emissions, implementation of abatement measures, integration with European-scale modelling, and environmental impacts. The model generates outputs from a national perspective which are used to evaluate alternative strategies in relation to emissions, deposition patterns, air quality metrics and ecosystem critical load exceedance. We present a selection of scenarios in relation to the 2020 Business-As-Usual projections and identify potential further reductions beyond those currently being planned. © 2013.

Centralization of cleft care in the UK. Part 6: a tale of two studies

PubMed Central

Ness, A R; Wills, A K; Waylen, A; Al-Ghatam, R; Jones, T E M; Preston, R; Ireland, A J; Persson, M; Smallridge, J; Hall, A J; Sell, D; Sandy, J R

2015-01-01

Structured Abstract Objectives We summarize and critique the methodology and outcomes from a substantial study which has investigated the impact of reconfigured cleft care in the United Kingdom (UK) 15 years after the UK government started to implement the centralization of cleft care in response to an earlier survey in 1998, the Clinical Standards Advisory Group (CSAG). Setting and Sample Population A UK multicentre cross-sectional study of 5-year-olds born with non-syndromic unilateral cleft lip and palate. Data were collected from children born in the UK with a unilateral cleft lip and palate between 1 April 2005 and 31 March 2007. Materials and Methods We discuss and contextualize the outcomes from speech recordings, hearing, photographs, models, oral health and psychosocial factors in the current study. We refer to the earlier survey and other relevant studies. Results We present arguments for centralization of cleft care in healthcare systems, and we evidence this with improvements seen over a period of 15 years in the UK. We also make recommendations on how future audit and research may configure. Conclusions Outcomes for children with a unilateral cleft lip and palate have improved after the introduction of a centralized multidisciplinary service, and other countries may benefit from this model. Predictors of early outcomes are still needed, and repeated cross-sectional studies, larger longitudinal studies and adequately powered trials are required to create a research-led evidence-based (centralized) service. PMID:26567856

What are the experiences of people with dementia in employment?

PubMed

Chaplin, Ruth; Davidson, Ian

2016-03-01

Statistics show that an increase in the statutory retirement age in the UK will mean that many more people will develop a dementia while still in employment. A review of the literature confirmed that there are no existing studies in the UK which examine this issue in any detail. The aim of this study was to investigate the experiences of people who develop a dementia while still in employment and to understand how they make sense of these experiences; therefore a qualitative explorative inquiry based on an Interpretive Phenomenological Analysis methodology was used. Interviews with five people who had developed a dementia while still in employment were carried out, with ages ranging from 58 to 74 years. Interview transcripts were analysed and four super-ordinate themes were identified: the realization that something is wrong; managing the situation in the workplace; trying to make sense of change; and coming to terms with retirement or unemployment. The results showed that people who develop a dementia while still in employment do not always receive the 'reasonable adjustments' in the workplace to which they are entitled under the Equality Act (2010). Some of the participants felt that they were poorly treated by their workplace and described some distressing experiences. The study highlights the need for more effective specialized advice and support regarding employment issues and more research into the numbers of people in the UK that are affected by this issue. © The Author(s) 2014.

The UK National Quantum Technologies Hub in sensors and metrology (Keynote Paper)

NASA Astrophysics Data System (ADS)

Bongs, K.; Boyer, V.; Cruise, M. A.; Freise, A.; Holynski, M.; Hughes, J.; Kaushik, A.; Lien, Y.-H.; Niggebaum, A.; Perea-Ortiz, M.; Petrov, P.; Plant, S.; Singh, Y.; Stabrawa, A.; Paul, D. J.; Sorel, M.; Cumming, D. R. S.; Marsh, J. H.; Bowtell, R. W.; Bason, M. G.; Beardsley, R. P.; Campion, R. P.; Brookes, M. J.; Fernholz, T.; Fromhold, T. M.; Hackermuller, L.; Krüger, P.; Li, X.; Maclean, J. O.; Mellor, C. J.; Novikov, S. V.; Orucevic, F.; Rushforth, A. W.; Welch, N.; Benson, T. M.; Wildman, R. D.; Freegarde, T.; Himsworth, M.; Ruostekoski, J.; Smith, P.; Tropper, A.; Griffin, P. F.; Arnold, A. S.; Riis, E.; Hastie, J. E.; Paboeuf, D.; Parrotta, D. C.; Garraway, B. M.; Pasquazi, A.; Peccianti, M.; Hensinger, W.; Potter, E.; Nizamani, A. H.; Bostock, H.; Rodriguez Blanco, A.; Sinuco-Leon, G.; Hill, I. R.; Williams, R. A.; Gill, P.; Hempler, N.; Malcolm, G. P. A.; Cross, T.; Kock, B. O.; Maddox, S.; John, P.

2016-04-01

The UK National Quantum Technology Hub in Sensors and Metrology is one of four flagship initiatives in the UK National of Quantum Technology Program. As part of a 20-year vision it translates laboratory demonstrations to deployable practical devices, with game-changing miniaturized components and prototypes that transform the state-of-the-art for quantum sensors and metrology. It brings together experts from the Universities of Birmingham, Glasgow, Nottingham, Southampton, Strathclyde and Sussex, NPL and currently links to over 15 leading international academic institutions and over 70 companies to build the supply chains and routes to market needed to bring 10-1000x improvements in sensing applications. It seeks, and is open to, additional partners for new application development and creates a point of easy open access to the facilities and supply chains that it stimulates or nurtures.

Towards a common framework for assessing the activity and associations of groups who sexually abuse children

PubMed Central

Cockbain, Ella; Brayley, Helen; Sullivan, Joe

2013-01-01

Extensive social psychological research emphasises the importance of groups in shaping individuals’ thoughts and actions. Within the child sexual abuse (CSA) literature criminal organisation has been largely overlooked, with some key exceptions. This research was a novel collaboration between academia and the UK's Child Exploitation and Online Protection Centre (CEOP). Starting from the premise that the group is, in itself, a form of social situation affecting abuse, it offers the first systematic situational analysis of CSA groups. In-depth behavioural data from a small sample of convicted CSA group-offenders (n = 3) were analysed qualitatively to identify factors and processes underpinning CSA groups’ activities and associations: group formation, evolution, identity and resources. The results emphasise CSA groups’ variability, fluidity and dynamism. The foundations of a general framework are proposed for researching and assessing CSA groups and designing effective interventions. It is hoped that this work will stimulate discussion and development in this long-neglected area of CSA, helping to build a coherent knowledge-base. PMID:26494978

Educational Research in Mainland China: Current Situation and Developmental Trends

ERIC Educational Resources Information Center

Sun, Miantao

2011-01-01

The influence of Confucian culture in Chinese Mainland China is reflected in the current situation and contextual trends of educational research content of educational thought of Confucianism, educational issues grounded on theoretical views of Confucianism, and the influence of the inclusiveness of Confucianism. In terms of research method, the…

Guideline for obtaining valid consent for gastrointestinal endoscopy procedures.

PubMed

Everett, Simon M; Griffiths, Helen; Nandasoma, U; Ayres, Katie; Bell, Graham; Cohen, Mike; Thomas-Gibson, Siwan; Thomson, Mike; Naylor, Kevin M T

2016-10-01

Much has changed since the last guideline of 2008, both in endoscopy and in the practice of obtaining informed consent, and it is vital that all endoscopists who are responsible for performing invasive and increasingly risky procedures are aware of the requirements for obtaining valid consent. This guideline is restricted to GI endoscopy but we cover elective and acute or emergency procedures. Few clinical trials have been carried out in relation to informed consent but most areas are informed by guidance from the General Medical Counsel (GMC) and/or are enshrined in legislation. Following an iterative voting process a series of recommendations have been drawn up that cover the majority of situations that will be encountered by endoscopists. This is not exhaustive and where doubt exists we have described where legal advice is likely to be required. This document relates to the law and endoscopy practice in the UK-where there is variation between the four devolved countries this is pointed out and endoscopists must be aware of the law where they practice. The recommendations are divided into consent for patients with and without capacity and we provide sections on provision of information and the consent process for patients in a variety of situations. This guideline is intended for use by all practitioners who request or perform GI endoscopy, or are involved in the pathway of such patients. If followed, we hope this document will enhance the experience of patients attending for endoscopy in UK units. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Primary goals, information-giving and men’s understanding: a qualitative study of Australian and UK doctors’ varied communication about PSA screening

PubMed Central

Pickles, Kristen; Rychetnik, Lucie; McCaffery, Kirsten; Entwistle, Vikki A

2018-01-01

Objectives (1) To characterise variation in general practitioners’ (GPs’) accounts of communicating with men about prostate cancer screening using the prostate-specific antigen (PSA) test, (2) to characterise GPs’ reasons for communicating as they do and (3) to explain why and under what conditions GP communication approaches vary. Study design and setting A grounded theory study. We interviewed 69 GPs consulting in primary care practices in Australia (n=40) and the UK (n=29). Results GPs explained their communication practices in relation to their primary goals. In Australia, three different communication goals were reported: to encourage asymptomatic men to either have a PSA test, or not test, or alternatively, to support men to make their own decision. As well as having different primary goals, GPs aimed to provide different information (from comprehensive to strongly filtered) and to support men to develop different kinds of understanding, from population-level to ‘gist’ understanding. Taking into account these three dimensions (goals, information, understanding) and building on Entwistle et al’s Consider an Offer framework, we derived four overarching approaches to communication: Be screened, Do not be screened, Analyse and choose, and As you wish. We also describe ways in which situational and relational factors influenced GPs’ preferred communication approach. Conclusion GPs’ reported approach to communicating about prostate cancer screening varies according to three dimensions—their primary goal, information provision preference and understanding sought—and in response to specific practice situations. If GP communication about PSA screening is to become more standardised in Australia, it is likely that each of these dimensions will require attention in policy and practice support interventions. PMID:29362252

Primary goals, information-giving and men's understanding: a qualitative study of Australian and UK doctors' varied communication about PSA screening.

PubMed

Pickles, Kristen; Carter, Stacy M; Rychetnik, Lucie; McCaffery, Kirsten; Entwistle, Vikki A

2018-01-23

(1) To characterise variation in general practitioners' (GPs') accounts of communicating with men about prostate cancer screening using the prostate-specific antigen (PSA) test, (2) to characterise GPs' reasons for communicating as they do and (3) to explain why and under what conditions GP communication approaches vary. A grounded theory study. We interviewed 69 GPs consulting in primary care practices in Australia (n=40) and the UK (n=29). GPs explained their communication practices in relation to their primary goals. In Australia, three different communication goals were reported: to encourage asymptomatic men to either have a PSA test, or not test, or alternatively, to support men to make their own decision. As well as having different primary goals, GPs aimed to provide different information (from comprehensive to strongly filtered) and to support men to develop different kinds of understanding, from population-level to 'gist' understanding. Taking into account these three dimensions (goals, information, understanding) and building on Entwistle et al' s Consider an Offer framework, we derived four overarching approaches to communication: Be screened , Do not be screened , Analyse and choose , and As you wish . We also describe ways in which situational and relational factors influenced GPs' preferred communication approach. GPs' reported approach to communicating about prostate cancer screening varies according to three dimensions-their primary goal, information provision preference and understanding sought-and in response to specific practice situations. If GP communication about PSA screening is to become more standardised in Australia, it is likely that each of these dimensions will require attention in policy and practice support interventions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Migration experiences, employment status and psychological distress among Somali immigrants: a mixed-method international study.

PubMed

Warfa, Nasir; Curtis, Sarah; Watters, Charles; Carswell, Ken; Ingleby, David; Bhui, Kamaldeep

2012-09-07

The discourse about mental health problems among migrants and refugees tends to focus on adverse pre-migration experiences; there is less investigation of the environmental conditions in which refugee migrants live, and the contrasts between these situations in different countries. This cross-national study of two samples of Somali refugees living in London (UK) and Minneapolis, Minnesota, (USA) helps to fill a gap in the literature, and is unusual in being able to compare information collected in the same way in two cities in different countries. There were two parts to the study, focus groups to gather in-depth qualitative data and a survey of health status and quantifiable demographic and material factors. Three of the focus groups involved nineteen Somali professionals and five groups included twenty-eight lay Somalis who were living in London and Minneapolis. The quantitative survey was done with 189 Somali respondents, also living in London and Minneapolis. We used the MINI International Neuropsychiatric Interview (MINI) to assess ICD-10 and DSM-IV mental disorders. The overall qualitative and quantitative results suggested that challenges to masculinity, thwarted aspirations, devalued refugee identity, unemployment, legal uncertainties and longer duration of stay in the host country account for poor psychological well-being and psychiatric disorders among this group. The use of a mixed-methods approach in this international study was essential since the quantitative and qualitative data provide different layers and depth of meaning and complement each other to provide a fuller picture of complex and multi-faceted life situations of refugees and asylum seekers. The comparison between the UK and US suggests that greater flexibility of access to labour markets for this refugee group might help to promote opportunities for better integration and mental well-being.

The predictive validity of selection for entry into postgraduate training in general practice: evidence from three longitudinal studies

PubMed Central

Patterson, Fiona; Lievens, Filip; Kerrin, Máire; Munro, Neil; Irish, Bill

2013-01-01

Background The selection methodology for UK general practice is designed to accommodate several thousand applicants per year and targets six core attributes identified in a multi-method job-analysis study Aim To evaluate the predictive validity of selection methods for entry into postgraduate training, comprising a clinical problem-solving test, a situational judgement test, and a selection centre. Design and setting A three-part longitudinal predictive validity study of selection into training for UK general practice. Method In sample 1, participants were junior doctors applying for training in general practice (n = 6824). In sample 2, participants were GP registrars 1 year into training (n = 196). In sample 3, participants were GP registrars sitting the licensing examination after 3 years, at the end of training (n = 2292). The outcome measures include: assessor ratings of performance in a selection centre comprising job simulation exercises (sample 1); supervisor ratings of trainee job performance 1 year into training (sample 2); and licensing examination results, including an applied knowledge examination and a 12-station clinical skills objective structured clinical examination (OSCE; sample 3). Results Performance ratings at selection predicted subsequent supervisor ratings of job performance 1 year later. Selection results also significantly predicted performance on both the clinical skills OSCE and applied knowledge examination for licensing at the end of training. Conclusion In combination, these longitudinal findings provide good evidence of the predictive validity of the selection methods, and are the first reported for entry into postgraduate training. Results show that the best predictor of work performance and training outcomes is a combination of a clinical problem-solving test, a situational judgement test, and a selection centre. Implications for selection methods for all postgraduate specialties are considered. PMID:24267856

The predictive validity of selection for entry into postgraduate training in general practice: evidence from three longitudinal studies.

PubMed

Patterson, Fiona; Lievens, Filip; Kerrin, Máire; Munro, Neil; Irish, Bill

2013-11-01

The selection methodology for UK general practice is designed to accommodate several thousand applicants per year and targets six core attributes identified in a multi-method job-analysis study To evaluate the predictive validity of selection methods for entry into postgraduate training, comprising a clinical problem-solving test, a situational judgement test, and a selection centre. A three-part longitudinal predictive validity study of selection into training for UK general practice. In sample 1, participants were junior doctors applying for training in general practice (n = 6824). In sample 2, participants were GP registrars 1 year into training (n = 196). In sample 3, participants were GP registrars sitting the licensing examination after 3 years, at the end of training (n = 2292). The outcome measures include: assessor ratings of performance in a selection centre comprising job simulation exercises (sample 1); supervisor ratings of trainee job performance 1 year into training (sample 2); and licensing examination results, including an applied knowledge examination and a 12-station clinical skills objective structured clinical examination (OSCE; sample 3). Performance ratings at selection predicted subsequent supervisor ratings of job performance 1 year later. Selection results also significantly predicted performance on both the clinical skills OSCE and applied knowledge examination for licensing at the end of training. In combination, these longitudinal findings provide good evidence of the predictive validity of the selection methods, and are the first reported for entry into postgraduate training. Results show that the best predictor of work performance and training outcomes is a combination of a clinical problem-solving test, a situational judgement test, and a selection centre. Implications for selection methods for all postgraduate specialties are considered.

Migration experiences, employment status and psychological distress among Somali immigrants: a mixed-method international study

PubMed Central

2012-01-01

Background The discourse about mental health problems among migrants and refugees tends to focus on adverse pre-migration experiences; there is less investigation of the environmental conditions in which refugee migrants live, and the contrasts between these situations in different countries. This cross-national study of two samples of Somali refugees living in London (UK) and Minneapolis, Minnesota, (USA) helps to fill a gap in the literature, and is unusual in being able to compare information collected in the same way in two cities in different countries. Methods There were two parts to the study, focus groups to gather in-depth qualitative data and a survey of health status and quantifiable demographic and material factors. Three of the focus groups involved nineteen Somali professionals and five groups included twenty-eight lay Somalis who were living in London and Minneapolis. The quantitative survey was done with 189 Somali respondents, also living in London and Minneapolis. We used the MINI International Neuropsychiatric Interview (MINI) to assess ICD-10 and DSM-IV mental disorders. Results The overall qualitative and quantitative results suggested that challenges to masculinity, thwarted aspirations, devalued refugee identity, unemployment, legal uncertainties and longer duration of stay in the host country account for poor psychological well-being and psychiatric disorders among this group. Conclusion The use of a mixed-methods approach in this international study was essential since the quantitative and qualitative data provide different layers and depth of meaning and complement each other to provide a fuller picture of complex and multi-faceted life situations of refugees and asylum seekers. The comparison between the UK and US suggests that greater flexibility of access to labour markets for this refugee group might help to promote opportunities for better integration and mental well-being. PMID:22954304

Metrics for Success in the Preservation of Scientific Data at the STFC Centre for Environmental Data Archival (CEDA).

NASA Astrophysics Data System (ADS)

Lawrence, B.; Pepler, S.

2009-04-01

CEDA (http://www.ceda.ac.uk) hosts three main data centres: the British Atmospheric Data Centre (http://badc.nerc.ac.uk), the NERC Earth Observation Data Centre (http://neodc.nerc.ac.uk), and the Intergovernmental Panel for Climate Change Dedicated Data Centre (http://ipcc-data.org) as well as components of many national and international projects. CEDA recieves both core funding (from the UK Natural Environment Research Council) and per project funding (from a variety of sources). However, all funders require metrics assessing success. In the case of preservation it is hard to measure success - usage alone is not enough, since next year someone may use currently unused data if it is well preserved, and so it is the act of preservation which in this case marks success. Even where data is accessed, it is not necessarily used. Hence at CEDA we have three key focii in our approach to metrics: measuring direct website access, benchmarking procedures against best practice, and hopefully soon, recording data citation. In this presentation we cover how we are addressing each of these three areas.

Launching biosimilar rituximab: an industry opinion on biosimilar uptake in Europe.

PubMed

Trollope, Richard; Johnson, Sue; Ireland, Henry

2017-06-01

Richard Trollope and Sue Johnson talk with Henry Ireland, Senior Editor about the recent approval of biosimilar rituximab (Truxima ® ) & the current state of biosimilar uptake across Europe Richard Trollope, Head of Biosimilars, Mundipharma International Limited, qualified as a biochemist before joining Wyeth's commercial operations, prior to its acquisition by Pfizer. Richard later joined Yamanouchi Pharmaceuticals (now Astellas Pharma). His fascination with oncology led him to join Mundipharma in Europe and after joining the company's UK arm (Napp Pharmaceuticals Limited), Richard began his journey in biosimilars. He now heads up the biosimilar franchise at Mundipharma International as it launches biosimilar rituximab (Truxima ® ) - the first biosimilar monoclonal antibody for the treatment of cancer, which will be distributed by Napp Pharmaceuticals in the UK. Sue Johnson, PhD, Medical Insights at Mundipharma International Limited, is a scientist by background and completed her postdoc fellowship at Harvard Medical School. On returning to the UK, she began her career in the pharmaceutical industry, working in UK Medical Affairs before transitioning to a European role with Mundipharma 2 years ago, where she leads on Medical Insights for the biosimilars franchise.

Nutritional Knowledge of UK Coaches

PubMed Central

Cockburn, Emma; Fortune, Alistair; Briggs, Marc; Rumbold, Penny

2014-01-01

Athletes obtain nutritional information from their coaches, yet their competency in this area is lacking. Currently, no research exists in the UK which has a different coach education system to many other countries. Therefore, the aim of this study was to evaluate the sports nutrition knowledge of UK coaching certificate (UKCC) level 2 and 3, hockey and netball qualified coaches. All coaches (n = 163) completed a sports nutrition questionnaire to identify: (a) if they provided nutritional advice; (b) their level of sport nutrition knowledge; and (c) factors that may have contributed to their level of knowledge. Over half the coaches provided advice to their athletes (n = 93, 57.1%), even though they were not competent to do so. Coaches responded correctly to 60.3 ± 10.5% of all knowledge questions with no differences between those providing advice and those who did not (p > 0.05). Those coaches who had undertaken formal nutrition training achieved higher scores than those who had not (p < 0.05). In conclusion, UK sports coaches would benefit from continued professional development in sports nutrition to enhance their coaching practice. PMID:24727434

Spurious claims for health-care products: an experimental approach to evaluating current UK legislation and its implementation.

PubMed

Rose, Leslie B; Posadzki, Paul; Ernst, Edzard

2012-01-01

The lay media, and especially the Internet, contain many misleading claims for health products which have previously been inadequately regulated by consumer law. This was an experimental interventional survey within a consumer health-care setting. Three health products were chosen on the basis of being widely available on the UK market and having no available evidence of effectiveness. Twelve volunteers submitted 39 complaints to Consumer Direct (UK portal for the regulator Trading Standards) regarding false health claims, and 36 complaints were followed up for a maximum of 4.8 months. The mean time from submission of complaints to Consumer Direct to acknowledgement by the relevant Trading Standards office was 13 days. There were no responses from Trading Standards for 22% of complaints. At the end of the study one supplier had amended their website following Trading Standards advice, but did not stop all health claims. Another stopped advertising their product on the Internet and the third continued the health claims unchanged. EU directive 2005/29/EC is largely ineffective in preventing misleading health claims for consumer products in the UK.

Using two on-going HIV studies to obtain clinical data from before, during and after pregnancy for HIV-positive women.

PubMed

Huntington, Susie E; Bansi, Loveleen K; Thorne, Claire; Anderson, Jane; Newell, Marie-Louise; Taylor, Graham P; Pillay, Deenan; Hill, Teresa; Tookey, Pat A; Sabin, Caroline A

2012-07-28

The UK Collaborative HIV Cohort (UK CHIC) is an observational study that collates data on HIV-positive adults accessing HIV clinical care at (currently) 13 large clinics in the UK but does not collect pregnancy specific data. The National Study of HIV in Pregnancy and Childhood (NSHPC) collates data on HIV-positive women receiving antenatal care from every maternity unit in the UK and Ireland. Both studies collate pseudonymised data and neither dataset contains unique patient identifiers. A methodology was developed to find and match records for women reported to both studies thereby obtaining clinical and treatment data on pregnant HIV-positive women not available from either dataset alone. Women in UK CHIC receiving HIV-clinical care in 1996-2009, were found in the NSHPC dataset by initially 'linking' records with identical date-of-birth, linked records were then accepted as a genuine 'match', if they had further matching fields including CD4 test date. In total, 2063 women were found in both datasets, representing 23.1% of HIV-positive women with a pregnancy in the UK (n = 8932). Clinical data was available in UK CHIC following most pregnancies (92.0%, 2471/2685 pregnancies starting before 2009). There was bias towards matching women with repeat pregnancies (35.9% (741/2063) of women found in both datasets had a repeat pregnancy compared to 21.9% (1502/6869) of women in NSHPC only) and matching women HIV diagnosed before their first reported pregnancy (54.8% (1131/2063) compared to 47.7% (3278/6869), respectively). Through the use of demographic data and clinical dates, records from two independent studies were successfully matched, providing data not available from either study alone.

Modelling coastal processes and morphological changes of the UK east coast in support of coastal decision-making

NASA Astrophysics Data System (ADS)

Li, Xiaorong; Leonardi, Nicoletta; Brown, Jennifer; Plater, Andy

2017-04-01

The coastline of Eastern England is home to about one quarter of the UK's coastal habitats, including intertidal salt marshes, tidal flats and sand dunes. These geomorphic features are of great importance to the local wildlife, global biodiversity, marine environment and human society and economy. Due to sea-level rise and the occurrence of extreme weather conditions, the coastline of Eastern England is under high risk of erosion and recession, which could lead to tidal inundation of sites such as the RSPB Minsmere Reserve and power generation infrastructure at Sizewell. This research responds to the need for sustainable shoreline management plans of the UK east coast through sensitivity studies at the Dunwich-Sizewell area, Suffolk, UK. Particular interest is on the long-term morphodynamic response of the study area to possible environmental variations associated with global climate change. Key coastal processes, i.e. current, waves and sediment transport, and morphological evolution are studied using a process-based numerical model under the following scenarios: current mean sea level + calm wave conditions, current mean sea level + storms, sea level rise + calm wave conditions, and sea level rise + storms, all with a 'do nothing' management plan which allows the coastal environment to exist and respond dynamically. As a further aspect of this research, rules will be generalized for reduced-complexity, system-based modelling. Alternative management plans, including 'managed realignment' and 'advance the line', are also investigated in this research under the same environmental forcing scenarios, for the purposes of protection of infrastructure of national importance and conservation of wetland habitats. Both 'hard' and 'soft' engineering options, such as groynes and beach nourishment respectively, are considered. A more ecohydrological option which utilizes aquatic plant communities for wave energy dissipation and sediment trapping is also studied. The last option requires the numerical models to be modified based on understandings obtained through analysis of on-site observations and laboratory measurements.

Widening access to medicine may improve general practitioner recruitment in deprived and rural communities: survey of GP origins and current place of work.

PubMed

Dowell, J; Norbury, M; Steven, K; Guthrie, B

2015-10-01

Widening access to medicine in the UK is a recalcitrant problem of increasing political importance, with associated strong social justice arguments but without clear evidence of impact on service delivery. Evidence from the United States suggests that widening access may enhance care to underserved communities. Additionally, rural origin has been demonstrated to be the factor most strongly associated with rural practice. However the evidence regarding socio-economic and rural background and subsequent practice locations in the UK has not been explored. The aim of this study was to investigate the association between general practitioners' (GPs) socio-economic and rural background at application to medical school and demographic characteristics of their current practice. The study design was a cross-sectional email survey of general practitioners practising in Scotland. Socio-economic status of GPs at application to medical school was assessed using the self-coded National Statistics Socio-Economic Classification. UK postcode at application was used to define urban-rural location. Current practice deprivation and remoteness was measured using NHS Scotland defined measures based on registered patients' postcodes. A survey was sent to 2050 Scottish GPs with a valid accessible email address, with 801 (41.5 %) responding. GPs whose parents had semi-routine or routine occupations had 4.3 times the odds of working in a deprived practice compared to those with parents from managerial and professional occupations (95 % CI 1.8-10.2, p = 0.001). GPs from remote and rural Scottish backgrounds were more likely to work in remote Scottish practices, as were GPs originating from other UK countries. This study showed that childhood background is associated with the population GPs subsequently serve, implying that widening access may positively affect service delivery in addition to any social justice rationale. Longitudinal research is needed to explore this association and the impact of widening access on service delivery more broadly.

Climate change effects on human health: projections of temperature-related mortality for the UK during the 2020s, 2050s and 2080s.

PubMed

Hajat, Shakoor; Vardoulakis, Sotiris; Heaviside, Clare; Eggen, Bernd

2014-07-01

The most direct way in which climate change is expected to affect public health relates to changes in mortality rates associated with exposure to ambient temperature. Many countries worldwide experience annual heat-related and cold-related deaths associated with current weather patterns. Future changes in climate may alter such risks. Estimates of the likely future health impacts of such changes are needed to inform public health policy on climate change in the UK and elsewhere. Time-series regression analysis was used to characterise current temperature-mortality relationships by region and age group. These were then applied to the local climate and population projections to estimate temperature-related deaths for the UK by the 2020s, 2050s and 2080s. Greater variability in future temperatures as well as changes in mean levels was modelled. A significantly raised risk of heat-related and cold-related mortality was observed in all regions. The elderly were most at risk. In the absence of any adaptation of the population, heat-related deaths would be expected to rise by around 257% by the 2050s from a current annual baseline of around 2000 deaths, and cold-related mortality would decline by 2% from a baseline of around 41 000 deaths. The cold burden remained higher than the heat burden in all periods. The increased number of future temperature-related deaths was partly driven by projected population growth and ageing. Health protection from hot weather will become increasingly necessary, and measures to reduce cold impacts will also remain important in the UK. The demographic changes expected this century mean that the health protection of the elderly will be vital. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The role of 'Big Society' in monitoring the state of the natural environment.

PubMed

Mackechnie, Colin; Maskell, Lindsay; Norton, Lisa; Roy, David

2011-10-01

Environmental monitoring is essential for assessing the current state of the environment, measuring impacts of environmental pressures and providing evidence to government. Recent UK government announcements have indicated an increased role for 'Big Society' in monitoring. In this paper, we review available literature concerning the use of citizen science for monitoring, present examples of successful volunteer monitoring work and highlight important issues surrounding the use of volunteers. We argue that in order to ensure that environmental monitoring continues to be effective it is important to learn from examples where volunteers are currently used, acknowledging constraints and identifying potential approaches which will help to maximise both their engagement and data quality. Effective partnerships between environmental monitoring organisations and volunteers may thus aid the UK in developing robust coordinated monitoring systems that will be less vulnerable to funding variances.

March of the Starbugs: Configuring Fiber-bearing Robots on the UK-Schmidt Optical Plane

NASA Astrophysics Data System (ADS)

Lorente, N. P. F.; Vuong, M.; Satorre, C.; Hong, S. E.; Shortridge, K.; Goodwin, M.; Kuehn, K.

2015-09-01

The TAIPAN instrument, currently being developed for the Australian Astronomical Observatory's UK Schmidt telescope at Siding Spring Observatory, makes use of the AAO's Starbug technology to deploy 150 science fibers to target positions on the optical plane. This paper describes the software system for controlling and deploying the fiber-bearing Starbug robots. The TAIPAN software is responsible for allocating each Starbug to its next target position based on its current position and the distribution of targets, finding a collision-free path for each Starbug, and then simultaneously controlling the Starbug hardware in a closed loop, with a metrology camera used to determine the position of each Starbug in the field during reconfiguration. The software is written in C++ and Java and employs a DRAMA middleware layer (Farrell et al. 1995).

Attitudes towards attrition among UK trainees in obstetrics and gynaecology.

PubMed

Gafson, Irene; Currie, Jane; O'Dwyer, Sabrina; Woolf, Katherine; Griffin, Ann

2017-06-02

Physician dissatisfaction in the workplace has consequences for patient safety. Currently in the UK, 1 in 5 doctors who enter specialist training in obstetrics and gynaecology leave the programme before completion. Trainee attrition has implications for workforce planning, organization of health-care services and patient care. The authors conducted a survey of current trainees' and former trainees' views concerning attrition and 'peri-attrition' - a term coined to describe the trainee who has seriously considered leaving the specialty. The authors identified six key themes which describe trainees' feelings about attrition in obstetrics and gynaecology: morale and undermining; training processes and paperwork; support and supervision; work-life balance and realities of life; NHS environment; and job satisfaction. This article discusses themes of an under-resourced health service, bullying, lack of work-life balance and poor personal support.

The current skills gaps in analytical sciences are failing industry: debate at the 21st International Reid Bioanalytical Forum.

PubMed

Spooner, Neil; Sangster, Timothy

2016-07-01

21st International Reid Bioanalytical Forum, University of Surrey, Guildford, UK, 7-10 September 2015 The 21st International Reid Bioanalytical Forum held between 7 and 10 September 2015, brought together over 100 scientists from around the world, representing industry, academia and vendors, for 4 days of engaging science at the University of Surrey in Guildford, UK. The scientific program consisted of 43 podium and 23 poster presentations from key opinion leaders and those just setting out on their scientific career. The latter being the focus of the meeting. One of the highlights of the forum was the debate. An expert panel helped spark off an active discussion among a passionate audience on the topic of 'The Current Skills Gaps in Analytical Sciences are Failing Industry.'

Current management of male-to-female gender identity disorder in the UK.

PubMed

Tugnet, Nicola; Goddard, Jonathan Charles; Vickery, Richard M; Khoosal, Deenesh; Terry, Tim R

2007-10-01

Gender identity disorder (GID), or transsexualism as it is more commonly known, is a highly complex clinical entity. Although the exact aetiology of GID is unknown, several environmental, genetic and anatomical theories have been described. The diagnosis of GID can be a difficult process but is established currently using standards of care as defined by the Harry Benjamin International Gender Dysphoria Association. Patients go through extensive psychiatric assessment, including the Real Life Experience, which entails living in the desired gender role 24 h a day for a minimum period of 12 months. The majority of GID patients will eventually go on to have gender realignment surgery, which includes feminising genitoplasty. The clinical features, diagnostic approach and management of male-to-female GID in the UK are reviewed, including the behavioural, psychological and surgical aspects.

Current management of male‐to‐female gender identity disorder in the UK

PubMed Central

Tugnet, Nicola; Goddard, Jonathan Charles; Vickery, Richard M; Khoosal, Deenesh; Terry, Tim R

2007-01-01

Gender identity disorder (GID), or transsexualism as it is more commonly known, is a highly complex clinical entity. Although the exact aetiology of GID is unknown, several environmental, genetic and anatomical theories have been described. The diagnosis of GID can be a difficult process but is established currently using standards of care as defined by the Harry Benjamin International Gender Dysphoria Association. Patients go through extensive psychiatric assessment, including the Real Life Experience, which entails living in the desired gender role 24 h a day for a minimum period of 12 months. The majority of GID patients will eventually go on to have gender realignment surgery, which includes feminising genitoplasty. The clinical features, diagnostic approach and management of male‐to‐female GID in the UK are reviewed, including the behavioural, psychological and surgical aspects. PMID:17916872

A Quantitative, Non-Destructive Methodology for Habitat Characterisation and Benthic Monitoring at Offshore Renewable Energy Developments

PubMed Central

Sheehan, Emma V.; Stevens, Timothy F.; Attrill, Martin J.

2010-01-01

Following governments' policies to tackle global climate change, the development of offshore renewable energy sites is likely to increase substantially over coming years. All such developments interact with the seabed to some degree and so a key need exists for suitable methodology to monitor the impacts of large-scale Marine Renewable Energy Installations (MREIs). Many of these will be situated on mixed or rocky substrata, where conventional methods to characterise the habitat are unsuitable. Traditional destructive sampling is also inappropriate in conservation terms, particularly as safety zones around (MREIs) could function as Marine Protected Areas, with positive benefits for biodiversity. Here we describe a technique developed to effectively monitor the impact of MREIs and report the results of its field testing, enabling large areas to be surveyed accurately and cost-effectively. The methodology is based on a high-definition video camera, plus LED lights and laser scale markers, mounted on a “flying array” that maintains itself above the seabed grounded by a length of chain, thus causing minimal damage. Samples are taken by slow-speed tows of the gear behind a boat (200 m transects). The HD video and randomly selected frame grabs are analysed to quantify species distribution. The equipment was tested over two years in Lyme Bay, UK (25 m depth), then subsequently successfully deployed in demanding conditions at the deep (>50 m) high-energy Wave Hub site off Cornwall, UK, and a potential tidal stream energy site in Guernsey, Channel Islands (1.5 ms−1 current), the first time remote samples from such a habitat have been achieved. The next stage in the monitoring development process is described, involving the use of Remote Operated Vehicles to survey the seabed post-deployment of MREI devices. The complete methodology provides the first quantitative, relatively non-destructive method for monitoring mixed-substrate benthic communities beneath MPAs and MREIs pre- and post-device deployment. PMID:21206748

Have restricted working hours reduced junior doctors’ experience of fatigue? A focus group and telephone interview study

PubMed Central

Morrow, Gill; Burford, Bryan; Carter, Madeline; Illing, Jan

2014-01-01

Objective To explore the effects of the UK Working Time Regulations (WTR) on trainee doctors’ experience of fatigue. Design Qualitative study involving focus groups and telephone interviews, conducted in Spring 2012 with doctors purposively selected from Foundation and specialty training. Final compliance with a 48 h/week limit had been required for trainee doctors since August 2009. Framework analysis of data. Setting 9 deaneries in all four UK nations; secondary care. Participants 82 doctors: 53 Foundation trainees and 29 specialty trainees. 36 participants were male and 46 female. Specialty trainees were from a wide range of medical and surgical specialties, and psychiatry. Results Implementation of the WTR, while acknowledged as an improvement to the earlier situation of prolonged excessive hours, has not wholly overcome experience of long working hours and fatigue. Fatigue did not only arise from the hours that were scheduled, but also from an unpredictable mixture of shifts, work intensity (which often resulted in educational tasks being taken home) and inadequate rest. Fatigue was also caused by trainees working beyond their scheduled hours, for reasons such as task completion, accessing additional educational opportunities beyond scheduled hours and staffing shortages. There were also organisational, professional and cultural drivers, such as a sense of responsibility to patients and colleagues and the expectations of seniors. Fatigue was perceived to affect efficiency of skills and judgement, mood and learning capacity. Conclusions Long-term risks of continued stress and fatigue, for doctors and for the effective delivery of a healthcare service, should not be ignored. Current monitoring processes do not reflect doctors’ true working patterns. The effectiveness of the WTR cannot be considered in isolation from the culture and context of the workplace. On-going attention needs to be paid to broader cultural issues, including the relationship between trainees and seniors. PMID:24604482

Coaching for recovery: a quality improvement project in mental healthcare

PubMed Central

Burhouse, Anna; Rowland, Madeleine; Marie Niman, Heather; Abraham, Daisy; Collins, Elizabeth; Matthews, Helen; Denney, Joanna; Ryland, Howard

2015-01-01

Approximately one in four adults in the UK will experience a mental health difficulty at some point in their life. This figure is approximately 400 million people worldwide.[1] Depression alone is currently estimated to cost the UK 1.7% of GDP and is one of the largest causes of ill health in the world.[2] For conditions like psychosis, evidence tells us that people have poorer quality of life outcomes, are more likely to die early, become obese, smoke, be unemployed, and have long term physical conditions than average.[3] People's social situation is also likely to be more complex, with housing needs, social isolation, stigma, and poverty.[4] All of these factors can make it hard for a person with a long-term mental health condition, or those supporting them, to hold onto a sense of hope that positive change is possible or that “recovery” towards a life that holds optimum meaning to them is achievable. An innovative “pop up” Recovery College model was co-produced, delivered, and evaluated by a team of people with lived experience of mental health difficulties, known as peer trainers. The Recovery College offered courses containing the best evidence-based knowledge about recovery in mental health, self-care and self-management. Each learning session included theory, personal testament from peer trainers, and volunteers and demonstrations of practical self-care skills and techniques. The courses were open to people experiencing mental health difficulties, their families, friends, and professionals. After the college course finished each student was offered up to three individual coaching sessions to help support putting the lessons learnt from the college into practice. The project aimed to test whether this innovative educational and coaching model could offer hope, knowledge and practical skills in self-management to support resilience and recovery. The project was underpinned by quality improvement methodologies to develop, deliver, and refine the model. PMID:26734387

A quantitative, non-destructive methodology for habitat characterisation and benthic monitoring at offshore renewable energy developments.

PubMed

Sheehan, Emma V; Stevens, Timothy F; Attrill, Martin J

2010-12-29

Following governments' policies to tackle global climate change, the development of offshore renewable energy sites is likely to increase substantially over coming years. All such developments interact with the seabed to some degree and so a key need exists for suitable methodology to monitor the impacts of large-scale Marine Renewable Energy Installations (MREIs). Many of these will be situated on mixed or rocky substrata, where conventional methods to characterise the habitat are unsuitable. Traditional destructive sampling is also inappropriate in conservation terms, particularly as safety zones around (MREIs) could function as Marine Protected Areas, with positive benefits for biodiversity. Here we describe a technique developed to effectively monitor the impact of MREIs and report the results of its field testing, enabling large areas to be surveyed accurately and cost-effectively. The methodology is based on a high-definition video camera, plus LED lights and laser scale markers, mounted on a "flying array" that maintains itself above the seabed grounded by a length of chain, thus causing minimal damage. Samples are taken by slow-speed tows of the gear behind a boat (200 m transects). The HD video and randomly selected frame grabs are analysed to quantify species distribution. The equipment was tested over two years in Lyme Bay, UK (25 m depth), then subsequently successfully deployed in demanding conditions at the deep (>50 m) high-energy Wave Hub site off Cornwall, UK, and a potential tidal stream energy site in Guernsey, Channel Islands (1.5 ms⁻¹ current), the first time remote samples from such a habitat have been achieved. The next stage in the monitoring development process is described, involving the use of Remote Operated Vehicles to survey the seabed post-deployment of MREI devices. The complete methodology provides the first quantitative, relatively non-destructive method for monitoring mixed-substrate benthic communities beneath MPAs and MREIs pre- and post-device deployment.

A review of total & added sugar intakes and dietary sources in Europe.

PubMed

Azaïs-Braesco, Véronique; Sluik, Diewertje; Maillot, Matthieu; Kok, Frans; Moreno, Luis A

2017-01-21

Public health policies, including in Europe, are considering measures and recommendations to limit the intake of added or free sugars. For such policies to be efficient and monitored, a precise knowledge of the current situation regarding sugar intake in Europe is needed. This review summarizes published or re-analyzed data from 11 representative surveys in Belgium, France, Denmark, Hungary, Ireland, Italy, Norway, The Netherlands, Spain and the UK. Relative intakes were higher in children than in adults: total sugars ranged between 15 and 21% of energy intake in adults and between 16 and 26% in children. Added sugars (or non-milk extrinsic sugars (NMES), in the UK) contributed 7 to 11% of total energy intake in adults and represented a higher proportion of children's energy intake (11 to 17%). Educational level did not significantly affect intakes of total or added sugars in France and the Netherlands. Sweet products (e.g. confectionery, chocolates, cakes and biscuits, sugar, and jam) were major contributors to total sugars intake in all countries, genders and age groups, followed by fruits, beverages and dairy products. Fruits contributed more and beverages contributed less to adults' total sugars intakes than to children's. Added sugars were provided mostly by sweet products (36 to 61% in adults and 40 to 50% in children), followed by beverages (12 to 31% in adults and 20 to 34% in children, fruit juices excluded), then by dairy products (4 to 15% in adults and 6 to 18% in children). Caution is needed, however, as survey methodologies differ on important items such as dietary data collection, food composition tables or estimation of added sugars. Cross-country comparisons are thus not meaningful and overall information might thus not be robust enough to provide a solid basis for implementation of policy measures. Data nevertheless confirm that intakes of total and added sugars are high in the European countries considered, especially in children, and point to sweet products and beverages as the major contributors to added sugar intakes.

Mammographic interpretation training in the UK: current difficulties and future outlook

NASA Astrophysics Data System (ADS)

Chen, Yan; Gale, Alastair G.; Scott, Hazel

2009-02-01

In the UK, most mammographic interpretation training needs to be undertaken where there is a mammo-alternator or other suitable light box; consequently limiting the time and places where training can take place. However, the gradual introduction of digital mammography is opening up new opportunities of providing such training without the restriction of current viewing devices. Whilst high-resolution monitors in appropriate viewing environments are de rigour for actual reporting; advantages of the digital image over film are in the flexibility of training opportunity afforded, e.g. training whenever, wherever suits the individual. A previous study indicated the possible potential for reporting mammographic cases utilising handheld devices with suitable interaction techniques. In a pilot study, a group of mammographers (n=4) were questioned in semi-structured interviews in order to help establish current UK film-readers' training profile. On the basis of the pilot study data, 109 Breast Screening Units (601 film readers) were approached to complete a structured questionnaire in order to establish the potential role of smaller computer devices in mammographic interpretation training (given the use of digital mammography). Subsequently, a study of radiologists' visual search behaviour in digital screening has begun. This has highlighted different image manipulations than found in structured experiments in this area and poses new challenges for visualising the inspection process. Overall the results indicate that using different display sizes for training is possible but is also a challenging task requiring novel interaction approaches.

The effect of recent amblyopia research on current practice in the UK.

PubMed

Newsham, D

2010-10-01

Several studies have recently provided insights into how amblyopia may be most effectively managed. Despite the new evidence, a US study reported that a recent randomised controlled trial had made little influence on clinical practice. The aims of this research are to assess current practice of amblyopia management in the UK and to determine the comparability with the evidence-based recommendations. A questionnaire was constructed to assess current amblyopia management practice, particularly in relation to areas investigated by recent research and emailed to every head orthoptist within the UK. There was a great deal of variability in the amount of occlusion that was prescribed for moderate and severe amblyopia. Sixty per cent of clinicians indicated that the maximum they would prescribe was in excess of the 6 h recommended by research. Atropine was rarely recommended as a first-line treatment, with occlusion generally being considered to be more effective. Despite recommendations regarding education as a means of reducing non-compliance, only 39% of clinicians always gave written information, although various other methods of enhancing compliance were used. A period of refractive adaptation was allowed by most clinicians but often far less than recommended. The uptake of recent research evidence into clinical practice is sporadic and incomplete with one-third of respondents indicating that following the studies, they had made no changes whatsoever to their practice. This is similar to other areas of medicine; the reasons are likely to be varied, and is an area that would benefit from greater attention.

Immunity to tetanus and diphtheria in the UK in 2009.

PubMed

Wagner, Karen S; White, Joanne M; Andrews, Nick J; Borrow, Ray; Stanford, Elaine; Newton, Emma; Pebody, Richard G

2012-11-19

This study aimed to estimate the immunity of the UK population to tetanus and diphtheria, including the potential impact of new glycoconjugatate vaccines, and the addition of diphtheria to the school leaver booster in 1994. Residual sera (n=2697) collected in England in 2009/10 were selected from 18 age groups and tested for tetanus and diphtheria antibody. Results were standardised by testing a panel of sera (n=150) to enable comparison with a previously (1996) published serosurvey. Data were then standardised to the UK population. In 2009, 83% of the UK population were protected (≥0.1 IU/mL) against tetanus compared to 76% in 1996 (p=0.079), and 75% had at least basic protection against diphtheria (≥0.01 IU/mL) in 2009 compared to 60% in 1996 (p<0.001). Higher antibody levels were observed in those aged 1-3 years in 2009 compared to 1996 for both tetanus and diphtheria. Higher diphtheria immunity was observed in those aged 16-34 years in 2009 compared to 1996 (geometric mean concentration [GMC] 0.15 IU/mL vs. 0.03 IU/mL, p<0.001). Age groups with the largest proportion of susceptible individuals to both tetanus and diphtheria in 2009 were <1 year old (>29% susceptible), 45-69 years (>20% susceptible) and 70+ years (>32% susceptible). Low immunity was observed in those aged 10-11 years (>19% susceptible), between the scheduled preschool and school leaver booster administration. The current schedule appears to induce protective levels; increases in the proportions protected/GMCs were observed for the ages receiving vaccinations according to UK policy. Glycoconjugate vaccines appear to have increased immunity, in particular for diphtheria, in preschool age groups. Diphtheria immunity in teenagers and young adults has increased as a result of the addition of diphtheria to the school leaver booster. However, currently older adults remain susceptible, without any further opportunities for immunisations planned according to the present schedule. Copyright © 2012 Elsevier Ltd. All rights reserved.

'Why not you?' Discourses of widening access on UK medical school websites.

PubMed

Alexander, Kirsty; Fahey Palma, Tania; Nicholson, Sandra; Cleland, Jennifer

2017-06-01

In the UK, applications to medicine from those in lower socio-economic groups remain low despite significant investments of time, interest and resources in widening access (WA) to medicine. This suggests that medical schools' core messages about WA may be working to embed or further reinforce marginalisation, rather than to combat this. Our objective was to investigate how the value of WA is communicated by UK medical schools through their websites, and how this may create expectations regarding who is 'suitable' for medicine. We conducted a critical discourse analysis of the webpages of UK medical schools in relation to WA. Our conceptual framework was underpinned by a Foucauldian understanding of discourse. Analysis followed an adapted version of Hyatt's analytical framework. This involved contextualising the data by identifying drivers, levers and warrants for WA, before undertaking a systematic investigation of linguistic features to reveal the discourses in use, and their assumptions. Discourses of 'social mobility for the individual' justified WA as an initiative to support individuals with academic ability and commitment to medicine, but who were disadvantaged by their background in the application process. This meritocratic discourse communicated the benefits of WA as flowing one way, with medical schools providing opportunities to applicants. Conversely, discourses justifying WA as an initiative to benefit patient care were marginalised and largely excluded. Alternative strengths typically attributed to students from lower socio-economic groups were not mentioned, which implies that these were not valued. Current discourses of WA on UK medical school websites do not present non-traditional applicants as bringing gains to medicine through their diversity. This may work as a barrier to attracting larger numbers of diverse applicants. Medical schools should reflect upon their website discourses, critically evaluate current approaches to encouraging applications from those in lower socio-economic groups, and consider avenues for positive change. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Current management of pregnancy-related low back pain: a national cross-sectional survey of U.K. physiotherapists.

PubMed

Bishop, A; Holden, M A; Ogollah, R O; Foster, N E

2016-03-01

Pregnancy-related low back pain (LBP) is very common. Evidence from a systematic review supports the use of exercise and acupuncture, although little is known about the care received by women with pregnancy-related back pain in the U.K. To describe current acupuncture and standard care management of pregnancy-related LBP by U.K. physiotherapists. Cross-sectional survey of physiotherapists with experience of treating women with pregnancy-related LBP from three professional networks of the Chartered Society of Physiotherapy. In total, 1093 physiotherapists were mailed a questionnaire. The questionnaire captured respondents' demographic and practice setting information, and experience of managing women with pregnancy-related back pain, and investigated the reported management of pregnancy-related LBP using a patient case vignette of a specific, 'typical' case. The overall response rate was 58% (629/1093). Four hundred and ninety-nine physiotherapists had experience of treating women with pregnancy-related LBP and were included in the analysis. Most respondents worked wholly or partly in the U.K. National Health Service (78%). Most respondents reported that they treat patients with pregnancy-related LBP in three to four one-to-one treatment sessions over 3 to 6 weeks. The results show that a range of management strategies are employed for pregnancy-related LBP, and multimodal management is common. The most common reported treatment was home exercises (94%), and 24% of physiotherapists reported that they would use acupuncture with the patient described in the vignette. This study provides the first robust data on the management of pregnancy-related LBP by U.K. physiotherapists. Multimodal management is common, although exercise is the most frequently used treatment for pregnancy-related LBP. Acupuncture is used less often for this patient group. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Heat protection behaviour in the UK: results of an online survey after the 2013 heatwave.

PubMed

Khare, Swarna; Hajat, Shakoor; Kovats, Sari; Lefevre, Carmen E; de Bruin, Wändi Bruine; Dessai, Suraje; Bone, Angie

2015-09-10

The Heatwave Plan for England provides guidance for personal and home protection measures during heatwaves. Although studies in the USA, Australia and Europe have surveyed heat-related behaviours during heatwaves, few have been conducted in the UK. This study assesses personal and housing (at-home) behaviour and housing characteristics of the UK population during the 2013 heatwave. This paper analyses data from 1497 respondents of an online survey on heat protection measures and behaviour. Participants were asked questions about their behaviour during the 2013 heatwave, the characteristics of their current housing as well as about any negative health outcomes experienced due to the hot weather. We used multinomial logit regression to analyse personal and home heat protection behaviour and logistic regression to analyse characteristics of participants' current home (installed air conditioner, curtains etc.). We stratified the outcomes by age, sex, ethnicity, income, education and regional location. In 2013, for all heat-related illness (except tiredness), a higher proportion of those in the younger age groups reported symptoms compared with those in the older age groups. Women, higher income groups and those with higher education levels were found to be more likely to report always/often taking personal heat protective measures. The elderly were less likely to take some personal and home protective measures but were more likely to live in insulated homes and open windows at night to keep their home cool. Our study has found a high level of awareness of the actions to take during heatwaves in the UK, and has identified important demographic indicators of sections of the UK population that might benefit from additional or more targeted information. The health agencies should attempt to provide better information about heatwaves to those vulnerable (elderly, those at risk living in London, low income earners) or identify any barriers that might be preventing them from undertaking protective behaviour.

The 'Antiretrovirals, Sexual Transmission Risk and Attitudes' (ASTRA) study. Design, methods and participant characteristics.

PubMed

Speakman, Andrew; Rodger, Alison; Phillips, Andrew N; Gilson, Richard; Johnson, Margaret; Fisher, Martin; Ed Wilkins; Anderson, Jane; O'Connell, Rebecca; Lascar, Monica; Aderogba, Kazeem; Edwards, Simon; McDonnell, Jeffrey; Perry, Nicky; Sherr, Lorraine; Collins, Simon; Hart, Graham; Johnson, Anne M; Miners, Alec; Elford, Jonathan; Geretti, Anna-Maria; Burman, William J; Lampe, Fiona C

2013-01-01

Life expectancy for people diagnosed with HIV has improved dramatically however the number of new infections in the UK remains high. Understanding patterns of sexual behaviour among people living with diagnosed HIV, and the factors associated with having condom-less sex, is important for informing HIV prevention strategies and clinical care. In addition, in view of the current interest in a policy of early antiretroviral treatment (ART) for all people diagnosed with HIV in the UK, it is of particular importance to assess whether ART use is associated with increased levels of condom-less sex. In this context the ASTRA study was designed to investigate current sexual activity, and attitudes to HIV transmission risk, in a large unselected sample of HIV-infected patients under care in the UK. The study also gathered background information on demographic, socio-economic, lifestyle and disease-related characteristics, and physical and psychological symptoms, in order to identify other key factors impacting on HIV patients and the behaviours which underpin transmission. In this paper we describe the study rationale, design, methods, response rate and the demographic characteristics of the participants. People diagnosed with HIV infection attending 8 UK HIV out-patient clinics in 2011-2012 were invited to participate in the study. Those who agreed to participate completed a confidential, self-administered pen-and-paper questionnaire, and their latest CD4 count and viral load test results were recorded. During the study period, 5112 eligible patients were invited to take part in the study and 3258 completed questionnaires were obtained, representing a response rate of 64% of eligible patients. The study includes 2248 men who have sex with men (MSM), 373 heterosexual men and 637 women. Future results from ASTRA will be a key resource for understanding HIV transmission within the UK, targeting prevention efforts, and informing clinical care of individuals living with HIV.

Educational Myth-Making with "Due Accuracy and Impartiality"? A Current Affairs TV Episode in the United Kingdom

ERIC Educational Resources Information Center

Wallace, Mike

2007-01-01

The mass media contribution to education politics is explored through the application of a pluralistic theoretical framework to evidence connected with the making of an episode of a U.K. current affairs television program. The episode addressed a politically contentious educational issue but proved controversial in itself. Several sources…

Group Therapy for School-Aged Children Who Stutter: A Survey of Current Practices

ERIC Educational Resources Information Center

Liddle, Hilary; James, Sarah; Hardman, Margaret

2011-01-01

Although group therapy is recommended for school-aged children who stutter (CWS), it is not widely researched. This study aimed to explore this provision, using a postal survey which investigated the current practices of Speech & Language Therapists (SLTs) in the UK. Seventy percent of SLT services provided some group therapy, but the level of…

Tobacco and tobacco branding in films most popular in the UK from 1989 to 2008.

PubMed

Lyons, Ailsa; McNeill, Ann; Chen, Yilu; Britton, John

2010-05-01

BACKGROUND Tobacco promotion is now tightly restricted in the UK and many other countries, but tobacco imagery including brand appearances in the media remain potentially powerful drivers of smoking uptake among children and young people. The extent to which tobacco imagery and specific products have appeared in the most popular films viewed in the UK over 20 years has been measured, in relation to year of release, the age certification allocated to the film by the British Board of Film Classification (BBFC), country of origin and other characteristics. METHODS Occurrence of tobacco intervals (tobacco use, implied use or appearance of smoking paraphernalia) and brand appearances were measured by 5 min interval coding in the 15 most commercially successful films in the UK each year from 1989 to 2008. RESULTS Tobacco intervals occurred in 70% of all films. Over half (56%) of those that contained tobacco intervals were rated by the BBFC as suitable for viewing by children aged <15, and 92% for people aged <18. Tobacco interval appearances fell by approximately 80% over the study period, but persisted in films in all BBFC categories. Brand appearances were nearly twice as likely to occur in films originating wholly or in part from the UK (UK films). Specific brands, particularly Marlboro and Silk Cut, appeared in 9% of all films, and most brand appearances (39%) were in films with BBFC 15 classification. CONCLUSIONS Tobacco imagery in the most popular films shown in the UK has declined substantially over the past 20 years but continues to occur, particularly in UK films, and predominantly in films categorised as suitable for viewing by children and young people. Specific brand appearances are now rare but occur repeatedly in some films. The BBFC is not currently protecting children and young people from exposure to tobacco imagery in film.

Comorbidities and medications of patients with chronic hepatitis C under specialist care in the UK

PubMed Central

Hudson, Benjamin; Walker, Alex J.

2017-01-01

Designing services with the capacity and expertise to meet the needs of the chronic hepatitis C (CHC) population in the era of direct acting antivirals (DAAs), and widening access to such treatments, requires detailed understanding of the characteristics and healthcare needs of the existing patient population. In this retrospective analysis of data from the National HCV Research UK Biobank between March 2012 and October 2014, the characteristics of the CHC population currently under specialist care in the UK were evaluated—with specific focus upon use of medications, adverse lifestyle choices, and comorbidities. Demographic data, risk factors for CHC acquisition, HCV genotype, liver disease status, lifestyle factors, comorbidities, and medication classes were collected. Data were analyzed by history of injecting drug use (IDU), age, and severity of liver disease. A total of 6278 patients (70.5% white; median age, 52 years) from 59 UK specialist centres were included; 59.1% of patients had acquired HCV through IDU. The prevalence of adverse lifestyle factors was significantly lower in non‐IDU compared with previous IDU or recent IDU patients. Depression was common in the previous (50.8%) and recent IDU (68.1%) groups, compared with 27.6% in non‐IDU patients. Cirrhosis was common (23.6%), and prevalence increased with age. We describe a heterogeneous, polymorbid, and aging population of CHC patients in secondary care, and demonstrate underrepresentation of injecting drug users within the current system. The implications of this present significant challenges to physicians and healthcare commissioners in designing services which are fit for purpose inthe DAA era. PMID:28480974

Towards a biological monitoring guidance value for acrylamide.

PubMed

Sams, C; Jones, K; Warren, N; Cocker, J; Bell, S; Bull, P; Cain, M

2015-08-19

Acrylamide is classified as a potential human carcinogen and neurotoxicant. Biological monitoring is a useful tool for monitoring worker exposure. However, other sources of exposure to acrylamide (including cigarette smoke and diet) also need to be considered. This study has performed repeat measurements of the urinary mercapturic acids of acrylamide (AAMA) and its metabolite glycidamide (GAMA) and determined globin adducts in 20 production-plant workers at a UK acrylamide production facility. The relationship between biomarker levels and environmental monitoring data (air levels and hand washes) was investigated. Good correlations were found between all of the biomarkers (r(2)=0.86-0.91) and moderate correlations were found between the biomarkers and air levels (r(2) = 0.56-0.65). Our data show that urinary AAMA is a reliable biomarker of acrylamide exposure. Occupational hygiene data showed that acrylamide exposure at the company was well within the current UK Workplace Exposure Limit. The 90th percentile of urinary AAMA in non-smoking production-plant workers (537 μmol/mol creatinine (n = 59 samples)) is proposed as a possible biological monitoring guidance value. This 90th percentile increased to 798 μmol/mol if smokers were included (n = 72 samples). These values would be expected following an airborne exposure of less than 0.07 mg/m(3), well below the current UK workplace exposure limit of 0.3mg/m(3). Comparison of biomarker levels in non-occupationally exposed individuals suggests regional variations (between UK and Germany), possibly due to differences in diet. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

A quantitative release assessment for the noncommercial movement of companion animals: risk of rabies reintroduction to the United kingdom.

PubMed

Goddard, A D; Donaldson, N M; Horton, D L; Kosmider, R; Kelly, L A; Sayers, A R; Breed, A C; Freuling, C M; Müller, T; Shaw, S E; Hallgren, G; Fooks, A R; Snary, E L

2012-10-01

In 2004, the European Union (EU) implemented a pet movement policy (referred to here as the EUPMP) under EU regulation 998/2003. The United Kingdom (UK) was granted a temporary derogation from the policy until December 2011 and instead has in place its own Pet Movement Policy (Pet Travel Scheme (PETS)). A quantitative risk assessment (QRA) was developed to estimate the risk of rabies introduction to the UK under both schemes to quantify any change in the risk of rabies introduction should the UK harmonize with the EU policy. Assuming 100 % compliance with the regulations, moving to the EUPMP was predicted to increase the annual risk of rabies introduction to the UK by approximately 60-fold, from 7.79 × 10(-5) (5.90 × 10(-5), 1.06 × 10(-4)) under the current scheme to 4.79 × 10(-3) (4.05 × 10(-3), 5.65 × 10(-3)) under the EUPMP. This corresponds to a decrease from 13,272 (9,408, 16,940) to 211 (177, 247) years between rabies introductions. The risks associated with both the schemes were predicted to increase when less than 100 % compliance was assumed, with the current scheme of PETS and quarantine being shown to be particularly sensitive to noncompliance. The results of this risk assessment, along with other evidence, formed a scientific evidence base to inform policy decision with respect to companion animal movement. © 2012 Crown Copyright. This article is published with the permission of the Controller of the HMSO and the Queen's Printer for Scotland.

Epidural analgesia in children. A survey of current opinions and practices amongst UK paediatric anaesthetists.

PubMed

Williams, D G; Howard, R F

2003-11-01

Despite the widespread use of epidural analgesia in children its place in paediatric pain management has not been clearly established. In order to investigate the current practice of paediatric epidural analgesia in the UK paediatric anaesthetists and paediatric pain management teams were surveyed. Questionnaires were sent to the members of the Association of Paediatric Anaesthetists (APA) working within the UK and to lead clinicians and clinical nurse specialists for acute pain in the 26 designated major paediatric centres. The response rate was 72%. There was little consensus regarding drugs and drug combinations used for epidural analgesia. A total of 36% of paediatric centres did not audit their epidural practice, and of those that did the reported incidences of side-effects showed wide variation. Important differences in practice were also identified in the areas of patient selection, informed consent, the use of epidural test doses, drug delivery systems, monitoring and the management of side-effects. Twelve per cent of specialist paediatric hospitals did not have an acute pain team and elsewhere the provision was often limited to staff with few or no specialist skills. There is wide variation in the practice of paediatric epidural analgesia in the UK. Inconsistencies are likely to be related to the poor evidence base available to guide clinical decision making and the lack of a specialized paediatric acute pain service in some centres. More research is required to determine the optimal management of epidural analgesia, and suitable clinical support for paediatric pain control should be more widely available.

The health effects of hotter summers and heat waves in the population of the United Kingdom: a review of the evidence.

PubMed

Arbuthnott, Katherine G; Hajat, Shakoor

2017-12-05

It is widely acknowledged that the climate is warming globally and within the UK. In this paper, studies which assess the direct impact of current increased temperatures and heat-waves on health and those which project future health impacts of heat under different climate change scenarios in the UK are reviewed.This review finds that all UK studies demonstrate an increase in heat-related mortality occurring at temperatures above threshold values, with respiratory deaths being more sensitive to heat than deaths from cardiovascular disease (although the burden from cardiovascular deaths is greater in absolute terms). The relationship between heat and other health outcomes such as hospital admissions, myocardial infarctions and birth outcomes is less consistent. We highlight the main populations who are vulnerable to heat. Within the UK, these are older populations, those with certain co-morbidities and those living in Greater London, the South East and Eastern regions.In all assessments of heat-related impacts using different climate change scenarios, deaths are expected to increase due to hotter temperatures, with some studies demonstrating that an increase in the elderly population will also amplify burdens. However, key gaps in knowledge are found in relation to how urbanisation and population adaptation to heat will affect health impacts, and in relation to current and future strategies for effective, sustainable and equitable adaptation to heat. These and other key gaps in knowledge, both in terms of research needs and knowledge required to make sound public- health policy, are discussed.

The pore space scramble

NASA Astrophysics Data System (ADS)

Gormally, Alexandra; Bentham, Michelle; Vermeylen, Saskia; Markusson, Nils

2015-04-01

Climate change and energy security continue to be the context of the transition to a secure, affordable and low carbon energy future, both in the UK and beyond. This is reflected in for example, binding climate policy targets at the EU level, the introduction of renewable energy targets, and has also led to an increasing interest in Carbon Capture and Storage (CCS) technology with its potential to help mitigate against the effects of CO2 emissions from fossil fuel burning. The UK has proposed a three phase strategy to integrate CCS into its energy system in the long term focussing on off-shore subsurface storage (DECC, 2014). The potential of CCS therefore, raises a number of challenging questions and issues surrounding the long-term storage of CO2 captured and injected into underground spaces and, alongside other novel uses of the subsurface, contributes to opening a new field for discussion on the governance of the subsurface. Such 'novel' uses of the subsurface have lead to it becoming an increasingly contested space in terms of its governance, with issues emerging around the role of ownership, liability and property rights of subsurface pore space. For instance, questions over the legal ownership of pore space have arisen with ambiguity over the legal standpoint of the surface owner and those wanting to utilise the pore space for gas storage, and suggestions of whether there are depths at which legal 'ownership' becomes obsolete (Barton, 2014). Here we propose to discuss this 'pore space scramble' and provide examples of the competing trajectories of different stakeholders, particularly in the off-shore context given its priority in the UK. We also propose to highlight the current ambiguity around property law of pore space in the UK with reference to approaches currently taken in different national contexts. Ultimately we delineate contrasting models of governance to illustrate the choices we face and consider the ethics of these models for the common good. Barton, B (2014) The Common Law of Subsurface Activity: General Principle and Current Problems. In: Zillman, D.N., McHarg, A., Barrera-Hernandez, L., Bradbrook., A. (Eds), The Law of Energy Underground: Understanding new developments in subsurface production, transmission, and storage. Oxford University Press, Croydon, pp. 21-36. DECC (2014) Next steps in CCS: Policy Scoping Document - Developing an approach for the next phase of Carbon Capture and Storage projects in the UK. HM Government.

Current neurosurgical trainees' perception of the European Working Time Directive and shift work.

PubMed

Tait, M J; Fellows, G A; Pushpananthan, S; Sergides, Y; Papadopoulos, M C; Bell, B A

2008-02-01

The introduction of the shift system in response to the European Working Time Directive has had an enormous impact on the running of neurosurgical units in the UK. This study seeks to establish what provisions are currently in place for out of hours cover and what has been the effect of the introduction of shifts in three main areas: patient safety, training and 'work/life balance'. The on-call registrar at each UK neurosurgical unit was contacted by telephone. Data regarding current emergency provision were sought. Registrars who had worked both on-calls and the shift system during their career as a neurosurgical registrar were asked to make a comparison. Data were collected from all 33 UK units. Twenty-two still use a traditional 24-h on-call system. Twenty-one on-call rotas were classed as non-resident although 12/21 of those officially on non-resident rotas were in fact resident whilst on call. Twenty-two registrars had worked both systems as a neurosurgical registrar. Twenty-one (95.45%) felt that traditional on-calls gave better clinical exposure. Twenty-one (95.45%) felt that on-calls allowed the provision of better patient care. Nineteen (86.36%) felt that on-calls were safer. Thirteen (59.09%) reported that they were more tired when doing shift work than on-calls. Fourteen (63.63%) found that the on-call system gives more useful spare time and more time to deal with family commitments. Current neurosurgery registrars feel the shift system is less safe, harmful to training and worse in terms of work/life balance. More than one-third of units are claiming to have non-resident on-call systems in order to appear compliant with EWTD when registrars are in fact resident.

Provision of medical student teaching in UK general practices: a cross-sectional questionnaire study

PubMed Central

Harding, Alex; Rosenthal, Joe; Al-Seaidy, Marwa; Gray, Denis Pereira; McKinley, Robert K

2015-01-01

Background Health care is increasingly provided in general practice. To meet this demand, the English Department of Health recommends that 50% of all medical students should train for general practice after qualification. Currently 19% of medical students express general practice as their first career choice. Undergraduate exposure to general practice positively influences future career choice. Appropriate undergraduate exposure to general practice is therefore highly relevant to workforce planning Aim This study seeks to quantify current exposure of medical students to general practice and compare it with past provision and also with postgraduate provision. Design and setting A cross-sectional questionnaire in the UK. Method A questionnaire regarding provision of undergraduate teaching was sent to the general practice teaching leads in all UK medical schools. Information was gathered on the amount of undergraduate teaching, how this was supported financially, and whether there was an integrated department of general practice. The data were then compared with results from previous studies of teaching provision. The provision of postgraduate teaching in general practice was also examined. Results General practice teaching for medical students increased from <1.0% of clinical teaching in 1968 to 13.0% by 2008; since then, the percentage has plateaued. The total amount of general practice teaching per student has fallen by 2 weeks since 2002. Medical schools providing financial data delivered 14.6% of the clinical curriculum and received 7.1% of clinical teaching funding. The number of departments of general practice has halved since 2002. Provision of postgraduate teaching has tripled since 2000. Conclusion Current levels of undergraduate teaching in general practice are too low to fulfil future workforce requirements and may be falling. Financial support for current teaching is disproportionately low and the mechanism counterproductive. Central intervention may be required to solve this. PMID:26009536

40 CFR 1054.660 - What are the provisions for exempting emergency rescue equipment?

Code of Federal Regulations, 2010 CFR

2010-07-01

... certified to current emission standards under the following conditions if the equipment will be used solely in emergency rescue situations: (1) You must determine annually that no engines certified to current... situations” means firefighting or other situations in which a person is retrieved from imminent danger. (c...

Cultural differences in musculoskeletal symptoms and disability.

PubMed

Madan, Ira; Reading, Isabel; Palmer, Keith T; Coggon, David

2008-10-01

To test the hypothesis that cultural factors such as health beliefs and expectations have an important influence on common musculoskeletal symptoms and associated disability, we compared prevalence rates in groups of workers carrying out similar physical activities in different cultural settings. We conducted a cross-sectional survey at factories and offices in Mumbai, India and in the UK. A questionnaire about symptoms, disability and risk factors was administered at interview to six occupational groups: three groups of office workers who regularly used computer keyboards (165 Indian, 67 UK of Indian subcontinental origin and 172 UK white), and three groups of workers carrying out repetitive manual tasks with the hands or arms (178 Indian, 73 UK of Indian subcontinental origin and 159 UK white). Modified Cox regression was used to calculate hazard ratios (HRs) for the prevalence of symptoms and disability by occupational group, adjusted for differences in sex, age, mental health and job satisfaction. Reported occupational activities were similar in the three groups of office workers (frequent use of keyboards) and in the three groups of manual workers (frequent movements of the wrist or fingers, bending of the elbow, work with the hands above shoulder height and work with the neck twisted). In comparison with the Indian manual workers, the prevalence of back, neck and arm pain was substantially higher in all of the other five occupational groups. The difference was greatest for arm pain lasting >30 days in the past year in UK white manual workers (HR 17.8, 95% CI 5.4-59.1) and UK manual workers of Indian subcontinental origin (HR 20.5, 95% CI 5.7-73.1). Office workers in India had lower rates of pain in the wrist and hand than office workers in the UK. Only 1% of the Indian manual workers and 16% of the Indian office workers had ever heard of 'RSI' or similar terms, as compared with 80% of the UK workers. Our findings support the hypothesized impact of cultural factors on common musculoskeletal complaints. Current controls on hazardous physical activities in the workplace may not have the benefits that would be predicted from observational epidemiology.

PREFACE: The 16th International Conference on Positron Annihilation (ICPA-16)

NASA Astrophysics Data System (ADS)

Alam, Ashraf; Coleman, Paul; Dugdale, Stephen; Roussenova, Mina

2013-06-01

The 16th International Conference on Positron Annihilation (ICPA-16) was held at the University of Bristol, United Kingdom during 19-24 August, 2012. This triennial conference is the foremost gathering of the Positron Annihilation Physics community and it was hosted in the UK for the first time since the series of meetings first started back in 1965. The University of Bristol, the Alma Mater of Paul Dirac, is situated at the heart of the city, and it has established a worldwide reputation in research and teaching. Many of the topics which were discussed during ICPA-16 form an integral part of the research themes in the schools of Physics, Chemistry and Engineering of this University. ICPA-16 attracted a diverse audience, both from academic and industrial institutions, with over 200 participants from 29 countries. It continued the long held tradition of showcasing novel research in the field of positron annihilation and a total of 170 papers were presented as talks and posters. The papers reported studies of metallic and semi-conducting solids, polymers and soft matter, porous materials, surfaces and interfaces, as well as advances in experimental, analytical and biomedical applications. The high quality of the presented work, coupled with the enthusiastic exchange of ideas, provided an invaluable forum, especially for younger researchers and postgraduate students. The excellence of student presentations was acknowledged by the award of prizes for the best student posters, which were received by David Billington (University of Bristol, UK), Moussa Sidibe (CEMHTI, France) and Hongxia Xu (Tohoku University, Japan). All papers published in the Conference Proceedings were reviewed by ICPA-16 participants. We are indebted to all reviewers who contributed their time and intellectual resources, allowing the refereeing and editing process to move smoothly toward the compilation of the Proceedings. Our sincere thanks and gratitude go to everyone who contributed to the success of the conference. We are grateful to all participants for their informative talks, poster presentations and fruitful discussions; the session chairs for keeping to the tight time schedule and for making sure the oral presentation sessions ran smoothly; Maria Dugdale for her time and effort in organising the social programme for the accompanying persons; the student volunteers from the Bristol Positron Group for all their help and time before, during and after the conference; the Bath positron group for helping with the organisation of the excursion and last, but not least, the University of Bristol Conference Office staff for their help with the organisation of the conference. We are also very grateful for the financial and logistical help from the University of Bristol and financial support from our sponsors and exhibitors, Ortec and Canberra. We conclude by wishing the Organising Committee of ICPA-17 all the best for a successful conference. We look forward to seeing everyone in China in 2015. Ashraf Alam, Paul Coleman, Stephen Dugdale and Mina Roussenova Guest Editors Bristol, April 2013 Local organising committeeInternational Advisory committee M A Alam, S Dugdale and M Roussenova P Coleman (UK, Chairman) University of Bristol, UK R Krause-Rehberg(Germany, Vice-chairman) P Coleman and S Townrow M A Alam (UK) University of Bath, UK G Laricchia (UK) M Charlton R Brusa (Italy) University of Swansea, UK M Doyama (Japan) G Laricchia B Ganguly (India) University College London, UK C Hugenschmidt (Germany) D Keeble Zs Kajcsos (Hungary, deceased) University of Dundee, UK Y Kobayashi (Japan) J Kuriplach (Czech Republic) P Mascher (Canada) A Mills (USA) Y Nagashima (Japan) Steering committee M Puska (Finland) M A Alam (UK, Secretary) H Schut (Netherlands) P Coleman (UK) A Seeger (Germany) B Ganguly (India) Y Shirai (Japan) Y Kobayashi (Japan) A Somoza (Argentina) P Mascher (Canada) A Stewart (Canada) H Schut (Netherlands) Z Tang (China) R Krause-Rehberg (Germany) A Weiss (USA) Sponsor logos Conference photograph

Comparison of the benefits of cochlear implantation versus contra-lateral routing of signal hearing aids in adult patients with single-sided deafness: study protocol for a prospective within-subject longitudinal trial.

PubMed

Kitterick, Pádraig T; O'Donoghue, Gerard M; Edmondson-Jones, Mark; Marshall, Andrew; Jeffs, Ellen; Craddock, Louise; Riley, Alison; Green, Kevin; O'Driscoll, Martin; Jiang, Dan; Nunn, Terry; Saeed, Shakeel; Aleksy, Wanda; Seeber, Bernhard U

2014-01-01

Individuals with a unilateral severe-to-profound hearing loss, or single-sided deafness, report difficulty with listening in many everyday situations despite having access to well-preserved acoustic hearing in one ear. The standard of care for single-sided deafness available on the UK National Health Service is a contra-lateral routing of signals hearing aid which transfers sounds from the impaired ear to the non-impaired ear. This hearing aid has been found to improve speech understanding in noise when the signal-to-noise ratio is more favourable at the impaired ear than the non-impaired ear. However, the indiscriminate routing of signals to a single ear can have detrimental effects when interfering sounds are located on the side of the impaired ear. Recent published evidence has suggested that cochlear implantation in individuals with a single-sided deafness can restore access to the binaural cues which underpin the ability to localise sounds and segregate speech from other interfering sounds. The current trial was designed to assess the efficacy of cochlear implantation compared to a contra-lateral routing of signals hearing aid in restoring binaural hearing in adults with acquired single-sided deafness. Patients are assessed at baseline and after receiving a contra-lateral routing of signals hearing aid. A cochlear implant is then provided to those patients who do not receive sufficient benefit from the hearing aid. This within-subject longitudinal design reflects the expected care pathway should cochlear implantation be provided for single-sided deafness on the UK National Health Service. The primary endpoints are measures of binaural hearing at baseline, after provision of a contra-lateral routing of signals hearing aid, and after cochlear implantation. Binaural hearing is assessed in terms of the accuracy with which sounds are localised and speech is perceived in background noise. The trial is also designed to measure the impact of the interventions on hearing- and health-related quality of life. This multi-centre trial was designed to provide evidence for the efficacy of cochlear implantation compared to the contra-lateral routing of signals. A purpose-built sound presentation system and established measurement techniques will provide reliable and precise measures of binaural hearing. Current Controlled Trials http://www.controlled-trials.com/ISRCTN33301739 (05/JUL/2013).

Mars Sample Return Architecture Assessment Study

NASA Astrophysics Data System (ADS)

Centuori, S.; Hermosín, P.; Martín, J.; De Zaiacomo, G.; Colin, S.; Godfrey, A.; Myles, J.; Johnson, H.; Sachdev, T.; Ahmed, R.

2018-04-01

Current paper presents the results of ESA funded activity "Mars Sample Return Architecture Assessment Study" carried-out by DEIMOS Space, Lockheed Martin UK Ampthill, and MDA Corporation, where more than 500 mission design options have been studied.

Managing Situation Awareness on the Flight Deck

NASA Technical Reports Server (NTRS)

Chappell, Sheryl L.; Connell, Linda (Technical Monitor)

1996-01-01

Awareness is required of the plane, the path and the people, both now and in the future. The steps to situation awareness are to monitor and evaluate the current situation. Anticipate the future to stay ahead of the airplane and consider contingencies, having a plan for 'what if situations. Continually update and modify the plan and share it with all crew members.

Mapping the birch and grass pollen seasons in the UK using satellite sensor time-series.

PubMed

Khwarahm, Nabaz R; Dash, Jadunandan; Skjøth, C A; Newnham, R M; Adams-Groom, B; Head, K; Caulton, Eric; Atkinson, Peter M

2017-02-01

Grass and birch pollen are two major causes of seasonal allergic rhinitis (hay fever) in the UK and parts of Europe affecting around 15-20% of the population. Current prediction of these allergens in the UK is based on (i) measurements of pollen concentrations at a limited number of monitoring stations across the country and (ii) general information about the phenological status of the vegetation. Thus, the current prediction methodology provides information at a coarse spatial resolution only. Most station-based approaches take into account only local observations of flowering, while only a small number of approaches take into account remote observations of land surface phenology. The systematic gathering of detailed information about vegetation status nationwide would therefore be of great potential utility. In particular, there exists an opportunity to use remote sensing to estimate phenological variables that are related to the flowering phenophase and, thus, pollen release. In turn, these estimates can be used to predict pollen release at a fine spatial resolution. In this study, time-series of MERIS Terrestrial Chlorophyll Index (MTCI) data were used to predict two key phenological variables: the start of season and peak of season. A technique was then developed to estimate the flowering phenophase of birch and grass from the MTCI time-series. For birch, the timing of flowering was defined as the time after the start of the growing season when the MTCI value reached 25% of the maximum. Similarly, for grass this was defined as the time when the MTCI value reached 75% of the maximum. The predicted pollen release dates were validated with data from nine pollen monitoring stations in the UK. For both birch and grass, we obtained large positive correlations between the MTCI-derived start of pollen season and the start of the pollen season defined using station data, with a slightly larger correlation observed for birch than for grass. The technique was applied to produce detailed maps for the flowering of birch and grass across the UK for each of the years from 2003 to 2010. The results demonstrate that the remote sensing-based maps of onset flowering of birch and grass for the UK together with the pollen forecast from the Meteorology Office and National Pollen and Aerobiology Research Unit (NPARU) can potentially provide more accurate information to pollen allergy sufferers in the UK. Copyright © 2016 Elsevier B.V. All rights reserved.

Youth Acquisition and Situational Use of Cigars, Cigarillos, and Little Cigars: A Cross-sectional Study

PubMed Central

Trapl, Erika S.; O’Rourke-Suchoff, Danielle; Yoder, Laura D.; Cofie, Leslie E.; Frank, Jean L.; Fryer, Craig S.

2017-01-01

Introduction Although adolescent use of cigars, cigarillos, and little cigars (CCLCs) has been increasing, little research has been conducted to understand how adolescents acquire CCLCs and the situations in which they smoke CCLCs. Thus, this study aims to understand how adolescent smokers acquire CCLCs and the situations in which they smoke them. Methods Data were drawn from the 2011 Cuyahoga County Youth Risk Behavior Survey. Current CCLC smoking was assessed; analysis was limited to current smokers (n=1,337). Current users were asked to identify situations in which they use cigars and ways in which they get cigars. Bivariate analyses assessed differences by sex, race, and concurrent substance use. Data were analyzed in 2014. Results Youth acquired CCLCs most commonly by buying (64.2%). CCLC smokers also reported high rates of social use (81.1%). There were no significant differences is situational use across sexes, but female adolescents were significantly more likely than male adolescents to share CCLCs and significantly less likely to buy or take CCLCs. Conversely, significant differences were seen for situational use by race/ethnicity, with whites significantly more likely to use in social situations and less likely to use in solitary situations versus blacks and Hispanics. Finally, significant differences were observed in both acquisition and use for youth who concurrently used CCLCs and cigarettes compared with CCLCs only; fewer differences were noted among those who concurrently used CCLCs and marijuana compared with CCLCs only. Conclusions These findings highlight how adolescents acquire and use CCLCs and can inform tobacco control strategies to prevent and reduce CCLC use. PMID:27717517

The ethics of general practice and advertising.

PubMed

Colman, R D

1989-06-01

UK general practitioners (GPs) are self-employed entrepreneurs running small businesses with commercial considerations. In this situation there is no clear distinction between information, self-promotion and advertising. In response to the growing public demand for more information about medical services, the medical profession should voluntarily accept the notion of soft self-promotion in the form of 'notices' or 'announcements' placed in newspapers. Newspapers are the most effective way of giving easy access to information. The resistance to newspapers may be more concerned with preserving certain medical traditions than consideration of the public interest. The General Medical Council's (GMC's) arguments against soft self-promotion are seen as misguided paternalism, inconsistent and irrational.

A history of the UK liquid hydrogen programme

NASA Astrophysics Data System (ADS)

Harlow, J.

1992-07-01

A review is presented of the evolution of UK liquid hydrogen (LH2) programs into the testing of low- and higher-pressure engines for upper stage applications with attention given to the production of LH2. The engine requirements are examined of launchers such as the Black Knight and Black Prince vehicles and LOX/LH2 upper stages for the European Launcher Development Organization (ELDO). High-energy second and third stages are described for the ELDO vehicles, and injector types and thrust-chamber designs are illustrated for the use of LH2/LOX. Successful firings of the RZ-20 chamber are reported, and the production of liquid hydrogen is shown to be adequate for testing and usage over all of the experimental phases. Developments from the LH2 programs in the UK can provide technologies for current items such as the propellant feed lines for the Ariane program.