The UKCAT-12 study: educational attainment, aptitude test performance, demographic and socio-economic contextual factors as predictors of first year outcome in a cross-sectional collaborative study of 12 UK medical schools.

PubMed

McManus, I C; Dewberry, Chris; Nicholson, Sandra; Dowell, Jonathan S

2013-11-14

Most UK medical schools use aptitude tests during student selection, but large-scale studies of predictive validity are rare. This study assesses the United Kingdom Clinical Aptitude Test (UKCAT), and its four sub-scales, along with measures of educational attainment, individual and contextual socio-economic background factors, as predictors of performance in the first year of medical school training. A prospective study of 4,811 students in 12 UK medical schools taking the UKCAT from 2006 to 2008 as a part of the medical school application, for whom first year medical school examination results were available in 2008 to 2010. UKCAT scores and educational attainment measures (General Certificate of Education (GCE): A-levels, and so on; or Scottish Qualifications Authority (SQA): Scottish Highers, and so on) were significant predictors of outcome. UKCAT predicted outcome better in female students than male students, and better in mature than non-mature students. Incremental validity of UKCAT taking educational attainment into account was significant, but small. Medical school performance was also affected by sex (male students performing less well), ethnicity (non-White students performing less well), and a contextual measure of secondary schooling, students from secondary schools with greater average attainment at A-level (irrespective of public or private sector) performing less well. Multilevel modeling showed no differences between medical schools in predictive ability of the various measures. UKCAT sub-scales predicted similarly, except that Verbal Reasoning correlated positively with performance on Theory examinations, but negatively with Skills assessments. This collaborative study in 12 medical schools shows the power of large-scale studies of medical education for answering previously unanswerable but important questions about medical student selection, education and training. UKCAT has predictive validity as a predictor of medical school outcome, particularly in mature applicants to medical school. UKCAT offers small but significant incremental validity which is operationally valuable where medical schools are making selection decisions based on incomplete measures of educational attainment. The study confirms the validity of using all the existing measures of educational attainment in full at the time of selection decision-making. Contextual measures provide little additional predictive value, except that students from high attaining secondary schools perform less well, an effect previously shown for UK universities in general.

The UKCAT-12 study: educational attainment, aptitude test performance, demographic and socio-economic contextual factors as predictors of first year outcome in a cross-sectional collaborative study of 12 UK medical schools

PubMed Central

2013-01-01

Background Most UK medical schools use aptitude tests during student selection, but large-scale studies of predictive validity are rare. This study assesses the United Kingdom Clinical Aptitude Test (UKCAT), and its four sub-scales, along with measures of educational attainment, individual and contextual socio-economic background factors, as predictors of performance in the first year of medical school training. Methods A prospective study of 4,811 students in 12 UK medical schools taking the UKCAT from 2006 to 2008 as a part of the medical school application, for whom first year medical school examination results were available in 2008 to 2010. Results UKCAT scores and educational attainment measures (General Certificate of Education (GCE): A-levels, and so on; or Scottish Qualifications Authority (SQA): Scottish Highers, and so on) were significant predictors of outcome. UKCAT predicted outcome better in female students than male students, and better in mature than non-mature students. Incremental validity of UKCAT taking educational attainment into account was significant, but small. Medical school performance was also affected by sex (male students performing less well), ethnicity (non-White students performing less well), and a contextual measure of secondary schooling, students from secondary schools with greater average attainment at A-level (irrespective of public or private sector) performing less well. Multilevel modeling showed no differences between medical schools in predictive ability of the various measures. UKCAT sub-scales predicted similarly, except that Verbal Reasoning correlated positively with performance on Theory examinations, but negatively with Skills assessments. Conclusions This collaborative study in 12 medical schools shows the power of large-scale studies of medical education for answering previously unanswerable but important questions about medical student selection, education and training. UKCAT has predictive validity as a predictor of medical school outcome, particularly in mature applicants to medical school. UKCAT offers small but significant incremental validity which is operationally valuable where medical schools are making selection decisions based on incomplete measures of educational attainment. The study confirms the validity of using all the existing measures of educational attainment in full at the time of selection decision-making. Contextual measures provide little additional predictive value, except that students from high attaining secondary schools perform less well, an effect previously shown for UK universities in general. PMID:24229380

Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is different in children compared to in adults: a study of UK and Dutch clinical cohorts.

PubMed

Collin, Simon M; Nuevo, Roberto; van de Putte, Elise M; Nijhof, Sanne L; Crawley, Esther

2015-10-28

To investigate differences between young children, adolescents and adults with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Comparison of clinical cohorts from 8 paediatric and 27 adult CFS/ME services in the UK and a paediatric randomised controlled trial from the Netherlands. Outcome measures include: fatigue (the UK-Chalder Fatigue Scale); Disability (the UK-SF-36 physical function subscale; the Netherlands-CHQ-CF87); school attendance, pain, anxiety and depression (the UK-Hospital Anxiety & Depression Scale, Spence Children's Anxiety Scale; the Netherlands-Spielberger State-Trait Anxiety Inventory for Children, Children's Depression Inventory); symptoms; time-to-assessment; and body mass index. We used multinomial regression to compare younger (aged <12 years) and older (aged 12-18 years) children with adults, and logistic regression to compare UK and Dutch adolescents. Younger children had a more equal gender balance compared to adolescents and adults. Adults had more disability and fatigue, and had been ill for longer. Younger children were less likely to have cognitive symptoms (OR 0.18 (95% CI 0.13 to 0.25)) and more likely to present with a sore throat (OR 1.42 (1.07 to 1.90). Adolescents were more likely to have headaches (81.1%, OR 1.56 (1.36% to 1.80%)) and less likely to have tender lymph nodes, palpitations, dizziness, general malaise and pain, compared to adults. Adolescents were more likely to have comorbid depression (OR 1.51 (1.33 to 1.72)) and less likely to have anxiety (OR 0.46 (0.41 to 0.53)) compared to adults. Paediatricians need to recognise that children with CFS/ME present differently from adults. Whether these differences reflect an underlying aetiopathology requires further investigation. FITNET trial registration numbers are ISRCTN59878666 and NCT00893438. This paper includes secondary (post-results) analysis of data from this trial, but are unrelated to trial outcomes. 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/

Evaluation of Unified Model Microphysics in High-resolution NWP Simulations Using Polarimetric Radar Observations

NASA Astrophysics Data System (ADS)

Johnson, Marcus; Jung, Youngsun; Dawson, Daniel; Supinie, Timothy; Xue, Ming; Park, Jongsook; Lee, Yong-Hee

2018-07-01

The UK Met Office Unified Model (UM) is employed by many weather forecasting agencies around the globe. This model is designed to run across spatial and time scales and known to produce skillful predictions for large-scale weather systems. However, the model has only recently begun running operationally at horizontal grid spacings of ˜1.5 km [e.g., at the UK Met Office and the Korea Meteorological Administration (KMA)]. As its microphysics scheme was originally designed and tuned for large-scale precipitation systems, we investigate the performance of UM microphysics to determine potential inherent biases or weaknesses. Two rainfall cases from the KMA forecasting system are considered in this study: a Changma (quasi-stationary) front, and Typhoon Sanba (2012). The UM output is compared to polarimetric radar observations in terms of simulated polarimetric radar variables. Results show that the UM generally underpredicts median reflectivity in stratiform rain, producing high reflectivity cores and precipitation gaps between them. This is partially due to the diagnostic rain intercept parameter formulation used in the one-moment microphysics scheme. Model drop size is generally both underand overpredicted compared to observations. UM frozen hydrometeors favor generic ice (crystals and snow) rather than graupel, which is reasonable for Changma and typhoon cases. The model performed best with the typhoon case in terms of simulated precipitation coverage.

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…

Preschool Affects Longer Term Literacy and Numeracy: Results from a General Population Longitudinal Study in Northern Ireland

ERIC Educational Resources Information Center

Melhuish, Edward; Quinn, Louise; Sylva, Kathy; Sammons, Pam; Siraj-Blatchford, Iram; Taggart, Brenda

2013-01-01

The Effective Pre-school Provision in Northern Ireland (EPPNI) project is a longitudinal study of child development from 3 to 11 years. It is one of the first large-scale UK projects to investigate the effects of different kinds of preschool provision, and to relate experience in preschool to child development. In EPPNI, 683 children were randomly…

Chinese Version of the EQ-5D Preference Weights: Applicability in a Chinese General Population

PubMed Central

Wu, Chunmei; Gong, Yanhong; Wu, Jiang; Zhang, Shengchao; Yin, Xiaoxv; Dong, Xiaoxin; Li, Wenzhen; Cao, Shiyi; Mkandawire, Naomie; Lu, Zuxun

2016-01-01

Objectives This study aimed to test the reliability, validity and sensitivity of Chinese version of the EQ-5D preference weights in Chinese general people, examine the differences between the China value set and the UK, Japan and Korea value sets, and provide methods for evaluating and comparing the EQ-5D value sets of different countries. Methods A random sample of 2984 community residents (15 years or older) were interviewed using a questionnaire including the EQ-5D scale. Level of agreement, convergent validity, known-groups validity and sensitivity of the EQ-5D China, United Kingdom (UK), Japan and Korea value sets were determined. Results The mean EQ-5D index scores were significantly (P<0.05) different among the UK (0.964), Japan (0.981), Korea (0.987), and China (0.985) weights. High level of agreement (intraclass correlations coefficients > 0.75) and convergent validity (Pearson’s correlation coefficients > 0.95) were found between each paired schemes. The EQ-5D index scores discriminated equally well for the four versions between levels of 10 known-groups (P< 0.05). The effect size and the relative efficiency statistics showed that the China weights had better sensitivity. Conclusions The China EQ-5D preference weights show equivalent psychometric properties with those from the UK, Japan and Korea weights while slightly more sensitive to known group differences than those from the Japan and Korea weights. Considering both psychometric and sociocultural issues, the China scheme should be a priority as an EQ-5D based measure of the health related quality of life in Chinese general population. PMID:27711169

The state of UK anaesthesia: a survey of National Health Service activity in 2013.

PubMed

Sury, M R J; Palmer, J H M G; Cook, T M; Pandit, J J

2014-10-01

Details of current UK anaesthetic practice are unknown and were needed for interpretation of reports of accidental awareness during general anaesthesia (GA) within the 5th National Audit Project. We surveyed NHS anaesthetic activity to determine numbers of patients managed by anaesthetists and details of 'who, when, what, and where': activity included GA, local anaesthesia, sedation, or patients managed awake. Anaesthetists in NHS hospitals collected data on all patients for 2 days. Scaling enabled estimation of annual activity. Hospital response rate was 100% with 20,400 returns. The median return rate within departments was 98% (inter-quartile range 0.95-1). Annual numbers (% of total) of general anaesthetics, sedation, and awake cases were 2,766,600 (76.9%), 308,800 (8.6%), and 523,100 (14.5%), respectively. A consultant or career grade anaesthetist was present in more than 87% of cases. Emergency cases accounted for 23.1% of workload, 75% of which were undertaken out of hours. Specialties with the largest workload were orthopaedics/trauma (22.1%), general surgery (16.1%), and gynaecology (9.6%): 6.2% of cases were non-surgical. The survey data describe: who anaesthetized patients according to time of day, urgency, and ASA grade; when anaesthesia took place by day and by weekday; the distribution of patient types, techniques, and monitoring; where patients were anaesthetized. Nine patients out of 15 460 receiving GA died intraoperatively. Anaesthesia in the UK is currently predominantly a consultant-delivered service. The low mortality rate supports the safety of UK anaesthetic care. The survey data should be valuable for planning and monitoring anaesthesia services. © The Author 2014. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The fine scale genetic structure of the British population

PubMed Central

Davison, Dan; Boumertit, Abdelhamid; Day, Tammy; Hutnik, Katarzyna; Royrvik, Ellen C; Cunliffe, Barry; Lawson, Daniel J; Falush, Daniel; Freeman, Colin; Pirinen, Matti; Myers, Simon; Robinson, Mark; Donnelly, Peter; Bodmer, Walter

2015-01-01

Summary Fine-scale genetic variation between human populations is interesting as a signature of historical demographic events and because of its potential for confounding disease studies. We use haplotype-based statistical methods to analyse genome-wide SNP data from a carefully chosen geographically diverse sample of 2,039 individuals from the United Kingdom (UK). This reveals a rich and detailed pattern of genetic differentiation with remarkable concordance between genetic clusters and geography. The regional genetic differentiation and differing patterns of shared ancestry with 6,209 individuals from across Europe carry clear signals of historical demographic events. We estimate the genetic contribution to SE England from Anglo-Saxon migrations to be under half, identify the regions not carrying genetic material from these migrations, suggest significant pre-Roman but post-Mesolithic movement into SE England from the Continent, and show that in non-Saxon parts of the UK there exist genetically differentiated subgroups rather than a general “Celtic” population. PMID:25788095

Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial.

PubMed

Davidson, Andrew J; Disma, Nicola; de Graaff, Jurgen C; Withington, Davinia E; Dorris, Liam; Bell, Graham; Stargatt, Robyn; Bellinger, David C; Schuster, Tibor; Arnup, Sarah J; Hardy, Pollyanna; Hunt, Rodney W; Takagi, Michael J; Giribaldi, Gaia; Hartmann, Penelope L; Salvo, Ida; Morton, Neil S; von Ungern Sternberg, Britta S; Locatelli, Bruno Guido; Wilton, Niall; Lynn, Anne; Thomas, Joss J; Polaner, David; Bagshaw, Oliver; Szmuk, Peter; Absalom, Anthony R; Frawley, Geoff; Berde, Charles; Ormond, Gillian D; Marmor, Jacki; McCann, Mary Ellen

2016-01-16

Preclinical data suggest that general anaesthetics affect brain development. There is mixed evidence from cohort studies that young children exposed to anaesthesia can have an increased risk of poor neurodevelopmental outcome. We aimed to establish whether general anaesthesia in infancy has any effect on neurodevelopmental outcome. Here we report the secondary outcome of neurodevelopmental outcome at 2 years of age in the General Anaesthesia compared to Spinal anaesthesia (GAS) trial. In this international assessor-masked randomised controlled equivalence trial, we recruited infants younger than 60 weeks postmenstrual age, born at greater than 26 weeks' gestation, and who had inguinal herniorrhaphy, from 28 hospitals in Australia, Italy, the USA, the UK, Canada, the Netherlands, and New Zealand. Infants were randomly assigned (1:1) to receive either awake-regional anaesthesia or sevoflurane-based general anaesthesia. Web-based randomisation was done in blocks of two or four and stratified by site and gestational age at birth. Infants were excluded if they had existing risk factors for neurological injury. The primary outcome of the trial will be the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Full Scale Intelligence Quotient score at age 5 years. The secondary outcome, reported here, is the composite cognitive score of the Bayley Scales of Infant and Toddler Development III, assessed at 2 years. The analysis was as per protocol adjusted for gestational age at birth. A difference in means of five points (1/3 SD) was predefined as the clinical equivalence margin. This trial is registered with ANZCTR, number ACTRN12606000441516 and ClinicalTrials.gov, number NCT00756600. Between Feb 9, 2007, and Jan 31, 2013, 363 infants were randomly assigned to receive awake-regional anaesthesia and 359 to general anaesthesia. Outcome data were available for 238 children in the awake-regional group and 294 in the general anaesthesia group. In the as-per-protocol analysis, the cognitive composite score (mean [SD]) was 98.6 (14.2) in the awake-regional group and 98.2 (14.7) in the general anaesthesia group. There was equivalence in mean between groups (awake-regional minus general anaesthesia 0.169, 95% CI -2.30 to 2.64). The median duration of anaesthesia in the general anaesthesia group was 54 min. For this secondary outcome, we found no evidence that just less than 1 h of sevoflurane anaesthesia in infancy increases the risk of adverse neurodevelopmental outcome at 2 years of age compared with awake-regional anaesthesia. Australia National Health and Medical Research Council (NHMRC), Health Technologies Assessment-National Institute for Health Research UK, National Institutes of Health, Food and Drug Administration, Australian and New Zealand College of Anaesthetists, Murdoch Childrens Research Institute, Canadian Institute of Health Research, Canadian Anesthesiologists' Society, Pfizer Canada, Italian Ministry of Heath, Fonds NutsOhra, and UK Clinical Research Network (UKCRN). Copyright © 2016 Elsevier Ltd. All rights reserved.

UK Announces Intention to Join ESO

NASA Astrophysics Data System (ADS)

2000-11-01

Summary The Particle Physics and Astronomy Research Council (PPARC) , the UK's strategic science investment agency, today announced that the government of the United Kingdom is making funds available that provide a baseline for this country to join the European Southern Observatory (ESO) . The ESO Director General, Dr. Catherine Cesarsky , and the ESO Community warmly welcome this move towards fuller integration in European astronomy. "With the UK as a potential member country of ESO, our joint opportunities for front-line research and technology will grow significantly", she said. "This announcement is a clear sign of confidence in ESO's abilities, most recently demonstrated with the construction and operation of the unique Very Large Telescope (VLT) on Paranal. Together we will look forward with confidence towards new, exciting projects in ground-based astronomy." It was decided earlier this year to place the 4-m UK Visible and Infrared Survey Telescope (VISTA) at Paranal, cf. ESO Press Release 03/00. Following negotiations between ESO and PPARC, a detailed proposal for the associated UK/ESO Agreement with the various entry modalities will now be presented to the ESO Council for approval. Before this Agreement can enter into force, the ESO Convention and associated protocols must also be ratified by the UK Parliament. Research and key technologies According to the PPARC press release, increased funding for science, announced by the UK government today, will enable UK astronomers to prepare for the next generation of telescopes and expand their current telescope portfolio through membership of the European Southern Observatory (ESO). The uplift to its baseline budget will enable PPARC to enter into final negotiations for UK membership of the ESO. This will ensure that UK astronomers, together with their colleagues in the ESO member states, are actively involved in global scale preparations for the next generation of astronomy facilities. among these are ALMA (Atacama Large Millimeter Array) in Chile and the very large optical/infrared telescopes now undergoing conceptual studies. ESO membership will give UK astronomers access to the suite of four world-class 8.2-meter VLT Unit Telescopes at the Paranal Observatory (Chile), as well as other state-of-the-art facilities at ESO's other observatory at La Silla. Through PPARC the UK already participates in joint collaborative European science programmes such as CERN and the European Space Agency (ESA), which have already proved their value on the world scale. Joining ESO will consolidate this policy, strengthen ESO and enhance the future vigour of European astronomy. Statements Commenting on the funding announcement, Prof. Ian Halliday , PPARC's CEO, said that " this new funding will ensure our physicists and astronomers remain at the forefront of international research - leading in discoveries that push back the frontiers of knowledge - and the UK economy will also benefit through the provision of highly trained people and the resulting advances in IT and commercial spin-offs ". Prof. Mike Edmunds , UCW Cardiff, and Chairman of the UK Astronomy Review Panel which recently set out a programme of opportunities and priorities for the next 10 - 20 years added that " this is excellent news for UK science and lays the foundation for cutting edge research over the next ten years. British astronomers will be delighted by the Government's rapid and positive response to their case. " Speaking on behalf of the ESO Organisation and the community of more than 2500 astronomers in the ESO member states [2], the ESO Director General, Dr. Catherine Cesarsky , declared: "When ESO was created in 1962, the UK decided not to join, because of access to other facilities in the Southern Hemisphere. But now ESO has developed into one of the world's main astronomical organisations, with top technology and operating the VLT at Paranal, the largest and most efficient optical/infrared telescope facility in the world. We look forward to receiving our UK colleagues in our midst and work together on the realization of future cutting-edge projects." Joining ESO was considered a top priority for UK astronomy following a community report to the UK Long Term Science Review, which set out a programme of opportunities and priorities for PPARC science over the next 10 to 20 years. The report is available on the web at URL: www.pparc.ac.uk/ltsr.

Understanding the relative valuation of research impact: a best–worst scaling experiment of the general public and biomedical and health researchers

PubMed Central

Pollitt, Alexandra; Potoglou, Dimitris; Patil, Sunil; Burge, Peter; Guthrie, Susan; King, Suzanne; Wooding, Steven; Grant, Jonathan

2016-01-01

Objectives (1) To test the use of best–worst scaling (BWS) experiments in valuing different types of biomedical and health research impact, and (2) to explore how different types of research impact are valued by different stakeholder groups. Design Survey-based BWS experiment and discrete choice modelling. Setting The UK. Participants Current and recent UK Medical Research Council grant holders and a representative sample of the general public recruited from an online panel. Results In relation to the study's 2 objectives: (1) we demonstrate the application of BWS methodology in the quantitative assessment and valuation of research impact. (2) The general public and researchers provided similar valuations for research impacts such as improved life expectancy, job creation and reduced health costs, but there was less agreement between the groups on other impacts, including commercial capacity development, training and dissemination. Conclusions This is the second time that a discrete choice experiment has been used to assess how the general public and researchers value different types of research impact, and the first time that BWS has been used to elicit these choices. While the 2 groups value different research impacts in different ways, we note that where they agree, this is generally about matters that are seemingly more important and associated with wider social benefit, rather than impacts occurring within the research system. These findings are a first step in exploring how the beneficiaries and producers of research value different kinds of impact, an important consideration given the growing emphasis on funding and assessing research on the basis of (potential) impact. Future research should refine and replicate both the current study and that of Miller et al in other countries and disciplines. PMID:27540096

International Intercomparison of Regular Transmittance Scales

NASA Astrophysics Data System (ADS)

Eckerle, K. L.; Sutter, E.; Freeman, G. H. C.; Andor, G.; Fillinger, L.

1990-01-01

An intercomparison of the regular spectral transmittance scales of NIST, Gaithersburg, MD (USA); PTB, Braunschweig (FRG); NPL, Teddington, Middlesex (UK); and OMH, Budapest (H) was accomplished using three sets of neutral glass filters with transmittances ranging from approximately 0.92 to 0.001. The difference between the results from the reference spectrophotometers of the laboratories was generally smaller than the total uncertainty of the interchange. The relative total uncertainty ranges from 0.05% to 0.75% for transmittances from 0.92 to 0.001. The sample-induced error was large - contributing 40% or more of the total except in a few cases.

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

NASA Astrophysics Data System (ADS)

Robson, A.

1984-11-01

Environmental issues relating to the introduction of large, MW-scale wind turbines at land-based sites in the UK are discussed. Noise, television interference, hazards to bird life, and visual effects are considered. Areas of uncertainty are identified, but enough is known from experience elsewhere in the world to enable the first UK machines to be introduced in a safe and environementally acceptable manner. Research to establish siting criteria more clearly, and significantly increase the potential wind-energy resource is mentioned. Studies of the comparative risk of energy systems are shown to be overpessimistic for UK wind turbines.

A comparative study of behavioral and psychological signs and symptoms of dementia in patients with dementia referred to psychogeriatric services in Korea and the United Kingdom.

PubMed

Shah, Ajit; Ellanchenny, Nalini; Suh, Guk-Hee

2004-06-01

There is a paucity of cross-cultural studies of behavioral and psychological symptoms of dementia (BPSD). BPSD were examined in a consecutive series of referrals to a psychogeriatric service in the United Kingdom (U.K.) and in Korea, using the BEHAVE-AD, the Cornell Scale for Depression in Dementia and the Mini-mental State Examination (MMSE). The U.K. service served a well-defined geographical catchment area with a multidisciplinary team and emphasis on home assessments. The Korean service was a nationwide service with limited community resources. The correlates of individual BPSD in each country and the differences between the two countries were examined. Koreans were younger, were more likely to be married, less likely to be single, had a greater number of people in their household and were more likely to live in their own homes than the U.K. sample. Koreans were more likely to be referred by general psychiatrists or family members, and the U.K. sample was more likely to be referred by general practitioners. Koreans were more likely to have Alzheimer's disease and the U.K. sample to have vascular dementia. The Korean sample had a lower MMSE score than the U.K. sample. In both countries, the total BEHAVE-AD score and most subscale scores were negatively correlated with the MMSE score. The total BEHAVE-AD score and all subscale scores were higher in the Korean sample than in the U.K. sample. The prevalence of all BPSD measured with the BEHAVE-AD were higher in the Korean sample (except aggressivity). These differences may be explained by differing interpretation and administration of the measurement instruments, models of service delivery, availability of primary and secondary care services, health seeking behavior of patients and families, cultural influences, and knowledge, expectations and recognition of BPSD by professionals in primary and secondary care. However, despite this, there was possible evidence of genuine differences worthy of further cross-cultural population-based epidemiological study of BPSD between these two countries.

Construct Validity of the WISC-IV[superscript UK] with a Large Referred Irish Sample

ERIC Educational Resources Information Center

Watkins, Marley W.; Canivez, Gary L.; James, Trevor; James, Kate; Good, Rebecca

2013-01-01

Irish educational psychologists frequently use the Wechsler Intelligence Scale for Children-Fourth U.K. Edition (WISC-IV[superscript UK]) in clinical assessments of children with learning difficulties. Unfortunately, reliability and validity studies of the WISC-IV[superscript UK] have not yet been reported. This study examined the construct…

Subsynoptic-scale features associated with extreme surface gusts in UK extratropical cyclone events

NASA Astrophysics Data System (ADS)

Earl, N.; Dorling, S.; Starks, M.; Finch, R.

2017-04-01

Numerous studies have addressed the mesoscale features within extratropical cyclones (ETCs) that are responsible for the most destructive winds, though few have utilized surface observation data, and most are based on case studies. By using a 39-station UK surface observation network, coupled with in-depth analysis of the causes of extreme gusts during the period 2008-2014, we show that larger-scale features (warm and cold conveyer belts) are most commonly associated with the top 1% of UK gusts but smaller-scale features generate the most extreme winds. The cold conveyor belt is far more destructive when joining the momentum of the ETC, rather than earlier in its trajectory, ahead of the approaching warm front. Sting jets and convective lines account for two thirds of severe surface gusts in the UK.

The Affective Reactivity Index: a concise irritability scale for clinical and research settings

PubMed Central

Stringaris, Argyris; Goodman, Robert; Ferdinando, Sumudu; Razdan, Varun; Muhrer, Eli; Leibenluft, Ellen; Brotman, Melissa A

2012-01-01

Background Irritable mood has recently become a matter of intense scientific interest. Here, we present data from two samples, one from the United States and the other from the United Kingdom, demonstrating the clinical and research utility of the parent- and self-report forms of the Affective Reactivity Index (ARI), a concise dimensional measure of irritability. Methods The US sample (n = 218) consisted of children and adolescents recruited at the National Institute of Mental Health meeting criteria for bipolar disorder (BD, n = 39), severe mood dysregulation (SMD, n = 67), children at family risk for BD (n = 35), or were healthy volunteers (n = 77). The UK sample (n = 88) was comprised of children from a generic mental health setting and healthy volunteers from primary and secondary schools. Results Parent- and self-report scales of the ARI showed excellent internal consistencies and formed a single factor in the two samples. In the US sample, the ARI showed a gradation with irritability significantly increasing from healthy volunteers through to SMD. Irritability was significantly higher in SMD than in BD by parent-report, but this did not reach significance by self-report. In the UK sample, parent-rated irritability was differentially related to emotional problems. Conclusions Irritability can be measured using a concise instrument both in a highly specialized US, as well as a general UK child mental health setting. PMID:22574736

Development and validation of the Australian version of the Birth Satisfaction Scale-Revised (BSS-R).

PubMed

Jefford, Elaine; Hollins Martin, Caroline J; Martin, Colin R

2018-02-01

The 10-item Birth Satisfaction Scale-Revised (BSS-R) has recently been endorsed by international expert consensus for global use as the birth satisfaction outcome measure of choice. English-language versions of the tool include validated UK and US versions; however, the instrument has not, to date, been contextualised and validated in an Australian English-language version. The current investigation sought to develop and validate an English-language version of the tool for use within the Australian context. A two-stage study. Following review and modification by expert panel, the Australian BSS-R (A-BSS-R) was (Stage 1) evaluated for factor structure, internal consistency, known-groups discriminant validity and divergent validity. Stage 2 directly compared the A-BSS-R data set with the original UK data set to determine the invariance characteristics of the new instrument. Participants were a purposive sample of Australian postnatal women (n = 198). The A-BSS-R offered a good fit to data consistent with the BSS-R tridimensional measurement model and was found to be conceptually and measurement equivalent to the UK version. The A-BSS-R demonstrated excellent known-groups discriminant validity, generally good divergent validity and overall good internal consistency. The A-BSS-R represents a robust and valid measure of the birth satisfaction concept suitable for use within Australia and appropriate for application to International comparative studies.

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.

Identification of alkaptonuria in the general population: a United Kingdom experience describing the challenges, possible solutions and persistent barriers.

PubMed

Ranganath, L; Taylor, A M; Shenkin, A; Fraser, W D; Jarvis, J; Gallagher, J A; Sireau, N

2011-06-01

Progress in research into rare diseases is challenging. This paper discusses strategies to identify individuals with the rare genetic disease alkaptonuria (AKU) within the general population. Strategies used included a questionnaire survey of general practitioners, a dedicated website and patient network contact, targeted family screening and medical conference targeting. Primary care physicians of the UK were targeted by a postal survey that involved mailing 11,151 UK GPs; the response rate was 18.2%. We have identified 75 patients in the UK with AKU by the following means: postal survey (23), targeted family screening (11), patient networks and the website (41). Targeting medical conferences (AKU, rare diseases, rheumatology, clinical biochemistry, orthopaedics, general practitioners) did not lead to new identification in the UK but helped identify overseas cases. We are now aware of 626 patients worldwide including newly identified non-UK people with AKU in the following areas: Slovakia (208), the rest of Europe (including Turkey) (79), North America (including USA and Canada) (110), and the rest of the world (154). A mechanism for identifying individuals with AKU in the general population-not just in the UK but worldwide-has been established. Knowledge of patients with AKU, both in the UK and outside, is often confined to establishing their location in a particular GP practice or association with a particular medical professional. Mere identification, however, does not always lead to full engagement for epidemiological research purposes or targeting treatment since further barriers exist.

A comparison of EuroQol 5-Dimension health-related utilities using Italian, UK, and US preference weights in a patient sample.

PubMed

Mozzi, Adelaide; Meregaglia, Michela; Lazzaro, Carlo; Tornatore, Valentina; Belfiglio, Maurizio; Fattore, Giovanni

2016-01-01

Weights associated with the EuroQol 5-Dimension 3-Level (EQ-5D-3L) instrument represent preferences for health states elicited from general population's samples. Weights have not been calculated for every country; however, empirical research shows that cross-country differences exist. This empirical study aims at investigating the impact of recently developed Italian weights in comparison with UK and US scores on health-related utility calculation using a sample of patients with Crohn's disease. The study is based on a survey on health-related quality of life in patients (n=552) affected by active Crohn's disease conducted in Italy from 2012 to 2013. Utilities computed through the Italian algorithm (mean: 0.76; SD: 0.20; median: 0.81) are generally higher than US (mean: 0.69; SD: 0.22; median: 0.77) and UK (mean: 0.57; SD: 0.32; median: 0.69) utilities, except for extremely severe health states where US values outweigh the Italian ones. UK preference weights generate the highest number of negative results. All the three value distributions are left-skewed due to very low scores associated with the most serious health states (ie, three or four levels equal to 3). As expected, despite the tariff set considered, more severe disease (Harvey Bradshaw Index >16) reduces the mean conditional EQ-5D-3L index (P<0.0001). Kendall's rank correlation between EQ Visual Analog Scale score and EQ-5D-3L index is positive (P<0.0001), even though patients tend to value their health-related quality of life more when responding to EQ-5D-3L questions than on EQ Visual Analog Scale. Regardless of the tariff set considered, ordinary least-square results highlight that more severe disease (Harvey Bradshaw Index >16) reduces the mean conditional EQ-5D-3L index (P<0.0001). Results reveal remarkable differences among the three national tariff sets and especially when severe health states occur, suggesting the need for country-specific preference weights when evaluating utilities, which can be problematic since they have not been calculated for every country yet.

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.

Image processing and Quality Control for the first 10,000 brain imaging datasets from UK Biobank.

PubMed

Alfaro-Almagro, Fidel; Jenkinson, Mark; Bangerter, Neal K; Andersson, Jesper L R; Griffanti, Ludovica; Douaud, Gwenaëlle; Sotiropoulos, Stamatios N; Jbabdi, Saad; Hernandez-Fernandez, Moises; Vallee, Emmanuel; Vidaurre, Diego; Webster, Matthew; McCarthy, Paul; Rorden, Christopher; Daducci, Alessandro; Alexander, Daniel C; Zhang, Hui; Dragonu, Iulius; Matthews, Paul M; Miller, Karla L; Smith, Stephen M

2018-02-01

UK Biobank is a large-scale prospective epidemiological study with all data accessible to researchers worldwide. It is currently in the process of bringing back 100,000 of the original participants for brain, heart and body MRI, carotid ultrasound and low-dose bone/fat x-ray. The brain imaging component covers 6 modalities (T1, T2 FLAIR, susceptibility weighted MRI, Resting fMRI, Task fMRI and Diffusion MRI). Raw and processed data from the first 10,000 imaged subjects has recently been released for general research access. To help convert this data into useful summary information we have developed an automated processing and QC (Quality Control) pipeline that is available for use by other researchers. In this paper we describe the pipeline in detail, following a brief overview of UK Biobank brain imaging and the acquisition protocol. We also describe several quantitative investigations carried out as part of the development of both the imaging protocol and the processing pipeline. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Paediatric home care in the UK.

PubMed Central

Tatman, M A; Woodroffe, C

1993-01-01

Paediatric home care services in the UK were ascertained in 1991 and 1992. Respondents from 209 (97%) UK health districts and boards identified 62 general and 124 specialist paediatric home care services by January 1993, 15% having opened in the previous year. Of all UK children, 30% lived in a district with a general home care service. Five health regions had only specialist services. Districts differed widely in the availability of home care for different disorders. The home care services were small, general services employing a mean (SD) of 2.5 (1.6) whole time equivalent (WTE) nurses, and specialist services 1.3 (0.8) WTE nurses. Few services were available 24 hours a day. Funding arrangements were diverse and some services had difficulties in obtaining consumables and equipment for home use. Despite rapid growth there remains considerable scope for the development of paediatric home care throughout the UK. PMID:8285782

Eating symptomatology and general psychopathology in patients with anorexia nervosa from China, UK and Spain: A cross-cultural study examining the role of social attitudes.

PubMed

Agüera, Zaida; Brewin, Nicola; Chen, Jue; Granero, Roser; Kang, Qing; Fernandez-Aranda, Fernando; Arcelus, Jon

2017-01-01

Cultural studies exploring differences in the manifestation of anorexia nervosa (AN) have primarily focus on Western and non-Western cultures. However, no study so far has considered the role that social attitudes (i.e. Collectivist vs. Individualist cultural values) have in the clinical manifestations of eating disorders, including AN patients. With this in mind, the aim of this study is to compare eating and general psychopathology in a large sample of individuals diagnosed with AN from China, Spain, and United Kingdom (UK), in order to study the differences according to belonging to Western or non-Western country, or the country's Individualist Index (IDV). The total sample comprised on 544 adults with a diagnosis of AN recruited from People´s Republic of China (n = 72), UK (n = 117), and Spain (n = 355). Assessment measures included the Eating Disorders Inventory and the Symptom Checklist-90-Revised. Our results show significant differences in most of the eating and psychopathological indices between the three countries. Patients from Western societies (Spain and UK) share more similarities regarding psychopathological expression of AN than the non-Western country (China). While Western countries show higher levels of body dissatisfaction, somatization and overall psychopathology, Chinese patients tend to deny or minimize depression, anxiety and other psychopathological symptoms. Besides, the IDV shows cultural differences in the interpersonal sensitivity scale, being AN patients from UK (the more individualistic society) who presented with higher levels of interpersonal sensitivity (i.e. discomfort during interpersonal interactions and more negative expectations concerning interpersonal behavior). In conclusion, our findings suggest that psychopathological expression of AN is better explained by Western/Eastern influence than by individualist/collectivist values. Although the diagnosis for the eating disorder may be the same, differences in the psychopathology comorbid to the eating disorders may suggest the need for treatments to be modified according to the culture.

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.

Eating symptomatology and general psychopathology in patients with anorexia nervosa from China, UK and Spain: A cross-cultural study examining the role of social attitudes

PubMed Central

Brewin, Nicola; Chen, Jue; Granero, Roser; Kang, Qing; Fernandez-Aranda, Fernando; Arcelus, Jon

2017-01-01

Cultural studies exploring differences in the manifestation of anorexia nervosa (AN) have primarily focus on Western and non-Western cultures. However, no study so far has considered the role that social attitudes (i.e. Collectivist vs. Individualist cultural values) have in the clinical manifestations of eating disorders, including AN patients. With this in mind, the aim of this study is to compare eating and general psychopathology in a large sample of individuals diagnosed with AN from China, Spain, and United Kingdom (UK), in order to study the differences according to belonging to Western or non-Western country, or the country's Individualist Index (IDV). The total sample comprised on 544 adults with a diagnosis of AN recruited from People´s Republic of China (n = 72), UK (n = 117), and Spain (n = 355). Assessment measures included the Eating Disorders Inventory and the Symptom Checklist-90-Revised. Our results show significant differences in most of the eating and psychopathological indices between the three countries. Patients from Western societies (Spain and UK) share more similarities regarding psychopathological expression of AN than the non-Western country (China). While Western countries show higher levels of body dissatisfaction, somatization and overall psychopathology, Chinese patients tend to deny or minimize depression, anxiety and other psychopathological symptoms. Besides, the IDV shows cultural differences in the interpersonal sensitivity scale, being AN patients from UK (the more individualistic society) who presented with higher levels of interpersonal sensitivity (i.e. discomfort during interpersonal interactions and more negative expectations concerning interpersonal behavior). In conclusion, our findings suggest that psychopathological expression of AN is better explained by Western/Eastern influence than by individualist/collectivist values. Although the diagnosis for the eating disorder may be the same, differences in the psychopathology comorbid to the eating disorders may suggest the need for treatments to be modified according to the culture. PMID:28301566

A preliminary investigation to explore the cognitive resources of physicians experiencing difficulty in training.

PubMed

Patterson, Fiona; Cousans, Fran; Coyne, Iain; Jones, Jo; Macleod, Sheona; Zibarras, Lara

2017-05-15

Treating patients is complex, and research shows that there are differences in cognitive resources between physicians who experience difficulties, and those who do not. It is possible that differences in some cognitive resources could explain the difficulties faced by some physicians. In this study, we explore differences in cognitive resources between different groups of physicians (that is, between native (UK) physicians and International Medical Graduates (IMG); those who continue with training versus those who were subsequently removed from the training programme); and also between physicians experiencing difficulties compared with the general population. A secondary evaluation was conducted on an anonymised dataset provided by the East Midlands Professional Support Unit (PSU). One hundred and twenty one postgraduate trainee physicians took part in an Educational Psychology assessment through PSU. Referrals to the PSU were mainly on the basis of problems with exam progression and difficulties in communication skills, organisation and confidence. Cognitive resources were assessed using the Wechsler Adult Intelligence Scale (WAIS-IV). Physicians were categorised into three PSU outcomes: 'Continued in training', 'Removed from training' and 'Active' (currently accessing the PSU). Using a one-sample Z test, we compared the referred physician sample to a UK general population sample on the WAIS-IV and found the referred sample significantly higher in Verbal Comprehension (VCI; z = 8.78) and significantly lower in Working Memory (WMI; z = -4.59). In addition, the native sample were significantly higher in Verbal Comprehension than the UK general population sample (VCI; native physicians: z = 9.95, p < .001, d = 1.25), whilst there was a lesser effect for the difference between the IMG sample and the UK general population (z = 2.13, p = .03, d = 0.29). Findings also showed a significant difference in VCI scores between those physicians who were 'Removed from training' and those who 'Continued in training'. Our results suggest it is important to understand the cognitive resources of physicians to provide a more focussed explanation of those who experience difficulties in training. This will help to implement more targeted interventions to help physicians develop compensatory strategies.

Guided Web-Based Cognitive Behavior Therapy for Perfectionism: Results From Two Different Randomized Controlled Trials.

PubMed

Rozental, Alexander; Shafran, Roz; Wade, Tracey D; Kothari, Radha; Egan, Sarah J; Ekberg, Linda; Wiss, Maria; Carlbring, Per; Andersson, Gerhard

2018-04-26

Perfectionism can become a debilitating condition that may negatively affect functioning in multiple areas, including mental health. Prior research has indicated that internet-based cognitive behavioral therapy can be beneficial, but few studies have included follow-up data. The objective of this study was to explore the outcomes at follow-up of internet-based cognitive behavioral therapy with guided self-help, delivered as 2 separate randomized controlled trials conducted in Sweden and the United Kingdom. In total, 120 participants randomly assigned to internet-based cognitive behavioral therapy were included in both intention-to-treat and completer analyses: 78 in the Swedish trial and 62 in the UK trial. The primary outcome measure was the Frost Multidimensional Perfectionism Scale, Concern over Mistakes subscale (FMPS CM). Secondary outcome measures varied between the trials and consisted of the Clinical Perfectionism Questionnaire (CPQ; both trials), the 9-item Patient Health Questionnaire (PHQ-9; Swedish trial), the 7-item Generalized Anxiety Disorder scale (GAD-7; Swedish trial), and the 21-item Depression Anxiety Stress Scale (DASS-21; UK trial). Follow-up occurred after 6 months for the UK trial and after 12 months for the Swedish trial. Analysis of covariance revealed a significant difference between pretreatment and follow-up in both studies. Intention-to-treat within-group Cohen d effect sizes were 1.21 (Swedish trial; 95% CI 0.86-1.54) and 1.24 (UK trial; 95% CI 0.85-1.62) for the FMPS CM. Furthermore, 29 (59%; Swedish trial) and 15 (43%; UK trial) of the participants met the criteria for recovery on the FMPS CM. Improvements were also significant for the CPQ, with effect sizes of 1.32 (Swedish trial; 95% CI 0.97-1.66) and 1.49 (UK trial; 95% CI 1.09-1.88); the PHQ-9, effect size 0.60 (95% CI 0.28-0.92); the GAD-7, effect size 0.67 (95% CI 0.34-0.99); and the DASS-21, effect size 0.50 (95% CI 0.13-0.85). The results are promising for the use of internet-based cognitive behavioral therapy as a way of targeting perfectionism, but the findings need to be replicated and include a comparison condition. ©Alexander Rozental, Roz Shafran, Tracey D Wade, Radha Kothari, Sarah J Egan, Linda Ekberg, Maria Wiss, Per Carlbring, Gerhard Andersson. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.04.2018.

Postural tachycardia syndrome is associated with significant symptoms and functional impairment predominantly affecting young women: a UK perspective

PubMed Central

McDonald, Claire; Koshi, Sharon; Busner, Lorna; Kavi, Lesley; Newton, Julia L

2014-01-01

Objective To examine a large UK cohort of patients with postural tachycardia syndrome (PoTS), to compare demographic characteristics, symptoms and treatment of PoTS at one centre compared to the largest patient group PoTS UK and to verify if their functional limitation is similar to patients with chronic fatigue syndrome (CFS). Design A cross-sectional study assessed the frequency of symptoms and their associated variables. Patients and setting Two PoTS cohorts were: (1) recruited via PoTS UK, (2) diagnosed at Newcastle Hospitals National Health Service (NHS) Foundation Trust 2009–2012. Patients with PoTS were then compared to a matched cohort with CFS. Main outcome measures Patients’ detailed demographics, time to diagnosis, education, disability, medications, comorbidity and precipitants. Symptom assessment tools captured, Fatigue Impact Scale, Epworth Sleepiness Scale, Orthostatic Grading Scale (OGS), Hospital Anxiety and Depression Scale, Health Assessment Questionnaire, Cognitive Failures Questionnaire. Results 136 patients with PoTS participated (84 members of PoTS UK (170 cohort; 50% return) and 52 (87 cohort; 60%) from Newcastle Clinics). The PoTS UK population was significantly younger than the clinic patients, with significantly fewer men (p=0.005). Over 60% had a university or postgraduate degree. Significantly more of the PoTS UK cohort were working, with hours worked being significantly higher (p=0.001). Time to diagnosis was significantly longer in the PoTS UK cohort (p=0.04). Symptom severity was comparable between cohorts. The PoTS total group was compared with a matched CFS cohort; despite comparable levels of fatigue and sleepiness, autonomic symptom burden (OGS) was statistically significantly higher. The most common treatment regime included β-blockers. Overall, 21 treatment combinations were described. Up to 1/3 were taking no treatment. Conclusions Patients with PoTS are predominantly women, young, well educated and have significant and debilitating symptoms that impact significantly on quality of life. Despite this, there is no consistent treatment. PMID:24934205

A novel representation of groundwater dynamics in large-scale land surface modelling

NASA Astrophysics Data System (ADS)

Rahman, Mostaquimur; Rosolem, Rafael; Kollet, Stefan

2017-04-01

Land surface processes are connected to groundwater dynamics via shallow soil moisture. For example, groundwater affects evapotranspiration (by influencing the variability of soil moisture) and runoff generation mechanisms. However, contemporary Land Surface Models (LSM) generally consider isolated soil columns and free drainage lower boundary condition for simulating hydrology. This is mainly due to the fact that incorporating detailed groundwater dynamics in LSMs usually requires considerable computing resources, especially for large-scale applications (e.g., continental to global). Yet, these simplifications undermine the potential effect of groundwater dynamics on land surface mass and energy fluxes. In this study, we present a novel approach of representing high-resolution groundwater dynamics in LSMs that is computationally efficient for large-scale applications. This new parameterization is incorporated in the Joint UK Land Environment Simulator (JULES) and tested at the continental-scale.

The impact and importance of intercalibration and intercomparisons for greenhouse gas observational networks

NASA Astrophysics Data System (ADS)

Stavert, Ann; O'Doherty, Simon; Rigby, Matthew; Palmer, Paul; Stanley, Kieran; Young, Dickon; Lunt, Mark; Grant, Aoife; Pitt, Joseph; Bauguitte, Stephane; Helfter, Carole; Mullinger, Neil; Robinson, Andrew; Harris, Neil; Riddick, Stuart; Sonderfeld, Hannah; Boesch, Hartmut; Foster, Grant

2016-04-01

Motivated by the UK 2008 Climate Change Act, which requires the UK to decrease its greenhouse gas (GHG) emissions by 80% of 1990 levels by 2050, the Greenhouse gAs Uk and Global Emissons (GAUGE) project aims to better quantify UK CO2, CH4 and N2O emissions. As part of this project a UK-focused GHG observational network has been established, drawing together new and existing GHG data streams from regional to global scales. These included high-density regional studies, tall-tower sites, moving platforms (ferry and aircraft) and satellite observations. Under the project these observations will be combined with modelling approaches to better quantify and characterise UK GHG emissions and place them within a global context. This presentation will describe the efforts made to ensure that common calibration scales were used within the GAUGE project and an assessment of the intercomparability of the stationary sites and moving platforms (including 6 near surface regional focused sites, 6 tall tower sites, ferry and aircraft measurements). This assessment was undertaken using both a cylinder intercomparison program (ICP) and a comparison between co-located flask and in situ measurements. The majority of the sites agreed within the WMO comparability guidelines, however, small relative biases in CO2 and CH4 were identified at some sites. These biases generally increased with concentration, with differences up to 0.3ppm in CO2 and 3ppb CH4 observed between tall tower sites and mobile platforms, while larger biases were found at some of the regional study sites. In order to investigate the impact of biases of these types an experiment using pseudo emissions and observations was conducted. To achieve this, sets of emissions estimates for key GHG sources (e.g. for CH4 the sum of anthropogenic, biomass burning, wetlands, rice and oceans and other natural sources) were used to estimate the GHG concentrations at the GAUGE observation sites and mobile platforms via the Met office NAME model. These pseudo observations were then adjusted using a range of biases and simulated calibration offsets. Regional UK emissions were then determined based on inversions performed using the Met office NAME model and hierarchical Bayesian inversion method. Using these emissions estimates we quantified the impact of systematic site biases on derived fluxes, assessing the relevance of the WMO comparability guidelines for our UK study and highlighting the importance of rigorous inter-calibration and comparability of data streams for regional emissions estimation.

Spatial coherence and large-scale drivers of drought

NASA Astrophysics Data System (ADS)

Svensson, Cecilia; Hannaford, Jamie

2017-04-01

Drought is a potentially widespread and generally multifaceted natural phenomenon affecting all aspects of the hydrological cycle. It mainly manifests itself at seasonal, or longer, time scales. Here, we use seasonal river flows across the climatologically and topographically diverse UK to investigate the spatial coherence of drought, and explore its oceanic and atmospheric drivers. A better understanding of the spatial characteristics and drivers will improve forecasting and help increase drought preparedness. The location of the UK in the mid-latitude belt of predominantly westerly winds, together with a pronounced topographical divide running roughly from north to south, produce strong windward and leeward effects. Weather fronts associated with storms tracking north-eastward between Scotland and Iceland typically lead to abundant precipitation in the mountainous north and west, while the south and east remain drier. In contrast, prolonged precipitation in eastern Britain tends to be associated with storms on a more southerly track, producing precipitation in onshore winds on the northern side of depressions. Persistence in the preferred storm tracks can therefore result in periods of wet/dry conditions across two main regions of the UK, a mountainous northwest region exposed to westerly winds and a more sheltered, lowland southeast region. This is reflected in cluster analyses of monthly river flow anomalies. A further division into three clusters separates out a region of highly permeable, slowly responding, catchments in the southeast. An expectation that the preferred storm tracks over seasonal time scales can be captured by atmospheric airflow indices, which in turn may be related to oceanic conditions, suggests that statistical methods may be used to describe the relationships between UK regional streamflows, and oceanic and atmospheric drivers. Such relationships may be concurrent or lagged, and the longer response time of the group of permeable catchments in the southeast also introduces lags in the statistical relationships. Three-month aggregations of the data were used to investigate potential oceanic and atmospheric drivers of streamflow drought in the three UK regions. Significant concurrent relationships were found for different parts of the year for several indices of northern hemisphere airflow patterns, including the North Atlantic Oscillation, the Arctic Oscillation, the East Atlantic, the East Atlantic/West Russia, and the Scandinavia patterns. Significant relationships with oceanic and atmospheric indices representing the El Niño/Southern Oscillation were found for both concurrent and lagged analyses.

Influencing Health Policy in the Antenatal and Postnatal Periods: The UK Experience

ERIC Educational Resources Information Center

Hawthorne, Joanna

2015-01-01

Since 1997, the Brazelton Centre UK has offered courses to a wide range of professionals working with newborn infants and their families. In 2009, the Neonatal Behavioral Assessment Scale was recommended in the Healthy Child Programme by the Department of Health. Both the Neonatal Behavioral Assessment Scale and the Newborn Behavioral Observations…

The short-form version of the Depression Anxiety Stress Scales (DASS-21): construct validity and normative data in a large non-clinical sample.

PubMed

Henry, Julie D; Crawford, John R

2005-06-01

To test the construct validity of the short-form version of the Depression anxiety and stress scale (DASS-21), and in particular, to assess whether stress as indexed by this measure is synonymous with negative affectivity (NA) or whether it represents a related, but distinct, construct. To provide normative data for the general adult population. Cross-sectional, correlational and confirmatory factor analysis (CFA). The DASS-21 was administered to a non-clinical sample, broadly representative of the general adult UK population (N = 1,794). Competing models of the latent structure of the DASS-21 were evaluated using CFA. The model with optimal fit (RCFI = 0.94) had a quadripartite structure, and consisted of a general factor of psychological distress plus orthogonal specific factors of depression, anxiety, and stress. This model was a significantly better fit than a competing model that tested the possibility that the Stress scale simply measures NA. The DASS-21 subscales can validly be used to measure the dimensions of depression, anxiety, and stress. However, each of these subscales also taps a more general dimension of psychological distress or NA. The utility of the measure is enhanced by the provision of normative data based on a large sample.

Can large surveys conducted on highly selected populations provide valid information on the epidemiology of common health conditions? An analysis of UK Biobank data on musculoskeletal pain

PubMed Central

Macfarlane, Gary J; Beasley, Marcus; Smith, Blair H; Jones, Gareth T; Macfarlane, Tatiana V

2015-01-01

Introduction: Biobank-type studies are typically large but have very low participation rates. It has been suggested that these studies may provide biased estimates of prevalence but are likely to provide valid estimates of association. We test these hypotheses using data collected on pain in a large Biobank study in the United Kingdom. Methods: UK Biobank recruited 503,325 persons aged 40–69 years (participation rate 5.5%). Participants completed questionnaires, including pain, lifestyle and environment factors. As a comparison, we used both a large population study of pain (MUSICIAN: n = 8847, aged: 40–69 years) conducted 2008–2009 and the National Child Development study (NCDS) which recruited all persons in Great Britain born during one week of 1958 and followed them up at age 44 years (n = 9377). Results: ‘Any pain’ (UK Biobank 61.0%; MUSICIAN 63.9%), chronic pain (42.9%, 52.2%) and site-specific musculoskeletal pain (back 26.2%, 29.7%; shoulder/neck 23.3%, 25.3%) were generally similar in UK Biobank and MUSICIAN. The prevalence of chronic pain and most regional musculoskeletal pains in UK Biobank were all within 2% of that in NCDS. Conclusion: UK Biobank has provided estimates of the prevalence of pain which are similar to those from previous large-scale studies, although a formal comparison of the estimates cannot be made. It has also confirmed known associations with the reporting of pain. Despite its very low participation rate, such a study provides the opportunity to investigate novel exposure–pain relationships and investigate rarer exposures and characteristics to further our knowledge of the epidemiology of pain. PMID:26526341

[The safety of biologics : a risk-benefit assessment of treating rheumatoid arthritis with biologics based on registry data on mortality].

PubMed

Sander, O

2010-11-01

The aim of this study is a risk-benefit assessment of treating rheumatoid arthritis with biologics based on registry data on mortality.UK, Sweden and Spain have published evaluable data on mortality. A parallel control group was conducted in the UK. Sweden and Spain used an historical cohort for comparison.Central registries supported British and Swedish research by sending details on all deaths. The variety of possible confounders prevents direct comparisons of the registers and safe predictions for individual patients.The death rate in TNF-inhibitor-treated patients is higher than in the general population but lower than in the control groups with RA. Thus comorbidities are not balanced, the weighted mortality rate scaled down the difference between exposed patients and controls. When TNF-inhibitors are given for the usual indication, mortality is reduced compared to conventional therapy.

Modelling human mobility patterns using photographic data shared online.

PubMed

Barchiesi, Daniele; Preis, Tobias; Bishop, Steven; Moat, Helen Susannah

2015-08-01

Humans are inherently mobile creatures. The way we move around our environment has consequences for a wide range of problems, including the design of efficient transportation systems and the planning of urban areas. Here, we gather data about the position in space and time of about 16 000 individuals who uploaded geo-tagged images from locations within the UK to the Flickr photo-sharing website. Inspired by the theory of Lévy flights, which has previously been used to describe the statistical properties of human mobility, we design a machine learning algorithm to infer the probability of finding people in geographical locations and the probability of movement between pairs of locations. Our findings are in general agreement with official figures in the UK and on travel flows between pairs of major cities, suggesting that online data sources may be used to quantify and model large-scale human mobility patterns.

Modelling human mobility patterns using photographic data shared online

PubMed Central

Barchiesi, Daniele; Preis, Tobias; Bishop, Steven; Moat, Helen Susannah

2015-01-01

Humans are inherently mobile creatures. The way we move around our environment has consequences for a wide range of problems, including the design of efficient transportation systems and the planning of urban areas. Here, we gather data about the position in space and time of about 16 000 individuals who uploaded geo-tagged images from locations within the UK to the Flickr photo-sharing website. Inspired by the theory of Lévy flights, which has previously been used to describe the statistical properties of human mobility, we design a machine learning algorithm to infer the probability of finding people in geographical locations and the probability of movement between pairs of locations. Our findings are in general agreement with official figures in the UK and on travel flows between pairs of major cities, suggesting that online data sources may be used to quantify and model large-scale human mobility patterns. PMID:26361545

A convenient method of obtaining percentile norms and accompanying interval estimates for self-report mood scales (DASS, DASS-21, HADS, PANAS, and sAD).

PubMed

Crawford, John R; Garthwaite, Paul H; Lawrie, Caroline J; Henry, Julie D; MacDonald, Marie A; Sutherland, Jane; Sinha, Priyanka

2009-06-01

A series of recent papers have reported normative data from the general adult population for commonly used self-report mood scales. To bring together and supplement these data in order to provide a convenient means of obtaining percentile norms for the mood scales. A computer program was developed that provides point and interval estimates of the percentile rank corresponding to raw scores on the various self-report scales. The program can be used to obtain point and interval estimates of the percentile rank of an individual's raw scores on the DASS, DASS-21, HADS, PANAS, and sAD mood scales, based on normative sample sizes ranging from 758 to 3822. The interval estimates can be obtained using either classical or Bayesian methods as preferred. The computer program (which can be downloaded at www.abdn.ac.uk/~psy086/dept/MoodScore.htm) provides a convenient and reliable means of supplementing existing cut-off scores for self-report mood scales.

Oral health-related quality of life following dental treatment under general anaesthesia for early childhood caries - a UK-based study.

PubMed

de Souza, Michelle C; Harrison, Mike; Marshman, Zoe

2017-01-01

To assess parental reports of changes in oral health-related quality of life (OHRQoL) of young children in the UK with early childhood caries (ECC) following dental treatment under general anaesthesia (DGA). To compare the impact of oral rehabilitation (OR) and extraction-only (Exo) treatment approaches on this. Data were collected using the proxy reported components of the Child Oral Health-Related Quality of Life (COHRQoL ® ) questionnaire: the Parent-Caregivers Perceptions questionnaire (P-CPQ) and Family Impact Scale (FIS), from a convenience sample of parents of children receiving DGA at a UK Paediatric Dental Department. Mean scores and prevalence impacts were compared pre- and postoperatively with mean change score and effect sizes calculations. Seventy-eight parents were recruited (51 children undergoing OR, 27 Exo) with 6 lost to follow-up (92.3%). Following treatment, changes in mean P-CPQ and FIS scores were statistically significant (P < 0.0001) with medium to large effect sizes (0.45-1.39). The differences in change scores between the two treatment approaches were not statistically different. DGA for young children with early childhood caries resulted in substantial improvements in parent's ratings of their child's OHRQoL and of the impact on their families. Larger cohort studies are needed to validate these preliminary findings. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Long-term negative impact on quality of life in patients with successfully treated Cushing's disease.

PubMed

Heald, Adrian H; Ghosh, Sandip; Bray, Stephanie; Gibson, Christine; Anderson, Simon G; Buckler, Helen; Fowler, Helen L

2004-10-01

A cohort of pituitary tumour patients, who had undergone definitive treatment within a 15-year period at a single neuroscience centre, were investigated as to whether there were differences in psychological well-being and psychosocial functioning, dependent on endocrine pathology and treatment variables. A detailed assessment of 114 patients with benign pituitary tumours in relation to primary diagnosis and mode of treatment was carried out. Psychological rating scales used were: the Hospital Anxiety and Depression Scale--UK version (HADS-UK), the World Health Organization Quality of Life Scale--abbreviated version (WHOQOL-BREF), General Health Questionnaire 28 (GHQ-28), the Functional Assessment of Cancer Therapy (FACT) and the Social Adjustment Scale--modified (SAS1 and SAS2; the former completed by the patient and the latter by another person who knows the patient well). All Cushing's patients were biochemically cured as defined by a normal 24-h urine free cortisol excretion within the previous 6 months. Patients with treated Cushing's disease had significantly impaired psychological well-being and psychosocial functioning across all tested domains compared with all other pituitary tumours, where scores were similar. When participants with Cushing's disease were excluded, patients who had undergone transfrontal surgery scored significantly higher on GHQ and HADS ratings than transsphenoidally treated patients. Cushing's disease even when biochemically stable has long-term adverse effects on mood and social functioning. We hypothesize that this may be related to irreversible changes in central neural function. Further studies are necessary to define the precise pathways involved.

Reducing the social gradient in smoking: initiatives in the United Kingdom.

PubMed

Murray, Rachael L; McNeill, Ann

2012-07-01

To describe initiatives aiming to reduce the social gradient of smoking in the UK. A description of government initiatives to support smokers from low socioeconomic and other key groups, including National Health Service Stop Smoking Services and how they are seeking to support smokers to quit. The UK is employing a number of strategies to reduce smoking prevalence and is currently top of the Tobacco Control Scale in Europe but the health gap does not yet appear to be decreasing (in relation to smoking prevalence in deprived and higher income groups). More recently, efforts have been made to target smokers in more deprived groups to draw more of these smokers into the quitting process. While Stop Smoking Services are a key part of the UK's comprehensive tobacco control strategy and are reaching smokers from low socioeconomic groups, wider population strategies, such as ensuring all contacts with health-care professionals include advice to stop and the prohibition of remaining channels of tobacco marketing, are required to maximise the impact on deprived smokers. While smoking prevalence decreases among the general population are important, reducing smoking among disadvantaged groups is imperative to reduce health inequalities. It is too soon to say whether the new measures recently adopted in the UK will help to achieve this. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Parliamentary privilege--mortality in members of the Houses of Parliament compared with the UK general population: retrospective cohort analysis, 1945-2011.

PubMed

Dennis, John; Crayford, Tim

2015-12-14

To examine mortality in members of the two UK Houses of Parliament compared with the general population, 1945-2011. Retrospective cohort analysis of death rates and predictors of mortality in Members of Parliament (MPs) and members of the House of Lords (Lords). UK. 4950 MPs and Lords first joining the UK parliament in 1945-2011. Standardised mortality ratios, comparing all cause death rates of MPs and Lords from first election or appointment with those in the age, sex, and calendar year matched general population. Between 1945 and 2011, mortality was lower in MPs (standardised mortality ratio 0.72, 95% confidence interval 0.67 to 0.76) and Lords (0.63, 0.60 to 0.67) than in the general population. Over the same period, death rates among MPs also improved more quickly than in the general population. For every 100 expected deaths, 22 fewer deaths occurred among MPs first elected in 1990-99 compared with MPs first elected in 1945-49. Labour party MPs had 19% higher death rates compared with the general population than did Conservative MPs (relative mortality ratio 1.19, 95% confidence interval 1.01 to 1.40). The effect of political party on mortality disappeared when controlling for education level. From 1945 to 2011, MPs and Lords experienced lower mortality than the UK general population, and, at least until 1999, the mortality gap between newly elected MPs and the general population widened. Even among MPs, educational background was an important predictor of mortality, and education possibly explains much of the mortality difference between Labour and Conservative MPs. Social inequalities are alive and well in UK parliamentarians, and at least in terms of mortality, MPs are likely to have never had it so good. 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.

A BEME systematic review of UK undergraduate medical education in the general practice setting: BEME Guide No. 32.

PubMed

Park, Sophie; Khan, Nada F; Hampshire, Mandy; Knox, Richard; Malpass, Alice; Thomas, James; Anagnostelis, Betsy; Newman, Mark; Bower, Peter; Rosenthal, Joe; Murray, Elizabeth; Iliffe, Steve; Heneghan, Carl; Band, Amanda; Georgieva, Zoya

2015-05-06

General practice is increasingly used as a learning environment in undergraduate medical education in the UK. The aim of this project was to identify, summarise and synthesise research about undergraduate medical education in general practice in the UK. We systematically identified studies of undergraduate medical education within a general practice setting in the UK from 1990 onwards. All papers were summarised in a descriptive report and categorised into two in-depth syntheses: a quantitative and a qualitative in-depth review. 169 papers were identified, representing research from 26 UK medical schools. The in-depth review of quantitative papers (n = 7) showed that medical students learned clinical skills as well or better in general practice settings. Students receive more teaching, and clerk and examine more patients in the general practice setting than in hospital. Patient satisfaction and enablement are similar whether a student is present or not in a consultation, however, patients experience lower relational empathy. Two main thematic groups emerged from the qualitative in-depth review (n = 10): the interpersonal interactions within the teaching consultation and the socio-cultural spaces of learning which shape these interactions. The GP has a role as a broker of the interactions between patients and students. General practice is a socio-cultural and developmental learning space for students, who need to negotiate the competing cultures between hospital and general practice. Lastly, patients are transient members of the learning community, and their role requires careful facilitation. General practice is as good, if not better, than hospital delivery of teaching of clinical skills. Our meta-ethnography has produced rich understandings of the complex relationships shaping possibilities for student and patient active participation in learning.

The impact of overactive bladder on mental health, work productivity and health-related quality of life in the UK and Sweden: results from EpiLUTS.

PubMed

Coyne, Karin S; Sexton, Chris C; Kopp, Zoe S; Ebel-Bitoun, Caty; Milsom, Ian; Chapple, Chris

2011-11-01

• To examine the prevalence and burden of overactive bladder (OAB) with bother in the UK and Sweden compared to OAB without bother and no/minimal OAB/lower urinary tract (LUTS) symptoms, respectively. • A cross-sectional population-representative survey was conducted via the Internet in the UK, Sweden and USA. • Participants rated the frequency and bother of OAB and LUTS. Patient outcomes included the Overactive Bladder Questionnaire Short Form, Patient Perception of Bladder Condition, Short Form-12, Hospital Anxiety and Depression Scale-Anxiety and Hospital Anxiety and Depression Scale-Depression, as well as questions about treatment seeking and work productivity. • OAB was defined as urgency at least sometimes or the presence of urinary urgency incontinence. Three subgroups were compared: no/minimal symptoms, OAB without bother and OAB with bother. • Analyses were conducted by gender and country using general linear and logistic regression models to examine bothersome OAB and treatment seeking. • Survey response was 59.2%; 10,000 people (4724 men and 5276 women) participated. • The prevalence of OAB with bother at least 'somewhat' was 10.9% and 14.6% for men in the UK and Sweden, and 22.5% and 33.7% for women in the UK and Sweden, respectively. • Men and women with bothersome OAB were significantly more likely to seek treatment, report the lowest levels of health-related quality of life and work productivity and the highest levels of anxiety and depression compared to those with no/minimal symptoms and OAB without bother. • Greater symptom severity of urgency, urgency urinary incontinence, frequency, nocturia, and increasing levels of anxiety were strongly predictive of OAB bother in both men and women. • Predictors of treatment seeking included frequency, bother as a result of urgency, and lower levels of depressive symptoms in men, and frequency, nocturia and urgency in women. • OAB is common in the UK and Sweden, and women are more likely to be affected then men. • The impact of OAB is evident across generic and condition-specific domains of health-related quality of life. © 2010 THE AUTHORS. BJU INTERNATIONAL © 2010 BJU INTERNATIONAL.

The Prevalence of Intellectual Disability in a Major UK Prison

ERIC Educational Resources Information Center

Hayes, Susan; Shackell, Phil; Mottram, Pat; Lancaster, Rachel

2007-01-01

Over-representation of people with learning disability in prisons has been demonstrated in many Western jurisdictions. This was the first comprehensive research in a UK prison. The research used a random 10% sample of a prison population (n = 140). A semi-structured interview, the Wechsler Adult Intelligence Scale-III (UK version) and the Vineland…

Working with Secondary School Leadership in a Large-Scale Reform in London, UK: Consultants' Perspectives of Their Role as Agents of School Change and Improvement

ERIC Educational Resources Information Center

Cameron, David Hagen

2010-01-01

This article uses a cultural and political theoretical framework to examine the relationship between consultants and secondary school leaders within a large-scale consultancy-based reform, the Secondary National Strategy (SNS), in London UK. The SNS follows a cascade model of implementation, in which nationally created initiatives are introduced…

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.

System hazards in managing laboratory test requests and results in primary care: medical protection database analysis and conceptual model.

PubMed

Bowie, Paul; Price, Julie; Hepworth, Neil; Dinwoodie, Mark; McKay, John

2015-11-27

To analyse a medical protection organisation's database to identify hazards related to general practice systems for ordering laboratory tests, managing test results and communicating test result outcomes to patients. To integrate these data with other published evidence sources to inform design of a systems-based conceptual model of related hazards. A retrospective database analysis. General practices in the UK and Ireland. 778 UK and Ireland general practices participating in a medical protection organisation's clinical risk self-assessment (CRSA) programme from January 2008 to December 2014. Proportion of practices with system risks; categorisation of identified hazards; most frequently occurring hazards; development of a conceptual model of hazards; and potential impacts on health, well-being and organisational performance. CRSA visits were undertaken to 778 UK and Ireland general practices of which a range of systems hazards were recorded across the laboratory test ordering and results management systems in 647 practices (83.2%). A total of 45 discrete hazard categories were identified with a mean of 3.6 per practice (SD=1.94). The most frequently occurring hazard was the inadequate process for matching test requests and results received (n=350, 54.1%). Of the 1604 instances where hazards were recorded, the most frequent was at the 'postanalytical test stage' (n=702, 43.8%), followed closely by 'communication outcomes issues' (n=628, 39.1%). Based on arguably the largest data set currently available on the subject matter, our study findings shed new light on the scale and nature of hazards related to test results handling systems, which can inform future efforts to research and improve the design and reliability of these systems. 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/

Development of a scale to measure symptoms of anxiety and depression in the general UK population: the psychiatric symptom frequency scale.

PubMed Central

Lindelow, M; Hardy, R; Rodgers, B

1997-01-01

OBJECTIVES: The psychiatric symptom frequency (PSF) scale was developed to assess symptoms of anxiety and depression (i.e. affective symptoms) experienced over the past year in the general population. This study aimed to examine the distribution of PSF scores, internal consistency, and factor structure and to investigate relationships between total scores for this scale and other indicators of poor mental health. PARTICIPANTS: The Medical Research Council national survey of health and development, a class stratified cohort study of men and women followed up from birth in 1946, with the most recent interview at age 43 when the PSF scale was administered. MAIN RESULTS: The PSF scale showed high internal consistency between the 18 items (Cronbach's alpha = 0.88). Ratings on items of the scale reflected one predominant factor, incorporating both depression and anxiety, and two additional factors of less statistical importance, one reflecting sleep problems and the other panic and situational anxiety. Total scores were calculated by adding 18 items of the scale, and high total scores were found to be strongly associated with reports of contact with a doctor or other health professional and use of prescribed medication for "nervous or emotional trouble or depression," and with suicidal ideas. CONCLUSIONS: The PSF is a useful and valid scale for evaluating affective symptoms in the general population. It is appropriate for administration by lay interviewers with minimal training, is relatively brief, and generates few missing data. The total score is a flexible measure which can be used in continuous or binary form to suit the purposes of individual investigations, and provides discrimination at lower as well as upper levels of symptom severity. PMID:9425466

Images of older people in UK magazine advertising: toward a typology.

PubMed

Williams, Angie; Wadleigh, Paul Mark; Ylänne, Virpi

2010-01-01

The use of images of older people in the British advertising media has been under-researched to date. Further, previous research in any country has tended to examine such images from an a priori framework of general impressions and stereotypes of older people. This study addresses these issues with British consumers' (n = 106) impressions, trait ascriptions, and similarity-between-images ratings of a representative sample of U.K. magazine advertisements featuring older characters. After a series of sorting task laboratory sessions, multidimensional scaling and hierarchical cluster analyses revealed four clearly defined groups representing types of portrayals. These types emerged from the advertisements and from the views of the consumers themselves. These emergent groupings are: (1) Frail and Vulnerable, (2) Happy and Affluent, (3) Mentors, (4) Active and Leisure-oriented older adults. These groupings seem to be a logical context-appropriate derivation from previous findings on generally held stereotypes of older persons. It is argued that the groupings have the potential to contribute to a reliable typology of advertising portrayals of older people, with potential heuristic leverage in social scientific research of intergenerational communication, lifespan concerns, and the aging process.

Validation of an instrument to measure quality of life in British children with inflammatory bowel disease.

PubMed

Ogden, C A; Akobeng, A K; Abbott, J; Aggett, P; Sood, M R; Thomas, A G

2011-09-01

To validate IMPACT-III (UK), a health-related quality of life (HRQoL) instrument, in British children with inflammatory bowel disease (IBD). One hundred six children and parents were invited to participate. IMPACT-III (UK) was validated by inspection by health professionals and children to assess face and content validity, factor analysis to determine optimum domain structure, use of Cronbach alpha coefficients to test internal reliability, ANOVA to assess discriminant validity, correlation with the Child Health Questionnaire to assess concurrent validity, and use of intraclass correlation coefficients to assess test-retest reliability. The independent samples t test was used to measure differences between sexes and age groups, and between paper and computerised versions of IMPACT-III (UK). IMPACT-III (UK) had good face and content validity. The most robust factor solution was a 5-domain structure: body image, embarrassment, energy, IBD symptoms, and worries/concerns about IBD, all of which demonstrated good internal reliability (α = 0.74-0.88). Discriminant validity was demonstrated by significant (P  < 0.05, P < 0.01) differences in HRQoL scores between the severe, moderate, and inactive/mild symptom severity groups for the embarrassment scale (63.7 vs 81.0 vs 81.2), IBD symptom scale (45.0 vs 64.2 vs 80.6), and the energy scale (46.4 vs 62.1 vs 77.7). Concurrent validity of IMPACT-III (UK) with comparable domains of the Child Health Questionnaire was confirmed. Test-retest reliability was confirmed with good intraclass correlation coefficients of 0.66 to 0.84. Paper and computer versions of IMPACT-III (UK) collected comparable scores, and there were no differences between the sexes and age groups. IMPACT-III (UK) appears to be a useful tool to measure HRQoL in British children with IBD.

DynamO: a free O(N) general event-driven molecular dynamics simulator.

PubMed

Bannerman, M N; Sargant, R; Lue, L

2011-11-30

Molecular dynamics algorithms for systems of particles interacting through discrete or "hard" potentials are fundamentally different to the methods for continuous or "soft" potential systems. Although many software packages have been developed for continuous potential systems, software for discrete potential systems based on event-driven algorithms are relatively scarce and specialized. We present DynamO, a general event-driven simulation package, which displays the optimal O(N) asymptotic scaling of the computational cost with the number of particles N, rather than the O(N) scaling found in most standard algorithms. DynamO provides reference implementations of the best available event-driven algorithms. These techniques allow the rapid simulation of both complex and large (>10(6) particles) systems for long times. The performance of the program is benchmarked for elastic hard sphere systems, homogeneous cooling and sheared inelastic hard spheres, and equilibrium Lennard-Jones fluids. This software and its documentation are distributed under the GNU General Public license and can be freely downloaded from http://marcusbannerman.co.uk/dynamo. Copyright © 2011 Wiley Periodicals, Inc.

On-Demand Testing and Maintaining Standards for General Qualifications in the UK Using Item Response Theory: Possibilities and Challenges

ERIC Educational Resources Information Center

He, Qingping

2012-01-01

Background: Although on-demand testing is being increasingly used in many areas of assessment, it has not been adopted in high stakes examinations like the General Certificate of Secondary Education (GCSE) and General Certificate of Education Advanced level (GCE A level) offered by awarding organisations (AOs) in the UK. One of the major issues…

Do neonatal hypoglycaemia guidelines in Australia and New Zealand facilitate breast feeding?

PubMed

Sundercombe, Samantha L; Raynes-Greenow, Camille H; Turner, Robin M; Jeffery, Heather E

2014-12-01

to establish how well postnatal ward neonatal hypoglycaemia guidelines facilitate breast feeding and adhere to UNICEF UK Baby Friendly Initiative (BFI) recommendations, and to compare compliance with different recommendations. an appraisal of guidelines obtained via email survey using a UNICEF UK BFI checklist tool. Information about Baby Friendly Health/Hospital Initiative (BFHI) accreditation status was obtained by email questionnaire. tertiary neonatal centres in Australia and New Zealand. 22 guidelines were returned from 23 centres eligible to participate. guidelines generally scored poorly. On a scale ranging from 31 to 124 of overall guideline quality, the median score was 71. On a scale of 9 to 36 for adherence to recommendations to facilitate breast feeding, the median guideline score was 20. Compliance with the recommendation to promote skin-to-skin contact and early breast feeding was poor across all centres, achieving a score of 59 out of 88. Nine of 22 guidelines mentioned skin-to-skin contact after birth and 14 advised feeding within one hour of birth. The recommendation about discussing artificial milk supplementation with parents received a score of 44 out of 88. Fourteen guidelines listed Large for Gestational Age (LGA) infants to be at risk of hypoglycaemia. Few guidelines included up-to-date references or flowcharts. guidelines need to recommend early skin-to-skin contact and discussion with parents before artificial milk supplementation. Guidelines suggest LGA neonates are being screened unnecessarily. guidelines need constant revision as evidence for best practice expands. The UNICEF UK BFI checklist provides a readily available quality improvement tool. Copyright © 2014 Elsevier Ltd. All rights reserved.

Codeine use, dependence and help-seeking behaviour in the UK and Ireland: an online cross-sectional survey.

PubMed

Kimergård, A; Foley, M; Davey, Z; Dunne, J; Drummond, C; Deluca, P

2017-09-01

Codeine misuse and dependence poses a clinical and public health challenge. However, little is known about dependence and treatment needs in the UK and Ireland. To characterize codeine use, dependence and help-seeking behaviour. An online cross-sectional survey advertised on Facebook, Twitter, health and drug websites and e-mail circulars. The survey collected data on demographics and codeine use amongst adults from the UK and Ireland. The Severity of Dependence Scale measured the level of codeine dependence. The sample of 316 respondents had a mean age of 35.3 years (SD = 12.3) and 67% were women. Of the 316 respondents, 54 scored ≥5 on the Severity of Dependence Scale indicating codeine dependence (17.1%). Our study found that codeine dependence is a problem with both prescribed and 'over-the-counter' codeine. Codeine dependence was associated with daily use of codeine, faking or exaggerating symptoms to get a prescription for codeine and 'pharmacy shopping' ( P < 0.01). A higher number of respondents had sought advice on the Internet (12%) rather than from their general medical practitioner (GP) (5.4%). Less than 1% of respondents had sought advice from a pharmacist. Codeine dependent users were more likely to seek help on the Internet to control their use of codeine than from a GP, which may indicate a potential for greater specialized addiction treatment demand through increased identification and referrals in primary care. © The Author 2017. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Soft governance, restratification and the 2004 general medical services contract: the case of UK primary care organisations and general practice teams.

PubMed

Grant, Suzanne; Ring, Adele; Gabbay, Mark; Guthrie, Bruce; McLean, Gary; Mair, Frances S; Watt, Graham; Heaney, David; O'Donnell, Catherine

2015-01-01

In the UK National Health Service, primary care organisation (PCO) managers have traditionally relied on the soft leadership of general practitioners based on professional self-regulation rather than direct managerial control. The 2004 general medical services contract (nGMS) represented a significant break from this arrangement by introducing new performance management mechanisms for PCO managers to measure and improve general practice work. This article examines the impact of nGMS on the governance of UK general practice by PCO managers through a qualitative analysis of data from an empirical study in four UK PCOs and eight general practices, drawing on Hood's four-part governance framework. Two hybrids emerged: (i) PCO managers emphasised a hybrid of oversight, competition (comptrol) and peer-based mutuality by granting increased support, guidance and autonomy to compliant practices; and (ii) practices emphasised a broad acceptance of increased PCO oversight of clinical work that incorporated a restratified elite of general practice clinical peers at both PCO and practice levels. Given the increased international focus on the quality, safety and efficiency in primary care, a key issue for PCOs and practices will be to achieve an effective, contextually appropriate balance between the counterposing governance mechanisms of peer-led mutuality and externally led comptrol. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Aspects of medical migration with particular reference to the United Kingdom and the Netherlands.

PubMed

Herfs, Paul G P

2014-10-14

In most countries of the European Economic Area (EEA), there is no large-scale migration of medical graduates with diplomas obtained outside the EEA, which are international medical graduates (IMGs). In the United Kingdom however, health care is in part dependent on the influx of IMGs. In 2005, of all the doctors practising in the UK, 31% were educated outside the country. In most EEA-countries, health care is not dependent on the influx of IMGs.The aim of this study is to present data relating to the changes in IMG migration in the UK since the extension of the European Union in May 2004. In addition, data are presented on IMG migration in the Netherlands. These migration flows show that migration patterns differ strongly within these two EU-countries. This study makes use of registration data on migrating doctors from the General Medical Council (GMC) in the UK and from the Dutch Department of Health. Moreover, data on the ratio of medical doctors in relation to a country's population were extracted from the World Health Organization (WHO). The influx of IMGs in the UK has changed in recent years due to the extension of the European Union in 2004, the expansion of UK medical schools and changes in the policy towards non-EEA doctors.The influx of IMGs in the Netherlands is described in detail. In the Netherlands, many IMGs come from Afghanistan, Iraq and Surinam. There are clear differences between IMG immigration in the UK and in the Netherlands. In the UK, the National Health Service continues to be very reliant on immigration to fill shortage posts, whereas the number of immigrant doctors working in the Netherlands is much smaller. Both the UK and the Netherlands' regulatory bodies have shared great concerns about the linguistic and communication skills of both EEA and non-EEA doctors seeking to work in these countries. IMG migration is a global and intricate problem. The source countries, not only those where English is the first or second language, experience massive IMG migration flows.

Undergraduate teaching in UK general practice: a geographical snapshot

PubMed Central

Derbyshire, Helen; Rees, Eliot; Gay, Simon P; McKinley, Robert K

2014-01-01

Background 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. Aim To identify the geographical distribution of undergraduate teaching practices and their distance from the host medical school. Design and setting National survey of all medical schools in the UK. Method 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. Results 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. Conclusion 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. PMID:24868071

Patients' perspectives on antiepileptic medication: relationships between beliefs about medicines and adherence among patients with epilepsy in UK primary care.

PubMed

Chapman, S C E; Horne, R; Chater, A; Hukins, D; Smithson, W H

2014-02-01

Nonadherence to antiepileptic drugs (AEDs) can result in suboptimal outcomes for patients. This study aimed to assess the utility of a theory-based approach to understanding patient perspectives on AEDs and adherence. Patients with epilepsy, identified by a GP case note review, were mailed validated questionnaires assessing their perceptions of AEDs and their adherence to them. Most (84.9%) of the 398 AED-treated respondents accepted the necessity of AEDs, but over half expressed doubts, with 55% disagreeing or uncertain about the statement 'I would prefer to take epilepsy medication than risk a seizure'. Over a third (36.4%) expressed strong concerns about the potential negative effects of AEDs. We used self-report and medication possession ratio to classify 36.4% of patients as nonadherent. Nonadherence was related to beliefs about medicines and implicit attitudes toward AEDs (p<0.05). Adherence-related attitudes toward AEDs were correlated with general beliefs about pharmaceuticals (BMQ General: General Harm, General Overuse, and General Benefit scales) and perceptions of personal sensitivity to medicines (PSM scale). We identified salient, adherence-related beliefs about AEDs. Patient-centered interventions to support medicine optimization for people with epilepsy should take account of these beliefs. © 2013.

Understanding and quantifying greenhouse gases (GHG) emissions: the UK GHG Emissions and Feedback Programme

NASA Astrophysics Data System (ADS)

Matthiesen, Stephan; Palmer, Paul; Watson, Andrew; Williams, Mathew

2016-04-01

We give an overview over the structure, objectives, and methods of the UK-based Greenhouse Gases Emissions and Feedback Programme. The overarching objective of this research programme is to deliver improved GHG inventories and predictions for the UK, and for the globe at a regional scale. To address this objective, the Programme has developed a comprehensive, multi-year and interlinked measurement and data analysis programme, focussing on the major GHGs carbon dioxide (CO2), methane (CH4) and nitrous oxide (N2O). The Programme integrates three UK research consortia with complementary objectives, focussing on observation and modelling in the atmosphere, the oceans, and the terrestrial biosphere: GAUGE (Greenhouse gAs Uk and Global Emissions) will produce robust estimates of the UK GHG budget, using new and existing atmospheric measurement networks and modelling activities at a range of scales. It integrates inter-calibrated information from ground-based, airborne, ferry-borne, balloon-borne, and space-borne sensors, including new sensor technology. The GREENHOUSE (Generating Regional Emissions Estimates with a Novel Hierarchy of Observations and Upscaled Simulation Experiments) project aims to understand the spatio-temporal patterns of biogenic GHG emissions in the UK's landscape of managed and semi-managed ecosystems. It uses existing UK field data and several targeted new measurement campaigns to build regional GHG inventories and improve the capabilities of land surface models. RAGNARoCC (Radiatively active gases from the North Atlantic Region and Climate Change) is an oceanographic project to investigate the air-sea fluxes of GHGs in the North Atlantic region. Through dedicated research cruises as well as data collection from ships of opportunity, it develops a comprehensive budget of natural and anthropogenic components of the carbon cycle in the North Atlantic and a better understanding of why the air-sea fluxes of CO2 vary regionally, seasonally and multi-annually. Integration activities link these three projects to foster knowledge exchange across different scales, methods and sub-disciplines, both within the Programme and with the wider research community. The three projects are integrated to improve our understanding of greenhouse gases across domains and scales. The observational components lay the foundation of new measurement infrastructure that will deliver beyond the lifetime of this Programme. Through the development of robust methods to reduce uncertainties in GHG emissions estimates, the Programme supports regulatory efforts to monitor emissions trends and the efficacy of reduction strategies.

Annual Review of Competence Progression (ARCP) performance of doctors who passed Professional and Linguistic Assessments Board (PLAB) tests compared with UK medical graduates: national data linkage study

PubMed Central

Illing, Jan; Kasim, Adetayo S; McLachlan, John C

2014-01-01

Objective To determine whether use of the Professional and Linguistic Assessments Board (PLAB) examination system used to grant registration for international medical graduates results in equivalent postgraduate medical performance, as evaluated at Annual Review of Competence Progression (ARCP), between UK based doctors who qualified overseas and those who obtained their primary medical qualification from UK universities. Design Observational study linking ARCP outcome data from the UK deaneries with PLAB test performance and demographic data held by the UK General Medical Council (GMC). Setting Doctors in postgraduate training for a medical specialty or general practice in the UK and doctors obtaining GMC registration via the PLAB system. Participants 53 436 UK based trainee doctors with at least one competency related ARCP outcome reported during the study period, of whom 42 017 were UK medical graduates and 11 419 were international medical graduates who were registered following a pass from the PLAB route. Main outcome measure Probability of obtaining a poorer versus a more satisfactory category of outcome at ARCP following successful registration as a doctor in the UK. Results International medical graduates were more likely to obtain a less satisfactory outcome at ARCP compared with UK graduates. This finding persisted even after adjustment for the potential influence of sex, age, years of UK based practice, and ethnicity and exclusion of outcomes associated with postgraduate examination failure (odds ratio 1.63, 95% confidence interval 1.30 to 2.06). However, international medical graduates who scored in the highest twelfth at part 1 of the PLAB (at least 32 points above the pass mark) had ARCP outcomes that did not differ significantly from those of UK graduates. Conclusions These findings suggest that the PLAB test used for registration of international medical graduates is not generally equivalent to the requirements for UK graduates. The differences in postgraduate performance, as captured at ARCP, following the two routes to registration might be levelled out by raising the standards of English language competency required as well as the pass marks for the two parts of the PLAB test. An alternative might be to introduce a different testing system. PMID:24742539

Towards a simple representation of chalk hydrology in land surface modelling

NASA Astrophysics Data System (ADS)

Rahman, Mostaquimur; Rosolem, Rafael

2017-01-01

Modelling and monitoring of hydrological processes in the unsaturated zone of chalk, a porous medium with fractures, is important to optimize water resource assessment and management practices in the United Kingdom (UK). However, incorporating the processes governing water movement through a chalk unsaturated zone in a numerical model is complicated mainly due to the fractured nature of chalk that creates high-velocity preferential flow paths in the subsurface. In general, flow through a chalk unsaturated zone is simulated using the dual-porosity concept, which often involves calibration of a relatively large number of model parameters, potentially undermining applications to large regions. In this study, a simplified parameterization, namely the Bulk Conductivity (BC) model, is proposed for simulating hydrology in a chalk unsaturated zone. This new parameterization introduces only two additional parameters (namely the macroporosity factor and the soil wetness threshold parameter for fracture flow activation) and uses the saturated hydraulic conductivity from the chalk matrix. The BC model is implemented in the Joint UK Land Environment Simulator (JULES) and applied to a study area encompassing the Kennet catchment in the southern UK. This parameterization is further calibrated at the point scale using soil moisture profile observations. The performance of the calibrated BC model in JULES is assessed and compared against the performance of both the default JULES parameterization and the uncalibrated version of the BC model implemented in JULES. Finally, the model performance at the catchment scale is evaluated against independent data sets (e.g. runoff and latent heat flux). The results demonstrate that the inclusion of the BC model in JULES improves simulated land surface mass and energy fluxes over the chalk-dominated Kennet catchment. Therefore, the simple approach described in this study may be used to incorporate the flow processes through a chalk unsaturated zone in large-scale land surface modelling applications.

An assessment of WISC-IIIUK on children with HIV infection.

PubMed

James, Anu Nikitha; Ittyerah, Miriam

2016-10-01

The Wechsler Intelligence Scale for Children - Third Edition UK test was administered to groups of children between the ages of 6 and 12 years with vertically transmitted HIV infection (n = 70) and a control group who were not infected by the virus (n = 70). The study was conducted in India. The two groups were matched for general verbal abilities, age and gender. The children were assessed for Verbal IQ, Performance IQ and Full-Scale IQ. The Verbal Comprehension Index, Perceptual Organization Index and Freedom from Distractibility Index were also obtained. A three-factor analysis of variance disclosed that school-age children with vertically transmitted HIV infection notched below in the areas of Verbal IQ, Performance IQ, Full-Scale IQ, Verbal Comprehension Index, Perceptual Organization Index and Freedom from Distractibility Index when collated with normal uninfected cohorts. Findings are discussed in the light of both theoretical and clinical implications. © The Author(s) 2015.

Prevalence of pain medication prescriptions in France, Germany, and the UK - a cross-sectional study including 4,270,142 patients.

PubMed

Jacob, Louis; Kostev, Karel

2018-01-01

The goal of the present study was to analyze the prevalence of pain medication prescriptions in general practices in France, Germany, and the UK. This study included all patients aged ≥18 years followed in 2016 in general practitioner practices in France, Germany and the UK. The primary outcome was the prevalence of patients receiving prescriptions for pain medications in France, Germany, and the UK in 2016. The following drugs were included in the analysis: anti-inflammatory and antirheumatic products, non-steroids and analgesics including opioids, antimigraine preparations, and other analgesics and antipyretics. Demographic variables included age and gender. This study included 4,270,142 patients. The prevalences of pain medication prescriptions were 57.3% in France, 29.6% in Germany, and 21.7% in the UK. Although this prevalence generally remained consistent between age groups in France (54.3%-60.3%), it increased with age in Germany (18-30 years: 23.8%; >70 years: 35.8%) and in the UK (18-30 years: 9.3%; >70 years: 43.8%). Finally, the prevalence of pain medication prescriptions was higher in women than in men in all three countries. Paracetamol was prescribed to 82.3% and 60.1% of patients receiving pain medication in France and the UK, respectively, whereas ibuprofen was prescribed to 46.5% of individuals in Germany. The prevalence of pain medication prescriptions was higher in France than in Germany and the UK. Further research is needed to gain a better understanding of the differences in the prescription patterns between these three European countries.

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.

Cross-Cultural Study of Information Processing Biases in Chronic Fatigue Syndrome: Comparison of Dutch and UK Chronic Fatigue Patients.

PubMed

Hughes, Alicia M; Hirsch, Colette R; Nikolaus, Stephanie; Chalder, Trudie; Knoop, Hans; Moss-Morris, Rona

2018-02-01

This study aims to replicate a UK study, with a Dutch sample to explore whether attention and interpretation biases and general attentional control deficits in chronic fatigue syndrome (CFS) are similar across populations and cultures. Thirty eight Dutch CFS participants were compared to 52 CFS and 51 healthy participants recruited from the UK. Participants completed self-report measures of symptoms, functioning, and mood, as well as three experimental tasks (i) visual-probe task measuring attentional bias to illness (somatic symptoms and disability) versus neutral words, (ii) interpretive bias task measuring positive versus somatic interpretations of ambiguous information, and (iii) the Attention Network Test measuring general attentional control. Compared to controls, Dutch and UK participants with CFS showed a significant attentional bias for illness-related words and were significantly more likely to interpret ambiguous information in a somatic way. These effects were not moderated by attentional control. There were no significant differences between the Dutch and UK CFS groups on attentional bias, interpretation bias, or attentional control scores. This study replicated the main findings of the UK study, with a Dutch CFS population, indicating that across these two cultures, people with CFS demonstrate biases in how somatic information is attended to and interpreted. These illness-specific biases appear to be unrelated to general attentional control deficits.

Development of the scale of perceived social support in HIV (PSS-HIV).

PubMed

Cortes, Aaron; Hunt, Nigel; McHale, Sue

2014-12-01

Social support (SS) plays a key role for HIV/AIDS prevention and disease management. Numerous general and disease-specific SS instruments have been developed and perception of support has been increasingly considered, though no scales have been specifically developed to measure perceived social support (PSS) in HIV/AIDS. To help fill this gap a 12-item scale was developed. The study comprised 406 (HIV(+) and HIV(-)) participants from Chile and the UK. A principal component factor analysis yielded three factors explaining 77.0 % of the total variance: Belonging, Esteem and Self-development with Cronbach α of 0.759, 0.882 and 0.927 respectively and 0.893 on the full scale. The PSS-HIV is brief, easy-to-apply, available in English and Spanish and evaluates the perception of supportive social interactions. Further research is needed to corroborate its capacity to detect psycho-socio-immune interactions, its connection with Maslow's hierarchy of need theory and to evaluate its properties for different health states.

Disordered Eating, Compulsive Exercise, and Sport Participation in a UK Adolescent Sample.

PubMed

Goodwin, Huw; Haycraft, Emma; Meyer, Caroline

2016-07-01

The sport literature has produced equivocal results as to whether sport participation is a protective or risk factor for disordered eating. One mechanism by which it could be a risk factor is the increased drive or compulsion to exercise. This study compared the levels of disordered eating and compulsive exercise between adolescent sport and non-sport participants. A sample of 417 male and female adolescents, aged 14-16 years old, was recruited from UK secondary schools. Participants completed questionnaire packs that included: the Eating Disorder Inventory; a measure of exercise behaviour; and the Compulsive Exercise Test (CET). Non-sport participants reported significantly greater body dissatisfaction than sport participants, and this was true for boys and girls. Significant group differences were also reported for many of the CET scales, with sport participants generally reporting greater levels of compulsive exercise than non-sport participants. Implications of these results are discussed. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Career destinations, views and future plans of the UK medical qualifiers of 1988.

PubMed

Taylor, Kathryn; Lambert, Trevor; Goldacre, Michael

2010-01-01

To report the career destinations, views and future plans of a cohort of senior doctors who qualified in the 1980s. Postal questionnaire survey of all doctors who qualified from all UK medical schools in 1988. The response rate was 69%. We estimated that 81% of the total cohort was working in the NHS, 16 years after qualification; and that at least 94% of graduates who, when students, were from UK homes, were working in medicine. Of NHS doctors, 30% worked part-time. NHS doctors rated their job satisfaction highly (median score 19.9, scale 5-25) but were less satisfied with the amount of leisure time available to them (median score 5.4, scale 1-10). NHS doctors were very positive about their careers, but were less positive about working hours and some other aspects of the NHS. Women were more positive than men about working conditions; general practitioners were more positive than hospital doctors. Twenty-five percent reported unmet needs for further training or career-related advice, particularly about career development. Twenty-nine percent intended to reduce their hours in future, while 6%, mainly part-time women, planned to increase their hours. Overall, 10% of NHS doctors planned to do more service work in future and 24% planned to do less; among part-time women, 18% planned to do more and only 14% less. These NHS doctors, now in their 40s, had a high level of satisfaction with their jobs and their careers but were less satisfied with some other aspects of their working environment. A substantial percentage had expectations about future career development and change.

Career destinations, views and future plans of the UK medical qualifiers of 1988

PubMed Central

Taylor, Kathryn; Lambert, Trevor; Goldacre, Michael

2010-01-01

Summary Objectives To report the career destinations, views and future plans of a cohort of senior doctors who qualified in the 1980s. Methods Postal questionnaire survey of all doctors who qualified from all UK medical schools in 1988. Results The response rate was 69%. We estimated that 81% of the total cohort was working in the NHS, 16 years after qualification; and that at least 94% of graduates who, when students, were from UK homes, were working in medicine. Of NHS doctors, 30% worked part-time. NHS doctors rated their job satisfaction highly (median score 19.9, scale 5–25) but were less satisfied with the amount of leisure time available to them (median score 5.4, scale 1–10). NHS doctors were very positive about their careers, but were less positive about working hours and some other aspects of the NHS. Women were more positive than men about working conditions; general practitioners were more positive than hospital doctors. Twenty-five percent reported unmet needs for further training or career-related advice, particularly about career development. Twenty-nine percent intended to reduce their hours in future, while 6%, mainly part-time women, planned to increase their hours. Overall, 10% of NHS doctors planned to do more service work in future and 24% planned to do less; among part-time women, 18% planned to do more and only 14% less. Conclusions These NHS doctors, now in their 40s, had a high level of satisfaction with their jobs and their careers but were less satisfied with some other aspects of their working environment. A substantial percentage had expectations about future career development and change. PMID:20056666

The Development of the Special Educational Needs Coordinator Role in a Higher Education Setting

ERIC Educational Resources Information Center

Taylor, Mark

2005-01-01

UK higher education appears to have generally been slow to adopt an organised means of provision for special educational needs for its students. This may be due to the fact that, historically, relatively few disabled students entered UK higher education. However, there is a growing number of disabled students entering UK higher education…

An Interdisciplinary Approach to Developing Renewable Energy Mixes at the Community Scale

NASA Astrophysics Data System (ADS)

Gormally, Alexandra M.; Whyatt, James D.; Timmis, Roger J.; Pooley, Colin G.

2013-04-01

Renewable energy has risen on the global political agenda due to concerns over climate change and energy security. The European Union (EU) currently has a target of 20% renewable energy by the year 2020 and there is increasing focus on the ways in which these targets can be achieved. Here we focus on the UK context which could be considered to be lagging behind other EU countries in terms of targets and implementation. The UK has a lower overall target of 15% renewable energy by 2020 and in 2011 reached only 3.8 % (DUKES, 2012), one of the lowest progressions compared to other EU Member States (European Commission, 2012). The reticence of the UK to reach such targets could in part be due to their dependence on their current energy mix and a highly centralised electricity grid system, which does not lend itself easily to the adoption of renewable technologies. Additionally, increasing levels of demand and the need to raise energy awareness are key concerns in terms of achieving energy security in the UK. There is also growing concern from the public about increasing fuel and energy bills. One possible solution to some of these problems could be through the adoption of small-scale distributed renewable schemes implemented at the community-scale with local ownership or involvement, for example, through energy co-operatives. The notion of the energy co-operative is well understood elsewhere in Europe but unfamiliar to many UK residents due to its centralised approach to energy provision. There are many benefits associated with engaging in distributed renewable energy systems. In addition to financial benefits, participation may raise energy awareness and can lead to positive responses towards renewable technologies. Here we briefly explore how a mix of small-scale renewables, including wind, hydro-power and solar PV, have been implemented and managed by a small island community in the Scottish Hebrides to achieve over 90% of their electricity needs from renewable resources (Yadoo et al., 2011), before considering how similar mixes could be developed for rural on-grid communities in the mainland UK. We adopt an interdisciplinary approach that combines quantitative methods (spatial analysis and calculated energy outputs) with secondary data sources to assess resource potential at the regional scale (resolution 1km2) to highlight areas with significant local resources for a mix of renewable energy technologies (Gormally et al., 2012). We then focus at the community-level and use a combination of primary qualitative data (questionnaires and interviews on community acceptance to technologies) and primary quantitative data (primary resource data to assess how renewable mixes may vary throughout the year eg. hourly, daily, monthly) to produce a portfolio of energy scenarios. The scenarios assess different 'supply side' options, including different scales and mixes of technology, 'demand side' options including business as usual and reduced demand, and resilience to change, for example extreme events (droughts, floods). Here we present a methodology and outputs for a case study community in the UK but will highlight how the approach may be adopted for use in other communities across Europe. DUKES (2012) Digest of UK Energy Statistics. Accessed:07/01/2013 European Commission (2012) EUROPE 2020 TARGETS: climate change and energy. Accessed:07/01/2013 Gormally, A. M., Whyatt, J. D., Timmis, R. J. & Pooley, C. G. (2012) A regional-scale assessment of local renewable energy resources in Cumbria, UK. Energy Policy, 50, 283-293. Yadoo, A., Gormally, A. & Cruickshank, H. (2011) Low-carbon off-grid electrification for rural areas in the United Kingdom: Lessons from the developing world. Energy Policy, 39, 6400-6407.

InterProScan 5: genome-scale protein function classification

PubMed Central

Jones, Philip; Binns, David; Chang, Hsin-Yu; Fraser, Matthew; Li, Weizhong; McAnulla, Craig; McWilliam, Hamish; Maslen, John; Mitchell, Alex; Nuka, Gift; Pesseat, Sebastien; Quinn, Antony F.; Sangrador-Vegas, Amaia; Scheremetjew, Maxim; Yong, Siew-Yit; Lopez, Rodrigo; Hunter, Sarah

2014-01-01

Motivation: Robust large-scale sequence analysis is a major challenge in modern genomic science, where biologists are frequently trying to characterize many millions of sequences. Here, we describe a new Java-based architecture for the widely used protein function prediction software package InterProScan. Developments include improvements and additions to the outputs of the software and the complete reimplementation of the software framework, resulting in a flexible and stable system that is able to use both multiprocessor machines and/or conventional clusters to achieve scalable distributed data analysis. InterProScan is freely available for download from the EMBl-EBI FTP site and the open source code is hosted at Google Code. Availability and implementation: InterProScan is distributed via FTP at ftp://ftp.ebi.ac.uk/pub/software/unix/iprscan/5/ and the source code is available from http://code.google.com/p/interproscan/. Contact: http://www.ebi.ac.uk/support or interhelp@ebi.ac.uk or mitchell@ebi.ac.uk PMID:24451626

A randomized, placebo-controlled pilot study of patients with spontaneous intraventricular haemorrhage treated with intraventricular thrombolysis.

PubMed

King, Nicolas K K; Lai, Jin Li; Tan, Li Bing; Lee, Kah Keow; Pang, Boon Chuan; Ng, Ivan; Wang, Ernest

2012-07-01

Intraventricular hemorrhage (IVH) occurring after spontaneous intracerebral hemorrhage (ICH) is an independent risk factor for mortality. The use of intraventricular urokinase (Uk) to reduce intraventricular blood clot volume and improve outcome was investigated. Patients with IVH requiring external ventricular drainage were recruited and randomized into a double-blind placebo controlled study. Assessments of collected cerebrospinal fluid (CSF) haemoglobin (Hb) and serial CT scans were performed. The study outcomes were: infection rates, length of stay in the intensive care unit, survival, National Institutes of Health Stroke Scale score; and modified Rankin Scale scores. Our results showed an increase in both the drained CSF Hb concentration in patients treated with Uk compared to placebo and in the rate of resolution clot volume. No differences were found in the other outcome measures but there was a trend towards lowered mortality in the group treated with Uk. Therefore, intraventricular Uk resulted in faster resolution of IVH with no adverse events. Copyright © 2011 Elsevier Ltd. All rights reserved.

Grip Strength Is Associated With Cognitive Performance in Schizophrenia and the General Population: A UK Biobank Study of 476559 Participants.

PubMed

Firth, Joseph; Stubbs, Brendon; Vancampfort, Davy; Firth, Josh A; Large, Matthew; Rosenbaum, Simon; Hallgren, Mats; Ward, Philip B; Sarris, Jerome; Yung, Alison R

2018-06-06

Handgrip strength may provide an easily-administered marker of cognitive functional status. However, further population-scale research examining relationships between grip strength and cognitive performance across multiple domains is needed. Additionally, relationships between grip strength and cognitive functioning in people with schizophrenia, who frequently experience cognitive deficits, has yet to be explored. Baseline data from the UK Biobank (2007-2010) was analyzed; including 475397 individuals from the general population, and 1162 individuals with schizophrenia. Linear mixed models and generalized linear mixed models were used to assess the relationship between grip strength and 5 cognitive domains (visual memory, reaction time, reasoning, prospective memory, and number memory), controlling for age, gender, bodyweight, education, and geographical region. In the general population, maximal grip strength was positively and significantly related to visual memory (coefficient [coeff] = -0.1601, standard error [SE] = 0.003), reaction time (coeff = -0.0346, SE = 0.0004), reasoning (coeff = 0.2304, SE = 0.0079), number memory (coeff = 0.1616, SE = 0.0092), and prospective memory (coeff = 0.3486, SE = 0.0092: all P < .001). In the schizophrenia sample, grip strength was strongly related to visual memory (coeff = -0.155, SE = 0.042, P < .001) and reaction time (coeff = -0.049, SE = 0.009, P < .001), while prospective memory approached statistical significance (coeff = 0.233, SE = 0.132, P = .078), and no statistically significant association was found with number memory and reasoning (P > .1). Grip strength is significantly associated with cognitive functioning in the general population and individuals with schizophrenia, particularly for working memory and processing speed. Future research should establish directionality, examine if grip strength also predicts functional and physical health outcomes in schizophrenia, and determine whether interventions which improve muscular strength impact on cognitive and real-world functioning.

Comparison of Sociodemographic and Health-Related Characteristics of UK Biobank Participants With Those of the General Population

PubMed Central

Fry, Anna; Littlejohns, Thomas J; Sudlow, Cathie; Doherty, Nicola; Adamska, Ligia; Sprosen, Tim; Collins, Rory; Allen, Naomi E

2017-01-01

Abstract The UK Biobank cohort is a population-based cohort of 500,000 participants recruited in the United Kingdom (UK) between 2006 and 2010. Approximately 9.2 million individuals aged 40–69 years who lived within 25 miles (40 km) of one of 22 assessment centers in England, Wales, and Scotland were invited to enter the cohort, and 5.5% participated in the baseline assessment. The representativeness of the UK Biobank cohort was investigated by comparing demographic characteristics between nonresponders and responders. Sociodemographic, physical, lifestyle, and health-related characteristics of the cohort were compared with nationally representative data sources. UK Biobank participants were more likely to be older, to be female, and to live in less socioeconomically deprived areas than nonparticipants. Compared with the general population, participants were less likely to be obese, to smoke, and to drink alcohol on a daily basis and had fewer self-reported health conditions. At age 70–74 years, rates of all-cause mortality and total cancer incidence were 46.2% and 11.8% lower, respectively, in men and 55.5% and 18.1% lower, respectively, in women than in the general population of the same age. UK Biobank is not representative of the sampling population; there is evidence of a “healthy volunteer” selection bias. Nonetheless, valid assessment of exposure-disease relationships may be widely generalizable and does not require participants to be representative of the population at large. PMID:28641372

Coastal biodiversity and ecosystem services flows at the landscape scale: The CBESS progamme.

NASA Astrophysics Data System (ADS)

Paterson, David; Bothwell, John; Bradbury, Richard; Burrows, Michael; Burton, Niall; Emmerson, Mark; Garbutt, Angus; Skov, Martin; Solan, Martin; Spencer, Tom; Underwood, Graham

2015-04-01

The health of the European coastline is inextricably linked to the economy and culture of coastal nations but they are sensitive to climate change. As global temperatures increase, sea levels will rise and the forces experienced where land meets sea will become more destructive. Salt marshes, mudflats, beaches will be affected. These landscapes support a wide range of economically valuable animal and plant species, but also act as sites of carbon storage, nutrient recycling, and pollutant capture and amelioration. Their preservation is of utmost importance. Our programme: "A hierarchical approach to the examination of the relationship between biodiversity and ecosystem service flows across coastal margins" (CBESS) is designed to understand the landscape-scale links between the functions that these systems provide (ecosystem service flows) and the organisms that provide these services (biodiversity stocks) and moves beyond most previous studies, conducted at smaller scales. Our consortium of experts ranges from microbial ecologists, through environmental economists, to mathematical modellers, and organisations (RSPB, BTO, CEFAS, EA) with vested interest in the sustainable use of coastal wetlands. CBESS spans the landscape scale, investigating how biodiversity stocks provide ecosystem services (cf. National Ecosystem Assessment: Supporting services; Provisioning services; Regulating services; and Cultural services). CBESS combined a detailed study of two regional landscapes with a broad-scale UK-wide study to allow both specific and general conclusions to be drawn. The regional study compares two areas of great UK national importance: Morecambe Bay on the west coast and the Essex coastline on the east. We carried out biological and physical surveys at more than 600 stations combined with in situ measures of ecosystem funtction to clarify how biodiversity can provide these important ecosystem functions across scales. This information will be shared with those interested in using and managing coastal systems and we will propose practical methods and improved tools for the future analysis, management, and sustainability of coastal wetlands. The progamme and progress over the last 3 years will be described.

PLAB and UK graduates' performance on MRCP(UK) and MRCGP examinations: data linkage study.

PubMed

McManus, I C; Wakeford, Richard

2014-04-17

To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence. Data linkage of GMC PLAB performance data with data from the Royal Colleges of Physicians and the Royal College of General Practitioners on performance of PLAB graduates and UK graduates at the MRCP(UK) and MRCGP examinations. Doctors in training for internal medicine or general practice in the United Kingdom. 7829, 5135, and 4387 PLAB graduates on their first attempt at MRCP(UK) Part 1, Part 2, and PACES assessments from 2001 to 2012 compared with 18,532, 14,094, and 14,376 UK graduates taking the same assessments; 3160 PLAB1 graduates making their first attempt at the MRCGP AKT during 2007-12 compared with 14,235 UK graduates; and 1411 PLAB2 graduates making their first attempt at the MRCGP CSA during 2010-12 compared with 6935 UK graduates. Performance at MRCP(UK) Part 1, Part 2, and PACES assessments, and MRCGP AKT and CSA assessments in relation to performance on PLAB1 and PLAB2 assessments, as well as to International English Language Testing System (IELTS) scores. MRCP(UK), MRCGP, and PLAB results were analysed as marks relative to the pass mark at the first attempt. PLAB1 marks were a valid predictor of MRCP(UK) Part 1, MRCP(UK) Part 2, and MRCGP AKT (r=0.521, 0.390, and 0.490; all P<0.001). PLAB2 marks correlated with MRCP(UK) PACES and MRCGP CSA (r=0.274, 0.321; both P<0.001). PLAB graduates had significantly lower MRCP(UK) and MRCGP assessments (Glass's Δ=0.94, 0.91, 1.40, 1.01, and 1.82 for MRCP(UK) Part 1, Part 2, and PACES and MRCGP AKT and CSA), and were more likely to fail assessments and to progress more slowly than UK medical graduates. IELTS scores correlated significantly with later performance, multiple regression showing that the effect of PLAB1 (β=0.496) was much stronger than the effect of IELTS (β=0.086). Changes to PLAB pass marks that would result in international medical graduate and UK medical graduate equivalence were assessed in two ways. Method 1 adjusted PLAB pass marks to equate median performance of PLAB and UK graduates. Method 2 divided PLAB graduates into 12 equally spaced groups according to PLAB performance, and compared these with mean performance of graduates from individual UK medical schools, assessing which PLAB groups were equivalent in MRCP(UK) and MRCGP performance to UK graduates. The two methods produced similar results. To produce equivalent performance on the MRCP and MRGP examinations, the pass mark for PLAB1 would require raising by about 27 marks (13%) and for PLAB2 by about 15-16 marks (20%) above the present standard. PLAB is a valid assessment of medical knowledge and clinical skills, correlating well with performance at MRCP(UK) and MRCGP. PLAB graduates' knowledge and skills at MRCP(UK) and MRCGP are over one standard deviation below those of UK graduates, although differences in training quality cannot be taken into account. Equivalent performance in MRCGP(UK) and MRCGP would occur if the pass marks of PLAB1 and PLAB2 were raised considerably, but that would also reduce the pass rate, with implications for medical workforce planning. Increasing IELTS requirements would have less impact on equivalence than raising PLAB pass marks.

PLAB and UK graduates’ performance on MRCP(UK) and MRCGP examinations: data linkage study

PubMed Central

Wakeford, Richard

2014-01-01

Objectives To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence. Design Data linkage of GMC PLAB performance data with data from the Royal Colleges of Physicians and the Royal College of General Practitioners on performance of PLAB graduates and UK graduates at the MRCP(UK) and MRCGP examinations. Setting Doctors in training for internal medicine or general practice in the United Kingdom. Participants 7829, 5135, and 4387 PLAB graduates on their first attempt at MRCP(UK) Part 1, Part 2, and PACES assessments from 2001 to 2012 compared with 18 532, 14 094, and 14 376 UK graduates taking the same assessments; 3160 PLAB1 graduates making their first attempt at the MRCGP AKT during 2007-12 compared with 14 235 UK graduates; and 1411 PLAB2 graduates making their first attempt at the MRCGP CSA during 2010-12 compared with 6935 UK graduates. Main outcome measures Performance at MRCP(UK) Part 1, Part 2, and PACES assessments, and MRCGP AKT and CSA assessments in relation to performance on PLAB1 and PLAB2 assessments, as well as to International English Language Testing System (IELTS) scores. MRCP(UK), MRCGP, and PLAB results were analysed as marks relative to the pass mark at the first attempt. Results PLAB1 marks were a valid predictor of MRCP(UK) Part 1, MRCP(UK) Part 2, and MRCGP AKT (r=0.521, 0.390, and 0.490; all P<0.001). PLAB2 marks correlated with MRCP(UK) PACES and MRCGP CSA (r=0.274, 0.321; both P<0.001). PLAB graduates had significantly lower MRCP(UK) and MRCGP assessments (Glass’s Δ=0.94, 0.91, 1.40, 1.01, and 1.82 for MRCP(UK) Part 1, Part 2, and PACES and MRCGP AKT and CSA), and were more likely to fail assessments and to progress more slowly than UK medical graduates. IELTS scores correlated significantly with later performance, multiple regression showing that the effect of PLAB1 (β=0.496) was much stronger than the effect of IELTS (β=0.086). Changes to PLAB pass marks that would result in international medical graduate and UK medical graduate equivalence were assessed in two ways. Method 1 adjusted PLAB pass marks to equate median performance of PLAB and UK graduates. Method 2 divided PLAB graduates into 12 equally spaced groups according to PLAB performance, and compared these with mean performance of graduates from individual UK medical schools, assessing which PLAB groups were equivalent in MRCP(UK) and MRCGP performance to UK graduates. The two methods produced similar results. To produce equivalent performance on the MRCP and MRGP examinations, the pass mark for PLAB1 would require raising by about 27 marks (13%) and for PLAB2 by about 15-16 marks (20%) above the present standard. Conclusions PLAB is a valid assessment of medical knowledge and clinical skills, correlating well with performance at MRCP(UK) and MRCGP. PLAB graduates’ knowledge and skills at MRCP(UK) and MRCGP are over one standard deviation below those of UK graduates, although differences in training quality cannot be taken into account. Equivalent performance in MRCGP(UK) and MRCGP would occur if the pass marks of PLAB1 and PLAB2 were raised considerably, but that would also reduce the pass rate, with implications for medical workforce planning. Increasing IELTS requirements would have less impact on equivalence than raising PLAB pass marks. PMID:24742473

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.

Validity of EQ-5D in general population of Taiwan: results of the 2009 National Health Interview and Drug Abuse Survey of Taiwan.

PubMed

Yu, Sheng-Tsung; Chang, Hsing-Yi; Yao, Kai-Ping; Lin, Yu-Hsuan; Hurng, Baai-Shyun

2015-10-01

The aim of this study was to examine the validity of the EuroQOL five dimensions questionnaire (EQ-5D) using a nationally representative data from the National Health Interview Survey (NHIS) through comparison with short-form 36 (SF-36). Data for this study came from the 2009 NHIS in Taiwan. The study sample was the 4007 participants aged 20-64 years who completed the survey. We used SUDAAN 10.0 (SAS-Callable) to carry out weighed estimation and statistical inference. The EQ index was estimated using norm values from a Taiwanese study as well as from Japan and the United Kingdom (UK). The SF-36 score was standardized using American norm values. In terms of concurrent validity, the EQ-5D met the five hypotheses. The results did not fulfill hypothesis that women would have lower visual analogue scale (EQ-VAS) scores. In terms of discriminant validity, the EQ-5D fulfilled two hypotheses. Our results approached but did not fulfill hypothesis that there would be a weak association between the physical and psychological dimensions of the EQ-5D and the mental component summary score of the SF-36. Results were comparable regardless of whether the Japanese or UK norm value sets were used. We were able to fulfill many, not all of our validity hypotheses regardless of whether the established Japanese or UK norm value sets or the Taiwanese norm values were used. The EQ-5D is an effective and simple instrument for assessing health-related quality of life of general population in Taiwan.

GP preferences for information systems: conjoint analysis of speed, reliability, access and users.

PubMed

Wyatt, Jeremy C; Batley, Richard P; Keen, Justin

2010-10-01

To elicit the preferences and trade-offs of UK general practitioners about key features of health information systems, to help inform the design of such systems in future. A stated choice study to uncover implicit preferences based on a binary choice between scenarios presented in random order. were all 303 general practice members of the UK Internet service provider, Medix who were approached by email to participate. The main outcome measure was the number of seconds delay in system response that general practitioners were willing to trade off for each key system feature: the reliability of the system, the sites from which the system could be accessed and which staff are able to view patient data. Doctors valued speed of response most in information systems but would be prepared to wait 28 seconds to access a system in exchange for improved reliability from 95% to 99%, a further 2 seconds for an improvement to 99.9% and 27 seconds for access to data from anywhere including their own home compared with one place in a single health care premises. However, they would require a system that was 14 seconds faster to compensate for allowing social care as well as National Health Service staff to read patient data. These results provide important new evidence about which system characteristics doctors value highly, and hence which characteristics designers need to focus on when large scale health information systems are planned. © 2010 Blackwell Publishing Ltd.

The modernisation of general practice in the UK: 1980 to 1995 and beyond. Part I.

PubMed Central

Iliffe, S.

1996-01-01

The UK is unusual in providing universal free healthcare in which access to specialists is largely controlled by general practitioners with 24-hour responsibility, throughout the year, for a defined list of patients of all ages. It is generally considered that this gatekeeper function has contributed to the relatively low cost of the National Health Service, but major changes in the organisation and clinical role of general practitioners have occurred, culminating in a new contract that aims to re-orientate general practice towards health promotion, disease prevention and the management of chronic disease. The implications of these changes are discussed. PMID:8733525

The Internal Consistency and Validity of the Vaccination Attitudes Examination Scale: A Replication Study.

PubMed

Wood, Louise; Smith, Michael; Miller, Christopher B; O'Carroll, Ronan E

2018-06-19

Vaccinations are important preventative health behaviors. The recently developed Vaccination Attitudes Examination (VAX) Scale aims to measure the reasons behind refusal/hesitancy regarding vaccinations. The aim of this replication study is to conduct an independent test of the newly developed VAX Scale in the UK. We tested (a) internal consistency (Cronbach's α); (b) convergent validity by assessing its relationships with beliefs about medication, medical mistrust, and perceived sensitivity to medicines; and (c) construct validity by testing how well the VAX Scale discriminated between vaccinators and nonvaccinators. A sample of 243 UK adults completed the VAX Scale, the Beliefs About Medicines Questionnaire, the Perceived Sensitivity to Medicines Scale, and the Medical Mistrust Index, in addition to demographics of age, gender, education levels, and social deprivation. Participants were asked (a) whether they received an influenza vaccination in the past year and (b) if they had a young child, whether they had vaccinated the young child against influenza in the past year. The VAX (a) demonstrated high internal consistency (α = .92); (b) was positively correlated with medical mistrust and beliefs about medicines, and less strongly correlated with perceived sensitivity to medicines; and (c) successfully differentiated parental influenza vaccinators from nonvaccinators. The VAX demonstrated good internal consistency, convergent validity, and construct validity in an independent UK sample. It appears to be a useful measure to help us understand the health beliefs that promote or deter vaccination behavior.

Attitudes to Mental Illness in the U.K. Military: A Comparison With the General Population

PubMed Central

Forbes, Harriet J.; Boyd, Caroline F. S.; Jones, Norman; Greenberg, Neil; Jones, Edgar; Wessely, Simon; Iversen, Amy C.; Fear, Nicola T.

2016-01-01

Objectives To compare attitudes to mental illness in the U.K. military and in the general population in England. Methods Using data from a cross-sectional survey of 821 U.K. military personnel and a separate cross-sectional survey of 1,729 members of the general population in England, levels of agreement with five statements about mental illness were compared in the military and the general population. Results The majority of respondents from both populations showed positive attitudes toward mental illness. The general population showed slightly more positive attitudes toward integrating people with mental illness into the community (68.0% [65.7%–70.1%] agreed that “People with mental illness have the same rights to a job as everyone else,” vs. 56.7% [51.5%–61.7%] of the military). However, the general population showed more negative attitudes about the causes of mental illness (62.4% [60.1%–64.6%] disagreed that “One of the main causes of mental illness is a lack of self-discipline and willpower,” vs. 81.3% [77.0%–84.9%] of the military). Conclusions Overall, attitudes toward mental illness are comparable in the general population in England and the U.K. military. Differences included the military holding more positive attitudes about the causes of mental illness, but more negatives attitudes about job rights of those with mental illness. Strategies aiming to improve attitudes toward mental illness could focus particularly on personnel’s concerns around mental illness impacting on their career. PMID:24005543

People of the British Isles: preliminary analysis of genotypes and surnames in a UK-control population

PubMed Central

Winney, Bruce; Boumertit, Abdelhamid; Day, Tammy; Davison, Dan; Echeta, Chikodi; Evseeva, Irina; Hutnik, Katarzyna; Leslie, Stephen; Nicodemus, Kristin; Royrvik, Ellen C; Tonks, Susan; Yang, Xiaofeng; Cheshire, James; Longley, Paul; Mateos, Pablo; Groom, Alexandra; Relton, Caroline; Bishop, D Tim; Black, Kathryn; Northwood, Emma; Parkinson, Louise; Frayling, Timothy M; Steele, Anna; Sampson, Julian R; King, Turi; Dixon, Ron; Middleton, Derek; Jennings, Barbara; Bowden, Rory; Donnelly, Peter; Bodmer, Walter

2012-01-01

There is a great deal of interest in a fine-scale population structure in the UK, both as a signature of historical immigration events and because of the effect population structure may have on disease association studies. Although population structure appears to have a minor impact on the current generation of genome-wide association studies, it is likely to have a significant part in the next generation of studies designed to search for rare variants. A powerful way of detecting such structure is to control and document carefully the provenance of the samples involved. In this study, we describe the collection of a cohort of rural UK samples (The People of the British Isles), aimed at providing a well-characterised UK-control population that can be used as a resource by the research community, as well as providing a fine-scale genetic information on the British population. So far, some 4000 samples have been collected, the majority of which fit the criteria of coming from a rural area and having all four grandparents from approximately the same area. Analysis of the first 3865 samples that have been geocoded indicates that 75% have a mean distance between grandparental places of birth of 37.3 km, and that about 70% of grandparental places of birth can be classed as rural. Preliminary genotyping of 1057 samples demonstrates the value of these samples for investigating a fine-scale population structure within the UK, and shows how this can be enhanced by the use of surnames. PMID:21829225

People of the British Isles: preliminary analysis of genotypes and surnames in a UK-control population.

PubMed

Winney, Bruce; Boumertit, Abdelhamid; Day, Tammy; Davison, Dan; Echeta, Chikodi; Evseeva, Irina; Hutnik, Katarzyna; Leslie, Stephen; Nicodemus, Kristin; Royrvik, Ellen C; Tonks, Susan; Yang, Xiaofeng; Cheshire, James; Longley, Paul; Mateos, Pablo; Groom, Alexandra; Relton, Caroline; Bishop, D Tim; Black, Kathryn; Northwood, Emma; Parkinson, Louise; Frayling, Timothy M; Steele, Anna; Sampson, Julian R; King, Turi; Dixon, Ron; Middleton, Derek; Jennings, Barbara; Bowden, Rory; Donnelly, Peter; Bodmer, Walter

2012-02-01

There is a great deal of interest in a fine-scale population structure in the UK, both as a signature of historical immigration events and because of the effect population structure may have on disease association studies. Although population structure appears to have a minor impact on the current generation of genome-wide association studies, it is likely to have a significant part in the next generation of studies designed to search for rare variants. A powerful way of detecting such structure is to control and document carefully the provenance of the samples involved. In this study, we describe the collection of a cohort of rural UK samples (The People of the British Isles), aimed at providing a well-characterised UK-control population that can be used as a resource by the research community, as well as providing a fine-scale genetic information on the British population. So far, some 4000 samples have been collected, the majority of which fit the criteria of coming from a rural area and having all four grandparents from approximately the same area. Analysis of the first 3865 samples that have been geocoded indicates that 75% have a mean distance between grandparental places of birth of 37.3 km, and that about 70% of grandparental places of birth can be classed as rural. Preliminary genotyping of 1057 samples demonstrates the value of these samples for investigating a fine-scale population structure within the UK, and shows how this can be enhanced by the use of surnames.

By land, sea and air (and space): Verifying UK methane emissions at a range of scales by integrating multiple measurement platforms

NASA Astrophysics Data System (ADS)

Rigby, M. L.; Lunt, M. F.; Ganesan, A.

2015-12-01

The Greenhouse gAs Uk and Global Emissions (GAUGE) programme and Department of Energy and Climate Change (DECC) network aim to quantify the magnitude and uncertainty of UK greenhouse gas (GHG) emissions at a resolution and accuracy higher than has previously been possible. The on going DECC tall tower network consists of three sites, and an eastern background site in Ireland. The GAUGE project includes instruments at two additional tall tower sites, a high-density measurement network over agricultural land in eastern England, a ferry that performs near-daily transects along the east coast of the UK, and a research aircraft that has been deployed on a campaign basis. Together with data collected by the GOSAT satellite, these data represent the GAUGE/DECC GHG measurement network that is being used to quantify UK GHG fluxes. As part of the wider GAUGE modelling efforts, we have derived methane flux estimates for the UK and northwest Europe using the UK Met Office NAME atmospheric transport model and a novel hierarchical Bayesian "trans-dimensional" inversion framework. We will show that our estimated fluxes for the UK as a whole are largely consistent between individual measurement platforms, albeit with very different uncertainties. Our novel inversion approach uses the data to objectively determine the extent to which we can further refine our national estimates to the level of large urban areas, major hotspots or larger sub-national regions. In this talk, we will outline some initial findings of the GAUGE project, tackling questions such as: At what spatial scale can we effectively derive greenhouse gas fluxes with a dense, multi-platform national network? Can we resolve individual metropolitan areas or major hotspots? What is relative impact of individual stations, platforms and network configurations on flux estimates for a country of the size of the UK? How can we effectively use multi-platform observations to cross-validate flux estimates and determine likely errors in model transport?

Late Neogene Orbitally-Forced Sea Surface Temperature Variability in the Eastern Equatorial Pacific as Measured by Uk'37 and TEX86

NASA Astrophysics Data System (ADS)

Lawrence, K. T.; Pearson, A.; Castañeda, I. S.; Peterson, L.

2017-12-01

Key features of late Neogene climate remain uncertain due to conflicting records derived from different sea surface temperature (SST) proxies. To resolve these disputes, it is necessary to explore both the consistencies and differences between paleotemperature estimates from critical oceanographic regimes. Here, we report orbital-scale climate variability at ODP Site 846 in the Eastern Equatorial Pacific (EEP) in the interval from 5-6 Ma using alkenone and TEX86 temperature estimates. Results from both proxies are very similar in their secular trends and magnitude of long-term temperature change; and spectral analysis demonstrates that the records are coherent and in-phase or nearly in-phase in both the obliquity and precession bands. However, we find that the temperatures reconstructed by TEX86 are consistently offset towards colder values by 2ºC with orbital-scale variations approximately twice the amplitude of the Uk'37 derived estimates. Both temperature records are antiphased - i.e. "colder" - at higher sediment alkenone concentrations, a qualitative indicator of increased glacial productivity. Temperature differences between the proxies are accentuated during glacial intervals in contrasts to modern observations of EEP surface and subsurface temperatures, which show that thermocline temperatures are fairly stable, and thus by analogy, glacial cooling and/or enhanced upwelling should have reduced rather than accentuated temperature gradients in the upper water column. Therefore, arguments that Uk'37 corresponds to temperature variability in the surface, while TEX86 responds to the subsurface, may be too simplistic. Instead, it appears generally true that high-productivity environments, including the EEP, tend to have negative TEX86 anomalies. This may reflect a dual dependence of TEX86 records on both water column temperature and local productivity. Overall, our data suggest that in the EEP and likely in other upwelling zones, paleotemperature data derived from these proxies should not necessarily be used interchangeably and only Uk'37 is suitable for determining absolute SSTs. However, our data also suggest that TEX86 may be suitable for estimating long-term trends in SST and for spectral and phase analysis in upwelling regimes.

Solute movement in drained fen peat: a field tracer study in a Somerset (UK) wetland

NASA Astrophysics Data System (ADS)

Baird, Andrew J.; Gaffney, Simon W.

2000-10-01

Little is known about solute transport in peats, despite the obvious importance of solute transport on eco-hydrological processes in both managed and natural peatlands. To address this lack of knowledge, we investigated solute transport processes in an agricultural fen peat using a conservative KBr tracer. The main aim of the study was to elucidate solute transport behaviour in general in this peat, with a more specific aim of investigating whether preferential or bypassing flow occurred. The tracer moved through the peat more rapidly than expected, and the pattern of movement showed clear evidence of plot-scale bypassing flow. The data also provide evidence that bypassing flow occurs in pores at smaller scales. The implications of this study for management of wetland pastures in the Somerset Moors in south-west England are discussed.

A coupled synoptic-hydrological model for climate change impact assessment

NASA Astrophysics Data System (ADS)

Wilby, Robert; Greenfield, Brian; Glenny, Cathy

1994-01-01

A coupled atmospheric-hydrological model is presented. Sequences of daily rainfall occurrence for the 20 year period 1971-1990 at sites in the British Isles are related to the Lamb's Weather Types (LWT) by using conditional probabilities. Time series of circulation patterns and hence rainfall were then generated using a Markov representation of matrices of transition probabilities between weather types. The resultant precipitation data were used as input to a semidistributed catchment model to simulate daily flows. The combined model successfully reproduced aspects of the daily weather, precipitation and flow regimes. A range of synoptic scenarios were further investigated with particular reference to low flows in the River Coln, UK. The modelling approach represents a means of translating general circulation model (GCM) climate change predictions at the macro-scale into hydrological concerns at the catchment scale.

Prevalence of common mental disorders in general practice attendees across Europe.

PubMed

King, Michael; Nazareth, Irwin; Levy, Gus; Walker, Carl; Morris, Richard; Weich, Scott; Bellón-Saameño, Juan Angel; Moreno, Berta; Svab, Igor; Rotar, Danica; Rifel, J; Maaroos, Heidi-Ingrid; Aluoja, Anu; Kalda, Ruth; Neeleman, Jan; Geerlings, Mirjam I; Xavier, Miguel; de Almeida, Manuel Caldas; Correa, Bernardo; Torres-Gonzalez, Francisco

2008-05-01

There is evidence that the prevalence of common mental disorders varies across Europe. To compare prevalence of common mental disorders in general practice attendees in six European countries. Unselected attendees to general practices in the UK, Spain, Portugal, Slovenia, Estonia and The Netherlands were assessed for major depression, panic syndrome and other anxiety syndrome. Prevalence of DSM-IV major depression, other anxiety syndrome and panic syndrome was compared between the UK and other countries after taking account of differences in demographic factors and practice consultation rates. Prevalence was estimated in 2,344 men and 4,865 women. The highest prevalence for all disorders occurred in the UK and Spain, and lowest in Slovenia and The Netherlands. Men aged 30-50 and women aged 18-30 had the highest prevalence of major depression; men aged 40-60 had the highest prevalence of anxiety, and men and women aged 40-50 had the highest prevalence of panic syndrome. Demographic factors accounted for the variance between the UK and Spain but otherwise had little impact on the significance of observed country differences. These results add to the evidence for real differences between European countries in prevalence of psychological disorders and show that the burden of care on general practitioners varies markedly between countries.

Validation of Warwick-Edinburgh Mental Well-being Scale (WEMWBS) in a population of people using Secondary Care Mental Health Services.

PubMed

Bass, Malcolm; Dawkin, Mathew; Muncer, Steven; Vigurs, Scott; Bostock, Janet

2016-08-01

The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) is a relatively new measure and to date has been validated in a number of populations, including student, general and adolescent samples across the UK. There is increasing interest in measuring the mental well-being of users of secondary care mental health services and therefore it is apt to validate WEMWBS for this population. To investigate the validity of WEMWBS in a secondary care mental health service user population. Data was collected from two NHS Trusts and one charity. Analyses are based on 1180 completed WEMWBS. WEMWBS scores for this population are significantly lower than those in a general population (Mean 34.9, SD 13.8). Overall the data analyses supported the use of WEMWBS in this population sample. The Rasch analysis found that the majority of the items can be seen as measuring one dimension. The confirmatory factor analysis supports a one factor solution and thus, measures a single underlying concept. The findings from this study show WEMWBS to be a valid and reliable measure for this population sample.

Brazilian normative data for the Short Form 36 questionnaire, version 2.

PubMed

Laguardia, Josue; Campos, Monica Rodrigues; Travassos, Claudia; Najar, Alberto Lopes; Anjos, Luiz Antonio dos; Vasconcellos, Miguel Murat

2013-12-01

The study Pesquisa Dimensões Sociais das Desigualdades (PDSD) (Social Dimensions of Inequalities) involves 12,423 randomly selected Brazilian men and women aged 18 years old or more from urban and rural areas of the five Brazilian regions, and the information collected included the SF-36 as a measure of health-related quality of life. This provided a unique opportunity to develop age and gender-adjusted normative data for the Brazilian population. Brazilian men scored substantially higher than women on all eight domains and the two summary component scales of the SF-36. Brazilians scored less than their international counterparts on almost all of SF-36 domains and both summary component scales, except on general health status (US), pain (UK) and vitality (Australia, US and Canada). The differences in the SF-36 scores between age groups, genders and countries confirm that these Brazilian norms are necessary for comparative purposes. The data will be useful for assessing the health status of the general population and of patient populations, and the effect of interventions on health-related quality of life.

Rasch analysis of the UK Functional Assessment Measure in patients with complex disability after stroke.

PubMed

Medvedev, Oleg N; Turner-Stokes, Lynne; Ashford, Stephen; Siegert, Richard J

2018-02-28

To determine whether the UK Functional Assessment Measure (UK FIM+FAM) fits the Rasch model in stroke patients with complex disability and, if so, to derive a conversion table of Rasch-transformed interval level scores. The sample included a UK multicentre cohort of 1,318 patients admitted for specialist rehabilitation following a stroke. Rasch analysis was conducted for the 30-item scale including 3 domains of items measuring physical, communication and psychosocial functions. The fit of items to the Rasch model was examined using 3 different analytical approaches referred to as "pathways". The best fit was achieved in the pathway where responses from motor, communication and psychosocial domains were summarized into 3 super-items and where some items were split because of differential item functioning (DIF) relative to left and right hemisphere location (χ2 (10) = 14.48, p = 0.15). Re-scoring of items showing disordered thresholds did not significantly improve the overall model fit. The UK FIM+FAM with domain super-items satisfies expectations of the unidimensional Rasch model without the need for re-scoring. A conversion table was produced to convert the total scale scores into interval-level data based on person estimates of the Rasch model. The clinical benefits of interval-transformed scores require further evaluation.

Modeling the spread and control of foot-and-mouth disease in Pennsylvania following its discovery and options for control

PubMed Central

Tildesley, Michael J.; Smith, Gary; Keeling, Matt J.

2013-01-01

In this paper, we simulate outbreaks of foot-and-mouth disease in the Commonwealth of Pennsylvania, USA – after the introduction of a state-wide movement ban – as they might unfold in the presence of mitigation strategies. We have adapted a model previously used to investigate FMD control policies in the UK to examine the potential for disease spread given an infection seeded in each county in Pennsylvania. The results are highly dependent upon the county of introduction and the spatial scale of transmission. Should the transmission kernel be identical to that for the UK, the epidemic impact is limited to fewer than 20 premises, regardless of the county of introduction. However, for wider kernels where infection can spread further, outbreaks seeded in or near the county with highest density of premises and animals result in large epidemics (>150 premises). Ring culling and vaccination reduce epidemic size, with the optimal radius of the rings being dependent upon the county of introduction. Should the kernel width exceed a given county-dependent threshold, ring culling is unable to control the epidemic. We find that a vaccinate-to-live policy is generally preferred to ring culling (in terms of reducing the overall number of premises culled), indicating that well-targeted control can dramatically reduce the risk of large scale outbreaks of foot-and-mouth disease occurring in Pennsylvania. PMID:22169708

Appearance concerns and psychosocial adjustment following head and neck cancer: A cross-sectional study and nine-month follow-up.

PubMed

Clarke, Sally-Ann; Newell, Robert; Thompson, Andrew; Harcourt, Diana; Lindenmeyer, Antje

2014-01-01

Psychosocial difficulties have been reported in head and neck cancer (HNC) patients, yet only few studies have assessed the impact of altered appearance following HNC treatment using theoretically selected measures of appearance-related distress. This study investigated appearance-related adjustment following HNC, and demographic and socio-cognitive predictors of adjustment. HNC patients (n=49) completed baseline questionnaires and a nine-month postal follow-up (n=20). Participants showed considerable variation in appearance-related adjustment, with females reporting higher levels of appearance-related distress (derriford appearance scale [DAS-24]) than females in the general population and male HNC survivors. Depression scores on the hospital anxiety and depression scale were higher than UK norms whilst anxiety was similar to UK norms. There were no significant differences between baseline and follow-up data. Fear of negative evaluation (a central feature of social anxiety) was a significant predictor of appearance-related adjustment at baseline, whilst dispositional optimism was a significant predictor of appearance-related adjustment at baseline and follow-up. Qualitative responses showed themes of appearance and disability, and coping strategies. Findings suggest that appearance-related adjustment post-HNC varies considerably and psychosocial services working with HNC patients should consider this broad pattern of response. Future research to examine the role of socio-cognitive predictors of appearance-related adjustment could progress development of effective psychological interventions.

General practitioners' psychosocial resources, distress, and sickness absence: a study comparing the UK and Finland.

PubMed

Heponiemi, Tarja; Elovainio, Marko; Presseau, Justin; Eccles, Martin P

2014-06-01

Many countries, including the UK and Finland, face difficulties in recruiting GPs and one reason for these difficulties may be due to negative psychosocial work environments. To compare psychosocial resources (job control and participative safety), distress and sickness absences between GPs from the UK and those from Finland. We also examined differences in how psychosocial resources are associated with distress and sickness absence and how distress is associated with sickness absence for both countries. Two independent cross-sectional surveys conducted in general practice in the UK and Finland. Analyses of covariance were used for continuous outcome variables and logistic regression for dichotomized variable (sickness absence) adjusted for gender, qualification year and response format. UK GPs reported more opportunities to control their work and had higher levels of participative safety but were more distressed than Finnish GPs. Finnish GPs were 2.3 (95% confidence interval = 1.8-3.1) times more likely to report sickness absence spells than UK GPs. Among Finnish GPs, job control opportunities and high participative safety were associated with lower levels of distress, but not among UK GPs. Among UK GPs, higher distress was associated with 2.1 (95% confidence interval = 1.3-3.6) times higher likelihood of sickness absence spells, but among Finnish GPs there were no such association. In Finland, primary health care organizations should try to improve participative safety and increase control opportunities of physicians to decrease GP distress, whereas in the UK, other work or private life factors may be more important. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Middle Managers in UK Higher Education Conceptualising Experiences in Support of Reflective Practice

ERIC Educational Resources Information Center

Birds, Rachel

2014-01-01

This paper examines the role of reflexivity in supporting middle managers in understanding and facilitating large-scale change management projects in their organisations. Utilising an example from a UK university, it is argued that the development of a conceptual model to fit local circumstances enables deeper understanding and better informed…

Interpreting Context to the UK's National Student (Satisfaction) Survey Data for Science Subjects

ERIC Educational Resources Information Center

Fielding, Alan; Dunleavy, Peter J.; Langan, A. Mark

2010-01-01

Universities capture and use student feedback to improve the student experience, but how should information from national scale surveys be used at local and institutional levels? The authors explored the UK's National Student (Satisfaction) Survey (NSS) data relevant to science and engineering programmes using percentages of students who were…

The Impact Debate: Hazards of Discourse in the UK

ERIC Educational Resources Information Center

Duke, Chris

2011-01-01

The UK higher education community is well served for news and policy discourse by the weekly "Times Higher Education" ("THE"). "THE" also provides a window into the conduct of this community. Concern about the contribution of research to the wider society beyond academe has risen along with its scale and cost. Views…

Perceptions of HPV Vaccine amongst UK University Students

ERIC Educational Resources Information Center

Martin, Ellen; Senior, Naomi; Abdullah, Ammar; Brown, Janine; Collings, Suzanne; Racktoo, Sophie; Walpole, Sarah; Zeiton, Moez; Heffernan, Catherine

2011-01-01

Purpose: The aim of this small-scale focus group study is to explore the impact the Human Papilloma Virus (HPV) vaccine has on attitudes towards HPV, cervical cancer and sexual risk taking amongst university students in the UK. Design/methodology/approach: Participants were recruited through advertisements placed on notice boards throughout the…

MWASTools: an R/bioconductor package for metabolome-wide association studies.

PubMed

Rodriguez-Martinez, Andrea; Posma, Joram M; Ayala, Rafael; Neves, Ana L; Anwar, Maryam; Petretto, Enrico; Emanueli, Costanza; Gauguier, Dominique; Nicholson, Jeremy K; Dumas, Marc-Emmanuel

2018-03-01

MWASTools is an R package designed to provide an integrated pipeline to analyse metabonomic data in large-scale epidemiological studies. Key functionalities of our package include: quality control analysis; metabolome-wide association analysis using various models (partial correlations, generalized linear models); visualization of statistical outcomes; metabolite assignment using statistical total correlation spectroscopy (STOCSY); and biological interpretation of metabolome-wide association studies results. The MWASTools R package is implemented in R (version  > =3.4) and is available from Bioconductor: https://bioconductor.org/packages/MWASTools/. m.dumas@imperial.ac.uk. Supplementary data are available at Bioinformatics online. © The Author(s) 2017. Published by Oxford University Press.

ICI and Penspen in Nigerian and Qatari methanol deals

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

Alperowicz, N.

The U.K. consulting and engineering company Penspen Ltd. (London) has signed a second joint venture agreement in Qatar and has selected the ICI (London) methanol process. The technology will also be used in a world-scale methanol plant in Nigeria that Penspen is helping to set up. Under the first agreement, signed on January 1 with Qatar General Petroleum Corp. (QGPC), a 50/50 venture is being formed to build a $370-million, 2,000-m.t./day methanol plant at Umm Said. ICI will provide its low-pressure technology and help market 75% of the output. Completion is due late 1994.

What's in a name? Nominative determinism in the UK dental workforce.

PubMed

Sleigh, J

2016-12-16

Background Nominative determinism describes the theory that people are more likely to pursue careers that are connected to their names. Compelling research has been carried out across the medical professions that provides strong evidence for this phenomenon, but as yet its applicability to the UK dental workforce remains unknown.Aim The aim of this study was to establish the prevalence of dentally-related surnames in the UK dental workforce (dentists and dental care professionals) and compare this to the UK population.Results Dentistry may provide a surprising counter-example to prevailing theories of nominative determinism, as UK dentists are significantly less likely than the UK general population to have dentally-related surnames. This new phenomenon of 'nominative antideterminism' was not observed in the dental care professional (DCP) cohort, for whom the prevalence of dentally-related surnames was similar to that in the wider UK population.

The strategic significance of wastewater sources to pollutant phosphorus levels in English rivers and to environmental management for rural, agricultural and urban catchments.

PubMed

Neal, Colin; Jarvie, Helen P; Withers, Paul J A; Whitton, Brian A; Neal, Margaret

2010-03-01

The relationship between soluble and particulate phosphorus was examined for 9 major UK rivers including 26 major tributaries and 68 monitoring points, covering wide-ranging rural and agricultural/urban impacted systems with catchment areas varying from 1 to 6000km(2) scales. Phosphorus concentrations in Soluble Reactive (SRP), Total Dissolved (TDP), Total (TP), Dissolved Hydrolysable (DHP) and Particulate (PP) forms correlated with effluent markers (sodium and boron) and SRP was generally dominant signifying the importance of sewage sources. Low flows were particularly enriched in SRP, TDP and TP for average SRP>100microg/l indicating low effluent dilution. At particularly low average concentrations, SRP increased with flow but effluent sources were still implicated as the effluent markers (boron in particular) increased likewise. For rural areas, DHP had proportionately high concentrations and SRP+DHP concentrations could exceed environmental thresholds currently set for SRP. Given DHP has a high bioavailability the environmental implications need further consideration. PP concentrations were generally highest at high flows but PP in the suspended solids was generally at its lowest and in general PP correlated with particulate organic carbon and more so than the suspended sediment in total. Separation of pollutant inputs solely between effluent and diffuse (agriculture) components is misleading, as part of the "diffuse" term comprises effluents flushed from the catchments during high flow. Effluent sources of phosphorus supplied directly or indirectly to the river coupled with within-river interactions between water/sediment/biota largely determine pollutant levels. The study flags the fundamental need of placing direct and indirect effluent sources and contaminated storage with interchange to/from the river at the focus for remediation strategies for UK rivers in relation to eutrophication and the WFD.

The Spanish version of the Warwick-Edinburgh mental well-being scale (WEMWBS) is valid for use in the general population.

PubMed

Castellví, Pere; Forero, Carlos G; Codony, Miquel; Vilagut, Gemma; Brugulat, Pilar; Medina, Antonia; Gabilondo, Andrea; Mompart, Anna; Colom, Joan; Tresserras, Ricard; Ferrer, Montse; Stewart-Brown, Sarah; Alonso, Jordi

2014-04-01

Mental well-being has aroused interest in Europe as an indicator of population health. The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) was developed in the United Kingdom showing good face validity and has been previously adapted into Spanish. The aim of this study is to assess the validity and reliability of the Spanish version of WEMWBS in the general population. Cross-sectional home face-to-face interview survey with computer-assisted personal interviewing was administered with the 2011 Catalan Health Interview Survey Wave 3, which is representative of the non-institutionalized general population of Catalonia, Spain. A total of 1,900 participants 15+ years of age were interviewed. The Spanish version of WEMWBS was administered together with socioeconomic and health-related variables, with a hypothesized level of association. Similar to the original, confirmatory factor analysis fits a one-factor model adequately (CFI = 0.974; TLI = 0.970; RMSEA = 0.059; χ (2) = 584.82; df = 77; p < .001) and has a high internal consistency (Cronbach's alpha = 0.930; Guttman's lambda 2 = 0.932). The WEMWBS discriminated between population groups in all health-related and socioeconomic variables, except in gender (p = 0.119), with a magnitude similar to that hypothesized. Overall, mental well-being was higher for the general population of Catalonia (average and whole distribution) than that for Scotland general population. The Spanish version of WEMWBS showed good psychometric properties similar to the UK original scale. Whether better mental well-being in Catalonia is due to methodological or substantive cultural, social, or environmental factors should be further researched.

Coupled carbon-nitrogen land surface modelling for UK agricultural landscapes using JULES and JULES-ECOSSE-FUN (JEF)

NASA Astrophysics Data System (ADS)

Comyn-Platt, Edward; Clark, Douglas; Blyth, Eleanor

2016-04-01

The UK is required to provide accurate estimates of the UK greenhouse gas (GHG; CO2, CH4 and N2O) emissions for the UNFCCC (United Nations Framework Convention on Climate Change). Process based land surface models (LSMs), such as the Joint UK Land Environment Simulator (JULES), attempt to provide such estimates based on environmental (e.g. land use and soil type) and meteorological conditions. The standard release of JULES focusses on the water and carbon cycles, however, it has long been suggested that a coupled carbon-nitrogen scheme could enhance simulations. This is of particular importance when estimating agricultural emission inventories where the carbon cycle is effectively managed via the human application of nitrogen based fertilizers. JULES-ECOSSE-FUN (JEF) links JULES with the Estimation of Carbon in Organic Soils - Sequestration and Emission (ECOSSE) model and the Fixation and Uptake of Nitrogen (FUN) model as a means of simulating C:N coupling. This work presents simulations from the standard release of JULES and the most recent incarnation of the JEF coupled system at the point and field scale. Various configurations of JULES and JEF were calibrated and fine-tuned based on comparisons with observations from three UK field campaigns (Crichton, Harwood Forest and Brattleby) specifically chosen to represent the managed vegetation types that cover the UK. The campaigns included flux tower and chamber measurements of CO2, CH4 and N2O amongst other meteorological parameters and records of land management such as application of fertilizer and harvest date at the agricultural sites. Based on the results of these comparisons, JULES and/or JEF will be used to provide simulations on the regional and national scales in order to provide improved estimates of the total UK emission inventory.

Estimation of gross land-use change and its uncertainty using a Bayesian data assimilation approach

NASA Astrophysics Data System (ADS)

Levy, Peter; van Oijen, Marcel; Buys, Gwen; Tomlinson, Sam

2018-03-01

We present a method for estimating land-use change using a Bayesian data assimilation approach. The approach provides a general framework for combining multiple disparate data sources with a simple model. This allows us to constrain estimates of gross land-use change with reliable national-scale census data, whilst retaining the detailed information available from several other sources. Eight different data sources, with three different data structures, were combined in our posterior estimate of land use and land-use change, and other data sources could easily be added in future. The tendency for observations to underestimate gross land-use change is accounted for by allowing for a skewed distribution in the likelihood function. The data structure produced has high temporal and spatial resolution, and is appropriate for dynamic process-based modelling. Uncertainty is propagated appropriately into the output, so we have a full posterior distribution of output and parameters. The data are available in the widely used netCDF file format from http://eidc.ceh.ac.uk/.

Aviation's Normal Operations Safety Audit: a safety management and educational tool for health care? Results of a small-scale trial.

PubMed

Bennett, Simon A

2017-01-01

A National Health Service (NHS) contingent liability for medical error claims of over £26 billion. To evaluate the safety management and educational benefits of adapting aviation's Normal Operations Safety Audit (NOSA) to health care. In vivo research, a NOSA was performed by medical students at an English NHS Trust. After receiving training from the author, the students spent 6 days gathering data under his supervision. The data revealed a threat-rich environment, where errors - some consequential - were made (359 threats and 86 errors were recorded over 2 weeks). The students claimed that the exercise improved their observational, investigative, communication, teamworking and other nontechnical skills. NOSA is potentially an effective safety management and educational tool for health care. It is suggested that 1) the UK General Medical Council mandates that all medical students perform a NOSA in fulfillment of their degree; 2) the participating NHS Trusts be encouraged to act on students' findings; and 3) the UK Department of Health adopts NOSA as a cornerstone risk assessment and management tool.

Learning preferences and learning styles: a study of Wessex general practice registrars.

PubMed Central

Lesmes-Anel, J; Robinson, G; Moody, S

2001-01-01

BACKGROUND: Experienced trainers know that individual registrars react very differently to identical learning experiences generated during the year in practice. This divergence reflects differences in registrars' learning styles. Only one study of United Kingdom (UK) general practitioners' learning styles has been undertaken. Learning style theory predicts that matching learning preference with learning style will enhance learning. This paper researches for the first time the evidence in the setting of UK general practice. AIM: To determine, for the general practice registrars within the Wessex Region, the nature of their learning preferences and learning styles and correlations between them. DESIGN OF STUDY: A descriptive confidential postal questionnaire survey. SETTING: Fifty-seven registrars identified in the Wessex Region with a minimum experience of six months in general practice. METHOD: The questionnaire gathered demographic data (sex, age, experience in general practice, years post-registration, and postgraduate qualifications). Learning preferences were elicited using a six-point Likert scale for learning experiences. The Honey and Mumford Learning Style Questionnaire (LSQ) elicited the registrars' learning styles. A second questionnaire was sent to non-responders. RESULTS: The response rate was 74%. Registrars report that interactive learning with feedback is preferred, but more passive learning formats remain valued. A wide range of learning style scores was found. The Honey and Mumford LSQ mean scores fell within the reflector-theorist quadrant. Evidence for correlations between learning preferences and learning styles was also found, in particular for the multiple choice question and audit components of summative assessment. CONCLUSION: A wide range of registrar learning styles exists in Wessex, and initial correlations are described between learning preferences and learning styles as predicted by style theory. This work sets the stage for a shared understanding and use of learning style theory to enhance professional learning throughout a GP's career. More research is needed in this domain. PMID:11462316

Trends in evaporation loss over the UK: 1962 to 2013

NASA Astrophysics Data System (ADS)

Blyth, Eleanor; Robinson, Emma; Martinez de la Torre, Alberto

2017-04-01

Many models of hydrology assume that an increase in air temperature will result in an increase in evaporation. However, there are some processes involved in transpiration (evaporation through the vegetation) that make the relationship more complicated: in a bid to conserve water, vegetation will reduce their stomata in response to drier soils and warmer drier air which leads to lower transpiration rates despite higher evaporative demands. In addition, the vegetation responds to increases in atmospheric carbon dioxide by closing their stomata, and this further reduces the transpiration. The JULES (Joint UK Land Environment Simulator) model, used widely in the UK to study the impacts of climate change on the environment, includes many of the processes that are likely to affect changes in water loss and its impact on large scale hydrology. A new assessment of the UK wide water balance for the last 52 years (1961 to 2013) at a 1km grid-scale has been made using this model in a system called CHESS (Climate Hydrology and Ecology research Support System). Some data is available to check the overall water balance. For instance, river flow data can be used at an annual time scale to capture the water balance, while evaporation data from flux towers can be used at some locations around the UK for the few years that it is available to evaluate the seasonal variations of evaporation. Both of these methods provide imperfect but useful evidence. Here we present the results of the modelling exercise and the evaluation: long term increasing evaporation loss trends are clearly present in the model output and these are discussed with respect to the different drivers of change.

Food Security Framings within the UK and the Integration of Local Food Systems

ERIC Educational Resources Information Center

Kirwan, James; Maye, Damian

2013-01-01

This paper provides a critical interpretation of food security politics in the UK. It applies the notion of food security collective action frames to assess how specific action frames are maintained and contested. The interdependency between scale and framing in food security discourse is also scrutinised. It does this through an examination of…

Professionalising Teaching in HE: The Impact of an Institutional Fellowship Scheme in the UK

ERIC Educational Resources Information Center

Shaw, Rob

2018-01-01

The professionalisation of teaching in higher education has been increasingly prioritised across the globe in response to changes in the scale and nature of higher education brought about by massification, marketisation and managerialism. The UK experience has been characterised by the application of codified professional standards and this is of…

Performance of the JULES land surface model for UK Biogenic VOC emissions

NASA Astrophysics Data System (ADS)

Hayman, Garry; Comyn-Platt, Edward; Vieno, Massimo; Langford, Ben

2017-04-01

Emissions of biogenic non-methane volatile organic compounds (NMVOCs) are important for air quality and tropospheric composition. Through their contribution to the production of tropospheric ozone and secondary organic aerosol (SOA), biogenic VOCs indirectly contribute to climate forcing and climate feedbacks [1]. Biogenic VOCs encompass a wide range of compounds and are produced by plants for growth, development, reproduction, defence and communication [2]. There are both biological and physico-chemical controls on emissions [3]. Only a few of the many biogenic VOCs are of wider interest and only two or three (isoprene and the monoterpenes, α- and β-pinene) are represented in chemical transport models. We use the Joint UK Land Environment Simulator (JULES), the UK community land surface model, to estimate biogenic VOC emission fluxes. JULES is a process-based model that describes the water, energy and carbon balances and includes temperature, moisture and carbon stores [4, 5]. JULES currently provides emission fluxes of the 4 largest groups of biogenic VOCs: isoprene, terpenes, methanol and acetone. The JULES isoprene scheme uses gross primary productivity (GPP), leaf internal carbon and the leaf temperature as a proxy for the electron requirement for isoprene synthesis [6]. In this study, we compare JULES biogenic VOC emission estimates of isoprene and terepenes with (a) flux measurements made at selected sites in the UK and Europe and (b) gridded estimates for the UK from the EMEP/EMEP4UK atmospheric chemical transport model [7, 8], using site-specific or EMEP4UK driving meteorological data, respectively. We compare the UK-scale emission estimates with literature estimates. We generally find good agreement in the comparisons but the estimates are sensitive to the choice of the base or reference emission potentials. References (1) Unger, 2014: Geophys. Res. Lett., 41, 8563, doi:10.1002/2014GL061616; (2) Laothawornkitkul et al., 2009: New Phytol., 183, 27, doi:10.1111/j.1469-8137.2009.02859.x; (3) Grote and Niinemets, 2008: Plant Biol., 10, 8, doi:10.1055/s-2007-964975; (4) Best et al., 2011: Geosci. Model Dev., 4, 677, doi:10.5194/gmd-4-677-2011; (5) Clark et al., 2011: Geosci. Model Dev., 4, 701, doi:10.5194/gmd-4-701-2011; (6) Pacifico et al., 2011: Atmos. Chem. Phys., 11, 4371, doi:10.5194/acp-11-4371-2011; [7] Simpson et al., 2012: Atmos. Chem. Phys., 12, 7825, doi: 10.5194/acp-12-7825-2012; [8] Vieno et al., 2016: Atmos. Chem. Phys., 16, 265, doi: 10.5194/acp-16-265-2016.

Do UK television alcohol advertisements abide by the code of broadcast advertising rules regarding the portrayal of alcohol?

PubMed

Searle, Rebecca; Alston, Daisy; French, David P

2014-01-01

The aim of the study was to assess the extent to which members of the UK general public perceive television alcohol advertisements to comply with the regulatory code governing these: the Advertising Standards Authority Code of Broadcast Advertising (BCAP Code). The Code provides a general principle and 16 rules to prevent such adverts implying, condoning or encouraging immoderate, irresponsible or anti-social drinking. Quota sample of 373 adults, representative of the UK population aged 18-74 years in terms of age and gender, were recruited at a train station. Participants were shown one of seven advertisements that had been broadcast in the previous month on the two leading commercial television channels, and then completed a questionnaire with 40 statements representing the BCAP Code rules. Overall, 75% of the participants rated the advertisements as breaching at least one rule from the BCAP Code. Breaches were observed for all the seven advertisements, ranging from 49 to 91% non-compliant. Rules regarding alcohol being presented as contributing to popularity or confidence, and implying that alcohol is capable of changing mood, physical condition, behaviour, or as nourishment, were seen as being breached by over 50% of participants. A clear majority of the UK general public perceive alcohol advertisements to breach the BCAP Code, suggesting that the current regulatory system for UK television alcohol advertisements is inadequate. © The Author 2014. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Career progression of men and women doctors in the UK NHS: a questionnaire study of the UK medical qualifiers of 1993 in 2010/2011

PubMed Central

Svirko, Elena; Goldacre, Michael J

2014-01-01

Summary Objectives To report the career progression of a cohort of UK medical graduates in mid-career, comparing men and women. Design Postal and questionnaire survey conducted in 2010/2011, with comparisons with earlier surveys. Setting UK. Participants In total, 2507 responding UK medical graduates of 1993. Main outcome measures Doctors’ career specialties, grade, work location and working pattern in 2010/2011 and equivalent data in earlier years. Results The respondents represented 72% of the contactable cohort; 90% were working in UK medicine and 7% in medicine outside the UK; 87% were in the UK NHS (87% of men and 86% of women). Of doctors in the NHS, 70.6% of men and 52.0% of women were in the hospital specialties and the great majority of the others were in general practice. Within hospital specialties, a higher percentage of men than women were in surgery, and a higher percentage of women than men were in paediatrics, obstetrics and gynaecology, clinical oncology, pathology and psychiatry. In the NHS, 63% of women and 8% of men were working less-than-full-time (in general practice, 19% of men and 83% of women; and in hospital specialties, 3% of men and 46% of women). Among doctors who had always worked full-time, 94% of men and 87% of women GPs were GP principals; in hospital practice, 96% of men and 93% of women had reached consultant level. Conclusions The 1993 graduates show a continuing high level of commitment to the NHS. Gender differences in seniority lessened considerably when comparing doctors who had always worked full-time. PMID:25408921

Comparing UK, USA and Australian values for EQ-5D as a health utility measure of oral health.

PubMed

Brennan, D S; Teusner, D N

2015-09-01

Using generic measures to examine outcomes of oral disorders can add additional information relating to health utility. However, different algorithms are available to generate health states. The aim was to assess UK-, US- and Australian-based algorithms for the EuroQol (EQ-5D) in relation to their discriminative and convergent validity. Methods: Data were collected from adults in Australia aged 30-61 years by mailed survey in 2009-10, including the EQ-5D and a range of self-reported oral health variables, and self-rated oral and general health. Responses were collected from n=1,093 persons (response rate 39.1%). UK-based EQ-5D estimates were lower (0.85) than the USA and Australian estimates (0.91). EQ-5D was associated (p<0.01) with all seven oral health variables, with differences in utility scores ranging from 0.03 to 0.06 for the UK, from 0.04 to 0.07 for the USA, and from 0.05 to 0.08 for the Australian-based estimates. The effect sizes (ESs) of the associations with all seven oral health variables were similar for the UK (ES=0.26 to 0.49), USA (ES=0.31 to 0.48) and Australian-based (ES=0.31 to 0.46) estimates. EQ-5D was correlated with global dental health for the UK (rho=0.29), USA (rho=0.30) and Australian-based estimates (rho=0.30), and correlations with global general health were the same (rho=0.42) for the UK, USA and Australian-based estimates. EQ-5D exhibited equivalent discriminative validity and convergent validity in relation to oral health variables for the UK, USA and Australian-based estimates.

UK Environmental Prediction - integration and evaluation at the convective scale

NASA Astrophysics Data System (ADS)

Lewis, Huw; Brunet, Gilbert; Harris, Chris; Best, Martin; Saulter, Andrew; Holt, Jason; Bricheno, Lucy; Brerton, Ashley; Reynard, Nick; Blyth, Eleanor; Martinez de la Torre, Alberto

2015-04-01

It has long been understood that accurate prediction and warning of the impacts of severe weather requires an integrated approach to forecasting. This was well demonstrated in the UK throughout winter 2013/14 when an exceptional run of severe winter storms, often with damaging high winds and intense rainfall led to significant damage from the large waves and storm surge along coastlines, and from saturated soils, high river flows and significant flooding inland. The substantial impacts on individuals, businesses and infrastructure indicate a pressing need to understand better the value that might be delivered through more integrated environmental prediction. To address this need, the Met Office, Centre for Ecology & Hydrology and National Oceanography Centre have begun to develop the foundations of a coupled high resolution probabilistic forecast system for the UK at km-scale. This links together existing model components of the atmosphere, coastal ocean, land surface and hydrology. Our initial focus on a 2-year Prototype project will demonstrate the UK coupled prediction concept in research mode, including an analysis of the winter 2013/14 storms and its impacts. By linking science development to operational collaborations such as the UK Natural Hazards Partnership, we can ensure that science priorities are rooted in user requirements. This presentation will provide an overview of UK environmental prediction activities and an update on progress during the first year of the Prototype project. We will present initial results from the coupled model development and discuss the challenges to realise the potential of integrated regional coupled forecasting for improving predictions and applications.

The bedrock electrical conductivity map of the UK

NASA Astrophysics Data System (ADS)

Beamish, David

2013-09-01

Airborne electromagnetic (AEM) surveys, when regionally extensive, may sample a wide-range of geological formations. The majority of AEM surveys can provide estimates of apparent (half-space) conductivity and such derived data provide a mapping capability. Depth discrimination of the geophysical mapping information is controlled by the bandwidth of each particular system. The objective of this study is to assess the geological information contained in accumulated frequency-domain AEM survey data from the UK where existing geological mapping can be considered well-established. The methodology adopted involves a simple GIS-based, spatial join of AEM and geological databases. A lithology-based classification of bedrock is used to provide an inherent association with the petrophysical rock parameters controlling bulk conductivity. At a scale of 1:625k, the UK digital bedrock geological lexicon comprises just 86 lithological classifications compared with 244 standard lithostratigraphic assignments. The lowest common AEM survey frequency of 3 kHz is found to provide an 87% coverage (by area) of the UK formations. The conductivities of the unsampled classes have been assigned on the basis of inherent lithological associations between formations. The statistical analysis conducted uses over 8 M conductivity estimates and provides a new UK national scale digital map of near-surface bedrock conductivity. The new baseline map, formed from central moments of the statistical distributions, allows assessments/interpretations of data exhibiting departures from the norm. The digital conductivity map developed here is believed to be the first such UK geophysical map compilation for over 75 years. The methodology described can also be applied to many existing AEM data sets.

Treatment of Diabetic Ketoacidosis (DKA)/Hyperglycemic Hyperosmolar State (HHS): Novel Advances in the Management of Hyperglycemic Crises (UK Versus USA).

PubMed

Dhatariya, Ketan K; Vellanki, Priyathama

2017-05-01

Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are diabetic emergencies that cause high morbidity and mortality. Their treatment differs in the UK and USA. This review delineates the differences in diagnosis and treatment between the two countries. Large-scale studies to determine optimal management of DKA and HHS are lacking. The diagnosis of DKA is based on disease severity in the USA, which differs from the UK. The diagnosis of HHS in the USA is based on total rather than effective osmolality. Unlike the USA, the UK has separate guidelines for DKA and HHS. Treatment of DKA and HHS also differs with respect to timing of fluid and insulin initiation. There is considerable overlap but important differences between the UK and USA guidelines for the management of DKA and HHS. Further research needs to be done to delineate a unifying diagnostic and treatment protocol.

Validation of the Sexual Communication Self-Efficacy Scale

ERIC Educational Resources Information Center

Quinn-Nilas, Christopher; Milhausen, Robin R.; Breuer, Rebecca; Bailey, Julia; Pavlou, Menelaos; DiClemente, Ralph J.; Wingood, Gina M.

2016-01-01

This study assessed a newly developed Sexual Communication Self-Efficacy Scale designed to measure the sexual communication self-efficacy of adolescent men and women. Three-hundred and seventy-four U.K. adolescents completed this new scale, along with several other validity measures. Factor analysis revealed that the Sexual Communication…

Careers of Professional Staff in Australian and UK Universities: A Mixed Methods Pilot Study

ERIC Educational Resources Information Center

Gander, Michelle

2017-01-01

This article confirms the reliability of a protean and boundaryless career attitudes scale, tested in a pilot study. Additionally, it summarises the results of this study into the career attitudes of professional staff in Australian and UK universities. A mixed methods approach was taken using a survey consisting of both closed questions on a…

visPIG--a web tool for producing multi-region, multi-track, multi-scale plots of genetic data.

PubMed

Scales, Matthew; Jäger, Roland; Migliorini, Gabriele; Houlston, Richard S; Henrion, Marc Y R

2014-01-01

We present VISual Plotting Interface for Genetics (visPIG; http://vispig.icr.ac.uk), a web application to produce multi-track, multi-scale, multi-region plots of genetic data. visPIG has been designed to allow users not well versed with mathematical software packages and/or programming languages such as R, Matlab®, Python, etc., to integrate data from multiple sources for interpretation and to easily create publication-ready figures. While web tools such as the UCSC Genome Browser or the WashU Epigenome Browser allow custom data uploads, such tools are primarily designed for data exploration. This is also true for the desktop-run Integrative Genomics Viewer (IGV). Other locally run data visualisation software such as Circos require significant computer skills of the user. The visPIG web application is a menu-based interface that allows users to upload custom data tracks and set track-specific parameters. Figures can be downloaded as PDF or PNG files. For sensitive data, the underlying R code can also be downloaded and run locally. visPIG is multi-track: it can display many different data types (e.g association, functional annotation, intensity, interaction, heat map data,…). It also allows annotation of genes and other custom features in the plotted region(s). Data tracks can be plotted individually or on a single figure. visPIG is multi-region: it supports plotting multiple regions, be they kilo- or megabases apart or even on different chromosomes. Finally, visPIG is multi-scale: a sub-region of particular interest can be 'zoomed' in. We describe the various features of visPIG and illustrate its utility with examples. visPIG is freely available through http://vispig.icr.ac.uk under a GNU General Public License (GPLv3).

Toddler foods, children's foods: assessing sodium in packaged supermarket foods targeted at children.

PubMed

Elliott, Charlene D; Conlon, Martin J

2011-03-01

To critically examine child-oriented packaged food products sold in Canada for their sodium content, and to assess them light of intake recommendations, the current policy context and suggested targets. Baby/toddler foods (n 186) and child-oriented packaged foods (n 354) were coded for various attributes (including sodium). Summary statistics were created for sodium, then the children's food products were compared with the UK Food Standards Agency (FSA) 'targets' for sodium in packaged foods. Also assessed were the products' per-serving sodium levels were assessed in light of the US Institute of Medicine's dietary reference intakes and Canada's Food Guide. Calgary, Alberta, Canada. None. Twenty per cent of products could be classified as having high sodium levels. Certain sub-categories of food (i.e. toddler entrées, children's packaged lunches, soups and canned pastas) were problematic. Significantly, when scaled in according to Schedule M or viewed in light of the serving sizes on the Nutrition Facts table, the sodium level in various dry goods products generally fell within, and below, the Adequate Intake (AI)/Tolerable Upper Intake Level (UL) band for sodium. When scaled in accordance with the UK FSA targets, however, none of the (same) products met the targets. In light of AI/UL thresholds based on age and per-serving cut-offs, packaged foodstuffs for youngsters fare relatively well, with the exception of some problematic areas. 'Stealth sodium' and 'subtle sodium' are important considerations; so is use of the FSA's scaling method to evaluate sodium content, because it is highly sensitive to the difference between the reference amount and the actual real-world serving size for the product being considered.

Predicting the 10-year risk of hip and major osteoporotic fracture in rheumatoid arthritis and in the general population: an independent validation and update of UK FRAX without bone mineral density

PubMed Central

Klop, Corinne; de Vries, Frank; Bijlsma, Johannes W J; Leufkens, Hubert G M; Welsing, Paco M J

2016-01-01

Objectives FRAX incorporates rheumatoid arthritis (RA) as a dichotomous predictor for predicting the 10-year risk of hip and major osteoporotic fracture (MOF). However, fracture risk may deviate with disease severity, duration or treatment. Aims were to validate, and if needed to update, UK FRAX for patients with RA and to compare predictive performance with the general population (GP). Methods Cohort study within UK Clinical Practice Research Datalink (CPRD) (RA: n=11 582, GP: n=38 755), also linked to hospital admissions for hip fracture (CPRD-Hospital Episode Statistics, HES) (RA: n=7221, GP: n=24 227). Predictive performance of UK FRAX without bone mineral density was assessed by discrimination and calibration. Updating methods included recalibration and extension. Differences in predictive performance were assessed by the C-statistic and Net Reclassification Improvement (NRI) using the UK National Osteoporosis Guideline Group intervention thresholds. Results UK FRAX significantly overestimated fracture risk in patients with RA, both for MOF (mean predicted vs observed 10-year risk: 13.3% vs 8.4%) and hip fracture (CPRD: 5.5% vs 3.1%, CPRD-HES: 5.5% vs 4.1%). Calibration was good for hip fracture in the GP (CPRD-HES: 2.7% vs 2.4%). Discrimination was good for hip fracture (RA: 0.78, GP: 0.83) and moderate for MOF (RA: 0.69, GP: 0.71). Extension of the recalibrated UK FRAX using CPRD-HES with duration of RA disease, glucocorticoids (>7.5 mg/day) and secondary osteoporosis did not improve the NRI (0.01, 95% CI −0.04 to 0.05) or C-statistic (0.78). Conclusions UK FRAX overestimated fracture risk in RA, but performed well for hip fracture in the GP after linkage to hospitalisations. Extension of the recalibrated UK FRAX did not improve predictive performance. PMID:26984006

Determining the psychometric properties of the Enhancing Decision-making Assessment in Midwifery (EDAM) measure in a cross cultural context.

PubMed

Jefford, Elaine; Jomeen, Julie; Martin, Colin R

2016-04-28

The ability to act on and justify clinical decisions as autonomous accountable midwifery practitioners, is encompassed within many international regulatory frameworks, yet decision-making within midwifery is poorly defined. Decision-making theories from medicine and nursing may have something to offer, but fail to take into consideration midwifery context and philosophy and the decisional autonomy of women. Using an underpinning qualitative methodology, a decision-making framework was developed, which identified Good Clinical Reasoning and Good Midwifery Practice as two conditions necessary to facilitate optimal midwifery decision-making during 2nd stage labour. This study aims to confirm the robustness of the framework and describe the development of Enhancing Decision-making Assessment in Midwifery (EDAM) as a measurement tool through testing of its factor structure, validity and reliability. A cross-sectional design for instrument development and a 2 (country; Australia/UK) x 2 (Decision-making; optimal/sub-optimal) between-subjects design for instrument evaluation using exploratory and confirmatory factor analysis, internal consistency and known-groups validity. Two 'expert' maternity panels, based in Australia and the UK, comprising of 42 participants assessed 16 midwifery real care episode vignettes using the empirically derived 26 item framework. Each item was answered on a 5 point likert scale based on the level of agreement to which the participant felt each item was present in each of the vignettes. Participants were then asked to rate the overall decision-making (optimal/sub-optimal). Post factor analysis the framework was reduced to a 19 item EDAM measure, and confirmed as two distinct scales of 'Clinical Reasoning' (CR) and 'Midwifery Practice' (MP). The CR scale comprised of two subscales; 'the clinical reasoning process' and 'integration and intervention'. The MP scale also comprised two subscales; women's relationship with the midwife' and 'general midwifery practice'. EDAM would generally appear to be a robust, valid and reliable psychometric instrument for measuring midwifery decision-making, which performs consistently across differing international contexts. The 'women's relationship with midwife' subscale marginally failed to meet the threshold for determining good instrument reliability, which may be due to its brevity. Further research using larger samples and in a wider international context to confirm the veracity of the instrument's measurement properties and its wider global utility, would be advantageous.

The Infobiotics Workbench: an integrated in silico modelling platform for Systems and Synthetic Biology.

PubMed

Blakes, Jonathan; Twycross, Jamie; Romero-Campero, Francisco Jose; Krasnogor, Natalio

2011-12-01

The Infobiotics Workbench is an integrated software suite incorporating model specification, simulation, parameter optimization and model checking for Systems and Synthetic Biology. A modular model specification allows for straightforward creation of large-scale models containing many compartments and reactions. Models are simulated either using stochastic simulation or numerical integration, and visualized in time and space. Model parameters and structure can be optimized with evolutionary algorithms, and model properties calculated using probabilistic model checking. Source code and binaries for Linux, Mac and Windows are available at http://www.infobiotics.org/infobiotics-workbench/; released under the GNU General Public License (GPL) version 3. Natalio.Krasnogor@nottingham.ac.uk.

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

Identifying critical success factors for designing selection processes into postgraduate specialty training: the case of UK general practice.

PubMed

Plint, Simon; Patterson, Fiona

2010-06-01

The UK national recruitment process into general practice training has been developed over several years, with incremental introduction of stages which have been piloted and validated. Previously independent processes, which encouraged multiple applications and produced inconsistent outcomes, have been replaced by a robust national process which has high reliability and predictive validity, and is perceived to be fair by candidates and allocates applicants equitably across the country. Best selection practice involves a job analysis which identifies required competencies, then designs reliable assessment methods to measure them, and over the long term ensures that the process has predictive validity against future performance. The general practitioner recruitment process introduced machine markable short listing assessments for the first time in the UK postgraduate recruitment context, and also adopted selection centre workplace simulations. The key success factors have been identified as corporate commitment to the goal of a national process, with gradual convergence maintaining locus of control rather than the imposition of change without perceived legitimate authority.

Approaches to the diagnosis and management of occupational asthma amongst UK respiratory physicians.

PubMed

Barber, C M; Naylor, S; Bradshaw, L M; Francis, M; Harris-Roberts, J; Rawbone, R; Curran, A D; Fishwick, D

2007-09-01

This study aimed to assess the approach to the diagnosis and management of occupational asthma amongst general (non-specialist) respiratory consultants in the UK. A random sample of 100 UK general respiratory physicians were invited to participate, and asked to provide information on their diagnostic approach to a case scenario of a patient with possible occupational asthma relating to flour exposure. Participation rates were 42% for the main part of the study. Less than half of consultants specifically reported they would ask whether symptoms improved away from work, and just over a third mentioned examining the patient. All of those interviewed recommended a chest X-ray, and 98% simple spirometry. Eighty-six per cent suggested measurement of serial peak flows, recorded for between 2 and 8 weeks, with measurements taken half-twelve hourly. Less than half advocated a specific flour allergy test, and almost one-quarter (23%) would not perform any immunological test at all. Once a diagnosis of occupational asthma was confirmed, less than two-thirds of those interviewed commented they would recommend some form of exposure reduction, and only 28% specifically stated they would offer compensation advice. The diagnosis of occupational asthma by general respiratory physicians within the UK lacks standardisation, and in some cases falls short of evidence-based best practise.

Selecting, training and assessing new general practice community teachers in UK medical schools.

PubMed

Hydes, Ciaran; Ajjawi, Rola

2015-09-01

Standards for undergraduate medical education in the UK, published in Tomorrow's Doctors, include the criterion 'everyone involved in educating medical students will be appropriately selected, trained, supported and appraised'. To establish how new general practice (GP) community teachers of medical students are selected, initially trained and assessed by UK medical schools and establish the extent to which Tomorrow's Doctors standards are being met. A mixed-methods study with questionnaire data collected from 24 lead GPs at UK medical schools, 23 new GP teachers from two medical schools plus a semi-structured telephone interview with two GP leads. Quantitative data were analysed descriptively and qualitative data were analysed informed by framework analysis. GP teachers' selection is non-standardised. One hundred per cent of GP leads provide initial training courses for new GP teachers; 50% are mandatory. The content and length of courses varies. All GP leads use student feedback to assess teaching, but other required methods (peer review and patient feedback) are not universally used. To meet General Medical Council standards, medical schools need to include equality and diversity in initial training and use more than one method to assess new GP teachers. Wider debate about the selection, training and assessment of new GP teachers is needed to agree minimum standards.

A Comparison of Japan and U.K. SF-6D Health-State Valuations Using a Non-Parametric Bayesian Method.

PubMed

Kharroubi, Samer A

2015-08-01

There is interest in the extent to which valuations of health may differ between different countries and cultures, but few studies have compared preference values of health states obtained in different countries. We sought to estimate and compare two directly elicited valuations for SF-6D health states between the Japan and U.K. general adult populations using Bayesian methods. We analysed data from two SF-6D valuation studies where, using similar standard gamble protocols, values for 241 and 249 states were elicited from representative samples of the Japan and U.K. general adult populations, respectively. We estimate a function applicable across both countries that explicitly accounts for the differences between them, and is estimated using data from both countries. The results suggest that differences in SF-6D health-state valuations between the Japan and U.K. general populations are potentially important. The magnitude of these country-specific differences in health-state valuation depended, however, in a complex way on the levels of individual dimensions. The new Bayesian non-parametric method is a powerful approach for analysing data from multiple nationalities or ethnic groups, to understand the differences between them and potentially to estimate the underlying utility functions more efficiently.

Recent Developments in Information about Programme Quality in the UK

ERIC Educational Resources Information Center

Brown, Roger; Carpenter, Caroline; Collins, Roz; Winkvist-Noble, Lilian

2007-01-01

There is general recognition that increased demand for information about programme quality has accompanied the nearly universal massification of higher education, the consequential pressures on public expenditure, and the associated requirements of greater accountability. The UK government has sought to respond to this demand by establishing an…

The Politics of Childhood and Asylum in the UK

ERIC Educational Resources Information Center

Giner, Clotilde

2007-01-01

This article considers the general treatment of asylum-seeking families with children in the UK, focusing on the government's practices and public reactions to these measures. It first describes both the exclusive asylum framework, based on institutionalised suspicion, welfare restrictions and detention, and the inclusive child policy framework,…

Catchment scale water resource constraints on UK policies for low-carbon energy system transition

NASA Astrophysics Data System (ADS)

Konadu, D. D.; Fenner, R. A.

2017-12-01

Long-term low-carbon energy transition policy of the UK presents national scale propositions of different low-carbon energy system options that lead to meeting GHG emissions reduction target of 80% on 1990 levels by 2050. Whilst national-scale assessments suggests that water availability may not be a significant constrain on future thermal power generation systems in this pursuit, these analysis fail to capture the appropriate spatial scale where water resource decisions are made, i.e. at the catchment scale. Water is a local resource, which also has significant spatio-temporal regional and national variability, thus any policy-relevant water-energy nexus analysis must be reflective of these characteristics. This presents a critical challenge for policy relevant water-energy nexus analysis. This study seeks to overcome the above challenge by using a linear spatial-downscaling model to allocate nationally projected water-intensive energy system infrastructure/technologies to the catchment level, and estimating the water requirements for the deployment of these technologies. The model is applied to the UK Committee on Climate Change Carbon Budgets to 2030 as a case study. The paper concludes that whilst national-scale analyses show minimal long-term water related impacts, catchment level appraisal of water resource requirements reveal significant constraints in some locations. The approach and results presented in this study thus, highlights the importance of bringing together scientific understanding, data and analysis tools to provide better insights for water-energy nexus decisions at the appropriate spatial scale. This is particularly important for water stressed regions where the water-energy nexus must be analysed at appropriate spatial resolution to capture the full water resource impact of national energy policy.

Job satisfaction among dually qualified dental hygienist-therapists in UK primary care: a structural model.

PubMed

Turner, S; Ross, M K; Ibbetson, R J

2011-02-26

To investigate job satisfaction among hygienist-therapists. Increasing numbers of hygienist-therapists work in UK primary dental care teams. Earlier studies suggest a clinical remit/clinical activity mismatch, without investigating any link with job satisfaction. A UK-wide survey of dental hygienist-therapists using a random sample of the General Dental Council Register of Dental Care Professionals. Factors associated with job satisfaction (measured by the Warr-Cook-Wall ten-dimension scale) were entered into a series of multiple regression analyses to build up a path model. Analysis was undertaken on 183 respondents (response rate: 60%). Mean score for overall satisfaction was 5.36 (SD 1.28) out of a range of 1-7. Multiple regression analysis confirmed the following direct predictors of overall job satisfaction: satisfaction with colleagues, remuneration, variety of work; rating of hygiene work as rewarding; and not being self-employed (R(2) = 0.69). Satisfaction with variety of work was the strongest predictor, itself strongly predicted by the extent the clinical remit was undertaken. Dentists' recognition of their remit, quality of clinical work and qualifications had a strong indirect effect on overall job satisfaction. The study suggests both greater use of the therapy skills these individuals possess, and better recognition of their remit, qualifications and quality of work by their dentist colleague, may be linked to higher job satisfaction. The implications for the policy of greater team working in dental primary care are discussed.

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

Five-year clinical evaluation of zirconia-based bridges in patients in UK general dental practices.

PubMed

Burke, F J T; Crisp, R J; Cowan, A J; Lamb, J; Thompson, O; Tulloch, N

2013-11-01

This study reported the results at 5 years of fixed-fixed all-ceramic bridges, constructed in a yttria oxide stabilized tetragonal zirconium oxide polycrystal (Y-TZP) substructure, placed in adult patients in UK general dental practices. Four UK general dental practitioners recruited patients who required fixed bridgework and, after obtaining informed written consent, appropriate clinical and radiographic assessments were completed. The teeth were prepared and bridges constructed in accordance with the manufacturer's instructions. Each bridge was reviewed annually within 3 months of the anniversary of its placement by a calibrated examiner, together with the clinician who had placed the restoration, using modified USPHS criteria. Of the 41 bridges originally placed, 33 bridges were examined at 5 years. All Y-TZP frameworks were intact and no bridge retainers had debonded. Eight chipping fractures in the veneering ceramic were noted over the 5-year period. In five cases the patients were unaware of these and these cases were polished. Of the remaining three cases, in one a repair was attempted but was unsuccessful, but the bridge remained in satisfactory service. However, in the case involving a chipping fracture of the mesial-incisal angle of a central incisor, it was considered that replacement of the bridge was necessary. 97% (n=32) of the 33 Lava Y-TZP fixed-fixed bridges, evaluated in patients attending UK general dental practices, were found to be performing satisfactorily. The use of Y-TZP frameworks holds promise. Copyright © 2013 Elsevier Ltd. All rights reserved.

Molar incisor hypomineralisation: experience and perceived challenges among dentists specialising in paediatric dentistry and a group of general dental practitioners in the UK.

PubMed

Kalkani, M; Balmer, R C; Homer, R M; Day, P F; Duggal, M S

2016-04-01

To assess the views and experience of the UK dentists specialising in paediatric dentistry (trainees) about molar incisor hypomineralisation (MIH) and compare the findings with the responses from a group of UK general dental practitioners. A web-based questionnaire was sent to dentists undergoing specialist training in paediatric dentistry. The same questionnaire was completed by a group of general dentists who stated an interest in treating children, with various levels of experience. The questionnaire sought information on clinical experience and the views of the dentists on the impact of MIH on children and families. Specialty trainees (37) from different paediatric dental departments in the UK completed the online survey, giving a total response rate of 71%. The questionnaire was also completed by 31 general dental practitioners. There was difficulty in distinguishing MIH from other conditions for both groups. Increased sensitivity of affected teeth was the most frequently encountered problem with 51% of the trainees and 76% of the dentists saying this was often or always a challenge. The trainees were particularly concerned about the pain children experienced and about the appearance of the condition. Both groups felt that parental anxiety occurred in almost all cases. Both groups felt that MIH presents several clinical challenges and has a negative effect on the quality of life of the affected children and their families. There were significant differences in the views and perceptions between the two groups.

The Distribution of and Relationship between Autistic Traits and Social Anxiety in a UK Student Population

ERIC Educational Resources Information Center

Freeth, Megan; Bullock, Tom; Milne, Elizabeth

2013-01-01

Traits associated with autism and social anxiety were assessed in a UK student population (n = 1325) using the Autism-spectrum Quotient and the Liebowitz Social Anxiety Scale. Clinically relevant levels of autistic traits were observed in 3.3% of the cohort; 10.1% of the cohort reported clinically relevant levels of social anxiety; 1.8% of the…

Establishing the Role and Impact of Academic Librarians in Supporting Open Research: A Case Study at Leeds Beckett University, UK

ERIC Educational Resources Information Center

Bower, Kirsty; Sheppard, Nick; Bayjoo, Jennifer; Pease, Adele

2017-01-01

This practical article presents findings of a small scale study undertaken at a large U.K. University. The purpose of the study was to encourage academic engagement with Open Access (OA) and the Higher Education Funding Council for England (HEFCE) mandate with the measurable impact being increased engagement with the Repository and dissemination…

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.

The economy-wide impact of pandemic influenza on the UK: a computable general equilibrium modelling experiment.

PubMed

Smith, Richard D; Keogh-Brown, Marcus R; Barnett, Tony; Tait, Joyce

2009-11-19

To estimate the potential economic impact of pandemic influenza, associated behavioural responses, school closures, and vaccination on the United Kingdom. A computable general equilibrium model of the UK economy was specified for various combinations of mortality and morbidity from pandemic influenza, vaccine efficacy, school closures, and prophylactic absenteeism using published data. The 2004 UK economy (the most up to date available with suitable economic data). The economic impact of various scenarios with different pandemic severity, vaccination, school closure, and prophylactic absenteeism specified in terms of gross domestic product, output from different economic sectors, and equivalent variation. The costs related to illness alone ranged between 0.5% and 1.0% of gross domestic product ( pound8.4bn to pound16.8bn) for low fatality scenarios, 3.3% and 4.3% ( pound55.5bn to pound72.3bn) for high fatality scenarios, and larger still for an extreme pandemic. School closure increases the economic impact, particularly for mild pandemics. If widespread behavioural change takes place and there is large scale prophylactic absence from work, the economic impact would be notably increased with few health benefits. Vaccination with a pre-pandemic vaccine could save 0.13% to 2.3% of gross domestic product ( pound2.2bn to pound38.6bn); a single dose of a matched vaccine could save 0.3% to 4.3% ( pound5.0bn to pound72.3bn); and two doses of a matched vaccine could limit the overall economic impact to about 1% of gross domestic product for all disease scenarios. Balancing school closure against "business as usual" and obtaining sufficient stocks of effective vaccine are more important factors in determining the economic impact of an influenza pandemic than is the disease itself. Prophylactic absence from work in response to fear of infection can add considerably to the economic impact.

The economy-wide impact of pandemic influenza on the UK: a computable general equilibrium modelling experiment

PubMed Central

Keogh-Brown, Marcus R; Barnett, Tony; Tait, Joyce

2009-01-01

Objectives To estimate the potential economic impact of pandemic influenza, associated behavioural responses, school closures, and vaccination on the United Kingdom. Design A computable general equilibrium model of the UK economy was specified for various combinations of mortality and morbidity from pandemic influenza, vaccine efficacy, school closures, and prophylactic absenteeism using published data. Setting The 2004 UK economy (the most up to date available with suitable economic data). Main outcome measures The economic impact of various scenarios with different pandemic severity, vaccination, school closure, and prophylactic absenteeism specified in terms of gross domestic product, output from different economic sectors, and equivalent variation. Results The costs related to illness alone ranged between 0.5% and 1.0% of gross domestic product (£8.4bn to £16.8bn) for low fatality scenarios, 3.3% and 4.3% (£55.5bn to £72.3bn) for high fatality scenarios, and larger still for an extreme pandemic. School closure increases the economic impact, particularly for mild pandemics. If widespread behavioural change takes place and there is large scale prophylactic absence from work, the economic impact would be notably increased with few health benefits. Vaccination with a pre-pandemic vaccine could save 0.13% to 2.3% of gross domestic product (£2.2bn to £38.6bn); a single dose of a matched vaccine could save 0.3% to 4.3% (£5.0bn to £72.3bn); and two doses of a matched vaccine could limit the overall economic impact to about 1% of gross domestic product for all disease scenarios. Conclusion Balancing school closure against “business as usual” and obtaining sufficient stocks of effective vaccine are more important factors in determining the economic impact of an influenza pandemic than is the disease itself. Prophylactic absence from work in response to fear of infection can add considerably to the economic impact. PMID:19926697

COPD management costs according to the frequency of COPD exacerbations in UK primary care.

PubMed

Punekar, Yogesh Suresh; Shukla, Amit; Müllerova, Hana

2014-01-01

The economic burden of chronic obstructive pulmonary disease (COPD) exacerbations is significant, but the impact of other sources on the overall cost of COPD management is largely unknown. We aimed to estimate overall costs for patients experiencing none, one, or two or more exacerbations per year in the UK. A retrospective cohort of prevalent COPD patients was identified in the Clinical Practice Research Datalink UK database. Patients with information recorded for at least 12 months before and after cohort entry date were included (first prevalent COPD diagnosis confirmed by spirometry on/after April 1, 2009). Patients were categorized as having none, one, or two or more moderate-to-severe COPD exacerbations in the 12 months after cohort entry and further classified by the Global initiative for chronic Obstructive Lung Disease (GOLD) category of airflow obstruction and the Medical Research Council dyspnea scale. Study outcomes included counts of general practitioner interactions, moderate-severe COPD exacerbations, and non-COPD hospitalizations. Estimated resource use costs were calculated using National Health Service reference costs for 2010-2011. The cohort comprised 58,589 patients (mean age 69.5 years, mean dyspnea grade 2.5, females 46.6%, current smokers 33.1%). The average total annual per patient cost of COPD management, excluding medications, was £2,108 for all patients and £1,523, £2,405, and £3,396 for patients experiencing no, one, or two or more moderate-to-severe exacerbations, respectively. General practitioner interactions contributed most to these annual costs, accounting for £1,062 (69.7%), £1,313 (54.6%), and £1,592 (46.9%) in patients with no, one, or two or more moderate-to-severe exacerbations, respectively. Disease management strategies focused on reducing costs in primary care may help reduce total COPD costs significantly.

A comparison of multidisciplinary team residential rehabilitation with conventional outpatient care for the treatment of non-arthritic intra-articular hip pain in UK Military personnel - a protocol for a randomised controlled trial.

PubMed

Coppack, Russell J; Bilzon, James L; Wills, Andrew K; McCurdie, Ian M; Partridge, Laura; Nicol, Alastair M; Bennett, Alexander N

2016-11-08

Non-arthritic hip disorders are defined as abnormalities of the articulating surfaces of the acetabulum and femur before the onset of osteoarthritis, including intra-articular structures such as the acetabular labrum and chondral surfaces. Abnormal femoroacetabular morphology is commonly seen in young men who constitute much of the UK military population. Residential multidisciplinary team (MDT) rehabilitation for patients with musculoskeletal injuries has a long tradition in the UK military, however, there are no studies presenting empirical data on the efficacy of a residential MDT approach compared with individualised conventional outpatient treatment. With no available data, the sustainability of this care pathway has been questioned. The purpose of this randomised controlled trial is to compare the effects of a residential multidisciplinary intervention, to usual outpatient care, on the clinical outcomes of young active adults undergoing treatment for non-arthritic intra-articular hip pain. The trial will be conducted at the Defence Medical Rehabilitation Centre, Headley Court, UK. One hundred military male participants with clinical indicators of non-arthritic intra-articular hip pain will be randomly allocated to either: (1) 7-day residential multidisciplinary team intervention, n = 50; (2) 6-week physiotherapist-led outpatient intervention (conventional care), n = 50. Measurements will be taken at baseline, post-treatment (1-week MDT group; 6-weeks physiotherapy group), and 12-weeks. The primary outcome measures are the function in daily living sub-scale of the Copenhagen Hip and Groin Outcome Score (HAGOS), the physical function subscale of the Non-arthritic Hip Score (NAHS), and VAS pain scale. Secondary outcomes include objective measures of physical capacity and general health. An intention-to-treat analysis will be performed using linear and mixed models. This study will be the first to assess the efficacy of intensive MDT rehabilitation, versus conventional outpatient care, for the management of non-arthritic hip pain. The results from this study will add to the evidence-base and inform clinical practice for the management of intra-articular non-arthritic hip pain and femoroacetabular impingement in young active adults. ISRCTN Reference: ISRCTN 59255714 dated 11-Nov-2015.

History of UK contribution to astronautics: Politics and government

NASA Astrophysics Data System (ADS)

Hicks CB, Colin

2009-12-01

In all developed countries, once it emerged from the amateur era, Space (and especially rocketry) moved on the public agenda because of its potential significance for both the civil and military policies of governments (coupled with its appetite for new money). In the UK the policy treatment of Space broadly paralleled that in other countries until the post-Empire trauma, the burn-out of the White-Hot Technological revolution of Harold Wilson, and the financial crises of the 1970s exhausted the public appetite for large scale publicly funded projects in high technology. The culmination for Space of these pressures came in 1986-1987 when the UK rejected the emerging international consensus and, almost alone, stayed outside the manned space commitments which developed into the International Space Station. In this paper, Colin Hicks will review the UK political developments which led up to the 1986-1987 decision and how the politics and organisation of UK space activity have developed since then to the point where in 2008 a major government review of the UK involvement in manned space was commissioned.

A comparison of top-down and bottom-up carbon dioxide fluxes in the UK using a multi-platform measurement network.

NASA Astrophysics Data System (ADS)

White, Emily; Rigby, Matt; O'Doherty, Simon; Stavert, Ann; Lunt, Mark; Nemitz, Eiko; Helfter, Carole; Allen, Grant; Pitt, Joe; Bauguitte, Stéphane; Levy, Pete; van Oijen, Marcel; Williams, Mat; Smallman, Luke; Palmer, Paul

2016-04-01

Having a comprehensive understanding, on a countrywide scale, of both biogenic and anthropogenic CO2 emissions is essential for knowing how best to reduce anthropogenic emissions and for understanding how the terrestrial biosphere is responding to global fossil fuel emissions. Whilst anthropogenic CO2 flux estimates are fairly well constrained, fluxes from biogenic sources are not. This work will help to verify existing anthropogenic emissions inventories and give a better understanding of biosphere - atmosphere CO2 exchange. Using an innovative top-down inversion scheme; a hierarchical Bayesian Markov Chain Monte Carlo approach with reversible jump "trans-dimensional" basis function selection, we aim to find emissions estimates for biogenic and anthropogenic sources simultaneously. Our approach allows flux uncertainties to be derived more comprehensively than previous methods, and allows the resolved spatial scales in the solution to be determined using the data. We use atmospheric CO2 mole fraction data from the UK Deriving Emissions related to Climate Change (DECC) and Greenhouse gAs UK and Global Emissions (GAUGE) projects. The network comprises of 6 tall tower sites, flight campaigns and a ferry transect along the east coast, and enables us to derive high-resolution monthly flux estimates across the UK and Ireland for the period 2013-2015. We have derived UK total fluxes of 675 PIC 78 Tg/yr during January 2014 (seasonal maximum) and 23 PIC 96 Tg/yr during May 2014 (seasonal minimum). Our disaggregated anthropogenic and biogenic flux estimates are compared to a new high-resolution time resolved anthropogenic inventory that will underpin future UNFCCC reports by the UK, and to DALEC carbon cycle model. This allows us to identify where significant differences exist between these "bottom-up" and "top-down" flux estimates and suggest reasons for discrepancies. We will highlight the strengths and limitations of the UK's CO2 emissions verification infrastructure at present and outline improvements that could be made in the future.

Cases relating to anaesthetists handled by the UK General Medical Council in 2009: methodological approach and patterns of referral.

PubMed

Campbell, G; Rollin, A M; Smith, A F

2013-05-01

The General Medical Council is the regulatory body charged with maintaining standards in the medical profession in the UK. We analysed cases relating to anaesthetists handled in 2009 using fitness-to-practise data, comparing them with the profession as a whole and examining patterns of referral. Complaints were made about 105 doctors practising in anaesthesia. The 81 anaesthetists who were investigated further were subject to a total of 225 separate allegations, median (IQR [range]) of 2 (1-3 ) allegations per anaesthetist. Anaesthetists had a lower rate of referral compared with doctors in general (0.095% vs 0.20%, respectively, p = 0.0001). They were less likely than doctors in general to be referred by an individual member of the public (27% vs 64%, respectively, p = 0.0001). As with other specialties, allegations were most commonly made about clinical care, probity and relationships with patients. On the basis of 2009 data, we calculated that a mean (95% CI) of 1 in 120 (1 in 100-145) doctors practising in anaesthesia in the UK will be referred to the General Medical Council every year. We have provided examples of allegations and made recommendations for maintaining good practice in anaesthesia. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

Good Practice in GNVQ Induction Programmes. Project Report.

ERIC Educational Resources Information Center

Benett, Yves

A 2-year research and development project was conducted to identify existing good practices for introducing students in the United Kingdom (UK) to General National Vocational Qualifications (GNVQs) and available teaching and learning materials for use in the induction of GNVQs in UK schools and colleges. The main activities of the project's three…

Marginal Groups in Marginal Times: Gypsy and Traveller Parents and Home Education in England, UK

ERIC Educational Resources Information Center

Bhopal, Kalwant; Myers, Martin

2016-01-01

This article examines the experiences of home education for Gypsy and Traveller groups in England, UK. We argue that home education is perceived in a particular historical "moment" characterised in the media and more generally throughout society by "risk". Against this backdrop this article considers Gypsy and Traveller…

Functions of Turkish Complementary Schools in the UK: Official vs. Insider Discourses

ERIC Educational Resources Information Center

Çavusoglu, Çise

2014-01-01

Complementary schools in the United Kingdom (UK) are community organised schools with the general aim of teaching younger generations their "native" languages and cultures. However, the aims and practices of these schools are predominantly dependent on changes in the social and political contexts both in the host country (in this case…

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.

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.

Cognitive functioning and disturbances of mood in UK veterans of the Persian Gulf War: a comparative study.

PubMed

David, A S; Farrin, L; Hull, L; Unwin, C; Wessely, S; Wykes, T

2002-11-01

Complaints of poor memory and concentration are common in veterans of the 1991 Persian Gulf War as are other symptoms. Despite a large research effort, such symptoms remain largely unexplained. A comprehensive battery of neuropsychological tests and rating scales was administered to 341 UK servicemen who were returnees from the Gulf War and peace keeping duties in Bosnia, plus non-deployed military controls. All were drawn from a large randomized survey. Most were selected on the basis of impaired physical functioning defined operationally. Group comparisons revealed an association between physical functioning and symptoms of depression, post-traumatic stress reactions, increased anger and subjective cognitive failures. Poorer performance on some general cognitive measures, sequencing and attention was also seen in association with being 'ill' but virtually all differences disappeared after adjusting for depressed mood or multiple comparisons. Deployment was also associated with symptoms of post-traumatic stress and subjective cognitive failures, independently of health status, as well as minor general cognitive and constructional impairment. The latter remained significantly poorer in the Gulf group even after adjusting for depressed mood. Disturbances of mood are more prominent than quantifiable cognitive deficits in Gulf War veterans and probably lead to subjective underestimation of ability. Task performance deficits can themselves be explained by depressed mood although the direction of causality cannot be inferred confidently. Reduced constructional ability cannot be explained in this way and could be an effect of Gulf-specific exposures.

What happens when GPs engage in commissioning? Two decades of experience in the English NHS.

PubMed

Miller, Rosalind; Peckham, Stephen; Coleman, Anna; McDermott, Imelda; Harrison, Stephen; Checkland, Kath

2016-04-01

To review the evidence on commissioning schemes involving clinicians in the United Kingdom National Health Service, between 1991 and 2010; report on the extent and impact of clinical engagement; and distil lessons for the development of such schemes both in the UK and elsewhere. A review of published evidence. Five hundred and fourteen abstracts were obtained from structured searches and screened. Full-text papers were retrieved for UK empirical studies exploring the relationship between commissioners and providers with clinician involvement. Two hundred and eighteen published materials were reviewed. The extent of clinical engagement varied between the various schemes. Schemes allowing clinicians to act autonomously were more likely to generate significant engagement, with 'virtuous cycles' (experience of being able to make changes feeding back to encourage greater engagement) and 'vicious cycles' (failure to influence services generating disengagement) observed. Engagement of the wider general practitioner (GP) membership was an important determinant of success. Most impact was seen in GP prescribing and the establishment of services in general practices. There was little evidence of GPs engaging more widely with public health issues. Evidence for a significant impact of clinical engagement on commissioning outcomes is limited. Initial changes are likely to be small scale and to focus on services in primary care. Engagement of GP members of primary care commissioning organizations is an important determinant of progress, but generates significant transaction costs. © The Author(s) 2015.

A comparison of individual and social time trade-off values for health states in the general population.

PubMed

Burström, Kristina; Johannesson, Magnus; Diderichsen, Finn

2006-05-01

This study aimed to compare directly elicited individual time trade-off (TTO) values in a general population sample with the social values derived using the UK EQ-5D index tariff. In the Stockholm County 1998 postal Public Health Survey (n=4950, 20-88 years), the EQ-5D self-classifier, a TTO and a rating scale (RS) question were included (n=2549 for all three questions). The mean TTO (EQ-5D) value was 0.943 (0.890) in the youngest age-group and 0.699 (0.733) in the oldest age-group. The difference between TTO and EQ-5D values was greater in more severe health status groups was. The same equation as for the UK EQ-5D index tariff was estimated for TTO and RS and resulted in significant and consistent coefficients for nearly all dimensions. The coefficients for moderate problems were closer to the EQ-5D index tariff than the coefficients for severe problems. Age was also significant after controlling for the EQ-5D dimensions (p<0.05). The results suggest that individual and social TTO values differ systematically and that the difference is greater the more severe the health status is. The social EQ-5D index tariff may also underestimate the severity in health status at older ages; age appears to correlate with additional health problems not captured by the EQ-5D classification.

Unrecognised bipolar disorder among UK primary care patients prescribed antidepressants: an observational study.

PubMed

Hughes, Tom; Cardno, Alastair; West, Robert; Marino-Francis, Federica; Featherstone, Imogen; Rolling, Keeley; Locker, Alice; McLintock, Kate; House, Allan

2016-02-01

Bipolar disorder is not uncommon, is associated with high disability and risk of suicide, often presents with depression, and can go unrecognised. To determine the prevalence of unrecognised bipolar disorder among those prescribed antidepressants for depressive or anxiety disorder in UK primary care; whether those with unrecognised bipolar disorder have more severe depression than those who do not; and the accuracy of a screening questionnaire for bipolar disorder, the Mood Disorder Questionnaire (MDQ), in this setting. Observational primary care study of patients on the lists of 21 general practices in West Yorkshire aged 16-40 years and prescribed antidepressant medication. Participants were recruited using primary care databases, interviewed using a diagnostic interview, and completed the screening questionnaire and rating scales of symptoms and quality of life. The prevalence of unrecognised bipolar disorder was 7.3%. Adjusting for differences between the sample and a national database gives a prevalence of 10.0%. Those with unrecognised bipolar disorder were younger and had greater lifetime depression. The predictive value of the MDQ was poor. Among people aged 16-40 years prescribed antidepressants in primary care for depression or anxiety, there is a substantial proportion with unrecognised bipolar disorder. When seeing patients with depression or anxiety disorder, particularly when they are young or not doing well, clinicians should review the life history for evidence of unrecognised bipolar disorder. Some clinicians might find the MDQ to be a useful supplement to non-standardised questioning. © British Journal of General Practice 2016.

The influence of zero-hours contracts on care worker well-being.

PubMed

Ravalier, J M; Fidalgo, A R; Morton, R; Russell, L

2017-07-01

Care workers have an important social role which is set to expand with the increasing age of the UK population. However, the majority of care workers are employed on zero-hours contracts. Firstly, to investigate the relationship between working conditions and employee outcomes such as engagement and general mental well-being in a sample of UK care workers and management. Secondly, to assess whether the use of zero-hours contracts affects employee well-being. A cross-sectional survey of domiciliary care and care home employees, undertaken using the Management Standards Indicator Tool (MSIT), Utrecht Work Engagement Scale (UWES) and General Health Questionnaire (GHQ). T-tests and multivariate linear regression evaluated the differences in scoring between those with differing contractual conditions and job roles, and associations of MSIT scores with UWES and GHQ factors. Employee understanding of their role and job control were found to be priority areas for improvement in the sample. Similarly, care workers reported greater occupational demands and lower levels of control than management. However, while zero-hours contracts did not significantly influence employee well-being, these employees had greater levels of engagement in their jobs. Despite this, a greater proportion of individuals with zero-hours contracts had scores above accepted mental health cut-offs. Individual understanding of their role as care workers appears to play an important part in determining engagement and general mental well-being. However, more research is needed on the influence of zero-hours contracts on well-being, particularly in groups with increased likelihood of developing mental health disorders. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Room for improvement? Leadership, innovation culture and uptake of quality improvement methods in general practice.

PubMed

Apekey, Tanefa A; McSorley, Gerry; Tilling, Michelle; Siriwardena, A Niroshan

2011-04-01

Leadership and innovation are currently seen as essential elements for the development and maintenance of high-quality care. Little is known about the relationship between leadership and culture of innovation and the extent to which quality improvement methods are used in general practice. This study aimed to assess the relationship between leadership behaviour, culture of innovation and adoption of quality improvement methods in general practice. Self-administered postal questionnaires were sent to general practitioner quality improvement leads in one county in the UK between June and December 2007. The questionnaire consisted of background information, a 12-item scale to assess leadership behaviour, a seven-dimension self-rating scale for culture of innovation and questions on current use of quality improvement tools and techniques. Sixty-three completed questionnaires (62%) were returned. Leadership behaviours were not commonly reported. Most practices reported a positive culture of innovation, featuring relationship most strongly, followed by targets and information but rated lower on other dimensions of rewards, risk and resources. There was a significant positive correlation between leadership behaviour and the culture of innovation (r = 0.57; P < 0.001). Apart from clinical audit and significant event analysis, quality improvement methods were not adopted by most participating practices. Leadership behaviours were infrequently reported and this was associated with a limited culture of innovation in participating general practices. There was little use of quality improvement methods beyond clinical and significant event audit. Practices need support to enhance leadership skills, encourage innovation and develop quality improvement skills if improvements in health care are to accelerate. © 2010 Blackwell Publishing Ltd.

Social preferences for health states associated with acute myeloid leukemia for patients undergoing treatment in the United Kingdom.

PubMed

Castejón, Nacho; Cappelleri, Joseph C; Cuervo, Jesús; Lang, Kathryn; Mehta, Priyanka; Mokgokong, Ruth; Mamolo, Carla

2018-04-18

Health state (HS) utility values for patients with acute myeloid leukemia (AML), a hematological malignancy, are not available in the United Kingdom (UK). This study aims to develop clinically sound HSs for previously untreated patients with AML and to assign utility values based on preferences of the general UK population. This study was conducted in the UK and comprised 2 stages. During the first stage, AML HSs were drafted based on evidence from a literature review of AML clinical and health-related quality-of-life studies (published January 2000-June 2016) and patient-reported outcome measures previously used in this population. A panel of UK hematologists with AML experience validated the clinical relevance and accuracy of the HSs. During the second stage, validated HSs were valued in an elicitation survey with a representative UK population sample using the time trade-off (TTO) method. Descriptive statistics and bivariate tests were obtained and performed. A total of eight HSs were developed and clinically validated, including treatment with chemotherapy, consolidation therapy, transplant, graft-vs-host disease (GvHD), remission, relapse, refractory, and functionally cured. In total, 125 adults participated (mean age, 49.6 years [range, 18-87 years], 52.8% female). Mean (95% confidence interval [CI]) TTO preference values (n = 120), ranked from lowest (worst HS) to highest (best HS) were as follows: refractory - 0.11 (- 0.21 to - 0.01), relapse 0.10 (0.00-0.20), transplant 0.28 (0.20-0.37), treatment with chemotherapy 0.36 (0.28-0.43), GvHD 0.43 (0.36-0.50), consolidation 0.46 (0.40-0.53), remission 0.62 (0.57-0.67), and functionally cured 0.76 (0.72-0.79). Mean (95% CI) visual analog scale preference values followed the same rank order, ranging from 0.15 (0.13-0.17) for refractory to 0.71 (0.68-0.73) for functionally cured. To our knowledge, this is the first study to report utility values for AML from the UK societal perspective. Participants were able to distinguish differences in severity among AML HSs, and preference values were consistent with clinical perception of HS severity. HS preference values observed in this study may be useful in future evaluations of treatment benefit, including cost-effectiveness analyses and improved patient well-being.

An exploration of differences between Japan and two European countries in the self-reporting and valuation of pain and discomfort on the EQ-5D.

PubMed

Feng, Yan; Herdman, Mike; van Nooten, Floortje; Cleeland, Charles; Parkin, David; Ikeda, Shunya; Igarashi, Ataru; Devlin, Nancy J

2017-08-01

To investigate the systematic differences in the self-reporting and valuation of overall health and, in particular, pain/discomfort between three countries (England/UK, Japan, and Spain) on the EQ-5D. Existing datasets were used to explore differences in responses on the EQ-5D descriptive system between Japan (3L and 5L), the UK (3L), England (5L), and Spain (5L), particularly on the dimension of pain/discomfort. The role of different EQ dimensions in determining self-reported overall health scores for the EuroQol visual analog scale (EQ-VAS) was investigated using ordinary least squares regression. Time trade-off (TTO) results from Japanese and UK respondents for the EQ-5D-3L as well as Japanese and English respondents for the EQ-5D-5L were compared using t tests. For the EQ-5D-3L, a higher percentage of respondents in Japan than in the UK reported 'no pain/discomfort' (81.6 vs 67.0%, respectively); for the EQ-5D-5L, the proportions were 79.2% in Spain, 73.2% in Japan, and 63-64% in England, after adjusting for age differences in samples. The 'pain/discomfort' dimension had the largest impact on respondents' self-reported EQ-VAS only for EQ-5D-3L in Japan. Using the EQ-5D-3L, Japanese respondents were considerably less willing to trade off time to avoid pain/discomfort than the UK respondents; for example, moving from health state, 11121 (some problems with pain/discomfort) to 11131 (extreme pain/discomfort) represented a decrement of 0.65 on the observed TTO value in the UK compared with 0.15 in Japan. Using the EQ-5D-5L, Japanese respondents were also less willing to trade off time to avoid pain/discomfort than respondents in England; however, the difference in values was much smaller than that observed using EQ-5D-3L data. This study provides evidence of between-country differences in the self-reporting and valuation of health, including pain/discomfort, when using EQ-5D in general population samples. The results suggest a need for caution when comparing or aggregating EQ-5D self-reported data in multi-country studies.

Factor structure of the Essen Climate Evaluation Schema measure of social climate in a UK medium-security setting.

PubMed

Milsom, Sophia A; Freestone, Mark; Duller, Rachel; Bouman, Marisa; Taylor, Celia

2014-04-01

Social climate has an influence on a number of treatment-related factors, including service users' behaviour, staff morale and treatment outcomes. Reliable assessment of social climate is, therefore, beneficial within forensic mental health settings. The Essen Climate Evaluation Schema (EssenCES) has been validated in forensic mental health services in the UK and Germany. Preliminary normative data have been produced for UK high-security national health services and German medium-security and high-security services. We aim to validate the use of the EssenCES scale (English version) and provide preliminary normative data in UK medium-security hospital settings. The EssenCES scale was completed in a medium-security mental health service as part of a service-wide audit. A total of 89 patients and 112 staff completed the EssenCES. The three-factor structure of the EssenCES and its internal construct validity were maintained within the sample. Scores from this medium-security hospital sample were significantly higher than those from earlier high-security hospital data, with three exceptions--'patient cohesion' according to the patients and 'therapeutic hold' according to staff and patients. Our data support the use of the EssenCES scale as a valid measure for assessing social climate within medium-security hospital settings. Significant differences between the means of high-security and medium-security service samples imply that degree of security is a relevant factor affecting the ward climate and that in monitoring quality of secure services, it is likely to be important to apply different scores to reflect standards. Copyright © 2013 John Wiley & Sons, Ltd.

Aviation’s Normal Operations Safety Audit: a safety management and educational tool for health care? Results of a small-scale trial

PubMed Central

Bennett, Simon A

2017-01-01

Background A National Health Service (NHS) contingent liability for medical error claims of over £26 billion. Objectives To evaluate the safety management and educational benefits of adapting aviation’s Normal Operations Safety Audit (NOSA) to health care. Methods In vivo research, a NOSA was performed by medical students at an English NHS Trust. After receiving training from the author, the students spent 6 days gathering data under his supervision. Results The data revealed a threat-rich environment, where errors – some consequential – were made (359 threats and 86 errors were recorded over 2 weeks). The students claimed that the exercise improved their observational, investigative, communication, teamworking and other nontechnical skills. Conclusion NOSA is potentially an effective safety management and educational tool for health care. It is suggested that 1) the UK General Medical Council mandates that all medical students perform a NOSA in fulfillment of their degree; 2) the participating NHS Trusts be encouraged to act on students’ findings; and 3) the UK Department of Health adopts NOSA as a cornerstone risk assessment and management tool. PMID:28860881

Increased level of linkage disequilibrium in rural compared with urban communities: a factor to consider in association-study design.

PubMed

Vitart, Veronique; Carothers, Andrew D; Hayward, Caroline; Teague, Peter; Hastie, Nicholas D; Campbell, Harry; Wright, Alan F

2005-05-01

Few studies have investigated genetic differentiation within nonisolate European populations, despite the initiation of large national sample collections such as U.K. Biobank. Here, we used short tandem repeat markers to explore fine-scale genetic structure and to examine the extent of linkage disequilibrium (LD) within national subpopulations. We studied 955 unrelated individuals of local ancestry from nine Scottish rural regions and the urban center of Edinburgh, as well as 96 unrelated individuals from the general U.K. population. Despite little overall differentiation on the basis of allele frequencies, there were clear differences among subpopulations in the extent of pairwise LD, measured between a subset of X-linked markers, that reflected presumed differences in the depths of the underlying genealogies within these subpopulations. Therefore, there are strategic advantages in studying rural subpopulations, in terms of increased power and reduced cost, that are lost by sampling across regions or within urban populations. Similar rural-urban contrasts are likely to exist in many other populations with stable rural subpopulations, which could influence the design of genetic association studies and national biobank data collections.

Identifying the most hazardous synoptic meteorological conditions for Winter UK PM10 exceedences

NASA Astrophysics Data System (ADS)

Webber, Chris; Dacre, Helen; Collins, Bill; Masato, Giacomo

2016-04-01

Summary We investigate the relationship between synoptic scale meteorological variability and local scale pollution concentrations within the UK. Synoptic conditions representative of atmospheric blocking highlighted significant increases in UK PM10 concentration ([PM10]), with the probability of exceeding harmful [PM10] limits also increased. Once relationships had been diagnosed, The Met Office Unified Model (UM) was used to replicate these relationships, using idealised source regions of PM10. This helped to determine the PM10 source regions most influential throughout UK PM10 exceedance events and to test whether the model was capable of capturing the relationships between UK PM10 and atmospheric blocking. Finally, a time slice simulation for 2050-2060 helped to answer the question whether PM10 exceedance events are more likely to occur within a changing climate. Introduction Atmospheric blocking events are well understood to lead to conditions, conducive to pollution events within the UK. Literature shows that synoptic conditions with the ability to deflect the Northwest Atlantic storm track from the UK, often lead to the highest UK pollution concentrations. Rossby wave breaking (RWB) has been identified as a mechanism, which results in atmospheric blocking and its relationship with UK [PM10] is explored using metrics designed in Masato, et al., 2013. Climate simulations facilitated by the Met Office UM, enable these relationships between RWB and PM10 to be found within the model. Subsequently the frequency of events that lead to hazardous PM10 concentrations ([PM10]) in a future climate, can be determined, within a climate simulation. An understanding of the impact, meteorology has on UK [PM10] within a changing climate, will help inform policy makers, regarding the importance of limiting PM10 emissions, ensuring safe air quality in the future. Methodology and Results Three Blocking metrics were used to subset RWB into four categories. These RWB categories were all shown to increase UK [PM10] and to increase the probability of exceeding a UK [PM10] threshold, when they occurred within constrained regions. Further analysis highlighted that Omega Block events lead to the greatest probability of exceeding hazardous UK [PM10] limits. These events facilitated the advection of European PM10, while also providing stagnant conditions over the UK, facilitating PM10 accumulation. The Met Office UM was used and nudged to ERA-Interim Reanalysis wind and temperature fields, to replicate the relationships found using observed UK [PM10]. Inert tracers were implemented into the model to replicate UK PM10 source regions throughout Europe. The modelled tracers were seen to correlate well with observed [PM10] and Figure 1 highlights the correlations between a RWB metric and observed (a) and modelled (b) [PM10]. A further free running model simulation highlighted the deficiency of the Met Office UM in capturing RWB frequency, with a reduction over the Northwest Atlantic/ European region. A final time slice simulation was undertaken for the period 2050-2060, using Representative Concentration Pathway 8.5, which attempted to determine the change in frequency of UK PM10 exceedance events, due to changing meteorology, in a future climate. Conclusions RWB has been shown to increase UK [PM10] and to lead to greater probabilities of exceeding a harmful [PM10] threshold. Omega block events have been determined the most hazardous RWB subset and this is due to a combination of European advection and UK stagnation. Simulations within the Met Office UM were undertaken and the relationships seen between observed UK [PM10] and RWB were replicated within the model, using inert tracers. Finally, time slice simulations were undertaken, determining the change in frequency of UK [PM10] exceedance events within a changing climate. References Masato, G., Hoskins, B. J., Woolings, T., 2013; Wave-breaking Characteristics of Northern Hemisphere Winter Blocking: A Two-Dimensional Approach. J. Climate, 26, 4535-4549.

UK Preparatory School Librarians' and Teachers' Design and Use of Reading Lists: A Qualitative Study of Approaches, Perceptions, and Content

ERIC Educational Resources Information Center

Scott, Rebecca; Inskip, Charles

2017-01-01

This paper reports the findings of a small-scale qualitative study that explored the perceptions of and approaches used by UK school librarians and teachers in the design and use of reading lists. The research question was: "What is the best way to construct reading lists to maximize their benefit in the school library or classroom?" The…

The Development of a Small-Scale Survey Instrument of UK Teachers to Study Professional Use (and Non-Use) of and Attitudes to Social Media

ERIC Educational Resources Information Center

Owen, Nathaniel; Fox, Alison; Bird, Terese

2016-01-01

This paper documents the creation, implementation and analysis of a survey instrument designed to reveal patterns of use and attitudes towards the value of social media by UK teachers. The study was motivated to discover which teachers use social media professionally, how they use it (both personally and professionally) and attitudes to social…

UK population norms for the modified dental anxiety scale with percentile calculator: adult dental health survey 2009 results

PubMed Central

2013-01-01

Background A recent UK population survey of oral health included questions to assess dental anxiety to provide mean and prevalence estimates of this important psychological construct. Methods A two-stage cluster sample was used for the survey across England, Wales, and Northern Ireland. The survey took place between October-December 2009, and January-April 2010. All interviewers were trained on survey procedures. Within the 7,233 households sampled there were 13,509 adults who were asked to participate in the survey and 11,382 participated (84%). Results The scale was reliable and showed some evidence of unidimensionality. Estimated proportion of participants with high dental anxiety (cut-off score = 19) was 11.6%. Percentiles and confidence intervals were presented and can be estimated for individual patients across various age ranges and gender using an on-line tool. Conclusions The largest reported data set on the MDAS from a representative UK sample was presented. The scale’s psychometrics is supportive for the routine assessment of patient dental anxiety to compare against a number of major demographic groups categorised by age and sex. Practitioners within the UK have a resource to estimate the rarity of a particular patient’s level of dental anxiety, with confidence intervals, when using the on-line percentile calculator. PMID:23799962

Assessing the effectiveness of scrub management at the landscape scale using rapid field assessment and remote sensing.

PubMed

Redhead, John; Cuevas-Gonzales, Maria; Smith, Geoffrey; Gerard, France; Pywell, Richard

2012-04-30

Controlling scrub encroachment is a major challenge for conservation management on chalk grasslands. However, direct comparisons of scrub removal methods have seldom been investigated, particularly at the landscape scale. Effective monitoring of grassland scrub is problematic as it requires simultaneous information on large scale patterns in scrub cover and fine-scale changes in the grassland community. This study addressed this by combining analysis of aerial imagery with rapid field surveys in order to compare the effectiveness of four scrub management strategies on Defence Training Estate Salisbury Plain, UK. Study plots were sited within areas undergoing management and in unmanaged controls. Controls showed dramatic increases in scrub cover, with encroachment of a mean 1096 m(2) per hectare over ten years. Whilst all management strategies were effective in reducing scrub encroachment, they differed in their ability to influence regeneration of scrub and grassland quality. There was a general trend, evident in both the floral community and scrub levels, of increased effectiveness with increasing management intensity. The dual methodology proved highly effective, allowing rapid collection of data over a range of variables and spatial scales unavailable to each method individually. The methodology thus demonstrates potential for a useful monitoring tool. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

Maitland, R.P.; Senior, D.

The Office for Nuclear Regulation (ONR) is an independent safety, security and transport regulator of the UK nuclear industry. ONR regulates all civil nuclear reactor power stations, fuel manufacture, enrichment, spent fuel reprocessing, most defence sites and installations that store and process legacy spent fuel and radioactive waste. The responsibility for funding and strategic direction of decommissioning and radioactive waste management of state owned legacy sites has rested solely with the Nuclear Decommissioning Authority (NDA) since 2005. A key component of NDA's mandate was to encourage new strategic approaches and innovation to dealing with the UK's waste legacy and whichmore » deliver value-for-money to the UK taxpayer. ONR, as an agency of the Health and Safety Executive, is entirely independent of NDA and regulates all prescribed activities on NDA's sites. NDA's competition of site management and closure contracts has attracted significant international interest and the formation of consortia comprised of major British, US, French and Swedish organizations bidding for those contracts. The prominence of US organizations in each of those consortia reflects the scale and breadth of existing waste management and D and D projects in the US. This paper will articulate, in broad terms, the challenges faced by international organizations seeking to employ 'off-the-shelf' technology and D and D techniques, successfully employed elsewhere, into the UK regulatory context. The predominantly 'goal-setting' regulatory framework in the UK does not generally prescribe a minimum standard to which a licensee must adhere. The legal onus on licensees in the UK is to demonstrate, whatever technology is selected, that in its applications, risks are reduced 'So Far As Is Reasonably Practicable' or 'SFAIRP'. By the nature of its role, ONR adopts a conservative approach to regulation; however ONR also recognises that in the decommissioning (and ultimately the site closure) domain, it is often necessary to consider and support novel approaches to achieve the nationally desired end-state. Crucial to successful and compliant operation in this regulatory environment is early and sustained engagement of the contractor with the regulator. There must be a 'no-surprises' culture to engender regulatory confidence early in a project. The paper considers some of the challenges facing international prime and lower tier contractors when undertaking D and D contracts in the UK, and emphasizes the importance of constructive and transparent dialogue with all regulators to sustain confidence at all stages of a major decommissioning project. The paper will also articulate ONR's strategy to increase collaboration with the US Department of Energy in light of increasing UK-US synergy in the area of waste management and to benchmark respective regulatory approaches. (authors)« less

Applying animal-based welfare assessments on New Zealand dairy farms: feasibility and a comparison with United Kingdom data.

PubMed

Laven, R A; Fabian, J

2016-07-01

To assess the feasibility of applying animal-based welfare assessments developed for use in Europe on New Zealand dairy farms; in particular, to identify measures which could be evaluated during a single visit at milking time alongside whole herd locomotion scoring. A protocol for animal welfare assessment, developed in the United Kingdom (UK), was evaluated. Measures that were suitable for use on pasture-based dairy farms in New Zealand were then assessed for practicability on 59 farms across New Zealand, during and immediately after milking, alongside whole herd locomotion scoring. Where data were collected the results were compared to those from a UK study of 53 dairy farms. Thirteen observations of the physical condition of cows were considered suitable for measurement, excluding observations related to hock lesions as they are rarely observed on pasture-based farms. Five of these measures were not assessed as there was not time to do so during milking alongside whole herd locomotion scoring. Thus, the prevalence of dirty flanks, hind limbs and udders, dull coat, thick hairy coat, significant hair loss, very fat cows (body condition score (BCS) ≥7 on 1-10 scale) and very thin cows (BCS≤3), were recorded. Three measures of behaviour were considered suitable for measurement on-farm, but only locomotion score was practicable and was measured. Farmer-estimates for the incidence of mastitis, lameness, sudden death, milk fever and other diseases were also obtained.Overall, dirty flanks, dirty udders and estimated milk fever incidence were more prevalent in this study than in the UK. The prevalence of thin and fat cows, lame cows and estimated mastitis incidence were much lower in the present study than on UK farms. Animal-based assessments can be used on dairy farms in New Zealand, but need to be modified from those developed for housed cows.Welfare on these farms was generally good compared to those in the UK, but these results need to be confirmed on more farms using a wider range of assessments than proved practicable in this study.

Scale-dependent spatial variability in peatland lead pollution in the southern Pennines, UK.

PubMed

Rothwell, James J; Evans, Martin G; Lindsay, John B; Allott, Timothy E H

2007-01-01

Increasingly, within-site and regional comparisons of peatland lead pollution have been undertaken using the inventory approach. The peatlands of the Peak District, southern Pennines, UK, have received significant atmospheric inputs of lead over the last few hundred years. A multi-core study at three peatland sites in the Peak District demonstrates significant within-site spatial variability in industrial lead pollution. Stochastic simulations reveal that 15 peat cores are required to calculate reliable lead inventories at the within-site and within-region scale for this highly polluted area of the southern Pennines. Within-site variability in lead pollution is dominant at the within-region scale. The study demonstrates that significant errors may be associated with peatland lead inventories at sites where only a single peat core has been used to calculate an inventory. Meaningful comparisons of lead inventories at the regional or global scale can only be made if the within-site variability of lead pollution has been quantified reliably.

Persistent Gender Inequities in Mathematics Achievement and Expectations in Australia, Canada and the UK

ERIC Educational Resources Information Center

Forgasz, Helen J.; Leder, Gilah C.

2017-01-01

We report the general public's perceptions and those of 15-year-old school students, about aspects of mathematics learning. For the adult sample, survey data were gathered from pedestrians and Facebook users in Australia, Canada and the UK-countries in which English is the dominant language spoken. Participants responded to items about the…

Informing the Public? UK Newspaper Reporting of Autism and Asperger's Syndrome

ERIC Educational Resources Information Center

Robertson, John W.

2009-01-01

An extensive survey of five leading UK newspapers reveals wide-ranging variation in coverage, from a tendency to rely on medical establishment sources in some to an apparently pro-choice, anti-establishment campaign in others but, generally, a neglect of the perspective of articulate autistics themselves. Based on an enhanced content analysis of…

Organizational and Pedagogical Fundamentals of Professional Training of Engineers in the Field of Nanoelectronics in UK Universities

ERIC Educational Resources Information Center

Mykhailiuk, Maryna

2014-01-01

The article deals with the organizational and pedagogical principles of the professional training of future nanoelectronics engineers in UK universities. There has been substantiated a number of general didactic and specific principles of the professional training of future nanoelectronics engineers, which facilitate the concretization of content,…

A Direct Comparison of Two Densely Sampled HIV Epidemics: The UK and Switzerland

NASA Astrophysics Data System (ADS)

Ragonnet-Cronin, Manon L.; Shilaih, Mohaned; Günthard, Huldrych F.; Hodcroft, Emma B.; Böni, Jürg; Fearnhill, Esther; Dunn, David; Yerly, Sabine; Klimkait, Thomas; Aubert, Vincent; Yang, Wan-Lin; Brown, Alison E.; Lycett, Samantha J.; Kouyos, Roger; Brown, Andrew J. Leigh

2016-09-01

Phylogenetic clustering approaches can elucidate HIV transmission dynamics. Comparisons across countries are essential for evaluating public health policies. Here, we used a standardised approach to compare the UK HIV Drug Resistance Database and the Swiss HIV Cohort Study while maintaining data-protection requirements. Clusters were identified in subtype A1, B and C pol phylogenies. We generated degree distributions for each risk group and compared distributions between countries using Kolmogorov-Smirnov (KS) tests, Degree Distribution Quantification and Comparison (DDQC) and bootstrapping. We used logistic regression to predict cluster membership based on country, sampling date, risk group, ethnicity and sex. We analysed >8,000 Swiss and >30,000 UK subtype B sequences. At 4.5% genetic distance, the UK was more clustered and MSM and heterosexual degree distributions differed significantly by the KS test. The KS test is sensitive to variation in network scale, and jackknifing the UK MSM dataset to the size of the Swiss dataset removed the difference. Only heterosexuals varied based on the DDQC, due to UK male heterosexuals who clustered exclusively with MSM. Their removal eliminated this difference. In conclusion, the UK and Swiss HIV epidemics have similar underlying dynamics and observed differences in clustering are mainly due to different population sizes.

Post-marketing studies: the work of the Drug Safety Research Unit.

PubMed

Mackay, F J

1998-11-01

The Drug Safety Research Unit (DSRU) is the centre for prescription-event monitoring (PEM) in England. PEM studies are noninterventional observational cohort studies which monitor the safety of newly marketed drugs. The need for post-marketing surveillance is well recognised in the UK and general practice is an ideal source of data. PEM studies are general practitioner (community)-based and exposure is based on dispensed prescription data in England. To date, 65 PEM studies have been completed with a mean cohort size of 10 979 patients and the DSRU database has clinical information on over 700000 patients prescribed new drugs. Unlike spontaneous reporting schemes, PEM produces incidence rates for events reported during treatment. Comparative studies can be conducted for drugs in the same class. The DSRU aggregates outcome data for pregnancies exposed to new drugs. Data for children and the elderly can also be specifically examined. PEM data have a number of advantages over data from computerised general practice databases in the UK. PEM is the only technique within the UK capable of monitoring newly marketed drugs in such a comprehensive and systematic way.

Predicting the 10-year risk of hip and major osteoporotic fracture in rheumatoid arthritis and in the general population: an independent validation and update of UK FRAX without bone mineral density.

PubMed

Klop, Corinne; de Vries, Frank; Bijlsma, Johannes W J; Leufkens, Hubert G M; Welsing, Paco M J

2016-12-01

FRAX incorporates rheumatoid arthritis (RA) as a dichotomous predictor for predicting the 10-year risk of hip and major osteoporotic fracture (MOF). However, fracture risk may deviate with disease severity, duration or treatment. Aims were to validate, and if needed to update, UK FRAX for patients with RA and to compare predictive performance with the general population (GP). Cohort study within UK Clinical Practice Research Datalink (CPRD) (RA: n=11 582, GP: n=38 755), also linked to hospital admissions for hip fracture (CPRD-Hospital Episode Statistics, HES) (RA: n=7221, GP: n=24 227). Predictive performance of UK FRAX without bone mineral density was assessed by discrimination and calibration. Updating methods included recalibration and extension. Differences in predictive performance were assessed by the C-statistic and Net Reclassification Improvement (NRI) using the UK National Osteoporosis Guideline Group intervention thresholds. UK FRAX significantly overestimated fracture risk in patients with RA, both for MOF (mean predicted vs observed 10-year risk: 13.3% vs 8.4%) and hip fracture (CPRD: 5.5% vs 3.1%, CPRD-HES: 5.5% vs 4.1%). Calibration was good for hip fracture in the GP (CPRD-HES: 2.7% vs 2.4%). Discrimination was good for hip fracture (RA: 0.78, GP: 0.83) and moderate for MOF (RA: 0.69, GP: 0.71). Extension of the recalibrated UK FRAX using CPRD-HES with duration of RA disease, glucocorticoids (>7.5 mg/day) and secondary osteoporosis did not improve the NRI (0.01, 95% CI -0.04 to 0.05) or C-statistic (0.78). UK FRAX overestimated fracture risk in RA, but performed well for hip fracture in the GP after linkage to hospitalisations. Extension of the recalibrated UK FRAX did not improve predictive performance. 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/.

Dental consultations in UK general practice and antibiotic prescribing rates: a retrospective cohort study.

PubMed

Cope, Anwen L; Chestnutt, Ivor G; Wood, Fiona; Francis, Nick A

2016-05-01

The frequency of consulting for dental problems in general medical practice, and antibiotic prescribing associated with these consultations, is poorly described. To describe consultation rates and antibiotic use for dental problems in UK general medical practice, and explore factors associated with antibiotic prescribing for dental conditions. A retrospective cohort study using Clinical Practice Research Datalink, a database of general practice patient records in the UK. All dental consultations between 2004 and 2013 were identified. The main outcome was the prescription of an antibiotic during a dental consultation. Multilevel logistic regression was conducted to examine factors associated with antibiotic prescription. In all, 288 169 dental consultations were included in the cohort. The average rate of dental consultations was 6.06 consultations per 1000 patient-years. Rates of dental consultation decreased from 6.84 consultations per 1000 patient-years in 2008, to 4.23 consultations per 1000 patient-years in 2013. Consultation rates were higher among females than males and highest in patients aged 20-29 years. An antibiotic was prescribed in 57.1% of consultations. Significant predictors (P<0.001) of antibiotic prescribing included: patient middle age, male sex, and previous consultations for tooth-related problems. Antibiotics were more likely to be prescribed during consultations in December (odds ratio [OR] 1.18, 95% confidence interval [CI] = 1.13 to 1.24, P<0.001, reference month: June) and on a Monday (OR 1.10, 95% CI = 1.07 to 1.13, P<0.001) or a Friday (OR 1.15, 95% CI = 1.12 to 1.18, P<0.001, reference day: Wednesday). Consultation rates for dental problems in UK general practice are relatively low but more than half result in the prescription of an antibiotic. This raises concerns about patient morbidity and contributions to antimicrobial resistance. © British Journal of General Practice 2016.

International educational partnerships for doctors in training: a collaborative framework with the RCP.

PubMed

Thomson, George A; Foster, Matthew; Sheriff, Rezvi; Mendis, Lalitha; Fernando, Devaka J S; Blundell, Caroline; Worrall, Jeffrey; Black, Carol

2005-01-01

The UK offers excellent postgraduate medical education, and overseas doctors in training often covet a period of training in the UK. Some overseas training authorities make UK training mandatory prior to appointment as a consultant. Unfortunately, the organisation of such training often proves to be ad hoc, and may lack educational value. UK training faces challenges as a result of reduced hours of work, more structured and intensive educational needs, and pressures of increasing clinical demand. A plethora of new 'trust' posts have developed, often with limited educational value, creating a risk that training quality for overseas doctors is reduced. Against this background, such posts can be used to create international training partnerships such as that at Sherwood Forest Hospitals NHS Trust (SFHT), providing high-quality general and specialty training. Given the success of this strategy, it would be desirable for other UK trusts to provide similar schemes offering specialties not covered at SFHT.

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.

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.

Ethnic variations in incidence of asthma episodes in England & Wales: national study of 502,482 patients in primary care.

PubMed

Netuveli, Gopalakrishnan; Hurwitz, Brian; Sheikh, Aziz

2005-10-21

Recent studies have demonstrated marked international variations in the prevalence of asthma, but less is known about ethnic variations in asthma epidemiology within individual countries and in particular the impact of migration on risk of developing asthma. Recent within country comparisons have however revealed that despite originating from areas of the world with a low risk for developing asthma, South Asian and Afro-Caribbean people in the UK are significantly (3x and 2x respectively) more likely to be admitted to hospital for asthma related problems than Whites. Using data from the Fourth National Study of Morbidity Statistics in General Practice, a one-percent broadly representative prospective cohort study of consultations in general practice, we investigated ethnic variations in incident asthma consultations (defined as new or first consultations), and compared consultation rates between those born inside and outside the UK (migrant status). Logistic regression models were used to examine the combined effects of ethnicity and migration on asthma incident consultations. Results showed significantly lower new/first asthma consultation rates for Whites than for each of the ethnic minority groups studied (mean age-adjusted consultation rates per 1000 patient-years: Whites 26.4 (95%CI 26.4, 26.4); South Asians 30.4 (95%CI 30.3, 30.5); Afro-Caribbeans 35.1 (95%CI 34.9, 35.3); and Others 27.8 (27.7, 28.0). Within each of these ethnic groups, those born outside of the UK showed consistently lower rates of incident asthma consultations. Modelling the combined effects of ethnic and migrant status revealed that UK-born South Asians and Afro-Caribbeans experienced comparable risks for incident GP consultations for asthma to UK-born Whites. Non-UK born Whites however experienced reduced risks (adjusted OR 0.82, 95%CI 0.69, 0.97) whilst non-UK born South Asians experienced increased risks (adjusted OR 1.33, 95%CI 1.04, 1.70) compared to UK-born Whites. These findings strongly suggest that ethnicity and migration have significant and independent effects on asthma incidence. The known poorer asthma outcomes in UK South Asians and Afro-Caribbeans may in part be explained by the offspring of migrants experiencing an increased risk of developing asthma when compared to UK-born Whites. This is the first study to find heterogeneity for incident asthma consultations in Whites by migrant status.

Influences on students’ career decisions concerning general practice: a focus group study

PubMed Central

Nicholson, Sandra; Hastings, Adrian Michael; McKinley, Robert Kee

2016-01-01

Background Despite concerns about recruitment to UK general practice, there has been no concerted educational intervention to address them. Aim To better understand how medical students’ perceptions of their experiences of their undergraduate curriculum may affect choosing general practice as a career. Design and setting Qualitative study comprising focus groups of a total of 58 students from a range of medical schools across the UK. Method A range of UK medical schools students were invited by email to participate in focus groups and return a questionnaire detailing their current career choice to facilitate sampling students with varied career preferences. Students late in their studies were sampled as they were likely to be considering future careers. Focus group discussions were audiotaped, transcribed, and anonymised for both school and participant, then thematically analysed. Perceived differences in medical school culture, curriculum philosophy, design, and intent were explored. Results Six focus groups (58 students) were convened. Some student participants’ career aspirations were strongly shaped by family and home, but clinical placements remained important in confirming or refuting these choices. High-quality general practice attachments are a powerful attractor to general practice and, when they reflect authentic clinical practice, promote general practice careers. GP tutors can be powerful, positive role models. Students’ comments revealed conflicting understandings about general practice. Conclusion Attracting rather than coercing students to general practice is likely to be more effective at changing their career choices. Early, high-quality, ongoing and, authentic clinical exposure promotes general practice and combats negative stereotyping. It is recommended that increasing opportunities to help students understand what it means to be a ‘good GP’ and how this can be achieved are created. PMID:27578812

Dataset of the livability performance of the city of Birmingham, UK, as measured by its citizen wellbeing, resource security, resource efficiency and carbon emissions.

PubMed

Leach, Joanne M; Lee, Susan E; Boyko, Christopher T; Coulton, Claire J; Cooper, Rachel; Smith, Nicholas; Joffe, Hélène; Büchs, Milena; Hale, James D; Sadler, Jonathan P; Braithwaite, Peter A; Blunden, Luke S; De Laurentiis, Valeria; Hunt, Dexter V L; Bahaj, AbuBakr S; Barnes, Katie; Bouch, Christopher J; Bourikas, Leonidas; Cavada, Marianna; Chilvers, Andrew; Clune, Stephen J; Collins, Brian; Cosgrave, Ellie; Dunn, Nick; Falkingham, Jane; James, Patrick; Kwami, Corina; Locret-Collet, Martin; Medda, Francesca; Ortegon, Adriana; Pollastri, Serena; Popan, Cosmin; Psarikidou, Katerina; Tyler, Nick; Urry, John; Wu, Yue; Zeeb, Victoria; Rogers, Chris D F

2017-12-01

This data article presents the UK City LIFE 1 data set for the city of Birmingham, UK. UK City LIFE 1 is a new, comprehensive and holistic method for measuring the livable sustainability performance of UK cities. The Birmingham data set comprises 346 indicators structured simultaneously (1) within a four-tier, outcome-based framework in order to aid in their interpretation (e.g., promote healthy living and healthy long lives, minimize energy use, uncouple economic vitality from CO2 emissions) and (2) thematically in order to complement government and disciplinary siloes (e.g., health, energy, economy, climate change). Birmingham data for the indicators are presented within an Excel spreadsheet with their type, units, geographic area, year, source, link to secondary data files, data collection method, data availability and any relevant calculations and notes. This paper provides a detailed description of UK city LIFE 1 in order to enable comparable data sets to be produced for other UK cities. The Birmingham data set is made publically available at http://epapers.bham.ac.uk/3040/ to facilitate this and to enable further analyses. The UK City LIFE 1 Birmingham data set has been used to understand what is known and what is not known about the livable sustainability performance of the city and to inform how Birmingham City Council can take action now to improve its understanding and its performance into the future (see "Improving city-scale measures of livable sustainability: A study of urban measurement and assessment through application to the city of Birmingham, UK" Leach et al. [2]).

SSTL UK-DMC SLIM-6 data quality assessment

USGS Publications Warehouse

Chander, G.; Saunier, S.; Choate, M.J.; Scaramuzza, P.L.

2009-01-01

Satellite data from the Surrey Satellite Technology Limited (SSTL) United Kingdom (UK) Disaster Monitoring Constellation (DMC) were assessed for geometric and radiometric quality. The UK-DMC Surrey Linear Imager 6 (SLIM-6) sensor has a 32-m spatial resolution and a ground swath width of 640 km. The UK-DMC SLIM-6 design consists of a three-band imager with green, red, and near-infrared bands that are set to similar bandpass as Landsat bands 2, 3, and 4. The UK-DMC data consisted of imagery registered to Landsat orthorectified imagery produced from the GeoCover program. Relief displacements within the UK-DMC SLIM-6 imagery were accounted for by using global 1-km digital elevation models available through the Global Land One-km Base Elevation (GLOBE) Project. Positional accuracy and relative band-to-band accuracy were measured. Positional accuracy of the UK-DMC SLIM-6 imagery was assessed by measuring the imagery against digital orthophoto quadrangles (DOQs), which are designed to meet national map accuracy standards at 1 : 24 000 scales; this corresponds to a horizontal root-mean-square accuracy of about 6 m. The UK-DMC SLIM-6 images were typically registered to within 1.0-1.5 pixels to the DOQ mosaic images. Several radiometric artifacts like striping, coherent noise, and flat detector were discovered and studied. Indications are that the SSTL UK-DMC SLIM-6 data have few artifacts and calibration challenges, and these can be adjusted or corrected via calibration and processing algorithms. The cross-calibration of the UK-DMC SLIM-6 and Landsat 7 Enhanced Thematic Mapper Plus was performed using image statistics derived from large common areas observed by the two sensors.

Open Science Strategies in Research Policies: A Comparative Exploration of Canada, the US and the UK

ERIC Educational Resources Information Center

Lasthiotakis, Helen; Kretz, Andrew; Sá, Creso

2015-01-01

Several movements have emerged related to the general idea of promoting "openness" in science. Research councils are key institutions in bringing about changes proposed by these movements, as sponsors and facilitators of research. In this paper we identify the approaches used in Canada, the US and the UK to advance open science, as a…

Teaching the Personal Science: From Impeccable Trivia to the Blooming Buzzing Confusion

ERIC Educational Resources Information Center

Banyard, Philip

2010-01-01

The argument presented here is that the teaching of psychology in the UK is focused on the learning of technical skills and is missing the opportunity to enthuse and inspire students in the personal science. This focus mirrors a general educational drive in the UK towards achievement at external examinations which are assessed by narrow cognitive…

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…

Statistical Literacy in Public Debate--Examples from the UK 2015 General Election

ERIC Educational Resources Information Center

Arnold, Phoebe

2017-01-01

Full Fact is an independent, non-partisan fact-checking charity. A particular focus is the analysis of factual claims in political debate in the UK; for example, fact-checking claims and counterclaims made during Prime Minister's questions. Facts do not appear in a vacuum as they are often used as key elements in an effort to make a coherent…

Investigating the Impact of the Tier 4 Policy on International Students at Private Colleges in the UK

ERIC Educational Resources Information Center

Mughal, Abdul Waheed

2016-01-01

In 2009, the United Kingdom government introduced the Tier 4 (general) student visa policy for foreign students, out of European Economic Area and Switzerland, aged 16 or over. According to this policy, any institution recruiting international students must be a highly trusted sponsor--a status determined by the UK Border Agency. Further, right to…

The End of the Botany Degree in the UK

ERIC Educational Resources Information Center

Drea, Sinead

2011-01-01

The last student enrolled in a pure "Botany" degree in the UK began in the University of Bristol this year, 2010. In recent years only the University of Reading also offered the Botany degree, before it was dropped there 3 years ago. This short article is written to draw attention to this fact and to a more general relative decline in…

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…

Psychology of Education in the UK: Development in the 1960s

ERIC Educational Resources Information Center

Thomas, J. B.

2007-01-01

This paper attempts an account and evaluation of the historical development of psychology of education in the 1960s in the UK. It contributes to both the history of the academic discipline of educational studies and to the history of higher education. Progress of the subject is introduced in the general context of university developments and the…

National Service Frameworks and UK general practitioners: street-level bureaucrats at work?

PubMed

Checkland, Kath

2004-11-01

This paper argues that the past decade has seen significant changes in the nature of medical work in general practice in the UK. Increasing pressure to use normative clinical guidelines and the move towards explicit quantitative measures of performance together have the potential to alter the way in which health care is delivered to patients. Whilst it is possible to view these developments from the well-established sociological perspectives of deprofessionalisation and proletarianisation, this paper takes a view of general practice as work, and uses the ideas of Lipsky to analyse practice-level responses to some of these changes. In addition to evidence-based clinical guidelines, National Service Frameworks, introduced by the UK government in 1997, also specify detailed models of service provision that health care providers are expected to follow. As part of a larger study examining the impact of National Service Frameworks in general practice, the response of three practices to the first four NSFs were explored. The failure of NSFs to make a significant impact is compared to the practices' positive responses to purely clinical guidelines such as those developed by the British Hypertension Society. Lipsky's concept of public service workers as 'street-level bureaucrats' is discussed and used as a framework within which to view these findings.

United Kingdom to Join ESO on July 1, 2002

NASA Astrophysics Data System (ADS)

2001-12-01

ESO and PPARC Councils Endorse Terms of Accession [1] The Councils of the European Southern Observatory (ESO) and the UK Particle Physics and Astronomy Research Council (PPARC) , at their respective meetings on December 3 and 5, 2001, have endorsed the terms for UK membership of ESO, as recently agreed by their Negotiating Teams. All members of the Councils - the governing bodies of the two organisations - welcomed the positive spirit in which the extensive negotiations had been conducted and expressed great satisfaction at the successful outcome of a complex process. The formal procedure of accession will now commence in the UK and is expected to be achieved in good time to allow accession from July 2002. The European Southern Observatory is the main European organisation for astronomy and the United Kingdom will become its tenth member state [2]. ESO operates two major observatories in the Chilean Atacama desert where the conditions for astronomical observations are second-to-none on earth and it has recently put into operation the world's foremost optical/infrared telescope, the Very Large Telescope (VLT) at Paranal. With UK membership, British astronomers will join their European colleagues in preparing new projects now being planned on a global scale. They will also be able to pursue their research on some of the most powerful astronomical instruments available. The ESO Director General, Dr. Catherine Cesarsky , is "delighted that we have come this far after the lengthy negotiations needed to prepare properly the admission of another major European country to our organisation. When ESO was created nearly 40 years ago, the UK was planning for its own facilities in the southern hemisphere, in collaboration with Australia, and decided not to join. However, the impressive scientific and technological advances since then and ESOs emergence as a prime player on the European research scene have convinced our UK colleagues of the great advantages of presenting a united European face in astronomy through ESO". The President of the ESO Council, Dr. Arno Freytag , shares this opinion fully. "This is a most important step in the continuing process of European integration. The entry of the UK will of course be very useful to the scientists in that country, but I have no doubt that the benefits will be mutual. With its world-level astronomical and engineering expertise and with one of the most active research communities in Europe, the UK will bring significant intellectual, technical and financial resources to strengthen ESO. I have no doubt that the impressive research that is now being carried out by numerous astronomers with the ESO facilities has been our best advertisement and I am sure that this has had an important effect on the very welcome decision by the UK to join ESO." The UK will pay the usual annual contribution to ESO from the date of its entry. It has also been decided that as an important part of the special contribution to be made on entry, the UK will deliver the VISTA infrared survey telescope to ESO as an in-kind contribution. This wide-field telescope facility is now being constructed in the UK for a consortium of universities and it was decided already last year to place it at Paranal, cf. ESO PR 03/00. It will now become a fully integrated part of the ESO Paranal Observatory providing important survey observations in support of the VLT. Ian Halliday , Chief Executive of PPARC, is "delighted that the negotiations with ESO and subsequent Council meetings have passed this critical decision point. We now expect a straightforward parliamentary process to ratify the intergovernmental treaty. This decision will allow UK astronomers to have access to the world-class VLT telescopes at Paranal. Just as importantly UK Astronomy will have a sound basis for the future ALMA and OWL projects in a European context. This is a major increase in investment in, and capability for, UK Astronomy." Notes [1]: Both ESO and PPARC issue co-ordinated Press Releases about the UK accession today. The PPARC release is available at URL: http://www.pparc.ac.uk/NW/ESOstars.asp [2]: ESO's current member state are Belgium, Denmark, France, Germany, Italy, the Netherlands, Portugal, Sweden and Switzerland.

Feasibility of using routinely collected inpatient data to monitor quality and inform choice: a case study using the UK inflammatory bowel disease audit

PubMed Central

Roberts, Stephen E; Williams, John G; Cohen, David R; Akbari, Ashley; Groves, Sam; Button, Lori A

2011-01-01

Objective To assess the utility and cost of using routinely collected inpatient data for large-scale audit. Design Comparison of audit data items collected nationally in a designed audit of inflammatory bowel disease (UK IBD audit) with routinely collected inpatient data; surveys of audit sites to compare costs. Setting National Health Service hospitals across England, Wales and Northern Ireland that participated in the UK IBD audit. Patients Patients in the UK IBD audit. Interventions None. Main outcome measures Percentage agreement between designed audit data items collected for the UK IBD audit and routine inpatient data items; costs of conducting the designed UK IBD audit and the routine data audit. Results There were very high matching rates between the designed audit data and routine data for a small subset of basic important information collected in the UK IBD audit, including mortality; major surgery; dates of admission, surgery, discharge and death; principal diagnoses; and sociodemographic patient characteristics. There were lower matching rates for other items, including source of admission, primary reason for admission, most comorbidities, colonoscopy and sigmoidoscopy. Routine data did not cover most detailed information collected in the UK IBD audit. Using routine data was much less costly than collecting designed audit data. Conclusion Although valuable for large population-based studies, and less costly than designed data, routine inpatient data are not suitable for the evaluation of individual patient care within a designed audit. PMID:28839601

The impact of synoptic weather on UK surface ozone and implications for premature mortality

NASA Astrophysics Data System (ADS)

Pope, R. J.; Butt, E. W.; Chipperfield, M. P.; Doherty, R. M.; Fenech, S.; Schmidt, A.; Arnold, S. R.; Savage, N. H.

2016-12-01

Air pollutants, such as ozone, have adverse impacts on human health and cause, for example, respiratory and cardiovascular problems. In the United Kingdom (UK), peak surface ozone concentrations typically occur in the spring and summer and are controlled by emission of precursor gases, tropospheric chemistry and local meteorology which can be influenced by large-scale synoptic weather regimes. In this study we composite surface and satellite observations of summer-time (April to September) ozone under different UK atmospheric circulation patterns, as defined by the Lamb weather types. Anticyclonic conditions and easterly flows are shown to significantly enhance ozone concentrations over the UK relative to summer-time average values. Anticyclonic stability and light winds aid the trapping of ozone and its precursor gases near the surface. Easterly flows (NE, E, SE) transport ozone and precursor gases from polluted regions in continental Europe (e.g. the Benelux region) to the UK. Cyclonic conditions and westerly flows, associated with unstable weather, transport ozone from the UK mainland, replacing it with clean maritime (North Atlantic) air masses. Increased cloud cover also likely decrease ozone production rates. We show that the UK Met Office regional air quality model successfully reproduces UK summer-time ozone concentrations and ozone enhancements under anticyclonic and south-easterly conditions for the summer of 2006. By using established ozone exposure-health burden metrics, anticyclonic and easterly condition enhanced surface ozone concentrations pose the greatest public health risk.

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.

Cause-specific mortality in professional flight crew and air traffic control officers: findings from two UK population-based cohorts of over 20,000 subjects.

PubMed

De Stavola, Bianca L; Pizzi, Costanza; Clemens, Felicity; Evans, Sally Ann; Evans, Anthony D; dos Santos Silva, Isabel

2012-04-01

Flight crew are exposed to several potential occupational hazards. This study compares mortality rates in UK flight crew to those in air traffic control officers (ATCOs) and the general population. A total of 19,489 flight crew and ATCOs were identified from the UK Civil Aviation Authority medical records and followed to the end of 2006. Consented access to medical records and questionnaire data provided information on demographic, behavioral, clinical, and occupational variables. Standardized mortality ratios (SMR) were estimated for these two occupational groups using the UK general population. Adjusted mortality hazard ratios (HR) for flight crew versus ATCOs were estimated via Cox regression models. A total of 577 deaths occurred during follow-up. Relative to the general population, both flight crew (SMR 0.32; 95% CI 0.30, 0.35) and ATCOs (0.39; 0.32, 0.47) had lower all-cause mortality, mainly due to marked reductions in mortality from neoplasms and cardiovascular diseases, although flight crew had higher mortality from aircraft accidents (SMR 42.8; 27.9, 65.6). There were no differences in all-cause mortality (HR 0.99; 95% CI 0.79, 1.25), or in mortality from any major cause, between the two occupational groups after adjustment for health-related variables, again except for those from aircraft accidents. The latter ratios, however, declined with increasing number of hours. The low all-cause mortality observed in both occupational groups relative to the general population is consistent with a strong "healthy worker effect" and their low prevalence of smoking and other risk factors. Mortality among flight crew did not appear to be influenced by occupational exposures, except for a rise in mortality from aircraft accidents.

Hirsch Index Value and Variability Related to General Surgery in a UK Deanery.

PubMed

Abdelrahman, Tarig; Brown, Josephine; Wheat, Jenny; Thomas, Charlotte; Lewis, Wyn

2016-01-01

The Hirsch Index (h-index) is often used to assess research impact, and on average a social science senior lecturer will have an h-index of 2.29, yet its validity within the context of UK General Surgery (GS) is unknown. The aim of this study was to calculate the h-indices of a cohort of GS consultants in a UK Deanery to assess its relative validity. Individual h-indices and total publication (TP) counts were obtained for GS consultants via the Scopus and Web of Science (WoS) Internet search engines. Assessment of construct validity and reliability of these 2 measures of the h-index was undertaken. All hospitals in a single UK National Health Service Deanery were included (14 general hospitals). All 136 GS consultants from the Deanery were included. Median h-index (Scopus) was 5 (0-52) and TP 15 (0-369), and strong correlation was found between h-index and TP (ρ = 0.932, p < 0.001), with the intraclass correlation between Scopus and WoS h-index also significant (intraclass correlation coefficient = 0.973 [95% CI: 0.962-0.981], p < 0.001). Academic GS consultants had higher h-indices than nonacademic University Hospital and District General Hospital consultants (Scopus 12 vs 7 vs 4 [p < 0.001] and WoS 10.5 vs 7 vs 4 [p < 0.001]). h-Index was >2.29 in 57.4% of consultants. No subspecialty differences were apparent in median h-indices (p = 0.792) and TP (p = 0.903). h-Index is a valid GS research productivity metric with over half of consultants performing at levels equivalent to social science Senior Lecturers. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Management of first-episode pelvic inflammatory disease in primary care: results from a large UK primary care database.

PubMed

Nicholson, Amanda; Rait, Greta; Murray-Thomas, Tarita; Hughes, Gwenda; Mercer, Catherine H; Cassell, Jackie

2010-10-01

Prompt and effective treatment of pelvic inflammatory disease (PID) may help prevent long-term complications. Many PID cases are seen in primary care but it is not known how well management follows recommended guidelines. To estimate the incidence of first-episode PID cases seen in UK general practice, describe their management, and assess its adequacy in relation to existing guidelines. Cohort study. UK general practices contributing to the General Practice Research Database (GPRD). Women aged 15 to 40 years, consulting with a first episode of PID occurring between 30 June 2003 and 30 June 2008 were identified, based on the presence of a diagnostic code. The records within 28 days either side of the diagnosis date were analysed to describe management. A total of 3797 women with a first-ever coded diagnosis of PID were identified. Incidence fell during the study period from 19.3 to 8.9/10 000 person-years. Thirty-four per cent of cases had evidence of care elsewhere, while 2064 (56%) appeared to have been managed wholly within the practice. Of these 2064 women, 34% received recommended treatment including metronidazole, and 54% had had a Chlamydia trachomatis test, but only 16% received both. Management was more likely to follow guidelines in women in their 20s, and later in the study period. These analyses suggest that the management of PID in UK primary care, although improving, does not follow recommended guidelines for the majority of women. Further research is needed to understand the delivery of care in general practice and the coding of such complex syndromic conditions.

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

An evaluation of general practice websites in the UK.

PubMed

Howitt, Alistair; Clement, Sarah; de Lusignan, Simon; Thiru, Krish; Goodwin, Daryl; Wells, Sally

2002-10-01

General practice websites are an emerging phenomenon, but there have been few critical evaluations of their content. Previously developed rating instruments to assess medical websites have been criticized for failing to report their reliability and validity. The purpose of this study was to develop a rating instrument for assessing UK general practice websites, and then to evaluate them critically. The STaRNet Website Assessment Tool (SWAT) was developed listing criteria that general practice websites may meet, which was then used to evaluate a random sample of websites drawn from an electronic database. A second assessor rated a subsample of the sites to assess the tool's inter-rater reliability. The setting was an information technology group of a general practice research network using a random sample of 108 websites identified from the database. The main outcome measures were identification of rating criteria and frequency counts from the website rating instrument. Ninety (93.3%) sites were accessible, of which 84 were UK general practice websites. Criteria most frequently met were those describing the scope of the website and their functionality. Apart from e-mail to practices, criteria related to electronic communication were rarely met. Criteria relating to the quality of information were least often met. Inter-rater reliability kappa values for the items in the tool ranged from -0.06 to 1.0 (mean 0.59). Values were >0.6 for 15 out of 25 criteria assessed in 40 sites which were rated by two assessors. General practice websites offer a wide range of information. They are technically satisfactory, but do not exploit fully the potential for electronic doctor-patient communication. The quality of information they provide is poor. The instrument may be developed as a template for general practices producing or revising their own websites.

Language support for linguistic minority chronic hepatitis B/C patients: an exploratory study of availability and clinicians' perceptions of language barriers in six European countries.

PubMed

Falla, Abby M; Veldhuijzen, Irene K; Ahmad, Amena A; Levi, Miriam; Richardus, Jan Hendrik

2017-02-20

Language support for linguistic minorities can improve patient safety, clinical outcomes and the quality of health care. Most chronic hepatitis B/C infections in Europe are detected among people born in endemic countries mostly in Africa, Asia and Central/Eastern Europe, groups that may experience language barriers when accessing health care services in their host countries. We investigated availability of interpreters and translated materials for linguistic minority hepatitis B/C patients. We also investigated clinicians' agreement that language barriers are explanations of three scenarios: the low screening uptake of hepatitis B/C screening, the lack of screening in primary care, and why cases do not reach specialist care. An online survey was developed, translated and sent to experts in five health care services involved in screening or treating viral hepatitis in six European countries: Germany, Hungary, Italy, the Netherlands, Spain and the United Kingdom (UK). The five areas of health care were: general practice/family medicine, antenatal care, health care for asylum seekers, sexual health and specialist secondary care. We measured availability using a three-point ordinal scale ('very common', 'variable or not routine' and 'rarely or never'). We measured agreement using a five-point Likert scale. We received 238 responses (23% response rate, N = 1026) from representatives in each health care field in each country. Interpreters are common in the UK, the Netherlands and Spain but variable or rare in Germany, Hungary and Italy. Translated materials are rarely/never available in Hungary, Italy and Spain but commonly or variably available in the Netherlands, Germany and the UK. Differing levels of agreement that language barriers explain the three scenarios are seen across the countries. Professionals in countries with most infrequent availability (Hungary and Italy) disagree strongest that language barriers are explanations. Our findings show pronounced differences between countries in availability of interpreters, differences that mirror socio-cultural value systems of 'difference-sensitive' and 'difference-blindness'. Improved language support is needed given the complex natural history of hepatitis B/C, the recognised barriers to screening and care, and the large undiagnosed burden among (potentially) linguistic minority migrant groups.

UK Environmental Prediction - integration and evaluation at the convective scale

NASA Astrophysics Data System (ADS)

Fallmann, Joachim; Lewis, Huw; Castillo, Juan Manuel; Pearson, David; Harris, Chris; Saulter, Andy; Bricheno, Lucy; Blyth, Eleanor

2016-04-01

Traditionally, the simulation of regional ocean, wave and atmosphere components of the Earth System have been considered separately, with some information on other components provided by means of boundary or forcing conditions. More recently, the potential value of a more integrated approach, as required for global climate and Earth System prediction, for regional short-term applications has begun to gain increasing research effort. In the UK, this activity is motivated by an understanding that accurate prediction and warning of the impacts of severe weather requires an integrated approach to forecasting. The substantial impacts on individuals, businesses and infrastructure of such events indicate a pressing need to understand better the value that might be delivered through more integrated environmental prediction. To address this need, the Met Office, NERC Centre for Ecology & Hydrology and NERC National Oceanography Centre have begun to develop the foundations of a coupled high resolution probabilistic forecast system for the UK at km-scale. This links together existing model components of the atmosphere, coastal ocean, land surface and hydrology. Our initial focus has been on a 2-year Prototype project to demonstrate the UK coupled prediction concept in research mode. This presentation will provide an update on UK environmental prediction activities. We will present the results from the initial implementation of an atmosphere-land-ocean coupled system, including a new eddy-permitting resolution ocean component, and discuss progress and initial results from further development to integrate wave interactions in this relatively high resolution system. We will discuss future directions and opportunities for collaboration in environmental prediction, and the challenges to realise the potential of integrated regional coupled forecasting for improving predictions and applications.

The attitudes of pharmacists, students and the general public on mHealth applications for medication adherence

PubMed Central

Davies, Michael J.; Kotadia, Alysha; Mughal, Hassan; Hannan, Ashraf; Alqarni, Hamdan

2015-01-01

Background: During recent years mobile technology has developed tremendously and has infiltrated the healthcare field. Mobile healthcare (mHealth) applications, or apps, may be used to support patient adherence to medication thus promoting optimal treatment outcomes and reducing medication wastage. Objective: This study shall consider the opinions of United Kingdom (UK) based pharmacists, pharmacy undergraduates and members of the general public towards the use of mHealth apps to promote adherence to prescribed medication regimens. Methods: On Liverpool John Moores University (LJMU) ethical approval, the 25 item questionnaire was distributed to UK registered pharmacists within inner city Liverpool and Manchester (n=500), pharmacy undergraduates studying at LJMU (n=420) and members of the general public within Liverpool City Centre (n=400). The questions were formatted as multiple choice, Likert scales or the open answer type. The data were analysed using simple frequencies, cross tabulations and non-parametric techniques in the SPSS v22 program. Results: The number of completed questionnaires from the pharmacist, student and general public cohorts were 245, 333 and 400; respectively. The data indicated that the general public rely heavily upon daily routine to take medication as prescribed (54.1%) with mHealth app use being extremely low (1.5%); a similar trend was noted for the pharmacist / student cohorts. The age of the individual is an important consideration, with the younger generation likely to engage with mHealth apps and the older generation less so. Here, education and training are important. Pharmacists (82.3%) would be happy to deliver training packages to the public who would in turn happily receive such training (84%). Key barriers precluding mHealth app use include data reliability, security and technical difficulties. Conclusion: Adherence apps hold great promise to support the patient and their healthcare needs. In order to increase acceptance and uptake simple, user-friendly designs must be considered and constructed. In addition, such technology requires effective promotion and end user training in order to reach its full potential. Furthermore, the regulation of mobile adherence apps will be essential in order to overcome underlying patient concerns. PMID:26759619

What can we learn from national-scale geodata describing soil erosion?

NASA Astrophysics Data System (ADS)

Benaud, Pia; Anderson, Karen; Carvalho, Jason; Evans, Martin; Glendell, Miriam; James, Mike; Lark, Murray; Quine, Timothy; Quinton, John; Rawlins, Barry; Rickson, Jane; Truckell, Ian; Brazier, Richard

2017-04-01

The United Kingdom has a rich dataset of soil erosion observations, which have been collected using a wide range of methodologies, across various spatial and temporal scales. Yet, while observations of soil erosion have been carried out along-side agricultural development and intensification, understanding whether or not the UK has a soil erosion problem remains a question to be answered. Furthermore, although good reviews of existing soil erosion rates exist, there is no single resource that brings all of this work together. Therefore, the primary aim of this research was to build a picture of why attempts to quantify erosion rates across the UK empirically have fallen short, through: (1) Collating all available, UK-based and empirically-derived soil erosion datasets into a spatially explicit and open-access database, (2) Developing an understanding of observed magnitudes of erosion, in the UK, (3) Evaluating impact of non-environmental controls on erosion observations i.e. study methodologies, and (4) Exploring trends between environmental controls and erosion rates. To-date, the database holds over 1500 records, which include results from both experimental and natural conditions, across arable, grassland and upland environments. Of the studies contained in the database, erosion has been observed ca. 40% of instances, ranging from <0.01 t.ha-1.yr-1 to 143 t.ha-1.yr-1. However, preliminary analysis has highlighted that over 90% of the studies included in the database only quantify soil loss via visible erosion features, such as rills or gullies, through volumetric assessments. Furthermore, there has been an inherent bias in the UK towards quantifying soil erosion in locations with either a known history or high probability of erosion occurrence. As a consequence, we conclude that such databases, may not be used to make a statistically unbiased assessment of national-scale erosion rates, however, they can highlight maximum likely rates under a wide range of soil, topography and land use conditions. Finally, this work suggests there is a strong argument for a replicable and statistically robust national soil erosion monitoring program to be carried out along-side the proposed sustainable intensification of agriculture.

Self-Perceived Employability: Construction and Initial Validation of a Scale for University Students

ERIC Educational Resources Information Center

Rothwell, Andrew; Herbert, Ian; Rothwell, Frances

2008-01-01

This paper reports the development of a research instrument to examine the expectations and self-perceptions of employability of business undergraduates (bachelor degree students) in three UK universities, and examines relationships with other measures. The scale was found to have a satisfactory internal reliability coefficient for an untested…

Improving UK Chalk hydrometeorology across spatial scales using a small hydrometeorological network

NASA Astrophysics Data System (ADS)

Rosolem, Rafael; Iwema, Joost; Rahman, Mostaquimur; Desilets, Darin; Koltermann da Silva, Juliana

2016-04-01

Chalk in the UK acts as a primary aquifer providing up to 80% of the public water supply locally. Chalk outcrops are located over most of southern and eastern England. Despite its importance, the characterization of Chalk in hydrometeorological models is still very limited. There is a need for a comprehensive and coherent integration of observations and modeling efforts across spatial scales for better understanding Chalk hydrometeorology. Here we introduce the "A MUlti-scale Soil moisture-Evapotranspiration Dynamics" (AMUSED) project. AMUSED goal is to better identify the key dominant processes controlling changes in soil moisture and surface fluxes (e.g., evapotranspiration) across spatial scales by combining ground-based observations with hydrometeorological models and satellite remote sensing products. The AMUSED observational platform consists of three sites located in Upper Chalk region of the Lambourn Catchment located in southern England covering approximately 2 square-km characterized by distinct combinations of soil and vegetation types. The network includes standard meteorological measurements, an eddy covariance system for turbulent fluxes and cosmic-ray neutron sensors for integrated soil moisture estimates at intermediate scales. Here we present our initial results from our three sites.

An Approach to the Derivation of the Cost of UK Vehicle Crash Injuries

PubMed Central

Morris, Andrew; Welsh, Ruth; Barnes, Jo; Chambers-Smith, Dawn

2006-01-01

An approach to costing of road crash injury has been developed using data from a ‘Willingness-to-pay’ survey mapped to injuries listed in the Abbreviated Injury Scale 1998 Revision. The costs derived have been applied to a database of real-world crash injuries that have been collected as part of the UK Cooperative Crash Injury Study (CCIS). The approach has been developed in order to determine future research priorities in vehicle passive safety. When all injuries in all crash-types are examined, the results highlight the cost of ‘Whiplash’ in the UK. When more serious injuries are considered, specifically those at AIS 2+, the cost of head injuries becomes evident in both frontal and side impacts. PMID:16968643

Universal inverse power-law distribution for temperature and rainfall in the UK region

NASA Astrophysics Data System (ADS)

Selvam, A. M.

2014-06-01

Meteorological parameters, such as temperature, rainfall, pressure, etc., exhibit selfsimilar space-time fractal fluctuations generic to dynamical systems in nature such as fluid flows, spread of forest fires, earthquakes, etc. The power spectra of fractal fluctuations display inverse power-law form signifying long-range correlations. A general systems theory model predicts universal inverse power-law form incorporating the golden mean for the fractal fluctuations. The model predicted distribution was compared with observed distribution of fractal fluctuations of all size scales (small, large and extreme values) in the historic month-wise temperature (maximum and minimum) and total rainfall for the four stations Oxford, Armagh, Durham and Stornoway in the UK region, for data periods ranging from 92 years to 160 years. For each parameter, the two cumulative probability distributions, namely cmax and cmin starting from respectively maximum and minimum data value were used. The results of the study show that (i) temperature distributions (maximum and minimum) follow model predicted distribution except for Stornowy, minimum temperature cmin. (ii) Rainfall distribution for cmin follow model predicted distribution for all the four stations. (iii) Rainfall distribution for cmax follows model predicted distribution for the two stations Armagh and Stornoway. The present study suggests that fractal fluctuations result from the superimposition of eddy continuum fluctuations.

The Mayo Portland Adaptability Inventory-4 outcome measure is superior to UK FIM+FAM in a British military population.

PubMed

McGilloway, Emer; Mitchell, James; Dharm-Datta, Shreshth; Roberts, Andrew; Tilley, Haydn; Etherington, John

2016-01-01

The aim of this study was to identify the most appropriate rehabilitation outcome measure for use in a young adult population with acquired brain injury. A 2-year prospective study of patients admitted to a UK military neuro-rehabilitation unit with acquired brain injury to compare the appropriateness of the Functional Independence Measure/Functional Assessment Measure (FIM+FAM) vs the Mayo-Portland Adaptability Inventory Version 4 (MPAI-4) in assessing outcomes. Patients were assessed at admission, discharge and at 4-month follow-up using FIM+FAM and MPAI-4. The FIM+FAM total motor score showed a marked ceiling affect, 42% of patients scored the maximum on admission rising to 80% at discharge. The MPAI-4 did not show significant ceiling effects. The other sub-scales of FIM+FAM and MPAI-4 were generally comparable, no more than 17% achieved ceiling at follow-up. This is the first comparative study of FIM+FAM and MPAI-4 in a young adult military population following acquired brain injury. All patients showed improvements in both outcome measures following intensive inpatient rehabilitation. However, the MPAI-4 did not show ceiling effects in motor scores. This measure was, therefore, found to be more appropriate in the cohort.

Practical barriers to the implementation of early goal directed therapy in the UK: trainee skills and awareness.

PubMed

McNally, S J; MacKinnon, M; Hawkins, M

2009-08-01

The Surviving Sepsis Campaign (SSC) recommends Early Goal Directed Therapy (EGDT) in the treatment of septic shock, which requires key critical care skills and knowledge. This study evaluates the availability of these skills in Specialist Registrars in acute hospital specialities in the UK. A questionnaire was sent to Specialist Registrars in Anaesthetics, General Surgery and General Medicine throughout Scotland. One hundred and eighty five responses were obtained. One hundred percent of anaesthetists, 70% of surgeons and 51% of physicians were aware of EGDT Only 62 trainees (6% of surgeons, 79% of anaesthetists, 19% of physicians) had the full complement of skills and knowledge to implement EGDT. This study demonstrates that non-anaesthetic registrars in the UK lack both knowledge and skills required to provide EGDT. The main deficit was in awareness, demonstrating that knowledge of EGDT is not penetrating into specialities beyond anaesthesia. It is now time for the SSC to specifically target non-anaesthetic specialities.

GenomeDiagram: a python package for the visualization of large-scale genomic data.

PubMed

Pritchard, Leighton; White, Jennifer A; Birch, Paul R J; Toth, Ian K

2006-03-01

We present GenomeDiagram, a flexible, open-source Python module for the visualization of large-scale genomic, comparative genomic and other data with reference to a single chromosome or other biological sequence. GenomeDiagram may be used to generate publication-quality vector graphics, rastered images and in-line streamed graphics for webpages. The package integrates with datatypes from the BioPython project, and is available for Windows, Linux and Mac OS X systems. GenomeDiagram is freely available as source code (under GNU Public License) at http://bioinf.scri.ac.uk/lp/programs.html, and requires Python 2.3 or higher, and recent versions of the ReportLab and BioPython packages. A user manual, example code and images are available at http://bioinf.scri.ac.uk/lp/programs.html.

Establishing the reliability and validity of the Zagazig Depression Scale in a UK student population: an online pilot study.

PubMed

Ibrahim, Ahmed K; Kelly, Shona J; Challenor, Emily C; Glazebrook, Cris

2010-12-10

It is thought that depressive disorders will be the second leading cause of disability worldwide by 2020. Recently, there is a steady increase in the number of university students diagnosed and treated as depression patients. It can be assumed that depression is a serious mental health problem for university students because it affects all age groups of the students either younger or older equally. The current study aims to establish the reliability and validity of the Zagazig Depression scale in a UK sample. The study was a cross-sectional online survey. A sample of 133 out of 275 undergraduate students from a range of UK Universities in the academic year 2008-2009, aged 20.3 ± 6.3 years old were recruited. A modified back translated version of Zagazig Depression scale was used. In order to validate the Zagazig Depression scale, participants were asked to complete the Patient Health Questionnaire. Statistical analysis includes Kappa analysis, Cronbach's alpha, Spearman's correlation analysis, and Confirmatory Factor analysis. Using the recommended cut-off of Zagazig Depression scale for possible minor depression it was found that 30.3% of the students have depression and higher percentage was identified according to the Patient Health Questionnaire (37.4%). Females were more depressed. The mean ZDS score was 8.3 ± 4.2. Rates of depression increase as students get older. The reliability of The ZDS was satisfactory (Cronbach's alpha was .894). For validity, ZDS score was strongly associated with PHQ, with no significant difference (p-value > 0.05), with strong positive correlation (r = +.8, p-value < 0.01). The strong, significant correlation between the PHQ and ZDS, along with high internal consistency of the ZDS as a whole provides evidence that ZDS is a reliable measure of depressive symptoms and is promising for the use of the translated ZDS in a large-scale cross-culture study.

Cystic echinococcosis in a fox-hound hunt worker, UK

PubMed Central

Craig, Philip S; Woods, Marion L; Boufana, Belgees; O’Loughlin, Barry; Gimpel, John; San Lett, Wai; McManus, Donald P

2012-01-01

A male resident in Vanuatu with prior history of employment as a hunt kennel-man in England (1980–2001) was surgically treated for the removal of a hydatid cyst subsequently confirmed as Echinococcus granulosus (G1 genotype). This is the first human molecularly identified CE case reported from the UK and a first in a fox-hound handler and indicates a general neglected occupational risk. PMID:23182144

Is 27 really a dangerous age for famous musicians? Retrospective cohort study.

PubMed

Wolkewitz, Martin; Allignol, Arthur; Graves, Nicholas; Barnett, Adrian G

2011-12-20

To test the "27 club" hypothesis that famous musicians are at an increased risk of death at age 27. Design Cohort study using survival analysis with age as a time dependent exposure. Comparison was primarily made within musicians, and secondarily relative to the general UK population. The popular music scene from a UK perspective. Musicians (solo artists and band members) who had a number one album in the UK between 1956 and 2007 (n = 1046 musicians, with 71 deaths, 7%). Risk of death by age of musician, accounting for time dependent study entry and the number of musicians at risk. Risk was estimated using a flexible spline which would allow a bump at age 27 to appear. We identified three deaths at age 27 amongst 522 musicians at risk, giving a rate of 0.57 deaths per 100 musician years. Similar death rates were observed at ages 25 (rate = 0.56) and 32 (0.54). There was no peak in risk around age 27, but the risk of death for famous musicians throughout their 20s and 30s was two to three times higher than the general UK population. The 27 club is unlikely to be a real phenomenon. Fame may increase the risk of death among musicians, but this risk is not limited to age 27.

High dependency units in the UK: variable size, variable character, few in number.

PubMed Central

Thompson, F. J.; Singer, M.

1995-01-01

An exploratory descriptive survey was conducted to determine the size and character of high dependency units (HDUs) in the UK. A telephone survey and subsequent postal questionnaire was sent to the 39 general HDUs in the UK determined by a recent survey from the Royal College of Anaesthetists; replies were received from 28. Most HDUs (82%, n = 23) were geographically distinct from the intensive care unit and varied in size from three to 13 beds, although only 64% (n = 18) reported that all beds were currently open. Nurse: patient ratios were at least 1:3. Fifty per cent of units had one or more designated consultants in charge, although only 11% (n = 3) had specifically designated consultant sessions. Junior medical cover was provided mainly by the on-call speciality term. Twenty units acted as a step-down facility for discharged intensive care unit patients and 21 offered a step-up facility for patients from general wards. Provision of facilities and levels of monitoring varied between these units. Few HDUs exist in the UK and they are variable in size and in the facilities and monitoring procedures which they provide. Future studies are urgently required to determine cost-effectiveness and outcome benefit of this intermediate care facility. Images p221-a PMID:7784281

High dependency units in the UK: variable size, variable character, few in number.

PubMed

Thompson, F J; Singer, M

1995-04-01

An exploratory descriptive survey was conducted to determine the size and character of high dependency units (HDUs) in the UK. A telephone survey and subsequent postal questionnaire was sent to the 39 general HDUs in the UK determined by a recent survey from the Royal College of Anaesthetists; replies were received from 28. Most HDUs (82%, n = 23) were geographically distinct from the intensive care unit and varied in size from three to 13 beds, although only 64% (n = 18) reported that all beds were currently open. Nurse: patient ratios were at least 1:3. Fifty per cent of units had one or more designated consultants in charge, although only 11% (n = 3) had specifically designated consultant sessions. Junior medical cover was provided mainly by the on-call speciality term. Twenty units acted as a step-down facility for discharged intensive care unit patients and 21 offered a step-up facility for patients from general wards. Provision of facilities and levels of monitoring varied between these units. Few HDUs exist in the UK and they are variable in size and in the facilities and monitoring procedures which they provide. Future studies are urgently required to determine cost-effectiveness and outcome benefit of this intermediate care facility.

Longitudinal study of infectious intestinal disease in the UK (IID2 study): incidence in the community and presenting to general practice

PubMed Central

Rodrigues, Laura C; Viviani, Laura; Dodds, Julie P; Evans, Meirion R; Hunter, Paul R; Gray, Jim J; Letley, Louise H; Rait, Greta; Tompkins, David S; O'Brien, Sarah J

2011-01-01

Objectives To estimate, overall and by organism, the incidence of infectious intestinal disease (IID) in the community, presenting to general practice (GP) and reported to national surveillance. Design Prospective, community cohort study and prospective study of GP presentation conducted between April 2008 and August 2009. Setting Eighty-eight GPs across the UK recruited from the Medical Research Council General Practice Research Framework and the Primary Care Research Networks. Participants 6836 participants registered with the 88 participating practices in the community study; 991 patients with UK-acquired IID presenting to one of 37 practices taking part in the GP presentation study. Main outcome measures IID rates in the community, presenting to GP and reported to national surveillance, overall and by organism; annual IID cases and GP consultations by organism. Results The overall rate of IID in the community was 274 cases per 1000 person-years (95% CI 254 to 296); the rate of GP consultations was 17.7 per 1000 person-years (95% CI 14.4 to 21.8). There were 147 community cases and 10 GP consultations for every case reported to national surveillance. Norovirus was the most common organism, with incidence rates of 47 community cases per 1000 person-years and 2.1 GP consultations per 1000 person-years. Campylobacter was the most common bacterial pathogen, with a rate of 9.3 cases per 1000 person-years in the community, and 1.3 GP consultations per 1000 person-years. We estimate that there are up to 17 million sporadic, community cases of IID and 1 million GP consultations annually in the UK. Of these, norovirus accounts for 3 million cases and 130 000 GP consultations, and Campylobacter is responsible for 500 000 cases and 80 000 GP consultations. Conclusions IID poses a substantial community and healthcare burden in the UK. Control efforts must focus particularly on reducing the burden due to Campylobacter and enteric viruses. PMID:21708822

Large-scale restoration mitigate land degradation and support the establishment of green infrastructure

NASA Astrophysics Data System (ADS)

Tóthmérész, Béla; Mitchley, Jonathan; Jongepierová, Ivana; Baasch, Annett; Fajmon, Karel; Kirmer, Anita; Prach, Karel; Řehounková, Klára; Tischew, Sabine; Twiston-Davies, Grace; Dutoit, Thierry; Buisson, Elise; Jeunatre, Renaud; Valkó, Orsolya; Deák, Balázs; Török, Péter

2017-04-01

Sustaining the human well-being and the quality of life, it is essential to develop and support green infrastructure (strategically planned network of natural and semi-natural areas with other environmental features designed and managed to deliver a wide range of ecosystem services). For developing and sustaining green infrastructure the conservation and restoration of biodiversity in natural and traditionally managed habitats is essential. Species-rich landscapes in Europe have been maintained over centuries by various kinds of low-intensity use. Recently, they suffered by losses in extent and diversity due to land degradation by intensification or abandonment. Conservation of landscape-scale biodiversity requires the maintenance of species-rich habitats and the restoration of lost grasslands. We are focusing on landscape-level restoration studies including multiple sites in wide geographical scale (including Czech Republic, France, Germany, Hungary, and UK). In a European-wide perspective we aimed at to address four specific questions: (i) What were the aims and objectives of landscape-scale restoration? (ii) What results have been achieved? (iii) What are the costs of large-scale restoration? (iv) What policy tools are available for the restoration of landscape-scale biodiversity? We conclude that landscape-level restoration offers exciting new opportunities to reconnect long-disrupted ecological processes and to restore landscape connectivity. Generally, these measures enable to enhance the biodiversity at the landscape scale. The development of policy tools to achieve restoration at the landscape scale are essential for the achievement of the ambitious targets of the Convention on Biological Diversity and the European Biodiversity Strategy for ecosystem restoration.

Can the benefits of physical seabed restoration justify the costs? An assessment of a disused aggregate extraction site off the Thames Estuary, UK.

PubMed

Cooper, Keith; Burdon, Daryl; Atkins, Jonathan P; Weiss, Laura; Somerfield, Paul; Elliott, Michael; Turner, Kerry; Ware, Suzanne; Vivian, Chris

2013-10-15

Physical and biological seabed impacts can persist long after the cessation of marine aggregate dredging. Whilst small-scale experimental studies have shown that it may be possible to mitigate such impacts, it is unclear whether the costs of restoration are justified on an industrial scale. Here we explore this question using a case study off the Thames Estuary, UK. By understanding the nature and scale of persistent impacts, we identify possible techniques to restore the physical properties of the seabed, and the costs and the likelihood of success. An analysis of the ecosystem services and goods/benefits produced by the site is used to determine whether intervention is justified. Whilst a comparison of costs and benefits at this site suggests restoration would not be warranted, the analysis is site-specific. We emphasise the need to better define what is, and is not, an acceptable seabed condition post-dredging. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Cross-cultural differences in comorbid symptoms of children with autism spectrum disorders: an international examination between Israel, South Korea, the United Kingdom and the United States of America.

PubMed

Zachor, Ditza; Yang, Jae-Won; Itzchak, Esther Ben; Furniss, Frederick; Pegg, Elinor; Matson, Johnny L; Horovitz, Max; Sipes, Megan; Chung, Kyong-Mee; Jung, Woohyun

2011-01-01

To examine the relationship between culture and symptoms of comorbid psychopathology in those with autism spectrum disorders (ASD). Multivariate analyses of variance (MANOVAs) for each country and each sub-scale of the Autism Spectrum Disorders-Comorbid for Children (ASD-CC). Follow-up independent univariate analyses and post-hoc tests as needed. Separate samples from South Korea, the UK and Israel were compared to a sample from the US in order to examine cultural contributions, using the ASD-CC. Overall, few differences were found. Significantly, the US had significantly higher scores than South Korea on the avoidant sub-scale. Additionally, the US had significantly higher scores than Israel on the over-eating and tantrum sub-scales. No significant differences were found between the US and the UK. Cultural factors, such as views of typical behaviour, should be taken into account when examining symptoms of comorbidity in children with ASD.

The Demonstration Test Catchment Approach to Land and Water Management in the river Eden Watershed, UK. (Invited)

NASA Astrophysics Data System (ADS)

Jonczyk, J.; Quinn, P. F.; Haygarth, P.; Reaney, S.; Wilkinson, M.; Burke, S.; McGonigle, D.; Harris, B.

2010-12-01

The Demonstration Test Catchment (DTC) initiative is a five year project to address pollution issues in catchments. The initiative will study the wider environmental problems suffered by catchments which are under intense farming pressures and potential climate change impacts. The UK Department for Food, Agriculture and Rural Affairs (Defra) in partnership with the Environment Agency for England and Wales (EA) have funded this initiative to answer key policy concerns in catchments. The first key step has been the establishment of a ‘research platform’ at three catchments in the UK (The Eden, Wensum and Hampshire Avon) whereby funding of 9.3 million dollars has gone into funding new equipment and pollution sampling regimes have been established. Within each catchment between three and four, 8-10km2 sub-catchments have been established. The experimental design and thinking for DTCs will be explained fully in this paper. The next phase of the project will install an extensive suite of land management and pollution mitigation interventions. In parallel to this monitoring work, a full knowledge exchange package will seek to engage with farmers, the rural community and understand the governance regime at the broader catchment scale. There is also a need for a modelling component to upscale the findings to the whole of the UK. Whilst this is an ambitious goal, there is a very basic commitment of working with rural communities to come up with real solutions that will help underpin effective policy making for the future. The research platform covers a multi-scale approach to the monitoring strategy that will allow local grouping of mitigation measures to be studied local in terms of impact and propagated to the catchment scale. Even with high level of funding, the DTC can only fully instrument a catchment of 8-10km2. Beyond this scale, the EA and the standard catchment monitoring will continue as normal. The focus here is to prove that mitigation can be achieved within smaller land units that have a clear catchment scale benefit. This will provide the evidence base for future policy which is of use to all location in the UK. Hence, the need to have suite of parameters that can be evaluated has given rise to specific experimental design. Fundamental to this is to use continuous telemetered sampling at as many location as possible, including field laboratories capable of measuring, Nitrate, Ammonia, Total Phosphorus, dissolved phosphorus, suspended sediment and chlorophyll a. Standard hydro-metrological equipment is also fully telemetered. The goal is to allow all the data to be freely available to all end users via an internet data portal. The long term goal is to invite experts from many environmental and social sciences to work at the established research platform and ultimately give a better understanding of what a healthy catchment should be like. Being able to communicate this point to both local and national audiences will also be made and will link closely to the UK Virtual Observatory project funded by the NERC.

Loss of functional diversity and network modularity in introduced plant–fungal symbioses

PubMed Central

Cooper, Jerry A.; Bufford, Jennifer L.; Hulme, Philip E.; Bates, Scott T.

2017-01-01

The introduction of alien plants into a new range can result in the loss of co-evolved symbiotic organisms, such as mycorrhizal fungi, that are essential for normal plant physiological functions. Prior studies of mycorrhizal associations in alien plants have tended to focus on individual plant species on a case-by-case basis. This approach limits broad scale understanding of functional shifts and changes in interaction network structure that may occur following introduction. Here we use two extensive datasets of plant–fungal interactions derived from fungal sporocarp observations and recorded plant hosts in two island archipelago nations: New Zealand (NZ) and the United Kingdom (UK). We found that the NZ dataset shows a lower functional diversity of fungal hyphal foraging strategies in mycorrhiza of alien when compared with native trees. Across species this resulted in fungal foraging strategies associated with alien trees being much more variable in functional composition compared with native trees, which had a strikingly similar functional composition. The UK data showed no functional difference in fungal associates of alien and native plant genera. Notwithstanding this, both the NZ and UK data showed a substantial difference in interaction network structure of alien trees compared with native trees. In both cases, fungal associates of native trees showed strong modularity, while fungal associates of alien trees generally integrated into a single large module. The results suggest a lower functional diversity (in one dataset) and a simplification of network structure (in both) as a result of introduction, potentially driven by either limited symbiont co-introductions or disruption of habitat as a driver of specificity due to nursery conditions, planting, or plant edaphic-niche expansion. Recognizing these shifts in function and network structure has important implications for plant invasions and facilitation of secondary invasions via shared mutualist populations. PMID:28039116

Can't see the woods for the trees: exploring the range and connection of tobacco industry argumentation in the 2012 UK standardised packaging consultation.

PubMed

Lie, Jessamina Lih Yan; Fooks, Gary; de Vries, Nanne K; Heijndijk, Suzanne M; Willemsen, Marc C

2017-07-25

Transnational tobacco company (TTC) submissions to the 2012 UK standardised packaging consultation are studied to examine TTC argumentation in the context of Better Regulation practices. A content analysis was conducted of Philip Morris International and British American Tobacco submissions to the 2012 UK consultation. Industry arguments concerning expected costs and (contested) benefits of the policy were categorised into themes and frames. The inter-relationship between frames through linked arguments was mapped to analyse central arguments using an argumentation network. 173 arguments were identified. Arguments fell into one of five frames: ineffectiveness, negative economic consequences, harm to public health, increased crime or legal ramifications. Arguments highlighted high costs to a wide range of groups, including government, general public and other businesses. Arguments also questioned the public health benefits of standardised packaging and highlighted the potential benefits to undeserving groups. An increase in illicit trade was the most central argument and linked to the greatest variety of arguments. In policy-making systems characterised by mandatory impact assessments and public consultations, the wide range of cost (and contested benefits) based arguments highlights the risk of TTCs overloading policy actors and causing delays in policy adoption. Illicit trade related arguments are central to providing a rationale for these arguments, which include the claim that standardised packaging will increase health risks. The strategic importance of illicit trade arguments to industry argumentation in public consultations underlines the risks of relying on industry data relating to the scale of the illicit trade. © 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.

Establishing a design for passive vertical flow constructed wetlands treating small sewage discharges to meet British Standard EN 12566.

PubMed

Weedon, Christopher Michael; Murphy, Clodagh; Sweaney, Geoff

2017-01-01

Owing to legislation change (which made General Binding Rules effective from 1 January 2015) unless discharge is to specified environmentally sensitive sites, small sewage discharges (SSDs) in England - that is, <2 m 3  d -1 to ground; <5 m 3  d -1 to surface waters - no longer require an Environmental Permit (EP) and need not be registered for exemption, provided discharge to surface waters is preceded by treatment using equipment complying with BS EN 12566. This effectively excludes the use of treatment wetlands, unless covered by an EP, because the cost of certification to EN 12566 for bespoke designs is prohibitive. EPs take up to four months to obtain. Therefore, the new legislation has created a commercial disadvantage for constructed wetlands treating SSDs, compared with mass-produced sewage treatment plants. However, the UK statutory pollution regulators have maintained a dialogue with the Constructed Wetland Association (CWA), with a view to assessing whether treatment of SSD using constructed wetlands might be allowable, without requiring EPs. This paper presents treatment performance data obtained over 15 years, from a variety of full-scale operational treatment wetlands, as supporting evidence for design guidelines, proposed by the CWA to the UK regulators, for the implementation of constructed wetlands continuously passively treating SSD to 20:30:20 mg l -1 BOD/SS/NH4-N under a wide range of loading rates. Relevant experience of UK designers, installers and operators since the early 1990s is included, resulting in recommended physical design criteria and loading rates for compact vertical flow reed beds, presented here as key elements of the draft guidelines.

A comparison of the scaling properties of the English, Spanish, French, and Chinese EQ-5D descriptive systems.

PubMed

Luo, Nan; Li, Minghui; Chevalier, Julie; Lloyd, Andrew; Herdman, Michael

2013-10-01

To compare the scaling properties of the English, Spanish, French, and Chinese versions of the EQ-5D-3L and EQ-5D-5L descriptive systems. Members of the general populations in the UK, Spain, France, and China were interviewed to measure the severity of health problems represented by the response labels used in the EQ-5D descriptive systems using a visual analog scale. Multiple linear regression models were used to compare the perceived label severity across the four language groups. Severity scores for labels from each EQ-5D-5L dimension scale were compared with each other to assess ordinality. EQ-5D-5L and EQ-5D-3L labels used for describing different levels of health problems were rated differently, while those describing the same level of health problems were rated similarly. For example, the deviation of any group mean from the grand severity mean score for the label 'slight(ly)' was no larger than 5 points on a 0-100 scale for all five EQ-5D dimensions (p > 0.05 for all, t tests). Label ratings violating hypothesized ordinality of the EQ-5D-5L scales were observed in only a small proportion of respondents. Our study provided some preliminary evidence supporting the ordinality and equivalence of the EQ-5D-5L and EQ-5D-3L descriptive systems across four major languages.

Operational Leadership in Kosovo

DTIC Science & Technology

2004-02-09

ARRC) LGEN Michael Jackson Allied Air Forces North (COMAIRNORTH) GEN John Jumper Allied Naval Forces North (COMNAVNORTH) U.K. Allied Naval Forces South... Michael Jackson reportedly told the US commander (Clark) during one heated exchange. When General Jackson refused, General Clark asked Admiral James

UK Environmental Prediction - integration and evaluation at the convective scale

NASA Astrophysics Data System (ADS)

Fallmann, Joachim; Lewis, Huw; Castillo, Juan Manuel; Pearson, David; Harris, Chris; Saulter, Andy; Bricheno, Lucy; Blyth, Eleanor

2016-04-01

It has long been understood that accurate prediction and warning of the impacts of severe weather requires an integrated approach to forecasting. For example, high impact weather is typically manifested through various interactions and feedbacks between different components of the Earth System. Damaging high winds can lead to significant damage from the large waves and storm surge along coastlines. The impact of intense rainfall can be translated through saturated soils and land surface processes, high river flows and flooding inland. The substantial impacts on individuals, businesses and infrastructure of such events indicate a pressing need to understand better the value that might be delivered through more integrated environmental prediction. To address this need, the Met Office, NERC Centre for Ecology & Hydrology and NERC National Oceanography Centre have begun to develop the foundations of a coupled high resolution probabilistic forecast system for the UK at km-scale. This links together existing model components of the atmosphere, coastal ocean, land surface and hydrology. Our initial focus has been on a 2-year Prototype project to demonstrate the UK coupled prediction concept in research mode. This presentation will provide an update on UK environmental prediction activities. We will present the results from the initial implementation of an atmosphere-land-ocean coupled system and discuss progress and initial results from further development to integrate wave interactions. We will discuss future directions and opportunities for collaboration in environmental prediction, and the challenges to realise the potential of integrated regional coupled forecasting for improving predictions and applications.

Round-robin pretest analyses of a 1:6-scale reinforced concrete containment model subject to static internal pressurization

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

Clauss, D.B.

Analyses of a 1:6-scale reinforced concrete containment model that will be tested to failure at Sandia National Laboratories in the spring of 1987 were conducted by the following organizations in the United States and Europe: Sandia National Laboratories (USA), Argonne National Laboratory (USA), Electric Power Research Institute (USA), Commissariat a L'Energie Atomique (France), HM Nuclear Installations Inspectorate (UK), Comitato Nazionale per la ricerca e per lo sviluppo dell'Energia Nucleare e delle Energie Alternative (Italy), UK Atomic Energy Authority, Safety and Reliability Directorate (UK), Gesellschaft fuer Reaktorsicherheit (FRG), Brookhaven National Laboratory (USA), and Central Electricity Generating Board (UK). Each organization wasmore » supplied with a standard information package, which included construction drawings and actual material properties for most of the materials used in the model. Each organization worked independently using their own analytical methods. This report includes descriptions of the various analytical approaches and pretest predictions submitted by each organization. Significant milestones that occur with increasing pressure, such as damage to the concrete (cracking and crushing) and yielding of the steel components, and the failure pressure (capacity) and failure mechanism are described. Analytical predictions for pressure histories of strain in the liner and rebar and displacements are compared at locations where experimental results will be available after the test. Thus, these predictions can be compared to one another and to experimental results after the test.« less

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.

Immunising Children in Primary Care in the UK--What Are the Concerns of Principal Immunisers?

ERIC Educational Resources Information Center

Maconachie, Moira; Lewendon, Gill

2004-01-01

Objective: To determine the levels of concern about risks associated with childhood immunisations among principal immunisers in general practice. Design: Self-administered postal questionnaire survey. Setting: South & West Devon Health Authority. Participants: Eighty-eight/102 general practices: 78 practice nurses, 7 general practitioners, 3…

SLAM, a Mathematica interface for SUSY spectrum generators

NASA Astrophysics Data System (ADS)

Marquard, Peter; Zerf, Nikolai

2014-03-01

We present and publish a Mathematica package, which can be used to automatically obtain any numerical MSSM input parameter from SUSY spectrum generators, which follow the SLHA standard, like SPheno, SOFTSUSY, SuSeFLAV or Suspect. The package enables a very comfortable way of numerical evaluations within the MSSM using Mathematica. It implements easy to use predefined high scale and low scale scenarios like mSUGRA or mhmax and if needed enables the user to directly specify the input required by the spectrum generators. In addition it supports an automatic saving and loading of SUSY spectra to and from a SQL data base, avoiding the rerun of a spectrum generator for a known spectrum. Catalogue identifier: AERX_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AERX_v1_0.html Program obtainable from: CPC Program Library, Queen’s University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 4387 No. of bytes in distributed program, including test data, etc.: 37748 Distribution format: tar.gz Programming language: Mathematica. Computer: Any computer where Mathematica version 6 or higher is running providing bash and sed. Operating system: Linux. Classification: 11.1. External routines: A SUSY spectrum generator such as SPheno, SOFTSUSY, SuSeFLAV or SUSPECT Nature of problem: Interfacing published spectrum generators for automated creation, saving and loading of SUSY particle spectra. Solution method: SLAM automatically writes/reads SLHA spectrum generator input/output and is able to save/load generated data in/from a data base. Restrictions: No general restrictions, specific restrictions are given in the manuscript. Running time: A single spectrum calculation takes much less than one second on a modern PC.

The transition of a large-scale quality improvement initiative: a bibliometric analysis of the Productive Ward: Releasing Time to Care programme.

PubMed

White, Mark; Wells, John S G; Butterworth, Tony

2014-09-01

To examine the literature related to a large-scale quality improvement initiative, the 'Productive Ward: Releasing Time to Care', providing a bibliometric profile that tracks the level of interest and scale of roll-out and adoption, discussing the implications for sustainability. Productive Ward: Releasing Time to Care (aka Productive Ward) is probably one of the most ambitious quality improvement efforts engaged by the UK-NHS. Politically and financially supported, its main driver was the NHS Institute for Innovation and Improvement. The NHS institute closed in early 2013 leaving a void of resources, knowledge and expertise. UK roll-out of the initiative is well established and has arguably peaked. International interest in the initiative however continues to develop. A comprehensive literature review was undertaken to identify the literature related to the Productive Ward and its implementation (January 2006-June 2013). A bibliometric analysis examined/reviewed the trends and identified/measured interest, spread and uptake. Overall distribution patterns identify a declining trend of interest, with reduced numbers of grey literature and evaluation publications. However, detailed examination of the data shows no reduction in peer-reviewed outputs. There is some evidence that international uptake of the initiative continues to generate publications and create interest. Sustaining this initiative in the UK will require re-energising, a new focus and financing. The transition period created by the closure of its creator may well contribute to further reduced levels of interest and publication outputs in the UK. However, international implementation, evaluation and associated publications could serve to attract professional/academic interest in this well-established, positively reported, quality improvement initiative. This paper provides nurses and ward teams involved in quality improvement programmes with a detailed, current-state, examination and analysis of the Productive Ward literature, highlighting the bibliometric patterns of this large-scale, international, quality improvement programme. It serves to disseminate updated publication information to those in clinical practice who are involved in Productive Ward or a similar quality improvement initiative. © 2014 John Wiley & Sons Ltd.

Using Quality Rating Scales for Professional Development: Experiences from the UK

ERIC Educational Resources Information Center

Mathers, Sandra; Linskey, Faye; Seddon, Judith; Sylva, Kathy

2007-01-01

The ECERS-R and ITERS-R are among two of the most widely used observational measures for describing the characteristics of early childhood education and care. This paper describes a professional development programme currently taking place in seven regions across England, designed to train local government staff in the application of the scales as…

The Development and Part Validation of a U.K. Scale for Mathematics Anxiety

ERIC Educational Resources Information Center

Hunt, Thomas E.; Clark-Carter, David; Sheffield, David

2011-01-01

There is a paucity of information surrounding maths anxiety levels in the British undergraduate student population, and, due to terminological issues, existing measures of maths anxiety may not be appropriate measures to use with this population. The current study, therefore, reports on the development and validation of a new maths anxiety scale.…

"It's Really Making a Difference": How Small-Scale Research Projects Can Enhance Teaching and Learning

ERIC Educational Resources Information Center

Dexter, Barbara; Seden, Roy

2012-01-01

Following an internal evaluation exercise, using Action Research, this paper identifies the positive impact of small-scale research projects on teaching and learning at a single case study UK University. Clear evidence is given of how the projects benefited students and staff, and enhanced institutional culture. Barriers to better practice are…

Large Scale PEM Electrolysis to Enable Renewable Hydrogen Fuel Production

DTIC Science & Technology

2010-02-10

PEM Fuel Cell Anode + -Cathode e- e- e- e- Electric load...BOP system. • Enables new product launch (C- Series) Proton PEM cell stack for UK Vanguard subs 18UNCLASSIFIED: Dist A. Approved for public release...UNCLASSIFIED: Dist A. Approved for public release “Large Scale PEM Electrolysis to Enable Renewable Hydrogen Fuel Production” Alternative Energy

A new quality of life scale for teenagers with food hypersensitivity.

PubMed

Mackenzie, Heather; Roberts, Graham; Van Laar, Darren; Dean, Taraneh

2012-08-01

A disease-specific health-related quality of life (HRQL) scale enables the impact of current and new interventions on the HRQL of teenagers with food hypersensitivity (FHS) to be evaluated. No such scale exists for teenagers with FHS living in the U.K. This research aimed to develop and validate a disease-specific HRQL scale for this group, thus facilitating HRQL measurement in this population. A preliminary 51-item questionnaire was generated from interviews with 21 teenagers with FHS, the coverage and acceptability of which was refined in pre- and pilot testing (N = 102). On the basis of the field test data (N = 299), principal components analysis identified those items best measuring HRQL. The final 34-item You and Your Food Allergy scale covered five domains: social well-being and independence, support, day-to-day activities, family relations and emotional well-being. The whole scale displayed excellent internal consistency (Cronbach's α = 0.92) and test-retest reliability (ICC = 0.87). The scale correlated as hypothesised with a generic HRQL scale (PedsQL) and discriminated by disease severity, providing evidence for its construct validity. The You and Your Food Allergy scale is the first HRQL scale to have been developed and validated with U.K. teenagers with FHS. Subject to further evaluation of its psychometric properties, its development has important applications in future research into the HRQL of teenagers with FHS. Short and easy-to-complete, the scale has been designed to appeal to teenagers and is likely to be useful to facilitate discussion of HRQL issues. © 2012 John Wiley & Sons A/S.

Geoelectrical monitoring of simulated subsurface leakage to support high-hazard nuclear decommissioning at the Sellafield Site, UK.

PubMed

Kuras, Oliver; Wilkinson, Paul B; Meldrum, Philip I; Oxby, Lucy S; Uhlemann, Sebastian; Chambers, Jonathan E; Binley, Andrew; Graham, James; Smith, Nicholas T; Atherton, Nick

2016-10-01

A full-scale field experiment applying 4D (3D time-lapse) cross-borehole Electrical Resistivity Tomography (ERT) to the monitoring of simulated subsurface leakage was undertaken at a legacy nuclear waste silo at the Sellafield Site, UK. The experiment constituted the first application of geoelectrical monitoring in support of decommissioning work at a UK nuclear licensed site. Images of resistivity changes occurring since a baseline date prior to the simulated leaks revealed likely preferential pathways of silo liquor simulant flow in the vadose zone and upper groundwater system. Geophysical evidence was found to be compatible with historic contamination detected in permeable facies in sediment cores retrieved from the ERT boreholes. Results indicate that laterally discontinuous till units forming localized hydraulic barriers substantially affect flow patterns and contaminant transport in the shallow subsurface at Sellafield. We conclude that only geophysical imaging of the kind presented here has the potential to provide the detailed spatial and temporal information at the (sub-)meter scale needed to reduce the uncertainty in models of subsurface processes at nuclear sites. Copyright © 2016 British Geological Survey, NERC. Published by Elsevier B.V. All rights reserved.

How to Establish and Follow up a Large Prospective Cohort Study in the 21st Century--Lessons from UK COSMOS.

PubMed

Toledano, Mireille B; Smith, Rachel B; Brook, James P; Douglass, Margaret; Elliott, Paul

2015-01-01

Large-scale prospective cohort studies are invaluable in epidemiology, but they are increasingly difficult and costly to establish and follow-up. More efficient methods for recruitment, data collection and follow-up are essential if such studies are to remain feasible with limited public and research funds. Here, we discuss how these challenges were addressed in the UK COSMOS cohort study where fixed budget and limited time frame necessitated new approaches to consent and recruitment between 2009-2012. Web-based e-consent and data collection should be considered in large scale observational studies, as they offer a streamlined experience which benefits both participants and researchers and save costs. Commercial providers of register and marketing data, smartphones, apps, email, social media, and the internet offer innovative possibilities for identifying, recruiting and following up cohorts. Using examples from UK COSMOS, this article sets out the dos and don'ts for today's cohort studies and provides a guide on how best to take advantage of new technologies and innovative methods to simplify logistics and minimise costs. Thus a more streamlined experience to the benefit of both research participants and researchers becomes achievable.

How to Establish and Follow up a Large Prospective Cohort Study in the 21st Century - Lessons from UK COSMOS

PubMed Central

Toledano, Mireille B.; Smith, Rachel B.; Brook, James P.; Douglass, Margaret; Elliott, Paul

2015-01-01

Large-scale prospective cohort studies are invaluable in epidemiology, but they are increasingly difficult and costly to establish and follow-up. More efficient methods for recruitment, data collection and follow-up are essential if such studies are to remain feasible with limited public and research funds. Here, we discuss how these challenges were addressed in the UK COSMOS cohort study where fixed budget and limited time frame necessitated new approaches to consent and recruitment between 2009-2012. Web-based e-consent and data collection should be considered in large scale observational studies, as they offer a streamlined experience which benefits both participants and researchers and save costs. Commercial providers of register and marketing data, smartphones, apps, email, social media, and the internet offer innovative possibilities for identifying, recruiting and following up cohorts. Using examples from UK COSMOS, this article sets out the dos and don’ts for today's cohort studies and provides a guide on how best to take advantage of new technologies and innovative methods to simplify logistics and minimise costs. Thus a more streamlined experience to the benefit of both research participants and researchers becomes achievable. PMID:26147611

Testing measurement invariance of the Depression, Anxiety, and Stress Scales (DASS-21) across four countries.

PubMed

Scholten, Saskia; Velten, Julia; Bieda, Angela; Zhang, Xiao Chi; Margraf, Jürgen

2017-11-01

The rising burden of mental and behavioral disorders has become a global challenge (Murray et al., 2012). Measurement invariant clinical instruments are necessary for the assessment of relevant symptoms across countries. The present study tested the measurement invariance of the 21-item version of the Depression, Anxiety, and Stress Scales (DASS; Lovibond & Lovibond, 1995b) in Poland, Russia, the United Kingdom (U.K.), and the United States of America (U.S.). Telephone interviews were conducted with population-based samples (nPL = 1003, nRU = 3020, nU.K. = 1002, nU.S. = 1002). The DASS-21 shows threshold measurement invariance. Comparisons of latent means did not indicate differences between U.K. and U.S. However, Polish and Russian samples reported more depressive symptoms compared with U.K. and U.S. samples; the Russian sample had the highest levels of anxiety symptoms and the Polish sample demonstrated the highest stress levels. The DASS-21 can be recommended to meaningfully compare the relationships between variables across groups and to compare latent means in Polish-, Russian-, and English-speaking populations. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The effects of geology and the impact of seasonal correction factors on indoor radon levels: a case study approach.

PubMed

Gillmore, Gavin K; Phillips, Paul S; Denman, Antony R

2005-01-01

Geology has been highlighted by a number of authors as a key factor in high indoor radon levels. In the light of this, this study examines the application of seasonal correction factors to indoor radon concentrations in the UK. This practice is based on an extensive database gathered by the National Radiological Protection Board over the years (small-scale surveys began in 1976 and continued with a larger scale survey in 1988) and reflects well known seasonal variations observed in indoor radon levels. However, due to the complexity of underlying geology (the UK arguably has the world's most complex solid and surficial geology over the shortest distances) and considerable variations in permeability of underlying materials it is clear that there are a significant number of occurrences where the application of a seasonal correction factor may give rise to over-estimated or under-estimated radon levels. Therefore, the practice of applying a seasonal correction should be one that is undertaken with caution, or not at all. This work is based on case studies taken from the Northamptonshire region and comparisons made to other permeable geologies in the UK.

Complex fragmentation and silicification structures in fault zones: quartz crystallization and repeated fragmentation in the Rusey fault zone (Cornwall/UK)

NASA Astrophysics Data System (ADS)

Yilmaz, Tim I.; Blenkinsop, Tom; Duschl, Florian; Kruhl, Jörn H.

2015-04-01

Silicified fault rocks typically show structures resulting from various stages of fragmentation and quartz crystallization. Both processes interact episodically and result in complex structures on various scales, which require a wide spectrum of analysis tools. Based on field and microstructural data, the spatial-temporal connection between deformation, quartz crystallization and fluid and material flow along the Rusey fault zone was investigated. The fault can be examined in detail in three dimensions on the north Cornwall coast, UK. It occurs within Carboniferous sandstones, siltstones, mudstones and slates of the Culm basin, and is likely to have had a long history. The fault rocks described here formed during the younger events, possibly due to Tertiary strike-slip reactivation. Frequent fragmentation, flow and crystallization events and their interaction led to various generations of complex-structured quartz units, among them quartz-mantled and partly silicified wall-rock fragments, microcrystalline quartz masses of different compositions and structures, and quartz vein patterns of various ages. Lobate boundaries of quartz masses indicate viscous flow. Fragments are separated by quartz infill, which contains cm-sized open pores, in which quartz crystals have pyramidal terminations. Based on frequent occurrence of feathery textures and the infill geometry, quartz crystallization from chalcedony appears likely, and an origin from silica gel is discussed. Fragmentation structures are generally fractal. This allows differentiation between various processes, such as corrosive wear, wear abrasion and hydraulic brecciation. Material transport along the brittle shear zone, and displacement of the wall-rocks, were at least partly governed by flow of mobile fluid-quartz-particle suspensions. The complex meso- to microstructures were generated by repeated processes of fragmentation, quartz precipitation and grain growth. In general, the brittle Rusey fault zone represents a zone of multiple fragmentation, fluid flow, crystallization and quartz dissolution and precipitation, and is regarded as key example of large-scale cyclic interaction of these processes. The geological evidence of interactions between processes implies that feedbacks and highly non-linear mechanical behaviour generated the complex meso- and microstructures. The fault zone rheology may also therefore have been complex.

Academic performance of ethnic minority candidates and discrimination in the MRCGP examinations between 2010 and 2012: analysis of data.

PubMed

Esmail, Aneez; Roberts, Chris

2013-09-26

To determine the difference in failure rates in the postgraduate examination of the Royal College of General Practitioners (MRCGP) by ethnic or national background, and to identify factors associated with pass rates in the clinical skills assessment component of the examination. Analysis of data provided by the Royal College of General Practitioners and the General Medical Council. Cohort of 5095 candidates sitting the applied knowledge test and clinical skills assessment components of the MRCGP examination between November 2010 and November 2012. A further analysis was carried out on 1175 candidates not trained in the United Kingdom, who sat an English language capability test (IELTS) and the Professional and Linguistic Assessment Board (PLAB) examination (as required for full medical registration), controlling for scores on these examinations and relating them to pass rates of the clinical skills assessment. United Kingdom. After controlling for age, sex, and performance in the applied knowledge test, significant differences persisted between white UK graduates and other candidate groups. Black and minority ethnic graduates trained in the UK were more likely to fail the clinical skills assessment at their first attempt than their white UK colleagues (odds ratio 3.536 (95% confidence interval 2.701 to 4.629), P<0.001; failure rate 17% v 4.5%). Black and minority ethnic candidates who trained abroad were also more likely to fail the clinical skills assessment than white UK candidates (14.741 (11.397 to 19.065), P<0.001; 65% v 4.5%). For candidates not trained in the UK, black or minority ethnic candidates were more likely to fail than white candidates, but this difference was no longer significant after controlling for scores in the applied knowledge test, IELTS, and PLAB examinations (adjusted odds ratio 1.580 (95% confidence interval 0.878 to 2.845), P=0.127). Subjective bias due to racial discrimination in the clinical skills assessment may be a cause of failure for UK trained candidates and international medical graduates. The difference between British black and minority ethnic candidates and British white candidates in the pass rates of the clinical skills assessment, despite controlling for prior attainment, suggests that subjective bias could also be a factor. Changes to the clinical skills assessment could improve the perception of the examination as being biased against black and minority ethnic candidates. The difference in training experience and other cultural factors between candidates trained in the UK and abroad could affect outcomes. Consideration should be given to strengthening postgraduate training for international medical graduates.

The privacy-reciprocity connection in biobanking: comparing German with UK strategies.

PubMed

Hobbs, A; Starkbaum, J; Gottweis, U; Wichmann, H E; Gottweis, H

2012-01-01

In recent years, the adequacy of the 'gift' model of research participation has been increasingly questioned. This study used focus groups to explore how potential and actual participants of biobanks in the UK and Germany negotiate the relationship between concerns over privacy protection, reciprocity and benefit sharing. In Germany, 15 focus groups (n = 151) were conducted: 11 general public groups (n = 116) and 4 with former cohort study participants including the KORA and the Popgen cohort study (n = 35). In the UK, 9 focus groups (n = 61) were conducted: 4 general public groups (n = 33) and 5 with UK Biobank and European Huntington's Disease (Euro-HD) Registry biorepository participants (n = 28). Forms of reciprocity were found to partially mitigate potential and actual biobank participants' concerns over personal privacy risks and future unintended consequences of biobank in both Germany and the UK. Specifically, notions of individual reciprocity were at the forefront in the context of personal disadvantages to participation, while communal reciprocity was prominent when potential and actual participants were discussing the uncertainty of the long-term nature of biobanking. The research indicates that reciprocity can be viewed as a mode to deal with individuals' concerns about participating in a biobank, both by acting as a return 'favor' or 'gift,' and through establishing an ongoing relationship between participants, researchers and society. It is suggested that future biobanking projects will need to flexibly combine individual and communal forms of reciprocity if they are to recruit and maintain sufficient numbers of participants. Copyright © 2012 S. Karger AG, Basel.

The future of UK/Irish surgery: A European solution.

PubMed

Varzgalis, M; Kerin, M J; Sweeney, K J

2015-11-01

The United Kingdom (UK) and Republic of Ireland (ROI) hospital systems are dependent on junior doctors for their functionality however it is increasingly difficult to recruit UK/ROI trained doctors to fill these posts. Directive 2005/36/EC, which came into force in 2007, is the principal European legislation on the recognition of equivalence of professional qualifications across Europe. European trained doctors are therefore attractive candidates for junior doctor posts. However, although their training is recognised as equivalent by the Irish Medical Council (IMC) and General Medical Council (GMC) they are not being appointed to equivalent posts by the Health Service Executive (HSE) or National Health Service (NHS). With the influence of European Union (EU) centralisation, modification of UK/ROI consultant grade is imminent, possibly to pyramidal structure of the Continental European model with clearer lines of corporate responsibility. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Factors that Promote High Post-16 Participation of Some Minority Ethnic Groups in England: A Systematic Review of the UK-Based Literature

ERIC Educational Resources Information Center

See, Beng Huat; Torgerson, Carole; Gorard, Stephen; Ainsworth, Hannah; Low, Graham; Wright, Kath

2011-01-01

The aim of the article is to identify those factors that drive the high participation in immediate post-16 and higher education of some minority ethnic groups in the UK. What could we learn from these examples to encourage higher aspirations more generally? The article reports a summary of a formal and systematic review of 1678 studies dated 1997…

Improving National Capability in Biogeochemical Flux Modelling: the UK Environmental Virtual Observatory (EVOp)

NASA Astrophysics Data System (ADS)

Johnes, P.; Greene, S.; Freer, J. E.; Bloomfield, J.; Macleod, K.; Reaney, S. M.; Odoni, N. A.

2012-12-01

The best outcomes from watershed management arise where policy and mitigation efforts are underpinned by strong science evidence, but there are major resourcing problems associated with the scale of monitoring needed to effectively characterise the sources rates and impacts of nutrient enrichment nationally. The challenge is to increase national capability in predictive modelling of nutrient flux to waters, securing an effective mechanism for transferring knowledge and management tools from data-rich to data-poor regions. The inadequacy of existing tools and approaches to address these challenges provided the motivation for the Environmental Virtual Observatory programme (EVOp), an innovation from the UK Natural Environment Research Council (NERC). EVOp is exploring the use of a cloud-based infrastructure in catchment science, developing an exemplar to explore N and P fluxes to inland and coastal waters in the UK from grid to catchment and national scale. EVOp is bringing together for the first time national data sets, models and uncertainty analysis into cloud computing environments to explore and benchmark current predictive capability for national scale biogeochemical modelling. The objective is to develop national biogeochemical modelling capability, capitalising on extensive national investment in the development of science understanding and modelling tools to support integrated catchment management, and supporting knowledge transfer from data rich to data poor regions, The AERC export coefficient model (Johnes et al., 2007) has been adapted to function within the EVOp cloud environment, and on a geoclimatic basis, using a range of high resolution, geo-referenced digital datasets as an initial demonstration of the enhanced national capacity for N and P flux modelling using cloud computing infrastructure. Geoclimatic regions are landscape units displaying homogenous or quasi-homogenous functional behaviour in terms of process controls on N and P cycling, underpin this approach (Johnes & Butterfield, 2002). Ten regions have been defined across the UK using GIS manipulation of spatial data describing hydrogeology, runoff, topographical slope and soil parent material. The export coefficient model operates within this regional modelling framework, providing mapped, tabulated and statistical outputs at scales from 1km2 grid scale to river catchment, WFD river basin district, major coastal drainage units to the North Sea, North Atlantic and English Channel, to the international reporting units defined under OSPAR, the International Convention for the protection of the marine environment of the North-East Atlantic. Here the geoclimatic modelling framework is presented together with modelled fluxes for N and P for each scale of reporting unit, together with scenario analysis applied at regional scale and mapped at national scale. The ways in which the results can be used to further explore the primary drivers for spatial variation and identify waterbodies at risk, especially in unmonitored and data-poor catchments are discussed, and the technical and computational support of a cloud-based infrastructure is evaluated as a mechanism to explore potential water quality impacts of future mitigation strategies applied at catchment to national scale.

Automated external defibrillators in public places: position statement from the Faculty of Sport and Exercise Medicine UK.

PubMed

Iqbal, Zafar; Somauroo, John

2015-11-01

Position statements published by the Faculty of Sport and Exercise Medicine UK are quick reference or information documents and include up to 10 short points of clinical relevance for the Sport and Exercise Medicine community as well as for general practitioners and health professionals. The Faculty of Sport and Exercise Medicine (FSEM) UK has published a statement to create greater awareness that the survival rate from Sudden Cardiac Arrest could improve with prompt access to an automated external defibrillator (AED). 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.

United Kingdom Country Analysis Brief

EIA Publications

2016-01-01

The United Kingdom (UK) is the fifth-largest economy in the world in terms of gross domestic product. Following years as a net exporter of crude oil and natural gas, the UK became a net importer of both fuels in 2004 and 2005, respectively. Production from UK oil and natural gas fields peaked in the late 1990s and has generally declined over the past several years as the discovery of new reserves and new production has not kept pace with the maturation of existing fields. Production of petroleum and other liquids increased in 2015, as investments made when oil prices were high came to fruition, but the UK remains a net importer. Renewable energy use, particularly in the electric power sector, has more than doubled over the past decade (2005-14). However, petroleum and natural gas continue to account for most of UK's energy consumption. In 2014, petroleum and natural gas accounted for 36% and 33%, respectively, of total energy consumption (Figure 2).1 Coal also continues to be a significant part of total energy consumption (16% in 2014). Energy use per unit of gross domestic product (GDP) in the UK is one of the lowest among western economies. The UK has seen total primary energy consumption decline by almost 20% over the past decade (2005-14). This decline resulted from smaller contribution of energy-intensive industry to the economy, economic contraction, and improvements in energy efficiency.

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.

Spatio-temporal Assessment Of The Land Use Implications Of Solar PV And Bioenergy Deployment In The UK TM Energy Model

NASA Astrophysics Data System (ADS)

Sobral Mourao, Z.; Konadu, D. D.; Skelton, S.; Lupton, R.

2015-12-01

The UK TIMES model (UKTM) succeeds the UK MARKAL as the underlying model of the UK Department of Energy and Climate Change (DECC) for long term energy system planning and policy development. It generates energy system pathways which achieve the 80% greenhouse gas (GHG) emissions reduction target by 2050, stipulated in the UK Climate Change Act (2008), at the least possible cost. Some of these pathways prescribe large-scale deployment of solar PV and indigenously sourced bioenergy, which are land intensive and could result in significant land use transitions; but would this create competition and stress for UK land use? To answer the above question, this study uses an integrated spatio-temporal modelling approach, ForeseerTM, which characterises the interdependencies between the energy and land systems by evaluating the land required under each pathways for solar PV and bioenergy, based on scenarios of a range of PV conversion efficiencies, and energy crop yield projections. The outcome is compared with availability of suitable locations for solar PV and sustainable limits of agricultural land appropriation for bioenergy production to assess potential stresses and competition with other land use services. Preliminary results show UKTM pathways could pose significant impact on the UK land use system. Bioenergy deployment could potentially compete with other land services by taking up a significant part of the available UK agricultural land thus competing directly with food production, most notably livestock production. For pathways with significant solar PV deployment, direct competition would not be focussed on the high quality land used for food crop production but rather for land used for livestock production and other ecosystem services.

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

76 FR 43263 - Application(s) for Duty-Free Entry of Scientific Instruments

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

.... Instrument: Nano test platform. Manufacturer: Micro Materials Ltd., UK. Intended Use: The instrument will be... will be used to study nano-scale domain formation associated with phase [[Page 43264

Towards national-scale greenhouse gas emissions evaluation with robust uncertainty estimates

NASA Astrophysics Data System (ADS)

Rigby, Matthew; Swallow, Ben; Lunt, Mark; Manning, Alistair; Ganesan, Anita; Stavert, Ann; Stanley, Kieran; O'Doherty, Simon

2016-04-01

Through the Deriving Emissions related to Climate Change (DECC) network and the Greenhouse gAs Uk and Global Emissions (GAUGE) programme, the UK's greenhouse gases are now monitored by instruments mounted on telecommunications towers and churches, on a ferry that performs regular transects of the North Sea, on-board a research aircraft and from space. When combined with information from high-resolution chemical transport models such as the Met Office Numerical Atmospheric dispersion Modelling Environment (NAME), these measurements are allowing us to evaluate emissions more accurately than has previously been possible. However, it has long been appreciated that current methods for quantifying fluxes using atmospheric data suffer from uncertainties, primarily relating to the chemical transport model, that have been largely ignored to date. Here, we use novel model reduction techniques for quantifying the influence of a set of potential systematic model errors on the outcome of a national-scale inversion. This new technique has been incorporated into a hierarchical Bayesian framework, which can be shown to reduce the influence of subjective choices on the outcome of inverse modelling studies. Using estimates of the UK's methane emissions derived from DECC and GAUGE tall-tower measurements as a case study, we will show that such model systematic errors have the potential to significantly increase the uncertainty on national-scale emissions estimates. Therefore, we conclude that these factors must be incorporated in national emissions evaluation efforts, if they are to be credible.

Provision of undergraduate otorhinolaryngology teaching within General Medical Council approved UK medical schools: what is current practice?

PubMed

Khan, M M; Saeed, S R

2012-04-01

Despite longstanding concern, provision of undergraduate ENT teaching has not improved in response to the aims of the UK General Medical Council's initiative Tomorrow's Doctors. Previous studies have demonstrated poor representation of ENT within the undergraduate curriculum. We aimed to identify current practice in order to establish undergraduate ENT experience across UK medical schools, a timely endeavour in light of the General Medical Council's new 2011-2013 education strategy. Questionnaires were sent to ENT consultants, medical school deans and students. All schools with a clinical curriculum were anonymously represented. Our outcome measures were the provision of mandatory or optional ENT placements, and their duration and content. A compulsory ENT placement was available to over half (53 per cent) of the students. Ten of the 26 participating schools did not offer an ENT attachment. The mean mandatory placement was 8 days. Overall, 38 per cent of students reported a satisfactory compulsory ENT placement. Most ENT consultants questioned considered that newly qualified doctors were not proficient in managing common ENT problems that did not require specialist referral. Little improvement in the provision of undergraduate ENT teaching was demonstrated. An increase in the proportion of students undertaking ENT training is necessary. Time and curriculum constraints on medical schools mean that optimisation of available resources is required.

Accelerated technology transfer: the UK quantum initiative

NASA Astrophysics Data System (ADS)

Bennett, Simon D.

2016-10-01

A new generation of quantum technology based systems, exploiting effects such as superposition and entanglement, will enable widespread, highly disruptive applications which are expected to be of great economic significance. However, the technology is only just emerging from the physics laboratory and generally remains at low TRLs. The question is: where, and when, will this impact be first manifest? The UK, with substantial Government backing, has embarked on an ambitious national program to accelerate the process of technology transfer with the objective of seizing a significant and sustainable share of the future economic benefit for the UK. Many challenges and uncertainties remain but the combined and co-ordinated efforts of Government, Industry and Academia are making great progress. The level of collaboration is unusually high and the goal of embedding a "QT Ecosystem" in the UK looks to be attainable. This paper describes the UK national programme, its key players, and their respective roles. It will illustrate some of the likely first commercial applications and provide a status update. Some of the challenges that might prevent realisation of the goal will be highlighted.

A survey of statistics in three UK general practice journal

PubMed Central

Rigby, Alan S; Armstrong, Gillian K; Campbell, Michael J; Summerton, Nick

2004-01-01

Background Many medical specialities have reviewed the statistical content of their journals. To our knowledge this has not been done in general practice. Given the main role of a general practitioner as a diagnostician we thought it would be of interest to see whether the statistical methods reported reflect the diagnostic process. Methods Hand search of three UK journals of general practice namely the British Medical Journal (general practice section), British Journal of General Practice and Family Practice over a one-year period (1 January to 31 December 2000). Results A wide variety of statistical techniques were used. The most common methods included t-tests and Chi-squared tests. There were few articles reporting likelihood ratios and other useful diagnostic methods. There was evidence that the journals with the more thorough statistical review process reported a more complex and wider variety of statistical techniques. Conclusions The BMJ had a wider range and greater diversity of statistical methods than the other two journals. However, in all three journals there was a dearth of papers reflecting the diagnostic process. Across all three journals there were relatively few papers describing randomised controlled trials thus recognising the difficulty of implementing this design in general practice. PMID:15596014

The multi-dimensional measure of informed choice: a validation study.

PubMed

Michie, Susan; Dormandy, Elizabeth; Marteau, Theresa M

2002-09-01

The aim of this prospective study is to assess the reliability and validity of a multi-dimensional measure of informed choice (MMIC). Participants were 225 pregnant women in two general hospitals in the UK, women receiving low-risk results following serum screening for Down syndrome. The MMIC was administered before testing and the Ottawa Decisional Conflict Scale was administered 6 weeks later. The component scales of the MMIC, knowledge and attitude, were internally consistent (alpha values of 0.68 and 0.78, respectively). Those who made a choice categorised as informed using the MMIC rated their decision 6 weeks later as being more informed, better supported and of higher quality than women whose choice was categorised as uninformed. This provides evidence of predictive validity, whilst the lack of association between the MMIC and anxiety shows construct (discriminant) validity. Thus, the MMIC has been shown to be psychometrically robust in pregnant women offered the choice to undergo prenatal screening for Down syndrome and receiving a low-risk result. Replication of this finding in other groups, facing other decisions, with other outcomes, should be assessed in future research.

Treatment of Asbestos Wastes Using the GeoMelt Vitrification Process

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

Finucane, K.G.; Thompson, L.E.; Abuku, T.

The disposal of waste asbestos from decommissioning activities is becoming problematic in countries which have limited disposal space. A particular challenge is the disposal of asbestos wastes from the decommissioning of nuclear sites because some of it is radioactively contaminated or activated and disposal space for such wastes is limited. GeoMelt{sup R} vitrification is being developed as a treatment method for volume and toxicity minimization and radionuclide immobilization for UK radioactive asbestos mixed waste. The common practice to date for asbestos wastes is disposal in licensed landfills. In some cases, compaction techniques are used to minimize the disposal space requirements.more » However, such practices are becoming less practical. Social pressures have resulted in changes to disposal regulations which, in turn, have resulted in the closure of some landfills and increased disposal costs. In the UK, tens of thousands of tonnes of asbestos waste will result from the decommissioning of nuclear sites over the next 20 years. In Japan, it is estimated that over 40 million tonnes of asbestos materials used in construction will require disposal. Methods for the safe and cost effective volume reduction of asbestos wastes are being evaluated for many sites. The GeoMelt{sup R} vitrification process is being demonstrated at full-scale in Japan for the Japan Ministry of Environment and plans are being developed for the GeoMelt treatment of UK nuclear site decommissioning-related asbestos wastes. The full-scale treatment operations in Japan have also included contaminated soils and debris. The GeoMelt{sup R} vitrification process result in the maximum possible volume reduction, destroys the asbestos fibers, treats problematic debris associated with asbestos wastes, and immobilizes radiological contaminants within the resulting glass matrix. Results from recent full-scale treatment operations in Japan are discussed and plans for GeoMelt treatment of UK nuclear site decommissioning-related asbestos wastes are outlined. (authors)« less

Evolution of Policy Leading to the 2006 General Dental Service Contract and Some Possible Outcomes

ERIC Educational Resources Information Center

Downer, Martin C.; Drugan, Caroline S.

2007-01-01

Background and objective: This paper was designed to rehearse the evolution of policy for the UK NHS General Dental Service (and related services) since its inception in 1948, culminating in the establishment of a new contract for general dental practitioners in 2006. Methods: Information was abstracted from the literature, historical records,…

The Counseling Center Assessment of Psychological Symptoms (CCAPS-62): Acceptance, feasibility, and initial psychometric properties in a UK student population.

PubMed

Broglia, Emma; Millings, Abigail; Barkham, Michael

2017-09-01

The burden and severity of student mental health continue to increase in parallel with increasing financial pressures on students and services alike. There is a need for a student-specific measure of distress that acknowledges their unique context. This study examined the feasibility, acceptance, and initial psychometric properties of a US measure, the Counseling Center Assessment of Psychological Symptoms (CCAPS), in a UK student sample. A sample of 294 UK help-seeking students from two universities completed the CCAPS-62 and Clinical Outcomes in Routine Evaluation (CORE-10) as a comparator. The factor solution and reliability of the CCAPS-62 were examined. Correlations and clinical boundaries were determined between the CCAPS-62 subscales and CORE-10, and comparisons were made with US published norms. The CCAPS-62 demonstrated a strong factor solution that matched the intended subscales. All subscales had good reliability and correlated significantly with the CORE-10. The agreement on caseness between the two measures was 92.8% with 86.3% reaching clinical threshold on both the CCAPS-62 and CORE-10. Severity was most noticeable for academic distress, depression, anxiety, and social anxiety. Compared to US data, UK students showed higher clinical severity for all psychological symptoms. The CCAPS-62 is a reliable and psychometrically valid assessment measure to use with UK students without revision. The overall distress indicated is similar to that of the CORE-10, but the individual subscales are more informative of specific student concerns including academic distress, social anxiety, and substance abuse. Potential benefits of administering a student-focused assessment measure in student counselling services are discussed. University students attending counselling in the UK demonstrate clinical severity for academic distress, depression, anxiety, and social anxiety. Compared to university students in the US, UK students present with higher clinical severity on all contextual measures of student psychological distress. It is advantageous for university counselling services to administer a student-specific clinical measure over measures intended for the general clinical population. CCAPS-62 is an acceptable, feasible, and psychometrically valid measure of student psychological distress that can be used in the UK without revision. It is important for university counselling services to continue to provide support from therapists that are trained and experienced in the university context over services intended for the general clinical population. Copyright © 2017 John Wiley & Sons, Ltd.

Doctors' enjoyment of their work and satisfaction with time available for leisure: UK time trend questionnaire-based study.

PubMed

Surman, Geraldine; Lambert, Trevor W; Goldacre, Michael

2016-04-01

Doctors' job satisfaction is important to the health service to ensure commitment, effective training, service provision and retention. Job satisfaction matters to doctors for their personal happiness, fulfilment, service to patients and duty to employers. Monitoring job satisfaction trends informs workforce planning. We surveyed UK-trained doctors up to 5 years after graduation for six graduation year cohorts: 1996, 1999, 2002, 2005, 2008, 2012. Doctors scored their job enjoyment (Enjoyment) and satisfaction with time outside work (Leisure) on a scale from 1 (lowest enjoyment/satisfaction) to 10 (highest). Overall, 47% had a high level of Enjoyment (scores 8-10) 1 year after graduation and 56% after 5 years. For Leisure, the corresponding figures were 19% and 37% at 1 and 5 years, respectively. For Leisure at 1 year, high scores were given by about 10% in the 1990s, rising to about 25% in the mid-2000s. Low scores (1-3) for Enjoyment were given by 15% of qualifiers of 1996, falling to 5% by 2008; corresponding figures for Leisure were 42% and 19%. At 5 years, the corresponding figures were 6% and 4%, and 23% and 17%. Enjoyment and Leisure were scored higher by general practitioners than doctors in other specialties. Both measures varied little by sex, ethnicity or medical school attended. Scores for Enjoyment were generally high; those for Leisure were lower. Policy initiatives should address why this aspect of satisfaction is low, particularly in the first year after graduation but also among hospital doctors 5 years after graduation. 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/

Doctors’ enjoyment of their work and satisfaction with time available for leisure: UK time trend questionnaire-based study

PubMed Central

Surman, Geraldine; Lambert, Trevor W; Goldacre, Michael

2016-01-01

Introduction Doctors’ job satisfaction is important to the health service to ensure commitment, effective training, service provision and retention. Job satisfaction matters to doctors for their personal happiness, fulfilment, service to patients and duty to employers. Monitoring job satisfaction trends informs workforce planning. Materials and methods We surveyed UK-trained doctors up to 5 years after graduation for six graduation year cohorts: 1996, 1999, 2002, 2005, 2008, 2012. Doctors scored their job enjoyment (Enjoyment) and satisfaction with time outside work (Leisure) on a scale from 1 (lowest enjoyment/satisfaction) to 10 (highest). Results Overall, 47% had a high level of Enjoyment (scores 8–10) 1 year after graduation and 56% after 5 years. For Leisure, the corresponding figures were 19% and 37% at 1 and 5 years, respectively. For Leisure at 1 year, high scores were given by about 10% in the 1990s, rising to about 25% in the mid-2000s. Low scores (1–3) for Enjoyment were given by 15% of qualifiers of 1996, falling to 5% by 2008; corresponding figures for Leisure were 42% and 19%. At 5 years, the corresponding figures were 6% and 4%, and 23% and 17%. Enjoyment and Leisure were scored higher by general practitioners than doctors in other specialties. Both measures varied little by sex, ethnicity or medical school attended. Conclusions Scores for Enjoyment were generally high; those for Leisure were lower. Policy initiatives should address why this aspect of satisfaction is low, particularly in the first year after graduation but also among hospital doctors 5 years after graduation. PMID:26783328

Recruitment and retention of general practitioners in the UK: what are the problems and solutions?

PubMed

Young, R; Leese, B

1999-10-01

Recruitment and retention of general practitioners (GPs) has become an issue of major concern in recent years. However, much of the evidence is anecdotal and some commentators continue to question the scale of workforce problems. Hence, there is a need to establish a clear picture of those instabilities (i.e. imbalances between demand and supply) that do exist in the GP labour market in the UK. Based on a review of the published literature, we identify problems that stem from: (i) the changing social composition of the workforce and the fact that a large proportion of qualified GPs are significantly underutilized within traditional career structures; and (ii) the considerable differences in the ability of local areas to match labour demand and supply. We argue that one way to address these problems would be to encourage greater flexibility in a number of areas highlighted in the literature: (i) time commitment across the working day and week; (ii) long-term career paths; (iii) training and education; and (iv) remuneration and contract conditions. Overall, although the evidence suggests that the predicted 'crisis' has not yet occurred in the GP labour market as a whole, there is no room for lack of imagination in planning terms. Workforce planners continue to emphasize national changes to the medical school intake as the means to balance labour demand and supply between the specialities; however, better retention and deployment of existing GP labour would arguably produce more effective supply-side solutions. In this context, current policy and practice developments (e.g. Primary Care Groups and Primary Care Act Pilot Sites) offer a unique learning base upon which to move forward.

The use of standard contracts in the English National Health Service: a case study analysis.

PubMed

Petsoulas, Christina; Allen, Pauline; Hughes, David; Vincent-Jones, Peter; Roberts, Jennifer

2011-07-01

The use of contracts is vital to market transactions. The introduction of market reforms in health care in the U.K. and other developed countries twenty years ago meant greater use of contracts. In the U.K., health care contracting was widely researched in the 1990s. Yet, despite the changing policy context, the subject has attracted less interest in recent years. This paper seeks to fill a gap by reporting findings from a study of contracting in the English National Health Service (NHS) after the introduction of the national standard contract in 2007. By using economic and socio-legal theories and two case studies we examine the way in which the new contract was implemented in practice and the extent to which implementation conformed to policy intentions and to our theoretical predictions. Data were collected using non-participant observation of 36 contracting meetings, 24 semi-structured interviews, and analysis of documents. We found that despite efforts to introduce a more detailed ('complete') contract, in practice, purchasers and providers often reverted to a more relational style of contracting. Frequently reliance on the NHS hierarchy proved to be indispensable; in particular, formal dispute resolution was avoided and financial risk was re-allocated in compromises that sometimes ignored contractual provisions. Serious data deficiencies and shortages of skilled personnel still caused major difficulties. We conclude that contracting for health care continues to raise serious problems, which may be exacerbated by the impending transfer of responsibility to groups of general practitioners (GPs) who generally lack experience and expertise in large-scale, secondary care contracting. Copyright © 2011 Elsevier Ltd. All rights reserved.

Students' clinical experience on outreach placements.

PubMed

Smith, M; Lennon, M A; Robinson, P G

2010-02-01

Primary care outreach placements increasingly feature in UK undergraduate dental curricula. The profile of clinical work undertaken on placement may differ from traditional hospital-based programmes and between outreach settings. An appreciation of any differences could inform curriculum development. To compare the profiles of clinical work experienced on a traditional hospital-based programme and outreach placements in different settings. One dental hospital and eight existing primary care block placements in England. Subjects were four cohorts of senior dental students in one UK dental school. Departmental records provided data on students' clinical experience in different settings and their achievement of placement learning objectives. Descriptive statistics for groups were compared. (1) Counts of patients encountered and of clinical procedures completed in the following categories: simple plastic restorations, endodontics, cast restorations, dentures, extractions and children's dentistry. (2) Student perceptions of placement learning reported via Likert scales. Outreach students encountered twice as many patients and typically completed about three times as much clinical work as students in the hospital, e.g. 44 cf 16 simple plastic restorations, seven cf two endodontic procedures. There were variations in profiles by setting. For example, amalgam being more likely to be used on outreach especially in the General Dental Service; more children's dentistry in community services and more extractions in Dental Access Centres. Students reported learning outcomes generally being achieved (average 94%) although with some variation by setting. Dental outreach training greatly increases the quantity of students' clinical experience in everyday dentistry compared to a hospital-based programme. Placements also increase awareness of service delivery and develop clinical skills. There are appreciable variations between outreach settings possibly reflecting their purposes. Multiple contrasting outreach placements for each student might increase the uniformity of learning experiences.

Spectral analysis of structure functions and their scaling exponents in forced isotropic turbulence

NASA Astrophysics Data System (ADS)

Linkmann, Moritz; McComb, W. David; Yoffe, Samuel; Berera, Arjun

2014-11-01

The pseudospectral method, in conjunction with a new technique for obtaining scaling exponents ζn from the structure functions Sn (r) , is presented as an alternative to the extended self-similarity (ESS) method and the use of generalized structure functions. We propose plotting the ratio | Sn (r) /S3 (r) | against the separation r in accordance with a standard technique for analysing experimental data. This method differs from the ESS technique, which plots the generalized structure functions Gn (r) against G3 (r) , where G3 (r) ~ r . Using our method for the particular case of S2 (r) we obtain the new result that the exponent ζ2 decreases as the Taylor-Reynolds number increases, with ζ2 --> 0 . 679 +/- 0 . 013 as Rλ --> ∞ . This supports the idea of finite-viscosity corrections to the K41 prediction for S2, and is the opposite of the result obtained by ESS. The pseudospectral method permits the forcing to be taken into account exactly through the calculation of the energy input in real space from the work spectrum of the stirring forces. The combination of the viscous and the forcing corrections as calculated by the pseudospectral method is shown to account for the deviation of S3 from Kolmogorov's ``four-fifths''-law at all scales. This work has made use of the resources provided by the UK supercomputing service HECToR, made available through the Edinburgh Compute and Data Facility (ECDF). A. B. is supported by STFC, S. R. Y. and M. F. L. are funded by EPSRC.

A national-scale analysis of the impacts of drought on water quality in UK rivers

NASA Astrophysics Data System (ADS)

Coxon, G.; Howden, N. J. K.; Freer, J. E.; Whitehead, P. G.; Bussi, G.

2015-12-01

Impacts of droughts on water quality qre difficult to quanitify but are essential to manage ecosystems and maintain public water supply. During drought, river water quality is significantly changed by increased residence times, reduced dilution and enhanced biogeochemical processes. But, the impact severity varies between catchments and depends on multiple factors including the sensitivity of the river to drought conditions, anthropogenic influences in the catchment and different delivery patterns of key nutrient, contaminant and mineral sources. A key constraint is data availability for key water quality parameters such that impacts of drought periods on certain determinands can be identified. We use national-scale water quality monitoring data to investigate the impacts of drought periods on water quality in the United Kingdom (UK). The UK Water Quality Sampling Harmonised Monitoring Scheme (HMS) dataset consists of >200 UK sites with weekly to monthly sampling of many water quality variables over the past 40 years. This covers several major UK droughts in 1975-1976, 1983-1984,1989-1992, 1995 and 2003, which cover severity, spatial and temporal extent, and how this affects the temporal impact of the drought on water quality. Several key water quality parameters, including water temperature, nitrate, dissolved organic carbon, orthophosphate, chlorophyll and pesticides, are selected from the database. These were chosen based on their availability for many of the sites, high sampling resolution and importance to the drinking water function and ecological status of the river. The water quality time series were then analysed to investigate whether water quality during droughts deviated significantly from non-drought periods and examined how the results varied spatially, for different drought periods and for different water quality parameters. Our results show that there is no simple conclusion as to the effects of drought on water quality in UK rivers; impacts are diverse both in terms of timing, magnitude and duration. We consider several scenarios in which management interventions may alleviate water quality pressures, and discuss how the many interacting factors need to be better characterised to support detailed mechanistic models to improve our process understanding.

Changes in O3 and NO2 due to emissions from Fracking in the UK.

NASA Astrophysics Data System (ADS)

Archibald, Alexander; Ordonez, Carlos

2016-04-01

Poor air quality is a problem that affects millions of people around the world. Understanding the driving forces behind air pollution is complicated as the precursor gases which combine to produce air pollutants react in a highly non-linear manner and are subject to a range of atmospheric transport mechanisms compounded by the weather. A great deal of money has been spent on mitigating air pollution and so it's important to assess the impacts that new technologies that emit air pollutant precursors may have on local and regional air pollution. One of the most highly discussed new technologies that could impact air quality is the adoption of wide-scale hydraulic fracturing or "fracking" for natural gas. Indeed in regions of the USA where fracking is commonplace large levels of ozone (O3 - a key air pollutant) have been observed and attributed directly to the fracking process. In this study, a numerical modelling framework was used to assess possible impacts of fracking in the UK where at present no large scale fracking facilities are in operation. A number of emissions scenarios were developed for the principle gas phase air pollution precursors: the oxides of nitrogen (NOx) and volatile organic compounds (VOCs). These emissions scenarios were then used in a state-of-the-art numerical air quality model (the UK Met Office operational air quality forecasting model AQUM) to determine potential impacts related to fracking on UK air quality. Comparison of base model results and observations for the year 2013 of NOx, O3 and VOCs from the UK Automatic Urban and Rural Network (AURN) showed that AQUM has good skill at simulating these gas phase air pollutants (O3 r=0.64, NMGE=0.3; NO2 r=0.62, NMGE=0.51). Analysis of the simulations with fracking emissions demonstrate that there are large changes in 1hr max NO2 (11.6±6.6 ppb) with modest increases in monthly mean NO2, throughout the British Isles (150±100 ppt). These results highlight that stringent measures should be applied to prevent deleterious impacts on air quality from emissions related to fracking in the UK.

The payment for performance model and its influence on British general practitioners' principles and practice.

PubMed

Norman, Armando Henrique; Russell, Andrew J; Macnaughton, Jane

2014-01-01

This article explores some effects of the British payment for performance model on general practitioners' principles and practice, which may contribute to issues related to financial incentive modalities and quality of primary healthcare services in low and middle-income countries. Aiming to investigate what general practitioners have to say about the effect of the British payment for performance on their professional ethos we carried out semi-structured interviews with 13 general practitioner educators and leaders working in academic medicine across the UK. The results show a shift towards a more biomedical practice model and fragmented care with nurse practitioners and other health care staff focused more on specific disease conditions. There has also been an increased medicalisation of the patient experience both through labelling and the tendency to prescribe medications rather than non-pharmacological interventions. Thus, the British payment for performance has gradually strengthened a scientific-bureaucratic model of medical practice which has had profound effects on the way family medicine is practiced in the UK.

Nurture Groups: A Large-Scale, Controlled Study of Effects on Development and Academic Attainment

ERIC Educational Resources Information Center

Reynolds, Sue; MacKay, Tommy; Kearney, Maura

2009-01-01

Nurture groups have contributed to inclusive practices in primary schools in the UK for some time now and have frequently been the subject of articles in this journal. This large-scale, controlled study of nurture groups across 32 schools in the City of Glasgow provides further evidence for their effectiveness in addressing the emotional…

The application of liquid air energy storage for large scale long duration solutions to grid balancing

NASA Astrophysics Data System (ADS)

Brett, Gareth; Barnett, Matthew

2014-12-01

Liquid Air Energy Storage (LAES) provides large scale, long duration energy storage at the point of demand in the 5 MW/20 MWh to 100 MW/1,000 MWh range. LAES combines mature components from the industrial gas and electricity industries assembled in a novel process and is one of the few storage technologies that can be delivered at large scale, with no geographical constraints. The system uses no exotic materials or scarce resources and all major components have a proven lifetime of 25+ years. The system can also integrate low grade waste heat to increase power output. Founded in 2005, Highview Power Storage, is a UK based developer of LAES. The company has taken the concept from academic analysis, through laboratory testing, and in 2011 commissioned the world's first fully integrated system at pilot plant scale (300 kW/2.5 MWh) hosted at SSE's (Scottish & Southern Energy) 80 MW Biomass Plant in Greater London which was partly funded by a Department of Energy and Climate Change (DECC) grant. Highview is now working with commercial customers to deploy multi MW commercial reference plants in the UK and abroad.

Prostate-specific antigen (PSA) testing of men in UK general practice: a 10-year longitudinal cohort study

PubMed Central

Young, Grace J; Harrison, Sean; Turner, Emma L; Walsh, Eleanor I; Oliver, Steven E; Ben-Shlomo, Yoav; Evans, Simon; Lane, J Athene; Neal, David E; Hamdy, Freddie C; Donovan, Jenny L; Martin, Richard M; Metcalfe, Chris

2017-01-01

Objectives Cross-sectional studies suggest that around 6% of men undergo prostate-specific antigen (PSA) testing each year in UK general practice (GP). This longitudinal study aims to determine the cumulative testing pattern of men over a 10-year period and whether this testing can be considered equivalent to screening for prostate cancer (PCa). Setting, participants and outcome measures Patient-level data on PSA tests, biopsies and PCa diagnoses were obtained from the UK Clinical Practice Research Datalink (CPRD) for the years 2002 to 2011. The cumulative risks of PSA testing and of being diagnosed with PCa were estimated for the 10-year study period. Associations of a man’s age, region and index of multiple deprivation with the cumulative risk of PSA testing and PCa diagnosis were investigated. Rates of biopsy and diagnosis, following a high test result, were compared with those from the programme of PSA testing in the Prostate Testing for Cancer and Treatment (ProtecT) study. Results The 10-year risk of exposure to at least one PSA test in men aged 45 to 69 years in UK GP was 39.2% (95% CI 39.0 to 39.4%). The age-specific risks ranged from 25.2% for men aged 45–49 years to 53.0% for men aged 65–69 years (p for trend <0.001). For those with a PSA level ≥3, a test in UK GP was less likely to result in a biopsy (6%) and/or diagnosis of PCa (15%) compared with ProtecT study participants (85% and 34%, respectively). Conclusion A high proportion of men aged 45–69 years undergo PSA tests in UK GP: 39% over a 10-year period. A high proportion of these tests appear to be for the investigation of lower urinary tract symptoms and not screening for PCa. Trial registration number ISRCTN20141297, NCT02044172. PMID:29084797

Addressing long-term physical healthcare needs in a forensic mental health inpatient population using the UK primary care Quality and Outcomes Framework (QOF): an audit.

PubMed

Ivbijaro, Go; Kolkiewicz, LA; McGee, Lsf; Gikunoo, M

2008-03-01

Objectives This audit aims to evaluate the effectiveness of delivering an equivalent primary care service to a long-term forensic psychiatric inpatient population, using the UK primary care national Quality and Outcomes Framework (QOF).Method The audit compares the targets met by the general practitioner with special interest (GPwSI) service, using local and national QOF benchmarks (2005-2006), and determines the prevalence of chronic disease in a long-term inpatient forensic psychiatry population.Results The audit results show that the UK national QOF is a useful tool for assessment and evaluation of physical healthcare needs in a non-community based population. It shows an increased prevalence of all QOF-assessed long-term physical conditions when compared to the local East London population and national UK population, confirming previously reported elevated levels of physical healthcare need in psychiatric populations.Conclusions This audit shows that the UK General Practice QOF can be used as a standardised instrument for commissioning and monitoring the delivery of physical health services to in-patient psychiatric populations, and for the evaluation of the effectiveness of clinical interventions in long-term physical conditions. The audit also demonstrates the effectiveness of using a GPwSI in healthcare delivery in non-community based settings. We suggest that the findings may be generalisable to other long-term inpatient psychiatric and prison populations in order to further the objective of delivering an equivalent primary care service to all populations.The QOF is a set of national primary care audit standards and is freely available on the British Medical Association website or the UK Department of Health website. We suggest that primary care workers in health economies who have not yet developed their own national primary care standards can access and adapt these standards in order to improve the clinical standards of care given to the primary care populations that they serve.

Addressing long-term physical healthcare needs in a forensic mental health inpatient population using the UK primary care Quality and Outcomes Framework (QOF): an audit

PubMed Central

2008-01-01

Objectives This audit aims to evaluate the effectiveness of delivering an equivalent primary care service to a long-term forensic psychiatric inpatient population, using the UK primary care national Quality and Outcomes Framework (QOF). Method The audit compares the targets met by the general practitioner with special interest (GPwSI) service, using local and national QOF benchmarks (2005–2006), and determines the prevalence of chronic disease in a long-term inpatient forensic psychiatry population. Results The audit results show that the UK national QOF is a useful tool for assessment and evaluation of physical healthcare needs in a non-community based population. It shows an increased prevalence of all QOF-assessed long-term physical conditions when compared to the local East London population and national UK population, confirming previously reported elevated levels of physical healthcare need in psychiatric populations. Conclusions This audit shows that the UK General Practice QOF can be used as a standardised instrument for commissioning and monitoring the delivery of physical health services to in-patient psychiatric populations, and for the evaluation of the effectiveness of clinical interventions in long-term physical conditions. The audit also demonstrates the effectiveness of using a GPwSI in healthcare delivery in non-community based settings. We suggest that the findings may be generalisable to other long-term inpatient psychiatric and prison populations in order to further the objective of delivering an equivalent primary care service to all populations. The QOF is a set of national primary care audit standards and is freely available on the British Medical Association website or the UK Department of Health website. We suggest that primary care workers in health economies who have not yet developed their own national primary care standards can access and adapt these standards in order to improve the clinical standards of care given to the primary care populations that they serve. PMID:22477846

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.

The impact of pay-for-performance on professional boundaries in UK general practice: an ethnographic study.

PubMed

Grant, Suzanne; Huby, Guro; Watkins, Francis; Checkland, Kath; McDonald, Ruth; Davies, Huw; Guthrie, Bruce

2009-03-01

The 2004 new General Medical Services (nGMS) contract exemplifies trends across the public services towards increased definition, measurement and regulation of professional work, with general practice income now largely dependent on the quality of care provided across a range of clinical and organisational indicators known collectively as the 'Quality and Outcomes Framework' (QOF). This paper reports an ethnographically based study of the impact of the new contract and the financial incentives contained within it on professional boundaries in UK general practice. The distribution of clinical and administrative work has changed significantly and there has been a new concentration of authority, with QOF decision making and monitoring being led by an internal QOF team of clinical and managerial staff who make the major practice-level decisions about QOF, monitor progress against targets, and intervene to resolve areas or indicators at risk of missing targets. General practitioners and nurses, however, appear to have accommodated these changes by re-creating long established narratives on professional boundaries and clinical hierarchies. This paper is concerned with the impact of these new arrangements on existing clinical hierarchies.

Examining the practice of generalist expertise: a qualitative study identifying constraints and solutions

PubMed Central

Reeve, Joanne; Dowrick, Christopher F; Freeman, George K; Gunn, Jane; Mair, Frances; May, Carl; Mercer, Stewart; Palmer, Victoria; Howe, Amanda; Irving, Greg; Shiner, Alice; Watson, Jessica

2013-01-01

Objectives Provision of person-centred generalist care is a core component of quality primary care systems. The World Health Organisation believes that a lack of generalist primary care is contributing to inefficiency, ineffectiveness and inequity in healthcare. In UK primary care, General Practitioners (GPs) are the largest group of practising generalists. Yet GPs fulfil multiple roles and the pressures of delivering these roles along with wider contextual changes create real challenges to generalist practice. Our study aimed to explore GP perceptions of enablers and constraints for expert generalist care, in order to identify what is needed to ensure health systems are designed to support the generalist role. Design Qualitative study in General Practice. Setting UK primary care. Main outcome measures A qualitative study – interviews, surveys and focus groups with GPs and GP trainees. Data collection and analysis was informed by Normalisation Process Theory. Design and setting Qualitative study in General Practice. We conducted interviews, surveys and focus groups with GPs and GP trainees based mainly, but not exclusively, in the UK. Data collection and analysis were informed by Normalization Process Theory. Participants UK based GPs (interview and surveys); European GP trainees (focus groups). Results Our findings highlight key gaps in current training and service design which may limit development and implementation of expert generalist practice (EGP). These include the lack of a consistent and universal understanding of the distinct expertise of EGP, competing priorities inhibiting the delivery of EGP, lack of the consistent development of skills in interpretive practice and a lack of resources for monitoring EGP. Conclusions We describe four areas for change: Translating EGP, Priority setting for EGP, Trusting EGP and Identifying the impact of EGP. We outline proposals for work needed in each area to help enhance the expert generalist role. PMID:24475347

How international medical graduates view their learning needs for UK GP training.

PubMed

Warwick, Christopher

2014-03-01

International medical graduates (IMGs) form a vital group of general practitioners (GPs) in the NHS. They are known to face additional challenges above and beyond those faced by UK medical graduates in the course of their GP training. Whilst they are a heterogeneous group of professionals, their views on what they need to learn, and how they are supported, are often distant from those of the educators responsible for planning their education. This study was undertaken, through narrative-based focus groups, to explore the issues which matter to the IMGs, in an attempt to empower their voices about their experiences in GP training, and to see what lessons could be drawn from these views. The findings confirmed the central importance, and considerable challenge involved, in making an effective transition into the culture of the NHS and UK general practice. The IMGs felt that induction needed to be an on-going, iterative process of learning which continued throughout training, with a more effective individualised learning needs analysis at the start of GP training. Lack of sophisticated language skills was highlighted as a real concern. Recognition that their lack of knowledge about the NHS at the start of training should not be seen as an indicator of deficiency, but a clue to what they needed to learn were also key messages. IMGs also felt the earlier in their training they undertook a GP placement, the quicker they would start to understand the culture of general practice in the UK. Further work following on from this research should include how to manage change in the educational network for these barriers to be overcome.

Interventions with potential to improve the mental health and wellbeing of UK veterinary surgeons.

PubMed

Bartram, D J; Sinclair, J M A; Baldwin, D S

2010-04-24

The proportion of UK veterinary surgeons who die by suicide as opposed to other causes is approximately four times that of the general population, and around twice that of other healthcare professionals. Recent research suggests that veterinary surgeons report high levels of psychological distress. This paper proposes a portfolio of evidence-based interventions, for both organisations and individuals, which have the potential to improve mental health and wellbeing in the veterinary profession.

Is 27 really a dangerous age for famous musicians? Retrospective cohort study

PubMed Central

Wolkewitz, Martin; Allignol, Arthur; Graves, Nicholas

2011-01-01

Objective To test the “27 club” hypothesis that famous musicians are at an increased risk of death at age 27. Design Cohort study using survival analysis with age as a time dependent exposure. Comparison was primarily made within musicians, and secondarily relative to the general UK population. Setting The popular music scene from a UK perspective. Participants Musicians (solo artists and band members) who had a number one album in the UK between 1956 and 2007 (n=1046 musicians, with 71 deaths, 7%). Main outcome measures Risk of death by age of musician, accounting for time dependent study entry and the number of musicians at risk. Risk was estimated using a flexible spline which would allow a bump at age 27 to appear. Results We identified three deaths at age 27 amongst 522 musicians at risk, giving a rate of 0.57 deaths per 100 musician years. Similar death rates were observed at ages 25 (rate=0.56) and 32 (0.54). There was no peak in risk around age 27, but the risk of death for famous musicians throughout their 20s and 30s was two to three times higher than the general UK population. Conclusions The 27 club is unlikely to be a real phenomenon. Fame may increase the risk of death among musicians, but this risk is not limited to age 27. PMID:22187325

Comparison of anaesthesia 'Day 1 skills' expectations between veterinary anaesthetists and general practitioners.

PubMed

Duncan, J C; Ross, M; Rhind, S; Clutton, E; Shaw, D J

2015-02-28

Day One Skills (DOS) were introduced by the Royal College of Veterinary Surgeons (RCVS) in 2006 as a guideline for minimum skills required by a veterinary graduate. However, the RCVS anaesthesia DOS are broad and do not specify differences in skills required for different species. The aims of this study were: (1) to determine which anaesthesia skills were considered essential for day one practice by UK-based veterinary practitioners (GPs) and anaesthetists; and (2) to explore current opinions on veterinary undergraduate anaesthesia training. Questionnaires for veterinary GPs (QGPs) and veterinary anaesthetists (QVAs) were developed which asked general information on expectations of anaesthesia skills as well as specific expectations for the common veterinary species. Fifty-five UK-based members of the Association of Veterinary Anaesthetists responded, with a random sample of veterinary practices stratified by UK county generating 234 responses and a convenience sample targeted at more specialist veterinary specialities in the UK generating 161 responses. There was close overall agreement between the two groups of GPs and anaesthetists on essential anaesthesia DOS. However, expectations varied with species-greatest in cats and dogs, lowest in exotics. Many respondents commented that new veterinary graduates lack practical skills and should not be expected to be omnicompetent across all species. In conclusion, anaesthesia undergraduate training should prioritise essential practical DOS. British Veterinary Association.

Dental bodies corporate and their approach to customer care.

PubMed

Newsome, P R H

2002-05-25

For many years the 27 bodies corporate registered with the General Dental Council were of little interest to most people in the UK dental profession, serving only as an anachronistic reminder of a bygone period. How times change. Although they still have only a small share of the dental market - with 4% of all dentists in the UK in early 1999 - they have expanded rapidly from a small base and are expected to continue to do so in the future. The reasons behind this growth are numerous and include such factors as: deregulation of the profession allowing dentists to advertise thus facilitating company branding; a general move away from NHS dentistry; a growing consumerism amongst the general public; precedents set by pharmacists and opticians; and, last but not least, the belief of venture capitalists amongst others that investment in dentistry will yield attractive returns.

Alcohol and drug use in UK university students.

PubMed

Webb, E; Ashton, C H; Kelly, P; Kamali, F

1996-10-05

Alcohol and illicit drug use are increasing among school children and young adults in the UK. Such increases have also been noted among university students and there is a need for a large survey across different universities and faculties. We report such a survey. Information about drinking, use of cannabis and other illicit drugs, other lifestyle variables, and subjective ratings of anxiety and depression was obtained by questionnaire in a cross-faculty sample of 3075 second-year university students (1610 men, 1447 women, 18 sex not stated) from ten UK universities. The questionnaire was personally administered during scheduled lecture hours and almost all the students participated. The sample reflected the interfaculty and sex distribution and the proportion of non-white students at UK universities. 11% of the students were non-drinkers. Among drinkers, 61% of the men and 48% of the women exceeded "sensible" limits of 14 units per week for women and 21 for men. Hazardous drinking (> or = 36 units per week for women, > or = 51 for men) was reported by 15% of the drinkers. Binge drinking was declared by 28% of drinkers. 60% of the men and 55% of the women reported having used cannabis once or twice and 20% of the sample reported regular cannabis use (weekly or more often). Experience with other illicit drugs was reported by 33% of the sample, most commonly LSD (lysergic acid diethylamide), amphetamines, Ecstasy (methylenedioxymethamphetamine), and amyl/butyl nitrate which had each been used by 13-18% of students. 34% of these had used several drugs. Drug use had started at school in 46% of the sample; 13% began after entering university. The overwhelming reason given for taking alcohol or drugs was pleasure. Subjective ratings of anxiety on the hospital anxiety depression scale were high, and sleep difficulties were common, but neither related to alcohol or drug use. There is a need for better education about alcohol, drugs, and general health in universities. Such education should include all faculties. It remains unclear whether university students' lifestyles are carried over into later life.

Playing it safe: addressing the emotional and physical health of lesbian and gay pupils in the U.K.

PubMed

Warwick, I; Aggleton, P; Douglas, N

2001-02-01

Compared to young people in general, young lesbians and gay men can face specific challenges to their physical and emotional well-being. These include discrimination, victimization, homophobic bullying and an elevated suicide risk. Relative to initiatives which attempt to address bullying in general, little has been done in schools in the U.K. to address physical and verbal homophobic bullying. This paper reports on an exploratory study to examine teachers' perceptions of homophobic bullying, the responses made to this form of bullying, and the factors which impact on the provision of education and support to lesbian and gay pupils. Findings suggested that teachers were aware of homophobic bullying but were confused, unable or unwilling to address the needs of lesbian and gay pupils. Implications for policy, practice and research are discussed. While current U.K. Government policy promoting Healthy Schools and Citizenship education offers hope for the future, much remains to be done to ensure that such initiatives are inclusive of all pupils. Copyright 2001 The Association for Professionals in Services for Adolescents.

Predictors of Treatment with Duloxetine or Venlafaxine XR among Adult Patients Treated for Depression in Primary Care Practices in the United Kingdom

PubMed Central

Shi, Nianwen; Durden, Emily; Torres, Amelito; Cao, Zhun; Happich, Michael

2012-01-01

Background. Knowledge about real-world use of duloxetine and venlafaxine XR to treat depression in the UK is limited. Aims. To identify predictors of duloxetine or venlafaxine XR initiation. Method. Adult depressed patients who initiated duloxetine or venlafaxine XR between January 1, 2006 and September 30, 2007 were identified in the UK's General Practice Research Database. Demographic and clinical predictors of treatment initiation with duloxetine and venlafaxine XR were identified using logistic regression. Results. Patients initiating duloxetine (n = 909) were 4 years older than venlafaxine XR recipients (n = 1286). Older age, preexisting unexplained pain, respiratory disease, and pre-period use of anticonvulsants, opioids, and antihyperlipidemics were associated with increased odds of initiating duloxetine compared to venlafaxine XR. Pre-period anxiety disorder was associated with decreased odds of receiving duloxetine. Conclusion. Initial treatment choice with duloxetine versus venlafaxine XR was primarily driven by patient-specific mental and medical health characteristics. General practitioners in the UK favor duloxetine over venlafaxine XR when pain conditions coexist with depression. PMID:22720149

Perinatal mental health service provision in Switzerland and in the UK.

PubMed

Amiel Castro, Rita T; Schroeder, Katrin; Pinard, Claudia; Blöchlinger, Patricia; Künzli, Hansjörg; Riecher-Rössler, Anita; Kammerer, Martin

2015-01-01

The epidemiology of maternal perinatal-psychiatric disorders as well as their effect on the baby is well recognised. Increasingly well researched specialised treatment methods can reduce maternal morbidity, positively affect mother-baby bonding and empower women's confidence as a mother. Here, we aimed to compare guidelines and the structure of perinatal-psychiatric service delivery in the United Kingdom and in Switzerland from the government's perspective. Swiss cantons provided information regarding guidelines and structure of service delivery in 2000. A subsequent survey using the same questionnaire was carried out in 2007. In the UK, similar information was accessed through published reports from 2000-2012. Guidelines for perinatal psychiatry exist in the UK, whereas in Switzerland in 2000 none of the 26 cantons had guidelines, and in 2007 only one canton did. Joint mother-baby admissions on general psychiatric wards were offered by 92% of the Swiss cantons. In the UK, pregnant women and joint mother-baby admissions are only advised onto specialised perinatal-psychiatric units. In Switzerland, in 2007, three specialised units (max. 24 beds) were in place corresponding to 1 unit per 2.5 million people, while in the UK there were 22 mother-baby units (168 beds) in 2012 (1 unit per 2.8 million). In the UK, less than 50% of trusts provided specialised perinatal-psychiatric health care. The main difference between the UK and Switzerland was the absence of guidelines, regular assessment and plans for future development of perinatal psychiatry in Switzerland. There are still geographical differences in the provision of perinatal-psychiatric services in the UK.

Ticks infesting domestic dogs in the UK: a large-scale surveillance programme.

PubMed

Abdullah, Swaid; Helps, Chris; Tasker, Severine; Newbury, Hannah; Wall, Richard

2016-07-07

Recent changes in the distribution of tick vectors and the incidence of tick-borne disease, driven variously by factors such as climate change, habitat modification, increasing host abundance and the increased movement of people and animals, highlight the importance of ongoing, active surveillance. This paper documents the results of a large-scale survey of tick abundance on dogs presented to veterinary practices in the UK, using a participatory approach that allows relatively cost- and time-effective extensive data collection. Over a period of 16 weeks (April-July 2015), 1094 veterinary practices were recruited to monitor tick attachment to dogs and provided with a tick collection and submission protocol. Recruitment was encouraged through a national publicity and communication initiative. Participating practices were asked to select five dogs at random each week and undertake a thorough, standardized examination of each dog for ticks. The clinical history and any ticks were then sent to the investigators for identification. A total of 12,000 and 96 dogs were examined and 6555 tick samples from infested dogs were received. Ixodes ricinus (Linnaeus) was identified on 5265 dogs (89 %), Ixodes hexagonus Leach on 577 (9.8 %) and Ixodes canisuga Johnston on 46 (0.8 %). Ten dogs had Dermacentor reticulatus (Fabricius), one had Dermacentor variabilis (Say), three had Haemaphysalis punctata Canesteini & Fanzago and 13 had Rhipicephalus sanguineus Latreille. 640 ticks were too damaged for identification. All the R. sanguineus and the single D. variabilis were on dogs with a recent history of travel outside the UK. The overall prevalence of tick attachment was 30 % (range 28-32 %). The relatively high prevalence recorded is likely to have been inflated by the method of participant recruitment. The data presented provide a comprehensive spatial understanding of tick distribution and species abundance in the UK against which future changes can be compared. Relative prevalence maps show the highest rates in Scotland and south west England providing a valuable guide to tick-bite risk in the UK.

UK-based, multisite, prospective cohort study of small bowel obstruction in acute surgical services: National Audit of Small Bowel Obstruction (NASBO) protocol

PubMed Central

Sayers, Adele E; Drake, Thomas M; Hollyman, Marianne; Bradburn, Mike; Hind, Daniel; Wilson, Timothy R; Fearnhead, Nicola S; Abercrombie, John

2017-01-01

Introduction Small bowel obstruction (SBO) is a common indication for emergency laparotomy in the UK, which is associated with a 90-day mortality rate of 13%. There are currently no UK clinical guidelines for the management of this condition. The aim of this multicentre prospective cohort study is to describe the burden, variation in management and associated outcomes of SBO in the UK adult population. Methods and analysis UK hospitals providing emergency general surgery are eligible to participate. This study has three components: (1) a clinical preference questionnaire to be completed by consultants providing emergency general surgical care to assesses preferences in diagnostics and therapeutic approaches, including laparoscopy and nutritional interventions; (2) site resource profile questionnaire to indicate ease of access to diagnostic services, operating theatres, nutritional support teams and postoperative support including intensive care; (3) prospective cohort study of all cases of SBO admitted during an 8-week period at participating trusts. Data on diagnostics, operative and nutritional interventions, and in-hospital mortality and morbidity will be captured, followed by data validation. Ethics and dissemination This will be conducted as a national audit of practice in conjunction with trainee research collaboratives, with support from patient representatives, surgeons, anaesthetists, gastroenterologists and a clinical trials unit. Site-specific reports will be provided to each participant site as well as an overall report to be disseminated through specialist societies. Results will be published in a formal project report endorsed by stakeholders, and in peer-reviewed scientific reports. Key findings will be debated at a focused national meeting with a view to quality improvement initiatives. PMID:28982819

UK-based, multisite, prospective cohort study of small bowel obstruction in acute surgical services: National Audit of Small Bowel Obstruction (NASBO) protocol.

PubMed

Lee, Matthew J; Sayers, Adele E; Drake, Thomas M; Hollyman, Marianne; Bradburn, Mike; Hind, Daniel; Wilson, Timothy R; Fearnhead, Nicola S

2017-10-05

Small bowel obstruction (SBO) is a common indication for emergency laparotomy in the UK, which is associated with a 90-day mortality rate of 13%. There are currently no UK clinical guidelines for the management of this condition. The aim of this multicentre prospective cohort study is to describe the burden, variation in management and associated outcomes of SBO in the UK adult population. UK hospitals providing emergency general surgery are eligible to participate. This study has three components: (1) a clinical preference questionnaire to be completed by consultants providing emergency general surgical care to assesses preferences in diagnostics and therapeutic approaches, including laparoscopy and nutritional interventions; (2) site resource profile questionnaire to indicate ease of access to diagnostic services, operating theatres, nutritional support teams and postoperative support including intensive care; (3) prospective cohort study of all cases of SBO admitted during an 8-week period at participating trusts. Data on diagnostics, operative and nutritional interventions, and in-hospital mortality and morbidity will be captured, followed by data validation. This will be conducted as a national audit of practice in conjunction with trainee research collaboratives, with support from patient representatives, surgeons, anaesthetists, gastroenterologists and a clinical trials unit. Site-specific reports will be provided to each participant site as well as an overall report to be disseminated through specialist societies. Results will be published in a formal project report endorsed by stakeholders, and in peer-reviewed scientific reports. Key findings will be debated at a focused national meeting with a view to quality improvement initiatives. © 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.

The UK Quality and Outcomes Framework pay-for-performance scheme and spirometry: rewarding quality or just quantity? A cross-sectional study in Rotherham, UK

PubMed Central

Strong, Mark; South, Gail; Carlisle, Robin

2009-01-01

Background Accurate spirometry is important in the management of COPD. The UK Quality and Outcomes Framework pay-for-performance scheme for general practitioners includes spirometry related indicators within its COPD domain. It is not known whether high achievement against QOF spirometry indicators is associated with spirometry to BTS standards. Methods Data were obtained from the records of 3,217 patients randomly sampled from 5,649 patients with COPD in 38 general practices in Rotherham, UK. Severity of airflow obstruction was categorised by FEV1 (% predicted) according to NICE guidelines. This was compared with clinician recorded COPD severity. The proportion of patients whose spirometry met BTS standards was calculated in each practice using a random sub-sample of 761 patients. The Spearman rank correlation between practice level QOF spirometry achievement and performance against BTS spirometry standards was calculated. Results Spirometry as assessed by clinical records was to BTS standards in 31% of cases (range at practice level 0% to 74%). The categorisation of airflow obstruction according to the most recent spirometry results did not agree well with the clinical categorisation of COPD recorded in the notes (Cohen's kappa = 0.34, 0.30 – 0.38). 12% of patients on COPD registers had FEV1 (% predicted) results recorded that did not support the diagnosis of COPD. There was no association between quality, as measured by adherence to BTS spirometry standards, and either QOF COPD9 achievement (Spearman's rho = -0.11), or QOF COPD10 achievement (rho = 0.01). Conclusion The UK Quality and Outcomes Framework currently assesses the quantity, but not the quality of spirometry. PMID:19558719

The UK Quality and Outcomes Framework pay-for-performance scheme and spirometry: rewarding quality or just quantity? A cross-sectional study in Rotherham, UK.

PubMed

Strong, Mark; South, Gail; Carlisle, Robin

2009-06-28

Accurate spirometry is important in the management of COPD. The UK Quality and Outcomes Framework pay-for-performance scheme for general practitioners includes spirometry related indicators within its COPD domain. It is not known whether high achievement against QOF spirometry indicators is associated with spirometry to BTS standards. Data were obtained from the records of 3,217 patients randomly sampled from 5,649 patients with COPD in 38 general practices in Rotherham, UK. Severity of airflow obstruction was categorised by FEV1 (% predicted) according to NICE guidelines. This was compared with clinician recorded COPD severity. The proportion of patients whose spirometry met BTS standards was calculated in each practice using a random sub-sample of 761 patients. The Spearman rank correlation between practice level QOF spirometry achievement and performance against BTS spirometry standards was calculated. Spirometry as assessed by clinical records was to BTS standards in 31% of cases (range at practice level 0% to 74%). The categorisation of airflow obstruction according to the most recent spirometry results did not agree well with the clinical categorisation of COPD recorded in the notes (Cohen's kappa = 0.34, 0.30 - 0.38). 12% of patients on COPD registers had FEV1 (% predicted) results recorded that did not support the diagnosis of COPD. There was no association between quality, as measured by adherence to BTS spirometry standards, and either QOF COPD9 achievement (Spearman's rho = -0.11), or QOF COPD10 achievement (rho = 0.01). The UK Quality and Outcomes Framework currently assesses the quantity, but not the quality of spirometry.

Prescription rates of adrenaline auto-injectors for children in UK general practice: a retrospective cohort study.

PubMed

Diwakar, Lavanya; Cummins, Carole; Ryan, Ronan; Marshall, Tom; Roberts, Tracy

2017-04-01

Adrenaline auto-injectors (AAI) should be provided to individuals considered to be at high risk of anaphylaxis. There is some evidence that the rate of AAI prescription is increasing, but the true extent has not been previously quantified. To estimate the trends in annual GP-issued prescriptions for AAI among UK children between 2000 and 2012. Retrospective cohort study using data from primary care practices that contributed to The Health Improvement Network (THIN) database. Children and young people aged between 0-17 years of age with a prescription for AAIs were identified, and annual AAI device prescription rates were estimated using Stata (version 12). A total of 1.06 million UK children were identified, providing 5.1 million person years of follow-up data. Overall, 23 837 children were deemed high risk by their GPs, and were prescribed 98 737 AAI devices. This equates to 4.67 children (95% confidence interval [CI] = 4.66 to 4.69), and 19.4 (95% CI = 19.2 to 19.5) devices per 1000 person years. Between 2000 and 2012, there has been a 355% increase in the number of children prescribed devices, and a 506% increase in the total number of AAI devices prescribed per 1000 person years in the UK. The number of devices issued per high-risk child during this period has also increased by 33%. The number of children being prescribed AAI devices and the number of devices being prescribed in UK primary care between 2000 and 2012 has significantly increased. A discussion to promote rational prescribing of AAIs in the NHS is needed. © British Journal of General Practice 2017.

'Neknomination': Predictors in a sample of UK university students.

PubMed

Moss, Antony C; Spada, Marcantonio M; Harkin, Jamila; Albery, Ian P; Rycroft, Nicola; Nikčević, Ana V

2015-06-01

To identify prevalence and predictors of participation in the online drinking game 'neknomination' amongst university students. A convenience sample of 145 university students participated in a study about drinking behaviours, completing a questionnaire about their participation in neknomination, the Alcohol Use Disorders Identification Test, and the Resistance to Peer Influence Scale. Out of 145 students sampled, 54% took part in neknomination in the previous month. Mann-Whitney U tests revealed significantly higher scores on the Alcohol Use Disorders Identification Test, and significantly lower scores on the Resistance to Peer Influence Scale, for those who had participated in neknomination. A significant correlation was also shown between specific peer pressure to neknominate, and engagement in neknomination. A logistic regression analysis indicated that scores on the Alcohol Use Disorders Identification Test, but not the Resistance to Peer Influence Scale, predicted classification as an individual who participated in neknomination. We found that over half of respondents had participated in a neknomination game in the past month, with almost all male respondents having done so. Participation in neknomination was strongly associated with general hazardous drinking behaviour but not with resistance to peer influence. Further research is needed to understand the role of engagement with social media in drinking games and risky drinking.

Content Development for 72,000 Learners: An Online Learning Environment for General Practitioners: A Case Study

ERIC Educational Resources Information Center

Pilat, Dirk

2016-01-01

Increasing workload due to reduced numbers of general practitioners, a population boom and an aging population has increased the need for accessible distance learning for the UK's primary care doctors. The Royal College of General Practitioners is now in its eighth year of delivering high quality e-learning to 72,000 registered users via its…

The Academic Backbone: longitudinal continuities in educational achievement from secondary school and medical school to MRCP(UK) and the specialist register in UK medical students and doctors

PubMed Central

2013-01-01

Background Selection of medical students in the UK is still largely based on prior academic achievement, although doubts have been expressed as to whether performance in earlier life is predictive of outcomes later in medical school or post-graduate education. This study analyses data from five longitudinal studies of UK medical students and doctors from the early 1970s until the early 2000s. Two of the studies used the AH5, a group test of general intelligence (that is, intellectual aptitude). Sex and ethnic differences were also analyzed in light of the changing demographics of medical students over the past decades. Methods Data from five cohort studies were available: the Westminster Study (began clinical studies from 1975 to 1982), the 1980, 1985, and 1990 cohort studies (entered medical school in 1981, 1986, and 1991), and the University College London Medical School (UCLMS) Cohort Study (entered clinical studies in 2005 and 2006). Different studies had different outcome measures, but most had performance on basic medical sciences and clinical examinations at medical school, performance in Membership of the Royal Colleges of Physicians (MRCP(UK)) examinations, and being on the General Medical Council Specialist Register. Results Correlation matrices and path analyses are presented. There were robust correlations across different years at medical school, and medical school performance also predicted MRCP(UK) performance and being on the GMC Specialist Register. A-levels correlated somewhat less with undergraduate and post-graduate performance, but there was restriction of range in entrants. General Certificate of Secondary Education (GCSE)/O-level results also predicted undergraduate and post-graduate outcomes, but less so than did A-level results, but there may be incremental validity for clinical and post-graduate performance. The AH5 had some significant correlations with outcome, but they were inconsistent. Sex and ethnicity also had predictive effects on measures of educational attainment, undergraduate, and post-graduate performance. Women performed better in assessments but were less likely to be on the Specialist Register. Non-white participants generally underperformed in undergraduate and post-graduate assessments, but were equally likely to be on the Specialist Register. There was a suggestion of smaller ethnicity effects in earlier studies. Conclusions The existence of the Academic Backbone concept is strongly supported, with attainment at secondary school predicting performance in undergraduate and post-graduate medical assessments, and the effects spanning many years. The Academic Backbone is conceptualized in terms of the development of more sophisticated underlying structures of knowledge ('cognitive capital’ and 'medical capital’). The Academic Backbone provides strong support for using measures of educational attainment, particularly A-levels, in student selection. PMID:24229333

The Sheffield RNAi Screening Facility (SRSF): portfolio growth and technology development.

PubMed

Brown, Stephen

2014-05-01

The Sheffield RNAi Screening Facility (SRSF) (www.rnai.group.shef.ac.uk) was established in 2008 with Wellcome Trust and University of Sheffield funding, with the task to provide the first UK RNAi screening resource for academic groups interested in identifying genes required in a diverse range of biological processes using Drosophila cell culture. The SRSF has carried out a wide range of screens varying in sizes from bespoke small-scale libraries, targeting a few hundred genes, to high-throughput, genome-wide studies. The SRSF has grown and improved with a dedicated partnership of its academic customers based mainly in the UK. We are part of the UK Academics Functional Genomics Network, participating in organizing an annual meeting in London and are part of the University of Sheffield's D3N (www.d3n.org.uk), connecting academics, biotech and pharmaceutical companies with a multidisciplinary network in Drug Discovery and Development. Recently, the SRSF has been funded by the Yorkshire Cancer Research Fund to perform genome-wide RNAi screens using human cells as part of a core facility for regional Yorkshire Universities and screens are now underway. Overall the SRSF has carried out more than 40 screens from Drosophila and human cell culture experiments.

Tiny radio is based on diamond effects

NASA Astrophysics Data System (ADS)

2017-02-01

You could soon be tuning into “Diamond FM”, thanks to a new radio receiver based on atomic-scale defects in diamond, unveiled by physicists at Harvard University in the US and Element Six in the UK.

Antenatal depression and male gender preference in Asian women in the UK.

PubMed

Dhillon, Navpreet; Macarthur, Christine

2010-06-01

to identify the prevalence of antenatal depression among Asian women living in the UK in one antenatal clinic, and to investigate the possible association with a desire for a male child and other risk factors. cross-sectional questionnaire-based study. general antenatal clinic in a hospital in Birmingham. 300 Asian women, irrespective of place of birth. consecutive Asian women attending routine antenatal appointments during the study period self-completed a questionnaire. The first part investigated socio-demographic, cultural and other possible risk factors, including gender preference. The second part comprised the Edinburgh Postnatal Depression Scale (EPDS). EPDS score greater than or equal to 12 indicating probable depression. the prevalence of depression was 30.7% (92/300, 95% confidence interval 25.4-35.9%). Maternal male gender preference was not common and was not associated with antenatal depression. Family male gender preference, unplanned pregnancy, a history of depression and feeling anxious in pregnancy were independently associated with an increased likelihood of depression, whilst support from family and friends, being satisfied with pregnancy and being multiparous were associated with a reduced likelihood of depression. rates of antenatal depression were very high in Asian women with some associated risk factors. However, male gender preference was not associated with antenatal depression. given the high prevalence, screening Asian women for depression may be indicated to allow treatment. Copyright 2008 Elsevier Ltd. All rights reserved.

A cross-cultural comparison of autistic traits in the UK, India and Malaysia.

PubMed

Freeth, Megan; Sheppard, Elizabeth; Ramachandran, Rajani; Milne, Elizabeth

2013-11-01

The disorder of autism is widely recognised throughout the world. However, the diagnostic criteria and theories of autism are based on research predominantly conducted in Western cultures. Here we compare the expression of autistic traits in a sample of neurotypical individuals from one Western culture (UK) and two Eastern cultures (India and Malaysia), using the Autism-spectrum Quotient (AQ) in order to identify possible cultural differences in the expression of autistic traits. Behaviours associated with autistic traits were reported to a greater extent in the Eastern cultures than the Western culture. Males scored higher than females and science students scored higher than non-science students in each culture. Indian students scored higher than both other groups on the Imagination sub-scale, Malaysian students scored higher than both other groups on the Attention Switching sub-scale. The underlying factor structures of the AQ for each population were derived and discussed.

IFLA General Conference, 1986. LIBER. Papers.

ERIC Educational Resources Information Center

International Federation of Library Associations and Institutions, The Hague (Netherlands).

Three papers on special book collections were presented at the 1986 IFLA general conference. They include: (1) "Far Eastern Collections in the United Kingdom" (B. C. Bloomfield, United Kingdom), which discusses the background of Eastern Studies in the United Kingdom (UK) and the coordination of library provision for Far Eastern…

Pathophysiology, assessment and management of multiple sclerosis spasticity: an update.

PubMed

Haas, Judith

2011-04-01

Spasticity is one of the most common and disabling symptoms associated with multiple sclerosis (MS). MS spasticity occurs through both myelin and nerve fiber (axonal) degradation, which commence in the early stages of the disease. More than 80% of MS patients experienced spasticity in a large UK survey, with more than 50% of patients reporting their spasticity to be `moderate' or `severe'. Data from a large US registry show that patients with moderate-to-severe MS spasticity experience levels of disability that correlate closely with being wheelchair-bound and/or bedridden. The Ashworth scale is the most commonly used scale for assessing the degree of MS spasticity. However, the validity, reliability and sensitivity of this scale have been challenged and it is not considered an ideal scale for assessing the severity of MS spasticity. The numerical rating scale, a well-established standard pain assessment tool, provides a reliable, valid and simplified scale for patient self-rated assessment of the mean level of spasticity over the previous 24 h (0 = no spasticity, 10 = worst possible spasticity). According to data from the German MS Register, almost a third of MS patients with spasticity were untreated. Despite the availability of oral agents for generalized spasticity (often used in conjunction with physical/rehabilitation management strategies), including baclofen, tizanidine, dantrolene and gabapentin, there is limited clinical evidence to support their use and there is a need for improved and better tolerated pharmacological therapies for MS spasticity. The endocannabinoid system modulator, Sativex(®) (nabiximols, USAN name), provides an alternative therapeutic approach in the management of MS spasticity.

Behavioral Predictors of Acute Stress Symptoms During Intense Military Training

DTIC Science & Technology

2009-06-01

the Ways of Coping Scale ( Folkman & Lazarus , 1988). During survival training, the Clinician- Administered Dissociative States Scale (Bremner et al...Published on behalf of the International Society for Traumatic Stress Studies. Acute Stress Symptoms 217 Folkman , S., & Lazarus , R. (1988). Manual...and performance in sport (pp. 17–42). Chichester, UK: Wiley. Lazarus , R. S. (2000). Cognitive-motivational-relational theory of emotion. In Y . Hanin

Emotional and Psychological Well-Being in Children: The Development and Validation of the Stirling Children's Well-Being Scale

ERIC Educational Resources Information Center

Liddle, Ian; Carter, Greg F. A.

2015-01-01

The Stirling Children's Well-being Scale (SCWBS) was developed by the Stirling Council Educational Psychology Service (UK) as a holistic, positively worded measure of emotional and psychological well-being in children aged eight to 15 years. Drawing on current theories of well-being and Positive Psychology, the aim was to provide a means of…

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.

Intercomparison of Operational Ocean Forecasting Systems in the framework of GODAE

NASA Astrophysics Data System (ADS)

Hernandez, F.

2009-04-01

One of the main benefits of the GODAE 10-year activity is the implementation of ocean forecasting systems in several countries. In 2008, several systems are operated routinely, at global or basin scale. Among them, the BLUElink (Australia), HYCOM (USA), MOVE/MRI.COM (Japan), Mercator (France), FOAM (United Kingdom), TOPAZ (Norway) and C-NOOFS (Canada) systems offered to demonstrate their operational feasibility by performing an intercomparison exercise during a three months period (February to April 2008). The objectives were: a) to show that operational ocean forecasting systems are operated routinely in different countries, and that they can interact; b) to perform in a similar way a scientific validation aimed to assess the quality of the ocean estimates, the performance, and forecasting capabilities of each system; and c) to learn from this intercomparison exercise to increase inter-operability and collaboration in real time. The intercomparison relies on the assessment strategy developed for the EU MERSEA project, where diagnostics over the global ocean have been revisited by the GODAE contributors. This approach, based on metrics, allow for each system: a) to verify if ocean estimates are consistent with the current general knowledge of the dynamics; and b) to evaluate the accuracy of delivered products, compared to space and in-situ observations. Using the same diagnostics also allows one to intercompare the results from each system consistently. Water masses and general circulation description by the different systems are consistent with WOA05 Levitus climatology. The large scale dynamics (tropical, subtropical and subpolar gyres ) are also correctly reproduced. At short scales, benefit of high resolution systems can be evidenced on the turbulent eddy field, in particular when compared to eddy kinetic energy deduced from satellite altimetry of drifter observations. Comparisons to high resolution SST products show some discrepancies on ocean surface representation, either due to model and forcing fields errors, or assimilation scheme efficiency. Comparisons to sea-ice satellite products also evidence discrepancies linked to model, forcing and assimilation strategies of each forecasting system. Key words: Intercomparison, ocean analysis, operational oceanography, system assessment, metrics, validation GODAE Intercomparison Team: L. Bertino (NERSC/Norway), G. Brassington (BMRC/Australia), E. Chassignet (FSU/USA), J. Cummings (NRL/USA), F. Davidson (DFO/Canda), M. Drévillon (CERFACS/France), P. Hacker (IPRC/USA), M. Kamachi (MRI/Japan), J.-M. Lellouche (CERFACS/France), K. A. Lisæter (NERSC/Norway), R. Mahdon (UKMO/UK), M. Martin (UKMO/UK), A. Ratsimandresy (DFO/Canada), and C. Regnier (Mercator Ocean/France)

Advances in the understanding of nutrient dynamics and management in UK agriculture.

PubMed

Dungait, Jennifer A J; Cardenas, Laura M; Blackwell, Martin S A; Wu, Lianhai; Withers, Paul J A; Chadwick, David R; Bol, Roland; Murray, Philip J; Macdonald, Andrew J; Whitmore, Andrew P; Goulding, Keith W T

2012-09-15

Current research on macronutrient cycling in UK agricultural systems aims to optimise soil and nutrient management for improved agricultural production and minimise effects on the environment and provision of ecosystem services. Nutrient use inefficiencies can cause environmental pollution through the release of greenhouse gases into the atmosphere and of soluble and particulate forms of N, P and carbon (C) in leachate and run-off into watercourses. Improving nutrient use efficiencies in agriculture calls for the development of sustainable nutrient management strategies: more efficient use of mineral fertilisers, increased recovery and recycling of waste nutrients, and, better exploitation of the substantial inorganic and organic reserves of nutrients in the soil. Long-term field experimentation in the UK has provided key knowledge of the main nutrient transformations in agricultural soils. Emerging analytical technologies, especially stable isotope labelling, that better characterise macronutrient forms and bioavailability and improve the quantification of the complex relationships between the macronutrients in soils at the molecular scale, are augmenting this knowledge by revealing the underlying processes. The challenge for the future is to determine the relationships between the dynamics of N, P and C across scales, which will require both new modelling approaches and integrated approaches to macronutrient cycling. Copyright © 2012 Elsevier B.V. All rights reserved.

Health information technology and sociotechnical systems: a progress report on recent developments within the UK National Health Service (NHS).

PubMed

Waterson, Patrick

2014-03-01

This paper summarises some of the research that Ken Eason and colleagues at Loughborough University have carried out in the last few years on the introduction of Health Information Technologies (HIT) within the UK National Health Service (NHS). In particular, the paper focuses on three examples which illustrate aspects of the introduction of HIT within the NHS and the role played by the UK National Programme for Information Technology (NPfIT). The studies focus on stages of planning and preparation, implementation and use, adaptation and evolution of HIT (e.g., electronic patient records, virtual wards) within primary, secondary and community care settings. Our findings point to a number of common themes which characterise the use of these systems. These include tensions between national and local strategies for implementing HIT and poor fit between healthcare work systems and the design of HIT. The findings are discussed in the light of other large-scale, national attempts to introduce similar technologies, as well as drawing out a set of wider lessons learnt from the NPfIT programme based on Ken Eason's earlier work and other research on the implementation of large-scale HIT. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Ten commandments for the future of ageing research in the UK: a vision for action

PubMed Central

Franco, Oscar H; Kirkwood, Thomas BL; Powell, Jonathan R; Catt, Michael; Goodwin, James; Ordovas, Jose M; van der Ouderaa, Frans

2007-01-01

Increases in longevity resulting from improvements in health care and living conditions together with a decrease in fertility rates have contributed to a shift towards an aged population profile. For the first time the UK has more people over age 60 than below 16 years of age. The increase in longevity has not been accompanied by an increase in disease-free life expectancy and research into ageing is required to improve the health and quality of life of older people. However, as the House of Lords reported, ageing research in the UK is not adequately structured and a clear vision and plan are urgently required. Hence, with the aim of setting a common vision for action in ageing research in the UK, a 'Spark Workshop' was organised. International experts from different disciplines related to ageing research gathered to share their perspectives and to evaluate the present status of ageing research in the UK. A detailed assessment of potential improvements was conducted and the prospective secondary gains were considered, which were subsequently distilled into a list of 'ten commandments'. We believe that these commandments, if followed, will help to bring about the necessary implementation of an action plan for ageing research in the UK, commensurate with the scale of the challenge, which is to transform the manifold opportunities of increased longevity into actual delivery of a society living not only for longer, but also healthier, wealthier and happier. PMID:17477869

Measurement of utility values in the UK for health states related to immune thrombocytopenic purpura.

PubMed

Szende, Agota; Brazier, John; Schaefer, Caroline; Deuson, Robert; Isitt, John J; Vyas, Paresh

2010-08-01

To measure utility values associated with immune (idiopathic) thrombocytopenic purpura (ITP), as perceived by the United Kingdom (UK) general public. A multi-step process, including clinical trial data, literature review, and patient focus group, was used to develop ITP health states valued in a web survey. Six ITP health states were defined based on platelet levels, risk of bleeding and key adverse events/disease complications. Clinical trial data on bleeding and ITP-specific quality of life data were key sources for developing health-state descriptions. 359 respondents, randomly selected from a managed web panel in the UK, completed the web-based Time Trade-Off survey. Wilcoxon signed-rank test was used to compare differences between each pair of health states. Sample characteristics (mean age: 47.9 +/- 16.9 years; 54% female) were comparable to the UK general population. ITP health states were valued as significantly worse than perfect health. Experiencing bleeding episodes was a more important driver than low platelet levels in valuing a health state to be worse. Substantial disutilities were associated with surviving an intracranial haemorrhage. Mean (SD) utility values for each ITP health state are: HS1: platelets >or=50 x 10(9)/L, no outpatient bleed: 0.863 +/- 0.15; HS2: platelets >or=50 x 10(9)/L, outpatient bleed: 0.734 +/- 0.19; HS3: platelets <50 x 10(9)/L, no outpatient bleed: 0.841 +/- 0.19; HS4: platelets <50 x 10(9)/L, outpatient bleed: 0.732 +/- 0.19; HS5: intracranial haemorrhage (2-6 months): 0.038 +/- 0.46; HS6: steroid treatment adverse events: 0.758 +/- 0.20. Potential limitations relate to web user population characteristics and lack of comparative testing of web-based TTO methods. Results provide evidence that the UK general population associate substantial loss of value living with ITP, suggesting an important role for new ITP treatments. Utility values based on these health states may be useful in future cost-effectiveness studies of existing and/or new ITP treatments.

Pathogens of skin and skin-structure infections in the UK and their susceptibility to antibiotics, including ceftaroline.

PubMed

Livermore, David M; Mushtaq, Shazad; Warner, Marina; James, Dorothy; Kearns, Angela; Woodford, Neil

2015-10-01

Bacterial skin and skin-structure infections (SSSIs) are frequent settings for antibiotic use. We surveyed their UK aetiology and pathogen susceptibility, including susceptibility to ceftaroline. Consecutive SSSI isolates were collected at 35 UK hospitals, to a maximum of 60/site, together with 15 'supplementary' MRSA/site. Isolates were re-identified and BSAC susceptibility testing was performed, with parallel CLSI agar testing for ceftaroline. Isolates (n = 1908) were collected from 1756 hospitalized patients, predominantly with surgical and traumatic infections, abscesses and infected ulcers and largely from general medicine and general surgery patients. They included 1271 Staphylococcus aureus (201 MRSA), 162 β-haemolytic streptococci, 269 Enterobacteriaceae, 138 Pseudomonas aeruginosa and 37 enterococci. Most (944/1756) patients had monomicrobial MSSA infections. Rates of resistance to quinolones, gentamicin and cephalosporins were <20% in Enterobacteriaceae and <10% in P. aeruginosa. MRSA rates varied greatly among hospitals and were 2.5-fold higher in general medicine than in general surgery patients. At breakpoint, ceftaroline inhibited: (i) all MSSA and 97.6% of MRSA, with MICs of 2 mg/L for the few resistant MRSA; (ii) all β-haemolytic streptococci; and (iii) 83% of Enterobacteriaceae. High-level ceftaroline resistance in Enterobacteriaceae involved ESBLs or AmpC enzymes. Ceftaroline MICs by CLSI methodology generally equalled those by BSAC or were 2-fold higher, but this differential was 4-16-fold for P. aeruginosa. Irrespective of patient group, SSSIs were dominated by S. aureus. Most pathogens were susceptible, but 15.8% of S. aureus were MRSA, with locally higher prevalence. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The LUCK study: Laxative Usage in patients with GP-diagnosed Constipation in the UK, within the general population and in pregnancy. An epidemiological study using the General Practice Research Database (GPRD)

PubMed Central

Shafe, Anna C. E.; Lee, Sally; Dalrymple, Jamie S. O.; Whorwell, Peter J.

2011-01-01

Background: Despite the high prevalence of constipation and its related public health implications, there is relatively little research available on the condition from large epidemiological studies. The aim of this study was to investigate the epidemiology of general practitioner (GP)-diagnosed constipation and the prescribing trends for laxatives in the UK, within the general population and during pregnancy. Methods: A cohort study for the period from 2005 to 2009 was performed using the UK primary care database (General Practice Research Database), which contains information on over 3 million individuals. Results: The prevalence of GP-diagnosed constipation ranged from 12 per 1000 persons in 2005 (0.012 per person year) to 12.8 per 1000 in 2009 (0.013 per person year). The prevalence was almost twice as high in women as in men, and was higher in older patients. In 2005 the most commonly prescribed laxatives were lactulose (37%), senna (26%), macrogol (19%), ispaghula (6%), docusate sodium (5%), bisacodyl (4%) and glycerol suppositories (2%). By 2009, this pattern had changed: macrogol (31%), lactulose (29%), senna (22%), ispaghula (5%), docusate sodium (6%), bisacodyl (3%) and glycerol suppositories (3%). In pregnancy, lactulose accounted for 81% of laxative use in 2005, falling to 64% by 2009. In contrast, macrogol use in pregnancy rose from 13% in 2005 to 32% in 2009. Conclusions: GP-diagnosed constipation is common, accounting for a large number of consultations. Laxative prescribing trends have changed over the 5-year study period, prescriptions for macrogol becoming increasingly common and prescriptions for lactulose and senna less common. Macrogol also appears to have been replacing lactulose for treating constipation in pregnant women. PMID:22043228

Is the Relationship between Common Mental Disorder and Adiposity Bidirectional? Prospective Analyses of a UK General Population-Based Study.

PubMed

Fezeu, Léopold K; Batty, G David; Batty, David G; Gale, Catharine R; Kivimaki, Mika; Hercberg, Serge; Czernichow, Sebastien

2015-01-01

The direction of the association between mental health and adiposity is poorly understood. Our objective was to empirically examine this link in a UK study. This is a prospective cohort study of 3 388 people (men) aged ≥ 18 years at study induction who participated in both the UK Health and Lifestyle Survey at baseline (HALS-1, 1984/1985) and the re-survey (HALS-2, 1991/1992). At both survey examinations, body mass index, waist circumference and self-reported common mental disorder (the 30-item General Health Questionnaire, GHQ) were measured. Logistic regression models were used to compute odds ratios (OR) and accompanying 95% confidence intervals (CI) for the associations between (1) baseline common mental disorder (QHQ score > 4) and subsequent general and abdominal obesity and (2) baseline general and abdominal obesity and re-survey common mental disorders. After controlling for a range of covariates, participants with common mental disorder at baseline experienced greater odds of subsequently becoming overweight (women, OR: 1.30, 1.03 - 1.64; men, 1.05, 0.81 - 1.38) and obese (women, 1.26, 0.82 - 1.94; men, OR: 2.10, 1.23 - 3.55) than those who were free of common mental disorder. Similarly, having baseline common mental health disorder was also related to a greater risk of developing moderate (1.57, 1.21 - 2.04) and severe (1.48, 1.09 - 2.01) abdominal obesity (women only). Baseline general or abdominal obesity was not associated with the risk of future common mental disorder. These findings of the present study suggest that the direction of association between common mental disorders and adiposity is from common mental disorder to increased future risk of adiposity as opposed to the converse.

Variation in clinical coding lists in UK general practice: a barrier to consistent data entry?

PubMed

Tai, Tracy Waize; Anandarajah, Sobanna; Dhoul, Neil; de Lusignan, Simon

2007-01-01

Routinely collected general practice computer data are used for quality improvement; poor data quality including inconsistent coding can reduce their usefulness. To document the diversity of data entry systems currently in use in UK general practice and highlight possible implications for data quality. General practice volunteers provided screen shots of the clinical coding screen they would use to code a diagnosis or problem title in the clinical consultation. The six clinical conditions examined were: depression, cystitis, type 2 diabetes mellitus, sore throat, tired all the time, and myocardial infarction. We looked at the picking lists generated for these problem titles in EMIS, IPS, GPASS and iSOFT general practice clinical computer systems, using the Triset browser as a gold standard for comparison. A mean of 19.3 codes is offered in the picking list after entering a diagnosis or problem title. EMIS produced the longest picking lists and GPASS the shortest, with a mean number of choices of 35.2 and 12.7, respectively. Approximately three-quarters (73.5%) of codes are diagnoses, one-eighth (12.5%) symptom codes, and the remainder come from a range of Read chapters. There was no readily detectable consistent order in which codes were displayed. Velocity coding, whereby commonly-used codes are placed higher in the picking list, results in variation between practices even where they have the same brand of computer system. Current systems for clinical coding promote diversity rather than consistency of clinical coding. As the UK moves towards an integrated health IT system consistency of coding will become more important. A standardised, limited list of codes for primary care might help address this need.

Genetics Home Reference: shingles

MedlinePlus

... Aftercare MedlinePlus Encyclopedia: Shingles National Health Service (UK): Post-Herpetic Neuralgia Treatment General Information from MedlinePlus (5 links) Diagnostic Tests Drug Therapy Genetic Counseling Palliative Care Surgery and ...

Academic performance of ethnic minority candidates and discrimination in the MRCGP examinations between 2010 and 2012: analysis of data

PubMed Central

Roberts, Chris

2013-01-01

Objective To determine the difference in failure rates in the postgraduate examination of the Royal College of General Practitioners (MRCGP) by ethnic or national background, and to identify factors associated with pass rates in the clinical skills assessment component of the examination. Design Analysis of data provided by the Royal College of General Practitioners and the General Medical Council. Participants Cohort of 5095 candidates sitting the applied knowledge test and clinical skills assessment components of the MRCGP examination between November 2010 and November 2012. A further analysis was carried out on 1175 candidates not trained in the United Kingdom, who sat an English language capability test (IELTS) and the Professional and Linguistic Assessment Board (PLAB) examination (as required for full medical registration), controlling for scores on these examinations and relating them to pass rates of the clinical skills assessment. Setting United Kingdom. Results After controlling for age, sex, and performance in the applied knowledge test, significant differences persisted between white UK graduates and other candidate groups. Black and minority ethnic graduates trained in the UK were more likely to fail the clinical skills assessment at their first attempt than their white UK colleagues (odds ratio 3.536 (95% confidence interval 2.701 to 4.629), P<0.001; failure rate 17% v 4.5%). Black and minority ethnic candidates who trained abroad were also more likely to fail the clinical skills assessment than white UK candidates (14.741 (11.397 to 19.065), P<0.001; 65% v 4.5%). For candidates not trained in the UK, black or minority ethnic candidates were more likely to fail than white candidates, but this difference was no longer significant after controlling for scores in the applied knowledge test, IELTS, and PLAB examinations (adjusted odds ratio 1.580 (95% confidence interval 0.878 to 2.845), P=0.127). Conclusions Subjective bias due to racial discrimination in the clinical skills assessment may be a cause of failure for UK trained candidates and international medical graduates. The difference between British black and minority ethnic candidates and British white candidates in the pass rates of the clinical skills assessment, despite controlling for prior attainment, suggests that subjective bias could also be a factor. Changes to the clinical skills assessment could improve the perception of the examination as being biased against black and minority ethnic candidates. The difference in training experience and other cultural factors between candidates trained in the UK and abroad could affect outcomes. Consideration should be given to strengthening postgraduate training for international medical graduates. PMID:24072882

Passing MRCP (UK) PACES: a cross-sectional study examining the performance of doctors by sex and country.

PubMed

Unwin, Emily; Potts, Henry W W; Dacre, Jane; Elder, Andrew; Woolf, Katherine

2018-04-06

There is much discussion about the sex differences that exist in medical education. Research from the United Kingdom (UK) and United States has found female doctors earn less, and are less likely to be senior authors on academic papers, but female doctors are also less likely to be sanctioned, and have been found to perform better academically and clinically. It is also known that international medical graduates tend to perform more poorly academically compared to home-trained graduates in the UK, US, and Canada. It is uncertain whether the magnitude and direction of sex differences in doctors' performance is variable by country. We explored the association between doctors' sex and their performance at a large international high-stakes clinical examination: the Membership of the Royal Colleges of Physicians (UK) Practical Assessment of Clinical Examination Skills (PACES). We examined how sex differences varied by the country in which the doctor received their primary medical qualification, the country in which they took the PACES examination, and by the country in which they are registered to practise. Seven thousand six hundred seventy-one doctors attempted PACES between October 2010 and May 2013. We analysed sex differences in first time pass rates, controlling for ethnicity, in three groups: (i) UK medical graduates (N = 3574); (ii) non-UK medical graduates registered with the UK medical regulator, the General Medical Council (GMC), and thus likely to be working in the UK (N = 1067); and (iii) non-UK medical graduates without GMC registration and so legally unable to work or train in the UK (N = 2179). Female doctors were statistically significantly more likely to pass at their first attempt in all three groups, with the greatest sex effect seen in non-UK medical graduates without GMC registration (OR = 1.99; 95% CI = 1.65-2.39; P < 0.0001) and the smallest in the UK graduates (OR = 1.18; 95% CI = 1.03-1.35; P = 0.02). As found in a previous format of this examination and in other clinical examinations, female doctors outperformed male doctors. Further work is required to explore why sex differences were greater in non-UK graduates, especially those without GMC registration, and to consider how examination performance may relate to performance in practice.

Breast is best: Positive mealtime interactions in breastfeeding mothers from Israel and the United Kingdom

PubMed Central

Rudolf, MCJ; Feltbower, RG; Mohebati, L; Hetherington, M

2015-01-01

We examined mealtime interactions to assess whether they varied according to maternal body mass index, country and mode of feeding in 41 Israeli and UK mother–infant dyads. Feeding behaviours were coded using the Simple Feeding Element Scale. Significantly, more UK mothers breastfed during the filmed meal compared to Israeli mothers. Mealtime interactions did not vary according to maternal body mass index or country. Women who breastfed (as opposed to those who bottle fed or fed solids) provided fewer distractions during the meal, a more ideal feeding environment and fed more responsively. PMID:28070352

Multiphase Flow Characteristics of Heterogeneous Rocks From CO2 Storage Reservoirs in the United Kingdom

NASA Astrophysics Data System (ADS)

Reynolds, Catriona A.; Blunt, Martin J.; Krevor, Samuel

2018-02-01

We have studied the impact of heterogeneity on relative permeability and residual trapping for rock samples from the Bunter sandstone of the UK Southern North Sea, the Ormskirk sandstone of the East Irish Sea, and the Captain sandstone of the UK Northern North Sea. Reservoir condition CO2-brine relative permeability measurements were made while systematically varying the ratio of viscous to capillary flow potential, across a range of flow rates, fractional flow, and during drainage and imbibition displacement. This variation resulted in observations obtained across a range of core-scale capillary number 0.2

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.

Unevenly distributed: a systematic review of the health literature about socioeconomic inequalities in adult obesity in the United Kingdom

PubMed Central

2012-01-01

Background There is a growing literature documenting socioeconomic inequalities in obesity risk among adults in the UK, with poorer groups suffering higher risk. Methods In this systematic review, we summarize and appraise the extant peer-reviewed literature about socioeconomic inequalities in adult obesity risk in the UK published between 1980 and 2010. Only studies featuring empirical assessments of relations between socioeconomic indicators and measures of obesity among adults in the UK were included. Results A total of 35 articles met inclusion criteria, and were reviewed here. Conclusion Socioeconomic indicators of low socioeconomic position (SEP), including occupational social class of the head-of-household at birth and during childhood, earlier adulthood occupational social class, contemporaneous occupational social class, educational attainment, and area-level deprivation were generally inversely associated with adult obesity risk in the UK. Measures of SEP were more predictive of obesity among women than among men. We outline important methodological limitations to the literature and recommend avenues for future research. PMID:22230643

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.

Complications of bariatric surgery--What the general surgeon needs to know.

PubMed

Healy, Paul; Clarke, Christopher; Reynolds, Ian; Arumugasamy, Mayilone; McNamara, Deborah

2016-04-01

Obesity is an important cause of physical and psychosocial morbidity and it places a significant burden on health system costs and resources. Worldwide an estimated 200 million people over 20 years are obese and in the U.K. the Department of Health report that 61.3% of people in the U.K. are either overweight or obese. Surgery for obesity (bariatric surgery) is being performed with increasing frequency in specialist centres both in the U.K. and Ireland and abroad due to the phenomenon of health tourism. Its role and success in treating medical conditions such as diabetes mellitus and hypertension in obese patients will likely lead to an even greater number of bariatric surgery procedures being performed. Patients with early postoperative complications may be managed in specialist centres but patients with later complications, occurring months or years after surgery, may present to local surgical units for assessment and management. This review will highlight the late complications of the 3 most commonly performed bariatric surgery procedures that the emergency general surgeon may encounter. It will also highlight the complications that require urgent intervention by the emergency general surgeon and those that can be safely referred to a bariatric surgeon for further management after initial assessment and investigations. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Palliative care for cirrhosis: a UK survey of health professionals’ perceptions, current practice and future needs

PubMed Central

Low, Joseph; Vickerstaff, Victoria; Davis, Sarah; Bichard, Julia; Greenslade, Lynda; Hopkins, Katherine; Marshall, Aileen; Thorburn, Douglas; Jones, Louise

2016-01-01

Objective To determine the knowledge and practice patterns of a UK cohort of relevant healthcare professionals (HCPs) about delivering palliative care in cirrhosis, and to inform priorities for future research. Design An on-line questionnaire survey with closed and open responses. Setting HCPs identified from the mailing list of special interest groups in hepatology and gastroenterology (liver), general practice and specialist palliative care (SPC) across the UK. Results Of the 6181 potential contacts identified, 517 HCPs responded. Most believed a role exists for SPC in caring for people with cirrhosis, but many SPC HCPs felt ill prepared to provide good care to those facing death. Further training was needed in managing liver-related symptoms, symptom control and end of life issues. All HCP groups wished to increase community provision of palliative care support, but many general practitioners felt unable to manage advanced cirrhosis in the community. There were differences in the optimal trigger for SPC referral with liver HCPs less likely to refer at symptom deterioration. Prognostication, symptom management and service configuration were key areas identified for future research. Conclusions All who responded acknowledged the role of SPC in caring for those dying with cirrhosis and need for further training to improve confidence and enable joint working between SPC, general practice and liver teams. Low response rates make it difficult to generalise these findings, which require further validation. PMID:28839829

Nature and governance of veterinary clinical research conducted in the UK.

PubMed

Fordyce, P; Mullan, S

2017-01-21

In order to quantify the amount of clinical research conducted on client-owned animals under the Veterinary Surgeons Act 1966, and the nature and extent of any ethical review of that research, a questionnaire was sent to 6 UK veterinary schools, 1 charity veterinary clinic and 12 private referral clinics. The questionnaire examined whether and how much clinical research respondents undertook, and the composition of any ethical review panels examining research proposals. The questionnaire revealed a substantial amount of clinical research was conducted in the UK, with over 200 veterinary surgeons involved in the year of the survey, with at least 170 academic papers involving clinical research published by respondents in the same year. However, it proved impossible to quantify the full extent of clinical research in the UK. All UK veterinary schools required ethical review of clinical research. The composition and working practices of their ethical review panels generally reflected skill sets in ethical review panels set-up under statute to consider the ethics of non-clinical biomedical research on animals and clinical research conducted on human patients. The process for review of clinical research in the private sector was less clear. British Veterinary Association.

Decompressive craniectomy and cranioplasty: experience and outcomes in deployed UK military personnel.

PubMed

Roberts, S A G; Toman, E; Belli, A; Midwinter, M J

2016-10-01

In recent conflicts, many UK personnel sustained head injuries requiring damage-control surgery and aeromedical transfer to the UK. This study aims to examine indications, complications and outcomes of UK military casualties undergoing craniectomy and cranioplasty from conflicts in Afghanistan and Iraq. The UK military Joint Theatre Trauma Registry (JTTR) was searched for all UK survivors in Afghanistan and Iraq between 2004 and 2014 requiring craniectomy and cranioplasty resulting from trauma. Fourteen decompressive craniectomies and cranioplasties were performed with blast and gunshot wounds equally responsible for head injury. Ten survivors (71%) had an Injury Severity Score (ISS) of 75, normally designated as 'unsurvivable'. Most were operated on the day of injury. Seventy-one percent received a reverse question mark incision and 7% received a bicoronal incision. Seventy-nine percent had bone flaps discarded. Overall infection rate was 43%. Acinetobacter spp was the causative organism in 50% of cases. Median Glasgow Outcome Scale (GOS) at final follow-up was 4. All casualties had a GOS score greater than 3. Timely neurosurgical intervention is imperative for military personnel given high survival rates in those sustaining what are designated 'un-survivable' injuries. Early decompression facilitates safe aeromedical evacuation of casualties. Excellent outcomes validate the UK military trauma system and the stepwise performance gains throughout recent conflicts however trauma registers most evolving to have specific relevance to military casualties. In high-energy trauma with contamination and soft-tissue destruction, surgery should be conducted with regard for future soft tissue reconstruction. Bone flaps should be discarded and cranioplasty performed according to local preference. Facilities receiving military casualties should have specialist microbiological input mindful of the difficulties treating unusual microbes.

The role of long-range transport and domestic emissions in determining atmospheric secondary inorganic particle concentrations across the UK

NASA Astrophysics Data System (ADS)

Vieno, M.; Heal, M. R.; Hallsworth, S.; Famulari, D.; Doherty, R. M.; Dore, A. J.; Tang, Y. S.; Braban, C. F.; Leaver, D.; Sutton, M. A.; Reis, S.

2013-12-01

Surface concentrations of secondary inorganic particle components over the UK have been analysed for 2001-2010 using the EMEP4UK regional atmospheric chemistry transport model. In early 2003 an episode of substantially elevated surface concentrations of ammonium nitrate was measured across the UK by the AGANET network. The EMEP4UK model was able accurately to represent both the long-term decadal surface concentrations and the episode in 2003. The latter was identified as consisting of three separate episodes, each of less than 1 month duration, in February, March and April. The primary cause of the elevated nitrate levels across the UK was meteorological, a persistent high pressure system, but whose varying location impacted the relative importance of transboundary vs. domestic emissions. Whilst long-range transport dominated the elevated nitrate in February, in contrast it was domestic emissions that mainly contributed to the March episode, and for the April episode both domestic emissions and long-range transport contributed. A prolonged episode such as the one in early 2003 can have substantial impact on annual average concentrations. The episode led to annual concentration differences at the regional scale of similar magnitude to those driven by long-term changes in precursor emissions over the full decade investigated here. The results demonstrate that a substantial part of the UK, particularly the south and south-east, may be close to or actually exceeding annual mean limit values because of import of inorganic aerosol components from continental Europe under specific conditions. The results reinforce the importance of employing multiple year simulations in the assessment of emissions reduction scenarios on PM concentrations and the need for international agreements to address the transboundary component of air pollution.

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

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.

Insights about health-related quality of life in cancer patients indicate demands for better pharmaceutical care.

PubMed

Ibrahim, Nagwa A; Björnsdottir, Ingunn; Al Alwan, Ashraf S; Honore, Per Hartvig

2014-08-01

To highlight the health-related quality of life scale scores for Saudi patients with different types of cancer, to get understanding and foundation for improvements. To suggest suitable plans for quality of life improvement based on study outcome. The role of oncology pharmacy will be stressed. A cross-sectional descriptive study was conducted at a tertiary regional hospital using the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire. Attendees were patients diagnosed with any type of cancer and eligible for active anticancer treatment and/or palliative care. Quality of life was evaluated for 87 participants. Most of patients were aged between 51 and 60 years; and 50% had active treatment with chemotherapy. Patients seemed to perform well with respect to average scores in both the symptoms and the functional health status scales. The mean score for the global quality of life scale was 47.2 ± 27.1, while the range of mean scores for the five function subscales was 59.0 ± 27.1 to 81.6 ± 13.8, indicating average level of general wellbeing with above average to high level of functional health status, while >50% of the patients met the operational criterion having less severe symptoms. Outpatients generally had somewhat higher scores as compared to hospitalized patients. The general quality of life seemed satisfactory, but there is still need to improve care. Based on results from other studies, oncology pharmacists' roles are essential to improve quality of life through treatment counseling, follow-up on drug support therapy, stress on patient's education through specific programs, review and update the local guidelines, and conduct more research. © Prince Sultan Military Medical City, Saudi Arabia 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey

PubMed Central

Laverty, Anthony A; Harris, Matthew J; Watt, Hilary C; Greaves, Felix; Majeed, Azeem

2017-01-01

Objective To examine associations between the contract and ownership type of general practices and patient experience in England. Design Multilevel linear regression analysis of a national cross-sectional patient survey (General Practice Patient Survey). Setting All general practices in England in 2013–2014 (n = 8017). Participants 903,357 survey respondents aged 18 years or over and registered with a general practice for six months or more (34.3% of 2,631,209 questionnaires sent). Main outcome measures Patient reports of experience across five measures: frequency of consulting a preferred doctor; ability to get a convenient appointment; rating of doctor communication skills; ease of contacting the practice by telephone; and overall experience (measured on four- or five-level interval scales from 0 to 100). Models adjusted for demographic and socioeconomic characteristics of respondents and general practice populations and a random intercept for each general practice. Results Most practices had a centrally negotiated contract with the UK government (‘General Medical Services’ 54.6%; 4337/7949). Few practices were limited companies with locally negotiated ‘Alternative Provider Medical Services’ contracts (1.2%; 98/7949); these practices provided worse overall experiences than General Medical Services practices (adjusted mean difference −3.04, 95% CI −4.15 to −1.94). Associations were consistent in direction across outcomes and largest in magnitude for frequency of consulting a preferred doctor (−12.78, 95% CI −15.17 to −10.39). Results were similar for practices owned by large organisations (defined as having ≥20 practices) which were uncommon (2.2%; 176/7949). Conclusions Patients registered to general practices owned by limited companies, including large organisations, reported worse experiences of their care than other patients in 2013–2014. PMID:29096580

Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey.

PubMed

Cowling, Thomas E; Laverty, Anthony A; Harris, Matthew J; Watt, Hilary C; Greaves, Felix; Majeed, Azeem

2017-11-01

Objective To examine associations between the contract and ownership type of general practices and patient experience in England. Design Multilevel linear regression analysis of a national cross-sectional patient survey (General Practice Patient Survey). Setting All general practices in England in 2013-2014 ( n = 8017). Participants 903,357 survey respondents aged 18 years or over and registered with a general practice for six months or more (34.3% of 2,631,209 questionnaires sent). Main outcome measures Patient reports of experience across five measures: frequency of consulting a preferred doctor; ability to get a convenient appointment; rating of doctor communication skills; ease of contacting the practice by telephone; and overall experience (measured on four- or five-level interval scales from 0 to 100). Models adjusted for demographic and socioeconomic characteristics of respondents and general practice populations and a random intercept for each general practice. Results Most practices had a centrally negotiated contract with the UK government ('General Medical Services' 54.6%; 4337/7949). Few practices were limited companies with locally negotiated 'Alternative Provider Medical Services' contracts (1.2%; 98/7949); these practices provided worse overall experiences than General Medical Services practices (adjusted mean difference -3.04, 95% CI -4.15 to -1.94). Associations were consistent in direction across outcomes and largest in magnitude for frequency of consulting a preferred doctor (-12.78, 95% CI -15.17 to -10.39). Results were similar for practices owned by large organisations (defined as having ≥20 practices) which were uncommon (2.2%; 176/7949). Conclusions Patients registered to general practices owned by limited companies, including large organisations, reported worse experiences of their care than other patients in 2013-2014.

Accessing remote data bases using microcomputers

PubMed Central

Saul, Peter D.

1985-01-01

General practitioners' access to remote data bases using microcomputers is increasing, making even the most obscure information readily available. Some of the systems available to general practitioners in the UK are described and the methods of access are outlined. General practitioners should be aware of the advances in technology; data bases are increasing in size, the cost of access is falling and their use is becoming easier. PMID:4020756

Long Term Large Scale river nutrient changes across the UK

NASA Astrophysics Data System (ADS)

Bell, Victoria; Naden, Pam; Tipping, Ed; Davies, Helen; Davies, Jessica; Dragosits, Ulli; Muhammed, Shibu; Quinton, John; Stuart, Marianne; Whitmore, Andy; Wu, Lianhai

2017-04-01

During recent decades and centuries, pools and fluxes of Carbon, Nitrogen and Phosphorus (C, N and P) in UK rivers and ecosystems have been transformed by the spread and fertiliser-based intensification of agriculture (necessary to sustain human populations), by atmospheric pollution, by human waste (rising in line with population growth), and now by climate change. The principal objective of the UK's NERC-funded Macronutrients LTLS research project has been to account for observable terrestrial and aquatic pools, concentrations and fluxes of C, N and P on the basis of past inputs, biotic and abiotic interactions, and transport processes. More specifically, over the last 200 years, what have been the temporal responses of plant and soil nutrient pools in different UK catchments to nutrient enrichment, and what have been the consequent effects on nutrient transfers from land to the atmosphere, freshwaters and estuaries? The work described here addresses the second question by providing an integrated quantitative description of the interlinked land and water pools and annual fluxes of C, N and P for UK catchments over time. A national-scale modelling environment has been developed, combining simple physically-based gridded models that can be parameterised using recent observations before application to long timescales. The LTLS Integrated Model (LTLS-IM) uses readily-available driving data (climate, land-use, nutrient inputs, topography), and model estimates of both terrestrial and freshwater nutrient loads have been compared with measurements from sites across the UK. Here, the focus is on the freshwater nutrient component of the LTLS-IM, but the terrestrial nutrient inputs required for this are provided by models of nutrient processes in semi-natural and agricultural systems, and from simple models of nutrients arising from human waste. In the freshwater model, lateral routing of dissolved and particulate nutrients and within-river processing such as denitrification, decomposition and chlorophyll growth are undertaken, and the effects of groundwater storage and processes in lakes connected to the river network can be included. Following assessment against observations of terrestrial and nutrient fluxes in rivers across the UK, the LTLS-IM has been run nationally for 200 years (1800 to 2010), and the work presented here provides, for the first time, national, regional or catchment estimates of the origins and trends in riverine nutrients in the period following the industrial revolution. Ongoing work is now exploring the effects of future climate, waste water treatment and land-management scenarios on water quality, and the effects of nutrient enrichment on the development of eutrophication in rivers.

Physical health indicators in major mental illness: data from the Quality and Outcome Framework in the UK.

PubMed

Martin, Julie Langan; Lowrie, Richard; McConnachie, Alex; McLean, Gary; Mair, Frances; Mercer, Stewart; Smith, Daniel

2015-02-26

In the UK, the Quality and Outcome Framework (QOF) has specific targets for general practictioners to record body-mass index (BMI) and blood pressure (BP) in major mental illness, diabetes, and chronic kidney disease. Although incentives are given for aspects of major mental illness (schizophrenia, bipolar disorder, and related psychoses), barriers to care can occur. Our aim was to compare recording of specific targets for BP and BMI in individuals with major mental illness relative to diabetes and chronic kidney disease across the UK. Using 2012 and 2013 QOF data from 9731 general practices across all four countries in the UK, we calculated median payment, population achievement, and exception rates for BP indicators in major mental illness and chronic kidney disease and BMI indicators in major mental illness and diabetes. Differences in unweighted rates between practices in the same UK country were tested with a sign test. Differences in population achievement rate between practices in different countries were compared with those in England by use of a quantile regression analysis. UK payment and population achievement rates for BMI recording in major mental illness were significantly lower than were those in diabetes (payment 92·7% vs 95·5% and population achievement 84·0% vs 92·5%, p<0·0001) and exception rates were higher (8·1% vs 2·0%, p<0·0001). For BP recording, UK payment and population achievement rates were significantly lower for major mental illness than for chronic kidney disease (94·1% vs 97·8% and 87·0% vs 97·1%, p<0·0001), whereas exception rate was higher (6·5% vs 0·0%, p<0·0001). This difference was observed for all UK countries. Median population achievement rates for BMI and BP recording in major mental illness were significantly lower in Scotland than in England (for BMI -1·5%, 99% CI -2·7 to -0·3, and for BP -1·8%, -2·7 to -0·9; p<0·0001 for both). There were no cross-jurisdiction differences for chronic kidney disease and diabetes. We found lower payment rates, higher exception rates, and lower population achievement rates for BMI and BP recording in major mental illness than in diabetes and chronic kidney disease throughout the UK. We also found variation in these rates between countries. This finding is probably multifactorial, reflecting a combination of patient, clinician, and wider organisational factors; however, it might also suggest inequality in access to certain aspects of health care for people with major mental illness. None. Copyright © 2015 Elsevier Ltd. All rights reserved.

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 potential impact of Brexit and immigration policies on the GP workforce in England: a cross-sectional observational study of GP qualification region and the characteristics of the areas and population they served in September 2016.

PubMed

Esmail, Aneez; Panagioti, Maria; Kontopantelis, Evangelos

2017-11-16

The UK is dependent on international doctors, with a greater proportion of non-UK qualified doctors working in its universal health care system than in any other European country, except Ireland and Norway. The terms of the UK exit from the European Union can reduce the ability of European Economic Area (EEA) qualified doctors to work in the UK, while new visa requirements will significantly restrict the influx of non-EEA doctors. We aimed to explore the implications of policy restrictions on immigration, by regionally and spatially describing the characteristics of general practitioners (GPs) by region of medical qualification and the characteristics of the populations they serve. This is a cross-sectional study on 37,792 of 41,865 GPs in England, as of 30 September 2016. The study involved age, sex, full-time equivalent (FTE), country and region of qualification and geography (organisational regions) of individual GPs. Additionally at the practice and geography levels, we studied patient list size by age groups, average patient location deprivation, the overall morbidity as measured by the Quality and Outcomes Framework (QOF) and the average payment made to primary care per patient. Non-UK qualified GPs comprised 21.1% of the total numbers of GPs, with the largest percentage observed in East England (29.8%). Compared to UK qualified GPs, EEA and elsewhere qualified GPs had higher FTE (medians were 0.80, 0.89 and 0.93, respectively) and worked in practices with higher median patient location deprivation (18.3, 22.5 and 25.2, respectively). Practices with high percentages of EEA and elsewhere qualified GPs served patients who resided in more deprived areas, had lower GP-to-patient ratios and lower GP-to-cumulative QOF register ratios. A decrease in pay as the percentage of elsewhere qualified GPs increased was observed; a 10% increase in elsewhere qualified GPs was linked to a £1 decrease (95% confidence interval 0.5-1.4) in average pay per patient. A large percentage of the UK general practice workforce consists of non-UK qualified GPs who work longer hours, are older and serve a larger number of patients in more deprived areas. Following Brexit, difficulties in replacing this valuable workforce will primarily threaten the care delivery in deprived areas.

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.

Media Roles in Influencing the Public Understanding of Educational Assessment Issues

ERIC Educational Resources Information Center

Murphy, Roger

2013-01-01

This paper explores the media coverage of UK national examination results. Utilising the findings from a previous Economic and Social Research Council-funded investigation into the media coverage of the release of General Certificate of Secondary Education and Advanced-level General Certificate of Education results, the paper builds on the…

The Oral Health of People with Intellectual Disability Participating in the UK Special Olympics

ERIC Educational Resources Information Center

Turner, Stephen; Sweeney, M.; Kennedy, C.; Macpherson, L.

2008-01-01

Background: Research on the dental health of people with intellectual disability has consistently reported more untreated dental disease, more extractions and fewer fillings than in the general population. This paper describes the oral health of participants at the 2005 Glasgow Special Olympics (SO), relating this to the general population…

Cross-cultural invariance of NPI-13: Entitlement as culturally specific, leadership and grandiosity as culturally universal.

PubMed

Żemojtel-Piotrowska, Magdalena; Piotrowski, Jarosław; Rogoza, Radosław; Baran, Tomasz; Hitokoto, Hidefumi; Maltby, John

2018-04-15

The current study explores the problem with the lack of measurement invariance for the Narcissistic Personality Inventory (NPI) by addressing two issues: conceptual heterogeneity of narcissism and methodological issues related to the binary character of data. We examine the measurement invariance of the 13-item version of the NPI in three populations in Japan, Poland and the UK. Analyses revealed that leadership/authority and grandiose exhibitionism dimensions of the NPI were cross-culturally invariant, while entitlement/exploitativeness was culturally specific. Therefore, we proposed NPI-9 as indicating scalar invariance, and we examined the pattern of correlations between NPI-9 and other variables across three countries. The results suggest that NPI-9 is valid brief scale measuring general levels of narcissism in cross-cultural studies, while the NPI-13 remains suitable for research within specific countries. © 2018 International Union of Psychological Science.

Prescription-event monitoring: methodology and recent progress.

PubMed

Rawson, N S; Pearce, G L; Inman, W H

1990-01-01

Event monitoring was first suggested 25 years ago as a way of detecting adverse reactions to drugs. Prescription-event monitoring (PEM), which has been developed by the Drug Safety Research Unit, is the first large-scale systematic post-marketing surveillance method to use event monitoring in the U.K. PEM identifies patients, who have been prescribed a particular drug, and their doctors from photocopies of National Health Service prescriptions which are processed centrally in England. A personalized follow-up questionnaire ("green form") is mailed to each patient's general practitioner, usually on the first anniversary of the initial prescription, asking for information about the patient, especially any "events" that he or she may have experienced since beginning treatment with the drug. The methodology of PEM is presented, together with examples of analyses that can be performed using results from recent studies. The problems and benefits of PEM are discussed.

True gender ratios and stereotype rating norms

PubMed Central

Garnham, Alan; Doehren, Sam; Gygax, Pascal

2015-01-01

We present a study comparing, in English, perceived distributions of men and women in 422 named occupations with actual real world distributions. The first set of data was obtained from previous a large-scale norming study, whereas the second set was mostly drawn from UK governmental sources. In total, real world ratios for 290 occupations were obtained for our perceive vs. real world comparison, of which 205 were deemed to be unproblematic. The means for the two sources were similar and the correlation between them was high, suggesting that people are generally accurate at judging real gender ratios, though there were some notable exceptions. Beside this correlation, some interesting patterns emerged from the two sources, suggesting some response strategies when people complete norming studies. We discuss these patterns in terms of the way real world data might complement norming studies in determining gender stereotypicality. PMID:26257681

To what extent can we explain time trade-off values from other information about respondents?

PubMed

Dolan, Paul; Roberts, Jennifer

2002-03-01

The time trade-off (TTO) is one of the most widely used health state valuation methods and was recently used to develop a set of values for the EQ-5D descriptive system from 3000 members of the UK general population. However, there is currently very little understanding of precisely what determines responses to TTO questions. The data that were used to generate this set of values are ideal for addressing this question since they contain a plethora of information relating to the respondents and their cognition during the TTO exercise. A particularly useful characteristic of this dataset is the existence of visual analogue scale (VAS) valuations on the same states for the same respondents. The results suggest that age, sex and marital status are the most important respondent characteristics determining health state valuations. The VAS valuations were found to add very little to the explanatory power of the models.

Job strain, rank, and mental health in the UK Armed Forces.

PubMed

Fear, Nicola Townsend; Rubin, G James; Hatch, Stephani; Hull, Lisa; Jones, Margaret; Hotopf, Matthew; Wessely, Simon; Rona, Roberto J

2009-01-01

We assessed whether job demand and job control have independent effects on psychological symptoms or whether job control modifies effect of job demand; we also assessed whether rank modified associations between job strain and psychological symptoms. We used the Post Traumatic Stress Disorder (PTSD) Checklist (PCL-C), General Health Questionnaire-12 (GHQ-12), Chalder Fatigue Scale, a checklist of 53 physical symptoms, and the WHO's Alcohol Use Disorders Identification Test (AUDIT). Job control, job demand, and rank were independently associated with PTSD, common mental disorders, multiple physical symptoms, and fatigue, but not with severe alcohol problems. Job control and demand had additive effects on psychological symptoms. Commissioned officers had lower risk of caseness for psychological symptoms than other ranks. Adjustment for rank had negligible effect on level of association between job strain and psychological symptoms. Reported job strain and rank contributed independently to psychological symptoms.

Evaluating UK research in speech and language therapy.

PubMed

Lewison, Grant; Carding, Paul

2003-01-01

There has been a steady growth in recent years in British higher-degree training in speech and language therapy. But what is the standing of UK research in the subject and its component areas which should underpin and inform such training? How can such research be evaluated? The intention was to compare UK publications relevant to speech and language therapy with those of other countries, both quantitatively and qualitatively. We sought then to examine the UK papers in more detail to analyse their sources of funding, their geographical distribution and the ways in which they could appropriately be evaluated. Papers were selectively retrieved from the Science Citation Index and the Social Sciences Citation Index for 1991-2000 by means of a filter based on journal names and paper title words. They were subsequently checked to remove many false positives. The papers were classified into one of seven subject areas and by their research level (from clinical to basic). Their importance was estimated through their potential impact on other researchers, as determined by the citation score of their journals, by the numbers of citations they actually received and by the subjective esteem in which the various journals were held by UK speech and language researchers. World output of speech and language therapy papers has averaged 1000 papers per year during the 1990s, and has grown by half over the period. UK output has been about 12% of the total, compared with 10% in biomedicine, and is published in high impact journals relative to the norm for the field, which is quite a low rate compared with biomedicine overall. Almost half the UK papers had no funding acknowledgements, with the private-non-profit and industrial sectors playing less of a role than in other biomedical areas. Papers in seven subject areas showed substantial differences in their performance on the four criteria selected. The state of British speech and language research appears to be satisfactory, with an above average output in both quantity and quality. However, it is not attracting funding from some types of sponsors and is not being published in general medical journals where it might have a wider influence on general clinical practice. It is also not clear how best such research can be evaluated, although conventional citation counts may be relevant for some subject areas.

Modelling potential production of macroalgae farms in UK and Dutch coastal waters

NASA Astrophysics Data System (ADS)

van der Molen, Johan; Ruardij, Piet; Mooney, Karen; Kerrison, Philip; O'Connor, Nessa E.; Gorman, Emma; Timmermans, Klaas; Wright, Serena; Kelly, Maeve; Hughes, Adam D.; Capuzzo, Elisa

2018-02-01

There is increasing interest in macroalgae farming in European waters for a range of applications, including food, chemical extraction for biofuel production. This study uses a 3-D numerical model of hydrodynamics and biogeochemistry to investigate potential production and environmental effects of macroalgae farming in UK and Dutch coastal waters. The model included four experimental farms in different coastal settings in Strangford Lough (Northern Ireland), in Sound of Kerrera and Lynn of Lorne (north-west Scotland) and in the Rhine plume (the Netherlands), as well as a hypothetical large-scale farm off the UK north Norfolk coast. The model could not detect significant changes in biogeochemistry and plankton dynamics at any of the farm sites averaged over the farming season. The results showed a range of macroalgae growth behaviours in response to simulated environmental conditions. These were then compared with in situ observations where available, showing good correspondence for some farms and less good correspondence for others. At the most basic level, macroalgae production depended on prevailing nutrient concentrations and light conditions, with higher levels of both resulting in higher macroalgae production. It is shown that under non-elevated and interannually varying winter nutrient conditions, farming success was modulated by the timings of the onset of increasing nutrient concentrations in autumn and nutrient drawdown in spring. Macroalgae carbohydrate content also depended on nutrient concentrations, with higher nutrient concentrations leading to lower carbohydrate content at harvest. This will reduce the energy density of the crop and thus affect its suitability for conversion into biofuel. For the hypothetical large-scale macroalgae farm off the UK north Norfolk coast, the model suggested high, stable farm yields of macroalgae from year to year with substantial carbohydrate content and limited environmental effects.

Benchmarking urban flood models of varying complexity and scale using high resolution terrestrial LiDAR data

NASA Astrophysics Data System (ADS)

Fewtrell, Timothy J.; Duncan, Alastair; Sampson, Christopher C.; Neal, Jeffrey C.; Bates, Paul D.

2011-01-01

This paper describes benchmark testing of a diffusive and an inertial formulation of the de St. Venant equations implemented within the LISFLOOD-FP hydraulic model using high resolution terrestrial LiDAR data. The models are applied to a hypothetical flooding scenario in a section of Alcester, UK which experienced significant surface water flooding in the June and July floods of 2007 in the UK. The sensitivity of water elevation and velocity simulations to model formulation and grid resolution are analyzed. The differences in depth and velocity estimates between the diffusive and inertial approximations are within 10% of the simulated value but inertial effects persist at the wetting front in steep catchments. Both models portray a similar scale dependency between 50 cm and 5 m resolution which reiterates previous findings that errors in coarse scale topographic data sets are significantly larger than differences between numerical approximations. In particular, these results confirm the need to distinctly represent the camber and curbs of roads in the numerical grid when simulating surface water flooding events. Furthermore, although water depth estimates at grid scales coarser than 1 m appear robust, velocity estimates at these scales seem to be inconsistent compared to the 50 cm benchmark. The inertial formulation is shown to reduce computational cost by up to three orders of magnitude at high resolutions thus making simulations at this scale viable in practice compared to diffusive models. For the first time, this paper highlights the utility of high resolution terrestrial LiDAR data to inform small-scale flood risk management studies.

The influence of topographic and dynamic cyclic variables on the distribution of small cetaceans in a shallow coastal system.

PubMed

de Boer, Marijke N; Simmonds, Mark P; Reijnders, Peter J H; Aarts, Geert

2014-01-01

The influence of topographic and temporal variables on cetacean distribution at a fine-scale is still poorly understood. To study the spatial and temporal distribution of harbour porpoise Phocoena phocoena and the poorly known Risso's dolphin Grampus griseus we carried out land-based observations from Bardsey Island (Wales, UK) in summer (2001-2007). Using Kernel analysis and Generalized Additive Models it was shown that porpoises and Risso's appeared to be linked to topographic and dynamic cyclic variables with both species using different core areas (dolphins to the West and porpoises to the East off Bardsey). Depth, slope and aspect and a low variation in current speed (for Risso's) were important in explaining the patchy distributions for both species. The prime temporal conditions in these shallow coastal systems were related to the tidal cycle (Low Water Slack and the flood phase), lunar cycle (a few days following the neap tidal phase), diel cycle (afternoons) and seasonal cycle (peaking in August) but differed between species on a temporary but predictable basis. The measure of tidal stratification was shown to be important. Coastal waters generally show a stronger stratification particularly during neap tides upon which the phytoplankton biomass at the surface rises reaching its maximum about 2-3 days after neap tide. It appeared that porpoises occurred in those areas where stratification is maximised and Risso's preferred more mixed waters. This fine-scale study provided a temporal insight into spatial distribution of two species that single studies conducted over broader scales (tens or hundreds of kilometers) do not achieve. Understanding which topographic and cyclic variables drive the patchy distribution of porpoises and Risso's in a Headland/Island system may form the initial basis for identifying potentially critical habitats for these species.

Reach‐scale river metabolism across contrasting sub‐catchment geologies: Effect of light and hydrology

PubMed Central

Attard, Karl M.; Binley, Andrew; Heppell, Catherine M.; Stahl, Henrik; Trimmer, Mark; Glud, Ronnie N.

2017-01-01

Abstract We investigated the seasonal dynamics of in‐stream metabolism at the reach scale (∼ 150 m) of headwaters across contrasting geological sub‐catchments: clay, Greensand, and Chalk of the upper River Avon (UK). Benthic metabolic activity was quantified by aquatic eddy co‐variance while water column activity was assessed by bottle incubations. Seasonal dynamics across reaches were specific for the three types of geologies. During the spring, all reaches were net autotrophic, with rates of up to 290 mmol C m−2 d−1 in the clay reach. During the remaining seasons, the clay and Greensand reaches were net heterotrophic, with peak oxygen consumption of 206 mmol m−2 d−1 during the autumn, while the Chalk reach was net heterotrophic only in winter. Overall, the water column alone still contributed to ∼ 25% of the annual respiration and primary production in all reaches. Net ecosystem metabolism (NEM) across seasons and reaches followed a general linear relationship with increasing stream light availability. Sub‐catchment specific NEM proved to be linearly related to the local hydrological connectivity, quantified as the ratio between base flow and stream discharge, and expressed on a timescale of 9 d on average. This timescale apparently represents the average period of hydrological imprint for carbon turnover within the reaches. Combining a general light response and sub‐catchment specific base flow ratio provided a robust functional relationship for predicting NEM at the reach scale. The novel approach proposed in this study can help facilitate spatial and temporal upscaling of riverine metabolism that may be applicable to a broader spectrum of catchments. PMID:29242670

Deficiencies in provision of integrated multidisciplinary podiatry care for patients with inflammatory arthritis: a UK district general hospital experience.

PubMed

Juarez, M; Price, E; Collins, D; Williamson, L

2010-01-01

Foot problems are highly prevalent in inflammatory arthritis (IA), especially rheumatoid arthritis (RA). Chronic inflammation can lead to permanent structural changes, deformity and disability. Early podiatry intervention in RA improves long term outcomes. National guidelines recommend that patients should be treated by a multidisciplinary team with dedicated podiatry services. In clinical practice funding constraints limit availability of these services. To assess prevalence of foot problems and quality and availability of foot care services at a UK district general hospital. 1200 IA patients in Swindon (Wiltshire, UK) were invited to complete an anonymised questionnaire regarding access to foot care services and education/information on foot problems. 448 patients. Prevalence of foot problems: 68%. Only 31% of patients had access to appropriate foot specialist. 24% had received foot assessment within 3 months of diagnosis of IA and 17% yearly review thereafter. Despite high prevalence of foot problems in our population we identified significant deficiencies in provision of integrated multidisciplinary podiatry care. The data we present could be used by others to support business cases to obtain funding to improve the links between rheumatology and podiatry services. Copyright 2010 Elsevier Ltd. All rights reserved.

Systems for the management of respiratory disease in primary care--an international series: United Kingdom.

PubMed

Worth, Allison; Pinnock, Hilary; Fletcher, Monica; Hoskins, Gaylor; Levy, Mark L; Sheikh, Aziz

2011-03-01

The UK National Health Service (NHS) is essentially publicly funded through general taxation. Challenges facing the NHS include the rise in prevalence of long-term conditions and financial pressures. NATIONAL POLICY TRENDS: Political devolution within the UK has led to variations in the way services are organised and delivered between the four nations. PRIMARY CARE RESPIRATORY SERVICES IN THE UK: Primary care is the first point of contact with services. Most respiratory conditions are managed here, including prevention, diagnosis, treatment and palliative care. Respiratory disease accounts for more primary care consultations than any other type of illness, with 24 million consultations annually. Equitable access to care is an ongoing challenge: telehealthcare is being tried as a possible solution for monitoring of asthma and COPD. REFERRAL AND ACCESS TO SPECIALIST CARE: Referrals for specialist advice are usually to a secondary care respiratory physician, though respiratory General Practitioners with a Special Interest (GPwSIs) are an option in some localities. Prevalence of asthma and COPD is high. Asthma services are predominantly nurse-led. Self-management strategies are widely promoted but poorly implemented. COPD is high on the policy agenda with a shift in focus to preventive lung health and longterm condition management.

The hydroclimatology of UK droughts: evidence from newly recovered and reconstructed datasets from the late 19th century to present

NASA Astrophysics Data System (ADS)

Smith, K. A.; Hannaford, J.; Bloomfield, J.; McCarthy, M.; Parry, S.; Barker, L. J.; Svensson, C.; Tanguy, M.; Marchant, B.; McKenzie, A.; Legg, T.; Prudhomme, C.

2017-12-01

While the UK is regarded as a wet country, it has periodically suffered from major droughts which have caused serious environmental and societal impacts. Parts of the UK are water stressed and, in a warming world, changes to supply/demand balances could have major implications. There is a pressing need for improved tools for drought risk assessment, which is contingent on a proper understanding of past occurrence of droughts. However, our understanding of hydrological drought occurrence is grounded in the post-1960 period when most UK river flow and groundwater records commenced. As such, water resources planners would benefit from a more thorough assessment of historical drought characteristics and their variability. The multi-disciplinary `Historic Droughts' project thus aims to rigorously characterise droughts in the UK back to the 1890s to inform improved drought management. The foundation of this is a comprehensive characterisation of the hydroclimatology of UK droughts. Here, we present the results of this initiative, based on a hydrological reconstruction campaign of unparalleled scope and detail. Driven by rainfall and potential evapotranspiration data, extended in time using newly recovered observational records, hydro(geo)logical models are used to reconstruct, back to 1890, river flows for >300 catchments across the UK, and groundwater levels from >50 boreholes. The reconstructions are derived within a state-of-the-art modelling framework which allows a comprehensive assessment of uncertainty. A suite of indicators are then applied to these datasets to identify and characterise drought events, integrating precipitation, evapotranspiration, streamflow and groundwater. The work provides new insights into the spatial and temporal dynamics of hitherto poorly quantified late 19th and early 20th century droughts. Similarly, the assessment of temporal variability of drought characteristics benefits from the long timescale of the reconstructions, in turn allowing improved assessment of the large-scale climate drivers of UK droughts. The propagation of UK drought is analysed comprehensively for the first time, highlighting the differential spatio-temporal expression of meteorological, streamflow and groundwater droughts, with important implications for water resources management.

Current training provision and training needs in oral health for UK general practice trainees: survey of General Practitioner Training Programme Directors.

PubMed

Ahluwalia, Aneeta; Crossman, Tim; Smith, Helen

2016-05-11

In the UK the incidence of oral cancers has risen by a third in the last decade, and there have been minimal improvements in survival rates. Moreover, a significant proportion of the population no longer access dental health services regularly, instead presenting their oral health concerns to their General Medical Practitioner. Therefore, General Practitioners (GP) have an important role in the diagnosis of oral health pathologies and the earlier detection of oral cancers. This study aims to understand the current provision of training in oral health and cancer for GP trainees and to identify how unmet training needs could be met. A cross-sectional survey of GP Training Programme Directors using an online questionnaire asking about current oral health education training (hospital placements and structured teaching), the competencies covered with trainees and ways to improve oral health training. Quantitative data were analysed using descriptive statistics and content analysis was undertaken of free text responses. We obtained responses from 132 GP Training Programme Directors (GPTPDs), from 13 of the 16 UK medical deaneries surveyed. The majority of respondents (71.2%) indicated that their programmes did not provide any structured oral health training to GP trainees and that ≤ 10% of their trainees were undertaking hospital posts relevant to oral health. GPTPDs were of the view that the quality of oral health training was poor, relative to the specified competencies, and that teaching on clinical presentations of 'normal' oral anatomy was particularly poor. It was envisaged that oral health training could be improved by access to specialist tutors, e-learning programmes and problem-based-learning sessions. Respondents highlighted the need for training sessions to be relevant to GPs. Barriers to improving training in oral health were time constraints, competing priorities and reluctance to taking on the workload of dentists. This UK-wide survey has identified important gaps in the training of GP trainees in relation to oral health care and cancer detection. Addressing these knowledge and skill gaps, particularly in the identification of oral cancers, will help to improve oral health and, more importantly, the timely diagnosis of oral cancer.

Whither British general practice after the 2004 GMS contract? Stories and realities of change in four UK general practices.

PubMed

Huby, Guro; Guthrie, Bruce; Grant, Suzanne; Watkins, Francis; Checkland, Kath; McDonald, Ruth; Davies, Huw

2008-01-01

The purpose of this article is to provide answers to two questions: what has been the impact of nGMS on practice organisation and teamwork; and how do general practice staff perceive the impact? The article is based on comparative in-depth case studies of four UK practices. There was a discrepancy between changes observed and the way practice staff described the impact of the contract. Similar patterns of organisational change were apparent in all practices. Decision-making became concentrated in fewer hands. Formally or informally constituted "elite" multidisciplinary groups monitored and controlled colleagues' behaviour for maximum performance and remuneration. This convergence of organisational form was not reflected in the dominant "story" each practice constructed about its unique ethos and style. The "stories" also failed to detect negative consequences to the practice flowing from its adaptation to the contract. The paper highlights how collective "sensemaking" in practices may fail to detect and address key organisational consequences from the nGMS.

Assessing Protective Factors for Violence Risk in U.K. General Mental Health Services Using the Structured Assessment of Protective Factors.

PubMed

Haines, Alina; Brown, Andrew; Javaid, Syed Fahad; Khan, Fayyaz; Noblett, Steve; Omodunbi, Oladipupo; Sadiq, Khurram; Zaman, Wahid; Whittington, Richard

2017-12-01

Violence risk assessment and management are key tasks in mental health services and should be guided by validated instruments covering both risk and protective factors. This article is part of an international effort to validate the Structured Assessment of Protective Factors (SAPROF) for violence. The SAPROF, Historical, Clinical, Risk Management-20 (HCR-20) and the Psychopathy Checklist-Screening Version (PCL-SV) were administered in a sample of 261 patients in U.K. forensic, general inpatient, and community mental health settings. There was significant variation between these groups on SAPROF scores with fewer protective factors in the forensic group. The prospective validity of the SAPROF for nonviolence in the general inpatient and community samples was moderate (area under the curve [AUC] = .60). Adoption of the SAPROF or similar instruments as a supplement to risk-focused assessments has the potential to improve awareness of protective factors and enhance therapeutic engagement in a range of mental health services.

Model of health? Distributed preparedness and multi-agency interventions surrounding UK regional airports.

PubMed

Warren, Adam; Bell, Morag; Budd, Lucy

2012-01-01

The liberalisation of the European aviation sector has multiplied paths of entry into the United Kingdom (UK) for the international traveller. These changing mobilities necessitate a reconceptualisation of the border as a series of potentially vulnerable nodes occurring within, and extending beyond, national boundaries. In this paper, we consider the border through the lens of port health, the collective term for various sanitary operations enacted at international transport terminals. In the UK, a critical player in the oversight of port health is the Health Protection Agency (HPA), which became a non-Departmental public body in 2005. A major part of port health is preparedness, a set of techniques aimed at managing, and responding to, emergencies of public health concern. More recently, certain jurisdictions have embarked on public health preparedness work across a number of different geographical scales. Using methods pioneered by the military, this form of 'distributed preparedness' is of increased interest to social science and medical scholars. With reference to case studies conducted in localities surrounding two UK regional airports following the 2009-10 H1N1 influenza pandemic, we consider the extent to which distributed preparedness as a concept and a set of practices can inform current debates - in the UK, and beyond - concerning interventions at the border 'within'. Copyright © 2011 Elsevier Ltd. All rights reserved.

Cognitive behaviour therapy for chronic fatigue syndrome: Differences in treatment outcome between a tertiary treatment centre in the United Kingdom and the Netherlands.

PubMed

Worm-Smeitink, M; Nikolaus, S; Goldsmith, K; Wiborg, J; Ali, S; Knoop, H; Chalder, T

2016-08-01

Cognitive behaviour therapy (CBT) reduces fatigue and disability in chronic fatigue syndrome (CFS). However, outcomes vary between studies, possibly because of differences in patient characteristics, treatment protocols, diagnostic criteria and outcome measures. The objective was to compare outcomes after CBT in tertiary treatment centres in the Netherlands (NL) and the United Kingdom (UK), using different treatment protocols but identical outcome measures, while controlling for differences in patient characteristics and diagnostic criteria. Consecutively referred CFS patients who received CBT were included (NL: n=293, UK: n=163). Uncontrolled effect sizes for improvement in fatigue (Chalder Fatigue Questionnaire), physical functioning (SF-36 physical functioning subscale) and social functioning (Work and Social Adjustment Scale) were compared. Multiple regression analysis was used to examine whether patient differences explained outcome differences between centres. Effect sizes differed between centres for fatigue (Cohen's D NL=1.74, 95% CI=1.52-1.95; UK=0.99, CI=0.73-1.25), physical functioning (NL=0.99, CI=0.81-1.18; UK=0.33, CI=0.08-0.58) and social functioning (NL=1.47, CI=1.26-1.69; UK=0.61, CI=0.35-0.86). Patients in the UK had worse physical functioning at baseline and there were minor demographic differences. These could not explain differences in centre outcome. Effectiveness of CBT differed between treatment centres. Differences in treatment protocols may explain this and should be investigated to help further improve outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Final quality of life and safety data for patients with metastatic castration-resistant prostate cancer treated with cabazitaxel in the UK Early Access Programme (EAP) (NCT01254279).

PubMed

Bahl, Amit; Masson, Susan; Malik, Zafar; Birtle, Alison J; Sundar, Santhanam; Jones, Rob J; James, Nicholas D; Mason, Malcolm D; Kumar, Satish; Bottomley, David; Lydon, Anna; Chowdhury, Simon; Wylie, James; de Bono, Johann S

2015-12-01

To compile the safety profile and quality of life (QoL) data for patients with metastatic castration-resistant prostate cancer (mCRPC) treated with cabazitaxel in the UK Early Access Programme (UK EAP). A total of 112 patients participated at 12 UK cancer centres. All had mCRPC with disease progression during or after docetaxel. Patients received cabazitaxel 25 mg/m(2) every 3 weeks with prednisolone 10 mg daily for up to 10 cycles. Safety assessments were performed before each cycle and QoL was recorded at alternate cycles using the EQ-5D-3L questionnaire and visual analogue scale (VAS). The safety profile was compiled after completion of the UK EAP and QoL measures were analysed to record trends. No formal statistical analysis was carried out. The incidences of neutropenic sepsis (6.3%), grade 3 and 4 diarrhoea (4.5%) and grade 3 and 4 cardiac toxicity (0%) were low. Neutropenic sepsis episodes, though low, occurred only in patients who did not receive prophylactic granulocyte-colony stimulating factor. There were trends towards improved VAS and EQ-5D-3L pain scores during treatment. The UK EAP experience indicates that cabazitaxel might improve QoL in mCRPC and represents an advance and a useful addition to the armamentarium of treatment for patients whose disease has progressed during or after docetaxel. In view of the potential toxicity, careful patient selection is important. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

Incremental Costs and Cost Effectiveness of Intensive Treatment in Individuals with Type 2 Diabetes Detected by Screening in the ADDITION-UK Trial: An Update with Empirical Trial-Based Cost Data.

PubMed

Laxy, Michael; Wilson, Edward C F; Boothby, Clare E; Griffin, Simon J

2017-12-01

There is uncertainty about the cost effectiveness of early intensive treatment versus routine care in individuals with type 2 diabetes detected by screening. To derive a trial-informed estimate of the incremental costs of intensive treatment as delivered in the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care-Europe (ADDITION) trial and to revisit the long-term cost-effectiveness analysis from the perspective of the UK National Health Service. We analyzed the electronic primary care records of a subsample of the ADDITION-Cambridge trial cohort (n = 173). Unit costs of used primary care services were taken from the published literature. Incremental annual costs of intensive treatment versus routine care in years 1 to 5 after diagnosis were calculated using multilevel generalized linear models. We revisited the long-term cost-utility analyses for the ADDITION-UK trial cohort and reported results for ADDITION-Cambridge using the UK Prospective Diabetes Study Outcomes Model and the trial-informed cost estimates according to a previously developed evaluation framework. Incremental annual costs of intensive treatment over years 1 to 5 averaged £29.10 (standard error = £33.00) for consultations with general practitioners and nurses and £54.60 (standard error = £28.50) for metabolic and cardioprotective medication. For ADDITION-UK, over the 10-, 20-, and 30-year time horizon, adjusted incremental quality-adjusted life-years (QALYs) were 0.014, 0.043, and 0.048, and adjusted incremental costs were £1,021, £1,217, and £1,311, resulting in incremental cost-effectiveness ratios of £71,232/QALY, £28,444/QALY, and £27,549/QALY, respectively. Respective incremental cost-effectiveness ratios for ADDITION-Cambridge were slightly higher. The incremental costs of intensive treatment as delivered in the ADDITION-Cambridge trial were lower than expected. Given UK willingness-to-pay thresholds in patients with screen-detected diabetes, intensive treatment is of borderline cost effectiveness over a time horizon of 20 years and more. Copyright © 2017. Published by Elsevier Inc.

Prostate-specific antigen (PSA) testing of men in UK general practice: a 10-year longitudinal cohort study.

PubMed

Young, Grace J; Harrison, Sean; Turner, Emma L; Walsh, Eleanor I; Oliver, Steven E; Ben-Shlomo, Yoav; Evans, Simon; Lane, J Athene; Neal, David E; Hamdy, Freddie C; Donovan, Jenny L; Martin, Richard M; Metcalfe, Chris

2017-10-30

Cross-sectional studies suggest that around 6% of men undergo prostate-specific antigen (PSA) testing each year in UK general practice (GP). This longitudinal study aims to determine the cumulative testing pattern of men over a 10-year period and whether this testing can be considered equivalent to screening for prostate cancer (PCa). Patient-level data on PSA tests, biopsies and PCa diagnoses were obtained from the UK Clinical Practice Research Datalink (CPRD) for the years 2002 to 2011. The cumulative risks of PSA testing and of being diagnosed with PCa were estimated for the 10-year study period. Associations of a man's age, region and index of multiple deprivation with the cumulative risk of PSA testing and PCa diagnosis were investigated. Rates of biopsy and diagnosis, following a high test result, were compared with those from the programme of PSA testing in the Prostate Testing for Cancer and Treatment (ProtecT) study. The 10-year risk of exposure to at least one PSA test in men aged 45 to 69 years in UK GP was 39.2% (95% CI 39.0 to 39.4%). The age-specific risks ranged from 25.2% for men aged 45-49 years to 53.0% for men aged 65-69 years (p for trend <0.001). For those with a PSA level ≥3, a test in UK GP was less likely to result in a biopsy (6%) and/or diagnosis of PCa (15%) compared with ProtecT study participants (85% and 34%, respectively). A high proportion of men aged 45-69 years undergo PSA tests in UK GP: 39% over a 10-year period. A high proportion of these tests appear to be for the investigation of lower urinary tract symptoms and not screening for PCa. ISRCTN20141297,NCT02044172. © 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.

The UK Functional Assessment Measure (UK FIM+FAM): Psychometric Evaluation in Patients Undergoing Specialist Rehabilitation following a Stroke from the National UK Clinical Dataset.

PubMed

Nayar, Meenakshi; Vanderstay, Roxana; Siegert, Richard J; Turner-Stokes, Lynne

2016-01-01

The UK Functional Assessment Measure (UKFIM+FAM) is the principal outcome measure for the UK Rehabilitation Outcomes Collaborative (UKROC) national database for specialist rehabilitation. Previously validated in a mixed neurorehabilitation cohort, this study is the first to explore its psychometric properties in a stroke population, and compare left and right hemispheric strokes (LHS vs RHS). We analysed in-patient episode data from 62 specialist rehabilitation units collated through the UKROC database 2010-2013. Complete data were analysed for 1,539 stroke patients (LHS: 588, RHS: 566 with clear localisation). For factor analysis, admission and discharge data were pooled and randomised into two equivalent samples; the first for exploratory factor analysis (EFA) using principal components analysis, and the second for confirmatory factor analysis (CFA). Responsiveness for each subject (change from admission to discharge) was examined using paired t-tests and differences between LHS and RHS for the entire group were examined using non-paired t-tests. EFA showed a strong general factor accounting for >48% of the total variance. A three-factor solution comprising motor, communication and psychosocial subscales, accounting for >69% total variance, provided acceptable fit statistics on CFA (Root Mean Square Error of Approximation was 0.08 and Comparative Fit Index/ Tucker Lewis Index 0.922/0.907). All three subscales showed significant improvement between admission and discharge (p<0.001) with moderate effect sizes (>0.5). Total scores between LHS and RHS were not significantly different. However, LHS showed significantly higher motor scores (Mean 5.7, 95%CI 2.7, 8.6 p<0.001), while LHS had significantly lower cognitive scores, primarily in the communication domain (-6.8 95%CI -7.7, -5.8 p<0.001). To conclude, the UK FIM+FAM has a three-factor structure in stroke, similar to the general neurorehabilitation population. It is responsive to change during in-patient rehabilitation, and distinguishes between LHS and RHS. This tool extends stroke outcome measurement beyond physical disability to include cognitive, communication and psychosocial function.

Management and Prevalence of Long-Term Conditions in Primary Health Care for Adults with Intellectual Disabilities Compared with the General Population: A Population-Based Cohort Study

ERIC Educational Resources Information Center

Cooper, Sally-Ann; Hughes-McCormack, Laura; Greenlaw, Nicola; McConnachie, Alex; Allan, Linda; Baltzer, Marion; McArthur, Laura; Henderson, Angela; Melville, Craig; McSkimming, Paula; Morrison, Jill

2018-01-01

Background: In the UK, general practitioners/family physicians receive pay for performance on management of long-term conditions, according to best-practice indicators. Method: Management of long-term conditions was compared between 721 adults with intellectual disabilities and the general population (n = 764,672). Prevalence of long-term…

The role of informal dimensions of safety in high-volume organisational routines: an ethnographic study of test results handling in UK general practice.

PubMed

Grant, Suzanne; Checkland, Katherine; Bowie, Paul; Guthrie, Bruce

2017-04-27

The handling of laboratory, imaging and other test results in UK general practice is a high-volume organisational routine that is both complex and high risk. Previous research in this area has focused on errors and harm, but a complementary approach is to better understand how safety is achieved in everyday practice. This paper ethnographically examines the role of informal dimensions of test results handling routines in the achievement of safety in UK general practice and how these findings can best be developed for wider application by policymakers and practitioners. Non-participant observation was conducted of high-volume organisational routines across eight UK general practices with diverse organisational characteristics. Sixty-two semi-structured interviews were also conducted with the key practice staff alongside the analysis of relevant documents. While formal results handling routines were described similarly across the eight study practices, the everyday structure of how the routine should be enacted in practice was informally understood. Results handling safety took a range of local forms depending on how different aspects of safety were prioritised, with practices varying in terms of how they balanced thoroughness (i.e. ensuring the high-quality management of results by the most appropriate clinician) and efficiency (i.e. timely management of results) depending on a range of factors (e.g. practice history, team composition). Each approach adopted created its own potential risks, with demands for thoroughness reducing productivity and demands for efficiency reducing handling quality. Irrespective of the practice-level approach adopted, staff also regularly varied what they did for individual patients depending on the specific context (e.g. type of result, patient circumstances). General practices variably prioritised a legitimate range of results handling safety processes and outcomes, each with differing strengths and trade-offs. Future safety improvement interventions should focus on how to maximise practice-level knowledge and understanding of the range of context-specific approaches available and the safeties and risks inherent in each within the context of wider complex system conditions and interactions. This in turn has the potential to inform new kinds of proactive, contextually appropriate approaches to intervention development and implementation focusing on the enhanced deliberation of the safety of existing high-volume routines.

Can Hepatitis C Virus (HCV) Direct-Acting Antiviral Treatment as Prevention Reverse the HCV Epidemic Among Men Who Have Sex With Men in the United Kingdom? Epidemiological and Modeling Insights.

PubMed

Martin, Natasha K; Thornton, Alicia; Hickman, Matthew; Sabin, Caroline; Nelson, Mark; Cooke, Graham S; Martin, Thomas C S; Delpech, Valerie; Ruf, Murad; Price, Huw; Azad, Yusef; Thomson, Emma C; Vickerman, Peter

2016-05-01

We report on the hepatitis C virus (HCV) epidemic among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) in the United Kingdom and model its trajectory with or without scaled-up HCV direct-acting antivirals (DAAs). A dynamic HCV transmission model among HIV-diagnosed MSM in the United Kingdom was calibrated to HCV prevalence (antibody [Ab] or RNA positive), incidence, and treatment from 2004 to 2011 among HIV-diagnosed MSM in the UK Collaborative HIV Cohort (UK CHIC). The epidemic was projected with current or scaled-up HCV treatment, with or without a 20% behavioral risk reduction. HCV prevalence among HIV-positive MSM in UK CHIC increased from 7.3% in 2004 to 9.9% in 2011, whereas primary incidence was flat (1.02-1.38 per 100 person-years). Over the next decade, modeling suggests 94% of infections are attributable to high-risk individuals, comprising 7% of the population. Without treatment, HCV chronic prevalence could have been 38% higher in 2015 (11.9% vs 8.6%). With current treatment and sustained virological response rates (status quo), chronic prevalence is likely to increase to 11% by 2025, but stabilize with DAA introduction in 2015. With DAA scale-up to 80% within 1 year of diagnosis (regardless of disease stage), and 20% per year thereafter, chronic prevalence could decline by 71% (to 3.2%) compared to status quo in 2025. With additional behavioral interventions, chronic prevalence could decline further to <2.5% by 2025. Epidemiological data and modeling suggest a continuing HCV epidemic among HIV-diagnosed MSM in the United Kingdom driven by high-risk individuals, despite high treatment rates. Substantial reductions in HCV transmission could be achieved through scale-up of DAAs and moderately effective behavioral interventions. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

Contemporary management of maxillofacial ballistic trauma.

PubMed

Breeze, J; Tong, D; Gibbons, A

2017-09-01

Ballistic maxillofacial trauma in the UK is fortunately relatively rare, and generally involves low velocity handguns and shotguns. Civilian terrorist events have, however, shown that all maxillofacial surgeons need to understand how to treat injuries from improvised explosive devices. Maxillofacial surgeons in the UK have also been responsible for the management of soldiers evacuated from Iraq and Afghanistan, and in this review we describe the newer types of treatment that have evolved from these conflicts, particularly that of damage-control maxillofacial surgery. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

The radiological impact of electricity generation by U.K. coal and nuclear systems.

PubMed

Robson, A

1984-05-01

Radiological impact is discussed for U.K. coal and nuclear power cycles under normal operation. The type having the greater impact depends on the radiological basis of the comparison, the particular nuclear reactor system considered and whether or not the whole fuel cycle, especially irradiated nuclear fule reprocessing , is included in the analysis. More importantly, the various impacts are shown to be generally acceptable in an absolute sense i.e. exposures are less than and usually low in comparison with radiological safety guidelines and everyday natural radiation exposures.

A Xhosa language translation of the CORE-OM using South African university student samples.

PubMed

Campbell, Megan M; Young, Charles

2016-10-01

The translation of well established psychometric tools from English into Xhosa may assist in improving access to psychological services for Xhosa speakers. The aim of this study was to translate the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM), a measure of general distress and dysfunction developed in the UK, into Xhosa for use at South African university student counselling centres. The CORE-OM and embedded CORE-10 were translated into Xhosa using a five-stage translation design. This design included (a) forward-translation, (b) back-translation, (c) committee approach, (d) qualitative piloting, and (e) quantitative piloting on South African university students. Clinical and general samples were drawn from English-medium South African universities. Clinical samples were generated from university student counselling centres. General student samples were generated through random stratified cluster sampling of full-time university students. Qualitative feedback from the translation process and results from quantitative piloting of the 34-item CORE-OM English and Xhosa versions supported the reduction of the scale to 10 items. This reduced scale is referred to as the South African CORE-10 (SA CORE-10). A measurement and structural model of the SA CORE-10 English version was developed and cross-validated using an English-speaking university student sample. Equivalence of this model with the SA CORE-10 Xhosa version was investigated using a first-language Xhosa-speaking university sample. Partial measurement equivalence was achieved at the metric level. The resultant SA CORE-10 Xhosa and English versions provide core measures of distress and dysfunction. Additional, culture- and language-specific domains could be added to increase sensitivity and specificity. © The Author(s) 2016.

A CFD study on the effectiveness of trees to disperse road traffic emissions at a city scale

NASA Astrophysics Data System (ADS)

Jeanjean, A. P. R.; Hinchliffe, G.; McMullan, W. A.; Monks, P. S.; Leigh, R. J.

2015-11-01

This paper focuses on the effectiveness of trees at dispersing road traffic emissions on a city scale. CFD simulations of air-pollutant concentrations were performed using the OpenFOAM software platform using the k-ε model. Results were validated against the CODASC wind tunnel database before being applied to a LIDAR database of buildings and trees representing the City of Leicester (UK). Most other CFD models in the literature typically use idealised buildings to model wind flow and pollution dispersion. However, the methodology used in this study uses real buildings and trees data from LIDAR to reconstruct a 3D representation of Leicester City Centre. It focuses on a 2 × 2 km area which is on a scale larger than those usually used in other CFD studies. Furthermore, the primary focus of this study is on the interaction of trees with wind flow dynamics. It was found that in effect, trees have a regionally beneficial impact on road traffic emissions by increasing turbulence and reducing ambient concentrations of road traffic emissions by 7% at pedestrian height on average. This was an important result given that previous studies generally concluded that trees trapped pollution by obstructing wind flow in street canyons. Therefore, this study is novel both in its methodology and subsequent results, highlighting the importance of combining local and regional scale models for assessing the impact of trees in urban planning.

Ten years on from the national service framework for long-term conditions: how far have we come?

PubMed

Mendes, Aysha

2015-03-01

Aysha Mendes investigates whether the Department of Health's blueprint for improving care of long-term conditions in the UK has been successful amid the large-scale changes occurring in the NHS over recent years.

Education for Professional Engineering Practice

ERIC Educational Resources Information Center

Bramhall, Mike D.; Short, Chris

2014-01-01

This paper reports on a funded collaborative large-scale curriculum innovation and enhancement project undertaken as part of a UK National Higher Education Science, Technology Engineering and Mathematics (STEM) programme. Its aim was to develop undergraduate curricula to teach appropriate skills for professional engineering practice more…

The Process of Psychological Consultation

ERIC Educational Resources Information Center

Nolan, Anna; Moreland, Neil

2014-01-01

Consultation is a key means of service delivery in many psychological services. However, the "process" of consultation is little explored in Educational Psychology literature, particularly in the United Kingdom (UK). This paper focuses on a small-scale qualitative research study of psychological consultation provided by educational…

The use of GIS and multi-criteria evaluation (MCE) to identify agricultural land management practices which cause surface water pollution in drinking water supply catchments.

PubMed

Grayson, Richard; Kay, Paul; Foulger, Miles

2008-01-01

Diffuse pollution poses a threat to water quality and results in the need for treatment for potable water supplies which can prove costly. Within the Yorkshire region, UK, nitrates, pesticides and water colour present particular treatment problems. Catchment management techniques offer an alternative to 'end of pipe' solutions and allow resources to be targeted to the most polluting areas. This project has attempted to identify such areas using GIS based modelling approaches in catchments where water quality data were available. As no model exists to predict water colour a model was created using an MCE method which is capable of predicting colour concentrations at the catchment scale. CatchIS was used to predict pesticide and nitrate N concentrations and was found to be generally capable of reliably predicting nitrate N loads at the catchment scale. The pesticides results did not match the historic data possibly due to problems with the historic pesticide data and temporal and spatially variability in pesticide usage. The use of these models can be extended to predict water quality problems in catchments where water quality data are unavailable and highlight areas of concern. IWA Publishing 2008.

Catchment-scale environmental controls of sediment-associated contaminant dispersal

NASA Astrophysics Data System (ADS)

Macklin, Mark

2010-05-01

Globally river sediment associated contaminants, most notably heavy metals, radionuclides, Polychlorinated Biphenyls (PCBs), Organochlorine pesticides (OCs) and phosphorous, constitute one the most significant long-term risks to ecosystems and human health. These can impact both urban and rural areas and, because of their prolonged environmental residence times, are major sources of secondary pollution if contaminated soil and sediment are disturbed by human activity or by natural processes such as water or wind erosion. River catchments are also the primary source of sediment-associated contaminants to the coastal zone, and to the ocean, and an understanding of the factors that control contaminated sediment fluxes and delivery in river systems is essential for effective environmental management and protection. In this paper the catchment-scale controls of sediment-associated contaminant dispersal are reviewed, including climate-related variations in flooding regime, land-use change, channel engineering, restoration and flood defence. Drawing on case studies from metal mining impacted catchments in Bolivia (Río Pilcomayo), Spain (Río Guadiamar), Romania (River Tisa) and the UK (River Swale) some improved methodologies for identifying, tracing, modelling and managing contaminated river sediments are proposed that could have more general application in similarly affected river systems worldwide.

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.

Student career choice in psychiatry: findings from 18 UK medical schools.

PubMed

Halder, Neel; Hadjidemetriou, Christiana; Pearson, Rachel; Farooq, Kitty; Lydall, Gregory J; Malik, Amit; Bhugra, Dinesh

2013-08-01

Psychiatry recruitment continues to be a problem in the UK and large-scale studies are required to understand the factors surrounding this. A quantitative, cross-sectional online survey, incorporating demographics, career choices, teaching exposure, attitudes to psychiatry and personality factors, was administered to final-year UK medical students. A total of 484 students from 18 medical schools responded (66% women). Sixteen (16%) had chosen psychiatry at medical school entry. By final year, 15 respondents (3%) had decided to pursue a career in psychiatry, while another 78 (17%) were seriously considering it. There was little difference in the quality ratings of lectures and small group teaching between those interested in psychiatry and those not. Experience of 'enrichment activities' (psychiatry special study modules or components, psychiatric research, university psychiatry clubs, and psychiatry electives) were significantly more likely to take up psychiatry. Causality cannot, however, be determined in this study. The study identified several distinct groups of UK students: those deciding on psychiatry before medical school and maintaining that career choice, those deciding on psychiatry during medical school, and those interested in other fields. Addressing psychiatry teaching and exposure may improve recruitment into the speciality.

CGAT: a model for immersive personalized training in computational genomics

PubMed Central

Sims, David; Ponting, Chris P.

2016-01-01

How should the next generation of genomics scientists be trained while simultaneously pursuing high quality and diverse research? CGAT, the Computational Genomics Analysis and Training programme, was set up in 2010 by the UK Medical Research Council to complement its investment in next-generation sequencing capacity. CGAT was conceived around the twin goals of training future leaders in genome biology and medicine, and providing much needed capacity to UK science for analysing genome scale data sets. Here we outline the training programme employed by CGAT and describe how it dovetails with collaborative research projects to launch scientists on the road towards independent research careers in genomics. PMID:25981124

A search for J-band variability from late-L and T brown dwarfs

NASA Astrophysics Data System (ADS)

Clarke, F. J.; Hodgkin, S. T.; Oppenheimer, B. R.; Robertson, J.; Haubois, X.

2008-06-01

We present J-band photometric observations of eight late-L and T type brown dwarfs designed to search for variability. We detect small amplitude periodic variability from three of the objects on time-scales of several hours, probably indicating the rotation period of the objects. The other targets do not show any variability down to the level of 0.5-5 per cent This work is based on observations obtained at the European Southern Observatory, La Silla, Chile (ESO Programme 72.C-0006). E-mail: fclarke@astro.ox.ac.uk (FJC); sth@ast.cam.ac.uk (STH); bro@amnh.org (BRO); xavier.haubois@obspm.fr (XH)

Tracking the rise in popularity of electronic nicotine delivery systems (electronic cigarettes) using search query surveillance.

PubMed

Ayers, John W; Ribisl, Kurt M; Brownstein, John S

2011-04-01

Public interest in electronic nicotine delivery systems (ENDS) is undocumented. By monitoring search queries, ENDS popularity and correlates of their popularity were assessed in Australia, Canada, the United Kingdom (UK), and the U.S. English-language Google searches conducted from January 2008 through September 2010 were compared to snus, nicotine replacement therapy (NRT), and Chantix® or Champix®. Searches for each week were scaled to the highest weekly search proportion (100), with lower values indicating the relative search proportion compared to the highest-proportion week (e.g., 50=50% of the highest observed proportion). Analyses were performed in 2010. From July 2008 through February 2010, ENDS searches increased in all nations studied except Australia, there an increase occurred more recently. By September 2010, ENDS searches were several-hundred-fold greater than searches for smoking alternatives in the UK and U.S., and were rivaling alternatives in Australia and Canada. Across nations, ENDS searches were highest in the U.S., followed by similar search intensity in Canada and the UK, with Australia having the fewest ENDS searches. Stronger tobacco control, created by clean indoor air laws, cigarette taxes, and anti-smoking populations, were associated with consistently higher levels of ENDS searches. The online popularity of ENDS has surpassed that of snus and NRTs, which have been on the market for far longer, and is quickly outpacing Chantix or Champix. In part, the association between ENDS's popularity and stronger tobacco control suggests ENDS are used to bypass, or quit in response to, smoking restrictions. Search query surveillance is a valuable, real-time, free, and public method to evaluate the diffusion of new health products. This method may be generalized to other behavioral, biological, informational, or psychological outcomes manifested on search engines. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

MRI-verified "asleep" deep brain stimulation in Malta through cross border collaboration: clinical outcome of the first five years.

PubMed

Chircop, Charmaine; Dingli, Nicola; Aquilina, Annelise; Zrinzo, Ludvic; Aquilina, Josanne

2018-05-26

Deep Brain Stimulation (DBS) requires a specialist multidisciplinary approach and lifelong follow-up. Patient access can be a challenge for small nation states. Malta is an island nation with a population of just under 450 000. The number of patients likely to benefit from DBS is around 5 to 10 per year. This study explores the outcome of a cross border collaboration between specialist services at Queen Square, London and a tertiary centre in Malta. Between 2011 and 2015, 35 patients underwent MRI-Guided and MRI-Verified DBS with 29 receiving bilateral subthalamic nucleus (STN) DBS for Parkinson's Disease under general anaesthesia. Pre-operative motor function was compared with one year post-operative motor function assessments in 26 patients (16 male; age 60 ± 9, range 32-70; disease duration 8.8 ± 2.7). Pre-operative and post-operative quality of life scores were also completed in 24 patients. There was significant improvement in off-medication Unified Parkinson's Disease Rating Scale (UPDRS) III motor function (41.7%), reduction in Levodopa Equivalent Dose (LED) (30.6%) and improvement in quality of life as measured by the Parkinson's Disease Questionnaire (PDQ-39) (52.3%) (p < .001). All PDQ-39 dimensions showed significant improvement except communication, with greatest benefit in activities of daily living (ADLs) (72.4%) and stigma (66.3%). Surgical complications did not lead to any permanent deficit. Patients receiving DBS to other targets and for different indications also benefitted from surgery. An MRI-guided and MRI-verified approach to DBS was successfully implemented through cross border collaboration with achievement of expected clinical results. This healthcare collaboration developed out of necessity and opportunity, taking advantage of a UK-based neurosurgeon from Malta. The UK healthcare system benefits from numerous immigrants at Consultant level. Such a mutually beneficial arrangement could enable such individuals to offer their expertise to citizens in the UK as well as their country of origin.

The educational background and qualifications of UK medical students from ethnic minorities.

PubMed

McManus, I C; Woolf, Katherine; Dacre, Jane

2008-04-16

UK medical students and doctors from ethnic minorities underperform in undergraduate and postgraduate examinations. Although it is assumed that white (W) and non-white (NW) students enter medical school with similar qualifications, neither the qualifications of NW students, nor their educational background have been looked at in detail. This study uses two large-scale databases to examine the educational attainment of W and NW students. Attainment at GCSE and A level, and selection for medical school in relation to ethnicity, were analysed in two separate databases. The 10th cohort of the Youth Cohort Study provided data on 13,698 students taking GCSEs in 1999 in England and Wales, and their subsequent progression to A level. UCAS provided data for 1,484,650 applicants applying for admission to UK universities and colleges in 2003, 2004 and 2005, of whom 52,557 applied to medical school, and 23,443 were accepted. NW students achieve lower grades at GCSE overall, although achievement at the highest grades was similar to that of W students. NW students have higher educational aspirations, being more likely to go on to take A levels, especially in science and particularly chemistry, despite relatively lower achievement at GCSE. As a result, NW students perform less well at A level than W students, and hence NW students applying to university also have lower A-level grades than W students, both generally, and for medical school applicants. NW medical school entrants have lower A level grades than W entrants, with an effect size of about -0.10. The effect size for the difference between white and non-white medical school entrants is about B0.10, which would mean that for a typical medical school examination there might be about 5 NW failures for each 4 W failures. However, this effect can only explain a portion of the overall effect size found in undergraduate and postgraduate examinations of about -0.32.

Recent and lifelong sexual dysfunction in a female UK population sample: prevalence and risk factors.

PubMed

Burri, Andrea; Spector, Timothy

2011-09-01

To date, no studies have tried to explore the prevalence and risk factors of recent and lifelong female sexual dysfunction (FSD) in the United Kingdom using validated questionnaires for the assessment of symptom severity and levels of associated sexual distress. To estimate the prevalence and comorbidity of recent and lifelong FSD and to further identify potential psychosocial and behavioral risk factors in a nationally representative sample of UK women. One thousand four hundred eighty-nine unselected female twin individuals aged 18-85 years. Validated questionnaires, such as the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale, were used for the assessment of symptom severity and degree of sexual distress. Prevalence and comorbidity of recent and lifelong FSD according to the FSFI cutoff points and the existence of sexual distress. Lifelong FSD refers to an individual's average sexual function ever since they have been sexually active. We further calculated odds ratios (ORs) with 95% confidence interval for FSD. We found that 5.8% of women reported any recent sexual dysfunction and 15.5% reported any lifelong sexual dysfunction. Hyposexual desire was the most prevalent recent and lifelong sexual complaint (21.4% and 17.3%, respectively). High intercorrelations were found for both recent and lifelong FSD (r=0.3-0.7). The most common independent, clinical predictor of recent and lifelong FSD diagnosis was relationship dissatisfaction (OR 1.2-4.5). Experience of abuse (OR 1.6-2.1), increased anxiety, and obsessive compulsive behavior were the most common predictors for lifelong FSD. The study provides the first UK population-based assessment of recent and lifelong FSD using validated outcome measures and accounting for sexual distress. Our results indicate that FSD is common in the general population and is influenced by psychosocial factors with different pathoetiologies underlying recent and lifelong FSD. © 2011 International Society for Sexual Medicine.

The educational background and qualifications of UK medical students from ethnic minorities

PubMed Central

McManus, IC; Woolf, Katherine; Dacre, Jane

2008-01-01

Background UK medical students and doctors from ethnic minorities underperform in undergraduate and postgraduate examinations. Although it is assumed that white (W) and non-white (NW) students enter medical school with similar qualifications, neither the qualifications of NW students, nor their educational background have been looked at in detail. This study uses two large-scale databases to examine the educational attainment of W and NW students. Methods Attainment at GCSE and A level, and selection for medical school in relation to ethnicity, were analysed in two separate databases. The 10th cohort of the Youth Cohort Study provided data on 13,698 students taking GCSEs in 1999 in England and Wales, and their subsequent progression to A level. UCAS provided data for 1,484,650 applicants applying for admission to UK universities and colleges in 2003, 2004 and 2005, of whom 52,557 applied to medical school, and 23,443 were accepted. Results NW students achieve lower grades at GCSE overall, although achievement at the highest grades was similar to that of W students. NW students have higher educational aspirations, being more likely to go on to take A levels, especially in science and particularly chemistry, despite relatively lower achievement at GCSE. As a result, NW students perform less well at A level than W students, and hence NW students applying to university also have lower A-level grades than W students, both generally, and for medical school applicants. NW medical school entrants have lower A level grades than W entrants, with an effect size of about -0.10. Conclusion The effect size for the difference between white and non-white medical school entrants is about B0.10, which would mean that for a typical medical school examination there might be about 5 NW failures for each 4 W failures. However, this effect can only explain a portion of the overall effect size found in undergraduate and postgraduate examinations of about -0.32. PMID:18416818

Occupational therapy for stroke patients not admitted to hospital: a randomised controlled trial.

PubMed

Walker, M F; Gladman, J R; Lincoln, N B; Siemonsma, P; Whiteley, T

1999-07-24

Patients who have a stroke are not always admitted to hospital, and 22-60% remain in the community, frequently without coordinated rehabilitation. We aimed to assess the efficacy of an occupational therapy intervention for patients with stroke who were not admitted to hospital. In this single-blind randomised controlled trial, consecutive stroke patients on a UK community register in Nottingham and Derbyshire were allocated randomly to up to 5 months of occupational therapy at home or to no intervention (control group) 1 month after their stroke. The aim of the occupational therapy was to encourage independence in personal and instrumental activities of daily living. Patients were assessed on outcome measures at baseline (before randomisation) and at 6 months. The primary outcome measure was the score on the extended activities of daily living (EADL) scale at 6 months. Other outcome measures included the Barthel index, the general health questionnaire 28, the carer strain index, and the London handicap scale. All assessments were done by an independent assessor who was unaware of treatment allocation. The analysis included only data from completed questionnaires. 185 patients were included: 94 in the occupational therapy group and 91 in the control group. 22 patients were not assessed at 6 months. At follow-up, patients who had occupational therapy had significantly higher median scores than the controls on: the EADL scale (16 vs 12, p<0.01, estimated difference 3 [95% CI 1 to 4]); the Barthel index (20 vs 18, p<0.01, difference 1, [0-1]); the carer strain index (1 vs 3, p<0.05, difference 1 [0 to 2]); and the London handicap scale (76 vs 65, p<0.05, difference 7, [0.3 to 13.5]). There were no significant differences on the general health questionnaire between the patient or carer. Occupational therapy significantly reduced disability and handicap in patients with stroke who were not admitted to hospital.

The Development of the Francis Moral Values Scales: A Study among 16- to 18-Year-Old Students Taking Religious Studies at A Level in the UK

ERIC Educational Resources Information Center

Village, Andrew; Francis, Leslie J.

2016-01-01

This article reports on the development of scales for measuring moral values in three domains: anti-social behaviour, sex and relationships, and substance use. Students studying religion at A level in 25 schools were invited to respond to 32 Likert items that referred to a wide range of moral issues and behaviours, employing a 5-point response…

Long-term monitoring of UK river basins: the disconnections between the timescales of hydrological processes and watershed management planning

NASA Astrophysics Data System (ADS)

Howden, N. J. K.; Burt, T.; Worrall, F.

2016-12-01

The UK has a wealth of hydrological monitoring data that has both good coverage in space since the early 1970s, and also a few locations where records have been kept continuously for almost 150 years. Such datasets offer unique opportunities for the hydrologist to consider how the concepts of stationarity, change, and definitions of "baseline" resources should be used to shape how we build models of these systems, and how we devise appropriate and sustainable watershed management strategies. In this paper we consider some of the UK's longest hydrological and biogeochemical records, to explore how long records can be used to shape such understanding and, in some cases, how they can be used to identify new modes of behaviour that need to be incorporated into management planning, from the scale of individual watersheds right up to the national scale. We also consider how key timescales of hydrological responses that are evident within the data may pose major problems for watershed management unless appropriate attention is paid to the potential impacts of processes that work over decadal timescales - much longer than sub-decadal water industry investment cycles or short-term projects for watershed management planning. We use our long-term records to show how key processes can be identified, and to illustrate how careful interpretation of shorter term records will improve decision-making for water resource management.

The role of fire in UK peatland and moorland management: the need for informed, unbiased debate

PubMed Central

Davies, G. Matt; Kettridge, Nicholas; Stoof, Cathelijne R.; Gray, Alan; Ascoli, Davide; Fernandes, Paulo M.; Marrs, Rob; Clay, Gareth D.; McMorrow, Julia; Vandvik, Vigdis

2016-01-01

Fire has been used for centuries to generate and manage some of the UK's cultural landscapes. Despite its complex role in the ecology of UK peatlands and moorlands, there has been a trend of simplifying the narrative around burning to present it as an only ecologically damaging practice. That fire modifies peatland characteristics at a range of scales is clearly understood. Whether these changes are perceived as positive or negative depends upon how trade-offs are made between ecosystem services and the spatial and temporal scales of concern. Here we explore the complex interactions and trade-offs in peatland fire management, evaluating the benefits and costs of managed fire as they are currently understood. We highlight the need for (i) distinguishing between the impacts of fires occurring with differing severity and frequency, and (ii) improved characterization of ecosystem health that incorporates the response and recovery of peatlands to fire. We also explore how recent research has been contextualized within both scientific publications and the wider media and how this can influence non-specialist perceptions. We emphasize the need for an informed, unbiased debate on fire as an ecological management tool that is separated from other aspects of moorland management and from political and economic opinions. This article is part of the themed issue ‘The interaction of fire and mankind’. PMID:27216512

The role of fire in UK peatland and moorland management: the need for informed, unbiased debate.

PubMed

Davies, G Matt; Kettridge, Nicholas; Stoof, Cathelijne R; Gray, Alan; Ascoli, Davide; Fernandes, Paulo M; Marrs, Rob; Allen, Katherine A; Doerr, Stefan H; Clay, Gareth D; McMorrow, Julia; Vandvik, Vigdis

2016-06-05

Fire has been used for centuries to generate and manage some of the UK's cultural landscapes. Despite its complex role in the ecology of UK peatlands and moorlands, there has been a trend of simplifying the narrative around burning to present it as an only ecologically damaging practice. That fire modifies peatland characteristics at a range of scales is clearly understood. Whether these changes are perceived as positive or negative depends upon how trade-offs are made between ecosystem services and the spatial and temporal scales of concern. Here we explore the complex interactions and trade-offs in peatland fire management, evaluating the benefits and costs of managed fire as they are currently understood. We highlight the need for (i) distinguishing between the impacts of fires occurring with differing severity and frequency, and (ii) improved characterization of ecosystem health that incorporates the response and recovery of peatlands to fire. We also explore how recent research has been contextualized within both scientific publications and the wider media and how this can influence non-specialist perceptions. We emphasize the need for an informed, unbiased debate on fire as an ecological management tool that is separated from other aspects of moorland management and from political and economic opinions.This article is part of the themed issue 'The interaction of fire and mankind'. © 2016 The Authors.

Higher Education in Recessionary Times: A UK Colloquium

ERIC Educational Resources Information Center

Evans, Mary

2010-01-01

This article talks about a meeting on "Higher Education in Recessionary Times" on March 24, 2010, which was hosted by the Society for Higher Education Research Policy Network. Although the meeting did take place in the context of an expected General Election, and on budget day, there was a general sense on the day that whoever won the…

Does Intelligence Foster Generalized Trust? An Empirical Test Using the UK Birth Cohort Studies

ERIC Educational Resources Information Center

Sturgis, Patrick; Read, Sanna; Allum, Nick

2010-01-01

Social, or "generalized" trust is often characterised as the "attitudinal dimension" of social capital. It has been posited as key to a host of normatively desirable outcomes at the societal and individual levels. Yet the origins of individual variation in trust remain something of a mystery and continue to be a source of…

The Increased Role of Regional Organizations in Peacekeeping and Effects on the United Nations Preeminence in Future Peace Operations

DTIC Science & Technology

2003-06-06

Lieutenant General (U.K.) Sir Michael Jackson , the KFOR commander, order the Russians to withdraw from the airport, but Jackson refused to act...1999 that his forces had disarmed fully, and this was confirmed by KFOR Commander Lieutenant General Sir. Michael Jackson (www.afsouth.nato/int.htm

"Always paracetamol, they give them paracetamol for everything": a qualitative study examining Eastern European migrants' experiences of the UK health service.

PubMed

Madden, Hannah; Harris, Jane; Blickem, Christian; Harrison, Rebecca; Timpson, Hannah

2017-08-29

The enlargement of the European Union since 2004 has led to an increase in the number of Eastern European migrants living in the UK. The health of this group is under-researched though some mixed evidence shows they are at higher risk of certain physical health conditions such as heart attacks, strokes, HIV and alcohol use and have poorer mental health. This is compounded by poor or insecure housing, low pay, isolation and prejudice. We aimed to understand the health needs and health service experiences of the Eastern European population in a town in Northern England. Five semi structured one-to-one and small group interviews and five focus groups were conducted with 42 Eastern European participants between June and September 2014. The majority of participants were Polish and other participants were from Belarus, Hungary, Latvia, Russia, Slovakia and Ukraine. The data were analysed using thematic framework analysis. Key findings included a good understanding the UK health service structure and high registration and use of general practice/primary care services. However, overall, there were high levels of dissatisfaction, frustration and distrust in General Practitioners (GP). The majority of participants viewed the GP as unhelpful and dismissive; a barrier to secondary/acute care; reluctant to prescribe antibiotics; and that GPs too often advised them to take paracetamol (acetaminophen) and rest. Overwhelmingly participants had strong opinions about access to primary care and the role of the general practitioners. Although the design of the UK health service was well understood, participants were unhappy with the system of GP as gatekeeper and felt it inferior to the consumer-focused health systems in their country of origin. More work is needed to promote the importance of self-care, reduce antibiotic and medication use, and to increase trust in the GP.

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.

Limits on Arcminute Scale Cosmic Microwave Background Anisotropy with the BIMA Array

NASA Technical Reports Server (NTRS)

Holzapfel, W. L.; Carlstrom, J. E.; Grego, L.; Holder, G. P.; Joy, M. K.; Reese, E. D.; Rose, M. Franklin (Technical Monitor)

2000-01-01

We have used the Berkeley-Illinois-Maryland-Association (BIMA) millimeter array outfitted with sensitive cm-wave receivers to search for Cosmic Microwave Background (CMB) anisotropies on arcminute scales. The interferometer was placed in a compact configuration which produces high brightness sensitivity, while providing discrimination against point sources. Operating at a frequency of 28.5 GHz, the FWHM primary beam of the instrument is 6.6 arcminutes. We have made sensitive images of seven fields, five of which where chosen specifically to have low IR dust contrast and be free of bright radio sources. Additional observations with the Owens Valley Radio Observatory (OVRO) millimeter array were used to assist in the location and removal of radio point sources. Applying a Bayesian analysis to the raw visibility data, we place limits on CMB anisotropy flat-band power Q_flat = 5.6 (+3.0, -5.6) uK and Q_flat < 14.1 uK at 68% and 95% confidence. The sensitivity of this experiment to flat band power peaks at a multipole of l = 5470, which corresponds to an angular scale of approximately 2 arcminutes The most likely value of Q_flat is similar to the level of the expected secondary anisotropies.

PREFACE: 4th Workshop on Theory, Modelling and Computational Methods for Semiconductors (TMCSIV)

NASA Astrophysics Data System (ADS)

Tomić, Stanko; Probert, Matt; Migliorato, Max; Pal, Joydeep

2014-06-01

These conference proceedings contain the written papers of the contributions presented at the 4th International Conference on Theory, Modelling and Computational Methods for Semiconductor materials and nanostructures. The conference was held at the MediaCityUK, University of Salford, Manchester, UK on 22-24 January 2014. The previous conferences in this series took place in 2012 at the University of Leeds, in 2010 at St William's College, York and in 2008 at the University of Manchester, UK. The development of high-performance computer architectures is finally allowing the routine use of accurate methods for calculating the structural, thermodynamic, vibrational, optical and electronic properties of semiconductors and their hetero- and nano-structures. The scope of this conference embraces modelling, theory and the use of sophisticated computational tools in semiconductor science and technology, where there is substantial potential for time-saving in R&D. Theoretical approaches represented in this meeting included: Density Functional Theory, Semi-empirical Electronic Structure Methods, Multi-scale Approaches, Modelling of PV devices, Electron Transport, and Graphene. Topics included, but were not limited to: Optical Properties of Quantum Nanostructures including Colloids and Nanotubes, Plasmonics, Magnetic Semiconductors, Photonic Structures, and Electronic Devices. This workshop ran for three days, with the objective of bringing together UK and international leading experts in the theoretical modelling of Group IV, III-V and II-VI semiconductors, as well as students, postdocs and early-career researchers. The first day focused on providing an introduction and overview of this vast field, aimed particularly at students, with several lectures given by recognized experts in various theoretical approaches. The following two days showcased some of the best theoretical research carried out in the UK in this field, with several contributions also from representatives of renowned theoretical groups from many European countries (Spain, France, Ireland, Germany, Switzerland, Luxemburg, Norway, Italy, Poland, Denmark, Sweden, Serbia, etc.), as well as Asia (Iran, Japan) and USA. We would like to thank all participants for making this a very successful meeting and for their contribution to the conference programme and these proceedings. We would also like to acknowledge the financial support from the Institute of Physics (Semiconductor Physics Group and Computational Physics Group), EPSRC-UK, the CECAM UK-Hartree Node, CCP9, and Quantum Wise (distributors of Atomistix). The Editors Acknowledgments Conference Organising Committee: Stanko Tomić (Chair, University of Salford) Matt Probert (University of York) Max Migliorato (University of Manchester) Joydeep Pal (University of Manchester) Programme Committee: David Whittaker (University of Sheffield, UK) John Robertson (University of Cambridge, UK) Risto Nieminen (Helsinki University of Technology Finland) Eoin O'Reilly (Tyndall Institute Cork Republic of Ireland) Marco Califano (University of Leeds, UK) Stewart Clark (University of Durham, UK) Stanko Tomić (University of Salford, UK) Mauro Pereira (Sheffield Hallam University, UK) Aldo Di Carlo (University of Rome ''Tor Vergata,'' Italy) Lev Kantorovich (King's College London, UK) Mervin Roy (University of Leicester, UK) Ben Hourahine (University of Strathclyde, UK) Rita Magri (University of Modena and Reggio Emilia, Italy) Zoran Ikonic (University of Leeds) John Barker (University of Glasgow) The proceedings were edited and compiled by Joydeep Pal, Max Migliorato and Stanko Tomić.

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.

UK Policy on Doctor Remediation: Trajectories and Challenges.

PubMed

Price, Tristan; Archer, Julian

2017-01-01

Around the world, policy-makers, academics, and health service professionals have become increasingly aware of the importance of remediation, the process by which poor performance is "remedied," as part of the changing landscape of medical regulation. It is, therefore, an opportune time to critique the UK experience with remediation policy. This article frames, for the first time, the UK remediation policy as developing from a central policy aim that was articulated in the 1990s: to accelerate the identification of underperformance and, subsequently, remedy any problems identified as soon as possible. In pursuit of this aim, three policy trajectories have emerged: professionalizing and standardizing remediation provision; linking remediation with other forms of regulation, namely relicensure (known in the UK as medical revalidation); and fostering obligations for doctors to report themselves and others for remediation needs. The operationalization of policy along these trajectories, and the challenges that have arisen, has relevance for anyone seeking to understand or indeed improve remediation practices within any health care system. It is argued here that the UK serves as an example of the more general challenges posed by seeking to integrate remediation policy within broader frameworks of medical governance, in particular systems of relicensure, and the need to develop a solid evidence base for remediation practices.

Development and preliminary validation of the 'Mind the Gap' scale to assess satisfaction with transitional health care among adolescents with juvenile idiopathic arthritis.

PubMed

Shaw, K L; Southwood, T R; McDonagh, J E

2007-07-01

To develop a scale to assess satisfaction with transitional health care among adolescents with a chronic illness and their parents. The 'Mind the Gap' scale was developed using evidence from a previous needs assessment, in three stages: (1) definition of the construct; (2) design of the scale items, response options and instructions; (3) full administration of the scale, item analysis and dimensionality analysis. The scale was administered to 308 adolescents with juvenile idiopathic arthritis (JIA) and 303 parents/guardians, prior to and 12 months after the implementation of an evaluation of a structured and co-ordinated programme of transitional care. The patient population involved adolescents with JIA and their parents recruited from 10 major UK rheumatology centres. A total of 301 (97.7%) adolescents and 286 (95.0%) parents chose to complete the questionnaire, with median item completion rates of 100.0% (0-100%) for both adolescents and parents thus confirming feasibility. Face and content validity were confirmed. Factor analyses revealed a three-factor structure which explained 49.5% and 56.1% of the variation in adolescent and parent scores respectively. The internal consistency of each subscale ('management of environment', 'provider characteristics' and 'process issues') was indicated by Cronbach's alphas of 0.71, 0.89 and 0.89 for adolescents, respectively, and 0.83, 0.91 and 0.92 for parents respectively. Cronbach's alphas for the entire scales were 0.91 and 0.94 for the adolescent and parent forms respectively. These preliminary results report the potential of the 'Mind the Gap' scale in evaluating transitional care for adolescents with JIA. In view of the generic nature of transitional care reflected in the scale, this scale has wider potential for use with adolescents with other chronic illness in view of the generic nature of transition. This development is particularly timely in the context of transitional care developments in the UK and further validation of the scale is in progress.

Establishing the characteristics for patients with chronic Complex Regional Pain Syndrome: the value of the CRPS-UK Registry.

PubMed

Shenker, Nicholas; Goebel, Andreas; Rockett, Mark; Batchelor, James; Jones, Gareth T; Parker, Richard; de C Williams, Amanda C; McCabe, Candida

2015-05-01

The long-term prognosis of patients with Complex Regional Pain Syndrome (CRPS) is unknown with no reported prospective studies from the United Kingdom longer than 18 months. The CRPS-UK Network aims to study this by use of a Registry. The aims of this article are, to outline the CRPS-UK Registry, assess the validity of the data and to describe the characteristics of a sample of the UK CRPS population. A web-based CRPS-UK Registry was developed and made accessible to centres experienced in diagnosing and managing patients with CRPS. Pragmatic annual follow-up questions were agreed. Up until July 2013, the Registry has recruited 240 patients. A blinded, validation study of 20 consecutive patients from two centres (10 each) demonstrated 95.6% completion and 99.4% accuracy of a random sample of the recorded data. These patients had chronic disease (median duration: 29 months); 72.5% were female (2.6:1), with a mean age at symptoms onset of 43 years, and were left-handed more than expected (21.8% versus 10% in the general population). Patients reported a delayed diagnosis, with the median time between symptom onset and diagnosis of 6 months. In all, 30 patients (12.5%) had multiple limb involvement and (83.3%) had a contiguous spread of CRPS. CRPS-UK Registry is a validated method for actively recruiting well-characterised patients with CRPS to provide further information on the long-term outcome.

Establishing the characteristics for patients with chronic Complex Regional Pain Syndrome: the value of the CRPS-UK Registry

PubMed Central

Goebel, Andreas; Rockett, Mark; Batchelor, James; Jones, Gareth T; Parker, Richard; de C Williams, Amanda C; McCabe, Candida

2015-01-01

Objective: The long-term prognosis of patients with Complex Regional Pain Syndrome (CRPS) is unknown with no reported prospective studies from the United Kingdom longer than 18 months. The CRPS-UK Network aims to study this by use of a Registry. The aims of this article are, to outline the CRPS-UK Registry, assess the validity of the data and to describe the characteristics of a sample of the UK CRPS population. Methods: A web-based CRPS-UK Registry was developed and made accessible to centres experienced in diagnosing and managing patients with CRPS. Pragmatic annual follow-up questions were agreed. Results: Up until July 2013, the Registry has recruited 240 patients. A blinded, validation study of 20 consecutive patients from two centres (10 each) demonstrated 95.6% completion and 99.4% accuracy of a random sample of the recorded data. These patients had chronic disease (median duration: 29 months); 72.5% were female (2.6:1), with a mean age at symptoms onset of 43 years, and were left-handed more than expected (21.8% versus 10% in the general population). Patients reported a delayed diagnosis, with the median time between symptom onset and diagnosis of 6 months. In all, 30 patients (12.5%) had multiple limb involvement and (83.3%) had a contiguous spread of CRPS. Conclusion: CRPS-UK Registry is a validated method for actively recruiting well-characterised patients with CRPS to provide further information on the long-term outcome. PMID:26516567

The psychological effects of improvised explosive devices (IEDs) on UK military personnel in Afghanistan.

PubMed

Jones, Norman; Thandi, Gursimran; Fear, Nicola T; Wessely, Simon; Greenberg, Neil

2014-07-01

To explore the psychological consequences of improvised explosive device (IED) exposure as IEDs have been the greatest threat to UK military personnel in Afghanistan though the mental health consequences of IED exposure are largely unknown. Deployed UK military personnel completed a survey while deployed in Afghanistan. Combat personnel and those dealing specifically with the IED threat were compared with all other deployed personnel; the relationship between IED exposure, general combat experiences, Post Traumatic Stress Disorder (PTSD) Checklist-Civilian Version (PCL-C) and General Health Questionnaire scores were evaluated. The response rate was 98% (n=2794). Half reported IED-related concerns, a third experienced exploding IEDs and a quarter gave medical aid to IED casualties. Combat and counter-IED threat personnel had higher levels of IED exposure than other deployed personnel. 18.8% of personnel who witnessed exploding IEDs scored positive for common mental disorder (General Health Questionnaire-12 scores ≥4) and 7.6% scored positive for probable PTSD symptoms (PTSD Checklist-Civilian Version scores ≥44). After adjusting for general combat exposure and other observed confounders, PTSD symptoms were associated with IED exposure whereas common mental disorder symptoms were not. IED exposure, IED-related concerns and functional impairment accumulated during deployment but functional impairment was related to factors other than IED exposure alone. In Afghanistan, a substantial proportion of personnel were exposed to exploding IEDs however, the majority of exposed personnel were psychologically healthy. Psychological effects were similar for combat personnel and those dealing specifically with the IED threat but both groups were at greater psychological risk than other deployed personnel. 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.

Compiling a register of patients with moderate or severe learning disabilities: experience at one United Kingdom general practice.

PubMed

Lodge, Keri-Michèle; Milnes, David; Gilbody, Simon M

2011-03-01

Background Identifying patients with learning disabilities within primary care is central to initiatives for improving the health of this population. UK general practitioners (GPs) receive additional income for maintaining registers of patients with learning disabilities as part of the Quality and Outcomes Framework (QOF), and may opt to provide Directed Enhanced Services (DES), which requires practices to maintain registers of patients with moderate or severe learning disabilities and offer them annual health checks.Objectives This paper describes the development of a register of patients with moderate or severe learning disabilities at one UK general practice.Methods A Read code search of one UK general practice's electronic medical records was conducted in order to identify patients with learning disabilities. Confirmation of diagnoses was sought by scrutinising records and GP verification. Cross-referencing with the practice QOF register of patients with learning disabilities of any severity, and the local authority's list of clients with learning disabilities, was performed.Results Of 15 001 patients, 229 (1.5%) were identified by the Read code search as possibly having learning disabilities. Scrutiny of records and GP verification confirmed 64 had learning disabilities and 24 did not, but the presence or absence of learning disability remained unclear in 141 cases. Cross-referencing with the QOF register (n=81) and local authority list (n=49) revealed little overlap.Conclusion Identifying learning disability and assessing its severity are tasks GPs may be unfamiliar with, and relying on Read code searches may result in under-detection. Further research is needed to define optimum strategies for identifying, cross-referencing and validating practice-based registers of patients with learning disabilities.

Compiling a register of patients with moderate or severe learning disabilities: experience at one United Kingdom general practice

PubMed Central

2011-01-01

Background Identifying patients with learning disabilities within primary care is central to initiatives for improving the health of this population. UK general practitioners (GPs) receive additional income for maintaining registers of patients with learning disabilities as part of the Quality and Outcomes Framework (QOF), and may opt to provide Directed Enhanced Services (DES), which requires practices to maintain registers of patients with moderate or severe learning disabilities and offer them annual health checks. Objectives This paper describes the development of a register of patients with moderate or severe learning disabilities at one UK general practice. Methods A Read code search of one UK general practice's electronic medical records was conducted in order to identify patients with learning disabilities. Confirmation of diagnoses was sought by scrutinising records and GP verification. Cross-referencing with the practice QOF register of patients with learning disabilities of any severity, and the local authority's list of clients with learning disabilities, was performed. Results Of 15 001 patients, 229 (1.5%) were identified by the Read code search as possibly having learning disabilities. Scrutiny of records and GP verification confirmed 64 had learning disabilities and 24 did not, but the presence or absence of learning disability remained unclear in 141 cases. Cross-referencing with the QOF register (n=81) and local authority list (n=49) revealed little overlap. Conclusion Identifying learning disability and assessing its severity are tasks GPs may be unfamiliar with, and relying on Read code searches may result in under-detection. Further research is needed to define optimum strategies for identifying, cross-referencing and validating practice-based registers of patients with learning disabilities. PMID:22479290

IQ AND SOCIOECONOMIC DEVELOPMENT ACROSS REGIONS OF THE UK.

PubMed

Carl, Noah

2016-05-01

Cross-regional correlations between average IQ and socioeconomic development have been documented in many different countries. This paper presents new IQ estimates for the twelve regions of the UK. These are weakly correlated (r=0.24) with the regional IQs assembled by Lynn (1979). Assuming the two sets of estimates are accurate and comparable, this finding suggests that the relative IQs of different UK regions have changed since the 1950s, most likely due to differentials in the magnitude of the Flynn effect, the selectivity of external migration, the selectivity of internal migration or the strength of the relationship between IQ and fertility. The paper provides evidence for the validity of the regional IQs by showing that IQ estimates for UK nations (England, Scotland, Wales and Northern Ireland) derived from the same data are strongly correlated with national PISA scores (r=0.99). It finds that regional IQ is positively related to income, longevity and technological accomplishment; and is negatively related to poverty, deprivation and unemployment. A general factor of socioeconomic development is correlated with regional IQ at r=0.72.

Does national scale economic and environmental indicators spur logistics performance? Evidence from UK.

PubMed

Khan, Syed Abdul Rehman; Qianli, Dong

2017-12-01

The aim of this study is to examine the association between national economic and environmental indicators with green logistics performance in a time series data of UK since 1981 to 2016. The research used autoregressive distributed lag method to understand the long-run and short-run relationships of national scale economic (foreign direct investment (FDI) inflows, per capita income) and environmental indicators (total greenhouse gases, fossil fuel, and renewable energy) on green logistics. In the short run, the research findings indicate that the green logistics and renewable energy have positive relationship, while fossil fuel is negatively correlated with green logistics operations. On the other hand, in the long run, the results show that FDI inflows, renewable energy sources, and per capita income have statistically significant and positive association with green logistics activities, while foreign investments attracted by environmental friendly policies and practices adopted in global logistics operations, which not only increase the environmental sustainability but also enhance economic activities with greater export opportunities in the region.

Relationship between physical and psychosocial dysfunction in Mexican patients with vertigo: a cross-cultural validation of the vertigo symptom scale.

PubMed

Yardley, L; Medina, S M; Jurado, C S; Morales, T P; Martinez, R A; Villegas, H E

1999-01-01

The Vertigo Symptom Scale (VSS) was designed to assess and differentiate symptoms of: (a) balance disorder; and (b) somatic anxiety and autonomic arousal in patients complaining of dizziness and vertigo. Although it has been translated for use in countries other than the UK, where it was originally developed, its validity in different languages and cultures has not previously been evaluated. This study examined the structure, reliability, and discriminative power of a Spanish translation of the VSS administered to a Mexican sample of 172 dizzy patients and 40 healthy controls. Scores on the two subscales of the VSS not only discriminated between patients and controls, but were also sensitive to differences between patient groups classified on the basis of diagnosis, test results, and occupational disability. The pattern of intercorrelations between symptoms, anxiety, depression, and handicap in the Mexican sample was almost identical to that observed in the original UK sample.

Macroinvertebrate community assembly in pools created during peatland restoration.

PubMed

Brown, Lee E; Ramchunder, Sorain J; Beadle, Jeannie M; Holden, Joseph

2016-11-01

Many degraded ecosystems are subject to restoration attempts, providing new opportunities to unravel the processes of ecological community assembly. Restoration of previously drained northern peatlands, primarily to promote peat and carbon accumulation, has created hundreds of thousands of new open water pools. We assessed the potential benefits of this wetland restoration for aquatic biodiversity, and how communities reassemble, by comparing pool ecosystems in regions of the UK Pennines on intact (never drained) versus restored (blocked drainage-ditches) peatland. We also evaluated the conceptual idea that comparing reference ecosystems in terms of their compositional similarity to null assemblages (and thus the relative importance of stochastic versus deterministic assembly) can guide evaluations of restoration success better than analyses of community composition or diversity. Community composition data highlighted some differences in the macroinvertebrate composition of restored pools compared to undisturbed peatland pools, which could be used to suggest that alternative end-points to restoration were influenced by stochastic processes. However, widely used diversity metrics indicated no differences between undisturbed and restored pools. Novel evaluations of restoration using null models confirmed the similarity of deterministic assembly processes from the national species pool across all pools. Stochastic elements were important drivers of between-pool differences at the regional-scale but the scale of these effects was also similar across most of the pools studied. The amalgamation of assembly theory into ecosystem restoration monitoring allows us to conclude with more certainty that restoration has been successful from an ecological perspective in these systems. Evaluation of these UK findings compared to those from peatlands across Europe and North America further suggests that restoring peatland pools delivers significant benefits for aquatic fauna by providing extensive new habitat that is largely equivalent to natural pools. More generally, we suggest that assembly theory could provide new benchmarks for planning and evaluating ecological restoration success. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Mental health and well-being in parents of excessively crying infants: Prospective evaluation of a support package.

PubMed

Powell, C; Bamber, D; Long, J; Garratt, R; Brown, J; Rudge, S; Morris, T; Bhupendra Jaicim, N; Plachcinski, R; Dyson, S; Boyle, E M; St James-Roberts, I

2018-04-17

During the first 4 months of age, approximately 20% of infants cry a lot without an apparent reason. Most research has targeted the crying, but the impact of the crying on parents, and subsequent outcomes, need to receive equal attention. This study reports the findings from a prospective evaluation of a package of materials designed to support the well-being and mental health of parents who judge their infant to be crying excessively. The resulting "Surviving Crying" package comprised a website, printed materials, and programme of Cognitive Behaviour Therapy-based support sessions delivered to parents by a qualified practitioner. It was designed to be suitable for United Kingdom (UK) National Health Service (NHS) use. Parents were referred to the study by 12 NHS Health Visitor/Community Public Health Nurse teams in one UK East Midlands NHS Trust. Fifty-two of 57 parents of excessively crying babies received the support package and completed the Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7 anxiety questionnaire, as well as other measures, before receiving the support package and afterwards. Significant reductions in depression and anxiety were found, with numbers of parents meeting clinical criteria for depression or anxiety halving between baseline and outcome. These improvements were not explained by reductions in infant crying. Reductions also occurred in the number of parents reporting the crying to be a large or severe problem (from 28 to 3 parents) or feeling very or extremely frustrated by the crying (from 31 to 1 parent). Other findings included increases in parents' confidence, knowledge of infant crying, and improvements in parents' sleep. The findings suggest that the Surviving Crying package may be effective in supporting the well-being and mental health of parents of excessively crying babies. Further, large-scale controlled trials of the package in NHS settings are warranted. © 2018 John Wiley & Sons Ltd.

Impact of late diagnosis and treatment on life expectancy in people with HIV-1: UK Collaborative HIV Cohort (UK CHIC) Study

PubMed Central

Gompels, Mark; Delpech, Valerie; Porter, Kholoud; Post, Frank; Johnson, Margaret; Dunn, David; Palfreeman, Adrian; Gilson, Richard; Gazzard, Brian; Hill, Teresa; Walsh, John; Fisher, Martin; Orkin, Chloe; Ainsworth, Jonathan; Bansi, Loveleen; Phillips, Andrew; Leen, Clifford; Nelson, Mark; Anderson, Jane; Sabin, Caroline

2011-01-01

Objectives To estimate life expectancy for people with HIV undergoing treatment compared with life expectancy in the general population and to assess the impact on life expectancy of late treatment, defined as CD4 count <200 cells/mm3 at start of antiretroviral therapy. Design Cohort study. Setting Outpatient HIV clinics throughout the United Kingdom. Population Adult patients from the UK Collaborative HIV Cohort (UK CHIC) Study with CD4 count ≤350 cells/mm3 at start of antiretroviral therapy in 1996-2008. Main outcome measures Life expectancy at the exact age of 20 (the average additional years that will be lived by a person after age 20), according to the cross sectional age specific mortality rates during the study period. Results 1248 of 17 661 eligible patients died during 91 203 person years’ follow-up. Life expectancy (standard error) at exact age 20 increased from 30.0 (1.2) to 45.8 (1.7) years from 1996-9 to 2006-8. Life expectancy was 39.5 (0.45) for male patients and 50.2 (0.45) years for female patients compared with 57.8 and 61.6 years for men and women in the general population (1996-2006). Starting antiretroviral therapy later than guidelines suggest resulted in up to 15 years’ loss of life: at age 20, life expectancy was 37.9 (1.3), 41.0 (2.2), and 53.4 (1.2) years in those starting antiretroviral therapy with CD4 count <100, 100-199, and 200-350 cells/mm3, respectively. Conclusions Life expectancy in people treated for HIV infection has increased by over 15 years during 1996-2008, but is still about 13 years less than that of the UK population. The higher life expectancy in women is magnified in those with HIV. Earlier diagnosis and subsequent timely treatment with antiretroviral therapy might increase life expectancy. PMID:21990260

Characterising the research profile of the critical care physiotherapy workforce and engagement with critical care research: a UK national survey

PubMed Central

Allum, Laura; Shaw, Michelle; Pattison, Natalie; Dark, Paul

2018-01-01

Objective To characterise the research profile of UK critical care physiotherapists including experience, training needs, and barriers and enablers to engagement in critical care research. ‘Research’ was defined broadly to encompass activities related to quantitative and qualitative studies, service evaluations, clinical audit and quality improvements. Design Closed-question online survey, with optional free-text responses. Setting UK critical care community. Participants UK critical care physiotherapists, regardless of clinical grade or existing research experience. Results 268 eligible survey responses were received during the 12-week study period (21 incomplete, 7.8%). Respondents were based in university-affiliated (n=133, 49.6%) and district general (n=111, 41.4%) hospitals, and generally of senior clinical grade. Nearly two-thirds had postgraduate qualifications at master’s level or above (n=163, 60.8%). Seven had a doctoral-level qualification. Respondents reported a range of research experience, predominantly data acquisition (n=144, 53.7%) and protocol development (n=119, 44.4%). Perceived research training needs were prevalent, including topics of research methods, critical literature appraisal, protocol development and statistical analysis (each reported by ≥50% respondents). Multiple formats for delivery of future research training were identified. Major barriers to research engagement included lack of protected time (n=220, 82.1%), funding (n=177, 66.0%) and perceived experience (n=151, 56.3%). Barriers were conceptually categorised into capability, opportunity and motivation themes. Key enabling strategies centred on greater information provision about clinical research opportunities, access to research training, secondment roles and professional networks. Conclusions UK critical care physiotherapists are skilled, experienced and motivated to participate in research, including pursuing defined academic research pathways. Nonetheless wide-ranging training needs and notable barriers preclude further involvement. Strategies to harness the unique skills of this profession to enhance the quality, quantity and scope of critical care research, benefiting from a multiprofessional National Clinical Research Network, are required. PMID:29866725

Management of shoulder pain by UK general practitioners (GPs): a national survey

PubMed Central

Artus, Majid; van der Windt, Danielle A; Afolabi, Ebenezer K; Buchbinder, Rachelle; Chesterton, Linda S; Hall, Alison; Roddy, Edward; Foster, Nadine E

2017-01-01

Objectives Studies in Canada, the USA and Australia suggested low confidence among general practitioners (GPs) in diagnosing and managing shoulder pain, with frequent use of investigations. There are no comparable studies in the UK; our objective was to describe the diagnosis and management of shoulder pain by GPs in the UK. Methods A national survey of a random sample of 5000 UK GPs collected data on shoulder pain diagnosis and management using two clinical vignettes that described primary care presentations with rotator cuff tendinopathy (RCT) and adhesive capsulitis (AdhC). Results Seven hundred and fourteen (14.7%) responses were received. 56% and 83% of GPs were confident in their diagnosis of RCT and AdhC, respectively, and a wide range of investigations and management options were reported. For the RCT presentation, plain radiographs of the shoulder were most common (60%), followed by blood tests (42%) and ultrasound scans (USS) (38%). 19% of those who recommended a radiograph and 76% of those who recommended a USS did so ‘to confirm the diagnosis’. For the AdhC presentation, the most common investigations were blood tests (60%), plain shoulder radiographs (58%) and USS (31%). More than two-thirds of those recommending a USS did so ‘to confirm the diagnosis’. The most commonly recommended treatment for both presentations was physiotherapy (RCT 77%, AdhC 71%) followed by non-steroidal anti-inflammatory drugs (RCT 58%, AdhC 74%). 17% opted to refer the RCT to secondary care (most often musculoskeletal interface service), compared with 31% for the AdhC. Conclusions This survey of GPs in the UK highlights reliance on radiographs and blood tests in the management of common shoulder pain presentations. GPs report referring more than 7 out of 10 patients with RCT and AdhC to physiotherapists. These findings need to be viewed in the context of low response to the survey and, therefore, potential non-response bias. PMID:28637737

Reproductive potential of Schistocephalus solidus-infected male three-spined stickleback Gasterosteus aculeatus from two U.K. populations.

PubMed

Macnab, V; Katsiadaki, I; Barber, I

2009-11-01

Male three-spined stickleback Gasterosteus aculeatus from two U.K. populations with endemic infections of the cestode Schistocephalus solidus were brought into the laboratory prior to the breeding season and transferred to nesting tanks under conditions designed to stimulate sexual maturation. Nesting and courtship behaviours were scored over a 35 day period, after which fish were euthanized and the liver, spleen, kidney and gonads were weighed. Among G. aculeatus from a park pond in Leicester, U.K., infected males rarely engaged in reproductive behaviours and exhibited reduced indices of sexual development, body condition and general health, with effects being largely independent of relative parasite mass (parasite index, I(P)). In contrast, the reproductive behaviour of infected fish from Kendoon Loch in Dumfriesshire, U.K. appeared to be less severely affected, with infected fish regularly building nests and courting females under laboratory conditions. This was paralleled by a more limited effect of infection on physiological indicators of development, condition and general health. Furthermore, behavioural and physiological variables typically correlated with I(P) among infected fish from this population. Although comparing the performance of infected fish from the two populations directly was difficult due to potentially confounding factors, the results support the findings of recent studies showing that the effects of S. solidus on host reproduction are unlikely to be uniform across G. aculeatus populations. One possibility is that variation in the effects of infection arises from differences in the co-evolutionary association times of G. aculeatus with the parasite.

Representation of people of South Asian origin in cardiovascular outcome trials of glucose-lowering therapies in Type 2 diabetes.

PubMed

Khunti, K; Bellary, S; Karamat, M A; Patel, K; Patel, V; Jones, A; Gray, J; Shepherd, P; Hanif, W

2017-01-01

Our aim was to investigate the proportional representation of people of South Asian origin in cardiovascular outcome trials of glucose-lowering drugs or strategies in Type 2 diabetes, noting that these are among the most significant pieces of evidence used to formulate the guidelines on which clinical practice is largely based. We searched for cardiovascular outcome trials in Type 2 diabetes published before January 2015, and extracted data on the ethnicity of participants. These were compared against expected values for proportional representation of South Asian individuals, based on population data from the USA, from the UK, and globally. Twelve studies met our inclusion criteria and, of these, eight presented a sufficiently detailed breakdown of participant ethnicity to permit numerical analysis. In general, people of South Asian origin were found to be under-represented in trials compared with UK and global expectations and over-represented compared with US expectations. Among the eight trials for which South Asian representation could be reliably estimated, seven under-represented this group relative to the 11.2% of the UK diabetes population estimated to be South Asian, with the representation in these trials ranging from 0.0% to 10.0%. Clinicians should exercise caution when generalizing the results of trials to their own practice, with regard to the ethnicity of individuals. Efforts should be made to improve reporting of ethnicity and improve diversity in trial recruitment, although we acknowledge that there are challenges that must be overcome to make this a reality. © 2016 Diabetes UK.

Professionalism among paramedic students: achieving the measure or missing the mark?

PubMed Central

Bowen, L Michael; Williams, Brett; Stanke, Luke

2017-01-01

Background Professionalism is a pillar of paramedicine. Internationally paramedic curricula emphasize valid assessment of three domains: cognitive, psychomotor, and affective domains (professionalism). Little is reported on competency measures for professionalism specific to paramedicine. Literature suggests that paramedic students, paramedic practitioners, medical directors, and patients believe that professional attributes should have an increased focus. Objective The objective of this scoping review is to outline valid and reliable assessments that evaluate professional behaviors. Method This review used Arksey and O’Malley’s six-stage scoping methodology. In September 2016, five databases were searched for articles of relevance; these were MEDLINE, Scopus, Google Scholar, PsycINFO/APA, and EMBASE. Results A total of 1587 articles were identified after removal of 468 duplicates. Five articles met the inclusion criteria, two of the articles were from the US and three from UK. The studies range from 2004 to 2014. Three different scales were identified but only two were recommended for use. A US-based scale is composed of 11 items and one generic form of professionalism. The UK scale has 77 items and identified 11 factors within 68 items. Conclusions This scoping review serves to describe valid and reliable measures for professionalism among paramedicine by outlining the quantity of instruments evident in the literature. The scoping review aimed to report the scales supporting evidence of validity and reliability. Three scales were identified in a total of five different studies that specifically measured professional attributes in paramedicine. Currently, two scales are available: an evaluation with 11 items and a self-reported questionnaire with 77 items. PMID:29118588

Effect of the new contract on GPs' working lives and perceptions of quality of care: a longitudinal survey.

PubMed

Whalley, Diane; Gravelle, Hugh; Sibbald, Bonnie

2008-01-01

An ambitious pay-for-performance system was implemented in UK general practice in 2004 amid doubts that it could improve both the working lives of doctors and quality of care. To evaluate doctors' perceptions of their working lives and quality of care before and after the new contract. Longitudinal questionnaire survey. England, UK. A longitudinal postal survey of English GPs in February 2004 and September 2005. Measures included reported job satisfaction (7-point scale), hours worked, income, and impact of the contract. Responses were available from 2105 doctors in 2004 and 1349 in 2005. Mean overall job satisfaction increased from 4.58 out of 7 in 2004 to 5.17 in 2005. The greatest improvements in satisfaction were with remuneration and hours of work. Mean reported hours worked fell from 44.5 to 40.8. Mean income increased from an estimated 73,400 pounds in 2004 to 92,600 pounds in 2005. Most GPs reported that the new contract had increased their income (88%), but decreased their professional autonomy (71%), and increased their administrative (94%) and clinical (86%) workloads. After the introduction of the contract doctors were more positive than they had anticipated about its impact on quality of care. GPs' job satisfaction increased after the introduction of the new contract, despite perceptions of negative consequences for workload and autonomy. GPs reported working fewer hours with a higher income, and their expectations regarding the impact of the contract on quality of care had been exceeded.

Cultural stereotypes of women from South Asian communities: mental health care professionals' explanations for patterns of suicide and depression.

PubMed

Burr, J

2002-09-01

Low rates of treated depression and high rates of suicide in women from some South Asian communities are evident in epidemiological studies in the UK. It is argued here that explanations for these apparent differences are likely to be located in stereotypes of repressive South Asian cultures. This small scale study, utilising focus groups and individual interviews, sought to explore the construction of cultural stereotypes within mental health discourse with specific reference to stereotypes of women from South Asian communities. Mental health carers from a UK inner city area of relatively high social deprivation were targeted. Focus groups were conducted with a range of mental health care professionals who worked in both inpatient and outpatient mental health care services. In addition, individual interviews were conducted with consultant psychiatrists and General Practitioners. Extensive reference is made in this paper to the content of focus groups and interviews and how health carer's knowledge about and experience of South Asian cultures and caring for women from these communities was contextualised. Mental health care professionals constructed cultural difference in terms of fixed and immutable categories which operated to inferiorise Britain's South Asian communities. It is argued that their knowledge is constructed upon stereotypes of western culture as superior to a construction of eastern cultures as repressive, patriarchal and inferior to a western cultural ideal. Ultimately, it is argued that these stereotypes become incorporated as 'fact' and have the potential to misdirect diagnosis and therefore, also misdirect treatment pathways.

Effectiveness of UK provider financial incentives on quality of care: a systematic review.

PubMed

Mandavia, Rishi; Mehta, Nishchay; Schilder, Anne; Mossialos, Elias

2017-11-01

Provider financial incentives are being increasingly adopted to help improve standards of care while promoting efficiency. To review the UK evidence on whether provider financial incentives are an effective way of improving the quality of health care. Systematic review of UK evidence, undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. MEDLINE and Embase databases were searched in August 2016. Original articles that assessed the relationship between UK provider financial incentives and a quantitative measure of quality of health care were included. Studies showing improvement for all measures of quality of care were defined as 'positive', those that were 'intermediate' showed improvement in some measures, and those classified as 'negative' showed a worsening of measures. Studies showing no effect were documented as such. Quality was assessed using the Downs and Black quality checklist. Of the 232 published articles identified by the systematic search, 28 were included. Of these, nine reported positive effects of incentives on quality of care, 16 reported intermediate effects, two reported no effect, and one reported a negative effect. Quality assessment scores for included articles ranged from 15 to 19, out of a maximum of 22 points. The effects of UK provider financial incentives on healthcare quality are unclear. Owing to this uncertainty and their significant costs, use of them may be counterproductive to their goal of improving healthcare quality and efficiency. UK policymakers should be cautious when implementing these incentives - if used, they should be subject to careful long-term monitoring and evaluation. Further research is needed to assess whether provider financial incentives represent a cost-effective intervention to improve the quality of care delivered in the UK. © British Journal of General Practice 2017.

Comparison of sexual behavior and HIV risk between two HIV-1 serodiscordant couple cohorts: the CHAVI 002 study.

PubMed

Ritchie, Adam J; Kuldanek, Kristin; Moodie, Zoe; Wang, Z Maggie; Fox, Julie; Nsubuga, Rebecca N; Legg, Kenneth; Birabwa, Esther F; Kaleebu, Pontiano; McMichael, Andrew J; Watera, Christine; Goonetilleke, Nilu; Fidler, Sarah

2012-01-01

The CHAVI002 study was designed to characterize immune responses, particularly HIV-specific T-cell responses, amongst 2 cohorts of HIV-exposed seronegative (HESN) individuals. The absence of a clear definition of HESNs has impaired comparison of research within and between such cohorts. This report describes two distinct HESN cohorts and attempts to quantify HIV exposure using a 'HIV risk index' (RI) model. HIV serodiscordant couples (UK; 24, Uganda; 72) and HIV unexposed seronegative (HUSN) controls (UK; 14, Uganda; 26 couples, 3 individuals) completed sexual behavior questionnaires every 3 months over a 9 month period. The two cohorts were heterogeneous, with most HESNs in the UK men who have sex with men (MSM), while all HESNs in Uganda were in heterosexual relationships. Concordance of responses between partners was determined. Each participant's sexual behavior score (SBS) was estimated based on the number and type of unprotected sex acts carried out in defined time periods. Independent HIV acquisition risk factors (partner plasma viral load, STIs, male circumcision, pregnancy) were integrated with the SBS, generating a RI for each HESN. 96 HIV serodiscordant couples completed 929 SBQs. SBSs remained relatively stable amongst the UK cohort, whilst decreasing from Visit 1 to 2 in the Ugandan cohort. Compared to the Ugandan cohort, SBSs and RIs in the UK cohort were lower at visit 1, and generally higher at later visits. Differences between the cohorts, with lower rates of ART use in Uganda and higher risk per-act sex in the UK, had major impacts on the SBSs and RIs of each cohort. There was one HIV transmission event in the UK cohort. Employment of a risk quantification model facilitated quantification and comparison of HIV acquisition risk across two disparate HIV serodiscordant couple cohorts.

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.

Modelling strategies to predict the multi-scale effects of rural land management change

NASA Astrophysics Data System (ADS)

Bulygina, N.; Ballard, C. E.; Jackson, B. M.; McIntyre, N.; Marshall, M.; Reynolds, B.; Wheater, H. S.

2011-12-01

Changes to the rural landscape due to agricultural land management are ubiquitous, yet predicting the multi-scale effects of land management change on hydrological response remains an important scientific challenge. Much empirical research has been of little generic value due to inadequate design and funding of monitoring programmes, while the modelling issues challenge the capability of data-based, conceptual and physics-based modelling approaches. In this paper we report on a major UK research programme, motivated by a national need to quantify effects of agricultural intensification on flood risk. Working with a consortium of farmers in upland Wales, a multi-scale experimental programme (from experimental plots to 2nd order catchments) was developed to address issues of upland agricultural intensification. This provided data support for a multi-scale modelling programme, in which highly detailed physics-based models were conditioned on the experimental data and used to explore effects of potential field-scale interventions. A meta-modelling strategy was developed to represent detailed modelling in a computationally-efficient manner for catchment-scale simulation; this allowed catchment-scale quantification of potential management options. For more general application to data-sparse areas, alternative approaches were needed. Physics-based models were developed for a range of upland management problems, including the restoration of drained peatlands, afforestation, and changing grazing practices. Their performance was explored using literature and surrogate data; although subject to high levels of uncertainty, important insights were obtained, of practical relevance to management decisions. In parallel, regionalised conceptual modelling was used to explore the potential of indices of catchment response, conditioned on readily-available catchment characteristics, to represent ungauged catchments subject to land management change. Although based in part on speculative relationships, significant predictive power was derived from this approach. Finally, using a formal Bayesian procedure, these different sources of information were combined with local flow data in a catchment-scale conceptual model application , i.e. using small-scale physical properties, regionalised signatures of flow and available flow measurements.

Sensitivity of peak flow to the change of rainfall temporal pattern due to warmer climate

NASA Astrophysics Data System (ADS)

Fadhel, Sherien; Rico-Ramirez, Miguel Angel; Han, Dawei

2018-05-01

The widely used design storms in urban drainage networks has different drawbacks. One of them is that the shape of the rainfall temporal pattern is fixed regardless of climate change. However, previous studies have shown that the temporal pattern may scale with temperature due to climate change, which consequently affects peak flow. Thus, in addition to the scaling of the rainfall volume, the scaling relationship for the rainfall temporal pattern with temperature needs to be investigated by deriving the scaling values for each fraction within storm events, which is lacking in many parts of the world including the UK. Therefore, this study analysed rainfall data from 28 gauges close to the study area with a 15-min resolution as well as the daily temperature data. It was found that, at warmer temperatures, the rainfall temporal pattern becomes less uniform, with more intensive peak rainfall during higher intensive times and weaker rainfall during less intensive times. This is the case for storms with and without seasonal separations. In addition, the scaling values for both the rainfall volume and the rainfall fractions (i.e. each segment of rainfall temporal pattern) for the summer season were found to be higher than the corresponding results for the winter season. Applying the derived scaling values for the temporal pattern of the summer season in a hydrodynamic sewer network model produced high percentage change of peak flow between the current and future climate. This study on the scaling of rainfall fractions is the first in the UK, and its findings are of importance to modellers and designers of sewer systems because it can provide more robust scenarios for flooding mitigation in urban areas.

Allometric scaling of UK urban emissions: interpretation and implications for air quality management

NASA Astrophysics Data System (ADS)

MacKenzie, Rob; Barnes, Matt; Whyatt, Duncan; Hewitt, Nick

2016-04-01

Allometry uncovers structures and patterns by relating the characteristics of complex systems to a measure of scale. We present an allometric analysis of air quality for UK urban settlements, beginning with emissions and moving on to consider air concentrations. We consider both airshed-average 'urban background' concentrations (cf. those derived from satellites for NO2) and local pollution 'hotspots'. We show that there is a strong and robust scaling (with respect to population) of the non-point-source emissions of the greenhouse gases carbon dioxide and methane, as well as the toxic pollutants nitrogen dioxide, PM2.5, and 1,3-butadiene. The scaling of traffic-related emissions is not simply a reflection of road length, but rather results from the socio-economic patterning of road-use. The recent controversy regarding diesel vehicle emissions is germane to our study but does not affect our overall conclusions. We next develop an hypothesis for the population-scaling of airshed-average air concentrations, with which we demonstrate that, although average air quality is expected to be worse in large urban centres compared to small urban centres, the overall effect is an economy of scale (i.e., large cities reduce the overall burden of emissions compared to the same population spread over many smaller urban settlements). Our hypothesis explains satellite-derived observations of airshed-average urban NO2 concentrations. The theory derived also explains which properties of nature-based solutions (urban greening) can make a significant contribution at city scale, and points to a hitherto unforeseen opportunity to make large cities cleaner than smaller cities in absolute terms with respect to their airshed-average pollutant concentration.

In plane stress analysis

NASA Technical Reports Server (NTRS)

Dillon, O. W., Jr.

1985-01-01

An investigation of the blowing up of UK numerical results for the inplane stress calculations for silicon ribbon is presented. The inplane stress that exists in a thin plate is governed by two general equations of equilibrium and compatibility.

The impact of general practitioner morale on patient satisfaction with care: a cross-sectional study.

PubMed

McKinstry, Brian; Walker, Jeremy; Porter, Mike; Fulton, Colette; Tait, Ashley; Hanley, Janet; Mercer, Stewart

2007-09-28

The association between stress and morale among general practitioners (GP) is well documented. However, the impact of GP stress or low morale on patient care is less clear. GPs in the UK now routinely survey patients about the quality of their care including organizational issues and consultation skills and the General Practice Assessment Questionnaire (GPAQ) is widely used for this purpose. We aimed to see if there was a relationship between doctor morale as measured by a validated instrument, the Morale Assessment in General Practice Index (MAGPI) and scores in the GPAQ. All GPs in Lothian, Scotland who were collecting GPAQ data were approached and asked to complete the MAGPI. Using an anonymised linkage system, individual scores on the MAGPI were linked to the doctors' GPAQ scores. Levels of association between the scores were determined by calculating rank correlations at the level of the individual doctor. Hypothesised associations between individual MAGPI and GPAQ items were also assessed. 276 of 475 GPs who were approached agreed to complete a MAGPI questionnaire and successfully collected anonymous GPAQ data from an average of 49.6 patients. There was no significant correlation between the total MAGPI score and the GPAQ communication or enablement scale. There were weak correlations between "control of work" in the MAGPI scale and GPAQ items on waiting times to see doctors (r = 0.24 p < 0.01). Doctors who perceived that their patients viewed them negatively also scored lower on individual communication, accessibility and continuity of care GPAQ items. This study showed no relationship between overall GP morale and patient perception of performance. There was a weak relationship between patients' perceptions ofquality and doctors' beliefs about their workload and whether patients value them. Further research is required to elucidate the complex relationship between workload, morale and patients' perception of care.

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

TB in healthcare workers in the UK: a cohort analysis 2009-2013.

PubMed

Davidson, Jennifer A; Lalor, Maeve K; Anderson, Laura F; Tamne, Surinder; Abubakar, Ibrahim; Thomas, H Lucy

2017-07-01

To describe the burden of TB in healthcare workers (HCWs) in the UK and determine whether HCWs are at increased risk of TB due to occupational exposure. Retrospective cohort analysis of national UK TB surveillance and genotyping data between 2009 and 2013. The rate of TB in HCWs compared with non-HCWs to calculate incidence rate ratios stratified by country of birth. 2320 cases of TB in HCWs were notified in the study period, 85% were born abroad. The TB rate in HCWs was 23.4 (95% CI 22.5 to 24.4) per 100 000 compared with 16.2 (95% CI 16.0 to 16.3) per 100 000 in non-HCWs. After stratifying by country of birth, there was not an increased TB incidence in HCWs for the majority of countries of birth, including in the UK-born. Using combined genotyping and epidemiological data, only 10 confirmed nosocomial transmission events involving HCWs were identified between 2010 and 2012. Of these, only two involved transmission to patients. The lack of an increased risk of TB after stratifying by country of birth, and the very few transmission events involving nosocomial transmission in the UK suggests that TB in HCWs in the UK is not generally acquired through UK occupational exposure. The majority of cases in foreign-born HCWs are likely to result from reactivation of latent TB infection (LTBI) acquired abroad, and is not likely to be prevented by BCG vaccination in the UK. Testing and treatment of LTBI in HCWs with exposure to high TB burden countries should be the focus of occupational health prevention activities. 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/.

Influence of the Scandinavian climate pattern on the UK asthma mortality: a time series and geospatial study.

PubMed

Majeed, Haris; Moore, G W K

2018-04-13

It is well known that climate variability and trends have an impact on human morbidity and mortality, especially during the winter. However, there are only a handful of studies that have undertaken quantitative investigations into this impact. We evaluate the association between the UK winter asthma mortality data to a well-established feature of the climate system, the Scandinavian (SCA) pattern. Time series analysis of monthly asthma mortality through the period of January 2001 to December 2015 was conducted, where the data were acquired from the UK's Office for National Statistics. The correlations between indices of important modes of climate variability impacting the UK such as the North Atlantic Oscillation as well as the SCA and the asthma mortality time series were computed. A grid point correlation analysis was also conducted with the asthma data with sea level pressure, surface wind and temperature data acquired from the European Centre for Medium-Range Weather Forecasts. We find that sea level pressure and temperature fluctuations associated with the SCA explain ~20% (>95% CL) of variance in the UK asthma mortality through a period of 2001-2015. Furthermore, the highest winter peak in asthma mortality occurred in the year 2015, during which there were strong northwesterly winds over the UK that were the result of a sea level pressure pattern similar to that associated with the SCA. Our study emphasises the importance of incorporating large-scale geospatial analyses into future research of understanding diseases and its environmental impact on human health. © 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.

Teachers' Self-Efficacy: Progressing Qualitative Analysis

ERIC Educational Resources Information Center

Glackin, Melissa; Hohenstein, Jill

2018-01-01

Teacher self-efficacy has predominantly been explored using quantitative instruments such as Likert scales-based questionnaires. Several researchers have questioned these methods, suggesting they offer only a limited view of the concept. This paper considers their claim by exploring the self-efficacy of UK secondary science teachers participating…

Negative "Marking"? University Research Administrators and the Contestation of Moral Exclusion

ERIC Educational Resources Information Center

Allen-Collinson, Jacquelyn

2009-01-01

With the exception of academics, occupational groups within universities remain relatively under-researched. Based upon qualitative interviews with 27 research administrators in 19 UK universities, this article reports on a small-scale qualitative project to investigate the workday worlds of these "boundary-crossing" and…

Barriers among Danish women and general practitioners to raising the issue of intimate partner violence in general practice: a qualitative study.

PubMed

Mørk, Trine; Andersen, Pernille Tanggaard; Taket, Ann

2014-06-03

Thirty-five percent of Danish women experience sexual or physical violence in their lifetime. However, health care professionals are not in the practice of asking about intimate partner violence (IPV) in Denmark. It is currently unknown what hinders general practitioners from asking about partner violence and how Danish women would perceive such an inquiry. This aspect has not previously been explored in Denmark. An exploratory study was conducted to examine what hinders general practitioners (GPs) from asking and what Danish women's views and attitudes are regarding being asked about IPV. Data were collected through individual and group interviews with a sample of three GPs and a diverse sample of 13 women, including both survivors of partner violence and those without any history of partner violence. An interpretative analysis was performed with the data. This study provides important knowledge regarding the barriers and attitudes towards inquiry about IPV in primary care in Denmark. Results indicate that Denmark is facing the same challenges when responding to survivors of IPV as other similar countries, including Sweden, Norway, the UK, USA, and Australia. Danish women want general practitioners to ask about violence in a respectful and non-judgemental manner. However, general practitioners are resistant towards such an inquiry and would benefit from training regarding how to respond to women who have been exposed to IPV. It is acceptable to inquire about IPV with women in Denmark in a non-judgemental and respectful way. Informing about IPV prevalence is important prior to the inquiry. However, general practitioners require more awareness and training before a favourable environment for this change in procedure can be created. Further large-scale research is needed to support the evidence generated by this small study.

Lightening the Load

DTIC Science & Technology

2007-09-09

Research, Engineering and Systems) Dr. John C. Sommerer NRAC, Vice Chair; Director, S&T, Johns Hopkins Applied Physics Laboratory Dr. Walt...O’Donohue, Staff Officer General Dynamics Robotic Systems John H. Northrop & Associates Mr. John H. Northrop, Executive Director General Dynamics...Equipment, US Army LtCol John Lemondes, PM Soldier as a System LTL Efforts US Army Mr. Bob Conklin, Staff UK LTL Efforts Equipment Capability

"Cascades, Torrents & Drowning" in Information: Seeking Help in the Contemporary General Practitioner Practice in the UK

ERIC Educational Resources Information Center

Holley, Debbie; Santos, Patricia; Cook, John; Kerr, Micky

2016-01-01

This paper responds to the Alpine Rendez-Vous "crisis" in technology-enhanced learning. It takes a contested area of policy as well as a rapid change in the National Health Service, and documents the responses to "information overload" by a group of general practitioners practices in the North of England. Located between the…

Is the Relationship between Common Mental Disorder and Adiposity Bidirectional? Prospective Analyses of a UK General Population-Based Study

PubMed Central

Fezeu, Léopold K.; Batty, David G.; Gale, Catharine R.; Kivimaki, Mika; Hercberg, Serge; Czernichow, Sebastien

2015-01-01

The direction of the association between mental health and adiposity is poorly understood. Our objective was to empirically examine this link in a UK study. This is a prospective cohort study of 3 388 people (men) aged ≥ 18 years at study induction who participated in both the UK Health and Lifestyle Survey at baseline (HALS-1, 1984/1985) and the re-survey (HALS-2, 1991/1992). At both survey examinations, body mass index, waist circumference and self-reported common mental disorder (the 30-item General Health Questionnaire, GHQ) were measured. Logistic regression models were used to compute odds ratios (OR) and accompanying 95% confidence intervals (CI) for the associations between (1) baseline common mental disorder (QHQ score > 4) and subsequent general and abdominal obesity and (2) baseline general and abdominal obesity and re-survey common mental disorders. After controlling for a range of covariates, participants with common mental disorder at baseline experienced greater odds of subsequently becoming overweight (women, OR: 1.30, 1.03 – 1.64; men, 1.05, 0.81 – 1.38) and obese (women, 1.26, 0.82 – 1.94; men, OR: 2.10, 1.23 – 3.55) than those who were free of common mental disorder. Similarly, having baseline common mental health disorder was also related to a greater risk of developing moderate (1.57, 1.21 – 2.04) and severe (1.48, 1.09 – 2.01) abdominal obesity (women only). Baseline general or abdominal obesity was not associated with the risk of future common mental disorder. These findings of the present study suggest that the direction of association between common mental disorders and adiposity is from common mental disorder to increased future risk of adiposity as opposed to the converse. PMID:25993130

The role of long-range transport and domestic emissions in determining atmospheric secondary inorganic particle concentrations across the UK

NASA Astrophysics Data System (ADS)

Vieno, M.; Heal, M. R.; Hallsworth, S.; Famulari, D.; Doherty, R. M.; Dore, A. J.; Tang, Y. S.; Braban, C. F.; Leaver, D.; Sutton, M. A.; Reis, S.

2014-08-01

Surface concentrations of secondary inorganic particle components over the UK have been analysed for 2001-2010 using the EMEP4UK regional atmospheric chemistry transport model and evaluated against measurements. Gas/particle partitioning in the EMEP4UK model simulations used a bulk approach, which may lead to uncertainties in simulated secondary inorganic aerosol. However, model simulations were able to accurately represent both the long-term decadal surface concentrations of particle sulfate and nitrate and an episode in early 2003 of substantially elevated nitrate measured across the UK by the AGANet network. The latter was identified as consisting of three separate episodes, each of less than 1 month duration, in February, March and April. The primary cause of the elevated nitrate levels across the UK was meteorological: a persistent high-pressure system, whose varying location impacted the relative importance of transboundary versus domestic emissions. Whilst long-range transport dominated the elevated nitrate in February, in contrast it was domestic emissions that mainly contributed to the March episode, and for the April episode both domestic emissions and long-range transport contributed. A prolonged episode such as the one in early 2003 can have substantial impact on annual average concentrations. The episode led to annual concentration differences at the regional scale of similar magnitude to those driven by long-term changes in precursor emissions over the full decade investigated here. The results demonstrate that a substantial part of the UK, particularly the south and southeast, may be close to or exceeding annual mean limit values because of import of inorganic aerosol components from continental Europe under specific conditions. The results reinforce the importance of employing multiple year simulations in the assessment of emissions reduction scenarios on particulate matter concentrations and the need for international agreements to address the transboundary component of air pollution.

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.

The Narrow Cold-Frontal Rainband of 22/23 November 2013

NASA Technical Reports Server (NTRS)

Kidd, Christopher

2015-01-01

The recent paper in Weather by Young (2014) provided a detailed analysis of an intensive cold front as it passed over the UK on 2223 November 2013. This was an extremely good example of linear convection, as it is described in the paper, or a narrow cold-frontal rainband (NCFR; Hobbs and Biswas, 1979). These features are associated with a low-level jet that lies ahead and parallel to the surface cold front, generating a band of intense but relatively shallow convection (see Koch and Kocin, 1991). Although the structure associated with these systems is not uncommon (e.g. Gatzen, 2011), this case was notable for the (linear) length and the longevity of the feature. Critically, fine-scale radar observations using the 1km, 5min UK composite radar product, produced by the UK Met Office and supplied by the British Atmospheric Data Centre, enabled the timing and progression of the most intense band of this feature tobe examined (see Figure 1).

The rationale for simple approaches for sustainability assessment and management in contaminated land practice.

PubMed

Bardos, R Paul; Bone, Brian D; Boyle, Richard; Evans, Frank; Harries, Nicola D; Howard, Trevor; Smith, Jonathan W N

2016-09-01

The scale of land-contamination problems, and of the responses to them, makes achieving sustainability in contaminated land remediation an important objective. The Sustainable Remediation Forum in the UK (SuRF-UK) was established in 2007 to support more sustainable remediation practice in the UK. The current international interest in 'sustainable remediation' has achieved a fairly rapid consensus on concepts, descriptions and definitions for sustainable remediation, which are now being incorporated into an ISO standard. However the sustainability assessment methods being used remain diverse with a range of (mainly) semi-quantitative and quantitative approaches and tools developed, or in development. Sustainability assessment is site specific and subjective. It depends on the inclusion of a wide range of considerations across different stakeholder perspectives. Taking a tiered approach to sustainability assessment offers important advantages, starting from a qualitative assessment and moving through to semi-quantitative and quantitative assessments on an 'as required' basis only. It is also clear that there are a number of 'easy wins' that could improve performance against sustainability criteria right across the site management process. SuRF-UK has provided a checklist of 'sustainable management practices' that describes some of these. This paper provides the rationale for, and an outline of, and recently published SuRF-UK guidance on preparing for and framing sustainability assessments; carrying out qualitative sustainability assessment; and simple good management practices to improve sustainability across contaminated land management activities. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Alien To Me? Science in Search for Life Beyond Earth and Perceptions of Alien Life in Popular Culture

NASA Astrophysics Data System (ADS)

Capova, K. A.

2013-09-01

The paper will introduce an original piece of research that is devoted to the socio-cultural aspects of scientifi c search for life in outer space and it draws from doctoral research in anthropology of science. In this piece of research the extraterrestrial life hypothesis is conceptualized as a significant part of the general world-view, constantly shaped by the work and discoveries of science. The paper presents data from qualitative ethnographic fieldwork conducted in the UK as well as uses quantitative data from public from the USA, UK and other countries.

UK Renal Registry 15th annual report: Chapter 5 survival and causes of death of UK adult patients on renal replacement therapy in 2011: national and centre-specific analyses.

PubMed

Steenkamp, Retha; Shaw, Catriona; Feest, Terry

2013-01-01

These analyses examine a) survival from the start of renal replacement therapy (RRT) based on the total incident UK RRT population reported to the UK Renal Registry, b) survival of prevalent patients. Changes in survival between 1997 and 2011 are also reported. Survival was calculated for both incident and prevalent patients on RRT and compared between the UK countries after adjustment for age. Survival of incident patients (starting RRT during 2010) was calculated both from the start of RRT and from 90 days after starting RRT, both with and without censoring at transplantation. Prevalent dialysis patients were censored at transplantation; this means that the patient is considered alive up to the point of transplantation, but the patient's status post-transplant is not considered. Both Kaplan-Meier and Cox adjusted models were used to calculate survival. Causes of death were analysed for both groups. The relative risk of death was calculated compared with the general UK population. The unadjusted 1 year after 90 day survival for patients starting RRT in 2010 was 87.3%, representing an increase from the previous year (86.6%). In incident patients aged 18-64 years, the unadjusted 1 year survival had risen from 86.0% in patients starting RRT in 1997 to 92.6% in patients starting RRT in 2010 and for those aged ≥65 it had increased from 63.9% to 77.0% over the same period. The age-adjusted one year survival (adjusted to age 60) of prevalent dialysis patients increased from 88.1% in the 2001 cohort to 89.8% in the 2010 cohort. Prevalent diabetic patient one year survival rose from 82.1% in the 2002 cohort to 84.7% in the 2010 cohort. The age-standardised mortality ratio for prevalent RRT patients compared with the general population was 18 for age group 30-34 and 2.5 at age 85+ years. In the prevalent RRT dialysis population, cardiovascular disease accounted for 22% of deaths, infection and treatment withdrawal 18% each and 25% were recorded as other causes of death. Treatment withdrawal was a more frequent cause of death in those incident patients aged ≥65 than in younger patients. The median life years remaining for a 25-29 year old on RRT was 18 years and approximately three years for a 75+ year old. Survival of patients starting RRT has improved in the 2010 incident cohort. The relative risk of death on RRT compared with the general population has fallen since 2001. Copyright © 2013 S. Karger AG, Basel.

Does the private sector receive an excessive return from investments in health care infrastructure projects? Evidence from the UK.

PubMed

Vecchi, Veronica; Hellowell, Mark; Gatti, Stefano

2013-05-01

This paper is concerned with the cost-efficiency of Private Finance Initiatives (PFIs) in the delivery of hospital facilities in the UK. We outline a methodology for identifying the "fair" return on equity, based on the Weighted Average Cost of Capital (WACC) of each investor. We apply this method to assess the expected returns on a sample of 77 contracts signed between 1997 and 2011 by health care provider organisations in the UK. We show that expected returns are in general in excess of the WACC benchmarks. The findings highlight significant problems in current procurement practices and the methodologies by which bids are assessed. To minimise the financial impact of hospital investments on health care systems, a regulatory regime must ensure that expected returns are set at the "fair" rate. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Clinical examination & record-keeping: Part 2: History taking.

PubMed

Hadden, A M

2017-12-15

This article is the second part of a BDJ series of Practice papers on the subject of clinical examination and related record keeping. The series is taken from the Faculty of General Dental Practice UK (FGDP[UK]) 2016 Good Practice Guidelines book on this topic, edited by A. M. Hadden. This particular article discusses history taking, where information may be gathered prior to the patient seeing the clinician or, in some cases, this may be carried out chairside by the individual. The information gathered can include a medical history, socio-behavioural history, and patient anxiety levels. It is important to note that throughout this article (and the BDJ series and associated FGDP[UK] book), the specific guidelines will be marked as follows: A: Aspirational, B: Basic, C: Conditional. Further information about this guideline notation system is provided in Part 1 of this series ( 2017; 223: 765-768).

History of Inclusive Design in the UK.

PubMed

John Clarkson, P; Coleman, Roger

2015-01-01

The UK Design Council describes Inclusive Design as neither a new genre of design, nor a separate specialism, but as a general approach to designing in which designers ensure that their products and services address the needs of the widest possible audience, irrespective of age or ability. Inclusive Design (also known [in Europe] as Design for All and as Universal Design in the USA) is in essence the inverse of earlier approaches to designing for disabled and elderly people as a sub-set of the population, and an integral part of a more recent international trend towards the integration of older and disabled people in the mainstream of society. This paper describes the development of Inclusive Design in the UK, from its early beginnings, through its subsequent adoption as a topic of academic research, leading to its recent emergence embodied as a framework and toolkit for design. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

How do directors of public health perceive leadership?

PubMed

McAreav, M J; Alimo-Metcalfe, B; Connelly, J

2001-01-01

This study examines how directors of public health (DsPH) perceive effective leadership. Kelly's repertory grid technique is used. A total of 13 out of a possible 14 DsPH in one NHS region of England were interviewed. Qualitative and quantitative analysis were carried out. The findings show that male DsPH (n = 8) rate their leadership ability more highly than do female DsPH (n = 5). Qualitative analysis produced a number of categories of constructs, some of which are perceived to be indicative of effective leadership, these being "working for others", "personal attributes", "vision and innovation" and "courage and integrity" Some categories appear to be applicable only to the UK (or to public health) and not to the existing dominant US models of leadership. In general, DsPH perceptions of effective leadership converge with current theories; most specifically the UK-based theories. This study therefore refutes any simple extrapolation of US theories of leadership to UK health organisations.

Soundscape in the sustainable living environment: A cross-cultural comparison between the UK and Taiwan.

PubMed

Yu, Chia-Jen; Kang, Jian

2014-06-01

This study examines the effects of cultural factors on the evaluation of acoustic quality of residential areas, within the context of general environmental conditions. A comparative study was carried out between the UK and Taiwan, through questionnaire surveys at three stages, namely in selected residential areas, with respondents in their place of work/study, and using a web-based survey, respectively. This study reveals the importance of considering cultural factors, as well as their living experiences. This is reflected by the significant differences between the two cultures in a number of aspects, including choosing and evaluating living environment, noise noticeability, annoyance and sleep disturbance, activities, and sound preference. It is interesting to note the factor 'quiet' is an important consideration compared to other factors, in both the UK and Taiwan. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.

Advance directives in the UK: legal, ethical, and practical considerations for doctors.

PubMed

Kessel, A S; Meran, J

1998-05-01

In the United Kingdom (UK), advance directives have recently received considerable attention from professional and voluntary organizations as well as medical journals and the media. However, despite such exposure, many doctors remain uncertain of the importance or relevance of advance directives with regard to their own clinical practice. This paper addresses these uncertainties by first explaining what advance directives are and then describing the current legal status of such directives in the UK. Examination of the cases underpinning this status reveals several key elements: competence, information, anticipation, applicability, and freedom from duress. Each is discussed. Although this paper focuses on legal issues, it is important that medical law does not dominate medical ethics. Accordingly, the paper also discusses some important philosophical and sociological considerations that have remained largely unexplored in the medical press. Finally, the paper deals with practical matters, including how the general practitioner might be involved.

Junior doctor dementia champions in a district general hospital (innovative practice).

PubMed

Wilkinson, Iain; Coates, Anna; Merrick, Sophie; Lee, Chooi

2016-03-01

Dementia is a common condition in the UK with around 25% of patients in acute hospitals having dementia. In the UK, there is national guidance on the assessment of cognitive impairment in acute hospitals. This article is a qualitative study of junior doctors' experiences as part of a dementia and delirium team involved in changing the care of patients with dementia in a hospital in the UK. It draws on data from a focus group and follow-up questionnaire in two hospital trusts. We examine what drives doctors to become involved in such projects and the effects of this experience upon them. We suggest a typology for getting junior doctors involved in projects generating change when working with patients with dementia. Being more actively involved in caring for and developing services for patients with dementia may represent the crossing of an educational threshold for these junior doctors. © The Author(s) 2016.

Socio-economic position and common mental disorders. Longitudinal study in the general population in the UK.

PubMed

Skapinakis, Petros; Weich, Scott; Lewis, Glyn; Singleton, Nicola; Araya, Ricardo

2006-08-01

Individuals in lower socio-economic groups have an increased prevalence of common mental disorders. To investigate the longitudinal association between socio-economic position and common mental disorders in a general population sample in the UK. Participants (n=2406) were assessed at two time points 18 months apart with the Revised Clinical Interview Schedule. The sample was stratified into two cohorts according to mental health status at baseline. None of the socio-economic indicators studied was significantly associated with an episode of common mental disorder at follow-up after adjusting for baseline psychiatric morbidity. The analysis of separate diagnostic categories showed that subjective financial difficulties at baseline were independently associated with depression at follow-up in both cohorts. These findings support the view that apart from objective measures of socio-economic position, more subjective measures might be equally important from an aetiological or clinical perspective.

Family-friendly policies: general nurses' preferences and experiences.

PubMed

Robinson, Sarah; Davey, Barbara; Murrells, Trevor

2003-01-01

While European Union policy emphasises that one of the aims of family-friendly working arrangements is to increasing gender equality, in the UK the focus has been primarily on workforce retention. Drawing on a study of Registered General Nurses who returned to work after breaks for maternity leave, this paper considers their preferences and experiences in light of current UK family-friendly policies and the implications of the findings for increasing gender equality. Questionnaires were completed by respondents in three regional health authorities and focused on the four to eight year period after qualification. The following topics were investigated: views about length of maternity break and reasons for returning to work sooner than preferred; hours sought after a return and hours obtained; the availability of preferred patterns of work and of flexible hours; retention of grade on return; the availability and use of workplace crèches, and childcare arrangements when children were unwell.

CGAT: a model for immersive personalized training in computational genomics.

PubMed

Sims, David; Ponting, Chris P; Heger, Andreas

2016-01-01

How should the next generation of genomics scientists be trained while simultaneously pursuing high quality and diverse research? CGAT, the Computational Genomics Analysis and Training programme, was set up in 2010 by the UK Medical Research Council to complement its investment in next-generation sequencing capacity. CGAT was conceived around the twin goals of training future leaders in genome biology and medicine, and providing much needed capacity to UK science for analysing genome scale data sets. Here we outline the training programme employed by CGAT and describe how it dovetails with collaborative research projects to launch scientists on the road towards independent research careers in genomics. © The Author 2015. Published by Oxford University Press.

Universal scaling laws in metro area election results.

PubMed

Bokányi, Eszter; Szállási, Zoltán; Vattay, Gábor

2018-01-01

We explain the anomaly of election results between large cities and rural areas in terms of urban scaling in the 1948-2016 US elections and in the 2016 EU referendum of the UK. The scaling curves are all universal and depend on a single parameter only, and one of the parties always shows superlinear scaling and drives the process, while the sublinear exponent of the other party is merely the consequence of probability conservation. Based on the recently developed model of urban scaling, we give a microscopic model of voter behavior in which we replace diversity characterizing humans in creative aspects with social diversity and tolerance. The model can also predict new political developments such as the fragmentation of the left and the immigration paradox.

The Implications of Programme Assessment Patterns for Student Learning

ERIC Educational Resources Information Center

Jessop, Tansy; Tomas, Carmen

2017-01-01

Evidence from 73 programmes in 14 U.K universities sheds light on the typical student experience of assessment over a three-year undergraduate degree. A previous small-scale study in three universities characterised programme assessment environments using a similar method. The current study analyses data about assessment patterns using descriptive…

School Mathematics Qualifications and Work

ERIC Educational Resources Information Center

Drake, Pat; Noyes, Andrew; Wake, Geoff

2012-01-01

This article explores the relationship between school mathematics qualifications and the transition into employment. As part of a large-scale, three-year independent evaluation of pilot qualifications in 14-19 school mathematics, all 39 Sector Skills Councils and Employment Skills Boards in the UK were invited to provide evidence regarding their…

Gendered Trends in Student Teachers' Professional Aspirations

ERIC Educational Resources Information Center

Smith, Joan

2015-01-01

The paper reports on a small-scale, exploratory study investigating the professional aspirations of a cohort of student teachers at a UK university. Questionnaires and interviews sought insights into the students' perceptions of leadership, future aspirations and self-perceptions as potential leaders. Whilst there was commonality in male and…

Patterns and processes of Mycobacterium bovis evolution revealed by phylogenomic analyses

USDA-ARS?s Scientific Manuscript database

Mycobacterium bovis is an important animal pathogen worldwide that parasitizes wild and domesticated vertebrate livestock as well as humans. A comparison of the five M. bovis complete genomes from UK, South Korea, Brazil and USA revealed four novel large-scale structural variations of at least 2,000...

Can the UK Learn To Manage?

ERIC Educational Resources Information Center

Keep, Ewart; Westwood, Andy

The United Kingdom management population is a large and moving target. A growing number of individuals describe themselves as managers; the widely held view is there will be many, many more. Figures suggest the scale of the potential market and need for management education and training development (METD) is considerable. Levels of qualifications…

The impact of smokefree legislation in Scotland: results from the Scottish ITC Scotland/UK longitudinal surveys

PubMed Central

Hassan, Louise M.; Higbee, Cheryl; Boudreau, Christian; Fong, Geoffrey T.; Borland, Ron; Cummings, K. Michael; Yan, Mi; Thompson, Mary E.; Hastings, Gerard

2009-01-01

Background: To evaluate how Scotland's smokefree law impacted self-reported secondhand smoke (SHS) exposure in hospitality venues, workplaces and in people's homes. In addition, we examine changes in support for the law, pub and restaurant patronage, smoking cessation indicators and whether any observed changes varied by socioeconomic status. Methods: A quasi-experimental longitudinal telephone survey of nationally representative samples of smokers and non-smokers interviewed before the Scottish law (February to March 2006) and 1 year later after the law (March 2007) in Scotland (n = 705 smokers and n = 417 non-smokers) and the rest of the UK (n = 1027 smokers and n = 447 non-smokers) where smoking in public places was not regulated at the time. Results: Dramatic declines in the observance of smoking in pubs, restaurants and workplaces were found in Scotland relative to the rest of the UK. The change in the percent of smokers reporting a smokefree home and number of cigarettes smoked inside the home in the evening was comparable in Scotland and the rest of the UK. Support for smokefree policies increased to a greater extent in Scotland than in the rest of the UK. Self-reported frequency of going to pubs and restaurants was generally comparable between Scotland and the rest of the UK; however, non-smokers in Scotland were more likely to frequent pubs more often. No differences in smoking cessation indicators were observed between countries. Conclusion: The Scottish smokefree law has been successful in decreasing secondhand smoke exposure while causing none of the hypothesized negative outcomes. PMID:19151105

Stakeholder perspectives on the use of positron emission tomography in phase III oncology trials in the UK.

PubMed

Rojas-Anaya, Hector; Skogen, Karoline; Miles, Kenneth Alan

2012-06-01

To identify factors that influence the use of PET in phase III oncology trials in the UK by evaluating stakeholder perspectives. A wide range of UK PET research stakeholders with a potential interest in the use of PET in phase III trials were identified and invited to participate. These UK PET research stakeholders were consulted using a semistructured questionnaire on their personal experience with and involvement in PET research, the role of PET in phase III oncology clinical trials and on the promotion of UK PET research and unmet clinical needs in oncology. Responses were analysed quantitatively and by qualitative content analysis of free-text responses. A total of 118 responses were received from a wide range of stakeholders representing several professional groups and working environments. Of these respondents, 49 (42%) were using PET in their research. There was the general perception that using PET in clinical research is beneficial in oncology. The two major barriers identified were poor availability of PET and perceived difficulties in funding of excess treatment costs (75% of respondents). Other factors included limited coverage of PET in training, uncertainty about developing imaging protocols or the status of tracers other than 18F-fluorodeoxyglucose, and low awareness of the role of PET in patient selection for therapeutic trials. Patient concerns about radiation were not perceived as a research barrier. Interventions that improve the availability and funding pathways for PET research scans and that increase researcher awareness could help promote the use of PET for phase III oncology trials in the UK.

The health of UK civilians deployed to Iraq

PubMed Central

Fear, Nicola T.; Cawkill, Paul; Jones, Norman; Greenberg, Neil; Wessely, Simon

2017-01-01

Abstract Background: Modern military operations have incorporated deployed civilians in a variety of roles (e.g. diplomats, private security staff). Many of these roles expose individuals to potentially dangerous or traumatic events. Evidence has shown that such exposures can cause psychological health problems in military personnel. It is likely that the same would be seen among civilians working in such environments. There is however limited research into the health of civilians deployed to war zones. This study compared health outcomes and related behaviours among UK regular and reserve Army personnel with UK civilian personnel deployed in direct support of the UK military in Iraq. Methods: The study sample comprised of 159 Ministry of Defence civilians, 1542 Army regulars and 408 Army reservists, all of whom served in non-combat roles. Data were gathered by questionnaires which asked about deployment experiences, lifestyle factors and health outcomes [i.e. post-traumatic stress disorder (PTSD), general health, multiple physical symptoms and alcohol use]. Results: Fewer deployed UK civilians smoked than regular Army personnel (adjusted OR 0.83 95% CI 0.70–0.98). UK civilians had better overall health and were less likely to report multiple physical symptoms compared with reservists (adjusted ORs 0.64 95% CI 0.44–0.93 and 0.60 95% CI 0.39–0.93, respectively). Conclusions: Overall, the psychological health of deployed civilians appears to be better than that of Army personnel deployed in non-combat roles. Civilians are also less likely to engage in some risky behaviours. PMID:27452892

Evaluation of the educational climate for specialty trainees in dermatology.

PubMed

Goulding, J M R; Passi, V

2016-06-01

Dermatology specialty trainees (STs) in the United Kingdom (UK) are few in number and will join a thinly spread national consultant body. It is of paramount importance to deliver training programmes of the highest quality for these doctors, central to which is the establishment and maintenance of an educational climate conducive to learning. To conduct a pilot study to evaluate the educational climate for dermatology STs in one UK deanery (West Midlands). Secondary analysis of published data was performed, from the UK's General Medical Council (GMC) national training survey, and the Job Evaluation Survey Tool (JEST) administered by the West Midlands deanery. A modified online version of the Postgraduate Hospital Educational Environment Measure (PHEEM) was circulated among dermatology STs. The GMC's survey data show that UK dermatology STs rated their training highly in comparison with undifferentiated UK postgraduate trainees. West Midlands dermatology STs (n = 22) scored very similarly to UK dermatology STs. The JEST gave broadly encouraging results, with 21/22 (95%) happy to recommend their posts to colleagues. The modified PHEEM yielded a global mean score of 96.5/152, attracting the descriptor 'more positive than negative but room for improvement'. Despite inherent methodological limitations, the GMC, JEST and modified PHEEM surveys have revealed useful comparative triangulated data which allows the conclusion that West Midlands dermatology STs seem to be training in a favourable educational climate. This represents an important facet of the quality assurance process for medical education, and allows insight into areas which may require improvement. © 2015 European Academy of Dermatology and Venereology.

Availability and Use of Cheap Tobacco in the United Kingdom 2002-2014: Findings From the International Tobacco Control Project.

PubMed

Partos, Timea R; Gilmore, Anna B; Hitchman, Sara C; Hiscock, Rosemary; Branston, J Robert; McNeill, Ann

2018-05-03

Raising tobacco prices is the most effective population-level intervention for reducing smoking, but this is undermined by the availability of cheap tobacco. This study monitors trends in cheap tobacco use among adult smokers in the United Kingdom between 2002 and 2014 via changes in product type, purchase source, and prices paid. Weighted data from 10 waves of the International Tobacco Control policy evaluation study were used. This is a longitudinal cohort study of adult smokers with replenishment; 6169 participants provided 15812 responses. Analyses contrasted (1) product type: roll-your-own (RYO) tobacco, factory-made packs (FM-P), and factory-made cartons (FM-C); (2) purchase source: UK store-based sources (e.g., supermarkets and convenience stores) with non-UK/nonstore sources representing tax avoidance/evasion (e.g., outside the UK, duty free, and informal sellers); and (3) prices paid (inflation-adjusted to 2014 values). Generalized estimating equations tested linear changes over time. (1) RYO use increased significantly over time as FM decreased. (2) UK store-based sources constituted approximately 80% of purchases over time, with no significant increases in tax avoidance/evasion. (3) Median RYO prices were less than half that of FM, with FM-C cheaper than FM-P. Non-UK/nonstore sources were cheapest. Price increases of all three product types from UK store-based sources from 2002 to 2014 were statistically significant but not substantial. Wide (and increasing for FM-P) price ranges meant each product type could be purchased in 2014 at prices below their 2002 medians from UK store-based sources. Options exist driving UK smokers to minimize their tobacco expenditure; smokers do so largely by purchasing cheap tobacco products from UK stores. The effectiveness of price increases as a deterrent to smoking is being undermined by the availability of cheap tobacco such as roll-your-own tobacco and cartons of packs of factory-made cigarettes. Wide price ranges allowed smokers in 2014 to easily obtain cigarettes at prices comparable to 12 years prior, without resorting to tax avoidance or evasion. UK store-based sources accounted for 80% or more of all tobacco purchases between 2002 and 2014, suggesting little change in tax avoidance or evasion over time. There was a widening price range between the cheapest and most expensive factory-made cigarettes.

Availability and Use of Cheap Tobacco in the United Kingdom 2002–2014: Findings From the International Tobacco Control Project

PubMed Central

Partos, Timea R; Gilmore, Anna B; Hitchman, Sara C; Hiscock, Rosemary; Branston, J Robert; McNeill, Ann

2018-01-01

Abstract Introduction Raising tobacco prices is the most effective population-level intervention for reducing smoking, but this is undermined by the availability of cheap tobacco. This study monitors trends in cheap tobacco use among adult smokers in the United Kingdom between 2002 and 2014 via changes in product type, purchase source, and prices paid. Methods Weighted data from 10 waves of the International Tobacco Control policy evaluation study were used. This is a longitudinal cohort study of adult smokers with replenishment; 6169 participants provided 15812 responses. Analyses contrasted (1) product type: roll-your-own (RYO) tobacco, factory-made packs (FM-P), and factory-made cartons (FM-C); (2) purchase source: UK store-based sources (e.g., supermarkets and convenience stores) with non-UK/nonstore sources representing tax avoidance/evasion (e.g., outside the UK, duty free, and informal sellers); and (3) prices paid (inflation-adjusted to 2014 values). Generalized estimating equations tested linear changes over time. Results (1) RYO use increased significantly over time as FM decreased. (2) UK store-based sources constituted approximately 80% of purchases over time, with no significant increases in tax avoidance/evasion. (3) Median RYO prices were less than half that of FM, with FM-C cheaper than FM-P. Non-UK/nonstore sources were cheapest. Price increases of all three product types from UK store-based sources from 2002 to 2014 were statistically significant but not substantial. Wide (and increasing for FM-P) price ranges meant each product type could be purchased in 2014 at prices below their 2002 medians from UK store-based sources. Conclusions Options exist driving UK smokers to minimize their tobacco expenditure; smokers do so largely by purchasing cheap tobacco products from UK stores. Implications The effectiveness of price increases as a deterrent to smoking is being undermined by the availability of cheap tobacco such as roll-your-own tobacco and cartons of packs of factory-made cigarettes. Wide price ranges allowed smokers in 2014 to easily obtain cigarettes at prices comparable to 12 years prior, without resorting to tax avoidance or evasion. UK store-based sources accounted for 80% or more of all tobacco purchases between 2002 and 2014, suggesting little change in tax avoidance or evasion over time. There was a widening price range between the cheapest and most expensive factory-made cigarettes. PMID:28525594

Genetics, lifestyle and environment. UK Biobank is an open access resource following the lives of 500,000 participants to improve the health of future generations.

PubMed

Trehearne, Andrew

2016-03-01

UK Biobank is a long-term prospective epidemiology study having recruited and now following the lives of 500,000 people in England, Scotland and Wales, aged 40-69 years when they joined the study (Sudlow et al., PLoS Med 12(3):e1001779, 2015). Participants were recruited by letter and asked to attend one of 22 assessment centres in towns and cities across Britain, where they provided consent, answered detailed questions about their health and lifestyle, had body measures taken and donated blood, urine and saliva. Participants provided consent for the long-term follow-up of their health via medical records, such as general practice and hospital records, cancer and death records. Samples are being stored long term for a wide range of analyses, including genetic. The resource is open to all bona fide scientists from the UK and overseas, academic and industry who register via its access management system. Summary of UK Biobank data can be viewed via its Data Showcase and the resource will be strengthened over time as the results of new analyses and studies are returned, health links and participants provide additional information about themselves. Some will attend full repeat assessment visits. UK Biobank is open for business, and it hopes researchers will find it a valuable tool to improve the health of future generations.

Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials.

PubMed

Clark, Catharine H; Aird, Edwin G A; Bolton, Steve; Miles, Elizabeth A; Nisbet, Andrew; Snaith, Julia A D; Thomas, Russell A S; Venables, Karen; Thwaites, David I

2015-01-01

Dosimetry audit plays an important role in the development and safety of radiotherapy. National and large scale audits are able to set, maintain and improve standards, as well as having the potential to identify issues which may cause harm to patients. They can support implementation of complex techniques and can facilitate awareness and understanding of any issues which may exist by benchmarking centres with similar equipment. This review examines the development of dosimetry audit in the UK over the past 30 years, including the involvement of the UK in international audits. A summary of audit results is given, with an overview of methodologies employed and lessons learnt. Recent and forthcoming more complex audits are considered, with a focus on future needs including the arrival of proton therapy in the UK and other advanced techniques such as four-dimensional radiotherapy delivery and verification, stereotactic radiotherapy and MR linear accelerators. The work of the main quality assurance and auditing bodies is discussed, including how they are working together to streamline audit and to ensure that all radiotherapy centres are involved. Undertaking regular external audit motivates centres to modernize and develop techniques and provides assurance, not only that radiotherapy is planned and delivered accurately but also that the patient dose delivered is as prescribed.

Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials

PubMed Central

Aird, Edwin GA; Bolton, Steve; Miles, Elizabeth A; Nisbet, Andrew; Snaith, Julia AD; Thomas, Russell AS; Venables, Karen; Thwaites, David I

2015-01-01

Dosimetry audit plays an important role in the development and safety of radiotherapy. National and large scale audits are able to set, maintain and improve standards, as well as having the potential to identify issues which may cause harm to patients. They can support implementation of complex techniques and can facilitate awareness and understanding of any issues which may exist by benchmarking centres with similar equipment. This review examines the development of dosimetry audit in the UK over the past 30 years, including the involvement of the UK in international audits. A summary of audit results is given, with an overview of methodologies employed and lessons learnt. Recent and forthcoming more complex audits are considered, with a focus on future needs including the arrival of proton therapy in the UK and other advanced techniques such as four-dimensional radiotherapy delivery and verification, stereotactic radiotherapy and MR linear accelerators. The work of the main quality assurance and auditing bodies is discussed, including how they are working together to streamline audit and to ensure that all radiotherapy centres are involved. Undertaking regular external audit motivates centres to modernize and develop techniques and provides assurance, not only that radiotherapy is planned and delivered accurately but also that the patient dose delivered is as prescribed. PMID:26329469

The Practicalities of Crowdsourcing: Lessons from the Tea Bag Index - UK

NASA Astrophysics Data System (ADS)

Duddigan, Sarah; Alexander, Paul; Shaw, Liz; Collins, Chris

2017-04-01

The Tea Bag Index -UK is a collaborative project between the University of Reading and the Royal Horticultural Society (RHS), working with members of the gardening community as citizen scientists. This project aims to quantify how decomposition varies across the country, and whether decomposition is influenced by how gardeners manage their soil, particularly with respect to the application of compost. Launched in 2015 as part of a PhD project, the Tea Bag Index- UK project asks willing volunteers to bury tea bags in their gardens, as part of a large scale, litter bag style decomposition rate study. Over 450 sets of tea bags have been dispatched to participants, across the length and breadth of the UK. The group was largely recruited via social media, magazine articles and public engagement events and active discourse was undertaken with these citizen scientists using Facebook, Twitter and regular email communication. In order to run a successful crowdsourcing citizen science project there are number of stages that need to be considered including (but not limited to): planning; launch and recruitment; communications; and feedback. Throughout a project of this nature an understanding of the motivations of your volunteers is vital. Reflecting on these motivations while publicising the project, and communicating regularly with its participants is incredibly important for a successful project.

How will Brexit affect health and health services in the UK? Evaluating three possible scenarios.

PubMed

Fahy, Nick; Hervey, Tamara; Greer, Scott; Jarman, Holly; Stuckler, David; Galsworthy, Mike; McKee, Martin

2017-11-04

The process of leaving the European Union (EU) will have profound consequences for health and the National Health Service (NHS) in the UK. In this paper, we use the WHO health system building blocks framework to assess the likely effects of three scenarios we term soft Brexit, hard Brexit, and failed Brexit. We conclude that each scenario poses substantial threats. The workforce of the NHS is heavily reliant on EU staff. Financing of health care for UK citizens in the EU and vice versa is threatened, as is access to some capital funds, while Brexit threatens overall economic performance. Access to pharmaceuticals, technology, blood, and organs for transplant is jeopardised. Information used for international comparisons is threatened, as is service delivery, especially in Northern Ireland. Governance concerns relate to public health, competition and trade law, and research. However, we identified a few potential opportunities for improvement in areas such as competition law and flexibility of training, should the UK Government take them. Overall, a soft version of Brexit would minimise health threats whereas failed Brexit would be the riskiest outcome. Effective parliamentary scrutiny of policy and legal changes will be essential, but the scale of the task risks overwhelming parliament and the civil service. Copyright © 2017 Elsevier Ltd. All rights reserved.

Multisource feedback questionnaires in appraisal and for revalidation: a qualitative study in UK general practice

PubMed Central

Hill, Jacqueline J; Asprey, Anthea; Richards, Suzanne H; Campbell, John L

2012-01-01

Background UK revalidation plans for doctors include obtaining multisource feedback from patient and colleague questionnaires as part of the supporting information for appraisal and revalidation. Aim To investigate GPs' and appraisers' views of using multisource feedback data in appraisal, and of the emerging links between multisource feedback, appraisal, and revalidation. Design and setting A qualitative study in UK general practice. Method In total, 12 GPs who had recently completed the General Medical Council multisource feedback questionnaires and 12 appraisers undertook a semi-structured, telephone interview. A thematic analysis was performed. Results Participants supported multisource feedback for formative development, although most expressed concerns about some elements of its methodology (for example, ‘self’ selection of colleagues, or whether patients and colleagues can provide objective feedback). Some participants reported difficulties in understanding benchmark data and some were upset by their scores. Most accepted the links between appraisal and revalidation, and that multisource feedback could make a positive contribution. However, tensions between the formative processes of appraisal and the summative function of revalidation were identified. Conclusion Participants valued multisource feedback as part of formative assessment and saw a role for it in appraisal. However, concerns about some elements of multisource feedback methodology may undermine its credibility as a tool for identifying poor performance. Proposals linking multisource feedback, appraisal, and revalidation may limit the use of multisource feedback and appraisal for learning and development by some doctors. Careful consideration is required with respect to promoting the accuracy and credibility of such feedback processes so that their use for learning and development, and for revalidation, is maximised. PMID:22546590

Multisource feedback questionnaires in appraisal and for revalidation: a qualitative study in UK general practice.

PubMed

Hill, Jacqueline J; Asprey, Anthea; Richards, Suzanne H; Campbell, John L

2012-05-01

UK revalidation plans for doctors include obtaining multisource feedback from patient and colleague questionnaires as part of the supporting information for appraisal and revalidation. To investigate GPs' and appraisers' views of using multisource feedback data in appraisal, and of the emerging links between multisource feedback, appraisal, and revalidation. A qualitative study in UK general practice. In total, 12 GPs who had recently completed the General Medical Council multisource feedback questionnaires and 12 appraisers undertook a semi-structured, telephone interview. A thematic analysis was performed. Participants supported multisource feedback for formative development, although most expressed concerns about some elements of its methodology (for example, 'self' selection of colleagues, or whether patients and colleagues can provide objective feedback). Some participants reported difficulties in understanding benchmark data and some were upset by their scores. Most accepted the links between appraisal and revalidation, and that multisource feedback could make a positive contribution. However, tensions between the formative processes of appraisal and the summative function of revalidation were identified. Participants valued multisource feedback as part of formative assessment and saw a role for it in appraisal. However, concerns about some elements of multisource feedback methodology may undermine its credibility as a tool for identifying poor performance. Proposals linking multisource feedback, appraisal, and revalidation may limit the use of multisource feedback and appraisal for learning and development by some doctors. Careful consideration is required with respect to promoting the accuracy and credibility of such feedback processes so that their use for learning and development, and for revalidation, is maximised.