Healthcare access and mobility between the UK and other European Union states: an 'implementation surplus'.

PubMed

Sheaff, R

1997-12-01

European Union (EU) policy on mobility requires ensuring healthcare access for EU residents who travel between EU states. This case-study investigates how this policy has been implemented in respect of EU visitors to the UK. EU visitors to the UK have similar access to 'immediately needed' National Health Service (NHS) healthcare to UK residents. For non-urgent healthcare, the NHS has official systems to discourage 'medical tourism' and divert such patients to the private sector or to reclaim the costs of NHS hospital treatment for EU visitors. Yet these official systems contrast with the flexibility and liberality of actual NHS practice towards EU visitors. Research on health policy implementation mostly examines reasons for 'implementation failure'. However, the present study indicates a health policy being implemented more fully than policy-makers may have anticipated. In the case of healthcare access for EU visitors to the UK, an implementation surplus is evident rather than an implementation deficit.

Followership among UK Secondary School Teachers

ERIC Educational Resources Information Center

Francis, Andrew

2014-01-01

This paper reports the preliminary findings of an exploratory study which investigates the followership of longstanding, classroom-based school teachers working in the UK secondary education sector. Using Gronn's (1999) educational leadership formation model as a frame of reference, the study employs a multiple case study methodology with data…

Infant birthweight and risk of childhood cancer: international population-based case control studies of 40 000 cases.

PubMed

O'Neill, Kate A; Murphy, Michael Fg; Bunch, Kathryn J; Puumala, Susan E; Carozza, Susan E; Chow, Eric J; Mueller, Beth A; McLaughlin, Colleen C; Reynolds, Peggy; Vincent, Tim J; Von Behren, Julie; Spector, Logan G

2015-02-01

High birthweight is an established risk factor for childhood leukaemia. Its association with other childhood cancers is less clear, with studies hampered by low case numbers. We used two large independent datasets to explore risk associations between birthweight and all subtypes of childhood cancer. Data for 16 554 cases and 53 716 controls were obtained by linkage of birth to cancer registration records across five US states, and 23 772 cases and 33 206 controls were obtained from the UK National Registry of Childhood Tumours. US, but not UK, data were adjusted for gestational age, birth order, plurality, and maternal age and race/ethnicity. Risk associations were found between birthweight and several childhood cancers, with strikingly similar results between datasets. Total cancer risk increased linearly with each 0.5 kg increase in birthweight in both the US [odds ratio 1.06 (95% confidence interval 1.04, 1.08)] and UK [1.06 (1.05, 1.08)] datasets. Risk was strongest for leukaemia [USA: 1.10 (1.06, 1.13), UK: 1.07 (1.04, 1.10)], tumours of the central nervous system [USA: 1.05 (1.01, 1.08), UK: 1.07 (1.04, 1.10)], renal tumours [USA: 1.17 (1.10, 1.24), UK: 1.12 (1.06, 1.19)] and soft tissue sarcomas [USA: 1.12 (1.05, 1.20), UK: 1.07 (1.00, 1.13)]. In contrast, increasing birthweight decreased the risk of hepatic tumours [USA: 0.77 (0.69, 0.85), UK: 0.79 (0.71, 0.89) per 0.5 kg increase]. Associations were also observed between high birthweight and risk of neuroblastoma, lymphomas, germ cell tumours and malignant melanomas. For some cancer subtypes, risk associations with birthweight were non-linear. We observed no association between birthweight and risk of retinoblastoma or bone tumours. Approximately half of all childhood cancers exhibit associations with birthweight. The apparent independence from other factors indicates the importance of intrauterine growth regulation in the aetiology of these diseases. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Full length articles published in BJOMS during 2010-11--an analysis by sub-specialty and study type.

PubMed

Arakeri, Gururaj; Colbert, Serryth; Rosenbaum, Gavin; Brennan, Peter A

2012-12-01

Full length articles such as prospective and retrospective studies, case series, laboratory-based research and reviews form the majority of papers published in the British Journal of Oral and Maxillofacial Surgery (BJOMS). We were interested to evaluate the breakdown of these types of articles both by sub-specialty and the type of study as well as the proportion that are written by UK colleagues compared to overseas authors over a 2 year period (2010-11). A total of 191 full length articles across all sub-specialties of our discipline were published, with 107 papers (56%) coming from UK authors. There were proportionately more oncology papers arising from the UK than overseas (60 and 30% of total respectively) while the opposite was found for cleft/deformity studies (10% and 22%). There was only one laboratory-based study published from the UK compared with 27 papers from overseas. The number of quality papers being submitted to the Journal continues to increase, and the type of article being published between UK and overseas probably reflects different practices and case-loads amongst colleagues. The relatively few UK laboratory based studies published in BJOMS compared to overseas authors are most likely due to authors seeking the most prestigious journals possible for their work. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Spring viraemia of carp (SVC) in the UK: the road to freedom.

PubMed

Taylor, N G H; Peeler, E J; Denham, K L; Crane, C N; Thrush, M A; Dixon, P F; Stone, D M; Way, K; Oidtmann, B C

2013-08-01

Spring viraemia of carp (SVC) is a disease of international importance that predominantly affects cyprinid fish and can cause significant mortality. In the United Kingdom (UK), SVC was first detected in 1977 with further cases occurring in fisheries, farms, wholesale and retail establishments throughout England and Wales (but not Scotland, where few cyprinid populations exist, nor Northern Ireland where SVC has never been detected) over the subsequent 30 years. Following a control and eradication programme for the disease initiated in 2005, the UK was recognised free of the disease in 2010. This study compiles historic records of SVC cases in England and Wales with a view to understanding its routes of introduction and spread, and assessing the effectiveness of the control and eradication programme in order to improve contingency plans to prevent and control future disease incursions in the cyprinid fish sectors. Between 1977 and 2010 the presence of SVC was confirmed on 108 occasions, with 65 of the cases occurring in sport fisheries and the majority of the remainder occurring in the ornamental fish sector. The study found that throughout the history of SVC in the UK, though cases were widely distributed, their occurrence was sporadic and the virus did not become endemic. All evidence indicates that SVC was not able to persist under UK environmental conditions, suggesting that the majority of cases were a result of new introductions to the UK as opposed to within-country spread. The control and eradication programme adopted in 2005 was highly effective and two years after its implementation cases of SVC ceased. Given the non-persistent nature of the pathogen the most important aspect of the control programme focused on preventing re-introduction of the virus to the UK. Despite the effectiveness of these controls against SVC, this approach is likely to be less effective against more persistent pathogens such as koi herpesvirus, which are likely to require more stringent measures to prevent within-country spread. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.

Accuracy of a history of blood donation from surrogate witnesses: data from the UK TMER study.

PubMed

Mackenzie, J M; Turner, M; Morris, K; Field, S; Molesworth, A M; Pal, S; Will, R G; Llewelyn, C A; Hewitt, P E

2018-05-15

Look-back studies of blood transfusion in Creutzfeldt-Jakob disease commonly rely on reported history from surrogate witnesses. Data from the UK Transfusion Medicine Epidemiology Review have been analysed to determine the accuracy of the blood donation history provided by the relatives of cases. Our results show that only a small percentage of cases were found to be registered as donors on UK Blood Service (UKBS) databases when there was no family report of blood donation. In contrast, a history of reported donation was less accurate. © 2018 The Authors. Vox Sanguinis published by John Wiley & Sons Ltd on behalf of International Society of Blood Transfusion.

How a Regional Broker Can Improve Industry Demand for University Interaction: A Case Study of the London Technology Network

ERIC Educational Resources Information Center

Reid, Peter; Schofield, Matt

2006-01-01

UK university research produces highly cited publications (DTI, 2004), but demand from UK business for commercial ideas from academia is weak (HM Treasury, 2003). This paper reviews factors in the development of one regional UK technology broker, the London Technology Network (LTN), which has achieved significant and audited business demand. The…

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

ERIC Educational Resources Information Center

Ferguson, Morag

2014-01-01

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

Conducting retrospective impact analysis to inform a medical research charity’s funding strategies: the case of Asthma UK

PubMed Central

2013-01-01

Background Debate is intensifying about how to assess the full range of impacts from medical research. Complexity increases when assessing the diverse funding streams of funders such as Asthma UK, a charitable patient organisation supporting medical research to benefit people with asthma. This paper aims to describe the various impacts identified from a range of Asthma UK research, and explore how Asthma UK utilised the characteristics of successful funding approaches to inform future research strategies. Methods We adapted the Payback Framework, using it both in a survey and to help structure interviews, documentary analysis, and case studies. We sent surveys to 153 lead researchers of projects, plus 10 past research fellows, and also conducted 14 detailed case studies. These covered nine projects and two fellowships, in addition to the innovative case studies on the professorial chairs (funded since 1988) and the MRC-Asthma UK Centre in Allergic Mechanisms of Asthma (the ‘Centre’) which together facilitated a comprehensive analysis of the whole funding portfolio. We organised each case study to capture whatever academic and wider societal impacts (or payback) might have arisen given the diverse timescales, size of funding involved, and extent to which Asthma UK funding contributed to the impacts. Results Projects recorded an average of four peer-reviewed journal articles. Together the chairs reported over 500 papers. All streams of funding attracted follow-on funding. Each of the various categories of societal impacts arose from only a minority of individual projects and fellowships. Some of the research portfolio is influencing asthma-related clinical guidelines, and some contributing to product development. The latter includes potentially major breakthroughs in asthma therapies (in immunotherapy, and new inhaled drugs) trialled by university spin-out companies. Such research-informed guidelines and medicines can, in turn, contribute to health improvements. The role of the chairs and the pioneering collaborative Centre is shown as being particularly important. Conclusions We systematically demonstrate that all types of Asthma UK’s research funding assessed are making impacts at different levels, but the main societal impacts from projects and fellowships come from a minority of those funded. Asthma UK used the study’s findings, especially in relation to the Centre, to inform research funding strategies to promote the achievement of impact. PMID:23651523

Student-Led Enterprise Groups and Entrepreneurial Learning: A UK perspective

ERIC Educational Resources Information Center

Preedy, Sarah; Jones, Paul

2017-01-01

This study considers the phenomenon of student-led enterprise groups in UK higher education institutions with regard to their role and activities and their potential to enhance entrepreneurial learning. The researchers adopted a case study methodology, acknowledging that a multiplicity of variables influences pedagogical development and therefore…

International Students' Networks: A Case Study in a UK University

ERIC Educational Resources Information Center

Taha, Nashrawan; Cox, Andrew

2016-01-01

The great influx of international students into UK universities has led to internationalisation becoming an important issue. Previous studies have focused on the integration of home and international students, illustrating a lack of intercultural interaction. Yet there has been a lack of research investigating international students' networks and…

Testing a model of research intention among U.K. clinical psychologists: a logistic regression analysis.

PubMed

Eke, Gemma; Holttum, Sue; Hayward, Mark

2012-03-01

Previous research highlights barriers to clinical psychologists conducting research, but has rarely examined U.K. clinical psychologists. The study investigated U.K. clinical psychologists' self-reported research output and tested part of a theoretical model of factors influencing their intention to conduct research. Questionnaires were mailed to 1,300 U.K. clinical psychologists. Three hundred and seventy-four questionnaires were returned (29% response-rate). This study replicated in a U.K. sample the finding that the modal number of publications was zero, highlighted in a number of U.K. and U.S. studies. Research intention was bimodally distributed, and logistic regression classified 78% of cases successfully. Outcome expectations, perceived behavioral control and normative beliefs mediated between research training environment and intention. Further research should explore how research is negotiated in clinical roles, and this issue should be incorporated into prequalification training. © 2012 Wiley Periodicals, Inc.

Trapped in Transition: Findings from a UK Study of Student Suicide

ERIC Educational Resources Information Center

Stanley, Nicky; Mallon, Sharon; Bell, Jo; Manthorpe, Jill

2009-01-01

This study of student suicide within UK higher education directs attention to the community context of suicide. A modified psychological autopsy approach was used to explore 20 case studies of student suicide from the period 2000-2005, drawing on the perspectives of family members, friends and university staff. The study identifies features of the…

Designing a Curriculum Model for the Teaching of the Bible in UK Jewish Secondary Schools: A Case Study

ERIC Educational Resources Information Center

Kohn, Eli

2012-01-01

This paper describes the process of designing a curriculum model for Bible teaching in UK Jewish secondary schools. This model was designed over the period 2008-2010 by a team of curriculum specialists from the Jewish Curriculum Partnership UK in collaboration with a group of teachers from Jewish secondary schools. The paper first outlines the…

Patients with Learning Disabilities Who Lack Capacity Detained under the Mental Health Act in the UK: A Case Study

ERIC Educational Resources Information Center

Sawhney, Indermeet; Zia, Asif; Gates, Bob

2017-01-01

In the UK, the Mental Health Tribunal is a long-established safeguard for patients detained under the Mental Health Act. This gives such patients an effective appeal mechanism to ensure legal protection of their liberty. This act contains sections that allow for civil detention in the case of mental disorder. The right to apply to the tribunal…

Monocular and binocular visual impairment in the UK Biobank study: prevalence, associations and diagnoses.

PubMed

McKibbin, Martin; Farragher, Tracey M; Shickle, Darren

2018-01-01

To determine the prevalence of, associations with and diagnoses leading to mild visual impairment or worse (logMAR >0.3) in middle-aged adults in the UK Biobank study. Prevalence estimates for monocular and binocular visual impairment were determined for the UK Biobank participants with fundus photographs and spectral domain optical coherence tomography images. Associations with socioeconomic, biometric, lifestyle and medical variables were investigated for cases with visual impairment and matched controls, using multinomial logistic regression models. Self-reported eye history and image grading results were used to identify the primary diagnoses leading to visual impairment for a sample of 25% of cases. For the 65 033 UK Biobank participants, aged 40-69 years and with fundus images, 6682 (10.3%) and 1677 (2.6%) had mild visual impairment or worse in one or both eyes, respectively. Increasing deprivation, age and ethnicity were independently associated with both monocular and binocular visual impairment. No primary diagnosis for the recorded level of visual impairment could be identified for 49.8% of eyes. The most common identifiable diagnoses leading to visual impairment were cataract, amblyopia, uncorrected refractive error and vitreoretinal interface abnormalities. The prevalence of visual impairment in the UK Biobank study cohort is lower than for population-based studies from other industrialised countries. Monocular and binocular visual impairment are associated with increasing deprivation, age and ethnicity. The UK Biobank dataset does not allow confident identification of the causes of visual impairment, and the results may not be applicable to the wider UK population.

Monocular and binocular visual impairment in the UK Biobank study: prevalence, associations and diagnoses

PubMed Central

Farragher, Tracey M; Shickle, Darren

2018-01-01

Objective To determine the prevalence of, associations with and diagnoses leading to mild visual impairment or worse (logMAR >0.3) in middle-aged adults in the UK Biobank study. Methods and analysis Prevalence estimates for monocular and binocular visual impairment were determined for the UK Biobank participants with fundus photographs and spectral domain optical coherence tomography images. Associations with socioeconomic, biometric, lifestyle and medical variables were investigated for cases with visual impairment and matched controls, using multinomial logistic regression models. Self-reported eye history and image grading results were used to identify the primary diagnoses leading to visual impairment for a sample of 25% of cases. Results For the 65 033 UK Biobank participants, aged 40–69 years and with fundus images, 6682 (10.3%) and 1677 (2.6%) had mild visual impairment or worse in one or both eyes, respectively. Increasing deprivation, age and ethnicity were independently associated with both monocular and binocular visual impairment. No primary diagnosis for the recorded level of visual impairment could be identified for 49.8% of eyes. The most common identifiable diagnoses leading to visual impairment were cataract, amblyopia, uncorrected refractive error and vitreoretinal interface abnormalities. Conclusions The prevalence of visual impairment in the UK Biobank study cohort is lower than for population-based studies from other industrialised countries. Monocular and binocular visual impairment are associated with increasing deprivation, age and ethnicity. The UK Biobank dataset does not allow confident identification of the causes of visual impairment, and the results may not be applicable to the wider UK population. PMID:29657974

The Adoption and Diffusion of eLearning in UK Universities: A Comparative Case Study Using Giddens's Theory of Structuration

ERIC Educational Resources Information Center

Hardaker, Glenn; Singh, Gurmak

2011-01-01

Purpose: This exploratory study seeks to identify the factors that influence the adoption and diffusion of instructional technology at five prominent universities in the UK. The study aims to examine the organisational factors that enable and inhibit organisational adoption and diffusion of innovation. Design/methodology/approach: A qualitative…

A Case Study of Japanese Language Teaching in a Multicultural Learning Environment

ERIC Educational Resources Information Center

Winch, Junko

2016-01-01

An increasing number of international students, whose teaching and learning practices are very different from that of the UK, is studying in the U.K. This study poses the question of whether Communicative Language Teaching (CLT) is the most optimum language teaching approach in today's multicultural society regardless of cultural differences. The…

Variant CJD

PubMed Central

Diack, Abigail B; Head, Mark W; McCutcheon, Sandra; Boyle, Aileen; Knight, Richard; Ironside, James W; Manson, Jean C; Will, Robert G

2014-01-01

It is now 18 years since the first identification of a case of vCJD in the UK. Since that time, there has been much speculation over how vCJD might impact human health. To date there have been 177 case reports in the UK and a further 51 cases worldwide in 11 different countries. Since establishing that BSE and vCJD are of the same strain of agent, we have also shown that there is broad similarity between UK and non-UK vCJD cases on first passage to mice. Transgenic mouse studies have indicated that all codon 129 genotypes are susceptible to vCJD and that genotype may influence whether disease appears in a clinical or asymptomatic form, supported by the appearance of the first case of potential asymptomatic vCJD infection in a PRNP 129MV patient. Following evidence of blood transfusion as a route of transmission, we have ascertained that all blood components and leucoreduced blood in a sheep model of vCJD have the ability to transmit disease. Importantly, we recently established that a PRNP 129MV patient blood recipient with an asymptomatic infection and limited PrPSc deposition in the spleen could readily transmit disease into mice, demonstrating the potential for peripheral infection in the absence of clinical disease. This, along with the recent appendix survey which identified 16 positive appendices in a study of 32 441 cases, underlines the importance of continued CJD surveillance and maintaining control measures already in place to protect human health. PMID:25495404

Snakebite enquiries to the UK National Poisons Information Service: 2004-2010.

PubMed

Coulson, James Michael; Cooper, Gillian; Krishna, Channarayapatna; Thompson, John Paul

2013-11-01

To describe trends regarding snakebite enquiries to the UK National Poisons Information Service (NPIS) from 2004 to 2010. The NPIS telephone enquiry database, the UK Poisons Information Database, was interrogated for enquiries to the four NPIS units from 2004 to 2010. Search terms used were 'snake' and 'snakebite'. Information from the national dataset was available from Cardiff and Edinburgh units from 2004 onwards, Birmingham from June 2005 and Newcastle from September 2006. Five hundred and ten cases were identified, of which 69% were male and 31% female. Average age of cases was 32 years (±1 95% CI). The snake was identified as follows: British Adder in 52% of cases, an exotic species in 26%, unknown in 18% and another UK snake in 4%. 82% of cases occurred between the months of April and September. Cases peaked during August (19%). Forty-two per cent of enquiries involved features of envenoming. Eighty-five cases were assessed as requiring antivenom. Eighty-four cases received treatment with antivenom. No adverse reactions to the antivenom were reported and resolution of clinical features was reported in all treated cases. Advice to use an antidote was followed in 98.8% of cases. Snakebites account for one to two NPIS cases per week. Adder bites account for over half of cases. A quarter of cases were due to non-UK snakes kept in captivity within the UK. Envenoming was said to have occurred in just under half of all cases. Advice given by the NPIS appears to closely reflect national practice guidelines.

The costs of managing genital warts in the UK by devolved nation: England, Scotland, Wales and Northern Ireland.

PubMed

Coles, V A H; Chapman, R; Lanitis, T; Carroll, S M

2016-01-01

Genital warts, 90% of which are caused by human papillomavirus types 6 and 11, are a significant problem in the UK. The cost of managing genital warts was previously estimated at £52.4 million for 2010. The objective of this study was to estimate the cost of genital warts management up to 2012 in the UK and by jurisdiction. Population statistics and the number of reported genital warts cases in genito-urinary medicine clinics were obtained and extrapolated to 2012. Cases of genital warts treated in primary care were estimated from The Health Improvement Network database. The number of visits and therapy required were estimated by genito-urinary medicine experts. Costs were obtained from the appropriate national tariffs. The model estimated there were 220,875 genital warts cases in the UK in 2012, costing £58.44 million (£265/patient). It estimated 157,793 cases in England costing £41.74 million; 7468 cases in Scotland costing £1.90 million; 7095 cases in Wales costing £1.87 million; and 3621 cases in Northern Ireland costing £948,000. The full National Health Service costs for the management of genital warts have never previously been estimated separately for each jurisdiction. Findings reveal a significant economic burden, which is important to quantify when understanding the value of quadrivalent human papilloma virus vaccination. © The Author(s) 2015.

Research impact in the community-based health sciences: an analysis of 162 case studies from the 2014 UK Research Excellence Framework.

PubMed

Greenhalgh, Trisha; Fahy, Nick

2015-09-21

The 2014 UK Research Excellence Framework (REF2014) generated a unique database of impact case studies, each describing a body of research and impact beyond academia. We sought to explore the nature and mechanism of impact in a sample of these. The study design was manual content analysis of a large sample of impact case studies (producing mainly quantitative data), plus in-depth interpretive analysis of a smaller sub-sample (for qualitative detail), thereby generating both breadth and depth. For all 162 impact case studies submitted to sub-panel A2 in REF2014, we extracted data on study design(s), stated impacts and audiences, mechanisms of impact, and efforts to achieve impact. We analysed four case studies (selected as exemplars of the range of approaches to impact) in depth, including contacting the authors for their narratives of impact efforts. Most impact case studies described quantitative research (most commonly, trials) and depicted a direct, linear link between research and impact. Research was said to have influenced a guideline in 122 case studies, changed policy in 88, changed practice in 84, improved morbidity in 44 and reduced mortality in 25. Qualitative and participatory research designs were rare, and only one case study described a co-production model of impact. Eighty-two case studies described strong and ongoing linkages with policymakers, but only 38 described targeted knowledge translation activities. In 40 case studies, no active efforts to achieve impact were described. Models of good implementation practice were characterised by an ethical commitment by researchers, strong institutional support and a proactive, interdisciplinary approach to impact activities. REF2014 both inspired and documented significant efforts by UK researchers to achieve impact. But in contrast with the published evidence on research impact (which depicts much as occurring indirectly through non-linear mechanisms), this sub-panel seems to have captured mainly direct and relatively short-term impacts one step removed from patient outcomes. Limited impacts on morbidity and mortality, and researchers' relatively low emphasis on the processes and interactions through which indirect impacts may occur, are concerns. These findings have implications for multi-stakeholder research collaborations such as UK National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care, which are built on non-linear models of impact.

Leprosy in England and Wales 1953-2012: surveillance and challenges in low incidence countries.

PubMed

Fulton, Nicholas; Anderson, Laura F; Watson, John M; Abubakar, Ibrahim

2016-05-03

To review all notified cases of leprosy in England and Wales between 1953 and 2012. National surveillance study of all reported cases. England and Wales. Number and characteristics of reported cases. During this period, a total of 1449 leprosy cases were notified. The incidence fell from 356 new cases notified between 1953 and 1962 to 139 new cases between 2003 and 2012. Where data were available, leprosy was more common in men, 15-45 year olds and those from the Indian subcontinent. There was considerable undernotification in 2001-2012. The high level of under-reporting indicates a need for improved surveillance in the UK. Public Health England, in collaboration with the UK Panel of Leprosy opinion, has revised the UK Memorandum on Leprosy in order to provide updated guidance on diagnostic procedures, treatment, case management, contact tracing and notification. 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/

Giving to Excellence: Generating Philanthropic Support for UK Higher Education. Ross-CASE Report 2016

ERIC Educational Resources Information Center

Jain, Yashraj

2016-01-01

This report presents findings from the 2016 Ross-CASE Survey of Philanthropic Giving to Universities in UK. The project was conducted by CASE Europe and funded by HEFCE and the Ross-Group. This year's survey comes at a time of great change for the UK charity sector. The historical trend data of previous surveys will be invaluable in helping…

How To: Preparing to Find a Job as a Spanish Teacher in the UK

ERIC Educational Resources Information Center

Talero, Gemma Carmen Belmonte

2016-01-01

This case study is about the design of the one-day course "How to find a job as a Spanish teacher in the UK," which is taught at the Instituto Cervantes in London. The course came to exist due to a large number of requests from Spaniards who have come to the UK in recent years--many of them wanting to find a job as a Spanish teacher--and…

Disciplinary Disjunctures in the Transition from Secondary School to Higher Education Study of Modern Foreign Languages: A Case Study from the UK

ERIC Educational Resources Information Center

Gallagher-Brett, Angela; Canning, John

2011-01-01

Discussions of student transition from the study of languages in UK high schools to the study of languages at university usually focus on the vertical transition, comparing the differences in curricula and approach to languages taken in each sector. Whilst acknowledging that this aspect of the student transition is important, this article explores…

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

ERIC Educational Resources Information Center

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

2016-01-01

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

UK Health and Social Care Case Studies: Iterative Technology Development.

PubMed

Blanchard, Adie; Gilbert, Laura; Dawson, Tom

2017-01-01

As a result of increasing demand in the face of reducing resources, technology has been implemented in many social and health care services to improve service efficiency. This paper outlines the experiences of deploying a 'Software as a Service' application in the UK social and health care sectors. The case studies demonstrate that every implementation is different, and unique to each organisation. Technology design and integration can be facilitated by ongoing engagement and collaboration with all stakeholders, flexible design, and attention to interoperability to suit services and their workflows.

GM2 gangliosidosis in a UK study of children with progressive neurodegeneration: 73 cases reviewed.

PubMed

Smith, Nicholas J; Winstone, Anne Marie; Stellitano, Lesley; Cox, Timothy M; Verity, Christopher M

2012-02-01

To report the demographic, phenotypic, and time-to-diagnosis characteristics of children with GM2 gangliosidosis referred to the UK study of Progressive Intellectual and Neurological Deterioration. Case notification is made via monthly surveillance card, administered by the British Paediatric Surveillance Unit to all UK-based paediatricians; children with GM2 gangliosidosis were identified from cases satisfying inclusion in the UK study of Progressive Intellectual and Neurological Deterioration and analysed according to phenotypic and biochemical categories. Between May 1997 and January 2010, 73 individuals with GM2 gangliosidoses were reported: 40 with Tay-Sachs disease, 31 with Sandhoff disease, and two with GM2 activator protein deficiency. Together they account for 6% (73/1164) of all diagnosed cases of progressive intellectual and neurological deterioration. The majority (62/73) were sporadic index cases with no family history. Children of Pakistani ancestry were overrepresented in all subtypes, particularly juvenile Sandhoff disease, accounting for 10 of 11 notified cases. Infantile-onset variants predominated (55/73); the mean age at onset of symptoms was 6.2 and 4.7 months for infantile-onset Tay-Sachs and Sandhoff disease respectively, and 26.2 and 34.7 months for the corresponding juvenile-onset variants. Time to diagnosis averaged 7.4 months and 28.0 months in infantile- and juvenile-onset disease respectively. GM2 gangliosidosis is a significant cause of childhood neurodegenerative disease; timely diagnosis relies upon improved clinical recognition, which may be increasingly important as specific therapies become available. There is a potential benefit from the introduction of screening programmes for high-risk ethnic groups. © The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.

Mind the gap: TB trends in the USA and the UK, 2000-2011.

PubMed

Nnadi, Chimeremma D; Anderson, Laura F; Armstrong, Lori R; Stagg, Helen R; Pedrazzoli, Debora; Pratt, Robert; Heilig, Charles M; Abubakar, Ibrahim; Moonan, Patrick K

2016-04-01

TB remains a major public health concern, even in low-incidence countries like the USA and the UK. Over the last two decades, cases of TB reported in the USA have declined, while they have increased substantially in the UK. We examined factors associated with this divergence in TB trends between the two countries. We analysed all cases of TB reported to the US and UK national TB surveillance systems from 1 January 2000 through 31 December 2011. Negative binominal regression was used to assess potential demographic, clinical and risk factor variables associated with differences in observed trends. A total of 259,609 cases were reported. From 2000 to 2011, annual TB incidence rates declined from 5.8 to 3.4 cases per 100,000 in the USA, whereas in the UK, TB incidence increased from 11.4 to 14.4 cases per 100,000. The majority of cases in both the USA (56%) and the UK (64%) were among foreign-born persons. The number of foreign-born cases reported in the USA declined by 15% (7731 in 2000 to 6564 in 2011) while native-born cases fell by 54% (8442 in 2000 to 3883 in 2011). In contrast, the number of foreign-born cases reported in the UK increased by 80% (3380 in 2000 to 6088 in 2011), while the number of native-born cases remained largely unchanged (2158 in 2000 to 2137 in 2011). In an adjusted negative binomial regression model, significant differences in trend were associated with sex, age, race/ethnicity, site of disease, HIV status and previous history of TB (p<0.01). Among the foreign-born, significant differences in trend were also associated with time since UK or US entry (p<0.01). To achieve TB elimination in the UK, a re-evaluation of current TB control policies and practices with a focus on foreign-born are needed. In the USA, maintaining and strengthening control practices are necessary to sustain the progress made over the last 20 years. 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/

Computational modeling in the optimization of corrosion control to reduce lead in drinking water

EPA Science Inventory

An international “proof-of-concept” research project (UK, US, CA) will present its findings during this presentation. An established computational modeling system developed in the UK is being calibrated and validated in U.S. and Canadian case studies. It predicts LCR survey resul...

University Students' Unions: Changing Functions, a UK and Comparative Perspective

ERIC Educational Resources Information Center

Guan, Lu; Cole, Michael; Worthington, Frank

2016-01-01

In this article, we consider the functions of students' unions (SUs) through a UK case study. First, a functional classification of educational representation; wider representation; delivery of commercial services and faciliating a student community is outlined. Second, we specify a theoretical framework in terms of neo-liberalism and therapeutic…

Operation Ajax: A Case Study on Analyst-Policymaker Tensions and the Challenges of Estimative Intelligence

DTIC Science & Technology

2015-05-21

London, UK: Granada , 1982). 140 Woodhouse, 117. 141 Ibid., 118. This comment is interesting, because Roosevelt recounted that Smith ultimately...1951. Foreign Relations of the United States, 1952-1954, Vol X, 71-73. Woodhouse, C. M. Something Ventured. London, UK: Granada , 1982

Digitally Included: Business-Community Partnerships To Promote the Use of Information and Communication Technologies.

ERIC Educational Resources Information Center

2003

This publication describes efforts in the United Kingdom (UK) to develop mutually beneficial, collaborative partnerships between businesses and communities that promote digital inclusion (access to information and communication technologies). Case studies of different kinds of relationships are listed, including UK online centers, schools, events…

Developing Internationalisation Strategies, University of Winchester, UK

ERIC Educational Resources Information Center

Neale, Richard Hugh; Spark, Alasdair; Carter, Joy

2018-01-01

Purpose: Internationalisation has been a theme in UK higher education for a decade or more. The review of this paper, a practice-based case study, is to find how Winchester formulated two successive internationalisation strategies. Design/methodology/approach: The strategies were developed using a research-oriented method: grounded in the…

Learning to Program with Game Maker

ERIC Educational Resources Information Center

Johnson, Claire

2017-01-01

"Game Maker" is widely used in UK secondary schools, yet under-researched in that context. This paper presents the findings of a qualitative case study that explores how authoring computer games using "Game Maker" can support the learning of basic programming concepts in a mainstream UK secondary setting. The research draws on…

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…

The Role of Feedback in Cross-Cultural Learning: A Case Study of Chinese Taught Postgraduate Students in a UK University

ERIC Educational Resources Information Center

Tian, Mei; Lowe, John

2013-01-01

Insufficient attention has been given to the role of cultural differences in feedback communication with the UK's increasingly internationalised student body. This issue is particularly significant for international students taking short -- one-year -- postgraduate taught courses and we illustrate this in a study of Chinese students at a UK…

The U.K.'s "Dash for Gas".

PubMed

Watterson, Andrew; Dinan, William

2017-05-01

The evidence on public health regulation of the unconventional gas extraction (fracking) industry was examined using a rapid evidence assessment of fifteen case studies from multiple countries. They included scientific and academic papers, professional reports, government agency reports, industry and industry-funded reports, and a nongovernment organization report. Each case study review was structured to address strengths and weaknesses of the publication in relation to our research questions. Some case studies emphasized inherent industry short-, medium-, and long-term dangers to public health directly and through global climate change impacts. Other case studies argued that fracking could be conducted safely assuming industry best practice, "robust" regulation, and mitigation, but the evidence base for such statements proved generally sparse. U.K. regulators' own assessments on fracking regulation are also evaluated. The existing evidence points to the necessity of a precautionary approach to protect public health from unconventional gas extraction development.

The Education of Asylum Seekers: Some UK Case Studies

ERIC Educational Resources Information Center

Reakes, Angharad

2007-01-01

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

Research Experiences of Staff within a Specialist UK Higher Education Institution: Challenges, Opportunities and Priorities

ERIC Educational Resources Information Center

Hemmings, Brian; Hill, Doug; Sharp, John

2013-01-01

The study discussed here was based on a collective case approach involving a specialist UK higher education institution. Six individual interviews were carried out with a cross-sectional sample of the institution's staff members. Additional information was gained through observations and examination of relevant documents. These data were…

Creating Cultures of Integrity: Ethics Education in UK Business Schools

ERIC Educational Resources Information Center

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

2014-01-01

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

Case Study: Meeting the Demand for Skilled Precision Engineers

ERIC Educational Resources Information Center

Sansom, Chris; Shore, Paul

2008-01-01

Purpose: This paper aims to demonstrate how science and engineering graduates can be recruited and trained to Masters level in precision engineering as an aid to reducing the skills shortage of mechanical engineers in UK industry. Design/methodology/approach: The paper describes a partnership between three UK academic institutions and industry,…

"Fitting In" or "Standing Out": Working-Class Students in UK Higher Education

ERIC Educational Resources Information Center

Reay, Diane; Crozier, Gill; Clayton, John

2010-01-01

Drawing on case studies of 27 working-class students across four UK higher education institutions, this article attempts to develop a multilayered, sociological understanding of student identities that draws together social and academic aspects. Working with a concept of student identity that combines the more specific notion of learner identity…

Distance Education and Training for Small Firms--United Kingdom.

ERIC Educational Resources Information Center

Dey, Ian; Harrison, Jean

This document on the United Kingdom (UK) is one of a series of five monographs published by the European Centre for the Development of Vocational Training (CEDEFOP). The document includes seven chapters, three appendices, and a section of case studies. The first chapter describes small and medium-sized business enterprises in the UK. Vocational…

A theoretical and practical test of geographical profiling with serial vehicle theft in a U.K. context.

PubMed

Tonkin, Matthew; Woodhams, Jessica; Bond, John W; Loe, Trudy

2010-01-01

Geographical profiling is an investigative methodology sometimes employed by the police to predict the residence of an unknown offender from the locations of his/her crimes. The validity of geographical profiling, however, has not been fully explored for certain crime types. This study, therefore, presents a preliminary test of the potential for geographical profiling with a sample of 145 serial vehicle thieves from the U.K. The behavioural assumptions underlying geographical profiling (distance decay and domocentricity) are tested and a simple practical test of profiling using the spatial mean is presented. There is evidence for distance decay but not domocentricity among the spatial behaviour of car thieves from the U.K. A degree of success was achieved when applying the spatial mean on a case-by-case basis. The level of success varied, however, and neither series length in days nor number of crimes could account for the variation. The findings question previously held assumptions regarding geographical profiling and have potential theoretical and practical implications for the study and investigation of vehicle theft in the U.K. 2009 John Wiley & Sons, Ltd.

Effectiveness and implementation of enhanced recovery after surgery programmes: a rapid evidence synthesis.

PubMed

Paton, Fiona; Chambers, Duncan; Wilson, Paul; Eastwood, Alison; Craig, Dawn; Fox, Dave; Jayne, David; McGinnes, Erika

2014-07-22

To assess the evidence on the impact of enhanced recovery programmes for patients undergoing elective surgery in acute hospital settings in the UK. Rapid evidence synthesis. Eight databases were searched from 1990 to March 2013 without language restrictions. Relevant reports and guidelines, websites and reference lists of retrieved articles were scanned to identify additional studies. Systematic reviews, RCTs not included in the systematic reviews, economic evaluations and UK NHS cost analysis, implementation case studies and surveys of patient experience in a UK setting were eligible for inclusion. We assessed the impact of enhanced recovery programmes on health or cost-related outcomes, and assessed implementation case studies and patient experience in UK settings. Studies were quality assessed where appropriate using the Centre for Reviews and Dissemination Database of Abstracts of Reviews of Effects critical appraisal process. 17 systematic reviews and 12 additional RCTs were included. Ten relevant economic evaluations were included. No cost analysis studies were identified. Most of the evidence focused on colorectal surgery. 14 innovation case studies and 15 implementation case studies undertaken in National Health Service settings described factors critical to the success of an enhanced recovery programme. Evidence for colorectal surgery suggests that enhanced recovery programmes may reduce hospital stays by 0.5-3.5 days compared with conventional care. There were no significant differences in reported readmission rates. Other surgical specialties showed greater variation in reductions in length of stay reflecting the limited evidence identified. Findings relating to other outcomes were hampered by a lack of robust evidence and poor reporting. There is consistent, albeit limited, evidence that enhanced recovery programmes can reduce length of patient hospital stay without increasing readmission rates. The extent to which managers and clinicians considering implementing enhanced recovery programmes in UK settings can realise savings will depend on length of stay achieved under their existing care pathway. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Cost of Ménière's Disease: A Novel Multisource Approach.

PubMed

Tyrrell, Jessica; Whinney, David J; Taylor, Timothy

2016-01-01

To estimate the annual cost of Ménière's disease and the cost per person in the UK population and to investigate the direct and indirect costs of the condition. The authors utilized a multidata approach to provide the first estimate of the cost of Ménière's. Data from the UK Biobank (a study of 500,000 individuals collected between 2007 and 2012), the Hospital Episode Statistics (data on all hospital admissions in England from 2008 to 2012) and the UK Ménière's Society (2014) were used to estimate the cost of Ménière's. Cases were self-reported in the UK Biobank and UK Ménière's Society, within the Hospital Episode Statistics cases were clinician diagnosed. The authors estimated the direct and indirect costs of the condition, using count data to represent numbers of individuals reporting specific treatments, operations etc. and basic statistical analyses (χ tests, linear and logistic regression) to compare cases and controls in the UK Biobank. Ménière's was estimated to cost between £541.30 million and £608.70 million annually (equivalent to US $829.9 to $934.2 million), equating to £3,341 to £3,757 ($5112 to $5748) per person per annum. The indirect costs were substantial, with loss of earnings contributing to over £400 million per annum. For the first time, the authors were able to estimate the economic burden of Ménière's disease. In the UK, the annual cost of this condition is substantial. Further research is required to develop cost-effective treatments and management strategies for Ménière's to reduce the economic burden of the disease. These findings should be interpreted with caution due to the uncertainties inherent in the analysis.

Prevalence of Parent-Reported ASD and ADHD in the UK: Findings from the Millennium Cohort Study

ERIC Educational Resources Information Center

Russell, Ginny; Rodgers, Lauren R.; Ukoumunne, Obioha C.; Ford, Tamsin

2014-01-01

The UK prevalence of parent-reported autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) were estimated from the Millennium Cohort Study. Case definition was if a doctor or health care professional had ever told parents that their child had ASD and/or ADHD. Data were collected in 2008/2009 for 14,043 children. 1.7%…

Investigating work-related neoplasia associated with solar radiation.

PubMed

Turner, S; Forman, S D; McNamee, R; Wilkinson, S M; Agius, R

2015-01-01

Both solar and non-solar exposures associated with occupation and work tasks have been reported as skin carcinogens. In the UK, there are well-established surveillance schemes providing relevant information, including when exposures took place, occupation, location of work and dates of symptom onset and diagnosis. To add to the evidence on work-related skin neoplasia, including causal agents, geographical exposure and time lag between exposure and diagnosis. This study investigated incident case reports of occupational skin disease originating from clinical specialists in dermatology reporting to a UK-wide surveillance scheme (EPIDERM) by analysing case reports of skin neoplasia from 1996 to 2012 in terms of diagnosis, employment, suspected causal agent and symptom onset. The suspected causal agent was 'sun/sunlight/ultraviolet light' in 99% of the reported work-related skin neoplasia cases. Most cases reported (91%) were in males, and the majority (62%) were aged over 65 at the time of reporting. More detailed information on exposure was available for 42% of the cases, with the median time from exposure to symptom onset ranging from 44 (melanoma) to 57 (squamous cell carcinoma) years. Irrespective of diagnostic category, the median duration of exposure to 'sun/sunlight/ultraviolet light' appeared longer where exposures occurred in the UK (range 39-51 years) rather than outside the UK (range 2.5-6.5 years). It is important to provide effective information about skin protection to workers exposed to solar radiation, especially to outdoor workers based outside the UK. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Heritage Quay: What Will You Discover? Transforming the Archives of the University of Huddersfield, Yorkshire, UK

ERIC Educational Resources Information Center

Wickham, M. Sarah

2015-01-01

The University of Huddersfield presents a key case study of the transformation of its Archives Service, using the newly-developed Staff/Space/Collections dependency model for archives and the lessons of the UK's Customer Service Excellence (CSE) scheme in order to examine and illustrate service development. Heritage Lottery Fund (HLF) and…

Teaching Students with Autistic Spectrum Disorders in HE

ERIC Educational Resources Information Center

Taylor, M. J.

2005-01-01

Purpose--The purpose of the research reported in this paper was to examine the type of adjustments to delivery appropriate for students with an autistic spectrum disorder in a UK higher education setting. Design/Methodology/Approach--A case study in a UK university was conducted over a two-year period. Findings--A variety of adjustments may be…

Incorporating Cultural and Linguistic Diversity into Policy and Practice: Case Studies from an English Primary School

ERIC Educational Resources Information Center

Dakin, Justine

2017-01-01

Global migration has increased the number of non-English speaking pupils in UK schools, challenging a system which is politically and ideologically monolingual. This article examines how staff at a UK primary school positioned newly arrived pupils and their families, both culturally and linguistically, in terms of Cummins' educator role…

Lifelong Learning through SMEs: Exploring Workplace Learning in the UK

ERIC Educational Resources Information Center

Ahlgren, Linda; Engel, Laura C.

2011-01-01

Purpose: The primary objective in this paper is to examine the role of small- to medium-sized enterprises (SMEs) in promoting and/or hindering educational opportunities to adult employees in the UK. Design/methodology/approach: The paper draws on 12 case studies of SMEs in England and Scotland, which form part of a larger European Sixth Framework…

Governance versus government: drug consumption rooms in Australia and the UK.

PubMed

Zampini, Giulia Federica

2014-09-01

To evaluate, through a case study, the extent to which elements of governance and elements of government are influential in determining the implementation or non-implementation of a drugs intervention. Comparative analysis of the case of a drug consumption room in the UK (England) and Australia (New South Wales), including 16 semi-structured interviews with key stakeholders and analysis of relevant documents according to characteristic features of governance and government (power decentralisation, power centralisation, independent self-organising policy networks, use of evidence, top-down steering/directing, legislation). Characteristic features of both governance and government are found in the data. Elements of governance are more prominent in New South Wales, Australia than in England, UK, where government prevails. Government is seen as the most important actor at play in the making, or absence, of drug consumption rooms. Both governance and government are useful frameworks in conceptualising the policy process. The governance narrative risks overlooking the importance of traditional government structures. In the case of drug consumption rooms in the UK and Australia, a focus on government is shown to have been crucial in determining whether the intervention was implemented. Copyright © 2014 Elsevier B.V. All rights reserved.

Comparative benefit of malaria chemoprophylaxis modelled in United Kingdom travellers.

PubMed

Toovey, Stephen; Nieforth, Keith; Smith, Patrick; Schlagenhauf, Patricia; Adamcova, Miriam; Tatt, Iain; Tomianovic, Danitza; Schnetzler, Gabriel

2014-01-01

Chemoprophylaxis against falciparum malaria is recommended for travellers from non-endemic countries to malarious destinations, but debate continues on benefit, especially with regard to mefloquine. Quantification of benefit for travellers from the United Kingdom (UK) was modelled to assist clinical and public health decision making. The model was constructed utilising: World Tourism Organization data showing total number of arrivals from the UK in countries with moderate or high malaria risk; data from a retrospective UK Clinical Practice Research Datalink (CPRD) drug utilisation study; additional information on chemoprophylaxis, case fatality and tolerability were derived from the travel medicine literature. Chemoprophylaxis with the following agents was considered: atovaquone-proguanil (AP), chloroquine with and without proguanil (C ± P), doxycycline (Dx), mefloquine (Mq). The model was validated for the most recent year with temporally matched datasets for UK travel destinations and imported malaria (2007) against UK Health Protection Agency data on imported malaria. The median (mean) duration of chemoprophylaxis for each agent in weeks (CPRD) was: AP 3.3 (3.5), C ± P 9 (12.1), Dx 8 (10.3), Mq 9 (12.3): the maximum duration of use of all regimens was 52 weeks. The model correctly predicted falciparum malaria deaths and gave a robust estimate of total cases--model: 5 deaths from 1118 cases; UK Health Protection Agency: 5 deaths from 1153 cases. The number needed to take chemoprophylaxis (NNP) to prevent a case of malaria considered against the 'background' reported incidence in non-users of chemoprophylaxis deemed in need of chemoprophylaxis was: C ± P 272, Dx 269, Mq 260, AP 252; the NNP to prevent a UK traveller malaria death was: C ± P 62613, Dx 61923, Mq 59973, AP 58059; increasing the 'background' rate by 50% yielded NNPs of: C ± P 176, Dx 175, Mq 171, AP 168. The impact of substituting atovaquone-proguanil for all mefloquine usage resulted in a 2.3% decrease in estimated infections. The number of travellers experiencing moderate adverse events (AE) or those requiring medical attention or drug withdrawal per case prevented is as follows: C ± P 170, Mq 146, Dx 114, AP 103. The model correctly predicted the number of malaria deaths, providing a robust and reliable estimate of the number of imported malaria cases in the UK, and giving a measure of benefit derived from chemoprophylaxis use against the likely adverse events generated. Overall numbers needed to prevent a malaria infection are comparable among the four options and are sensitive to changes in the background infection rates. Only a limited impact on the number of infections can be expected if Mq is substituted by AP.

Toxic shock syndrome surveillance in UK children.

PubMed

Adalat, S; Dawson, T; Hackett, S J; Clark, J E

2014-12-01

Toxic shock syndrome (TSS) is an acute toxin-mediated illness caused by toxin-producing strains of Staphylococcus aureus and Streptococcus pyogenes. There is no recent data regarding incidence, management and mortality of TSS in UK children. Consultants from paediatric and burns units in the UK and Ireland, reported cases of TSS seen between November 2008 and December 2009, via the British Paediatric Surveillance Unit. Respondents were sent questionnaires requesting detailed information about TSS cases. Established criteria were used to divide cases into staphylococcal or streptococcal TSS. Forty-nine cases were identified overall; 29 cases of streptococcal TSS (18 confirmed and 11 probable) and 20 cases of staphylococcal TSS (15 confirmed and 5 probable). The incidence of TSS children in the UK & the Republic of Ireland was calculated to be 0.38 per 100 000 children. Children with staphylococcal TSS were older than those with streptococcal TSS (9.5 vs 3.8 years; p<0.003). Paediatric intensive care facilities were used for 78% of cases (invasive ventilatory support 69%; inotropic support 67%; haemofiltration 12%). Agents with antitoxin effects were underused; clindamycin 67%, intravenous immunoglobulin (IVIG) 20%, fresh frozen plasma 40%. There were eight deaths, all in the streptococcal group (28% of streptococcal cases)-none were given IVIG. Streptococcal TSS was as frequent as staphylococcal TSS, contrasting with previous literature. Children with streptococcal TSS had a higher mortality than those with staphylococcal TSS (28% vs 0%; p<0.05). Recommended immunomodulatory agents (IVIG and clindamycin) were underused. This study highlights the need for a guideline to improve management of TSS in children. 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.

Protest and survive, the U.K. Construction Safety Campaign: a case study of workers' and victims' family action and legal and regulatory inaction on construction health and safety.

PubMed

Holder, Mick; O'Brien, Tony

2007-01-01

The U.K. Construction Safety Campaign, based on grass-roots rank-and-file trade union activity, has both a domestic agenda and a wider sphere with regard to international developments. Using organized protests and media exposure to achieve its ends, the Campaign has contributed substantially to reducing injuries and fatalities in the U.K. construction industry, as well as achieving some justice for victims of the industry's neglect of safe management practices.

Facilities for investigating occupational asthma in UK non-specialist respiratory departments.

PubMed

Barber, Christopher M; Naylor, Steven; Bradshaw, Lisa; Francis, Mandy; Harris-Roberts, Joanne; Rawbone, Roger; Curran, Andrew; Fishwick, David

2008-01-01

The facilities which should be available to physicians offering specialist occupational asthma services have recently been agreed upon by a UK panel of experts. This study aimed to investigate whether these facilities are available in UK non-specialist secondary care respiratory departments and to document tertiary care referral patterns. A random sample of 100 UK respiratory units was selected, and the lead consultant invited to participate. Face-to-face interviews were conducted to document information on departmental facilities available for investigating cases of occupational asthma and utilization of tertiary referral centres. In total, 66% of consultants interviewed had seen a case of occupational asthma in the previous month, and 76% reported having ever referred a patient with suspected occupational asthma to a specialist centre for further investigation (referral distance range 1-111 miles). All the departments were able to perform the investigations previously deemed an absolute necessity in all patients. The availability of in-house facilities that were deemed as must be available varied between 3-100%. The results of this study demonstrate that while the majority of basic facilities are widely available, many respiratory departments do not have direct access to investigations routinely required to investigate occupational asthma. Access to specialist occupational respiratory centres varies within the UK, and in some parts of the country involves long travelling distances for patients.

Exploring the Influence of Individual and Academic Differences on the Placement Participation Rate among International Students: A UK Case Study

ERIC Educational Resources Information Center

Crawford, Ian; Wang, Zhiqi; Andrews, Georgina

2016-01-01

Purpose: The purpose of this paper is to investigate the low placement participation rate among international students compared with UK students, by examining the impact of individual factors such as gender and domicile and academic achievement such as prior academic qualification, prior academic results and subsequent academic results on…

A Critical Account of Employability Construction through the Eyes of Chinese Postgraduate Students in the UK

ERIC Educational Resources Information Center

Li, Zhen

2013-01-01

This paper presents a multiple ("n"?=?23), longitudinal case study of the construction of personal employability by Chinese students at a UK university. It draws on the work of Brown and Hesketh to frame notions of employability in order to understand how these students engage with the international and Chinese labour markets from their…

Overcoming the Barriers of Distance: Using Mobile Technology to Facilitate Moderation and Best Practice in Initial Teacher Training

ERIC Educational Resources Information Center

Leggatt, Simon

2016-01-01

This case study describes the development process of a model using readily-available technology to facilitate collaboration, moderation and the dissemination of best practice in initial teacher training in the UK. Students, mentors, tutors and external examiners from a number of educational institutions in a UK, higher education-led Lifelong…

Girls in the UK Have Similar Reasons to Boys for Intending to Study Mathematics Post-16 Thanks to the Support and Encouragement They Receive

ERIC Educational Resources Information Center

Mujtaba, Tamjid; Reiss, Michael

2016-01-01

This paper focuses on the aspirations of 13- and 15-year-olds to continue with mathematics after the age of 16 and the association with perceptions of their mathematics education during the academic year 2008/9. A quantitative analysis was undertaken on the views of 12,176 UK students, obtained through surveys, with qualitative case studies on two…

Characteristics and incidence of transfusion-associated necrotizing enterocolitis in the UKCharacteristics and incidence of transfusion-associated necrotizing enterocolitis in the UK.

PubMed

Faraday, Christopher; Hamad, Sheima; Jones, Kelsey; Sim, Kathleen; Cherian, Shobha; James, Anitha; Godambe, Sunit; New, Helen; Kroll; Clarke, Paul

2018-06-26

The etiology of necrotizing enterocolitis (NEC) is unclear and postulated as being multifactorial. It has been suggested that one causative factor is the transfusion of packed red bloods cells (PRBCs) leading to the disease entity commonly referred to as transfusion-associated NEC (TANEC). TANEC has been reported in North America but its incidence has not been formally investigated in the United Kingdom (UK). Our aims were to identify the incidence of NEC and TANEC in tertiary-level UK neonatal units and to describe characteristics of TANEC cases. Using strict case definitions for NEC and TANEC, we undertook a retrospective review to estimate the incidence of TANEC cases occurring in four UK tertiary-level centers during a 38-month period. Of 8007 consecutive neonatal admissions of all gestations to the four centers, 68 babies went on to develop NEC and all affected infants were of very low birth weight (VLBW); 34 of these had previously received a transfusion of PRBCs but did not fit the diagnostic criteria for TANEC, while 15 (22%) of the 68 babies with NEC qualified as TANEC cases. UK cases occurred at an earlier postnatal age than cases reported in multiple large North American series and were of a lower birth weight. We have confirmed the presence of TANEC in the UK VLBW neonatal population. Its incidence lies within the wide range described in previous reports of this phenomenon globally, though with some local variation in characteristics. Further work is needed to clarify causation, pathophysiology, and possible mechanisms of prevention of TANEC.

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.

Analyzing the Roles, Activities, and Skills of Learning Technologists: A Case Study from City University London

ERIC Educational Resources Information Center

Fox, Olivia; Sumner, Neal

2014-01-01

This article reports on a case study carried out at City University London into the role of learning technologists. The article examines how the role developed by providing points of comparison with a report on the career development of learning technology staff in UK universities in 2001. This case study identified that learning technologists…

The Use of Case Studies in OR Teaching

ERIC Educational Resources Information Center

Penn, Marion L.; Currie, Christine S. M.; Hoad, Kathryn A.; O'Brien, Frances A.

2016-01-01

This article investigates the current use of case studies in the teaching of Operational Research (OR) in the UK: how and where they are used; how they are developed; and whether there is an interest in training this area. It is aimed at lecturers teaching OR who are using or planning to use case studies in their teaching. It may also be of…

Nutrient cycles in agricultural systems at sub-catchment scale within the UK and China

NASA Astrophysics Data System (ADS)

Bellarby, Jessica; Surridge, Ben; Haygarth, Philip M.; Lai, Xin; Zhang, Guilong; Song, Xiaolong; Zhou, Jianbin; Meng, Fanqiao; Shen, Jianbo; Rahn, Clive; Smith, Laurence; Burke, Sean

2015-04-01

Diffuse water pollution from agriculture (DWPA) represents a significant challenge in both the UK and China. The UK has developed policies and practices which seek to mitigate DWPA, yet the risks and adverse impacts of DWPA remain widespread. In contrast, China's past priorities have largely focussed on food security, with an emphasis on increasing food production through high fertiliser application rates with little attention being paid to enhanced nutrient export from land to water and to air. This has contributed to severe environmental problems which are only now beginning to be recognised and addressed. We have prepared nutrient balances (phosphorus and nitrogen) in contrasting agricultural production systems at sub-catchment scale within China and the UK. These draw from a variety of sources ranging from general yearly statistics collected by the respective government to farm surveys. Our aim is to use the resulting nutrient balances to underpin the sharing of knowledge and innovation to mitigate DWPA in both nations. In the UK, the case studies focus on the three Demonstration Test Catchment locations, covering a range of livestock and arable production systems across England. Here, the high frequency monitoring of phosphorus river loads enables the cross-validation of the simple nutrient budget approaches applied in this study. In China, our case studies span kiwi orchard, fruit and vegetable solar greenhouse systems, double cropped rice-wheat and wheat-maize production systems. Substantial differences in nutrient stocks and flows exist between individual production systems both across and within the two countries. These differences will be expressed along the source-mobilisation-delivery-impact continuum that underpins our budgets for both phosphorus and nitrogen. We will present the phosphorus cycles of some case studies and highlight their challenges and relevance at sub-catchment scale. Based on our nutrient budgets, general recommendations can be formulated to mitigate DWPA from farm to policy levels.

What is driving rates of social policy preliminary references to the CJEU? Evidence from the United Kingdom and France

PubMed Central

Sigafoos, Jennifer

2013-01-01

Preliminary references to the Court of Justice for the European Union are unevenly distributed across the EU, creating differing access to justice for European citizens. This study presents case studies of the UK and France, exploring factors affecting rates of social policy preliminary references from 1996–2009. The UK had a rate twice that of France. What accounts for this difference? Analysis of documentary evidence and 25 expert interviews help to explain the differing rates. Themes were related to policy, structural factors and the agency of actors. In the UK, policy themes are the free movement of persons and the ‘Right to Reside’ test. Legal aid and legal NGOs help individuals access the Court and drive test case strategies. In France, a high degree of dualisation in the welfare state creates an insider/outsider dynamic. Coupled with the resistance of courts and a lack of comparable actors to drive preliminary references, this contributes to a lower rate of references. PMID:23565042

The Reality of Rhetoric in Information Systems Adoption: A Case Study Investigation of the Uk National Health Service

NASA Astrophysics Data System (ADS)

Khan, Imran; Ferneley, Elaine

The UK National Health Service is undergoing a tremendous IS -led change, the purpose of which is to create a service capable of meeting the demands of the 21st century. The aim of this paper is to examine the extent to which persuasive discourse, or rhetoric, influences and affects the adoption of information systems within the health sector. It seeks to explore the ways in which various actors use rhetoric to advance their own agendas and the impact this has on the system itself. As such, the paper seeks to contribute to diffusion research through the use of a case study analysis of the implementation of an Electronic Single Patient Care Record system within one UK Health Service Trust. The findings of the paper suggest that rhetoric is an important and effective persuasive tool, employed by system trainers to coax users into not only adopting the system but also using the system in a predefined manner.

Bringing about Positive Change in the Higher Education Student Experience: A Case Study

ERIC Educational Resources Information Center

Brown, Sally

2011-01-01

Purpose: The purpose of this article is to outline the ways in which staff of a post-1992 UK university set about enhancing the student experience, at a time when the institution had poor student evaluations as demonstrated by the UK National Student Survey and other indicators. Using a range of interventions led by the PVC (Academic), a concerted…

Leadership at the Top: Some Insights from a Longitudinal Case Study of a UK Business School

ERIC Educational Resources Information Center

Williams, Allan P. O.

2009-01-01

A UK business school was researched to record its history and to account for its development. The data collection and interpretation were influenced by the flexible and iterative nature of the methodology. Theories and concepts used to make sense of the findings include: open systems, force fields, and power. The focus is on strategic leadership,…

Homegrown Terror: The United Kingdom as a Case Study

DTIC Science & Technology

2007-06-01

Name: Nabeel Hussain340 Age: 22 (March 10, 1984 – Waltham Forest, UK) Role: Member Date or Arrest: Aug 10, 2006 Place or Arrest: UK...profiles/muhammed_usman_saddique.htm (accessed February 2, 2007). 340 Global Security, “ Nabeel Hussain,” GlobalSecurity.Org, http...Nationality: British Country of Family Origin: Not clearly stated Other Affiliation: None stated Family Ties: Possible brother of Umair and Nabeel

Cats, Comics, and Knausgård: Promoting Student Reading at a U.K. Academic Library with a Leisure Reading Collection

ERIC Educational Resources Information Center

Hurst, Susan; Marsh, Dominic; Brown, Dean; Forbes, Shona

2017-01-01

This case study describes the creation of a leisure reading collection in the Clifford Whitworth library at the University of Salford. It briefly surveys existing literature on leisure reading collections and looks at the growing interest among U.K. academic libraries in recreational reading. It considers the reasons for promoting reading as a…

Putting Place on the Menu: The Negotiation of Locality in UK Food Tourism, from Production to Consumption

ERIC Educational Resources Information Center

Sims, Rebecca

2010-01-01

This paper uses a case study of tourism in the Lake District and Exmoor to explore the relationship between "local food" and sustainable rural tourism in the UK. Drawing on qualitative interviews with tourists, food producers and cafe, pub and restaurant owners, I use an approach based upon the commodity chain to trace the shifts in the…

Research and Teaching Revisited: A Pre-Humboldtian or Post-Humboldtian Phenomenon? The Cases of France and the UK

ERIC Educational Resources Information Center

Chiang, Kuang-Hsu

2012-01-01

The evidence about the relationship between research and teaching at the level of doctoral education is far from conclusive. The focus of this study is to examine how teaching and research are related at doctoral level, especially when students' voices are heard, in two contrasting higher education systems--France and the UK. Models from Schimank…

Barriers to e-health business processes.

PubMed

Mieczkowska, Suzanne; Hinton, Matthew; Barnes, David

2004-01-01

This paper builds from recent case study research in commercial organisations to develop the hypothesis that many of the barriers to e-health processes are similar to those encountered by commercial businesses. The paper reports findings from a case study within the pathology department of a UK National Health Service (NHS) Trust. The NHS has a risk-averse culture where many individuals practice defensive behaviour and there are deeply embedded working practices. The paper suggests that if the NHS is to seize the opportunities offered by substantial new investments in e-health systems that utilise internet-based ICTs, greater effort needs to be made to understand and address the socio-cultural factors affecting the UK healthcare system.

Unusual case of suspected recurrent scarlet fever in a UK serviceman.

PubMed

Phillips, Rachel; Martin-Bates, A J; Withnall, R

2018-05-01

The UK prevalence of scarlet fever, a Group A streptococcal infection, is increasing. We present an unusual case of suspected recurrent scarlet fever in a member of the UK Armed Forces. Treatments, occupational implication and public health measures to mitigate the risk of disease spread. © 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.

Survey of cases of paracetamol overdose in the UK referred to National Poisons Information Service (NPIS) consultants.

PubMed

Thanacoody, H K R; Good, A M; Waring, W S; Bateman, D N

2008-03-01

Paracetamol is the most common means of drug overdose in the UK. Guidance on management is available to junior doctors through TOXBASE, the online resource managed by the UK National Poisons Information Service (NPIS) and in poster form. TOXBASE is supported by NPIS units and further by a UK national rota of clinical toxicologists. A study was undertaken to examine reasons why calls about paracetamol are referred to consultants to better understand issues in managing this common poisoning. Calls relating to paracetamol overdose referred by a poisons information specialist to the duty NPIS consultant between 1 May 2005 and 30 April 2006 were identified from the database and the number of TOXBASE accesses during the same time period was determined. Enquiries that resulted in consultant referral were classified into six categories. Calls referred to NPIS consultants pertain mainly to patients who present late, staggered overdoses, adverse reactions to N-acetylcysteine, and interpretation of blood results. This information has been used to inform the development of TOXBASE so that comprehensive advice is readily available to end users. The operation of a national consultant rota enables information on difficult or unusual cases of poisoning to be pooled so that treatment guidelines can be developed to optimise treatment throughout the UK.

The CASE Project: Evaluation of Case-Based Approaches to Learning and Teaching in Statistics Service Courses

ERIC Educational Resources Information Center

Fawcett, Lee

2017-01-01

The CASE project (Case-based Approaches to Statistics Education; see www.mas.ncl.ac.uk/~nlf8/innovation) was established to investigate how the use of real-life, discipline-specific case study material in Statistics service courses could improve student engagement, motivation, and confidence. Ultimately, the project aims to promote deep learning…

Universities: Can They Be Considered as Learning Organizations?: A Preliminary Micro-Level Perspective

ERIC Educational Resources Information Center

Bak, Ozlem

2012-01-01

Purpose: The purpose of this study is to explore a department in a UK higher education (HE) institute based on Senge's five characteristics of learning organizations. Design/methodology/approach: In this study, a case study method was utilized. The case study entailed two lines of enquiry: a questionnaire, which was distributed to a UK…

Work-related mental ill-health and 'stress' in the UK (2002-05).

PubMed

Carder, Melanie; Turner, Susan; McNamee, Roseanne; Agius, Raymond

2009-12-01

There is concern about the frequency of work-related mental ill-health and 'stress' within the UK. To provide a measure of the incidence of work-related mental ill-health reported by specialist psychiatrists and occupational physicians to UK voluntary reporting schemes during the period 2002-05. Additionally, an investigation of determinants, notably factors identified by reporters as precipitants in cases of work-related mental ill-health was undertaken. The study used data collected by The Health and Occupation Reporting Network (THOR) from 2002 to 2005. Cases were analysed by age, gender, industry and precipitating event. Estimated annual average incidence rates and 95% confidence intervals of work-related mental ill-health diagnoses reported to THOR between 2002 and 2005 by psychiatrists were 89 (78, 101) per million and by occupational physicians were 1589 (1443, 1735) per million. For both groups of reporters, anxiety and depression continued to make up the largest proportion of diagnoses. The majority of cases were attributed to factors such as workload and difficulties with other workers. There was some suggestion that the type of factors associated with the mental ill-health case reports varied between industrial sectors. Work-related anxiety and depression and stress continue to constitute a significant proportion of all work-related mental ill-health diagnoses in the UK, with workload and interpersonal relationships reported as significant risk factors. Further investigations may determine whether guidance for employers and employees on work-related mental ill-health would benefit from being more industry specific.

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.

Use of Murine Bioassay to Resolve Ovine Transmissible Spongiform Encephalopathy Cases Showing a Bovine Spongiform Encephalopathy Molecular Profile

PubMed Central

Beck, Katy E; Sallis, Rosemary E; Lockey, Richard; Vickery, Christopher M; Béringue, Vincent; Laude, Hubert; Holder, Thomas M; Thorne, Leigh; Terry, Linda A; Tout, Anna C; Jayasena, Dhanushka; Griffiths, Peter C; Cawthraw, Saira; Ellis, Richard; Balkema-Buschmann, Anne; Groschup, Martin H; Simmons, Marion M; Spiropoulos, John

2012-01-01

Two cases of unusual transmissible spongiform encephalopathy (TSE) were diagnosed on the same farm in ARQ/ARQ PrP sheep showing attributes of both bovine spongiform encephalopathy (BSE) and scrapie. These cases, UK-1 and UK-2, were investigated further by transmissions to wild-type and ovine transgenic mice. Lesion profiles (LP) on primary isolation and subpassage, incubation period (IP) of disease, PrPSc immunohistochemical (IHC) deposition pattern and Western blot profiles were used to characterize the prions causing disease in these sheep. Results showed that both cases were compatible with scrapie. The presence of BSE was contraindicated by the following: LP on primary isolation in RIII and/or MR (modified RIII) mice; IP and LP after serial passage in wild-type mice; PrPSc deposition pattern in wild-type mice; and IP and Western blot data in transgenic mice. Furthermore, immunohistochemistry (IHC) revealed that each case generated two distinct PrPSc deposition patterns in both wild-type and transgenic mice, suggesting that two scrapie strains coexisted in the ovine hosts. Critically, these data confirmed the original differential IHC categorization that these UK-1 and UK-2 cases were not compatible with BSE. PMID:21919992

Cost-Effectiveness of Ibrutinib Compared With Obinutuzumab With Chlorambucil in Untreated Chronic Lymphocytic Leukemia Patients With Comorbidities in the United Kingdom.

PubMed

Sinha, Richa; Redekop, William Ken

2018-02-01

Ibrutinib shows superiority over obinutuzumab with chlorambucil (G-Clb) in untreated patients with chronic lymphocytic leukemia with comorbidities who cannot tolerate fludarabine-based therapy. However, ibrutinib is relatively more expensive than G-Clb. In this study we evaluated the cost-effectiveness of ibrutinib compared with G-Clb from the United Kingdom (UK) health care perspective. A 3-state semi-Markov model was parameterized to estimate the lifetime costs and benefits associated with ibrutinib compared with G-Clb as first-line treatment. Idelalisib with rituximab was considered as second-line treatment. Unit costs were derived from standard sources, (dis)utilities from UK elicitation studies, progression-free survival, progression, and death from clinical trials, and postprogression survival and background mortality from published sources. Additional analyses included threshold analyses with ibrutinib and idelalisib at various discount rates, and scenario analysis with ibrutinib as second-line treatment after G-Clb. An average gain of 1.49 quality-adjusted life-years (QALYs) was estimated for ibrutinib compared with G-Clb at an average additional cost of £112,835 per patient. To be cost-effective as per the UK thresholds, ibrutinib needs to be discounted at 30%, 40%, and 50% if idelalisib is discounted at 0%, 25%, and 50% respectively. The incremental cost-effectiveness ratio was £75,648 and £-143,279 per QALY gained for the base-case and scenario analyses, respectively. Sensitivity analyses showed the robustness of the results. As per base-case analyses, an adequate discount on ibrutinib is required to make it cost-effective as per the UK thresholds. The scenario analysis substantiates ibrutinib's cost-savings for the UK National Health Services and advocates patient's access to ibrutinib in the UK. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

Lessons from local engagement in Latin American health systems.

PubMed

Meads, Geoffrey D; Griffiths, Frances E; Goode, Sarah D; Iwami, Michiyo

2007-12-01

To examine the management of recent policies for stronger patient and public involvement in Latin American health systems, identifying common features and describing local practice examples of relevance to the UK. Participation is a core principle of many contemporary policies for health system reform. In Latin America, as in the UK, it is frequently associated with innovations in primary care services and their organizational developments. This shared interest in alternative models of local engagement offers new opportunities for collaborative research and policy development. Commissioned by UK policy makers, a 4-year research programme was designed to promote exchanges with international counterparts focusing on how modern reform policies are being implemented. The selected countries possessed comparable principles and timeframes for their reforms. A series of individual country case studies were undertaken. Data were drawn from literature and documentary reviews; semi-structured interviews with national policy makers and expert advisers; and with management representatives at local exemplar sites. The aggregate data were subjected to thematic analysis applying a model for sustainable development. Six common factors were identified in Latin American policies for stronger patient and public involvement. From these the most significant transferable learning for the UK relates to the position and status of professions and non-governmental agencies. Illustrative case exemplars were located in each of the eight countries studied.

Complaints, complainants, and rulings regarding drug promotion in the United Kingdom and Sweden 2004-2012: a quantitative and qualitative study of pharmaceutical industry self-regulation.

PubMed

Zetterqvist, Anna V; Merlo, Juan; Mulinari, Shai

2015-02-01

In many European countries, medicines promotion is governed by voluntary codes of practice administered by the pharmaceutical industry under its own system of self-regulation. Involvement of industry organizations in policing promotion has been proposed to deter illicit conduct, but few detailed studies on self-regulation have been carried out to date. The objective of this study was to examine the evidence for promotion and self-regulation in the UK and Sweden, two countries frequently cited as examples of effective self-regulation. We performed a qualitative content analysis of documents outlining the constitutions and procedures of these two systems. We also gathered data from self-regulatory bodies on complaints, complainants, and rulings for the period 2004-2012. The qualitative analysis revealed similarities and differences between the countries. For example, self-regulatory bodies in both countries are required to actively monitor promotional items and impose sanctions on violating companies, but the range of sanctions is greater in the UK where companies may, for instance, be audited or publicly reprimanded. In total, Swedish and UK bodies ruled that 536 and 597 cases, respectively, were in breach, equating to an average of more than one case/week for each country. In Sweden, 430 (47%) complaints resulted from active monitoring, compared with only two complaints (0.2%) in the UK. In both countries, a majority of violations concerned misleading promotion. Charges incurred on companies averaged €447,000 and €765,000 per year in Sweden and the UK, respectively, equivalent to about 0.014% and 0.0051% of annual sales revenues, respectively. One hundred cases in the UK (17% of total cases in breach) and 101 (19%) in Sweden were highlighted as particularly serious. A total of 46 companies were ruled in breach of code for a serious offence at least once in the two countries combined (n = 36 in the UK; n = 27 in Sweden); seven companies were in serious violation more than ten times each. A qualitative content analysis of serious violations pertaining to diabetes drugs (UK, n = 15; Sweden, n = 6; 10% of serious violations) and urologics (UK, n = 6; Sweden, n = 13; 9%) revealed various types of violations: misleading claims (n = 23; 58%); failure to comply with undertakings (n = 9; 23%); pre-licensing (n = 7; 18%) or off-label promotion (n = 2; 5%); and promotion of prescription drugs to the public (n = 6; 15%). Violations that go undetected or unpunished by self-regulatory bodies are the main limitation of this study, since they are likely to lead to an underestimate of industry misconduct. The prevalence and severity of breaches testifies to a discrepancy between the ethical standard codified in industry Codes of Conduct and the actual conduct of the industry. We discuss regulatory reforms that may improve the quality of medicines information, such as pre-vetting and intensified active monitoring of promotion, along with larger fines, and giving greater publicity to rulings. But despite the importance of improving regulatory arrangements in an attempt to ensure unbiased medicines information, such efforts alone are insufficient because simply improving oversight and increasing penalties fail to address additional layers of industry bias.

Complaints, Complainants, and Rulings Regarding Drug Promotion in the United Kingdom and Sweden 2004–2012: A Quantitative and Qualitative Study of Pharmaceutical Industry Self-Regulation

PubMed Central

Zetterqvist, Anna V.; Merlo, Juan; Mulinari, Shai

2015-01-01

Background In many European countries, medicines promotion is governed by voluntary codes of practice administered by the pharmaceutical industry under its own system of self-regulation. Involvement of industry organizations in policing promotion has been proposed to deter illicit conduct, but few detailed studies on self-regulation have been carried out to date. The objective of this study was to examine the evidence for promotion and self-regulation in the UK and Sweden, two countries frequently cited as examples of effective self-regulation. Methods and Findings We performed a qualitative content analysis of documents outlining the constitutions and procedures of these two systems. We also gathered data from self-regulatory bodies on complaints, complainants, and rulings for the period 2004–2012. The qualitative analysis revealed similarities and differences between the countries. For example, self-regulatory bodies in both countries are required to actively monitor promotional items and impose sanctions on violating companies, but the range of sanctions is greater in the UK where companies may, for instance, be audited or publicly reprimanded. In total, Swedish and UK bodies ruled that 536 and 597 cases, respectively, were in breach, equating to an average of more than one case/week for each country. In Sweden, 430 (47%) complaints resulted from active monitoring, compared with only two complaints (0.2%) in the UK. In both countries, a majority of violations concerned misleading promotion. Charges incurred on companies averaged €447,000 and €765,000 per year in Sweden and the UK, respectively, equivalent to about 0.014% and 0.0051% of annual sales revenues, respectively. One hundred cases in the UK (17% of total cases in breach) and 101 (19%) in Sweden were highlighted as particularly serious. A total of 46 companies were ruled in breach of code for a serious offence at least once in the two countries combined (n = 36 in the UK; n = 27 in Sweden); seven companies were in serious violation more than ten times each. A qualitative content analysis of serious violations pertaining to diabetes drugs (UK, n = 15; Sweden, n = 6; 10% of serious violations) and urologics (UK, n = 6; Sweden, n = 13; 9%) revealed various types of violations: misleading claims (n = 23; 58%); failure to comply with undertakings (n = 9; 23%); pre-licensing (n = 7; 18%) or off-label promotion (n = 2; 5%); and promotion of prescription drugs to the public (n = 6; 15%). Violations that go undetected or unpunished by self-regulatory bodies are the main limitation of this study, since they are likely to lead to an underestimate of industry misconduct. Conclusions The prevalence and severity of breaches testifies to a discrepancy between the ethical standard codified in industry Codes of Conduct and the actual conduct of the industry. We discuss regulatory reforms that may improve the quality of medicines information, such as pre-vetting and intensified active monitoring of promotion, along with larger fines, and giving greater publicity to rulings. But despite the importance of improving regulatory arrangements in an attempt to ensure unbiased medicines information, such efforts alone are insufficient because simply improving oversight and increasing penalties fail to address additional layers of industry bias. PMID:25689460

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

PubMed Central

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

2003-01-01

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

Case Study: What Supports Students to Improve Their Grades?

ERIC Educational Resources Information Center

Sieminski, Sandy; Messenger, Julie; Murphy, Sam

2016-01-01

This case study considers students who achieved "borderline" (40-45%) grades in their first assignment on a module, but went on to markedly improve their grades over the course of the module. The students were studying nursing and social work at the UK Open University, and they were all sponsored by employers. Semi-structured telephone…

A Case Study of Emerging Challenges and Reflections on Internationalization of Higher Education

ERIC Educational Resources Information Center

Jiang, Nan; Carpenter, Victoria

2014-01-01

The purpose of this research was to examine challenges and issues of higher education (HE) internationalization. A qualitative study was conducted at a UK university. A total of 20 interviewees from the case study institution participated in this research. Content analysis, critical discourse analysis and categorization of meaning were adopted as…

Case Studies of Interactive Whole-Class Teaching in Primary Science: Communicative Approach and Pedagogic Purposes

ERIC Educational Resources Information Center

McMahon, Kendra

2012-01-01

By developing two case studies of expert teaching in action, this study aimed to develop knowledge of talk in whole-class teaching in UK primary science lessons and understand this in relation to both the teachers' interpretations and sociocultural theoretical frameworks. Lessons were observed and video-recorded and the teachers engaged in…

Strategies to enhance waste minimization and energy conservation within organizations: a case study from the UK construction sector.

PubMed

Jones, Jo; Jackson, Janet; Tudor, Terry; Bates, Margaret

2012-09-01

Strategies for enhancing environmental management are a key focus for the government in the UK. Using a manufacturing company from the construction sector as a case study, this paper evaluates selected interventionist techniques, including environmental teams, awareness raising and staff training to improve environmental performance. The study employed a range of methods including questionnaire surveys and audits of energy consumption and generation of waste to examine the outcomes of the selected techniques. The results suggest that initially environmental management was not a focus for either the employees or the company. However, as a result of employing the techniques, the company was able to reduce energy consumption, increase recycling rates and achieve costs savings in excess of £132,000.

A critical review of hydrological data collection for assessing preservation risk for urban waterlogged archaeology: A case study from the City of York, UK.

PubMed

Holden, Joseph; Howard, Andy J; West, L Jared; Maxfield, Eleanor; Panter, Ian; Oxley, John

2009-08-01

Environmental change caused by urban development, possibly augmented by climate change, may result in accelerated decay of in situ archaeological resources. Damage may be related to changes in hydrological processes. Such archaeological resources have to be considered in environmental planning. In this paper we highlight the need for improved hydrological data from urban archaeological sites using the case study of the City of York, UK, arguably one of the most well studied and well preserved urban archaeological environments globally. We suggest that the quality of hydrological data collected during routine surveys and experimental work must be improved and standardised in order for us to produce reliable archaeological risk models for urban sites.

Exploring Barriers to Effective E-Learning: Case Study of DNPA

ERIC Educational Resources Information Center

Annansingh, Fenio; Bright, Ali

2010-01-01

Purpose: The purpose of this paper is to discuss a case study which examines and analyses a information communication technology training programme conducted using an e-learning platform at the Dartmoor National Park Authority, UK. Design/methodology/approach: The research adopted a mixed method approach which involved the use of questionnaires…

Changing the Library Brand: A Case Study

ERIC Educational Resources Information Center

Wynne, Ben; Dixon, Simon; Donohue, Neil; Rowlands, Ian

2016-01-01

This article outlines some of the opportunities and challenges of changing what the library "brand" means to academic and professional services staff in the rapidly changing environment of UK higher education, taking the University of Leicester as a case study. It makes a practitioner contribution to the growing body of evidence of how…

Auditing and Evaluating University-Community Engagement: Lessons from a UK Case Study

ERIC Educational Resources Information Center

Hart, Angie; Northmore, Simon

2011-01-01

The growing importance of community and public engagement activities in universities has led to an increasing emphasis on auditing and evaluating university-community partnerships. However, the development of effective audit and evaluation tools is still at a formative stage. This article presents a case study of the University of Brighton's…

Ideologies of Adventure: Authority and Decision Making in Sail Training

ERIC Educational Resources Information Center

McCulloch, Kenneth H.

2004-01-01

Case studies of the contemporary UK sail training movement are used to illustrate the competing expressions of purpose in this field. Two sail training organisations are described and a case study voyage under the aegis of each is presented. The differences between the approaches are analysed as "traditions" or ideologies, articulated…

Embedding Academic Writing Instruction into Subject Teaching: A Case Study

ERIC Educational Resources Information Center

Wingate, Ursula; Andon, Nick; Cogo, Alessia

2011-01-01

The benefits of embedding the teaching of writing into the curriculum have been advocated by educators and researchers. However, there is currently little evidence of embedded writing instruction in the UK's higher education context. In this article, we present a case study in which we report the design, implementation and evaluation of an…

Epiphany? A Case Study of Learner-Centredness in Educational Supervision

ERIC Educational Resources Information Center

Talbot, Martin

2009-01-01

Graduate medical trainees in the UK appreciate mentors who demonstrate learner-centredness as modelled by Rogers. This case study was undertaken to examine how, in one instance, learner-centred may be supervision within the tight confines of a formal, competency-based programme of training. Four formal interviews (in 18 months), were analysed to…

A study of HIV positive undocumented African migrants' access to health services in the UK.

PubMed

Whyte, James; Whyte, Maria D; Hires, Kimberly

2015-01-01

Newly immigrated persons, whatever their origin, tend to fall in the lower socioeconomic levels. In fact, failure of an asylum application renders one destitute in a large proportion of cases, often resulting in a profound lack of access to basic necessities. With over a third of HIV positive failed asylum seekers reporting no income, and the remainder reporting highly limited resources, poverty is a reality for the vast majority. The purpose of the study was to determine the basic social processes that guide HIV positive undocumented migrant's efforts to gain health services in the UK. The study used the Grounded Theory Approach. Theoretical saturation occurred after 16 participants were included in the study. The data included reflections of the prominent factors related to the establishment of a safe and productive life and the ability of individuals to remain within the UK. The data reflected heavily upon the ability of migrants to enter the medical care system during their asylum period, and on an emerging pattern of service denial after loss on immigration appeal. The findings of this study are notable in that they have demonstrated sequence of events along a timeline related to the interaction between the asylum process and access to health-related services. The results reflect that African migrants maintain a degree of formal access to health services during the period that they possess legal access to services and informal access after the failure of their asylum claim. The purpose of this paper is to examine the basic social processes that characterize efforts to gain access to health services among HIV positive undocumented African migrants to the UK. The most recent estimates indicate that there are a total of 618,000 migrants who lack legal status within the UK. Other studies have placed the number of undocumented migrants within the UK in the range of 525,000-950,000. More than 442,000 are thought to dwell in the London metropolitan area. Even in cases where African migrants enter the UK legally, they often face considerable difficulty in their quest to gain legal employment due to barriers inherent to the system that grants work permits. With over a third of HIV positive failed asylum seekers reporting no income, and the remainder reporting highly limited resources, poverty is a reality for the vast majority.

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

Autopsy findings in bodies repatriated to the UK.

PubMed

Williams, Edward John; Davison, Andrew

2014-07-01

Following the death of a British National on foreign soil, a primary investigation is conducted by the authorities of that country; HM Coroner and the United Kingdom police have no jurisdiction to conduct investigations abroad. Upon repatriation of a body, the legal investigation in the UK remains largely unchanged since the publication of the "harmonisation of medico-legal autopsy rules" (1999) and the passing of the Coroners and Justice Act (2009). We identified 44 cases within a 10-year period. An invasive autopsy had been performed abroad in 25 cases; an autopsy report was received prior to UK autopsy in one case. Seven cases showed incomplete evisceration; the absence of part or whole organs was recorded in 11 cases. Toxicology was performed abroad in five cases. Recurring technical difficulties related chiefly to embalming, including difficulty with dissection and noxious fumes. When an autopsy had been performed abroad, the time to UK inquest was prolonged by an average of seven months. A verdict of unlawful killing was returned in nine cases. The discussion expands on these issues, and attempts to offer reasoned explanation where possible. Two cases are used as exemplars to highlight difficulties to both the pathologist and Coroner. This casework remains rare but the potential problems include: absence of tissue; lack of information; technical difficulties; and a disproportionately high number of unlawful killings, making clear the need for experience and caution when making the post mortem examination.

Mortality among immigrants in England and Wales by major causes of death, 1971-2012: A longitudinal analysis of register-based data.

PubMed

Wallace, Matthew; Kulu, Hill

2015-12-01

Recent research has found a migrant mortality advantage among immigrants relative to the UK-born population living in England and Wales. However, while all-cause mortality is useful to show differences in mortality between immigrants and the host population, it can mask variation in mortality patterns from specific causes of death. This study analyses differences in the causes of death among immigrants living in England and Wales. We extend previous research by applying competing-risks survival analysis to study a large-scale longitudinal dataset from 1971 to 2012 to directly compare causes of death. We confirm low all-cause mortality among nearly all immigrants, except immigrants from Scotland, Northern Ireland and the Republic of Ireland (who have high mortality). In most cases, low all-cause mortality among immigrants is driven by lower mortality from chronic diseases (in nearly all cases by lower cancer mortality and in some cases by lower mortality from cardiovascular diseases (CVD)). This low all-cause mortality often coexists with low respiratory disease mortality and among non-western immigrants, coexists with high mortality from infectious diseases; however, these two causes of death contribute little to mortality among immigrants. For men, CVD is the leading cause of death (particularly among South Asians). For women, cancer is the leading cause of death (except among South Asians, for whom CVD is also the leading cause). Differences in CVD mortality over time remain constant between immigrants relative to UK-born, but immigrant cancer patterns shows signs of some convergence to the cancer mortality among the UK-born (though cancer mortality is still low among immigrants by age 80). The study provides the most up-to-date, reliable UK-based analysis of immigrant mortality. Copyright © 2015 Elsevier Ltd. 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.

Insiders and incomers: how lay public health workers' knowledge might improve public health practice.

PubMed

Yoeli, Heather; Cattan, Mima

2017-11-01

Since 2005, health trainers and other lay public health workers (LPHWs) have been increasingly active in the UK. Although elsewhere in the world LPHWs are expected to come from the communities within which they work and know that their knowledge is valued, neither is the case for LPHWs in the UK. This study sought to discover the lay knowledge of health trainers and other LPHWs, aiming to ascertain how this knowledge might more effectively be utilised within UK public health services. This paper describes a participatory and ethnographic case study research project undertaken on an anonymised urban estate in North East England. Findings were generated by a range of means including by participant observation and semi-structured interviews. Seven LPHWs took part, as did 32 other community members. This study found that the lay health knowledge of an individual UK LPHW is determined primarily by his or her position within, or in relation to, the community within which he or she works. Insider LPHWs possess an embodied knowledge and incomer LPHWs possess an experiential knowledge which, although different from one another, are essentially interpersonal in nature. Lay health knowledge can take different forms, and different LPHWs can provide different forms of lay health knowledge. Public health structures and services in the UK should make better use of all forms of LPHW knowledge, and should seek from LPHWs training on how to engage the most 'hard-to-reach' or 'difficult-to-engage' groups. Services recruiting LPHWs should decide whether they are seeking embodied insider LPHW knowledge, experiential incomer LPHW knowledge or a mixture of both. © 2017 John Wiley & Sons Ltd.

Doping in sport: an analysis of sanctioned UK rugby union players between 2009 and 2015.

PubMed

Whitaker, L; Backhouse, S

2017-08-01

To inform anti-doping policy and practice, it is important to understand the complexities of doping. The purpose of this study was to collate and systematically examine the reasoned decisions published by UK Anti-Doping for doping sanctions in rugby union in the UK since the introduction of the 2009 World Anti-Doping Code. Case files were content analysed to extract demographic information and details relating to the anti-doping rule violation (ADRV), including individuals' explanations for how/why the ADRV occurred. Between 2009 and 2015, 49 rugby union players and one coach from across the UK were sanctioned. Over 50% of the cases involved players under the age of 25, competing at sub-elite levels. Reasons in defence of the ADRV focused on functional use and lifestyle factors rather than performance enhancement. An a priori assessment of the "need", "risk" and "consequence" of using a substance was not commonplace; further strengthening calls for increasing the reach of anti-doping education. The findings also deconstruct the view that "doped" athletes are the same. Consequently, deepening understanding of the social and cultural conditions that encourage doping remains a priority.

Inequalities in maternal health: national cohort study of ethnic variation in severe maternal morbidities.

PubMed

Knight, Marian; Kurinczuk, Jennifer J; Spark, Patsy; Brocklehurst, Peter

2009-03-03

To describe on a national basis ethnic differences in severe maternal morbidity in the United Kingdom. National cohort study using the UK Obstetric Surveillance System (UKOSS). All hospitals with consultant led maternity units in the UK. 686 women with severe maternal morbidity between February 2005 and February 2006. Rates, risk ratios, and odds ratios of severe maternal morbidity in different ethnic groups. 686 cases of severe maternal morbidity were reported in an estimated 775 186 maternities, representing an estimated incidence of 89 (95% confidence interval 82 to 95) cases per 100 000 maternities. 74% of women were white, and 26% were non-white. The estimated risk of severe maternal morbidity in white women was 80 cases per 100 000 maternities, and that in non-white women was 126 cases per 100,000 (risk difference 46 (27 to 66) cases per 100 000; risk ratio 1.58, 95% confidence interval 1.33 to 1.87). Black African women (risk difference 108 (18 to 197) cases per 100,000 maternities; risk ratio 2.35, 1.45 to 3.81) and black Caribbean women (risk difference 116 (59 to 172) cases per 100 000 maternities; risk ratio 2.45, 1.81 to 3.31) had the highest risk compared with white women. The risk in non-white women remained high after adjustment for differences in age, socioeconomic and smoking status, body mass index, and parity (odds ratio 1.50, 1.15 to 1.96). Severe maternal morbidity is significantly more common among non-white women than among white women in the UK, particularly in black African and Caribbean ethnic groups. This pattern is very similar to reported ethnic differences in maternal death rates. These differences may be due to the presence of pre-existing maternal medical factors or to factors related to care during pregnancy, labour, and birth; they are unlikely to be due to differences in age, socioeconomic or smoking status, body mass index, or parity. This highlights to clinicians and policy makers the importance of tailored maternity services and improved access to care for women from ethnic minorities. National information on the ethnicity of women giving birth in the UK is needed to enable ongoing accurate study of these inequalities.

Fostering Interdisciplinary Research in Universities: A Case Study of Leadership, Alignment and Support

ERIC Educational Resources Information Center

Townsend, Tony; Pisapia, John; Razzaq, Jamila

2015-01-01

The aim of this paper is to describe actions designed to foster interdisciplinary research efforts at a major university in the UK. The study employed a descriptive mixed method case study approach to collecting and analysing the data used to draw its conclusions. One hundred and twenty-seven academic staff responded to the survey. The results of…

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/.

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

NASA Astrophysics Data System (ADS)

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

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

Statistical Tools for Fitting Models of the Population Consequences of Acoustic Disturbance to Data from Marine Mammal Populations (PCAD Tools II)

DTIC Science & Technology

2015-09-30

Interim PCOD approach. In both of these case studies we relied on expert knowledge to link disturbance to vital rates. In the right whale case study...the Interim Population Consequences of Disturbance ( PCoD ) Approach: Quantifying and Assessing the Effects of UK Offshore Renewable Energy

Engaging Parents with Sex and Relationship Education: A UK Primary School Case Study

ERIC Educational Resources Information Center

Alldred, Pam; Fox, Nick; Kulpa, Robert

2016-01-01

Objective: To assess an intervention to familiarise parents with children's books for use in primary (5-11 years) sex and relationship education (SRE) classes. Method: Case study of a 7-week programme in one London primary school, using ethnographic observation, semi-structured interviews and focus groups with parents (n = 7) and key stakeholders…

The identification of incident cancers in UK primary care databases: a systematic review.

PubMed

Rañopa, Michael; Douglas, Ian; van Staa, Tjeerd; Smeeth, Liam; Klungel, Olaf; Reynolds, Robert; Bhaskaran, Krishnan

2015-01-01

UK primary care databases are frequently used in observational studies with cancer outcomes. We aimed to systematically review methods used by such studies to identify and validate incident cancers of the breast, colorectum, and prostate. Medline and Embase (1980-2013) were searched for UK primary care database studies with incident breast, colorectal, or prostate cancer outcomes. Data on the methods used for case ascertainment were extracted and summarised. Questionnaires were sent to corresponding authors to obtain details about case ascertainment. Eighty-four studies of breast (n = 51), colorectal (n = 54), and prostate cancer (n = 31) were identified; 30 examined >1 cancer type. Among the 84 studies, 57 defined cancers using only diagnosis codes, while 27 required further evidence such as chemotherapy. Few studies described methods used to create cancer code lists (n = 5); or made lists available directly (n = 5). Twenty-eight code lists were received on request from study authors. All included malignant neoplasm diagnosis codes, but there was considerable variation in the specific codes included which was not explained by coding dictionary changes. Code lists also varied in terms of other types of codes included, such as in-situ, cancer morphology, history of cancer, and secondary/suspected/borderline cancer codes. In UK primary care database studies, methods for identifying breast, colorectal, and prostate cancers were often unclear. Code lists were often unavailable, and where provided, we observed variation in the individual codes and types of codes included. Clearer reporting of methods and publication of code lists would improve transparency and reproducibility of studies. Copyright © 2014 John Wiley & Sons, Ltd.

Two Linked Enteroinvasive Escherichia coli Outbreaks, Nottingham, UK, June 2014.

PubMed

Newitt, Sophie; MacGregor, Vanessa; Robbins, Vivienne; Bayliss, Laura; Chattaway, Marie Anne; Dallman, Tim; Ready, Derren; Aird, Heather; Puleston, Richard; Hawker, Jeremy

2016-07-01

Enteroinvasive Escherichia coli (EIEC) outbreaks are uncommon in Europe. In June 2014, two EIEC outbreaks occurred in Nottingham, UK, within 2 days; outbreak A was linked to a takeaway restaurant and outbreak B to a wedding party. We conducted 2 analytical studies: a case-control study for outbreak A and a cohort study for outbreak B. We tested microbiological and environmental samples, including by using whole-genome sequencing. For both outbreaks combined, we identified 157 probable case-patients; 27 were laboratory-confirmed as EIEC O96:H19-positive. Combined epidemiologic, microbiological, and environmental findings implicated lettuce as the vehicle of infection in outbreak A, but the source of the organism remained unknown. Whole-genome sequencing identified the same organism in cases from both outbreaks, but no epidemiologic link was confirmed. These outbreaks highlight that EIEC has the capacity to cause large and severe gastrointestinal disease outbreaks and should be considered as a potential pathogen in foodborne outbreaks in Europe.

UK and Italian EIA systems: A comparative study on management practice and performance in the construction industry

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

Bassi, Andrea, E-mail: ab395@bath.co.uk; Howard, Robert, E-mail: robhoward@constcom.demon.co.uk; Geneletti, Davide, E-mail: davide.geneletti@ing.unitn.it

This study evaluates and contrasts the management practice and the performance that characterise Environmental Impact Assessments (EIA) in Italy and in the UK. The methodology relies on the investigation of six carefully selected case studies, critically reviewed by referring to EIA and project design information, as well as collecting the opinion of key project participants. The study focuses on the construction industry and on specific key sectors like infrastructure for transport and renewable energy and commercial and tourism development. A main term of reference for the analyses has been established by critically reviewing international literature so as to outline commonmore » good practice, requirements for the enhancement of sustainability principles and typically incurred drawbacks. The proposed approach enhances transfer of knowledge and of experiences between the analyzed contexts and allows the provision of guidelines for practitioners. Distinctive differences between the UK and the Italian EIA systems have been detected for pivotal phases and elements of EIA, like screening, scoping, analysis of alternatives and of potential impacts, definition of mitigation strategies, review, decision making, public participation and follow up. - Highlights: Black-Right-Pointing-Pointer The Italian and the UK Environmental Impact Assessment systems are compared. Black-Right-Pointing-Pointer The research is centred on the construction industry. Black-Right-Pointing-Pointer Issues and shortcomings are analysed by investigating six case studies. Black-Right-Pointing-Pointer Integration of EIA with sustainability principles is appraised. Black-Right-Pointing-Pointer General guidelines are provided to assist practitioners in the two national contexts.« less

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.

The uk Lidar-sunphotometer operational volcanic ash monitoring network

NASA Astrophysics Data System (ADS)

Adam, Mariana; Buxmann, Joelle; Freeman, Nigel; Horseman, Andrew; Salmon, Christopher; Sugier, Jacqueline; Bennett, Richard

2018-04-01

The Met Office completed the deployment of ten lidars (UV Raman and depolarization), each accompanied by a sunphotometer (polarized model), to provide quantitative monitoring of volcanic ash over UK for VAAC London. The lidars provide range corrected signal and volume depolarization ratio in near-real time. The sunphotometers deliver aerosol optical depth, Ångstrom exponent and degree of linear polarization. Case study analyses of Saharan dust events (as a proxy for volcanic ash) are presented.

Current optometric practices and attitudes in keratoconus patient management.

PubMed

Ortiz-Toquero, Sara; Martin, Raul

2017-08-01

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

Active screening and surveillance in the United Kingdom for Middle East respiratory syndrome coronavirus in returning travellers and pilgrims from the Middle East: a prospective descriptive study for the period 2013-2015.

PubMed

Atabani, Sowsan F; Wilson, Steven; Overton-Lewis, Clare; Workman, Judith; Kidd, I Michael; Petersen, Eskild; Zumla, Alimuddin; Smit, Erasmus; Osman, Husam

2016-06-01

Over 25000 pilgrims from the UK visit Saudi Arabia every year for the Umrah and Hajj pilgrimages. The recent outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in South Korea and the continuing reports of MERS-CoV cases from Saudi Arabia highlight the need for active surveillance for MERS-CoV in returning pilgrims or travellers from the Middle East. Public Health England Birmingham Laboratory (PHEBL) is one of a few selected UK public health laboratories responsible for MERS-CoV screening in travellers returning to the UK from the Middle East who present to hospital with severe respiratory symptoms. The results of the PHEBL MERS-CoV screening and surveillance over the past 3 years is presented. UK travellers/pilgrims who returned from the Middle East and presented to a hospital with respiratory symptoms were studied over the period February 1, 2013 to December 31, 2015. Patients with respiratory symptoms, who satisfied the Public Health England MERS-CoV case algorithm, were tested for MERS-CoV and other respiratory tract viruses on admission to hospital. Two hundred and two patients suspected of having MERS-CoV were tested. None of them had a laboratory-confirmed MERS-CoV infection. A viral aetiology was detected in half (50.3%) of the cases, with rhinoviruses, influenza A (H1N1 and H3N2), and influenza B being most frequent. Peak testing occurred following the annual Hajj season and in other periods of raised national awareness. Respiratory tract infections in travellers/pilgrims returning to the UK from the Middle East are mainly due to rhinoviruses, influenza A, and influenza B. Whilst MERS-CoV was not detected in the 202 patients studied, heightened awareness of the possibility of MERS-CoV and continuous proactive surveillance are essential to rapidly identify cases of MERS-CoV and other seasonal respiratory tract viruses such as avian influenza, in patients presenting to hospital. Early identification and isolation may prevent outbreaks in nosocomial settings. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Clinical predictors of rectal lymphogranuloma venereum infection: results from a multicentre case–control study in the UK

PubMed Central

Pallawela, S N S; Sullivan, A K; Macdonald, N; French, P; White, J; Dean, G; Smith, A; Winter, A J; Mandalia, S; Alexander, S; Ison, C; Ward, H

2014-01-01

Objective Since 2003, over 2000 cases of lymphogranuloma venereum (LGV) have been diagnosed in the UK in men who have sex with men (MSM). Most cases present with proctitis, but there are limited data on how to differentiate clinically between LGV and other pathology. We analysed the clinical presentations of rectal LGV in MSM to identify clinical characteristics predictive of LGV proctitis and produced a clinical prediction model. Design A prospective multicentre case–control study was conducted at six UK hospitals from 2008 to 2010. Cases of rectal LGV were compared with controls with rectal symptoms but without LGV. Methods Data from 98 LGV cases and 81 controls were collected from patients and clinicians using computer-assisted self-interviews and clinical report forms. Univariate and multivariate logistic regression was used to compare symptoms and signs. Clinical prediction models for LGV were compared using receiver operating curves. Results Tenesmus, constipation, anal discharge and weight loss were significantly more common in cases than controls. In multivariate analysis, tenesmus and constipation alone were suggestive of LGV (OR 2.98, 95% CI 0.99 to 8.98 and 2.87, 95% CI 1.01 to 8.15, respectively) and that tenesmus alone or in combination with constipation was a significant predictor of LGV (OR 6.97, 95% CI 2.71 to 17.92). The best clinical prediction was having one or more of tenesmus, constipation and exudate on proctoscopy, with a sensitivity of 77% and specificity of 65%. Conclusions This study indicates that tenesmus alone or in combination with constipation makes a diagnosis of LGV in MSM presenting with rectal symptoms more likely. PMID:24687130

Association between grip strength and diabetes prevalence in black, South-Asian, and white European ethnic groups: a cross-sectional analysis of 418 656 participants in the UK Biobank study.

PubMed

Ntuk, U E; Celis-Morales, C A; Mackay, D F; Sattar, N; Pell, J P; Gill, J M R

2017-08-01

To quantify the extent to which ethnic differences in muscular strength might account for the substantially higher prevalence of diabetes in black and South-Asian compared with white European adults. This cross-sectional study used baseline data from the UK Biobank study on 418 656 white European, black and South-Asian participants, aged 40-69 years, who had complete data on diabetes status and hand-grip strength. Associations between hand-grip strength and diabetes were assessed using logistic regression and were adjusted for potential confounding factors. Lower grip strength was associated with higher prevalence of diabetes, independent of confounding factors, across all ethnicities in both men and women. Diabetes prevalence was approximately three- to fourfold higher in South-Asian and two- to threefold higher in black participants compared with white European participants across all levels of grip strength, but grip strength in South-Asian men and women was ~ 5-6 kg lower than in the other ethnic groups. Thus, the attributable risk for diabetes associated with low grip strength was substantially higher in South-Asian participants (3.9 and 4.2 cases per 100 men and women, respectively) than in white participants (2.0 and 0.6 cases per 100 men and women, respectively). Attributable risk associated with low grip strength was also high in black men (4.3 cases) but not in black women (0.4 cases). Low strength is associated with a disproportionately large number of diabetes cases in South-Asian men and women and in black men. Trials are needed to determine whether interventions to improve strength in these groups could help reduce ethnic inequalities in diabetes prevalence. © 2017 Diabetes UK.

Food production and service in UK hospitals.

PubMed

Ahmed, Mohamed; Jones, Eleri; Redmond, Elizabeth; Hewedi, Mahmoud; Wingert, Andreas; Gad El Rab, Mohamed

2015-01-01

The purpose of this paper is to apply value stream mapping holistically to hospital food production/service systems focused on high-quality food. Multiple embedded case study of three (two private-sector and one public-sector) hospitals in the UK. The results indicated various issues affecting hospital food production including: the menu and nutritional considerations; food procurement; food production; foodservice; patient perceptions/expectations. Value stream mapping is a new approach for food production systems in UK hospitals whether private or public hospitals. The paper identifies opportunities for enhancing hospital food production systems. The paper provides a theoretical basis for process enhancement of hospital food production and the provision of high-quality hospital food.

Whole-genome sequencing to determine Neisseria gonorrhoeae transmission: an observational study

PubMed Central

Cole, Kevin; Cole, Michelle J; Cresswell, Fiona; Dean, Gillian; Dave, Jayshree; Thomas, Daniel Rh; Foster, Kirsty; Waldram, Alison; Wilson, Daniel J; Didelot, Xavier; Grad, Yonatan H; Crook, Derrick W; Peto, Tim EA; Walker, A Sarah

2016-01-01

Background New approaches are urgently required to address increasing rates of gonorrhoea and the emergence and global spread of antibiotic-resistant Neisseria gonorrhoeae. Whole genome sequencing (WGS) can be applied to study transmission and track resistance. Methods We performed WGS on 1659 isolates from Brighton, UK, and 217 additional isolates from other UK locations. We included WGS data (n=196) from the USA. Estimated mutation rates, plus diversity observed within patients across anatomical sites and probable transmission pairs, were used to fit a coalescent model to determine the number of single nucleotide polymorphisms (SNPs) expected between sequences related by direct/indirect transmission, depending on the time between samples. Findings We detected extensive local transmission. 281/1061(26%) Brighton cases were indistinguishable (0 SNPs) to ≥1 previous case(s), and 786(74%) had evidence of a sampled direct or indirect Brighton source. There was evidence of sustained transmission of some lineages. We observed multiple related samples across geographic locations. Of 1273 infections in Brighton, 225(18%) were linked to another case from elsewhere in the UK, and 115(9%) to a case from the USA. Four lineages initially identified in Brighton could be linked to 70 USA sequences, including 61 from a lineage carrying the mosaic penA XXXIV associated with reduced cefixime susceptibility. Interpretation We present a WGS-based tool for genomic contact tracing of N. gonorrhoeae and demonstrate local, national and international transmission. WGS can be applied across geographical boundaries to investigate gonorrhoea transmission and to track antimicrobial resistance. Funding Oxford NIHR Health Protection Research Unit and Biomedical Research Centre. PMID:27427203

Investigating Time Lags and Attribution in the Translation of Cancer Research: A Case Study Approach.

PubMed

Guthrie, Susan; Pollitt, Alexandra; Hanney, Stephen; Grant, Jonathan

2014-01-01

In 2012, RAND Europe and the Health Economics Research Group (Brunel University) were commissioned by the Wellcome Trust, Cancer Research UK, the National Institute for Health Research and the Academy of Medical Science to conduct a study of the returns to the public/charitable investment in cancer-related research. This study built on previous work published in the 2008 "What's it worth?" report that estimated the economic returns to medical research in terms of spillover benefits and health gain. The 2008 study was extensively quoted and cited as a clear justification for the economic importance of medical research and appears to have played a role in achieving the protection of the medical science budget in the recent public expenditure cuts. This cancer study used a similar approach to that used in the previous study, but with some methodological developments. One of the methodological developments was the inclusion of case studies to examine the validity and variability of the estimates on elapsed time between funding and health gains, and the amount of health gains that can be attributed to UK research. This study provides the full text of the five case studies conducted as well as some discussion of observations emerging across the case study set.

Variations in mortality after emergency laparotomy: the first report of the UK Emergency Laparotomy Network.

PubMed

Saunders, D I; Murray, D; Pichel, A C; Varley, S; Peden, C J

2012-09-01

Emergency laparotomy is a common intra-abdominal procedure. Outcomes are generally recognized to be poor, but there is a paucity of hard UK data, and reports have mainly been confined to single-centre studies. Clinicians were invited to join an 'Emergency Laparotomy Network' and to collect prospective non-risk-adjusted outcome data from a large number of NHS Trusts providing emergency surgical care. Data concerning what were considered to be key aspects of perioperative care, including thirty-day mortality, were collected over a 3 month period. Data from 1853 patients were collected from 35 NHS hospitals. The unadjusted 30 day mortality was 14.9% for all patients and 24.4% in patients aged 80 or over. There was a wide variation between units in terms of the proportion of cases subject to key interventions that may affect outcomes. The presence of a consultant surgeon in theatre varied between 40.6% and 100% of cases, while a consultant anaesthetist was present in theatre for 25-100% of cases. Goal-directed fluid management was used in 0-63% of cases. Between 0% and 68.9% of the patients returned to the ward (level one) after surgery, and between 9.7% and 87.5% were admitted to intensive care (level three). Mortality rates varied from 3.6% to 41.7%. This study confirms that emergency laparotomy in the UK carries a high mortality. The variation in clinical management and outcomes indicates the need for a national quality improvement programme.

Clinical predictors of rectal lymphogranuloma venereum infection: results from a multicentre case-control study in the U.K.

PubMed

Pallawela, S N S; Sullivan, A K; Macdonald, N; French, P; White, J; Dean, G; Smith, A; Winter, A J; Mandalia, S; Alexander, S; Ison, C; Ward, H

2014-06-01

Since 2003, over 2000 cases of lymphogranuloma venereum (LGV) have been diagnosed in the U.K. in men who have sex with men (MSM). Most cases present with proctitis, but there are limited data on how to differentiate clinically between LGV and other pathology. We analysed the clinical presentations of rectal LGV in MSM to identify clinical characteristics predictive of LGV proctitis and produced a clinical prediction model. A prospective multicentre case-control study was conducted at six U.K. hospitals from 2008 to 2010. Cases of rectal LGV were compared with controls with rectal symptoms but without LGV. Data from 98 LGV cases and 81 controls were collected from patients and clinicians using computer-assisted self-interviews and clinical report forms. Univariate and multivariate logistic regression was used to compare symptoms and signs. Clinical prediction models for LGV were compared using receiver operating curves. Tenesmus, constipation, anal discharge and weight loss were significantly more common in cases than controls. In multivariate analysis, tenesmus and constipation alone were suggestive of LGV (OR 2.98, 95% CI 0.99 to 8.98 and 2.87, 95% CI 1.01 to 8.15, respectively) and that tenesmus alone or in combination with constipation was a significant predictor of LGV (OR 6.97, 95% CI 2.71 to 17.92). The best clinical prediction was having one or more of tenesmus, constipation and exudate on proctoscopy, with a sensitivity of 77% and specificity of 65%. This study indicates that tenesmus alone or in combination with constipation makes a diagnosis of LGV in MSM presenting with rectal symptoms more likely. 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.

Genetic isolation of a now extinct population of bottlenose dolphins (Tursiops truncatus)

PubMed Central

Nichols, Courtney; Herman, Jerry; Gaggiotti, Oscar E; Dobney, Keith M; Parsons, Kim; Hoelzel, A. Rus

2007-01-01

A number of dolphin species, though highly mobile, show genetic structure among parapatric and sometimes sympatric populations. However, little is known about the temporal patterns of population structure for these species. Here, we apply Bayesian inference and data from ancient DNA to assess the structure and dynamics of bottlenose dolphin (Tursiops truncatus) populations in the coastal waters of the UK. We show that regional population structure in UK waters is consistent with earlier studies suggesting local habitat dependence for this species in the Mediterranean Sea and North Atlantic. One genetically differentiated UK population went extinct at least 100 years ago and has not been replaced. The data indicate that this was a local extinction, and not a case of historical range shift or contraction. One possible interpretation is a declining metapopulation and conservation need for this species in the UK. PMID:17456457

Lessons from America? US magnet hospitals and their implications for UK nursing.

PubMed

Buchan, J

1994-02-01

This paper examines possible implications of the US 'magnet hospital' concept for the UK nursing labour market. Magnet hospitals have been researched in the US and have been demonstrated to exhibit lower nurse turnover and higher levels of reported job satisfaction than other hospitals. Key characteristics include a decentralized organizational structure, a commitment to flexible working hours, an emphasis on professional autonomy and development, and systematic communication between management and staff. The paper examines the labour market characteristics of UK nurses and US nurses and finds many similarities. Detailed case studies of employment practice in 10 US hospitals and 10 Scottish hospitals are reported, with specific attention to remuneration practice, methods of organizing nursing care, establishment-setting and flexible hours. The paper concludes that there are features of the magnet hospital concept which are of relevance and applicable to the UK nursing labour market, but that piecemeal importation of ideas is unlikely to be beneficial.

How Zoos Are Meeting the Challenges Facing Biodiversity: Bristol Zoo Gardens as a Case Study

ERIC Educational Resources Information Center

Garrett, Simon

2010-01-01

As ideas about effective conservation of biodiversity develop, zoos are adapting their roles to meet the new challenges. This article considers these changes, using the work of Bristol and other UK zoos as a case study. The significance of zoos in both global and local conservation of biodiversity, their role in promoting public engagement and…

Implications of Student and Lecturer Qualitative Views on Reading Lists: A Case Study at Loughborough University, UK

ERIC Educational Resources Information Center

Brewerton, Gary

2014-01-01

This case study explores student and lecturer views of reading lists at Loughborough University. Taking the qualitative data from two surveys previously undertaken at the institution, it uses the grounded theory approach to identify key issues regarding the purpose, importance, visibility, content, currency, and length of reading lists, as well as…

Modifiable and non-modifiable risk factors for poor sperm morphology.

PubMed

Pacey, A A; Povey, A C; Clyma, J-A; McNamee, R; Moore, H D; Baillie, H; Cherry, N M

2014-08-01

Are common lifestyle factors associated with poor sperm morphology? Common lifestyle choices make little contribution to the risk of poor sperm morphology. Although many studies have claimed that men's lifestyle can affect sperm morphology, the evidence is weak with studies often underpowered and poorly controlled. Unmatched case-referent study with 318 cases and 1652 referents. Cases had poor sperm morphology (<4% normal forms based on 200 sperm assessed). Exposures included self-reported exposures to alcohol, tobacco, recreational drugs as well as occupational and other factors. Eligible men, aged 18 years or above, were part of a couple who had been attempting conception without success following at least 12 months of unprotected intercourse and also had no knowledge of any semen analysis before being enrolled. They were recruited from 14 fertility clinics across the UK during a 37-month period from 1 January 1999. Risk factors for poor sperm morphology, after adjustment for centre and other risk factors, included: (i) sample production in summer [odds ratio (OR) = 1.99, 95% confidence interval (CI) 1.43-2.72]; and (ii) use of cannabis in the 3 months prior to sample collection in men aged ≤30 years (OR = 1.94, 95% CI 1.05-3.60). Men who produced a sample after 6 days abstinence were less likely to be a case (OR = 0.64, 95% CI 0.43-0.95). No significant association was found with body mass index, type of underwear, smoking or alcohol consumption or having a history of mumps. This suggests that an individual's lifestyle has very little impact on sperm morphology and that delaying assisted conception to make changes to lifestyle is unlikely to enhance conception. Data were collected blind to outcome and so exposure information should not have been subject to reporting bias. Less than half the men attending the various clinics met the study eligibility criteria and among those who did, two out of five did not participate. It is not known whether any of those who refused to take part did so because they had a lifestyle which they did not want subjected to investigation. Although the power of the study was sufficient to draw conclusions about common lifestyle choices, this is not the case for exposures that were rare or poorly reported. All participating clinics saw patients at no cost (under the UK National Health Service) and the study population may differ from those in countries without such provision. Even within the UK, low-income couples may choose not to undertake any investigation believing that they would subsequently be unable to afford treatment. Since a computer performed the measurements of sperm morphology, these results may not be comparable with studies where sperm morphology was assessed by other methods. The study was funded by the UK Health and Safety Executive, the UK Department of Environment, Transport and the Regions, the UK Department of Health (Grant Code DoH 1216760) and the European Chemical Industry Council (grant code EMSG19). No competing interests declared. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Pharmaceutical Industry Off-label Promotion and Self-regulation: A Document Analysis of Off-label Promotion Rulings by the United Kingdom Prescription Medicines Code of Practice Authority 2003–2012

PubMed Central

Vilhelmsson, Andreas; Davis, Courtney; Mulinari, Shai

2016-01-01

Background European Union law prohibits companies from marketing drugs off-label. In the United Kingdom—as in some other European countries, but unlike the United States—industry self-regulatory bodies are tasked with supervising compliance with marketing rules. The objectives of this study were to (1) characterize off-label promotion rulings in the UK compared to the whistleblower-initiated cases in the US and (2) shed light on the UK self-regulatory mechanism for detecting, deterring, and sanctioning off-label promotion. Methods and Findings We conducted structured reviews of rulings by the UK self-regulatory authority, the Prescription Medicines Code of Practice Authority (PMCPA), between 2003 and 2012. There were 74 off-label promotion rulings involving 43 companies and 65 drugs. Nineteen companies were ruled in breach more than once, and ten companies were ruled in breach three or more times over the 10-y period. Drawing on a typology previously developed to analyse US whistleblower complaints, we coded and analysed the apparent strategic goals of each off-label marketing scheme and the practices consistent with those alleged goals. 50% of rulings cited efforts to expand drug use to unapproved indications, and 39% and 38% cited efforts to expand beyond approved disease entities and dosing strategies, respectively. The most frequently described promotional tactic was attempts to influence prescribers (n = 72, 97%), using print material (70/72, 97%), for example, advertisements (21/70, 30%). Although rulings cited prescribers as the prime target of off-label promotion, competing companies lodged the majority of complaints (prescriber: n = 16, 22%, versus companies: n = 42, 57%). Unlike US whistleblower complaints, few UK rulings described practices targeting consumers (n = 3, 4%), payers (n = 2, 3%), or company staff (n = 2, 3%). Eight UK rulings (11%) pertaining to six drugs described promotion of the same drug for the same off-label use as was alleged by whistleblowers in the US. However, while the UK cases typically related to only one or a few claims made in printed material, several complaints in the US alleged multifaceted and covert marketing activities. Because this study is limited to PMCPA rulings and whistleblower-initiated federal cases, it may offer a partial view of exposed off-label marketing. Conclusion The UK self-regulatory system for exposing marketing violations relies largely on complaints from company outsiders, which may explain why most off-label promotion rulings relate to plainly visible promotional activities such as advertising. This contrasts with the US, where Department of Justice investigations and whistleblower testimony have alleged complex off-label marketing campaigns that remain concealed to company outsiders. UK authorities should consider introducing increased incentives and protections for whistleblowers combined with US-style governmental investigations and meaningful sanctions. UK prescribers should be attentive to, and increasingly report, off-label promotion. PMID:26812151

Pharmaceutical Industry Off-label Promotion and Self-regulation: A Document Analysis of Off-label Promotion Rulings by the United Kingdom Prescription Medicines Code of Practice Authority 2003-2012.

PubMed

Vilhelmsson, Andreas; Davis, Courtney; Mulinari, Shai

2016-01-01

European Union law prohibits companies from marketing drugs off-label. In the United Kingdom--as in some other European countries, but unlike the United States--industry self-regulatory bodies are tasked with supervising compliance with marketing rules. The objectives of this study were to (1) characterize off-label promotion rulings in the UK compared to the whistleblower-initiated cases in the US and (2) shed light on the UK self-regulatory mechanism for detecting, deterring, and sanctioning off-label promotion. We conducted structured reviews of rulings by the UK self-regulatory authority, the Prescription Medicines Code of Practice Authority (PMCPA), between 2003 and 2012. There were 74 off-label promotion rulings involving 43 companies and 65 drugs. Nineteen companies were ruled in breach more than once, and ten companies were ruled in breach three or more times over the 10-y period. Drawing on a typology previously developed to analyse US whistleblower complaints, we coded and analysed the apparent strategic goals of each off-label marketing scheme and the practices consistent with those alleged goals. 50% of rulings cited efforts to expand drug use to unapproved indications, and 39% and 38% cited efforts to expand beyond approved disease entities and dosing strategies, respectively. The most frequently described promotional tactic was attempts to influence prescribers (n = 72, 97%), using print material (70/72, 97%), for example, advertisements (21/70, 30%). Although rulings cited prescribers as the prime target of off-label promotion, competing companies lodged the majority of complaints (prescriber: n = 16, 22%, versus companies: n = 42, 57%). Unlike US whistleblower complaints, few UK rulings described practices targeting consumers (n = 3, 4%), payers (n = 2, 3%), or company staff (n = 2, 3%). Eight UK rulings (11%) pertaining to six drugs described promotion of the same drug for the same off-label use as was alleged by whistleblowers in the US. However, while the UK cases typically related to only one or a few claims made in printed material, several complaints in the US alleged multifaceted and covert marketing activities. Because this study is limited to PMCPA rulings and whistleblower-initiated federal cases, it may offer a partial view of exposed off-label marketing. The UK self-regulatory system for exposing marketing violations relies largely on complaints from company outsiders, which may explain why most off-label promotion rulings relate to plainly visible promotional activities such as advertising. This contrasts with the US, where Department of Justice investigations and whistleblower testimony have alleged complex off-label marketing campaigns that remain concealed to company outsiders. UK authorities should consider introducing increased incentives and protections for whistleblowers combined with US-style governmental investigations and meaningful sanctions. UK prescribers should be attentive to, and increasingly report, off-label promotion.

An overview of the flight campaign for the GAUGE project: airborne greenhouse gas (and other complementary trace gas) measurements around and over the UK between April 2014 and May 2015

NASA Astrophysics Data System (ADS)

Allen, Grant; Pitt, Joseph; Le Breton, Michael; Percival, Carl; Bannan, Thomas; O'Doherty, Simon; Manning, Alistair; Rigby, Matt; Gannesan, Anita; Mead, Mohammed; Bauguitte, Stephane; Lee, James; Wenger, Angelina; Palmer, Paul

2016-04-01

This work highlights data measured during flights by the UK Facility for Airborne Atmospheric Measurement (FAAM) as part of the Greenhouse gAs UK and Global Emissions (GAUGE) campaign. A total of 17 flights (85 flight-hours) have been conducted so far around the UK mainland and Ireland to sample precision in situ CH4, CO2, N2O (and other trace gas) concentrations and meteorological parameters at altitudes up to 9500m throughout the period April 2014 to May 2015. Airborne remote sensing retrievals of greenhouse gas total columns have also been calculated using the Manchester Airborne Retrieval Scheme for the UK Met Office ARIES high resolution FTIR instrument. This airborne dataset represents a mapped climatology and a series of case studies from which to assess top-down bulk-net-flux snapshots for regions of the UK, and provides for evaluation of inverse modelling approaches that challenge bottom-up inventories, satellite remote sensing measurements, and assessment of model transport uncertainty. In this paper, we shall describe the instrumentation on the FAAM aircraft and provide a diary of GAUGE FAAM flights (and data highlights) to date; and discuss selected flights of interest to studies such as those above with a focus of net mass flux evaluation.

Maintenance Work, Maintenance Skills: The Case of a Major Water Company in the UK.

ERIC Educational Resources Information Center

Cooke, Fang Lee

2002-01-01

A case study of a British water company found that technological change had only a moderate impact on technical skills but increased the need for diagnostic and information technology skills for the maintenance of electronic equipment. Organizational restructuring increased requirements for functional flexibility and interpersonal skills.…

Privatising the Public University: The Case of Law

ERIC Educational Resources Information Center

Thornton, Margaret

2011-01-01

"Privatising the Public University: The Case of Law" is the first full-length critical study examining the impact of the dramatic reforms that have swept through universities over the last two decades. Drawing on extensive research and interviews in Australia, New Zealand, the UK and Canada, Margaret Thornton considers the impact of the…

A multi-country Salmonella Enteritidis phage type 14b outbreak associated with eggs from a German producer: 'near real-time' application of whole genome sequencing and food chain investigations, United Kingdom, May to September 2014.

PubMed

Inns, T; Lane, C; Peters, T; Dallman, T; Chatt, C; McFarland, N; Crook, P; Bishop, T; Edge, J; Hawker, J; Elson, R; Neal, K; Adak, G K; Cleary, P

2015-04-23

We report an outbreak of Salmonella Enteritidis phage type 14b (PT14b) in the United Kingdom (UK) between May and September 2014 where Public Health England launched an investigation to identify the source of infection and implement control measures. During the same period, outbreaks caused by a Salmonella Enteritidis strain with a specific multilocus variable-number tandem repeat analysis (MLVA) profile occurred in other European Union Member States. Isolates from a number of persons affected by the UK outbreak, who had initially been tested by MLVA also shared this particular profile. Cases were defined as any person infected with S. Enteritidis PT14b, resident in England or Wales and without history of travel outside of this geographical area during the incubation period, reported from 1 June 2014 onwards, with a MLVA profile of 2–11–9-7–4-3–2-8–9 or a single locus variant thereof. In total, 287 cases met the definition. Food traceback investigations in the UK and other affected European countries linked the outbreaks to chicken eggs from a German company. We undertook whole genome sequencing of isolates from UK and European cases, implicated UK premises, and German eggs: isolates were highly similar. Combined with food traceback information, this confirmed that the UK outbreak was also linked to a German producer.

Detection and molecular characterization of Livestock-Associated MRSA in raw meat on retail sale in North West England.

PubMed

Fox, A; Pichon, B; Wilkinson, H; Doumith, M; Hill, R L R; McLauchlin, J; Kearns, A M

2017-03-01

Limited data are available on the prevalence of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) in the UK. We tested 124 raw meat samples for MRSA including pork (n = 63), chicken (n = 50) and turkey (n = 11) collected from retail outlets in North West England between March and July 2015. MRSA was recovered from nine (7·3%) samples (four chicken, three pork and two turkey) from different butchers and supermarkets. Four were labelled of UK origin, three were from continental Europe; the origin was not specified for two samples. Whole-genome sequencing (WGS), spa typing and the presence of lineage-specific canonical single nucleotide polymorphisms confirmed that they belonged to the livestock-associated clade of clonal complex (CC) 398. Seven (77·8%) isolates were multi-drug resistant. Phylogenetic analyses showed the isolates were diverse, suggesting multiple silent introductions of LA-MRSA into the UK food chain. Two chicken meat isolates belonged to a sub-clade recently reported from human cases in Europe where poultry meat was the probable source. The low levels of MRSA identified (<20 CFU per g) and absence of enterotoxin genes suggest the risk of acquisition of, or food-poisoning due to, LA-MRSA is low. Nevertheless, the MRSA contamination rate is higher than previously estimated; further evaluation of the public health impacts of LA-MRSA is warranted. Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) is a public health concern worldwide, but has only been reported sporadically in the UK. In the largest UK study to date, samples of raw meat at retail sale were examined for both the presence and levels of MRSA. We report the first isolations of CC398 LA-MRSA from poultry meat in the UK including representatives of a particular sub-clade associated with cases of human infection/colonization in Europe. Although levels were low (<20 CFU per g), the contamination rate was higher than previous UK studies. Moreover, whole-genome sequencing revealed multiple independent introductions of LA-MRSA into the UK food chain. © 2016 Crown copyright. Letters in Applied Microbiology © 2016 The Society for Applied Microbiology This article is published with the permission of the Controller of HMSO and the Queen's Printer for Scotland.

Results from an exploratory study to identify the factors that contribute to success for UK medical device small- and medium-sized enterprises.

PubMed

Hourd, P C; Williams, D J

2008-07-01

This paper reports the results from an exploratory study that sets out to identify and compare the strategic approaches and patterns of business practice employed by 14 UK small- and medium-sized enterprises to achieve success in the medical device sector of the health-care industry. An interview-based survey was used to construct individual case studies of the medical device technology (MDT) companies. A cross-case analysis was performed to search for patterns and themes that cut across these individual cases. Exploratory results revealed the heterogeneity of MDT companies and the distinctive features of the MDT innovation process that emphasize the importance of a strategic approach for achieving milestones in the product development and exploitation process and for creating value for the company and its stakeholders. Recognizing the heterogeneity of MDT companies, these exploratory findings call for further investigation to understand better the influence of components of the MDT innovation process on the commercialization life cycle and value trajectory. This is required to assist start-up or spin-out MDT companies in the UK and worldwide to navigate the critical transitions that determine access to financial and consumer markets and enhance the potential to build a successful business. This will be important not only for bioscience-based companies but also for engineering-based companies aiming to convert their activities into medical devices and the health- and social-care market.

National outbreak of Shiga toxin-producing Escherichia coli O157:H7 linked to mixed salad leaves, United Kingdom, 2016.

PubMed

Gobin, Maya; Hawker, Jeremy; Cleary, Paul; Inns, Thomas; Gardiner, Daniel; Mikhail, Amy; McCormick, Jacquelyn; Elson, Richard; Ready, Derren; Dallman, Tim; Roddick, Iain; Hall, Ian; Willis, Caroline; Crook, Paul; Godbole, Gauri; Tubin-Delic, Drazenka; Oliver, Isabel

2018-05-01

We investigated a large outbreak of Escherichia coli O157 in the United Kingdom (UK) with 165 cases between 31 May and 29 July 2016. No linked cases were reported in other countries. Cases were predominately female (n = 128) and adult (n = 150), 66 attended hospital and nine had features of haemorrhagic uraemic syndrome. A series of epidemiological studies (case-control, case-case, ingredients-based and venue-based studies) and supply chain investigations implicated mixed salad leaves from Supplier A as the likely outbreak vehicle. Whole genome sequencing (WGS) indicated a link with strains from the Mediterranean and informed the outbreak control team to request that Supplier A cease distributing salad leaves imported from Italy. Microbiological tests of samples of salad leaves from Supplier A were negative. We were unable to confirm the source of contamination or the contaminated constituent leaf although our evidence pointed to red batavia received from Italy as the most likely vehicle. Variations in Shiga toxin-producing E. coli surveillance and diagnosis may have prevented detection of cases outside the UK and highlights a need for greater standardisation. WGS was useful in targeting investigations, but greater coverage across Europe is needed to maximise its potential.

Online market research panel members as controls in case-control studies to investigate gastrointestinal disease outbreaks: early experiences and lessons learnt from the UK.

PubMed

Mook, P; McCormick, J; Kanagarajah, S; Adak, G K; Cleary, P; Elson, R; Gobin, M; Hawker, J; Inns, T; Sinclair, C; Trienekens, S C M; Vivancos, R; McCarthy, N D

2018-03-01

Established methods of recruiting population controls for case-control studies to investigate gastrointestinal disease outbreaks can be time consuming, resulting in delays in identifying the source or vehicle of infection. After an initial evaluation of using online market research panel members as controls in a case-control study to investigate a Salmonella outbreak in 2013, this method was applied in four further studies in the UK between 2014 and 2016. We used data from all five studies and interviews with members of each outbreak control team and market research panel provider to review operational issues, evaluate risk of bias in this approach and consider methods to reduce confounding and bias. The investigators of each outbreak reported likely time and cost savings from using market research controls. There were systematic differences between case and control groups in some studies but no evidence that conclusions on the likely source or vehicle of infection were incorrect. Potential selection biases introduced by using this sampling frame and the low response rate are unclear. Methods that might reduce confounding and some bias should be balanced with concerns for overmatching. Further evaluation of this approach using comparisons with traditional methods and population-based exposure survey data is recommended.

Facilitating the recruitment of minority ethnic people into research: qualitative case study of South Asians and asthma.

PubMed

Sheikh, Aziz; Halani, Laila; Bhopal, Raj; Netuveli, Gopalakrishnan; Partridge, Martyn R; Car, Josip; Griffiths, Chris; Levy, Mark

2009-10-01

There is international interest in enhancing recruitment of minority ethnic people into research, particularly in disease areas with substantial ethnic inequalities. A recent systematic review and meta-analysis found that UK South Asians are at three times increased risk of hospitalisation for asthma when compared to white Europeans. US asthma trials are far more likely to report enrolling minority ethnic people into studies than those conducted in Europe. We investigated approaches to bolster recruitment of South Asians into UK asthma studies through qualitative research with US and UK researchers, and UK community leaders. Interviews were conducted with 36 researchers (19 UK and 17 US) from diverse disciplinary backgrounds and ten community leaders from a range of ethnic, religious, and linguistic backgrounds, followed by self-completion questionnaires. Interviews were digitally recorded, translated where necessary, and transcribed. The Framework approach was used for analysis. Barriers to ethnic minority participation revolved around five key themes: (i) researchers' own attitudes, which ranged from empathy to antipathy to (in a minority of cases) misgivings about the scientific importance of the question under study; (ii) stereotypes and prejudices about the difficulties in engaging with minority ethnic populations; (iii) the logistical challenges posed by language, cultural differences, and research costs set against the need to demonstrate value for money; (iv) the unique contexts of the two countries; and (v) poorly developed understanding amongst some minority ethnic leaders of what research entails and aims to achieve. US researchers were considerably more positive than their UK counterparts about the importance and logistics of including ethnic minorities, which appeared to a large extent to reflect the longer-term impact of the National Institutes of Health's requirement to include minority ethnic people. Most researchers and community leaders view the broadening of participation in research as important and are reasonably optimistic about the feasibility of recruiting South Asians into asthma studies provided that the barriers can be overcome. Suggested strategies for improving recruitment in the UK included a considerably improved support structure to provide academics with essential contextual information (e.g., languages of particular importance and contact with local gatekeepers), and the need to ensure that care is taken to engage with the minority ethnic communities in ways that are both culturally appropriate and sustainable; ensuring reciprocal benefits was seen as one key way of avoiding gatekeeper fatigue. Although voluntary measures to encourage researchers may have some impact, greater impact might be achieved if UK funding bodies followed the lead of the US National Institutes of Health requiring recruitment of ethnic minorities. Such a move is, however, likely in the short- to medium-term, to prove unpopular with many UK academics because of the added "hassle" factor in engaging with more diverse populations than many have hitherto been accustomed to.

Facilitating the Recruitment of Minority Ethnic People into Research: Qualitative Case Study of South Asians and Asthma

PubMed Central

Sheikh, Aziz; Halani, Laila; Bhopal, Raj; Netuveli, Gopalakrishnan; Partridge, Martyn R.; Car, Josip; Griffiths, Chris; Levy, Mark

2009-01-01

Background There is international interest in enhancing recruitment of minority ethnic people into research, particularly in disease areas with substantial ethnic inequalities. A recent systematic review and meta-analysis found that UK South Asians are at three times increased risk of hospitalisation for asthma when compared to white Europeans. US asthma trials are far more likely to report enrolling minority ethnic people into studies than those conducted in Europe. We investigated approaches to bolster recruitment of South Asians into UK asthma studies through qualitative research with US and UK researchers, and UK community leaders. Methods and Findings Interviews were conducted with 36 researchers (19 UK and 17 US) from diverse disciplinary backgrounds and ten community leaders from a range of ethnic, religious, and linguistic backgrounds, followed by self-completion questionnaires. Interviews were digitally recorded, translated where necessary, and transcribed. The Framework approach was used for analysis. Barriers to ethnic minority participation revolved around five key themes: (i) researchers' own attitudes, which ranged from empathy to antipathy to (in a minority of cases) misgivings about the scientific importance of the question under study; (ii) stereotypes and prejudices about the difficulties in engaging with minority ethnic populations; (iii) the logistical challenges posed by language, cultural differences, and research costs set against the need to demonstrate value for money; (iv) the unique contexts of the two countries; and (v) poorly developed understanding amongst some minority ethnic leaders of what research entails and aims to achieve. US researchers were considerably more positive than their UK counterparts about the importance and logistics of including ethnic minorities, which appeared to a large extent to reflect the longer-term impact of the National Institutes of Health's requirement to include minority ethnic people. Conclusions Most researchers and community leaders view the broadening of participation in research as important and are reasonably optimistic about the feasibility of recruiting South Asians into asthma studies provided that the barriers can be overcome. Suggested strategies for improving recruitment in the UK included a considerably improved support structure to provide academics with essential contextual information (e.g., languages of particular importance and contact with local gatekeepers), and the need to ensure that care is taken to engage with the minority ethnic communities in ways that are both culturally appropriate and sustainable; ensuring reciprocal benefits was seen as one key way of avoiding gatekeeper fatigue. Although voluntary measures to encourage researchers may have some impact, greater impact might be achieved if UK funding bodies followed the lead of the US National Institutes of Health requiring recruitment of ethnic minorities. Such a move is, however, likely in the short- to medium-term, to prove unpopular with many UK academics because of the added “hassle” factor in engaging with more diverse populations than many have hitherto been accustomed to. Please see later in the article for the Editors' Summary PMID:19823568

Iron supplementation in Switzerland - A bi-national, descriptive and observational study.

PubMed

Biétry, Fabienne A; Hug, Balthasar; Reich, Oliver; Susan, Jick S; Meier, Christoph Rudolf

2017-07-11

Iron deficiency is the most common nutritional disorder in the world, and it is the only common nutrient deficiency in industrialised nations. It is thought to be the most common cause of anaemia. Use of iron supplementation in Switzerland has not been previously quantified in detail. We quantified use of iron supplementation from Swiss data and compared it with data from the UK. We assessed the frequency of serum ferritin and haemoglobin tests prior to newly started iron therapy to see whether use was based on documented low iron levels or blood parameters, especially in the case of parenteral iron supplementation. We conducted a retrospective descriptive study of prescription iron supplementation use, and compared use of oral or parenteral iron drugs between Switzerland (CH) and the UK. We retrieved Swiss data from the Swiss Health Insurance Helsana Group, and UK data were from the Clinical Practice Research Datalink (CPRD). The study period was 2012 to 2014. The 3-year prevalence of iron supplementation was 9.4% in Switzerland and 4.4% in the UK. Iron use increased slightly between 2012 and 2014 in both countries (CH +0.3%, UK +0.2%). Recorded parenteral iron administration was roughly a thousand times higher in Switzerland (1.9%) than in the UK in 2014. In Switzerland, iron supplements were mostly given to patients aged 20 to 49 years or older than of 80 years. In the UK, iron supplementation was less frequent in younger people, but more prevalent in the elderly. Prior to a first iron prescription, ferritin tests were done more frequently in Switzerland (oral 67.2%, parenteral 86.6%) than in the UK (oral 43.3%, parenteral 65.5%). Haemoglobin was measured before a new parenteral iron therapy rarely in Switzerland (oral 14.9%, parenteral 11.7%), but frequently in the UK (oral 77.4%, parenteral 85.6%). Iron supplementation is more common in Switzerland than in the UK, particularly parenteral iron supplementation. Haemoglobin measurements prior to a new parenteral iron therapy are relatively infrequent in Switzerland despite the required documentation of haemoglobin prior to therapy.

SMART Moves? A Case Study of One Teacher's Pedagogical Change through Use of the Interactive Whiteboard

ERIC Educational Resources Information Center

Mohon, Elizabeth H.

2008-01-01

This case study investigates how the use of an interactive whiteboard (IWB) leads to pedagogical change within a UK secondary school classroom. A teacher's experiences as recorded in a reflective journal, and the responses of students as recorded in a questionnaire, are set within the context of rhetoric about the value of IWBs. It is argued that…

Beyond the Books: Case Study of a Collaborative and Holistic Support Model for University Students with Asperger Syndrome

ERIC Educational Resources Information Center

MacLeod, Andrea; Green, Sue

2009-01-01

This article reflects on the experience of one UK higher education institution in its efforts to develop more effective support mechanisms for the growing numbers of students with Asperger syndrome and autism, in collaboration with a specialist support organisation. Case studies are used to illustrate the complex needs of this group of students.…

"Languages in the Workplace": Embedding Employability in the Foreign Language Undergraduate Curriculum

ERIC Educational Resources Information Center

Organ, Alison

2017-01-01

This case study examines student perceptions of the experiential value of a work placement carried out as part of a languages degree programme. The data for the case study consists of a corpus of 67 reports submitted from 2011 to 2015, reflecting on placements carried out in Europe, Japan, the UK and the US. The data offers a student view of the…

A Case-Study of One Teacher's Use of an Interactive Whiteboard System to Support Knowledge Co-Construction in the History Classroom

ERIC Educational Resources Information Center

Deaney, Rosemary; Chapman, Arthur; Hennessy, Sara

2009-01-01

Interactive whiteboards (IWBs) have rapidly become an integral feature of many classrooms across the UK and elsewhere, but debate continues regarding the pedagogical implications of their use. This article reports on an in-depth case-study from the wider T-MEDIA project (Teacher Mediation of Subject Learning with ICT: a Multimedia Approach). A key…

Food waste disposal units in UK households: the need for policy intervention.

PubMed

Iacovidou, Eleni; Ohandja, Dieudonne-Guy; Voulvoulis, Nikolaos

2012-04-15

The EU Landfill Directive requires Member States to reduce the amount of biodegradable waste disposed of to landfill. This has been a key driver for the establishment of new waste management options, particularly in the UK, which in the past relied heavily on landfill for the disposal of municipal solid waste (MSW). MSW in the UK is managed by Local Authorities, some of which in a less conventional way have been encouraging the installation and use of household food waste disposal units (FWDs) as an option to divert food waste from landfill. This study aimed to evaluate the additional burden to water industry operations in the UK associated with this option, compared with the benefits and related savings from the subsequent reductions in MSW collection and disposal. A simple economic analysis was undertaken for different FWD uptake scenarios, using the Anglian Region as a case study. Results demonstrated that the significant savings from waste collection arising from a large-scale uptake of FWDs would outweigh the costs associated with the impacts to the water industry. However, in the case of a low uptake, such savings would not be enough to cover the increased costs associated with the wastewater provision. As a result, this study highlights the need for policy intervention in terms of regulating the use of FWDs, either promoting them as an alternative to landfill to increase savings from waste management, or banning them as a threat to wastewater operations to reduce potential costs to the water industry. Copyright © 2012 Elsevier B.V. All rights reserved.

A qualitative study of advanced nurse practitioners' use of physical assessment skills in the community: shifting skills across professional boundaries.

PubMed

Raleigh, Mary; Allan, Helen

2017-07-01

To explore multiple perspectives on the use of physical assessment skills by advanced nurse practitioners in the UK. Physical assessment skills practices are embedded in advanced nursing practice roles in the UK. There is little evidence on how these skills are used by advanced nurse practitioners in the community. Case study. A qualitative interpretative single-embedded case study of 22 participants from South of England. A framework method analysed interview data collected by the researcher between March-August 2013. Participants included nurses, doctors, nurse educators and managers. Physical assessment skills education at universities is part of a policy shift to develop a flexible workforce in the UK. Shared physical assessment practices are less to do with role substitution and more about preparing practitioners with skills that are fit for purpose. Competence, capability and performance with physical assessment skills are an expectation of advanced nursing practice. These skills are used successfully by community advanced nurse practitioners to deliver a wide range of services in response to changing patient need. The introduction of physical assessment skills education to undergraduate professional preparation would create a firm foundation to develop these skills in postgraduate education. Physical assessment education prepares nurses with the clinical competencies to carry out healthcare reforms in the UK. Shared sets of clinical assessment competencies between disciplines have better outcomes for patients. Levels of assessment competence can depend on the professional attributes of individual practitioners. Unsupportive learning cultures can hinder professional development of advanced nursing practice. © 2016 John Wiley & Sons Ltd.

A management approach that drives actions strategically: balanced scorecard in a mental health trust case study.

PubMed

Schmidt, Stefan; Bateman, Ian; Breinlinger-O'Reilly, Jochen; Smith, Peter

2006-01-01

Achieving excellence is a current preoccupation in U.K. public health organisations. This article aims to use a case study to explain how a mental health trust delivers excellent performance using a balanced scorecard (BSC) management approach. Reports a project to implement a BSC approach in the South West Yorkshire Mental Health NHS Trust to achieve its "excellence" objectives. The authors were participants in the project. The design of the pilot project was informed theoretically by the work of Kaplan and Norton and practically by in-house discussions on a strategy to achieve excellence. Explains the process of building a BSC strategy step-by-step. Discusses how the vision and strategies of a mental health trust can be translated into tangible measures, which are the basis for actions that are driven strategically. There are many possibilities for a BSC management approach and this case study is specific to mental health trusts in the UK, although it is believed that the case has a universally applicable modus operandi. This article will help healthcare managers to evaluate the benefits of a BSC management approach. This article explains how actions can be structured in connection with a BSC management approach.

Cross-border-assisted reproduction: a qualitative account of UK travellers' experiences.

PubMed

Hudson, Nicky; Culley, Lorraine; Blyth, Eric; Norton, Wendy; Pacey, Allan; Rapport, Frances

2016-06-01

Surveys on patients' experiences of cross-border fertility treatment have reported a range of positive and challenging features. However, the number of such studies is limited, and there is no detailed qualitative account of the experiences of UK patients who travel overseas for fertility treatment. The present study used a cross-sectional, qualitative design and in-depth interviews. Fifty-one participants (41 women and 10 men, representing 41 treatment 'cases') participated in semi-structured interviews. The experiences reported were broadly positive with a large proportion of participants (39 cases, 95%) citing a favourable overall experience with only two cases (5%) reporting a more negative experience. Thematic analysis revealed 6 major categories and 20 sub-categories, which described the positive and challenging aspects of cross-border fertility travel. The positive aspects were represented by the categories: 'access', 'control' and 'care and respect'. The more challenging aspects were categorized as 'logistics and coordination of care', 'uncertainty' and 'cultural dissonance'. The study confirms findings from others that despite some challenges, there is a relatively high level of patient satisfaction with cross-border treatment with participants able to extend the boundaries of their fertility-seeking trajectories and in some cases, regain a sense of control over their treatment.

Cost-effectiveness evaluation of quadrivalent influenza vaccines for seasonal influenza prevention: a dynamic modeling study of Canada and the United Kingdom.

PubMed

Thommes, Edward W; Ismaila, Afisi; Chit, Ayman; Meier, Genevieve; Bauch, Christopher T

2015-10-27

The adoption of quadrivalent influenza vaccine (QIV) to replace trivalent influenza vaccine (TIV) in immunization programs is growing worldwide, thus helping to address the problem of influenza B lineage mismatch. However, the price per dose of QIV is higher than that of TIV. In such circumstances, cost-effectiveness analyses provide important and relevant information to inform national health recommendations and implementation decisions. This analysis assessed potential vaccine impacts and cost-effectiveness of a country-wide switch from TIV to QIV, in Canada and the UK, from a third-party payer perspective. An age-stratified, dynamic four-strain transmission model which incorporates strain interaction, transmission-rate seasonality and age-specific mixing in the population was used. Model input data were obtained from published literature and online databases. In Canada, we evaluated a switch from TIV to QIV in the entire population. For the UK, we considered two strategies: Children aged 2-17 years who receive the live-attenuated influenza vaccine (LAIV) switch to the quadrivalent formulation (QLAIV), while individuals aged > 18 years switch from TIV to QIV. Two different vaccination uptake scenarios in children (UK1 and UK2, which differ in the vaccine uptake level) were considered. Health and cost outcomes for both vaccination strategies, and the cost-effectiveness of switching from TIV/LAIV to QIV/QLAIV, were estimated from the payer perspective. For Canada and the UK, cost and outcomes were discounted using 5 % and 3.5 % per year, respectively. Overall, in an average influenza season, our model predicts that a nationwide switch from TIV to QIV would prevent 4.6 % influenza cases, 4.9 % general practitioner (GP) visits, 5.7 % each of emergency room (ER) visits and hospitalizations, and 6.8 % deaths in Canada. In the UK (UK1/UK2), implementing QIV would prevent 1.4 %/1.8 % of influenza cases, 1.6 %/2.0 % each of GP and ER visits, 1.5 %/1.9 % of hospitalizations and 4.3 %/4.9 % of deaths. Discounted incremental cost-utility ratios of $7,961 and £7,989/£7,234 per quality-adjusted life-year (QALY) gained are estimated for Canada and the UK (UK1/UK2), both of which are well within their respective cost-effectiveness threshold values. Switching from TIV to QIV is expected to be a cost-effective strategy to further reduce the burden of influenza in both countries.

The impact of market oriented reforms on choice and information: a case study of cataract surgery in outer London and Stockholm.

PubMed

Fotaki, M

1999-05-01

In the early 1990s, a set of market-oriented reforms was introduced into health care systems of the UK and Sweden, two exemplary cases of reliance on planned budgeting and integrated provision of services. In the pursuit of increased efficiency, several County Councils in Sweden have followed the public competition model, while in the UK internal market reforms were introduced. It was expected that the separation of functions of planners and purchasers from those of providers, which were to be freely chosen by the former, would achieve higher allocative efficiency but also enhance users' satisfaction with care. This paper uses cataract surgery as a case study to trace the impact of competition among providers on choice and information. Qualitative research methods were employed to record the perception of changes in their type and amount as it was given to both purchasers and patients. A set of open ended and standardised questionnaires was designed to elicit the views of all actors involved and to measure the likely transformations. Four study sites from Outer London were selected representing the diversity of responses, and the only existing large provider of eye services to Stockholm County Council was used. The analysis of the data showed that the quasi-market reforms have resulted in a change of attitude of providers. Some improvements in the amount and type of information given to purchasers and patients could also be detected, although as far as direct users were concerned, the demand has not been fully satisfied. However, the impact on choice available to patients and purchasers alike seemed to be adverse, an effect that was particularly strong in the UK case.

Managing the Tensions between Maintaining Academic Standards and the Commercial Imperative in a UK Private Sector Higher Education Institution

ERIC Educational Resources Information Center

Pitcher, Graham Simons

2013-01-01

In a changing landscape of higher education, universities have been moving towards a market-led approach to strategic management. This paper examines the case of a UK private sector education provider that gained degree-awarding powers following changes made in 2004 by the UK Government to the accreditation criteria for recognised degree-awarding…

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

DTIC Science & Technology

2016-05-26

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

The production of black carbon during managed burning of UK peatlands: could managed burning of peatlands lead to enhanced carbon storage?

NASA Astrophysics Data System (ADS)

Clay, G.; Worrall, F.

2008-12-01

Peatlands are the UK's largest single terrestrial carbon store with carbon stored in UK peatlands than in forests of Britain and France combined. Unlike most northern peatlands in the peat soils of the UK are heavily managed for recreation and agriculture and due to their proximity to major centres of population are under more anthropogenic pressure than most peatlands. A typical management strategy on UK upland peats is the use of managed fire to restrict vegetation. Fires are used upon a 10-25 year rotation and are described as "cool" as they are designed to remove the crown of the vegetation without scorching the litter layer or the underlying soil. In this case the fire destroys primary productivity and limits litter production but produces char. Char is a low volume, highly refractory, high carbon content product while litter is a high volume, decomposable, lower carbon content product. Therefore, the question is if there are fire conditions under which the production of char causes more carbon to be stored in the peat than would have been stored if no fire management had been employed. This study combines field studies of recent managed burns and wildfires along with detailed vegetation studies from a long term monitoring site in order to assess litter, biomass and black carbon production. In the laboratory experimental burns were undertaken in order to assess the amount and controls upon char production and the carbon content of that char. Results of field and laboratory observations are used to model carbon accumulation under a series of fire management scenarios and the modelling shows that cools burns at long rotations could lead to higher carbon storage than if no fire had occurred, further in several cases more carbon accumulation occurred even if less depth of peat was generated.

Accessibility and implementation in UK services of an effective depression relapse prevention programme – mindfulness-based cognitive therapy (MBCT): ASPIRE study protocol

PubMed Central

2014-01-01

Background Mindfulness-based cognitive therapy (MBCT) is a cost-effective psychosocial prevention programme that helps people with recurrent depression stay well in the long term. It was singled out in the 2009 National Institute for Health and Clinical Excellence (NICE) Depression Guideline as a key priority for implementation. Despite good evidence and guideline recommendations, its roll-out and accessibility across the UK appears to be limited and inequitably distributed. The study aims to describe the current state of MBCT accessibility and implementation across the UK, develop an explanatory framework of what is hindering and facilitating its progress in different areas, and develop an Implementation Plan and related resources to promote better and more equitable availability and use of MBCT within the UK National Health Service. Methods/Design This project is a two-phase qualitative, exploratory and explanatory research study, using an interview survey and in-depth case studies theoretically underpinned by the Promoting Action on Implementation in Health Services (PARIHS) framework. Interviews will be conducted with stakeholders involved in commissioning, managing and implementing MBCT services in each of the four UK countries, and will include areas where MBCT services are being implemented successfully and where implementation is not working well. In-depth case studies will be undertaken on a range of MBCT services to develop a detailed understanding of the barriers and facilitators to implementation. Guided by the study’s conceptual framework, data will be synthesized across Phase 1 and Phase 2 to develop a fit for purpose implementation plan. Discussion Promoting the uptake of evidence-based treatments into routine practice and understanding what influences these processes has the potential to support the adoption and spread of nationally recommended interventions like MBCT. This study could inform a larger scale implementation trial and feed into future implementation of MBCT with other long-term conditions and associated co-morbidities. It could also inform the implementation of interventions that are acceptable and effective, but are not widely accessible or implemented. PMID:24884603

Human Mycobacterium bovis infection in the United Kingdom: Incidence, risks, control measures and review of the zoonotic aspects of bovine tuberculosis.

PubMed

de la Rua-Domenech, Ricardo

2006-03-01

Amongst the members of the Mycobacterium tuberculosis complex (MTBC), M. tuberculosis is mainly a human pathogen, whereas M. bovis has a broad host range and is the principal agent responsible for tuberculosis (TB) in domestic and wild mammals. M. bovis also infects humans, causing zoonotic TB through ingestion, inhalation and, less frequently, by contact with mucous membranes and broken skin. Zoonotic TB is indistinguishable clinically or pathologically from TB caused by M. tuberculosis. Differentiation between the causative organisms may only be achieved by sophisticated laboratory methods involving bacteriological culture of clinical specimens, followed by typing of isolates according to growth characteristics, biochemical properties, routine resistance to pyrazinamide (PZA) and specific non-commercial nucleic acid techniques. All this makes it difficult to accurately estimate the proportion of human TB cases caused by M. bovis infection, particularly in developing countries. Distinguishing between the various members of the MTBC is essential for epidemiological investigation of human cases and, to a lesser degree, for adequate chemotherapy of the human TB patient. Zoonotic TB was formerly an endemic disease in the UK population, usually transmitted to man by consumption of raw cows' milk. Human infection with M. bovis in the UK has been largely controlled through pasteurization of cows' milk and systematic culling of cattle reacting to compulsory tuberculin tests. Nowadays the majority of the 7000 cases of human TB annually reported in the UK are due to M. tuberculosis acquired directly from an infectious person. In the period 1990-2003, between 17 and 50 new cases of human M. bovis infection were confirmed every year in the UK. This represented between 0.5% and 1.5% of all the culture-confirmed TB cases, a proportion similar to that of other industrialized countries. Most cases of zoonotic TB diagnosed in the UK are attributed to (i) reactivation of long-standing latent infections acquired before widespread adoption of milk pasteurization, or (ii) M. bovis infections contracted abroad. Since 1990, only one case has been documented in the UK of confirmed, indigenous human M. bovis infection recently acquired from an animal source. Therefore, for the overwhelming majority of the population, the risk of contracting M. bovis infection from animals appears to be extremely low. However, bovine TB is once again a major animal health problem in the UK. Given the increasing numbers of cattle herds being affected each year, physicians and other public health professionals must remember that zoonotic TB is not just a disease of the past. A significant risk of M. bovis infection remains in certain segments of the UK population in the form of (i) continuing on-farm consumption of unpasteurized cows' milk, (ii) retail sales by approved establishments of unpasteurized milk and dairy products and (iii) occupational exposure to infectious aerosols from tuberculous animals and their carcases.

A community outbreak of travel-acquired measles, Ontario 2009

PubMed Central

Armstrong, J; Arajs, A; Bailey, N; Wang, HL

2014-01-01

Background Canada has held elimination status for measles since 1998; however, imported cases continue to occur. Objective To describe the public health response to an imported measles case in the Waterloo Region of Ontario in May 2009. Results Contacts and exposures were traced, and cases were quickly investigated to identify the source. Through routine reporting mechanisms it was found that the index case had likely been exposed while on holiday in Disney World to a laboratory-confirmed measles case in a nine year old unimmunized boy from the United Kingdom (UK). Canada’s National Microbiology Laboratory confirmed that the index case had the same D4 measles strain as the UK case and the strain that had been circulating in the UK. In total, one probable case and six confirmed cases were reported. The median age of confirmed cases was 14.5 years (mean age 17 years, range 6 to 39 years). Five confirmed cases (83%) were female. One confirmed case (17%) was hospitalized; no deaths were associated with the outbreak. Conclusion This outbreak highlights the importance of collaboration with clinical care, the laboratory and public health at all levels of government to investigate and control a measles outbreak. Global travel and sustained local transmission may continue to pose a challenge with respect to the eradication of measles in developed countries. PMID:29769848

A review of dietary selenium intake and selenium status in Europe and the Middle East.

PubMed

Stoffaneller, Rita; Morse, Nancy L

2015-02-27

This is a systematic review of existing data on dietary selenium (Se) intake and status for various population groups in Europe (including the United Kingdom (UK)) and the Middle East. It includes English language systematic reviews, meta-analyses, randomised controlled trials, cohort studies, cross-sectional and case-control studies obtained through PUBMED searches from January, 2002, to November, 2014, for European data and from 1990 to November 2014, for Middle Eastern data. Reports were selected if they included data on Se intake and status. The search identified 19 European/UK studies and 15 investigations in the Middle East that reported Se intake and Se concentration in water and/or food and 48 European/UK studies and 44 investigations in the Middle East reporting Se status. Suboptimal Se status was reported to be widespread throughout Europe, the UK and the Middle East, and these results agreed with previous reports highlighting the problem. Eastern European countries had lower Se intake than Western European countries. Middle Eastern studies provided varying results, possibly due to varying food habits and imports in different regions and within differing socioeconomic groups. In conclusion, Se intake and status is suboptimal in European and Middle Eastern countries, with less consistency in the Middle East.

A Review of Dietary Selenium Intake and Selenium Status in Europe and the Middle East

PubMed Central

Stoffaneller, Rita; Morse, Nancy L.

2015-01-01

This is a systematic review of existing data on dietary selenium (Se) intake and status for various population groups in Europe (including the United Kingdom (UK)) and the Middle East. It includes English language systematic reviews, meta-analyses, randomised controlled trials, cohort studies, cross-sectional and case-control studies obtained through PUBMED searches from January, 2002, to November, 2014, for European data and from 1990 to November 2014, for Middle Eastern data. Reports were selected if they included data on Se intake and status. The search identified 19 European/UK studies and 15 investigations in the Middle East that reported Se intake and Se concentration in water and/or food and 48 European/UK studies and 44 investigations in the Middle East reporting Se status. Suboptimal Se status was reported to be widespread throughout Europe, the UK and the Middle East, and these results agreed with previous reports highlighting the problem. Eastern European countries had lower Se intake than Western European countries. Middle Eastern studies provided varying results, possibly due to varying food habits and imports in different regions and within differing socioeconomic groups. In conclusion, Se intake and status is suboptimal in European and Middle Eastern countries, with less consistency in the Middle East. PMID:25734564

Survey of the incidence of pectinate ligament dysplasia and glaucoma in the UK Leonberger population.

PubMed

Fricker, Georgina V; Smith, Kerry; Gould, David J

2016-09-01

To determine the prevalence of pectinate ligament dysplasia (PLD) in UK Leonbergers and identify cases affected by glaucoma. Also, to define the spectrum of pectinate ligament (PL) appearance in this breed and determine whether gonioscopic monitoring should be recommended. Data were compiled from 78 prospective gonioscopy examinations performed by one author (GF) and retrospective analysis of 233 UK eye scheme certificates (2009-2014). Clinical cases of glaucoma in Leonbergers diagnosed by UK veterinary ophthalmologists, where gonioscopy of the fellow eyes or histology of affected eyes had been performed, were also reviewed. In the prospective study, intraocular pressure was recorded prior to gonioscopy using a rebound tonometer. Gonioscopy was performed using a slit-lamp biomicroscope with a Koeppe goniolens. PLD was categorized according to the percentage of the iridocorneal drainage angle affected (grade 0 = <25% affected; grade 1 = 25-50% affected; grade 2 = 51-75% affected; and grade 3 = >75% affected), and the degree of narrowing of the angle was noted. Of 78 dogs examined prospectively, 64/78 (82%) were grade 0, 7/78 (9%) were grade 1, 3/78 (4%) were grade 2, and 4/78 (5%) were grade 3. A large phenotypic variation was observed. Spearman's rank correlation showed a positive correlation between age and severity of PLD (P < 0.0055). 52 (22%) of Leonbergers examined under the UK eye scheme 2009-2014 were affected by PLD. Five clinical cases of glaucoma were reviewed where gonioscopy had been performed and one where histology was performed. All individuals had grade 3 PLD with gonioscopy of the contralateral eye or severe goniodysgenesis with histological sections of the affected eye. This survey suggests the prevalence of PLD is sufficient to justify ongoing screening of Leonbergers. © 2015 American College of Veterinary Ophthalmologists.

A mapping review of the literature on UK-focused health and social care databases.

PubMed

Cooper, Chris; Rogers, Morwenna; Bethel, Alison; Briscoe, Simon; Lowe, Jenny

2015-03-01

Bibliographic databases are a day-to-day tool of the researcher: they offer the researcher easy and organised access to knowledge, but how much is actually known about the databases on offer? The focus of this paper is UK health and social care databases. These databases are often small, specialised by topic, and provide a complementary literature to the large, international databases. There is, however, good evidence that these databases are overlooked in systematic reviews, perhaps because little is known about what they can offer. To systematically locate and map, published and unpublished literature on the key UK health and social care bibliographic databases. Systematic searching and mapping. Two hundred and forty-two items were identified which specifically related to the 24 of the 34 databases under review. There is little published or unpublished literature specifically analysing the key UK health and social care databases. Since several UK databases have closed, others are at risk, and some are overlooked in reviews, better information is required to enhance our knowledge. Further research on UK health and social care databases is required. This paper suggests the need to develop the evidence base through a series of case studies on each of the databases. © 2014 The authors. Health Information and Libraries Journal © 2014 Health Libraries Journal.

A Community of Practice Approach to Delivering Research Support Services in a Post-92 Higher Education Institution: A Reflective Case Study

ERIC Educational Resources Information Center

Coombs, Jenny; Thomas, Mandy; Rush, Nathan; Martin, Elizabeth

2017-01-01

The need for research support in U.K. universities is growing at a fast pace and a number of different professional and academic units within universities are involved in the process. This case study takes place in a post-92 higher education institution and discusses the benefit of utilizing a cross-university Community of Practice (CoP) approach…

Competition and quality in health care: the UK experience.

PubMed

Glennerster, H

1998-10-01

The aims of this paper are threefold: first to review briefly the theoretical literature on competition and its predicted effects on health care quality; secondly to describe the attempts to introduce competition into the UK National Health Service (NHS); and third to review the outcomes of this experiment and ask how far the research findings are consistent with the next phase of reform that the new Labour Government proposed in late 1997. A search was conducted using electronic data bases Unicorn, Medline and Health Planning and official monitoring statistics within the NHS. All references relating to district-based purchasing, general practitioner (GP) fundholding in its various forms and GP commissioning were reviewed. Preference was given to prospective before and after studies with and without control groups, retrospective studies with and without controls, and case studies which were reinforced by similar supporting case studies. The evidence suggests that there was little overall change for good or bad as a result of the reforms. The changes that did occur had an impact on speed of treatment, patient convenience and choice, but medical quality was largely unaffected. These benefits were reaped, in particular, by the more competitive agents - the family doctors or GPs. Although not dramatic in outcome, these changes were significant because speed and convenience were the main deficiencies of the NHS in the eyes of UK consumers.

Crossing borders for fertility treatment: motivations, destinations and outcomes of UK fertility travellers.

PubMed

Culley, L; Hudson, N; Rapport, F; Blyth, E; Norton, W; Pacey, A A

2011-09-01

There are few systematic studies of the incidence of cross-border fertility care and even fewer reports of qualitative research with those undertaking treatment outside their country of origin. This paper reports findings from a qualitative study of UK residents with experience of cross-border care: the socio-demographic characteristics of UK travellers; their reasons for seeking treatment abroad; the treatments they sought; the destinations they chose and the outcomes of their treatment. Data regarding cross-border fertility treatment were collected from a purposive sample of 51 people by means of in-depth, semi-structured interviews between May 2009 and June 2010. Data were analysed using a systematic thematic coding method and also subjected to quantitative translation. Patient motivations for travelling abroad are complex. A desire for timely and affordable treatment with donor gametes was evident in a high number of cases (71%). However, most people gave several reasons, including: the cost of UK treatment; higher success rates abroad; treatment in a less stressful environment and dissatisfaction with UK treatment. People travelled to 13 different countries, the most popular being Spain and the Czech Republic. Most organized their own treatment and travel. The mean age of women seeking treatment was 38.8 years (range 29-46 years) and the multiple pregnancy rate was 19%. UK residents have diverse reasons for, and approaches to, seeking overseas treatment and do not conform to media stereotypes. Further research is needed to explore implications of cross-border treatment for donors, offspring and healthcare systems.

Highlights from SelectBio 2015: Academic Drug Discovery Conference, Cambridge, UK, 19-20 May 2015.

PubMed

Spencer, John; Coaker, Hannah

2015-01-01

The SelectBio 2015: Academic Drug Discovery Conference was held in Cambridge, UK, on 19-20 May 2015. Building on the success of academic drug discovery events in the USA, this conference aimed to showcase the exciting new research emerging from academic drug discovery and to help bridge the gap between basic research and commercial application. At the event the authors heard from a number of speakers on a broad array of topics, from partnering models for academia and industry to novel drug discovery approaches across various therapeutic areas, with a few talks, such as those by Susanne Muller-Knapp (Structure Genomics Consortium, Oxford University, Oxford, UK) and Julian Blagg (Institute of Cancer Research, UK), covering both remits, by highlighting a number of such partnerships and then delving into some case studies. The conference concluded with a heated debate on whether phenotypic discovery should be favored over targeted discovery in academia and pharma, in a panel discussion chaired by Roland Wolkowicz (San Diego State University, USA).

The relationship between childhood trauma and adult psychosis in a UK Early Intervention Service: results of a retrospective case note study.

PubMed

Reeder, Francesca D; Husain, Nusrat; Rhouma, Abdul; Haddad, Peter M; Munshi, Tariq; Naeem, Farooq; Khachatryan, Davit; Chaudhry, Imran B

2017-01-01

There is evidence that childhood trauma is a risk factor for the development of psychosis and it is recommended that childhood trauma is inquired about in all patients presenting with psychosis. This study aimed to determine the prevalence of childhood trauma in patients in the UK Early Intervention Service based on a case note review. This is a retrospective case note study of 296 patients in an UK Early Intervention Service. Trauma history obtained on service entry was reviewed and trauma experienced categorized. Results were analyzed using crosstab and frequency analysis. The mean age of the sample was 24 years, 70% were male, 66% were White, and 23% Asian (ethnicity not documented in 11% of the sample). Approximately 60% of patients reported childhood trauma, 21% reported no childhood trauma, and data were not recorded for the remaining 19%. Among those reporting trauma, the prevalence of most frequently reported traumas were: severe or repeated disruption (21%), parental mental illness (19%), bullying (18%), absence of a parent (13%), and 'other' trauma (24%) - the majority of which were victimization events. Sixty-six percent of those reporting trauma had experienced multiple forms of trauma. A high prevalence of childhood trauma (particularly trauma related to the home environment or family unit) was reported. This is consistent with other studies reporting on trauma and psychosis. The main weakness of the study is a lack of a control group reporting experience of childhood trauma in those without psychosis. Guidelines recommend that all patients with psychosis are asked about childhood trauma; but in 19% of our sample there was no documentation that this had been done indicating the need for improvement in assessment.

Fraying at the Edges: UK Surrogacy Law in 2015.

PubMed

Horsey, Kirsty

2016-11-01

This commentary examines a series of high-profile surrogacy cases decided in 2015. Taken singly or together, these cases serve to illustrate how the UK's law on surrogacy—in particular its provisions regarding eligibility for parental orders—is not only out of date but also becoming nonsensical. These problems culminate in an evident inability of the law to protect the best interests of children born through surrogacy and indicate strongly a need for reform.

Migrants' decision-process shaping work destination choice: the case of long-term care work in the United Kingdom and Norway.

PubMed

Christensen, Karen; Hussein, Shereen; Ismail, Mohamed

2017-09-01

Escalating demands for formal long-term care (LTC) result in the reliance on migrant workers in many developed countries. Within Europe, this is currently framed by progressive European immigration policies favouring inter-European mobility. Using the UK and Norway as case studies, this article has two main aims: (1) to document changes in the contribution of European Union (EU) migrants to the LTC sectors in Western Europe, and (2) to gain further understanding of migrants' decision-processes relating to destination and work choices. The UK and Norway provide examples of two European countries with different immigration histories, welfare regimes, labour market characteristics and cultural values, offering a rich comparison platform. The analysis utilizes national workforce datasets and data obtained from migrants working in the LTC sector in the UK and Norway ( n  = 248) and other stakeholders ( n  = 136). The analysis establishes a significant increase in the contribution of EU migrants (particularly from Eastern Europe) to the LTC sector in both the UK and Norway despite their different welfare regimes. The findings also highlight how migrant care workers develop rational decision-processes influenced by subjective perspectives of investments and returns within a context of wider structural migration barriers. The latter includes welfare and social care policies framing the conditions for migrants' individual actions.

Could managed burning of peatlands lead to enhanced carbon storage?

NASA Astrophysics Data System (ADS)

Worrall, F.; Clay, G. D.

2009-04-01

Peatlands are the UK's largest single terrestrial carbon store with carbon stored in UK peatlands than in forests of Britain and France combined. Unlike most northern peatlands in the peat soils of the UK are heavily managed for recreation and agriculture and due to their proximity to major centres of population are under more anthropogenic pressure than most peatlands. A typical management strategy on UK upland peats is the use of managed fire to restrict vegetation. Fires are used upon a 10-25 year rotation and are described as "cool" as they are designed to remove the crown of the vegetation without scorching the litter layer or the underlying soil. In this case the fire destroys primary productivity and limits litter production but produces char. Char is a low volume, highly refractory, high carbon content product while litter is a high volume, decomposable, lower carbon content product. Therefore, the question is if there are fire conditions under which the production of char causes more carbon to be stored in the peat than would have been stored if no fire management had been employed. This study combines field studies of recent managed burns and wildfires along with detailed vegetation studies from a long term monitoring site in order to assess litter, biomass and black carbon production. In the laboratory experimental burns were undertaken in order to assess the amount and controls upon char production and the carbon content of that char. Results of field and laboratory observations are used to model carbon accumulation under a series of fire management scenarios and the modelling shows that cools burns at long rotations could lead to higher carbon storage than if no fire had occurred, further in several cases more carbon accumulation occurred even if less depth of peat was generated.

Raising Roma Educational Participation and Achievement: Collaborative Relationships, Transformative Change, and a Social Europe

ERIC Educational Resources Information Center

Ryder, Andrew Richard

2015-01-01

The paper gives an overview of Roma, Gypsy and Traveller (RGT) educational exclusion in the European Union and seeks to provide insights into good practice through case studies focusing on Bulgaria and the UK. The paper makes a case for the promotion of collaborative relationships, where RGT communities are active partners in developing curricula…

Communicating geohazard information for emergency responders, a case study from the UK.

NASA Astrophysics Data System (ADS)

Banks, Vanessa; Cooper, Anthony

2016-04-01

SSS11.4/ESSI4.6/HS11.39/NH9.13 Communication of uncertain information in earth sciences: data, models and visualization Communicating geohazard information for emergency responders, a case study from the UK. Cooper, A. H.1, Banks, V.J.1, Cowup, P.2, Curness, J.3, Davis, R.4, Dawson, L3. and Gazzard, L.4 1 British Geological Survey, Keyworth, NG12 5GG, UK 2 London Fire Brigade, 169 Union Street, London, SE1 0LL, UK 3.Coventry University, Priory Street, Coventry, CV1 5FB, UK 4.Avon Fire and Rescue, Temple Back, Bristol, BS1 6EU, UK. In February 2013 a sinkhole opened beneath a Florida Home resulting in the loss of a life and demolition of the affected home. The resulting void was in the order of 15 m deep. Neighbouring homes also had to be demolished. Television footage of this unfortunate incident resonated with an Assistant Commissioner of the London Fire Brigade who questioned whether or not such a feature would be recognised in the UK and if so, how the emergency response would be managed. Stemming from this, the British Geological Survey was invited to work with the Chief Fire Officers Association Urban Search and Rescue working group on geohazards. The aim of this group was to develop national tactical operational guidance on geohazards that would form the basis for regional guidance and training. The project was addressed collaboratively providing opportunities for two students from the Coventry University Disaster Management course, that were on placements with Avon Fire and Rescue, to work with the BGS to develop the guidance. Key to the success of the project was an iterative approach to knowledge exchange with respect to firstly, the characterization of the geohazards, and the processes and uncertainties associated with them and secondly, with respect to emergency responders' needs and priorities. Effective communication was achieved through challenging and rationalising the geoscience language for the end user and through a series of customised illustrations that portray the geohazard and associated zoning for response management. This paper shows the value of BGS data in developing resilience through preparedness, describes the approach to this project and the key outcomes in terms of geohazard communication, as well as considering how the project may develop in the future.

Constructed wetlands in UK urban surface drainage systems.

PubMed

Shutes, B; Ellis, J B; Revitt, D M; Scholes, L N L

2005-01-01

This paper presents the outcome of an inventory of planted wetland systems in the UK which are classified according to land use type and are all examples of sustainable drainage systems. The introduction of constructed wetlands to treat surface runoff essentially followed a 1997 Environment Agency for England and Wales report advocating the use of "soft engineered" facilities including wetlands in the context of sustainable development and Agenda 21. Subsequently published reports by the UK Construction Industry Research and Information Association (CIRIA) have promoted the potential benefits to both developer and the community of adopting constructed wetlands and other vegetated systems as a sustainable drainage approach. In addition, the UK Environment Agency and Highways Agency (HA) have recently published their own design criteria and requirements for vegetative control and treatment of road runoff. A case study of the design and performance of a constructed wetland system for the treatment of road runoff is discussed. The performance of these systems will be assessed in terms of their design criteria, runoff loadings as well as vegetation and structure maintenance procedures. The differing design approaches in guidance documents published in the UK by the Environment Agency, CIRIA and HA will also be evaluated.

The influence of academic discourses on medical students' identification with the discipline of family medicine.

PubMed

Rodríguez, Charo; López-Roig, Sofía; Pawlikowska, Teresa; Schweyer, François-Xavier; Bélanger, Emmanuelle; Pastor-Mira, Maria Angeles; Hugé, Sandrine; Spencer, Sarah; Lévasseur, Gwenola; Whitehead, Ian; Tellier, Pierre-Paul

2015-05-01

To understand the influence of academic discourses about family medicine on medical students' professional identity construction during undergraduate training. The authors used a multiple case study research design involving international medical schools, one each from Canada, France, Spain, and the United Kingdom (UK). The authors completed the fieldwork between 2007 and 2009 by conducting 18 focus groups (with 132 students) and 67 semistructured interviews with educators and by gathering pertinent institutional documents. They carried out discursive thematic analyses of the verbatim transcripts and then performed within- and cross-case analyses. The most striking finding was the diverging responses between those at the UK school and those at the other schools. In the UK case, family medicine was recognized as a prestigious academic discipline; students and faculty praised the knowledge and skills of family physicians, and students more often indicated their intent to pursue family medicine. In the other cases, family medicine was not well regarded by students or faculty. This was expressed overtly or through a paradoxical academic discourse that stressed the importance of family medicine to the health care system while decrying its lack of innovative technology and the large workload-to-income ratio. Students at these schools were less likely to consider family medicine. These results stress the influence of academic discourses on medical students' ability to identify with the practice of family medicine. Educators must consider processes of professional identity formation during undergraduate medical training as they develop and reform medical education.

The ISS SOLAR payload data preservation in the frame of the PERICLES FP-7 project: metadata aspects.

NASA Astrophysics Data System (ADS)

Muller, Christian; Pandey, Praveen

2016-04-01

PERICLES (Promoting and Enhancing the Reuse of Information throughout the Content Lifecycle exploiting Evolving Semantics) is an FP7 project started on February 2013. It aims at preserving by design large and complex data sets. PERICLES is coordinated by King's College London, UK and its partners are University of Borås (Sweden), CERTH- ITI (Greece), DotSoft (Greece), Georg-August-Universität Göttingen (Germany), University of Liverpool (UK), Space Application Services (Belgium), XEROX France and University of Edinburgh (UK). Two additional partners provide the two case studies: Tate Gallery (UK) brings the digital art and media case study and B.USOC (Belgian Users Support and Operations Centre) brings the space science case study . PERICLES addresses the life-cycle of large and complex data sets in order to cater for the evolution of context of data sets and user communities, including groups unanticipated when the data was created. Semantics of data sets are thus also expected to evolve and the project includes elements which could address the reuse of data sets at periods where the data providers and even their institutions are not available any more. PERICLES uses the Linked Resources Model (LRM) which will be compared with the OAIS standard. In this study we present the space science case associated with PERICLES. B.USOC supports experiments on the International Space Station and is the curator of the collected data and operations history. B.USOC has chosen to analyse the SOLAR payload flying since 2008 on the ESA COLUMBUS module of the ISS as the PERICLES prime space science case. Solar observation data are prime candidates for long term data preservation as variabilities of the solar spectral irradiance have an influence on earth climate. The nature of the data to be preserved for the reuse of the current SOLAR series is much more extended than a simple set of time tagged tables of spectral irradiances, it is an important inventory of more than 50 classes of documents and/or metadata directly relevant to SOLAR, it includes not only the calibration elements and their evolution during SOLAR lifetime but also all tools used as the software's and versions used in interpretation. In order to foster potential user's present and future needs, there is an ongoing survey involving a community of practice. Its initial outcome will be presented here. The aspects of data appraisal and metadata constitution in the frame of the PERICLES project will be developed.

Possible Case of Maternal Transmission of Feline Spongiform Encephalopathy in a Captive Cheetah

PubMed Central

Bencsik, Anna; Debeer, Sabine; Petit, Thierry; Baron, Thierry

2009-01-01

Feline spongiform encephalopathy (FSE) is considered to be related to bovine spongiform encephalopathy (BSE) and has been reported in domestic cats as well as in captive wild cats including cheetahs, first in the United Kingdom (UK) and then in other European countries. In France, several cases were described in cheetahs either imported from UK or born in France. Here we report details of two other FSE cases in captive cheetah including a 2nd case of FSE in a cheetah born in France, most likely due to maternal transmission. Complete prion protein immunohistochemical study on both brains and peripheral organs showed the close likeness between the two cases. In addition, transmission studies to the TgOvPrP4 mouse line were also performed, for comparison with the transmission of cattle BSE. The TgOvPrP4 mouse brains infected with cattle BSE and cheetah FSE revealed similar vacuolar lesion profiles, PrPd brain mapping with occurrence of typical florid plaques. Collectively, these data indicate that they harbor the same strain of agent as the cattle BSE agent. This new observation may have some impact on our knowledge of vertical transmission of BSE agent-linked TSEs such as in housecat FSE, or vCJD. PMID:19738899

Two Linked Enteroinvasive Escherichia coli Outbreaks, Nottingham, UK, June 2014

PubMed Central

MacGregor, Vanessa; Robbins, Vivienne; Bayliss, Laura; Chattaway, Marie Anne; Dallman, Tim; Ready, Derren; Aird, Heather; Puleston, Richard; Hawker, Jeremy

2016-01-01

Enteroinvasive Escherichia coli (EIEC) outbreaks are uncommon in Europe. In June 2014, two EIEC outbreaks occurred in Nottingham, UK, within 2 days; outbreak A was linked to a takeaway restaurant and outbreak B to a wedding party. We conducted 2 analytical studies: a case–control study for outbreak A and a cohort study for outbreak B. We tested microbiological and environmental samples, including by using whole-genome sequencing. For both outbreaks combined, we identified 157 probable case-patients; 27 were laboratory-confirmed as EIEC O96:H19–positive. Combined epidemiologic, microbiological, and environmental findings implicated lettuce as the vehicle of infection in outbreak A, but the source of the organism remained unknown. Whole-genome sequencing identified the same organism in cases from both outbreaks, but no epidemiologic link was confirmed. These outbreaks highlight that EIEC has the capacity to cause large and severe gastrointestinal disease outbreaks and should be considered as a potential pathogen in foodborne outbreaks in Europe. PMID:27314432

SemEHR: A general-purpose semantic search system to surface semantic data from clinical notes for tailored care, trial recruitment, and clinical research.

PubMed

Wu, Honghan; Toti, Giulia; Morley, Katherine I; Ibrahim, Zina M; Folarin, Amos; Jackson, Richard; Kartoglu, Ismail; Agrawal, Asha; Stringer, Clive; Gale, Darren; Gorrell, Genevieve; Roberts, Angus; Broadbent, Matthew; Stewart, Robert; Dobson, Richard J B

2018-05-01

Unlocking the data contained within both structured and unstructured components of electronic health records (EHRs) has the potential to provide a step change in data available for secondary research use, generation of actionable medical insights, hospital management, and trial recruitment. To achieve this, we implemented SemEHR, an open source semantic search and analytics tool for EHRs. SemEHR implements a generic information extraction (IE) and retrieval infrastructure by identifying contextualized mentions of a wide range of biomedical concepts within EHRs. Natural language processing annotations are further assembled at the patient level and extended with EHR-specific knowledge to generate a timeline for each patient. The semantic data are serviced via ontology-based search and analytics interfaces. SemEHR has been deployed at a number of UK hospitals, including the Clinical Record Interactive Search, an anonymized replica of the EHR of the UK South London and Maudsley National Health Service Foundation Trust, one of Europe's largest providers of mental health services. In 2 Clinical Record Interactive Search-based studies, SemEHR achieved 93% (hepatitis C) and 99% (HIV) F-measure results in identifying true positive patients. At King's College Hospital in London, as part of the CogStack program (github.com/cogstack), SemEHR is being used to recruit patients into the UK Department of Health 100 000 Genomes Project (genomicsengland.co.uk). The validation study suggests that the tool can validate previously recruited cases and is very fast at searching phenotypes; time for recruitment criteria checking was reduced from days to minutes. Validated on open intensive care EHR data, Medical Information Mart for Intensive Care III, the vital signs extracted by SemEHR can achieve around 97% accuracy. Results from the multiple case studies demonstrate SemEHR's efficiency: weeks or months of work can be done within hours or minutes in some cases. SemEHR provides a more comprehensive view of patients, bringing in more and unexpected insight compared to study-oriented bespoke IE systems. SemEHR is open source, available at https://github.com/CogStack/SemEHR.

U. K. pressing campaign to improve offshore safety

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

Knott, D.

1994-02-14

The U.K. government is making progress in its campaign to improve the safety of personnel working offshore. The government's Health and Safety Executive (HSE) plans to assess and pass judgment on at lease one safety plan, called a safety case, from each U.K. North Sea operator as soon as possible. HSE has agreed with the industry on a list of 61 priority safety cases, known as exemplars. Feedback from exemplar assessment will help operators review safety management and assist in preparation or revision of future safety cases. It also will give HSE practice in assessing a range of case types.more » The requirement for a safety program is part of new U.K. offshore legislation designed to prevent another accident similar to the Piper Alpha platform fire and explosion of 1988. After the transition period it will be against the law to operate an oil and gas installation in British waters without an accepted safety case. Besides existing installations, safety cases are also required for new installations reaching design stage by May 31, 1993, the date safety case regulations went into force. The paper describes the Cullen report, companies' experiences with the new law, and the safety assessment progress so far.« less

Current UK practice in emergency laparotomy

PubMed Central

Barrow, E; Varley, S; Pichel, AC; Peden, CJ; Saunders, DI; Murray, D

2013-01-01

Introduction Emergency laparotomy is a common procedure, with 30,000–50,000 performed annually in the UK. This large scale study reports the current spectrum of emergency laparotomies, and the influence of the surgical procedure, underlying pathology and subspecialty of the operating surgeon on mortality. Methods Anonymised data on consecutive patients undergoing an emergency laparotomy were submitted for a three-month period. The primary outcome measure was unadjusted 30-day mortality. Appendicectomy and cholecystectomy were among the procedures excluded. Results Data from 1,708 patients from 35 National Health Service hospitals were analysed. The overall 30-day mortality rate was 14.8%. ‘True’ emergency laparotomies (ie those classified by the National Confidential Enquiry into Patient Outcome and Death as immediate or urgent) comprised 86.5% of cases. The mortality rate rose from 8.0% among expedited cases to 14.3% among urgent cases and to 25.7% among laparotomies termed immediate. Among the most common index procedures, small bowel resection exhibited the highest 30-day mortality rate of 21.1%. The presence of abdominal sepsis was associated with raised 30-day mortality (17.5% in the presence of sepsis vs 12.6%, p=0.027). Colorectal procedures comprised 44.3% and within this group, data suggest that mortality from laparotomy may be influenced by surgical subspecialisation. Conclusions This report of a large number of patients undergoing emergency laparotomy in the UK confirms a remarkably high mortality by modern standards across the range. Very few pathologies or procedures can be considered anything other than high risk. The need for routine consultant involvement and critical care is evident, and the case distribution helps define the surgical skill set needed for a modern emergency laparotomy service. Preliminary data relating outcomes from emergency colonic surgery to surgical subspecialty require urgent further study. PMID:24165345

Current UK practice in emergency laparotomy.

PubMed

Barrow, E; Anderson, I D; Varley, S; Pichel, A C; Peden, C J; Saunders, D I; Murray, D

2013-11-01

Emergency laparotomy is a common procedure, with 30,000-50,000 performed annually in the UK. This large scale study reports the current spectrum of emergency laparotomies, and the influence of the surgical procedure, underlying pathology and subspecialty of the operating surgeon on mortality. Anonymised data on consecutive patients undergoing an emergency laparotomy were submitted for a three-month period. The primary outcome measure was unadjusted 30-day mortality. Appendicectomy and cholecystectomy were among the procedures excluded. Data from 1,708 patients from 35 National Health Service hospitals were analysed. The overall 30-day mortality rate was 14.8%. 'True' emergency laparotomies (ie those classified by the National Confidential Enquiry into Patient Outcome and Death as immediate or urgent) comprised 86.5% of cases. The mortality rate rose from 8.0% among expedited cases to 14.3% among urgent cases and to 25.7% among laparotomies termed immediate. Among the most common index procedures, small bowel resection exhibited the highest 30-day mortality rate of 21.1%. The presence of abdominal sepsis was associated with raised 30-day mortality (17.5% in the presence of sepsis vs 12.6%, p=0.027). Colorectal procedures comprised 44.3% and within this group, data suggest that mortality from laparotomy may be influenced by surgical subspecialisation. This report of a large number of patients undergoing emergency laparotomy in the UK confirms a remarkably high mortality by modern standards across the range. Very few pathologies or procedures can be considered anything other than high risk. The need for routine consultant involvement and critical care is evident, and the case distribution helps define the surgical skill set needed for a modern emergency laparotomy service. Preliminary data relating outcomes from emergency colonic surgery to surgical subspecialty require urgent further study.

The Epidemiology of and Outcome from Pancreatoduodenal Trauma in the UK, 1989–2013

PubMed Central

Bouamra, O; Kausar, A; Dickson, EJ; Lecky, F

2015-01-01

Introduction Pancreatoduodenal (PD) injury is an uncommon but serious complication of blunt and penetrating trauma, associated with high mortality. The aim of this study was to assess the incidence, mechanisms of injury, initial operation rates and outcome of patients who sustained PD trauma in the UK from a large trauma registry, over the period 1989–2013. Methods The Trauma Audit and Research Network database was searched for details of any patient with blunt or penetrating trauma to the pancreas, duodenum or both. Results Of 356,534 trauma cases, 1,155 (0.32%) sustained PD trauma. The median patient age was 27 years for blunt trauma and 27.5 years for penetrating trauma. The male-to-female ratio was 2.5:1. Blunt trauma was the most common type of injury seen, with a ratio of blunt-to-penetrating PD injury ratio of 3.6:1. Road traffic collision was the most common mechanism of injury, accounting for 673 cases (58.3%). The median injury severity score (ISS) was 25 (IQR: 14–35) for blunt trauma and 14 (IQR: 9–18) for penetrating trauma. The mortality rate for blunt PD trauma was 17.6%; it was 12.2% for penetrating PD trauma. Variables predicting mortality after pancreatic trauma were increasing age, ISS, haemodynamic compromise and not having undergone an operation. Conclusions Isolated pancreatic injuries are uncommon; most coexist with other injuries. In the UK, a high proportion of cases are due to blunt trauma, which differs from US and South African series. Mortality is high in the UK but comparison with other surgical series is difficult because of selection bias in their datasets. PMID:25723689

The epidemiology of and outcome from pancreatoduodenal trauma in the UK, 1989-2013.

PubMed

O'Reilly, D A; Bouamra, O; Kausar, A; Malde, D J; Dickson, E J; Lecky, F

2015-03-01

Pancreatoduodenal (PD) injury is an uncommon but serious complication of blunt and penetrating trauma, associated with high mortality. The aim of this study was to assess the incidence, mechanisms of injury, initial operation rates and outcome of patients who sustained PD trauma in the UK from a large trauma registry, over the period 1989-2013. The Trauma Audit and Research Network database was searched for details of any patient with blunt or penetrating trauma to the pancreas, duodenum or both. Of 356,534 trauma cases, 1,155 (0.32%) sustained PD trauma. The median patient age was 27 years for blunt trauma and 27.5 years for penetrating trauma. The male-to-female ratio was 2.5:1. Blunt trauma was the most common type of injury seen, with a ratio of blunt-to-penetrating PD injury ratio of 3.6:1. Road traffic collision was the most common mechanism of injury, accounting for 673 cases (58.3%). The median injury severity score (ISS) was 25 (IQR: 14-35) for blunt trauma and 14 (IQR: 9-18) for penetrating trauma. The mortality rate for blunt PD trauma was 17.6%; it was 12.2% for penetrating PD trauma. Variables predicting mortality after pancreatic trauma were increasing age, ISS, haemodynamic compromise and not having undergone an operation. Isolated pancreatic injuries are uncommon; most coexist with other injuries. In the UK, a high proportion of cases are due to blunt trauma, which differs from US and South African series. Mortality is high in the UK but comparison with other surgical series is difficult because of selection bias in their datasets.

Food for thought: an ethnographic study of negotiating ill health and food insecurity in a UK foodbank.

PubMed

Garthwaite, K A; Collins, P J; Bambra, C

2015-05-01

Emergency foodbanks have become an increasingly prominent and controversial feature of austerity in Europe and the USA. In the UK, foodbanks have been called a 'public health emergency'. Despite this, there has been no UK research examining the health of foodbank users. Through an ethnographic study, this paper is the first to explore the health and health perceptions of foodbank users via a case study of Stockton-on-Tees in the North East of England, UK during a period of welfare reform and austerity. Participant observation, field notes and interviews with foodbank users and volunteers were conducted over a seventeen month period (November 2013 to March 2015) inside a Trussell Trust foodbank. Foodbank users were almost exclusively of working age, both men and women, with and without dependent children. All were on very low incomes - from welfare benefits or insecure, poorly paid employment. Many had pre-existing health problems which were exacerbated by their poverty and food insecurity. The latter meant although foodbank users were well aware of the importance and constitution of a healthy diet, they were usually unable to achieve this for financial reasons - constantly having to negotiate their food insecurity. More typically they had to access poor quality, readily available, filling, processed foods. Foodbank users are facing the everyday reality of health inequalities at a time of ongoing austerity in the UK. Copyright © 2015 Elsevier Ltd. All rights reserved.

Meeting the needs of people in emergencies: a review of UK experiences and capability

PubMed Central

Eyre, A

2008-01-01

This article summarises the key findings of two research studies conducted for the UK Government in 2006–2007. The first was a literature review of evidence about provisions and interventions to meet the needs of people affected by ‘emergencies’ as defined within the Civil Contingencies Act (2004). Drawing on both historical and contemporary research and practice, the literature review presented an assessment of people's psychosocial needs after events such as natural disasters, terrorism, and other major incidents. Although some reference was made about the needs of and consequences on disaster workers responding to these events, the main emphasis was on those directly affected as bereaved people and/or injured survivors. The review offered best practice guidelines based on the most effective methods of humanitarian assistance in the immediate, short-term, and long-term aftermath of major emergencies. The second report was a follow-up study conducted in 2007. This was a piece of primary research focusing on the UK's current capability in humanitarian assistance in terms of the extent of planning, training, exercising, and experience relating to meeting people's needs in emergencies. A variety of methods were used to gather quantitative and qualitative evidence of the nature and status of such activity across the UK, including questionnaires, focus groups, and a review of literature and documentary evidence. The report included a number of good practice case studies and made recommendations for the development of best practice in humanitarian assistance within the UK. PMID:22460218

Organisational Blogging: The Problem of Engagement

ERIC Educational Resources Information Center

Baxter, Gavin J.; Connolly, Thomas; Stansfield, Mark

2011-01-01

This paper investigates the implementation and use of an internal organisational blog by several departments in the HR division in a large public sector financial organisation in the UK. This qualitative study adopts a case study approach and examines the experiences of staff using the blog to explore whether it can facilitate organisational…

Impact of regulation of Community Pharmacies on efficiency, access and equity. Evidence from the UK and Spain.

PubMed

Lluch, Maria; Kanavos, Panos

2010-05-01

In this paper, we focus on regulatory restrictions on Community Pharmacies and whether these have an impact on efficiency, access and equity and thus in the delivery of services community pharmacists provide to patients. Primary data collection through semi-structured interviews and secondary data collection through literature review have been used with a particular focus on Spain (a country where Community Pharmacy is strictly regulated) and the UK (a country where Community Pharmacy is considered liberalised by EU standards). The findings indicate that improved pharmacy operational efficiency is the result of appropriate incentive structures, ownership liberalisation and OTC price freedom as is the case in the UK. Equity and access seem to be better achieved by establishing geographic, demographic or needs-based criteria to open new pharmacies (as is the case in Spain). In sum, there are useful lessons for both countries: the UK could look into the policies applied in Spain that increase access and equity whilst Spain could adopt some of the policies from the UK to increase efficiency in the system. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Improving the Process of Career Decision Making: An Action Research Approach

ERIC Educational Resources Information Center

Greenbank, Paul

2011-01-01

Purpose: This study adopts an action research approach with the aim of improving the process of career decision making among undergraduates in a business school at a "new" university in the UK. Design/methodology/approach: The study utilised unfreezing techniques, multiple case studies in conjunction with the principle of analogical…

Journey through Transformation: A Case Study of Two Literacy Learners

ERIC Educational Resources Information Center

Duckworth, Vicky; Ade-Ojo, Gordon O.

2016-01-01

The study draws on life history, literacy studies, and ethnographic approaches to exploring social practices as a frame to explore the narratives of two UK adult literacy learners who provide a description of their engagement with a transformative curriculum and pedagogical approach. One of the learners reveals his frustration at the lack of…

Impact of recurrent Clostridium difficile infection: hospitalization and patient quality of life.

PubMed

Wilcox, Mark H; Ahir, Harblas; Coia, John E; Dodgson, Andrew; Hopkins, Susan; Llewelyn, Martin J; Settle, Chris; Mclain-Smith, Susan; Marcella, Stephen W

2017-09-01

Data quantifying outcomes of recurrent Clostridium difficile infection (rCDI) are lacking. We sought to determine the UK hospital resource use and health-related quality of life (HRQoL) associated with rCDI hospitalizations. A non-interventional study in six UK acute hospitals collected retrospective clinical and resource use data from medical records of 64 adults hospitalized for rCDI and 64 matched inpatient controls with a first episode only (f)CDI. Patients were observed from the index event (date rCDI/fCDI confirmed) for 28 days (or death, if sooner); UK-specific reference costs were applied. HRQoL was assessed prospectively in a separate cohort of 30 patients hospitalized with CDI, who completed the EQ-5D-3L questionnaire during their illness. The median total management cost (post-index) was £7539 and £6294 for rCDI and fCDI, respectively (cost difference, P = 0.075); median length of stay was 21 days and 15.5 days, respectively (P = 0.269). The median cost difference between matched rCDI and fCDI cases was £689 (IQR=£1873-£3954). Subgroup analysis demonstrated the highest median costs (£8542/patient) in severe rCDI cases. CDI management costs were driven primarily by hospital length of stay, which accounted for >85% of costs in both groups. Mean EQ-5D index values were 46% lower in CDI patients compared with UK population values (0.42 and 0.78, respectively); EQ visual analogue scale scores were 38% lower (47.82 and 77.3, respectively). CDI has considerable impact on patients and healthcare resources. This multicentre study provides a contemporaneous estimate of the real-world UK costs associated with rCDI management, which are substantial and comparable to fCDI costs. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The carbon component of the UK power price

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

Kris Voorspools

2006-08-01

CO{sub 2} emissions trading is in full swing in Europe and is already having an impact on the price of power in the UK. If EU allowances (EUAs) trade at euro 20/t-CO{sub 2}, the EUA component in the power price is estimated to be slightly < euro 10/MW.h. In the case of UK power for delivery 1 year ahead, this is {approximately} 10% of the market price of power. The introduction of a carbon components into the UK power prices took place along before the 'official' start of ETS in 2005. Analysis of historical data of the price of power,more » gas, coal and EUAs shows that the first trace of a CO{sub 2} component in UK power dates back to August 2003, shortly after EUAs first started to trade. In April 2004, CO{sub 2} was fully integrated into the UK power price. 4 refs., 5 figs.« less

Marketing of alcohol to young people: a comparison of the UK and Poland.

PubMed

Cooke, Emma; Hastings, Gerard; Wheeler, Colin; Eadie, Douglas; Moskalewicz, Jacek; Dabrowska, Katarzyna

2004-01-01

This paper takes an international perspective on the marketing of alcohol to young people by examining case studies of the marketing of alcohol in the UK and Poland. It is suggested that marketing is a powerful mechanism for attracting young consumers. The alcohol industry is an innovative industry able to use a wide variety of marketing tools to achieve success in the market-place. It is important to recognise that the marketing activities of the industry are becoming increasingly transnational and that policy response has to be equally transnational. Copyright 2004 S. Karger AG, Basel

The UK water crisis: What actions the government and private sector need to take.

PubMed

Skelton, Emmeline

2015-01-01

The paper discusses why resilience is increasingly important for companies to measure and address, thinking about relevant issues such as climate change and extreme weather. It gives insight on how companies measure their resilience and that it is more than a business continuity issue; indeed, it is a board issue. The paper looks at the role of regulation for companies with national critical infrastructure in putting in resilience guidelines and discusses the benefits of regulation in resilience, presenting a case study of the UK Water Services Regulation Authority resilience guidelines.

Dust mass concentrations from the UK volcanic ash lidar network compared with in-situ aircraft measurements

NASA Astrophysics Data System (ADS)

Osborne, Martin; Marenco, Franco; Adam, Mariana; Buxmann, Joelle; Haywood, Jim

2018-04-01

The Met Office has recently established a series of 10 lidar / sun-photometer installations across the UK, consolidating their ash / aerosol remote sensing capabilities [1]. In addition to this network, the Met Office have acquired the Civil Contingency Aircraft (MOCCA) which allows airborne in-situ measurements of ash / aerosol scattering and size-distributions. Two case studies are presented in which mass concentrations of Saharan dust are obtained remotely using lidar returns, and are then compared with those obtained in-situ. A thorough analysis of the mass concentration uncertainty will be provided at the conference.

Syndromic surveillance models using Web data: the case of scarlet fever in the UK.

PubMed

Samaras, Loukas; García-Barriocanal, Elena; Sicilia, Miguel-Angel

2012-03-01

Recent research has shown the potential of Web queries as a source for syndromic surveillance, and existing studies show that these queries can be used as a basis for estimation and prediction of the development of a syndromic disease, such as influenza, using log linear (logit) statistical models. Two alternative models are applied to the relationship between cases and Web queries in this paper. We examine the applicability of using statistical methods to relate search engine queries with scarlet fever cases in the UK, taking advantage of tools to acquire the appropriate data from Google, and using an alternative statistical method based on gamma distributions. The results show that using logit models, the Pearson correlation factor between Web queries and the data obtained from the official agencies must be over 0.90, otherwise the prediction of the peak and the spread of the distributions gives significant deviations. In this paper, we describe the gamma distribution model and show that we can obtain better results in all cases using gamma transformations, and especially in those with a smaller correlation factor.

The UK Ecosystem for Fostering Innovation in the Earth & Space Sciences

NASA Astrophysics Data System (ADS)

Lee, V. E.

2015-12-01

The UK national government supports an ecosystem of government-funded organisations that carry a specific remit for innovation. By specifically cultivating the commercialisation of research where appropriate, the UK demonstrates a forward-thinking and coordinated approach to deriving economic and societal impact from scientific research activities. This presentation provides an overview of innovation activities at government-backed organisations that support the Earth and space science communities. At the broadest and highest levels, the UK has a whole-of-government approach to fostering innovation. The government also has a designated innovation agency - Innovate UK - which works with people, companies, and partner organisations to find and drive the science & technology innovations that will grow the UK economy. A primary source of scientific funding to UK-based researchers comes from the Research Councils UK (RCUK), which has seven constituent Research Councils. Along with funding activities that support basic research, innovation is supported through a variety of activities. The National Environmental Research Council (NERC), the UK's leading public funder for Earth & environmental science, has brought to market a wide variety of ideas and innovations, including by helping to register patents, negotiating licensing deals, and setting up spin-out companies or joint ventures with commercial organisations. Case studies of NERC commercialization successes will be given, as well as an overview of mechanisms by which NERC supports innovation. These include 'Pathfinder' awards that help enable researchers to develop a greater understanding of the commercial aspects and possibilities of their research. Complementary 'Follow-on Fund' awards provide proof-of-concept funding to support the commercialisation of ideas arising from NERC-funded research. Early-career researchers are also eligible for NERC's Environment Young Entrepreneurs Scheme. Innovation activity, like basic research, can be enhanced through international collaboration and engagement. Approaches taken by UK organisations such as RCUK seek to bring together the correct teams, regardless of nationality, to develop innovations needed to address common challenges.

Does the increased rate of schizophrenia diagnosis in African-Caribbean men in the UK shown by the AESOP study reflect cultural bias in healthcare?

PubMed

Ngaage, Millie; Agius, Mark

2016-09-01

The UK-based AESOP study conducted over a two-year period in three UK sites simultaneously (London, Nottingham, and Bristol), is the largest study to date to conduct a first contact case-control study of psychosis. The study found that rates of schizophrenia were markedly elevated in both African-Caribbean and Black African people, in both sexes and across all age groups. English language literature published up to 2016 was searched. The initial search included: PubMed, The Cochrane Library, and Web of Science. A second search was conducted using Medical Subject Headings (MeSH) and keywords. Studies selected for retrieval were assessed by two independent reviewers. The search yielded eight results, all of which supported the conclusion of an increased incidence of schizophrenia in Black African and Black Caribbean population in the AESOP study. England is a multicultural landscape; multiplicity of cultures makes diagnosis difficult. The lessons we must learn from the AESOP study is the need for transcultural training and the removal of blinding to ethnicity when a large epidemiological study is conducted - psychiatrists need to be cognisant of cultures and aware of the context of symptoms.

Investigation of Caucasian rheumatoid arthritis susceptibility loci in African patients with the same disease

PubMed Central

2012-01-01

Introduction The largest genetic risk to develop rheumatoid arthritis (RA) arises from a group of alleles of the HLA DRB1 locus ('shared epitope', SE). Over 30 non-HLA single nucleotide polymorphisms (SNPs) predisposing to disease have been identified in Caucasians, but they have never been investigated in West/Central Africa. We previously reported a lower prevalence of the SE in RA patients in Cameroon compared to European patients and aimed in the present study to investigate the contribution of Caucasian non-HLA RA SNPs to disease susceptibility in Black Africans. Methods RA cases and controls from Cameroon were genotyped for Caucasian RA susceptibility SNPs using Sequenom MassArray technology. Genotype data were also available for 5024 UK cases and 4281 UK controls and for 119 Yoruba individuals in Ibadan, Nigeria (YRI, HapMap). A Caucasian aggregate genetic-risk score (GRS) was calculated as the sum of the weighted risk-allele counts. Results After genotyping quality control procedures were performed, data on 28 Caucasian non-HLA susceptibility SNPs were available in 43 Cameroonian RA cases and 44 controls. The minor allele frequencies (MAF) were tightly correlated between Cameroonian controls and YRI individuals (correlation coefficient 93.8%, p = 1.7E-13), and they were pooled together. There was no correlation between MAF of UK and African controls; 13 markers differed by more than 20%. The MAF for markers at PTPN22, IL2RA, FCGR2A and IL2/IL21 was below 2% in Africans. The GRS showed a strong association with RA in the UK. However, the GRS did not predict RA in Africans (OR = 0.71, 95% CI 0.29 - 1.74, p = 0.456). Random sampling from the UK cohort showed that this difference in association is unlikely to be explained by small sample size or chance, but is statistically significant with p<0.001. Conclusions The MAFs of non-HLA Caucasian RA susceptibility SNPs are different between Caucasians and Africans, and several polymorphisms are barely detectable in West/Central Africa. The genetic risk of developing RA conferred by a set of 28 Caucasian susceptibility SNPs is significantly different between the UK and Africa with p<0.001. Taken together, these observations strengthen the hypothesis that the genetic architecture of RA susceptibility is different in different ethnic backgrounds. PMID:23121884

Investigation of Caucasian rheumatoid arthritis susceptibility loci in African patients with the same disease.

PubMed

Viatte, Sebastien; Flynn, Edward; Lunt, Mark; Barnes, Joanne; Singwe-Ngandeu, Madeleine; Bas, Sylvette; Barton, Anne; Gabay, Cem

2012-11-03

The largest genetic risk to develop rheumatoid arthritis (RA) arises from a group of alleles of the HLA DRB1 locus ('shared epitope', SE). Over 30 non-HLA single nucleotide polymorphisms (SNPs) predisposing to disease have been identified in Caucasians, but they have never been investigated in West/Central Africa. We previously reported a lower prevalence of the SE in RA patients in Cameroon compared to European patients and aimed in the present study to investigate the contribution of Caucasian non-HLA RA SNPs to disease susceptibility in Black Africans. RA cases and controls from Cameroon were genotyped for Caucasian RA susceptibility SNPs using Sequenom MassArray technology. Genotype data were also available for 5024 UK cases and 4281 UK controls and for 119 Yoruba individuals in Ibadan, Nigeria (YRI, HapMap). A Caucasian aggregate genetic-risk score (GRS) was calculated as the sum of the weighted risk-allele counts. After genotyping quality control procedures were performed, data on 28 Caucasian non-HLA susceptibility SNPs were available in 43 Cameroonian RA cases and 44 controls. The minor allele frequencies (MAF) were tightly correlated between Cameroonian controls and YRI individuals (correlation coefficient 93.8%, p = 1.7E-13), and they were pooled together. There was no correlation between MAF of UK and African controls; 13 markers differed by more than 20%. The MAF for markers at PTPN22, IL2RA, FCGR2A and IL2/IL21 was below 2% in Africans. The GRS showed a strong association with RA in the UK. However, the GRS did not predict RA in Africans (OR = 0.71, 95% CI 0.29 - 1.74, p = 0.456). Random sampling from the UK cohort showed that this difference in association is unlikely to be explained by small sample size or chance, but is statistically significant with p<0.001. The MAFs of non-HLA Caucasian RA susceptibility SNPs are different between Caucasians and Africans, and several polymorphisms are barely detectable in West/Central Africa. The genetic risk of developing RA conferred by a set of 28 Caucasian susceptibility SNPs is significantly different between the UK and Africa with p<0.001. Taken together, these observations strengthen the hypothesis that the genetic architecture of RA susceptibility is different in different ethnic backgrounds.

Supporting knowledge translation through collaborative translational research initiatives: ‘Bridging’ versus ‘blurring’ boundary-spanning approaches in the UK CLAHRC initiative

PubMed Central

Evans, Sarah; Scarbrough, Harry

2014-01-01

Recent policy initiatives in the UK and internationally have sought to promote knowledge translation between the ‘producers’ and ‘users’ of research. Within this paper we explore how boundary-spanning interventions used within such initiatives can support knowledge translation between diverse groups. Using qualitative data from a 3-year research study conducted from January 2010 to December 2012 of two case-sites drawn from the CLAHRC initiative in the UK, we distinguish two different approaches to supporting knowledge translation; a ‘bridging’ approach that involves designated roles, discrete events and activities to span the boundaries between communities, and a ‘blurring’ approach that de-emphasises the boundaries between groups, enabling a more continuous process of knowledge translation as part of day-to-day work-practices. In this paper, we identify and differentiate these boundary-spanning approaches and describe how they emerged from the context defined by the wider CLAHRC networks. This highlights the need to develop a more contextualised analysis of the boundary-spanning that underpins knowledge translation processes, relating this to the distinctive features of a particular case. PMID:24561773

Impact of Export Control and Technology Transfer Regimes: International Perspectives

DTIC Science & Technology

2012-01-07

major national security and public policy issue. Exploring the ITAR environment through a set of case studies was the central idea in a project...cover) was based on a survey of UK stakeholders. The results were unambiguous and striking. Our British partners conclude ITAR is a good idea gone...ITAR) regime is a major national security and public policy issue. Exploring the ITAR environment through a set of case studies was the central idea

A comparative analysis of drug safety withdrawals in the UK and the US (1971-1992): implications for current regulatory thinking and policy.

PubMed

Abraham, John; Davis, Courtney

2005-09-01

By going beyond individual case studies and solely quantitative surveys, this paper systematically examines why there were over twice as many new prescription drugs withdrawn from the market on grounds of safety in the UK as there were in the US between 1971 and 1992. Drawing on interviews with regulators, industry scientists and others involved, and on regulatory data never before accessed outside governments and companies, five key hypotheses which might explain this difference in drug safety withdrawals are analysed. These are: (1) simply because the UK approved more new drugs than the US; (2) because of an industrial corporate strategy to seek approval of 'less safe' drugs in the UK earlier; (3) because British regulators were more vigilant at spotting post-marketing safety problems than their US counterparts; (4) because the slowness of the US in approving new drugs enabled regulators there to learn from, and avoid, safety problems that had already emerged in the UK or European market; and (5) because more stringent regulation in the US meant that they approved fewer unsafe drugs on to the market in the first place. It is concluded that the main explanation for fewer drug safety withdrawals in the US is that the regulatory agency there applied more stringent pre-market review and/or standards, which took longer than UK regulatory checks, but prevented unsafe drugs marketed in the UK from entering the US market. Contrary to the claims frequently made by the pharmaceutical industry and regulatory agencies on both sides of the Atlantic, these results imply that it is likely that acceleration of regulatory review times in the US and the UK since the early 1990s is compromising drug safety.

Implementing statistical equating for MRCP(UK) Parts 1 and 2.

PubMed

McManus, I C; Chis, Liliana; Fox, Ray; Waller, Derek; Tang, Peter

2014-09-26

The MRCP(UK) exam, in 2008 and 2010, changed the standard-setting of its Part 1 and Part 2 examinations from a hybrid Angoff/Hofstee method to statistical equating using Item Response Theory, the reference group being UK graduates. The present paper considers the implementation of the change, the question of whether the pass rate increased amongst non-UK candidates, any possible role of Differential Item Functioning (DIF), and changes in examination predictive validity after the change. Analysis of data of MRCP(UK) Part 1 exam from 2003 to 2013 and Part 2 exam from 2005 to 2013. Inspection suggested that Part 1 pass rates were stable after the introduction of statistical equating, but showed greater annual variation probably due to stronger candidates taking the examination earlier. Pass rates seemed to have increased in non-UK graduates after equating was introduced, but was not associated with any changes in DIF after statistical equating. Statistical modelling of the pass rates for non-UK graduates found that pass rates, in both Part 1 and Part 2, were increasing year on year, with the changes probably beginning before the introduction of equating. The predictive validity of Part 1 for Part 2 was higher with statistical equating than with the previous hybrid Angoff/Hofstee method, confirming the utility of IRT-based statistical equating. Statistical equating was successfully introduced into the MRCP(UK) Part 1 and Part 2 written examinations, resulting in higher predictive validity than the previous Angoff/Hofstee standard setting. Concerns about an artefactual increase in pass rates for non-UK candidates after equating were shown not to be well-founded. Most likely the changes resulted from a genuine increase in candidate ability, albeit for reasons which remain unclear, coupled with a cognitive illusion giving the impression of a step-change immediately after equating began. Statistical equating provides a robust standard-setting method, with a better theoretical foundation than judgemental techniques such as Angoff, and is more straightforward and requires far less examiner time to provide a more valid result. The present study provides a detailed case study of introducing statistical equating, and issues which may need to be considered with its introduction.

Maintaining quality in the UK breast screening program

NASA Astrophysics Data System (ADS)

Gale, Alastair

2010-02-01

Breast screening in the UK has been implemented for over 20 years and annually nearly two million women are now screened with an estimated 1,400 lives saved. Nationally, some 700 individuals interpret screening mammograms in almost 110 screening centres. Currently, women aged 50 to 70 are invited for screening every three years and by 2012 this age range will increase to 47 - 73 years. There is a rapid ongoing transition from using film mammograms to full field digital mammography such that in 2010 every screening centre will be partly digital. An early, and long running, concern has been how to ensure the highest quality of imaging interpretation across the UK, an issue enhanced by the use of a three year screening interval. To partly address this question a self assessment scheme was developed in 1988 and subsequently implemented nationally in the UK as a virtually mandatory activity. The scheme is detailed from its beginnings, through its various developments to current incarnation and future plans. This encompasses both radiological (single view screening, two view screening, mammographic film and full field digital mammography) as well as design changes (cases reported by means of: form filling; PDA; tablet PC; iPhone, and the internet). The scheme provides a rich data source which is regularly studied to examine different aspects of radiological performance. Overall it aids screening radiologists by giving them regular access to a range of difficult exemplar cases together with feedback on their performance as compared to their peers.

Cost-utility of enoxaparin compared with unfractionated heparin in unstable coronary artery disease

PubMed Central

Nicholson, Tricia; McGuire, Alistair; Milne, Ruairidh

2001-01-01

Background Low molecular weight heparins hold several advantages over unfractionated heparin including convenience of administration. Enoxaparin is one such heparin licensed in the UK for use in unstable coronary artery disease (unstable stable angina and non-Q wave myocardial infarction). In these patients, two large randomised controlled trials and their meta-analysis showed small benefits for enoxaparin over unfractionated heparin at 30–43 days and potentially at one year. We found no relevant published full economic evaluations, only cost studies, one of which was conducted in the UK. The other studies, from the US, Canada and France, are difficult to interpret since their resource use and costs may not reflect UK practice. Methods We aimed to compare the benefits and costs of short-term treatment (two to eight days) with enoxaparin and unfractionated heparin in unstable coronary artery disease. We used published data sources to estimate the incremental cost per quality adjusted life year (QALY), adopting a NHS perspective and using 1998 prices. Results The base case was a 0.013 QALY gain and net cost saving of £317 per person treated with enoxaparin instead of unfractionated heparin. All but one sensitivity analysis showed net savings and QALY gains, the exception (the worst case) being a cost per QALY of £3,305. Best cases were a £495 saving and 0.013 QALY gain, or a £317 saving and 0.014 QALY gain per person. Conclusions Enoxaparin appears cost saving compared with unfractionated heparin in patients with unstable coronary artery disease. However, cost implications depend on local revascularisation practice. PMID:11701090

Case-control Studies on the Effectiveness of Breast Cancer Screening: Insights from the UK Age Trial.

PubMed

van der Waal, Daniëlle; Broeders, Mireille J M; Verbeek, André L M; Duffy, Stephen W; Moss, Sue M

2015-07-01

Ongoing breast cancer screening programs can only be evaluated using observational study designs. Most studies have observed a reduction in breast cancer mortality, but design differences appear to have resulted in different estimates. Direct comparison of case-control and trial analyses gives more insight into this variation. Here, we performed case-control analyses within the randomized UK Age Trial. The Age Trial assessed the effect of screening on breast cancer mortality in women ages 40-49 years. In our approach, case subjects were defined as breast cancer deaths between trial entry (1991-1997) and 2004. Women were ages 39-41 years at entry. For every case subject, five control subjects were selected. All case subjects were included in analyses of screening invitation (356 case subjects, 1,780 controls), whereas analyses of attendance were restricted to women invited to screening (105 case subjects, 525 age-matched controls). Odds ratios (OR) were estimated with conditional logistic regression. We used and compared two methods to correct for self-selection bias. Screening invitation resulted in a breast cancer mortality reduction of 17% (95% confidence interval [CI]: -36%, +6%), similar to trial results. Different exposure definitions and self-selection adjustments influenced the observed breast cancer mortality reduction. Depending on the method, "ever screened" appeared to be associated with a small reduction (OR: 0.86, 95% CI: 0.40, 1.89) or no reduction (OR: 1.02, 95% CI: 0.48, 2.14) using the two methods of correction. Recent attendance resulted in an adjusted mortality reduction of 36% (95% CI: -69%, +31%) or 45% (95% CI: -71%, +5%). Observational studies, and particularly case-control studies, are an important monitoring tool for breast cancer screening programs. The focus should be on diminishing bias in observational studies and gaining a better understanding of the influence of study design on estimates of mortality reduction.

Case-mix analysis and variation in rates of non-surgical treatment of older women with operable breast cancer.

PubMed

Morgan, J; Richards, P; Ward, S; Francis, M; Lawrence, G; Collins, K; Reed, M; Wyld, L

2015-08-01

Non-surgical management of older women with oestrogen receptor (ER)-positive operable breast cancer is common in the UK, with up to 40 per cent of women aged over 70 years receiving primary endocrine therapy. Although this may be appropriate for frailer patients, for some it may result in treatment failure, contributing to the poor outcomes seen in this age group. Wide variation in the rates of non-operative management of breast cancer in older women exists across the UK. Case mix may explain some of this variation in practice. Data from two UK regional cancer registries were analysed to determine whether variation in treatment observed between 2002 and 2010 at hospital and clinician level persisted after adjustment for case mix. Expected case mix-adjusted surgery rates were derived by logistic regression using the variables age, proxy Charlson co-morbidity score, deprivation quintile, method of cancer detection, tumour size, stage, grade and node status. Data on 17,129 women aged 70 years or more with ER-positive operable breast cancer were analysed. There was considerable variation in rates of surgery at both hospital and clinician level. Despite adjusting for case mix, this variation persisted at hospital level, although not at clinician level. This study demonstrates variation in selection criteria for older women for operative treatment of early breast cancer, indicating that some older women may be undertreated or overtreated, and may partly explain the inferior disease outcomes in this age group. It emphasizes the urgent need for evidence-based guidelines for treatment selection criteria in older women with breast cancer. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

Persistence, how do they do it? A case study of Access to Higher Education learners on a U.K. Diploma/BSc nursing programme.

PubMed

Hinsliff-Smith, Kathryn; Gates, Peter; Leducq, Marion

2012-01-01

In 2006, the United Kingdom (U.K.) Department of Health (DoH) produced guidelines, requiring institutions to address the attrition rates for student nurses and midwives. This issue is not only a concern in the U.K. but has gained prominence in other Schools of Nursing including the U.S.A., Australia, and developing countries. Many Schools of Nursing have witnessed a change in their student population with a growing prominence of mature entrants (those over 21). Studies that focus on learner persistence, in particular mature students are relatively rare and very scarce on entrants with an Access to Higher Education (HE) qualification. This study, using focus group interviews, involved Access to HE learners who successfully progressed to a Diploma of Higher Education (DipHE)/Bachelor of Science (BSc) in Nursing at one U.K. University. The study findings indicated that Access to HE learners are able to develop a range of coping strategies in relation to academic demands and caring responsibilities, which are drawn upon in their DipHE/BSc programme. The findings have relevance for all Schools of Nursing as we face new and difficult challenges not least the global shortage of qualified nurses and the pressures placed on educators to retain student nurses. Copyright © 2011 Elsevier Ltd. All rights reserved.

Balancing Academic and Professional Pedagogies: A Comparative Study of Two Accounting Departments in South Africa and the UK

ERIC Educational Resources Information Center

van der Merwe, Nico; McChlery, Stuart; Visser, Sarah Susanna

2014-01-01

The paper adds to extant professional education literature by reflecting on apparent differences in pedagogy of similar professional programmes of study, allowing deeper insight into the unique strand of higher education influenced by the professions. A comparative international case study approach is adopted of an interpretive qualitative nature…

Placement-Based Learning and Learner Engagement: Findings from a New University in the UK

ERIC Educational Resources Information Center

Murphy, Timothy R. N.; Folgueiras Bertomeu, Pilar; Mannix McNamara, Patricia

2016-01-01

This paper addresses the potential for engaged learning among final-year undergraduate Education Studies students at a new, post-1992. It discusses a case study analysis of a "Directed Experiential Learning" (DEL) intervention in the final year of an education studies degree designed to engage and motivate students and emphasise the…

'1966 and all that': Trends and developments in UK ergonomics during the 1960s.

PubMed

Waterson, Patrick; Eason, Ken

2009-11-01

The 1960s represents a key decade in the expansion of ergonomics within the UK. This paper reviews trends and developments that emerged out of the 1960s and compares these with ergonomics research and practice today. The focus in particular is on the expansion of ergonomics as a discipline within industry, as well as more specific topics, such as the emergence of areas of interest, for example, computers and technology, automation and systems ergonomics and consumer ergonomics. The account is illustrated with a detailed timeline of developments, a set of industrial case studies and the contents of important publications during the decade. A key aim of the paper is to provide the opportunity to reflect on the past and the implications this may have for future directions for ergonomics within the UK. The paper provides practitioners with an insight into the development of ergonomics in the UK during one of the most important decades of its history. This is especially relevant given the fact that in 2009 the Ergonomics Society celebrates its 60th anniversary.

Impacts of Directed Tutorial Activities in Computer Conferencing: A Case Study

ERIC Educational Resources Information Center

Painter, Clare; Coffin, Caroline; Hewings, Ann

2003-01-01

This paper describes a qualitative study of asynchronous electronic conferencing by three tutorial groups on the same postgraduate course ("Teaching English to Speakers of Other Languages Worldwide"), forming part of an MA in Applied Linguistics (via Distance Education) at the Open University, UK. The groups varied in the degree to which…

Generic Behavioural Criteria of Managerial Effectiveness: An Empirical and Comparative Case Study of UK Local Government

ERIC Educational Resources Information Center

Hamlin, Robert G.; Serventi, Susan A.

2008-01-01

Purpose: The purpose of this paper is to present the findings of a "partnership-research" study of effective and ineffective managerial behaviour within the "local government" setting of the Wolverhampton City Council Social Care Department, and to describe how the research supports and challenges the organisation's existing…

The Development and Positioning of Business Related University Tourism Education: A UK Perspective.

ERIC Educational Resources Information Center

Evans, Nigel

2001-01-01

Categorization and analysis of articles on tourism research provided evidence that tourism is not a discipline but a field. A case study of a travel and tourism management program at a British university shows how business studies are emphasized in preparing for the field. (Contains 50 references.) (SK)

Tropical Rainforests: A Case Study of UK, 13-Year-Olds' Knowledge and Understanding of These Environments

ERIC Educational Resources Information Center

Dove, Jane

2012-01-01

Tropical rainforests are biologically rich ecosystems, which are threatened by a variety of different human activities. This study focuses on students' knowledge and understanding of rainforest locations, their reasons for protecting these environments and their familiarity with selected concepts about rainforest vegetation and soil. These…

Local Skills Case Study. Research Report

ERIC Educational Resources Information Center

Green, Anne; Hogarth, Terence; Thom, Graham; MacLeod, Katie; Warhurst, Chris; Willis, Robert; Mackay, Susan

2017-01-01

This study, jointly conducted by the University of Warwick Institute for Employment Research (IER) and SQW Ltd., discusses the UK Government's intention to accelerate the process of ceding more responsibility for delivering a range of services to the local level. The logic is that local actors are better placed to identify local priorities. This…

SIFT-MS and FA-MS methods for ambient gas phase analysis: developments and applications in the UK.

PubMed

Smith, David; Španěl, Patrik

2015-04-21

Selected ion flow tube mass spectrometry, SIFT-MS, a relatively new gas/vapour phase analytical method, is derived from the much earlier selected ion flow tube, SIFT, used for the study of gas phase ion-molecule reactions. Both the SIFT and SIFT-MS techniques were conceived and developed in the UK, the former at Birmingham University, the latter at Keele University along with the complementary flowing afterglow mass spectrometry, FA-MS, technique. The focus of this short review is largely to describe the origins, developments and, most importantly, the unique features of SIFT-MS as an analytical tool for ambient analysis and to indicate its growing use to analyse humid air, especially exhaled breath, its unique place as a on-line, real time analytical method and its growing use and applications as a non-invasive diagnostic in clinical diagnosis and therapeutic monitoring, principally within several UK universities and hospitals, and briefly in the wider world. A few case studies are outlined that show the potential of SIFT-MS and FA-MS in the detection and quantification of metabolites in exhaled breath as a step towards recognising pathophysiology indicative of disease and the presence of bacterial and fungal infection of the airways and lungs. Particular cases include the detection of Pseudomonas aeruginosa infection of the airways of patients with cystic fibrosis (SIFT-MS) and the measurement of total body water in patients with chronic kidney disease (FA-MS). The growing exploitation of SIFT-MS in other areas of research and commerce are briefly listed to show the wide utility of this unique UK-developed analytical method, and future prospects and developments are alluded to.

Information on 'Overdiagnosis' in Breast Cancer Screening on Prominent United Kingdom- and Australia-Oriented Health Websites.

PubMed

Ghanouni, Alex; Meisel, Susanne F; Hersch, Jolyn; Waller, Jo; Wardle, Jane; Renzi, Cristina

2016-01-01

Health-related websites are an important source of information for the public. Increasing public awareness of overdiagnosis and ductal carcinoma in situ (DCIS) in breast cancer screening may facilitate more informed decision-making. This study assessed the extent to which such information was included on prominent health websites oriented towards the general public, and evaluated how it was explained. Cross-sectional study. Websites identified through Google searches in England (United Kingdom) and New South Wales (Australia) for "breast cancer screening" and further websites included based on our prior knowledge of relevant organisations. Content analysis was used to determine whether information on overdiagnosis or DCIS existed on each site, how the concepts were described, and what statistics were used to quantify overdiagnosis. After exclusions, ten UK websites and eight Australian websites were considered relevant and evaluated. They originated from charities, health service providers, government agencies, and an independent health organisation. Most contained some information on overdiagnosis (and/or DCIS). Descriptive information was similar across websites. Among UK websites, statistical information was often based on estimates from the Independent UK Panel on Breast Cancer Screening; the most commonly provided statistic was the ratio of breast cancer deaths prevented to overdiagnosed cases (1:3). A range of other statistics was included, such as the yearly number of overdiagnosed cases and the proportion of women screened who would be overdiagnosed. Information on DCIS and statistical information was less common on the Australian websites. Online information about overdiagnosis has become more widely available in 2015-16 compared with the limited accessibility indicated by older research. However, there may be scope to offer more information on DCIS and overdiagnosis statistics on Australian websites. Moreover, the variability in how estimates are presented across UK websites may be confusing for the general public.

Could managed burning of peatlands lead to carbon storage?

NASA Astrophysics Data System (ADS)

Clay, G.; Worrall, F.

2007-12-01

Peatlands are the UK's largest single terrestrial carbon store with carbon stored in UK peatlands than in forests of Britain and France combined. Unlike most northern peatlands in the peat soils of the UK are heavily managed for recreation and agriculture and due to their proximity to major centres of population are under more anthropogenic pressure than most peatlands. A typical management strategy on UK upland peats is the use of managed fire to restrict vegetation. Fires are used upon a 10-25 year rotation and are described as "cool" as they remove the crown of the vegetation without scorching the litter layer or the underlying soil. In this case the fire destroys primary productivity and limits litter production but produces char. Char is a low volume, highly refractory, high carbon content product while litter is a high volume, decomposable, lower carbon content product. Therefore, the question is if there are fire conditions underwhich the production of char causes more carbon to be stored in the peat than would have been stored if no fire management had been employed. This study uses detailed vegetation studies from a long term monitoring site in order to assess litter and biomass production; in laboratory experimental burns were undertaken in order to assess the amount and controls upon char production and the carbon content of that char. Results of field and laboratory observations are used to model carbon accumulation under s aseries of fire management scenarios and the modelling shows that cools burns at long rotations could lead to higher carbon storage than if no fire had occurred, further than in several cases more carbon accumulation occurred even if less depth of peat was generated.

The risk of hydraulic fracturing on public health in the UK and the UK's fracking legislation.

PubMed

Reap, Elisabeth

2015-01-01

Hydraulic fracturing to extract natural gas from shale rock is a new, rapidly expanding industry in the United States (US). However, there is concern that these operations could be having large negative impacts such as groundwater contamination, increased air pollution and seismic events. The United Kingdom (UK) is looking at the potential for emulating the success of 'shale gas' in the US. Differences in population density and geological conditions mean that the public health impacts recorded in the US cannot be directly extrapolated to the UK. There is limited academic literature available but findings suggest that the UK government is not fully recognising the inherent risks of hydraulic fracturing exposed by this literature. Government reports suggest a reliance on engineering solutions and better practice to overcome problems found in the US when evidence suggests that there are inherent risks and impacts that cannot be eliminated. This study applies US results to approximate the impact of one exposure pathway, inhalation of hydrocarbons by the public from operational air emissions over the 30 year lifetime of a well and finds that 7.2 extra cancer cases from exposure to air contamination would be expected in the UK if all test sites, approved test sites and test sites awaiting approval as of January 2015 went on to extract gas. In conclusion, limited assessment of the public health implications of hydraulic fracturing operations is available but the UK government appears to not be applying the precautionary principle to potentially significant legislation.

Case study of the use of pulsed field gel electrophoresis in the detection of a food-borne outbreak.

PubMed

De Lappe, Niall; Cormican, Martin

2015-01-01

In early July 2008, a cluster of six Salmonella Agona was identified in the Republic of Ireland. A dispersed, common source outbreak was suspected. Later in July a further case was identified and the Health Protection Agency in the UK indicated that they had 32 cases of S. Agona since Feb 2008. This chapter discusses how pulsed field gel electrophoresis was used to help confirm an outbreak and to trace the source of the outbreak.

Incidence, risk factors, management and outcomes of amniotic-fluid embolism: a population-based cohort and nested case-control study.

PubMed

Fitzpatrick, K E; Tuffnell, D; Kurinczuk, J J; Knight, M

2016-01-01

To describe the incidence, risk factors, management and outcomes of amniotic-fluid embolism (AFE) over time. A population-based cohort and nested case-control study using the UK Obstetric Surveillance System (UKOSS). All UK hospitals with obstetrician-led maternity units. All women diagnosed with AFE in the UK between February 2005 and January 2014 (n = 120) and 3839 control women. Prospective case and control identification through UKOSS monthly mailing. Amniotic-fluid embolism, maternal death or permanent neurological injury. The total and fatal incidence of AFE, estimated as 1.7 and 0.3 per 100 000, respectively, showed no significant temporal trend over the study period and there was no notable temporal change in risk factors for AFE. Twenty-three women died (case fatality 19%) and seven (7%) of the surviving women had permanent neurological injury. Women who died or had permanent neurological injury were more likely to present with cardiac arrest (83% versus 33%, P < 0.001), be from ethnic-minority groups (adjusted odds ratio [OR] 2.85, 95% confidence interval [95% CI] 1.02-8.00), have had a hysterectomy (unadjusted OR 2.49, 95% CI 1.02-6.06), had a shorter time interval between the AFE event and when the hysterectomy was performed (median interval 77 minutes versus 248 minutes, P = 0.0315), and were less likely to receive cryoprecipitate (unadjusted OR 0.30, 95% CI 0.11-0.80). There is no evidence of a temporal change in the incidence of or risk factors for AFE. Further investigation is needed to establish whether earlier treatments can reverse the cascade of deterioration leading to severe outcomes. © 2015 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

Comparative genetic diversity in a sample of pony breeds from the U.K. and North America: a case study in the conservation of global genetic resources.

PubMed

Winton, Clare L; Plante, Yves; Hind, Pamela; McMahon, Robert; Hegarty, Matthew J; McEwan, Neil R; Davies-Morel, Mina C G; Morgan, Charly M; Powell, Wayne; Nash, Deborah M

2015-08-01

Most species exist as subdivided ex situ daughter population(s) derived from a single original group of individuals. Such subdivision occurs for many reasons both natural and manmade. Traditional British and Irish pony breeds were introduced to North America (U.S.A. and Canada) within the last 150 years, and subsequently equivalent breed societies were established. We have analyzed selected U.K. and North American equivalent pony populations as a case study for understanding the relationship between putative source and derived subpopulations. Diversity was measured using mitochondrial DNA and a panel of microsatellite markers. Genetic signatures differed between the North American subpopulations according to historical management processes. Founder effect and stochastic drift was apparent, particularly pronounced in some breeds, with evidence of admixture of imported mares of different North American breeds. This demonstrates the importance of analysis of subpopulations to facilitate understanding the genetic effects of past management practices and to lead to informed future conservation strategies.

Breast cancer in ethnic minority groups in developed nations: Case studies of the United Kingdom and Australia.

PubMed

Brennan, Meagan

2017-05-01

Recent research from the United Kingdom (UK) has highlighted some of the differences in breast cancer presentations between women of different ethnic groups. Analysis of a large database showed that Black women of African or Caribbean heritage living in England and Wales are more likely to present with stage 3 or 4 cancer than White British women and less likely to have their cancer detected through screening. In many countries around the world, migrant and cultural minority groups experience social and economic disadvantage and this is reflected in their health outcomes. With world migration at record levels, it is timely to reflect on ethnic disparities and to consider how developed nations can care for their minority groups, which are increasing in number and diversity. These issues and challenges are discussed, using the UK's migrant population and Australia's Indigenous and migrant populations as case studies. Copyright © 2017 Elsevier B.V. All rights reserved.

The geography of imported malaria to non-endemic countries: a meta-analysis of nationally reported statistics.

PubMed

Tatem, Andrew J; Jia, Peng; Ordanovich, Dariya; Falkner, Michael; Huang, Zhuojie; Howes, Rosalind; Hay, Simon I; Gething, Peter W; Smith, David L

2017-01-01

Malaria remains a problem for many countries classified as malaria free through cases imported from endemic regions. Imported cases to non-endemic countries often result in delays in diagnosis, are expensive to treat, and can sometimes cause secondary local transmission. The movement of malaria in endemic countries has also contributed to the spread of drug resistance and threatens long-term eradication goals. Here we focused on quantifying the international movements of malaria to improve our understanding of these phenomena and facilitate the design of mitigation strategies. In this meta-analysis, we studied the database of publicly available nationally reported statistics on imported malaria in the past 10 years, covering more than 50 000 individual cases. We obtained data from 40 non-endemic countries and recorded the geographical variations. Infection movements were strongly skewed towards a small number of high-traffic routes between 2005 and 2015, with the west Africa region accounting for 56% (13 947/24 941) of all imported cases to non-endemic countries with a reported travel destination, and France and the UK receiving the highest number of cases, with more than 4000 reported cases per year on average. Countries strongly linked by movements of imported cases are grouped by historical, language, and travel ties. There is strong spatial clustering of plasmodium species types. The architecture of the air network, historical ties, demographics of travellers, and malaria endemicity contribute to highly heterogeneous patterns of numbers, routes, and species compositions of parasites transported. With global malaria eradication on the international agenda, malaria control altering local transmission, and the threat of drug resistance, understanding these patterns and their drivers is increasing in importance. Bill & Melinda Gates Foundation, National Institutes of Health, UK Medical Research Council, UK Department for International Development, Wellcome Trust. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Impact of environmental discourses on public health policy arrangements: a comparative study in the UK and Flanders, (Belgium).

PubMed

Stassen, K R; Gislason, M; Leroy, P

2010-10-01

Theoretically inspired by discursive institutionalism and multi-level governance, this paper assesses the extent to which 'environmental health' has emerged as a new discourse at European level, the effects it has had on national public health governance in two European countries, and what mechanisms have triggered or hindered these effects. Comparison of the dynamics in public health policy arrangements in Flanders (Belgium) and the UK, nations influenced by both international and European environmental health discourses. The Policy Arrangement Approach was the analytical framework used to structure the results of this textual analysis. Despite their shared focus on environmental health, Belgium and the UK display quite different approaches to environmental health governance. While Belgium works on environmental health in a predominantly top-down approach, the UK has developed a more inward-facing approach to environmental health policies. The cases of the UK and Belgium show that, although these countries respond similarly to internationally agreed charters and both are members of the European Union, national differences in environmental health policies persist, mainly due to pre-existing national policy arrangements and the activities of national institutions. This leads to a divergent interplay between national and international institutions. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Soil geohazard mapping for improved asset management of UK local roads

NASA Astrophysics Data System (ADS)

Pritchard, O. G.; Hallett, S. H.; Farewell, T. S.

2015-09-01

Unclassified roads comprise 60 % of the road network in the United Kingdom (UK). The resilience of this locally important network is declining. It is considered by the Institution of Civil Engineers to be "at risk" and is ranked 26th in the world. Many factors contribute to the degradation and ultimate failure of particular road sections. However, several UK local authorities have identified that in drought conditions, road sections founded upon shrink-swell susceptible clay soils undergo significant deterioration compared with sections on non-susceptible soils. This arises from the local road network having little, if any, structural foundations. Consequently, droughts in East Anglia have resulted in millions of pounds of damage, leading authorities to seek emergency governmental funding. This paper assesses the use of soil-related geohazard assessments in providing soil-informed maintenance strategies for the asset management of the locally important road network of the UK. A case study draws upon the UK administrative county of Lincolnshire, where road assessment data have been analysed against mapped clay-subsidence risk. This reveals a statistically significant relationship between road condition and susceptible clay soils. Furthermore, incorporation of UKCP09 future climate projections within the geohazard models has highlighted roads likely to be at future risk of clay-related subsidence.

Soil geohazard mapping for improved asset management of UK local roads

NASA Astrophysics Data System (ADS)

Pritchard, O. G.; Hallett, S. H.; Farewell, T. S.

2015-05-01

Unclassified roads comprise 60% of the road network in the United Kingdom (UK). The resilience of this locally important network is declining. It is considered by the Institution of Civil Engineers to be "at risk" and is ranked 26th in the world. Many factors contribute to the degradation and ultimate failure of particular road sections. However, several UK local authorities have identified that in drought conditions, road sections founded upon shrink/swell susceptible clay soils undergo significant deterioration compared with sections on non-susceptible soils. This arises from the local road network having little, if any structural foundations. Consequently, droughts in East Anglia have resulted in millions of pounds of damage, leading authorities to seek emergency governmental funding. This paper assesses the use of soil-related geohazard assessments in providing soil-informed maintenance strategies for the asset management of the locally important road network of the UK. A case study draws upon the UK administrative county of Lincolnshire, where road assessment data have been analysed against mapped clay-subsidence risk. This reveals a statistically significant relationship between road condition and susceptible clay soils. Furthermore, incorporation of UKCP09 future climate projections within the geohazard models has highlighted roads likely to be at future risk of clay-related subsidence.

Reanalysis of the start of the UK 1967 to 1968 foot-and-mouth disease epidemic to calculate airborne transmission probabilities.

PubMed

Sanson, R L; Gloster, J; Burgin, L

2011-09-24

The aims of this study were to statistically reassess the likelihood that windborne spread of foot-and-mouth disease (FMD) virus (FMDV) occurred at the start of the UK 1967 to 1968 FMD epidemic at Oswestry, Shropshire, and to derive dose-response probability of infection curves for farms exposed to airborne FMDV. To enable this, data on all farms present in 1967 in the parishes near Oswestry were assembled. Cases were infected premises whose date of appearance of first clinical signs was within 14 days of the depopulation of the index farm. Logistic regression was used to evaluate the association between infection status and distance and direction from the index farm. The UK Met Office's NAME atmospheric dispersion model (ADM) was used to generate plumes for each day that FMDV was excreted from the index farm based on actual historical weather records from October 1967. Daily airborne FMDV exposure rates for all farms in the study area were calculated using a geographical information system. Probit analyses were used to calculate dose-response probability of infection curves to FMDV, using relative exposure rates on case and control farms. Both the logistic regression and probit analyses gave strong statistical support to the hypothesis that airborne spread occurred. There was some evidence that incubation period was inversely proportional to the exposure rate.

Case study of an anxious child with extensive caries treated in general dental practice: financial viability under the terms of the UK National Health Service.

PubMed

Shelley, A; Mackie, I

2001-10-01

This case study describes the management of Callum, an anxious 7-year-old boy with extensive caries. Callum's dental care was carried out in a general dental practice in the North of England under the terms of the National Health Service. A preventive programme was carried out in conjunction with the restorative philosophy according to guidelines published by the Dental Practice Board in 1997.

Vitamin D receptor gene polymorphisms, serum 25-hydroxyvitamin D levels, and melanoma: UK case-control comparisons and a meta-analysis of published VDR data

PubMed Central

Randerson-Moor, Juliette A.; Taylor, John C.; Elliott, Faye; Chang, Yu-Mei; Beswick, Samantha; Kukalizch, Kairen; Affleck, Paul; Leake, Susan; Haynes, Sue; Karpavicius, Birute; Marsden, Jerry; Gerry, Edwina; Bale, Linda; Bertram, Chandra; Field, Helen; Barth, Julian; dos Santos Silva, Isabel; Swerdlow, Anthony; Kanetsky, Peter A.; Barrett, Jennifer H.; Bishop, D. Timothy; Bishop, Julia A. Newton

2009-01-01

We have carried out melanoma case-control comparisons for six vitamin D receptor (VDR) gene single nucleotide polymorphisms (SNPs) and serum 25-hydroxyvitamin D3 levels in order to investigate the role of vitamin D in melanoma susceptibility. There was no significant evidence of an association between any VDR SNP and risk in 1028 population-ascertained cases and 402 controls from Leeds, UK. In a second Leeds case-control study (299 cases and 560 controls) the FokI T allele was associated with increased melanoma risk (OR 1.42, 95% CI 1.06-1.91, p=0.02). In a meta-analysis in conjunction with published data from other smaller data sets (total 3769 cases and 3636 controls), the FokI T allele was associated with increased melanoma risk (odds ratio (OR) 1.19, 95% confidence interval (CI) 1.05-1.35), and the BsmI A allele was associated with a reduced risk (OR 0.81, 95% CI 0.72-0.92), in each instance under a parsimonious dominant model. In the first Leeds case-control comparison cases were more likely to have a higher body mass index (BMI) than controls (p=0.007 for linear trend). There was no evidence of a case-control difference in serum 25-hydroxyvitamin D3 levels. In 1043 incident cases from the first Leeds case-control study, a single estimation of serum 25-hydroxyvitamin D3 level taken at recruitment was inversely correlated with Breslow thickness (p=0.03 for linear trend). These data provide evidence to support the view that vitamin D and VDR may have a small but potentially important role in melanoma susceptibility, and putatively a greater role in disease progression. PMID:19615888

Acute retinal necrosis in the United Kingdom: results of a prospective surveillance study

PubMed Central

Cochrane, T F; Silvestri, G; McDowell, C; Foot, B; McAvoy, C E

2012-01-01

Background To determine the incidence of acute retinal necrosis (ARN) in the United Kingdom and to describe the demographics, management, and visual outcome in these patients. Methods This was a prospective study carried out by the British Ophthalmological Surveillance Unit (BOSU) between September 2007 and October 2008. Initial and 6-month questionnaires were sent to UK ophthalmologists who reported cases of ARN via the monthly BOSU report card system. Results In all, 45 confirmed cases (52 eyes) of ARN were reported in the 14-month study period, giving a minimum incidence of 0.63 cases per million population per year. There were 20 females and 25 males. Age ranged from 10 to 94 years. Eight patients had a history of herpetic CNS disease. Aqueous sampling was carried out in 13 patients, vitreous in 27, and cerebrospinal fluid (CSF) in 4. Varicella-zoster virus followed by herpes simplex were the most common causative agents. Treatment in 76% of the cases was with intravenous antivirals; however, 24% received only oral antivirals. In all, 47% of patients had intravitreal antiviral therapy. Visual outcome at 6 months was <6/60 in 48% of the affected eyes. Conclusion The minimum incidence of ARN in the UK is 0.63 cases per million. Patients with a history of herpetic CNS disease should be warned to immediately report any visual symptoms. There is increased use of oral and intravitreal antivirals in initial treatment. PMID:22281865

Maturity and Interculturality: Chinese Students' Experiences in UK Higher Education

ERIC Educational Resources Information Center

Gu, Qing

2009-01-01

Increasing global competition for students has witnessed an ever more rapid internationalisation of higher education. In the case of the UK, there has been a major influx of Chinese students to British universities since the launch of the British Government's long-term worldwide educational campaign in 1999. Drawing upon evidence from an extensive…

Management and Leadership in UK Universities: Exploring the Possibilities of Change

ERIC Educational Resources Information Center

Waring, Matt

2017-01-01

This paper considers the case for reform of management structures in UK universities and offers proposals for change. The model of top-down, performance-led management that characterises many institutions is both outmoded and ill-suited to the challenges of an increasingly turbulent higher education sector. Drawing on the experiences of a…

[A study of Creutzfeldt-Jakob disease during 1985-96. No indication of cases of the "mad cow disease" in Sweden].

PubMed

Lundberg, P O

1999-02-10

A retrospective study of Creutzfeldt-Jakob disease (CJD) in Sweden during the period 1985-96 yielded an annual incidence of 1.18 per million. Data for incidence, age distribution (at onset and at death), and duration of illness were similar to those of other countries, with the exception of new variant CJD (nvCJD) cases in the UK, and as far as can be judged the symptomatology was also similar. So far, there is no indication of the occurrence of any cases of nvCJD in Sweden.

Metrics for Success in the Preservation of Scientific Data at the STFC Centre for Environmental Data Archival (CEDA).

NASA Astrophysics Data System (ADS)

Lawrence, B.; Pepler, S.

2009-04-01

CEDA (http://www.ceda.ac.uk) hosts three main data centres: the British Atmospheric Data Centre (http://badc.nerc.ac.uk), the NERC Earth Observation Data Centre (http://neodc.nerc.ac.uk), and the Intergovernmental Panel for Climate Change Dedicated Data Centre (http://ipcc-data.org) as well as components of many national and international projects. CEDA recieves both core funding (from the UK Natural Environment Research Council) and per project funding (from a variety of sources). However, all funders require metrics assessing success. In the case of preservation it is hard to measure success - usage alone is not enough, since next year someone may use currently unused data if it is well preserved, and so it is the act of preservation which in this case marks success. Even where data is accessed, it is not necessarily used. Hence at CEDA we have three key focii in our approach to metrics: measuring direct website access, benchmarking procedures against best practice, and hopefully soon, recording data citation. In this presentation we cover how we are addressing each of these three areas.

Engineers: Going Global

ERIC Educational Resources Information Center

Feest, Tim

2008-01-01

This article demonstrates the need for engineering courses in UK higher education to give a higher priority to global and sustainability issues. In support of this case, the author summarizes and assesses evidence from a recently-concluded study by the Institute of Education, University of London, and Engineers Against Poverty, a specialist…

Whether Foreign Military Sales or Direct Commercial Sales: A Case Study of the UK E-3 AWACS

DTIC Science & Technology

1990-09-01

arrangements available include coproduction, licensed production, subcontractor production, overseas investment, technology transfer, and countertrade ...commercial arrangement between the U.S. manufacturer and a foreign entity. Countertrade - Purchase of goods and services from the buyer country as a

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.

Culture confirmation of tuberculosis cases in Birmingham, UK.

PubMed

Hayer, Kalbir S; Sitch, Alice J; Dedicoat, Martin; Wood, Annette L

2013-10-01

The proportion of culture-confirmed tuberculosis (TB) cases in Birmingham had gradually decreased to less than 65% in 2008. Reasons for this were unclear, therefore this study assessed diagnostic methods used for confirming TB and reviewed factors involved in positive culture. A cross-sectional study was carried out. A list of notified TB cases for Birmingham in those aged 16 y and over in 2009 was collated. Where no positive culture was recorded, further data were collected from hospital databases and case notes. Of 449 TB cases, 419 (93%) had samples taken for culture testing. Of all cases, 309 (69%) were confirmed by culture testing; of those receiving culture testing, 73% were confirmed. Pulmonary TB was identified as a predictor of positive culture in both the unadjusted and adjusted analyses: odds ratio (OR) 2.05, 95% confidence interval (CI) 1.32-3.19, and OR 2.32, 95% CI 1.29-4.17, respectively. Gender, age, ethnicity, UK born, and treatment delay were not significantly associated with positive culture. Of 140 cases not confirmed by culture, 129 (92%) had their diagnosis supported by at least one other test. The vast majority of TB cases had microbiological specimens taken to help confirm the disease. Furthermore, culture confirmation rates in Birmingham were meeting national targets in 2009. However culture confirmation rates were significantly lower in extrapulmonary TB, therefore further work is suggested in this group. The role of other investigations (e.g. interferon-gamma release assay (IGRA), Mantoux) is unclear. Further collaboration between clinicians, histopathologists, and microbiologists is advised to ensure samples are sent appropriately and culture confirmation is optimized.

First person - Pawel Leznicki.

PubMed

2018-05-16

First Person is a series of interviews with the first authors of a selection of papers published in Journal of Cell Science, helping early-career researchers promote themselves alongside their papers. Pawel Leznicki is the first author on 'Expansion of DUB functionality generated by alternative isoforms - USP35, a case study', published in Journal of Cell Science. Pawel conducted the research in this article while in Yogesh Kulathu's lab at the University of Dundee, UK. He is now a research associate in the lab of Stephen High at the University of Manchester, UK, investigating protein biogenesis processes and their quality control. © 2018. Published by The Company of Biologists Ltd.

How do chiropractors manage clinical risk? A questionnaire study.

PubMed

Wangler, Martin; Peterson, Cynthia; Zaugg, Beatrice; Thiel, Haymo; Finch, Rob

2013-06-08

The literature on chiropractic safety tends to focus on adverse events and little is known about how chiropractors ensure safety and manage risk in the course of their daily practice. The purpose of this study was to investigate how chiropractors manage potentially risky clinical scenarios. We also sought to establish how chiropractors perceive the safety climate in their workplace and thus whether there is an observable culture of safety within the profession. An online questionnaire was designed to determine which of nine management options would be chosen by the respondent in response to four defined clinical case scenarios. Safety climate within the respondent's practice setting was measured by seeking the level of agreement with 23 statements relating to six different safety dimensions. 260 licensed chiropractors in Switzerland and 1258 UK members of The Royal College of Chiropractors were invited to complete the questionnaire. Questionnaire responses were analysed quantitatively in respect of the four clinical scenarios and the nine management options to determine the likelihood of each option being undertaken, with results recorded in terms of % likelihood. Gender differences in response to the management options for each scenario were evaluated using the Mann-Whitney U (MWU) test. Positive agreement with elements comprising each of the six safety dimensions contributed to a composite '% positive agreement' score calculated for each dimension. Questionnaire responses were received from 76% (200/260) of Swiss participants and 31% (393/1258) of UK members of The Royal College of Chiropractors. There was a general trend for Swiss and UK chiropractors to manage clinical scenarios where treatment appears not to be successful, not indicated, possibly harmful or where a patient is apparently getting worse, by re-evaluating their care. Stopping treatment and/or incident reporting to a safety incident reporting and learning system were generally found to be unlikely courses of action. Gender differences were observed with female chiropractors appearing to be more risk averse. Swiss and UK chiropractors tend to manage potentially risky clinical scenarios by re-evaluating the case. The unlikeliness of safety incident reporting is probably due to a range of recognised barriers, although Swiss and UK chiropractors are positive about local communication and openness which are important tenets for safety incident reporting. The observed positivity towards key aspects of clinic safety indicates a developing safety culture within the Swiss and UK chiropractic professions.

Food in Foster Families: Care, Communication and Conflict

ERIC Educational Resources Information Center

Rees, Alyson; Holland, Sally; Pithouse, Andrew

2012-01-01

This study explores the significance of food and mealtimes in relation to the transition into foster care and the therapeutic settling of the child in a new family. In doing so, we draw upon an in-depth, qualitative case study of 10 experienced foster families in the UK focusing on what helped them to be successful. At the time of the study, there…

Developing a Model for a "Ladder of Incubation" Linked to Higher and Further Education Institutions in Wales

ERIC Educational Resources Information Center

Voisey, Pam; Gornall, Lynne; Jones, Paul; Thomas, Brychan

2005-01-01

Business incubators play a critical role in economic regeneration through the development and support of new and sustainable enterprises. Many UK incubator projects are funded by the European Commission through the higher education sector. This study compares and contrasts six business incubation case studies and identifies significant criteria…

Distributed Leadership and Social Justice: Images and Meanings from across the School Landscape

ERIC Educational Resources Information Center

Woods, Philip A.; Roberts, Amanda

2016-01-01

This paper reports data from a study investigating distributed leadership (DL) and its relationship to social justice and democratic values. The research comprised a case study of a UK secondary school, which describes itself as having a finely distributed leadership culture, and involved teaching staff, non-teaching staff, senior leaders and…

Integrating E-Learning into Postgraduate Radiotherapy and Oncology Education: A Case Study

ERIC Educational Resources Information Center

Probst, Heidi; Eddy, David; Doughty, Jo; Hodgson, Denyse

2009-01-01

Training health professionals within university environments has traditionally focused on face-to-face methods. Practitioners working within the UK National Health Service (NHS) have found it difficult to gain leave from work to attend for study due to the demands of the NHS and staff shortages. In response, the authors developed a distance…

Staff and Student Perceptions of English Language Policies and Practices in "International" Universities: A UK Case Study

ERIC Educational Resources Information Center

Jenkins, Jennifer; Wingate, Ursula

2015-01-01

This article presents a small qualitative study which aimed to gain an understanding of how lecturers and international students perceive the English language policies and practices at their institutions. The findings show that most participants perceive current policies and practices as unfair. However, there were discrepancies in lecturers' and…

Providing a Positive Learning Experience for International Students Studying at UK Universities: A Literature Review

ERIC Educational Resources Information Center

Lillyman, Sue; Bennett, Clare

2014-01-01

Much of the current literature relating to international students at university level tends to highlight their experiences from a deficit perspective and in some cases even problematises the experience for the student and university. Other studies tend to focus on recruitment and motivation rather than the lived experiences of the student, thereby…

Forest Schools and Environmental Attitudes: A Case Study of Children Aged 8-11 Years

ERIC Educational Resources Information Center

Turtle, Christina; Convery, Ian; Convery, Katie

2015-01-01

There is growing evidence that children in the UK are suffering from a lack of engagement with nature and the outdoor environment. This paper investigates the attitudes of children towards the natural environment and focuses on Forest School programmes as a mechanism to promote a "pro-environmental" attitude. The study identified that…

Access Granted: Modern Languages and Issues of Accessibility at University--A Case Study from Australia

ERIC Educational Resources Information Center

Brown, Joshua; Caruso, Marinella

2016-01-01

Discussion about how to monitor and increase participation in languages study is gaining relevance in the UK, the US and Australia across various sectors, but particularly in higher education. In recent times levels of enrolment in modern languages at universities around the world have been described in terms of "crisis" or even…

Jumping from the Highest Graded Readers to Ungraded Novels: Four Case Studies

ERIC Educational Resources Information Center

Uden, Jez; Schmitt, Diane; Schmitt, Norbert

2014-01-01

This study follows a small group of learners in the UK to the end of a graded reading program using the Cambridge Readers and investigates whether this particular graded reading series provides a bridge to reading unsimplified novels for pleasure. The participants' reading comprehension, reading rates, vocabulary text coverage, and overall affect…

Peer Mentoring for International Students in a UK Law School: Lessons from a Pilot Case Study

ERIC Educational Resources Information Center

Ragavan, Shamini K.

2014-01-01

This qualitative study discusses the impact of a support network for international students of culturally diverse backgrounds using a peer mentoring scheme. The scheme focused on facilitating cultural integration in the international student community in Newcastle and sought to engender a cooperative community among new students. Data obtained…

Cultural characteristics of "high" and "low" performing hospitals.

PubMed

Mannion, R; Davies, H T O; Marshall, M N

2005-01-01

To compare and contrast the cultural characteristics of "high" and "low" performing hospitals in the UK National Health Service (NHS). A multiple case study design incorporating a purposeful sample of "low" and "high" performing acute hospital Trusts, as assessed by the star performance rating system. These case studies suggest that "high" and "low" performing acute hospital organisations may be very different environments in which to work. Although each case possessed its own unique character, significant patternings were observed within cases grouped by performance to suggest considerable cultural divergence. The key points of divergence can be grouped under four main headings: leadership and management orientation; accountability and information systems; human resources policies; and relationships within the local health economy. As with any study, interpretation of findings should be tempered with a degree of caution because of methodological considerations. First, there are the limitations of case study which proceeds on the basis of theoretical rather than quantitative generalisation. Second, organisational culture was assessed by exploring the views of middle and senior managers. While one should in no way suggest that such an approach can capture all important cultural characteristics of organisations, it is believed that it may be at least partially justified, given the agenda-setting powers and influence of the senior management team. Finally "star" performance measures are far from a perfect measure of organisational performance. Despite such reservations, the findings indicate that organisational culture is associated in a variety of non-trivial ways with the measured performance of hospital organisations. Highlights considerable cultural divergence within UK NHS hospitals.

Exposure of children and adolescents to alcohol marketing on social media websites.

PubMed

Winpenny, Eleanor M; Marteau, Theresa M; Nolte, Ellen

2014-01-01

In 2011, online marketing became the largest marketing channel in the UK, overtaking television for the first time. This study aimed to describe the exposure of children and young adults to alcohol marketing on social media websites in the UK. We used commercially available data on the three most used social media websites among young people in the UK, from December 2010 to May 2011. We analysed by age (6-14 years; 15-24 years) and gender the reach (proportion of internet users who used the site in each month) and impressions (number of individual pages viewed on the site in each month) for Facebook, YouTube and Twitter. We further analysed case studies of five alcohol brands to assess the marketer-generated brand content available on Facebook, YouTube and Twitter in February and March 2012. Facebook was the social media site with the highest reach, with an average monthly reach of 89% of males and 91% of females aged 15-24. YouTube had a similar average monthly reach while Twitter had a considerably lower usage in the age groups studied. All five of the alcohol brands studied maintained a Facebook page, Twitter page and YouTube channel, with varying levels of user engagement. Facebook pages could not be accessed by an under-18 user, but in most cases YouTube content and Twitter content could be accessed by those of all ages. The rise in online marketing of alcohol and the high use of social media websites by young people suggests that this is an area requiring further monitoring and regulation.

Comparing Anesthesiology Residency Training Structure and Requirements in Seven Different Countries on Three Continents.

PubMed

Yamamoto, Satoshi; Tanaka, Pedro; Madsen, Matias V; Macario, Alex

2017-02-26

Little has been published comparing the graduate medical education training structure and requirements across multiple countries. The goal of this study was to summarize and compare the characteristics of anesthesiology training programs in the USA, UK, Canada, Japan, Brazil, Denmark, and Switzerland as a way to better understand efforts to train anesthesiologists in different countries. Two physicians trained in each of the seven countries (convenience sample) were interviewed using a semi-structured approach. The interview was facilitated by use of a predetermined questionnaire that included, for example, the duration of post-medical school training and national requirements for certain rotations, a number of cases, faculty supervision, national in-training written exams, and duty hour limits. These data were augmented by review of each country's publicly available residency training documents as available on the internet. Post-medical school anesthesia residency duration varied: three years (Brazil), four years (USA), five years (Canada and Switzerland), six years (Japan and Denmark) to nine years (UK), as did the number of explicitly required clinical rotations of a defined duration: zero (Denmark), one (Switzerland and UK), four (Brazil), six (Canada), and 12 (USA). Minimum case requirements exist in the USA, Japan, and Brazil, but not in the other countries. National written exams taken during training exist for all countries studied except Japan and Denmark. The countries studied increasingly aim to have competency-based education with milestone assessments. Training duty hour limits also varied including for example 37 hours/week averaged over a one month with limitations on night duties (Denmark), a weekly average of 48 hours taken over a 17 week period (UK), 50 hours/week maximum (Switzerland), 60 hours/week maximum (Brazil), and 80 hours/week averaged over four weeks (USA). Some countries have highly structured training programs with multiple national requirements with training principally carried out at a home institution. Other countries have a more decentralized and unregulated approach with fewer (if any) specific case or rotation requirements, where the trainee creates his/her own customized training to meet broad objectives and goals. The countries studied have different national training requirements, unique duty hour rules and are at varying stages in transitioning to an outcome based model of residency.

Gender & Education Association: A Case Study in Feminist Education?

ERIC Educational Resources Information Center

David, Miriam E.

2015-01-01

This article focuses on feminist activist academics who were instrumental in creating the UK Gender & Education Association at the turn of the twenty-first century. Drawing on my own intellectual biography (David, M. E. 2003. "Personal and Political: Feminisms, Sociology and Family Lives" Stoke-on-Trent. Trentham Books.) linked to…

Delaying the Academy: A Gap Year Education

ERIC Educational Resources Information Center

O'Shea, Joseph

2011-01-01

This investigation serves as one of the first empirical analyses to examine the international volunteering gap year from an educational perspective, concluding an in-depth case study of a prominent gap year organisation in the UK. Contrary to widespread industry promotion of international development, the findings suggest that the experience can…

From sacred cows to sacrificial lambs: implementing agricultural phosphorus science and management to combat eutrophication

USDA-ARS?s Scientific Manuscript database

Experience with implementing agricultural phosphorus (P) strategies highlights successes and uncertainty over outcomes. We examine case studies from the USA, UK, and Sweden to examine P management under voluntary, litigated and regulatory settings. In the USA, voluntary strategies to curtail P loadi...

The Visible Hand of Research Performance Assessment

ERIC Educational Resources Information Center

Hamann, Julian

2016-01-01

Far from allowing a governance of universities by the invisible hand of market forces, research performance assessments do not just measure differences in research quality, but yield themselves visible symptoms in terms of a stratification and standardization of disciplines. The article illustrates this with a case study of UK history departments…

Preventing Dropout: Lessons from Europe

ERIC Educational Resources Information Center

Arnold, Christopher; Baker, Tracey

2017-01-01

This book describes an initiative that has proved effective in keeping more young people from dropping out of education, training or employment. The authors present case studies based on in-depth interviews with participants from five widely divergent European countries--the UK, Spain, the Czech Republic, Hungary and Ireland--which illustrate the…

Risk: The Ethics of a Creative Curriculum

ERIC Educational Resources Information Center

Hargreaves, Janet

2008-01-01

Higher education in the UK espouses to develop intelligence and critical skills in undergraduates. To do this requires exposing students to challenge and thus risk. However, current models of quality assurance are risk-averse and thus potentially limit the scope of creative learning and teaching strategies. Using two case studies, this paper…

Transnational Academic Mobility, Knowledge, and Identity Capital

ERIC Educational Resources Information Center

Kim, Terri

2010-01-01

This article begins with the contemporary context of transnational academic mobility, and sketches a typology of mobile academics according to their self-identification. UK examples are offered as the main case study here. The article will then explore the relations of mobile academics and their embodied and encultured knowledge. It employs a…

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.

Protecting personal data in epidemiological research: DataSHIELD and UK law.

PubMed

Wallace, Susan E; Gaye, Amadou; Shoush, Osama; Burton, Paul R

2014-01-01

Data from individual collections, such as biobanks and cohort studies, are now being shared in order to create combined datasets which can be queried to ask complex scientific questions. But this sharing must be done with due regard for data protection principles. DataSHIELD is a new technology that queries nonaggregated, individual-level data in situ but returns query data in an anonymous format. This raises questions of the ability of DataSHIELD to adequately protect participant confidentiality. An ethico-legal analysis was conducted that examined each step of the DataSHIELD process from the perspective of UK case law, regulations, and guidance. DataSHIELD reaches agreed UK standards of protection for the sharing of biomedical data. All direct processing of personal data is conducted within the protected environment of the contributing study; participating studies have scientific, ethics, and data access approvals in place prior to the analysis; studies are clear that their consents conform with this use of data, and participants are informed that anonymisation for further disclosure will take place. DataSHIELD can provide a flexible means of interrogating data while protecting the participants' confidentiality in accordance with applicable legislation and guidance. © 2014 S. Karger AG, Basel.

Implications of climate change predictions for UK cropping and prospects for possible mitigation: a review of challenges and potential responses.

PubMed

Rial-Lovera, Karen; Davies, W Paul; Cannon, Nicola D

2017-01-01

The UK, like the rest of the world, is confronting the impacts of climate change. Further changes are expected and they will have a profound effect on agriculture. Future crop production will take place against increasing CO 2 levels and temperatures, decreasing water availability, and increasing frequency of extreme weather events. This review contributes to research on agricultural practices for climate change, but with a more regional perspective. The present study explores climate change impacts on UK agriculture, particularly food crop production, and how to mitigate and build resilience to climate change by adopting and/or changing soil management practices, including fertilisation and tillage systems, new crop adoption and variety choice. Some mitigation can be adopted in the shorter term, such as changes in crop type and reduction in fertiliser use, but in other cases the options will need greater investment and longer adaptation period. This is the case for new crop variety development and deployment, and possible changes to soil cultivations. Uncertainty of future weather conditions, particularly extreme weather, also affect decision-making for adoption of practices by farmers to ensure more stable and sustainable production. Even when there is real potential for climate change mitigation, it can sometimes be more difficult to accomplish with certainty on-farm. Better future climate projections and long-term investments will be required to create more resilient agricultural systems in the UK in the face of climate change challenges. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

The experience of international nursing students studying for a PhD in the U.K: A qualitative study.

PubMed

Evans, Catrin; Stevenson, Keith

2011-06-13

Educating nurses to doctoral level is an important means of developing nursing capacity globally. There is an international shortage of doctoral nursing programmes, hence many nurses seek their doctorates overseas. The UK is a key provider of doctoral education for international nursing students, however, very little is known about international doctoral nursing students' learning experiences during their doctoral study. This paper reports on a national study that sought to investigate the learning expectations and experiences of overseas doctoral nursing students in the UK. Semi-structured qualitative interviews were conducted in 2008/09 with 17 international doctoral nursing students representing 9 different countries from 6 different UK universities. Data were analysed thematically. All 17 interviewees were enrolled on 'traditional' 3 year PhD programmes and the majority (15/17) planned to work in higher education institutions back in their home country upon graduation. Studying for a UK PhD involved a number of significant transitions, including adjusting to a new country/culture, to new pedagogical approaches and, in some cases, to learning in a second language. Many students had expected a more structured programme of study, with a stronger emphasis on professional nursing issues as well as research - akin to the professional doctorate. Students did not always feel well integrated into their department's wider research environment, and wanted more opportunities to network with their UK peers. A good supervision relationship was perceived as the most critical element of support in a doctoral programme, but good relationships were sometimes difficult to attain due to differences in student/supervisor expectations and in approaches to supervision. The PhD was perceived as a difficult and stressful journey, but those nearing the end reflected positively on it as a life changing experience in which they had developed key professional and personal skills. Doctoral programmes need to ensure that structures are in place to support international students at different stages of their doctoral journey, and to support greater local-international student networking. Further research is needed to investigate good supervision practice and the suitability of the PhD vis a vis other doctoral models (e.g. the professional doctorate) for international nursing students.

Journeys into Higher Education: The Case of Refugees in the UK

ERIC Educational Resources Information Center

Morrice, Linda

2009-01-01

Higher education (HE) is one of the routes that refugees who come to the UK from professional and highly educated backgrounds can re-establish their lives and professional identities. This research follows up a group of such refugees who were on a programme designed to support refugees gain access to HE or appropriate employment. The findings…

Managing Leadership in the UK University: A Case for Researching the Missing Professoriate?

ERIC Educational Resources Information Center

Rayner, Steve; Fuller, Mary; McEwen, Lindsey; Roberts, Hazel

2010-01-01

This article offers a critical review of literature dealing with the topic of educational management and academic leadership as applied to the role of the professor or professoriate in the UK. The review identified a range of leadership issues and associated contemporary developments in the "management" of higher education. The subject…

Crossing the Binary Line: The Founding of the Polytechnic in Colonial Hong Kong

ERIC Educational Resources Information Center

Wong, Ting-Hong

2014-01-01

Using the case of the Hong Kong Polytechnic (HKP), this paper examines academic drift in colonial settings. The HKP, like polytechnics in the UK, was supposedly a service sector institution. Under the binary system in the UK, schools in the service division were governed by the state educational bureaucracy, while the universities--the autonomous…

A Review of the Case of a Levy-Grant Scheme (LGS) in the UK Construction Industry

ERIC Educational Resources Information Center

Abdel-Wahab, Mohamed; Dainty, Andrew; Ison, Stephen

2010-01-01

A Levy-Grant Scheme (LGS) has existed in the UK construction industry since 1964 to provide financial support for companies undertaking training activities. Despite the support of the LGS for various training activities, notably apprenticeships, the construction industry continues to suffer from both labour shortages and an under-investment in…

Maturity-onset diabetes of the young (MODY): how many cases are we missing?

PubMed

Shields, B M; Hicks, S; Shepherd, M H; Colclough, K; Hattersley, A T; Ellard, S

2010-12-01

Maturity-onset diabetes of the young is frequently misdiagnosed as type 1 or type 2 diabetes. A correct diagnosis of MODY is important for determining treatment, but can only be confirmed by molecular genetic testing. We aimed to compare the regional distribution of confirmed MODY cases in the UK and to estimate the minimum prevalence. UK referrals for genetic testing in 2,072 probands and 1,280 relatives between 1996 and 2009 were examined by region, country and test result. Referral rate and prevalence were calculated using UK Census 2001 figures. MODY was confirmed in 1,177 (35%) patients, with HNF1A (52%) and GCK mutations (32%) being most frequent in probands confirmed with MODY. There was considerable regional variation in proband referral rates (from <20 per million in Wales and Northern Ireland to >50 per million for South West England and Scotland) and patients diagnosed with MODY (5.3 per million in Northern Ireland, 48.9 per million in South West England). Referral rates and confirmed cases were highly correlated (r = 0.96, p < 0.0001). The minimum prevalence of MODY was estimated to be 108 cases per million. Assuming this minimal prevalence throughout the UK then >80% of MODY is not diagnosed by molecular testing. The marked regional variation in the prevalence of confirmed MODY directly results from differences in referral rates. This could reflect variation in awareness of MODY or unequal access to genetic testing. Increased referral for diagnostic testing is required if the majority of MODY patients are to have the genetic diagnosis necessary for optimal treatment.

HLA-B is the best candidate of susceptibility genes in HLA for Japanese ulcerative colitis.

PubMed

Aizawa, H; Kinouchi, Y; Negoro, K; Nomura, E; Imai, G; Takahashi, S; Takagi, S; Kakuta, Y; Tosa, M; Mochida, A; Matsumura, Y; Endo, K; Shimosegawa, T

2009-06-01

Recently, a genome-wide association study for ulcerative colitis (UC) in the UK population was reported, and several susceptibility loci including the human leukocyte antigen (HLA) region were identified. The strongest association in the HLA region was found at a 400 kb haplotype block containing HLA-DRB1. In Japanese population, previous study suggested the association between UC and HLA-B*52; however, HLA typing was determined using serotyping with the small sample size. The purpose of this study was to perform an association study in HLA-B by genotyping. A total of 320 patients with UC and 322 healthy controls were recruited in this case-control study. All subjects were Japanese. Genotyping of HLA-B was performed by polymerase chain reaction using a sequence-specific primer. When the allele frequencies were compared, significant associations were found with B*52 [odds ratio (OR) = 3.65, P = 1.6 x 10(-17), P(c) = 3.7 x 10(-16)] and B*4002 (OR = 0.52, P = 0.00030, P(c) = 0.0068). The allele frequency of B*52 was significantly higher in patients diagnosed before 40 years of age than in those diagnosed after 40 years (OR = 1.79, P = 0.010, P(c) = 0.020). A combination association map of Japanese UC using our current and previous studies showed two equal peaks of association on HLA-DRB1 and HLA-B, indicating the possible existence of two casual variants in the HLA region inside and outside the 400 kb block found in UK. We conclude that HLA-B contributes to the susceptibility to Japanese UC, especially cases with younger age of onset. The strength of association for HLA-B was equal to that for HLA-DRB1 in Japanese UC, in contrast to the UK population.

Human Immunodeficiency Virus (HIV) and migrant "risk environments": the case of the Ethiopian and Eritrean immigrant community in the West Midlands of the UK.

PubMed

Barrett, Hazel R; Mulugeta, Betselot

2010-05-01

The flow of migrants from high human immunodeficiency virus (HIV) prevalence regions such as sub-Saharan Africa to western countries is changing the profile of HIV infection in host countries, with immigrants from these countries accounting for the majority of heterosexually acquired HIV infection. Few studies have been conducted on the sexual culture and practices of different migrant African communities living in western countries including the UK. Significant gaps therefore exist in our knowledge of the HIV/AIDS prevention needs of culturally diverse communities, particularly those from sub-Saharan Africa living in the UK. Based on empirical research undertaken in 2007, this article explores the knowledge and practices concerning HIV amongst the Ethiopian and Eritrean immigrant community living in the West Midlands of the UK. Using in-depth qualitative methods, the study investigated the HIV "risk environment" of this immigrant community. The research found that the group had little knowledge or understanding of the HIV epidemic in the UK and this resulted in serious misconceptions which led to risky sexual practice. Whilst the group had good knowledge and understanding of the disease and its transmission which had been acquired in their country of origin, this was not translated into practice. The perceived "low-risk environment" of HIV in the UK, as well as traditional male domination concerning sexual issues goes some way in explaining the low usage of the male condom amongst this group. Promoting the use of the female condom could empower women within this community to practice safe sex, which is acceptable to their male partners. The study identified a number of issues relevant to this immigrant group that could be easily tackled, empowering them to make informed decisions and take actions commensurate with the real, rather than perceived, HIV "risk environment" of their new home.

Anger in the UK Armed Forces: strong association with mental health, childhood antisocial behavior, and combat role.

PubMed

Rona, Roberto J; Jones, Margaret; Hull, Lisa; MacManus, Deirdre; Fear, Nicola T; Wessely, Simon

2015-01-01

We assessed the strength of the association of several mental health problems, childhood difficulties, and combat role with anger, as well as the contribution of these factors to explain anger assessed by population attributable fraction (PAF). A total of 9885 UK service personnel, some of them deployed to Iraq and Afghanistan, participated in the study. There was a strong or intermediate association between cases and subthreshold cases of symptoms of posttraumatic stress disorder, psychological distress, multiple physical symptoms and alcohol misuse, having a combat role, childhood adversity, and childhood antisocial behavior with anger. The PAF for any mental health problem and combat role and childhood difficulties was 0.64 (95% confidence interval [CI], 0.56-0.70) and increased to 0.77 (95% CI, 0.69-0.83) if subthreshold cases were included. Anger is a frequent component of mental disorders; health care professionals need to be aware of the interference of anger in the management of mental illness and that anger infrequently presents as an isolated phenomenon.

UK newspapers' representations of the 2009-10 outbreak of swine flu: one health scare not over-hyped by the media?

PubMed

Hilton, Shona; Hunt, Kate

2011-10-01

A/H1N1, more commonly referred to as swine flu, emerged in Mexico in spring 2009. It rapidly spread across the world and was classed as a global pandemic on 11 June 2009. To analyse UK newsprint coverage of the swine flu pandemic. Content analysis of 2374 newsprint articles published in eight UK national newspapers between 1 March 2009 and 28 February 2010. Newsprint coverage of the swine flu epidemic was immense. The threat from swine flu was portrayed as greatest in the spring and summer of 2009 when scientific uncertainties about the impact on the UK and global population were at their height and when swine flu cases in the UK first peaked. Thereafter the number of news articles waned, failing to mirror the October peak in flu cases as the virus failed to be as virulent as first feared. Content analysis found little evidence of the media 'over-hyping' the swine flu pandemic. The news media's role as a disseminator of scientific information is particularly important in areas of risk perception. Despite a succession of health scares in recent years in which the media has been accused of exaggerating the risks and contributing to public misunderstandings of the issues, this analysis suggests that the UK newsprint reporting of swine flu in the 2009-10 outbreak was largely measured. The news media's role as disseminators of factual health information on swine flu is to be welcomed, particularly in relation to their handling and responsible reporting on scientific uncertainty.

First UK case report of kidney transplantation from an HIV-infected deceased donor to two HIV-infected recipients.

PubMed

Nolan, Eileen; Karydis, Nikolaos; Drage, Martin; Hilton, Rachel

2018-04-01

Kidney transplantation is now considered the treatment of choice for many human immunodeficiency virus (HIV)-infected patients with end-stage renal disease (ESRD). Graft survival rates using HIV-negative donors and carefully selected HIV-positive ESRD patients are similar to those observed in HIV-uninfected kidney transplant recipients. To address the relative shortfall in donated organs it has been proposed that organs from HIV-infected deceased donors might be allocated to HIV-infected patients on the transplant waiting list. Preliminary experience in South Africa reports promising short-term outcomes in a small number of HIV-infected recipients of kidney transplants from HIV-infected donors. We sought to replicate this experience in the UK by accepting kidney offers from HIV infected deceased donors for patients with HIV-infection on the kidney transplant waiting list. Here we report the UK's first cases of kidney transplantation between HIV-positive donors and recipients.

Leadership, cohesion, morale, and the mental health of UK Armed Forces in Afghanistan.

PubMed

Jones, Norman; Seddon, Rachel; Fear, Nicola T; McAllister, Pete; Wessely, Simon; Greenberg, Neil

2012-01-01

UK Armed Forces (AF) personnel deployed to Afghanistan are frequently exposed to intense combat and yet little is known about the short-term mental health consequences of this exposure and the potential mitigating effects of military factors such as cohesion, morale, and leadership. To assess the possible modulating influence of cohesion, morale, and leadership on post-traumatic stress disorder (PTSD) symptoms and common mental disorders resulting from combat exposure among UK AF personnel deployed to Afghanistan, UK AF personnel, during their deployment to Afghanistan in 2010, completed a self-report survey about aspects of their current deployment, including perceived levels of cohesion, morale, leadership, combat exposure, and their mental health status. Outcomes were symptoms of common mental disorder and symptoms of PTSD. Combat exposure was associated with both PTSD symptoms and symptoms of common mental disorder. Of the 1,431 participants, 17.1% reported caseness levels of common mental disorder, and 2.7% were classified as probable PTSD cases. Greater self-reported levels of unit cohesion, morale, and perceived good leadership were all associated with lower levels of common mental disorder and PTSD. Greater levels of unit cohesion, morale, and good leadership may help to modulate the effects of combat exposure and the subsequent development of mental health problems among UK Armed Forces personnel deployed to Afghanistan. © 2012 Guilford Publications, Inc.

Investigating the use of paired Uk'37 and TEX86 measurements to reconstruct past sea surface and subsurface (thermocline) temperatures (Invited)

NASA Astrophysics Data System (ADS)

Castaneda, I. S.; Urann, B.; Phu, V.

2013-12-01

Two organic geochemical temperature proxies widely applied to marine sediments are the Uk'37 Index, based on long-chain alkenones produced by haptophyte algae, and TEX86, based on isoprenoid glycerol dialkyl glycerol tetraethers (GDGTs), produced by Thaumarchaeota. At some locations, temperature reconstructions based on Uk'37 and TEX86 are in agreement within the calibration errors of each proxy, while at other sites absolute Uk'37 and TEX86 reconstructed temperatures differ but both proxies reveal similar overall trends (e.g. Caley et al., 2011). In contrast, at other locations Uk'37 and TEX86 temperature reconstructions from the same samples yield dramatically different overall trends. Differences observed between Uk'37 and TEX86 temperature reconstructions have been attributed to a variety of factors including seasonal production biases, differences in preservation and lateral transport, and differences related to the depth habitat of the source organisms. An increasing number of studies have provided evidence that TEX86 likely reflects a subsurface water temperature in certain areas of the world's oceans and have used paired Uk'37 and TEX86 measurements to simultaneously examine sea surface and subsurface (in some cases thermocline) temperature variability (e.g. Lopes dos Santos et al., 2010; Rommerskirchen et al., 2011; Li et al., 2013). In the tropical N Atlantic, a distinctive signature of Atlantic Meridional Overturning Circulation (AMOC) slowdown is anticorrelated variation between surface and subsurface water temperatures (e.g. Chang et al., 2008; Zhang et al., 2007) where sea surface temperature (SST) cooling is accompanied by shallow subsurface warming (e.g. Chang et al., 2008). Lopes dos Santos et al. (2010) examined a site in the tropical NE Atlantic where they showed that in the modern Uk'37 reflects SST while TEXH86 likely reflects a thermocline temperature. The authors noted several periods during the past 200 kyr when surface cooling and subsurface warming occurred, which they attributed to AMOC slowdown. In this study, we examine sediments from ODP site 660 (NE Atlantic), located near the site studied by Lopes dos Santos et al. (2010), and use paired Uk'37-TEXH86 temperature measurements to investigate changes in sea surface and thermocline temperature variability over the past 4 Ma. We find that following Pliocene warmth, the Uk'37 record indicates an overall cooling trend since ~2.2 Ma, superimposed on glacial-interglacial temperature fluctuations. In contrast, the TEX86 record, which yields consistently cooler temperatures in comparison to Uk'37, does not exhibit an overall cooling trend during the Pleistocene nor elevated warmth during the Pliocene. In portions of the record, anticorrelated variability between Uk'37 and TEX86 temperatures is observed, likely reflecting differences in SST and thermocline temperatures related to AMOC variability. In addition, we examine the carbon (δ13C) and deuterium (δD) isotopic composition of plant leaf waxes, proxies for vegetation type (C3 vs. C4) and precipitation amount, respectively, as several studies have demonstrated close ties between AMOC variability and hydrological conditions in N Africa during the late Pleistocene and Holocene.

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

PubMed Central

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

2016-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2016-12-01

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

Prevalence of parent-reported ASD and ADHD in the UK: findings from the Millennium Cohort Study.

PubMed

Russell, Ginny; Rodgers, Lauren R; Ukoumunne, Obioha C; Ford, Tamsin

2014-01-01

The UK prevalence of parent-reported autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) were estimated from the Millennium Cohort Study. Case definition was if a doctor or health care professional had ever told parents that their child had ASD and/or ADHD. Data were collected in 2008/2009 for 14,043 children. 1.7 % of children were reported as having ASD (95 % CI 1.4-2.0) at mean age 7.2 years (SD = 0.2; range = 6.3-8.2). 1.4 % reportedly had ADHD (95 % CI 1.2-1.7), and 0.3 % had both ASD and ADHD (95 % CI 0.2-0.5). After adjusting for socio-economic disadvantage, only male sex (p < 0.001 for both conditions) and cognitive ability, p = 0.004 (ASD); p = 0.01 (ADHD) remained strongly associated. The observed prevalence of parent-reported ASD is high compared to earlier UK and US estimates. Parent-reported ADHD is low compared to US estimates using the same measure.

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.

Health and economic impact of PHiD-CV in Canada and the UK: a Markov modelling exercise.

PubMed

Knerer, Gerhart; Ismaila, Afisi; Pearce, David

2012-01-01

The spectrum of diseases caused by Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) represents a large burden on healthcare systems around the world. Meningitis, bacteraemia, community-acquired pneumonia (CAP), and acute otitis media (AOM) are vaccine-preventable infectious diseases that can have severe consequences. The health economic model presented here is intended to estimate the clinical and economic impact of vaccinating birth cohorts in Canada and the UK with the 10-valent, pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) compared with the newly licensed 13-valent pneumococcal conjugate vaccine (PCV-13). The model described herein is a Markov cohort model built to simulate the epidemiological burden of pneumococcal- and NTHi-related diseases within birth cohorts in the UK and Canada. Base-case assumptions include estimates of vaccine efficacy and NTHi infection rates that are based on published literature. The model predicts that the two vaccines will provide a broadly similar impact on all-cause invasive disease and CAP under base-case assumptions. However, PHiD-CV is expected to provide a substantially greater reduction in AOM compared with PCV-13, offering additional savings of Canadian $9.0 million and £4.9 million in discounted direct medical costs in Canada and the UK, respectively. The main limitations of the study are the difficulties in modelling indirect vaccine effects (herd effect and serotype replacement), the absence of PHiD-CV- and PCV-13-specific efficacy data and a lack of comprehensive NTHi surveillance data. Additional limitations relate to the fact that the transmission dynamics of pneumococcal serotypes have not been modelled, nor has antibiotic resistance been accounted for in this paper. This cost-effectiveness analysis suggests that, in Canada and the UK, PHiD-CV's potential to protect against NTHi infections could provide a greater impact on overall disease burden than the additional serotypes contained in PCV-13.

Current management of pregnancy-related low back pain: a national cross-sectional survey of U.K. physiotherapists.

PubMed

Bishop, A; Holden, M A; Ogollah, R O; Foster, N E

2016-03-01

Pregnancy-related low back pain (LBP) is very common. Evidence from a systematic review supports the use of exercise and acupuncture, although little is known about the care received by women with pregnancy-related back pain in the U.K. To describe current acupuncture and standard care management of pregnancy-related LBP by U.K. physiotherapists. Cross-sectional survey of physiotherapists with experience of treating women with pregnancy-related LBP from three professional networks of the Chartered Society of Physiotherapy. In total, 1093 physiotherapists were mailed a questionnaire. The questionnaire captured respondents' demographic and practice setting information, and experience of managing women with pregnancy-related back pain, and investigated the reported management of pregnancy-related LBP using a patient case vignette of a specific, 'typical' case. The overall response rate was 58% (629/1093). Four hundred and ninety-nine physiotherapists had experience of treating women with pregnancy-related LBP and were included in the analysis. Most respondents worked wholly or partly in the U.K. National Health Service (78%). Most respondents reported that they treat patients with pregnancy-related LBP in three to four one-to-one treatment sessions over 3 to 6 weeks. The results show that a range of management strategies are employed for pregnancy-related LBP, and multimodal management is common. The most common reported treatment was home exercises (94%), and 24% of physiotherapists reported that they would use acupuncture with the patient described in the vignette. This study provides the first robust data on the management of pregnancy-related LBP by U.K. physiotherapists. Multimodal management is common, although exercise is the most frequently used treatment for pregnancy-related LBP. Acupuncture is used less often for this patient group. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Exploring the Contribution of Professional Staff to Student Outcomes: A Comparative Study of Australian and UK Case Studies

ERIC Educational Resources Information Center

Graham, Carroll; Regan, Julie-Anne

2016-01-01

This paper reports on the second stage of a comparative study between two higher education institutions: one in Australia and the other in the United Kingdom, which explored the contributions of professional staff to student outcomes. The first stage acted as a scoping exercise to ascertain how the contributions of professional staff to student…

A United Kingdom national survey of trends in ectopic pregnancy management.

PubMed

Taheri, M; Bharathan, R; Subramaniam, A; Kelly, T

2014-08-01

Our national survey demonstrates increased use of medical and laparoscopic management of ectopic pregnancy in the UK. In the UK in 2000, 35% of cases were managed by laparoscopy, 63% by laparotomy and 1% with medication. A recent review in the USA revealed increasing rates of medical management and decreasing rates of laparotomy; a trend driven by both cost-effectiveness and patient choice. A total of 119 early pregnancy units were surveyed regarding the nature and management of the three most recent cases of ectopic pregnancy; in addition, feasibility of training residents was also requested. Participants reported on 124 cases with a median of five cases per month per department. A total of 57% of cases were managed laparoscopically, 31% medically, 5% by laparotomy and 6% conservatively. Out of 44 centres, 29 have the facilities for training in both intermediate laparoscopic surgery and early pregnancy ultrasound.

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

ERIC Educational Resources Information Center

Gieve, Simon; Clark, Rose

2005-01-01

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

Attitudes to Ancient Greek in Three Schools: A Case Study

ERIC Educational Resources Information Center

Foster, Frances

2018-01-01

This study comes in response to recent changes in UK policy, whereby Ancient Greek and Latin have been included alongside modern languages as part of the curriculum at Key Stage 2. It aims to understand how Ancient Greek is surviving and thriving in three different types of schools. After a short overview of the history of Greek teaching in the…

Introducing Tablets in a Portuguese School: a Micool Project Case Study Analysis

ERIC Educational Resources Information Center

Judge, Miriam

2017-01-01

The increasing popularity of tablets in society generally has sparked much interest in their educational potential and while a number of studies on the use of tablets in schools have been conducted world-wide most of these have been conducted in English-speaking and well-resourced education jurisdictions such as the UK, Australia, New Zealand and…

Professional Identities of Middle Managers: A Case Study in the Faculty of Health and Social Care

ERIC Educational Resources Information Center

Thomas-Gregory, Annette

2014-01-01

This article presents and discusses the findings of a recent study on the professional identities of middle managers in a school of healthcare in a selected Chartered (pre-1992) UK university. Attention focuses on the career backgrounds of the middle managers, perception of identity and the interactional balance between the professional, academic…

Preparing Sports Coaches for the 21st Century: A Qualitative Case Study of A Graduate Sports Coaching Education Program

ERIC Educational Resources Information Center

Kjaer, Jorgen Bagger

2017-01-01

Sports coaching education and research in higher education have received increased attention lately, especially in English-speaking countries such as the U.S., Canada, New Zealand, Australia, and the UK (Potrac, Gilbert, & Denison, 2013). Although research on sports coaching education is on the rise, very few studies have explored formal…

Diversity between and within: Approaches to Teaching about Distant Place in the Secondary School Curriculum

ERIC Educational Resources Information Center

Taylor, Liz

2014-01-01

This study outlines some challenges of teaching about distant place and demonstrates how different strategies can influence school students' framings of diversity. The analysis is based on an interpretive case study of 13-14?year-old students learning about Japan in a UK school. Their changing representations of Japan were tracked in detail over a…

The Role of Nurse Educators in the Development of Reflective Practitioners: A Selective Case Study of the Australian and UK Experience.

ERIC Educational Resources Information Center

Mallik, Maggie

1998-01-01

A study tour of two British and eight Australian nursing schools found reflective practice fully endorsed in Australia, but the movement is threatened by concern with cost effectiveness. Issues to be resolved include ethical use of student journals and process and outcome evaluation of the effectiveness of reflection. (SK)

Experiential Learning--A Case Study of the Use of Computerised Stock Market Trading Simulation in Finance Education

ERIC Educational Resources Information Center

Marriott, Pru; Tan, Siew Min; Marriott, Neil

2015-01-01

Finance is a popular programme of study in UK higher education despite it being a challenging subject that requires students to understand and apply complex and abstract mathematical models and academic theories. Educational simulation is an active learning method found to be useful in enhancing students' learning experience, but there has been…

Whip use and race progress are associated with horse falls in hurdle and steeplechase racing in the UK.

PubMed

Pinchbeck, G L; Clegg, P D; Proudman, C J; Morgan, K L; French, N R

2004-07-01

Falls during racing present a risk of injury to both horse and jockey and a risk of fatality to horses. To use video recordings of races to describe the circumstances surrounding horse falls at hurdle and steeplechase fences and to identify and quantify within-race risk factors for horse falls in National Hunt racing in the UK. A retrospective, matched, nested case-control study using video recordings of races was conducted on 6 UK racecourses. Cases and controls were matched on both race type and jump number at which the fall occurred. Conditional logistic regression analysis was used to examine the univariable and multivariable relationship between predictor variables and the risk of falling. The risk of falling was significantly associated with whip use and race progress. Horses which were being whipped and progressing through the race were at greater than 7 times the risk of falling compared to horses which were not being whipped and which had no change in position or lost position through the field. This study has identified whip use and the position of the horse with respect to others in the field as potential risk factors for horse falls. If these findings are confirmed by the use of intervention trials (e.g. with whip-free or restricted whip use races), modifications could be introduced which would reduce the frequency of horse falls, leading to improved equine welfare.

Outbreak of Salmonella enteritidis phage type 1B associated with frozen pre-cooked chicken cubes, Finland 2012.

PubMed

Huusko, S; Pihlajasaari, A; Salmenlinna, S; Sõgel, J; Dontšenko, I; DE Pinna, E; Lundström, H; Toikkanen, S; Rimhanen-Finne, R

2017-10-01

In August to October 2012, a nationwide outbreak of Salmonella enteritidis phase type (PT) 1B with 53 cases occurred in Finland. Hypothesis generating interviews pointed toward ready-to-eat chicken salad from a Finnish company and at the same time Estonian authorities informed of a S. enteritidis PT 1B outbreak linked to chicken wrap prepared at an Estonian restaurant. We found that chicken salad was associated with the infection (odds ratio (OR) 16·1, 95% confidence interval (CI) 1·7-148·7 for consumption and OR 17·5. 95% CI 4·0-76·0 for purchase). The frozen pre-cooked chicken cubes used in Finnish salad and in Estonian wraps were traced back to a production plant in China. Great Britain made two Rapid Alert Systems for Food and Feed notifications on chicken cubes imported to the UK from the same Chinese production plant. Microbiological investigation confirmed that the patient isolates in Estonia and in Finland were indistinguishable from the strains isolated from chicken cubes in Estonia and in the UK. We recommend that despite certificates for tested Salmonella, food items should be analyzed when Salmonella contamination in outbreak investigations is suspected. In outbreak investigations, electronically implemented case-case study saves time, effort, and money compared with case-control study.

A nested case-control study of predictors for tuberculosis recurrence in a large UK Centre.

PubMed

Rosser, Andrew; Richardson, Matthew; Wiselka, Martin J; Free, Robert C; Woltmann, Gerrit; Mukamolova, Galina V; Pareek, Manish

2018-02-27

Tuberculosis (TB) recurrence represents a challenge to control programs. In low incidence countries, the prevailing risk factors leading to recurrence are poorly characterised. We conducted a nested case-control study using the Leicester TB service TBIT database. Cases were identified from database notifications between 1994 and 2014. Controls had one episode and were matched to cases on a ratio of two to one by the date of notification. Multiple imputation was used to account for missing data. Multivariate conditional logistic regression analysis was employed to identify clinical, sociodemographic and TB specific risk factors for recurrence. From a cohort of 4628 patients, 82 TB recurrences occurred (1.8%). Nineteen of 82 patients had paired isolates with MIRU-VNTR strain type profiles available, of which 84% were relapses and 16% reinfections. On multivariate analysis, smoking (OR 3.8; p = 0.04), grade 3/4 adverse drug reactions (OR 5.6; p = 0.02), ethnicity 'Indian subcontinent' (OR 8.5; p = <0.01), ethnicity 'other' (OR 31.2; p = 0.01) and receipt of immunosuppressants (OR 6.8; p = <0.01) were independent predictors of TB recurrence. Within this UK setting, the rate of TB recurrence was low, predominantly due to relapse. The identification of an elevated recurrence risk amongst the ethnic group contributing most cases to the national TB burden presents an opportunity to improve individual and population health.

"Too Many Actors and Too Few Jobs": A Case for Curriculum Extension in UK Vocational Actor Training

ERIC Educational Resources Information Center

Wilkie, Ian

2015-01-01

This article questions the current situation for vocational acting training (VAT) in the UK. It aims to provide an update on the report into burgeoning provision of acting training (and the attempt to address subsequent high rates of actor unemployment) that was originally undertaken by the Calouste Gulbenkian Foundation (CGF, 1975) in their…

Benchmarking of DFLAW Solid Secondary Wastes and Processes with UK/Europe Counterparts

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

Brown, Elvie E.; Swanberg, David J.; Surman, J.

This report provides information and background on UK solid wastes and waste processes that are similar to those which will be generated by the Direct-Feed Low Activity Waste (DFLAW) facilities at Hanford. The aim is to further improve the design case for stabilizing and immobilizing of solid secondary wastes, establish international benchmarking and review possibilities for innovation.

The Case for Using Student Voice in Teacher Selection and Recruitment: Reflections from a School Leader

ERIC Educational Resources Information Center

Kent, Peter

2012-01-01

In this piece Peter Kent, headteacher of Lawrence Sheriff School in Rugby in the UK, reflects upon the role of the student voice in selecting and recruiting new teaching staff. Contextualised by some recent unsympathetic reporting in the UK media, Peter explains why for their school community, using the student voice to inform teacher recruitment…

Training in the Public Sector in a Period of Austerity: The Case of the UK

ERIC Educational Resources Information Center

Jewson, Nick; Felstead, Alan; Green, Francis

2015-01-01

This article examines what has happened to training in public sector organisations in the UK in a period of austerity. It draws on individual-level data collected over the period 2000-2012 and establishment-level data collected from employer surveys carried out between 2005 and 2012. To understand these data further, 75 qualitative interviews with…

Cumulative social disadvantage, ethnicity and first-episode psychosis: a case-control study.

PubMed

Morgan, C; Kirkbride, J; Hutchinson, G; Craig, T; Morgan, K; Dazzan, P; Boydell, J; Doody, G A; Jones, P B; Murray, R M; Leff, J; Fearon, P

2008-12-01

Numerous studies have reported high rates of psychosis in the Black Caribbean population in the UK. Recent speculation about the reasons for these high rates has focused on social factors. However, there have been few empirical studies. We sought to compare the prevalence of specific indicators of social disadvantage and isolation, and variations by ethnicity, in subjects with a first episode of psychosis and a series of healthy controls. All cases with a first episode of psychosis who made contact with psychiatric services in defined catchment areas in London and Nottingham, UK and a series of community controls were recruited over a 3-year period. Data relating to clinical and social variables were collected from cases and controls. On all indicators, cases were more socially disadvantaged and isolated than controls, after controlling for potential confounders. These associations held when the sample was restricted to those with an affective diagnosis and to those with a short prodrome and short duration of untreated psychosis. There was a clear linear relationship between concentrated disadvantage and odds of psychosis. Similar patterns were evident in the two main ethnic groups, White British and Black Caribbean. However, indicators of social disadvantage and isolation were more common in Black Caribbean subjects than White British subjects. We found strong associations between indicators of disadvantage and psychosis. If these variables index exposure to factors that increase risk of psychosis, their greater prevalence in the Black Caribbean population may contribute to the reported high rates of psychosis in this population.

Assessment and comparison of extreme sea levels and waves during the 2013/2014 storm season in two UK coastal regions

NASA Astrophysics Data System (ADS)

Wadey, M. P.; Brown, J. M.; Haigh, I. D.; Dolphin, T.; Wisse, P.

2015-04-01

The extreme sea levels and waves experienced around the UK's coast during the 2013/2014 winter caused extensive coastal flooding and damage. In such circumstances, coastal managers seek to place such extremes in relation to the anticipated standards of flood protection, and the long-term recovery of the natural system. In this context, return periods are often used as a form of guidance. We therefore provide these levels for the winter storms, as well as discussing their application to the given data sets and case studies (two UK case study sites: Sefton, northwest England; and Suffolk, east England). We use tide gauge records and wave buoy data to compare the 2013/2014 storms with return periods from a national dataset, and also generate joint probabilities of sea level and waves, incorporating the recent events. The UK was hit at a national scale by the 2013/2014 storms, although the return periods differ with location. We also note that the 2013/2014 high water and waves were extreme due to the number of events, as well as the extremity of the 5 December 2013 "Xaver" storm, which had a very high return period at both case study sites. Our return period analysis shows that the national scale impact of this event is due to its coincidence with spring high tide at multiple locations as the tide and storm propagated across the continental shelf. Given that this event is such an outlier in the joint probability analyses of these observed data sets, and that the season saw several events in close succession, coastal defences appear to have provided a good level of protection. This type of assessment should be recorded alongside details of defence performance and upgrade, with other variables (e.g. river levels at estuarine locations) included and appropriate offsetting for linear trends (e.g. mean sea level rise) so that the storm-driven component of coastal flood events can be determined. Local offsetting of the mean trends in sea level allows long-term comparison of storm severity and also enables an assessment of how sea level rise is influencing return levels over time, which is important when considering long-term coastal resilience in strategic management plans.

Developing and Implementing an Online Doctoral Programme

ERIC Educational Resources Information Center

Combe, Colin

2005-01-01

Purpose: This article is a critical reflection of the development and implementation of one of the first online doctoral programs in the UK set up at the University of Northumbria, Newcastle in 2000. Design/methodology/approach: The method adopted for analysis takes the form of a case study. Findings: Effective market research has to be undertaken…

Creating an Enterprise Culture in a University: The Role of an Entrepreneurial Learning Team

ERIC Educational Resources Information Center

Rae, David; Gee, Simon; Moon, Robert

2009-01-01

The "entrepreneurial university" is considered a desirable and achievable goal, but how do universities become entrepreneurial? The role of the enterprising academic in stimulating cultural change is often overlooked. This article presents as a case study the teaching team at the University of Derby, UK, who "acted as…

Erasmus Language Students in a British University: A Case Study

ERIC Educational Resources Information Center

Bogain, Ariane

2012-01-01

Students' assessment of their academic experience is actively sought by higher education institutions, as evidenced in the UK's National Student Survey, introduced in 2005. Erasmus students, despite their growing numbers, tend to be excluded from these satisfaction surveys, even though they, too, are primary customers of a university. This study…

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

ERIC Educational Resources Information Center

Penman, Christine

2015-01-01

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

Optimizaton of corrosion control for lead in drinking water using computational modeling techniques

EPA Science Inventory

Computational modeling techniques have been used to very good effect in the UK in the optimization of corrosion control for lead in drinking water. A “proof-of-concept” project with three US/CA case studies sought to demonstrate that such techniques could work equally well in the...

International Community-Based Service Learning: Two Comparative Case Studies of Benefits and Tensions

ERIC Educational Resources Information Center

Akhurst, Jacqueline

2016-01-01

The drives to internationalise the UK curriculum and psychology students' desires to work in communities are brought together in this paper. International community-based learning (ICBL) links with many psychology students' motivations to make contributions to others; with the potential to enhance students' learning and cultural sensitivities. The…

Assessment and Management of the Communication Difficulties of Children with Cerebral Palsy: A UK Survey of SLT Practice

ERIC Educational Resources Information Center

Watson, Rose Mary; Pennington, Lindsay

2015-01-01

Background: Communication difficulties are common in cerebral palsy (CP) and are frequently associated with motor, intellectual and sensory impairments. Speech and language therapy research comprises single-case experimental design and small group studies, limiting evidence-based intervention and possibly exacerbating variation in practice. Aims:…

The Contribution of Individual Learning Accounts to the Lifelong Learning Policies of the UK Government: A Case-Study.

ERIC Educational Resources Information Center

Payne, John

2000-01-01

A survey of 765 adult learners who funded education through the British government's Individual Learning Accounts showed the program brought in new lifelong learning participants, encouraged more demanding learning, and increased participation of underrepresented groups. Advice and guidance played an important role. (SK)

Disciplinary Regimes of "Care" and Complementary Alternative Education

ERIC Educational Resources Information Center

Thomson, Pat; Pennacchia, Jodie

2016-01-01

In schools, the notion of "care" is often synonymous with welfare and disciplinary regimes. Drawing on Foucault, and a study of alternative education (AE) across the UK, and looking in depth at two cases of complementary AE, we identify three types of disciplinary regimes at work in schools: (1) dominant performative reward and…

A Model for Outsourcing HRD

ERIC Educational Resources Information Center

Simmonds, David; Gibson, Rebecca

2008-01-01

Purpose: The purpose of this paper is to provide an overview of approaches to outsourcing HRD in the UK. Design/methodology/approach: This paper employs semi-structured interviews and case studies. The research model was developed from a literature review. Findings: There are many problems associated with outsourcing any or all aspects of the HRD…

The Flipped Classroom in Further Education: Literature Review and Case Study

ERIC Educational Resources Information Center

Little, Christopher

2015-01-01

The flipped classroom seeks to remove didactic instruction from the classroom and deliver it via electronic videos outside of the classroom, leaving contact time free for more interactive and engaging teaching and learning activities. This paper has two distinct aims: (1) to conduct a literature review of published UK-based "flipped…

Students' Perceptions of the Introduction of a Blended Learning Environment: An Exploratory Case Study

ERIC Educational Resources Information Center

Osgerby, Julia

2013-01-01

Virtual Learning Environments (VLE) provide the opportunity to deliver blended learning approaches that combine mixes of Information and Communications Technology (ICT) with various delivery methods and media. In 2008 and 2009, the University of Winchester in the UK redesigned a variety of accounting and financial management modules for…

What Does the Student Psychological Contract Mean? Evidence from a UK Business School

ERIC Educational Resources Information Center

Koskina, Aikaterini

2013-01-01

Much has been written about psychological contracts in organisational contexts but very little in educational settings, especially within higher education. Using an exploratory single case study this article provides qualitative empirical evidence about the ways in which the psychological contract is perceived by a group of postgraduate students…

International Curriculum Transfer in Geography in Higher Education: An Example

ERIC Educational Resources Information Center

Khan, Amanat Ullah; Hassan, Manzurul; Atkins, Peter

2014-01-01

Internationalization of geography in higher education comes in many guises. This paper discusses some of these, with particular attention to curriculum development and transfer. The context is Bangladesh and a case study is presented of a link programme between three higher education institutions in that country and one in the UK. The British…

Higher Education Change and Its Managers: Alternative Constructions

ERIC Educational Resources Information Center

Hotho, Sabine

2013-01-01

This article is based on a case study conducted in the context of UK higher education change. The article argues that "change" is a construct created in discourses of change policy and change management, and resulting in reductivist change management discourses which may impede rather than facilitate effective change management in the…

Creativity-Based Assessment and Neural Understandings: A Discussion and Case Study Analysis

ERIC Educational Resources Information Center

Penaluna, Andrew; Coates, Jackie; Penaluna, Kathryn

2010-01-01

Purpose: Enabling entrepreneurial creativity is a key aim of UK Government; however, there is a dearth of constructively aligned models of teaching and assessment. This paper aims to introduce design-based pedagogies and to highlight cognitive approaches that develop innovative mindsets; it seeks to indicate their propensity for adoption in…

Graduate Development, Discursive Resources and the Employment Relationship at BAE Systems

ERIC Educational Resources Information Center

Jenner, Shirley

2008-01-01

Purpose: The purpose of this paper is to examine the evolution of an employee opinion survey and to evaluate its impact on the graduate training programme and associated employment relationships. Design/methodology/approach: The paper provides a detailed, longitudinal case study of one large-scale UK organisation. The approach recognises that…

Facilitating Experiential Learning of Study Skills in Sports Students

ERIC Educational Resources Information Center

Groves, Mark; Bowd, Belinda; Smith, Julian

2010-01-01

In recent years the student population in the UK has grown considerably, and students are entering higher education with a more diverse range of qualifications and skills. This is particularly the case in post-1992 universities with a widening participation agenda, as these institutions have a larger share of students from non-traditional…

Strengthening Student Engagement with Quantitative Subjects in a Business Faculty

ERIC Educational Resources Information Center

Warwick, Jon; Howard, Anna

2014-01-01

This paper reflects on the results of research undertaken at a large UK university relating to the teaching of quantitative subjects within a Business Faculty. It builds on a simple model of student engagement and, through the description of three case studies, describes research undertaken and developments implemented to strengthen aspects of the…

Evaluating the influence of ivy canopy cover on brickwork: A case study from Warnham, West Sussex, UK

NASA Astrophysics Data System (ADS)

Coombes, Martin; Viles, Heather

2014-05-01

Biogeomorphological understanding is becoming increasingly applied in a range of environmental management contexts. The concept of 'bioprotection' is of particular relevance in the built environment. Here, the influence of higher plants on the condition of buildings and building materials, particularly vulnerable historic structures, is of great interest for conservationists and managing authorities tasked with preserving built cultural heritage. Ivy (Hedera spp.) is a widespread and prolific creeping and climbing plant that is commonly found on built structures. Opinion varies as to whether ivy is good or bad for buildings, but there is evidence to suggest it can have both protective and deteriorative influences. Here we present a case study assessment of ivy removal from a brick and mortar wall (c.100 years old) in West Sussex, UK. Using measurements of hardness (Equotip L), moisture (protimeter %WME) and visual inspection we find that the condition of brickwork varied with ivy canopy cover extent, but that this effect was not consistent between different heights on the wall. The roles of ivy in moderating wall moisture dynamics is discussed as a possible contributing factor.

Brain pathologies in extreme old age

PubMed Central

Neltner, Janna H.; Abner, Erin L.; Jicha, Gregory A.; Schmitt, Frederick A.; Patel, Ela; Poon, Leonard W.; Gearing, Marla; Green, Robert C.; Davey, Adam; Johnson, Mary Ann; Jazwinski, S. Michal; Kim, Sangkyu; Davis, Daron; Woodard, John L.; Kryscio, Richard J.; Van Eldik, Linda J.; Nelson, Peter T.

2015-01-01

With an emphasis on evolving concepts in the field, we evaluated neuropathologic data from very old research volunteers whose brain autopsies were performed at University of Kentucky (UK-ADC), incorporating data from the Georgia Centenarian Study (N=49 cases included), the Nun Study (N=17), and UK-ADC (N=11) cohorts. Average age of death was 102.0 years (range: 98–107) overall. Alzheimer’s disease (AD) pathology was not universal (62% with “moderate” or “frequent” neuritic amyloid plaque densities) whereas frontotemporal lobar degeneration (FTLD) was absent. By contrast, some hippocampal neurofibrillary tangles (including primary age-related tauopathy [PART]) were observed in every case. Lewy body pathology was seen in 16.9% of subjects, hippocampal sclerosis of aging (HS-Aging) in 20.8%. We describe anatomical distributions of pigment-laden macrophages, expanded Virchow-Robin spaces, and arteriolosclerosis among Georgia Centenarians. Moderate or severe arteriolosclerosis pathology, throughout the brain, was associated with both HS-Aging pathology and an ABCC9 gene variant. These results provide fresh insights into the complex cerebral multimorbidity, and a novel genetic risk factor, at the far end of the human aging spectrum. PMID:26597697

Alternative perspectives of safety in home delivered health care: a sequential exploratory mixed method study.

PubMed

Jones, Sarahjane

2016-10-01

The aim of this study was to discover and describe how patients, carers and case management nurses define safety and compare it to the traditional risk reduction and harm avoidance definition of safety. Care services are increasingly being delivered in the home for patients with complex long-term conditions. However, the concept of safety remains largely unexplored. A sequential, exploratory mixed method design. A qualitative case study of the UK National Health Service case management programme in the English UK National Health Service was deployed during 2012. Thirteen interviews were conducted with patients (n = 9) and carers (n = 6) and three focus groups with nurses (n = 17) from three community care providers. The qualitative element explored the definition of safety. Data were subjected to framework analysis and themes were identified by participant group. Sequentially, a cross-sectional survey was conducted during 2013 in a fourth community care provider (patient n = 35, carer n = 19, nurse n = 26) as a form of triangulation. Patients and carers describe safety differently to case management nurses, choosing to focus on meeting needs. They use more positive language and recognize the role they have in safety in home-delivered health care. In comparison, case management nurses described safety similarly to the definitions found in the literature. However, when offered the patient and carer definition of safety, they preferentially selected this definition to their own or the literature definition. Patients and carers offer an alternative perspective on patient safety in home-delivered health care that identifies their role in ensuring safety and is more closely aligned with the empowerment philosophy of case management. © 2016 John Wiley & Sons Ltd.

Assessment of the magnitude of ammonia emissions in the United Kingdom

NASA Astrophysics Data System (ADS)

Sutton, M. A.; Place, C. J.; Eager, M.; Fowler, D.; Smith, R. I.

Estimates of ammonia emission in the U.K. have been critically reviewed with the aim of establishing the magnitude and uncertainty of each of the sources. European studies are also reviewed, with the U.K. providing a useful case study to highlight the uncertainties common to all ammonia emission inventories. This analysis of the emission factors and their application to U.K. sources supports an emission of 450 (231-715) Gg NH 3 yr -1. Agricultural activities are confirmed as the major source, providing 406 (215-630) Gg NH 3yr -1 (90% of the total), and therefore dominate uncertainties. Non-agricultural sources include sewage, pets, horses, humans, combustion and wild animals, though these contribute only 44 (16-85) Gg yr -1. Cattle represent the largest single uncertainty, accounting for 245 (119-389) Gg yr -1. The major uncertainties for cattle derive from estimation of the amount of nitrogen (N) excreted, the % N volatilized from land spreading of wastes, and the % N volatilized from stored farm-yard manure. Similar relative uncertainties apply to each of sheep, pigs and poultry, as well as fertilized crops, though these are quantitatively less important. Accounting; for regional differences in livestock demography, emission of 347, 63 and 40 Gg yr -1 are estimated for England & Wales, Scotland, and Northern Ireland, respectively. Though very uncertain, the total is in good agreement with estimates required to balance the U.K. atmospheric NH. budget.

A case study of machinery maintenance protocols and procedures within the UK utilities sector.

PubMed

Edwards, David J; Love, Peter E D

2016-08-01

Failure to conduct periodic fixed-time-to (or scheduled) maintenance on off-highway plant and equipment represents a significant health and safety hazard and major litigation risk for utility contractors completing service excavation and reinstatement works on public highways. Mini-excavators are a ubiquitous mobile plant item used for such tasks and have recently been responsible for several major injuries and fatalities involving workers and members of the public in the United Kingdom (UK). The research utilises the method of triangulation to examine the maintenance practices of utility contractors in the UK. Findings from the research reveal that a combination of prevailing market forces and internal 'company' pressures have inadvertently removed knowledgeable and trained operators, site foremen and managerial supervisors from hands-on maintenance inspections. Rather, 'virtual' maintenance protocols and procedures are adopted by head office but rarely fully implemented on-site. The research concludes with pragmatic recommendations and direction for future research. Copyright © 2015 Elsevier Ltd. All rights reserved.

The effectiveness of health appraisal processes currently in addressing health and wellbeing during spatial plan appraisal: a systematic review.

PubMed

Gray, Selena; Carmichael, Laurence; Barton, Hugh; Mytton, Julie; Lease, Helen; Joynt, Jennifer

2011-11-24

Spatial planning affects the built environment, which in turn has the potential to have a significant impact on health, for good or ill. One way of ensuring that spatial plans take due account of health is through the inclusion of health considerations in the statutory and non statutory appraisal processes linked to plan-making processes. A systematic review to identify evaluation studies of appraisals or assessments of plans where health issues were considered from 1987 to 2010. A total of 6161 citations were identified: 6069 from electronic databases, 57 fromwebsite searches, with a further 35 citations from grey literature, of which 20 met the inclusion criteria. These 20 citations reported on a total of 135 different case studies: 11 UK HIA; 11 non UK high income countries HIA, 5 UK SEA or other integrated appraisal; 108 non UK high income SEA or other integrated appraisal. All studies were in English. No relevant studies were identified reporting on low or middle income countries.The studies were limited by potential bias (no independent evaluation, with those undertaking the appraisal also responsible for reporting outcomes), lack of detail and a lack of triangulation of results. Health impact assessments generally covered the four specified health domains (physical activity, mental health and wellbeing, environmental health issues such as pollution and noise, injury) more comprehensively than SEA or other integrated appraisals, although mental health and wellbeing was an underdeveloped area. There was no evidence available on the incorporation of health in Sustainability Appraisal, limited evidence that the recommendations from any type of appraisal were implemented, and almost no evidence that the recommendations had led to the anticipated outcomes or improvements in health postulated. Research is needed to assess (i) the degree to which statutory plan appraisal processes (SA in the UK) incorporate health; (ii) whether recommendations arising from health appraisal translate into the development process and (iii) whether outcomes are as anticipated.

"#discrimination": The Online Response to a Case of a Breastfeeding Mother Being Ejected from a UK Retail Premises.

PubMed

Grant, Aimee

2016-02-01

Stigma is a significant barrier to breastfeeding. Internationally, mothers have reported stigma surrounding public breastfeeding. In the United Kingdom, the Equality Act 2010 gives women the right to breastfeed in public, including within private businesses. In April 2014, a woman who was breastfeeding in a UK sports shop was asked to leave, resulting in a localized protest by breastfeeding mothers. This resulted in the issue of public breastfeeding being highlighted in local, national, and social media. To examine online opinion regarding breastfeeding in public and protesting about the right to breastfeed in public within the context of a single case. Online user-generated content relating to the case of Wioletta Komar was downloaded from Twitter and the comments section of a UK online news source, Mail Online. Data comprised 884 comments and 1210 tweets, collected within 24 hours of the incident. Semiotic and thematic analysis was facilitated by NVivo 10. Comments from Twitter were supportive (76%) or neutral (22%) regarding the protesting women and public breastfeeding. Conversely, Mail Online comments were mostly negative (85%). Mail Online posters questioned the legality of public breastfeeding, while Twitter comments acknowledged and supported women's legal right to breastfeed publicly. Many Mail Online commenters stated that they found it uncomfortable to watch breastfeeding or thought it was unnecessary to breastfeed in public. If the UK government is serious about increasing breastfeeding, interventions to promote public support for public breastfeeding are urgently required. © The Author(s) 2015.

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.

Insights into the Management of Emerging Infections: Regulating Variant Creutzfeldt-Jakob Disease Transfusion Risk in the UK and the US

PubMed Central

Ponte, Maya L

2006-01-01

Background Variant Creutzfeldt-Jakob disease (vCJD) is a human prion disease caused by infection with the agent of bovine spongiform encephalopathy. After the recognition of vCJD in the UK in 1996, many nations implemented policies intended to reduce the hypothetical risk of transfusion transmission of vCJD. This was despite the fact that no cases of transfusion transmission had yet been identified. In December 2003, however, the first case of vCJD in a recipient of blood from a vCJD-infected donor was announced. The aim of this study is to ascertain and compare the factors that influenced the motivation for and the design of regulations to prevent transfusion transmission of vCJD in the UK and US prior to the recognition of this case. Methods and Findings A document search was conducted to identify US and UK governmental policy statements and guidance, transcripts (or minutes when transcripts were not available) of scientific advisory committee meetings, research articles, and editorials published in medical and scientific journals on the topic of vCJD and blood transfusion transmission between March 1996 and December 2003. In addition, 40 interviews were conducted with individuals familiar with the decision-making process and/or the science involved. All documents and transcripts were coded and analyzed according to the methods and principles of grounded theory. Data showed that while resulting policies were based on the available science, social and historical factors played a major role in the motivation for and the design of regulations to protect against transfusion transmission of vCJD. First, recent experience with and collective guilt resulting from the transfusion-transmitted epidemics of HIV/AIDS in both countries served as a major, historically specific impetus for such policies. This history was brought to bear both by hemophilia activists and those charged with regulating blood products in the US and UK. Second, local specificities, such as the recall of blood products for possible vCJD contamination in the UK, contributed to a greater sense of urgency and a speedier implementation of regulations in that country. Third, while the results of scientific studies played a prominent role in the construction of regulations in both nations, this role was shaped by existing social and professional networks. In the UK, early focus on a European study implicating B-lymphocytes as the carrier of prion infectivity in blood led to the introduction of a policy that requires universal leukoreduction of blood components. In the US, early focus on an American study highlighting the ability of plasma to serve as a reservoir of prion infectivity led the FDA and its advisory panel to eschew similar measures. Conclusions The results of this study yield three important theoretical insights that pertain to the global management of emerging infectious diseases. First, because the perception and management of disease may be shaped by previous experience with disease, especially catastrophic experience, there is always the possibility for over-management of some possible routes of transmission and relative neglect of others. Second, local specificities within a given nation may influence the temporality of decision making, which in turn may influence the choice of disease management policies. Third, a preference for science-based risk management among nations will not necessarily lead to homogeneous policies. This is because the exposure to and interpretation of scientific results depends on the existing social and professional networks within a given nation. Together, these theoretical insights provide a framework for analyzing and anticipating potential conflicts in the international management of emerging infectious diseases. In addition, this study illustrates the utility of qualitative methods in investigating research questions that are difficult to assess through quantitative means. PMID:17076547

Insights into the management of emerging infections: regulating variant Creutzfeldt-Jakob disease transfusion risk in the UK and the US.

PubMed

Ponte, Maya L

2006-10-01

Variant Creutzfeldt-Jakob disease (vCJD) is a human prion disease caused by infection with the agent of bovine spongiform encephalopathy. After the recognition of vCJD in the UK in 1996, many nations implemented policies intended to reduce the hypothetical risk of transfusion transmission of vCJD. This was despite the fact that no cases of transfusion transmission had yet been identified. In December 2003, however, the first case of vCJD in a recipient of blood from a vCJD-infected donor was announced. The aim of this study is to ascertain and compare the factors that influenced the motivation for and the design of regulations to prevent transfusion transmission of vCJD in the UK and US prior to the recognition of this case. A document search was conducted to identify US and UK governmental policy statements and guidance, transcripts (or minutes when transcripts were not available) of scientific advisory committee meetings, research articles, and editorials published in medical and scientific journals on the topic of vCJD and blood transfusion transmission between March 1996 and December 2003. In addition, 40 interviews were conducted with individuals familiar with the decision-making process and/or the science involved. All documents and transcripts were coded and analyzed according to the methods and principles of grounded theory. Data showed that while resulting policies were based on the available science, social and historical factors played a major role in the motivation for and the design of regulations to protect against transfusion transmission of vCJD. First, recent experience with and collective guilt resulting from the transfusion-transmitted epidemics of HIV/AIDS in both countries served as a major, historically specific impetus for such policies. This history was brought to bear both by hemophilia activists and those charged with regulating blood products in the US and UK. Second, local specificities, such as the recall of blood products for possible vCJD contamination in the UK, contributed to a greater sense of urgency and a speedier implementation of regulations in that country. Third, while the results of scientific studies played a prominent role in the construction of regulations in both nations, this role was shaped by existing social and professional networks. In the UK, early focus on a European study implicating B-lymphocytes as the carrier of prion infectivity in blood led to the introduction of a policy that requires universal leukoreduction of blood components. In the US, early focus on an American study highlighting the ability of plasma to serve as a reservoir of prion infectivity led the FDA and its advisory panel to eschew similar measures. The results of this study yield three important theoretical insights that pertain to the global management of emerging infectious diseases. First, because the perception and management of disease may be shaped by previous experience with disease, especially catastrophic experience, there is always the possibility for over-management of some possible routes of transmission and relative neglect of others. Second, local specificities within a given nation may influence the temporality of decision making, which in turn may influence the choice of disease management policies. Third, a preference for science-based risk management among nations will not necessarily lead to homogeneous policies. This is because the exposure to and interpretation of scientific results depends on the existing social and professional networks within a given nation. Together, these theoretical insights provide a framework for analyzing and anticipating potential conflicts in the international management of emerging infectious diseases. In addition, this study illustrates the utility of qualitative methods in investigating research questions that are difficult to assess through quantitative means.

Multidisciplinary approach to the management of children with female genital mutilation (FGM) or suspected FGM: service description and case series.

PubMed

Creighton, Sarah M; Dear, Joanna; de Campos, Claudia; Williams, Louise; Hodes, Deborah

2016-02-29

To describe the first dedicated clinic in the UK for children with suspected or confirmed female genital mutilation (FGM) including referral patterns, clinical findings and subsequent management. A prospective study of all children seen in a dedicated multidisciplinary FGM clinic for children over a 1-year period. Patients aged under 18 years referred for clinical assessment or for a second opinion on Digital Versatile Disc (DVD) images. Data were collected on reasons for referral, demography, genital examination findings including FGM type, and clinical recommendations. 38 children were referred of whom 18 (47%) had confirmed FGM; most frequently type 4 (61%). Social care and police referred 78% of cases. According to UK law FGM had been performed illegally in three cases. Anonymous information given to the police led to the referral of six children, none of whom had had FGM. Mandatory reporting and increased media attention may increase the numbers of referrals of children with suspected FGM. This patient group have complex needs and management in a dedicated multidisciplinary service is essential. Paediatricians and gynaecologists should have the skills to carry out the consultation and detect all types of FGM including type 4 which was the most common type seen in this series. This is the first dedicated FGM service for children in the UK and similar clinics in high-prevalence areas should be established. 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/

Management of obstetric postpartum hemorrhage: a national service evaluation of current practice in the UK

PubMed Central

Al Wattar, Bassel H; Tamblyn, Jennifer A; Parry-Smith, William; Prior, Mathew; Van Der Nelson, Helen

2017-01-01

Background Postpartum hemorrhage (PPH) continues to be one of the major causes of maternal mortality and morbidity in obstetrics. Variations in practice often lead to adverse maternity outcomes following PPH. Our objective was to assess the current practice in managing PPH in the UK. Methods We performed a national multicenter prospective service evaluation study over one calendar month and compared the current performance to national standards for managing PPH. We used a standardized data collection tool and collected data on patients’ demographics, incidence of PPH, estimated blood loss (EBL), prophylactic and treatment measures, onset of labor, and mode of delivery. Results We collected data from 98 obstetric units, including 3663 cases of primary PPH. Fifty percent of cases were minor PPH (EBL 500–1000 mL, n=1900/3613, 52.6%) and the remaining were moderate PPH (EBL >1000 to <2000 mL, n=1424/3613, 39.4%) and severe PPH (EBL >2000 mL, n=289/3613, 8%). The majority of women received active management of the third stage of labor (3504/3613, 97%) most commonly with Syntometrine intramuscular (1479/3613, 40.9%). More than half required one additional uterotonic agent (2364/3613, 65.4%) most commonly with Syntocinon intravenous infusion (1155/2364, 48.8%). There was a poor involvement of consultant obstetricians and anesthetists in managing PPH cases, which was more prevalent when managing major PPH (p=0.0001). Conclusion There are still variations in managing PPH in the UK against national guidelines. More senior doctor involvement and regular service evaluation are needed to improve maternal outcomes following PPH. PMID:28176919

How effective is good domestic kitchen hygiene at reducing diarrhoeal disease in developed countries? A systematic review and reanalysis of the UK IID study

PubMed Central

Stenberg, Anna; Macdonald, Clare; Hunter, Paul R

2008-01-01

Background To assess whether domestic kitchen hygiene is an important contributor to the development of diarrhoea in the developed world. Methods Electronic searches were carried out in October 2006 in EMBASE, MEDLINE, Web of Knowledge, Cochrane central register of clinical trials and CINAHL. All publications, irrespective of study design, assessing food hygiene practices with an outcome measure of diarrhoea were included in the review. All included studies underwent data extraction and the data was subsequently analysed. The analysis was conducted by qualitative synthesis of the results. Given the substantial heterogeneity in study design and outcome measures meta-analysis was not done. In addition the existing dataset of the UK IID study was reanalysed to investigate possible associations between self-reported diarrhoea and variables indicative of poor domestic kitchen hygiene Results Some 14 studies were finally included in subsequent analyses. Of the 14 studies included in this systematic review, 11 were case-control studies, 2 cross-sectional surveys, and 1 RCT. Very few studies identified any significant association with good environmental kitchen hygiene. Although some of the variables in the reanalysis of the UK IID study were statistically significant no obvious trend was seen. Conclusion The balance of the available evidence does not support the hypothesis that poor domestic kitchen hygiene practices are important risk factors for diarrhoeal disease in developed countries. PMID:18294383

How effective is good domestic kitchen hygiene at reducing diarrhoeal disease in developed countries? A systematic review and reanalysis of the UK IID study.

PubMed

Stenberg, Anna; Macdonald, Clare; Hunter, Paul R

2008-02-22

To assess whether domestic kitchen hygiene is an important contributor to the development of diarrhoea in the developed world. Electronic searches were carried out in October 2006 in EMBASE, MEDLINE, Web of Knowledge, Cochrane central register of clinical trials and CINAHL. All publications, irrespective of study design, assessing food hygiene practices with an outcome measure of diarrhoea were included in the review. All included studies underwent data extraction and the data was subsequently analysed. The analysis was conducted by qualitative synthesis of the results. Given the substantial heterogeneity in study design and outcome measures meta-analysis was not done. In addition the existing dataset of the UK IID study was reanalysed to investigate possible associations between self-reported diarrhoea and variables indicative of poor domestic kitchen hygiene Some 14 studies were finally included in subsequent analyses. Of the 14 studies included in this systematic review, 11 were case-control studies, 2 cross-sectional surveys, and 1 RCT. Very few studies identified any significant association with good environmental kitchen hygiene. Although some of the variables in the reanalysis of the UK IID study were statistically significant no obvious trend was seen. The balance of the available evidence does not support the hypothesis that poor domestic kitchen hygiene practices are important risk factors for diarrhoeal disease in developed countries.

Exposure of Children and Adolescents to Alcohol Marketing on Social Media Websites

PubMed Central

Winpenny, Eleanor M.; Marteau, Theresa M.; Nolte, Ellen

2014-01-01

Aims: In 2011, online marketing became the largest marketing channel in the UK, overtaking television for the first time. This study aimed to describe the exposure of children and young adults to alcohol marketing on social media websites in the UK. Methods: We used commercially available data on the three most used social media websites among young people in the UK, from December 2010 to May 2011. We analysed by age (6–14 years; 15–24 years) and gender the reach (proportion of internet users who used the site in each month) and impressions (number of individual pages viewed on the site in each month) for Facebook, YouTube and Twitter. We further analysed case studies of five alcohol brands to assess the marketer-generated brand content available on Facebook, YouTube and Twitter in February and March 2012. Results: Facebook was the social media site with the highest reach, with an average monthly reach of 89% of males and 91% of females aged 15–24. YouTube had a similar average monthly reach while Twitter had a considerably lower usage in the age groups studied. All five of the alcohol brands studied maintained a Facebook page, Twitter page and YouTube channel, with varying levels of user engagement. Facebook pages could not be accessed by an under-18 user, but in most cases YouTube content and Twitter content could be accessed by those of all ages. Conclusion: The rise in online marketing of alcohol and the high use of social media websites by young people suggests that this is an area requiring further monitoring and regulation. PMID:24293506

The incidence of congenital syphilis in the United Kingdom: February 2010 to January 2015.

PubMed

Simms, I; Tookey, P A; Goh, B T; Lyall, H; Evans, B; Townsend, C L; Fifer, H; Ison, C

2017-01-01

To estimate the incidence of congenital syphilis in the UK. Prospective study. United Kingdom. Children born between February 2010 and January 2015 with a suspected diagnosis of congenital syphilis were reported through an active surveillance system. Number of congenital syphilis cases and incidence. For all years, reported incidence was below the WHO threshold for elimination (<0.5/1000 live births). Seventeen cases (12 male, five female) were identified. About 50% of infants (8/17) were born preterm (<37 weeks' gestation): median birthweight 2000 g (865-3170 g). Clinical presentation varied from asymptomatic to acute disease, including severe anaemia, hepatosplenomegaly, rhinitis, thrombocytopaenia, skeletal damage, and neurosyphilis. One infant was deaf and blind. Median maternal age was 20 years (17-31) at delivery. Where maternal stage of infection was recorded, 6/10 had primary, 3/10 secondary and 1/10 early latent syphilis. Most mothers were white (13/16). Country of birth was recorded for 12 mothers: UK (n = 6), Eastern Europe (n = 3), Middle East (n = 1), and South East Asia (n = 2). The social circumstances of mothers varied and included drug use and sex work. Some experienced difficulty accessing health care. The incidence of congenital syphilis is controlled and monitored by healthcare services and related surveillance systems, and is now below the WHO elimination threshold. However, reducing the public health impact of this preventable disease in the UK is highly dependent on the successful implementation of WHO elimination standards across Europe. Congenital syphilis incidence in the UK is at a very low level and well below the WHO elimination threshold. © 2016 Royal College of Obstetricians and Gynaecologists.

Clinical characteristics of mephedrone toxicity reported to the UK National Poisons Information Service

PubMed Central

James, D; Adams, R D; Spears, R; Cooper, G; Lupton, D J; Thompson, J P

2010-01-01

Objective To describe the patterns and clinical features of toxicity related to recreational use of mephedrone and other cathinones in the UK using data collected by the National Poisons Information Service (NPIS). Methods The number of accesses to TOXBASE, the NPIS online poisons information database, details of consecutive cases uploaded onto TOXBASE and the number and details of telephone enquiries made to the NPIS by health professionals in the UK were collected for the period March 2009 to February 2010. Results Over the year of study there were 2901 TOXBASE accesses and 188 telephone enquiries relating to cathinones, the majority relating to mephedrone (TOXBASE 1664, telephone 157), with a month-on-month increase in numbers. In 131 telephone enquiries concerning mephedrone, alone or in combination with alcohol, common clinical features reported included agitation or aggression (n=32, 24%, 95% CI 18% to 33%), tachycardia (n=29, 22%, 95% CI 16% to 30%), confusion or psychosis (n=18, 14%, 95% CI 9% to 21%), chest pain (n=17, 13%, 95% CI 8% to 20%), nausea (n=15, 11%, 95% CI 7% to 18%), palpitations (n=14, 11%, 95% CI 6% to 18%), peripheral vasoconstriction (n=10, 8%, 95% CI 4% to 14%) and headache (n=7, 5%, 95% CI 2% to 11%). Convulsions were reported in four cases (3%, 95% CI 1% to 8%). One exposed person died following cardiac arrest (1%, 95% CI 0% to 4%), although subsequent investigation suggested that mephedrone was not responsible. Conclusions Toxicity associated with recreational mephedrone use is increasingly common in the UK. Sympathomimetic adverse effects are common and severe effects are also reported. Structured data collected by the NPIS may be of use in identifying trends in poisoning and in establishing toxidromes for new drugs of abuse. PMID:20798084

Maternal death from stroke: a thirty year national retrospective review.

PubMed

Foo, Lin; Bewley, Susan; Rudd, Anthony

2013-12-01

In the United Kingdom (UK), the maternal mortality rate from stroke is reported at 0.3/100,000 deliveries, but only antenatal data have previously been reviewed. We hypothesise that the true rate is much higher due to a propensity for stroke occurring in the post-partum period, and that the rate will rise in parallel with trends of increasing maternal age and medical co-morbidities. Our objectives are to investigate the UK stroke mortality rate in pregnancy and the puerperium, and to examine temporal changes in fatal maternal strokes over a 30 year period. Retrospective review of stroke-related maternal deaths reported to the UK confidential enquiries into maternal death between 1979 and 2008, encompassing 21,514,457 maternities. In accordance with the ICD.10 classification, cases were divided into direct or indirect deaths. Late and coincidental deaths were not included in analyses. Lessons from sub-standard care associated with maternal death from stroke were collated. In 1979-2008 there were 347 maternal deaths from stroke: 139 cases were direct deaths, i.e. the fatal stroke was a direct result of pregnancy. The incidence of fatal stroke is relatively constant at 1.61/100,000 maternities, with a 13.9% (95% CI 12.6-15.3) proportional mortality rate. Intracranial haemorrhage was the single greatest cause of maternal death from stroke. This is the largest UK study examining the incidence of fatal maternal stroke in pregnancy and the puerperium. Our results highlight the high proportion of women who die from stroke in the puerperium. Sub-standard care featured especially in regard to management of dangerously high systolic blood pressure levels. These deaths highlight the importance of education in managing rapid-onset hypertension and superimposed coagulopathies. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The Hidden Benefits of Part-Time Higher Education Study to Working Practices: Is There a Case for Making Them More Visible?

ERIC Educational Resources Information Center

Callender, Claire; Little, Brenda

2015-01-01

Within the UK, part-time study is now seen as important in meeting wider government objectives for higher education (HE) and for sustainable economic growth through skills development. Yet, measures to capture the impact of HE may not be wholly appropriate to part-time study. In particular, the continuing focus on tangible, economic measures may…

Information on 'Overdiagnosis' in Breast Cancer Screening on Prominent United Kingdom- and Australia-Oriented Health Websites

PubMed Central

Ghanouni, Alex; Meisel, Susanne F.; Hersch, Jolyn; Waller, Jo; Renzi, Cristina

2016-01-01

Objectives Health-related websites are an important source of information for the public. Increasing public awareness of overdiagnosis and ductal carcinoma in situ (DCIS) in breast cancer screening may facilitate more informed decision-making. This study assessed the extent to which such information was included on prominent health websites oriented towards the general public, and evaluated how it was explained. Design Cross-sectional study. Setting Websites identified through Google searches in England (United Kingdom) and New South Wales (Australia) for “breast cancer screening” and further websites included based on our prior knowledge of relevant organisations. Main Outcomes Content analysis was used to determine whether information on overdiagnosis or DCIS existed on each site, how the concepts were described, and what statistics were used to quantify overdiagnosis. Results After exclusions, ten UK websites and eight Australian websites were considered relevant and evaluated. They originated from charities, health service providers, government agencies, and an independent health organisation. Most contained some information on overdiagnosis (and/or DCIS). Descriptive information was similar across websites. Among UK websites, statistical information was often based on estimates from the Independent UK Panel on Breast Cancer Screening; the most commonly provided statistic was the ratio of breast cancer deaths prevented to overdiagnosed cases (1:3). A range of other statistics was included, such as the yearly number of overdiagnosed cases and the proportion of women screened who would be overdiagnosed. Information on DCIS and statistical information was less common on the Australian websites. Conclusions Online information about overdiagnosis has become more widely available in 2015–16 compared with the limited accessibility indicated by older research. However, there may be scope to offer more information on DCIS and overdiagnosis statistics on Australian websites. Moreover, the variability in how estimates are presented across UK websites may be confusing for the general public. PMID:27010593

The value of carbon sequestration and storage in coastal habitats

NASA Astrophysics Data System (ADS)

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

2014-01-01

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

The Case to Widen Defence Acquisition Research Paradigms

DTIC Science & Technology

2012-04-30

achieved in the delivery of government services (Steger & Roy, 2010). In the 1980s , the United Kingdom (UK) government gave expression to...motivation to work across conceptual divides as new knowledge and ideas are often generated within the spaces between disciplines ( Hislop , 2009). The...Advances in computers (pp. 293–392), 34. Hislop , D. (2009). Knowledge management in organizations: A critical introduction. Oxford, UK: Oxford

The Use of Social Marketing to Influence the Development of Problem Gambling in the UK: Implications for Public Health

ERIC Educational Resources Information Center

Powell, Jane E.; Tapp, Alan J.

2009-01-01

In this paper the authors present and debate the theoretical case for the use of social marketing to help reduce problem gambling in the public health context of the UK. Is triangulated between the key theories and principles of social marketing, the key literature and its theoretical application to the debate about reducing problem gambling in…

Promissory identities: Sociotechnical representations & innovation in regenerative medicine.

PubMed

Gardner, John; Higham, Ruchi; Faulkner, Alex; Webster, Andrew

2017-02-01

The field of regenerative medicine (RM) is championed as a potential source of curative treatments and economic wealth, and initiatives have been launched in several countries to facilitate innovation within the field. As a way of examining the social dimensions of innovation within regenerative medicine, this paper explores the sociotechnical representations of RM technologies in the UK, and the tensions, affordances and complexities these representations present for actors within the field. Specifically, the paper uses the Science and Technology Studies-inspired notions of 'technology identity' and 'development space' to examine how particular technologies are framed and positioned by actors, and how these positionings subsequently shape innovation pathways. Four developing RM technologies are used as case studies: bioengineered tracheas; autologous chondrocyte implantation; T-cell therapies; and a 'point-of-care' cell preparation device. Using these case studies we argue that there are particular identity aspects that have powerful performative effects and provide momentum to innovation projects, and we argue that there are particular stakeholders in the UK RM landscape who appear to have considerable power in shaping these technology identities and thus innovation pathways. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The projected health care burden of Type 2 diabetes in the UK from 2000 to 2060.

PubMed

Bagust, A; Hopkinson, P K; Maslove, L; Currie, C J

2002-07-01

To predict the incidence and prevalence of Type 2 diabetes in the UK, the trends in the levels of diabetes-related complications, and the associated health care costs for the period 2000-60. An established epidemiological and economic model of the long-term complications and health care costs of Type 2 diabetes was applied to UK population projections from 2000 to 2060. The model was used to calculate the incidence and prevalence of Type 2 diabetes, the caseloads and population burden for diabetes-related complications, and annual NHS health care costs for Type 2 diabetes over this time period. The total UK population will not increase by more than 3% at any time in the next 60 years. However, the population over 30 will increase by a maximum of 11% by 2030. Due to population ageing, in 2036 there will be approximately 20% more cases of Type 2 diabetes than in 2000. Cases of diabetes-related complications will increase rapidly to peak 20-30% above present levels between 2035 and 2045, before showing a modest decline. The cost of health care for patients with Type 2 diabetes rises by up to 25% during this period, but because of reductions in the economically active age groups, the relative economic burden of the disease can be expected to increase by 40-50%. In the next 30 years Type 2 diabetes will present a serious clinical and financial challenge to the UK NHS.

Orlistat and the risk of acute liver injury: self controlled case series study in UK Clinical Practice Research Datalink

PubMed Central

Langham, Julia; Bhaskaran, Krishnan; Brauer, Ruth; Smeeth, Liam

2013-01-01

Objective To measure the association between orlistat and acute liver injury. Design Self controlled case series study. Setting Population based primary care setting, United Kingdom. Participants 94 695 patients receiving orlistat and registered in the UK Clinical Practice Research Datalink and linked with Hospital Episode Statistics data between 1999 and 2011. Main outcome measure Relative incidence of acute liver injury comparing periods when patients were receiving orlistat with periods of non-usage. Results Among 94 695 patients who received orlistat, 988 cases of acute liver injury were identified, with 335 confirmed as definite cases and 653 as probable cases. For all cases an increased incidence of liver injury was detected during the 90 day period before orlistat was first started, with an incidence rate ratio of 1.50 (95% confidence interval 1.10 to 2.06). The incidence remained raised during the first 30 days of treatment (2.21, 1.43 to 3.42), before returning to baseline levels with prolonged treatment. When the risk during the first 90 days of treatment was compared with the 90 days preceding first treatment, the incidence of liver injury was not increased (1.02, 0.67 to 1.56). An analysis restricted to definite cases showed no evidence of an increased risk of liver injury during treatment. Conclusion The incidence of acute liver injury was higher in the periods both immediately before and immediately after the start of orlistat treatment. This suggests that the observed increased risks of liver injury linked to the start of treatment may reflect changes in health status associated with the decision to begin treatment rather than any causal effect of the drug. PMID:23585064

Selection of population controls for a Salmonella case-control study in the UK using a market research panel and web-survey provides time and resource savings.

PubMed

Mook, P; Kanagarajah, S; Maguire, H; Adak, G K; Dabrera, G; Waldram, A; Freeman, R; Charlett, A; Oliver, I

2016-04-01

Timely recruitment of population controls in infectious disease outbreak investigations is challenging. We evaluated the timeliness and cost of using a market research panel as a sampling frame for recruiting controls in a case-control study during an outbreak of Salmonella Mikawasima in the UK in 2013. We deployed a web-survey by email to targeted members of a market research panel (panel controls) in parallel to the outbreak control team interviewing randomly selected public health staff by telephone and completing paper-based questionnaires (staff controls). Recruitment and completion of exposure history web-surveys for panel controls (n = 123) took 14 h compared to 15 days for staff controls (n = 82). The average staff-time cost per questionnaire for staff controls was £13·13 compared to an invoiced cost of £3·60 per panel control. Differences in the distribution of some exposures existed between these control groups but case-control studies using each group found that illness was associated with consumption of chicken outside of the home and chicken from local butchers. Recruiting market research panel controls offers time and resource savings. More rapid investigations would enable more prompt implementation of control measures. We recommend that this method of recruiting controls is considered in future investigations and assessed further to better understand strengths and limitations.

Carotid endarterectomy in the U.K. and Ireland: audit of 30-day outcome. The Audit Committee for the Vascular Surgical Society.

PubMed

McCollum, P T; da Silva, A; Ridler, B D; de Cossart, L

1997-11-01

A prospective study of 709 patients undergoing carotid surgery in the U.K. and Ireland was performed to evaluate the performance of vascular surgeons. Fifty-nine surgeons (range 2-39 cases each) were sampled and all patients undergoing surgery over a 6-month period (1 March 1994-31 August 1994) were included in the study. Indications for surgery were TIA (35.9%), AF (23.3%), CVA (21.4%) and "others" (19.6%). Mean ipsilateral stenosis was 82% (30%-99%). Thirty-one percent of patients had preoperative neurological consults. Shunts were used in 67.6%, tacking sutures in 40.1%, drains in 71.9% and patches in 54.4% of cases. At 30 days there were nine (1.3%) deaths (four cardiac, three neurological). There were 15 ipsilateral postoperative CVAs (2.1%); 19% of patients had one or more complication, usually minor. Statistical analysis showed no independent risk factor for CVA other than seniority of the surgeon. A combined stroke/death rate of 3% for the series was obtained at 30 days for all cases. This large, validated study suggests that members of the Vascular Society of G.B. and Ireland currently have a very low morbidity/mortality rate for performing carotid surgery. Continued audit is required to ensure that this quality of service does not deteriorate.

Telling the Story of the Computer Geek: Children Becoming Authors and Translators

ERIC Educational Resources Information Center

Sneddon, Raymonde

2012-01-01

The paper offers a case study of two bilingual girls aged 10, born in London, of Albanian-speaking families who arrived in the UK as refugees. An earlier study, when the girls were aged six, explored the strategies they used as they learned to read with their mothers in Albanian using dual language books. Four years on, supported by a primary…

Investigating Provision and Impact of the Primary Physical Education and Sport Premium: A West Midlands Case Study

ERIC Educational Resources Information Center

Griggs, Gerald

2018-01-01

In March 2013, the UK government announced that it was to award the Primary Physical Education and Sport Premium funding to all English state-funded primary schools to improve provision of Physical Education and sport following the London 2012 Olympic Games. This study reports on seven schools in close geographical proximity to each other within…

The Role of the Company in Generating Skills. The Learning Effects of Work Organization in the United Kingdom.

ERIC Educational Resources Information Center

Walsh, Kenneth; Green, Andy; Steedman, Hilary

The impact of developments in work organizations on the skilling process in the United Kingdom was studied through a macro analysis of available statistical information about the development of workplace training in the United Kingdom and case studies of three U.K. firms. The macro analysis focused on the following: initial training arrangements;…

Using iPad-Based Mobile Learning to Teach Creative Engineering within a Problem-Based Learning Pedagogy

ERIC Educational Resources Information Center

Li, Yulong; Wang, Lixun

2018-01-01

This case study, noting the increasing interest in iPad-based mobile learning research and aware of the current dearth of engineering talent in the UK, aims to contribute to a still sparse area of research that links iPad use to engineering education. To achieve this, the study investigates the integration of iPad-based mobile learning…

10 Years of the LLAS eLearning Symposium: Case Studies in Good Practice

ERIC Educational Resources Information Center

Borthwick, Kate, Ed.; Corradini, Erika, Ed.; Dickens, Alison, Ed.

2015-01-01

This e-book is a celebration of and reflection on 10 years of the LLAS elearning symposium, an event which is run by the Centre for Languages, Linguistics and Area Studies (LLAS) based at the University of Southampton, UK. Over the past ten years, the symposium has followed the innovations brought about in the digital realm and has offered a…

Exploring Processes and Outcomes of Wireless Internet in Higher Education: A Case Study of a University's Early Experience

ERIC Educational Resources Information Center

Lee, Lisa

2007-01-01

Many universities in the UK have recently started offering their staff and students free wireless Internet access through Wireless Local Area Network (WLAN) technologies, such as Wi-Fi. Based on a small empirical study of WLAN deployment in a university setting, the article explores adoption processes of the new technology by both the organisation…

International stem cell collaboration: how disparate policies between the United States and the United Kingdom impact research.

PubMed

Luo, Jingyuan; Flynn, Jesse M; Solnick, Rachel E; Ecklund, Elaine Howard; Matthews, Kirstin R W

2011-03-08

As the scientific community globalizes, it is increasingly important to understand the effects of international collaboration on the quality and quantity of research produced. While it is generally assumed that international collaboration enhances the quality of research, this phenomenon is not well examined. Stem cell research is unique in that it is both politically charged and a research area that often generates international collaborations, making it an ideal case through which to examine international collaborations. Furthermore, with promising medical applications, the research area is dynamic and responsive to a globalizing science environment. Thus, studying international collaborations in stem cell research elucidates the role of existing international networks in promoting quality research, as well as the effects that disparate national policies might have on research. This study examined the impact of collaboration on publication significance in the United States and the United Kingdom, world leaders in stem cell research with disparate policies. We reviewed publications by US and UK authors from 2008, along with their citation rates and the political factors that may have contributed to the number of international collaborations. The data demonstrated that international collaborations significantly increased an article's impact for UK and US investigators. While this applied to UK authors whether they were corresponding or secondary, this effect was most significant for US authors who were corresponding authors. While the UK exhibited a higher proportion of international publications than the US, this difference was consistent with overall trends in international scientific collaboration. The findings suggested that national stem cell policy differences and regulatory mechanisms driving international stem cell research in the US and UK did not affect the frequency of international collaborations, or even the countries with which the US and UK most often collaborated. Geographical and traditional collaborative relationships were the predominate considerations in establishing international collaborations.

Food and beverage cues in UK and Irish children-television programming.

PubMed

Scully, Paul; Reid, Orlaith; Macken, Alan; Healy, Mark; Saunders, Jean; Leddin, Des; Cullen, Walter; Dunne, Colum; O'Gorman, Clodagh S

2014-11-01

Increased time in which children spend watching television is a well-described contributor to paediatric obesity. This study investigated the frequency and type of food and beverage placement in children-specific television broadcasts and compared data from UK (UK) and Irish television stations. Content analysis, totalling 82.5 h, reflecting 5 weekdays of children-specific television broadcasting on UK and Irish television channels was performed. To allow comparison between UK and Irish food and beverage cues, only broadcasts between 06.00 and 11.30 were analysed. Data were coded separately by two analysts and transferred to SPSS for analyses. Food and beverage cues were coded based on type of product, product placement, product use, motivation, outcome and characters involved. A total of 1155 food and beverage cues were recorded. Sweet snacks were the most frequent food cue (13.3%), followed by sweets/candy (11.4%). Tea/coffee was the most frequent beverage cue (13.5%), followed by sugar-sweetened beverages (13.0%). The outcome of the cue was positive in 32.6%, negative in 19.8%, and neutral in 47.5% of cases. The most common motivating factor associated with each cue was celebratory/social (25.2%), followed by hunger/thirst (25.0%). Comparison of UK and Irish placements showed both to portray high levels of unhealthy food cues. However, placements for sugar-sweetened beverages were relatively low on both channels. This study provides further evidence of the prominence of unhealthy foods in children's programming. These data may provide guidance for healthcare professionals, regulators and programme makers in planning for a healthier portrayal of food and beverage in children's television. 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.

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

PubMed Central

Exworthy, Mark; Blane, David; Marmot, Michael

2003-01-01

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

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

NASA Astrophysics Data System (ADS)

Rey Vicario, D.; Holman, I.

2016-12-01

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

International Stem Cell Collaboration: How Disparate Policies between the United States and the United Kingdom Impact Research

PubMed Central

Solnick, Rachel E.; Ecklund, Elaine Howard; Matthews, Kirstin R. W.

2011-01-01

As the scientific community globalizes, it is increasingly important to understand the effects of international collaboration on the quality and quantity of research produced. While it is generally assumed that international collaboration enhances the quality of research, this phenomenon is not well examined. Stem cell research is unique in that it is both politically charged and a research area that often generates international collaborations, making it an ideal case through which to examine international collaborations. Furthermore, with promising medical applications, the research area is dynamic and responsive to a globalizing science environment. Thus, studying international collaborations in stem cell research elucidates the role of existing international networks in promoting quality research, as well as the effects that disparate national policies might have on research. This study examined the impact of collaboration on publication significance in the United States and the United Kingdom, world leaders in stem cell research with disparate policies. We reviewed publications by US and UK authors from 2008, along with their citation rates and the political factors that may have contributed to the number of international collaborations. The data demonstrated that international collaborations significantly increased an article's impact for UK and US investigators. While this applied to UK authors whether they were corresponding or secondary, this effect was most significant for US authors who were corresponding authors. While the UK exhibited a higher proportion of international publications than the US, this difference was consistent with overall trends in international scientific collaboration. The findings suggested that national stem cell policy differences and regulatory mechanisms driving international stem cell research in the US and UK did not affect the frequency of international collaborations, or even the countries with which the US and UK most often collaborated. Geographical and traditional collaborative relationships were the predominate considerations in establishing international collaborations. PMID:21408134

Comparison of hospital variation in acute myocardial infarction care and outcome between Sweden and United Kingdom: population based cohort study using nationwide clinical registries.

PubMed

Chung, Sheng-Chia; Sundström, Johan; Gale, Chris P; James, Stefan; Deanfield, John; Wallentin, Lars; Timmis, Adam; Jernberg, Tomas; Hemingway, Harry

2015-08-07

To assess the between hospital variation in use of guideline recommended treatments and clinical outcomes for acute myocardial infarction in Sweden and the United Kingdom. Population based longitudinal cohort study using nationwide clinical registries. Nationwide registry data comprising all hospitals providing acute myocardial infarction care in Sweden (SWEDEHEART/RIKS-HIA, n=87; 119,786 patients) and the UK (NICOR/MINAP, n=242; 391,077 patients), 2004-10. Between hospital variation in 30 day mortality of patients admitted with acute myocardial infarction. Case mix standardised 30 day mortality from acute myocardial infarction was lower in Swedish hospitals (8.4%) than in UK hospitals (9.7%), with less variation between hospitals (interquartile range 2.6% v 3.5%). In both countries, hospital level variation and 30 day mortality were inversely associated with provision of guideline recommended care. Compared with the highest quarter, hospitals in the lowest quarter for use of primary percutaneous coronary intervention had higher volume weighted 30 day mortality for ST elevation myocardial infarction (10.7% v 6.6% in Sweden; 12.7% v 5.8% in the UK). The adjusted odds ratio comparing the highest with the lowest quarters for hospitals' use of primary percutaneous coronary intervention was 0.70 (95% confidence interval 0.62 to 0.79) in Sweden and 0.68 (0.60 to 0.76) in the UK. Differences in risk between hospital quarters of treatment for non-ST elevation myocardial infarction and secondary prevention drugs for all discharged acute myocardial infarction patients were smaller than for reperfusion treatment in both countries. Between hospital variation in 30 day mortality for acute myocardial infarction was greater in the UK than in Sweden. This was associated with, and may be partly accounted for by, the higher practice variation in acute myocardial infarction guideline recommended treatment in the UK hospitals. High quality healthcare across all hospitals, especially in the UK, with better use of guideline recommended treatment, may not only reduce unacceptable practice variation but also deliver improved clinical outcomes for patients with acute myocardial infarction. Clinical trials registration Clinical trials NCT01359033. © Chung et al 2015.

The rhetoric of caring and the recruitment of overseas nurses: the social production of a care gap.

PubMed

Allan, Helen

2007-12-01

I will argue that overseas nurse recruitment is the consequence of a care gap, which arose from several policy shifts in the 1990s and in part from the rhetoric of a normative moral discourse in the UK which claims that caring is the moral essence of nursing. I will suggest that this discourse has masked the uncoupling of caring from nursing practice and that this uncoupling places the overseas nurses in a contradictory position. In an increasingly competitive global labour market, the UK is faced with a nursing shortage and has been recruiting trained nurses from abroad (NMC 1993-2002). This paper is based on two related, qualitative studies using semi-structured focus groups and individual interviews. The first explored the experiences of overseas nurses in the UK and the second investigated the equal opportunities and career progression of overseas nurses in the UK. The data from these studies challenge the normative UK value that caring is at the heart of nursing. These data are the lens through which we see this contradiction explicitly played out. Overseas nurses observe that caring (as undertaken by health care assistants in care homes) is not nursing yet caring is being passed down the line as a process that marginalizes the overseas nurses and at the same time devalues their skills. I do not argue that overseas nurses care at a higher standard (although this may be the case) just that they care differently, that they expected UK nurses to deliver basic care and, instead, experience UK nursing practice as less autonomous and of a lower standard than they expected. I argue that the overseas nurses' views help us understand the processes by which the uncoupling of caring from nursing has come about. This paper discusses a workforce issue which is directly relevant to clinical practice because it focuses on the meaning of care; what is caring, what are caring activities and how are these represented in the discourse on caring in the literature? This paper also reveals significant worries among nursing managers about how to staff the nursing workforce and what nurses should be doing in the clinical areas.

Adverse social circumstances and depression in people of Pakistani origin in the UK.

PubMed

Husain, N; Creed, F; Tomenson, B

1997-11-01

The social origins of depression in people of Pakistani origin in the UK are not fully understood; they may not be the same as for the indigenous White population. Patients attending a GP's surgery were screened with the Personal Health Questionnaire to detect depressive illness, which was confirmed using the Psychiatric Assessment Schedule; the estimated prevalence of major depression was 42%. Forty-four people with depression and 33 non-depressed comparison subjects were successfully interviewed using the Life Event and Difficulty Schedule, either in Urdu or English. Seventy-five per cent of the sample were Pakistani born; 57% of cases and 33% of non-cases spoke English with difficulty. Seventy-five per cent of the cases and 36% of the non-cases had experienced an independent severe event and/or a major difficulty (P = 0.0015). Difficulties associated with depression were most commonly in the marital, health and housing categories; overt racial harassment and discrimination were rare. This is a preliminary study because of the small sample of GP attenders. The somatic presentation of depression in this population is clear. Acceptable forms of social support and help with marital, housing and employment problems will be needed to help relieve the depression in this population.

Understanding general practice: a conceptual framework developed from case studies in the UK NHS.

PubMed

Checkland, Kath

2007-01-01

General practice in the UK is undergoing a period of rapid and profound change. Traditionally, research into the effects of change on general practice has tended to regard GPs as individuals or as members of a professional group. To understand the impact of change, general practices should also be considered as organisations. To use the organisational studies literature to build a conceptual framework of general practice organisations, and to test and develop this empirically using case studies of change in practice. This study used the implementation of National Service Frameworks (NSFs) and the new General Medical Services (GMS) contract as incidents of change. In-depth, qualitative case studies. The design was iterative: each case study was followed by a review of the theoretical ideas. The final conceptual framework was the result of the dynamic interplay between theory and empirical evidence. Five general practices in England, selected using purposeful sampling. Semi-structured interviews with all clinical and managerial personnel in each practice, participant and nonparticipant observation, and examination of documents. A conceptual framework was developed that can be used to understand how and why practices respond to change. This framework enabled understanding of observed reactions to the introduction of NSFs and the new GMS contract. Important factors for generating responses to change included the story that the practice members told about their practice, beliefs about what counted as legitimate work, the role played by the manager, and previous experiences of change. Viewing general practices as small organisations has generated insights into factors that influence responses to change. Change tends to occur from the bottom up and is determined by beliefs about organisational reality. The conceptual framework suggests some questions that can be asked of practices to explain this internal reality.

Fly Caught in Foreskin: An Usual Case of Preputial Myiasis

PubMed Central

Parkinson, Richard J; Robinson, Simon; Lessells, Richard; Lemberger, John

2008-01-01

Cutaneous bot fly infestation is common in travellers to Mexico and Central America. Myiasis affecting the genitalia is rare, however, with few previous reports. We document an unusual case in Nottingham, UK PMID:18492386

The management and outcomes of placenta accreta, increta, and percreta in the UK: a population-based descriptive study

PubMed Central

Fitzpatrick, KE; Sellers, S; Spark, P; Kurinczuk, JJ; Brocklehurst, P; Knight, M

2014-01-01

Objective To describe the management and outcomes of placenta accreta, increta, and percreta in the UK. Design A population-based descriptive study using the UK Obstetric Surveillance System (UKOSS). Setting All 221 UK hospitals with obstetrician-led maternity units. Population All women diagnosed with placenta accreta, increta, and percreta in the UK between May 2010 and April 2011. Methods Prospective case identification through the monthly mailing of UKOSS. Main outcome measures Median estimated blood loss, transfusion requirements. Results A cohort of 134 women were identified with placenta accreta, increta, or percreta: 50% (66/133) were suspected to have this condition antenatally. In women with a final diagnosis of placenta increta or percreta, antenatal diagnosis was associated with reduced levels of haemorrhage (median estimated blood loss 2750 versus 6100 ml, P = 0.008) and a reduced need for blood transfusion (59 versus 94%, P = 0.014), possibly because antenatally diagnosed women were more likely to have preventative therapies for haemorrhage (74 versus 52%, P = 0.007), and were less likely to have an attempt made to remove their placenta (59 versus 93%, P < 0.001). Making no attempt to remove any of the placenta, in an attempt to conserve the uterus or prior to hysterectomy, was associated with reduced levels of haemorrhage (median estimated blood loss 1750 versus 3700 ml, P = 0.001) and a reduced need for blood transfusion (57 versus 86%, P < 0.001). Conclusions Women with placenta accreta, increta, or percreta who have no attempt to remove any of their placenta, with the aim of conserving their uterus, or prior to hysterectomy, have reduced levels of haemorrhage and a reduced need for blood transfusion, supporting the recommendation of this practice. PMID:23924326

The management and outcomes of placenta accreta, increta, and percreta in the UK: a population-based descriptive study.

PubMed

Fitzpatrick, K E; Sellers, S; Spark, P; Kurinczuk, J J; Brocklehurst, P; Knight, M

2014-01-01

To describe the management and outcomes of placenta accreta, increta, and percreta in the UK. A population-based descriptive study using the UK Obstetric Surveillance System (UKOSS). All 221 UK hospitals with obstetrician-led maternity units. All women diagnosed with placenta accreta, increta, and percreta in the UK between May 2010 and April 2011. Prospective case identification through the monthly mailing of UKOSS. Median estimated blood loss, transfusion requirements. A cohort of 134 women were identified with placenta accreta, increta, or percreta: 50% (66/133) were suspected to have this condition antenatally. In women with a final diagnosis of placenta increta or percreta, antenatal diagnosis was associated with reduced levels of haemorrhage (median estimated blood loss 2750 versus 6100 ml, P = 0.008) and a reduced need for blood transfusion (59 versus 94%, P = 0.014), possibly because antenatally diagnosed women were more likely to have preventative therapies for haemorrhage (74 versus 52%, P = 0.007), and were less likely to have an attempt made to remove their placenta (59 versus 93%, P < 0.001). Making no attempt to remove any of the placenta, in an attempt to conserve the uterus or prior to hysterectomy, was associated with reduced levels of haemorrhage (median estimated blood loss 1750 versus 3700 ml, P = 0.001) and a reduced need for blood transfusion (57 versus 86%, P < 0.001). Women with placenta accreta, increta, or percreta who have no attempt to remove any of their placenta, with the aim of conserving their uterus, or prior to hysterectomy, have reduced levels of haemorrhage and a reduced need for blood transfusion, supporting the recommendation of this practice. © 2013 RCOG.

The UK Out of Hospital Cardiac Arrest Outcome (OHCAO) project.

PubMed

Perkins, Gavin D; Brace-McDonnell, Samantha J

2015-10-01

Reducing premature death is a key priority for the UK National Health Service (NHS). NHS Ambulance services treat approximately 30 000 cases of suspected cardiac arrest each year but survival rates vary. The British Heart Foundation and Resuscitation Council (UK) have funded a structured research programme--the Out of Hospital Cardiac Arrest Outcomes (OHCAO) programme. The aim of the project is to establish the epidemiology and outcome of OHCA, explore sources of variation in outcome and establish the feasibility of setting up a national OHCA registry. This is a prospective observational study set in UK NHS Ambulance Services. The target population will be adults and children sustaining an OHCA who are attended by an NHS ambulance emergency response and where resuscitation is attempted. The data collected will be characterised broadly as system characteristics, emergency medical services (EMS) dispatch characteristics, patient characteristics and EMS process variables. The main outcome variables of interest will be return of spontaneous circulation and medium-long-term survival (30 days to 10-year survival). Ethics committee permissions were gained and the study also has received approval from the Confidentiality Advisory Group Ethics and Confidentiality committee which provides authorisation to lawfully hold identifiable data on patients without their consent. To identify the key characteristics contributing to better outcomes in some ambulance services, reliable and reproducible systems need to be established for collecting data on OHCA in the UK. Reports generated from the registry will focus on data completeness, timeliness and quality. Subsequent reports will summarise demographic, patient, process and outcome variables with aim of improving patient care through focus quality improvement initiatives. 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.

Diversity in the Academy? Staff Perceptions of Equality Policies in Six Contemporary Higher Education Institutions

ERIC Educational Resources Information Center

Deem, Rosemary; Morley, Louise

2006-01-01

The article is based on recent research involving qualitative case studies of staff experiences of equality policies in six English, Scottish and Welsh higher education institutions (HEIs). Recent changes to UK legislation (e.g. on "race" and disability) and a series of European Union employment directives (including on religion and…

Gendered Transitions, Career Identities and Possible Selves: The Case of Engineering Graduates

ERIC Educational Resources Information Center

Papafilippou, Vanda; Bentley, Laura

2017-01-01

This article, drawing upon the Paired Peers project, a longitudinal qualitative study (n = 90), examines how seven UK engineering graduates, four women and three men, construct their career identities during the transitionary period from university to work. It explores how gender and the occupational cultures that reside within the sector, and the…

Negotiating Pragmatic Competence in Computer Mediated Communication: The Case of Korean Address Terms

ERIC Educational Resources Information Center

Kim, Eun Young; Brown, Lucien

2014-01-01

This paper examines how L2 learners of Korean manifest pragmatic competence in their use of address terms in computer mediated communication (CMC) and how they use these terms to negotiate their identities. Four UK-based learners of Korean with competence levels ranging from Novice High through Intermediate High participated in the study,…

Does the Gender of Examiners Influence Their Marking?

ERIC Educational Resources Information Center

Greatorex, Jackie; Bell, John

2004-01-01

For many years there has been concern about whether sex bias exists in various assessments. A literature review reveals little if any sex bias in UK national assessments at GCSE. Oxford, Cambridge and RSA examiners, for three case study subjects, completed the Bem Sex Role Inventory, a self-report inventory that measures the extent to which…

Supporting Both Learning and Research in a UK Post-1992 University Library: A Case Study

ERIC Educational Resources Information Center

Wakeham, Maurice; Garfield, Diana

2005-01-01

Nationally, there has been debate on the role of research within higher education and increased interest in the teaching/research nexus. A team of Academic Liaison Librarians at Anglia Polytechnic University was awarded funding to investigate the extent to which learning resources overlap with research resources, whether researcher/teachers…

Online Library Accessibility Support: A Case Study within the Open University Library

ERIC Educational Resources Information Center

Mears, Wendy; Clough, Helen

2015-01-01

The Open University (OU) is the UK's largest distance education provider and has a large and growing disabled student population. Disabled user support presents particular challenges for an online library service in the distance learning environment. The OU introduced guidelines for working with non-OU--authored content (external content) in 2011…

Understanding, Evidencing, and Promoting Adolescent Well-Being: An Emerging Agenda for Schools

ERIC Educational Resources Information Center

Matthews, Nic; Kilgour, Lindsey; Christian, Polly; Mori, Kate; Hill, Denise M.

2015-01-01

The well-being of young people is of considerable concern with many initiatives targeting the health behaviors of this population. Educators are among the professional groups being challenged to understand, evidence, and enhance childhood well-being. Working with a case study U.K. school adolescent subjective well-being (SWB) was examined through…

Teacher and Student Perceptions of the Development of Learner Autonomy; A Case Study in the Biological Sciences

ERIC Educational Resources Information Center

Scott, G. W.; Furnell, J.; Murphy, C. M.; Goulder, R.

2015-01-01

Biology teachers in a UK university expressed a majority view that student learning autonomy increases with progression through university. A minority suggested that pre-existing diversity in learning autonomy was more important and that individuals not cohorts differ in their learning autonomy. They suggested that personal experience prior to…

Whose Job Is It? Exploring Subject Tutor Roles in Addressing Students' Academic Writing via Essay Feedback

ERIC Educational Resources Information Center

Court, Krista; Johnson, Helen

2016-01-01

Strong arguments have been forwarded for embedding academic writing development into the UK higher education curriculum and for subject tutors to facilitate this development (Hyland, 2000; Lea & Street, 2006; Monroe, 2003; Wingate, 2006). This small-scale case study explores subject tutors' practices and beliefs with regard to the provision of…

Housing Mix, School Mix: Barriers to Success

ERIC Educational Resources Information Center

Camina, M. M.; Iannone, P.

2014-01-01

Recent UK policy has emphasised both the development of socially mixed communities and the creation of balanced school intakes. In this paper, we use a case study of an area of mixed tenure in eastern England to explore policy in practice and the extent to which mechanisms of segregation impact on both the creation of socially mixed neighbourhoods…

Developing School Students' Identity and Engagement through Lifestyle Sports: A Case Study of Unicycling

ERIC Educational Resources Information Center

Bignold, Wendy J.

2013-01-01

This article emerges from a background of UK policy concerns about young people's participation in physical activity. It rehearses the arguments for lifestyle sports as a rich ground for enhancing students' engagement with physical education (PE). A review of the still limited literature suggests that lifestyle sports may have an under-exploited…

Teachers' Stories of Change: Stress, Care and Economic Rationality

ERIC Educational Resources Information Center

Easthope, Chris; Easthope, Gary

2007-01-01

The impact of economic rationalism on teachers' working lives has been documented extensively, particularly in the UK. This article provides a case study of its impact in the early 1990s in a small Australian state, Tasmania, to illustrate that although the particular institutional forms through which it is expressed may differ its impact is…

"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…

Language Learning and the Raising of Cultural Awareness through Internet Telephony: A Case Study

ERIC Educational Resources Information Center

Polisca, Elena

2011-01-01

This article seeks to assess the impact of V-Pal (Virtual Partnerships for All Languages) on the student language learning experience within a conventional UK higher education (HE) curriculum. V-Pal is an innovative computer-mediated language scheme, based on a reciprocal, distance-learning language project, run by the University of Manchester in…

A Case Study of Issues of Strategy Implementation in Internationalization of Higher Education

ERIC Educational Resources Information Center

Jiang, Nan; Carpenter, Victoria

2013-01-01

Purpose: The purpose of this research is to identify and critically evaluate key issues faced by an institution in the quest to implement higher education internationalization. Design/methodology/approach: A qualitative research is conducted in a post-1992 UK university. A total of 20 interviewees from three key departments participated in this…

The School Choice Market in China: A Case Study

ERIC Educational Resources Information Center

Wu, Xiaoxin

2013-01-01

Background: In contrast to the top-down government-designated school choice programmes in many countries, e.g. in the UK and USA in particular, school choice in the Chinese context is a bottom-up movement initiated by parents and is characterised by the payment of a substantial "choice fee" to the preferred school, and by competition by…

Creating and Nurturing a Community of Practice for Language Teachers in Higher Education

ERIC Educational Resources Information Center

MacKinnon, Teresa

2013-01-01

This case study investigates the implementation of a virtual learning environment designed for language teachers for an institution-wide language programme in a UK higher education institution. This development has taken place over a 3 year period and included a pilot virtual learning environment for 300, followed by a full implementation to more…

Think Tanks as Research Mediators? Case Studies from Public Health

ERIC Educational Resources Information Center

Smith, Katherine E.; Kay, Louise; Torres, Jennifer

2013-01-01

The number of think tanks operating in the UK is increasing, providing an ever important source of ideas and research for policy audiences. They have been framed by some as useful intermediaries between research and policy, which academics aiming to influence policy might seek to emulate. Yet, there has been very little empirical work to explore…

Selecting a Suitable Cloud Computing Technology Deployment Model for an Academic Institute : A Case Study

ERIC Educational Resources Information Center

Ramachandran, N.; Sivaprakasam, P.; Thangamani, G.; Anand, G.

2014-01-01

Purpose: Cloud Computing (CC) technology is getting implemented rapidly in the educational sector to improve learning, research and other administrative process. As evident from the literature review, most of these implementations are happening in the western countries such as USA, UK, while the level of implementation of CC in developing…

The experience of international nursing students studying for a PhD in the U.K: A qualitative study

PubMed Central

2011-01-01

Background Educating nurses to doctoral level is an important means of developing nursing capacity globally. There is an international shortage of doctoral nursing programmes, hence many nurses seek their doctorates overseas. The UK is a key provider of doctoral education for international nursing students, however, very little is known about international doctoral nursing students' learning experiences during their doctoral study. This paper reports on a national study that sought to investigate the learning expectations and experiences of overseas doctoral nursing students in the UK. Methods Semi-structured qualitative interviews were conducted in 2008/09 with 17 international doctoral nursing students representing 9 different countries from 6 different UK universities. Data were analysed thematically. All 17 interviewees were enrolled on 'traditional' 3 year PhD programmes and the majority (15/17) planned to work in higher education institutions back in their home country upon graduation. Results Studying for a UK PhD involved a number of significant transitions, including adjusting to a new country/culture, to new pedagogical approaches and, in some cases, to learning in a second language. Many students had expected a more structured programme of study, with a stronger emphasis on professional nursing issues as well as research - akin to the professional doctorate. Students did not always feel well integrated into their department's wider research environment, and wanted more opportunities to network with their UK peers. A good supervision relationship was perceived as the most critical element of support in a doctoral programme, but good relationships were sometimes difficult to attain due to differences in student/supervisor expectations and in approaches to supervision. The PhD was perceived as a difficult and stressful journey, but those nearing the end reflected positively on it as a life changing experience in which they had developed key professional and personal skills. Conclusions Doctoral programmes need to ensure that structures are in place to support international students at different stages of their doctoral journey, and to support greater local-international student networking. Further research is needed to investigate good supervision practice and the suitability of the PhD vis a vis other doctoral models (e.g. the professional doctorate) for international nursing students. PMID:21668951

Mechanism of concave ``tafoni'' and convex ``domal shape'' formation on TRIASSIC red sandstone of some old buildings, Chester City, UK, Case study

NASA Astrophysics Data System (ADS)

Kamh, G. M. E.

2005-08-01

The weathering factors act on the recent and archaeological sites through different processes based on the dominant environmental conditions. The net result of weathering is deformation of the original form of construction rock. In the current case study, the main aim is to find out the mechanism of formation of two different weathering forms recorded on many old buildings taking Chester City as a case study. The construction rock in the case study is arenitic sandstone with carbonate content ranging from 0.0 to 15.6%. The sandstone blocks are cemented together by hydraulic lime mortar that can easily be altered chemically to salts by acid rain that dominates at the study area. In case of mortar with worse geotechnical limits than the sandstone blocks, the net result is convex “domal” shape blocks, but in case of mortar with better geotechnical limits than the construction sandstone, the net result of weathering is tafoni “concave” weathering form.

Development of an e-learning package for sepsis care.

PubMed

Davis, Anna; Henderson, James; Langmack, Gill

Severe sepsis is a major cause of morbidity and mortality in the UK. This article describes the collaborative development and implementation of an interactive online learning package to understand the key role nurses have in recognising and then starting to apply the Sepsis Six care bundle in clinical practice. The e-learning package, developed in a UK teaching hospital, uses a case study approach to address the knowledge that is required to be able to recognise sepsis, to understand the processes that occur and the ongoing care and treatment required. The package is relevant to final-year student nurses, newly registered nurses in preceptorship and other health professionals involved in assessing and treating patients who may be developing sepsis.

Role of mtDNA haplogroups in the prevalence of osteoarthritis in different geographic populations: a meta-analysis.

PubMed

Shen, Jin-Ming; Feng, Lei; Feng, Chun

2014-01-01

Osteoarthritis (OA) is the most common form of arthritis and has become an increasingly important public-health problem. However, the pathogenesis of OA is still unclear. In recent years, its correlation with mtDNA haplogroups attracts much attention. We aimed to perform a meta-analysis to investigate the association between mtDNA haplogroups and OA. Published English or Chinese literature from PubMed, Web of Science, SDOS, and CNKI was retrieved up until April 15, 2014. Case-control or cohort studies that detected the frequency of mtDNA haplogroups in OA patients and controls were included. The quality of the included studies was evaluated by the Newcastle-Ottawa Scale (NOS) assessment. A meta-analysis was conducted to calculate pooled odds ratio (OR) with 95% confidence interval (CI) through the random or fixed effect model, which was selected based on the between-study heterogeneity assessed by Q test and I2 test. Subgroup analysis was performed to explore the origin of heterogeneity. A total of 6 case-control studies (10590 cases and 7161 controls) with an average NOS score of 6.9 were involved. For the analysis between mtDNA haplogroup J and OA, random model was selected due to high heterogeneity. No significant association was found initially (OR = 0.73, 95%CI: 0.52-1.03), however, once any study from UK population was removed the association emerged. Further subgroup analysis demonstrated that there was a significant association in Spain population (OR = 0.57, 95%CI: 0.46-0.71), but not in UK population. Also, subgroup analysis revealed that there was a significant correlation between cluster TJ and OA in Spain population (OR = 0.70, 95%CI: 0.58-0.84), although not in UK population. No significant correlation was found between haplogroup T/cluster HV/cluster KU and OA. Our current meta-analysis suggests that mtDNA haplogroup J and cluster TJ correlate with the risk of OA in Spanish population, but the associations in other populations require further investigation.

Tracking and responding to an outbreak of tuberculosis using MIRU-VNTR genotyping and whole genome sequencing as epidemiological tools.

PubMed

Black, Anne T; Hamblion, Esther L; Buttivant, Helen; Anderson, Sarah R; Stone, Madeline; Casali, Nicola; Drobniewski, Francis; Nwoguh, Francisca; Marshall, Ben G; Booth, Linda

2017-07-05

We describe an outbreak that contributed to a near doubling of the incidence of tuberculosis in Southampton, UK. We examine the importance of 24 locus mycobacterial interspersed repetitive unit variable number tandem repeat (MIRU-VNTR) genotyping in its identification and management and the role of whole genome sequencing (WGS) in tracing the spread of the strain. Outbreak cases were defined as those diagnosed between January and December 2011 with indistinguishable 24 locus-MIRU-VNTR genotypes or, cases linked epidemiologically. A cluster questionnaire was administered by TB nurses to identify contacts and social settings. Overall, 25 patients fulfilled the case definition. No cases with this MIRU-VNTR genotype had been detected in the UK previously. Connections were found between all cases through household contacts or social venues including a football club, Internet cafe and barber's shop. Public health actions included extended contact tracing, venue screening and TB awareness-raising. The outbreak resulted in a high rate of transmission and high incidence of clinical disease among contacts. This outbreak illustrates the value of combining active case-finding with prospective MIRU-VNTR genotyping to identify settings to undertake public health action. In addition WGS revealed that the VNTR-defined cluster was a single outbreak and that active TB transmission not reactivation was responsible for this outbreak in non-UK born individuals. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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

PubMed

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

2009-12-21

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

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

[Investigation of the age-dependent development of brachygnathia inferior in the East Friesian milk sheep].

PubMed

Pielmeier, Ricarda; Kerkmann, Andrea; Distl, Ottmar

2012-01-01

Shortness of the lower jaw (brachygnathia inferior, underbite) is a common anomaly in sheep. In order to study the age-dependent development of brachygnathia inferior, data of 73 East Friesian milk sheep from a breeding experiment over six generations were analysed. Data were recorded in regular intervals of four weeks from birth up to an age of at least 25 weeks. Brachygnathia inferior was determined by the distance between the edge of the central incisor of the lower jaw and the anterior surrounding of the upper jaw (DIFF-UK) using a measuring tape. Four main types of brachygnathia inferior were distinguished using means, standard deviations and maximum values of the individual animals.The thresholds were a maximum and mean DIFF-UK of 0.5 cm and a standard deviation of 0.266 cm. A total of 14 sheep (main types 3 and 4) showed an obvious brachygnathia inferior with mean DIFF-UK larger than 0.5 cm whereof ten animals showed a large variation of DIFF-UK values (standard deviation > 0.226 cm). Mean DIFF-UK values of 59 sheep were smaller than 0.5 cm (main types 1 and 2). One of these 59 animals had during the first four weeks of life DIFF-UK values of 1 cm and than decreasing values reaching zero within the next nine months (main type 2). Five of the 58 animals with main type 1 had a perfect occlusion of jaws, all with DIFF-UK values at zero during the whole recording period. Parents with severe or mild brachygnathia inferior had severely affected progeny. Selection of sheep for breeding with a perfect occlusion of jaws decreases the risk to pass on the hereditary disposition for brachygnathia inferior. An early inspection of potential breeding animals is advisable to detect all cases of brachygnathia inferior even if the underbite decreases in the first year of life.

Health visiting assessment--unpacking critical attributes in health visitor needs assessment practice: a case study.

PubMed

Appleton, Jane V; Cowley, Sarah

2008-02-01

Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK. The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry. A case study design informed by a constructivist methodology was used to examine health visitors' professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support. The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site. Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place. The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors' assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.

Risk factors for first trimester miscarriage--results from a UK-population-based case-control study.

PubMed

Maconochie, N; Doyle, P; Prior, S; Simmons, R

2007-02-01

The aim of this study was to examine the association between biological, behavioural and lifestyle risk factors and risk of miscarriage. Population-based case-control study. Case-control study nested within a population-based, two-stage postal survey of reproductive histories of women randomly sampled from the UK electoral register. Six hundred and three women aged 18-55 years whose most recent pregnancy had ended in first trimester miscarriage (<13 weeks of gestation; cases) and 6116 women aged 18-55 years whose most recent pregnancy had progressed beyond 12 weeks (controls). Women were questioned about socio-demographic, behavioural and other factors in their most recent pregnancy. First trimester miscarriage. After adjustment for confounding, the following were independently associated with increased risk: high maternal age; previous miscarriage, termination and infertility; assisted conception; low pre-pregnancy body mass index; regular or high alcohol consumption; feeling stressed (including trend with number of stressful or traumatic events); high paternal age and changing partner. Previous live birth, nausea, vitamin supplementation and eating fresh fruits and vegetables daily were associated with reduced risk, as were feeling well enough to fly or to have sex. After adjustment for nausea, we did not confirm an association with caffeine consumption, smoking or moderate or occasional alcohol consumption; nor did we find an association with educational level, socio-economic circumstances or working during pregnancy. The results confirm that advice to encourage a healthy diet, reduce stress and promote emotional wellbeing might help women in early pregnancy (or planning a pregnancy) reduce their risk of miscarriage. Findings of increased risk associated with previous termination, stress, change of partner and low pre-pregnancy weight are noteworthy, and we recommend further work to confirm these findings in other study populations.

Proton pump inhibitor and histamine-2 receptor antagonist use and risk of liver cancer in two population-based studies.

PubMed

Tran, K T; McMenamin, Ú C; Hicks, B; Murchie, P; Thrift, A P; Coleman, H G; Iversen, L; Johnston, B T; Lee, A J; Cardwell, C R

2018-05-09

Proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) are commonly used. PPIs have been shown to promote liver cancer in rats; however, only one study has examined the association in humans. To investigate PPIs and H2RAs and risk of primary liver cancer in two large independent study populations. We conducted a nested case-control study within the Primary Care Clinical Informatics Unit (PCCIU) database in which up to five controls were matched to cases with primary liver cancer, recorded by General Practitioners. Odds ratios (ORs) and 95% confidence intervals (95% CIs) for associations with prescribed PPIs and H2RAs were calculated using conditional logistic regression. We also conducted a prospective cohort study within the UK Biobank using self-reported medication use and cancer-registry recorded primary liver cancer. Hazard ratios (HRs) and 95% CIs were calculated using Cox regression. In the PCCIU case-control analysis, 434 liver cancer cases were matched to 2103 controls. In the UK Biobank cohort, 182 of 475 768 participants developed liver cancer. In both, ever use of PPIs was associated with increased liver cancer risk (adjusted OR 1.80, 95% CI 1.34, 2.41 and adjusted HR 1.99, 95% CI 1.34, 2.94 respectively). There was little evidence of association with H2RA use (adjusted OR 1.21, 95% CI 0.84, 1.76 and adjusted HR 1.70, 95% CI 0.82, 3.53 respectively). We found some evidence that PPI use was associated with liver cancer. Whether this association is causal or reflects residual confounding or reverse causation requires additional research. © 2018 John Wiley & Sons Ltd.

Cost of Stem Cell-Based Tissue-Engineered Airway Transplants in the United Kingdom: Case Series

PubMed Central

Culme-Seymour, Emily J.; Mason, Katrina; Vallejo-Torres, Laura; Carvalho, Carla; Partington, Leanne; Crowley, Claire; Hamilton, Nick J.; Toll, Ed C.; Butler, Colin R.; Elliott, Martin J.; Birchall, Martin A.; Lowdell, Mark W.

2016-01-01

Stem cell-based tissue-engineered tracheas are at an early stage in their product development cycle. Tens of patients have been treated worldwide in predominantly compassionate use settings, demonstrating significant promise. This potentially life-saving treatment is complex, and the cost and its implications for such treatments are yet to be fully understood. The costs are compounded by varying strategies for graft preparation and transplant, resulting in differing clinical and laboratory costs from different research groups. In this study, we present a detailed breakdown of the clinical and manufacturing costs for three of the United Kingdom (UK) patients treated with such transplants. All three patients were treated under Compassionate Use legislation, within the UK National Health Service (NHS) hospital setting. The total costs for the three UK patients treated ranged from $174,420 to $740,500. All three patients were in a state of poor health at time of treatment and had a number of complexities in addition to the restricted airway. This is the first time a cost analysis has been made for a tissue-engineered organ and provides a benchmark for future studies, as well as comparative data for use in reimbursement considerations. PMID:26559535

Multiple vaccinations, health, and recall bias within UK armed forces deployed to Iraq: cohort study.

PubMed

Murphy, Dominic; Hotopf, Matthew; Wessely, Simon

2008-06-30

To assess the relation between self reported number of vaccinations received and health, and between numbers of vaccinations recorded from individuals' medical records and health. First phase of a cohort study. UK armed forces personnel. 4882 randomly selected military personnel deployed to Iraq since 2003 and a subset of 378 whose vaccination records were accessed. Psychological distress, fatigue, symptoms of post-traumatic stress disorder, health perception, and multiple physical symptoms. Personnel who reported receiving two or more vaccinations on a single day were more likely to report symptoms of fatigue (adjusted risk ratio 1.17, 95% confidence interval 1.05 to 1.30), show caseness according to the general health questionnaire (1.31, 1.13 to 1.53), and have multiple physical symptoms (1.32, 1.08 to 1.60). These associations were no longer significant when number of vaccinations recorded in individuals' medical records was used as the independent variable. Multiple vaccinations given to personnel in the UK armed forces in preparation for deployment to Iraq are not associated with adverse health consequences when vaccinations are recorded objectively from medical records. Adverse health consequences associated with self reported multiple vaccinations could be explained by recall bias.

Cost of Stem Cell-Based Tissue-Engineered Airway Transplants in the United Kingdom: Case Series.

PubMed

Culme-Seymour, Emily J; Mason, Katrina; Vallejo-Torres, Laura; Carvalho, Carla; Partington, Leanne; Crowley, Claire; Hamilton, Nick J; Toll, Ed C; Butler, Colin R; Elliott, Martin J; Birchall, Martin A; Lowdell, Mark W; Mason, Chris

2016-02-01

Stem cell-based tissue-engineered tracheas are at an early stage in their product development cycle. Tens of patients have been treated worldwide in predominantly compassionate use settings, demonstrating significant promise. This potentially life-saving treatment is complex, and the cost and its implications for such treatments are yet to be fully understood. The costs are compounded by varying strategies for graft preparation and transplant, resulting in differing clinical and laboratory costs from different research groups. In this study, we present a detailed breakdown of the clinical and manufacturing costs for three of the United Kingdom (UK) patients treated with such transplants. All three patients were treated under Compassionate Use legislation, within the UK National Health Service (NHS) hospital setting. The total costs for the three UK patients treated ranged from $174,420 to $740,500. All three patients were in a state of poor health at time of treatment and had a number of complexities in addition to the restricted airway. This is the first time a cost analysis has been made for a tissue-engineered organ and provides a benchmark for future studies, as well as comparative data for use in reimbursement considerations.

Incidence and Risk Factors for Placenta Accreta/Increta/Percreta in the UK: A National Case-Control Study

PubMed Central

Fitzpatrick, Kathryn E.; Sellers, Susan; Spark, Patsy; Kurinczuk, Jennifer J.; Brocklehurst, Peter; Knight, Marian

2012-01-01

Background Placenta accreta/increta/percreta is associated with major pregnancy complications and is thought to be becoming more common. The aims of this study were to estimate the incidence of placenta accreta/increta/percreta in the UK and to investigate and quantify the associated risk factors. Methods A national case-control study using the UK Obstetric Surveillance System was undertaken, including 134 women diagnosed with placenta accreta/increta/percreta between May 2010 and April 2011 and 256 control women. Results The estimated incidence of placenta accreta/increta/percreta was 1.7 per 10,000 maternities overall; 577 per 10,000 in women with both a previous caesarean delivery and placenta praevia. Women who had a previous caesarean delivery (adjusted odds ratio (aOR) 14.41, 95%CI 5.63–36.85), other previous uterine surgery (aOR 3.40, 95%CI 1.30–8.91), an IVF pregnancy (aOR 32.13, 95%CI 2.03–509.23) and placenta praevia diagnosed antepartum (aOR 65.02, 95%CI 16.58–254.96) had raised odds of having placenta accreta/increta/percreta. There was also a raised odds of placenta accreta/increta/percreta associated with older maternal age in women without a previous caesarean delivery (aOR 1.30, 95%CI 1.13–1.50 for every one year increase in age). Conclusions Women with both a prior caesarean delivery and placenta praevia have a high incidence of placenta accreta/increta/percreta. There is a need to maintain a high index of suspicion of abnormal placental invasion in such women and preparations for delivery should be made accordingly. PMID:23300807

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

Nixon, J.D., E-mail: j.nixon@kingston.ac.uk; Wright, D.G.; Dey, P.K.

Highlights: • We evaluate operational municipal solid waste incinerators in the UK. • The supply chain of four case study plants are examined and compared in detail. • Technical, financial and operational data has been gathered for the four plants. • We suggest the best business practices for waste incinerators. • Appropriate strategy choices are the major difficulties for waste to energy plants. - Abstract: The uptake in Europe of Energy from Waste (EfW) incinerator plants has increased rapidly in recent years. In the UK, 25 municipal waste incinerators with energy recovery are now in operation; however, their waste supplymore » chains and business practices vary significantly. With over a hundred more plant developments being considered it is important to establish best business practices for ensuring efficient environmental and operational performance. By reviewing the 25 plants we identify four suitable case study plants to compare technologies (moving grate, fluidised bed and rotary kiln), plant economics and operations. Using data collected from annual reports and through interviews and site visits we provide recommendations for improving the supply chain for waste incinerators and highlight the current issues and challenges faced by the industry. We find that plants using moving grate have a high availability of 87–92%. However, compared to the fluidised bed and rotary kiln, quantities of bottom ash and emissions of hydrogen chloride and carbon monoxide are high. The uptake of integrated recycling practices, combined heat and power, and post incineration non-ferrous metal collections needs to be increased among EfW incinerators in the UK. We conclude that one of the major difficulties encountered by waste facilities is the appropriate selection of technology, capacity, site, waste suppliers and heat consumers. This study will be of particular value to EfW plant developers, government authorities and researchers working within the sector of waste management.« less

Exhaust system-related burns affecting children: a UK perspective and literature review

PubMed Central

Vermaak, P.V.; Deall, C.E.; McArdle, C.; Burge, T.

2016-01-01

Summary Burns caused by exhaust systems in children may be associated with considerable morbidity. Current epidemiological data varies, but no data are available for the UK population. We aim to identify the pattern of exhaust-related burns affecting children who presented to a regional centre for paediatric burn care in the UK. Patients who sustained burns related to exhaust mechanisms between May 2005 and August 2012 were identified via the departmental database. Data collected included patient demographics, burn injury information, management and outcomes. Thirty-nine patients sustained 43 burns from contact with exhaust mechanisms, and the majority were less than 5 years of age. 77% of the patients were male. Burns affected critical areas such as the hands and feet in 26% of cases. Most burns involved a total body surface area of ≤1% and were partial thickness in depth. Thirty-three percent of patients required operative intervention. Time to heal was less than 3 weeks in 69% of cases and 3 patients healed with hypertrophic scarring. The majority of burns were small in size and partial thickness in depth. Most were treated conservatively and healed with low complication rates. More than 1 in 5 injuries involved critical burn areas, highlighting the potential for considerable morbidity. The age profile in our study contrasted with other results worldwide. Our study highlights the need for vigilant supervision of children around motorcycles. We recommend the wearing of protective long trousers when riding motorcycles and the fitting of external shields to motorcycle exhaust pipes. PMID:28149228

Mental health consequences of overstretch in the UK armed forces: first phase of a cohort study

PubMed Central

Fear, Nicola T; Hull, Lisa; Greenberg, Neil; Earnshaw, Mark; Hotopf, Matthew; Wessely, Simon

2007-01-01

Objective To assess the relation between frequency and duration of deployment of UK armed forces personnel on mental health. Design First phase of a cohort study. Setting UK armed forces personnel. Participants Operational history in past three years of a randomly chosen stratified sample of 5547 regulars with experience of deployment. Main outcome measures Psychological distress (general health questionnaire-12), caseness for post-traumatic stress disorder, physical symptoms, and alcohol use (alcohol use disorders identification test). Results Personnel who were deployed for 13 months or more in the past three years were more likely to fulfil the criteria for post-traumatic stress disorder (odds ratio 1.55, 95% confidence interval 1.07 to 2.32), show caseness on the general health questionnaire (1.35, 1.10 to 1.63), and have multiple physical symptoms (1.49, 1.19 to 1.87). A significant association was found between duration of deployment and severe alcohol problems. Exposure to combat partly accounted for these associations. The associations between number of deployments in the past three years and mental disorders were less consistent than those related to duration of deployment. Post-traumatic stress disorder was also associated with a mismatch between expectations about the duration of deployment and the reality. Conclusions A clear and explicit policy on the duration of each deployment of armed forces personnel may reduce the risk of post-traumatic stress disorder. An association was found between deployment for more than a year in the past three years and mental health that might be explained by exposure to combat. PMID:17664192

Establishing and sustaining research partnerships in Africa: a case study of the UK-Africa Academic Partnership on Chronic Disease

PubMed Central

2012-01-01

This paper examines the challenges and opportunities in establishing and sustaining north–south research partnerships in Africa through a case study of the UK-Africa Academic Partnership on Chronic Disease. Established in 2006 with seed funding from the British Academy, the partnership aimed to bring together multidisciplinary chronic disease researchers based in the UK and Africa to collaborate on research, inform policymaking, train and support postgraduates and create a platform for research dissemination. We review the partnership’s achievements and challenges, applying established criteria for developing successful partnerships. During the funded period we achieved major success in creating a platform for research dissemination through international meetings and publications. Other goals, such as engaging in collaborative research and training postgraduates, were not as successfully realised. Enabling factors included trust and respect between core working group members, a shared commitment to achieving partnership goals, and the collective ability to develop creative strategies to overcome funding challenges. Barriers included limited funding, administrative support, and framework for monitoring and evaluating some goals. Chronic disease research partnerships in low-income regions operate within health research, practice, funding and policy environments that prioritise infectious diseases and other pressing public health and developmental challenges. Their long-term sustainability will therefore depend on integrated funding systems that provide a crucial capacity building bridge. Beyond the specific challenges of chronic disease research, we identify social capital, measurable goals, administrative support, creativity and innovation and funding as five key ingredients that are essential for sustaining research partnerships. PMID:22897937

"If There Is a Job Description I Don't Think I've Read One": A Case Study of Programme Leadership in a UK Pre-1992 University

ERIC Educational Resources Information Center

Mitchell, Rafael

2015-01-01

This paper reports on an exploratory study of the role of programme leaders (PLs) in a pre-1992 university, based on interviews with PLs (7) and a survey of taught Masters students (54) in a single school. The study elicits PLs' activities, most of which might be categorised as managerial and administrative, with leadership required…

Assembling the evidence jigsaw: insights from a systematic review of UK studies of individual-focused return to work initiatives for disabled and long-term ill people

PubMed Central

2011-01-01

Background Employment rates of long-term ill and disabled people in the UK are low and 2.63 million are on disability-related state benefits. Since the mid-1990 s, UK governments have experimented with a range of active labour market policies aimed to move disabled people off benefits and into work to reduce the risk of poverty and social exclusion. This systematic review asks what employment impact have these interventions had and how might they work better? Methods A systematic review of observational and qualitative empirical studies and systematic reviews published between 2002 and mid-2008 reporting employment effects and/or process evaluations of national UK government interventions focused on helping long-term sick or disabled people (aged 16-64) into the open labour market. This built on our previous systematic review which covered the years 1970 to 2001. Results Searches identified 42 studies, 31 of which evaluated initiatives with an individual focus (improving an individual's employability or providing financial support in returning to work) while 11 evaluated initiatives with an environmental focus (directed at the employment environment or changing the behaviour of employers). This paper synthesises evidence from the 31 studies with an individual focus. The use of personal advisors and individual case management in these schemes helped some participants back to work. Qualitative studies, however, revealed that time pressures and job outcome targets influenced advisors to select 'easier-to-place' claimants into programmes and also inhibited the development of mutual trust, which was needed for individual case management to work effectively. Financial incentives can help with lasting transitions into work, but the incentives were often set too low or were too short-term to have an effect. Many of the studies suffered from selection bias into these programmes of more work-ready claimants. Even though these were national programmes, they had very low awareness and take-up rates, making it unlikely that a population-level impact would be achieved even if effective for participants. Conclusions The evidence reveals barriers and facilitators for the effective implementation of these types of interventions that could inform the continuing welfare reforms. The evidence points towards the need for more long-term, sustained and staged support for those furthest from the labour market. PMID:21418621

Should High Non-Completion Rates amongst Ethnic Minority Students Be Seen as an Ethnicity Issue? Evidence from a Case Study of a Student Cohort from a British University

ERIC Educational Resources Information Center

Rodgers, Timothy

2013-01-01

This paper examines the question of how the high non-completion rates found amongst ethnic minority students in UK higher education should be interpreted. US studies examining the nexus between academic performance, ethnicity and social background have concluded that ethnicity-related performance differences are not just the by-product of social…

Recognition of and intervention in forced marriage as a form of violence and abuse.

PubMed

Chantler, Khatidja

2012-07-01

This paper highlights the importance of recognising forced marriage as a form of violence and draws attention to the interventions that are developing in Europe as a response to forced marriage. The paper highlights the difficulties of conflating all child marriages as forced marriage and discusses the different contexts of childhood in different parts of the globe. The UK is reputed to have the widest range of policy interventions and practice guidance to tackle forced marriage and is therefore used as a case study in this paper, but reference is also made to other countries thus ensuring a wider relevance. The paper's analysis of UK based research studies on forced marriage identifies three key themes: i) lack of adequate reporting of incidents of forced marriage; ii) lack of professional knowledge of forced marriage and their fear of intervention; iii) the tension between conceptualizing forced marriage as purely cultural or as a form of gender based violence. It also highlights the largely legislative responses to forced marriage in Europe; Civil Protection for victims of forced marriage in the UK is discussed and a critical analysis is offered of the increase in marriage and sponsorship age in the UK and in many European countries. Health and clinical issues related to forced marriage are highlighted and the paper calls for further research globally to i) better understand the extent and nature of forced marriage; ii) to evaluate current interventions; iii) to investigate the clinical and potential mental health implications of forced marriage.

Prospective drug safety monitoring using the UK primary-care General Practice Research Database: theoretical framework, feasibility analysis and extrapolation to future scenarios.

PubMed

Johansson, Saga; Wallander, Mari-Ann; de Abajo, Francisco J; García Rodríguez, Luis Alberto

2010-03-01

Post-launch drug safety monitoring is essential for the detection of adverse drug signals that may be missed during preclinical trials. Traditional methods of postmarketing surveillance such as spontaneous reporting have intrinsic limitations, many of which can be overcome by the additional application of structured pharmacoepidemiological approaches. However, further improvement in drug safety monitoring requires a shift towards more proactive pharmacoepidemiological methods that can detect adverse drug signals as they occur in the population. To assess the feasibility of using proactive monitoring of an electronic medical record system, in combination with an independent endpoint adjudication committee, to detect adverse events among users of selected drugs. UK General Practice Research Database (GPRD) information was used to detect acute liver disorder associated with the use of amoxicillin/clavulanic acid (hepatotoxic) or low-dose aspirin (acetylsalicylic acid [non-hepatotoxic]). Individuals newly prescribed these drugs between 1 October 2005 and 31 March 2006 were identified. Acute liver disorder cases were assessed using GPRD computer records in combination with case validation by an independent endpoint adjudication committee. Signal generation thresholds were based on the background rate of acute liver disorder in the general population. Over a 6-month period, 8148 patients newly prescribed amoxicillin/clavulanic acid and 5577 patients newly prescribed low-dose aspirin were identified. Within this cohort, searches identified 11 potential liver disorder cases from computerized records: six for amoxicillin/clavulanic acid and five for low-dose aspirin. The independent endpoint adjudication committee refined this to four potential acute liver disorder cases for whom paper-based information was requested for final case assessment. Final case assessments confirmed no cases of acute liver disorder. The time taken for this study was 18 months (6 months for recruitment and 12 months for data management and case validation). To reach the estimated target exposure necessary to raise or rule out a signal of concern to public health, we determined that a recruitment period 2-3 times longer than that used in this study would be required. Based on the real market uptake of six commonly used medicinal products launched between 2001 and 2006 in the UK (budesonide/eformoterol [fixed-dose combination], duloxetine, ezetimibe, metformin/rosiglitazone [fixed-dose combination], tiotropium bromide and tadalafil) the target exposure would not have been reached until the fifth year of marketing using a single database. It is feasible to set up a system that actively monitors drug safety using a healthcare database and an independent endpoint adjudication committee. However, future successful implementation will require multiple databases to be queried so that larger study populations are included. This requires further development and harmonization of international healthcare databases.

Point-of-care controls for nosocomial legionellosis combined with chlorine dioxide potable water decontamination: a two-year survey at a Welsh teaching hospital.

PubMed

Hosein, I K; Hill, D W; Tan, T Y; Butchart, E G; Wilson, K; Finlay, G; Burge, S; Ribeiro, C D

2005-10-01

This study reports a two-year programme of attempted eradication of Legionella colonization in the potable water supply of a 1000-bed tertiary care teaching hospital in Wales. There was a simultaneous, point-of-care, sterile-water-only policy for all intensive care units (ICU) and bone marrow and renal transplant units in order to prevent acquisition of nosocomial Legionnaires' disease. The programme was initiated following a case of nosocomial pneumonia caused by Legionella pneumophila serogroup 1-Bellingham-like genotype A on the cardiac ICU. The case occurred 14 days after mitral and aortic valve replacement surgery. Clinical and epidemiological investigations implicated aspiration of hospital potable water as the mechanism of infection. Despite interventions with chlorine dioxide costing over 25000 UK pounds per annum, Legionella has remained persistently present in significant numbers (up to 20000 colony forming units/L) and with little reduction in the number of positive sites. Two further cases of nosocomial disease occurred over the following two-year period; in one case, aspiration of tap water was implicated again, and in the other case, instillation of contaminated water into the right main bronchus via a misplaced nasogastric tube was implicated. These cases arose because of inadvertent non-compliance with the sterile-water-only policy in high-risk locations. Enhanced clinical surveillance over the same two-year period detected no other cases of nosocomial disease. This study suggests that attempts at eradication of Legionella spp. from complex water systems may not be a cost-effective measure for prevention of nosocomial infections, and to the best of our knowledge is the first study from the UK to suggest that the introduction of a sterile-water-only policy for ICUs and other high-risk units may be a more cost-effective approach.

Case mix, outcome and activity for patients with severe acute kidney injury during the first 24 hours after admission to an adult, general critical care unit: application of predictive models from a secondary analysis of the ICNARC Case Mix Programme Database

PubMed Central

Kolhe, Nitin V; Stevens, Paul E; Crowe, Alex V; Lipkin, Graham W; Harrison, David A

2008-01-01

Introduction This study pools data from the UK Intensive Care National Audit and Research Center (ICNARC) Case Mix Programme (CMP) to evaluate the case mix, outcome and activity for 17,326 patients with severe acute kidney injury (AKI) occurring during the first 24 hours of admission to intensive care units (ICU). Methods Severe AKI admissions (defined as serum creatinine ≥300 μmol/l and/or urea ≥40 mmol/l during the first 24 hours) were extracted from the ICNARC CMP database of 276,326 admissions to UK ICUs from 1995 to 2004. Subgroups of oliguric and nonoliguric AKI were identified by daily urine output. Data on surgical status, survival and length of stay were also collected. Severity of illness scores and mortality prediction models were compared (UK Acute Physiology and Chronic Health Evaluation [APACHE] II, Stuivenberg Hospital Acute Renal Failure [SHARF] T0, SHARF II0 and the Mehta model). Results Severe AKI occurred in 17,326 out of 276,731 admissions (6.3%). The source of admission was nonsurgical in 83.7%. Sepsis was present in 47.3% and AKI was nonoliguric in 63.9% of cases. Admission to ICU with severe AKI accounted for 9.3% of all ICU bed-days. Oliguric AKI was associated with longer length of stay for survivors and shorter length of stay for nonsurvivors compared with nonoliguric AKI. Oliguric AKI was associated with significantly greater ICU and hospital mortality (55.8% and 77.3%, respectively) compared with nonoliguric AKI (33.4% and 49.3%, respectively). Surgery during the 1 week before admission or during the first week in the CMP unit was associated with decreased odds of mortality. UK APACHE II and the Mehta scores under-predicted the number of deaths, whereas SHARF T0 and SHARF II0 over-predicted the number of deaths. Conclusions Severe AKI accounts for over 9% of all bed-days in adult, general ICUs, representing a considerable drain on resources. Although nonoliguric AKI continues to confer a survival benefit, overall survival from AKI in the ICU and survival to leave hospital remains poor. The use of APACHE II score measured during the first 24 hours of ICU stay performs well as compared with SHARF T0, SHARF II0 and the Mehta score, but it lacks perfect calibration. PMID:19105800

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

Variability in testing policies and impact on reported Clostridium difficile infection rates: results from the pilot Longitudinal European Clostridium difficile Infection Diagnosis surveillance study (LuCID).

PubMed

Davies, K; Davis, G; Barbut, F; Eckert, C; Petrosillo, N; Wilcox, M H

2016-12-01

Lack of standardised Clostridium difficile testing is a potential confounder when comparing infection rates. We used an observational, systematic, prospective large-scale sampling approach to investigate variability in C. difficile sampling to understand C. difficile infection (CDI) incidence rates. In-patient and institutional data were gathered from 60 European hospitals (across three countries). Testing methodology, testing/CDI rates and case profiles were compared between countries and institution types. The mean annual CDI rate per hospital was lowest in the UK and highest in Italy (1.5 vs. 4.7 cases/10,000 patient bed days [pbds], p < 0.001). The testing rate was highest in the UK compared with Italy and France (50.7/10,000 pbds vs. 31.5 and 30.3, respectively, p < 0.001). Only 58.4 % of diarrhoeal samples were tested for CDI across all countries. Overall, only 64 % of hospitals used recommended testing algorithms for laboratory testing. Small hospitals were significantly more likely to use standalone toxin tests (SATTs). There was an inverse correlation between hospital size and CDI testing rate. Hospitals using SATT or assays not detecting toxin reported significantly higher CDI rates than those using recommended methods, despite testing similar testing frequencies. These data are consistent with higher false-positive rates in such (non-recommended) testing scenarios. Cases in Italy and those diagnosed by SATT or methods NOT detecting toxin were significantly older. Testing occurred significantly earlier in the UK. Assessment of testing practice is paramount to the accurate interpretation and comparison of CDI rates.

Breast cancer statistics and prediction methodology: a systematic review and analysis.

PubMed

Dubey, Ashutosh Kumar; Gupta, Umesh; Jain, Sonal

2015-01-01

Breast cancer is a menacing cancer, primarily affecting women. Continuous research is going on for detecting breast cancer in the early stage as the possibility of cure in early stages is bright. There are two main objectives of this current study, first establish statistics for breast cancer and second to find methodologies which can be helpful in the early stage detection of the breast cancer based on previous studies. The breast cancer statistics for incidence and mortality of the UK, US, India and Egypt were considered for this study. The finding of this study proved that the overall mortality rates of the UK and US have been improved because of awareness, improved medical technology and screening, but in case of India and Egypt the condition is less positive because of lack of awareness. The methodological findings of this study suggest a combined framework based on data mining and evolutionary algorithms. It provides a strong bridge in improving the classification and detection accuracy of breast cancer data.

Tuberculosis screening of migrants to low-burden nations: insights from evaluation of UK practice.

PubMed

Pareek, M; Abubakar, I; White, P J; Garnett, G P; Lalvani, A

2011-05-01

Tuberculosis (TB) primarily occurs in the foreign-born in European countries, such as the UK, where increasing notifications and the high proportion of foreign-born cases has refocused attention on immigrant (new entrant) screening. We investigated how UK primary care organisations (PCOs) screen new entrants and whether this differs according to TB burden in the PCOs (incidence < 20 or ≥ 20 cases per 100,000 per annum). An anonymous, 20-point questionnaire was sent to all 192 UK PCOs asking which new entrants are screened, who is screened for active TB/latent TB infection (LTBI) and the methods used. Descriptive analyses were undertaken. Categorical responses were compared using the Chi-squared test. 177 (92.2%) out of 192 PCOs responded; all undertook screening action in response to abnormal chest radiographs, but only 107 (60.4%) screened new entrants for LTBI. Few new entrants had active TB diagnosed (median 0.0%, interquartile range (IQR) 0.0-0.5%) but more were identified with LTBI (median 7.85%, IQR 4.30-13.50%). High-burden PCOs were significantly less likely to screen new entrants for LTBI (OR 0.26, 95% CI 0.12-0.54; p<0.0001). Among PCOs screening for LTBI, there was substantial deviation from national guidance in selection of new entrant subgroups and screening method. Considerable heterogeneity and deviation from national guidance exist throughout the UK new entrant screening process, with high-burden regions undertaking the least screening. Forming an accurate picture of current front-line practice will help to inform future development of European new entrant screening policy.

Results of a prospective surgical audit of bilateral paediatric cochlear implantation in the UK.

PubMed

Broomfield, Stephen J; Murphy, John; Wild, Dominik C; Emmett, Stevan R; O'Donoghue, Gerard M

2014-09-01

Since being approved in 2009, bilateral simultaneous cochlear implantation (CI) has been the standard treatment for children in the UK who meet the criteria for CI. The aim was to report surgical outcomes of bilateral CI in the UK. Between January 2010 and December 2011, 14 UK CI centres collected data prospectively: demographics, aetiology, use of imaging, device type, surgery duration, use of intra-operative electrophysiology, length of stay, and post-operative complications. 1397 CI procedures in 961 CI recipients were included; 436 bilateral simultaneous, 394 bilateral sequential, and 131 unilateral. The majority (85%) were congenitally deaf. The commonest causes of acquired deafness were meningitis and cytomegalovirus infection. The median age for congenitally deaf bilateral simultaneous CI was 2.2 years, mean surgical duration 4.5 hours. 6.3% surgeries were day case procedures. Eight cases (2.0%) of planned bilateral CI had unilateral surgery. The overall major complication rate was 1.6% (0.9% excluding device failures), including explantation due to infection (0.2%), cerebrospinal fluid leak (0.2%), and meningitis (0.1%). There were no permanent facial nerve palsies and no deaths. Sixty-two (6.5%) immediate minor complications included 12 (1.3%) children with significant vestibular impairment. The complication rate was similar following bilateral CI compared to sequential and unilateral CI, and is comparable to other published series. This prospective multi-centre audit provides evidence that bilateral paediatric CI is a safe procedure in the UK, thus endorsing its role as a major therapeutic intervention in childhood deafness.

The cost of pressure ulcers in the UK.

PubMed

Bennett, Gerry; Dealey, Carol; Posnett, John

2004-05-01

To estimate the annual cost of treating pressure ulcers in the UK. Costs were derived from a bottom-up methodology, based on the daily resources required to deliver protocols of care reflecting good clinical practice. Health and social care system in the UK. Patients developing a pressure ulcer. A bottom-up costing approach is used to estimate treatment cost per episode of care and per patient for ulcers of different grades and level of complications. Also, total treatment cost to the health and social care system in the UK. The cost of treating a pressure ulcer varies from pound 1,064 (Grade 1) to pound 10,551 (Grade 4). Costs increase with ulcer grade because the time to heal is longer and because the incidence of complications is higher in more severe cases. The total cost in the UK is pound 1.4- pound 2.1 billion annually (4% of total NHS expenditure). Most of this cost is nurse time. Pressure ulcers represent a very significant cost burden in the UK. Without concerted effort this cost is likely to increase in the future as the population ages. To the extent that pressure ulcers are avoidable, pressure damage may be indicative of clinical negligence and there is evidence that litigation could soon become a significant threat to healthcare providers in the UK, as it is in the USA.

Mortality rates and causes of death in children with epilepsy prescribed antiepileptic drugs: a retrospective cohort study using the UK General Practice Research Database.

PubMed

Ackers, Ruth; Besag, Frank M C; Hughes, Elaine; Squier, Waney; Murray, Macey L; Wong, Ian C K

2011-05-01

Patients with epilepsy, including children, have an increased risk of mortality compared with the general population. Antiepileptic drugs (AEDs) were the most frequent class of drugs reported in a study looking at fatal suspected adverse drug reactions in children in the UK. The objective of the study was to identify cases and causes of death in a paediatric patient cohort prescribed AEDs with an associated epilepsy diagnosis. This was a retrospective cohort study supplemented with general practitioner-completed questionnaires, post-mortem reports and death certificates. The setting was UK primary care practices contributing to the General Practice Research Database. Participants were children and adolescents aged 0-18 years prescribed AEDs between 1993 and 2005. Causality assessment was undertaken by a consensus panel comprising paediatric specialists in neuropathology, neurology, neuropsychiatry, paediatric epilepsy, pharmacoepidemiology and pharmacy to determine crude mortality rate (CMR) and standardized mortality ratios (SMRs), and the likelihood of an association between AED(s) and the event of death. There were 6190 subjects in the cohort (contributing 26,890 person-years of data), of whom 151 died. Median age at death was 8.0 years. CMR was 56.2 per 10,000 person-years and the SMR was 22.4 (95% CI 18.9, 26.2). The majority of deceased subjects had severe underlying disorders. Death was attributable to epilepsy in 18 subjects; in 9 the cause of death was sudden unexpected death in epilepsy (SUDEP) [3.3 per 10 000 person-years (95% CI 1.5, 6.4)]. AEDs were probably (n = 2) or possibly (n = 3) associated causally with death in five subjects. Two status epilepticus deaths were associated causally with AED withdrawal. Children prescribed AEDs have an increased risk of mortality relative to the general population. Most of the deaths were in children with serious underlying disorders. A small number of SUDEP cases were identified. AEDs are not a major cause of death but in a small proportion of cases, a causal relationship between death and AEDs could not be excluded.

The Case for the Development of a Theoretical Framework for Defence Acquisition

DTIC Science & Technology

2014-04-30

the preliminary results of a pan-European working party of defence academics based in Sweden, Germany , and the UK. This group sought to surface the...preliminary results of a pan-European working party of defence academics based in Sweden, Germany , and the UK. This group sought to surface the...it involved a series of on-going discussions over a six month period between European academics and practitioners (drawn from France, Germany

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

ERIC Educational Resources Information Center

Davies, Mark R.; Lee, Barbara A.

2008-01-01

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

An evaluation of the quality of Emergency Nurse Practitioner services for patients presenting with minor injuries to one rural urgent care centre in the UK: a descriptive study.

PubMed

McDevitt, Joe; Melby, Vidar

2015-02-01

To evaluate the quality of the emergency nurse practitioner service provided to people presenting to a rural urgent care centre with minor injuries. The three objectives that were focused were an evaluation of the safety and effectiveness of the emergency nurse practitioner service, an assessment of patients' satisfaction with the emergency nurse practitioner service and a determination of factors that may enhance the quality of the emergency nurse practitioner service. Urgent care centres have become increasingly prevalent across the UK. Emergency nurse practitioner services at these rural urgent care centres remain largely unevaluated. This study attempts to redress this deficit by evaluating the quality of an emergency nurse practitioner service in relation to the care of patients presenting with minor injuries to a rural urgent care centre. This descriptive study used a case-note review and a survey design with one open-ended exploratory question. Patient views were collected using a self-completed questionnaire and a data extraction tool to survey patients' case notes retrospectively. Despite comparatively low total length-of-stay times, most patients felt they had enough time to discuss things fully with the emergency nurse practitioner. Although emergency nurse practitioners routinely impart injury advice, feedback from some patients suggests a need for the provision of more in-depth information regarding their injury. The vast majority (97·3%) of patients felt that the quality of the emergency nurse practitioner service was of a high standard. Contrary to some other studies, the findings in this study indicate that patient satisfaction is not influenced by waiting times. Emergency nurse practitioners in rural urgent care centres have the potential to deliver a safe and effective quality service that is reflected in high levels of patient satisfaction. This study provides some evidence to support the continued expansion of the emergency nurse practitioner service in rural settings in the UK. © 2014 John Wiley & Sons Ltd.

Amniotic membrane transplantation for ocular disease: a review of the first 233 cases from the UK user group

PubMed Central

Saw, Valerie P J; Minassian, Darwin; Dart, John K G; Ramsay, Andrew; Henderson, Hugo; Poniatowski, Stefan; Warwick, Ruth M; Cabral, Suzanne

2007-01-01

Background Amniotic membrane transplantation (AMT), as a new tool in the armamentarium of therapies available for ocular surface problems, became widely available in the UK in 1998. This study evaluates the indications for treatment, the surgical procedures used, and the results of a subset of the first AMT cases carried out by the group using this nationally available supply. This user group model provides data which is different from that obtained from uncontrolled case series, or clinical trials, and may be more representative of the outcomes that can be expected when a procedure becomes widely available. Methods The first 233 AMTs, performed by the UK user group, were evaluated by audit and outcomes were assessed at 3 months. Results Of the 233 transplants, there were 126 (54.1%) valid outcome returns: the outcome for persistent epithelial defects was a healed and stable surface in 11/35 (31.4%, 95% CI 16.9 to 49.3); for chemical/thermal injuries, a healed uninflamed eye with clear cornea in 5/18 (27.8%, 95% CI 9.7 to 53.4); for bullous keratopathy a pain‐free, stable surface without bullae in 4/18 (22.2%, 95% CI 6.4 to 47.6); for ocular surface reconstruction, an epithelialised uninflamed conjunctiva without scarring in 12/23 (52.2%, 95% CI 30.6 to 73.2); and for limbal stem cell deficiency, a corneal phenotype in 4/7 (57.1%). The operative technique least associated with failure was use of a bandage contact lens at the end of the procedure (OR 0.19, 95% CI 0.06 to 0.59, p = 0.004). Previous treatment with topical steroids was significantly associated with failure (OR 5.70, 95% CI 1.77 to 18.43, p = 0.004). Conclusion Although the outcome criteria used in this study were stringent, and the follow‐up duration was short, the results of AMT by this user group were generally less favourable than those of previously reported case series. Controlled clinical trials would improve the quality of evidence for use of amniotic membrane in ocular disease. PMID:17314154

Vitreoretinal interface abnormalities in middle-aged adults with visual impairment in the UK Biobank study: prevalence, impact on visual acuity and associations.

PubMed

McKibbin, Martin; Farragher, Tracey; Shickle, Darren

2017-01-01

The aim of this study was to determine the prevalence of vitreoretinal interface abnormalities (VRIA), the degree of visual impairment and associations with VRIA among adults, aged 40-69 years, in the UK Biobank study. Colour fundus photographs and spectral domain optical coherence tomography images were graded for 25% of the 8359 UK Biobank participants with mild visual impairment or worse (LogMAR >0.3 or Snellen <6/12) in at least one eye. The prevalence and contribution of VRIA to visual impairment was determined and multinomial logistic regression models were used to investigate association with known risk factors and other predetermined socioeconomic, biometric, lifestyle and medical variables for cases and matched controls. The minimum prevalence of any VRIA was 17.6% and 8.1% in the eyes with and without visual impairment, respectively. VRIA were identified as the primary cause of visual impairment in 3.6% of eyes. Although epiretinal membrane and vitreomacular traction were the most common VRIA, the degree of visual impairment was typically milder with these than with other VRIA. Visual impairment with a VRIA was positively associated with increasing age (relative risk ratio (RRR) 1.22 (95% CI 1.07 to 1.40)), female gender (RRR 1.28; 1.08 to 1.52) and Asian or Asian British ethnicity (RRR 1.60; 1.10 to 2.32). VRIA are common in middle-aged adults in the UK Biobank study, especially in eyes with visual impairment. VRIA were considered to be the primary cause of visual impairment in 3.6% of all eyes with visual impairment, although there was variation in the degree of visual impairment for each type of VRIA.

Vitreoretinal interface abnormalities in middle-aged adults with visual impairment in the UK Biobank study: prevalence, impact on visual acuity and associations

PubMed Central

Farragher, Tracey; Shickle, Darren

2017-01-01

Objective The aim of this study was to determine the prevalence of vitreoretinal interface abnormalities (VRIA), the degree of visual impairment and associations with VRIA among adults, aged 40–69 years, in the UK Biobank study. Methods and analysis Colour fundus photographs and spectral domain optical coherence tomography images were graded for 25% of the 8359 UK Biobank participants with mild visual impairment or worse (LogMAR >0.3 or Snellen <6/12) in at least one eye. The prevalence and contribution of VRIA to visual impairment was determined and multinomial logistic regression models were used to investigate association with known risk factors and other predetermined socioeconomic, biometric, lifestyle and medical variables for cases and matched controls. Results The minimum prevalence of any VRIA was 17.6% and 8.1% in the eyes with and without visual impairment, respectively. VRIA were identified as the primary cause of visual impairment in 3.6% of eyes. Although epiretinal membrane and vitreomacular traction were the most common VRIA, the degree of visual impairment was typically milder with these than with other VRIA. Visual impairment with a VRIA was positively associated with increasing age (relative risk ratio (RRR) 1.22 (95% CI 1.07 to 1.40)), female gender (RRR 1.28; 1.08 to 1.52) and Asian or Asian British ethnicity (RRR 1.60; 1.10 to 2.32). Conclusions VRIA are common in middle-aged adults in the UK Biobank study, especially in eyes with visual impairment. VRIA were considered to be the primary cause of visual impairment in 3.6% of all eyes with visual impairment, although there was variation in the degree of visual impairment for each type of VRIA. PMID:29354705

The Role of Feedback in the Under-Attainment of Ethnic Minority Students: Evidence from Distance Education

ERIC Educational Resources Information Center

Richardson, John T. E.; Alden Rivers, Bethany; Whitelock, Denise

2015-01-01

In UK higher education, the attainment of ethnic minority students is lower than that of white students, and this remains the case when differences in entry qualifications have been taken into account. The present study investigated whether the under-attainment of ethnic minority students might be due to the nature of the feedback that they…

Moral and Spiritual Education as an Intrinsic Part of the Curriculum

ERIC Educational Resources Information Center

Clifford, Philomena

2013-01-01

This paper reports on a case study undertaken within a small, rural primary school in the UK to explore the extent to which it was possible to run a moral and spiritual programme as an intrinsic and inclusive part of the curriculum based on the children's acquisition of virtues. The pupils were encouraged to build on their own experience and…

Lecturers' Leadership Practices and Their Impact on Students' Experiences of Participation with Implications for Marketing Higher Education Services

ERIC Educational Resources Information Center

Andy-Wali, Hope Adanne; Wali, Andy Fred

2018-01-01

This study investigates the impact of lecturers' leadership practices on students' experiences of participation within a case university in the UK's HE sector. The qualitative phenomenological research strategy, specifically the focus group interview approach, was used for data collection. Two key focus group interviews were conducted with a total…

The Effects of Discipline on the Application of Learning Object Metadata in UK Higher Education: The Case of the Jorum Repository

ERIC Educational Resources Information Center

Balatsoukas, Panos; O'Brien, Ann; Morris, Anne

2011-01-01

Introduction: This paper reports on the findings of a study investigating the potential effects of discipline (sciences and engineering versus humanities and social sciences) on the application of the Institute of Electrical and Electronic Engineers learning object metadata elements for the description of learning objects in the Jorum learning…

Recognition of Prior Learning, Self-Realisation and Identity within Axel Honneth's Theory of Recognition

ERIC Educational Resources Information Center

Sandberg, Fredrik; Kubiak, Chris

2013-01-01

This paper argues for the significance of Axel Honneth's theory of recognition for understanding recognition of prior learning (RPL). Case studies of the experiences of RPL by paraprofessional workers in health and social care in the UK and Sweden are used to explicate this significance. The results maintain that there are varying conditions of…

Reciprocal Learning by Experienced Teachers and Their Educators on a Master's Degree Programme in the Netherlands

ERIC Educational Resources Information Center

van Swet, Jacqueline; Ponte, Petra

2007-01-01

This article reports findings from a case study into reciprocal learning in tutor groups in a research-based master's programme, run jointly by Roehampton University, London, UK and Fontys OSO, The Netherlands. The research was designed to investigate to what extent, and how, forms of reciprocal learning arose in tutor groups for experienced…

A Partnership Approach to Developing Student Capacity to Engage and Staff Capacity to Be Engaging: Opportunities for Academic Developers

ERIC Educational Resources Information Center

Curran, Roisín; Millard, Luke

2016-01-01

Many higher education institutions are adopting learning and teaching approaches that embrace "students as partners". This can be met with trepidation by academic staff and students. The purpose of this paper is to demonstrate, through two UK-based institutional case studies, that a partnership approach provides an opportunity for staff…

Learning within a Connectivist Educational Collective Blog Model: A Case Study of UK Higher Education

ERIC Educational Resources Information Center

Garcia, Elaine; Brown, Mel; Elbeltagi, Ibrahim

2013-01-01

The use Web 2.0 technologies and specifically blogs has become increasingly prevalent within the Higher Education (HE) sector within recent years as educators begin to maximise the opportunities such tools can provide for teaching and learning and to experiment with their usage in a wide range of context. The use of such technologies has been…

Video Diaries: A Tool to Investigate Sustainability-Related Learning in Threshold Spaces

ERIC Educational Resources Information Center

Roberts, Jane

2011-01-01

This paper takes as a case study an undergraduate field class from a UK university to rural Uganda. It describes and evaluates the use of video diaries as a tool for investigating the process of transformative learning in the context of education for sustainability. The applicability of threshold concept theory to this learning is investigated.…

Social Mobility or Social Reproduction? A Case Study of the Attainment Patterns of Students According to Their Social Background and Ethnicity

ERIC Educational Resources Information Center

Collins, Matthew; Collins, Gemma; Butt, Graham

2015-01-01

This paper explores levels of achievement amongst boys who attended a selective school in Birmingham, UK through consideration of their attainment, social background and ethnicity. It seeks to answer three main questions. Firstly, to what extent does academic attainment vary between students from different socio-economic groups and ethnic…

Unlocking the Potential to Influence Government Skills Policy: A Case Study of the UK Construction Industry

ERIC Educational Resources Information Center

Morgan, Arthur; Raiden, Ani; Naylor, Gerald

2008-01-01

Despite a series of national policy initiatives aimed at addressing skills shortages in a number of sectors, little evidence of longer-term change is apparent. This paper examines concerns expressed by small businesses that their local views are not sought or considered when national training policies and initiatives are either being developed or…

The Participation and Decision Making of "At Risk" Youth in Community Music Projects: An Exploration of Three Case Studies

ERIC Educational Resources Information Center

Rimmer, Mark

2012-01-01

In the UK, recent years have witnessed a considerable growth in youth participation activities that seek to involve children and young people in various forms of decision-making. One such form of youth participation to benefit from increased government support since the late 1990s concerns community arts activities, especially those targeting…

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…

Getting to Know You? Issues of Trust and Mistrust in Understanding Community, Developing Partnerships and Delivering Policy Change in Children's Services

ERIC Educational Resources Information Center

Griffin, Michaela

2010-01-01

This case study examined a joint assessment and allocation panel set up to inform local implementation of the UK Government's policy of integrating children's services, particularly the introduction of a Common Assessment Framework and the lead practitioner role. It brought together agencies serving one community. Professionals and parents agreed…

Application of Standard Project Management Tools to Research--A Case Study from a Multi-National Clinical Trial

ERIC Educational Resources Information Center

Gist, Peter; Langley, David

2007-01-01

PRINCE2, which stands for Projects in Controlled Environments, is a project management method covering the organisation, management, and control of projects and is widely used in both government and commercial IT and building projects in the UK. This paper describes the application of PRINCE2 to the management of large clinical trials…

Library Subject Guides: A Content Management Case Study at the Open University, UK

ERIC Educational Resources Information Center

Wales, Tim

2005-01-01

Purpose: To share the experiences and challenges faced by the Open University Library (OUL) in developing a content management (CM) system for its subject guides. Design/methodology/approach: A summary of multi-format subject guide production at the OUL is provided to justify the decision to develop a new system for their production using a…

Exploring Action Learning for Academic Development in Research Intensive Settings

ERIC Educational Resources Information Center

Stocks, Claire; Trevitt, Chris; Hughes, Joseph

2018-01-01

The potential of action learning (AL) for academic development has not received a lot of attention. Building from two case studies in which AL has been used in different ways in research-intensive universities in Australia and the UK, we suggest that the approach may be of benefit to developers in the changing landscape in which they are expected…

Child Rights Theatre for Development in Rural Bangladesh: A Case Study

ERIC Educational Resources Information Center

Munier, Asif; Etherton, Michael

2006-01-01

The authors facilitated a Theatre for Development training workshop for Save the Children UK with a number of children in three villages in northern Bangladesh in 2000. In 2005 they revisited the young people, unofficially and informally, to assess for themselves if there had been any impact of the TfD on their lives. They asked what the young…

"Emboldened Bodies": Social Class, School Health Policy and Obesity Discourse

ERIC Educational Resources Information Center

De Pian, Laura

2012-01-01

This paper examines the multiple ways in which health policy relating to obesity, diet and exercise is recontextualised and mediated by teachers and pupils in the context of social class in the UK. Drawing on a case study of a middle-class primary school in central England, the paper documents the complexity of the policy process, its uncertainty,…

Support Structures for Facilitators of Student Personal Development Planning: Lessons from Two Departmental Case Studies

ERIC Educational Resources Information Center

Hulme, Claire; Lisewski, Bernard

2010-01-01

In the UK, following guidelines set out by the Quality Assurance Agency, personal development planning (PDP) is now operational across all higher education (HE) awards. Like many policy initiatives, PDP requires change, and vital to its implementation are those who facilitate PDP at the grassroots level. Staff given the task of implementing PDP…

Voices from the Field: Developing Employability Skills for Archaeological Students Using a Project Based Learning Approach

ERIC Educational Resources Information Center

Wood, Gaynor

2016-01-01

Graduate employment statistics are receiving considerable attention in UK universities. This paper looks at how a wide range of employability attributes can be developed with students, through the innovative use of the Project Based Learning (PjBL) approach. The case study discussed here involves a group of archaeology students from the University…

Selling "Impact": Peer Reviewer Projections of What Is Needed and What Counts in REF Impact Case Studies. A Retrospective Analysis

ERIC Educational Resources Information Center

Watermeyer, Richard; Hedgecoe, Adam

2016-01-01

The intensification of an audit culture in higher education is made no more apparent than with the growing prevalence of performance-based research funding systems like the UK's Research Excellence Framework (REF) and the introduction of new measures of assessment like "impact" or more specifically, the economic and societal impacts of…

Evolving Knowledge Integration and Absorptive Capacity Perspectives upon University-Industry Interaction within a University

ERIC Educational Resources Information Center

Sparrow, John; Tarkowski, Krystyna; Lancaster, Nick; Mooney, Michele

2009-01-01

Purpose: The purpose of this paper is to report upon an initiative within a case study UK university to facilitate service innovation in small firms. The paper aims to outline how explicit use of such concepts has the potential to enhance the effectiveness of this form of university-industry interaction. Design/methodology/approach: The paper…

NATO’s Small States: Albania as a Case Study

DTIC Science & Technology

2016-12-01

worth of marijuana per 158 Ibid. 159 Spahlu, “Ethnic Albanian Foreign Fighters and the Islamic State...strongly to regional stabilization efforts. 164 Jill Reilly, “The Day Europe’s ‘ Marijuana Mecca...Went up in Smoke,” Mail, June 16, 2014, http://www.dailymail.co.uk/news/article-2658903/Albanian-police-storm-lawless- marijuana -village.html. 165

The Usefulness of the DBC-ASA as a Screening Instrument for Autism in Children with Intellectual Disabilities: A Pilot Study

ERIC Educational Resources Information Center

Deb, Shoumitro; Dhaliwal, Akal-Joat; Roy, Meera

2009-01-01

Aims: To explore the validity of Developmental Behaviour Checklist-Autism Screening Algorithm (DBC-ASA) as a screening instrument for autism among children with intellectual disabilities. Method: Data were collected from the case notes of 109 children with intellectual disabilities attending a specialist clinic in the UK. Results: The mean score…

A retrospective analysis of 34 potentially missed cases of female genital mutilation in the emergency department.

PubMed

Fawcett, Richard John; Kernohan, George

2017-09-12

To discover if healthcare professionals working within an ED are able to make a diagnosis of female genital mutilation (FGM) in those patients who have previously undergone the procedure and report it as per UK law. A retrospective analysis of patients' notes who were assigned an FGM code during the period of May 2015 to August 2016. Single-centre, large UK major trauma centre offering a tertiary FGM clinic. Any woman coded during the study period as having undergone FGM. Number of FGM cases identified by the ED. Mean age, presenting complaint, discharge diagnosis, genitourinary exam and defibulation status. 34 patients were identified as having undergone FGM, 19 had previously attended ED and none had their FGM identified during their ED attendance. The age range of those identified was 23 to 40 years. None had undergone defibulation. This study demonstrates that the identification of FGM victims by an ED is very poor, and more work needs to be done to increase awareness of the subject by front-line staff. © 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.

Suicide verdicts as opposed to accidental deaths in substance-related fatalities (UK, 2001-2007).

PubMed

Vento, Alessandro E; Schifano, Fabrizio; Corkery, John M; Pompili, Maurizio; Innamorati, Marco; Girardi, Paolo; Ghodse, Hamid

2011-07-01

Substance-related deaths account for a great number of suicides. To investigate levels and characteristics of suicide verdicts, as opposed to accidental deaths, in substance misusers. Psychological autopsy study of cases from the UK National Programme on Substance Abuse Deaths (np-SAD) during the period 2001-2007. Between January 2001 and December 2007, 2108 suicides were reported to the np-SAD. Typical suicide victims were White and older than 50 (respectively 95% and 41% of cases). Medications, especially antidepressants (44%), were prescribed to 87% of victims. Significantly fewer suicide victims than controls presented positive blood toxicological results for illicit drugs (namely: cocaine, heroin, amphetamines, ecstasy-type drugs, cannabis, and GHB/GBL) and alcohol. Suicide prevention programmes should devote specific attention to deaths among substance misusers who are at high risk of fatal intentional self-harm. Specific characteristics distinguish those at risk; caregivers should be better educated as to what these factors are. Limitations of the current study included lack of provision of comprehensive information relating to the victims' psychosocial variables. Furthermore, no differentiation between different classes of antidepressants in terms of involvement in suicide was here provided. Copyright © 2011 Elsevier Inc. All rights reserved.

DNA barcoding for biosecurity: case studies from the UK plant protection program.

PubMed

Hodgetts, Jennifer; Ostojá-Starzewski, Jozef C; Prior, Thomas; Lawson, Rebecca; Hall, Jayne; Boonham, Neil

2016-11-01

Since its conception, DNA barcoding has seen a rapid uptake within the research community. Nevertheless, as with many new scientific tools, progression towards the point of routine deployment within diagnostic laboratories has been slow. In this paper, we discuss the application of DNA barcoding in the Defra plant health diagnostic laboratories, where DNA barcoding is used primarily for the identification of invertebrate pests. We present a series of case studies that demonstrate the successful application of DNA barcoding but also reveal some potential limitations to expanded use. The regulated plant pest, Bursephalenchus xylophilus, and one of its vectors, Monochamus alternatus, were found in dining chairs. Some traded wood products are potentially high risk, allowing the movement of longhorn beetles; Trichoferus campestris, Leptura quadrifasciata, and Trichoferus holosericeus were found in a wooden cutlery tray, a railway sleeper, and a dining chair, respectively. An outbreak of Meloidogyne fallax was identified in Allium ampeloprasum and in three weed species. Reference sequences for UK native psyllids were generated to enable the development of rapid diagnostics to be used for monitoring following the release of Aphalara itadori as a biological control agent for Fallopia japonica.

Hyperlipemia in a population of aged donkeys: description, prevalence, and potential risk factors.

PubMed

Burden, F A; Du Toit, N; Hazell-Smith, E; Trawford, A F

2011-01-01

Hyperlipemia is a common disorder of the donkey, with mortality rates of up to 80% reported. Such a poor prognosis makes prevention of this disorder or amelioration in the early stages crucial. The objective of this study was to describe and determine the prevalence of hyperlipemia in a population of donkeys and to determine risk factors for development of the disease. A total of 449 cases were investigated from a population of 3829 donkeys; donkeys were resident at The Donkey Sanctuary, a charity providing refuge for unwanted donkeys in the UK. Animals were selected on the basis of presence of clinical disease. A retrospective case-control study design was used, and all donkeys presenting with hyperlipemia over a 4-year period were included. Each case was matched with 2 controls that had not suffered from hyperlipemia in the previous month. Multivariable analysis was carried out to determine risk factors. A total of 449 clinical cases of hyperlipemia were reported with an associated mortality rate of 48.5%. Concurrent disease was present in 72% of donkeys and was the greatest risk factor (OR = 76.98); others included cardboard bedding (OR = 3.86), movement (OR = 3.94), weight loss (OR = 6.4), dental disease (OR = 1.73), and concentrate feeding (OR = 1.87). This study shows that this population of donkeys in the UK often develops hyperlipemia, particularly in response to stress or primary illness, and provides useful insights in to health and management risk factors that may be addressed to decrease the risk of hyperlipemia both in the study population and in other similar donkey populations. Copyright © 2011 by the American College of Veterinary Internal Medicine.

The Role of China in the UK Relative Imports from Three Selected Trading Regions: The Case of Textile Raw Material Industry.

PubMed

Xu, Junqian

2017-11-30

The UK textile industry was very prosperous in the past but in the 1970s Britain started to import textile materials from abroad. Since 1990, half of its textile materials have been imported from the EEA (European Economic Area), ASEAN (Association of Southeast Asian Nations) and North America countries. Meanwhile, UK imports from China have increased dramatically. Through comparisons, this paper calculates the trade competitiveness index and relative competitive advantages of regions and investigates the impact of Chinese textiles on UK imports from three key free trade regions across the textile sectors in the period 1990-2016 on the basis of United Nation Comtrade Rev. 3. We find that China's textile prices, product techniques, political trade barriers and even tax system have made a varied impact on the UK's imports across related sectors in the context of green trade and the strengthening of barriers, which helps us recognize China's competitiveness in international trading and also provides advice on China's sustainable development of textile exports.

Herpes zoster as a risk factor for stroke and TIA: a retrospective cohort study in the UK.

PubMed

Breuer, Judith; Pacou, Maud; Gautier, Aline; Brown, Martin M

2014-07-08

Stroke and TIA are recognized complications of acute herpes zoster (HZ). Herein, we evaluate HZ as a risk factor for cerebrovascular disease (stroke and TIA) and myocardial infarction (MI) in a UK population cohort. A retrospective cohort of 106,601 HZ cases and 213,202 controls, matched for age, sex, and general practice, was identified from the THIN (The Health Improvement Network) general practice database. Cox proportional hazard models were used to examine the risks of stroke, TIA, and MI in cases and controls, adjusted for vascular risk factors, including body mass index >30 kg/m(2), smoking, cholesterol >6.2 mmol/L, hypertension, diabetes, ischemic heart disease, atrial fibrillation, intermittent arterial claudication, carotid stenosis, and valvular heart disease, over 24 (median 6.3) years after HZ infection. Risk factors for vascular disease were significantly increased in cases of HZ compared with controls. Adjusted hazard ratios for TIA and MI but not stroke were increased in all patients with HZ (adjusted hazard ratios [95% confidence intervals]: 1.15 [1.09-1.21] and 1.10 [1.05-1.16], respectively). However, stroke, TIA, and MI were increased in cases whose HZ occurred when they were younger than 40 years (adjusted hazard ratios [95% confidence intervals]: 1.74 [1.13-2.66], 2.42 [1.34-4.36], and 1.49 [1.04-2.15], respectively). Subjects younger than 40 years were significantly less likely to be asked about vascular risk factors compared with older patients (p < 0.001). HZ is an independent risk factor for vascular disease in the UK population, particularly for stroke, TIA, and MI in subjects affected before the age of 40 years. In older subjects, better ascertainment of vascular risk factors and earlier intervention may explain the reduction in risk of stroke after HZ infection. © 2014 American Academy of Neurology.

Hitting and missing targets by ambulance services for emergency calls: effects of different systems of performance measurement within the UK

PubMed Central

Bevan, Gwyn; Hamblin, Richard

2009-01-01

Following devolution, differences developed between UK countries in systems of measuring performance against a common target that ambulance services ought to respond to 75% of calls for what may be immediately life threatening emergencies (category A calls) within 8 minutes. Only in England was this target integral to a ranking system of ‘star rating’, which inflicted reputational damage on services that failed to hit targets, and only in England has this target been met. In other countries, the target has been missed by such large margins that services would have been publicly reported as failing, if they had been covered by the English system of star ratings. The paper argues that this case-study adds to evidence from comparisons of different systems of hospital performance measurement that, to have an effect, these systems need to be designed to inflict reputational damage on those that have performed poorly; and it explores implications of this hypothesis. The paper also asks questions about the adequacy of systems of performance measurement of ambulance services in UK countries. PMID:19381327

The entrepreneur: a new breed of health service leader?

PubMed

Exton, Rosemary

2008-01-01

This paper aims to critically examine the notion of entrepreneurship in the UK National Health Service (NHS), promoted by government ministers and senior civil servants as part of the rhetoric of the modernisation agenda. The paper explores literature on entrepreneurship in the private and public sector and qualitative case study evidence on the emergence (and non-emergence) of "entrepreneurs" who led the improving working lives (IWL) initiative in the UK National Health Service and discusses the issues involved. The rhetoric serves an essentially ideological function, obscuring the real difficulty of securing effective and sustainable change, in organisations with deeply engrained power structures and as complex and intransient as the NHS in particular and health services more generally. A "new breed of entrepreneurial leaders" may eventually appear but they face the challenge of surviving in the hierarchical NHS culture and in a climate of turbulent change created by the volatility of government policy. The paper shows that efforts to pursue entrepreneurship in the UK NHS have to overcome obstacles involving the interplay of power, gender and language.

The effects of climate change on fungal diversity patterns in the UK and Greece: Contrasting trends and ecological interpretations

NASA Astrophysics Data System (ADS)

Damialis, A.; Gange, A. C.; Mohammad, A. B.; Halley, J. M.

2013-05-01

It is well known that climate change has been affecting the ecology of living organisms. However, very little research has been done concerning alterations in fungal ecology. The changes in climate are expected to have an impact on fungal biodiversity patterns. Such changes in turn might have implications for public health since the spores of certain fungal taxa (e.g. Alternaria, Cladosporium) cause respiratory problems in sensitised individuals, with symptoms manifested even as acute respiratory failure. The objectives of this study were: a) to perform a comprehensive analysis of trends in long-term time series of fungal fruiting and sporulation variables for a wide range of fungal taxa, b) to investigate the response of fungal abundance and diversity to environmental variability. Data from two different geoclimatic areas were used: a) England, UK from more than 350 fungal species belonging to 10 different functional groups and with phenological records of fungal fruiting (start, end and duration) since 1950, b) Thessaloniki, Greece for 14 airborne fungal types with quantitative records (total annual concentration) and phenological records (start, peak, end, duration) of the atmospheric spore season since 1987. In parallel, various meteorological factors were examined in both areas in order to elucidate the relationship between climate and fungal diversity patterns. Long-term trends were found in most cases: these were particularly pronounced in the UK, where more than 300 species (~82%) displayed trends. Of these, ~77% were towards an earlier beginning and ~81% towards a later ending of the fruiting season; overall, an extension of the fruiting season seems to occur in more than 200 species. On a per-functional-group basis, except for manure, soil and mycorrhizal deciduous fungal species, all the other (137 species) exhibited earlier first fruiting dates and extended seasons. On the other hand, in Greece, although a tendency was observed towards lower yearly spore concentration (86% of the total) and later and shorter spore season (86% and 71% of the total, respectively), most cases only approached statistical significance. However, in both study areas the sole meteorological factor to change significantly over the last decades was minimum air temperature, and especially in the case of Thessaloniki, Greece. We observed a persistent correlation of this factor with fungal data, which frequently revealed a lag-effect of several decades. Particularly in the longer time-series of fungal fruiting in the UK, several fungal functional groups and species displayed a persistent 'memory' lasting up to four decades in the past as observed through patterns of variance growth. Biodiversity in the two study areas exhibits contrasting patterns over time with diversity increasing with time in the UK and decreasing in Greece, which suggests a more nuanced role for climate change as a driver of fungal diversity.

A Nested Case-Control Study of Luteinizing Hormone Variants and Risk of Breast Cancer

DTIC Science & Technology

1999-10-01

study has addressed the relationship of the presence of the variant LH to clinical and hormonal parameters among women with polycystic ovaries as...compared to healthy subjects (6). In this study, the variant was appreciably more frequent in obese women with polycystic ovaries than in normal women...immunological LH- 13-subunit variant in a UK population of healthy women and women with polycystic ovary syndrome. Clin Endocrinol. 1995; 43:297-303

International Students' Perceptions of Service Quality in the UK Banking Sector: An Exploratory Study

ERIC Educational Resources Information Center

Bond, Christopher; Hsu, Marc Ting-Chun

2011-01-01

This study reviews and evaluates international students' perceptions of UK banks. The specific research objectives were to identify international students' expectations and perceptions of service quality from UK banks and to assess the quality GAP or dissonance between these. A total of 297 international students studying in the UK responded to…

Understanding how and why health is integrated into foreign policy - a case study of health is global, a UK Government Strategy 2008-2013.

PubMed

Gagnon, Michelle L; Labonté, Ronald

2013-06-06

Over the past decade, global health issues have become more prominent in foreign policies at the national level. The process to develop state level global health strategies is arguably a form of global health diplomacy (GHD). Despite an increase in the volume of secondary research and analysis in this area, little primary research, particularly that which draws directly on the perspectives of those involved in these processes, has been conducted. This study seeks to fill this knowledge gap through an empirical case study of Health is Global: A UK Government Strategy 2008-2013. It aims to build understanding about how and why health is integrated into foreign policy and derive lessons of potential relevance to other nations interested in developing whole-of-government global health strategies. The major element of the study consisted of an in-depth investigation and analysis of the UK global health strategy. Document analysis and twenty interviews were conducted. Data was organized and described using an adapted version of Walt and Gilson's policy analysis triangle. A general inductive approach was used to identify themes in the data, which were then analysed and interpreted using Fidler's health and foreign policy conceptualizations and Kingdon's multiples streams model of the policymaking process. The primary reason that the UK decided to focus more on global health is self-interest - to protect national and international security and economic interests. Investing in global health was also seen as a way to enhance the UK's international reputation. A focus on global health to primarily benefit other nations and improve global health per se was a prevalent through weaker theme. A well organized, credible policy community played a critical role in the process and a policy entrepreneur with expertise in both international relations and health helped catalyze attention and action on global health when the time was right. Support from the Prime Minister and from the Foreign and Commonwealth Office was essential. The process to arrive at a government-wide strategy was complex and time-consuming, but also broke down silos. Significant negotiation and compromise were required from actors with widely varying perspectives on global health and conflicting priorities. As primarily an exploratory study, this research sheds significant light on the global health policymaking process at the level of the state. It provides a useful and important starting point for further hypothesis driven empirical research that focuses on the integration of health in foreign policy, how and why this happens and whether or not it makes an impact on improving global health.

A retrospective study of pyometra at five RSPCA hospitals in the UK: 1728 cases from 2006 to 2011

PubMed Central

Gibson, A.; Dean, R.; Yates, D.; Stavisky, J.

2013-01-01

A retrospective cross-sectional study was used to analyse pyometra cases at five RSPCA Animal Hospitals across the UK from 2006 to 2011. A total of 1728 cases of pyometra were recovered from a female dog outpatient caseload of 78,469 animals, giving a total prevalence of 2.2 per cent over the study period. There was an annual increase in the incidence of pyometra within the population, while elective ovariohysterectomy caseload has declined. There were variations in breed and age at presentation. Bullmastiffs (P<0.0001), golden retrievers (P=0.001) and dogue de Bordeaux (P=0.008) were over-represented in the pyometra population when compared with the female dog outpatient caseload. Mean age at presentation was 7.7 years. Some breeds presented at a significantly lower age, including dogue de Bordeaux (mean age 3.3 years) and bullmastiffs (mean age 5.4 years), while others presented as older dogs, including Yorkshire terriers (mean age 9.4 years) and border collies (mean age 10.3 years). Surgical mortality rate at the Greater Manchester Animal Hospital was 3.2 per cent. Pyometra is of significant welfare concern, and also has cost implications, particularly in charity practice. These results serve to highlight this condition so that future change in charity practice caseload can be anticipated and strategies can be directed to improve animal welfare. PMID:24114733

Safe travels? HIV transmission among Britons travelling abroad.

PubMed

Rice, B; Gilbart, V L; Lawrence, J; Smith, R; Kall, M; Delpech, V

2012-05-01

The aim of the study was to identify and describe the characteristics of persons born in the UK who acquire HIV infection abroad. Analyses using case reports and follow-up data from the national HIV database held at the Health Protection Agency were performed. Fifteen per cent (2066 of 13 891) of UK-born adults diagnosed in England, Wales and Northern Ireland between 2002 and 2010 acquired HIV infection abroad. Thailand (534), the USA (117) and South Africa (108) were the countries most commonly reported. As compared with UK-born adults acquiring HIV infection in the UK, those acquiring HIV infection abroad were significantly (P < 0.01) more likely to have acquired it heterosexually (70% vs. 22%, respectively), to be of older age at diagnosis (median 42 years vs. 36 years, respectively), and to have reported sex with a commercial sex worker (5.6% vs. 1%, respectively). Among men infected in Thailand, 11% reported sex with a commercial sex worker. A substantial number of UK-born adults are acquiring HIV infection in countries with generalized HIV epidemics, and in common holiday destinations. Of particular concern is the high proportion of men infected reporting sex with a commercial sex worker. We recommend HIV prevention and testing efforts be extended to include travellers abroad, and that sexual health advice be provided routinely in travel health consultations and in occupational health travel advice packs, particularly to those travelling to high HIV prevalence areas and destinations for sex tourism. Safer sex messages should include an awareness of the potential detrimental health and social impacts of the sex industry. © 2012 British HIV Association.

The UKC2 regional coupled prediction system

NASA Astrophysics Data System (ADS)

Castillo, Juan; Lewis, Huw; Graham, Jennifer; Saulter, Andrew; Arnold, Alex; Fallmann, Joachim; Martinez de la Torre, Alberto; Blyth, Eleanor; Bricheno, Lucy

2017-04-01

It is hypothesized that more accurate prediction and warning of natural hazards, such as of the impacts of severe weather through the environment, requires a more integrated approach to forecasting. This approach also delivers research benefits through providing tools with which to explore the known interactions and feedbacks between different physical and biogeochemical components of the environment across sky, sea and land. This hypothesis is being tested in a UK regional context at km-scale through the UK Environmental Prediction Project. This presentation will provide an introduction to the UKC2 UK Environmental Prediction research system. This incorporates models of the atmosphere (Met Office Unified Model), land surface (JULES), shelf-sea ocean (NEMO) and ocean waves (WAVEWATCH III). These components are coupled (via OASIS3-MCT libraries) at unprecedentedly high resolution across the UK and the wider north-west European regional domain. A research framework has been established to explore the representation of feedback processes in coupled and uncoupled modes, providing a unique new research tool for UK environmental science. The presentation will highlight work undertaken to review and improve the computational cost of running these systems for efficient research application. Research will be presented highlighting case study evaluation on the sensitivity of the ocean and surface waves to the representation of feedbacks to the atmosphere, and on the sensitivity of weather systems and boundary layer cloud development to the exchange of heat and momentum at the ocean surface modified through sea surface temperature and wave-induced roughness. The presentation will discuss plans for future development through UKC3 and beyond.

Occupational contact dermatitis in the UK: a surveillance report from EPIDERM and OPRA.

PubMed

Meyer, J D; Chen, Y; Holt, D L; Beck, M H; Cherry, N M

2000-05-01

Since February 1993 the EPIDERM surveillance scheme has collected data on occupational skin disease from consultant dermatologists in the UK. Reporting by occupational physicians to the scheme began in May 1994 and was superseded in January 1996 by the Occupational Physicians Reporting Activity (OPRA). The schemes currently receive reports on incident cases from 244 dermatologists and 790 occupational physicians. An estimated total of 9937 cases of contact dermatitis reported by dermatologists was calculated from surveillance data; 8129 contact dermatitis cases were estimated from reports by occupational physicians. The annual incidence of occupational contact dermatitis from dermatologist reports was 6.4 cases per 100,000 workers and 6.5 per 100,000 from reports by occupational physicians, an overall rate of 12.9 cases per 100,000 workers. Manufacturing industries account for the greatest number of cases seen by both sets of reporting physicians, with health care employment second. Reports from dermatologists also indicate high rates of dermatitis in the personal service industries (mainly hairdressers and barbers) and in agriculture. With the exception of an increase in cases seen in nurses in both schemes, the numbers and proportions of cases of contact dermatitis within occupations have remained fairly constant over the 6-year reporting period. Agents accounting for the highest number of allergic contact dermatitis cases were rubber (23.4% of allergic cases reported by dermatologists), nickel (18.2), epoxies and other resins (15.6), aromatic amines (8.6), chromium and chromates (8.1), fragrances and cosmetics (8.0), and preservatives (7.3). Soaps (22.0% of cases), wet work (19.8), petroleum products (8.7), solvents (8.0), and cutting oils and coolants (7.8) were the most frequently cited agents in cases of irritant dermatitis. The national scope of the data, together with the parallel structure by which both dermatologists and occupational physicians report incident cases, is useful in determining the extent of skin hazards in UK industry and may help in better targeting efforts to reduce the burden of skin disease at work.

Risk communication of vaccines: challenges in the post-trust environment.

PubMed

Bouder, Frederic

2015-01-01

Highly publicised vaccine scares and recent debates about the risks suggest that public trust in immunisation programmes is fragile. For instance, the recent outbreak of Measles in Wales was the direct result of almost fifteen years of distrust for the MMR vaccine in the UK. This article shows how the latest science on risk communication will help critical actors, especially policy-makers, to build trust when they communicate risks to citizens and patients. The article offers policy advice on risk communication based on the results of three vaccines case studies. Five procedural principles which were developed for the UK government - the so-called "five As" of public risk communication are used to structure the discussion. Conclusions and recommendations suggest ways to move forward and build a two-way proactive risk communication practice.

Power in Operation: A Case Study Focussing on How Subject-Based Knowledge Is Constrained by the Methods of Assessment in GCE A Level Dance

ERIC Educational Resources Information Center

Sanders, Lorna

2008-01-01

The General Certificate of Education (GCE) A Level Dance specification, offered by the Assessment and Qualifications Alliance (AQA), is the only GCE course of study in the UK that focuses solely on dance. Acquisition of subject specific knowledge is a feature of its aims, while assessment, as constructed by its objectives, is assumed to be a…

Perceptions in the Mind Maps of Turkish Children Living in England at Primary Education Level about Their Home Country Turkey and the World

ERIC Educational Resources Information Center

Aydin, Gülnur; Baysan, Sultan; Aydogan, Selcen

2017-01-01

This research was conducted to determine the perceptions of Turkish children in their mind maps at the primary educational level living in the UK and parental views on these perceptions about the children's home country Turkey and the world. For this purpose, case study approach in qualitative research is preferred. The study group consists of 36…

A Study into the Impact of the Reading Education Assistance Dogs Scheme on Reading Engagement and Motivation to Read among Early Years Foundation-Stage Children

ERIC Educational Resources Information Center

Noble, Olivia; Holt, Nicole

2018-01-01

This research explores the impact of the Reading Education Assistance Dogs (READ) scheme on reading engagement and motivation among Early Years Foundation-Stage children using a case study approach at a primary school in the English Midlands. There is a notable lack of UK-based research into the READ scheme, which offers a potential alternative…

Implementing service improvement projects within pre-registration nursing education: a multi-method case study evaluation.

PubMed

Baillie, Lesley; Bromley, Barbara; Walker, Moira; Jones, Rebecca; Mhlanga, Fortune

2014-01-01

Preparing healthcare students for quality and service improvement is important internationally. A United Kingdom (UK) initiative aims to embed service improvement in pre-registration education. A UK university implemented service improvement teaching for all nursing students. In addition, the degree pathway students conducted service improvement projects as the basis for their dissertations. The study aimed to evaluate the implementation of service improvement projects within a pre-registration nursing curriculum. A multi-method case study was conducted, using student questionnaires, focus groups with students and academic staff, and observation of action learning sets. Questionnaire data were analysed using SPSS v19. Qualitative data were analysed using Ritchie and Spencer's (1994) Framework Approach. Students were very positive about service improvement. The degree students, who conducted service improvement projects in practice, felt more knowledgeable than advanced diploma students. Selecting the project focus was a key issue and students encountered some challenges in practice. Support for student service improvement projects came from action learning sets, placement staff, and academic staff. Service improvement projects had a positive effect on students' learning. An effective partnership between the university and partner healthcare organisations, and support for students in practice, is essential. Copyright © 2013 Elsevier Ltd. All rights reserved.

Assaults from corrosive substances and medico legal considerations in a large regional burn centre in the United Kingdom: calls for increased vigilance and enforced legislation

PubMed Central

Tan, Alethea; Bharj, Amrit Kaur; Nizamoglu, Metin; Barnes, David; Dziewulski, Peter

2015-01-01

Burn injuries from corrosive substances have been recognised as a common method of assault in low and middle income countries (LMICs) motivated by various factors. Such injuries often leave survivors with severely debilitating physical and psychological injuries and scars. The number of reported cases of acid assaults within the United Kingdom (UK) appears to be on the rise. As one of the largest regional burn centres in the UK, we have reviewed our experience of chemical burns from assault. This study aims to: (1) review the demographics, incidence and patient outcomes; (2) evaluate the long-term psychosocial support provided; and (3) review current criminal litigation proceedings and preventative legislations in the UK specific to assault by corrosive substances. A 15-year retrospective review of 21 burn injuries from assault with corrosive substances presenting to a regional burn unit was conducted. Victims were mostly young men; male perpetrators were more common. The most common motive cited was assault. The most common anatomical region affected was the face and neck. The number of victims who pursue litigation is disproportionately lower than the number of total cases at presentation. In an effort to better understand the legal considerations surrounding such assaults, we also collaborated with lawyers experienced in this particular field. We hope that our work will help educate healthcare professionals regarding the legal assistance and existing laws available to protect these patients. PMID:29799575