Sample records for uk national household

  1. Hazard of household cleaning products: a study undertaken by the UK National Poisons Information Service.

    PubMed

    Williams, Hayley; Moyns, Emma; Bateman, D Nicholas; Thomas, Simon H L; Thompson, John P; Vale, J Allister

    2012-09-01

    To ascertain the reported toxicity of current United Kingdom (UK) household products following the launch of new products, such as liquid detergent capsules, and the manufacture of more concentrated formulations. Between 1 March 2008 and 30 April 2009 the UK National Poisons Information Service (NPIS) collected prospectively 5939 telephone enquiries relating to household products, approximately 10% of all telephone enquiries received over this period. The majority of enquiries (n = 3893; 65.5%) concerned children 5 years of age or less and were received predominantly from hospitals (n = 1905; 32.1%), general practitioners (n = 1768; 29.8%) and NHS Direct/NHS 24 (n = 1694; 28.5%). The majority of exposures occurred at home (n = 5795; 97.6%); most exposures were accidental (n = 5561; 93.6%). Liquid detergent capsules were most commonly involved (n = 647), followed by bleaches (n = 481), air fresheners (n = 429), multipurpose cleaners (n = 408), dishwasher products (n = 399) and descalers (n = 397). Exposure to household products occurred mainly as a result of ingestion (n = 4616; 75.8%), with eye contact (n = 513; 8.4%), inhalation (n = 420; 6.9%) and skin contact (n = 187; 3.1%) being less common; 5.1% (n = 313) of enquiries involved multiple routes of exposure. The most commonly reported features were vomiting (ingestion), pain (eye contact), dyspnoea (inhalation) and burns (skin contact). In 5840 of 5939 enquiries the Poisoning Severity Score (PSS) was known. The majority of patients (n = 4117; 70.5%) were asymptomatic (PSS 0), 28.0% (n = 1638) developed minor features (PSS 1), 1.3% (75 patients) developed moderate features (PSS 2) and 0.15% (nine patients) developed serious features (PSS 3). Four of these nine patients made a complete recovery, two died from exposure to drain cleaner and PVC solvent cleaner; the outcome in three was unknown. In the UK, advice from the NPIS is sought commonly regarding household products, but such exposures only rarely result in

  2. Symposium on 'Intervention policies for deprived households' Policy initiatives to address low-income households' nutritional needs in the UK.

    PubMed

    Dowler, Elizabeth

    2008-08-01

    Members of low-income households in the UK are more likely to have patterns of food and nutrient intakes that are less inclined to lead to good health outcomes in the short and long term. Health inequalities, including the likelihood of child and adulthood obesity, have long been documented in the UK and show little sign of improving so far, despite 10 years of attention from a government that has committed itself to addressing them. Following the Acheson Inquiry into Inequalities in Health (1998) in England a number of initiatives to tackle inequalities in food and diet were established, both nationally and within the devolved nations of Scotland, Wales and Northern Ireland. Nevertheless, until recently, there has been no overall strategic policy addressing the food and nutritional needs of low-income households. The present paper reviews how the problems have been constructed and understood and how they have been addressed, briefly drawing on recent evaluations of food and nutrition policies in Scotland and Wales. The contemporary challenge is to frame cross-cutting policy initiatives that move beyond simple targeting and local actions, encompass a life-course approach and recognise both the diversity of households that fall into 'low-income' categories and the need for 'upstream' intervention.

  3. Household hazardous waste data for the UK by direct sampling.

    PubMed

    Slack, Rebecca J; Bonin, Michael; Gronow, Jan R; Van Santen, Anton; Voulvoulis, Nikolaos

    2007-04-01

    The amount of household hazardous waste (HHW) disposed of in the United Kingdom (UK) requires assessment. This paper describes a direct analysis study carried out in three areas in southeast England involving over 500 households. Each participating householder was provided with a special bin in which to place items corresponding to a list of HHW. The amount of waste collected was split into nine broad categories: batteries, home maintenance (DIY), vehicle upkeep, pesticides, pet care, pharmaceuticals, photographic chemicals, household cleaners, and printer cartridges. Over 1 T of waste was collected from the sample households over a 32-week period, which would correspond to an estimated 51,000 T if extrapolated to the UK population for the same period or over 7,000 T per month. Details of likely disposal routes adopted by householders were also sought, demonstrating the different pathways selected for different waste categories. Co-disposal with residual household waste dominated for waste batteries and veterinary medicines, hence avoiding classification as hazardous waste under new UK waste regulations. The information can be used to set a baseline for the management of HHW and provides information for an environmental risk assessment of the disposal of such wastes to landfill.

  4. Occurrence of Legionella in UK household showers.

    PubMed

    Collins, Samuel; Stevenson, David; Bennett, Allan; Walker, Jimmy

    2017-04-01

    Household water systems have been proposed as a source of sporadic, community acquired Legionnaires' disease. Showers represent a frequently used aerosol generating device in the domestic setting yet little is known about the occurrence of Legionella spp. in these systems. This study has investigated the prevalence of Legionella spp. by culture and qPCR in UK household showers. Ninety nine showers from 82 separate properties in the South of England were sampled. Clinically relevant Legionella spp. were isolated by culture in 8% of shower water samples representing 6% of households. Legionella pneumophila sg1 ST59 was isolated from two showers in one property and air sampling demonstrated its presence in the aerosol state. A further 31% of showers were positive by Legionella spp. qPCR. By multi-variable binomial regression modelling Legionella spp. qPCR positivity was associated with the age of the property (p=0.02), the age of the shower (p=0.01) and the frequency of use (p=0.09). The concentration of Legionella spp. detected by qPCR was shown to decrease with increased frequency of use (p=0.04) and more frequent showerhead cleaning (p=0.05). There was no association between Legionella spp. qPCR positivity and the cold water supply or the showerhead material (p=0.65 and p=0.71, respectively). Household showers may be important reservoirs of clinically significant Legionella and should be considered in source investigations. Simple public health advice may help to mitigate the risk of Legionella exposure in the domestic shower environment. Crown Copyright © 2016. Published by Elsevier GmbH. All rights reserved.

  5. 2017 National Household Travel Survey - California Add-On |

    Science.gov Websites

    Transportation Secure Data Center | NREL 7 National Household Travel Survey - California Add-On 2017 National Household Travel Survey - California Add-On The California add-on survey supplements the 2017 National Household Travel Survey (NHTS) with additional household samples and detailed travel

  6. Data on Income inequality in Germany, France, Italy, Spain, the UK, and other affluent nations, 2012.

    PubMed

    Dorling, Danny

    2015-12-01

    This data article contains information on the distribution of household incomes in the five most populous European countries as surveyed in 2012, with data released in 2014 and published here aggregated and so further anonymized in 2015. The underlying source data is the already anonymized EU Statistics on Income and Living Conditions (EUSILC) Microdata. The data include the annual household income required in each country to fall within the best-off 1% in that country, median and mean incomes, average (mean) incomes of the best off 1%, 0.1% and estimates for the 0.01%, 0.001% and so on for the UK, and of the 90% and worse-off 10%, the best-off 10% and best-off 1% of households for all countries. Average income from the state is also calculated by these income categories and the number of people working in finance and receiving over €1,000,000 a year in income is reported from other sources (the European Banking Authority). Finally income distribution data is provided from the USA and the rest of Europe in order to allow comparisons to be made. The data revealed the gross household (simple unweighted) median incomes in 2012 to have been (in order from best-off country by median to worse-off): France €39,000, Germany: €33,400, UK: €36,300, Italy €33,400 and Spain €27,000. However the medians, once households are weighted to reflect the nation populations do differ although they are in the same order: France €36,000, Germany: €33,400, UK: €31,300, Italy €31,000 and Spain €23,700. Thus weighting to increase representativeness of the medians reduces each by €3000, €0, €5000, €3300 and €3300 respectively. In short, the middle (weighted median) French household is €4700 a year better off than the middle UK family, and that is before housing costs are considered. This Data in Brief article accompanies Dorling, D. (2015) Income Inequality in the UK: Comparisons with five large Western European countries and the USA [1].

  7. Lost in transition? An exploration of attempts to reduce energy consumption by UK households

    NASA Astrophysics Data System (ADS)

    Kukla, Christopher

    As significant energy consumers, UK households need to reduce their energy use if the UK is to achieve its greenhouse gas reduction targets. Low levels of engagement and adoption rates of energy curtailment measures need to be overcome. Policies perceived as ‘fair’ can increase levels of engagement and acceptability. This thesis explores how households approach reducing their own energy use, the reductions they can achieve and any existing barriers. Households’ perception of what is ‘fair’ in the context of energy reductions is explored based on households' own experiences of energy reduction. Households recruited from the South East of England participated in a mixed-methods study attempting to reduce their energy use over a 12-month period. Provided with estimates of their carbon footprints and a comparison to the UK average, the participants discussed their energy use, reductions and perceptions of how reductions could be encouraged fairly. Participants’ energy use was something of an enigma, as were the associated GHG emissions. However, its use was protected and seen as ‘acceptable’ and ‘necessary’ for them to be comfortable in their day-to-day lives. Reducing their energy use was seen as possible and acceptable in areas of energy use viewed as ‘wasteful’ or ‘unnecessary’. While seen as possible, these targets were not necessarily achievable, with 50 per cent of the participants making measurable reductions, and 50 per cent unable to. Energy reductions of ten per cent were seen as possible, even by those unable to reduce, with little scope to move beyond this as participants did not know what they should or could do next. To move forward participants viewed fairness as important, citing energy reductions needing to be a valid, legitimate aim of society; with required reductions being achievable, supported by information, and placing the burden of responsibility on those who use the most.

  8. Exploring the potential of Product Service Systems to achieve household waste prevention on new housing developments in the UK.

    PubMed

    Gottberg, Annika; Longhurst, Philip J; Cook, Matthew B

    2010-03-01

    Product service systems (PSS) are cleaner product concepts which have been developed to achieve improvements in resource productivity which may be realized from modern trends in service delivery. However, there is a paucity of research on the waste prevention performance of PSS in UK household markets. This paper reports the findings of exploratory research which begins to address this gap in knowledge. An exploratory waste prevention assessment was completed on four experimental PSS which were developed in conjunction with a major UK house-builder for delivery on their new housing developments. The results of the assessment show that the selected PSS concepts have potential to prevent high value and harmful Waste Electrical and Electronic Equipment (WEEE) arising in UK household waste streams. Consistent with the canon of exploratory research, the assessment also identifies a number of factors which are thought to influence PSS waste prevention performance. It is recognized that further research is needed to gain an in-depth understanding of these factors as well as to define policy measures which enable the conditions in which PSS prevent household waste on new housing developments in the UK to be created.

  9. Parental smoking and child poverty in the UK: an analysis of national survey data.

    PubMed

    Belvin, Charmaine; Britton, John; Holmes, John; Langley, Tessa

    2015-05-29

    In 2011/12 approximately 2.3 million children, 17% of children in the UK, were estimated to be in relative poverty. Cigarette smoking is expensive and places an additional burden on household budgets, and is strongly associated with socioeconomic deprivation. The aim of this study was to provide an illustrative first estimate of the extent to which parental smoking exacerbates child poverty in the UK. Findings from the 2012 Households Below Average Income report and the 2012 Opinions and Lifestyle Survey were combined to estimate the number of children living in poor households containing smokers; the expenditure of typical smokers in these households on tobacco; and the numbers of children drawn into poverty if expenditure on smoking is subtracted from household income. 1.1 million children - almost half of all children in poverty - were estimated to be living in poverty with at least one parent who smokes; and a further 400,000 would be classed as being in poverty if parental tobacco expenditure were subtracted from household income. Smoking exacerbates poverty for a large proportion of children in the UK. Tobacco control interventions which effectively enable low income smokers to quit can play an important role in reducing the financial burden of child poverty.

  10. The interference of paid work with household demands in different social policy contexts: perceived work-household conflict in Sweden, the UK, the Netherlands, Hungary, and the Czech Republic.

    PubMed

    Strandh, Mattias; Nordenmark, Mikael

    2006-12-01

    The article explores whether people experiences a lower level of work-household conflict in a context that is characterized by extensive family policies (Sweden and to some extent Hungary and Czech Republic) aimed at facilitating participation in the labour market. This is done by studying perceived work-household conflict among women and men living in Sweden, the UK, the Netherlands, Hungary, and the Czech Republic. The analyses are based on the answers to a questionnaire distributed to nearly 6,000 randomly selected individuals within the framework of the European Union financed 'Household, Work, and Flexibility' (HWF) study. The results show that women in Sweden experience conflicts between work and household demands to a higher degree than any other category in all five countries. The differences between Swedish women and women living in the Netherlands and the UK are explained by variables indicating qualifications and workload in the main job, but the lower degree of work-household conflict among Czech and Hungarian women is still significant when controlling for household composition and working conditions. Data indicate that a possible explanation for this can be found in the interplay between men's and women's attitudes toward gender roles and the actual situation in terms of division of labour.

  11. Sexual orientation health inequality: Evidence from Understanding Society, the UK Longitudinal Household Study.

    PubMed

    Booker, Cara L; Rieger, Gerulf; Unger, Jennifer B

    2017-08-01

    Few studies from the United Kingdom have fully investigated inequalities between members of different sexual minority groups and heterosexuals over range of health outcomes. Using data from over 40,000 individuals, this study explores the health inequalities of sexual minority UK adults. We include respondents who identify as other and those who prefer not to say (PNS). Data come from wave three (2011-2012) of the nationally-representative Understanding Society, the UK Household Longitudinal Study. Sexual orientation was asked in the self-completion portion of the study. Markers of health include physical and mental functioning, minor psychological distress, self-rated health, substance use and disability. Multiple linear and logistic regression analyses tested for differences in markers of health between sexual orientation groups. Overall, heterosexual respondents had the best health while bisexual respondents had the worst. Gay and lesbian respondents reported poorer health than heterosexuals, specifically with regards to mental functioning, distress and illness status. The other and PNS respondents were most similar to each other and generally experienced fewer health inequalities than gay and lesbian respondents; they were less likely to use tobacco or alcohol. In sum, sexual minorities experience health inequality. The inclusion of other and PNS respondents has not been done in other studies and shows that while they may be healthier than gay/lesbian and bisexual respondents they still experiences poorer health than heterosexuals. Health promotion interventions are needed for these other and PNS individuals, who might not participate in interventions targeted toward known sexual minority groups. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Food insecurity in veteran households: findings from nationally representative data.

    PubMed

    Miller, Daniel P; Larson, Mary Jo; Byrne, Thomas; DeVoe, Ellen

    2016-07-01

    The present study is the first to use nationally representative data to compare rates of food insecurity among households with veterans of the US Armed Forces and non-veteran households. We used data from the 2005-2013 waves of the Current Population Survey - Food Security Supplement to identify rates of food insecurity and very low food security in veteran and non-veteran households. We estimated the odds and probability of food insecurity in veteran and non-veteran households in uncontrolled and controlled models. We replicated these results after separating veteran households by their most recent period of service. We weighted models to create nationally representative estimates. Nationally representative data from the 2005-2013 waves of the Current Population Survey - Food Security Supplement. US households (n 388 680). Uncontrolled models found much lower rates of food insecurity (8·4 %) and very low food security (3·3 %) among veteran households than in non-veteran households (14·4 % and 5·4 %, respectively), with particularly low rates among households with older veterans. After adjustment, average rates of food insecurity and very low food security were not significantly different for veteran households. However, the probability of food insecurity was significantly higher among some recent veterans and significantly lower for those who served during the Vietnam War. Although adjusting eliminated many differences between veteran and non-veteran households, veterans who served from 1975 and onwards may be at higher risk for food insecurity and should be the recipients of targeted outreach to improve nutritional outcomes.

  13. NHTS : highlights of the 2001 National Household Travel Survey

    DOT National Transportation Integrated Search

    2003-01-01

    The 2001 National Household Travel Survey (NHTS) is the first comprehensive household survey of both daily and long-distance travel, allowing for analysis of the full continuum of personal travel by Americans. This report presents selected highlights...

  14. Hazards of household cleaning products.

    PubMed

    Edwards, J N; Jenkins, H L; Volans, G N

    1982-10-01

    1 All enquiries received by the London Centre of the National Poisons Information Service [NPIS(L)] relating to household cleaning products were followed up by questionnaire for a 4-month period from November 1978 to February 1979. 2 130 reports (43% of total followed-up) were received. 3 The incidence of misuse of household cleaning products has remained largely unchanged since a less detailed survey was performed in 1974-1975. 4 The source of enquiries, age groups and products involved were similar to the earlier survey. 5 Sixty-two per cent of cases were asymptomatic and no serious or life-threatening reactions were reported. 6 Although an increasing number of patients were admitted to hospital, little treatment was needed and the use of gastric lavage and aspiration had declined markedly. 7 Household cleaning products in the UK still cause no serious poisoning when misused or accidentally ingested.

  15. 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.

  16. The relationship between parity and overweight varies with household wealth and national development.

    PubMed

    Kim, Sonia A; Yount, Kathryn M; Ramakrishnan, Usha; Martorell, Reynaldo

    2007-02-01

    Recent studies support a positive relationship between parity and overweight among women of developing countries; however, it is unclear whether these effects vary by household wealth and national development. Our objective was to determine whether the association between parity and overweight [body mass index (BMI) > or =25 kg/m(2)] in women living in developing countries varies with levels of national human development and/or household wealth. We used data from 28 nationally representative, cross-sectional surveys conducted between 1996 and 2003 (n = 275 704 women, 15-49 years). The relationship between parity and overweight was modelled using logistic regression, controlling for several biological and sociodemographic factors and national development, as reflected by the United Nations' Human Development Index. We also modelled the interaction between parity and national development, and the three-way interaction between parity, household wealth and national development. Parity had a weak, positive association with overweight, which varied by household wealth and national development. Among the poorest women and women in the second tertile of household wealth, parity was positively related to overweight only in the most developed countries. Among the wealthiest women, parity was positively related to overweight regardless of the level of national development. As development increases, the burden of parity-related overweight shifts to include poor as well as wealthy women. In the least-developed countries, programmes to prevent parity-related overweight should target wealthy women, whereas such programmes should be provided to all women in more developed countries.

  17. Impact of the UK voluntary sodium reduction targets on the sodium content of processed foods from 2006 to 2011: analysis of household consumer panel data.

    PubMed

    Eyles, Helen; Webster, Jacqueline; Jebb, Susan; Capelin, Cathy; Neal, Bruce; Ni Mhurchu, Cliona

    2013-11-01

    In 2006 the UK Food Standards Agency (FSA) introduced voluntary sodium reduction targets for more than 80 categories of processed food. Our aim was to determine the impact of these targets on the sodium content of processed foods in the UK between 2006 and 2011. Household consumer panel data (n>18,000 households) were used to calculate crude and sales-weighted mean sodium content for 47,337 products in 2006 and 49,714 products in 2011. Two sample t-tests were used to compare means. A secondary analysis was undertaken to explore reformulation efforts and included only products available for sale in both 2006 and 2011. Between 2006 and 2011 there was an overall mean reduction in crude sodium content of UK foods of -26 mg/100g (p ≤ 0.001), equivalent to a 7% fall (356 mg/100g to 330 mg/100g). The corresponding sales-weighted reduction was -21 mg/100g (-6%). For products available for sale in both years the corresponding reduction was -23 mg/100g (p<0.001) or -7%. The UK FSA voluntary targets delivered a moderate reduction in the mean sodium content of UK processed foods between 2006 and 2011. Whilst encouraging, regular monitoring and review of the UK sodium reduction strategy will be essential to ensure continued progress. © 2013.

  18. A model of the dynamics of household vegetarian and vegan rates in the U.K.

    PubMed

    Waters, James

    2018-08-01

    Although there are many studies of determinants of vegetarianism and veganism, there have been no previous studies of how their rates in a population jointly change over time. In this paper, we present a flexible model of vegetarian and vegan dietary choices, and derive the joint dynamics of rates of consumption. We fit our model to a pseudo-panel with 23 years of U.K. household data, and find that while vegetarian rates are largely determined by current household characteristics, vegan rates are additionally influenced by their own lagged value. We solve for equilibrium rates of vegetarianism and veganism, show that rates of consumption return to their equilibrium levels following a temporary event which changes those rates, and estimate the effects of campaigns to promote non-meat diets. We find that a persistent vegetarian campaign has a significantly positive effect on the rate of vegan consumption, in answer to an active debate among vegan campaigners. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Complex association between rural/urban residence, household wealth and women's overweight: evidence from 30 cross-sectional national household surveys in Africa.

    PubMed

    Madise, Nyovani Janet; Letamo, Gobopamang

    2017-01-01

    We sought to demonstrate that the relationship between urban or rural residence and overweight status among women in Sub-Saharan Africa is complex and confounded by wealth status. We applied multilevel logistic regression to data from 30 sub-Saharan African countries which were collected between 2006 and 2012 to examine the association between women's overweight status (body mass index ≥ 25) and household wealth, rural or urban place of residence, and their interaction. Macro-level statistics from United Nations agencies were used as contextual variables to assess the link between progress in globalization and patterns of overweight. Household wealth was associated with increased odds of being overweight in nearly all of the countries. Urban/rural living and household wealth had a complex association with women's overweight status, shown by 3 patterns. In one group of countries, characterised by low national wealth (median per capita gross national income (GNI) = $660 in 2012) and lower overall prevalence of female overweight (median = 24 per cent in 2010), high household wealth and urban living had independent associations with increased risks of being overweight. In the second group of less poor countries (median per capita GNI = $870) and higher national levels of female overweight (median = 29), there was a cross-over association where rural women had lower risks of overweight than urban women at lower levels of household wealth, but in wealthier households, rural women had higher risks of overweight than urban women. In the final group of countries, household wealth was an important predictor of overweight status, but the association between urban or rural place of residence and overweight status was not statistically significant. The median per capita GNI for this third group was $800 and national prevalence of female overweight was high (median = 32% in 2010). As nations develop and household wealth increases, rural African women

  20. Prevalence of Giardia infection in households of Giardia cases and risk factors for household transmission.

    PubMed

    Waldram, Alison; Vivancos, Roberto; Hartley, Catherine; Lamden, Kenneth

    2017-07-11

    Giardia is a leading but neglected cause of infectious gastroenteritis worldwide and is treatable. There is a substantial burden of undetected Giardia in the UK and for every one case of Giardia reported to national surveillance there are 14 cases in the community. We aimed to ascertain the prevalence of, and risk factors associated with secondary household Giardia infections to assess the burden of infection and inform control measures. We identified all giardiasis cases notified in nine local authorities in Lancashire between June 2014 and June 2015, and invited their household contacts to submit faecal specimens for Giardia testing and complete a risk factor questionnaire. We estimated the proportion of households with additional Giardia infection. We compared household risk factors between households with and without additional Giardia using Fisher's exact test. We used multivariable logistic regression to identify independent risk factors for additional Giardia infections. We identified additional Giardia infections in 30% (27/91) of included households. A total of 41 infections were found from 212 household members, of which 37 were asymptomatic. The majority of infections were assemblage B (57%) but there were also a high number of mixed infections (20%). Risk factors significantly associated with additional household infections were; having children under 5 years in the household (odds ratio 42; 95% confidence intervals 10-178) and the presence of gastrointestinal illness in the household before the onset of the index case (odds ratio 9; 95% confidence intervals 1.5-48). Our finding of a high household prevalence of asymptomatic infection has raised the public health question of whether treatment of asymptomatic household contacts may be justified in preventing Giardia re-infection of the index case or in preventing secondary cases and household clusters. We recommend the communication of this risk in household contacts of Giardia and reinforcement of

  1. Older workers in the UK: variations in economic activity status by socio-demographic characteristics, household and caring commitments.

    PubMed

    Dini, Ercilia

    2009-01-01

    The most significant demographic trend affecting the size and composition of the labour force over the next 25 years will be the decrease in the number of people in the age group 16 to 49 and an increase in the number of people aged between 50 and 64, Increasing the participation of adults of older ages in the paid labour market is a central policy issue. There has been an increase in employment rates of women and men aged 50 to State Pension Age (SPA) in the UK since the early 1990s. However, there are differences in the economic activity status of adults of older ages across UK countries and by demographic and socio-economic characteristics, household circumstances and caring commitments.

  2. Ability to Pay for Future National Health Financing Scheme among Malaysian Households.

    PubMed

    Aizuddin, Azimatun Noor; Aljunid, Syed Mohamed

    Malaysia is no exception to the challenging health care financing phenomenon of globalization. The objective of the present study was to assess the ability to pay among Malaysian households as preparation for a future national health financing scheme. This was a cross-sectional study involving representative samples of 774 households in Peninsular Malaysia. A majority of households were found to have the ability to pay for their health care. Household expenditure on health care per month was between MYR1 and MYR2000 with a mean (standard deviation [SD]) of 73.54 (142.66), or in a percentage of per-month income between 0.05% and 50% with mean (SD) 2.74 (5.20). The final analysis indicated that ability to pay was significantly higher among younger and higher-income households. Sociodemographic and socioeconomic statuses are important eligibility factors to be considered in planning the proposed national health care financing scheme to shield the needed group from catastrophic health expenditures. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

  3. Educational Attainment across the UK Nations: Performance, Inequality and Evidence

    ERIC Educational Resources Information Center

    Machin, Stephen; McNally, Sandra; Wyness, Gill

    2013-01-01

    Background: Political devolution occurred in the UK in 1998-99, following many years in which some degree of policy administration had been devolved to the four nations. Since devolution, all four countries of the UK have pursued increasingly divergent education policies. This is true in England in particular, where diversity, choice and…

  4. Household availability of ultra-processed foods and obesity in nineteen European countries.

    PubMed

    Monteiro, Carlos Augusto; Moubarac, Jean-Claude; Levy, Renata Bertazzi; Canella, Daniela Silva; Louzada, Maria Laura da Costa; Cannon, Geoffrey

    2018-01-01

    To assess household availability of NOVA food groups in nineteen European countries and to analyse the association between availability of ultra-processed foods and prevalence of obesity. Ecological, cross-sectional study. Europe. Estimates of ultra-processed foods calculated from national household budget surveys conducted between 1991 and 2008. Estimates of obesity prevalence obtained from national surveys undertaken near the budget survey time. Across the nineteen countries, median average household availability amounted to 33·9 % of total purchased dietary energy for unprocessed or minimally processed foods, 20·3 % for processed culinary ingredients, 19·6 % for processed foods and 26·4 % for ultra-processed foods. The average household availability of ultra-processed foods ranged from 10·2 % in Portugal and 13·4 % in Italy to 46·2 % in Germany and 50·4 % in the UK. A significant positive association was found between national household availability of ultra-processed foods and national prevalence of obesity among adults. After adjustment for national income, prevalence of physical inactivity, prevalence of smoking, measured or self-reported prevalence of obesity, and time lag between estimates on household food availability and obesity, each percentage point increase in the household availability of ultra-processed foods resulted in an increase of 0·25 percentage points in obesity prevalence. The study contributes to a growing literature showing that the consumption of ultra-processed foods is associated with an increased risk of diet-related non-communicable diseases. Its findings reinforce the need for public policies and actions that promote consumption of unprocessed or minimally processed foods and make ultra-processed foods less available and affordable.

  5. Faecal contamination of household drinking water in Rwanda: A national cross-sectional study.

    PubMed

    Kirby, Miles A; Nagel, Corey L; Rosa, Ghislaine; Iyakaremye, Laurien; Zambrano, Laura Divens; Clasen, Thomas F

    2016-11-15

    Unsafe drinking water is a leading cause of morbidity and mortality, especially among young children in low-income settings. We conducted a national survey in Rwanda to determine the level of faecal contamination of household drinking water and risk factors associated therewith. Drinking water samples were collected from a nationally representative sample of 870 households and assessed for thermotolerant coliforms (TTC), a World Health Organization (WHO)-approved indicator of faecal contamination. Potential household and community-level determinants of household drinking water quality derived from household surveys, the 2012 Rwanda Population and Housing Census, and a precipitation dataset were assessed using multivariate logistic regression. Widespread faecal contamination was present, and only 24.9% (95% CI 20.9-29.4%, n=217) of household samples met WHO Guidelines of having no detectable TTC contamination, while 42.5% (95% CI 38.0-47.1%, n=361) of samples had >100TTC/100mL and considered high risk. Sub-national differences were observed, with poorer water quality in rural areas and Eastern province. In multivariate analyses, there was evidence for an association between detectable contamination and increased open waste disposal in a sector, lower elevation, and water sources other than piped to household or rainwater/bottled. Risk factors for intermediate/high risk contamination (>10TTC/100mL) included low population density, increased open waste disposal, lower elevation, water sources other than piped to household or rainwater/bottled, and occurrence of an extreme rain event the previous day. Modelling suggests non-household-based risk factors are determinants of water quality in this setting, and these results suggest a substantial proportion of Rwanda's population are exposed to faecal contamination through drinking water. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Comparison between household budget survey and 24-hour recall data in a nationally representative sample of Polish households.

    PubMed

    Sekula, W; Nelson, M; Figurska, K; Oltarzewski, M; Weisell, R; Szponar, L

    2005-06-01

    Household budget survey (HBS) data are used regularly for nutritional epidemiological purposes. The validity of HBS data, however, is not well established. The aim of this project was to compare HBS and individual nutrition survey (INS) data in a nationally representative sample of Polish households. Estimates of food consumption and nutrient intake were compared between household food acquisition data collected over 1 month and a single 24-hour recall collected from every household member in a nationally representative sample of Polish households surveyed between September and November 2000. To facilitate the comparison, INS food consumption data excluded food eaten away from home and were modified using a computer program to estimate food 'as purchased' (including disaggregation of recipe data) and to allow for wastage. Poland. Participants were 3716 individuals in 1215 households (representing co-operation rates of 86.2% and 89.2%, respectively). Good agreement was shown between median estimates of foods such as potatoes, vegetables (including processed), meat, meat products and poultry, and animal fats (excluding butter), but agreement was poor for bread and rolls, fruit, vegetable fats and oils, eggs and six other food groups. Estimates of energy and nutrient intake were within +/-10% with the exceptions of polyunsaturated fats, potassium and vitamin C. Possible reasons for differences in findings between the two surveys include survey bias (e.g. social approval bias leading to overreporting of fruit), seasonal variations (e.g. high potato purchases between September and November) and aspects of the methodology (e.g. HBS data were based on records collected over 1 month, whereas 24-hour recall data were based on recalls collected from all household respondents on only 1 day and averaged for each household type). HBSs provide useful data for epidemiological research, but findings need to be interpreted in the light of other data regarding consumption, and

  7. ELIXIR-UK role in bioinformatics training at the national level and across ELIXIR.

    PubMed

    Larcombe, L; Hendricusdottir, R; Attwood, T K; Bacall, F; Beard, N; Bellis, L J; Dunn, W B; Hancock, J M; Nenadic, A; Orengo, C; Overduin, B; Sansone, S-A; Thurston, M; Viant, M R; Winder, C L; Goble, C A; Ponting, C P; Rustici, G

    2017-01-01

    ELIXIR-UK is the UK node of ELIXIR, the European infrastructure for life science data. Since its foundation in 2014, ELIXIR-UK has played a leading role in training both within the UK and in the ELIXIR Training Platform, which coordinates and delivers training across all ELIXIR members. ELIXIR-UK contributes to the Training Platform's coordination and supports the development of training to address key skill gaps amongst UK scientists. As part of this work it acts as a conduit for nationally-important bioinformatics training resources to promote their activities to the ELIXIR community. ELIXIR-UK also leads ELIXIR's flagship Training Portal, TeSS, which collects information about a diverse range of training and makes it easily accessible to the community. ELIXIR-UK also works with others to provide key digital skills training, partnering with the Software Sustainability Institute to provide Software Carpentry training to the ELIXIR community and to establish the Data Carpentry initiative, and taking a lead role amongst national stakeholders to deliver the StaTS project - a coordinated effort to drive engagement with training in statistics.

  8. National Prevalence of PTSD Among Sexually Revictimized Adolescent, College, and Adult Household-Residing Women

    PubMed Central

    Walsh, Kate; Danielson, Carla Kmett; McCauley, Jenna L.; Saunders, Benjamin E.; Kilpatrick, Dean G.; Resnick, Heidi S.

    2012-01-01

    Context Despite empirical links between sexual revictimization (i.e., experiencing two or more sexual assaults) and posttraumatic stress disorder (PTSD), no epidemiological studies document the prevalence of sexual revictimization and PTSD. Establishing estimates is essential to determine the scope, public health impact, and psychiatric sequelae of sexual revictimization. Objective Estimate the prevalence of sexual revictimization and PTSD among three national female samples (adolescent, college, adult household probability). Design Surveys were used to collect data from The National Women’s Study – Replication (2006; college) as well as household probability samples from the National Survey of Adolescents-Replication (2005) and the National Women’s Study-Replication (2006; household probability). Setting Households and college campuses across the U.S. Participants 1,763 adolescent girls, 2,000 college women, and 3,001 household-residing adult women. Main Outcomes Behaviorally specific questions assessed unwanted sexual acts occurring over the lifespan due to use of force, threat of force, or incapacitation via drug or alcohol use. PTSD was assessed with a module validated against the criterion standard, Structured Clinical Interview for DSM-IV. Results 52.7% of victimized adolescents, 50.0% of victimized college women, and 58.8% of victimized household-residing women reported sexual revictimization. Current PTSD was reported by 20.0% of revictimized adolescents, 40.0% of revictimized college women, and 27.2% of revictimized household-residing women. Compared to non-victims, odds of meeting past 6-month PTSD were 4.3–8.2 times higher for revictimized respondents and 2.4–3.5 times higher for single victims. Conclusions Population prevalence estimates suggest that 769,000 adolescent girls, 625,000 college women, and 13.4 million women in US households reported sexual revictimization. Further, 154,000 sexually revictimized adolescents, 250,000 sexually

  9. Increased household financial strain, the Great Recession and child health—findings from the UK Millennium Cohort Study

    PubMed Central

    Law, Catherine; Pearce, Anna

    2017-01-01

    Background There is a growing body of evidence associating financial strain (FS) with poor health but most of this research has been cross-sectional and adult-focused. During the ‘Great Recession’ many UK households experienced increased FS. The primary aim of this study was to determine the impact of increased FS on child health. Methods We analysed the Millennium Cohort Study, a longitudinal study of children born in the UK between 2000 and 2002. Surveys at 7 years (T1, 2008) and 11 years (T2, 2012) spanned the ‘Great Recession’. Three measures of increased FS were defined; ‘became income poor’ (self-reported household income dropped below the ‘poverty line’ between T1 and T2); ‘developed difficulty managing’ (parental report of being ‘financially comfortable’ at T1 and finding it ‘difficult to manage’ at T2); ‘felt worse off’ (parental report of feeling financially ‘worse off’ at T2 compared with T1). Poisson regression was used to estimate risk ratios (RR), adjusted risk ratios (aRR) and 95% CIs for six child health outcomes: measured overweight/obesity, problematic behaviour as scored by parents and teachers, and parental reports of fair/poor general health, long-standing illness and bedwetting at T2 (N=13 112). In subanalyses we limited our sample to those who were above the poverty line at T2. Results Compared with those who were not financially strained at both time points, children in households which experienced increased FS were at an increased risk of all unhealthy outcomes examined. In most cases, these increased risks persisted after adjustment for confounding and when limiting the sample to those above the poverty line. Conclusions FS is associated with a range of new or continued poor child health outcomes. During times of widespread economic hardship, such as the ‘Great Recession’, measures should be taken to buffer children and their families from the impact of FS, and these should not be limited to

  10. ELIXIR-UK role in bioinformatics training at the national level and across ELIXIR

    PubMed Central

    Larcombe, L.; Hendricusdottir, R.; Attwood, T.K.; Bacall, F.; Beard, N.; Bellis, L.J.; Dunn, W.B.; Hancock, J.M.; Nenadic, A.; Orengo, C.; Overduin, B.; Sansone, S-A; Thurston, M.; Viant, M.R.; Winder, C.L.; Goble, C.A.; Ponting, C.P.; Rustici, G.

    2017-01-01

    ELIXIR-UK is the UK node of ELIXIR, the European infrastructure for life science data. Since its foundation in 2014, ELIXIR-UK has played a leading role in training both within the UK and in the ELIXIR Training Platform, which coordinates and delivers training across all ELIXIR members. ELIXIR-UK contributes to the Training Platform’s coordination and supports the development of training to address key skill gaps amongst UK scientists. As part of this work it acts as a conduit for nationally-important bioinformatics training resources to promote their activities to the ELIXIR community. ELIXIR-UK also leads ELIXIR’s flagship Training Portal, TeSS, which collects information about a diverse range of training and makes it easily accessible to the community. ELIXIR-UK also works with others to provide key digital skills training, partnering with the Software Sustainability Institute to provide Software Carpentry training to the ELIXIR community and to establish the Data Carpentry initiative, and taking a lead role amongst national stakeholders to deliver the StaTS project – a coordinated effort to drive engagement with training in statistics. PMID:28781748

  11. Differences in the social patterning of active travel between urban and rural populations: findings from a large UK household survey.

    PubMed

    Hutchinson, Jayne; White, Piran C L; Graham, Hilary

    2014-12-01

    To determine the social patterning of active travel of short journeys for urban and rural residents in a large UK representative sample. Associations between frequently walking or cycling short journeys and socio-demographic factors in the UK Household Longitudinal Study were determined using logistic regression. Urban residents were 64 % more likely to frequently engage in active travel than rural residents (95 % CI 1.52, 1.77). Being younger, male, without full-time employment and having a lower income independently predicted greater active travel for both urban and rural residents. Degree level education and not having children were independent predictors for urban, but not rural residents. Actively travelling short journeys is less common and independently associated with fewer socio-demographic factors in rural than in urban populations.

  12. 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.

  13. National Context, Family Satisfaction, and Fairness in the Division of Household Labor

    ERIC Educational Resources Information Center

    Greenstein, Theodore N.

    2009-01-01

    This study uses data from married women in 30 nations to examine justice processes involving perceptions of fairness of the division of household labor and satisfaction with family life. Relative deprivation theory suggests that national context--operationalized here as nation-level gender equity--might serve as a comparative referent used by…

  14. Household waste prevention--a review of evidence.

    PubMed

    Cox, Jayne; Giorgi, Sara; Sharp, Veronica; Strange, Kit; Wilson, David C; Blakey, Nick

    2010-03-01

    This paper reports a synthesis of policy-relevant evidence on household waste prevention, based on a UK portfolio of primary research and a broad international review. Waste prevention was defined as strict avoidance, reduction at source (e.g. home composting) and reuse (for the product's original purpose) - recycling was excluded. A major focus was on consumers. Waste prevention is not one but many behaviours; the review revealed a general hierarchy in their popularity, from donating goods to charity at the top; through small reuse behaviours around the home; to activities involving changes in consumption habits at the bottom; one estimate is that 60% of the public does at least one of these activities, some of the time. Barriers to engaging householders include both modern consumer culture and a genuine confusion that waste prevention is equivalent to recycling. The public can be engaged through local or national campaigns, with a wide range of interventions and communications approaches available. On the products and services side, the primary opportunity within the scope of the review was identified as increasing reuse. The barriers included operational difficulties (funding, capacity, logistics) and consumer attitudes towards second-hand goods. The main opportunities are to ensure more strategic planning for reuse by local authorities and better co-ordination and joint working with the third sector. The review examined the impact or potential of various policy measures designed to influence household behaviour directly or the products and services provided to them. Overall, the international evidence suggests that waste prevention benefits will be derived from a 'package' of measures, including, for example, prevention targets, producer responsibility, householder charging, funding for pilot projects, collaboration between the public, private and third sectors, and public intervention campaigns. UK evidence suggests that the greatest tonnage diversions can be

  15. National Household Education Survey. Adult and Course Data Files User's Manual.

    ERIC Educational Resources Information Center

    Brick, J. Michael; And Others

    This manual provides documentation and guidance for users of the public release data files (adult file and course file) for Adult Education (AE) component of the 1991 National Household Education Survey (NHES:91). The NHES:91 was a random-digit dial telephone survey developed by the National Center for Education Statistics (NCES) and conducted by…

  16. Increased household financial strain, the Great Recession and child health-findings from the UK Millennium Cohort Study.

    PubMed

    McKenna, Caoimhe; Law, Catherine; Pearce, Anna

    2017-03-09

    There is a growing body of evidence associating financial strain (FS) with poor health but most of this research has been cross-sectional and adult-focused. During the 'Great Recession' many UK households experienced increased FS. The primary aim of this study was to determine the impact of increased FS on child health. We analysed the Millennium Cohort Study, a longitudinal study of children born in the UK between 2000 and 2002. Surveys at 7 years (T1, 2008) and 11 years (T2, 2012) spanned the 'Great Recession'. Three measures of increased FS were defined; 'became income poor' (self-reported household income dropped below the 'poverty line' between T1 and T2); 'developed difficulty managing' (parental report of being 'financially comfortable' at T1 and finding it 'difficult to manage' at T2); 'felt worse off' (parental report of feeling financially 'worse off' at T2 compared with T1). Poisson regression was used to estimate risk ratios (RR), adjusted risk ratios (aRR) and 95% CIs for six child health outcomes: measured overweight/obesity, problematic behaviour as scored by parents and teachers, and parental reports of fair/poor general health, long-standing illness and bedwetting at T2 (N=13 112). In subanalyses we limited our sample to those who were above the poverty line at T2. Compared with those who were not financially strained at both time points, children in households which experienced increased FS were at an increased risk of all unhealthy outcomes examined. In most cases, these increased risks persisted after adjustment for confounding and when limiting the sample to those above the poverty line. FS is associated with a range of new or continued poor child health outcomes. During times of widespread economic hardship, such as the 'Great Recession', measures should be taken to buffer children and their families from the impact of FS, and these should not be limited to those who are income poor. Published by the BMJ Publishing Group Limited. For

  17. National prevalence of posttraumatic stress disorder among sexually revictimized adolescent, college, and adult household-residing women.

    PubMed

    Walsh, Kate; Danielson, Carla Kmett; McCauley, Jenna L; Saunders, Benjamin E; Kilpatrick, Dean G; Resnick, Heidi S

    2012-09-01

    Despite empirical links between sexual revictimization (ie, experiencing 2 or more sexual assaults) and posttraumatic stress disorder (PTSD), to our knowledge, no epidemiological studies document the prevalence of sexual revictimization and PTSD. Establishing estimates is essential to determine the scope, public health impact, and psychiatric sequelae of sexual revictimization. To estimate the prevalence of sexual revictimization and PTSD among 3 national female samples (adolescent, college, and adult household probability). Surveys were used to collect data from the National Women's Study-Replication (2006; college) as well as household probability samples from the National Survey of Adolescents-Replication (2005) and the National Women's Study-Replication (2006; household probability). Households and college campuses across the United States. One thousand seven hundred sixty-three adolescent girls, 2000 college women, and 3001 household-residing adult women. Behaviorally specific questions assessed unwanted sexual acts occurring over the life span owing to the use of force, threat of force, or incapacitation via drug or alcohol use. Posttraumatic stress disorder was assessed with a module validated against the criterion standard Structured Clinical Interview for DSM-IV. About 53% of victimized adolescents, 50% of victimized college women, and 58.8% of victimized household-residing women reported sexual revictimization. Current PTSD was reported by 20% of revictimized adolescents, 40% of revictimized college women, and 27.2% of revictimized household-residing women. Compared with nonvictims, odds of meeting past 6-month PTSD were 4.3 to 8.2 times higher for revictimized respondents and 2.4 to 3.5 times higher for single victims. Population prevalence estimates suggest that 769 000 adolescent girls, 625 000 college women, and 13.4 million women in US households reported sexual revictimization. Further, 154 000 sexually revictimized adolescents, 250 000 sexually

  18. Household coverage of Swaziland's national community health worker programme: a cross-sectional population-based study.

    PubMed

    Geldsetzer, Pascal; Vaikath, Maria; De Neve, Jan-Walter; Bossert, Thomas J; Sibandze, Sibusiso; Bärnighausen, Till

    2017-08-01

    To ascertain household coverage achieved by Swaziland's national community health worker (CHW) programme and differences in household coverage across clients' sociodemographic characteristics. Household survey from June to September 2015 in two of Swaziland's four administrative regions using two-stage cluster random sampling. Interviewers administered a questionnaire to all household members in 1542 households across 85 census enumeration areas. While the CHW programme aims to cover all households in the country, only 44.5% (95% confidence interval: 38.0% to 51.1%) reported that they had ever been visited by a CHW. In both uni- and multivariable regressions, coverage was negatively associated with household wealth (OR for most vs. least wealthy quartile: 0.30 [0.16 to 0.58], P < 0.001) and education (OR for >secondary schooling vs. no schooling: 0.65 [0.47 to 0.90], P = 0.009), and positively associated with residing in a rural area (OR: 2.95 [1.77 to 4.91], P < 0.001). Coverage varied widely between census enumeration areas. Swaziland's national CHW programme is falling far short of its coverage goal. To improve coverage, the programme would likely need to recruit additional CHWs and/or assign more households to each CHW. Alternatively, changing the programme's ambitious coverage goal to visiting only certain types of households would likely reduce existing arbitrary differences in coverage between households and communities. This study highlights the need to evaluate and reform large long-standing CHW programmes in sub-Saharan Africa. © 2017 John Wiley & Sons Ltd.

  19. The National Falls and Bone Health Audit: implications for UK emergency care.

    PubMed

    Banerjee, Jay; Benger, Jonathan; Treml, Jonathan; Martin, Finbarr C; Grant, Rob; Lowe, Derek; Potter, Jonathan; Husk, Janet

    2012-10-01

    The National Clinical Audit of Falls and Bone Health, coordinated by the Royal College of Physicians, assesses progress in implementing integrated falls services across the UK against national standards and enables benchmarking between service providers. Nationally, falls are a leading contributor towards mortality and morbidity in older people and account for 700,000 visits to emergency departments and 4 million annual bed days in England alone. Two rounds of national organisational audit in 2005 and 2008 and one national clinical audit in 2006 were carried out based on indicators developed by a multidisciplinary group. These showed that management of falls and bone health in older people remains suboptimal in emergency departments and minor injury units and opportunities are being missed in carrying out evidence-based risk assessment and management. Older people attending emergency departments in the UK following a fall are receiving a poor deal. There is an urgent need to ensure more effective assessment and management to prevent further falls and fractures.

  20. Federal Highway Administration Research and Technology National Household Travel Survey Program

    DOT National Transportation Integrated Search

    2017-08-01

    This evaluation of the National Household Travel Survey (NHTS) Program addresses three key questions: 1) What is the breadth and depth of NHTS usage? 2) What impact does the NHTS Program have on policy, project, or regulatory decision making? 3) How ...

  1. National Prevalence and Exposure Risk for Cockroach Allergen in U.S. Households

    PubMed Central

    Cohn, Richard D.; Arbes, Samuel J.; Jaramillo, Renee; Reid, Laura H.; Zeldin, Darryl C.

    2006-01-01

    We characterized the prevalence of cockroach allergen exposure in a nationally representative sample of U.S. homes and assessed risk factors for elevated concentrations. Design We used data from the National Survey of Lead and Allergens in Housing, a population-based cross-sectional survey. Participants Participants were residents of 831 U.S. homes in the survey. Evaluations/Measurements We analyzed allergen, questionnaire, and observational data of 831 U.S. homes. Results Cockroach allergen (Bla g 1) concentrations exceed 2.0 U/g, a level associated with allergic sensitization, in 11% of U.S. living room floors and 13% of kitchen floors. Concentrations exceed 8.0 U/g, a level associated with asthma morbidity, in 3% of living room floors and 10% of kitchen floors. Elevated concentrations were observed in high-rise apartments, urban settings, pre-1940 constructions, and households with incomes < $20,000. Odds of having concentrations > 8.0 U/g were greatest when roach problems were reported or observed and increased with the number of cockroaches observed and with indications of recent cockroach activity. Conclusions Household cockroach allergen exposure is characterized in a nationally representative context. The allergen is prevalent in many settings, at levels that may contribute to allergic sensitization and asthma morbidity. Relevance to Clinical or Professional Practice Likelihood of exposure can be assessed by consideration of demographic and household determinants. PMID:16581539

  2. Relationship between mean daily energy intake and frequency of consumption of out-of-home meals in the UK National Diet and Nutrition Survey.

    PubMed

    Goffe, Louis; Rushton, Stephen; White, Martin; Adamson, Ashley; Adams, Jean

    2017-09-22

    Out-of-home meals have been characterised as delivering excessively large portions that can lead to high energy intake. Regular consumption is linked to weight gain and diet related diseases. Consumption of out-of-home meals is associated with socio-demographic and anthropometric factors, but the relationship between habitual consumption of such meals and mean daily energy intake has not been studied in both adults and children in the UK. We analysed adult and child data from waves 1-4 of the UK National Diet and Nutrition Survey using generalized linear modelling. We investigated whether individuals who report a higher habitual consumption of meals out in a restaurant or café, or takeaway meals at home had a higher mean daily energy intake, as estimated by a four-day food diary, whilst adjusting for key socio-demographic and anthropometric variables. Adults who ate meals out at least weekly had a higher mean daily energy intake consuming 75-104 kcal more per day than those who ate these meals rarely. The equivalent figures for takeaway meals at home were 63-87 kcal. There was no association between energy intake and frequency of consumption of meals out in children. Children who ate takeaway meals at home at least weekly consumed 55-168 kcal more per day than those who ate these meals rarely. Additionally, in children, there was an interaction with socio-economic position, where greater frequency of consumption of takeaway meals was associated with higher mean daily energy intake in those from less affluent households than those from more affluent households. Higher habitual consumption of out-of-home meals is associated with greater mean daily energy intake in the UK. More frequent takeaway meal consumption in adults and children is associated with greater daily energy intake and this effect is greater in children from less affluent households. Interventions seeking to reduce energy content through reformulation or reduction of portion sizes in restaurants

  3. Association between household food access insecurity and nutritional status indicators among children aged <5 years in Nepal: results from a national, cross-sectional household survey.

    PubMed

    Sreeramareddy, Chandrashekhar T; Ramakrishnareddy, N; Subramaniam, Mayoori

    2015-11-01

    To examine the association between household food insecurity score and Z-scores of childhood nutritional status indicators. Population-based, cross-sectional survey, Nepal Demographic and Health Survey 2011. A nationally representative sample of 11 085 households selected by a two-stage, stratified cluster sampling design to interview eligible men and women. Children (n 2591) aged 0-60 months in a sub-sample of households selected for men's interview. Prevalence of moderate and severe household food insecurity was 23·2% and 19·0%, respectively, for children aged 0-60 months. Weighted prevalence rates for stunting (height-for-age Z-score (HAZ) <-2), wasting (weight-for-height Z-score (WHZ) <-2) and underweight (weight-for-age Z-score (WAZ) <-2) were 41·6% (95% CI 38·9, 44·3%), 11·5% (95% CI 9·8, 13·2%) and 30·1% (95% CI 27·5, 32·8%), respectively. Prevalences of stunting, severe stunting (HAZ<-3) and underweight by level of household food insecurity were statistically significant (P<0·001). By multiple linear regression analyses and after adjustment for sociodemographic, child and environmental factors, household food access insecurity score was associated with HAZ (β=-0·02, P=0·01) and WAZ (β=-0·01, P=0·01) but was not associated with WHZ and BMI-for-age Z-score. A 10-point increase in household food access insecurity score was associated with a decrease in HAZ of 0·2 (95% CI 0·05, 0·39) and decrease in WAZ of 0·1 (95% CI 0·03, 0·27). Our results from a nationally representative sample confirm the previously reported association of household food insecurity with stunting and underweight. Community nutrition interventions may use household food insecurity scales for identifying those households where children may be at risk of growth faltering.

  4. Constructing a National Higher Education Brand for the UK: Positional Competition and Promised Capitals

    ERIC Educational Resources Information Center

    Lomer, Sylvie; Papatsiba, Vassiliki; Naidoo, Rajani

    2018-01-01

    This article examines national branding of UK higher education, a strategic intent and action to collectively brand UK higher education with the aim to attract prospective international students, using a Bourdieusian approach to understanding promises of capitals. We trace its development between 1999 and 2014 through a sociological study, one of…

  5. Incidence and risk factors of homicide-suicide in Swiss households: National Cohort study.

    PubMed

    Panczak, Radoslaw; Zwahlen, Marcel; Spoerri, Adrian; Tal, Kali; Killias, Martin; Egger, Matthias

    2013-01-01

    Homicide-suicides are rare but catastrophic events. This study examined the epidemiology of homicide-suicide in Switzerland. The study identified homicide-suicide events 1991-2008 in persons from the same household in the Swiss National Cohort, which links census and mortality records. The analysis examined the association of the risk of dying in a homicide-suicide event with socio-demographic variables, measured at the individual-level, household composition variables and area-level variables. Proportional hazards regression models were calculated for male perpetrators and female victims. Results are presented as age-adjusted hazard ratios (HR) with 95% confidence intervals (95%CI). The study identified 158 deaths from homicide-suicide events, including 85 murder victims (62 women, 4 men, 19 children and adolescents) and 68 male and 5 female perpetrators. The incidence was 3 events per million households and year. Firearms were the most prominent method for both homicides and suicides. The risk of perpetrating homicide-suicide was higher in divorced than in married men (HR 3.64; 95%CI 1.56-8.49), in foreigners without permanent residency compared to Swiss citizens (HR 3.95; 1.52-10.2), higher in men without religious affiliations than in Catholics (HR 2.23; 1.14-4.36) and higher in crowded households (HR 4.85; 1.72-13.6 comparing ≥2 with <1 persons/room). There was no association with education, occupation or nationality, the number of children, the language region or degree of urbanicity. Associations were similar for female victims. This national longitudinal study shows that living conditions associated with psychological stress and lower levels of social support are associated with homicide-suicide events in Switzerland.

  6. Household out-of-pocket medical expenditures and national health insurance in Taiwan: income and regional inequality

    PubMed Central

    Chu, Tu-Bin; Liu, Tsai-Ching; Chen, Chin-Shyan; Tsai, Yi-Wen; Chiu, Wen-Ta

    2005-01-01

    Background Unequal geographical distribution of medical care resources and insufficient healthcare coverage have been two long-standing problems with Taiwan's public health system. The implementation of National Health Insurance (NHI) attempted to mitigate the inequality in health care use. This study examines the degree to which Taiwan's National Health Insurance (NHI) has reduced out-of-pocket medical expenditures in households in different regions and varying levels of income. Methods Data used in this study were drawn from the 1994 and 1996 Surveys of Family Income and Expenditure. We pooled the data from 1994 and 1996 and included a year dummy variable (NHI), equal to 1 if the household data came from 1996 in order to assess the impact of NHI on household out-of-pocket medical care expenditures shortly after its implementation in 1995. Results An individual who was older, female, married, unemployed, better educated, richer, head of a larger family household, or living in the central and eastern areas was more likely to have greater household out-of-pocket medical expenditures. NHI was found to have effectively reduced household out-of-pocket medical expenditures by 23.08%, particularly for more affluent households. With the implementation of NHI, lower and middle income quintiles had smaller decreases in out-of-pocket medical expenditure. NHI was also found to have reduced household out-of-pocket medical expenditures more for households in eastern Taiwan. Conclusion Although NHI was established to create free medical care for all, further effort is needed to reduce the medical costs for certain disadvantaged groups, particularly the poor and aborigines, if equality is to be achieved. PMID:16137336

  7. Monetary and nonmonetary household consumption of health services and the role of insurance benefits: An analysis of the Mexico's National Household Income and Expenditure Survey.

    PubMed

    Serván-Mori, Edson; Wirtz, Veronika J

    2018-05-23

    To study the monetary and nonmonetary consumption of healthcare services at household level in Mexico and the magnitude of the contribution of public programs. By using the National Household Income and Expenditure Survey 2012, we performed a cross-sectional and observational analysis of actual household consumption of health services by insurance type (no insurance, social security, Seguro Popular (SP)). Household consumption was divided into 2 categories: consumption related to "monetary" expenditure in health care and "nonmonetary" consumption in health care by the household. Nonmonetary included self-consumption or gifts received from other households and institutional contributions such as government payments or private organization transfers. In SP households, monetary and nonmonetary consumption of health services represented the highest proportion of available household expenditure (11.2%) compared to uninsured (8.4%) and social security (5.9%) households. The prevalence of outpatient consultation and medicine use is the highest among the health service consumption categories regardless of insurance status. Distribution of nonmonetary versus monetary consumption of health services was pro-poor: The poorer the households, the larger the proportion of nonmonetary consumption. The higher probability of receiving nonmonetary resources as a component of health service consumption in SP households is likely to increase the affordability to health services and likely to reduce healthcare expenditures. Future research should focus on the type of nonmonetary consumption of health services at household level to better understand financial protection and access to health care in Mexico. Copyright © 2018 John Wiley & Sons, Ltd.

  8. Does the National Health Insurance Scheme provide financial protection to households in Ghana?

    PubMed

    Kusi, Anthony; Hansen, Kristian Schultz; Asante, Felix A; Enemark, Ulrika

    2015-08-15

    Excessive healthcare payments can impede access to health services and also disrupt the welfare of households with no financial protection. Health insurance is expected to offer financial protection against health shocks. Ghana began the implementation of its National Health Insurance Scheme (NHIS) in 2004. The NHIS is aimed at removing the financial barrier to healthcare by limiting direct out-of-pocket health expenditures (OOPHE). The study examines the effect of the NHIS on OOPHE and how it protects households against catastrophic health expenditures. Data was obtained from a cross-sectional representative household survey involving 2,430 households from three districts across Ghana. All OOPHE associated with treatment seeking for reported illness in the household in the last 4 weeks preceding the survey were analysed and compared between insured and uninsured persons. The incidence and intensity of catastrophic health expenditures (CHE) among households were measured by the catastrophic health payment method. The relative effect of NHIS on the incidence of CHE in the household was estimated by multiple logistic regression analysis. About 36% of households reported at least one illness during the 4 weeks period. Insured patients had significantly lower direct OOPHE for out-patient and in-patient care compared to the uninsured. On financial protection, the incidence of CHE was lower among insured households (2.9%) compared to the partially insured (3.7%) and the uninsured (4.0%) at the 40% threshold. The incidence of CHE was however significantly lower among fully insured households (6.0%) which sought healthcare from NHIS accredited health facilities compared to the partially insured (10.1%) and the uninsured households (23.2%). The likelihood of a household incurring CHE was 4.2 times less likely for fully insured and 2.9 times less likely for partially insured households relative to being uninsured. The NHIS has however not completely eliminated OOPHE for the

  9. Crime and the Nation's Households, 1990. Bureau of Justice Statistics Bulletin.

    ERIC Educational Resources Information Center

    Rand, Michael R.

    The National Crime Victimization Survey (NCVS) collects data on crimes that are not reported to the police as well as those that are reported. Because some crimes are difficult or impossible to examine in a general population survey, the NCVS measures only the personal victimizations of rape, robbery, assault, and theft, and the household crimes…

  10. A UK national audit of hereditary and acquired angioedema

    PubMed Central

    Jolles, S; Williams, P; Carne, E; Mian, H; Huissoon, A; Wong, G; Hackett, S; Lortan, J; Platts, V; Longhurst, H; Grigoriadou, S; Dempster, J; Deacock, S; Khan, S; Darroch, J; Simon, C; Thomas, M; Pavaladurai, V; Alachkar, H; Herwadkar, A; Abinun, M; Arkwright, P; Tarzi, M; Helbert, M; Bangs, C; Pastacaldi, C; Phillips, C; Bennett, H; El-Shanawany, T

    2014-01-01

    Hereditary angioedema (HAE) and acquired angioedema (AAE) are rare life-threatening conditions caused by deficiency of C1 inhibitor (C1INH). Both are characterized by recurrent unpredictable episodes of mucosal swelling involving three main areas: the skin, gastrointestinal tract and larynx. Swelling in the gastrointestinal tract results in abdominal pain and vomiting, while swelling in the larynx may be fatal. There are limited UK data on these patients to help improve practice and understand more clearly the burden of disease. An audit tool was designed, informed by the published UK consensus document and clinical practice, and sent to clinicians involved in the care of HAE patients through a number of national organizations. Data sets on 376 patients were received from 14 centres in England, Scotland and Wales. There were 55 deaths from HAE in 33 families, emphasizing the potentially lethal nature of this disease. These data also show that there is a significant diagnostic delay of on average 10 years for type I HAE, 18 years for type II HAE and 5 years for AAE. For HAE the average annual frequency of swellings per patient affecting the periphery was eight, abdomen 5 and airway 0·5, with wide individual variation. The impact on quality of life was rated as moderate or severe by 37% of adult patients. The audit has helped to define the burden of disease in the UK and has aided planning new treatments for UK patients. PMID:23786259

  11. Incidence and Risk Factors of Homicide–Suicide in Swiss Households: National Cohort Study

    PubMed Central

    Panczak, Radoslaw; Zwahlen, Marcel; Spoerri, Adrian; Tal, Kali; Killias, Martin; Egger, Matthias

    2013-01-01

    Background Homicide–suicides are rare but catastrophic events. This study examined the epidemiology of homicide-suicide in Switzerland. Methods The study identified homicide–suicide events 1991–2008 in persons from the same household in the Swiss National Cohort, which links census and mortality records. The analysis examined the association of the risk of dying in a homicide–suicide event with socio-demographic variables, measured at the individual-level, household composition variables and area-level variables. Proportional hazards regression models were calculated for male perpetrators and female victims. Results are presented as age-adjusted hazard ratios (HR) with 95% confidence intervals (95%CI). Results The study identified 158 deaths from homicide–suicide events, including 85 murder victims (62 women, 4 men, 19 children and adolescents) and 68 male and 5 female perpetrators. The incidence was 3 events per million households and year. Firearms were the most prominent method for both homicides and suicides. The risk of perpetrating homicide-suicide was higher in divorced than in married men (HR 3.64; 95%CI 1.56–8.49), in foreigners without permanent residency compared to Swiss citizens (HR 3.95; 1.52–10.2), higher in men without religious affiliations than in Catholics (HR 2.23; 1.14–4.36) and higher in crowded households (HR 4.85; 1.72–13.6 comparing ≥2 with <1 persons/room). There was no association with education, occupation or nationality, the number of children, the language region or degree of urbanicity. Associations were similar for female victims. Conclusions This national longitudinal study shows that living conditions associated with psychological stress and lower levels of social support are associated with homicide-suicide events in Switzerland. PMID:23326491

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  13. The management of household hazardous waste in the United Kingdom.

    PubMed

    Slack, R J; Gronow, J R; Voulvoulis, N

    2009-01-01

    Waste legislation in the United Kingdom (UK) implements European Union (EU) Directives and Regulations. However, the term used to refer to hazardous waste generated in household or municipal situations, household hazardous waste (HHW), does not occur in UK, or EU, legislation. The EU's Hazardous Waste Directive and European Waste Catalogue are the principal legislation influencing HHW, although the waste categories described are difficult to interpret. Other legislation also have impacts on HHW definition and disposal, some of which will alter current HHW disposal practices, leading to a variety of potential consequences. This paper discusses the issues affecting the management of HHW in the UK, including the apparent absence of a HHW-specific regulatory structure. Policy and regulatory measures that influence HHW management before disposal and after disposal are considered, with particular emphasis placed on disposal to landfill.

  14. Family Meal Frequency and Association with Household Food Availability in United States Multi-Person Households: National Health and Nutrition Examination Survey 2007-2010.

    PubMed

    Newman, Sarah L; Tumin, Rachel; Andridge, Rebecca; Anderson, Sarah E

    2015-01-01

    Family meals are associated with a healthier diet among children and adolescents, but how family meal frequency varies in the U.S. population overall by household food availability and sociodemographic characteristics is not well characterized. The U.S. National Health and Nutrition Examination Survey 2007-2010 assessed the frequency of family meals eaten at home in the past week and the household availability of fruits, dark green vegetables, salty snacks, and sugar-sweetened beverages. Computer-assisted face-to-face interviews with a selected adult (≥18 years) who owned or rented the home (i.e., the household reference person). We analyzed information on family meal frequency for 18,031 participants living in multi-person households in relation to sociodemographic characteristics and food availability. Among the U.S. population living in households of two or more individuals, the prevalence (95% confidence interval) of having 0-2, 3-6 and ≥7 family meals/week was 18.0% (16.6-19.3), 32.4% (31.0-33.9), and 49.6% (47.8-51.4), respectively. Greater household availability of fruits and dark green vegetables and less availability of salty snacks and sugar-sweetened beverages was associated with more frequent family meals. Family meals were more prevalent in low-income households and those in which the reference person was ≥65 years, married, or had less than high school education. About half of the US population living in households of 2 or more people shares meals frequently with their family at home. Family meal frequency was positively associated with a healthier pattern of household food availability.

  15. Family Meal Frequency and Association with Household Food Availability in United States Multi-Person Households: National Health and Nutrition Examination Survey 2007-2010

    PubMed Central

    Newman, Sarah L.; Tumin, Rachel; Andridge, Rebecca; Anderson, Sarah E.

    2015-01-01

    Objective Family meals are associated with a healthier diet among children and adolescents, but how family meal frequency varies in the U.S. population overall by household food availability and sociodemographic characteristics is not well characterized. Design The U.S. National Health and Nutrition Examination Survey 2007–2010 assessed the frequency of family meals eaten at home in the past week and the household availability of fruits, dark green vegetables, salty snacks, and sugar-sweetened beverages. Setting Computer-assisted face-to-face interviews with a selected adult (≥18 years) who owned or rented the home (i.e., the household reference person). Subjects We analyzed information on family meal frequency for 18,031 participants living in multi-person households in relation to sociodemographic characteristics and food availability. Results Among the U.S. population living in households of two or more individuals, the prevalence (95% confidence interval) of having 0–2, 3–6 and ≥7 family meals/week was 18.0% (16.6–19.3), 32.4% (31.0–33.9), and 49.6% (47.8–51.4), respectively. Greater household availability of fruits and dark green vegetables and less availability of salty snacks and sugar-sweetened beverages was associated with more frequent family meals. Family meals were more prevalent in low-income households and those in which the reference person was ≥65 years, married, or had less than high school education. Conclusions About half of the US population living in households of 2 or more people shares meals frequently with their family at home. Family meal frequency was positively associated with a healthier pattern of household food availability. PMID:26636976

  16. The UK National Quantum Technologies Hub in sensors and metrology (Keynote Paper)

    NASA Astrophysics Data System (ADS)

    Bongs, K.; Boyer, V.; Cruise, M. A.; Freise, A.; Holynski, M.; Hughes, J.; Kaushik, A.; Lien, Y.-H.; Niggebaum, A.; Perea-Ortiz, M.; Petrov, P.; Plant, S.; Singh, Y.; Stabrawa, A.; Paul, D. J.; Sorel, M.; Cumming, D. R. S.; Marsh, J. H.; Bowtell, R. W.; Bason, M. G.; Beardsley, R. P.; Campion, R. P.; Brookes, M. J.; Fernholz, T.; Fromhold, T. M.; Hackermuller, L.; Krüger, P.; Li, X.; Maclean, J. O.; Mellor, C. J.; Novikov, S. V.; Orucevic, F.; Rushforth, A. W.; Welch, N.; Benson, T. M.; Wildman, R. D.; Freegarde, T.; Himsworth, M.; Ruostekoski, J.; Smith, P.; Tropper, A.; Griffin, P. F.; Arnold, A. S.; Riis, E.; Hastie, J. E.; Paboeuf, D.; Parrotta, D. C.; Garraway, B. M.; Pasquazi, A.; Peccianti, M.; Hensinger, W.; Potter, E.; Nizamani, A. H.; Bostock, H.; Rodriguez Blanco, A.; Sinuco-Leon, G.; Hill, I. R.; Williams, R. A.; Gill, P.; Hempler, N.; Malcolm, G. P. A.; Cross, T.; Kock, B. O.; Maddox, S.; John, P.

    2016-04-01

    The UK National Quantum Technology Hub in Sensors and Metrology is one of four flagship initiatives in the UK National of Quantum Technology Program. As part of a 20-year vision it translates laboratory demonstrations to deployable practical devices, with game-changing miniaturized components and prototypes that transform the state-of-the-art for quantum sensors and metrology. It brings together experts from the Universities of Birmingham, Glasgow, Nottingham, Southampton, Strathclyde and Sussex, NPL and currently links to over 15 leading international academic institutions and over 70 companies to build the supply chains and routes to market needed to bring 10-1000x improvements in sensing applications. It seeks, and is open to, additional partners for new application development and creates a point of easy open access to the facilities and supply chains that it stimulates or nurtures.

  17. Unit and Item Response, Weighting, and Imputation Procedures in the 1995 National Household Education Survey (NHES:95). Working Paper Series.

    ERIC Educational Resources Information Center

    Brick, J. Michael; Broene, Pam

    The National Household Education Survey (NHES) is a data collection effort of the National Center for Education Statistics that collects and publishes data on the condition of education in the United States. The NHES is designed to provide information on issues that are best addressed by contacting households rather than institutions. It is a…

  18. Can Higher Household Education Expenditure Improve the National College Entrance Exam Performance? Empirical Evidence from Jinan, China

    ERIC Educational Resources Information Center

    Zhang, Yu; Zhou, Xuehan

    2017-01-01

    The purpose of this study was to examine the effect of household education expenditure on National College Entrance Exam (NCEE) performance in China. Using a comprehensive dataset with a sample size of 5840 students collected in Jinan, China, this study found that the average effect of household education expenditure on NCEE performance is not…

  19. Environmental performance of household waste management in Europe - An example of 7 countries.

    PubMed

    Andreasi Bassi, Susanna; Christensen, Thomas H; Damgaard, Anders

    2017-11-01

    An attributional life cycle assessment (LCA) of the management of 1ton of household waste was conducted in accordance with ISO 14044:2006 and the ILCD Handbook for seven European countries, namely Germany, Denmark, France, UK, Italy, Poland and Greece, representing different household waste compositions, waste management practices, technologies, and energy systems. National data were collected from a range of sources regarding household waste composition, household sorting efficiency, collection, waste treatments, recycling, electricity and heat composition, and technological efficiencies. The objective was to quantify the environmental performance in the different countries, in order to analyze the sources of the main environmental impacts and national differences which affect the results. In most of the seven countries, household waste management provides environmental benefits when considering the benefits of recycling of materials and recovering and utilization of energy. Environmental benefits come from paper recycling and, to a lesser extent, the recycling of metals and glass. Waste-to-energy plants can lead to an environmental load (as in France) or a saving (Germany and Denmark), depending mainly on the composition of the energy being substituted. Sensitivity analysis and a data quality assessment identified a range of critical parameters, suggesting from where better data should be obtained. The study concluded that household waste management is environmentally the best in European countries with a minimum reliance on landfilling, also induced by the implementation of the Waste Hierarchy, though environmental performance does not correlate clearly with the rate of material recycling. From an environmental point of view, this calls for a change in the waste management paradigm, with less focus on where the waste is routed and more of a focus on the quality and utilization of recovered materials and energy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. The New Localism in the UK: Local Governance amid National Goals

    ERIC Educational Resources Information Center

    Storey, Valerie A.; Farrar, Maggie

    2009-01-01

    Both in the United States and the United Kingdom there has been a recent resurgence of interest and support for "new localism" in response to the need to provide local solutions to national complex problems. In this paper, the authors begin by exploring the contextual framework in the U.S. and the UK, explaining recent policy reform and…

  1. Comparison of Estimates in the 1996 National Household Education Survey. Working Paper Series.

    ERIC Educational Resources Information Center

    Nolin, Mary Jo; Collins, Mary A.; Vaden-Kiernan, Nancy; Davies, Elizabeth

    This report compares selected estimates from the 1996 National Household Education Survey (NHES:96) with estimates from previous NHES collections, the Current Population Survey (CPS), and other relevant data sources. The comparisons provide an indication of the reasonableness of selected NHES:96 estimates. Where discrepancies were found between…

  2. National Student Feedback Surveys in Distance Education: An Investigation at the UK Open University

    ERIC Educational Resources Information Center

    Ashby, Alison; Richardson, John T. E.; Woodley, Alan

    2011-01-01

    National student feedback surveys are administered in a number of countries, and several of these encompass both campus-based and distance learning students. The UK Open University achieves a high ranking in the annual National Student Survey (NSS), but there are some anomalies in the results. The NSS questionnaire was administered to three…

  3. A New Measurement and Ranking System for the UK National Student Survey

    ERIC Educational Resources Information Center

    Canning, John

    2015-01-01

    Despite numerous criticisms of the UK National Student Survey (NSS) institutional managers still strongly support its use in informing student choice, quality and assurance and quality enhancement activities. This article outlines a granular and nuanced benchmarking system for the NSS which provides both a "raw" score (weighted student…

  4. Characterisation of UK diets according to degree of food processing and associations with socio-demographics and obesity: cross-sectional analysis of UK National Diet and Nutrition Survey (2008-12).

    PubMed

    Adams, Jean; White, Martin

    2015-12-18

    Food processing alters food from its natural state for safety, convenience, taste or palatability. Previous research suggests that industrially processed foods, and diets high in these products, tend to be less healthful. However, most previous work is based on household, rather than individual-level, data. Little has been reported on the relationship between processed food consumption and markers of health; or on socio-demographic correlates of processed food consumption. Our objective was to describe: the nutritional content of foods classified according to degree of processing; the nutritional content of diets with different relative intakes of processed foods; the socio-demographic characteristics of individuals with different relative intakes of processed foods; and the association between intake of processed foods and body weight. Secondary analysis of data from the UK National Diet and Nutrition Survey (2008-12), a large national cross-sectional study of diet. Dietary information was collected using four-day, unweighed, food-diaries. Foods were classified as: unprocessed or minimally processed (MPF; foods with no processing or mostly physical processes applied to single whole foods), processed ingredients (PI; extracted and purified components of single whole foods), or ultra-processed food products (UPF; products produced from industrial combining of MPF and PI). Two thousand one hundred seventy four adults were included. MPF and diets high in these foods, had the most healthful nutritional profile. UPF did not necessarily have the least healthful nutritional profile, but diets high in these foods did. Women, and older adults consumed more energy from MPF, and less from UPF. Those living in lower occupation social class households consumed less energy from MPF, but no more from UPF. Only higher intake of PI was consistently, inversely, associated with body weight. This is the first study to explore correlates of processed food consumption, using individual

  5. Adult Education in the 1990s: A Report on the 1991 National Household Education Survey. Working Paper Series.

    ERIC Educational Resources Information Center

    Kopka, Teresita L. Chan; Schantz, Nancy Borkow; Korb, Roslyn Abrevaya

    The 1991 National Household Education Survey adult education component, a household-based data collection, provided estimates of adult education participation. About 32 percent of adults participated in adult education during the prior 12 months to the 1991 survey. Adults 25-54 years old, persons with a bachelor's degree or higher, and employed…

  6. The Development of National Occupational Standards for Intercultural Working in the UK

    ERIC Educational Resources Information Center

    MacDonald, Malcolm N.; O'Regan, John P.; Witana, Julie

    2009-01-01

    From 2007 to 2008, CILT (Centre for Information for Language Teachers) developed a set of National Occupational Standards for Intercultural Working in the UK. This paper reports on three questions arising from the development project: how these standards are distinctive from others, how they realise intercultural competence and how they meet…

  7. National Household Education Survey of 1991: Preprimary and Primary Data Files User's Manual.

    ERIC Educational Resources Information Center

    Brick, J. Michael; And Others

    This manual provides documentation and guidance for users of the public release data files for the Early Childhood Education (ECE) component of the 1991 National Household Education Survey (NHES:91). Information is presented about the purpose of the study, the data collection instruments, the sample design, and data collection and data processing…

  8. Self-regulation and household routines at age three and obesity at age eleven: longitudinal analysis of the UK Millennium Cohort Study

    PubMed Central

    Anderson, Sarah E; Sacker, Amanda; Whitaker, Robert C; Kelly, Yvonne

    2017-01-01

    Objective To examine, in a population-based cohort of three-year-old children, the association between self-regulation and exposure to the household routines of regular bedtime, regular mealtime, and limits on watching television/video; and to determine whether self-regulation and these routines predict the risk of obesity at age 11. Methods Analyses included 10 955 children in the nationally-representative UK Millennium Cohort Study. When children were age 3, parents reported whether children had a regular bedtime and mealtime and the amount of television/video watched. Emotional and cognitive self-regulation at age 3 were assessed by parent-report with the Child Social Behaviour Questionnaire. Children’s height and weight were measured at age 11 and obesity was defined using the International Obesity Task Force (IOTF) criteria. Results At age 3, 41% of children always had a regular bedtime, 47% always had a regular mealtime, and 23% were limited to ≤1 hour television/video daily. At age 11, 6.2% of children were obese. All three household routines were significantly associated with better emotional self-regulation, but not better cognitive self-regulation. In a multi-variable logistic regression model including emotional and cognitive self-regulation, all routines, and controlling for sociodemographic covariates, a 1 unit difference in emotional self-regulation at age 3 was associated with an OR (95% CI) for obesity of 1.38 (1.11, 1.71) at age 11, and inconsistent bedtimes with an OR (95% CI) for obesity of 1.87 (1.39, 2.51) at age 11. There was no evidence that emotional self-regulation mediated the relationship between regular bedtimes and later obesity. Cognitive self-regulation was not associated with later obesity. Conclusions Three-year-old children who had regular bedtimes, mealtimes, and limits on their television/video time had better emotional self-regulation. Lack of a regular bedtime and poorer emotional self-regulation at age 3 were independent

  9. National health insurance scheme: how protected are households in Oyo State, Nigeria from catastrophic health expenditure?

    PubMed Central

    Ilesanmi, Olayinka Stephen; Adebiyi, Akindele Olupelumi; Fatiregun, Akinola Ayoola

    2014-01-01

    Background: The major objective of the National Health Insurance Scheme (NHIS) in Nigeria is to protect families from the financial hardship of large medical bills. Catastrophic Health Expenditure (CHE) is rampart in Nigeria despite the take-off of the NHIS. This study aimed to determine if households enrolled in the NHIS were protected from having CHE. Methods: The study took place among 714 households in urban communities of Oyo State. CHE was measured using a threshold of 40% of monthly non-food expenditure. Descriptive statistics were done, Principal Component Analysis was used to divide households into wealth quintiles. Chi-square test and binary logistic regression were done. Results: The mean age of household respondent was 33.5 years. The median household income was 43,500 naira (290 US dollars) and the range was 7,000–680,000 naira (46.7–4,533 US dollars) in 2012. The overall median household healthcare cost was 890 naira (5.9 US dollars) and the range was 10-17,700 naira (0.1–118 US dollars) in 2012. In all, 67 (9.4%) households were enrolled in NHIS scheme. Healthcare services was utilized by 637 (82.9%) and CHE occurred in 42 (6.6%) households. CHE occurred in 14 (10.9%) of the households in the lowest quintile compared to 3 (2.5%) in the highest wealth quintile (P= 0.004). The odds of CHE among households in lowest wealth quintile is about 5 times. They had Crude OR (CI): 4.7 (1.3–16.8), P= 0.022. Non enrolled households were two times likely to have CHE, though not significant Conclusion: Households in the lowest wealth quintiles were at higher risk of CHE. Universal coverage of health insurance in Nigeria should be fast-tracked to give the expected financial risk protection and decreased incidence of CHE. PMID:24847483

  10. National health insurance scheme: how protected are households in Oyo State, Nigeria from catastrophic health expenditure?

    PubMed

    Ilesanmi, Olayinka Stephen; Adebiyi, Akindele Olupelumi; Fatiregun, Akinola Ayoola

    2014-05-01

    The major objective of the National Health Insurance Scheme (NHIS) in Nigeria is to protect families from the financial hardship of large medical bills. Catastrophic Health Expenditure (CHE) is rampart in Nigeria despite the take-off of the NHIS. This study aimed to determine if households enrolled in the NHIS were protected from having CHE. The study took place among 714 households in urban communities of Oyo State. CHE was measured using a threshold of 40% of monthly non-food expenditure. Descriptive statistics were done, Principal Component Analysis was used to divide households into wealth quintiles. Chi-square test and binary logistic regression were done. The mean age of household respondent was 33.5 years. The median household income was 43,500 naira (290 US dollars) and the range was 7,000-680,000 naira (46.7-4,533 US dollars) in 2012. The overall median household healthcare cost was 890 naira (5.9 US dollars) and the range was 10-17,700 naira (0.1-118 US dollars) in 2012. In all, 67 (9.4%) households were enrolled in NHIS scheme. Healthcare services was utilized by 637 (82.9%) and CHE occurred in 42 (6.6%) households. CHE occurred in 14 (10.9%) of the households in the lowest quintile compared to 3 (2.5%) in the highest wealth quintile (P= 0.004). The odds of CHE among households in lowest wealth quintile is about 5 times. They had Crude OR (CI): 4.7 (1.3-16.8), P= 0.022. Non enrolled households were two times likely to have CHE, though not significant Conclusion: Households in the lowest wealth quintiles were at higher risk of CHE. Universal coverage of health insurance in Nigeria should be fast-tracked to give the expected financial risk protection and decreased incidence of CHE.

  11. An Evaluation of Bias in the 2007 National Household Education Surveys Program: Results from a Special Data Collection Effort. NCES 2009-029

    ERIC Educational Resources Information Center

    Van de Kerckhove, Wendy; Montaquila, Jill M.; Carver, Priscilla R.; Brick, J. Michael

    2009-01-01

    The National Household Education Surveys Program (NHES) is a random digit dialing (RDD) survey program developed by the National Center for Education Statistics (NCES) in the Institute of Education Sciences, U.S. Department of Education. The surveys are designed to help NCES collect data directly from households about important education topics.…

  12. 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.

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

    PubMed Central

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

    2017-01-01

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

  14. Fruit and vegetable consumption and sports participation among UK Youth.

    PubMed

    McAloney, Kareena; Graham, Hilary; Law, Catherine; Platt, Lucinda; Wardle, Heather; Hall, Julia

    2014-02-01

    UK guidelines for youth recommend daily physical activity and five portions of fruit and vegetables per day. This study examined the prevalence and clustering of meeting recommendations among 10- to 15-year old. Data for 3,914 youth, from the first wave of Understanding Society: the UK Household Longitudinal Study, were analysed. Clustering was assessed using the observed/expected ratio method. A minority of youth met both recommendations, and these behaviours were clustered. The odds of meeting both recommendations were lower for older youth and for Pakistani and Bangladeshi youth; boys in lower income households were less likely to meet both recommendations. Most youth met neither recommendation and the behaviours clustered with variations by ethnicity and socioeconomic conditions.

  15. Prevalence and socio-demographic correlates of cooking skills in UK adults: cross-sectional analysis of data from the UK National Diet and Nutrition Survey.

    PubMed

    Adams, Jean; Goffe, Louis; Adamson, Ashley J; Halligan, Joel; O'Brien, Nicola; Purves, Richard; Stead, Martine; Stocken, Deborah; White, Martin

    2015-08-05

    Poor cooking skills may be a barrier to healthy eating and a contributor to overweight and obesity. Little population-representative data on adult cooking skills has been published. We explored prevalence and socio-demographic correlates of cooking skills among adult respondents to wave 1 of the UK National Diet and Nutrition Survey (2008-9). Socio-demographic variables of interest were sex, age group, occupational socio-economic group and whether or not respondents had the main responsibility for food in their households. Cooking skills were assessed as self-reported confidence in using eight cooking techniques, confidence in cooking ten foods, and ability to prepare four types of dish (convenience foods, a complete meal from ready-made ingredients, a main meal from basic ingredients, and cake or biscuits from basic ingredients). Frequency of preparation of main meals was also reported. Of 509 respondents, almost two-thirds reported cooking a main meal at least five times per week. Around 90 % reported being able to cook convenience foods, a complete meal from ready-made ingredient, and a main dish from basic ingredients without help. Socio-demographic differences in all markers of cooking skills were scattered and inconsistent. Where these were found, women and main food providers were most likely to report confidence with foods, techniques or dishes, and respondents in the youngest age (19-34 years) and lowest socio-economic group least likely. This is the only exploration of the prevalence and socio-demographic correlates of adult cooking skills using recent and population-representative UK data and adds to the international literature on cooking skills in developed countries. Reported confidence with using most cooking techniques and preparing most foods was high. There were few socio-demographic differences in reported cooking skills. Adult cooking skills interventions are unlikely to have a large population impact, but may have important individual effects

  16. Adolescent accounts of the UK National Lottery and scratchcards: an analysis using Q-sorts.

    PubMed

    Wood, Richard T A; Griffiths, Mark D; Derevensky, Jeffrey L; Gupta, Rina

    2002-01-01

    The study examined adolescents' accounts of the UK National Lottery and scratchcards. Q-sorts were used to examine the views of 62 participants aged between 11 and 15 years of age. Findings identified four distinct accounts in relation to the National Lottery (Moral Opposition, Luck Seeking, Rationalist, & Uncertainty), and four distinct accounts in relation to scratchcards (Scepticism, Thrill-Seeking, Rationalist, & Libertarian). Some of the accounts identified described the UK National Lottery and scratchcards as bona fide forms of gambling. Reports indicated that adolescents were pessimistic about the chances of winning large sums of money, while other accounts demonstrated gambling misperceptions particularly in relation to their belief in luck and the laws of probability. It is argued that to fully understand why adolescents take part in these activities it is important to consider the diverse ways that adolescents represent these activities. These differing representations will have consequences for measures aimed at reducing, preventing, or treating adolescent problem gambling. The utility of Q-sorts as a technique for examining the views of problem and non-problem gamblers is also discussed.

  17. National Household Education Survey of 1993. School Safety and Discipline Data File User's Manual.

    ERIC Educational Resources Information Center

    Brick, J. Michael; And Others

    This manual provides documentation and guidance for users of the public release data file for the School Safety and Discipline component of the 1993 National Household Education Survey (NHES:93). Information about the purpose of the study, the data collection instruments, the sample design, and data collection and processing is presented. The…

  18. 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.

  19. Evaluation of a national neurosurgical formative examination: the UK experience.

    PubMed

    Anderson, Ian; Corns, Robert; Thomson, Simon

    2018-05-24

    Formative assessment is a key component in medical education and that it is a helpful process for all involved. Until recently there was no national formative examination for neurosurgical trainees. The Neurosurgery Annual in Training Examination (NAiTE) is an annual online, formative assessment that was introduced in 2014. In this paper, we seek to discuss how well NAiTE relates to established educational practice and principles and its fitness for purpose by discussing its rationale, structure and utility. A national online examination was introduced in 2014. The NAiTE consists of 100 single best answer multiple choice questions. The examination and questions with were reviewed and the global results presented. The existing literature and educational theory are used to guide subjective assessment of the process. In 2016, 191 candidates participated in the NAiTE, of whom 154 were trainees working in UK neurosurgical units. The mean score for early stage UK trainees (years 1-3) was 52.4%, intermediate (years 4-5) 58.5% and senior (years 6-8) 65.4%. The NAiTE was found to be a reliable (Cronbach-Alpha of 0.89) and valid assessment of trainees with scores approximating those attained in the Intercollegiate Specialty Examination itself. Potential areas for improvement are highlighted, including reference to some that have already been implemented. Overall, the examination is a cheap, viable and reliable means of testing trainees and encouraging their onward development and learning as they work towards the Intercollegiate Specialty Examination.

  20. Household Wealth in China

    PubMed Central

    Xie, Yu; Jin, Yongai

    2015-01-01

    With new nationwide longitudinal survey data now available from the China Family Panel Studies (CFPS), we study the level, distribution, and composition of household wealth in contemporary China. We find that the wealth Gini coefficient of China was 0.73 in 2012. The richest 1 percent owned more than one-third of the total national household wealth, while the poorest 25 percent owned less than 2 percent. Housing assets, which accounted for over 70 percent, were the largest component of household wealth. Finally, the urban-rural divide and regional disparities played important roles in household wealth distribution, and institutional factors significantly affected household wealth holdings, wealth growth rate, and wealth mobility. PMID:26435882

  1. Prevalence and severity of household food insecurity of First Nations people living in an on-reserve, sub-Arctic community within the Mushkegowuk Territory.

    PubMed

    Skinner, Kelly; Hanning, Rhona M; Tsuji, Leonard J S

    2014-01-01

    To measure and describe the prevalence and severity of household food insecurity in a remote on-reserve First Nations community using the Household Food Security Survey Module (HFSSM) and to evaluate the perceived relevance of the HFSSM for this population. Household food security status was determined from the eighteen-item HFSSM following the classifications developed by Health Canada for the Canadian Community Health Survey, Cycle 2·2 Nutrition. One adult from each household in the community was invited to complete the HFSSM and to comment on its relevance as a tool to measure food security for First Nations communities. Sub-Arctic Ontario, Canada. Households (n 64). Seventy per cent of households were food insecure, 17% severely and 53% moderately. The prevalence of food insecurity in households with children was 76%. Among respondents from homes rated as having severe food insecurity, all (100 %) reported worrying that food would run out, times when food didn't last and there wasn't money to buy more, and times when they couldn't afford to eat balanced meals. The majority of respondents felt the HFSSM did not capture an accurate picture of food security for their situation. Aspects missing from the HFSSM included the high cost of market food and the incorporation of traditional food practices. A high prevalence of household food insecurity was reported in this community. On-reserve remote First Nations communities may be more susceptible to food insecurity than off-reserve Aboriginal populations. Initiatives that promote food security for this vulnerable population are needed.

  2. Break-up of New Orleans Households after Hurricane Katrina

    PubMed Central

    Rendall, Michael S.

    2011-01-01

    Theory and evidence on disaster-induced population displacement have focused on individual and population-subgroup characteristics. Less is known about impacts on households. I estimate excess incidence of household break-up due to Hurricane Katrina by comparing a probability sample of pre-Katrina New Orleans resident adult household heads and non–household heads (N = 242), traced just over a year later, with a matched sample from a nationally representative survey over an equivalent period. One in three among all adult non–household heads, and one in two among adult children of household heads, had separated from the household head 1 year post-Katrina. These rates were, respectively, 2.2 and 2.7 times higher than national rates. A 50% higher prevalence of adult children living with parents in pre-Katrina New Orleans than nationally increased the hurricane’s impact on household break-up. Attention to living arrangements as a dimension of social vulnerability in disaster recovery is suggested. PMID:21709733

  3. Financial burden of household out-of pocket health expenditure in Viet Nam: findings from the National Living Standard Survey 2002-2010.

    PubMed

    Van Minh, Hoang; Kim Phuong, Nguyen Thi; Saksena, Priyanka; James, Chris D; Xu, Ke

    2013-11-01

    In Viet Nam, household direct out-of-pocket (OOP) health expenditure as a share of the total health expenditure has been always high, ranging from 50% to 70%. The high share of OOP expenditure has been linked to different inequity problems such as catastrophic health expenditure (households must reduce their expenditure on other necessities) and impoverishment. This paper aims to examine catastrophic and poverty impacts of household out-of-pocket health expenditure in Viet Nam over time and identify socio-economic indicators associated with them. Data used in this research were obtained from a nationally representative household survey, Viet Nam Living Standard Survey 2002, 2004, 2006, 2008 and 2010. The findings revealed that there were problems in health care financing in Viet Nam - many households encountered catastrophic health expenditure and/or were pushed into poverty due to health care payments. The issues were pervasive over time. Catastrophic expenditure and impoverishment problems were more common among the households who had more elderly people and those located in rural areas. Importantly, the financial protection aspect of the national health insurance schemes was still modest. Given these findings, more attention is needed on developing methods of financial protection in Viet Nam. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Same-Sex and Different-Sex Parent Households and Child Health Outcomes: Findings from the National Survey of Children's Health.

    PubMed

    Bos, Henny M W; Knox, Justin R; van Rijn-van Gelderen, Loes; Gartrell, Nanette K

    2016-04-01

    Using the 2011-2012 National Survey of Children's Health data set, we compared spouse/partner relationships and parent-child relationships (family relationships), parenting stress, and children's general health, emotional difficulties, coping behavior, and learning behavior (child outcomes) in households of same-sex (female) versus different-sex continuously coupled parents with biological offspring. We assessed whether associations among family relationships, parenting stress, and child outcomes were different in the 2 household types. Parental and child characteristics were matched for 95 female same-sex parent and 95 different-sex parent households with children 6 to 17 years old. One parent per household was interviewed by telephone. Multivariate analyses of variance and multiple linear regressions were conducted. No differences were observed between household types on family relationships or any child outcomes. Same-sex parent households scored higher on parenting stress (95% confidence interval = 2.03-2.30) than different-sex parent households (95% confidence interval = 1.76-2.03), p = .006. No significant interactions between household type and family relationships or household type and parenting stress were found for any child outcomes. Children with female same-sex parents and different-sex parents demonstrated no differences in outcomes, despite female same-sex parents reporting more parenting stress. Future studies may reveal the sources of this parenting stress.

  5. Promoting SETI in the UK

    NASA Astrophysics Data System (ADS)

    Penny, Alan

    2013-10-01

    MEETING REPORT What does the UK presently do in the search for extraterrestrial intelligence and what are the plans for the future? Alan Penny reports on a meeting of UK academics active in SETI, held as sessions in the recent National Astronomy Meeting in Scotland - and the formation of the UK SETI Research Network to promote UK academic work.

  6. Driving after drug or alcohol use : findings from the 1996 national household survey on drug abuse

    DOT National Transportation Integrated Search

    1998-12-01

    Author's abstract: This report contains findings from questions included in the 1996 National Household Survey on Drug Abuse (NHSDA). The data presented describe the prevalence and patterns of driving following drug use and/or alcohol use by 11,847 N...

  7. Low-income Children's participation in the National School Lunch Program and household food insufficiency.

    PubMed

    Huang, Jin; Barnidge, Ellen

    2016-02-01

    Assessing the impact of the National School Lunch Program (NSLP) on household food insufficiency is critical to improve the implementation of public food assistance and to improve the nutrition intake of low-income children and their families. To examine the association of receiving free/reduced-price lunch from the NSLP with household food insufficiency among low-income children and their families in the United States, the study used data from four longitudinal panels of the Survey of Income and Program Participation (SIPP; 1996, 2001, 2004, and 2008), which collected information on household food insufficiency covering both summer and non-summer months. The sample included 15, 241 households with at least one child (aged 5-18) receiving free/reduced-price lunch from the NSLP. A dichotomous measure describes whether households have sufficient food to eat in the observed months. Fixed-effects regression analysis suggests that the food insufficiency rate is .7 (95%CI: .1, 1.2) percentage points higher in summer months among NSLP recipients. Since low-income families cannot participate in the NSLP in summer when the school is not in session, the result indicates the NSLP participation is associated with a reduction of food insufficiency risk by nearly 14%. The NSLP plays a significant role to protect low-income children and their families from food insufficiency. It is important to increase access to school meal programs among children at risk of food insufficiency in order to ensure adequate nutrition and to mitigate the health problems associated with malnourishment among children. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Coherence between Text Comments and the Quantitative Ratings in the UK's National Student Survey

    ERIC Educational Resources Information Center

    Langan, A. Mark; Scott, Nick; Partington, Shobana; Oczujda, Agnieszka

    2017-01-01

    Institutions are understandably interested in the profile of their own reputations based upon publicly available data about student experiences. The UK's National Student Survey (NSS) metrics are integrated into several "Good University" calculations, whereas teaching teams most often use the survey's text comments to change practices,…

  9. Literacy: State of the Nation--A Picture of Literacy in the UK Today

    ERIC Educational Resources Information Center

    Jama, Deeqa; Dugdale, George

    2012-01-01

    Literacy is the combination of reading, writing, speaking and listening skills we all need to fulfil our potential. These life skills are essential to the happiness, health and wealth of individuals and society. "Literacy: State of the Nation" provides a coherent picture of literacy in the UK today. It reveals that: (1) One in six people…

  10. Promoting Your e-Books: Lessons from the UK JISC National e-Book Observatory

    ERIC Educational Resources Information Center

    Lonsdale, Ray; Armstrong, Chris

    2010-01-01

    Purpose: The purpose of this paper is to describe the findings from the qualitative strand of the National e-Book Observatory (2007-2009) project, relating to the promotion of e-textbooks in UK universities by the library, academics and publishers. A complementary paper on the ways in which students and academics locate e-books provided by their…

  11. Media Use, Sports Participation, and Well-Being in Adolescence: Cross-Sectional Findings From the UK Household Longitudinal Study

    PubMed Central

    Booker, Cara L.; Skew, Alexandra J.; Kelly, Yvonne J.; Sacker, Amanda

    2015-01-01

    Objectives. We investigated the relationship between selected types of screen-based media (SBM) use, total SBM use, sports participation, and markers of well-being. Methods. Data came from the youth panel (n = 4899) of Understanding Society, the UK Household Longitudinal Study, conducted in 2009. Well-being was measured by the Strengths and Difficulties Questionnaire and markers of happiness in different life domains. Results. The majority of young people used multiple types of SBM for at least 1 hour per day; only 30% participated in sports every day. Overall, young people with heavy SBM use were less happy than moderate users and more likely to have socioemotional difficulties. Chatting on social networking Web sites and game console use were associated with higher odds of socioemotional problems. Higher total SBM use was associated with lower odds of happiness and higher odds of socioemotional difficulties. Greater participation in sports was associated with higher odds of happiness and lower odds of socioemotional difficulties. Conclusions. Further longitudinal research could inform future interventions to reduce sedentary behavior and encourage healthy lifestyles among young people. PMID:25494209

  12. Supplemental Nutrition Assistance Program participation is associated with an increase in household food security in a national evaluation.

    PubMed

    Mabli, James; Ohls, Jim

    2015-02-01

    The Supplemental Nutrition Assistance Program (SNAP) provides nutrition assistance benefits to low-income families in an effort to reduce hunger and improve health and well-being. Because 1 in 7 Americans participate in the program each month, policymakers need to know whether the program is meeting these objectives effectively. The objective of this study was to estimate the association between SNAP participation and household food security using recent data from the largest national survey of the food security of SNAP participants to date. The analysis used a survey of nearly 6500 households and a quasi-experimental research design that consisted of 2 sets of comparisons. Using a cross-sectional sample, we compared information collected from SNAP households within days of program entry with information collected from a contemporaneous sample of SNAP households that had participated for ∼6 mo. Next, using a longitudinal sample, we compared baseline information collected from new-entrant SNAP households with information from those same households 6 mo later. Multivariate logistic regression analysis was used to estimate associations between SNAP and household food security. SNAP participation decreased the percentage of SNAP households that were food insecure in both samples by 6-17%. SNAP participation also decreased the percentage of households experiencing severe food insecurity--designated very low food security--by 12-19%. Findings were qualitatively robust to different empirical specifications. SNAP serves a vital role in improving the health and well-being of households by increasing food security. Given recent legislation to reduce program size and limit program eligibility, this study underscores SNAP's continued importance in affecting households' well-being. Future research is needed to determine whether specific groups of households experience differential improvements in food security. © 2015 American Society for Nutrition.

  13. UK national survey of management of breast lobular carcinoma in situ.

    PubMed

    Chester, R; Bokinni, O; Ahmed, I; Kasem, A

    2015-11-01

    There is no national standard treatment for patients with breast lobular carcinoma in situ (LCIS). Association of Breast Surgery guidelines for the management of breast cancer suggest that lesions containing LCIS should be excised for definitive diagnosis and recommend close surveillance after excision biopsy. The aim of this study was to form a picture of the current management of LCIS by UK breast surgeons. A questionnaire about the management of LCIS was sent to 490 UK breast surgeons. Of 490 questionnaires sent out, 173 (35%) were returned. When LCIS is present in a core biopsy, 61% of breast surgeons perform surgical excision, 22% would not excise but would continue follow-up and the remainder perform neither or set no clear management plan. Over half (54%) follow patients up with five years of annual mammography. If classic LCIS were found at the margins of wide local excision, 92% would not re-excise. Conversely, if pleomorphic LCIS were found, 71% would achieve clear margins. Respondents were split evenly regarding management of classic LCIS with a family history as 54% would not alter management whereas 43% would treat the disease more aggressively. Our survey has shown that in cases where LCIS is found at core biopsy, most surgeons follow Association of Breast Surgery guidance, obtaining further histological samples to exclude pleomorphic LCIS, ductal carcinoma in situ or invasive cancer, whereas others opt for annual surveillance and some discharge the patient. This study highlighted the huge variability in LCIS management, and the need for randomised controlled trials and input into national audits such as the Sloane Project to establish evidence-based national standard guidelines.

  14. National Household Education Surveys of 2003: Data File User's Manual, Volume I. NCES 2004-001

    ERIC Educational Resources Information Center

    Hagedorn, Mary; Montaquila, Jill; Vaden-Kiernan, Nancy; Kim, Kwang; Chapman, Christopher

    2004-01-01

    This manual describes the development of the surveys fielded in 2003 under the National Household Education Surveys Program (NHES: 2003). It describes how the questionnaires were designed, how the samples were developed, data collection experiences, and file information needed to analyze the NHES: 2003 data sets. The surveys fielded as part of…

  15. Comparison of Estimates from the 1995 National Household Education Survey (NHES:95). Working Paper Series.

    ERIC Educational Resources Information Center

    Kim, Kwang; Loomis, Laura S.; Collins, Mary A.

    This report compares selected estimates from the two components of the 1995 National Household Education Survey (NHES:95) with estimates from other survey data. The two different components of the NHES:95, the Adult Education (AE) and the Early Childhood Program Participation (ECPP) components, cover a variety of topics related to participation in…

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

    PubMed

    Checkland, Kath

    2004-11-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2012-12-01

    The best outcomes from watershed management arise where policy and mitigation efforts are underpinned by strong science evidence, but there are major resourcing problems associated with the scale of monitoring needed to effectively characterise the sources rates and impacts of nutrient enrichment nationally. The challenge is to increase national capability in predictive modelling of nutrient flux to waters, securing an effective mechanism for transferring knowledge and management tools from data-rich to data-poor regions. The inadequacy of existing tools and approaches to address these challenges provided the motivation for the Environmental Virtual Observatory programme (EVOp), an innovation from the UK Natural Environment Research Council (NERC). EVOp is exploring the use of a cloud-based infrastructure in catchment science, developing an exemplar to explore N and P fluxes to inland and coastal waters in the UK from grid to catchment and national scale. EVOp is bringing together for the first time national data sets, models and uncertainty analysis into cloud computing environments to explore and benchmark current predictive capability for national scale biogeochemical modelling. The objective is to develop national biogeochemical modelling capability, capitalising on extensive national investment in the development of science understanding and modelling tools to support integrated catchment management, and supporting knowledge transfer from data rich to data poor regions, The AERC export coefficient model (Johnes et al., 2007) has been adapted to function within the EVOp cloud environment, and on a geoclimatic basis, using a range of high resolution, geo-referenced digital datasets as an initial demonstration of the enhanced national capacity for N and P flux modelling using cloud computing infrastructure. Geoclimatic regions are landscape units displaying homogenous or quasi-homogenous functional behaviour in terms of process controls on N and P cycling

  18. Complex Households and the Distribution of Multiple Resources in Later Life: Findings From a National Survey.

    PubMed

    Kim, Juyeon; Waite, Linda J

    2016-02-01

    The availability of social and financial resources has profound implications for health and well-being in later life. Older adults often share resources with others who live with them, sometimes in households including relatives or friends. We examine differences in social support, social connections, money, and the household environment across types of living arrangements, develop hypotheses from two theoretical perspectives, one focusing on obligations toward kin, and one focused on social exchange within households, and test them using data from the National Social Life, Health, and Aging Project. We find that availability of resources is not consistently associated with the presence of grandchildren and other young relatives, but often differs with presence of other adults. These findings suggest that a single type of resource tells us little about the distribution of the resources of older adults, and call on us to examine multiple resources simultaneously. © The Author(s) 2015.

  19. Complex Households and the Distribution of Multiple Resources in Later Life: Findings from A National Survey

    PubMed Central

    Kim, Juyeon; Link, Arts; Waite, Linda

    2016-01-01

    The availability of social and financial resources has profound implications for health and well-being in later life. Older adults often share resources with others who live with them, sometimes in households including relatives or friends. We examine differences in social support, social connections, money, and the household environment across types of living arrangements, develop hypotheses from two theoretical perspectives, one focusing on obligations toward kin, and one focused on social exchange within households, and test them using data from the National Social Life, Health, and Aging Project. We find that availability of resources is not consistently associated with the presence of grandchildren and other young relatives, but often differs with presence of other adults. These findings suggest that a single type of resource tells us little about the distribution of the resources of older adults, and call on us to examine multiple resources simultaneously. PMID:25904682

  20. Potential Barriers to Healthcare in Malawi for Under-five Children with Cough and Fever: A National Household Survey

    PubMed Central

    Ngwira, Bagrey; Stockman, Lauren J.; Deming, Michael; Nyasulu, Peter; Bowie, Cameron; Msyamboza, Kelias; Meyrowitsch, Dan W.; Cunliffe, Nigel A.; Bresee, Joseph; Fischer, Thea K.

    2014-01-01

    Failure to access healthcare is an important contributor to child mortality in many developing countries. In a national household survey in Malawi, we explored demographic and socioeconomic barriers to healthcare for childhood illnesses and assessed the direct and indirect costs of seeking care. Using a cluster-sample design, we selected 2,697 households and interviewed 1,669 caretakers. The main reason for households not being surveyed was the absence of a primary caretaker in the household. Among 2,077 children aged less than five years, 504 episodes of cough and fever during the previous two weeks were reported. A trained healthcare provider was visited for 48.0% of illness episodes. A multivariate regression model showed that children from the poorest households (p=0.02) and children aged >12 months (p=0.02) were less likely to seek care when ill compared to those living in wealthier households and children of higher age-group respectively. Families from rural households spent more time travelling compared to urban households (68.9 vs 14.1 minutes; p<0.001). In addition, visiting a trained healthcare provider was associated with longer travel time (p<0.001) and higher direct costs (p<0.001) compared to visiting an untrained provider. Thus, several barriers to accessing healthcare in Malawi for childhood illnesses exist. Continued efforts to reduce these barriers are needed to narrow the gap in the health and healthcare equity in Malawi. PMID:24847595

  1. State and national household concentrations of PM2.5 from solid cookfuel use: Results from measurements and modeling in India for estimation of the global burden of disease

    PubMed Central

    2013-01-01

    Background Previous global burden of disease (GBD) estimates for household air pollution (HAP) from solid cookfuel use were based on categorical indicators of exposure. Recent progress in GBD methodologies that use integrated–exposure–response (IER) curves for combustion particles required the development of models to quantitatively estimate average HAP levels experienced by large populations. Such models can also serve to inform public health intervention efforts. Thus, we developed a model to estimate national household concentrations of PM2.5 from solid cookfuel use in India, together with estimates for 29 states. Methods We monitored 24-hr household concentrations of PM2.5, in 617 rural households from 4 states in India on a cross-sectional basis between November 2004 and March 2005. We then, developed log-linear regression models that predict household concentrations as a function of multiple, independent household level variables available in national household surveys and generated national / state estimates using The Indian National Family and Health Survey (NFHS 2005). Results The measured mean 24-hr concentration of PM2.5 in solid cookfuel using households ranged from 163 μg/m3 (95% CI: 143,183; median 106; IQR: 191) in the living area to 609 μg/m3 (95% CI: 547,671; median: 472; IQR: 734) in the kitchen area. Fuel type, kitchen type, ventilation, geographical location and cooking duration were found to be significant predictors of PM2.5 concentrations in the household model. k-fold cross validation showed a fair degree of correlation (r = 0.56) between modeled and measured values. Extrapolation of the household results by state to all solid cookfuel-using households in India, covered by NFHS 2005, resulted in a modeled estimate of 450 μg/m3 (95% CI: 318,640) and 113 μg/m3 (95% CI: 102,127) , for national average 24-hr PM2.5 concentrations in the kitchen and living areas respectively. Conclusions The model affords substantial improvement

  2. 100 years of STIs in the UK: a review of national surveillance data.

    PubMed

    Mohammed, Hamish; Blomquist, Paula; Ogaz, Dana; Duffell, Stephen; Furegato, Martina; Checchi, Marta; Irvine, Neil; Wallace, Lesley A; Thomas, Daniel Rhys; Nardone, Anthony; Dunbar, J Kevin; Hughes, Gwenda

    2018-04-13

    The 1916 Royal Commission on Venereal Diseases was established in response to epidemics of syphilis and gonorrhoea in the UK. In the 100 years since the Venereal Diseases Act (1917), the UK has experienced substantial scientific, economic and demographic changes. We describe historical and recent trends in STIs in the UK. We analysed surveillance data derived from STI clinics' statistical returns from 1917 to 2016. Since 1918, gonorrhoea and syphilis diagnoses have fluctuated, reflecting social, economic and technological trends. Following spikes after World Wars I and II, rates declined before re-emerging during the 1960s. At that time, syphilis was more common in men, suggestive of transmission within the men who have sex with men (MSM) population. Behaviour change following the emergence of HIV/AIDS in the 1980s is thought to have facilitated a precipitous decline in diagnoses of both STIs in the mid-1980s. Since the early 2000s, gonorrhoea and syphilis have re-emerged as major public health concerns due to increased transmission among MSM and the spread of antimicrobial-resistant gonorrhoea. Chlamydia and genital warts are now the most commonly diagnosed STIs in the UK and have been the focus of public health interventions, including the national human papillomavirus vaccination programme, which has led to substantial declines in genital warts in young people, and the National Chlamydia Screening Programme in England. Since the 1980s, MSM, black ethnic minorities and young people have experienced the highest STI rates. Although diagnoses have fluctuated over the last century, STIs continue to be an important public health concern, often affecting more marginalised groups in society. Prevention must remain a public health priority and, as we enter a new era of sexual healthcare provision including online services, priority must be placed on maintaining prompt access for those at greatest risk of STIs. © Article author(s) (or their employer(s) unless otherwise

  3. A national UK survey of radiology trainees special interest choices: what and why?

    PubMed

    Parvizi, Nassim; Bhuva, Shaheel

    2017-11-01

    A national survey was designed to better understand factors influencing special interest choices, future aspirations of UK radiology trainees and perceptions of breast radiology. A SurveyMonkey questionnaire was developed and distributed to all radiology trainees in the UK through the British Institute of Radiology, RCR Junior Radiologists Forum and by directly contacting UK training schemes as well as by social media between December 2015 and January 2016. From 21 training schemes across the UK, 232 responses were received. Over half entered radiology after foundation training and 62% were ST1-3; one-fifth of trainees intended to leave the NHS. The most popular special interests were musculoskeletal (18%), abdominal imaging (16%) and neuroradiology (13%). Gynaecological and oncological imaging proved to be the least popular. Strong personal interest, a successful rotation during training, a mix of imaging modalities, direct impact on patient care and job prospects were the most popular factors influencing career choice. Research and potential for private income were the least influential factors. Respondents detailed their perceptions of breast radiology, selecting an awareness of career prospects (41%) and a better trainee experience (36%) as factors that would increase their interest in pursuing it as a career. Understanding the factors that influence special interest choice is essential to addressing the alarming staffing shortfalls that will befall certain radiology special interests. Addressing trainee's preconceptions and improving the trainee experience are key to attracting trainees to breast radiology. Advances in knowledge: This is the first survey of its kind in the UK literature designed to evaluate special interest career choices and the factors that influence those among radiology trainees.

  4. The association of household food security, household characteristics and school environment with obesity status among off-reserve First Nations and Métis children and youth in Canada: results from the 2012 Aboriginal Peoples Survey

    PubMed Central

    Jasmin, Bhawra; Martin, J. Cooke; Yanling, Guo; Piotr, Wilk

    2017-01-01

    Introduction: Indigenous children are twice as likely to be classified as obese and three times as likely to experience household food insecurity when compared with non- Indigenous Canadian children. The purpose of this study was to explore the relationship between food insecurity and weight status among Métis and off-reserve First Nations children and youth across Canada. Methods: We obtained data on children and youth aged 6 to 17 years (n = 6900) from the 2012 Aboriginal Peoples Survey. We tested bivariate relationships using Pearson chisquare tests and used nested binary logistic regressions to examine the food insecurity− weight status relationship, after controlling for geography, household and school characteristics and cultural factors. Results: Approximately 22% of Métis and First Nations children and youth were overweight, and 15% were classified as obese. Over 80% of the sample was reported as food secure, 9% experienced low food security and 7% were severely food insecure. Off-reserve Indigenous children and youth from households with very low food security were at higher risk of overweight or obese status; however, this excess risk was not independent of household socioeconomic status, and was reduced by controlling for household income, adjusted for household size. Negative school environment was also a significant predictor of obesity risk, independent of demographic, household and geographic factors. Conclusion: Both food insecurity and obesity were prevalent among the Indigenous groups studied, and our results suggest that a large proportion of children and youth who are food insecure are also overweight or obese. This study reinforces the importance of including social determinants of health, such as income, school environment and geography, in programs or policies targeting child obesity. PMID:28273035

  5. The association of household food security, household characteristics and school environment with obesity status among off-reserve First Nations and Métis children and youth in Canada: results from the 2012 Aboriginal Peoples Survey.

    PubMed

    Bhawra, Jasmin; Cooke, Martin J; Guo, Yanling; Wilk, Piotr

    2017-03-01

    Indigenous children are twice as likely to be classified as obese and three times as likely to experience household food insecurity when compared with non- Indigenous Canadian children. The purpose of this study was to explore the relationship between food insecurity and weight status among Métis and off-reserve First Nations children and youth across Canada. We obtained data on children and youth aged 6 to 17 years (n = 6900) from the 2012 Aboriginal Peoples Survey. We tested bivariate relationships using Pearson chi-square tests and used nested binary logistic regressions to examine the food insecurity-weight status relationship, after controlling for geography, household and school characteristics and cultural factors. Approximately 22% of Métis and First Nations children and youth were overweight, and 15% were classified as obese. Over 80% of the sample was reported as food secure, 9% experienced low food security and 7% were severely food insecure. Off-reserve Indigenous children and youth from households with very low food security were at higher risk of overweight or obese status; however, this excess risk was not independent of household socioeconomic status, and was reduced by controlling for household income, adjusted for household size. Negative school environment was also a significant predictor of obesity risk, independent of demographic, household and geographic factors. Both food insecurity and obesity were prevalent among the Indigenous groups studied, and our results suggest that a large proportion of children and youth who are food insecure are also overweight or obese. This study reinforces the importance of including social determinants of health, such as income, school environment and geography, in programs or policies targeting child obesity.

  6. The impact of the UK National Minimum Wage on mental health.

    PubMed

    Kronenberg, Christoph; Jacobs, Rowena; Zucchelli, Eugenio

    2017-12-01

    Despite an emerging literature, there is still sparse and mixed evidence on the wider societal benefits of Minimum Wage policies, including their effects on mental health. Furthermore, causal evidence on the relationship between earnings and mental health is limited. We focus on low-wage earners, who are at higher risk of psychological distress, and exploit the quasi-experiment provided by the introduction of the UK National Minimum Wage (NMW) to identify the causal impact of wage increases on mental health. We employ difference-in-differences models and find that the introduction of the UK NMW had no effect on mental health. Our estimates do not appear to support earlier findings which indicate that minimum wages affect mental health of low-wage earners. A series of robustness checks accounting for measurement error, as well as treatment and control group composition, confirm our main results. Overall, our findings suggest that policies aimed at improving the mental health of low-wage earners should either consider the non-wage characteristics of employment or potentially larger wage increases.

  7. Acute myocardial infarction: a comparison of short-term survival in national outcome registries in Sweden and the UK

    PubMed Central

    Chung, Sheng-Chia; Gedeborg, Rolf; Nicholas, Owen; James, Stefan; Jeppsson, Anders; Wolfe, Charles; Heuschmann, Peter; Wallentin, Lars; Deanfield, John; Timmis, Adam; Jernberg, Tomas; Hemingway, Harry

    2014-01-01

    Summary Background International research for acute myocardial infarction lacks comparisons of whole health systems. We assessed time trends for care and outcomes in Sweden and the UK. Methods We used data from national registries on consecutive patients registered between 2004 and 2010 in all hospitals providing care for acute coronary syndrome in Sweden and the UK. The primary outcome was all-cause mortality 30 days after admission. We compared effectiveness of treatment by indirect casemix standardisation. This study is registered with ClinicalTrials.gov, number NCT01359033. Findings We assessed data for 119 786 patients in Sweden and 391 077 in the UK. 30-day mortality was 7·6% (95% CI 7·4–7·7) in Sweden and 10·5% (10·4–10·6) in the UK. Mortality was higher in the UK in clinically relevant subgroups defined by troponin concentration, ST-segment elevation, age, sex, heart rate, systolic blood pressure, diabetes mellitus status, and smoking status. In Sweden, compared with the UK, there was earlier and more extensive uptake of primary percutaneous coronary intervention (59% vs 22%) and more frequent use of β blockers at discharge (89% vs 78%). After casemix standardisation the 30-day mortality ratio for UK versus Sweden was 1·37 (95% CI 1·30–1·45), which corresponds to 11 263 (95% CI 9620–12 827) excess deaths, but did decline over time (from 1·47, 95% CI 1·38–1·58 in 2004 to 1·20, 1·12–1·29 in 2010; p=0·01). Interpretation We found clinically important differences between countries in acute myocardial infarction care and outcomes. International comparisons research might help to improve health systems and prevent deaths. Funding Seventh Framework Programme for Research, National Institute for Health Research, Wellcome Trust (UK), Swedish Association of Local Authorities and Regions, Swedish Heart-Lung Foundation. PMID:24461715

  8. Acute myocardial infarction: a comparison of short-term survival in national outcome registries in Sweden and the UK.

    PubMed

    Chung, Sheng-Chia; Gedeborg, Rolf; Nicholas, Owen; James, Stefan; Jeppsson, Anders; Wolfe, Charles; Heuschmann, Peter; Wallentin, Lars; Deanfield, John; Timmis, Adam; Jernberg, Tomas; Hemingway, Harry

    2014-04-12

    International research for acute myocardial infarction lacks comparisons of whole health systems. We assessed time trends for care and outcomes in Sweden and the UK. We used data from national registries on consecutive patients registered between 2004 and 2010 in all hospitals providing care for acute coronary syndrome in Sweden and the UK. The primary outcome was all-cause mortality 30 days after admission. We compared effectiveness of treatment by indirect casemix standardisation. This study is registered with ClinicalTrials.gov, number NCT01359033. We assessed data for 119,786 patients in Sweden and 391,077 in the UK. 30-day mortality was 7·6% (95% CI 7·4-7·7) in Sweden and 10·5% (10·4-10·6) in the UK. Mortality was higher in the UK in clinically relevant subgroups defined by troponin concentration, ST-segment elevation, age, sex, heart rate, systolic blood pressure, diabetes mellitus status, and smoking status. In Sweden, compared with the UK, there was earlier and more extensive uptake of primary percutaneous coronary intervention (59% vs 22%) and more frequent use of β blockers at discharge (89% vs 78%). After casemix standardisation the 30-day mortality ratio for UK versus Sweden was 1·37 (95% CI 1·30-1·45), which corresponds to 11,263 (95% CI 9620-12,827) excess deaths, but did decline over time (from 1·47, 95% CI 1·38-1·58 in 2004 to 1·20, 1·12-1·29 in 2010; p=0·01). We found clinically important differences between countries in acute myocardial infarction care and outcomes. International comparisons research might help to improve health systems and prevent deaths. Seventh Framework Programme for Research, National Institute for Health Research, Wellcome Trust (UK), Swedish Association of Local Authorities and Regions, Swedish Heart-Lung Foundation. Copyright © 2014 Chung et al. Open Access article distributed under the terms of CC BY-NC-ND. Published by Elsevier Ltd. All rights reserved.

  9. Does household composition explain welfare regime poverty risks for older adults and other household members?

    PubMed

    Tai, Tsui-o; Treas, Judith

    2009-11-01

    This cross-national study examines the poverty of older adults and their household members and relates the risk of poverty to macrolevel state approaches to welfare as well as to microlevel composition of households. Data on individuals in households with older adults for 22 countries come from the Luxembourg Income Survey. Robust cluster analysis relates the risk of poverty to the type of state welfare regime; the characteristics of the household head (age, gender, marital status, and education); as well as the household's numbers of earners, older adults, and children. Persons in households with older adults are significantly less likely to be poor in countries with social democratic and conservative welfare regimes than in Taiwan, an exemplar of limited social welfare programs. Controlling for country differences in household composition increases the differences in poverty risks. Living with fewer children, more older adults, and more earners lowers the risk of poverty, as does having a married and better educated household head. Countries with more generous social welfare provisions have lower risks of poverty despite having household characteristics that are comparatively unfavorable. As Taiwan demonstrates, household composition, particularly a reliance on multigenerational households, compensates for limited state welfare programs.

  10. Association between household size, residential area, and osteoporosis: analysis of 2008 to 2011 Korea National Health and Nutrition Examination Survey

    PubMed Central

    Kim, Sung-Woo; Bae, Kwi-Hyun; Seo, Jung-Beom; Jeon, Jae-Han; Lee, Won-Kee; Lee, In-Kyu; Kim, Jung-Guk; Park, Keun-Gyu

    2016-01-01

    Background/Aims: The prevalence of single-person households has rapidly increased in Korea. Individuals living alone and in rural areas may have a higher risk of various metabolic diseases due to differences in lifestyle. However, few studies have investigated the association of household size and residential area with health-related problems. This study aimed to evaluate the association of household size and residential area with risk of osteoporosis in postmenopausal women. Methods: This cross-sectional study enrolled 3,058 postmenopausal women from the 2008 to 2011 Korea National Health and Nutrition Examination Survey (KNHANES). We examined the association between bone mineral density (BMD) and household size and residential area. Results: Individuals living in rural areas had significantly lower BMD of the lumbar spine than those living in an urban area. Subsequently, we divided the participants into four groups according to household size and residential areas. Lumbar spine BMD was significantly lower in individuals living in rural single-person households than those in urban households with two or more individuals, even after adjustment for multiple confounding factors. In addition, individuals in rural single-person households had significantly greater odds of osteoporosis in the lumbar spine than those in urban households with two or more residents. Conclusions: Individuals in rural single-person households had significantly lower BMD and greater odds of osteoporosis in lumbar spine than urban households with two or more individuals. The results of this study suggest that individuals living in rural single-person households may benefit from more careful screening for osteoporosis. PMID:27079326

  11. Association between household size, residential area, and osteoporosis: analysis of 2008 to 2011 Korea National Health and Nutrition Examination Survey.

    PubMed

    Kim, Sung-Woo; Bae, Kwi-Hyun; Seo, Jung-Beom; Jeon, Jae-Han; Lee, Won-Kee; Lee, In-Kyu; Kim, Jung-Guk; Park, Keun-Gyu

    2016-07-01

    The prevalence of single-person households has rapidly increased in Korea. Individuals living alone and in rural areas may have a higher risk of various metabolic diseases due to differences in lifestyle. However, few studies have investigated the association of household size and residential area with health-related problems. This study aimed to evaluate the association of household size and residential area with risk of osteoporosis in postmenopausal women. This cross-sectional study enrolled 3,058 postmenopausal women from the 2008 to 2011 Korea National Health and Nutrition Examination Survey (KNHANES). We examined the association between bone mineral density (BMD) and household size and residential area. Individuals living in rural areas had significantly lower BMD of the lumbar spine than those living in an urban area. Subsequently, we divided the participants into four groups according to household size and residential areas. Lumbar spine BMD was significantly lower in individuals living in rural single-person households than those in urban households with two or more individuals, even after adjustment for multiple confounding factors. In addition, individuals in rural single-person households had significantly greater odds of osteoporosis in the lumbar spine than those in urban households with two or more residents. Individuals in rural single-person households had significantly lower BMD and greater odds of osteoporosis in lumbar spine than urban households with two or more individuals. The results of this study suggest that individuals living in rural single-person households may benefit from more careful screening for osteoporosis.

  12. Seasonal Difference in National School Lunch Program Participation and Its Impacts on Household Food Security.

    PubMed

    Huang, Jin; Kim, Youngmi; Barnidge, Ellen

    2016-11-20

    The National School Lunch Program (NSLP) is one of the most important food assistance programs in the United States to ensure children's food security and healthy development. Previous studies have offered mixed results and challenges in estimating the effects of program participation. This study assesses NSLP's effect on household food security using data from the Survey of Income and Program Participation (SIPP). SIPP collects information on food security that covers four reference months, including both summer (June, July, August) and nonsummer months. The number of summer months in these four reference months varies by SIPP rotation group. These unique features allow this study to address the potential selection bias in the research of NSLP and food security by examining a seasonal difference in program participation. The analysis found that one more summer month in the reference period increases the difference in low food security rates by about 1.5 percentage points between recipients and nonrecipients eligible for free or reduced-price lunch. Findings have important social work and health policy implications for increasing food security among low-income households with children. © 2016 National Association of Social Workers.

  13. Parents' Reports of the School Readiness of Young Children from the National Household Education Surveys Program of 2007. First Look. NCES 2008-051

    ERIC Educational Resources Information Center

    O'Donnell, Kevin

    2008-01-01

    This report presents data on the school readiness of children in the United States as reported by their parents. This report incorporates basic demographic information about the children, parent/guardian characteristics, and household characteristics. These data come from the School Readiness Survey (SR) of the 2007 National Household Education…

  14. Financial burden of household out-of-pocket expenditures for prescription drugs: Cross-sectional analysis based on national survey data

    PubMed Central

    McLeod, Logan; Bereza, Basil G; Shim, Minsup; Grootendorst, Paul

    2011-01-01

    Background Commentaries on the adequacy of insurance coverage for prescription drugs available to Canadians have emphasized differences in the coverage provided by different provincial governments. Less is known about the actual financial burden of prescription drug spending and how this burden varies by province of residence, affluence and source of primary drug coverage. Methods We used data from a nationally representative household expenditure survey to analyze the financial burden of prescription drugs. We focused on the drug budget share (defined as the share of the household budget spent on prescription drugs), considering how it varied by province, total household budget and likely primary source of drug insurance coverage (i.e., provincial government plan for senior citizens, social assistance plan or private coverage). We examined both “typical” households (at the median of the distribution of the drug budget share) and households with relatively large shares (in the top 5%). Finally, we estimated the percentage of households with catastrophic drug expenditures (defined as a drug budget share of 10% or more) and the average catastrophic drug expenditures. Results Senior, social assistance and general population households accounted for 21.1%, 8.9% and 69.9% of the sample of 14 430 respondents to the 2006 Survey of Household Spending, respectively. The median drug budget share in Canada was 1.1% for senior households (range 0.4% [Ontario] to 3.6% [Saskatchewan]) and 0.1% for both social assistance households and general population households, with little appreciable variation across provinces for these latter 2 categories. The 95th percentile drug budget share in Canada was 7.4% for senior households (range 3.5% [Ontario] to 12.7% [Saskatchewan]), 5.4% for social assistance households (range 2.3% [British Columbia] to 13.0% [Prince Edward Island]) and 2.6% for general population households (range 2.1% [Ontario] to 5.4% [Prince Edward Island]). The

  15. Comparison of accessions from the UK and US national pear germplasm collections with a standardized set of microsatellite markers

    USDA-ARS?s Scientific Manuscript database

    A standardized set of 12 microsatellite markers, previously agreed upon following an ECP/GR workshop in 2006, was used to screen accessions from the UK National Pear Collection at Brogdale and from the US National Pear Germplasm Repository (NCGR), Corvallis. Eight standard varieties were chosen from...

  16. Discrete Choice Model of Food Store Trips Using National Household Food Acquisition and Purchase Survey (FoodAPS).

    PubMed

    Hillier, Amy; Smith, Tony E; Whiteman, Eliza D; Chrisinger, Benjamin W

    2017-09-27

    Where households across income levels shop for food is of central concern within a growing body of research focused on where people live relative to where they shop, what they purchase and eat, and how those choices influence the risk of obesity and chronic disease. We analyzed data from the National Household Food Acquisition and Purchase Survey (FoodAPS) using a conditional logit model to determine where participants shop for food to be prepared and eaten at home and how individual and household characteristics of food shoppers interact with store characteristics and distance from home in determining store choice. Store size, whether or not it was a full-service supermarket, and the driving distance from home to the store constituted the three significant main effects on store choice. Overall, participants were more likely to choose larger stores, conventional supermarkets rather than super-centers and other types of stores, and stores closer to home. Interaction effects show that participants receiving Supplemental Nutrition Assistance Program (SNAP) were even more likely to choose larger stores. Hispanic participants were more likely than non-Hispanics to choose full-service supermarkets while White participants were more likely to travel further than non-Whites. This study demonstrates the value of explicitly spatial discrete choice models and provides evidence of national trends consistent with previous smaller, local studies.

  17. Discrete Choice Model of Food Store Trips Using National Household Food Acquisition and Purchase Survey (FoodAPS)

    PubMed Central

    Hillier, Amy; Smith, Tony E.; Whiteman, Eliza D.

    2017-01-01

    Where households across income levels shop for food is of central concern within a growing body of research focused on where people live relative to where they shop, what they purchase and eat, and how those choices influence the risk of obesity and chronic disease. We analyzed data from the National Household Food Acquisition and Purchase Survey (FoodAPS) using a conditional logit model to determine where participants shop for food to be prepared and eaten at home and how individual and household characteristics of food shoppers interact with store characteristics and distance from home in determining store choice. Store size, whether or not it was a full-service supermarket, and the driving distance from home to the store constituted the three significant main effects on store choice. Overall, participants were more likely to choose larger stores, conventional supermarkets rather than super-centers and other types of stores, and stores closer to home. Interaction effects show that participants receiving Supplemental Nutrition Assistance Program (SNAP) were even more likely to choose larger stores. Hispanic participants were more likely than non-Hispanics to choose full-service supermarkets while White participants were more likely to travel further than non-Whites. This study demonstrates the value of explicitly spatial discrete choice models and provides evidence of national trends consistent with previous smaller, local studies. PMID:28953221

  18. Nurse staffing levels and outcomes - mining the UK national data sets for insight.

    PubMed

    Leary, Alison; Tomai, Barbara; Swift, Adrian; Woodward, Andrew; Hurst, Keith

    2017-04-18

    Purpose Despite the generation of mass data by the nursing workforce, determining the impact of the contribution to patient safety remains challenging. Several cross-sectional studies have indicated a relationship between staffing and safety. The purpose of this paper is to uncover possible associations and explore if a deeper understanding of relationships between staffing and other factors such as safety could be revealed within routinely collected national data sets. Design/methodology/approach Two longitudinal routinely collected data sets consisting of 30 years of UK nurse staffing data and seven years of National Health Service (NHS) benchmark data such as survey results, safety and other indicators were used. A correlation matrix was built and a linear correlation operation was applied (Pearson product-moment correlation coefficient). Findings A number of associations were revealed within both the UK staffing data set and the NHS benchmarking data set. However, the challenges of using these data sets soon became apparent. Practical implications Staff time and effort are required to collect these data. The limitations of these data sets include inconsistent data collection and quality. The mode of data collection and the itemset collected should be reviewed to generate a data set with robust clinical application. Originality/value This paper revealed that relationships are likely to be complex and non-linear; however, the main contribution of the paper is the identification of the limitations of routinely collected data. Much time and effort is expended in collecting this data; however, its validity, usefulness and method of routine national data collection appear to require re-examination.

  19. Perceptions and utilization of primary health care services in Iraq: findings from a national household survey

    PubMed Central

    2011-01-01

    Background After many years of sanctions and conflict, Iraq is rebuilding its health system, with a strong emphasis on the traditional hospital-based services. A network exists of public sector hospitals and clinics, as well as private clinics and a few private hospitals. Little data are available about the approximately 1400 Primary Health Care clinics (PHCCs) staffed with doctors. How do Iraqis utilize primary health care services? What are their preferences and perceptions of public primary health care clinics and private primary care services in general? How does household wealth affect choice of services? Methods A 1256 household national survey was conducted in the catchment areas of randomly selected PHCCs in Iraq. A cluster of 10 households, beginning with a randomly selected start household, were interviewed in the service areas of seven public sector PHCC facilities in each of 17 of Iraq's 18 governorates. A questionnaire was developed using key informants. Teams of interviewers, including both males and females, were recruited and provided a week of training which included field practice. Teams then gathered data from households in the service areas of randomly selected clinics. Results Iraqi participants are generally satisfied with the quality of primary care services available both in the public and private sector. Private clinics are generally the most popular source of primary care, however the PHCCs are utilized more by poorer households. In spite of free services available at PHCCs many households expressed difficulty in affording health care, especially in the purchase of medications. There is no evidence of informal payments to secure health services in the public sector. Conclusions There is widespread satisfaction reported with primary health care services, and levels did not differ appreciably between public and private sectors. The public sector PHCCs are preferentially used by poorer populations where they are important providers. PHCC

  20. UK Renal Registry 15th annual report: Chapter 6 haemoglobin, ferritin and erythropoietin amongst UK adult dialysis patients in 2011: national and centre-specific analyses.

    PubMed

    Rao, Anirudh; Gilg, Julie; Williams, Andrew

    2013-01-01

    The UK Renal Association (RA) and National Institute for Health and Care Excellence (NICE) have published Clinical Practice Guidelines which include recommendations for management of anaemia in established renal failure. To determine the extent to which the guidelines for anaemia management are met in the UK. Quarterly data were obtained for haemoglobin (Hb) and factors that influence Hb from renal centres in England, Wales, Northern Ireland (E, W, NI) and the Scottish Renal Registry for the incident and prevalent renal replacement therapy (RRT) cohorts for 2011. In the UK, in 2011 51% of patients commenced dialysis therapy with Hb ≥10.0 g/dl (median Hb 10 g/dl). Of patients in the early presentation group, 55% started dialysis with Hb ≥10.0 g/dl whilst 37% of patients presenting late started dialysis with Hb ≥10.0 g/dl. The UK median Hb of haemodialysis (HD) patients was 11.2 g/dl with an inter-quartile range (IQR) of 10.3-12.1 g/dl. Of UK HD patients, 82% had Hb ≥10.0 g/dl. The median Hb of peritoneal dialysis (PD) patients in the UK was 11.4 g/dl (IQR 10.5-12.3 g/dl). Of UK PD patients, 85% had Hb ≥10.0 g/dl. The median ferritin in HD patients in the UK was 436 mg/L (IQR 292-625) and 96% of HD patients had a ferritin ≥100 mg/ L. In EW&NI the median ferritin in PD patients was 273 mg/ L (IQR 153-446) with 86% of PD patients having a ferritin ≥100 mg/L. In EW&NI the mean erythropoietin stimulating agent (ESA) dose was higher for HD than PD patients (8,740 vs. 6,624 IU/week). Prevalent HD and PD patients had 56% and 53% respectively within the Hb ≥10 and ≤12 g/dl target. Copyright © 2013 S. Karger AG, Basel.

  1. UK Renal Registry 16th annual report: chapter 10 haemoglobin, ferritin and erythropoietin amongst UK adult dialysis patients in 2012: national and centre-specific analyses.

    PubMed

    Rao, Anirudh; Gilg, Julie; Williams, Andrew

    2013-01-01

    Anaemia treatment in chronic kidney disease (CKD) patients has changed dramatically since the implementation of erythropoietin stimulating agents (ESAs) and has shifted the emphasis from treating severe anaemia in dialysis patients to preventing anaemia. The aim of this chapter is to determine the extent to which the UK Renal Association (RA) and National Institute for Health and Care Excellence (NICE) guidelines for anaemia management are met in the UK. Quarterly data were obtained for haemoglobin (Hb) and factors that influence Hb from UK renal centres for the incident and prevalent renal replacement therapy (RRT) cohorts for 2012. In the UK, in 2012, 51% of patients commenced dialysis therapy with Hb 100 g/L (median Hb 100 g/L). Of patients in the early presentation group, 54% started dialysis with Hb 100 g/L whilst 34% of patients presenting late started dialysis with Hb 100 g/L. The UK median Hb of haemodialysis (HD) patients was 112 g/L, with 82% of patients having Hb 100 g/L. The median Hb of peritoneal dialysis (PD) patients in the UK was 114 g/L, with 85% of patients having Hb 100 g/L. The median ferritin in HD patients in the UK was 431 µg/L and 95% of HD patients had a ferritin 100 µg/L. In EW&NI the median ferritin in PD patients was 285 µg/L (IQR 164-466) with 88% of PD patients having a ferritin 100 µg/L. In EW&NI the median ESA dose was higher for HD than PD patients (7,248 vs. 4,250 IU/week). The percentage of patients treated with an ESA and having Hb >120 g/L ranged between centres from 7-39% for HD and from 0-33% for PD. There was poor correlation between median Hb achieved and median ferritin and ESA usage across the EW&NI centres. There was also a significant variation between centres in the percentages of patients treated with an ESA and having Hb >120 g/L. © 2014 S. Karger AG, Basel.

  2. At-School Victimization and Violence Exposure Assessed in a National Household Survey of Children and Youth

    ERIC Educational Resources Information Center

    Finkelhor, David; Vanderminden, Jennifer; Turner, Heather; Shattuck, Anne; Hamby, Sherry

    2016-01-01

    This national household telephone survey of youth and parents assessed exposure to a broad range of at-school victimizations among a representative sample of 3,391 children and youth ages 5 to 17. Nearly half the sample (48%) had been exposed to at least one form of victimization at school during the past year (in 2011), most of which was…

  3. Implementing business continuity effectively within the UK National Health Service.

    PubMed

    Roberts, Patrick; Molyneux, Helen

    2010-11-01

    Whereas major incident planning is very well established within National Health Service (NHS) organisations in the UK, business continuity management (BCM) planning, in many cases, is a relatively new activity; however, a combination of factors including the emergence of H1N1 influenza, has led to growing interest in the subject. This paper draws on both the personal experience of the authors and published research in relevant fields to make a number of specific recommendations about the effective implementation of BCM within NHS organisations. These include the need to define the BCM project properly; conduct a thorough business impact analysis considering 'back office' as well as clinical activities; define suitable command and control arrangements with clear delegated authority; and support plan development with appropriate training.

  4. Income and Social Rank Influence UK Children's Behavioral Problems: A Longitudinal Analysis.

    PubMed

    Garratt, Elisabeth A; Chandola, Tarani; Purdam, Kingsley; Wood, Alex M

    2017-07-01

    Children living in low-income households face elevated risks of behavioral problems, but the impact of absolute and relative income to this risk remains unexplored. Using the U.K. Millennium Cohort Study data, longitudinal associations between Strengths and Difficulties Questionnaire scores and absolute household income, distance from the regional median and mean income, and regional income rank were examined in 3- to 12-year-olds (n = 16,532). Higher absolute household incomes were associated with lower behavioral problems, while higher income rank was associated with lower behavioral problems only at the highest absolute incomes. Higher absolute household incomes were associated with lower behavioral problems among children in working households, indicating compounding effects of income and socioeconomic advantages. Both absolute and relative incomes therefore appear to influence behavioral problems. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.

  5. Predicted savings to the UK National Health Service from switching to generic antiretrovirals, 2014-2018.

    PubMed

    Hill, Andrew; Hill, Teresa; Jose, Sophie; Pozniak, Anton

    2014-01-01

    In other disease areas, generic drugs are normally used after patent expiry. Patents on zidovudine, lamivudine, nevirapine and efavirenz have already expired. Patents will expire for abacavir in late 2014, lopinavir/r in 2016, and tenofovir, darunavir and atazanavir in 2017. However, patents on single-tablet regimens do not expire until after 2026. The number of people taking each antiretroviral in the UK was estimated from 23,655 individuals in the UK CHIC cohort (2012 database). Costs of patented drugs were taken from the British National Formulary database, assuming a 30% discount. Costs of generic antiretrovirals were estimated using an 80% discount from patented prices, or actual costs where available. Two options were analysed: 1 - all patients use single-tablet regimens and patented versions of drugs; prices remain stable over time; 2 - all people switch from patented to generic drugs when available, after patent expiry (dates shown above). There were an estimated 67,000 people taking antiretrovirals in the UK in 2014, estimated to rise by 8% per year until 2018 (in line with previous rises). The most widely used antiretrovirals in the CHIC cohort were tenofovir (TDF) (75%), emtricitabine (FTC) (69%), efavirenz (EFV) (39%), lamivudine (3TC) (23%), abacavir (ABC) (18%), darunavir (DRV) (21%) and atazanavir (ATV) (16%). The predicted annual UK cost of generic ABC/3TC/EFV (three generic tablets once daily) was £1018 per person-year. Costs of patented single-tablet regimens ranged from £5000 to £7500 per person-year. Assuming continued use of patented antiretrovirals in the UK, the predicted total national costs of antiretroviral treatment were predicted to rise from £425 million in 2014 to £459 m in 2015, £495 m in 2016, £536 m in 2017 and £578 m in 2018. With a 100% switch to generics, total predicted costs were £337 m in 2014, £364 m in 2015, £382 m in 2016, £144 m in 2017 and £169 m in 2018. The total predicted saving over five years from a

  6. How Couples Manage the Household: Work and Power in Cross-National Perspective

    ERIC Educational Resources Information Center

    Treas, Judith; Tai, Tsui-o

    2012-01-01

    Despite many studies on the gendered division of housework, there is little research on how couples divide the work of household management. Relative resource theories of household bargaining inform analyses of who does the housework, but their applicability to household management is unclear, if only because management responsibility may be…

  7. Credentialism, National Targets, and the Learning Society: Perspectives on Educational Attainment in the UK Steel Industry.

    ERIC Educational Resources Information Center

    Fuller, Alison; Unwin, Lorna

    1999-01-01

    The UK's National Learning Targets for Education and Training, embracing 11- to 21-year-olds, adults, and employers, promote a credentialist approach to economic and social development. This article shows how the steel industry measures up. Using qualifications-based targets as a proxy for adult workforce capability is misguided. (Contains 40…

  8. Vegaphobia: derogatory discourses of veganism and the reproduction of speciesism in UK national newspapers.

    PubMed

    Cole, Matthew; Morgan, Karen

    2011-03-01

    This paper critically examines discourses of veganism in UK national newspapers in 2007. In setting parameters for what can and cannot easily be discussed, dominant discourses also help frame understanding. Discourses relating to veganism are therefore presented as contravening commonsense, because they fall outside readily understood meat-eating discourses. Newspapers tend to discredit veganism through ridicule, or as being difficult or impossible to maintain in practice. Vegans are variously stereotyped as ascetics, faddists, sentimentalists, or in some cases, hostile extremists. The overall effect is of a derogatory portrayal of vegans and veganism that we interpret as 'vegaphobia'. We interpret derogatory discourses of veganism in UK national newspapers as evidence of the cultural reproduction of speciesism, through which veganism is dissociated from its connection with debates concerning nonhuman animals' rights or liberation. This is problematic in three, interrelated, respects. First, it empirically misrepresents the experience of veganism, and thereby marginalizes vegans. Second, it perpetuates a moral injury to omnivorous readers who are not presented with the opportunity to understand veganism and the challenge to speciesism that it contains. Third, and most seriously, it obscures and thereby reproduces exploitative and violent relations between human and nonhuman animals. © London School of Economics and Political Science 2011.

  9. Diabetes services in the UK: third national survey confirms continuing deficiencies.

    PubMed

    Jefferson, I G; Swift, P G F; Skinner, T C; Hood, G K

    2003-01-01

    To determine the current level of diabetes services and to compare the results with previous national surveys. A questionnaire was mailed to all paediatricians in the UK identified as providing care for children with diabetes aged under 16 years. Information was sought on staffing, personnel, clinic size, facilities, and patterns of care. Responses were compared with results of two previous national surveys. Replies were received from 244 consultant paediatricians caring for an estimated 17 192 children. A further 2234 children were identified as being cared for by other consultants who did not contribute to the survey. Of 244 consultants, 78% expressed a special interest in diabetes and 91% saw children in a designated diabetic clinic. In 93% of the clinics there was a specialist nurse (44% were not trained to care for children; 47% had nurse:patient ratio >1:100), 65% a paediatric dietitian, and in 25% some form of specialist psychology or counselling available. Glycated haemoglobin was measured routinely at clinics in 88%, retinopathy screening was performed in 87%, and microalbuminuria measured in 66%. Only 34% consultants used a computer database. There were significant differences between the services provided by paediatricians expressing a special interest in diabetes compared with "non-specialists", the latter describing less frequent clinic attendance of dietitians or psychologists, less usage of glycated haemoglobin measurements, and less screening for vascular complications. Non-specialist clinics met significantly fewer of the recommendations of good practice described by Diabetes UK. The survey shows improvements in services provided for children with diabetes, but serious deficiencies remain. There is a shortage of diabetes specialist nurses trained to care for children and paediatric dietitians, and a major shortfall in the provision of psychology/counselling services. The services described confirm the need for more consultant paediatricians to

  10. Household wealth and child health in India.

    PubMed

    Chalasani, Satvika; Rutstein, Shea

    2014-03-01

    Using data from the Indian National Family Health Surveys (1992-93, 1998-99, 2005-06), this study examined how the relationship between household wealth and child health evolved during a time of significant economic change in India. The main predictor was an innovative measure of household wealth that captures changes in wealth over time. Discrete-time logistic models (with community fixed effects) were used to examine mortality and malnutrition outcomes: infant, child, and under-5 mortality; stunting, wasting, and being underweight. Analysis was conducted at the national, urban/rural, and regional levels, separately for boys and girls. The results indicate that the relationship between household wealth and under-5 mortality weakened over time but this result was dominated by infant mortality. The relationship between wealth and child mortality stayed strong for girls. The relationship between household wealth and malnutrition became stronger over time for boys and particularly for girls, in urban and (especially) rural areas.

  11. Comparison of UK and US screening criteria for detection of retinopathy of prematurity in a developing nation.

    PubMed

    Ugurbas, Silay Canturk; Gulcan, Hande; Canan, Handan; Ankarali, Handan; Torer, Birgin; Akova, Yonca Aydın

    2010-12-01

    To determine the incidence, risk factors, and appropriateness of differing guidelines in developed nations for screening for retinopathy of prematurity (ROP) in a single nursery in a large urban city in southern Turkey. The records of 260 premature infants born ≤34 weeks in a single tertiary unit were retrospectively reviewed for ROP risk factors and diagnosis. Applicability of UK and US criteria were assessed by the use of receiver operating characteristic curves. ROP of any stage was present in 60 infants (23%); ROP requiring treatment was seen in 30 (11.5%). Univariate analysis showed a significant relationship among the following factors: gestational age, birth weight, total duration of supplemental oxygen, duration of mechanical ventilation, respiratory distress syndrome, anemia, and intraventricular hemorrhage (p < 0.0001). Multiple logistic regression analysis showed gestational age (p = 0.039), birth weight (p = 0.05), respiratory distress syndrome (p = 0.05), and anemia (p = 0.004) as independent predictors of ROP requiring treatment. Area under curve for gestational age alone for diagnosing stage 2 or greater ROP was 0.824 ± 0.03 (p = 0.0001) and for birth weight alone was 0.808 ± 0.03 (p = 0.0001). UK screening criteria detected all stage 2 and greater ROP; US screening criteria missed 2 infants with stage 2 ROP but detected all treatment-requiring disease. Adoption of these screening criteria would have reduced unnecessary examinations by either 21% (UK) or 37% (US). UK and US criteria improved the detection accuracy for ROP requiring treatment in Turkey and should be studied for other developing nations. Copyright © 2010 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  12. Management of shoulder pain by UK general practitioners (GPs): a national survey

    PubMed Central

    Artus, Majid; van der Windt, Danielle A; Afolabi, Ebenezer K; Buchbinder, Rachelle; Chesterton, Linda S; Hall, Alison; Roddy, Edward; Foster, Nadine E

    2017-01-01

    Objectives Studies in Canada, the USA and Australia suggested low confidence among general practitioners (GPs) in diagnosing and managing shoulder pain, with frequent use of investigations. There are no comparable studies in the UK; our objective was to describe the diagnosis and management of shoulder pain by GPs in the UK. Methods A national survey of a random sample of 5000 UK GPs collected data on shoulder pain diagnosis and management using two clinical vignettes that described primary care presentations with rotator cuff tendinopathy (RCT) and adhesive capsulitis (AdhC). Results Seven hundred and fourteen (14.7%) responses were received. 56% and 83% of GPs were confident in their diagnosis of RCT and AdhC, respectively, and a wide range of investigations and management options were reported. For the RCT presentation, plain radiographs of the shoulder were most common (60%), followed by blood tests (42%) and ultrasound scans (USS) (38%). 19% of those who recommended a radiograph and 76% of those who recommended a USS did so ‘to confirm the diagnosis’. For the AdhC presentation, the most common investigations were blood tests (60%), plain shoulder radiographs (58%) and USS (31%). More than two-thirds of those recommending a USS did so ‘to confirm the diagnosis’. The most commonly recommended treatment for both presentations was physiotherapy (RCT 77%, AdhC 71%) followed by non-steroidal anti-inflammatory drugs (RCT 58%, AdhC 74%). 17% opted to refer the RCT to secondary care (most often musculoskeletal interface service), compared with 31% for the AdhC. Conclusions This survey of GPs in the UK highlights reliance on radiographs and blood tests in the management of common shoulder pain presentations. GPs report referring more than 7 out of 10 patients with RCT and AdhC to physiotherapists. These findings need to be viewed in the context of low response to the survey and, therefore, potential non-response bias. PMID:28637737

  13. Impact of the National Food Supplementary Program for Children on Household Food Security and Maternal Weight Status in Iran.

    PubMed

    Ghodsi, Delaram; Omidvar, Nasrin; Eini-Zinab, Hassan; Rashidian, Arash; Raghfar, Hossein

    2016-01-01

    Food aid programs are strategies that aim to improve nutritional status and to tackle food insecurity. This study aimed to evaluate the effect of a National Food Supplementary Program for Children on households' food security. The study sample included 359 mothers of children aged 6-72 months under the coverage of the program in two provinces of Iran. Demographic and socioeconomic characteristics of the households and percentage of supplementary food items consumed by target child were assessed by a questionnaire and checklist. Data on household food security were collected by locally adapted Household Food Insecurity Access Scale at the baseline of the study and 6 months thereafter. At the baseline, only 4.7% of families were food secure, while 43.5% were severely food insecure, and these proportions were changed to 7.9% and 38%, respectively ( P < 0.001), at the end of the study. Odds of having worse food insecurity in households with medium and high wealth index was 65% and 87% lower than those with low wealth index, respectively (odds ratio [OR] = 0.35, 95% confidence interval [CI]: 0.2-0.61, and OR = 0.23, 95% CI: 0.12-0.43). Food sharing was common among more than 95% of the studied households. Mean maternal body mass index (BMI) increased significantly after 6 months ( P < 0.001). However, there was no significant association between mother's BMI and household food security in the baseline and at the end of the study ( P > 0.05). Findings show that the food supplementary program for children can also improve the household food security status. Further research is needed to assess other factors that affect the effectiveness of this kind of programs.

  14. The UK Functional Assessment Measure (UK FIM+FAM): Psychometric Evaluation in Patients Undergoing Specialist Rehabilitation following a Stroke from the National UK Clinical Dataset.

    PubMed

    Nayar, Meenakshi; Vanderstay, Roxana; Siegert, Richard J; Turner-Stokes, Lynne

    2016-01-01

    The UK Functional Assessment Measure (UKFIM+FAM) is the principal outcome measure for the UK Rehabilitation Outcomes Collaborative (UKROC) national database for specialist rehabilitation. Previously validated in a mixed neurorehabilitation cohort, this study is the first to explore its psychometric properties in a stroke population, and compare left and right hemispheric strokes (LHS vs RHS). We analysed in-patient episode data from 62 specialist rehabilitation units collated through the UKROC database 2010-2013. Complete data were analysed for 1,539 stroke patients (LHS: 588, RHS: 566 with clear localisation). For factor analysis, admission and discharge data were pooled and randomised into two equivalent samples; the first for exploratory factor analysis (EFA) using principal components analysis, and the second for confirmatory factor analysis (CFA). Responsiveness for each subject (change from admission to discharge) was examined using paired t-tests and differences between LHS and RHS for the entire group were examined using non-paired t-tests. EFA showed a strong general factor accounting for >48% of the total variance. A three-factor solution comprising motor, communication and psychosocial subscales, accounting for >69% total variance, provided acceptable fit statistics on CFA (Root Mean Square Error of Approximation was 0.08 and Comparative Fit Index/ Tucker Lewis Index 0.922/0.907). All three subscales showed significant improvement between admission and discharge (p<0.001) with moderate effect sizes (>0.5). Total scores between LHS and RHS were not significantly different. However, LHS showed significantly higher motor scores (Mean 5.7, 95%CI 2.7, 8.6 p<0.001), while LHS had significantly lower cognitive scores, primarily in the communication domain (-6.8 95%CI -7.7, -5.8 p<0.001). To conclude, the UK FIM+FAM has a three-factor structure in stroke, similar to the general neurorehabilitation population. It is responsive to change during in

  15. Incarceration in the household: academic outcomes of adolescents with an incarcerated household member.

    PubMed

    Nichols, Emily Bever; Loper, Ann Booker

    2012-11-01

    The United States has the highest incarceration rate in the world, yet there is relatively little information on how the removal of these adults from households impacts the youth who are left behind. This study used a child-centered lens to examine the impact of incarceration on the school outcomes of youth who resided with a family member or family associate who was incarcerated prior to the youth's 18th birthday. We used data from 11 waves of the National Longitudinal Survey of Youth: Child and Young Adult (n = 3,338, 53 % female). Initial analyses indicated that youth who experienced a household members' incarceration evidenced more socioeconomic challenges, more frequent home adversities, and lower cognitive skills relative to youth who did not experience a household members' incarceration. Results also revealed that youth who had experienced a household member's incarceration were more likely to report extended absence from school and were less likely to graduate from high school relative to those youth who did not experience a household members' incarceration. Counter to our hypotheses, results revealed the incarceration of an extended family member being in the household was the only relation significantly associated with worse school outcomes. Plausibly, families who allow non-immediate criminally involved individuals to reside in the household are experiencing a more pervasive chaotic home environment than those with a parent or sibling incarcerated. Our study suggests that efforts to address the needs of children with incarcerated parents need to be widened to those who experience the loss of any household member due to incarceration.

  16. [Trends and factors associated with food insecurity in Brazil: the National Household Sample Survey, 2004, 2009, and 2013].

    PubMed

    Santos, Taíse Gama Dos; Silveira, Jonas Augusto Cardoso da; Longo-Silva, Giovana; Ramires, Elyssia Karine Nunes Mendonça; Menezes, Risia Cristina Egito de

    2018-03-29

    The aim of this study was to analyze trends and factors associated with food insecurity in Brazil in 2004, 2009, and 2013, using microdata from the National Household Sample Survey (PNAD). Food insecurity was assessed using the Brazilian Food Insecurity Scale. Independent variables were selected from a conceptual model of determination of food insecurity, which was also used in the elaboration of multiple generalized linear models. The results show a downward trend in food insecurity prevalence from 2004 to 2013, especially for moderate and severe food insecurity, from 17% in 2004 (95%CI: 15.7-18.4) to 7.9% in 2013 (95%CI: 7.2-8.7). Despite important decreases in the prevalence of moderate and severe food insecurity, regardless of the level of determination, the population strata with the lowest prevalence in 2004 showed the largest relative reduction. As for factors associated with moderate and severe food insecurity, they remained the same in the ten years covered by the PNAD survey, namely: the North and Northeast regions, urban areas with inadequate sanitation, household density > 2 persons per bedroom, ≤ 4 household durable consumer goods, and households headed by females, individuals < 60 years, and non-whites, ≤ 4 years of schooling, and being unemployed. From 2004 to 2013, the prevalence of Brazilian households with moderate and severe food insecurity dropped by half, but from the perspective of equity the advances occurred unequally and were lower in strata with greater social, economic, and demographic vulnerability.

  17. Early Childhood Program Participation, Results from the National Household Education Surveys Program of 2016. First Look. NCES 2017-101

    ERIC Educational Resources Information Center

    Corcoran, Lisa; Steinley, Katrina

    2017-01-01

    This report presents findings from the Early Childhood Program Participation Survey of the National Household Education Surveys Program of 2016 (NHES:2016). The Early Childhood Program Participation Survey collected data on children's participation in relative care, nonrelative care, and center-based care arrangements. It also collected…

  18. Estimating the impact of the "digital switchover" on disposal of WEEE at household waste recycling centres in England.

    PubMed

    Ongondo, F O; Williams, I D; Keynes, S

    2011-04-01

    Using Hampshire County Council (HCC) as a case study, this paper evaluates and discusses the estimated impacts of the so-called digital switchover (DSO) (scheduled for 2012 in Hampshire) on Household Waste Recycling Centres (HWRCs) in England and the UK. Two public surveys of Hampshire residents were used to collect data on their preparedness for and awareness of the switchover and its implications. The survey also sought to establish the quantities of televisions (TVs) and TV related devices that are ready for the DSO. The quantities of TV and related devices that are likely to be disposed via HCC's collection network have been established and compared to the County's current handling capacities for waste electronic and electrical equipment (WEEE). Best and worst case potential net disposal scenarios have been established and the latter compared to Government projections. In addition, the potential environmental, logistical, financial and legal impacts of the WEEE arising as a consequence of the switchover have been identified and discussed. The results indicate that the majority of TVs both in Hampshire and the UK are digital ready and that awareness of the switchover is high. In contrast, most recording devices in Hampshire are not ready for the DSO. Awareness of the timeframe of the event remains modest however and about half of Hampshire households were not aware that TV recording devices will be affected by the switchover. A significant proportion of waste TVs and related equipment would be taken to HWRCs in contrast to smaller items such as remote controls that would more likely be disposed with normal household waste. Projected figures for the DSO year show that if Hampshire maintained its current collection capacity for WEEE it would experience a handling shortfall of around ∼100K for TVs and recording devices, respectively. The most important finding of the study is that the UK Government may have substantially underestimated the quantities of TV and

  19. Estimating the impact of the 'digital switchover' on disposal of WEEE at household waste recycling centres in England

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

    Ongondo, F.O.; Williams, I.D., E-mail: idw@soton.ac.uk; Keynes, S.

    2011-04-15

    Using Hampshire County Council (HCC) as a case study, this paper evaluates and discusses the estimated impacts of the so-called digital switchover (DSO) (scheduled for 2012 in Hampshire) on Household Waste Recycling Centres (HWRCs) in England and the UK. Two public surveys of Hampshire residents were used to collect data on their preparedness for and awareness of the switchover and its implications. The survey also sought to establish the quantities of televisions (TVs) and TV related devices that are ready for the DSO. The quantities of TV and related devices that are likely to be disposed via HCC's collection networkmore » have been established and compared to the County's current handling capacities for waste electronic and electrical equipment (WEEE). Best and worst case potential net disposal scenarios have been established and the latter compared to Government projections. In addition, the potential environmental, logistical, financial and legal impacts of the WEEE arising as a consequence of the switchover have been identified and discussed. The results indicate that the majority of TVs both in Hampshire and the UK are digital ready and that awareness of the switchover is high. In contrast, most recording devices in Hampshire are not ready for the DSO. Awareness of the timeframe of the event remains modest however and about half of Hampshire households were not aware that TV recording devices will be affected by the switchover. A significant proportion of waste TVs and related equipment would be taken to HWRCs in contrast to smaller items such as remote controls that would more likely be disposed with normal household waste. Projected figures for the DSO year show that if Hampshire maintained its current collection capacity for WEEE it would experience a handling shortfall of around {approx}100 K for TVs and recording devices, respectively. The most important finding of the study is that the UK Government may have substantially underestimated the

  20. Firearm Storage in Gun-Owning Households with Children: Results of a 2015 National Survey.

    PubMed

    Azrael, Deborah; Cohen, Joanna; Salhi, Carmel; Miller, Matthew

    2018-06-01

    Data from a nationally representative probability-based online survey sample of US adults conducted in 2015 (n = 3949, response rate 55%) were used to assess self-reported gun storage practices among gun owners with children. The presence of firearms and children in the home, along with other household and individual level characteristics, was ascertained from all respondents. Questions pertaining to household firearms (how guns are stored, number, type, etc.) were asked only of those respondents who reported that they personally owned a gun. We found that approximately one in three US households contains at least one firearm, regardless of whether children lived in the home (0.34 [0.29-0.39]) or not (0.35 [0.32-0.38]). Among gun-owning households with children, approximately two in ten gun owners store at least one gun in the least safe manner, i.e., loaded and unlocked (0.21 [0.17-0.26]); three in ten store all guns in the safest manner, i.e., unloaded and locked (0.29, [0.24-0.34]; and the remaining half (0.50 [0.45-0.55]) store firearms in some other way. Although firearm storage practices do not appear to vary across some demographic characteristics, including age, sex, and race, gun owners are more likely to store at least one gun loaded and unlocked if they are female (0.31 [0.23-0.41]) vs. male (0.17 [0.13-0.22]); own at least one handgun (0.27 [0.22-0.32] vs. no handguns (0.05 [0.02-0.15]); or own firearms for protection (0.29 [0.24-0.35]) vs. do not own for protection (0.03 [0.01-0.08]). Approximately 7% of US children (4.6 million) live in homes in which at least one firearm is stored loaded and unlocked, an estimate that is more than twice as high as estimates reported in 2002, the last time a nationally representative survey assessed this outcome. To the extent that the high prevalence of children exposed to unsafe storage that we observe reflects a secular change in public opinion towards the belief that having a gun in the home makes the home

  1. Assessing national nutrition security: The UK reliance on imports to meet population energy and nutrient recommendations

    PubMed Central

    Clark, Heather; Whybrow, Stephen; de Ruiter, Henri; McNeill, Geraldine

    2018-01-01

    Nutrition security describes the adequacy of the food supply to meet not only energy but also macronutrient and micronutrient requirements for the population. The aim of this study was to develop a method to assess trends in national nutrition security and the contribution of imports to nutrition security, using the UK as a case study. Food supply data from FAO food balance sheets and national food composition tables were used to estimate the nutrient content of domestically produced food, imported food and exported food. Nutrition security was defined as the total nutrient supply (domestic production, minus exports, plus imports) to meet population-level nutrient requirements. The results showed that the UK was nutrition secure over the period 1961–2011 for energy, macronutrients and key micronutrients, with the exception of total carbohydrates and fibre, which may be due to the loss of fibre incurred by processing cereals into refined products. The supply of protein exceeded population requirements and could be met with domestic production alone. Even excluding all meat there was sufficient protein for population requirements. The supply of total fat, saturated fat and sugar considerably exceeded the current dietary recommendation. As regards nutrition security in 2010, the UK was reliant on imported foods to meet energy, fibre, total carbohydrate, iron, zinc and vitamin A requirements. This analysis demonstrates the importance of including nutrients other than energy to determine the adequacy of the food supply. The methodology also provides an alternative perspective on food security and self-sufficiency by assessing the dependency on imports to meet population level nutritional requirements. PMID:29489830

  2. Assessing national nutrition security: The UK reliance on imports to meet population energy and nutrient recommendations.

    PubMed

    Macdiarmid, Jennie I; Clark, Heather; Whybrow, Stephen; de Ruiter, Henri; McNeill, Geraldine

    2018-01-01

    Nutrition security describes the adequacy of the food supply to meet not only energy but also macronutrient and micronutrient requirements for the population. The aim of this study was to develop a method to assess trends in national nutrition security and the contribution of imports to nutrition security, using the UK as a case study. Food supply data from FAO food balance sheets and national food composition tables were used to estimate the nutrient content of domestically produced food, imported food and exported food. Nutrition security was defined as the total nutrient supply (domestic production, minus exports, plus imports) to meet population-level nutrient requirements. The results showed that the UK was nutrition secure over the period 1961-2011 for energy, macronutrients and key micronutrients, with the exception of total carbohydrates and fibre, which may be due to the loss of fibre incurred by processing cereals into refined products. The supply of protein exceeded population requirements and could be met with domestic production alone. Even excluding all meat there was sufficient protein for population requirements. The supply of total fat, saturated fat and sugar considerably exceeded the current dietary recommendation. As regards nutrition security in 2010, the UK was reliant on imported foods to meet energy, fibre, total carbohydrate, iron, zinc and vitamin A requirements. This analysis demonstrates the importance of including nutrients other than energy to determine the adequacy of the food supply. The methodology also provides an alternative perspective on food security and self-sufficiency by assessing the dependency on imports to meet population level nutritional requirements.

  3. Mental Health Chaplains: Practitioners' Perspectives on Their Value, Purpose and Function in the UK National Health Service

    ERIC Educational Resources Information Center

    Gubi, Peter Madsen; Smart, Harry

    2016-01-01

    There is limited research into the value, purpose and function of Mental Health (MH) Chaplains. Yet, they are employed within National Health Service Trusts in the UK. Eight MH Chaplains were interviewed to explore how they see their value, purpose and function. The data were analysed using interpretative phenomenological analysis. The data reveal…

  4. Are we safe? NLM's household products database.

    PubMed

    Bronson Fitzpatrick, Roberta

    2004-01-01

    This column features an overview of the Division of Specialized Information Services, National Library of Medicine Household Products Database. Basic searching techniques are presented, as well as a brief overview of the data contained in this file. The Household Products Database contains information on chemical ingredients in various products used in U.S. homes.

  5. Home Literacy Experiences and Early Childhood Disability: A Descriptive Study Using the National Household Education Surveys (NHES) Program Database

    ERIC Educational Resources Information Center

    Breit-Smith, Allison; Cabell, Sonia Q.; Justice, Laura M.

    2010-01-01

    Purpose: The present article illustrates how the National Household Education Surveys (NHES; U.S. Department of Education, 2009) database might be used to address questions of relevance to researchers who are concerned with literacy development among young children. Following a general description of the NHES database, a study is provided that…

  6. Identification of poor households for premium exemptions in Ghana's National Health Insurance Scheme: empirical analysis of three strategies.

    PubMed

    Aryeetey, Genevieve Cecilia; Jehu-Appiah, Caroline; Spaan, Ernst; D'Exelle, Ben; Agyepong, Irene; Baltussen, Rob

    2010-12-01

    To evaluate the effectiveness of three alternative strategies to identify poor households: means testing (MT), proxy means testing (PMT) and participatory wealth ranking (PWR) in urban, rural and semi-urban settings in Ghana. The primary motivation was to inform implementation of the National Health Insurance policy of premium exemptions for the poorest households. Survey of 145-147 households per setting to collect data on consumption expenditure to estimate MT measures and of household assets to estimate PMT measures. We organized focus group discussions to derive PWR measures. We compared errors of inclusion and exclusion of PMT and PWR relative to MT, the latter being considered the gold standard measure to identify poor households. Compared to MT, the errors of exclusion and inclusion of PMT ranged between 0.46-0.63 and 0.21-0.36, respectively, and of PWR between 0.03-0.73 and 0.17-0.60, respectively, depending on the setting. Proxy means testing and PWR have considerable errors of exclusion and inclusion in comparison with MT. PWR is a subjective measure of poverty and has appeal because it reflects community's perceptions on poverty. However, as its definition of the poor varies across settings, its acceptability as a uniform strategy to identify the poor in Ghana may be questionable. PMT and MT are potential strategies to identify the poor, and their relative societal attractiveness should be judged in a broader economic analysis. This study also holds relevance to other programmes that require identification of the poor in low-income countries. © 2010 Blackwell Publishing Ltd.

  7. Pre-earthquake national patterns of preschool child undernutrition and household food insecurity in Nepal in 2013 and 2014.

    PubMed

    Shrestha, Sudeep; Thorne-Lyman, Andrew L; Manohar, Swetha; Shrestha, Binod; Neupane, Sumanta; Rajbhandary, Ruchita; Shrestha, Raman; Klemm, Rolf Dw; Nonyane, Bareng As; Adhikari, Ramesh K; Webb, Patrick; West, Keith P

    2018-01-01

    Preschool undernutrition remains a burden in Nepal. This paper reports results of surveys in 2013 and 2014, examining patterns of child nutritional status across the country, associations with household food insecurity and antecedent comparative national data for subsequent evaluations of nutritional status following the earthquake in Nepal in 2015. A multi-stage sample was drawn comprising 21 sites in 75 districts of the country, representing the mountains, hills and Terai zones, providing proportionate to zonal samples of 4286 and 4947 households and 5401 and 5474 preschool children in each year, respectively. Children 6 to 59 months of age were measured for weight and height, expressed as standardized z-scores for height-for-age (HAZ), weight-for-height (WHZ), and stunting and wasting (<-2 z for each). The household food insecurity access scale (HFIAS) was used to measure food security. Between 2013 and 2014, HAZ decreased from a mean (SD) of -1.46 (1.39) to -1.54 (1.33) z-scores, while the prevalence of stunting increased from 35.5% to 37.4% (p<0.05 for both), evident in the mountains and Terai but not hills. In both years, wasting was highest (~22%) in the Terai versus mountains or hills (~8%). More households were classified food secure in 2014 (73%) than 2013 (59%), evident in all zones. Two midyear surveys in Nepal revealed a stable nutritional situation among preschool children, reflecting a pause in the long-term decline in stunting noted in previous years. The same period saw a slight reduction in wasting and improved household food security.

  8. National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM): household survey component methods

    PubMed Central

    Mengue, Sotero Serrate; Bertoldi, Andréa Dâmaso; Boing, Alexandra Crispim; Tavares, Noemia Urruth Leão; Pizzol, Tatiane da Silva Dal; Oliveira, Maria Auxiliadora; Arrais, Paulo Sérgio Dourado; Ramos, Luiz Roberto; Farias, Mareni Rocha; Luiza, Vera Lucia; Bernal, Regina Tomie Ivata; de Barros, Aluísio Jardim Dornellas

    2016-01-01

    ABSTRACT OBJECTIVE To describe methodological aspects of the household survey National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM) related to sampling design and implementation, the actual obtained sample, instruments and fieldwork. METHODS A cross-sectional, population-based study with probability sampling in three stages of the population living in households located in Brazilian urban areas. Fieldwork was carried out between September 2013 and February 2014. The data collection instrument included questions related to: information about households, residents and respondents; chronic diseases and medicines used; use of health services; acute diseases and events treated with drugs; use of contraceptives; use of pharmacy services; behaviors that may affect drug use; package inserts and packaging; lifestyle and health insurance. RESULTS In total, 41,433 interviews were carried out in 20,404 households and 576 urban clusters corresponding to 586 census tracts distributed in the five Brazilian regions, according to eight domains defined by age and gender. CONCLUSIONS The results of the survey may be used as a baseline for future studies aiming to assess the impact of government action on drug access and use. For local studies using a compatible method, PNAUM may serve as a reference point to evaluate variations in space and population. With a comprehensive evaluation of drug-related aspects, PNAUM is a major source of data for a variety of analyses to be carried out both at academic and government level. PMID:27982381

  9. [Characterization of Mexican households with food insecurity].

    PubMed

    Mundo-Rosas, Verónica; Méndez-Gómez Humarán, Ignacio; Shamah-Levy, Teresa

    2014-01-01

    To describe the sociodemographic and health characteristics associated with food insecurity (FI) in Mexican households. The study included information about 40 809 households from the National Health and Nutrition Survey 2012. The Latin American and Caribbean Scale Food Safety (ELCSA) was used to categorize households in terms of food insecurity. Classification and regression trees were used to identify the most significant characteristics in households with high prevalence of FI. The characteristics associated with higher prevalence of FI in homes were: lowest quintiles of welfare status, lack of education or walking or moving disability of household head, and not receiving money from social programmes, pension or remittances. Monitoring of the factors that favor the presence of FI is required to detect social groups being excluded from the right to food.

  10. Does the national health insurance scheme in Ghana reduce household cost of treating malaria in the Kassena-Nankana districts?

    PubMed Central

    Dalaba, Maxwell Ayindenaba; Akweongo, Patricia; Aborigo, Raymond; Awine, Timothy; Azongo, Daniel Kweku; Asaana, Prosper; Atuguba, Frank; Oduro, Abraham

    2014-01-01

    Introduction The Government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2003 to replace out-of-pocket (OOP) payment for health services with the inherent aim of reducing the direct cost of treating illness to households. Objective To assess the effects of the NHIS in reducing cost of treating malaria to households in the Kassena-Nankana districts of northern Ghana. Methods We conducted a cross-sectional survey between October 2009 and October 2011 in the Kassena-Nankana districts. A sample of 4,226 households was randomly drawn from the Navrongo Health and Demographic Surveillance System household database and administered a structured interview. The costs of malaria treatment were collected from the patient perspective. Results Of the 4,226 households visited, a total of 1,324 (31%) household members reported fever and 51% (675) reported treatment for malaria and provided information on where they sought care. Most respondents sought malaria treatment from formal health facilities 63% (424), with the remainder either self-medicating with drugs from chemical shops 32% (217) or with leftover drugs or herbs 5% (34). Most of those who sought care from formal health facilities were insured 79% (334). The average direct medical cost of treating malaria was GH¢3.2 (US$2.1) per case with the insured spending less (GH¢2.6/US$1.7) per case than the uninsured (GH¢3.2/US$2.1). The overall average cost (direct and indirect) incurred by households per malaria treatment was GH¢20.9 (US$13.9). Though the insured accounted for a larger proportion of admissions at health facilities 76% (31) than the uninsured 24% (10), the average amount households spent on the insured was less (GH¢4/US$2.7) than their uninsured counterparts (GH¢6.4/US$4.3). The difference was not statistically significant (p=0.2330). Conclusion Even though some insured individuals made OOP payments for direct medical care, there is evidence that the NHIS has a protective effect on cost

  11. Does the National Health Insurance Scheme in Ghana reduce household cost of treating malaria in the Kassena-Nankana districts?

    PubMed

    Ayindenaba Dalaba, Maxwell; Akweongo, Patricia; Aborigo, Raymond; Awine, Timothy; Kweku Azongo, Daniel; Asaana, Prosper; Atuguba, Frank; Oduro, Abraham

    2014-01-01

    The Government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2003 to replace out-of-pocket (OOP) payment for health services with the inherent aim of reducing the direct cost of treating illness to households. To assess the effects of the NHIS in reducing cost of treating malaria to households in the Kassena-Nankana districts of northern Ghana. We conducted a cross-sectional survey between October 2009 and October 2011 in the Kassena-Nankana districts. A sample of 4,226 households was randomly drawn from the Navrongo Health and Demographic Surveillance System household database and administered a structured interview. The costs of malaria treatment were collected from the patient perspective. Of the 4,226 households visited, a total of 1,324 (31%) household members reported fever and 51% (675) reported treatment for malaria and provided information on where they sought care. Most respondents sought malaria treatment from formal health facilities 63% (424), with the remainder either self-medicating with drugs from chemical shops 32% (217) or with leftover drugs or herbs 5% (34). Most of those who sought care from formal health facilities were insured 79% (334). The average direct medical cost of treating malaria was GH¢3.2 (US$2.1) per case with the insured spending less (GH¢2.6/US$1.7) per case than the uninsured (GH¢3.2/US$2.1). The overall average cost (direct and indirect) incurred by households per malaria treatment was GH¢20.9 (US$13.9). Though the insured accounted for a larger proportion of admissions at health facilities 76% (31) than the uninsured 24% (10), the average amount households spent on the insured was less (GH¢4/US$2.7) than their uninsured counterparts (GH¢6.4/US$4.3). The difference was not statistically significant (p=0.2330). Even though some insured individuals made OOP payments for direct medical care, there is evidence that the NHIS has a protective effect on cost (outpatient and in-patient) of malaria treatment.

  12. Enacting open disclosure in the UK National Health Service: A qualitative exploration.

    PubMed

    Harrison, Reema; Birks, Yvonne; Bosanquet, Kate; Iedema, Rick

    2017-08-01

    Open and honest discussion between healthcare providers and patients and families affected by error is considered to be a central feature of high quality and safer patient care, evidenced by the implementation of open disclosure policies and guidance internationally. This paper discusses the perceived enablers that UK doctors and nurses report as facilitating the enactment of open disclosure. Semistructured interviews with 13 doctors and 22 nurses from a range of levels and specialities from 5 national health service hospitals and primary care trusts in the UK were conducted and analysed using a framework approach. Five themes were identified which appear to capture the factors that are critical in supporting open disclosure: open disclosure as a moral and professional duty, positive past experiences, perceptions of reduced litigation, role models and guidance, and clarity. Greater openness in relation to adverse events requires health professionals to recognise candour as a professional and moral duty, exemplified in the behaviour of senior clinicians and that seems more likely to occur in a nonpunitive, learning environment. Recognising incident disclosure as part of ongoing respectful and open communication with patients throughout their care is critical. © 2017 The Authors Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd.

  13. Household and neighborhood conditions partially account for associations between education and physical capacity in the National Health and Aging Trends Study

    PubMed Central

    Samuel, Laura J.; Glass, Thomas A.; Thorpe, Roland J.; Szanton, Sarah L.; Roth, David L.

    2015-01-01

    Socioeconomic resources, such as education, prevent disability but are not readily modifiable. We tested the hypothesis that household and neighborhood conditions, which may be modifiable, partially account for associations between education and physical capacity in a population-based sample of older adults. The National Health and Aging Trends Study measured education (household and neighborhood conditions, using a 16-item environmental checklist and a 3-item social cohesion scale, and physical capacity with the Short Physical Performance Battery (SPPB), grip strength and peak expiratory flow. Structural equation models were used to decompose total educational effects into direct effects and indirect effects via household and neighborhood conditions, using sample weights and adjusting for age, sex, race/ethnicity, marital status, household size, BMI, self-reported health, and number of medical conditions in 6874 community-dwelling participants. Education was directly associated with SPPB scores (β=0.055, p<0.05) and peak flow (β=0.095, p<0.05), but not grip strength. Also, indirect effects were found for household disorder with SPPB scores (β=0.013, p<0.05), grip strength (β=0.007, p<0.05), and peak flow (β=0.010, p<0.05). Indirect effects were also found for street disorder with SPPB scores (β=0.012, p<0.05). Indirect effects of household and neighborhood conditions accounted for approximately 35%, 27% and 14% of the total association between education and SPPB scores, grip strength level, and peak expiratory flow level, respectively. Household disorder and street disorder partially accounted for educational disparities in physical capacity. However, educational disparities in SPPB scores and peak expiratory flow persisted after accounting for household and neighborhood conditions and chronic conditions, suggesting additional pathways. Interventions and policies aiming to support aging in place

  14. Household energy consumption and expenditures 1993

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

    NONE

    1995-10-05

    This presents information about household end-use consumption of energy and expenditures for that energy. These data were collected in the 1993 Residential Energy Consumption Survey; more than 7,000 households were surveyed for information on their housing units, energy consumption and expenditures, stock of energy-consuming appliances, and energy-related behavior. The information represents all households nationwide (97 million). Key findings: National residential energy consumption was 10.0 quadrillion Btu in 1993, a 9% increase over 1990. Weather has a significant effect on energy consumption. Consumption of electricity for appliances is increasing. Houses that use electricity for space heating have lower overall energy expendituresmore » than households that heat with other fuels. RECS collected data for the 4 most populous states: CA, FL, NY, TX.« less

  15. 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.

  16. The Structure of the Household Economy in Rural North Norway.

    ERIC Educational Resources Information Center

    Nicholson, Beryl

    In Norway, one of the world's most developed nations, a considerable proportion of households still obtain income from more than one source. From the time rural North Norway was settled, households have combined production for sale with production for their own consumption and have exploited various resources to do so. The household's requirements…

  17. The UK's National Programme for IT: Why was it dismantled?

    PubMed

    Justinia, Taghreed

    2017-02-01

    This paper discusses the UK's National Programme for IT (NPfIT), which was an ambitious programme launched in 2002 with an initial budget of some £6.2 billion. It attempted to implement a top-down digitization of healthcare in England's National Health Service (NHS). The core aim of the NPfIT was to bring the NHS' use of information technology into the 21st century, through the introduction of an integrated electronic patient record systems, and reforming the way that the NHS uses information, and hence to improve services and the quality of patient care. The initiative was not trusted by doctors and appeared to have no impact on patient safety. The project was marred by resistance due to the inappropriateness of a centralized authority making top-down decisions on behalf of local organizations. The NPfIT was officially dismantled in September 2011. Deemed the world's largest civil IT programme, its failure and ultimate demise sparked a lot of interest as to the reasons why. This paper summarises the underlying causes that lead to dismantling the NPfIT. At the forefront of those circumstances were the lack of adequate end user engagement, the absence of a phased change management approach, and underestimating the scale of the project.

  18. Utilization of breast cancer screening methods in a developing nation: results from a nationally representative sample of Malaysian households.

    PubMed

    Dunn, Richard A; Tan, Andrew K G

    2011-01-01

    As is the case in many developing nations, previous studies of breast cancer screening behavior in Malaysia have used relatively small samples that are not nationally representative, thereby limiting the generalizability of results. Therefore, this study uses nationally representative data from the Malaysia Non-Communicable Disease Surveillance-1 to investigate the role of socio-economic status on breast cancer screening behavior in Malaysia, particularly differences in screening behaviour between ethnic groups. The decisions of 816 women above age 40 in Malaysia to screen for breast cancer using mammography, clinical breast exams (CBE), and breast self-exams (BSE) are modeled using logistic regression. Results indicate that after adjusting for differences in age, education, household income, marital status, and residential location, Malay women are less likely than Chinese and Indian women to utilize mammography, but more likely to perform BSE. Education level and urban residence are positively associated with utilization of each method, but these relationships vary across ethnicity. Higher education levels are strongly related to using each screening method among Chinese women, but have no statistically significant relationship to screening among Malays. © 2011 Wiley Periodicals, Inc.

  19. Staged residential post-acute rehabilitation for adults following acquired brain injury: A comparison of functional gains rated on the UK Functional Assessment Measure (UK FIM+FAM) and the Mayo-Portland Adaptability Inventory (MPAI-4).

    PubMed

    Jackson, Diana; Seaman, Karla; Sharp, Kristylee; Singer, Rachel; Wagland, Janet; Turner-Stokes, Lynne

    2017-01-01

    To compare the UK Functional Assessment Measure (UK FIM+FAM) and Mayo-Portland Adaptability Inventory (MPAI-4) as measures of functional change in patients with brain injury receiving a staged residential post-acute community-based rehabilitation programme. Longitudinal cohort study of consecutive admissions (N = 42) over 3 years. Patients were assessed at admission and discharge/annual review. We examined groups according to stage of independence on admission: Maximum support (stages 1 and 2: N = 17); moderate/maximum self-care/household support (stage 3: N = 15); minimal self-care and moderate household/community support (stages 4-6: N = 10). Median (IQR) age: 50 (37-56) years. Male:female ratio: (71%:29%). Aetiology: stroke (50%), traumatic (36%) and other brain injuries (14%). Both tools demonstrated significant gains in overall scores and all subscales (p < 0.01). However, the UK FIM+FAM provides more detailed evaluation of personal activities of daily living and mobility, which were most relevant in clients admitted in graduation stages 1 and 2 of the programme, whereas the MPAI-4 was more sensitive to changes in adjustment and participation for clients admitted in the later stages (4-6). The UK FIM+FAM and MPAI-4 provide complementary evaluation across functional tasks ranging from self-care to participation. This study supports their use for longitudinal outcome evaluation in community residential rehabilitation services that take patients at different stages of recovery.

  20. Revealing the unequal household health footprints in China

    NASA Astrophysics Data System (ADS)

    Zhao, H.; Li, X.; Zhang, Q.

    2017-12-01

    Household consumption scale and patterns varies among rural and urban, rich and poor households across regions and nations, these bring uneven direct and indirect production related pollutant emissions and related health footprint. Here, by integrating four stat-of-the-art social-economical and physical models, we quantify PM2.5 related health burden from consumption of 12 income groups for rural and urban households in seven regions of China. We show that, despite earn and spend far less than urban residents, rural households show similar health footprints (3.4×10-4 deaths per capita) with that of urban (3.2×10-4 deaths per capita), primarily because 50% of its consumption related deaths were contributed by the less controlled direct biofuel consumption emissions. Income or expenditure is a main contributor of household health footprints, national averagely, the highest income brackets in rural and urban is 1.8 and 3.4 times of their lowest income groups, respectively. From regions perspective, the household in east coast regions show higher footprint than that of central and western regions, and part of their footprint were occurred in central and west regions through trade or atmospheric transportation. Our results indicate that urbanization will not solve the pollution effects, and efforts to reduce the household health impact should focus on the mitigation of the biofuel consumption emissions in rural area and encourage sustainable consumption in urban area.

  1. Health and social exclusion in older age: evidence from Understanding Society, the UK household longitudinal study.

    PubMed

    Sacker, Amanda; Ross, Andy; MacLeod, Catherine A; Netuveli, Gopal; Windle, Gill

    2017-07-01

    Social exclusion of the elderly is a key policy focus but evidence on the processes linking health and social exclusion is hampered by the variety of ways that health is used in social exclusion research. We investigated longitudinal associations between health and social exclusion using an analytical framework that did not conflate them. Data employed in this study came from 4 waves of Understanding Society, the UK Household Longitudinal Study 2009-2013. The sample comprised all adults who took part in all 4 waves, were 65 years or more in Wave 3, and had complete data on our variables of interest for each analysis. We used linear regression to model the relationship between Wave 2/3 social exclusion and Wave1-2 health transitions (N=4312) and logistic regression to model the relationship between Wave2/3 social exclusion and Wave 4 health states, conditional on Wave 3 health (N=4244). There was a dose-response relationship between poor health in Waves 1 and 2 and later social exclusion. Use of a car, mobile phone and the internet moderated the association between poor health and social exclusion. Given the health status in Wave 3, those who were more socially excluded had poorer outcomes on each of the three domains of health in Wave 4. Use of the internet and technology protected older adults in poor health from social exclusion. Age-friendly hardware and software design might have public health benefits. 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/.

  2. ASSESSMENT OF HOUSEHOLD CARBON FOOTPRINT REDUCTION POTENTIALS

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

    Kramer, Klaas Jan; Homan, Greg; Brown, Rich

    2009-04-15

    The term ?household carbon footprint? refers to the total annual carbon emissions associated with household consumption of energy, goods, and services. In this project, Lawrence Berkeley National Laboratory developed a carbon footprint modeling framework that characterizes the key underlying technologies and processes that contribute to household carbon footprints in California and the United States. The approach breaks down the carbon footprint by 35 different household fuel end uses and 32 different supply chain fuel end uses. This level of end use detail allows energy and policy analysts to better understand the underlying technologies and processes contributing to the carbon footprintmore » of California households. The modeling framework was applied to estimate the annual home energy and supply chain carbon footprints of a prototypical California household. A preliminary assessment of parameter uncertainty associated with key model input data was also conducted. To illustrate the policy-relevance of this modeling framework, a case study was conducted that analyzed the achievable carbon footprint reductions associated with the adoption of energy efficient household and supply chain technologies.« less

  3. Equity, Emotion, and Household Division of Labor Response

    ERIC Educational Resources Information Center

    Lively, Kathryn J.; Steelman, Lala Carr; Powell, Brian

    2010-01-01

    Building upon insights generated by social psychological scholarship on equity, emotions, and identity, we use the General Social Survey (1996) Modules on Emotion and Gender and the National Survey of Family and Households (1992-1994) to investigate the relationship between perceived inequity in the household division of labor and emotion. These…

  4. Psychiatric Morbidity and Social Functioning among Adults with Borderline Intelligence Living in Private Households

    ERIC Educational Resources Information Center

    Hassiotis, A.; Strydom, A.; Hall, I.; Ali, A.; Lawrence-Smith, G.; Meltzer, H.; Head, J; Bebbington, P.

    2008-01-01

    Background: Approximately one-eighth of the population will have DSM-IV borderline intelligence. Various mental disorders and social disability are associated with it. Method: The paper uses data (secondary analysis) from a UK-wide cross-sectional survey of 8450 adults living in private households. Data were collected on psychiatric disorders,…

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

    PubMed

    Waterson, Patrick

    2014-03-01

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

  6. The perceived impact of the National Health Service on personalised nutrition service delivery among the UK public.

    PubMed

    Fallaize, Rosalind; Macready, Anna L; Butler, Laurie T; Ellis, Judi A; Berezowska, Aleksandra; Fischer, Arnout R H; Walsh, Marianne C; Gallagher, Caroline; Stewart-Knox, Barbara J; Kuznesof, Sharon; Frewer, Lynn J; Gibney, Mike J; Lovegrove, Julie A

    2015-04-28

    Personalised nutrition (PN) has the potential to reduce disease risk and optimise health and performance. Although previous research has shown good acceptance of the concept of PN in the UK, preferences regarding the delivery of a PN service (e.g. online v. face-to-face) are not fully understood. It is anticipated that the presence of a free at point of delivery healthcare system, the National Health Service (NHS), in the UK may have an impact on end-user preferences for deliverances. To determine this, supplementary analysis of qualitative data obtained from focus group discussions on PN service delivery, collected as part of the Food4Me project in the UK and Ireland, was undertaken. Irish data provided comparative analysis of a healthcare system that is not provided free of charge at the point of delivery to the entire population. Analyses were conducted using the 'framework approach' described by Rabiee (Focus-group interview and data analysis. Proc Nutr Soc 63, 655-660). There was a preference for services to be led by the government and delivered face-to-face, which was perceived to increase trust and transparency, and add value. Both countries associated paying for nutritional advice with increased commitment and motivation to follow guidelines. Contrary to Ireland, however, and despite the perceived benefit of paying, UK discussants still expected PN services to be delivered free of charge by the NHS. Consideration of this unique challenge of free healthcare that is embedded in the NHS culture will be crucial when introducing PN to the UK.

  7. Body shape by 3-D photonic scanning in Thai and UK adults: comparison of national sizing surveys.

    PubMed

    Wells, J C K; Treleaven, P; Charoensiriwath, S

    2012-01-01

    Body mass index (BMI) cut-offs associated with increased risk of diabetes and cardiovascular disease differ between European and Asian populations, and among Asian populations. Within-population and ethnic variability in body shape has likewise been linked with variability in cardiovascular risk in western settings. To explore differences between Thai and White UK adults in body shape and its associations with height, age and BMI. Data on weight and body shape by 3-D photonic scanning from National Sizing Surveys of UK (3542 men, 4130 women) and Thai (5889 men, 6499 women) adults aged 16-90 years, using a common protocol and methodology, were analysed. Thai adults in both sexes had significantly smaller body girths than UK adults after adjusting for age and height. Matching for BMI, and adjusting for height and age, Thais in both sexes tended to have similar or greater limb girths, but significantly smaller torso girths (especially waist and hip) than UK individuals. These results were replicated within narrow BMI bands at ∼20 and ∼25 kg m(-2). Shape-age associations also differed between the populations. Young Thai adults have a significantly slighter physique than White UK adults, with a less central distribution of body weight. However these differences reduce with age, especially in males. The 3-D photonic scanning provides detailed digital anthropometric data capable of monitoring between- and within-individual shape variability. The technology merits further application to investigate whether variability in body shape is more sensitive to metabolic risk than BMI within and between-populations.

  8. Grade Inflation in UK Higher Education

    ERIC Educational Resources Information Center

    Bachan, Ray

    2017-01-01

    This paper examines the continual increase in the proportion of "good" honour degrees awarded by UK universities since the mid-2000s. This trend has brought with it the charge of "grade inflation" that may reflect falling standards in UK higher education. This issue has been raised in the national press and in government which…

  9. UK-trained junior doctors' intentions to work in UK medicine: questionnaire surveys, three years after graduation

    PubMed Central

    Surman, Geraldine; Goldacre, Michael J

    2017-01-01

    Objective To report on the career intentions, three years after qualification, of 12 national cohorts of UK-trained doctors who qualified between 1974 and 2012, and, specifically, to compare recent UK medical graduates’ intentions to work in medicine in the UK with earlier graduates. Design Questionnaire surveys of cohorts of UK medical graduates defined by year of graduation. Setting UK. Participants 30,272 UK medical graduates. Main outcome measures Stated level of intention to pursue a long-term career in medicine in the UK. Results The response rate was 62% (30,272/48,927). We examined responses to the question ‘Apart from temporary visits abroad, do you intend to practise medicine in the United Kingdom for the foreseeable future?' Of doctors from UK homes, 90% had specified that they would ‘definitely or probably’ practise medicine in the UK in the surveys of 1977–1986, 81% in 1996–2011 and 64% in 2015. Those who said that they would probably or definitely not practise medicine in the UK comprised 5% in 1977–1986, 8% in 1996–2011 and 15% in 2015. Most who were not definite about a future career in UK medicine indicated that they would wish to practise medicine outside the UK rather than to leave medicine. Conclusions The wish to remain in UK medical practice in the 2015 survey was unprecedentedly low in this unique series of 40 years of surveys. PMID:29116902

  10. UK-trained junior doctors' intentions to work in UK medicine: questionnaire surveys, three years after graduation.

    PubMed

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

    2017-12-01

    Objective To report on the career intentions, three years after qualification, of 12 national cohorts of UK-trained doctors who qualified between 1974 and 2012, and, specifically, to compare recent UK medical graduates' intentions to work in medicine in the UK with earlier graduates. Design Questionnaire surveys of cohorts of UK medical graduates defined by year of graduation. Setting UK. Participants 30,272 UK medical graduates. Main outcome measures Stated level of intention to pursue a long-term career in medicine in the UK. Results The response rate was 62% (30,272/48,927). We examined responses to the question ' Apart from temporary visits abroad, do you intend to practise medicine in the United Kingdom for the foreseeable future?' Of doctors from UK homes, 90% had specified that they would 'definitely or probably' practise medicine in the UK in the surveys of 1977-1986, 81% in 1996-2011 and 64% in 2015. Those who said that they would probably or definitely not practise medicine in the UK comprised 5% in 1977-1986, 8% in 1996-2011 and 15% in 2015. Most who were not definite about a future career in UK medicine indicated that they would wish to practise medicine outside the UK rather than to leave medicine. Conclusions The wish to remain in UK medical practice in the 2015 survey was unprecedentedly low in this unique series of 40 years of surveys.

  11. An Agenda for Action To Achieve the Information Society in the UK.

    ERIC Educational Resources Information Center

    Oppenheim, Charles

    1996-01-01

    Discusses the development a national information policy in the United Kingdom (UK): policies for national information infrastructures, electronic information services, privacy and data protection, copyright, public and national libraries; reviews problems inhibiting Internet use; compares the UK's and the European Commission's approaches to…

  12. The national employment guarantee scheme and inequities in household spending on food and non-food determinants of health in rural India.

    PubMed

    Dilip, T R; Dandona, Rakhi; Dandona, Lalit

    2013-10-15

    Inequities in a population in spending on food and non-food items can contribute to disparities in health status. The Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) was launched in rural India in 2006, aimed at providing at least 100 days of manual work to a member in needy households. We used nationally representative data from the consumer expenditure surveys of 2004-05 and 2009-10 and the employment survey of 2009-10 conducted by National Sample Survey Organisation to assess the effect of MGNREGS in reducing inequities in consumption of food and non-food items between poor and non-poor households in the states of India. Variations among the states in implementation of MGNREGS were examined using the employment and unemployment survey data, and compared with official programme data up to 2012-13. Inequity in spending on food and non-food items was assessed using the ratio of monthly per capita consumer expenditure (MPCE) between the most vulnerable (labourer) and least vulnerable categories of households. The survey data suggested 1.42 billion person-days of MGNRGES employment in the 2009-10 financial year, whereas the official programme data reported 2.84 billion person-days. According to the official data, the person-days of MGNRGES employment decreased by 43.3% from 2009-10 to 2012-13 for the 9 large less developed states of India. Survey data revealed that the average number of MGNREGS work days in a year per household varied from 42 days in Rajasthan to less than 10 days in 14 of the 20 major states in India in 2009-10. Rajasthan with the highest implementation of MGNRGES among the 9 less developed states of India had the highest relative decline of 10.4% in the food spending inequity from 2004-05 to 2009-10 between the most vulnerable and less vulnerable households. The changes in inequity for non-food spending did not have any particular pattern across the less developed states. In the most vulnerable category, the households in

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  14. Patient satisfaction and non-UK educated nurses: a cross-sectional observational study of English National Health Service Hospitals

    PubMed Central

    Griffiths, Peter; Sloane, Douglas M; Rafferty, Anne Marie; Ball, Jane E; Aiken, Linda H

    2015-01-01

    Objectives To examine whether patient satisfaction with nursing care in National Health Service (NHS) hospitals in England is associated with the proportion of non-UK educated nurses providing care. Design Cross-sectional analysis using data from the 2010 NHS Adult Inpatient Survey merged with data from nurse and hospital administrator surveys. Logistic regression models with corrections for clustering were used to determine whether the proportions of non-UK educated nurses were significantly related to patient satisfaction before and after taking account of other hospital, nursing and patient characteristics. Setting 31 English NHS trusts. Participants 12 506 patients 16 years of age and older with at least one overnight stay that completed a satisfaction survey; 2962 bedside care nurses who completed a nurse survey; and 31 NHS trusts. Main outcome measure Patient satisfaction. Results The percentage of non-UK educated nurses providing bedside hospital care, which ranged from 1% to 52% of nurses, was significantly associated with patient satisfaction. After controlling for potential confounding factors, each 10-point increase in the percentage of non-UK educated nurses diminished the odds of patients reporting good or excellent care by 12% (OR=0.88), and decreased the odds of patients agreeing that they always had confidence and trust in nurses by 13% (OR=0.87). Other indicators of patient satisfaction also revealed lower satisfaction in hospitals with higher percentages of non-UK educated nurses. Conclusions Use of non-UK educated nurses in English NHS hospitals is associated with lower patient satisfaction. Importing nurses from abroad to substitute for domestically educated nurses may negatively impact quality of care. PMID:26634400

  15. Recent trend in family households in Beijing.

    PubMed

    Guo, Z; Guo, L

    1997-01-01

    This study examined trends in household size and age structure in Beijing, China, in 1995. Data were reliably obtained from the 1% sample survey of China. Findings indicate that the average size of a family household was 3.15 persons, that is, 0.050 persons fewer than the 3.20 from the 1990 Census. Children aged 0-14 years in each household averaged 0.04 fewer children during 1990-95. 80% of the decline in household size was due to decreases in the number of children. The percentage of single-family and single-person households declined. Three-person households were the only size group that increased (23.2-40.7%). The household headship (HH) rate for males increased dramatically between the ages of 20 and 30 years and stabilized after 35 years. The HH rate for women grew slowly and continuously until age 50 years and then stabilized. The gender gap in HH appeared at an early age and remained thereafter. The HH rate declined at older ages. The HH rate in Beijing, compared to the national rate, suggests relative gender equity in Beijing. As a child ages, the percentage of three-generation households declines and the percentage of two-generation households rises. As a child becomes an adult, the percentages of single-person households and single-couple households increase. Single-couple households decreased among the middle-aged. 67.4% of the elderly lived in two- or three-generation households. 31.4% of elderly lived in single-person/couple households. The percentage of elderly living with their children declined by 2 points during 1990-95.

  16. UK Renal Registry 13th Annual Report (December 2010): Chapter 9: haemoglobin, ferritin and erythropoietin amongst UK adult dialysis patients in 2009: national and centre-specific analyses.

    PubMed

    Gilg, Julie; Webb, Lynsey; Feest, Terry; Fogarty, Damian

    2011-01-01

    The UK Renal Association (RA) and National Institute for Health and Clinical Excellence (NICE) have published Clinical Practice Guidelines which include recommendations for management of anaemia in established renal failure. To determine the extent to which the guidelines for anaemia management are met in the UK. Quarterly data were obtained regarding haemoglobin (Hb) and factors that influence Hb from renal centres in England, Wales, Northern Ireland (EWNI) and the Scottish Renal Registry for the incident and prevalent renal replacement therapy (RRT) cohorts for 2009. In the UK, in 2009 55% of patients commenced dialysis therapy with Hb x10.0 g/dl (median Hb 10.2 g/dl). The median Hb of haemodialysis (HD) patients was 11.6 g/dl with an interquartile range (IQR) of 10.6 - 12.4 g/dl. Of HD patients 85% had Hb ≥ 10.0 g/dl. The median Hb of peritoneal dialysis (PD) patients in the UK was 11.7 g/dl (IQR 10.7-12.6 g/dl). Of UK PD patients, 88% had Hb ≥ 10.0 g/dl. The median ferritin in HD patients in EWNI was 441 mg/L (IQR 289-629) and 96% of HD patients had a ferritin ≥ 100 mg/L. The median ferritin in PD patients was 249 mg/L (IQR 142-412) with 86% of PD patients having a ferritin 5100 mg/L. In EWNI the mean Erythropoietin Stimulating Agent (ESA) dose was higher for HD than PD patients (9,507 vs. 6,212 IU/week). In 2009, 56% of prevalent HD patients had a Hb ≥ 10.5 and ≤ 12.5 g/dl compared with 54% in 2008 and 53% in 2007. Fifty-four percent of prevalent PD patients had a Hb ≥10.5 and ≤12.5 g/dl compared to 55% in 2008. Copyright © 2011 S. Karger AG, Basel.

  17. INFLUENCES OF ASTHMA AND HOUSEHOLD ENVIRONMENT ON LUNG FUNCTION OF CHILDREN AND ADOLESCENTS: THE THIRD NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY

    EPA Science Inventory

    We examined influences of asthma and household environment (passive smoking, gas stove use, and having a dog or cat), on seven measures of spirometric lung function in 8-16 yearold subjects, as measured in the Third National Health and Nutrition Examination Survey (NHANES III). ...

  18. Education in Rural Peru: Exploring the Role of Household Electrification in School Enrollment

    ERIC Educational Resources Information Center

    Kulkarni, Veena S.; Barnes, Douglas F.

    2017-01-01

    This study employs Peru's National Survey of Rural Household Energy Use data to investigate the correlation between household access to electricity and enrollment of children age 6-18 after taking into account individual-child and household level characteristics. Results indicate that children residing in households with access to electricity…

  19. Household training vs. mass campaigns: a better method of health communication for preventing malaria.

    PubMed

    Chourasia, Mehul Kumar; Abraham, Vinod J; John, Jacob

    2014-10-01

    Malaria is endemic in several states of India with high tribal population. Effective use of long-lasting insecticide treated bed nets (LLITNs) can reduce the burden of malaria in these settings. This study assessed the knowledge and behaviour regarding malaria in a tribal population and compared two health education strategies for enhancing effective utilisation of bed nets. A community-based intervention study was carried out among 218 households in two villages. One community received household level training on effective utilisation of LLITNs while the others received training in a mass campaign and outcomes were measured after 2 months. The study showed that the proportion utilising LLITNs was significantly higher among those receiving household level training as compared to those who received the mass campaign. Household level training appears to be a more effective form of health education for improving knowledge and promoting use of LLITNs in these isolated community groups. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  20. 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

  1. Supporting UK adaptation: building services for the next set of UK climate projections

    NASA Astrophysics Data System (ADS)

    Fung, Fai; Lowe, Jason

    2016-04-01

    As part of the Climate Change Act 2008, the UK Government sets out a national adaptation programme to address the risks and opportunities identified in a national climate change risk assessment (CCRA) every five years. The last risk assessment in 2012 was based on the probabilistic projections for the UK published in 2009 (UKCP09). The second risk assessment will also use information from UKCP09 alongside other evidence on climate projections. However, developments in the science of climate projeciton, and evolving user needs (based partly on what has been learnt about the diverse user requirements of the UK adaptation community from the seven years of delivering and managing UKCP09 products, market research and the peer-reviewed literature) suggest now is an appropriate time to update the projections and how they are delivered. A new set of UK climate projections are now being produced to upgrade UKCP09 to reflect the latest developments in climate science, the first phase of which will be delivered in 2018 to support the third CCRA. A major component of the work is the building of a tailored service to support users of the new projections during their development and to involve users in key decisions so that the projections are of most use. We will set out the plan for the new climate projections that seek to address the evolving user need. We will also present a framework which aims to (i) facilitate the dialogue between users, boundary organisations and producers, reflecting their different decision-making roles (ii) produce scientifically robust, user-relevant climate information (iii) provide the building blocks for developing further climate services to support adaptation activities in the UK.

  2. Family Responsibilities: How Are They Shared in European Households?

    ERIC Educational Resources Information Center

    Statistics in Focus: Population and Social Conditions, 1997

    1997-01-01

    This newsletter focuses on the division of family responsibilities in European households, which is based on results of the European Community Household Panel, a multi-dimensional survey covering several subjects, including demographic and employment characteristics. The survey was based on a questionnaire adapted by various national data…

  3. Household and neighborhood conditions partially account for associations between education and physical capacity in the National Health and Aging Trends Study.

    PubMed

    Samuel, Laura J; Glass, Thomas A; Thorpe, Roland J; Szanton, Sarah L; Roth, David L

    2015-03-01

    Socioeconomic resources, such as education, prevent disability but are not readily modifiable. We tested the hypothesis that household and neighborhood conditions, which may be modifiable, partially account for associations between education and physical capacity in a population-based sample of older adults. The National Health and Aging Trends Study measured education (household and neighborhood conditions, using a 16-item environmental checklist and a 3-item social cohesion scale, and physical capacity with the Short Physical Performance Battery (SPPB), grip strength and peak expiratory flow. Structural equation models were used to decompose total educational effects into direct effects and indirect effects via household and neighborhood conditions, using sample weights and adjusting for age, sex, race/ethnicity, marital status, household size, BMI, self-reported health, and number of medical conditions in 6874 community-dwelling participants. Education was directly associated with SPPB scores (β = 0.055, p < 0.05) and peak flow (β = 0.095, p < 0.05), but not grip strength. Also, indirect effects were found for household disorder with SPPB scores (β = 0.013, p < 0.05), grip strength (β = 0.007, p < 0.05), and peak flow (β = 0.010, p < 0.05). Indirect effects were also found for street disorder with SPPB scores (β = 0.012, p < 0.05). Indirect effects of household and neighborhood conditions accounted for approximately 35%, 27% and 14% of the total association between education and SPPB scores, grip strength level, and peak expiratory flow level, respectively. Household disorder and street disorder partially accounted for educational disparities in physical capacity. However, educational disparities in SPPB scores and peak expiratory flow persisted after accounting for household and neighborhood conditions and chronic conditions, suggesting additional pathways. Interventions and policies aiming to

  4. 2004-based national population projections for the UK and constituent countries.

    PubMed

    Shaw, Chris

    2006-01-01

    The 2004-based national population projections, carried out by the Government Actuary in consultation with the Registrars General, show the population of the United Kingdom (UK) rising from 59.8 million in 2004, passing 60 million in 2005 and 65 million in 2023, to reach 67.0 million by 2031. In the longer-term, the projections suggest that the population will continue rising beyond 2031 but at a much lower rate of growth. The population will become older with the median age expected to rise from 38.6 years in 2004 to 42.9 years by 2031. With the current plans for a common state pension age of 65 for both sexes from 2020, the number of people of working age for every person of state pensionable age is projected to fall from 3.33 in 2004 to 2.62 by 2031.

  5. Development of the UK Engagement Survey

    ERIC Educational Resources Information Center

    Kandiko Howson, Camille; Buckley, Alex

    2017-01-01

    Student engagement has become a key feature of UK higher education, but until recently there has been a lack of data to track, benchmark and drive enhancement. In 2015 the first full administration ran in the UK a range of survey items drawn from the US-based National Survey of Student Engagement (NSSE). This is the latest example of international…

  6. Household Vehicles Energy Consumption 1994

    DOT National Transportation Integrated Search

    1997-08-01

    This document reports on the results of the 1994 Residential Transportation Energy Consumption Survey (RTECS). The RTECS is a national sample survey that has been conducted every 3 years since 1985. For the 1994 survey, more than 3,000 households tha...

  7. The National Children's Study: Recruitment Outcomes Using an Enhanced Household-Based Approach.

    PubMed

    Blaisdell, Laura L; Zellner, Jennifer A; King, Alison A; Faustman, Elaine; Wilhelm, Mari; Hudak, Mark L; Annett, Robert D

    2016-06-01

    Ten National Children's Study (NCS) study locations with diverse demographic characteristics used an enhanced household-based recruitment (EHBR) approach to enroll preconceptional and pregnant women. Study centers used different types and dosages of community outreach and engagement (COE) activities and supplemental strategies. The goal of the study was to determine whether variability in enumeration and recruitment outcomes correlated with study location characteristics or types and dosages of COE activities (number of COE events, number of advance household mailings, total media expenditures, and total COE expenditures). Each of the sites provided data on COE activities, protocol implementation, supplemental recruitment activities, location demographic characteristics, and enumeration/recruitment outcomes. COE activities varied across sites in breadth and scope. Numerous strategies were used, including media advertising, social media, participation in community-wide events, presentations to stakeholders, and creation of advisory boards. Some sites included supplemental recruitment efforts. EHBR sites enrolled 1404 women at the initial pregnancy screening. No significant relationships were found between study location demographic characteristics or between the types and dosages of COE activities and recruitment outcomes. Probability sampling for a long-term study requires a positive image with stakeholders and within communities; this requirement may be especially true for door-to-door recruitment. EHBR sites successfully recruited a representative sample of preconceptional and pregnant women. Sites reported implementing similar COE activities but with varying dosage and cost; however, analyses did not support a benefit of COE strategies on study recruitment. Copyright © 2016 by the American Academy of Pediatrics.

  8. Does national scale economic and environmental indicators spur logistics performance? Evidence from UK.

    PubMed

    Khan, Syed Abdul Rehman; Qianli, Dong

    2017-12-01

    The aim of this study is to examine the association between national economic and environmental indicators with green logistics performance in a time series data of UK since 1981 to 2016. The research used autoregressive distributed lag method to understand the long-run and short-run relationships of national scale economic (foreign direct investment (FDI) inflows, per capita income) and environmental indicators (total greenhouse gases, fossil fuel, and renewable energy) on green logistics. In the short run, the research findings indicate that the green logistics and renewable energy have positive relationship, while fossil fuel is negatively correlated with green logistics operations. On the other hand, in the long run, the results show that FDI inflows, renewable energy sources, and per capita income have statistically significant and positive association with green logistics activities, while foreign investments attracted by environmental friendly policies and practices adopted in global logistics operations, which not only increase the environmental sustainability but also enhance economic activities with greater export opportunities in the region.

  9. Walk, Bicycle, and Transit Trips of Transit-Dependent and Choice Riders in the 2009 United States National Household Travel Survey.

    PubMed

    Lachapelle, Ugo

    2015-08-01

    Previous research has shown that public transit use may be associated with active transportation. Access to a car may influence active transportation of transit riders. Using the 2009 United States National Household Travel Survey (NHTS), transit users ≥ 16 years old (n = 25,550) were categorized according to driver status and number of cars and drivers in the household. This typology ranged from choice transit riders (ie, "fully motorized drivers") to transit-dependent riders (ie, "unmotorized nondriver"). Transit trips, walking trips, and bicycling trips of transit users are estimated in negative binomial models against the car availability typology. Sixteen percent of participants took transit in the past month; most (86%) lived in car-owning households. As income increased, car availability also increased. Transit user groups with lower car availability were generally more likely than fully motorized drivers to take more public transit, walking, and bicycle trips. Transit riders have varying levels of vehicle access; their use of combinations of alternative modes of transportation fluctuates accordingly. Transit-dependent individuals without cars or sharing cars used active transportation more frequently than car owners. Policies to reduce vehicle ownership in households may enable increases in the use of alternative modes of transportation for transit users, even when cars are still owned.

  10. Variation in beliefs about ‘fracking’ between the UK and US

    NASA Astrophysics Data System (ADS)

    Evensen, Darrick; Stedman, Richard; O'Hara, Sarah; Humphrey, Mathew; Andersson-Hudson, Jessica

    2017-12-01

    In decision-making on the politically-contentious issue of unconventional gas development, the UK Government and European Commission are attempting to learn from the US experience. Although economic, environmental, and health impacts and regulatory contexts have been compared cross-nationally, public perceptions and their antecedents have not. We conducted similar online panel surveys of national samples of UK and US residents simultaneously in September 2014 to compare public perceptions and beliefs affecting such perceptions. The US sample was more likely to associate positive impacts with development (i.e. production of clean energy, cheap energy, and advancing national energy security). The UK sample was more likely to associate negative impacts (i.e. water contamination, higher carbon emissions, and earthquakes). Multivariate analyses reveal divergence cross-nationally in the relationship between beliefs about impacts and support/opposition—especially for beliefs about energy security. People who associated shale gas development with increased energy security in the UK were over three times more likely to support development than people in the US with this same belief. We conclude with implications for policy and communication, discussing communication approaches that could be successful cross-nationally and policy foci to which the UK might need to afford more attention in its continually evolving regulatory environment.

  11. Monitoring drinking water, sanitation, and hygiene in non-household settings: Priorities for policy and practice.

    PubMed

    Cronk, Ryan; Slaymaker, Tom; Bartram, Jamie

    2015-11-01

    Inadequate drinking water, sanitation, and hygiene (WaSH) in non-household settings, such as schools, health care facilities, and workplaces impacts the health, education, welfare, and productivity of populations, particularly in low and middle-income countries. There is limited knowledge on the status of WaSH in such settings. To address this gap, we reviewed international standards, international and national actors, and monitoring initiatives; developed the first typology of non-household settings; and assessed the viability of monitoring. Based on setting characteristics, non-household settings include six types: schools, health care facilities, workplaces, temporary use settings, mass gatherings, and dislocated populations. To-date national governments and international actors have focused monitoring of non-household settings on schools and health care facilities with comparatively little attention given to other settings such as workplaces and markets. Nationally representative facility surveys and national management information systems are the primary monitoring mechanisms. Data suggest that WaSH coverage is generally poor and often lower than in corresponding household settings. Definitions, indicators, and data sources are underdeveloped and not always comparable between countries. While not all countries monitor non-household settings, examples are available from countries on most continents suggesting that systematic monitoring is achievable. Monitoring WaSH in schools and health care facilities is most viable. Monitoring WaSH in other non-household settings would be viable with: technical support from local and national actors in addition to international organizations such as WHO and UNICEF; national prioritization through policy and financing; and including WaSH indicators into monitoring initiatives to improve cost-effectiveness. International consultations on targets and indicators for global monitoring of WaSH post-2015 identified non-household

  12. Screening for iron deficiency and iron deficiency anaemia in pregnancy: a structured review and gap analysis against UK national screening criteria.

    PubMed

    Rukuni, Ruramayi; Knight, Marian; Murphy, Michael F; Roberts, David; Stanworth, Simon J

    2015-10-20

    Iron deficiency anaemia is a common problem in pregnancy despite national recommendations and guidelines for treatment. The aim of this study was to appraise the evidence against the UK National Screening Committee (UKNSC) criteria as to whether a national screening programme could reduce the prevalence of iron deficiency anaemia and/or iron deficiency in pregnancy and improve maternal and fetal outcomes. Search strategies were developed for the Cochrane library, Medline and Embase to identify evidence relevant to UK National Screening Committee (UKNSC) appraisal criteria which cover the natural history of iron deficiency and iron deficiency anaemia, the tests for screening, clinical management and evidence of cost effectiveness. Many studies evaluated haematological outcomes of anaemia, but few analysed clinical consequences. Haemoglobin and ferritin appeared the most suitable screening tests, although future options may follow recent advances in understanding iron homeostasis. The clinical consequences of iron deficiency without anaemia are unknown. Oral and intravenous iron are effective in improving haemoglobin and iron parameters. There have been no trials or economic evaluations of a national screening programme for iron deficiency anaemia in pregnancy. Iron deficiency in pregnancy remains an important problem although effective tests and treatment exist. A national screening programme could be of value for early detection and intervention. However, high quality studies are required to confirm whether this would reduce maternal and infant morbidity and be cost effective.

  13. The UK population: how does it compare?

    PubMed

    Matheson, Jil

    2010-01-01

    This is the fourth demographic report for the UK, providing an overview of the latest statistics on the population. This year's article compares the UK with other European countries and a range of nations from around the world. Statistical comparisons are made for fertility, mortality, ageing, migration and population density. The UK has an ageing population, but one that is not ageing as rapidly as some other countries such as Germany, Italy and Japan. Although life expectation in the UK is improving in line with most western European countries, relatively high levels of fertility ensure that the proportion of the population that is young remains high. Around one in ten residents of the UK are foreign born, a lower proportion than many developed countries. UK population density has increased steadily and is the fourth highest in the EU.

  14. Illicit drug use by persons with disabilities: insights from the National Household Survey on Drug Abuse.

    PubMed Central

    Gilson, S F; Chilcoat, H D; Stapleton, J M

    1996-01-01

    OBJECTIVES: This study sought to evaluate the association of drug use with disability in a representative sample of the US household population. METHODS: The use of illicit drugs and alcohol reported by respondents in the 1991 National Household Survey on Drug Abuse who identified themselves as "disabled, unable to work" was compared with respondents without disabilities. RESULTS: Among younger adults (18-24 years), persons with disabilities were more likely than those without disabilities to report that they had used heroin (adjusted odds ratio [OR] = 6.89; 95% confidence interval [CI] = 1.35, 35.1) or crack cocaine (OR = 6.38; 95% CI = 1.05, 38.6). Among older adults (35 years and older), persons with disabilities were more likely to report the use of sedatives (OR = 2.46; 95% CI = 1.21, 4.94) or tranquilizers (OR = 2.18: 95% CI = 1.08; 4.42) not medically prescribed. CONCLUSIONS: These results suggest that use of illicit drugs is a potentially serious problem among persons with disabilities and requires both research and clinical attention. PMID:8916529

  15. Management of gout by UK rheumatologists: a British Society for Rheumatology national audit.

    PubMed

    Roddy, Edward; Packham, Jon; Obrenovic, Karen; Rivett, Ali; Ledingham, Joanna M

    2018-05-01

    To assess the concordance of gout management by UK rheumatologists with evidence-based best-practice recommendations. Data were collected on patients newly referred to UK rheumatology out-patient departments over an 8-week period. Baseline data included demographics, method of diagnosis, clinical features, comorbidities, urate-lowering therapy (ULT), prophylaxis and blood tests. Twelve months later, the most recent serum uric acid level was collected. Management was compared with audit standards derived from the 2006 EULAR recommendations, 2007 British Society for Rheumatology/British Health Professionals in Rheumatology guideline and the National Institute for Health and Care Excellence febuxostat technology appraisal. Data were collected for 434 patients from 91 rheumatology departments (mean age 59.8 years, 82% male). Diagnosis was crystal-proven in 13%. Of 106 taking a diuretic, this was reduced/stopped in 29%. ULT was continued/initiated in 76% of those with one or more indication for ULT. One hundred and fifty-eight patients started allopurinol: the starting dose was most commonly 100 mg daily (82%); in those with estimated glomerular filtration rate <60 ml/min the highest starting dose was 100 mg daily. Of 199 who started ULT, prophylaxis was co-prescribed for 94%. Fifty patients started a uricosuric or febuxostat: 84% had taken allopurinol previously. Of 44 commenced on febuxostat, 18% had a history of heart disease. By 12 months, serum uric acid levels ⩽360 and <300 μmol/l were achieved by 45 and 25%, respectively. Gout management by UK rheumatologists concords well with guidelines for most audit standards. However, fewer than half of patients achieved a target serum uric level over 12 months. Rheumatologists should help ensure that ULT is optimized to achieve target serum uric acid levels to benefit patients.

  16. 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

  17. Regression Analysis to Identify Factors Associated with Household Salt Iodine Content at the Sub-National Level in Bangladesh, India, Ghana and Senegal

    PubMed Central

    Knowles, Jacky; Kupka, Roland; Dumble, Sam; Garrett, Greg S.; Pandav, Chandrakant S.; Yadav, Kapil; Nahar, Baitun; Touré, Ndeye Khady; Amoaful, Esi Foriwa; Gorstein, Jonathan

    2018-01-01

    Regression analyses of data from stratified, cluster sample, household iodine surveys in Bangladesh, India, Ghana and Senegal were conducted to identify factors associated with household access to adequately iodised salt. For all countries, in single variable analyses, household salt iodine was significantly different (p < 0.05) between strata (geographic areas with representative data, defined by survey design), and significantly higher (p < 0.05) among households: with better living standard scores, where the respondent knew about iodised salt and/or looked for iodised salt at purchase, using salt bought in a sealed package, or using refined grain salt. Other country-level associations were also found. Multiple variable analyses showed a significant association between salt iodine and strata (p < 0.001) in India, Ghana and Senegal and that salt grain type was significantly associated with estimated iodine content in all countries (p < 0.001). Salt iodine relative to the reference (coarse salt) ranged from 1.3 (95% CI 1.2, 1.5) times higher for fine salt in Senegal to 3.6 (95% CI 2.6, 4.9) times higher for washed and 6.5 (95% CI 4.9, 8.8) times higher for refined salt in India. Sub-national data are required to monitor equity of access to adequately iodised salt. Improving household access to refined iodised salt in sealed packaging, would improve iodine intake from household salt in all four countries in this analysis, particularly in areas where there is significant small-scale salt production. PMID:29671774

  18. Drug rationing in the UK National Health Service. Current status and future prospects.

    PubMed

    Walley, T; Haycox, A; Barton, S

    1997-09-01

    There are major problems in attempting to ration drug use in the UK. These include the large indigenous pharmaceutical industry, the nature of funding of drugs within the National Health Service (NHS) and the political sensitivities of rationing. Rationing of services within the NHS has therefore usually been implicit rather than explicit, and there is little public debate about rationing of health services. In relation to drug therapy, prescribing in primary care technically can only be rationed by encouraging the general practitioner (GP) to contain his or her own costs-effectively moving the difficult decision to the GP. Direct incentives to the GP, in the form of incentive payments or by fundholding seem to have some success in containing costs, largely by simple generic substitution. There are established systems in hospitals to control the costs of drugs, including formularies and drug management committees. Hospitals commonly try to transfer drug costs to the GP budget. While in part this is clinically appropriate, it can lead to tensions. Health authorities and GP fundholders now include prescribing, particularly at this interface, in their contracts with hospitals. Economic evaluations currently play little part in aiding decisions about choice of drug. These decisions tend to be dominated by the need for short term cost containment in the UK. Recent reforms of the NHS have moved responsibility for the rationing of services to the local authorities or purchasers; this might in time create an additional, local hurdle for pharmaceutical companies trying to market new drugs. A proposal to introduce a national limited formulary in which drugs will be selected partly on the basis of an economic evaluation seems impractical, although similar ideas might be further developed.

  19. Projection for household development in China.

    PubMed

    Guo, Z

    1991-01-01

    In traditional Chinese culture, marriage and setting up a new household is the most important event in life with the requisite purchases of real estate, furniture and other large items from years of savings. The development of the national economy depends on these households to as significant extent as they also provide microeconomic functions in society. The sex age-specific householder rate method was used for forecasting the number of future households. The UN medium projection of the population of China for the year 2000 indicated 1,285,000,000, the low projection showed 1,260,000,000 and the high projection came up with 1,300,000,000 with an essentially unchanged number of households and probably smaller average household size. The 1988, the China Population Statistics Almanac disclosed that in 1987 there was a total 258,340,000 households expected to increase according to the medium projection to 370,000,000 households expected to increase according to the medium projection to 370,640,000 by 2000. This annual growth rate of 2.8% exceeds the rate of 1.4% in the 1950s, 1.8% in the 1960s and early 1970s and 2.4% during 1975-87. The data of the Statistics Bureau and the Ministry of Public Security for 1985-89 yielded an annual household growth rate of 3.6%. This could be attributed to the increased number of births following the troublesome early 1960s who enter marriage age now. Based on the average household living space of 61.37 sq m there would be an additional 6,890,000,000 sq m of living space requirement for 112,300,000 new households. The proportion of urban population would rise from the level of 1987 when the agricultural population made up 80.1% and the nonagricultural segment comprised 19.8%. New household construction would require planning, raising funds, building materials, construction teams, and land.

  20. Accelerated technology transfer: the UK quantum initiative

    NASA Astrophysics Data System (ADS)

    Bennett, Simon D.

    2016-10-01

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

  1. Economic burden of cancer in India: Evidence from cross-sectional nationally representative household survey, 2014.

    PubMed

    Rajpal, Sunil; Kumar, Abhishek; Joe, William

    2018-01-01

    With the ongoing demographic and epidemiological transition, cancer is emerging as a major public health concern in India. This paper uses nationally representative household survey to examine the overall prevalence and economic burden of cancer in India. The age-standardized prevalence of cancer is estimated to be 97 per 100,000 persons with greater prevalence in urban areas. The evidence suggests that cancer prevalence is highest among the elderly and also among females in the reproductive age groups. Cancer displays a significant socioeconomic gradient even after adjusting for age-sex specifics and clustering in a multilevel regression framework. We find that out of pocket expenditure on cancer treatment is among the highest for any ailment. The average out of pocket spending on inpatient care in private facilities is about three-times that of public facilities. Furthermore, treatment for about 40 percent of cancer hospitalization cases is financed mainly through borrowings, sale of assets and contributions from friends and relatives. Also, over 60 percent of the households who seek care from the private sector incur out of pocket expenditure in excess of 20 percent of their annual per capita household expenditure. Given the catastrophic implications, this study calls for a disease-based approach towards financing such high-cost ailment. It is suggested that universal cancer care insurance should be envisaged and combined with existing accident and life insurance policies for the poorer sections in India. In concluding, we call for policies to improve cancer survivorship through effective prevention and early detection. In particular, greater public health investments in infrastructure, human resources and quality of care deserve priority attention.

  2. Economic burden of cancer in India: Evidence from cross-sectional nationally representative household survey, 2014

    PubMed Central

    Kumar, Abhishek; Joe, William

    2018-01-01

    With the ongoing demographic and epidemiological transition, cancer is emerging as a major public health concern in India. This paper uses nationally representative household survey to examine the overall prevalence and economic burden of cancer in India. The age-standardized prevalence of cancer is estimated to be 97 per 100,000 persons with greater prevalence in urban areas. The evidence suggests that cancer prevalence is highest among the elderly and also among females in the reproductive age groups. Cancer displays a significant socioeconomic gradient even after adjusting for age-sex specifics and clustering in a multilevel regression framework. We find that out of pocket expenditure on cancer treatment is among the highest for any ailment. The average out of pocket spending on inpatient care in private facilities is about three-times that of public facilities. Furthermore, treatment for about 40 percent of cancer hospitalization cases is financed mainly through borrowings, sale of assets and contributions from friends and relatives. Also, over 60 percent of the households who seek care from the private sector incur out of pocket expenditure in excess of 20 percent of their annual per capita household expenditure. Given the catastrophic implications, this study calls for a disease-based approach towards financing such high-cost ailment. It is suggested that universal cancer care insurance should be envisaged and combined with existing accident and life insurance policies for the poorer sections in India. In concluding, we call for policies to improve cancer survivorship through effective prevention and early detection. In particular, greater public health investments in infrastructure, human resources and quality of care deserve priority attention. PMID:29481563

  3. Disability prevalence and disability-related employment gaps in the UK 1998-2012: Different trends in different surveys?

    PubMed

    Baumberg, Ben; Jones, Melanie; Wass, Victoria

    2015-09-01

    The persistently low employment rate among disabled individuals has been an enduring concern of governments across developed countries and has been the subject of a succession of policy initiatives, including labour market activation programmes, equality laws and welfare reform. A key indicator of progress is the trend in the disability-related employment gap, the percentage point difference between the employment rate for disabled and non-disabled individuals. Confusingly for the UK, studies undertaken between 1998 and 2012 have simultaneously reported both a widening and a narrowing of the gap. The source of the discrepancy can be found in the choice of survey, the General Household Survey (GHS) or the Labour Force Survey (LFS), although both use a common conception of disability and collect self-reported information from a random sample of households. The literature has analysed these surveys separately from each other and ignored inter-survey differences in findings. The Health Survey for England (HSE), a third national household survey, replicates the GHS questions on disability but has had limited use in this context. This empirical study compares the trends in disability prevalence and the disability-related employment gap across the three surveys using a three-stage harmonisation process. The negative relationship between the prevalence of disability and the employment gap found in cross-section inter-survey comparisons prompts an initial focus on differences in the definition of disability as an explanation of the discrepancy. This is broadened to include differences in survey methods and sample composition. Differences in the trend in disability prevalence and the employment gap remain following harmonisation for definition, survey method and sample composition. It is the LFS, the main policy-influencing and policy-assessment survey, which generates outlying results. As such, we cannot be confident that the disability-related employment gap has narrowed

  4. Minority and poor households: patterns of travel and transportation fuel use

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

    Millar, M.; Morrison, R.; Vyas, A.

    1986-05-01

    This report documents the travel behavior and transportation fuel use of minority and poor households in the US, using information from numerous national-level sources. The resulting data base reveals distinctive patterns of household vehicle availability and use, travel, and fuel use and enables us to relate observed differences between population groups to differences in their demographic characteristics and in the attributes of their household vehicles. When income and residence location are controlled, black (and to a lesser extent, Hispanic and poor) households have fewer vehicles regularly available than do comparable white or nonpoor households; moreover, these vehicles are older andmore » larger and thus have significantly lower fuel economy. The net result is that average black, Hispanic, and poor households travel fewer miles per year but use more fuel than do average white and nonpoor households. Certain other findings - notably, that of significant racial differences in vehicle availability and use by low-income households - challenge the conventional wisdom that such racial variations arise solely because of differences in income and residence location. Results of the study suggest important differences - primarily in the yearly fluctuation of income - between black and white low-income households even when residence location is controlled. These variables are not captured by cross-sectional data sets (either the national surveys used in our analysis or the local data sets that are widely used for urban transportation planning).« less

  5. A critical analysis of UK public health policies in relation to diet and nutrition in low-income households.

    PubMed

    Attree, Pamela

    2006-04-01

    Diet and nutrition, particularly among low-income groups, is a key public health concern in the UK. Low levels of fruit and vegetable consumption, and obesity, especially among children, have potentially severe consequences for the future health of the nation. From a public health perspective, the UK government's role is to help poorer families make informed choices within healthy frameworks for living. However, the question is - to what extent are such policies in accordance with lay experiences of managing diet and nutrition on a low-income? This paper critically examines contemporary public health policies aimed at improving diet and nutrition, identifying the underlying theories about the influences on healthy eating in poor families, and exploring the extent to which these assumptions are based on experiential accounts. It draws on two qualitative systematic reviews - one prioritizing low-income mothers' accounts of 'managing' in poverty; and the other focusing on children's perspectives. The paper finds some common ground between policies and lay experiences, but also key divergencies. Arguably, the emphasis of public health policy on individual behaviour, coupled with an ethos of empowered consumerism, underplays material limitations on 'healthy eating' for low-income mothers and children. Health policies fail to take into account the full impact of structural influences on food choices, or recognize the social and emotional factors that influence diet and nutrition. In conclusion, it is argued that while health promotion campaigns to improve low-income families' diets do have advantages, these are insufficient to outweigh the negative effects of poverty on nutrition.

  6. Initial Results from the Royal College of Radiologists' UK National Audit of Anal Cancer Radiotherapy 2015.

    PubMed

    Muirhead, R; Drinkwater, K; O'Cathail, S M; Adams, R; Glynne-Jones, R; Harrison, M; Hawkins, M A; Sebag-Montefiore, D; Gilbert, D C

    2017-03-01

    UK guidance was recently developed for the treatment of anal cancer using intensity-modulated radiotherapy (IMRT). We audited the current use of radiotherapy in UK cancer centres for the treatment of anal cancer against such guidance. We describe the acute toxicity of IMRT in comparison with patient population in the audit treated with two-phase conformal radiotherapy and the previous published data from two-phase conformal radiotherapy, in the UK ACT2 trial. A Royal College of Radiologists' prospective national audit of patients treated with radiotherapy in UK cancer centres was carried out over a 6 month period between February and July 2015. Two hundred and forty-two cases were received from 40/56 cancer centres (71%). In total, 231 (95%) underwent full dose radiotherapy with prophylactic nodal irradiation. Of these, 180 (78%) received IMRT or equivalent, 52 (22%) two-phase conformal (ACT2) technique. The number of interruptions in radiotherapy treatment in the ACT2 trial was 15%. Interruptions were noted in 7% (95% confidence interval 0-14%) of courses receiving two-phase conformal and 4% (95% confidence interval 1-7%) of those receiving IMRT. The percentage of patients completing the planned radiotherapy dose, irrelevant of gaps, was 90% (95% confidence interval 82-98%) and 96% (95% confidence interval 93-99%), in two-phase conformal and IMRT respectively. The toxicity reported in the ACT2 trial, in patients receiving two-phase conformal in the audit and in patients receiving IMRT in the audit was: any toxic effect 71%, 54%, 48%, non-haematological 62%, 49%, 40% and haematological 26%, 13%, 18%, respectively. IMRT implementation for anal cancer is well underway in the UK with most patients receiving IMRT delivery, although its usage is not yet universal. This audit confirms that IMRT results in reduced acute toxicity and minimised treatment interruptions in comparison with previous two-phase conformal techniques. Copyright © 2016 The Royal College of

  7. Different approaches to the tasks of educating and training information systems professionals, within the National Health Service (UK).

    PubMed

    Grant, R M; Horkin, E J; Melhuish, P J; Norris, A C

    1998-06-01

    In 1994, La Sainte Union College of Higher Education (LSU) developed an MSc in Health Informatics course, in conjunction with Southampton University NHS Trust (SUHT). The original part-time, 1 day per week mode of delivery has since been broadened to include a distance leaning route and recently a block release mode, by which students combine usage of the distance learning materials with attendance in College for an intensive 2-day taught element. Because the course was designed in close co-operation with a major teaching hospital, it has always been 'market led' to meet the needs both of the individual students and of the organisations that they work for. At the same time, students acquire a quality-assured qualification from a premier UK university, a qualification that holds credence outside the National Health Service (NHS). At the same time as LSU and SUHT were developing the MSc in Health Informatics, the UK NHS Training Division (NHSTD) started to promote a professional qualification for health service professionals. the so-called 'Statement of Recognition' (SoR). In contrast to the academic format of an MSc, the SoR was not a formal course, but a combination of modules designed to help candidates demonstrate their competence and achievement at work by portfolio evidence. This approach has national standing throughout the UK in a set of qualifications known as NVQs (National Vocational Qualifications). The NHSTD, through its successor, the Institute of Health Care Development (IHCD), has further refined this competency based model, culminating in the launch in 1996 of the Diploma and Advanced Diploma in Information and Technology (Health). Professionals within the area of Information Management and Technology (IM&T) in the NHS now have the alternatives of an academic or a competency route to achieve their goals. This paper traces the development of and the relationship between, these two approaches to the educational and training of healthcare professionals

  8. Correlates of out-of-pocket and catastrophic health expenditures in Tanzania: results from a national household survey.

    PubMed

    Brinda, Ethel Mary; Andrés, Antonio Rodríguez; Andrés, Rodriguez Antonio; Enemark, Ulrika

    2014-03-05

    Inequality in health services access and utilization are influenced by out-of-pocket health expenditures in many low and middle-income countries (LMICs). Various antecedents such as social factors, poor health and economic factors are proposed to direct the choice of health care service use and incurring out-of-pocket payments. We investigated the association of these factors with out-of-pocket health expenditures among the adult and older population in the United Republic of Tanzania. We also investigated the prevalence and associated determinants contributing to household catastrophic health expenditures. We accessed the data of a multistage stratified random sample of 7279 adult participants, aged between 18 and 59 years, as well as 1018 participants aged above 60 years, from the first round of the Tanzania National Panel survey. We employed multiple generalized linear and logistic regression models to evaluate the correlates of out-of-pocket as well as catastrophic health expenditures, accounting for the complex sample design effects. Increasing age, female gender, obesity and functional disability increased the adults' out-of-pocket health expenditures significantly, while functional disability and visits to traditional healers increased the out-of-pocket health expenditures in older participants. Adult participants, who lacked formal education or worked as manual laborers earned significantly less (p < 0.001) and spent less on health (p < 0.001), despite having higher levels of disability. Large household size, household head's occupation as a manual laborer, household member with chronic illness, domestic violence against women and traditional healer's visits were significantly associated with high catastrophic health expenditures. We observed that the prevalence of inequalities in socioeconomic factors played a significant role in determining the nature of both out-of-pocket and catastrophic health expenditures. We propose that investment in social welfare

  9. Estimations of daily energy and nutrient availability based on nationally representative household budget survey data. The Data Food Networking (DAFNE) project.

    PubMed

    Naska, A; Oikonomou, E; Trichopoulou, A; Wagner, K; Gedrich, K

    2007-12-01

    To describe a cost-efficient method for estimating energy and nutrient availability using household budget survey (HBS) data. Four different approaches were tested and the results were compared with published nutrient intake data. The selected method was exemplarily applied in German and Greek data. Germany, 1998; Greece, 1998/99. Nationally representative HBSs. Comparisons showed that HBS-based estimates were generally close to intake data when results were presented as contributions to daily energy intake. Daily energy and protein availabilities were similar in Germany and Greece. Differences were observed in the availability of carbohydrates (German households reported a 5 percentage points higher contribution to daily energy availability) and lipids (Greek households recorded higher values for total fat, but lower values for saturated fat). Meat, added lipids and potatoes were important energy suppliers in Germany, whereas in Greece the first three energy suppliers were added lipids, cereals and meat. In both countries, meat, cereals, milk and cheese were important protein sources and cereals, potatoes, fruits and nuts contributed more than 60% of the daily carbohydrate availability. Added lipids were the major source of fat in the daily diet of both countries, but their contribution amounted to less than one-third in Germany and two-thirds in Greece. National HBS data can be used for monitoring and comparing nutrient availability among representative population samples of different countries. The ground is set for the development of a harmonised food composition table to be applied to HBS food data at international level.

  10. Parent and Family Involvement in Education: Results from the National Household Education Surveys Program of 2016. First Look. NCES 2017-102

    ERIC Educational Resources Information Center

    McQuiggan, Meghan; Megra, Mahi

    2017-01-01

    This report presents findings from the Parent and Family Involvement in Education Survey of the National Household Education Surveys Program of 2016 (NHES:2016). The Parent and Family Involvement in Education Survey collected data on children enrolled in public or private school for kindergarten through 12th grade or homeschooled for these grades.…

  11. Research investments for UK infectious disease research 1997-2013: A systematic analysis of awards to UK institutions alongside national burden of disease.

    PubMed

    Head, Michael G; Brown, Rebecca J; Clarke, Stuart C

    2018-01-01

    Infectious disease remains a significant burden in the UK and the focus of significant amounts of research investment each year. The Research Investments in Global Health study has systematically assessed levels of funding for infection research, and here considers investment alongside UK burden of individual infectious diseases. The study included awards to UK institutions between 1997 and 2013 that were related to infectious disease. Awards related to global health projects were excluded here. UK burden data (mortality, years lived with disability, and disability adjusted life years) was sourced from the Global Burden of Disease study (IHME, USA). Awards were categorised by pathogen, disease, disease area and by type of science along the research pipeline (pre-clinical, phase I-III trials, product development, public health, cross-disciplinary research). New metrics present relative levels of funding by comparing sum investment with measures of disease burden. There were 5685 relevant awards comprising investment of £2.4 billion. By disease, HIV received most funding (£369.7m; 15.6% of the total investment). Pre-clinical science was the predominant type of science (£1.6 billion, 68.7%), with the UK Medical Research Council (MRC) the largest funder (£714.8 million, 30.1%). There is a broad temporal trend to increased fundingper annum. Antimicrobial resistance received (£102.8 million, 4.2%), whilst sepsis received £23.6 million (1.0%). Compared alongside disease burden, acute hepatitis C and measles typically were relatively well-funded, whilst pneumonia, syphilis and gonorrhoea were poorly-funded. The UK has a broad research portfolio across a wide range of infectious diseases and disciplines. There are notable strengths including HIV, some respiratory infections and in pre-clinical science, though there was less funding for UK-relevant trials and public health research. Compared to the UK burden of disease, syphilis, gonorrhoea and pneumonia appear

  12. Re-employment, job quality, health and allostatic load biomarkers: prospective evidence from the UK Household Longitudinal Study

    PubMed Central

    Chandola, Tarani; Zhang, Nan

    2018-01-01

    Abstract Background There is little evidence on whether becoming re-employed in poor quality work is better for health and well-being than remaining unemployed. We examined associations of job transition with health and chronic stress-related biomarkers among a population-representative cohort of unemployed British adults. Methods A prospective cohort of 1116 eligible participants aged 35 to 75 years, who were unemployed at wave 1 (2009/10) of the UK Household Longitudinal Study, were followed up at waves 2 (2010/11) and 3 (2011/12) for allostatic load biomarkers and self-reported health. Negative binomial and multiple regression models estimated the association between job adversity and these outcomes. Results Compared with adults who remained unemployed, formerly unemployed adults who transitioned into poor quality jobs had higher levels of overall allostatic load (0.51, 0.32–0.71), log HbA1c (0.06, <0.001–0.12), log triglycerides (0.39, 0.22–0.56), log C-reactive protein (0.45, 0.16–0.75), log fibrinogen (0.09, 0.01–0.17) and total cholesterol to high-density lipoprotein (HDL) ratio (1.38, 0.88–1.88). Moreover, physically healthier respondents at wave 1 were more likely to transition into good quality and poor quality jobs after 1 year than those who remained unemployed. Conclusions Formerly unemployed adults who transitioned into poor quality work had greater adverse levels of biomarkers compared with their peers who remained unemployed. The selection of healthier unemployed adults into these poor quality or stressful jobs was unlikely to explain their elevated levels of chronic stress-related biomarkers. Job quality cannot be disregarded from the employment success of the unemployed, and may have important implications for their health and well-being. PMID:29024973

  13. The effects of a soft drink tax in the UK.

    PubMed

    Tiffin, Richard; Kehlbacher, Ariane; Salois, Matthew

    2015-05-01

    The majority of the UK population is either overweight or obese. Health economists, nutritionists and doctors are calling for the UK to follow the example of other European countries and introduce a tax on soft drinks as a result of the perception that high intakes contribute to diet-related disease. We use a demand model estimated with household-level data on beverage purchases in the UK to investigate the effects of a tax on soft drink consumption. The model is a Quadratic Almost Ideal Demand System, and censoring is handled by applying a double hurdle. Separate models are estimated for low, moderate and high consumers to allow for a differential impact on consumption between these groups. Applying different hypothetical tax rates, we conclude that understanding the nature of substitute/complement relationships is crucial in designing an effective policy as these relationships differ between consumers depending on their consumption level. The overall impact of a soft drink tax on calorie consumption is likely to be small. Copyright © 2014 John Wiley & Sons, Ltd.

  14. Cross-Cultural Household Influence on Vaccination Decisions.

    PubMed

    Taylor, Eric; Atkins, Katherine E; Medlock, Jan; Li, Meng; Chapman, Gretchen B; Galvani, Alison P

    2016-10-01

    Uptake of vaccination against seasonal influenza is suboptimal in most countries, and campaigns to promote vaccination may be weakened by clustering of opinions and decisions not to vaccinate. This clustering can occur at myriad interacting levels: within households, social circles, and schools. Given that influenza is more likely to be transmitted to a household contact than any other contact, clustering of vaccination decisions is arguably most problematic at the household level. We conducted an international survey study to determine whether household members across different cultures offered direct advice to each other regarding influenza vaccination and whether this advice was associated with vaccination decisions. The survey revealed that household members across the world advise one another to vaccinate, although to varying degrees, and that advice correlates with an increase in vaccination uptake. In addition, respondents in Japan, China, and the United States were less likely to offer advice to older adults than to the young, despite older adults' being the target age group for vaccination in both Far Eastern countries. Furthermore, advice was not primarily directed to household members within the age groups advised to vaccinate by national health policies. In Japan, advice was offered more to ages outside of the policy guidelines than inside. Harnessing the influence of household members may offer a novel strategy to improve vaccination coverage across cultures worldwide. © The Author(s) 2015.

  15. Results from the 2001 National Household Survey on Drug Abuse. Volume I: Summary of National Findings [and] Volume II: Technical Appendices and Selected Data Tables [and] Volume III: Detailed Tables.

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Office of Applied Studies.

    This document presents the technical appendices and selected data tables from the 2001 National Household Survey on Drug Abuse. Included are a description of the survey; statistical methods and limitations of the data; effects of changes in survey protocol on trend measurement; key definitions for the 1999-2001 survey years; and other sources of…

  16. [Pattern changes in food and beverages expenditure in Mexican households (1984-2014)].

    PubMed

    Garza-Montoya, Beatriz Gabriela; Ramos-Tovar, María Elena

    2017-01-01

    To analyze the proportion of expenditure and its frequency in food and beverages consumed inside and outside of households, at national and regional level, in Mexico between 1984 and 2014. It analyzes data of household expenditure of food and beverages taken from the National Survey of Mexican Household Income and Expenditures 1984, 1994, 2005 and 2014. It conducted descriptive statistics analyses such as percentages, growth rates and crosstabs. There were changes in food expenditure patterns at national and regional level. The proportion of expenditure and its frequency increased in non-alcoholic beverages, prepared food, meals made outside home and cereals. The proportion of expenditure and its frequency decreased in oils and fats, fruits, vegetables, sugar and honeys. These changes can be related to political, economic, social and cultural transformations experienced in the last decades.

  17. A review of UK space activity and historiography, 1957-2007

    NASA Astrophysics Data System (ADS)

    Millard, Douglas

    2010-04-01

    In over 50 years the United Kingdom has designed, built, launched, operated or otherwise contributed to hundreds of spacecraft and space missions. Its scientists, engineers and officials have carved centres of astronautical excellence around the country, participated in a great number of international space programmes and missions and played a leading role in the establishment of the world's main pan-national space agency (ESA) and its two precursors, the European Launcher Development Organisation (ELDO) and the European Space Research Organization (ESRO). With its Skylark sounding rocket launch of November 1957 the UK was one of the first nations to gather new scientific data as part of the International Geophysical Year. Fifty years on, the UK is an enthusiastic supporter of the Global Exploration Strategy with major commitments to future missions to the moon and to the Mars that exploit the nation's expertise in small satellite and planetary robot technology. And while such mission involvement takes UK space technologies out into the solar system as never before the nation continues to excel in Earth orbit with its development and manufacture of large, increasingly powerful telecommunications satellites. The UK's space heritage and its ongoing and directed activities are rich and productive. And yet—the representation of UK space endeavour is all too often skewed—misleading and unduly pejorative: '…British space…more romance than reality.' Why does such partisan commentary occur and why has such an attitude prevailed for so long? This paper seeks some answers by reviewing UK space activity and its historiography in the wider and global context of astronautics between 1957 and 2007. In Praise of…the British Space Programme, The Guardian Newspaper, March 4th, 2008.

  18. The current cost of angina pectoris to the National Health Service in the UK

    PubMed Central

    Stewart, S; Murphy, N; Walker, A; McGuire, A; McMurray, J J V

    2003-01-01

    Objective: To calculate the cost of angina pectoris to the UK National Health Service (NHS) in the year 2000. Methods: Calculation of the cost of hospital admissions, revascularisation procedures, hospital outpatient consultations, general practice (GP) consultations, and prescribed drug treatment. Results: 634 000 individuals (1.1% of the UK population) consulted GPs 2.35 million times, costing £60.5 million. They required 16.0 million prescriptions (cost £80.7 million) and 254 000 hospital outpatient referrals (cost £30.4 million). There were 149 000 hospital admissions, 117 000 coronary angiograms, 21 400 coronary artery bypass operations, 17 700 percutaneous coronary interventions, and 516 000 outpatient visits, at a cost of £208.4 million, £69.9 million, £106.2 million, £60.7 million, and £52.2 million, respectively. The direct cost of angina was therefore £669 million (1.3% of total NHS expenditure), with hospital bed occupancy and procedures accounting for 32% and 35% of this total, respectively. Conclusions: Angina is a common and costly public health problem. It consumed over 1% of all NHS expenditure in the year 2000, mainly because of hospital bed occupancy and revascularisation procedures. This is likely to be a conservative estimate of its true cost. PMID:12860855

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

    PubMed Central

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

    2018-01-01

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

  20. Universities UK Submission to the 2010 Spending Review

    ERIC Educational Resources Information Center

    Universities UK, 2010

    2010-01-01

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

  1. [Food availability according to food security-insecurity among Mexican households].

    PubMed

    Valencia-Valero, Reyna Guadalupe; Ortiz-Hernández, Luis

    2014-04-01

    To know the differences in food availability according to food insecurity level among the Mexican households. We analyzed the database of the National Survey of Household's Incomes and Expenditures (n=27 445 households). Households were classified according to the Latin American and Caribbean Inventory of Food Security. The availability of each food group was estimated as grams per day per equivalent adult. 50.0% of Mexican households experienced some degree of food insecurity. Among households with food insecurity there was high availability of corn, wheat, egg, and sugars; but there was low availability of fresh fruits and vegetables, lean meat, poultry, seafood, milk, cheeses, and sweetened beverages. Although in households with food insecurity there is lower availability of most food groups (both with high nutrient density and with high energy density); they have higher availability of cheap foods, which in some cases are only source of energy but do not provide nutrients.

  2. Chapter 8 Haemoglobin, ferritin and erythropoietin amongst UK adult dialysis patients in 2010: national and centre-specific analyses.

    PubMed

    Webb, Lynsey; Gilg, Julie; Wilkie, Martin

    2012-01-01

    The UK Renal Association (RA) and National Institute for Health and Clinical Excellence (NICE) have published clinical practice guidelines which include recommendations for management of anaemia in established renal failure. To determine the extent to which the guidelines for anaemia management are met in the UK. Quarterly data were obtained regarding haemoglobin (Hb) and factors that influence Hb from renal centres in England, Wales, Northern Ireland (EWNI) and the Scottish Renal Registry for the incident and prevalent renal replacement therapy (RRT) cohorts for 2010. In the UK, in 2010 53.6% of patients commenced dialysis therapy with Hb ≥ 10.0 g/dl (median Hb 10.1 g/dl). The median Hb of haemodialysis (HD) patients was 11.5 g/dl with an interquartile range (IQR) of 10.5-12.3 g/dl. Of HD patients 84.6% had Hb ≥ 10.0 g/dl. The median Hb of peritoneal dialysis (PD) patients in the UK was 11.6 g/dl (IQR 10.6-12.5 g/dl). Of UK PD patients, 87.2% had Hb ≥ 10.0 g/dl. The median ferritin in HD patients in EWNI was 444 µg/L (IQR 299-635) and 96% of HD patients had a ferritin ≥ 100 µg/L. The median ferritin in PD patients was 264 µg/L (IQR 148-426) with 86% of PD patients having a ferritin ≥ 100 µg/L. In EWNI the mean Erythropoietin Stimulating Agent (ESA) dose was higher for HD than PD patients (9,020 vs. 6,202 IU/week). Of prevalent HD patients, 52.7% had Hb ≥ 10 and ≤ 12 g/dl. Of prevalent PD patients, 54.3% had Hb 10.5-12.5 g/dl. Copyright © 2012 S. Karger AG, Basel.

  3. Frequency and socio-demographic correlates of eating meals out and take-away meals at home: cross-sectional analysis of the UK national diet and nutrition survey, waves 1-4 (2008-12).

    PubMed

    Adams, Jean; Goffe, Louis; Brown, Tamara; Lake, Amelia A; Summerbell, Carolyn; White, Martin; Wrieden, Wendy; Adamson, Ashley J

    2015-04-16

    Food prepared out-of-home tends to be less healthful than food prepared at home, with a positive association between frequency of consumption and both fat intake and body fatness. There is little current data on who eats out-of-home food. We explored frequency and socio-demographic correlates of eating meals out and take-away meals at home, using data from a large, UK, population representative study. Data were from waves 1-4 of the UK National Diet and Nutrition Survey (2008-12). Socio-demographic variables of interest were gender, age group, and socio-economic position. Self-reported frequency of consuming meals out and take-away meals at home was categorised as: less than once per week and once per week or more. Analyses were performed separately for adults (aged 18 years or older) and children. Data from 2001 adults and 1963 children were included. More than one quarter (27.1%) of adults and one fifth (19.0%) of children ate meals out once per week or more. One fifth of adults (21.1%) and children (21.0%) ate take-away meals at home once per week or more. There were no gender differences in consumption of meals out, but more boys than girls ate take-away meals at home at least weekly. The proportion of participants eating both meals out and take-away meals at home at least weekly peaked in young adults aged 19-29 years. Adults living in more affluent households were more likely to eat meals out at least once per week, but children living in less affluent households were more likely to eat take-away meals at home at least once per week. There was no relationship between socio-economic position and consumption of take-away meals at home in adults. One-fifth to one-quarter of individuals eat meals prepared out-of-home weekly. Interventions seeking to improve dietary intake by reducing consumption of out-of-home food may be more effective if tailored to and targeted at adults aged less than 30 years. It may also be important to develop interventions to help

  4. Commercial viability of hybrid vehicles : best household use and cross national considerations.

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

    Santini, D. J.; Vyas, A. D.

    1999-07-16

    Japanese automakers have introduced hybrid passenger cars in Japan and will soon do so in the US. In this paper, we report how we used early computer simulation model results to compare the commercial viability of a hypothetical near-term (next decade) hybrid mid-size passenger car configuration under varying fuel price and driving patterns. The fuel prices and driving patterns evaluated are designed to span likely values for major OECD nations. Two types of models are used. One allows the ''design'' of a hybrid to a specified set of performance requirements and the prediction of fuel economy under a number ofmore » possible driving patterns (called driving cycles). Another provides an estimate of the incremental cost of the hybrid in comparison to a comparably performing conventional vehicle. In this paper, the models are applied to predict the NPV cost of conventional gasoline-fueled vehicles vs. parallel hybrid vehicles. The parallel hybrids are assumed to (1) be produced at high volume, (2) use nickel metal hydride battery packs, and (3) have high-strength steel bodies. The conventional vehicle also is assumed to have a high-strength steel body. The simulated vehicles are held constant in many respects, including 0-60 time, engine type, aerodynamic drag coefficient, tire rolling resistance, and frontal area. The hybrids analyzed use the minimum size battery pack and motor to meet specified 0-60 times. A key characteristic affecting commercial viability is noted and quantified: that hybrids achieve the most pronounced fuel economy increase (best use) in slow, average-speed, stop-and-go driving, but when households consistently drive these vehicles under these conditions, they tend to travel fewer miles than average vehicles. We find that hours driven is a more valuable measure than miles. Estimates are developed concerning hours of use of household vehicles versus driving cycle, and the pattern of minimum NPV incremental cost (or benefit) of selecting the

  5. An Overview of Food Patterns and Diet Quality in Qatar: Findings from the National Household Income Expenditure Survey.

    PubMed

    Al-Thani, Mohammed; Al-Thani, Al-Anoud; Al-Mahdi, Nasser; Al-Kareem, Hefzi; Barakat, Darine; Al-Chetachi, Walaa; Tawfik, Afaf; Akram, Hammad

    2017-05-15

    Availability of accurate data pertaining to a population's dietary patterns and associated health outcomes is critical for proper development and implementation of related policies. This article is a first attempt to share the food patterns, amounts and diet quality among households (HH) in Qatar. Data from the 2012-2013 Qatar National Household Income and Expenditure Survey (HIES) was used. This cross-sectional survey included 3723 HH (1826 Qatari HH and 1897 non-Qatari HH). Dietary data on monthly amounts food items available at HH according to the nationality was used. The food items were expressed in terms of grams per capita per day and aggregated into groups to examine the food patterns, energy, and adequacy. The overall average amount of purchased food at HH in Qatar was 1885 g/capita/day. Qatari HH purchased more food (2118 g/capita/day) versus non-Qataris (1373 g/capita/day); however, the percentages of the amounts purchased by food types were similar among both nationalities. Average daily energy (kcal) per capita was almost double among Qatari HH (4275 kcal) vs. non-Qatari HH (2424 kcal). The food items under subsidy program for Qatari citizens provided 1753 kcal/capita/day and accounted for 41% of total daily energy. Proteins (29.2), fats (39.2), sodium (3.3), and vitamin C (32.5) had higher than recommended levels of nutrient density (grams per 1000 kcal). Calcium (227), vitamin A (302.3), fiber (2.0), and carbohydrates (132.6) had lower than recommended levels of nutrient energy density (g/1000 kcal). The study predicts unhealthy dietary habits among HH in Qatar and provides useful information for policy makers and healthcare community.

  6. 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.

  7. UK national clinical audit: management of pregnancies in women with HIV.

    PubMed

    Raffe, S; Curtis, H; Tookey, P; Peters, H; Freedman, A; Gilleece, Y

    2017-02-20

    The potential for HIV transmission between a pregnant woman and her unborn child was first recognized in 1982. Since then a complex package of measures to reduce risk has been developed. This project aims to review UK management of HIV in pregnancy as part of the British HIV Association (BHIVA) audit programme. The National Study of HIV in Pregnancy and Childhood (NSHPC), a population-based surveillance study, provided data for pregnancies with an expected delivery date from 1/1/13 - 30/6/14. Services also completed a survey on local management policies. Data were audited against the 2012 BHIVA pregnancy guidelines. During the audit period 1483 pregnancies were reported and 112 services completed the survey. Use of dedicated multidisciplinary teams was reported by 99% although 26% included neither a specialist midwife nor nurse. 17% of services reported delays >1 week for HIV specialist review of women diagnosed antenatally. Problematic urgent HIV testing had been experienced by 9% of services although in a further 49% the need for urgent testing had not arisen. Delays of >2 h in obtaining urgent results were common. Antiretroviral therapy (ART) was started during pregnancy in 37% women with >94% regimens in accordance with guidelines. Late ART initiation was common, particularly in those with a low CD4 count or high viral load. Eleven percent of services reported local policy contrary to guidelines regarding delivery mode for women with a VL <50 copies/mL at ≥36 weeks. According to NSHPC reports 27% of women virologically eligible for vaginal delivery planned to deliver by CS. Pregnant women in the UK are managed largely in accordance with BHIVA guidelines. Improvements are needed to ensure timely referral and ART initiation to ensure the best possible outcomes.

  8. Changes needed to medicine in the UK before senior UK-trained doctors, working outside the UK, will return: questionnaire surveys undertaken between 2004 and 2015.

    PubMed

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

    2017-12-01

    To report the changes to UK medicine which doctors who have emigrated tell us would increase their likelihood of returning to a career in UK medicine. Questionnaire survey. UK-trained medical graduates. Questionnaires were sent 11 years after graduation to 7158 doctors who qualified in 1993 and 1996 in the UK: 4763 questionnaires were returned. Questionnaires were sent 17 and 19 years after graduation to the same cohorts: 4554 questionnaires were returned. Comments from doctors working abroad about changes needed to UK medicine before they would return. Eleven years after graduation, 290 (6%) of respondents were working in medicine abroad; 277 (6%) were doing so 17/19 years after graduation. Eleven years after graduation, 53% of doctors working abroad indicated that they did not intend to return, and 71% did so 17/19 years after graduation. These respondents reported a number of changes which would need to be made to UK medicine in order to increase the likelihood of them returning. The most frequently mentioned changes cited concerned 'politics/management/funding', 'pay/pension', 'posts/security/opportunities', 'working conditions/hours', and 'factors outside medicine'. Policy attention to factors including funding, pay, management and particularly the clinical-political interface, working hours, and work-life balance may pay dividends for all, both in terms of persuading some established doctors to return and, perhaps more importantly, encouraging other, younger doctors to believe that the UK and the National Health Service can offer them a satisfying and rewarding career.

  9. Association of Adiposity and Mental Health Functioning across the Lifespan: Findings from Understanding Society (The UK Household Longitudinal Study).

    PubMed

    Davillas, Apostolos; Benzeval, Michaela; Kumari, Meena

    2016-01-01

    Evidence on the adiposity-mental health associations is mixed, with studies finding positive, negative or no associations, and less is known about how these associations may vary by age. To examine the association of adiposity -body mass index (BMI), waist circumference (WC) and percentage body fat (BF%)- with mental health functioning across the adult lifespan. Data from 11,257 participants (aged 18+) of Understanding Society: the UK Household Longitudinal Study (waves 2 and 3, 5/2010-7/2013) were employed. Regressions of mental health functioning, assessed by the Mental Component Summary (MCS-12) and the General Health Questionnaire (GHQ-12), on adiposity measures (continuous or dichotomous indicators) were estimated adjusted for covariates. Polynomial age-adiposity interactions were estimated. Higher adiposity was associated with poorer mental health functioning. This emerged in the 30s, increased up to mid-40s (all central adiposity and obesity-BF% measures) or early 50s (all BMI measures) and then decreased with age. Underlying physical health generally accounted for these associations except for central adiposity, where associations remained statistically significant from the mid-30s to 50s. Cardiovascular, followed by arthritis and endocrine, conditions played the greatest role in attenuating the associations under investigation. We found strong age-specific patterns in the adiposity-mental health functioning association that varied across adiposity measures. Underlying physical health had the dominant role in attenuating these associations. Policy makers and health professionals should target increased adiposity, mainly central adiposity, as it is a risk factor for poor mental health functioning in those aged between mid-30s to 50 years.

  10. Household food insecurity during childhood and adolescent misconduct.

    PubMed

    Jackson, Dylan B; Vaughn, Michael G

    2017-03-01

    A large body of research has found that household food insecurity can interfere with the healthy development of children. The link between household food insecurity during childhood and misbehaviors during adolescence, however, is not commonly explored. The objective of the current study is to assess whether household food insecurity across childhood predicts four different forms of misconduct during early adolescence. Data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (ECLS-K), a nationally representative sample of U.S. children, were employed in the present study. Associations between household food insecurity during childhood and adolescent misconduct were examined using Logistic and Negative Binomial Regression. Analyses were performed separately for males and females. The results revealed that household food insecurity and food insecurity persistence were predictive of most forms of misconduct for males, and were consistently predictive of engagement in multiple forms of misconduct and a greater variety of forms of misconduct for males. For females, however, household food insecurity generally failed to predict adolescent misconduct. The behavioral development of males during adolescence appears to be sensitive to the presence and persistence of household food insecurity during childhood. Future research should seek to replicate and extend the present findings to late adolescence and adulthood. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Innovative Solutions for Clinical Trial Follow-up: Adding Value from Nationally Held UK Data.

    PubMed

    Appleyard, S E; Gilbert, D C

    2017-12-01

    Clinical trials provide the data that underpin evidence-based oncological practice. Over and above their primary outcome measures, collected and analysed by the clinical trials unit, trials provide an opportunity to generate a wide range of additional information over a prolonged period of time. Nationally held data have potential to facilitate longer term follow-up and explore associated toxicities and downstream consequences and in the UK include data from secondary care, including hospital episode statistics, national chemotherapy and radiotherapy datasets and primary care records. Specific to use in oncological practice, the National Cancer Data Repository contains linked data from a variety of sources for patients with a diagnosis of cancer, both cancer and non-cancer related. The challenge of using these data in clinical trials relates to the need to extract identifiable patient data, with the associated ethical and legal issues. The data access processes are time consuming and require evidence of information governance compliance. This overview article reviews the current data available, the current and potential uses both within and outside clinical trials and the challenges encountered in the process of acquiring data. We focus specifically on the use of nationally held data for non-cancer outcomes, including toxicity and associated conditions. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  12. Association between home food preparation skills and behaviour, and consumption of ultra-processed foods: Cross-sectional analysis of the UK National Diet and nutrition survey (2008-2009).

    PubMed

    Lam, Matthew Chak Leung; Adams, Jean

    2017-05-23

    'Ultra-processed foods' (UPF) have been industrially processed and tend to be higher in saturated fat, sodium and sugar than other foods. There is some evidence that consumption of UPF is associated with overweight, obesity and related diseases. In developed countries more than half of dietary energy is attributed to UPF. One reason for reliance on UPF may be poor home food preparation skills or infrequent use of these. This relationship has been previously proposed but not tested. We examined the relationship between home food preparation skills and behaviour and consumption of UPF. We used data from adults in the UK National Diet & Nutrition Survey 2008-09. Home food preparation skills and behaviours of adults (n = 509) were assessed using questions on confidence using eight cooking techniques, confidence cooking 10 foods, ability to prepare a cake or biscuits without help, and whether or not participants prepared a main meal five or more days per week. Individuals' UPF consumption was determined from four-day estimated diet diaries. Associations were adjusted for age, gender, occupational social class and household composition. In fully adjusted models, individuals who were confident with all 10 foods (adjusted beta (95% CI) = -3.76 (-6.02 to -1.50)), able to bake cakes or biscuits without help (-3.87 (-6.62 to -1.12)), and cooked a main meal at least five days a week (-2.84 (-5.43 to -0.24)) consumed a lower percentage of dietary energy from UPF. In UK adults better home food preparation skills and more frequent use of these skills tended to be cross-sectionally associated with lower UPF consumption. Greater encouragement of these skills may help reduce reliance on UPF.

  13. Implementing UK Autism Policy & National Institute for Health and Care Excellence Guidance--Assessing the Impact of Autism Training for Frontline Staff in Community Learning Disabilities Teams

    ERIC Educational Resources Information Center

    Clark, Alex; Browne, Sarah; Boardman, Liz; Hewitt, Lealah; Light, Sophie

    2016-01-01

    UK National Autism Strategy (Department of Health, 2010 and National Institute for Health and Care Excellence guidance (NICE, 2012) states that frontline staff should have a good understanding of Autism. Fifty-six clinical and administrative staff from a multidisciplinary community Learning Disability service completed an electronic questionnaire…

  14. Prevalence of Obesity Among Youths by Household Income and Education Level of Head of Household - United States 2011-2014.

    PubMed

    Ogden, Cynthia L; Carroll, Margaret D; Fakhouri, Tala H; Hales, Craig M; Fryar, Cheryl D; Li, Xianfen; Freedman, David S

    2018-02-16

    Obesity prevalence varies by income and education level, although patterns might differ among adults and youths (1-3). Previous analyses of national data showed that the prevalence of childhood obesity by income and education of household head varied across race/Hispanic origin groups (4). CDC analyzed 2011-2014 data from the National Health and Nutrition Examination Survey (NHANES) to obtain estimates of childhood obesity prevalence by household income (≤130%, >130% to ≤350%, and >350% of the federal poverty level [FPL]) and head of household education level (high school graduate or less, some college, and college graduate). During 2011-2014 the prevalence of obesity among U.S. youths (persons aged 2-19 years) was 17.0%, and was lower in the highest income group (10.9%) than in the other groups (19.9% and 18.9%) and also lower in the highest education group (9.6%) than in the other groups (18.3% and 21.6%). Continued progress is needed to reduce disparities, a goal of Healthy People 2020. The overall Healthy People 2020 target for childhood obesity prevalence is <14.5% (5).

  15. Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012.

    PubMed

    Hennessee, Ian; Chinkhumba, Jobiba; Briggs-Hagen, Melissa; Bauleni, Andy; Shah, Monica P; Chalira, Alfred; Moyo, Dubulao; Dodoli, Wilfred; Luhanga, Misheck; Sande, John; Ali, Doreen; Gutman, Julie; Lindblade, Kim A; Njau, Joseph; Mathanga, Don P

    2017-10-02

    With 71% of Malawians living on < $1.90 a day, high household costs associated with severe malaria are likely a major economic burden for low income families and may constitute an important barrier to care seeking. Nevertheless, few efforts have been made to examine these costs. This paper describes household costs associated with seeking and receiving inpatient care for malaria in health facilities in Malawi. A cross-sectional survey was conducted in a representative nationwide sample of 36 health facilities providing inpatient treatment for malaria from June-August, 2012. Patients admitted at least 12 h before study team visits who had been prescribed an antimalarial after admission were eligible to provide cost information for their malaria episode, including care seeking at previous health facilities. An ingredients-based approach was used to estimate direct costs. Indirect costs were estimated using a human capital approach. Key drivers of total household costs for illness episodes resulting in malaria admission were assessed by fitting a generalized linear model, accounting for clustering at the health facility level. Out of 100 patients who met the eligibility criteria, 80 (80%) provided cost information for their entire illness episode to date and were included: 39% of patients were under 5 years old and 75% had sought care for the malaria episode at other facilities prior to coming to the current facility. Total household costs averaged $17.48 per patient; direct and indirect household costs averaged $7.59 and $9.90, respectively. Facility management type, household distance from the health facility, patient age, high household wealth, and duration of hospital stay were all significant drivers of overall costs. Although malaria treatment is supposed to be free in public health facilities, households in Malawi still incur high direct and indirect costs for malaria illness episodes that result in hospital admission. Finding ways to minimize the economic

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

    PubMed

    Shaw, Catriona; Steenkamp, Retha; Davenport, Andrew

    2013-01-01

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

  17. Coping with child hunger in Canada: have household strategies changed over a decade?

    PubMed

    McIntyre, Lynn; Bartoo, Aaron C; Pow, Jody; Potestio, Melissa L

    2012-11-05

    To determine if household coping strategies for child hunger in Canada have changed over a decade (1996-2007). We applied t-tests to data derived from Cycle 2 (1996-1997; n=8165) and Cycle 7 (2006-2007; n=15,961) of the National Longitudinal Survey of Children and Youth (NLSCY) to determine changes in household coping strategies for child hunger. Data were restricted to households with children aged 2-9 years, allowing for cross-sectional analysis of two independent samples. Logistic regression was employed to estimate the odds of reporting child hunger for socio-demographic characteristics and the odds of using different coping strategies. The national prevalence of child hunger fell from 1.5% in 1997 to 0.7% in 2007 (p<0.001). The determinants of child hunger (increased child age and household size, lack of home ownership, low household income, lone-parent status, family dysfunction) and hunger frequency (regular versus occasional) were similar in both NLSCY cycles. Utilization of food banks and other community resources as a method of coping with child hunger remained static despite an increase in national food banks/affiliated agencies in Canada (2,141 in 1998 to 3,540 in 2007). In contrast, there was an increased reliance on reducing household food variety, an internal coping mechanism, to manage child hunger (17.6% Cycle 2 to 35.1% Cycle 7; p=0.03). Community outreach programs between 1997 and 2007 had little impact on coping strategies utilized by households facing child hunger. Our results indicate that current initiatives fail to reach these families.

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

    PubMed

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

    2018-05-01

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

  19. Correlates of out-of-pocket and catastrophic health expenditures in Tanzania: results from a national household survey

    PubMed Central

    2014-01-01

    Background Inequality in health services access and utilization are influenced by out-of-pocket health expenditures in many low and middle-income countries (LMICs). Various antecedents such as social factors, poor health and economic factors are proposed to direct the choice of health care service use and incurring out-of-pocket payments. We investigated the association of these factors with out-of-pocket health expenditures among the adult and older population in the United Republic of Tanzania. We also investigated the prevalence and associated determinants contributing to household catastrophic health expenditures. Methods We accessed the data of a multistage stratified random sample of 7279 adult participants, aged between 18 and 59 years, as well as 1018 participants aged above 60 years, from the first round of the Tanzania National Panel survey. We employed multiple generalized linear and logistic regression models to evaluate the correlates of out-of-pocket as well as catastrophic health expenditures, accounting for the complex sample design effects. Results Increasing age, female gender, obesity and functional disability increased the adults’ out-of-pocket health expenditures significantly, while functional disability and visits to traditional healers increased the out-of-pocket health expenditures in older participants. Adult participants, who lacked formal education or worked as manual laborers earned significantly less (p < 0.001) and spent less on health (p < 0.001), despite having higher levels of disability. Large household size, household head’s occupation as a manual laborer, household member with chronic illness, domestic violence against women and traditional healer’s visits were significantly associated with high catastrophic health expenditures. Conclusion We observed that the prevalence of inequalities in socioeconomic factors played a significant role in determining the nature of both out-of-pocket and catastrophic health

  20. 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

  1. An exploration of socio-economic and food characteristics of high trans fatty acid consumers in the Dutch and UK national surveys after voluntary product reformulation.

    PubMed

    Rippin, H L; Hutchinson, J; Ocke, M; Jewell, J; Breda, J J; Cade, J E

    2017-01-01

    Trans fatty acids (TFA) increase the risk of mortality and chronic diseases. TFA intakes have fallen since reformulation, but may still be high in certain, vulnerable, groups. This paper investigates socio-economic and food consumption characteristics of high TFA consumers after voluntary reformulation in the Netherlands and UK. Post-reformulation data of adults aged 19-64 was analysed in two national surveys: the Dutch National Food Consumption Survey (DNFCS) collected 2007-2010 using 2*24hr recalls (N = 1933) and the UK National Diet and Nutrition Survey (NDNS) years 3&4 collected 2010/11 and 2011/12 using 4-day food diaries (N = 848). The socio-economic and food consumption characteristics of the top 10% and remaining 90% TFA consumers were compared. Means of continuous data were compared using t-tests and categorical data means using chi-squared tests. Multivariate logistic regression models indicated which socio-demographic variables were associated with high TFA consumption. In the Dutch analyses, women and those born outside the Netherlands were more likely to be top 10% TFA consumers than men and Dutch-born. In the UK unadjusted analyses there was no significant trend in socio-economic characteristics between high and lower TFA consumers, but there were regional differences in the multivariate logistic regression analyses. In the Netherlands, high TFA consumers were more likely to be consumers of cakes, buns & pastries; cream; and fried potato than the remaining 90%. Whereas in the UK, high TFA consumers were more likely to be consumers of lamb; cheese; and dairy desserts and lower crisps and savoury snack consumers. Some socio-demographic differences between high and lower TFA consumers were evident post-reformulation. High TFA consumers in the Dutch 2007-10 survey appeared more likely to obtain TFA from artificial sources than those in the UK survey. Further analyses using more up-to-date food composition databases may be needed.

  2. Changes needed to medicine in the UK before senior UK-trained doctors, working outside the UK, will return: questionnaire surveys undertaken between 2004 and 2015

    PubMed Central

    Lambert, Trevor W; Goldacre, Michael J

    2017-01-01

    Objective To report the changes to UK medicine which doctors who have emigrated tell us would increase their likelihood of returning to a career in UK medicine. Design Questionnaire survey. Setting UK-trained medical graduates. Participants Questionnaires were sent 11 years after graduation to 7158 doctors who qualified in 1993 and 1996 in the UK: 4763 questionnaires were returned. Questionnaires were sent 17 and 19 years after graduation to the same cohorts: 4554 questionnaires were returned. Main outcome measures Comments from doctors working abroad about changes needed to UK medicine before they would return. Results Eleven years after graduation, 290 (6%) of respondents were working in medicine abroad; 277 (6%) were doing so 17/19 years after graduation. Eleven years after graduation, 53% of doctors working abroad indicated that they did not intend to return, and 71% did so 17/19 years after graduation. These respondents reported a number of changes which would need to be made to UK medicine in order to increase the likelihood of them returning. The most frequently mentioned changes cited concerned ‘politics/management/funding’, ‘pay/pension’, ‘posts/security/opportunities’, ‘working conditions/hours’, and ‘factors outside medicine’. Conclusions Policy attention to factors including funding, pay, management and particularly the clinical–political interface, working hours, and work–life balance may pay dividends for all, both in terms of persuading some established doctors to return and, perhaps more importantly, encouraging other, younger doctors to believe that the UK and the National Health Service can offer them a satisfying and rewarding career. PMID:29230305

  3. Measuring the Population Burden of Injuries—Implications for Global and National Estimates: A Multi-centre Prospective UK Longitudinal Study

    PubMed Central

    Lyons, Ronan A.; Kendrick, Denise; Towner, Elizabeth M.; Christie, Nicola; Macey, Steven; Coupland, Carol; Gabbe, Belinda J.

    2011-01-01

    Background Current methods of measuring the population burden of injuries rely on many assumptions and limited data available to the global burden of diseases (GBD) studies. The aim of this study was to compare the population burden of injuries using different approaches from the UK Burden of Injury (UKBOI) and GBD studies. Methods and Findings The UKBOI was a prospective cohort of 1,517 injured individuals that collected patient-reported outcomes. Extrapolated outcome data were combined with multiple sources of morbidity and mortality data to derive population metrics of the burden of injury in the UK. Participants were injured patients recruited from hospitals in four UK cities and towns: Swansea, Nottingham, Bristol, and Guildford, between September 2005 and April 2007. Patient-reported changes in quality of life using the EQ-5D at baseline, 1, 4, and 12 months after injury provided disability weights used to calculate the years lived with disability (YLDs) component of disability adjusted life years (DALYs). DALYs were calculated for the UK and extrapolated to global estimates using both UKBOI and GBD disability weights. Estimated numbers (and rates per 100,000) for UK population extrapolations were 750,999 (1,240) for hospital admissions, 7,982,947 (13,339) for emergency department (ED) attendances, and 22,185 (36.8) for injury-related deaths in 2005. Nonadmitted ED-treated injuries accounted for 67% of YLDs. Estimates for UK DALYs amounted to 1,771,486 (82% due to YLDs), compared with 669,822 (52% due to YLDs) using the GBD approach. Extrapolating patient-derived disability weights to GBD estimates would increase injury-related DALYs 2.6-fold. Conclusions The use of disability weights derived from patient experiences combined with additional morbidity data on ED-treated patients and inpatients suggests that the absolute burden of injury is higher than previously estimated. These findings have substantial implications for improving measurement of the national

  4. Household Disorder, Network Ties, and Social Support in Later Life

    PubMed Central

    Cornwell, Erin York

    2016-01-01

    Family relationships, social interactions, and exchanges of support often revolve around the household context, but scholars rarely consider the social relevance of this physical space. In this article the author considers social causes and consequences of household disorder in the dwellings of older adults. Drawing from research on neighborhood disorder and social connectedness in later life, she describes how network characteristics may contribute to household disorder and how household disorder may weaken relationships and reduce access to support. This is explored empirically by estimating cross-lagged panel models with data from 2 waves of the National Social Life, Health, and Aging Project. The results reveal that household disorder reflects a lack of social support, and it leads to more kin-centered networks and more strain within family relationships. The author concludes by urging greater attention to how the household context shapes—and is shaped by—the social interactions and processes that occur within it. PMID:27524834

  5. Chronic kidney disease and diabetes in the national health service: a cross-sectional survey of the U.K. national diabetes audit.

    PubMed

    Hill, C J; Cardwell, C R; Patterson, C C; Maxwell, A P; Magee, G M; Young, R J; Matthews, B; O'Donoghue, D J; Fogarty, D G

    2014-04-01

    We investigated the prevalence of chronic kidney disease and attainment of therapeutic targets for HbA1c and blood pressure in a large U.K.-based diabetes population. The U.K. National Diabetes Audit provided data from 1 January 2007 to 31 March 2008. Inclusion criteria were a documented urinary albumin:creatinine ratio and serum creatinine. Patients were stratified according to chronic kidney disease stage and albuminuria status. Chronic kidney disease was defined as an estimated glomerular filtration rate < 60 ml min(-1) 1.73 m(-2) , albuminuria or both. The proportions of patients achieving nationally defined glycaemic and systolic blood pressure targets were determined. The cohort comprised 1,423,669 patients, of whom 868,616 (61%) met inclusion criteria. Of the patients analysed, 92.2% had Type 2 diabetes. A higher proportion of people with Type 2 diabetes (42.3%) had renal dysfunction compared with those with Type 1 diabetes (32.4%). Achievement of systolic blood pressure and HbA1c targets was poor. Among people with Type 1 diabetes, 67.8% failed to achieve an HbA1c < 58 mmol/mol (7.5%). Of all people with diabetes, 37.8% failed to achieve a systolic blood pressure < 140 mmHg. Blood pressure control was poor in advanced chronic kidney disease. For example, mean (standard deviation) systolic blood pressure rose from 128.6 (15.4) mmHg among people with Type 1 diabetes and normal renal function to 141.0 (23.6) mmHg in those with chronic kidney disease stage 5 and macroalbuminuria. The high prevalence of chronic kidney disease and poor attainment of treatment targets highlights a large subset of the diabetes population at increased risk of cardiovascular mortality or progressive kidney disease. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

  6. Promoting the UK Doctorate: Opportunities and Challenges. Research Report

    ERIC Educational Resources Information Center

    Emery, Faye; Metcalfe, Janet

    2009-01-01

    The last decade has seen increased interest in various aspects of the UK doctorate. This report brings together issues arising from national policy developments, the doctoral researcher cohort, the diversification of doctoral level provision in the UK and the development of the third cycle in the Bologna process. Through discussions with key…

  7. Nonresponse and Underreporting Errors Increase over the Data Collection Week Based on Paradata from the National Household Food Acquisition and Purchase Survey.

    PubMed

    Hu, Mengyao; Gremel, Garrett W; Kirlin, John A; West, Brady T

    2017-05-01

    Background: Food acquisition diary surveys are important for studying food expenditures, factors affecting food acquisition decisions, and relations between these decisions with selected measures of health (e.g., body mass index, self-reported health). However, to our knowledge, no studies have evaluated the errors associated with these diary surveys, which can bias survey estimates and research findings. The use of paradata, which has been largely ignored in previous literature on diary surveys, could be useful for studying errors in these surveys. Objective: We used paradata to assess survey errors in the National Household Food Acquisition and Purchase Survey (FoodAPS). Methods: To evaluate the patterns of nonresponse over the diary period, we fit a multinomial logistic regression model to data from this 1-wk diary survey. We also assessed factors influencing respondents' probability of reporting food acquisition events during the diary process by using logistic regression models. Finally, with the use of an ordinal regression model, we studied factors influencing respondents' perceived ease of participation in the survey. Results: As the diary period progressed, nonresponse increased, especially for those starting the survey on Friday (where the odds of a refusal increased by 12% with each fielding day). The odds of reporting food acquisition events also decreased by 6% with each additional fielding day. Similarly, the odds of reporting ≥1 food-away-from-home event (i.e., meals, snacks, and drinks obtained outside the home) decreased significantly over the fielding period. Male respondents, larger households, households that eat together less often, and households with frequent guests reported a significantly more difficult time getting household members to participate, as did non-English-speaking households and households currently experiencing difficult financial conditions. Conclusions: Nonresponse and underreporting of food acquisition events tended to

  8. Do nurses wish to continue working for the UK National Health Service? A comparative study of three generations of nurses.

    PubMed

    Robson, Andrew; Robson, Fiona

    2015-01-01

    To identify the combination of variables that explain nurses' continuation intention in the UK National Health Service. This alternative arena has permitted the replication of a private sector Australian study. This study provides understanding about the issues that affect nurse retention in a sector where employee attrition is a key challenge, further exacerbated by an ageing workforce. A quantitative study based on a self-completion survey questionnaire completed in 2010. Nurses employed in two UK National Health Service Foundation Trusts were surveyed and assessed using seven work-related constructs and various demographics including age generation. Through correlation, multiple regression and stepwise regression analysis, the potential combined effect of various explanatory variables on continuation intention was assessed, across the entire nursing cohort and in three age-generation groups. Three variables act in combination to explain continuation intention: work-family conflict, work attachment and importance of work to the individual. This combination of significant explanatory variables was consistent across the three generations of nursing employee. Work attachment was identified as the strongest marginal predictor of continuation intention. Work orientation has a greater impact on continuation intention compared with employer-directed interventions such as leader-member exchange, teamwork and autonomy. UK nurses are homogeneous across the three age-generations regarding explanation of continuation intention, with the significant explanatory measures being recognizably narrower in their focus and more greatly concentrated on the individual. This suggests that differentiated approaches to retention should perhaps not be pursued in this sectoral context. © 2014 John Wiley & Sons Ltd.

  9. An Overview of Food Patterns and Diet Quality in Qatar: Findings from the National Household Income Expenditure Survey

    PubMed Central

    Al-Thani, Mohammed; Al-Thani, Al-Anoud; Al-Mahdi, Nasser; Al-Kareem, Hefzi; Barakat, Darine; Al-Chetachi, Walaa; Tawfik, Afaf

    2017-01-01

    Introduction Availability of accurate data pertaining to a population’s dietary patterns and associated health outcomes is critical for proper development and implementation of related policies. This article is a first attempt to share the food patterns, amounts and diet quality among households (HH) in Qatar. Methods Data from the 2012-2013 Qatar National Household Income and Expenditure Survey (HIES) was used. This cross-sectional survey included 3723 HH (1826 Qatari HH and 1897 non-Qatari HH). Dietary data on monthly amounts food items available at HH according to the nationality was used. The food items were expressed in terms of grams per capita per day and aggregated into groups to examine the food patterns, energy, and adequacy. Results The overall average amount of purchased food at HH in Qatar was 1885 g/capita/day. Qatari HH purchased more food (2118 g/capita/day) versus non-Qataris (1373 g/capita/day); however, the percentages of the amounts purchased by food types were similar among both nationalities. Average daily energy (kcal) per capita was almost double among Qatari HH (4275 kcal) vs. non-Qatari HH (2424 kcal). The food items under subsidy program for Qatari citizens provided 1753 kcal/capita/day and accounted for 41% of total daily energy. Proteins (29.2), fats (39.2), sodium (3.3), and vitamin C (32.5) had higher than recommended levels of nutrient density (grams per 1000 kcal). Calcium (227), vitamin A (302.3), fiber (2.0), and carbohydrates (132.6) had lower than recommended levels of nutrient energy density (g/1000 kcal). Conclusions The study predicts unhealthy dietary habits among HH in Qatar and provides useful information for policy makers and healthcare community. PMID:28630807

  10. Household Food Insecurity Is Associated with Adverse Mental Health Indicators and Lower Quality of Life among Koreans: Results from the Korea National Health and Nutrition Examination Survey 2012-2013.

    PubMed

    Chung, Hye-Kyung; Kim, Oh Yoen; Kwak, So Young; Cho, Yoonsu; Lee, Kyong Won; Shin, Min-Jeong

    2016-12-16

    Food insecurity is an ongoing public health issue and contributes to mental health status. We investigated whether food insecurity is associated with inadequate nutrient intake and whether it affects mental health indicators (perceived stress/experience of depressive symptom/suicidal ideation) and quality of life (QOL) among Koreans ( n = 5862, 20-64 years) using data from the Korea National Health and Nutritional Examination Survey (2012-2013). Household food security status was categorized as "food-secure household", "food-insecure household without hunger", and "food-insecure household with hunger". Data on food insecurity, sociodemographic factors, nutrient intake, mental health indicators, and QOL were used. A logistic regression model was conducted to determine odds ratios (ORs) for psychological health. A greater proportion of food-insecure participants were nutritionally deficient compared with expectations of the 2015 Korean Dietary Reference Intakes. These deficiencies were generally higher in both "food-insecure household" groups. Both "food-insecure household" groups, particularly the "food-insecure household with hunger" group showed significantly adverse mental health status (ORs: 1.52-3.83) and lower QOL (ORs: 1.49-3.92) than did the "food-secure household" group before and after adjusting for sex, age, education, household income, smoking/alcohol consumption, physical activity, marital status, and receiving food assistance. In conclusion, food insecurity may be significantly associated with adverse mental health indicators and decreased QOL in young/middle-aged Koreans.

  11. 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.

  12. The household-level economic burden of heart disease in India.

    PubMed

    Karan, Anup; Engelgau, Michael; Mahal, Ajay

    2014-05-01

    To estimate healthcare use and financial burden associated with heart disease among Indian households. Data from the 2004 round household survey of the National Sample Survey in India were used to assess the implications of heart disease for out-of-pocket health spending, spending on items other than health care, employment and healthcare financing patterns, by matching households with a member self-reporting heart disease (cardiovascular disease (CVD)-affected households) to (control) households with similar socio-economic and demographic characteristics. Propensity score matching methods were used. Compared with control households, CVD-affected households had more outpatient visits and inpatient stays, spent an extra INT$ (International Dollars) 232 (P < 0.01) per member on inpatient care annually, had lower non-medical spending (by INT$5 (P < 0.01) per member for a 15-day reference period), had a share of out-of-pocket health spending in total household expenditure that was 16.5% higher (P < 0.01) and relied more on borrowing and asset sales to finance inpatient care (32.7% vs. 12.8%, P < 0.01). Members of CVD-affected households had lower employment rates than members of control households (43.6% vs. 46.4%, P < 0.01), and elderly members experienced larger declines in employment than younger adults. CVD-affected households with lower socio-economic status were at heightened financial risk. Non-communicable conditions such as CVD can impose a serious economic burden on Indian households. © 2014 John Wiley & Sons Ltd.

  13. The health benefits of a targeted cash transfer: The UK Winter Fuel Payment.

    PubMed

    Crossley, Thomas F; Zilio, Federico

    2018-05-09

    Each year, the UK records 25,000 or more excess winter deaths, primarily among the elderly. A key policy response is the "Winter Fuel Payment" (WFP), a labelled but unconditional cash transfer to households with a member above the female state pension age. The WFP has been shown to raise fuel spending among eligible households. We examine the causal effect of the WFP on health outcomes, including self-reports of chest infection, measured hypertension, and biomarkers of infection and inflammation. We find a robust, 6 percentage point reduction in the incidence of high levels of serum fibrinogen. Reductions in other disease markers point to health benefits, but the estimated effects are less robust. © 2018 The Authors. Health Economics published by John Wiley & Sons Ltd.

  14. 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.

  15. An equity analysis of utilization of health services in Afghanistan using a national household survey.

    PubMed

    Kim, Christine; Saeed, Khwaja Mir Ahad; Salehi, Ahmad Shah; Zeng, Wu

    2016-12-05

    Afghanistan has made great strides in the coverage of health services across the country but coverage of key indicators remains low nationally and whether the poorest households are accessing these services is not well understood. We analyzed the Afghanistan Mortality Survey 2010 on utilization of inpatient and outpatient care, institutional delivery and antenatal care by wealth quintiles. Concentration indexes (CIs) were generated to measure the inequality of using the four services. Additional analyses were conducted to examine factors that explain the health inequalities (e.g. age, gender, education and residence). Among households reporting utilization of health services, public health facilities were used more often for inpatient care, while they were used less for outpatient care. Overall, the utilization of inpatient and outpatient care, and antenatal care was equally distributed among income groups, with CIs of 0.04, 0.03 and 0.08, respectively. However, the poor used more public facilities while the wealthy used more private facilities. There was a substantial inequality in the use of institutional delivery services, with a CI of 0.31. Poorer women had a lower rate of institutional deliveries overall, in both public and private facilities, compared to the wealthy. Location was an important factor in explaining the inequality in the use of health services. The large gap between the rich and poor in access to and utilization of key maternal services, such as institutional delivery, may be a central factor to the high rates of maternal mortality and morbidity and impedes efforts to make progress toward universal health coverage. While poorer households use public health services more often, the use of public facilities for outpatient visits remains half that of private facilities. Pro-poor targeting as well as a better understanding of the private sector's role in increasing equitable coverage of maternal health services is needed. Equity-oriented approaches

  16. Association of Adiposity and Mental Health Functioning across the Lifespan: Findings from Understanding Society (The UK Household Longitudinal Study)

    PubMed Central

    2016-01-01

    Background Evidence on the adiposity-mental health associations is mixed, with studies finding positive, negative or no associations, and less is known about how these associations may vary by age. Objective To examine the association of adiposity -body mass index (BMI), waist circumference (WC) and percentage body fat (BF%)- with mental health functioning across the adult lifespan. Methods Data from 11,257 participants (aged 18+) of Understanding Society: the UK Household Longitudinal Study (waves 2 and 3, 5/2010-7/2013) were employed. Regressions of mental health functioning, assessed by the Mental Component Summary (MCS-12) and the General Health Questionnaire (GHQ-12), on adiposity measures (continuous or dichotomous indicators) were estimated adjusted for covariates. Polynomial age-adiposity interactions were estimated. Results Higher adiposity was associated with poorer mental health functioning. This emerged in the 30s, increased up to mid-40s (all central adiposity and obesity-BF% measures) or early 50s (all BMI measures) and then decreased with age. Underlying physical health generally accounted for these associations except for central adiposity, where associations remained statistically significant from the mid-30s to50s. Cardiovascular, followed by arthritis and endocrine, conditions played the greatest role in attenuating the associations under investigation. Conclusions We found strong age-specific patterns in the adiposity-mental health functioning association that varied across adiposity measures. Underlying physical health had the dominant role in attenuating these associations. Policy makers and health professionals should target increased adiposity, mainly central adiposity, as it is a risk factor for poor mental health functioning in those aged between mid-30s to 50 years. PMID:26849046

  17. Restart: The Resurgence of Computer Science in UK Schools

    ERIC Educational Resources Information Center

    Brown, Neil C. C.; Sentance, Sue; Crick, Tom; Humphreys, Simon

    2014-01-01

    Computer science in UK schools is undergoing a remarkable transformation. While the changes are not consistent across each of the four devolved nations of the UK (England, Scotland, Wales and Northern Ireland), there are developments in each that are moving the subject to become mandatory for all pupils from age 5 onwards. In this article, we…

  18. Do generics offer significant savings to the UK National Health Service?

    PubMed

    Kanavos, Panos

    2007-01-01

    The UK has traditionally had strong proxy demand-side measures favouring generic drug use, including prescribing guidance, financial incentives and encouraging generic prescribing. At distribution level, pharmacies are paid a salary for their dispensing work, based on volume dispensed, and procure generic products on the basis of discounts given to them by manufacturers or wholesalers. The supply-side has been subject to price regulation, and the recent requirement for manufacturers/wholesalers to report prices net of discounts to the DoH, indicate that reimbursed prices for generics may be higher than commodity level. To investigate the level of discounts off the Drug Tariff Price made available to pharmacies and, determine whether the NHS could have a better deal than currently from generic drug purchasing. Data on net prices were acquired for different presentations of 12 generic molecules selected across different therapeutic categories and included in the 50 most selling generic prescription only products in the UK in the first quarter of 2005. For these products, 31 out of a possible 34 presentations (90%) were surveyed. The data sources were price lists of three leading full-line wholesalers (one national, two regional), out of a possible 11 full-line wholesalers (27.2%), and three leading generic drug manufacturers, out of a possible 15 manufacturers (20%). Generic prescribing in the selected molecules was 94.6%, above the national average of 80%, and the total net ingredient cost (NIC) was 675 million pounds, of which 607.5 million pounds (90%) was generic. In 20 of the product presentations reviewed (64.5%), maximum discounts exceeded 60%, whereas in seven (22.6%) maximum discounts ranged between 50 and 60% off the Drug Tariff Price. Reimbursed prices for leading generic molecules are significantly higher than their pharmacy acquisition cost. The NHS is reimbursing generics at too high prices and a significant proportion of the reimbursed price accrues to

  19. 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

  20. A national survey of the effects of fatigue on trainees in anaesthesia in the UK.

    PubMed

    McClelland, L; Holland, J; Lomas, J-P; Redfern, N; Plunkett, E

    2017-09-01

    Long daytime and overnight shifts remain a major feature of working life for trainees in anaesthesia. Over the past 10 years, there has been an increase in awareness and understanding of the potential effects of fatigue on both the doctor and the patient. The Working Time Regulations (1998) implemented the European Working Time Directive into UK law, and in August 2009 it was applied to junior doctors, reducing the maximum hours worked from an average of 56 per week to 48. Despite this, there is evidence that problems with inadequate rest and fatigue persist. There is no official guidance regarding provision of a minimum standard of rest facilities for doctors in the National Health Service, and the way in which rest is achieved by trainee anaesthetists during their on-call shift depends on rota staffing and workload. We conducted a national survey to assess the incidence and effects of fatigue among the 3772 anaesthetists in training within the UK. We achieved a response rate of 59% (2231/3772 responses), with data from 100% of NHS trusts. Fatigue remains prevalent among junior anaesthetists, with reports that it has effects on physical health (73.6% [95%CI 71.8-75.5]), psychological wellbeing (71.2% [69.2-73.1]) and personal relationships (67.9% [65.9-70.0]). The most problematic factor remains night shift work, with many respondents commenting on the absence of breaks, inadequate rest facilities and 57.0% (55.0-59.1) stating they had experienced an accident or near-miss when travelling home from night shifts. We discuss potential explanations for the results, and present a plan to address the issues raised by this survey, aiming to change the culture around fatigue for the better. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

  1. Household Structure and Children's Educational Attainment: A Perspective on Coresidence with Grandparents

    ERIC Educational Resources Information Center

    Monserud, Maria A.; Elder, Glen H., Jr.

    2011-01-01

    Children from alternative households complete fewer years of schooling. Yet little is known about the implications of coresidence with grandparents for educational attainment. Using data from the National Longitudinal Study of Adolescent Health (N = 10,083), this study found that extended households with two biological parents were not detrimental…

  2. Staple Food Self-Sufficiency of Farmers Household Level in The Great Solo

    NASA Astrophysics Data System (ADS)

    Darsono

    2017-04-01

    Analysis of food security level of household is a novelty of measurement standards which usually includes regional and national levels. With household approach is expected to provide the basis of sharp food policy formulation. The purpose of this study are to identify the condition of self-sufficiency in staple foods, and to find the main factors affecting the dynamics of self-sufficiency in staple foods on farm household level in Great Solo. Using primary data from 50 farmers in the sample and secondary data in Great Solo (Surakarta city, Boyolali, Sukoharjo, Karanganyar, Wonogiri, Sragen and Klaten). Compiled panel data were analyzed with linear probability regression models to produce a good model. The results showed that farm households in Great Solo has a surplus of staple food (rice) with an average consumption rate of 96.8 kg/capita/year. This number is lower than the national rate of 136.7 kg/capita/year. The main factors affecting the level of food self-sufficiency in the farmer household level are: rice production, rice consumption, land tenure, and number of family members. Key recommendations from this study are; improvement scale of the land cultivation for rice farming and non-rice diversification consumption.

  3. The GP Patient Survey for use in primary care in the National Health Service in the UK--development and psychometric characteristics.

    PubMed

    Campbell, John; Smith, Patten; Nissen, Sonja; Bower, Peter; Elliott, Marc; Roland, Martin

    2009-08-22

    The UK National GP Patient Survey is one of the largest ever survey programmes of patients registered to receive primary health care, inviting five million respondents to report their experience of NHS primary healthcare. The third such annual survey (2008/9) involved the development of a new survey instrument. We describe the process of that development, and the findings of an extensive pilot survey in UK primary healthcare. The survey was developed following recognised guidelines and involved expert and stakeholder advice, cognitive testing of early versions of the survey instrument, and piloting of the questionnaire in a cross sectional pilot survey of 1,500 randomly selected individuals from the UK electoral register with two reminders to non-respondents. The questionnaire comprises 66 items addressing a range of aspects of UK primary healthcare. A response rate of 590/1500 (39.3%) was obtained. Non response to individual items ranged from 0.8% to 15.3% (median 5.2%). Participants did not always follow internal branching instructions in the questionnaire although electronic controls allow for correction of this problem in analysis. There was marked skew in the distribution of responses to a number of items indicating an overall favourable impression of care. Principal components analysis of 23 items offering evaluation of various aspects of primary care identified three components (relating to doctor or nurse care, or addressing access to care) accounting for 68.3% of the variance in the sample. The GP Patient Survey has been carefully developed and pilot-tested. Survey findings, aggregated at practice level, will be used to inform the distribution of pound sterling 65 million ($107 million) of UK NHS resource in 2008/9 and this offers the opportunity for NHS service planners and providers to take account of users' experiences of health care in planning and delivering primary healthcare in the UK.

  4. 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.

  5. Twenty-first-century medical microbiology services in the UK.

    PubMed

    Duerden, Brian

    2005-12-01

    With infection once again a high priority for the UK National Health Service (NHS), the medical microbiology and infection-control services require increased technology resources and more multidisciplinary staff. Clinical care and health protection need a coordinated network of microbiology services working to consistent standards, provided locally by NHS Trusts and supported by the regional expertise and national reference laboratories of the new Health Protection Agency. Here, I outline my thoughts on the need for these new resources and the ways in which clinical microbiology services in the UK can best meet the demands of the twenty-first century.

  6. The medline UK filter: development and validation of a geographic search filter to retrieve research about the UK from OVID medline.

    PubMed

    Ayiku, Lynda; Levay, Paul; Hudson, Tom; Craven, Jenny; Barrett, Elizabeth; Finnegan, Amy; Adams, Rachel

    2017-07-13

    A validated geographic search filter for the retrieval of research about the United Kingdom (UK) from bibliographic databases had not previously been published. To develop and validate a geographic search filter to retrieve research about the UK from OVID medline with high recall and precision. Three gold standard sets of references were generated using the relative recall method. The sets contained references to studies about the UK which had informed National Institute for Health and Care Excellence (NICE) guidance. The first and second sets were used to develop and refine the medline UK filter. The third set was used to validate the filter. Recall, precision and number-needed-to-read (NNR) were calculated using a case study. The validated medline UK filter demonstrated 87.6% relative recall against the third gold standard set. In the case study, the medline UK filter demonstrated 100% recall, 11.4% precision and a NNR of nine. A validated geographic search filter to retrieve research about the UK with high recall and precision has been developed. The medline UK filter can be applied to systematic literature searches in OVID medline for topics with a UK focus. © 2017 Crown copyright. Health Information and Libraries Journal © 2017 Health Libraries GroupThis article is published with the permission of the Controller of HMSO and the Queen's Printer for Scotland.

  7. Synthetic biology in the UK - An outline of plans and progress.

    PubMed

    Clarke, L J; Kitney, R I

    2016-12-01

    Synthetic biology is capable of delivering new solutions to key challenges spanning the bioeconomy, both nationally and internationally. Recognising this significant potential and the associated need to facilitate its translation and commercialisation the UK government commissioned the production of a national Synthetic Biology Roadmap in 2011, and subsequently provided crucial support to assist its implementation. Critical infrastructural investments have been made, and important strides made towards the development of an effectively connected community of practitioners and interest groups. A number of Synthetic Biology Research Centres, DNA Synthesis Foundries, a Centre for Doctoral Training, and an Innovation Knowledge Centre have been established, creating a nationally distributed and integrated network of complementary facilities and expertise. The UK Synthetic Biology Leadership Council published a UK Synthetic Biology Strategic Plan in 2016, increasing focus on the processes of translation and commercialisation. Over 50 start-ups, SMEs and larger companies are actively engaged in synthetic biology in the UK, and inward investments are starting to flow. Together these initiatives provide an important foundation for stimulating innovation, actively contributing to international research and development partnerships, and helping deliver useful benefits from synthetic biology in response to local and global needs and challenges.

  8. [Intra-household distribution of energy and macronutrients in Colombian households].

    PubMed

    Ardila, Víctor A; Prada, Gloria E; Herrán, Oscar F

    2013-01-01

    Knowing the intra-household distribution of dietary intake is useful to establish food policy. To estimate the intra-household distribution of energy and macronutrients by kinship in Colombian households. We applied two recalls of dietary intake for the last 24 hours (R24H) in 1,505 subjects living in 432 households. Usual intake was calculated for each subject, aggregated for each household and calculated the share (%) for each of its members. Participation data was adjusted in linear models for age, gender, body mass index, energy requirement, socioeconomic levels, education and household size. The head of the household participates on average in 27.4% (95% CI: 26.5 to 28.2) of the total energy, without sex differences or if they contribute to the household income or not. The participation of unrelated subjects was 30.3% (95% CI: 25.3 to 35.3), and 26.0% (95% CI: 22.7 to 29.3) of the siblings of the head of the household, which is equivalent to that of the head of the household. By adjusting participation, the grandson becomes important with 29.8% (95% CI: 27.4 to 30.9). Men participate more than women (p<0.05). Even in smaller households, participation is lower if the economic level is low and they are receiving food aids (p<0.05). In the context of the structures of power and authority, the need for a cultural intervention with nutritional purposes to modify the principles of contribution, necessity, equity and demand emerges. Inequality is evident in the distribution.

  9. [Using of household budget survey data for public health monitoring of dietary habits in Croatia--DAFNE initiative].

    PubMed

    Antonić-Degac, Katica; Kamenski, Marija; Katić, Dubravka; Butigan, Mila; Laido, Zrinka; Kaić-Rak, Antoinette; Pucarin-Cvetković, Jasna; Trichopoulou, Antonia; Naska, Adroniki; Bountziouka, Vasiliki

    2010-03-01

    The aim of the study was to determine mean food availability based on the data of national Household Budget Surveys (HBS) provided for the years 1999 and 2004, and also to identify the trends in dietary patterns of the Croatian population according to the Data Food Networking (DAFNE) procedure. The Croatian National Statistics Bureau conducted the first HBS survey in 1999 on the sample of 2937 households and the second in 2004 on 2847 households, respectively. Those two raw data sets together with the data on relevant socio-demographic characteristics: household locality, number of household members, education and occupation of the household head were sent to the DAFNE coordinating centre in Athens. A post-harmonisation of the raw data was performed according to DAFNE procedure. Further, data were statistically analysed and integrated into the DAFNE databank (DafneSoft). Average daily food availability per person/day for both surveyed years seems to be satisfying. However, a dietary pattern showed discrepancies between proposed dietary guidelines and consumption of some food items. In comparison with proposed daily intake of 400 grams or more of fruits and vegetables, an average availability is lower and accounts 343 grams in 1999 and 314 grams in 2004. Availability of fish and seafood is low (23-27 g) but in the same time daily availability of meat and meat products is high (181-186 g), especially regarding red meat. During the five year period a decreasing trend is evident for availability of most food items, including lipids and sugar products. The availability has increased only for nuts, fruit and vegetable juices. The differences in availability of certain food groups are evident amongst some socio-economic categories of households. In urban households the availability of milk products, fish, vegetables, fruit and fruit juices is higher than in rural households, as it is in households with higher educated in comparison to low educated household heads. The

  10. The economic effects of supporting tuberculosis-affected households in Peru

    PubMed Central

    Tovar, Marco A.; Huff, Doug; Boccia, Delia; Montoya, Rosario; Ramos, Eric; Lewis, James J.; Gilman, Robert H.; Evans, Carlton A.

    2016-01-01

    The End TB Strategy mandates that no tuberculosis (TB)-affected households face catastrophic costs due to TB. However, evidence is limited to evaluate socioeconomic support to achieve this change in policy and practice. The objective of the present study was to investigate the economic effects of a TB-specific socioeconomic intervention. The setting was 32 shantytown communities in Peru. The participants were from households of consecutive TB patients throughout TB treatment administered by the national TB programme. The intervention consisted of social support through household visits and community meetings, and economic support through cash transfers conditional upon TB screening in household contacts, adhering to TB treatment/chemoprophylaxis and engaging with social support. Data were collected to assess TB-affected household costs. Patient interviews were conducted at treatment initiation and then monthly for 6 months. From February 2014 to June 2015, 312 households were recruited, of which 135 were randomised to receive the intervention. Cash transfer total value averaged US$173 (3.5% of TB-affected households' average annual income) and mitigated 20% of households' TB-related costs. Households randomised to receive the intervention were less likely to incur catastrophic costs (30% (95% CI 22–38%) versus 42% (95% CI 34–51%)). The mitigation impact was higher among poorer households. The TB-specific socioeconomic intervention reduced catastrophic costs and was accessible to poorer households. Socioeconomic support and mitigating catastrophic costs are integral to the End TB strategy, and our findings inform implementation of these new policies. PMID:27660507

  11. The economic effects of supporting tuberculosis-affected households in Peru.

    PubMed

    Wingfield, Tom; Tovar, Marco A; Huff, Doug; Boccia, Delia; Montoya, Rosario; Ramos, Eric; Lewis, James J; Gilman, Robert H; Evans, Carlton A

    2016-11-01

    The End TB Strategy mandates that no tuberculosis (TB)-affected households face catastrophic costs due to TB. However, evidence is limited to evaluate socioeconomic support to achieve this change in policy and practice. The objective of the present study was to investigate the economic effects of a TB-specific socioeconomic intervention.The setting was 32 shantytown communities in Peru. The participants were from households of consecutive TB patients throughout TB treatment administered by the national TB programme. The intervention consisted of social support through household visits and community meetings, and economic support through cash transfers conditional upon TB screening in household contacts, adhering to TB treatment/chemoprophylaxis and engaging with social support. Data were collected to assess TB-affected household costs. Patient interviews were conducted at treatment initiation and then monthly for 6 months.From February 2014 to June 2015, 312 households were recruited, of which 135 were randomised to receive the intervention. Cash transfer total value averaged US$173 (3.5% of TB-affected households' average annual income) and mitigated 20% of households' TB-related costs. Households randomised to receive the intervention were less likely to incur catastrophic costs (30% (95% CI 22-38%) versus 42% (95% CI 34-51%)). The mitigation impact was higher among poorer households.The TB-specific socioeconomic intervention reduced catastrophic costs and was accessible to poorer households. Socioeconomic support and mitigating catastrophic costs are integral to the End TB strategy, and our findings inform implementation of these new policies. Copyright ©ERS 2016.

  12. Local distributions of wealth to describe health inequalities in India: a new approach for analyzing nationally representative household survey data, 1992-2008.

    PubMed

    Bassani, Diego G; Corsi, Daniel J; Gaffey, Michelle F; Barros, Aluisio J D

    2014-01-01

    Worse health outcomes including higher morbidity and mortality are most often observed among the poorest fractions of a population. In this paper we present and validate national, regional and state-level distributions of national wealth index scores, for urban and rural populations, derived from household asset data collected in six survey rounds in India between 1992-3 and 2007-8. These new indices and their sub-national distributions allow for comparative analyses of a standardized measure of wealth across time and at various levels of population aggregation in India. Indices were derived through principal components analysis (PCA) performed using standardized variables from a correlation matrix to minimize differences in variance. Valid and simple indices were constructed with the minimum number of assets needed to produce scores with enough variability to allow definition of unique decile cut-off points in each urban and rural area of all states. For all indices, the first PCA components explained between 36% and 43% of the variance in household assets. Using sub-national distributions of national wealth index scores, mean height-for-age z-scores increased from the poorest to the richest wealth quintiles for all surveys, and stunting prevalence was higher among the poorest and lower among the wealthiest. Urban and rural decile cut-off values for India, for the six regions and for the 24 major states revealed large variability in wealth by geographical area and level, and rural wealth score gaps exceeded those observed in urban areas. The large variability in sub-national distributions of national wealth index scores indicates the importance of accounting for such variation when constructing wealth indices and deriving score distribution cut-off points. Such an approach allows for proper within-sample economic classification, resulting in scores that are valid indicators of wealth and correlate well with health outcomes, and enables wealth-related analyses at

  13. Relationships between adverse childhood experiences and adult mental well-being: results from an English national household survey.

    PubMed

    Hughes, Karen; Lowey, Helen; Quigg, Zara; Bellis, Mark A

    2016-03-03

    Individuals' childhood experiences can strongly influence their future health and well-being. Adverse childhood experiences (ACEs) such as abuse and dysfunctional home environments show strong cumulative relationships with physical and mental illness yet less is known about their effects on mental well-being in the general population. A nationally representative household survey of English adults (n = 3,885) measuring current mental well-being (Short Edinburgh-Warwick Mental Well-being Scale SWEMWBS) and life satisfaction and retrospective exposure to nine ACEs. Almost half of participants (46.4 %) had suffered at least one ACE and 8.3 % had suffered four or more. Adjusted odds ratios (AORs) for low life satisfaction and low mental well-being increased with the number of ACEs. AORs for low ratings of all individual SWEMWBS components also increased with ACE count, particularly never or rarely feeling close to others. Of individual ACEs, growing up in a household affected by mental illness and suffering sexual abuse had the most relationships with markers of mental well-being. Childhood adversity has a strong cumulative relationship with adult mental well-being. Comprehensive mental health strategies should incorporate interventions to prevent ACEs and moderate their impacts from the very earliest stages of life.

  14. Using DNA fingerprints to infer familial relationships within NHANES III households

    PubMed Central

    Katki, Hormuzd A.; Sanders, Christopher L.; Graubard, Barry I.; Bergen, Andrew W.

    2009-01-01

    Developing, targeting, and evaluating genomic strategies for population-based disease prevention require population-based data. In response to this urgent need, genotyping has been conducted within the Third National Health and Nutrition Examination (NHANES III), the nationally-representative household-interview health survey in the U.S. However, before these genetic analyses can occur, family relationships within households must be accurately ascertained. Unfortunately, reported family relationships within NHANES III households based on questionnaire data are incomplete and inconclusive with regards to actual biological relatedness of family members. We inferred family relationships within households using DNA fingerprints (Identifiler®) that contain the DNA loci used by law enforcement agencies for forensic identification of individuals. However, performance of these loci for relationship inference is not well understood. We evaluated two competing statistical methods for relationship inference on pairs of household members: an exact likelihood ratio relying on allele frequencies to an Identical By State (IBS) likelihood ratio that only requires matching alleles. We modified these methods to account for genotyping errors and population substructure. The two methods usually agree on the rankings of the most likely relationships. However, the IBS method underestimates the likelihood ratio by not accounting for the informativeness of matching rare alleles. The likelihood ratio is sensitive to estimates of population substructure, and parent-child relationships are sensitive to the specified genotyping error rate. These loci were unable to distinguish second-degree relationships and cousins from being unrelated. The genetic data is also useful for verifying reported relationships and identifying data quality issues. An important by-product is the first explicitly nationally-representative estimates of allele frequencies at these ubiquitous forensic loci. PMID

  15. UK National Data Guardian for Health and Care's Review of Data Security: Trust, better security and opt-outs.

    PubMed

    Chan, Tom; Di Iorio, Concetta Tania; De Lusignan, Simon; Lo Russo, Daniel; Kuziemsky, Craig; Liaw, Siaw-Teng

    2016-12-20

    Sharing health and social care data is essential to the delivery of high quality health care as well as disease surveillance, public health, and for conducting research. However, these societal benefits may be constrained by privacy and data protection principles. Hence, societies are striving to find a balance between the two competing public interests. Whilst the spread of IT advancements in recent decades has increased the demand for an increased privacy and data protection in many ways health is a special case. UK are adopting guidelines, codes of conduct and regulatory instruments aimed to implement privacy principles into practical settings and enhance public trust. Accordingly, in 2015, the UK National Data Guardian (NDG) requested to conduct a further review of data protection, referred to as Caldicott 3.  The scope of this review is to strengthen data security standards and confidentiality. It also proposes a consent system based on an "opt-out" model rather than on "opt-in.Across Europe as well as internationally the privacy-health data sharing balance is not fixed.  In Europe enactment of the new EU Data Protection Regulation in 2016 constitute a major breakthrough, which is likely to have a profound effect on European countries and beyond.  In Australia and across North America different ways are being sought to balance out these twin requirements of a modern society - to preserve privacy alongside affording high quality health care for an ageing population.  Whilst in the UK privacy legal framework remains complex and fragmented into different layers of legislation, which may negatively impact on both the rights to privacy and health the UK is at the forefront in the uptake of international and EU privacy and data protection principles. And, if the privacy regime were reorganised in a more comprehensive manner, it could be used as a sound implementation model for other countries.

  16. Socio-economic dietary inequalities in UK adults: an updated picture of key food groups and nutrients from national surveillance data.

    PubMed

    Maguire, Eva R; Monsivais, Pablo

    2015-01-14

    Socio-economic differences in diet are a potential contributor to health inequalities. The present study provides an up-to-date picture of socio-economic differences in diet in the UK, focusing on the consumption of three food groups and two nutrients of public health concern: fruit and vegetables; red and processed meat; oily fish; saturated fats; non-milk extrinsic sugars (NMES). We analysed data for 1491 adults (age ≥ 19 years) from the National Diet and Nutrition Survey 2008-2011. Socio-economic indicators were household income, occupational social class and highest educational qualification. Covariate-adjusted estimates for intakes of fruit and vegetables, red and processed meat, and both nutrients were estimated using general linear models. Covariate-adjusted OR for oily fish consumption were derived with logistic regression models. We observed consistent socio-economic gradients in the consumption of the three food groups as estimated by all the three indicators. Contrasting highest and lowest levels of each socio-economic indicator, we observed significant differences in intakes for the three food groups and NMES. Depending on the socio-economic indicator, highest socio-economic groups consumed up to 128 g/d more fruit and vegetables, 26 g/d less red and processed meat, and 2·6% points less NMES (P< 0·05 for all). Relative to lowest socio-economic groups, highest socio-economic groups were 2·4 to 4·0 times more likely to eat oily fish. No significant patterns in saturated fat consumption were apparent. In conclusion, socio-economic differences were identified in the consumption of food groups and one nutrient of public health importance. Aligning dietary intakes with public health guidance may require interventions specifically designed to reduce health inequalities.

  17. Tuberculosis screening in patients with HIV: An audit against UK national guidelines to assess current practice and the effectiveness of an electronic tuberculosis-screening prompt.

    PubMed

    Fox-Lewis, A; Brima, N; Muniina, P; Grant, A D; Edwards, S G; Miller, R F; Pett, S L

    2016-09-01

    A retrospective clinical audit was performed to assess if the British HIV Association 2011 guidelines on routine screening for tuberculosis in HIV are being implemented in a large UK urban clinic, and if a tuberculosis-screening prompt on the electronic patient record for new attendees was effective. Of 4658 patients attending during the inclusion period, 385 were newly diagnosed first-time attendees and routine tuberculosis screening was recommended in 165. Of these, only 6.1% of patients had a completed tuberculosis screening prompt, and 12.1% underwent routine tuberculosis screening. This audit represents the first published UK data on routine screening rates for tuberculosis in HIV and demonstrates low rates of tuberculosis screening despite an electronic screening prompt designed to simplify adherence to the national guideline. Reasons why tuberculosis screening rates were low, and the prompt ineffective, are unclear. A national audit is ongoing, and we await the results to see if our data reflect a lack of routine tuberculosis screening in HIV-infected patients at a national level. © The Author(s) 2016.

  18. Parental Influences on Adolescent Marijuana Use and the Baby Boom Generation: Findings from the 1979-1996 National Household Surveys on Drug Abuse. Analytic Series.

    ERIC Educational Resources Information Center

    Kandel, Denise B.; Griesler, Pamela C.; Lee, Gang; Davies, Mark; Schaffsan, Christine

    This report uses the 1979-1996 National Household Surveys on Drug Abuse to investigate the role of parents, especially members of the baby boom generation, on the marijuana use of children. The association of marijuana use between parents and children, the differences among parental birth cohorts, and the determinants of child marijuana use are…

  19. Understanding Head Start Children's Problem Behaviors in the Context of Arrest or Incarceration of Household Members

    ERIC Educational Resources Information Center

    Ziv, Yair; Alva, Soumya; Zill, Nicholas

    2010-01-01

    Using data from the nationally representative Head Start Family and Child Experiences Survey (FACES), the relationships between living in a household where a household member had been arrested or incarcerated and conduct problems of preschool children enrolled in Head Start were examined. Children who lived in such households showed more…

  20. A Water Grid for the UK

    NASA Astrophysics Data System (ADS)

    Leathard, A.; Fowler, H. J.; Kilsby, C. G.

    2009-12-01

    Anthropogenically aggravated climate change associated with intensive expansion of the global economy has increased the demand for water whilst simultaneously altering natural variability in its distribution, straining water resources unsustainably and inequitably in many parts of the world, increasing drought risk, and encouraging decision-makers to reconsider the security of water supply. Indeed, in the absence of additional resource development, contemporary planning forecasts imply increased water stress across much of the United Kingdom. Until recently the regulatory authorities of the UK promoted increased efficiency of water delivery and consumption combined with a portfolio of financial instruments as a means of reducing water stress, maintaining present levels of consumer service without significant further exploitation of the environment. However, despite an increasingly sophisticated understanding of climate change and its effects, significant uncertainty remains in the quantification of its impacts on the water sector, and questions persist as to the effectiveness of such demand management measures compared to that of more traditional infrastructure improvements. Faced with possible futures provided for by detrimentally over-stressed resources, what opportunities remain for future strategic development in the UK? Is there a single national strategy that is both politically and socially acceptable? Do the benefits of national water infrastructure projects outweigh their costs? This ongoing study aims to evolve robust national adaptation strategies by quantifying the projected impacts of climate change across mainland UK using multi-model and perturbed-physics ensembles of projected future climate, encapsulating uncertainties in a scenario-driven integrated water resources model incorporating socio-economic elements.

  1. Adherence to UK national guidance for discharge information: an audit in primary care

    PubMed Central

    Hammad, Eman A; Wright, David John; Walton, Christine; Nunney, Ian; Bhattacharya, Debi

    2014-01-01

    Aims Poor communication of clinical information between healthcare settings is associated with patient harm. In 2008, the UK National Prescribing Centre (NPC) issued guidance regarding the minimum information to be communicated upon hospital discharge. This study evaluates the extent of adherence to this guidance and identifies predictors of adherence. Methods This was an audit of discharge summaries received by medical practices in one UK primary care trust of patients hospitalized for 24 h or longer. Each discharge summary was scored against the applicable NPC criteria which were organized into: ‘patient, admission and discharge’, ‘medicine’ and ‘therapy change’ information. Results Of 3444 discharge summaries audited, 2421 (70.3%) were from two teaching hospitals and 906 (26.3%) from three district hospitals. Unplanned admissions accounted for 2168 (63.0%) of the audit sample and 74.6% (2570) of discharge summaries were electronic. Mean (95% CI) adherence to the total NPC minimum dataset was 71.7% [70.2, 73.2]. Adherence to patient, admission and discharge information was 77.3% (95% CI 77.0, 77.7), 67.2% (95% CI 66.3, 68.2) for medicine information and 48.9% (95% CI 47.5, 50.3) for therapy change information. Allergy status, co-morbidities, medication history and rationale for therapy change were the most frequent omissions. Predictors of adherence included quality of the discharge template, electronic discharge summaries and smaller numbers of prescribed medicines. Conclusions Despite clear guidance regarding the content of discharge information, omissions are frequent. Adherence to the NPC minimum dataset might be improved by using comprehensive electronic discharge templates and implementation of effective medicines reconciliation at both sides of the health interface. PMID:25041244

  2. Adherence to UK national guidance for discharge information: an audit in primary care.

    PubMed

    Hammad, Eman A; Wright, David John; Walton, Christine; Nunney, Ian; Bhattacharya, Debi

    2014-12-01

    Poor communication of clinical information between healthcare settings is associated with patient harm. In 2008, the UK National Prescribing Centre (NPC) issued guidance regarding the minimum information to be communicated upon hospital discharge. This study evaluates the extent of adherence to this guidance and identifies predictors of adherence. This was an audit of discharge summaries received by medical practices in one UK primary care trust of patients hospitalized for 24 h or longer. Each discharge summary was scored against the applicable NPC criteria which were organized into: 'patient, admission and discharge', 'medicine' and 'therapy change' information. Of 3444 discharge summaries audited, 2421 (70.3%) were from two teaching hospitals and 906 (26.3%) from three district hospitals. Unplanned admissions accounted for 2168 (63.0%) of the audit sample and 74.6% (2570) of discharge summaries were electronic. Mean (95% CI) adherence to the total NPC minimum dataset was 71.7% [70.2, 73.2]. Adherence to patient, admission and discharge information was 77.3% (95% CI 77.0, 77.7), 67.2% (95% CI 66.3, 68.2) for medicine information and 48.9% (95% CI 47.5, 50.3) for therapy change information. Allergy status, co-morbidities, medication history and rationale for therapy change were the most frequent omissions. Predictors of adherence included quality of the discharge template, electronic discharge summaries and smaller numbers of prescribed medicines. Despite clear guidance regarding the content of discharge information, omissions are frequent. Adherence to the NPC minimum dataset might be improved by using comprehensive electronic discharge templates and implementation of effective medicines reconciliation at both sides of the health interface. © 2014 The British Pharmacological Society.

  3. Household Structure and Children’s Educational Attainment: A Perspective on Coresidence with Grandparents

    PubMed Central

    Monserud, Maria A.; Elder, Glen H.

    2013-01-01

    Children from alternative households complete fewer years of schooling. Yet little is known about the implications of coresidence with grandparents for educational attainment. Using data from the National Longitudinal Study of Adolescent Health (N = 10,083), this study found that extended households with two biological parents were not detrimental to high school completion or college enrollment. Although coresidence with grandparents did not compensate for not living with two biological parents, it seemed to be beneficial for the educational attainment of youth from single-mother households. In contrast, skipped-generation households were associated with a persistent disadvantage for educational attainment. Limited socioeconomic resources partially accounted for the adverse effects of alternative households, whereas parenting quality did not explain these effects. Interactions of gender by household structure suggested that stepfather households could have negative consequences for high school completion and college enrollment only for girls. PMID:24415799

  4. The UK National Health Service's 'innovation agenda': lessons on commercialisation and trust.

    PubMed

    Sterckx, Sigrid; Cockbain, Julian

    2014-01-01

    The UK National Health Service (the 'NHS'), encouraged by the 2011 report Innovation Health and Wealth, Accelerating Adoption and Diffusion in the NHS, and empowered by the Health and Social Care Act 2012, is in the process of adopting a new agenda for stimulating innovation in healthcare. For this, the bodies, body materials, and confidential health information of NHS patients may be co-opted. We explain why this brings the NHS into a moral conflict with its basic goal of providing a universal healthcare service. Putting NHS databases at the disposal of industry, without addressing ethical concerns regarding the privacy, autonomy, and moral integrity of patients and without requiring a 'kick-back' to enhance the service that the NHS provides, is inappropriate. As this article shows, with reference to the commercial arena of direct-to-consumer genetic testing, it is crucial that patient and public trust in the NHS is not eroded. © The Author 2014. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

    PubMed

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

    2011-09-15

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

  6. Patterns of Drug and Alcohol Use Associated with Lifetime Sexual Revictimization and Current Posttraumatic Stress Disorder Among Three National Samples of Adolescent, College, and Household-Residing Women

    PubMed Central

    Walsh, Kate; Resnick, Heidi S.; Danielson, Carla Kmett; McCauley, Jenna L.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2014-01-01

    Sexual revictimization (experiencing 2 or more rapes) is prevalent and associated with increased risk for posttraumatic stress disorder (PTSD) and substance use. However, no national epidemiologic studies have established the prevalence or relative odds of a range of types of substance use as a function of sexual victimization history and PTSD status. Using three national female samples, the current study examined associations between sexual revictimization, PTSD, and past-year substance use. Participants were 1763 adolescent girls, 2000 college women, and 3001 household-residing women. Rape history, PTSD, and use of alcohol, marijuana, other illicit drugs, and non-medical prescription drugs were assessed via structured telephone interviews of U.S households and colleges in 2005–2006. Chi-square and logistic regression were used to estimate the prevalence and odds of past-year substance use. Relative to single and non-victims: Revictimized adolescents and household-residing women reported more other illicit and non-medical prescription drug use; revictimized college women reported more other illicit drug use. Past 6-month PTSD was associated with increased odds of drug use for adolescents, non-medical prescription drug use for college women, and all substance use for household-residing women. Revictimization and PTSD were associated with more deviant substance use patterns across samples, which may reflect self-medication with substances. Findings also could be a function of high-risk environment or common underlying mechanisms. Screening and early intervention in pediatric, primary care, and college clinics may prevent subsequent rape, PTSD, and more severe substance use. PMID:24370205

  7. Predicting nutrient responses to mitigation at catchment to national scale: the UK research platform (Invited)

    NASA Astrophysics Data System (ADS)

    Johnes, P.

    2013-12-01

    Nutrient enrichment of waters from land-based and atmospheric sources presents a significant management challenge, requiring effective stakeholder engagement and policy development, properly underpinned by robust scientific evidence. The challenge is complex, raising significant questions about the specific sources, apportionment and pathways that determine nutrient enrichment and the key priorities for effective management and policy intervention. This paper presents outputs from 4 major UK research programmes: the Defra Demonstration Test Catchments programme (DTC), the Environment Agency's Catchment Sensitive Farming monitoring and evaluation programme (CSF), Natural Resources Wales Welsh Catchment Initiative (WCI) and the NERC Environmental Virtual Observatory programme (EVOp). Funded to meet this challenge, they are delivering new understanding of the rates and sources of pollutant fluxes from land to water, their impacts on ecosystem goods and services, and likely trends under future climate and land use change from field to national scale. DTC, a 12m investment by the UK Government, has set up long-term, high resolution research platforms equipped with novel telemetered sensor networks to monitor stream ecosystem responses to on-farm mitigation measures at a representative scale for catchment management. Ecosystem structural and functional responses and bulk hydrochemistry are also being monitored using standard protocols. CSF has set up long-term, enhanced monitoring in 8 priority catchments, with monthly monitoring in a further 72 English catchments and 6 Welsh priority catchments, to identify shifts in pollutant flux to waters resulting from mitigation measures in priority areas and farming sectors. CSF and WCI have contributed to >50 million of targeted farm improvements to date, representing a significant shift in farming practice. Each programme has generated detailed evidence on stream ecosystem responses to targeted mitigation. However, to provide

  8. Land use and household energy dynamics in Malawi

    NASA Astrophysics Data System (ADS)

    Jagger, Pamela; Perez-Heydrich, Carolina

    2016-12-01

    Interventions to mitigate household air pollution (HAP) from cooking with solid fuels often fail to take into account the role of access to freely available woodfuels in determining fuel choice and willingness to adopt clean cooking technologies, key factors in mitigating the burden of HAP. We use national-scale remote sensing data on land use land cover change, and population representative data from two waves of the Malawi Living Standards Measurement Survey to explore the relationship between land use change and the type of fuel households use, time spent collecting fuel, and expenditures on fuel, hypothesizing that land use dynamics influence household-level choice of primary cooking fuel. We find considerable heterogeneity with respect to regeneration and deforestation/degradation dynamics and evidence of spatial clustering. We find that regeneration of forests and woodlands increases the share of households that collect fuelwood, whereas deforestation and degradation lead households to purchase fuelwood. We also find that a relatively large share of land under woody savannah or degraded forest (versus fully stocked forest) increases fuel collection time. Areas with regeneration happening at broader scale experience increases in fuel expenditures. Our findings have implications for the spatial targeting of interventions designed to mitigate HAP.

  9. Recent psychopathology, suicidal thoughts and suicide attempts in households with and without firearms: findings from the National Comorbidity Study Replication.

    PubMed

    Miller, M; Barber, C; Azrael, D; Hemenway, D; Molnar, B E

    2009-06-01

    To assess the relationship between firearm ownership and possible psychiatric confounders of the firearm-suicide relationship. Multivariate logistic regression was used to estimate the association between living in a home with firearms and 12-month occurrence of major Diagnostic and statistical manual of mental disorders (DSM)-IV disorders and suicidal behaviour among respondents to the National Comorbidity Survey Replication, a household survey of 9282 adults aged 18+. Analyses controlled for sociodemographic characteristics including age, sex, race/ethnicity, educational attainment and poverty. Approximately one in three Americans reported living in a home with firearms. People living in a home with firearms were no more or less likely than people in homes without firearms to have recent (past year) anxiety disorders (OR = 1.0, 95% CI 0.8 to 1.2), mood disorders (OR = 0.9, 95% CI 0.7 to 1.1) or substance dependence and/or abuse (OR = 0.9, 95% CI 0.6 to 1.3). Past year suicidal ideation (OR = 0.8, 95% CI 0.5 to 1.3) and suicide planning (OR = 0.5, 95% CI 0.2 to 1.4) were also not associated with living in households with firearms. Having made a suicide attempt over the previous year was the only outcome more common among participants reporting that they currently lived in a home without [corrected] firearms. The previously reported association between household firearm ownership and heightened risk of suicide is not explained by a higher risk of psychopathology among gun-owning families. As there are Americans with suicidal ideation and/or significant and recent psychiatric disorders currently living in homes with firearms, future work should focus on understanding the impediments to effectively communicating the suicide risk associated with household firearms.

  10. Residential Energy Consumption Survey (RECS): National interim energy consumption survey, 1978-1979, household monthly energy consumption and expenditures. Shopper's guide

    NASA Astrophysics Data System (ADS)

    Windell, P.

    1981-08-01

    The data from the National Interim Energy Consumption Survey (NIECS) is available to the public on machine readable magnetic tapes. Brief overviews of the Residential Energy Consumption Survey as a whole and of the NIECS in particular is a brief description of each of the files included in this tape, and a list of the variables in the data set are included. A copy of the fuel supplier record form used to collect consumption and expenditure data for each of the sample households is also included.

  11. Teachers of the Alexander Technique in the UK and the people who take their lessons: A national cross-sectional survey.

    PubMed

    Eldred, J; Hopton, A; Donnison, E; Woodman, J; MacPherson, H

    2015-06-01

    Given the rising profile of the Alexander Technique in the UK, there is a need for a comprehensive description of its teachers and of those who currently take lessons. In a national survey of Alexander teachers, we set out to address this information gap. A cross-sectional survey of 871 UK members of three main Alexander Technique teachers' professional associations was conducted. A questionnaire requested information about their professional background, teaching practice and methods, and about the people who attend lessons and their reasons for seeking help. With an overall response rate of 61%, 534 teachers responded; 74% were female with median age of 58 years, 60% had a higher education qualification, and 95% were self-employed, many with additional non-Alexander paid employment. The majority (87%) offered lessons on their own premises or in a privately rented room, and 19% provided home visits; both individual and group lessons were provided. People who took lessons were predominantly female (66%) with a median age of 48 years, and 91% paid for their lessons privately. Nearly two-thirds (62%) began lessons for reasons related to musculoskeletal conditions, including back symptoms, posture, neck pain, and shoulder pain. Other reasons were general (18%, including well-being), performance-related (10%, including voice-, music-, and sport-related), psychological (5%) and neurological (3%). We estimate that Alexander teachers in the UK provide approximately 400,000 lessons per year. This study provides an overview of Alexander Technique teaching in the UK today and data that may be useful when planning future research. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Characterising freeze in the UK: applications for the insurance industry

    NASA Astrophysics Data System (ADS)

    Raven, E. K.; Keef, C.; Busby, K.

    2012-04-01

    The UK winters of 2009-2010 and 2010-2011 were characterised by prolonged and widespread low temperatures. This was challenging for the UK insurance industry and organisations such as the emergency services, the Highways Agency and British Gas who had to manage the extra demands that resulted. In the 6-day period running to Christmas Eve 2010, British Gas reported 100,000 boiler repair call-outs, whilst those 190,000 homes and businesses left with frozen and subsequently burst pipes contributed to the ABI's estimated £ 900 million in insured losses for December 2010 alone; the highest payout by the industry for damages associated with cold weather. Unfortunately, the severity of these winters made the difference between profit and loss for some primary UK insurance companies. To enable better pricing of premiums in the future, insurance companies are looking to understand the potential risk from cold waves at a local, postcode-level, whilst reinsurance firms seek to determine the accumulated loss across the UK associated with spatially coherent events. Other industry sectors also strive to improve their understanding of weather extremes for planning and management. Underpinning this is the need to statistically characterise the physical hazard. Aimed primarily at the re/insurance industry, we have applied an established methodology for developing statistical event sets and applied this to generate a UK freeze event set. An event set provides a stochastic set of several thousand events over 10's of 1000's of years and is typically applied within probabilistic catastrophe models. Our method applies extreme value theory and dependence modelling to explain low-temperature relationships across the UK and over time using historical records. The resulting event set represents the spatial and temporal dependence of cold waves in the UK and is modelled against household factors that increase the vulnerability to freezing conditions, such as property type, age and condition

  13. Household Coverage with Adequately Iodized Salt Varies Greatly between Countries and by Residence Type and Socioeconomic Status within Countries: Results from 10 National Coverage Surveys.

    PubMed

    Knowles, Jacky M; Garrett, Greg S; Gorstein, Jonathan; Kupka, Roland; Situma, Ruth; Yadav, Kapil; Yusufali, Rizwan; Pandav, Chandrakant; Aaron, Grant J

    2017-05-01

    Background: Household coverage with iodized salt was assessed in 10 countries that implemented Universal Salt Iodization (USI). Objective: The objective of this paper was to summarize household coverage data for iodized salt, including the relation between coverage and residence type and socioeconomic status (SES). Methods: A review was conducted of results from cross-sectional multistage household cluster surveys with the use of stratified probability proportional to size design in Bangladesh, Ethiopia, Ghana, India, Indonesia, Niger, the Philippines, Senegal, Tanzania, and Uganda. Salt iodine content was assessed with quantitative methods in all cases. The primary indicator of coverage was percentage of households that used adequately iodized salt, with an additional indicator for salt with some added iodine. Indicators of risk were SES and residence type. We used 95% CIs to determine significant differences in coverage. Results: National household coverage of adequately iodized salt varied from 6.2% in Niger to 97.0% in Uganda. For salt with some added iodine, coverage varied from 52.4% in the Philippines to 99.5% in Uganda. Coverage with adequately iodized salt was significantly higher in urban than in rural households in Bangladesh (68.9% compared with 44.3%, respectively), India (86.4% compared with 69.8%, respectively), Indonesia (59.3% compared with 51.4%, respectively), the Philippines (31.5% compared with 20.2%, respectively), Senegal (53.3% compared with 19.0%, respectively), and Tanzania (89.2% compared with 57.6%, respectively). In 7 of 8 countries with data, household coverage of adequately iodized salt was significantly higher in high- than in low-SES households in Bangladesh (58.8% compared with 39.7%, respectively), Ghana (36.2% compared with 21.5%, respectively), India (80.6% compared with 70.5%, respectively), Indonesia (59.9% compared with 45.6%, respectively), the Philippines (39.4% compared with 17.3%, respectively), Senegal (50.7% compared

  14. Women's Land Tenure Security and Household Human Capital: Evidence from Ethiopia's Land Certification.

    PubMed

    Muchomba, Felix M

    2017-10-01

    This paper examines the impact of Ethiopia's gendered land certification programs on household consumption of healthcare, food, education, and clothing. Ethiopia embarked on a land tenure reform program in 1998, after years of communism during which all land was nationalized. The reform began in Tigray region where land certificates were issued to household heads, who were primarily male. In a second phase carried out in 2003-2005, three other regions issued land certificates jointly to household heads and spouses, presenting variation in land tenure security by gender. Results using household panel data show that joint land certification to spouses was accompanied by increased household consumption of healthcare and homegrown food and decreased education expenditure, compared to household-head land certification. Joint land certification was also accompanied by increased consumption of women's and girls' clothing, and decreased men's clothing expenditures indicating results may be explained by a shift in the gender balance of power within households. Analysis on the incidence and duration of illness indicates that increased healthcare expenditures after joint land certification may be due to joint certification households seeking more effective treatment than head-only certification households for household members who fell ill or suffered injuries.

  15. National Household Education Surveys Program of 2012: Data File User's Manual. Parent and Family Involvement in Education Survey. Early Childhood Program Participation Survey. NCES 2015-030

    ERIC Educational Resources Information Center

    McPhee, C.; Bielick, S.; Masterton, M.; Flores, L.; Parmer, R.; Amchin, S.; Stern, S.; McGowan, H.

    2015-01-01

    The 2012 National Household Education Surveys Program (NHES:2012) Data File User's Manual provides documentation and guidance for users of the NHES:2012 data files. The manual provides information about the purpose of the study, the sample design, data collection procedures, data processing procedures, response rates, imputation, weighting and…

  16. Local Distributions of Wealth to Describe Health Inequalities in India: A New Approach for Analyzing Nationally Representative Household Survey Data, 1992–2008

    PubMed Central

    Bassani, Diego G.; Corsi, Daniel J.; Gaffey, Michelle F.; Barros, Aluisio J. D.

    2014-01-01

    Background Worse health outcomes including higher morbidity and mortality are most often observed among the poorest fractions of a population. In this paper we present and validate national, regional and state-level distributions of national wealth index scores, for urban and rural populations, derived from household asset data collected in six survey rounds in India between 1992–3 and 2007–8. These new indices and their sub-national distributions allow for comparative analyses of a standardized measure of wealth across time and at various levels of population aggregation in India. Methods Indices were derived through principal components analysis (PCA) performed using standardized variables from a correlation matrix to minimize differences in variance. Valid and simple indices were constructed with the minimum number of assets needed to produce scores with enough variability to allow definition of unique decile cut-off points in each urban and rural area of all states. Results For all indices, the first PCA components explained between 36% and 43% of the variance in household assets. Using sub-national distributions of national wealth index scores, mean height-for-age z-scores increased from the poorest to the richest wealth quintiles for all surveys, and stunting prevalence was higher among the poorest and lower among the wealthiest. Urban and rural decile cut-off values for India, for the six regions and for the 24 major states revealed large variability in wealth by geographical area and level, and rural wealth score gaps exceeded those observed in urban areas. Conclusions The large variability in sub-national distributions of national wealth index scores indicates the importance of accounting for such variation when constructing wealth indices and deriving score distribution cut-off points. Such an approach allows for proper within-sample economic classification, resulting in scores that are valid indicators of wealth and correlate well with health

  17. Factors associated with child hunger among food insecure households in Bangladesh.

    PubMed

    Haque, Md Ahshanul; Farzana, Fahmida Dil; Sultana, Sabiha; Raihan, Mohammad Jyoti; Rahman, Ahmed Shafiqur; Waid, Jillian L; Choudhury, Nuzhat; Ahmed, Tahmeed

    2017-02-16

    Hunger is associated with food insecurity at the household level and is considered as a global public health problem with long term adverse consequences on children's health. This study aims to determine the factors associated with child hunger from a nationally representative sample in Bangladesh among food insecure households. Data was derived from the Food Security and Nutritional Surveillance Project; 14,712 children aged 6-59 months belonging to food insecure households contributed to the analysis. Information on food security at the household level was collected for 30 days preceding the survey. Descriptive statistics served to illustrate the variables studied and multiple logistic regression analysis was conducted to identify the significant risk factors for child hunger. Overall 10% of the children were found to be hungry. After adjusting for seasonality, residence type and education level of household head, the variables - female headed households [OR: 1.87 (1.43-2.45); p < 0.001], severely food insecure households [OR: 10.5 (1.43-76.6); p < 0.05], households having women with no education [OR: 1.56 (1.27-1.92); p < 0.05], poorest asset quintile [OR: 1.50 (1.11-2.15); p < 0.05] and the amount of rice consumed per household per week [OR: 0.94 (0.92-0.96); p < 0.001] were found to be significantly and independently associated with child hunger. Out of the potential risk factors examined, our study found significant and independent association of five variables with child hunger: sex of the household head, household food insecurity status, educational status of household women and asset index. Despite all sampled household being food insecure, degree of household food insecurity status appeared to be the strongest predictor of child hunger.

  18. Violence, mental health and violence risk factors among women in the general population: an0020epidemiology study based on two national household surveys in the UK

    PubMed Central

    2013-01-01

    Background Females who perpetrated violence in the community have important mental health and public protection implications. There is a dearth of research in this area. This study investigated the prevalence of psychiatric morbidity, personality disorders as well as victim characteristics and violence risk factors of women in the community who self-reported violence against others. Methods The study sample consisted of 8,275 community women aged 16–74 years obtained from the 2000 and 2007 UK national psychiatric morbidity surveys. Self report incidences of violence, personality disorders and the presence of psychiatric symptoms were assessed by interviews and/or established structured psychiatric assessment protocols. Results Weighted prevalence of female violence, which primarily involved partners and friends, was 5.5% in 2000 and 5.1% in 2007. Violence-prone women also had significantly higher prevalence of common mental disorders and comorbidity (adjusted odds ratio 3.3 and 2.9 respectively) than non-violent women. Multivariate analyses identified eight significant risk factors that characterized violence prone women: young age, residing in social-assisted housing, presence of early conduct problems, victim of domestic violence, self-harming, excessive drinking and past criminal justice involvements. Conclusion A higher prevalence of common mental disorders and some types of personality disorder was found among violence prone women compared to their non-violence prone counterparts. The identified violence risk factors could be used to develop a quick and easily administered rating tool suitable for use by non-mental health trained frontline workers such as police and social support workers in the community to identify violence-prone women. Mental health and support services then can be provided to them for mental health care and violence prevention purposes. PMID:24165544

  19. Critical factors for active transportation to school among low-income and minority students. Evidence from the 2001 National Household Travel Survey.

    PubMed

    McDonald, Noreen C

    2008-04-01

    Walking to school may be an important source of daily physical activity in children's lives, and government agencies are supporting programs to encourage walking to school (e.g., Safe Routes to School and the CDC's KidsWalk programs). However, little research has looked at differences in behavior across racial/ethnic and income groups. This cross-sectional study used data from the 2001 National Household Travel Survey to document rates of walking and biking to school among low-income and minority youth in the U.S. (N=14,553). Binary models of the decision to use active transport to school were developed to simultaneously adjust for trip, individual, household, and neighborhood correlates. All analyses were conducted in 2007. The data showed that low-income and minority groups, particularly blacks and Hispanics, use active travel modes to get to school at much higher rates than whites or higher-income students. However, racial variation in travel patterns is removed by controlling for household income, vehicle access, distance between home and school, and residential density. Active transportation to school may be an important strategy to increase and maintain physical activity levels for low-income and minority youth. Current policy interventions such as Safe Routes to School have the opportunity to provide benefits for low-income and minority students who are the most likely to walk to school.

  20. UK report on waste management

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

    Ferguson, J.

    1995-09-01

    Arising jointly from the National and European Union requirements for more intensive attention to be paid to the environment, the United Kingdom (UK) has taken many strides forward in protecting the environment from pollution and preventing harm to human health arising from the handling, transport and disposal of wastes. Major adjustments are taking place in Europe following the opening up of the Eastern European countries. The consequences of the illegal movement of wastes and its mistreatment and disposal are now recognised within the European Union. The UK as a member State is well aware of the consequences which arise frommore » the lack of proper waste management. This paper discusses waste management and legislation pertaining to waste management in the United Kingdom.« less

  1. Relationship between household access to food and malnutrition in eastern and southern Africa.

    PubMed

    Mwadime, R K; Baldwin, S L

    1994-09-01

    This review paper gives an overview of the relationship between household access to food and malnutrition using national level data in the Eastern and Southern Africa Region. The overall prevalence of malnutrition amongst the under-five population have not changed significantly over the decade and, in some cases, have deteriorated. The situation of household access to food differs between economies and production systems, but most households (average of 80%) in the region do not have access to adequate food. A preliminary analysis of the determinants of malnutrition at country level pointed to the importance of: financial access to food (an indicator of household access to food) and; access to safe water (an indicator of household healthy environment), as the most significant variables predicting rates of malnutrition. Several areas for action by governments in the region and for further study within the subject of household access to food are delineated. These are: more clear determination of the relative contribution of household access to food, to the nutritional status of women and children and, improved analysis of indicators of household access to food.

  2. Influences of Preparedness Knowledge and Beliefs on Household Disaster Preparedness.

    PubMed

    Thomas, Tracy N; Leander-Griffith, Michelle; Harp, Victoria; Cioffi, Joan P

    2015-09-11

    In response to concern about strengthening the nation's ability to protect its population and way of life (i.e., security) and ability to adapt and recover from emergencies (i.e., resilience), the President of the United States issued Presidential Policy Directive 8: National Preparedness (PPD-8) (1). Signed on March 30, 2011, PPD-8 is a directive for the U.S. Department of Homeland Security to coordinate a comprehensive campaign across government, private and nonprofit sectors, and individuals to build and sustain national preparedness. Despite efforts by the Federal Emergency Management Agency (FEMA) and other organizations to educate U.S. residents on becoming prepared, growth in specific preparedness behaviors, including actions taken in advance of a disaster to be better prepared to respond to and recover, has been limited (2). In 2012, only 52% of U.S. residents surveyed by FEMA reported having supplies for a disaster (2), a decline from 57% who reported having such supplies in 2009 (3). It is believed that knowledge influences behavior, and that attitudes and beliefs, which are correlated with knowledge, might also influence behavior (4). To determine the association between knowledge and beliefs and household preparedness, CDC analyzed baseline data from Ready CDC, a personal disaster preparedness intervention piloted among Atlanta- and Morgantown-based CDC staff members during 2013–2015. Compared with persons with basic preparedness knowledge, persons with advanced knowledge were more likely to have assembled an emergency kit (44% versus 17%), developed a written household disaster plan (9% versus 4%), and received county emergency alert notifications (63% versus 41%). Similarly, differences in household preparedness behaviors were correlated with beliefs about preparedness. Persons identified as having strong beliefs in the effectiveness of disaster preparedness engaged in preparedness behaviors at levels 7%–30% higher than those with weaker

  3. The effect of household poverty on tuberculosis.

    PubMed

    Siroka, A; Law, I; Macinko, J; Floyd, K; Banda, R P; Hoa, N B; Tsolmon, B; Chanda-Kapata, P; Gasana, M; Lwinn, T; Senkoro, M; Tupasi, T; Ponce, N A

    2016-12-01

    pSETTING: Households in Malawi, Mongolia, Myanmar, the Philippines, Rwanda, Tanzania, Viet Nam and Zambia.OBJECTIVE To assess the relationship between household socio-economic level, both relative and absolute, and individual tuberculosis (TB) disease. We analysed national TB prevalence surveys from eight countries individually and in pooled multicountry models. Socio-economic level (SEL) was measured in terms of both relative household position and absolute wealth. The outcome of interest was whether or not an individual had TB disease. Logistic regression models were used to control for putative risk factors for TB disease such as age, sex and previous treatment history. Overall, a strong and consistent association between household SEL and individual TB disease was not found. Significant results were found in four individual country models, with the lowest socio-economic quintile being associated with higher TB risk in Mongolia, Myanmar, Tanzania and Viet Nam. TB prevalence surveys are designed to assess prevalence of disease and, due to the small numbers of cases usually detected, may not be the most efficient means of investigating TB risk factors. Different designs are needed, including measuring the SEL of individuals in nested case-control studies within TB prevalence surveys or among TB patients seeking treatment in health care facilities.

  4. A UK national survey of investigations for beta-lactam hypersensitivity - heterogeneity in practice and a need for national guidelines - on behalf of British Society for Allergy and Clinical Immunology (BSACI).

    PubMed

    Richter, A G; Nasser, S M; Krishna, M T

    2013-08-01

    Beta lactams (BL) are the most widely prescribed antibiotics in the UK and the commonest cause of hypersensitivity reactions. There are no UK guidelines for BL testing and the most relevant guidelines were devised by the European Network for Drug Allergy (ENDA) on behalf of the European Academy of Allergy and Clinical Immunology. Delivery of allergy services differs across Europe, so this survey was designed to investigate how closely UK practice adhered to these guidelines. An online survey, using surveymonkey.com software, was sent to all consultants offering an allergy service in the UK and who were members of either BSACI or 'Travellers' (Immunology consultant group). The response rate was 48% (n=81/165) and BL allergy testing was undertaken by 78% of respondents. All responders requested SsIgE, although four responders stated they rarely requested. Skin testing was undertaken by 87% of respondents who perform beta lactam testing with 17% undertaking skin prick testing (SPT) only, 77% SPT followed by intra-dermal testing (IDT) if the former were negative or indeterminate and 6% SPT and IDT in all cases. The drugs, doses and protocols for skin testing varied considerably. Drug provocation testing was undertaken by 87% of respondents who undertake beta lactam testing with significant heterogeneity in protocols. Respondents that investigated ≤ 20 patients per year demonstrated lower adherence to ENDA recommendations compared to those who saw > 20. Following positive testing, 79% advised avoidance of all penicillins only and the remainder advised additional drug avoidance. This survey revealed variation in the investigation and management of BL hypersensitivity in the UK with some centres reporting procedures that could potentially put patients at risk of anaphylaxis if allergy was falsely excluded. This survey highlights an urgent need for evidence based national guidelines and standardisation of practice. © 2013 John Wiley & Sons Ltd.

  5. Household cleaning product-related injuries treated in US emergency departments in 1990-2006.

    PubMed

    McKenzie, Lara B; Ahir, Nisha; Stolz, Uwe; Nelson, Nicolas G

    2010-09-01

    The goal was to examine comprehensively the patterns and trends of household cleaning product-related injuries among children treated in US emergency departments. Through use of the National Electronic Injury Surveillance System database, cases of unintentional, nonfatal, household cleaning product-related injuries were selected by using product codes for drain cleaners, ammonia, metal polishes/tarnish removers, turpentine, dishwasher detergents, acids, swimming pool chemicals, oven cleaners, pine oil cleaners/disinfectants, laundry soaps/detergents, toilet bowl products, abrasive cleaners, general-purpose household cleaners, noncosmetic bleaches, windshield wiper fluids, caustic agents, lye, wallpaper cleaners, room deodorizers/fresheners, spot removers, and dishwashing liquids. Products were categorized according to major toxic ingredients, mode of action, and exposure. An estimated 267 269 childrenhousehold cleaning product-related injuries. The number of injuries attributable to household cleaning product exposure decreased 46.0% from 22 141 in 1990 to 11 964 in 2006. The product most-commonly associated with injury was bleach (37.1%). Children 1 to 3 years of age accounted for 72.0% of cases. The primary mechanism of injury was ingestion (62.7%). The most common source or container was spray-bottles (40.1%). Although rates of household cleaner-related injuries from regular bottles or original containers and kitchenware decreased during the study period, spray-bottle injury rates showed no decrease. Although national rates of household cleaning product-related injuries in children decreased significantly over time, the number of injuries remains high.

  6. Procuring interoperability at the expense of usability: a case study of UK National Programme for IT assurance process.

    PubMed

    Krause, Paul; de Lusignan, Simon

    2010-01-01

    The allure of interoperable systems is that they should improve patient safety and make health services more efficient. The UK's National Programme for IT has made great strides in achieving interoperability; through linkage to a national electronic spine. However, there has been criticism of the usability of the applications in the clinical environment. Analysis of the procurement and assurance process to explore whether they predetermine usability. Processes separate developers from users, and test products against theoretical assurance models of use rather than simulate or pilot in a clinical environment. The current process appears to be effective for back office systems and high risk applications, but too inflexible for developing applications for the clinical setting. For clinical applications agile techniques are more appropriate. Usability testing should become an integrated part of the contractual process and be introduced earlier in the development process.

  7. Risk for household safety hazards: Socioeconomic and sociodemographic factors.

    PubMed

    Mayes, Sunnye; Roberts, Michael C; Stough, Cathleen Odar

    2014-12-01

    Many unintentional injuries to young children occur in the home. The current study examines the relation between family socioeconomic and sociodemographic factors and risk factors for home injury. Presence of household hazards was examined in 80 families with toddler-aged children. Parental ability to identify household hazards in pictures was also assessed. ANOVAs and Pearson product-moment correlations examined the relationship between presence of household hazards, knowledge to identify hazards, and factors of yearly family income, parental age, parental education, parental marital status, child ethnicity, and the number of children living in the home. A greater number of hazards were found in the homes of both the lowest and highest income families, but poorer knowledge to identify household hazards was found only among parents of the lowest income families and younger parents. Across family socioeconomic status, parent knowledge of hazards was related to observed household hazards. The relationship between family income and risk for injury is complex, and children of both lower and higher SES families may be at risk for injury. While historically particular focus has been placed on risk for injury among children in low income families, injury prevention efforts should target reducing presence of household hazards in both high and low SES families. Copyright © 2014 National Safety Council and Elsevier Ltd. Published by Elsevier Ltd. All rights reserved.

  8. Spirituality and Health Education: A National Survey of Academic Leaders UK.

    PubMed

    Culatto, A; Summerton, C B

    2015-12-01

    Whole person care is deemed important within UK medical practice and is therefore fundamental in education. However, spirituality is an aspect of this often neglected. Confusion and discomfort exists regarding how care relating to issues of spirituality and health (S&H) should be delivered. Different interpretations have even led to disciplinary action with professionals seeking to address these needs [ http://www.telegraph.co.uk/health/healthnews/4409168/Nurse-suspended-for-offering-to-prayfor-patients-recovery.html ]. Previous research shows 45% of patients want spiritual needs to be addressed within their care (Jackson and Summerton 2008). Two-thirds of healthcare professionals want to do this. However, lack of knowledge is a significant barrier (Moynihan 2008). Little is known regarding how Medical schools address S&H, only one limited study exists in the literature (Koenig et al. in Int J Psychiat Med 40: 391-8, 2010). Thirty-two UK educational institutions were surveyed. The chosen survey was compiled by Koenig and Meador (Spirituality and Health in Education and Researc. Duke University, Durham, 2008). Fifty-nine academics were contacted across UK medical schools, and the response rate was 57.6%. Statistical analysis was performed using SPSS 16.0. 5.6% institutions provide required and dedicated S&H teaching, 63.4% provided it as an integrated component. Nearly 40% felt staff were not adequately trained to teach S&H but welcomed opportunities for training. S&H is given value in undergraduate education but with little evidence of formal teaching. Institutions feel that this area is addressed within other topic delivery, although previous studies have shown integrating S&H with PBL leads to poor clinical performance (Musick et al. in Acad Psychiatry 27(2):67-73, 2003). Seminars or lectures are students' preferred methods of learning (Guck and Kavan in Med Teach 28(8):702-707, 2006). Further consideration should be given towards S&H delivery and training for

  9. The Household School as Life-Span Learning Center.

    ERIC Educational Resources Information Center

    Warnat, Winifred I.

    A constructive, effective, and realistic national educational policy should be established which takes into account the contributions of the household school to individual learning in areas of life roles, feelings, values formation, and behavior development. The adversary relationship between formal educational institutions and the family will be…

  10. Leadership and management in UK medical school curricula.

    PubMed

    Jefferies, Richard; Sheriff, Ibrahim H N; Matthews, Jacob H; Jagger, Olivia; Curtis, Sarah; Lees, Peter; Spurgeon, Peter C; Fountain, Daniel Mark; Oldman, Alex; Habib, Ali; Saied, Azam; Court, Jessica; Giannoudi, Marilena; Sayma, Meelad; Ward, Nicholas; Cork, Nick; Olatokun, Olamide; Devine, Oliver; O'Connell, Paul; Carr, Phoebe; Kotronias, Rafail Angelos; Gardiner, Rebecca; Buckle, Rory T; Thomson, Ross J; Williams, Sarah; Nicholson, Simon J; Goga, Usman

    2016-10-10

    Purpose Although medical leadership and management (MLM) is increasingly being recognised as important to improving healthcare outcomes, little is understood about current training of medical students in MLM skills and behaviours in the UK. The paper aims to discuss these issues. Design/methodology/approach This qualitative study used validated structured interviews with expert faculty members from medical schools across the UK to ascertain MLM framework integration, teaching methods employed, evaluation methods and barriers to improvement. Findings Data were collected from 25 of the 33 UK medical schools (76 per cent response rate), with 23/25 reporting that MLM content is included in their curriculum. More medical schools assessed MLM competencies on admission than at any other time of the curriculum. Only 12 schools had evaluated MLM teaching at the time of data collection. The majority of medical schools reported barriers, including overfilled curricula and reluctance of staff to teach. Whilst 88 per cent of schools planned to increase MLM content over the next two years, there was a lack of consensus on proposed teaching content and methods. Research limitations/implications There is widespread inclusion of MLM in UK medical schools' curricula, despite the existence of barriers. This study identified substantial heterogeneity in MLM teaching and assessment methods which does not meet students' desired modes of delivery. Examples of national undergraduate MLM teaching exist worldwide, and lessons can be taken from these. Originality/value This is the first national evaluation of MLM in undergraduate medical school curricula in the UK, highlighting continuing challenges with executing MLM content despite numerous frameworks and international examples of successful execution.

  11. Household food insecurity, diabetes and hypertension among Mexican adults: results from Ensanut 2012.

    PubMed

    Pérez-Escamilla, Rafael; Villalpando, Salvador; Shamah-Levy, Teresa; Méndez-Gómez Humarán, Ignacio

    2014-01-01

    To examine the independent association of household food insecurity (HFI) with diabetes and hypertension in a nationally representative cross-sectional sample from Mexico. We assessed the association between HFI and self-reported doctor diagnosed diabetes and hypertension among 32 320 adult individuals using multiple logistic regression. HFI was measured using an adapted version for Mexico of the Latin American and Caribbean Food Security Scale (ELCSA). HFI was a risk factor for diabetes among women but not men and for hypertension among both genders. Diabetes odds were higher by 31, 67 and 48%, among women living in mild, moderate, and severe food-insecure (vs. food-secure) households, respectively. Living in moderate to severe food-insecure (vs. food-secure) households was associated with hypertension odds that were 28 and 32% higher, respectively. Decreasing HFI may help improve public health and national development in Mexico.

  12. Utilisation of preventative health check-ups in the UK: findings from individual-level repeated cross-sectional data from 1992 to 2008

    PubMed Central

    Labeit, Alexander; Peinemann, Frank; Baker, Richard

    2013-01-01

    Objectives To analyse and compare the determinants of screening uptake for different National Health Service (NHS) health check-ups in the UK. Design Individual-level analysis of repeated cross-sectional surveys with balanced panel data. Setting The UK. Participants Individuals taking part in the British Household Panel Survey (BHPS), 1992–2008. Outcome measure Uptake of NHS health check-ups for cervical cancer screening, breast cancer screening, blood pressure checks, cholesterol tests, dental screening and eyesight tests. Methods Dynamic panel data models (random effects panel probit with initial conditions). Results Having had a health check-up 1 year before, and previously in accordance with the recommended schedule, was associated with higher uptake of health check-ups. Individuals who visited a general practitioner (GP) had a significantly higher uptake in 5 of the 6 health check-ups. Uptake was highest in the recommended age group for breast and cervical cancer screening. For all health check-ups, age had a non-linear relationship. Lower self-rated health status was associated with increased uptake of blood pressure checks and cholesterol tests; smoking was associated with decreased uptake of 4 health check-ups. The effects of socioeconomic variables differed for the different health check-ups. Ethnicity did not have a significant influence on any health check-up. Permanent household income had an influence only on eyesight tests and dental screening. Conclusions Common determinants for having health check-ups are age, screening history and a GP visit. Policy interventions to increase uptake should consider the central role of the GP in promoting screening examinations and in preserving a high level of uptake. Possible economic barriers to access for prevention exist for dental screening and eyesight tests, and could be a target for policy intervention. Trial registration This observational study was not registered. PMID:24366576

  13. Age- and sex-specific relationships between household income, education, and diabetes mellitus in Korean adults: the Korea National Health and Nutrition Examination Survey, 2008-2010.

    PubMed

    Kim, So-Ra; Han, Kyungdo; Choi, Jin-Young; Ersek, Jennifer; Liu, Junxiu; Jo, Sun-Jin; Lee, Kang-Sook; Yim, Hyeon Woo; Lee, Won-Chul; Park, Yong Gyu; Lee, Seung-Hwan; Park, Yong-Moon

    2015-01-01

    To investigate the effects of age and sex on the relationship between socioeconomic status (SES) and the prevalence and control status of diabetes mellitus (DM) in Korean adults. Data came from 16,175 adults (6,951 men and 9,227 women) over the age of 30 who participated in the 2008-2010 Korea National Health and Nutrition Examination Survey. SES was measured by household income or education level. The adjusted odds ratios (ORs) and corresponding 95% confidence intervals (95% CI) for the prevalence or control status of diabetes were calculated using multiple logistic regression analyses across household income quartiles and education levels. The household income-DM and education level-DM relationships were significant in younger age groups for both men and women. The adjusted ORs and 95% CI for diabetes were 1.51 (0.97, 2.34) and 2.28 (1.29, 4.02) for the lowest vs. highest quartiles of household income and education level, respectively, in women younger than 65 years of age (both P for linear trend < 0.05 with Bonferroni adjustment). The adjusted OR and 95% CI for diabetes was 2.28 (1.53, 3.39) for the lowest vs. highest quartile of household income in men younger than 65 (P for linear trend < 0.05 with Bonferroni adjustment). However, in men and women older than 65, no associations were found between SES and the prevalence of DM. No significant association between SES and the status of glycemic control was detected. We found age- and sex-specific differences in the relationship of household income and education with the prevalence of DM in Korea. DM preventive care is needed for groups with a low SES, particularly in young or middle-aged populations.

  14. Age- and Sex-Specific Relationships between Household Income, Education, and Diabetes Mellitus in Korean Adults: The Korea National Health and Nutrition Examination Survey, 2008-2010

    PubMed Central

    Kim, So-Ra; Han, Kyungdo; Choi, Jin-Young; Ersek, Jennifer; Liu, Junxiu; Jo, Sun-Jin; Lee, Kang-Sook; Yim, Hyeon Woo; Lee, Won-Chul; Park, Yong Gyu; Lee, Seung-Hwan; Park, Yong-Moon

    2015-01-01

    Background To investigate the effects of age and sex on the relationship between socioeconomic status (SES) and the prevalence and control status of diabetes mellitus (DM) in Korean adults. Methods Data came from 16,175 adults (6,951 men and 9,227 women) over the age of 30 who participated in the 2008-2010 Korea National Health and Nutrition Examination Survey. SES was measured by household income or education level. The adjusted odds ratios (ORs) and corresponding 95% confidence intervals (95% CI) for the prevalence or control status of diabetes were calculated using multiple logistic regression analyses across household income quartiles and education levels. Results The household income-DM and education level-DM relationships were significant in younger age groups for both men and women. The adjusted ORs and 95% CI for diabetes were 1.51 (0.97, 2.34) and 2.28 (1.29, 4.02) for the lowest vs. highest quartiles of household income and education level, respectively, in women younger than 65 years of age (both P for linear trend < 0.05 with Bonferroni adjustment). The adjusted OR and 95% CI for diabetes was 2.28 (1.53, 3.39) for the lowest vs. highest quartile of household income in men younger than 65 (P for linear trend < 0.05 with Bonferroni adjustment). However, in men and women older than 65, no associations were found between SES and the prevalence of DM. No significant association between SES and the status of glycemic control was detected. Conclusions We found age- and sex-specific differences in the relationship of household income and education with the prevalence of DM in Korea. DM preventive care is needed for groups with a low SES, particularly in young or middle-aged populations. PMID:25622031

  15. Catastrophic health expenditures and its inequality in elderly households with chronic disease patients in China.

    PubMed

    Wang, Zhonghua; Li, Xiangjun; Chen, Mingsheng

    2015-01-20

    Although numerous studies examine catastrophic health expenditures (CHE) worldwide, most focus on whole populations rather than specific vulnerable groups. This study analyzes the extent, associated factors and inequality of CHE in elderly household with chronic disease patients in China. Data were obtained from a nationally representative elderly household survey-the China Health and Retirement Longitudinal Study-that was conducted by the National School of Development of Peking University in 2011. An elderly household with chronic disease patients is defined by ≥ 1 chronic disease patient who is ≥ 45 years of age. CHE was measured according to the proportion of out-of-pocket health payments to non-food household expenditures. The associated factors of CHE were estimated using ordinary least square and logistic regression modeling. CHE inequality was measured according to the concentration index (CI) and its decomposition. CHE incidence and intensity were relatively high among elderly households with chronic disease patients. The main associated factors of CHE include household size, having members > 65 years, having members with ≥ 2 chronic diseases, per capita income, and elderly household members demonstrating healthcare-seeking behaviors. Healthcare insurance did not significantly affect CHE risk. Disproportionate concentration of CHE was noted among elderly households, and poor elderly households demonstrated a higher probability of experiencing CHE. Factors such as household size, per capita income, having members > 65 years, and having members with ≥ 2 chronic diseases are major and positive contributors to CHE inequality. Some inpatient and outpatient services are negatively contributed to CHE inequality,suggesting that the unequal usage of such services reduces CHE inequality among elderly households with chronic disease patients. Policy efforts should focus on improving financial protection and relieving the economic

  16. Examining effects of food insecurity and food choices on health outcomes in households in poverty.

    PubMed

    Lombe, Margaret; Nebbitt, Von Eugene; Sinha, Aakanksha; Reynolds, Andrew

    2016-07-01

    Evidence documenting effects of food assistance programs, household food insecurity, and nutrition knowledge on health outcomes is building. Using data from a sub-sample of adults who are 185% of the poverty line from the 2007-2008 National Health and Nutrition Examination Survey (N = 2,171), we examine whether household food insecurity, food stamp take-up, and use of informal food supports are associated with health risk among low-income households. Findings indicate that while nutrition knowledge provides protection against health risk in food secure households, the health benefits of nutrition knowledge were not evident in food insecure households. We discuss these findings in light of current policy and practice interventions that recognize the importance of providing healthy, affordable food options for food insecure households.

  17. Household Coverage with Adequately Iodized Salt Varies Greatly between Countries and by Residence Type and Socioeconomic Status within Countries: Results from 10 National Coverage Surveys123

    PubMed Central

    Knowles, Jacky M; Garrett, Greg S; Gorstein, Jonathan; Kupka, Roland; Situma, Ruth; Yadav, Kapil; Yusufali, Rizwan; Pandav, Chandrakant; Aaron, Grant J

    2017-01-01

    Background: Household coverage with iodized salt was assessed in 10 countries that implemented Universal Salt Iodization (USI). Objective: The objective of this paper was to summarize household coverage data for iodized salt, including the relation between coverage and residence type and socioeconomic status (SES). Methods: A review was conducted of results from cross-sectional multistage household cluster surveys with the use of stratified probability proportional to size design in Bangladesh, Ethiopia, Ghana, India, Indonesia, Niger, the Philippines, Senegal, Tanzania, and Uganda. Salt iodine content was assessed with quantitative methods in all cases. The primary indicator of coverage was percentage of households that used adequately iodized salt, with an additional indicator for salt with some added iodine. Indicators of risk were SES and residence type. We used 95% CIs to determine significant differences in coverage. Results: National household coverage of adequately iodized salt varied from 6.2% in Niger to 97.0% in Uganda. For salt with some added iodine, coverage varied from 52.4% in the Philippines to 99.5% in Uganda. Coverage with adequately iodized salt was significantly higher in urban than in rural households in Bangladesh (68.9% compared with 44.3%, respectively), India (86.4% compared with 69.8%, respectively), Indonesia (59.3% compared with 51.4%, respectively), the Philippines (31.5% compared with 20.2%, respectively), Senegal (53.3% compared with 19.0%, respectively), and Tanzania (89.2% compared with 57.6%, respectively). In 7 of 8 countries with data, household coverage of adequately iodized salt was significantly higher in high- than in low-SES households in Bangladesh (58.8% compared with 39.7%, respectively), Ghana (36.2% compared with 21.5%, respectively), India (80.6% compared with 70.5%, respectively), Indonesia (59.9% compared with 45.6%, respectively), the Philippines (39.4% compared with 17.3%, respectively), Senegal (50.7% compared

  18. The epidemiology, healthcare and societal burden and costs of asthma in the UK and its member nations: analyses of standalone and linked national databases.

    PubMed

    Mukherjee, Mome; Stoddart, Andrew; Gupta, Ramyani P; Nwaru, Bright I; Farr, Angela; Heaven, Martin; Fitzsimmons, Deborah; Bandyopadhyay, Amrita; Aftab, Chantelle; Simpson, Colin R; Lyons, Ronan A; Fischbacher, Colin; Dibben, Christopher; Shields, Michael D; Phillips, Ceri J; Strachan, David P; Davies, Gwyneth A; McKinstry, Brian; Sheikh, Aziz

    2016-08-29

    There are a lack of reliable data on the epidemiology and associated burden and costs of asthma. We sought to provide the first UK-wide estimates of the epidemiology, healthcare utilisation and costs of asthma. We obtained and analysed asthma-relevant data from 27 datasets: these comprised national health surveys for 2010-11, and routine administrative, health and social care datasets for 2011-12; 2011-12 costs were estimated in pounds sterling using economic modelling. The prevalence of asthma depended on the definition and data source used. The UK lifetime prevalence of patient-reported symptoms suggestive of asthma was 29.5 % (95 % CI, 27.7-31.3; n = 18.5 million (m) people) and 15.6 % (14.3-16.9, n = 9.8 m) for patient-reported clinician-diagnosed asthma. The annual prevalence of patient-reported clinician-diagnosed-and-treated asthma was 9.6 % (8.9-10.3, n = 6.0 m) and of clinician-reported, diagnosed-and-treated asthma 5.7 % (5.7-5.7; n = 3.6 m). Asthma resulted in at least 6.3 m primary care consultations, 93,000 hospital in-patient episodes, 1800 intensive-care unit episodes and 36,800 disability living allowance claims. The costs of asthma were estimated at least £1.1 billion: 74 % of these costs were for provision of primary care services (60 % prescribing, 14 % consultations), 13 % for disability claims, and 12 % for hospital care. There were 1160 asthma deaths. Asthma is very common and is responsible for considerable morbidity, healthcare utilisation and financial costs to the UK public sector. Greater policy focus on primary care provision is needed to reduce the risk of asthma exacerbations, hospitalisations and deaths, and reduce costs.

  19. Diabetes UK Position Statement. Competency frameworks in diabetes.

    PubMed

    Simmons, D; Deakin, T; Walsh, N; Turner, B; Lawrence, S; Priest, L; George, S; Vanterpool, G; McArdle, J; Rylance, A; Terry, G; Little, P

    2015-05-01

    The quality, skills and attitudes of staff working in the healthcare system are central to multidisciplinary learning and working, and to the delivery of the quality of care patients expect. Patients want to know that the staff supporting them have the right knowledge and attitudes to work in partnership, particularly for conditions such as diabetes where 95% of all care is delivered by the person with diabetes themselves. With the current changes in the NHS structures in England, and the potential for greater variation in the types of 'qualified provider', along with the recent scandal at Mid-Staffordshire Hospital, staff need to be shown to be competent and named/accredited or recognized as such. This will help to restore faith in an increasingly devolved delivery structure. The education and validation of competency needs to be consistently delivered and assured to ensure standards are maintained for different roles and disciplines across each UK nation. Diabetes UK recommends that all NHS organizations prioritize healthcare professional education, training and competency through the implementation of a National Diabetes Competency Framework and the phased approach to delivery to address this need. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

  20. SSTL UK-DMC SLIM-6 data quality assessment

    USGS Publications Warehouse

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

    2009-01-01

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

  1. SIBLING CONFLICTS IN FULL- AND HALF-SIBLING HOUSEHOLDS IN THE UK.

    PubMed

    Tanskanen, Antti O; Danielsbacka, Mirkka; Jokela, Markus; Rotkirch, Anna

    2017-01-01

    Sibling relations are by nature ambivalent with high levels of both altruistic helping and competition. Higher relatedness is often assumed to reduce the occurrence of conflicts between siblings, but evidence of this has been scarce and mixed. Siblings typically compete over resources and parental attention, and parental constellations vary with sibship types. Since full-siblings compete over the same two biological parents, while half-siblings have only one shared biological parent and often a higher number of parents overall, it is hypothesized that conflicts are more common between full- than half-siblings. This study tested this assumption using the British Millennium Cohort Study (n=7527 children at age 11). Conflicts were measured as children's reports of how much siblings picked on and hurt each other. Households with full-siblings only, maternal half-siblings only, and both full- and maternal half-siblings were compared. The results show that children who were living with only their full-siblings were more likely to experience sibling conflicts compared with children living with their maternal half-siblings only. This was the case also after controlling for several potentially confounding variables. The results suggest that differential access to parental resources of available biological and step-parents may explain the higher amount of sibling conflict between full- compared with maternal half-siblings.

  2. IQ AND SOCIOECONOMIC DEVELOPMENT ACROSS REGIONS OF THE UK.

    PubMed

    Carl, Noah

    2016-05-01

    Cross-regional correlations between average IQ and socioeconomic development have been documented in many different countries. This paper presents new IQ estimates for the twelve regions of the UK. These are weakly correlated (r=0.24) with the regional IQs assembled by Lynn (1979). Assuming the two sets of estimates are accurate and comparable, this finding suggests that the relative IQs of different UK regions have changed since the 1950s, most likely due to differentials in the magnitude of the Flynn effect, the selectivity of external migration, the selectivity of internal migration or the strength of the relationship between IQ and fertility. The paper provides evidence for the validity of the regional IQs by showing that IQ estimates for UK nations (England, Scotland, Wales and Northern Ireland) derived from the same data are strongly correlated with national PISA scores (r=0.99). It finds that regional IQ is positively related to income, longevity and technological accomplishment; and is negatively related to poverty, deprivation and unemployment. A general factor of socioeconomic development is correlated with regional IQ at r=0.72.

  3. Head Lice in Norwegian Households: Actions Taken, Costs and Knowledge

    PubMed Central

    Rukke, Bjørn Arne; Birkemoe, Tone; Soleng, Arnulf; Lindstedt, Heidi Heggen; Ottesen, Preben

    2012-01-01

    Introduction Head lice infestations cause distress in many families. A well-founded strategy to reduce head lice prevalence must shorten the infectious period of individual hosts. To develop such a strategy, information about the actions taken (inspection, treatment and informing others about own infestations), level of knowledge and costs is needed. The present study is the first to consider all these elements combined. Materials and Methods A questionnaire was answered by 6203 households from five geographically separated municipalities in Norway. Results 94% of the households treated members with pediculicides when head lice were discovered. Nearly half of the households checked biannually or not at all. Previous occurrence of head lice and multiple children in a household improved both checking frequency and method. More than 90% of the households informed close contacts about their own pediculosis. Direct costs of pediculosis were low (less than €6.25 yearly) for 70% of the households, but the ability to pay for pediculicides decreased with the number of head lice infestations experienced. One in three households kept children from school because of pediculosis. Other widespread misconceptions, such as that excessive cleaning is necessary to fight head lice, may also add unnecessary burden to households. School affiliation had a significant effect on checking frequency and method, knowledge and willingness to inform others about own pediculosis. Conclusions Increased checking frequencies appear to be the most important element to reduce head lice prevalence in Norway and should be a primary focus of future strategies. National campaigns directed through schools to individual households, might be an important tool to achieve this goal. In addition to improving actions taken, such campaigns should also provide accurate information to reduce costs and enhance the level of knowledge about head lice in households. PMID:22393437

  4. Head lice in Norwegian households: actions taken, costs and knowledge.

    PubMed

    Rukke, Bjørn Arne; Birkemoe, Tone; Soleng, Arnulf; Lindstedt, Heidi Heggen; Ottesen, Preben

    2012-01-01

    Head lice infestations cause distress in many families. A well-founded strategy to reduce head lice prevalence must shorten the infectious period of individual hosts. To develop such a strategy, information about the actions taken (inspection, treatment and informing others about own infestations), level of knowledge and costs is needed. The present study is the first to consider all these elements combined. A questionnaire was answered by 6203 households from five geographically separated municipalities in Norway. 94% of the households treated members with pediculicides when head lice were discovered. Nearly half of the households checked biannually or not at all. Previous occurrence of head lice and multiple children in a household improved both checking frequency and method. More than 90% of the households informed close contacts about their own pediculosis. Direct costs of pediculosis were low (less than €6.25 yearly) for 70% of the households, but the ability to pay for pediculicides decreased with the number of head lice infestations experienced. One in three households kept children from school because of pediculosis. Other widespread misconceptions, such as that excessive cleaning is necessary to fight head lice, may also add unnecessary burden to households. School affiliation had a significant effect on checking frequency and method, knowledge and willingness to inform others about own pediculosis. Increased checking frequencies appear to be the most important element to reduce head lice prevalence in Norway and should be a primary focus of future strategies. National campaigns directed through schools to individual households, might be an important tool to achieve this goal. In addition to improving actions taken, such campaigns should also provide accurate information to reduce costs and enhance the level of knowledge about head lice in households.

  5. Healthcare financing in Syria: satisfaction with the current system and the role of national health insurance--a qualitative study of householders' views.

    PubMed

    Mershed, Mania; Busse, Reinhard; van Ginneken, Ewout

    2012-01-01

    This study aims to identify the satisfaction with the current public health system and health benefit schemes, examine willingness to participate in national health insurance and review expectations and preferences of national health insurance. To this end, qualitative semi-structured interviews were carried out with 19 Syrian householders. Our results show that a need for health reform exists and that Syrian people are willing to support a national health insurance scheme if some key issues are properly addressed. Funding of the scheme is a major concern and should take into account the ability to pay and help the poor. In addition, waiting times should be shortened and sufficient coverage guaranteed. On the whole, the people would support a national health insurance with national pooling and purchasing under a public set-up, but important concerns of such a system regarding corruption and inefficiency were voiced too. Installing a quasi non-governmental organisation as manager of the insurance system under the stewardship of the Ministry of Health could provide a compromise acceptable to the people. Copyright © 2012 John Wiley & Sons, Ltd.

  6. A Water Grid for the UK

    NASA Astrophysics Data System (ADS)

    Leathard, A.; Fowler, H. J.; Kilsby, C. G.

    2009-04-01

    Anthropogenically aggravated climate change associated with intensive expansion of the global economy has increased the demand for water whilst simultaneously altering natural variability in its distribution, straining water resources unsustainably and inequitably in many parts of the world, increasing drought risk, and encouraging decision-makers to reconsider the security of water supply. Indeed, in the absence of additional resource development, contemporary planning forecasts imply increased water stress across much of the United Kingdom. The regulatory authorities of the UK currently promote increased efficiency of water delivery and consumption combined with a portfolio of financial instruments as a means of reducing water stress, maintaining present levels of consumer service without significant further exploitation of the environment. Despite an increasingly sophisticated understanding of climate change and its effects, significant uncertainty remains in the quantification of its impacts on the water sector, and questions persist as to the effectiveness of such demand management measures compared to that of more traditional infrastructure improvements. Faced with possible futures provided for by detrimentally over-stressed resources, what opportunities remain for future strategic development in the UK? Is there a single national strategy that is both politically and socially acceptable? This ongoing study aims to evolve robust national adaptation strategies by quantifying the projected impacts of climate change across mainland UK using multi-model and perturbed-physics ensembles of projected future climate, encapsulating uncertainties in a scenario-driven integrated water resources model incorporating socio-economic elements.

  7. Meeting UK dietary recommendations is associated with higher estimated consumer food costs: an analysis using the National Diet and Nutrition Survey and consumer expenditure data, 2008-2012.

    PubMed

    Jones, Nicholas Rv; Tong, Tammy Yn; Monsivais, Pablo

    2018-04-01

    To test whether diets achieving recommendations from the UK's Scientific Advisory Committee on Nutrition (SACN) were associated with higher monetary costs in a nationally representative sample of UK adults. A cross-sectional study linking 4 d diet diaries in the National Diet and Nutrition Survey (NDNS) to contemporaneous food price data from a market research firm. The monetary cost of diets was assessed in relation to whether or not they met eight food- and nutrient-based recommendations from SACN. Regression models adjusted for potential confounding factors. The primary outcome measure was individual dietary cost per day and per 2000 kcal (8368 kJ). UK. Adults (n 2045) sampled between 2008 and 2012 in the NDNS. On an isoenergetic basis, diets that met the recommendations for fruit and vegetables, oily fish, non-milk extrinsic sugars, fat, saturated fat and salt were estimated to be between 3 and 17 % more expensive. Diets meeting the recommendation for red and processed meats were 4 % less expensive, while meeting the recommendation for fibre was cost-neutral. Meeting multiple targets was also associated with higher costs; on average, diets meeting six or more SACN recommendations were estimated to be 29 % more costly than isoenergetic diets that met no recommendations. Food costs may be a population-level barrier limiting the adoption of dietary recommendations in the UK. Future research should focus on identifying systems- and individual-level strategies to enable consumers achieve dietary recommendations without increasing food costs. Such strategies may improve the uptake of healthy eating in the population.

  8. The association between household poverty rates and tuberculosis case notification rates in Cambodia, 2010.

    PubMed

    Wong, Man Kai; Yadav, Rajendra-Prasad; Nishikiori, Nobuyuku; Eang, Mao Tan

    2013-01-01

    Poverty is a risk factor for tuberculosis (TB); it increases the risk of infection and active disease but limits diagnostic opportunities. The role of poverty in the stagnant case detection in Cambodia is unclear. This study aims to assess the relationship between district household poverty rates and sputum-positive TB case notification rates (CNRs) in Cambodia in 2010. Poisson regression models were used to calculate the relative risk of new sputum-positive TB CNR for Operational Districts (ODs) with different poverty rates using data from the National Centre for Tuberculosis and Leprosy Control and the National Committee for SubNational Democratic Development. Models were adjusted for other major covariates and a geographical information system was used to examine the spatial distribution of these covariates in the country. The univariate model showed a positive association between household poverty rates and sputum-positive TB CNRs. However, in multivariate models, after adjusting for major covariates, household poverty rates showed a significantly negative association with sputum-positive TB CNRs (relative risk [RR] = 0.95 per 5% increase in poverty rate). The negative association was stronger among males than females (RR = 0.93 versus 0.96 per 5% increase in poverty rate). Similar spatial patterns were observed between household poverty rates and other covariates, particularly OD population density. Household poverty rate is associated with a decrease in sputum-positive TB CNR in Cambodia, particularly in men. The potential of combining surveillance data and socioeconomic variables should be explored further to provide more insights for TB control programme planning.

  9. Household food production is positively associated with dietary diversity and intake of nutrient-dense foods for older preschool children in poorer families: Results from a nationally-representative survey in Nepal.

    PubMed

    Mulmi, Prajula; Masters, William A; Ghosh, Shibani; Namirembe, Grace; Rajbhandary, Ruchita; Manohar, Swetha; Shrestha, Binod; West, Keith P; Webb, Patrick

    2017-01-01

    Nutrition-sensitive interventions supporting enhanced household food production have potential to improve child dietary quality. However, heterogeneity in market access may cause systematic differences in program effectiveness depending on household wealth and child age. Identifying these effect modifiers can help development agencies specify and target their interventions. This study investigates mediating effects of household wealth and child age on links between farm production and child diets, as measured by production and intake of nutrient-dense food groups. Two rounds (2013 and 2014) of nationally representative survey data (n = 5,978 observations) were used to measure production and children's dietary intake, as well as a household wealth index and control variables, including breastfeeding. Novel steps used include measuring production diversity in terms of both species grown and food groups grown, as well as testing for mediating effects of family wealth and age of child. We find significant associations between child dietary diversity and agricultural diversity in terms of diversity of food groups and of species grown, especially for older children in poorer households, and particularly for fruits and vegetables, dairy and eggs. With each additional food group produced, log-odds of meeting minimum dietary diversity score (≥4) increase by 0.25 (p = 0.01) for children aged 24-59 months. For younger children aged 18-23 months there is a similar effect size but only in the poorest two quintiles of household wealth, and for infants 6-18 months we find no correlation between production and intake in most models. Child dietary intake is associated with the composition of farm production, most evident among older preschool children and in poorer households. To improve the nutrition of infants, other interventions are needed; and for relatively wealthier households, own farm production may displace market purchases, which could attenuate the impact of household

  10. Household catastrophic health expenditures: a comparative analysis of twelve Latin American and Caribbean Countries.

    PubMed

    Knaul, Felicia Marie; Wong, Rebeca; Arreola-Ornelas, Héctor; Méndez, Oscar

    2011-01-01

    Compare patterns of catastrophic health expenditures in 12 countries in Latin America and the Caribbean. Prevalence of catastrophic expenses was estimated uniformly at the household level using household surveys. Two types of prevalence indicators were used based on out-of-pocket health expense: a) relative to an international poverty line, and b) relative to the household's ability to pay net of their food basket. Ratios of catastrophic expenditures were estimated across subgroups defined by economic and social variables. The percent of households with catastrophic health expenditures ranged from 1 to 25% in the twelve countries. In general, rural residence, lowest quintile of income, presence of older adults, and lack of health insurance in the household are associated with higher propensity of catastrophic health expenditures. However, there is vast heterogeneity by country. Cross national studies may serve to examine how health systems contribute to the social protection of Latin American households.

  11. Evaluating the health benefits and cost-effectiveness of the radon remediation programme in domestic properties in Northamptonshire, UK.

    PubMed

    Denman, Antony; Groves-Kirkby, Christopher; Coskeran, Thomas; Parkinson, Steven; Phillips, Paul; Tornberg, Roges

    2005-08-01

    Although previous analysis of health benefits and cost-effectiveness of radon remediation in a series of houses in Northamptonshire suggested that testing and remediation was justified, recent results indicate fewer predicted affected houses than previously assumed. Despite numerous awareness campaigns, limited numbers of householders have tested their homes, only a minority of affected householders have remediated, and those most at risk generally fail to remediate. Moreover, a recent survey shows a wide range of public perception of radon risk, not significantly influenced by public health campaigns. These observations impact our previous analysis, which has been reviewed in the light of these observations. Following the declaration of Northamptonshire, UK, as a radon Affected Area in 1992, a series of public awareness campaigns encouraged householders to assess domestic radon levels and, if appropriate, to take action to reduce them. Despite these awareness campaigns, however, only moderate numbers of householders have taken remediatory action. The costs of such remedial work in a series of domestic properties in Northamptonshire, the radon level reduction achieved, and the resultant heath benefit to the residents, have been the subject of study by our group for some years. Previous analysis, based on estimates of the total number of affected houses derived from the National Radiological Protection Board (NRPB) test data for the area, suggested that a programme of testing and remediation in Northamptonshire could be justified. The NRPB has continued to initiate and to collate radon testing, and published further results in 2003. These results include revised predictions of the numbers of affected houses, now considered to be less than the numbers previously assumed. More recently, the availability of the European Community Radon Software (ECRS) has permitted calculation of individual, rather than population-average, risk, demonstrating that those most at risk

  12. Case management of malaria fever in Cambodia: results from national anti-malarial outlet and household surveys

    PubMed Central

    2011-01-01

    Background Continued progress towards global reduction in morbidity and mortality due to malaria requires scale-up of effective case management with artemisinin-combination therapy (ACT). The first case of artemisinin resistance in Plasmodium falciparum was documented in western Cambodia. Spread of artemisinin resistance would threaten recent gains in global malaria control. As such, the anti-malarial market and malaria case management practices in Cambodia have global significance. Methods Nationally-representative household and outlet surveys were conducted in 2009 among areas in Cambodia with malaria risk. An anti-malarial audit was conducted among all public and private outlets with the potential to sell anti-malarials. Indicators on availability, price and relative volumes sold/distributed were calculated across types of anti-malarials and outlets. The household survey collected information about management of recent "malaria fevers." Case management in the public versus private sector, and anti-malarial treatment based on malaria diagnostic testing were examined. Results Most public outlets (85%) and nearly half of private pharmacies, clinics and drug stores stock ACT. Oral artemisinin monotherapy was found in pharmacies/clinics (9%), drug stores (14%), mobile providers (4%) and grocery stores (2%). Among total anti-malarial volumes sold/distributed nationally, 6% are artemisinin monotherapies and 72% are ACT. Only 45% of people with recent "malaria fever" reportedly receive a diagnostic test, and the most common treatment acquired is a drug cocktail containing no identifiable anti-malarial. A self-reported positive diagnostic test, particularly when received in the public sector, improves likelihood of receiving anti-malarial treatment. Nonetheless, anti-malarial treatment of reportedly positive cases is low among people who seek treatment exclusively in the public (61%) and private (42%) sectors. Conclusions While data on the anti-malarial market shows

  13. Simulating household travel study data in metropolitan areas : technical summary.

    DOT National Transportation Integrated Search

    2001-05-01

    The objectives of this study are: 1. To develop and validate a methodology for MPOs to synthesize household travel survey data using local sociodemographic characteristics in conjunction with a national source of simulated travel data. 2. To evalu...

  14. The millennium development goals and household energy requirements in Nigeria.

    PubMed

    Ibitoye, Francis I

    2013-01-01

    Access to clean and affordable energy is critical for the realization of the United Nations' Millennium Development Goals, or MDGs. In many developing countries, a large proportion of household energy requirements is met by use of non-commercial fuels such as wood, animal dung, crop residues, etc., and the associated health and environmental hazards of these are well documented. In this work, a scenario analysis of energy requirements in Nigeria's households is carried out to compare estimates between 2005 and 2020 under a reference scenario, with estimates under the assumption that Nigeria will meet the millennium goals. Requirements for energy under the MDG scenario are measured by the impacts on energy use, of a reduction by half, in 2015, (a) the number of household without access to electricity for basic services, (b) the number of households without access to modern energy carriers for cooking, and (c) the number of families living in one-room households in Nigeria's overcrowded urban slums. For these to be achieved, household electricity consumption would increase by about 41% over the study period, while the use of modern fuels would more than double. This migration to the use of modern fuels for cooking results in a reduction in the overall fuelwood consumption, from 5 GJ/capita in 2005, to 2.9 GJ/capita in 2015.

  15. Lebanese household carbon footprint: Measurements, analysis and challenges

    NASA Astrophysics Data System (ADS)

    Nasr, Rawad; Tall, Ibrahim; Nachabe, Nour; Chaaban, Farid

    2016-07-01

    The main purpose of this paper is to estimate the carbon footprint of a typical Lebanese household, and compare the results with international standards and trends. The estimation of this footprint will reflect the impact of the daily Lebanese household activities on the environment in terms of carbon dioxide emissions. The method used in estimating the carbon emissions is based on gathering the primary footprints from various household activities. Another proposed method that provides more accurate results is the estimation of emissions based on secondary footprint, which reflects the total emissions not only from the regular activities but also from a lifecycle perspective. Practical and feasible solutions were proposed to help reduce the amount of C02 emissions per household. This would lead to a better air quality, money savings, greenhouse gases emissions reduction and would ensure the sustainability and prosperity of future generations. A detailed survey was conducted in which the questions were focused mainly on energy, food, and transportation issues. The fourteen questions were addressed to one hundred families in different Lebanese regions coming from different social and economic backgrounds. This diversity would constitute a reflective sample of the actual Lebanese society, allowing us to extrapolate the gathered results on a national level.

  16. Women's participation in household decision-making and higher dietary diversity: findings from nationally representative data from Ghana.

    PubMed

    Amugsi, Dickson A; Lartey, Anna; Kimani, Elizabeth; Mberu, Blessing U

    2016-05-31

    Low-quality monotonous diet is a major problem confronting resource-constrained settings across the world. Starchy staple foods dominate the diets in these settings. This places the population, especially women of reproductive age, at a risk of micronutrients deficiencies. This study seeks to examine the association between women's decision-making autonomy and women's achievement of higher dietary diversity (DD) and determine the socio-demographic factors that can independently predict women's attainment of higher DD. The study used data from the 2008 Ghana Demographic and Health Survey. The participants comprised of 2262 women aged 15-49 years and who have complete dietary data. The DD score was derived from a 24-h recall of intake of foods from nine groups. The score was dichotomized into lower DD (DD ≤4) and higher (DD ≥5). Logistic regression was used to assess the association between women decision-making autonomy (final say on how to spend money, making household purchases, own health care, opinions on wife-beating, and sexual intercourse with husband) and the achievement of higher DD. The logistic regression models were adjusted for covariates at the individual and household levels. The analysis showed that women participation in decision-making regarding household purchases was significantly associated with higher DD, after adjusting for individual and household level covariates. The odds of achieving higher DD were higher among women who had a say in deciding household purchases, compared to women who did not have a say (OR = 1.74, 95 % CI = 1.24, 2.42). Women who had more than primary education were 1.6 times more likely to achieve higher DD, compared to those with no education (95 % CI = 1.12, 2.20). Compared to women who lived in polygamous households, those who lived in monogamous households had higher odds of achieving higher DD (OR = 1.42, 95 % CI = 1.04, 1.93). Net other covariates, women who have a say in making

  17. Obesity and household food insecurity: evidence from a sample of rural households in Malaysia.

    PubMed

    Shariff, Z Mohd; Khor, G L

    2005-09-01

    The study examined nutritional outcomes related to body fat accumulation of food insecurity among women from selected rural communities in Malaysia. Cross-sectional study. Rural communities (seven villages and two palm plantations) in a district with high percentage of welfare recipients. Malay (n = 140) and Indian (n = 60) women were interviewed and measured for demographic, socioeconomic, anthropometric, dietary and physical activity information. The women were measured for their body mass index and waist circumference (WC). Energy and nutrient intakes, food group intake and food variety score were analyzed from 24 h dietary recalls and food-frequency questionnaire. Daily physical activity of the women was examined as the number of hours spent in economic, domestic, leisure and sport activities. Using the Radimer/Cornell Hunger and Food Insecurity Instrument, 58% of the women reported some degree of food insecurity (household insecure 14%, adult insecure 9.5% and child hunger 34.5%). In general, food-insecure women had lower years of education, household income and income per capita, more children and mothers as housewives. More than 50% of food-insecure women were overweight and obese than women from food-secure households (38%). Similarly, more food-insecure women (32-47%) had at-risk WC (> or = 88 cm) than food-secure women (29%). Food-insecure women spent significantly more time in domestic and leisure activities than food-secure women. Overweight and abdominal adiposity among the women were associated with a number of independent variables, such as women as housewives, women with more children, larger household size, food insecurity, shorter time spent in economic activities, longer time spent in leisure activities and lower food variety score. After adjusting for factors that are related to both adiposity and food insecurity, women from food-insecure households were significantly more likely to have at-risk WC, but not obese. Among this sample of rural

  18. Unwanted childbearing and household food insecurity in the United States

    PubMed Central

    Patel, SA; Surkan, PJ

    2015-01-01

    Household food insecurity is a population health concern disproportionately affecting families with children in the United States. Unwanted childbearing may place unanticipated strain on families to meet basic needs, heightening the risk for household food insecurity. We investigated the association between mother’s and father’s report of unwanted childbearing and exposure to household food insecurity among children residing in two-parent households in the United States. Data from the Early Childhood Longitudinal Study - Birth Cohort, a nationally representative cohort of US children (n~6,150) were used to estimate the odds of household food insecurity when children were aged 9 months and 2 years, separately, based on parental report of unwanted childbearing. The majority of children were reported as wanted by both parents (74.4%). Of the sample, report of unwanted childbearing by father-only was 20.0%, mother-only was 3.4%, and joint mother and father was 2.2%. Household food insecurity was higher when children were 9 months compared to 2 years. In adjusted models accounting for confounders, children born to mothers and fathers who jointly reported unwanted childbearing were at higher odds of exposure to household food insecurity at 9 months (AOR=3.31; 95% CI: 1.97,5.57) and 2 years (AOR=2.52; 95% CI: 1.12,5.68). In two-parent households, we found children raised by parents reporting unwanted childbearing were more likely to be exposed to food insecurity and potentially related stressors. Further studies that prospectively measure wantedness before the child’s birth will aid in confirming the direction of this association. PMID:25138233

  19. UK parliamentary debate analysis: bombing ISIL in Syria.

    PubMed

    Rashed, Haifa

    2016-01-01

    This paper examines the arguments presented for and against the UK government's motion for the UK to intervene militarily in Syria in the House of Commons debate on ISIL in Syria that took place on 2 December 2015. It considers what the most common arguments were in favour of and in opposition to the motion as well as which arguments were given the most emphasis, in order to understand the prime justifications given that led to the decision to approve the motion. It suggests that due to the shadow of the 2003 Iraq war, politicians in the debate placed a considerable emphasis on the legal justification for military intervention. It argues that the focus on the national security of the UK and its allies in this particular debate seems to contrast with previous military interventions where humanitarian motives were more widely stated. This paper calls for further comparative research of parliamentary debates in order to track such changes in the rhetoric used by UK politicians to defend their support for military intervention.

  20. What are the priorities for future success in critical care research in the UK? Report from a national stakeholder meeting.

    PubMed

    Walsh, Tim; Brett, Stephen J

    2015-11-01

    Critical care in the United Kingdom is now well-established in terms of professional status, standards of clinical practice and training, and national audit through professional bodies and government representation. Research is fundamental to the further development and maturation of the specialty, to develop new therapies and technologies, more efficient and effective service organisation, and to improve patient and family experience and outcomes. Critical care research has expanded rapidly in the UK, and now has established organisations and infrastructure to share and develop ideas, through the UK Critical Care Research Forum and similar meetings. In September 2014, the Intensive Care Foundation and Critical Care Leadership Forum hosted a research colloquium to reflect, in part, on achievements, but more importantly plan for the future. With an invited list of participants the meeting explored firstly - the practical delivery of clinical research and secondly - the future financing landscape, from both academic funders' and commercial developers' perspectives. The following article summarises the important 'take home' messages from this meeting and suggests key issues for future strategy.

  1. Assessing the impact of the Indian Ocean tsunami on households: a modified domestic assets index approach.

    PubMed

    Arlikatti, Sudha; Peacock, Walter Gillis; Prater, Carla S; Grover, Himanshu; Sekar, Arul S Gnana

    2010-07-01

    This paper offers a potential measurement solution for assessing disaster impacts and subsequent recovery at the household level by using a modified domestic assets index (MDAI) approach. Assessment of the utility of the domestic assets index first proposed by Bates, Killian and Peacock (1984) has been confined to earthquake areas in the Americas and southern Europe. This paper modifies and extends the approach to the Indian sub-continent and to coastal surge hazards utilizing data collected from 1,000 households impacted by the Indian Ocean tsunami (2004) in the Nagapattinam district of south-eastern India. The analyses suggest that the MDAI scale is a reliable and valid measure of household living conditions and is useful in assessing disaster impacts and tracking recovery efforts over time. It can facilitate longitudinal studies, encourage cross-cultural, cross-national comparisons of disaster impacts and inform national and international donors of the itemized monetary losses from disasters at the household level.

  2. The beneficial effect of family meals on obesity differs by race, sex, and household education: the national survey of children's health, 2003-2004.

    PubMed

    Rollins, Brandi Y; Belue, Rhonda Z; Francis, Lori A

    2010-09-01

    Studies have indicated that family meals may be a protective factor for childhood obesity; however, limited evidence is available in children with different racial, socioeconomic, and individual characteristics. The purpose of this study was to examine family meal frequency as a protective factor for obesity in a US-based sample of non-Hispanic white, non-Hispanic black, and Hispanic children age 6 to 11 years, and to identify individual, familial, and socioeconomic factors that moderate this association. Data were from the 2003 National Survey of Children's Health (n=16,770). Multinomial logistic regression analyses were used to test the association between family meal frequency and weight status, and the moderating effects of household structure, education, poverty level, and sex, by racial group. Non-Hispanic white children who consumed family meals every day were less likely to be obese than those eating family meals zero or a few days per week. A moderating effect for sex was observed in non-Hispanic black children such that family meal frequency was marginally protective in boys but not in girls. Higher family meal frequency was a marginal risk factor for obesity in Hispanic boys from low-education households, but not in girls from similar households. In conclusion, family meals seem to be protective of obesity in non-Hispanic white children and non-Hispanic black boys, whereas they may put Hispanic boys living in low-education households at risk. Greater emphasis is needed in future research on assessing why this association differs among different race/ethnic groups, and evaluating the influence of the quality and quantity of family meals on child obesity. Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

  3. Height, body mass index, and socioeconomic status: mendelian randomisation study in UK Biobank

    PubMed Central

    Tyrrell, Jessica; Jones, Samuel E; Beaumont, Robin; Astley, Christina M; Lovell, Rebecca; Yaghootkar, Hanieh; Tuke, Marcus; Ruth, Katherine S; Freathy, Rachel M; Hirschhorn, Joel N; Wood, Andrew R; Murray, Anna; Weedon, Michael N

    2016-01-01

    Objective To determine whether height and body mass index (BMI) have a causal role in five measures of socioeconomic status. Design Mendelian randomisation study to test for causal effects of differences in stature and BMI on five measures of socioeconomic status. Mendelian randomisation exploits the fact that genotypes are randomly assigned at conception and thus not confounded by non-genetic factors. Setting UK Biobank. Participants 119 669 men and women of British ancestry, aged between 37 and 73 years. Main outcome measures Age completed full time education, degree level education, job class, annual household income, and Townsend deprivation index. Results In the UK Biobank study, shorter stature and higher BMI were observationally associated with several measures of lower socioeconomic status. The associations between shorter stature and lower socioeconomic status tended to be stronger in men, and the associations between higher BMI and lower socioeconomic status tended to be stronger in women. For example, a 1 standard deviation (SD) higher BMI was associated with a £210 (€276; $300; 95% confidence interval £84 to £420; P=6×10−3) lower annual household income in men and a £1890 (£1680 to £2100; P=6×10−15) lower annual household income in women. Genetic analysis provided evidence that these associations were partly causal. A genetically determined 1 SD (6.3 cm) taller stature caused a 0.06 (0.02 to 0.09) year older age of completing full time education (P=0.01), a 1.12 (1.07 to 1.18) times higher odds of working in a skilled profession (P=6×10−7), and a £1130 (£680 to £1580) higher annual household income (P=4×10−8). Associations were stronger in men. A genetically determined 1 SD higher BMI (4.6 kg/m2) caused a £2940 (£1680 to £4200; P=1×10−5) lower annual household income and a 0.10 (0.04 to 0.16) SD (P=0.001) higher level of deprivation in women only. Conclusions These data support evidence that height and BMI play an

  4. Height, body mass index, and socioeconomic status: mendelian randomisation study in UK Biobank.

    PubMed

    Tyrrell, Jessica; Jones, Samuel E; Beaumont, Robin; Astley, Christina M; Lovell, Rebecca; Yaghootkar, Hanieh; Tuke, Marcus; Ruth, Katherine S; Freathy, Rachel M; Hirschhorn, Joel N; Wood, Andrew R; Murray, Anna; Weedon, Michael N; Frayling, Timothy M

    2016-03-08

    To determine whether height and body mass index (BMI) have a causal role in five measures of socioeconomic status. Mendelian randomisation study to test for causal effects of differences in stature and BMI on five measures of socioeconomic status. Mendelian randomisation exploits the fact that genotypes are randomly assigned at conception and thus not confounded by non-genetic factors. UK Biobank. 119,669 men and women of British ancestry, aged between 37 and 73 years. Age completed full time education, degree level education, job class, annual household income, and Townsend deprivation index. In the UK Biobank study, shorter stature and higher BMI were observationally associated with several measures of lower socioeconomic status. The associations between shorter stature and lower socioeconomic status tended to be stronger in men, and the associations between higher BMI and lower socioeconomic status tended to be stronger in women. For example, a 1 standard deviation (SD) higher BMI was associated with a £210 (€276; $300; 95% confidence interval £84 to £420; P=6 × 10(-3)) lower annual household income in men and a £1890 (£1680 to £2100; P=6 × 10(-15)) lower annual household income in women. Genetic analysis provided evidence that these associations were partly causal. A genetically determined 1 SD (6.3 cm) taller stature caused a 0.06 (0.02 to 0.09) year older age of completing full time education (P=0.01), a 1.12 (1.07 to 1.18) times higher odds of working in a skilled profession (P=6 × 10(-7)), and a £1130 (£680 to £1580) higher annual household income (P=4 × 10(-8)). Associations were stronger in men. A genetically determined 1 SD higher BMI (4.6 kg/m(2)) caused a £2940 (£1680 to £4200; P=1 × 10(-5)) lower annual household income and a 0.10 (0.04 to 0.16) SD (P=0.001) higher level of deprivation in women only. These data support evidence that height and BMI play an important partial role in determining several aspects of a person

  5. Household demography and early childhood mortality in a rice-farming village in Northern Laos.

    PubMed

    Tomita, Shinsuke; Parker, Daniel M; Jennings, Julia A; Wood, James

    2015-01-01

    This paper extends Alexandr Chayanov's model of changing household demography (specifically the ratio of food consumers to food producers) and its influence on agricultural behavior so that it includes possible adverse effects of a rising ratio on nutritional status and early childhood mortality within the household. We apply the model to 35 years' worth of longitudinal demographic and economic data collected in the irrigated-rice growing village of Na Savang in northern Laos. When appropriate controls are included for other household variables, unobserved inter-household heterogeneity, and changes in local conditions and national policy over the study period, the analysis suggests that a unit increase in the household's consumer/producer ratio induces something like a nine-fold increase in the risk of death among household members aged less than five years. Monte Carlo simulation studies suggest that this may be an over-estimate but also that the effect is probably real and likely to be an important factor in household demography. At the very least, the results suggest that Chayanov's model still has theoretical relevance and deserves to be revived.

  6. Spatial modeling of households' knowledge about arsenic pollution in Bangladesh.

    PubMed

    Sarker, M Mizanur Rahman

    2012-04-01

    Arsenic in drinking water is an important public health issue in Bangladesh, which is affected by households' knowledge about arsenic threats from their drinking water. In this study, spatial statistical models were used to investigate the determinants and spatial dependence of households' knowledge about arsenic risk. The binary join matrix/binary contiguity matrix and inverse distance spatial weight matrix techniques are used to capture spatial dependence in the data. This analysis extends the spatial model by allowing spatial dependence to vary across divisions and regions. A positive spatial correlation was found in households' knowledge across neighboring districts at district, divisional and regional levels, but the strength of this spatial correlation varies considerably by spatial weight. Literacy rate, daily wage rate of agricultural labor, arsenic status, and percentage of red mark tube well usage in districts were found to contribute positively and significantly to households' knowledge. These findings have policy implications both at regional and national levels in mitigating the present arsenic crisis and to ensure arsenic-free water in Bangladesh. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Validity of an adapted Household Food Insecurity Access Scale in urban households in Iran.

    PubMed

    Mohammadi, Fatemeh; Omidvar, Nasrin; Houshiar-Rad, Anahita; Khoshfetrat, Mohammad-Reza; Abdollahi, Morteza; Mehrabi, Yadollah

    2012-01-01

    To assess the validity of a locally adapted Household Food Insecurity Access Scale (HFIAS) in the measurement of household food insecurity (FI) in the city of Tehran. A cross-sectional study. Urban households were selected through a systematic cluster sampling method from six different districts of Tehran. The socio-economic status of households was evaluated using a questionnaire by means of interviews. An adapted HFIAS was used to measure FI. Content validity was assessed by an expert panel, and the questionnaire was then tested among ten households for clarity. Criterion validity was assessed by comparing the measure with a number of determinants and consequences of FI. Internal consistency was evaluated by Cronbach's α and exploratory factor analysis. For repeatability, the questionnaire was administered twice to twenty-five households at an interval of 20 d and Pearson's correlation coefficient was calculated. A total of 416 households. In all, 11·8 %, 14·4 % and 17·5 % of the households were severely, moderately and mildly food insecure, respectively. Cronbach's α was 0·855. A significant correlation was observed between the two administrations of the questionnaire (r = 0·895, P < 0·001). Factor analysis of HFIAS items revealed two factors: the first five items as factor 1 (mild-to-moderate FI) and the last four as factor 2 (severe FI). Heads of food-secure households had higher education and higher job position compared with heads of food-insecure households (P < 0·001). Income and expenditure were lower in food-insecure households compared with food-secure households. Adapted HFIAS showed acceptable levels of internal consistency, criterion validity and reliability in assessing household FI among Tehranians.

  8. The influence of economic development level, household wealth and maternal education on child health in the developing world.

    PubMed

    Boyle, Michael H; Racine, Yvonne; Georgiades, Katholiki; Snelling, Dana; Hong, Sungjin; Omariba, Walter; Hurley, Patricia; Rao-Melacini, Purnima

    2006-10-01

    This study estimates the relative importance to child health (indicated by weight and height for age) of economic development level [gross domestic product (GDP) converted to international dollars using purchasing power parity (PPP) rates: GDP-PPP], household wealth and maternal education and examines the modifying influence of national contexts on these estimates. It uses information collected from mothers aged 15-49-years participating in Demographic Health Surveys (DHS) conducted in 42 developing countries. In multilevel regression models, the three study variables exhibited strong independent associations with child health: GDP-PPP accounted for the largest amount of unique variation, followed by maternal education and household wealth. There was also substantial overlap (shared variance) between maternal education and the other two study variables. The regressions of child health on household wealth and maternal education exhibited substantial cross-national variation in both strength and form of association. Although higher education levels were associated with disproportionately greater returns to child health, the pattern for household wealth was erratic: in many countries there were diminishing returns to child health at higher levels of household wealth. We conclude that there are inextricable links among different strategies for improving child health and that policy planners, associating benefits with these strategies, must take into account the strong moderating impact of national context.

  9. The nutrient content of US household food purchases by store types

    PubMed Central

    Stern, Dalia; Ng, Shu Wen; Popkin, Barry M

    2015-01-01

    Introduction Little is known about where households shop for packaged foods, what foods and beverages they purchase, and the nutrient content of these purchases. The objectives are to describe volume trends and nutrient content (food groups and nutrient profiles) of household packaged foods purchases (PFP) by store-type. Methods Cross-sectional analysis of US households’ food purchases (Nielsen Homescan) from 2000 to 2012 (n=652,023 household-year observations) with survey weights used for national representativeness. Household PFP trends (% volume) by store-type, household purchases of key food and beverage groups based on caloric contribution by store-type, and mean caloric and nutrient densities (sugars, saturated fat and sodium) of household PFP by store-type are analyzed. Data were collected from 2000–2012. Analyses were conducted in 2014–2015. Results The proportion of total volume of household PFP significantly increased from 2000 to 2012 for mass-merchandisers (13.1 to 23.9%), convenience-stores (3.6 to 5.9%) and warehouse-club (6.2 to 9.8%), and significantly decreased for grocery-chains (58.5 to 46.3%) and non-chain grocerys (10.3 to 5.2%). Top common sources of calories (%) from household PFP by food/beverage group include: savory snacks, grain-based desserts and regular soft-drinks. The energy, total sugar, sodium and saturated fat densities of household PFP from mass-merchandisers, warehouse-club and convenience-stores were higher, compared to grocery-stores. Conclusions PFP from stores with poorer nutrient density (more energy, total sugar, sodium and saturated fat-dense), such as warehouse-club, mass-merchandisers and convenience-stores are growing, representing a potential US public health concern. PMID:26437868

  10. How is stroke thrombolysis portrayed in UK national and London local newspapers? A review and critical discourse analysis.

    PubMed

    Cluckie, Gillian; Rudd, Anthony G; McKevitt, Christopher

    2012-05-01

    thrombolysis for stroke has been licensed in the UK since 2007 and needs to be administered within 4.5 h. Given this time critical factor, the media may have an important role in public awareness. this review aimed to find out how stroke thrombolysis was reported in UK national and London local newspapers and how treatment risks and benefits were communicated. Newspapers published between 1 January 2007 and 31 March 2010 were searched for articles on thrombolysis. Fifty-six articles were included and dispositive analysis, a qualitative analysis method, was used to identify themes. four main themes were identified: inaccurate description of thrombolysis, stroke clinicians' involvement, presentation of risks and benefits and patient stories. Inaccuracies included the presentation of thrombolysis as a treatment for transient ischaemic attack. Clinicians were quoted to suggest that thrombolysis produced complete recovery but were not reported to discuss risks or broader stroke management. The articles reported little or no risks of treatment. Patients' stories were used to reinforce that thrombolysis produces full recovery. this review found that newspaper media provides the public with inaccurate perspectives on thrombolysis. Clinicians may wish to check press articles prior to publishing and to consider the impact of reporting thrombolysis as a treatment which produces complete recovery.

  11. Early years postgraduate surgical training programmes in the UK are failing to meet national quality standards: An analysis from the ASiT/BOTA Lost Tribe prospective cohort study of 2,569 surgical trainees.

    PubMed

    2018-04-01

    This study aimed to assess training of Senior House Officer-grade equivalent doctors in postgraduate surgical training or service (SHO-DIPST) in surgical specialties across the United Kingdom (UK), against nationally agreed Joint Committee on Surgical Training Quality Indicators (JCST QIs). Specific recommendations are made, with a view to improving quality of training, workforce retention and recruitment to Higher Surgical Training. Prospective, observational, multicentre study conducted by the Association of Surgeons in Training, using the UK National Research Collaborative model. Any centres in the UK providing acute surgical services were eligible. SHO-DIPST with a permanent contract, on out-of-hours 'on-call rota' were included across four, one-week data capture periods (September to October 2016, February to March 2017). Adherence to five quality indicators was reported using descriptive statistics. P-values were calculated using Student's t-test for continuous data, with a 5% level of significance. 2569 SHO-DIPST were included from all ten surgical specialties in 141 NHS trusts across all 16 Local Education and Training Boards in the UK. 960 SHO-DIPST were in registered 'training' posts (37.3%). The median number of SHO-DIPST per rota was 7.0 (IQR 5.0-9.0). Adherence to the five included JCST QIs ranged from 6.0 to 53.1%. Only four SHO-DIPST posts across the study population met all five JCST QIs (0.3%). The total number of training sessions was higher for those in registered training posts (p < 0.001), with significant specialty and regional variation. Only four early years postgraduate surgical training posts in the UK meet nationally approved minimum quality standards. Specific recommendations are made to improve training in this cohort and to bolster recruitment and retention into Higher Surgical Training. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  12. Paediatric post-burn scar management in the UK: a national survey.

    PubMed

    Liuzzi, Francesca; Chadwick, Sarah; Shah, Mamta

    2015-03-01

    Thermal injuries affect 250,000 people annually in the United Kingdom. As burn survival improves, good scar management is paramount to help individuals living with the resultant scars lead a life without restrictions. Post-burn hypertrophic scars can limit growth in children, interfere with function and cause psychological problems. In the current literature there is great variation in post-burn scar management across the world and in the evidence available for the efficacy of these management modalities. The aim of this study was to investigate the variances if any, in the management of post-burn scarring in children across the UK. A telephone survey of UK paediatric burn services was conducted to obtain information on post-burn scar management and advice given to patients/carers. Of the 19 burn services that participated, all advised moisturising of scars but with variable emphasis on massaging. Silicones and pressure therapy were used by 18 services but commencement of use varied from soon after healing to onset of hypertrophic scarring. Laser therapy, ultrasound therapy and steroid therapy were used sporadically. This study highlights the common modalities of post-burn scar management in children across the UK. However, there is marked variation in timing and selection of the commonly used modalities. Although this study did not investigate the outcomes of scar management, it clearly identifies the need for a well-designed multi-centred study to establish evidence-based best practice in the management of post-burn scarring in children as these modalities are time consuming and not without potential complications. Evidence based practice could potentially lead to significant financial savings to the health service. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  13. Examining Household Asthma Management Behavior through a Microeconomic Framework

    ERIC Educational Resources Information Center

    Magzamen, Sheryl; Brandt, Sylvia J.; Tager, Ira B.

    2014-01-01

    National guidelines on the effective management of pediatric asthma have been promoted for over 20 years, yet asthma-related morbidity among low-income children remains disproportionately high. To date, household and clinical interventions designed to remediate these differences have been informed largely by a health behavior framework. However,…

  14. Catastrophic Health Expenditure and Rural Household Impoverishment in China: What Role Does the New Cooperative Health Insurance Scheme Play?

    PubMed Central

    Wu, Qunhong; Liu, Chaojie; Jiao, Mingli; Liu, Guoxiang; Hao, Yanhua; Ning, Ning

    2014-01-01

    Objective To determine whether the New Cooperative Medical Insurance Scheme (NCMS) is associated with decreased levels of catastrophic health expenditure and reduced impoverishment due to medical expenses in rural households of China. Methods An analysis of a national representative sample of 38,945 rural households (129,635 people) from the 2008 National Health Service Survey was performed. Logistic regression models used binary indicator of catastrophic health expenditure as dependent variable, with household consumption, demographic characteristics, health insurance schemes, and chronic illness as independent variables. Results Higher percentage of households experiencing catastrophic health expenditure and medical impoverishment correlates to increased health care need. While the higher socio-economic status households had similar levels of catastrophic health expenditure as compared with the lowest. Households covered by the NCMS had similar levels of catastrophic health expenditure and medical impoverishment as those without health insurance. Conclusion Despite over 95% of coverage, the NCMS has failed to prevent catastrophic health expenditure and medical impoverishment. An upgrade of benefit packages is needed, and effective cost control mechanisms on the provider side needs to be considered. PMID:24714605

  15. A Household-Based Distribution-Sensitive Human Development Index: An Empirical Application to Mexico, Nicaragua and Peru

    ERIC Educational Resources Information Center

    Lopez-Calva, Luis F.; Ortiz-Juarez, Eduardo

    2012-01-01

    In measuring human development, one of the main concerns relates to the inclusion of a measure that penalizes inequalities in the distribution of achievements across the population. Using indicators from nationally representative household surveys and census data, this paper proposes a straightforward methodology to estimate a household-based…

  16. Potential use of telephone surveys for non-communicable disease surveillance in developing countries: evidence from a national household survey in Lebanon.

    PubMed

    Sibai, Abla M; Ghandour, Lilian A; Chaaban, Rawan; Mokdad, Ali H

    2016-05-31

    Given the worldwide proliferation of cellphones, this paper examines their potential use for the surveillance of non-communicable disease (NCD) risk factors in a Middle Eastern country. Data were derived from a national household survey of 2,656 adults (aged 18 years or older) in Lebanon in 2009. Responses to questions on phone ownership yielded two subsamples, the 'cell phone sample' (n = 1,404) and the 'any phone sample' (n = 2,158). Prevalence estimates of various socio-demographics and 11 key NCD risk factors and comorbidities were compared between each subsample and the overall household sample. Adjusting for baseline age and sex distribution, no differences were observed for all NCD indicators when comparing either of subsamples to the overall household sample, except for binge drinking [(OR = 1.55, 95 % CI: 1.33-1.81) and (OR = 1.48, 95 % CI: 1.18-1.85) for 'cell phone subsample' and 'any phone subsample', respectively] and self-rated health (OR = 1.23, 95 % CI: 1.10-1.36) and (OR = 1.16, 95 % CI: 1.02-1.32), respectively). Differences in the odds of hyperlipidemia (OR = 1.27, 95 % CI: 1.06-1.51) was also found in the subsample of 'any phone' carriers. Multi-mode telephone surveillance techniques provide viable alternative to face-to-face surveys in developing countries. Cell phones may also be useful for personalized public health and medical care interventions in young populations.

  17. The psychological contract: is the UK National Health Service a model employer?

    PubMed

    Fielden, Sandra; Whiting, Fiona

    2007-05-01

    The UK National Health Service (NHS) is facing recruitment challenges that mean it will need to become an 'employer of choice' if it is to continue to attract high-quality employees. This paper reports the findings from a study focusing on allied health professional staff (n = 67), aimed at establishing the expectations of the NHS inherent in their current psychological contract and to consider whether the government's drive to make the NHS a model employer meets those expectations. The findings show that the most important aspects of the psychological contract were relational and based on the investment made in the employment relationship by both parties. The employment relationship was one of high involvement but also one where transactional contract items, such as pay, were still of some importance. Although the degree of employee satisfaction with the relational content of the psychological contract was relatively positive, there was, nevertheless, a mismatch between levels of importance placed on such aspects of the contract and levels of satisfaction, with employees increasingly placing greater emphasis on those items the NHS is having the greatest difficulty providing. Despite this apparent disparity between employee expectation and the fulfilment of those expectations, the overall health of the psychological contract was still high.

  18. Local and National Testing in the UK: The Last Ten Years.

    ERIC Educational Resources Information Center

    Gipps, Caroline; Goldstein, Harvey

    New developments in testing in the United Kingdom (UK) since 1965 are described. Standardized testing at the local level declined dramatically with the widespread introduction of comprehensive secondary education. However, in the late 1970's widespread local testing programs were re-introduced for the purposes of monitoring student progress,…

  19. Household transmission of SARS, 2003

    PubMed Central

    Wilson-Clark, Samantha D.; Deeks, Shelley L.; Gournis, Effie; Hay, Karen; Bondy, Susan; Kennedy, Erin; Johnson, Ian; Rea, Elizabeth; Kuschak, Theodore; Green, Diane; Abbas, Zahid; Guarda, Brenda

    2006-01-01

    Background In the 2003 outbreak in Toronto (in Ontario, Canada) of severe acute respiratory syndrome (SARS), about 20% of cases resulted from household transmission. The purpose of our study was to determine characteristics associated with the transmission of SARS within households. Methods A retrospective cohort of SARS-affected households was studied to determine risk factors for household transmission. Questionnaires addressed characteristics of the index case, the household and behaviours among household members. Potential risk factors for secondary transmission of infection were assessed in regression models appropriate to the outcome (secondary cases) and nonindependence of household members. Results The 74 households that participated included 18 secondary cases and 158 uninfected household members in addition to the 74 index cases. The household secondary attack rate was 10.2% (95% confidence interval [CI] 6.7%–23.5%). There was a linear association between the time the index patient spent at home after symptom onset and the secondary attack rate. Infected health care workers who were index cases had lower rates of household transmission. Interpretation SARS transmission in households is complex and increases with the length of time an ill person spends at home. Risk of transmission was lower when the index case was a health care worker. Rapid case identification is the public health measure most useful in minimizing exposure in the home. PMID:17098951

  20. On-Farm Crop Species Richness Is Associated with Household Diet Diversity and Quality in Subsistence- and Market-Oriented Farming Households in Malawi.

    PubMed

    Jones, Andrew D

    2017-01-01

    On-farm crop species richness (CSR) may be important for maintaining the diversity and quality of diets of smallholder farming households. The objectives of this study were to 1) determine the association of CSR with the diversity and quality of household diets in Malawi and 2) assess hypothesized mechanisms for this association via both subsistence- and market-oriented pathways. Longitudinal data were assessed from nationally representative household surveys in Malawi between 2010 and 2013 (n = 3000 households). A household diet diversity score (DDS) and daily intake per adult equivalent of energy, protein, iron, vitamin A, and zinc were calculated from 7-d household consumption data. CSR was calculated from plot-level data on all crops cultivated during the 2009-2010 and 2012-2013 agricultural seasons in Malawi. Adjusted generalized estimating equations were used to assess the longitudinal relation of CSR with household diet quality and diversity. CSR was positively associated with DDS (β: 0.08; 95% CI: 0.06, 0.12; P < 0.001), as well as daily intake per adult equivalent of energy (kilocalories) (β: 41.6; 95% CI: 20.9, 62.2; P < 0.001), protein (grams) (β: 1.78; 95% CI: 0.80, 2.75; P < 0.001), iron (milligrams) (β: 0.30; 95% CI: 0.16, 0.44; P < 0.001), vitamin A (micrograms of retinol activity equivalent) (β: 25.8; 95% CI: 12.7, 38.9; P < 0.001), and zinc (milligrams) (β: 0.26; 95% CI: 0.13, 0.38; P < 0.001). Neither proportion of harvest sold nor distance to nearest population center modified the relation between CSR and household diet diversity or quality (P ≥ 0.05). Households with greater CSR were more commercially oriented (least-squares mean proportion of harvest sold ± SE, highest tertile of CSR: 17.1 ± 0.52; lowest tertile of CSR: 8.92 ± 1.09) (P < 0.05). Promoting on-farm CSR may be a beneficial strategy for simultaneously supporting enhanced diet quality and diversity while also creating opportunities for smallholder farmers to engage with

  1. Study on Information Security and e-Trust in Spanish households

    NASA Astrophysics Data System (ADS)

    Aguado, José

    The study on Information Security and e-Trust in Spanish households has been conducted by INTECO (The National Institute of Communication Technologies) through the Information Security Observatory. It is a study on the incidence and trust of users in the Internet by means of measuring the frequency of the episodes of individual risk in a wide sample of users that are monitored online on a monthly basis, combining quantitative data of incidences (monthly scans of home computers) and qualitative perception data (quarterly surveys). The study is supplied with data from more than 3,000 households with Internet connection, spread across the whole country.

  2. 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.

  3. Quality of life of middle-aged adults in single households in South Korea.

    PubMed

    Song, Hyun Jin; Park, Susan; Kwon, Jin-Won

    2018-04-18

    The number of single households has increased worldwide with middle-aged people in such households indicating the highest increase. However, there is a lack of studies on the topic. This study estimated the quality of life (QOL) by household type for middle-aged Korean adults. We used the Korea National Health and Nutrition Examination Survey data from 2007 to 2015. QOL was analyzed using EQ-5D 3-level, and demographic and health-related variables were included as confounders. The households were divided into single household, married couple without child, other one-generation, married couple with child, single parent with child, other two-generation, and three-generation. Logistic regression using level, strata, and sample weight of data was performed based on average QOL. This study included 18,147 responders aged 45-64 years, with single households constituting 5.7%. Single households having average or less QOL were 48.4%, with men and women constituting 40.1 and 53.3%, respectively. After adjusting socioeconomic factors and health-related factors, the odds ratio (OR) of single households was 1.375 (95% CI 1.122-1.684) compared to the three-generation group. According to the sex, the OR of single households with men was higher (OR 1.552, 95% CI 1.121-2.149). However, no significance was found in women. The study results revealed that middle-aged people in single households had low QOL than those in multi-person households. The trend was significantly observable in men than in women. Because middle-aged adults might transform into elderly with low QOL, program development and social support for middle-aged adults in single households should be provided.

  4. Effects of Union Type on Division of Household Labor: Do Cohabiting Men Really Perform More Housework?

    ERIC Educational Resources Information Center

    Davis, Shannon N.; Greenstein, Theodore N.; Marks, Jennifer P. Gerteisen

    2007-01-01

    Using data from 17,636 respondents in 28 nations, this research uses multilevel modeling to compare the reported division of household labor and factors affecting it for currently married and currently cohabiting couples. Cohabiting men report performing more household labor than do married men, and cohabiting women report performing less…

  5. The Household Health Spending and Impoverishment: Findings from the Households Survey in Shiraz, Iran.

    PubMed

    Khammarnia, M; Keshtkaran, A; Kavosi, Z; Hayati, R

    2014-08-01

    The present study aimed to investigate the households' impoverishment due to the healthcare costs in Shiraz in 2012. In this household's survey, 800 households were studied in Shiraz. The study sample was selected using stratified and cluster sampling in the urban and rural areas, respectively. The information was collected using the household section of the World Health Survey questionnaire. In order to determine impoverishment due to health spending, at first, the households' food-based poverty line (subsistence expenditure) was measured. Then, households' health expenditure was subtracted from their total expenditure and if the obtained value was lower than the households' food-based poverty line, the households was considered to be impoverished due to health expenditures. The collected data were entered into the SPSS (version 16) statistical software and analyzed using descriptive statistic, Chi-square test, and logistic regression in backward method. The study results showed that 7.1% of the households (CI: 0.071 ± 0.018) were impoverished because of healthcare expenditures. Besides, the households in the first quintile were more likely to be faced with poverty compared to those in the other quintiles (p < 0.05). Being covered by health insurance did not affect the protection from poverty due to health costs. Moreover, the participants living in rural areas were faced with poverty more than those living in urban areas (p < 0.05). It seems that health expenditure can be an economic shock for household in Shiraz and through spending on health a household may fall into poverty. As insurance had no effect on impoverishment, it implies that change in health insurance plans and ways of health financing is necessary.

  6. Impact of a Randomized Controlled Trial in Arsenic Risk Communication on Household Water-Source Choices in Bangladesh

    PubMed Central

    Tarozzi, Alessandro; Pfaff, Alexander; Balasubramanya, Soumya; Ahmed, Kazi Matin; van Geen, Alexander

    2013-01-01

    We conducted a randomized controlled trial in rural Bangladesh to examine how household drinking-water choices were affected by two different messages about risk from naturally occurring groundwater arsenic. Households in both randomized treatment arms were informed about the arsenic level in their well and whether that level was above or below the Bangladesh standard for arsenic. Households in one group of villages were encouraged to seek water from wells below the national standard. Households in the second group of villages received additional information explaining that lower-arsenic well water is always safer and these households were encouraged to seek water from wells with lower levels of arsenic, irrespective of the national standard. A simple model of household drinking-water choice indicates that the effect of the emphasis message is theoretically ambiguous. Empirically, we find that the richer message had a negative, but insignificant, effect on well-switching rates, but the estimates are sufficiently precise that we can rule out large positive effects. The main policy implication of this finding is that a one-time oral message conveying richer information on arsenic risks, while inexpensive and easily scalable, is unlikely to be successful in reducing exposure relative to the status-quo policy. PMID:23997355

  7. The UK Human Genome Mapping Project online computing service.

    PubMed

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

    1992-04-01

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

  8. The economic burden of angina on households in South Asia

    PubMed Central

    2014-01-01

    Background Globally, an estimated 54 million people have angina, 16 million of whom are from the WHO South-East Asia region. Despite the increasing burden of cardiovascular disease (CVD) in South Asia, there is no evidence of an economic burden of angina on households in this region. We investigated the economic burden of angina on households in South Asia. Methods We applied a novel propensity score matching approach to assess the economic burden of angina on household out-of-pocket (OOP) health spending, borrowing or selling assets, non-medical consumption expenditure, and employment status of angina-affected individual using nationally representative World Health Survey data from Bangladesh, India, Nepal and Sri Lanka collected during 2002-2003. We used multiple matching methods to match households where the respondent reported symptomatic or diagnosed angina with control households with similar propensity scores. Results Angina-affected households had significantly higher OOP health spending per person in the four weeks preceding the survey than matched controls, in Bangladesh (I$1.94, p = 0.04), in Nepal (I$4.68, p = 0.03) and in Sri Lanka (I$1.99, p < 0.01). Nearly half of this difference was accounted for by drug expenditures. Catastrophic spending, defined as the ratio of OOP health spending to total household expenditure in excess of 20%, was significantly higher in angina-affected households relative to matched controls in India (9.60%, p < 0.01), Nepal (4.90%, p = 0.02) and Sri Lanka (9.10%, p < 0.01). Angina-affected households significantly relied on borrowing or selling assets to finance OOP health expenses in Bangladesh (6%, p = 0.03), India (8.20%, p < 0.01) and Sri Lanka (7.80%, p = 0.01). However, impoverishment, non-medical consumption expenditure and employment status of the angina-affected individual remained mostly unaffected. We adjusted our estimates for comorbidities, but limitations on comorbidity data in the WHS mean that our results may

  9. The economic burden of angina on households in South Asia.

    PubMed

    Alam, Khurshid; Mahal, Ajay

    2014-02-19

    Globally, an estimated 54 million people have angina, 16 million of whom are from the WHO South-East Asia region. Despite the increasing burden of cardiovascular disease (CVD) in South Asia, there is no evidence of an economic burden of angina on households in this region. We investigated the economic burden of angina on households in South Asia. We applied a novel propensity score matching approach to assess the economic burden of angina on household out-of-pocket (OOP) health spending, borrowing or selling assets, non-medical consumption expenditure, and employment status of angina-affected individual using nationally representative World Health Survey data from Bangladesh, India, Nepal and Sri Lanka collected during 2002-2003. We used multiple matching methods to match households where the respondent reported symptomatic or diagnosed angina with control households with similar propensity scores. Angina-affected households had significantly higher OOP health spending per person in the four weeks preceding the survey than matched controls, in Bangladesh (I$1.94, p = 0.04), in Nepal (I$4.68, p = 0.03) and in Sri Lanka (I$1.99, p < 0.01). Nearly half of this difference was accounted for by drug expenditures. Catastrophic spending, defined as the ratio of OOP health spending to total household expenditure in excess of 20%, was significantly higher in angina-affected households relative to matched controls in India (9.60%, p < 0.01), Nepal (4.90%, p = 0.02) and Sri Lanka (9.10%, p < 0.01). Angina-affected households significantly relied on borrowing or selling assets to finance OOP health expenses in Bangladesh (6%, p = 0.03), India (8.20%, p < 0.01) and Sri Lanka (7.80%, p = 0.01). However, impoverishment, non-medical consumption expenditure and employment status of the angina-affected individual remained mostly unaffected. We adjusted our estimates for comorbidities, but limitations on comorbidity data in the WHS mean that our results may be upwardly biased

  10. Variation in assessment and standard setting practices across UK undergraduate medicine and the need for a benchmark.

    PubMed

    MacDougall, Margaret

    2015-10-31

    The principal aim of this study is to provide an account of variation in UK undergraduate medical assessment styles and corresponding standard setting approaches with a view to highlighting the importance of a UK national licensing exam in recognizing a common standard. Using a secure online survey system, response data were collected during the period 13 - 30 January 2014 from selected specialists in medical education assessment, who served as representatives for their respective medical schools. Assessment styles and corresponding choices of standard setting methods vary markedly across UK medical schools. While there is considerable consensus on the application of compensatory approaches, individual schools display their own nuances through use of hybrid assessment and standard setting styles, uptake of less popular standard setting techniques and divided views on norm referencing. The extent of variation in assessment and standard setting practices across UK medical schools validates the concern that there is a lack of evidence that UK medical students achieve a common standard on graduation. A national licensing exam is therefore a viable option for benchmarking the performance of all UK undergraduate medical students.

  11. Household food production is positively associated with dietary diversity and intake of nutrient-dense foods for older preschool children in poorer families: Results from a nationally-representative survey in Nepal

    PubMed Central

    Mulmi, Prajula; Ghosh, Shibani; Namirembe, Grace; Rajbhandary, Ruchita; Manohar, Swetha; Shrestha, Binod; West, Keith P.; Webb, Patrick

    2017-01-01

    Background Nutrition-sensitive interventions supporting enhanced household food production have potential to improve child dietary quality. However, heterogeneity in market access may cause systematic differences in program effectiveness depending on household wealth and child age. Identifying these effect modifiers can help development agencies specify and target their interventions. Objective This study investigates mediating effects of household wealth and child age on links between farm production and child diets, as measured by production and intake of nutrient-dense food groups. Methods Two rounds (2013 and 2014) of nationally representative survey data (n = 5,978 observations) were used to measure production and children’s dietary intake, as well as a household wealth index and control variables, including breastfeeding. Novel steps used include measuring production diversity in terms of both species grown and food groups grown, as well as testing for mediating effects of family wealth and age of child. Results We find significant associations between child dietary diversity and agricultural diversity in terms of diversity of food groups and of species grown, especially for older children in poorer households, and particularly for fruits and vegetables, dairy and eggs. With each additional food group produced, log-odds of meeting minimum dietary diversity score (≥4) increase by 0.25 (p = 0.01) for children aged 24–59 months. For younger children aged 18–23 months there is a similar effect size but only in the poorest two quintiles of household wealth, and for infants 6–18 months we find no correlation between production and intake in most models. Conclusions Child dietary intake is associated with the composition of farm production, most evident among older preschool children and in poorer households. To improve the nutrition of infants, other interventions are needed; and for relatively wealthier households, own farm production may displace market

  12. Comparison of NIS and NHIS/NIPRCS vaccination coverage estimates. National Immunization Survey. National Health Interview Survey/National Immunization Provider Record Check Study.

    PubMed

    Bartlett, D L; Ezzati-Rice, T M; Stokley, S; Zhao, Z

    2001-05-01

    The National Immunization Survey (NIS) and the National Health Interview Survey (NHIS) produce national coverage estimates for children aged 19 months to 35 months. The NIS is a cost-effective, random-digit-dialing telephone survey that produces national and state-level vaccination coverage estimates. The National Immunization Provider Record Check Study (NIPRCS) is conducted in conjunction with the annual NHIS, which is a face-to-face household survey. As the NIS is a telephone survey, potential coverage bias exists as the survey excludes children living in nontelephone households. To assess the validity of estimates of vaccine coverage from the NIS, we compared 1995 and 1996 NIS national estimates with results from the NHIS/NIPRCS for the same years. Both the NIS and the NHIS/NIPRCS produce similar results. The NHIS/NIPRCS supports the findings of the NIS.

  13. Antibiotics in Serbian Households: a Source of Potential Health and Environmental Threats?

    PubMed

    Kusturica, Milica Paut; Tomić, Zdenko; Bukumirić, Zoran; Horvat, Olga; Pavlović, Nebojša; Mikov, Momir; Sabo, Ana

    2015-06-01

    Worldwide data indicate that antibiotics are frequently used inappropriately. The objective of this study was to investigate the extent of storage and wastage of antibacterial agents in households in Novi Sad, Serbia. The study was performed in 8 months period (December 2011-July 2012) in households in Novi Sad, Serbia. The households were randomly selected from the telephone directory. The interviewer performed the survey visiting each household. The total number of antibacterial agents in the 383 surveyed households was 318, constituting 7.3% of the total stored medications. From 383 families included in the study antibiotics were found in 178 (46.5%). In 13 (7.3%) families were found more than one pack of the same antibiotics. The median number of antibacterial agents per household was 1 (range 1-5). The most common antibacterial agents that were not in current use were cephalexin (22.1%) and amoxicillin (16.6%), followed by doxycycline (11.4%), sulfamethoxazole/trimethoprim (11.4%) and amoxicillin/clavulanic acid (9.2%). The percentage of expired antibacterial agents was 20.8%, while 85.2% were not currently in use. Antibacterial agents were commonly encountered in Serbian households, and a relatively large percentage was wasted. Informational and educational activities aimed at improving the public knowledge about antimicrobials play the leading role in reducing imprudent use of antibiotics. Copyright© by the National Institute of Public Health, Prague 2015.

  14. Managing variation in demand: lessons from the UK National Health Service.

    PubMed

    Walley, Paul; Silvester, Kate; Steyn, Richard

    2006-01-01

    Managers within the U.S. healthcare system are becoming more aware of the impact of variation in demand on healthcare processes. The UK National Health Service provides a prime example of a system that has experienced the consequences when the issue is not dealt with satisfactorily, having suffered from excessive queues for a prolonged period. These delays are mostly caused by a lack of attention to variation and inappropriate responses to the queues, rather than a capacity shortage. A number of collaborative programs recently have come to grips with many of the causes of the queues in both elective care and emergency care. Although there are still areas that need large-scale improvement, good progress has been made, especially within emergency care. The authors of this article have acted as technical advisors to a number of these improvement programs and have been able to document many of the practices that have helped to reduce or eliminate unnecessary queues and delays across the 200 sites in England that have 24-hour emergency care facilities. Local program managers at these sites continuously reported progress for a period of 18 months. A number of important lessons for both the design and control of healthcare processes have emerged from the collaborative work. These lessons focus on understanding and measurement of demand, capacity planning, reduction of introduced variation, segmentation and streaming of work, process design, capacity yield management, and measurement of variation.

  15. Sex Differences in Cognitive Abilities Test Scores: A UK National Picture

    ERIC Educational Resources Information Center

    Strand, Steve; Deary, Ian J.; Smith, Pauline

    2006-01-01

    Background and aims: There is uncertainty about the extent or even existence of sex differences in the mean and variability of reasoning test scores ( Jensen, 1998; Lynn, 1994, ; Mackintosh, 1996). This paper analyses the Cognitive Abilities Test (CAT) scores of a large and representative sample of UK pupils to determine the extent of any sex…

  16. Household Production.

    ERIC Educational Resources Information Center

    Scholl, Kathleen K.; And Others

    1982-01-01

    Compiled to give readers information on current research in household production, this special issue focuses on the family as a provider of goods and services. It includes five feature articles, a summary of a survey of American farm women, and a brief analysis of sources of time-use data for estimating the value of household production. Covered…

  17. American household structure in transition.

    PubMed

    Glick, P C

    1984-01-01

    The number of U.S. households rose by 58 percent between 1960 and 1983, with nontraditional household types accounting for most of the increase. Whereas the number of households containing married couples with children younger than 18 rose by only four percent over the period, one-parent households increased by 175 percent; one-person households, by 173 percent; and households composed of unmarried couples, by 331 percent. In 1983, households maintained by married couples constituted six in 10 U.S. households; the second most common household type--adults living alone--accounted for about one-quarter of all households. Lone parents living with their children represent nearly one in 10 households. Almost all of these parents are women--of whom two-thirds are separated or divorced, one-quarter have never been married, and fewer than one in 10 are widows. Among adults living alone, women aged 45 and older predominate; but the rate at which the practice has been adopted since 1960 has been greatest among those under age 45. Most of the growth in the number of one-person households occurred during the 1970s. The increase in cohabitation--most of it also in the 1970s--has similarly been concentrated in the younger age-groups. The living arrangements of children younger than 18 have changed accordingly over the two decades. Since 1960, the number of children living with two parents has declined by nearly one-fifth, and the number living with one parent--generally the mother--has more than doubled.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Individual, household, and community level risk factors of stunting in children younger than 5 years: Findings from a national surveillance system in Nepal.

    PubMed

    Dorsey, Jamie L; Manohar, Swetha; Neupane, Sumanta; Shrestha, Binod; Klemm, Rolf D W; West, Keith P

    2018-01-01

    Despite substantial reductions in recent years in Nepal, stunting prevalence in children younger than 5 years remains high and represents a leading public health concern. To identify factors contributing to the stunting burden, we report multilevel risk factors associated with stunting in 4,853 children aged 6-59 months in a nationally and agroecologically representative random sample from the first year of the Policy and Science for Health, Agriculture, and Nutrition Community Studies, a community-based observational, mixed-panel study. Mixed effects logistic regressions controlling for multilevel clustering in the study design were used to examine the association of individual-, household-, and community-level factors associated with stunting. Stunting prevalence was 38% in our sample. After adjustment for potential confounding variables, maternal factors, including maternal height and education, were generally the strongest individual-level risk factors for stunting, adjusted odds ratio (AOR) = 2.52, 95% CI [1.96, 3.25], short (<145 cm) versus not short mothers; AOR = 2.09, 95% CI [1.48, 2.96], uneducated mothers versus secondary school graduates. Among the household- and community-level factors, household expenditure and community infrastructure (presence of paved roads, markets, or hospitals) were strongly, inversely associated with increased stunting risk, AOR = 1.68, 95% CI [1.27, 2.24], lowest versus highest household expenditure quintile; AOR = 2.38, 95% CI [1.36, 4.14], less developed (lacking paved roads, markets, or hospitals) versus more developed communities. Although most factors associated with stunting are not rapidly modifiable, areas for future research and possible interventions emerged. © 2017 John Wiley & Sons Ltd.

  19. Catastrophic Health Expenditures for Households with Disabled Members: Evidence from the Korean Health Panel

    PubMed Central

    2016-01-01

    Persons with disabilities use more health care services due to ill health and face higher health care expenses and burden. This study explored the incidence of catastrophic health expenditures of households with persons with disabilities compared to that of those without such persons. We used the Korean Health Panel (KHP) dataset for the years 2010 and 2011. The final sample was 5,610 households; 800 (14.3%) of these were households with a person with a disability and 4,810 (85.7%) were households without such a person. Households with a person with a disability faced higher catastrophic health expenditures, spending about 1.2 to 1.4 times more of their annual living expenditures for out-of-pocket medical expenses, compared to households without persons with disabilities. Households having low economic status and members with chronic disease were more likely to face catastrophic health expenditures, while those receiving public assistance were less likely. Exemption or reduction of out-of-pocket payments in the National Health Insurance and additional financial support are needed so that the people with disabilities can use medical services without suffering financial crisis. PMID:26955233

  20. Catastrophic Health Expenditures for Households with Disabled Members: Evidence from the Korean Health Panel.

    PubMed

    Lee, Jeong-Eun; Shin, Hyung-Ik; Do, Young Kyung; Yang, Eun Joo

    2016-03-01

    Persons with disabilities use more health care services due to ill health and face higher health care expenses and burden. This study explored the incidence of catastrophic health expenditures of households with persons with disabilities compared to that of those without such persons. We used the Korean Health Panel (KHP) dataset for the years 2010 and 2011. The final sample was 5,610 households; 800 (14.3%) of these were households with a person with a disability and 4,810 (85.7%) were households without such a person. Households with a person with a disability faced higher catastrophic health expenditures, spending about 1.2 to 1.4 times more of their annual living expenditures for out-of-pocket medical expenses, compared to households without persons with disabilities. Households having low economic status and members with chronic disease were more likely to face catastrophic health expenditures, while those receiving public assistance were less likely. Exemption or reduction of out-of-pocket payments in the National Health Insurance and additional financial support are needed so that the people with disabilities can use medical services without suffering financial crisis.

  1. Greenhouse gas emissions accounting of urban residential consumption: a household survey based approach.

    PubMed

    Lin, Tao; Yu, Yunjun; Bai, Xuemei; Feng, Ling; Wang, Jin

    2013-01-01

    Devising policies for a low carbon city requires a careful understanding of the characteristics of urban residential lifestyle and consumption. The production-based accounting approach based on top-down statistical data has a limited ability to reflect the total greenhouse gas (GHG) emissions from residential consumption. In this paper, we present a survey-based GHG emissions accounting methodology for urban residential consumption, and apply it in Xiamen City, a rapidly urbanizing coastal city in southeast China. Based on this, the main influencing factors determining residential GHG emissions at the household and community scale are identified, and the typical profiles of low, medium and high GHG emission households and communities are identified. Up to 70% of household GHG emissions are from regional and national activities that support household consumption including the supply of energy and building materials, while 17% are from urban level basic services and supplies such as sewage treatment and solid waste management, and only 13% are direct emissions from household consumption. Housing area and household size are the two main factors determining GHG emissions from residential consumption at the household scale, while average housing area and building height were the main factors at the community scale. Our results show a large disparity in GHG emissions profiles among different households, with high GHG emissions households emitting about five times more than low GHG emissions households. Emissions from high GHG emissions communities are about twice as high as from low GHG emissions communities. Our findings can contribute to better tailored and targeted policies aimed at reducing household GHG emissions, and developing low GHG emissions residential communities in China.

  2. Greenhouse Gas Emissions Accounting of Urban Residential Consumption: A Household Survey Based Approach

    PubMed Central

    Lin, Tao; Yu, Yunjun; Bai, Xuemei; Feng, Ling; Wang, Jin

    2013-01-01

    Devising policies for a low carbon city requires a careful understanding of the characteristics of urban residential lifestyle and consumption. The production-based accounting approach based on top-down statistical data has a limited ability to reflect the total greenhouse gas (GHG) emissions from residential consumption. In this paper, we present a survey-based GHG emissions accounting methodology for urban residential consumption, and apply it in Xiamen City, a rapidly urbanizing coastal city in southeast China. Based on this, the main influencing factors determining residential GHG emissions at the household and community scale are identified, and the typical profiles of low, medium and high GHG emission households and communities are identified. Up to 70% of household GHG emissions are from regional and national activities that support household consumption including the supply of energy and building materials, while 17% are from urban level basic services and supplies such as sewage treatment and solid waste management, and only 13% are direct emissions from household consumption. Housing area and household size are the two main factors determining GHG emissions from residential consumption at the household scale, while average housing area and building height were the main factors at the community scale. Our results show a large disparity in GHG emissions profiles among different households, with high GHG emissions households emitting about five times more than low GHG emissions households. Emissions from high GHG emissions communities are about twice as high as from low GHG emissions communities. Our findings can contribute to better tailored and targeted policies aimed at reducing household GHG emissions, and developing low GHG emissions residential communities in China. PMID:23405187

  3. Prevention of secondary household transmission during Shiga toxin-producing Escherichia coli outbreaks.

    PubMed

    Tokuda, K; Yahata, Y; Sunagawa, T

    2016-10-01

    Prevention of secondary household transmission of Shiga toxin-producing Escherichia coli (STEC) is important in outbreak settings. We examined factors contributing to secondary household transmission during STEC outbreaks in daycare centres in Japan. Suspected STEC outbreaks in daycare centres were identified by the National Epidemiological Surveillance of Infectious Diseases. Questionnaires were sent to local health centres that responded to outbreaks. Secondary household transmission rates were calculated, and factors affecting secondary household transmission rate were analysed by multilevel analysis. The secondary household transmission rates in 16 outbreaks ranged from 0% to 34·4% (median 4·4%). The highest rate (23·0%) was observed in siblings aged 6-9 years, and the infection rate was significantly higher for mothers than for fathers and grandparents (P < 0·05). Using multilevel analysis, the following variables were selected in the best model: information provided face-to-face (vs. letter or telephone) to families of children in daycare centres (at initial response), STEC type and lag time (days) between onset and providing information. Early response and hygiene education by visiting local health centre staff may be effective measures to prevent secondary household transmission in STEC outbreaks. Hygiene education should be emphasized for children aged 6-9 years, as well as for younger children.

  4. Household food insecurity and Canadian Aboriginal women's self-efficacy in food preparation.

    PubMed

    Mercille, Genevieve; Receveur, Olivier; Potvin, Louise

    2012-01-01

    Determinants of self-efficacy related to food preparation using store-bought food were examined in women belonging to the Atikamekw Nation. Also examined was whether self-efficacy was associated with household food insecurity. A cross-sectional survey was conducted with 107 women responsible for household food supplies. Two self-efficacy scores were calculated, one for healthy food preparation and one for food preparation in general. Household food insecurity was measured with an adapted version of the United States Food Security Core Module. The other variables were household composition, income sources, food supplies, tobacco use, participants' health status, and lifestyle and sociodemographic characteristics. Multiple linear regression was used to analyze associations between self-efficacy and household food insecurity in 99 participants. Severe household food insecurity was associated with significantly lower healthy food preparation scores in Atikamekw women. Other associated variables were food supplies, marital status, alcohol consumption, weight status, and understanding of the native language. Application of the concept of self-efficacy contributes to a better understanding of the factors influencing food preparation in Atikamekw women. In this study, self-efficacy in healthy food preparation was linked to food insecurity and obesity, particularly in the most serious cases. Efforts to improve diet will require not only behavioural interventions, but public policies.

  5. Audit of healthcare professionals' attitudes towards patients who self-harm and adherence to national guidance in a UK burns and plastic surgery department.

    PubMed

    Heyward-Chaplin, Jessica; Shepherd, Laura; Arya, Reza; O'Boyle, Ciaran P

    2018-01-01

    Rates of self-harm injuries are considered to be increasing. The attitudes of healthcare staff towards patients who self-harm may be negative and a small amount of research specifically investigating burns and plastic surgery healthcare professionals has recently been conducted exploring this issue. This study aimed to determine attitudes towards and adherence to national guidance by healthcare professionals in a UK burns and plastic surgery department with respect to patients who self-harm. An audit questionnaire, completed in a designated Burns Unit and plastic surgery department, within a UK hospital with a major trauma centre. Data were obtained from 59 healthcare professionals. The majority of responders held positive attitudes towards those who had self-harmed. However, a significant minority held negative attitudes, stating that they found it difficult to be compassionate (10%; n = 6) and believing that patients usually self-harm to get attention (9%; n = 5). One-fifth (n = 12) agreed that, on a departmental level, conservative management (as opposed to surgery) was offered more frequently for self-harm injuries compared with accidental injuries, contrary to national guidance. Awareness of national guidance in relation to self-harm injuries was markedly lacking, in only 12% (n = 7/59) and the frequency of completing relevant training was low (34%, n = 20/59). Education among healthcare professionals is important, to ensure adherence to best practice. The findings of this study strongly suggest that many healthcare professionals do not know the current best practice. As a result, these highly vulnerable patients may be receiving sub-optimal care, with consequentially poor outcomes.

  6. Characterising the research profile of the critical care physiotherapy workforce and engagement with critical care research: a UK national survey

    PubMed Central

    Allum, Laura; Shaw, Michelle; Pattison, Natalie; Dark, Paul

    2018-01-01

    Objective To characterise the research profile of UK critical care physiotherapists including experience, training needs, and barriers and enablers to engagement in critical care research. ‘Research’ was defined broadly to encompass activities related to quantitative and qualitative studies, service evaluations, clinical audit and quality improvements. Design Closed-question online survey, with optional free-text responses. Setting UK critical care community. Participants UK critical care physiotherapists, regardless of clinical grade or existing research experience. Results 268 eligible survey responses were received during the 12-week study period (21 incomplete, 7.8%). Respondents were based in university-affiliated (n=133, 49.6%) and district general (n=111, 41.4%) hospitals, and generally of senior clinical grade. Nearly two-thirds had postgraduate qualifications at master’s level or above (n=163, 60.8%). Seven had a doctoral-level qualification. Respondents reported a range of research experience, predominantly data acquisition (n=144, 53.7%) and protocol development (n=119, 44.4%). Perceived research training needs were prevalent, including topics of research methods, critical literature appraisal, protocol development and statistical analysis (each reported by ≥50% respondents). Multiple formats for delivery of future research training were identified. Major barriers to research engagement included lack of protected time (n=220, 82.1%), funding (n=177, 66.0%) and perceived experience (n=151, 56.3%). Barriers were conceptually categorised into capability, opportunity and motivation themes. Key enabling strategies centred on greater information provision about clinical research opportunities, access to research training, secondment roles and professional networks. Conclusions UK critical care physiotherapists are skilled, experienced and motivated to participate in research, including pursuing defined academic research pathways. Nonetheless wide

  7. Information Society: Agenda for Action in the UK.

    ERIC Educational Resources Information Center

    Phillips of Ellesmere, Lord

    1997-01-01

    Explains the House of Lords Select Committee on Science and Technology in the UK (United Kingdom) and discusses its report that addresses the need for information technology planning on a national basis. Topics include electronic publishing for access to government publications, universal access, regulatory framework, encryption and verification,…

  8. Measurement of household food security in the USA and other industrialised countries.

    PubMed

    Radimer, Kathy L; Radimer, Kathy L

    2002-12-01

    To describe the history and current status of household food security measurement. In the 1980s evidence of rising levels of hunger was a concern for many, but disputed by some, Americans. Acknowledgement and quantification of hunger was hindered by the lack of an accepted definition and measure of hunger. Qualitative research at Cornell provided a conceptual framework, description, definition and survey items for hunger. The Community Childhood Hunger Identification Project developed an instrument used in numerous communities. Based upon these initiatives, widely accepted definitions of hunger and food insecurity, and the US Household Food Security Module for its measurement, now exist. The module classifies households as food-secure, or food-insecure without hunger or with moderate or severe hunger, and contains household-, adult- and child-referent items. Its inclusion in the Current Population Survey (CPS) since 1995 has yielded annual estimates of food insecurity. A six-item short form of the module, for surveys with severe time constraints, classifies households only as food-secure or food-insecure without or with hunger and contains no child-specific items. Surveys using the 18-item or short-form module can compare results with published national data from the CPS. Information about the module is available at http://www.ers.usda.gov/briefing/foodsecurity and http://www.fns.usda/fsec. Current research on food security measurement includes measurement of individual food insecurity and hunger, module performance regarding hunger duration and frequency, performance of the module in population sub-groups, and the effect of translations on module meaning and performance. National surveys in Canada, New Zealand and Australia also have measured food security.

  9. UK Hazard Assessment for a Laki-type Volcanic Eruption

    NASA Astrophysics Data System (ADS)

    Witham, Claire; Felton, Chris; Daud, Sophie; Aspinall, Willy; Braban, Christine; Loughlin, Sue; Hort, Matthew; Schmidt, Anja; Vieno, Massimo

    2014-05-01

    Following the impacts of the Eyjafjallajokull eruption in 2010, two types of volcanic eruption have been added to the UK Government's National Risk Register for Civil Emergencies. One of these, a large gas-rich volcanic eruption, was identified as a high impact natural hazard, one of the three highest priority natural hazards faced by the UK. This eruption scenario is typified by the Laki eruption in Iceland in 1783-1784. The Civil Contingency Secretariat (CCS) of the UK's Cabinet Office, responsible for Civil Protection in the UK, has since been working on quantifying the risk and better understanding its potential impacts. This involves cross-cutting work across UK Government departments and the wider scientific community in order to identify the capabilities needed to respond to an effusive eruption, to exercise the response and develop increased resilience where possible. As part of its current work, CCS has been working closely with the UK Met Office and other UK agencies and academics (represented by the co-authors and others) to generate and assess the impacts of a 'reasonable worst case scenario', which can be used for decision making and preparation in advance of an eruption. Information from the literature and the findings of an expert elicitation have been synthesised to determine appropriate eruption source term parameters and associated uncertainties. This scenario is then being used to create a limited ensemble of model simulations of the dispersion and chemical conversion of the emissions of volcanic gases during such an eruption. The UK Met Office's NAME Lagrangian dispersion model and the Centre for Ecology and Hydrology's EMEP4UK Eulerian model are both being used. Modelling outputs will address the likelihood of near-surface concentrations of sulphur and halogen species being above specified health thresholds. Concentrations at aviation relevant altitudes will also be evaluated, as well as the effects of acid deposition of volcanic species on

  10. Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys.

    PubMed

    Giovino, Gary A; Mirza, Sara A; Samet, Jonathan M; Gupta, Prakash C; Jarvis, Martin J; Bhala, Neeraj; Peto, Richard; Zatonski, Witold; Hsia, Jason; Morton, Jeremy; Palipudi, Krishna M; Asma, Samira

    2012-08-18

    Despite the high global burden of diseases caused by tobacco, valid and comparable prevalence data for patterns of adult tobacco use and factors influencing use are absent for many low-income and middle-income countries. We assess these patterns through analysis of data from the Global Adult Tobacco Survey (GATS). Between Oct 1, 2008, and March 15, 2010, GATS used nationally representative household surveys with comparable methods to obtain relevant information from individuals aged 15 years or older in 14 low-income and middle-income countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Poland, Russia, Thailand, Turkey, Ukraine, Uruguay, and Vietnam). We compared weighted point estimates and 95% CIs of tobacco use between these 14 countries and with data from the 2008 UK General Lifestyle Survey and the 2006-07 US Tobacco Use Supplement to the Current Population Survey. All these surveys had cross-sectional study designs. In countries participating in GATS, 48·6% (95% CI 47·6-49·6) of men and 11·3% (10·7-12·0) of women were tobacco users. 40·7% of men (ranging from 21·6% in Brazil to 60·2% in Russia) and 5·0% of women (0·5% in Egypt to 24·4% in Poland) in GATS countries smoked a tobacco product. Manufactured cigarettes were favoured by most smokers (82%) overall, but smokeless tobacco and bidis were commonly used in India and Bangladesh. For individuals who had ever smoked daily, women aged 55-64 years at the time of the survey began smoking at an older age than did equivalently aged men in most GATS countries. However, those individuals who had ever smoked daily and were aged 25-34-years when surveyed started to do so at much the same age in both sexes. Quit ratios were very low (<20% overall) in China, India, Russia, Egypt, and Bangladesh. The first wave of GATS showed high rates of smoking in men, early initiation of smoking in women, and low quit ratios, reinforcing the view that efforts to prevent initiation and promote

  11. Spousal violence in sub-Saharan Africa: does household poverty-wealth matter?

    PubMed Central

    2014-01-01

    Introduction Despite the threat of violence to the health and rights of women yet, for many years, there has been a dearth of nationally comparable data on domestic violence in sub-Saharan Africa. This paper examines whether women from poor households are more likely to experience violence from husband/partner than other women who are from middle or rich households. Method Data for the study are derived from most recent DHS surveys of ever-married women age 15-49 in Cameroun(3,691), Kenya(4,336), Mozambique(5610), Nigeria (16,763), Zambia(3,010) and Zimbabwe(5,016) who participated in the questions on Domestic Violence Module. Bivariate analysis and Binary Logistic Regression Analysis are used to explore the linkage between household poverty-wealth and spousal violence while simultaneously controlling for confounding variables. Results The overall prevalence of any form of violence (physical, sexual or emotional) ranges from 30.5% in Nigeria to 43.4% in Zimbabwe; 45.3% in Kenya; 45.5% in Mozambique; 53.9% in Zambia and 57.6% in Cameroun. Both bivariate and multivariate analyses show that in two of the six countries –Zambia and Mozambique, experience of violence is significantly higher among women from non-poor (rich) households than those from other households (poor and middle). For Zimbabwe and Kenya, women from poor households are more likely to have ever experienced spousal violence than those from non-poor households. In the remaining two countries- Nigeria and Cameroun, women from the middle class are more likely to have ever suffered abuse from husband/partner than those from the poor and rich households. Conclusion Our results thus show that similar measurements of household poverty-wealth have produced varying relationships with respect to experience of spousal violence in six sub-Saharan African countries. In other words, experience of violence cuts across all household poverty-wealth statuses and therefore may not provide enough explanations on whether

  12. Exploring the impact of targeted distribution of free bed nets on households bed net ownership, socio-economic disparities and childhood malaria infection rates: analysis of national malaria survey data from three sub-Saharan Africa countries

    PubMed Central

    2013-01-01

    Background The last decade has witnessed increased funding for malaria control. Malaria experts have used the opportunity to advocate for rollout of such interventions as free bed nets. A free bed net distribution strategy is seen as the quickest way to improve coverage of effective malaria control tools especially among poorest communities. Evidence to support this claim is however, sparse. This study explored the effectiveness of targeted free bed net distribution strategy in achieving equity in terms of ownership and use of bed nets and also reduction of malaria prevalence among children under-five years of age. Methods National malaria indicator survey (MIS) data from Angola, Tanzania and Uganda was used in the analysis. Hierarchical multilevel logistic regression models were used to analyse the relationship between variables of interest. Outcome variables were defined as: childhood test-confirmed malaria infections, household ownership of any mosquito net and children’s use of any mosquito nets. Marginal effects of having free bed net distribution on households with different wealth status were calculated. Results Angolan children from wealthier households were 6.4 percentage points less likely to be parasitaemic than those in poorest households, whereas those from Tanzania and Uganda were less likely to test malaria positive by 7 and 11.6 percentage points respectively (p < 0.001). The study estimates and present results on the marginal effects based on the impact of free bed net distribution on children's malaria status given their socio-economic background. Poorest households were less likely to own a net by 21.4% in Tanzania, and 2.8% in Uganda, whereas both poorer and wealthier Angolan households almost achieved parity in bed net ownership (p < 0.001). Wealthier households had a higher margin of using nets than poorest people in both Tanzania and Uganda by 11.4% and 3.9% respectively. However, the poorest household in Angola had a 6.1% net use

  13. Differences in the sodium content of bread products in the USA and UK: implications for policy.

    PubMed

    Coyne, Kasey J; Baldridge, Abigail S; Huffman, Mark D; Jenner, Katharine; Xavier, Dagan; Dunford, Elizabeth K

    2018-02-01

    Americans consume Na in excess of daily recommendations. Most dietary Na comes from packaged foods, and bread is a major contributor. In the UK, national Na reduction strategies contributed to lower Na levels in packaged foods and lower population Na intake. Similar initiatives are emerging in the USA and require surveillance to assess effectiveness. We aimed to examine Na levels in bread products in the USA and compare levels with similar UK products. Na data for bread products were obtained from the US Label Insight Open Data Initiative (n 4466) and the FoodSwitch UK database (n 1651). Mean, median and range of Na content, and proportion of products meeting Na targets established by the National Salt Reduction Initiative (NSRI) and the UK Department of Health (DH) were calculated overall, by bread type and by country. Mean (sd) Na content in bread was 455 (170) mg/100 g in the USA and 406 (179) mg/100 g in the UK. In both countries, savoury bread had the highest mean Na (USA=584 mg/100 g, UK=543 mg/100 g) and fruit bread the lowest mean Na (USA=345 mg/100 g, UK=277 mg/100 g). Na content of US bread products was 12 % higher than in the UK, with 21 % of US bread products and 31 % of UK bread products meeting the NSRI and DH targets, respectively. US bread products have, on average, 12 % more Na than similar products in the UK. Variation in Na content within product categories, and between countries, suggests the feasibility of manufacturing products with lower Na to lower dietary Na intake.

  14. Food crop production, nutrient availability, and nutrient intakes in Bangladesh: exploring the agriculture-nutrition nexus with the 2010 Household Income and Expenditure Survey.

    PubMed

    Fiedler, John L

    2014-12-01

    Systematic collection of national agricultural data has been neglected in many low- and middle-income countries for the past 20 years. Commonly conducted nationally representative household surveys collect substantial quantities of highly underutilized food crop production data. To demonstrate the potential usefulness of commonly available household survey databases for analyzing the agriculture-nutrition nexus. Using household data from the 2010 Bangladesh Household Income and Expenditure Survey, the role and significance of crop selection, area planted, yield, nutrient production, and the disposition of 34 food crops in affecting the adequacy of farming households' nutrient availability and nutrient intake status are explored. The adequacy of each farming household's available energy, vitamin A, calcium, iron, and zinc and households' apparent intakes and intake adequacies are estimated. Each household's total apparent nutrient intake adequacies are estimated, taking into account the amount of each crop that households consume from their own production, together with food purchased or obtained from other sources. Even though rice contains relatively small amounts of micronutrients, has relatively low nutrient density, and is a relatively poor source of nutrients compared with what other crops can produce on a given tract of land, because so much rice is produced in Bangladesh, it is the source of 90% of the total available energy, 85% of the zinc, 67% of the calcium, and 55% of the iron produced by the agricultural sector. The domination of agriculture and diet by rice is a major constraint to improving nutrition in Bangladesh. Simple examples of how minor changes in the five most common cropping patterns could improve farming households' nutritional status are provided. Household surveys' agricultural modules can provide a useful tool for better understanding national nutrient production realities and possibilities.

  15. The Effect of Household Smoking Bans on Household Smoking

    PubMed Central

    Bleakley, Amy; Mallya, Giridhar; Romer, Daniel

    2014-01-01

    Objectives. Because household smoking levels and adoption of domestic smoking rules may be endogenously related, we estimated a nonrecursive regression model to determine the simultaneous relationship between home smoking restrictions and household smoking. Methods. We used data from a May–June 2012 survey of Philadelphia, Pennsylvania, households with smokers (n = 456) to determine the simultaneous association between smoking levels in the home and the presence of home restrictions on smoking. Results. We found that home smoking rules predicted smoking in the home but smoking in the home had no effect on home smoking restrictions. Conclusions. Absent in-home randomized experiments, a quasi-experimental causal inference suggesting that home smoking rules result in lower home smoking levels may be plausible. PMID:24524533

  16. High vulnerability to household food insecurity in a sample of Canadian renter households in government-subsidized housing.

    PubMed

    Fafard St-Germain, Andrée-Anne; Tarasuk, Valerie

    2017-06-16

    To determine the prevalence and severity of household food insecurity and examine household material circumstances related to food insecurity in a sample of renter households in government-subsidized housing. Cross-sectional data from the 2010 Survey of Household Spending were used to determine the food insecurity status of 455 renter households living in the 10 provinces and receiving a government housing subsidy. Multivariable logistic regressions were conducted to examine the relationship between household characteristics describing material circumstances and food insecurity. One in two households was food insecure. Marginal, moderate and severe food insecurity affected 9.0%, 23.3% and 18.5% of households respectively. Household economic resources, as captured with after-tax income, after-rent income, or total expenditure, had an independent, inverse relationship with food insecurity. Among the other characteristics examined, more adults or children in the household, presence of a member with disability, and receipt of social assistance increased the odds of food insecurity, but receipt of social assistance lost statistical significance when controlling for total expenditure. Presence of a senior in the household was independently associated with lower odds of food insecurity. Our findings suggest that more effective income-based interventions are needed to address food insecurity among low-income households receiving government housing subsidies. A better integration of housing and income-based policies is necessary to support household food security among government-subsidized renter households.

  17. Estimating the incidence, prevalence and true cost of asthma in the UK: secondary analysis of national stand-alone and linked databases in England, Northern Ireland, Scotland and Wales—a study protocol

    PubMed Central

    Mukherjee, Mome; Gupta, Ramyani; Farr, Angela; Heaven, Martin; Stoddart, Andrew; Nwaru, Bright I; Fitzsimmons, Deborah; Chamberlain, George; Bandyopadhyay, Amrita; Fischbacher, Colin; Dibben, Christopher; Shields, Michael; Phillips, Ceri; Strachan, David; Davies, Gwyneth; McKinstry, Brian; Sheikh, Aziz

    2014-01-01

    Introduction Asthma is now one of the most common long-term conditions in the UK. It is therefore important to develop a comprehensive appreciation of the healthcare and societal costs in order to inform decisions on care provision and planning. We plan to build on our earlier estimates of national prevalence and costs from asthma by filling the data gaps previously identified in relation to healthcare and broadening the field of enquiry to include societal costs. This work will provide the first UK-wide estimates of the costs of asthma. In the context of asthma for the UK and its member countries (ie, England, Northern Ireland, Scotland and Wales), we seek to: (1) produce a detailed overview of estimates of incidence, prevalence and healthcare utilisation; (2) estimate health and societal costs; (3) identify any remaining information gaps and explore the feasibility of filling these and (4) provide insights into future research that has the potential to inform changes in policy leading to the provision of more cost-effective care. Methods and analysis Secondary analyses of data from national health surveys, primary care, prescribing, emergency care, hospital, mortality and administrative data sources will be undertaken to estimate prevalence, healthcare utilisation and outcomes from asthma. Data linkages and economic modelling will be undertaken in an attempt to populate data gaps and estimate costs. Separate prevalence and cost estimates will be calculated for each of the UK-member countries and these will then be aggregated to generate UK-wide estimates. Ethics and dissemination Approvals have been obtained from the NHS Scotland Information Services Division's Privacy Advisory Committee, the Secure Anonymised Information Linkage Collaboration Review System, the NHS South-East Scotland Research Ethics Service and The University of Edinburgh's Centre for Population Health Sciences Research Ethics Committee. We will produce a report for Asthma-UK, submit papers to

  18. Estimating the incidence, prevalence and true cost of asthma in the UK: secondary analysis of national stand-alone and linked databases in England, Northern Ireland, Scotland and Wales-a study protocol.

    PubMed

    Mukherjee, Mome; Gupta, Ramyani; Farr, Angela; Heaven, Martin; Stoddart, Andrew; Nwaru, Bright I; Fitzsimmons, Deborah; Chamberlain, George; Bandyopadhyay, Amrita; Fischbacher, Colin; Dibben, Christopher; Shields, Michael; Phillips, Ceri; Strachan, David; Davies, Gwyneth; McKinstry, Brian; Sheikh, Aziz

    2014-11-04

    Asthma is now one of the most common long-term conditions in the UK. It is therefore important to develop a comprehensive appreciation of the healthcare and societal costs in order to inform decisions on care provision and planning. We plan to build on our earlier estimates of national prevalence and costs from asthma by filling the data gaps previously identified in relation to healthcare and broadening the field of enquiry to include societal costs. This work will provide the first UK-wide estimates of the costs of asthma. In the context of asthma for the UK and its member countries (ie, England, Northern Ireland, Scotland and Wales), we seek to: (1) produce a detailed overview of estimates of incidence, prevalence and healthcare utilisation; (2) estimate health and societal costs; (3) identify any remaining information gaps and explore the feasibility of filling these and (4) provide insights into future research that has the potential to inform changes in policy leading to the provision of more cost-effective care. Secondary analyses of data from national health surveys, primary care, prescribing, emergency care, hospital, mortality and administrative data sources will be undertaken to estimate prevalence, healthcare utilisation and outcomes from asthma. Data linkages and economic modelling will be undertaken in an attempt to populate data gaps and estimate costs. Separate prevalence and cost estimates will be calculated for each of the UK-member countries and these will then be aggregated to generate UK-wide estimates. Approvals have been obtained from the NHS Scotland Information Services Division's Privacy Advisory Committee, the Secure Anonymised Information Linkage Collaboration Review System, the NHS South-East Scotland Research Ethics Service and The University of Edinburgh's Centre for Population Health Sciences Research Ethics Committee. We will produce a report for Asthma-UK, submit papers to peer-reviewed journals and construct an interactive map

  19. Carbon footprints of cities and other human settlements in the UK

    NASA Astrophysics Data System (ADS)

    Minx, Jan; Baiocchi, Giovanni; Wiedmann, Thomas; Barrett, John; Creutzig, Felix; Feng, Kuishuang; Förster, Michael; Pichler, Peter-Paul; Weisz, Helga; Hubacek, Klaus

    2013-09-01

    A growing body of literature discusses the CO2 emissions of cities. Still, little is known about emission patterns across density gradients from remote rural places to highly urbanized areas, the drivers behind those emission patterns and the global emissions triggered by consumption in human settlements—referred to here as the carbon footprint. In this letter we use a hybrid method for estimating the carbon footprints of cities and other human settlements in the UK explicitly linking global supply chains to local consumption activities and associated lifestyles. This analysis comprises all areas in the UK, whether rural or urban. We compare our consumption-based results with extended territorial CO2 emission estimates and analyse the driving forces that determine the carbon footprint of human settlements in the UK. Our results show that 90% of the human settlements in the UK are net importers of CO2 emissions. Consumption-based CO2 emissions are much more homogeneous than extended territorial emissions. Both the highest and lowest carbon footprints can be found in urban areas, but the carbon footprint is consistently higher relative to extended territorial CO2 emissions in urban as opposed to rural settlement types. The impact of high or low density living remains limited; instead, carbon footprints can be comparatively high or low across density gradients depending on the location-specific socio-demographic, infrastructural and geographic characteristics of the area under consideration. We show that the carbon footprint of cities and other human settlements in the UK is mainly determined by socio-economic rather than geographic and infrastructural drivers at the spatial aggregation of our analysis. It increases with growing income, education and car ownership as well as decreasing household size. Income is not more important than most other socio-economic determinants of the carbon footprint. Possibly, the relationship between lifestyles and infrastructure only

  20. An Introduction to ESERO-UK, the UK Space Education Office

    ERIC Educational Resources Information Center

    Clements, Allan; Mather, Edward

    2012-01-01

    This article introduces the UK branch of the European Space Education Resource Office (ESERO-UK), also known as the UK Space Education Office. It is a teaching project designed to use space to enthuse primary and secondary students to study science, technology, engineering and mathematics (STEM) subjects. The office is funded by the European Space…

  1. Household air pollution, health, and climate change: cleaning the air

    NASA Astrophysics Data System (ADS)

    Goldemberg, Jose; Martinez-Gomez, Javier; Sagar, Ambuj; Smith, Kirk R.

    2018-03-01

    Air pollution from the use of solid household fuels is now recognized to be a major health risk in developing countries. Accordingly, there has been some shift in development thinking and investment from previous efforts, which has focused only on improving the efficiency of household fuel use, to those that focus on reducing exposure to the air pollution that leads to health impact. Unfortunately, however, this is occurring just as the climate agenda has come to dominate much of the discourse and action on international sustainable development. Thus, instead of optimizing approaches that centrally focus on the large health impact, the household energy agenda has been hampered by the constraints imposed by a narrow definition of sustainability—one primarily driven by the desire to mitigate greenhouse emissions by relying on renewable biomass fueling so-called improved cookstoves. In reality, however, solid biomass is extremely difficult to burn sufficiently cleanly in household stoves to reach health goals. In comparison to the international development community, however, some large countries, notably Brazil historically and more recently, India have substantially expanded the use of liquefied petroleum gas (LPG) in their household energy mix, using their own resources, having a major impact on their national energy picture. The net climate impact of such approaches compared to current biomass stoves is minimal or non-existent, and the social and health benefits are, in contrast, potentially great. LPG can be seen as a transition fuel for clean household energy, with induction stoves powered by renewables as the holy grail (an approach already being adopted by Ecuador as also discussed here). The enormous human and social benefits of clean energy, rather than climate concerns, should dominate the household energy access agenda today.

  2. What is the effect of secondary (high) schooling on subsequent medical school performance? A national, UK-based, cohort study

    PubMed Central

    Tiffin, Paul A; Paton, Lewis W; Kasim, Adetayo S; Böhnke, Jan R

    2018-01-01

    Objectives University academic achievement may be inversely related to the performance of the secondary (high) school an entrant attended. Indeed, some medical schools already offer ‘grade discounts’ to applicants from less well-performing schools. However, evidence to guide such policies is lacking. In this study, we analyse a national dataset in order to understand the relationship between the two main predictors of medical school admission in the UK (prior educational attainment (PEA) and performance on the United Kingdom Clinical Aptitude Test (UKCAT)) and subsequent undergraduate knowledge and skills-related outcomes analysed separately. Methods The study was based on national selection data and linked medical school outcomes for knowledge and skills-based tests during the first five years of medical school. UKCAT scores and PEA grades were available for 2107 students enrolled at 18 medical schools. Models were developed to investigate the potential mediating role played by a student’s previous secondary school’s performance. Multilevel models were created to explore the influence of students’ secondary schools on undergraduate achievement in medical school. Results The ability of the UKCAT scores to predict undergraduate academic performance was significantly mediated by PEA in all five years of medical school. Undergraduate achievement was inversely related to secondary school-level performance. This effect waned over time and was less marked for skills, compared with undergraduate knowledge-based outcomes. Thus, the predictive value of secondary school grades was generally dependent on the secondary school in which they were obtained. Conclusions The UKCAT scores added some value, above and beyond secondary school achievement, in predicting undergraduate performance, especially in the later years of study. Importantly, the findings suggest that the academic entry criteria should be relaxed for candidates applying from the least well performing

  3. Variation in assessment and standard setting practices across UK undergraduate medicine and the need for a benchmark

    PubMed Central

    2015-01-01

    Objectives The principal aim of this study is to provide an account of variation in UK undergraduate medical assessment styles and corresponding standard setting approaches with a view to highlighting the importance of a UK national licensing exam in recognizing a common standard. Methods Using a secure online survey system, response data were collected during the period 13 - 30 January 2014 from selected specialists in medical education assessment, who served as representatives for their respective medical schools. Results Assessment styles and corresponding choices of standard setting methods vary markedly across UK medical schools. While there is considerable consensus on the application of compensatory approaches, individual schools display their own nuances through use of hybrid assessment and standard setting styles, uptake of less popular standard setting techniques and divided views on norm referencing. Conclusions The extent of variation in assessment and standard setting practices across UK medical schools validates the concern that there is a lack of evidence that UK medical students achieve a common standard on graduation. A national licensing exam is therefore a viable option for benchmarking the performance of all UK undergraduate medical students. PMID:26520472

  4. The cost effectiveness of ivabradine in the treatment of chronic heart failure from the U.K. National Health Service perspective.

    PubMed

    Griffiths, A; Paracha, N; Davies, A; Branscombe, N; Cowie, M R; Sculpher, M

    2014-07-01

    Ivabradine, a specific heart rate lowering therapy, has been shown in a randomised placebo-controlled study, Systolic HF Treatment with the If Inhibitor Ivabradine Trial (SHIfT), to significantly reduce the composite end point of cardiovascular death and hospitalisation for worsening heart failure (HF) in patients with systolic HF who are in sinus rhythm and with a heart rate ≥70 bpm, when added to optimised medical therapy (HR: 0.82, 95% CI 0.75 to 0.90, p<0.0001). We assessed the cost effectiveness of ivabradine, from a UK National Health Service perspective, based on the results of SHIfT. A Markov model estimated the cost effectiveness of ivabradine compared with standard care for two cohorts of patients with HF (heart rate ≥75 bpm in line with the EU labelled indication; and heart rate ≥70 bpm in line with the SHIfT study population). Modelled outcomes included death, hospitalisation, quality of life and New York Heart Association class. Total costs and quality adjusted life years (QALYs) for ivabradine and standard care were estimated over a lifetime horizon. The incremental cost per additional QALY for ivabradine plus standard care versus standard care has been estimated as £8498 for heart rate ≥75 bpm and £13 764 for heart rate ≥70 bpm. Ivabradine is expected to have a 95% chance of being cost-effective in the EU licensed population using the current National Institute for Health and Care Excellence cost effectiveness threshold of £20 000 per QALY. These results were robust in sensitivity analyses. This economic evaluation suggests that the use of ivabradine is likely to be cost-effective in eligible patients with HF from a UK National Health Service perspective. 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.

  5. Specialist perioperative allergy clinic services in the UK 2016: Results from the Royal College of Anaesthetists Sixth National Audit Project.

    PubMed

    Egner, W; Cook, T; Harper, N; Garcez, T; Marinho, S; Kong, K L; Nasser, S; Thomas, M; Warner, A; Hitchman, J; Floss, K

    2017-10-01

    Guidelines for investigation of perioperative drug allergy exist, but the quality of services is unknown. Specialist perioperative anaphylaxis services were surveyed through the Royal College of Anaesthetists 6 th National Audit Project. We compare self-declared UK practice in specialist perioperative allergy services with national recommendations. A SurveyMonkey™ questionnaire was distributed to providers of allergy services in the UK. Responses were assessed for adherence to the best practice recommendations of the British Society for Allergy and Clinical Immunology (BSACI), the Association of Anaesthetists of Great Britain and Ireland and the National Institute for Health and Care Excellence (NICE) Guidance on Drug Allergy-CG183. Over 1200 patients were evaluated in 44 centres annually. Variation in workload, waiting times, access, staffing and diagnostic approach was noted. Paediatric centres had the longest routine waiting times (most wait >13 weeks) in contrast to adult centres (most wait <12 weeks). Service leads are allergists/immunologists (91%) or anaesthetists (7%). Potentially important differences were seen in: testing repertoire [10/44 (23%) lacked BSACI compliant neuromuscular blocking agent (NMBA) panels and 17/44 (39%) lacked a NAP6-defined extended panel; many failed to screen all cases for chlorhexidine 19/44 (43%) or latex 21/44 (48%)], staffing [only 26/44 (59%) had specialist nurses and 18/44 (41%) an anaesthetist] and provision of information [18/44 (41%) gave immediate information in clinic and 5/44 (11%) sign-posted support groups]. Most centres were able to provide diagnostic challenges to antibiotics [40/44 (91%]) and local anaesthetics [41/44 (93%)]. Diagnostic testing is not harmonized, with marked variability in the NMBA panels used to identify safe alternatives. Chlorhexidine and latex are not part of routine testing in many centres. Poor access to services and patient information provision require attention. Harmonization of

  6. Well-Being in Adolescence--An Association with Health-Related Behaviors: Findings from "Understanding Society," the UK Household Longitudinal Study

    ERIC Educational Resources Information Center

    Booker, Cara L.; Skew, Alexandra J.; Sacker, Amanda; Kelly, Yvonne J.

    2014-01-01

    The objective of this study was to investigate the demographic distribution of selected health-related behaviors and their relationship with different indicators of well-being. The data come from Wave 1 of the youth panel of "Understanding Society" household panel study. The Strengths and Difficulties Questionnaire (SDQ) measured…

  7. Radon in harvested rainwater at the household level, Palestine.

    PubMed

    Al-Khatib, Issam A; Al Zabadi, Hamzeh; Saffarini, Ghassan

    2017-04-01

    The main objective of this study was to assess Radon concentration in the harvested rainwater (HRW) at the household level in Yatta area, Palestine. HRW is mainly used for drinking as it is the major source of water for domestic uses due to water scarcity. Ninety HRW samples from the household cisterns were collected from six localities (a town and five villages) and Radon concentrations were measured. The samples were randomly collected from different households to represent the Yatta area. Fifteen samples were collected from each locality at the same day. RAD7 device was used for analysis and each sample was measured in duplicate. Radon concentrations ranged from 0.037 to 0.26 Bq/L with a mean ± standard deviation of 0.14 ± 0.06 Bq/L. The estimated annual effective radiation doses for babies, children and adults were all far below the maximum limit of 5 mSvy -1 set by the National Council on Radiation Protection and Measurements. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Health economic burden that wounds impose on the National Health Service in the UK

    PubMed Central

    Guest, Julian F; Ayoub, Nadia; McIlwraith, Tracey; Uchegbu, Ijeoma; Gerrish, Alyson; Weidlich, Diana; Vowden, Kathryn; Vowden, Peter

    2015-01-01

    Objective To estimate the prevalence of wounds managed by the UK's National Health Service (NHS) in 2012/2013 and the annual levels of healthcare resource use attributable to their management and corresponding costs. Methods This was a retrospective cohort analysis of the records of patients in The Health Improvement Network (THIN) Database. Records of 1000 adult patients who had a wound in 2012/2013 (cases) were randomly selected and matched with 1000 patients with no history of a wound (controls). Patients’ characteristics, wound-related health outcomes and all healthcare resource use were quantified and the total NHS cost of patient management was estimated at 2013/2014 prices. Results Patients’ mean age was 69.0 years and 45% were male. 76% of patients presented with a new wound in the study year and 61% of wounds healed during the study year. Nutritional deficiency (OR 0.53; p<0.001) and diabetes (OR 0.65; p<0.001) were independent risk factors for non-healing. There were an estimated 2.2 million wounds managed by the NHS in 2012/2013. Annual levels of resource use attributable to managing these wounds and associated comorbidities included 18.6 million practice nurse visits, 10.9 million community nurse visits, 7.7 million GP visits and 3.4 million hospital outpatient visits. The annual NHS cost of managing these wounds and associated comorbidities was £5.3 billion. This was reduced to between £5.1 and £4.5 billion after adjusting for comorbidities. Conclusions Real world evidence highlights wound management is predominantly a nurse-led discipline. Approximately 30% of wounds lacked a differential diagnosis, indicative of practical difficulties experienced by non-specialist clinicians. Wounds impose a substantial health economic burden on the UK's NHS, comparable to that of managing obesity (£5.0 billion). Clinical and economic benefits could accrue from improved systems of care and an increased awareness of the impact that wounds impose on patients

  9. Correlates of Intra-Household ITN Use in Liberia: A Multilevel Analysis of Household Survey Data.

    PubMed

    Babalola, Stella; Ricotta, Emily; Awantang, Grace; Lewicky, Nan; Koenker, Hannah; Toso, Michael

    2016-01-01

    Malaria is a major cause of morbidity and mortality in Liberia. At the same time, insecticide-treated net (ITN) ownership and use remain low. Access is a key determinant of ITN use but it is not the only one; prior studies have identified factors that affect the use of ITNs in households with at least one ITN. These factors operate at the individual, household, and community levels. However, studies have generally not assessed the psychosocial or ideational determinants of ITN use. Using 2014 household survey data, this manuscript examines the socio-demographic, ideational, household, and community factors associated with household member use of ITNs in Liberia. Multilevel modeling was used to assess fixed effects at the individual, household, and community levels, and random effects at the household and cluster levels. The data showed significant residual clustering at the household level, indicating that there were unmeasured factors operating at this level that are associated with ITN use. The association of age with ITN use was moderated by sex such that men, older children, and teenagers were less likely to sleep under an ITN compared to women and children under five years old. Female caregivers' perceived severity of malaria, perceived self-efficacy to detect a complicated case of malaria, and exposure to the "Take Cover" communication campaign were positively associated with ITN use by members of her household. The association with household size was negative, while the relationship with the number of ITNs was positive. Programs should seek to achieve universal coverage (that is, one ITN for every two household members) and promote the notion that everyone needs to sleep under an ITN every night. Programs should also seek to strengthen perceived severity of malaria and educate intended audience groups on the signs of malaria complications. Given the significance of residual clustering at the household level, interventions that engage men as heads of

  10. Addressing Household Food Insecurity in Canada - Position Statement and Recommendations - Dietitians of Canada.

    PubMed

    2016-09-01

    POSITION STATEMENT It is the position of Dietitians of Canada that household food insecurity is a serious public health issue with profound effects on physical and mental health and social well-being. All households in Canada must have sufficient income for secure access to nutritious food after paying for other basic necessities. Given the alarming prevalence, severity and impact of household food insecurity in Canada, Dietitians of Canada calls for a pan-Canadian, government-led strategy to specifically reduce food insecurity at the household level, including policies that address the unique challenges of household food insecurity among Indigenous Peoples. Regular monitoring of the prevalence and severity of household food insecurity across all of Canada is required. Research must continue to address gaps in knowledge about household vulnerability to food insecurity and to evaluate the impact of policies developed to eliminate household food insecurity in Canada. Dietitians of Canada recommends: Development and implementation of a pan-Canadian government-led strategy that includes coordinated policies and programs, to ensure all households have consistent and sufficient income to be able to pay for basic needs, including food. Implementation of a federally-supported strategy to comprehensively address the additional and unique challenges related to household food insecurity among Indigenous Peoples, including assurance of food sovereignty, with access to lands and resources, for acquiring traditional/country foods, as well as improved access to more affordable and healthy store-bought/market foods in First Nation reserves and northern and remote communities. Commitment to mandatory, annual monitoring and reporting of the prevalence of marginal, moderate and severe household food insecurity in each province and territory across Canada, including among vulnerable populations, as well as regular evaluation of the impact of poverty reduction and protocols for

  11. The influence of health expenditures on household impoverishment in Brazil

    PubMed Central

    Boing, Alexandra Crispim; Bertoldi, Andréa Dâmaso; Posenato, Leila Garcia; Peres, Karen Glazer

    2014-01-01

    OBJECTIVE To analyze the variation in the proportion of households living below the poverty line in Brazil and the factors associated with their impoverishment. METHODS Income and expenditure data from the Household Budget Survey, which was conducted in Brazil between 2002-2003 (n = 48,470 households) and 2008-2009 (n = 55,970 households) with a national sample, were analyzed. Two cutoff points were used to define poverty. The first cutoff is a per capita monthly income below R$100.00 in 2002-2003 and R$140.00 in 2008-2009, as recommended by the Bolsa Família Program. The second, which is proposed by the World Bank and is adjusted for purchasing power parity, defines poverty as per capita income below US$2.34 and US$3.54 per day in 2002-2003 and 2008-2009, respectively. Logistic regression was used to identify the sociodemographic factors associated with the impoverishment of households. RESULTS After subtracting health expenditures, there was an increase in households living below the poverty line in Brazil. Using the World Bank poverty line, the increase in 2002-2003 and 2008-2009 was 2.6 percentage points (6.8%) and 2.3 percentage points (11.6%), respectively. Using the Bolsa Família Program poverty line, the increase was 1.6 (11.9%) and 1.3 (17.3%) percentage points, respectively. Expenditure on prescription drugs primarily contributed to the increase in poor households. According to the World Bank poverty line, the factors associated with impoverishment include a worse-off financial situation, a household headed by an individual with low education, the presence of children, and the absence of older adults. Using the Bolsa Família Program poverty line, the factors associated with impoverishment include a worse-off financial situation and the presence of children. CONCLUSIONS Health expenditures play an important role in the impoverishment of segments of the Brazilian population, especially among the most disadvantaged. PMID:25372171

  12. The influence of health expenditures on household impoverishment in Brazil.

    PubMed

    Boing, Alexandra Crispim; Bertoldi, Andréa Dâmaso; Posenato, Leila Garcia; Peres, Karen Glazer

    2014-10-01

    To analyze the variation in the proportion of households living below the poverty line in Brazil and the factors associated with their impoverishment. Income and expenditure data from the Household Budget Survey, which was conducted in Brazil between 2002-2003 (n = 48,470 households) and 2008-2009 (n = 55,970 households) with a national sample, were analyzed. Two cutoff points were used to define poverty. The first cutoff is a per capita monthly income below R$100.00 in 2002-2003 and R$140.00 in 2008-2009, as recommended by the Bolsa Família Program. The second, which is proposed by the World Bank and is adjusted for purchasing power parity, defines poverty as per capita income below US$2.34 and US$3.54 per day in 2002-2003 and 2008-2009, respectively. Logistic regression was used to identify the sociodemographic factors associated with the impoverishment of households. After subtracting health expenditures, there was an increase in households living below the poverty line in Brazil. Using the World Bank poverty line, the increase in 2002-2003 and 2008-2009 was 2.6 percentage points (6.8%) and 2.3 percentage points (11.6%), respectively. Using the Bolsa Família Program poverty line, the increase was 1.6 (11.9%) and 1.3 (17.3%) percentage points, respectively. Expenditure on prescription drugs primarily contributed to the increase in poor households. According to the World Bank poverty line, the factors associated with impoverishment include a worse-off financial situation, a household headed by an individual with low education, the presence of children, and the absence of older adults. Using the Bolsa Família Program poverty line, the factors associated with impoverishment include a worse-off financial situation and the presence of children. Health expenditures play an important role in the impoverishment of segments of the Brazilian population, especially among the most disadvantaged.

  13. Maternal employment and Mexican school-age children overweight in 2012: the importance of households features.

    PubMed

    Espinosa, Alejandro Martínez

    2018-01-01

    International evidence regarding the relationship between maternal employment and school-age children overweight and obesity shows divergent results. In Mexico, this relationship has not been confirmed by national data sets analysis. Consequently, the objective of this article was to evaluate the role of the mothers' participation in labor force related to excess body weight in Mexican school-age children (aged 5-11 years). A cross-sectional study was conducted on a sample of 17,418 individuals from the National Health and Nutrition Survey 2012, applying binomial logistic regression models. After controlling for individual, maternal and contextual features, the mothers' participation in labor force was associated with children body composition. However, when the household features (living arrangements, household ethnicity, size, food security and socioeconomic status) were incorporated, maternal employment was no longer statically significant. Household features are crucial factors for understanding the overweight and obesity prevalence levels in Mexican school-age children, despite the mother having a paid job. Copyright: © 2018 Permanyer.

  14. Household Hazardous Waste and Demolition

    EPA Pesticide Factsheets

    Household wastes that are toxic, corrosive, ignitable, or reactive are known as Household Hazardous Waste (HHW). Household Hazardous Waste may be found during residential demolitions, and thus require special handling for disposal.

  15. Household spending on health care.

    PubMed

    Chaplin, R; Earl, L

    2000-10-01

    This article examines changes in household spending on health care between 1978 and 1998. It also provides a detailed look at household spending on health care in 1998. Data on household spending are from Statistics Canada's Family Expenditure Survey for survey years between 1978 and 1996, and from the annual Survey of Household Spending for 1997 and 1998. Proportion of after-tax spending was calculated by subtracting average personal income taxes from average total expenditures and then dividing health care expenditures by this figure. Per capita spending was calculated by dividing average household spending by average household size. Constant dollar figures and adjustments for inflation were calculated using the Consumer Price Index (1998 = 100) to control for the effect of inflation over time. Almost every Canadian household (98.2%) reported health care expenditures in 1998, spending an average of close to $1,200, up from around $900 in 1978. In 1998, households dedicated a larger share of their average after-tax spending (2.9%) to health care than they did 20 years earlier (2.3%). Health insurance premiums claimed the largest share (29.8%) of average health care expenditures, followed by dental care, then prescription medications and pharmaceutical products.

  16. National audit of cerebrospinal fluid testing.

    PubMed

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

    2007-09-01

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

  17. Predictors of knowledge about tuberculosis: results from SANHANES I, a national, cross-sectional household survey in South Africa.

    PubMed

    Naidoo, Pamela; Simbayi, Leickness; Labadarios, Demetre; Ntsepe, Yoliswa; Bikitsha, Nwabisa; Khan, Gadija; Sewpaul, Ronel; Moyo, Sizulu; Rehle, Thomas

    2016-03-18

    South Africa is one of the 22 high tuberculosis burden countries that contribute 80% of the global tuberculosis cases. Tuberculosis is infectious and due to its rapid and easy transmission route poses a threat to population health. Considering the importance of social and psychological factors in influencing health outcomes, appraising knowledge and awareness of tuberculosis, remain vital for effective tuberculosis control. The main aim of this study was to investigate the factors that predict knowledge about tuberculosis among 18-64 year old adults in South Africa. A cross-sectional survey method was used. Multi-stage disproportionate, stratified cluster sampling was used to select households within enumeration areas stratified by province and locality type. Based on the Human Sciences Research Council 2007 master sample, 500 Enumerator Areas representative of the socio-demographic profile of South Africa were identified and a random sample of 20 households was randomly selected from each Enumerator Area, yielding an overall sample of 10,000 households. The tuberculosis module contained in the South African National Health And Nutrition Examination Survey I was the only module that examined the social determinants of an infectious disease. This module was questionnaire-based with no biomarkers obtained to screen for the presence of tuberculosis disease among the participants. Data was collected by administering a researcher developed individual level questionnaire. Simple and multiple linear regression was used to determine the independent variables associated with tuberculosis knowledge. Half the sample (52.6%) was female and the majority of the respondents were black African (76.5%). More than two thirds (68.0%) resided in urban areas, 56.9% did not complete high school and half were not in formal employment. Significant predictors of tuberculosis knowledge were race, sex, completion of high school, being in employment, having a diagnosis of the disease in ones

  18. Household Food Insecurity Is Associated with Adverse Mental Health Indicators and Lower Quality of Life among Koreans: Results from the Korea National Health and Nutrition Examination Survey 2012–2013

    PubMed Central

    Chung, Hye-Kyung; Kim, Oh Yoen; Kwak, So Young; Cho, Yoonsu; Lee, Kyong Won; Shin, Min-Jeong

    2016-01-01

    Food insecurity is an ongoing public health issue and contributes to mental health status. We investigated whether food insecurity is associated with inadequate nutrient intake and whether it affects mental health indicators (perceived stress/experience of depressive symptom/suicidal ideation) and quality of life (QOL) among Koreans (n = 5862, 20–64 years) using data from the Korea National Health and Nutritional Examination Survey (2012–2013). Household food security status was categorized as “food-secure household”, “food-insecure household without hunger”, and “food-insecure household with hunger”. Data on food insecurity, sociodemographic factors, nutrient intake, mental health indicators, and QOL were used. A logistic regression model was conducted to determine odds ratios (ORs) for psychological health. A greater proportion of food-insecure participants were nutritionally deficient compared with expectations of the 2015 Korean Dietary Reference Intakes. These deficiencies were generally higher in both “food-insecure household” groups. Both “food-insecure household” groups, particularly the “food-insecure household with hunger” group showed significantly adverse mental health status (ORs: 1.52–3.83) and lower QOL (ORs: 1.49–3.92) than did the “food-secure household” group before and after adjusting for sex, age, education, household income, smoking/alcohol consumption, physical activity, marital status, and receiving food assistance. In conclusion, food insecurity may be significantly associated with adverse mental health indicators and decreased QOL in young/middle-aged Koreans. PMID:27999277

  19. Why doctors consider leaving UK medicine: qualitative analysis of comments from questionnaire surveys three years after graduation

    PubMed Central

    Lambert, Trevor W; Goldacre, Michael J

    2017-01-01

    Objective To report the reasons why doctors are considering leaving medicine or the UK. Design Questionnaire survey. Setting UK. Participants Questionnaires were sent three years after graduation to all UK medical graduates of 2008 and 2012. Main outcome measures Comments from doctors about their main reasons for considering leaving medicine or the UK (or both). Results The response rate was 46.2% (5291/11,461). Among the 60% of respondents who were not definitely intent on remaining in UK medicine, 50% were considering working in medicine outside the UK and 10% were considering leaving medicine. Among those considering working in medicine outside the UK, the most commonly cited reasons were to gain wider experience, that things would be ‘better’ elsewhere and a negative view of the National Health Service and its culture, state and politics. Other reasons included better training or job opportunities, better pay and conditions, family reasons and higher expectations. Three years after graduation, doctors surveyed in 2015 were significantly more likely than doctors surveyed in 2011 to cite factors related to the National Health Service, to pay and conditions, to their expectations and to effects on work–life balance and patient care. Among those considering leaving medicine, the dominant reason for leaving medicine was a negative view of the National Health Service (mentioned by half of those in this group who commented). Three years after graduation, doctors surveyed in 2015 were more likely than doctors surveyed in 2011 to cite this reason, as well as excessive hours and workload, and financial reasons. Conclusions An increasingly negative view is held by many doctors of many aspects of the experience of being a junior doctor in the National Health Service, and the difficulty of delivering high-quality patient care within what many see as an under-funded system. Policy changes designed to encourage more doctors to remain should be motivated by a desire to

  20. Why doctors consider leaving UK medicine: qualitative analysis of comments from questionnaire surveys three years after graduation.

    PubMed

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

    2018-01-01

    Objective To report the reasons why doctors are considering leaving medicine or the UK. Design Questionnaire survey. Setting UK. Participants Questionnaires were sent three years after graduation to all UK medical graduates of 2008 and 2012. Main outcome measures Comments from doctors about their main reasons for considering leaving medicine or the UK (or both). Results The response rate was 46.2% (5291/11,461). Among the 60% of respondents who were not definitely intent on remaining in UK medicine, 50% were considering working in medicine outside the UK and 10% were considering leaving medicine. Among those considering working in medicine outside the UK, the most commonly cited reasons were to gain wider experience, that things would be 'better' elsewhere and a negative view of the National Health Service and its culture, state and politics. Other reasons included better training or job opportunities, better pay and conditions, family reasons and higher expectations. Three years after graduation, doctors surveyed in 2015 were significantly more likely than doctors surveyed in 2011 to cite factors related to the National Health Service, to pay and conditions, to their expectations and to effects on work-life balance and patient care. Among those considering leaving medicine, the dominant reason for leaving medicine was a negative view of the National Health Service (mentioned by half of those in this group who commented). Three years after graduation, doctors surveyed in 2015 were more likely than doctors surveyed in 2011 to cite this reason, as well as excessive hours and workload, and financial reasons. Conclusions An increasingly negative view is held by many doctors of many aspects of the experience of being a junior doctor in the National Health Service, and the difficulty of delivering high-quality patient care within what many see as an under-funded system. Policy changes designed to encourage more doctors to remain should be motivated by a desire to address

  1. Environmental health impacts: occurrence, exposure and significance, Lancaster University, UK, 9-10 September 2003.

    PubMed

    Martin, Francis L; Semple, Kirk T

    2004-09-01

    Speakers: John Ashby (Syngenta CTL, UK), Peter A. Behnisch (Eurofins GfA, Germany), Paul L. Carmichael (Unilever Colworth, UK), Curtis C.Harris (National Cancer Institute, USA), Kevin C. Jones (Lancaster University, UK), Andreas Kortenkamp (School of Pharmacy, London, UK), Caroline J. Langdon (Reading University, UK), Anthony M. Lynch (GlaxoSmithKline, UK), Francis L. Martin (Lancaster University, UK), Trevor J. McMillan (Lancaster University, UK), David H. Phillips (Institute of Cancer Research, UK), Huw J. Ricketts (University of Cardiff, UK), Michael N. Routledge (University of Leeds, UK), J. Thomas Sanderson (Utrecht University, The Netherlands) and Kirk T. Semple (Lancaster University, UK) The effects of many environmental exposures to either single contaminants or to mixtures still remain to be properly assessed in ecotoxicological and human toxicological settings. Such assessments need to be carried out using relevant biological assays. On a mechanistic basis, future studies need to be able to extrapolate exposure to disease risk. It is envisaged that such an approach would lead to the development of appropriate strategies to either reduce exposures or to initiate preventative measures in susceptible individuals or populations. To mark the opening of a new Institute, the Lancaster Environmental Centre, an environmental health workshop was held over 2 days (9-10 September 2003) at Lancaster University, UK. The fate, behaviour and movement of chemicals in the environment, together with environmental exposures and human health, biomarkers of such exposures, hormone-like compounds and appropriate genetic toxicology methodologies, were discussed.

  2. UK national guidelines on the management of syphilis 2015.

    PubMed

    Kingston, M; French, P; Higgins, S; McQuillan, O; Sukthankar, A; Stott, C; McBrien, B; Tipple, C; Turner, A; Sullivan, A K; Radcliffe, Keith; Cousins, Darren; FitzGerald, Mark; Fisher, Martin; Grover, Deepa; Higgins, Stephen; Kingston, Margaret; Rayment, Michael; Sullivan, Ann

    2016-05-01

    These guidelines are an update for 2015 of the 2008 UK guidelines for the management of syphilis. The writing group have piloted the new BASHH guideline methodology, notably using the GRADE system for assessing evidence and making recommendations. We have made significant changes to the recommendations for screening infants born to mothers with positive syphilis serology and to facilitate accurate and timely communication between the teams caring for mother and baby we have developed a birth plan. Procaine penicillin is now an alternative, not preferred treatment, for all stages of syphilis except neurosyphilis, but the length of treatment for this is shortened. Other changes are summarised at the start of the guideline. © The Author(s) 2016.

  3. Audit of healthcare professionals’ attitudes towards patients who self-harm and adherence to national guidance in a UK burns and plastic surgery department

    PubMed Central

    Heyward-Chaplin, Jessica; Shepherd, Laura; Arya, Reza; O’Boyle, Ciaran P

    2018-01-01

    Background: Rates of self-harm injuries are considered to be increasing. The attitudes of healthcare staff towards patients who self-harm may be negative and a small amount of research specifically investigating burns and plastic surgery healthcare professionals has recently been conducted exploring this issue. This study aimed to determine attitudes towards and adherence to national guidance by healthcare professionals in a UK burns and plastic surgery department with respect to patients who self-harm. Method: An audit questionnaire, completed in a designated Burns Unit and plastic surgery department, within a UK hospital with a major trauma centre. Results: Data were obtained from 59 healthcare professionals. The majority of responders held positive attitudes towards those who had self-harmed. However, a significant minority held negative attitudes, stating that they found it difficult to be compassionate (10%; n = 6) and believing that patients usually self-harm to get attention (9%; n = 5). One-fifth (n = 12) agreed that, on a departmental level, conservative management (as opposed to surgery) was offered more frequently for self-harm injuries compared with accidental injuries, contrary to national guidance. Awareness of national guidance in relation to self-harm injuries was markedly lacking, in only 12% (n = 7/59) and the frequency of completing relevant training was low (34%, n = 20/59). Conclusion: Education among healthcare professionals is important, to ensure adherence to best practice. The findings of this study strongly suggest that many healthcare professionals do not know the current best practice. As a result, these highly vulnerable patients may be receiving sub-optimal care, with consequentially poor outcomes. PMID:29873329

  4. Household Demography and Early Childhood Mortality in a Rice-Farming Village in Northern Laos

    PubMed Central

    Tomita, Shinsuke; Parker, Daniel M.; Jennings, Julia A.; Wood, James

    2015-01-01

    This paper extends Alexandr Chayanov’s model of changing household demography (specifically the ratio of food consumers to food producers) and its influence on agricultural behavior so that it includes possible adverse effects of a rising ratio on nutritional status and early childhood mortality within the household. We apply the model to 35 years’ worth of longitudinal demographic and economic data collected in the irrigated-rice growing village of Na Savang in northern Laos. When appropriate controls are included for other household variables, unobserved inter-household heterogeneity, and changes in local conditions and national policy over the study period, the analysis suggests that a unit increase in the household’s consumer/producer ratio induces something like a nine-fold increase in the risk of death among household members aged less than five years. Monte Carlo simulation studies suggest that this may be an over-estimate but also that the effect is probably real and likely to be an important factor in household demography. At the very least, the results suggest that Chayanov’s model still has theoretical relevance and deserves to be revived. PMID:25775467

  5. MANAGEMENT OF HOUSEHOLD AND SMALL-QUANTITY-GENERATOR HAZARDOUS WASTE IN THE UNITED STATES

    EPA Science Inventory

    The International Solid Waste and Public Cleansing Association (ISWA), an international nongovernmental organization comprising twenty-seven national organizations of waste management professionals, conducted a survey to obtain information regarding household and small-quantity-g...

  6. Household demand for preventive HIV/AIDS vaccines in Thailand: do husbands' and wives' preferences differ?

    PubMed

    Whittington, Dale; Suraratdecha, Chutima; Poulos, Christine; Ainsworth, Martha; Prabhu, Vimalanand; Tangcharoensathien, Viroj

    2008-01-01

    The aims of this study were to estimate household demand in the general population of Thailand for a (hypothetical) preventive HIV vaccine; to determine whether spouses in the same household would purchase the same number of vaccines for household members and have the same demand function; to determine whether spouses would allocate vaccines to the same household members; and to estimate household and per capita average willingness to pay (WTP) for an HIV vaccine price. The data come from a national contingent valuation survey of 2524 residents (aged 18-20 years) of 1235 households in Thailand during the period 2000 to 2001. In a subsample of 561 households, both head of household and spouse completed independent (separate) interviews. Respondents were asked whether they would purchase an HIV vaccine for themselves and for other household members if one were available at a specified price. For the full sample, average household WTP for the vaccine was substantial (US$610 at 50% vaccine effectiveness, US$671 at 95% effectiveness); the average per capita WTP for household members was US$220 at 50% effectiveness and US$242 at 95% effectiveness. Although spouses reported that they would purchase the same total number of vaccines, and had essentially the same demand functions, at lower vaccine prices wives were significantly more likely than husbands to allocate vaccines to their daughters than to sons. Because wives are more likely to allocate vaccines to daughters, vaccination programs aimed at women and girls might have different outcomes than programs directed at males or at all potential adults without regard to sex.

  7. National Audit of Seizure management in Hospitals (NASH): results of the national audit of adult epilepsy in the UK

    PubMed Central

    Dixon, Peter A; Kirkham, Jamie J; Marson, Anthony G; Pearson, Mike G

    2015-01-01

    Objectives About 100 000 people present to hospitals each year in England with an epileptic seizure. How they are managed is unknown; thus, the National Audit of Seizure management in Hospitals (NASH) set out to assess prior care, management of the acute event and follow-up of these patients. This paper describes the data from the second audit conducted in 2013. Setting 154 emergency departments (EDs) across the UK. Participants Data from 4544 attendances (median age of 45 years, 57% men) showed that 61% had a prior diagnosis of epilepsy, 12% other neurological problems and 22% were first seizure cases. Each ED identified 30 consecutive adult cases presenting due to a seizure. Primary and secondary outcome measures Details were recorded of the patient's prior care, management at hospital and onward referral to neurological specialists onto an online database. Descriptive results are reported at national level. Results Of those with epilepsy, 498 (18%) were on no antiepileptic drug therapy and 1330 (48%) were on monotherapy. Assessments were often incomplete and witness histories were sought in only 759 (75%) of first seizure patients, 58% were seen by a senior doctor and 57% were admitted. For first seizure patients, advice on further seizure management was given to 264 (27%) and only 55% were referred to a neurologist or epilepsy specialist. For each variable, there was wide variability among sites that was not explicable. For the sites who partook in both audits, there was a trend towards better care in 2013, but this was small and dwarfed by the intersite variability. Conclusions These results have parallels with the Sentinel Audit of Stroke performed a decade earlier. There is wide intersite variability in care covering the entire care pathway, and a need for better organised and accessible care for these patients. PMID:25829372

  8. The Economic Burden of Road Traffic Injuries on Households in South Asia

    PubMed Central

    Alam, Khurshid; Mahal, Ajay

    2016-01-01

    Globally, road traffic injuries accounted for about 1.36 million deaths in 2015 and are projected to become the fourth leading cause of disability-adjusted life years (DALYs) lost by 2030. One-fifth of these deaths occurred in South Asia where road traffic injuries are projected to increase by 144% by 2020. Despite this rapidly increasing disease burden there is limited evidence on the economic burden of road traffic injuries on households in South Asia. We applied a novel coarsened exact matching method to assess the household economic burden of road traffic injuries using nationally representative World Health Survey data from five South Asian countries- Bangladesh, India, Nepal, Pakistan and Sri Lanka collected during 2002–2003. We examined the impact of road traffic injuries on household out-of-pocket (OOP) health spending, household non-medical consumption expenditure and the employment status of the traffic injury-affected respondent. We exactly matched a household (after ‘coarsening’) where a respondent reported being involved in a road traffic injury to households where the respondent did not report a road traffic injury on each of multiple observed household characteristics. Our analysis found that road traffic injury-affected households had significantly higher levels of OOP health spending per member (I$0.75, p<0.01), higher OOP spending on drugs per member (I$0.30, p = 0.03), and higher OOP hospital spending per member (I$0.29, p<0.01) in the four weeks preceding the survey. Indicators of “catastrophic spending” were also significantly higher in road traffic injury-affected households: 6.45% (p<0.01) for a threshold of OOP health spending to total household spending ratio of 20%, and 7.40% (p<0.01) for a threshold of OOP health spending to household ‘capacity to pay’ ratio of 40%. However, no statistically significant effects were observed for household non-medical consumption expenditure, and employment status of the road traffic injury

  9. The effects of employment status and daily stressors on time spent on daily household chores in middle-aged and older adults.

    PubMed

    Wong, Jen D; Almeida, David M

    2013-02-01

    This study examines how employment status (worker vs. retiree) and life course influences (age, gender, and marital status) are associated with time spent on daily household chores. Second, this study assesses whether the associations between daily stressors and time spent on daily household chores differ as a function of employment status and life course influences. Men and women aged 55-74 from the National Study of Daily Experiences (N = 268; 133 workers and 135 retirees), a part of the National Survey of Midlife in the United States (MIDUS), completed telephone interviews regarding their daily experiences across 8 consecutive evenings. Working women spent more than double the amount of time on daily household chores than working men. Unmarried retirees spent the most time on daily household chores in comparison to their counterparts. There was a trend toward significance for the association between home stressors from the previous day and time spent on daily household chores as a function of employment and marital status. These findings highlight the importance of gender and marital status in the associations between employment status and time spent on daily household chores and the role that daily stressors, in particular home stressful events, have on daily household chore participation.

  10. Career choices for paediatrics: national surveys of graduates of 1974-2002 from UK medical schools.

    PubMed

    Turner, G; Lambert, T W; Goldacre, M J; Turner, Steve

    2007-05-01

    Knowledge of UK doctors' career intentions and pathways is essential for understanding future workforce requirements. The aim of this study was to report career choices for and career progression in paediatrics in the UK. Postal questionnaire surveys of qualifiers from all UK medical schools in nine qualification years since 1974. In total, 74% (24 621/33 412) and 73% (20 720/28 459) of doctors responded at 1 and 3 years after graduation. Choices for paediatrics 1 year after qualifying fell from 7.8% of 1974 graduates to 5.0% of 1983 graduates, increased to 7.2% of 1993 graduates, and since the level has remained fairly constant. Approximately twice the percentage of women graduates than men graduates indicated a long-term career choice for paediatrics. A total of 44% of those who chose paediatrics 1 year after graduation were working in it 10 years after qualifying. Experience of the subject as a student, and enthusiasm/commitment: what I really want to do, affected long-term career choices more for paediatrics than for other medical careers. The proportion of junior doctors wishing to become paediatricians has not changed much during the last 30 years. The planned increase in the number of medical school graduates is necessary to increase the number of UK-trained consultant paediatricians. Medical students who experience enthusiastic and stimulating training in paediatrics may be more likely to become paediatricians.

  11. Household catastrophic health expenditure: evidence from Georgia and its policy implications

    PubMed Central

    Gotsadze, George; Zoidze, Akaki; Rukhadze, Natia

    2009-01-01

    Background To quantify extent of catastrophic household health expenditures, determine factors influencing it and estimate Fairness in Financial Contribution (FFC) index in Georgia to establish the baseline for expected reforms and contribute to the design and fine-tuning of the major reforms in health care financing initiated by the government mid-2007. Methods The research is based on the nationally representative Health Care Utilization and Expenditure survey conducted during May-June 2007, prior to preparing for new phase of implementation for the health care financing reforms. Households' catastrophic health expenditures were estimated according to the methodology proposed by WHO – Ke Xu [1]. A logistic regression (logit) model was used to predict probability of catastrophic health expenditure occurrence. Results In Georgia between 2000 and 2007 access to care for poor has improved slightly and the share of households facing catastrophic health expenditures have seemingly increased from 2.8% in 1999 to 11.7% in 2007. However, this variance may be associated with the methodological differences of the respective surveys from which the analysis were derived. The high level of the catastrophic health expenditure may be associated with the low share of prepayment in national health expenditure, adequate availability of services and a high level of poverty in the country. Major factors determining the financial catastrophe related to ill health were hospitalization, household members with chronic illness and poverty status of the household. The FFC for Georgia appears to have improved since 2004. Conclusion Reducing the prevalence of catastrophic health expenditure is a policy objective of the government, which can be achieved by focusing on increased financial protection offered to poor and expanding government financed benefits for poor and chronically ill by including and expanding inpatient coverage and adding drug benefits. This policy recommendation may also

  12. The influence of crop production and socioeconomic factors on seasonal household dietary diversity in Burkina Faso.

    PubMed

    Somé, Jérôme W; Jones, Andrew D

    2018-01-01

    Households in low-income settings are vulnerable to seasonal changes in dietary diversity because of fluctuations in food availability and access. We assessed seasonal differences in household dietary diversity in Burkina Faso, and determined the extent to which household socioeconomic status and crop production diversity modify changes in dietary diversity across seasons, using data from the nationally representative 2014 Burkina Faso Continuous Multisectoral Survey (EMC). A household dietary diversity score based on nine food groups was created from household food consumption data collected during four rounds of the 2014 EMC. Plot-level crop production data, and data on household assets and education were used to create variables on crop diversity and household socioeconomic status, respectively. Analyses included data for 10,790 households for which food consumption data were available for at least one round. Accounting for repeated measurements and controlling for the complex survey design and confounding covariates using a weighted multi-level model, household dietary diversity was significantly higher during both lean seasons periods, and higher still during the harvest season as compared to the post-harvest season (mean: post-harvest: 4.76 (SE 0.04); beginning of lean: 5.13 (SE 0.05); end of lean: 5.21 (SE 0.05); harvest: 5.72 (SE 0.04)), but was not different between the beginning and the end of lean season. Seasonal differences in household dietary diversity were greater among households with higher food expenditures, greater crop production, and greater monetary value of crops sale (P<0.05). Seasonal changes in household dietary diversity in Burkina Faso may reflect nutritional differences among agricultural households, and may be modified both by households' socioeconomic status and agricultural characteristics.

  13. The Nexus between Routine Household Chores and a Filial Heart

    ERIC Educational Resources Information Center

    Li, Shi

    2017-01-01

    The findings of a seven-year national investigation about filial piety in China released in November 2015 indicate that an adult daughter has a stronger affective bond with old parents than an adult son. One major construct to distinguish family roles of daughters and sons is participation with household chores. By employing some psychological and…

  14. Health and human rights: a statistical measurement framework using household survey data in Uganda.

    PubMed

    Wesonga, Ronald; Owino, Abraham; Ssekiboobo, Agnes; Atuhaire, Leonard; Jehopio, Peter

    2015-05-03

    Health is intertwined with human rights as is clearly reflected in the right to life. Promotion of health practices in the context of human rights can be accomplished if there is a better understanding of the level of human rights observance. In this paper, we evaluate and present an appraisal for a possibility of applying household survey to study the determinants of health and human rights and also derive the probability that human rights are observed; an important ingredient into the national planning framework. Data from the Uganda National Governance Baseline Survey were used. A conceptual framework for predictors of a hybrid dependent variable was developed and both bivariate and multivariate statistical techniques employed. Multivariate post estimation computations were derived after evaluations of the significance of coefficients of health and human rights predictors. Findings, show that household characteristics of respondents considered in this study were statistically significant (p < 0.05) to provide a reliable assessment of human rights observance. For example, a unit increase of respondents' schooling levels results in an increase of about 34% level of positively assessing human rights observance. Additionally, the study establishes, through the three models presented, that household assessment of health and human rights observance was 20% which also represents how much of the entire continuum of human rights is demanded. Findings propose important evidence for monitoring and evaluation of health in the context human rights using household survey data. They provide a benchmark for health and human rights assessments with a focus on international and national development plans to achieve socio-economic transformation and health in society.

  15. Quantifying UK emissions of carbon dioxide using an integrative measurement strategy

    NASA Astrophysics Data System (ADS)

    Gonzi, S.; Palmer, P.

    2015-12-01

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

  16. Parameters of Household Composition as Demographic Measures

    ERIC Educational Resources Information Center

    Akkerman, Abraham

    2005-01-01

    Cross-sectional data, such as Census statistics, enable the re-enactment of household lifecourse through the construction of the household composition matrix, a tabulation of persons in households by their age and by the age of their corresponding household-heads. Household lifecourse is represented in the household composition matrix somewhat…

  17. The social context of parenting 3-year-old children with developmental delay in the UK.

    PubMed

    Emerson, E; Graham, H; McCulloch, A; Blacher, J; Hatton, C; Llewellyn, G

    2009-01-01

    Children with intellectual or developmental disability have significantly poorer health and mental health than their non-disabled peers and are at high risk of social exclusion. The aim of the present paper is to provide information on the circumstances in which 3-year-old children at risk of intellectual or developmental disability are growing up in the UK. Secondary analysis of data on 12 689 families in English-speaking monolingual households from the first two waves of the UK's Millennium Cohort Study. A total of 440 children (3% of the weighted sample) were identified as being developmentally delayed. When compared with other children, children with developmental delays were more disadvantaged on every indicator of social and economic disadvantage examined. Two out of three children with developmental delays had been exposed to repeated disadvantage as measured by income poverty, material hardship, social housing and receipt of means-tested benefits. The effect of repeated disadvantage on the risk of developmental delay remained after account was taken of parental education and occupational status. Young children with delayed development in the UK are likely to be exposed to repeated socio-economic disadvantage. Implications for policy and understanding the nature of the link between poverty and child disability are discussed.

  18. Student Disability Claims in the UK and USA: Does the Jurisprudence Converge?

    ERIC Educational Resources Information Center

    Davies, Mark; Lee, Barbara A.

    2008-01-01

    Laws in the UK and the USA protect college students with disabilities from discrimination. The laws of both nations are complex and require institutions of higher education to accommodate qualified students. This article examines the requirements of both nations' laws with respect to the kinds of inquiries that may be made of students with…

  19. Long Term Large Scale river nutrient changes across the UK

    NASA Astrophysics Data System (ADS)

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

    2017-04-01

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

  20. Head lice prevalence among households in Norway: importance of spatial variables and individual and household characteristics

    PubMed Central

    RUKKE, BJØRN ARNE; BIRKEMOE, TONE; SOLENG, ARNULF; LINDSTEDT, HEIDI HEGGEN; OTTESEN, PREBEN

    2011-01-01

    SUMMARY Head lice prevalence varies greatly between and within countries, and more knowledge is needed to approach causes of this variation. In the present study, we investigated head lice prevalence among elementary school students and their households in relation to individual and household characteristics as well as spatial variables. The investigation included households from 5 geographically separated municipalities. Present infestations among household members as well as previous infestations in the household were reported in a questionnaire. In elementary school students prevalence was low (1·63%), but more than one-third of the households (36·43%) had previously experienced pediculosis. Prevalence was higher in elementary school students than in other household members, and highest in third-grade children. Prevalence was also influenced by the school attended, which suggested that interactions between children in the same school are important for head lice transmission. Previous occurrence of head lice in homes also increased the risk of present infestation. Prevalence of previous infestations was higher in households with more children and in more densely populated municipalities, indicating that the density of hosts or groups of hosts influences transmission rates. These results demonstrate that information of hosts’ spatial distribution as well as household and individual characteristics is needed to better understand head lice population dynamics. PMID:21767439

  1. Head lice prevalence among households in Norway: importance of spatial variables and individual and household characteristics.

    PubMed

    Rukke, Bjørn Arne; Birkemoe, Tone; Soleng, Arnulf; Lindstedt, Heidi Heggen; Ottesen, Preben

    2011-09-01

    Head lice prevalence varies greatly between and within countries, and more knowledge is needed to approach causes of this variation. In the present study, we investigated head lice prevalence among elementary school students and their households in relation to individual and household characteristics as well as spatial variables. The investigation included households from 5 geographically separated municipalities. Present infestations among household members as well as previous infestations in the household were reported in a questionnaire. In elementary school students prevalence was low (1·63%), but more than one-third of the households (36·43%) had previously experienced pediculosis. Prevalence was higher in elementary school students than in other household members, and highest in third-grade children. Prevalence was also influenced by the school attended, which suggested that interactions between children in the same school are important for head lice transmission. Previous occurrence of head lice in homes also increased the risk of present infestation. Prevalence of previous infestations was higher in households with more children and in more densely populated municipalities, indicating that the density of hosts or groups of hosts influences transmission rates. These results demonstrate that information of hosts' spatial distribution as well as household and individual characteristics is needed to better understand head lice population dynamics.

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

    PubMed

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

    2015-11-01

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

  3. Who Is Doing the Housework in Multicultural Britain?

    PubMed Central

    Kan, Man-Yee; Laurie, Heather

    2016-01-01

    There is an extensive literature on the domestic division of labour within married and cohabiting couples and its relationship to gender equality within the household and the labour market. Most UK research focuses on the white majority population or is ethnicity ‘blind’, effectively ignoring potentially significant intersections between gender, ethnicity, socio-economic position and domestic labour. Quantitative empirical research on the domestic division of labour across ethnic groups has not been possible due to a lack of data that enables disaggregation by ethnic group. We address this gap using data from a nationally representative panel survey, Understanding Society, the UK Household Longitudinal Study containing sufficient sample sizes of ethnic minority groups for meaningful comparisons. We find significant variations in patterns of domestic labour by ethnic group, gender, education and employment status after controlling for individual and household characteristics. PMID:29416186

  4. A decision analytic model to investigate the cost-effectiveness of poisoning prevention practices in households with young children.

    PubMed

    Achana, Felix; Sutton, Alex J; Kendrick, Denise; Hayes, Mike; Jones, David R; Hubbard, Stephanie J; Cooper, Nicola J

    2016-08-03

    Systematic reviews and a network meta-analysis show home safety education with or without the provision of safety equipment is effective in promoting poison prevention behaviours in households with children. This paper compares the cost-effectiveness of home safety interventions to promote poison prevention practices. A probabilistic decision-analytic model simulates healthcare costs and benefits for a hypothetical cohort of under 5 year olds. The model compares the cost-effectiveness of home safety education, home safety inspections, provision of free or low cost safety equipment and fitting of equipment. Analyses are conducted from a UK National Health Service and Personal Social Services perspective and expressed in 2012 prices. Education without safety inspection, provision or fitting of equipment was the most cost-effective strategy for promoting safe storage of medicines with an incremental cost-effectiveness ratio of £2888 (95 % credible interval (CrI) £1990-£5774) per poison case avoided or £41,330 (95%CrI £20,007-£91,534) per QALY gained compared with usual care. Compared to usual care, home safety interventions were not cost-effective in promoting safe storage of other household products. Education offers better value for money than more intensive but expensive strategies for preventing medicinal poisonings, but is only likely to be cost-effective at £30,000 per QALY gained for families in disadvantaged areas and for those with more than one child. There was considerable uncertainty in cost-effectiveness estimates due to paucity of evidence on model parameters. Policy makers should consider both costs and effectiveness of competing interventions to ensure efficient use of resources.

  5. Disposable versus non-disposable tonometer prisms: a UK national survey

    PubMed Central

    Jasani, Kirti M; Putri, Christine; Pearl, Amy; Sattar, Nayeem; Mercieca, Karl; Spaeth, George; Bhan-Bhargava, Archana

    2017-01-01

    Purpose To determine the prevalence of disposable tonometer versus non-disposable tonometer use in the UK and to determine methods of decontamination and frequency of replacement of prisms. A total of 137 ophthalmology departments were interviewed by telephone using a structured questionnaire. The main outcome measured were:types of tonometer prisms used in clinic (disposable, non-disposable and/or other)average disposable prisms used per clinic sessionaverage lifespan of non-disposable prismsprism preference by glaucoma and other teams within department. A cost and benefit analysis was then performed on the data acquired. Results One hundred and fifty-five departments were identified for the survey. Of these, 137 (88.3%) responded. Eighty-one departments (59.1%) used Tonosafe prisms alone, whereas 22 departments (16.1%) used Goldmann non-disposable prisms exclusively. Thirty-five departments (64%) on average have a change rate of 26.5% per year (range: 0–100, median: 20) attributed to damage, loss or theft. Sixteen departments (29%) reported that prisms were used until damaged or lost. Four departments (7%) were uncertain of their prism usage and could not provide further information. Conclusions Majority of eye departments in the UK opt for disposable prisms. This survey shows the perceived cost-effectiveness of disposable prisms is overestimated when the true cost of disinfection and damage is taken into account. Significant cost savings coupled with the low risk of infectivity (if decontaminated properly) should prompt clinicians and ophthalmic departments worldwide to reconsider the use of non-disposable prisms. PMID:29354698

  6. Food insufficiency in the households of reproductive-age Ecuadorian women: association with food and nutritional status indicators.

    PubMed

    Weigel, M Margaret; Armijos, Maria Mercedes

    2015-01-01

    Data from a nationally representative survey of Ecuadorian households with reproductive-aged women (n = 10,784) were used to analyze the prevalence of household food insufficiency (HFI) and its association with sociodemographic characteristics, food acquisition and expenditure patterns, dietary diversity, and anthropometric indicators. Fifteen percent of households had food insufficiency and 15% had marginal food sufficiency. HFI was associated with poverty-linked indicators. Marginally food sufficient households reported social and economic capital than food which appeared protective against HFI. Food insufficiency was associated with reduced household acquisition/expenditures on high quality protein and micronutrient-rich food sources. HFI was not associated with adult or adolescent female overweight/obesity but was associated with short adult stature (< 1.45 m). The ongoing nutrition transition in Ecuador is expected to continue to modify population food security, diet, and nutrition. Systematic surveillance of household level food security is needed to inform recent food-related policies and programs implemented by the Ecuadorian government.

  7. Who Matters for Children’s Early Development? Race/Ethnicity and Extended Household Structures in the United States

    PubMed Central

    Fomby, Paula; Dennis, Jeff A.

    2011-01-01

    Taking advantage of recent data that permit an assessment of the importance of extended household members in operationalizing the relationship between family structure and children’s early development, this study incorporated coresident grandparents, other kin, and nonkin to investigate the associations between extended household structure and U.S. children’s cognitive and behavioral outcomes at age 2. Analyses assessed whether these relationships differed for Latino, African American, and White children and tested four potential explanations for such differences. Nationally representative data came from the Early Childhood Longitudinal Study-Birth Cohort of 2001 (N ≈ 8,450). Extended household structures were much more prevalent in households of young African American and Latino children than among Whites. Nuclear households were beneficial for White children, but living with a grandparent was associated with the highest cognitive scores for African American children. Nuclear, vertically extended, and laterally extended households had similar associations with Latino children’s cognitive and behavior scores. Results suggest that expanded indicators of household structure that include grandparents, other kin, and nonkin are useful for understanding children’s early development. PMID:21927627

  8. National data study showed that adolescents living in poorer households and with one parent were more likely to be bullied.

    PubMed

    Låftman, S B; Fransson, E; Modin, B; Östberg, V

    2017-12-01

    The aim of this study was to assess whether sociodemographic household characteristics were associated with which Swedish adolescents were more likely to be bullied. The data were derived from the Swedish Living Conditions Survey and its child supplements from the survey years 2008-2011. The analyses included information on 3951 adolescents aged 10-18 years. Exposure to bullying was reported by adolescents, and information on sociodemographic household characteristics was reported by parents and obtained from official registers. Binary logistic regression was used to analyse the data. Adolescents were more likely to be bullied if they lived in households with no cash margin, defined as the ability to pay an unexpected bill of 8000 Swedish Kronor or about 800 Euros, and if they lived with just one custodial parent. In the unadjusted analyses, elevated risks were identified if adolescents lived in working class households and had unemployed and foreign-born parents. However, these associations were at least partly accounted for by other sociodemographic household characteristics, in particular the lack of a cash margin. This study showed that Swedish adolescents living in households with more limited financial resources had an increased risk of being bullied, supporting results from previous international research. ©2017 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  9. Determination of beryllium concentrations in UK ambient air

    NASA Astrophysics Data System (ADS)

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

    2016-12-01

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

  10. National survey of clinical communication assessment in medical education in the United Kingdom (UK)

    PubMed Central

    2014-01-01

    Background All medical schools in the UK are required to be able to provide evidence of competence in clinical communication in their graduates. This is usually provided by summative assessment of clinical communication, but there is considerable variation in how this is carried out. This study aimed to gain insight into the current assessment of clinical communication in UK medical schools. Methods The survey was sent via e-mail to communication leads who then were asked to consult with all staff within their medical school involved in the assessment of communication. Results Results were obtained from 27 out of 33 schools (response rate 82%) and a total of 34 courses. The average number of assessments per year was 2.4 (minimum 0, maximum 10). The Objective Structured Clinical Exam (OSCE) was the most commonly used method of assessment (53%). Other assessments included MCQ and workplace based assessments. Only nine courses used a single method of assessment. Issues raised included, logistics and costs of assessing mainly by OSCE, the robustness and reliability of such exams and integration with other clinical skills. Conclusions It is encouraging that a variety of assessment methods are being used within UK medical schools and that these methods target different components of clinical communication skills acquisition. PMID:24417939

  11. UK Renal Registry 16th annual report: chapter 12 biochemical variables amongst UK adult dialysis patients in 2012: national and centre-specific analyses.

    PubMed

    Nicholas, Johann; Shaw, Catriona; Pitcher, David; Dawnay, Anne

    2013-01-01

    The UK Renal Association clinical practice guidelines include clinical performance measures for biochemical variables in dialysis patients. The UK Renal Registry (UKRR) annually audits dialysis centre performance against these measures as part of its role in promoting continuous quality improvement. Cross sectional performance analyses were undertaken to compare dialysis centre achievement of clinical audit measures for prevalent haemodialysis (HD) and peritoneal dialysis (PD) cohorts in 2012. The biochemical variables studied were phosphate, adjusted calcium, parathyroid hormone, bicarbonate and total cholesterol. In addition, longitudinal analyses were performed (2002-2012) to show changes in achievement of clinical performance measures over time. Fifty-six percent of HD and 61% of PD patients achieved a phosphate within the range recommended by the RA clinical practice guidelines. Seventy-seven percent of HD and 78% of PD patients had adjusted calcium between 2.2-2.5 mmol/L. Fifty-eight percent of HD and 65% of PD patients had parathyroid hormone between 16-72 pmol/L. Fifty-nine percent of HD and 80% of PD patients achieved the audit measure for bicarbonate. There was significant inter-centre variation for all variables studied. The UKRR consistently demonstrates significant inter-centre variation in achievement of biochemical clinical audit measures. Understanding the causes of this variation is an important part of improving the care of dialysis patients in the UK.

  12. Studying "exposure" to firearms: household ownership v access

    PubMed Central

    Ikeda, R; Dahlberg, L; Kresnow, M; Sacks, J; Mercy, J

    2003-01-01

    Background: Firearm ownership has often been used to measure access to weapons. However, persons who own a firearm may not have access to it and conversely, persons who do not own a firearm may be able to access one quickly. Objectives: To examine whether using firearm ownership is a reasonable proxy for access by describing the demographic characteristics associated with ownership and access. Methods: Data are from the 1994 Injury Control and Risk Survey, a national, random digit dial survey. Information about household firearm ownership and ready access to a loaded firearm were collected and weighted to provide national estimates. Adjusted odds ratios for three separate models were calculated using logistic regression. Results: A total of 1353 (27.9%) respondents reported both having a firearm in the household and ready access to one. An additional 313 respondents (8.1%) reported having a firearm, but were not able to access these weapons. Another 421 respondents (7.2%) did not have a firearm in or around their home, yet reported being able to retrieve and fire one within 10 minutes. Based on the logistic regression findings, the demographic characteristics of this latter group are quite different from those who report ownership. Those who do not have a firearm, but report ready access to one, are more likely to be ethnic minorities, single, and living in attached homes. Conclusions: Asking only about the presence of a firearm in a household may miss some respondents with ready access to a loaded firearm. More importantly, those who do not own a firearm, but report ready access to one, appear to be qualitatively different from those who report ownership. Caution should be exercised when using measures of ownership as a proxy for access. PMID:12642560

  13. Increasing belief but issue fatigue: Changes in Australian Household Climate Change Segments between 2011 and 2016.

    PubMed

    Morrison, Mark; Parton, Kevin; Hine, Donald W

    2018-01-01

    Using national Australian samples collected in 2011 (n = 1927) and 2016 (n = 2503), we identified six Australian household segments which we labelled Alarmed, Concerned, Cautious, Disengaged, Doubtful and Dismissive. Between the two periods, we found the proportion of households in the Alarmed and Concerned segments was stable; however there was a decrease (28% to 20%) in the proportion of households in the Doubtful and Dismissive segments and an increase (27% to 33%) in the Cautious and Disengaged segments. We found that a greater proportion of households have personally experienced climate change, and were more likely to believe in human causation and believe that there is a scientific consensus about the issue. However, there was evidence of issue fatigue. Households were less likely to report that they had thought about climate change or talked about it with their friends in 2016 relative to 2011. They were also less likely to pursue certain climate friendly behaviours or reward or punish companies for their climate behaviours. These findings suggest a need to motivate households to maintain efforts to mitigate climate change, particularly the Cautious and Disengaged households that are more amenable to changing their views about this issue.

  14. Fragrance ingredient labelling in products on sale in the U.K.

    PubMed

    Buckley, D A

    2007-08-01

    The seventh amendment of the European Union (EU) Cosmetics Directive (March 2005) and the Detergents Regulations of the EU (October 2005) are now legal requirements in Europe. Cosmetic products and detergents must be labelled for 26 individual named fragrances, when present at concentrations of > 10 parts per million (p.p.m.) in leave-on products and > 100 p.p.m. in rinse-off products. To make an assessment of the exposure pattern to fragrance of the U.K. consumer and to determine the frequency with which the constituent fragrances of fragrance mix I (FM I) and fragrance mix II (FM II) are included in products currently sold in the U.K. A study of perfumed cosmetic and household products available on the shelves of U.K. retailers was carried out in January 2006. Products were included if 'parfum' or 'aroma' was listed among the ingredients. Three hundred products were surveyed and any of the 26 listed fragrances named on the label were recorded. The top six most frequently labelled fragrances were linalool (190; 63%), limonene (189; 63%), citronellol (145; 48%), geraniol (126; 42%), butyl phenyl methyl propional (Lilial(trade mark)) (126; 42%) and hexyl cinnamal (125; (42%). One of these, geraniol, is present in FM I and two others, citronellol and hexyl cinnamal, in FM II, thus tested as part of the British Standard patch test series. The frequencies of other constituents of FM I were as follows: eugenol, 80 (27%); hydroxycitronellal, 52 (17%); isoeugenol, 27 (9%); cinnamic alcohol, 25 (8%); amyl cinnamal, 22 (7%); cinnamal, 17 (6%); Evernia prunastri (oak moss absolute), 13 (4%). The other constituents of FM II occurred as follows: coumarin, 90 (30%); hydroxyisohexyl-3-cyclohexene carboxaldehyde (Lyral(trade mark)), 88 (29%); citral, 74 (25%); farnesol, 23 (8%). Linalool (n = 46; 66%) was the most frequently found fragrance in 70 personal care products (soap, shampoo, shower gel). Linalool (n = 47; 80%) and limonene (n = 45; 76%) were the most frequent in 59

  15. [Poisoning with household cleaning products in a city in Northeast Brazil].

    PubMed

    Fook, Sayonara Maria Lia; Azevedo, Esthefanye Fernandes de; Costa, Monalisa Maciel; Feitosa, Itavielly Layany França; Bragagnoli, Gerson; Mariz, Saulo Rios

    2013-05-01

    This study analyzes toxic exposures to household cleaning products based on data from the Center for Notification and Treatment of Poisoning (CEATOX) in Campina Grande, Paraíba State, Brazil, from 2007 to 2010. The data were collected from the reporting forms from the Information System on Notifiable Diseases (SINAN), analyzed with SPSS (Version 17). Chemical identification was performed in urine samples using high-resolution chromatography techniques (GC-MS and HPLC-UV). Six hundred and sixty cases of poisoning were reported, with pesticides as the principal causal agents (42.2%). Poisoning with household cleaning products occurred mainly in children (30.1%) and/or females (55.21%) who were exposed to the product accidentally (55.4%) by the oral route (82%). These data indicate that poisoning with household cleaning products in Campina Grande should be treated with specific prevention and control measures, including evaluation of ease of access to pesticides, in order to reach the goals set by the Brazilian National Health Plan for 2012-2015.

  16. Measurement of inequality using household energy consumption data in rural China

    NASA Astrophysics Data System (ADS)

    Wu, Shimei; Zheng, Xinye; Wei, Chu

    2017-10-01

    Measuring inequality can be challenging due to the limitations of using household income or expenditure data. Because actual energy consumption can be measured more easily and accurately and is relatively more stable, it may be a better measure of inequality. Here we use data on energy consumption for specific devices from a large nation-wide household survey (n = 3,404 rural households from 12 provinces) to assess inequality in rural China. We find that the overall inequality of energy consumption and expenditure varies greatly in terms of energy type, end-use demand, regions and climatic zones. Biomass, space heating and cooking, intraregional differences, and climatic zones characterized as cold or hot summer/cold winter contribute the most to total inequality for each indicator, respectively. The results suggest that the expansion of infrastructure does not accompany alleviation of energy inequality, and that energy affordability should be improved through income growth and targeted safety-net programmes instead of energy subsidies.

  17. How do United Kingdom (UK) medical schools identify and support undergraduate medical students who ‘fail’ communication assessments? A national survey

    PubMed Central

    2013-01-01

    Background The doctor’s ability to communicate effectively (with patients, relatives, advocates and healthcare colleagues) relates directly to health outcomes, and so is core to clinical practice. The remediation of medical students’ clinical communication ability is rarely addressed in medical education literature. There is nothing in the current literature reporting a contemporary national picture of how communication difficulties are managed, and the level of consequence (progression implications) for students of performing poorly. This survey aimed to consolidate practices for identifying and processes for managing students who ‘fail’ communication assessments across all UK medical schools. Methods Data were collected via an email survey to all leads for clinical communication in all UK Medical Schools for the UK Council for Clinical Communication in Undergraduate Medical Education. Results All but two participating Schools reported some means of support and/or remediation in communication. There was diversity of approach, and variance in the level of systemisation adopted. Variables such as individuality of curricula, resourcing issues, student cohort size and methodological preferences were implicated as explaining diversity. Support is relatively ad hoc, and often in the hands of a particular dedicated individual or team with an interest in communication delivery with few Schools reporting robust, centralised, school level processes. Conclusions This survey has demonstrated that few Medical Schools have no identifiable system of managing their students’ clinical communication difficulties. However, some Schools reported ad hoc approaches and only a small number had a centralised programme. There is scope for discussion and benchmarking of best practice across all Schools with allocation of appropriate resources to support this. PMID:23834990

  18. UK technical activities associated with the return to Earth of the MIR space station

    NASA Astrophysics Data System (ADS)

    Crowther, Richard; Tremayne-Smith, Richard

    2002-11-01

    The British National Space Centre (BNSC) acts as the focus in the United Kingdom (UK) for space-related activities. With the anticipated return to Earth of the MIR space station, BNSC established a group of technical experts to consider the associated implications for the UK, and to address both national and international activities relating to the planned de-orbit. In particular, the risk to the UK of an uncontrolled re-entry was considered in contingency planning and the means for the provision of accurate information to the public and media were established to ensure balanced view of the potential hazards that MIR posed to persons and property on the ground. The MIR de-orbit was exemplary, both in terms of the technical activities of the Rosaviakosmos and the safe disposal of MIR in the Pacific, and in relation to the open and effective communication between agencies and the positive reporting by the media.

  19. Rights-based approaches to addressing food poverty and food insecurity in Ireland and UK.

    PubMed

    Dowler, Elizabeth A; O'Connor, Deirdre

    2012-01-01

    Food poverty is an important contributing factor to health inequalities in industrialised countries; it refers to the inability to acquire or eat an adequate quality or sufficient quantity of food in socially acceptable ways (or the uncertainty of being able to do so). Synonymous with household food insecurity, the issue needs to be located within a social justice framework. Recognising the clear interdependence between the right to food and the right to health, this paper explores how international human rights obligations could inform approaches to addressing food poverty and insecurity with specific reference to Ireland and the UK. Little attention has been paid to how countries should meet their obligations to respect, protect and fulfil the right to food in developed countries. The paper contributes by examining the social and policy circumstances which inhibit poor households from obtaining sufficient food to eat healthily, along with strategies and interventions from State and civil society actors in the two countries. In practice, problems and potential solutions have largely been directed towards the individual rather than at social determinants, particularly as research on environmental factors such as distance to shops has produced equivocal results. Other key structural aspects such as income sufficiency for food are broadly ignored by the State, and anti-poverty strategies are often implemented without monitoring for effects on food outcomes. Thus scant evidence exists for either Ireland or the UK meeting its rights to food obligations to date, in terms of roles and responsibilities in ensuring access to affordable, available and appropriate food for all. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Clinical roles in clinical biochemistry: a national survey of practice in the UK.

    PubMed

    Choudhury, Sirazum M; Williams, Emma L; Barnes, Sophie C; Alaghband-Zadeh, Jamshid; Tan, Tricia M; Cegla, Jaimini

    2017-05-01

    Background Using an online survey, we collected data to present a picture of how clinical authorization is performed in the UK. Methods A 21-question survey was uploaded to www.surveymonkey.com , and responses were invited via the mail base of the Association for Clinical Biochemistry and Laboratory Medicine. The questionnaire examined the intensity and function of the duty biochemist role and how different types of authorization are used to handle and release results. Results Of 70 responses received, 60 were suitable for analysis. Responses were received from every region of the UK. A typical duty biochemist shift started on average at 8:50, and finished at 17:25. The mean duration was 8 h 58 min. Clinical scientists are the most abundantly represented group on duty biochemist rotas. Higher banded clinical scientists and chemical pathologists covered out-of-hours shifts. Results were handled differently depending on the level of abnormality and the requesting area. Normal results tended to be released either directly from the analyser or after technical then autoauthorization (90%). A greater preference for clinical authorization was seen for abnormal and critical results originating from outpatients (49% and 69%, respectively) or general practice (51% and 71%) than for inpatients (33% and 53%) or A&E (25% and 37%). Conclusions The handling and authorization of biochemistry results varies greatly between laboratories. The role is clearly heterogeneous in the UK. Guidance from the Association for Clinical Biochemistry and Royal College of Pathologists may help to clarify the essential roles of the duty biochemist.

  1. Predictors of Essential Health and Nutrition Service Delivery in Bihar, India: Results From Household and Frontline Worker Surveys

    PubMed Central

    Kosec, Katrina; Avula, Rasmi; Holtemeyer, Brian; Tyagi, Parul; Hausladen, Stephanie; Menon, Purnima

    2015-01-01

    Background: In Bihar, India, coverage of essential health and nutrition interventions is low. These interventions are provided by 2 national programs—the Integrated Child Development Services (ICDS) and Health/National Rural Health Mission (NRHM)—through Anganwadi workers (AWWs) and Accredited Social Health Activists (ASHAs), respectively. Little is known, however, about factors that predict effective service delivery by these frontline workers (FLWs) or receipt of services by households. This study examined the predictors of use of 4 services: (1) immunization information and services, (2) food supplements, (3) pregnancy care information, and (4) general nutrition information. Methods: Data are from a 2012 cross-sectional survey of 6,002 households in 400 randomly selected villages in 1 district of Bihar state, as well as an integrated survey of 377 AWWs and 382 ASHAs from the same villages. For each of the 4 service delivery outcomes, logistic regression models were specified using a combination of variables hypothesized to be supply- and demand-side drivers of service utilization. Results: About 35% of households reported receiving any of the 4 services. Monetary immunization incentives for AWWs (OR = 1.55, CI = 1.02–2.36) and above-median household head education (OR = 1.39, CI = 1.05–1.82) were statistically significant predictors of household receipt of immunization services. Higher household socioeconomic status was associated with significantly lower odds of receiving food supplements (OR = 0.87, CI = 0.79–0.96). ASHAs receiving incentives for institutional delivery (OR = 1.52, CI = 0.99–2.33) was marginally associated with higher odds of receiving pregnancy care information, and ASHAs who maintained records of pregnant women was significantly associated with households receiving such information (OR = 2.25, CI = 1.07–4.74). AWWs receiving immunization incentives was associated with significantly higher

  2. 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.

  3. Household Structure, Family Ties, and Psychological Distress among US-born and Immigrant Latino Women

    PubMed Central

    Molina, Kristine M.; Alcántara, Carmela

    2013-01-01

    Latino women endorse the highest rates of past-month depressive symptoms relative to Latino men and to non-Latino White men and women. Yet, research into the specific domains of family life that reduce or engender psychological distress among Latinas is sparse. We examine the hypothesis that indicators of household structure and family ties will relate to psychological distress among Latinas in the USA, and that these associations will vary by nativity status. We employed nationally representative data of Latina adults (N = 1,427) from the National Latino and Asian American Study. Nativity-stratified regression analyses revealed that strained family ties (i.e., family burden, family cultural conflict) were associated with greater levels of past-month psychological distress for both US-born and immigrant Latinas. Yet, the effect of household structures on psychological distress differed by nativity status. Adjusting for sociodemographic factors, lower levels of household income were associated with greater psychological distress; and having children/adolescents in the household was associated with lower levels of psychological distress among US-born Latinas. In contrast, for immigrant Latinas, being out of the labor force was associated with greater levels of psychological distress. Results suggest that dynamics of both the household and family context predict differential as well as similar mental health outcomes across segments of the Latina population in the USA. These findings underscore the need to understand the pathways by which different facets of family life—structural and social domains—relate to mental health status among subgroups of Latinas. Our results also have implications for the development of tailored interventions to meet the specific needs of Latinas. PMID:23421842

  4. Influencing factors for household water quality improvement in reducing diarrhoea in resource-limited areas.

    PubMed

    Zin, Thant; Mudin, Kamarudin D; Myint, Than; Naing, Daw K S; Sein, Tracy; Shamsul, B S

    2013-01-01

    Water and sanitation are major public health issues exacerbated by rapid population growth, limited resources, disasters and environmental depletion. This study was undertaken to study the influencing factors for household water quality improvement for reducing diarrhoea in resource-limited areas. Data were collected from articles and reviews from relevant randomized controlled trials, new articles, systematic reviews and meta-analyses from PubMed, World Health Organization (WHO), United Nations Children's Fund (UNICEF) and WELL Resource Centre For Water, Sanitation And Environmental Health. Water quality on diarrhoea prevention could be affected by contamination during storage, collection and even at point-of-use. Point-of-use water treatment (household-based) is the most cost-effective method for prevention of diarrhoea. Chemical disinfection, filtration, thermal disinfection, solar disinfection and flocculation and disinfection are five most promising household water treatment methodologies for resource-limited areas. Promoting household water treatment is most essential for preventing diarrhoeal disease. In addition, the water should be of acceptable taste, appropriate for emergency and non-emergency use.

  5. Household characteristics for older adults and study background from SAGE Ghana Wave 1.

    PubMed

    Biritwum, Richard B; Mensah, George; Minicuci, Nadia; Yawson, Alfred E; Naidoo, Nirmala; Chatterji, Somnath; Kowal, Paul

    2013-06-11

    Globally, the population aged 60 years and older is projected to reach 22% by 2050. In sub-Saharan Africa, this figure is projected to exceed 8%, while in Ghana, the older adult population will reach 12% by 2050. The living arrangements and household characteristics are fundamental determinants of the health and well-being of this population, data sources about which are increasingly available. The World Health Organization's Study on global AGEing and adult health (SAGE) Wave 1 was conducted in China, Ghana, India, Russian Federation, Mexico, and South Africa between 2007 and 2010. SAGE Ghana Wave 1 was implemented in 2007/08 using face-to-face interviews in a nationally representative sample of persons aged 50-plus, along with a smaller cohort aged 18-49 years for comparison purposes. Household information included a household roster including questions about health insurance coverage for all household members, household and sociodemographic characteristics, status of the dwelling, and economic situation. Re-interviews were done in a random 10% of the sample and proxy interviews done where necessary. Verbal autopsies were conducted for deaths occurring in older adult household members in the 24 months prior to interview. The total household population was 27,270 from 5,178 households. The overall household response rate was 86% and household cooperation rate was 98%. Thirty-four percent of household members were under 15 years of age while 8.3% were aged 65-plus years. Households with more than 11 members were more common in rural areas (57.2%) and in the highest income quintile (30.6%). Household members with no formal education formed 24.7% of the sample, with Northern and Upper East regions reaching more than 50%. Only 26.8% of the household members had insurance coverage. Households with hard floors ranged from 25.7% in Upper West to 97.7% in Ashanti region. Overall, 84.9% of the households had access to improved sources of drinking water, with the lowest at

  6. Household characteristics for older adults and study background from SAGE Ghana Wave 1

    PubMed Central

    Biritwum, Richard B.; Mensah, George; Minicuci, Nadia; Yawson, Alfred E.; Naidoo, Nirmala; Chatterji, Somnath; Kowal, Paul

    2013-01-01

    Background Globally, the population aged 60 years and older is projected to reach 22% by 2050. In sub-Saharan Africa, this figure is projected to exceed 8%, while in Ghana, the older adult population will reach 12% by 2050. The living arrangements and household characteristics are fundamental determinants of the health and well-being of this population, data sources about which are increasingly available. Methods The World Health Organization's Study on global AGEing and adult health (SAGE) Wave 1 was conducted in China, Ghana, India, Russian Federation, Mexico, and South Africa between 2007 and 2010. SAGE Ghana Wave 1 was implemented in 2007/08 using face-to-face interviews in a nationally representative sample of persons aged 50-plus, along with a smaller cohort aged 18–49 years for comparison purposes. Household information included a household roster including questions about health insurance coverage for all household members, household and sociodemographic characteristics, status of the dwelling, and economic situation. Re-interviews were done in a random 10% of the sample and proxy interviews done where necessary. Verbal autopsies were conducted for deaths occurring in older adult household members in the 24 months prior to interview. Results The total household population was 27,270 from 5,178 households. The overall household response rate was 86% and household cooperation rate was 98%. Thirty-four percent of household members were under 15 years of age while 8.3% were aged 65-plus years. Households with more than 11 members were more common in rural areas (57.2%) and in the highest income quintile (30.6%). Household members with no formal education formed 24.7% of the sample, with Northern and Upper East regions reaching more than 50%. Only 26.8% of the household members had insurance coverage. Households with hard floors ranged from 25.7% in Upper West to 97.7% in Ashanti region. Overall, 84.9% of the households had access to improved sources of

  7. Nationally representative household survey of surgery and mortality in Sierra Leone.

    PubMed

    Kwon, Steve; Groen, Reinou S; Kamara, Thaim B; Cassidy, Laura D; Samai, Mohamed; Yambasu, Sahr E; Kushner, Adam L

    2013-08-01

    There is limited evidence to characterize the burden of unmet need of surgical diseases in low- and middle-income countries. The purpose of this study was to determine rate of deaths attributable to a surgical condition and reasons for not seeking surgical care in Sierra Leone. The Surgeons OverSeas Assessment of Surgical Need (SOSAS) is a survey tool developed collaboratively to be used for cross-sectional data collection of the prevalence of surgical conditions in any country. A population-weighted cluster-sample household survey was conducted throughout Sierra Leone in 2012 using the SOSAS survey tool. Total of 1,840 households (11,870 individuals) were sampled, yielding a 98.3 % response rate. Overall, there were 709 total deaths reported (6.0 %). The mean age at death was 36.4 ± 30.1 years: 330 (46.6 %) were female. Most deaths occurred at home (58.1 % vs. 34.1 % in hospitals). Of the 709 deaths, 237 (33.4 %) were associated with conditions included in our predefined surgical disease category. Abdominal distension/pain was the most commonly associated surgical condition (13.9 %) followed by perinatal bleeding/illness (6.0 %). Among the 237 with surgical conditions, 51 (21.9 %) did not seek medical care, most commonly because of a lack of money (35.3 %) or inability to provide timely care (37.3 %). A large proportion of deaths in Sierra Leone was associated with surgical conditions, the majority of which did not undergo surgical intervention. Our results indicate that to remove barriers to effective surgical care in Sierra Leone policymakers should first focus on relieving financial burdens and increasing access to timely surgical care.

  8. Undergraduate teaching in UK general practice: a geographical snapshot.

    PubMed

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

    2014-06-01

    Learning in general practice is an essential component of undergraduate medical education; currently, on average, 13% of clinical placements in the UK are in general practice. However, whether general practice can sustainably deliver more undergraduate placements is uncertain. To identify the geographical distribution of undergraduate teaching practices and their distance from the host medical school. National survey of all medical schools in the UK. All 33 UK medical schools were invited to provide the postcodes of their undergraduate teaching practices. These were collated, de-duplicated, and mapped. The distance in kilometres and journey times by car and public transport between each medical school and its teaching practices was estimated using Transport Direct (www.transportdirect.info). The postcodes of every practice in the UK were obtained from the UK's health departments. All 33 UK medical schools responded; 4392 practices contributed to teaching, with a median (minimum-maximum) of 142 (17-385) practices per school. The median (minimum-maximum) distance between a school and a teaching practice was 28 km (0-1421 km), 41 (0:00-23:26) minutes' travel by car and 1 hour 12 (0:00-17:29) minutes' travel by public transport. All teaching practices were accessible by public transport in one school and 90-99% were in a further four schools; 24 schools had >20% of practices that were inaccessible by public transport. The 4392 undergraduate teaching general practices are widely distributed and potentially any practice, no matter how isolated, could contribute to undergraduate education. However, this is, at the price of a considerable travel burden. © British Journal of General Practice 2014.

  9. 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

  10. Dentists' perceptions of trends in restorative dentistry in the UK.

    PubMed

    Randall, Ros C; Vrijhoef, Matthijs M A; Wilson, Nairn H F

    2003-04-01

    To obtain responses to a questionnaire on likely trends in the clinical practice of restorative dentistry from a national sample of general dental practitioners (GDPs) who were principals of group practices in the UK. A panel of nine experts had been convened previously to define areas of trends in restorative dentistry in the UK and to formulate these into statements. Twenty trends were identified and framed into a 22-item questionnaire based on the trend statements. The questionnaire was sent to a national sample of 2800 principal dentists in group practices. Names of principal dentists were taken from the Yellow Pages directories, a group practice being defined as at least one principal dentist and one other practitioner. Levels of agreement for questionnaire scores of > or = 70% for all segments of a statement were taken as indicating a possible trend. Of the 2800 questionnaires sent out, 1448 were returned, a return rate of 52%. Of these, 1217 questionnaires were usable, an overall response rate of 44%. Good agreement was obtained for 14 statements (64%). The 14 trend statements that scored a level of good agreement were taken as indicating possible trends in dentistry in the UK as perceived by those GDPs who responded to the questionnaire. However, in view of the fact that the 1217 usable questionnaires received reflected the opinions of 10% of the principal dentists in group practice in the UK, this will not be representative of all principal dentists in practice. Nevertheless for the purposes of gaining some insight into trends in restorative dentistry, it could be considered to be of value.

  11. Sugar and total energy content of household food purchases in Brazil.

    PubMed

    Levy, Renata Bertazzi; Claro, Rafael Moreira; Monteiro, Carlos Augusto

    2009-11-01

    To study the role of energy derived from sugar (both table sugar and sugar added to processed foods) in the total energy content of food purchases in Brazil. Food purchase data were collected during a national household budget survey carried out between June 2002 and July 2003 on a probabilistic sample representative of all households in the country. The amount of food purchased in this 12-month period was transformed into energy and energy from sugar using food composition tables. Multiple linear regression models were used to study the association between amount of energy from sugar and total energy content of food purchases, controlling for sociodemographic variables and potential interactions between these variables and sugar purchases. There was a positive and significant association between energy from sugar and total household energy purchases. A 1 kJ increase in sugar purchase corresponded to a 3.637 kJ increase in total energy. In the absence of expenditure on meals outside the home, i.e. when household food purchases tend to approximate actual food consumption by household members, sugar purchase of 1926.35 kJ/d (the 90th percentile of the distribution of sugar purchases in Brazil) was associated, depending on income strata, with total energy purchase over 40-60 % of the recommended daily value for energy intake in Brazil. The present results corroborate the recommendations of the WHO and the Brazilian Ministry of Health regarding limiting the consumption of sugar.

  12. Impact of targeted beverage taxes on higher- and lower-income households.

    PubMed

    Finkelstein, Eric A; Zhen, Chen; Nonnemaker, James; Todd, Jessica E

    2010-12-13

    Sugar-sweetened beverage (SSB) taxes are increasingly being considered as a strategy for addressing the obesity epidemic. We sought to investigate the differential impact of targeted beverage taxes on higher- and lower-income households. This analysis relied on data from the 2006 Nielsen Homescan panel, which included a national sample of households that scan and transmit their store-bought food and beverage purchases weekly for a 12-month period. We assessed associations among beverage prices, energy intake, and weight using multivariate regression models. A 20% and 40% tax on carbonated SSBs only would reduce beverage purchases by a mean (SE) of 4.2 (1.6) and 7.8 (2.8) kcal/d per person, respectively. Extending the tax to all SSBs generates mean (SE) reductions of 7.0 (1.9) and 12.4 (3.4) kcal/d per person, respectively. Estimated mean (SE) weight losses resulting from a 20% and 40% tax on all SSBs are 0.32 (0.09) and 0.59 (0.16) kg/y per person, respectively. The 40% tax on SSBs, which costs a mean (SE) of $28.48 ($0.87) per household per year, would generate $2.5 billion ($77.5 million) in tax revenue, with the largest share coming from high-income households. Large taxes on SSBs have the potential to positively influence weight outcomes, especially for middle-income households. These taxes would also generate substantial revenue that could be used to fund obesity prevention programs or for other causes.

  13. Household crowding associated with childhood otitis media hospitalisations in New Zealand.

    PubMed

    Bowie, Christopher; Pearson, Amber L; Campbell, Malcolm; Barnett, Ross

    2014-06-01

    To examine the association between hospitalisations for otitis media and area-level measures of household crowding among children in New Zealand. Counts of hospital admissions for otitis media by census area unit were offset against population data from the 2006 national census. Area-level household crowding, exposure to tobacco smoke in the home, equivalised income and individual-level characteristics age and sex were adjusted for. To examine effect modification by ethnicity, three separate poisson models were examined for the total, Māori and non-Māori populations. Household crowding was significantly associated with hospital admissions for otitis media after adjustment in all three models. Neighbourhoods with the highest compared to the lowest proportion of crowded homes exhibited incidence rate ratios of 1.25 (95%CI 1.12-1.37) in the total population, 1.59 (95%CI 1.21-2.04) in the Māori restricted model and 1.17 (95%CI 1.06-1.32) in the non-Māori restricted model. Otitis media hospitalisations are associated with area-level measures of household crowding and other risk factors in this ecological study. The largest increase in otitis media incidence relative to neighbourhood rates of household crowding was exhibited among Māori cases of otitis media. This study adds weight to the growing body of literature linking infectious disease risk to overcrowding in the home. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.

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

    PubMed

    McManus, I C; Wakeford, Richard

    2014-04-17

    To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence. Data linkage of GMC PLAB performance data with data from the Royal Colleges of Physicians and the Royal College of General Practitioners on performance of PLAB graduates and UK graduates at the MRCP(UK) and MRCGP examinations. Doctors in training for internal medicine or general practice in the United Kingdom. 7829, 5135, and 4387 PLAB graduates on their first attempt at MRCP(UK) Part 1, Part 2, and PACES assessments from 2001 to 2012 compared with 18,532, 14,094, and 14,376 UK graduates taking the same assessments; 3160 PLAB1 graduates making their first attempt at the MRCGP AKT during 2007-12 compared with 14,235 UK graduates; and 1411 PLAB2 graduates making their first attempt at the MRCGP CSA during 2010-12 compared with 6935 UK graduates. Performance at MRCP(UK) Part 1, Part 2, and PACES assessments, and MRCGP AKT and CSA assessments in relation to performance on PLAB1 and PLAB2 assessments, as well as to International English Language Testing System (IELTS) scores. MRCP(UK), MRCGP, and PLAB results were analysed as marks relative to the pass mark at the first attempt. PLAB1 marks were a valid predictor of MRCP(UK) Part 1, MRCP(UK) Part 2, and MRCGP AKT (r=0.521, 0.390, and 0.490; all P<0.001). PLAB2 marks correlated with MRCP(UK) PACES and MRCGP CSA (r=0.274, 0.321; both P<0.001). PLAB graduates had significantly lower MRCP(UK) and MRCGP assessments (Glass's Δ=0.94, 0.91, 1.40, 1.01, and 1.82 for MRCP(UK) Part 1, Part 2, and PACES and MRCGP AKT and CSA), and were more likely to fail assessments and to progress more slowly than UK medical graduates. IELTS scores correlated

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

    PubMed Central

    Wakeford, Richard

    2014-01-01

    Objectives To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence. Design Data linkage of GMC PLAB performance data with data from the Royal Colleges of Physicians and the Royal College of General Practitioners on performance of PLAB graduates and UK graduates at the MRCP(UK) and MRCGP examinations. Setting Doctors in training for internal medicine or general practice in the United Kingdom. Participants 7829, 5135, and 4387 PLAB graduates on their first attempt at MRCP(UK) Part 1, Part 2, and PACES assessments from 2001 to 2012 compared with 18 532, 14 094, and 14 376 UK graduates taking the same assessments; 3160 PLAB1 graduates making their first attempt at the MRCGP AKT during 2007-12 compared with 14 235 UK graduates; and 1411 PLAB2 graduates making their first attempt at the MRCGP CSA during 2010-12 compared with 6935 UK graduates. Main outcome measures Performance at MRCP(UK) Part 1, Part 2, and PACES assessments, and MRCGP AKT and CSA assessments in relation to performance on PLAB1 and PLAB2 assessments, as well as to International English Language Testing System (IELTS) scores. MRCP(UK), MRCGP, and PLAB results were analysed as marks relative to the pass mark at the first attempt. Results PLAB1 marks were a valid predictor of MRCP(UK) Part 1, MRCP(UK) Part 2, and MRCGP AKT (r=0.521, 0.390, and 0.490; all P<0.001). PLAB2 marks correlated with MRCP(UK) PACES and MRCGP CSA (r=0.274, 0.321; both P<0.001). PLAB graduates had significantly lower MRCP(UK) and MRCGP assessments (Glass’s Δ=0.94, 0.91, 1.40, 1.01, and 1.82 for MRCP(UK) Part 1, Part 2, and PACES and MRCGP AKT and CSA), and were more likely to fail assessments

  16. Household Structure and Living Conditions in Nigeria

    ERIC Educational Resources Information Center

    Mberu, Blessing Uchenna

    2007-01-01

    Data on 7,632 households from the 1999 Nigeria Demographic and Health Survey are used to examine household structure and living conditions in Nigeria. The study finds significant disadvantage in living conditions of single-adult, female- and single-adult, male-headed households relative to two-parent households. Extended households show no…

  17. The effect of alcohol consumption on household income in Ireland.

    PubMed

    Ormond, Gillian; Murphy, Rosemary

    2016-11-01

    This paper presents a study of the effects of alcohol consumption on household income in Ireland using the Slán National Health and Lifestyle Survey 2007 dataset, accounting for endogeneity and selection bias. Drinkers are categorised into one of four categories based on the recommended weekly drinking levels by the Irish Health Promotion Unit; those who never drank, non-drinkers, moderate and heavy drinkers. A multinomial logit OLS Two Step Estimate is used to explain individual's choice of drinking status and to correct for selection bias which would result in the selection into a particular category of drinking being endogenous. Endogeneity which may arise through the simultaneity of drinking status and income either due to the reverse causation between the two variables, income affecting alcohol consumption or alcohol consumption affecting income, or due to unobserved heterogeneity, is addressed. This paper finds that the household income of drinkers is higher than that of non-drinkers and of those who never drank. There is very little difference between the household income of moderate and heavy drinkers, with heavy drinkers earning slightly more. Weekly household income for those who never drank is €454.20, non-drinkers is €506.26, compared with €683.36 per week for moderate drinkers and €694.18 for heavy drinkers. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Chance UK

    ERIC Educational Resources Information Center

    McGrath, Gracia

    2003-01-01

    Chance UK is a unique charity in the UK that specialises in mentoring programmes for primary schoolchildren with behavioural problems. It was founded in 1995 by a policeman, Chief Superintendent Paul Mathias, who believed that by stepping in early, young children with behavioural difficulties could be given the chance to develop the necessary…

  19. Household Work Complexity, Intellectual Functioning, and Self-Esteem in Men and Women

    ERIC Educational Resources Information Center

    Caplan, Leslie J.; Schooler, Carmi

    2006-01-01

    Using data from a U.S. longitudinal investigation of psychological effects of occupational conditions (a project of the National Institute of Mental Health's unit on Socioenvironmental Studies), we examined the relationship between the complexity of household work and 2 psychological variables: intellectual flexibility and self-esteem.…

  20. Tsunami evacuation simulation considering differences in evacuation means depending on the household attribute

    NASA Astrophysics Data System (ADS)

    Sugiki, Nao; Hirata, Yoshiki; Matsuo, Kojiro

    2017-10-01

    Large scale earthquakes occur frequently in Japan in recent years. In the Great East Japan Earthquake that occurred in 2011 and caused major damage, more than 90% of the dead were due to the tsunami. The speed of evacuation is important in considering evacuation at the time of the attack of the tsunami, especially the elderly evacuation speed is assumed to be slower than non-elderly people. Elderly people may have different means of evacuation and speed depending on the composition of the households to which they belong because of the different possibilities of riding in families' driven cars. However, a simulation taking such a difference of evacuation into consideration has not been conducted. The purpose of this study is to conduct a tsunami evacuation simulation in consideration of evacuation measures and speed depending on the type of households belonging to in the tsunami inundation area of Toyohashi city, Japan. In order to conduct the tsunami evacuation simulation considering the household type, detailed data on individual households is necessary. However, it is difficult to obtain from aggregated data such as National Census. Therefore, detailed data on individual households is created by using the household micro data estimation system developed by Sugiki et al. [1]. Evacuation simulation is performed by shortest path search using Esri's ArcGIS Network Analyst's OD cost matrix analysis. The elderly people who cannot complete evacuation by the time of the arrival of the tsunami were found from evacuation simulation results assuming evacuation measures available for each household attribute to which the evacuees belong.

  1. Environmental baselines: preparing for shale gas in the UK

    NASA Astrophysics Data System (ADS)

    Bloomfield, John; Manamsa, Katya; Bell, Rachel; Darling, George; Dochartaigh, Brighid O.; Stuart, Marianne; Ward, Rob

    2014-05-01

    Groundwater is a vital source of freshwater in the UK. It provides almost 30% of public water supply on average, but locally, for example in south-east England, it is constitutes nearly 90% of public supply. In addition to public supply, groundwater has a number of other uses including agriculture, industry, and food and drink production. It is also vital for maintaining river flows especially during dry periods and so is essential for maintaining ecosystem health. Recently, there have been concerns expressed about the potential impacts of shale gas development on groundwater. The UK has abundant shales and clays which are currently the focus of considerable interest and there is active research into their characterisation, resource evaluation and exploitation risks. The British Geological Survey (BGS) is undertaking research to provide information to address some of the environmental concerns related to the potential impacts of shale gas development on groundwater resources and quality. The aim of much of this initial work is to establish environmental baselines, such as a baseline survey of methane occurrence in groundwater (National methane baseline study) and the spatial relationships between potential sources and groundwater receptors (iHydrogeology project), prior to any shale gas exploration and development. The poster describes these two baseline studies and presents preliminary findings. BGS are currently undertaking a national survey of baseline methane concentrations in groundwater across the UK. This work will enable any potential future changes in methane in groundwater associated with shale gas development to be assessed. Measurements of methane in potable water from the Cretaceous, Jurassic and Triassic carbonate and sandstone aquifers are variable and reveal methane concentrations of up to 500 micrograms per litre, but the mean value is relatively low at < 10 micrograms per litre. These values compare with much higher levels of methane in aquicludes

  2. Household resources as determinants of child mortality in Ghana.

    PubMed

    Nutor, Jerry John; Bell, Janice F; Slaughter-Acey, Jaime C; Joseph, Jill G; Apesoa-Varano, Ester Carolina; de Leon Siantz, Mary Lou

    2017-01-01

    Although the association between child mortality and socioeconomic status is well established, the role of household assets as predictors of child mortality, over and above other measures of socioeconomic status, is not well studied in developing nations. This study investigated the contribution of several household resources to child mortality, beyond the influence of maternal education as a measure of socioeconomic status. This secondary analysis used data from the 2007 Ghana Maternal Health Survey to explore the relationship of child mortality to household resources. The analysis of 7183 parous women aged 15-45 years examined household resources for their association with maternal reports of any child's death for children aged less than 5 years using a survey-weighted logistic regression model while controlling for sociodemographic and health covariates. The overall household resources index was significantly associated with the death of one or more child in the entire sample (adjusted odd ratios (OR)=0.95; 95% confidence interval (CI): 0.92, 0.98]. In stratified analysis, this finding held for women living in rural but not in urban areas. Having a refrigerator at the time of interview was associated with lower odds of reporting child mortality (OR=0.63; 95%CI: 0.48, 0.83). Having a kerosene lantern (OR=1.40; 95%CI: 1.06, 1.85) or flush toilet (OR=1.84; 95%CI: 1.23, 2.75) was associated with higher odds of reporting child mortality. Adjusted regression models showed only possession of a refrigerator retained significance. Possession of a refrigerator may play a role in child mortality. This finding may reflect unmeasured socioeconomic status or the importance of access to refrigeration in preventing diarrheal disease or other proximal causes of child mortality in sub-Saharan Africa.

  3. Ethnic differences in parental feeding behaviors in UK parents of preschoolers

    PubMed Central

    Cihang, Gu; Sarah, Warkentin; Amaral, Mais Laís; Susan, Carnell

    2017-01-01

    Childhood obesity is prevalent among ethnic minorities in the UK but little is known about parent feeding practices in these populations. We administered questionnaires assessing parental feeding behaviors and perceptions and concerns relating to child weight to White British (n=271), South Asian (n=59), and Black Afro-Caribbean (n=42) parents of UK 3–5 year-olds. Child BMI z-scores were determined from measured heights and weights. South Asian and Black Afro-Caribbean parents exhibited greater pressure to eat than White British parents. Black Afro-Caribbean parents additionally scored higher on instrumental feeding and lower on monitoring, while South Asian parents scored higher on emotional feeding. Black Afro-Caribbean parents reported the greatest concern about both child overweight and underweight. Ethnic differences were unchanged by controlling for perceptions and concerns relating to child weight, or for actual BMI z, parent education, or household income. Exploratory analyses suggested some evidence for sex differences within ethnic groups. For example, South Asian parents of daughters scored higher than White British parents of daughters on emotional feeding, with no ethnic differences apparent for parents of sons. Our findings support considering variation in parent feeding behaviors and weight-related attitudes by parental ethnicity and child sex when developing obesity interventions. PMID:28274650

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

    PubMed

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

    2011-12-01

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

  5. Which U.S. Households Use Education Loans?

    ERIC Educational Resources Information Center

    Hsu, Chungwen; Fisher, Patti J.

    2016-01-01

    This empirical study uses the 2013 Survey of Consumer Finances (SCF) to investigate the characteristics of households that hold at least one loan for educational expenses. The benefit of using household-level data is that a single household may have education loans for multiple people in the household, including the household head, spouse/partner,…

  6. Dominance of international 'high-risk clones' among metallo-β-lactamase-producing Pseudomonas aeruginosa in the UK.

    PubMed

    Wright, Laura L; Turton, Jane F; Livermore, David M; Hopkins, Katie L; Woodford, Neil

    2015-01-01

    Carbapenem-resistant isolates of Pseudomonas aeruginosa producing metallo-β-lactamases (MBLs) are increasingly reported worldwide and often belong to particular 'high-risk clones'. This study aimed to characterize a comprehensive collection of MBL-producing P. aeruginosa isolates referred to the UK national reference laboratory from multiple UK laboratories over a 10 year period. Isolates were referred to the UK national reference laboratory between 2003 and 2012 for investigation of resistance mechanisms and/or outbreaks. MBL genes were detected by PCR. Typing was carried out by nine-locus variable-number tandem repeat (VNTR) analysis and MLST. MBL-producing P. aeruginosa isolates were referred from 267 source patients and 89 UK laboratories. The most common isolation sites were urine (24%), respiratory (18%), wounds (17%) and blood (13%). VIM-type MBLs predominated (91% of all MBLs found), but a few IMP- and NDM-type enzymes were also identified. Diverse VNTR types were seen, but 86% of isolates belonged to six major complexes. MLST of representative isolates from each complex showed that they corresponded to STs 111, 233, 235, 357, 654 and 773, respectively. Isolates belonging to these complexes were received from between 9 and 25 UK referring laboratories each. The incidence of MBL-producing P. aeruginosa is increasing in the UK. The majority of these isolates belong to several 'high-risk clones', which have been previously reported internationally as host clones of MBLs. © Crown copyright 2014.

  7. Kidney donation and transplantation in the UK from 1998 to 2007.

    PubMed

    Johnson, Rachel; Collett, Dave; Birch, Rhiannon; Fuggle, Susan; Rudge, Chris

    2008-01-01

    There are many changes happening in donation and transplantation in the UK and this review provides a baseline against which the success of future developments can be assessed. There has been a decrease in donation after brain death over the 10-year review period, but increases in both donation after cardiac death and living kidney donation. Antibody incompatible transplantation and paired and altruistic donation programmes are starting to have an impact on the number of living donor transplants carried out and are expected to make a more marked impact in the years ahead. A new national Kidney Allocation Scheme for deceased donors after brain death was introduced in 2006 to replace the previous scheme implemented in 1998. The 2006 scheme aims to improve equity of access to transplant and is showing significant benefits for long-waiting patients. To ensure that all UK transplant centres continue to achieve high standards, both within- and across-centre monitoring of graft and patient outcomes is routinely undertaken and reported. The most important factor in increasing organ donation and transplantation in the UK is the government funding that has been provided to develop national organ donation infrastructures. These major changes are expected to have a significant impact on numbers of donors and transplants in the next 5 years.

  8. Ammonia emissions from non-agricultural sources in the UK

    NASA Astrophysics Data System (ADS)

    Sutton, M. A.; Dragosits, U.; Tang, Y. S.; Fowler, D.

    A detailed literature review has been undertaken of the magnitude of non-agricultural sources of ammonia (NH 3) in the United Kingdom. Key elements of the work included estimation of nitrogen (N) excreted by different sources (birds, animals, babies, human sweat), review of miscellaneous combustion sources, as well as identification of industrial sources and use of NH 3 as a solvent. Overall the total non-agricultural emission of NH 3 from the UK in 1996 is estimated here as 54 (27-106) kt NH 3-N yr -1, although this includes 11 (6-23) kt yr -1 from agriculture related sources (sewage sludge spreading, biomass burning and agro-industry). Compared with previous estimates for 1990, component source magnitudes have changed both because of revised average emissions per source unit (emission factors) and changes in the source activity between 1990 and 1996. Sources with larger average emission factors than before include horses, wild animals and sea bird colonies, industry, sugar beet processing, household products and non-agricultural fertilizer use, with the last three sources being included for the first time. Sources with smaller emission factors than before include: land spreading of sewage sludge, direct human emissions (sweat, breath, smoking, infants), pets (cats and dogs) and fertilizer manufacture. Between 1990 and 1996 source activities increased for sewage spreading (due to reduced dumping at sea) and transport (due to increased use of catalytic converters), but decreased for coal combustion. Combined with the current UK estimates of agricultural NH 3 emissions of 229 kt N yr -1 (1996), total UK NH 3 emissions are estimated at 283 kt N yr -1. Allowing for an import of reduced nitrogen (NH x) of 30 kt N yr -1 and deposition of 230 kt N yr -1, these figures imply an export of 83 kt NH 3-N yr -1. Although export is larger than previously estimated, due to the larger contribution of non-agricultural NH 3 emissions, it is still insufficient to balance the UK

  9. Maternal employment and child socio-emotional behaviour in the UK: longitudinal evidence from the UK Millennium Cohort Study.

    PubMed

    McMunn, Anne; Kelly, Yvonne; Cable, Noriko; Bartley, Mel

    2012-07-01

    Mothers of young children are increasingly combining paid work with childrearing. Empirical evidence on the effects of maternal employment on children is contradictory and little work has considered the impact of maternal employment within the context of the employment patterns of both parents. Data on parental employment across three sweeps (when children were in infancy, age 3 and age 5 y) of the Millennium Cohort Study, a large nationally representative prospective birth cohort study, were used to investigate the relation between parental employment and child socio-emotional behaviour at age 5 years independent of maternal education, maternal depression or household income. The cumulative effect of maternal employment across the early years was investigated. The impact of maternal employment in the first year of life was separately examined as a potentially 'sensitive period'. There was no evidence of detrimental effects of maternal employment in the early years on subsequent child socio-emotional behaviour. There were significant gender differences in the effects of parental employment on behavioural outcomes. The most beneficial working arrangement for both girls and boys was that in which both mothers and fathers were present in the household and in paid work independent of maternal educational attainment and household income. No detrimental effects of maternal employment in the early years were seen. There were important gender differences in relationships between parental working arrangements and child socio-emotional outcomes.

  10. Prevalence and correlates of disability among older Ugandans: evidence from the Uganda National Household Survey

    PubMed Central

    Wandera, Stephen O.; Ntozi, James; Kwagala, Betty

    2014-01-01

    Background Nationally representative evidence on the burden and determinants of disability among older people in sub-Saharan Africa in general, and Uganda in particular, is limited. Objective The aim of this study was to estimate the prevalence and investigate the correlates of disability among older people in Uganda. Design We conducted secondary analysis of data from a sample of 2,382 older persons from the Uganda National Household Survey. Disability was operationalized as either: 1) having a lot of difficulty on any one question; 2) being unable to perform on any one question; or, 3) having some difficulty with two of the six domains. We used frequency distributions for description, chi-square tests for initial associations, and multivariable logistic regressions to assess the associations. Results A third of the older population was disabled. Among all older persons, disability was associated with advancement in age (OR=4.91, 95% CI: 3.38–7.13), rural residence (0.56, 0.37–0.85), living alone (1.56, 1.07–2.27), separated or divorced (1.96, 1.31–2.94) or widowed (1.86, 1.32–2.61) marital status, households’ dependence on remittances (1.48, 1.10–1.98), ill health (2.48, 1.95–3.15), and non-communicable diseases (NCDs) (1.81, 0.80–2.33). Gender was not associated with disability among older persons. Conclusions Disability was associated with advancement in age, rural residence, living alone, divorced/separated/widowed marital status, dependence on remittances, ill health, and NCDs. Interventions to improve health and functioning of older people need to focus on addressing social inequalities and on the early preventive interventions and management of NCDs in old age in Uganda. PMID:25413721

  11. Quantifying household waste of fresh fruit and vegetables in the EU.

    PubMed

    De Laurentiis, Valeria; Corrado, Sara; Sala, Serenella

    2018-04-11

    According to national studies conducted in EU countries, fresh fruit and vegetables contribute to almost 50% of the food waste generated by households. This study presents an estimation of this waste flow, differentiating between unavoidable and avoidable waste. The calculation of these two flows serves different purposes. The first (21.1 kg per person per year) provides a measure of the amount of household waste intrinsically linked to the consumption of fresh fruit and vegetables, and which would still be generated even in a zero-avoidable waste future scenario. The second (14.2 kg per person per year) is a quantity that could be reduced/minimised by applying targeted prevention strategies. The unavoidable waste was assessed at product level, by considering the inedible fraction and the purchased amounts of the fifty-one most consumed fruits and vegetables in Europe. The avoidable waste was estimated at commodity group level, based on the results of national studies conducted in six EU member states. Significant differences in the amounts of avoidable and unavoidable waste generated were found across countries, due to different levels of wasteful behaviours (linked to cultural and economic factors) and different consumption patterns (influencing the amount of unavoidable waste generated). The results of this study have implications for policies both on the prevention and the management of household food waste. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  12. The bedrock electrical conductivity map of the UK

    NASA Astrophysics Data System (ADS)

    Beamish, David

    2013-09-01

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

  13. Assessing the need for a new nationally representative household panel survey in the United States

    PubMed Central

    Moffitt, Robert; Schoeni, Robert F.; Brown, Charles; Chase-Lansdale, P. Lindsay; Couper, Mick P.; Diez-Roux, Ana V.; Hurst, Erik; Seltzer, Judith A.

    2015-01-01

    We introduce this special issue on the critical matter of whether the existing household panel surveys in the U.S. are adequate to address the important emerging social science and policy questions of the next few decades. We summarize the conference papers which address this issue in different domains. The papers detail many new and important emerging research questions but also identify key limitations in existing panels in addressing those questions. To address these limitations, we consider the advantages and disadvantages of initiating a new, general-purpose omnibus household panel in the U.S. We also discuss the particular benefits of starting new panels that have specific targeted domains such as child development, population health and health care. We also develop a list of valuable enhancements to existing panels which could address many of their limitations. PMID:26688609

  14. Update on dialysis economics in the UK.

    PubMed

    Sharif, Adnan; Baboolal, Keshwar

    2011-03-01

    The burgeoning population of patients requiring renal replacement therapy contributes a disproportionate strain on National Health Service resources. Although renal transplantation is the preferred treatment modality for patients with established renal failure, achieving both clinical and financial advantages, limitations to organ donation and clinical comorbidities will leave a significant proportion of patients with established renal failure requiring expensive dialysis therapy in the form of either hemodialysis or peritoneal dialysis. An understanding of dialysis economics is essential for both healthcare providers and clinical leaders to establish clinically efficient and cost-effective treatment modalities that maximize service provision. In light of changes to the provision of healthcare funds in the form of "Payment by Results," it is imperative for UK renal units to adopt clinically effective and financially accountable dialysis programs. This article explores the role of dialysis economics and implications for UK renal replacement therapy programs.

  15. Potential challenges facing distributed leadership in health care: evidence from the UK National Health Service.

    PubMed

    Martin, Graeme; Beech, Nic; MacIntosh, Robert; Bushfield, Stacey

    2015-01-01

    The discourse of leaderism in health care has been a subject of much academic and practical debate. Recently, distributed leadership (DL) has been adopted as a key strand of policy in the UK National Health Service (NHS). However, there is some confusion over the meaning of DL and uncertainty over its application to clinical and non-clinical staff. This article examines the potential for DL in the NHS by drawing on qualitative data from three co-located health-care organisations that embraced DL as part of their organisational strategy. Recent theorising positions DL as a hybrid model combining focused and dispersed leadership; however, our data raise important challenges for policymakers and senior managers who are implementing such a leadership policy. We show that there are three distinct forms of disconnect and that these pose a significant problem for DL. However, we argue that instead of these disconnects posing a significant problem for the discourse of leaderism, they enable a fantasy of leadership that draws on and supports the discourse. © 2014 The Authors. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  16. The effect of high medical expenses on household income in South Korea: a longitudinal study using propensity score matching.

    PubMed

    Choi, Jae Woo; Park, Eun Cheol; Yoo, Ki Bong; Lee, Sang Gyu; Jang, Sung In; Kim, Tae Hyun

    2015-09-10

    Almost 97% of the Korean population is covered by National Health Insurance and are entitled to receive the same level of insurance benefits, regardless of how much each enrollee contributes to the system. However, the percentage of out-of-pocket payments is still high. This study examines whether the incurrence of high medical expenses affects household income. We use the Korea Welfare Panel and select 4,962 households to measure repeatedly over 5 years. Using propensity score matching, we set households with medical expenses of three times the annual average as "occurrence households" while "non-occurrence households" are those below the cut-off but with all other factors, such as income, held constant. We analyze whether the income of occurrence households differs significantly from the comparison group using a linear mixed effect model. After the occurrence of high medical expenditure, occurrence households (n = 825) had US$ 1,737 less income than non-occurrence households. In addition, the income of households (n = 200) that incurred high medical costs repeatedly for 2 years was US$ 3,598 lower than the non-occurrence group. Although it is important for the government to focus on medical assistance for households that have medical expense burdens, it needs to consider providing income indemnity insurance to protect them.

  17. Impulsivity and cognitive distortions in pathological gamblers attending the UK National Problem Gambling Clinic: a preliminary report.

    PubMed

    Michalczuk, R; Bowden-Jones, H; Verdejo-Garcia, A; Clark, L

    2011-12-01

    Pathological gambling (PG) is a form of behavioural addiction that has been associated with elevated impulsivity and also cognitive distortions in the processing of chance, probability and skill. We sought to assess the relationship between the level of cognitive distortions and state and trait measures of impulsivity in treatment-seeking pathological gamblers. Thirty pathological gamblers attending the National Problem Gambling Clinic, the first National Health Service clinic for gambling problems in the UK, were compared with 30 healthy controls in a case-control design. Cognitive distortions were assessed using the Gambling-Related Cognitions Scale (GRCS). Trait impulsivity was assessed using the UPPS-P, which includes scales of urgency, the tendency to be impulsive in positive or negative mood states. Delay discounting rates were taken as a state measure of impulsive choice. Pathological gamblers had elevated impulsivity on several UPPS-P subscales but effect sizes were largest (Cohen's d>1.4) for positive and negative urgency. The pathological gamblers also displayed higher levels of gambling distortions, and elevated preference for immediate rewards, compared to controls. Within the pathological gamblers, there was a strong relationship between the preference for immediate rewards and the level of cognitive distortions (R2=0.41). Impulsive choice in the gamblers was correlated with the level of gambling distortions, and we hypothesize that an impulsive decision-making style may increase the acceptance of erroneous beliefs during gambling play.

  18. One dimensional shock Initiation of UK Comp B

    NASA Astrophysics Data System (ADS)

    Burns, Malcolm

    2017-06-01

    Ten shock initiation experiments have been carried out on the UK isostatically pressed Composition B (59.5% RDX, 39.5% TNT, 1% wax) comprising of seven sustained pulse experiments with input pressures ranging from 2.89 to 9.86 GPa and three short shock experiments using the embedded gauge technique at the Los Alamos National Laboratory gas gun facility. The evolution of the reactive growth at and behind the shock front has been measured along with the run to detonation distance. These data have been used to create the Pop plot and hugoniot states for the UK Comp B. The shock initiation behavior of the UK Comp B has been compared to that of the equivalent US Composition. The reactive growth shows a feature that was observed in the US composition in which the wave profiles dispay a high level of pre-detonation noise. This was hypothesized to be due to a piezoelectric effect in the RDX crystals. The results of these experiments have shown that this effect may be localized in the gamma phase at shock pressures in the region of 5 GP and above.

  19. Adolescent mothers leaving multigenerational households.

    PubMed

    Oberlander, Sarah E; Shebl, Fatma M; Magder, Laurence S; Black, Maureen M

    2009-01-01

    This study examined how the developmental processes of autonomy and relatedness are related to changes in the residential status of 181 first-time, adolescent, urban, low-income, African American mothers over the first 24 months postpartum. Although adolescent mothers were eager to live independently, few made a clear transition out of the multigenerational household; 56% lived in the household of origin continuously (IN), 21% left and never returned (OUT), and 23% had multiple moves in and out of the household (IN/OUT). Older adolescent maternal age, less supportive adolescent mother-grandmother relations, and high household density were associated with leaving the household of origin. The IN/OUT group had difficulty adopting the roles of adult and parent. Helping adolescent mothers and grandmothers negotiate roles to reduce conflict may promote autonomy and relatedness, allowing mothers to learn parenting skills, qualify for public assistance, and continue their education.

  20. Female Participation in Household Decision Making and the Justification of Wife Beating in Bangladesh.

    PubMed

    Alam, Md Shahin; Tareque, Md Ismail; Peet, Evan D; Rahman, Md Mosfequr; Mahmud, Tanvir

    2018-04-01

    We examined female participation in household decision making and its association with the justification of wife beating in Bangladesh. We used nationally representative data from the 2014 Bangladesh Demographic and Health Survey. Our sample consisted of currently married women of age 15 to 49 years ( n = 16,463). Chi-square tests and multilevel logistic regression models were performed. Approximately 84% of women in the survey were participants in at least one household decision, and 72% reported that wife beating is not justified in any circumstance. Women who reported their participation in at least one type of household decision less frequently reported that wife beating could be justified than those who did not participate in any household decisions (adjusted odds ratio = 1.49; 95% confidence interval = [1.25, 1.78]). In addition to participation in household decision making, other factors including age at first marriage, females' and their husbands' education, religion, parity, contraceptive use, and socioeconomic status were associated with the justification of wife beating. The results indicate that female participation in household decision making is significantly associated with the justification of wife beating in Bangladesh. Further study is needed, but the results suggest that policy makers should consider interventions proven to empower women and lead to increased participation in decision making as methods that may reduce domestic violence against women.