The West Midlands breast cancer screening status algorithm - methodology and use as an audit tool.

PubMed

Lawrence, Gill; Kearins, Olive; O'Sullivan, Emma; Tappenden, Nancy; Wallis, Matthew; Walton, Jackie

2005-01-01

To illustrate the ability of the West Midlands breast screening status algorithm to assign a screening status to women with malignant breast cancer, and its uses as a quality assurance and audit tool. Breast cancers diagnosed between the introduction of the National Health Service [NHS] Breast Screening Programme and 31 March 2001 were obtained from the West Midlands Cancer Intelligence Unit (WMCIU). Screen-detected tumours were identified via breast screening units, and the remaining cancers were assigned to one of eight screening status categories. Multiple primaries and recurrences were excluded. A screening status was assigned to 14,680 women (96% of the cohort examined), 110 cancers were not registered at the WMCIU and the cohort included 120 screen-detected recurrences. The West Midlands breast screening status algorithm is a robust simple tool which can be used to derive data to evaluate the efficacy and impact of the NHS Breast Screening Programme.

Offering the vaccine and accepting it: an audit of hepatitis B vaccination in West Midlands region.

PubMed

Jaleel, Henna; Allan, P S; Huengsberg, Mia; Natin, D

2003-09-01

The practice of hepatitis B screening and vaccination in genitourinary medicine clinics in the West Midlands Region is audited against the standards set by 1999 Medical Society for the Study of Venereal Disease National Guidelines.

Strengths, weaknesses, opportunities, threats.

PubMed

2002-12-01

Meeting fellow older people enthusiasts is always a pleasure and this month's encounters particularly so. The annual conference of the two RCN older people forums offered its usual blend of innovative ideas, stimulating debate, esoteric humour and a camaraderie shared with strangers as well as friends. Working with multidisciplinary colleagues on the West Midlands pilot development programme for leaders of older people services was equally inspiring. Despite the ongoing challenges of competing priorities, inadequate resources and ageist attitudes, committed teams around the UK are striving to offer high quality services to older people.

Were attendances to accident and emergency departments in England and Australia influenced by the Rugby World Cup Final 2003?

PubMed

Moody, William E; Hendry, Ross G; Muscatello, David

2007-04-01

To determine changes in volume and timing of accident and emergency (A&E) attendances associated with the Rugby World Cup Final 2003. Retrospective analysis of A&E attendance data from the West Midlands Surveillance Centre and the New South Wales Emergency Department Collection. West Midlands, England and New South Wales, Australia. Relative risk of accident and emergency attendance during a 18-h period in 2003 compared with the same 18-h period in the years 2000-2002. In the West Midlands, in the 2 h before kick-off there were 72 attendances compared with an expected 101 in 2000-2002 [relative risk (RR) 0.71, 95% confidence interval (CI) 0.55-0.89]. For New South Wales, there were 326 attendances compared with an expected 384 (RR 0.85, 95% CI 0.76-0.95). The West Midlands saw a significant increase in attendance peaking 6-8 h after the kick-off (RR 1.27, 95% CI 1.10-1.46). In the West Midlands, it appears that attendance was reduced in the hours immediately surrounding the final, but in subsequent hours attendances increased, potentially as a result of celebration of the win. In New South Wales, the final was associated with reduced attendance in the hours leading up to the final, but they quickly returned to normal. Major sporting events can influence accident and emergency workload.

An alternative marker for the effectiveness of water fluoridation: hospital extraction rates for dental decay, a two-region study.

PubMed

Elmer, T B; Langford, J W; Morris, A J

2014-03-01

Contemporary evidence for the effectiveness of water fluoridation schemes in the U.K. is sparse. The utility of routinely collected data in providing evidence warrants further research. To examine inpatient hospital episodes statistics for dental extractions as an alternative population marker for the effectiveness of water fluoridation by comparing hospital admissions between two major strategic health authority (SHA) areas, the West Midlands SHA-largely fluoridated--and the North West SHA--largely unfluoridated. Hospital episodes statistics (HES) were interrogated to provide data on admissions for simple and surgical dental extractions, which had a primary diagnostic code of either dental caries or diseases of pulp and periapical tissues for financial years 2006/7, 2007/8 and 2008/9. Data was aggregated by SHA area and quinary age group. Directly standardised rates (DSR) of admissions purchased for each primary care trust (PCT) were calculated and ranked by index of multiple deprivation (IMD). A significant difference in DSRs of admission between PCTs in the West Midlands and North West was observed (Mann-Whitney U test [p <0.0001]) irrespective of IMD ranking. The difference in rates between the two most deprived PCTs was 27-fold. After ranking by IMD, DSRs of hospital admissions for the extraction of decayed or pulpally/periapically involved teeth is lower in areas with a fluoridated water supply. The analysis of routinely collected HES data may help identify the impact of water fluoridation schemes.

Report on accreditation learning sets in the West Midlands region of the NHS.

PubMed

Giles, G

2000-12-01

This article reports on the evaluation of the first year of a project, which utilized learning sets to support librarians undergoing the accreditation process, in the health libraries in the West Midlands region of the NHS. The West Midlands Health region is divided up into education consortia patches. Each group of patch librarians was allocated a local accreditation facilitator. The groups met regularly to discuss problems and progress relating to their library's accreditation. The results of the evaluation suggest that this is a valuable approach to use. The recommendations state that regular, frequent meetings are needed. Extra training and guidance would help the facilitators to be more effective in their role.

Comparison of built environment adaptations to heat exposure and mortality during hot weather, West Midlands region, UK.

PubMed

Taylor, Jonathon; Wilkinson, Paul; Picetti, Roberto; Symonds, Phil; Heaviside, Clare; Macintyre, Helen L; Davies, Michael; Mavrogianni, Anna; Hutchinson, Emma

2018-02-01

There is growing recognition of the need to improve protection against the adverse health effects of hot weather in the context of climate change. We quantify the impact of the Urban Heat Island (UHI) and selected adaptation measures made to dwellings on temperature exposure and mortality in the West Midlands region of the UK. We used 1) building physics models to assess indoor temperatures, initially in the existing housing stock and then following adaptation measures (energy efficiency building fabric upgrades and/or window shutters), of representative dwelling archetypes using data from the English Housing Survey (EHS), and 2) modelled UHI effect on outdoor temperatures. The ages of residents were combined with evidence on the heat-mortality relationship to estimate mortality risk and to quantify population-level changes in risk following adaptations to reduce summertime heat exposure. Results indicate that the UHI effect accounts for an estimated 21% of mortality. External shutters may reduce heat-related mortality by 30-60% depending on weather conditions, while shutters in conjunction with energy-efficient retrofitting may reduce risk by up to 52%. The use of shutters appears to be one of the most effective measures providing protection against heat-related mortality during periods of high summer temperatures, although their effectiveness may be limited under extreme temperatures. Energy efficiency adaptations to the dwellings and measures to increase green space in the urban environment to combat the UHI effect appear to be less beneficial for reducing heat-related mortality. Copyright © 2017 Elsevier Ltd. All rights reserved.

Is the faculty of family planning and reproductive health care guidance on emergency contraception being followed in general practice? An audit in the West Midlands, UK.

PubMed

Bannister, Lisa; Macve, Joanna; Pinkey, Benjamin; Webberley, Helen

2007-07-01

In 2003, the Faculty of Family Planning and Reproductive Health Care (FFPRHC) of the Royal College of Obstetricians and Gynaecologists published guidance on emergency contraception (EC). A literature search revealed no published work describing doctors' actions when prescribing EC. In order to assess the extent to which the FFPRHC Guidance is being followed in general practice, an audit of the medical notes of women requesting EC between January 2003 and December 2004 in six general practice surgeries located in the West Midlands, UK was conducted. From the medical notes, discussions between health care professionals and patients requesting EC regarding ongoing contraceptive needs, the risk of sexually transmitted infections (STIs) and the availability of the emergency intrauterine device (IUD) were recorded. A total of 718 emergency contraceptive pill consultations were analysed. The median age for presentation was 24 years. The 20-24 years age group accounted for the most consultations (30.9%). In 40% of consultations there was no evidence of future contraceptive needs having been discussed. Only 20 (2.8%) consultation notes contained evidence that STIs had been discussed. Chlamydia tests were undertaken in only 15/718 (1.7%) consultations. In only 10 (1.4%) of the consultations was the IUD discussed with the patient as an alternative form of EC. This audit suggests that the FFPRHC Guidance on EC is not being followed in general practice, and therefore patients requesting EC may not be receiving the highest standard of care.

78 FR 72911 - Changes in Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-04

.... Midland Fields, MI 48640. 333 West Ellsworth Street, Midland, MI 48640. Oakland City of Troy (13- The....fema.gov/ City of Troy, Troy, MI 48084. lomc. 500 West Big Beaver Road, Troy, MI 48084. Missouri...:// January 30, 2014 290869 Areas of Lincoln Presiding Troy, MO 63379. www.msc.fema.gov/ County (13-07...

Borehole Shear Device Phase II Development.

DTIC Science & Technology

1982-02-01

FIGURE 8 ITEM QUANTITY DESCRIPTION B1 1 Torque/Normal Load Transducer - First Extension Coupling. B2 1 Torque/Normal Load Transducer - Gauge Tube. B3 I...235, type RFN 7012. Supplier - Ringfeder Limited, Forum Drive, Midland Indus- trial Estate, Rugby , Warwickshire CV21 iNT, UK. FB 1 Expanding Friction...Midland Industrial Estate, Rugby , Warwickshire CV21 INT, UK. GF 2 Deep Groove Ball Bearing (upper support bearing), 80 x 100 x 10. Supplier - SKF ref

Participation motivation in martial artists in the west midlands region of England.

PubMed

Jones, Gareth W; Mackay, Ken S; Peters, Derek M

2006-01-01

The objectives were to identify the participation motivations and the perceived importance of certain participation factors in martial artists in the West Midlands, England, UK. A 28-item adapted version of the Participation Motivation Questionnaire with additional demographic questions was distributed to 30 martial arts clubs in the West Midlands region. Eight questions that assessed the perceived importance for participation of progression through grades, learning self defence skills, technical ability of instructors, cost of participating, development of confidence, underpinning philosophy and instructional style were included. Seventy-five questionnaires were returned from a total of 11 clubs from across representing practitioners in Tai Chi, Karate, Kung fu, Aikido, Jeet Kune Do, British Free Fighting, Taekwon-Do and Jujitsu. Results indicated that the rank order in terms of participation motives was: 1-Affiliation; 2-Friendship; 3-Fitness; 4-Reward/status; 5-Competition; 6-Situational and 7-Skill development. Participants who trained for more than 4 hours per week placed greater importance on the underpinning philosophy of the martial art. Findings suggest that whilst there is a gender discrepancy in participation level, once engaged, females were equally committed to weekly training. The 'style' of the instructor is of paramount importance for enhancing student motivation to participate. High volume practitioners would appear to be fully immersed in the holistic appreciation of the martial art through increased value placed on its underpinning philosophy. Key PointsWhilst there is a gender discrepancy in participation level, once engaged, females were equally committed to weekly training.The four most important participation motivations evident were 'Affiliation', 'Fitness', 'Skill Development' and 'Friendship'.The three least influential motives were 'Rewards/status; 'Situational' and 'Competition'. " There were no significant gender or experience differences for any of the emergent motivational factors.Instructor 'style' is of paramount importance for enhancing student motivation to participate.

Participation Motivation In Martial Artists In The West Midlands Region Of England

PubMed Central

Jones, Gareth W.; Mackay, Ken S.; Peters, Derek M.

2006-01-01

The objectives were to identify the participation motivations and the perceived importance of certain participation factors in martial artists in the West Midlands, England, UK. A 28-item adapted version of the Participation Motivation Questionnaire with additional demographic questions was distributed to 30 martial arts clubs in the West Midlands region. Eight questions that assessed the perceived importance for participation of progression through grades, learning self defence skills, technical ability of instructors, cost of participating, development of confidence, underpinning philosophy and instructional style were included. Seventy-five questionnaires were returned from a total of 11 clubs from across representing practitioners in Tai Chi, Karate, Kung fu, Aikido, Jeet Kune Do, British Free Fighting, Taekwon-Do and Jujitsu. Results indicated that the rank order in terms of participation motives was: 1-Affiliation; 2-Friendship; 3-Fitness; 4-Reward/status; 5-Competition; 6-Situational and 7-Skill development. Participants who trained for more than 4 hours per week placed greater importance on the underpinning philosophy of the martial art. Findings suggest that whilst there is a gender discrepancy in participation level, once engaged, females were equally committed to weekly training. The 'style' of the instructor is of paramount importance for enhancing student motivation to participate. High volume practitioners would appear to be fully immersed in the holistic appreciation of the martial art through increased value placed on its underpinning philosophy. Key Points Whilst there is a gender discrepancy in participation level, once engaged, females were equally committed to weekly training. The four most important participation motivations evident were 'Affiliation', 'Fitness', 'Skill Development' and 'Friendship'. The three least influential motives were 'Rewards/status; 'Situational' and 'Competition'. “ There were no significant gender or experience differences for any of the emergent motivational factors. Instructor 'style' is of paramount importance for enhancing student motivation to participate. PMID:24357973

Prehospital anaesthesia performed by physician/critical care paramedic teams in a major trauma network in the UK: a 12 month review of practice.

PubMed

McQueen, Carl; Crombie, Nicholas; Hulme, Jonathan; Cormack, Stef; Hussain, Nageena; Ludwig, Frank; Wheaton, Steve

2015-01-01

In the West Midlands region of the UK, delivery of pre-hospital care has been remodelled through introduction of a 24 h Medical Emergency Response Incident Team (MERIT). Teams including physicians and critical care paramedics (CCP) are deployed to incidents on land-based and helicopter-based platforms. Clinical practice, including delivery of rapid sequence induction of anaesthesia (RSI), is underpinned by standard operating procedures (SOP). This study describes the first 12 months experience of prehospital RSI in the MERIT scheme in the West Midlands. Retrospective review of the MERIT clinical database for the 12 months following the launch of the scheme. Data was collected relating to the number of RSIs performed; indication for RSI; number of intubation attempts; grade of view on laryngoscopy and the base speciality/grade of the operator performing intubation. MERIT teams were activated 1619 times, attending scene in 1029 cases. RSI was performed 142 times (13.80% of scene attendances). There was one recorded case of failure to intubate requiring insertion of a supraglottic airway device (0.70%). In over a third of RSI cases, CCPs performed laryngoscopy and intubation (n=53, 37.32%). Proficiency of obtaining Grade I view at laryngoscopy was similar for physicians (74.70%) and CCPs (77.36%). Intubation was successful at the first attempt in over 90% of cases. This study demonstrates that operation within a system that provides high levels of exposure, underpinned by comprehensive and robust training and governance frameworks, promotes levels of performance in successful prehospital RSI regardless of base speciality or profession. 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.

William W. Momyer: A Biography of an Airpower Mind

DTIC Science & Technology

2013-06-01

Europe to the Mediterranean and Soviet Union 1935-45 ( Helion and Company, West Midlands, England, 2010), 169. 22 Richard G. Davis, Carl A. Spaatz and... Helion and Company, West Midlands, England, 2010), 169. 31 60th Fighter Squadron History, 62-63; 58th Fighter Squadron History, 131; Craven and... Energy Commission (AEC) to recommend, “an intensification of efforts to make atomic weapons available for

Collaborating for Success: Collaborative Arrangements for 14-19 Provision in the West Midlands. Summary and Analysis of Research Findings from Six Case Studies. Research Report

ERIC Educational Resources Information Center

Hardman, Jill

2006-01-01

These findings from six case study areas in the West Midlands examine how 14-19 collaborative arrangements have developed and changed in response to local circumstances, assess the impact of the developments and changes on the curriculum offer, learner choice and participation, and identify the main success factors for starting and sustaining…

Agents and trends in health care workers' occupational asthma.

PubMed

Walters, G I; Moore, V C; McGrath, E E; Burge, P S; Henneberger, P K

2013-10-01

There is a disproportionately high number of cases of work-related asthma occurring in health care occupations due to agents such as glutaraldehyde, latex and cleaning products. To understand the causes and measure trends over time of occupational asthma (OA) in health care workers (HCWs). We reviewed OA notifications from the Midland Thoracic Society's Surveillance Scheme of Occupational Asthma (SHIELD) database in the West Midlands, UK, from 1991 to 2011 and gathered data on occupation, causative agent and annual number of notifications. There were 182 cases of OA in HCWs (median annual notifications = 7; interquartile range [IQR] = 5-11), representing 5-19% of annual SHIELD notifications. The modal annual notification was 20 (in 1996); notifications have declined since then, in line with total SHIELD notifications. The majority of cases (136; 75%) occurred in nursing, operating theatre, endoscopy and radiology staff. The most frequently implicated agents were glutaraldehyde (n = 69), latex (n = 47) and cleaning products (n = 27), accounting for 79% of the 182 cases. Cleaning product-related OA was an emerging cause with 22 cases after 2001 and only 5 cases between 1991 and 2000. Control measures within the UK National Health Service have seen a decline in OA in HCWs due to latex and glutaraldehyde, though OA remains a problem amongst HCWs exposed to cleaning products. Continuing efforts are required to limit the number of cases in this employment sector.

Agents and trends in health care workers' occupational asthma

PubMed Central

Walters, G. I.; Moore, V. C.; McGrath, E. E.; Burge, P. S.; Henneberger, P. K.

2015-01-01

Background There is a disproportionately high number of cases of work-related asthma occurring in health care occupations due to agents such as glutaraldehyde, latex and cleaning products. Aims To understand the causes and measure trends over time of occupational asthma (OA) in health care workers (HCWs). Methods We reviewed OA notifications from the Midland Thoracic Society's Surveillance Scheme of Occupational Asthma (SHIELD) database in the West Midlands, UK, from 1991 to 2011 and gathered data on occupation, causative agent and annual number of notifications. Results There were 182 cases of OA in HCWs (median annual notifications = 7; interquartile range [IQR] = 5–11), representing 5–19% of annual SHIELD notifications. The modal annual notification was 20 (in 1996); notifications have declined since then, in line with total SHIELD notifications. The majority of cases (136; 75%) occurred in nursing, operating theatre, endoscopy and radiology staff. The most frequently implicated agents were glutaraldehyde (n = 69), latex (n = 47) and cleaning products (n = 27), accounting for 79% of the 182 cases. Cleaning product-related OA was an emerging cause with 22 cases after 2001 and only 5 cases between 1991 and 2000. Conclusions Control measures within the UK National Health Service have seen a decline in OA in HCWs due to latex and glutaraldehyde, though OA remains a problem amongst HCWs exposed to cleaning products. Continuing efforts are required to limit the number of cases in this employment sector. PMID:23933593

19 CFR 122.24 - Landing requirements for certain aircraft arriving from areas south of U.S.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., Fla Opa-Locka Airport. Miami, Fla Tamiami Airport. Midland, TX Midland International Airport. New Orleans, La New Orleans International Airport (Moissant Field). New Orleans, La New Orleans Lakefront.... West Palm Beach, Fla Palm Beach International Airport. Wilmington, NC New Hanover County Airport Yuma...

Cobalt asthma in metalworkers from an automotive engine valve manufacturer.

PubMed

Walters, G I; Robertson, A S; Moore, V C; Burge, P S

2014-07-01

Cobalt asthma has previously been described in cobalt production workers, diamond polishers and glassware manufacturers. To describe a case series of occupational asthma (OA) due to cobalt, identified at the Birmingham Heartlands Occupational Lung Disease Unit, West Midlands, UK. Cases of cobalt asthma from a West Midlands' manufacturer of automotive engine valves, diagnosed between 1996 and 2005, were identified from the SHIELD database of OA. Case note data on demographics, employment status, asthma symptoms and diagnostic tests, including spirometry, peak expiratory flow (PEF) measurements, skin prick testing (SPT) and specific inhalational challenge (SIC) tests to cobalt chloride, were gathered, and descriptive statistics used to illustrate the data. The natural history of presentations has been described in detail, as well as a case study of one of the affected workers. Fourteen metalworkers (86% male; mean age 44.9 years) were diagnosed with cobalt asthma between 1996 and 2005. Workers were principally stellite grinders, stellite welders or machine setter-operators. All workers had positive Occupational Asthma SYStem analyses of serial PEF measurements, and sensitization to cobalt chloride was demonstrated in nine workers, by SPT or SIC. We have described a series of 14 workers with cobalt asthma from the automotive manufacturing industry, with objective evidence for sensitization. Health care workers should remain vigilant for cobalt asthma in the automotive manufacturing industry. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Identifying individuals for primary cardiovascular disease prevention in UK general practice: priorities and resource implications

PubMed Central

Holt, Tim A; Thorogood, Margaret; Griffiths, Frances; Munday, Stephen; Stables, David

2008-01-01

Targeted cardiovascular disease prevention relies on risk-factor information held in primary care records. A risk algorithm, the ‘e-Nudge’, was applied to data from a population of ≥50-year-olds in 19 West Midlands practices, to identify those individuals at risk of cardiovascular disease. Altogether, 5.9% were identified aged 50–74 years at ≥20% 10-year risk based on existing data, and a further 26.4% were potentially at risk but had missing risk-factor information; 9.2% of patients aged over 50 years with established cardiovascular disease had at least one modifiable risk factor outside the audit target of the Quality and Outcomes Framework. Implications for resource allocation are discussed. PMID:18611316

Assessment of continuous oil resources in the Wolfcamp shale of the Midland Basin, Permian Basin Province, Texas, 2016

USGS Publications Warehouse

Gaswirth, Stephanie B.

2017-03-06

The U.S. Geological Survey completed a geology-based assessment of undiscovered, technically recoverable continuous petroleum resources in the Wolfcamp shale in the Midland Basin part of the Permian Basin Province of west Texas. This is the first U.S. Geological Survey evaluation of continuous resources in the Wolfcamp shale in the Midland Basin. Since the 1980s, the Wolfcamp shale in the Midland Basin has been part of the “Wolfberry” play. This play has traditionally been developed using vertical wells that are completed and stimulated in multiple productive stratigraphic intervals that include the Wolfcamp shale and overlying Spraberry Formation. Since the shift to horizontal wells targeting the organic-rich shale of the Wolfcamp, more than 3,000 horizontal wells have been drilled and completed in the Midland Basin Wolfcamp section. The U.S. Geological Survey assessed technically recoverable mean resources of 20 billion barrels of oil and 16 trillion cubic feet of associated gas in the Wolfcamp shale in the Midland Basin.

The Value of Trainee Networks in Pediatric Surgical Research.

PubMed

Skerritt, Clare; Hall, Nigel J

2015-12-01

In 2007, the first trainee-led surgical research network was founded in the United Kingdom (UK). The West Midlands Research Collaborative was started by a group of enthusiastic adult surgical trainees who saw the benefits of altruistic collaboration to generate high quality, multicenter research. Seeing the success of their research projects, including randomized controlled trials, trainees in other regions and specialties were spurred on to founding their own research collaboratives. The Pediatric Surgical Trainee Research Network was started in 2011 by a group of UK trainees with the aim to promote, facilitate, and encourage trainee-led research in pediatric surgery. This article summarizes the history and evolution of the trainee collaborative surgical research. It examines the challenges which multicenter research entails and the steps the collaboratives have taken to overcome them. We describe some of the projects which have been successfully completed and the benefits that the trainee networks have for patients and surgeons alike. Georg Thieme Verlag KG Stuttgart · New York.

Fifteen-year trends in occupational asthma: data from the Shield surveillance scheme.

PubMed

Bakerly, N Diar; Moore, V C; Vellore, A D; Jaakkola, M S; Robertson, A S; Burge, P S

2008-05-01

Trends of occupational asthma (OA) differ between regions depending on local industries, provisions for health and safety at the workplace and the availability of a reporting scheme to help in data collection and interpretation. To assess trends in OA in an industrialized part of the UK over a 15-year period. Occupational and chest physicians in the West Midlands were invited to submit details of newly diagnosed cases with OA. Data were then transferred to the regional centre for occupational lung diseases for analysis. A total of 1461 cases were reported to the scheme. Sixty-eight per cent were males with mean (standard deviation) age of 44 (12) years. The annual incidence of OA was 42 per million of working population (95% CI = 37-45). OA was most frequently reported in welders (9%) and health care-related professions (9%) while < 1% of cases were reported in farmers. Isocyanates were the commonest offending agents responsible for 21% of reports followed by metal working fluids (MWFs) (11%), adhesives (7%), chrome (7%), latex (6%) and glutaraldehyde (6%). Flour was suspected in 5% of cases while laboratory animals only in 1%. Our data confirm a high annual incidence of OA in this part of the UK. MWFs are an emerging problem, while isocyanates remain the commonest cause. Incidence remained at a fairly stable background level with many small and a few large epidemics superimposed. Schemes like Midland Thoracic Society's Rare Respiratory Disease Registry Surveillance Scheme of Occupational Asthma could help in identifying outbreaks by linking cases at the workplace.

Mobile telecommunications and health: report of an investigation into an alleged cancer cluster in Sandwell, West Midlands.

PubMed

Stewart, Antony; Rao, Jammi N; Middleton, John D; Pearmain, Philippa; Evans, Tim

2012-11-01

Residents of one street expressed concern about the number of incident cancers, following the installation of a nearby mobile phone base station. The investigation explored whether the base station could be responsible for the cancers. Data were collected from residents' medical records. GPs and oncologists provided further information. Ward-level cancer incidence and mortality data were also obtained, over four three-year time periods. A total of 19 residents had developed cancer. The collection of cancers did not fulfil the criteria for a cancer cluster. Standardized mortality ratios (SMRs) for all malignant neoplasms (excluding non-melanoma skin cancers) in females (1.38 (95% CI, 1.08-1.74)) and all persons (1.27 (CI, 1.06-1.51)) were significantly higher than in the West Midlands during 2001-3. There were no significant differences for colorectal, female breast and prostate cancers, for any time period. Standardized incidence ratios (SIRs) for non-melanoma skin cancers in males and all persons was significantly lower than in the West Midlands during 1999-2001, and significantly lower in males, females and all persons during 2002-4. We cannot conclude that the base station was responsible for the cancers. It is unlikely that information around a single base station can either demonstrate or exclude causality.

Drug formularies--good or evil? A view using prescribing analyses and cost trends data.

PubMed

Chapman, S

1994-01-01

In the UK, the drugs bill has almost trebled in the last 10 years and is consuming an increasing proportion of the total National Health Service spend. If the drugs bill can be limited, greater funds will be available for other areas of the health service. Therefore, cost containment measures which include prescribing from a formulary or generic prescribing are now widely encouraged. Prescribing analyses and cost trends data generated from pharmacists sending dispensed general practitioners' prescriptions to a central point for reimbursement are a valuable tool in the assessment of prescribing habits and can be used by general practitioners when preparing a formulary. In the West Midlands, such data have been used to identify areas of growth in cardiovascular drugs and problem areas where prescribing an expensive formulation has led to a dramatic increase in costs.

Changing times, similar challenges.

PubMed

Baillie, Jonathan

2013-11-01

With IHEEM celebrating its 70th Anniversary this month, HEJ editor, Jonathan Baillie, recently met the Institute's oldest surviving Past-President, Lawrence Turner OBE, who, having in 1964 established a small engineering business producing some of the NHS's earliest nurse call systems from the basement of his three-storey West Midlands home, has since seen the company, Static Systems Group, grow to become one of the U.K. market-leaders in its field. The Institute's President from 1979-1981, he looked back, during a fascinating two-hour discussion, at his time in the role, talked through some of the key technological and other changes he has seen in the past five decades, reflected on an interesting and varied career, and considered some of the very different current-day challenges that today's IHEEM President, and the Institute as a whole, face.

Establishing Influential Decision Making Factors for University Library Opening Hours: An Exploratory UK Regional Study

ERIC Educational Resources Information Center

Ravenwood, Clare; Stephens, Derek; Walton, Graham

2015-01-01

Many factors and pressures affect decisions made in UK university libraries on opening hours especially 24/7. This article reports on a project to examine the decision-making process, influential factors, and stakeholders. A workshop for senior library managers in the East Midlands was held to gather data and share experiences. From analysis of…

NORM in the East Midlands' oil and gas producing region of the UK.

PubMed

Garner, Joel; Cairns, James; Read, David

2015-12-01

Naturally occurring radioactive material (NORM) is a common feature in North Sea oil and gas production offshore but, to date, has been reported from only one production site onshore in the United Kingdom. The latter, Wytch Farm on the Dorset coast, revealed high activity concentrations of (210)Pb in metallic form but little evidence of radium accumulation. NORM has now been discovered at two further onshore sites in the East Midlands region of the UK. The material has been characterized in terms of its mineralogy, bulk composition and disequilibrium in the natural uranium and thorium series decay chains. In contrast to Wytch Farm, scale and sludge samples from the East Midlands were found to contain elevated levels of radium and radioactive progeny associated with crystalline strontiobarite. The highest (226)Ra and (228)Ra activity concentrations found in scale samples were 132 and 60 Bq/g, with mean values of 86 and 40 Bq/g respectively; somewhat higher than the mean for the North Sea and well above national exemption levels for landfill disposal. The two East Midlands sites exhibited similar levels of radioactivity. Scanning electron microscope imaging shows the presence of tabular, idiomorphic and acicular strontiobarite crystals with elemental mapping confirming that barium and strontium are co-located throughout the scale. Bulk compositional data show a corresponding correlation between barium-strontium concentrations and radium activity. Scales and sludge were dated using the (226)Ra/(210)Pb method giving mean ages of 2.2 and 3.7 years, respectively. The results demonstrate clearly that these NORM deposits, with significant radium activity, can form over a very short period of time. Although the production sites studied here are involved in conventional oil recovery, the findings have direct relevance should hydraulic fracturing for shale gas be pursued in the East Midlands oilfield. Copyright © 2015 Elsevier Ltd. All rights reserved.

Physiotherapy students' experiences of bullying on clinical internships: an exploratory study.

PubMed

Stubbs, Brendon; Soundy, Andy

2013-06-01

To consider the prevalence and type of bullying behaviours experienced whilst on clinical placement in a cohort of final-year BSc undergraduate students. Cross-sectional survey. University in the West Midlands, UK. Fifty-two final-year undergraduate students. Prevalence of incivility and bullying behaviours. Twenty-five percent of students reported at least one incident of bullying behaviour. The perpetrator of the bullying behaviour was most often the clinical educator (8/13, 62%). Despite the negative effects caused, the majority of students (11/13, 84%) did not report this experience to the university. Bullying behaviour may take many forms and can have a negative effect on the well-being of students. It should be addressed by all stakeholders including universities, National Health Service trusts and researchers. Possible strategies to move forwards and better protect the future of the physiotherapy profession are briefly considered. Copyright © 2013 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Urinary symptoms, sexual intercourse and significant bacteriuria in male patients attending STD clinics.

PubMed Central

David, L M; Natin, D; Walzman, M; Stocker, D

1996-01-01

OBJECTIVE: To assess the relationship between sexual behaviour, urinary symptoms, urinalysis and bacteriuria in men attending STD clinics. DESIGN: A prospective study recording sexual behaviour, urinary symptoms and collecting mid-stream urine specimens. SETTING: Two West Midlands STD clinics, UK. SUBJECTS: 1086 new male patients. RESULTS: 704 patients had had sexual intercourse (SI) within 14 days of testing, 424 had urinary symptoms and 122 had pyuria. All 13 patients with positive culture had SI < 14 days before testing, urinary symptoms and pyuria. No association was found between sexual orientation, type of SI, number of sexual partners, condom usage and bacteriuria. CONCLUSION: Bacteriuria does not behave as an STD but SI may be a factor in acquiring bacteriuria. Dysuria with or without urethral discharge is the most predictive symptom of bacteriuria. Pyuria has a high sensitivity for predicting bacteriuria among males. PMID:8976831

Healthier central England or North–South divide? Analysis of national survey data on smoking and high-risk drinking

PubMed Central

Beard, Emma; Brown, Jamie; West, Robert; Angus, Colin; Kaner, Eileen; Michie, Susan

2017-01-01

Objectives This paper compares patterns of smoking and high-risk alcohol use across regions in England, and assesses the impact on these of adjusting for sociodemographic characteristics. Design Population survey of 53 922 adults in England aged 16+ taking part in the Alcohol and Smoking Toolkit Studies. Measures Participants answered questions regarding their socioeconomic status (SES), gender, age, ethnicity, Government Office Region, smoking status and completed the Alcohol Use Disorders Identification Test (AUDIT). High-risk drinkers were defined as those with a score of 8 or more (7 or more for women) on the AUDIT. Results In unadjusted analyses, relative to the South West, those in the North of England were more likely to smoke, while those from the East of England, South East and London were less likely. After adjustment for sociodemographics, smoking prevalence was no higher in North East (RR 0.97, p>0.05), North West (RR 0.98, p>0.05) or Yorkshire and the Humber (RR 1.03, p>0.05) but was less common in the East and West Midlands (RR 0.86, p<0.001; RR 0.91, p<0.05), East of England (RR 0.86, p<0.001), South East (RR 0.92, p<0.05) and London (RR 0.85, p<0.001). High-risk drinking was more common in the North but was less common in the Midlands, London and East of England. Adjustment for sociodemographics had little effect. There was a higher prevalence in the North East (RR 1.67, p<0.001), North West (RR 1.42, p<0.001) and Yorkshire and the Humber (RR 1.35, p<0.001); lower prevalence in the East Midlands (RR 0.69, p<0.001), West Midlands (RR 0.77, p<0.001), East of England (RR 0.72, p<0.001) and London (RR 0.71, p<0.001); and a similar prevalence in the South East (RR 1.10, p>0.05) Conclusions In adjusted analyses, smoking and high-risk drinking appear less common in ‘central England’ than in the rest of the country. Regional differences in smoking, but not those in high-risk drinking, appear to be explained to some extent by sociodemographic disparities. PMID:28249851

Occupational asthma in a highly industrialized region of UK: report from a local surveillance scheme.

PubMed

Di Stefano, Fabio; Siriruttanapruk, Somkiat; McCoach, Jennifer; Di Gioacchino, Mario; Burge, Peter Sherwood

2004-02-01

Estimates of the incidence of occupational asthma may be derived from surveillance schemes established in several countries. SHIELD is a voluntary surveillance scheme for occupational asthma in the West Midlands, a highly industrialized region of UK. The aim of this study was to estimate the general and specific incidence of occupational asthma in the West Midlands in 1990-97. The annual incidence was 41.2/million. There was a two fold difference in the incidence by sex (male 59.6/million/yr; female 27.4/million/yr). The highest annual incidence (53.2/million) was observed in the age group 45-64 yr (male) and 45-59 yr (female). Spray painters were the occupation at the highest risk of developing occupational asthma, followed by electroplaters, rubber and plastic workers, bakery workers and moulders. Although the percentage of reported cases was low among healthcare workers, there was a raising trend. Isocyanates still remained the most common causative agents with 190 (17.3%) out of the total 1097 cases reported to the surveillance scheme in seven years. There was a decrease in the reported cases due to colophony (9.5% to 4.6%), flour & wheat (8.9% to 4.9%). There was an increase of reported cases due to latex (0.4% to 4.9%) and glutaraldehyde (1.3% to 5.6%). The serial mesurement of peak expiratory flow at and away from work was the most used method of diagnosis to confirm the occupational cause of asthma. Specific bronchial challenge test with the occupational agents were used when the serial measurement of peak expiratory flow was not able to confirm undoubtdely the diagnostic suspicion or when it was difficult to identify the possible causative agent due to multiple exposures in the workplace. Following diagnosis, 24% of the patients were moved away from exposure within the same workplace in 1997, compared to 15.8% in the previous years. Those remaining exposed to the causative agent in the same workplace decreased from 28.3% to 17.7% between 1990-97. The surveillance of occupational asthma trough this voluntary scheme has allowed to monitor the incidence of the disease in the region and to identify clusters of cases, where control measures are a priority.

Family history in primary care: understanding GPs' resistance to clinical genetics--qualitative study.

PubMed

Mathers, Jonathan; Greenfield, Sheila; Metcalfe, Alison; Cole, Trevor; Flanagan, Sarah; Wilson, Sue

2010-05-01

National and local evaluations of clinical genetics service pilots have experienced difficulty in engaging with GPs. To understand GPs' reluctance to engage with clinical genetics service developments, via an examination of the role of family history in general practice. Qualitative study using semi-structured one-to-one interviews. The West Midlands, UK. Interviews with 21 GPs working in 15 practices, based on a stratified random sample from the Midlands Research Practices Consortium database. Thematic analysis proceeded alongside data generation. Framework grids were constructed for comparative analytical questioning. Interpretation was framed by two explanatory models: a knowledge deficit model, and practice and professional identity model. There is a clear distinction between the routine use and function of family history in GPs' clinical decision making, and contrasting conceptualisations of genetics and 'genetic conditions'. Although genetics is clearly a part of current GP practice, with acknowledgement of genetic components to multifactorial disease, this is distinguished from 'genetic conditions' which are seen as rare, complex single-gene disorders. Importantly, family history takes its place within a broader notion of the 'family doctor' that interviewees identified as a key aspect of their role. In contrast, clinical genetics was not identified as a core component of generalist practice. The likely effectiveness of educational policy interventions aimed at GPs that focus solely on knowledge deficit models, is questionable. There is a need to acknowledge how appropriate practice is constructed by GPs, within the context of accepted generalist roles and related identities.

Healthier central England or North-South divide? Analysis of national survey data on smoking and high-risk drinking.

PubMed

Beard, Emma; Brown, Jamie; West, Robert; Angus, Colin; Kaner, Eileen; Michie, Susan

2017-03-01

This paper compares patterns of smoking and high-risk alcohol use across regions in England, and assesses the impact on these of adjusting for sociodemographic characteristics. Population survey of 53 922 adults in England aged 16+ taking part in the Alcohol and Smoking Toolkit Studies. Participants answered questions regarding their socioeconomic status (SES), gender, age, ethnicity, Government Office Region, smoking status and completed the Alcohol Use Disorders Identification Test (AUDIT). High-risk drinkers were defined as those with a score of 8 or more (7 or more for women) on the AUDIT. In unadjusted analyses, relative to the South West, those in the North of England were more likely to smoke, while those from the East of England, South East and London were less likely. After adjustment for sociodemographics, smoking prevalence was no higher in North East (RR 0.97, p>0.05), North West (RR 0.98, p>0.05) or Yorkshire and the Humber (RR 1.03, p>0.05) but was less common in the East and West Midlands (RR 0.86, p<0.001; RR 0.91, p<0.05), East of England (RR 0.86, p<0.001), South East (RR 0.92, p<0.05) and London (RR 0.85, p<0.001). High-risk drinking was more common in the North but was less common in the Midlands, London and East of England. Adjustment for sociodemographics had little effect. There was a higher prevalence in the North East (RR 1.67, p<0.001), North West (RR 1.42, p<0.001) and Yorkshire and the Humber (RR 1.35, p<0.001); lower prevalence in the East Midlands (RR 0.69, p<0.001), West Midlands (RR 0.77, p<0.001), East of England (RR 0.72, p<0.001) and London (RR 0.71, p<0.001); and a similar prevalence in the South East (RR 1.10, p>0.05) CONCLUSIONS: In adjusted analyses, smoking and high-risk drinking appear less common in 'central England' than in the rest of the country. Regional differences in smoking, but not those in high-risk drinking, appear to be explained to some extent by sociodemographic disparities. 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/.

Enhanced care team response to incidents involving major trauma at night: are helicopters the answer?

PubMed

McQueen, Carl; Nutbeam, Tim; Crombie, Nick; Lecky, Fiona; Lawrence, Thomas; Hathaway, Karen; Wheaton, Steve

2015-07-01

Challenges exist in how to deliver enhanced care to patients suffering severe injury in geographically remote areas within regionalised trauma networks at night. The physician led Enhanced Care Teams (ECTs) in the West Midlands region of England do not currently utilise helicopters to respond to incidents at night. This study describes this remote trauma workload at night within the regional network in terms of incident location; injury profile and patient care needs and discusses various solutions to the delivery of ECTs to such incidents, including the need for helicopter based platforms. We present a retrospective analysis of incidents involving Major Trauma occurring in the West Midlands Regional Trauma Network in England over a one year period (1st April 2012 until the 31st March 2013). Anonymised patient records from the Trauma Audit and Research Network (TARN) for patients that had been conveyed to hospital by ambulance/air ambulance were cross-referenced with the West Midlands Ambulance Service NHS Foundation Trust (WMAS) Computer Assisted Dispatch (CAD) archive for the same period. Data were abstracted from the combined dataset relating to injury severity (ISS/ICU admission/death at scene or as inpatient); ECT resource activations/scene attendances; incident location and the need for enhanced level care. A total of 603 incidents involving Major Trauma were identified during night time hours. Enhanced Care Team resources attended scene in 167 cases (27.7%). Of the incidents not attended by an ECT 179 (41.1%) were due to falls and 91 (20.9%) involved a 'Road Traffic Collision'. A total of 36 incidents (6.0% of total at night) occurred in locations identified as being greater than 45min by road from the nearest major trauma centre. In these cases 13 patients had enhanced care needs that could not be addressed at scene by the attending ambulance service personnel. There is limited evidence to support the need for night HEMS operations in the West Midlands regional trauma network. The potential role of night HEMS in other regional trauma networks in England requires further evaluation with specific reference to the incidence of Major Trauma and efficiency of existing road based systems. Copyright © 2015. Published by Elsevier Ltd.

Migration and maternity in the age of superdiversity.

PubMed

Newall, Dave; Phillimore, Jenny; Sharpe, Hilary

2012-01-01

The UK has entered an era of superdiversity with our communities being more diverse than ever before. Migration has contributed to rising birth rates, and poor birth outcomes have been increasingly associated with ethnicity, often in areas with high concentrations of migrants. This article sets out the findings of a study looking at the maternity needs and experiences of migrant women and professionals living in the West Midlands. The study found that migrant women tended to book late or drop out of the maternity system due to a range of barriers including lack of understanding of the system, lack of information, poor language skills and poverty. Migrant women often had negative birth experiences and did not receive the follow on care they needed. Professionals recognised many of the problems migrant women experienced but lacked the time and resources to meet needs. The article concludes by recognising that additional training and time are needed to help professionals to address those needs and signposts the reader to good practice.

Study of Genes and Environment in Patients With Cancer in East Anglia, Trent, or West Midlands Regions of the United Kingdom

ClinicalTrials.gov

2013-08-23

Bladder Cancer; Brain and Central Nervous System Tumors; Esophageal Cancer; Intraocular Melanoma; Kidney Cancer; Lymphoma; Melanoma (Skin); Pancreatic Cancer; Transitional Cell Cancer of the Renal Pelvis and Ureter

Investigating the influence of African American and African Caribbean race on primary care doctors' decision making about depression.

PubMed

Adams, A; Vail, L; Buckingham, C D; Kidd, J; Weich, S; Roter, D

2014-09-01

This paper explores differences in how primary care doctors process the clinical presentation of depression by African American and African-Caribbean patients compared with white patients in the US and the UK. The aim is to gain a better understanding of possible pathways by which racial disparities arise in depression care. One hundred and eight doctors described their thought processes after viewing video recorded simulated patients presenting with identical symptoms strongly suggestive of depression. These descriptions were analysed using the CliniClass system, which captures information about micro-components of clinical decision making and permits a systematic, structured and detailed analysis of how doctors arrive at diagnostic, intervention and management decisions. Video recordings of actors portraying black (both African American and African-Caribbean) and white (both White American and White British) male and female patients (aged 55 years and 75 years) were presented to doctors randomly selected from the Massachusetts Medical Society list and from Surrey/South West London and West Midlands National Health Service lists, stratified by country (US v.UK), gender, and years of clinical experience (less v. very experienced). Findings demonstrated little evidence of bias affecting doctors' decision making processes, with the exception of less attention being paid to the potential outcomes associated with different treatment options for African American compared with White American patients in the US. Instead, findings suggest greater clinical uncertainty in diagnosing depression amongst black compared with white patients, particularly in the UK. This was evident in more potential diagnoses. There was also a tendency for doctors in both countries to focus more on black patients' physical rather than psychological symptoms and to identify endocrine problems, most often diabetes, as a presenting complaint for them. This suggests that doctors in both countries have a less well developed mental model of depression for black compared with white patients. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Re-framing 'binge drinking' as calculated hedonism: empirical evidence from the UK.

PubMed

Szmigin, Isabelle; Griffin, Christine; Mistral, Willm; Bengry-Howell, Andrew; Weale, Louise; Hackley, Chris

2008-10-01

Recent debates on 'binge drinking' in the UK have represented the activities of young drinkers in urban areas as a particular source of concern, as constituting a threat to law and order, a drain on public health and welfare services and as a source of risk to their own future health and well being. The discourse of moral panic around young people's 'binge drinking' has pervaded popular media, public policy and academic research, often differentiating the excesses of 'binge drinking' from 'normal' patterns of alcohol consumption, although in practice definitions of 'binge drinking' vary considerably. However, recent research in this area has drawn on the notion of 'calculated hedonism' to refer to a way of 'managing' alcohol consumption that might be viewed as excessive. The paper presents a critical analysis of contemporary discourses around 'binge drinking' in the British context, highlighting contradictory messages about responsibility and self control in relation to the recent liberalisation of licensing laws and the extensive marketing of alcohol to young people. The paper analyses marketing communications which present drinking as a crucial element in 'having fun', and as an important aspect of young people's social lives. The empirical study involves analysis of focus group discussions and individual interviews with young people aged 18-25 in three areas of Britain: a major city in the West Midlands, a seaside town in the South-West of England and a small market town also in the South-West. The initial findings present the varied forms and meanings that socialising and drinking took in these young people's social lives. In particular the results illustrate the ways in which drinking is constituted and managed as a potential source of pleasure. The paper concludes that the term 'calculated hedonism' better describes the behaviour of the young people in this study and in particular the way they manage their pleasure around alcohol, than the emotive term 'binge drinking'.

Older and Younger Workers: The Equalling Effects of Health

ERIC Educational Resources Information Center

Beck, Vanessa; Quinn, Martin

2012-01-01

Purpose: The purpose of this paper is to consider the statistical evidence on the effects that ill health has on labour market participation and opportunities for younger and older workers in the East Midlands (UK). Design/methodology/approach: A statistical analysis of Labour Force Survey data was undertaken to demonstrate that health issues…

Use of antimicrobial resistance information and prescribing guidance for management of urinary tract infections: survey of general practitioners in the West Midlands.

PubMed

Ironmonger, Dean; Edeghere, Obaghe; Gossain, Savita; Hawkey, Peter M

2016-05-24

There is a marked variation in both antibiotic prescribing practice and urine sampling rates for diagnostic microbiology across general practices in England. To help understand factors driving this variation, we undertook a survey in 2012/13 to determine sampling protocols and antibiotic formularies used by general practitioners (GPs) for managing urinary tract infections (UTIs) in the West Midlands region of England. Cross-sectional survey of all eligible general practices in the West Midlands region of England undertaken in November 2012. GPs were invited to complete an online survey questionnaire to gather information on policies used within the practice for urine sampling for microbiological examination, and the source of antibiotic formularies used to guide treatment of UTIs. The questionnaire also gathered information on how they would manage five hypothetical clinical scenarios encountered in the community. The response rate was 11.3 % (409/3635 GPs), equivalent to a practice response rate of 26 % (248/950). Only 50 % of GPs reported having a practice policy for urine sampling. Although there was good agreement from GPs regarding collecting specimens in scenarios symbolising treatment failure (98 %), UTI in an adult male (98 %) and asymptomatic UTI in pregnancy (97 %), there was variation in GPs requesting a specimen for the scenarios involving a suspected uncomplicated urinary tract infection (UTI) and an asymptomatic catheterised elderly patient; with 40 and 38 % respectively indicating they would collect a specimen for microbiological examination. Standardised evidence based clinical management policies and antibiotic formularies for GPs should be readily available. This will promote the rational use of diagnostic microbiology services, improve antimicrobial stewardship and aid the interpretation of ongoing antimicrobial resistance surveillance.

PREDICT: a new UK prognostic model that predicts survival following surgery for invasive breast cancer.

PubMed

Wishart, Gordon C; Azzato, Elizabeth M; Greenberg, David C; Rashbass, Jem; Kearins, Olive; Lawrence, Gill; Caldas, Carlos; Pharoah, Paul D P

2010-01-01

The aim of this study was to develop and validate a prognostication model to predict overall and breast cancer specific survival for women treated for early breast cancer in the UK. Using the Eastern Cancer Registration and Information Centre (ECRIC) dataset, information was collated for 5,694 women who had surgery for invasive breast cancer in East Anglia from 1999 to 2003. Breast cancer mortality models for oestrogen receptor (ER) positive and ER negative tumours were derived from these data using Cox proportional hazards, adjusting for prognostic factors and mode of cancer detection (symptomatic versus screen-detected). An external dataset of 5,468 patients from the West Midlands Cancer Intelligence Unit (WMCIU) was used for validation. Differences in overall actual and predicted mortality were <1% at eight years for ECRIC (18.9% vs. 19.0%) and WMCIU (17.5% vs. 18.3%) with area under receiver-operator-characteristic curves (AUC) of 0.81 and 0.79 respectively. Differences in breast cancer specific actual and predicted mortality were <1% at eight years for ECRIC (12.9% vs. 13.5%) and <1.5% at eight years for WMCIU (12.2% vs. 13.6%) with AUC of 0.84 and 0.82 respectively. Model calibration was good for both ER positive and negative models although the ER positive model provided better discrimination (AUC 0.82) than ER negative (AUC 0.75). We have developed a prognostication model for early breast cancer based on UK cancer registry data that predicts breast cancer survival following surgery for invasive breast cancer and includes mode of detection for the first time. The model is well calibrated, provides a high degree of discrimination and has been validated in a second UK patient cohort.

Right Iliac Fossa Pain Treatment (RIFT) Study: protocol for an international, multicentre, prospective observational study

PubMed Central

2018-01-01

Introduction Patients presenting with right iliac fossa (RIF) pain are a common challenge for acute general surgical services. Given the range of potential pathologies, RIF pain creates diagnostic uncertainty and there is subsequent variation in investigation and management. Appendicitis is a diagnosis which must be considered in all patients with RIF pain; however, over a fifth of patients undergoing appendicectomy, in the UK, have been proven to have a histologically normal appendix (negative appendicectomy). The primary aim of this study is to determine the contemporary negative appendicectomy rate. The study’s secondary aims are to determine the rate of laparoscopy for appendicitis and to validate the Appendicitis Inflammatory Response (AIR) and Alvarado prediction scores. Methods and analysis This multicentre, international prospective observational study will include all patients referred to surgical specialists with either RIF pain or suspected appendicitis. Consecutive patients presenting within 2-week long data collection periods will be included. Centres will be invited to participate in up to four data collection periods between February and August 2017. Data will be captured using a secure online data management system. A centre survey will profile local policy and service delivery for management of RIF pain. Ethics and dissemination Research ethics are not required for this study in the UK, as determined using the National Research Ethics Service decision tool. This study will be registered as a clinical audit in participating UK centres. National leads in countries outside the UK will oversee appropriate registration and study approval, which may include completing full ethical review. The study will be disseminated by trainee-led research collaboratives and through social media. Peer-reviewed publications will be published under corporate authorship including ‘RIFT Study Group’ and ‘West Midlands Research Collaborative’. PMID:29331965

Utility of Ambulance Data for Real-Time Syndromic Surveillance: A Pilot in the West Midlands Region, United Kingdom.

PubMed

Todkill, Dan; Loveridge, Paul; Elliot, Alex J; Morbey, Roger A; Edeghere, Obaghe; Rayment-Bishop, Tracy; Rayment-Bishop, Chris; Thornes, John E; Smith, Gillian

2017-12-01

Introduction The Public Health England (PHE; United Kingdom) Real-Time Syndromic Surveillance Team (ReSST) currently operates four national syndromic surveillance systems, including an emergency department system. A system based on ambulance data might provide an additional measure of the "severe" end of the clinical disease spectrum. This report describes the findings and lessons learned from the development and preliminary assessment of a pilot syndromic surveillance system using ambulance data from the West Midlands (WM) region in England. Hypothesis/Problem Is an Ambulance Data Syndromic Surveillance System (ADSSS) feasible and of utility in enhancing the existing suite of PHE syndromic surveillance systems? An ADSSS was designed, implemented, and a pilot conducted from September 1, 2015 through March 1, 2016. Surveillance cases were defined as calls to the West Midlands Ambulance Service (WMAS) regarding patients who were assigned any of 11 specified chief presenting complaints (CPCs) during the pilot period. The WMAS collected anonymized data on cases and transferred the dataset daily to ReSST, which contained anonymized information on patients' demographics, partial postcode of patients' location, and CPC. The 11 CPCs covered a broad range of syndromes. The dataset was analyzed descriptively each week to determine trends and key epidemiological characteristics of patients, and an automated statistical algorithm was employed daily to detect higher than expected number of calls. A preliminary assessment was undertaken to assess the feasibility, utility (including quality of key indicators), and timeliness of the system for syndromic surveillance purposes. Lessons learned and challenges were identified and recorded during the design and implementation of the system. The pilot ADSSS collected 207,331 records of individual ambulance calls (daily mean=1,133; range=923-1,350). The ADSSS was found to be timely in detecting seasonal changes in patterns of respiratory infections and increases in case numbers during seasonal events. Further validation is necessary; however, the findings from the assessment of the pilot ADSSS suggest that selected, but not all, ambulance indicators appear to have some utility for syndromic surveillance purposes in England. There are certain challenges that need to be addressed when designing and implementing similar systems. Todkill D , Loveridge P , Elliot AJ , Morbey RA , Edeghere O , Rayment-Bishop T , Rayment-Bishop C , Thornes JE , Smith G . Utility of ambulance data for real-time syndromic surveillance: a pilot in the West Midlands region, United Kingdom. Prehosp Disaster Med. 2017;32(6):667-672.

Scientific Data and Its Limits: Rethinking the Use of Evidence in Local Climate Change Policy

ERIC Educational Resources Information Center

Pearce, Warren

2014-01-01

Climate policy is typically seen as informed by scientific evidence that anthropogenic carbon emissions require reducing in order to avoid dangerous consequences. However, agreement on these matters has not translated into effective policy. Using interviews with local authority officials in the UK's East Midlands region, this paper argues that the…

Texas as seen from the Apollo 6 unmanned spacecraft

NASA Image and Video Library

1968-04-06

AS6-02-1455 (4 April 1968) --- Texas is photographed from the Apollo 6 (Spacecraft 020/Saturn 502) unmanned space mission. Seen in this photograph are Midland, Brownfield, Big Spring, J. B. Thomas Lake, headwaters of Colorado and Brazos Rivers, and the west Texas gas and oil fields.

International Trade Seminar (Austin, Texas, December 2, 1988).

ERIC Educational Resources Information Center

Midland Coll., TX. Business and Economic Development Center.

Selected presentations from a 1988 seminar on international trade hosted by Midland College (MC) are included in this report. Designed to direct west Texas businesses toward diversification and to prepare them for international trade and business opportunities, the seminar featured speakers in the field of international trade, including bank…

How does the outcome of research training fellowships funded via the NHS compare with that from competitively funded fellowships from the MRC and other charities: a cross-sectional retrospective survey of trainees undertaking research training in the West Midlands.

PubMed

Maybury, Charlotte; Morgan, Matthew David; Smith, Russell; Harper, Lorraine

2018-01-23

This study aimed to investigate the impact of research training funded via the National Health Service (NHS) on medical trainees compared with traditional clinical research training fellowships (CRTFs). Online survey of 221 clinical trainees who had completed a period of research during their clinical training between 2009 and 2015 in the West Midlands. Research outcomes. Overall response rate was 59%, of whom 72 participants were funded by CRTFs and 51 funded by the NHS. Although participants with CRTFs were more likely to be awarded a higher degree compared with those on NHS-administered funding (66/72 CRTFs and 37/51 NHS, P=0.005), similar proportions of NHS-funded and CRTF-funded participants entered clinical lecturer posts on completing initial research training (8/51 NHS and 16/72 CRTF, P=0.37). 77% of participants had three or more publications (CRTF 57 and NHS 39, P=0.72). 57 participants had completed clinical training; similar proportions of CRTF-funded and NHS-funded trainees had research included in their consultant contract (12/22 NHS and 14/26 CRTF, P=0.96) or were appointed to academic posts (3 of 25 NHS funded and 6 of 32 CRTF, P>0.05). 95% of participants would recommend to colleagues and 82% of participants felt the research experience improved their provision of clinical care with no difference between CRTF-funded and NHS-funded participants (P=0.49). Continuing to participate in clinical work during the research reduced reports of trainee difficulty on returning to clinical work (23/108 continued clinical work vs 12/22 no clinical work, P=0.001). Research training funded by the NHS provides a quality experience and contributes to the clinical academic capacity within the UK. More needs to be done to support NHS participants to successfully achieve a higher degree. © 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.

Imported chicken meat as a potential source of quinolone-resistant Escherichia coli producing extended-spectrum beta-lactamases in the UK.

PubMed

Warren, R E; Ensor, V M; O'Neill, P; Butler, V; Taylor, J; Nye, K; Harvey, M; Livermore, D M; Woodford, N; Hawkey, P M

2008-03-01

Escherichia coli producing CTX-M-15 enzyme began to rapidly spread in the UK from around 2003 but other types also occur, notably CTX-M-14. We examined breasts from UK-reared (n = 62) and imported (n = 27) chickens as potential sources of quinolone-resistant E. coli with bla(CTX-M) genes. A further 40 samples for which the country of rearing could not be identified were examined. During 2006, 129 fresh and frozen chicken breast fillets were purchased from retail outlets in the West Midlands. These were cultured for E. coli on CLED agar containing 8 mg/L ciprofloxacin and carrying a 10 microg cefpodoxime disc. Resistant isolates were identified and typed by RAPD fingerprinting; bla(CTX-M) was identified by PCR and genotyped by reverse-line hybridization. The country of rearing was identified from the packaging for 89 of 129 purchased samples. Only one of the 62 UK-reared chicken samples carried E. coli producing a CTX-M-1 enzyme, whereas 10 of 27 samples reared overseas had E. coli with CTX-M enzymes. Specifically, 4/10 Brazilian, 3/4 Brazilian/Polish/French, and 2/2 Dutch samples had E. coli with CTX-M-2 enzymes. Six of 40 samples for which the country of rearing was not known had producers of CTX-M enzymes, 5 of them with CTX-M-14. Quinolone-resistant E. coli with various CTX-M beta-lactamase genes that are common in human infections worldwide were found in imported chicken breasts, indicating a possible source for gut colonization. Samples from Brazil were commonly positive for E. coli with CTX-M-2, the dominant bla(CTX-M) genotype from human infections in South America, which is currently rare in clinical infections in the UK. CTX-M-15, the dominant CTX-M type in human infections in the UK, was not found in chicken isolates, suggesting that the UK-reared chickens are not a reservoir of CTX-M-15.

Some regional variations in dietary patterns in a random sample of British adults.

PubMed

Whichelow, M J; Erzinclioglu, S W; Cox, B D

1991-05-01

Comparison was made of the reported frequency of consumption or choice of 30 food items by 8860 adults in the 11 standard regions of Great Britain, with the use of log-linear analysis to allow for the age, sex, social class and smoking habit variations between the regions. The South-East was taken as the base region against which the others were compared. The number of food items for which there were significant differences from the South-East were Scotland 23, North 25, North-West and Yorkshire/Humberside 20, Wales 19, West Midlands 15, East Midlands 10, East Anglia 8, South-West 7 and Greater London 9. Overall the findings confirm a North/South trend in relation to eating habits, even when demographic and smoking-habit variations are taken into account, with the frequent consumption of many fruit and vegetable products being much less common and of several high-fat foods (chips, processed meats and fried food) more common in Scotland, Wales and the northern part of England. In most regions there was a significantly lower frequency of consumption of fresh fruit, fruit juice, 'brown' bread, pasta/rice, poultry, skimmed/semi-skimmed milk, light desserts and nuts, and a higher consumption of red meat, fish and fried food than in the South-East.

Understanding interactions with the food environment: an exploration of supermarket food shopping routines in deprived neighbourhoods.

PubMed

Thompson, Claire; Cummins, Steven; Brown, Tim; Kyle, Rosemary

2013-01-01

Despite a sustained academic interest in the environmental determinants of diet, relatively little is known about the ways in which individuals interact with their neighbourhood food environment and the use of its most important element, the supermarket. This qualitative study explores how residents of deprived neighbourhoods shop for food and how the supermarket environment influences their choices. Go-along interviews were conducted with 26 residents of Sandwell, a uniformly deprived metropolitan borough in the West Midlands, UK. Routine approaches to food shopping are characterised in terms of planning and reliance on the supermarket environment. Four distinct routines are identified: chaotic and reactive; working around the store; item-by-item; and restricted and budgeted. This suggests that residents of deprived neighbourhoods do not have uniform responses to food environments. Responses to supermarket environments appear to be mediated by levels of individual autonomy. A better understanding of how residents of deprived neighbourhoods interact with their food environment may help optimise environmental interventions aimed at improving physical access to food in these places. Copyright © 2012 Elsevier Ltd. All rights reserved.

Impact of infection control interventions on rates of Staphylococcus aureus bacteraemia in National Health Service acute hospitals, East Midlands, UK, using interrupted time-series analysis.

PubMed

Newitt, S; Myles, P R; Birkin, J A; Maskell, V; Slack, R C B; Nguyen-Van-Tam, J S; Szatkowski, L

2015-05-01

Reducing healthcare-associated infection (HCAI) is a UK national priority. Multiple national and regional interventions aimed at reduction have been implemented in National Health Service acute hospitals, but assessment of their effectiveness is methodologically challenging. To assess the effectiveness of national and regional interventions undertaken between 2004 and 2008 on rates of meticillin-resistant Staphylococcus aureus (MRSA) and meticillin-sensitive Staphylococcus aureus (MSSA) bacteraemia within acute hospitals in the East Midlands, using interrupted time-series analysis. We used segmented regression to compare rates of MRSA and MSSA bacteraemia in the pre-intervention, implementation, and post-intervention phases for combined intervention packages in eight acute hospitals. Most of the change in MSSA and MRSA rates occurred during the implementation phase. During this phase, there were significant downward trends in MRSA rates for seven of eight acute hospital groups; in four, this was a steeper quarter-on-quarter decline compared with the pre-intervention phase, and, in one, an upward trend in the pre-intervention phase was reversed. Regarding MSSA, there was a significant positive effect in four hospital groups: one upward trend during the pre-intervention phase was reversed, two upward trends plateaued, and in one hospital group an indeterminate trend decreased significantly. However, there were significant increasing trends in quarterly MSSA rates in four hospital groups during the implementation or post-intervention periods. The impact of interventions varied by hospital group but the overall results suggest that national and regional campaigns had a beneficial impact on MRSA and MSSA bacteraemia within the East Midlands. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Partnership as Cultural Practice in the Face of Neoliberal Reform

ERIC Educational Resources Information Center

Smith, Rob; O'Leary, Matt

2015-01-01

This article examines the nature of an on-going educational partnership between a Higher Education institution and a number of Further Education (FE) colleges in the West Midlands region of England, forged against the backdrop of sectoral marketisation and neoliberal reform. The partnership originates in the organisation and administration of…

Embodied Faith: Islam, Religious Freedom and Educational Practices in Physical Education

ERIC Educational Resources Information Center

Benn, Tansin; Dagkas, Symeon; Jawad, Haifaa

2011-01-01

The growing incidence of withdrawal of Muslim girls from physical education prompted this study into tensions between religious freedom and educational practices. It was located in a city in the West Midlands of England. Data on experiences, issues, concerns and solutions related to participation of Muslim girls in physical education were…

More than an Exercise Class

ERIC Educational Resources Information Center

Stanistreet, Paul

2008-01-01

This article describes a project to improve the health and quality of life of minority ethnic communities in the West Midlands. The project demonstrates the difference adult learning can make to agendas such as health and community cohesion. "Tandrusti" is a Punjabi word meaning a sound condition of the body or mind. It's also the name…

"Boys Don't Do Dance, Do They?"

ERIC Educational Resources Information Center

Holdsworth, Nadine

2013-01-01

In 2005, the Warwick Arts Centre launched the "Boys Dancing" project through the formation of the West Midlands Boys Dance Alliance. Aimed exclusively at boys and young men, the project has offered a range of performance-making opportunities with male professionals including Liam Steel (DV8, Stan Won't Dance) and David McKenna…

Economic evaluation of gastric ulcer prophylaxis in patients with arthritis receiving non-steroidal anti-inflammatory drugs.

PubMed Central

Knill-Jones, R.; Drummond, M.; Kohli, H.; Davies, L.

1990-01-01

This study assesses the economic benefits of misoprostol in the prophylaxis of gastric ulcers larger than 0.3 cm in patients with osteoarthritis receiving non-steroidal anti-inflammatory drugs. Independent epidemiological data were obtained for patients in Scotland and the West Midlands. Co-diagnosis of arthritis with gastric ulcer recorded in the routine data was substantially less (4% Scotland, 10% West Midlands) than the 21% found at case review. These data were combined with cost and patient management data in a decision analysis model to explore whether prophylactic use of misoprostol altered substantially the average cost of managing gastric ulcer. Using conservative assumptions and a daily dose of 400 micrograms, cost savings per patient to the National Health Service of 5-8 pounds over a 3-month period are expected in the groups of patients studied, while at the 800 micrograms dose there would be a net cost of 23-25 pounds. Sensitivity analysis showed that under many assumptions misoprostol is expected to be cost saving or cost neutral. PMID:2120690

Perceptions of risk factors of cardiovascular disease and cardiac rehabilitation: a cross-sectional study targeting the Chinese population in the Midlands, UK.

PubMed

Za, Tay; Lau, Jeff C F; Wong, Arthur C K; Wong, Alice W S; Lui, Sally; Fong, James W D; Chow, Patrick Y C; Jolly, Kate B

2012-01-01

To find out and explore the knowledge and opinion of Chinese people on cardiovascular disease and awareness of cardiac rehabilitation. A cross-sectional study using 14-item bilingual (Chinese and English) questionnaires that include information on demographics, health status, cardiovascular disease related knowledge and perception, and awareness and understanding of the cardiac rehabilitation programme. Chinese community groups in the Midlands, UK from January to April 2008. 436 questionnaires from Chinese adults over 18 were obtained. Current knowledge and attitude towards cardiovascular disease and awareness of cardiac rehabilitation. Obesity was the most common risk factor identified by 80.7% of participants. Those originated from China had significantly less knowledge compared with subjects from other countries (p<0.001). People who have had exposure or experience of cardiac disease rated a higher risk of cardiac disease for Chinese living in the UK than people without experience. A majority (81.7%) used orthodox medicine and perceived it to be most effective against cardiac disease. Only 30% of participants were aware of cardiac rehabilitation. The coronary artery disease (CAD) risk factors of Chinese population have increased significantly in the last decade. Cardiac rehabilitation awareness was poor among the sample population of this study and language barrier is still a problem. More large studies on Chinese population assessing CAD risk should be done to provide more evidence on CAD prevention for this growing population in the Western world.

Does Adding Mathematics to English Language Learners' Timetables Improve Their Acquisition of English?

ERIC Educational Resources Information Center

Stacey, Jenny

2016-01-01

This enquiry based project set out to find out if adult English language learners, known as ESOL (English for Speakers of Other Languages) learners in the UK, might benefit, in terms of their acquisition of English, from studying maths. This research has been conducted at a medium sized FE college in the East Midlands where I teach. I evaluate…

Pakistani and Bangladeshi Young Men: Re-Racialization, Class and Masculinity within the Neo-Liberal School

ERIC Educational Resources Information Center

Mac an Ghaill, Mairtin; Haywood, Chris

2014-01-01

This article explores Pakistani and Bangladeshi young men's experiences of schooling to examine what inclusion/exclusion means to them. Qualitative research was undertaken with 48 Pakistani and Bangladeshi young men living in areas of the West Midlands, England. The young men highlighted three key areas: the emergence of a schooling regime…

Building Colleges for the Future: Pedagogical and Ideological Spaces

ERIC Educational Resources Information Center

Smith, Rob

2017-01-01

This article focuses on the "Building Colleges for the Future" (BCF) initiative (2008) which saw a wave of new-build Further Education (FE) colleges spring up across England in the final years of the New Labour government. It draws on qualitative data from a research study focusing on four new-build colleges in the West Midlands of…

College Re-Culturing, Marketisation and Knowledge: The Meaning of Incorporation

ERIC Educational Resources Information Center

Smith, Rob

2015-01-01

The further education (FE) sector in England has experienced two decades of marketisation. This article takes as its focus the first five years of incorporation (1993-1998) for one case study college in a city ("Coppleton") in the West Midlands of England, five years that were dominated by a contract dispute. Data from interviews with…

Cooking the Books: What Counts as Literacy for Young Children in a Public Library?

ERIC Educational Resources Information Center

Smith, Helen Victoria

2018-01-01

At a time when government funding cuts mean that public libraries face an uncertain future and need to make sure they stay relevant to young users and their families, this paper explores what counts as literacy for young children in a public library in a town in the East Midlands, UK. It is based on a study which adopted an ethnographic approach,…

Senior paediatric specialist registrars' experience in management.

PubMed

Bindal, Taruna; Wall, David; Goodyear, Helen M

2010-06-01

There is an increasing focus on trainees acquiring management skills which form part of college curricula and the guidance provided by the General Medical Council in the UK. To explore the managerial learning activities of senior paediatric specialist registrars (SpRs). Questionnaire study; West Midlands region, UK; senior paediatric SpRs in the last 2 years of training. A 17 item questionnaire was sent by post to all 45 paediatric SpRs in the last 2 years of training. A follow-up email was sent to non-responders. 87% (39/45) SpRs completed a questionnaire. All had participated in clinical managerial activities with 44% (17/39) doing >or=4 h per week. Popular activities were teaching and development of treatment guidelines. Non-clinical managerial experience, mainly rota management and teaching programme organisation, was limited with 64% (25/39) doing

Teaching musculoskeletal examination skills to UK medical students: a comparative survey of Rheumatology and Orthopaedic education practice.

PubMed

Blake, Tim

2014-03-28

Specialists in Rheumatology and Orthopaedics are frequently involved in undergraduate teaching of musculoskeletal (MSK) examination skills. Students often report that specialty-led teaching is inconsistent, confusing and bears little resemblance to the curricula. The Gait, Arms, Legs and Spine (GALS) is a MSK screening tool that provides a standardised approach to examination despite it being fraught with disapproval and low uptake. Recent studies would appear to support innovative instructional methods of engaging learners such as patient educators and interactive small group teaching. This comparative cross-sectional survey evaluates the current state of undergraduate teaching in Rheumatology and Orthopaedics, including preferred teaching methods, attitudes towards GALS, and barriers to effective teaching. An electronic questionnaire was sent to specialist trainees and Consultants in the East and West Midlands region, representing 5 UK medical schools. Descriptive statistical data analysis was performed. There were 76 respondents representing 5 medical schools. There was a request for newer teaching methodologies to be used: multi-media computer-assisted learning (35.5%), audio-visual aids (31.6%), role-playing (19.7%), and social media (3.9%). It is evident that GALS is under-utilised with 50% of clinicians not using GALS in their teaching. There is a genuine desire for clinical educators to improve their teaching ability, collaborate more with curriculum planners, and feel valued by institutions. There remains a call for implementing a standardised approach to MSK clinical teaching to supersede GALS.

Teaching musculoskeletal examination skills to UK medical students: A comparative survey of Rheumatology and Orthopaedic education practice

PubMed Central

2014-01-01

Background Specialists in Rheumatology and Orthopaedics are frequently involved in undergraduate teaching of musculoskeletal (MSK) examination skills. Students often report that specialty-led teaching is inconsistent, confusing and bears little resemblance to the curricula. The Gait, Arms, Legs and Spine (GALS) is a MSK screening tool that provides a standardised approach to examination despite it being fraught with disapproval and low uptake. Recent studies would appear to support innovative instructional methods of engaging learners such as patient educators and interactive small group teaching. Methods This comparative cross-sectional survey evaluates the current state of undergraduate teaching in Rheumatology and Orthopaedics, including preferred teaching methods, attitudes towards GALS, and barriers to effective teaching. An electronic questionnaire was sent to specialist trainees and Consultants in the East and West Midlands region, representing 5 UK medical schools. Descriptive statistical data analysis was performed. Results There were 76 respondents representing 5 medical schools. There was a request for newer teaching methodologies to be used: multi-media computer-assisted learning (35.5%), audio-visual aids (31.6%), role-playing (19.7%), and social media (3.9%). It is evident that GALS is under-utilised with 50% of clinicians not using GALS in their teaching. Conclusions There is a genuine desire for clinical educators to improve their teaching ability, collaborate more with curriculum planners, and feel valued by institutions. There remains a call for implementing a standardised approach to MSK clinical teaching to supersede GALS. PMID:24678598

Molecular testing for familial hypercholesterolaemia-associated mutations in a UK-based cohort: development of an NGS-based method and comparison with multiplex polymerase chain reaction and oligonucleotide arrays.

PubMed

Reiman, Anne; Pandey, Sarojini; Lloyd, Kate L; Dyer, Nigel; Khan, Mike; Crockard, Martin; Latten, Mark J; Watson, Tracey L; Cree, Ian A; Grammatopoulos, Dimitris K

2016-11-01

Background Detection of disease-associated mutations in patients with familial hypercholesterolaemia is crucial for early interventions to reduce risk of cardiovascular disease. Screening for these mutations represents a methodological challenge since more than 1200 different causal mutations in the low-density lipoprotein receptor has been identified. A number of methodological approaches have been developed for screening by clinical diagnostic laboratories. Methods Using primers targeting, the low-density lipoprotein receptor, apolipoprotein B, and proprotein convertase subtilisin/kexin type 9, we developed a novel Ion Torrent-based targeted re-sequencing method. We validated this in a West Midlands-UK small cohort of 58 patients screened in parallel with other mutation-targeting methods, such as multiplex polymerase chain reaction (Elucigene FH20), oligonucleotide arrays (Randox familial hypercholesterolaemia array) or the Illumina next-generation sequencing platform. Results In this small cohort, the next-generation sequencing method achieved excellent analytical performance characteristics and showed 100% and 89% concordance with the Randox array and the Elucigene FH20 assay. Investigation of the discrepant results identified two cases of mutation misclassification of the Elucigene FH20 multiplex polymerase chain reaction assay. A number of novel mutations not previously reported were also identified by the next-generation sequencing method. Conclusions Ion Torrent-based next-generation sequencing can deliver a suitable alternative for the molecular investigation of familial hypercholesterolaemia patients, especially when comprehensive mutation screening for rare or unknown mutations is required.

Choosing a career in paediatrics: do trainees' views change over the first year of specialty training?

PubMed

Goodyear, Helen M; Lakshminarayana, Indumathy; Wall, David; Bindal, Taruna

2014-09-01

To look at why a regional cohort of UK doctors chose a paediatric career and to ascertain views on their career near the end of training year one. A 20-item questionnaire was sent to all new regional paediatric specialty trainees. Three focus groups were held with trainees near the end of year one to elicit key themes. West Midlands Deanery, UK. Twenty-nine new regional paediatric specialty trainees in year one completed the questionnaire. A total of 15 trainees participated in the focus groups near the end of year one training. Reasons for choosing a paediatric career and factors which further influence career choice for trainees during their first specialty training year. Key influencing factors for choosing paediatrics were enjoying working with children and positive undergraduate experience of the specialty. All trainees had paediatrics as their first choice specialty and undertook a paediatric Foundation post. Near the end of year one, doubts were cast on career aspirations due to seeing middle grade colleagues struggling with work-life balance and a growing feeling that family came first. Senior trainees need to be aware that they act as powerful role models for their more junior colleagues and therefore have an influential role on how juniors perceive a paediatric career. Family friendly flexible working patterns in paediatrics are vital to retain junior trainees. All paediatric staff are role models and need to be enthusiastic, keen to teach and to promote a positive working environment.

Markets for hospital services in Zambia.

PubMed

Nakamba, Pamela; Hanson, Kara; McPake, Barbara

2002-01-01

Hospital reforms involving the introduction of measures to increase competition in hospital markets are being implemented in a range of low and middle-income countries. However, little is understood about the operation of hospital markets outside the USA and the UK. This paper assesses the degree of competition for hospital services in two hospital markets in Zambia (Copperbelt and Midlands), and the implications for prices, quality and efficiency. We found substantial differences among different hospital types in prices, costs and quality, suggesting that the hospital service market is a segmented market. The two markets differ significantly in their degree of competition, with the high cost inpatient services market in Copperbelt relatively more competitive than that in the Midlands market. The implications of these differences are discussed in terms of the potential for competition to improve hospital performance, the impact of market structure on equity of access, and how the government should address the problem of the mine hospitals.

Factors affecting the initiation of breastfeeding: implications for breastfeeding promotion.

PubMed

Earle, Sarah

2002-09-01

Breastfeeding rates in the United Kingdom (UK) are one of the lowest in the developed world and certainly the lowest in Europe. There have been numerous studies of breastfeeding in the UK, most of which have adopted a quantitative approach, and they have largely focused on obstetric or socio-demographic factors in the decision to breastfeed. Whilst these studies have an important role to play, this paper draws on a study that adopts a qualitative methodology to explore women's personal experiences and perceptions of breastfeeding. A qualitative study of 19 primagravidae was undertaken and completed in 1998. Participants were recruited to the study via 12 antenatal clinics in the West Midlands, England, UK. Their ages ranged from 16 to 30 years and the majority described themselves as 'white'. The majority of participants were in paid employment in a variety of occupations. The study was prospective in design. Participants were interviewed three times either during pregnancy or after childbirth: the first stage was between 6 and 14 weeks of pregnancy; the second stage was between 34 and 39 weeks; and the third stage was between 6 and 14 weeks after childbirth. The data indicate that there are several factors affecting breastfeeding initiation. First, infant feeding decisions seem to be made prior to, or irrespective of, contact with health professionals. Secondly, the data suggest that health promotion campaigns in the UK have been influential in their ability to educate women about the benefits of breastfeeding. However, this did not dissuade participants from formula feeding once their decision was made. The desire for paternal involvement also seemed to be another influential factor; fathers were either seen as able to alleviate the daily grind of early motherhood, or there was a desire for 'shared parenting'. Finally, some of the formula feeding women expressed a strong desire to re-establish their identities as separate individuals and as 'non-mothers'.

Utilisation of a Helicopter Emergency Medical Service (HEMS) for equestrian accidents in a regional major trauma network in the United Kingdom.

PubMed

McQueen, Carl; Crombie, Nick; Cormack, Stef; George, Arun; Wheaton, Steve

2015-05-01

The utilisation of Helicopter Emergency Medical Services (HEMS) in response to equestrian accidents has been an integral part of operations for many years throughout the UK. The recent establishment of major trauma networks in the UK has placed great emphasis on the appropriate tasking of HEMS units to cases where added benefit can be provided and the incidence of time critical injury in cases of equestrian accidents has been shown to be low. This study assesses the impact made on the utilisation of the different HEMS resources for cases of equestrian accidents within the West Midlands following the launch of the regional trauma network. We present a retrospective analysis of all equestrian accidents attended by Midlands Air Ambulance (MAA) between 1 April 2012 and 1 April 2013. Data were abstracted from the MAA operational database relating to mission activations/scene attendances; team configuration (physician led and Critical Care Paramedic (CCP) led); on-scene interventions; mission timings and patient conveyance by helicopter. A total of 114 activations involved equestrian accidents (6% of overall workload). The contribution of equestrian accidents to overall workload was similar for physician led and CCP-led (69/1069) platforms (5% vs. 6%, p=0.50). Only three patients (3%) required pre-hospital RSI during the period analysed and there were no recorded cases of ketamine administration for analgesia/conscious sedation. In approximately half of all scene attendances patients did not require any medication to be administered by the HEMS team. The vast majority of incidents occurred in rural locations with over 80% of patients conveyed to hospital by helicopter. The average mission time for scene attendances resulting in conveyance by helicopter was in excess of 90 min on both types of platform. There is a clear requirement for the design and implementation of informed and intelligent tasking models to respond to the need for assistance in equestrian accidents. Such models may include preferential deployment of non-physician led HEMS resources to equestrian accidents or the utilisation of other local or regional resources, such as those with specially adapted vehicles with off road capability, to offer alternative solutions to access/egress challenges posed in such cases. Copyright © 2014 Elsevier Ltd. All rights reserved.

Supporting Police Community Support Officers to Become Effective School Link Officers: Key Stakeholder Perceptions of a Pilot Professional Development Programme

ERIC Educational Resources Information Center

Thomas, Lorraine; Trotman, Dave

2017-01-01

This article presents the findings of a pilot professional development programme designed to support police community support officers (PCSOs) to become effective school link officers (SLOs) within urban secondary schools in the English West Midlands. Findings are presented via perceptions of key stakeholders: SLOs themselves; school-based mentors…

What Difference Does "Difference" Make? A Discussion with Ethnic Minority Students about Their Learning Experience in Higher Education

ERIC Educational Resources Information Center

Housee, Shirin

2011-01-01

This article explores the everyday experiences of minority ethnic students at a university in the West Midlands. Based on interviews with 23 second-level students taking Sociology modules, it seeks to highlight the key social, personal and pedagogic issues for this group of minority ethnic students and to deepen understandings of cultural identity…

Spending the Primary Physical Education and Sport Premium: A West Midlands Case Study

ERIC Educational Resources Information Center

Griggs, Gerald

2016-01-01

In March 2013 the government announced that it was to provide funding to improve provision of Physical Education and sport in primary schools in England. Entitled The Primary Physical Education and Sport Premium, this ring-fenced annual funding has been allocated to schools that are free to choose how the money is spent but are accountable for its…

Multiple Voices: Improving Participation of Muslim Girls in Physical Education and School Sport

ERIC Educational Resources Information Center

Dagkas, Symeon; Benn, Tansin; Jawad, Haifaa

2011-01-01

This study reports on data from a larger-scale research project in one city in the West Midlands, England. The study was commissioned by the local education authority because of the rising incidence of parental withdrawal of Muslim girls from physical education. The aim was to provide evidence-based guidance to schools on improving the inclusion…

Perceptions of risk factors of cardiovascular disease and cardiac rehabilitation: a cross-sectional study targeting the Chinese population in the Midlands, UK

PubMed Central

Za, Tay; Lau, Jeff C F; Wong, Arthur C K; Wong, Alice W S; Lui, Sally; Fong, James W D; Chow, Patrick Y C; Jolly, Kate B

2012-01-01

Objectives To find out and explore the knowledge and opinion of Chinese people on cardiovascular disease and awareness of cardiac rehabilitation. Design A cross-sectional study using 14-item bilingual (Chinese and English) questionnaires that include information on demographics, health status, cardiovascular disease related knowledge and perception, and awareness and understanding of the cardiac rehabilitation programme. Setting Chinese community groups in the Midlands, UK from January to April 2008. Participants 436 questionnaires from Chinese adults over 18 were obtained. Main outcome measures Current knowledge and attitude towards cardiovascular disease and awareness of cardiac rehabilitation. Results Obesity was the most common risk factor identified by 80.7% of participants. Those originated from China had significantly less knowledge compared with subjects from other countries (p<0.001). People who have had exposure or experience of cardiac disease rated a higher risk of cardiac disease for Chinese living in the UK than people without experience. A majority (81.7%) used orthodox medicine and perceived it to be most effective against cardiac disease. Only 30% of participants were aware of cardiac rehabilitation. Conclusion The coronary artery disease (CAD) risk factors of Chinese population have increased significantly in the last decade. Cardiac rehabilitation awareness was poor among the sample population of this study and language barrier is still a problem. More large studies on Chinese population assessing CAD risk should be done to provide more evidence on CAD prevention for this growing population in the Western world. PMID:27326032

A Study into the Impact of the Reading Education Assistance Dogs Scheme on Reading Engagement and Motivation to Read among Early Years Foundation-Stage Children

ERIC Educational Resources Information Center

Noble, Olivia; Holt, Nicole

2018-01-01

This research explores the impact of the Reading Education Assistance Dogs (READ) scheme on reading engagement and motivation among Early Years Foundation-Stage children using a case study approach at a primary school in the English Midlands. There is a notable lack of UK-based research into the READ scheme, which offers a potential alternative…

Do pre-diagnosis primary care consultation patterns explain deprivation-specific differences in net survival among women with breast cancer? An examination of individually-linked data from the UK West Midlands cancer registry, national screening programme and Clinical Practice Research Datalink.

PubMed

Morris, M; Woods, L M; Bhaskaran, K; Rachet, B

2017-02-23

In England and Wales breast cancer survival is higher among more affluent women. Our aim was to investigate the potential of pre-diagnostic factors for explaining deprivation-related differences in survival. Individually-linked data from women aged 50-70 in the West Midlands region of England, diagnosed with breast cancer 1989-2006 and continuously eligible for screening, was retrieved from the cancer registry, screening service and Clinical Practice Research Datalink. Follow-up was to the end of July 2012. Deprivation was measured at small area level, based on the quintiles of the income domain of the English indices of deprivation. Consultation rates per woman per week, time from last breast-related GP consultation to diagnosis, and from diagnosis to first surgery were calculated. We estimated net survival using the non-parametric Pohar-Perme estimator. The rate of primary care consultations was similar during the 18 months prior to diagnosis in each deprivation group for breast and non-breast symptoms. Survival was lower for more deprived women from 4 years after diagnosis. Lower net survival was associated with more advanced extent of disease and being non-screen-detected. There was a persistent trend of lower net survival for more deprived women, irrespective of the woman's obesity, alcohol, smoking or comorbidity status. There was no significant variation in time from last breast symptom to diagnosis by deprivation. However, women in more deprived categories experienced significantly longer periods between cancer diagnosis and first surgery (mean = 21.5 vs. 28.4 days, p = 0.03). Those whose surgery occurred more than 12 weeks following their cancer diagnosis had substantially lower net survival. Our data suggest that although more deprived women with breast cancer display lifestyle factors associated with poorer outcomes, their consultation frequency, comorbidities and the breast cancer symptoms they present with are similar. We found weak evidence of extended times to surgical treatment among most deprived women who were not screen-detected but who presented with symptoms in primary care, which suggests that treatment delay may play a role. Further investigation of interrelationships between these variables within a larger dataset is warranted.

Diesel exhaust causing low-dose irritant asthma with latency?

PubMed

Adewole, Femi; Moore, Vicky C; Robertson, Alastair S; Burge, P S

2009-09-01

Diesel exhaust exposure may cause acute irritant-induced asthma and potentiate allergen-induced asthma. There are no previous reports of occupational asthma due to diesel exhaust. To describe occupational asthma with latency in workers exposed to diesel exhaust in bus garages. The Shield database of occupational asthma notifications in the West Midlands, UK, was searched between 1990 and 2006 for workers where diesel exhaust exposure was thought to be the cause of the occupational asthma. Those without other confounding exposures whose occupational asthma was validated by serial peak expiratory flow (PEF) analysis using Oasys software were included. Fifteen workers were identified with occupational asthma attributed to diesel exhaust. Three had validated new-onset asthma with latency. All worked in bus garages where diesel exhaust exposure was the only likely cause of their occupational asthma. Occupational asthma was confirmed by measures of non-specific reactivity and serial measurements of PEF with Oasys scores of 2.9, 3.73 and 4 (positive score > 2.5). The known non-specific irritant effects of diesel exhaust suggest that this is an example of low-dose irritant-induced asthma and that exposures to diesel exhaust in at least some bus garages are at a sufficient level to cause this.

Medical Emergency Workload of a Regional UK HEMS Service.

PubMed

McQueen, Carl; Crombie, Nick; Cormack, Stef; Wheaton, Steve

2015-01-01

Regionalized trauma networks have been established in England to centralize specialist care at dedicated centers of excellence throughout the country. Helicopter emergency medical services (HEMS) in the West Midlands region have been redesigned to form an integrated component of such systems. The continued use of such valuable and scarce resources for medical emergencies requires evaluation. A retrospective review of mission data for a regional Air Ambulance Service in England over a two year period. Medical emergencies continue to contribute a large proportion of the overall workload of the service. Requirement for advanced interventions at the scene was rare, with less than 10% of patients attended by HEMS teams having care needs that fall beyond the scope of standard paramedic practice. Dynamic solutions are needed to ensure that HEMS support for cases of medical emergency are appropriately targeted to incidents in which clinical benefit is conferred to the patient. Intelligent tasking of appropriate resources has the potential to improve the HEMS response to medical emergencies while optimizing the availability of resources to respond to other incidents, most notably cases of major trauma. Copyright © 2015 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

The Clubbers' Guide: New Academic Year, New Science/STEM Club?

ERIC Educational Resources Information Center

Scott, Linda; Howarth, Sue

2011-01-01

In this article, the authors present some ideas to help one start (or continue) a successful science/STEM club. Some "tips" are given by Mike Bullock, a teacher from the West Midlands, who set up a STEM club after his NQT (newly qualified teacher) year and whose club members went on to do well in the STEM Challenges. Information is provided about…

Trust, Responsiveness and Communities of Care: An Ethnographic Study of the Significance and Development of Parent-Caregiver Relationships in Irish Early Years Settings

ERIC Educational Resources Information Center

Garrity, Sheila; Canavan, John

2017-01-01

Conceptualising early years settings as "communities of care" reflects the narrative arising from recent ethnographic research conducted in the West and Midlands areas of Ireland. Drawing on the ethic of care as an underpinning theoretical framework, this article outlines the potential of early years settings to represent reliable,…

'How Will I Know When I'm Ready?' Re-Imagining FE/HE 'Transitions' as Collaborative Identity Work

ERIC Educational Resources Information Center

Kendall, Alex; Kempson, Michelle; French, Amanda

2018-01-01

Drawing on the findings of a Quality Assurance Agency for Higher Education (QAA) funded, multi-institutional, regional project, "Transitions West Midlands", this paper works with Further Education (FE) students' transition narratives as they look forward to, and back from the move from FE to HE and explores the role of the local,…

Characterization of the Lower Wolfcamp, Midland Basin, Texas, using subsurface stratigraphic and geochemical datasets.

NASA Astrophysics Data System (ADS)

Perlman, Z. S.; Ryan, P. T.; Baldwin, P.; Lucas, J.; McGlue, M. M.; Waite, L.; Woodruff, O. P.

2016-12-01

In recent years, the Midland Basin of west Texas has resurfaced as a strong and viable unconventional oil field, especially within the late Pennsylvanian-Early Permian section. In addition to exploring for hydrocarbons, studying this basin allows for a better understanding of the paleoceanographic and paleoenvironmental conditions that prevailed during deposition. This research focuses on subsurface data from the Lower Wolfcamp interval of the northern Midland Basin proximal to the Horseshoe Atoll. Chemostratigraphic and lithostratigraphic analyses were conducted on 388 ft of continuous drill core extracted from Martin County, Texas. Comprehensive analyses revealed repetitive stacking of organic-rich siliceous mudrocks, aluminum-rich clayey mudrocks, and diverse carbonate facies. High resolution energy dispersive X-ray fluorescence data demonstrate cyclic variability in silicon, aluminum, and calcium weight percentages. These data suggest that during the time of deposition, the Midland Basin was a mixed siliciclastic-carbonate system influenced by a global icehouse climate with high frequency glacio-eustatic sea level fluctuations. Organic carbon preservation at this time was at least partially influenced by bottom water redox conditions. Elemental trace metal data suggests the potential for anoxia and possibly euxinia, likely influenced by recharge from the Panthalassic Ocean. Stratal evidence for bottom water conditions and patterns of organic enrichment vary across the basin and in vertical succession; these factors may be explained by evolving oceanographic processes and environmental gradients within the basin. The timing of Lower Wolfcamp deposition may be Late Pennsylvanian, based on correlations to fusulinids in shelfal carbonates. Thus, our preliminary interpretations focus on Lower Wolfcamp strata as a condensed package of deep-basin cyclothems.

Geological Map of the Fredegonde (V-57) Quadrangle, Venus

NASA Technical Reports Server (NTRS)

Ivanov, M. A.; Head, J. W.

2009-01-01

The area of V-57, the Fredegonde quadrangle (50-75degS, 60-120degE, Fig.1), is located within the eastern portion of Lada Terra within the topographic province of midlands (0-2 km above MPR [1,2]). Midlands form the most abundant portion of the surface of Venus and are characterized by diverse sets of units and structures [3-11]. The area of the Fredegonde quadrangle is in contact with the elevated portion of Lada Terra to the W and with the lowland of Aino Planitia to the NE. The transitions of the mid-lands to the lowlands and highlands are, thus, one of the main themes of the geology within the V-57 quadrangle. The character of the transitions and distribution and sequence of units/structures in the midlands are crucially important in understanding the time and modes of formation of this topographic province. The most prominent features in the map area are linear deformational zones consisting of swarms of grooves and graben and large coronae. The zones characterize the central and NW portions of the map area and represent regionally important, broad (up to 100s km wide) ridges that are 100s m high. Relatively small (100s km across, 100s m deep) equidimensional basins occur between the corona-groove-chains in the west and border the central chain from the east. Here we describe units that make up the surface within the V-57 quadrangle and present a summary of our geological map that shows the areal distribution of the major groups of units.

Rayleigh wave tomography of the British Isles from ambient seismic noise

NASA Astrophysics Data System (ADS)

Nicolson, Heather; Curtis, Andrew; Baptie, Brian

2014-08-01

We present the first Rayleigh wave group speed maps of the British Isles constructed from ambient seismic noise. The maps also constitute the first surface wave tomography study of the crust under the British Isles at a relatively high resolution. We computed interferometric, interstation Rayleigh waves from vertical component records of ambient seismic noise recorded on 63 broad-band and short-period stations across the UK and Ireland. Group velocity measurements were made from the resulting surface wave dispersion curves between 5 and 25 s using a multiple phase-matched filter method. Uncertainties in the group velocities were computed by calculating the standard deviation of four dispersion curves constructed by stacking a random selection of daily cross-correlations. Where an uncertainty could not be obtained for a ray path using this method, we estimated it as a function of the interreceiver distance. Group velocity maps were computed for 5-25-s period using the Fast Marching forward solution of the eikonal equation and iterative, linearized inversion. At short and intermediate periods, the maps show remarkable agreement with the major geological features of the British Isles including: terrane boundaries in Scotland; regions of late Palaeozoic basement uplift; areas of exposed late Proterozoic/early Palaeozoic rocks in southwest Scotland, northern England and northwest Wales and, sedimentary basins formed during the Mesozoic such as the Irish Sea Basin, the Chester Basin, the Worcester Graben and the Wessex Basin. The maps also show a consistent low-velocity anomaly in the region of the Midlands Platform, a Proterozoic crustal block in the English Midlands. At longer periods, which are sensitive velocities in the lower crustal/upper mantle, the maps suggest that the depth of Moho beneath the British Isles decreases towards the north and west. Areas of fast velocity in the lower crust also coincide with areas thought to be associated with underplating of the lower crust such as Northern Ireland, the eastern Irish Sea and northwest Wales.

Cannon Fodder or Corps D’Elite? The American Expeditionary Force in the Great War

DTIC Science & Technology

2006-06-16

never been able to devote the amount of time and energy required to complete successfully this project. v TABLE OF CONTENTS Page MASTER OF...their energy simply reaching the frontlines. Grossly incompetent staff work contributed to the failure of these green units. 66 The orders were...Midlands, UK: Helion & Company Ltd., 2005), 23. The Canadian division had already been in battle on 25 May 1915, participating in the Battle of

Predominance of enterovirus B and echovirus 30 as cause of viral meningitis in a UK population.

PubMed

Holmes, Christopher W; Koo, Sharon S F; Osman, Husam; Wilson, Steven; Xerry, Jacqueline; Gallimore, Chris I; Allen, David J; Tang, Julian W

2016-08-01

Enteroviruses are the most common cause of aseptic or lymphocytic meningitis, particularly in children. With reports of unusually severe neurological disease in some patients infected with enterovirus D68 in North America, and a recent increase in the number of paediatric enterovirus meningitis cases presenting in this UK Midlands population, a retrospective regional surveillance study was performed. Cerebrospinal fluid (CSF) samples received were tested using the polymerase chain reaction (PCR) for HSV-1/2, VZV, enteroviruses and parechoviruses. Enterovirus PCR positive CSF samples were sent for further serotyping. A phylogenetic tree was constructed of the echovirus 30 VP1 sequences, where sufficient sample remained for sequencing. The number of enterovirus positive CSFs from each year were: 21 (2008), 7 (2011), 53 (2012), 58 (2013) and 31 (2014). Overall, 163 of the 170 serotyped enteroviruses belonged to the species B (echovirus 5, 6, 7, 9, 11, 13, 16, 17, 18, 21, 25, 30; coxsackie B1, B2, B3, B4, B5, A9), with only 7 belonging to species A (coxsackie A2, A6, A16 and enterovirus 71). Echovirus 30 was the predominant serotype overall, identified in 43 (25.3%) of samples, with a significantly higher proportion in the adult age group (37.3%) compared to the infant age group (12.3%). Phylogenetic analysis showed that these UK Midlands echovirus 30 VP1 sequences clustered most closely with those from Europe and China. This study showed a continued predominance of echovirus 30 as a cause of viral meningitis, particularly in adults, though more surveillance is needed. Copyright © 2016 Elsevier B.V. All rights reserved.

Choosing a career in paediatrics: do trainees’ views change over the first year of specialty training?

PubMed Central

Lakshminarayana, Indumathy; Wall, David; Bindal, Taruna

2014-01-01

Summary Objectives To look at why a regional cohort of UK doctors chose a paediatric career and to ascertain views on their career near the end of training year one. Design A 20-item questionnaire was sent to all new regional paediatric specialty trainees. Three focus groups were held with trainees near the end of year one to elicit key themes. Setting West Midlands Deanery, UK Participants Twenty-nine new regional paediatric specialty trainees in year one completed the questionnaire. A total of 15 trainees participated in the focus groups near the end of year one training. Main outcome measures Reasons for choosing a paediatric career and factors which further influence career choice for trainees during their first specialty training year. Results Key influencing factors for choosing paediatrics were enjoying working with children and positive undergraduate experience of the specialty. All trainees had paediatrics as their first choice specialty and undertook a paediatric Foundation post. Near the end of year one, doubts were cast on career aspirations due to seeing middle grade colleagues struggling with work–life balance and a growing feeling that family came first. Conclusions Senior trainees need to be aware that they act as powerful role models for their more junior colleagues and therefore have an influential role on how juniors perceive a paediatric career. Family friendly flexible working patterns in paediatrics are vital to retain junior trainees. All paediatric staff are role models and need to be enthusiastic, keen to teach and to promote a positive working environment. PMID:25352989

Subjective experience or objective process: understanding the gap between values and practice for involving patients in designing patient-centred care.

PubMed

Lord, Laura; Gale, Nicola

2014-01-01

Patient-centred care and patient involvement are increasingly central concepts in health policy in the UK and elsewhere. However, there is little consensus regarding their definition or how to achieve "patient-centred" care in everyday practice or how to involve patients in service redesign initiatives. The purpose of this paper is to explore these issues from the perspective of key stakeholders within National Health Service (NHS) hospitals in the UK. Semi-structured interviews, covering a range of topics related to service redesign, were conducted with 77 key stakeholders across three NHS Trusts in the West Midlands. In total, 20 of these stakeholders were re-interviewed 18 months later. Data were managed and analysed using the Framework Method. While patient-centred care and patient involvement were regularly cited as important to the stakeholders, a gap persisted between values and reported practice. This gap is explained through close examination of the ways in which the concepts were used by stakeholders, and identifying the way in which they were adapted to fit other organizational priorities. The value placed on positive subjective experience changed to concerns about objective measurement of the patients as they move through the system. Increased awareness and reflection on the conceptual tensions between objective processes and subjective experiences could highlight reasons why patient-centred values fail to translate into improved practice. The paper describes and explains a previously unarticulated tension in health organisations between values and practice in patient centred care and patient involvement in service redesign.

An Audit of Adults with Profound and Multiple Learning Disabilities within a West Midlands Community Health Trust--Implications for Service Development

ERIC Educational Resources Information Center

Gittins, Deborah; Rose, Nikki

2008-01-01

An audit was carried out to gain an overview of the profound and multiple learning disabilities (PMLD) population in a local health trust to inform current and future service provision. An overview of the issues faced in developing clear defining criteria is presented. Published definitions of PMLD were used to identify clients from data held on…

Cancer and congenital abnormalities in Asian children: a population-based study from the West Midlands.

PubMed Central

Powell, J. E.; Kelly, A. M.; Parkes, S. E.; Cole, T. R.; Mann, J. R.

1995-01-01

Cancer and associated congenital abnormalities were investigated in Muslim and non-Muslim Asian children from the West Midlands. Cancer incidence rates were calculated for Indian (non-Muslim), Pakistani/Bangladeshi (Muslim) and white children diagnosed from 1978 to 1992. Incidence was significantly higher in the Pakistanis, with an age-standardised rate (ASR) of 163 cases per million per year, compared with 115 for Indian and 125 for white children. Among Asian cancer patients, congenital malformations were significantly more common in Muslim (21%) compared with non-Muslim (7%). In Muslims the malformation excess was caused by autosomal recessive and dominant disorders (in 8% and 5% of cases respectively). Cancer malformation/predisposition syndromes were found in 10% of Muslims, compared with 2% of non-Muslims. In 33% of the Muslims with malformations, childhood cancer and a malformation were also present in a close relative. None of the non-Muslims with malformations had a relative with childhood cancer. The cancer excess in Muslims may be partly related to inherited genes causing both malformations and cancer. The prevalence of autosomal recessive disorders may be related to consanguinity, which is common in the Pakistani Muslim population. The high incidence of autosomal dominant disorders may be related to older paternal age at conception, giving rise to spontaneous mutations. PMID:8519679

Depositional environments, sequence stratigraphy, and trap configuration of lower Wolfcampian clastics along eastern edge of Midland basin, west Texas

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

Stewart, N.R.; Reuter, S.G.

1989-03-01

The Lower Permian (lower Wolfcampian) along the eastern edge of the Midland basin, west Texas, is characterized by ramp-type shelf margins. During eustatic lowstand, nearshore sedimentation shifted drastically to the west into a basinal setting below the Pennsylvanian (Canyon) shelf margin. Core descriptions demonstrate that lowstand systems tract (LST) and transgressive systems tract (TST) siliciclastics were deposited in deltaic and coastal-plain environments. Prodelta, delta-front, and stream-mouth bar facies are associated with the LST. Coastal-plain and distributary channels are preserved in the TST. The sequence stratigraphic framework indicates type 1 sequence boundaries at 287 Ma, 282 Ma, and 280 Ma inmore » the lower Wolfcampian clastics. This lower Wolfcampian package of sedimentary rocks overlies the Pennsylvanian and is capped by the 279-Ma middle Wolfcampian unconformity. All three sequence boundaries and associated systems tract deposits exhibit a prograding stacking pattern within the sequence stratigraphic framework. Basinally restricted prograding LST deltaic rocks are overlain by backstepping TST deltaics and highstand systems tract (HST) outer marine shales. Production in lower Wolfcampian clastic fields is associated with fine-grained quartzarenites up to 45 ft thick which were deposited in stream-mouth bars. Delta-front and prodelta low-permeability shales encase the reservoir facies, forming lateral permeability barriers. HST outer marine shales deposited over the stream-mouth-bar sandstones act as a top seal, creating a stratigraphic trap and providing source for the high-BTU gas and oil produced from these basinally restricted LST deltaics.« less

Knowledge and attitudes of UK university students in relation to ultraviolet radiation (UVR) exposure and their sun-related behaviours: a qualitative study

PubMed Central

Kirk, Lucy; Greenfield, Sheila

2017-01-01

Objectives To explore whether knowledge about the harms of ultraviolet radiation (UVR) influences UK university students' sun-related behaviours and examine in depth their attitudes towards: sun protection, natural and artificial tanning behaviours. Design Qualitative methodology with 15 semistructured, individual interviews. Thematic analysis using the Framework Method with analyst triangulation and member validation. Setting One university in the West Midlands, UK. Participants 15 Caucasian male (n=4) and female (n=11) students, aged 18–22 years, from a UK university. Participants were recruited using convenience sampling from the university's main campus followed by purposive sampling for: gender, course and sun-related behaviours. Results Five main themes emerged: (1) knowledge of UVR; (2) sun-protection practices; (3) attitudes towards tanning; (4) external influences and (5) internal influences. All students knew the associated skin cancer risks from the sun and sunbed use, but this did not appear an important influence in their sun-related behaviours. Body image strongly motivated sun-protection practices and the desire to tan naturally or artificially, across both genders. However, participants' final decision-making appeared to be influenced by their beliefs that practising known harmful sun-related behaviours would not affect them or the perceived susceptibility to sunburn. Beliefs about sunbathing and sunscreen use prompted improper use of sun protection and inadvertently caused more harmful practices. Participants' peers, family and the media had dual roles influencing the development of attitudes towards sun protection and tanning, which contributed to how participants behaved in the sun and their engagement in tanning methods. Conclusions Knowledge about the risk of skin cancer associated with UVR did not strongly influence sun-related behaviours, whereas body image appeared as a key motivator. Attitudes towards sun protection and tanning stemmed from the media, peers and family, and particularly from childhood habits. Public health strategies may benefit from appearance-related skin cancer prevention campaigns, encouraging safer parental sun-related habits and correcting sun-related misconceptions. PMID:28289050

Barriers to early diagnosis of symptomatic breast cancer: a qualitative study of Black African, Black Caribbean and White British women living in the UK.

PubMed

Jones, Claire E L; Maben, Jill; Lucas, Grace; Davies, Elizabeth A; Jack, Ruth H; Ream, Emma

2015-03-13

Understanding barriers to early diagnosis of symptomatic breast cancer among Black African, Black Caribbean and White British women in the UK. In-depth qualitative interviews using grounded theory methods to identify themes. Findings validated through focus groups. 94 women aged 33-91 years; 20 Black African, 20 Black Caribbean and 20 White British women diagnosed with symptomatic breast cancer were interviewed. Fourteen Black African and 20 Black Caribbean women with (n=19) and without (n=15) breast cancer participated in six focus groups. Eight cancer centres/hospital trusts in London (n=5), Somerset (n=1), West Midlands (n=1) and Greater Manchester (n=1) during 2012-2013. There are important differences and similarities in barriers to early diagnosis of breast cancer between Black African, Black Caribbean and White British women in the UK. Differences were influenced by country of birth, time spent in UK and age. First generation Black African women experienced most barriers and longest delays. Second generation Black Caribbean and White British women were similar and experienced fewest barriers. Absence of pain was a barrier for Black African and Black Caribbean women. Older White British women (≥70 years) and first generation Black African and Black Caribbean women shared conservative attitudes and taboos about breast awareness. All women viewed themselves at low risk of the disease, and voiced uncertainty over breast awareness and appraising non-lump symptoms. Focus group findings validated and expanded themes identified in interviews. Findings challenged reporting of Black women homogenously in breast cancer research. This can mask distinctions within and between ethnic groups. Current media and health promotion messages need reframing to promote early presentation with breast symptoms. Working with communities and developing culturally appropriate materials may lessen taboos and stigma, raise awareness, increase discussion of breast cancer and promote prompt help-seeking for breast symptoms among women with low cancer awareness. 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.

Barriers to early diagnosis of symptomatic breast cancer: a qualitative study of Black African, Black Caribbean and White British women living in the UK

PubMed Central

Jones, Claire E L; Maben, Jill; Lucas, Grace; Davies, Elizabeth A; Jack, Ruth H; Ream, Emma

2015-01-01

Objectives Understanding barriers to early diagnosis of symptomatic breast cancer among Black African, Black Caribbean and White British women in the UK. Design In-depth qualitative interviews using grounded theory methods to identify themes. Findings validated through focus groups. Participants 94 women aged 33–91 years; 20 Black African, 20 Black Caribbean and 20 White British women diagnosed with symptomatic breast cancer were interviewed. Fourteen Black African and 20 Black Caribbean women with (n=19) and without (n=15) breast cancer participated in six focus groups. Setting Eight cancer centres/hospital trusts in London (n=5), Somerset (n=1), West Midlands (n=1) and Greater Manchester (n=1) during 2012–2013. Results There are important differences and similarities in barriers to early diagnosis of breast cancer between Black African, Black Caribbean and White British women in the UK. Differences were influenced by country of birth, time spent in UK and age. First generation Black African women experienced most barriers and longest delays. Second generation Black Caribbean and White British women were similar and experienced fewest barriers. Absence of pain was a barrier for Black African and Black Caribbean women. Older White British women (≥70 years) and first generation Black African and Black Caribbean women shared conservative attitudes and taboos about breast awareness. All women viewed themselves at low risk of the disease, and voiced uncertainty over breast awareness and appraising non-lump symptoms. Focus group findings validated and expanded themes identified in interviews. Conclusions Findings challenged reporting of Black women homogenously in breast cancer research. This can mask distinctions within and between ethnic groups. Current media and health promotion messages need reframing to promote early presentation with breast symptoms. Working with communities and developing culturally appropriate materials may lessen taboos and stigma, raise awareness, increase discussion of breast cancer and promote prompt help-seeking for breast symptoms among women with low cancer awareness. PMID:25770231

Knowledge and attitudes of UK university students in relation to ultraviolet radiation (UVR) exposure and their sun-related behaviours: a qualitative study.

PubMed

Kirk, Lucy; Greenfield, Sheila

2017-03-13

To explore whether knowledge about the harms of ultraviolet radiation (UVR) influences UK university students' sun-related behaviours and examine in depth their attitudes towards: sun protection, natural and artificial tanning behaviours. Qualitative methodology with 15 semistructured, individual interviews. Thematic analysis using the Framework Method with analyst triangulation and member validation. One university in the West Midlands, UK. 15 Caucasian male (n=4) and female (n=11) students, aged 18-22 years, from a UK university. Participants were recruited using convenience sampling from the university's main campus followed by purposive sampling for: gender, course and sun-related behaviours. Five main themes emerged: (1) knowledge of UVR; (2) sun-protection practices; (3) attitudes towards tanning; (4) external influences and (5) internal influences . All students knew the associated skin cancer risks from the sun and sunbed use, but this did not appear an important influence in their sun-related behaviours. Body image strongly motivated sun-protection practices and the desire to tan naturally or artificially, across both genders. However, participants' final decision-making appeared to be influenced by their beliefs that practising known harmful sun-related behaviours would not affect them or the perceived susceptibility to sunburn. Beliefs about sunbathing and sunscreen use prompted improper use of sun protection and inadvertently caused more harmful practices. Participants' peers, family and the media had dual roles influencing the development of attitudes towards sun protection and tanning, which contributed to how participants behaved in the sun and their engagement in tanning methods. Knowledge about the risk of skin cancer associated with UVR did not strongly influence sun-related behaviours, whereas body image appeared as a key motivator. Attitudes towards sun protection and tanning stemmed from the media, peers and family, and particularly from childhood habits. Public health strategies may benefit from appearance-related skin cancer prevention campaigns, encouraging safer parental sun-related habits and correcting sun-related misconceptions. 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/.

Assessing the quality of radiographic processing in general dental practice.

PubMed

Thornley, P H; Stewardson, D A; Rout, P G J; Burke, F J T

2006-05-13

To determine if a commercial device (Vischeck) for monitoring film processing quality was a practical option in general dental practice, and to assess processing quality among a group of GDPs in the West Midlands with this device. Clinical evaluation. General dental practice, UK, 2004. Ten GDP volunteers from a practice based research group processed Vischeck strips (a) when chemicals were changed, (b) one week later, and (c) immediately before the next change of chemicals. These were compared with strips processed under ideal conditions. Additionally, a series of duplicate radiographs were produced and processed together with Vischeck strips in progressively more dilute developer solutions to compare the change in radiograph quality assessed clinically with that derived from the Vischeck. The Vischeck strips suggested that at the time chosen for change of processing chemicals, eight dentists had been processing films well beyond the point indicated for replacement. Solutions were changed after a wide range of time periods and number of films processed. The calibration of the Vischeck strip correlated closely to a clinical assessment of acceptable film quality. Vischeck strips are a useful aid to monitoring processing quality in automatic developers in general dental practice. Most of this group of GDPs were using chemicals beyond the point at which diagnostic yield would be affected.

What does it mean to be a 'picky eater'? A qualitative study of food related identities and practices.

PubMed

Thompson, Claire; Cummins, Steven; Brown, Tim; Kyle, Rosemary

2015-01-01

Picky eaters are defined as those who consume an inadequate variety of food through rejection of a substantial amount of food stuffs that are both familiar and unfamiliar. Picky eating is a relatively recent theoretical concept and while there is increasing concern within public health over the lack of diversity in some children's diets, adult picky eaters remain an under researched group. This paper reports on the findings of a qualitative study on the routine food choices and practices of 26 families in Sandwell, West Midlands, UK. Photo elicitation and go-along interview data collection methods were used to capture habitual food related behaviours and served to describe the practices of nine individuals who self identified or were described as picky eaters. A thematic analysis revealed that those with the food related identity of picky eater had very restricted diets and experienced strong emotional and physical reactions to certain foods. For some this could be a distressing and alienating experience that hindered their ability to engage in episodes of social eating. Further research is needed to illuminate the specific practices of adult picky eaters, how this impacts on their lives, and how possible interventions might seek to address the challenges they face. Copyright © 2014 Elsevier Ltd. All rights reserved.

Computer-based teaching is as good as face to face lecture-based teaching of evidence based medicine: a randomised controlled trial

PubMed Central

2007-01-01

Background At postgraduate level evidence based medicine (EBM) is currently taught through tutor based lectures. Computer based sessions fit around doctors' workloads, and standardise the quality of educational provision. There have been no randomized controlled trials comparing computer based sessions with traditional lectures at postgraduate level within medicine. Methods This was a randomised controlled trial involving six postgraduate education centres in the West Midlands, U.K. Fifty five newly qualified foundation year one doctors (U.S internship equivalent) were randomised to either computer based sessions or an equivalent lecture in EBM and systematic reviews. The change from pre to post-intervention score was measured using a validated questionnaire assessing knowledge (primary outcome) and attitudes (secondary outcome). Results Both groups were similar at baseline. Participants' improvement in knowledge in the computer based group was equivalent to the lecture based group (gain in score: 2.1 [S.D = 2.0] versus 1.9 [S.D = 2.4]; ANCOVA p = 0.078). Attitudinal gains were similar in both groups. Conclusion On the basis of our findings we feel computer based teaching and learning is as effective as typical lecture based teaching sessions for educating postgraduates in EBM and systematic reviews. PMID:17659076

Prediction of habitual physical activity level and weight status from fundamental movement skill level.

PubMed

Bryant, Elizabeth Sarah; James, Rob S; Birch, Samantha Louise; Duncan, Mike

2014-01-01

Fundamental movement skills (FMS) have been assessed in children in order to investigate the issues of the low proportion of children who meet physical activity (PA) guidelines and rising levels of obesity. The aim of this research was to identify whether previous or current FMS level is a better predictor of PA levels and weight status in children. In January 2012 (year 1), 281 children were recruited from one primary school in the West Midlands, UK. Children performed eight FMS three times, which were videoed and assessed using a subjective checklist. Sprint speed and jump height were measured objectively. Height and mass were measured to calculate the body mass index to determine the weight status. Skinfold calliper readings were used to calculate body fat percentage. One year later, in January 2013, all these tests were repeated on the same children, with the additional collection of PA data via the use of pedometers. Following multiple linear regression, it was identified that prior mastery in FMS was a better predictor of current PA, whereas current FMS was a better predictor of current weight status. Overall, FMS mastery is needed in childhood to be able to participate in PA and maintain a healthy weight status.

Advertising of food to children: is brand logo recognition related to their food knowledge, eating behaviours and food preferences?

PubMed

Kopelman, C A; Roberts, L M; Adab, P

2007-12-01

There remains controversy about the contribution of food advertising targeted at children to the epidemic of childhood obesity in the UK. The aim of this study is to explore the relationship between the ability to recognize brand logos featured in promotional campaigns of the food industry and eating behaviours, food knowledge and preferences in children aged 9-11 attending six primary schools in Birmingham, West Midlands. A '20 flashcard' brand logo quiz assessed children's brand logo recognition ability; a self-completed questionnaire collected information on children's socio-demographic characteristics, eating behaviours, food knowledge and preferences (n=476). Children demonstrated both high brand logo recognition abilities with 88.4% (420/476) recognizing at least 16/20 brand logos in the quiz and high levels of poor diet. No strong correlation was found between higher brand logo recognition ability and poorer eating behaviours, food knowledge and preferences. Although many children are familiar with commonly presented logos of food products, brand awareness does not appear to be a major influence on the consumption of a poor diet amongst children. The regulation or restriction of food advertising to children is unlikely to have a significant impact on obesity rates among children unless combined with measures to address other detrimental influences.

Needle stick injuries: a comparison of practice and attitudes in two UK District General Hospitals.

PubMed

Raghavendran, S; Bagry, H S; Leith, S; Budd, J M

2006-09-01

Hospital staff are at risk from occupational exposure to blood-borne viruses due to needle stick injuries. Occupational health departments have invested considerable resources in the prevention of these injuries, which can be very distressing to the affected individuals. We surveyed health care workers, i.e. doctors, nurses and operating department practitioners, in the operating theatre and critical care units of two UK hospitals located in the Midlands and Merseyside to compare attitudes and experiences. There were significant deficiencies in several aspects of the safe practice of universal precautions. These deficiencies were similar in the two hospitals surveyed and may reflect a national trend. We conclude that every individual, department and trust needs to reflect on their practice and address these deficiencies.

Influences on British South Asian Women's Choice of Teaching as a Career: "You're Either a Career Person or a Family Person; Teaching Kind of Fits in the Middle"

ERIC Educational Resources Information Center

Butt, Graham; MacKenzie, Lin; Manning, Russell

2010-01-01

This article reports the findings of the first year of a four year research project into the influences on British South Asian women's choice of teaching as a career. Trainees from minority ethnic groups on a secondary PGCE (Postgraduate Certificate in Education) course in the English West Midlands were invited to discuss, both in focus groups and…

AmWeb: a novel interactive web tool for antimicrobial resistance surveillance, applicable to both community and hospital patients.

PubMed

Ironmonger, Dean; Edeghere, Obaghe; Gossain, Savita; Bains, Amardeep; Hawkey, Peter M

2013-10-01

Antimicrobial resistance (AMR) is recognized as one of the most significant threats to human health. Local and regional AMR surveillance enables the monitoring of temporal changes in susceptibility to antibiotics and can provide prescribing guidance to healthcare providers to improve patient management and help slow the spread of antibiotic resistance in the community. There is currently a paucity of routine community-level AMR surveillance information. The HPA in England sponsored the development of an AMR surveillance system (AmSurv) to collate local laboratory reports. In the West Midlands region of England, routine reporting of AMR data has been established via the AmSurv system from all diagnostic microbiology laboratories. The HPA Regional Epidemiology Unit developed a web-enabled database application (AmWeb) to provide microbiologists, pharmacists and other stakeholders with timely access to AMR data using user-configurable reporting tools. AmWeb was launched in the West Midlands in January 2012 and is used by microbiologists and pharmacists to monitor resistance profiles, perform local benchmarking and compile data for infection control reports. AmWeb is now being rolled out to all English regions. It is expected that AmWeb will become a valuable tool for monitoring the threat from newly emerging or currently circulating resistant organisms and helping antibiotic prescribers to select the best treatment options for their patients.

Research in higher surgical training--the West Midlands view.

PubMed

Kmiot, W A; Neoptolemos, J P; Temple, J G

1993-09-01

A questionnaire on the role of research in higher surgical training was posted to all in-post NHS Consultants (n = 96) and Higher Surgical Trainees (n = 42) in the West Midlands Region. Replies were received from 80 consultants (83 per cent) and 37 trainees (88 per cent). Over 95 per cent of responders had undertaken some research activity previously. The vast majority of consultants (90 per cent) and trainees (95 per cent) thought that their research period had been beneficial; most would undertake research again even if not essential for higher surgical training (consultants 80 per cent, trainees 70 per cent). Research was felt to be essential for all trainees by 50 per cent of respondents in both groups; 78 per cent of consultants and 86 per cent of trainees also thought that all potential academics should obtain a degree by thesis. Most of the study participants thought that the appropriate time for research activity was as a post-FRCS registrar (consultants 72 per cent, trainees 80 per cent); 80 per cent of consultants and 67 per cent of trainees felt that this research period should be funded by the NHS. A planned, supervised and funded one-year period of research was favoured by the majority of consultants (54 per cent) and trainees (73 per cent) for non-academic general surgical trainees in the future.

Is ambient air pollution associated with onset of sudden infant death syndrome: a case-crossover study in the UK

PubMed Central

Ayres, Jon G; Mohammed, Nuredin I

2018-01-01

Objectives Air pollution has been associated with increased mortality and morbidity in several studies with indications that its effect could be more severe in children. This study examined the relationship between short-term variations in criteria air pollutants and occurrence of sudden infant death syndrome (SIDS). Design We used a case-crossover study design which is widely applied in air pollution studies and particularly useful for estimating the risk of a rare acute outcome associated with short-term exposure. Setting The study used data from the West Midlands region in the UK. Participants We obtained daily time series data on SIDS mortality (ICD-9: 798.0 or ICD-10: R95) for the period 1996–2006 with a total of 211 SIDS events. Primary outcome measures Daily counts of SIDS events. Results For an IQR increase in previous day pollutant concentration, the percentage increases (95% CI) in SIDS were 16 (6 to 27) for PM10, 1 (−7 to 10) for SO2, 5 (−4 to 14) for CO, −17 (−27 to –6) for O3, 16 (2 to 31) for NO2 and 2 (−3 to 8) for NO after controlling for average temperature and national holidays. PM10 and NO2 showed relatively consistent association which persisted across different lag structures and after adjusting for copollutants. Conclusions The results indicated ambient air pollutants, particularly PM10 and NO2, may show an association with increased SIDS mortality. Thus, future studies are recommended to understand possible mechanistic explanations on the role of air pollution on SIDS incidence and the ways in which we might reduce pollution exposure among infants. PMID:29654005

Is ambient air pollution associated with onset of sudden infant death syndrome: a case-crossover study in the UK.

PubMed

Litchfield, Ian J; Ayres, Jon G; Jaakkola, Jouni J K; Mohammed, Nuredin I

2018-04-12

Air pollution has been associated with increased mortality and morbidity in several studies with indications that its effect could be more severe in children. This study examined the relationship between short-term variations in criteria air pollutants and occurrence of sudden infant death syndrome (SIDS). We used a case-crossover study design which is widely applied in air pollution studies and particularly useful for estimating the risk of a rare acute outcome associated with short-term exposure. The study used data from the West Midlands region in the UK. We obtained daily time series data on SIDS mortality (ICD-9: 798.0 or ICD-10: R95) for the period 1996-2006 with a total of 211 SIDS events. Daily counts of SIDS events. For an IQR increase in previous day pollutant concentration, the percentage increases (95% CI) in SIDS were 16 (6 to 27) for PM 10 , 1 (-7 to 10) for SO 2 , 5 (-4 to 14) for CO, -17 (-27 to -6) for O 3 , 16 (2 to 31) for NO 2 and 2 (-3 to 8) for NO after controlling for average temperature and national holidays. PM 10 and NO 2 showed relatively consistent association which persisted across different lag structures and after adjusting for copollutants. The results indicated ambient air pollutants, particularly PM 10 and NO 2 , may show an association with increased SIDS mortality. Thus, future studies are recommended to understand possible mechanistic explanations on the role of air pollution on SIDS incidence and the ways in which we might reduce pollution exposure among infants. © 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.

Improving management and effectiveness of home blood pressure monitoring: a qualitative UK primary care study.

PubMed

Grant, Sabrina; Greenfield, Sheila M; Nouwen, Arie; McManus, Richard J

2015-11-01

Self-monitoring blood pressure (SMBP) is becoming an increasingly prevalent practice in UK primary care, yet there remains little conceptual understanding of why patients with hypertension engage in self-monitoring. To identify psychological factors or processes prompting the decision to self-monitor blood pressure. A qualitative study of patients previously participating in a survey study about SMBP from four general practices in the West Midlands. Taped and transcribed in-depth interviews with 16 patients (6 currently monitoring, 2 used to self-monitor, and 8 had never self-monitored). Thematic analysis was undertaken. Three main themes emerged: 'self' and 'living with hypertension' described the emotional element of living with an asymptomatic condition; 'self-monitoring behaviour and medication' described overall views about self-monitoring, current practice, reasons for monitoring, and the impact on medication adherence; and 'the GP-patient transaction' described the power relations affecting decisions to self-monitor. Self-monitoring was performed by some as a protective tool against the fears of a silent but serious condition, whereas others self-monitor simply out of curiosity. People who self-monitored tended not to discuss this with their nurse or GP, partly due to perceiving minimal or no interest from their clinician about home monitoring, and partly due to fear of being prescribed additional medication. The decision to self-monitor appeared often to be an individual choice with no schedule or systems to integrate it with other medical care. Better recognition by clinicians that patients are self-monitoring, perhaps utilising the results in shared decision-making, might help integrate it into daily practice. © British Journal of General Practice 2015.

Laparoscopic pelvic lymphadenectomy: experience of a Gynaecological Cancer Centre in the UK.

PubMed

Karanjgaokar, Vrunda C; Wright, Jeremy T; Murphy, Damian J; Mann, Christopher H

2012-04-01

The role of laparoscopic lymphadenectomy in the management of gynaecological cancers has been established over the last two decades, having been first described in Dargent and Selvat (L'envahissement ganglionnaire pelvin. Medsi-Mcgraw Hill, Paris, 1989). It has been shown that laparoscopic lymphadenectomy can be performed in the majority of patients and is associated with a low complication rate. However, the technique continues to be undertaken in only a relatively small number of Gynaecological Cancer Centres in the UK owing to the long learning curve and wide variations in training. At the Royal Wolverhampton NHS Trust Gynaecological Cancer Centre in the Greater Midlands Cancer Network laparoscopic lymphadenectomy has been performed since 1999 in the management of early cervical and high grade endometrial cancers. We have undertaken a retrospective audit (1999-2009) of these 42 cases to assess the feasibility of the procedure as well as to assess the complication rate. We are presenting the first reported series of exclusive laparoscopic transperitoneal lymphadenectomies from a Gynaecological Cancer Centre in the UK.

Facies heterogeneity, pay continuity, and infill potential in barrier-island, fluvial, and submarine fan reservoirs: examples from the Texas Gulf Coast and Midland basins

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

Ambrose, W.A.; Tyler, N.

1989-03-01

Three reservoirs representing different depositional environments - barrier island (West Ranch field, south-central Texas), fluvial (La Gloria field, south Texas), and submarine fan (Spraberry trend, Midland basin) - illustrate variations in reservoir continuity. Pay continuity methods based on facies geometry and variations in permeability and thickness between wells can quantify reservoir heterogeneity in each of these examples. Although barrier-island reservoirs are relatively homogeneous, West Ranch field contains wide (1000-5000 ft or 300-1500 m) dip-parallel belts of lenticular inlet-fill facies that disrupt reservoir continuity in the main barrier-core facies. Other reservoir compartments in West Ranch field are in flood-tidal delta depositsmore » partly encased in lagoonal mudstones updip of the barrier core. Fluvial reservoirs have a higher degree of internal complexity than barrier-island reservoirs. In La Gloria field, reservoirs exhibit significant heterogeneity in the form of numerous sandstone stringers bounded vertically and laterally by thin mudstone layers. Successful infill wells in La Gloria field contact partly drained reservoir compartments in splay deposits that pinch out laterally into flood-plain mudstones. Recompletions in vertically isolated sandstone stringers in La Gloria field contact other reservoir compartments. Submarine fan deposits are extremely heterogeneous and may have the greatest potential for infill drilling to tap isolated compartments in clastic reservoirs. The Spraberry trend contains thin discontinuous reservoir sandstones deposited in complex mid-fan channels. Although facies relationships in Spraberry reservoirs are similar to those in fluvial reservoirs in La Gloria field, individual pay stringers are thinner and more completely encased in low-permeability mudstone facies.« less

Confidence in leadership among the newly qualified.

PubMed

Bayliss-Pratt, Lisa; Morley, Mary; Bagley, Liz; Alderson, Steven

2013-10-23

The Francis report highlighted the importance of strong leadership from health professionals but it is unclear how prepared those who are newly qualified feel to take on a leadership role. We aimed to assess the confidence of newly qualified health professionals working in the West Midlands in the different competencies of the NHS Leadership Framework. Most respondents felt confident in their abilities to demonstrate personal qualities and work with others, but less so at managing or improving services or setting direction.

The U.S. and Southern Africa: Progress, Potential, and Stable States

DTIC Science & Technology

2016-02-01

V. MILITARY AND SECURITY RELATIONS..…........…….…………………...…...…… 15 VI. ENVIRONMENT AND ENERGY ...Force in Combat, 1966-1989. Solihull, West Midlands; Pinetown: Helion & Company; 30° South, 2012. (UGH 1651 .B35 2012) Bellamy, Alex J. and Paul D...Leiden; Brill, 2010. (D 575 .W67 2010) Lithgow, Nick. LZ Hot!: Flying South Africa’s Border War. Solihull: Helion , 2012. (DT 1436 .L58 2012) Lord

Association of PTPN22 with rheumatoid arthritis among South Asians in the UK.

PubMed

Mastana, Sarabjit; Gilmour, Ashley; Ghelani, Anant; Smith, Hannah; Samanta, Ash

2007-10-01

To compare the distribution and assess genetic associations of the PTPN22 R620W single-nucleotide polymorphism among South Asian (Asiatic Indian) patients with rheumatoid arthritis (RA) and ethnically matched controls. DNA samples from 133 rheumatoid factor-positive South Asian RA patients and 149 control subjects from the East Midlands of the UK were genotyped for PTPN22 R620W polymorphism. Genotyping was performed by the polymerase chain reaction-restriction fragment length polymorphism method. The PTPN22 *T allele frequency was lower than in the Caucasian populations, but the disease association was significant (odds ratio 5.87, 95% confidence interval 1.68-20.52). Similar association was observed for genotypes containing *T allele. Our results suggest that the T variant acts as a susceptibility allele for autoantibody-positive RA among South Asians.

A Method for Correlation of Gravestone Weathering and Air Quality (SO2), West Amidlands, UK

NASA Astrophysics Data System (ADS)

Carlson, Michael John

From the beginning of the Industrial Revolution through the environmental revolution of the 1970s Britain suffered the effects of poor air quality primarily from particulate matter and acid in the form of NOx and SO x compounds. Air quality stations across the region recorded SO 2 beginning in the 1960s however the direct measurement of air quality prior to 1960 is lacking and only anecdotal notations exist. Proxy records including lung tissue samples, particulates in sediments cores, lake acidification studies and gravestone weathering have all been used to reconstruct the history of air quality. A 120-year record of acid deposition reconstructed from lead-lettered marble gravestone weathering combined with SO2 measurements from the air monitoring network across the West Midlands, UK region beginning in the 1960s form the framework for this study. The study seeks to create a spatial and temporal correlation between the gravestone weathering and measured SO 2. Successful correlation of the dataset from 1960s to the 2000s would allow a paleo-air quality record to be generated from the 120-year record of gravestone weathering. Decadal gravestone weathering rates can be estimated by non-linear regression analysis of stone loss at individual cemeteries. Gravestone weathering rates are interpolated across the region through Empirical Bayesian Kriging (EBK) methods performed through ArcGISRTM and through a land use based approach based on digitized maps of land use. Both methods of interpolation allow for the direct correlation of gravestone weathering and measured SO2 to be made. Decadal scale correlations of gravestone weathering rates and measured SO2 are very weak and non-existent for both EBK and the land use based approach. Decadal results combined together on a larger scale for each respective method display a better visual correlation. However, the relative clustering of data at lower SO2 concentrations and the lack of data at higher SO2 concentrations make the confidence in the correlations made too weak to rely on. The relation between surrounding land use and gravestone weathering rates was very strong for the 1960s-1980s with diminishing correlations approaching the 2000s. Gravestone weathering of cemeteries is highly influenced by the amount of industrial sources of pollution within a 7km radius. Reduced correlation of land use and weathering beyond the 1980s is solid grounds for the success of environmental regulation and control put in place across the UK during later parts of the 20th century.

Deconstructing alcohol use on a night out in England: promotions, preloading and consumption.

PubMed

McClatchley, Kirstie; Shorter, Gillian W; Chalmers, Jenny

2014-07-01

To examine alcohol consumed during a drinking event (a single drinking occasion) by those attending public house/on-trade establishments on nights with standard pricing and nights with promotional prices. Data (n = 425) were collected in an ecological momentary assessment over eight nights in two locations (Midlands and London) on both promotional and standard (Saturday) nights. Multiple regression was used to predict event alcohol consumption by sex, age, type of night, alcohol preloading behaviour, marital and employment status, education, Alcohol Use Disorders Identification Test alcohol consumption questions separately or total AUDIT-C and social group size. Mean (UK) units consumed were 11.8 (London) and 14.4 (Midlands). In London, consumption was similar on promotional and standard nights, but in the Midlands, standard night consumption was three units higher. Preloading was reported by 30%; more common on standard nights. Regression analyses revealed being male, preloading and past-year total AUDIT-C were associated with higher event consumption. However, when AUDIT-C questions were added separately, being a standard night was associated with increased event consumption and different AUDIT-C questions were significantly associated with event consumption in each location. Event consumption reflected heavy episodic drinking and was influenced by price. Promotional night consumption either matched standard Saturday night consumption or was slightly lower. In London, there was a significant preference for drinking at least one promotional beverage on promotional nights. On standard nights, consumption was over a wider range of venues, and preloading with off-trade alcohol was more likely. © 2014 Australasian Professional Society on Alcohol and other Drugs.

Midland's Economy: Past, Present and Future; The Midland/Odessa Economy: Foundation and Future; and Report on Labor Demand in the Permian Basin.

ERIC Educational Resources Information Center

Williams, James L.; McCarty, Nolan M.

As part of an effort to identify ways in which Midland College (Texas) and local businesses can respond to the economic needs of the community, these three papers by the Midland's Business and Economic Development Center offer various perspectives on the economic climate and labor market of the Permian Basis. The first report, "Midland's…

Why are patients prescribed proton pump inhibitors? Retrospective analysis of link between morbidity and prescribing in the General Practice Research Database

PubMed Central

Bashford, James N R; Norwood, Jeff; Chapman, Stephen R

1998-01-01

Objectives: To establish the relation between new prescriptions for proton pump inhibitors and recorded upper gastrointestinal morbidity within a large computerised general practitioner database. Design: Retrospective survey of morbidity and prescribing data linked to new prescriptions for proton pump inhibitors and comparison with licensed indications between 1991 and 1995. Setting: General Practice Research Database and prescribing analysis and cost (PACT) data for the former West Midlands region. Subjects: Information for 612 700 patients in the General Practice Research Database. Anonymous PACT data for all general practitioners in West Midlands region. Main outcome measures: Diagnostic codes linked to the first prescriptions issued for proton pump inhibitors; relation between new prescriptions and licensed indications; yearly change in ratio of new to repeat prescriptions and prescribing volumes measured as defined daily doses. Results: Oesophagitis was the commonest recorded indication in 1991, accounting for 31% of new prescriptions, but was third in 1995 (14%). During the study new prescriptions increased substantially, especially for duodenal disease (780%) and non-ulcer dyspepsia (690%). In 1995 non-specific morbidity accounted for 46% of new prescriptions. The total volume of prescribing rose 10-fold between 1991 and 1995, when repeat prescribing accounted for 77% of the total. Conclusions: Changes in recorded morbidity associated with new prescriptions of proton pump inhibitors did not necessarily reflect changes in licensed indications. Although general practitioners seemed to respond to changes in licensing, particularly for duodenal and gastric disease, prescribing for unlicensed indications non-ulcer dyspepsia and non-specific abdominal pain increased. Key messages There has been much speculation about the reasons behind the substantial rise in prescribing of proton pump inhibitors, especially their use for minor symptoms. We used the General Practitioner Research Database for the former West Midlands region to show that the volume of proton pump inhibitor prescribing rose 10-fold between 1992 and 1995 and repeat prescribing had risen to 77% of the volume by 1995 Prescribing for uncomplicated dyspepsia and non-specific abdominal symptoms, which were outside the licensed indications, accounted for 46% of new prescribing by 1995 The proportion of prescribing for the licensed indication of oesophagitis fell during the study, but that for duodenal ulceration increased in line with the expansion of licensed indications Analysis of PACT data showed similar prescribing trends to those found with the General Practitioner Research Database PMID:9703528

Emerald oil field on production in North Sea

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

Not Available

1992-08-31

This paper reports that Midland and Scottish Energy Ltd. (MSE) has placed Emerald oil field on stream in the U.K. North Sea with a floating production unit. Initial production, from two satellite wells, will be used to commission facilities. Three water injection wells have been unplugged and are ready for start-up. MSE will place a central cluster of wells-five producers and one water injector-on stream during the next few weeks. Production will build to an expected 25,000 b/d from 35 million bbl of reserves. Field development has undergone an unusually large number of setbacks and changes.

An evaluation of taster days to recruit untrained health care staff to pre-registration mental health nurse education within one UK university.

PubMed

Rhodes, Sheri; Bouic, Louise

2005-10-01

With a decrease in the amount of college leavers available to recruit to nurse training and a simultaneous increase in demand for nurses, achieving recruitment targets is becoming more difficult. The widening participation agenda has encouraged us to look wider and one very rich area for recruitment is untrained health and social care staff. Some of this group do eventually opt for professional education, but many could take up places sooner, but lack the confidence or the information they need to make informed decisions. The mental health directorate of an NHS Trust (Shropshire County PCT) agreed to fund 2 'Taster Days' for up to 40 untrained healthcare staff. The Trust was keen that this opportunity was offered to value the contribution, continued learning and skills development of their untrained staff. The Taster Days were to be delivered within the Faculty of Health & Sciences of Staffordshire University. The Trust gave permission for their name to be used on advertising materials and in subsequent publication. A literature review highlighted a dearth of material, consequently allowing freedom to develop and trial our own ideas. Current students and student nurse ambassadors (funded by Advantage West Midlands and Stoke Local Strategic Partnership through Full Circle) were involved in developing materials and the delivery of the day. An evaluation of the day and recommendations are included.

78 FR 15714 - Welch Motel, Inc., Welch Oil, Inc., Boondocks USA Truck Stop, Bob Welch v. Midland Power...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-12

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL13-50-000] Welch Motel, Inc., Welch Oil, Inc., Boondocks USA Truck Stop, Bob Welch v. Midland Power Cooperative, Corn Belt...) filed a complaint against Midland Power Cooperative (Midland) and Corn Belt Power Cooperative...

The importance of interdisciplinary communication in the process of anticipatory prescribing.

PubMed

Wilson, Eleanor; Seymour, Jane

2017-03-16

In the UK there has been a widespread introduction of 'anticipatory prescribing' in community based palliative care. This involves general practitioners (GPs) writing prescriptions in anticipation of them being needed and has been encouraged to try to minimise the risk of patients suffering uncontrolled symptoms and distress; a key reason why terminally ill patients are admitted to hospital in contradiction of most people's preferences. This paper presents the findings from an ethnographic study of healthcare professionals across four care homes and four community sites in two regions (East Midlands and Lancashire/South Cumbria) of the UK. Data were collected from a range of community health professionals, resulting in 83 episodes of observation and 72 interviews. Findings highlight how essential good interdisciplinary communication is to the process of anticipatory prescribing and end-of-life care. This study found that when interdisciplinary communication worked well the anticipatory prescribing process could be carried out smoothly, optimising patient care.

Controls of late Palaeozoic and Mesozoic extension in the British Isles: evidence from seismic reflection data in the Central North Sea

NASA Astrophysics Data System (ADS)

Smith, K.; Cameron, T. D. J.

2009-04-01

Controls of late Palaeozoic and Mesozoic extension in the British Isles: evidence from seismic reflection data in the Central North Sea. Kevin Smith (1) and Don Cameron (2) (1) British Geological Survey, Murchison House, West Mains Road, Edinburgh, EH9 3LA. (ksm@bgs.ac.uk). (2) British Geological Survey, 376 Gilmerton Road, Edinburgh, EH17 7QS. In the area of the British Isles during the late Devonian and early Carboniferous, the oblique convergence of Laurentia and Gondwana imposed a torque on the adjoining terranes of Baltica and Avalonia. Their resulting clockwise rotation was accommodated by widely distributed N-S extension in the intervening zones previously formed by Caledonian and Acadian convergence. South of Laurentia and Baltica, late Palaeozoic extension was focused (1) at terrane margins, (2) in areas of limited Caledonian-Acadian plutonism, and (3) in places where the western (Iapetus) and eastern (Tornquist) convergence zones intersect at a high angle. One of these latter areas lies in Central England immediately north of the Midland Microcraton (part of Eastern Avalonia), where thermal subsidence associated with early Carboniferous extension gave rise to the late Carboniferous Pennine Basin. Interpretation of an extensive set of 3D and 2D long-offset seismic reflection data suggests that a similar area of enhanced extension at a fold belt intersection lies to north of the Mid North Sea High in the middle of the Central North Sea. Variscan uplift and inversion of the late Palaeozoic basins began to predominate in mid-Carboniferous times as final amalgamation of all the different terranes to form Pangaea curtailed the initial episode of extension and thermal subsidence. This change in the tectonic regime was associated with the onset of tholeiitic volcanism within the convergence zones, and was followed by localised extension during the earliest Permian. Evidence obtained from seismic interpretation of the deep structure of the UK sector of the Central North Sea, suggests that late Carboniferous uplift and inversion along a northerly-trending axis analogous to the Pennine anticline controlled rift orientation during the episode of late Jurassic and early Cretaceous extension that formed the Central Graben. Other evidence indicates that subsequent local inversion of the Mesozoic basins in the same area can be spatially linked to the previous framework of late Devonian and early Carboniferous extension. In Scotland, north of the Southern Uplands, the pattern of late Palaeozoic extension in the Midland Valley is similar to that in England and the Central North Sea. Minor differences can be attributed to the greater effect of Laurentian tectonics in Scotland, including the development of Lower Devonian basins and volcanic rocks, and the influence of strike-slip faults of the NNE-trending Great Glen set, which originated between Laurentia and Baltica, largely to the north of the terranes of southern, Gondwanan, affinity. Published regional interpretations of variation in depth to the Moho in the UK can be used to examine the relative contribution of crustal stretching and magmatic underplating across the area.

UK Fixation of Distal Tibia Fractures (UK FixDT): protocol for a randomised controlled trial of ‘locking’ plate fixation versus intramedullary nail fixation in the treatment of adult patients with a displaced fracture of the distal tibia

PubMed Central

Achten, Juul; Parsons, Nicholas R; McGuinness, Katie R; Petrou, Stavros; Lamb, Sarah E; Costa, Matthew L

2015-01-01

Introduction The treatment of displaced, extra-articular fractures of the distal tibia remains controversial. These injuries are difficult to manage due to limited soft tissue cover, poor vascularity of the area and proximity to the ankle joint. Surgical treatment options are expanding and include locked intramedullary nails, plate and screw fixation and external fixator systems. The nail and plate options are most commonly used in the UK, but controversy exists over which treatment is most clinically and cost-effective. In this multicentre randomised controlled trial we aim to assess ratings of disability 6 months postinjury in patients who have sustained a distal tibia fracture treated with either an intramedullary nail or plate and locking screw fixation. Methods and analysis Adult patients presenting at trial centres with an acute fracture of the distal tibia will be considered for inclusion. A total of 320 patients will provide 90% power to detect a difference of 8 points in Disability Rating Index (DRI) score at 6 months at the 5% level. The randomisation sequence is stratified by trial centre and age, and administered via web-based service with 1:1 treatment allocation. Baseline demographic and pre-injury functional data and radiographs will be collected using the DRI, Olerud and Molander, and EuroQol EQ-5D questionnaire. Clinical assessment, early complications and radiographs will be recorded at 6–8 weeks. Functional outcome, health-related quality of life and resource use will be collected at 3, 6 and 12 months postoperatively. The main analysis will investigate differences in DRI 6 months postsurgery, between the two treatment groups, on an intention-to-treat basis. Tests will be two-sided and considered to provide evidence for a significant difference if p values are <0.05. Ethics and dissemination NRES Committee West-Midlands, 6/11/2012 (ref:12/WM/0340). The results of the trial will be disseminated via peer-reviewed publications and presentations at relevant conferences. Trial registration number ISRCTN99771224. PMID:26384729

Dietary intake in Black British adults; an observational assessment of nutritional composition and the role of traditional foods in UK Caribbean and West African diets.

PubMed

Goff, Louise M; Timbers, Louise; Style, Hannah; Knight, Annemarie

2015-08-01

Acculturation to the UK diet may contribute to the increased burden of non-communicable diseases in Black British communities. The present study aimed to assess nutritional composition and the contribution that traditional foods make to dietary intake in a group of UK-residing Caribbean and West African adults and to explore differences according to ethnicity and duration of residence. Observational study. Dietary intake was assessed using multiple, standardised triple-pass 24 h recalls and analysed using a nutritional composition database. Associations between sociodemographic variables and duration of residence with dietary intake were assessed using ANCOVA. London, UK, October 2011-December 2012. UK adults of Caribbean (n 50) or West African (n 83) ancestry, aged 18-75 years. The Caribbean participants were older and more likely to be born in the UK. After adjusting for age, sex and ethnicity, those who had been resident in the UK for the longest duration had significantly higher intakes of energy (P<0·001), fat (P=0·002) and Na (P=0·03). The West African participants sourced significantly more energy (P=0·04), fat (P=0·02), saturated fat (P=0·02) and Na (P=0·001) from traditional cultural foods compared with the Caribbean diet, which was more reliant on 'Westernised' foods such as sugar-sweetened beverages. These results are novel in demonstrating dietary acculturation in UK adults of Caribbean and West African ancestry. We have provided detailed data regarding the role of traditional foods, presenting dietary information that may guide in individualising care for patients from these communities and improve the cultural sensitivity of public health strategies.

Emergence of infection with Aphanomyces invadans in fish in some main aquatic ecosystems in Zimbabwe: A threat to national fisheries production.

PubMed

Sibanda, Sitokozile; Pfukenyi, Davies M; Barson, Maxwell; Hang'ombe, Bernard; Matope, Gift

2018-06-07

The first outbreak on the African continent of infection with Aphanomyces invadans (the causative agent of epizootic ulcerative syndrome) in fish was confirmed in the Chobe-Zambezi rivers in 2007. The emergence of massive outbreaks of infection with A. invadans in multiple fish species exposed serious aquatic biosecurity challenges in the Southern African region. This study investigated the incursion of infection with A. invadans in fish from the main aquatic ecosystems of Zimbabwe from 2012 to 2015 using data obtained from the Department of Livestock and Veterinary Services, Zimbabwe. In some outbreaks, fish samples were collected and tested at the University of Zambia, for confirmation by histopathology and species-specific PCR. The infection was first confirmed at Darwendale water impoundment (Mashonaland West Province) in 2012, followed by Matabeleland South Province at Mtshabezi water impoundment and Nkankezi River (both 2013). An apparent southward spread continued in 2014, with virgin outbreaks at Ntalale water impoundment (Matabeleland South Province) and Mwenezi River in Midlands Province. In 2015, inland incursion was confirmed at Dutchman's Pool in Midlands Province and further north-west at the Sanyati River Basin in Lake Kariba (Mashonaland West Province). In all outbreaks, infection with A. invadans was confirmed in seven fish species, namely the African sharptooth catfish (Clarias gariepinus, Burchell, 1822), blunt-toothed African catfish (Clarias ngamensis Castelnau, 1861), yellow belly bream (Serranochromis robustus Gunther, 1864), straight fin barb (Enteromius paludinosus Peters, 1852), dashtail barb (Enteromius poechii Steindachner, 1911), large-mouth bass (Micropterus salmoides Lac'epe'de, 1802) and the three-spot tilapia (Oreochromis andersonii Castelnau, 1861). Cases were most common in the African sharptooth catfish, with mortalities more pronounced in young fish of all species. The results suggested a gradual emergence of an intractable infection with A. invadans in fish in the main aquatic ecosystems of Zimbabwe, which may have negative impact on biodiversity conservation and aquaculture. © 2018 Blackwell Verlag GmbH.

Habitat Composition and Connectivity Predicts Bat Presence and Activity at Foraging Sites in a Large UK Conurbation

PubMed Central

Hale, James D.; Fairbrass, Alison J.; Matthews, Tom J.; Sadler, Jon P.

2012-01-01

Background Urbanization is characterized by high levels of sealed land-cover, and small, geometrically complex, fragmented land-use patches. The extent and density of urbanized land-use is increasing, with implications for habitat quality, connectivity and city ecology. Little is known about densification thresholds for urban ecosystem function, and the response of mammals, nocturnal and cryptic taxa are poorly studied in this respect. Bats (Chiroptera) are sensitive to changing urban form at a species, guild and community level, so are ideal model organisms for analyses of this nature. Methodology/Principal Findings We surveyed bats around urban ponds in the West Midlands conurbation, United Kingdom (UK). Sites were stratified between five urban land classes, representing a gradient of built land-cover at the 1 km2 scale. Models for bat presence and activity were developed using land-cover and land-use data from multiple radii around each pond. Structural connectivity of tree networks was used as an indicator of the functional connectivity between habitats. All species were sensitive to measures of urban density. Some were also sensitive to landscape composition and structural connectivity at different spatial scales. These results represent new findings for an urban area. The activity of Pipistrellus pipistrellus (Schreber 1774) exhibited a non-linear relationship with the area of built land-cover, being much reduced beyond the threshold of ∼60% built surface. The presence of tree networks appears to mitigate the negative effects of urbanization for this species. Conclusions/Significance Our results suggest that increasing urban density negatively impacts the study species. This has implications for infill development policy, built density targets and the compact city debate. Bats were also sensitive to the composition and structure of the urban form at a range of spatial scales, with implications for land-use planning and management. Protecting and establishing tree networks may improve the resilience of some bat populations to urban densification. PMID:22428015

Masculinities fathering and health: the experiences of African-Caribbean and white working class fathers.

PubMed

Williams, Robert Alan

2007-01-01

There is a developing body of research that investigates the links between masculinities and men's health experiences, but the links between masculinities and the health of fathers has been a neglected focus for research in the UK. This paper presents some of the findings drawn from a parent study which investigated African-Caribbean and white working class fathers' experiences of fathering, health and social connectedness. Data are drawn from interviews with 13 men (6 African-Caribbean and 7 White working class) living in a city in the West Midlands area of the UK. In this paper, I analyse and discuss African-Caribbean and white working class fathers' stories about the meaning of health, the influences upon their health, and their health practices. It was found that for the African-Caribbean fathers specifically, anticipated or perceived racist prejudice, abuse or discrimination influenced their health experiences. However, the meaning of health for both ethnic groups of fathers was as functional capacity, that is health was an asset that allowed fathers to meet the obligations of paid work and fathering. These obligations were also associated with a restricted sense of personal agency for the men interviewed, and the associated constraints were linked to transgressive consumption of alcohol, food and tobacco. In addition, fathers were also involved in solitary ways of dealing with their vulnerability, vulnerability that was associated with fathers' health concerns, and other difficult life experiences. Fathers' solitary experiences of vulnerability were also mediated by hegemonic forms of masculinity. Nevertheless, the experience of fathering within the lifecourse influenced men's health experiences: reflexivity and challenges to both transgressive consumption and solitary experiences were linked to fathers' perceived obligations to children. The significance of gender, ethnicity and social class for theory and future research with working class fathers and boys is identified, and the need for gender-sensitive public health and health promotion interventions regarding the 'work-family balance' and working class fathers' personal and social skills is also discussed.

Refining Ovarian Cancer Test accuracy Scores (ROCkeTS): protocol for a prospective longitudinal test accuracy study to validate new risk scores in women with symptoms of suspected ovarian cancer

PubMed Central

Sundar, Sudha; Rick, Caroline; Dowling, Francis; Au, Pui; Rai, Nirmala; Champaneria, Rita; Stobart, Hilary; Neal, Richard; Davenport, Clare; Mallett, Susan; Sutton, Andrew; Kehoe, Sean; Timmerman, Dirk; Bourne, Tom; Van Calster, Ben; Gentry-Maharaj, Aleksandra; Deeks, Jon

2016-01-01

Introduction Ovarian cancer (OC) is associated with non-specific symptoms such as bloating, making accurate diagnosis challenging: only 1 in 3 women with OC presents through primary care referral. National Institute for Health and Care Excellence guidelines recommends sequential testing with CA125 and routine ultrasound in primary care. However, these diagnostic tests have limited sensitivity or specificity. Improving accurate triage in women with vague symptoms is likely to improve mortality by streamlining referral and care pathways. The Refining Ovarian Cancer Test Accuracy Scores (ROCkeTS; HTA 13/13/01) project will derive and validate new tests/risk prediction models that estimate the probability of having OC in women with symptoms. This protocol refers to the prospective study only (phase III). Methods and analysis ROCkeTS comprises four parallel phases. The full ROCkeTS protocol can be found at http://www.birmingham.ac.uk/ROCKETS. Phase III is a prospective test accuracy study. The study will recruit 2450 patients from 15 UK sites. Recruited patients complete symptom and anxiety questionnaires, donate a serum sample and undergo ultrasound scored as per International Ovarian Tumour Analysis (IOTA) criteria. Recruitment is at rapid access clinics, emergency departments and elective clinics. Models to be evaluated include those based on ultrasound derived by the IOTA group and novel models derived from analysis of existing data sets. Estimates of sensitivity, specificity, c-statistic (area under receiver operating curve), positive predictive value and negative predictive value of diagnostic tests are evaluated and a calibration plot for models will be presented. ROCkeTS has received ethical approval from the NHS West Midlands REC (14/WM/1241) and is registered on the controlled trials website (ISRCTN17160843) and the National Institute of Health Research Cancer and Reproductive Health portfolios. PMID:27507231

Habitat composition and connectivity predicts bat presence and activity at foraging sites in a large UK conurbation.

PubMed

Hale, James D; Fairbrass, Alison J; Matthews, Tom J; Sadler, Jon P

2012-01-01

Urbanization is characterized by high levels of sealed land-cover, and small, geometrically complex, fragmented land-use patches. The extent and density of urbanized land-use is increasing, with implications for habitat quality, connectivity and city ecology. Little is known about densification thresholds for urban ecosystem function, and the response of mammals, nocturnal and cryptic taxa are poorly studied in this respect. Bats (Chiroptera) are sensitive to changing urban form at a species, guild and community level, so are ideal model organisms for analyses of this nature. We surveyed bats around urban ponds in the West Midlands conurbation, United Kingdom (UK). Sites were stratified between five urban land classes, representing a gradient of built land-cover at the 1 km(2) scale. Models for bat presence and activity were developed using land-cover and land-use data from multiple radii around each pond. Structural connectivity of tree networks was used as an indicator of the functional connectivity between habitats. All species were sensitive to measures of urban density. Some were also sensitive to landscape composition and structural connectivity at different spatial scales. These results represent new findings for an urban area. The activity of Pipistrellus pipistrellus (Schreber 1774) exhibited a non-linear relationship with the area of built land-cover, being much reduced beyond the threshold of ∼60% built surface. The presence of tree networks appears to mitigate the negative effects of urbanization for this species. Our results suggest that increasing urban density negatively impacts the study species. This has implications for infill development policy, built density targets and the compact city debate. Bats were also sensitive to the composition and structure of the urban form at a range of spatial scales, with implications for land-use planning and management. Protecting and establishing tree networks may improve the resilience of some bat populations to urban densification.

How to succeed as a junior doctor.

PubMed

Azad, Michael

2016-10-01

The Royal College of Physicians (RCP) organised an inaugural 1-day conference, the aim of which was to look into some of the key issues that junior doctors need to address when beginning their careers. The target audience was medical students but a few foundation doctors were also in attendance. The conference also helped to increase RCP engagement with medical students and foundation doctors. The day was co-chaired by Professor Kate Thomas (vice dean, University of Birmingham) and Dr Andrew Macleod and Dr Kanwaljit Sandhu (RCP regional advisors for the West Midlands). © Royal College of Physicians 2016. All rights reserved.

Compliance with NICE guidance on the use of anti-TNFalpha agents in ankylosing spondylitis: an east and west Midlands regional audit.

PubMed

Rees, Frances; Peffers, Gillian; Bell, Carolyn; Obrenovic, Karen; Sandhu, Ravinder; Packham, Jonathan; Erb, Nicola

2012-08-01

Here we report on an audit performed to examine compliance with National Institute for Health and Clinical Excellence (NICE) guidelines for the use of anti-tumour necrosis factor alpha (anti-TNFalpha) in treating patients with ankylosing spondylitis (AS). Data from 17 rheumatology centres across the Midlands were collected prospectively from patients with AS attending outpatient clinics and retrospectively in patients receiving anti-TNFalpha but not attending outpatient clinics during the audit. In total, 80% of the 416 patients for whom data were collected were male. Of the 238 patients recruited prospectively, 41% were receiving anti-TNFalpha. Reviewing all patients on anti-TNFalpha (N=275), pre-treatment assessments 12 weeks apart were documented in 55% of patients. After anti-TNFalpha treatment had started, regular 12-weekly assessments occurred in 46% of patients. Therefore, compliance with NICE guidance was found to vary among centres. Based on our audit, clinical capacity, and clinical or patient choice might be influencing the suboptimal adherence seen in assessment timing suggested by NICE guidelines relating to the use of anti-TNFalpha in treating patients with AS.

Nurse prescribing: reflections on safety in practice.

PubMed

Bradley, Eleanor; Hynam, Brian; Nolan, Peter

2007-08-01

This qualitative study explores how recently qualified nurse prescribers describe, and rate, the safety of their prescribing. Internationally, the costs of drug errors are enormous and they can have serious implications for staff and patients. Nurses are now undertaking extended prescribing practice throughout the UK. Nurse prescribers work across different work settings and although safe prescribing is a priority in all of them, it is essential to ascertain the conditions that foster the highest levels of safety and how nurses can be supported in practice. Thirty-one nurses form the West Midlands area of England agreed to participate in an in-depth interview which sought to elicit their responses to various aspects of their prescribing work. They came from a variety of specialities and from hospital, community and general practice backgrounds. On completion of their training nurses were acutely aware of the responsibility that prescribing imposed on them. Although this awareness was thought to encourage caution and safety, it may also account for the fact that 26% of the nurses (n=8) had not prescribed since qualifying. Nurses felt that the multidisciplinary team had a vital role to play in supporting their prescribing practice as did collaborative working. It is concluded that those working in specialty areas that are less well-defined in terms of scope of practice (e.g. older adult nursing and learning disability) would benefit in particular from ongoing mentoring relationships with experienced prescribers and the development of individual formularies.

Perceptions and Impact of Mandatory eLearning for Foundation Trainee Doctors: A Qualitative Evaluation.

PubMed

Brooks, Hannah L; Pontefract, Sarah K; Vallance, Hannah K; Hirsch, Christine A; Hughes, Elizabeth; Ferner, Robin E; Marriott, John F; Coleman, Jamie J

2016-01-01

Junior doctors in the UK must complete various educational components during their two year Foundation training programme. It is important that mandatory learning is informative and engaging. The aim of this study was to evaluate trainee doctors' perceptions of a Technology Enhanced Learning (TEL) programme developed to improve prescribing competency. Focus groups and interviews were conducted at three hospital sites in the West Midlands. Codes, sub-themes and themes were determined using deductive and inductive thematic analysis. Data were collected from 38 Foundation trainee doctors. Results revealed major themes relating to prescribing education, the user experience and user engagement. Key findings included the positive impact of preparedness following undergraduate education on the user experience of the TEL programme at the postgraduate level; the impact of content, structure, and individual learning needs and styles on the user experience; and the impact of motivation and time on engagement. Most trainees engaged with the programme owing to its mandatory nature; however, some trainees also used the programme voluntarily, for example, to acquire knowledge prior to starting a new placement. It is important to ensure that learners are willing to engage with mandatory TEL, and that they have the time and motivation to do so. It is also important to ensure that learners have a positive user experience and that in designing TEL individual differences in learning styles and needs are taken into account. These findings have implications for educators and system developers in the construction and design of mandatory eLearning programmes.

Food choices made by low-income households when feeding their pre-school children: a qualitative study.

PubMed

Lovelace, Sally; Rabiee-Khan, Fatemeh

2015-10-01

The growing concern about poor dietary practices among low-income families has led to a 'victim blaming' culture that excludes wider social and environmental factors, which influence household food choices. This small-scale qualitative study investigated influences on the diets of young children in families on a low income in the West Midlands, UK. Using semi-structured interview schedule, rich data was gathered through individual interviews with 11 mothers of pre-school children. Information was collected about the type and range of food given following the introduction of solid foods including factors influencing parent's knowledge and diet, sources of nutrition advice and financial constraints. Food accessibility and storage issues were also explored. Interviews were audio-recorded, transcribed and analysed using a modified grounded theory approach. Findings highlighted that parents and professionals may have different interpretations about 'cooking from scratch'. The results indicated that some parents have poor understanding of what constitutes a healthy diet. However, most parents included fruit and vegetables to varying degrees and were motivated to give their children healthy foods, suggesting that, with adequate support and information, the diets of these children could be improved. There was evidence that when striving to improve the diet of their children, many parents' diets also improved. The findings from this small-scale in-depth study highlighted a number of issues for local and national policy and practice in the area of nutrition and child health in the early years. © 2013 John Wiley & Sons Ltd.

Training lay-people to use automatic external defibrillators: are all of their needs being met?

PubMed

Harrison-Paul, Russell; Timmons, Stephen; van Schalkwyk, Wilna Dirkse

2006-10-01

We explored the experiences of lay people who have been trained to use automatic external defibrillators. The research questions were: (1) How can training courses help prepare people for dealing with real life situations? (2) Who is ultimately responsible for providing critical incident debriefing and how should this be organised? (3) What is the best process for providing feedback to those who have used an AED? Fifty-three semi-structured, qualitative interviews were conducted, some with those who had been trained and others with trainers. Locations included airports, railway stations, private companies and first responder schemes. Geographically, we covered Nottinghamshire, Lincolnshire, Yorkshire, Staffordshire, Essex and the West Midlands in the UK. Our analysis of the data indicates that most people believe scenarios based within their place of work were most useful in preparing for 'real life'. Many people had not received critical incident debriefing after using an AED. There were a variety of systems in place to provide support after an incident, many of which were informal. Training scenarios should be conducted outside the classroom. There should be more focus on critical incident debriefing during training and a clear identification of who should provide support after an incident. Other issues which were of interest included: (1) people's views on do not attempt resuscitation (DNAR); (2) perceived boundaries of responsibility when using an AED; (3) when is someone no longer 'qualified' to use an AED?

Midlands Teaching Factory, LTD.

ERIC Educational Resources Information Center

Midlands Technical Coll., Columbia, SC.

In 1987, Midlands Technical College (MTC), in Columbia, South Carolina, initiated a Computer Integrated Manufacturing (CIM) project, the Midlands Teaching Factory, LTD, which integrated various college departments with the goal of manufacturing a high quality, saleable product. The faculty developed a teaching factory model which was designed to…

Improving the care of patients with cystic fibrosis (CF)

PubMed Central

Khan, Ahsan Aftab; Nash, Edward F; Whitehouse, Joanna; Rashid, Rifat

2017-01-01

Background The West Midlands Adult Cystic Fibrosis (CF) Centre based at Birmingham Heartlands Hospital provides care for adults with CF in the West Midlands. People with CF are prone to pulmonary exacerbations, which often require inpatient admission for intravenous antibiotics. We observed that the admission process was efficient during working hours (9:00–17:00, Monday–Friday) when the CF team are routinely available, but out-of-working hours, there were delays in these patients being clerked and receiving their first antibiotic dose. We were concerned that this was resulting in quality and potential safety issues by causing delays in starting treatment and prolonging hospital inpatient stays. We therefore undertook a quality improvement project (QIP) aimed at addressing these issues. An initial survey showed median time to clerk of 5 hours, with 60% of patients missing their first dose of antibiotics and mean length of stay of 16 days. Methods We applied the Plan-Do-Study-Act (PDSA) cycle approach, with the first PDSA cycle involving raising awareness of the issue through education to doctors, nurses and patients. Results This led to a reduction of median time to clerk from 5 to 2 hours with 23% of patients missing their first antibiotic dose and mean length of stay reducing to 14 days. The second cycle involved introducing an admissions checklist and displaying education posters around the hospital, resulting in median time to clerk remaining at 2 hours but only 20% of patients missing their first antibiotic dose and the mean length of stay remaining at 14 days. Conclusion This QIP has improved the out-of-hours admissions process for adults with CF in our centre. We plan to review the longer term effects of the project including sustainability, effects on clinical outcomes and patient satisfaction. PMID:28959778

The West Midlands ActiVe lifestyle and healthy Eating in School children (WAVES) study: a cluster randomised controlled trial testing the clinical effectiveness and cost-effectiveness of a multifaceted obesity prevention intervention programme targeted at children aged 6-7 years.

PubMed

Adab, Peymane; Barrett, Timothy; Bhopal, Raj; Cade, Janet E; Canaway, Alastair; Cheng, Kar Keung; Clarke, Joanne; Daley, Amanda; Deeks, Jonathan; Duda, Joan; Ekelund, Ulf; Frew, Emma; Gill, Paramjit; Griffin, Tania; Hemming, Karla; Hurley, Kiya; Lancashire, Emma R; Martin, James; McGee, Eleanor; Pallan, Miranda J; Parry, Jayne; Passmore, Sandra

2018-02-01

Systematic reviews suggest that school-based interventions can be effective in preventing childhood obesity, but better-designed trials are needed that consider costs, process, equity, potential harms and longer-term outcomes. To assess the clinical effectiveness and cost-effectiveness of the WAVES (West Midlands ActiVe lifestyle and healthy Eating in School children) study intervention, compared with usual practice, in preventing obesity among primary school children. A cluster randomised controlled trial, split across two groups, which were randomised using a blocked balancing algorithm. Schools/participants could not be blinded to trial arm. Measurement staff were blind to allocation arm as far as possible. Primary schools, West Midlands, UK. Schools within a 35-mile radius of the study centre and all year 1 pupils (aged 5-6 years) were eligible. Schools with a higher proportion of pupils from minority ethnic populations were oversampled to enable subgroup analyses. The 12-month intervention encouraged healthy eating/physical activity (PA) by (1) helping teachers to provide 30 minutes of additional daily PA, (2) promoting 'Villa Vitality' (interactive healthy lifestyles learning, in an inspirational setting), (3) running school-based healthy cooking skills/education workshops for parents and children and (4) highlighting information to families with regard to local PA opportunities. The primary outcomes were the difference in body mass index z-scores (BMI-zs) between arms (adjusted for baseline body mass index) at 3 and 18 months post intervention (clinical outcome), and cost per quality-adjusted life-year (QALY) (cost-effectiveness outcome). The secondary outcomes were further anthropometric, dietary, PA and psychological measurements, and the difference in BMI-z between arms at 27 months post intervention in a subset of schools. Two groups of schools were randomised: 27 in 2011 ( n  = 650 pupils) [group 1 (G1)] and another 27 in 2012 ( n  = 817 pupils) [group 2 (G2)]. Primary outcome data were available at first follow-up ( n  = 1249 pupils) and second follow-up ( n  = 1145 pupils) from 53 schools. The mean difference (MD) in BMI-z between the control and intervention arms was -0.075 [95% confidence interval (CI) -0.183 to 0.033] and -0.027 (95% CI -0.137 to 0.083) at 3 and 18 months post intervention, respectively. The main analyses showed no evidence of between-arm differences for any secondary outcomes. Third follow-up included data on 467 pupils from 27 G1 schools, and showed a statistically significant difference in BMI-z (MD -0.20, 95% CI -0.40 to -0.01). The mean cost of the intervention was £266.35 per consented child (£155.53 per child receiving the intervention). The incremental cost-effectiveness ratio associated with the base case was £46,083 per QALY (best case £26,804 per QALY), suggesting that the intervention was not cost-effective. The presence of baseline primary outcome imbalance between the arms, and interschool variation in fidelity of intervention delivery. The primary analyses show no evidence of clinical effectiveness or cost-effectiveness of the WAVES study intervention. A post hoc analysis, driven by findings at third follow-up, suggests a possible intervention effect, which could have been attenuated by baseline imbalances. There was no evidence of an intervention effect on measures of diet or PA and no evidence of harm. A realist evidence synthesis could provide insights into contextual factors and strategies for future interventions. School-based interventions need to be integrated within a wider societal framework and supported by upstream interventions. Current Controlled Trials ISRCTN97000586. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 22, No. 8. See the NIHR Journals Library website for further project information.

Diversification: Midland/Odessa Health & Retirement Endeavor.

ERIC Educational Resources Information Center

Skipper, P. K.

In reaction to the economic risks associated with an over reliance on oil and gas exports, residents of the Midland/Odessa area of Texas began seeking diversification options for the local economy and, in 1986, formed the Midland/Odessa Health and Retirement Endeavor (MOHRE). This non-profit corporation was formed to examine the feasibility of…

The impact of newspaper advertising on a regional antenatal health campaign.

PubMed

Berry, J M

1984-01-01

In 1981 the West Midlands Health services undertook a publicity campaign aimed at helping women to understand more about keeping healthy during pregnancy and encouraging them to seek early ante-natal care. A series of full page advertisements on ante-natal care were placed in local newspapers in the Region. Set out here are the findings of two studies of the impact of the publicity campaign. The first shows how far people's knowledge of what to do during pregnancy was altered by the publicity, and the second shows what people thought of the advertisements themselves and the further information sent to them on request.

76 FR 69719 - Gregory R. Swecker and Beverly F. Swecker v. Midland Power Cooperative and State of Iowa; Notice...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-09

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL11-39-001] Gregory R. Swecker and Beverly F. Swecker v. Midland Power Cooperative and State of Iowa; Notice of Filing Take... of disconnection of back-up power to Complainant's QF and residence by Midland Power Cooperative...

Localized geohazards in West Texas, captured by multi-temporal Sentinel-1A/B interferometry

NASA Astrophysics Data System (ADS)

Kim, J. W.; Lu, Z.

2017-12-01

West Texas contains the Permian Basin and is particularly composed of three major geologic sedimentary basins: Delaware Basin, Central Basin Platform, and Midland Basin. Because the vast region was once covered by a shallow sea and had experienced long-lasting evaporation million years ago, the West Texas is underlain by a thick layer of water soluble rocks including the carbonate and evaporite rocks. In addition, the geologic composition provided abundant hydrocarbons in the depth of several kilometers, but the human activities exploiting the massive oil and gas from the subsurface made negative impacts on the stability of underground and ground surface. Most deformation and localized geohazards have been unnoticed by means of field measurements or remote sensing methods, because the West Texas is located in the low populated, remote region. The Sentinel-1A/B has continuously acquired the SAR imagery with a large swath of 250 km over the region, and its multi-temporal measurements can provide clues on what are really taking place on the ground surface, what are the causes to trigger the localized subsidence/uplift, and what should be done to prevent more severe disasters in the future. We have established an automated Sentinel-1A/B InSAR processing system on SMU supercomputer (Maneframe), its continuous monitoring will help us unveil the current status of deformation occurring in West Texas.

Business models and leadership styles in small medical device and bio-science businesses--examples in a region and their implications.

PubMed

Williams, D J; Hourd, P C

2004-01-01

This paper reviews the leadership styles and business models found in small technologically based businesses operating in the healthcare sector within one of the UK regions, the East Midlands. The most frequently encountered business model strands were 1) mixed economies: that fund development with service income; cross-sectoral product portfolios; and decoupled business portfolios led by a single entrepreneur and 2) scale sensitive "stay small" models including the avoidance of venture capital; "early exit"; and virtual business strands. There was found to be little correlation between leadership style and business model for the small number of businesses surveyed. The avoidance of venture capital is in direct contrast to adjacent regions.

Perceptions and Impact of Mandatory eLearning for Foundation Trainee Doctors: A Qualitative Evaluation

PubMed Central

Brooks, Hannah L.; Vallance, Hannah K.; Hirsch, Christine A.; Hughes, Elizabeth; Ferner, Robin E.; Marriott, John F.; Coleman, Jamie J.

2016-01-01

Background Junior doctors in the UK must complete various educational components during their two year Foundation training programme. It is important that mandatory learning is informative and engaging. The aim of this study was to evaluate trainee doctors’ perceptions of a Technology Enhanced Learning (TEL) programme developed to improve prescribing competency. Method Focus groups and interviews were conducted at three hospital sites in the West Midlands. Codes, sub-themes and themes were determined using deductive and inductive thematic analysis. Results Data were collected from 38 Foundation trainee doctors. Results revealed major themes relating to prescribing education, the user experience and user engagement. Key findings included the positive impact of preparedness following undergraduate education on the user experience of the TEL programme at the postgraduate level; the impact of content, structure, and individual learning needs and styles on the user experience; and the impact of motivation and time on engagement. Most trainees engaged with the programme owing to its mandatory nature; however, some trainees also used the programme voluntarily, for example, to acquire knowledge prior to starting a new placement. Conclusions It is important to ensure that learners are willing to engage with mandatory TEL, and that they have the time and motivation to do so. It is also important to ensure that learners have a positive user experience and that in designing TEL individual differences in learning styles and needs are taken into account. These findings have implications for educators and system developers in the construction and design of mandatory eLearning programmes. PMID:28005938

A feasibility randomised controlled trial of pre-operative occupational therapy to optimise recovery for patients undergoing primary total hip replacement for osteoarthritis (PROOF-THR).

PubMed

Jepson, Paul; Sands, Gina; Beswick, Andrew D; Davis, Edward T; Blom, Ashley W; Sackley, Catherine M

2016-02-01

To assess the feasibility of a pre-operative occupational therapy intervention for patients undergoing primary total hip replacement. Single blinded feasibility randomised controlled trial, with data collection prior to the intervention, and at 4, 12, and 26 weeks following surgery. Recruitment from two NHS orthopaedic outpatient centres in the West Midlands, UK. Patients awaiting primary total hip replacement due to osteoarthritis were recruited. Following pre-operative assessment, patients were individually randomised to intervention or control by a computer-generated block randomisation algorithm stratified by age and centre. The intervention group received a pre-surgery home visit by an occupational therapist who discussed expectations, assessed home safety, and provided appropriate adaptive equipment. The control group received treatment as usual. The study assessed the feasibility of recruitment procedures, delivery of the intervention, appropriateness of outcome measures and data collection methods. Health related quality of life and resource use were recorded at 4, 12 and 26 weeks. Forty-four participants were recruited, 21 were randomised to the occupational therapy intervention and 23 to usual care. Analysis of 26 week data included 18 participants in the intervention group and 21 in the control. The intervention was delivered successfully with no withdrawals or crossovers; 5/44 were lost to follow-up with further missing data for participation and resource use. The feasibility study provided the information required to conduct a definitive trial. Burden of assessment would need to be addressed. A total of 219 patients would be required in an efficacy trial. © The Author(s) 2015.

Effectiveness of an e-learning course in evidence-based medicine for foundation (internship) training.

PubMed

Hadley, Julie; Kulier, Regina; Zamora, Javier; Coppus, Sjors F P J; Weinbrenner, Susanne; Meyerrose, Berrit; Decsi, Tamas; Horvath, Andrea R; Nagy, Eva; Emparanza, Jose I; Arvanitis, Theodoros N; Burls, Amanda; Cabello, Juan B; Kaczor, Marcin; Zanrei, Gianni; Pierer, Karen; Kunz, Regina; Wilkie, Veronica; Wall, David; Mol, Ben Wj; Khan, Khalid S

2010-07-01

To evaluate the educational effectiveness of a clinically integrated e-learning course for teaching basic evidence-based medicine (EBM) among postgraduate medical trainees compared to a traditional lecture-based course of equivalent content. We conducted a cluster randomized controlled trial to compare a clinically integrated e-learning EBM course (intervention) to a lecture-based course (control) among postgraduate trainees at foundation or internship level in seven teaching hospitals in the UK West Midlands region. Knowledge gain among participants was measured with a validated instrument using multiple choice questions. Change in knowledge was compared between groups taking into account the cluster design and adjusted for covariates at baseline using generalized estimating equations (GEE) model. There were seven clusters involving teaching of 237 trainees (122 in the intervention and 115 in the control group). The total number of postgraduate trainees who completed the course was 88 in the intervention group and 72 in the control group. After adjusting for baseline knowledge, there was no difference in the amount of improvement in knowledge of EBM between the two groups. The adjusted post course difference between the intervention group and the control group was only 0.1 scoring points (95% CI -1.2-1.4). An e-learning course in EBM was as effective in improving knowledge as a standard lecture-based course. The benefits of an e-learning approach need to be considered when planning EBM curricula as it allows standardization of teaching materials and is a potential cost-effective alternative to standard lecture-based teaching.

Extended training to prepare GPs for future workforce needs: a qualitative investigation of a 1-year fellowship in urgent care.

PubMed

Dale, Jeremy; Russell, Rachel; Harkness, Frances; Wilkie, Veronica; Aiello, Matthew

2017-09-01

It has been argued that UK general practice specialist training should be extended to better prepare GPs for the challenges facing 21st-century health care. Evidence is needed to inform how this should occur. To investigate the experience of recently trained GPs undertaking a 1-year full-time fellowship programme designed to provide advanced skills training in urgent care, integrated care, leadership, and academic practice; and its impact on subsequent career development. Semi-structured interviews conducted longitudinally over 2 years augmented by observational data in the West Midlands, England. Participants were interviewed on at least three occasions: twice while undertaking the fellowship, and at least once post-completion. Participants' clinical and academic activities were observed. Data were analysed using a framework approach. Seven GPs participated in the pilot scheme. The fellowship was highly rated and felt to be balanced in terms of the opportunities for skill development, academic advancement, and confidence building. GPs experienced enhanced employability on completing the scheme, and at follow-up were working in a variety of primary care/urgent care interface clinical and leadership roles. Participants believed it was making general practice a more attractive career option for newly qualified doctors. The 1-year fellowship provides a defined framework for training GPs to work in an enhanced manner across organisational interfaces with the skills to support service improvement and integration. It appears to be well suited to preparing GPs for portfolio roles, but its wider applicability and impact on NHS service delivery needs further investigation. © British Journal of General Practice 2017.

Sharing information about diagnosis and outcome of first-episode psychosis in patients presenting to early intervention services.

PubMed

Farooq, Saeed; Green, Debra J; Singh, Swaran P

2018-05-04

First-episode psychosis (FEP) can be a serious and debilitating disease, but there is limited literature on how to inform patients and carers about its diagnosis and outcome. We aimed to examine the attitudes, practices and views of clinicians working in Early Intervention Service about sharing information on diagnosis and outcome of FEP. A 26-item questionnaire was sent electronically to clinical staff who have been involved in the discussion of FEP diagnosis in Early Intervention Services in the West Midlands, UK. A total of 51 clinicians completed the questionnaire. All respondents stated that patients or carers of those presenting with FEP wish to be informed of their diagnosis, and three-quarters (76%) felt there is a need to develop guidelines on how to inform about diagnosis; 57% stated that they usually use broad diagnostic groups such as psychosis when discussing diagnosis, and only 11% use the term schizophrenia. A total of 40% thought that the therapeutic relationship and treatment adherence (58%) would improve if patients know about their diagnosis; 42 (88%) respondents felt that the likely outcome of the illness should also be discussed with patients when the diagnosis is communicated. The clinicians were aware that service users wished to be informed about the diagnosis and outcome of FEP but had no guidance on the subject. Despite the limitations of an online self-administered survey, the study highlights the need for guidance and improving clinical practice in discussing the diagnosis of FEP in a vulnerable population. © 2018 John Wiley & Sons Australia, Ltd.

Obesity prevention in English primary schools: headteacher perspectives.

PubMed

Clarke, J L; Pallan, M J; Lancashire, E R; Adab, P

2017-06-01

Schools are seen as important contributors to obesity prevention, yet face barriers in fulfilling this function. This qualitative study investigates headteacher views on the primary school role in preventing obesity. Semi-structured interviews were held with 22 headteachers from ethnically and socio-economically diverse schools in the West Midlands, UK. Data analysis was conducted using the framework approach. Two over-arching categories were identified: 'School roles and responsibilities' and 'Influencing factors'. Participants agreed that although schools contribute towards obesity prevention in many ways, a moral responsibility to support children's holistic development was the principal motivator, rather than preventing obesity per se. The perceived impact on learning was a key driver for promoting health. Parents were believed to have the main responsibility for preventing obesity, but barriers were identified. Whilst headteachers recognized the advantageous position of schools in offering support to parents, opinion varied on the degree to which schools could and should take on this role. Headteachers serving more deprived areas reported adopting certain responsibilities that elsewhere were fulfilled by parents, and were more likely to view working with families on healthy lifestyles as an important school function. Several factors were perceived as barriers to schools doing more to prevent obesity, including academic pressure, access to expert support and space. In conclusion, school leaders need more support, through resources and government policy, to enable them to maximize their role in obesity prevention. Additionally, school-based obesity prevention should be an integral part of the education agenda rather than bolt-on initiatives. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Systematic kidney disease management in a population with diabetes mellitus: turning the tide of kidney failure.

PubMed

Rayner, Hugh C; Hollingworth, Lee; Higgins, Robert; Dodds, Simon

2011-10-01

A significant proportion of patients with diabetes mellitus do not get the benefit of treatment that would reduce their risk of progressive kidney disease and reach a nephrologist once significant loss of kidney function has already occurred. Systematic disease management of patients with diabetes and kidney disease. Diverse population (approximately 800,000) in and around Birmingham, West Midlands, UK. Number of outpatient appointments, estimated glomerular filtration rate (eGFR) at first contact with nephrologist, number of patients starting kidney replacement therapy (KRT) and mode of KRT at start. Identification of patients with low or deteriorating trend in eGFR from weekly database review, specialist diabetes-kidney clinic, self-management of blood pressure and transfer to multidisciplinary clinic >12 months before end-stage kidney disease. New patients increased from 62 in 2003 to 132 in 2010; follow-ups fell from 251 to 174. Median eGFR at first clinic visit increased from 28.8 ml/min/1.73 m(2) (range 6.1-67.0) in 2000/2001 to 35.0 (11.1-147.5) in 2010 (p<0.006). In 2010, the number of patients starting KRT fell 30% below the projected activity using 1993-2003 data as baseline (p<0.003). The proportion starting KRT with either a kidney transplant, peritoneal dialysis or haemodialysis via an arteriovenous fistula increased from 26% in 2000 to 55% in 2010. Systematic disease management across a large population significantly improves patient outcomes, increases the productivity of a specialist service and could reduce healthcare costs compared with the current model of care.

Geographical trends in infant mortality: England and Wales, 1970-2006.

PubMed

Norman, Paul; Gregory, Ian; Dorling, Danny; Baker, Allan

2008-01-01

At national level in England and Wales, infant mortality rates fell rapidly from the early 1970s and into the 1980s. Subnational areas have also experienced a reduction in levels of infant mortality. While rates continued to fall to 2006, the rate of reduction has slowed. Although the Government Office Regions Yorkshire and The Humber, the North West and the West Midlands and the Office for National Statistics local authority types Cities and Services and London Cosmopolitan have experienced relatively large absolute reductions in infant mortality, their rates remained high compared with the national average. Within all regions and local authority types, a strong relationship was found between ward level deprivation and infant mortality rates. Nevertheless, levels of infant mortality declined over time even in the most deprived areas with a narrowing of absolute differences in rates between areas. Areas in which the level of deprivation eased have experienced greater than average reductions in levels of infant mortality.

Use of colliery spoil for infilling mine workings

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

Ghataora, G.S.; Jarvis, S.T.

1996-12-31

Colliery spoil has been used as a major constituent of rock paste, a controlled low-strength bulk infill material, to infill abandoned limestone mines in the West Midlands of England since the early 1980s. During this time the design of colliery spoil rock paste has been modified and improved to ensure that strengths are achieved and consolidation is minimized. This paper describes the methods used for measuring and monitoring the development of the strength of rock paste used to infill the Littleton Street Mine in Walsall, England. The mine had a volume of about 500,000 m{sup 3} and is possibly themore » largest underground void to be infilled with rock paste.« less

Reconnaissance Study for the Western Lake Huron Basin, Watershed Study, Michigan, Section 905(b)

DTIC Science & Technology

2012-05-01

Isle, Alpena , Alcona, Iosco, Arenac, Bay, Tuscola, Huron, Sanilac, St. Clair, Midland, and Saginaw. With the exception of Midland and Saginaw Counties...Cheboygan, Presque Isle, Alpena , Alcona, Iosco, Arenac, Bay, Midland, Saginaw, Tuscola, Huron, Sanilac, and St. Clair. The study area includes the... Alpena Harbor. Alpena Harbor is at the mouth of the Thunder Bay River, which empties into Thunder Bay, Lake Huron. The harbor is 100 miles southeast of

Refining Ovarian Cancer Test accuracy Scores (ROCkeTS): protocol for a prospective longitudinal test accuracy study to validate new risk scores in women with symptoms of suspected ovarian cancer.

PubMed

Sundar, Sudha; Rick, Caroline; Dowling, Francis; Au, Pui; Snell, Kym; Rai, Nirmala; Champaneria, Rita; Stobart, Hilary; Neal, Richard; Davenport, Clare; Mallett, Susan; Sutton, Andrew; Kehoe, Sean; Timmerman, Dirk; Bourne, Tom; Van Calster, Ben; Gentry-Maharaj, Aleksandra; Menon, Usha; Deeks, Jon

2016-08-09

Ovarian cancer (OC) is associated with non-specific symptoms such as bloating, making accurate diagnosis challenging: only 1 in 3 women with OC presents through primary care referral. National Institute for Health and Care Excellence guidelines recommends sequential testing with CA125 and routine ultrasound in primary care. However, these diagnostic tests have limited sensitivity or specificity. Improving accurate triage in women with vague symptoms is likely to improve mortality by streamlining referral and care pathways. The Refining Ovarian Cancer Test Accuracy Scores (ROCkeTS; HTA 13/13/01) project will derive and validate new tests/risk prediction models that estimate the probability of having OC in women with symptoms. This protocol refers to the prospective study only (phase III). ROCkeTS comprises four parallel phases. The full ROCkeTS protocol can be found at http://www.birmingham.ac.uk/ROCKETS. Phase III is a prospective test accuracy study. The study will recruit 2450 patients from 15 UK sites. Recruited patients complete symptom and anxiety questionnaires, donate a serum sample and undergo ultrasound scored as per International Ovarian Tumour Analysis (IOTA) criteria. Recruitment is at rapid access clinics, emergency departments and elective clinics. Models to be evaluated include those based on ultrasound derived by the IOTA group and novel models derived from analysis of existing data sets. Estimates of sensitivity, specificity, c-statistic (area under receiver operating curve), positive predictive value and negative predictive value of diagnostic tests are evaluated and a calibration plot for models will be presented. ROCkeTS has received ethical approval from the NHS West Midlands REC (14/WM/1241) and is registered on the controlled trials website (ISRCTN17160843) and the National Institute of Health Research Cancer and Reproductive Health portfolios. 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/

No ‘cure’ within 12 years of diagnosis among breast cancer patients who are diagnosed via mammographic screening: women diagnosed in the West Midlands region of England 1989–2011

PubMed Central

Woods, L. M.; Morris, M.; Rachet, B.

2016-01-01

Background We have previously reported that there is little evidence of population ‘cure’ among two populations of women diagnosed with invasive breast cancer. ‘Cure’ has not yet been examined in the context of screen-detection. Patients and methods We examined cancer registry data on 19 800 women aged 50–70, diagnosed with a primary, invasive, non-metastatic breast cancer between 1 April 1989 and 31 March 2011 in the West Midlands region of England, linked to Hospital Episode Statistics (HES) and the National Breast Screening Service (NBSS). Follow-up was complete on all women up to 31 July 2012. Analyses were stratified by screening status, age, tumour stage, deprivation and ethnicity. We estimated net survival for the whole cohort and each subgroup. Population ‘cure’ was evaluated by fitting flexible parametric log-cumulative excess hazard regression models in which the excess hazard of breast cancer death was assumed to be equal to zero after a given follow-up time. Results There was an overall lack of evidence for ‘cure’. Across all subgroups examined, the general pattern was that of a continuous decrease in net survival over time, with no obvious asymptotic tendency within 12 years of follow-up. Model-based analyses confirmed this observation. Conclusions Despite dramatic improvements in survival over past decades, diagnosis with breast cancer remains associated with a small but persistent increased risk of death for all groups of women, including those whose cancer is detected asymptomatically. These findings are unlikely to be due to methodological inadequacies. Communication of these long-term consequences of breast cancer among women recently diagnosed and to those considering undergoing screening should take due consideration of these patterns. PMID:27573567

No 'cure' within 12 years of diagnosis among breast cancer patients who are diagnosed via mammographic screening: women diagnosed in the West Midlands region of England 1989-2011.

PubMed

Woods, L M; Morris, M; Rachet, B

2016-11-01

We have previously reported that there is little evidence of population 'cure' among two populations of women diagnosed with invasive breast cancer. 'Cure' has not yet been examined in the context of screen-detection. We examined cancer registry data on 19 800 women aged 50-70, diagnosed with a primary, invasive, non-metastatic breast cancer between 1 April 1989 and 31 March 2011 in the West Midlands region of England, linked to Hospital Episode Statistics (HES) and the National Breast Screening Service (NBSS). Follow-up was complete on all women up to 31 July 2012. Analyses were stratified by screening status, age, tumour stage, deprivation and ethnicity. We estimated net survival for the whole cohort and each subgroup. Population 'cure' was evaluated by fitting flexible parametric log-cumulative excess hazard regression models in which the excess hazard of breast cancer death was assumed to be equal to zero after a given follow-up time. There was an overall lack of evidence for 'cure'. Across all subgroups examined, the general pattern was that of a continuous decrease in net survival over time, with no obvious asymptotic tendency within 12 years of follow-up. Model-based analyses confirmed this observation. Despite dramatic improvements in survival over past decades, diagnosis with breast cancer remains associated with a small but persistent increased risk of death for all groups of women, including those whose cancer is detected asymptomatically. These findings are unlikely to be due to methodological inadequacies. Communication of these long-term consequences of breast cancer among women recently diagnosed and to those considering undergoing screening should take due consideration of these patterns. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology.

Challenges and lessons learned from implementing a risk-based approach to school advice and closure during the containment phase of the 2009 influenza pandemic in the West Midlands, England.

PubMed

Awofisayo, A; Ibbotson, S; Smith, G E; Janmohamed, K; Mohamed, H; Olowokure, B

2013-07-01

School closure as a social distancing measure was used in some countries during the initial phases of the influenza A(H1N1)pdm09 pandemic. The objective of this paper is to describe the use of a risk-based approach to public health interventions for schools during the 'containment phase' of the pandemic and to describe lessons learnt. The development of a framework for risk assessment and decision-making to determine school closures in the West Midlands, England, during the 'containment phase' of influenza A(H1N1)pdm09 pandemic is described. Using the framework developed during the 'containment phase', assessments were conducted for 344 educational institutions who reported confirmed cases or 'particularly high absenteeism'. Of these, 209 (60%) had confirmed cases and 65 were closed, mainly for public health or operational reasons. Schools were closed on an individual basis, during the most intense period of the pandemic and for an average period of six days (maximum 11 days). The risk-based approach evolved as experience and knowledge of influenza A(H1N1)pdm09 pandemic virus increased, however some decisions were difficult to communicate to parents, schools and stakeholders particularly when the number of schools affected escalated and the pandemic response phases changed. The management of school closures is an 'uncertain art'. Numerous challenges and lessons were identified in attempting, during the containment phase of the influenza A(H1N1)pdm09 pandemic, to ensure consistency and transparency in an increasingly complex process. The overall approach described could be further developed to improve decision-making for infectious diseases in schools. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The Importance of Non Struck Side Occupants in Side Collisions

PubMed Central

Frampton, R. J.; Brown, R.; Thomas, P.; Fay, P.

1998-01-01

In a representative sample of tow-away side collisions from the UK Midlands, one third of front seat occupants were alone, on the struck side of the car. The other two thirds were either a non struck side occupant alone or two occupants sitting together. Occupant restraint, especially in perpendicular side impacts, was a notable factor in determining injury outcome for belted non struck side occupants. With both front seats occupied, there was a reduction in AIS 2+ injury to belted non struck side occupants due to a reduction in chest and lower limb injuries. Struck side occupants sustained increased injury rates to the extremities when accompanied by a belted non struck side occupant but no notable increases in moderate to serious injury to the head, chest, abdomen or pelvis.

Description of trihalomethane levels in three UK water suppliers.

PubMed

Whitaker, Heather; Nieuwenhuijsen, Mark J; Best, Nicola; Fawell, John; Gowers, Alison; Elliot, Paul

2003-01-01

Samples of drinking water are routinely analysed for four trihalomethanes (THMs), which are indicators of by-products of disinfection with chlorine, by UK water suppliers to demonstrate compliance with regulations. The THM data for 1992-1993 to 1997-1998 for three water suppliers in the north and midlands of England were made available for a UK epidemiological study of the association between disinfection by-products and adverse birth outcomes. This paper describes the THM levels in these three supply regions and discusses possible sources of variation. THM levels varied between different suppliers' water, and average THM levels were within the regulatory limits. Chloroform was the predominant THM in all water types apart from the ground water of one supplier. The supplier that distributed more ground and lowland surface water had higher dibromochloromethane (DBCM) and bromoform levels and lower chloroform levels than the other two suppliers. In the water of two suppliers, seasonal fluctuations in bromodichloromethane (BDCM) and DBCM levels were found with levels peaking in the summer and autumn. In the other water supplier, chloroform levels followed a similar seasonal trend whereas BDCM and DBCM levels did not. For all three water suppliers, chloroform levels declined throughout 1995 when there was a drought period. There was a moderate positive correlation between the THMs most similar in their structure (chloroform and BDCM, BDCM and DBCM, and DBCM and bromoform) and a slight negative correlation between chloroform and bromoform levels.

Universities and Economic Development Activities: A UK Regional Comparison

ERIC Educational Resources Information Center

Decter, Moira; Cave, Frank; Rose, Mary; Peers, Gill; Fogg, Helen; Smith, Susan M.

2011-01-01

A number of UK universities prioritize economic development or regeneration activities and for some of these universities such activities are the main focus of their knowledge transfer work. This study compares two regions of the UK--the North West and the South East of England--which have very different levels of economic performance.…

Delivery of health surveillance for hand-arm vibration in the West Midlands.

PubMed

Kinoulty, Mary

2006-01-01

Concerns about provider competence and quality of hand-arm vibrations (HAVs) health surveillance programmes were identified by Health & Safety Executive (HSE) inspectors. To evaluate health surveillance programmes and compare them with published HSE guidance. To identify deficiencies and areas for improvement in the health surveillance programmes. A proforma was developed for the study and used on a sample of 10 local occupational health providers. All 10 organizations were aware of current HSE guidance for health surveillance for HAVs but only a minority (30%) were following it. Occupational health provider training, written procedures and health surveillance delivery were all identified as areas requiring improvement. The majority of organizations were not following HSE guidance. Occupational health providers undertaking health surveillance for HAV require specific training.

Dementia skills for all: a core competency framework for the workforce in the United Kingdom.

PubMed

Tsaroucha, Anna; Benbow, Susan Mary; Kingston, Paul; Le Mesurier, Nick

2013-01-01

One of the biggest challenges facing health and social care in the United Kingdom is the projected increase in the number of older people who require dementia care. The National Dementia Strategy (Department of Health, 2009) emphasizes the critical need for a skilled workforce in all aspects of dementia care. In the West Midlands, the Strategic Health Authority commissioned a project to develop a set of generic core competencies that would guide a competency based curriculum to meet the demands for improved dementia training and education. A systematic literature search was conducted to identify relevant frameworks to assist with this work. The core competency framework produced and the methods used for the development of the framework are presented and discussed.

Automated electronic reminders to facilitate primary cardiovascular disease prevention: randomised controlled trial

PubMed Central

Holt, Tim A; Thorogood, Margaret; Griffiths, Frances; Munday, Stephen; Friede, Tim; Stables, David

2010-01-01

Background Primary care databases contain cardiovascular disease risk factor data, but practical tools are required to improve identification of at-risk patients. Aim To test the effects of a system of electronic reminders (the ‘e-Nudge’) on cardiovascular events and the adequacy of data for cardiovascular risk estimation. Design of study Randomised controlled trial. Setting Nineteen general practices in the West Midlands, UK. Method The e-Nudge identifies four groups of patients aged over 50 years on the basis of estimated cardiovascular risk and adequacy of risk factor data in general practice computers. Screen messages highlight individuals at raised risk and prompt users to complete risk profiles where necessary. The proportion of the study population in the four groups was measured, as well as the rate of cardiovascular events in each arm after 2 years. Results Over 38 000 patients' electronic records were randomised. The intervention led to an increase in the proportion of patients with sufficient data who were identifiably at risk, with a difference of 1.94% compared to the control group (95% confidence interval [CI] = 1.38 to 2.50, P<0.001). A corresponding reduction occurred in the proportion potentially at risk but requiring further data for a risk estimation (difference = –3.68%, 95% CI = –4.53 to –2.84, P<0.001). No significant difference was observed in the incidence of cardiovascular events (rate ratio = 0.96, 95% CI = 0.85 to 1.10, P = 0.59). Conclusion Automated electronic reminders using routinely collected primary care data can improve the adequacy of cardiovascular risk factor information during everyday practice and increase the visibility of the at-risk population. PMID:20353659

Increasing physical activity levels in primary school physical education: The SHARP Principles Model.

PubMed

Powell, Emma; Woodfield, Lorayne A; Nevill, Alan M

2016-06-01

To evaluate the effectiveness of a one-year teaching intervention to increase moderate to vigorous physical activity (MVPA) during primary school physical education (PE). A quasi-experimental, non-equivalent group design involving four classes from two primary schools in the West Midlands, UK. In March 2014 schools were selected through purposive sampling to match schools in terms of size and demographics (baseline, n = 111: post-intervention, n = 95); data were collected from children in school years 3 and 4 (aged 7 to 9 years). The intervention involved developing teacher effectiveness through the SHARP Principles Model which was grounded in the Self Determination Theory (SDT), the Social Ecological Model (SEM) and three key ingredients from the Behaviour Change Taxonomy (BCT). MVPA was assessed at baseline and four weeks post-intervention using the System for Observing Fitness and Instruction Time (SOFIT). Four individual teacher interviews were conducted with the intervention school, to explore teachers' perceptions of the intervention. A two-way ANOVA (Analysis of Variance) indicated large interaction effect sizes for time spent in MVPA (F(1, 27) = 11.07, p = 0.003, ηp (2) = .316) and vigorous activity (VPA) (F = (1,27) = 8.557, p = .007, ηp (2) = .263). PA in the intervention school increased significantly whereas in the control school MVPA remained relatively constant and VPA decreased. The qualitative findings revealed two main emergent themes: a paradigm shift and teacher's developing pedagogy. The intervention was effective in increasing MVPA in PE. Recommendations based on this evaluation would be for the SHARP Principles Model to be replicated and evaluated on a wider scale across a variety of contexts.

Increasing physical activity levels in primary school physical education: The SHARP Principles Model

PubMed Central

Powell, Emma; Woodfield, Lorayne A.; Nevill, Alan M.

2015-01-01

Objectives: To evaluate the effectiveness of a one-year teaching intervention to increase moderate to vigorous physical activity (MVPA) during primary school physical education (PE). Methods: A quasi-experimental, non-equivalent group design involving four classes from two primary schools in the West Midlands, UK. In March 2014 schools were selected through purposive sampling to match schools in terms of size and demographics (baseline, n = 111: post-intervention, n = 95); data were collected from children in school years 3 and 4 (aged 7 to 9 years). The intervention involved developing teacher effectiveness through the SHARP Principles Model which was grounded in the Self Determination Theory (SDT), the Social Ecological Model (SEM) and three key ingredients from the Behaviour Change Taxonomy (BCT). MVPA was assessed at baseline and four weeks post-intervention using the System for Observing Fitness and Instruction Time (SOFIT). Four individual teacher interviews were conducted with the intervention school, to explore teachers' perceptions of the intervention. Results: A two-way ANOVA (Analysis of Variance) indicated large interaction effect sizes for time spent in MVPA (F(1, 27) = 11.07, p = 0.003, ηp2 = .316) and vigorous activity (VPA) (F = (1,27) = 8.557, p = .007, ηp2 = .263). PA in the intervention school increased significantly whereas in the control school MVPA remained relatively constant and VPA decreased. The qualitative findings revealed two main emergent themes: a paradigm shift and teacher's developing pedagogy. Conclusions: The intervention was effective in increasing MVPA in PE. Recommendations based on this evaluation would be for the SHARP Principles Model to be replicated and evaluated on a wider scale across a variety of contexts. PMID:26844179

Portage in the UK: recent developments.

PubMed

Russell, F

2007-11-01

Portage provides home-based, early intervention and support to families who have a young child with additional needs. Working in the context of the Every Child Matters agenda, the National Portage Association (NPA) aims to develop inclusive, high-quality provision. This paper reviews their recent work, presents a summary of the findings of a national survey of Portage and discusses their implications. All Portage services known to the NPA and local authorities in England were asked to complete a questionnaire and forward another to families using early years' services to evaluate the support they receive. The survey identified the extent and gaps in Portage provision and the level of unmet need. Families who contributed said they valued Portage because it helped their child and provided support for the whole family. DISCUSSION OF FINDINGS: The survey identified 31 local authorities in England, where Portage is not available. Geographical gaps were most notable in the North East and West Midlands regions. Despite a small increase in the extent of Portage provision, it is estimated that services only meet the needs of a small proportion of families that are eligible. Current work may help overcome geographical gaps through supporting the development of high-quality Portage services but, in endeavouring to meet the needs of families waiting for Portage, it is important not to diminish the quality of support already provided. Portage aims to provide flexible support for families to respond to their individual needs. Evaluating its effectiveness is problematic because of its complex nature but this survey provided an opportunity for families to share their views at a national level. Continued development work can help Portage provision become more accessible and one of the options routinely available to families who have a young child with additional needs.

Reactive transport modeling of processes controlling the distribution and natural attenuation of phenolic compounds in a deep sandstone aquifer

NASA Astrophysics Data System (ADS)

Mayer, K. U.; Benner, S. G.; Frind, E. O.; Thornton, S. F.; Lerner, D. N.

2001-12-01

Reactive solute transport modeling was utilized to evaluate the potential for natural attenuation of a contaminant plume containing phenolic compounds at a chemical producer in the West Midlands, UK. The reactive transport simulations consider microbially mediated biodegradation of the phenolic compounds (phenols, cresols, and xylenols) by multiple electron acceptors. Inorganic reactions including hydrolysis, aqueous complexation, dissolution of primary minerals, formation of secondary mineral phases, and ion exchange are considered. One-dimensional (1D) and three-dimensional (3D) simulations were conducted. Mass balance calculations indicate that biodegradation in the saturated zone has degraded approximately 1-5% of the organic contaminant plume over a time period of 47 years. Simulations indicate that denitrification is the most significant degradation process, accounting for approximately 50% of the organic contaminant removal, followed by sulfate reduction and fermentation reactions, each contributing 15-20%. Aerobic respiration accounts for less than 10% of the observed contaminant removal in the saturated zone. Although concentrations of Fe(III) and Mn(IV) mineral phases are high in the aquifer sediment, reductive dissolution is limited, producing only 5% of the observed mass loss. Mass balance calculations suggest that no more than 20-25% of the observed total inorganic carbon (TIC) was generated from biodegradation reactions in the saturated zone. Simulations indicate that aerobic biodegradation in the unsaturated zone, before the contaminant entered the aquifer, may have produced the majority of the TIC observed in the plume. Because long-term degradation is limited to processes within the saturated zone, use of observed TIC concentrations to predict the future natural attenuation may overestimate contaminant degradation by a factor of 4-5.

Effects of the Diabetes Manual 1:1 structured education in primary care.

PubMed

Sturt, J A; Whitlock, S; Fox, C; Hearnshaw, H; Farmer, A J; Wakelin, M; Eldridge, S; Griffiths, F; Dale, J

2008-06-01

To determine the effects of the Diabetes Manual on glycaemic control, diabetes-related distress and confidence to self-care of patients with Type 2 diabetes. A cluster randomized, controlled trial of an intervention group vs. a 6-month delayed-intervention control group with a nested qualitative study. Participants were 48 urban general practices in the West Midlands, UK, with high population deprivation levels and 245 adults with Type 2 diabetes with a mean age of 62 years recruited pre-randomization. The Diabetes Manual is 1:1 structured education designed for delivery by practice nurses. Measured outcomes were HbA(1c), cardiovascular risk factors, diabetes-related distress measured by the Problem Areas in Diabetes Scale and confidence to self-care measured by the Diabetes Management Self-Efficacy Scale. Outcomes were assessed at baseline and 26 weeks. There was no significant difference in HbA(1c) between the intervention group and the control group [difference -0.08%, 95% confidence interval (CI) -0.28, 0.11]. Diabetes-related distress scores were lower in the intervention group compared with the control group (difference -4.5, 95% CI -8.1, -1.0). Confidence to self-care Scores were 11.2 points higher (95% CI 4.4, 18.0) in the intervention group compared with the control group. The patient response rate was 18.5%. In this population, the Diabetes Manual achieved a small improvement in patient diabetes-related distress and confidence to self-care over 26 weeks, without a change in glycaemic control. Further study is needed to optimize the intervention and characterize those for whom it is more clinically and psychologically effective to support its use in primary care.

Presidential Green Chemistry Challenge: 2005 Greener Synthetic Pathways Award (Archer Daniels Midland Company/Novozymes)

EPA Pesticide Factsheets

Presidential Green Chemistry Challenge 2005 award winners, Archer Daniels Midland (ADM) and Novozymes, developed an enzymatic interesterification process to make edible fats and oils containing low trans fatty acids and oils.

Spatial variations in the incidence of breast cancer and potential risks associated with soil dioxin contamination in Midland, Saginaw, and Bay Counties, Michigan, USA

PubMed Central

Dai, Dajun; Oyana, Tonny J

2008-01-01

Background High levels of dioxins in soil and higher-than-average body burdens of dioxins in local residents have been found in the city of Midland and the Tittabawassee River floodplain in Michigan. The objective of this study is threefold: (1) to evaluate dioxin levels in soils; (2) to evaluate the spatial variations in breast cancer incidence in Midland, Saginaw, and Bay Counties in Michigan; (3) to evaluate whether breast cancer rates are spatially associated with the dioxin contamination areas. Methods We acquired 532 published soil dioxin data samples collected from 1995 to 2003 and data pertaining to female breast cancer cases (n = 4,604) at ZIP code level in Midland, Saginaw, and Bay Counties for years 1985 through 2002. Descriptive statistics and self-organizing map algorithm were used to evaluate dioxin levels in soils. Geographic information systems techniques, the Kulldorff's spatial and space-time scan statistics, and genetic algorithms were used to explore the variation in the incidence of breast cancer in space and space-time. Odds ratio and their corresponding 95% confidence intervals, with adjustment for age, were used to investigate a spatial association between breast cancer incidence and soil dioxin contamination. Results High levels of dioxin in soils were observed in the city of Midland and the Tittabawassee River 100-year floodplain. After adjusting for age, we observed high breast cancer incidence rates and detected the presence of spatial clusters in the city of Midland, the confluence area of the Tittabawassee, and Saginaw Rivers. After accounting for spatiotemporal variations, we observed a spatial cluster of breast cancer incidence in Midland between 1985 and 1993. The odds ratio further suggests a statistically significant (α = 0.05) increased breast cancer rate as women get older, and a higher disease burden in Midland and the surrounding areas in close proximity to the dioxin contaminated areas. Conclusion These findings suggest that increased breast cancer incidences are spatially associated with soil dioxin contamination. Aging is a substantial factor in the development of breast cancer. Findings can be used for heightened surveillance and education, as well as formulating new study hypotheses for further research. PMID:18939976

Sedimentology and genetic stratigraphy of Dean and Spraberry Formations (Permian), Midland basin, Texas

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

Handford, C.R.

1981-09-01

The Spraberry trend of west Texas, once known as the world's largest uneconomic oil field, will undoubtedly become an increasingly important objective for the development of enhanced oil recovery techniques in fine-grained, low-permeability, low-pressure reservoirs. As the trend expands, facies and stratigraphic data should be integrated into exploration strategies. The Spraberry and Dean Formations may be divided into three genetic sequences, each consisting of several hundred feet of interbedded shale and carbonate overlain by a roughly equal amount of sandstone and siltstone. These sequences record episodes of shelf-margin progradation, deep-water resedimentation of shelf-derived carbonate debris, followed by influxes of terrigenousmore » clastics into the basin by way of feeder channels or submarine canyons, and suspension settling of fine-grained sediment from the water column. Four lithofacies comprise the terrigenous clastics of the Spraberry and Dean Fomations: (1) cross-laminated, massive, and parallel-laminated sandstone, (2) laminated siltstone, (3) bioturbated siltstone, and (4) black, organic-rich shale. Carbonate lithofacies occur mostly in the form of thin-bedded turbidites, slump, and debris-flow deposits. Terrigenous clastic rocks display facies sequences, isopach patterns, and sedimentary structures suggestive of deposition from turbidity currents, and long-lived saline density underflow and interflow currents. Clastic isopach patterns reflect an overall southward thinning of clastics in the Midland basin. Channelized flow and suspension settling were responsible for the formation of elongate fan-shaped accumulations of clastic sediments.« less

High School Science Technology Additions, Midland Public Schools.

ERIC Educational Resources Information Center

Design Cost Data, 2001

2001-01-01

Discusses design goals, space requirements, and need for mobile furniture and "imagination stations" at Michigan's Midland Public High School science technology addition. Describes the architectural design, costs, and specifications. Includes floor plans, general description, photos and a list of consultants, manufacturers, and suppliers…

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

PubMed

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

2016-11-16

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

Smartcards in Libraries: A Brave New World.

ERIC Educational Resources Information Center

Myhill, Martin

1998-01-01

Describes the University of Exeter (UK), Mondex, and NatWest UK smartcard-based campus card system project. Smartcards, wallet-sized plastic cards with microprocessors, interface with network terminal devices and are programmable as data, identity, and finance cards. International standard multiple operating system (MULTOS) increases current…

UK-based prospective cohort study to anglicise and validate the FACE-Q Skin Cancer Module in patients with facial skin cancer undergoing surgical reconstruction: the PROMISCR (Patient-Reported Outcome Measure in Skin Cancer Reconstruction) study.

PubMed

Dobbs, Thomas; Hutchings, Hayley A; Whitaker, Iain S

2017-09-24

Skin cancer is the most common malignancy worldwide, often occurring on the face, where the cosmetic outcome of treatment is paramount. A number of skin cancer-specific patient-reported outcome measures (PROMs) exist, however none adequately consider the difference in type of reconstruction from a patient's point of view. It is the aim of this study to 'anglicise' (to UK English) a recently developed US PROM for facial skin cancer (the FACE-Q Skin Cancer Module) and to validate this UK version of the PROM. The validation will also involve an assessment of the items for relevance to facial reconstruction patients. This will either validate this new measure for the use in clinical care and research of various facial reconstructive options, or provide evidence that a more specific PROM is required. This is a prospective validation study of the FACE-Q Skin Cancer Module in a UK facial skin cancer population with a specific focus on the difference between types of reconstruction. The face and content validity of the FACE-Q questionnaire will initially be assessed by a review process involving patients, skin cancer specialists and methodologists. An assessment of whether questions are relevant and any missing questions will be made. Initial validation will then be carried out by recruiting a cohort of 100 study participants with skin cancer of the face pre-operatively. All eligible patients will be invited to complete the questionnaire preoperatively and postoperatively. Psychometric analysis will be performed to test validity, reliability and responsiveness to change. Subgroup analysis will be performed on patients undergoing different forms of reconstruction postexcision of their skin cancer. This study has been approved by the West Midlands, Edgbaston Research Ethics Committee (Ref 16/WM/0445). All personal data collected will be anonymised and patient-specific data will only be reported in terms of group demographics. Identifiable data collected will include the patient name and date of birth. Other collected personal data will include their diagnosis, treatment performed, method of reconstruction and complications. A unique identifier will be applied to each patient so that pretreatment and post-treatment questionnaire results can be compared. All data acquisition and storage will be in accordance with the Data Protection Act 1998. Following completion of the study, all records will be stored in the Abertawe Bro Morgannwg University (AMBU) Health Board archive facility. Only qualified personnel working on the project will have access to the data.The outputs from this work will be published as widely as possible in peer-review journals and it is our aim to make this open access. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Ebola epidemic and public health response.

PubMed

Moll, R; Reece, S; Cosford, P; Kessel, A

2016-03-01

An unprecedented global effort has been required to tackle the Ebola outbreak in West Africa. In this paper, we describe the contribution of Public Health England (PHE) in West Africa and the UK. Public Health England The epidemic has been a humanitarian crisis for the three worst affected countries. PHE contributions have included expertise in outbreak control and microbiology services in West Africa, and UK preparedness for an imported case. National and international systems require change to enhance the response to the next international public health crisis. Legacy planning following the epidemic will be crucial, supporting the recovery of the health and public health systems in West Africa and ensuring that the knowledge gained during this outbreak is put to best use. Ongoing PHE-associated research includes efforts to understand the pathogenicity of Ebola virus disease, improve diagnostic capability, explore therapeutic options and develop new vaccines. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Taking hospital treatments home: a mixed methods case study looking at the barriers and success factors for home dialysis treatment and the influence of a target on uptake rates.

PubMed

Combes, Gill; Allen, Kerry; Sein, Kim; Girling, Alan; Lilford, Richard

2015-10-27

Despite healthcare policies and evidence which promote home dialysis, uptake rates have been falling for over 10 years in England. A target introduced by commissioners in the West Midlands provided a unique opportunity to study how hospitals can increase home-based treatment for a group of patients with complex life-threatening conditions. Quantitative changes in home treatment uptake rates in seven hospitals in the West Midlands were compared with the rest of England for 3 years pre and post the introduction of the target in 2010, using a logistic regression model. Qualitative interviews in four hospitals with 96 clinical and managerial staff and 93 dialysis patients explored the barriers and facilitators to increasing the uptake of home treatment and the impact of the target. Home treatment uptake rates increased significantly in the seven study hospitals compared with the 3 years prior to the introduction of the target and compared with the rest of England where rates remained static. The four main factors facilitating increased uptake were as follows: the commissioner's target, linked to financial penalties; additional funding for specialist staff and equipment; committed, visible clinical champions and good systems for patient training and ongoing healthcare support at home. The three main barriers were as follows: lack of training for non-specialist staff, poorly developed patient education and considerable unrecognised and unmet emotional and psychological patient needs. This study shows the impact of using targets with financial penalties to achieve change and how hospitals can increase significantly the uptake of home-based self-care for a group of patients with complex medical needs. It provides useful pointers to the main barriers and facilitators, which are likely to be relevant to other groups of patients who could be treated at home. It also highlights two neglected areas which need to improve if patients with life-threatening long-term conditions are to be encouraged to take up home treatment: individualised patient education which allows exploration of the impacts of treatment options and the provision of ongoing emotional support.

Space Radar Image of West Texas - SAR Scan

NASA Image and Video Library

1999-04-15

This radar image of the Midland/Odessa region of West Texas, demonstrates an experimental technique, called ScanSAR, that allows scientists to rapidly image large areas of the Earth's surface. The large image covers an area 245 kilometers by 225 kilometers (152 miles by 139 miles). It was obtained by the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) flying aboard the space shuttle Endeavour on October 5, 1994. The smaller inset image is a standard SIR-C image showing a portion of the same area, 100 kilometers by 57 kilometers (62 miles by 35 miles) and was taken during the first flight of SIR-C on April 14, 1994. The bright spots on the right side of the image are the cities of Odessa (left) and Midland (right), Texas. The Pecos River runs from the top center to the bottom center of the image. Along the left side of the image are, from top to bottom, parts of the Guadalupe, Davis and Santiago Mountains. North is toward the upper right. Unlike conventional radar imaging, in which a radar continuously illuminates a single ground swath as the space shuttle passes over the terrain, a Scansar radar illuminates several adjacent ground swaths almost simultaneously, by "scanning" the radar beam across a large area in a rapid sequence. The adjacent swaths, typically about 50 km (31 miles) wide, are then merged during ground processing to produce a single large scene. Illumination for this L-band scene is from the top of the image. The beams were scanned from the top of the scene to the bottom, as the shuttle flew from left to right. This scene was acquired in about 30 seconds. A normal SIR-C image is acquired in about 13 seconds. The ScanSAR mode will likely be used on future radar sensors to construct regional and possibly global radar images and topographic maps. The ScanSAR processor is being designed for 1996 implementation at NASA's Alaska SAR Facility, located at the University of Alaska Fairbanks, and will produce digital images from the forthcoming Canadian RADARSAT satellite. http://photojournal.jpl.nasa.gov/catalog/PIA01787

Vitrinite reflectance data for the Permian Basin, west Texas and southeast New Mexico

USGS Publications Warehouse

Pawlewicz, Mark; Barker, Charles E.; McDonald, Sargent

2005-01-01

This report presents a compilation of vitrinite reflectance (Ro) data based on analyses of samples of drill cuttings collected from 74 boreholes spread throughout the Permian Basin of west Texas and southeast New Mexico (fig. 1). The resulting data consist of 3 to 24 individual Ro analyses representing progressively deeper stratigraphic units in each of the boreholes (table 1). The samples, Cambrian-Ordovician to Cretaceous in age, were collected at depths ranging from 200 ft to more than 22,100 ft.The R0 data were plotted on maps that depict three different maturation levels for organic matter in the sedimentary rocks of the Permian Basin (figs. 2-4). These maps show depths at the various borehole locations where the R0 values were calculated to be 0.6 (fig. 2), 1.3 (fig. 3), and 2.0 (fig. 4) percent, which correspond, generally, to the onset of oil generation, the onset of oil cracking, and the limit of oil preservation, respectively.The four major geologic structural features within the Permian Basin–Midland Basin, Delaware Basin, Central Basin Platform, and Northwest Shelf (fig. 1) differ in overall depth, thermal history and tectonic style. In the western Delaware Basin, for example, higher maturation is observed at relatively shallow depths, resulting from uplift and eastward basin tilting that began in the Mississippian and ultimately exposed older, thermally mature rocks. Maturity was further enhanced in this basin by the emplacement of early and mid-Tertiary intrusives. Volcanic activity also appears to have been a controlling factor for maturation of organic matter in the southern part of the otherwise tectonically stable Northwest Shelf (Barker and Pawlewicz, 1987). Depths to the three different Ro values are greatest in the eastern Delaware Basin and southern Midland Basin. This appears to be a function of tectonic activity related to the Marathon-Ouachita orogeny, during the Late-Middle Pennsylvanian, whose affects were widespread across the Permian Basin. The Central Basin Platform has been a positive feature since the mid to-late Paleozoic, during which time sedimentation occurred along its flanks. This nonsubsidence, along with the lack of supplemental heating (volcanism), implies lower maturation levels.

Randomised controlled pilot study to assess the feasibility of a Mediterranean Portfolio dietary intervention for cardiovascular risk reduction in HIV dyslipidaemia: a study protocol.

PubMed

Stradling, Clare; Thomas, G Neil; Hemming, Karla; Frost, Gary; Garcia-Perez, Isabel; Redwood, Sabi; Taheri, Shahrad

2016-02-08

HIV drug treatment has greatly improved life expectancy, but increased risk of cardiovascular disease remains, potentially due to the additional burdens of infection, inflammation and antiretroviral treatment. The Mediterranean Diet has been shown to reduce cardiovascular risk and mortality in the general population, but no evidence exists for this effect in the HIV population. This study will explore the feasibility of a randomised controlled trial (RCT) to examine whether a Mediterranean-style diet that incorporates a portfolio of cholesterol-lowering foods, reduces cardiovascular risk in people with HIV dyslipidaemia. 60 adults with stable HIV infection on antiretroviral treatment and low-density lipoprotein cholesterol >3 mmol/L will be recruited from 3 West Midlands HIV services. Participants will be randomised 1:1 to 1 of 2 dietary interventions, with stratification by gender and smoking status. Participants allocated to Diet1 will receive advice to reduce saturated fat intake, and those to Diet2 on how to adopt the Mediterranean Portfolio Diet with additional cholesterol-lowering foods (nuts, stanols, soya, oats, pulses). Measurements of fasting blood lipids, body composition and arterial stiffness will be conducted at baseline, and month 6 and 12 of the intervention. Food intake will be assessed using the Mediterranean Diet Score, 3-day food diaries and metabolomic biomarkers. Questionnaires will be used to assess quality of life and process evaluation. Qualitative interviews will explore barriers and facilitators to making dietary changes, and participant views on the intervention. Qualitative data will be analysed using the Framework Method. Feasibility will be assessed in terms of trial recruitment, retention, compliance to study visits and the intervention. SD of outcomes will inform the power calculation of the definitive RCT. The West Midlands Ethics Committee has approved this study and informed consent forms. This trial is the first to test cholesterol-lowering foods in adults with HIV. ISRCTN32090191; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Promoting Community Language Learning in the United Kingdom

ERIC Educational Resources Information Center

Handley, Sharon

2011-01-01

The COLT (Community and Lesser Taught Languages) project is a consortium of five UK universities, working with various other regional organisations to set up replicable projects and structures to promote languages in North West England. It received funding under the UK's national "Routes into Languages" initiative. One objective was to…

Cross cultural evaluation of the Warwick-Edinburgh mental well-being scale (WEMWBS) -a mixed methods study

PubMed Central

2013-01-01

Background We aimed to validate the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) among English speaking adults representing two of the minority ethnic groups living in the UK, self-identified as Chinese or Pakistani by background, in a mixed methods study. Methods Quantitative data were collected in two cities in the West Midlands, UK. Item response, dimensionality, internal consistency, and construct validity of the WEMWBS were assessed in Chinese and Pakistani groups separately, using data from both cities combined. Qualitative data were collected in the first city in eight focus groups of different ages recruited by the community workers. Three mixed sex Chinese and five single sex Pakistani groups discussed ease of completion and comprehension of items, together with overall reactions to the scale and underlying concept. Results of quantitative and qualitative analysis were examined for commonalities and differences. Results Item completion and item total correlations were satisfactory in both groups. In the Chinese data, Exploratory Factor Analysis showed a single factor with loadings ranging from 0.60 to 0.82 for all 14 items. In the Pakistani data, three factors reached statistical significance; however, a substantial drop in eigenvalues between the first and second factors and the limited variance explained by the second and third factors supported a one-factor model. All items loaded on this factor from 0.51 to 0.83. In the Chinese and Pakistani data respectively, Cronbach’s alpha was 0.92 (0.89 – 0.94) and 0.91 (0.88 – 0.94); Spearman’s correlation with GHQ-12 was - 0.63 (−0.73 to −0.49) and −0.55 (−0.70 to −0.36), and with the WHO-5 0.62 (0.46-0.75) and 0.64 (0.50 to 0.76). Qualitative analysis revealed good comprehension and ease of completion of almost all items. Some culturally determined differences in understanding of mental well-being, which varied both between and within communities, emerged. Conclusions The WEMWBS was well received by members of both Pakistani and Chinese communities. It showed high levels of consistency and reliability compared with accepted criteria. Data were sufficiently strong to recommend the WEMWBS for use in general population surveys. PMID:23445544

Real time monitoring of urban surface water quality using a submersible, tryptophan-like fluorescence sensor

NASA Astrophysics Data System (ADS)

Khamis, Kieran; Bradley, Chris; Hannah, David; Stevens, Rob

2014-05-01

Due to the recent development of field-deployable optical sensor technology, continuous quantification and characterization of surface water dissolved organic matter (DOM) is possible now. Tryptophan-like (T1) fluorescence has the potential to be a particularly useful indicator of human influence on water quality as T1 peaks are associated with the input of labial organic carbon (e.g. sewage or farm waste) and its microbial breakdown. Hence, real-time recording of T1 fluorescence could be particular useful for monitoring waste water infrastructure, treatment efficiency and the identification of contamination events at higher temporal resolution than available hitherto. However, an understanding of sensor measurement repeatability/transferability and interaction with environmental parameters (e.g. turbidity) is required. Here, to address this practical knowledge gap, we present results from a rigorous test of a commercially available submersible tryptophan fluorometer (λex 285, λem 350). Sensor performance was first examined in the laboratory by incrementally increasing turbidity under controlled conditions. Further to this the sensor was integrated into a multi-parameter sonde and field tests were undertaken involving: (i) a spatial sampling campaign across a range of surface water sites in the West Midlands, UK; and (ii) collection of high resolution (sub-hourly) samples from an urban stream (Bournbrook, Birmingham, U.K). To determine the ability of the sensor to capture spatiotemporal dynamics of urban waters DOM was characterized for each site or discrete time step using Excitation Emission Matrix spectroscopy and PARAFAC. In both field and laboratory settings fluorescence intensity was attenuated at high turbidity due to suspended particles increasing absorption and light scattering. For the spatial survey, instrument readings were compared to those obtained by a laboratory grade fluorometer (Varian Cary Eclipse) and a strong, linear relationship was apparent (R2 > 0.7). Parallel water sampling and laboratory analysis identified the potential for correction of T1 fluorescence intensity based on turbidity readings. These findings highlight the potential utility of real time monitoring of T1 fluorescence for a range of environmental applications (e.g. monitoring sewage treatment processes and tracing polluting DOM sources). However, if high/variable suspended sediment loads are anticipated concurrent monitoring of turbidity is required for accurate readings.

76 FR 34805 - Arkansas Midland Railroad Company, Inc., Trackage Rights Exemption; Caddo Valley Railroad Company

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-14

... Railroad Company, Inc., Trackage Rights Exemption; Caddo Valley Railroad Company Pursuant to a written trackage rights agreement, Caddo Valley Railroad Company (CVR) has agreed to grant local trackage rights to Arkansas Midland Railroad Company, Inc. (AKMD) over approximately 2.57 miles of CVR's rail line, known as...

75 FR 71487 - Norfolk Southern Railway Company-Abandonment Exemption-in Crawford County, GA; Georgia Midland...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-23

... 1059X] Norfolk Southern Railway Company--Abandonment Exemption--in Crawford County, GA; Georgia Midland Railroad, Inc.\\1\\--Discontinuance of Service Exemption--in Crawford County, GA \\1\\ Based on information in a letter from one of NSR's attorneys, this is the correct name of the discontinuing railroad-- not...

76 FR 19304 - Endangered and Threatened Wildlife and Plants; Endangered Status for Dunes Sagebrush Lizard

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-07

....m., on each of the following dates: 1. April 27, 2011: Midland, Texas. 2. April 28, 2011: Roswell... N. Main Street, Midland, Texas 79701. 2. Roswell, New Mexico: ENMU--Roswell, Performing Arts Center, 64 University Blvd., Roswell, New Mexico 88202. People needing reasonable accommodations in order to...

Dioxin in Midland: A Case Study of Press Coverage of Expert Disagreement.

ERIC Educational Resources Information Center

Palen, John

Drawing from articles appearing in several national publications about the dioxin contamination found in Midland, Michigan, in l983, a case study examined how the publications handled the phenomenon of expert disagreement concerning the nature of dioxin. Specifically, it examined how the publications handled expert disagreement about (1) the way…

75 FR 47677 - CSX Transportation, Inc.-Corporate Family Merger Exemption-Gainesville Midland Railroad Company

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-06

..., Inc.--Corporate Family Merger Exemption-- Gainesville Midland Railroad Company CSX Transportation, Inc... under 49 CFR 1180.2(d)(3) for a corporate family transaction. CSXT is a Class I rail carrier that... corporate structure and reduce overhead costs and duplication by eliminating one corporation while retaining...

Assessment of undiscovered oil and gas resources in the Spraberry Formation of the Midland Basin, Permian Basin Province, Texas, 2017

USGS Publications Warehouse

Marra, Kristen R.; Gaswirth, Stephanie B.; Schenk, Christopher J.; Leathers-Miller, Heidi M.; Klett, Timothy R.; Mercier, Tracey J.; Le, Phuong A.; Tennyson, Marilyn E.; Finn, Thomas M.; Hawkins, Sarah J.; Brownfield, Michael E.

2017-05-15

Using a geology-based assessment methodology, the U.S. Geological Survey estimated mean resources of 4.2 billion barrels of oil and 3.1 trillion cubic feet of gas in the Spraberry Formation of the Midland Basin, Permian Basin Province, Texas.

Living and Learning as an International Postgraduate Student at a Midlands University

ERIC Educational Resources Information Center

Busher, Hugh; Lewis, Gareth; Comber, Chris

2016-01-01

This paper investigates the views of 20 full-time international postgraduate students, many of whom were Chinese, on living, learning and becoming successful students at one university in a multicultural city in the Midlands of England. The qualitative study built on findings from the International Students' Barometer (ISB) survey for the…

77 FR 26603 - Central Midland Railway Company and Progressive Rail Inc.-Intra-Corporate Family Transaction...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-04

... Railway Company and Progressive Rail Inc.--Intra- Corporate Family Transaction Exemption Central Midland... verified notice of exemption under 49 CFR 1180.2(d)(3) and 1180.2(d)(6) for an intra-corporate family...). \\2\\ See Progressive Rail Inc.--Intra-Corporate Family Transaction Exemption--Airlake Terminal Ry., FD...

Comparative Labor Market Policies of Japan, West Germany, United Kingdom, France, Australia. Conference Proceedings of the National Council on Employment Policy (Washington, DC, April 25, 1985).

ERIC Educational Resources Information Center

Rosen, Howard, Ed.

These five papers underscore the fact that the labor market policies of Japan, West Germany, the United Kingdom, France, and Australia are similar in many ways. The papers are "Japanese Labor Market Policies" (Koji Taira), "The Labor Market Policies of West Germany" (Deborah R. Cichon), "The Management of the U.K. Labour…

20 years of local ecological public health: the experience of Sandwell in the English West Midlands.

PubMed

Middleton, J; Saunders, P

2015-10-01

A long-term picture of the economy and living conditions of Sandwell, an area of England's industrial Midlands, is presented to explore how these underpin and influence its 'health economy'. Sandwell's experience illustrates how public health actors have to tackle industrial and other factors which shape human health. The paper explores how the ecological public health perspective has helped inform the modern public health task in an area such as Sandwell. Some lessons are offered, including: the need to understand the specific economic legacy of a local area (in Sandwell, principally one of polluting and then declining manufacturing industries); the continuing story of infection control; the complexity of tackling poor diet; and the importance of the built environment and town planning. Faced by such challenges, local public health action represents, in effect, an attempt to transcend unecological public health. This can be exciting, innovative and ultimately successful; but it also means being prepared to face daunting and politically charged obstacles and superior national or international forces over which local public health practitioners conventionally have little leverage. The paper argues that, in such unequal power circumstances, public health practitioners have to draw on the creativity within the local population and build a facilitative alliance of formal and informal pro-public health actors. Despite the confounding odds and ever-present stretched resources, the Sandwell experience gives grounds for optimism, being a story of constant creativity and effective local alliances. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Evaluation of high intensity precipitation from 16 Regional climate models over a meso-scale catchment in the Midlands Regions of England

NASA Astrophysics Data System (ADS)

Wetterhall, F.; He, Y.; Cloke, H.; Pappenberger, F.; Freer, J.; Wilson, M.; McGregor, G.

2009-04-01

Local flooding events are often triggered by high-intensity rain-fall events, and it is important that these can be correctly modelled by Regional Climate Models (RCMs) if the results are to be used in climate impact assessment. In this study, daily precipitation from 16 RCMs was compared with observations over a meso-scale catchment in the Midlands Region of England. The RCM data was provided from the European research project ENSEMBLES and the precipitation data from the UK MetOffice. The RCMs were all driven by reanalysis data from the ERA40 dataset over the time period 1961-2000. The ENSEMBLES data is on the spatial scale of 25 x 25 km and it was disaggregated onto a 5 x 5 km grid over the catchment and compared with interpolated observational data with the same resolution. The mean precipitation was generally underestimated by the ENSEMBLES data, and the maximum and persistence of high intensity rainfall was even more underestimated. The inter-annual variability was not fully captured by the RCMs, and there was a systematic underestimation of precipitation during the autumn months. The spatial pattern in the modelled precipitation data was too smooth in comparison with the observed data, especially in the high altitudes in the western part of the catchment where the high precipitation usually occurs. The RCM outputs cannot reproduce the current high intensity precipitation events that are needed to sufficiently model extreme flood events. The results point out the discrepancy between climate model output and the high intensity precipitation input needs for hydrological impact modelling.

Assessment of undiscovered continuous oil resources in the Wolfcamp shale of the Midland Basin, Permian Basin Province, Texas, 2016

USGS Publications Warehouse

Gaswirth, Stephanie B.; Marra, Kristen R.; Lillis, Paul G.; Mercier, Tracey J.; Leathers-Miller, Heidi M.; Schenk, Christopher J.; Klett, Timothy R.; Le, Phuong A.; Tennyson, Marilyn E.; Hawkins, Sarah J.; Brownfield, Michael E.; Pitman, Janet K.; Finn, Thomas M.

2016-11-15

Using a geology-based assessment methodology, the U.S. Geological Survey assessed technically recoverable mean resources of 20 billion barrels of oil and 16 trillion cubic feet of gas in the Wolfcamp shale in the Midland Basin part of the Permian Basin Province, Texas.

Master Plan for Educational Facilities: Midland Park, Bergen County, New Jersey.

ERIC Educational Resources Information Center

Engelhardt and Engelhardt, Inc., Purdy Station, NY.

Midland Park, New Jersey, is a small borough with an estimated population in 1978 of 8,500 persons. The first part of the master plan for educational facilities in the area begins with an overview using maps to illustrate characteristics including its topography, relationship to key population centers and major transportation routes, boundaries,…

Exploring Management Strategies to Reduce Cheating in Written Examinations: Case Study of Midlands State University

ERIC Educational Resources Information Center

Taderera, Ever; Nyikahadzoi, Loveness; Matamande, Wilson; Mandimika, Elinah

2014-01-01

This study was concerned about cheating in written examinations at Midlands State University (MSU). The study revealed that both male and female students cheat in written examination; business studies students cheat more than other faculties, and younger (lower class) students cheat more than (upper class) older students. Factors influencing…

The Midlands Consortium Star Schools Project: Final Report, Final Evaluation Report, Final Evaluation Report Appendices.

ERIC Educational Resources Information Center

Midlands Consortium.

The reports presented in this document describe the results of the first 2 years of the Midlands Consortium Star Schools Project (MCSSP) (October 1, 1988-December 31, 1990). The first report summarizes the major accomplishments of the MCSSP, including: (1) the installation of communications satellites at schools in Alabama, Kansas, Mississippi,…

The Identification of Seniors at Risk (ISAR) score to predict clinical outcomes and health service costs in older people discharged from UK acute medical units.

PubMed

Edmans, Judi; Bradshaw, Lucy; Gladman, John R F; Franklin, Matthew; Berdunov, Vladislav; Elliott, Rachel; Conroy, Simon P

2013-11-01

tools are required to identify high-risk older people in acute emergency settings so that appropriate services can be directed towards them. to evaluate whether the Identification of Seniors At Risk (ISAR) predicts the clinical outcomes and health and social services costs of older people discharged from acute medical units. an observational cohort study using receiver-operator curve analysis to compare baseline ISAR to an adverse clinical outcome at 90 days (where an adverse outcome was any of death, institutionalisation, hospital readmission, increased dependency in activities of daily living (decrease of 2 or more points on the Barthel ADL Index), reduced mental well-being (increase of 2 or more points on the 12-point General Health Questionnaire) or reduced quality of life (reduction in the EuroQol-5D) and high health and social services costs over 90 days estimated from routine electronic service records. two acute medical units in the East Midlands, UK. a total of 667 patients aged ≥70 discharged from acute medical units. an adverse outcome at 90 days was observed in 76% of participants. The ISAR was poor at predicting adverse outcomes (AUC: 0.60, 95% CI: 0.54-0.65) and fair for health and social care costs (AUC: 0.70, 95% CI: 0.59-0.81). adverse outcomes are common in older people discharged from acute medical units in the UK; the poor predictive ability of the ISAR in older people discharged from acute medical units makes it unsuitable as a sole tool in clinical decision-making.

Late Paleozoic paleolatitude and paleogeography of the Midland basin, Texas

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

Walker, D.A.; Golonka, J.; Reid, A.M.

1992-04-01

During the Late Pennsylvanian through Early Permian, the Midland basin was located in the low latitudes. In the Desmoinesian (Strawn), the basin was astride the equator; during the Missourian (Canyon), the center of the basin had migrated northward so it was located at 1-2N latitude. In the Virgilian (Cisco), the basin center was located around 2-4N latitude, and by the Wolfcampian, it was positioned at around 4-6N latitude. From the Desmoinesian (312 Ma) through the Missourian (306 Ma), the relative motion of the basin was 63NE. Later during the Virgilian (298 Ma) to Wolfcampian (280 Ma), the direction of motionmore » was 24NE. This change in motion reflects a major tectonic event, occurring between the Missourian and Virgilian, that greatly modifed the movement of the Laurentian (North American) plate. At that time, Laurentia had collided with Gondwana and become part of the supercontinent Pangea. Throughout the late Paleozoic, Laurentia was rotated so the Midland basin was oriented 43{degree} northeast from its current setting. Late Paleozoic paleogeography and paleolatitude controlled the direction of prevailing winds and ocean currents, thereby influencing the distribution of carbonate facies in the Midland basin. Present prevailing winds and ocean currents have been shown to have a major impact on modern carbonate sedimentation and facies distribution in Belize, the Bahamas and Turks, and Caicos. A clearer understanding of how late Paleozoic latitude and geography affected sedimentation helps explain and predict the distribution of carbonates throughout the Midland basin.« less

The Permeability of Dialect Boundaries: A Case Study of the Region Surrounding Erie, Pennsylvania

ERIC Educational Resources Information Center

Evanini, Keelan

2009-01-01

This dissertation presents a dialectological study of the city of Erie, Pennsylvania, and the neighboring towns in the boundary area between the North and Midland dialect regions. Erie occupies a unique place in the dialect geography of North America, in that it appears to have switched status from the North to the Midland. Since the dialect…

Theorising "Sacred" Space in Educational Contexts: A Case Study of Three English Midlands Sixth Form Colleges

ERIC Educational Resources Information Center

Parker, Stephen G.

2009-01-01

Sixth Form Colleges (along with the general Further Education sector) in England and Wales have of late begun to appoint new chaplains and to set aside space for quiet, prayer and reflection. This article explores this phenomenon as exhibited by three colleges in the English Midlands, utilising spatial theory and the sociology of…

Understanding Student Satisfaction and Dissatisfaction: An Interpretive Study in the UK Higher Education Context

ERIC Educational Resources Information Center

Douglas, Jacqueline Ann; Douglas, Alexander; McClelland, Robert James; Davies, John

2015-01-01

This article represents a cross-sectional study of undergraduate students across two north-west university business schools in the UK. A purposefully designed questionnaire was collected from 350 students. The student experience was described in the form of hand-written narratives by first and final year students and had been identified by the…

Selected results from LLNL-Hughes RAR for West Coast Scotland Experiment 1992

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

Lehman, S.K.; Johnston, B.; Twogood, R.

1993-01-05

The joint US-UK 1992 West Coast Scotland Experiment (WCSEX) was held in the Sound of Sleat from June 6 to 25. The LLNL-Hughes team fielded a fully polarimetric X-band hill-side real aperture radar to collect internal wave wake data. We present here a sample data set of the best radar runs.

Geologic Map of the Meskhent Tessera Quadrangle (V-3), Venus: Evidence for Early Formation and Preservation of Regional Topography

NASA Technical Reports Server (NTRS)

Ivanov, M. A.; Head, James W.

2008-01-01

The area of the Meskhent Tessera quadrangle (V-3, 50-75degN, 60-120degE, Fig. 1) corresponds to a transition zone from the uplands of Ishtar Terra to the west to the lowlands of Atalanta Planitia to the east. The topographic configuration, gravity signature, and presence of large tesserae in Ishtar Terra are consistent with extensive areas of thickened crust and tectonically stabilized lithosphere representing ancient and now extinct regimes of mantle convection. The gravity and topographic characteristics of Atalanta Planitia have been cited as evidence for large-scale mantle downwelling. Thus, the region of Meskhent Tessera quadrangle represents an important sample for the study of the regional history of long-wavelength topography (highlands, midlands, and lowlands), interaction between the downwelling and areas of thickened crust/lithosphere, formation of associated tectonic features, and emplacement of volcanic plains.

The 'Severe Hypertensive Illness in Pregnancy' (SHIP) audit: promoting quality care using a high risk monitoring chart and eclampsia treatment pack.

PubMed

Baldwin, K Joanne; Leighton, Nicola A; Kilby, M D; Wyldes, M; Churchill, D; Jones, P W; Johanson, R B

2002-07-01

We set out to measure the standards of care in a regional cohort of women with severe hypertensive illness of pregnancy and to subsequently improve the quality of care using a series of interventions. This was a multi centre cyclical criterion audit involving 21 maternity units in the West Midlands Region. Prospective data collection involved named co-ordinators in each unit using customised proformas. Intervention comprised feedback of baseline results to each hospital, a monitoring chart and eclampsia treatment pack. The first audit period (n = 183) was for a 4-month period between 1/9/96 and 31/12/96 and the second audit period (n = 111) was during the same 4-month period 1 year later. Although compliance with the audit standards set increased in all but one standard, there is clearly a need to make further improvements in the quality of care administered.

From cognition to the system: developing a multilevel taxonomy of patient safety in general practice.

PubMed

Kostopoulou, O

The paper describes the process of developing a taxonomy of patient safety in general practice. The methodologies employed included fieldwork, task analysis and confidential reporting of patient-safety events in five West Midlands practices. Reported events were traced back to their root causes and contributing factors. The resulting taxonomy is based on a theoretical model of human cognition, includes multiple levels of classification to reflect the chain of causation and considers affective and physiological influences on performance. Events are classified at three levels. At level one, the information-processing model of cognition is used to classify errors. At level two, immediate causes are identified, internal and external to the individual. At level three, more remote causal factors are classified as either 'work organization' or 'technical' with subcategories. The properties of the taxonomy (validity, reliability, comprehensiveness) as well as its usability and acceptability remain to be tested with potential users.

An evaluation of UK foundation trainee doctors' learning behaviours in a technology-enhanced learning environment.

PubMed

Brooks, Hannah L; Pontefract, Sarah K; Hodson, James; Blackwell, Nicholas; Hughes, Elizabeth; Marriott, John F; Coleman, Jamie J

2016-05-03

Technology-Enhanced Learning (TEL) can be used to educate Foundation Programme trainee (F1 and F2) doctors. Despite the advantages of TEL, learning behaviours may be exhibited that are not desired by system developers or educators. The aim of this evaluation was to investigate how learner behaviours (e.g. time spent on task) were affected by temporal (e.g. time of year), module (e.g. word count), and individual (e.g. knowledge) factors for 16 mandatory TEL modules related to prescribing and therapeutics. Data were extracted from the SCRIPT e-Learning platform for first year Foundation trainee (F1) doctors in the Health Education England's West Midland region from 1(st) August 2013 to 5(th) August 2014. Generalised Estimating Equation models were used to examine the relationship between time taken to complete modules, date modules were completed, pre- and post-test scores, and module factors. Over the time period examined, 688 F1 doctors interacted with the 16 compulsory modules 10,255 times. The geometric mean time taken to complete a module was 28.9 min (95% Confidence Interval: 28.4-29.5) and 1,075 (10.5%) modules were completed in less than 10 min. In February and June (prior to F1 progression reviews) peaks occurred in the number of modules completed and troughs in the time taken. Most modules were completed, and the greatest amount of time was spent on the learning on a Sunday. More time was taken by those doctors with greater pre-test scores and those with larger improvements in test scores. Foundation trainees are exhibiting unintended learning behaviours in this TEL environment, which may be attributed to several factors. These findings can help guide future developments of this TEL programme and the integration of other TEL programmes into curricula by raising awareness of potential behavioural issues that may arise.

Factors influencing career intentions on completion of general practice vocational training in England: a cross-sectional study

PubMed Central

Russell, Rachel; Scott, Emma; Owen, Katherine

2017-01-01

Objectives General practice is experiencing a growing crisis with the numbers of doctors who are training and then entering the profession in the UK failing to keep pace with workforce needs. This study investigated the immediate to medium term career intentions of those who are about to become general practitioners (GPs) and the factors that are influencing career plans. Design Online questionnaire survey, with quantitative answers analysed using descriptive statistics and free text data analysed using a thematic framework approach. Setting and participants Doctors approaching the end of 3-year GP vocational training in the West Midlands, England. Results 178 (57.2%) doctors completed the survey. Most participants planned to work as salaried GPs or locums rather than entering a general practice partnership for at least the first 5 years post-completion of training; others failed to express a career plan or planned to leave general practice completely or work overseas. Many were interested in developing portfolio careers. The quality of general practice experience across undergraduate, foundation and vocational training were reported as influencing personal career plans, and in particular perceptions about workload pressure and morale within the training practices in which they had been placed. Experience of a poor work–life balance as a trainee had a negative effect on career intentions, as did negative perceptions about how general practice is portrayed by politicians and the media. Conclusion This study describes a number of potentially modifiable factors related to training programmes that are detrimentally influencing the career plans of newly trained GPs. In addition, there are sociodemographic factors, such as age, gender and having children, which are also influencing career plans and so need to be accommodated. With ever-increasing workload in general practice, there is an urgent need to understand and where possible address these issues at national and local level. PMID:28819069

The phylogeny of fossil whip spiders.

PubMed

Garwood, Russell J; Dunlop, Jason A; Knecht, Brian J; Hegna, Thomas A

2017-04-21

Arachnids are a highly successful group of land-dwelling arthropods. They are major contributors to modern terrestrial ecosystems, and have a deep evolutionary history. Whip spiders (Arachnida, Amblypygi), are one of the smaller arachnid orders with ca. 190 living species. Here we restudy one of the oldest fossil representatives of the group, Graeophonus anglicus Pocock, 1911 from the Late Carboniferous (Duckmantian, ca. 315 Ma) British Middle Coal Measures of the West Midlands, UK. Using X-ray microtomography, our principal aim was to resolve details of the limbs and mouthparts which would allow us to test whether this fossil belongs in the extant, relict family Paracharontidae; represented today by a single, blind species Paracharon caecus Hansen, 1921. Tomography reveals several novel and significant character states for G. anglicus; most notably in the chelicerae, pedipalps and walking legs. These allowed it to be scored into a phylogenetic analysis together with the recently described Paracharonopsis cambayensis Engel & Grimaldi, 2014 from the Eocene (ca. 52 Ma) Cambay amber, and Kronocharon prendinii Engel & Grimaldi, 2014 from Cretaceous (ca. 99 Ma) Burmese amber. We recovered relationships of the form ((Graeophonus (Paracharonopsis + Paracharon)) + (Charinus (Stygophrynus (Kronocharon (Charon (Musicodamon + Paraphrynus)))))). This tree largely reflects Peter Weygoldt's 1996 classification with its basic split into Paleoamblypygi and Euamblypygi lineages; we were able to score several of his characters for the first time in fossils. Our analysis draws into question the monophyly of the family Charontidae. Our data suggest that Graeophonus is a crown group amblypygid, and falls within a monophyletic Paleoamblypgi clade, but outside the family Paracharontidae (= Paracharonopsis + Paracharon). Our results also suggest a new placement for the Burmese amber genus Kronocharon, a node further down from its original position. Overall, we offer a broad phylogenetic framework for both the fossil and Recent whip spiders against which future discoveries can be tested.

Landscape scale estimation of soil carbon stock using 3D modelling.

PubMed

Veronesi, F; Corstanje, R; Mayr, T

2014-07-15

Soil C is the largest pool of carbon in the terrestrial biosphere, and yet the processes of C accumulation, transformation and loss are poorly accounted for. This, in part, is due to the fact that soil C is not uniformly distributed through the soil depth profile and most current landscape level predictions of C do not adequately account the vertical distribution of soil C. In this study, we apply a method based on simple soil specific depth functions to map the soil C stock in three-dimensions at landscape scale. We used soil C and bulk density data from the Soil Survey for England and Wales to map an area in the West Midlands region of approximately 13,948 km(2). We applied a method which describes the variation through the soil profile and interpolates this across the landscape using well established soil drivers such as relief, land cover and geology. The results indicate that this mapping method can effectively reproduce the observed variation in the soil profiles samples. The mapping results were validated using cross validation and an independent validation. The cross-validation resulted in an R(2) of 36% for soil C and 44% for BULKD. These results are generally in line with previous validated studies. In addition, an independent validation was undertaken, comparing the predictions against the National Soil Inventory (NSI) dataset. The majority of the residuals of this validation are between ± 5% of soil C. This indicates high level of accuracy in replicating topsoil values. In addition, the results were compared to a previous study estimating the carbon stock of the UK. We discuss the implications of our results within the context of soil C loss factors such as erosion and the impact on regional C process models. Copyright © 2014 Elsevier B.V. All rights reserved.

Factors influencing career intentions on completion of general practice vocational training in England: a cross-sectional study.

PubMed

Dale, Jeremy; Russell, Rachel; Scott, Emma; Owen, Katherine

2017-08-17

General practice is experiencing a growing crisis with the numbers of doctors who are training and then entering the profession in the UK failing to keep pace with workforce needs. This study investigated the immediate to medium term career intentions of those who are about to become general practitioners (GPs) and the factors that are influencing career plans. Online questionnaire survey, with quantitative answers analysed using descriptive statistics and free text data analysed using a thematic framework approach. Doctors approaching the end of 3-year GP vocational training in the West Midlands, England. 178 (57.2%) doctors completed the survey. Most participants planned to work as salaried GPs or locums rather than entering a general practice partnership for at least the first 5 years post-completion of training; others failed to express a career plan or planned to leave general practice completely or work overseas. Many were interested in developing portfolio careers.The quality of general practice experience across undergraduate, foundation and vocational training were reported as influencing personal career plans, and in particular perceptions about workload pressure and morale within the training practices in which they had been placed. Experience of a poor work-life balance as a trainee had a negative effect on career intentions, as did negative perceptions about how general practice is portrayed by politicians and the media. This study describes a number of potentially modifiable factors related to training programmes that are detrimentally influencing the career plans of newly trained GPs. In addition, there are sociodemographic factors, such as age, gender and having children, which are also influencing career plans and so need to be accommodated. With ever-increasing workload in general practice, there is an urgent need to understand and where possible address these issues at national and local level. © 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.

Safety and feasibility evaluation of tourniquets for total knee replacement (SAFE-TKR): study protocol.

PubMed

Wall, Peter Dh; Ahmed, Imran; Metcalfe, Andrew; Price, Andrew J; Seers, Kate; Hutchinson, Charles E; Parsons, Helen; Warwick, Jane; Rahman, Bushra; Brown, Jaclyn; Underwood, Martin

2018-04-10

This study is designed to determine whether a full randomised controlled trial (RCT) examining the clinical effectiveness and safety of total knee replacement surgery with or without a tourniquet is warranted and feasible. Single centre, patient-blinded and assessor-blinded RCT. A computer-generated randomisation service will allocate 50 participants into one of two trial treatments, surgery with or without a tourniquet. The primary objective is to estimate recruitment, crossovers and follow-up of patients. All patients will have an MRI scan of their brain preoperatively and day 1 or 2 postoperatively to identify ischaemic cerebral emboli (primary clinical outcome). Oxford Cognitive Screen, Montreal Cognitive Assessment and Mini-Mental State Examination will be evaluated as outcome tools for measuring cognitive impairment at days 1, 2 and 7 postoperatively. Thigh pain, blood transfusion requirements, venous thromboembolism, revision surgery, surgical complications, mortality and Oxford knee and five-level EuroQol-5D scores will be collected over 12 months. Integrated qualitative research study : 30 trial patients and 20 knee surgeons will take part in semistructured interviews. Interviews will capture views regarding the pilot trial and explore barriers and potential solutions to a full trial. Multicentre cohort study : UK National Joint Registry data will be linked to Hospital Episode Statistics to estimate the relationship between tourniquet use and venous thromboembolic event, length of hospital stay, risk of revision surgery and death. The study will conclude with a multidisciplinary workshop to reach a consensus on whether a full trial is warranted and feasible. National Research Ethics Committee (West Midlands-Edgbaston) approved this study on 27 January 2016 (15/WM/0455). The study is sponsored by University of Warwick and University Hospitals Coventry and Warwickshire. The results will be disseminated via high-impact peer-reviewed publication. ISRCTN20873088; Pre-results. © 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.

Classification of Rainbows

NASA Astrophysics Data System (ADS)

Ricard, J. L.; Peter, A. L.; Barckicke, J.

2015-12-01

CLASSIFICATION OF RAINBOWS Jean Louis Ricard,1,2,* Peter Adams ,2 and Jean Barckicke 2,3 1CNRM, Météo-France,42 Avenue Gaspard Coriolis, 31057 Toulouse, France 2CEPAL, 148 Himley Road, Dudley, West Midlands DY1 2QH, United Kingdom 3DP/Compas,Météo-France,42 Avenue Gaspard Coriolis, 31057 Toulouse, France *Corresponding author: Dr_Jean_Ricard@yahoo,co,ukRainbows are the most beautiful and most spectacular optical atmospheric phenomenon. Humphreys (1964) pointedly noted that "the "explanations" generally given of the rainbow [ in textbooks] may well be said to explain beautifully that which does not occur, and to leave unexplained which does" . . . "The records of close observations of rainbows soon show that not even the colors are always the same". Textbooks stress that the main factor affecting the aspect of the rainbow is the radius of the water droplets. In his well-known textbook entitled "the nature of light & colour in the open air", Minnaert (1954) gives the chief features of the rainbow depending on the diameter of the drops producing it. For this study, we have gathered hundreds of pictures of primary bows. We sort out the pictures into classes. The classes are defined in a such way that rainbows belonging to the same class look similar. Our results are surprising and do not confirm Minnaert's classification. In practice, the size of the water droplets is only a minor factor controlling the overall aspect of the rainbow. The main factor appears to be the height of the sun above the horizon. At sunset, the width of the red band increases, while the width of the other bands of colours decreases. The orange, the violet, the blue and the green bands disappear completely in this order. At the end, the primary bow is mainly red and slightly yellow. Picture = Contrast-enhanced photograph of a primary bow picture (prepared by Andrew Dunn).

Policies and Procedures for Bachelor of Business Administration Degree through the External Plan of Study from Northwood Institute, Midland, in Cooperation with Lansing Community College.

ERIC Educational Resources Information Center

Lansing Community Coll., MI.

Information is provided for students interested in completing a bachelor's degree through a cooperative program between Lansing (Michigan) Community College (LCC) and Northwood Institute (Midland, Michigan). A 4-year program has been designed in which a student takes approximately 144 credit hours of course work at LCC and a minimum of 36 credit…

"How People Read and Write and They Don't Even Notice": Everyday Lives and Literacies on a Midlands Council Estate

ERIC Educational Resources Information Center

Jones, Susan

2014-01-01

This article presents data from a British Academy-funded study of the everyday literacy practices of three families living on a predominantly white working-class council housing estate on the edge of a Midlands city. The study explored, as one participant succinctly put it, "how people read and write and they don't even notice". This…

Diagnosing and managing anorexia nervosa in UK primary care: a focus group study.

PubMed

Hunt, D; Churchill, R

2013-08-01

Anorexia is a leading cause of adolescent hospital admission and death from psychiatric disorder. Despite the potential role of general practitioners in diagnosis, appropriate referral and coordinating treatment, few existing studies provide fine-grained accounts of GPs' beliefs about anorexia. To identify GPs' understandings and experiences of diagnosing and managing patients with anorexia in primary care. Case-based focus groups with co-working general practitioners in the East Midlands region of England were used to explore attitudes towards issues common to patients with eating disorders. Group discussions were transcribed and analysed using corpus linguistic and discourse analytic approaches. Participants' discussion focused on related issues of making hesitant diagnoses, the utility of the body mass index, making referrals and overcoming patient resistance. Therapeutic relationships with patients with anorexia are considered highly complex, with participants using diagnostic tests as rhetorical strategies to help manage communicative obstacles. Overcoming patient repudiation and securing referrals are particular challenges with this patient group. Successfully negotiating these problems appears to require advanced communication skills.

A controlled evaluation of comprehensive geriatric assessment in the emergency department: the ‘Emergency Frailty Unit’

PubMed Central

Conroy, Simon Paul; Ansari, Kharwar; Williams, Mark; Laithwaite, Emily; Teasdale, Ben; Dawson, Jeremey; Mason, Suzanne; Banerjee, Jay

2014-01-01

Background: the ageing demographic means that increasing numbers of older people will be attending emergency departments (EDs). Little previous research has focused on the needs of older people in ED and there have been no evaluations of comprehensive geriatric assessment (CGA) embedded within the ED setting. Methods: a pre-post cohort study of the impact of embedding CGA within a large ED in the East Midlands, UK. The primary outcome was admission avoidance from the ED, with readmissions, length of stay and bed-day use as secondary outcomes. Results: attendances to ED increased in older people over the study period, whereas the ED conversion rate fell from 69.6 to 61.2% in people aged 85+, and readmission rates in this group fell from 26.0% at 90 days to 19.9%. In-patient bed-day use increased slightly, as did the mean length of stay. Discussion: it is possible to embed CGA within EDs, which is associated with improvements in operational outcomes. PMID:23880143

2008 Homeland Security S and T Stakeholders Conference West. Volume 4. Wednesday

DTIC Science & Technology

2008-01-16

www.npia.police.uk Polonium 210 Interoperability - lessons Major Incident - CBRN Images courtesy of BBC www.npia.police.uk Boscastle 2007...Washington Training Session 37: Preparing First Responders for Food Systems Disasters Jerry Gillespie, DVM, PhD Director, Western Institute for... Food Safety and Security Training Session 39: Technology Adoption & Innovation 1 Dr. Neal Thornberry, Innovation Chair Graduate School of

Modern methods rediscover deep gas. [Texas

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

McDonald, J.S.

1979-03-01

In 1973, Northern Natural Gas (NNG) Co.'s Midland exploration and production district acquired a 7-section lease block on a Devonian-Montoya prospect suggested by trend geology and limited seismic data. This acreage block was 2 miles west of the abandoned Hershey field, and included acreage on which the Devonian was tested at noncommercial rates in 1962. Additional seismic data confirmed the presence of a drillable prospect on NNG's acreage block. Engineering analyses of the reservoir characteristics suggested that modern completion and treatment techniques would result in a commercial producer. NNG's management approved the expenditure and the first well was spudded inmore » April, 1977. This well, the No. 1 Hershenson, was completed in Sept., 1977 as the discovery well in the Hershey West (Devonian-Montoya) field for a calculated open flow potential (CAOFP) of 20.5 mmcfd dry gas from perforations at 15,445 to 16,017 ft. The confirmation well, No. 1 Hershenson 6, was spudded in May, 1978, and completed in Oct., 1978, for a CAOFP of 86.3 mmcfd from perforations at 16,000 to 16,624 ft. A third well, No. 1 Maddox-Willbanks 15, was spudded in Nov., 1978. Rediscovered field potential justified construction of a gas processing plant and a 16-mile pipeline.« less

A Qualitative Study of the Impact of the London 2012 Olympics on Families in the East Midlands of England: Lessons for Sports Development Policy and Practice

ERIC Educational Resources Information Center

Mackintosh, Chris; Darko, Natalie; Rutherford, Zoe; Wilkins, Hetty-May

2015-01-01

The dynamics and culture of families are central to individual and community sport and physical activity participation. This research project examined the lived experiences and day-to-day realities of the London 2012 Olympics from the perspectives of five families in the East Midlands region of England. The aims of the project were to assess the…

2016 Visionary Leader: Bob Dent.

PubMed

Bredimus, Brandon Kit

2017-01-01

The following manuscript is the winning Richard Hader Visionary Leader 2016 entry submitted to Nursing Management in recognition of Dr. Bob Dent, DNP, MBA, RN, NEA-BC, CENP, FACHE, senior vice president, chief operating officer, and CNO for Midland Memorial Hospital in Midland, Tex. Dr. Dent was formally recognized for his achievements before the Keynote Address at Congress2016, November 8, in Las Vegas, Nev. There, he received the award, sponsored by Hackensack Meridian Health.

What caused the Extreme Storm Season over the North Atlantic and the UK in Winter 2013-14?

NASA Astrophysics Data System (ADS)

Leckebusch, G. C.; Wild, S.; Befort, D. J.

2015-12-01

In winter 2013-2014, the UK experienced exceptional stormy and rainy weather conditions. Concurrently, surface temperatures over large parts of central North America fell to near record minimum values. One potential driver for these cold conditions is discussed to be the increasingly warm surface waters of the tropical west Pacific. It has been suggested these increasing sea surface temperatures could also be the cause for extreme weather over the British Isles. Testing this hypothesis, we investigate mechanisms linking the tropical west Pacific and European wind storm activity. We focus on two research questions. Firstly: Was a chain of anomaly patterns with origin in the west Pacific present in the winter 2013-14? And secondly: Can centres of action along such a chain be identified with a strong interannual relationship in the recent past? Our results, using primarily ERA-Interim Reanalysis from 1979 to 2014, show an absolute maximum of wind storm frequency over the northeast Atlantic and the British Isles in winter 2013-14. We also find absolute minimum surface temperatures in central North America and increased convective activity over the tropical west Pacific in the same season. The winter 2013-14 was additionally characterized by anomalous warm sea surface temperatures over the subtropical northwest Atlantic. Although the interannual variability of wind storms in the northeast Atlantic and surface temperatures in North America are significantly anti-correlated, we cannot directly relate wind storm frequency with tropical west Pacific anomalies. We thus conclude that the conditions over the Pacific in winter 2013-14 were favourable but not sufficient to explain the record number of wind storms in this season. Instead, we suggest that warm north Atlantic sea surface temperature anomalies in combination with cold surface temperatures over North America played a more important role for generating higher wind storm counts over the northeast Atlantic and the UK.

Moderation and Assessment Project--South West. A Presentation of a Model for Moderating Pupils' Work That Is Teacher Assessed, Developed in England, UK.

ERIC Educational Resources Information Center

Radnor, Hilary

The Moderation and Assessment Project, South West, was an outgrowth of the Technical and Vocational Educational Initiative of the government of the United Kingdom that attempted to develop more courses with vocational relevance for adolescents. Growing from research projects under the Moderation and Assessment project, a new model of moderation is…

Hydrogeology and Migration of Septic-Tank Effluent in the Surficial Aquifer System in the Northern Midlands Area, Palm Beach County, Florida

USGS Publications Warehouse

Miller, Wesley L.

1992-01-01

The northern Midlands area in Palm Beach County is an area of expected residential growth, but its flat topography, poor drainage, and near-surface marl layers retard rainfall infiltration and cause frequent flooding. Public water supplies and sewer services are not planned for the area, thus, residents must rely on domestic wells and septic tanks. The water table in the northern Midlands area is seldom more than 5 feet below land surface, and regional ground-water flows are east, southwest, and south from the north-central part of the area where ground-water levels are highest. Ground-water quality in the western part of the area and in the Loxahatchee Slough is greatly influenced by residual seawater emplaced during the Pleistocene Epoch. Chloride and dissolved-solids concentrations of ground water in the surficial aquifer system in these areas often exceed secondary drinking-water standards. Residual seawater has been more effectively flushed from the more permeable sediments elsewhere in the eastern and southwestern parts of the study area. Test at three septic-tank sites showed traces of effluent in ground water (38-92 feet from the septic tank outlets) and that near-surface marl layers greatly impede the downward migration of the effluent in the surficial aquifer system throughout the northern midlands.

Large Scale Drivers for the Extreme Storm Season over the North Atlantic and the UK in Winter 2013-14

NASA Astrophysics Data System (ADS)

Wild, Simon; Befort, Daniel J.; Leckebusch, Gregor C.

2016-04-01

The British Isles experienced exceptional stormy and rainy weather conditions in winter 2013-2014 while large parts of central North America recorded near record minimum surface temperatures values. Potential drivers for these cold conditions include increasingly warm surface waters of the tropical west Pacific. It has been suggested these increasing sea surface temperatures could also be the cause for extreme weather over the Europe, particularly the UK. Testing this hypothesis, we investigate mechanisms linking the tropical west Pacific and European wind storm activity. We will firstly analyse anomaly patterns along such a potential link in winter 2013-14. Secondly, we will investigate whether these identified anomaly patterns show a strong interannual relationship in the recent past. Our results, using primarily ERA-Interim Reanalysis from 1979 to 2014, show an absolute maximum of wind storm frequency over the northeast Atlantic and the British Isles in winter 2013-14. We also find absolute minimum surface temperatures in central North America and increased convective activity over the tropical west Pacific in the same season. The winter 2013-14 was additionally characterized by anomalous warm sea surface temperatures over the subtropical northwest Atlantic. Although the interannual variability of wind storms in the northeast Atlantic and surface temperatures in North America are significantly anti-correlated, we cannot directly relate wind storm frequency with tropical west Pacific anomalies. We thus conclude that the conditions over the Pacific in winter 2013-14 were favourable but not sufficient to explain the record number of wind storms in this season. Instead, we suggest that warm north Atlantic sea surface temperature anomalies in combination with cold surface temperatures over North America played a more important role for generating higher wind storm counts over the northeast Atlantic and the UK.

Geological Map of the Fredegonade (V-57) Quadrangle, Venus: Status Report

NASA Technical Reports Server (NTRS)

Ivanov, M. A.; Head, J. W.

2010-01-01

The Fredegonde quadrangle (V-57; 50-75degS, 60-120degE, Fig. 1) corresponds to the northeastern edge of Lada Terra and covers a broad area of the topographic province of midlands (0-2 km above MPR [1,2]). This province is most abundant on Venus and displays a wide variety of units and structures [3-11]. The sequence of events that formed the characteristic features of the midlands is crucially important in understanding of the timing and modes of evolution of this topographic province. Topographically, the Fredegonde quadrangle is within a transition zone between the elevated portion of Lada Terra to the west (Quetzalpetlatl-Boala Coronae rise, approx.3.5 km) and the lowland of Aino Planitia to the north and northeast (approx.-0.5 km). This transition is one of the key features of the V-57 quadrangle. In this respect the quadrangle resembles the region of V-4 quadrangle [12] that shows transition between the midlands and the lowlands of Atalanta Planitia. One of the main goals of our mapping within the V-57 quadrangle is comparison of this region with the other transitional topographic zones such as quadrangles V-4 and V-3 [13]. The most prominent features in the V-57 quadrangle are linear deformational zones of grooves and large coronae. The zones characterize the central and NW portions of the map area and represent broad (up to 100s of km wide) ridges that are 100s of m high. Morphologically and topographically, these zones are almost identical to the groove belt/corona complexes at the western edge of Atalanta Planitia [12]. Within the Fredegonde area, however, the zones are oriented at high angles to the general trend of elongated Aino Planitia, whereas within the V-4 quadrangle they are parallel to the edge of Atalanta Planitia. Relatively small (100s of km across, 100s of m deep) equidimensional basins occur between the corona-groove-chains in the area of V-57 quadrangle. These basins are similar to those that populate the area of the V-3 quadrangle [13]. Broad regional plains cover the surface of the basins in both regions. In contrast to Fredegonde, the area of the V-3 quadrangle displays a greater diversity of units and features [13]. Here we describe units that make up the surface within the V-57 quadrangle and present a summary of our geological map that shows the areal distribution of the major groups of units.

A qualitative study of the perspectives of key stakeholders on the delivery of clinical academic training in the East Midlands.

PubMed

Green, Ruth H; Evans, Val; MacLeod, Sheona; Barratt, Jonathan

2018-02-01

Major changes in the design and delivery of clinical academic training in the United Kingdom have occurred yet there has been little exploration of the perceptions of integrated clinic academic trainees or educators. We obtained the views of a range of key stakeholders involved in clinical academic training in the East Midlands. A qualitative study with inductive iterative thematic content analysis of findings from trainee surveys and facilitated focus groups. The East Midlands School of Clinical Academic Training. Integrated Clinical Academic Trainees, clinical and academic educators involved in clinical academic training. The experience, opinions and beliefs of key stakeholders about barriers and enablers in the delivery of clinical academic training. We identified key themes many shared by both trainees and educators. These highlighted issues in the systems and process of the integrated academic pathways, career pathways, supervision and support, the assessment process and the balance between clinical and academic training. Our findings help inform the future development of integrated academic training programmes.

Red and processed meat consumption and purchasing behaviours and attitudes: impacts for human health, animal welfare and environmental sustainability.

PubMed

Clonan, Angie; Wilson, Paul; Swift, Judy A; Leibovici, Didier G; Holdsworth, Michelle

2015-09-01

Higher intakes of red and processed meat are associated with poorer health outcomes and negative environmental impacts. Drawing upon a population survey the present paper investigates meat consumption behaviours, exploring perceived impacts for human health, animal welfare and the environment. Structured self-completion postal survey relating to red and processed meat, capturing data on attitudes, sustainable meat purchasing behaviour, red and processed meat intake, plus sociodemographic characteristics of respondents. Urban and rural districts of Nottinghamshire, East Midlands, UK, drawn from the electoral register. UK adults (n 842) aged 18-91 years, 497 females and 345 males, representing a 35·6 % response rate from 2500 randomly selected residents. Women were significantly more likely (P60 years) were more likely to hold positive attitudes towards animal welfare (P<0·01). Less than a fifth (18·4 %) of the sample agreed that the impact of climate change could be reduced by consuming less meat, dairy products and eggs. Positive attitudes towards animal welfare were associated with consuming less meat and a greater frequency of 'higher welfare' meat purchases. Human health and animal welfare are more common motivations to avoid red and processed meat than environmental sustainability. Policy makers, nutritionists and health professionals need to increase the public's awareness of the environmental impact of eating red and processed meat. A first step could be to ensure that dietary guidelines integrate the nutritional, animal welfare and environmental components of sustainable diets.

U.K. Flooding Captured by NASA Spacecraft

NASA Image and Video Library

2014-02-19

This image acquired by NASA Terra spacecraft depicts the high water levels and flooding along the Thames River west of London as record-breaking rains covered the United Kingdom in January and February.

An Examination of the Association between Seeing Smoking in Films and Tobacco Use in Young Adults in the West of Scotland: Cross-Sectional Study

ERIC Educational Resources Information Center

Hunt, Kate; Sweeting, Helen; Sargent, James; Lewars, Heather; Cin, Sonya Dal; Worth, Keilah

2009-01-01

The objective is to examine the association between the amount of smoking seen in films and current smoking in young adults living in the west of Scotland in the UK. Cross-sectional analyses (using multivariable logistic regression) of data collected at age 19 (2002-04) from a longitudinal cohort originally surveyed at age 11 (1994-95) were…

Selected results from LLNL-Hughes RAR for West Coast Scotland Experiment 1991

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

Lehman, S K; Johnston, B; Twogood, R

1993-01-05

The joint US -- UK 1991 West Coast Scotland Experiment (WCSEX) was held in two locations. From July 5 to 12, 1991, in Upper Loch Linnhe, and from July 18 to July 26, 1991, in the Sound of Sleat. The LLNL-Hughes team fielded a fully polarimetric X-band hill-side real aperture radar to collect internal wave wake data. We present here a sample data set of the best radar runs.

Eight years' experience of regional audit: an assessment of its value as a clinical governance tool.

PubMed

John, H; Paskins, Z; Hassell, A; Rowe, I F

2010-02-01

Strengthening clinical audit is crucial for improving the quality of healthcare provision. The West Midlands Rheumatology Service and Training Committee coordinates an innovative programme of regional audits and the experience of rheumatology healthcare professionals involved was surveyed. This was a questionnaire-based study in which respondents rated statements relating to regional audit on Likert scales. Out of 105 staff, 70 replied. There was consensus that results of regional audit have been robust, valid and reliable; regional audits benefit patients and units; provide educational opportunities for specialist registrars (SpRs); and are more efficient than local audit by allowing comparison between units. Opinion was divided about how well informed respondents were and how effective they are at closing the audit loop. Many units reported changes in practice. Regional audit is widely perceived to be a valuable clinical governance tool supporting significant changes to clinical practice, and an excellent training opportunity for SpRs. Recommendations for a successful regional audit scheme are described in this article.

Ethnic identity, self-esteem, and occupational aspirations of Indian and Anglo-Saxon British adolescents.

PubMed

Hogg, M A; Abrams, D; Patel, Y

1987-11-01

A questionnaire monitoring occupational aspiration, ethnic identification, adolescent experience, and self-esteem was administered to a large sample of Indian and Anglo-Saxon British male and female adolescents attending school in the West Midlands. The relationship between these variables and differences between the four groups were consistent with predictions derived from the social identity approach to intergroup relations and group behaviour (Tajfel & Turner, 1979). Indian males were found to possess a social mobility belief structure that mediates high occupational aspirations and keeness to marry out of their ethnic group. In contrast, Indian females were found to possess a social change belief structure associated with acceptance of the status quo and lower aspirations. Males and Anglo-Saxons reported higher self-esteem than females or Indians. The adolescent experience findings were less clear, but were consistent with the general interpretation of the data that the differences in intersex relations and gender-related experiences are contingent on ethnicity.

National Service Framework for Older People: stroke coordinators.

PubMed

McDonald, Paul S; Mayer, Peter; Dunn, Linda

The National Service Framework (NSF) for Older People aims to develop integrated stroke services with specialized treatment, carer involvement, secondary prevention and rehabilitation. There is an emphasis upon the role of stroke coordinators. The aim of this study was to examine the relationships between stroke coordinators and other agencies involved in stroke care, and to describe stroke coordinators' current roles. Interviews with 11 stroke coordinators across the West Midlands region took place and were evaluated using a grounded theory approach. The roles of stroke coordinators and the perceived levels of integration among stroke services varied between localities. In a few areas, a number of 'adhesive' factors helped bond the coordinator role to successful integration, while in most areas the absence of all or some of these factors made the role less effective. To meet the demands of the NSF, a stroke coordinator's role needs to be a high profile, corporate function, requiring a higher level of autonomy, accountability and responsibility, and demanding creativity and innovation from post holders.

Social Firms as a means of vocational recovery for people with mental illness: a UK survey.

PubMed

Gilbert, Eleanor; Marwaha, Steven; Milton, Alyssa; Johnson, Sonia; Morant, Nicola; Parsons, Nicholas; Fisher, Adrian; Singh, Swaran; Cunliffe, Di

2013-07-11

Employment is associated with better quality of life and wellbeing in people with mental illness. Unemployment is associated with greater levels of psychological illness and is viewed as a core part of the social exclusion faced by people with mental illness. Social Firms offer paid employment to people with mental illness but are under-investigated in the UK. The aims of this phase of the Social Firms A Route to Recovery (SoFARR) project were to describe the availability and spread of Social Firms across the UK, to outline the range of opportunities Social Firms offer people with severe mental illness and to understand the extent to which they are employed within these firms. A UK national survey of Social Firms, other social enterprises and supported businesses was completed to understand the extent to which they provide paid employment for the mentally ill. A study-specific questionnaire was developed. It covered two broad areas asking employers about the nature of the Social Firm itself and about the employees with mental illness working there. We obtained returns from 76 Social Firms and social enterprises / supported businesses employing 692 people with mental illness. Forty per cent of Social Firms were in the south of England, 24% in the North and the Midlands, 18% in Scotland and 18% in Wales. Other social enterprises/supported businesses were similarly distributed. Trading activities were confined mainly to manufacturing, service industry, recycling, horticulture and catering. The number of employees with mental illness working in Social Firms and other social enterprises/supported businesses was small (median of 3 and 6.5 respectively). Over 50% employed people with schizophrenia or bipolar disorder, though the greatest proportion of employees with mental illness had depression or anxiety. Over two thirds of Social Firms liaised with mental health services and over a quarter received funding from the NHS or a mental health charity. Most workers with mental illness in Social Firms had been employed for over 2 years. Social Firms have significant potential to be a viable addition to Individual Placement and Support (IPS), supporting recovery orientated services for people with the full range of mental disorders. They are currently an underdeveloped sector in the UK.

Social firms as a means of vocational recovery for people with mental illness: a UK survey

PubMed Central

2013-01-01

Background Employment is associated with better quality of life and wellbeing in people with mental illness. Unemployment is associated with greater levels of psychological illness and is viewed as a core part of the social exclusion faced by people with mental illness. Social Firms offer paid employment to people with mental illness but are under-investigated in the UK. The aims of this phase of the Social Firms A Route to Recovery (SoFARR) project were to describe the availability and spread of Social Firms across the UK, to outline the range of opportunities Social Firms offer people with severe mental illness and to understand the extent to which they are employed within these firms. Method A UK national survey of Social Firms, other social enterprises and supported businesses was completed to understand the extent to which they provide paid employment for the mentally ill. A study-specific questionnaire was developed. It covered two broad areas asking employers about the nature of the Social Firm itself and about the employees with mental illness working there. Results We obtained returns from 76 Social Firms and social enterprises / supported businesses employing 692 people with mental illness. Forty per cent of Social Firms were in the south of England, 24% in the North and the Midlands, 18% in Scotland and 18% in Wales. Other social enterprises/supported businesses were similarly distributed. Trading activities were confined mainly to manufacturing, service industry, recycling, horticulture and catering. The number of employees with mental illness working in Social Firms and other social enterprises/supported businesses was small (median of 3 and 6.5 respectively). Over 50% employed people with schizophrenia or bipolar disorder, though the greatest proportion of employees with mental illness had depression or anxiety. Over two thirds of Social Firms liaised with mental health services and over a quarter received funding from the NHS or a mental health charity. Most workers with mental illness in Social Firms had been employed for over 2 years. Conclusions Social Firms have significant potential to be a viable addition to Individual Placement and Support (IPS), supporting recovery orientated services for people with the full range of mental disorders. They are currently an underdeveloped sector in the UK. PMID:23844779

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

PubMed

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

2017-05-15

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

High-resolution measurements from the airborne Atmospheric Nitrogen Dioxide Imager (ANDI)

NASA Astrophysics Data System (ADS)

Lawrence, J. P.; Anand, J. S.; Vande Hey, J. D.; Leigh, R. R.; Monks, P. S.; Leigh, R. J.

2015-06-01

Nitrogen Dioxide is both a primary pollutant with direct health effects and a key precursor of the secondary pollutant ozone. This paper reports on the development, characterisation and test flight of the Atmospheric Nitrogen Dioxide Imager (ANDI) remote sensing system. The ANDI system includes an imaging (UV)-vis grating spectrometer able to capture scattered sunlight spectra for the determination of tropospheric nitrogen dioxide (NO2) concentrations by way of DOAS slant column density and vertical column density measurements. Results are shown for an ANDI test flight over Leicester City in the UK. Retrieved NO2 columns at a surface resolution of 80 m x 20 m revealed hot spots in a series of locations around Leicester City, including road junctions, the train station, major car parks, areas of heavy industry, a nearby airport (East Midlands) and a power station (Ratcliffe-on-Soar). In the city centre the dominant source of NO2 emissions was identified as road traffic, contributing to a background concentration as well as producing localised hot spots. Quantitative analysis revealed a significant urban increment over the city centre which increased throughout the flight.

The North West London Integrated Care Pilot: innovative strategies to improve care coordination for older adults and people with diabetes.

PubMed

Harris, Matthew; Greaves, Felix; Patterson, Sue; Jones, Jessica; Pappas, Yannis; Majeed, Azeem; Car, Josip

2012-01-01

The North West London Integrated Care Pilot (ICP) was launched in June 2011 and brings together more than 100 general practices, 2 acute care trusts, 5 primary care trusts, 2 mental health care trusts, 3 community health trusts, 5 local authorities, and 2 voluntary sector organizations (Age UK and Diabetes UK) to improve the coordination of care for a pilot population of 550 000 people. Specifically, the ICP serves people older than 75 years and those with diabetes. Although still in the early stages of implementation, the ICP has already received national awards for its innovations in design and delivery. This article critically describes the ICP objectives, facilitating processes, and planned impact as well as the organizational and financial challenges that policy makers are facing in the implementation of the pilot program.

The MOYA aircraft campaign: First measurements of methane, ethane and C-13 isotopes from West African biomass burning and other regional sources using the UK FAAM aircraft

NASA Astrophysics Data System (ADS)

Allen, Grant; Pitt, Joseph; Lee, James; Hopkins, James; Young, Stuart; Bauguitte, Stéphane; Gallagher, Martin; Fisher, Rebecca; Lowry, David; Nisbet, Euan

2017-04-01

Global methane concentrations continue to rise due to an imbalance between sources and sinks. There remains little consensus on the relative components of the manifold source types and their geographical origin. The Global Methane Budget and Yearly Assessments (MOYA) project is tasked with better characterising the global methane budget through an augmented global measurement and modelling programme. As part of MOYA, the UK's Facility for Airborne Atmospheric Measurement (FAAM), will fly four campaigns based out of West Africa and Ascension Island in the period 2017-2019, to focus on the important role of tropical sources. The first of these, to be conducted in late February 2017, will focus on the biomass burning season in West Africa. This paper will present the plan for future FAAM MOYA campaigns and report on our first aircraft data gathered in the West African region. The new addition of an interband cascade laser spectrometer to the FAAM aircraft, flown in this campaign for the first time, promises to provide the first real-time, continuous, and simultaneous, airborne measurements of methane, ethane and methane C-13 isotopologues. Together, these measurements, when interpreted in combination with other trace gases and aerosol measured on the aircraft, will serve as case studies to inform modelling of regional and global fluxes through their isotopic fingerprints.

Burns Centre and fire services: What information can be exchanged to manage the burn patient?

PubMed

Pujji, O; Nizar, B; Bechar, J; North, D; Jeffery, S

2018-05-01

To describe the experience of using a "Burns Extrication Form" at a regional Burns Centre. Communication between the fire services and burns team previously has been regarded as poor. Significant information is collected by the fire services at the scene and this can aid the management of the patient. The Burns Extrication Form was devised to provide a clear framework of communication between the two services. Information regarding time frames, exposure to heat & smoke, fire loading (potential severity of a fire in a given space by measuring amount of combustible material in confined space), building construction, chemicals involved is passed to the medical team through this form through a National Health Service mailbox. Also, treatment provided by the fire service was documented. All data collected by this form was collated for the purpose of this study. Data ranging from 2014 to 2017 was included in this descriptive study. The patient journey following contact by fire services shows that out of the 598 persons who were involved in a fire only 92 (15%) attended the Accident and Emergency (A&E) department at the Queen Elizabeth Hospital. Signs of smoke inhalation, singed nose hair and coughing were found in 190 (32%) patients; the fire service administered oxygen to 106 (18%) of these patients although this may have been initiated by Ambulance crews who were on scene prior to the Fire Crew. The remaining 506 (85%) may have not attended A&E at UHB or may have attended another A&E in the West Midlands base on the location of the incident and clinical needs. Of the 92 patients who attended the A&E at UHB 48 (52%) were admitted to the Burns Centre in the hospital. Nine (19%) of these patients had smoke inhalation and three of these patients were managed by intubation. Birmingham North and Black Country North had the highest incidence of burns incidents, 120 and 103 respectively. Whilst, the lowest numbers were found in Birmingham South and Coventry and Solihull with 65 and 61 respectively. Additional results are described in the study. Data provided by the Fire Extrication forms helps us to assess the magnitude of fire-related injury across the West Midlands. The fire services have been shown to provide important first aid as one of the first responders at the scene. Their value in assessing the environment in and patient status helps clinicians further down the patient's journey. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

A regional audit of the use of COX-2 selective non-steroidal anti-inflammatory drugs (NSAIDs) in rheumatology clinics in the West Midlands, in relation to NICE guidelines.

PubMed

Price-Forbes, A N; Callaghan, R; Allen, M E; Rowe, I F

2005-07-01

Whilst all non-steroidal anti-inflammatory drugs (NSAIDs) can cause adverse gastrointestinal events, COX-2-selective inhibitors (COX-2) may have improved gastrointestinal safety compared with non-selective NSAIDs (NSNSAIDs). In 2001, the National Institute for Clinical Excellence (NICE) published guidance on the use of the COX-2 agents celecoxib, rofecoxib, meloxicam and etodolac for rheumatoid arthritis (RA) and osteoarthritis (OA). This study aimed to audit the appropriateness of NSAID use in relation to NICE guidance in rheumatology out-patients. Questionnaires were completed for all patients attending clinics in 18 rheumatology units in the West Midlands over a 2-week period. Data collected included patient demographics, NSAID type, indications, duration of use (> or =3 months was considered prolonged), and concomitant prescription of corticosteroids, warfarin and gastroprotective agents. Data were collected on 2846 patients; 1164 (41%) were taking NSAIDs (791 NSNSAIDs, 373 COX-2). Of the 1164 NSAID users, 753 (65%) had a diagnosis of RA or OA (483 NSNSAIDs, 270 COX-2). Overall, 37% of NSAID prescriptions were appropriate. Of the NSNSAID users, 92% had at least one risk factor for adverse gastrointestinal events and were therefore inappropriately treated. Prolonged use (in 89%) and age > or =65 yr (in 23%) were the most frequent risk factors identified. Of the COX-2 users, 97% had one or more risk factors and were appropriately treated. Analysis of the RA/OA subgroup revealed similar findings. Thirty-six per cent were taking NSAIDs appropriately; 97% of NSNSAID use was inappropriate and 97% of COX-2 use was appropriate treatment. In the whole cohort, gastroprotective agents were used in 26% of NSNSAID users, 56% of gastroprotective agents being proton pump inhibitors. Ninety-two per cent of patients attending rheumatology clinics who were taking NSNSAIDs should have been prescribed a COX-2-selective agent in relation to NICE guidance. Duration of use and age > or =65 yr emerged numerically as the most important risk factors. Significant numbers of patients taking NSNSAIDs may be at risk from adverse gastrointestinal events and clinicians may wish to review their prescribing patterns. Conversely, 97% of patients taking COX-2 agents were treated appropriately. Although practice overall conformed poorly with NICE guidance, NSAID prescribing also needs to be considered in the context of recent concerns regarding the cardiovascular risks of COX-2 agents.

A qualitative study of the perspectives of key stakeholders on the delivery of clinical academic training in the East Midlands

PubMed Central

Evans, Val; MacLeod, Sheona

2018-01-01

Objective Major changes in the design and delivery of clinical academic training in the United Kingdom have occurred yet there has been little exploration of the perceptions of integrated clinic academic trainees or educators. We obtained the views of a range of key stakeholders involved in clinical academic training in the East Midlands. Design A qualitative study with inductive iterative thematic content analysis of findings from trainee surveys and facilitated focus groups. Setting The East Midlands School of Clinical Academic Training. Participants Integrated Clinical Academic Trainees, clinical and academic educators involved in clinical academic training. Main outcome measures The experience, opinions and beliefs of key stakeholders about barriers and enablers in the delivery of clinical academic training. Results We identified key themes many shared by both trainees and educators. These highlighted issues in the systems and process of the integrated academic pathways, career pathways, supervision and support, the assessment process and the balance between clinical and academic training. Conclusions Our findings help inform the future development of integrated academic training programmes. PMID:29487745

Preventing cerebral palsy in preterm labour: a multiorganisational quality improvement approach to the adoption and spread of magnesium sulphate for neuroprotection

PubMed Central

Burhouse, Anna; Lea, Charlotte; Ray, Stephen; Bailey, Hannah; Davies, Ruth; Harding, Hannah; Howard, Rachel; Jordan, Sharon; Menzies, Noshin; White, Sarah; Phillips, Kathryn; Luyt, Karent

2017-01-01

Magnesium sulphate has been demonstrated to be an effective neuroprotectant for babies delivered prematurely (under 37 weeks’ gestational age). Antenatal administration reduces infant mortality and cerebral palsy (CP); however, uptake in the UK has been significantly lower than other countries. A quality improvement (QI) project (PReventing Cerebral palsy in Pre Term labour (PReCePT)) was carried out in the West of England, UK, to raise awareness of evidence and to improve the uptake of magnesium sulphate as neuroprotectant in preterm deliveries. Five National Health Service (NHS) Trusts and the West of England Academic Health Science Network participated in the QI project. The project was underpinned by a multifaceted QI approach that included: patient and clinical coproduction of resources; recruitment of clinical champions to support the local microsystems and create a stimulating/supporting environment for change; Plan, Do, Study, Act cycles; training for over 600 NHS staff and awareness raising and strategic influencing of key leaders. A baseline audit and regular measurement of the number of eligible women receiving magnesium sulphate was undertaken at each hospital site, and the overall programme was evaluated using data from an international benchmarking organisation for neonatal care outcomes—the Vermont Oxford Network. During the project 664 staff received magnesium sulphate training. The use of magnesium sulphate increased across the West of England from an average baseline of 21% over the 2 years preceding the project to 88% by the conclusion of the project. The project was also able to influence the development of a national data collection process for benchmarking the use of magnesium sulphate for neuroprotection in preterm deliveries in the U.K. PReCePT appears to have had a favourable effect on the uptake of magnesium sulphate across the West of England. The project has also provided learning about how to stimulate adoption and spread of evidence using a QI approach across a network. PMID:29450301

The prevalence and impact of Fusarium head blight pathogens and mycotoxins on malting barley quality in UK

PubMed Central

Nielsen, L.K.; Cook, D.J.; Edwards, S.G.; Ray, R.V.

2014-01-01

Fusarium head blight (FHB) caused by Fusarium and Microdochium species can significantly affect the yield of barley grain as well as the quality and safety of malt and beer. The present study provides new knowledge on the impacts of the FHB pathogen complex on the malting and brewing quality parameters of naturally infected barley. Quantitative real-time PCR and liquid chromatography double mass spectrometry were used to quantify the predominant FHB pathogens and Fusarium mycotoxins, respectively, in commercially grown UK malting barley samples collected between 2007 and 2011. The predominant Fusarium species identified across the years were F. poae, F. tricinctum and F. avenaceum. Microdochium majus was the predominant Microdochium species in 2007, 2008, 2010 and 2011 whilst Microdochium nivale predominated in 2009. Deoxynivalenol and zearalenone quantified in samples collected between 2007 and 2009 were associated with F. graminearum and F. culmorum, whilst HT-2 and T-2, and nivalenol in samples collected between 2010 and 2011 correlated positively with F. langsethiae and F. poae, respectively. Analysis of the regional distribution and yearly variation in samples from 2010 to 2011 showed significant differences in the composition of the FHB species complex. In most regions (Scotland, the South and North of England) the harvest in 2010 had higher concentrations of Fusarium spp. than in 2011, although no significant difference was observed in the Midlands between the two years. Microdochium DNA was significantly higher in 2011 and in the North of England and Scotland compared to the South or Midlands regions. Pathogens of the FHB complex impacted negatively on grain yield and quality parameters. Thousand grain weight of malting barley was affected significantly by M. nivale and M. majus whilst specific weight correlated negatively with F. avenaceum and F. graminearum. To determine the impact of sub-acute infections of the identified Fusarium and Microdochium species on malting and brewing quality of naturally infected samples, selected malting barley cultivars (Optic, Quench and Tipple) were micromalted and subjected to malt and wort analysis of key quality parameters. F. poae and M. nivale decreased germinative energy and increased water sensitivity of barley. The fungal biomass of F. poae and F. langsethiae correlated with increased wort free amino nitrogen and with decreased extract of malt. DNA of M. nivale correlated with increased malt friability as well as decreased wort filtration volume. The findings of this study indicate that the impact of species such as the newly emerging F. langsethiae, as well as F. poae and the two non-toxigenic Microdochium species should be considered when evaluating the quality of malting barley. PMID:24727381

TargetCOPD: a pragmatic randomised controlled trial of targeted case finding for COPD versus routine practice in primary care: protocol.

PubMed

Jordan, Rachel E; Adab, Peymané; Jowett, Sue; Marsh, Jen L; Riley, Richard D; Enocson, Alexandra; Miller, Martin R; Cooper, Brendan G; Turner, Alice M; Ayres, Jon G; Cheng, Kar Keung; Jolly, Kate; Stockley, Robert A; Greenfield, Sheila; Siebert, Stanley; Daley, Amanda; Fitzmaurice, David A

2014-10-04

Many people with clinically significant chronic obstructive pulmonary disease (COPD) remain undiagnosed worldwide. There are a number of small studies which have examined possible methods of case finding through primary care, but no large RCTs that have adequately assessed the most cost-effective approach. In this study, using a cluster randomised controlled trial (RCT) in 56 general practices in the West Midlands, we plan to investigate the effectiveness and cost-effectiveness of a Targeted approach to case finding for COPD compared with routine practice. Using an individual patient RCT nested in the Targeted arm, we plan also to compare the effectiveness and cost-effectiveness of Active case finding using a postal questionnaire (with supplementary opportunistic questionnaires), and Opportunistic-only case finding during routine surgery consultations.All ever-smoking patients aged 40-79 years, without a current diagnosis of COPD and registered with participating practices will be eligible. Patients in the Targeted arm who report positive respiratory symptoms (chronic cough or phlegm, wheeze or dyspnoea) using a brief questionnaire will be invited for further spirometric assessment to ascertain whether they have COPD or not. Post-bronchodilator spirometry will be conducted to ATS standards using an Easy One spirometer by trained research assistants.The primary outcomes will be new cases of COPD and cost per new case identified, comparing targeted case finding with routine care, and two types of targeted case finding (active versus opportunistic). A multilevel logistic regression model will be used to model the probability of detecting a new case of COPD for each treatment arm, with clustering of patients (by practice and household) accounted for using a multi-level structure.A trial-based analysis will be undertaken using costs and outcomes collected during the trial. Secondary outcomes include the feasibility, efficiency, long-term cost-effectiveness, patient and primary care staff views of each approach. This will be the largest RCT of its kind, and should inform how best to identify undiagnosed patients with COPD in the UK and other similar healthcare systems. Sensitivity analyses will help local policy-makers decide which sub-groups of the population to target first. Current controlled trials ISRCTN14930255.

Description and preliminary results from a structured specialist behavioural weight management group intervention: Specialist Lifestyle Management (SLiM) programme

PubMed Central

Brown, Adrian; Gouldstone, Amy; Fox, Emily; Field, Annmarie; Todd, Wendy; Shakher, Jayadave; Bellary, Srikanth; Teh, Ming Ming; Azam, Muhammad; John, Reggie; Jagielski, Alison; Arora, Teresa; Thomas, G Neil; Taheri, Shahrad

2015-01-01

Background Specialist Lifestyle Management (SLiM) is a structured patient education and self-management group weight management programme. Each session is run monthly over a 6-month period providing a less intensive long-term approach. The groups are patient-centred incorporating educational, motivational, behavioural and cognitive elements. The theoretical background, programme structure and preliminary results of SLiM are presented. Subjects/methods The study was a pragmatic service evaluation of obese patients with a body mass index (BMI) ≥35 kg/m2 with comorbidity or ≥40 kg/m2 without comorbidity referred to a specialist weight management service in the West Midlands, UK. 828 patients were enrolled within SLiM over a 48-month period. Trained facilitators delivered the programme. Preliminary anonymised data were analysed using the intention-to-treat principle. The primary outcome measure was weight loss at 3 and 6 months with comparisons between completers and non-completers performed. The last observation carried forward was used for missing data. Results Of the 828 enrolled within SLiM, 464 completed the programme (56%). The mean baseline weight was 135 kg (BMI=49.1 kg/m2) with 87.2% of patients having a BMI≥40 kg/m2 and 12.4% with BMI≥60 kg/m2. The mean weight change of all patients enrolled was −4.1 kg (95% CI −3.6 to −4.6 kg, p=0.0001) at the end of SLiM, with completers (n=464) achieving −5.5 kg (95% CI −4.2 to −6.2 kg, p=0.0001) and non-completers achieving −2.3 kg (p=0.0001). The majority (78.6%) who attended the 6-month programme achieved weight loss with 32.3% achieving a ≥5% weight loss. Conclusions The SLiM programme is an effective group intervention for the management of severe and complex obesity. PMID:25854970

Evaluating recovery following hip fracture: a qualitative interview study of what is important to patients.

PubMed

Griffiths, Frances; Mason, Victoria; Boardman, Felicity; Dennick, Katherine; Haywood, Kirstie; Achten, Juul; Parsons, Nicholas; Griffin, Xavier; Costa, Matthew

2015-01-06

To explore what patients consider important when evaluating their recovery from hip fracture and to consider how these priorities could be used in the evaluation of the quality of hip fracture services. Semistructured interviews exploring the experience of recovery from hip fracture at two time points-4 weeks and 4 months postoperative hip fixation. Two approaches to analysis: thematic analysis of data specifically related to recovery from hip fracture; summarising the participant's experience overall. 31 participants were recruited, of whom 20 were women and 12 were cognitively impaired. Mean age was 81.5 years. Interviews were provided by 19 patients, 14 carers and 8 patient/carer dyad; 10 participants were interviewed twice. Single major trauma centre in the West Midlands of the UK. Stable mobility (without falls or fear of falls) for valued activities was considered most important by participants who had some prefracture mobility and were able to articulate what they valued during recovery. Mobility was important for managing personal care, for day-to-day activities such as shopping and gardening, and for maintenance of mental well-being. Some participants used assistive mobility devices or adapted to their limitations. Others maintained their previous limited function through increased care provision. Many participants were unable to articulate what they valued as hip fracture was perceived as part of their decline with age. The fracture and problems from other health conditions were an inseparable part of one health experience. Prefracture mobility, adaptations to reduced mobility before or after fracture, and whether or not patients perceive themselves to be declining with age influence what patients consider important during recovery from hip fracture. No single patient-reported outcome measure could evaluate quality of care for all patients following hip fracture. General health-related quality of life tools may provide useful information within clinical trials. 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.

Child and adolescent musculoskeletal pain (CAM-Pain) feasibility study: testing a method of identifying, recruiting and collecting data from children and adolescents who consult about a musculoskeletal condition in UK general practice.

PubMed

Michaleff, Zoe A; Campbell, Paul; Hay, Alastair D; Warburton, Louise; Dunn, Kate M

2018-06-14

Test a method of identifying, recruiting and collecting data from children and adolescents who consult their general practitioner about a musculoskeletal condition. Prospective cohort feasibility study. 13 general practices in West Midlands of England. Patients aged 8-19 years who consult their general practice about a musculoskeletal condition. Patients were identified via a relevant musculoskeletal Read code entered at the point of consultation. Feasibility was assessed in terms of study processes (recruitment rates), data collection procedures (duration, response variability), resource utilisation (mail-outs) and ethical considerations (acceptability). From October 2016 to February 2017, an eligible musculoskeletal Read code was entered on 343 occasions, 202 patients were excluded (declined, n=153; screened not suitable, n=49) at the point of consultation. The remaining 141 patients were mailed an invitation to participate (41.1%); 46 patients responded to the invitation (response rate: 32.6%), of which 27 patients consented (consent rate: 19.1%). Participants mean age was 13.7 years (SD 2.7) and current pain intensity was 2.8 (SD 2.7). All participants completed the 6-week follow-up questionnaire. All participants found the interview questions to be acceptable and would consider participating in a similar study in the future. The majority of general practitioners/nurse practitioners, and all of the research nurses reported to be adequately informed about the study and found the study processes acceptable. The expected number of participants were identified and invited, but consent rate was low (<20%) indicating that this method is not feasible (eg, for use in a large prospective study). Recruiting children and adolescents with musculoskeletal conditions in a primary care setting currently presents a challenge for researchers. Further work is needed to identify alternative ways to conduct studies in this population in order to address the current knowledge gap in this field. © 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.

A content analysis of the UK press response to the diagnosis of Ebola in a British healthcare worker.

PubMed

Hobbs, Constance; Myles, Puja; Pritchard, Catherine

2017-12-01

The Ebola epidemic led to considerable media attention, which may influence public risk perception. Therefore, this study analysed the UK press response following diagnosis of a British healthcare worker (HCW) with Ebola. Using the Nexis database, the frequency of Ebola-related articles in UK national newspaper articles was mapped. This was followed by a content analysis of Ebola-related articles in the four newspapers with highest UK net readership from November 2014 to February 2015. During the 16-week study period, 1349 articles were found. The day with the highest number of Ebola-related articles was 31 December 2014, the day after the diagnosis of Ebola in a UK HCW. Seventy-seven articles were included in the content analysis. Content analysis demonstrated a shift from West African to UK-focused articles, increased discussion of border control, UK policy decisions and criticism, and an increased number of articles with a reassuring/threatening message. UK press coverage of Ebola increased following a HCW's diagnosis, particularly regarding discussion of screening measures. This is likely to have increased risk perception of Ebola in the UK population and may have contributed to subsequent strengthening of UK screening policy beyond World Health Organisation requirements. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Psychosocial risk factors for coronary heart disease in UK South Asian men and women.

PubMed

Williams, E D; Steptoe, A; Chambers, J C; Kooner, J S

2009-12-01

South Asian people in the UK and other western countries have elevated rates of coronary heart disease (CHD). Psychosocial factors contribute to CHD risk, but information about psychosocial risk profiles in UK South Asians is limited. This study aimed to examine the profile of conventional and novel psychosocial risk factors in South Asian compared with white men and women. Using a cross-sectional population study design, psychosocial profiles were assessed in 1130 South Asian and 818 white European healthy men and women aged between 35 and 75 years, who had previously participated in a cardiovascular risk assessment programme in West London. Psychosocial factors potentially contributing to CHD risk were assessed using standardised questionnaires. UK South Asians reported significantly higher psychosocial adversity compared with UK whites. South Asian men and women experienced greater chronic stress, in the form of financial strain, residential crowding, family conflict, social deprivation and discrimination, than white Europeans. They had larger social networks, but reported lower social support and greater depression and hostility. These effects were largely independent of socioeconomic status. UK South Asians experience significant psychosocial adversity compared with UK white Europeans. This is consistent with the heightened vulnerability to CHD observed in this population.

A detrital zircon provenance study of the Lower Carboniferous sequences in the East Fife section of the Midland Valley of Scotland

NASA Astrophysics Data System (ADS)

Murchie, Sean; Robinson, Ruth, ,, Dr; Lancaster, Penelope, ,, Dr

2014-05-01

Detrital zircons from the Lower Carboniferous clastic rocks of the Midland Valley of Scotland have been dated using U-Pb laser ablation inductively coupled plasma mass spectrometry (LA-ICPMS) to determine which source areas contributed sediment to the basin during its development, and to investigate whether provenance changed during deposition of these units. Specific provenance detection using U/Pb dating of zircons has never been attempted in these rocks, and there are uncertainties remaining about the regional paleogeographic setting for the Midland Valley. Four samples from the Dinantian Strathclyde Group have been analysed, and the units are locally known as the Fife Ness, Anstruther, Pittenweem, Sandy Craig, and Pathhead formations. The formations are composed of shallow marine, deltaic, fluvial and floodplain deposits and these predominantly siliciclastic sedimentary rocks are interbedded with thin fossiliferous carbonate bands. The samples are quartz arenitic, sub-arkosic and lithic arkosic medium-grained sandstones, predominantly from a fluvial origin. The British Geological Survey developed a lithostratigraphy which is the most used framework for the Strathclyde Group (Browne et al., 1997), but a different biostratigraphical framework based on palynology has been proposed by Owens et al. (2005). In addition to identifying provenance, the zircon age populations for each formation are compared to test which stratigraphic framework is correct. More broadly, the provenance data provides a way to improve the regional palaeogeographic setting for the Midland Valley. Zircon ages in the Strathclyde Group are dominated by Late Mesoproterozoic to Late Palaeoproterozoic (0.9 - 2.0 Ga) and Early Palaeozoic (350 - 450 Ma) ages which reflect Caledonide (Laurentian-Baltica margin including Scotland, Scandinavia, Greenland, Newfoundland), Grampian and internal Midland Valley source areas. Notable peaks occur at 400 Ma, 1.0 --1.1 Ga, 1.3 Ga, 1.6 - 1.7 Ga, and 2.7 Ga, and the Proterozoic age peaks are consistent with a Dalradian source. Although the age spectra for each formation are broadly similar, the proportions of age populations differ and age peaks present in the Anstruther Formation are absent in other formations. For instance, the Anstruther Formation has a significantly larger proportion of Archaean-aged zircons compared to the Pittenweem Formation, and contains a 1.3 Ga peak which is absent in the other formations. This suggests that source areas evolved throughout the deposition of the Strathclyde Group. The dominance of Mesoproterozoic and Palaeoproterozoic ages relative to Palaeozoic ages contrasts to similar ages units in the Pennine Basin and offshore North Sea, where the latter dominate the age spectra (Hallsworth et al., 2000; Morton et al., 2001). This may reflect the proximity of the Dalradian terrane and organisation of river systems draining into the Fife section of the Midland Valley during the Dinantian. References: Browne, M.A. et al. (1997). A lithostratigraphical framework for the Carboniferous rocks of the Midland Valley of Scotland. BGS Technical Report WA/96/29 Owens, B. et al. (2005). Reappraisal of the Mississippian palynostratigraphy of the East Fife coast, Scotland, United Kingdom. Palynology, 29, 23-47 Hallsworth et al (2000). Carboniferous sand provenance in the Pennine Basin. Sedimentary Geology, 137, 137-145 Morton et al (2001). Zircon age and heavy mineral constraints on provenance of North Sea Carboniferous sandstones. Marine and petroleum geology, 18, 319-337

Turbidity dynamics during spring storm events in an urban headwater river system: the Upper Tame, West Midlands, UK.

PubMed

Lawler, D M; Petts, G E; Foster, I D L; Harper, S

2006-05-01

Turbidity is an important water quality variable, through its relation to light suppression, BOD impact, sediment-associated contaminant transport, and suspended sediment effects on organisms and habitats. Yet few published field investigations of wet-weather turbidity dynamics, through several individual and sequenced rainstorms in extremely urbanised headwater basins, have emerged. This paper aims to address this gap through a turbidity analysis of multiple storm events in spring 2001 in an urban headwater basin (57 km2) of the River Tame, central England, the most urbanised basin for its size in the UK ( approximately 42%). Data were collected at 15-min frequency at automated monitoring stations for rainfall, streamflow and six water quality variables (turbidity, EC, temperature, DO, pH, ammonia). Disturbance experiments also allowed estimates of bed sediment storage to be obtained. Six important and unusual features of the storm event turbidity response were apparent: (1) sluggish early turbidity response, followed by a turbidity 'rush'; (2) quasi-coincident flow and turbidity peaks; (3) anti-clockwise hysteresis in the discharge-turbidity relationship on all but one event, resulting from Falling-LImb Turbidity Extensions (FLITEs); (4) increases in peak turbidity levels through storm sequences; (5) initial micro-pulses (IMP) in turbidity; and (6) secondary turbidity peaks (STP) or 'turbidity shoulders' (TS). These features provided very little evidence of a true 'first-flush' effect: instead, substantial suspended solids transport continued right through the flow recessions, and little storm-event sediment exhaustion was evident. A new, dimensionless, hysteresis index, HI(mid), is developed to quantify the magnitude and direction of hysteresis in a simple, clear, direct and intuitive manner. This allowed the degree of departure from the classic 'first-flush', clockwise hysteresis models to be assessed. Of the 15 turbidity events considered, 10 coincided with ammonia spikes of up to 6.25 mg l(-1) at Water Orton (the downstream station): this suggests that spills from combined sewer overflows (CSO) or waste water treatment works (WwTWs) are significant in the throughput of turbid waters here. Substantial ammonia peaks related most strongly to total storm rainfall receipt, of four rainfall variables considered, and significant ammonia peaks were generated even from low-magnitude storms (rainfall totals <4 mm), indicating that spills are a frequent occurrence. Local bed sediment stores appear to be limited, suggesting that other distal sediment sources, such as road networks and old mineworkings are possibly more important. Biofilms may also play a part in delaying sediment release until late in the hydrograph, and in suppressing late spring turbidity levels. Existing first-flush models appear to be an oversimplification here. Such urban headwater basin responses can provide useful insights into the generation of contaminant waves, and offer vital early-warning systems for pollution events propagating downstream.

I hope the memory café initiative takes off in hospitals across the UK.

PubMed

Ryan, Bridget

2014-12-15

What a wonderful 'Tea and sympathy' piece from staff nurse Katy Hope and assistant practitioner Jo Pope (Reflections December 3) about the 'memory café' for patients with dementia at the West Cornwall Hospital in Penzance.

Levels of advertised unprotected vaginal and oral sex by independent indoor female sex workers in West Yorkshire, UK.

PubMed

Eccles, Claire; Clarke, Janette

2014-02-01

To assess the proportion of independent indoor female sex workers (FSW) in West Yorkshire, UK who advertise unprotected sex, and to investigate any association with cost, location and provision of anal sex. Data on whether independent indoor FSW (defined as those not advertising via an escort agency or through a parlour) advertised unprotected sexual services, along with demographic data, were collected from 462 advertisement profiles of FSW in West Yorkshire from the website http://www.adultwork.com. Independent t test and χ(2) statistics were used to test the association between advertised unprotected vaginal and oral sex, and FSW age, cost of services, location and whether they advertised anal sex. Unprotected vaginal sex was advertised by 8% of FSW, and unprotected oral sex by 74% of FSW. FSW advertising unprotected vaginal sex were more likely to live in Wakefield and Bradford than in Leeds, had significantly lower hourly rates, and were more likely to advertise anal sex. Advertised condom use for vaginal and oral sex by independent indoor FSW in West Yorkshire was significantly lower than reported rates of protected sex found in previous studies based in London and the south of England. The advertisement of unprotected vaginal sex is associated with factors such as lower hourly rates and the advertisement of higher risk anal sex, which may signify greater economic need. FSW offering unprotected sex therefore represent an at-risk target group for health promotion.

Case study: design and implementation of training for scientists deploying to Ebola diagnostic field laboratories in Sierra Leone: October 2014 to February 2016

PubMed Central

Lewis, Suzanna M.; Lansley, Amber; Fraser, Sara; Shieber, Clare; Shah, Sonal; Semper, Amanda; Bailey, Daniel; Busuttil, Jason; Evans, Liz; Carroll, Miles W.; Silman, Nigel J.; Brooks, Tim; Shallcross, Jane A.

2017-01-01

As part of the UK response to the 2013–2016 Ebola virus disease (EVD) epidemic in West Africa, Public Health England (PHE) were tasked with establishing three field Ebola virus (EBOV) diagnostic laboratories in Sierra Leone by the UK Department for International Development (DFID). These provided diagnostic support to the Ebola Treatment Centre (ETC) facilities located in Kerry Town, Makeni and Port Loko. The Novel and Dangerous Pathogens (NADP) Training group at PHE, Porton Down, designed and implemented a pre-deployment Ebola diagnostic laboratory training programme for UK volunteer scientists being deployed to the PHE EVD laboratories. Here, we describe the training, workflow and capabilities of these field laboratories for use in response to disease epidemics and in epidemiological surveillance. We discuss the training outcomes, the laboratory outputs, lessons learned and the legacy value of the support provided. We hope this information will assist in the recruitment and training of staff for future responses and in the design and implementation of rapid deployment diagnostic field laboratories for future outbreaks of high consequence pathogens. This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’. PMID:28396470

Determining aspects of ethnicity amongst persons of South Asian origin: the use of a surname-classification programme (Nam Pehchan).

PubMed

Macfarlane, Gary J; Lunt, Mark; Palmer, Benedict; Afzal, Cara; Silman, Alan J; Esmail, Aneez

2007-03-01

Name-based classification systems are potentially useful in identifying study samples based on probable ethnic minority group. The aim of the current study was to assess the validity of the Nam Pehchan name classification programme of religion and language against subject self-report. A population-based cross-sectional survey conducted in areas of the North-West and West Midland regions of England with a relatively high density of South Asian ethnic minority groups. The sampling frame was age-sex registers of selected general practices and subjects were classified according to language and religion using the Nam Pehchan programme. These were compared with responses by subjects on a self-complete postal questionnaire. One thousand nine hundred and forty-nine subjects who participated, classified themselves as South Asian. Sensitivity in identifying religion was high amongst Muslims (92%) and Sikhs (86%), and somewhat lower in Hindus (62%). Specificity exceeded 95% for all ethnic groups. The vast majority of subjects assigned Punjabi or Gujarati as their main South Asian language indicated that they did in fact speak these languages (97% and 94%, respectively). Subjects assigned Urdu or Bengali, however, were less likely to do so (61% and 35%, respectively). The name-based classification system Nam Pehchan has demonstrated high levels of accuracy in some sub-groups of the South Asian population in determining subjects likely language spoken and religion-and is likely to be a useful additional tool when information on ethnicity is not already available.

Near patient testing in general practice: attitudes of general practitioners and practice nurses, and quality assurance procedures carried out.

PubMed Central

Hilton, S; Rink, E; Fletcher, J; Sibbald, B; Freeling, P; Szczepura, A; Davies, C; Stilwell, J

1994-01-01

BACKGROUND. The evaluation of near patient testing in British general practice has largely been confined to studies examining individual tests or comparing equipment. AIM. This study set out to determine the attitudes of practice staff to near patient testing, and the extent to which staff undertook quality assessment. METHOD. Four types of near patient testing machines were introduced into 12 general practices in two regions of England, south west Thames and west Midlands. General practitioner and practice nurse attitudes to near patient testing were assessed by semi-structured interview before and six months after the introduction of the machines. The extent to which routine quality assurance procedures were carried out within the surgery and as part of local and national schemes was examined. RESULTS. Although 80% of general practitioners anticipated changing patient management with near patient testing, only two fifths reported having done so after six months. Nurses generally were enthusiastic at the outset, although one third were unhappy about incorporating near patient testing into their work schedules. Time pressure was the most important factor restricting uptake of near patient testing. Nurses performed quality control regularly but complete local external quality assurance procedures were established in only half the practices. All the practices participated in a national scheme for cholesterol assays. CONCLUSION. General practitioners in this study did not find near patient testing a very useful addition to their resources. Pressure on nurses' time was the most frequently reported limitation. PMID:7748669

Mycobacterium bovis infection in domestic pigs in Great Britain.

PubMed

Bailey, Suzanne S; Crawshaw, Timothy R; Smith, Noel H; Palgrave, Christopher J

2013-11-01

Mycobacterium bovis, the causative agent of bovine tuberculosis (TB), infects a wide range of wild and domestic mammals. Despite a control programme spanning decades, M. bovis infection levels in cattle in Great Britain (GB) have continued to rise over recent years. As the incidence of infection in cattle and wildlife may be linked to that in swine, data relating to infection of pigs identified at slaughter were examined in this study. Between 2007 and 2011, almost all M. bovis-infected pigs originated from farms in the South-West and West-Midland regions of England. The data suggest that pigs raised outdoors or on holdings with poor biosecurity may be more vulnerable to infection with M. bovis. In the majority of cases, the same strains of M. bovis were found in pigs and cattle, despite that fact that direct contact between these species was rarely observed. Genotyping and geographical mapping data indicated that some strains found in pigs may correlate better with those present in badgers, rather than cattle. In consequence, it is proposed that pigs may represent a useful sentinel for M. bovis infection in wildlife in GB. Given the potential implications of this infection for the pig industry, and for the on-going effort to control bovine TB, the importance of understanding the epidemiology and pathogenesis of M. bovis infection, as well as monitoring its prevalence, in pigs should not be underestimated. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Impact of introducing near patient testing for standard investigations in general practice.

PubMed Central

Rink, E; Hilton, S; Szczepura, A; Fletcher, J; Sibbald, B; Davies, C; Freeling, P; Stilwell, J

1993-01-01

OBJECTIVE--To assess the clinical and economic impact of surgery based near patient testing in general practice for six commonly used biochemical and bacteriological tests. DESIGN--After four months' monitoring, equipment for two bacteriological and four biochemical tests was introduced without cost into 12 practices using a crossover design. Structured request forms were used to monitor laboratory investigations. SETTING--12 general practices in west midlands and south west Thames with list sizes above 9000. MAIN OUTCOME MEASURES--Investigation rates per 1000 consultations. Changes from baseline rates. Reasons for requesting investigations and provisional diagnoses. Cost per test and sensitivity of costs to rate of use. RESULTS--Investigation rates for the six tests rose by 16.5% (from 78.6/1000 consultations to 91.6/1000) when equipment was available in the surgery and reverted to baseline rates when it was withdrawn. The average weekly number of tests when equipment was available ranged from 0.5 to 10.5 (mean 9.0). Cholesterol tests were used as an addition to laboratory testing, usually for screening. Midstream urine analysis was often done in the surgery instead of in the laboratory, although 30% of samples were tested by both methods. Doctors' reasons for investigation and conditions tested were largely unaffected by availability of surgery tests. Costs for surgery tests were higher for all tests except midstream urine. CONCLUSIONS--Availability of surgery based testing increased the number of tests performed. It was cost effective only for midstream urine analysis. PMID:8219952

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

PubMed

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

2017-03-01

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

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

PubMed

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

2010-12-01

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

Audit of the annual reports of directors of public health: production methods.

PubMed

Sidhu, K S

1992-07-01

An audit of production methods used for the Directors of Public Health (DsPH) Annual Report of the health of their local population. Postal questionnaire survey. 23 Departments of Public Health in the West Midlands Region. Costs and problems relating to different production techniques used. The majority of DsPH favoured reports with figures and graphs. This led to most DsPH using in-house desktop publishing or employing external graphic designers. Those using the former technique had more problems related to computers and felt they spent too much medical time working on the document. However, they also valued the relative low cost, editorial freedom and the ability to correct mistakes easily. Departments which employed external graphic designers generally paid more, but appreciated the extra time made available by delegating the work. They also felt that the expertise was valuable in document design. However, inaccuracies were cited as being more difficult to correct. Perhaps the best way of producing an annual report is to amalgamate the two commonest production techniques (i.e. external graphic design and in-house desktop publishing).

Multiple primary cancers of breast and cervix uteri: An epidemiological approach to analysis

PubMed Central

Prior, P.; Waterhouse, J. A. H.

1981-01-01

Index sites of breast and cervix uteri were selected from populationbased data held at the West Midlands and Birmingham Regional Cancer Registry, and the expected numbers of second primary cancers in cervix and breast were computed (sequence analyses). In the breast series (17,756 patients) a small deficit of cervical tumours was observed (O = 16, E = 2·119, O/E = 0·76, P > 0·05), while in the cervix series (4817 patients) a small excess of breast tumours was found (O = 29, E = 23·38, O/E = 1·24, P > 0·05) over a period of 15 years. A theoretical statement of the combined risk of the 2 tumours occurring in the same individual of a general population was developed and was compared with the practical approach of summing the sequence analyses (complementary analysis). Complementary analysis indicated that there was no excess of women with the 2 primary tumours (O = 45, E = 44·57, O/E = 1·01) and that cancers of the breast and cervix uteri are not aetiologically related. PMID:7248147

Accessibility and quality of secondary care rheumatology services for people with inflammatory arthritis: a regional survey.

PubMed

Sandhu, R S; Treharne, G J; Justice, E A; Jordan, A C; Saravana, S; Obrenovic, K; Erb, N; Kitas, G D; Rowe, I F

2007-12-01

Secondary care rheumatology services for patients with inflammatory arthritis (IA) in the West Midlands were audited using Arthritis and Musculoskeletal Alliance (ARMA) standards of care. Questionnaires were analysed from 1,715 patients in 11 rheumatology departments. ARMA standards recommend full multidisciplinary team assessment; referral rates to nurse specialists (52.3%), physiotherapists (48.7%) and occupational therapists (36.5%) were, however, lower than expected. Attendance at existing hospital-led education groups was rare (8.9%), awareness of existing helplines was moderate (59.2%) but the proportion of patients reporting satisfaction with advice about their disease was high (80.5%). Significant variations were found between departments. For patients with IA < 2 years (n = 236), 84.5% were seen by a rheumatologist within the ARMA standard of 12 weeks of referral; diagnosis of a type of IA was made at the first rheumatology appointment in 66.4%; 82.8% of rheumatoid arthritis patients had commenced disease-modifying drugs, although time to commencement varied across departments. This study raises issues regarding provision of rheumatology services, prioritisation of patient referral and patient education.

Operation GRITROCK: the Defence Medical Services' story and emerging lessons from supporting the UK response to the Ebola crisis.

PubMed

Bricknell, Martin; Hodgetts, T; Beaton, K; McCourt, A

2016-06-01

This paper is a record of the UK Defence Medical Services (DMS) contribution to the UK response to the Ebola crisis in West Africa from the start of planning in July 2014 to the closure of the Ministry of Defence Ebola Virus Disease Treatment Unit at the end of June 2015. The context and wider UK government decisions are summarised. This paper describes the decisions and processes that resulted in the deployment of a DMS delivered Ebola Treatment Unit in conjunction with the Department for International Development and Save the Children. It covers arrangements for medical care for disease and non-battle injury, the Air Transportable Isolator and Force Health Protection policy, and finally, considers the medical lessons from this deployment. The core message is that the UK DMS are the only part of the UK health sector that is trained, equipped, manned and available to rapidly deploy and operate a complete medical unit as part of an international response to a health crisis. 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/

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

Knott, D.

Floating production system (FPS) technology has come of age in the North Sea. That's apparent in plans to use FPSs to tap two of Northwest Europe's largest offshore oil discoveries in the last 10 years. First North Sea oil production with a floater involved a converted semisubmersible drilling rig. Floaters have been in use for small field development projects ever since. Now, industry's rising interest in FPSs reflects two trends: As the North Sea matures, discoveries are likely to be in deeper, more remote locations; and Operators increasingly are under pressure to slash costs. The paper discusses UK trends, Norway'smore » needs, the Norne field, Norne contract, discovery of oil west of the Shetland Islands, Shell-Esso plans, the UK Machar field test, the UK Fife field, and prospects for other potential floater developments.« less

High-resolution measurements from the airborne Atmospheric Nitrogen Dioxide Imager (ANDI)

NASA Astrophysics Data System (ADS)

Lawrence, J. P.; Anand, J. S.; Vande Hey, J. D.; White, J.; Leigh, R. R.; Monks, P. S.; Leigh, R. J.

2015-11-01

Nitrogen dioxide is both a primary pollutant with direct health effects and a key precursor of the secondary pollutant ozone. This paper reports on the development, characterisation and test flight of the Atmospheric Nitrogen Dioxide Imager (ANDI) remote sensing system. The ANDI system includes an imaging UV/Vis grating spectrometer able to capture scattered sunlight spectra for the determination of tropospheric nitrogen dioxide (NO2) concentrations by way of DOAS slant column density and vertical column density measurements. Results are shown for an ANDI test flight over Leicester City in the UK on a cloud-free winter day in February 2013. Retrieved NO2 columns gridded to a surface resolution of 80 m × 20 m revealed hotspots in a series of locations around Leicester City, including road junctions, the train station, major car parks, areas of heavy industry, a nearby airport (East Midlands) and a power station (Ratcliffe-on-Soar). In the city centre the dominant source of NO2 emissions was identified as road traffic, contributing to a background concentration as well as producing localised hotspots. Quantitative analysis revealed a significant urban increment over the city centre which increased throughout the flight.

Dissemination of aerial and root infecting Phytophthoras by human vectors

Treesearch

J.F. Webber; J. Rose

2008-01-01

Two new Phytophthora pathogens, Phytophthora kernoviae and P. ramorum, have recently established in parts of the U.K. They are most prevalent in the south west of England where they cause intense episodes of foliar blight and dieback on both ornamental and naturalised rhododendron such as Rhododendron ponticum,...

New Patterns of Collaboration and Rivalry in the US and European Defense and Aerospace Industries

DTIC Science & Technology

2009-08-19

of DaimlerChrysler Aerospace (DASA) of Germany, Aerospatiale Matra of France, and Construcciones Aeronauticas S.A. (CASA) of Spain. Its statutory...of the Cobham company of the UK) at its Bridgeport, West Virginia, plant. EADS also anticipates constructing a facility near the Sargent-Fletcher

On the Potential of Surfers to Monitor Environmental Indicators in the Coastal Zone.

PubMed

Brewin, Robert J W; de Mora, Lee; Jackson, Thomas; Brewin, Thomas G; Shutler, Jamie

2015-01-01

The social and economic benefits of the coastal zone make it one of the most treasured environments on our planet. Yet it is vulnerable to increasing anthropogenic pressure and climate change. Coastal management aims to mitigate these pressures while augmenting the socio-economic benefits the coastal region has to offer. However, coastal management is challenged by inadequate sampling of key environmental indicators, partly due to issues relating to cost of data collection. Here, we investigate the use of recreational surfers as platforms to improve sampling coverage of environmental indicators in the coastal zone. We equipped a recreational surfer, based in the south west United Kingdom (UK), with a temperature sensor and Global Positioning System (GPS) device that they used when surfing for a period of one year (85 surfing sessions). The temperature sensor was used to derive estimates of sea-surface temperature (SST), an important environmental indicator, and the GPS device used to provide sample location and to extract information on surfer performance. SST data acquired by the surfer were compared with data from an oceanographic station in the south west UK and with satellite observations. Our results demonstrate: (i) high-quality SST data can be acquired by surfers using low cost sensors; and (ii) GPS data can provide information on surfing performance that may help motivate data collection by surfers. Using recent estimates of the UK surfing population, and frequency of surfer participation, we speculate around 40 million measurements on environmental indicators per year could be acquired at the UK coastline by surfers. This quantity of data is likely to enhance coastal monitoring and aid UK coastal management. Considering surfing is a world-wide sport, our results have global implications and the approach could be expanded to other popular marine recreational activities for coastal monitoring of environmental indicators.

Potential impact of climate change on emerging vector-borne and other infections in the UK.

PubMed

Baylis, Matthew

2017-12-05

Climate is one of several causes of disease emergence. Although half or more of infectious diseases are affected by climate it appears to be a relatively infrequent cause of human disease emergence. Climate mostly affects diseases caused by pathogens that spend part of their lifecycle outside of the host, exposed to the environment. The most important routes of transmission of climate sensitive diseases are by arthropod (insect and tick) vectors, in water and in food. Given the sensitivity of many diseases to climate, it is very likely that at least some will respond to future climate change. In the case of vector-borne diseases this response will include spread to new areas. Several vector-borne diseases have emerged in Europe in recent years; these include vivax malaria, West Nile fever, dengue fever, Chikungunya fever, leishmaniasis, Lyme disease and tick-borne encephalitis. The vectors of these diseases are mosquitoes, sand flies and ticks. The UK has endemic mosquito species capable of transmitting malaria and probably other pathogens, and ticks that transmit Lyme disease. The UK is also threatened by invasive mosquito species known to be able to transmit West Nile, dengue, chikungunya and Zika, and sand flies that spread leishmaniasis. Warmer temperatures in the future will increase the suitability of the UK's climate for these invasive species, and increase the risk that they may spread disease. While much attention is on invasive species, it is important to recognize the threat presented by native species too. Proposed actions to reduce the future impact of emerging vector-borne diseases in the UK include insect control activity at points of entry of vehicles and certain goods, wider surveillance for mosquitoes and sand flies, research into the threat posed by native species, increased awareness of the medical profession of the threat posed by specific diseases, regular risk assessments, and increased preparedness for the occurrence of a disease emergency.

On the Potential of Surfers to Monitor Environmental Indicators in the Coastal Zone

PubMed Central

Brewin, Robert J. W.; de Mora, Lee; Jackson, Thomas; Brewin, Thomas G.; Shutler, Jamie

2015-01-01

The social and economic benefits of the coastal zone make it one of the most treasured environments on our planet. Yet it is vulnerable to increasing anthropogenic pressure and climate change. Coastal management aims to mitigate these pressures while augmenting the socio-economic benefits the coastal region has to offer. However, coastal management is challenged by inadequate sampling of key environmental indicators, partly due to issues relating to cost of data collection. Here, we investigate the use of recreational surfers as platforms to improve sampling coverage of environmental indicators in the coastal zone. We equipped a recreational surfer, based in the south west United Kingdom (UK), with a temperature sensor and Global Positioning System (GPS) device that they used when surfing for a period of one year (85 surfing sessions). The temperature sensor was used to derive estimates of sea-surface temperature (SST), an important environmental indicator, and the GPS device used to provide sample location and to extract information on surfer performance. SST data acquired by the surfer were compared with data from an oceanographic station in the south west UK and with satellite observations. Our results demonstrate: (i) high-quality SST data can be acquired by surfers using low cost sensors; and (ii) GPS data can provide information on surfing performance that may help motivate data collection by surfers. Using recent estimates of the UK surfing population, and frequency of surfer participation, we speculate around 40 million measurements on environmental indicators per year could be acquired at the UK coastline by surfers. This quantity of data is likely to enhance coastal monitoring and aid UK coastal management. Considering surfing is a world-wide sport, our results have global implications and the approach could be expanded to other popular marine recreational activities for coastal monitoring of environmental indicators. PMID:26154173

Translational research needs us to go back to basics and collaborate: interview with Lars Sundstrom.

PubMed

Sundstrom, Lars

2016-09-01

Lars Sundstrom is Director of Enterprise and Translation at the West of England Academic Health Sciences Network [1] (UK), a Professor of Practice in Translational Medicine and Co-Director of the Elizabeth Blackwell Institute for Health Research at Bristol University [2] (UK), and an honorary Professor of Medicine at Cardiff University (UK). He has extensive experience in translational medicine and clinical neurosciences, holding positions at several eminent universities. He has also held executive and board-level positions at several SMEs, developing new therapeutics for neurological conditions and tools for drug discovery. He has also been an advisor to several UK and local government task forces and to the European Commission and the European Federation of Pharmaceutical Industry Associations. He was a founding member of the European Brain Council in Brussels, and set up the Severnside Alliance for Translational Research, developing a regional network partnership to link clinical and basic scientists. He was also involved in the creation of Health Research Wales.

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

O'Sullivan, D.A.

The growing concern about acid rain in Europe with particular reference to West Germany, the UK and Scandinavia is discussed. Damage has occurred not only to trees but also to many historic buildings throughout Europe. The mechanism of acid deposition is outlined; monitoring systems have established correlations between transport of sulfur dioxide and nitrogen oxides from the UK and central Europe and increased acidity in lakes and rivers in Scandinavia. In November 1979 thirty four countries and the European Economic Community signed a convention on longrange transboundary air pollution; in 1983 Finland, Norway, and Sweden proposed that member countries ofmore » the so-called 30% Club should cut annual sulfur emissions 30% from their 1980 base emission levels, by 1993 at the latest. The UK and the US are conspicuous by their absence from the 30% Club. In the UK in particular it is argued that firm proof is lacking that sulfur dioxide is the prime factor in forest decline; nitrogen oxides, hydrocarbons and ozone may be more critical factors.« less

Perspectives on enhancing physical activity and diet for health promotion among at-risk urban UK South Asian communities: a qualitative study

PubMed Central

Cross-Bardell, Laura; George, Tracey; Bhoday, Mandeep; Tuomainen, Helena; Qureshi, Nadeem; Kai, Joe

2015-01-01

Objectives To explore perspectives on enhancing physical activity and diet among South Asians in urban deprived communities at high risk of chronic disease and to inform development of culturally appropriate health promotion intervention. Design Qualitative study using semistructured one-to-one and family group interviews with thematic analysis of data. Setting Urban disadvantaged communities in the East Midlands of the UK. Participants 45 respondents, including 34 people of South Asian origin (16 at-risk individuals, six family groups involving 18 relatives), of mainly Pakistani and Indian origin, including 16 non-English speakers; and 11 health professionals working locally with communities of concern. Results South Asian participants underlined the challenges of requiring family members across generations to engage in modifying dietary behaviours, and the central role of communal eating of traditional ‘Asian’ food in their cultural lives. Barriers to increasing physical activity included cost, personal safety and lack of time outside of long working hours and carer commitments. However, increasing walking activity was regarded as feasible by both community and health professional participants. Respondents emphasised using a social approach for potential interventions, undertaking activity with family or friends and with bilingual community peers to facilitate engagement, motivation and support. Spoken content and delivery of interventions was favoured, including personal stories and multilingual audio–visual information; within local informal rather than provider settings, including the home; and aided by pedometers for self-monitoring. Conclusions Focusing on physical activity by increasing walking may hold promise as health promotion in this deprived South Asian community context. Further intervention development, with exploration of feasibility and acceptability of the social approach and elements suggested, is merited. PMID:25724983

Exploring physiotherapists' experiences of implementing a cognitive behavioural approach for managing low back pain and identifying barriers to long-term implementation.

PubMed

Richmond, Helen; Hall, Amanda M; Hansen, Zara; Williamson, Esther; Davies, David; Lamb, Sarah E

2018-03-01

Our objectives were two-fold: (i) to describe physiotherapists' experiences of implementing a cognitive behavioural approach (CBA) for managing low back pain (LBP) after completing an extensive online training course (iBeST), and (ii) to identify how iBeST could be enhanced to support long-term implementation before scale up for widespread use. We conducted semi-structured interviews with 11 physiotherapists from six National Health Service departments in the Midlands, Oxfordshire and Derbyshire. Questions centred on (i) using iBeST to support implementation, (ii) what barriers they encountered to implementation and (iii) what of information or resources they required to support sustained implementation. Interviews were transcribed and thematically analysed using NVivo. Themes were categorised using the Theoretical Domains Framework (TDF). Evidence-based techniques were identified using the behaviour change technique taxonomy to target relevant TDF domains. Three themes emerged from interviews: anxieties about using a CBA, experiences of implementing a CBA, and sustainability for future implementation of a CBA. Themes crossed multiple TDF domains and indicated concerns with knowledge, beliefs about capabilities and consequences, social and professional roles, social influences, emotion, and environmental context and resources. We identified evidence-based strategies that may support sustainable implementation of a CBA for LBP in a physiotherapy setting. This study highlighted potential challenges for physiotherapists in the provision of evidence-based LBP care within the current UK NHS. Using the TDF provided the foundation to develop a tailored, evidence-based, implementation intervention to support long term use of a CBA by physiotherapists managing LBP within UK NHS outpatient departments. Copyright © 2017 Chartered Society of Physiotherapy. All rights reserved.

Improving the Velocity Structure in the Delaware Basin of West Texas for Seismicity Monitoring

NASA Astrophysics Data System (ADS)

Huang, D.; Aiken, C.; Savvaidis, A.; Young, B.; Walter, J. I.

2017-12-01

The State of Texas has commissioned the Bureau of Economic Geology to install a seismic network (TexNet) which, when complete, will employ 22 permanent and 33 portable new stations. In the area of west Texas, where it consists of two major sedimentary basins - the Delaware and Midland basins, 7 new permanent stations have been deployed. Starting from January 2017, TexNet has detected several hundreds of small-sized earthquakes in the area adjacent to the Pecos township. In response to the detection of a surprisingly high occurrence of seismicity in this area, we have increased the number of seismic stations through the addition of portable deployments. The depth range of the detected seismicity is from subsurface down to 14 km depth. Based on the initial hypocentral information determined by the TexNet's routine process, we further relocated these earthquakes using the double-difference relocation method (i.e., hypoDD). At the same time, we employed statistic regression (i.e., the Wadati diagram) to constrain the origin times of these relocated earthquakes, while their hypocentral locations have been better constrained by hypoDD relocation. The constrained origin times and relocated earthquake hypocenters, along with the velocity information of subsurface from a local sonic-log profile, are used in tomographic inversion to update the crustal velocity model for the Delaware basin and surrounding area. Preliminary results suggest that both local topography and subsurface structures have strong influence on locating earthquakes that occurred at a shallower depth range in west Texas. A subsurface layer with Vp of 4.5-5.0 km/s is suggested to corroborate the regional tectonic setting as a sedimentary basin. Our next steps are to include more local and teleseismic data recorded by TexNet as well as by stations from the previous US Transportable Array. Inclusion of these data will increase ray-crossing coverage within the volume of the velocity model, resulting in a better model resolution.

Improving the management of behaviour that challenges associated with dementia in care homes: protocol for pharmacy-health psychology intervention feasibility study.

PubMed

Maidment, Ian D; Shaw, Rachel L; Killick, Kirsty; Damery, Sarah; Hilton, Andrea; Wilcock, Jane; Barnes, Nigel; Brown, Graeme; Gillespie, Sarah; Fox, Chris; Barton, Garry; Iliffe, Steve; Seare, Nichola

2016-03-23

The inappropriate use of antipsychotics in people with dementia for behaviour that challenges is associated with an estimated 1800 deaths annually. However, solely focusing on antipsychotics may transfer prescribing to other equally dangerous psychotropics. Little is known about the role of pharmacists in the management of psychotropics used to treat behaviours that challenge. This research aims to determine whether it is feasible to implement and measure the effectiveness of a combined pharmacy-health psychology intervention incorporating a medication review and staff training package to limit the prescription of psychotropics to manage behaviour that challenges in care home residents with dementia. 6 care homes within the West Midlands will be recruited. People with dementia receiving medication for behaviour that challenges, or their personal consultee, will be approached regarding participation. Medication used to treat behaviour that challenges will be reviewed by the pharmacist, in collaboration with the general practitioner (GP), person with dementia and carer. The behavioural intervention consists of a training package for care home staff and GPs promoting person-centred care and treating behaviours that challenge as an expression of unmet need. The primary outcome measure is the Neuropsychiatric Inventory-Nursing Home version (NPI-NH). Other outcomes include quality of life (EQ-5D and DEMQoL), cognition (sMMSE), health economic (CSRI) and prescribed medication including whether recommendations were implemented. Outcome data will be collected at 6 weeks, and 3 and 6 months. Pretraining and post-training interviews will explore stakeholders' expectations and experiences of the intervention. Data will be used to estimate the sample size for a definitive study. The project has received a favourable opinion from the East Midlands REC (15/EM/3014). If potential participants lack capacity, a personal consultee will be consulted regarding participation in line with the Mental Capacity Act. Results will be published in peer-reviewed journals and presented at conferences. 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/

Book review: Handbook of cyanobacterial monitoring and cyanotoxin analysis

USGS Publications Warehouse

Graham, Jennifer L.; Loftin, Keith A.

2018-01-01

Review of Meriluoto, Jussi, Lisa Spoof, and GeoffreyA. Codd [eds.]. 2017. Handbook of Cyanobacterial Monitoring and Cyanotoxin Analysis. John Wiley & Sons, Ltd.: Chichester, West Sussex, UK, ISBN 978‐1‐119‐06868‐6 (978‐1‐119‐06876‐1 eBook), DOI 10.1002/9781119068761.

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

ERIC Educational Resources Information Center

Maconachie, Moira; Lewendon, Gill

2004-01-01

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

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

NASA Astrophysics Data System (ADS)

Coombes, Martin; Viles, Heather

2014-05-01

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

Macronutrient status of UK groundwater: Nitrogen, phosphorus and organic carbon.

PubMed

Stuart, M E; Lapworth, D J

2016-12-01

Groundwater is a large, slowly changing pool of the macronutrients nitrogen (N), phosphorus (P) and dissolved organic carbon (DOC), with impacts on receptors, surface waters, dependent wetlands and coastal marine ecosystems. Sources of N to groundwater include fertilisers, animal wastes and septic effluents. N species are well-quantified in groundwater and NO 3 -N has a wide range of median values (0-12mg/L). The highest concentrations are in the Chalk of East Anglia and Humberside and the Permo-Triassic Sandstone (PTS) of Staffordshire. The highest concentrations of NH 4 -N are found in confined aquifers. N concentrations have increased with time peaking during the 1980s. Changes in practice have led to the reduction observed in rapidly-responding aquifers. For the Chalk, where the unsaturated zone is thick, improvements may not be seen for decades. P is less well-characterised in UK groundwater reflecting the lack of historical interest in groundwater P, although it can be significant in some aquifer matrices. Groundwater P concentrations are elevated in sandstone formations compared to other lithology and highest in the PTS of the Midlands and northern England (median values>50μg/L). Overall half of the aquifers studied in the UK have median TDP>50μg/L, with values of up to 100μg/L under some urban areas, such as Manchester and Liverpool as well as the Lee Valley. P concentrations in arable areas are variable (20-100μg/L), whereas under semi-natural conditions they are lower (20-50μg/L). There is little information on P trends in groundwater. Most DOC is derived from soils, playing an important part in redox processes. The aquifer matrix can contain high OC and contribute significantly to groundwater DOC. Median values range between 0.4 and 9mg/L, but rarely exceed 5mg/L, except in the Chalk of Yorkshire and Humberside and PTS of Liverpool which have long legacies of anthropogenic pollution. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Regional scale climatic trends derived from Younger Dryas glaciers in the U.K.

NASA Astrophysics Data System (ADS)

Pearce, D.; Rea, B. R.; Barr, I.; Small, D.; McDougall, D.

2014-12-01

In the U.K., the glacial geomorphological record has been utilised to infer paleo-glacier geometries and ice dynamics, with much of this work focussing on the Scottish Highlands during the Younger Dryas (YD; c. 12.9 - 11.7 ka BP). During the YD the West Highlands Ice-cap covered the majority of the Scottish Highlands (c. 13,000 sq mi), which is thought to have affected accumulation rates beyond the ice-cap margins, resulting in a steep (c. 80%) easterly decline in precipitation and smaller ice-masses. We present multi-proxy data investigating YD glaciation in the Tweedsmuir Hills, Southern Uplands, Scotland (55°46' N, 03°34' W), suggesting conditions were less arid. The area forms the most easterly upland region in the Southern Uplands and south of the West Highlands Ice-cap, reaching an altitude of 840 m and covering c. 200 sq mi. Results of air-photo interpretation and field mapping, which utilised a morphostratigraphic approach, have demonstrated a more extensive glaciation than previously mapped. The reconstruction consists of two separate icefields covering an area c. 40 sq mi. and new 14C dates of basal contact organics place the ice-mass within the context of the YD but new Cosmogenic Nuclide Analysis (CNA) of bedrock and in situ boulders are inconclusive, implying limited erosion and limited resetting during the YD. Equilibrium Line Altitudes are calculated to have ranged from c. 419 - 634 m. Paleo-precipitation values were derived using two precipitation-temperature relationships and suggest slightly lower totals than YD ice-masses located on the west coast of the U.K. but do not support a significant easterly reduction in precipitation. Analysis of present-day (c. 30 year) meteorological data across the U.K. demonstrates a pronounced reduction in precipitation of c. 50% on the east coast. This disparity between present-day and glacier-based YD precipitation patterns is partly attributable to the methodology employed in glacier reconstruction and represents an avenue for future research. These results differ significantly from the traditional paradigm which due to low accumulation rates, only restricted ice-masses developed in the Tweedsmuir Hills. Within a wider context this data questions the steep precipitation gradients thought to have been present during the YD.

Prevalence and causes of self-reported work-related stress in head teachers.

PubMed

Phillips, Samantha; Sen, Dil; McNamee, Roseanne

2007-08-01

Work-related stress (WRS) is the leading cause of occupational ill-health in the education sector in the UK. Headship is believed to be a stressful role although there is little current research into stress in head teachers. Changes in the education sector since the late 1980s have meant that the findings of many existing studies are outdated. To investigate prevalence and causes of self-reported, WRS in head teachers in West Sussex, UK. A cross-sectional study using postal questionnaire in a population of 290 head teachers and principals. The measuring instrument was a short stress evaluation tool (ASSET) plus additional questions derived from previous studies. Stress cases were defined as respondents who felt their work was 'very or extremely stressful'. Prevalence of self-reported, WRS was 43%. Using ASSET scoring, work overload and work-life imbalance were the key stressors. Females were significantly more stressed than males for a number of stressors including overload and control. Although there was some evidence that primary head teachers fared worse than their secondary counterparts, once the confounding effects of gender were included, there were few significant differences. The prevalence of self-reported stress in head teachers in West Sussex is significantly increased compared to recent studies of workers in the UK. The recurring theme in existing studies of workload as a main stressor is confirmed in the findings of this study. Gender and type of school does affect outcome and female head teachers have more reported stressors than their male colleagues.

Process evaluation results of a cluster randomised controlled childhood obesity prevention trial: the WAVES study.

PubMed

Griffin, T L; Clarke, J L; Lancashire, E R; Pallan, M J; Adab, P

2017-08-29

Increasing prevalence of childhood obesity and its related consequences emphasises the importance of developing and evaluating interventions aimed at prevention. The importance of process evaluation in health intervention research is increasingly recognised, assessing implementation and participant response, and how these may relate to intervention success or failure. A comprehensive process evaluation was designed and undertaken for the West Midlands ActiVe lifestyle and healthy Eating in School children (WAVES) study that tested the effectiveness of an obesity prevention programme for children aged 6-7 years, delivered in 24 UK schools. The four intervention components were: additional daily school-time physical activity (PA); cooking workshops for children and parents; Villa Vitality (VV), a 6-week healthy lifestyle promotion programme run by a local football club; and signposting to local PA opportunities. Data relating to six dimensions (Fidelity, Reach, Recruitment, Quality, Participant Responsiveness, Context) were collected via questionnaires, logbooks, direct observations, focus groups and interviews. Multiple data collection methods allowed for data triangulation and validation of methods, comparing research observations with teacher records. The 6-stage WAVES study model ((i) Data collection, (ii) Collation, (iii) Tabulation, (iv) Score allocation and discussion, (v) Consultation, (vi) Final score allocation) was developed to guide the collection, assimilation and analysis of process evaluation data. Two researchers independently allocated school scores on a 5-point Likert scale for each process evaluation dimension. Researchers then discussed school score allocations and reached a consensus. Schools were ranked by total score, and grouped to reflect low, medium or high intervention implementation. The intervention was predominantly well-implemented and well-received by teachers, parents and children. The PA component was identified as the most challenging, VV the least. Median implementation score across schools was 56/75 (IQR, 51.0 - 60.8). Agreement between teacher logbooks and researcher observations was generally high, the main discrepancies occurred in session duration reporting where in some cases teachers' estimations tended to be higher than researchers'. The WAVES study model provides a rigorous and replicable approach to undertaking and analysing a multi-component process evaluation. Challenges to implementing school-based obesity prevention interventions have been identified which can be used to inform future trials. ISRCTN97000586 . 19 May 2010.

Evaluation of a bespoke training to increase uptake by midwifery teams of NICE Guidance for membrane sweeping to reduce induction of labour: a stepped wedge cluster randomised design.

PubMed

Kenyon, Sara; Dann, Sophie; Hope, Lucy; Clarke, Paula; Hogan, Amanda; Jenkinson, David; Hemming, Karla

2017-07-27

National guidance recommends pregnant women are offered membrane sweeping at term to reduce induction of labour. Local audit suggested this was not being undertaken routinely across two maternity units in the West Midlands, UK between March and November 2012. Bespoke training session for midwifery teams (nine community and one antenatal clinic) was developed to address identified barriers to encourage offer of membrane sweeping, together with an information leaflet for women and appointment of a champion within each team. The timing of training session on membrane sweeping to ten midwifery teams was randomly allocated using a stepped wedge cluster randomised design. All women who gave birth in the Trusts after 39 + 3/40 weeks gestation within the study time period were eligible. Relevant anonymised data were extracted from maternity notes for three months before and after training. Data were analysed using a generalised linear mixed model, allowing for clustering and adjusting for temporal effects. Primary outcomes were number of women offered and accepting membrane sweeping and average number of sweeps per woman. Sub-group comparisons were undertaken for adherence to Trust guidance and potential influence of pre-specified maternal characteristics. Data included whether sweeping was offered but declined and no record of membrane sweeping. Training was given to all teams as planned. Analyses included data from 2787 of the 2864 (97%) eligible low-risk women over 39 + 4 weeks pregnant. Characteristics of the women were similar before and after training. No evidence of difference in proportion of women being offered and accepting membrane sweeping (44.4% before training versus 46.8% after training (adjusted relative risk [aRR] = 0.90, 95% confidence interval [CI] = 0.71-1.13), nor in average number of sweeps per woman (0.603 versus 0.627, aRR = 0.83, 95% CI = 0.67-1.01). No differences in any secondary outcomes nor influence of maternal characteristics were demonstrated. The midwives evaluated training positively. This stepped wedge cluster trial enabled randomised evaluation within a natural roll-out and demonstrates the importance of robust evaluation in circumstances in which it is rarely undertaken. While the midwives evaluated the training positively, it did not appear to change practice. ISRCTN14300475 . Registered on 23 August 2016.

A License to Produce? Farmer Interpretations of the New Food Security Agenda

ERIC Educational Resources Information Center

Fish, Rob; Lobley, Matt; Winter, Michael

2013-01-01

Drawing on the findings of empirical research conducted in the South West of England, this paper explores how farmers make sense of re-emerging imperatives for "food security" in UK policy and political discourse. The analysis presented is based on two types of empirical inquiry. First, an extensive survey of 1543 farmers, exploring the…

ABA and Diverse Cultural and Linguistic Environments: A Welsh Perspective

ERIC Educational Resources Information Center

Jones, E. W.; Hoerger, M.; Hughes, J. C.; Williams, B. M.; Jones, B.; Moseley, Y.; Hughes, D. R.; Prys, D.

2011-01-01

Gwynedd Local Education Authority (LEA) in North West Wales, UK, is funding a small-scale autism-specific specialist education service using ABA methodology. The program is available through the medium of Welsh, English or bilingually, depending on the individual needs of the child (Jones and Hoerger in Eur J Behav Anal 10:249-253,…

Marine and Maritime Sector Skills Shortages in the South West of England: Developing Regional Training Provision

ERIC Educational Resources Information Center

Beer, Julian; Meethan, Kevin

2007-01-01

Clustering theory assumes that companies gravitate towards each other on the basis of locally and regionally specific resources and supply chain characteristics, which lead in turn to innovation and high-value economic development. In line with such thinking, UK government policy has devolved certain functions to regional development agencies such…

Presidential Green Chemistry Challenge: 2005 Designing Greener Chemicals Award

EPA Pesticide Factsheets

Presidential Green Chemistry Challenge 2005 award winner, Archer Daniels Midland, developed Archer RC, a nonvolatile, biobased, reactive coalescent that replaces volatile organic coalescents in architectural latex paints.

Gender differences amongst adult arsonists at psychiatric assessment.

PubMed

Dickens, Geoff; Sugarman, Philip; Ahmad, Farooq; Edgar, Simon; Hofberg, Kristina; Tewari, Sidharta

2007-07-01

Reports of gender differences amongst arsonists at psychiatric assessment are not uncommon, however some are based on relatively small samples. A new retrospective study highlighting gender differences could help to confirm or refute the current state of knowledge. The aim of the current study was to examine gender differences amongst a sample of 167 adult arsonists (129 males and 38 females). Information was collected from clinical records on sociodemographic, family background and childhood factors; adult adjustment; fire setting history; motives; features of pyromania and other offending, from the case notes of a group of arsonists referred to the West Midlands Psychiatry Service over a 24-year period. Female arsonists were older than males and more likely to have a psychiatric diagnosis. Women more frequently had a history of sexual abuse, while men had a more varied criminal background and more substance abuse problems. Our findings largely support previous research, and are discussed in this context, whilst also bringing attention to a more recently developed theory (Action System Model). Significant gender differences amongst arsonists indicates that different emphases in the treatment of male and female arsonists may be advisable, though a reliable evidence base for treatment has yet to be established.

Managing crisis: the role of primary care for people with serious mental illness.

PubMed

Lester, Helen; Tritter, Jonathan Q; Sorohan, Helen

2004-01-01

More than 30% of patients with serious mental illness in the United Kingdom now receive all their health care solely from primary care. This study explored the process of managing acute mental health crises from the dual perspective of patients and primary care health professionals. Eighteen focus groups involving 45 patients, 39 general practitioners, and eight practice nurses were held between May and November 2002 in six Primary Care Trusts across the British West Midlands. The topic guide explored perceptions of gold standard care, current issues and critical incidents in receiving/providing care, and ideas on improving services. Themes relevant to the management of acute crisis included issues of process, such as access, advocacy, communication, continuity, and coordination of care; the development of more structured care that might reduce the need for crisis responses; and issues raised by the development of a more structured approach to care. Access to services is a complicated yet crucial feature of managing care in a crisis, with patients identifying barriers at the level of primary care and health professionals at the interface with secondary care. The development of more structured systems as a solution may generate its own ethical and pragmatic challenges.

Learning, assessment and professional identity development in public health training.

PubMed

Wood, Annette

2016-06-01

Professional identity formation is important for new recruits to training programmes. The integration of the accumulation of knowledge and assessment is a key aspect in its acquisition. This study assessed this interaction in Public Health Training in one English region. Semi-structured interviews were held with 15 registrars from the West Midlands Public Health Training Programme. Pre-interview questionnaires gathered background information. A thematic content analysis approach was taken. There was a lack of integration between academic and workplace learning, the professional examination process and professional identity development. Registrars considered sitting the examination and their workplace learning as two parallel processes. Passing the examination was considered a key part in the early development of a professional identity but this was replaced by the opinions of others by the third year of training. Having a Masters' in Public Health was less important but played a different role in their perceived acceptance by the wider Public Health workforce. The lack of integration between assessment and learning seemed to have a detrimental effect on professional identity development. A review of how these two aspects might combine in a more positive manner is needed.

Supporting care home staff to manage residents' care safely and avoid admissions.

PubMed

Wills, Susan; Ross, Dena

2018-05-31

The community matron care homes team (CHT) was set up in Sandwell, West Midlands in 2011 to support care home staff to manage residents' care safely and reduce unplanned and/or avoidable use of acute health services. The service was reviewed in 2015 and attention focused on care homes with the highest levels of hospital use and emergency 999 services. Working with these care home staff and health professionals, a training and education opportunity to aid staff to manage residents in crisis was sourced, organised and implemented. The outcome of this training was positive: it demonstrated a reduction in hospital attendances and admissions and an increase in the confidence and morale of care home staff. The community matron CHT won the Nursing Older People category of the RCNi Nurse Awards in May 2017. This award has resulted in the team's profile being raised, and the team being asked to participate in further initiatives to provide enhanced support for care homes. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

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

PubMed Central

2012-01-01

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

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

PubMed

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

2012-11-03

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

Theory of mind and executive function during middle childhood across cultures.

PubMed

Wang, Zhenlin; Devine, Rory T; Wong, Keri K; Hughes, Claire

2016-09-01

Previous studies with preschoolers have reported "East-West" contrasts in children's executive function (East>West) and theory of mind (East

Ethnic variation in the prevalence of visual impairment in people attending diabetic retinopathy screening in the United Kingdom (DRIVE UK).

PubMed

Sivaprasad, Sobha; Gupta, Bhaskar; Gulliford, Martin C; Dodhia, Hiten; Mann, Samantha; Nagi, Dinesh; Evans, Jennifer

2012-01-01

To provide estimates of visual impairment in people with diabetes attending screening in a multi-ethnic population in England (United Kingdom). The Diabetic Retinopathy In Various Ethnic groups in UK (DRIVE UK) Study is a cross-sectional study on the ethnic variations of the prevalence of DR and visual impairment in two multi-racial cohorts in the UK. People on the diabetes register in West Yorkshire and South East London who were screened, treated or monitored between April 2008 to July 2009 (London) or August 2009 (West Yorkshire) were included in the study. Data on age, gender, ethnic group, visual acuity and diabetic retinopathy were collected. Ethnic group was defined according to the 2011 census classification. The two main ethnic minority groups represented here are Blacks ("Black/African/Caribbean/Black British") and South Asians ("Asians originating from the Indian subcontinent"). We examined the prevalence of visual impairment in the better eye using three cut-off points (a) loss of vision sufficient for driving (approximately <6/9) (b) visual impairment (<6/12) and (c) severe visual impairment (<6/60), standardising the prevalence of visual impairment in the minority ethnic groups to the age-structure of the white population. Data on visual acuity and were available on 50,331 individuals 3.4% of people diagnosed with diabetes and attending screening were visually impaired (95% confidence intervals (CI) 3.2% to 3.5%) and 0.39% severely visually impaired (0.33% to 0.44%). Blacks and South Asians had a higher prevalence of visual impairment (directly age standardised prevalence 4.6%, 95% CI 4.0% to 5.1% and 6.9%, 95% CI 5.8% to 8.0% respectively) compared to white people (3.3%, 95% CI 3.1% to 3.5%). Visual loss was also more prevalent with increasing age, type 1 diabetes and in people living in Yorkshire. Visual impairment remains an important public health problem in people with diabetes, and is more prevalent in the minority ethnic groups in the UK.

‘This wound has spoilt everything’: emotional capital and the experience of surgical site infections

PubMed Central

Brown, Brian; Tanner, Judith; Padley, Wendy

2014-01-01

In this article we explore the experience of suffering from a surgical site infection, a common complication of surgery affecting around 5 per cent of surgical patients, via an interview study of 17 patients in the Midlands in the UK. Despite their prevalence, the experience of surgical site infections has received little attention so far. In spite of the impairment resulting from these iatrogenic problems, participants expressed considerable stoicism and we interpret this via the notion of emotional capital. This idea derives from the work of Pierre Bourdieu, Helga Nowotny and Diane Reay and helps us conceptualise the emotional resources accumulated and expended in managing illness and in gaining the most from healthcare services. Participants were frequently at pains not to blame healthcare personnel or hospitals, often discounting the infection's severity, and attributing it to chance, to ‘germs’ or to their own failure to buy and apply wound care products. The participants' stoicism was thus partly afforded by their refusal to blame healthcare institutions or personnel. Where anger was described, this was either defused or expressed on behalf of another person. Emotional capital is associated with deflecting the possibility of complaint and sustaining a deferential and grateful position in relation to the healthcare system. PMID:25470322

Rodentolepis straminea (Cestoda: Hymenolepididae) in an urban population of Apodemus sylvaticus in the UK.

PubMed

Rushworth, R L; Boufana, B; Hall, J L; Brannan, V; Mastin, A; Birtles, R J; Craig, P S; Rogan, M T

2016-07-01

The presence of the cyclophyllidean cestode Rodentolepis straminea (Cestoda: Hymenolepididae), was confirmed by molecular DNA analysis from a wood mouse (Apodemus sylvaticus) population inhabiting urban woodland in Salford, Greater Manchester (UK) with a prevalence of 27.8%. It would appear that the only previously published record of this species in A. sylvaticus in the British Isles is that from south-west Ireland, where 24% of the wood mice examined were infected with R. straminea. This species has been recorded in studies on A. sylvaticus in continental Europe. The current report represents a new record for R. straminea on mainland Britain and a first study of helminth parasites in an urban wood mouse population.

PNNL Provides Catalyst for Sustainable Propylene Glycol Production

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

Madison, Alison L.; Lund, Eric C.

2012-02-28

Submission for annual FLC magazine publication, Technology for Today, featuring technologies transferred by federal labs. Subject: PNNL transfer of Propylene Glycol from Renewable Sources catalytic process to Archer Daniels Midland Company.

Behind the Public Face of Kew: Education and Conservation in the Millennium Seed Bank

ERIC Educational Resources Information Center

McFarlane, Angela

2010-01-01

At its Wakehurst Place garden in West Sussex, the Royal Botanic Gardens, Kew, has established the UK home of one of the world's largest conservation projects, the Millennium Seed Bank (MSB) partnership, a global project to conserve biodiversity by collecting and preserving seeds. This article describes what the MSB partnership does, how seeds are…

Beginning of grain harvest in the tri-border region Basel as a proxy for mean April - May temperatures; creation of a long Swiss series c. 1455 AD - 1950 AD

NASA Astrophysics Data System (ADS)

Wetter, Oliver; Pfister, Christian

2010-05-01

Beginning of grain harvest in the tri-border region Basel as a proxy for mean April-July temperatures; creation of a long Swiss series c. 1454 AD - 1950 AD O. Wetter and C. Pfister Section of Economic, Social and Environmental History, Institute of History, University of Bern, Bern, Switzerland (oliver.wetter@hist.unibe.ch) Before agricultural harvesting machines replaced manual labour the date of the grain harvest was largely dependent on mean temperatures from spring to early summer. It thus constitutes a very valuable source of information to reconstruct these temperatures. The later the harvest began, the cooler spring and early summer must have been and vice versa. For this reconstruction a new data series of grain harvests in the tri-border region Basel (representative for north-west Switzerland, the Alsace (France) and south-west Germany) was used as a temperature proxy. The harvesting dates have been extracted from the account books of the hospital of Basel which cover the period from c.1454 AD to 1705 AD. This series could be completed with several series of grain tithe dates originating from the Swiss Midland, covering the period between 1557 and 1825 and several grain harvest dates series covering the time between 1825 and 1950. Thus a series of almost 500 years could be compiled. Since the method of harvesting remained unchanged until the 1950's when manual labour was replaced by machines, the harvest dates of the modern series, lying within the temperature measurement series, could be used for calibrating the medieval dates.

Rural women's perspectives of maternity services in the Midland Region of New Zealand.

PubMed

Gibbons, Veronique; Lancaster, Gytha; Gosman, Kim; Lawrenson, Ross

2016-09-01

INTRODUCTION Rural women face many challenges with regards to maternity services. Many rural primary birthing facilities in New Zealand have closed. The Lead Maternity Carer (LMC) model of maternity care, introduced in 1990, has moved provision of rural maternity care from doctors to independent midwifery services. Shortages of rural midwives in the Midland region led to rural maternity care being seen as a vulnerable service. AIM To understand the views and experiences of rural women concerning maternity care, to inform the future design and provision of rural maternity services. METHODS Participants were drawn from areas purposively selected to represent the five District Health Boards comprising the Midland health region. A demographic questionnaire, focus groups and individual interviews explored rural women's perspectives of antenatal care provision. These were analysed thematically. RESULTS Sixty-two women were recruited. Key themes emerging from focus groups and interviews included: access to services, the importance of safety and quality of care, the need for appropriate information at different stages, and the role of partners, family and friends in the birthing journey. While most women were happy with access to services, quality of care, provision of information, and the role of family in their care, for some women, this experience could be enhanced. CONCLUSION Midwives are the frontline service for women seeking antenatal services. Support for rural midwives and for local birthing units is needed to ensure rural women receive services equal to that of their urban counterparts.

Source apportionment of speciated PM10 in the United Kingdom in 2008: Episodes and annual averages

NASA Astrophysics Data System (ADS)

Redington, A. L.; Witham, C. S.; Hort, M. C.

2016-11-01

The Lagrangian atmospheric dispersion model NAME (Numerical Atmospheric-dispersion Modelling Environment), has been used to simulate the formation and transport of PM10 over North-West Europe in 2008. The model has been evaluated against UK measurement data and been shown to adequately represent the observed PM10 at rural and urban sites on a daily basis. The Lagrangian nature of the model allows information on the origin of pollutants (and hence their secondary products) to be retained to allow attribution of pollutants at receptor sites back to their sources. This source apportionment technique has been employed to determine whether the different components of the modelled PM10 have originated from UK, shipping, European (excluding the UK) or background sources. For the first time this has been done to evaluate the composition during periods of elevated PM10 as well as the annual average composition. The episode data were determined by selecting the model data for each hour when the corresponding measurement data was >50 μg/m3. All the modelled sites show an increase in European pollution contribution and a decrease in the background contribution in the episode case compared to the annual average. The European contribution is greatest in southern and eastern parts of the UK and decreases moving northwards and westwards. Analysis of the speciated attribution data over the selected sites reveals that for 2008, as an annual average, the top three contributors to total PM10 are UK primary PM10 (17-25%), UK origin nitrate aerosol (18-21%) and background PM10 (11-16%). Under episode conditions the top three contributors to modelled PM10 are UK origin nitrate aerosol (12-33%), European origin nitrate aerosol (11-19%) and UK primary PM10 (12-18%).

Effect of climate change on vector-borne disease risk in the UK.

PubMed

Medlock, Jolyon M; Leach, Steve A

2015-06-01

During the early part of the 21st century, an unprecedented change in the status of vector-borne disease in Europe has occurred. Invasive mosquitoes have become widely established across Europe, with subsequent transmission and outbreaks of dengue and chikungunya virus. Malaria has re-emerged in Greece, and West Nile virus has emerged throughout parts of eastern Europe. Tick-borne diseases, such as Lyme disease, continue to increase, or, in the case of tick-borne encephalitis and Crimean-Congo haemorrhagic fever viruses, have changed their geographical distribution. From a veterinary perspective, the emergence of Bluetongue and Schmallenberg viruses show that northern Europe is equally susceptible to transmission of vector-borne disease. These changes are in part due to increased globalisation, with intercontinental air travel and global shipping transport creating new opportunities for invasive vectors and pathogens. However, changes in vector distributions are being driven by climatic changes and changes in land use, infrastructure, and the environment. In this Review, we summarise the risks posed by vector-borne diseases in the present and the future from a UK perspective, and assess the likely effects of climate change and, where appropriate, climate-change adaptation strategies on vector-borne disease risk in the UK. Lessons from the outbreaks of West Nile virus in North America and chikungunya in the Caribbean emphasise the need to assess future vector-borne disease risks and prepare contingencies for future outbreaks. Ensuring that adaptation strategies for climate change do not inadvertently exacerbate risks should be a primary focus for decision makers. Copyright © 2015 Elsevier Ltd. All rights reserved.

The puzzle of high heads beneath the West Cumbrian coast, UK: a possible solution

NASA Astrophysics Data System (ADS)

Black, John H.; Barker, John A.

2016-03-01

A region of high heads within the Borrowdale Volcanic Group (BVG; a fractured crystalline rock) beneath the coastal plain of West Cumbria, England (UK), is identified as a possible relic left over by the Late Devensian ice sheet. It was found during investigations in the 1990s. Contemporary modelling work failed to produce a satisfactory explanation of the high heads compatible with the `cold recharge' isotopic signature of the groundwater. This study has reassessed the original hydraulic testing results. By plotting density-adjusted heads versus their depth below the water table in the immediate vicinity of the borehole in which they were measured, a depth profile resembling a `wave' was revealed with a peak value located at 1,100 m depth. The possibility that this wave represents relic heads from the last major ice sheet has been assessed using one-dimensional mathematical analysis based on a poroelastic approach. It is found that a wet-based ice sheet above the West Cumbrian coast was probably thick enough and sufficiently long-lasting to leave such relic heads providing that the hydraulic diffusivity of the BVG is in the order of 10-6 m s-1. Initial assessment 20 years ago of the long-interval slug tests suggested that such low values are not likely. More recent interpretation argues for such low values of hydraulic diffusivity. It is concluded that ice sheet recharge is the most likely cause of the raised heads, that the BVG contains significant patches of very low conductivity rock, and that long-interval single-hole tests should be avoided in fractured crystalline rock.

The use of an air filtration system in podiatry clinics.

PubMed

McLarnon, Nichola; Burrow, Gordon; Maclaren, William; Aidoo, Kofi; Hepher, Mike

2003-06-01

A small-scale study was conducted to ascertain the efficiency and effectiveness of an air filtration system for use in podiatry/chiropody clinics (Electromedia Model 35F (A), Clean Air Ltd, Scotland, UK). Three clinics were identified, enabling comparison of data between podiatry clinics in the West of Scotland. The sampling was conducted using a portable Surface Air Sampler (Cherwell Laboratories, Bicester, UK). Samples were taken on two days at three different times before and after installation of the filtration units. The global results of the study indicate the filter has a statistically significant effect on microbial counts, with an average percentage decrease of 65%. This study is the first time, to the authors' knowledge, such a system has been tested within podiatric practice.

UK's first NHS high-energy proton beam facility.

PubMed

Shaw, Phil

2017-05-01

With the UK's first high-energy Proton Beam Therapy Centre set to open next year at Manchester's The Christie, young patients with head and neck tumours, cancers close to the skull or spine, or a variety of soft tissue tumours, and adults with cancers difficult to treat using 'conventional' photon-based radiotherapy will, for the first time, be able to receive NHS proton beam therapy (PBT) without having to travel overseas. HEJ editor, Jonathan Baillie, visited the site of The Christie's new £135 million PBT Centre to find out more about the design and construction of a facility which interserve construction director for the North-West, Phil Shaw, describes as one of the most complex and specialist he has worked on.

Preparing Potential Teachers for the Transition from Employment to Teacher Training: An Evaluative Case Study of a Maths Enhancement Course

ERIC Educational Resources Information Center

May, Steve; Gay, Jane; Atkins, Nigel; Marks-Maran, Diane

2008-01-01

In response to a UK government drive to improve maths teaching in schools, the South West London Maths Enhancement Course (MEC) has been set up through collaboration between three higher education institutions (HEIs) to provide an efficient route for non-maths graduates in employment to upgrade their subject knowledge and give a smooth transition…

The Midland fiber-optic analog transmission system development project (FATS)

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

Baumgart, J.S.; Anaya, R.; Morris, G.

1988-07-01

This report was written to document the overall effort related to the development and testing of the various components comprising the fiber optic analog transmission system (FATS) and to the validation of the FATS itself. The overall project was approached as a joint effort between the Los Alamos National Laboratory; the Atomic Weapons Research Establishment (AWRE); and EGandG Energy Measurements. The ultimate goal of the project was to develop a system, based on laser diodes and a streak camera system, to measure alpha. Although the FATS was not fielded on the MIDLAND event, in the course of the project wemore » did in fact answer technology questions identified on previous experiments and develop a better understanding of system needs. We hope that the information contained in this report will provide a basis for planning future experiments, as well as defining the direction for additional laboratory measurements. 94 figs.« less

U.S. Geological Survey input-data forms for the assessment of the Spraberry Formation of the Midland Basin, Permian Basin Province, Texas, 2017

USGS Publications Warehouse

Marra, Kristen R.

2017-10-24

In 2017, the U.S. Geological Survey (USGS) completed an updated assessment of undiscovered, technically recoverable oil and gas resources in the Spraberry Formation of the Midland Basin (Permian Basin Province) in southwestern Texas (Marra and others, 2017). The Spraberry Formation was assessed using both the standard continuous (unconventional) and conventional methodologies established by the USGS for three assessment units (AUs): (1) Lower Spraberry Continuous Oil Trend AU, (2) Middle Spraberry Continuous Oil Trend AU, and (3) Northern Spraberry Conventional Oil AU. The revised assessment resulted in total estimated mean resources of 4,245 million barrels of oil, 3,112 billion cubic feet of gas, and 311 million barrels of natural gas liquids. The purpose of this report is to provide supplemental documentation of the input parameters used in the USGS 2017 Spraberry Formation assessment.

Tables of asymptotic directions, cutoff rigidities, and reentrant albedo calculations for Palestine, Dallas, and Midland, Texas. Special repts

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

Shea, M.A.; Smart, D.F.

1974-03-26

Using the trajectory-tracing technique, the asymptotic directions and cut-off rigidities for Palestine, Dallas, amd Midland,Texas were calculated as a function of various zenith and azimuth angles. Continuation of the trajectory-tracing process below the Stormer cutoff allows an evaluation of the reentrant albedo; the invariant latitude of the guiding center of the trajectory at the albedo origin is seen to be the same as the invariant latitude of the guiding center of the particle trajectory at the specified zenith and azimuth angle of the detection point. Tables of asymptotic directions, cutoff rigidities, and the location of the reentrant albedo for eachmore » of these locations are given. Summaries of cutoff rigidity calculations as a function of zenith and azimuth directions for some miscellaneous locations are also included. (GRA)« less

NEWS: Paperclip Physics: anatomy of a competition

NASA Astrophysics Data System (ADS)

2000-09-01

'Do something about schools' was the request from the Institute of Physics to its branches in 1994. In response the Midland Branch of the Institute of Physics decided to set up a competition that asked sixth-formers to explain some aspect of physics to a non-scientist in five minutes. It was decreed that teams would be expected to do a demonstration but, in order to avoid disadvantaging schools with a small science budget, only items that might be found in the average home would be allowed. So, with a fairly simple set of rules, which also excluded the use of any mains services, and with none of us knowing what to expect, the competition was launched in 1995. Even though we had given careful consideration to the rules and to the matter of the judges (a non-scientist, a physicist and a physics teacher), one thing we had not anticipated was how much fun it would be! The first year's winners used a baby bath and a margarine tub to demonstrate why a boat cannot sail into the wind unless it has a keel. Other contestants used jelly, a kitchen whisk, balloons, talcum powder and sundry kitchen items to demonstrate everything from Archimedes' principle to fusion. And a good time was had by all! And such is the way it has continued, with boiling carrots, a home made van der Graaf generator, a hot air balloon (made from shower curtains!), plenty of acting and dressing-up, rolling pins, plastic guttering, red noses, lots of fun and always a tremendous `buzz' in the room. For four years the competition was run in the Midlands and gradually grew in popularity. In 1998 we decided that it ought to have a proper name and, after much head-scratching, it was named `Paperclip Physics', a name that we hope reflects the ingenious nature of the entries. 1999 was an even more important year for the competition as it was then that the IOP agreed to fund the competition in all its branches in the UK and Ireland. Instead of heats and then a final within the Midlands, now we had regional heats, regional finals and then a Grand Final in London. That year 132 teams were whittled down to nine teams who went to London for the grand final. The competition and the top prizes of Psion organizers were won by a team of girls from St~Anne's School, Southampton with an excellent demonstration of static electricity (see Physics World, June 1999, 12 (6) 54). In 2000 the pattern of heats and regional finals was repeated, this time with 160 teams in 11 branches. On this occasion the overall winners were Shrewsbury School, who explained why a cat, when dropped upside down, can turn itself the right way up before reaching the ground, and can do so without violating any laws of physics (see Physics World, May 2000, 13 (5) 52). Their demonstration did not, as they were at pains to point out, involve any live animals (only toy ones!) but did give a very clear explanation of what angular momentum is, and how it must be conserved by the falling cat. Figure 1 Figure 1. Kirby Kendal School show that the tablecloth trick has more to do with inertia than magic. Figure 2 Figure 2. Shrewsbury School, overall winners in 2000, demonstrate why angular momentum is important to falling cats. Figure 3 Figure 3. Pupils from Omagh Academy demonstrating electrostatics. So why do we bother and, perhaps more importantly, why should teachers bother to encourage their pupils to enter? First of all because it all adds to the message that physics can be fun. Judges, organizers, pupils and teachers would all endorse that. Many of the schools are coming back year after year with another group of sixth-formers. And we hear of this year's contestants who did not win their heat going back to the school to help next year's team. Secondly it develops, in a very enjoyable way, some of the skills that we all know are useful and which have recently been labelled as `key skills' in the new A-level syllabuses for the UK---communicating science, team-working, problem solving and personal organization. This competition allows pupils to practise these skills by doing a presentation `for real'. It also allows them to demonstrate other (perhaps previously latent) talents such as acting. And we are constantly amazed by the ingenuity that the teams use in developing interesting and convincing demonstrations. Last but definitely not least, all of us who teach physics for a living are well aware that you really have to understand something in order to be able to explain it to others. The learning process that goes on while preparing the presentation should not be underrated, nor should the sense of achievement that the presenters feel afterwards, whether they win or not. As for the teachers' workload, we are assured that frequently they have had little to do with the presentations. There was even one memorable occasion when a team was nearly withdrawn from the regional competition because their teacher had not had time to watch their demonstration. The team insisted on going ahead and won the regional final to earn themselves a trip to London! So teachers should be assured that this is not one of those competitions that will involve them in endless work---the ideas, the ingenuity and the enthusiasm come from the pupils. The 2001 competition, which is open to first-year sixth form or equivalent, is to be launched with a mailing of flyers and posters to schools in September. Details are also on the IOP website (www.iop.org/Schools/paperclip.html). The closing date will be the end of November 2000 and heats and regional finals will take place in February and early March. The Grand Final will be at the IOP headquarters in London in late March. We look forward to having entries from all over the UK and Ireland. E M Parvin Chairman of IOP Midland Branch

Mental health and well-being in parents of excessively crying infants: Prospective evaluation of a support package.

PubMed

Powell, C; Bamber, D; Long, J; Garratt, R; Brown, J; Rudge, S; Morris, T; Bhupendra Jaicim, N; Plachcinski, R; Dyson, S; Boyle, E M; St James-Roberts, I

2018-04-17

During the first 4 months of age, approximately 20% of infants cry a lot without an apparent reason. Most research has targeted the crying, but the impact of the crying on parents, and subsequent outcomes, need to receive equal attention. This study reports the findings from a prospective evaluation of a package of materials designed to support the well-being and mental health of parents who judge their infant to be crying excessively. The resulting "Surviving Crying" package comprised a website, printed materials, and programme of Cognitive Behaviour Therapy-based support sessions delivered to parents by a qualified practitioner. It was designed to be suitable for United Kingdom (UK) National Health Service (NHS) use. Parents were referred to the study by 12 NHS Health Visitor/Community Public Health Nurse teams in one UK East Midlands NHS Trust. Fifty-two of 57 parents of excessively crying babies received the support package and completed the Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7 anxiety questionnaire, as well as other measures, before receiving the support package and afterwards. Significant reductions in depression and anxiety were found, with numbers of parents meeting clinical criteria for depression or anxiety halving between baseline and outcome. These improvements were not explained by reductions in infant crying. Reductions also occurred in the number of parents reporting the crying to be a large or severe problem (from 28 to 3 parents) or feeling very or extremely frustrated by the crying (from 31 to 1 parent). Other findings included increases in parents' confidence, knowledge of infant crying, and improvements in parents' sleep. The findings suggest that the Surviving Crying package may be effective in supporting the well-being and mental health of parents of excessively crying babies. Further, large-scale controlled trials of the package in NHS settings are warranted. © 2018 John Wiley & Sons Ltd.

Perspectives on enhancing physical activity and diet for health promotion among at-risk urban UK South Asian communities: a qualitative study.

PubMed

Cross-Bardell, Laura; George, Tracey; Bhoday, Mandeep; Tuomainen, Helena; Qureshi, Nadeem; Kai, Joe

2015-02-27

To explore perspectives on enhancing physical activity and diet among South Asians in urban deprived communities at high risk of chronic disease and to inform development of culturally appropriate health promotion intervention. Qualitative study using semistructured one-to-one and family group interviews with thematic analysis of data. Urban disadvantaged communities in the East Midlands of the UK. 45 respondents, including 34 people of South Asian origin (16 at-risk individuals, six family groups involving 18 relatives), of mainly Pakistani and Indian origin, including 16 non-English speakers; and 11 health professionals working locally with communities of concern. South Asian participants underlined the challenges of requiring family members across generations to engage in modifying dietary behaviours, and the central role of communal eating of traditional 'Asian' food in their cultural lives. Barriers to increasing physical activity included cost, personal safety and lack of time outside of long working hours and carer commitments. However, increasing walking activity was regarded as feasible by both community and health professional participants. Respondents emphasised using a social approach for potential interventions, undertaking activity with family or friends and with bilingual community peers to facilitate engagement, motivation and support. Spoken content and delivery of interventions was favoured, including personal stories and multilingual audio-visual information; within local informal rather than provider settings, including the home; and aided by pedometers for self-monitoring. Focusing on physical activity by increasing walking may hold promise as health promotion in this deprived South Asian community context. Further intervention development, with exploration of feasibility and acceptability of the social approach and elements suggested, is merited. 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.

LOD 1 VS. LOD 2 - Preliminary Investigations Into Differences in Mobile Rendering Performance

NASA Astrophysics Data System (ADS)

Ellul, C.; Altenbuchner, J.

2013-09-01

The increasing availability, size and detail of 3D City Model datasets has led to a challenge when rendering such data on mobile devices. Understanding the limitations to the usability of such models on these devices is particularly important given the broadening range of applications - such as pollution or noise modelling, tourism, planning, solar potential - for which these datasets and resulting visualisations can be utilized. Much 3D City Model data is created by extrusion of 2D topographic datasets, resulting in what is known as Level of Detail (LoD) 1 buildings - with flat roofs. However, in the UK the National Mapping Agency (the Ordnance Survey, OS) is now releasing test datasets to Level of Detail (LoD) 2 - i.e. including roof structures. These datasets are designed to integrate with the LoD 1 datasets provided by the OS, and provide additional detail in particular on larger buildings and in town centres. The availability of such integrated datasets at two different Levels of Detail permits investigation into the impact of the additional roof structures (and hence the display of a more realistic 3D City Model) on rendering performance on a mobile device. This paper describes preliminary work carried out to investigate this issue, for the test area of the city of Sheffield (in the UK Midlands). The data is stored in a 3D spatial database as triangles and then extracted and served as a web-based data stream which is queried by an App developed on the mobile device (using the Android environment, Java and OpenGL for graphics). Initial tests have been carried out on two dataset sizes, for the city centre and a larger area, rendering the data onto a tablet to compare results. Results of 52 seconds for rendering LoD 1 data, and 72 seconds for LoD 1 mixed with LoD 2 data, show that the impact of LoD 2 is significant.

Scorched Earth: how will changes in the strength of the vegetation sink to ozone deposition affect human health and ecosystems?

NASA Astrophysics Data System (ADS)

Emberson, L. D.; Kitwiroon, N.; Beevers, S.; Büker, P.; Cinderby, S.

2013-07-01

This study investigates the effect of ozone (O3) deposition on ground level O3 concentrations and subsequent human health and ecosystem risk under hot summer "heat wave" type meteorological events. Under such conditions, extended drought can effectively "turn off" the O3 vegetation sink leading to a substantial increase in ground level O3 concentrations. Two models that have been used for human health (the CMAQ chemical transport model) and ecosystem (the DO3SE O3 deposition model) risk assessment are combined to provide a powerful policy tool capable of novel integrated assessments of O3 risk using methods endorsed by the UNECE Convention on Long-Range Transboundary Air Pollution. This study investigates 2006, a particularly hot and dry year during which a heat wave occurred over the summer across much of the UK and Europe. To understand the influence of variable O3 dry deposition three different simulations were investigated during June and July: (i) actual conditions in 2006, (ii) conditions that assume a perfect vegetation sink for O3 deposition and (iii) conditions that assume an extended drought period that reduces the vegetation sink to a minimum. The risks of O3 to human health, assessed by estimating the number of days during which running 8 h mean O3 concentrations exceeded 100 μg m-3, show that on average across the UK, there is a difference of 16 days exceedance of the threshold between the perfect sink and drought conditions. These average results hide local variation with exceedances between these two scenarios reaching as high as 20 days in the East Midlands and eastern UK. Estimates of acute exposure effects show that O3 removed from the atmosphere through dry deposition during the June and July period would have been responsible for approximately 460 premature deaths. Conversely, reduced O3 dry deposition will decrease the amount of O3 taken up by vegetation and, according to flux-based assessments of vegetation damage, will lead to a reduction in the impact of O3 on vegetation across the UK. The new CMAQ-DO3SE model was evaluated by comparing observation vs. modelled estimates of various health related metrics with data from both urban and rural sites across the UK; although these comparisons showed reasonable agreement there were some biases in the model predictions with attributable deaths at urban sites being over predicted by a small margin, the converse was true for rural sites. The study emphasises the importance of accurate estimates of O3 deposition both for human health and ecosystem risk assessments. Extended periods of drought and heat wave type conditions are likely to occur with more frequency in coming decades, therefore understanding the importance of these effects will be crucial to inform the development of appropriate national and international policy to mitigate against the worst consequences of this air pollutant.

Understanding drought propagation in the UK in the context of climatology and catchment properties

NASA Astrophysics Data System (ADS)

Barker, Lucy; Hannaford, Jamie; Bloomfield, John; Marchant, Ben

2017-04-01

Droughts are a complex natural phenomena that are challenging to plan and prepare for. The propagation of droughts through the hydrological cycle is one of many factors which contribute to this complexity, and a thorough understanding of drought propagation is crucial for informed drought management, particularly in terms of water resources management in both the short and long term. Previous studies have found that both climatological and catchment factors cause lags in drought propagation from meteorological to hydrological and hydrogeological droughts. There are strong gradients in both climatology and catchment properties across the UK. Catchments in the north and west of the UK are relatively impermeable, upland catchments with thin soils and receive the highest annual precipitation with relatively low mean annual temperatures. Conversely, in the south and east of the UK, characterised by higher mean temperatures and lower annual precipitation, catchments are underlain by a number of major aquifers (e.g. Chalk, limestone) and are typically associated with high baseflow rivers. Here we explore the effects of these gradients in climatology and catchments on the propagation of droughts. Using standardised drought indices (the Standardised Precipitation Index; the Standardised Streamflow Index; and the Standardised Groundwater Index) we analyse drought propagation characteristics for selected catchment-borehole pairs across the UK using reconstructed time series back to the 19th century. We investigate how the timing, nature and predictability of drought propagation changes across the UK, given gradients in climatology and catchment characteristics. We use probability of detection methods, usually used for forecast verification, to investigate how well precipitation and streamflow deficits predict deficits in streamflow and groundwater levels and how this varies across the UK.

Regional variations of basal cell carcinoma incidence in the U.K. using The Health Improvement Network database (2004-10).

PubMed

Musah, A; Gibson, J E; Leonardi-Bee, J; Cave, M R; Ander, E L; Bath-Hextall, F

2013-11-01

Basal cell carcinoma (BCC) is one of the most common types of nonmelanoma skin cancer affecting the white population; however, little is known about how the incidence varies across the U.K. To determine the variation in BCC throughout the U.K. Data from 2004 to 2010 were obtained from The Health Improvement Network database. European and world age-standardized incidence rates (EASRs and WASRs, respectively) were obtained for country-level estimates and levels of socioeconomic deprivation, while strategic health-authority-level estimates were directly age and sex standardized to the U.K. standard population. Incidence-rate ratios were estimated using multivariable Poisson regression models. The overall EASR and WASR of BCC in the U.K. were 98.6 per 100,000 person-years and 66.9 per 100,000 person-years, respectively. Regional-level incidence rates indicated a significant geographical variation in the distribution of BCC, which was more pronounced in the southern parts of the country. The South East Coast had the highest BCC rate followed by South Central, Wales and the South West. Incidence rates were substantially higher in the least deprived groups and we observed a trend of decreasing incidence with increasing levels of deprivation (P < 0.001). Finally, in terms of age groups, the largest annual increase was observed among those aged 30-49 years. Basal cell carcinoma is an increasing health problem in the U.K.; the southern regions of the U.K. and those in the least deprived groups had a higher incidence of BCC. Our findings indicate an increased incidence of BCC for younger age groups below 49 years. © 2013 British Association of Dermatologists.

78 FR 68052 - Gregory Swecker, Beverly Swecker; Notice of Petition for Enforcement

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-13

... section 210(h) of the Public Utility Regulatory Policies Act of 1978 (PURPA), 16 U.S.C. 824 and Rules 385... enforcement action against Midland Power Cooperative to ensure that PURPA regulations are properly and...

76 FR 28019 - Gregory R. Swecker, Beverly F. Swecker v. Midland Power Cooperative, State of Iowa; Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-13

... 1978 (PURPA),\\1\\ Gregory R. Swecker and Beverly F. Swecker (Complainants) filed a petition requesting that the Federal Energy Regulatory Commission (Commission) enforce the requirements of PURPA against...

EPA Region 5 Comments on Archer Daniel Midland Decatur Plant Expansion

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database.

Spatial coherence and large-scale drivers of drought

NASA Astrophysics Data System (ADS)

Svensson, Cecilia; Hannaford, Jamie

2017-04-01

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

Closed anterior scoring for prominent-ear correction revisited.

PubMed

Thomas, S S; Fatah, F

2001-10-01

The closed-anterior-scoring technique has been used over the past 3 years to correct 56 prominent ears in 32 patients at the West Midlands Regional Plastic Surgery Unit at Wordsley Hospital. A review was carried out to assess the result of this surgical procedure. We briefly discuss the historical development of other surgical techniques for prominent-ear correction, and describe in detail the operative technique for this procedure, which includes closed scoring and suturing of the cartilage. We used this technique to treat 24 patients with bilateral prominent ears and eight patients with unilateral prominent ears. The series comprised 20 females and 12 males, 26 children and six adults. The age range was from 4 to 24 years old. There were two complications (an upper-pole recurrence and protrusion of a buried prolene suture). Patients were followed up for between 6 months and 3 years (mean: 1.5 years). This procedure is quick and technically easy to learn, with no anterior scars or posterior cartilage overlap. Minimal dissection is involved, leading to a low rate of complications. The learning curve is rapid; this paper represents the experience of a specialist trainee (SST) after he was taught the technique by the senior author. Copyright 2001 The British Association of Plastic Surgeons.

The 2008 Cholera Epidemic in Zimbabwe: Experience of the icddr,b Team in the Field

PubMed Central

Bardhan, Pradip Kumar; Iqbal, Anwarul; Mazumder, Ramendra Nath; Khan, Azharul Islam; Islam, Md. Sirajul; Siddique, Abul Kasem; Cravioto, Alejandro

2011-01-01

During August 2008–June 2009, an estimated 95,531 suspected cases of cholera and 4,282 deaths due to cholera were reported during the 2008 cholera outbreak in Zimbabwe. Despite the efforts by local and international organizations supported by the Zimbabwean Ministry of Health and Child Welfare in the establishment of cholera treatment centres throughout the country, the case-fatality rate (CFR) was much higher than expected. Over two-thirds of the deaths occurred in areas without access to treatment facilities, with the highest CFRs (>5%) reported from Masvingo, Manicaland, Mashonaland West, Mashonaland East, Midland, and Matabeleland North provinces. Some factors attributing to this high CFR included inappropriate cholera case management with inadequate use of oral rehydration therapy, inappropriate use of antibiotics, and a shortage of experienced healthcare professionals. The breakdown of both potable water and sanitation systems and the widespread contamination of available drinking-water sources were also considered responsible for the rapid and widespread distribution of the epidemic throughout the country. Training of healthcare professionals on appropriate cholera case management and implementation of recommended strategies to reduce the environmental contamination of drinking-water sources could have contributed to the progressive reduction in number of cases and deaths as observed at the end of February 2009. PMID:22106761

Communication between South Asian patients and GPs: comparative study using the Roter Interactional Analysis System

PubMed Central

Neal, Richard D; Ali, Nasreen; Atkin, Karl; Allgar, Victoria L; Ali, Shahid; Coleman, Tim

2006-01-01

Background The UK South Asian population has poorer health outcomes. Little is known about their process of care in general practice, or in particular the process of communication with GPs. Aim To compare the ways in which white and South Asian patients communicate with white GPs. Design of study Observational study of video-recorded consultations using the Roter Interactional Analysis System (RIAS). Setting West Yorkshire, UK. Method One hundred and eighty–three consultations with 11 GPs in West Yorkshire, UK were video-recorded and analysed. Results Main outcome measures were consultation length, verbal domination, 16 individual abridged RIAS categories, and three composite RIAS categories; with comparisons between white patients, South Asian patients fluent in English and South Asian patients non-fluent in English. South Asians fluent in English had the shortest consultations and South Asians non-fluent in English the longest consultations (one-way ANOVA F = 7.173, P = 0.001). There were no significant differences in verbal domination scores between the three groups. White patients had more affective (emotional) consultations than South Asian patients, and played a more active role in their consultations, as did their GPs. GPs spent less time giving information to South Asian patients who were not fluent in English and more time asking questions. GPs spent less time giving information to South Asian patients fluent in English compared with white patients. Conclusions These findings were expected between patients fluent and non-fluent in English but do demonstrate their nature. The differences between white patients and South Asian patients fluent in English warrant further explanation. How much of this was due to systematic differences in behaviour by the GPs, or was in response to patients' differing needs and expectations is unknown. These differences may contribute to differences in health outcomes. PMID:17132355

Avoiding the Leviathan: A Strategy to Limit Post-Conflict Normative Breakdown

DTIC Science & Technology

2013-03-01

Emile Durkheim in his seminal work Suicide hypothesized that societies that go through periods of rapid change (such as the industrial revolution...French 4 sociologist and philosopher Emile Durkheim in his seminal work Suicide.13 Anomie (from the Greek a nomos, meaning without norms) is a...and Effervescence,” Durkheim and Violence. ed. S. Romi Mukherjee, (West Sussex, UK: Blackwell Publishing, 2010), 5-7. 13 Emile Durkheim , Suicide

JPRS Report, Science & Technology, Europe & Latin America

DTIC Science & Technology

1987-12-21

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

A preliminary study into performing routine tube output and automatic exposure control quality assurance using radiology information system data.

PubMed

Charnock, P; Jones, R; Fazakerley, J; Wilde, R; Dunn, A F

2011-09-01

Data are currently being collected from hospital radiology information systems in the North West of the UK for the purposes of both clinical audit and patient dose audit. Could these data also be used to satisfy quality assurance (QA) requirements according to UK guidance? From 2008 to 2009, 731 653 records were submitted from 8 hospitals from the North West England. For automatic exposure control QA, the protocol from Institute of Physics and Engineering in Medicine (IPEM) report 91 recommends that milliamperes per second can be monitored for repeatability and reproducibility using a suitable phantom, at 70-81 kV. Abdomen AP and chest PA examinations were analysed to find the most common kilovoltage used with these records then used to plot average monthly milliamperes per second with time. IPEM report 91 also recommends that a range of commonly used clinical settings is used to check output reproducibility and repeatability. For each tube, the dose area product values were plotted over time for two most common exposure factor sets. Results show that it is possible to do performance checks of AEC systems; however more work is required to be able to monitor tube output performance. Procedurally, the management system requires work and the benefits to the workflow would need to be demonstrated.

'This wound has spoilt everything': emotional capital and the experience of surgical site infections.

PubMed

Brown, Brian; Tanner, Judith; Padley, Wendy

2014-11-01

In this article we explore the experience of suffering from a surgical site infection, a common complication of surgery affecting around 5 per cent of surgical patients, via an interview study of 17 patients in the Midlands in the UK. Despite their prevalence, the experience of surgical site infections has received little attention so far. In spite of the impairment resulting from these iatrogenic problems, participants expressed considerable stoicism and we interpret this via the notion of emotional capital. This idea derives from the work of Pierre Bourdieu, Helga Nowotny and Diane Reay and helps us conceptualise the emotional resources accumulated and expended in managing illness and in gaining the most from healthcare services. Participants were frequently at pains not to blame healthcare personnel or hospitals, often discounting the infection's severity, and attributing it to chance, to 'germs' or to their own failure to buy and apply wound care products. The participants' stoicism was thus partly afforded by their refusal to blame healthcare institutions or personnel. Where anger was described, this was either defused or expressed on behalf of another person. Emotional capital is associated with deflecting the possibility of complaint and sustaining a deferential and grateful position in relation to the healthcare system. © 2014 The Authors. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

What influences pre-hospital cannulation intentions in paramedics? An application of the theory of reasoned action.

PubMed

Banerjee, Smita C; Siriwardena, A Niroshan; Iqbal, Mohammad

2011-02-01

Intravenous cannulation is a common and important intervention undertaken by paramedics for administration of fluids and drugs in the pre-hospital setting. This study was a partial application of the theory of reasoned action to the prediction of pre-hospital cannulation intentions as part of an evaluation of an educational intervention to change cannulation behaviour in paramedics in line with national guidance. In 2008 a self-completion questionnaire was sent to paramedics from Nottinghamshire and Lincolnshire divisions of East Midlands Ambulance Service NHS Trust, UK. This included measures of prior behaviour related to cannulation, attitude towards cannulation, normative influence related to cannulation and intention to cannulate as well as demographic information. Of the 323 paramedics sent questionnaires 137 (42.2%) responded. Attitude towards cannulation (but not normative or peer influence) was a necessary factor for prediction of intention to cannulate in respondents. Past cannulation behaviour was indirectly related to intention to cannulate through the mediation of attitude towards cannulation. The theory of reasoned action provides a parsimonious way to predict intentions to cannulate. This study suggests that design and evaluation of interventions to reduce inappropriate cannulation should be targeted towards changing attitudes of paramedics, rather than towards addressing behavioural norms. Future research could utilize social-psychological theories to better understand clinical behaviour prior to implementation of complex educational or organizational interventions. © 2010 Blackwell Publishing Ltd.

Practical compassions: repertoires of practice and compassion talk in acute mental healthcare.

PubMed

Brown, Brian; Crawford, Paul; Gilbert, Paul; Gilbert, Jean; Gale, Corinne

2014-03-01

This article reports an exploratory study of the concept of compassion in the work of 20 mental health practitioners in a UK Midlands facility. Using notions of practice derived from phenomenology and Bourdieusian sociology and notions of emotional labour we identify two contrasting interpretive repertoires in discussions of compassion. The first, the practical compassion repertoire, evokes the practical, physical and bodily aspects of compassion. It involves organising being with patients, playing games, anticipating disruption and taking them outside for cigarettes. Practitioners described being aware that these practical, bodily activities could lead to patients 'opening up', disclosing their interior concerns and enabling practical, compassionate mental health work to take place. In contrast, the second, organisational repertoire, concerns organisational constraints on compassionate practice. The shortage of staff, the record-keeping and internal processes of quality control were seen as time-greedy and apt to detract from contact with patients. The findings are discussed in relation to Bourdieu and Merleau-Ponty's phenomenological accounts of practice and habit and set in context in the growing interest in placing compassion centrally in healthcare. We also explore how the exercise of compassion in the way our participants describe it can afford the more effective exercise of medical power. © 2013 The Author. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Mortality in neurofibromatosis 1: in North West England: an assessment of actuarial survival in a region of the UK since 1989.

PubMed

Evans, D Gareth R; O'Hara, Catherine; Wilding, Anna; Ingham, Sarah L; Howard, Elizabeth; Dawson, John; Moran, Anthony; Scott-Kitching, Vilka; Holt, Felicity; Huson, Susan M

2011-11-01

Neurofibromatosis 1 (NF1) is a comparatively common autosomal dominant disorder. However, relatively few studies have assessed lifetime risk; and information about the effect of NF1 on mortality remains uncertain. NF1 patients were identified using The North West regional family Genetic Register, which covers the 4.1 million people living in North West England, including the regions of Greater Manchester, Cheshire and Cumbria. Data relating to tumours and malignancies were obtained from The North West Cancer Intelligence Service. Death data for the general North West population were obtained from the Office of National Statistics. We identified 1186 individuals with NF1, of whom 1023 lived within the strict regional boundaries (constituting a region of North West England bound by The Pennines to the east and Irish Sea to the west, but excluding the conurbation of Liverpool (Merseyside) and the Wirral peninsula) and 131 had died. MPNST and glioma were found to be the two most common causes of reduced life expectancy among NF1 patients. In Kaplan-Meier analyses the median survival for NF1 patients was shown to be 71.5 years, with women living ∼7.4 years longer than men. On average both men and women lived ∼8 years less than their counterparts in the general population. Reduction in life expectancy for NF1 patients was found to be much lower (8 years) than the previously estimated 15-year decrease. Limitations relating to the underreporting of NF1 on death certificates were once again highlighted and should be considered in future investigations.

Virus Genomes Reveal the Factors that Spread and Sustained the West African Ebola Epidemic

DTIC Science & Technology

2016-08-09

Highfield, Southampton SO17 1BJ, UK, 4Flowminder Foundation, Stockholm, Sweden, 5Department of Microbiology and Immunology, Rega Institute, KU Leuven...Sierra Leone, 27Institute of Microbiology , Chinese Academy of Sciences, Beijing 100101, China, 28University of Bristol, BS8 1TD, United Kingdom...29Institute of Microbiology and Infection, University of Birmingham, Birmingham B15 2TT, United Kingdom, 30University of Nebraska Medical Center, Omaha

Risk and Distributional Inequality.

DTIC Science & Technology

1984-03-01

judgments about the weight to be attached to inequality at different points on the income scale.... [Thus, in choosing a measure of inequality ,] it may... Rawls , 1971.) Thus, it might be concluded that the U.K. has greater inequality of incomes than West Germany for the reason that A its Lorenz curve lies...suffices to summarize matters as follows: (1) in welfare economics , measurement of the inequality of income (or wealth) is made difficult by the fact that

A Qualitative Evaluation of Holiday Breakfast Clubs in the UK: Views of Adult Attendees, Children, and Staff.

PubMed

Defeyter, Margaret Anne; Graham, Pamela Louise; Prince, Kate

2015-01-01

Across the UK, 1.3 million children access free school meals for around 38 weeks of the year. However, during school holidays, many families face considerable difficulties in providing a consistent and nutritious supply of food for their children, particularly during the extended summer break. In an effort to address this issue, a number of community-based breakfast clubs were set-up across the North West of England and in Northern Ireland where people could access a free breakfast meal during the summer holidays. Qualitative interviews were carried out with 17 children, 18 adult attendees, and 15 breakfast club staff to determine the uses and impacts associated with holiday breakfast club participation and to investigate potential areas for future development of holiday food provision. Findings highlighted a need for holiday food provision and revealed a multitude of nutritional, social, and financial benefits for those who accessed holiday breakfast clubs. Areas for further development and investigation are discussed in addition to implications for UK food and educational policies.

A Qualitative Evaluation of Holiday Breakfast Clubs in the UK: Views of Adult Attendees, Children, and Staff

PubMed Central

Defeyter, Margaret Anne; Graham, Pamela Louise; Prince, Kate

2015-01-01

Across the UK, 1.3 million children access free school meals for around 38 weeks of the year. However, during school holidays, many families face considerable difficulties in providing a consistent and nutritious supply of food for their children, particularly during the extended summer break. In an effort to address this issue, a number of community-based breakfast clubs were set-up across the North West of England and in Northern Ireland where people could access a free breakfast meal during the summer holidays. Qualitative interviews were carried out with 17 children, 18 adult attendees, and 15 breakfast club staff to determine the uses and impacts associated with holiday breakfast club participation and to investigate potential areas for future development of holiday food provision. Findings highlighted a need for holiday food provision and revealed a multitude of nutritional, social, and financial benefits for those who accessed holiday breakfast clubs. Areas for further development and investigation are discussed in addition to implications for UK food and educational policies. PMID:26322303

Late presentation of canine nasal tumours in a UK referral hospital and treatment outcomes.

PubMed

Mason, S L; Maddox, T W; Lillis, S M; Blackwood, L

2013-07-01

To determine the computed tomographic stage of dogs with nasal tumours in a UK referral population, and whether stage, time to referral and treatment correlates with outcome. Retrospective review of clinical records and computed tomography scans of dogs with nasal tumours. Dogs (n=78) presented to a referral practice in the UK with suspected nasal tumours are presented with more late stage tumours than dogs in the USA and Japan. Length of time from initial presentation to referral did not correlate with tumour stage at diagnosis. Median survival times for radiotherapy-treated dogs in this population are equivalent to those previously reported for late stage nasal tumours. Dogs with nasal tumours are presented late in the course of disease in the North West of England. Dogs with clinical signs consistent with a nasal tumour should have timely imaging and biopsy, in order to make prompt treatment decisions. Although survival times are comparable with previous reports and radiotherapy is a valid treatment option for dogs with late stage disease, better outcomes are likely to be achievable with earlier treatment. © 2013 British Small Animal Veterinary Association.

Epidemiological study of bovine brucellosis in three agro-ecological areas of central Oromiya, Ethiopia.

PubMed

Jergefa, T; Kelay, B; Bekana, M; Teshale, S; Gustafson, H; Kindahl, H

2009-12-01

A cross-sectional sero-epidemiological study of bovine brucellosis was conducted between September 2005 and March 2006 in three separate agroecological areas of central Oromiya, Ethiopia. In this study, a total of 176 clusters (farms) and 1,238 animals were selected, using the one-stage cluster sampling method. Fifty-nine clusters and 423 animals were selected from the lowland areas; 58 clusters and 385 animals from the midland areas and 59 clusters and 430 animals from the highlands. Serum samples were collected from a total of 1,238 animals older than six months. The rose bengal plate test and complement fixation test were used as screening and confirmatory tests, respectively, to detect Brucella seropositivity. Questionnaires were also administered to 176 households to gather information on the farm and livestock. Results showed that the overall seroprevalence of bovine brucellosis at the individual animal level was 2.9% (low). The seroprevalence was 4.2% in the lowlands, 1.0% in the midlands and 3.4% in the highlands. The overall seroprevalence at the herd level was 13.6% (moderate). At the herd level, seroprevalence in the lowlands was 17%; in the midlands: 5.1%; and in highland areas: 18.6%. Logistic regression analysis, revealed that the breed of cattle and the method of disposing of aborted foetuses and foetal membranes had a statistically significant effect on individual animal seroprevalence (p < 0.05). In lowland areas, the breed (p < 0.05), animal management system (p <0.05), mating method (p < 0.05), herd size (p < 0.05) and source of replacement stock (p <0.05) all had significant effects on individual animal seroprevalence.

Delineation of ground water potential zones using GIS and remote sensing - A case study from midland region of Vamanapuram river basin, Kerala, India

NASA Astrophysics Data System (ADS)

Prasad, Geena; Vinod P., G.; John, Shaleena Elizabeth

2018-04-01

In a highly rugged terrain, shielded by hard crystalline rocks like that of Kerala, locating potential zones of groundwater is found to be an unenviable task. Remote sensing and Geographical information system technologies have been attempted widely to delineate the potential regions in such terrain. Geographical information system tool has been used for delineation of groundwater prospect zones in midland physiographic zone (30-200m) of Vamanapuram river basin. The terrain variables are generated using satellite imageries, SRTM DEM data of 30m resolution and SOI toposheets. The groundwater prospect zones were delineated through the integration of the reclassified raster map layers of geomorphology, slope percent, geology, land use / land cover and soil texture using the weighted overlay analysis in the GIS platform. The groundwater prospects in the study area were grouped into five classes and their distribution are; `very high/high' (8.79%), `moderate' (39.08%), and `very low / low' (52.01%). The study result of the area has been validated with water level data of dug wells and bore wells of the area. The spatial distribution map of the water level of the region is overlaid on groundwater prospect map and shows a positive correlation i.e., the water level at shallow depth in higher prospect zones and at deeper depth in poor to very poor zones. The Groundwater prospect map of midland region of Vamanapuram river basin can be used as base level information which can be further investigated with geophysical methods to locate potential well sites for the execution of water supply schemes.

Observations of watersnake (Nerodia, Colubridae predation on Darters (Percidae)

Treesearch

Melvin L. Warren; Wendell R. Haag; Amy M. Commens

2004-01-01

We report observations of predation by watersnakes (Nerodia, colubridae) on darters (Percidae)and summarize other literature documenting this relationship. We observed two midland watersnakes, Nerodia sipedon pleuralis, preying on darters (Percidae) in the Sipsey Fork of the Black Warrior River (Mobile Basin), Bankhead National...

Knowledge, skills and attitude of evidence-based medicine among obstetrics and gynaecology trainees: a questionnaire survey.

PubMed

Jeve, Yadava Bapurao; Doshani, Angi; Singhal, Tanu; Konje, Justin

2013-12-01

To determine current evidence-based medicine skills and practice among trainees. Questionnaire study. Electronic survey was sent to all obstetrics and gynaecology trainees in East Midlands South Deanery, and responses collected were anonymous. All obstetrics and gynaecology trainees in East Midland South Deanery. Self-reported attitude, skills and knowledge in various components of evidence-based medicine. 69 trainees were included in the study of which 35 responded. Among all respondents, almost 72% of trainees use non-evidence-based methods to find answers for their clinical questions, whereas only 18% use appropriate evidence-based medicine practice for such queries. Just 35% of trainees have minimum skills of literature searching. Most of the trainees struggle to understand various components of evidence-based medicine. Nearly 80% of trainees do not have formal education or training with regard to evidence-based medicine. This study highlights the inadequacy of evidence-based medicine skills among trainees and urges that evidence-based medicine be incorporated in formal training along with specialty study modules.

Howard Doris anticipates still-uncommitted work

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

Not Available

1985-05-01

Although more than $3.5 billion a year is being spent in the UK offshore sector it is believed that not all the spending promised has yet been committed. The Howard Doris Kishorn yard, one of the most successful in the UK, is likely to benefit from the long-promised upturn in business now under way. Kishorn has just finished work on the Buchan floater, and it won two module contracts for Total's North Alwyn field worth $17.6 million. The yard has a long list of major projects behind it, including Ninian Central's enormous concrete platform and the integrated deck used bymore » Phillips on Maureen. New business coming to Kishorn from development off the Scottish west coast, where large quantities of frontier acreage are likely to be included with mature acreage in ninth round awards, is described.« less

Demasking Wall Street's Influence on Stock Prices.

ERIC Educational Resources Information Center

Saban, Kenneth A.

1987-01-01

Presents an in-depth review of the market research approach of a comprehensive financial community. Discusses the applied corporate findings when author was Vice President, Corporate Communications, Midland-Ross Corporation. Suggests that the basic concept is applicable to any publicly traded company whose senior management desires a more…

Dry Matter Losses and Greenhouse Gas Emissions From Outside Storage of Short Rotation Coppice Willow Chip.

PubMed

Whittaker, Carly; Yates, Nicola E; Powers, Stephen J; Misselbrook, Tom; Shield, Ian

This study examined the dry matter losses and the greenhouse gas (GHG) concentrations within two short rotation coppice (SRC) willow wood chip storage heaps. One heap was built on a grassland area (East Midlands) and the other (Rothamsted) on a concrete hard standing. A series of 1- and 3-m probes were embedded in the heaps in order to retrieve gas samples for analysis, and pre-weighed net bags were positioned in the core of the heap to detect dry matter losses. The bagged samples showed dry matter losses of 18 and 19 % in the East Midlands and Rothamsted heaps after 210 and 97 days storage, respectively. The Rothamsted heap showed a whole-heap dry matter loss of 21 %. During this time, the wood chips dried from 54 to 39 % moisture content in the East Midlands heap and 50 to 43 % at Rothamsted. The results from analysing the whole Rothamsted heap indicated an overall loss of 1.5 GJ per tonne stored, although measurements from bagged samples in the core suggested that the chips dried sufficiently to have a minimal energy loss from storage. The process of mixing the heap, however, led to incorporation of wet outer layers and hence the average moisture content was higher in an average sample of chip. After establishment of the heaps, the temperature rose rapidly and this correlated with a peak in carbon dioxide (CO 2 ) concentration within the heap. A peak in methane (CH 4 ) concentration was also detected in both heaps, though more noticeably in the East Midlands heap after around 55 days. In both instances, the peak CH 4 concentration occurred as CO 2 concentrations dropped, suggesting that after an active period of aerobic decomposition in the first 2 months of storage, the conditions in the heap became anaerobic. The results from this study suggest that outside wood chip storage is not an efficient method of storing biomass, though this may be location-specific as there are some studies showing lower dry matter losses. It is necessary to explore other methods of harvesting SRC to minimise losses and optimise land use efficiency. Further research is required to detect whether there are fugitive emissions of CH 4 from wood chip heaps, as this will compromise the net GHG savings from utilising the biomass stored in this way.

Can Collaboration between Education and Health Professionals Improve the Identification and Referral of Young People with Eating Disorders in Schools? A Pilot Study

ERIC Educational Resources Information Center

Rees, Liz; Clark-Stone, Sam

2006-01-01

In this pilot study, a number of different methods of identifying young people with eating disorders in schools were compared. Pupils aged 16-18 years from 3 schools in the South West of the UK participated (389 boys and 374 girls in total). A self-report questionnaire (EDE-Q) was found to be the most effective method of case identification.…

A Practitioner's Commentary

ERIC Educational Resources Information Center

McVey, Richard

2010-01-01

I have been delivering the flexible family work approaches outlined in this supplement at Aquarius for the past 8 years. Aquarius is an English Midlands-based addictions charity working with people who have problems with alcohol, drugs, or gambling and supporting their family members/concerned others. I have been a practitioner participating in…

CYTOKINE PROFILING FOR CHEMICAL RESPIRATORY SENSITIZERS

EPA Science Inventory

CYTOKINE PROFILING FOR CHEMICAL RESPIRATORY SENSITIZERS. LM Plitnick1, SE Loveless2, GS Ladics2, MP Holsapple3, MJ Selgrade4, DM Sailstad4 & RJ Smialowicz4. 1UNC, Chapel Hill, NC; 2DuPont Co., Haskell Laboratory, Newark, DE; 3Dow Chemical, Midland, MI & 4USEPA, NHEERL, RTP, NC.

75 FR 71187 - Wolverine Bank, MI; Approval of Conversion Application

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-22

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision [AC-55: OTS Nos. 02620 and H4753] Wolverine Bank, MI; Approval of Conversion Application Notice is hereby given that on November 12, 2010, the Office of Thrift Supervision approved the application of Wolverine Bank, Midland, Michigan, to convert to...

75 FR 24820 - Suspension of Community Eligibility

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-06

... March 12, 1975, ......do do. Sebastian County. Emerg; March 15, 1982, Reg; May 20, 2010, Susp. Lavaca, City of, Sebastian 050201 May 6, 1975, ......do do. County. Emerg; March 15, 1982, Reg; May 20, 2010... 18, 1987, Reg; May 20, 2010, Susp. Midland, Town of, 050203 January 22, 1976, ......do do. Sebastian...

Mainstream Early Childhood Education Teacher Preparation for Inclusion in Zimbabwe

ERIC Educational Resources Information Center

Majoko, Tawanda

2017-01-01

This study examined mainstream teachers' preparation for inclusion in Early Childhood Education (ECE). Embedded within the "core expertise" of inclusive pedagogy, this descriptive study drew on a sample of 23 mainstream teachers purposively drawn from the Midlands educational province of Zimbabwe. A constant comparative approach of…

Managing a Multi-ethnic and Multicultural City in Europe: Leicester.

ERIC Educational Resources Information Center

Winstone, Paul

1996-01-01

Profiles the English Midlands city of Leicester, an industrial center with a growing immigrant and minority population. Discusses the city government's response to problems concerning jobs, housing, and a racist backlash. The outlook is optimistic as the minority citizens assume new roles in the social and economic community. (MJP)

Dilemmas experienced by government veterinarians when responding professionally to farm animal welfare incidents in Ireland.

PubMed

Devitt, C; Kelly, P; Blake, M; Hanlon, A; More, S J

2014-01-01

This paper identifies the dilemmas experienced by government veterinarians during their investigations of farm animal welfare incidents that involve herd owner social, health, and/or psychological difficulties. The paper builds on exploratory qualitative research into the impact of these difficulties on farm animal welfare. The study used a qualitative research approach. Focus groups were conducted. In Ireland, an Early Warning System (EWS), which brings together relevant agencies, is in place to identify and prevent farm animal welfare problems before they become critical. This study is concerned with the experiences of government veterinarians who respond to farm animal welfare incidents. Specific focus is on incidents that involve herd owner social/psychological/health-related difficulties. In total, n=18 government veterinarians (representing 15 per cent of the population sample), all with a keen interest in farm animal welfare, participated. These were selected on the basis of their interest, experience, and involvement in farm animal welfare. One government veterinarian declined to participate. Four focus groups were conducted with government veterinarians. These took place in the south (S), south-west (SW), midlands (M), and north-west region of Ireland (NW). All 16 District Veterinary Offices (DVOs) were represented in the focus groups. The results reveal three professional dilemmas that exist for government veterinarians: (1) defining professional parameters; (2) determining the appropriate response; (3) involvement versus detachment. Participants reported not wanting any additional training. Instead, it was agreed that a formal bridge to social service providers who have the professional capability to respond appropriately and with confidence, was required. Clearly defined guidelines are required for government veterinarians in their encounters with farm animal welfare incidents where there is a complex human component. A coordinated multiagency approach that is flexible enough to meet the needs of individual farm animal welfare cases is required.

Dilemmas experienced by government veterinarians when responding professionally to farm animal welfare incidents in Ireland

PubMed Central

Devitt, C.; Kelly, P.; Blake, M.; Hanlon, A.; More, S. J.

2014-01-01

Objectives This paper identifies the dilemmas experienced by government veterinarians during their investigations of farm animal welfare incidents that involve herd owner social, health, and/or psychological difficulties. The paper builds on exploratory qualitative research into the impact of these difficulties on farm animal welfare. Design The study used a qualitative research approach. Focus groups were conducted. Setting In Ireland, an Early Warning System (EWS), which brings together relevant agencies, is in place to identify and prevent farm animal welfare problems before they become critical. This study is concerned with the experiences of government veterinarians who respond to farm animal welfare incidents. Specific focus is on incidents that involve herd owner social/psychological/health-related difficulties. Participants In total, n=18 government veterinarians (representing 15 per cent of the population sample), all with a keen interest in farm animal welfare, participated. These were selected on the basis of their interest, experience, and involvement in farm animal welfare. One government veterinarian declined to participate. Four focus groups were conducted with government veterinarians. These took place in the south (S), south-west (SW), midlands (M), and north-west region of Ireland (NW). All 16 District Veterinary Offices (DVOs) were represented in the focus groups. Results The results reveal three professional dilemmas that exist for government veterinarians: (1) defining professional parameters; (2) determining the appropriate response; (3) involvement versus detachment. Participants reported not wanting any additional training. Instead, it was agreed that a formal bridge to social service providers who have the professional capability to respond appropriately and with confidence, was required. Conclusions Clearly defined guidelines are required for government veterinarians in their encounters with farm animal welfare incidents where there is a complex human component. A coordinated multiagency approach that is flexible enough to meet the needs of individual farm animal welfare cases is required. PMID:26392869

Inter-professional work based learning within an MSc in Advanced Practice: lessons from one UK higher education programme.

PubMed

Gaskell, Lynne; Beaton, Susan

2010-09-01

This paper will describe the implementation of inter-professional work based education (IPE) in one postgraduate Advanced Practitioner programme in the UK. The concept of Advanced Practice has developed as a response of a number of drivers including change in junior doctor training; government policy and increasing demands on the central government funded UK health service (the NHS). The programme was commissioned by the then greater Manchester Strategic Health Authority (now NHS North West) to meet service needs. The educational philosophy underpinning the MSc Advanced Practice (health and social care) provided by the University of Salford is IPE linked to work based learning. The process of work based learning (WBL) and inter-professional learning underpinning the programme will be discussed in relation to feedback from university staff, Advanced Practitioner (AP) students and employer feedback taken from programme and module evaluations. We argue that IPE at this level facilitates a greater understanding of the connectivity between professionals working in the health care system in the UK; a better understanding of the skills and knowledge base of colleagues; more inter-professional working and appropriate referrals in the work place. This has raised the profile of Advanced Practice (AP) in the region and ultimately resulted in better patient care with more effective and efficient use of resources (Acton Shapiro, 2006, 2008). (c) 2009 Elsevier Ltd. All rights reserved.

The UKC2 regional coupled prediction system

NASA Astrophysics Data System (ADS)

Castillo, Juan; Lewis, Huw; Graham, Jennifer; Saulter, Andrew; Arnold, Alex; Fallmann, Joachim; Martinez de la Torre, Alberto; Blyth, Eleanor; Bricheno, Lucy

2017-04-01

It is hypothesized that more accurate prediction and warning of natural hazards, such as of the impacts of severe weather through the environment, requires a more integrated approach to forecasting. This approach also delivers research benefits through providing tools with which to explore the known interactions and feedbacks between different physical and biogeochemical components of the environment across sky, sea and land. This hypothesis is being tested in a UK regional context at km-scale through the UK Environmental Prediction Project. This presentation will provide an introduction to the UKC2 UK Environmental Prediction research system. This incorporates models of the atmosphere (Met Office Unified Model), land surface (JULES), shelf-sea ocean (NEMO) and ocean waves (WAVEWATCH III). These components are coupled (via OASIS3-MCT libraries) at unprecedentedly high resolution across the UK and the wider north-west European regional domain. A research framework has been established to explore the representation of feedback processes in coupled and uncoupled modes, providing a unique new research tool for UK environmental science. The presentation will highlight work undertaken to review and improve the computational cost of running these systems for efficient research application. Research will be presented highlighting case study evaluation on the sensitivity of the ocean and surface waves to the representation of feedbacks to the atmosphere, and on the sensitivity of weather systems and boundary layer cloud development to the exchange of heat and momentum at the ocean surface modified through sea surface temperature and wave-induced roughness. The presentation will discuss plans for future development through UKC3 and beyond.

Audit of conservative management of chronic low back pain in a secondary care setting--part I: facet joint and sacroiliac joint interventions.

PubMed

Chakraverty, Robin; Dias, Richard

2004-12-01

The work of a chronic back pain service in secondary care in the West Midlands is reported. The service offers acupuncture, spinal injection procedures, osteopathy and a range of other interventions for patients whose back pain has not responded to conservative management. This section of the report focuses on injection procedures for lumbar facet joint and sacroiliac joint pain, which have been shown to be the cause of chronic low back pain in 16-40% and 13-19% of patients respectively. Diagnosis relies on the use of intra-articular or sensory nerve block injections with local anaesthetic. Possible treatments following diagnosis include intra-articular corticosteroid, radiofrequency denervation (for facet joint pain) or ligament prolotherapy injections (for sacroiliac joint pain). The results of several hospital audits are reported. At six month follow up, 50% of 38 patients undergoing radiofrequency denervation following diagnostic blocks for facet joint pain had improved by more than 50%, compared to 29% of 34 patients treated with intra-articular corticosteroid injection. Sixty three per cent of 19 patients undergoing prolotherapy following diagnostic block injection for sacroiliac joint pain had improved at six months, compared to 33% of 33 who had intra-articular corticosteroid. Both radiofrequency denervation and sacroiliac prolotherapy showed good long-term outcomes at one year.

Prevalence of Fusarium species of the Liseola section on Zimbabwean corn and their ability to produce the mycotoxins zearalenone, moniliformin and fumonisin B1.

PubMed

Mubatanhema, W; Moss, M O; Frank, M J; Wilson, D M

1999-12-01

Maize samples were collected from nine Grain Marketing Board (G.M.B) centers in Zimbabwe during the 1991 harvest season. A further 47 samples collected directly from farmers and from the G.M.B., centers in Chinhoyi and Kwekwe during the 1992 harvest season. These samples were analyzed mycologically and the predominant flora was Fusarium although Penicillium, Nigrospora, Aspergillus and Chaetomium could be isolated from some samples. From the first nine samples studied, F. verticillioides and F. subglutinans were isolated in almost equal proportions on samples from the central and the south of the country whereas only F. verticillioides was isolated on the samples from the north. The subsequent study demonstrated that there was a greater fungal diversity in samples from North (Mashonaland West) than samples from the South (Midlands area) with species of Nigrospora, Chaetomium, Acremonium and Diplodia occurring in significant numbers. From a total of 2821 fungal isolates obtained from all the maize samples analyzed, 1485 (53%) were found to belong to the liseola section of Fusarium. The ability of these isolates to produce the mycotoxins zearalenone, moniliformin and fumonisin B1 was tested using a simplified TLC Agar plate method. Out of the 886 isolates tested, only one produced all the three mycotoxins simultaneously whilst most produced fumonisin B1 and/or moniliformin. Only nine isolates produced zearalenone.

Vocational Education and Training for the Hotel and Catering Industry in the Federal Republic of Germany. Report of a Visiting Party. Studies in Vocational Education and Training in the Federal Republic of Germany. Number Eight.

ERIC Educational Resources Information Center

Ripper, Chris, Ed.; Russell, Russ, Ed.

A party of vocational educators from the United Kingdom (UK) traveled to the Federal Republic of Germany (FRG) to examine West German vocational education and training for the hotel and catering industry. During the study, the investigators examined the training with respect to regulations, the content of training, and the structure of the…

A critical review of the state of foreign space technology

NASA Technical Reports Server (NTRS)

Grey, J.; Gerard, M.

1978-01-01

Scientific and technical capabilities of foreign nations, i.e., USSR, Japan, West Germany, UK, France, and other ESA nations, are reviewed. Attention is given to areas in which these nations are concentrating their efforts, as well as to areas in which achievements have already been realized. Among them: space industry and processing (including nonterrestrial mining), communications satellite technology, life support systems and space colonies, earth observation, space-borne astronomy and unmanned planetary probes, materials and propulsion, and exobiology (CETI/SETI).

First record of Streptosyllis nunezi Faulwetter et al., 2008 (Annelida, Syllidae) from the United Kingdom, and amendment to the genus Streptosyllis Webster & Benedict, 1884.

PubMed

Musk, Will; Faulwetter, Sarah; McIlwaine, Paul

2016-01-01

During a benthic survey of a Marine Conservation Zone located on the Skerries Bank in the English Channel off the south-west coast of England, three specimens of Streptosyllis nunezi Faulwetter et al., 2008 were found. This is the second ever record of the species after its original description, and the first record from waters around the U.K. and a significant northerly range extension for a species previously only recorded from the Canary Islands and the Mediterranean Sea. A single simple ventral chaeta in each of the two posterior-most segments was discovered in this and two other species of Streptosyllis Webster & Benedict, 1884. The generic definition of Streptosyllis is emended to include this feature previously unknown for the genus, and an updated key to the Streptosyllis found in UK waters is provided.

Informal 'Sorter' Houses: A qualitative insight of the 'shooting gallery' phenomenon in a UK setting.

PubMed

Parkin, Stephen; Coomber, Ross

2009-12-01

This paper considers the 'shooting gallery' phenomenon and presents findings from a sample of injecting drug users with experience of attending such premises in the South-West of England (UK). Due to the reciprocal relationship within these settings, involving the provision of drugs for place, the term Informal Sorter House has been coined by the authors. The social organisation and associative health risks within Informal Sorter Houses were found to have resounding similarities with those previously identified within American settings. However, several differences were also noted. Namely, Informal Sorter Houses appear to be located within a continuum of control that contains regulated, unregulated, and restored injecting environments and accordingly, it is suggested that such environments are in constant flux. A further difference relates to drug-user activism identified within such settings. This involves the establishment of an informal, street-based harm reduction practice that provides potential for future service development.

KSC-84PC-0228

NASA Image and Video Library

1984-07-13

CAPE CANAVERAL, Fla. -- At Cape Canaveral Air Force Station in Florida, British engineers conduct tests on the United Kingdom Subsatellite, part of the three-spacecraft international Active Magnetospheric Particle Tracer Explorer AMPTE mission scheduled for launch on Aug. 9, 1984 aboard a Delta rocket. The 172-pound UKS contains a comprehensive set of plasma measuring instruments to record the effects of chemical clouds released by the West German built Ion Release Module. The other AMPTE spacecraft – the Charged Composition Explorer CCEUnited States) – will operate far below, from inside the Earth’s magnetosphere, where it will track the ionized clouds as it is swept along by the solar wind. With the CCE studying this activity from below, and the IRM and UKS studying it from above, scientists expect to acquire valuable new data on exactly how the solar wind interacts with the Earth’s magnetic fields. Photo Credit: NASA

Physiotherapy students' experiences of bullying on clinical internships: a qualitative study.

PubMed

Whiteside, Diana; Stubbs, Brendon; Soundy, Andy

2014-03-01

To consider the experiences of final-year physiotherapy students who have experienced workplace bullying on a clinical internship. Qualitative methodology using individual semi-structured interviews. A university in the Midlands region of the UK. Eight undergraduate physiotherapy students who had experienced one incident of bullying on a clinical internship. Thematic analysis of semi-structured interviews. Four main themes were identified: (1) external and situational influences of bullying; (2) students' reactions to the experience of bullying; (3) inability to reveal the experience; and (4) overcoming problems. Bullying had a range of adverse effects on the students, with many expressing self-doubt in their competence and viewing their supervisor as unapproachable and unsupportive. Five students were not initially able to recognise the experience as bullying. In addition, students did not feel able to report the experience and use the support mechanisms in place. This may have been a result of having concerns that the problem would escalate if they reported the experience and, as a consequence, have a negative effect on their grade. Students were keen to offer a range of strategies for clinical practice in order to prevent bullying for future generations of students. Students' health, security and confidence in their ability as a physiotherapist can be at great risk from bullying. Steps are needed to ensure that students are better protected from bullying, and feel more able to address bullying behaviour during clinical internships. Copyright © 2013 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Parenting styles, family structure and adolescent dietary behaviour.

PubMed

Pearson, Natalie; Atkin, Andrew J; Biddle, Stuart J H; Gorely, Trish; Edwardson, Charlotte

2010-08-01

To examine associations between parenting styles, family structure and aspects of adolescent dietary behaviour. Cross-sectional study. Secondary schools in the East Midlands, UK. Adolescents aged 12-16 years (n 328, 57 % boys) completed an FFQ assessing their consumption of fruit, vegetables, unhealthy snacks and breakfast. Adolescents provided information on parental and sibling status and completed a seventeen-item instrument measuring the general parenting style dimensions of involvement and strictness, from which four styles were derived: indulgent, neglectful, authoritarian, authoritative. After controlling for adolescent gender and age, analysis of covariance revealed no significant interactions between parenting style and family structure variables for any of the dietary behaviours assessed. Significant main effects for family structure were observed only for breakfast consumption, with adolescents from dual-parent families (P < 0.01) and those with no brothers (P < 0.05) eating breakfast on more days per week than those from single-parent families and those with one or more brother, respectively. Significant main effects for parenting style were observed for all dietary behaviours apart from vegetable consumption. Adolescents who described their parents as authoritative ate more fruit per day, fewer unhealthy snacks per day, and ate breakfast on more days per week than those who described their parents as neglectful. The positive associations between authoritative parenting style and adolescent dietary behaviour transcend family structure. Future research should be food-specific and assess the efficacy of strategies promoting the central attributes of an authoritative parenting style on the dietary behaviours of adolescents from a variety of family structures.

Access, continuity of care and consultation quality: which best predicts urgent cancer referrals from general practice?

PubMed

Rogers, Stephen; Gildea, Carolynn; Meechan, David; Baker, Richard

2014-12-01

For some cancers, late presentation is associated with poor survival. In England, less than half of patients are diagnosed following a general practitioner-initiated urgent referral. We explore whether particular practice or practitioner characteristics are associated with use of the urgent referral system. The study sample was 603/614 practices in the East Midlands. Logistic regression models were fitted to investigate relationships between cancer detection rate, how easy it is to book appointments quickly, in advance or with a preferred doctor, and whether patients have confidence and trust in the doctor. The percentage of patients who definitely have confidence and trust in the doctor was positively associated with the cancer detection rate [odds ratio = 1.08 (95% confidence interval (CI) 1.01, 1.15) per 10 percentage points]. When all four survey variables were modelled together, the percentage of patients who were able to see a preferred doctor was negatively associated with the cancer detection rate [odds ratio = 0.93 (95% CI 0.88, 0.98) per 10 percentage points]. Our analyses suggest that in the UK National Health Service, confidence and trust in the doctor may be more important in cancer detection than the ease of access or whether there is choice of doctor. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Alcohol use disorders and hazardous drinking among undergraduates at English universities.

PubMed

Heather, Nick; Partington, Sarah; Partington, Elizabeth; Longstaff, Fran; Allsop, Susan; Jankowski, Mark; Wareham, Helen; St Clair Gibson, Alan

2011-01-01

To report on alcohol use disorders and hazardous drinking from a survey of university students in England in 2008-2009. A cross-sectional survey using the Alcohol Use Disorders Identification Test (AUDIT) was carried out in a purposive sample of 770 undergraduates from seven universities across England. Sixty-one per cent of the sample (65% men; 58% women) scored positive (8+) on the AUDIT, comprising 40% hazardous drinkers, 11% harmful drinkers and 10% with probable dependence. There were large and significant differences in mean AUDIT scores between the universities taking part in the survey. Two universities in the North of England showed a significantly higher combined mean AUDIT score than two universities in the Midlands which in turn showed a significantly higher mean AUDIT score than three universities in the South. When the effects of university attended were extracted in a binary logistic regression analysis, independent significant predictors of AUDIT positive status were younger age, 'White' ethnicity and both on-campus and off-campus term-time student accommodation. Undergraduates at some universities in England show very high levels of alcohol-related risk and harm. University authorities should estimate the level of hazardous drinking and alcohol use disorders among students at their institutions and take action to reduce risk and harm accordingly. Research is needed using nationally representative samples to estimate the prevalence of alcohol risk and harm in the UK student population and to determine the future course of drinking problems among students currently affected.

Hodgkin disease survival in Europe and the U.S.: prognostic significance of morphologic groups.

PubMed

Allemani, Claudia; Sant, Milena; De Angelis, Roberta; Marcos-Gragera, Rafael; Coebergh, Jan Willem

2006-07-15

The survival of patients with Hodgkin disease (HD) varies markedly across Europe and generally is shorter than the survival of patients in the U.S. To investigate these differences, the authors compared population-based HD survival in relation to morphologic type among populations in Europe and the U.S. The authors analyzed 6726 patients from 37 cancer registries that participated in EUROCARE-3 and 3442 patients from 9 U.S. Surveillance, Epidemiology, and End Results (SEER) registries. Patients were diagnosed during 1990 to 1994 and were followed for at least 5 years. The European registries were grouped into EUROCARE West, EUROCARE UK, and EUROCARE East. Morphologic groups were nodular sclerosis, mixed cellularity, lymphocyte depletion, lymphocyte predominance, and not otherwise specified (NOS). The influence of morphology on geographic differences in 5-year relative survival was explored by using multiple regression analysis. In the model that was adjusted by age, gender, and years since diagnosis, the relative excess risk (RER) of death was 0.93 (95% confidence interval [95% CI], 0.81-1.05) in EUROCARE West, 1.15 (95% CI, 1.04-1.28) in EUROCARE UK, and 1.39 (95% CI, 1.21-1.60) in EUROCARE East (compared with the SEER data). When morphology was included, EUROCARE UK and SEER no longer differed (RER, 1.06; 95% CI, 0.95-1.18). Morphology distribution varied markedly across Europe and much less in the U.S., with nodular sclerosis less common in Europe (45.9%) than the U.S. (61.7%). The RER data showed that patients who had lymphocyte depletion, NOS, and mixed cellularity had a significantly worse prognoses compared with patients who had nodular sclerosis, whereas patients who had lymphocyte predominance had the best prognosis. The current results provide population-based evidence that morphology strongly influences the prognosis of patients with HD. However differences in the morphologic case mix explains only some of the geographic variations observed in survival.

A note on the proposed UK VHF radar

NASA Technical Reports Server (NTRS)

Hall, A. J.

1984-01-01

The proposal for the establishment of a VHF radar in the UK is still under active consideration, although for financial reasons no start has yet been made on an installation. Several changes have been made to the scheme as described and these are listed. (1) The initial installation will be suitable for stratosphere-troposphere (ST) operation only using 64 antennas and 2 power modules. (2) An existing site is being examined on the west coast of Wales, which because it is a former Loran ground station is provided with the buildings, power and communications facilities to enable a radar to be assembled much more quickly than a green field site would allow. Because the site is not within a mountain valley as originally intended, careful early attention will have to be given to the possible problems of local interference and sea-surface returns. (3) Preliminary discussions with the UK licensing authorities suggest that a frequency of 47 MHz is more likely than 50 MHz. (4) Minor changes are planned in the antenna array connection scheme of the 400-element mesosphere-stratosphere-troposphere (MST) array to allow more precise sidelobe suppression to be achieved in the receive mode.

Work capacity, thermal responses and lung function: united kingdom studies in the L.B.P.

PubMed

Weiner, J S

1976-07-01

Results of physiological studies from some ten U.K. Human Adaptability projects are presented. U.K. investigators made major contributions in developing and adapting techniques for the assussment under field conditions of work capacity, heat tolerance and respiratory function. The various ethnic studies of work capacity revealed the special role of body size and muscularity, as well as training, in determining the observed inter- and intra-population variance. The results on samples from U.K., New Guinea, the Caribbean, Israel, West and East Africa and the Ethiopian highlands gave no indication that genetic difference were significant in determining population differences. Differences in heat tolerance reflect in general the intensity of heat exposure, especially when combined with hard physical work. Indigenous peoples in Africa and New Guinea show some modification in sweating responses which do not appear to be genetically determined but are in some way, as yet not clearly established, attributable to long continued residence in tropical climates. In renal function of some seven ethnic groups were analysed in terms of lung volume bellows function, gas exchange and responses to excercise and carbon dioxide. The relative importance of genetic and non-genetic factors was examined.

Energy crops on floodplains - flood risk or benefit?

NASA Astrophysics Data System (ADS)

Rosolova, Zdenka; Baylis, Adam; Rose, Steve

2010-05-01

Land use and land management on floodplains have increasingly come into focus, particularly in relation to their impact on flooding. To date, research and modelling has explored the impact of land use changes such as floodplain afforestation, changes to management of upland moorlands or re-establishment of wet meadows on floodplains. However, no such investigation has been carried out into the impact on floodplain flows of growing energy crops. In the UK, a strong emphasis is being given to promotion of renewable energy. Farmers are encouraged to plant energy crops such as Miscanthus or Short Rotation Crops (e.g. Willow) in suitable locations, which typically exclude farmland in Flood Zone 3 (i.e. areas likely to be flooded by an event with a 100-year return period). However, there is a lack of understanding as to what impact, if any, the dense character of these crops planted on floodplains might have on flooding. This gap in knowledge currently prevents energy crops from being planted in areas where they could provide high economic and environmental benefit, and even possibly contribute to flood mitigation. At present, no guidance or policy exists to advise whether allowing farmers to establish energy crop plantations in Flood Zone 3 could alter the existing flood risk. Consequently, if energy crops could provide a coupled benefit of renewable energy source and flood mitigation, this benefit is not being utilised. To help fill in this gap in knowledge, a short term project was carried out in order to investigate, using suitable hydraulic modelling, the possible scale of impact of growing energy crops on river and floodplain flows, flood depth and overall impact on flood risk locally as well as downstream. 2D hydraulic modelling using TUFLOW was deemed to be the most appropriate approach for these investigations. The methodology included gaining an understanding of the life cycle and planting regime of Miscanthus and Willow, review of current knowledge on the likely behaviour of mature energy crops when flooded, their likely hydraulic roughness and selection of suitable existing hydraulic models. This informed establishment of feasible modelling scenarios, which represent the plantations in terms of their size, location, orientation to flow and percentage cover on the floodplain. A baseline scenario was included to enable comparison of results. Two case studies were selected for this project; the River Severn at Uckinghall, in the Environment Agency's Midlands Region, and the River Isle at Ashford Mill, in South West Region. Additionally, a theoretical model was set up in order to help define scenarios which produced the biggest impacts, but excluding the effect of local subtleties that are different in each case study. This paper will demonstrate the methodology and the modelling approach adopted for this study. The outputs of the modelled scenarios (compared to baseline) will be presented in context of flood risk and flood mitigation, bearing in mind the assumptions and limitations that had to be introduced in order to carry out this project. The results will include changes to river flow, flow on the floodplain, flood depths, flood velocities and overall likely impact of the energy crops upstream and downstream of the plantations. Finally, the conclusions will discuss how the findings may be used to change guidance and practice regarding energy crops, and how such change could inform national policy in the UK.

Space Radar Image of West Texas - SAR scan

NASA Technical Reports Server (NTRS)

1999-01-01

This radar image of the Midland/Odessa region of West Texas, demonstrates an experimental technique, called ScanSAR, that allows scientists to rapidly image large areas of the Earth's surface. The large image covers an area 245 kilometers by 225 kilometers (152 miles by 139 miles). It was obtained by the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) flying aboard the space shuttle Endeavour on October 5, 1994. The smaller inset image is a standard SIR-C image showing a portion of the same area, 100 kilometers by 57 kilometers (62 miles by 35 miles) and was taken during the first flight of SIR-C on April 14, 1994. The bright spots on the right side of the image are the cities of Odessa (left) and Midland (right), Texas. The Pecos River runs from the top center to the bottom center of the image. Along the left side of the image are, from top to bottom, parts of the Guadalupe, Davis and Santiago Mountains. North is toward the upper right. Unlike conventional radar imaging, in which a radar continuously illuminates a single ground swath as the space shuttle passes over the terrain, a Scansar radar illuminates several adjacent ground swaths almost simultaneously, by 'scanning' the radar beam across a large area in a rapid sequence. The adjacent swaths, typically about 50 km (31 miles) wide, are then merged during ground processing to produce a single large scene. Illumination for this L-band scene is from the top of the image. The beams were scanned from the top of the scene to the bottom, as the shuttle flew from left to right. This scene was acquired in about 30 seconds. A normal SIR-C image is acquired in about 13 seconds. The ScanSAR mode will likely be used on future radar sensors to construct regional and possibly global radar images and topographic maps. The ScanSAR processor is being designed for 1996 implementation at NASA's Alaska SAR Facility, located at the University of Alaska Fairbanks, and will produce digital images from the forthcoming Canadian RADARSAT satellite. Spaceborne Imaging Radar-C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v.(DLR), the major partner in science, operations, and data processing of X-SAR.

Uptake of Space Technologies - An Educational Programme

NASA Astrophysics Data System (ADS)

Bacai, Hina; Zolotikova, Svetlana; Young, Mandy; Cowsill, Rhys; Wells, Alan; Monks, Paul; Archibald, Alexandra; Smith, Teresa

2013-04-01

Earth Observation data and remote sensing technologies have been maturing into useful tools that can be utilised by local authorities and businesses to aid in activates such as monitoring climate change trends and managing agricultural land and water uses. The European Earth observation programme Copernicus, previously known as GMES (Global Monitoring for Environment and Security), provides the means to collect and process multi-source EO and environmental data that supports policy developments at the European level. At the regional and local level, the Copernicus programme has been initiated through Regional Contact Office (RCO), which provide knowledge, training, and access to expertise both locally and at a European level through the network of RCOs established across Europe in the DORIS_Net (Downstream Observatory organised by Regions active In Space - Network) project (Grant Agreement No. 262789 Coordination and support action (Coordinating) FP7 SPA.2010.1.1-07 "Fostering downstream activities and links with regions"). In the East Midlands UK RCO, educational and training workshops and modules have been organised to highlight the wider range of tools and application available to businesses and local authorities in the region. Engagement with businesses and LRA highlighted the need to have a tiered system of training to build awareness prior to investigating innovative solutions and space technology uses for societal benefits. In this paper we outline education and training programmes which have been developed at G-STEP (GMES - Science and Technology Education Partnership), University of Leicester, UK to open up the Copernicus programme through the Regional Contact Office to downstream users such as local businesses and LRAs. Innovative methods to introduce the operational uses of Space technologies in real cases through e-learning modules and web-based tools will be described and examples of good practice for educational training in these sectors will be demonstrated. The results from these workshops and awareness building campaigns will show the end-user 'pull' in the uptake of remote sensing and Earth Observation data to implement successful Local Authority action plans and projects developing innovative solutions to critical Local Authority issues.

A cluster randomised controlled trial to investigate the effectiveness and cost effectiveness of the 'Girls Active' intervention: a study protocol.

PubMed

Edwardson, C L; Harrington, D M; Yates, T; Bodicoat, D H; Khunti, K; Gorely, T; Sherar, L B; Edwards, R T; Wright, C; Harrington, K; Davies, M J

2015-06-04

Despite the health benefits of physical activity, data from the UK suggest that a large proportion of adolescents do not meet the recommended levels of moderate-to-vigorous physical activity (MVPA). This is particularly evident in girls, who are less active than boys across all ages and may display a faster rate of decline in physical activity throughout adolescence. The 'Girls Active' intervention has been designed by the Youth Sport Trust to target the lower participation rates observed in adolescent girls. 'Girls Active' uses peer leadership and marketing to empower girls to influence decision making in their school, develop as role models and promote physical activity to other girls. Schools are provided with training and resources to review their physical activity, sport and PE provision, culture and practices to ensure they are relevant and attractive to adolescent girls. This study is a two-arm cluster randomised controlled trial (RCT) aiming to recruit 20 secondary schools. Clusters will be randomised at the school level (stratified by school size and proportion of Black and Minority Ethnic (BME) pupils) to receive either the 'Girls Active' intervention or carry on with usual practice (1:1). The 20 secondary schools will be recruited from state secondary schools within the Midlands area. We aim to recruit 80 girls aged 11-14 years in each school. Data will be collected at three time points; baseline and seven and 14 months after baseline. Our primary aim is to investigate whether 'Girls Active' leads to higher objectively measured (GENEActiv) moderate-to-vigorous physical activity in adolescent girls at 14 months after baseline assessment compared to the control group. Secondary outcomes include other objectively measured physical activity variables, adiposity, physical activity-related psychological factors and the cost-effectiveness of the 'Girls Active' intervention. A thorough process evaluation will be conducted during the course of the intervention delivery. The findings of this study will provide valuable information on whether this type of school-based approach to increasing physical activity in adolescent girls is both effective and cost-effective in the UK. ISRCTN10688342. Registered 12 January 2015.

Starting a Business in the Permian Basin.

ERIC Educational Resources Information Center

Harrison, Danny

The business and economic development center of Midland College provides assistance to small businesses. Written for use by future and current small business owners and entrepreneurs living in a 17-county area of the Permian Basin of Texas, this guidebook describes the procedures for developing a business plan and for successfully starting and…

The Power of One? Conditions Which Challenge Managerial Professional Development Practices

ERIC Educational Resources Information Center

Hardy, Ian

2014-01-01

This paper draws upon Bourdieu's concepts of habitus, capital and field to better understand and appreciate the conditions which encouraged the productive professional development (PD) practices of one very capable teacher working in a secondary school in the British Midlands. Rather than celebrating this teacher's practices and perspective as…

Focus on the 1990's: International Trade Opportunities for the Permian Basin.

ERIC Educational Resources Information Center

Midland Coll., TX. Business and Economic Development Center.

Designed to highlight business opportunities of the 1990s as well as available educational programs relating to international business, this report contains six presentations from a 1990 conference on international trade hosted by Midland College (MC). The first article, "Texas in the Global Economy: Attitude and Opportunity," by John A.…

76 FR 81475 - Foreign-Trade Zones 140 and 78 Applications for Subzone Authority Dow Corning Corporation...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-28

...-Trade Zones 140 and 78 Applications for Subzone Authority Dow Corning Corporation, Hemlock Semiconductor Corporation and Hemlock Semiconductor, L.L.C.; Notice of Public Hearing and Extension of Comment Period A... facility in Midland, Michigan (76 FR 63282-63283, 10/12/2011), the Hemlock Semiconductor Corporation...

77 FR 42771 - License Renewal for the Dow Chemical TRIGA Research Reactor

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

... Chemical Company in Midland, MI and is a part of the Analytical Sciences Laboratory. The reactor is housed...-Radiological Impacts The Dow TRIGA Research Reactor core is cooled by a light water primary system consisting... provided by the volume of primary coolant allows several hours of full-power operation without any...

Desktop Publishing as a Learning Resources Service.

ERIC Educational Resources Information Center

Drake, David

In late 1988, Midland College in Texas implemented a desktop publishing service to produce instructional aids and reduce and complement the workload of the campus print shop. The desktop service was placed in the Media Services Department of the Learning Resource Center (LRC) for three reasons: the LRC was already established as a campus-wide…

The Effect of Green Sugarcane on Downstream Processing at Two Midlands Factories

USDA-ARS?s Scientific Manuscript database

There is a worldwide shift to green cane from burnt cane harvesting. In many countries including the U.S. and South Africa, certain areas are changing to green cane harvesting due to public and environmental pressures against open field burning, increasing labor costs, and the current trend to inve...

An Ecological Momentary Assessment of the Physical Activity and Sedentary Behaviour Patterns of University Students

ERIC Educational Resources Information Center

Rouse, Peter C.; Biddle, Stuart J. H.

2010-01-01

Objective: We used ecological momentary assessment to understand the physical activity and sedentary behaviour patterns of university students. Study design: Cross sectional, opportunistic sample from a university in the English midlands. Methods: Ecological momentary assessment diaries were completed every 15 minutes across two days. The sample…

Repeat what after whom? Exploring variable selectivity in a cross-dialectal shadowing task

PubMed Central

Walker, Abby; Campbell-Kibler, Kathryn

2015-01-01

Twenty women from Christchurch, New Zealand and 16 from Columbus Ohio (dialect region U.S. Midland) participated in a bimodal lexical naming task where they repeated monosyllabic words after four speakers from four regional dialects: New Zealand, Australia, U.S. Inland North and U.S. Midland. The resulting utterances were acoustically analyzed, and presented to listeners on Amazon Mechanical Turk in an AXB task. Convergence is observed, but differs depending on the dialect of the speaker, the dialect of the model, the particular word class being shadowed, and the order in which dialects are presented to participants. We argue that these patterns are generally consistent with findings that convergence is promoted by a large phonetic distance between shadower and model (Babel, 2010, contra Kim et al., 2011), and greater existing variability in a vowel class (Babel, 2012). The results also suggest that more comparisons of accommodation toward different dialects are warranted, and that the investigation of the socio-indexical meaning of specific linguistic forms in context is a promising avenue for understanding variable selectivity in convergence. PMID:26029129

Seismic and potential field studies over the East Midlands

NASA Astrophysics Data System (ADS)

Kirk, Wayne John

A seismic refraction profile was undertaken to investigate the source of an aeromagnetic anomaly located above the Widmerpool Gulf, East Midlands. Ten shots were fired into 51 stations at c. 1.5km spacing in a 70km profile during 41 days recording. The refraction data were processed using standard techniques to improve the data quality. A new filtering technique, known as Correlated Adaptive Noise Cancellation was tested on synthetic data and successfully applied to controlled source and quarry blast data. Study of strong motion data reveals that the previous method of site calibration is invalid. A new calibration technique, known as the Scaled Amplitude method is presented to provide safer charge size estimation. Raytrace modelling of the refraction data and two dimensional gravity interpretation confirms the presence of the Widmerpool Gulf but no support is found for the postulated intrusion. Two dimensional magnetic interpretation revealed that the aeromagnetic anomaly could be modelled with a Carboniferous igneous source. A Lower Palaeozoic refractor with a velocity of 6.0 km/s is identified at a maximum depth of c. 2.85km beneath the Widmerpool Gulf. Carboniferous and post-Carboniferous sediments within the gulf have velocities between 2.6-5.5 km/s with a strong vertical gradient. At the gulf margins, a refractor with a constant velocity of 5.2 km/s is identified as Dinantian limestone. A low velocity layer of proposed unaltered Lower Palaeozoics is identified beneath the limestone at the eastern edge of the Derbyshire Dome. The existence and areal extent of this layer are also determined from seismic reflection data. Image analysis of potential field data, presents a model identifying 3 structural provinces, the Midlands Microcraton, the Welsh and English Caledonides and a central region of complex linears. This model is used to explain the distribution of basement rocks determined from seismic and gravity profiles.

Views of breastfeeding difficulties among drop-in-clinic attendees.

PubMed

Berridge, Kirstin; McFadden, K; Abayomi, J; Topping, J

2005-10-01

Breast-milk is the optimum form of nutrition for the first 6 months of life. However, breastfeeding rates in the UK are low and static compared to other European countries and those in the North-west of England in the UK are even lower. Of the women who initiate breastfeeding, many cease in the first month following the birth for reasons that might be avoided. To try and prevent this, UNICEF Baby Friendly Hospital Initiative (BFHI) 'Ten Steps to Successful Breastfeeding' state that maternity facilities should foster the development of support groups for breastfeeding women. The aim of the present study was to describe breastfeeding difficulties reported by women who attended the infant feeding clinic at a Women's Hospital in the North-west of England. During the study period, the clinic was attended mainly by primiparous mothers who were educated beyond 18 years of age and of higher socio-economic status. They presented with a variety of problems including baby not latching on, concerns about baby's weight gain/loss, sore nipples and advice about expressing milk in preparation for return to work. The women highlighted the importance of meeting other mothers and having someone to talk to who understood what they were going through. Inconsistent information/lack of detailed knowledge from health professionals was cited as contributing to breastfeeding difficulties. A number of women reported that expert hands-on, one-to-one support, was invaluable and many felt they were able to continue breastfeeding but without the support, they may have given up.

Radio-echo sounding of 'active' Antarctic subglacial lakes

NASA Astrophysics Data System (ADS)

Siegert, M. J.; Ross, N.; Blankenship, D. D.; Young, D. A.; Greenbaum, J. S.; Richter, T.; Rippin, D. M.; Le Brocq, A. M.; Wright, A.; Bingham, R.; Corr, H.; Ferraccioli, F.; Jordan, T. A.; Smith, B. E.; Payne, A. J.; Dowdeswell, J. A.; Bamber, J. L.

2013-12-01

Repeat-pass satellite altimetry has revealed 124 discrete surface height changes across the Antarctic Ice Sheet, interpreted to be caused by subglacial lake discharges (surface lowering) and inputs (surface uplift). Few of these active lakes have been confirmed by radio-echo sounding (RES) despite several attempts, however. Over the last 5 years, major geophysical campaigns have acquired RES data from several 'active' lake sites, including the US-UK-Australian ICECAP programme in East Antactica and the UK survey of the Institute Ice Stream in West Antarctica. In the latter case, a targeted RES survey of one 'active' lake was undertaken. RES evidence of the subglacial bed beneath 'active' lakes in both East and West Antarctica will be presented, and the evidence for pooled subglacial water from these data will be assessed. Based on this assessment, the nature of 'active' subglacial lakes, and their associated hydrology and relationship with surrounding topography will be discussed, as will the likelihood of further 'active' lakes in Antarctica. Hydraulic potential map of the Byrd Glacier catchment with contours at 5 MPa intervals. Predicted subglacial flowpaths are shown in blue. Subglacial lakes known from previous geophysical surveys are shown as black triangles while the newly discovered 'Three-tier lakes' are shown in dashed black outline. Surface height change features within the Byrd subglacial catchment are shown in outline and are shaded to indicate whether they were rising or falling during the ICESat campaign. Those features are labelled in-line with the numbering system of Smith et al. (J. Glac. 2009).

Assessing the impact of adjusting for maturity in weight status classification in a cross-sectional sample of UK children.

PubMed

Gillison, Fiona; Cumming, Sean; Standage, Martyn; Barnaby, Catherine; Katzmarzyk, Peter

2017-06-26

To compare the weight categorisation of a cohort of UK children using standard procedures (ie, comparing body mass index (BMI) centiles to age-matched UK reference data) versus an approach adjusted for maturation status (ie, matching relative to biological age). Analysis of data collected from an observational study of UK primary school children. Schools in South West England. Four hundred and seven 9-11 year-old children (98% white British). Weight status was classified using BMI centiles using (1) sex and chronological age-matched referents and (2) sex and biological age-matched referents (based on % of predicted adult stature) relative to UK 1990 reference growth charts. For both approaches, children were classified as a normal weight if >2nd centile and <85thcentile, overweight if 85th and <95thcentiles, and obese if ≥95thcentile. Fifty-one children (12.5%) were overweight, and a further 51 obese (12.5%) according to standard chronological age-matched classifications. Adjustment for maturity resulted in 32% of overweight girls, and 15% of overweight boys being reclassified as a normal weight, and 11% and 8% of obese girls and boys, respectively, being reclassified as overweight. Early maturing children were 4.9 times more likely to be reclassified from overweight to normal weight than 'on-time' maturers (OR 95% CI 1.3 to 19). Incorporating assessments of maturational status into weight classification resulted in significant changes to the classification of early-maturing adolescents. Further research exploring the implications for objective health risk and well-being is needed. © 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.

Estimating National-scale Emissions using Dense Monitoring Networks

NASA Astrophysics Data System (ADS)

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

2014-12-01

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

Human and fishing vessel losses in sea accidents in the UK fishing industry from 1948 to 2008.

PubMed

Roberts, Stephen E; Jaremin, Bogdan; Marlow, Peter B

2010-01-01

To investigate long-term trends in mortality rates for accidents to fishing vessels in the UK fishing industry from 1948 to 2008; to investigate the circumstances and causes of these fishing vessel accidents and trends in fishing vessel losses. Examination of paper death inquiry files, death registers, marine accident investigative files, annual casualty and death returns. Of 1039 fatalities from accidents to UK fishing vessels from 1948 to 2008, most (65%) resulted from vessels that foundered (or capsized or disappeared), followed by vessels grounding (21%), collisions (7%), and fires and explosions (5%). There was a significant increase over time of 1.04% per year in the overall fishing vessel loss rate and for vessels that foundered (5.19%), a reduction for vessels grounding (1.13%), but no trends for collisions or fires and explosions. Regarding mortality, there was a significant reduction over time for grounding (1.44%) and a non-significant reduction for vessel accidents overall, but no trends for other types of vessel accident. Mortality was highest during the winter months (for foundering and grounding), during night time (for grounding, fires and explosions), and afternoons (foundering and collisions). Since 1976, most fatalities from collisions (83%) occurred in the English Channel and North Sea, while 49% from grounding occurred off the west coast of Scotland. The mortality rate from fishing vessel casualties in UK fishing is still very high. Fatalities in recent years have often been linked to fishing vessels that are unstable, overloaded, and unseaworthy.

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

NASA Astrophysics Data System (ADS)

Rey Vicario, D.; Holman, I.

2016-12-01

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

Modelling secondary organic aerosol in the United Kingdom

NASA Astrophysics Data System (ADS)

Redington, A. L.; Derwent, R. G.

2013-01-01

The Lagrangian atmospheric dispersion model, NAME, has been used to model the formation and transport of anthropogenic and biogenic secondary organic aerosol (SOA) over North-West Europe in 2008. The model has been tested against daily organic carbon measurements at Harwell, a rural site in southern UK, where it was able to represent adequately the observed values in summer, with some under-prediction in winter. The model has been used to look at the contribution of SOA to total measured PM10 at four selected UK sites. The site with the greatest contribution (32%) of SOA to PM10 was Auchencorth, a rural site in Scotland and least (9%) at London Bloomsbury. The biogenic SOA (BSOA) dominated over the anthropogenic SOA (ASOA) in the UK and showed a strong seasonal cycle peaking in the summer. There was also a slight summer increase in ASOA. The model has been employed to provide source attribution between UK sources and sources in the rest of Europe. The contribution from Europe was generally small but varied considerably due to meteorology. The UK component showed a seasonal cycle, peaking in the summer months. On an annual basis, considering the four measurement sites, the percentage of SOA arriving from outside the UK was least at Auchencorth (9.8%) and most at London (28.4%). Total modelled SOA had a maximum contribution of 2-3 μg m-3 as a monthly average. (It should be noted that in addition there will be a small contribution from background SOA to these figures.) Emission sensitivity studies revealed that the response of ASOA was highly non-linear, showing both positive and negative responses to a 30% reduction in all man-made NOx sources and the response was greater than 1:1 to a 30% reduction in all man-made VOC sources. BSOA showed only a small negative response to a 30% NOx reduction and no change to a 30% VOC reduction.

'"Navvy" Import Alions [Sic]': The Schooling of Navvy Children in the Midlands in the 1890s

ERIC Educational Resources Information Center

Ayres, Bryan John

2017-01-01

The children of navvies were subject to the vagaries of an itinerant lifestyle, and during the latter years of the nineteenth century this invariably affected their relationship with an educational system that mandated compulsory attendance. Based primarily on school records, this article explores the contrasting ways in which teachers perceived…

"Outside of Everything and Everybody": Renegotiating Place in the Classroom

ERIC Educational Resources Information Center

Robinson, Jo

2016-01-01

This article examines a series of plays created by Nottingham Playhouse Roundabout Theatre in Education Company in the first years of the twenty-first century that aimed to respond to rising concerns about the impact of increasing numbers of refugees in the East Midlands. My discussion focuses on two of these: Mohammed, performed to Year 6…

75 FR 47041 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-04

... Exploration CI CIGNA Corp. & Production Co. GPS Gap Inc/The........ ESI ITT Educational Services Inc. TSL... CB Chubb Corp. ATPG ATP Oil & Gas Corp/ ADM Archer-Daniels- United States. Midland Co. YUM Yum! Brands Inc.... HSY Hershey Co/The. RCL Royal Caribbean TXT Textron Inc. Cruises Ltd. BPOP Popular Inc...

Changing the Story: Making Renewable Energy Central to Learning

ERIC Educational Resources Information Center

Goddard, Lise; Hahn, Josh

2012-01-01

This article examines two independent schools as case studies for educating for sustainability, and shares what they have learned, what works, and best of all, what can be replicated elsewhere. Midland School--rigorous, rustic, and full of heart--is a small college preparatory boarding school on almost 3,000 acres in the Santa Ynez Valley in…

77 FR 16585 - Arkansas Midland Railroad Company, Inc.-Abandonment Exemption-in Phillips County, AK

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-21

... filed with the Board should be sent to AKMD's representative: Jeremy M. Berman, Fletcher & Sippel LLC... Surface Transportation Board (Board) or with any U.S. District Court or has been decided in favor of... this condition adequately protects affected employees, a petition for partial revocation under 49 U.S.C...

Seeking to Engage "Hard-to-Reach" Families: Towards a Transferable Model of Intervention

ERIC Educational Resources Information Center

Evangelou, Maria; Coxon, Kate; Sylva, Kathy; Smith, Sally; Chan, Lydia L. S.

2013-01-01

This paper describes an exploratory evaluation of the Peers Early Education Partnership "Room to Play", an innovative and experimental "drop-in" service seeking to attract and engage "hard-to-reach" families in one of the most deprived areas of a Midlands city. Located in a shop unit of a busy community shopping…

78 FR 21100 - Grant of Authority for Subzone Status; Dow Corning Corporation (Silicon-Based Products); Midland, MI

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-09

... DEPARTMENT OF COMMERCE Foreign-Trade Zones Board [Order No. 1893] Grant of Authority for Subzone... foreign commerce, and for other purposes,'' and authorizes the Foreign-Trade Zones Board to grant to..., and when the activity results in a significant public benefit and is in the public interest; Whereas...

Law Schools and Public Legal Education: The Community Law Programme at Windsor.

ERIC Educational Resources Information Center

MacDonald, R. A.

1979-01-01

Described is a public legal education program at the University of Windsor (Canada) that aims to educate the layperson in Canadian law and procedure. Objectives, program elements, and ancillary activities are outlined briefly. Available from The Carswell Co., Ltd., 2330 Midland Ave., Agincourt, Ontario M1S 1P7 Canada. (MSE)

Rail-trails and special events: community and economic benefits

Treesearch

Charles Nelson; Christine Vogt; Joel Lynch; Daniel Stynes

2002-01-01

This paper discusses community and economic benefits associated with two recreational bicycle special events held on the Pere Marquette Rail-Trail (PMRT) in Midland County Michigan during the summer of 1999. One event was an annual ride to fundraise for the Rails to Trails Conservancy of Michigan. Approximately 1,800 participants rode in the event which included two...

DOE Zero Energy Ready Home Case Study: Cobblestone Homes — 2014 Model Home, Midland, MI

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

none,

2014-09-01

This builder's first DOE Zero Energy Ready Home won a Custom Builder award in the 2014 Housing Innovation Awards, scored HERS 49 without PV or HERS 44 with 1.4 kW of PV, and served as a prototype and energy efficiency demonstration model while performance testing was conducted.

Associations between Children's Physical Activities, Sedentary Behaviours and Family Structure: A Sequential Mixed Methods Approach

ERIC Educational Resources Information Center

Quarmby, T.; Dagkas, S.; Bridge, M.

2011-01-01

This mixed method paper explored the effect of family structure on children's physical activities and sedentary pursuits. It furthers the limited understanding of how family structure impacts on children's time in, and reasons behind engaging in, certain physical activities. Children from three inner city comprehensive schools in the Midlands,…

Habitat usage by prairie grouse on the Sheyenne National Grasslands

Treesearch

Llewellyn L. Manske; William T. Barker

1988-01-01

Prairie grouse habitat usage was observed for six years. Spring and summer habitat usage was primarily in the upland and midland grassland habitat types. Habitat usage shifted during the fall and winter to cropland and associated tree shelterbelts. The switchgrass plant community was the primary concealment cover for nesting and roosting. Cropland and associated tree...

How are Leaders Integrating the Ideology of Globalisation in Primary School Contexts?

ERIC Educational Resources Information Center

Mistry, Malini; Sood, Krishan

2013-01-01

This study carried out research focusing on diverse learners, such as pupils who have English as additional language (EAL) in primary schools in the Midlands, England. Essentially, we wanted to know how they are supported to become global learners. Therefore, questions were posed to school leaders on their understanding of the concept of…

Why Study A Level Religious Studies? Qualitative Perspectives from Two English Midlands Sixth Forms

ERIC Educational Resources Information Center

Jones, Ian

2017-01-01

Religious Studies (RS) is expected to impact students' personal development as well as enabling acquisition of knowledge and understanding of religious and philosophical traditions. But to what extent does this actually occur? As part of a larger quantitative investigation of the effects of A Level RS in students' beliefs, values and worldviews…

Teacher Education in Further Education 2000-2010: Subversion, Avoidance and Compliance

ERIC Educational Resources Information Center

Aubrey, Karl; Bell, Les

2017-01-01

This article explores the impact of key teacher education policies created between 2000 and 2010 on further education teacher educators. Data was collected from a group of experienced teacher educators in the Midlands through a series of semi-structured interviews. This article argues that the reforms were driven by too great a concern for…

Marine geological and geophysical records of the last British-Irish Ice Sheet on the continental shelf west of Ireland

NASA Astrophysics Data System (ADS)

O'Cofaigh, Colm; Callard, S. Louise; Benetti, Sara; Chiverell, Richard C.; Saher, Margot; van Landeghem, Katrien; Livingstone, Stephen J.; Scourse, James; Clark, Chris D.

2015-04-01

The record of glaciation on the continental shelf west of Ireland has, until recently, been relatively poorly studied. The UK NERC funded project BRITICE-CHRONO collected marine geophysical data in the form of multibeam swath bathymetry and sub-bottom profiles supplemented by over 50 vibro- and piston cores across the continental shelf west of Ireland during cruise JC106 of the RRS James Cook in 2014. Across the western Irish shelf, offshore of counties Galway and Clare, a series of large arcuate moraines record the former presence of a grounded ice sheet on the shelf. However, geophysical data from further to the west across the Porcupine Bank show a series of ridges and wedge-shaped sedimentary features whose form is consistent with an origin as moraines and/or grounding-zone wedges. Sediment cores from several of these landforms recovered stiff, massive diamictons containing reworked shells that are interpreted as subglacial tills. Cores from the eastern Porcupine Bank recovered laminated muds with cold-water glacimarine foraminifera, in some cases overlying till. Collectively the geophysical and sedimentary data imply the presence of grounded ice across the northern Porcupine Bank and thus much further west on the Irish margin than has previously been considered. This ice underwent retreat in a glacimarine setting. The large 'Olex Moraine' on the western Irish shelf is thus interpreted as recessional feature. Work is currently underway to dates these features and to obtain a retreat chronology for this sector of the last British-Irish Ice Sheet.

Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: cluster randomised controlled trial (WAVES study)

PubMed Central

Pallan, Miranda J; Lancashire, Emma R; Hemming, Karla; Frew, Emma; Barrett, Tim; Bhopal, Raj; Cade, Janet E; Canaway, Alastair; Clarke, Joanne L; Daley, Amanda; Deeks, Jonathan J; Duda, Joan L; Ekelund, Ulf; Gill, Paramjit; Griffin, Tania; McGee, Eleanor; Hurley, Kiya; Martin, James; Parry, Jayne; Passmore, Sandra; Cheng, K K

2018-01-01

Abstract Objective To assess the effectiveness of a school and family based healthy lifestyle programme (WAVES intervention) compared with usual practice, in preventing childhood obesity. Design Cluster randomised controlled trial. Setting UK primary schools from the West Midlands. Participants 200 schools were randomly selected from all state run primary schools within 35 miles of the study centre (n=980), oversampling those with high minority ethnic populations. These schools were randomly ordered and sequentially invited to participate. 144 eligible schools were approached to achieve the target recruitment of 54 schools. After baseline measurements 1467 year 1 pupils aged 5 and 6 years (control: 28 schools, 778 pupils) were randomised, using a blocked balancing algorithm. 53 schools remained in the trial and data on 1287 (87.7%) and 1169 (79.7%) pupils were available at first follow-up (15 month) and second follow-up (30 month), respectively. Interventions The 12 month intervention encouraged healthy eating and physical activity, including a daily additional 30 minute school time physical activity opportunity, a six week interactive skill based programme in conjunction with Aston Villa football club, signposting of local family physical activity opportunities through mail-outs every six months, and termly school led family workshops on healthy cooking skills. Main outcome measures The protocol defined primary outcomes, assessed blind to allocation, were between arm difference in body mass index (BMI) z score at 15 and 30 months. Secondary outcomes were further anthropometric, dietary, physical activity, and psychological measurements, and difference in BMI z score at 39 months in a subset. Results Data for primary outcome analyses were: baseline, 54 schools: 1392 pupils (732 controls); first follow-up (15 months post-baseline), 53 schools: 1249 pupils (675 controls); second follow-up (30 months post-baseline), 53 schools: 1145 pupils (621 controls). The mean BMI z score was non-significantly lower in the intervention arm compared with the control arm at 15 months (mean difference −0.075 (95% confidence interval −0.183 to 0.033, P=0.18) in the baseline adjusted models. At 30 months the mean difference was −0.027 (−0.137 to 0.083, P=0.63). There was no statistically significant difference between groups for other anthropometric, dietary, physical activity, or psychological measurements (including assessment of harm). Conclusions The primary analyses suggest that this experiential focused intervention had no statistically significant effect on BMI z score or on preventing childhood obesity. Schools are unlikely to impact on the childhood obesity epidemic by incorporating such interventions without wider support across multiple sectors and environments. Trial registration Current Controlled Trials ISRCTN97000586. PMID:29437667

Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: cluster randomised controlled trial (WAVES study).

PubMed

Adab, Peymane; Pallan, Miranda J; Lancashire, Emma R; Hemming, Karla; Frew, Emma; Barrett, Tim; Bhopal, Raj; Cade, Janet E; Canaway, Alastair; Clarke, Joanne L; Daley, Amanda; Deeks, Jonathan J; Duda, Joan L; Ekelund, Ulf; Gill, Paramjit; Griffin, Tania; McGee, Eleanor; Hurley, Kiya; Martin, James; Parry, Jayne; Passmore, Sandra; Cheng, K K

2018-02-07

To assess the effectiveness of a school and family based healthy lifestyle programme (WAVES intervention) compared with usual practice, in preventing childhood obesity. Cluster randomised controlled trial. UK primary schools from the West Midlands. 200 schools were randomly selected from all state run primary schools within 35 miles of the study centre (n=980), oversampling those with high minority ethnic populations. These schools were randomly ordered and sequentially invited to participate. 144 eligible schools were approached to achieve the target recruitment of 54 schools. After baseline measurements 1467 year 1 pupils aged 5 and 6 years (control: 28 schools, 778 pupils) were randomised, using a blocked balancing algorithm. 53 schools remained in the trial and data on 1287 (87.7%) and 1169 (79.7%) pupils were available at first follow-up (15 month) and second follow-up (30 month), respectively. The 12 month intervention encouraged healthy eating and physical activity, including a daily additional 30 minute school time physical activity opportunity, a six week interactive skill based programme in conjunction with Aston Villa football club, signposting of local family physical activity opportunities through mail-outs every six months, and termly school led family workshops on healthy cooking skills. The protocol defined primary outcomes, assessed blind to allocation, were between arm difference in body mass index (BMI) z score at 15 and 30 months. Secondary outcomes were further anthropometric, dietary, physical activity, and psychological measurements, and difference in BMI z score at 39 months in a subset. Data for primary outcome analyses were: baseline, 54 schools: 1392 pupils (732 controls); first follow-up (15 months post-baseline), 53 schools: 1249 pupils (675 controls); second follow-up (30 months post-baseline), 53 schools: 1145 pupils (621 controls). The mean BMI z score was non-significantly lower in the intervention arm compared with the control arm at 15 months (mean difference -0.075 (95% confidence interval -0.183 to 0.033, P=0.18) in the baseline adjusted models. At 30 months the mean difference was -0.027 (-0.137 to 0.083, P=0.63). There was no statistically significant difference between groups for other anthropometric, dietary, physical activity, or psychological measurements (including assessment of harm). The primary analyses suggest that this experiential focused intervention had no statistically significant effect on BMI z score or on preventing childhood obesity. Schools are unlikely to impact on the childhood obesity epidemic by incorporating such interventions without wider support across multiple sectors and environments. Current Controlled Trials ISRCTN97000586. 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.

Does legislation to prevent alcohol sales to drunk individuals work? Measuring the propensity for night-time sales to drunks in a UK city.

PubMed

Hughes, Karen; Bellis, Mark A; Leckenby, Nicola; Quigg, Zara; Hardcastle, Katherine; Sharples, Olivia; Llewellyn, David J

2014-05-01

By measuring alcohol retailers' propensity to illegally sell alcohol to young people who appear highly intoxicated, we examine whether UK legislation is effective at preventing health harms resulting from drunk individuals continuing to access alcohol. 73 randomly selected pubs, bars and nightclubs in a city in North West England were subjected to an alcohol purchase test by pseudo-drunk actors. Observers recorded venue characteristics to identify poorly managed and problematic (PMP) bars. 83.6% of purchase attempts resulted in a sale of alcohol to a pseudo-intoxicated actor. Alcohol sales increased with the number of PMP markers bars had, yet even in those with no markers, 66.7% of purchase attempts resulted in a sale. Bar servers often recognised signs of drunkenness in actors, but still served them. In 18% of alcohol sales, servers attempted to up-sell by suggesting actors purchase double rather than single vodkas. UK law preventing sales of alcohol to drunks is routinely broken in nightlife environments, yet prosecutions are rare. Nightlife drunkenness places enormous burdens on health and health services. Preventing alcohol sales to drunks should be a public health priority, while policy failures on issues, such as alcohol pricing, are revisited.

Decomposing the crude divorce rate in five countries: Singapore, Taiwan, South Korea, the UK, and Australia

PubMed Central

Chen, Mengni

2018-01-01

ABSTRACT Over the past few decades, the level of divorce, measured by the crude divorce rate (CDR), has increased dramatically in both the East and the West, but has recently appeared to fall or level off in some countries. To investigate whether the recent decline or stabilisation of the CDRs reflects the real trends in divorce risk, a decomposition analysis was conducted on the changes in the CDRs over the past 20 years on two western and three East Asian countries, namely, the UK, Australia, Taiwan, South Korea, and Singapore. The following is observed: the decline in the CDRs of the UK and Australia in the 1990s, and of Taiwan and Korea in the 2000s, was mainly due to shrinkage in the proportion of the married population rather than any reduction in divorce risk; only Australia experienced a genuine reduction in divorce risk between 2001 and 2011; and the continuous increase of Singapore’s divorce level between 1990 and 2010 may be is an unintentional effect of the government’s marriage promotion policies. The shift in the population age structure, and more importantly, the drastic decline in marriage, has seriously distorted the CDRs, making them unreliable indicators for monitoring divorce trends. PMID:29930691

Environmental Public Health Tracking: a cost-effective system for characterizing the sources, distribution and public health impacts of environmental hazards.

PubMed

Saunders, P J; Middleton, J D; Rudge, G

2017-09-01

The contemporary environment is a complex of interactions between physical, biological, socio-economic systems with major impacts on public health. However, gaps in our understanding of the causes, extent and distribution of these effects remain. The public health community in Sandwell West Midlands has collaborated to successfully develop, pilot and establish the first Environmental Public Health Tracking (EPHT) programme in Europe to address this 'environmental health gap' through systematically linking data on environmental hazards, exposures and diseases. Existing networks of environmental, health and regulatory agencies developed a suite of innovative methods to routinely share, integrate and analyse data on hazards, exposures and health outcomes to inform interventions. Effective data sharing and horizon scanning systems have been established, novel statistical methods piloted, plausible associations framed and tested, and targeted interventions informed by local concerns applied. These have influenced changes in public health practice. EPHT is a powerful tool for identifying and addressing the key environmental public health impacts at a local level. Sandwell's experience demonstrates that it can be established and operated at virtually no cost. The transfer of National Health Service epidemiological skills to local authorities in 2013 provides an opportunity to expand the programme to fully exploit its potential. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Geostatistics and spatial analysis in biological anthropology.

PubMed

Relethford, John H

2008-05-01

A variety of methods have been used to make evolutionary inferences based on the spatial distribution of biological data, including reconstructing population history and detection of the geographic pattern of natural selection. This article provides an examination of geostatistical analysis, a method used widely in geology but which has not often been applied in biological anthropology. Geostatistical analysis begins with the examination of a variogram, a plot showing the relationship between a biological distance measure and the geographic distance between data points and which provides information on the extent and pattern of spatial correlation. The results of variogram analysis are used for interpolating values of unknown data points in order to construct a contour map, a process known as kriging. The methods of geostatistical analysis and discussion of potential problems are applied to a large data set of anthropometric measures for 197 populations in Ireland. The geostatistical analysis reveals two major sources of spatial variation. One pattern, seen for overall body and craniofacial size, shows an east-west cline most likely reflecting the combined effects of past population dispersal and settlement. The second pattern is seen for craniofacial height and shows an isolation by distance pattern reflecting rapid spatial changes in the midlands region of Ireland, perhaps attributable to the genetic impact of the Vikings. The correspondence of these results with other analyses of these data and the additional insights generated from variogram analysis and kriging illustrate the potential utility of geostatistical analysis in biological anthropology. (c) 2008 Wiley-Liss, Inc.

Patients' unvoiced agendas in general practice consultations: qualitative study

PubMed Central

Barry, Christine A; Bradley, Colin P; Britten, Nicky; Stevenson, Fiona A; Barber, Nick

2000-01-01

Objective To investigate patients' agendas before consultation and to assess which aspects of agendas are voiced in the consultation and the effects of unvoiced agendas on outcomes. Design Qualitative study. Setting 20 general practices in south east England and the West Midlands. Participants 35 patients consulting 20 general practitioners in appointment and emergency surgeries. Results Patients' agendas are complex and multifarious. Only four of 35 patients voiced all their agendas in consultation. Agenda items most commonly voiced were symptoms and requests for diagnoses and prescriptions. The most common unvoiced agenda items were: worries about possible diagnosis and what the future holds; patients' ideas about what is wrong; side effects; not wanting a prescription; and information relating to social context. Agenda items that were not raised in the consultation often led to specific problem outcomes (for example, major misunderstandings), unwanted prescriptions, non-use of prescriptions, and non-adherence to treatment. In all of the 14 consultations with problem outcomes at least one of the problems was related to an unvoiced agenda item. Conclusion Patients have many needs and when these are not voiced they can not be addressed. Some of the poor outcomes in the case studies were related to unvoiced agenda items. This suggests that when patients and their needs are more fully articulated in the consultation better health care may be effected. Steps should be taken in both daily clinical practice and research to encourage the voicing of patients' agendas. PMID:10797036

Development of an accurate portable recording peak-flow meter for the diagnosis of asthma.

PubMed

Hitchings, D J; Dickinson, S A; Miller, M R; Fairfax, A J

1993-05-01

This article describes the systematic design of an electronic recording peak expiratory flow (PEF) meter to provide accurate data for the diagnosis of occupational asthma. Traditional diagnosis of asthma relies on accurate data of PEF tests performed by the patients in their own homes and places of work. Unfortunately there are high error rates in data produced and recorded by the patient, most of these are transcription errors and some patients falsify their records. The PEF measurement itself is not effort independent, the data produced depending on the way in which the patient performs the test. Patients are taught how to perform the test giving maximal effort to the expiration being measured. If the measurement is performed incorrectly then errors will occur. Accurate data can be produced if an electronically recording PEF instrument is developed, thus freeing the patient from the task of recording the test data. It should also be capable of determining whether the PEF measurement has been correctly performed. A requirement specification for a recording PEF meter was produced. A commercially available electronic PEF meter was modified to provide the functions required for accurate serial recording of the measurements produced by the patients. This is now being used in three hospitals in the West Midlands for investigations into the diagnosis of occupational asthma. In investigating current methods of measuring PEF and other pulmonary quantities a greater understanding was obtained of the limitations of current methods of measurement, and quantities being measured.(ABSTRACT TRUNCATED AT 250 WORDS)

75 FR 47670 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-06

... NIKE Inc. 282 EWW iShares MSCI 335 FIS Fidelity Mexico National Investable Information Market Index... Inc. 316 CB Chubb Corp. 205 MA Mastercard Inc. 320 ADM Archer-Daniels- Midland Co. 224 ATPG ATP Oil & Gas 322 HSY Hershey Co./The Corp/United States 226 YUM Yum! Brands Inc 323 TXT Textron Inc. 232 RCL...

Challenges to the Implementation of PLAP in Primary Schools: Perceptions of ZOU Bachelor of Educational Management Students

ERIC Educational Resources Information Center

Mercy, Kurebwa; Mabhanda, Wilson

2015-01-01

The study explored the challenges that impact on the implementation of PLAP in the Primary schools. The research was conducted with teachers who study towards the BEd Management degree with Zimbabwe Open University (ZOU) in the Midlands Region. The study used a qualitative research approach and collected data through open ended questionnaires and…

Converting abandoned railroads to recreation use in Isabella and Midland Counties: a comparison of residents and businesses adjacent to a rail-trail

Treesearch

Afke Moufakkir-van der Woud; Christine A. Vogt; Joel Lynch; Charles Nelson

2003-01-01

Converting abandoned railroad corridors to recreational trails often generates opposition from adjacent residents. Opposition can arise during the planning process of establishing the trail. However, concerns about abandoned railroads being converted to trails are often misconceptions. Once a park is developed these concerns often disappear. This research examined the...

To redesignate the Federal building and United States Courthouse located at 200 East Wall Street in Midland, Texas, as the "George H. W. Bush and George W. Bush United States Courthouse and George Mahon Federal Building".

THOMAS, 111th Congress

Rep. Conaway, K. Michael [R-TX-11

2009-01-28

House - 01/29/2009 Referred to the Subcommittee on Economic Development, Public Buildings and Emergency Management. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Re-Presenting the "Forgotten Estate": Participatory Theatre, Place and Community Identity

ERIC Educational Resources Information Center

Jones, Susan; Hall, Christine; Thomson, Pat; Barrett, Andy; Hanby, Julian

2013-01-01

In this article, we discuss the work undertaken in the first phase of a participatory theatre project which took place on a council housing estate in the Midlands of England, in which residents were invited to share their memories for a production which would present the history of the estate. This community is often characterised as deficient,…

"It's the Best Thing I've Done in a Long While": Teenage Mothers' Experiences of Educational Alternatives

ERIC Educational Resources Information Center

Vincent, Kerry

2016-01-01

Pregnant and mothering schoolgirls have been identified as an educationally vulnerable group. Many are not welcomed in their mainstream schools and as a consequence, access a range of educational alternatives. This article presents the views and experiences of 14 young women in the English Midlands, who became pregnant while still of statutory…

National Day of Listening Comes to Midland, Michigan: A StoryCorps Project

ERIC Educational Resources Information Center

Burke, Ann

2011-01-01

In this article, the author describes a StoryCorps project for the National Day of Listening. StoryCorps is a non-profit organization whose mission is to provide Americans of all backgrounds and beliefs with the opportunity to record, share, and preserve the stories of their lives. The organization initiated The National Day of Listening in 2008…

Dental Health Services Research Unit celebrates 30 years: Report of conference to mark the 30th anniversary of the Dental Health Services Research Unit (DHSRU) at Dundee, held on 1st December 2008.

PubMed

Eaton, Kenneth A; Pitts, Nigel B

2009-04-01

Over the years, several members of the staff of the Dental Health Services Research Unit (DHSRU) at Dundee have published papers in Primary Dental Care. Furthermore, its Director, Professor Nigel Pitts, together with Drs Jan Clarkson and Gail Topping have co-edited a number of the Faculty of General Dental Practice (UK)'s standards manuals and contributed to others. It had been suggested to the Unit by several parties that, having been in funded existence for some 30 years, it would be appropriate to mark this anniversary with a conference to explore 'Dental Health Services Research: After 30 years, what was the impact, what have we learned and where are we going?' So, following a range of consultations, the conference was convened at the West Park Conference Centre in Dundee with a mixed audience representing both dental research and dental practice.

Organizational barriers and ethnicity in the Scottish NHS.

PubMed

Sheffield, J; Hussain, A; Coleshill, P

1999-01-01

The NHS faces a crisis in terms of staffing and recruitment. Many of the ethnic minority GPs in inner city areas throughout the UK are coming up to retirement age, and there is an insufficient supply of trainees to fill estimated vacancies. Over 2,000 nursing vacancies exist across the UK, and recruitment to the profession and retention within the profession are poor. Nurses have been recruited from overseas for the past 40 years, and are currently being recruited from Finland, Malaysia, and the West Indies, whilst doctors are being sought in India, Pakistan and Africa. Overseas recruitment is not a new phenomenon, and numerous studies have been carried out to examine equal opportunities and racial discrimination within the NHS. The aim of this paper was to examine ethnicity and equal opportunities within the Scottish NHS and record the levels of organisational awareness of ethnicity and equal opportunities' issues. The paper also examines the link between health service delivery to ethnic minorities and internal cultural attitudes to staff.

Febrile illness in healthcare workers caring for Ebola virus disease patients in a high-resource setting.

PubMed

Fink, Douglas; Cropley, Ian; Jacobs, Michael; Mepham, Stephen

2017-01-26

Ebola virus disease (EVD) patients treated in high-resource facilities are cared for by large numbers of healthcare staff. Monitoring these healthcare workers (HCWs) for any illness that may represent transmission of Ebola virus is important both for the individuals and to minimise the community risk. International policies for monitoring HCWs vary considerably and their effectiveness is unknown. Here we describe the United Kingdom (UK) experience of illness in HCWs who cared for three patients who acquired EVD in West Africa. Five of these 93 high-level isolation unit (HLIU) HCWs presented with fever within 21 days of working on the unit; one of these five presented outside of the UK. This article discusses different approaches to monitoring of HCW symptom reporting. The potential impact of these approaches on HLIU staff recruitment, including travel restrictions, is also considered. An international surveillance system enhancing collaboration between national public health authorities may assist HLIU HCW monitoring in case they travel. This article is copyright of The Authors, 2017.

Febrile illness in healthcare workers caring for Ebola virus disease patients in a high-resource setting

PubMed Central

Fink, Douglas; Cropley, Ian; Jacobs, Michael; Mepham, Stephen

2017-01-01

Ebola virus disease (EVD) patients treated in high-resource facilities are cared for by large numbers of healthcare staff. Monitoring these healthcare workers (HCWs) for any illness that may represent transmission of Ebola virus is important both for the individuals and to minimise the community risk. International policies for monitoring HCWs vary considerably and their effectiveness is unknown. Here we describe the United Kingdom (UK) experience of illness in HCWs who cared for three patients who acquired EVD in West Africa. Five of these 93 high-level isolation unit (HLIU) HCWs presented with fever within 21 days of working on the unit; one of these five presented outside of the UK. This article discusses different approaches to monitoring of HCW symptom reporting. The potential impact of these approaches on HLIU staff recruitment, including travel restrictions, is also considered. An international surveillance system enhancing collaboration between national public health authorities may assist HLIU HCW monitoring in case they travel. PMID:28182538

Irish Ice Sheet dynamics during deglaciation of the central Irish Midlands: Evidence of ice streaming and surging from airborne LiDAR

NASA Astrophysics Data System (ADS)

Delaney, Catherine A.; McCarron, Stephen; Davis, Stephen

2018-04-01

High resolution digital terrain models (DTMs) generated from airborne LiDAR data and supplemented by field evidence are used to map glacial landform assemblages dating from the last glaciation (Midlandian glaciation; OI stages 2-3) in the central Irish Midlands. The DTMs reveal previously unrecognised low-amplitude landforms, including crevasse-squeeze ridges and mega-scale glacial lineations overprinted by conduit fills leading to ice-marginal subaqueous deposits. We interpret this landform assemblage as evidence for surging behaviour during ice recession. The data indicate that two separate phases of accelerated ice flow were followed by ice sheet stagnation during overall deglaciation. The second surge event was followed by a subglacial outburst flood, forming an intricate esker and crevasse-fill network. The data provide the first clear evidence that ice flow direction was eastward along the eastern watershed of the Shannon River basin, at odds with previous models, and raise the possibility that an ice stream existed in this area. Our work demonstrates the potential for airborne LiDAR surveys to produce detailed paleoglaciological reconstructions and to enhance our understanding of complex palaeo-ice sheet dynamics.

Asymmetrical local adaptation of maize landraces along an altitudinal gradient.

PubMed

Mercer, Kristin; Martínez-Vásquez, Ángel; Perales, Hugo R

2008-08-01

Crop landraces are managed populations that evolve in response to gene flow and selection. Cross-pollination among fields, seed sharing by farmers, and selection by management and environmental conditions play roles in shaping crop characteristics. We used common gardens to explore the local adaptation of maize (Zea mays ssp. mays) landrace populations from Chiapas, Mexico to altitude. We sowed seeds of 21 populations from three altitudinal ranges in two common gardens and measured two characteristics that estimate fitness: likelihood of producing good quality seed and the total mass of good quality seed per plant. The probability of lowland plants producing good quality seed was invariably high regardless of garden, while highland landraces were especially sensitive to altitude. Their likelihood of producing good seed quadrupled in the highland site. The mass of good quality seed showed a different pattern, with lowland landraces producing 25% less seed mass than the other types at high elevations. Combining these two measures of fitness revealed that the highland landraces were clearly adapted to highland sites, while lowland and midland landraces appear more adapted to the midland site. We discuss this asymmetry in local adaptation in light of climate change and in situ conservation of crop genetic resources.

The extent of wind-induced undercatch in the UK winter storms of 2015

NASA Astrophysics Data System (ADS)

Pollock, Michael; Colli, Matteo; Stagnaro, Mattia; Quinn, Paul; Dutton, Mark; O'Donnell, Greg; Wilkinson, Mark; Black, Andrew; O'Connell, Enda; Lanza, Luca

2016-04-01

The most widely used device for measuring rainfall is the rain gauge, of which the tipping bucket (TBR) is the most prevalent type. Rain gauges are considered by many to be the most accurate method currently available. The data they produce are used in flood-forecasting and flood risk management, water resource management, hydrological modelling and evaluating impacts on climate change; to name but a few. Rain gauges may provide the most accurate measurement of rainfall at a point in space and time, but they are subject to errors - and some gauges are more prone than others. The most significant error is the 'wind-induced undercatch'. This is caused by the gauge itself contributing to an acceleration of the wind speed near the orifice, which disturbs and distorts the airflow. The trajectories of precipitation particles are affected, resulting in an undercatch. Results from Computational Fluid Dynamics (CFD) simulations, presented herein, describe in detail the physical processes contributing to this. High resolution field measurements of rainfall and wind are collected at four field research stations in the UK. Each site is equipped with juxtaposed rain gauges with different funnel profiles, in addition to a WMO reference pit rain gauge measurement. These data describe the rainfall measurement uncertainty. The sites were selected to represent the prevalent rainfall regimes observed in the UK. Two research stations are on the west coast; which is prone to frontal weather systems and storms swept in from the Atlantic, often enhanced by orography. Two are located in the east. Rural lowland and upland areas are represented, both in the west and the east. Urban sites will also have significant undercatch problems but are outside the scope of this study. Data from the four research stations are analysed for the 2015 winter storms which caused devastating flooding in the west of the UK, particularly Cumbria and the Scottish Borders, where two of the sites are located. An assessment of the effect of wind on the rainfall catch during these large storm events is presented for each research station. Based on a reference pit rain gauge, the undercatch for these events is calculated. The difference in rainfall catch between several types of rain gauge mounted at variable heights is also investigated. This work aims to demonstrate the importance of improving the accuracy of rainfall measurements, and to emphasise the need to provide an assessment of the measurement uncertainty. A knowledge gap exists in the understanding of precisely how physical phenomena are contributing to wind-induced undercatch. For instance, a priori, the effect of the wind on the rainfall catch will change depending upon the dimensions of the rain droplets. Rainfall 'type' and rainfall intensity may be able to inform corrections, but rigorous multi-variate statistical analysis of high resolution measurements will be key to the success of these procedures. As the spatio-temporal distribution of rainfall can be highly variable, and each measurement location is different; it is a challenging undertaking to understand and pin down the fundamental processes responsible for the wind-induced undercatch.

Physiotherapy students' experience, confidence and attitudes on the causes and management of violent and aggressive behaviour.

PubMed

Stubbs, Brendon; Rayment, Nick; Soundy, Andrew

2011-12-01

Healthcare professionals are at risk of experiencing violent and aggressive behaviour from patients. This is most notable in those with least experience, such as students, yet little reported research has considered the experiences of physiotherapy students. The aims of this study were to: (1) explore the incidence and nature of violent and aggressive behaviour experienced by physiotherapy students; and (2) consider the attitudes and confidence of the students in dealing with such behaviour. Retrospective survey. A university in the Midlands region of the UK. Sixty-four final year physiotherapy students. The Management of Aggression and Violence Attitude Scale and an additional survey. Over half (33/64, 52%) of the respondents had experienced at least one incident of violent and aggressive behaviour on a clinical placement. The overwhelming majority of victims (60/64, 94%) did not feel adequately confident to deal with such situations. However, no incidents were officially reported to the university. Both victims and non-victims agreed broadly with the internal model of the causes of aggression and violence, but significantly (P=0.02) more victims did not associate the violent and aggressive behaviour with the responsibility of the patient to control their feelings. Many physiotherapy students experience at least one incident of violent and aggressive behaviour whilst on a clinical placement. Training in the recognition and management of violent and aggressive behaviour would be a beneficial addition to the curricula of physiotherapy programmes. Further larger scale research is warranted. Copyright © 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

The Role of Ultrasound Simulation in Obstetrics and Gynecology Training: A UK Trainees' Perspective.

PubMed

Patel, Hersha; Chandrasekaran, Dhivya; Myriokefalitaki, Eva; Gebeh, Alpha; Jones, Kate; Jeve, Yadava B

2016-10-01

Ultrasonography is a core skill required by all obstetrics and gynecology trainees; however, training opportunities in clinical ultrasound are declining. Simulation ultrasound training has been proposed as a strategy to overcome this.The study aims were to determine the current availability of clinical and simulation ultrasound training in obstetrics and gynecology in the United Kingdom and to explore the trainees' perspective on the role of ultrasound simulation. All obstetrics and gynecology trainees within the East Midlands Local Education Training Board in the United Kingdom were asked to complete an anonymous web-based survey in July 2014. Of 140 trainees, 70 (50%) responded to the survey, and 69% reported rarely having dedicated clinical ultrasound sessions. Fifty percent had failed to achieve ultrasound competencies required for their stage of training, and 83% felt that the pressures of service provision limited their exposure to clinical ultrasound.Seventy-three percent of the trainees considered ultrasound simulation to be an essential component of training, and 69% agreed that it would help improve their clinical skills. Only 50% had access to an ultrasound simulator. Seventy-seven percent of the trainees thought that it would be useful to have ultrasound simulation integrated into training. Trainees are struggling to achieve minimal ultrasound competences with clinical ultrasound training alone. They believe that ultrasound simulation will shorten the learning curve and improve their clinical skills and knowledge. Despite the cost implications of simulation training, we propose that consideration is given to formal integration of ultrasound simulation into the curriculum as a possible way forward.

Can the accuracy of multifocal intraocular lens power calculation be improved to make patients spectacle free?

PubMed

Ramji, Hasnain; Moore, Johnny; Moore, C B Tara; Shah, Sunil

2016-04-01

To optimise intraocular lens (IOL) power calculation techniques for a segmental multifocal IOL, LENTIS™ MPlus(®) (Oculentis GmbH, Berlin, Germany) and assess outcomes. A retrospective consecutive non-randomised case series of patients receiving the MPlus(®) IOL following cataract surgery or clear lens extraction was performed at a privately owned ophthalmic hospital, Midland Eye, Solihull, UK. Analysis was undertaken of 116 eyes, with uncomplicated lens replacement surgery using the LENTIS™ MPlus(®) lenses. Pre-operative biometry data were stratified into short (<22.00 mm) and long axial lengths (ALs) (≥22.00 mm). IOL power predictions were calculated with SRK/T, Holladay I, Hoffer Q, Holladay II and Haigis formulae and compared to the final manifest refraction. These were compared with the OKULIX ray tracing method and the stratification technique suggested by the Royal College of Ophthalmologists (RCOphth). Using SRK/T for long eyes and Hoffer Q for short eyes, 64% achieved postoperative subjective refractions of ≤±0.25 D, 83%≤±0.50 D and 93%≤±0.75 D, with a maximum predictive error of 1.25D. No specific calculation method performed best across all ALs; however for ALs under 22 mm Hoffer Q and Holliday I methods performed best. Excellent but equivalent overall refractive results were found between all biometry methods used in this multifocal IOL study. For eyes with ALs under 22 mm Hoffer Q and Holliday I performed best. Current techniques mean that patients are still likely to need top up glasses for certain situations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Exploring the link between meteorological drought and streamflow to inform water resource management

NASA Astrophysics Data System (ADS)

Lennard, Amy; Macdonald, Neil; Hooke, Janet

2015-04-01

Drought indicators are an under-used metric in UK drought management. Standardised drought indicators offer a potential monitoring and management tool for operational water resource management. However, the use of these metrics needs further investigation. This work uses statistical analysis of the climatological drought signal based on meteorological drought indicators and observed streamflow data to explore the link between meteorological drought and hydrological drought to inform water resource management for a single water resource region. The region, covering 21,000 km2 of the English Midlands and central Wales, includes a variety of landscapes and climatological conditions. Analysis of the links between meteorological drought and hydrological drought performed using streamflow data from 'natural' catchments indicates a close positive relationship between meteorological drought indicators and streamflow, enhancing confidence in the application of drought indicators for monitoring and management. However, many of the catchments in the region are subject to modification through impoundments, abstractions and discharge. Therefore, it is beneficial to explore how climatological drought signal propagates into managed hydrological systems. Using a longitudinal study of catchments and sub-catchments that include natural and modified river reaches the relationship between meteorological and hydrological drought is explored. Initial statistical analysis of meteorological drought indicators and streamflow data from modified catchments shows a significantly weakened statistical relationship and reveals how anthropogenic activities may alter hydrological drought characteristics in modified catchments. Exploring how meteorological drought indicators link to streamflow across the water supply region helps build an understanding of their utility for operational water resource management.

Intervention against excessive alcohol consumption in primary health care: a survey of GPs' attitudes and practices in England 10 years on.

PubMed

Wilson, Graeme B; Lock, Catherine A; Heather, Nick; Cassidy, Paul; Christie, Marilyn M; Kaner, Eileen F S

2011-01-01

To ascertain the views of general practitioners (GPs) regarding the prevention and management of alcohol-related problems in practice, together with perceived barriers and incentives for this work; to compare our findings with a comparable survey conducted 10 years earlier. In total, 282 (73%) of 419 GPs surveyed in East Midlands, UK, completed a postal questionnaire, measuring practices and attitudes, including the Shortened Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ). GPs reported lower levels of post-graduate education or training on alcohol-related issues (<4 h for the majority) than in 1999 but not significantly so (P = 0.031). In the last year, GPs had most commonly requested more than 12 blood tests and managed 1-6 patients for alcohol. Reports of these preventive practices were significantly increased from 1999 (P < 0.001). Most felt that problem or dependent drinkers' alcohol issues could be legitimately (88%, 87%) and adequately (78%, 69%) addressed by GPs. However, they had low levels of motivation (42%, 35%), task-related self-esteem (53%, 49%) and job satisfaction (15%, 12%) for this. Busyness (63%) and lack of training (57%) or contractual incentives (48%) were key barriers. Endorsement for government policies on alcohol was very low. Among GPs, there still appears to be a gap between actual practice and potential for preventive work relating to alcohol problems; they report little specific training and a lack of support. Translational work on understanding the evidence-base supporting screening and brief intervention could incentivize intervention against excessive drinking and embedding it into everyday primary care practice.

Revisiting the West Clearwater Lake Impact Structure, Canada

NASA Technical Reports Server (NTRS)

Osinski, G. R.; Brunner, A.; Collins, G.; Cohen, B. A.; Coulter, A.; Elphic, R.; Grieve, R. A. F.; Hodges, K.; Horne, A.; Kerrigan, M.

2015-01-01

The West and East Clearwater Lake impact structures are two of the most distinctive and recognizable impact structures on Earth. Known regionally as the "Clearwater Lake Complex", these structures are located in northern Quebec, Canada (56 deg 10 N, 74 deg 20 W) approximately 125 km east of Hudson Bay. The currently accepted diameters are 36 km and 26 km for the West and East structures, respectively. Long thought to represent a rare example of a double impact, recent age dating has called this into question with ages of approximately 286 Ma and approximately 460-470 Ma being proposed for the West and East structures, respectively. Relatively little is known about the East Clearwater Lake structure. There is no surface exposure and what information there is comes from geophysics and two drill cores obtained in the 1960s. In contrast, the West Clearwater Lake structure is relatively well preserved with large ring of islands in the approximately 30 km diameter lake. Much of the work done on West Clearwater stems from field investigations carried out in 1977 driven by the Apollo program, with a focus on the impact melt rocks and other impactites, which are well exposed on the ring of islands. To our knowledge, the Clearwater Lake impact structures have not been the focus of detailed impact geology field investigations since the 1977 expedition and the only geological map that exists is from the 1960s and is at the reconnaissance level. Our knowledge of impact cratering processes have increased substantially since this time, as have the analytical techniques available for samples. This provided the motivation for a joint Canadian-US-UK expedition to the West Clearwater Lake impact structure in August and September 2015, under the auspices of the FINESSE (Field Investigations to Enable Solar System Science and Exploration) project, part of NASA's Solar System Exploration Research Virtual Institute (SSERVI). We focus here on the impactites of the West Clearwater Lake impact structure. Other ongoing studies, also presented at this conference, focus on central uplift formation, the impact-generated hydrothermal system, xxxx and using WCIS as an analog test site for crew studies of sampling protocols].

Defining geo-habitats for groundwater ecosystem assessments: an example from England and Wales (UK)

NASA Astrophysics Data System (ADS)

Weitowitz, Damiano C.; Maurice, Louise; Lewis, Melinda; Bloomfield, John P.; Reiss, Julia; Robertson, Anne L.

2017-12-01

Groundwater ecosystems comprising micro-organisms and metazoans provide an important contribution to global biodiversity. Their complexity depends on geology, which determines the physical habitat available, and the chemical conditions within it. Despite this, methods of classifying groundwater habitats using geological data are not well established and researchers have called for higher resolution habitat frameworks. A novel habitat typology for England and Wales (UK) is proposed, which distinguishes 11 geological habitats (geo-habitats) on hydrogeological principles and maps their distribution. Hydrogeological and hydrochemical data are used to determine the characteristics of each geo-habitat, and demonstrate their differences. Using these abiotic parameters, a new method to determine abiotic habitat quality is then developed. The geo-habitats had significantly different characteristics, validating the classification system. All geo-habitats were highly heterogeneous, containing both high quality habitat patches that are likely to be suitable for fauna, and areas of low quality that may limit faunal distributions. Karstic and porous habitats generally were higher quality than fractured habitats. Overall, 70% of England and Wales are covered by lower quality fractured habitats, with only 13% covered by higher quality habitats. The main areas of high quality habitats occur in central England as north-south trending belts, possibly facilitating dispersal along this axis. They are separated by low quality geo-habitats that may prevent east-west dispersal of fauna. In south-west England and Wales suitable geo-habitats occur as small isolated patches. Overall, this paper provides a new national-scale typology that is adaptable for studies in other geographic areas.

Late-glacial recolonization and phylogeography of European red deer (Cervus elaphus L.).

PubMed

Meiri, Meirav; Lister, Adrian M; Higham, Thomas F G; Stewart, John R; Straus, Lawrence G; Obermaier, Henriette; González Morales, Manuel R; Marín-Arroyo, Ana B; Barnes, Ian

2013-09-01

The Pleistocene was an epoch of extreme climatic and environmental changes. How individual species responded to the repeated cycles of warm and cold stages is a major topic of debate. For the European fauna and flora, an expansion-contraction model has been suggested, whereby temperate species were restricted to southern refugia during glacial times and expanded northwards during interglacials, including the present interglacial (Holocene). Here, we test this model on the red deer (Cervus elaphus) a large and highly mobile herbivore, using both modern and ancient mitochondrial DNA from the entire European range of the species over the last c. 40,000 years. Our results indicate that this species was sensitive to the effects of climate change. Prior to the Last Glacial Maximum (LGM) haplogroups restricted today to South-East Europe and Western Asia reached as far west as the UK. During the LGM, red deer was mainly restricted to southern refugia, in Iberia, the Balkans and possibly in Italy and South-Western Asia. At the end of the LGM, red deer expanded from the Iberian refugium, to Central and Northern Europe, including the UK, Belgium, Scandinavia, Germany, Poland and Belarus. Ancient DNA data cannot rule out refugial survival of red deer in North-West Europe through the LGM. Had such deer survived, though, they were replaced by deer migrating from Iberia at the end of the glacial. The Balkans served as a separate LGM refugium and were probably connected to Western Asia with genetic exchange between the two areas. © 2013 John Wiley & Sons Ltd.

Country-of-birth differences in adverse health behaviours among people with type 2 diabetes.

PubMed

Shamshirgaran, Seyed Morteza; Jorm, Louisa; Bambrick, Hilary; Hennessy, Annemarie

2015-06-01

To identify differences in patterns of adverse health behaviours among people with type 2 diabetes according to country or region of birth. Population-based study of 23,112 individuals with type 2 diabetes aged 45 years and older, from New South Wales, Australia. Self-reported questionnaire data and logistic regression models were used to estimate odds ratios for adverse health behaviours according to country or region of birth, adjusted for confounding factors. People with diabetes born in the Middle East and in the United Kingdom (UK) were more likely to be current smokers than those born in Australian, while those from Asia were less likely to be smokers. Relative to Australian-born people with diabetes, those born in the Middle East were more likely to have insufficient physical activity, while those born in Oceania, North West Europe and the UK were less likely. People with diabetes from Asia, North Africa, the Middle East and Sub-Saharan Africa were less likely to consume alcohol than those born in Australia, but people born in the UK were slightly more likely to consume alcohol. People with diabetes born in the UK, Asia, and North Africa were more likely than those born in Australia to have an inadequate intake of fruit and vegetables. Adverse health behaviours among people with type 2 diabetes varied markedly according to country or region of birth. Promoting smoking cessation and increasing physical activity levels among people with diabetes who were born in Middle Eastern countries are clear priorities. © 2014 Public Health Association of Australia.

Ebola exposure, illness experience, and Ebola antibody prevalence in international responders to the West African Ebola epidemic 2014–2016: A cross-sectional study

PubMed Central

McGowan, Catherine R.; Dicks, Steve; Baguelin, Marc; Mabey, David; Kumar, Alex; Tedder, Richard

2017-01-01

Background Healthcare and other front-line workers are at particular risk of infection with Ebola virus (EBOV). Despite the large-scale deployment of international responders, few cases of Ebola virus disease have been diagnosed in this group. Since asymptomatic or pauci-symptomatic infection has been described, it is plausible that infections have occurred in healthcare workers but have escaped being diagnosed. We aimed to assess the prevalence of asymptomatic or pauci-symptomatic infection, and of exposure events, among returned responders to the West African Ebola epidemic 2014–2016. Methods and findings We used snowball sampling to identify responders who had returned to the UK or Ireland, and used an online consent and questionnaire to determine their exposure to EBOV and their experience of illness. Oral fluid collection devices were sent and returned by post, and samples were tested using an EBOV IgG capture assay that detects IgG to Ebola glycoprotein. Blood was collected from returnees with reactive samples for further testing. Unexposed UK controls were also recruited. In all, 300 individuals consented, of whom 268 (89.3%) returned an oral fluid sample (OFS). The majority had worked in Sierra Leone in clinical, laboratory, research, and other roles. Fifty-three UK controls consented and provided samples using the same method. Of the returnees, 47 (17.5%) reported that they had had a possible EBOV exposure. Based on their free-text descriptions, using a published risk assessment method, we classified 43 (16%) as having had incidents with risk of Ebola transmission, including five intermediate-risk and one high-risk exposure. Of the returnees, 57 (21%) reported a febrile or diarrhoeal illness in West Africa or within 1 mo of return, of whom 40 (70%) were not tested at the time for EBOV infection. Of the 268 OFSs, 266 were unreactive. Two returnees, who did not experience an illness in West Africa or on return, had OFSs that were reactive on the EBOV IgG capture assay, with similar results on plasma. One individual had no further positive test results; the other had a positive result on a double-antigen bridging assay but not on a competitive assay or on an indirect EBOV IgG ELISA. All 53 controls had non-reactive OFSs. While the participants were not a random sample of returnees, the number participating was high. Conclusions This is the first study, to our knowledge, of the prevalence of EBOV infection in international responders. More than 99% had clear negative results. Sera from two individuals had discordant results on the different assays; both were negative on the competitive assay, suggesting that prior infection was unlikely. The finding that a significant proportion experienced “near miss” exposure events, and that most of those who experienced symptoms did not get tested for EBOV at the time, suggests a need to review and standardise protocols for the management of possible exposure to EBOV, and for the management of illness, across organisations that deploy staff to outbreaks. PMID:28510604

Mapping bare soil in South West Wales, UK, using high resolution colour infra-red aerial photography for water quality and flood risk management applications

NASA Astrophysics Data System (ADS)

Sykes, Helena; Neale, Simon; Coe, Sarah

2016-04-01

Natural Resources Wales is a UK government body responsible for environmental regulation, among other areas. River walks in Water Framework Directive (WFD) priority catchments in South West Wales, UK, identified soil entering water courses due to poaching and bank erosion, leading to deterioration in the water quality and jeopardising the water quality meeting legal minimum standards. Bare soil has also been shown to cause quicker and higher hydrograph peaks in rural catchments than if those areas were vegetated, which can lead to flooding of domestic properties during peak storm flows. The aim was to target farm visits by operational staff to advise on practices likely to improve water quality and to identify areas where soft engineering solutions such as revegetation could alleviate flood risk in rural areas. High resolution colour-infrared aerial photography, 25cm in the three colour bands and 50cm in the near infrared band, was used to map bare soil in seven catchments using supervised classification of a five band stack including the Normalised Difference Vegetation Index (NDVI). Mapping was combined with agricultural land use and field boundary data to filter out arable fields, which are supposed to bare soil for part of their cycle, and was very successful when compared to ground truthing, with the exception of silage fields which contained sparse, no or unproductive vegetation at the time the imagery was acquired leading to spectral similarity to bare soil. A raindrop trace model was used to show the path sediment from bare soil areas would take when moving through the catchment to a watercourse, with hedgerows inserted as barriers following our observations from ground truthing. The findings have been used to help farmers gain funding for improvements such as fencing to keep animals away from vulnerable river banks. These efficient and automated methods can be rolled out to more catchments in Wales and updated using aerial imagery acquired more recently to examine the effects of change.

Performance and standards for the process of head and neck cancer care: South and West audit of head and neck cancer 1996-1997 (SWAHN I). South and West Regional Cancer Organisation Tumour Panel for Head and Neck Cancer.

PubMed

Birchall, M A; Bailey, D; Lennon, A

2000-08-01

Evidence suggests wide variation in cancer care between different hospitals in the UK. To establish bench-marking data, we designed a prospective, 1 year regional study comparing key performance measures with established standards for the 28 hospital Trusts in the South and West of England involved in head and neck cancer care. 566 sequential patients with a newly-diagnosed head and neck cancer were included. Numbers referred and treated per hospital Trust were 1-58 and 1-65 respectively. 59% of patients received a pretreatment chest X-ray (standard 95%). 45% of patients were seen in a multidisciplinary clinic pretreatment (standard 95%), and this was proportional to the frequency of clinics held (P<0.0001). Median number of cases treated per surgeon was 4 (1-26), and by radiotherapist was 10 (1-51). Times between parts of the process of oral cancer care were closer to the standards than those for laryngeal cancer. Two patients were entered into a clinical trial. One had a quality-of-life score. Thus, in 1996-1997, in the South and West of England, there were major discrepancies between actual performance and established standards in many fundamental aspects of head and neck cancer care. Re-audit is essential to determine if the implementation of the Calman-Hine report has resulted in improvements.

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Local Responses to National Policy: The Contrasting Experiences of Two Midlands Cities to the Academies Act 2010

ERIC Educational Resources Information Center

Smith, Penny; Abbott, Ian

2014-01-01

Drawing on data from a series of semi-structured interviews this article reports on findings from a research project focusing on the responses of two local authorities and their secondary schools to the Academies Act 2010. The article considers the background and the development of the education system in both localities. It goes on to focus on…

Zimbabwean Female Participation in Physics: Facets of Identity Formation Considered to Be of Significance by Female Students in Relation to Physics

ERIC Educational Resources Information Center

Gudyanga, Anna

2016-01-01

The study explored facets of identity formation considered to be of significance by Zimbabwean female adolescent students in physics. Four high schools that were offering physics at A' level in the Midlands Province, in Zimbabwe were targeted. Nine female adolescents doing mathematics and physics and only mathematics were chosen. Data generation…

Behind the statistics: the ethnography of suicide in Palestine.

PubMed

Dabbagh, Nadia

2012-06-01

As part of the first anthropological study on suicide in the modern Arab world, statistics gathered from the Ramallah region of the West Bank in Palestine painted an apparently remarkably similar picture to that found in Western countries such as the UK and France. More men than women completed suicide, more women than men attempted suicide. Men used more violent methods such as hanging and women softer methods such as medication overdose. Completed suicide was higher in the older age range, attempted suicide in the younger. However, ethnographic fieldwork and detailed examination of the case studies and suicide narratives gathered and analysed within the cultural, political and economic contexts illustrated more starkly the differences in suicidal practices between Palestinian West Bank society of the 1990s and other regions of the world. The central argument of the paper is that although statistics tell a very important story, ethnography uncovers a multitude of stories 'behind the statistics', and thus helps us to make sense of both cultural context and subjective experience.

Britain's nuclear secrets: inside Sellafield

NASA Astrophysics Data System (ADS)

Marino, Antigone

2017-11-01

Lying on the remote north west coast of England, Sellafield is one of the most secret places in UK, and even one of the most controversial nuclear fuel reprocessing and nuclear decommissioning sites in Britain. The film director Tim Usborne let us enter into the world's first nuclear power station, revealing Britain's attempts to harness the almost limitless power of the atom. It is precisely the simplicity and the scientific rigor used in the film to speak of nuclear, which led this documentary to win the Physics Prize supported by the European Physical Society at the European Science TV and New Media Festival and Awards 2016.

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

NASA Astrophysics Data System (ADS)

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

2016-04-01

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

Evaluation of biomass burning across North West Europe and its impact on air quality

NASA Astrophysics Data System (ADS)

Cordell, R. L.; Mazet, M.; Dechoux, C.; Hama, S. M. L.; Staelens, J.; Hofman, J.; Stroobants, C.; Roekens, E.; Kos, G. P. A.; Weijers, E. P.; Frumau, K. F. A.; Panteliadis, P.; Delaunay, T.; Wyche, K. P.; Monks, P. S.

2016-09-01

Atmospheric particulate pollution is a significant problem across the EU and there is concern that there may be an increasing contribution from biomass burning, driven by rising fuel prices and an increased interest in the use of renewable energy sources. This study was carried out to assess current levels of biomass burning and the contribution to total PM10 across five sites in North-West Europe; an area which is frequently affected by poor air quality. Biomass burning was quantified by the determination of levoglucosan concentrations from PM10 aerosol filters collected over a 14 month period in 2013/2014 and continued for a further 12 months at the UK site in Leicester. Levoglucosan levels indicated a distinct period of increased biomass combustion between November and March. Within this period monthly average concentrations ranged between 23 ± 9.7 and 283 ± 163 ng/m3, with Lille showing consistently higher levels than the sites in Belgium, the Netherlands and the UK. The estimated contribution to PM10 was, as expected, highest in the winter season where the season average percentage contribution was lowest in Wijk aan Zee at 2.7 ± 1.4% and again highest in Lille at 11.6 ± 3.8%, with a PM10 mass concentration from biomass that ranged from 0.56 μg/m3 in Leicester to 2.08 μg/m3 in Lille. Overall there was poor correlation between the levoglucosan concentrations measured at the different sites indicating that normally biomass burning would only affect atmospheric particulate pollution in the local area; however, there was evidence that extreme burning events such as the Easter fires traditionally held in parts of North-West Europe can have far wider ranging effects on air quality. Network validation measurements were also taken using a mobile monitoring station which visited the fixed sites to carry out concurrent collections of aerosol filters; the result of which demonstrated the reliability of both PM10 and levoglucosan measurements.

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

PubMed

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

2016-07-07

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

Access to HIV community services by vulnerable populations: evidence from an enhanced HIV/AIDS surveillance system.

PubMed

Madden, H C E; Phillips-Howard, P A; Hargreaves, S C; Downing, J; Bellis, M A; Vivancos, R; Morley, C; Syed, Q; Cook, P A

2011-05-01

HIV disproportionately affects vulnerable populations such as black and minority ethnic groups, men who have sex with men (MSM) and migrants, in many countries including those in the UK. Community organisations in the UK are charitable non-governmental organisations with a proportion of the workforce who volunteer, and provide invaluable additional support for people living with HIV (PLWHIV). Information on their contribution to HIV care in vulnerable groups is relatively sparse. Data generated from an enhanced HIV surveillance system in North West England, UK, was utilised for this study. We aimed to determine the characteristics of individuals who chose to access community services in addition to clinical services (1375 out of 4195 records of PLWHIV in clinical services). Demographic information, risk factors including residency status, uniquely gathered in this region, and deprivation scores were examined. Multivariate logistic regression modelling was conducted to predict the relative effect of patient characteristics on attendance at community services. Attendance at community services was highest in those living in the most, compared with least, deprived areas (p<0.001), and was most evident in MSM and heterosexuals. Compared to white UK nationals attendance was significantly higher in non-UK nationals of uncertain residency status (Adjusted odds ratio [AOR] = 21.91, 95% confidence interval [CI] 10.48-45.83; p<0.001), refugees (AOR = 5.75, 95% CI 3.3-10.03; p<0.001), migrant workers (AOR = 5.48, 95% CI 2.22-13.51; p<0.001) and temporary visitors (AOR = 3.44, 95% CI 1.68-7.05; p<0.001). Community services, initially established predominantly to support MSM, have responded to the changing demography of HIV and reach the most vulnerable members of society. Consequent to their support of migrant populations, community services are vital for the management of HIV in black and minority groups. Paradoxically, this coincides with increasing funding pressures on these services.

Is the mothers' country of birth associated with the sex of their offspring in England and Wales from 2007 to 2011?

PubMed

Smith, Cameron; Fogarty, Andrew

2014-09-25

Preference for sons in India has resulted in a skewed sex ratio at live birth, probably as a consequence of female feticide. However, it is unclear if these cultural preferences are also currently present in communities who have emigrated from India to England and Wales. Data of all live births in England and Wales from 2007-2011 were obtained from the Office of National Statistics. A logistic regression analysis was used to compare the probability of having a male infant in mothers born inside the United Kingdom (UK) to those born outside the UK, stratified by mothers' region and country of birth. Mothers born in India were not observed to be giving birth to disproportionately more boys than mothers that were born in the UK (Odds Ratio OR: 1.00, 95% Confidence Interval CI: 0.98-1.02), although an excess of male births were observed in mothers born in South-East Asia (OR 1.03; 95% CI: 1.01-1.05, p = 0.005), the Middle East (OR 1.02; 95% CI: 1.00-1.05, p = 0.047), and South America (1.04; 95% CI: 1.00-1.07, p = 0.025). Mothers who were born in Africa were found to be less likely to give birth to boys than girls when compared to mothers born in the UK (OR: 0.98, 95% CI: 0.97-0.99), and this observation was attributable to women born in East and West Africa. There was no evidence of an excess of males born to women from India in England and Wales. An excess of males were observed in mothers born in South-East Asia, the Middle East and South America. Women born in Africa are less likely to give birth to boys than UK born mothers, an observation that is consistent with previous data.

Urinary arsenic profiles reveal exposures to inorganic arsenic from private drinking water supplies in Cornwall, UK.

PubMed

Middleton, D R S; Watts, M J; Hamilton, E M; Ander, E L; Close, R M; Exley, K S; Crabbe, H; Leonardi, G S; Fletcher, T; Polya, D A

2016-05-09

Private water supplies (PWS) in Cornwall, South West England exceeded the current WHO guidance value and UK prescribed concentration or value (PCV) for arsenic of 10 μg/L in 5% of properties surveyed (n = 497). In this follow-up study, the first of its kind in the UK, volunteers (n = 207) from 127 households who used their PWS for drinking, provided urine and drinking water samples for total As determination by inductively coupled plasma mass spectrometry (ICP-MS) and urinary As speciation by high performance liquid chromatography ICP-MS (HPLC-ICP-MS). Arsenic concentrations exceeding 10 μg/L were found in the PWS of 10% of the volunteers. Unadjusted total urinary As concentrations were poorly correlated (Spearman's ρ = 0.36 (P < 0.001)) with PWS As largely due to the use of spot urine samples and the dominance of arsenobetaine (AB) from seafood sources. However, the osmolality adjusted sum, U-As(IMM), of urinary inorganic As species, arsenite (As(III)) and arsenate (As(V)), and their metabolites, methylarsonate (MA) and dimethylarsinate (DMA), was found to strongly correlate (Spearman's ρ: 0.62 (P < 0.001)) with PWS As, indicating private water supplies as the dominant source of inorganic As exposure in the study population of PWS users.

Urinary arsenic profiles reveal exposures to inorganic arsenic from private drinking water supplies in Cornwall, UK

PubMed Central

Middleton, D. R. S.; Watts, M. J.; Hamilton, E. M.; Ander, E. L.; Close, R. M.; Exley, K. S.; Crabbe, H.; Leonardi, G. S.; Fletcher, T.; Polya, D. A.

2016-01-01

Private water supplies (PWS) in Cornwall, South West England exceeded the current WHO guidance value and UK prescribed concentration or value (PCV) for arsenic of 10 μg/L in 5% of properties surveyed (n = 497). In this follow-up study, the first of its kind in the UK, volunteers (n = 207) from 127 households who used their PWS for drinking, provided urine and drinking water samples for total As determination by inductively coupled plasma mass spectrometry (ICP-MS) and urinary As speciation by high performance liquid chromatography ICP-MS (HPLC-ICP-MS). Arsenic concentrations exceeding 10 μg/L were found in the PWS of 10% of the volunteers. Unadjusted total urinary As concentrations were poorly correlated (Spearman’s ρ = 0.36 (P < 0.001)) with PWS As largely due to the use of spot urine samples and the dominance of arsenobetaine (AB) from seafood sources. However, the osmolality adjusted sum, U-AsIMM, of urinary inorganic As species, arsenite (AsIII) and arsenate (AsV), and their metabolites, methylarsonate (MA) and dimethylarsinate (DMA), was found to strongly correlate (Spearman’s ρ: 0.62 (P < 0.001)) with PWS As, indicating private water supplies as the dominant source of inorganic As exposure in the study population of PWS users. PMID:27156998

Urinary arsenic profiles reveal exposures to inorganic arsenic from private drinking water supplies in Cornwall, UK

NASA Astrophysics Data System (ADS)

Middleton, D. R. S.; Watts, M. J.; Hamilton, E. M.; Ander, E. L.; Close, R. M.; Exley, K. S.; Crabbe, H.; Leonardi, G. S.; Fletcher, T.; Polya, D. A.

2016-05-01

Private water supplies (PWS) in Cornwall, South West England exceeded the current WHO guidance value and UK prescribed concentration or value (PCV) for arsenic of 10 μg/L in 5% of properties surveyed (n = 497). In this follow-up study, the first of its kind in the UK, volunteers (n = 207) from 127 households who used their PWS for drinking, provided urine and drinking water samples for total As determination by inductively coupled plasma mass spectrometry (ICP-MS) and urinary As speciation by high performance liquid chromatography ICP-MS (HPLC-ICP-MS). Arsenic concentrations exceeding 10 μg/L were found in the PWS of 10% of the volunteers. Unadjusted total urinary As concentrations were poorly correlated (Spearman’s ρ = 0.36 (P < 0.001)) with PWS As largely due to the use of spot urine samples and the dominance of arsenobetaine (AB) from seafood sources. However, the osmolality adjusted sum, U-AsIMM, of urinary inorganic As species, arsenite (AsIII) and arsenate (AsV), and their metabolites, methylarsonate (MA) and dimethylarsinate (DMA), was found to strongly correlate (Spearman’s ρ: 0.62 (P < 0.001)) with PWS As, indicating private water supplies as the dominant source of inorganic As exposure in the study population of PWS users.

Subgroup differences in psychosocial factors relating to coronary heart disease in the UK South Asian population☆

PubMed Central

Williams, Emily D.; Nazroo, James Y.; Kooner, Jaspal S.; Steptoe, Andrew

2010-01-01

Objectives To explore the differences in psychosocial risk factors related to coronary heart disease (CHD) between South Asian subgroups in the UK. South Asian people suffer significantly higher rates of CHD than other ethnic groups, but vulnerability varies between South Asian subgroups, in terms of both CHD rates and risk profiles. Psychosocial factors may contribute to the excess CHD propensity that is observed; however, subgroup heterogeneity in psychosocial disadvantage has not previously been systematically explored. Methods With a cross-sectional design, 1065 healthy South Asian and 818 white men and women from West London, UK, completed psychosocial questionnaires. Psychosocial profiles were compared between South Asian religious groups and the white sample, using analyses of covariance and post hoc tests. Results Of the South Asian sample, 50.5% was Sikh, 28.0% was Hindu, and 15.8% was Muslim. Muslim participants were more socioeconomically deprived and experienced higher levels of chronic stress, including financial strain, low social cohesion, and racial discrimination, compared with other South Asian religious groups. In terms of health behaviors, Muslim men smoked more than Sikhs and Hindus, and Muslims also reported lower alcohol consumption and were less physically active than other groups. Conclusion This study found that Muslims were exposed to more psychosocial and behavioral adversity than Sikhs and Hindus, and highlights the importance of investigating subgroup heterogeneity in South Asian CHD risk. PMID:20846539

Spatial-Temporal dynamics of surface water flooding and consequences for emergency services accessibility

NASA Astrophysics Data System (ADS)

Pattison, Ian; Green, Daniel; Yu, Dapeng; Bosher, Lee; Wilby, Rob; Yang, Lili; Ryley, Tim

2016-04-01

Urban areas are increasingly susceptible to surface water flooding, with more intense precipitation and intensification of land development. Flooding has both direct impacts i.e. locations inundated with water, and indirect impacts i.e. transport networks, utility e.g. electricity/water services etc. The direct areas flooded evolve in space through the event, and are predicted by standard inundation models. However, the wider indirect impacts and the spatial-temporal patterns are less constrained and it is these that are needed to manage the impacts in real-time. This paper focusses on the Category One responders of the Fire and Rescue and Ambulance Services in the City of Leicester, East Midlands, UK. Leicester is ranked 16th out of 4215 settlements at risk of surface water flooding in the UK based upon the population at risk (15,200 people) (DEFRA, 2009). The analysis undertaken involved overlaying the flood extent with the Integrated Transport Network (ITN) data within a GIS framework. Then a simple transport routing algorithm was used to predict the travel time from specific nodes representing ambulance or fire stations to different parts of the city. Flood magnitudes with 1:20, 1:100 and 1:1000 return periods have been investigated. Under a scenario of no flooding, 100% of the city is accessible by the six fire stations in the city. However, in the 1 in 20 year surface water flood event the peak inundation results in 66.5% being accessible in the 10 minute permitted time and 6% is totally inaccessible. This falls to 40% and 13% respectively for the 1 in 100 year event. Maps show the area of the city that are accessible by two or more stations within the permitted response time, which shows these areas are the most resilient to surface water flooding. However, it isn't just the peak water depths at every location which impacts accessibility within the city but the spatial-temporal patterns of the inundation. The areas within the 10 minute response time expand and contract through the event as the inundated area makes roads in different parts of the city inaccessible through the event. These maps also allow key access roads to be identified. Key stakeholders, within the City of Leicester, have highlighted the potential benefit of such dynamic accessibility maps for their multi-agency planning and response for surface water flooding.

Cross-sectional surveillance study to phenotype lorry drivers’ sedentary behaviours, physical activity and cardio-metabolic health

PubMed Central

Varela-Mato, Veronica; O’Shea, Orlagh; King, James A; Yates, Thomas; Stensel, David J; Biddle, Stuart JH; Nimmo, Myra A; Clemes, Stacy A

2017-01-01

Objectives Elevated risk factors for a number of chronic diseases have been identified in lorry drivers. Unhealthy lifestyle behaviours such as a lack of physical activity (PA) and high levels of sedentary behaviour (sitting) likely contribute to this elevated risk. This study behaviourally phenotyped UK lorry drivers’ sedentary and non-sedentary behaviours during workdays and non-workdays and examined markers of drivers cardio-metabolic health. Setting A transport company from the East Midlands, UK. Participants A sample of 159 male heavy goods vehicle drivers (91% white European; (median (range)) age: 50 (24, 67) years) completed the health assessments. 87 (age: 50.0 (25.0, 65.0); body mass index (BMI): 27.7 (19.6, 43.4) kg/m2) provided objective information on sedentary and non-sedentary time. Outcomes Participants self-reported their sociodemographic information. Primary outcomes: sedentary behaviour and PA, assessed over 7 days using an activPAL3 inclinometer. Cardio-metabolic markers included: blood pressure (BP), heart rate, waist circumference (WC), hip circumference, body composition and fasted capillary blood glucose, triglycerides, high-density lipopreotein cholesterol, low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) levels. These cardio-metabolic markers were treated as secondary outcomes. Results Lorry drivers presented an unhealthy cardio-metabolic health profile (median (IQR) systolic BP: 129 (108.5, 164) mm Hg; diastolic BP: 81 (63, 104) mm Hg; BMI: 29 (20, 47) kg/m2; WC: 102 (77.5, 146.5) cm; LDL-C: 3 (1, 6) mmol/L; TC: 4.9 (3, 7.5) mmol/L). 84% were overweight or obese, 43% had type 2 diabetes or prediabetes and 34% had the metabolic syndrome. The subsample of lorry drivers with objective postural data (n=87) accumulated 13 hours/day and 8 hours/day of sedentary behaviour on workdays and non-workdays (p<0.001), respectively. On average, drivers accrued 12 min/day on workdays and 6 min/day on non-workdays of moderate-to-vigorous PA (MVPA). Conclusion Lorry drivers demonstrate a high-risk cardio-metabolic profile and are highly sedentary and physically inactive. Interventions to reduce sitting and increase MVPA during breaks and leisure time to improve cardio-metabolic health are urgently needed. Educational programmes to raise awareness about diet and exercise are recommended. PMID:28637722

Modelling potential production of macroalgae farms in UK and Dutch coastal waters

NASA Astrophysics Data System (ADS)

van der Molen, Johan; Ruardij, Piet; Mooney, Karen; Kerrison, Philip; O'Connor, Nessa E.; Gorman, Emma; Timmermans, Klaas; Wright, Serena; Kelly, Maeve; Hughes, Adam D.; Capuzzo, Elisa

2018-02-01

There is increasing interest in macroalgae farming in European waters for a range of applications, including food, chemical extraction for biofuel production. This study uses a 3-D numerical model of hydrodynamics and biogeochemistry to investigate potential production and environmental effects of macroalgae farming in UK and Dutch coastal waters. The model included four experimental farms in different coastal settings in Strangford Lough (Northern Ireland), in Sound of Kerrera and Lynn of Lorne (north-west Scotland) and in the Rhine plume (the Netherlands), as well as a hypothetical large-scale farm off the UK north Norfolk coast. The model could not detect significant changes in biogeochemistry and plankton dynamics at any of the farm sites averaged over the farming season. The results showed a range of macroalgae growth behaviours in response to simulated environmental conditions. These were then compared with in situ observations where available, showing good correspondence for some farms and less good correspondence for others. At the most basic level, macroalgae production depended on prevailing nutrient concentrations and light conditions, with higher levels of both resulting in higher macroalgae production. It is shown that under non-elevated and interannually varying winter nutrient conditions, farming success was modulated by the timings of the onset of increasing nutrient concentrations in autumn and nutrient drawdown in spring. Macroalgae carbohydrate content also depended on nutrient concentrations, with higher nutrient concentrations leading to lower carbohydrate content at harvest. This will reduce the energy density of the crop and thus affect its suitability for conversion into biofuel. For the hypothetical large-scale macroalgae farm off the UK north Norfolk coast, the model suggested high, stable farm yields of macroalgae from year to year with substantial carbohydrate content and limited environmental effects.

Knowledge and periconceptional use of folic acid for the prevention of neural tube defects in ethnic communities in the United Kingdom: systematic review and meta-analysis.

PubMed

Peake, Jordana N; Copp, Andrew J; Shawe, Jill

2013-07-01

It is widely accepted that periconceptional supplementation with folic acid can prevent a significant proportion of neural tube defects (NTDs). The present study evaluated how folic acid knowledge and periconceptional use for NTD prevention varies by ethnicity in the United Kingdom (U.K.). A literature search was conducted to identify studies that included assessment of folic acid knowledge or use in U.K. women of different ethnicities. Only research and referenced sources published after 1991, the year of the landmark Medical Research Council's Vitamin Study, were included. A meta-analysis was performed of studies that assessed preconceptional folic acid use in Caucasians and non-Caucasians. Five studies met the inclusion criteria for assessment of knowledge and/or use of folic acid supplements in U.K. women including non-Caucasians. The available evidence indicates that South Asians specifically have less knowledge and lower periconceptional use of folic acid than Caucasians; one study found that West Indian and African women also had lower folic acid uptake. A synthesis of results from three of the studies, in a meta-analysis, shows that Caucasians are almost three times more likely to take folic acid before conception than non-Caucasians. From the limited evidence available, U.K. women of non-Caucasian ethnicity appear to have less knowledge and a lower uptake of folic acid supplementation than Caucasians during the periconceptional period. Implementing targeted, innovative education campaigns together with a mandatory fortification policy, including the fortification of ethnic minority foods, will be required for maximum prevention of folic acid-preventable NTDs across different ethnic groups. Copyright © 2013 Wiley Periodicals, Inc.

Spatially explicit estimation of heat stress-related impacts of climate change on the milk production of dairy cows in the United Kingdom.

PubMed

Fodor, Nándor; Foskolos, Andreas; Topp, Cairistiona F E; Moorby, Jon M; Pásztor, László; Foyer, Christine H

2018-01-01

Dairy farming is one the most important sectors of United Kingdom (UK) agriculture. It faces major challenges due to climate change, which will have direct impacts on dairy cows as a result of heat stress. In the absence of adaptations, this could potentially lead to considerable milk loss. Using an 11-member climate projection ensemble, as well as an ensemble of 18 milk loss estimation methods, temporal changes in milk production of UK dairy cows were estimated for the 21st century at a 25 km resolution in a spatially-explicit way. While increases in UK temperatures are projected to lead to relatively low average annual milk losses, even for southern UK regions (<180 kg/cow), the 'hottest' 25×25 km grid cell in the hottest year in the 2090s, showed an annual milk loss exceeding 1300 kg/cow. This figure represents approximately 17% of the potential milk production of today's average cow. Despite the potential considerable inter-annual variability of annual milk loss, as well as the large differences between the climate projections, the variety of calculation methods is likely to introduce even greater uncertainty into milk loss estimations. To address this issue, a novel, more biologically-appropriate mechanism of estimating milk loss is proposed that provides more realistic future projections. We conclude that South West England is the region most vulnerable to climate change economically, because it is characterised by a high dairy herd density and therefore potentially high heat stress-related milk loss. In the absence of mitigation measures, estimated heat stress-related annual income loss for this region by the end of this century may reach £13.4M in average years and £33.8M in extreme years.

Physiotherapy for plantar fasciitis: a UK-wide survey of current practice.

PubMed

Grieve, Rob; Palmer, Shea

2017-06-01

To identify how United Kingdom (UK) physiotherapists currently diagnose, assess and manage plantar fasciitis in routine practice. Online questionnaire survey. Practising physiotherapists across the UK who treat patients with plantar fasciitis. Physiotherapists were approached via 'interactive Chartered Society of Physiotherapy (CSP)' online networks and an email database of clinical educators in South West England. An online questionnaire was developed by reviewing similar existing physiotherapy surveys and consultation with experienced musculoskeletal researchers/clinicians. Descriptive statistics were used to analyse the data. 285 physiotherapists responded, with 257 complete survey responses. Pain on palpation and early morning pain were the most common diagnostic criteria, with some physiotherapists using no formal test criteria. Advice (237/257, 92%), plantar fasciitis pathology education (207/257, 81%) and general stretching exercises (189/257, 74%) were most routinely used. Prefabricated orthotics, custom made orthotics and night splints were seldom always used. For the manual therapy approach, the most frequently used modalities were massage, myofascial release, specific soft tissue mobilisations and myofascial trigger point therapy. Commonly used outcome measures were pain assessment, functional tests and range of movement. Physiotherapists appeared to follow most of the established diagnostic criteria for PF, but have not followed established outcome measure guidelines. Advice as well as education with an emphasis on self-management including calf/hamstring stretching was the most commonly reported treatment approach. There was uncertainty whether this approach accurately reflected clinical practice used throughout the UK, owing to potential response bias/unknown response rate and the low number of patients with PF treated by the respondents. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Equal Educational Choices for Parents. Hearing before the Committee on Education and the Workforce. House of Representatives, One Hundred Seventh Congress, Second Session (April 16, 2002).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Education and the Workforce.

This hearing presents information to help lay the groundwork for legislative action on expanded parental choice in education. After an opening statement by John Boehner, Chairman, Committee on Education and the Workforce, U.S. House of Representatives, there are statements by: Lawrence W. Reed, President Mackinac Center for Public Policy, Midland,…

77 FR 34797 - Safety Zones; Recurring Events in Captain of the Port New York Zone

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-12

... Safety Zone, 33 CFR 165.160(5.9). position 40[deg]45'56.9'' N, 074[deg]00'25.4'' W (NAD 1983..., 074[deg]04'29.6'' W (NAD 1983), approximately 800 yards southeast of the Midland Beach. Date: June 16...]30'52.1'' N, 074[deg]10'58.8'' W (NAD 1983), approximately 540 yards east of Wolfe's Pond Park...

Clinical characteristics and public health management of invasive meningococcal group W disease in the East Midlands region of England, United Kingdom, 2011 to 2013.

PubMed

Bethea, Jane; Makki, Sophia; Gray, Steve; MacGregor, Vanessa; Ladhani, Shamez

2016-06-16

In England and Wales, meningococcal disease caused by group W has historically been associated with outbreaks of disease among travellers to high-risk countries. Following a large outbreak associated with travel to the Hajj in 2000, the number of cases declined and, in 2008, only 19 laboratory-confirmed cases were identified nationally. In 2013, in the East Midlands region of England, eight cases of meningococcal disease caused by this serogroup were recorded, compared with six from 2011 to 2012. To explore this further, data for all cases with a date of onset between 1 January 2011 and 31 December 2013 were collected. Data collected included geographical location, clinical presentation and outcome. Fourteen cases were identified; two died as a result of their illness and two developed long-term health problems. No commonality in terms of geographical location, shared space or activities was identified, suggesting that group W is circulating endemically with local transmission. Clinical presentation was variable. Half presented with symptoms not typical of a classical meningococcal disease, including two cases of cellulitis, which may have implications for clinicians, in terms of timely identification and treatment, and public health specialists, for offering timely antibiotic chemoprophylaxis to close contacts. This article is copyright of The Authors, 2016.

Work stress and health in Western European and post-communist countries: an East-West comparison study.

PubMed

Salavecz, G; Chandola, T; Pikhart, H; Dragano, N; Siegrist, J; Jöckel, K-H; Erbel, R; Pajak, A; Malyutina, S; Kubinova, R; Marmot, M; Bobak, M; Kopp, M

2010-01-01

There is evidence that psychosocial factors at work influence the risk of poor health in Western societies, but little is known about the effect of work stress in the former communist countries. The aim of this paper is to compare the association of work stress with self-rated health in Western European and post-communist countries. Data from four epidemiological studies were used: the HAPIEE study (Poland, Russia and the Czech Republic), the Hungarian Epidemiological Panel (Hungary), the Heinz Nixdorf Recall study (Germany) and the Whitehall II study (UK). The overall sample consisted of 18 494 male and female workers aged 35-65 years. High effort-reward imbalance at work was associated with poor self-rated health. The adjusted odds ratios for the highest versus lowest quartile of the effort-reward ratio were 3.8 (95% CI 1.9 to 7.7) in Hungary, 3.6 (95% CI 2.3 to 5.7) in the Czech Republic, 2.5 (95% CI 1.5 to 4.1) in the UK, 2.3 (95% CI 1.6 to 3.5) in Germany, 1.5 (95% CI 1.0 to 2.1) in Poland and 1.4 (95% CI 1.1 to 1.8) in Russia. The differences in odds ratios between countries were statistically significant (p<0.05). A similar pattern was observed for the effect of overcommitment on poor health. The association of effort-reward imbalance at work and of a high degree of work-related overcommitment with poor self-rated health was seen in all countries, but the size of the effects differed considerably. It does not appear that the effects in Eastern Europe are systematically stronger than in the West.

Work stress and health in Western European and post-communist countries: an East–West comparison study

PubMed Central

Salavecz, G; Chandola, T; Pikhart, H; Dragano, N; Siegrist, J; Jöckel, K-H; Erbel, R; Pajak, A; Malyutina, S; Kubinova, R; Marmot, M; Bobak, M; Kopp, M

2014-01-01

Background There is evidence that psychosocial factors at work influence the risk of poor health in Western societies, but little is known about the effect of work stress in the former communist countries. The aim of this paper is to compare the association of work stress with self-rated health in Western European and post-communist countries. Methods Data from four epidemiological studies were used: the HAPIEE study (Poland, Russia and the Czech Republic), the Hungarian Epidemiological Panel (Hungary), the Heinz Nixdorf Recall study (Germany) and the Whitehall II study (UK). The overall sample consisted of 18 494 male and female workers aged 35–65 years. Results High effort-reward imbalance at work was associated with poor self-rated health. The adjusted odds ratios for the highest versus lowest quartile of the effort-reward ratio were 3.8 (95% CI 1.9 to 7.7) in Hungary, 3.6 (95% CI 2.3 to 5.7) in the Czech Republic, 2.5 (95% CI 1.5 to 4.1) in the UK, 2.3 (95% CI 1.6 to 3.5) in Germany, 1.5 (95% CI 1.0 to 2.1) in Poland and 1.4 (95% CI 1.1 to 1.8) in Russia. The differences in odds ratios between countries were statistically significant (p<0.05). A similar pattern was observed for the effect of overcommitment on poor health. Conclusion The association of effort-reward imbalance at work and of a high degree of work-related overcommitment with poor self-rated health was seen in all countries, but the size of the effects differed considerably. It does not appear that the effects in Eastern Europe are systematically stronger than in the West. PMID:19692735

Clinical outcome in patients from a single region who were dependent on parenteral nutrition for 28 days or more.

PubMed

Köglmeier, J; Day, C; Puntis, J W L

2008-04-01

The frequency and outcome of intestinal failure (IF) in children are not well defined in the UK. Long-term parenteral nutrition (PN) is an effective intervention, with intestine transplantation offering the possibility of survival should life-threatening complications arise in those with long-term dependency. The ideal model for service provision is a subject of debate. We aimed to identify all new cases of IF (defined as PN dependency > or =28 days) in West Yorkshire over a two-year period to determine the rate of serious complications, establish the outcome after two years and clarify the role of specialist referral. Pharmacists in all the West Yorkshire paediatric units were contacted to establish the number of children with IF during 2001-2002. Underlying diagnosis, complications and outcome at two years were obtained by case-note review for 93 of the 96 children identified. IF patients were exclusively managed in one or other of the three large teaching hospitals. At the two-year follow-up, six (6.4%) children had died (one while listed for a small bowel transplantation), but 85 (91%) had established full enteral feeding and were well. Two remained PN dependent and were assessed in the supra-regional intestinal transplantation unit (Birmingham); in neither case was small bowel transplantation thought to be appropriate. The most common complications were central venous catheter sepsis (69% of patients) and cholestasis (59%). This study shows that a favourable outcome for IF can be achieved in a regional centre with appropriate multidisciplinary support. A single UK supra-regional unit undertaking small bowel transplantation is probably adequate for assessment of the most complex patients, although this should remain under review.

Changes in the geographical distribution of plant species and climatic variables on the West Cornwall peninsula (South West UK).

PubMed

Kosanic, Aleksandra; Anderson, Karen; Harrison, Stephan; Turkington, Thea; Bennie, Jonathan

2018-01-01

Recent climate change has had a major impact on biodiversity and has altered the geographical distribution of vascular plant species. This trend is visible globally; however, more local and regional scale research is needed to improve understanding of the patterns of change and to develop appropriate conservation strategies that can minimise cultural, health, and economic losses at finer scales. Here we describe a method to manually geo-reference botanical records from a historical herbarium to track changes in the geographical distributions of plant species in West Cornwall (South West England) using both historical (pre-1900) and contemporary (post-1900) distribution records. We also assess the use of Ellenberg and climate indicator values as markers of responses to climate and environmental change. Using these techniques we detect a loss in 19 plant species, with 6 species losing more than 50% of their previous range. Statistical analysis showed that Ellenberg (light, moisture, nitrogen) and climate indicator values (mean January temperature, mean July temperature and mean precipitation) could be used as environmental change indicators. Significantly higher percentages of area lost were detected in species with lower January temperatures, July temperatures, light, and nitrogen values, as well as higher annual precipitation and moisture values. This study highlights the importance of historical records in examining the changes in plant species' geographical distributions. We present a method for manual geo-referencing of such records, and demonstrate how using Ellenberg and climate indicator values as environmental and climate change indicators can contribute towards directing appropriate conservation strategies.

Changes in the geographical distribution of plant species and climatic variables on the West Cornwall peninsula (South West UK)

PubMed Central

Kosanic, Aleksandra; Anderson, Karen; Harrison, Stephan; Turkington, Thea; Bennie, Jonathan

2018-01-01

Recent climate change has had a major impact on biodiversity and has altered the geographical distribution of vascular plant species. This trend is visible globally; however, more local and regional scale research is needed to improve understanding of the patterns of change and to develop appropriate conservation strategies that can minimise cultural, health, and economic losses at finer scales. Here we describe a method to manually geo-reference botanical records from a historical herbarium to track changes in the geographical distributions of plant species in West Cornwall (South West England) using both historical (pre-1900) and contemporary (post-1900) distribution records. We also assess the use of Ellenberg and climate indicator values as markers of responses to climate and environmental change. Using these techniques we detect a loss in 19 plant species, with 6 species losing more than 50% of their previous range. Statistical analysis showed that Ellenberg (light, moisture, nitrogen) and climate indicator values (mean January temperature, mean July temperature and mean precipitation) could be used as environmental change indicators. Significantly higher percentages of area lost were detected in species with lower January temperatures, July temperatures, light, and nitrogen values, as well as higher annual precipitation and moisture values. This study highlights the importance of historical records in examining the changes in plant species’ geographical distributions. We present a method for manual geo-referencing of such records, and demonstrate how using Ellenberg and climate indicator values as environmental and climate change indicators can contribute towards directing appropriate conservation strategies. PMID:29401494

Attitudes toward transplantation in U.K. Muslim Indo-Asians in west London.

PubMed

Alkhawari, Fawzi S; Stimson, Gerry V; Warrens, Anthony N

2005-06-01

The worldwide shortage of organs for transplantation makes it important to understand why some oppose donation. Attitudes vary with religion and ethnicity. Accordingly, we undertook a qualitative study of the attitudes of 141 U.K. Muslim Indo-Asians to organ donation. Participants were observed, focus group discussions held and in-depth individual interviews conducted. We identified a high level of alienation from the health care system in general. With respect to organ donation in particular, its importance was generally discounted, often in deference to authority figures within the community who appeared negatively disposed. The culture-specific issues arguing against donation included a sense of the sacredness of the body, a fatalistic approach to illness, a belief that organs took on an independent role as 'witnesses' to an individual's life on Judgement Day and an anxiety that the donor would have no control of the probity of the recipient of an organ. We believe these data suggest a need to improve in a culturally sensitive fashion the provision of health information provided to this community.

The use of surgery in the treatment of ER+ early stage breast cancer in England: Variation by time, age and patient characteristics.

PubMed

Richards, P; Ward, S; Morgan, J; Lagord, C; Reed, M; Collins, K; Wyld, L

2016-04-01

To assess whether the proportion of patients aged 70 and over with ER+ operable breast cancer in England who are treated with surgery has changed since 2002, and to determine whether age and individual level factors including tumour characteristics and co-morbidity influence treatment choice. A retrospective cohort analysis of routinely collected cancer registration data from two English regions (West Midlands, Northern & Yorkshire) was carried out (n = 17,129). Trends in surgical use over time for different age groups were assessed graphically and with linear regression. Uni- and multivariable logistic regressions were used to assess the effects of age, comorbidity, deprivation and disease characteristics on treatment choice. Missing data was handled using multiple imputation. There is no evidence of a change in the proportion of patients treated surgically over time. The multivariable model shows that age remains an important predictor of whether or not a woman with ER+ operable breast cancer receives surgery after covariate adjustment (Odds ratio of surgery vs no surgery, 0.82 (per year over 70)). Co-morbidity, deprivation, symptomatic presentation, later stage at diagnosis and low grade are also associated with increased probability of non-surgical treatment. Contrary to current NICE guidance in England, age appears to be an important factor in the decision to treat operable ER+ breast cancer non-surgically. Further research is needed to assess the role of other age-related factors on treatment choice, and the effect that current practice has on survival and mortality from breast cancer for older women. Copyright © 2016 Elsevier Ltd. All rights reserved.

Impact of the Irish smoking ban on sales in bars using a large business-level data set from 1999 to 2007.

PubMed

Cornelsen, Laura; Normand, Charles

2014-09-01

Ireland introduced comprehensive smoke-free workplace legislation in 2004. This study evaluates the economic impact of the workplace smoking ban on the value of sales in bars. Data on the value of bar sales were derived from a large, nationally representative, annual business-level survey from 1999 to 2007. The economic impact of the smoking ban was evaluated according to geographical region and bar size. Analysis was based on an econometric model which controlled for background changes in population income and wealth and for investments made by the bars during this period. The overall impact of the Irish smoking ban on bar sales appears to be very small. The ban was associated with an increase in sales among medium to large bars in the Border-Midland-West (more rural) region of Ireland, and a small reduction in sales among large bars in the more urban, South-East region. We failed to find any evidence of a change in bar sales in the remaining categories studied. The results indicate that although some bars saw positive effects and some negative, the overall impact of the smoking ban on the value of sales in bars was negligible. These findings provide further supporting evidence that comprehensive smoke-free workplace legislation does not harm hospitality businesses while having positive health effects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A Survey of English Sixth Formers' Knowledge of Early Brain Development.

PubMed

Nolan, Mary

2017-10-01

Objectives To ascertain the knowledge of young people aged 16 to 19 of early brain development and their attitudes towards the care of babies and preschool children. Design Cross-sectional, school- and college-based survey including all sixth form students present on the days of data collection. The survey instrument comprised forced-choice questions in four sections: Demographics, Perceptions and Understanding of Early Childhood Development, Parental Behaviors to Support Early Brain development, and Resource Needs and Usage. Setting Two sixth form schools and one sixth form college in three towns of varying affluence in the West Midlands of the United Kingdom. Method The survey was mounted online and completed by 905 students who returned it directly to the researcher. Results Most students knew that tobacco, alcohol, and drugs are hazardous in pregnancy, and many recognized the impact of maternal stress on fetal brain development. Many believed that babies can be "spoiled" and did not appreciate the importance of reading to babies and of the relationship between play and early brain development. A significant minority thought that physical activity and a healthy diet have little impact on young children's development. Respondents said they would turn firstly to their parents for advice on baby care rather than professionals. Conclusion Young people need educating about parenting activities that support the all-round healthy development of infants. The importance of a healthy diet, physical activity, reading, and play should be included in sixth form curricula and antenatal classes. Consideration should be given to educating grandparents because of their influence on new parents.

Mindful organizing in patients' contributions to primary care medication safety.

PubMed

Phipps, Denham L; Giles, Sally; Lewis, Penny J; Marsden, Kate S; Salema, Ndeshi; Jeffries, Mark; Avery, Anthony J; Ashcroft, Darren M

2018-04-14

There is a need to ensure that the risks associated with medication usage in primary health care are controlled. To maintain an understanding of the risks, health-care organizations may engage in a process known as "mindful organizing." While this is typically conceived of as involving organizational members, it may in the health-care context also include patients. Our study aimed to examine ways in which patients might contribute to mindful organizing with respect to primary care medication safety. Qualitative focus groups and interviews were carried out with 126 members of the public in North West England and the East Midlands. Participants were taking medicines for a long-term health condition, were taking several medicines, had previously encountered problems with their medication or were caring for another person in any of these categories. Participants described their experiences of dealing with medication-related concerns. The transcripts were analysed using a thematic method. We identified 4 themes to explain patient behaviour associated with mindful organizing: knowledge about clinical or system issues; artefacts that facilitate control of medication risks; communication with health-care professionals; and the relationship between patients and the health-care system (in particular, mutual trust). Mindful organizing is potentially useful for framing patient involvement in safety, although there are some conceptual and practical issues to be addressed before it can be fully exploited in this setting. We have identified factors that influence (and are strengthened by) patients' engagement in mindful organizing, and as such would be a useful focus of efforts to support patient involvement. © 2018 The Authors Health Expectations published by John Wiley & Sons Ltd.

Growth in an English population from the Industrial Revolution.

PubMed

Mays, S; Brickley, M; Ives, R

2008-05-01

The rapid urbanization of the Industrial Revolution in 18th-19th century England presented new health challenges. Our aim is to investigate using English skeletal remains whether the living conditions for an urban working class group in the Industrial Revolution negatively impacted upon their skeletal growth compared with a population from a rural agrarian parish. The Industrial Revolution skeletal material is from St Martin's Churchyard, Birmingham (SMB), West Midlands. It dates primarily from the first half of the nineteenth century when Birmingham was a major manufacturing center. The rural group is from Wharram Percy (WP), North Yorkshire, and dates from 10th-19th century AD. The methodology involves plotting diaphyseal bone lengths versus dental age for subadults. No overall difference was found between the two populations in bone length-for-age among the 2- to 18-year cohort. However the younger parts of the SMB cohort were smaller than at WP; the opposite was true of the older parts of the cohort. Growth rate, as inferred from crosssectional data, appeared greater at SMB than at WP. The only result consistent with expectations is the larger bone dimensions in young children from WP, but this likely reflects prolonged breastfeeding at WP not differences in urban and rural environments. That the deleterious health effects that we know accompanied the major transition in human society from a rural agrarian to an urban industrialized living environment should be little manifest in skeletal endochondral growth data is discouraging for those who would use such methodology to monitor health in earlier populations. (c) 2008 Wiley-Liss, Inc.

A genomic portrait of the emergence, evolution, and global spread of a methicillin-resistant Staphylococcus aureus pandemic

PubMed Central

Holden, Matthew T.G.; Hsu, Li-Yang; Kurt, Kevin; Weinert, Lucy A.; Mather, Alison E.; Harris, Simon R.; Strommenger, Birgit; Layer, Franziska; Witte, Wolfgang; de Lencastre, Herminia; Skov, Robert; Westh, Henrik; Žemličková, Helena; Coombs, Geoffrey; Kearns, Angela M.; Hill, Robert L.R.; Edgeworth, Jonathan; Gould, Ian; Gant, Vanya; Cooke, Jonathan; Edwards, Giles F.; McAdam, Paul R.; Templeton, Kate E.; McCann, Angela; Zhou, Zhemin; Castillo-Ramírez, Santiago; Feil, Edward J.; Hudson, Lyndsey O.; Enright, Mark C.; Balloux, Francois; Aanensen, David M.; Spratt, Brian G.; Fitzgerald, J. Ross; Parkhill, Julian; Achtman, Mark; Bentley, Stephen D.; Nübel, Ulrich

2013-01-01

The widespread use of antibiotics in association with high-density clinical care has driven the emergence of drug-resistant bacteria that are adapted to thrive in hospitalized patients. Of particular concern are globally disseminated methicillin-resistant Staphylococcus aureus (MRSA) clones that cause outbreaks and epidemics associated with health care. The most rapidly spreading and tenacious health-care-associated clone in Europe currently is EMRSA-15, which was first detected in the UK in the early 1990s and subsequently spread throughout Europe and beyond. Using phylogenomic methods to analyze the genome sequences for 193 S. aureus isolates, we were able to show that the current pandemic population of EMRSA-15 descends from a health-care-associated MRSA epidemic that spread throughout England in the 1980s, which had itself previously emerged from a primarily community-associated methicillin-sensitive population. The emergence of fluoroquinolone resistance in this EMRSA-15 subclone in the English Midlands during the mid-1980s appears to have played a key role in triggering pandemic spread, and occurred shortly after the first clinical trials of this drug. Genome-based coalescence analysis estimated that the population of this subclone over the last 20 yr has grown four times faster than its progenitor. Using comparative genomic analysis we identified the molecular genetic basis of 99.8% of the antimicrobial resistance phenotypes of the isolates, highlighting the potential of pathogen genome sequencing as a diagnostic tool. We document the genetic changes associated with adaptation to the hospital environment and with increasing drug resistance over time, and how MRSA evolution likely has been influenced by country-specific drug use regimens. PMID:23299977