Public inquiry and enquete publique - forms of public participation in England and France

International Nuclear Information System (INIS)

Macrory, R.; Lafontaine, M.

1982-01-01

The subject is covered in chapters, entitled: introduction; the enquete publique in France - a case study; the public inquiry in England - a case study; the French system - an English view; the English system - a French view; distinctive features of the two systems. Appendices cover: the methodology; the Advisory Committee; the legal and administrative background in England; the legal and administrative background in France; examination and cross-examination; the audition publique; selected bibliography and references. (U.K.)

Management and valuation of an environmentally sensitive area: Norfolk Broadland, England, case study

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Turner, R. Kerry; Brooke, Jan

1988-03-01

Wetlands, like any other environmentally sensitive resource, require very careful evaluation. While it is accepted that all wetlands may be equally valuable in terms of maintaining global life-support systems, individual areas may be ranked according to their uniqueness or the irreplaceability of the resource should the wetland be developed. The various techniques available for evaluating the wetland resource in the development versus conservation conflict situation are critically assessed. Indirect appraisal via the opportunity cost method can generate valuable data which have contributed to the mitigation of such conflict situations. The Broadland, in Norfolk, England, recently designated an environmentally sensitive area (ESA), provides a case study example of wetland management. The search for an “acceptable” flood alleviation strategy for the ESA is examined in detail. The economic and environmental asset structure of the study area is examined at two levels. A basic “screening” system is applied to each of the identified flood protection planning units to enable the rank ordering of the units. A more detailed appraisal is then made of the value of selected units so that the cost-effectiveness of any planned expenditure on flood protection works can be assessed. Specific management issues and their likely effect on the environment, in terms of land use for example, are also addressed. The 1986 Agriculture Act marks a potential watershed in British conservation policy. The ESA policy encompasses a dual management strategy that attempts to stimulate compatible agricultural and conservation practices and activities. Other countries that still retain significant unspoiled wetland resources may find that preemptive regulatory government intervention in favor of conservation would help to avoid the worst aspects of the British experience.

The risk of intussusception following monovalent rotavirus vaccination in England: A self-controlled case-series evaluation.

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Stowe, Julia; Andrews, Nick; Ladhani, Shamez; Miller, Elizabeth

2016-07-12

To investigate the risk of intussusception after monovalent rotavirus vaccine (RV1) given to infants aged 2 and 3 months in England. Hospital Episode Statistics (HES) were used to identify infants aged 48-183 days admitted between 11/03/2013 and 31/10/2014 with intussusception. Diagnosis was confirmed from medical records and HES procedure codes. Vaccination status was obtained from general practitioners. The risk of admission within 1-7 and 8-21 days of vaccination was analysed using the self-controlled case-series (SCCS) method with age effect adjustment by including historical data before RVI introduction in July 2013. A total of 119 cases were identified during the study period and intussusception confirmed in 95 of whom 39 were vaccinated 1-21 days before onset. An increased relative incidence (RI) in this period was found, 4.53 (95% confidence interval 2.34-8.58) and 2.60 (1.43-4.81) respectively after the 1st and 2nd doses with an attributable risk of 1.91 and 1.49 per 100,000 doses respectively. The peak risk was 1-7 days after the first dose, RI 13.81 (6.44-28.32), with an estimated 93% of the 15 cases being vaccine-attributable. Mean interval between onset and admission, and clinical features were similar between vaccine-associated and background cases. Despite intussusception being a contraindication to rotavirus vaccination, 10 infants received a further dose; none had a recurrence. The RIs in a meta-analysis combing our results with Australia, Mexico, Brazil and Singapore using RV1, a 2, 4 month schedule and SCCS gave pooled RI estimates of 2.35 (1.45-3.8) and 1.77 (1.29-2.43) in the 21 day period after the 1st and 2nd doses, respectively. The earlier age at the 2nd dose in England did not affect the risk. We estimate that the RVI programme causes around 21 intussusception admissions annually in England but, since it prevents around 25,000 gastro-intestinal infection admissions, its benefit/risk profile remains strongly positive. Crown Copyright �

Geographical variation in anophthalmia and microphthalmia in England, 1988-94

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Dolk, H; Busby, A; Armstrong, B G; Walls, P H

1998-01-01

Objective: To investigate the geographical variation and clustering of congenital anophthalmia and microphthalmia in England, in response to media reports of clusters. Design: Comparison of pattern of residence at birth of cases of anophthalmia and microphthalmia in England in 1988-94, notified to a special register, with pattern of residence of all births. Three groups studied included all cases, all severe cases, and all severe cases of unknown aetiology. Outcome measures: Prevalence rates of anophthalmia and microphthalmia by region and district, and by ward population density and socioeconomic deprivation index of enumeration district grouped into fifths. Clustering expressed as the tendency for the three nearest neighbours of a case to be more likely to be cases than expected by chance, or for there to be more cases within circles of fixed radius of a case than expected by chance. Results: The overall prevalence of anophthalmia and microphthalmia was 1.0 per 10 000 births. Regional and district variation in prevalence did not reach statistical significance. Prevalence was higher in rural than urban areas: the relative risk in the group of wards of lowest population density compared with the most densely populated group was 1.79 (95% confidence interval 1.15 to 2.81) for all cases and 2.37 (1.38 to 4.08) for severe cases. There was no evidence of a trend in risk with socioeconomic deprivation. There was very little evidence of localised clustering. Conclusions: There is very little evidence to support the presence of strongly localised environmental exposures causing clusters of children to be born with anophthalmia or microphthalmia. The excess risk in rural areas requires further investigation. Key messagesClusters of anophthalmia and microphthalmia in England have been alleged in the media, with hypothesised links to environmental exposure such as pesticidesTo answer concerns about clustering a register has been established of all cases of anophthalmia and

Changing Land Use: The Fens of England. A Case Study in Land Reclamation [And] Student Work Book.

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Laws, Kevin

A social studies unit and student workbook explore changes in land use that have occurred in the Fenlands of England since the time it was first inhabited. Fens are lowlying land which is partially or completely covered with water. The English Fens are located on the eastern side of the British Isles and cover a total area of about 2,000 square…

Incorporating global warming risks in power sector planning: A case study of the New England region

International Nuclear Information System (INIS)

Krause, F.; Busch, J.; Koomey, J.

1992-11-01

Growing international concern over the threat of global climate change has led to proposals to buy insurance against this threat by reducing emissions of carbon (short for carbon dioxide) and other greenhouse gases below current levels. Concern over these and other, non-climatic environmental effects of electricity generation has led a number of states to adopt or explore new mechanisms for incorporating environmental externalities in utility resource planning. For example, the New York and Massachusetts utility commissions have adopted monetized surcharges (or adders) to induce emission reductions of federally regulated air pollutants (notably, SO 2 , NO x , and particulates) beyond federally mandated levels. These regulations also include preliminary estimates of the cost of reducing carbon emissions, for which no federal regulations exist at this time. Within New England, regulators and utilities have also held several workshops and meetings to discuss alternative methods of incorporating externalities as well as the feasibility of regional approaches. This study examines the potential for reduced carbon emissions in the New England power sector as well as the cost and rate impacts of two policy approaches: environmental externality surcharges and a target- based approach. We analyze the following questions: Does New England have sufficient low-carbon resources to achieve significant reductions (10% to 20% below current levels) in fossil carbon emissions in its utility sector? What reductions could be achieved at a maximum? What is the expected cost of carbon reductions as a function of the reduction goal? How would carbon reduction strategies affect electricity rates? How effective are environmental externality cost surcharges as an instrument in bringing about carbon reductions? To what extent could the minimization of total electricity costs alone result in carbon reductions relative to conventional resource plans?

Perceptions and experiences of financial incentives: a qualitative study of dialysis care in England.

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Abma, Inger; Jayanti, Anuradha; Bayer, Steffen; Mitra, Sandip; Barlow, James

2014-02-12

The objective of the study was to understand the extent to which financial incentives such as Payment by Results and other payment mechanisms motivate kidney centres in England to change their practices. The study followed a qualitative design. Data collection involved 32 in-depth semistructured interviews with healthcare professionals and managers, focusing on their subjective experience of payment structures. Participants were kidney healthcare professionals, clinical directors, kidney centre managers and finance managers. Healthcare commissioners from different parts of England were also interviewed. Participants worked at five kidney centres from across England. The selection was based on the prevalence of home haemodialysis, ranging from low (8%) prevalence, with at least one centre in each one of these categories at the time of selection. While the tariff for home haemodialysis is not a clear incentive for its adoption due to uncertainty about operational costs, Commissioning for Quality and Innovation (CQUIN) targets and the Best Practice Tariff for vascular access were seen by our case study centres as a motivator to change practices. The impact of financial incentives designed at a policy level is influenced by the understanding of cost and benefits at the local operational level. In a situation where costs are unclear, incentives which are based on the improvement of profit margins have a smaller impact than incentives which provide an additional direct payment, even if this extra financial support is relatively small.

A Different Kind of Smart: A Study of the Educational Obstacles Confronting Homeless Youth in New England.

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Wilson, Melanie; Houghton, Alison

This study provides information on obstacles facing homeless youth in school. Research occurred in four diverse New England cities. Researchers collected detailed case histories on youth age 10-15 years who were currently homeless or who had recently been homeless. Data came from staff of local youth agencies, government officials, and youths…

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

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

2016-05-03

To review all notified cases of leprosy in England and Wales between 1953 and 2012. National surveillance study of all reported cases. England and Wales. Number and characteristics of reported cases. During this period, a total of 1449 leprosy cases were notified. The incidence fell from 356 new cases notified between 1953 and 1962 to 139 new cases between 2003 and 2012. Where data were available, leprosy was more common in men, 15-45 year olds and those from the Indian subcontinent. There was considerable undernotification in 2001-2012. The high level of under-reporting indicates a need for improved surveillance in the UK. Public Health England, in collaboration with the UK Panel of Leprosy opinion, has revised the UK Memorandum on Leprosy in order to provide updated guidance on diagnostic procedures, treatment, case management, contact tracing and notification. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Schools That Make a Difference to Post-Compulsory Uptake of Physical Science Subjects: Some comparative case studies in England

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Bennett, Judith; Lubben, Fred; Hampden-Thompson, Gillian

2013-03-01

This paper presents the findings of the qualitative component of a combined methods research study that explores a range of individual and school factors that influence the uptake of chemistry and physics in post-compulsory study in England. The first phase involves using the National Pupil Database to provide a sampling frame to identify four matched pairs of high-uptake and low-uptake schools by salient school factors. Case studies of these eight schools indicate that students employ selection strategies related to their career aspirations, their sense of identity and tactics, and their prior experience. The school factors influencing subject choice relate to school management, student support and guidance, and student empowerment. The most notable differences between students in high-uptake and low-uptake schools are that students in high-uptake schools appear to make a proactive choice in relation to career aspirations, rather than a reactive choice on the basis of past experience. Schools with a high uptake offer a diverse science curriculum in the final two years of compulsory study, set higher examination entry requirements for further study and, crucially, provide a range of opportunities for students to interact with the world of work and to gain knowledge and experience of science-related careers.

Comparison of mortality following hospitalisation for isolated head injury in England and Wales, and Victoria, Australia.

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Belinda J Gabbe

Full Text Available BACKGROUND: Traumatic brain injury (TBI remains a leading cause of death and disability. The National Institute for Health and Clinical Excellence (NICE guidelines recommend transfer of severe TBI cases to neurosurgical centres, irrespective of the need for neurosurgery. This observational study investigated the risk-adjusted mortality of isolated TBI admissions in England/Wales, and Victoria, Australia, and the impact of neurosurgical centre management on outcomes. METHODS: Isolated TBI admissions (>15 years, July 2005-June 2006 were extracted from the hospital discharge datasets for both jurisdictions. Severe isolated TBI (AIS severity >3 admissions were provided by the Trauma Audit and Research Network (TARN and Victorian State Trauma Registry (VSTR for England/Wales, and Victoria, respectively. Multivariable logistic regression was used to compare risk-adjusted mortality between jurisdictions. FINDINGS: Mortality was 12% (749/6256 in England/Wales and 9% (91/1048 in Victoria for isolated TBI admissions. Adjusted odds of death in England/Wales were higher compared to Victoria overall (OR 2.0, 95% CI: 1.6, 2.5, and for cases <65 years (OR 2.36, 95% CI: 1.51, 3.69. For severe TBI, mortality was 23% (133/575 for TARN and 20% (68/346 for VSTR, with 72% of TARN and 86% of VSTR cases managed at a neurosurgical centre. The adjusted mortality odds for severe TBI cases in TARN were higher compared to the VSTR (OR 1.45, 95% CI: 0.96, 2.19, but particularly for cases <65 years (OR 2.04, 95% CI: 1.07, 3.90. Neurosurgical centre management modified the effect overall (OR 1.12, 95% CI: 0.73, 1.74 and for cases <65 years (OR 1.53, 95% CI: 0.77, 3.03. CONCLUSION: The risk-adjusted odds of mortality for all isolated TBI admissions, and severe TBI cases, were higher in England/Wales when compared to Victoria. The lower percentage of cases managed at neurosurgical centres in England and Wales was an explanatory factor, supporting the changes made to the NICE

Partnering for bioregionalism in England: a case study of the Westcountry Rivers Trust

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Hadrian Cook

2016-06-01

Full Text Available The adoption of bioregionalism by institutions that are instrumental in river basin management has significant potential to resolve complex water resource management problems. The Westcountry Rivers Trust (WRT in England provides an example of how localized bioregional institutionalization of adaptive comanagement, consensus decision making, local participation, indigenous technical and social knowledge, and "win-win" outcomes can potentially lead to resilient partnership working. Our analysis of the WRT's effectiveness in confronting nonpoint source water pollution, previously impervious to centralized agency responses, provides scope for lesson-drawing on institutional design, public engagement, and effective operation, although some evident issues remain.

Fatal Child Maltreatment in England, 2005-2009

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Sidebotham, Peter; Bailey, Sue; Belderson, Pippa; Brandon, Marian

2011-01-01

Objective: This paper presents comprehensive and up-to-date data covering 4 years of Serious Case Reviews into fatal child maltreatment in England. Methods: Information on all notified cases of fatal maltreatment between April 2005 and March 2009 was examined to obtain case characteristics related to a systemic classification of 5 broad groups of…

Sustained transmission of high-level azithromycin-resistant Neisseria gonorrhoeae in England: an observational study.

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Fifer, Helen; Cole, Michelle; Hughes, Gwenda; Padfield, Simon; Smolarchuk, Christa; Woodford, Neil; Wensley, Adrian; Mustafa, Nazim; Schaefer, Ulf; Myers, Richard; Templeton, Kate; Shepherd, Jill; Underwood, Anthony

2018-05-01

Between Nov 3, 2014, and Feb 24, 2017, 70 cases of high-level azithromycin-resistant (HL-AziR; minimum inhibitory concentration [MIC] ≥256 mg/L) Neisseria gonorrhoeae were reported from across England. Whole-genome sequencing was done to investigate this outbreak to determine whether the ongoing outbreak represented clonal spread of an HL-AziR N gonorrhoeae strain identified in Leeds. We also wanted to elucidate the molecular mechanisms of azithromycin resistance in N gonorrhoeae in the UK. In this observational study, whole-genome sequencing was done on the HL-AziR N gonorrhoeae isolates from England. As comparators, 110 isolates from the UK and Ireland with a range of azithromycin MICs were also sequenced, including eight isolates from Scotland with azithromycin MICs ranging from 0·12 mg/L to 1·00 mg/L that were N gonorrhoeae multi-antigen sequence type 9768 (ST9768), which was the sequence type initially responsible for the outbreak. The presence of mutations or genes associated with azithromycin resistance was also investigated. 37 of the 60 HL-AziR isolates from England belonged to ST9768, and were genetically similar (mean 4·3 single-nucleotide polymorphisms). A 2059A→G mutation was detected in three or all four alleles of the 23S rRNA gene. Five susceptible ST9768 isolates had one mutated 23S rRNA allele and one low-level resistant ST9768 isolate had two mutated alleles. Sustained transmission of a successful HL-AziR clone was seen across England. Mutation 2059A→G was found in isolates with lower azithromycin MICs. Azithromycin exposure might have provided the selection pressure for one or two mutated copies of the 23S rRNA gene to recombine with wild-type copies, leading to three or four mutated copies and the HL-AziR phenotype. HL-AziR could emerge in isolates with low azithromycin MICs and eliminate the effectiveness of azithromycin as part of dual therapy for the treatment of gonorrhoea. Public Health England. Copyright © 2018 Elsevier Ltd. All

Neutropenia and agranulocytosis in England and Wales: incidence and risk factors

NARCIS (Netherlands)

van Staa, T. P.; Boulton, F.; Cooper, C.; Hagenbeek, A.; Inskip, H.; Leufkens, H. G. M.

2003-01-01

The objectives of this study were to estimate the incidence of idiosyncratic neutropenia and agranulocytosis in England and Wales and to evaluate their risk factors and outcomes. The study was conducted using data from the General Practice Research Database. All cases of idiosyncratic neutropenia or

Integrating management tools and concepts to develop an estuarine planning support system: A case study of the Humber Estuary, Eastern England.

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Lonsdale, Jemma-Anne; Weston, Keith; Barnard, Steve; Boyes, Suzanne J; Elliott, Michael

2015-11-15

Estuaries are important because of their multiple uses and users which often makes them challenging to manage since management must strike a balance between the needs of users, the estuaries' ecological and economic value and the context of multiple legislative drivers. To facilitate management we have therefore developed an Estuarine Planning Support System (EPSS) framework using the Humber Estuary, Eastern England, as a case study which integrates the current legislation tools and concepts. This integrated EPSS framework is an improvement on previous approaches for assessing cumulative impacts as it takes into account legislative drivers, management tools and other mechanisms for controlling plans/projects specific to the estuary. It therefore enables managers and users to assess and address both the current state and the way in which a new industrial, port or urban development could impact an estuary in an accessible and understandable framework. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Incorporating global warming risks in power sector planning: A case study of the New England region

International Nuclear Information System (INIS)

Krause, F.; Busch, J.; Koomey, J.

1992-11-01

The following topics are described in reference to electric power production in New England: Fuel Prices; Emission Factors and Externality Surcharges; Cost and Potential of Demand-Site Efficiency Improvements; Fuel Switching; Conventional Utility Generation; Gas Supply Constraints; Cogeneration Potential; Biomass Resources; Potential Power Production from Municipal Solid Waste; and Wind Resource Potential

McDonald's restaurants and neighborhood deprivation in Scotland and England.

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Cummins, Steven C J; McKay, Laura; MacIntyre, Sally

2005-11-01

Features of the local fast food environment have been hypothesized to contribute to the greater prevalence of obesity in deprived neighborhoods. However, few studies have investigated whether fast food outlets are more likely to be found in poorer areas, and those that have are local case studies. In this paper, using national-level data, we examine the association between neighborhood deprivation and the density of McDonald's restaurants in small census areas (neighborhoods) in Scotland and England. Data on population, deprivation, and the location of McDonald's Restaurants were obtained for 38,987 small areas in Scotland and England (6505 "data zones" in Scotland, and 32,482 "super output areas" in England) in January 2005. Measures of McDonald's restaurants per 1000 people for each area were calculated, and areas were divided into quintiles of deprivation. Associations between neighborhood deprivation and outlet density were examined during February 2005, using one-way analysis of variance in Scotland, England, and both countries combined. Statistically significant positive associations were found between neighborhood deprivation and the mean number of McDonald's outlets per 1000 people for Scotland (p<0.001), England (p<0.001), and both countries combined (p<0.001). These associations were broadly linear with greater mean numbers of outlets per 1000 people occurring as deprivation levels increased. Observed associations between presence or absence of fast food outlets and neighborhood deprivation may provide support for environmental explanations for the higher prevalence of obesity in poor neighborhoods.

Rural Action: A Collection of Community Work Case Studies.

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Henderson, Paul, Ed.; Francis, David, Ed.

This book contains 10 case studies of rural community development in England, Wales, Scotland, Ireland, and Catalonia, as seen from the perspective of community-work practitioners. Development projects encompassed such activities as promotion of tourism, establishment of community centers, vocational training for school dropouts, adult community…

Translation and Manipulation in Renaissance England

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John Denton

2016-12-01

Full Text Available This supplementary volume to JEMS is part of an ongoing research project which began with a series of articles published by the author in the 1990s on the translation of Classical historical texts in Renaissance England. The methodology followed is that of Descriptive Translation Studies as developed by scholars such as Lefevere and Hermans with the accent on manipulation of the source text in line with the ideological stance of the translator and the need to ensure that readers of the translation received the ‘correct’ moral lessons.  Particular attention is devoted to a case study of the strategies followed in Thomas North’s domesticating English translation of Jacques Amyot’s French translation of Plutarch’s Lives and the consequences for Shakespeare’s perception of Plutarch.Biography John Denton was associate professor of English Language and Translation at the University of Florence until retirement in 2015. He  has published on contrastive analysis, history of translation (with special reference to the Early Modern England, religious discourse, literary and audiovisual translation. 

The future of smoking-attributable mortality: the case of England & Wales, Denmark and the Netherlands.

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Stoeldraijer, Lenny; Bonneux, Luc; van Duin, Coen; van Wissen, Leo; Janssen, Fanny

2015-02-01

We formally estimate future smoking-attributable mortality up to 2050 for the total national populations of England & Wales, Denmark and the Netherlands, providing an update and extension of the descriptive smoking-epidemic model. We used smoking prevalence and population-level lung cancer mortality data for England & Wales, Denmark and the Netherlands, covering the period 1950-2009. To estimate the future smoking-attributable mortality fraction (SAF) we: (i) project lung cancer mortality by extrapolating age-period-cohort trends, using the observed convergence of smoking prevalence and similarities in past lung cancer mortality between men and women as input; and (ii) add other causes of death attributable to smoking by applying a simplified version of the indirect Peto-Lopez method to the projected lung cancer mortality. The SAF for men in 2009 was 19% (44 872 deaths) in England & Wales, 22% (5861 deaths) in Denmark and 25% (16 385 deaths) in the Netherlands. In our projections, these fractions decline to 6, 12 and 14%, respectively, in 2050. The SAF for women peaked at 14% (38 883 deaths) in 2008 in England & Wales, and is expected to peak in 2028 in Denmark (22%) and in 2033 in the Netherlands (23%). By 2050, a decline to 9, 17 and 19%, respectively, is foreseen. Different indirect estimation methods of the SAF in 2050 yield a range of 1-8% (England & Wales), 8-13% (Denmark) and 11-16% (the Netherlands) for men, and 7-16, 12-26 and 13-31% for women. From northern European data we project that smoking-attributable mortality will remain important for the future, especially for women. Whereas substantial differences between countries remain, the age-specific evolution of smoking-attributable mortality remains similar across countries and between sexes. © 2014 Society for the Study of Addiction.

Temporal associations between national outbreaks of meningococcal serogroup W and C disease in the Netherlands and England: an observational cohort study.

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Knol, Mirjam J; Hahné, Susan J M; Lucidarme, Jay; Campbell, Helen; de Melker, Hester E; Gray, Stephen J; Borrow, Ray; Ladhani, Shamez N; Ramsay, Mary E; van der Ende, Arie

2017-10-01

Since 2009, the incidence of meningococcal serogroup W disease has increased rapidly in the UK because of a single strain (the so-called original UK strain) belonging to the hypervirulent sequence type-11 clonal complex (cc11), with a variant outbreak strain (the so-called 2013 strain) emerging in 2013. Subsequently, the Netherlands has had an increase in the incidence of meningococcal serogroup W disease. We assessed the temporal and phylogenetic associations between the serogroup W outbreaks in the Netherlands and England, and the historical serogroup C outbreaks in both countries. For this observational cohort study, we used national surveillance data for meningococcal serogroup W and serogroup C disease in the Netherlands and England for the epidemiological years (July to June) 1992-93 to 2015-16. We also did whole genome sequencing and core genome multilocus sequence typing (1546 loci) on serogroup W disease isolates from both countries for surveillance years 2008-09 to 2015-16. We used Poisson regression to compare the annual relative increase in the incidence of serogroup W and serogroup C between both countries. In the Netherlands, the incidence of meningococcal serogroup W disease increased substantially in 2015-16 compared with 2014-15, with an incidence rate ratio of 5·2 (95% CI 2·0-13·5) and 11% case fatality. In England, the incidence increased substantially in 2012-13 compared with 2011-12, with an incidence rate ratio of 1·8 (1·2-2·8). The relative increase in the Netherlands from 2014-15 to 2015-16 was 418% (95% CI 99-1248), which was significantly higher than the annual relative increase of 79% (61-99) per year in England from 2011-12 to 2014-15 (p=0·03). Cases due to meningococcal serogroup W cc11 (MenW:cc11) emerged in 2012-13 in the Netherlands. Of 29 MenW:cc11 cases found up to 2015-16, 26 (90%) were caused by the 2013 strain. For both the current serogroup W outbreak and the historical serogroup C outbreak, the increase in incidence

Variations in dementia diagnosis in England and association with general practice characteristics.

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Walker, Ian F; Lord, Paul A; Farragher, Tracey M

2017-05-01

Improving dementia diagnosis rates in England has been a key strategic aim of the UK Government but the variation and low diagnosis rates are poorly understood. The aim of this study was to explore the variation in actual versus expected diagnosis of dementia across England, and how these variations were associated with general practice characteristics. A cross-sectional, ecological study design using secondary data sources and median regression modelling was used. Data from the year 2011 for 7711 of the GP practices in England (92.7%). Associations of dementia diagnosis rates (%) per practice, calculated using National Health Service England's 'Dementia Prevalence Calculator' and various practice characteristics were explored using a regression model. The median dementia diagnosis rate was 41.6% and the interquartile range was 31.2-53.9%. Multivariable regression analysis demonstrated positive associations between dementia diagnosis rates and deprivation of the population, overall Quality and Outcomes Framework performance, type of primary care contract and size of practice list. Negative associations were found between dementia diagnosis rates and average experience of GPs in the practice and the proportion of the practice caseload over 65 years old. Dementia diagnosis rates vary greatly across GP practices in England. This study has found independent associations between dementia diagnosis rates and a number of patient and practice characteristics. Consideration of these factors locally may provide targets for case-finding interventions and so facilitate timely diagnosis.

Socioeconomic impacts of nuclear power plant siting: a case study of two New England communities

International Nuclear Information System (INIS)

Purdy, B.J.

1976-01-01

An examination is presented of the social, economic and political/institutional impacts of two operating nuclear power complexes on two New England communities. The work is one of a series planned to broaden knowledge of the effects of large energy-generating facilities upon the social structure of local communities. Its primary objectives are to investigate and assess social and economic impacts resulting from construction and operation of nuclear power plants and to generate hypotheses about such impacts for future testing

Fatal injuries while under the influence of psychoactive drugs: a cross-sectional exploratory study in England

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Dryden Ruth

2006-06-01

Full Text Available Abstract Background Studies of drug-related mortality rarely describe fatal injuries due to psychoactive drug intoxication (FIUI. The main aim of this study was to determine the nature, extent and pattern of FIUI. Methods This observational study covered the period January 1999 to December 2001. Data were provided by members of a study panel of coroners in England using a standard protocol. Sources of data for this study included autopsy protocols, death certificates, hospital records, police reports, toxicology reports and inquest transcripts. Inclusion criteria for this were (i the mention of one or more psychoactive substances as contributing to fatality; and (ii the presence of a Controlled Drug at post mortem. Results A total of 3,803 drug-related deaths of persons aged 16–64 years were reported by the study panel during the three-year period. The study panel accounted for 86% of drug-related deaths in England in this period. There were 147 FIUI cases (119 males, 28 females, giving a proportionate mortality ratio of approximately 4%. The majority of FIUI cases (84% were aged 16–44 years, with a median age at death of 33 years (Quartile deviation = 7. Fifty-six percent of FIUI occurred in urban areas of England. The population of the study jurisdictions aged 16–64 years contributed 49,545,766 person-years (py to the study, giving an annual crude rate of 3/1,000,000 person-years (py. Rates for male and females were 4.9 and 1.1/1,000,000 py respectively, giving a male/female rate ratio of 4.5 (95%CI = 2.9–6.8. The rates of intentional and unintentional FIUI were 2 and 1/1,000,000 py respectively. The leading mechanism for intentional FIUI was suffocation while the predominant mechanisms in unintentional FIUI were road traffic accidents and falls. There is a significant difference in the pattern of drug-specific risk between FIUI and fatal poisoning. Risks of intentional FIUI are elevated among Black and Minority Ethnic groups

Is education the best contraception: the case of teenage pregnancy in England?

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Girma, Sourafel; Paton, David

2015-04-01

This paper examines potential explanations for recent declines in teenage pregnancy in England. We estimate panel data models of teenage conception, birth and abortion rates from regions in England. Although point estimates are consistent with the promotion of long acting reversible contraception (LARC) having a negative impact on teenage pregnancy rates, the effects are generally small and statistically insignificant. In contrast, improvements in educational achievement and, to a lesser extent, increases in the non-white proportion of the population are associated with large and statistically significant reductions in teenage pregnancy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Improving School Leadership. Volume 2: Case Studies on System Leadership

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Hopkins, David, Ed.; Nusche, Deborah, Ed.; Pont, Beatriz, Ed.

2008-01-01

This book explores what specialists are saying about system leadership for school improvement. Case studies examine innovative approaches to sharing leadership across schools in Belgium (Flanders), Finland and the United Kingdom (England) and leadership development programmes for system improvement in Australia and Austria. As these are emerging…

75 FR 16096 - New England Power Generators Association Inc., Complainant v. ISO New England Inc., Respondent...

Science.gov (United States)

2010-03-31

...-787-000] New England Power Generators Association Inc., Complainant v. ISO New England Inc., Respondent; ISO New England Inc. and New England Power Pool; Notice of Complaint March 24, 2010. Take notice... Inc. (Complainant) filed a formal complaint against ISO New England Inc. (Respondent) alleging that...

Prevalence of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS in three regions of England: a repeated cross-sectional study in primary care

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Fayyaz Shagufta

2011-07-01

Full Text Available Abstract Background Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS or chronic fatigue syndrome (CFS has been used to name a range of chronic conditions characterized by extreme fatigue and other disabling symptoms. Attempts to estimate the burden of disease have been limited by selection bias, and by lack of diagnostic biomarkers and of agreed reproducible case definitions. We estimated the prevalence and incidence of ME/CFS in three regions in England, and discussed the implications of frequency statistics and the use of different case definitions for health and social care planning and for research. Methods We compared the clinical presentation, prevalence and incidence of ME/CFS based on a sample of 143,000 individuals aged 18 to 64 years, covered by primary care services in three regions of England. Case ascertainment involved: 1 electronic search for chronic fatigue cases; 2 direct questioning of general practitioners (GPs on cases not previously identified by the search; and 3 clinical review of identified cases according to CDC-1994, Canadian and Epidemiological Case (ECD Definitions. This enabled the identification of cases with high validity. Results The estimated minimum prevalence rate of ME/CFS was 0.2% for cases meeting any of the study case definitions, 0.19% for the CDC-1994 definition, 0.11% for the Canadian definition and 0.03% for the ECD. The overall estimated minimal yearly incidence was 0.015%. The highest rates were found in London and the lowest in East Yorkshire. All but one of the cases conforming to the Canadian criteria also met the CDC-1994 criteria, however presented higher prevalence and severity of symptoms. Conclusions ME/CFS is not uncommon in England and represents a significant burden to patients and society. The number of people with chronic fatigue who do not meet specific criteria for ME/CFS is higher still. Both groups have high levels of need for service provision, including health and social

Fertility, the Reproductive Lifespan and the Formal Curriculum in England: A Case for Reassessment

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Littleton, Fiona Kisby

2012-01-01

Historical studies have shown that, since its beginnings, sex education in England has mostly focused on "damage limitation", emphasising only the dangerous inevitability of pregnancy and childbirth after unprotected sex and the hazards of sexually transmitted diseases. This approach is largely based on restrictive notions of teenage…

Geography of hospital admissions for multiple sclerosis in England and comparison with the geography of hospital admissions for infectious mononucleosis: a descriptive study

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Ramagopalan, Sreeram V; Hoang, Uy; Seagroatt, Valerie; Handel, Adam; Ebers, George C; Giovannoni, Gavin

2011-01-01

Objective It is well recognised that variation in the geographical distribution of multiple sclerosis (MS) exists. Early studies in England have shown the disease to have been more common in the North than the South. However, this could be an artefact of inaccurate diagnosis and ascertainment, and recent data on MS prevalence are lacking. In the present study, data were analysed to provide a more contemporary map of the distribution of MS in England and, as infectious mononucleosis (IM) has been shown to be associated with the risk of MS, the geographical distribution of IM with that of MS was compared. Methods Analysis of linked statistical abstracts of hospital data for England between 1999 and 2005. Results There were 56 681 MS patients. The admission rate for MS was higher in females (22/105; 95% CI 21.8 to 22.3) than males (10.4/105; 95% CI 10.2 to 10.5). The highest admission rate for MS was seen for residents of Cumbria and Lancashire (North of England) (20.1/105; 95% CI 19.3 to 20.8) and the lowest admission rate was for North West London residents (South of England) (12.4/105; 95% CI 11.8 to 13.1). The geographical distributions of IM and MS were significantly correlated (weighted regression coefficient (r (w))=0.70, p<0.0001). Admission rates for MS were lowest in the area quintile with the highest level of deprivation and they were also lowest in the area quintile with the highest percentage of population born outside the UK. A significant association between northernliness and MS remained after adjustment for deprivation and UK birthplace. Conclusions The results show the continued existence of a latitude gradient for MS in England and show a correlation with the distribution of IM. The data have implications for healthcare provision, because lifetime costs of MS exceed £1 million per case in the UK, as well as for studies of disease causality and prevention. PMID:21212107

Rates of surgery for frozen shoulder: an experience in England.

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Kwaees, Tariq A; Charalambous, Charalambos P

2015-01-01

the aim of this study was to identify the incidence of surgical treatment for frozen shoulder in a western population. patients included in this study all resided within a well-defined area in the North West of England, all had surgery for frozen shoulder over a 3-year period and were identified from theatre logbooks of two local hospitals. Cases having surgery for shoulder stiffness other than frozen shoulder were excluded. Local and national population size estimates were based on data obtained from the UK Office for National Statistics. 117 patients underwent surgery for frozen shoulder during the period examined; of these 101 had arthroscopic arthrolysis and 16 had manipulation under anaesthesia. The overall incidence of frozen shoulder surgery was calculated at 2.67 procedures per 10,000 general population per year, and at 7.55 for those aged 40-60. surgical intervention for frozen shoulder is common, estimated at over 14,180 cases per year in England. Given the variation in costs associated with arthroscopic arthrolysis and manipulation under anaesthesia, comparative studies of the cost effectiveness of the two procedures would be of great value. 2C (outcome research).

Educating Anglicans: A case study investigating group work in the Church of England

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Roger Grainger

2014-12-01

Full Text Available The dominant form of group work in the Church of England is educational and directive. An investigation was carried out to determine whether other forms of group work could be valuable for the Church in addition to this approach. The same group of nine members, members of two Church of England parishes in the North of England, were involved in 12 sessions of group work, four sessions of each of the three types of group structure, in order for them to report their individual reactions to each type. An Interpretive Phenomenological Analysis (IPA showed that all three kinds of groups drew attention to four principle areas of comment. In all these kinds of groups, belonging, safety, enrichment and personalvalidation, with each one of the three groups scoring more highly than the other two on one or other of these dimensions. No group showed itself as more directly educational than the others, showing that, for church educational purposes, a range of group structures maybe used as actual learning comes from the experience of group membership itself. Using the qualitative research model of IPA, an investigation was carried out into the principal themes emerging from members’ self-reports concerning their experiences of the three different group structures, revealing four value constructs – belonging or alienation, safety or danger, enrichment or impoverishment and validation or rejection – which played a dominant role in all three kinds of groups. Taken together, each of the three group structures gave a different degree of prominence to each of the four evaluative constructs so that each of the three was shown to be particularly relevant for, and associated with, a particular area of experiential learning. Die onderrig van Anglikane – ’n ondersoek na groepwerk in die Kerk van Engeland: ’n gevallestudie. Die belangrikste vorm van groepwerk in die Kerk van Engeland is opvoedkundig en rigtinggewend van aard. ’n Ondersoek is gedoen na die

Homicide-suicide (dyadic death), homicide, and firearms use in England and Wales.

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Travis, Angela R; Johnson, Luke J; Milroy, Christopher M

2007-12-01

Homicide-suicide forms a distinct form of homicide. An analysis of cases in the Yorkshire and Humberside region of England between 1991 and 2005 revealed 37 episodes with 42 victims. Previous studies have shown a high rate of use of firearms. Over the last 2 decades firearms legislation has become more restrictive. In this study all assailants were male, mean age 46.8 years. The commonest method of homicide was strangulation (36%) with 16% killed by firearms. This is a reduction compared with a previous study in the same region. All killers who shot their victims killed themselves with firearms. There were no multiple killings with firearms in this study and no stranger killings. Hanging was the commonest method of suicide. During the same period the use of firearms as a method of homicide increased in England and Wales with handguns, the most common weapon. Nationally, suicide after homicide has remained at a similar rate over the half century and is an uncommon phenomenon. Firearms use remains low in both homicide and homicide-suicide episodes in England, and further analysis is required to determine changes in patterns of killing.

A qualitative study of uptake of free vitamins in England.

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Jessiman, Tricia; Cameron, Ailsa; Wiggins, Meg; Lucas, Patricia J

2013-08-01

To identify reasons why eligible families are not accessing free 'Healthy Start' vitamin supplementation (providing vitamins A, C and D) in England. Qualitative study using in-depth interviews. 13 primary care trusts in England. Purposive sample of 15 Healthy Start coordinators, 50 frontline health and children's professionals and 107 parents. Vitamin take-up was low across all research sites, reported as below 10% of eligible beneficiaries for free vitamins. Reasons identified by both parents and professionals included (1) poor accessibility of vitamins, (2) low promotion of the scheme by health professionals, (3) a lack of awareness among eligible families, and (4) low motivation among mothers to take vitamins for themselves during pregnancy or for children under 4 years old. Low uptake rates can be explained by poor accessibility of vitamins and lack of awareness and motivation to take vitamin supplements among eligible families. Universal provision (at least for pregnant women) and better training for health professionals are identified as potential solutions worthy of further research and evaluation.

A Population-Based Cohort Study of Emergency Appendectomy Performed in England and New York State.

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Al-Khyatt, Waleed; Mytton, Jemma; Tan, Benjamin H L; Aquina, Christopher T; Evison, Felicity; Fleming, Fergal J; Pasquali, Sandro; Griffiths, Ewen A; Vohra, Ravinder S

2017-08-01

To compare selected outcomes (30-day reoperation and total length of hospital stay) following emergency appendectomy between populations from New York State and England. This retrospective cohort study used demographic and in-hospital outcome data from Hospital Episode Statistics (HES) and the New York Statewide Planning and Research Cooperative System (SPARCS) administrative databases for all patients aged 18+ years undergoing appendectomy between April 2009 and March 2014. Univariate and adjusted multivariable logistic regression were used to test significant factors. A one-to-one propensity score matched dataset was created to compare odd ratios (OR) of reoperations between the two populations. A total of 188,418 patient records, 121,428 (64.4%) from England and 66,990 (35.6%) from NYS, were extracted. Appendectomy was completed laparoscopically in 77.7% of patients in New York State compared to 53.6% in England (P New York State, respectively. All 30-day reoperation rates were higher in England compared to New York State (1.2 vs. 0.6%, P New York State. Increasing the numbers of appendectomy completed laparoscopically may decrease length of stay and reoperations.

An outbreak of Salmonella dublin infection in England and Wales associated with a soft unpasteurized cows' milk cheese.

OpenAIRE

Maguire, H.; Cowden, J.; Jacob, M.; Rowe, B.; Roberts, D.; Bruce, J.; Mitchell, E.

1992-01-01

An outbreak of Salmonella dublin infection occurred in England and Wales in October to December 1989. Forty-two people were affected, mainly adults, and most lived in south-east England. Microbiological and epidemiological investigations implicated an imported Irish soft unpasteurized cows' milk cheese as the vehicle of infection. A case-control study showed a statistically significant association between infection and consumption of the suspect cheese (p = 0.001). Salmonella dublin was subse...

Suicide in children and young people in England: a consecutive case series.

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Rodway, Cathryn; Tham, Su-Gwan; Ibrahim, Saied; Turnbull, Pauline; Windfuhr, Kirsten; Shaw, Jenny; Kapur, Nav; Appleby, Louis

2016-08-01

There is concern about the mental health of children and young people and a possible rise in suicidal behaviour in this group. We have done a comprehensive national multi-agency study of suicide in under 20s in England. We aimed to establish how frequently suicide is preceded by child-specific and young person-specific suicide risk factors, as well as all-age factors, and to identify contact with health-care and social-care services and justice agencies. This study is a descriptive examination of suicide in a national consecutive sample of children and young people younger than 20 years who died by suicide in England between Jan 1, 2014, and April 30, 2015. We obtained general population mortality data from the Office for National Statistics (ONS). We collected information about antecedents considered to be relevant to suicide (eg, abuse, bullying, bereavement, academic pressures, self-harm, and physical health) from a range of investigations and inquiries, including coroner inquest hearings, child death investigations, criminal justice system reports, and the National Health Service, including data on people in contact with mental health services in the 12 months before their death. 145 suicides in people younger than 20 years were notified to us during the study period, of which we were able to obtain report data about antecedents for 130 (90%). The number of suicides rose sharply during the late teens with 79 deaths by suicide in people aged 18-19 years compared with 66 in people younger than 18 years. 102 (70%) deaths were in males. 92 (63%) deaths were by hanging. Various antecedents were reported among the individuals for whom we had report data, including academic (especially exam) pressures (35 [27%] individuals), bullying (28 [22%]), bereavement (36 [28%]), suicide in family or friends (17 [13%]), physical health conditions (47 [36%]), family problems (44 [34%]), social isolation or withdrawal (33 [25%]), child abuse or neglect (20 [15%]), excessive

Clinical negligence in hospitals in France and England.

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Kelly, Michael J; de Bono Q C, John; Métayer, Patrice

2015-12-01

This article arose from the back-to-back presentations by Michael Kelly and Patrice Métayer to the Anglo-French Medical Society in 2013 on the French and English legal systems handling a case of alleged clinical negligence as it proceeds from complaint to settlement or judgment in the two jurisdictions. Both systems have a hospital-based first stage with various avenues being available for amicable resolution, the French version being more regulated and prescribed than the English one. In both jurisdictions fewer than 5% cases go down the criminal route. Before the court is involved, in England there is an elaborate lawyer-controlled phase involving negotiations between the two sides and their experts which is expensive but often leads to pre-trial settlement for significant sums of money. Medical experts are central to all of this. In England they are largely unregulated and entirely advisory in an open market, in France they are both regulated and supervised by judges, being placed on official lists. These experts take a major inquisitorial role in a Debate between the two sides, combining the functions of Single Joint Expert (SJE), arbiter and mentor. If agreement is not reached, a second Debate before a different Expert is arranged. In both countries fewer than 5% cases reach a court for a hearing before a judge. In England a trial is an elaborate lengthy, expensive adversarial contest where all of the issues are rehearsed in full with factual and expert evidence, whereas in France in a contested case the judge reviews the reports of the two Debates with the lawyers who were involved (and not the experts, factual witnesses or parties). © The Author(s) 2015.

Protecting Geoheritage - Geodiversity Charter for England

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Dunlop, Lesley

2016-04-01

character and qualities across the country and the continued development and sharing of good geoconservation practice • encourage a sustained legacy through maintenance and conservation of museum geology collections and archives and support initiatives to reach a wide audience • integrate geodiversity into relevant local and national policies, guidance and advice ensuring a sustainable and integrated approach to the management of our natural environment for the wider benefit of England's people, environment and economy • carry out research to improve our understanding of the role of geodiversity in providing benefits to ecosystems and people, leading to better decisions about managing our natural environment • secure resources to support the delivery of these goals from a local to a national level through existing organisations and funding provision and continue to encourage the provision The Geodiversity Charter encourages determined action from all sectors of society to fulfil the vision set out above. There are a number of actions can be taken to achieve this ambition and sections within the Charter to explain how individuals, groups, industry, land owners and local government etc can become involved and a case study approach is used to highlight good practice. The Charter provides an opportunity to engage with organisations and to highlight the importance of the England's geoheritage using the clear objectives set out as guidance. English Geodiversity Forum, (2014) Geodiversity Charter for England, Keyworth, UK

Sarcomas in north west England: I. Histopathological peer review.

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Harris, M; Hartley, A L; Blair, V; Birch, J M; Banerjee, S S; Freemont, A J; McClure, J; McWilliam, L J

1991-08-01

A total of 468 cases of bone, soft tissue and visceral sarcomas (and certain other tumours) diagnosed during the years 1982-84 in North West England were entered in a study of histopathological peer review, incidence and survival. This paper describes the effects of peer review. Material was reviewed by a panel of five pathologists for 413 of the 450 cases originally registered as sarcomas with the Regional Cancer Registry. The diagnosis of sarcomas was confirmed in 76% cases and and there was agreement on sub-type for 53% cases. Measures of agreement were lowest for the two sub-types most commonly diagnosed i.e. malignant fibrous histiocytoma and leiomyosarcoma. Degree of agreement between individual pathologists and final panel diagnosis was also very variable but never less than 65%. It is concluded that second opinion is essential in cases of presumed sarcomas for studies of incidence and aetiology and to ensure that appropriate treatment is selected.

Tree rings and time: recent historical studies in England

Directory of Open Access Journals (Sweden)

Martin Bridge

2000-11-01

Full Text Available By studying the annual growth rings of long-lived trees, and those preserved in ancient timbers that have survived in waterlogged or very dry conditions, it is possible to date past events in calendar years and to investigate climatic and other environmental changes. Dendrochronology has many applications, including the dating of buildings and ships and the calibration of the radiocarbon timescale that is so widely used in archaeology. Here the technique is outlined and some recent applications of it in England are described.

Journal Articles as Case Studies--The New England Journal of Medicine on Breast Cancer.

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Herreid, Clyde Freeman

1994-01-01

Describes a case study on breast cancer and the access to adequate medical care to help demonstrate the use of the case study method in instruction. This is one of a series of articles written to stimulate interest in the use of the case study method in teaching undergraduate level science. (ZWH)

The New England travel market: changes in generational travel patterns

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Rodney B. Warnick

1995-01-01

The purpose of this study was to examine and explore the New England domestic travel market trends, from 1979 through 1991 within the context of generations. The existing travel markets, who travel to New England, are changing by age cohorts and specifically within different generations. The New England changes in generational travel patterns do not reflect national...

Recruiting Young Volunteers in an Area of Selective Education: A Qualitative Case Study

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Dean, Jon

2016-01-01

This article presents findings from a small qualitative case study of a youth volunteering brokerage organisation in England, operating in an area of selective state education. Data show how brokerage workers felt grammar schools managed their students in a concerted way to improve students' chances of attending university. Conversely, workers…

78 FR 1851 - New England States Committee on Electricity v. ISO New England Inc.; Notice of Complaint

Science.gov (United States)

2013-01-09

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL13-34-000] New England States Committee on Electricity v. ISO New England Inc.; Notice of Complaint Take notice that on December... (Complainant) filed a formal complaint against ISO New England Inc. (Respondent) alleging that the Respondent's...

Study protocol: cross-national comparative case study of recovery-focused mental health care planning and coordination (COCAPP).

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Simpson, Alan; Hannigan, Ben; Coffey, Michael; Jones, Aled; Barlow, Sally; Cohen, Rachel; Všetečková, Jitka; Faulkner, Alison; Haddad, Mark

2015-07-03

The collaborative care planning study (COCAPP) is a cross-national comparative study of care planning and coordination in community mental healthcare settings. The context and delivery of mental health care is diverging between the countries of England and Wales whilst retaining points of common interest, hence providing a rich geographical comparison for research. Across England the key vehicle for the provision of recovery-focused, personalised, collaborative mental health care is the care programme approach (CPA). The CPA is a form of case management introduced in England in 1991, then revised in 2008. In Wales the CPA was introduced in 2003 but has now been superseded by The Mental Health (Care Co-ordination and Care and Treatment Planning) (CTP) Regulations (Mental Health Measure), a new statutory framework. In both countries, the CPA/CTP requires providers to: comprehensively assess health/social care needs and risks; develop a written care plan (which may incorporate risk assessments, crisis and contingency plans, advanced directives, relapse prevention plans, etc.) in collaboration with the service user and carer(s); allocate a care coordinator; and regularly review care. The overarching aim of this study is to identify and describe the factors that ensure CPA/CTP care planning and coordination is personalised, recovery-focused and conducted collaboratively. COCAPP will employ a concurrent transformative mixed methods approach with embedded case studies. Phase 1 (Macro-level) will consider the national context through a meta-narrative mapping (MNM) review of national policies and the relevant research literature. Phase 2 (Meso-level and Micro-level) will include in-depth micro-level case studies of everyday 'frontline' practice and experience with detailed qualitative data from interviews and reviews of individual care plans. This will be nested within larger meso-level survey datasets, senior-level interviews and policy reviews in order to provide

Pulp fictions of medieval England: Essays in popular romance

OpenAIRE

McDonald, Nicola

2004-01-01

Middle English popular romance is the most audacious and compendious testimony to the imaginary world of the English Middle Ages. Yet, with few exceptions, it remains under read and under studied. Pulp fictions of medieval England demonstrates that popular romance merits and rewards serious critical attention and that it is crucial to our understanding of the complex and conflicted world of medieval England. Pulp fictions of medieval England comprises ten essays on individual romances that, w...

Severe Enterovirus Infections in Hospitalized Children in the South of England

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de Graaf, Hans; Pelosi, Emanuela; Cooper, Andrea; Pappachan, John; Sykes, Kim; MacIntosh, Iain; Gbesemete, Diane; Clark, Tristan W.; Patel, Sanjay V.; Faust, Saul N.

2016-01-01

Background: Most enterovirus surveillance studies lack detailed clinical data, which limits their clinical usefulness. This study aimed to describe the clinical spectrum and outcome of severe enterovirus infections in children, and to determine whether there are associations between causative enterovirus genotypes and clinical phenotypes. Methods: Retrospective analysis of microbiological and clinical data from a tertiary children’s hospital in the South of England over a 17-month period (2012–2013). Results: In total, 30 patients were identified, comprising sepsis (n = 9), myocarditis (n = 8), meningitis (n = 8) and encephalitis (n = 5). Cases with sepsis or myocarditis were significantly younger than those with central nervous system disease (median age 21 and 15 days vs. 79 days; P = 0.0244 and P = 0.0310, respectively). There was considerable diversity in the causative genotypes in each of the clinical phenotypes, with some predominance of echoviruses in the meningitis group, and coxsackie B viruses in the myocarditis group. Thirteen cases required mechanical ventilation, 11 cases inotropic support, 3 cases dialysis and 3 cases extracorporal membrane oxygenation. The overall mortality was 10% (sepsis group, n = 1; myocarditis group, n = 2). Of the survivors, 5 (19%) had long-term sequelae (myocardial dysfunction, n = 2; neurological sequelae, n = 3). Patients with encephalitis had the longest hospital stay (median: 16 days), compared with 9, 6 and 3 days in patients with myocarditis, sepsis and meningitis, respectively (P = 0.005). Conclusions: Enterovirus infections, particularly enteroviral myocarditis and encephalitis, can cause significant morbidity and mortality. The results show that there are currently no strong associations between clinical phenotypes and particular causative enterovirus genotypes in the South of England. PMID:26882165

Greenhouse gas inventories for England, Scotland, Wales and Northern Ireland: 1990 and 1995. A scoping study

Energy Technology Data Exchange (ETDEWEB)

Salway, A.G.; Dore, C.; Watterson, J.; Murrells, T.

1999-11-01

This report presents the results of a scoping study to develop a methodology to produce desegregated greenhouse gas emission inventories for the devoved administrations of the UK. Separate greenhouse gas emission inventories were estimated for England, Scotland, Wales and Northern Ireland for the years 1990 and 1995. The gases reported are carbon dioxide, methane, nitrous oxide, hydrofluorocarbons, perfluorocarbons, and SF{sub 6}. The estimates are consistent with the 1997 UK Greenhouse Gas Inventory and hence the UNFCCC reporting guidelines. Some emissions mainly mobile and offshore sources could not be allocated to any region, so an extra unallocated category was used to report these. Where possible the same methodology was used to calculate the regional emissions as for the UK Inventory. The study showed that the distribution of regional greenhouse gas emissions expressed as global warming potentials in 1995 were: England 75.5%, Scotland, 11.4%; Wales 6.4%; Northern Ireland 3.1%: unallocated, 4%. Following this scoping study, it is intended to publish annually disaggregated inventories for each year from 1990 for England, Scotland, Wales and Northern Ireland, in addition to the UK Greenhouse Gas Inventory. 50 refs., 6 figs., 16 tabs., 2 apps.

A New England Land-Grant Network; A Study of the Feasibility of Establishing Educational Information Links Between the Six Land-Grant Universities in New England.

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Bardwell, John D.

This study sought to identify physical facilities needed to connect the six New England land-grant universities. Criteria were time (use of current technology), cost (regular operating budgets of participating institutions), minimal personnel requirements, flexibility, and compatibility. The telephone system, an existing microwave network, a…

Factors Moderating Children's Adjustment to Parental Separation: Findings from a Community Study in England

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Cheng, Helen; Dunn, Judy; O'Connor, Thomas G.; Golding, Jean

2006-01-01

Research findings show that there is marked variability in children's response to parental separation, but few studies identify the sources of this variation. This prospective longitudinal study examines the factors modifying children's adjustment to parental separation in a community sample of 5,635 families in England. Children's…

Minority Voices: A Case Study of Children and Parents in a Manchester Primary School

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Winterbottom, Christian; Leedy, Allyson K.

2014-01-01

Presently, there are a growing number of ethnic minority students in the primary schools in northwest England. Through sociocultural theory, this paper examines student and parent perspectives of their experiences in the schools. Using a qualitative methodology, including observation, in-depth interviews, and field notes this case study focused on…

Identification of myocardial infarction type from electronic hospital data in England and Australia: a comparative data linkage study

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Nedkoff, Lee; Lopez, Derrick; Goldacre, Michael; Hobbs, Michael; Wright, F Lucy

2017-01-01

Objective To determine the utility of International Classification of Diseases (ICD) codes in investigating trends in ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) using person-linked electronic hospitalisation data in England and Western Australia (WA). Methods All hospital admissions with myocardial infarction (MI) as the principal diagnosis were identified from 2000 to 2013 from both jurisdictions. Fourth-digit ICD-10 codes were used to delineate all MI types—STEMI, NSTEMI, unspecified and subsequent MI. The annual frequency of each MI type was calculated as a proportion of all MI admissions. For all MI and each MI type, age-standardised rates were calculated and age-adjusted Poisson regression models used to estimate annual percentage changes in rates. Results In 2000, STEMI accounted for 49% of all MI admissions in England and 59% in WA, decreasing to 35% and 25% respectively by 2013. Less than 10% of admissions were recorded as NSTEMI in England throughout the study period, whereas by 2013, 70% of admissions were NSTEMI in WA. Unspecified MI comprised 60% of all MI admissions in England by 2013, compared with standards in each country. This has important implications for using electronic hospital data for monitoring MI and identifying MI types for outcome studies. PMID:29133337

Quantifying policy options for reducing future coronary heart disease mortality in England: a modelling study.

Directory of Open Access Journals (Sweden)

Shaun Scholes

Full Text Available To estimate the number of coronary heart disease (CHD deaths potentially preventable in England in 2020 comparing four risk factor change scenarios.Using 2007 as baseline, the IMPACTSEC model was extended to estimate the potential number of CHD deaths preventable in England in 2020 by age, gender and Index of Multiple Deprivation 2007 quintiles given four risk factor change scenarios: (a assuming recent trends will continue; (b assuming optimal but feasible levels already achieved elsewhere; (c an intermediate point, halfway between current and optimal levels; and (d assuming plateauing or worsening levels, the worst case scenario. These four scenarios were compared to the baseline scenario with both risk factors and CHD mortality rates remaining at 2007 levels. This would result in approximately 97,000 CHD deaths in 2020. Assuming recent trends will continue would avert approximately 22,640 deaths (95% uncertainty interval: 20,390-24,980. There would be some 39,720 (37,120-41,900 fewer deaths in 2020 with optimal risk factor levels and 22,330 fewer (19,850-24,300 in the intermediate scenario. In the worst case scenario, 16,170 additional deaths (13,880-18,420 would occur. If optimal risk factor levels were achieved, the gap in CHD rates between the most and least deprived areas would halve with falls in systolic blood pressure, physical inactivity and total cholesterol providing the largest contributions to mortality gains.CHD mortality reductions of up to 45%, accompanied by significant reductions in area deprivation mortality disparities, would be possible by implementing optimal preventive policies.

Quantifying policy options for reducing future coronary heart disease mortality in England: a modelling study.

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Scholes, Shaun; Bajekal, Madhavi; Norman, Paul; O'Flaherty, Martin; Hawkins, Nathaniel; Kivimäki, Mika; Capewell, Simon; Raine, Rosalind

2013-01-01

To estimate the number of coronary heart disease (CHD) deaths potentially preventable in England in 2020 comparing four risk factor change scenarios. Using 2007 as baseline, the IMPACTSEC model was extended to estimate the potential number of CHD deaths preventable in England in 2020 by age, gender and Index of Multiple Deprivation 2007 quintiles given four risk factor change scenarios: (a) assuming recent trends will continue; (b) assuming optimal but feasible levels already achieved elsewhere; (c) an intermediate point, halfway between current and optimal levels; and (d) assuming plateauing or worsening levels, the worst case scenario. These four scenarios were compared to the baseline scenario with both risk factors and CHD mortality rates remaining at 2007 levels. This would result in approximately 97,000 CHD deaths in 2020. Assuming recent trends will continue would avert approximately 22,640 deaths (95% uncertainty interval: 20,390-24,980). There would be some 39,720 (37,120-41,900) fewer deaths in 2020 with optimal risk factor levels and 22,330 fewer (19,850-24,300) in the intermediate scenario. In the worst case scenario, 16,170 additional deaths (13,880-18,420) would occur. If optimal risk factor levels were achieved, the gap in CHD rates between the most and least deprived areas would halve with falls in systolic blood pressure, physical inactivity and total cholesterol providing the largest contributions to mortality gains. CHD mortality reductions of up to 45%, accompanied by significant reductions in area deprivation mortality disparities, would be possible by implementing optimal preventive policies.

A Population-Based Study of Juvenile Perpetrators of Homicide in England and Wales

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Rodway, Cathryn; Norrington-Moore, Victoria; While, David; Hunt, Isabelle M.; Flynn, Sandra; Swinson, Nicola; Roscoe, Alison; Appleby, Louis; Shaw, Jenny

2011-01-01

This study aimed to describe the social, behavioural and offence characteristics of all convicted perpetrators of homicide aged 17 and under; to examine their previous contact with mental health services, and to discuss strategies for homicide prevention. An eight-year (1996-2004) sample of 363 juvenile homicide perpetrators in England and Wales…

Education governance and standardised tests in Denmark and England

DEFF Research Database (Denmark)

Kousholt, Kristine; Kelly, Peter; McNess, Elizabeth

2017-01-01

In this study we identify and compare the impact of standardised student assessment in England, an established neoliberal context, and in Denmark where a neoliberal education reform agenda is emerging in response to both national concerns and international governance. National reading tests...... for students aged 11–12 years, long established in England, were introduced in Denmark in 2010. The form they take differs considerably, being primarily formative in Denmark and largely summative in England. Culturally sensitive extended semi-structured interviews are conducted with both teachers and students...... they believe to be their students’ best interests. In England, however, teachers try to accommodate a concern for both their students’ and their own interests, and the pedagogy they enact is more often controlling, instrumental and reductionist; their wish to be proactive is compromised by their need...

Mortality from ruptured abdominal aortic aneurysms: clinical lessons from a comparison of outcomes in England and the USA.

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Karthikesalingam, Alan; Holt, Peter J; Vidal-Diez, Alberto; Ozdemir, Baris A; Poloniecki, Jan D; Hinchliffe, Robert J; Thompson, Matthew M

2014-03-15

The outcome of patients with ruptured abdominal aortic aneurysm (rAAA) varies by country. Study of practice differences might allow the formulation of pathways to improve care. We compared data from the Hospital Episode Statistics for England and the Nationwide Inpatient Sample for the USA for patients admitted to hospital with rAAA from 2005 to 2010. Primary outcomes were in-hospital mortality, mortality after intervention, and decision to follow non-corrective treatment. In-hospital mortality and the rate of non-corrective treatment were analysed by binary logistic regression for each health-care system, after adjustment for age, sex, year, and Charlson comorbidity index. The study included 11,799 patients with rAAA in England and 23,838 patients with rAAA in the USA. In-hospital mortality was lower in the USA than in England (53·05% [95% CI 51·26-54·85] vs 65·90%; pUSA than in England (19,174 [80·43%] vs 6897 [58·45%]; pUSA than in England (4003 [20·88%] vs 589 [8·54%]; pUSA). These observations persisted in age-matched and sex-matched comparisons. In both countries, reduced mortality was associated with increased use of endovascular repair, increased hospital caseload (volume) for rAAA, high hospital bed capacity, hospitals with teaching status, and admission on a weekday. In-hospital survival from rAAA, intervention rates, and uptake of endovascular repair are lower in England than in the USA. In England and the USA, the lowest mortality for rAAA was seen in teaching hospitals with larger bed capacities and doing a greater proportion of cases with endovascular repair. These common factors suggest strategies for improving outcomes for patients with rAAA. None. Copyright © 2014 Elsevier Ltd. All rights reserved.

Professional Development and the Teaching Schools Experiment in England: Leadership Challenges in an Alliance's First Year

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Dowling, Simon

2016-01-01

This article reports findings from the first year of a longitudinal, mixed-methods case study of a large teaching school alliance in England. This national initiative is intended to drive improvement at system level by grouping schools around formally designated teaching schools. These "alliances" work collaboratively to share learning,…

Trends in hospital admission rates for anorexia nervosa in Oxford (1968-2011) and England (1990-2011): database studies.

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Holland, Josephine; Hall, Nick; Yeates, David G R; Goldacre, Michael

2016-02-01

To report on long-term trends in hospital admission rates for anorexia nervosa using two English datasets. We used data on hospital day-case and inpatient care across five decades in the Oxford Record Linkage Study (ORLS), and similar data for all England from 1990. We analysed rates of admission for anorexia nervosa in people aged 10-44 years, using hospital episodes (counting every admission) and first-recorded admissions (counting only the first record for each person). Former Oxford NHS Region; and England. None; anonymous statistical records were used. In the longstanding ORLS, the age-standardised first-recorded admission rate for women was 2.7 (95% confidence interval 1.6-3.8) per 100,000 female population aged 10-44 years in 1968-1971; 2.7 (2.1-3.3) in 1992-1996; and 6.3 (5.5-7.2) in 2007-2011. Male rates were zero in the 1960s; 0.07 (0.0-0.1) per 100,000 men in 1992-1996; and 0.4 (0.2-0.6) in 2007-2011. In England, female rates increased from 4.2 (4.0-4.4) in 1998-2001 to 6.9 (6.7-7.1) in 2007-2011; and the corresponding male rates were 0.2 (0.1-0.3) and 0.5 (0.4-0.6). Episode-based admission rates rose more than person-based rates. The highest rates by far were in girls and women aged 15-19 years. In recent years, anorexia nervosa has become a greater burden on secondary care: not only have admission rates increased but so too have multiple admissions per person with anorexia nervosa. The increase in admission rates might reflect an increase in prevalence rates of anorexia nervosa in the general population, but other explanations, including lower clinical thresholds for admission, are possible and are discussed. © The Royal Society of Medicine.

Understanding differences in cervical cancer incidence in Western Europe: comparing Portugal and England.

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Mendes, Diana; Mesher, David; Pista, Angela; Baguelin, Marc; Jit, Mark

2018-04-01

Cervical cancer incidence has decreased over time in England particularly after the introduction of organized screening. In Portugal, where opportunistic screening has been widely available with only slightly lower coverage than that of the organized programme in England, rates of cervical cancer have been higher than in England. We compared the burden of cervical cancer, risk factors and preventive interventions over time in both countries, to identify elements hindering the further decline in incidence and mortality in Portugal. We used joinpoint regression to identify significant changes in rate time-trends. We also analyzed individual-level Portuguese data on sexual behaviour and human papillomavirus prevalence, and recent aggregate data on organized and opportunistic screening coverage. We compared published estimates of survival, risk factors and historical screening coverage for both countries. Despite stable incidence, cervical cancer mortality has declined in both countries in the last decade. The burden has been 4 cases and 1 death per 100 000 women annually higher in Portugal than in England. Differences in human papillomavirus prevalence and risk factors for infection and disease progression do not explain the difference found in cervical cancer incidence. Significant mortality declines in both countries followed the introduction of different screening policies, although England showed a greater decline than Portugal over nearly 2 decades after centralizing organized screening. The higher rates of cervical cancer in Portugal compared to England can be explained by differences in screening quality and coverage.

Geomorphology of New England

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Denny, C.S.

1982-01-01

Widely scattered terrestrial deposits of Cretaceous or Tertiary age and extensive nearshore and fluvial Coastal Plain deposits now largely beneath the sea indicate that the New England region has been above sea level during and since the Late Cretaceous. Estimates of rates of erosion based on sediment load in rivers and on volume of sediments in the Coastal Plain suggest that if the New England highlands had not been uplifted in the Miocene, the area would now be largely a lowland. If the estimated rates of erosion and uplift are of the right order of magnitude, then it is extremely unlikely that any part of the present landscape dates back before Miocene time. The only exception would be lowlands eroded in the early Mesozoic, later buried beneath Mesozoic and Cenozoic deposits, and exhumed by stream and glacial erosion during the later Cenozoic. Many of the rocks in the New England highlands are similar to those that underlie the Piedmont province in the central and southern Appalachians, where the relief over large areas is much less than in the highlands of New England. These comparisons suggest that the New England highlands have been upwarped in late Cenozoic time. The uplift took place in the Miocene and may have continued into the Quaternary. The New England landscape is primarily controlled by the underlying bedrock. Erosion and deposition during the Quaternary, related in large part to glaciation, have produced only minor changes in drainage and in topography. Shale and graywacke of Ordovician, Cambrian, and Proterozoic age forming the Taconic highlands, and akalic plutonic rocks of Mesozoic age are all highland makers. Sandstone and shale of Jurassic and Triassic age, similar rocks of Carboniferous age, and dolomite, limestone, and shale of Ordovician and Cambrian age commonly underlie lowlands. High-grade metapelites are more resistant than similar schists of low metamorphic grade and form the highest mountains in New England. Feldspathic rocks tend to

Neuro-Linguistic Programming and Learning: Teacher Case Studies on the Impact of NLP in Education

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Carey, John; Churches, Richard; Hutchinson, Geraldine; Jones, Jeff; Tosey, Paul

2010-01-01

This research paper reports on evidence from 24 teacher-led action research case studies and builds on the 2008 CfBT Education Trust published paper by Richard Churches and John West-Burnham "Leading learning through relationships: the implications of Neurolinguistic programming for personalisation and the children's agenda in England".…

In or Out: The Cultural Integration of Part-Time Faculty at Two New England Community Colleges

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Shanahan, Ellen C.

2013-01-01

Public community colleges rely increasingly on high percentages of adjunct or part-time faculty. While these faculty members often teach many course sections, they often are disconnected from the institutional culture and mission. This comparative case study examined two New England community colleges, one with 100% part-time faculty and one with…

EPA Region 1 - New England Towns, with Population

Data.gov (United States)

U.S. Environmental Protection Agency — The New England Town Boundary coverage is a compilation of coverages received from the six New England State GIS Offices. The EPA New England GIS Center appended the...

Quantifying the need for enhanced case management for TB patients as part of TB cohort audit in the North West of England: a descriptive study.

Science.gov (United States)

Tucker, Angela; Mithoo, Jeniffer; Cleary, Paul; Woodhead, Mark; MacPherson, Peter; Wingfield, Tom; Davies, Stefanie; Wake, Carolyn; McMaster, Paddy; Bertel Squire, S

2017-11-15

Patients with TB have diverse and often challenging clinical and social needs that may hamper successful treatment outcomes. Understanding the need for additional support during treatment (enhanced case management, or ECM) is important for workforce capacity planning. North West England TB Cohort Audit (TBCA) has introduced a 4-level ECM classification system (ECM 0-3) to quantify the need for ECM in the region. This study describes the data from the first 2 years of ECM classification. Data collected between April 2013 and July 2015 were used to analyse the proportions of patients allocated to each ECM level and the prevalence of social and clinical factors indicating need for ECM. Single variable and multivariable logistic regression models were constructed to examine the association between ECM level and treatment outcome. Of 1714 notified cases 99.8% were assigned an ECM level: 31% ECM1, 19% ECM2 and 14% ECM3. The most common factors indicating need for ECM were language barriers (20.3%) and clinical complexity (16.9%). 1342/1493 (89.9%) of drug-sensitive, non-CNS cases completed treatment within 12 months. Patients in ECM2 and 3 were less likely to complete treatment at 12 months than patients in ECM0 (adjusted OR 0.47 [95% CI 0.27-0.84] and 0.23 [0.13-0.41] respectively). Use of TBCA to quantify different levels of need for ECM is feasible and has demonstrated that social and clinical complexity is common in the region. Results will inform regional workforce planning and assist development of innovative methods to improve treatment outcomes in these vulnerable groups.

Socioeconomic disparities in first stroke incidence, quality of care, and survival: a nationwide registry-based cohort study of 44 million adults in England

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Benjamin D Bray, MD

2018-04-01

Full Text Available Summary: Background: We aimed to estimate socioeconomic disparities in the incidence of hospitalisation for first-ever stroke, quality of care, and post-stroke survival for the adult population of England. Methods: In this cohort study, we obtained data collected by a nationwide register on patients aged 18 years or older hospitalised for first-ever acute ischaemic stroke or primary intracerebral haemorrhage in England from July 1, 2013, to March 31, 2016. We classified socioeconomic status at the level of Lower Super Output Areas using the Index of Multiple Deprivation, a neighbourhood measure of deprivation. Multivariable models were fitted to estimate the incidence of hospitalisation for first stroke (negative binomial, quality of care using 12 quality metrics (multilevel logistic, and all-cause 1 year case fatality (Cox proportional hazards. Findings: Of the 43·8 million adults in England, 145 324 were admitted to hospital with their first-ever stroke: 126 640 (87% with ischaemic stroke, 17 233 (12% with intracerebral haemorrhage, and 1451 (1% with undetermined stroke type. We observed a socioeconomic gradient in the incidence of hospitalisation for ischaemic stroke (adjusted incidence rate ratio 2·0, 95% CI 1·7–2·3 for the most vs least deprived deciles and intracerebral haemorrhage (1·6, 1·3–1·9. Patients from the lowest socioeconomic groups had first stroke a median of 7 years earlier than those from the highest (p<0·0001, and had a higher prevalence of pre-stroke disability and diabetes. Patients from lower socioeconomic groups were less likely to receive five of 12 care processes but were more likely to receive early supported discharge (adjusted odds ratio 1·14, 95% CI 1·07–1·22. Low socioeconomic status was associated with a 26% higher adjusted risk of 1-year mortality (adjusted hazard ratio 1·26, 95% CI 1·20–1·33, for highest vs lowest deprivation decile, but this gradient was largely attenuated after

Postgraduate Work-Based Learning Programmes in English Higher Education: Exploring Case Studies of Organizational Practice

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Smith, Paul; Preece, David

2009-01-01

The first part of the paper outlines and discusses the nature of work-based learning (WBL) and WBL programmes, and the overall direction of government strategy towards WBL programmes in Higher Education (HE) in England, with particular reference to postgraduate programmes, policy documents, and the WBL literature. Drawing upon case study research,…

Barriers and facilitators to care for the terminally ill: a cross-country case comparison study of Canada, England, Germany, and the United States.

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Klinger, Christopher A; Howell, Doris; Zakus, David; Deber, Raisa B

2014-02-01

Why do many patients not die at their preferred location? Analyze system-level characteristics influencing the ability to implement best practices in delivering care for terminally ill adults (barriers and facilitators). Cross-country comparison study from a "most similar-most different" perspective, triangulating evidence from a scoping review of the literature, document analyses, and semi-structured key informant interviews. Case study of Canada, England, Germany, and the United States. While similar with regard to leading causes of death, patient needs, and potential avenues to care, different models of service provision were employed in the four countries studied. Although hospice and palliative care services were generally offered with standard care along the disease continuum and in various settings, and featured common elements such as physical, psycho-social, and spiritual care, outcomes (access, utilization, etc.) varied across jurisdictions. Barriers to best practice service provision included legislative (including jurisdictional), regulatory (e.g. education and training), and financial issues as well as public knowledge and perception ("giving up hope") challenges. Advance care planning, dedicated and stable funding toward hospice and palliative care, including caregiver benefits, population aging, and standards of practice and guidelines to hospice and palliative care, were identified as facilitators. Successful implementation of effective and efficient best practice approaches to care for the terminally ill, such as shared care, requires concerted action to align these system-level characteristics; many factors were identified as being essential but not sufficient. Policy implementation needs to be tailored to the respective health-care system(s), monitored, and fine-tuned.

Childhood cancer incidence and survival in Japan and England: A population-based study (1993-2010).

Science.gov (United States)

Nakata, Kayo; Ito, Yuri; Magadi, Winnie; Bonaventure, Audrey; Stiller, Charles A; Katanoda, Kota; Matsuda, Tomohiro; Miyashiro, Isao; Pritchard-Jones, Kathy; Rachet, Bernard

2018-02-01

The present study aimed to compare cancer incidence and trends in survival for children diagnosed in Japan and England, using population-based cancer registry data. The analysis was based on 5192 children with cancer (age 0-14 years) from 6 prefectural cancer registries in Japan and 21 295 children diagnosed in England during 1993-2010. Differences in incidence rates between the 2 countries were measured with Poisson regression models. Overall survival was estimated using the Kaplan-Meier method. Incidence rates for Hodgkin lymphoma, renal tumors and Ewing sarcomas in England were more than twice as high as those in Japan. Incidence of germ cell tumors, hepatic tumors, neuroblastoma and acute myeloid leukemia (AML) was higher in Japan than in England. Incidence of all cancers combined decreased in Japan throughout the period 1993 to 2010, which was mainly explained by a decrease in registration of neuroblastoma in infants. For many cancers, 5-year survival improved in both countries. The improvement in survival in chronic myeloid leukemia (CML) was particularly dramatic in both countries. However, 5-year survival remained less than 80% in 2005-2008 in both countries for AML, brain tumors, soft tissue sarcomas, malignant bone tumors and neuroblastoma (age 1-14 years). There were significant differences in incidence of several cancers between countries, suggesting variation in genetic susceptibility and possibly environmental factors. The decrease in incidence for all cancers combined in Japan was related to the cessation of the national screening program for neuroblastoma. The large improvement in survival in CML coincided with the introduction of effective therapy (imatinib). © 2017 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

Learning from contract change in primary care dentistry: A qualitative study of stakeholders in the north of England.

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Holmes, Richard D; Steele, Jimmy G; Donaldson, Cam; Exley, Catherine

2015-09-01

The aim of this research was to explore and synthesise learning from stakeholders (NHS dentists, commissioners and patients) approximately five years on from the introduction of a new NHS dental contract in England. The case study involved a purposive sample of stakeholders associated with a former NHS Primary Care Trust (PCT) in the north of England. Semi-structured interviews were conducted with 8 commissioners of NHS dental services and 5 NHS general dental practitioners. Three focus group meetings were held with 14 NHS dental patients. All focus groups and interviews were audio recorded and transcribed verbatim. The data were analysed using a framework approach. Four themes were identified: 'commissioners' views of managing local NHS dental services'; 'the risks of commissioning for patient access'; 'costs, contract currency and commissioning constraints'; and 'local decision-making and future priorities'. Commissioners reported that much of their time was spent managing existing contracts rather than commissioning services. Patients were unclear about the NHS dental charge bands and dentists strongly criticised the contract's target-driven approach which was centred upon them generating 'units of dental activity'. NHS commissioners remained relatively constrained in their abilities to reallocate dental resources amongst contracts. The national focus upon practitioners achieving their units of dental activity appeared to outweigh interest in the quality of dental care provided. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Key Strategies for Improving School Nutrition: A Case Study of Three School Nutrition Program Innovators

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Sacheck, Jennifer M.; Morgan, Emily H.; Wilde, Parke; Griffin, Timothy; Nahar, Elizabeth; Economos, Christina D.

2012-01-01

Purpose/Objective: This case study identified common elements of three diverse New England school districts that were real-world models of improving school meals. Methods: School districts that had greater than 1,000 students, [greater than or equal to]3 schools, and [greater than or equal to]40% of students who qualified for free- or…

Perspectives on the "Silent Period" for Emergent Bilinguals in England

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Bligh, Caroline; Drury, Rose

2015-01-01

This article draws together the research findings from two ethnographic studies as a means to problematize the "silent period" as experienced by young bilingual learners in two English speaking early-years settings in England. Most teachers and senior early-years practitioners in England are monolingual English speakers. The children…

Racism as Policy: A Critical Race Analysis of Education Reforms in the United States and England

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Gillborn, David

2014-01-01

Critical race theory (CRT) views education as one of the principal means by which white supremacy is maintained and presented as normal in society. The article applies CRT to two real-world case studies: changes to education statutes in the state of Arizona (USA) and the introduction of a new measure of educational success in England, the English…

A survey of non-accidental injury imaging in England, Scotland and Wales

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James, S L.J.; Halliday, K; Somers, J; Broderick, N

2003-09-01

AIM: To identify the potential national variation in non-accidental injury (NAI) imaging in England, Scotland and Wales. MATERIALS AND METHODS: A postal survey was sent to 323 hospitals with both paediatric and radiology departments. These were identified by a search through the Medical Directory. RESULTS: One hundred and thirteen of 323 postal questionnaires were returned within the study period (35%). Sixteen were excluded from the study because either no NAI imaging was performed at that institution or an incorrect address had been used. The total number of completed questionnaires was 97 (30%). Extensive variation was seen in all aspects of NAI imaging including imaging techniques used, total case numbers, follow-up imaging and those who report the NAI imaging. CONCLUSIONS: There is currently no national protocol that incorporates all aspects of NAI imaging in England, Scotland and Wales. Extensive variation in practice has been shown by this survey. Further standardization of NAI imaging practice is required. The draft BSPR skeletal survey guidelines and routine neurological imaging is recommended.

Radon atlas of England and Wales

International Nuclear Information System (INIS)

Green, B.M.R.; Miles, J.C.H.; Bradley, E.J.; Rees, D.M.

2002-01-01

This new report brings together and updates the information in three earlier reports on radon levels in English and Welsh homes. In particular, data from measurements in over 400,000 homes in England and Wales are presented in tabular format. The tables give the data by various administrative divisions, down to electoral wards for Cornwall, Devon and Somerset and council areas elsewhere and to sector level of the postcode system. The radon probability maps are based on the national grid system and show significantly more locational detail than the previous publications, an extra division in the probability banding to coincide with current Government initiatives on radon in England and, in southwest England, more detailed probability mapping than before - by 1 km grid squares in place of the 5 km grid squares used in Wales and the rest of England. (author)

Framing in policy processes: a case study from hospital planning in the National Health Service in England.

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Jones, Lorelei; Exworthy, Mark

2015-01-01

This paper reports from an ethnographic study of hospital planning in England undertaken between 2006 and 2009. We explored how a policy to centralise hospital services was espoused in national policy documents, how this shifted over time and how it was translated in practice. We found that policy texts defined hospital planning as a clinical issue and framed decisions to close hospitals or hospital departments as based on the evidence and necessary to ensure safety. We interpreted this framing as a rhetorical strategy for implementing organisational change in the context of community resistance to service closure and a concomitant policy emphasising the importance of public and patient involvement in planning. Although the persuasive power of the framing was limited, a more insidious form of power was identified in the way the framing disguised the political nature of the issue by defining it as a clinical problem. We conclude by discussing how the clinical rationale constrains public participation in decisions about the delivery and organisation of healthcare and restricts the extent to which alternative courses of action can be considered. Copyright © 2014 Elsevier Ltd. All rights reserved.

A new sentinel surveillance system for severe influenza in England shows a shift in age distribution of hospitalised cases in the post-pandemic period.

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Shelly Bolotin

Full Text Available BACKGROUND: The World Health Organization and European Centre for Disease Prevention and Control have highlighted the importance of establishing systems to monitor severe influenza. Following the H1N1 (2009 influenza pandemic, a sentinel network of 23 Trusts, the UK Severe Influenza Surveillance System (USISS, was established to monitor hospitalisations due to confirmed seasonal influenza in England. This article presents the results of the first season of operation of USISS in 2010/11. METHODOLOGY/PRINCIPAL FINDINGS: A case was defined as a person hospitalised with confirmed influenza of any type. Weekly aggregate numbers of hospitalised influenza cases, broken down by flu type and level of care, were submitted by participating Trusts. Cases in 2010/11 were compared to cases during the 2009 pandemic in hospitals with available surveillance data for both time periods (n = 19. An unexpected resurgence in seasonal A/H1N1 (2009 influenza activity in England was observed in December 2010 with reports of severe disease. Reported cases over the period of 4 October 2010 to 13 February 2011 were mostly due to influenza A/H1N1 (2009. One thousand and seventy-one cases of influenza A/H1N1 (2009 occurred over this period compared to 409 at the same Trusts over the 2009/10 pandemic period (1 April 2009 to 6 January 2010. Median age of influenza A/H1N1 (2009 cases in 2010/11 was 35 years, compared with 20 years during the pandemic (p = <0.0001. CONCLUSIONS/SIGNIFICANCE: The Health Protection Agency successfully established a sentinel surveillance system for severe influenza in 2010/11, detecting a rise in influenza cases mirroring other surveillance indicators. The data indicate an upward shift in the age-distribution of influenza A/H1N1 (2009 during the 2010/11 influenza season as compared to the 2009/10 pandemic. Systems to enable the ongoing surveillance of severe influenza will be a key component in understanding and responding to the evolving

Comparative epidemiology of Clostridium difficile infection: England and the USA.

Science.gov (United States)

King, Alice; Mullish, Benjamin H; Williams, Horace R T; Aylin, Paul

2017-10-01

To examine whether there is an epidemiological difference between Clostridium difficile infection (CDI) inpatient populations in England and the United States. A cross-sectional study. National administrative inpatient discharge data from England (Hospital Episode Statistics) and the USA (National Inpatient Sample) in 2012. De-identifiable non-obstetric inpatient discharges from the national datasets were used to estimate national CDI incidence in the United States and England using ICD9-CM(008.45) and ICD10(A04.7) respectively. The rate of CDI was calculated per 100 000 population using national population estimates. Rate per 100 000 inpatient discharges was also calculated separated by primary and secondary diagnosis of CDI. Age, sex and Elixhauser comorbidities profiles were examined. The USA had a higher rate of CDI compared to England: 115.1/100 000 vs. 19.3/100 000 population (P USA (OR 1.20 95% CI [1.18,1.22] P USA compared to England apart from dementia, which was greater in England (9.63% vs. 1.25%, P USA was much higher than in England. Age and comorbidity profiles also differed between CDI patients in both countries. The reasons for this are likely multi-factorial but may reflect national infection control policy. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Options for the management of Chernobyl-restricted areas in England and Wales

International Nuclear Information System (INIS)

Nisbet, A.; Woodman, R.

1999-01-01

Areas in England and Wales are still subject to restrictions on tile movement, sale and slaughter of sheep because concentrations of radiocaesium in sheep meat may exceed the 1000 Bq kg -1 limit imposed after the Chernobyl nuclear power plant accident. Various monitoring programmes have been implemented to enable lamb production to be sustained in these restricted areas, although no alternative management strategies have been considered to date. Current management practices have been reviewed and costed. An assessment has also been undertaken to establish the practicability and cost effectiveness of five alternative management options. The practicability of each option, which encompasses technical feasibility, capacity, cost, impact and acceptability, was assessed through a series of case studies carried out on farms in the restricted area of north Wales, and through consultation with a range of organisations with interests in farming and/or the environment. Recommendations are made for the future management of the restricted areas in England and Wales. (author)

Compiling a national register of babies born with anophthalmia/microphthalmia in England 1988-94

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Busby, A.; Dolk, H.; Collin, R.; Jones, R; Winter, R.

1998-01-01

AIM—To describe the prevalence of anophthalmia/microphthalmia in babies born in England 1988-94, as well as their overall survival, and the incidence of associated eye and non-eye malformations; to determine the usefulness of different sources of medical and health service information for establishing a retrospective register of anophthalmia/microphthalmia.
METHODS—Multiple sources for initial (retrospective) case ascertainment were surveyed, followed by questionnaires to clinicians to establish severity, associated malformations, and aetiology for England, 1988-94. The population surveyed was all births in England for this time period (4 570 350 births). Cases included live births, stillbirths, or terminations after prenatal diagnosis of congenital anomaly, with anophthalmia/microphthalmia, with or without other malformations and syndromes. Trisomy 13 was subsequently excluded.
RESULTS—The proportion of cases notified by any one information source was not more than 26% (Office for National Statistics Register 22%, paediatricians 26%, district sources 25%). Sixty nine per cent of cases (51% of severe cases) were notified by only one source. A total of 449 cases were reported, prevalence 1.0 per 10 000 births. The prevalence was stable over time, although the proportion notified by clinicians rose in more recent years. Thirty four per cent of affected babies had mild microphthalmia. Of those with severe anophthalmia/microphthalmia, 51% were bilateral, other eye malformations were present in 72%, non-eye malformations in 65%, and a "known aetiology" was attributed in 22%. Three quarters of those severely affected survived infancy.
CONCLUSIONS—Despite high response rates from the sources of information contacted, the lack of duplication between sources indicates the difficulties of retrospective ascertainment and the need for multiple sources when establishing a register. Anophthalmos/microphthalmos is usually associated with other malformations. Most

78 FR 32384 - New England Power Generators Association v. ISO New England Inc.; Notice of Complaint

Science.gov (United States)

2013-05-30

... Power Generators Association v. ISO New England Inc.; Notice of Complaint Take notice that on May 17... New England Power Generators Association (Complainant) filed a formal complaint against ISO New...., Washington, DC 20426. This filing is accessible on-line at http://www.ferc.gov , using the ``eLibrary'' link...

Quantifying the need for enhanced case management for TB patients as part of TB cohort audit in the North West of England: a descriptive study

Directory of Open Access Journals (Sweden)

Angela Tucker

2017-11-01

Full Text Available Abstract Background Patients with TB have diverse and often challenging clinical and social needs that may hamper successful treatment outcomes. Understanding the need for additional support during treatment (enhanced case management, or ECM is important for workforce capacity planning. North West England TB Cohort Audit (TBCA has introduced a 4-level ECM classification system (ECM 0–3 to quantify the need for ECM in the region. This study describes the data from the first 2 years of ECM classification. Methods Data collected between April 2013 and July 2015 were used to analyse the proportions of patients allocated to each ECM level and the prevalence of social and clinical factors indicating need for ECM. Single variable and multivariable logistic regression models were constructed to examine the association between ECM level and treatment outcome. Results Of 1714 notified cases 99.8% were assigned an ECM level: 31% ECM1, 19% ECM2 and 14% ECM3. The most common factors indicating need for ECM were language barriers (20.3% and clinical complexity (16.9%. 1342/1493 (89.9% of drug-sensitive, non-CNS cases completed treatment within 12 months. Patients in ECM2 and 3 were less likely to complete treatment at 12 months than patients in ECM0 (adjusted OR 0.47 [95% CI 0.27–0.84] and 0.23 [0.13–0.41] respectively. Conclusions Use of TBCA to quantify different levels of need for ECM is feasible and has demonstrated that social and clinical complexity is common in the region. Results will inform regional workforce planning and assist development of innovative methods to improve treatment outcomes in these vulnerable groups.

Prevalence of diabetic macular oedema and related health and social care resource use in England.

Science.gov (United States)

Minassian, D C; Owens, D R; Reidy, A

2012-03-01

To address the absence from the public health ophthalmology literature of age- and sex-specific prevalence and related resource use for diabetic macular oedema (DMO) in England, UK. Calculation of age- and sex-specific rates from primary source clinical data, and application to the demographic structure of England to estimate the number of cases affected by DMO. A public health commissioner and provider of social care perspective was adopted in a standard cost of illness study. The number of people with diabetes in England in 2010 was estimated at 2,342,951 of which 2,334,550 were aged ≥ 12 years. An estimated 166,325 (7.12%) had DMO in one or both eyes, and of these, 64,725 individuals had clinically significant DMO reducing the visual acuity to poorer than 6/6 in at least one eye. The overall health and social care costs in 2010, on the pathway from screening to rehabilitation and care in the home, are estimated at £116,296,038. The outcomes of this study should alert public health commissioners and clinical providers to the burden of DMO. The methods employed should also encourage the use of clinical ophthalmic data at the interface between local population and hospital-based recording systems.

Improving the health forecasting alert system for cold weather and heat-waves in England: a case-study approach using temperature-mortality relationships

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Masato, Giacomo; Cavany, Sean; Charlton-Perez, Andrew; Dacre, Helen; Bone, Angie; Carmicheal, Katie; Murray, Virginia; Danker, Rutger; Neal, Rob; Sarran, Christophe

2015-04-01

The health forecasting alert system for cold weather and heatwaves currently in use in the Cold Weather and Heatwave plans for England is based on 5 alert levels, with levels 2 and 3 dependent on a forecast or actual single temperature action trigger. Epidemiological evidence indicates that for both heat and cold, the impact on human health is gradual, with worsening impact for more extreme temperatures. The 60% risk of heat and cold forecasts used by the alerts is a rather crude probabilistic measure, which could be substantially improved thanks to the state-of-the-art forecast techniques. In this study a prototype of a new health forecasting alert system is developed, which is aligned to the approach used in the Met Office's (MO) National Severe Weather Warning Service (NSWWS). This is in order to improve information available to responders in the health and social care system by linking temperatures more directly to risks of mortality, and developing a system more coherent with other weather alerts. The prototype is compared to the current system in the Cold Weather and Heatwave plans via a case-study approach to verify its potential advantages and shortcomings. The prototype health forecasting alert system introduces an "impact vs likelihood matrix" for the health impacts of hot and cold temperatures which is similar to those used operationally for other weather hazards as part of the NSWWS. The impact axis of this matrix is based on existing epidemiological evidence, which shows an increasing relative risk of death at extremes of outdoor temperature beyond a threshold which can be identified epidemiologically. The likelihood axis is based on a probability measure associated with the temperature forecast. The new method is tested for two case studies (one during summer 2013, one during winter 2013), and compared to the performance of the current alert system. The prototype shows some clear improvements over the current alert system. It allows for a much greater

A call for improved transparency in financial aspects of clinical trials: a case study of the CREATE-X trial in the New England Journal of Medicine.

Science.gov (United States)

Ozaki, Akihiko; Takita, Morihito; Tanimoto, Tetsuya

2018-06-01

Introduction Globally, laws and guidelines for managing conflict of interest are increasingly implemented to achieve transparency in financial ties between physicians and pharmaceutical and medical device industries, yet little information is available regarding the limitations of the current frameworks for disclosing these financial ties. Case In June 2017, the Capecitabine for Residual Cancer as Adjuvant Therapy (CREATE-X) trial was published in the New England Journal of Medicine. In this study, which suggested the post-surgery addition of capecitabine would improve survival of high-risk breast cancer patients, the cost of capecitabine for off-label use was illegally claimed to the Japanese public health insurance system, rather than being covered by the research budget. This illegal claim led to the profit of more than 100,000,000 JPY (approximately 0.91 million USD) for Chugai Pharmaceutical Company (CPC), which manufactures capecitabine. Additional evidence suggests that the CPC made donations of at least 100,000,000 JPY (approximately 0.91 million USD) and 236,000,000 JPY (approximately 2.1 million USD) to the Japan Breast Cancer Research Group (JBCRG), the study's sponsor and funder where the majority of the Japanese authors served high-level positions, and the Advanced Clinical Research Organization, the other study funder, respectively, during the study period, though the total amount has not been clarified. Neither the CPC's involvement nor its undue profit was mentioned in the published article. Conclusion This case report highlights the lack of financial transparency in the CREATE-X trial, and discusses the potential limitations that may exist in the current frameworks for disclosing financial ties between physicians and relevant industries in clinical trials. Achieving improved transparency is essential to heighten credibility in the findings of clinical trials.

The potential for measles transmission in England

Directory of Open Access Journals (Sweden)

Fraser Graham

2008-09-01

Full Text Available Abstract Background Since the schools vaccination campaign in 1994, measles has been eliminated from England. Maintaining elimination requires low susceptibility levels to keep the effective reproduction number R below 1. Since 1995, however, MMR coverage in two year old children has decreased by more than 10%. Methods Quarterly MMR coverage data for children aged two and five years resident in each district health authority in England were used to estimate susceptibility to measles by age. The effective reproduction numbers for each district and strategic health authority were calculated and possible outbreak sizes estimated. Results In 2004/05, about 1.9 million school children and 300,000 pre-school children were recorded as incompletely vaccinated against measles in England, including more than 800,000 children completely unvaccinated. Based on this, approximately 1.3 million children aged 2–17 years were susceptible to measles. In 14 of the 99 districts, the level of susceptibility is sufficiently high for R to exceed 1, indicating the potential for sustained measles transmission. Eleven of these districts are in London. Our model suggests that the potential exists for an outbreak of up to 100,000 cases. These results are sensitive to the accuracy of reported vaccination coverage data. Conclusion Our analysis identified several districts with the potential for sustaining measles transmission. Many London areas remain at high risk even allowing for considerable under-reporting of coverage. Primary care trusts should ensure that accurate systems are in place to identify unimmunised children and to offer catch-up immunisation for those not up to date for MMR.

Applications of biological tools or biomarkers in aquatic biota: A case study of the Tamar estuary, South West England.

Science.gov (United States)

Dallas, Lorna J; Jha, Awadhesh N

2015-06-30

Biological systems are the ultimate recipients of pollutant-induced damage. Consequently, our traditional reliance on analytical tools is not enough to assess ecosystem health. Biological responses or biomarkers are therefore also considered to be important tools for environmental hazard and risk assessments. Due to historical mining, other anthropogenic activities, and its conservational importance (e.g. NATURA sites, SACs), the Tamar estuary in South West England is an ideal environment in which to examine applications of such biological tools. This review presents a thorough and critical evaluation of the different biological tools used in the Tamar estuary thus far, while also discussing future perspectives for biomarker studies from a global perspective. In particular, we focus on the challenges which hinder applications of biological tools from being more readily incorporated into regulatory frameworks, with the aim of enabling both policymakers and primary stakeholders to maximise the environmental relevance and regulatory usefulness of such tools. Copyright © 2015 Elsevier Ltd. All rights reserved.

Elevated bladder cancer in northern New England: The role of drinking water and arsenic

Science.gov (United States)

Baris, Dalsu; Wadell, Richard; Freeman, Laura; Schwenn, Molly; Colt, Joanne; Ayotte, Joseph; Ward, Mary; Nuckols, John; Schned, Alan; Jackson, Brian; Clerkin, Castine; Rothman, Nathanial; Moore, Lee; Taylor, Anne; Robinson, Gilpin; Hosain, Monawar G.; Armenti, Carla; McCoy, Richard; Samanic, Claudine; Hoover, Robert; Fraumeni, Joseph; Johnson, Alison; Karagas, Margaret; Silverman, Debra

2016-01-01

Background: Bladder cancer mortality rates have been elevated in northern New England for at least five decades. Incidence rates in Maine, New Hampshire, and Vermont are about 20% higher than the United States overall. We explored reasons for this excess, focusing on arsenic in drinking water from private wells, which are particularly prevalent in the region.Methods: In a population-based case-control study in these three states, 1213 bladder cancer case patients and 1418 control subjects provided information on suspected risk factors. Log transformed arsenic concentrations were estimated by linear regression based on measurements in water samples from current and past homes. All statistical tests were two-sided.Results: Bladder cancer risk increased with increasing water intake ( Ptrend = .003). This trend was statistically significant among participants with a history of private well use ( Ptrend = .01). Among private well users, this trend was apparent if well water was derived exclusively from shallow dug wells (which are vulnerable to contamination from manmade sources, Ptrend = .002) but not if well water was supplied only by deeper drilled wells ( Ptrend = .48). If dug wells were used pre-1960, when arsenical pesticides were widely used in the region, heavier water consumers (>2.2 L/day) had double the risk of light users (bladder cancer risk in New England. In addition, historical consumption of water from private wells, particularly dug wells in an era when arsenical pesticides were widely used, was associated with increased bladder cancer risk and may have contributed to the New England excess.

"Willing Enthusiasts" or "Lame Ducks"? Issues in Teacher Professional Development Policy in England and Wales 1910-1975

Science.gov (United States)

Robinson, Wendy; Bryce, Marie

2013-01-01

Though there is a well-established body of research in the field of teacher professional development, it is characterised by a real dearth of any detailed historical analysis. This paper seeks to address this gap, by offering a new historical analysis of a case study of the evolution of organised teacher professional development in England and…

Emerging Voices: "Speak White": Language Policy, Immigration Discourse, and Tactical Authenticity in a French Enclave in New England

Science.gov (United States)

Peters, Jason

2013-01-01

This article provides a historical case study of the Sentinelle Affair, a conflict between French language rights and the English Only educational policies of the Catholic Church in New England in the 1920s. An analysis of this conflict reveals a correspondence between programs of language centralization and the production of language differences…

Identifying dietary differences between Scotland and England: a rapid review of the literature.

Science.gov (United States)

Chambers, Stephanie; Barton, Karen L; Albani, Viviana; Anderson, Annie S; Wrieden, Wendy L

2017-10-01

Rates of premature mortality have been higher in Scotland than in England since the 1970s. Given the known association of diet with chronic disease, the study objective was to identify and synthesise evidence on current and historical differences in food and nutrient intakes in Scotland and England. A rapid review of the peer-reviewed and grey literature was carried out. After an initial scoping search, Medline, CINAHL, Embase and Web of Science were searched. Relevant grey literature was also included. Inclusion criteria were: any date; measures of dietary intake; representative populations; cross-sectional or observational cohort studies; and English-language publications. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. A narrative synthesis of extracted information was conducted. Fifty publications and reports were included in the review. Results indicated that children and adults in Scotland had lower intakes of vegetables and vitamins compared with those living in England. Higher intakes of salt in Scotland were also identified. Data were limited by small Scottish samples, difficulty in finding England-level data, lack of statistical testing and adjustment for key confounders. Further investigation of adequately powered and analysed surveys is required to examine more fully dietary differences between Scotland and England. This would provide greater insight into potential causes of excess mortality in Scotland compared with England and suitable policy recommendations to address these inequalities.

The nursing contribution to chronic disease management: a case of public expectation? Qualitative findings from a multiple case study design in England and Wales.

Science.gov (United States)

Wilson, Patricia Mary; Brooks, Fiona; Procter, Susan; Kendall, Sally

2012-01-01

The global response to the rise in prevalence of chronic disease is a focus on the way services are managed and delivered, in which nurses are seen as central in shaping patient experience. However, there is relatively little known on how patients perceive the changes to service delivery envisaged by chronic care models. The PEARLE project aimed to explore, identify and characterise the origins, processes and outcomes of effective chronic disease management models and the nursing contributions to the models. Design, settings and participants Case study design of seven sites in England and Wales ensuring a range of chronic disease management models. Participants included over ninety patients and family carers ranging in age from children to older people with conditions such as diabetes, respiratory disease, epilepsy, or coronary heart disease. Semi-structured interviews with patients and family carers. Focus groups were conducted with adolescents and children. A whole systems approach guided data collection and data were thematically analysed. Despite nurses' role and skill development and the shift away from the acute care model, the results suggested that patients had a persisting belief in the monopoly of expertise continuing to exist in the acute care setting. Patients were more satisfied if they saw the nurse as diagnostician, prescriber and medical manager of the condition. Patients were less satisfied when they had been transferred from an established doctor-led to nurse-led service. While nurses within the study were highly skilled, patient perception was guided by the familiar rather than most appropriate service delivery. Most patients saw chronic disease management as a medicalised approach and the nursing contribution was most valued when emulating it. Patients' preferences and expectations of chronic disease management were framed by a strongly biomedical discourse. Perceptions of nurse-led chronic disease management were often shaped by what was

Meeting needs of Muslim girls in school sport: case studies exploring cultural and religious diversity.

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Benn, Tansin; Pfister, Gertrud

2013-01-01

This paper contains a sociocultural analysis of school sport experiences of Muslim girls in two countries with different gender policies in physical education (PE) classes: England and Denmark. In Denmark, PE lessons take place in co-educative classes, in England schools are more diverse, with predominantly co-educational but also single-sex and faith schools offering different learning contexts. Two case studies from Denmark and England are used to explore the experiences of migrant Muslim girls in these different settings. A social constructionist approach to gender underpins the interpretation of stakeholders' voices on the inclusion of Muslim girls and the analysis of PE discourses in these countries. Findings illustrate similarities and differences at the interface of cultural diversity, political rhetoric of inclusion and realities of sport experiences for Muslim girls in both countries. Complex influences on PE experiences include gender stereotypes, cultural and religious orientations and practices, as well as actions and expectations of parents, communities and coaches/teachers. The studies provide insights into the ways participants managed their identities as Muslim girls in different sport environments to enable participation and retention of their cultural identities. Highlighted throughout the paper are the ways in which school sport policy and practice, providers and gatekeepers, can include or exclude groups, in this case Muslim girls. Too often coaches and teachers are unaware of crucial facts about their learners, not only in terms of their physical development and capabilities but also in terms of their cultural needs. Mistakes in creating conducive learning environments leave young people to negotiate a way to participate or refrain from participation.

Tech Talk for Social Studies Teachers: Exploring the Viking Invasion of Anglo-Saxon England (AD 1008)

Science.gov (United States)

Street, Chris

2008-01-01

It was 1,000 years ago that King Ethelred ordered the building of a large fleet of ships to blockade England from Viking invaders in a last-ditch effort to stop a series of invasions that had plagued England for decades. Although teachers may already have a personal and professional fascination with this and other events surrounding the Viking…

78 FR 67357 - New England Power Generators Association, Inc. v. ISO New England Inc.; Notice of Complaint

Science.gov (United States)

2013-11-12

... Power Generators Association, Inc. v. ISO New England Inc.; Notice of Complaint Take notice that on...), 18 CFR 385.206 (2013), the New England Power Generators Association, Inc. (NEPGA or Complainant..., 888 First Street NE., Washington, DC 20426. This filing is accessible on-line at http://www.ferc.gov...

Markets in New England

International Nuclear Information System (INIS)

Simpson, J.D.

1998-01-01

Bay State Gas Company is a large American natural gas local distribution company which provides unbundled services and unbundled gas transportation service to about 306,000 residential, commercial and industrial customers in Massachusetts, Maine and New Hampshire. They operate as Northern Utilities Inc. in Maine and New Hampshire. Bay State Gas Company recently announced a strategic merger with NIPSCO Industries. The merger will allow the company to take advantage of opportunities that stem from their location in a high growth potential region, and the growth potential associated with retail unbundling. New England is a small natural gas market with an annual consumption of about 600 BCF, but the market is greatly under saturated. Only 31 per cent of New England homes heat with natural gas compared to 54 per cent of the U.S. as a whole. Three important changes in the New England energy market have been identified that will help the natural gas industry grow in the region: (1) unbundling of retail natural gas markets, (2) deregulation of electric markets, and (3) development of a new pipeline infrastructure. 7 figs

Impacts of a national strategy to reduce population salt intake in England: serial cross sectional study.

Science.gov (United States)

Millett, Christopher; Laverty, Anthony A; Stylianou, Neophytos; Bibbins-Domingo, Kirsten; Pape, Utz J

2012-01-01

The UK introduced an ambitious national strategy to reduce population levels of salt intake in 2003. The aim of this study was to evaluate the impact of this strategy on salt intake in England, including potential effects on health inequalities. Secondary analysis of data from the Health Survey for England. Our main outcome measure was trends in estimated daily salt intake from 2003-2007, as measured by spot urine. Secondary outcome measures were knowledge of government guidance and voluntary use of salt in food preparation over this time period. There were significant reductions in salt intake between 2003 and 2007 (-0.175 grams per day per year, pprofessional; 64.9% v 71.0% AOR 0.76 95% CI 0.58-0.99). Self reported use of salt added at the table reduced significantly during the study period (56.5% to 40.2% pcooking (white 42.8%, black 74.1%, south Asian 88.3%) and those from lower social class groups (unskilled manual 46.6%, professional 35.2%) were more likely to add salt at the table. The introduction a national salt reduction strategy was associated with uniform but modest reductions in salt intake in England, although it is not clear precisely which aspects of the strategy contributed to this. Knowledge of government guidance was lower and voluntary salt use and total salt intake was higher among occupational and ethnic groups at greatest risk of cardiovascular disease.

Severe Enterovirus Infections in Hospitalized Children in the South of England: Clinical Phenotypes and Causative Genotypes.

Science.gov (United States)

de Graaf, Hans; Pelosi, Emanuela; Cooper, Andrea; Pappachan, John; Sykes, Kim; MacIntosh, Iain; Gbesemete, Diane; Clark, Tristan W; Patel, Sanjay V; Faust, Saul N; Tebruegge, Marc

2016-07-01

Most enterovirus surveillance studies lack detailed clinical data, which limits their clinical usefulness. This study aimed to describe the clinical spectrum and outcome of severe enterovirus infections in children, and to determine whether there are associations between causative enterovirus genotypes and clinical phenotypes. Retrospective analysis of microbiological and clinical data from a tertiary children's hospital in the South of England over a 17-month period (2012-2013). In total, 30 patients were identified, comprising sepsis (n = 9), myocarditis (n = 8), meningitis (n = 8) and encephalitis (n = 5). Cases with sepsis or myocarditis were significantly younger than those with central nervous system disease (median age 21 and 15 days vs. 79 days; P = 0.0244 and P = 0.0310, respectively). There was considerable diversity in the causative genotypes in each of the clinical phenotypes, with some predominance of echoviruses in the meningitis group, and coxsackie B viruses in the myocarditis group. Thirteen cases required mechanical ventilation, 11 cases inotropic support, 3 cases dialysis and 3 cases extracorporal membrane oxygenation. The overall mortality was 10% (sepsis group, n = 1; myocarditis group, n = 2). Of the survivors, 5 (19%) had long-term sequelae (myocardial dysfunction, n = 2; neurological sequelae, n = 3). Patients with encephalitis had the longest hospital stay (median: 16 days), compared with 9, 6 and 3 days in patients with myocarditis, sepsis and meningitis, respectively (P = 0.005). Enterovirus infections, particularly enteroviral myocarditis and encephalitis, can cause significant morbidity and mortality. The results show that there are currently no strong associations between clinical phenotypes and particular causative enterovirus genotypes in the South of England.

Deprivation and mortality in non-metropolitan areas of England and Wales.

Science.gov (United States)

Jessop, E G

1996-10-01

To test the hypothesis that the relationship between deprivation and mortality is weaker among residents of non-metropolitan areas of England and Wales than among residents of metropolitan areas. This study compared mortality, expressed as standardised mortality ratios (SMRs), in residents of metropolitan and non-metropolitan districts at three levels of deprivation classified by an electoral ward deprivation score and by home and car ownership. SMRs were computed for all causes of death, for bronchitis and asthma (ICD9 codes 490-493), and for accident, violence, and poisoning (ICD9 codes 800-999). England and Wales. Members of the longitudinal study of the Office of Population Censuses and Surveys, a quasi-random 1% sample of the population of England and Wales. There was an association between deprivation and mortality which was clear for all cause mortality, more noticeable for respiratory disease, and less clear for deaths from accident, violence, and poison. In general, the results showed a remarkable similarity between metropolitan and non-metropolitan areas. This study does not support the hypothesis that the relationship between mortality and deprivation differs between residents of metropolitan and non-metropolitan areas of England and Wales.

Lyme disease and Bell's palsy: an epidemiological study of diagnosis and risk in England.

Science.gov (United States)

Cooper, Lilli; Branagan-Harris, Michael; Tuson, Richard; Nduka, Charles

2017-05-01

Lyme disease is caused by a tick-borne spirochaete of the Borrelia species. It is associated with facial palsy, is increasingly common in England, and may be misdiagnosed as Bell's palsy. To produce an accurate map of Lyme disease diagnosis in England and to identify patients at risk of developing associated facial nerve palsy, to enable prevention, early diagnosis, and effective treatment. Hospital episode statistics (HES) data in England from the Health and Social Care Information Centre were interrogated from April 2011 to March 2015 for International Classification of Diseases 10th revision (ICD-10) codes A69.2 (Lyme disease) and G51.0 (Bell's palsy) in isolation, and as a combination. Patients' age, sex, postcode, month of diagnosis, and socioeconomic groups as defined according to the English Indices of Deprivation (2004) were also collected. Lyme disease hospital diagnosis increased by 42% per year from 2011 to 2015 in England. Higher incidence areas, largely rural, were mapped. A trend towards socioeconomic privilege and the months of July to September was observed. Facial palsy in combination with Lyme disease is also increasing, particularly in younger patients, with a mean age of 41.7 years, compared with 59.6 years for Bell's palsy and 45.9 years for Lyme disease ( P = 0.05, analysis of variance [ANOVA]). Healthcare practitioners should have a high index of suspicion for Lyme disease following travel in the areas shown, particularly in the summer months. The authors suggest that patients presenting with facial palsy should be tested for Lyme disease. © British Journal of General Practice 2017.

A Case Study of a School Science Department: A Site for Workplace Learning?

OpenAIRE

Heighes, Deborah Anne

2017-01-01

This descriptive and illuminative case study of one science department in a successful, urban, secondary school in the south of England considers the science department as a site of workplace learning and the experience of beginning teachers in this context. Policy change in initial teacher training (ITT) has given schools a major role in the recruitment of trainees and emphasized the schools’ role in their training. Additionally, there continue to be significant challenges to recruit science...

A Comparative Study of Cybercrime in Criminal Law: China, US, England, Singapore and the Council of Europe

NARCIS (Netherlands)

Q. Wang (Qianyun)

2016-01-01

markdownabstractThis research intends to unveil problems in the criminal law when dealing with cybercrime and explore possible solutions through comparative study of China, US, England, Singapore and the Council of Europe. Criminals have abused the convenience brought by information technology. When

Leadership of healthcare commissioning networks in England: a mixed-methods study on clinical commissioning groups

Science.gov (United States)

Zachariadis, Markos; Oborn, Eivor; Barrett, Michael; Zollinger-Read, Paul

2013-01-01

Objective To explore the relational challenges for general practitioner (GP) leaders setting up new network-centric commissioning organisations in the recent health policy reform in England, we use innovation network theory to identify key network leadership practices that facilitate healthcare innovation. Design Mixed-method, multisite and case study research. Setting Six clinical commissioning groups and local clusters in the East of England area, covering in total 208 GPs and 1 662 000 population. Methods Semistructured interviews with 56 lead GPs, practice managers and staff from the local health authorities (primary care trusts, PCT) as well as various healthcare professionals; 21 observations of clinical commissioning group (CCG) board and executive meetings; electronic survey of 58 CCG board members (these included GPs, practice managers, PCT employees, nurses and patient representatives) and subsequent social network analysis. Main outcome measures Collaborative relationships between CCG board members and stakeholders from their healthcare network; clarifying the role of GPs as network leaders; strengths and areas for development of CCGs. Results Drawing upon innovation network theory provides unique insights of the CCG leaders’ activities in establishing best practices and introducing new clinical pathways. In this context we identified three network leadership roles: managing knowledge flows, managing network coherence and managing network stability. Knowledge sharing and effective collaboration among GPs enable network stability and the alignment of CCG objectives with those of the wider health system (network coherence). Even though activities varied between commissioning groups, collaborative initiatives were common. However, there was significant variation among CCGs around the level of engagement with providers, patients and local authorities. Locality (sub) groups played an important role because they linked commissioning decisions with

Facilitating Sustainable Waste Management Behaviors Within the Health Sector: A Case Study of the National Health Service (NHS in Southwest England, UK

Directory of Open Access Journals (Sweden)

Janet Richardson

2012-04-01

Full Text Available Waste costs the National Health Service (NHS £71.2 million in 2007/2008; recycling all papers, newspapers and cardboard produced by the NHS in England and Wales could save up to 42,000 tonnes of CO2. As the largest employer in the UK, the NHS is in a prime position to both lead the way towards a sustainable future, but also act as a test bed for organizational change and provide evidence of what works at an individual level to change attitudes and behavior. However these require changes in mindset, including values, attitudes, norms and behaviors which are required along with clear definitions of the problems faced in terms of economics, society and culture. Initial investigations of the literature indicate that behavior change theory may provide a feasible means of achieving constructive changes in clinical waste management; such approaches require further investigation. This paper describes a feasibility study designed to examine issues that might affect the introduction of a behavior change strategy and improve waste management in a healthcare setting. Guided by the evidence gained from our systematic review, 20 interviews were carried out with senior managers, clinicians and support staff involved in the management of healthcare waste from a broad range of agencies in South West England. Interviews were audio-recorded and transcribed for analysis. Thematic content analysis was conducted in order to identify key issues and actions. Data extraction, coding and analysis were cross checked independently by the four members of the research team. Initial findings suggest tensions, between Government and local policies, between packaging and storage space at ward level and, and between the operational requirements of infection control and maintaining appropriate and ethical patient care. These tensions increase pressures on staff already trying to maintain high quality care in a resource restricted and changing environment.

Meal patterns and cooking practices in Southern France and Central England

OpenAIRE

Pettinger, C.; Holdsworth, Michelle; Gerber, M.

2006-01-01

Objective: To evaluate whether meal patterns and cooking practices in Central England and Mediterranean France conform to popular stereotypes, eating together as a household, preparation of meals, food purchasing patterns, cooking practices and eating out were investigated. Design: Cross-sectional studies conducted simultaneously in April 2001 using self-administered postal questionnaires. Setting: England (Nottingham, East Midlands) and France (Montpellier, Languedoc-Roussillon). Subjects: A...

Gender Comparison of Young People Charged With Murder in England and Wales.

Science.gov (United States)

Gerard, F Jeane; Browne, Kevin D; Whitfield, Kate C

2017-03-01

This study investigated gender differences regarding young people charged with murder in England and Wales. A sample of 318 cases was collected from the Home Office's Homicide Index and analysed. Of these cases, 93% of the offenders were male and 7% female. The analyses explored gender differences in terms of the offender's race, offender's age, victim's age, victim's gender, weapon used, offender-victim relationship, and circumstances of the offence. The study found that a female offender was significantly more likely to murder a family member than a male offender, and a male offender was significantly more likely to murder a stranger than a female offender. In addition, a female offender was significantly more likely to murder a victim below the age of 5 than a male offender. Implications for interventions with young people who are charged with murder are discussed.

Communication, Collaboration, and Enhancing the Learning Experience: Developing a Collaborative Virtual Enquiry Service in University Libraries in the North of England

Science.gov (United States)

Jolly, Liz; White, Sue

2016-01-01

This article uses the case study of developing a collaborative "out-of-hours" virtual enquiry service by members of the Northern Collaboration Group of academic libraries in the north of England to explore the importance of communication and collaboration between academic library services in enhancing student learning. Set within the…

New England Takes Stock of Midterm Elections

Science.gov (United States)

Harney, John O.; Morwick, Carolyn

2014-01-01

The recent midterm elections brought New England two new governors. Rhode Island elected its first woman chief executive in Gina Raimondo (D). Massachusetts elected Charlie Baker (R), a former Harvard Pilgrim CEO and official in the Weld and Cellucci administrations. Otherwise, the New England corner offices cautiously welcomed back incumbents:…

The challenge of implementing peer-led interventions in a professionalized health service: a case study of the national health trainers service in England.

Science.gov (United States)

Mathers, Jonathan; Taylor, Rebecca; Parry, Jayne

2014-12-01

Policy Points: In 2004, England's National Health Service introduced health trainer services to help individuals adopt healthier lifestyles and to redress national health inequalities. Over time these anticipated community-focused services became more NHS-focused, delivering "downstream" lifestyle interventions. At the same time, individuals' lifestyle choices were abstracted from the wider social determinants of health and the potential to address inequalities was diminished. While different service models are needed to engage hard-to-reach populations, the long-term sustainability of any new service model depends on its aligning with the established medical system's characteristics. In 2004, the English Public Health White Paper Choosing Health introduced "health trainers" as new members of the National Health Service (NHS) workforce. Health trainers would offer one-to-one peer-support to anyone who wished to adopt and maintain a healthier lifestyle. Choosing Health implicitly envisaged health trainers working in community settings in order to engage "hard-to-reach" individuals and other groups who often have the poorest health but who engage the least with traditional health promotion and other NHS services. During longitudinal case studies of 6 local health trainer services, we conducted in-depth interviews with key stakeholders and analyzed service activity data. Rather than an unproblematic and stable implementation of community-focused services according to the vision in Choosing Health, we observed substantial shifts in the case studies' configuration and delivery as the services embedded themselves in the local NHS systems. To explain these observations, we drew on a recently proposed conceptual framework to examine and understand the adoption and diffusion of innovations in health care systems. The health trainer services have become more "medicalized" over time, and in doing so, the original theory underpinning the program has been threatened. The

Recent trends in children's exposure to second-hand smoke in England: cotinine evidence from the Health Survey for England.

Science.gov (United States)

Jarvis, Martin J; Feyerabend, Colin

2015-09-01

To examine changes in children's exposure to second-hand tobacco smoke in England since 1998. Repeated cross-sectional surveys of the general population in England. The Health Survey for England. A total of 37 038 children participating in surveys from 1998 to 2012, 13 327 of whom were aged 4-15 years, had available cotinine and were confirmed non-smokers. The proportion of children with smoking parents; the proportion of children living in homes reported to be smoke-free; the proportion of children with undetectable concentrations of cotinine; linear and quadratic trend estimates of geometric mean cotinine across years. By 2012, 87.3% of children lived in a home that was smoke-free {97.2% [95% confidence interval (CI) = 95.9-98.1] when parents were non-smokers, 61.3% (95% CI = 55.5-66.8) when one or both parents smoked}. A total of 68.6% (95% CI = 64.3-72.6%) of children had undetectable cotinine in 2012, up from 14.3% (95% CI = 12.7-16.0%) in 1998. There was a highly significant linear trend across years (with a small but significant quadratic term) to declining geometric mean cotinine in all children from 0.52 ng/ml (95% CI = 0.48-0.57) in 1998 to 0.11 ng/ml (95% CI = 0.10-0.12) in 2012. Children from routine/manual backgrounds were more exposed, but experienced similar gains across years to those from non-manual backgrounds. In England, children's exposure to second-hand smoke has declined by 79% since 1998, with continuing progress since smoke-free legislation in 2007. An emerging social norm in England has led to the adoption of smoke-free homes not only when parents are non-smokers, but also when they smoke. © 2015 Society for the Study of Addiction.

Interconnection France-England; Interconnexion France-Angleterre

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-07-01

These documents defines the interconnection France-England rules for the 2000 MW DC submarine cable directly linking the transmission networks of England and Wales and France. Rights to use Interconnector capacity from 1 April 2001 are to be offered through competitive tenders and auctions, full details of which are set out in the Rules. The contract and a guide to the application form are provided. (A.L.B.)

Inventory of Selected Freshwater-Ecology Studies From the New England Coastal Basins (Maine, New Hampshire, Massachusetts, Rhode Island), 1937-1997

National Research Council Canada - National Science Library

Tessler, Steven; Coles, James F; Beaulieu, Karen M

1999-01-01

An inventory of published studies that address freshwater ecology within the New England Coastal Basins was created through computerized bibliographic literature searches and consultation with environmental agencies...

Effectiveness and impact of a reduced infant schedule of 4CMenB vaccine against group B meningococcal disease in England: a national observational cohort study.

Science.gov (United States)

Parikh, Sydel R; Andrews, Nick J; Beebeejaun, Kazim; Campbell, Helen; Ribeiro, Sonia; Ward, Charlotte; White, Joanne M; Borrow, Ray; Ramsay, Mary E; Ladhani, Shamez N

2016-12-03

In September, 2015, the UK became the first country to introduce the multicomponent group B meningococcal (MenB) vaccine (4CMenB, Bexsero) into a publicly funded national immunisation programme. A reduced two-dose priming schedule was offered to infants at 2 months and 4 months, alongside an opportunistic catch-up for 3 month and 4 month olds. 4CMenB was predicted to protect against 73-88% of MenB strains. We aimed to assess the effectiveness and impact of 4CMenB in vaccine-eligible infants in England. Public Health England (PHE) undertakes enhanced surveillance of meningococcal disease through a combination of clinical, public health, and laboratory reporting. Laboratory-confirmed cases of meningococcal disease are followed up with PHE local health protection teams, general practitioners, and hospital clinicians to collect demographic data, vaccination history, clinical presentation, and outcome. For cases diagnosed between Sept 1, 2015, and June 30, 2016, vaccine effectiveness was assessed using the screening method. Impact was assessed by comparing numbers of cases of MenB in vaccine-eligible children to equivalent cohorts in the previous 4 years and to cases in vaccine-ineligible children. Coverage of 4CMenB in infants eligible for routine vaccination was high, achieving 95·5% for one dose and 88·6% for two doses by 6 months of age. Two-dose vaccine effectiveness was 82·9% (95% CI 24·1-95·2) against all MenB cases, equivalent to a vaccine effectiveness of 94·2% against the highest predicted MenB strain coverage of 88%. Compared with the prevaccine period, there was a 50% incidence rate ratio (IRR) reduction in MenB cases in the vaccine-eligible cohort (37 cases vs average 74 cases; IRR 0·50 [95% CI 0·36-0·71]; p=0·0001), irrespective of the infants' vaccination status or predicted MenB strain coverage. Similar reductions were observed even after adjustment for disease trends in vaccine-eligible and vaccine-ineligible children. The two-dose 4CMen

Distribution of cocaine on banknotes in general circulation in England and Wales.

Science.gov (United States)

Aitken, C G G; Wilson, A; Sleeman, R; Morgan, B E M; Huish, J

2017-01-01

A study of the quantities of cocaine on banknotes in general circulation was conducted to investigate regional variations across England and Wales. No meaningful support was found for the proposition that there is regional variation in the quantities of cocaine in banknotes in general circulation in England and Wales. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effects of seasonal and pandemic influenza on health-related quality of life, work and school absence in England: Results from the Flu Watch cohort study.

Science.gov (United States)

Fragaszy, Ellen B; Warren-Gash, Charlotte; White, Peter J; Zambon, Maria; Edmunds, William J; Nguyen-Van-Tam, Jonathan S; Hayward, Andrew C

2018-01-01

Estimates of health-related quality of life (HRQoL) and work/school absences for influenza are typically based on medically attended cases or those meeting influenza-like-illness (ILI) case definitions and thus biased towards severe disease. Although community influenza cases are more common, estimates of their effects on HRQoL and absences are limited. To measure quality-adjusted life days and years (QALDs and QALYs) lost and work/school absences among community cases of acute respiratory infections (ARI), ILI and influenza A and B and to estimate community burden of QALY loss and absences from influenza. Flu Watch was a community cohort in England from 2006 to 2011. Participants were followed up weekly. During respiratory illness, they prospectively recorded daily symptoms, work/school absences and EQ-5D-3L data and submitted nasal swabs for RT-PCR influenza testing. Average QALD lost was 0.26, 0.93, 1.61 and 1.84 for ARI, ILI, H1N1pdm09 and influenza B cases, respectively. 40% of influenza A cases and 24% of influenza B cases took time off work/school with an average duration of 3.6 and 2.4 days, respectively. In England, community influenza cases lost 24 300 QALYs in 2010/11 and had an estimated 2.9 million absences per season based on data from 2006/07 to 2009/10. Our QALDs and QALYs lost and work and school absence estimates are lower than previous estimates because we focus on community cases, most of which are mild, may not meet ILI definitions and do not result in healthcare consultations. Nevertheless, they contribute a substantial loss of HRQoL on a population level. © 2017 The Authors. Influenza and Other Respiratory Viruses. Published by John Wiley & Sons Ltd.

New England Energy Congress: progress report - a descriptive summary

Energy Technology Data Exchange (ETDEWEB)

Pratt, Robert L.; Mayer, Jean; Buckley, John G.; Spencer, Bailey; Alford, Zeb D.; Keating, Jr., Stephen J.; Aubin, Elmer B.

1978-09-01

New England's dependence on oil (about 80%) is posing a double threat to the region and its economic prosperity, as oil dependency means extreme supply vulnerability and substantially higher prices than the national average. The New England Energy Congress, sponsored by the New England Congressional Caucus and Tufts Univ., represents the concerted effort of a highly diverse group of New Englanders to address these problems. The work of the six committees of the Congress is reviewed in this report. The committees are the Supply Committee, Energy Demand Committee, Energy Conservation Committee, Regulatory and Institutional Processes Committee, Economic Development through Alternative Sources of Energy Committee, and Energy Economics and Financing Committee. (MCW)

Melmark New England

Science.gov (United States)

Cancro, Lorraine

2009-01-01

This article features Melmark New England, a private, nonprofit, community based organization dedicated to serving children and adolescents with autism spectrum disorders, acquired brain injury, neurological diseases and disorders, and severe challenging behaviors. The Melmark parent corporation, a Pennsylvania based provider of services for those…

Gauging the brownfield land supply in England

OpenAIRE

Williams, K.; Sinnett, D.; Miner, P.; Carmichael, L.

2015-01-01

This paper reports on the findings of a study that aimed to help fill the information gap left by the loss of the National Land Use Database – and asked ‘Is there enough brownfield land in England to meet housing needs?’

Effectiveness of tobacco control television advertising in changing tobacco use in England: a population-based cross-sectional study.

Science.gov (United States)

Sims, Michelle; Salway, Ruth; Langley, Tessa; Lewis, Sarah; McNeill, Ann; Szatkowski, Lisa; Gilmore, Anna B

2014-06-01

To examine whether government-funded tobacco control television advertising shown in England between 2002 and 2010 reduced adult smoking prevalence and cigarette consumption. Analysis of monthly cross-sectional surveys using generalised additive models. England. More than 80 000 adults aged 18 years or over living in England and interviewed in the Opinions and Lifestyle Survey. Current smoking status, smokers' daily cigarette consumption, tobacco control gross rating points (GRPs-a measure of per capita advertising exposure combining reach and frequency), cigarette costliness, tobacco control activity, socio-demographic variables. After adjusting for other tobacco control policies, cigarette costliness and individual characteristics, we found that a 400-point increase in tobacco control GRPs per month, equivalent to all adults in the population seeing four advertisements per month (although actual individual-level exposure varies according to TV exposure), was associated with 3% lower odds of smoking 2 months later [odds ratio (OR) = 0.97, 95% confidence interval (CI) = 0.95, 0.999] and accounted for 13.5% of the decline in smoking prevalence seen over this period. In smokers, a 400-point increase in GRPs was associated with a 1.80% (95%CI = 0.47, 3.11) reduction in average cigarette consumption in the following month and accounted for 11.2% of the total decline in consumption over the period 2002-09. Government-funded tobacco control television advertising shown in England between 2002 and 2010 was associated with reductions in smoking prevalence and smokers' cigarette consumption. © 2014 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Why does education matter to employers in different institutional contexts? A vignette study in England and the Netherlands

NARCIS (Netherlands)

Di Stasio, V.; van de Werfhorst, H.G.

We study the process by which employers evaluate and interpret information related to the educational background of job applicants in simulated hiring contexts. We focus on England and the Netherlands, countries with very different education systems and labor-market institutions. Using a vignette

Cross-national diagnostic analysis of patient empowerment in England and Greece

Directory of Open Access Journals (Sweden)

Graham Lister

2012-01-01

Full Text Available Background: Different NHS patient empowerment policies have been adopted in England and Greece; the voluntary sector development and its influence also differ. Although various aspects of patient empowerment have been explored in England, the patient empowerment systems’ application is under-researched. In Greece, the few relevant attempts looking at patients’ experiences focus on patient satisfaction, with only one study exploring the public hospitals managers’ perspectives on user involvement. However, patient empowerment questions may be similar in both countries.Aims and Objectives:The study aimed to explore and compare the general patient empowerment settings in the two countries, with main objectives to:a. identify and explore the relationships of national voluntary and governmental organisations,b. explore the cross-national challenges and facilitators, and make cross-national recommendations.Methodology: This is a cross-national comparative research study. A ‘diagnostic analysis’ approach, an assessment of potential and actual barriers and facilitators, including the context and potential change, was chosen. The methods used were:a. a network analysis of national voluntary and governmental organisations;b. semi-structured interviews with key representatives of these, andc. documentary analysis.Results: The network analysis revealed the potential of English organisations to influence more people, withextensive memberships and stronger interrelationship between them than the Greek organisations. Different levels of awareness, knowledge and perceptions of application of the national patient empowerment policies, systems and mechanisms were identified; being generally good in England, limited in Greece. Variable generalinformation provision, with good verbal information in England, and limited, written and verbal, information in Greece was also identified. Although the commonest cross-national perceived challenges were

Estimating Water Supply Arsenic Levels in the New England Bladder Cancer Study

Science.gov (United States)

Freeman, Laura E. Beane; Lubin, Jay H.; Airola, Matthew S.; Baris, Dalsu; Ayotte, Joseph D.; Taylor, Anne; Paulu, Chris; Karagas, Margaret R.; Colt, Joanne; Ward, Mary H.; Huang, An-Tsun; Bress, William; Cherala, Sai; Silverman, Debra T.; Cantor, Kenneth P.

2011-01-01

Background: Ingestion of inorganic arsenic in drinking water is recognized as a cause of bladder cancer when levels are relatively high (≥ 150 µg/L). The epidemiologic evidence is less clear at the low-to-moderate concentrations typically observed in the United States. Accurate retrospective exposure assessment over a long time period is a major challenge in conducting epidemiologic studies of environmental factors and diseases with long latency, such as cancer. Objective: We estimated arsenic concentrations in the water supplies of 2,611 participants in a population-based case–control study in northern New England. Methods: Estimates covered the lifetimes of most study participants and were based on a combination of arsenic measurements at the homes of the participants and statistical modeling of arsenic concentrations in the water supply of both past and current homes. We assigned a residential water supply arsenic concentration for 165,138 (95%) of the total 173,361 lifetime exposure years (EYs) and a workplace water supply arsenic level for 85,195 EYs (86% of reported occupational years). Results: Three methods accounted for 93% of the residential estimates of arsenic concentration: direct measurement of water samples (27%; median, 0.3 µg/L; range, 0.1–11.5), statistical models of water utility measurement data (49%; median, 0.4 µg/L; range, 0.3–3.3), and statistical models of arsenic concentrations in wells using aquifers in New England (17%; median, 1.6 µg/L; range, 0.6–22.4). Conclusions: We used a different validation procedure for each of the three methods, and found our estimated levels to be comparable with available measured concentrations. This methodology allowed us to calculate potential drinking water exposure over long periods. PMID:21421449

Molybdenum distributions and variability in drinking water from England and Wales.

Science.gov (United States)

Smedley, P L; Cooper, D M; Lapworth, D J

2014-10-01

An investigation has been carried out of molybdenum in drinking water from a selection of public supply sources and domestic taps across England and Wales. This was to assess concentrations in relation to the World Health Organization (WHO) health-based value for Mo in drinking water of 70 μg/l and the decision to remove the element from the list of formal guideline values. Samples of treated drinking water from 12 water supply works were monitored up to four times over an 18-month period, and 24 domestic taps were sampled from three of their supply areas. Significant (p  0.05) were detected. Tap water samples collected from three towns (North Wales, the English Midlands, and South East England) supplied uniquely by upland reservoir water, river water, and Chalk groundwater, respectively, also showed a remarkable uniformity in Mo concentrations at each location. Within each, the variability was very small between houses (old and new), between pre-flush and post-flush samples, and between the tap water and respective source water samples. The results indicate that water distribution pipework has a negligible effect on supplied tap water Mo concentrations. The findings contrast with those for Cu, Zn, Ni, Pb, and Cd, which showed significant differences (p water samples. In two pre-flush samples, concentrations of Ni or Pb were above drinking water limits, although in all cases, post-flush waters were compliant. The high concentrations, most likely derived from metal pipework in the domestic distribution system, accumulated during overnight stagnation. The concentrations of Mo observed in British drinking water, in all cases less than 2 μg/l, were more than an order of magnitude below the WHO health-based value and suggest that Mo is unlikely to pose a significant health or water supply problem in England and Wales.

Childhood obesity trends from primary care electronic health records in England between 1994 and 2013: population-based cohort study

NARCIS (Netherlands)

Jaarsveld, C.H.M. van; Gulliford, M.C.

2015-01-01

OBJECTIVE: This study aimed to use primary care electronic health records to evaluate the prevalence of overweight and obesity in 2-15-year-old children in England and compare trends over the last two decades. DESIGN: Cohort study of primary care electronic health records. SETTING: 375 general

New England Energy Congress: A Blueprint for Energy Action. Final Report

Energy Technology Data Exchange (ETDEWEB)

Pratt, Robert L.; Mayer, Jean; Buckley, John G.; Connolly, Patrick F.; Spencer, Bailey

1979-05-01

The New England Energy Congress consists of six committees, with members from each of the six New England states. Since May 1978, the Congress has been working to frame and substantiate energy action recommendations. Committee jurisdictions include New England Energy Supply, Economic Development through Alternative Sources of Energy, New England Energy Demand, Energy Conservation, Regulatory and Institutional Processes, and Energy Economics and Financing. The findings and recommendations that have resulted from their work are summarized. (MCW)

Review: Local Government in England: Centralisation, Autonomy and Control by Colin Corpus, Mark Roberts, Rachel Wall

Directory of Open Access Journals (Sweden)

Jonathan Carr-West

2018-04-01

Full Text Available Local Government in England: Centralisation, Autonomy and Control is a serious book and an important contribution to the scholarship around local government. It opens however, with a pleasingly comic tableau as academics from England, Portugal and Poland bicker amiably at a conference and on Twitter about whose country is really the most centralised. The rest of the book is devoted to showing why the English academics were right, why it matters and what should be done about it. The main thrust of the text is an analysis of the impact of the dominant policy narratives around centralism and localism. The argument that Copus, Wall and Roberts put forward could be boiled down to the assertion that the problem with local government in England is that it is neither local nor government. But to make this case they first helpfully unpack several sets of concepts that are all too often elided together.

Mathematics anxiety in secondary students in England.

Science.gov (United States)

Chinn, Steve

2009-02-01

Whatever the changes that are made to the mathematics curriculum in England, there will always remain a problem with mathematics anxiety. Maths anxiety is rarely facilitative. This study examined aspects of mathematics in secondary schools and how students rated them as sources of anxiety. Over 2000 students in independent and mainstream schools in England completed a 20-item questionnaire designed to investigate maths anxiety levels. The same questionnaire was given to over 440 dyslexic males in specialist schools within the same age range. The results showed that examinations and tests create high levels of anxiety in approximately 4% of students. The results suggest that certain aspects and topics in the maths curriculum, such as long division, cause similar levels of anxiety for students in all year groups in secondary schools.

Public Hospital Spending in England: Evidence from National Health Service Administrative Records

OpenAIRE

Kelly, E.; Stoye, G.; Vera-Hernández, M.

2016-01-01

© 2016 The Authors. Fiscal Studies published by John Wiley & Sons Ltd. on behalf of Institute for Fiscal StudiesHealth spending per capita in England has almost doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the life cycle, and the concentration of spendi...

Comparison of elderly suicide rates among migrants in England and Wales with their country of origin.

Science.gov (United States)

Shah, Ajit; Lindesay, James; Dennis, Mick

2009-03-01

The black and minority ethnic (BME) elderly population size in England and Wales has progressively increased over the last three decades. Only two studies, both well over a decade old, have compared suicide rates in BME groups in England and Wales with those in their country of origin. A study comparing suicide rates among elderly migrants in England and Wales and in their country of origin using the latest available mortality data from the Office of National Statistics and the World Health Organization was conducted. There were wide variations in standardised mortality ratios for elderly suicides among migrants from different countries compared with those born in England and Wales and in their country of origin. There was convergence towards elderly suicide rates for England and Wales in some migrant groups in males in the age-bands 65-74 years and 75 + years, and in females in the age-band 75 + years. However, males aged 75 + years from most migrant groups had higher rates than those born in England and Wales. A more detailed analysis of suicide of older people from migrant groups is required to determine vulnerability and protective influences.

An outbreak of Salmonella dublin infection in England and Wales associated with a soft unpasteurized cows' milk cheese.

Science.gov (United States)

Maguire, H; Cowden, J; Jacob, M; Rowe, B; Roberts, D; Bruce, J; Mitchell, E

1992-12-01

An outbreak of Salmonella dublin infection occurred in England and Wales in October to December 1989. Forty-two people were affected, mainly adults, and most lived in south-east England. Microbiological and epidemiological investigations implicated an imported Irish soft unpasteurized cows' milk cheese as the vehicle of infection. A case-control study showed a statistically significant association between infection and consumption of the suspect cheese (p = 0.001). Salmonella dublin was subsequently isolated from cheeses obtained from the manufacturer's premises. Initial control measures included the withdrawal of the cheese from retail sale and a Food Hazard Warning to Environmental Health Departments, as well as a press release, from the Department of Health. Subsequently, a decision was taken by the manufacturer to pasteurize milk used in the production of cheese for the UK market and importation of the cheese resumed in June 1990.

Impacts of a national strategy to reduce population salt intake in England: serial cross sectional study.

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Christopher Millett

Full Text Available BACKGROUND: The UK introduced an ambitious national strategy to reduce population levels of salt intake in 2003. The aim of this study was to evaluate the impact of this strategy on salt intake in England, including potential effects on health inequalities. METHODS: Secondary analysis of data from the Health Survey for England. Our main outcome measure was trends in estimated daily salt intake from 2003-2007, as measured by spot urine. Secondary outcome measures were knowledge of government guidance and voluntary use of salt in food preparation over this time period. RESULTS: There were significant reductions in salt intake between 2003 and 2007 (-0.175 grams per day per year, p<0.001. Intake decreased uniformly across all other groups but remained significantly higher in younger persons, men, ethnic minorities and lower social class groups and those without hypertension in 2007. Awareness of government guidance on salt use was lowest in those groups with the highest intake (semi-skilled manual v professional; 64.9% v 71.0% AOR 0.76 95% CI 0.58-0.99. Self reported use of salt added at the table reduced significantly during the study period (56.5% to 40.2% p<0.001. Respondents from ethnic minority groups remained significantly more likely to add salt during cooking (white 42.8%, black 74.1%, south Asian 88.3% and those from lower social class groups (unskilled manual 46.6%, professional 35.2% were more likely to add salt at the table. CONCLUSIONS: The introduction a national salt reduction strategy was associated with uniform but modest reductions in salt intake in England, although it is not clear precisely which aspects of the strategy contributed to this. Knowledge of government guidance was lower and voluntary salt use and total salt intake was higher among occupational and ethnic groups at greatest risk of cardiovascular disease.

Nocturnal Oviposition Behavior of Forensically Important Diptera in Central England.

Science.gov (United States)

Barnes, Kate M; Grace, Karon A; Bulling, Mark T

2015-11-01

Timing of oviposition on a corpse is a key factor in entomologically based minimum postmortem interval (mPMI) calculations. However, there is considerable variation in nocturnal oviposition behavior of blow flies reported in the research literature. This study investigated nocturnal oviposition in central England for the first time, over 25 trials from 2011 to 2013. Liver-baited traps were placed in an urban location during control (diurnal), and nocturnal periods and environmental conditions were recorded during each 5-h trial. No nocturnal activity or oviposition was observed during the course of the study indicating that nocturnal oviposition is highly unlikely in central England. © 2015 American Academy of Forensic Sciences.

Experiences of women who travel to England for abortions: an exploratory pilot study.

Science.gov (United States)

Gerdts, Caitlin; DeZordo, Silvia; Mishtal, Joanna; Barr-Walker, Jill; Lohr, Patricia A

2016-10-01

Restrictive policies that limit access to abortion often lead women to seek services abroad. We present results from an exploratory study aimed at documenting the socio-demographic characteristics, travel and abortion-seeking experiences of non-resident women seeking abortions in the UK. Between August 2014 and March 2015, we surveyed a convenience sample of 58 non-UK residents seeking abortions at three British Pregnancy Advisory Service (BPAS) abortion clinics in England in order to better understand the experiences of non-resident women who travel to the UK seeking abortion services. Participants travelled to England from 14 countries in Europe and the Middle East. Twenty-six percent of participants reported gestational ages between 14 and 20 weeks, and 14% (n = 8) were beyond 20 weeks since their last menstrual period (LMP). More women from Western Europe sought abortions beyond 13 weeks gestation than from any other region. Women reported seeking abortion outside of their country of residence for a variety of reasons, most commonly, that abortion was not legal (51%), followed by having passed the gestational limit for a legal abortion (31%). Women paid an average of £631 for travel expenses, and an average of £210 for accommodation. More than half of women in our study found it difficult to cover travel costs. Understanding how and why women seek abortion care far from their countries of residence is an important topic for future research and could help to inform abortion-related policy decisions in the UK and in Europe.

Handgrip strength and its prognostic value for mortality in Moscow, Denmark, and England

DEFF Research Database (Denmark)

Oksuzyan, Anna; Demakakos, Panayotes; Shkolnikova, Maria

2017-01-01

BACKGROUND: This study compares handgrip strength and its association with mortality across studies conducted in Moscow, Denmark, and England. MATERIALS: The data collected by the Study of Stress, Aging, and Health in Russia, the Study of Middle-Aged Danish Twins and the Longitudinal Study of Aging...... Danish Twins, and the English Longitudinal Study of Ageing was utilized. RESULTS: Among the male participants, the age-standardized grip strength was 2 kg and 1 kg lower in Russia than in Denmark and in England, respectively. The age-standardized grip strength among the female participants was 1.9 kg...... and 1.6 kg lower in Russia than in Denmark and in England, respectively. In Moscow, a one-kilogram increase in grip strength was associated with a 4% (hazard ratio [HR] = 0.96, 95% confidence interval [CI]: 0.94, 0.99) reduction in mortality among men and a 10% (HR = 0.90, 95%CI: 0.86, 0.94) among women...

General Practitioners' Concerns About Online Patient Feedback: Findings From a Descriptive Exploratory Qualitative Study in England.

Science.gov (United States)

Patel, Salma; Cain, Rebecca; Neailey, Kevin; Hooberman, Lucy

2015-12-08

The growth in the volume of online patient feedback, including online patient ratings and comments, suggests that patients are embracing the opportunity to review online their experience of receiving health care. Very little is known about health care professionals' attitudes toward online patient feedback and whether health care professionals are comfortable with the public nature of the feedback. The aim of the overall study was to explore and describe general practitioners' attitudes toward online patient feedback. This paper reports on the findings of one of the aims of the study, which was to explore and understand the concerns that general practitioners (GPs) in England have about online patient feedback. This could then be used to improve online patient feedback platforms and help to increase usage of online patient feedback by GPs and, by extension, their patients. A descriptive qualitative approach using face-to-face semistructured interviews was used in this study. A topic guide was developed following a literature review and discussions with key stakeholders. GPs (N=20) were recruited from Cambridgeshire, London, and Northwest England through probability and snowball sampling. Interviews were transcribed verbatim and analyzed in NVivo using the framework method, a form of thematic analysis. Most participants in this study had concerns about online patient feedback. They questioned the validity of online patient feedback because of data and user biases and lack of representativeness, the usability of online patient feedback due to the feedback being anonymous, the transparency of online patient feedback because of the risk of false allegations and breaching confidentiality, and the resulting impact of all those factors on them, their professional practice, and their relationship with their patients. The majority of GPs interviewed had reservations and concerns about online patient feedback and questioned its validity and usefulness among other things

Qualitative scale for estimating sulphur dioxide air pollution in England and Wales using epiphytic lichens

Energy Technology Data Exchange (ETDEWEB)

Hawksworth, D L; Rose, F

1970-01-01

The sulphur dioxide in the air can be estimated qualitatively by studying the lichens growing on trees. A ten-point scale has been constructed and used in pilot surveys in England and Wales, Southeast England and the city of Leicester.

England in Europe

DEFF Research Database (Denmark)

Tyler, Elizabeth Muir

In England in Europe, Elizabeth Tyler focuses on two histories: the Encomium Emmae Reginae, written for Emma the wife of the Æthelred II and Cnut, and The Life of King Edward, written for Edith the wife of Edward the Confessor. Tyler offers a bold literary and historical analysis of both texts...

Clinical negligence claims in pediatric surgery in England: pattern and trends.

Science.gov (United States)

Thyoka, Mandela

2015-02-01

We hypothesized that there has been an increase in the number of successful litigation claims in pediatric surgery in England. Our aim was to report the incidence, causes, and costs of clinical negligence claims against the National Health Service (NHS) in relation to pediatric surgery. We queried the NHS Litigation Authority (NHSLA) on litigation claims among children undergoing pediatric surgery in England (2004-2012). We decided a priori to only examine closed cases (decision and payment made). Data included year of claim, year of payment of claim, payment per claim, paid-to-closed ratio, and severity of outcome of clinical incident. Out of 112 clinical negligence claims in pediatric surgery, 93 (83%) were finalized-73 (65%) were settled and damages paid to the claimant and 20 (18%) were closed with no payment, and 19 (17%) remain open. The median payment was £13,537 (600-500,000) and median total cost borne by NHSLA was £31,445 (600-730,202). Claims were lodged at a median interval of 2 (0-13) years from time of occurrence with 55 (75%) cases being settled within the 3 years of being received. The commonest reasons for claims were postoperative complications (n=20, 28%), delayed treatment (n=16, 22%), and/or diagnosis (n=14, 19%). Out of 73, 17 (23%) closed claims resulted in case fatality. Conclusion: Two-thirds of all claims in pediatric surgery resulted in payment to claimant, and the commonest reasons for claims were postoperative complications, delayed treatment, and/or diagnosis. Nearly a quarter of successful claims were in cases where negligence resulted in case fatality. Pediatric surgeons should be aware of common diagnostic and treatment shortfalls as high-risk areas of increased susceptibility to clinical negligence claims. Georg Thieme Verlag KG Stuttgart · New York.

Evaluating the Impact of Business Service Expertise and Business Links on the Performance of SMEs in England

OpenAIRE

John Bryson; David Ingram; Peter Daniels

1999-01-01

The last decade has seen a growing body of research on information-intensive business service firms. These are companies that supply expertise and knowledge which are considered to add value to the output of their clients. This paper explores the impact of business service expertise provided via business link on the performance, profitability and competitiveness of client companies. The authors use a unique survey of small and medium-sized enterprises (SMEs) in England as well as case studies...

Scrubbing the Whitewash from New England History: Citizenship, Race and Gender in Eighteenth- and Nineteenth-Century Nantucket

OpenAIRE

Bulger, Teresa Dujnic

2013-01-01

This dissertation examines how racial ideologies have historically been entangled with discourses on citizenship and gender difference in the United States. In looking at the case study of the 18th- and 19th-century African American community on Nantucket, I ask how these ideologies of difference and inequality were experienced, reinterpreted, and defied by women and men in the past. Whereas New England has maintained a liberal and moralistic regional narrative since the early-19th century, t...

Retaining the general practitioner workforce in England: what matters to GPs? A cross-sectional study.

Science.gov (United States)

Dale, Jeremy; Potter, Rachel; Owen, Katherine; Parsons, Nicholas; Realpe, Alba; Leach, Jonathan

2015-10-16

The general practice (GP) workforce in England is in crisis, reflected in increasing rates of early retirement and intentions to reduce hours of working. This study aimed to investigate underlying factors and how these might be mitigated. GPs in central England were invited to participate in an on-line survey exploring career plans and views and experiences of work-related pressures. Quantitative data were analysed using logistic regression analysis and principal components analysis. Qualitative data were analysed using a thematic framework approach. Of 1,192 GPs who participated, 978 (82.0 %) stated that they intend to leave general practice, take a career break and/or reduce clinical hours of work within the next five years. This included 488 (41.9 %) who intend to leave practice, and almost a quarter (279; 23.2 %) intending to take a career break. Only 67 (5.6 %) planned to increase their hours of clinical work. For participants planning to leave practice, the issues that most influenced intentions were volume and intensity of workload, time spent on "unimportant tasks", introduction of seven-day working and lack of job satisfaction. Four hundred fifty five participants responded to open questions (39128 words in total). The main themes were the cumulative impact of work-related pressures, the changing and growing nature of the workload, and the consequent stress. Reducing workload intensity, workload volume, administrative activities, with increased time for patient care, no out-of-hour commitments, more flexible working conditions and greater clinical autonomy were identified as the most important requirements to address the workforce crisis. In addition, incentive payments, increased pay and protected time for education and training were also rated as important. New models of professionalism and organisational arrangements may be needed to address the issues described here. Without urgent action, the GP workforce crisis in England seems set to worsen.

Assessment of Data Management Services at New England Region Resource Libraries

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Julie Goldman

2015-07-01

Full Text Available Objective: To understand how New England medical libraries are addressing scientific research data management and providing services to their communities. Setting: The National Network of Libraries of Medicine, New England Region (NN/LM NER contains 17 Resource Libraries. The University of Massachusetts Medical School serves as the New England Regional Medical Library (RML. Sixteen of the NER Resource Libraries completed this survey. Methods: A 40-question online survey assessed libraries’ services and programs for providing research data management education and support. Libraries shared their current plans and institutional challenges associated with developing data services. Results: This study shows few NER Resource Libraries currently integrate scientific research data management into their services and programs, and highlights the region’s use of resources provided by the NN/LM NER RML at the University of Massachusetts Medical School. Conclusions: Understanding the types of data services being delivered at NER libraries helps to inform the NN/LM NER about the eScience learning needs of New England medical librarians and helps in the planning of professional development programs that foster effective biomedical research data services.

Instructional Technology and School Ethos: A Primary School Model in Southwest England

Directory of Open Access Journals (Sweden)

Erik Jon Byker

2014-04-01

Full Text Available The way in which information and communication technology (ICT enhances the dimensions of teaching and student learning is not well understood. As a result, schools and teacher often integrate ICT with little thought to how it could be educationally profitable or pedagogically meaningful. The literature calls for models of primary school ICT integration. This paper reports on a case study of a primary school (or elementary school model of technology integration. Specifically, the case study investigates a public, primary school located in rural Southwest England. In particular, the paper describes how ICT is integrated in a Grade Six classroom in this primary school. Using a mixed-methods research methodology, the study’s data is drawn from 60 participants (n=60, including the school’s teachers and students. The analyses of this study uncovered a strong link between successful ICT integration and school ethos. Furthermore, the study found that along with school ethos the teacher leadership fostered an environment where the integration of ICT can flourish and students are motivated to learn.

Irish women who seek abortions in England.

Science.gov (United States)

Francome, C

1992-01-01

In 1991, 4158 women from Ireland and 1766 from Northern Ireland traveled to England for abortions. This situation has been ignored by Irish authorities. The 1992 case of the 14-year old seeking an abortion in England finally caught legal attention. This study attempts to help define who these abortion seekers are. Questionnaires from 200 Irish abortion seeking women attending private Marie Stopes clinics in London and the British Pregnancy Advisory Services clinic in Liverpool between September 1988 and December 1990 were analyzed. Findings pertain to demographic characteristics, characteristics of first intercourse, family discussion of sexual activity, and contraceptive use. From this limited sample, it appears that Irish women are sexually reserved and without access to modern methods of birth control and abortion. Sex is associated with shame and guilt. 23% had intercourse before the age of 18 years and 42% after the age of 20. 76% were single and 16% were currently married. 95% were Catholic; 33% had been to church the preceding Sunday and 68% within the past month. Basic information about menstruation is also limited and procedures such as dilatation and curettage may be performed selectively. 28% of married women were uninformed about menstruation prior to its onset. Only 24% had been using birth control around the time of pregnancy. The reason for nonuse was frequently the unexpectedness of intercourse. 62% of adults and 66% of women believe in legalizing abortion in Ireland. British groups have tried to break through the abortion information ban by sending telephone numbers of abortion clinics to Irish firms for distribution to employees. On November 25, 1992, in the general election, there was approval of constitutional amendments guaranteeing the right to travel for abortions and to receive information on abortion access. The amendment to allow abortion to save the life of the mother was not accepted.

Sense, sensibility and censorship : a comparative study of censorship in Victorian England and contemporary America

OpenAIRE

Myklebust, Anne

2005-01-01

This thesis is essentially a discourse analysis which purports to explore how the discussion and activity of movements such as the Moral Majority may shape public opinion on the necessity of censorship. When studying the Moral Majority s discussions of censorship, I noticed a resemblance between their rhetoric and that of the critics of decadent literature in late 19th -century England. This resemblance was reinforced by the fact that these contemporary Americans not only responded to what ...

Ground-level Ozone (Smog) Information | New England | US ...

Science.gov (United States)

2017-09-05

Ground-level ozone presents a serious air quality problem in New England. In 2008, EPA revised the ozone standard to a level of 0.075 parts per million, 8-hour average. Over the last 5 years (2006 through 2010), there have been an average of 31 days per summer when New England's air exceeded this standard.

The Effectiveness of Paid Services in Supporting Unpaid Carers' Employment in England.

Science.gov (United States)

Pickard, Linda; King, Derek; Brimblecombe, Nicola; Knapp, Martin

2015-07-01

This paper explores the effectiveness of paid services in supporting unpaid carers' employment in England. There is currently a new emphasis in England on 'replacement care', or paid services for the cared-for person, as a means of supporting working carers. The international evidence on the effectiveness of paid services as a means of supporting carers' employment is inconclusive and does not relate specifically to England. The study reported here explores this issue using the 2009/10 Personal Social Services Survey of Adult Carers in England . The study finds a positive association between carers' employment and receipt of paid services by the cared-for person, controlling for covariates. It therefore gives support to the hypothesis that services for the cared-for person are effective in supporting carers' employment. Use of home care and a personal assistant are associated on their own with the employment of both men and women carers, while use of day care and meals-on-wheels are associated specifically with women's employment. Use of short-term breaks are associated with carers' employment when combined with other services. The paper supports the emphasis in English social policy on paid services as a means of supporting working carers, but questions the use of the term 'replacement care' and the emphasis on 'the market'.

Christmas in England

Institute of Scientific and Technical Information of China (English)

孟伟根

1991-01-01

In England,Christmas is the most important of all the ’Bank Holidays’ in the year.Two important things,apart from itsreligious significance,help to set this holiday apart fromall others:the custom of giving gifts and the habit ofspending it with family. In the present highly commercialised age we arereminded of Christmas many weeks before the event.In

Private Well Owners | Drinking Water in New England | US ...

Science.gov (United States)

2017-07-06

Recent studies in New England identified contamination of some private wells from methyl-tertiary-butyl ether (MtBE), radon and arsenic. But, many homeowners are not aware of this risk to their drinking water.

"It's a complex mesh"- how large-scale health system reorganisation affected the delivery of the immunisation programme in England: a qualitative study.

Science.gov (United States)

Chantler, Tracey; Lwembe, Saumu; Saliba, Vanessa; Raj, Thara; Mays, Nicholas; Ramsay, Mary; Mounier-Jack, Sandra

2016-09-15

The English health system experienced a large-scale reorganisation in April 2013. A national tri-partite delivery framework involving the Department of Health, NHS England and Public Health England was agreed and a new local operational model applied. Evidence about how health system re-organisations affect constituent public health programmes is sparse and focused on low and middle income countries. We conducted an in-depth analysis of how the English immunisation programme adapted to the April 2013 health system reorganisation, and what facilitated or hindered the delivery of immunisation services in this context. A qualitative case study methodology involving interviews and observations at national and local level was applied. Three sites were selected to represent different localities, varying levels of immunisation coverage and a range of changes in governance. Study participants included 19 national decision-makers and 56 local implementers. Two rounds of interviews and observations (immunisation board/committee meetings) occurred between December 2014 and June 2015, and September and December 2015. Interviews were audio recorded and transcribed verbatim and written accounts of observed events compiled. Data was imported into NVIVO 10 and analysed thematically. The new immunisation programme in the new health system was described as fragmented, and significant effort was expended to regroup. National tripartite arrangements required joint working and accountability; a shift from the simpler hierarchical pre-reform structure, typical of many public health programmes. New local inter-organisational arrangements resulted in ambiguity about organisational responsibilities and hindered data-sharing. Whilst making immunisation managers responsible for larger areas supported equitable resource distribution and strengthened service commissioning, it also reduced their ability to apply clinical expertise, support and evaluate immunisation providers' performance

Demand response and energy efficiency in the capacity resource procurement: Case studies of forward capacity markets in ISO New England, PJM and Great Britain

International Nuclear Information System (INIS)

Liu, Yingqi

2017-01-01

Demand-side resources like demand response (DR) and energy efficiency (EE) can contribute to the capacity adequacy underpinning power system reliability. Forward capacity markets are established in many liberalised markets to procure capacity, with a strong interest in procuring DR and EE. With case studies of ISO New England, PJM and Great Britain, this paper examines the process and trends of procuring DR and EE in forward capacity markets, and the design for integration mechanisms. It finds that the contribution of DR and EE varies wildly across these three capacity markets, due to a set of factors regarding mechanism design, market conditions and regulatory provisions, and the offering of EE is more heavily influenced by regulatory utility EE obligation. DR and EE are complementary in targeting end-uses and customers for capacity resources, thus highlighting the value of procuring them both. System needs and resources’ market potential need to be considered in defining capacity products. Over the long-term, it is important to ensure the removal of barriers for these demand-side resources and the capability of providers in addressing risks of unstable funding and forward planning. For the EDR Pilot in the UK, better coordination with forward capacity auction needs to be achieved. - Highlights: • Trends of demand response and energy efficiency in capacity markets are analysed. • Integration mechanisms, market conditions and regulatory provisions are key factors. • Participation of energy efficiency is influenced by regulatory utility obligations. • Procuring both demand response and energy efficiency in capacity market is valuable. • Critical analysis of the design of capacity products and integration mechanisms.

Characterisation of influenza A viruses isolated from turkeys in England during March-May 1979.

Science.gov (United States)

Alexander, D J; Spackman, D

1981-07-01

During the early spring of 1979 turkeys on at least twelve sites in England became infected with influenza A viruses. On five of these sites no virus was isolated but birds were shown to have antibodies to Havl (four sites) and Hav2 antigenic subtypes of influenza A viruses. The eight viruses isolated were typed: A/turkey/England/192-328/79 (Havl Nav2/3), A/turkey/England/192-329/79 (Hav1 N2), A/turkey/England/199/79 (Hav1 Neq1), A/turkey/ England/214/79 (Hav1 Neq1), A/turkey/England/250/79 (Hsw1 N1), A/turkey/England/262/79 (Hav1 Nav2/3), A/turkey/England/272/79 (Havl Neq1), A/turkey/England/384/79 (Hav2 Nav4). Pathogenicity index tests in 6-week-old chickens agreed with the clinical signs seen in turkeys in the field. Three of the isolates: 199, 214 and 272 were of extremely high virulence, 384 showed intermediate virulence, while the other isolates were of low virulence.

Mortality of People with Intellectual Disabilities in England: A Comparison of Data from Existing Sources

Science.gov (United States)

Heslop, Pauline; Glover, Gyles

2015-01-01

Background: At present, there is limited statistical information about mortality of people with intellectual disabilities in England. This study explores the data that are currently available. Materials and Methods: Four recent sources of data about mortality of people with intellectual disabilities in England are reviewed: the Confidential…

The National Singing Programme for Primary Schools in England: An Initial Baseline Study

Science.gov (United States)

Welch, G. F.; Himonides, E.; Papageorgi, I.; Saunders, J.; Rinta, T.; Stewart, C.; Preti, C.; Lani, J.; Vraka, M.; Hill, J.

2009-01-01

The "Sing Up" National Singing Programme for primary schools in England was launched in November 2007 under the UK government's "Music Manifesto". "Sing Up" is a four-year programme whose overall aim is to raise the status of singing and increase opportunities for children throughout the country to enjoy singing as…

Early Learning Experience and Adolescent Anxiety: A Cross-Cultural Comparison between Japan and England

Science.gov (United States)

Essau, Cecilia A.; Ishikawa, Shin-ichi; Sasagawa, Satoko

2011-01-01

The main aim of this study was to compare the frequency of anxiety symptoms among adolescents in Japan and England, and to examine the association between early learning experiences and anxiety symptoms. A total of 299 adolescents (147 from England and 152 from Japan), aged 12 to 17 years were investigated. Results showed that adolescents in…

Elevated bladder cancer in northern New England: The role of drinking water and arsenic

Science.gov (United States)

Baris, Dalsu; Wadell, Richard; Freeman, Laura; Schwenn, Molly; Colt, Joanne; Ayotte, Joseph; Ward, Mary; Nuckols, John; Schned, Alan; Jackson, Brian; Clerkin, Castine; Rothman, Nathanial; Moore, Lee; Taylor, Anne; Robinson, Gilpin; Hosain, Monawar G.; Armenti, Carla; McCoy, Richard; Samanic, Claudine; Hoover, Robert; Fraumeni, Joseph; Johnson, Alison; Karagas, Margaret; Silverman, Debra

2016-01-01

Background: Bladder cancer mortality rates have been elevated in northern New England for at least five decades. Incidence rates in Maine, New Hampshire, and Vermont are about 20% higher than the United States overall. We explored reasons for this excess, focusing on arsenic in drinking water from private wells, which are particularly prevalent in the region.Methods: In a population-based case-control study in these three states, 1213 bladder cancer case patients and 1418 control subjects provided information on suspected risk factors. Log transformed arsenic concentrations were estimated by linear regression based on measurements in water samples from current and past homes. All statistical tests were two-sided.Results: Bladder cancer risk increased with increasing water intake ( Ptrend = .003). This trend was statistically significant among participants with a history of private well use ( Ptrend = .01). Among private well users, this trend was apparent if well water was derived exclusively from shallow dug wells (which are vulnerable to contamination from manmade sources, Ptrend = .002) but not if well water was supplied only by deeper drilled wells ( Ptrend = .48). If dug wells were used pre-1960, when arsenical pesticides were widely used in the region, heavier water consumers (>2.2 L/day) had double the risk of light users (dug wells in an era when arsenical pesticides were widely used, was associated with increased bladder cancer risk and may have contributed to the New England excess.

Trends in hospital admissions and surgical procedures for degenerative lumbar spine disease in England: a 15-year time-series study

Science.gov (United States)

Sivasubramaniam, Vinothan; Patel, Hitesh C; Ozdemir, Baris A; Papadopoulos, Marios C

2015-01-01

Objectives Low back pain (LBP), from degenerative lumbar spine disease, represents a significant burden on healthcare resources. Studies worldwide report trends attributable to their country's specific demographics and healthcare system. Considering England's specific medico-socioeconomic conditions, we investigate recent trends in hospital admissions and procedures for LBP, and discuss the implications for the allocation of healthcare resources. Design Retrospective cohort study using Hospital Episode Statistics data relating to degenerative lumbar spine disease in England, between 1999 and 2013. Regression models were used to analyse trends. Outcome measures Trends in the number of admissions and procedures for LBP, mean patient age, gender and length of stay. Results Hospital admissions and procedures have increased significantly over the study period, from 127.09 to 216.16 and from 24.5 to 48.83 per 100 000, respectively, (pdisease, and highlight the need for services capable of dealing with the increased comorbidity burden associated with an ageing patient group. PMID:26671956

Trends in violence in England and Wales 2010-2014.

Science.gov (United States)

Sivarajasingam, Vaseekaran; Page, Nicholas; Wells, John; Morgan, Peter; Matthews, Kent; Moore, Simon; Shepherd, Jonathan

2016-06-01

The National Violence Surveillance Network (NVSN) of emergency departments (ED), minor injuries units and walk-in-centres in England and Wales has brought clarity to contradictory violence trends derived from crime survey and police data. Gender, age-specific and regional trends in violence-related injury in England and Wales since 2010 have not been studied. Data on violence-related injury were collected from a structured sample of 151 EDs in England and Wales. ED attendance date and age and gender of patients who reported injury in violence from 1 January 2010 to 31 December 2014 were identified from attendance codes, specified at the local level. Time series statistical methods were used to detect both regional and national trends. In total, 247 016 (178 709 males: 72.3%) violence-related attendances were identified. Estimated annual injury rate across England and Wales was 4.4/1000 population (95% CI 3.9 to 4.9); males 6.5/1000 (95% CI 5.6 to 7.2) and females 2.4/1000 (95% CI 2.1 to 2.6). On average, overall attendances decreased by 13.8% per year over the 5 years (95% CI -14.8 to -12.1). Attendances decreased significantly for both genders and all age groups (0-10, 11-17, 18-30, 31-50, 51+ years); declines were greatest among children and adolescents. Significant decreases in violence-related injury were found in all but two regions. Violence peaked in May and July. From an ED perspective, violence in England and Wales decreased substantially between 2010 and 2014, especially among children and adolescents. Violence prevention efforts should focus on regions with the highest injury rates and during the period May-July. 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/

Spatial Accessibility of Primary Care in England: A Cross-Sectional Study Using a Floating Catchment Area Method.

Science.gov (United States)

Bauer, Jan; Müller, Ruth; Brüggmann, Dörthe; Groneberg, David A

2017-07-07

To analyze the general practitioners (GPs) with regard to the degree of urbanization, social deprivation, general health, and disability. Small area population data and GP practice data in England. We used a floating catchment area method to measure spatial GP accessibility with regard to the degree of urbanization, social deprivation, general health, and disability. Data were collected from the Office for National Statistics and the general practice census and analyzed using a geographic information system. In all, 25.8 percent of the population in England lived in areas with a significant low GP accessibility (mean z-score: -4.2); 27.6 percent lived in areas with a significant high GP accessibility (mean z-score: 7.7); 97.8 percent of high GP accessibility areas represented urban areas, and 31.1 percent of low GP accessibility areas represented rural areas (correlation of accessibility and urbanity: r = 0.59; psocial deprivation was present (r = -0.19; paccessibility throughout England. However, socially deprived areas did not have poorer spatial access to GPs. © Health Research and Educational Trust.

From "Stranger" to "Arrived": The Citizens' Library in England.

Science.gov (United States)

Meyers, Arthur S.

1998-01-01

Discusses studies of public library multicultural services in England. Describes multicultural programs in Birmingham and Brent that involve the citizens in planning and implementing these services. Access to electronic technology will affect the provision of these services. (MMU)

Ethnic group variations in alcohol-related hospital admissions in England: does place matter?

Science.gov (United States)

Barry, Eleanor; Laverty, Anthony A; Majeed, Azeem; Millett, Christopher

2015-01-01

The health burden of alcohol use is socially and geographically patterned in many countries. Less is known about variations in this burden between ethnic groups and whether this differs across place of residence. National cross-sectional study using hospital admission data in England. Alcohol-related admission rates, where an alcohol-related condition was either the primary diagnosis (considered as the reason for admission) or a comorbidity, were calculated using ethnic group specific rates for English regions. In 2010/11 there were a total of 264,870 alcohol-related admissions in England. Admission rates were higher in the North of England than elsewhere (e.g. for primary diagnosis 161 per 100,000 population in the North vs. 62 per 100,000 in the South). These patterns were not uniform across ethnic groups however. For example, admission rates for alcohol-related comorbidity were four times higher among White Irish in London compared with those in the South of England (306 to 76 per 100,000) and four times higher in Indians living in the Midlands compared with those in the South of England (128 to 29 per 100,000). These patterns were similar for admissions with a comorbid alcohol-related condition. Geographical location may be an important determinant of within and between ethnic group variations in alcohol-related hospital admissions in England. While a number of factors were not examined here, this descriptive analysis suggests that this heterogeneity should be taken into account when planning interventions and services for the prevention and management of alcohol misuse.

Molecular and Epidemiological Review of Toxigenic Diphtheria Infections in England between 2007 and 2013

Science.gov (United States)

Both, Leonard; Collins, Sarah; de Zoysa, Aruni; White, Joanne; Mandal, Sema

2014-01-01

Human infections caused by toxigenic corynebacteria occur sporadically across Europe. In this report, we undertook the epidemiological and molecular characterization of all toxigenic corynebacterium strains isolated in England between January 2007 and December 2013. Epidemiological aspects include case demographics, risk factors, clinical presentation, treatment, and outcome. Molecular characterization was performed using multilocus sequence typing (MLST) alongside traditional phenotypic methods. In total, there were 20 cases of toxigenic corynebacteria; 12 (60.0%) were caused by Corynebacterium ulcerans, where animal contact was the predominant risk factor. The remaining eight (40.0%) were caused by Corynebacterium diphtheriae strains; six were biovar mitis, which were associated with recent travel abroad. Adults 45 years and older were particularly affected (55.0%; 11/20), and typical symptoms included sore throat and fever. Respiratory diphtheria with the absence of a pharyngeal membrane was the most common presentation (50.0%; 10/20). None of the eight C. diphtheriae cases were fully immunized. Diphtheria antitoxin was issued in two (9.5%) cases; both survived. Two (9.5%) cases died, one due to a C. diphtheriae infection and one due to C. ulcerans. MLST demonstrated that the majority (87.5%; 7/8) of C. diphtheriae strains represented new sequence types (STs). By adapting several primer sequences, the MLST genes in C. ulcerans were also amplified, thereby providing the basis for extension of the MLST scheme, which is currently restricted to C. diphtheriae. Despite high population immunity, occasional toxigenic corynebacterium strains are identified in England and continued surveillance is required. PMID:25502525

Youth, alcohol and place-based leisure behaviours: a study of two locations in England.

Science.gov (United States)

Townshend, Tim G

2013-08-01

Excessive alcohol consumption among young people in England regularly features in national media and has been a focus of recent academic research and government policy. Though the majority of young people do not regularly drink excessively, heavy sessional drinking - 'binge' drinking - is associated with negative health and social consequences for those who do. Alcohol-related health problems in young people are not spread consistently across England, however, and while there are significant intra-regional differences, northern regions fare worse overall than those in the south. This paper draws on an 18-month project which explored differences in the physical, social and regulatory environments (highlighted by previous research as influential) in two locations with contrasting alcohol harm profiles. The paper focuses on the lives of 15-16 year olds and examines potential differences that influence behaviour at this crucial age; and in particular issues that might presage risky and/or harmful drinking in young adulthood. The study examines evidence from young people themselves (activity diaries and interviews); stakeholder interviews; and observation analysis. The study finds social practices in the two areas to be largely similar; moreover, the collectivised and social nature of alcohol consumption suggests sources of influence from a wider context, beyond immediate family and friendship groups. However these social practices were acted out in locations with very different physical characteristics, in particular these related to the availability of non-alcohol focused leisure activities and the spatial arrangement/visibility of adult drinking culture. Copyright © 2013 Elsevier Ltd. All rights reserved.

Identification of Forged Bank of England 20 Gbp Banknotes Using IR Spectroscopy

Science.gov (United States)

Sonnex, Emily

2014-06-01

Bank of England notes of 20 GBP denomination have been studied using infrared spectroscopy in order to generate a method to identify forged notes. A principal aim of this work was to develop a method so that a small, compact ATR FTIR instrument could be used by bank workers, police departments or others such as shop assistants to identify forged notes in a non-lab setting. The ease of use of the instrument is the key to this method, as well as the relatively low cost. The presence of a peak at 1400 wn from the blank paper section of a forged note proved to be a successful indicator of the note's illegality for the notes that we studied. Moreover, differences between the spectra of forged and genuine 20 GBP notes were observed in the ν(OH) (ca. 3500 wn), ν(C-H) (ca. 2900 wn) and ν(C=O) (ca. 1750 wn) regions of the IR spectrum recorded for the polymer film covering the holographic strip. In cases where these simple tests fail, we have shown how an infrared microscope can be used to further differentiate genuine and forged banknotes by producing infrared maps of selected areas of the note contrasting inks with background paper. Further to this, with an announcement by the Bank of England to produce polymer banknotes in the future, the work has been extended using Australian polymer banknotes to show that the method would be transferable.

Characterizing tobacco control mass media campaigns in England.

Science.gov (United States)

Langley, Tessa; Lewis, Sarah; McNeill, Ann; Gilmore, Anna; Szatkowski, Lisa; West, Robert; Sims, Michelle

2013-11-01

To characterize publically funded tobacco control campaigns in England between 2004 and 2010 and to explore if they were in line with recommendations from the literature in terms of their content and intensity. International evidence suggests that campaigns which warn of the negative consequences of smoking and feature testimonials from real-life smokers are most effective, and that four exposures per head per month are required to reduce smoking prevalence. Characterization of tobacco control advertisements using a theoretically based framework designed to describe advertisement themes, informational and emotional content and style. Study of the intensity of advertising and exposure to different types of advertisement using data on population-level exposure to advertisements shown during the study period. England. Television Ratings (TVRs), a standard measure of advertising exposure, were used to calculate exposure to each different campaign type. A total of 89% of advertising was for smoking cessation; half of this advertising warned of the negative consequences of smoking, while half contained how-to-quit messages. Acted scenes featured in 72% of advertising, while only 17% featured real-life testimonials. Only 39% of months had at least four exposures to tobacco control campaigns per head. A theory-driven approach enabled a systematic characterization of tobacco control advertisements in England. Between 2004 and 2010 only a small proportion of tobacco control advertisements utilized the most effective strategies-negative health effects messages and testimonials from real-life smokers. The intensity of campaigns was lower than international recommendations. © 2013 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of The Society for the Study of Addiction.

Two families from New England with usher syndrome type IC with distinct haplotypes.

Science.gov (United States)

DeAngelis, M M; McGee, T L; Keats, B J; Slim, R; Berson, E L; Dryja, T P

2001-03-01

To search for patients with Usher syndrome type IC among those with Usher syndrome type I who reside in New England. Genotype analysis of microsatellite markers closely linked to the USH1C locus was done using the polymerase chain reaction. We compared the haplotype of our patients who were homozygous in the USH1C region with the haplotypes found in previously reported USH1C Acadian families who reside in southwestern Louisiana and from a single family residing in Lebanon. Of 46 unrelated cases of Usher syndrome type I residing in New England, two were homozygous at genetic markers in the USH1C region. Of these, one carried the Acadian USH1C haplotype and had Acadian ancestors (that is, from Nova Scotia) who did not participate in the 1755 migration of Acadians to Louisiana. The second family had a haplotype that proved to be the same as that of a family with USH1C residing in Lebanon. Each of the two families had haplotypes distinct from the other. This is the first report that some patients residing in New England have Usher syndrome type IC. Patients with Usher syndrome type IC can have the Acadian haplotype or the Lebanese haplotype compatible with the idea that at least two independently arising pathogenic mutations have occurred in the yet-to-be identified USH1C gene.

Thallium in the hydrosphere of south west England

Energy Technology Data Exchange (ETDEWEB)

Law, Sin [School of Geography, Earth and Environmental Sciences, University of Plymouth, Drake Circus, Plymouth PL4 8AA (United Kingdom); Turner, Andrew, E-mail: aturner@plymouth.ac.uk [School of Geography, Earth and Environmental Sciences, University of Plymouth, Drake Circus, Plymouth PL4 8AA (United Kingdom)

2011-12-15

Thallium is a highly toxic metal whose environmental concentrations, distributions and behaviour are not well understood. In the present study we measure the concentrations of Tl in filtered and unfiltered samples of rain, tap, river, estuarine and waste waters collected from south west England. Dissolved Tl was lowest (<20 ng L{sup -1}) in tap water, rain water, treated sewage and landfill effluents, estuarine waters, and rivers draining catchments of sandstones and shales. Concentrations up to about 450 ng L{sup -1} were observed in rivers whose catchments are partly mineralized and where metal mining was historically important, and the highest concentration ({approx}1400 ng L{sup -1}) was measured in water abstracted directly from an abandoned mine. Compared with other trace metals measured (e.g. As, Cd, Co, Cr, Cu, Ni, Pb, Zn), Tl has a low affinity for suspended particles and undergoes little removal by conventional (hydroxide precipitation) treatment of mine water. - Highlights: > Thallium concentrations have been measured in natural and waste waters from south west England. > Dissolved concentrations spanned three orders of magnitude and were highest in water from an abandoned mine. > Inputs associated with historical metal mine workings are the most important to the regional hydrosphere. - Concentrations of dissolved thallium in waters of south west England span two orders of magnitude and are greatest in water from an abandoned mine.

Thallium in the hydrosphere of south west England

International Nuclear Information System (INIS)

Law, Sin; Turner, Andrew

2011-01-01

Thallium is a highly toxic metal whose environmental concentrations, distributions and behaviour are not well understood. In the present study we measure the concentrations of Tl in filtered and unfiltered samples of rain, tap, river, estuarine and waste waters collected from south west England. Dissolved Tl was lowest ( -1 ) in tap water, rain water, treated sewage and landfill effluents, estuarine waters, and rivers draining catchments of sandstones and shales. Concentrations up to about 450 ng L -1 were observed in rivers whose catchments are partly mineralized and where metal mining was historically important, and the highest concentration (∼1400 ng L -1 ) was measured in water abstracted directly from an abandoned mine. Compared with other trace metals measured (e.g. As, Cd, Co, Cr, Cu, Ni, Pb, Zn), Tl has a low affinity for suspended particles and undergoes little removal by conventional (hydroxide precipitation) treatment of mine water. - Highlights: → Thallium concentrations have been measured in natural and waste waters from south west England. → Dissolved concentrations spanned three orders of magnitude and were highest in water from an abandoned mine. → Inputs associated with historical metal mine workings are the most important to the regional hydrosphere. - Concentrations of dissolved thallium in waters of south west England span two orders of magnitude and are greatest in water from an abandoned mine.

Quality of communication and master impressions for the fabrication of cobalt chromium removable partial dentures in general dental practice in England, Ireland and Wales in 2009.

Science.gov (United States)

Kilfeather, G P; Lynch, C D; Sloan, A J; Youngson, C C

2010-04-01

The aim of this study was to investigate the quality of communication and master impressions for the fabrication of cobalt chromium removable partial dentures (RPDs) in general dental practice in England, Ireland and Wales in 2009. Two hundred and ten questionnaires were distributed to 21 laboratories throughout England, Ireland and Wales. Information was collected regarding the quality of written communication and selection of master impression techniques for cobalt chromium partial dentures in general dental practice. One hundred and forty-four questionnaires were returned (response rate = 68%). Alginate was the most popular impression material being used in 58% of cases (n = 84), while plastic stock trays were the most popular impression tray, being used in 31% of cases (n = 44). Twenty-four per cent (n = 35) of impressions were not adequately disinfected. Opposing casts were provided in 81% of cases (n = 116). Written instructions were described as being 'clear' in 31% of cases (n = 44). In 54% of cases (n = 76), the technician was asked to design the RPD. Based on the findings of this study, written communication for cobalt chromium RPDs by general dental practitioners is inadequate. This finding is in breach of relevant contemporary legal and ethical guidance. There are also concerns in relation to the fabrication process for this form of prosthesis, particularly, in relation to consideration of occlusal schemes.

Six States, One Destiny: Critical Issues for New England

Science.gov (United States)

Mass, William; Soule, David C.

2005-01-01

Midway through the first decade of the 21st century, New England innovation and creative capacity are being challenged by other regions of the nation and the world. New England needs foresight to understand what its emerging economic sectors need to thrive in a changing demography. The region is losing 20- to 34-year-olds and seeing a growing…

Implementing personalisation for people with mental health problems: a comparative case study of four local authorities in England.

Science.gov (United States)

Larsen, John; Ainsworth, Emily; Harrop, Clare; Patterson, Sue; Hamilton, Sarah; Szymczynska, Paulina; Tew, Jerry; Manthorpe, Jill; Pinfold, Vanessa

2013-04-01

Enhancing choice and control for people using services is a mental health and social-care service priority in England. Personalisation is a new policy and practice for delivery of social-care services where eligible adults are allocated a personal budget to spend to meet their agreed support needs. To describe approaches to introducing personal budgets to people with severe and enduring mental health needs, and to identify facilitators or barriers encountered. Within four English local authority (LA) areas, purposively selected to provide maximum variation, semi-structured interviews were undertaken with 58 participants from LAs, NHS trusts and third-sector organisations. An Interpretive Framework analysis considered within- and across-site insights. Issues arising from the implementation of personalisation for people with mental health needs are presented under two general themes: "responsibility and power" and "vision and leadership". Key challenges identified were complexities of working across NHS and LAs, the importance of effective leadership and engagement with service user representatives. Implementing personal budgets in mental health requires effective engagement of health and social-care systems. Change processes need strong leadership, clear vision and personal commitment, with ownership by all key stakeholders, including front-line practitioners.

Is cancer survival associated with cancer symptom awareness and barriers to seeking medical help in England? An ecological study.

OpenAIRE

Niksic, M; Rachet, B; Duffy, SW; Quaresma, M; Møller, H; Forbes, LJ

2016-01-01

Abstract\\ud \\ud BACKGROUND: \\ud \\ud Campaigns aimed at raising cancer awareness and encouraging early presentation have been implemented in England. However, little is known about whether people with low cancer awareness and increased barriers to seeking medical help have worse cancer survival, and whether there is a geographical variation in cancer awareness and barriers in England.\\ud \\ud METHODS: \\ud \\ud From population-based surveys (n=35 308), using the Cancer Research UK Cancer Awarenes...

The social and emotional dimensions of schooling : a case study in challenging the ‘barriers to learning’\\ud

OpenAIRE

Wyness, Michael G.; Lang, Peter

2016-01-01

The educational landscape in England and Wales is shaped by demands made on head teachers, teachers and pupils to perform within a ‘field of judgement’ dominated by clearly defined outcomes of academic success (Ball 2003). This puts schools from challenging socio-economic contexts where there are potentially ‘barriers to learning’ at a considerable disadvantage. This paper draws on case study data from an English secondary school in an area of considerable deprivation. The empirical focus rev...

Preparing an educated nurse: past and future trends in England and mainland China

OpenAIRE

Zhang, R.

2012-01-01

This cross-national comparative study aims to explore previous changes and future trends in nursing in England and mainland China, and the impact that reform has had on the way in which nurses are currently and prospectively educated in the two countries. Nursing education in both countries has experienced considerable development related to societal, health care, and technological advances, alongside economic growth. In England, there is a policy imperative to shift nursing to an all-graduat...

Schooling Reforms in England: From Quasi-Markets to Co-Opetition?

Science.gov (United States)

Adnett, Nick; Davies, Peter

2003-01-01

Economic analysis of the impact of recent schooling reforms in England designed to promote competition or cooperation between schools. Outlines the theoretical relationships between school competition and cooperation and school effectiveness. Briefly describes the development of policy in England and analyzes the interaction between the incentives…

England Policy in Gifted Education: Current Problems and Promising Directions

Science.gov (United States)

Koshy, Valsa; Smith, Carole Portman; Casey, Ronald

2018-01-01

This article presents and analyzes policies in identification and provisions in England with respect to gifted education. England has developed a national policy to provide services to identified students. Surveys and interviews with teachers illustrate how implementation of both identification and provision policy elements were handled. Although…

Dementia case-finding in hospitals: a qualitative study exploring the views of healthcare professionals in English primary care and secondary care.

Science.gov (United States)

Burn, Anne-Marie; Fleming, Jane; Brayne, Carol; Fox, Chris; Bunn, Frances

2018-03-17

In 2012-2013, the English National Health Service mandated hospitals to conduct systematic case-finding of people with dementia among older people with unplanned admissions. The method was not defined. The aim of this study was to understand current approaches to dementia case-finding in acute hospitals in England and explore the views of healthcare professionals on perceived benefits and challenges. Qualitative study involving interviews, focus groups and thematic content analysis. Primary care and secondary care across six counties in the East of England. Hospital staff involved in dementia case-finding and primary care staff in the catchment areas of those hospitals. We recruited 23 hospital staff and 36 primary care staff, including 30 general practitioners (GPs). Analysis resulted in three themes: (1) lack of consistent approaches in case-finding processes, (2) barriers between primary care and secondary care which impact on case-finding outcomes and (3) perceptions of rationale, aims and impacts of case-finding. The study shows that there were variations in how well hospitals recorded and reported outcomes to GPs. Barriers between primary care and secondary care, including GPs' lack of access to hospital investigations and lack of clarity about roles and responsibilities, impacted case-finding outcomes. Staff in secondary care were more positive about the initiative than primary care staff, and there were conflicting priorities for primary care and secondary care regarding case-finding. The study suggests a more evidence-based approach was needed to justify approaches to dementia case-finding. Information communicated to primary care from hospitals needs to be comprehensive, appropriate and consistent before GPs can effectively plan further investigation, treatment or care. Follow-up in primary care further requires access to options for postdiagnostic support. There is a need to evaluate the outcomes for patients and the economic impact on health and care

Home-mortgage lending trends in New England in 2010

OpenAIRE

Ana Patricia Muñoz

2012-01-01

This brief analysis of home-mortgage lending trends in New England is based on data collected under the Home Mortgage Disclosure Act (HMDA). HMDA provides information on mortgage lending trends and includes data by loan purpose, type of loan, income, and the race and ethnicity of borrowers. In this report we focus on home-purchase and refinance loans in New England.

Reparation for a Violent Boyhood: Pedagogies of Mourning in Shane Meadow's "This Is England"

Science.gov (United States)

Dyer, Hannah

2017-01-01

This article turns to Shane Meadow's film "This is England" (2006) to describe the impact that losing a parent can have on a child's development. In doing so it also, more broadly, makes a case for creative fiction as a resource for teaching about children's mourning. The film's protagonist is a boy named Shaun Fields whose father has…

Childhood obesity trends from primary care electronic health records in England between 1994 and 2013: population-based cohort study.

Science.gov (United States)

van Jaarsveld, Cornelia H M; Gulliford, Martin C

2015-03-01

This study aimed to use primary care electronic health records to evaluate the prevalence of overweight and obesity in 2-15-year-old children in England and compare trends over the last two decades. Cohort study of primary care electronic health records. 375 general practices in England that contribute to the UK Clinical Practice Research Datalink. Individual participants were sampled if they were aged between 2 and 15 years during the period 1994-2013 and had one or more records of body mass index (BMI). Prevalence of overweight (including obesity) was defined as a BMI equal to or greater than the 85th centile of the 1990 UK reference population. Data were analysed for 370 544 children with 507 483 BMI records. From 1994 to 2003, the odds of overweight and obesity increased by 8.1% per year (95% CI 7.2% to 8.9%) compared with 0.4% (-0.2% to 1.1%) from 2004 to 2013. Trends were similar for boys and girls, but differed by age groups, with prevalence stabilising in 2004 to 2013 in the younger (2-10 year) but not older (11-15 year) age group, where rates continued to increase. Primary care electronic health records in England may provide a valuable resource for monitoring obesity trends. More than a third of UK children are overweight or obese, but the prevalence of overweight and obesity may have stabilised between 2004 and 2013. 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.

General outbreaks of vero cytotoxin producing Escherichia coli O157 in England and Wales from 1992 to 1994.

LENUS (Irish Health Repository)

Wall, P G

1996-02-02

We have reviewed all general outbreaks of infection due to Vero cytotoxin producing Escherichia coli (VTEC) O157 reported in England and Wales from 1992 to 1994. One hundred and seventy-three people were affected in 18 outbreaks, compared with 76 people in seven outbreaks in the preceding three years (1989 to 1991). Outbreaks occurred throughout England and Wales. Thirty-eight per cent of cases were admitted to hospital, 21% developed haemolytic uraemic syndrome, and 3% died. VTEC O157 infection causes particular concern because of its serious complications--haemorrhagic colitis and haemolytic uraemic syndrome, its capacity to spread from person to person as well as by food and water, and its reservoir in dairy and beef cattle.

The nature of methadone diversion in England: a Merseyside case study

Directory of Open Access Journals (Sweden)

Duffy Paul

2012-01-01

Full Text Available Abstract Background Methadone maintenance treatment (MMT is a key element in treatment for opiate addiction; however concerns about the diversion of methadone remain. More current empirical data on methadone diversion are required. This research investigated the market for diverted methadone in Merseyside, UK, in order to provide a case study which can be transferred to other areas undertaking methadone maintenance treatment on a large scale. Methods Questionnaires were completed (in interview format with 886 past year users of methadone recruited both in and out of prescribing agencies. Topic areas covered included current prescribing, obtaining and providing methadone, reasons for using illicit methadone and other drug use. Results Large proportions of participants had obtained illicit methadone for use in the past year with smaller proportions doing so in the past month. Proportions of participants buying and being given methadone were similar. Exchange of methadone primarily took place between friends and associates, with 'dealers' rarely involved. Gender, age, whether participant's methadone consumption was supervised and whether the aims of their treatment had been explained to them fully, influenced the extent to which participants were involved in diverting or using diverted methadone. Conclusion Methadone diversion is widespread although drug users generally do not make use of illicit methadone regularly (every month. The degree of altruism involved in the exchange of methadone does not negate the potential role of this action in overdose or the possibility of criminal justice action against individuals. Treatment agencies need to emphasise these risks whilst ensuring that treatment aims are effectively shared with clients to ensure adherence to treatment.

Political Assumptions Underlying Pedagogies of National Education: The Case of Student Teachers Teaching 'British Values' in England

Science.gov (United States)

Sant, Edda; Hanley, Chris

2018-01-01

Teacher education in England now requires that student teachers follow practices that do not undermine "fundamental British values" where these practices are assessed against a set of ethics and behaviour standards. This paper examines the political assumptions underlying pedagogical interpretations about the education of national…

Writing masters and accountants in England – a study of occupation, status and ambition in the early modern period

OpenAIRE

Edwards , John Richard

2010-01-01

The purpose of this paper is to address the lack of knowledge of the accounting occupational group in England prior to the formation of professional accounting bodies. It does so by focusing on attempts made by the occupational group of writing masters and accountants to establish a recognisable persona in the public domain, in England, during the seventeenth and eighteenth century, and to enhance that identity by behaving in a manner designed to convince the public of the professionalism ass...

Philosophy of experiment in early modern England: the case of Bacon, Boyle and Hooke.

Science.gov (United States)

Anstey, Peter R

2014-01-01

Serious philosophical reflection on the nature of experiment began in earnest in the seventeenth century. This paper expounds the most influential philosophy of experiment in seventeenth-century England, the Bacon-Boyle-Hooke view of experiment. It is argued that this can only be understood in the context of the new experimental philosophy practised according to the Baconian theory of natural history. The distinctive typology of experiments of this view is discussed, as well as its account of the relation between experiment and theory. This leads into an assessment of other recent discussions of early modern experiment, namely, those of David Gooding, Thomas Kuhn, J.E. Tiles and Peter Dear.

The public health system in England

National Research Council Canada - National Science Library

Hunter, David J; Marks, Linda; Smith, Katherine E

2010-01-01

.... The Public Health System in England offers a wide-ranging, provocative and accessible assessment of challenges confronting a public health system, exploring how its parameters have shifted over time...

Quantifying the healthcare costs of treating severely bleeding major trauma patients: a national study for England.

Science.gov (United States)

Campbell, Helen E; Stokes, Elizabeth A; Bargo, Danielle N; Curry, Nicola; Lecky, Fiona E; Edwards, Antoinette; Woodford, Maralyn; Seeney, Frances; Eaglestone, Simon; Brohi, Karim; Gray, Alastair M; Stanworth, Simon J

2015-07-06

Severely bleeding trauma patients are a small proportion of the major trauma population but account for 40% of all trauma deaths. Healthcare resource use and costs are likely to be substantial but have not been fully quantified. Knowledge of costs is essential for developing targeted cost reduction strategies, informing health policy, and ensuring the cost-effectiveness of interventions. In collaboration with the Trauma Audit Research Network (TARN) detailed patient-level data on in-hospital resource use, extended care at hospital discharge, and readmissions up to 12 months post-injury were collected on 441 consecutive adult major trauma patients with severe bleeding presenting at 22 hospitals (21 in England and one in Wales). Resource use data were costed using national unit costs and mean costs estimated for the cohort and for clinically relevant subgroups. Using nationally available data on trauma presentations in England, patient-level cost estimates were up-scaled to a national level. The mean (95% confidence interval) total cost of initial hospital inpatient care was £19,770 (£18,177 to £21,364) per patient, of which 62% was attributable to ventilation, intensive care, and ward stays, 16% to surgery, and 12% to blood component transfusion. Nursing home and rehabilitation unit care and re-admissions to hospital increased the cost to £20,591 (£18,924 to £22,257). Costs were significantly higher for more severely injured trauma patients (Injury Severity Score ≥15) and those with blunt injuries. Cost estimates for England were £148,300,000, with over a third of this cost attributable to patients aged 65 years and over. Severely bleeding major trauma patients are a high cost subgroup of all major trauma patients, and the cost burden is projected to rise further as a consequence of an aging population and as evidence continues to emerge on the benefits of early and simultaneous administration of blood products in pre-specified ratios. The findings from

Elevated Bladder Cancer in Northern New England: The Role of Drinking Water and Arsenic.

Science.gov (United States)

Baris, Dalsu; Waddell, Richard; Beane Freeman, Laura E; Schwenn, Molly; Colt, Joanne S; Ayotte, Joseph D; Ward, Mary H; Nuckols, John; Schned, Alan; Jackson, Brian; Clerkin, Castine; Rothman, Nathaniel; Moore, Lee E; Taylor, Anne; Robinson, Gilpin; Hosain, Gm Monawar; Armenti, Karla R; McCoy, Richard; Samanic, Claudine; Hoover, Robert N; Fraumeni, Joseph F; Johnson, Alison; Karagas, Margaret R; Silverman, Debra T

2016-09-01

Bladder cancer mortality rates have been elevated in northern New England for at least five decades. Incidence rates in Maine, New Hampshire, and Vermont are about 20% higher than the United States overall. We explored reasons for this excess, focusing on arsenic in drinking water from private wells, which are particularly prevalent in the region. In a population-based case-control study in these three states, 1213 bladder cancer case patients and 1418 control subjects provided information on suspected risk factors. Log transformed arsenic concentrations were estimated by linear regression based on measurements in water samples from current and past homes. All statistical tests were two-sided. Bladder cancer risk increased with increasing water intake (Ptrend = .003). This trend was statistically significant among participants with a history of private well use (Ptrend = .01). Among private well users, this trend was apparent if well water was derived exclusively from shallow dug wells (which are vulnerable to contamination from manmade sources, Ptrend = .002) but not if well water was supplied only by deeper drilled wells (Ptrend = .48). If dug wells were used pre-1960, when arsenical pesticides were widely used in the region, heavier water consumers (>2.2 L/day) had double the risk of light users (<1.1 L/day, Ptrend = .01). Among all participants, cumulative arsenic exposure from all water sources, lagged 40 years, yielded a positive risk gradient (Ptrend = .004); among the highest-exposed participants (97.5th percentile), risk was twice that of the lowest-exposure quartile (odds ratio = 2.24, 95% confidence interval = 1.29 to 3.89). Our findings support an association between low-to-moderate levels of arsenic in drinking water and bladder cancer risk in New England. In addition, historical consumption of water from private wells, particularly dug wells in an era when arsenical pesticides were widely used, was associated with increased bladder cancer risk and

Meal patterns and cooking practices in Southern France and Central England.

Science.gov (United States)

Pettinger, Clare; Holdsworth, Michelle; Gerber, Mariette

2006-12-01

To evaluate whether meal patterns and cooking practices in Central England and Mediterranean France conform to popular stereotypes, eating together as a household, preparation of meals, food purchasing patterns, cooking practices and eating out were investigated. Cross-sectional studies conducted simultaneously in April 2001 using self-administered postal questionnaires. England (Nottingham, East Midlands) and France (Montpellier, Languedoc-Roussillon). A stratified random sample of 1000 males and 1000 females aged 18-65 years was generated from the electoral roll in each country. The final sample comprised 826 subjects in England (58% males, 42% females; mean age 44 years) and 766 subjects in France (42% males, 58% females; mean age 42 years). Analyses were conducted on samples standardised for sociodemographic differences. The French cooked from raw ingredients most often (PFrench and English food cultures, as the importance of the convivial aspects of eating, as well as more traditional practices such as cooking meals from basic ingredients, structured mealtimes and less between-meal snacking, remain more prominent within the French population. This may contribute to the differences in prevalence of obesity seen between the two countries.

Understanding low colorectal cancer screening uptake in South Asian faith communities in England--a qualitative study.

Science.gov (United States)

Palmer, Cecily K; Thomas, Mary C; McGregor, Lesley M; von Wagner, Christian; Raine, Rosalind

2015-10-01

Colorectal cancer screening uptake within the South Asian population in England is approximately half that of the general population (33 % vs 61 %), and varies by Muslim (31.9 %), Sikh (34.6 %) and Hindu (43.7 %) faith background. This study sought to explore reasons for low uptake of CRC screening in South Asian communities and for the variability of low uptake between three faith communities; and to identify strategies by which uptake might be improved. We interviewed 16 'key informants' representing communities from the three largest South Asian faith backgrounds (Islam, Hinduism and Sikhism) in London, England. Reasons for low colorectal cancer screening uptake were overwhelmingly shared across South Asian faith groups. These were: limitations posed by written English; limitations posed by any written language; reliance on younger family members; low awareness of colorectal cancer and screening; and difficulties associated with faeces. Non-written information delivered verbally and interactively within faith or community settings was preferred across faith communities. Efforts to increase accessibility to colorectal cancer screening in South Asian communities should use local language broadcasts on ethnic media and face-to-face approaches within community and faith settings to increase awareness of colorectal cancer and screening, and address challenges posed by written materials.

Patterns of antimicrobial resistance in Streptococcus suis isolates from pigs with or without streptococcal disease in England between 2009 and 2014.

Science.gov (United States)

Hernandez-Garcia, Juan; Wang, Jinhong; Restif, Olivier; Holmes, Mark A; Mather, Alison E; Weinert, Lucy A; Wileman, Thomas M; Thomson, Jill R; Langford, Paul R; Wren, Brendan W; Rycroft, Andrew; Maskell, Duncan J; Tucker, Alexander W

2017-08-01

Antimicrobial resistance in Streptococcus suis, a global zoonotic pathogen of pigs, has been mostly studied only in diseased animals using surveys that have not evaluated changes over time. We compared patterns of resistance between S. suis isolates from clinical cases of disease (CC) and non-clinical case (NCC) pigs in England, collected over two discrete periods, 2009-2011 and 2013-2014. Minimum inhibitory concentrations (MIC) of 17 antimicrobials (nine classes) were determined on 405 S. suis isolates categorised by sampling period and disease association to assess changes in resistance over time and association with disease. First, isolates were characterized as resistant or susceptible using published clinical breakpoints. Second, epidemiological cut-offs (ECOFF) were derived from MIC values, and isolates classified as wild type (WT) below the ECOFF and non-wild type (NWT) above the ECOFF. Finally, isolate subsets were analysed for shifts in MIC distribution. NCC isolates were more resistant than CC isolates to cephalosporins, penams, pleuromutilins, potentiated sulphonamides and tetracyclines in both study periods. Resistance levels among CC isolates increased in 2013-2014 relative to 2009-2011 for antimicrobials including aminoglycosides, cephalosporins, fluoroquinolones, pleuromutilins, potentiated sulphonamides and tetracyclines. The prevalence of isolates categorised as NWT for five or more classes of antimicrobials was greater among NCC than CC isolates for both time periods, and increased with time. This study used standardised methods to identify significant shifts in antimicrobial resistance phenotypes of S. suis isolated from pigs in England, not only over time but also between isolates from known clinical cases or disease-free pigs. Copyright © 2017. Published by Elsevier B.V.

The geography of early childhood mortality in England and Wales, 1881-1911

Directory of Open Access Journals (Sweden)

Hannaliis Jaadla

2017-12-01

Full Text Available Background: Considerable regional variation existed in 19th-century infant mortality (IMR in England and Wales. Objective: This study estimates early childhood mortality (ECMR for over 2,000 registration subdistricts (RSDs of England and Wales and analyses spatial and temporal variations in IMR and ECMR between 1881 and 1911. Methods: The combination of mortality statistics from the Registrar General and individual-level census data from the Integrated Census Microdata (I-CeM project is used to estimate spatial models of the relationship between early childhood death rates and a range of district-specific contextual variables. Results: All regions of England and Wales experienced noticeable decline in early childhood mortality, but the spatial patterns were remarkably persistent, with high mortality in London and in the mining and textile centres. The earlier decline of childhood than infant mortality produced a widening gap between them, and in early phases this development was concentrated along the East-Midlands coastal area from Suffolk to North Yorkshire, and in mid-Wales. This gap continued to widen, and in 1911 IMR was at least twice as high as ECMR in most parts of England and Wales. Conclusions: The changing spatial pattern of ECMR was influenced by a set of factors over and above those that influenced IMR, and these were related more to the disease environment than to social and economic influences. Contribution: These new estimates of early childhood mortality, at a finer spatial scale than previously possible, highlight the vast spatial variation in mortality in England and Wales. It is likely that these regional differences also manifest in variation in other demographic outcomes.

Analysis of the isoprene chemistry observed during the New England Air Quality Study (NEAQS) 2002 intensive experiment

Science.gov (United States)

Roberts, James M.; Marchewka, Mathew; Bertman, Steven B.; Goldan, Paul; Kuster, William; de Gouw, Joost; Warneke, Carsten; Williams, Eric; Lerner, Brian; Murphy, Paul; Apel, Eric; Fehsenfeld, Fred C.

2006-12-01

Isoprene and its first and second generation photochemical products, methyl vinyl ketone (MVK), methacrolein (MACR), and peroxymethacrylic nitric anhydride (MPAN), were measured off the coast of New England during the 2002 New England Air Quality Study (NEAQS) on board the NOAA Research Vessel Ronald H. Brown. The results of these measurements were analyzed using a simple sequential reaction model that has been used previously to examine regional oxidant chemistry. The highest isoprene impact was observed in air masses that had passed over an area of high isoprene emission WSW of Boston. The relative concentrations of isoprene and its first generation products show that the photochemistry is consistently "older" than the isoprene photochemistry observed at continental sites. The sequential reaction model was also applied to the aldehyde-PANs (Peroxycarboxylic nitric anhydride) system, and the resulting PPN (peroxypropionic nitric anhydride)/propanal and PAN (peroxyacetic nitric anhydride)/acetaldehyde relationships were consistent with additional sources of PAN in this environment, e.g., isoprene photochemistry. This isoprene source was estimated to result in approximately 1.6 to 4 times more PAN in this environment relative to that produced from anthropogenic VOCs (volatile organic compounds) alone.

Factors influencing nurses' job satisfaction in selected private hospitals in England.

Science.gov (United States)

Lephalala, R P; Ehlers, V J; Oosthuizen, M J

2008-09-01

The quantitative descriptive survey used self-completion questionnaires to study factors influencing nurses' job satisfaction in selected private hospitals in England. Herzberg's Theory of Motivation was used to contextualise the results obtained from 85 completed questionnaires. In terms of Herzberg's Theory of Motivation, the most important extrinsic (hygiene) factor was no satisfaction with their salaries compared to nurses' salaries in other private hospitals in England, in the NHS and even at their own hospitals. However, most nurses were satisfied with the other extrinsic factors (organisation and administration policies, supervision and interpersonal relations). The most important intrinsic factors (motivators), influencing nurses' job satisfaction was their lack of satisfaction with promotions (including the fact that their qualifications were reportedly not considered for promotions), lack of advancement opportunities and being in dead-end jobs, and lack of involvement in decision- and policy-making activities. Nurses' levels of job satisfaction might be enhanced if promotion policies could be consistent, advancement opportunities implemented, qualifications considered for promotions, salary issues clarified, and if nurses could be involved in decision- and policy-making. Enhanced levels of job satisfaction could help to reduce turnover rates among registered nurses at the private hospitals in England that participated in this study.

Casebooks in Early Modern England:

Science.gov (United States)

Kassell, Lauren

2014-01-01

summary Casebooks are the richest sources that we have for encounters between early modern medical practitioners and their patients. This article compares astrological and medical records across two centuries, focused on England, and charts developments in the ways in which practitioners kept records and reflected on their practices. Astrologers had a long history of working from particular moments, stellar configurations, and events to general rules. These practices required systematic notation. Physicians increasingly modeled themselves on Hippocrates, recording details of cases as the basis for reasoned expositions of the histories of disease. Medical records, as other scholars have demonstrated, shaped the production of medical knowledge. Instead, this article focuses on the nature of casebooks as artifacts of the medical encounter. It establishes that casebooks were serial records of practice, akin to diaries, testimonials, and registers; identifies extant English casebooks and the practices that led to their production and preservation; and concludes that the processes of writing, ordering, and preserving medical records are as important for understanding the medical encounter as the records themselves. PMID:25557513

Evaluating variation in use of definitive therapy and risk-adjusted prostate cancer mortality in England and the USA.

Science.gov (United States)

Sachdeva, Ashwin; van der Meulen, Jan H; Emberton, Mark; Cathcart, Paul J

2015-02-24

Prostate cancer mortality (PCM) in the USA is among the lowest in the world, whereas PCM in England is among the highest in Europe. This paper aims to assess the association of variation in use of definitive therapy on risk-adjusted PCM in England as compared with the USA. Observational study. Cancer registry data from England and the USA. Men diagnosed with non-metastatic prostate cancer (PCa) in England and the USA between 2004 and 2008. Competing-risks survival analyses to estimate subhazard ratios (SHR) of PCM adjusted for age, ethnicity, year of diagnosis, Gleason score (GS) and clinical tumour (cT) stage. 222,163 men were eligible for inclusion. Compared with American patients, English patients were more likely to present at an older age (70-79 years: England 44.2%, USA 29.3%, pUSA 8.6%, pUSA 11.2%, pUSA 77%, pUSA. This difference may be explained by less frequent use of definitive therapy in England. 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.

Popular political continuity in urban England, 1867-1918: the case studies of Bristol and Northampton

OpenAIRE

Kidd, Matthew

2016-01-01

This thesis examines the transition between working-class radicalism and labour politics in two provincial English constituencies, Bristol and Northampton, between 1867 and 1918. By combining local case studies with a textual analysis of empirical material and a conceptual approach to ideology, it offers fresh insights into popular political change in late nineteenth- and early twentieth-century Britain. \\ud \\ud Its central argument is that, contrary to the prevailing historiography on labour...

How Technicians Can Lead Science Improvements in Any School: A Small-Scale Study in England

Science.gov (United States)

Jones, Beth; Quinnell, Simon

2015-01-01

This article describes how seven schools in England improved their science provision by focusing on the professional development of their science technicians. In September 2013, the Gatsby Charitable Foundation funded the National Science Learning Centre to lead a project connecting secondary schools with experienced senior science technicians…

Increasing rates of cerebral palsy across the severity spectrum in north-east England 1964-1993. The North of England Collaborative Cerebral Palsy Survey.

Science.gov (United States)

Colver, A F; Gibson, M; Hey, E N; Jarvis, S N; Mackie, P C; Richmond, S

2000-07-01

To report epidemiological trends in cerebral palsy including analyses by severity. Descriptive longitudinal study in north-east England. Every child with suspected cerebral palsy was examined by a developmental paediatrician to confirm the diagnosis. Severity of impact of disability was derived from a parent completed questionnaire already developed and validated for this purpose. All children with cerebral palsy, not associated with any known postneonatal insult, born 1964-1993 to mothers resident at the time of birth in the study area. Cerebral palsy rates by year, birth weight, and severity. Severity of 30% and above defines the more reliably ascertained cases; children who died before assessment at around 6 years of age are included in the most severe group (70% and above). 584 cases of cerebral palsy were ascertained, yielding a rate that rose from 1.68 per 1000 neonatal survivors during 1964-1968 to 2.45 during 1989-1993 (rise = 0.77; 95% confidence interval 0.2-1.3). For the more reliably ascertained cases there was a twofold increase in rate from 0.98 to 1.96 (rise = 0.98; 95% confidence interval 0.5-1.4). By birth weight, increases in rates were from 29.8 to 74.2 per 1000 neonatal survivors rate of cerebral palsy has risen in spite of falling perinatal and neonatal mortality rates, a rise that is even more pronounced when the mildest and least reliably ascertained are excluded. The effect of modern care seems to be that many babies rates, and to monitor changes in the distribution of severity.

Ho hum, another work of the devil. Buggery and sodomy in early Stuart England.

Science.gov (United States)

Burg, B R

A study of contemporary handbooks for justices of the peace, sworn depositions, and other judicial records shows that in early Stuart England people were relatively tolerant of homosexuality. Sodomy was a minor felony, but more than homosexual activity was required to prosecute an offender. Persons accused of religious heresy, political offenses, or violating social-class distinctions also might be charged with sodomy, as illustrated by the cases of Lord Audley, Earl of Castlehaven and John Atherton, Bishop of Waterford and Lismore. Although the Puritans expanded the list of sexual acts proscribed as vices, even they did not react to it with the extreme horror characteristic of the Victorian era and the present day.

New England Energy Congress: preliminary report for public review

Energy Technology Data Exchange (ETDEWEB)

Pratt, Robert L.; Mayer, Jean; Buckley, John G.; Spencer, Bailey

1978-11-01

The New England Energy Congress represents the concerted effort of a group of New Englanders to address the energy problem of the area. New England is dependent on oil, with fully 80% of its energy requirements derived from this single source. Detailed reports are presented by the Supply Committee (fossil fuels, nuclear, and alternative sources); the Committee on Economic Development Through Alternative Sources of Energy (defining the state of the art and future directions of the technologies applicable to renewable energy resources, specifically, biomass, direct solar, and wind/hydroelectric/tidal/wave energy; identifying, and formulating policies to reduce the institutional impediments and adverse environmental impacts of developing these resources; and evaluationg the relationship between renewable energy systems and regional economic development); Energy Demand Committee; Energy Conservation Committee; Regulatory and Institutional Processes Committee; and Energy Economics and Financing Committee.

A Comparative Analysis of Primary Teacher Professionalism in England and Finland

Science.gov (United States)

Webb, Rosemary; Vulliamy, Graham; Hamalainen, Seppo; Sarja, Anneli; Kimonen, Eija; Nevalainen, Raimo

2004-01-01

Policy-makers' conceptions of teacher professionalism currently differ markedly in England and Finland. In England they are shaped by agendas associated with the drive to raise standards and "commercialized professionalism" whilst in Finland they are influenced by notions of "teacher empowerment". This article analyses findings…

National Assessment of Shoreline Change; historical shoreline change along the New England and Mid-Atlantic coasts

Science.gov (United States)

Hapke, Cheryl J.; Himmelstoss, Emily A.; Kratzmann, Meredith G.; List, Jeffrey H.; Thieler, E. Robert

2011-01-01

Beach erosion is a chronic problem along many open-ocean shores of the United States. As coastal populations continue to grow and community infrastructures are threatened by erosion, there is increased demand for accurate information regarding past and present trends and rates of shoreline movement. There is also a need for a comprehensive analysis of shoreline movement that is consistent from one coastal region to another. To meet these national needs, the U.S. Geological Survey (USGS) is conducting an analysis of historical shoreline changes along open-ocean sandy shores of the conterminous United States and parts of Hawaii, Alaska, and the Great Lakes. One purpose of this work is to develop standard, repeatable methods for mapping and analyzing shoreline movement so that periodic, systematic, internally consistent updates regarding coastal erosion and land loss can be made nationally. In the case of this study, the shoreline is the interpreted boundary between the ocean water surface and the sandy beach. This report on the New England and Mid-Atlantic coasts is the fifth in a series of reports on historical shoreline change. Previous investigations include analyses and descriptive reports of the Gulf of Mexico, the Southeast Atlantic, and, for California, the sandy shoreline and the coastal cliffs. The rates of change presented in this report represent conditions up to the date of the most recent shoreline data and therefore are not intended for predicting future shoreline positions or rates of change. Because of the geomorphology of the New England and Mid-Atlantic (rocky coastlines, large embayments and beaches) as well as data gaps in some areas, this report presents beach erosion rates for 78 percent of the 1,360 kilometers of the New England and Mid-Atlantic coasts. The New England and Mid-Atlantic shores were subdivided into a total of 10 analysis regions for the purpose of reporting regional trends in shoreline change rates. The average rate of long

How Do Teachers in Ireland and England Conceptualise Dyslexia?

Science.gov (United States)

Bell, Sheena; McPhillips, Therese; Doveston, Mary

2011-01-01

This paper presents the findings of a comparative study using data from questionnaire surveys carried out in England (n = 57) and Ireland (n = 72). The researchers examine how teachers and teaching assistants who are currently teaching pupils with dyslexia in primary schools describe dyslexia and what may have influenced their conceptualisation.…

Quantifying the contribution of statins to the decline in population mean cholesterol by socioeconomic group in England 1991 - 2012: a modelling study.

Directory of Open Access Journals (Sweden)

Chris Kypridemos

Full Text Available Serum total cholesterol is one of the major targets for cardiovascular disease prevention. Statins are effective for cholesterol control in individual patients. At the population level, however, their contribution to total cholesterol decline remains unclear. The aim of this study was to quantify the contribution of statins to the observed fall in population mean cholesterol levels in England over the past two decades, and explore any differences between socioeconomic groups.This is a modelling study based on data from the Health Survey for England. We analysed changes in observed mean total cholesterol levels in the adult England population between 1991-92 (baseline and 2011-12. We then compared the observed changes with a counterfactual 'no statins' scenario, where the impact of statins on population total cholesterol was estimated and removed. We estimated uncertainty intervals (UI using Monte Carlo simulation, where confidence intervals (CI were impractical. In 2011-12, 13.2% (95% CI: 12.5-14.0% of the English adult population used statins at least once per week, compared with 1991-92 when the proportion was just 0.5% (95% CI: 0.3-1.0%. Between 1991-92 and 2011-12, mean total cholesterol declined from 5.86 mmol/L (95% CI: 5.82-5.90 to 5.17 mmol/L (95% CI: 5.14-5.20. For 2011-12, mean total cholesterol was lower in more deprived groups. In our 'no statins' scenario we predicted a mean total cholesterol of 5.36 mmol/L (95% CI: 5.33-5.40 for 2011-12. Statins were responsible for approximately 33.7% (95% UI: 28.9-38.8% of the total cholesterol reduction since 1991-92. The statin contribution to cholesterol reduction was greater among the more deprived groups of women, while showing little socio-economic gradient among men.Our model suggests that statins explained around a third of the substantial falls in total cholesterol observed in England since 1991. Approximately two thirds of the cholesterol decrease can reasonably be attributed non

A comparative study of contemporary user involvement within healthcare systems across England, Poland and Slovenia.

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Lichon, Mateusz; Kavcic, Matic; Masterson, Daniel

2015-01-01

The purpose of this paper is to explore how healthcare-users' engagement is perceived, how it occurs and how these perceptions differ between three European countries: England, Poland and Slovenia, using the concepts of voice, choice and coproduction. This comparative, qualitative study is based on a review of legal documents, academic literature and semi-structured interviews conducted in October and November 2011. A research sample consisted of 21 interviewees representing various stakeholders including healthcare-users, doctors and managers. Primary and secondary data were analysed using theoretical thematic analysis. Emerging themes were identified from the interviews and related to the indicators describing healthcare-users' involvement in the voice, choice and coproduction model. Results of the comparative qualitative research suggest that the healthcare-users' influence is strongly grounded in England where the healthcare system and professionals are prepared to include healthcare-users in the decision-making process. In Slovenia, cultural development of healthcare-users' involvement seems to proceed the institutional development. In Poland, institutions are ready to involve healthcare-users in decision-making process although the cultural desirability of involving users among doctors and patients is lacking. The notion of user involvement is increasingly gaining importance and research attention, yet there is still little known about the way cultural, political, historical differences between various European countries influence it. This paper explores this little known area using the original approach of user involvement (Dent et al., 2011) with input from various stakeholders including patients, healthcare representatives and academics.

Factors influencing nurses’ job satisfaction in selected private hospitals in England

OpenAIRE

RP Lephalala

2008-01-01

The quantitative descriptive survey used self-completion questionnaires to study factors influencing nurses’ job satisfaction in selected private hospitals in England. Herzberg’s Theory of Motivation was used to contextualise the results obtained from 85 completed questionnaires.

Use of atomoxetine and suicidal ideation in children and adolescents: Results of an observational cohort study within general practice in England.

Science.gov (United States)

Davies, M; Coughtrie, A; Layton, D; Shakir, S A S

2017-01-01

To investigate the association between atomoxetine, a drug used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD), and suicidal ideation, within a cohort of 2-18-year-old patients in England. The study was conducted using the observational cohort technique of Modified prescription event monitoring (M-PEM). Patients prescribed atomoxetine were identified from dispensed prescriptions issued by primary care physicians. A customised postal GP questionnaire was used to capture outcome data for suicidal ideation. A matched pair cohort analysis was performed within patients to compare the risk of suicidal ideation in the period after starting atomoxetine with the risk prior to starting atomoxetine; this was stratified by age and concomitant use of methylphenidate. Additional information on patient characteristics, and events of interest was also collected; individual cases of suicidal ideation were qualitatively assessed for drug relatedness. Of the final cohort (n=4509); 85.5% male (n=3857), median age 11 years (IQR: 9,14). Primary prescribing indication for atomoxetine was ADHD (n=4261, 94.6%). Almost a quarter of the cohort had been co-prescribed methylphenidate. Results of the matched pair cohort analysis indicated that the period after starting atomoxetine was not associated with an increase in the incidence of suicidal ideation compared to the period prior to starting treatment (RR: 0.71; CI: 0.48-1.07; P-value: 0.104). Individual case assessment of suicidal ideation suggested a causal association within a number of cases. This study found no evidence of an increased risk of suicidal ideation during treatment with atomoxetine, compared to the period prior to starting treatment. Amongst age specific subgroups, this risk may change. Nonetheless, individual case assessment suggested a causal relationship in some patients, hence physicians need to be aware of the possibility of developing this event, and furthermore consider how best to detect it in

The organisation of interagency training to safeguard children in England: a case study using realistic evaluation

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Demi Patsios

2010-11-01

Full Text Available Background: Joint training for interagency working is carried out by Local Safeguarding Children Boards in England to promote effective local working to safeguard and promote the welfare of children.Purpose: This paper reports on the findings of the outputs and outcomes of interagency training to safeguard children in eight Local Safeguarding Children Boards.Methods: A review of Local Safeguarding Children Board documentation, observations of Local Safeguarding Children Board training sub-group meetings and a series of interviews with training key stakeholders in each Local Safeguarding Children Board were used to assess how partner agencies in the Local Safeguarding Children Boards carried out their statutory responsibilities to organise interagency training. 'Realistic Evaluation' was used to evaluate the mechanisms by which a central government mandate produced particular inter-agency training outputs (number of courses, training days and joint working outcomes (effective partnerships, within particular Local Safeguarding Children Board contexts.Results: The 'mandated partnership' imposed on Local Safeguarding Children Boards by central government left little choice but for partner agencies to work together to deliver joint training, which in turn affected the dynamics of working partnerships across the various sites. The effectiveness of the training sub group determined the success of the organisation and delivery of training for joint working. Despite having a central mandate, Local Safeguarding Children Boards had heterogeneous funding and training arrangements. These resulted in significant variations in the outputs in terms of the number of courses per 'children in need' in the locality and in the cost per course.Conclusions: Interagency training which takes account of the context of the Local Safeguarding Children Board is more likely to produce better trained staff, effective partnership working, and lead to better integrated

Human influences on streamflow drought characteristics in England and Wales

Science.gov (United States)

Tijdeman, Erik; Hannaford, Jamie; Stahl, Kerstin

2018-02-01

catchments affected by groundwater abstractions and a decrease in streamflow drought occurrence for some of the catchments with either reservoirs or groundwater abstractions. In conclusion, the proposed screening approaches were sometimes successful in identifying streamflow records with deviating drought characteristics that are likely related to different human influences. However, a quantitative attribution of the impact of human influences on streamflow drought characteristics requires more detailed case-by-case information about the type and degree of all different human influences. Given that, in many countries, such information is often not readily accessible, the approaches adopted here could provide useful in targeting future efforts. In England and Wales specifically, the catchments with deviating streamflow drought characteristics identified in this study could serve as the starting point of detailed case study research.

Human influences on streamflow drought characteristics in England and Wales

Directory of Open Access Journals (Sweden)

E. Tijdeman

2018-02-01

some of the catchments affected by groundwater abstractions and a decrease in streamflow drought occurrence for some of the catchments with either reservoirs or groundwater abstractions. In conclusion, the proposed screening approaches were sometimes successful in identifying streamflow records with deviating drought characteristics that are likely related to different human influences. However, a quantitative attribution of the impact of human influences on streamflow drought characteristics requires more detailed case-by-case information about the type and degree of all different human influences. Given that, in many countries, such information is often not readily accessible, the approaches adopted here could provide useful in targeting future efforts. In England and Wales specifically, the catchments with deviating streamflow drought characteristics identified in this study could serve as the starting point of detailed case study research.

Circles of Support and Personalization: Exploring the Economic Case

Science.gov (United States)

Wistow, Gerald; Perkins, Margaret; Knapp, Martin; Bauer, Annette; Bonin, Eva-Maria

2016-01-01

Circles of Support aim to enable people with learning disabilities (and others) to live full lives as part of their communities. As part of a wider study of the economic case for community capacity building conducted from 2012 to 2014, we conducted a mixed methods study of five Circles in North West England. Members of these Circles were…

Clinical outcomes and costs for people with complex psychosis; a naturalistic prospective cohort study of mental health rehabilitation service users in England.

Science.gov (United States)

Killaspy, Helen; Marston, Louise; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; Arbuthnott, Maurice; Koeser, Leonardo; McCrone, Paul; Omar, Rumana Z; King, Michael

2016-04-07

Mental health rehabilitation services in England focus on people with complex psychosis. This group tend to have lengthy hospital admissions due to the severity of their problems and, despite representing only 10-20 % of all those with psychosis, they absorb 25-50 % of the total mental health budget. Few studies have investigated the effectiveness of these services and there is little evidence available to guide clinicians working in this area. As part of a programme of research into inpatient mental health rehabilitation services, we carried out a prospective study to investigate longitudinal outcomes and costs for patients of these services and the predictors of better outcome. Inpatient mental health rehabilitation services across England that scored above average (median) on a standardised quality assessment tool used in a previous national survey were eligible for the study. Unit quality was reassessed and costs of care and patient characteristics rated using standardised tools at recruitment. Multivariable regression modelling was used to investigate the relationship between service quality, patient characteristics and the following clinical outcomes at 12 month follow-up: social function; length of admission in the rehabiliation unit; successful community discharge (without readmission or community placement breakdown) and costs of care. Across England, 50 units participated and 329 patients were followed over 12 months (94 % of those recruited). Service quality was not associated with patients' social function or length of admission (median 16 months) at 12 months but most patients were successfully discharged (56 %) or ready for discharge (14 %), with associated reductions in the costs of care. Factors associated with successful discharge were the recovery orientation of the service (OR 1.04, 95 % CI 1.00-1.08), and patients' activity (OR 1.03, 95 % CI 1.01-1.05) and social skills (OR 1.13, 95 % CI 1.04-1.24) at recruitment. Inpatient mental health

Analysis of the RB1 gene in children with retinoblastoma having residential connections to West Cumbria, England

Energy Technology Data Exchange (ETDEWEB)

Cowell, J K [Department of Cancer Genetics, Roswell Park Cancer Institute, Buffalo, NY 14263 (United States); Morris, J A [Department of Pathology, Royal Lancaster Infirmary, Lancaster LA1 4RP (United Kingdom); Tawn, E J [Westlakes Research Institute, Moor Row, Cumbria CA24 3JY (United Kingdom)

2005-03-01

Six of eight cases of retinoblastoma previously identified as having a residential association with West Cumbria, England, in which the Sellafield nuclear installation is situated, were examined for the presence of a constitutional RB1 mutation. No mutations were detected, thus providing strong evidence against an environmental or occupational genotoxic effect causing germline mutations in the parents of these children. (note)

Characterizing New England Emergency Departments by Telemedicine Use.

Science.gov (United States)

Zachrison, Kori S; Hayden, Emily M; Schwamm, Lee H; Espinola, Janice A; Sullivan, Ashley F; Boggs, Krislyn M; Raja, Ali S; Camargo, Carlos A

2017-10-01

Telemedicine connects emergency departments (ED) with resources necessary for patient care; its use has not been characterized nationally, or even regionally. Our primary objective was to describe the prevalence of telemedicine use in New England EDs and the clinical applications of use. Secondarily, we aimed to determine if telemedicine use was associated with consultant availability and to identify ED characteristics associated with telemedicine use. We analyzed data from the National Emergency Department Inventory-New England survey, which assessed basic ED characteristics in 2014. The survey queried directors of every ED (n=195) in the six New England states (excluding federal hospitals and college infirmaries). Descriptive statistics characterized ED telemedicine use; multivariable logistic regression identified independent predictors of use. Of the 169 responding EDs (87% response rate), 82 (49%) reported using telemedicine. Telemedicine EDs were more likely to be rural (18% of users vs. 7% of non-users, p=0.03); less likely to be academic (1% of users vs. 11% of non-users, p=0.01); and less likely to have 24/7 access to neurology (ptelemedicine was more likely in rural EDs (odds ratio [OR] 4.39, 95% confidence interval [CI] 1.30-14.86), and less likely in EDs with 24/7 neurologist availability (OR 0.21, 95% CI [0.09-0.49]), and annual volume Telemedicine is commonly used in New England EDs. In 2014, use was more common among rural EDs and EDs with limited neurology consultant availability. In contrast, telemedicine use was less common among very low-volume EDs.

Risk factors for testicular cancer: a case-control study in twins.

Science.gov (United States)

Swerdlow, A J; De Stavola, B L; Swanwick, M A; Mangtani, P; Maconochie, N E

1999-06-01

Early life and anthropometric risk factors for testicular cancer were examined in a case-control study in England and Wales in which affected male twins were compared with their unaffected male co-twins. Questionnaire data was obtained for 60 twin pairs. Significantly raised risk of testicular cancer occurred in twins who had longer arms and legs than their co-twin. There was a significant excess of testicular cancer reported in non-twin brothers, as well as in twin brothers, of cases. Risk was also significantly raised in relation to cryptorchidism. The results on limb length suggest that factors, perhaps nutritional, affecting growth before puberty, may be causes of testicular cancer. The results on risk in brothers add to evidence of a large genetic component in aetiology of the tumour. The risk associated with cryptorchidism in the twins accords with the hypothesis that cryptorchidism is causally associated with testicular cancer because it is a cause of the malignancy, rather than because the same maternal factors experienced in utero cause both conditions.

Variations in prison mental health services in England and Wales.

Science.gov (United States)

Forrester, Andrew; Exworthy, Tim; Olumoroti, Olumuyiwa; Sessay, Mohammed; Parrott, Janet; Spencer, Sarah-Jane; Whyte, Sean

2013-01-01

In responding to high levels of psychiatric morbidity amongst prisoners and recognising earlier poor quality prison mental health care, prison mental health in-reach teams have been established in England and Wales over the last decade. They are mostly provided by the National Health Service (NHS), which provides the majority of UK healthcare services. Over the same period, the prison population has grown to record levels, such that prisons in England and Wales now contain almost 90,000 of the world's overall prison population of over 10 million people (roughly the size of Paris or Istanbul). This study provides an overview of mental health in-reach services in prisons in England and Wales, including variations between them, through a telephone survey of senior staff in all prisons and young offender institutions in England and Wales. 73% of prisons took part; of them 13% had no in-reach team at all (usually low security establishments) and the majority of services were run by NHS teams, usually according to a generic community mental health team (CMHT) model rather than other specialist models. Team size was unrelated to prison size. Each nurse covered around 500 prisoners, each doctor over 3700. Many provided few or no healthcare cells and 24-h psychiatric cover (including on-call cover) was uncommon. Despite developments in recent years, mental health in-reach services still fall short of community equivalence and there is wide variation in service arrangements that cannot be explained by prison size or function. The aim of community equivalence has not yet been reached in prison healthcare and a more sophisticated measure of service improvement and standardisation would now be useful to drive and monitor future development. Copyright © 2013 Elsevier Ltd. All rights reserved.

Predictors of eyewitness identification decisions from video lineups in England: A field study

OpenAIRE

horry, ruth; Memon, Amina; Wright, Daniel; Milne, Rebecca

2012-01-01

Eyewitness identification decisions from 1,039 real lineups in England were analysed. Identification procedures have undergone dramatic change in the United Kingdom over recent years. Video lineups are now standard procedure, in which each lineup member is seen sequentially. The whole lineup is seen twice before the witness can make a decision, and the witness can request additional viewings of the lineup. A key aim of this paper was to investigate the association between repeated viewing and...

Study of living kidney donor-recipient relationships: variation with socioeconomic deprivation in the white population of England.

Science.gov (United States)

Bailey, Phillippa K; Tomson, Charles Rv; Ben-Shlomo, Yoav

2013-01-01

Socioeconomic deprivation is associated with higher renal replacement therapy acceptance rates in the UK but lower rates of living kidney transplantation. This study examines donor-recipient relationship patterns with socioeconomic deprivation in the white population of England. Demographic characteristics of all white live renal transplant donors and recipients between 2001 and 2010 in England were analyzed. Patterns of donor-recipient relationship were analyzed to see whether they differed according to an ecological measure of socioeconomic status (Index of Multiple Deprivation). Group comparisons were performed using chi-square tests and multivariable logistic regression. Sources of living kidney transplants differed with deprivation (p Recipients living in poorer areas were more likely to receive a kidney from a sibling, child, and "other relative" donor and less likely from spouses/partners. Logistic regression suggested differences seen with spouse/partner donations with deprivation were explained by differences in the age and gender of the recipients. The source of living kidneys differs by level of area deprivation. Given the disparity in rates of living kidney transplants between the most and least socioeconomically deprived, there is a need to understand the reasons behind these observed relationship differences, with the aim of increasing transplantation rates in the most deprived. © 2013 John Wiley & Sons A/S.

Innovations in major system reconfiguration in England: a study of the effectiveness, acceptability and processes of implementation of two models of stroke care

Directory of Open Access Journals (Sweden)

Fulop Naomi

2013-01-01

Full Text Available Abstract Background Significant changes in provision of clinical care within the English National Health Service (NHS have been discussed in recent years, with proposals to concentrate specialist services in fewer centres. Stroke is a major public health issue, accounting for over 10% of deaths in England and Wales, and much disability among survivors. Variations have been highlighted in stroke care, with many patients not receiving evidence-based care. To address these concerns, stroke services in London and Greater Manchester were reorganised, although different models were implemented. This study will analyse processes involved in making significant changes to stroke care services over a short time period, and the factors influencing these processes. We will examine whether the changes have delivered improvements in quality of care and patient outcomes; and, in light of this, whether the significant extra financial investment represented good value for money. Methods/design This study brings together quantitative data on ‘what works and at what cost?’ with qualitative data on ‘understanding implementation and sustainability’ to understand major system change in two large conurbations in England. Data on processes of care and their outcomes (e.g. morbidity, mortality, and cost will be analysed to evidence services’ performance before and after reconfiguration. The evaluation draws on theories related to the dissemination and sustainability of innovations and the ‘social matrix’ underlying processes of innovation. We will conduct a series of case studies based on stakeholder interviews and documentary analysis. These will identify drivers for change, how the reconfigurations were governed, developed, and implemented, and how they influenced service quality. Discussion The research faces challenges due to: the different timings of the reconfigurations; the retrospective nature of the evaluation; and the current organisational

Innovations in major system reconfiguration in England: a study of the effectiveness, acceptability and processes of implementation of two models of stroke care.

Science.gov (United States)

Fulop, Naomi; Boaden, Ruth; Hunter, Rachael; McKevitt, Christopher; Morris, Steve; Pursani, Nanik; Ramsay, Angus Ig; Rudd, Anthony G; Tyrrell, Pippa J; DA Wolfe, Charles

2013-01-05

Significant changes in provision of clinical care within the English National Health Service (NHS) have been discussed in recent years, with proposals to concentrate specialist services in fewer centres. Stroke is a major public health issue, accounting for over 10% of deaths in England and Wales, and much disability among survivors. Variations have been highlighted in stroke care, with many patients not receiving evidence-based care. To address these concerns, stroke services in London and Greater Manchester were reorganised, although different models were implemented. This study will analyse processes involved in making significant changes to stroke care services over a short time period, and the factors influencing these processes. We will examine whether the changes have delivered improvements in quality of care and patient outcomes; and, in light of this, whether the significant extra financial investment represented good value for money. This study brings together quantitative data on 'what works and at what cost?' with qualitative data on 'understanding implementation and sustainability' to understand major system change in two large conurbations in England. Data on processes of care and their outcomes (e.g. morbidity, mortality, and cost) will be analysed to evidence services' performance before and after reconfiguration. The evaluation draws on theories related to the dissemination and sustainability of innovations and the 'social matrix' underlying processes of innovation. We will conduct a series of case studies based on stakeholder interviews and documentary analysis. These will identify drivers for change, how the reconfigurations were governed, developed, and implemented, and how they influenced service quality. The research faces challenges due to: the different timings of the reconfigurations; the retrospective nature of the evaluation; and the current organisational turbulence in the English NHS. However, these issues reflect the realities of major

Developing Professionalism within a Regulatory Framework in England: Challenges and Possibilities

Science.gov (United States)

Miller, Linda

2008-01-01

Early Childhood Education and Care (ECEC) is now firmly on government agendas in many countries, including England, and the need to develop a professional workforce is generally agreed. The reform of the children's workforce in England acknowledges that increasing the skills and competence of this workforce is critical to its success. Two new…

Mapping Patterns and Trends in the Spatial Availability of Alcohol Using Low-Level Geographic Data: A Case Study in England 2003-2013.

Science.gov (United States)

Angus, Colin; Holmes, John; Maheswaran, Ravi; Green, Mark A; Meier, Petra; Brennan, Alan

2017-04-12

Much literature examines the relationship between the spatial availability of alcohol and alcohol-related harm. This study aims to address an important gap in this evidence by using detailed outlet data to examine recent temporal trends in the sociodemographic distribution of spatial availability for different types of alcohol outlet in England. Descriptive analysis of measures of alcohol outlet density and proximity using extremely high resolution market research data stratified by outlet type and quintiles of area-level deprivation from 2003, 2007, 2010 and 2013 was undertaken and hierarchical linear growth models fitted to explore the significance of socioeconomic differences. We find that overall availability of alcohol changed very little from 2003 to 2013 (density +1.6%), but this conceals conflicting trends by outlet type and area-level deprivation. Mean on-trade density has decreased substantially (-2.2 outlets within 1 km (Inter-Quartile Range (IQR) -3-0), although access to restaurants has increased (+1.0 outlets (IQR 0-1)), while off-trade access has risen substantially (+2.4 outlets (IQR 0-3)). Availability is highest in the most deprived areas ( p trends in the spatial availability of alcohol. There are significant variations in these trends by outlet type and deprivation level which may have important implications for health inequalities and public health policy.

Public Holidays of England

Institute of Scientific and Technical Information of China (English)

梁泽标

1992-01-01

In England, Christmas Day and Good Friday havebeen holidays (literally ’Holy Days’) for religious reasonssince the establishment of Christianity in this country.Christmas is celebrated on December 25, not ChristmasEve as in several other European countries. The otherpublic holidays (or ’Bank Holidays’) are Easter Monday,May Day (May 1st), the Spring Bank Holiday (the lastMonday in May), the Summer Bank Holiday (the last

Factors influencing nurses’ job satisfaction in selected private hospitals in England

Directory of Open Access Journals (Sweden)

RP Lephalala

2008-09-01

Full Text Available The quantitative descriptive survey used self-completion questionnaires to study factors influencing nurses’ job satisfaction in selected private hospitals in England. Herzberg’s Theory of Motivation was used to contextualise the results obtained from 85 completed questionnaires.

Talking active citizenship: framing welfare state reform in England and the Netherlands

NARCIS (Netherlands)

Verhoeven, I.; Tonkens, E.

2013-01-01

This article reviews how activation policies frame citizens as individual welfare agents. The analysis focuses on the framing of feeling rules employed by governments that encourage active citizenship, in this instance in the Netherlands and England. In England, encouraging voluntarism is central to

New England Energy Congress project. Final report, June 1978-July 1980

Energy Technology Data Exchange (ETDEWEB)

None

1981-11-20

From May 1978 until April 1979, 120 New Englanders volunteered for one of six committees to devise and consider energy policy recommendations for the region's twenty-five Member, six state Congressional delegation. Sponsored by the New England Congressional Caucus and Tufts University, the New England Energy Congress was funded by grants from the Economic Development Administration, US Department of Commerce and the Office of Environment, US Department of Energy. The results of the work of the 120 delegates and nine staff was a 500 page report, Blueprint for Energy Action, containing over 150 policy recommendations to the Congress, Executive agencies, state legislatures and municipalities. The New England Congressional Caucus responded in June 1979 with an Energy Package, including twenty (and ultimately twenty-five) legislative bills and several letters to federal agencies, based on the recommendations of the Energy Congress. Following the release of the report in June 1979, 55 delegates continued their efforts as members of the Implementation Group of the Energy Congress. In July 1980, this group released a volume of Strategy Papers designed to assist in the implementation of Energy Congress recommendations. As a result of this work, a broad array of energy activities were initiated in New England and in Washington. By January 1981, 20 of the 25 bills in the Caucus package had been passed in whole or in part. This final report discusses the Energy Congress' activities, consensus decision-making process and its findings. The report reviews the results of a thorough evaluation conducted through the mail and by phone of participants, outside observers and from Capital Hill. The clear conclusion is that the Energy Congress made a unique and significant contribution towards enabling New Englanders, both in the region and in Washington, to set energy goals and priorities and to begin serious efforts to reduce the region's precarious dependence on oil imports.

Cost-effectiveness of microscopy of urethral smears for asymptomatic Mycoplasma genitalium urethritis in men in England.

Science.gov (United States)

Sutton, Andrew J; Roberts, Tracy E; Jackson, Louise; Saunders, John; White, Peter J; Birger, Ruthie; Estcourt, Claudia

2018-01-01

The objective was to determine whether or not the limited use of urethral microscopy to diagnose asymptomatic and symptomatic non-chlamydial, non-gonococcal urethritis (NCNGU) in men is a cost-effective strategy to avert pelvic inflammatory disease (PID), ectopic pregnancy or infertility in female partners. Outputs from a transmission dynamic model of NCNGU in a population of 16-30 year olds in England simulating the number of consultations, PID cases and patients treated over time amongst others, were used along with secondary data to undertake a cost-effectiveness analysis carried out from a health care provider perspective. The main outcome measure was cost per case of PID averted. A secondary outcome measure was cost per major outcome averted, where a major outcome is a case of symptomatic PID, ectopic pregnancy, or infertility. Offering a limited number of asymptomatic men urethral microscopy was more effective than the current practice of no microscopy in terms of reducing the number of cases of PID with an incremental cost-effectiveness ratio of £15,700, meaning that an investment of £15,800 is required to avert one case of PID. For major outcomes averted, offering some asymptomatic men urethral microscopy was again found to be more effective than no microscopy, but here an investment of £49,900 is required to avert one major outcome. Testing asymptomatic men for NCNGU in a small number of genitourinary medicine settings in England is not cost-effective, and thus by maintaining the current practice of not offering this patient group microscopy, this continues to make savings for the health care provider.

The rise of agrarian capitalism and the decline of family farming in England.

Science.gov (United States)

Shaw-Taylor, Leigh

2012-01-01

Historians have documented rising farm sizes throughout the period 1450–1850. Existing studies have revealed much about the mechanisms underlying the development of agrarian capitalism. However, we currently lack any consensus as to when the critical developments occurred. This is largely due to the absence of sufficiently large and geographically wide-ranging datasets but is also attributable to conceptual weaknesses in much of the literature. This article develops a new approach to the problem and argues that agrarian capitalism was dominant in southern and eastern England by 1700 but that in northern England the critical developments came later.

A Comparison of Mortality Following Emergency Laparotomy Between Populations From New York State and England.

Science.gov (United States)

Tan, Benjamin H L; Mytton, Jemma; Al-Khyatt, Waleed; Aquina, Christopher T; Evison, Felicity; Fleming, Fergal J; Griffiths, Ewen; Vohra, Ravinder S

2017-08-01

The aim of this study was to compare mortality following emergency laparotomy between populations from New York State and England. Mortality following emergency surgery is a key quality improvement metric in both the United States and UK. Comparison of the all-cause 30-day mortality following emergency laparotomy between populations from New York State and England might identify factors that could improve care. Patient demographics, in-hospital, and 30-day outcomes data were extracted from Hospital Episode Statistics (HES) in England and the New York Statewide Planning and Research Cooperative System (SPARCS) administrative databases for all patients older than 18 years undergoing laparotomy for emergency open bowel surgery between April 2009 and March 2014. The primary outcome measure was all-cause mortality within 30 days of the index laparotomy. Mixed-effects logistic regression was performed to model independent demographic variables against mortality. A one-to-one propensity score matched dataset was created to compare the odd ratios of mortality between the 2 populations. Overall, 137,869 patient records, 85,286 (61.9%) from England and 52,583 (38.1%) from New York State, were extracted. Crude 30-day mortality for patients was significantly higher in the England compared with New York State [11,604 (13.6%) vs 3633 (6.9%) patients, P New York State (odds ratio 2.35, confidence interval 2.24-2.46, P New York State despite similar patient groups.

Social Policy and Governance: Conceptual Reflections on Ageing in England

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Jason L. Powell

2011-12-01

Full Text Available This paper looks in more detail at the incidence and consequence of social policies for older people through the conceptual lens of governmentality (Foucault, 1977 in England. This international paper with focus on England will enable us to consider the implications of the re-figuring of the relationship between the state, older people and helping professions. In many ways, policy provides three trajectories for older people: first, as independent self-managing consumers with private means and resources; second, as people in need of some support to enable them to continue to self-manage; and third, as dependent and unable to commit to self-management. Governmentality provides the theoretical framework through which to view policy and practice that is largely governed by discourses of personalisation, safeguarding, capability and risk for older people in England.

Neuropsychological performance and family history in children at age 7 who develop adult schizophrenia or bipolar psychosis in the New England Family Studies.

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Seidman, L J; Cherkerzian, S; Goldstein, J M; Agnew-Blais, J; Tsuang, M T; Buka, S L

2013-01-01

Persons developing schizophrenia (SCZ) manifest various pre-morbid neuropsychological deficits, studied most often by measures of IQ. Far less is known about pre-morbid neuropsychological functioning in individuals who later develop bipolar psychoses (BP). We evaluated the specificity and impact of family history (FH) of psychosis on pre-morbid neuropsychological functioning. We conducted a nested case-control study investigating the associations of neuropsychological data collected systematically at age 7 years for 99 adults with psychotic diagnoses (including 45 SCZ and 35 BP) and 101 controls, drawn from the New England cohort of the Collaborative Perinatal Project (CPP). A mixed-model approach evaluated full-scale IQ, four neuropsychological factors derived from principal components analysis (PCA), and the profile of 10 intelligence and achievement tests, controlling for maternal education, race and intra-familial correlation. We used a deviant responder approach (children who later develop SCZ, especially in the SCZ FH+ subgroup, but less so in BP, suggesting especially impaired neurodevelopment underlying cognition in pre-SCZ children. Future work should assess genetic and environmental factors that explain this FH effect.

Snapshots of language and literature teaching in Denmark and England

DEFF Research Database (Denmark)

Kelly, Peter; Dorf, Hans

2016-01-01

To illustrate differences in lower secondary-level language and literature teaching, we contrast a typical teaching episode in Denmark with one in England. Both reflect the dominant discourses in each country alongside recent policy initiatives, and each exemplifies a different orientation...... to language and literature teaching focussing on performance in England and a personal formation in Denmark. Descriptions of the episodes are linked to wider debates and potential areas for further consideration are identified....

Standardised testing in compulsory schooling in England and Denmark

DEFF Research Database (Denmark)

Andreasen, Karen Egedal; Kelly, Peter; Kousholt, Kristine

2015-01-01

Within education, national testing is flourishing and, considering the important role which assessment plays in the production and reproduction of culture, it is important to examine further the possible impact of such practice. While England has a long tradition of national educational testing...... have on pupils´ perceptions of their potential academic skills. This article draws on research into the national testing of reading conducted in England and Denmark in Spring 2013 and draws on the work of Basil Bernstein to compare and contrast both sets of national assessment practices....

Factors influencing recording of drug misuse in primary care: a qualitative study of GPs in England.

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Davies-Kershaw, Hilary; Petersen, Irene; Nazareth, Irwin; Stevenson, Fiona

2018-04-01

Drug misuse is a serious public health problem. Evidence from previous epidemiological studies show that GPs are recording drug misuse in electronic patient records (EPR). However, although the recording trends are similar to national surveys, recording rates are much lower. To explore the factors that influence GPs to record drug misuse in the EPR, and to gain a clearer understanding of the gap between the amount of drug misuse recorded in primary care and that in national surveys and other studies. A semi-structured qualitative interview study of GPs working in general practices across England. Purposive sampling was employed to recruit 12 GPs, both with and without a special interest in drug misuse, from across England. Semi-structured face-to-face interviews were conducted to consider whether and why GPs record drug misuse, which methods GPs use for recording, GPs' actions if a patient asks for the information not to be recorded, and GPs' actions if they think a patient misuses drugs but does not disclose the information. Resulting data were analysed using a combination of inductive and deductive thematic analysis. The complexity of asking about drug misuse preceded GPs' decision to record. They described how the context of the general practice protocols, interaction between GP and patient, and the questioning process affected whether, how, and in which circumstances they asked about drug use. This led to GPs making a clinical decision on whether, who, and how to record in the EPR. When making decisions about whether or not to record drug misuse, GPs face complex choices. Aside from their own views, they reported feelings of pressure from the general practice environment in which they worked and their clinical commissioning group, as well as government policies. © British Journal of General Practice 2018.

Suicide in murderers in England and Wales.

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Lester, David

2003-06-01

In England and Wales, the suicide rate of murderers was positively associated with the male suicide rate in the general population, and both of these rates were positively associated with the unemployment rate.

River Restoration by Dam Removal: Assessing Riverine Re-Connectivity Across New England

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Magilligan, F. J.; Nislow, K. H.; Graber, B.; Sneddon, C.; Fox, C.; Martin, E.

2014-12-01

The impacts of dams in New England are especially acute as it possesses one of the highest densities of dams in the US, with the NID documenting more than 4,000 dams, and state agency records indicating that >14,000 dams are peppered throughout the landscape. This large number of dams contributes to pervasive watershed fragmentation, threatening the ecological integrity of rivers and streams, and in the case of old, poorly maintained structures, posing a risk to lives and property. These concerns have generated active dam removal efforts throughout New England. To best capture the geomorphic, hydrologic, and potential ecological effects of dam removal at a regional level, we have compiled a dataset of 127 removed dams in New England, which includes information about structural characteristics, georectified locations, and key watershed attributes (including basin size, distance to next upstream obstacle, and number of free-flowing river kms opened up). Our specific research questions address (1) what is the spatial distribution of removed dams and how does this pattern relate to stated management goals of restoring critical habitat for native resident freshwater and diadromous fish, (2) what are the structural or management commonalities in dam types that have been removed, and (3) what has been the incremental addition of free-flowing river length? Rather than reflecting an overall management prioritization strategy, results indicate that dam removals are characterized more by opportunistic removals. For example, despite a regional emphasis on diadromous fish protection and restoration, most removals are inland rather than coastal settings. Most of the removed dams were small (~ 45% 2,300 river kms over the past several decades, with implication for both resident and diadromous fish, and with many removals located in mid-sized rivers that are a key link between upstream and downstream/coastal aquatic ecosystems.

DENITRIFICATION ENZYME ACTIVITY OF FRINGE SALT MARSHES IN NEW ENGLAND (USA)

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Coastal salt marshes are a buffer between the uplands and adjacent coastal waters in New England (USA). With increasing N loads from developed watersheds, salt marshes could play an important role in the water quality maintenance of coastal waters. In this study we examined seaso...

Equity of access to specialist chronic fatigue syndrome (CFS/ME) services in England (2008–2010): a national survey and cross-sectional study

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

2012-01-01

Objectives Provision of National Health Service (NHS) specialist chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) services in England has been deemed patchy and inconsistent. Our objective was to explore variation in the provision of NHS specialist CFS/ME services and to investigate whether access is related to measures of deprivation and inequality. Design Survey of all CFS/ME clinical teams in England, plus cross-sectional data from a subset of teams. Setting Secondary care. Outcome measures We used clinic activity data from CFS/ME clinical teams in England to describe provision of specialist CFS/ME services (referral, assessment and diagnosis rates per 1000 adults per year) during 2008–2011 according to Primary Care Trust (PCT) population estimates, and to investigate whether use of services was related to PCT-level measures of deprivation and inequality. We used postcode data from seven services to investigate variation in provision by deprivation. Results Clinic activity data were obtained from 93.9% (46/49) of clinical teams in England which between them received referrals from 84.9% (129/152) of PCTs. 12 PCTs, covering a population of 2.08 million adults, provided no specialist CFS/ME service. There was a six-fold variation in referral and assessment rates between services which could not be explained by PCT-level measures of deprivation and inequality. The median assessment rate in 2010 was 0.25 (IQR 0.17, 0.35) per 1000 adults per year. 91.9% (IQR 76.5%, 100.0%) of adults assessed were diagnosed with CFS/ME. Postcode data from seven clinical teams showed that assessment rates were equal across deprivation quartiles for four teams but were 40–50% lower in the most deprived compared with the most affluent areas for three teams. Conclusions Two million adults in England do not have access to a specialist CFS/ME service. In some areas which do have a specialist service, access is inequitable. This inequity may worsen with the impending

Long-term trends of men's co-residence with children in England and Wales

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Ursula Henz

2014-03-01

Full Text Available Background: Increasing numbers of childless men as well as fathers with reduced or no contact with their children have sparked concern about an erosion of fatherhood. Although the general trend is undisputed, claims about men's decreasing family involvement lack a sound empirical basis that enables comparisons between countries and sub-groups of society. Objective: This study derives long-term trends in father-child co-residence over the life course in England and Wales, and provides comparisons of these trends by level of education and ethnic origin. Methods: The paper calculates shares of father-child co-residence from the National Statistics Longitudinal Study (LS and the British Labour-Force Surveys (LFS. Results: There has been a decline of father-child co-residence in England and Wales for men in their thirties, an even greater decline for men in their twenties, and a small increase in the shares of father-child co-residence at higher ages. The trends for different educational groups were similar, but men with a degree had particularly low rates of father-child co-residence at younger ages, and relatively high ones at older ages. Neither less-educated men, nor men from Black-Caribbean and Black-African origins showed rates of father-child co-residence as low as one might have expected. Conclusions: The steady decline of father-child co-residence among men born between 1930 and 1979 in England and Wales lends support to claims about an erosion of fatherhood. However, it is unwarranted to generalize findings from other countries about particularly low levels of father-child co-residence among less-educated men to men in England and Wales.

Teaching Children the Geography of England and Wales: An Analysis of Selected Georgian and Victorian Textbooks and Educational Pastimes

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Dove, Jane

2017-01-01

Children in Georgian and Victorian times were expected to be familiar with the geography of England and Wales. This study analyses some of the resources then available which taught children this information. John Aikin's "England Delineated" is evaluated as a geographical text and then compared with less formal games and puzzles, then on…

Incorporating Cognitive Behavioural Therapy into a Public Health Care System: Canada and England Compared

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Noushon Farmanara

2016-06-01

Full Text Available Since the second half of the 2000s, Canada and England have instituted differing reforms to address the inadequate provision and quality of mental health services in both nations. With growing evidence demonstrating the success and cost-effectiveness of psychotherapy, the English reform sought to expand the delivery of psychological services through the Improving Access to Psychological Therapies program (IAPT focusing on cognitive behavioural therapy (CBT. In contrast, Canadian interventions at the federal level were centred on knowledge exchange and advocacy, primarily through the Mental Health Commission of Canada. While significant improvements were made during this period to increase CBT access in England, there continues to be an insufficient availability of psychological services to meet the growing need in Canada. While a national roll-out akin to the IAPT program in England is unlikely in Canada, similar reforms could be initiated at the provincial level of government. Indeed, several provincial governments have acknowledged the need for an expansion of CBT services and, over the last decade, some have tried to make CBT techniques more widely accessible. We review the case of the Bounce Back program developed in British Columbia (BC to illustrate this potential in the Canadian context. Best practices indicate that care is needed beyond the provision of psychiatric services and pharmacotherapy alone, and the initial results of both the IAPT program and BC’s Bounce Back program strongly suggest that it is possible to provide these cost-effective services in a public system.

Assessing the external validity of model-based estimates of the incidence of heart attack in England: a modelling study

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Peter Scarborough

2016-11-01

Full Text Available Abstract Background The DisMod II model is designed to estimate epidemiological parameters on diseases where measured data are incomplete and has been used to provide estimates of disease incidence for the Global Burden of Disease study. We assessed the external validity of the DisMod II model by comparing modelled estimates of the incidence of first acute myocardial infarction (AMI in England in 2010 with estimates derived from a linked dataset of hospital records and death certificates. Methods Inputs for DisMod II were prevalence rates of ever having had an AMI taken from a population health survey, total mortality rates and AMI mortality rates taken from death certificates. By definition, remission rates were zero. We estimated first AMI incidence in an external dataset from England in 2010 using a linked dataset including all hospital admissions and death certificates since 1998. 95 % confidence intervals were derived around estimates from the external dataset and DisMod II estimates based on sampling variance and reported uncertainty in prevalence estimates respectively. Results Estimates of the incidence rate for the whole population were higher in the DisMod II results than the external dataset (+54 % for men and +26 % for women. Age-specific results showed that the DisMod II results over-estimated incidence for all but the oldest age groups. Confidence intervals for the DisMod II and external dataset estimates did not overlap for most age groups. Conclusion By comparison with AMI incidence rates in England, DisMod II did not achieve external validity for age-specific incidence rates, but did provide global estimates of incidence that are of similar magnitude to measured estimates. The model should be used with caution when estimating age-specific incidence rates.

Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study.

NARCIS (Netherlands)

Brocklehurst, P.; Kwee, A.; Birthplace in England Collaborative Group

2011-01-01

Objective: To compare perinatal outcomes, maternal outcomes, and interventions in labour by planned place of birth at the start of care in labour for women with low risk pregnancies. Design: Prospective cohort study. Setting: England: all NHS trusts providing intrapartum care at home,

Exploring human papillomavirus vaccination refusal among ethnic minorities in England: A comparative qualitative study

OpenAIRE

Forster, Alice S.; Rockliffe, Lauren; Marlow, Laura A.V.; Bedford, Helen; McBride, Emily; Waller, Jo

2017-01-01

Abstract Objectives In England, uptake of human papillomavirus (HPV) vaccination to prevent HPV‐related cancer is lower among girls from ethnic minority backgrounds. We aimed to explore the factors that prevented ethnic minority parents from vaccinating, compared to White British nonvaccinating parents and vaccinating ethnic minority parents. Methods Interviews with 33 parents (n = 14 ethnic minority non‐vaccinating, n = 10 White British nonvaccinating, and n = 9 ethnic minority vaccinating) ...

Being Mad in Early Modern England

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Aleksandar eDimitrijevic

2015-11-01

Full Text Available It has become almost a rule that the birth of scientific psychiatry and what we today term clinical psychology took place in the short period between the last decade of the XVIII century and the 1820s. Everything that happened before that period – every description, diagnosis, and therapy – has been considered ‘pre-scientific,’ outdated, in a way worthless.In this paper, however, I am providing the argument that, first, the roots of contemporary psychiatry reach at least to England of the early modern period, and that, second, it may still turn out that in the field of mental health care historical continuities are more numerous and persistent than discontinuities. Thus, I briefly review the most important surviving documents about the treatment of mental disorders in England of Elizabethan and Jacobian period, organizing the argument around the well-known markers: diagnostics and aetiology, therapy, organization of the asylum, the public image of the mentally ill…

Energy profiles of the New England States and Eastern Canadian Provinces

Energy Technology Data Exchange (ETDEWEB)

Parsons, P.; Rodgers, B. [Newfoundland and Labrador Dept. of Mines and Energy, Energy Policy Analysis Div., St. John`s, NF (Canada)

1998-06-01

Recent developments affecting Atlantic Canada and New England`s energy sectors were discussed. Historically, both regions have relied on each other as an energy supplier or consumer. Fuels such as electricity and natural gas have been traded within the regions for decades. This trade is expected to continue because of the developments in the electricity restructuring in the United States and the planned increases in electricity capacity in Canada through new projects and expansions. Offshore oil and natural gas production in Eastern Canada is also expected to continue with planned natural gas pipeline additions in New England and Eastern Canada. This report presents regional comparisons as well as profiles of the energy economies of the eleven jurisdictions that make up New England and Eastern Canada. There are specific sections on electricity, energy forecasts and the environment. The report also includes basic demographic and economic performance indicators and updates and expands the profile of the region`s energy supply, consumption, trade and related trends. The report is largely statistical in nature and is intended to provide a quick snapshot of the region`s energy situation. 6 tabs., 23 figs.

Jeremy Bentham and Church of England Education.

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Taylor, Brian

1979-01-01

The author traces Jeremy Bentham's attacks, in 1815 and 1816, on the Church of England's role in the provision of schooling in Britain, particularly his objections to Church policies excluding non-adherents from instruction. (SJL)

Impact of case-mix on comparisons of patient-reported experience in NHS acute hospital trusts in England.

Science.gov (United States)

Raleigh, Veena; Sizmur, Steve; Tian, Yang; Thompson, James

2015-04-01

To examine the impact of patient-mix on National Health Service (NHS) acute hospital trust scores in two national NHS patient surveys. Secondary analysis of 2012 patient survey data for 57,915 adult inpatients at 142 NHS acute hospital trusts and 45,263 adult emergency department attendees at 146 NHS acute hospital trusts in England. Changes in trust scores for selected questions, ranks, inter-trust variance and score-based performance bands were examined using three methods: no adjustment for case-mix; the current standardization method with weighting for age, sex and, for inpatients only, admission method; and a regression model adjusting in addition for ethnicity, presence of a long-term condition, proxy response (inpatients only) and previous emergency attendances (emergency department survey only). For both surveys, all the variables examined were associated with patients' responses and affected inter-trust variance in scores, although the direction and strength of impact differed between variables. Inter-trust variance was generally greatest for the unadjusted scores and lowest for scores derived from the full regression model. Although trust scores derived from the three methods were highly correlated (Kendall's tau coefficients 0.70-0.94), up to 14% of trusts had discordant ranks of when the standardization and regression methods were compared. Depending on the survey and question, up to 14 trusts changed performance bands when the regression model with its fuller case-mix adjustment was used rather than the current standardization method. More comprehensive case-mix adjustment of patient survey data than the current limited adjustment reduces performance variation between NHS acute hospital trusts and alters the comparative performance bands of some trusts. Given the use of these data for high-impact purposes such as performance assessment, regulation, commissioning, quality improvement and patient choice, a review of the long-standing method for analysing

A nationally representative study of maternal obesity in England, UK : trends in incidence and demographic inequalities in 619323 births, 1989-2007.

OpenAIRE

Heslehurst, N.; Rankin, J.; Wilkinson, J.R.; Summerbell, C.D.

2010-01-01

Background: There is an absence of national statistics for maternal obesity in the UK. This study is the first to describe a nationally representative maternal obesity research data set in England. Design: Retrospective epidemiological study of first trimester obesity. Methods: Data from 34 maternity units were analysed, including 619 323 births between 1989 and 2007. Data analysis included trends in first trimester maternal body bass index status over time, and geographical distribut...

Organizational learning in the implementation and adoption of national electronic health records: case studies of two hospitals participating in the National Programme for Information Technology in England.

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Takian, Amirhossein; Sheikh, Aziz; Barber, Nicholas

2014-09-01

To explore the role of organizational learning in enabling implementation and supporting adoption of electronic health record systems into two English hospitals. In the course of conducting our prospective and sociotechnical evaluation of the implementation and adoption of electronic health record into 12 "early adopter" hospitals across England, we identified two hospitals implementing virtually identical versions of the same "off-the-shelf" software (Millennium) within a comparable timeframe. We undertook a longitudinal qualitative case study-based analysis of these two hospitals (referred to hereafter as Alpha and Omega) and their implementation experiences. Data included the following: 63 in-depth interviews with various groups of internal and external stakeholders; 41-h on-site observation; and content analysis of 218 documents of various types. Analysis was both inductive and deductive, the latter being informed by the "sociotechnical changing" theoretical perspective. Although Alpha and Omega shared a number of contextual similarities, our evaluation revealed fundamental differences in visions of electronic health record and the implementation strategy between the hospitals, which resulted in distinct local consequences of electronic health record implementation and impacted adoption. Both hospitals did not, during our evaluation, see the hoped-for benefits to the organization as a result of the introduction of electronic health record, such as speeding-up tasks. Nonetheless, the Millennium software worked out to be easier to use at Omega. Interorganizational learning was at the heart of this difference. Despite the turbulent overall national "roll out" of electronic health record systems into the English hospitals, considerable opportunities for organizational learning were offered by sequential delivery of the electronic health record software into "early adopter" hospitals. We argue that understanding the process of organizational learning and its

An Analysis of the Stakeholder Model of Public Boards and the Case of School Governing Bodies in England and Wales

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Connolly, Michael; Farrell, Catherine; James, Christopher

2017-01-01

This article analyses the stakeholder model of boards that is widely used in public and third sector institutions in England and Wales. The central tenet of this model is that such institutions should be strategically led by individuals who are representative of and from the groups that have an interest in them. The article focuses in particular…

Mathematical modelling long-term effects of replacing Prevnar7 with Prevnar13 on invasive pneumococcal diseases in England and Wales.

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Yoon Hong Choi

Full Text Available England and Wales recently replaced the 7-valent pneumococcal conjugate vaccine (PCV7 with its 13-valent equivalent (PCV13, partly based on projections from mathematical models of the long-term impact of such a switch compared to ceasing pneumococcal conjugate vaccination altogether.A compartmental deterministic model was used to estimate parameters governing transmission of infection and competition between different groups of pneumococcal serotypes prior to the introduction of PCV13. The best-fitting parameters were used in an individual based model to describe pneumococcal transmission dynamics and effects of various options for the vaccination programme change in England and Wales. A number of scenarios were conducted using (i different assumptions about the number of invasive pneumococcal disease cases adjusted for the increasing trend in disease incidence prior to PCV7 introduction in England and Wales, and (ii a range of values representing serotype replacement induced by vaccination of the additional six serotypes in PCV13.Most of the scenarios considered suggest that ceasing pneumococcal conjugate vaccine use would cause an increase in invasive pneumococcal disease incidence, while replacing PCV7 with PCV13 would cause an overall decrease. However, the size of this reduction largely depends on the level of competition induced by the additional serotypes in PCV13. The model estimates that over 20 years of PCV13 vaccination, around 5000-62000 IPD cases could be prevented compared to stopping pneumococcal conjugate vaccination altogether.Despite inevitable uncertainty around serotype replacement effects following introduction of PCV13, the model suggests a reduction in overall invasive pneumococcal disease incidence in all cases. Our results provide useful evidence on the benefits of PCV13 to countries replacing or considering replacing PCV7 with PCV13, as well as data that can be used to evaluate the cost-effectiveness of such a switch.

Data-based decision making in the Netherlands and England : A comparison

NARCIS (Netherlands)

Ebbeler, Johanna; Schildkamp, Kim; Downey, Christopher

2012-01-01

Data-based decision making is receiving increased attention in education, not only in the USA but also in Europe. This paper describes findings from an international comparative study that examined data use by school staff in secondary education in the Netherlands and in England. Eighty six

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

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Wallace, Matthew; Kulu, Hill

2015-12-01

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

New England's Drinking Water | Drinking Water in New ...

Science.gov (United States)

2017-07-06

Information on Drinking Water in New England. Major Topics covered include: Conservation, Private Wells, Preventing Contamination, Drinking Water Sources, Consumer Confidence Reports, and Drinking Water Awards.

Case Study: Testing with Case Studies

Science.gov (United States)

Herreid, Clyde Freeman

2015-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses using case studies to test for knowledge or lessons learned.

Market Accountability in Schools: Policy Reforms in England, Germany, France and Italy

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Mattei, Paola

2012-01-01

This article concentrates on the policy reforms of schools in England, Germany, France and Italy, from 1988 to 2009, with a focus on the introduction of market accountability. Pressing demands for organisational change in schools, shaped by the objectives of "efficiency" and competition, which were introduced in England in the 1980s,…

Fate of semi-natural grassland in England between 1960 and 2013: A test of national conservation policy

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Lucy E. Ridding

2015-07-01

Full Text Available It is well documented that significant losses in semi-natural grassland occurred across Europe during the second half of the twentieth century. However, comparatively few studies have investigated and quantified the fate of large numbers of individual grassland areas. This is important for understanding the causes of decline, and consequently establishing new policies to conserve and restore lost habitats. This study addresses this problem; GIS was used to compare historic survey data collected between 1960 and 1981 with two contemporary spatial datasets of habitats in England. The datasets included the Priority Habitats Inventory 2013 and the Land Cover Map 2007 and this was undertaken for different types of semi-natural grassland across England. Considerable decreases occurred across the different grassland types, with a loss of 47% of studied semi-natural grasslands sites in England over 32–53 years. Of this, the majority of grassland was lost to conversion to agriculturally-improved grassland or arable cultivation, 45% and 43% respectively. Changes to woodland and urban areas were also evident, but on a much smaller scale. Sites receiving statutory protection as a Site of Special Scientific Interest were found to have retained more grassland (91%, compared with non-protected sites (27%, thus highlighting the effectiveness of this aspect of current conservation policy in England, and the need for this to continue in the future.

A cross-sectional questionnaire study of the rules governing pupils' carriage of inhalers for asthma treatment in secondary schools in North East England.

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Funston, Wendy; Howard, Simon J

2016-01-01

Objectives. The primary objective of this study was to assess the rules governing secondary school pupils' carriage of inhalers for emergency treatment of asthma in the North East of England. Design. This study was based upon a postal questionnaire survey. Setting. The setting for this study was mainstream free-to-attend secondary schools which admit 16 year old pupils within the 12 Local Authority areas which make up the North East of England. Participants. All 153 schools meeting the inclusion criteria were invited to participate in the study, of which 106 (69%) took part. Main Outcome Measures. Our three main outcome measures were: whether pupils are permitted to carry inhalers on their person while at school; whether advance permission is required for pupils to carry inhalers, and from whom; and whether the school has an emergency 'standby' salbutamol inhaler for use in asthma emergencies, as permitted since October 2014 under recent amendments to The Human Medicines Regulations 2012. Results. Of 98 schools submitting valid responses to the question, 99% (n = 97) permitted pupils to carry inhalers on their person while at school; the remaining school stored pupils' inhalers in a central location within the school. A total of 22% of included schools (n = 22) required parental permission before pupils were permitted to carry inhalers. Of 102 schools submitting valid responses to the question, 44% (n = 45) had purchased a 'standby' salbutamol inhaler for use in asthma emergencies. Conclusions. Most secondary schools in North East England permit pupils to carry inhalers on their person. The requirement in a minority of schools for parental permission to be given possibly contravenes the standard ethical practices in clinical medicine for children of this age. Only a minority of schools hold a 'standby' salbutamol inhaler for use in asthma emergencies. Wider availability may improve outcomes for asthma emergencies occurring in schools.

Civil society and the Health and Social Care Act in England and Wales: theory and praxis for the twenty-first century.

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Scambler, Graham; Scambler, Sasha; Speed, Ewen

2014-12-01

In this paper we revisit the notion of civil society in the light of recent attempts to privatize health care in England via the passing of the Health and Social Care Act of 2013. This legislation promises a re-commodification of the National Health Service (NHS) in England. The Bill was bitterly contested during its passage through parliament, most vigorously in 2011. Much of the opposition occurred at a time of widespread, global rebellion, most notably in the 'Arab uprisings' and through the 'occupy movement'. Despite a plethora of protests, we argue, a non-porous boundary between what we call the 'protest sector' of civil society and the wider public sphere of the lifeworld has become apparent in England. A good deal of collective action, whether campaign-focused (like opposition to the Health and Social Care Bill) or more generalized (like rejections of corporate greed), has so far proved ineffective, at least in the short-term; no crisis of legitimation is apparent. We highlight a new 'class/command dynamic', leading to oligarchic rule, in the present era of financial capitalism. We use this health care case-study to re-examine the notion of civil society and its changing properties in what Castells calls a 'networked society'. The contribution ends with a discussion of the role of the sociologist re-civil society and the advocacy of both 'action' and 'foresight sociologies'. Copyright © 2014 Elsevier Ltd. All rights reserved.

Environmental isotope studies related to groundwater flow and saline encroachment in the chalk aquifer of Lincolnshire, England

International Nuclear Information System (INIS)

Lloyd, J.W.; Howard, K.W.F.

1978-01-01

The isotopes of tritium and carbon are used to study part of the North Lincolnshire Chalk aquifer in England. The tritium data support the view that the aquifer is a thin fissure system and indicate that some changes in flow direction have occurred due to recent abstraction. The data are also consistent with other chemical data in elucidating groundwater entering the Chalk from deeper aquifers. Carbon isotopes are used to distinguish between saline water bodies and suggest that saline water was entrapped within the aquifer in the Eemian and Flandrian stages of the Pleistocene. (orig.) [de

Theoretical Framework of Leadership in Higher Education of England and Wales

Science.gov (United States)

Mukan, Nataliya; Havrylyuk, Marianna; Stolyarchuk, Lesia

2015-01-01

In the article the theoretical framework of leadership in higher education of England and Wales has been studied. The main objectives of the article are defined as analysis of scientific and pedagogical literature, which highlights different aspects of the problem under research; characteristic of the theoretical fundamentals of educational…

Real or Illusory? Case Studies on the Public Perception of Environmental Health Risks in the North West of England

Science.gov (United States)

Stewart, Alex G; Luria, Paolo; Reid, John; Lyons, Mary; Jarvis, Richard

2010-01-01

Applied research in a public health setting seeks to provide professionals with insights and knowledge into complex environmental issues to guide actions that reduce inequalities and improve health. We describe ten environmental case studies that explore the public perception of health risk. We employed logical analysis of components of each case study and comparative information to generate new evidence. The findings highlight how concerns about environmental issues measurably affect people’s wellbeing and led to the development of new understanding about the benefits of taking an earlier and more inclusive approach to risk communication that can now be tested further. PMID:20617024

Whales of New England. Secondary Curriculum.

Science.gov (United States)

New England Aquarium, Boston, MA.

Instructional materials and suggestions for conducting a whale watching field trip are contained in this curriculum packet for secondary science teachers. It is one unit in a series of curricular programs developed by the New England Aquarium Education Department. Activities and information are organized into three sections: (1) pre-trip…

78 FR 38027 - ISO New England Inc.; Notice of Initiation of Proceeding and Refund Effective Date

Science.gov (United States)

2013-06-25

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL13-72-000] ISO New England... III.A.15 of Appendix A of ISO New England Inc.'s existing tariff. Dominion Energy Marketing, Inc. and ISO New England Inc., 143 FERC ] 61,233 (2013). The refund effective date in Docket No. EL13-72-000...

Effect of Smoke-Free Legislation on Adult Smoking Behaviour in England in the 18 Months following Implementation

OpenAIRE

Lee, John Tayu; Glantz, Stanton A.; Millett, Christopher

2011-01-01

Background Comprehensive smoke-free legislation covering all enclosed public places and workplaces was implemented in England on 1 July 2007. This study examines the impact of this legislation on smoking prevalence, number of cigarettes smoked and location of smoking, controlling for secular trends through the end of 2008. Method and Findings Repeat cross sectional survey using nationally representative data from the Health Survey for England (HSE). In total there are 54,333 respondents from ...

Breast Density Legislation in New England: A Survey Study of Practicing Radiologists.

Science.gov (United States)

Lourenco, Ana P; DiFlorio-Alexander, Roberta M; Slanetz, Priscilla J

2017-10-01

This study aimed to assess radiologists' knowledge about breast density legislation as well as perceived practice changes resulting from the enactment of breast density legislation. This is an institutional review board-exempt anonymous email survey of 523 members of the New England Roentgen Ray Society. In addition to radiologist demographics, survey questions addressed radiologist knowledge of breast density legislation, knowledge of breast density as a risk factor for breast cancer, recommendations for supplemental screening, and perceived practice changes resulting from density notification legislation. Of the 523 members, 96 responded, yielding an 18% response rate. Seventy-three percent of respondents practiced in a state with breast density legislation. Sixty-nine percent felt that breast density notification increased patient anxiety about breast cancer, but also increased patient (74%) and provider (66%) understanding of the effect of breast density on mammographic sensitivity. Radiologist knowledge of the relative risk of breast cancer when comparing breasts of different density was variable. Considerable confusion and controversy regarding breast density persists, even among practicing radiologists. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Cancer patient experience, hospital performance and case mix: evidence from England.

Science.gov (United States)

Abel, Gary A; Saunders, Catherine L; Lyratzopoulos, Georgios

2014-01-01

  This study aims to explore differences between crude and case mix-adjusted estimates of hospital performance with respect to the experience of cancer patients. This study analyzed the English 2011/2012 Cancer Patient Experience Survey covering all English National Health Service hospitals providing cancer treatment (n = 160). Logistic regression analysis was used to predict hospital performance for each of the 64 evaluative questions, adjusting for age, gender, ethnic group and cancer diagnosis. The degree of reclassification was explored across three categories (bottom 20%, middle 60% and top 20% of hospitals). There was high concordance between crude and adjusted ranks of hospitals (median Kendall's τ = 0.84; interquartile range: 0.82-0.88). Across all questions, a median of 5.0% (eight) of hospitals (interquartile range: 3.8-6.4%; six to ten hospitals) moved out of the extreme performance categories after case mix adjustment. In this context, patient case mix has only a small impact on measured hospital performance for cancer patient experience.

'Healthy gums do matter': A case study of clinical leadership within primary dental care.

Science.gov (United States)

Moore, D; Saleem, S; Hawthorn, E; Pealing, R; Ashley, M; Bridgman, C

2015-09-25

The Health and Social Care Act 2012 heralded wide reaching reforms intended to place clinicians at the heart of the health service. For NHS general dental practice, the conduits for this clinical leadership are the NHS England local professional networks. In Greater Manchester, the local professional network has developed and piloted a clinician led quality improvement project: 'Healthy Gums DO Matter, a Practitioner's Toolkit'. Used as a case study, the project highlighted the following facilitators to clinical leadership in dentistry: supportive environment; mentoring and transformational leadership; alignment of project goals with national policy; funding allowance; cross-boundary collaboration; determination; altruism; and support from wider academic and specialist colleagues. Barriers to clinical leadership identified were: the hierarchical nature of healthcare, territorialism and competing clinical commitments.

The impact of new forms of large-scale general practice provider collaborations on England's NHS: a systematic review.

Science.gov (United States)

Pettigrew, Luisa M; Kumpunen, Stephanie; Mays, Nicholas; Rosen, Rebecca; Posaner, Rachel

2018-03-01

Over the past decade, collaboration between general practices in England to form new provider networks and large-scale organisations has been driven largely by grassroots action among GPs. However, it is now being increasingly advocated for by national policymakers. Expectations of what scaling up general practice in England will achieve are significant. To review the evidence of the impact of new forms of large-scale general practice provider collaborations in England. Systematic review. Embase, MEDLINE, Health Management Information Consortium, and Social Sciences Citation Index were searched for studies reporting the impact on clinical processes and outcomes, patient experience, workforce satisfaction, or costs of new forms of provider collaborations between general practices in England. A total of 1782 publications were screened. Five studies met the inclusion criteria and four examined the same general practice networks, limiting generalisability. Substantial financial investment was required to establish the networks and the associated interventions that were targeted at four clinical areas. Quality improvements were achieved through standardised processes, incentives at network level, information technology-enabled performance dashboards, and local network management. The fifth study of a large-scale multisite general practice organisation showed that it may be better placed to implement safety and quality processes than conventional practices. However, unintended consequences may arise, such as perceptions of disenfranchisement among staff and reductions in continuity of care. Good-quality evidence of the impacts of scaling up general practice provider organisations in England is scarce. As more general practice collaborations emerge, evaluation of their impacts will be important to understand which work, in which settings, how, and why. © British Journal of General Practice 2018.

Ethics Education in Initial Teacher Education: Pre-Service Provision in England

Science.gov (United States)

Walters, Sue; Heilbronn, Ruth; Daly, Caroline

2018-01-01

Ethics education exists in most professions internationally, yet is less prevalent in teacher education. This article reports on research exploring how ethics education is provided in university courses of initial teacher education (ITE) in England that was conducted as the second phase of an international survey study which considered the…

New England wildlife: management forested habitats

Science.gov (United States)

Richard M. DeGraaf; Mariko Yamasaki; William B. Leak; John W. Lanier

1992-01-01

Presents silvicultural treatments for six major cover-type groups in New England to produce stand conditions that provide habitat opportunities for a wide range of wildlife species. Includes matrices for species occurrence and utilization by forested and nonforested habitats, habitat breadth and size class, and structural habitat features for the 338 wildlife species...

Crime and immigration: new evidence from England and Wales

OpenAIRE

Laura Jaitman; Stephen Machin

2013-01-01

We study a high profile public policy question on immigration, namely the link between crime and immigration, presenting new evidence from England and Wales in the 2000s. For studying immigration impacts, this period is of considerable interest as the composition of migration to the UK altered dramatically with the accession of Eastern European countries (the A8) to the European Union in 2004. As we show, this has important implications for ensuring a causal impact of immigration can be ident...

The fertility of recent migrants to England and Wales

Directory of Open Access Journals (Sweden)

James Robards

2016-06-01

Full Text Available Background: Estimates of fertility for the overseas-born based on the period Total Fertility Rate (TFR suggest that levels of childbearing are significantly higher among foreign-born women than women born in the UK. However, migration and timing of subsequent family formation mean that aggregate measures of fertility based on period TFRs may not be a useful indicator of the likely completed family size that migrant women will have at the end of their reproductive lives. Objective: The paper quantifies childbearing according to duration since migration among female migrants to England and Wales arriving between 2001 and 2011, and examines how these patterns differ according to age at arrival and country of birth. Methods: Data from the Office for National Statistics Longitudinal Study, a 1Š sample of the population of England and Wales, are used to identify the reported date of arrival in the UK and to estimate childbearing prior to and subsequent to arrival. Results: Fertility rates peak in the first one to four years subsequent to arrival among migrants from Pakistan and Bangladesh. Migrants from India and Poland show a delay in childbearing after migration to England and Wales, and lower fertility rates compared to migrants from Pakistan and Bangladesh, who show high fertility after migration at least for the first five years. Conclusions: There are large differences in the timing of fertility among migrants according to age at arrival and migrant country of origin, which are likely to be related to the reason for migration. Tempo distortions among some migrant groups mean that the period TFR is not necessarily a useful summary measure of the likely lifetime fertility of migrant groups.

Are Postgraduate Students "Rational Choosers"? An Investigation of Motivation for Graduate Study amongst International Students in England

Science.gov (United States)

Mowjee, Bisma

2013-01-01

In England, since the 1980s, neo-liberalism has dominated political discourse, and its effects have been extending into the higher-education landscape, challenging traditional conceptions of the university as serving the public good and driving them towards becoming corporate entities selling private commodities. This change has created an…

Self-Esteem and Academic Achievement: A Comparative Study of Adolescent Students in England and the United States

Science.gov (United States)

Booth, Margaret Zoller; Gerard, Jean M.

2011-01-01

Utilizing mixed methodology, this paper investigates the relationship between self-esteem and academic achievement for young adolescents within two Western cultural contexts: the United States and England. Quantitative and qualitative data from 86 North American and 86 British adolescents were utilized to examine the links between self-esteem and…

Further occurrences of Dohrniphora cornuta (Bigot) (Diptera, Phoridae) in forensic cases indicate likely importance of this species in future cases.

Science.gov (United States)

Disney, R Henry L; Garcia-Rojo, Ana; Lindström, Anders; Manlove, John D

2014-08-01

Dohrniphora cornuta (Bigot), an oriental species of scuttle fly, has been transported around the world by man. We report it from forensic cases in England, Spain and Sweden. It is likely to feature in forensic cases elsewhere in the world. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Pooling local public health budgets to achieve exceptional value for money: the case of the North East of England

Directory of Open Access Journals (Sweden)

Ailsa Rutter

2018-03-01

Significant economies of scale have been achieved with high value for money. In the UK there is a need for effective tobacco action from the community grass roots level right up to the national and international stage. A similar approach is in place around alcohol denormalisation now through the regional programme "Balance" and the two programmes are working together with notable success.The North East England provides a useful model for others.

A human rights approach to advocacy for people with dementia: A review of current provision in England and Wales.

Science.gov (United States)

Dixon, Jeremy; Laing, Judy; Valentine, Christine

2018-01-01

In this article, we review current advocacy services for people with dementia in England and Wales (provided, respectively, under the Mental Capacity Act 2005 , the Mental Health Act 1983 /2007 and the Care Act 2014) through the lens of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). We examine what a human rights' approach to advocacy support would entail, and whether current frameworks in England and Wales are adequate for this approach and provide a sufficient safeguard. First, we consider how the human rights of persons with dementia have become increasingly important and the extent to which the CRPD provides an opportunity to bolster safeguards and protection. Second, we discuss cause and case advocacy, and how these advocacy models could be shaped by the CRPD to promote the rights of persons with dementia at each stage of the disease. Third, we highlight current dilemmas and challenges in the provision of advocacy support in England and Wales by focusing on case law, commissioning of services and current practice. In particular, we analyse how the different legislative schemes have given rise to some confusion about the various advocacy provisions, as well as potential for overlap and discrepancies between different regimes. We also highlight the need for further research to address important gaps in knowledge, including the scale of need, patterns of referral and attitudes to advocacy services. The article concludes by highlighting how advocacy support could be recalibrated as a universal right to promote the aims and aspirations of the CRPD, and how education is needed to address the stigma of dementia and promote the benefits of advocacy in protecting the rights of those with dementia.

77 FR 11532 - Notice of Attendance at ISO New England and NEPOOL Meetings

Science.gov (United States)

2012-02-27

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Notice of Attendance at ISO New England... members of the Commission and Commission staff may attend upcoming ISO New England Inc. (ISO-NE) and New..., the Commission and Commission staff may monitor the various meetings posted on the ISO-NE Web site...

New England Wind Forum: A Wind Powering America Project, Volume 1, Issue 4 -- May 2008 (Newsletter)

Energy Technology Data Exchange (ETDEWEB)

Grace, R. C.; Gifford, J.

2008-05-01

The New England Wind Forum electronic newsletter summarizes the latest news in wind energy development activity, markets, education, and policy in the New England region. It also features an interview with a key figure influencing New England's wind energy development. Volume 1, Issue 4 features an interview with Brian Fairbank, president and CEO of Jiminy Peak Mountain Resort.

New England Wind Forum: A Wind Powering America Project, Volume 1, Issue 3 -- October 2007 (Newsletter)

Energy Technology Data Exchange (ETDEWEB)

Grace, R. C.; Gifford, J.

2007-10-01

The New England Wind Forum electronic newsletter summarizes the latest news in wind energy development activity, markets, education, and policy in the New England region. It also features an interview with a key figure influencing New England's wind energy development. Volume 1, Issue 3 features an interview with Andrew Dzykewicz, Commissioner of the Rhode Island Office of Energy Resources.

Extent of misclassification of death from Creutzfeldt-Jakob disease in England 1979-96: retrospective examination of clinical records

Science.gov (United States)

Majeed, Azeem; Lehmann, Petra; Kirby, Liz; Knight, Richard; Coleman, Michel

2000-01-01

Objective To investigate the extent to which deaths from Creutzfeldt-Jakob disease were misclassified during 1979-96. Design Structured review of clinical records based on predetermined criteria to determine whether death could have been due to sporadic or variant Creutzfeldt-Jakob disease. Setting 100 health authorities and 275 NHS trusts in England. Subjects 1485 people who died aged 15-44 years from selected neurological disorders in England during 1979-96. Main outcome measure Cause of death. Results The clinical records of 705 (48%) subjects were successfully traced. Tracing of clinical records was highest in subjects who died during 1990-6. There was sufficient information in the records of 640 (91%) of the 705 subjects to exclude Creutzfeldt-Jakob disease as a cause of death. In 61 (9%) subjects, there was insufficient information to reach any conclusion about the validity of the cause of death recorded on the death certificate. The clinical records of four subjects were examined further by the National Creutzfeldt-Jakob Disease Surveillance Unit; none was thought to have died from Creutzfeldt-Jakob disease. Conclusions No new cases of sporadic or variant Creutzfeldt-Jakob disease were detected in a sample of deaths most likely to have included misclassified cases. This suggests that the surveillance system is unlikely to have missed a significant number of cases among people aged 15-44 years. Hence, any rapid increase in the number of cases of variant Creutzfeldt-Jakob disease in this age group is likely to be real not artefactual. PMID:10634732

Fatal methadone and heroin overdoses : Time trends in England and Wales

NARCIS (Netherlands)

Neeleman, J; Farrell, M

Study objective-Although the total number of self poisonings in England and Wales has dropped by 32%, the number involving methadone and/or heroin rose by 900% in 1974-92. Because of concern about the role of methadone in this increase, the part played by methadone and heroin in poisoning deaths in

Estimating the volatility of electricity prices: The case of the England and Wales wholesale electricity market

International Nuclear Information System (INIS)

Tashpulatov, Sherzod N.

2013-01-01

Price fluctuations that partially comove with demand are a specific feature inherent to liberalized electricity markets. The regulatory authority in Great Britain, however, believed that sometimes electricity prices were significantly higher than what was expected and, therefore, introduced price-cap regulation and divestment series. In this study, I analyze how the introduced institutional changes and regulatory reforms affected the dynamics of daily electricity prices in the England and Wales wholesale electricity market during 1990–2001. This research finds that the introduction of price-cap regulation did achieve the goal of lowering the price level at the cost of higher price volatility. Later, the first series of divestments is found to be successful at lowering price volatility, which however happens at the cost of a higher price level. Finally, this study also documents that the second series of divestments was more successful at lowering both the price level and volatility. - Author-Highlights: • The impact of regulation on the dynamics of electricity prices is examined. • Price-cap regulation has decreased the level at the cost of higher volatility. • The first series of divestments has reversed the trade-off. • The reversed trade-off is explained as an indication of tacit collusion. • The second series of divestments is found generally successful

Persistent and emerging micro-organic contaminants in Chalk groundwater of England and France

International Nuclear Information System (INIS)

Lapworth, D.J.; Baran, N.; Stuart, M.E.; Manamsa, K.; Talbot, J.

2015-01-01

The Chalk aquifer of Northern Europe is an internationally important source of drinking water and sustains baseflow for surface water ecosystems. The areal distribution of microorganic (MO) contaminants, particularly non-regulated emerging MOs, in this aquifer is poorly understood. This study presents results from a reconnaissance survey of MOs in Chalk groundwater, including pharmaceuticals, personal care products and pesticides and their transformation products, conducted across the major Chalk aquifers of England and France. Data from a total of 345 sites collected during 2011 were included in this study to provide a representative baseline assessment of MO occurrence in groundwater. A suite of 42 MOs were analysed for at each site including industrial compounds (n = 16), pesticides (n = 14) and pharmaceuticals, personal care and lifestyle products (n = 12). Occurrence data is evaluated in relation to land use, aquifer exposure, well depth and depth to groundwater to provide an understanding of vulnerable groundwater settings. - Highlights: • Broad range of microorganics detected in Chalk groundwater in England and France. • Plasticisers, pesticides, BPA and THM detected at the highest concentrations. • Pesticides higher in outcrop Chalk, caffeine and BPA at concealed sites. • Occurrences show some relationship to land use, borehole depth and water level. - Broad screening reveals for the first time the extent of emerging microorganic pollution in Chalk groundwater sources across England and France

ISO New England Dual Fuel Capabilities to Limit Natural Gas and Electricity Interdependencies

Energy Technology Data Exchange (ETDEWEB)

Adder, Justin M. [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States)

2016-04-22

Since 2000, natural gas has seen tremendous growth as a fuel source for electricity generation in the United States (U.S.) with annual installations exceeding 20 GW in all but four years. It also accounts for an increasingly significant share of the nation’s electricity generation, growing from around 15 percent in the early part of the 2000s to between 26 and 29 percent in the last three years. (1) Increasing reliance on natural gas has led to concerns that an extreme weather event – which may cause curtailments in gas delivery – or a natural gas infrastructure failure could lead to local or regional electric reliability issues. (2) These concerns stem from differences in delivery methods of natural gas to electric generating units (EGUs) contrasted with the fuel delivery and storage methods for traditional baseload power systems (i.e. coal and nuclear units).1 (3) Although it seems that there is an abundance of natural gas in a post-shale gas world, infrastructure limitations and differences in electric and natural gas markets persist that differentiate natural gas-fired generators from traditional baseload power generators. Such concerns can be partially mitigated by modifying natural gas EGUs for operation on secondary fuels and installing on-site fuel storage for the secondary fuel, thus ensuring continuity of operation in the case of a gas delivery problem.2 This report examines technical, regulatory, and market issues associated with operating power plants primarily fueled with natural gas, on a secondary fuel, such as fuel oil or liquefied natural gas (LNG). In addition, a regional case study was completed to identify the current and near-term potential for dual fuel operation in New England, along with a market impact analysis of potential cost savings during an extreme weather event. The New England Independent System Operator (ISO-NE) was selected as the study area based on a preponderance of natural gas-fired generators contributing to the

Contrasting styles of Sn-W mineralisation in peninsular Thailand and SW England

Science.gov (United States)

Manning, D. A. C.

1986-01-01

The Sn-W deposits of SW England and SE Asia are associated with crustally derived granitic rocks with late volatile-enriched (F, Li, B, P) differentiates. In peninsular Thailand, primary ores are principally pegmatitic, and hydrothermal vein systems are only locally important. In SW England, wolframite and cassiterite mainly occur in hydrothermal vein systems, and are associated with greisening and tourmalinisation; mineralised pegmatites are rare. These two styles of mineralisation are thought to arise because of differences in the character of late magmatic processes. In peninsular Thailand, late-stage tourmaline-bearing granitic rocks are enriched in B, but not Li and F, compared to earlier biotite granites. Similar late-stage granitic rocks occur also in SW England, but a later topaz granite, enriched in F, Li and P, also occurs. The Thai pegmatitic Sn-W deposits are thought to have formed by late magmatic crystallisation from an aqueous phase enriched in metals and derived by exsolution from a B and metal-rich magma, whereas the SW England mineralisation involved essentially post-magmatic hydrothermal processes. Complexing agents (especially F) and metals may have been derived from granitic or country rocks during hydrothermal circulation at the current level of emplacement.

Understanding Linear Function: A Comparison of Selected Textbooks from England and Shanghai

Science.gov (United States)

Wang, Yuqian; Barmby, Patrick; Bolden, David

2017-01-01

This study describes a comparison of how worked examples in selected textbooks from England and Shanghai presented possible learning trajectories towards understanding linear function. Six selected English textbooks and one Shanghai compulsory textbook were analysed with regards to the understanding required for pure mathematics knowledge in…

Measurements of PANs during the New England Air Quality Study 2002

Science.gov (United States)

Roberts, J. M.; Marchewka, M.; Bertman, S. B.; Sommariva, R.; Warneke, C.; de Gouw, J.; Kuster, W.; Goldan, P.; Williams, E.; Lerner, B. M.; Murphy, P.; Fehsenfeld, F. C.

2007-10-01

Measurements of peroxycarboxylic nitric anhydrides (PANs) were made during the New England Air Quality Study 2002 cruise of the NOAA RV Ronald H Brown. The four compounds observed, PAN, peroxypropionic nitric anhydride (PPN), peroxymethacrylic nitric anhydride (MPAN), and peroxyisobutyric nitric anhydride (PiBN) were compared with results from other continental and Gulf of Maine sites. Systematic changes in PPN/PAN ratio, due to differential thermal decomposition rates, were related quantitatively to air mass aging. At least one early morning period was observed when O3 seemed to have been lost probably due to NO3 and N2O5 chemistry. The highest O3 episode was observed in the combined plume of isoprene sources and anthropogenic volatile organic compounds (VOCs) and NOx sources from the greater Boston area. A simple linear combination model showed that the organic precursors leading to elevated O3 were roughly half from the biogenic and half from anthropogenic VOC regimes. An explicit chemical box model confirmed that the chemistry in the Boston plume is well represented by the simple linear combination model. This degree of biogenic hydrocarbon involvement in the production of photochemical ozone has significant implications for air quality control strategies in this region.

British Asian Women and the Costs of Higher Education in England

Science.gov (United States)

Bhopal, Kalwant

2016-01-01

This article will examine Asian women's experiences of financial support in higher education. The article is based on 30 in-depth interviews with Asian women who were studying at a "new" (post-1992) university in the South East of England. Women identified themselves as Muslim, Hindu and Sikh. The findings reveal that women's religious…

Characterizing New England Emergency Departments by Telemedicine Use

Directory of Open Access Journals (Sweden)

Kori S. Zachrison

2017-09-01

Full Text Available Introduction: Telemedicine connects emergency departments (ED with resources necessary for patient care; its use has not been characterized nationally, or even regionally. Our primary objective was to describe the prevalence of telemedicine use in New England EDs and the clinical applications of use. Secondarily, we aimed to determine if telemedicine use was associated with consultant availability and to identify ED characteristics associated with telemedicine use. Methods: We analyzed data from the National Emergency Department Inventory-New England survey, which assessed basic ED characteristics in 2014. The survey queried directors of every ED (n=195 in the six New England states (excluding federal hospitals and college infirmaries. Descriptive statistics characterized ED telemedicine use; multivariable logistic regression identified independent predictors of use. Results: Of the 169 responding EDs (87% response rate, 82 (49% reported using telemedicine. Telemedicine EDs were more likely to be rural (18% of users vs. 7% of non-users, p=0.03; less likely to be academic (1% of users vs. 11% of non-users, p=0.01; and less likely to have 24/7 access to neurology (p<0.001, neurosurgery (p<0.001, orthopedics (p=0.01, plastic surgery (p=0.01, psychiatry (p<0.001, and hand surgery (p<0.001 consultants. Neuro/stroke (68%, pediatrics (11%, psychiatry (11%, and trauma (10% were the most commonly reported applications. On multivariable analysis, telemedicine was more likely in rural EDs (odds ratio [OR] 4.39, 95% confidence interval [CI] 1.30–14.86, and less likely in EDs with 24/7 neurologist availability (OR 0.21, 95% CI [0.09–0.49], and annual volume <20,000 (OR 0.24, 95% CI [0.08–0.68]. Conclusion: Telemedicine is commonly used in New England EDs. In 2014, use was more common among rural EDs and EDs with limited neurology consultant availability. In contrast, telemedicine use was less common among very low-volume EDs.

Early Years Educators' Perceptions of Professional Development in England: An Exploratory Study of Policy and Practice

Science.gov (United States)

Ingleby, Ewan

2018-01-01

This article explores the perceptions of professional development held by a selection of early years educators who have experience of working in statutory and private early years settings in the north of England. The research participants (n = 20) reflected on their experiences of professional development in early years. The research process is…

School Nurses' perspectives on the role of the school nurse in health education and health promotion in England: a qualitative study.

Science.gov (United States)

Hoekstra, Beverley A; Young, Vicki L; Eley, Charlotte V; Hawking, Meredith K D; McNulty, Cliodna A M

2016-01-01

The role of the school nurse is complex with many possible elements identified by previous research. The aim of this study is to understand perceptions of the role of the school nurse in order to support school nurses in the delivery of health education. The study used an inductive, qualitative research design involving semi-structured interviews and focus groups. Participants were recruited from four NHS trusts across England and final sample size was thirty one school nurses. Three focus groups and two interviews took place in person, and three interviews were over the phone. Data was thematically analysed. School nurses described six main themes. Four themes directly related to the school nurse role: the main roles of a school nurse, school nurses' role in health education, prioritisation of workload and activities, and community work. A further two other themes related to the delivery of health education: the school nursing system and educational resources. The role of the school nurse in England is very diverse and the school nurse role in health education is primarily to advise and support schools, rather than to directly deliver education. The study identified that tailored public health educational resources are needed to support school nurses.

A systematic analysis of misleading evidence in unsafe rulings in England and Wales.

Science.gov (United States)

Smit, Nadine M; Morgan, Ruth M; Lagnado, David A

2018-03-01

Evidence has the potential to be misleading if its value when expressing beliefs in hypotheses is not fully understood or presented. Although the knowledge base to understand uncertainties is growing, a challenge remains to prioritise research and to continuously assess the magnitude and consequences of misleading evidence in criminal cases. This study used a systematic content analysis to identify misleading evidence, drawing information from case transcripts of rulings argued unsafe by the Court of Appeal of England and Wales. In the 7-year study period, 218 applications were successful on appeal, containing 235 cases of misleading evidence. The majority (76%) of successful appeals were based upon the same materials available in the original trial, rather than the presentation of new relevant information. Witness (39%), forensic (32%), and character evidence (19%) were the most commonly observed evidence types, with the validity of witnesses (26%), probative value of forensic evidence (12%), and relevance of character evidence (10%) being the most prevalent combinations of identified issues. Additionally, the majority (66%) of misleading evidence types relate to their interpretation at activity level. The findings suggest that many of these misleading aspects could have been prevented by providing more transparency in the relationship between evidence and hypotheses. Generally, the results contribute to gaining a more complete picture of the role of misleading evidence in the criminal justice system. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

A case-control study of risk of leukaemia in relation to mobile phone use.

Science.gov (United States)

Cooke, R; Laing, S; Swerdlow, A J

2010-11-23

Mobile phone use is now ubiquitous, and scientific reviews have recommended research into its relation to leukaemia risk, but no large studies have been conducted. In a case-control study in South East England to investigate the relation of acute and non-lymphocytic leukaemia risk to mobile phone use, 806 cases with leukaemia incident 2003-2009 at ages 18-59 years (50% of those identified as eligible) and 585 non-blood relatives as controls (provided by 392 cases) were interviewed about mobile phone use and other potentially aetiological variables. No association was found between regular mobile phone use and risk of leukaemia (odds ratio (OR)=1.06, 95% confidence interval (CI)=0.76, 1.46). Analyses of risk in relation to years since first use, lifetime years of use, cumulative number of calls and cumulative hours of use produced no significantly raised risks, and there was no evidence of any trends. A non-significantly raised risk was found in people who first used a phone 15 or more years ago (OR=1.87, 95% CI=0.96, 3.63). Separate analyses of analogue and digital phone use and leukaemia subtype produced similar results to those overall. This study suggests that use of mobile phones does not increase leukaemia risk, although the possibility of an effect after long-term use, while biologically unlikely, remains open.

Groundwater vulnerability to onshore unconventional and conventional hydrocarbon activities in England

Science.gov (United States)

Loveless, Sian; Bloomfield, John; Ward, Rob; Davey, Ian; Hart, Alwyn

2016-04-01

://www.bgs.ac.uk/research/groundwater/shaleGas/iHydrogeology.html) - identified key shale units and Principal Aquifers (http://apps.environment-agency.gov.uk/wiyby/117020.aspx) in England and Wales. The BGS GB3D model (Mathers et al., 2014) was used to produce maps of these and the separation distance between aquifer-shale pairs. The latter maps show large variations across the country and even within basins for the aquifer-shale pairs. For example, the separation distance between the Bowland shale and Triassic sandstone aquifer varies between 1,500 m. However it is not yet clear what constitutes a safe separation distance. Due to the geological variability across England a current project (3DGWV) will address the need to assess risk and uncertainties both conceptually and on a more site-specific scale. The method above will be extended to other onshore hydrocarbons. Conceptual models of these source releases and pathways will be compared in the context of English geology. Another important outcome of the ihydrogeology project was the recognition that the definition of groundwater bodies with respect to the Water Framework Directive might need to be redefined in a UK context, taking into account these new, 3D risks. In addition to this work the BGS and EA are also conducting one of the first comprehensive baseline monitoring studies in potential shale gas areas and a project looking at the impacts of abandoned wells. Reference: Mathers, et al. (2014). GB3D-a framework for the bedrock geology of Great Britain. Geoscience Data Journal, 1(1), 30-42.

Learning Cultures in Retail: Apprenticeship, Identity and Emotional Work in England and Germany

Science.gov (United States)

Brockmann, Michaela

2013-01-01

The paper is based on a study of apprentices in retail and motor vehicle maintenance in England and Germany, exploring their perceptions of themselves as learners over time and in particular learning environments. The study combines biographical interviews with participant observation in colleges and workplaces. The paper examines the concept of…

"The Counties of England": A Nineteenth-Century Geographical Game to Amuse and Instruct

Science.gov (United States)

Dove, Jane Elizabeth

2014-01-01

This study examines a Victorian geographical card game entitled "The Counties of England" published by Jaques & Son. Advertised as highly instructive and educational, it was designed to teach children about the principal towns in each county, their products and notable buildings. The aims of the study were to discover whether the…

"Living as a single person". Marital Status, Performance and the Law in Late Medieval England

OpenAIRE

Beattie, Cordelia

2008-01-01

This article contributes to the debate about how we define the single woman by thinking about what makes someone ‘married’ as opposed to ‘not married’. It argues that understanding what marriage meant in a particular society can shed light on what it meant to live as a single person in that society, in this case, the society of fourteenth and fifteenth century England. It also argues that ‘the margins of marriage’, the grey areas produced by definitions of marriage, are also at the margins of...

MERGANSER - An Empirical Model to Predict Fish and Loon Mercury in New England Lakes

Science.gov (United States)

MERGANSER (MERcury Geo-spatial AssessmeNtS for the New England Region) is an empirical least-squares multiple regression model using mercury (Hg) deposition and readily obtainable lake and watershed features to predict fish (fillet) and common loon (blood) Hg in New England lakes...

Hot Topics/New Initiatives | Drinking Water in New England ...

Science.gov (United States)

2017-07-06

Information on Drinking Water in New England. Major Topics covered include: Conservation, Private Wells, Preventing Contamination, Drinking Water Sources, Consumer Confidence Reports, and Drinking Water Awards.

Determinants of general practitioners' wages in England.

Science.gov (United States)

Morris, Stephen; Goudie, Rosalind; Sutton, Matt; Gravelle, Hugh; Elliott, Robert; Hole, Arne Risa; Ma, Ada; Sibbald, Bonnie; Skåtun, Diane

2011-02-01

We analyse the determinants of annual net income and wages (net income/hours) of general practitioners (GPs) using data for 2271 GPs in England recorded during Autumn 2008. The average GP had an annual net income of £97,500 and worked 43 h per week. The mean wage was £51 per h. Net income and wages depended on gender, experience, list size, partnership size, whether or not the GP worked in a dispensing practice, whether they were salaried of self-employed, whether they worked in a practice with a nationally or locally negotiated contract, and the characteristics of the local population (proportion from ethnic minorities, rurality, and income deprivation). The findings have implications for pay discrimination by GP gender and ethnicity, GP preferences for partnership size, incentives for competition for patients, and compensating differentials for local population characteristics. They also shed light on the attractiveness to GPs in England of locally negotiated (personal medical services) versus nationally negotiated (general medical services) contracts.

Human babesiosis - A case report

Directory of Open Access Journals (Sweden)

Marathe A

2005-01-01

Full Text Available Babesiosis is an emerging, tick-transmitted, zoonotic disease caused by hematotropic parasites of the genus Babesia. Most cases of Babesial infections in humans have been acquired in temperate regions of the United States, Europe, France and England. A few cases of Babesiosis have been described in other parts of the world, including China, Taiwan, Egypt, South Africa, and Mexico.1,2 We report the first case of human Babesiosis, in a normosplenic, previously healthy individual from India.

GPs' perceptions of workload in England: a qualitative interview study.

Science.gov (United States)

Croxson, Caroline Hd; Ashdown, Helen F; Hobbs, Fd Richard

2017-02-01

GPs report the lowest levels of morale among doctors, job satisfaction is low, and the GP workforce is diminishing. Workload is frequently cited as negatively impacting on commitment to a career in general practice, and many GPs report that their workload is unmanageable. To gather an in-depth understanding of GPs' perceptions and attitudes towards workload. All GPs working within NHS England were eligible. Advertisements were circulated via regional GP e-mail lists and national social media networks in June 2015. Of those GPs who responded, a maximum-variation sample was selected until data saturation was reached. Semi-structured, qualitative interviews were conducted. Data were analysed thematically. In total, 171 GPs responded, and 34 were included in this study. GPs described an increase in workload over recent years, with current working days being long and intense, raising concerns over the wellbeing of GPs and patients. Full-time partnership was generally not considered to be possible, and many participants felt workload was unsustainable, particularly given the diminishing workforce. Four major themes emerged to explain increased workload: increased patient needs and expectations; a changing relationship between primary and secondary care; bureaucracy and resources; and the balance of workload within a practice. Continuity of care was perceived as being eroded by changes in contracts and working patterns to deal with workload. This study highlights the urgent need to address perceived lack of investment and clinical capacity in general practice, and suggests that managing patient expectations around what primary care can deliver, and reducing bureaucracy, have become key issues, at least until capacity issues are resolved. © British Journal of General Practice 2017.

Risk factors for hospital admission with RSV bronchiolitis in England: a population-based birth cohort study.

Directory of Open Access Journals (Sweden)

Joanna Murray

Full Text Available To examine the timing and duration of RSV bronchiolitis hospital admission among term and preterm infants in England and to identify risk factors for bronchiolitis admission.A population-based birth cohort with follow-up to age 1 year, using the Hospital Episode Statistics database.71 hospitals across England.We identified 296618 individual birth records from 2007/08 and linked to subsequent hospital admission records during the first year of life.In our cohort there were 7189 hospital admissions with a diagnosis of bronchiolitis, 24.2 admissions per 1000 infants under 1 year (95%CI 23.7-24.8, of which 15% (1050/7189 were born preterm (47.3 bronchiolitis admissions per 1000 preterm infants (95% CI 44.4-50.2. The peak age group for bronchiolitis admissions was infants aged 1 month and the median was age 120 days (IQR = 61-209 days. The median length of stay was 1 day (IQR = 0-3. The relative risk (RR of a bronchiolitis admission was higher among infants with known risk factors for severe RSV infection, including those born preterm (RR = 1.9, 95% CI 1.8-2.0 compared with infants born at term. Other conditions also significantly increased risk of bronchiolitis admission, including Down's syndrome (RR = 2.5, 95% CI 1.7-3.7 and cerebral palsy (RR = 2.4, 95% CI 1.5-4.0.Most (85% of the infants who are admitted to hospital with bronchiolitis in England are born at term, with no known predisposing risk factors for severe RSV infection, although risk of admission is higher in known risk groups. The early age of bronchiolitis admissions has important implications for the potential impact and timing of future active and passive immunisations. More research is needed to explain why babies born with Down's syndrome and cerebral palsy are also at higher risk of hospital admission with RSV bronchiolitis.

Floodplain Condition and Water Framework Directive River Classification in England: Evidence of a Disconnect.

Science.gov (United States)

Bentley, S.

2017-12-01

The European Union Water Framework Directive came into force in October 2000 committing European Union member states to achieve Good Ecological Status for all water bodies. By 2015 29% of rivers across England had achieved this level suggesting that these watercourse units are now functioning well. This study utilises recently published land cover data for England clipped to the floodplain boundary as defined by the 100 year return period discharge to examine the state of valley bottom vegetation and function for these Good Status rivers. Agricultural use of floodplain areas is high with cereal and horticulture covering an average of 24% and pasture accounting for some 37% of the area. Maximum values increase to 77% and 92% respectively. In all cases wetland accounts for less than 2% of the floodplain and rough grassland averages 7%. Such significant and widespread alteration to floodplain vegetation character suggests that the ecological functioning of this component of the fluvial system has been severely negatively impacted calling into question the Water Framework Directive status level. This is a fault of the Water Framework Directive process which only explicitly evaluates the hydromorphological component of the fluvial system for high status rivers preferring to infer functioning from biological indicators that are focused on in-channel assessments. The fundamental omission of floodplain condition in the Water Framework Directive process will result in only partial achievement of the original goals of the Directive with the majority of Europe's floodplains remaining in a highly degraded, non-functional state.

Explaining variation in the uptake of HPV vaccination in England

Directory of Open Access Journals (Sweden)

Whynes David K

2011-03-01

Full Text Available Abstract Background In England, two national programmes of HPV vaccination for girls have been instituted, a routine programme for 12- and 13-year-olds and a catch-up programme for 17- and 18-year-olds. Uptake rates across the country have been far from uniform, and this research sought to identify factors explaining the variation in uptake by locality. Methods An association between uptake, deprivation and ethnic background had been established in pilot research. The present analysis was conducted at an aggregate, Primary Care Trust (PCT, level for the first year of the programmes. Published measures of HPV vaccination uptake, material deprivation, ethnic composition of PCT populations, primary care quality, and uptake of cervical screening and of other childhood immunisations were collated. Strong evidence of collinearity amongst the explanatory variables required a factor analysis to be undertaken. This provided four independent factors, used thereafter in regression models to explain uptake by PCT. Results The factor analysis revealed that ethnic composition was associated with attitudes towards cervical screening and other childhood vaccinations, whilst material deprivation and quality of primary care were orthogonal. Ethnic composition, early childhood vaccination, cervical screening and primary care quality were found to be influential in predicting uptake in both the routine and the catch-up cohorts, although with a lower degree of confidence in the case of the last two independent variables. Lower primary care quality was significant in explaining a greater fall in vaccination uptake between the first two doses in the catch-up cohort. Greater deprivation was a significant explanatory factor for both uptake and the fall in uptake between doses for the catch-up cohort but not for uptake in the routine cohort. Conclusion These results for uptake of the first year of the national programme using aggregate data corroborate findings from

A cross-sectional questionnaire study of the rules governing pupils’ carriage of inhalers for asthma treatment in secondary schools in North East England

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Wendy Funston

2016-05-01

Full Text Available Objectives. The primary objective of this study was to assess the rules governing secondary school pupils’ carriage of inhalers for emergency treatment of asthma in the North East of England. Design. This study was based upon a postal questionnaire survey. Setting. The setting for this study was mainstream free-to-attend secondary schools which admit 16 year old pupils within the 12 Local Authority areas which make up the North East of England. Participants. All 153 schools meeting the inclusion criteria were invited to participate in the study, of which 106 (69% took part. Main Outcome Measures. Our three main outcome measures were: whether pupils are permitted to carry inhalers on their person while at school; whether advance permission is required for pupils to carry inhalers, and from whom; and whether the school has an emergency ‘standby’ salbutamol inhaler for use in asthma emergencies, as permitted since October 2014 under recent amendments to The Human Medicines Regulations 2012. Results. Of 98 schools submitting valid responses to the question, 99% (n = 97 permitted pupils to carry inhalers on their person while at school; the remaining school stored pupils’ inhalers in a central location within the school. A total of 22% of included schools (n = 22 required parental permission before pupils were permitted to carry inhalers. Of 102 schools submitting valid responses to the question, 44% (n = 45 had purchased a ‘standby’ salbutamol inhaler for use in asthma emergencies. Conclusions. Most secondary schools in North East England permit pupils to carry inhalers on their person. The requirement in a minority of schools for parental permission to be given possibly contravenes the standard ethical practices in clinical medicine for children of this age. Only a minority of schools hold a ‘standby’ salbutamol inhaler for use in asthma emergencies. Wider availability may improve outcomes for asthma emergencies occurring in schools.

Comparing Episodes of Mathematics Teaching for Higher Achievers in England and Germany

Science.gov (United States)

Kelly, Peter; Kotthoff, Hans-Georg

2016-01-01

To illustrate similarities and differences in lower secondary level mathematics teaching with higher achievers and thereby explore privileging processes, we contrast a teaching episode in Baden-Württemberg, Germany with one in South West England. These have been selected from a larger study as typical within each region for higher achieving…

Future enhanced clinical role of pharmacists in Emergency Departments in England: multi-site observational evaluation.

Science.gov (United States)

Hughes, Elizabeth; Terry, David; Huynh, Chi; Petridis, Konstantinos; Aiello, Matthew; Mazard, Louis; Ubhi, Hirminder; Terry, Alex; Wilson, Keith; Sinclair, Anthony

2017-08-01

Background There are concerns about maintaining appropriate clinical staffing levels in Emergency Departments. Pharmacists may be one possible solution. Objective To determine if Emergency Department attendees could be clinically managed by pharmacists with or without advanced clinical practice training. Setting Prospective 49 site cross-sectional observational study of patients attending Emergency Departments in England. Method Pharmacist data collectors identified patient attendance at their Emergency Department, recorded anonymized details of 400 cases and categorized each into one of four possible options: cases which could be managed by a community pharmacist; could be managed by a hospital pharmacist independent prescriber; could be managed by a hospital pharmacist independent prescriber with additional clinical training; or medical team only (unsuitable for pharmacists to manage). Impact indices sensitive to both workload and proportion of pharmacist manageable cases were calculated for each clinical group. Main outcome measure Proportion of cases which could be managed by a pharmacist. Results 18,613 cases were observed from 49 sites. 726 (3.9%) of cases were judged suitable for clinical management by community pharmacists, 719 (3.9%) by pharmacist prescribers, 5202 (27.9%) by pharmacist prescribers with further training, and 11,966 (64.3%) for medical team only. Impact Indices of the most frequent clinical groupings were general medicine (13.18) and orthopaedics (9.69). Conclusion The proportion of Emergency Department cases that could potentially be managed by a pharmacist was 36%. Greatest potential for pharmacist management was in general medicine and orthopaedics (usually minor trauma). Findings support the case for extending the clinical role of pharmacists.

Defining geo-habitats for groundwater ecosystem assessments: an example from England and Wales (UK)

Science.gov (United States)

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.

The evolution of policy and actions to tackle obesity in England.

Science.gov (United States)

Jebb, S A; Aveyard, P N; Hawkes, C

2013-11-01

Tackling obesity has been a policy priority in England for more than 20 years. Two formal government strategies on obesity in 2008 and 2011 drew together a range of actions and developed new initiatives to fill perceived gaps. Today, a wide range of policies are in place, including support for breastfeeding and healthy weaning practices, nutritional standards in schools, restrictions on marketing foods high in fat, sugar and salt to children, schemes to boost participation in sport, active travel plans, and weight management services. Data from annual surveys show that the rate of increase in obesity has attenuated in recent years, but has not yet been reversed. This paper considers the actions taken and what is known about the impact of individual policies and the overarching strategy to tackle obesity in England. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

The use of UAVs to monitor archeological sites: the case study of Choirokoitia within the PROTHEGO project

Science.gov (United States)

Themistocleous, K.

2017-09-01

PROTHEGO (PROTection of European Cultural HEritage from GeO-hazards) is a collaborative research project funded in the framework of the Joint Programming Initiative on Cultural Heritage and Global Change (JPICH) - Heritage Plus in 2015-2018 (www.prothego.eu). PROTHEGO aims to make an innovative contribution towards the analysis of geo-hazards in areas of cultural heritage, and uses novel space technology for the management of sites and world heritage monuments located throughout Europe, using specialized remote sensing techniques. Τhe methodology will include the 395 monuments of UNESCO in Europe, with case studies conducted in 4 UNESCO sites in England, Spain, Italy and Cyprus. For the Cyprus case study in Choirokoitia, Unmanned Aerial Vehicles (UAVs) are used to monitor and assess the risk from natural hazards on the archaeological site to evaluate cultural heritage sites deformation. The UAVs were flown over the study area to produce time-series data, including orthoimages, 3D models and digital elevation models of the Choirokoitia site in order to identify changes in the area caused by natural hazards.

An overview of the proposal to create a regional transmission organization for New England

International Nuclear Information System (INIS)

LaPlante, D.

2003-01-01

The history of the regional transmission organization (RTO) in New England was reviewed in this PowerPoint presentation. Application for the RTO structure, based on FERC's Order 2000, was first filed by ISO New England and transmission owners in January 2001. It was rejected due to inadequate scope and independence. A second application, which included a plan for a single Northeast RTO and a merger of the system operators in New England (NE), New York and Pennsylvania, New Jersey and Maryland, was also deemed infeasible. In October 2003, the ISO New England filed for a New England-only RTO. The main benefits of an RTO include greater independence of system operations, improved reliability, enhanced market efficiency, an improved regional planning process and a more stable organizational structure for the New England system operator. This presentation reviewed the extensive stakeholder process, RTO governing documents, and the RTO-NE tariff. The objective of system planning and expansion is to clarify the role of the RTO regarding authority and process and to publish an annual regional system plan by the RTO-NE which identifies reliability and market efficiency needs. The regional system plan considers projected generation, transmission projects and supply and demand issues. Two types of transmission operating agreements were also reviewed. The responsibility of the transmission operator is to physically operate the transmission facilities in accordance with RTO-NE directions; establish ratings and rating procedures for transmission facilities; and, operate, repair and maintain transmission facilities. The allocation of Section 205 Rights was discussed along with coordination efforts with New York and cooperation with Canadian entities. 1 fig

New England Energy Congress: a blueprint for energy action. Executive summary and recommendations. Final report

Energy Technology Data Exchange (ETDEWEB)

Pratt, Robert L.; Mayer, Jean; Buckley, John G.; Connolly, Patrick F.; Spencer, Bailey

1979-05-01

The task of the New England Congress deals with reducing the region's dependence on foreign oil and its cost disadvantage compared to the rest of the country. The work of the Congress is summarized. Recommendations address the demand side of the energy equation and then analysis and recommendations address supply options. Reports from the following committees are included: New England Energy Supply; Alternatives; Economic Development Through Alternative Sources of Energy; New England Energy Demand; Conservation; Demand Transportation; Energy Conservation; Residential Energy Package; Regulatory and Institutional Processes; and Energy Economics and Financing.

The effect of ambient temperature on type-2-diabetes: case-crossover analysis of 4+ million GP consultations across England.

Science.gov (United States)

Hajat, S; Haines, A; Sarran, C; Sharma, A; Bates, C; Fleming, L E

2017-07-12

Given the double jeopardy of global increases in rates of obesity and climate change, it is increasingly important to recognise the dangers posed to diabetic patients during periods of extreme weather. We aimed to characterise the associations between ambient temperature and general medical practitioner consultations made by a cohort of type-2 diabetic patients. Evidence on the effects of temperature variation in the primary care setting is currently limited. Case-crossover analysis of 4,474,943 consultations in England during 2012-2014, linked to localised temperature at place of residence for each patient. Conditional logistic regression was used to assess associations between each temperature-related consultation and control days matched on day-of-week. There was an increased odds of seeking medical consultation associated with high temperatures: Odds ratio (OR) = 1.097 (95% confidence interval = 1.041, 1.156) per 1 °C increase above 22 °C. Odds during low temperatures below 0 °C were also significantly raised: OR = 1.024 (1.019, 1.030). Heat-related consultations were particularly high among diabetics with cardiovascular comorbidities: OR = 1.171 (1.031, 1.331), but there was no heightened risk with renal failure or neuropathy comorbidities. Surprisingly, lower odds of heat-related consultation were associated with the use of diuretics, anticholinergics, antipsychotics or antidepressants compared to non-use, especially among those with cardiovascular comorbidities, although differences were not statistically significant. Type-2 diabetic patients are at increased odds of medical consultation during days of temperature extremes, especially during hot weather. The common assumption that certain medication use heightens the risk of heat illness was not borne-out by our study on diabetics in a primary care setting and such advice may need to be reconsidered in heat protection plans.

Establishing a National Maternal Morbidity Outcome Indicator in England: A Population-Based Study Using Routine Hospital Data.

Directory of Open Access Journals (Sweden)

Manisha Nair

Full Text Available As maternal deaths become rarer, monitoring near-miss or severe maternal morbidity becomes important as a tool to measure changes in care quality. Many calls have been made to use routinely available hospital administration data to monitor the quality of maternity care. We investigated 1 the feasibility of developing an English Maternal Morbidity Outcome Indicator (EMMOI by reproducing an Australian indicator using routinely available hospital data, 2 the impact of modifications to the indicator to address potential data quality issues, 3 the reliability of the indicator.We used data from 6,389,066 women giving birth in England from April 2003 to March 2013 available in the Hospital Episode Statistics (HES database of the Health and Social care Information centre (HSCIC. A composite indicator, EMMOI, was generated from the diagnoses and procedure codes. Rates of individual morbid events included in the EMMOI were compared with the rates in the UK reported by population-based studies.EMMOI included 26 morbid events (17 diagnosis and 9 procedures. Selection of the individual morbid events was guided by the Australian indicator and published literature for conditions associated with maternal morbidity and mortality in the UK, but was mainly driven by the quality of the routine hospital data. Comparing the rates of individual morbid events of the indicator with figures from population-based studies showed that the possibility of false positive and false negative cases cannot be ruled out.While routine English hospital data can be used to generate a composite indicator to monitor trends in maternal morbidity during childbirth, the quality and reliability of this monitoring indicator depends on the quality of the hospital data, which is currently inadequate.

Radon in private water supplies in SW England

International Nuclear Information System (INIS)

Bowring, C.S.; Banks, D.

1995-01-01

It has been known since at least the early 1960s that high levels of radon gas can be found dissolved in some water supplies in South West England and, as a result of this, degassing plant was installed in some mains water supplies at this time in order to remove the radon from the water. More recently the result of a survey of just over 500 drinking water supplies throughout the UK has been published. This concluded that the radon level in UK water supplies in general do not constitute a health hazard. In this note we present results from 22 private water supplies in South West England and conclude that for certain individuals levels of radon in water may well present a radiological hazard which is not negligible and that this problem needs to be investigated more fully. (author)

Retrovirus D/New England and its relation to Mason-Pfizer monkey virus.

OpenAIRE

Desrosiers, R C; Daniel, M D; Butler, C V; Schmidt, D K; Letvin, N L; Hunt, R D; King, N W; Barker, C S; Hunter, E

1985-01-01

Seventeen isolates of retrovirus D/New England have been obtained from three species of macaques at the New England Regional Primate Research Center. Seven of the isolates were obtained from macaques who subsequently died with the macaque immunodeficiency syndrome; other isolates were obtained from macaques with less severe or other forms of illness. Attempts to isolate type D retrovirus from peripheral lymphocytes of 97 apparently healthy macaques have not been successful. Cloned DNA was pre...

Radionuclide levels in food, animals and agricultural products. Post Chernobyl monitoring in England and Wales

International Nuclear Information System (INIS)

1987-01-01

Data are presented in the following lists: 1) General Monitoring results, for England and Wales, presented separately (milk, milk products, dairy, vegetables, fruit, meat, fish, game, herbage, honey). 2) Restricted area sheep monitoring results, England and Wales presented separately. (U.K.)

The Politics of Education Policy in England

Science.gov (United States)

Gunter, Helen M.

2015-01-01

In this appreciative discussion paper I provide an overview of the reforms made to education in England, and engage with the politics of education through examining the simultaneous and inter-related processes of politicisation, depoliticisation and repoliticisation of educational matters. I engage in a discussion of the papers in this special…

Health economic evaluation in England.

Science.gov (United States)

Raftery, James

2014-01-01

The 2010 National Health Service Constitution for England specified rights and responsibilities, including health economic evaluation for the National Institute for Health and Care Excellence (NICE) and the Joint Committee on Vaccinations and Immunisations. The National Screening Committee and the Health Protection Agency also provide advice to the Government based on health economic evaluation. Each agency largely follows the methods specified by NICE. To distinguish the methods from neoclassical economics they have been termed "extra-welfarist". Key differences include measurement and valuation of both benefits (QALYs) and costs (healthcare related). Policy on discounting has also changed over time and by agency. The debate over having NICE's methods align more closely with neoclassical economics has been prominent in the ongoing development of "value based pricing". The political unacceptability of some decisions has led to special funding for technologies not recommended by NICE. These include the 2002 Multiple Sclerosis Risk Sharing Scheme and the 2010 Cancer Drugs Fund as well as special arrangements for technologies linked to the end of life and for innovation. Since 2009 Patient Access Schemes have made price reductions possible which sometimes enables drugs to meet NICE's cost-effectiveness thresholds. As a result, the National Health Service in England has denied few technologies on grounds of cost-effectiveness. Copyright © 2014. Published by Elsevier GmbH.

Lost Opportunities: The Language Skills of Linguistic Minorities in England and Wales.

Science.gov (United States)

Carr-Hill, Roy; Passingham, Steve; Wolf, Alison; Kent, Naomi

A study investigated the English language needs of five minority language communities in England (Bengali, Gujerati, Punjabi Urdu, Punjabi Gurmukhi, Chinese) and four refugee groups (Bosnians, Kurds, Somalis, Tamils). Data were gathered from 997 individuals in the language groups and 176 in the refugee groups using a test of listening, reading,…

Radon baseline monitoring around a potential shale gas development site in Yorkshire, England

International Nuclear Information System (INIS)

Daraktchieva, Z.; Wasikiewicz, J. M.; Howarth, C. B.; Bradley, E.J.

2017-01-01

The Vale of Pickering in Yorkshire, England has been identified as a potential area for shale gas extraction. Public Health England joined a collaboration led by the British Geological Survey for environmental baseline monitoring near the potential shale gas extraction site following a grant award from UK Government Department for Business, Energy and Industrial Strategy. The analysis of results for the first 6 months of indoor monitoring indicated that the results followed a log-normal distribution. The numbers of homes found to be at or above the Action Level followed the numbers predicted by the radon potential maps. The results from the measurements of outdoor air in this study indicated that the radon concentrations are slightly higher than previously measured but close to the detection limit of the technique. (authors)

Autistic Disorder in Nineteenth-Century London. Three Case Reports

Science.gov (United States)

Waltz, Mitzi; Shattock, Paul

2004-01-01

This article examines the existence, description, perception, treatment, and outcome of symptoms consistent with autistic disorder in nineteenth-century London, England, based on case histories from the notes of Dr William Howship Dickinson at Great Ormond Street Hospital for Children. Three cases meeting the DSM-IV criteria for autistic disorder…

New England's travel & tourism markets: trends in the geographic target markets in the 90's

Science.gov (United States)

Rodney B. Warnick

2001-01-01

The purpose of this paper was to examine the travel and lifestyle activity market trends to New England in the 90s. The central theme was to fully examine in detail the primary, secondary and tertiary geographic markets targeted by New England destinations.

Beginnings of the Industrial Revolution in England.

Science.gov (United States)

Scrofani, E. Robert, Ed.

These teacher-developed materials are designed to help educators integrate economic concepts into the teaching of history. The materials include readings on the Industrial Revolution in England and a series of activities that require students to analyze the impact of industrialization first on English peasant farmers, and then on workers in early…

Myxomatosis in farmland rabbit populations in England and Wales.

OpenAIRE

Ross, J.; Tittensor, A. M.; Fox, A. P.; Sanders, M. F.

1989-01-01

The overall pattern and consequences of myxomatosis in wild rabbit populations were studied at three farmland sites in lowland southern England and upland central Wales between 1971 and 1978. When results from all years were combined, the disease showed a clear two-peaked annual cycle, with a main autumn peak between August and January, and a subsidiary spring peak during February to April. Rabbit fleas, the main vectors of myxomatosis in Britain, were present on full-grown rabbits in suffici...

Is cancer survival associated with cancer symptom awareness and barriers to seeking medical help in England? An ecological study.

Science.gov (United States)

Niksic, Maja; Rachet, Bernard; Duffy, Stephen W; Quaresma, Manuela; Møller, Henrik; Forbes, Lindsay Jl

2016-09-27

Campaigns aimed at raising cancer awareness and encouraging early presentation have been implemented in England. However, little is known about whether people with low cancer awareness and increased barriers to seeking medical help have worse cancer survival, and whether there is a geographical variation in cancer awareness and barriers in England. From population-based surveys (n=35 308), using the Cancer Research UK Cancer Awareness Measure, we calculated the age- and sex-standardised symptom awareness and barriers scores for 52 primary care trusts (PCTs). These measures were evaluated in relation to the sex-, age-, and type of cancer-standardised cancer survival index of the corresponding PCT, from the National Cancer Registry, using linear regression. Breast, lung, and bowel cancer survival were analysed separately. Cancer symptom awareness and barriers scores varied greatly between geographical regions in England, with the worst scores observed in socioeconomically deprived parts of East London. Low cancer awareness score was associated with poor cancer survival at PCT level (estimated slope=1.56, 95% CI: 0.56; 2.57). The barriers score was not associated with overall cancer survival, but it was associated with breast cancer survival (estimated slope=-0.66, 95% CI: -1.20; -0.11). Specific barriers, such as embarrassment and difficulties in arranging transport to the doctor's surgery, were associated with worse breast cancer survival. Cancer symptom awareness and cancer survival are associated. Campaigns should focus on improving awareness about cancer symptoms, especially in socioeconomically deprived areas. Efforts should be made to alleviate barriers to seeking medical help in women with symptoms of breast cancer.

Public hospital spending in England: Evidence from National Health Service administrative records

OpenAIRE

Kelly, Elaine; Stoye, George; Vera-Hernández, Marcos

2015-01-01

Health spending per capita in England has more than doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the lifecycle, and the concentration of spending among people and over time. We find that costs per person start to increase after age 50 and escalate after...

An analysis of suicide trends in Scotland 1950-2014: comparison with England & Wales.

Science.gov (United States)

Dougall, Nadine; Stark, Cameron; Agnew, Tim; Henderson, Rob; Maxwell, Margaret; Lambert, Paul

2017-12-20

Scotland has disproportionately high rates of suicide compared with England. An analysis of trends may help reveal whether rates appear driven more by birth cohort, period or age. A 'birth cohort effect' for England & Wales has been previously reported by Gunnell et al. (B J Psych 182:164-70, 2003). This study replicates this analysis for Scotland, makes comparisons between the countries, and provides information on 'vulnerable' cohorts. Suicide and corresponding general population data were obtained from the National Records of Scotland, 1950 to 2014. Age and gender specific mortality rates were estimated. Age, period and cohort patterns were explored graphically by trend analysis. A pattern was found whereby successive male birth cohorts born after 1940 experienced higher suicide rates, in increasingly younger age groups, echoing findings reported for England & Wales. Young men (aged 20-39) were found to have a marked and statistically significant increase in suicide between those in the 1960 and 1965 birth cohorts. The 1965 cohort peaked in suicide rate aged 35-39, and the subsequent 1970 cohort peaked even younger, aged 25-29; it is possible that these 1965 and 1970 cohorts are at greater mass vulnerability to suicide than earlier cohorts. This was reflected in data for England & Wales, but to a lesser extent. Suicide rates associated with male birth cohorts subsequent to 1975 were less severe, and not statistically significantly different from earlier cohorts, suggestive of an amelioration of any possible influential 'cohort' effect. Scottish female suicide rates for all age groups converged and stabilised over time. Women have not been as affected as men, with less variation in patterns by different birth cohorts and with a much less convincing corresponding pattern suggestive of a 'cohort' effect. Trend analysis is useful in identifying 'vulnerable' cohorts, providing opportunities to develop suicide prevention strategies addressing these cohorts as they age.

Understanding Revenge Pornography: A National Survey of Police Officers and Staff in England and Wales.

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Bond, Emma; Tyrrell, Katie

2018-02-01

Online abuse, facilitated via social media and mobile technologies, has recently attracted considerable academic attention. The nonconsensual sharing of intimate images-revenge pornography-can have a devastating effect on victims, is a global problem, and constitutes interpersonal violence. The national helpline in the United Kingdom has now received over 7,000 calls. In the United Kingdom, new legislation making revenge pornography a crime was introduced in 2014, yet the police do not always respond appropriately to victims. This article presents the findings of a national online survey of police understanding of revenge pornography, undertaken in the United Kingdom in March 2017. The study set out to investigate police knowledge of revenge pornography legislation, their confidence in responding to cases of revenge pornography, and what level of training they had received. A total of 783 members of the police force responded to the survey and, to the authors' knowledge, this the first study to seek to quantify the understanding of revenge pornography by police officers and staff in England and Wales. The findings suggest that the police in the United Kingdom have a limited understanding of revenge pornography legislation and lack confidence both in investigating cases and in effectively responding to victims. The implications of the study demonstrate that there is an urgent need for training across police forces to ensure that cases of revenge pornography are appropriately responded to, victims are safeguarded, and offenders brought to justice.

Prison mental health in-reach teams in England: the care programme approach and sexual abuse/violence.

Science.gov (United States)

Brooker, Charles G D; Forrester, Andrew

2017-12-01

Prison mental health in-reach teams have doubled in size over the past decade and case-loads have reduced. Since 2010 it has been mandatory for keyworkers to ask whether prisoners with serious mental illness being treated under the care programme approach have experienced sexual or physical abuse. This is known as routine enquiry and should take place for these prisoners but NHS England, the commissioners, do not audit this activity. It is time to review current interventions and their associated outcomes. © The Royal College of Psychiatrists 2017.

Financing of the National Churches in the Nordic Countries, England and Scotland

DEFF Research Database (Denmark)

Kjems, Sidsel; Bille, Trine

This article analyses the financing of seven national churches in a large comparative study. The national churches in the Nordic countries and in England and Scotland are compared. They have many similarities in terms of history, intertwinement with the state, type and level of religiosity...... of the population, public role and public responsibilities, but the level of financing differs greatly. The purpose of the article is to discuss possible explanations for the differences in the level of financing. Adjusting for cost of public service tasks and for GDP leaves a large difference in financing among...... the seven national churches. We suggest that the source of finance is a determinant factor for the level of finance of national churches. Comparing the sources and level of financing of seven national churches in the Nordic countries, England and Scotland shows that financing by a taxation right yields...

Child Marriage or Forced Marriage? South Asian Communities in North East England

Science.gov (United States)

Gangoli, Geetanjali; McCarry, Melanie; Razak, Amina

2009-01-01

This article addresses the links between child marriage and forced marriage in the UK, drawing from a research study on South Asian communities in North East England. It looks at definitional issues through an analysis of UK and South Asian policies. It also analyses how these concepts are understood by service providers, survivors of child…

Status of exotic grasses and grass-like vegetation and potential impacts on wildlife in New England

Science.gov (United States)

DeStefano, Stephen

2013-01-01

The Northeastern section of the United States, known as New England, has seen vast changes in land cover and human population over the past 3 centuries. Much of the region is forested; grasslands and other open-land cover types are less common, but provide habitat for many species that are currently declining in abundance and distribution. New England also consists of some of the most densely populated and developed states in the country. The origin, distribution, and spread of exotic species are highly correlated with human development. As such, exotics are common throughout much of New England, including several species of graminoids (grasses and grass-like plants such as sedges and rushes). Several of the more invasive grass species can form expansive dense mats that exclude native plants, alter ecosystem structure and functions, and are perceived to provide little-to-no value as wildlife food or cover. Although little research has been conducted on direct impacts of exotic graminoids on wildlife populations in New England, several studies on the common reed (Phragmites australis) in salt marshes have shown this species to have variable effects as cover for birds and other wildlife, depending on the distribution of the plant (e.g., patches and borders of reeds are used more by wildlife than expansive densely growing stands). Direct impacts of other grasses on wildlife populations are largely unknown. However, many of the invasive graminoid species that are present in New England have the capability of outcompeting native plants and thereby potentially affecting associated fauna. Preservation, protection, and restoration of grassland and open-land cover types are complex but necessary challenges in the region to maintain biological and genetic diversity of grassland, wetland, and other open-land obligate species.

Dupuytren's contracture: a retrospective database analysis to assess clinical management and costs in England.

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Gerber, Robert A; Perry, Richard; Thompson, Robin; Bainbridge, Christopher

2011-04-12

Dupuytren's disease is a fibro-proliferative disorder affecting ~3-5% of the UK population. Current surgical treatments for Dupuytren's contracture (DC) include fasciectomy and fasciotomy. We assessed the clinical management of DC in England over a 5-year period; associated NHS costs were assessed for a 1-year period. Hospital Episode Statistics were extracted from April 2003 to March 2008 for patients with Palmar Fascial Fibromatosis (ICD10=M720) and DC-related procedures. Variables included demographics, OPCS, patient status and physician specialty. To estimate 2010-2011 costs, HRG4 codes and the National Schedule of Tariff 2010-11-NHS Trusts were applied to the 2007-2008 period. Over 5 years, 75,157 DC admissions were recorded; 64,506 were analyzed. Mean admissions per year were 12,901 and stable. Day cases increased from 42% (2003-2004) to 62% (2007-2008). The percent of patients having two or more admissions per year increased from 5.5% in 2003-2004 to 26.1% in 2007-2008. Between 2003 and 2007, 91% of procedures were Fasciectomy. Revision of Fasciectomy and Fasciotomy each accounted for ~4%; Amputation for 1%. In 2007, classification was extended to identify Digital Fasciectomy, its Revision and Dermofasciectomy. In 2007-2008, admissions were: 70% Palmar Fasciectomy, 16% Digital Fasciectomy, 1.3% Other Fasciectomy, 4.4% Revision of Palmar Fasciectomy, 1.3% Revision of Digital Fasciectomy, 3.8% Division of Palmar Fascia, 2.6% Dermofasciectomy and 1.1% Amputation. 79% of cases were overseen by trauma and orthopaedic surgeons, 19% by plastic surgeons. Mean (±SD) inpatient hospital length of stay was 1.5 (±1.4) days in 2003-2004 and 1.0 (±1.3) days in 2007-2008. Total estimated costs for 1 year (2010-2011) were £41,576,141. Per-patient costs were £2,885 (day case) and £3,534 (inpatient). Costs ranged from £2,736 (day-case Fasciectomy) to £9,210 (day-case Revision Digital). Between 2003 and 2008, fasciectomy was the most common surgical procedure for DC in

Timing of positive blood samples does not differentiate pathogens causing healthcare-associated from community-acquired bloodstream infections in children in England: a linked retrospective cohort study

OpenAIRE

HENDERSON, K. L.; M?LLER-PEBODY, B.; WADE, A.; SHARLAND, M.; MINAJI, M.; JOHNSON, A. P.; GILBERT, R

2014-01-01

SUMMARY Paediatricians recognize that using the time-dependent community-acquired vs. hospital-acquired bloodstream infection (BSI) dichotomy to guide empirical treatment no longer distinguishes between causative pathogens due to the emergence of healthcare-associated BSIs. However, paediatric epidemiological evidence of the aetiology of BSIs in relation to hospital admission in England is lacking. For 12 common BSI-causing pathogens in England, timing of laboratory reports of positive paedia...

Implementing graduate entry registration for nursing in England: a scope review.

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DeBell, Diane; Branson, Kathy

2009-07-01

A graduate entry workforce for nurse registration has been approved for England by 2010/11. The aim of this research was to discover the immediate tasks facing nurse managers in implementing that change. Previous research has focused on making the case for change rather than on implementation. Similar to the implementation of Project 2000, this change in nurse education and employment will raise questions for employers and for higher education institutions. It will also raise questions about nurse recruitment numbers, workforce development, and the profiles of entrants to a changing workforce. In preparation for these changes, we conducted a scope review of published and grey literature in the English language. We also reviewed the earlier experiences of transfer to graduate status amongst other workforces such as teaching and social work and we investigated reported practice in other industrialised countries. The education provider changes necessary for such a large professional workforce will need considerable leadership skills from within nursing and nurse management. At present, there are too many employers and education providers in England who appear to be relatively unaware of the changes facing nurse education and professional practice and the urgency needed to lead that change. Education, training and development as well as employer/commissioner practice will rely on leadership from within the nurse profession itself. For nurse managers, this requires a rapid planning process in order to ensure smooth implementation. The danger is that either education providers or commissioners of nursing services will react rather than proactively plan for the changes that are already in progress.

Genetic variation in populations of Culicoides variipennis complex in the six New England states, U.S.A.

Science.gov (United States)

Holbrook, F R; Tabachnick, W J; Brady, R

1996-04-01

We investigated the identity and distribution of members of the Culicoides variipennis complex in the six New England states of the U.S.A., a region where bluetongue transmission has not been detected. Analyses of seven polymorphic isozyme-encoding loci showed that only C.v.variipennis, not considered to be a vector of the bluetongue viruses, was present. The populations of C.v.variipennis were significantly more hetero-zygous than C.v.sonorensis and C.v.occidentalis populations from similar studies in the state of California. Estimates of genetic diversity among populations of C.v.variipennis in New England were similar to C.v.sonorensis in the state of Colorado, but were significantly more genetically divergent than California populations of C.v.occidentalis. The impact of these findings on the status of New England as a possible bluetongue-free region for the purpose of international trade in ruminant livestock and their germplasm is discussed.

National Policy and the Development of Inclusive School Practices: A Case Study

Science.gov (United States)

Dyson, Alan; Gallannaugh, Frances

2007-01-01

National education policy in England under New Labour Governments has encompassed both a "standards agenda" and an "inclusion agenda", with schools required to respond to both simultaneously. Some previous studies have seen these agendas as contradictory and have seen schools' efforts to develop inclusive practices as being…

Building on research evidence to change health literacy policy and practice in England

DEFF Research Database (Denmark)

Rowlands, Gillian; Berry, Jonathan; Protheroe, Joanne

2015-01-01

Background: Health literacy is important because of the high proportion of the population with skills below those needed to become and stay healthy, and the resultant negative impact on people’s lives. A recent study in England has shown that, as is true in other industrialized nations, a signifi...

The Politics of PISA: The Media, Policy and Public Responses in Norway and England

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Hopfenbeck, Therese N.; Görgen, Kristine

2017-01-01

Using the PISA 2015 releases in Norway and England, this article explores how PISA has been presented in the media and how the policy level has responded to the results. England will be used as an example for comparison. The article presents early media responses from the 20 most circulated daily newspapers in the two countries and discusses them…

New England's travel and recreation markets: trends in the geographic target markets beyond 2000

Science.gov (United States)

Rodney B. Warnick; David C. Bojanic

2007-01-01

The purpose of this paper was to re-examine and update geographic travel and lifestyle activity market trends for those areas targeted by New England destinations beyond the year 2000. The central theme was to examine in detail the primary, secondary and tertiary geographic markets targeted by New England destinations through both travel behavior and lifestyle behavior...

Controlling behaviours and technology‐facilitated abuse perpetrated by men receiving substance use treatment in England and Brazil: Prevalence and risk factors

Science.gov (United States)

Canfield, Martha; Radcliffe, Polly; D'Oliveira, Ana Flavia Pires Lucas

2017-01-01

Abstract Introduction and Aims Controlling behaviours are highly prevalent forms of non‐physical intimate partner violence (IPV). The prevalence of perpetrating controlling behaviours and technology‐facilitated abuse (TFA) was compared by men receiving substance use treatment in England (n = 223) and Brazil (n = 280). Factors associated with perpetrating these behaviours towards their current/most recent partner and their association with other types of IPV were explored. Design and Methods Secondary analysis from two cross‐sectional studies was performed. Data on socio‐demographic characteristics, infidelity, IPV perpetration and victimisation, adverse childhood experiences (ACE), attitudes towards gender relations and roles, substance use, depressive symptoms and anger expression were collected. Results Sixty‐four percent (143/223) and 33% (73/223) of participants in England and 65% (184/280) and 20% (57/280) in Brazil reported controlling behaviours and TFA, respectively, during their current/most recent relationship. Excluding IPV victimisation from the multivariate models; perpetrating controlling behaviours was associated with a higher number of ACE, higher anger expression (England) and severe physical IPV perpetration (Brazil), and perpetrating TFA was associated with younger age. Including both IPV victimisation and perpetration in the multivariate models; perpetrating controlling behaviour was associated with experiencing a higher number of ACE, higher anger expression (England), emotional IPV victimisation (England) and experiencing controlling behaviour from a partner (England). The perpetration of TFA was associated with younger age and experiencing TFA from a partner. Conclusions Technological progress provides opportunities for perpetrators to control and abuse their partners. Controlling behaviours and TFA should be addressed to reduce IPV perpetration by males in substance use treatment. [Gilchrist G, Canfield M,Radcliffe P, d

The Role of the Chair of the School Governing Body in England

Science.gov (United States)

James, Chris; Jones, Jeff; Connolly, Michael; Brammer, Steve; Fertig, Mike; James, Jane

2012-01-01

The research reported here analysed the role of the chair of the school governing body in England, drawing on a national survey of governors and the study of governing in 30 schools. The role encompassed: being a governor; appointing and working with the head teacher; acting as a change agent; active participation in the school; organising the…

Wind energy planning in England, Wales and Denmark: Factors influencing project success

International Nuclear Information System (INIS)

McLaren Loring, Joyce

2007-01-01

Land-use planning poses a significant barrier to the further development of on-shore wind energy in many countries. There has been increasing discussion regarding the use of public participation in the planning process in order to address concerns of local residents and ease conflicts. This research explores the dynamics of the planning process for wind energy in England, Wales and Denmark in order to better understand the factors influencing project success. Through 18 in-depth case studies, it investigates the degree of local community participation in the planning process and the stability of the network of individuals and organisations involved in the project to determine their relationship to the public's acceptance of the project and the planning outcome. The study draws on the frameworks of public participation in planning and actor-network theories in order to develop indicators of the level of community involvement and network formation for each case. The analysis discusses predictions made by the theoretical approaches as to the importance of these variables to the success of new projects. The results indicate that projects with high levels of participatory planning are more likely to be publicly accepted and successful. In addition, stable supporting networks are more likely to form. The presence of a stable network of supporters is not found to be related to project acceptance and success; however, the absence of a stable network of opponents is found to be necessary for project acceptance and success in receiving planning permission

11 New England Organizations Recognized as Energy Star Partners

Science.gov (United States)

The U.S. Environmental Protection Agency’s New England office, along with the U.S. Department of Energy are honoring 11 ENERGY STAR partners for their outstanding contributions to public health and the environment.

Neuropsychological Performance and Family History in Children at Age 7 who Develop Adult Schizophrenia or Bipolar Psychosis in the New England Family Studies

Science.gov (United States)

Seidman, Larry J.; Cherkerzian, Sara; Goldstein, Jill M.; Agnew-Blais, Jessica; Tsuang, Ming T.; Buka, Stephen L.

2013-01-01

Objective Persons developing schizophrenia (SCZ) manifest various premorbid neuropsychological deficits, studied most often by measures of IQ. Far less is known about premorbid neuropsychological functioning in individuals who later develop bipolar psychoses (BP). We evaluated the specificity and impact of family history (FH) of psychosis on premorbid neuropsychological functioning. Methods We conducted a nested case-control study investigating the associations of neuropsychological data systematically collected at age 7 years for 99 adults with psychotic diagnoses (including 45 SCZ and 35 BP) and 101 controls, drawn from the New England cohort of the Collaborative Perinatal Project. A mixed model approach evaluated Full Scale IQ, four neuropsychological factors derived from principal components analysis, and the profile of 10 intelligence and achievement tests, controlling for maternal education, race, and intrafamilial correlation. We used a deviant responder approach (neuropsychologically impaired. Presence of psychosis in first-degree relatives (FH+) significantly increased the severity of childhood impairment for SCZ but not for BP. Conclusions Premorbid neuropsychological deficits are found in a substantial proportion of children who later develop SCZ, especially in the SCZ FH+ subgroup, but less so in BP, suggesting especially impaired neurodevelopment underlying cognition in pre-SCZ children. Future work should assess genetic and environmental factors that explain this FH effect. PMID:22575089

The engineering assessment for New England's power asset divestiture

International Nuclear Information System (INIS)

Rogers, T.; Sullivan, W.; Feldman, B.

1998-01-01

The structuring of the electric industry is progressing. On October 1, 1996, New England Electric System (NEES) announced that it would divest its generating assets. Since then other utilities in California and New England have also decided to divest all or some of their generating facilities. NEES owns 3,962 MWs of generating assets consisting of two coal/oil fired stations, one combined cycle gas station, fourteen hydro stations and one pumped storage station. Also included in the asset sale is 1,155 MWs of purchased capacity under power purchasing agreements. This paper will describe the activities undertaken by NEES and Stone and Weber in preparing for the asset sale. It will provide insight for others on how these activities help to maximize the value obtained for the generating assets

Impact on smoking of England's 2012 partial tobacco point of sale display ban: a repeated cross-sectional national study.

Science.gov (United States)

Kuipers, Mirte A G; Beard, Emma; Hitchman, Sara C; Brown, Jamie; Stronks, Karien; Kunst, Anton E; McNeill, Ann; West, Robert

2017-03-01

A partial tobacco point of sale (PoS) display ban was introduced in large shops (>280 m 2 floor area) in England on 6 April 2012. The aim of this study was to assess the medium-term effects of the partial tobacco PoS display ban on smoking in England. Data were used from 129 957 respondents participating in monthly, cross-sectional household surveys of representative samples of the English adult population aged 18+ years from January 2009 to February 2015. Interrupted-time series regression models assessed step changes in the level of current smoking and cigarette consumption in smokers and changes in the trends postban compared with preban. Models were adjusted for sociodemographic variables and e-cigarette use, seasonality and autocorrelation. Potential confounding by cigarette price was accounted for by time, as price was almost perfectly correlated with time. Following the display ban, there was no immediate step level change in smoking (-3.69% change, 95% CI -7.94 to 0.75, p=0.102) or in cigarette consumption (β -0.183, 95% CI -0.602 to 0.236). There was a significantly steeper decline in smoking post display ban (-0.46% change, 95% CI -0.72 to -0.20, p=0.001). This effect was demonstrated by respondents in manual occupations (-0.62% change, 95% CI -0.72 to -0.20, p=0.001), but not for those in non-manual occupations (-0.42, 95% CI -0.90 to 0.06, p=0.084). Cigarette consumption declined preban period (β -0.486, 95% CI -0.633 to -0.339, p<0.001), but no significant change in cigarette consumption trend was observed (β 0.019, 95% CI -0.006 to 0.042, p=0.131). The partial tobacco PoS display ban introduced in England in April 2012 did not lead to an immediate decline in smoking, but was followed by a decline in the trend of smoking prevalence that could not be accounted for by seasonal factors, e-cigarette use or price changes. 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/.

Characterization of fHbp, nhba (gna2132), nadA, porA, and sequence type in group B meningococcal case isolates collected in England and Wales during January 2008 and potential coverage of an investigational group B meningococcal vaccine.

Science.gov (United States)

Lucidarme, Jay; Comanducci, Maurizio; Findlow, Jamie; Gray, Stephen J; Kaczmarski, Edward B; Guiver, Malcolm; Vallely, Pamela J; Oster, Philipp; Pizza, Mariagrazia; Bambini, Stefania; Muzzi, Alessandro; Borrow, Ray

2010-06-01

Invasive disease caused by meningococcal capsular groups A, C, W-135, and Y is now preventable by means of glycoconjugate vaccines that target their respective polysaccharide capsules. The capsule of group B meningococci (MenB) is poorly immunogenic and may induce autoimmunity. Vaccines based on the major immunodominant surface porin, PorA, are effective against clonal epidemics but, thus far, have a limited scope of coverage against the wider MenB population at large. In an alternative approach, the first-generation, investigational, recombinant MenB (rMenB) plus outer membrane vesicle (OMV) (rMenB-OMV) vaccine contains a number of relatively conserved surface proteins, fHBP, NHBA (previously GNA2132), and NadA, alongside PorA P1.4-containing OMVs from the New Zealand MeNZB vaccine. MenB currently accounts for approximately 90% of cases of meningococcal disease in England and Wales. To assess potential rMenB-OMV vaccine coverage of pathogenic MenB isolates within this region, all English and Welsh MenB case isolates from January 2008 (n = 87) were genetically characterized with respect to fHBP, NHBA, NadA, and PorA. Alleles for fHbp, nhba, and porA were identified in all of the isolates, of which 22% were also found to harbor nadA alleles. On the basis of genotypic data and predicted immunological cross-reactivity, the potential level of rMenB-OMV vaccine coverage in England and Wales ranges from 66% to 100%.

Investigating the governance of autonomous public hospitals in England: multi-site case study of NHS foundation trusts.

Science.gov (United States)

Allen, Pauline; Keen, Justin; Wright, John; Dempster, Paul; Townsend, Jean; Hutchings, Andrew; Street, Andrew; Verzulli, Rossella

2012-04-01

To investigate the external and internal governance of NHS foundation trusts (FTs), which have increased autonomy, and local members and governors unlike other NHS trusts. In depth, three-year case studies of four FTs; and analysis of national quantitative data on all FT hospitals and NHS Trust hospitals to give national context. Data included 111 interviews with managers, clinicians, governors and members, and local purchasers; observation of meetings; and analysis of FTs' documents. The four case study FTs were similar to other FTs. They had used their increased autonomy to develop more business-like practices. The FT regulator, Monitor, intervened only when there were reported problems in FT performance. National targets applying to the NHS also had a large effect on FT behaviour. FTs saw themselves as part of the local health economy and tried to maintain good relationships with local organisations. Relationships between governors and the FTs' executives were still developing, and not all governors felt able to hold their FT to account. The skills and experience of staff members and governors were under-used in the new governance structures. It is easier to increase autonomy for public hospitals than to increase local accountability. Hospital managers are likely to be interested in making decisions with less central government control, whilst mechanisms for local accountability are notoriously difficult to design and operate. Further consideration of internal governance of FTs is needed. In a deteriorating financial climate, FTs should be better placed to make savings, due to their more business-like practices.

Choosing Wisely Imaging Recommendations: Initial Implementation in New England Emergency Departments

Directory of Open Access Journals (Sweden)

Ali S. Raja

2017-04-01

Full Text Available Introduction: In June 2016, the American College of Emergency Physicians (ACEP Emergency Quality Network began its Reduce Avoidable Imaging Initiative, designed to “reduce testing and imaging with low risk patients through the implementation of Choosing Wisely recommendations.” However, it is unknown whether New England emergency departments (ED have already implemented evidence-based interventions to improve adherence to ACEP Choosing Wisely recommendations related to imaging after their initial release in 2013. Our objective was to determine this, as well as whether provider-specific audit and feedback for imaging had been implemented in these EDs. Methods: This survey study was exempt from institutional review board review. In 2015, we mailed surveys to 195 hospital-affiliated EDs in all six New England states to determine whether they had implemented Choosing Wisely-focused interventions in 2014. Initial mailings included cover letters denoting the endorsement of each state’s ACEP chapter, and we followed up twice with repeat mailings to nonresponders. Data analysis included descriptive statistics and a comparison of state differences using Fisher’s exact test. Results: A total of 169/195 (87% of New England EDs responded, with all individual state response rates >80%. Overall, 101 (60% of responding EDs had implemented an intervention for at least one Choosing Wisely imaging scenario; 57% reported implementing a specific guideline/policy/clinical pathway and 28% reported implementing a computerized decision support system. The most common interventions were for chest computed tomography (CT in patients at low risk of pulmonary embolism (47% of EDs and head CT in patients with minor trauma (45% of EDs. In addition, 40% of EDs had implemented provider-specific audit and feedback, without significant interstate variation (range: 29-55%. Conclusion: One year after release of the ACEP Choosing Wisely recommendations, most New England EDs

Politics, Society and Communication in the Constitution of Modern Society: Early Modern England

Directory of Open Access Journals (Sweden)

Devrim ÖZKAN

2014-12-01

Full Text Available The inception of Modern England comprises a hundred and fifty years between sixteenth and mid eighteenth centuries. The structural qualities of modern societies of this day occur in this era. The political and economic changes and transformations that England experienced in this period of time are in enormous scale. In this period all social structure and institutions experienced structural change in terms of cultural, economic and political processes. In addition to this in this period the framework of the international system regarding economy and politics is established too. Important qualities of current modern societies are the speed of communication and interaction between its elements, its transformational capacity and the extent of its scope. In this, it is possible to apprehend the basic cornerstones of today’s information and communication age by analyzing the early modern period of England

Invasive fish species in the largest lakes of Scotland, Northern Ireland, Wales and England: the collective U.K. experience

OpenAIRE

Winfield, I.J.; Fletcher, J.M.; James, J.B.

2011-01-01

An invasive species is defined as an alien (or introduced or non-native) species whose establishment and spread threaten ecosystems, habitats or species with harm. Such threats to UK lake fish communities have long been appreciated and this review assembles case histories, including new data, from the largest lakes of Scotland, Northern Ireland, Wales and England to examine the hypothesis that at least some of these introductions have become invasive. Loch Lomond in Scotland has experienced s...

77 FR 71585 - Brookfield Energy Marketing LP v. ISO New England Inc.; Notice of Complaint

Science.gov (United States)

2012-12-03

... Energy Marketing LP v. ISO New England Inc.; Notice of Complaint Take notice that on November 21, 2012...), Brookfield Energy Marketing LP (Complainant) filed a formal complaint against ISO New England Inc... notification when a document is added to a subscribed docket(s). For assistance with any FERC Online service...

Evidence for an apartheid-like social structure in early Anglo-Saxon England.

Science.gov (United States)

Thomas, Mark G; Stumpf, Michael P H; Härke, Heinrich

2006-10-22

The role of migration in the Anglo-Saxon transition in England remains controversial. Archaeological and historical evidence is inconclusive, but current estimates of the contribution of migrants to the English population range from less than 10000 to as many as 200000. In contrast, recent studies based on Y-chromosome variation posit a considerably higher contribution to the modern English gene pool (50-100%). Historical evidence suggests that following the Anglo-Saxon transition, people of indigenous ethnicity were at an economic and legal disadvantage compared to those having Anglo-Saxon ethnicity. It is likely that such a disadvantage would lead to differential reproductive success. We examine the effect of differential reproductive success, coupled with limited intermarriage between distinct ethnic groups, on the spread of genetic variants. Computer simulations indicate that a social structure limiting intermarriage between indigenous Britons and an initially small Anglo-Saxon immigrant population provide a plausible explanation of the high degree of Continental male-line ancestry in England.

Excavating past population structures by surname-based sampling: the genetic legacy of the Vikings in northwest England.

Science.gov (United States)

Bowden, Georgina R; Balaresque, Patricia; King, Turi E; Hansen, Ziff; Lee, Andrew C; Pergl-Wilson, Giles; Hurley, Emma; Roberts, Stephen J; Waite, Patrick; Jesch, Judith; Jones, Abigail L; Thomas, Mark G; Harding, Stephen E; Jobling, Mark A

2008-02-01

The genetic structures of past human populations are obscured by recent migrations and expansions and have been observed only indirectly by inference from modern samples. However, the unique link between a heritable cultural marker, the patrilineal surname, and a genetic marker, the Y chromosome, provides a means to target sets of modern individuals that might resemble populations at the time of surname establishment. As a test case, we studied samples from the Wirral Peninsula and West Lancashire, in northwest England. Place-names and archaeology show clear evidence of a past Viking presence, but heavy immigration and population growth since the industrial revolution are likely to have weakened the genetic signal of a 1,000-year-old Scandinavian contribution. Samples ascertained on the basis of 2 generations of residence were compared with independent samples based on known ancestry in the region plus the possession of a surname known from historical records to have been present there in medieval times. The Y-chromosomal haplotypes of these 2 sets of samples are significantly different, and in admixture analyses, the surname-ascertained samples show markedly greater Scandinavian ancestry proportions, supporting the idea that northwest England was once heavily populated by Scandinavian settlers. The method of historical surname-based ascertainment promises to allow investigation of the influence of migration and drift over the last few centuries in changing the population structure of Britain and will have general utility in other regions where surnames are patrilineal and suitable historical records survive.

75 FR 61746 - New England Wire Technologies Corp; Supplemental Notice That Initial Market-Based Rate Filing...

Science.gov (United States)

2010-10-06

...-referenced proceeding of New England Wire Technologies Corp's application for market-based rate authority... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER10-2754-000] New England Wire Technologies Corp; Supplemental Notice That Initial Market-Based Rate Filing Includes Request for...

A management guide for northern hardwoods in New England

Science.gov (United States)

Adrian M. Gilbert; Victor S. Jensen

1958-01-01

Northern hardwood forests occupy about 9 million acres of land in New England. In recent years, these hardwood forests have made increasing contributions to the economy of this region. Their future management should be even more rewarding.

The Black diaspora and health inequalities in the US and England: does where you go and how you get there make a difference?

Science.gov (United States)

Nazroo, James; Jackson, James; Karlsen, Saffron; Torres, Myriam

2007-09-01

The relatively poor health of Black American people in the US and Black Caribbean people in England is a consistent finding in the health inequalities literature. Indeed, there are many similarities between the health, social, economic and demographic profiles of these two groups. However, there is evidence that Caribbean people in the US are faring considerably better. This paper explores differences in the social and economic position of Black American, Black Caribbean and white people in the US and Black Caribbean and white people in England, how these relate to ethnic inequalities in health, and may be underpinned by differences in patterns and contexts of migration. We use similar surveys from the US and England to explore these questions. The US data were drawn from the National Survey of American Life and the English data were drawn from the Health Survey for England and a follow up study. Findings show the advantaged health position of Caribbean American people in comparison with both Caribbean people in England and Black American people. Multivariate analyses indicate that these differences, and the differences in health between Black and white people in the two countries, are a consequence of social and economic inequalities.

The burden of disease and health care use among pertussis cases in school aged children and adults in England and Wales; a patient survey.

Directory of Open Access Journals (Sweden)

Albert Jan van Hoek

Full Text Available In 2011-2012 a large pertussis outbreak occurred in England. This provided an opportunity to estimate the disease burden in those aged 5 years and over. As pertussis is likely to be under reported both laboratory-confirmed and non-confirmed cases were included.Laboratory-confirmed cases of pertussis, as well as their coughing but non-confirmed household members, were sent a questionnaire that collected information on clinical features and quality of life for the most severe day of disease and the day the patient filled in the questionnaire. The EuroQol-5 dimension questionnaire (EQ-5D was used to evaluate quality of life. The duration of symptoms was obtained by contacting the patient every two weeks until symptoms stopped.Data for 535 (out of 1262 laboratory confirmed pertussis patients and 44 (out of 140 coughing household contacts was available for analysis. On the most severe day, 56% of laboratory-confirmed cases reported they had 20+ more paroxysms, 58% reported they had a severe cough and 46% reported disruption of sleep for more than 4 hours. For non-confirmed coughing household contacts there were a similar number of coughing spells per day at the height, though the cough was reported to be less severe and to cause less sleep disruption. The main clinical symptoms on the worst day for both were shortness of breath, tiredness, sore ribs and vomiting. The duration of symptoms for both patient groups was around 160 days (162 and 168 days. Under base case assumptions the overall loss of quality of life was 0.097 QALY (0.089-0.106 for confirmed pertussis cases and 0.0365 QALY (0.023-0.054 for coughing household contacts.Pertussis is a serious disease in those aged 5 years and over, causing disruption of sleep and daily activities over long period of time. The burden of illness due to undiagnosed pertussis is also considerable.

‘The 19th-century construction of the Renaissance’: Katherine Wheeler, Victorian Perceptions of Renaissance Architecture, Farnham England and Burlington, Vermont: Ashgate, 2014

Directory of Open Access Journals (Sweden)

Medina Lasansky

2014-12-01

Full Text Available Katherine Wheeler’s Victorian Perceptions of Renaissance Architecture provides a study of the architecture profession and the history of Renaissance architecture in nineteenth century England. Establishing a canon of Renaissance architectural history was key to the rise of architectural professionalism as well as the education of the architect. As we discover, the study of the Renaissance influenced design in England on all scales while also influencing the design of the architect himself.

The evolutionary New England experience and the role of the independent system operator (ISO)

International Nuclear Information System (INIS)

Sinclair, J.

1998-01-01

The evolution of the New England pool (NEPOOL) that treats the whole of the New England Region as one utility control area, is discussed. NEPOOL was established in 1971 in response to the 1965 blackout. The goal of the NEPOOL is to improve electric power reliability and efficiency. Discussions to restructure the New England market place began in 1994 and again later in 1996 with FERC order 888 which proposed the establishment of an independent system operator (ISO) and with the NEPOOL 888 filing in December of 1996, which defined the role of the ISO, the underlying principles being non-discriminatory governance, system operations, and market administration and transmission service. This speaker described the structure of the nation's first ISO, the principles of its operations regarding open access, single tariff, pricing for efficient resource use, open access same-time information systems, as well as its roles that go beyond the FERC definitions. Characteristic features of the energy market in New England are also described, along with some 50 current new power plant projects under consideration; not unexpectedly, all of them will be powered by natural gas

MERGANSER - A Predictive Model of Mercury in Fish and Loons in New England Lakes

Science.gov (United States)

Moore, R. B.; Shanley, J. B.; Smith, R. A.; Miller, E. K.; Simcox, A.; Kamman, N. C.; Nacci, D. E.; Robinson, K. W.; Johnston, J. M.; Hughes, M.; Johnston, C. M.; Williams, K.; Graham, J.; King, S.

2010-12-01

MERGANSER (MERcury Geo-spatial AssessmeNtS for the New England Region) is an empirical least squares multiple regression model using atmospheric deposition of mercury (Hg) and readily obtainable lake and watershed features to predict fish and common loon Hg in New England lakes. We modeled lakes larger than 8 ha and with drainage area completely within the USA (4404 lakes), using 3827 fish (12 species) and loon Hg values from 420 lakes. MERGANSER predictor variables included Hg deposition, watershed alkalinity, percent wetlands, percent forest canopy, percent agriculture, drainage area, population, mean annual temperature and watershed slope. The model returns fish tissue or loon blood Hg for user-entered species and length. MERGANSER explained 63% of the variance in fish fillet and loon Hg concentrations. MERGANSER predicted that 32-cm small mouth bass had a median Hg concentration of 0.53 µg g-1 and exceeded EPA’s maximum contaminant level (MCL) of 0.3 µg/g Hg in 90% of New England lakes. Common loon had a median Hg concentration of 1.07 µg g-1 and was in the moderate or higher risk category of >1 µg/g Hg in 58% of New England lakes.

Impact of national cancer policies on cancer survival trends and socioeconomic inequalities in England, 1996-2013: population based study

Science.gov (United States)

Rachet, Bernard; Belot, Aurélien; Maringe, Camille; Coleman, Michel P

2018-01-01

Abstract Objective To assess the effectiveness of the NHS Cancer Plan (2000) and subsequent national cancer policy initiatives in improving cancer survival and reducing socioeconomic inequalities in survival in England. Design Population based cohort study. Setting England. Population More than 3.5 million registered patients aged 15-99 with a diagnosis of one of the 24 most common primary, malignant, invasive neoplasms between 1996 and 2013. Main outcome measures Age standardised net survival estimates by cancer, sex, year, and deprivation group. These estimates were modelled using regression model with splines to explore changes in the cancer survival trends and in the socioeconomic inequalities in survival. Results One year net survival improved steadily from 1996 for 26 of 41 sex-cancer combinations studied, and only from 2001 or 2006 for four cancers. Trends in survival accelerated after 2006 for five cancers. The deprivation gap observed for all 41 sex-cancer combinations among patients with a diagnosis in 1996 persisted until 2013. However, the gap slightly decreased for six cancers among men for which one year survival was more than 65% in 1996, and for cervical and uterine cancers, for which survival was more than 75% in 1996. The deprivation gap widened notably for brain tumours in men and for lung cancer in women. Conclusions Little evidence was found of a direct impact of national cancer strategies on one year survival, and no evidence for a reduction in socioeconomic inequalities in cancer survival. These findings emphasise that socioeconomic inequalities in survival remain a major public health problem for a healthcare system founded on equity. PMID:29540358

Does social capital travel? Influences on the life satisfaction of young people living in England and Spain

Directory of Open Access Journals (Sweden)

Morgan Antony R

2012-02-01

Full Text Available Abstract Background This study used a social capital framework to examine the relationship between a set of potential protective ('health assets' factors and the wellbeing of 15 year adolescents living in Spain and England. The overall purpose of the study was to compare the consistency of these relationships between countries and to investigate their respective relative importance. Methods Data were drawn from the 2002, English and Spanish components of the WHO Health Behaviour in School-Aged Children (HBSC survey A total of 3,591 respondents (1884, Spain; 1707, England aged 15, drawn from random samples of students in 215 and 80 schools respectively were included in the study. A series of univariate, bivariate and multivariate (general linear modelling and decision tree analyses were used to establish the relationships. Results Results showed that the wellbeing of Spanish and English adolescents is similar and good. Three measures of social capital and 2 measures of social support were found to be important factors in the general linear model. Namely, family autonomy and control; family and school sense of belonging; and social support at home and school. However, there were differences in how the sub components of social capital manifest themselves in each country--feelings of autonomy of control, were more important in England and social support factors in Spain. Conclusions There is some evidence to suggest that social capital (and its related concept of social support do travel and are applicable to young people living in Spain and England. Given the different constellation of assets found in each country, it is not possible to define exactly the precise formula for applying social capital across cultures. This should more appropriately be defined at the programme planning stage.

Chapter 3: Crossing Boundaries--Foundation Degrees in England

Science.gov (United States)

Longhurst, Derek

2010-01-01

This chapter traces the history, purposes, and distinctive features of the foundation degree, a short-cycle higher education qualification introduced in England in 2000-2001 and offered by both universities and further education colleges. The key characteristics of the foundation degree are discussed: employer involvement in curriculum development…

Briefing book on the energy situation in New England

Energy Technology Data Exchange (ETDEWEB)

Brainard, J P; Munson, J S; Palmedo, P F

1976-10-01

This briefing book is designed to give a concise overview of the facts of the energy situation in New England and of attitudes within the region towards current energy issues. Many of the central problems of U.S. energy policy are manifested in the region in a magnified form. The region entered the period of energy shortages and increasing prices in an economically declining condition. Energy prices were already high in 1970, 30% higher than the rest of the country; the difference increased to 38% by 1974. With essentially no indigenous energy resources, New England is an energy-importing region. For various reasons it is also more dependent on petroleum than other regions of the country and, at the same time, distant from domestic petroleum-producing regions. The result is that over 60% of the fuels it consumes is imported from abroad. Although the future supply of energy to the region is critically dependent on energy-resource policies, policies related for example to coal and oil shale development, the region's concerns cluster around policies and technologies that are perceived to have a more direct impact on its energy welfare. Thus, energy conservation, solar energy, nuclear power, offshore oil development and, in general, the price of energy to the region are paramount issues of concern and debate. Following the Introductory chapter, these issues are discussed in four additional chapters: The Energy Situation in New England; Regional Energy Issues; Energy-Related Institutions; and State Legislation.

Innovation in European Vocational Education and Training: Network Learning in England, Finland and Germany

Science.gov (United States)

Heikkila, Eila

2013-01-01

This article presents a comparative study of innovation in vocational education and training (VET) in three innovative European countries: England, Finland and Germany. The focus is on innovation emerging from VET practitioners' (directors, teachers, project coordinators, etc.) participation in inter-organisational networks with local, regional,…

Dynamics of whlte pine in New England

Science.gov (United States)

William B. Leak; J.B. Cullen; Thomas S. Frieswyk

1995-01-01

Analysis of growth, regeneration, and quality changes for white pine between the 1970's and 1980's in the six-state New England region. Growth rates seemed comparable among ail states except Rhode Island, where the percentage of growth (1.71%) seemed low. Over all states, the proportion of acreage in seedling/sapling white pine stands averaged too low (8%) to...

Should we use a direct regulation to implement the Healthy Prisons Agenda in England? A qualitative study among prison key policy makers.

Science.gov (United States)

Ismail, N; de Viggiani, N

2017-08-31

The Healthy Prisons Agenda seeks to reduce prisoners' health risks, balance prisoners' rights with a security regime, ensure equivalent prison health service provisions to community health services, and facilitate the whole-prison approach. There is an established assumption that legislation will ensure better implementation of health promotion programmes. This study aimed to examine whether a legislative framework, via a direct regulation, could lead to enhanced implementation of the Healthy Prisons Agenda in England. A qualitative study design was conducted using semi-structured interviews with 30 key prison policy makers in England. Our findings contradict the established assumption that legislation improves the implementation of health promotion programmes. A direct regulation was perceived as restrictive, manifesting excessive compliance and encouraging a risk-averse culture, whilst preoccupation with security, order and discipline amongst prison governors and custody staff was deemed an internal institutional barrier to implementing the Healthy Prisons Agenda. External barriers included diminishing resources, lengthier or delayed sentencing, and an unsympathetic public and political stance towards prisoner rehabilitation. A direct regulation should not be used to operationalize the Healthy Prisons Agenda. Rather, self-regulation, along with proactive solutions for the identified barriers to implementing the Agenda, is the most appropriate path forward. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

A wall of information? Exploring the public health component of maternity care in England.

Science.gov (United States)

Sanders, Julia; Hunter, Billie; Warren, Lucie

2016-03-01

midwives have traditionally had an important role in providing public health messages to women. The range and diversity of the public health remit within maternity services has expanded rapidly over the past decade and maternity support workers as well as midwives are now engaged in public health work in many areas. Given these changes a review of current practice was indicated. to identify student midwives׳, midwives׳ and midwifery support workers׳ current knowledge of and involvement in the public health agenda in England. descriptive qualitative study using online discussion forums. England, United Kingdom undergraduate student midwives, midwives and maternity support workers employed by the National Health Service in England and University employed Leads for Midwifery Education. key themes identified were: the scope of the midwives׳ public health role, training and support for public health role, barriers and facilitators, specific client groups, specialist referral services. Student midwives, midwives and maternity support workers view engagement with, and delivery of, public health initiatives as an integral component of their roles, but are on occasions frustrated by constraints of time, training and public engagement. the National Health Service in England aims to engage pregnant women and new mothers in a diverse range of population based and individualised, public health initiatives. Currently, there are high levels of involvement in the public health agenda from the maternity workforce across a wide range of activities. However, midwives and maternity support workers are restricted by barriers of time, training and resources. These barriers will need addressing for optimal maternity care engagement in public health to be realised. policy makers, commissioners and National Health Service providers need to provide clear guidance on the expectations of the public health remit of midwives and maternity support workers and ensure that such expectations

RADON BASELINE MONITORING AROUND A POTENTIAL SHALE GAS DEVELOPMENT SITE IN YORKSHIRE, ENGLAND.

Science.gov (United States)

Daraktchieva, Z; Wasikiewicz, J M; Howarth, C B; Bradley, E J

2017-11-01

The Vale of Pickering in Yorkshire, England has been identified as a potential area for shale gas extraction. Public Health England joined a collaboration led by the British Geological Survey for environmental baseline monitoring near the potential shale gas extraction site following a grant award from UK Government Department for Business, Energy and Industrial Strategy. The analysis of results for the first 6 months of indoor monitoring indicated that the results followed a log-normal distribution. The numbers of homes found to be at or above the Action Level followed the numbers predicted by the radon potential maps. The results from the measurements of outdoor air in this study indicated that the radon concentrations are slightly higher than previously measured but close to the detection limit of the technique. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Teacher Labour Market, Teacher Turnover and Disadvantaged Schools: New Evidence for England

Science.gov (United States)

Allen, Rebecca; Burgess, Simon; Mayo, Jennifer

2018-01-01

We study the market for teachers in England, in particular teacher turnover. We show that there is a positive raw association between the level of school disadvantage and the turnover rate of its teachers. This association diminishes as we control for school, pupil and local teacher labour market characteristics, but is not eliminated. The…

Origins of modern economic system: England or Holland

Directory of Open Access Journals (Sweden)

Rozinskaya Natalia, A.

2015-06-01

Full Text Available This paper, following the approach of the Dutch scholars de Vries and vab der Woude, claims that the Netherlands, rather than England (as it is generally assumed, were the first country, which performed the transition from the traditional society to modern one. Identification of criteria distinguishing traditional and modern societies follows the works of W. Rostow, S. Kuznets and other authors who studied the issue. In order to prove the thesis, author compares urbanization level in Holland and in England, as well as degree of commercialization of those economies, and considers the process of commercial and productive specialization in the United Provinces. Besides that, the formation of modern-type institutional system in Holland is analyzed: the genesis of the markets of factors of production, development of monetary and credit systems and of institutional and technological basis of the industry, strengthening of competitive forces in the economy. Land ownership structure in Holland is considered and its role in genesis of the markets of factors of production. Attention is paid to technological basis of the industry, examined is the impact of immigration. It concludes that the Netherlands were the first country where modern economic growth, as defined by S. Kuznets, started. It was Holland where for the first time the markets of factors of production were formed and, what is particularly important, the industry began to operate on a competitive basis.

CASE STUDY CRITIQUE; UPPER CLINCH CASE STUDY

Science.gov (United States)

Case study critique: Upper Clinch case study (from Research on Methods for Integrating Ecological Economics and Ecological Risk Assessment: A Trade-off Weighted Index Approach to Integrating Economics and Ecological Risk Assessment). This critique answers the questions: 1) does ...

Liberal Conservatism, Vocationalism and Further Education in England

Science.gov (United States)

Fisher, Roy; Simmons, Robin

2012-01-01

Focusing on vocational learning in the English further education (FE) sector and situating it within its social, political and historical context, this paper provides an overview of English attitudes towards the vocational and its subordinate status in relation to "academic" education. It outlines the development of FE in England,…

78 FR 61958 - New England Hydropower Company, LLC; Notice of Preliminary Permit Application Accepted for Filing...

Science.gov (United States)

2013-10-08

... Hydropower Company, LLC; Notice of Preliminary Permit Application Accepted for Filing and Soliciting Comments, Motions To Intervene, and Competing Applications On August 20, 2013, the New England Hydropower Company... river are owned by the city of Meriden. Applicant Contact: Mr. Michael C. Kerr, New England Hydropower...

An investigation into the move towards electronic journals: a case study of NHS libraries in Kent, Surrey and Sussex.

Science.gov (United States)

England, Rebecca

2013-09-01

Electronic journals are so embedded into practice in academic libraries that it is easy to forget that this is not the case everywhere. In NHS libraries, for example, the staff face a particular set of issues. This article is based on Rebecca England's dissertation on this topic, completed as part of the MSc Econ course in Information and Library studies at Aberystwyth University. Rebecca is E-resources Librarian at the Maidstone and Tunbridge Wells NHS Trust. She investigated the momentum towards electronic journals in NHS libraries in the Kent, Surrey and Sussex region and the potential for a regional purchasing consortium. © 2013 The author. Health Information and Libraries Journal © 2013 Health Libraries Group.

Burden, duration and costs of hospital bed closures due to acute gastroenteritis in England per winter, 2010/11-2015/16.

Science.gov (United States)

Sandmann, F G; Jit, M; Robotham, J V; Deeny, S R

2017-09-01

Bed closures due to acute gastroenteritis put hospitals under pressure each winter. In England, the National Health Service (NHS) has monitored the winter situation for all acute trusts since 2010/11. To estimate the burden, duration and costs of hospital bed closures due to acute gastroenteritis in winter. A retrospective analysis of routinely collected time-series data of bed closures due to diarrhoea and vomiting was conducted for the winters 2010/11 to 2015/16. Two key issues were addressed by imputing non-randomly missing values at provider level, and filtering observations to a range of dates recorded in all six winters. The lowest and highest values imputed were taken to represent the best- and worst-case scenarios. Bed-days were costed using NHS reference costs, and potential staff absence costs were based on previous studies. In the best-to-worst case, a median of 88,000-113,000 beds were closed due to gastroenteritis each winter. Of these, 19.6-20.4% were unoccupied. On average, 80% of providers were affected, and had closed beds for a median of 15-21 days each winter. Hospital costs of closed beds were £5.7-£7.5 million, which increased to £6.9-£10.0 million when including staff absence costs due to illness. The median number of hospital beds closed due to acute gastroenteritis per winter was equivalent to all general and acute hospital beds in England being unavailable for a median of 0.88-1.12 days. Costs for hospitals are high but vary with closures each winter. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Towards a poststructural understanding of abortion and social class in England.

Science.gov (United States)

Love, Gillian

2018-06-01

Despite previous research suggesting that social class influences experiences of and attitudes to abortion, there is a dearth of research which studies the intersection of abortion and social class in England. Across the UK, abortion rates and experiences differ by region and socio-economic status, reflecting broader health inequalities. Contemporary austerity in the UK creates an imperative for new research which contextualises the experience of abortion within this socio-historical moment, and the worsening inequalities which have accompanied it. Whilst work on abortion and social inequality exists, it has often approached class as an a priori category. I argue that contemporary post-structural work on class provides a framework to go beyond this approach by examining how these social classifications occur; who has the power to classify; and how these classifications might be resisted. This framework is demonstrated with emerging findings from a life history study of abortion experiences in England. The applications of this to the work on abortion are potentially rich, because the act of ending a pregnancy invites classification from many quarters, from the legal (legal/illegal) to the medical (early/late) to the moral (deserved/undeserved). This work, therefore, speaks to public health concerns about access to and stigma around abortion and social inequalities.

Reconceptualising the Standard of Care in Sport: The Case of Youth Rugby in England and South Africa

Directory of Open Access Journals (Sweden)

Steve Greenfield

2015-12-01

Full Text Available Sport is an important area of civil society in both South Africa and England, and this article is broadly concerned with the relationship between sport and personal injury. More specifically, the article compares how rugby is regulated by the tort of negligence in England and delict in South Africa respectively. Regarding liability, for sport there are very specific factors that need to be taken into account. The article is concerned with, firstly, the broader context of sport as an important social and cultural activity, and secondly the specific sporting context that includes the rules of the game as well as the playing culture, with a focus on rugby at junior level. Through a critical and comparative analysis of how the standards of care in sport have been developed in both jurisdictions, the aim of this article is to consider how sport specific elements can be incorporated into the traditional legal principles. This comparative analysis contextualises the various discussions in the light of the differences between the English tort of negligence and the South African law of delict. Our argument is that the context and specificity of rugby should be more explicitly taken into account when evaluating potential liability. To establish a standard of care for sport is complex, with many factors to be taken into account and balanced against one another. The law of negligence/delict therefore needs to be adaptable and flexible to resolve new situations where injuries have occurred. Even in established situations where liability has been previously determined, novel events do occur and knowledge develops that requires a reconsideration of the principles that govern liability. In junior rugby, the risk of very serious injuries is relatively small and the law needs to tread a cautious path through liability, ensuring it is a vehicle that promotes sport rather than creating barriers to its enjoyment and practice. A greater understanding of sport

76 FR 17626 - New England Fishery Management Council; Public Meeting

Science.gov (United States)

2011-03-30

... affecting New England fisheries in the exclusive economic zone (EEZ). DATES: The meeting will be held on... disadvantages of allowing trading allocations of stocks managed under the US/Canada Resource Sharing...

78 FR 20618 - New England Fishery Management Council; Public Meeting

Science.gov (United States)

2013-04-05

... affecting New England fisheries in the exclusive economic zone (EEZ). DATES: The meeting will be held on... to discuss quota trading, assessment timing, alternative management strategies and the U.S./Canada...

Natural and Anthropogenic Methane Sources, New England, USA, 1990-1994

Data.gov (United States)

National Aeronautics and Space Administration — This data set contains an inventory of natural and anthropogenic methane emissions for all counties in the six New England states of Connecticut, Rhode Island,...

76 FR 39075 - New England Fishery Management Council; Public Meeting

Science.gov (United States)

2011-07-05

... Committee will discuss measures to minimize the adverse effects of fishing on Essential Fish Habitat (EFH... England Fishery Management Council (Council) is scheduling a public meeting of its Habitat/MPA/Ecosystem...

Trends over time in the incidence of congenital anophthalmia, microphthalmia and orbital malformation in England: database study.

Science.gov (United States)

Dharmasena, Aruna; Keenan, Tiarnan; Goldacre, Raph; Hall, Nick; Goldacre, Michael J

2017-06-01

To study trends over time in the incidence of congenital anophthalmia, microphthalmia and orbital malformations in England, along with changes in hospital admission rates for these conditions. Using English National Hospital Episode Statistics (1999-2011), the annual rate of hospital admissions related to anophthalmia, microphthalmia and congenital malformations of orbit/lacrimal apparatus was calculated per 100 000 infants. The records were person-linked, which enabled patients' 'first record' rates to be calculated as proxies for incidence. Similar analyses on pre-1999 datasets were also undertaken for microphthalmia. There was no systematic increase or decrease over time in the incidence of these conditions, but there was some fluctuation from year to year. The incidence of congenital anophthalmia ranged from 2.4 (95% CI 1.3 to 4.0) per 100 000 infants in 1999 to 0.4 (0 to 1.3) in 2011. The annual incidence of congenital microphthalmia was 10.8 (8.2 to 13.5) in 1999 and 10.0 (7.6 to 12.4) in 2011. The annual incidence of congenital orbital/lacrimal malformations was 0.5 (0 to 1.1) in 1999 and 0.7 (0 to 1.4) in 2011. Including multiple admissions per person, admission rates for microphthalmia showed a linear increase over time from 1999. The earlier data for microphthalmia indicated an increase in admission rates, but no change in incidence, from 1971 to 2011. The incidence of these conditions has remained stable in England in recent years. Although the incidence of microphthalmia was stable, hospital admission rates for it increased over time reflecting an increase in multiple admissions per affected person. These data may be useful for planning service provision. 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/.

Comparing teacher roles in Denmark and England

DEFF Research Database (Denmark)

Kelly, Peter; Dorf, Hans; Pratt, Nick

2014-01-01

This article reports the findings of a comparative study of teaching in Denmark and England. Its broader aim is to help develop an approach for comparing pedagogy. Lesson observations and interviews identified the range of goals towards which teachers in each country worked and the actions...... these prompted. These were clustered using the lens of Bernstein’s pedagogic discourse to construct teacher roles, which provided a view of pedagogy. Through this approach we have begun to identify variations in pedagogy across two countries. All teachers in this study adopted a variety of roles. Of significance...... was the ease with which competent English teachers moved between roles. The English teachers observed adopted roles consistent with a wider techno-rationalist discourse. There was a greater subject emphasis by Danish teachers, whose work was set predominantly within a democratic humanist discourse, whilst...

Comparing pedagogy in mathematics in Denmark and England

DEFF Research Database (Denmark)

Dorf, Hans; Kelly, Peter; Hohmann, Ulrike

2013-01-01

This paper reports the findings of a comparative study of pedagogy in lower-secondary school mathematics in Denmark and England. Lesson observations and interviews identified the range of goals towards which teachers in each country worked and the actions these prompted. These were clustered using...... the lens of Bernstein’s pedagogic discourse (1990; 1996) to construct mathematics teacher roles which provided a view of pedagogy. Comparison allowed variations in pedagogy across the two countries to be identified and implications drawn. Of particular interest were the differences in experience of lower...... attaining pupils, and some of the advantages and disadvantages of mathematics pedagogy in each country for this group are indicated....

A phenomenological study of the effects of clinical negligence litigation on midwives in England: the personal perspective.

Science.gov (United States)

Robertson, Judith H; Thomson, Ann M

2014-03-01

to explore how midwives' personal involvement in clinical negligence litigation affects their emotional and psychological well-being. descriptive phenomenological study using semi-structured interviews. in-depth interviews were conducted in participants' homes or at their place of work and focused on participants' experience of litigation. Participants were recruited from various regions of England. 22 National Health Service (NHS) midwives who had been alleged negligent. unfamiliarity with the legal process when writing statements, attending case conferences and being a witness in court provoked significant stress for midwives. This was exacerbated by the prolonged nature of maternity claims. Support ranged from good to inadequate. Participants who no longer worked for the defendant Trust felt unsupported. Stress could manifest as physical and mental ill-health. Some midwives internalised the allegations of negligence believing their whole career had become worthless. Previous knowledge of the legal process ameliorated the experience. Midwives also exhibited anger and resentment when litigation concluded and some took years to heal from the experience. midwives come from a caring and relational paradigm. When interfacing with the adversarial and contentious paradigm of tort law, midwives can abreact and suffer emotional, physical and psychological harm. Support for midwives experiencing litigation must be improved. Understanding the effects of personal involvement in litigation is important in order to improve the quality of support for this group of midwives. It will also aid development of targeted education for undergraduate, post-graduate and in-service midwives. In the longer term it may help policy makers when considering reform of clinical negligence litigation and NHS employers to structure support mechanisms for staff involved. Copyright © 2013 Elsevier Ltd. All rights reserved.

Incidence and mortality of primary liver cancer in England and Wales: changing patterns and ethnic variations.

Science.gov (United States)

Ladep, Nimzing G; Khan, Shahid A; Crossey, Mary Me; Thillainayagam, Andrew V; Taylor-Robinson, Simon D; Toledano, Mireille B

2014-02-14

To explore recent trends, modes of diagnosis, ethnic distribution and the mortality to incidence ratio of primary liver cancer by subtypes in England and Wales. We obtained incidence (1979-2008) and mortality (1968-2008) data for primary liver cancer for England and Wales and calculated age-standardised incidence and mortality rates. Trends in age-standardised mortality (ASMR) and incidence (ASIR) rates and basis of diagnosis of primary liver cancer and subcategories: hepatocellular carcinoma, intrahepatic bile duct and unspecified liver tumours, were analysed over the study period. Changes in guidelines for the diagnosis of primary liver cancer (PLC) may impact changing trends in the rates that may be obtained. We thus explored changes in the mode of diagnosis as reported to cancer registries. Furthermore, we examined the distribution of these tumours by ethnicity. Most of the statistical manipulations of these data was carried out in Microsoft excel® (Seattle, Washington, United Sttaes). Additional epidemiological statistics were done in Epi Info software (Atlanta, GA, United Sttaes). To define patterns of change over time, we evaluated trends in ASMR and ASIR of PLC and intrahepatic bile duct carcinoma (IHBD) using a least squares regression line fitted to the natural logarithm of the mortality and incidence rates. We estimated the patterns of survival over subsequent 5 and 10 years using complement of mortality to incidence ratio (1-MIR). Age-standardised mortality rate of primary liver cancer increased in both sexes: from 2.56 and 1.29/100000 in 1968 to 5.10 and 2.63/100000 in 2008 for men and women respectively. The use of histology for diagnostic confirmation of primary liver cancer increased from 35.7% of registered cases in 1993 to plateau at about 50% during 2005 to 2008. Reliance on cytology as a basis of diagnosis has maintained a downward trend throughout the study period. Although approximately 30% of the PLC registrations had information on

Evidence that soil aluminum enforces site fidelity of southern New England forest trees

Science.gov (United States)

S. W. Bigelow; C. D. Canham

2010-01-01

Tree species composition of hardwood forests of the northeastern United States corresponds with soil chemistry, and differential performance along soil calcium (Ca) gradients has been proposed as a mechanism for enforcing this fidelity of species to site. We conducted studies in a southern New England forest to test if surface-soil Ca is more important than other...

Primary Teacher Education in England: 40 Years On

Science.gov (United States)

Murray, Jean; Passy, Rowena

2014-01-01

This article examines the relationship between pre-service teacher education (ITE) for primary schooling and primary teaching in England between 1974 and 2014, and explores the "fitness of purpose" of the current system of preparing teachers for the classrooms of the twenty-first century. Our historical analysis suggests that, despite 40…

Potential benefits of minimum unit pricing for alcohol versus a ban on below cost selling in England 2014: modelling study.

Science.gov (United States)

Brennan, Alan; Meng, Yang; Holmes, John; Hill-McManus, Daniel; Meier, Petra S

2014-09-30

To evaluate the potential impact of two alcohol control policies under consideration in England: banning below cost selling of alcohol and minimum unit pricing. Modelling study using the Sheffield Alcohol Policy Model version 2.5. England 2014-15. Adults and young people aged 16 or more, including subgroups of moderate, hazardous, and harmful drinkers. Policy to ban below cost selling, which means that the selling price to consumers could not be lower than tax payable on the product, compared with policies of minimum unit pricing at £0.40 (€0.57; $0.75), 45 p, and 50 p per unit (7.9 g/10 mL) of pure alcohol. Changes in mean consumption in terms of units of alcohol, drinkers' expenditure, and reductions in deaths, illnesses, admissions to hospital, and quality adjusted life years. The proportion of the market affected is a key driver of impact, with just 0.7% of all units estimated to be sold below the duty plus value added tax threshold implied by a ban on below cost selling, compared with 23.2% of units for a 45 p minimum unit price. Below cost selling is estimated to reduce harmful drinkers' mean annual consumption by just 0.08%, around 3 units per year, compared with 3.7% or 137 units per year for a 45 p minimum unit price (an approximately 45 times greater effect). The ban on below cost selling has a small effect on population health-saving an estimated 14 deaths and 500 admissions to hospital per annum. In contrast, a 45 p minimum unit price is estimated to save 624 deaths and 23,700 hospital admissions. Most of the harm reductions (for example, 89% of estimated deaths saved per annum) are estimated to occur in the 5.3% of people who are harmful drinkers. The ban on below cost selling, implemented in the England in May 2014, is estimated to have small effects on consumption and health harm. The previously announced policy of a minimum unit price, if set at expected levels between 40 p and 50 p per unit, is estimated to have an approximately 40-50 times

Classification of paraglacial barrier systems: coastal New England, USA.

NARCIS (Netherlands)

FitzGerald, D.M.; van Heteren, S.

1999-01-01

The New England coast harbours a wide variety of barrier forms, which we organize into six barrier-coastline types. The barriers develop in response to the relative importance of several spatially and temporally variable parameters, particularly antecedent topography and geology, sediment abundance

The Incidence of Thyroid Cancer in England and Wales over A Ten-Year Period

Directory of Open Access Journals (Sweden)

Louise Marie Evans

2017-04-01

Full Text Available Introduction The incidence of thyroid cancer has increased worldwide, whether a real or apparent increase is debated. Literature from the USA suggests greater diagnostic scrutiny, environmental and genetic factors may all play a part. This increase will result in a greater number of referrals for surgical assessment. This study examined the trend in incidence of thyroid cancer in England and Wales. Materials and Methods A retrospective study, using the HES database over the period 2000-2010. Data were extracted of all newly diagnosed thyroid cancers in England and Wales and the age at diagnosis. Data were examined for the change in incidence of thyroid cancer diagnosis dependent on the age group of the patient using the linear regression model. Results 45411 patients were identified. In England the incidence of thyroid cancer rose from 5.7/100,000 of the population in 2000 to 9.9/100,000 in 2010 and in Wales it rose from 3.5/100,000 in 2000 to 7.5/100,000. There was a statistical increase (P≤0.02 (t-stat >2 in the diagnosis of thyroid cancers across all age groups with exception of the 0-14 age group (P>0.5.  Conclusion There has been a statistical increase in the incidence of thyroid cancer. This is likely to impact on hospitals and cancer service resources. An increase in surgical demand and the coinciding ageing population highlights the importance of further investigation into the etiology, use of imaging, patient demographics, histology and overall mortality of this patient group.

Redesign and commissioning of sexual health services in England - a qualitative study.

Science.gov (United States)

Walker, I F; Leigh-Hunt, N; Lee, A C K

2016-10-01

Responsibility for the commissioning of sexual and reproductive health (SRH) services transferred from the National Health Service to local authorities in England in 2013. This transfer prompted many local authorities to undertake new procurements of these SRH services. This study was undertaken to capture some of the lessons learnt in order to inform future commissioning and system redesign. A qualitative study was carried out involving semi-structured interviews. Interviews were conducted with 13 local authority sexual health commissioners in Yorkshire and the Humber from 11 interviews. Thematic analysis was used to identify themes from transcripts of the interviews with the 13 participants. Key themes identified were as follows: the challenge and complexity to those new to clinical commissioning; the prerequisites of robust infrastructural inputs to undertake the process, including technical expertise, a dependable project team, with clarity over the timescales and the budget; the requirement for good governance, stakeholder engagement and successful management of relationships with the latter; and the need to focus on the outcomes, aiming for value for money and improved system performance. Several key issues emerged from our study that significantly influenced the outcome of the redesign and commissioning process for sexual health services. An adapted model of the Donabedian evaluation framework was developed to provide a tool to inform future system redesign. Our model helps identify the key determinants for successful redesign in this context which is essential to both mitigate potential risks and maximize the likelihood of successful outcomes. Our model may have wider applications. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Predicted median July stream/river temperature regime in New England

Data.gov (United States)

U.S. Environmental Protection Agency — This shapefile includes the predicted thermal regime for all NHDPlus version 1 stream and river reaches in New England within the model domain based on the spatial...

French Revolution or Industrial Revolution? A Note on the Contrasting Experiences of England and France up to 1800

OpenAIRE

Paul R. Sharp; Jacob L. Weisdorf

2011-01-01

At the end of the eighteenth century, England and France both underwent revolutions: France the French Revolution, England the industrial revolution. This note sheds new light on these contrasting experiences in the histories of England and France by looking at the evolution of real consumer prices in London and Paris in the centuries leading up to 1800. Whilst in London, building workers were facing low and stable consumer prices over the period, leaving plenty of scope for a demand-driven c...

New England Wind Energy Education Project (NEWEEP)

Energy Technology Data Exchange (ETDEWEB)

Grace, Robert C.; Craddock, Kathryn A.; von Allmen, Daniel R.

2012-04-25

Project objective is to develop and disseminate accurate, objective information on critical wind energy issues impacting market acceptance of hundreds of land-based projects and vast off-shore wind developments proposed in the 6-state New England region, thereby accelerating the pace of wind installation from today's 140 MW towards the region's 20% by 2030 goals of 12,500 MW. Methodology: This objective will be accomplished by accumulating, developing, assembling timely, accurate, objective and detailed information representing the 'state of the knowledge' on critical wind energy issues impacting market acceptance, and widely disseminating such information. The target audience includes state agencies and local governments; utilities and grid operators; wind developers; agricultural and environmental groups and other NGOs; research organizations; host communities and the general public, particularly those in communities with planned or operating wind projects. Information will be disseminated through: (a) a series of topic-specific web conference briefings; (b) a one-day NEWEEP conference, back-to-back with a Utility Wind Interest Group one-day regional conference organized for this project; (c) posting briefing and conference materials on the New England Wind Forum (NEWF) web site and featuring the content on NEWF electronic newsletters distributed to an opt-in list of currently over 5000 individuals; (d) through interaction with and participation in Wind Powering America (WPA) state Wind Working Group meetings and WPA's annual All-States Summit, and (e) through the networks of project collaborators. Sustainable Energy Advantage, LLC (lead) and the National Renewable Energy Laboratory will staff the project, directed by an independent Steering Committee composed of a collaborative regional and national network of organizations. Major Participants - the Steering Committee: In addition to the applicants, the initial collaborators committing

Temporal trends in dancing among adults between 1994 and 2012: The Health Survey for England.

Science.gov (United States)

Vassallo, Amy Jo; Hiller, Claire E; Pappas, Evangelos; Stamatakis, Emmanuel

2018-01-01

The benefits of physical activity are established, however, increasing population physical activity levels remains a challenge. Participating in activities that are enjoyable and multidimensional, such as dancing, are associated with better adherence. However, the extent to which the general population participates in dancing and its temporal trends has not been well studied. The aim of this study was to investigate temporal trends and patterns and correlates of dance participation in England from 1994 to 2012 using a series of large nationally representative surveys. We used data from the Health Survey for England 1994, 1997, 1998, 1999, 2003, 2004, 2006, 2008 and 2012 to examine dance temporal trends. Temporal trends data were age-standardized and correlates of dance participation were examined for males and females over each study year. Changes in population prevalence of dance participation were determined using multiple logistical regression with 1997 as the reference year. Of all survey participants (n=98,178) 7.8% (95%CI: 7.63-7.96) reported dance participation. There was a marked steady decrease over time, with the steepest decline from 2003 onwards. The multivariable-adjusted odds ratios for dance participation were 0.51 for males (95%CI 0.408-0.630, p<0.001) and 0.69 for females (95%CI: 0.598-0.973, p<0.001) in 2012 compared to 1997. Dance participation in adults in England has decreased markedly over time. This study suggests that dance is not being adequately utilized as a health enhancing physical activity, and therefore further research and resources should be dedicated to supporting dance in the community. Copyright © 2017 Elsevier Inc. All rights reserved.

Impact of national cancer policies on cancer survival trends and socioeconomic inequalities in England, 1996-2013: population based study.

Science.gov (United States)

Exarchakou, Aimilia; Rachet, Bernard; Belot, Aurélien; Maringe, Camille; Coleman, Michel P

2018-03-14

To assess the effectiveness of the NHS Cancer Plan (2000) and subsequent national cancer policy initiatives in improving cancer survival and reducing socioeconomic inequalities in survival in England. Population based cohort study. England. More than 3.5 million registered patients aged 15-99 with a diagnosis of one of the 24 most common primary, malignant, invasive neoplasms between 1996 and 2013. Age standardised net survival estimates by cancer, sex, year, and deprivation group. These estimates were modelled using regression model with splines to explore changes in the cancer survival trends and in the socioeconomic inequalities in survival. One year net survival improved steadily from 1996 for 26 of 41 sex-cancer combinations studied, and only from 2001 or 2006 for four cancers. Trends in survival accelerated after 2006 for five cancers. The deprivation gap observed for all 41 sex-cancer combinations among patients with a diagnosis in 1996 persisted until 2013. However, the gap slightly decreased for six cancers among men for which one year survival was more than 65% in 1996, and for cervical and uterine cancers, for which survival was more than 75% in 1996. The deprivation gap widened notably for brain tumours in men and for lung cancer in women. Little evidence was found of a direct impact of national cancer strategies on one year survival, and no evidence for a reduction in socioeconomic inequalities in cancer survival. These findings emphasise that socioeconomic inequalities in survival remain a major public health problem for a healthcare system founded on equity. 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.

Implementation of collaborative governance in cross-sector innovation and education networks: evidence from the National Health Service in England.

Science.gov (United States)

Ovseiko, Pavel V; O'Sullivan, Catherine; Powell, Susan C; Davies, Stephen M; Buchan, Alastair M

2014-11-08

Increasingly, health policy-makers and managers all over the world look for alternative forms of organisation and governance in order to add more value and quality to their health systems. In recent years, the central government in England mandated several cross-sector health initiatives based on collaborative governance arrangements. However, there is little empirical evidence that examines local implementation responses to such centrally-mandated collaborations. Data from the national study of Health Innovation and Education Clusters (HIECs) are used to provide comprehensive empirical evidence about the implementation of collaborative governance arrangements in cross-sector health networks in England. The study employed a mixed-methods approach, integrating both quantitative and qualitative data from a national survey of the entire population of HIEC directors (N = 17; response rate = 100%), a group discussion with 7 HIEC directors, and 15 in-depth interviews with HIEC directors and chairs. The study provides a description and analysis of local implementation responses to the central government mandate to establish HIECs. The latter represent cross-sector health networks characterised by a vague mandate with the provision of a small amount of new resources. Our findings indicate that in the case of HIECs such a mandate resulted in the creation of rather fluid and informal partnerships, which over the period of three years made partial-to-full progress on governance activities and, in most cases, did not become self-sustaining without government funding. This study has produced valuable insights into the implementation responses in HIECs and possibly other cross-sector collaborations characterised by a vague mandate with the provision of a small amount of new resources. There is little evidence that local dominant coalitions appropriated the central HIEC mandate to their own ends. On the other hand, there is evidence of interpretation and implementation of the

Chemical Quality Status of Rivers for the Water Framework Directive: A Case Study of Toxic Metals in North West England

Directory of Open Access Journals (Sweden)

Colin Neal

2011-06-01

Full Text Available This paper provides data from two years of monitoring of the chemical quality of rivers and streams in North West England from the clean headwaters to polluted rivers just above the tidal reach and covers 26 sites including the Ribble, Wyre and the tributary rivers of the Calder and Douglas. Across the basins that include areas of rural, urban and industrial typologies, data is presented for three of the priority substances in the Water Framework Directive i.e., nickel (Ni, cadmium (Cd, and lead (Pb. Average concentrations are low and well below the Environmental Quality Standards values for all three of these substances. Cadmium and Pb appear in approximately equal proportions in the dissolved (0.45 µm whilst Ni occurs predominantly in the dissolved form (92%. Regional inputs of these metals arise mostly from diffuse sources as the storm-flow concentrations are generally greater than at base-flow condition. Greater concentrations of Ni are transported at the headwaters and smaller tributary sites under storm flow condition than for the main stream of the Ribble. For Ni, amounts increase as the river proceeds from its headwaters down towards the Ribble and Wyre estuaries, whilst Cd and Pb show consistent values throughout the catchment. There is annual cycling of dissolved concentrations of Cd, Pb and Ni for the clean headwater streams that gives maxima during the latter half of the year when the river flow is greater. For the impacted sites the pattern is less distinct or absent. Our estimates suggest that the Ribble estuary receives 550 t y−1 of dissolved Ni, 16 t y−1 of dissolved Cd and 240 t y−1 of dissolved Pb.

Occupation and bladder cancer in a population-based case-control study in Northern New England.

Science.gov (United States)

Colt, Joanne S; Karagas, Margaret R; Schwenn, Molly; Baris, Dalsu; Johnson, Alison; Stewart, Patricia; Verrill, Castine; Moore, Lee E; Lubin, Jay; Ward, Mary H; Samanic, Claudine; Rothman, Nathaniel; Cantor, Kenneth P; Beane Freeman, Laura E; Schned, Alan; Cherala, Sai; Silverman, Debra T

2011-04-01

We used data from a large, population-based case-control study in Maine, New Hampshire, and Vermont to examine relationships between occupation, industry and bladder cancer risk. Lifetime occupational histories were obtained by personal interview from 1158 patients newly diagnosed with urothelial carcinoma of the bladder in 2001-2004, and from 1402 population controls. Unconditional logistic regression was used to calculate ORs and 95% CIs, adjusted for demographic factors, smoking and employment in other high-risk occupations. Male precision metalworkers and metalworking/plasticworking machine operators had significantly elevated risks and significant trends in risk with duration of employment (precision metalworkers: OR 2.2, 95% CI 1.4 to 3.4, p(trend) = 0.0065; metalworking/plasticworking machine operators: OR 1.6, 95% CI 1.01 to 2.6, p(trend) = 0.047). Other occupations/industries for which risk increased significantly with duration of employment included: for men, textile machine operators, mechanics/repairers, automobile mechanics, plumbers, computer systems analysts, information clerks, and landscape industry workers; for women, service occupations, health services, cleaning and building services, management-related occupations, electronic components manufacturing and transportation equipment manufacturing. Men reporting use of metalworking fluids (MWF) had a significantly elevated bladder cancer risk (OR 1.7, 95% CI 1.1 to 2.5). Our findings support the hypothesis that some component(s) of MWF may be carcinogenic to the bladder. Our results also corroborate many other previously reported associations between bladder cancer risk and various occupations. More detailed analyses using information from the study's job-specific questionnaires may help to identify MWF components that may be carcinogenic, and other bladder carcinogens associated with a variety of occupations.

75 FR 18828 - PSEG Power Connecticut LLC, Complainant v. ISO New England Inc., Respondent; Notice of Complaint

Science.gov (United States)

2010-04-13

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL10-58-000] PSEG Power Connecticut LLC, Complainant v. ISO New England Inc., Respondent; Notice of Complaint April 6, 2010. Take... ISO New England Inc. (Respondent) challenging the justness and reasonableness of the Respondent's...

Enacting corporate governance of healthcare safety and quality: a dramaturgy of hospital boards in England.

Science.gov (United States)

Freeman, Tim; Millar, Ross; Mannion, Russell; Davies, Huw

2016-02-01

The governance of patient safety is a challenging concern for all health systems. Yet, while the role of executive boards receives increased scrutiny, the area remains theoretically and methodologically underdeveloped. Specifically, we lack a detailed understanding of the performative aspects at play: what board members say and do to discharge their accountabilities for patient safety. This article draws on qualitative data from overt non-participant observation of four NHS hospital Foundation Trust boards in England. Applying a dramaturgical framework to explore scripting, setting, staging and performance, we found important differences between case study sites in the performative dimensions of processing and interpretation of infection control data. We detail the practices associated with these differences--the legitimation of current performance, the querying of data classification, and the naming and shaming of executives--to consider their implications. © 2015 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

Prediction of cervical cancer incidence in England, UK, up to 2040, under four scenarios: a modelling study.

Science.gov (United States)

Castanon, Alejandra; Landy, Rebecca; Pesola, Francesca; Windridge, Peter; Sasieni, Peter

2018-01-01

In the next 25 years, the epidemiology of cervical cancer in England, UK, will change: human papillomavirus (HPV) screening will be the primary test for cervical cancer. Additionally, the proportion of women screened regularly is decreasing and women who received the HPV vaccine are due to attend screening for the first time. Therefore, we aimed to estimate how vaccination against HPV, changes to the screening test, and falling screening coverage will affect cervical cancer incidence in England up to 2040. We did a data modelling study that combined results from population modelling of incidence trends, observable data from the individual level with use of a generalised linear model, and microsimulation of unobservable disease states. We estimated age-specific absolute risks of cervical cancer in the absence of screening (derived from individual level data). We used an age period cohort model to estimate birth cohort effects. We multiplied the absolute risks by the age cohort effects to provide absolute risks of cervical cancer for unscreened women in different birth cohorts. We obtained relative risks (RRs) of cervical cancer by screening history (never screened, regularly screened, or lapsed attender) using data from a population-based case-control study for unvaccinated women, and using a microsimulation model for vaccinated women. RRs of primary HPV screening were relative to cytology. We used the proportion of women in each 5-year age group (25-29 years to 75-79 years) and 5-year period (2016-20 to 2036-40) who have a combination of screening and vaccination history, and weighted to estimate the population incidence. The primary outcome was the number of cases and rates per 100 000 women under four scenarios: no changes to current screening coverage or vaccine uptake and HPV primary testing from 2019 (status quo), changing the year in which HPV primary testing is introduced, introduction of the nine-valent vaccine, and changes to cervical screening coverage

Did smokefree legislation in England reduce exposure to secondhand smoke among nonsmoking adults? Cotinine analysis from the Health Survey for England.

Science.gov (United States)

Sims, Michelle; Mindell, Jennifer S; Jarvis, Martin J; Feyerabend, Colin; Wardle, Heather; Gilmore, Anna

2012-03-01

On 1 July 2007, smokefree legislation was implemented in England, which made virtually all enclosed public places and workplaces smokefree. We examined trends in and predictors of secondhand smoke exposure among nonsmoking adults to determine whether exposure changed after the introduction of smokefree legislation and whether these changes varied by socioeconomic status (SES) and by household smoking status. We analyzed salivary cotinine data from the Health Survey for England that were collected in 7 of 11 annual surveys undertaken between 1998 and 2008. We conducted multivariate regression analyses to examine secondhand smoke exposure as measured by the proportion of nonsmokers with undetectable levels of cotinine and by geometric mean cotinine. Secondhand smoke exposure was higher among those exposed at home and among lower-SES groups. Exposure declined markedly from 1998 to 2008 (the proportion of participants with undetectable cotinine was 2.9 times higher in the last 6 months of 2008 compared with the first 6 months of 1998 and geometric mean cotinine declined by 80%). We observed a significant fall in exposure after legislation was introduced--the odds of having undetectable cotinine were 1.5 times higher [95% confidence interval (CI): 1.3, 1.8] and geometric mean cotinine fell by 27% (95% CI: 17%, 36%) after adjusting for the prelegislative trend and potential confounders. Significant reductions were not, however, seen in those living in lower-social class households or homes where smoking occurs inside on most days. We found that the impact of England's smokefree legislation on secondhand smoke exposure was above and beyond the underlying long-term decline in secondhand smoke exposure and demonstrates the positive effect of the legislation. Nevertheless, some population subgroups appear not to have benefitted significantly from the legislation. This finding suggests that these groups should receive more support to reduce their exposure.

Meningococcal vaccination in primary care amongst adolescents in North West England: an ecological study investigating associations with general practice characteristics.

Science.gov (United States)

Blagden, Sarah; Hungerford, Daniel; Limmer, Mark

2018-01-27

In 2015 the meningococcal ACWY (MenACWY) vaccination was introduced amongst adolescents in England following increased incidence and mortality associated with meningococcal group W. MenACWY vaccination uptake data for 17-18 years old and students delivered in primary care were obtained for 20 National Health Service clinical commissioning groups (CCGs) via the ImmForm vaccination system. Data on general practice characteristics, encompassing demographics and patient satisfaction variables, were extracted from the National General Practice Profiles resource. Univariable analysis of the associations between practice characteristics and vaccination was performed, followed by multivariable negative binomial regression. Data were utilized from 587 general practices, accounting for ~8% of all general practices in England. MenACWY vaccination uptake varied from 20.8% to 46.8% across the CCGs evaluated. Upon multivariable regression, vaccination uptake increased with increasing percentage of patients from ethnic minorities, increasing percentage of patients aged 15-24 years, increasing percentage of patients that would recommend their practice and total Quality and Outcomes Framework achievement for the practice. Conversely, vaccination uptake decreased with increasing deprivation. This study has identified several factors independently associated with MenACWY vaccination in primary care. These findings will enable a targeted approach to improve general practice-level vaccination uptake. © The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Salience Effects in the North-West of England

Directory of Open Access Journals (Sweden)

Sandra Jansen

2014-06-01

Full Text Available The question of how we can define salience, what properties it includes and how we can quantify it have been discussed widely over the past thirty years but we still have more questions than answers about this phenomenon, e. g. not only how salience arises, but also how we can define it. However, despite the lack of a clear definition, salience is often taken into account as an explanatory factor in language change. The scientific discourse on salience has in most cases revolved around phonetic features, while hardly any variables on other linguistic levels have been investigated in terms of their salience. Hence, one goal of this paper is to argue for an expanded view of salience in the sociolinguistic context. This article investigates the variation and change of two groups of variables in Carlisle, an urban speech community in the north west of England. I analyse the variable (th and in particular the replacement of /θ/ with [f] which is widely known as th-fronting. The use of three discourse markers is also examined. Both groups of features will then be discussed in the light of sociolinguistic salience.

New England States environmental radiation surveillance programs

International Nuclear Information System (INIS)

Molloy, E.J.

1980-01-01

An overview of the environmental radiation surveillance programs in the New England States from the viewpoint of their organization and administration is provided. Moreover, the specific monitoring and analytical programs conducted at selected sites in each state is detailed with emphasis on sample types, collection frequencies, and analysis. Also, a comparison is made between the programs of all the states in order to determine the reasons for their differences

Abused women's experiences of a primary care identification and referral intervention: a case study analysis.

Science.gov (United States)

Bradbury-Jones, Caroline; Clark, Maria; Taylor, Julie

2017-12-01

The aim of this study was to report the findings of a qualitative case study that investigated abused women's experiences of an identification and referral intervention and to discuss the implications for nurses, specifically those working in primary and community care. Domestic violence and abuse is a significant public health issue globally but it is a hidden problem that is under-reported. In the UK, Identification and Referral to Improve Safety is a primary care-based intervention that has been found to increase referral rates of abused women to support and safety services. This paper reports on the findings of an evaluation study of two sites in England. Qualitative study with a case study design. In line with case study design, the entire evaluation study employed multiple data collection methods. We report on the qualitative interviews with women referred through the programme. The aim was to elicit their experiences of the three aspects of the intervention: identification; referral; safety. Data collection took place March 2016. Ten women took part. Eight had exited the abusive relationship but two remained with the partner who had perpetrated the abuse. Women were overwhelmingly positive about the programme and irrespective of whether they had remained or exited the relationship all reported perceptions of increased safety and improved health. Nurses have an important role to play in identifying domestic violence and abuse and in referral and safety planning. As part of a portfolio of domestic violence and abuse interventions, those that empower women to take control of their safety (such as Identification and Referral to Improve Safety) are important. © 2017 John Wiley & Sons Ltd.

Individual social capital, neighbourhood deprivation, and self-rated health in England.

Science.gov (United States)

Verhaeghe, Pieter-Paul; Tampubolon, Gindo

2012-07-01

Individual social capital is increasingly considered to be an important determinant of an individual's health. This study examines the extent to which individual social capital is associated with self-rated health and the extent to which individual social capital mediates t.he relationship between neighbourhood deprivation and self-rated health in an English sample. Individual social capital was conceptualized and operationalized in both the social cohesion- and network resource tradition, using measures of generalized trust, social participation and social network resources. Network resources were measured with the position generator. Multilevel analyses were applied to wave 2 and 3 of the Taking Part Surveys of England, which consist of face-to-face interviews among the adult population in England (N(i) = 25,366 respondents, N(j) = 12,388 neighbourhoods). The results indicate that generalized trust, participation with friends and relatives and having network members from the salariat class are positively associated with self-rated health. Having network members from the working class is, however, negatively related to self-rated health. Moreover, these social capital elements are partly mediating the negative relationship between neighbourhood deprivation and self-rated health. Copyright © 2012 Elsevier Ltd. All rights reserved.

Downy mildew disease of New England aster (Symphyotrichum novae-angliae) caused by Basidiophora simplex in New York

Science.gov (United States)

The native perennial New England aster (Symphyotrichum novae-angliae; syn.=Aster novae-anglicae) is ubiquitous throughout most of the United States, as they self-seed and are well-adapted to many environments. New England asters are valued for their prominent dense clusters of purple flowers that at...

Ethnicity, Gender, Deprivation and Low Educational Attainment in England: Political Arithmetic, Ideological Stances and the Deficient Society

Science.gov (United States)

Parsons, Carl

2016-01-01

Attainment data on England's school pupils are more extensive in coverage, detail, quantity, accessibility and of higher quality than monitoring statistics routinely available in other European countries. These data facilitate investigation of low attainment in England's schools and its relationship to ethnicity, gender and poverty. This article…

Frustration of contracts, signed in compliance with law of England, as a probable consequence of EU sanctions against Russian companies

Directory of Open Access Journals (Sweden)

Aleksandr V. Padiryakov

2017-03-01

Full Text Available Objective comprehensive analysis of the doctrine of the frustration of contracts signed in compliance with law of England and the practice of its application for the Russian companies. Methods dialectical approach to cognition of social phenomena allowing to analyze them in historical development and functioning in the context of the totality of objective and subjective factors that determined the choice of the following research methods systematicstructural formallegal comparativelegal legal modeling method. Results due to the introduction of the EU sanctions there is the risk of foreign counterpartiesrsquo refusal to execute contracts with Russian companies on the legal basis of frustration of treaties. The essence of the frustration doctrine is that the contract obligations may be terminated if after their signing such events occur which make their fulfillment impossible or unlawful. When signing international agreements under English law the lawyers of Russian companies should include provisions governing the relationships of the parties in case of impossibility of the contract execution due to the occurrence of an event that caused the treaty frustration in particular the imposition of sanctions. It is recommended to specify in the contract how the losses arising from the inability to execute the contract will be distributed between the parties. Scientific novelty for the first time basing on court practice review the definition of the frustration of contracts according to the law of England is formulated the legal implications of the recognition of the contract frustrated are discussed and the legal conditions are proposed that should be provided for in the text of a contract to avoid the problem of uncertainty in the allocation of losses of the parties in case of occurrence of external events including sanctions. Practical significance the main provisions and conclusions of the article can be used in scientific and lawenforcement activity

Exploring ethnic inequalities in health: Evidence from the Health Survey for England, 1998-2011

OpenAIRE

Darlington, F; Norman, P; Ballas, D; Exeter, DJ

2015-01-01

Issues of social justice and social and spatial inequalities in health have long been researched, yet there is a relative paucity of research on ethnic inequalities in health. Given the increasing ethnic diversity of England's population and the persistence of unjust differences in health this research is timely. We used annual data from the Health Survey for England between 1998 and 2011, combined into a time-series dataset, to examine the influence of socioeconomic and spatial factors on et...

Accountability and the pressures to exclude: A cautionary tale from England.

Directory of Open Access Journals (Sweden)

E. Rustique-Forrester

2005-04-01

Full Text Available Recent studies have produced conflicting findings about whether test-based rewards and sanctions create incentives that improve student performance, or hurdles that increase dropout and pushout rates from schools. This article reports the findings from a study that examined the impact of England's accountability reforms and investigated whether the confluent pressures associated with increased testing, school ranking systems, and other sanctions contributed to higher levels of student exclusion (expulsion and suspension. The study found that England's high-stakes approach to accountability, combined with the dynamics of school choice and other curriculum and testing pressures led to a narrowing of the curriculum, the marginalization of low-performing students, and a climate perceived by teachers to be less tolerant of students with academic and behavioral difficulties. A comparison of higher- and lower-excluding schools, however, found that these effects were more pronounced in the higher-excluding schools, which lacked strong systems and internal structures for supporting staff communication, teacher collaboration, and students' individual needs. The study offers an international perspective on recent trends toward greater accountability in education, pointing to a complex inter-relationship between the pressures of national policies and the unintended consequences on schools' organizational and teachers' instructional capacities. The study's findings raise particular implications for the United States and show that in the design of accountability systems, attention must be paid to how the pressures from accountability will affect the capacity of schools and teachers to respond to students who are low-performing and struggling academically.

New England Wind Forum: A Wind Powering America Project, Newsletter #5 -- January 2010, Wind and Hydropower Technologies Program (WHTP)

Energy Technology Data Exchange (ETDEWEB)

Grace, R. C.; Gifford, J.

2010-01-01

Wind Powering America program launched the New England Wind Forum (NEWF) in 2005 to provide a single comprehensive source of up-to-date, Web-based information on a broad array of wind energy issues pertaining to New England. The NEWF newsletter provides New England stakeholders with updates on wind energy development in the region. In addition to regional updates, Issue #5 offers an interview with Angus King, former governor of Maine and co-founder of Independence Wind.

Public health professionals' perceptions toward provision of health protection in England: a survey of expectations of Primary Care Trusts and Health Protection Units in the delivery of health protection

Directory of Open Access Journals (Sweden)

Horsley Stephen S

2006-12-01

Full Text Available Abstract Background Effective health protection requires systematised responses with clear accountabilities. In England, Primary Care Trusts and the Health Protection Agency both have statutory responsibilities for health protection. A Memorandum of Understanding identifies responsibilities of both parties, but there is a potential lack of clarity about responsibility for specific health protection functions. We aimed to investigate professionals' perceptions of responsibility for different health protection functions, to inform future guidance for, and organisation of, health protection in England. Methods We sent a postal questionnaire to all health protection professionals in England from the following groups: (a Directors of Public Health in Primary Care Trusts; (b Directors of Health Protection Units within the Health Protection Agency; (c Directors of Public Health in Strategic Health Authorities and; (d Regional Directors of the Health Protection Agency Results The response rate exceeded 70%. Variations in perceptions of who should be, and who is, delivering health protection functions were observed within, and between, the professional groups (a-(d. Concordance in views of which organisation should, and which does deliver was high (≥90% for 6 of 18 health protection functions, but much lower (≤80% for 6 other functions, including managing the implications of a case of meningitis out of hours, of landfill environmental contamination, vaccination in response to mumps outbreaks, nursing home infection control, monitoring sexually transmitted infections and immunisation training for primary care staff. The proportion of respondents reporting that they felt confident most or all of the time in the safe delivery of a health protection function was strongly correlated with the concordance (r = 0.65, P = 0.0038. Conclusion Whilst we studied professionals' perceptions, rather than actual responses to incidents, our study suggests that there

Incentives and control in primary health care: findings from English pay-for-performance case studies.

Science.gov (United States)

McDonald, Ruth; Harrison, Stephen; Checkland, Kath

2008-01-01

The authors' aim was to investigate mechanisms and perceptions of control following the implementation of a new "pay-for-performance" contract (the new General Medical Services, or GMS, contract) in general practice. This article was based on an in-depth qualitative case study approach in two general practices in England. A distinction is emerging amongst ostensibly equal partners between those general practitioners conducting and those subject to surveillance. Attitudes towards the contract were largely positive, although discontent was higher in the practice which employed a more intensive surveillance regime and greater amongst nurses than doctors. The sample was small and opportunistic. Further research is required to examine the longer-term effects as new contractual arrangements evolve. Increased surveillance and feedback mechanisms associated with new pay-for-performance schemes have the potential to constrain and shape clinical practice. The paper highlights the emergence of new tensions within and between existing professional groupings.

"Health for All" in England and Brazil?

Science.gov (United States)

Duncan, Peter; Bertolozzi, Maria Rita; Cowley, Sarah; Egry, Emiko Yoshikawa; Chiesa, Anna Maria; de Siqueira França, Francisco Oscar

2015-01-01

This article discusses the achievements and challenges that England and Brazil face in relation to their capacity to address inequalities in health through health promotion and public health policies. Using secondary data (policy texts and related documents), this article contextualizes, explains, and critically appraises health promotion and public health efforts for the reduction of inequalities in health in the 2 countries. A historic documentary analysis was undertaken, with hermeneutics as the methodological framework. The global economic crisis has prompted the so-called developed economies of Europe to reconsider their economic and social priorities. England represents a state facing this kind of challenge. Equally, Brazil is assuming new positions not only on the world stage but also in terms of the relationship it has with its citizens and the priorities it has for state welfare. The United Kingdom continues to finance a health care system allowing universal access in the form of the National Health Service, and state concern about the public health task of reducing inequalities has recently been underlined in policy. For Brazil, although there have been recent achievements related to population access to healthcare, challenges continue, especially with regard to the quality of care. © SAGE Publications 2015.

Anthropocene Survival of Southern New England's Salt ...

Science.gov (United States)

In southern New England, salt marshes are exceptionally vulnerable to the impacts of accelerated sea level rise. Regional rates of sea level rise have been as much as 50 % greater than the global average over past decades, a more than fourfold increase over late Holocene background values. In addition, coastal development blocks many potential marsh migration routes, and compensatory mechanisms relying on positive feedbacks between inundation and sediment deposition are insufficient to counter inundation increases in extreme low-turbidity tidal waters. Accordingly, multiple lines of evidence suggest that marsh submergence is occurring in southern New England. A combination of monitoring data, field re-surveys, radiometric dating, and analysis of peat composition have established that, beginning in the early and mid-twentieth century, the dominant low-marsh plant, Spartina alterniflora, has encroached upward in tidal marshes, and typical high-marsh plants, including Juncus gerardii and Spartina patens, have declined, providing strong evidence that vegetation changes are being driven, at least in part, by higher water levels. Additionally, aerial and satellite imagery show shoreline retreat, widening and headward extension of channels, and new and expanded interior depressions. Papers in this special section highlight changes in marsh-building processes, patterns of vegetation loss, and shifts in species composition. The final papers turn to strategies for minimiz

New England observed and predicted median July stream/river temperature points

Data.gov (United States)

U.S. Environmental Protection Agency — The shapefile contains points with associated observed and predicted median July stream/river temperatures in New England based on a spatial statistical network...

New England observed and predicted median August stream/river temperature points

Data.gov (United States)

U.S. Environmental Protection Agency — The shapefile contains points with associated observed and predicted median August stream/river temperatures in New England based on a spatial statistical network...

From what we know to what we do: lessons learned from the translational CLAHRC initiative in England.

Science.gov (United States)

Currie, Graeme; Lockett, Andy; El Enany, Nellie

2013-10-01

There exists a translation gap between academic research and clinical practice in health care systems. One policy-driven initiative to address the translation gap in England are the Collaborations for Leadership in Applied Health Research and Care (CLAHRCs), funded by the National Institute of Health Research (NIHR). These aim to bring together NHS organizations and universities to accelerate the translation of evidence-based innovation into clinical practice. Our aim was to draw out lessons for policy-makers regarding the mobilization of such initiatives. Qualitative semi-structured interviews with 174 participants across nine CLAHRCs plus in-depth case studies across four CLAHRCs. Those interviewed were staff who were central to the CLAHRCs including senior managers and directors, junior and senior academics, and health care practitioners. Social positions of the CLAHRC leaders, conceived as institutional entrepreneurs, together with the antecedent conditions for CLAHRC bids, had an impact on the vision for a CLAHRC. The process of envisioning encompassed diagnostic and prognostic framing. Within the envisioning process, the utilization of existing activities and established relationships in the CLAHRC bid influenced early mobilization. However, in some cases, it led to a translational 'lock in' towards established models regarding applied research. The CLAHRC experiment in England holds important lessons for policy-makers regarding how to address the translation gap. First, policy makers need to consider whether they set out a defined template for translational initiatives or whether variation is encouraged. We might expect a degree of learning from pilot activities within a CLAHRC that allows for greater clarity in the design of subsequent translational initiatives. Second, policy makers and practitioners need to understand the importance of both antecedent conditions and the social position of senior members of a CLAHRC (institutional entrepreneurs) leading

Seasonal Changes in Central England Temperatures

DEFF Research Database (Denmark)

Proietti, Tommaso; Hillebrand, Eric

The aim of this paper is to assess how climate change is reflected in the variation of the seasonal patterns of the monthly Central England Temperature time series between 1772 and 2013. In particular, we model changes in the amplitude and phase of the seasonal cycle. Starting from the seminal work...... by Thomson (“The Seasons, Global Temperature and Precession”, Science, 7 April 1995, vol 268, p. 59–68), a number of studies have documented a shift in the phase of the annual cycle implying an earlier onset of the spring season at various European locations. A significant reduction in the amplitude...... and stochastic trends, as well as seasonally varying autocorrelation and residual variances. The model can be summarized as containing a permanent and a transitory component, where global warming is captured in the permanent component, on which the seasons load differentially. The phase of the seasonal cycle...

Options for the management of Chernobyl-restricted areas in England and Wales

International Nuclear Information System (INIS)

Nisbet, Anne; Woodman, Rona

2000-01-01

Areas in England and Wales are still subject to restrictions on the movement, sale and slaughter of sheep because activity concentrations of 137 Cs in sheepmeat may exceed the 1000 Bq kg -1 limit imposed after the Chernobyl nuclear power plant accident. The operation of various monitoring programmes has enabled lamb production to be sustained in restricted areas. Under present circumstances, it is predicted that some restrictions will remain until at least 2003. This paper describes an assessment of the practicability and cost-effectiveness of five alternative management options: utilisation of existing improved land for the purposes of clean feeding; improvement of unimproved upland grazing for the purposes of clean feeding; provision of housing and clean feed; administration of boli containing ammonium ferric hexacyanoferrate; and monitoring at the market place. The practicability of each option, which encompasses technical feasibility, capacity, cost, impact and acceptability, was assessed through a series of case studies carried out on farms in the restricted area of north Wales, and through consultation with a range of organisations with interests in farming and/or the environment. Recommendations are made for the future management of the restricted areas

Ocean and Coastal Acidification off New England and Nova Scotia

Science.gov (United States)

New England coastal and adjacent Nova Scotia shelf waters have a reduced buffering capacity because of significant freshwater input, making the region’s waters potentially more vulnerable to coastal acidification. Nutrient loading and heavy precipitation events further acid...

Mobile phone use by drivers : 2009 - survey results for England

Science.gov (United States)

2009-01-01

Premise/hypothesis : The Department for Transport has commissioned surveys to monitor the levels of mobile phone use by drivers across England since 2002. Methods : Two or three-person teams conducted observational surveys of mobile phone use on repr...

Postgraduate Clinical Training at the New England School of Optometry.

Science.gov (United States)

Hoffman, Douglas J.

1989-01-01

The New England College of Optometry's two separate but integrated clinical postgraduate programs, one providing Veterans' Administration residencies and the other, college-based fellowships, are described. The shared curriculum components, exchange process, and evaluation system are highlighted. (MSE)

Whistleblowing in the pharmaceutical industry in the United States, England, Canada, and Australia.

Science.gov (United States)

Boumil, Sylvester James; Nariani, Ashiyana; Boumil, Marcia M; Berman, Harris A

2010-04-01

Fraud and abuse in the spending of public monies plague governments around the world. In the United States the False Claims Act encourages whistleblowing by private individuals to expose evidence of fraud. They are rewarded for their efforts with monetary compensation and protection from retaliation. Such is not the case in Canada, England, and Australia. Although some recent legislation has increased the protections afforded to whistleblowers, they are still likely to be viewed more as disloyal employees than courageous public servants, and there is little incentive to risk their jobs and reputation. Qui tam laws provide a police force of thousands in the effort to reduce rampant fraud, waste, and abuse, and would be an asset in any health-care system where pubic health policy requires conservation of resources.

A Comparison of Substance Abuse and Mental Illness in Male Offenders in Jamaica and England and Wales

Directory of Open Access Journals (Sweden)

CA Sewell

2015-03-01

Full Text Available Background: The present study sought to determine the prevalence of substance abuse, mental illness, sociodemographics and clinical characteristics of mentally ill offenders. These data were compared to data from the prison population in the United Kingdom. Method: This is a cross-sectional study of male, mentally ill offenders in two prisons in Jamaica, and four prisons in England and Wales. For the Jamaican sample, a psychopathology and forensic survey instrument was developed by the research personnel to extract specific information from the diagnostic interview. Data extraction was done over a one-year period. For the England and Wales sample, the participants were interviewed and assessed using various structured instruments. Results: The results indicate that approximately 18% of persons within the Jamaican prison population under study had a mental illness. Of this number, 57% of these persons had been previously diagnosed with a Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM IV-TR Axis 1 disorder. Substance abuse was the most frequently diagnosed DSM-IV Axis I disorder within both populations. The prevalence of mental illness found in the Jamaican prison population was approximately four times greater than the rate in the comparison population of England and Wales. Conclusions: There was an over-representation of mentally ill offenders in the Jamaican prison population. This is most likely linked to the lack of appropriate diversion programmes and a forensic mental hospital in Jamaica.

75 FR 26747 - U.S. Gas & Electric, Inc., Energy Services Providers, Inc., ESPI New England, Inc; Supplemental...

Science.gov (United States)

2010-05-12

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Docket Nos. ER10-1129-000; ER10-1130-000; ER10-1131-000] U.S. Gas & Electric, Inc., Energy Services Providers, Inc., ESPI New England, Inc... & Electric, Inc., Energy Services Providers, Inc., and ESPI New England, Inc.'s application for market-based...

Backward- and forward-looking responsibility for obesity: policies from WHO, the EU and England.

Science.gov (United States)

Vallgårda, Signild; Nielsen, Morten Ebbe Juul; Hartlev, Mette; Sandøe, Peter

2015-10-01

In assigning responsibility for obesity prevention a distinction may be drawn between who is responsible for the rise in obesity prevalence ('backward-looking responsibility'), and who is responsible for reducing it ('forward-looking responsibility'). We study how the two aspects of responsibility figure in the obesity policies of WHO (European Region), the EU and the Department of Health (England). Responsibility for the emergence and reduction of obesity is assigned to both individuals and other actors to different degrees in the policies, combining an individual and a systemic view. The policies assign backward-looking responsibility to individuals, the social environment, the authorities and businesses. When it comes to forward-looking responsibility, individuals are expected to play a central role in reducing and preventing obesity, but other actors are also urged to act. WHO assigns to individuals the lowest degree of backward- and forward-looking responsibility, and the Department of Health (England) assigns them the highest degree of responsibility. Differences in the assignment of backward- and above all forward-looking responsibility could be explained to some extent by the different roles of the three authorities making the plans. WHO is a UN agency with health as its goal, the EU is a liberal economic union with optimization of the internal European market as an important task, and England, as an independent sovereign country, has its own economic responsibilities. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Implementing nurse prescribing: a case study in diabetes.

Science.gov (United States)

Stenner, Karen; Carey, Nicola; Courtenay, Molly

2010-03-01

This paper is a report of a study exploring the views of nurses and team members on the implementation of nurse prescribing in diabetes services. Nurse prescribing is adopted as a means of improving service efficiency, particularly where demand outstretches resources. Although factors that support nurse prescribing have been identified, it is not known how these function within specific contexts. This is important as its uptake and use varies according to mode of prescribing and area of practice. A case study was undertaken in nine practice settings across England where nurses prescribed medicines for patients with diabetes. Thematic analysis was conducted on qualitative data from 31 semi-structured interviews undertaken between 2007 and 2008. Participants were qualified nurse prescribers, administrative staff, physicians and non-nurse prescribers. Nurses prescribed more often following the expansion of nurse independent prescribing rights in 2006. Initial implementation problems had been resolved and few current problems were reported. As nurses' roles were well-established, no major alterations to service provision were required to implement nurse prescribing. Access to formal and informal resources for support and training were available. Participants were accepting and supportive of this initiative to improve the efficiency of diabetes services. The main factors that promoted implementation of nurse prescribing in this setting were the ability to prescribe independently, acceptance of the prescribing role, good working relationships between doctors and nurses, and sound organizational and interpersonal support. The history of established nursing roles in diabetes care, and increasing service demand, meant that these diabetes services were primed to assimilate nurse prescribing.

Genealogy of Self-Expression: A Reappraisal of the History of Art Education in England and Japan

Science.gov (United States)

Komatsu, Kayoko

2017-01-01

In both England and Japan, art education was viewed as having nothing to do with self-expression, but was considered to be an efficient means for industrial development. In England, it was designed to train the eyes and hands of artisans. The art critic Ruskin has often been referred to in the context of the transition to self-expression in the…

A comparison of the causes, effects and aftermaths of the coastal flooding of England in 1953 and France in 2010

Directory of Open Access Journals (Sweden)

D. M. Lumbroso

2011-08-01

Full Text Available This paper provides a comparison of the causes, effects and aftermaths of the coastal flooding that occurred on the east coast of England in 1953 and the west coast of France in 2010 that resulted in 307 and 47 deaths respectively. The causes of both events are strikingly similar. Both were caused by a combination of high tides, low atmospheric pressure, high winds and the failure of poorly maintained flood defences. In both cases the number of deaths was related to the vulnerability of the buildings and people. Buildings in the flood zones were often single storey bungalows and the people who died were mostly over 60 yr of age. Both tragedies were national disasters. The 1953 flood in England acted as a catalyst for an acceleration in flood risk management policy and practice. It resulted in: the development of a Storm Tide Warning System for the east coast of England; the setting of new design standards for coastal flood defences; increased investment in improving coastal defences; and a substantial new research effort into coastal processes, protection and forecasting. In France there has also been an episodic shift in flood risk management policy with the focus falling on: control of urban developments in areas at risk of flooding; improved coastal forecasting and warning; strengthening of flood defences; and developing a "culture of risk awareness". This paper outlines the lessons that can be learnt from the two events and provides recommendations concerning how future loss of life as a result of coastal flooding can be reduced.

Understanding general practice: a conceptual framework developed from case studies in the UK NHS.

Science.gov (United States)

Checkland, Kath

2007-01-01

General practice in the UK is undergoing a period of rapid and profound change. Traditionally, research into the effects of change on general practice has tended to regard GPs as individuals or as members of a professional group. To understand the impact of change, general practices should also be considered as organisations. To use the organisational studies literature to build a conceptual framework of general practice organisations, and to test and develop this empirically using case studies of change in practice. This study used the implementation of National Service Frameworks (NSFs) and the new General Medical Services (GMS) contract as incidents of change. In-depth, qualitative case studies. The design was iterative: each case study was followed by a review of the theoretical ideas. The final conceptual framework was the result of the dynamic interplay between theory and empirical evidence. Five general practices in England, selected using purposeful sampling. Semi-structured interviews with all clinical and managerial personnel in each practice, participant and nonparticipant observation, and examination of documents. A conceptual framework was developed that can be used to understand how and why practices respond to change. This framework enabled understanding of observed reactions to the introduction of NSFs and the new GMS contract. Important factors for generating responses to change included the story that the practice members told about their practice, beliefs about what counted as legitimate work, the role played by the manager, and previous experiences of change. Viewing general practices as small organisations has generated insights into factors that influence responses to change. Change tends to occur from the bottom up and is determined by beliefs about organisational reality. The conceptual framework suggests some questions that can be asked of practices to explain this internal reality.

Radionuclides around nuclear sites in England and Wales

International Nuclear Information System (INIS)

Sanchez, A.L.; Horrill, A.D.; Singleton, D.L.; Leonard, D.R.P.

1996-01-01

Environmental releases of low levels of radioactivity can occur as a consequence of normal operations at nuclear facilities. In England and Wales, the impact of gaseous discharges on the terrestrial environment is monitored routinely by the site operators as well as by Food Science Division of the Ministry of Agriculture, Fisheries and Food. The terrestrial surveillance programme carried out by MAFF Food Science concentrates on agricultural produce to provide assessments of doses to members of the population derived from the consumption of terrestrial foodstuffs. We present here the results of a survey, undertaken in 1993 to supplement the monitoring data of MAFF, of artificial radioactive contamination around eighteen nuclear establishments in England and Wales. Grass and soil samples were used as indicators of environmental contamination at these sites for the radionuclides 137 Cs, 90 Sr, 239+240 Pu and 241 Am. When compared to estimated background radionuclide concentrations close to each site, these data reveal that four of the 18 sites have contributed measurable increases to both the 137 Cs and 239+240 Pu inventory within 500 m outside the boundary fence. Two additional sites showed slight increases above the expected background soil levels of 239+240 Pu

76 FR 71939 - New England Fishery Management Council; Public Meeting

Science.gov (United States)

2011-11-21

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XA837 New England... Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New... Scientific and Statistical Committee (SSC) will discuss the 2012 SSC calendar and tasks, social science...

77 FR 14351 - New England Fishery Management Council; Public Meeting

Science.gov (United States)

2012-03-09

... assessments and develop ABC recommendations for the Council for redfish, Georges Bank haddock, Gulf of Maine/Georges Bank windowpane flounder, Southern New England/Mid-Atlantic windowpane flounder, ocean pout... address the emergency. Special Accommodations This meeting is physically accessible to people with...

77 FR 68735 - New England Fishery Management Council; Public Meeting

Science.gov (United States)

2012-11-16

... Committee will continue to develop options and alternatives for Omnibus Essential Fish Habitat Amendment 2 (OA2). Specifically, the Committee will review Habitat Advisory Panel and Plan Development Team... England Fishery Management Council (Council) is scheduling a public meeting of its Habitat Oversight...

78 FR 51711 - New England Fishery Management Council; Public Meeting

Science.gov (United States)

2013-08-21

...: (978) 465-0492. SUPPLEMENTARY INFORMATION: The Council's Habitat and Groundfish Oversight Committees will meet jointly to discuss alternatives under development in Omnibus Essential Fish Habitat Amendment... Groundfish/Habitat Committees on September 5, 2013 to consider actions affecting New England fisheries in the...

Salt Marsh Sustainability in New England: Progress and Remaining Challenges

Science.gov (United States)

Natural resource managers, conservationists, and scientists described marsh loss and degradation in many New England coastal systems at the 2014 “Effects of Sea Level Rise on Rhode Island’s Salt Marshes” workshop, organized by the Narragansett Bay National Estuarine Research Rese...

Nurse prescriber-patient consultations: a case study in dermatology.

Science.gov (United States)

Courtenay, Molly; Carey, Nicola; Stenner, Karen

2009-06-01

This paper is a report of a study exploring the content and processes in consultations between nurse prescribers and patients with dermatological conditions. Communication skills, consultation time, information and follow-up are central to the treatment and management of patients with dermatological conditions. The contribution nurses make to the care of these patients has great potential. A multiple case study was conducted with 10 practice settings across England in which nurses prescribed medicines for patients with dermatological conditions. Data were collected between June 2006 and September 2007 using semi-structured interviews (n = 40), patient questionnaires (n = 165/200) and videotaped observations of nurse consultations (n = 40). Data analysis included thematic analysis, descriptive statistics, chi-square and non-parametric tests. Nurses believed that their holistic approach to assessment, combined with their prescribing knowledge, improved prescribing decisions. Listening and explanation of treatments were aspects of nurse communication that were rated highly by patients. Listening and dealing sensitively with emotions were also aspects of the videotaped consultations that were rated highly by assessors. Nurses were less consistent in providing information about medicines. Triangulated data from this study suggest that nurse prescribing enhances the care of patients with dermatological conditions through improved prescribing decisions. If patients are to be more involved in this decision-making, nurses must give them more information about their medicines. The benefits of prescribing were most evident in the practices of dermatology specialist nurses. Further evidence is required to identify whether prescribing by specialist nurses offers similar benefits in other therapeutic areas.

The role of alcohol and drugs in homicides in England and Wales.

Science.gov (United States)

Shaw, Jenny; Hunt, Isabelle M; Flynn, Sandra; Amos, Tim; Meehan, Janet; Robinson, Jo; Bickley, Harriet; Parsons, Rebecca; McCann, Kerry; Burns, James; Kapur, Nav; Appleby, Louis

2006-08-01

The annual number of homicide convictions in England and Wales is increasing. Previous studies have highlighted the aetiological role of alcohol and drugs in homicide. To examine rates of alcohol and drug misuse and dependence in people convicted of homicide; the role of alcohol and drugs in the offence; the social and clinical characteristics of alcohol- and drug-related homicides; and the social and clinical characteristics of patients with dual diagnosis who commit homicide. A national clinical survey based on a 3-year (1996-9) consecutive sample of people convicted of homicide in England and Wales. Information on rates of alcohol and drug misuse/dependence, the role of alcohol and drugs in the offence and social and clinical characteristics of perpetrators were collected from psychiatric reports prepared for the court in homicide convictions. Detailed clinical information was gathered from questionnaires completed by mental health teams for those in contact with mental health services. Of the 1594 homicide perpetrators, more than one-third (42%) occurred in people with a history of alcohol misuse or dependence and 40% in people with a history of drug misuse or dependence. Alcohol or drug misuse played a contributory role in two-fifths of homicides. Alcohol played a major role in 52 (6%) and a minor role in 364 (39%) homicides. Drugs played a major role in six (1%) and a minor role in 138 (14%) homicides. Forty-two homicides (17%) were committed by patients with severe mental illness and substance misuse. Alcohol- and drug-related homicides were generally associated with male perpetrators who had a history of violence, personality disorders, mental health service contact and with stranger victims. Substance misuse contributes to the majority of homicides in England and Wales. A public health approach to homicide would highlight alcohol and drugs before severe mental illness.

A critical analysis of national policies, systems, and structures of patient empowerment in England and Greece.

Science.gov (United States)

Boudioni, Markella; McLaren, Susan; Lister, Graham

2017-01-01

Comparison of patient empowerment (PE) policies in European countries can provide evidence for improvement and reform across different health systems. It may also influence patient and public involvement, patient experience, preference, and adherence. The objective of this study was to compare PE within national policies, systems, and structures in England and Greece for achieving integrated people-centered health services. We performed a critical search and review of policy and legislation papers in English and Greek languages. This included 1) general health policy and systems papers, 2) PE, patient and/or public involvement or patients' rights policy and legislation (1990-2015), and 3) comparative or discussion papers for England and/or Greece. A total of 102 papers on PE policies, systems, and structures were identified initially; 80 papers were included, in which 46 were policy, legislative, and discussion papers about England, 21 were policy, legislation, and discussion papers about Greece, and 13 were comparative or discussion papers including both the countries. In England, National Health Service policies emphasized patient-centered services, involvement, and empowerment, with recent focus on patients' rights; while in Greece, they emphasized patients' rights and quality of services, with recent mentions on empowerment. The health ombudsman is a very important organization across countries; however, it may be more powerful in Greece, because of the nonexistence of local mediating bodies. Micro-structures at trusts/hospitals are comparable, but legislation gives more power to the local structures in Greece. PE policies and systems have been developed and expressed differently in these countries. However, PE similarities, comparable dimensions and mechanisms, were identified. For both the countries, comparative research and these findings could be beneficial in building connections and relationships, contributing to wider European and international

12 New England Organizations Honored for Outstanding Achievements in Energy Efficiency

Science.gov (United States)

EPA and the U.S. Department of Energy (DOE) are honoring 12 New England businesses and organizations for their commitment to saving energy, saving money, and protecting the environment through superior energy efficiency achievements.

MERGANSER: an empirical model to predict fish and loon mercury in New England lakes.

Science.gov (United States)

Shanley, James B; Moore, Richard; Smith, Richard A; Miller, Eric K; Simcox, Alison; Kamman, Neil; Nacci, Diane; Robinson, Keith; Johnston, John M; Hughes, Melissa M; Johnston, Craig; Evers, David; Williams, Kate; Graham, John; King, Susannah

2012-04-17

MERGANSER (MERcury Geo-spatial AssessmeNtS for the New England Region) is an empirical least-squares multiple regression model using mercury (Hg) deposition and readily obtainable lake and watershed features to predict fish (fillet) and common loon (blood) Hg in New England lakes. We modeled lakes larger than 8 ha (4404 lakes), using 3470 fish (12 species) and 253 loon Hg concentrations from 420 lakes. MERGANSER predictor variables included Hg deposition, watershed alkalinity, percent wetlands, percent forest canopy, percent agriculture, drainage area, population density, mean annual air temperature, and watershed slope. The model returns fish or loon Hg for user-entered species and fish length. MERGANSER explained 63% of the variance in fish and loon Hg concentrations. MERGANSER predicted that 32-cm smallmouth bass had a median Hg concentration of 0.53 μg g(-1) (root-mean-square error 0.27 μg g(-1)) and exceeded EPA's recommended fish Hg criterion of 0.3 μg g(-1) in 90% of New England lakes. Common loon had a median Hg concentration of 1.07 μg g(-1) and was in the moderate or higher risk category of >1 μg g(-1) Hg in 58% of New England lakes. MERGANSER can be applied to target fish advisories to specific unmonitored lakes, and for scenario evaluation, such as the effect of changes in Hg deposition, land use, or warmer climate on fish and loon mercury.

Assessing the impact of a new health sector pay system upon NHS staff in England

Directory of Open Access Journals (Sweden)

Buchan James

2008-06-01

Full Text Available Abstract Background Pay and pay systems are a critical element in any health sector human resource strategy. Changing a pay system can be one strategy to achieve or sustain organizational change. This paper reports on the design and implementation of a completely new pay system in the National Health Service (NHS in England. 'Agenda for Change' constituted the largest-ever attempt to introduce a new pay system in the UK public services, covering more than one million staff. Its objectives were to improve the delivery of patient care as well as enhance staff recruitment, retention and motivation, and to facilitate new ways of working. Methods This study was the first independent assessment of the impact of Agenda for Change at a local and national level. The methods used in the research were a literature review; review of 'grey' unpublished documentation provided by key stakeholders in the process; analysis of available data; interviews with key national informants (representing government, employers and trade unions, and case studies conducted with senior human resource managers in ten NHS hospitals in England Results Most of the NHS trust managers interviewed were in favour of Agenda for Change, believing it would assist in delivering improvements in patient care and staff experience. The main benefits highlighted were: 'fairness', moving different staff groups on to harmonized conditions; equal pay claim 'protection'; and scope to introduce new roles and working practices. Conclusion Agenda for Change took several years to design, and has only recently been implemented. Its very scale and central importance to NHS costs and delivery of care argues for a full assessment at an early stage so that lessons can be learned and any necessary changes made. This paper highlights weaknesses in evaluation and limitations in progress. The absence of systematically derived and applied impact indicators makes it difficult to assess impact and impact

Health visiting assessment--unpacking critical attributes in health visitor needs assessment practice: a case study.

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Appleton, Jane V; Cowley, Sarah

2008-02-01

Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK. The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry. A case study design informed by a constructivist methodology was used to examine health visitors' professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support. The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site. Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place. The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors' assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.

New England and northern New York forest ecosystem vulnerability assessment and synthesis: a report from the New England Climate Change Response Framework project

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Maria K. Janowiak; Anthony W. D' Amato; Christopher W. Swanston; Louis Iverson; Frank R. Thompson; William D. Dijak; Stephen Matthews; Matthew P. Peters; Anantha Prasad; Jacob S. Fraser; Leslie A. Brandt; Patricia Butler-Leopold; Stephen D. Handler; P. Danielle Shannon; Diane Burbank; John Campbell; Charles Cogbill; Matthew J. Duveneck; Marla R. Emery; Nicholas Fisichelli; Jane Foster; Jennifer Hushaw; Laura Kenefic; Amanda Mahaffey; Toni Lyn Morelli; Nicholas J. Reo; Paul G. Schaberg; K. Rogers Simmons; Aaron Weiskittel; Sandy Wilmot; David Hollinger; Erin Lane; Lindsey Rustad; Pamela H. Templer

2018-01-01

Forest ecosystems will face direct and indirect impacts from a changing climate over the 21st century. This assessment evaluates the vulnerability of forest ecosystems across the New England region (Connecticut, Maine, Massachusetts, New Hampshire, northern New York, Rhode Island, and Vermont) under a range of future climates. We synthesized and summarized information...

77 FR 72846 - H.Q. Energy Services (U.S.) Inc. v. ISO New England Inc.; Notice of Complaint

Science.gov (United States)

2012-12-06

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL13-25-000] H.Q. Energy Services (U.S.) Inc. v. ISO New England Inc.; Notice of Complaint Take notice that on November 28, 2012... ISO New England Inc. (Respondent), requesting the Commission to issue an order requiring the...

77 FR 50472 - New England Fishery Management Council; Public Meeting

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2012-08-21

... Region Logbook Family of Forms Federal Register (77 FR 153, 8/8/12). Other business may be discussed. The... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council's (Council) VMS/ Enforcement Committee and Advisory Panel will meet to...

77 FR 47373 - New England Fishery Management Council; Public Meeting

Science.gov (United States)

2012-08-08

..., Southern New England/Mid-Atlantic yellowtail flounder, Georges Bank yellowtail flounder, witch flounder, plaice and Georges Bank/Gulf of Maine white hake. The committee may not develop all the recommendations... accessible to people with disabilities. Requests for sign language interpretation or other auxiliary aids...

75 FR 62507 - New England Fishery Management Council; Public Meeting

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2010-10-12

... jointly with the Habitat Plan Development Team to discuss management alternatives related to minimizing the adverse effects of fishing on Essential Fish Habitat (EFH), which are being developed for the... England Fishery Management Council (Council) is scheduling a public meeting of its Habitat/MPA/Ecosystem...

78 FR 25256 - New England Fishery Management Council; Public Meeting

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2013-04-30

...: (978) 465-0492. SUPPLEMENTARY INFORMATION: The Groundfish and Habitat Committees will convene jointly to continue development of alternatives for inclusion in Omnibus Essential Fish Habitat Amendment 2... Committee and Habitat Committee on May 17, 2013 to consider actions affecting New England fisheries in the...

76 FR 50183 - New England Fishery Management Council; Public Meeting

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2011-08-12

... minimize the adverse effects of fishing on essential fish habitat and will also continue development of... September meeting. The Committee will also review remaining essential fish habitat designation issues held... England Fishery Management Council (Council) is scheduling a public meeting of its Habitat/MPA/Ecosystem...

Forest health monitoring in New England: 1990 annual report

Science.gov (United States)

Robert T. Brooks; David R. Dickson; William B. Burkman; Imants Millers; Margaret Miller-Weeks; Ellen Cooter; Luther Smith; Luther Smith

1992-01-01

The USDA Forest Service, in cooperation with the U.S. Environmental Protection Agency and the New England State Forestry Agencies initiated field sampling for the Forest Health Monitoring program in 1990. Two hundred and sixty-three permanent sample plots were established. Measurements were taken to characterize the physical conditions of the plots. This publication...

Privatizing Education: Free School Policy in Sweden and England

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Wiborg, Susanne

2015-01-01

The aim of this article is to investigate why Sweden, the epitome of social democracy, has implemented education reforms leading to an extraordinary growth in Free Schools in contrast to liberal England, where Free School policy has been met with enormous resistance. Conventional wisdom would predict the contrary, but as a matter of fact Sweden…