Comparative study of liberalization process of passengers railway market in Spain and England

Energy Technology Data Exchange (ETDEWEB)

Fernandez Morote, G.; Ortuño Padilla, A.; Fernandez Aracil, P.

2016-07-01

This article provides an overview of the privatization of railway passengers market in Spain through a background to the most relevant cases studies in Europe, particularly the liberalization process in England. The English case study is a paradigmatic example to assess how the liberalization process was developed and its effect in the present. This assessment has been undertaken to analyse the railway franchise structure, ticketing measures, role of national and regional authorities, etc. and possible analogies to be adapted to the case of Spain. Firstly, this article reviews the origin of the privatization of the railway market in both Spain and England, describing every phase of the liberalization and the success of every stage. Secondly, a critical approach assessment exposes those market failures of the liberalization process in England that caused negative impacts on society. In addition, the role of the Government is analysed to measure their implication in order to solve that situation. Furthermore, the paper expounds a wide analysis of the rail ticketing in England, its effects on increased passenger number. Finally, this article proposes some measures to be followed on the privatization of passenger rail market in Spain, as well as some key concepts to guarantee its success as taken from the case studies that have been reviewed. (Author)

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.

Recognition and enforcement of foreign judgments in the Law of Iran and England: a comparative study

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Abasat Pour Mohammad

2017-07-01

Full Text Available The aim of this study was to Recognition and Enforcement of Foreign Judgments in the Law of Iran and England: A Comparative Study. There are a lot of similarities and commonalities between the legal system of Iran and England in the field of recognition and enforcement of the foreign judgments including public discipline and conflicting judgments. Public discipline in England Law is more specific than that of Iran. Being a civil case of the judgment, impossibility of recognition, enforcement of tax and criminal judgments are among the similarities of the two systems. On the other hand, reciprocity, precise of the foreign court, and the jurisdiction governing the nature of the claim are among instances which are different in Iran and England legal systems on the recognizing of the enforcement of foreign judgments.

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...

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

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.

Cost-effectiveness of national mandatory screening of all admissions to English National Health Service hospitals for meticillin-resistant Staphylococcus aureus: a mathematical modelling study.

Science.gov (United States)

Robotham, Julie V; Deeny, Sarah R; Fuller, Chris; Hopkins, Susan; Cookson, Barry; Stone, Sheldon

2016-03-01

In December, 2010, National Health Service (NHS) England introduced national mandatory screening of all admissions for meticillin-resistant Staphylococcus aureus (MRSA). We aimed to assess the effectiveness and cost-effectiveness of this policy, from a regional or national health-care decision makers' perspective, compared with alternative screening strategies. We used an individual-based dynamic transmission model parameterised with national MRSA audit data to assess the effectiveness and cost-effectiveness of admission screening of patients in English NHS hospitals compared with five alternative strategies (including no screening, checklist-activated screening, and high-risk specialty-based screening), accompanied by patient isolation and decolonisation, over a 5 year time horizon. We evaluated strategies for different NHS hospital types (acute, teaching, and specialist), MRSA prevalence, and transmission potentials using probabilistic sensitivity analyses. Compared with no screening, mean cost per quality-adjusted life-year (QALY) of screening all admissions was £89,000-148,000 (range £68,000-222,000), and this strategy was consistently more costly and less effective than alternatives for all hospital types. At a £30,000/QALY willingness-to-pay threshold and current prevalence, only the no-screening strategy was cost effective. The next best strategies were, in acute and teaching hospitals, targeting of high-risk specialty admissions (30-40% chance of cost-effectiveness; mean incremental cost-effectiveness ratios [ICERs] £45,200 [range £35,300-61,400] and £48,000/QALY [£34,600-74,800], respectively) and, in specialist hospitals, screening these patients plus risk-factor-based screening of low-risk specialties (a roughly 20% chance of cost-effectiveness; mean ICER £62,600/QALY [£48,000-89,400]). As prevalence and transmission increased, targeting of high-risk specialties became the optimum strategy at the NHS willingness-to-pay threshold (£30,000/QALY

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.

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.

A qualitative study of uptake of free vitamins in England.

Science.gov (United States)

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.

Science.gov (United States)

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.

Pathogens as Predictors of Honey Bee Colony Strength in England and Wales.

Science.gov (United States)

Budge, Giles E; Pietravalle, Stéphane; Brown, Mike; Laurenson, Lynn; Jones, Ben; Tomkies, Victoria; Delaplane, Keith S

2015-01-01

Inspectors with the UK National Bee Unit were asked for 2007-2008 to target problem apiaries in England and Wales for pathogen screening and colony strength measures. Healthy colonies were included in the sampling to provide a continuum of health conditions. A total of 406 adult bee samples was screened and yielded 7 viral, 1 bacterial, and 2 microsporidial pathogens and 1 ectoparasite (Acarapis woodi). In addition, 108 samples of brood were screened and yielded 4 honey bee viruses. Virus prevalence varied from common (deformed wing virus, black queen cell virus) to complete absence (Israeli acute paralysis virus). When colonies were forced into one of two classes, strong or weak, the weak colonies contained more pathogens in adult bees. Among observed pathogens, only deformed wing virus was able to predict colony strength. The effect was negative such that colonies testing positive for deformed wing virus were likely to have fewer combs of bees or brood. This study constitutes the first record for Nosema ceranae in Great Britain. These results contribute to the growing body of evidence linking pathogens to poor honey bee health.

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

Men and women: beliefs about cancer and about screening

Directory of Open Access Journals (Sweden)

Whynes David K

2009-11-01

Full Text Available Abstract Background Cancer screening programmes in England are publicly-funded. Professionals' beliefs in the public health benefits of screening can conflict with individuals' entitlements to exercise informed judgement over whether or not to participate. The recognition of the importance of individual autonomy in decision making requires greater understanding of the knowledge, attitudes and beliefs upon which people's screening choices are founded. Until recently, the technology available required that cancer screening be confined to women. This study aimed to discover whether male and female perceptions of cancer and of screening differed. Methods Data on the public's cancer beliefs were collected by means of a postal survey (anonymous questionnaire. Two general practices based in Nottingham and in Mansfield, in east-central England, sent questionnaires to registered patients aged 30 to 70 years. 1,808 completed questionnaires were returned for analysis, 56.5 per cent from women. Results Women were less likely to underestimate overall cancer incidence, although each sex was more likely to cite a sex-specific cancer as being amongst the most common cancer site. In terms of risk factors, men were most uncertain about the role of stress and sexually-transmitted diseases, whereas women were more likely to rate excessive alcohol and family history as major risk factors. The majority of respondents believed the public health care system should provide cancer screening, but significantly more women than men reported having benefiting from the nationally-provided screening services. Those who were older, in better health or had longer periods of formal education were less worried about cancer than those who had illness experiences, lower incomes, or who were smokers. Actual or potential participation in bowel screening was higher amongst those who believed bowel cancer to be common and amongst men, despite women having more substantial worries about

A study of whether automated Diabetic Retinopathy Image Assessment could replace manual grading steps in the English National Screening Programme.

Science.gov (United States)

Kapetanakis, Venediktos V; Rudnicka, Alicja R; Liew, Gerald; Owen, Christopher G; Lee, Aaron; Louw, Vern; Bolter, Louis; Anderson, John; Egan, Catherine; Salas-Vega, Sebastian; Rudisill, Caroline; Taylor, Paul; Tufail, Adnan

2015-09-01

Diabetic retinopathy screening in England involves labour intensive manual grading of digital retinal images. We present the plan for an observational retrospective study of whether automated systems could replace one or more steps of human grading. Patients aged 12 or older who attended the Diabetes Eye Screening programme, Homerton University Hospital (London) between 1 June 2012 and 4 November 2013 had macular and disc-centred retinal images taken. All screening episodes were manually graded and will additionally be graded by three automated systems. Each system will process all screening episodes, and screening performance (sensitivity, false positive rate, likelihood ratios) and diagnostic accuracy (95% confidence intervals of screening performance measures) will be quantified. A sub-set of gradings will be validated by an approved Reading Centre. Additional analyses will explore the effect of altering thresholds for disease detection within each automated system on screening performance. 2,782/20,258 diabetes patients were referred to ophthalmologists for further examination. Prevalence of maculopathy (M1), pre-proliferative retinopathy (R2), and proliferative retinopathy (R3) were 7.9%, 3.1% and 1.2%, respectively; 4749 (23%) patients were diagnosed with background retinopathy (R1); 1.5% were considered ungradable by human graders. Retinopathy prevalence was similar to other English diabetic screening programmes, so findings should be generalizable. The study population size will allow the detection of differences in screening performance between the human and automated grading systems as small as 2%. The project will compare performance and economic costs of manual versus automated systems. © The Author(s) 2015.

Promoting chlamydia screening with posters and leaflets in general practice--a qualitative study.

Science.gov (United States)

Freeman, Elaine; Howell-Jones, Rebecca; Oliver, Isabel; Randall, Sarah; Ford-Young, William; Beckwith, Philippa; McNulty, Cliodna

2009-10-12

General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP), have been available to general practices, through local chlamydia screening offices, since its launch. In this study we explored the attitudes of general practice staff to these screening promotional materials, how they used them, and explored other promotional strategies to encourage chlamydia screening. Twenty-five general practices with a range of screening rates, were purposively selected from six NCSP areas in England. In focus groups doctors, nurses, administrative staff and receptionists were encouraged to discuss candidly their experiences about their use and opinions of posters, leaflets and advertising to promote chlamydia screening. Researchers observed whether posters and leaflets were on display in reception and/or waiting areas. Data were collected and analysed concurrently using a stepwise framework analytical approach. Although two-thirds of screening practices reported that they displayed posters and leaflets, they were not prominently displayed in most practices. Only a minority of practices reported actively using screening promotional materials on an ongoing basis. Most staff in all practices were not following up the advertising in posters and leaflets by routinely offering opportunistic screening to their target population. Some staff in many practices thought posters and leaflets would cause offence or embarrassment to their patients. Distribution of chlamydia leaflets by receptionists was thought to be inappropriate by some practices, as they thought patients would be offended when being offered a leaflet in a public area. Practice staff suggested the development of pocket-sized leaflets. The NCSP should consider developing a range of more discrete but eye

Promoting chlamydia screening with posters and leaflets in general practice - a qualitative study

Science.gov (United States)

Freeman, Elaine; Howell-Jones, Rebecca; Oliver, Isabel; Randall, Sarah; Ford-Young, William; Beckwith, Philippa; McNulty, Cliodna

2009-01-01

Background General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP), have been available to general practices, through local chlamydia screening offices, since its launch. In this study we explored the attitudes of general practice staff to these screening promotional materials, how they used them, and explored other promotional strategies to encourage chlamydia screening. Methods Twenty-five general practices with a range of screening rates, were purposively selected from six NCSP areas in England. In focus groups doctors, nurses, administrative staff and receptionists were encouraged to discuss candidly their experiences about their use and opinions of posters, leaflets and advertising to promote chlamydia screening. Researchers observed whether posters and leaflets were on display in reception and/or waiting areas. Data were collected and analysed concurrently using a stepwise framework analytical approach. Results Although two-thirds of screening practices reported that they displayed posters and leaflets, they were not prominently displayed in most practices. Only a minority of practices reported actively using screening promotional materials on an ongoing basis. Most staff in all practices were not following up the advertising in posters and leaflets by routinely offering opportunistic screening to their target population. Some staff in many practices thought posters and leaflets would cause offence or embarrassment to their patients. Distribution of chlamydia leaflets by receptionists was thought to be inappropriate by some practices, as they thought patients would be offended when being offered a leaflet in a public area. Practice staff suggested the development of pocket-sized leaflets. Conclusion The NCSP should consider developing

Promoting chlamydia screening with posters and leaflets in general practice - a qualitative study

Directory of Open Access Journals (Sweden)

Ford-Young William

2009-10-01

Full Text Available Abstract Background General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP, have been available to general practices, through local chlamydia screening offices, since its launch. In this study we explored the attitudes of general practice staff to these screening promotional materials, how they used them, and explored other promotional strategies to encourage chlamydia screening. Methods Twenty-five general practices with a range of screening rates, were purposively selected from six NCSP areas in England. In focus groups doctors, nurses, administrative staff and receptionists were encouraged to discuss candidly their experiences about their use and opinions of posters, leaflets and advertising to promote chlamydia screening. Researchers observed whether posters and leaflets were on display in reception and/or waiting areas. Data were collected and analysed concurrently using a stepwise framework analytical approach. Results Although two-thirds of screening practices reported that they displayed posters and leaflets, they were not prominently displayed in most practices. Only a minority of practices reported actively using screening promotional materials on an ongoing basis. Most staff in all practices were not following up the advertising in posters and leaflets by routinely offering opportunistic screening to their target population. Some staff in many practices thought posters and leaflets would cause offence or embarrassment to their patients. Distribution of chlamydia leaflets by receptionists was thought to be inappropriate by some practices, as they thought patients would be offended when being offered a leaflet in a public area. Practice staff suggested the development of pocket-sized leaflets. Conclusion The NCSP

Tree rings and time: recent historical studies in England

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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.

A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demographics and decision-making style

Directory of Open Access Journals (Sweden)

Alex Ghanouni

2017-04-01

Full Text Available Abstract Background There is broad agreement that cancer screening invitees should know the risks and benefits of testing before deciding whether to participate. In organised screening programmes, a primary method of relaying this information is via leaflets provided at the time of invitation. Little is known about why individuals do not engage with this information. This study assessed factors associated with reading information leaflets provided by the three cancer screening programmes in England. Methods A cross-sectional survey asked screening-eligible members of the general population in England about the following predictor variables: uptake of previous screening invitations, demographic characteristics, and ‘decision-making styles’ (i.e. the extent to which participants tended to make decisions in a way that was avoidant, rational, intuitive, spontaneous, or dependent. The primary outcome measures were the amount of the leaflet that participants reported having read at their most recent invitation, for any of the three programmes for which they were eligible. Associations between these outcomes and predictor variables were assessed using binary or ordinal logistic regression. Results After exclusions, data from 275, 309, and 556 participants were analysed in relation to the breast, cervical, and bowel screening programmes, respectively. Notable relationships included associations between regularity of screening uptake and reading (more of the information leaflets for all programmes (e.g. odds ratio: 0.16 for participants who never/very rarely attended breast screening vs. those who always attended previously; p = .009. Higher rational decision-making scores were associated with reading more of the cervical and bowel screening leaflets (OR: 1.13, p < .0005 and OR: 1.11, p = .045, respectively. Information engagement was also higher for White British participants compared with other ethnic groups for breast (OR: 3.28, p = .008

A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demographics and decision-making style.

Science.gov (United States)

Ghanouni, Alex; Renzi, Cristina; Waller, Jo

2017-04-18

There is broad agreement that cancer screening invitees should know the risks and benefits of testing before deciding whether to participate. In organised screening programmes, a primary method of relaying this information is via leaflets provided at the time of invitation. Little is known about why individuals do not engage with this information. This study assessed factors associated with reading information leaflets provided by the three cancer screening programmes in England. A cross-sectional survey asked screening-eligible members of the general population in England about the following predictor variables: uptake of previous screening invitations, demographic characteristics, and 'decision-making styles' (i.e. the extent to which participants tended to make decisions in a way that was avoidant, rational, intuitive, spontaneous, or dependent). The primary outcome measures were the amount of the leaflet that participants reported having read at their most recent invitation, for any of the three programmes for which they were eligible. Associations between these outcomes and predictor variables were assessed using binary or ordinal logistic regression. After exclusions, data from 275, 309, and 556 participants were analysed in relation to the breast, cervical, and bowel screening programmes, respectively. Notable relationships included associations between regularity of screening uptake and reading (more of) the information leaflets for all programmes (e.g. odds ratio: 0.16 for participants who never/very rarely attended breast screening vs. those who always attended previously; p = .009). Higher rational decision-making scores were associated with reading more of the cervical and bowel screening leaflets (OR: 1.13, p < .0005 and OR: 1.11, p = .045, respectively). Information engagement was also higher for White British participants compared with other ethnic groups for breast (OR: 3.28, p = .008) and bowel (OR: 2.58, p = .015) information; an

Pathogens as Predictors of Honey Bee Colony Strength in England and Wales.

Directory of Open Access Journals (Sweden)

Giles E Budge

Full Text Available Inspectors with the UK National Bee Unit were asked for 2007-2008 to target problem apiaries in England and Wales for pathogen screening and colony strength measures. Healthy colonies were included in the sampling to provide a continuum of health conditions. A total of 406 adult bee samples was screened and yielded 7 viral, 1 bacterial, and 2 microsporidial pathogens and 1 ectoparasite (Acarapis woodi. In addition, 108 samples of brood were screened and yielded 4 honey bee viruses. Virus prevalence varied from common (deformed wing virus, black queen cell virus to complete absence (Israeli acute paralysis virus. When colonies were forced into one of two classes, strong or weak, the weak colonies contained more pathogens in adult bees. Among observed pathogens, only deformed wing virus was able to predict colony strength. The effect was negative such that colonies testing positive for deformed wing virus were likely to have fewer combs of bees or brood. This study constitutes the first record for Nosema ceranae in Great Britain. These results contribute to the growing body of evidence linking pathogens to poor honey bee health.

The New England travel market: changes in generational travel patterns

Science.gov (United States)

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...

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...

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...

Incentives in Diabetic Eye Assessment by Screening (IDEAS): study protocol of a three-arm randomized controlled trial using financial incentives to increase screening uptake in London.

Science.gov (United States)

Judah, Gaby; Vlaev, Ivo; Gunn, Laura; King, Dominic; King, Derek; Valabhji, Jonathan; Darzi, Ara; Bicknell, Colin

2016-03-18

Diabetes is an increasing public health problem in the UK and globally. Diabetic retinopathy is a microvascular complication of diabetes, and is one of the leading causes of blindness in the UK working age population. The diabetic eye screening programme in England aims to invite all people with diabetes aged 12 or over for retinal photography to screen for the presence of diabetic retinopathy. However, attendance rates are only 81 %, leaving many people at risk of preventable sight loss. This is a three arm randomized controlled trial to investigate the impact of different types of financial incentives (based on principles from behavioral economics) on increasing attendance at diabetic eye screening appointments in London. Eligible participants will be aged 16 or over, and are those who have been invited to screening appointments annually, but who have not attended, or telephoned to rearrange an appointment, within the last 24 months. Eligible participants will be randomized to one of three conditions: 1. Control condition (usual invitation letter) 2. Fixed incentive condition (usual invitation letter, including a voucher for £10 if they attend their appointment) 3. Probabilistic incentive condition (invitation letter, including a voucher for a 1 in 100 chance of winning £1000 if they attend their appointment). Participants will be sent invitation letters, and the primary outcome will be whether or not they attend their appointment. One thousand participants will be included in total, randomized with a ratio of 1.4:1:1. In order to test whether the incentive scheme has a differential impact on patients from different demographic or socio-economic groups, information will be recorded on age, gender, distance from screening center, socio-economic status and length of time since they were last screened. A cost-effectiveness analysis will also be performed. This study will be the first trial of financial incentives for improving uptake of diabetic eye screening. If

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.

Science.gov (United States)

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…

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

Science.gov (United States)

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.

Changes in detection of retinopathy in type 2 diabetes in the first 4 years of a population-based diabetic eye screening program: retrospective cohort study.

Science.gov (United States)

Forster, Alice S; Forbes, Angus; Dodhia, Hiten; Connor, Clare; Du Chemin, Alain; Sivaprasad, Sobha; Mann, Samantha; Gulliford, Martin C

2013-09-01

Annual diabetic eye screening has been implemented in England since 2008. This study aimed to estimate changes in the detection of retinopathy in the first 4 years of the program. Participants included 32,340 patients with type 2 diabetes resident in three London boroughs with one or more screening records between 2008 and 2011. Data for 87,570 digital images from 2008 to 2011 were analyzed. Frequency of sight-threatening diabetic retinopathy (STDR) was estimated by year of screen for first screens and for subsequent screens according to retinopathy status at first screen. Among 16,621 first-ever screens, the frequency of STDR was 7.1% in 2008, declining to 6.4% in 2011 (P = 0.087). The proportion with a duration of diabetes of retinopathy at first screen, the proportion with STDR at second or later screen declined from 21.6% in 2008 to 8.4% in 2011 (annual change -2.2% [95% CI -3.3 to -1.0], P retinopathy at first screen, STDR declined from 9.2% in 2008 to 3.2% in 2011 (annual change -1.8% [-2.0 to -1.7], P diabetic eye screening, patients at lower risk of STDR contribute an increasing proportion to the eligible population, and the proportion detected with STDR at second or subsequent screening rounds declines rapidly.

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

Science.gov (United States)

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…

Imparting carrier status results detected by universal newborn screening for sickle cell and cystic fibrosis in England: a qualitative study of current practice and policy challenges

Directory of Open Access Journals (Sweden)

Ulph Fiona

2007-12-01

Full Text Available Abstract Background Universal newborn screening for early detection of children affected by sickle cell disorders and cystic fibrosis is currently being implemented across England. Parents of infants identified as carriers of these disorders must also be informed of their baby's result. However there is a lack of evidence for most effective practice internationally when doing so. This study describes current or proposed models for imparting this information in practice and explores associated challenges for policy. Methods Thematic analysis of semi-structured interviews with Child Health Coordinators from all English Health Regions. Results Diverse methods for imparting carrier results, both within and between regions, and within and between conditions, were being implemented or planned. Models ranged from result by letter to in-person communication during a home visit. Non-specialists were considered the best placed professionals to give results and a similar approach for both conditions was emphasised. While national guidance has influenced choice of models, other factors contributed such as existing service structures and lack of funding. Challenges included uncertainty about guidance specifying face to face notification; how best to balance allaying parental anxiety by using familiar non-specialist health professionals with concerns about practitioner competence; and extent of information parents should be given. Inadequate consideration of resource and service workload was seen as the main policy obstacle. Clarification of existing guidance; more specific protocols to ensure consistent countrywide practice; integration of the two programmes; and 'normalising' carrier status were suggested as improvements. Conclusion Differing models for communicating carrier results raise concerns about equity and clinical governance. However, this variation provides opportunity for evaluation. Timely and more detailed guidance on protocols with

Aspirations for a Master's-Level Teaching Profession in England

Science.gov (United States)

Thomas, Lorraine

2016-01-01

This research investigates aspirations for a master's-level teaching profession in England, providing key stakeholder perceptions in one densely populated region within a multiple case study. Although this intended move to a master's-level profession represented a major shift in teachers' professional development in England, only limited…

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

Science.gov (United States)

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

A lack of information engagement among colorectal cancer screening non-attenders: cross-sectional survey

Directory of Open Access Journals (Sweden)

Lindsay C. Kobayashi

2016-07-01

Full Text Available Abstract Background The NHS Cancer Screening Programmes in England now operate a policy of ‘informed choice’ about participation in cancer screening. Engagement with written information about screening is important to facilitate informed choice, although the degree to which the screening-eligible public engages with the available information is unknown. We examined the association between reading of the standard informational booklet (‘Bowel Cancer Screening: The Facts' and participation in the nationally organised NHS Bowel Cancer Screening Programme in England. Methods Face-to-face interviews were conducted with 1307 adults who were age-eligible for nationally organised colorectal cancer (CRC; also called bowel cancer in a population-based survey in England in 2014. Respondents were shown an image of ‘The Facts’ booklet and were asked how much of it they had read when they received their screening invitation (‘none’, ‘a little’, ‘some’, ‘most’, ‘almost all’, or ‘all’. Logistic regression was used to estimate the associations between screening uptake status (‘never’ vs. ‘ever’ and self-reported reading of ‘The Facts’ booklet (dichotomised to ‘none vs. ‘any’, adjusting for age, sex, ethnicity, educational attainment, and occupation-based social grade. Results Overall, 69 % of the sample (908/1307 had participated in CRC screening at least once (‘ever’ screeners. One-fifth of the sample reported that they had read ‘none’ of ‘The Facts’ booklet (22 %; 287/1307, while half reported having read ‘all’ of it (52 %; 680/1307. Reading of the booklet was strongly differential according to screening uptake status: nearly two-thirds of ‘never’ screeners had read none of ‘The Facts’ booklet (63 %; 251/399, compared to less than one in twenty ‘ever’ screeners (4 %; 36/908; adjusted OR = 39.0; 95 % CI: 26.2-58.1 for reading ‘none’ in ‘never’ vs. �

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

Science.gov (United States)

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...

Empirical study of supervised gene screening

Directory of Open Access Journals (Sweden)

Ma Shuangge

2006-12-01

Full Text Available Abstract Background Microarray studies provide a way of linking variations of phenotypes with their genetic causations. Constructing predictive models using high dimensional microarray measurements usually consists of three steps: (1 unsupervised gene screening; (2 supervised gene screening; and (3 statistical model building. Supervised gene screening based on marginal gene ranking is commonly used to reduce the number of genes in the model building. Various simple statistics, such as t-statistic or signal to noise ratio, have been used to rank genes in the supervised screening. Despite of its extensive usage, statistical study of supervised gene screening remains scarce. Our study is partly motivated by the differences in gene discovery results caused by using different supervised gene screening methods. Results We investigate concordance and reproducibility of supervised gene screening based on eight commonly used marginal statistics. Concordance is assessed by the relative fractions of overlaps between top ranked genes screened using different marginal statistics. We propose a Bootstrap Reproducibility Index, which measures reproducibility of individual genes under the supervised screening. Empirical studies are based on four public microarray data. We consider the cases where the top 20%, 40% and 60% genes are screened. Conclusion From a gene discovery point of view, the effect of supervised gene screening based on different marginal statistics cannot be ignored. Empirical studies show that (1 genes passed different supervised screenings may be considerably different; (2 concordance may vary, depending on the underlying data structure and percentage of selected genes; (3 evaluated with the Bootstrap Reproducibility Index, genes passed supervised screenings are only moderately reproducible; and (4 concordance cannot be improved by supervised screening based on reproducibility.

Geomorphology of New England

Science.gov (United States)

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

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

Science.gov (United States)

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

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...

Costs and cost effectiveness of different strategies for chlamydia screening and partner notification: an economic and mathematical modelling study.

Science.gov (United States)

Turner, Katy; Adams, Elisabeth; Grant, Arabella; Macleod, John; Bell, Gill; Clarke, Jan; Horner, Paddy

2011-01-04

To compare the cost, cost effectiveness, and sex equity of different intervention strategies within the English National Chlamydia Screening Programme. To develop a tool for calculating cost effectiveness of chlamydia control programmes at a local, national, or international level. An economic and mathematical modelling study with cost effectiveness analysis. Costs were restricted to those of screening and partner notification from the perspective of the NHS and excluded patient costs, the costs of reinfection, and costs of complications arising from initial infection. England. Population Individuals eligible for the National Chlamydia Screening Programme. Cost effectiveness of National Chlamydia Screening Programme in 2008-9 (as cost per individual tested, cost per positive diagnosis, total cost of screening, number screened, number infected, sex ratio of those tested and treated). Comparison of baseline programme with two different interventions-(i) increased coverage of primary screening in men and (ii) increased efficacy of partner notification. In 2008-9 screening was estimated to cost about £46.3m in total and £506 per infection treated. Provision for partner notification within the screening programme cost between £9 and £27 per index case, excluding treatment and testing. The model results suggest that increasing male screening coverage from 8% (baseline value) to 24% (to match female coverage) would cost an extra £22.9m and increase the cost per infection treated to £528. In contrast, increasing partner notification efficacy from 0.4 (baseline value) to 0.8 partners per index case would cost an extra £3.3m and would reduce the cost per infection diagnosed to £449. Increasing screening coverage to 24% in men would cost over six times as much as increasing partner notification to 0.8 but only treat twice as many additional infections. In the English National Chlamydia Screening Programme increasing the effectiveness of partner notification is likely

Alignment of breast cancer screening guidelines, accountability metrics, and practice patterns.

Science.gov (United States)

Onega, Tracy; Haas, Jennifer S; Bitton, Asaf; Brackett, Charles; Weiss, Julie; Goodrich, Martha; Harris, Kimberly; Pyle, Steve; Tosteson, Anna N A

2017-01-01

Breast cancer screening guidelines and metrics are inconsistent with each other and may differ from breast screening practice patterns in primary care. This study measured breast cancer screening practice patterns in relation to common evidence-based guidelines and accountability metrics. Cohort study using primary data collected from a regional breast cancer screening research network between 2011 and 2014. Using information on women aged 30 to 89 years within 21 primary care practices of 2 large integrated health systems in New England, we measured the proportion of women screened overall and by age using 2 screening definition categories: any mammogram and screening mammogram. Of the 81,352 women in our cohort, 54,903 (67.5%) had at least 1 mammogram during the time period, 48,314 (59.4%) had a screening mammogram. Women aged 50 to 69 years were the highest proportion screened (82.4% any mammogram, 75% screening indication); 72.6% of women at age 40 had a screening mammogram with a median of 70% (range = 54.3%-84.8%) among the practices. Of women aged at least 75 years, 63.3% had a screening mammogram, with the median of 63.9% (range = 37.2%-78.3%) among the practices. Of women who had 2 or more mammograms, 79.5% were screened annually. Primary care practice patterns for breast cancer screening are not well aligned with some evidence-based guidelines and accountability metrics. Metrics and incentives should be designed with more uniformity and should also include shared decision making when the evidence does not clearly support one single conclusion.

Insomnia management in prisons in England and Wales: a mixed-methods study.

Science.gov (United States)

Dewa, Lindsay H; Hassan, Lamiece; Shaw, Jenny J; Senior, Jane

2017-06-01

Insomnia in prison is common; however, research is limited regarding the management strategies that prison establishments employ. To address this knowledge gap, we conducted a survey to identify how insomnia is detected, diagnosed and treated in adult prisons in England and Wales. Telephone interviews with a purposive sample of health-care managers were then conducted. The survey was sent to all establishments holding adult prisoners, covering screening and assessment methods to detect insomnia; treatment options, both pharmacological and non-pharmacological; the importance of insomnia as a treatable condition; and staff training available. Eighty-four (73%) prisons completed the survey. Few had a stepped approach to insomnia management, as recommended by National Institute for Health and Care Excellence (NICE) guidelines. The most common treatments available were sleep hygiene education and medication, offered by 94 and 88% of respondents, respectively. Analysis of telephone interviews revealed four main themes: insomnia as a normal occurrence in prison; the problem of medication in prison; the negative impact of the prison environment; and effective management of insomnia in prison. The current findings suggest that logistical, ethical and security barriers and a lack of staff knowledge and training impact negatively on the management of insomnia in prison. © 2017 European Sleep Research Society.

A UK guide to intake fish-screening regulations, policy and best practice with particular reference to hydroelectric power schemes

Energy Technology Data Exchange (ETDEWEB)

Turnpenny, A W.H.; Struthers, G; Hanson, P

1998-07-01

A review of fish screening regulations in England, Wales, Scotland, and Northern Ireland is presented, and a summary of findings on screening legislation is given. The views of hydroelectric scheme developers, owners and operators are considered, and recommendations including the development of a risk assessment procedure are discussed. Fish screening technology, bypasses and other escape routes, and common fault in screen design and operation are examined, and guidance to Best Practice is given. (UK)

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

Science.gov (United States)

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…

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)

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

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...

Comparing landscape planning in England, Germany and the Netherlands : policy contexts and three case study plans

NARCIS (Netherlands)

Schröder, R.R.G.; Wascher, D.M.; Odell, S.; Smith, C.

2010-01-01

This comparative study of landscape planning, within three case-studies in England, Germany and the Netherlands, has the proposed outcomes to create a mutually understood model for ‘landscape planning’, a catalogue of key concepts on space, landscape and planning and a proposal for further European

Co-operation and conflict under hard and soft contracting regimes: case studies from England and Wales.

Science.gov (United States)

Hughes, David; Allen, Pauline; Doheny, Shane; Petsoulas, Christina; Vincent-Jones, Peter

2013-01-01

This paper examines NHS secondary care contracting in England and Wales in a period which saw increasing policy divergence between the two systems. At face value, England was making greater use of market levers and utilising harder-edged service contracts incorporating financial penalties and incentives, while Wales was retreating from the 1990 s internal market and emphasising cooperation and flexibility in the contracting process. But there were also cross-border spill-overs involving common contracting technologies and management cultures that meant that differences in on-the-ground contracting practices might be smaller than headline policy differences suggested. The nature of real-world contracting behaviour was investigated by undertaking two qualitative case studies in England and two in Wales, each based on a local purchaser/provider network. The case studies involved ethnographic observations and interviews with staff in primary care trusts (PCTs) or local health boards (LHBs), NHS or Foundation trusts, and the overseeing Strategic Health Authority or NHS Wales regional office, as well as scrutiny of relevant documents. Wider policy differences between the two NHS systems were reflected in differing contracting frameworks, involving regional commissioning in Wales and commissioning by either a PCT, or co-operating pair of PCTs in our English case studies, and also in different oversight arrangements by higher tiers of the service. However, long-term relationships and trust between purchasers and providers had an important role in both systems when the financial viability of organisations was at risk. In England, the study found examples where both PCTs and trusts relaxed contractual requirements to assist partners faced with deficits. In Wales, news of plans to end the purchaser/provider split meant a return to less precisely-specified block contracts and a renewed concern to build cooperation between LHB and trust staff. The interdependency of local

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.

Understanding increases in smoking prevalence: case study from France in comparison with England 2000-10.

Science.gov (United States)

McNeill, Ann; Guignard, Romain; Beck, François; Marteau, Rosie; Marteau, Theresa M

2015-03-01

In France, following a long-term decline in smoking prevalence, an increase in smoking was observed between 2005 and 2010, an unusual occurrence in countries in the 'mature' stage of the smoking epidemic. By contrast, smoking prevalence in England, the neighbouring country, continued its long-term decline. We identified and translated recent reports on smoking and tobacco control in France and using these assessed the main data sources on smoking and compared them with similar sources in England, in order to explore possible explanations. In France, national smoking prevalence data are collected 5-yearly, minimizing opportunities for fine-grained analysis; the comparable study in England is implemented annually. We identified several probable causes of the recent increased prevalence of smoking in France, the primary one being the absence of sufficient price rises between 2005 and 2010, due probably to the lack of a robust tobacco control strategy, which also appeared to have empowered tobacco industry influence. Funding to compensate tobacconists appears to incentivize tobacco sales and is significantly higher than tobacco control funding. Mindful of the limitations of a case-study approach, the absence of sufficient price rises in the context of a weak tobacco control strategy seems the most likely explanation for the recent increase in smoking prevalence in France. A new cancer control plan and a national smoking reduction programme have been proposed by the French government in 2014 which, depending on implementation, may reverse the trend. In both countries, the higher levels of smoking among the more disadvantaged groups are of great concern and require greater political leadership for effective action. © 2014 Society for the Study of Addiction.

Divergence With Age in Blood Pressure in African-Caribbean and White Populations in England: Implications for Screening for Hypertension

NARCIS (Netherlands)

Agyemang, Charles; Humphry, Roger W.; Bhopal, Raj

2012-01-01

BACKGROUND We assessed when blood pressure (BP) and hypertension begin to rise in African-Caribbeans compared to the white population; and whether the change relates to body mass index (BMI). METHODS Secondary analysis of the cross-sectional Health Surveys for England among 22,723 participants

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

Social Cognitive Mediators of Sociodemographic Differences in Colorectal Cancer Screening Uptake

Directory of Open Access Journals (Sweden)

Siu Hing Lo

2015-01-01

Full Text Available Background. This study examined if and how sociodemographic differences in colorectal cancer (CRC screening uptake can be explained by social cognitive factors. Methods. Face-to-face interviews were conducted with individuals aged 60–70 years (n=1309 living in England as part of a population-based omnibus survey. Results. There were differences in screening uptake by SES, marital status, ethnicity, and age but not by gender. Perceived barriers (stand. b=-0.40, p<0.001, social norms (stand. b=0.33, p<0.001, and screening knowledge (stand. b=0.17, p<0.001 had independent associations with uptake. SES differences in uptake were mediated through knowledge, social norms, and perceived barriers. Ethnic differences were mediated through knowledge. Differences in uptake by marital status were primarily mediated through social norms and to a lesser extent through knowledge. Age differences were largely unmediated, except for a small mediated effect via social norms. Conclusions. Sociodemographic differences in CRC screening uptake were largely mediated through social cognitive factors. Impact. Our findings suggest that multifaceted interventions might be needed to reduce socioeconomic inequalities. Ethnic differences might be reduced through improved screening knowledge. Normative interventions could emphasise screening as an activity endorsed by important others outside the immediate family to appeal to a wider audience.

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.

The agreement between self-reported cervical smear abnormalities and screening programme records.

Science.gov (United States)

Canfell, Karen; Beral, Valerie; Green, Jane; Cameron, Rebecca; Baker, Krys; Brown, Anna

2006-01-01

The Million Women Study is a cohort study of women aged 50-64 years in England and Scotland. As a component of the follow-up questionnaire, participants were asked to indicate if they had an abnormal cervical smear in the previous five years. This study compared self-reported cervical abnormalities with screening records obtained from the National Health Service Cervical Screening Programme. For 1944 randomly selected Million Women Study participants in Oxfordshire, screening records were assessed over a six-year period prior to the date of self-reporting. The six-year period was chosen to allow for errors in the recall of timing of abnormal smears. A total of 68 women (3.5%) had a record of at least one equivocal or abnormal smear within the last six years, whereas 49 women (2.5%) self-reported an abnormality. There was a strong trend for an increased probability of self-reporting a history of an abnormal smear as the severity of the recorded abnormality increased (P screening programme records show an abnormal smear, the proportion self-reporting an abnormality increases with the severity of the recorded lesion. Almost all women with a record of negative or inadequate smear(s) correctly interpret the result and do not self-report an abnormality.

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

Science.gov (United States)

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.

Implementation of depression screening in antenatal clinics through tablet computers: results of a feasibility study.

Science.gov (United States)

Marcano-Belisario, José S; Gupta, Ajay K; O'Donoghue, John; Ramchandani, Paul; Morrison, Cecily; Car, Josip

2017-05-10

Mobile devices may facilitate depression screening in the waiting area of antenatal clinics. This can present implementation challenges, of which we focused on survey layout and technology deployment. We assessed the feasibility of using tablet computers to administer a socio-demographic survey, the Whooley questions and the Edinburgh Postnatal Depression Scale (EPDS) to 530 pregnant women attending National Health Service (NHS) antenatal clinics across England. We randomised participants to one of two layout versions of these surveys: (i) a scrolling layout where each survey was presented on a single screen; or (ii) a paging layout where only one question appeared on the screen at any given time. Overall, 85.10% of eligible pregnant women agreed to take part. Of these, 90.95% completed the study procedures. Approximately 23% of participants answered Yes to at least one Whooley question, and approximately 13% of them scored 10 points of more on the EPDS. We observed no association between survey layout and the responses given to the Whooley questions, the median EPDS scores, the number of participants at increased risk of self-harm, and the number of participants asking for technical assistance. However, we observed a difference in the number of participants at each EPDS scoring interval (p = 0.008), which provide an indication of a woman's risk of depression. A scrolling layout resulted in faster completion times (median = 4 min 46 s) than a paging layout (median = 5 min 33 s) (p = 0.024). However, the clinical significance of this difference (47.5 s) is yet to be determined. Tablet computers can be used for depression screening in the waiting area of antenatal clinics. This requires the careful consideration of clinical workflows, and technology-related issues such as connectivity and security. An association between survey layout and EPDS scoring intervals needs to be explored further to determine if it corresponds to a survey layout effect

Emergency response facilities including primary and secondary prevention strategies across 79 professional football clubs in England.

Science.gov (United States)

Malhotra, Aneil; Dhutia, Harshil; Gati, Sabiha; Yeo, Tee-Joo; Finocchiaro, Gherardo; Keteepe-Arachi, Tracey; Richards, Thomas; Walker, Mike; Birt, Robin; Stuckey, David; Robinson, Laurence; Tome, Maite; Beasley, Ian; Papadakis, Michael; Sharma, Sanjay

2017-06-14

To assess the emergency response planning and prevention strategies for sudden cardiac arrest (SCA) across a wide range of professional football clubs in England. A written survey was sent to all professional clubs in the English football league, namely the Premiership, Championship, League 1 and League 2. Outcomes included: (1) number of clubs performing cardiac screening and frequency of screening; (2) emergency planning and documentation; (3) automated external defibrillator (AED) training and availability; and (4) provision of emergency services at sporting venues. 79 clubs (86%) responded to the survey. 100% clubs participated in cardiac screening. All clubs had AEDs available on match days and during training sessions. 100% Premiership clubs provided AED training to designated staff. In contrast, 30% of lower division clubs with AEDs available did not provide formal training. Most clubs (n=66; 83%) reported the existence of an emergency action plan for SCA but formal documentation was variable. All clubs in the Premiership and League 1 provided an ambulance equipped for medical emergencies on match days compared with 75% of clubs in the Championship and 66% in League 2. The majority of football clubs in England have satisfactory prevention strategies and emergency response planning in line with European recommendations. Additional improvements such as increasing awareness of European guidelines for emergency planning, AED training and mentorship with financial support to lower division clubs are necessary to further enhance cardiovascular safety of athletes and spectators and close the gap between the highest and lower divisions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

More misinformation on breast cancer screening.

Science.gov (United States)

Kopans, Daniel B

2017-02-01

Unfortunately, a great deal of misinformation has accumulated in the breast cancer screening literature that is based on flawed analyses in an effort to reduce access to screening. Quite remarkably, much of this has come from publications in previously highly respected medical journals. In several papers the intervention (mammography screening) is faulted yet the analyses provided no data on who participated in mammography screening, and which cancers were detected by mammography screening. It is remarkable that a highly respected journal can fault an intervention with no data on the intervention. Claims of massive over diagnosis of invasive breast cancer due to breast cancer screening have been made using "guesses" that have no scientific basis. No one has ever seen a mammographically detected, invasive breast cancer, disappear on its own, yet analysts have claimed that this occurs thousands of times each year. In fact, the" miraculous" resolution, without intervention, of a handful of breast cancers have all been palpable cancers, yet there is no suggestion to stop treating palpable cancers. A review of several publications in the New England Journal of Medicine shows some of the flaws in these analyses. There is clearly a problem with peer review that is allowing scientifically unsupportable material, which is misleading women and their physicians, to be published in prestigious journals.

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.

Online health check for reducing alcohol intake among employees: a feasibility study in six workplaces across England.

Science.gov (United States)

Khadjesari, Zarnie; Newbury-Birch, Dorothy; Murray, Elizabeth; Shenker, Don; Marston, Louise; Kaner, Eileen

2015-01-01

Most hazardous and harmful drinkers are of working age and do not seek help with their drinking. Occupational health services are uniquely placed to universally screen employees across the range of socioeconomic and ethnic groups. The aim was to explore the feasibility and acceptability of offering electronic screening and brief intervention for alcohol misuse in the context of a health check in six different workplace settings. Employees were recruited from six workplaces across England, including three local authorities, one university, one hospital and one petro-chemical company. A total of 1,254 (8%) employees completed the health check and received personalised feedback on their alcohol intake, alongside feedback on smoking, fruit and vegetable consumption and physical activity. Most participants were female (65%) and of 'White British' ethnicity (94%), with a mean age of 43 years (SD 11). Participants were mostly in Intermediate occupations (58%), followed by Higher managerial / professional (39%) and Routine and manual occupations (2%). A quarter of participants (25%) were drinking at hazardous levels (33% male, 21% female), which decreased with age. Sixty-four percent (n=797) of participants completed online follow-up at three months. Most participants were supportive of workplaces offering employees an online health check (95%), their preferred format was online (91%) and many were confident of the confidentiality of their responses (60%). Whilst the feedback reminded most participants of things they already knew (75%), some were reportedly motivated to change their behaviour (13%). Online health screening and personalised feedback appears feasible and acceptable, but challenges include low participation rates, potentially attracting 'worried well' employees rather than those at greatest health risk, and less acceptance of the approach among older employees and those from ethnic minority backgrounds and routine or manual occupations.

Online health check for reducing alcohol intake among employees: a feasibility study in six workplaces across England.

Directory of Open Access Journals (Sweden)

Zarnie Khadjesari

Full Text Available Most hazardous and harmful drinkers are of working age and do not seek help with their drinking. Occupational health services are uniquely placed to universally screen employees across the range of socioeconomic and ethnic groups. The aim was to explore the feasibility and acceptability of offering electronic screening and brief intervention for alcohol misuse in the context of a health check in six different workplace settings.Employees were recruited from six workplaces across England, including three local authorities, one university, one hospital and one petro-chemical company. A total of 1,254 (8% employees completed the health check and received personalised feedback on their alcohol intake, alongside feedback on smoking, fruit and vegetable consumption and physical activity. Most participants were female (65% and of 'White British' ethnicity (94%, with a mean age of 43 years (SD 11. Participants were mostly in Intermediate occupations (58%, followed by Higher managerial / professional (39% and Routine and manual occupations (2%. A quarter of participants (25% were drinking at hazardous levels (33% male, 21% female, which decreased with age. Sixty-four percent (n=797 of participants completed online follow-up at three months. Most participants were supportive of workplaces offering employees an online health check (95%, their preferred format was online (91% and many were confident of the confidentiality of their responses (60%. Whilst the feedback reminded most participants of things they already knew (75%, some were reportedly motivated to change their behaviour (13%.Online health screening and personalised feedback appears feasible and acceptable, but challenges include low participation rates, potentially attracting 'worried well' employees rather than those at greatest health risk, and less acceptance of the approach among older employees and those from ethnic minority backgrounds and routine or manual occupations.

The Identification and Assessment of Dyslexia: Class Teachers' Perceptions of the Usefulness of the Dyslexia Screening Test for Seven to Eight Year-Old Pupils.

Science.gov (United States)

Lawrence, Brenda; Carter, Jenny

1999-01-01

This study evaluated the use of the Dyslexia Screening Test (DST) in six primary schools in England with 44 children from 12 classes. Teachers perceived the DST to be useful and necessary. The great majority of teachers indicated that the test's findings were consistent with their expectations from pupils' classroom performance and that they…

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

Nosocomial outbreak of staphyloccocal scalded skin syndrome in neonates in England, December 2012 to March 2013.

Science.gov (United States)

Paranthaman, K; Bentley, A; Milne, L M; Kearns, A; Loader, S; Thomas, A; Thompson, F; Logan, M; Newitt, S; Puleston, R

2014-08-21

Staphylococcal scalded skin syndrome (SSSS) is a blistering skin condition caused by exfoliative toxin-producing strains of Staphylococcus aureus. Outbreaks of SSSS in maternity settings are rarely reported. We describe an outbreak of SSSS that occurred among neonates born at a maternity unit in England during December 2012 to March 2013. Detailed epidemiological and microbiological investigations were undertaken. Eight neonates were found to be infected with the outbreak strain of S. aureus, of spa type t346, representing a single pulsotype. All eight isolates contained genes encoding exfoliative toxin A (eta) and six of them contained genes encoding toxin B (etb). Nasal swabs taken during targeted staff screening yielded a staphylococcal carriage rate of 21% (17/80), but none contained the outbreak strain. Mass screening involving multi-site swabbing and pooled, enrichment culture identified a healthcare worker (HCW) with the outbreak strain. This HCW was known to have a chronic skin condition and their initial nasal screen was negative. The outbreak ended when they were excluded from work. This outbreak highlights the need for implementing robust swabbing and culture methodswhen conventional techniques are unsuccessful in identifying staff carrier(s). This study adds to the growing body of evidence on the role of HCWs in nosocomial transmission of S. aureus.

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...

Co-operation and conflict under hard and soft contracting regimes: case studies from England and Wales

OpenAIRE

Hughes, David; Allen, Pauline; Doheny, Shane; Petsoulas, Christina; Vincent-Jones, Peter

2013-01-01

BACKGROUND: This paper examines NHS secondary care contracting in England and Wales in a period which saw increasing policy divergence between the two systems. At face value, England was making greater use of market levers and utilising harder-edged service contracts incorporating financial penalties and incentives, while Wales was retreating from the 1990 s internal market and emphasising cooperation and flexibility in the contracting process. But there were also cross-border spill-overs inv...

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

Science.gov (United States)

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

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:…

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.)

Protecting Geoheritage - Geodiversity Charter for England

Science.gov (United States)

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

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

Science.gov (United States)

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.

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...

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.

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)

Communication of carrier status information following universal newborn screening for sickle cell disorders and cystic fibrosis: qualitative study of experience and practice.

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Kai, J; Ulph, F; Cullinan, T; Qureshi, N

2009-11-01

To describe and explore current practice, methods and experience of communicating carrier status information following newborn screening for cystic fibrosis (CF) and sickle cell (SC) disorders, to inform practice and further research. Three linked qualitative studies. All nine health regions in England. Child health screening coordinators in all English health regions, health professionals communicating results to parents and parents of newborn carriers. A preliminary phase of semi-structured telephone interviews with child health screening coordinators in all nine English health regions, and thematic analysis of data; semi-structured face-to-face interviews with purposeful samples of 67 family members of 51 infants identified by universal newborn screening as carriers of CF or SC with data analysis by constant comparison; and semi-structured telephone interviews, and focus groups, with a key informant sample of 16 differing health professionals currently tasked with communicating results to parents in a range of ways, with thematic analysis of data. Methods for and respondents' experiences of communication of carrier results varied considerably within and between regions, and within and between SC and CF contexts. Approaches ranged from letter or telephone call alone, to in-person communication in the clinic or at home, with health professionals from haemoglobinopathy, CF, screening and genetics backgrounds, or from community and primary care, such as health visitors with SC carrier results. Health professionals identified pros and cons of different methods, preferring opportunity for face-to-face communication with parents where possible, particularly for CF carrier results. They were concerned by regional variations in protocols, the lack of availability of translated information on SC carrier results, and the feasibility of sustaining more 'specialist' involvement at current levels, particularly for SC carriers. Parents were often poorly prepared for the

Melmark New England

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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…

Screening for diabetes in optometry practices: acceptability to users.

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Howse, Jennifer H; Jones, Steve; Hungin, A Pali S

2011-07-01

Diabetes is a leading cause of blindness in the working age population. While optometrists have an established role in screening people with known diabetes for eye disease, their role in screening for diabetes has not been evaluated. For diabetes screening in optometry practices to be successful it must be acceptable to both optometrists and to the public. The purpose of this study was to determine acceptability to people attending optometry practices of using random capillary blood glucose (rCBG) tests to detect raised blood glucose levels in optometry practices. A screening service offering people with risk factors or symptoms of diabetes rCBG tests was piloted in five high street opticians' practices in North East England. One thousand and two people used the screening service during a 20 week period. Each was given a questionnaire to complete and return following a rCBG test. Nine hundred and thirty-nine questionnaires were returned (return rate 93.7%). The mean age of participants was 54.5 years, 63.3% were female and 75.0% had not been screened for diabetes previously. 99.1% agreed or strongly agreed that the location was convenient for them and 98.0% would recommend others to use the screening service. 83.8% of the participants would not have gone elsewhere to have any tests done and 148 (16.2%) responded that they would have sought a test elsewhere; 14.2% at the GP, 0.8% at a pharmacy and 0.5% elsewhere. Only 3.2% reported that the test procedure was uncomfortable.   To those attending opticians' practices, screening using rCBG tests is acceptable in terms of convenience and test comfort, and they would recommend the test to others. Screening in optometry practices provides an opportunity to identify people at risk of diabetes in a hitherto unutilised setting. Ophthalmic & Physiological Optics © 2011 The College of Optometrists.

Gauging the brownfield land supply in England

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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.

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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

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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

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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

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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

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. 

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

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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

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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)

Mathematics anxiety in secondary students in England.

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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

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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...

Human influences on streamflow drought characteristics in England and Wales

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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

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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.

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

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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.

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…

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.

Descriptive epidemiology of screen and non-screen sedentary time in adolescents: a cross sectional study

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Ridley Kate

2010-12-01

Full Text Available Abstract Background Much attention has been paid to adolescents' screen time, however very few studies have examined non-screen sedentary time (NSST. This study aimed to (1 describe the magnitude and composition of screen sedentary time (SST and NSST in Australian adolescents, (2 describe the socio-demographic correlates of SST and NSST, and (3 determine whether screen time is an adequate surrogate for total sedentary behaviour in this population. Methods 2200 9-16 year old Australians provided detailed use of time data for four days. Non-screen sedentary time (NSST included time spent participating in activities expected to elicit Results Adolescents spent a mean (SD of 345 (105 minutes/day in NSST, which constituted 60% of total sedentary time. School activities contributed 42% of NSST, socialising 19%, self-care (mainly eating 16%, and passive transport 15%. Screen time and NSST showed opposite patterns in relation to key socio-demographic characteristics, including sex, age, weight status, household income, parental education and day type. Because screen time was negatively correlated with NSST (r = -0.58, and exhibited a moderate correlation (r = 0.53 with total sedentary time, screen time was only a moderately effective surrogate for total sedentary time. Conclusions To capture a complete picture of young people's sedentary time, studies should endeavour to measure both screen time and NSST.

Evaluation of the risk for Tay-Sachs disease in individuals of French Canadian ancestry living in new England.

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Martin, Dianna C; Mark, Brian L; Triggs-Raine, Barbara L; Natowicz, Marvin R

2007-03-01

The assessment of risk for Tay-Sachs disease (TSD) in individuals of French Canadian background living in New England is an important health issue. In preliminary studies of the enzyme-defined carrier frequency for TSD among Franco-Americans in New England, we found frequencies (1:53) higher than predicted from the incidence of infantile TSD in this region. We have now further evaluated the risk for TSD in the Franco-American population of New England. Using a fluorescence-based assay for beta-hexosaminidase activity, we determined the carrier frequencies for TSD in 2783 Franco-Americans. DNA analysis was used to identify mutations causing enzyme deficiency in TSD carriers. We determined the enzyme-defined carrier frequency for TSD as 1:65 (95% confidence interval 1:49 to 1:90). DNA-based analysis of 24 of the enzyme-defined carriers revealed 21 with sequence changes: 9 disease-causing, 4 benign, and 8 of unknown significance. Six of the unknowns were identified as c.748G>A p.G250S, a mutation we show by expression analysis to behave similarly to the previously described c.805G>A p.G269S adult-onset TSD mutation. This putative adult-onset TSD c.748G>A p.G250S mutation has a population frequency similar to the common 7.6 kb deletion mutation that occurs in persons of French Canadian ancestry. We estimate the frequency of deleterious TSD alleles in Franco-Americans to be 1:73 (95% confidence interval 1:55 to 1:107). These data provide a more complete data base from which to formulate policy recommendations regarding TSD heterozygosity screening in individuals of French Canadian background.

Nocturnal Oviposition Behavior of Forensically Important Diptera in Central England.

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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.

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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

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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.

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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

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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

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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...

Screening for type 2 diabetes and population mortality over 10 years (ADDITION-Cambridge): a cluster-randomised controlled trial.

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Simmons, Rebecca K; Echouffo-Tcheugui, Justin B; Sharp, Stephen J; Sargeant, Lincoln A; Williams, Kate M; Prevost, A Toby; Kinmonth, Ann Louise; Wareham, Nicholas J; Griffin, Simon J

2012-11-17

The increasing prevalence of type 2 diabetes poses a major public health challenge. Population-based screening and early treatment for type 2 diabetes could reduce this growing burden. However, uncertainty persists around the benefits of screening for type 2 diabetes. We assessed the effect of a population-based stepwise screening programme on mortality. In a pragmatic parallel group, cluster-randomised trial, 33 general practices in eastern England were randomly assigned by the method of minimisation in an unbalanced design to: screening followed by intensive multifactorial treatment for people diagnosed with diabetes (n=15); screening plus routine care of diabetes according to national guidelines (n=13); and a no-screening control group (n=5). The study population consisted of 20,184 individuals aged 40-69 years (mean 58 years), at high risk of prevalent undiagnosed diabetes, on the basis of a previously validated risk score. In screening practices, individuals were invited to a stepwise programme including random capillary blood glucose and glycated haemoglobin (HbA(1c)) tests, a fasting capillary blood glucose test, and a confirmatory oral glucose tolerance test. The primary outcome was all-cause mortality. All participants were flagged for mortality surveillance by the England and Wales Office of National Statistics. Analysis was by intention-to-screen and compared all-cause mortality rates between screening and control groups. This study is registered, number ISRCTN86769081. Of 16,047 high-risk individuals in screening practices, 15,089 (94%) were invited for screening during 2001-06, 11,737 (73%) attended, and 466 (3%) were diagnosed with diabetes. 4137 control individuals were followed up. During 184,057 person-years of follow up (median duration 9·6 years [IQR 8·9-9·9]), there were 1532 deaths in the screening practices and 377 in control practices (mortality hazard ratio [HR] 1·06, 95% CI 0·90-1·25). We noted no significant reduction in

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

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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.

Role of carotid duplex imaging in carotid screening programmes – an overview

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Gillard Jonathan H

2008-07-01

Full Text Available Abstract Background Stroke is the third most common cause of death in the UK and the largest single cause of severe disability. Each year more than 110,000 people in England suffer from a stroke which costs the National Health Service (NHS over GBP2.8 billion. Thus, it is imperative that patients at risk be screened for underlying carotid artery atherosclerosis. Aim To assess the role of carotid ultrasound in different carotid screening programmes. Methods A literature overview was carried out by using PubMed search engine, to identify different carotid screening programmes that had used ultrasound scan as a screening tool. Results It appears that the carotid ultrasound is an effective method for screening carotid artery disease in community as it effectively predicts the presence of stenosis with high accuracy. There is a need for primary care to recommend high risk patients for regular screening, to reduce stroke and transient ischemic attack (TIA related morbidity and mortality. Conclusion Screening programmes using carotid ultrasonography contribute to public health awareness and promotion which in long term could potentially benefit in disease prevention and essentially promote better standards of healthcare.

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.

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.

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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'.

Concerns, perceived need and competing priorities: a qualitative exploration of decision-making and non-participation in a population-based flexible sigmoidoscopy screening programme to prevent colorectal cancer.

Science.gov (United States)

Hall, N; Birt, L; Rees, C J; Walter, F M; Elliot, S; Ritchie, M; Weller, D; Rubin, G

2016-11-11

Optimising uptake of colorectal cancer (CRC) screening is important to achieve projected health outcomes. Population-based screening by flexible sigmoidoscopy (FS) was introduced in England in 2013 (NHS Bowel scope screening). Little is known about reactions to the invitation to participate in FS screening, as offered within the context of the Bowel scope programme. We aimed to investigate responses to the screening invitation to inform understanding of decision-making, particularly in relation to non-participation in screening. Qualitative analysis of semistructured in-depth interviews and written accounts. People from 31 general practices in the North East and East of England invited to attend FS screening as part of NHS Bowel scope screening programme were sent invitations to take part in the study. We purposively sampled interviewees to ensure a range of accounts in terms of beliefs, screening attendance, sex and geographical location. 20 screeners and 25 non-screeners were interviewed. Written responses describing reasons for, and circumstances surrounding, non-participation from a further 28 non-screeners were included in the analysis. Thematic analysis identified a range of reactions to the screening invitation, decision-making processes and barriers to participation. These include a perceived or actual lack of need; inability to attend; anxiety and fear about bowel preparation, procedures or hospital; inability or reluctance to self-administer an enema; beliefs about low susceptibility to bowel cancer or treatment and understanding of harm and benefits. The strength, rather than presence, of concerns about the test and perceived need for reassurance were important in the decision to participate for screeners and non-screeners. Decision-making occurs within the context of previous experiences and day-to-day life. Understanding the reasons for non-participation in FS screening can help inform strategies to improve uptake and may be transferable to other

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

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

Directory of Open Access Journals (Sweden)

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

Targeted case finding for hepatitis B using dry blood spot testing in the British-Chinese and South Asian populations of the North-East of England.

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McPherson, S; Valappil, M; Moses, S E; Eltringham, G; Miller, C; Baxter, K; Chan, A; Shafiq, K; Saeed, A; Qureshi, R; Hudson, M; Bassendine, M F

2013-09-01

Chronic infection with the hepatitis B virus (HBV) is a frequent cause of cirrhosis and liver cancer. Targeted HBV screening is recommended by the Centre for Disease Control (CDC) and Prevention for subjects born in countries with >2% HBV prevalence. However, there are no UK guidelines. Here, we applied the (CDC) recommendations to the British-Chinese and British-South Asian community of North-East (NE) England. British-Chinese and South Asian subjects were invited to attend for HBV education and screening sessions held in community centres. Hepatitis B surface antigen (HBsAg) and hepatitis B core total antibody (HBcAb) were tested with dry blood spot tests. South Asians were also tested for hepatitis C antibody (HCVAb). A total of 1126 subjects (606 Chinese and 520 South Asian) were screened. Sixty-two (5.5%) were HBsAg positive. Ten of these reported a previous diagnosis of HBV. The prevalence of HBsAg positivity was 4.6% when previously diagnosed individuals were excluded. The HBsAg prevalence was significantly higher in the Chinese subjects compared with South Asians (8.7% VS. 1.7% P < 0.001). In Chinese subjects, HBsAg positivity was highest in subjects born in Vietnam (17.4%), followed by China (11%), Hong Kong (7.8%) and the UK (6.7%). Subjects from Pakistan had the highest HBsAg and HCV Ab prevalence in the South Asians (3.1% and 1.8%, respectively). Ten percentage of HBsAg positive patients who had follow-up assessment had active disease requiring antiviral treatment. Undiagnosed HBV infection was above the 2% threshold for screening suggested by the CDC in the British-Chinese and Pakistani community of NE England, which provides evidence for a UK HBV-targeted screening programme. © 2013 John Wiley & Sons Ltd.

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.)

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.

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

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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.

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

Science.gov (United States)

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…

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…

Constructing Oneself as a Teacher of History: Case Studies of the Journey to the Other Side of the Desk by Preservice Teachers in England and America

OpenAIRE

Hicks, David

1999-01-01

The research described in this dissertation has its antecedents in my own experiences as a student and teacher of history in both England and the USA. Reflecting back on such experiences as a teacher educator in the US has led to a hypothesis that history teaching is conceptualized and performed differently by teachers in England and the US. This study used contrasting case studies of two English and two American preservice history teachers to illuminate and compare how the development of t...

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…

Local Perspectives on Globalisation and Learning: A Case Study of the Printing and Packaging Industry in South-West England.

Science.gov (United States)

Payne, John

2001-01-01

A case study of union initiatives to rebuild the training infrastructure for small businesses in the printing industry in Southwest England illustrates two points: (1) unions are responding to the individualizing tendency of globalization while maintaining collectivist traditions; and (2) organizational culture can inhibit the acquisition,…

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…

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.

GP leadership in clinical commissioning groups: a qualitative multi-case study approach across England.

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Marshall, Martin; Holti, Richard; Hartley, Jean; Matharu, Tatum; Storey, John

2018-06-01

Clinical commissioning groups (CCGs) were established in England in 2013 to encourage GPs to exert greater influence over the processes of service improvement and redesign in the NHS. Little is known about the extent and the ways in which GPs have assumed these leadership roles. To explore the nature of clinical leadership of GPs in CCGs, and to examine the enablers and barriers to implementing a policy of clinical leadership in the NHS. A qualitative multi-case study approach in six localities across England. The case studies were purposefully sampled to represent different geographical localities and population demographics, and for their commitment to redesigning specified clinical or service areas. Data were collected from the case study CCGs and their partner organisations using a review of relevant documents, semi-structured individual or group interviews, and observations of key meetings. The data were analysed thematically and informed by relevant theories. GPs prefer a collaborative style of leadership that may be unlikely to produce rapid or radical change. Leadership activities are required at all levels in the system from strategy to frontline delivery, and the leadership behaviours of GPs who are not titular leaders are as important as formal leadership roles. A new alliance is emerging between clinicians and managers that draws on their different skillsets and creates new common interests. The uncertain policy environment in the English NHS is impacting on the willingness and the focus of GP leaders. GPs are making an important contribution as leaders of health service improvement and redesign but there are significant professional and political barriers to them optimising a leadership role. © British Journal of General Practice 2018.

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

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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?

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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.

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

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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.

Alcohol, young people and the media: a study of radio output in six radio stations in England.

Science.gov (United States)

Daykin, N; Irwin, R; Kimberlee, R; Orme, J; Plant, M; McCarron, L; Rahbari, M

2009-03-01

This research investigated the representation of alcohol in radio output. The study was prompted by concerns that media output might be part of a developing culture of excessive drinking among young people. Alcohol comments were examined across six radio stations in England. 1200 h of weekend output was screened and the sampling frame included periods when references to alcohol would be expected, such as the Christmas period. Statistical analysis identified the volume and proportion of comments, whereas qualitative analysis explored these in more depth, focusing on the themes and discourses surrounding alcohol talk. Of 703 alcohol comments identified, 244 involved presenters. The volume of comments about alcohol varied between stations, being lower on BBC than on commercial stations and being influenced by music genre. Seventy-three percent of comments initiated by presenters, compared with 45% of comments from all sources, encouraged drinking. The majority of comments by presenters support drinking in relation to partying and socializing. Alcohol comments seem to create identity for programmes and forge connections between presenters and audiences, although some presenters achieve this without mentioning drinking. The assumption that alcohol is necessary to have a good time is seldom directly challenged. While it may be unsurprising that much of this content reflected themes of weekend drinking and partying, the study suggests that alcohol comments play a particular role in marketing and branding of radio output. Comments about alcohol are shaped by broadcasting conventions that make it difficult to challenge discourses surrounding excessive drinking. Further research is needed on the influence that radio output may have on drinking behaviour among young people.

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?

Trouble sleeping inside: a cross-sectional study of the prevalence and associated risk factors of insomnia in adult prison populations in England.

Science.gov (United States)

Dewa, Lindsay H; Hassan, Lamiece; Shaw, Jenny J; Senior, Jane

2017-04-01

To investigate the prevalence of insomnia and identify associated demographic, clinical and forensic risk factors in adult prisoners in England. A cross-sectional study of 237 prisoners aged 18-72 years, across two male prisons and one female prison in North England. We used the Sleep Condition Indicator to measure probable DSM-V insomnia disorder (ID) and the Pittsburgh Sleep Quality Index to examine sleep quality. Multiple demographic, sleep, clinical and forensic self-reported measures were recorded to identify any associations with insomnia. Overall, the prevalence of possible DSM-V ID was 61.6% (95% CI, 55.5%-67.8%). Subjective poor sleep quality was reported by 88.2% (95% CI, 84.1%-92.3%). Seven in ten (70.6%) female prisoners had possible DSM-V ID (95% CI, 64.8%-76.4%). Multivariable logistic regression analysis, adjusting for gender and age, indicated odds of having possible ID in prison were increased for the following factors: history of physical ill-health (OR = 3.62, 95% CI, 1.31-9.98); suicidality (OR = 2.79, 95% CI, 1.01.7.66), previously asked for help for insomnia (OR = 2.58, 95% CI, 1.21-5.47), depression (OR = 2.06, 95% CI 1.31-3.24), greater endorsement of dysfunctional beliefs about sleep (OR = 1.50, 95% CI, 1.21-1.87), poor sleep hygiene (OR = 1.11, 95% CI, 1.04-1.19), and problematic prison environment (eg, noise, light or temperature) (OR = 1.07, 95% CI, 1.02-1.12). For the first time we have established the prevalence and associated factors of insomnia in a large sample of adult English prisoners. ID and poor sleep quality are common, especially in female prisoners. These findings emphasize/amplify the need for dedicated treatment pathways to improve screening, assessment and treatment of insomnia in prison. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

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

Science.gov (United States)

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.

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.

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.

Studies Comparing Screen-Film Mammography and Full-Field Digital Mammography in Breast Cancer Screening: Updated Review

International Nuclear Information System (INIS)

Skaane, P.

2009-01-01

Full-field digital mammography (FFDM) has several potential benefits as compared with screen-film mammography (SFM) in mammography screening. Digital technology also opens for implementation of advanced applications, including computer-aided detection (CAD) and tomosynthesis. Phantom studies and experimental clinical studies have shown that FFDM is equal or slightly superior to SFM for detection and characterization of mammographic abnormalities. Despite obvious advantages, the conversion to digital mammography has been slower than anticipated, and not only due to higher costs. Until very recently, some countries did not even permit the use of digital mammography in breast cancer screening. The reason for this reluctant attitude was concern about lower spatial resolution and about using soft-copy reading. Furthermore, there was a lack of data supporting improved diagnostic accuracy using FFDM in a screening setting, since two pioneer trials both showed nonsignificantly lower cancer detection rate at FFDM. The 10 studies comparing FFDM and SFM in mammography screening published so far have shown divergent and rather conflicting results. Nevertheless, there is a rapid conversion to digital mammography in breast cancer screening in many western countries. The aim of this article is to give an updated review of these studies, discuss the conflicting findings, and draw some conclusions from the results

Autism characteristics and behavioural disturbances in ~ 500 children with Down's syndrome in England and Wales.

Science.gov (United States)

Warner, Georgina; Moss, Joanna; Smith, Patrick; Howlin, Patricia

2014-08-01

Recent research shows that a significant minority of children with Down's syndrome (DS) also meet diagnostic criteria for an autism spectrum disorder (ASD). The present study investigated what proportion of children aged 6-15 years with a confirmed diagnosis of DS in England and Wales display autistic-type behaviours, and explored the characteristics of this group of children. The Social Communication Questionnaire (SCQ) was used to screen for autism characteristics and the Strengths and Difficulties Questionnaire (SDQ) to explore behavioural difficulties. The proportion of children who met the cut-off score for ASD on the SCQ (total score ≥ 15) was 37.7% (95% CI: 33.4-42.0%); for autism (total score ≥ 22) the proportion was 16.5% (95% CI: 13.2-19.8%). Children who met the cut-off for ASD were significantly more likely to be reported as having emotional symptoms, conduct problems and hyperactivity on the SDQ than children who scored well below cut-off (total score autism characteristics on the SCQ was atypical compared with individuals with idiopathic ASD. The pervasiveness of ASD in children with DS in England and Wales is substantially higher than in the general population. These children also experience significantly greater behavioural problems than children with DS only. Early detection of autism characteristics is important for appropriate intervention. However, the unusual profile of autism characteristics in this group may affect the recognition of the disorder and hinder the implementation of appropriate interventions. © 2014 International Society for Autism Research, Wiley Periodicals, Inc.

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…

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...

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…

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.

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.

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...

Evaluation of community provision of a preventive cardiovascular programme - the National Health Service Health Check in reaching the under-served groups by primary care in England: cross sectional observational study.

Science.gov (United States)

Woringer, Maria; Cecil, Elizabeth; Watt, Hillary; Chang, Kiara; Hamid, Fozia; Khunti, Kamlesh; Dubois, Elizabeth; Evason, Julie; Majeed, Azeem; Soljak, Michael

2017-06-14

Cardiovascular disease (CVD) is the leading cause of premature mortality and a major contributor of health inequalities in England. Compared to more affluent and white counterparts, deprived people and ethnic minorities tend to die younger due to preventable CVD associated with lifestyle. In addition, deprived, ethnic minorities and younger people are less likely to be served by CVD prevention services. This study assessed the effectiveness of community-based outreach providers in delivering England's National Health Services (NHS) Health Check programme, a CVD preventive programme to under-served groups. Between January 2008 and October 2013, community outreach providers delivered a preventive CVD programme to 50,573 individuals, in their local communities, in a single consultation without prescheduled appointments. Community outreach providers operated on evenings and weekends as well as during regular business hours in venues accessible to the general public. After exclusion criteria, we analysed and compared socio-demographic data of 43,177 Health Check attendees with the general population across 38 local authorities (LAs). We assessed variation between local authorities in terms of age, sex, deprivation and ethnicity structures using two sample t-tests and within local authority variation in terms of ethnicity and deprivation using Chi squared tests and two sample t-tests respectively. Using Index of Multiple Deprivation, the mean deprivation score of the population reached by community outreach providers was 6.01 higher (p successful in recruiting ethnic minority groups. The mean proportion of men screened was 11.39% lower (p successful in motivating the under-served groups to improve lifestyle, it may reduce health inequalities therein.

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

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.

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.

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.

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…

Luminescence studies on phosphor screens

International Nuclear Information System (INIS)

Panayiotakis, G.; Nomikos, C.; Bakas, A.; Proimos, B.

1994-01-01

We report our results on x-ray phosphor screens prepared of some new materials focusing attention on their efficiency under fluoroscopy conditions, on optimization conditions and on comparisons among the various materials. All data are presented in absolute values. A theoretical model is presented, that takes into account the granular structure of the screens, permitting the explanation and prediction of the luminescence properties of the screens. (authors)

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…

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

Luminescence studies on phosphor screens

Energy Technology Data Exchange (ETDEWEB)

Panayiotakis, G; Nomikos, C; Bakas, A; Proimos, B [Medical Physics Department, University of Patras, 265 00 Patras, Greece (Greece)

1994-12-31

We report our results on x-ray phosphor screens prepared of some new materials focusing attention on their efficiency under fluoroscopy conditions, on optimization conditions and on comparisons among the various materials. All data are presented in absolute values. A theoretical model is presented, that takes into account the granular structure of the screens, permitting the explanation and prediction of the luminescence properties of the screens. (authors). 12 refs, 3 figs.

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

Does gender discrimination impact regular mammography screening? Findings from the race differences in screening mammography study.

Science.gov (United States)

Dailey, Amy B; Kasl, Stanislav V; Jones, Beth A

2008-03-01

ABSTRACT Objective: To determine if gender discrimination, conceptualized as a negative life stressor, is a deterrent to adherence to mammography screening guidelines. African American and white women (1451) aged 40-79 years who obtained an index screening mammogram at one of five urban hospitals in Connecticut between October 1996 and January 1998 were enrolled in this study. This logistic regression analysis includes the 1229 women who completed telephone interviews at baseline and follow-up (average 29.4 months later) and for whom the study outcome, nonadherence to age-specific mammography screening guidelines, was determined. Gender discrimination was measured as lifetime experience in seven possible situations. Gender discrimination, reported by nearly 38% of the study population, was significantly associated with nonadherence to mammography guidelines in women with annual family incomes of > or =$50,000 (OR 1.99, 95% CI 1.33, 2.98) and did not differ across racial/ethnic group. Our findings suggest that gender discrimination can adversely influence regular mammography screening in some women. With nearly half of women nonadherent to screening mammography guidelines in this study and with decreasing mammography rates nationwide, it is important to address the complexity of nonadherence across subgroups of women. Life stressors, such as experiences of gender discrimination, may have considerable consequences, potentially influencing health prevention prioritization in women.

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

Science.gov (United States)

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.

Evaluation of the population dose to the UK population from the National Health Service breast screening programme

International Nuclear Information System (INIS)

Faulkner, K.; Wallis, M. G.; Neilson, F.; Whitaker, C. J.

2008-01-01

In the United Kingdom National Health Service Breast Screening Programme (NHSBSP), women aged between 50 and 70 y are invited for mammography every 3 y. Screening histories for each woman, over four screening rounds, were analysed. Data from five screening programmes were used to select 57 425 women into the study. Cases were selected on the basis of being between the ages of 50 and 53 at the start of the NHSBSP (i.e. between 1989 and 1992). Assessment of the outcome for each screening round for each woman involved assigning a simple outcome code. Each of the possible pathways through the four screening rounds was analysed. This comprises of 500 possible pathways. This data enabled the following information to be determined: (i) The number of times a woman attended the screening programme. (ii) The number of women referred for assessment at each screening round. This information may be used to deduce the population dose to this group of women averaged over four screening rounds. Patient doses have been monitored since the programme's inception and are typically 4.5 mGy for two-view screening. It is possible to determine the mean glandular dose received by this cohort of women over four screening rounds by multiplying the number of examinations by the mean glandular dose for a typical woman. Allowance has to be made for the number of projections taken at each screening round. Once a woman has been screened, she may be invited back for further assessment if an abnormality is found on her mammogram. A stereotactic attachment is used to determine where to place the biopsy device. Although the dose received during a normal screening mammogram is well known, the dose for a stereotactic procedure and other assessment procedures is less well known, partly because only a small part of the breast is directly irradiated during stereo-taxis. However, the woman may have multiple exposures during this stage. A prospective survey of doses was completed to deduce the mean

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.

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

Science.gov (United States)

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

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

Science.gov (United States)

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.

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

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

Science.gov (United States)

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.

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.

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.

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…

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.

Exposure of birds to radionuclides and other contaminants in Special Protection Areas (SPAs) in North-West England

International Nuclear Information System (INIS)

Marshall, K.; Watson, S.; McDonald, P.; Copplestone, D.; Watts, S.J.

2010-01-01

There has been a decline in the population of some bird species at Morecambe Bay and the Solway Firth Special Protected Areas in North-West England during the last fifty years. It was suggested that the declines were caused, in part, by contaminants in the food and environment, primarily from the radioactive effluent discharge from the Sellafield Ltd nuclear fuel reprocessing plant in Cumbria. This study analysed bird feathers and tissues, vegetation and sediment for radionuclides, metals and persistent organic compounds. The non-radionuclide results were all low compared to relevant action limits. The ERICA model was used with field data to estimate the radiological dose to birds from exposure to 137 Cs and 241 Am with results between 1.26 to 3.83 μGy h -1 , below the ERICA screening level of 10 μGy h -1 and within the IAEA 40 μGy h -1 guideline value below which potential adverse impacts on biota are unlikely. The study showed no link between bird population decline and anthropogenic discharges to the SPAs.

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.

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.

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

Science.gov (United States)

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

Social Policy and Governance: Conceptual Reflections on Ageing in England

Directory of Open Access Journals (Sweden)

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.

What Could Replace the Phonics Screening Check during the Early Years of Reading Development?

OpenAIRE

Glazzard, J

2017-01-01

This article argues that the phonics screening check, introduced in England in 2012, is not fit for purpose. It is a test of children’s ability to decode words rather than an assessment of their reading skills. Whilst this assessment may, to some extent, support the needs of children who rely on phonemic decoding as a route to word recognition, it does not support the needs of more advanced readers who have automatic word recognition. In addition, for children who struggle with phonemic decod...

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....

Mixed messages: An evaluation of NHS Trust Social Media policies in the North West of England.

Science.gov (United States)

Scragg, B; Shaikh, S; Robinson, L; Mercer, C

2017-08-01

Despite National Health Service (NHS) information strategy promoting the use of Social Media (SoMe) to encourage greater engagement between service users and providers, a team investigating online SoMe interaction between breast screening practitioners and clients found that practitioners alleged discouragement from employers' policies. This study aimed to investigate whether this barrier was genuine, and illuminate whether local policy differed from national strategy. The study used a qualitative grounded theory approach to generate a theory. Nine policies from the North West of England were analysed. A framework was derived from the data, and an analysis of policy tone followed by a detailed coding of policy content was undertaken. Comparative analysis continued by reviewing the literature, and a condensed framework revealed five broad categories that policies addressed. The analysis revealed the policies varied in content, but not in tone, which was mostly discouraging. Coding the content revealed that the most frequently addressed point was that of protecting the employers' reputation, and after further analysis, the resultant condensed framework showed that policies were imbalanced and heavily skewed towards Security, Conduct & Behaviour and Reputation. Practitioners within breast screening services are discouraged by overly prohibitive and prescriptive SoMe policies; with these varying tremendously in comprehensiveness, but with a narrow focus on security and employers reputation; in contrast with national strategy. Recommendations are that policy revision is undertaken with consultation by more than one stakeholder, and SoMe training is offered for all members of NHS staff. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

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.

Science.gov (United States)

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.

Science.gov (United States)

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.

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

Science.gov (United States)

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

Science.gov (United States)

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

Directory of Open Access Journals (Sweden)

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

Science.gov (United States)

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…

How is adults' screen time behaviour influencing their views on screen time restrictions for children? A cross-sectional study.

Science.gov (United States)

Schoeppe, Stephanie; Rebar, Amanda L; Short, Camille E; Alley, Stephanie; Van Lippevelde, Wendy; Vandelanotte, Corneel

2016-03-01

High screen time in children and its detrimental health effects is a major public health problem. How much screen time adults think is appropriate for children remains little explored, as well as whether adults' screen time behaviour would determine their views on screen time restrictions for children. This study aimed to investigate how adults' screen time behaviour influences their views on screen time restrictions for children, including differences by gender and parental status. In 2013, 2034 Australian adults participated in an online survey conducted by the Population Research Laboratory at Central Queensland University, Rockhampton. Adult screen time behaviour was assessed using the Workforce Sitting Questionnaire. Adults reported the maximum time children aged between 5-12 years should be allowed to spend watching TV and using a computer. Ordinal logistic regression was used to compare adult screen time behaviour with views on screen time restrictions for children. Most adults (68%) held the view that children should be allowed no more than 2 h of TV viewing and computer use on school days, whilst fewer adults (44%) thought this screen time limit is needed on weekend days. Women would impose higher screen time restrictions for children than men (p 2 h on watching TV and using the computer at home on work days (66%) and non-work days (88%). Adults spending ≤ 2 h/day in leisure-related screen time were less likely to permit children > 2 h/day of screen time. These associations did not differ by adult gender and parental status. Most adults think it is appropriate to limit children's screen time to the recommended ≤ 2 h/day but few adults themselves adhere to this screen time limit. Adults with lower screen use may be more inclined to limit children's screen time. Strategies to reduce screen time in children may also need to target adult screen use.

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

Directory of Open Access Journals (Sweden)

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.

Science.gov (United States)

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)

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...

[Comparing audiological evaluation and screening: a study on presbycusis].

Science.gov (United States)

Samelli, Alessandra Giannella; Negretti, Camila Aparecida; Ueda, Kerli Saori; Moreira, Renata Rodrigues; Schochat, Eliane

2011-01-01

Given the high prevalence of presbycusis and the damage it brings about, a screening test can be useful in the identification of hearing loss in primary care. To estimate the prevalence of hearing loss in a representative sample of elderly people living at Butantan using an audiological screening method (questionnaire) and a basic audiological evaluation; to compare the results of the two kinds of evaluations, checking the validity of this tool for hearing loss screening. Cross sectional descriptive study. 200 individuals (above 60 years old, both genders) were randomly selected to undergo audiological screening (questionnaire). Another randomly selected group encompassed 100 individuals who were submitted to a set of audiological tests. Then, we compared the results from the two methods. There were no statistically significant associations between the questionnaire and the degree of hearing loss of the patients. The prevalence of hearing loss in our sample was of 56% in the screening and of 95% when checked by the audiological evaluation. Therefore, screening was not proven valid to assess hearing when compared to audiological evaluation.

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

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

Zagreb Amblyopia Preschool Screening Study: near and distance visual acuity testing increase the diagnostic accuracy of screening for amblyopia.

Science.gov (United States)

Bušić, Mladen; Bjeloš, Mirjana; Petrovečki, Mladen; Kuzmanović Elabjer, Biljana; Bosnar, Damir; Ramić, Senad; Miletić, Daliborka; Andrijašević, Lidija; Kondža Krstonijević, Edita; Jakovljević, Vid; Bišćan Tvrdi, Ana; Predović, Jurica; Kokot, Antonio; Bišćan, Filip; Kovačević Ljubić, Mirna; Motušić Aras, Ranka

2016-02-01

To present and evaluate a new screening protocol for amblyopia in preschool children. Zagreb Amblyopia Preschool Screening (ZAPS) study protocol performed screening for amblyopia by near and distance visual acuity (VA) testing of 15 648 children aged 48-54 months attending kindergartens in the City of Zagreb County between September 2011 and June 2014 using Lea Symbols in lines test. If VA in either eye was >0.1 logMAR, the child was re-tested, if failed at re-test, the child was referred to comprehensive eye examination at the Eye Clinic. 78.04% of children passed the screening test. Estimated prevalence of amblyopia was 8.08%. Testability, sensitivity, and specificity of the ZAPS study protocol were 99.19%, 100.00%, and 96.68% respectively. The ZAPS study used the most discriminative VA test with optotypes in line as they do not underestimate amblyopia. The estimated prevalence of amblyopia was considerably higher than reported elsewhere. To the best of our knowledge, the ZAPS study protocol reached the highest sensitivity and specificity when evaluating diagnostic accuracy of VA tests for screening. The pass level defined at ≤0.1 logMAR for 4-year-old children, using Lea Symbols in lines missed no amblyopia cases, advocating that both near and distance VA testing should be performed when screening for amblyopia.

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.

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

Science.gov (United States)

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

Directory of Open Access Journals (Sweden)

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.

Science.gov (United States)

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.

Variations in screening outcome among pairs of screening radiologists at non-blinded double reading of screening mammograms: a population-based study

NARCIS (Netherlands)

Klompenhouwer, E. G.; Duijm, L. E. M.; Voogd, A. C.; den Heeten, G. J.; Nederend, J.; Jansen, F. H.; Broeders, M. J. M.

2014-01-01

Substantial inter-observer variability in screening mammography interpretation has been reported at single reading. However, screening results of pairs of screening radiologists have not yet been published. We determined variations in screening performances among pairs of screening radiologists at

Pre-entry screening programmes for tuberculosis in migrants to low-incidence countries: a systematic review and meta-analysis.

Science.gov (United States)

Aldridge, Robert W; Yates, Tom A; Zenner, Dominik; White, Peter J; Abubakar, Ibrahim; Hayward, Andrew C

2014-12-01

Several high-income countries have pre-entry screening programmes for tuberculosis. We aimed to establish the yield of pre-entry screening programmes to inform evidence-based policy for migrant health screening. We searched six bibliographic databases for experimental or observational studies and systematic reviews, which reported data on migrant screening for active or latent tuberculosis by any method before migration to a low-incidence country. Primary outcomes were principal reported screening yield of active tuberculosis, yield of culture-confirmed cases, and yield of sputum smear for acid-fast bacilli cases. Where appropriate, fixed-effects models were used to summarise the yield of pre-entry screening across included studies. We identified 15 unique studies with data for 3 739 266 migrants screened pre-entry for tuberculosis between 1982 and 2010. Heterogeneity was high for all primary outcomes. After stratification by prevalence in country of origin, heterogeneity was reduced for culture-confirmed and smear-confirmed cases. Yield of culture-confirmed cases increased with prevalence in the country of origin, and summary estimates ranged from 19·7 (95% CI 10·3-31·5) cases identified per 100 000 individuals screened in countries with a prevalence of 50-149 cases per 100 000 population to 335·9 (283·0-393·2) per 100 000 in countries with a prevalence of greater than 350 per 100 000 population. Targeting high-prevalence countries could result in the highest yield for active disease. Pre-entry screening should be considered as part of a broad package of measures to ensure early diagnosis and effective management of migrants with active tuberculosis, and be integrated with initiatives that address the health needs of migrants. Wellcome Trust, UK National Institute for Health Research, Medical Research Council, Public Health England. Copyright © 2014 Aldridge et al. Open Access article distributed under the terms of CC BY. Published by Elsevier

Ebola 2014: Setting up a port health screening programme at an international train station.

Science.gov (United States)

Cleary, Vivien; Wynne-Evans, Edward; Freed, James; Fleet, Katie; Thorn, Simone; Turbitt, Deborah

2017-12-01

An outbreak of Ebola virus disease (EVD) began in Guinea in December 2013 and was declared a Public Health Emergency of International Concern by the World Health Organization in August 2014. In October, the UK government tasked Public Health England (PHE) to set up EVD screening at key ports. The key aim of port-of-entry screening was to identify passengers coming from areas with high risk of EVD, and give them advice to raise their awareness of symptoms and what actions to take. Direct flights from Sierra Leone, Guinea or Liberia had all been cancelled, so intelligence on passenger numbers and routes was used to identify the most commonly used routes from the affected countries into the UK. One of these was St Pancras International train station. Screening had never previously been implemented at a UK train station so had to be set up from scratch. Key to the success of this was excellent multi-agency working between PHE, the UK Border Force, Eurostar, Network Rail and the Cabinet Office. This paper gives an overview of the activation of EVD screening at St Pancras International and the subsequent decommissioning.

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

Science.gov (United States)

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).

Spent-fuel-stabilizer screening studies

International Nuclear Information System (INIS)

Wynhoff, N.; Girault, S.E.; Fish, R.L.

1980-11-01

A broad range of potential stabilizer materials was identified and screened for packaging spent fuel assemblies for underground storage. The screening took into consideration the thermal gradient, stress, differential thermal expansion, nuclear criticality, radiation shielding, cost, and availability. Recommended stabilizer materials for further testing include silica, quartz, mullite, zircon, bentonite, graphite, gases, lead, Zn alloys, Cu alloys, etc

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

How is adults’ screen time behaviour influencing their views on screen time restrictions for children? A cross-sectional study

Directory of Open Access Journals (Sweden)

Stephanie Schoeppe

2016-03-01

Full Text Available Abstract Background High screen time in children and its detrimental health effects is a major public health problem. How much screen time adults think is appropriate for children remains little explored, as well as whether adults’ screen time behaviour would determine their views on screen time restrictions for children. This study aimed to investigate how adults’ screen time behaviour influences their views on screen time restrictions for children, including differences by gender and parental status. Methods In 2013, 2034 Australian adults participated in an online survey conducted by the Population Research Laboratory at Central Queensland University, Rockhampton. Adult screen time behaviour was assessed using the Workforce Sitting Questionnaire. Adults reported the maximum time children aged between 5–12 years should be allowed to spend watching TV and using a computer. Ordinal logistic regression was used to compare adult screen time behaviour with views on screen time restrictions for children. Results Most adults (68 % held the view that children should be allowed no more than 2 h of TV viewing and computer use on school days, whilst fewer adults (44 % thought this screen time limit is needed on weekend days. Women would impose higher screen time restrictions for children than men (p  2 h on watching TV and using the computer at home on work days (66 % and non-work days (88 %. Adults spending ≤ 2 h/day in leisure-related screen time were less likely to permit children > 2 h/day of screen time. These associations did not differ by adult gender and parental status. Conclusions Most adults think it is appropriate to limit children’s screen time to the recommended ≤ 2 h/day but few adults themselves adhere to this screen time limit. Adults with lower screen use may be more inclined to limit children’s screen time. Strategies to reduce screen time in children may also need to target adult screen use.

Colonoscopic screening for colorectal cancer improves quality of life measures: a population-based screening study

Directory of Open Access Journals (Sweden)

Shadbolt Bruce

2006-10-01

Full Text Available Abstract Background Screening asymptomatic individuals for neoplasia can have adverse consequences on quality of life. Colon cancer screening is widespread but the quality of life (QOL consequences are unknown. This study determined the impact of screening colonoscopy on QOL measures in asymptomatic average-risk participants. Methods Asymptomatic male and female participants aged 55–74 years were randomly selected from the Australian Electoral Roll or six primary care physicians' databases. Participants completed the Short-Form (SF-36 Quality of Life Assessment at baseline and at a mean of 39 days after colonoscopy. Outcome measures were (i significant changes in raw scores in any of the eight SF-36 domains assessed following colonoscopic screening and (ii improvements or declines in previously validated categories, representing clinically significant changes, within any of the eight SF-36 domains. Results Baseline QOL measures were similar to those of a matched general population sample. Role Limitations due to Emotions, Mental Health and Vitality raw scores significantly improved following colonoscopy (P Conclusion Average-risk persons benefit significantly from colon cancer screening with colonoscopy, improving in Mental Health and Vitality domains of Quality of Life. This improvement is not offset by declines in other domains.

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…

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 ...

Detections of MTBE in surficial and bedrock aquifers in New England

International Nuclear Information System (INIS)

Grady, S.J.

1995-01-01

The gasoline additive methyl tert-butyl ether (MTBE) was detected in 24% of water samples collected from surficial and bedrock aquifers in areas of New England. MTBE was the most frequently detected volatile organic compound among the 60 volatile chemicals analyzed and was present in 33 of 133 wells sampled from July 1993 through September 1995. The median MTBE concentration measured in ground-water samples was 0.45 microgram per liter and concentrations ranged from 0.2 to 5.8 microgram per liter. The network of wells sampled for MTBE consisted of 103 monitoring wells screened in surficial sand-and-gravel aquifers and 30 domestic-supply wells in fractured crystalline bedrock aquifers. Seventy-seven percent of all MTBE detections were from 26 shallow monitoring wells screened in surficial aquifers. MTBE was detected in42% of monitoring wells in urban areas. In agricultural areas, MTBE was detected i 8% (2 of 24) of wells and was not detected in undeveloped areas. Sixty-two percent of the MTBE detections in surficial aquifers were from wells within 0.25 mile of gasoline stations or underground gasoline storage tanks; all but one of these wells were in Connecticut and Massachusetts, where reformulated gasoline is used. MTBE was detected in 23% of deep domestic-supply wells that tapped fractured bedrock aquifers. MTBE was detected in bedrock wells only in Connecticut and Massachusetts; land use near the wells was suburban to rural, and none of the sampled bedrock wells were within 0.25 mile of a gasoline station

Danish method study on cervical screening in women offered HPV vaccination as girls (Trial23): a study protocol.

Science.gov (United States)

Thamsborg, Lise Holst; Andersen, Berit; Larsen, Lise Grupe; Christensen, Jette; Johansen, Tonje; Hariri, Jalil; Christiansen, Sanne; Rygaard, Carsten; Lynge, Elsebeth

2018-05-26

The first birth cohorts of women offered human papillomavirus (HPV) vaccination as girls are now entering cervical screening. However, there is no international consensus on how to screen HPV vaccinated women. These women are better protected against cervical cancer and could therefore be offered less intensive screening. Primary HPV testing is more sensitive than cytology, allowing for a longer screening interval. The aim of Trial23 is to investigate if primary HPV testing with cytology triage of HPV positive samples is a reasonable screening scheme for women offered HPV vaccination as girls. Trial23 is a method study embedded in the existing cervical screening programme in four out of five Danish regions. Without affecting the screening programme, women born in 1994 are randomised to present screening with liquid-based cytology every third year (present programme arm) or present screening plus an HPV test (HPV arm). The study started 1 February 2017 and will run over three screening rounds corresponding to 7-8 years. The primary endpoint is cervical intraepithelial neoplasia grade 3 or above. The trial is undertaken as a non-inferiority study including intention-to-treat and per-protocol analyses. The potential effect of primary HPV screening with a 6-year interval will be calculated from the observed data. The study protocol has been submitted to the ethical committee and deemed a method study. All women are screened according to routine guidelines. The study will contribute new evidence on the future screening of HPV vaccinated birth cohorts of women. All results will be published in open-access journal. NCT03049553; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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...

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

Breast cancer screening; cost-effective in practice?

International Nuclear Information System (INIS)

Koning, Harry J. de

2000-01-01

The main aim of national breast screening is a reduction in breast cancer mortality. The data on the reduction in breast cancer mortality from three (of the five) Swedish trials in particular gave rise to the expectation that the Dutch programme of 2-yearly screening for women aged 50-70 would produce a 16% reduction in the total population. In all likelihood, many of the years of life gained as a result of screening are enjoyed in good health. According to its critics the actual benefit that can be achieved from the national breast cancer screening programmes is overstated. Considerable benefits have recently been demonstrated in England and Wales. However, the fall was so considerable in such a relatively short space of time that screening (started in 1987) was thought to only have played a small part. As far as the Dutch screening programme is concerned it is still too early to reach any conclusions about a possible reduction in mortality. The first short-term results of the screening are favourable and as good as (or better than) expectations. In Swedish regions where mammographic screening was introduced, a 19% reduction in breast cancer mortality can be estimated at population level, and recently a 20% reduction was presented in the UK. In countries where women are expected to make appointments for screening themselves, the attendance figures are significantly lower and the quality of the process as a whole is sometimes poorer. The benefits of breast cancer screening need to be carefully balanced against the burden to women and to the health care system. Mass breast screening requires many resources and will be a costly service. Cost-effectiveness of a breast cancer screening programme can be estimated using a computer model. Published cost-effectiveness ratios may differ tremendously, but are often the result of different types of calculation, time periods considered, including or excluding downstream cost. The approach of simulation and estimation is here

Barriers to colorectal cancer screening in community health centers: A qualitative study

Directory of Open Access Journals (Sweden)

Fletcher Robert H

2008-02-01

Full Text Available Abstract Background Colorectal cancer screening rates are low among disadvantaged patients; few studies have explored barriers to screening in community health centers. The purpose of this study was to describe barriers to/facilitators of colorectal cancer screening among diverse patients served by community health centers. Methods We identified twenty-three outpatients who were eligible for colorectal cancer screening and their 10 primary care physicians. Using in-depth semi-structured interviews, we asked patients to describe factors influencing their screening decisions. For each unscreened patient, we asked his or her physician to describe barriers to screening. We conducted patient interviews in English (n = 8, Spanish (n = 2, Portuguese (n = 5, Portuguese Creole (n = 1, and Haitian Creole (n = 7. We audiotaped and transcribed the interviews, and then identified major themes in the interviews. Results Four themes emerged: 1 Unscreened patients cited lack of trust in doctors as a barrier to screening whereas few physicians identified this barrier; 2 Unscreened patients identified lack of symptoms as the reason they had not been screened; 3 A doctor's recommendation, or lack thereof, significantly influenced patients' decisions to be screened; 4 Patients, but not their physicians, cited fatalistic views about cancer as a barrier. Conversely, physicians identified competing priorities, such as psychosocial stressors or comorbid medical illness, as barriers to screening. In this culturally diverse group of patients seen at community health centers, similar barriers to screening were reported by patients of different backgrounds, but physicians perceived other factors as more important. Conclusion Further study of these barriers is warranted.

Perceived discrimination and cancer screening behaviors in US Hispanics: the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study.

Science.gov (United States)

Valdovinos, Cristina; Penedo, Frank J; Isasi, Carmen R; Jung, Molly; Kaplan, Robert C; Giacinto, Rebeca Espinoza; Gonzalez, Patricia; Malcarne, Vanessa L; Perreira, Krista; Salgado, Hugo; Simon, Melissa A; Wruck, Lisa M; Greenlee, Heather A

2016-01-01

Perceived discrimination has been associated with lower adherence to cancer screening guidelines. We examined whether perceived discrimination was associated with adherence to breast, cervical, colorectal, and prostate cancer screening guidelines in US Hispanic/Latino adults. Data were obtained from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study, including 5,313 Hispanic adults aged 18–74 from Bronx, NY, Chicago, IL, Miami, FL, and San Diego, CA, and those who were within appropriate age ranges for specific screening tests were included in the analysis. Cancer screening behaviors were assessed via self-report. Perceived discrimination was measured using the Perceived Ethnic Discrimination Questionnaire. Confounder-adjusted multivariable polytomous logistic regression models assessed the association between perceived discrimination and adherence to cancer screening guidelines. Among women eligible for screening, 72.1 % were adherent to cervical cancer screening guidelines and 71.3 %were adherent to breast cancer screening guidelines. In participants aged 50–74, 24.6 % of women and 27.0 % of men were adherent to fecal occult blood test guidelines; 43.5 % of women and 34.8 % of men were adherent to colonoscopy/sigmoidoscopy guidelines; 41.0 % of men were adherent to prostate-specific antigen screening guidelines. Health insurance coverage, rather than perceived ethnic discrimination,was the variable most associated with receiving breast, cervical,colorectal, or prostate cancer screening. The influence of discrimination as a barrier to cancer screening may be modest among Hispanics/Latinos in urban US regions. Having health insurance facilitates cancer screening in this population. Efforts to increase cancer screening in Hispanics/Latinos should focus on increasing access to these services, especially among the uninsured.

The fertility of recent migrants to England and Wales

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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

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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…

Breast Cancer Challenges and Screening in China: Lessons From Current Registry Data and Population Screening Studies.

Science.gov (United States)

Song, Qing-Kun; Wang, Xiao-Li; Zhou, Xin-Na; Yang, Hua-Bing; Li, Yu-Chen; Wu, Jiang-Ping; Ren, Jun; Lyerly, Herbert Kim

2015-07-01

screening program targeting women aged 35-59 years had a low detection rate that resulted in a second-generation screening program that extended the cohort size and ages screened to 35-64 years. Cancer registration has been active in China for decades; however, a national survey of registries has not been routinely reported. This study used MapInfo to describe the reported data and found asymmetric registration activities, geographic variations in breast cancer (BC) burdens, and an increasing incidence with a peak at age 50. The initial Chinese BC screening programs focused on a relatively young population of women aged 35-59 years and had a low detection rate, but 69.7% of patients had early stage BC. Older women were included in the second-generation screening programs, and an additional 6 million women were screened. Consideration of regional variations and age is necessary to optimize the efficiency and utility of BC screening in China, with the ultimate goal to reduce BC mortality. ©AlphaMed Press.

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...

Using educational outreach and a financial incentive to increase general practices’ contribution to chlamydia screening in South-East London 2003–2011

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Kalwij Sebastian

2012-09-01

Full Text Available Abstract Background The London Boroughs of Lambeth and Southwark have high levels of sexually transmitted infections including Chlamydia trachomatis. Modelling studies suggest that reductions in the prevalence of chlamydia infection will require a high level of population screening coverage and positivity among those screened. General practice has a potentially important role to play in delivering these levels of coverage since large numbers (up to 60% of young people visit their general practice every year but previous work suggests that there are barriers to delivering screening in this setting. The aim of this study was to evaluate an intervention to increase chlamydia screening in general practice within Primary Care Trusts (PCTs of Lambeth and Southwark, a strategy combining financial incentives and supportive practice visits to raise awareness and solve problems. Methods Data on age, gender, venue and chlamydia result for tests on under 25 s in Lambeth from 2003–11 was obtained from the National Chlamydia Screening Programme. We analysed the number and percentage of tests generated in general practice, and looked at the number of practices screening more than 10% of their practice cohort of 15–24 year olds, male/female ratio and positivity rates across other screening venues. We also looked at practices screening less than 10% and studied change over time. We compared data from Lambeth and Southwark with London and England. We also studied features of the level and type of educational and financial incentive interventions employed. Results Chlamydia tests performed in general practice increased from 23 tests in 2003–4 to 4813 tests in 2010–11 in Lambeth. In Southwark they increased from 5 tests in 2003/04 to 4321 in 2010/11. In 2011, 44.6% of tests came from GPs in Lambeth and 46% from GP’s in Southwark. In Lambeth 62.7% of practices tested more than 10% of their cohort and in Southwark this was 55.8%. In Lambeth, postivity

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.

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

Science.gov (United States)

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/

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

Grading and disease management in national screening for diabetic retinopathy in England and Wales.

Science.gov (United States)

Harding, S; Greenwood, R; Aldington, S; Gibson, J; Owens, D; Taylor, R; Kohner, E; Scanlon, P; Leese, G

2003-12-01

A National Screening Programme for diabetic eye disease in the UK is in development. We propose a grading and early disease management protocol to detect sight-threatening diabetic retinopathy and any retinopathy, which will allow precise quality assurance at all steps while minimizing false-positive referral to the hospital eye service. Expert panel structured discussions between 2000 and 2002 with review of existing evidence and grading classifications. Principles of the protocol include: separate grading of retinopathy and maculopathy, minimum number of steps, compatible with central monitoring, expandable for established more complex systems and for research, no lesion counting, no 'questionable' lesions, attempt to detect focal exudative, diffuse and ischaemic maculopathy and fast track referral from primary or secondary graders. Sight-threatening diabetic retinopathy is defined as: preproliferative retinopathy or worse, sight-threatening maculopathy and/or the presence of photocoagulation. In the centrally reported minimum data set retinopathy is graded into four levels: none (R0), background (R1), preproliferative (R2), proliferative (R3). Maculopathy and photocoagulation are graded as absent (M0, P0) or present (M1, P1). The protocol developed by the Diabetic Retinopathy Grading and Disease Management Working Party represents a new consensus upon which national guidelines can be based leading to the introduction of quality-assured screening for people with diabetes.

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.

Preferences for Mental Health Screening Among Pregnant Women: A Cross-Sectional Study.

Science.gov (United States)

Kingston, Dawn E; Biringer, Anne; McDonald, Sheila W; Heaman, Maureen I; Lasiuk, Gerri C; Hegadoren, Kathy M; McDonald, Sarah D; Veldhuyzen van Zanten, Sander; Sword, Wendy; Kingston, Joshua J; Jarema, Karly M; Vermeyden, Lydia; Austin, Marie-Paule

2015-10-01

The process of mental health screening can influence disclosure, uptake of referral, and treatment; however, no studies have explored pregnant women's views of methods of mental health screening. The objectives of this study are to determine pregnant women's comfort and preferences regarding mental health screening. Pregnant women were recruited (May-December 2013) for this cross-sectional descriptive survey from prenatal classes and maternity clinics in Alberta, Canada, if they were aged >16 years and spoke/read English. Descriptive statistics summarized acceptability of screening, and multivariable logistic regression identified factors associated with women's comfort with screening methods. Analysis was conducted in January-December 2014. The participation rate was 92% (N=460/500). Overall, 97.6% of women reported that they were very (74.8%) or somewhat (22.8%) comfortable with mental health screening in pregnancy. Women were most comfortable with completing paper- (>90%) and computer-based (>82%) screening in a clinic or at home, with fewest reporting comfort with telephone-based screening (62%). The majority of women were very/somewhat comfortable with provider-initiated (97.4%) versus self-initiated (68.7%) approaches. Women's ability to be honest with their provider about emotional health was most strongly associated with comfort with each method of screening. The majority of pregnant women viewed prenatal mental health screening favorably and were comfortable with a variety of screening methods. These findings provide evidence of high acceptability of screening--a key criterion for implementation of universal screening--and suggest that providers can select from a variety of screening methods best suited for their clinical setting. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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.

The potential for measles transmission in England

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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.

Screens

OpenAIRE

2016-01-01

This Sixth volume in the series The Key Debates. Mutations and Appropriations in European Film Studies investigates the question of screens in the context both of the dematerialization due to digitalization and the multiplication of media screens. Scholars offer various infomations and theories of topics such as the archeology of screen, film and media theories, contemporary art, pragmatics of new ways of screening (from home video to street screening).

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

Science.gov (United States)

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.

National outbreak of Salmonella Enteritidis phage type 14b in England, September to December 2009: case-control study.

Science.gov (United States)

Janmohamed, K; Zenner, D; Little, C; Lane, C; Wain, J; Charlett, A; Adak, B; Morgan, D

2011-04-14

We conducted an unmatched retrospective case–control study to investigate an upsurge of non-travel-related sporadic cases of infection with Salmonella enterica subsp. enterica serotype Enteritidis phage type 14b with antimicrobial resistance to nalidixic acid and partial resistance to ciprofloxacin (S. Enteritidis PT 14b NxCp(L)) that was reported in England from 1 September to 31 December 2009. We analysed data from 63 cases and 108 controls to determine whether cases had the same sources of infection as those found through investigation of 16 concurrent local foodborne outbreaks in England and Wales. Multivariable logistic regression analysis adjusting for age and sex identified food consumption at restaurants serving Chinese or Thai cuisine (odds ratio (OR): 4.4; 95% CI: 1.3–14.8; p=0.02), egg consumed away from home (OR: 5.1; 95% CI: 1.3–21.2; p=0.02) and eating vegetarian foods away from home (OR: 14.6; 95% CI: 2.1–99; p=0.006) as significant risk factors for infection with S. Enteritidis PT 14b NxCp(L). These findings concurred with those from the investigation of the16 outbreaks, which identified the same Salmonella strain in eggs from a specified source outside the United Kingdom. The findings led to a prohibition of imports from this source, in order to control the outbreak.

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

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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…

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...

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.

Screening for congenital hypothyroidism (CH) among Filipino newborn infants. Philippine Newborn Screening Study Group.

Science.gov (United States)

Fagela-Domingo, C; Padilla, C D; Cutiongco, E M

1999-01-01

From June 1996 to June 1998 a total of 62.841 newborn infants were screened for congenital hypothyroidism with thyroid stimulating hormone assay as a primary test. The method used was an immunofluorescent assay using the DELFIA TSH Kit on dried blood specimens collected by heelprick on filter paper. All infants with TSH values greater than 20 microU/ml were retested. If the results remained abnormally high, confirmatory testing was done by radioimmunoassay. All infants who were confirmed to be hypothyroid were referred to pediatric endocrinologists for initial management. The overall weighted incidence of congenital hypothyroidism obtained in this study was 0.000277 (95% CI; 0.000122 - 0.000432) or 1:3,610 which may be higher than that reported by most screening programs worldwide. The recall rate was 0.16%. The higher recall rate may be explained by early testing in a number of cases and by the possibility of iodine deficiency in some of the mothers. On the basis of the results of this study, we would recommend (1) screening on a greater number of infants to verify the incidence of CH and (2) establishing normal TSH values at different hours of life to improve our recall rate.

[Hearing screening at nursery schools: results of an evaluation study].

Science.gov (United States)

Weichbold, Viktor; Rohrer, Monika; Winkler, Cornelia; Welzl-Müller, Kunigunde

2004-07-31

This study aimed to evaluate the hearing screening of pre-school children at nursery schools in Tyrol, Austria. 47 nursery schools with a total of 2199 enrolled children participated in the study. At the screening, the children were presented a series of tones at frequencies 0.5 kHz (25dB), 1 kHz, 2 kHz, 3 kHz, and 4 kHz (20 dB each) from portable audiometers. The tones were presented over headphones for each ear separately and at irregular intervals. Failure to respond to any of the frequencies was considered failure of the screening. Parents were then advised in written form to have the child examined by an ENT-specialist. 1832 individuals were screened (coverage: 83% of nursery school children; corresponding to at least 63% of all Tyrolean children aged 3 to 5 years). Of these, 390 failed the test (referral rate: 21% of all screened). Examination through an ENT-specialist occurred with 217 children, and this confirmed the positive test in 139 children (hit rate: 64%). In most cases, a temporary conductive hearing loss due to external or middle ear problems (glue ear, tube dysfunction, cerumen, otitis media) was diagnosed. A sensorineural hearing loss was found in 4 children (in 3 of them bilateral). The need for therapy was recognized in 81 children (4% of all screened). Pre-school hearing screening identifies children with ear and hearing problems that need therapeutical intervention. Although the hearing problems are mostly of a temporary nature, some may require monitoring over some period. Also some children with permanent sensorineural hearing loss may be detected through this measure. Hearing screening is an efficient means of assessing ear and hearing problems in pre-school children. However, the follow-up rate needs to be improved for optimizing the efficacy.

Groundwater vulnerability to onshore unconventional and conventional hydrocarbon activities in England

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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

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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

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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…

A Multi-Center Diabetes Eye Screening Study in Community Settings: Study Design and Methodology.

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Murchison, Ann P; Friedman, David S; Gower, Emily W; Haller, Julia A; Lam, Byron L; Lee, David J; McGwin, Gerald; Owsley, Cynthia; Saaddine, Jinan; Insight Study Group

2016-01-01

Diabetes is the leading cause of new cases of blindness among adults aged 20-74 years within the United States. The Innovative Network for Sight Research group (INSIGHT) designed the Diabetic Eye Screening Study (DESS) to examine the feasibility and short-term effectiveness of non-mydriatic diabetic retinopathy (DR) screening for adults with diabetes in community-based settings. Study enrollment began in December 2011 at four sites: an internal medicine clinic at a county hospital in Birmingham, Alabama; a Federally-qualified community healthcare center in Miami-Dade County, Florida; a university-affiliated outpatient pharmacy in Philadelphia, Pennsylvania; and a medical home in Winston-Salem, North Carolina. People 18 years or older with previously diagnosed diabetes were offered free DR screening using non-mydriatic retinal photography that was preceded by a brief questionnaire addressing demographic information and previous eye care use. Visual acuity was also measured for each eye. Images were evaluated at a telemedicine reading center by trained evaluators using the National Health System DR grading classification. Participants and their physicians were sent screening report results and telephoned for a follow-up survey 3 months post-screening to determine whether participants had sought follow-up comprehensive eye care and their experiences with the screening process. Target enrollment at each site was a minimum of 500 persons. Three of the four sites met this enrollment goal. The INSIGHT/DESS is intended to establish the feasibility and short-term effectiveness of DR screening using non-mydriatic retinal photography in persons with diabetes who seek services in community-based clinic and pharmacy settings.

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

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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 ...

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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.

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.

Determinants of general practitioners' wages in England.

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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.

Nurses' roles in screening for intimate partner violence: a phenomenological study.

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Al-Natour, A; Qandil, A; Gillespie, G L

2016-09-01

To describe Jordanian nurses' roles and practices in screening for intimate partner violence. Intimate partner violence is a recognized global health problem with a prevalence of 37% for the Eastern Mediterranean region. Jordanian nurses screening for intimate partner violence is as low as 10.8%. Nurses have encountered institutional and personal barriers hindering their screening practice. A descriptive phenomenological design was used for this study. A purposive sample of 12 male and female Jordanian nurses working at a university hospital in Jordan participated. Participants were interviewed in 2014 using a semi-structured, face-to-face interview. Steps of Colaizzi's phenomenological method were used to analyse the qualitative data. Four themes were derived from the data: (1) screening practices and roles for suspected IPV cases, (2) advantages for screening and disadvantages for not screening for intimate partner violence, (3) factors hindering screening practice and (4) feelings towards screening and not screening for intimate partner violence. Increasing Jordanian nurses' awareness of the need for intimate partner violence screening in this sample was needed. Professional education and training may facilitate the adoption of intimate partner violence screening practices. A key barrier to intimate partner violence screening is Jordanian nurses' personal beliefs. Overcoming these personal beliefs will necessitate a multi-faceted approach starting with schools of nursing and bridging into healthcare settings. Healthcare professionals including nursing and policy makers at health institutions should enforce screening policies and protocols for all receipt of care at first contact. In addition, an emphasis on modelling culturally congruent approaches to develop the trusting nurse-patient relationships and process for screening patients for intimate partner violence. © 2016 International Council of Nurses.

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

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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.

Factors affecting attendance to cervical cancer screening among women in the Paracentral Region of El Salvador: a nested study within the CAPE HPV screening program.

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Alfaro, Karla M; Gage, Julia C; Rosenbaum, Alan J; Ditzian, Lauren R; Maza, Mauricio; Scarinci, Isabel C; Miranda, Esmeralda; Villalta, Sofia; Felix, Juan C; Castle, Philip E; Cremer, Miriam L

2015-10-16

Cervical cancer is the third most commonly occurring cancer among women and the fourth leading cause of cancer-related deaths in women worldwide, with more than 85 % of these cases occurring in developing countries. These global disparities reflect the differences in cervical cancer screening rates between high-income and medium- and low-income countries. At 19 %, El Salvador has the lowest reported screening coverage of all Latin American countries. The purpose of this study is to identify factors affecting public sector HPV DNA-based cervical cancer screening participation in El Salvador. This study was nested within a public sector screening program where health promoters used door-to-door outreach to recruit women aged 30-49 years to attend educational sessions about HPV screening. A subgroup of these participants was chosen randomly and questioned about demographic factors, healthcare utilization, previous cervical cancer screening, and HPV knowledge. Women then scheduled screening appointments at their public health clinics. Screening participants were adherent if they attended their scheduled appointment or rescheduled and were screened within 6 months. The association between non-adherence and demographic variables, medical history, history of cancer, sexual history, birth control methods, and screening barriers was assessed using Chi-square tests of significance and logistic regression. All women (n = 409) enrolled in the study scheduled HPV screening appointments, and 88 % attended. Non-adherence was associated with a higher number of lifetime partners and being under-screened-defined as not having participated in cervical cancer screening within the previous 3 years (p = 0.03 and p = 0.04, respectively); 22.8 % of participants in this study were under-screened. Adherence to cervical cancer screening after educational sessions was higher than expected, in part due to interactions with the community-based health promoters as well as the educational session

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

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

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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.

Study of mammography in mass screening for breast cancer

International Nuclear Information System (INIS)

Kitada, Masahiro; Sakai, Hiroko; Kubo, Yoshihiko; Samejima, Natsuki; Kurowarabi, Kunio; Iwabuchi, Shuji.

1995-01-01

In order to examine the rate of correct diagnosis by mammography at initial mass screening for breast cancer, we carried out a retrospective study of mammography findings in 267 cases of breast cancer detected at Asahikawa Cancer Screening Center. The screening was performed by physical examination, and in cases where disease was suspected, mammography, ultrasonography, and needle biopsy were done. Mammographically, 172 cases (64.4%) were cancer-positive, 58 cases (21.7%) were suspicious for cancer, and 37 cases (13.9%) were cancer-negative. Patients below 50 years of age and those with tumors of small diameter (<20 mm) showed a significantly lower rate of cancer positivity than patients aged 50 years or more and those with tumors 20 mm or more in diameter. Mammographic abnormalities were not specific, since these changes were also found in normal subjects and patients with benign diseases. Therefore, we concluded that mammography without physical examination at initial mass screening has a high risk of missing breast cancer. Mass screening for breast cancer should be performed by physical examination involving inspection and palpation at the first instance. If any suspicious findings are obtained, mammography, ultrasonography, and needle biopsy should be done. (author)

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.

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

Associations between the organisation of stroke services, process of care, and mortality in England: prospective cohort study.

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Bray, Benjamin D; Ayis, Salma; Campbell, James; Hoffman, Alex; Roughton, Michael; Tyrrell, Pippa J; Wolfe, Charles D A; Rudd, Anthony G

2013-05-10

To estimate the relations between the organisation of stroke services, process measures of care quality, and 30 day mortality in patients admitted with acute ischaemic stroke. Prospective cohort study. Hospitals (n=106) admitting patients with acute stroke in England and participating in the Stroke Improvement National Audit Programme and 2010 Sentinel Stroke Audit. 36,197 adults admitted with acute ischaemic stroke to a participating hospital from 1 April 2010 to 30 November 2011. Associations between process of care (the assessments, interventions, and treatments that patients receive) and 30 day all cause mortality, adjusting for patient level characteristics. Process of care was measured using six individual measures of stroke care and summarised into an overall quality score. Of 36,197 patients admitted with acute ischaemic stroke, 25,904 (71.6%) were eligible to receive all six care processes. Patients admitted to stroke services with high organisational scores were more likely to receive most (5 or 6) of the six care processes. Three of the individual processes were associated with reduced mortality, including two care bundles: review by a stroke consultant within 24 hours of admission (adjusted odds ratio 0.86, 95%confidence interval 0.78 to 0.96), nutrition screening and formal swallow assessment within 72 hours (0.83, 0.72 to 0.96), and antiplatelet therapy and adequate fluid and nutrition for first the 72 hours (0.55, 0.49 to 0.61). Receipt of five or six care processes was associated with lower mortality compared with receipt of 0-4 in both multilevel (0.74, 0.66 to 0.83) and instrumental variable analyses (0.62, 0.46 to 0.83). Patients admitted to stroke services with higher levels of organisation are more likely to receive high quality care as measured by audited process measures of acute stroke care. Those patients receiving high quality care have a reduced risk of death in the 30 days after stroke, adjusting for patient characteristics and

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

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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…

Controversies about cervical cancer screening: A qualitative study of Roma women's (non)participation in cervical cancer screening in Romania.

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Andreassen, Trude; Weiderpass, Elisabete; Nicula, Florian; Suteu, Ofelia; Itu, Andreea; Bumbu, Minodora; Tincu, Aida; Ursin, Giske; Moen, Kåre

2017-06-01

Romania has Europe's highest incidence and mortality of cervical cancer. While a free national cervical cancer-screening programme has been in operation since 2012, participation in the programme is low, particularly in minority populations. The aim of this study was to explore Roma women's (non)participation in the programme from women's own perspectives and those of healthcare providers and policy makers. We carried out fieldwork for a period of 125 days in 2015/16 involving 144 study participants in Cluj and Bucharest counties. Fieldwork entailed participant observation, qualitative interviewing and focus group discussions. A striking finding was that screening providers and Roma women had highly different takes on the national screening programme. We identified four fundamental questions about which there was considerable disagreement between them: whether a free national screening programme existed in the first place, whether Roma women were meant to be included in the programme if it did, whether Roma women wanted to take part in screening, and to what degree screening participation would really benefit women's health. On the background of insights from actor-network theory, the article discusses to what degree the programme could be said to speak to the interest of its intended Roma public, and considers the controversies in light of the literature on patient centred care and user involvement in health care. The paper contributes to the understanding of the health and health-related circumstances of the largest minority in Europe. It also problematizes the use of the concept of "barriers" in research into participation in cancer screening, and exemplifies how user involvement can potentially help transform and improve screening programmes. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

The screening effects of the screened exchange hybrid functional in surface systems: A case study on the CO/Pt(111) problem

Energy Technology Data Exchange (ETDEWEB)

Li, H., E-mail: li-huanglong@mail.tsinghua.edu.cn [Department of Precision Instrument, Tsinghua University, Beijing, 100084 (China); Gillen, R. [Institut für Festkörperphysik. Technische Universität Berlin. Hardenbergstr. 36, 10623 Berlin (Germany); Robertson, J., E-mail: jr214@cam.ac.uk [Engineering Department, University of Cambridge, Cambridge CB2 1PZ (United Kingdom)

2016-06-15

The screened exchange (sX) hybrid functional has been widely used in computational material science. Although it has widely been studied in bulk systems, less is known about its functional behavior in surface systems which are crucial to many technologies such as materials synthesis and nano-electronic devices. Assessing the screening dependent functional behaviors in the surface systems is therefore important for its application in such systems. In this work, we investigate the screening effects of the sX in CO adsorption on Pt(111) surface. The differences between the sX and Heyd-Scuseria-Ernzerhof (HSE06) hybrid functionals, and the effects of screening parameters are studied. The screening has two effects: first, the HOMO-LUMO gap is screening dependent. This affects the site preference most significantly. In this work, atop adsorption of CO/Pt(111) is predicted by the hybrid functionals with screened exchange potential. The sX(1.44) gives the largest HOMO-LUMO gap for the isolated CO molecule. The adsorption energy difference between the atop and fcc site is also the largest by the sX(1.44) which is explained by the reduced metal d states to the CO 2π* state back-donation, with stronger effect for the fcc adsorption than for the atop adsorption; second, the adsorption energy is screening dependent. This can be seen by comparing the sX(2.38) and HSE06 which have different screening strengths. They show similar surface band structures for the CO adsorption but different adsorption energies, which is explained by the stronger CO 5σ state to the metal d states donation or the effectively screened Pauli repulsion. This work underlines the screening strength as a main difference between sX and HSE06, as well as an important hybrid functional parameter for surface calculation.

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

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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.

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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.

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.

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)

Register-based studies of cancer screening effects

DEFF Research Database (Denmark)

Von Euler-Chelpin, My; Lynge, Elsebeth; Rebolj, Matejka

2011-01-01

INTRODUCTION: There are two organised cancer screening programmes in Denmark, against cervical and breast cancers. The aim with this study was to give an overview of the available register-based research regarding these two programmes, to demonstrate the usefulness of data from the national regis...

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...

Overdiagnosis in breast cancer screening: The impact of study design and calculations.

Science.gov (United States)

Lynge, Elsebeth; Beau, Anna-Belle; Christiansen, Peer; von Euler-Chelpin, My; Kroman, Niels; Njor, Sisse; Vejborg, Ilse

2017-07-01

Overdiagnosis in breast cancer screening is an important issue. A recent study from Denmark concluded that one in three breast cancers diagnosed in screening areas in women aged 50-69 years were overdiagnosed. The purpose of this short communication was to disentangle the study's methodology in order to evaluate the soundness of this conclusion. We found that both the use of absolute differences as opposed to ratios; the sole focus on non-advanced tumours and the crude allocation of tumours and person-years by screening history for women aged 70-84 years, all contributed to the very high estimate of overdiagnosis. Screening affects cohorts of screened women. Danish registers allow very accurate mapping of the fate of every woman. We should be past the phase where studies of overdiagnosis are based on the fixed age groups from routine statistics. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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

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…

Impact of Prostatic-specific Antigen Threshold and Screening Interval in Prostate Cancer Screening Outcomes: Comparing the Swedish and Finnish European Randomised Study of Screening for Prostate Cancer Centres.

Science.gov (United States)

Saarimäki, Lasse; Hugosson, Jonas; Tammela, Teuvo L; Carlsson, Sigrid; Talala, Kirsi; Auvinen, Anssi

2017-08-10

The European Randomised Study of Screening for Prostate Cancer trial has shown a 21% reduction in prostate cancer (PC) mortality with prostate-specific antigen (PSA)-based screening. Sweden used a 2-yr screening interval and showed a larger mortality reduction than Finland with a 4-yr interval and higher PSA cut-off. To evaluate the impact of screening interval and PSA cut-off on PC detection and mortality. We analysed the core age groups (55-69 yr at entry) of the Finnish (N=31 866) and Swedish (N=5901) screening arms at 13 yr and 16 yr of follow-up. Sweden used a screening interval of 2 yr and a PSA cut-off of 3.0ng/ml, while in Finland the screening interval was 4 yr and the PSA cut-off 4.0ng/ml (or PSA 3.0-3.9ng/ml with free PSAprostate-specific antigen threshold of 3ng/ml versus 4ng/ml or a screening interval of 2 yr instead of 4 yr is unlikely to explain the larger mortality reduction achieved in Sweden compared with Finland. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Barriers to cervical cancer screening in Mulanje, Malawi: a qualitative study

Directory of Open Access Journals (Sweden)

Victoria K Fort

2011-03-01

Full Text Available Victoria K Fort1, Mary Sue Makin2, Aaron J Siegler1, Kevin Ault3, Roger Rochat11Rollins School of Public Health, Atlanta, Georgia, USA; 2Mulanje Mission Hospital, Mulanje, Malawi; 3Emory University Medical School, Atlanta, Georgia, USABackground: In Malawi, cervical cancer is the most prevalent form of cancer among women, with an 80% mortality rate. The Mulanje Mission Hospital has offered free cervical cancer screening for eight years; however, patients primarily seek medical help for gynecologic complaints after the disease is inoperable.Methods: We investigated how women in rural Malawi make health-seeking decisions regarding cervical cancer screening using qualitative research methods. The study was conducted between May and August of 2009 in Mulanje, Malawi.Results: This study found that the primary cue to action for cervical cancer screening was symptoms of cervical cancer. Major barriers to seeking preventative screening included low knowledge levels, low perceived susceptibility and low perceived benefits from the service. Study participants did not view cervical cancer screening as critical health care. Interviews suggested that use of the service could increase if women are recruited while visiting the hospital for a different service.Conclusion: This study recommends that health care providers and health educators target aspects of perceived susceptibility among their patients, including knowledge levels and personal risk assessment. We believe that continued support and advertisement of cervical cancer screening programs along with innovative recruitment strategies will increase usage density and decrease unnecessary deaths from cervical cancer in Malawi.Keywords: cervical cancer, interviews, health care, Mulanje Mission Hospital

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,…

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

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)

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...

Feasibility and acceptability of targeted screening for congenital CMV-related hearing loss.

Science.gov (United States)

Williams, Eleri J; Kadambari, Seilesh; Berrington, Janet E; Luck, Suzanne; Atkinson, Claire; Walter, Simone; Embleton, Nicholas D; James, Peter; Griffiths, Paul; Davis, Adrian; Sharland, Mike; Clark, Julia E

2014-05-01

Congenital cytomegalovirus (cCMV) is the most common non-genetic cause of sensorineural hearing loss (SNHL) in children. Ganciclovir has been shown to prevent the continued deterioration in hearing of children with symptomatic cCMV, but some children with cCMV-related SNHL are unidentified in the neonatal treatment period. Neonatal cCMV screening provides an opportunity to identify infants with cCMV-related SNHL who might benefit from early treatment. To assess the feasibility (ability to take samples before 3 weeks of age and clinical assessment by 30 days of age) and acceptability (maternal anxiety) of targeted CMV testing of infants who are 'referred' for further audiological testing after routine newborn hearing screening programme (NHSP). Parents of infants who have 'no clear responses' on routine NHSP before 22 days of life in London and North East England were approached. Salivary and urine samples were tested by CMV PCR. At recruitment and 3 months, the short form Spielberger State-Trait Anxiety Inventory measured maternal anxiety. 411 infants were recruited. 99% (407/411) returned a sample; 98% (404/411) successfully yielded a CMV result, 6 had cCMV, all diagnosed on salivary samples taken CMV within 3 weeks. All positive screening CMV results were known by day 23, and 5/6 infants with cCMV were assessed within 31 days. Anxiety was not increased in mothers of infants screened for cCMV. Targeted salivary screening for cCMV within the NHSP is feasible, acceptable and detects infants with cCMV-related SNHL who could benefit from early treatment.

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.

Mixed messages: An evaluation of NHS Trust Social Media policies in the North West of England

International Nuclear Information System (INIS)

Scragg, B.; Shaikh, S.; Robinson, L.; Mercer, C.

2017-01-01

Introduction: Despite National Health Service (NHS) information strategy promoting the use of Social Media (SoMe) to encourage greater engagement between service users and providers, a team investigating online SoMe interaction between breast screening practitioners and clients found that practitioners alleged discouragement from employers' policies. This study aimed to investigate whether this barrier was genuine, and illuminate whether local policy differed from national strategy. Method: The study used a qualitative grounded theory approach to generate a theory. Nine policies from the North West of England were analysed. A framework was derived from the data, and an analysis of policy tone followed by a detailed coding of policy content was undertaken. Comparative analysis continued by reviewing the literature, and a condensed framework revealed five broad categories that policies addressed. Results: The analysis revealed the policies varied in content, but not in tone, which was mostly discouraging. Coding the content revealed that the most frequently addressed point was that of protecting the employers' reputation, and after further analysis, the resultant condensed framework showed that policies were imbalanced and heavily skewed towards Security, Conduct & Behaviour and Reputation. Conclusion: Practitioners within breast screening services are discouraged by overly prohibitive and prescriptive SoMe policies; with these varying tremendously in comprehensiveness, but with a narrow focus on security and employers reputation; in contrast with national strategy. Recommendations are that policy revision is undertaken with consultation by more than one stakeholder, and SoMe training is offered for all members of NHS staff. - Highlights: • Practitioners are discouraged from using SoMe by employers' policies. • This is at odds with national strategy of engagement with all stakeholders. • Policies are skewed towards protecting reputation and

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...

Contributing Factors to Colorectal Cancer Screening among Chinese People: A Review of Quantitative Studies

Directory of Open Access Journals (Sweden)

Doris Y. P. Leung

2016-05-01

Full Text Available Colorectal cancer (CRC is a major health problem in Asia. It has been reported that the Chinese are more susceptible to CRC than many other ethnic groups. Screening for CRC is a cost-effective prevention and control strategy; however, the screening rates among the Chinese are sub-optimal. We conducted a review to identify the factors associated with CRC screening participation among Chinese people. Twenty-two studies that examined the factors related to CRC screening behaviors among the Chinese were identified through five databases. Seven factors were consistently reported to influence CRC screening behaviors in at least one of the studies: socio-demographic characteristics (educational level, health insurance, and knowledge about CRC and its screening; psychological factors (perceived severity of CRC, susceptibility of having CRC, and barriers to screening; and contact with medical provider (physician recommendation. The evidence base for many of these relationships is quite limited. Furthermore, the associations of many factors, including age, gender, income, cancer worry/fear, and self-efficacy with CRC screening behaviors, were mixed or inconsistent across these studies, thereby indicating that more studies are needed in this area.

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.

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

Energy Technology Data Exchange (ETDEWEB)

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.

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...

Scintillating screens study for LEIR/LHC heavy ion beams

CERN Document Server

Bal, C; Lefèvre, T; Scrivens, R; Taborelli, M

2005-01-01

It has been observed on different machines that scintillating ceramic screens (like chromium doped alumina) are quickly damaged by low energy ion beams. These particles are completely stopped on the surface of the screens, inducing both a high local temperature increase and the electrical charging of the material. A study has been initiated to understand the limiting factors and the damage mechanisms. Several materials, ZrO2, BN and Al2O3, have been tested at CERN on LINAC3 with 4.2MeV/u lead ions. Alumina (Al2O3) is used as the reference material as it is extensively used in beam imaging systems. Boron nitride (BN) has better thermal properties than Alumina and Zirconium oxide (ZrO2). BN has in fact the advantage of increasing its electrical conductivity when heated. This contribution presents the results of the beam tests, including the post-mortem analysis of the screens and the outlook for further measurements. The strategy for the choice of the screens for the Low Energy Ion Ring (LEIR), currently under ...

Fatal Child Maltreatment in England, 2005-2009

Science.gov (United States)

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…

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.

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...

Diabetic Retinopathy Screening Using Telemedicine Tools: Pilot Study in Hungary

Directory of Open Access Journals (Sweden)

Dóra J. Eszes

2016-01-01

Full Text Available Introduction. Diabetic retinopathy (DR is a sight-threatening complication of diabetes. Telemedicine tools can prevent blindness. We aimed to investigate the patients’ satisfaction when using such tools (fundus camera examination and the effect of demographic and socioeconomic factors on participation in screening. Methods. Pilot study involving fundus camera screening and self-administered questionnaire on participants’ experience during fundus examination (comfort, reliability, and future interest in participation, as well as demographic and socioeconomic factors was performed on 89 patients with known diabetes in Csongrád County, a southeastern region of Hungary. Results. Thirty percent of the patients had never participated in any ophthalmological screening, while 25.7% had DR of some grade based upon a standard fundus camera examination and UK-based DR grading protocol (Spectra™ software. Large majority of the patients were satisfied with the screening and found it reliable and acceptable to undertake examination under pupil dilation; 67.3% were willing to undergo nonmydriatic fundus camera examination again. There was a statistically significant relationship between economic activity, education and marital status, and future interest in participation. Discussion. Participants found digital retinal screening to be reliable and satisfactory. Telemedicine can be a strong tool, supporting eye care professionals and allowing for faster and more comfortable DR screening.

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

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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...

CANCER SCREENING AWARENESS AMONG NURSING STAFF IN GOVERNMENT MEDICAL COLLEGE: A PROSPECTIVE STUDY

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Mukesh Shanthilal

2016-07-01

Full Text Available BACKGROUND Cervical and breast cancers are the common malignancies among female population in India. Though there are approved screening methods available to prevent and detect these cancers at an early stage, there is a lack of awareness about cancer screening among general public as well as the health care professionals. This study is aimed to identify the knowledge, attitude and practice (KAP among the nursing staff regarding cancer screening in these two diseases. METHOD A cross-sectional interview based survey was conducted among 303 female nursing staff working in a government medical college hospital from November 2015 to December 2015. Ethical committee approval was taken. Verbal informed consent was sought from the study subjects. Nursing staff who gave consent to participate in the study were enrolled. There were no specific inclusion or exclusion criteria for the study subjects. A structured pretested questionnaire regarding knowledge, attitude and practice (KAP was used to collect the data. The questions were open-ended. Recall and recognition type of questions were used. The data was entered into MS Excel worksheet and analysed using descriptive statistics. RESULTS Total of 303 nurses included in the study. The age ranged from 21 to 64 years. Median age is 38 years. Only 24.4% (74/303 of Nurses were aware of cancer screening and many of them were aware of Pap smear (55.1%, 167/303 and mammogram (66.3%, 201/303 as investigational tools in diagnosing cancer. Only 17 out of 303 (5.6% nurses had Pap smear test done with an average of 1.23% Pap smear per individual. Mammogram screening was done in 13% (15/115 of the eligible nurses with an average of 1.2% mammogram per individual. The most common reason for not undergoing screening as expressed was they did not feel the need to be screened unless they were symptomatic (55%, they are too young for screening (14.8%, shyness (11.1%, fear (11.1% and lack of time (7.4%. However, 90% of them

Site locality identification study: Hanford Site. Volume I. Methodology, guidelines, and screening

International Nuclear Information System (INIS)

1980-07-01

Presented in this report are the results of the site locality identification study for the Hanford Site using a screening process. To enable evaluation of the entire Hanford Site, the screening process was applied to a somewhat larger area; i.e., the Pasco Basin. The study consisted of a series of screening steps that progressively focused on smaller areas which are within the Hanford Site and which had a higher potential for containing suitable repository sites for nuclear waste than the areas not included for further study. Five site localities, designated H-1, H-2, H-3, H-4, H-5 (Figure A), varying in size from approximately 10 to 50 square miles, were identified on the Hanford Site. It is anticipated that each site locality may contain one or more candidate sites suitable for a nuclear waste repository. The site locality identification study began with definition of objectives and the development of guidelines for screening. Three objectives were defined: (1) maximize public health and safety; (2) minimize adverse environmental and socioeconomic impacts; and (3) minimize system costs. The screening guidelines have numerical values that provided the basis for the successive reduction of the area under study and to focus on smaller areas that had a higher likelihood of containing suitable sites

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

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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

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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…

The effect of information about false negative and false positive rates on people's attitudes towards colorectal cancer screening using faecal occult blood testing (FOBt).

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Miles, Anne; Rodrigues, Vania; Sevdalis, Nick

2013-11-01

To examine the impact of numeric risk information about false negative (FN) and false positive (FP) rates in faecal occult blood testing (FOBt) on attitudes towards screening. 95 people aged 45-59, living in England, read 6 hypothetical vignettes presented online about the use of FOB testing to detect bowel cancer, in which information about FN and FP rates was systematically varied. Both verbal and numeric FN risk information reduced people's interest in screening compared with no FN information. Numeric FN risk information reduced people's perceptions of screening effectiveness and lowered perceived trust in the results of screening compared with both verbal FN information and no FN information. FP information did not affect attitudes towards FOB testing. There was limited evidence that FN information reduced interest and perceptions of screening effectiveness more in educated groups. Numeric FN risk information decreased people's perceptions of screening effectiveness and trust in the results of screening but did not affect people's interest in screening anymore than verbal FN risk information. Numeric FN information could be added to patient information without affecting interest in screening, although this needs to be replicated in a larger, more representative sample. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

11 New England Organizations Recognized as Energy Star Partners

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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.

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.

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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/.

iScreen: Image-Based High-Content RNAi Screening Analysis Tools.

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Zhong, Rui; Dong, Xiaonan; Levine, Beth; Xie, Yang; Xiao, Guanghua

2015-09-01

High-throughput RNA interference (RNAi) screening has opened up a path to investigating functional genomics in a genome-wide pattern. However, such studies are often restricted to assays that have a single readout format. Recently, advanced image technologies have been coupled with high-throughput RNAi screening to develop high-content screening, in which one or more cell image(s), instead of a single readout, were generated from each well. This image-based high-content screening technology has led to genome-wide functional annotation in a wider spectrum of biological research studies, as well as in drug and target discovery, so that complex cellular phenotypes can be measured in a multiparametric format. Despite these advances, data analysis and visualization tools are still largely lacking for these types of experiments. Therefore, we developed iScreen (image-Based High-content RNAi Screening Analysis Tool), an R package for the statistical modeling and visualization of image-based high-content RNAi screening. Two case studies were used to demonstrate the capability and efficiency of the iScreen package. iScreen is available for download on CRAN (http://cran.cnr.berkeley.edu/web/packages/iScreen/index.html). The user manual is also available as a supplementary document. © 2014 Society for Laboratory Automation and Screening.

Modelling the relationship between obesity and mental health in children and adolescents: findings from the Health Survey for England 2007

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Summerbell Carolyn D

2011-10-01

Full Text Available Abstract A number of studies have reported significant associations between obesity and poor psychological wellbeing in children but findings have been inconsistent. Methods: This study utilised data from 3,898 children aged 5-16 years obtained from the Health Survey for England 2007. Information was available on Body Mass Index (BMI, parental ratings of child emotional and behavioural health (Strengths and Difficulties Questionnaire, self-reported physical activity levels and sociodemographic variables. A multilevel modelling approach was used to allow for the clustering of children within households. Results: Curvilinear relationships between both internalising (emotional and externalising (behavioural symptoms and adjusted BMI were observed. After adjusting for potential confounders the relationships between obesity and psychological adjustment (reported externalising and internalising symptoms remained statistically significant. Being overweight, rather than obese, had no impact on overall reported mental health. 17% of children with obesity were above the suggested screening threshold for emotional problems, compared to 9% of non-obese children. Allowing for clustering and potential confounding variables children classified as obese had an odds ratio (OR of 2.13 (95% CI 1.39 to 3.26 for being above the screening threshold for an emotional disorder compared to non-obese young people. No cross-level interactions between household income and the relationships between obesity and internalising or externalising symptoms were observed. Conclusions: In this large, representative, UK-based community sample a curvilinear association with emotional wellbeing was observed for adjusted BMI suggesting the possibility of a threshold effect. Further research could focus on exploring causal relationships and developing targeted interventions.

Choosing Wisely Imaging Recommendations: Initial Implementation in New England Emergency Departments

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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

Men's perspectives of prostate cancer screening: A systematic review of qualitative studies.

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Laura J James

Full Text Available Prostate cancer is the most commonly diagnosed non-skin cancer in men. Screening for prostate cancer is widely accepted; however concerns regarding the harms outweighing the benefits of screening exist. Although patient's play a pivotal role in the decision making process, men may not be aware of the controversies regarding prostate cancer screening. Therefore we aimed to describe men's attitudes, beliefs and experiences of prostate cancer screening.Systematic review and thematic synthesis of qualitative studies on men's perspectives of prostate cancer screening. Electronic databases and reference lists were searched to October 2016.Sixty studies involving 3,029 men aged from 18-89 years, who had been screened for prostate cancer by Prostate Specific Antigen (PSA or Digital Rectal Examination (DRE and not screened, across eight countries were included. Five themes were identified: Social prompting (trusting professional opinion, motivation from family and friends, proximity and prominence of cancer; gaining decisional confidence (overcoming fears, survival imperative, peace of mind, mental preparation, prioritising wellbeing; preserving masculinity (bodily invasion, losing sexuality, threatening manhood, medical avoidance; avoiding the unknown and uncertainties (taboo of cancer-related death, lacking tangible cause, physiological and symptomatic obscurity, ambiguity of the procedure, confusing controversies; and prohibitive costs.Men are willing to participate in prostate cancer screening to prevent cancer and gain reassurance about their health, particularly when supported or prompted by their social networks or healthcare providers. However, to do so they needed to mentally overcome fears of losing their masculinity and accept the intrusiveness of screening, the ambiguities about the necessity and the potential for substantial costs. Addressing the concerns and priorities of men may facilitate informed decisions about prostate cancer screening

Politics, Society and Communication in the Constitution of Modern Society: Early Modern England

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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

77 FR 71585 - Brookfield Energy Marketing LP v. ISO New England Inc.; Notice of Complaint

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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...

[Economic impact of lung cancer screening in France: A modeling study].

Science.gov (United States)

Gendarme, S; Perrot, É; Reskot, F; Bhoowabul, V; Fourre, G; Souquet, P-J; Milleron, B; Couraud, S

2017-09-01

The National Lung Screening Trial found that, in a selected population with a high risk of lung cancer, an annual low-dose CT-scan decreased lung cancer mortality by 20% and overall mortality by 7% compared to annual chest X-Ray. In France, a work group stated that individual screening should be considered in this setting. However, the economic impact of an organized and generalized (to all eligible individuals) screening in France was never reported. This is a modeling study using French population demographic data and published data from randomized screening trials. We used the same selection criteria as NLST: 55-74-year-old smokers for at least 30 pack-years, current smoker or quit less than 15 years. We computed a second model including also 50-54-year-old individuals. Then, we used different participation rates: 65%, 45%, and 32%. According to the considered model, there would be 1,650,588 to 2,283,993 subjects eligible to screening in France. According to the model and participation rate, lung cancer screening would diagnose 3600 to 10,118 stages 1/2 lung cancer each year. There would be 5991 to 16,839 false-positives, of whom 1416 to 3981 would undergo unnecessary surgery. Screening policy would cost 105 to 215 € million per year. However, increasing the price of a cigarette pack by 0.05 to 0.10 € would fully cover the screening costs. Participation rate is a key point for screening impact. Screening could be easily funded by a small increase in cigarette prices. Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.

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.

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)

Final screening round of the NELSON lung cancer screening trial: the effect of a 2.5-year screening interval

NARCIS (Netherlands)

Yousaf-Khan, U.; Aalst, C. van der; Jong, P.A. de; Heuvelmans, M.; Scholten, E.T.; Lammers, J.-W.J.; Ooijen, P. van; Nackaerts, K.; Weenink, C.; Groen, H.; Vliegenthart, R.; Haaf, K. Ten; Oudkerk, M.; Koning, H. de

2016-01-01

In the USA annual lung cancer screening is recommended. However, the optimal screening strategy (eg, screening interval, screening rounds) is unknown. This study provides results of the fourth screening round after a 2.5-year interval in the Dutch-Belgian Lung Cancer Screening trial

Final screening round of the NELSON lung cancer screening trial : the effect of a 2.5-year screening interval

NARCIS (Netherlands)

Yousaf-Khan, Uraujh; van der Aalst, Carlijn; de Jong, Pim A; Heuvelmans, Marjolein; Scholten, Ernst; Lammers, Jan-Willem; van Ooijen, Peter; Nackaerts, Kristiaan; Weenink, Carla; Groen, Harry; Vliegenthart, Rozemarijn; Ten Haaf, Kevin; Oudkerk, Matthijs; de Koning, Harry

BACKGROUND: In the USA annual lung cancer screening is recommended. However, the optimal screening strategy (eg, screening interval, screening rounds) is unknown. This study provides results of the fourth screening round after a 2.5-year interval in the Dutch-Belgian Lung Cancer Screening trial

Final screening round of the NELSON lung cancer screening trial : the effect of a 2.5-year screening interval

NARCIS (Netherlands)

Yousaf-Khan, Uraujh; van der Aalst, Carlijn; de Jong, Pim A.; Heuvelmans, Marjolein; Scholten, Ernst; Lammers, Jan-Willem; van Ooijen, Peter; Nackaerts, Kristiaan; Weenink, Carla; Groen, Harry; Vliegenthart, Rozemarijn; Ten Haaf, Kevin; Oudkerk, Matthijs; de Koning, Harry

Background In the USA annual lung cancer screening is recommended. However, the optimal screening strategy (eg, screening interval, screening rounds) is unknown. This study provides results of the fourth screening round after a 2.5-year interval in the Dutch-Belgian Lung Cancer Screening trial

Primary care colorectal cancer screening correlates with breast cancer screening: implications for colorectal cancer screening improvement interventions.

Science.gov (United States)

Weiss, Jennifer M; Pandhi, Nancy; Kraft, Sally; Potvien, Aaron; Carayon, Pascale; Smith, Maureen A

2018-04-25

National colorectal cancer (CRC) screening rates have plateaued. To optimize interventions targeting those unscreened, a better understanding is needed of how this preventive service fits in with multiple preventive and chronic care needs managed by primary care providers (PCPs). This study examines whether PCP practices of other preventive and chronic care needs correlate with CRC screening. We performed a retrospective cohort study of 90 PCPs and 33,137 CRC screening-eligible patients. Five PCP quality metrics (breast cancer screening, cervical cancer screening, HgbA1c and LDL testing, and blood pressure control) were measured. A baseline correlation test was performed between these metrics and PCP CRC screening rates. Multivariable logistic regression with clustering at the clinic-level estimated odds ratios and 95% confidence intervals for these PCP quality metrics, patient and PCP characteristics, and their relationship to CRC screening. PCP CRC screening rates have a strong correlation with breast cancer screening rates (r = 0.7414, p < 0.001) and a weak correlation with the other quality metrics. In the final adjusted model, the only PCP quality metric that significantly predicted CRC screening was breast cancer screening (OR 1.25; 95% CI 1.11-1.42; p < 0.001). PCP CRC screening rates are highly concordant with breast cancer screening. CRC screening is weakly concordant with cervical cancer screening and chronic disease management metrics. Efforts targeting PCPs to increase CRC screening rates could be bundled with breast cancer screening improvement interventions to increase their impact and success.

75 FR 61746 - New England Wire Technologies Corp; Supplemental Notice That Initial Market-Based Rate Filing...

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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.

Randomized controlled dissemination study of community-to-clinic navigation to promote CRC screening: Study design and implications.

Science.gov (United States)

Larkey, Linda; Szalacha, Laura; Herman, Patricia; Gonzalez, Julie; Menon, Usha

2017-02-01

Regular screening facilitates early diagnosis of colorectal cancer (CRC) and reduction of CRC morbidity and mortality. Screening rates for minorities and low-income populations remain suboptimal. Provider referral for CRC screening is one of the strongest predictors of adherence, but referrals are unlikely among those who have no clinic home (common among poor and minority populations). This group randomized controlled study will test the effectiveness of an evidence based tailored messaging intervention in a community-to-clinic navigation context compared to no navigation. Multicultural, underinsured individuals from community sites will be randomized (by site) to receive CRC screening education only, or education plus navigation. In Phase I, those randomized to education plus navigation will be guided to make a clinic appointment to receive a provider referral for CRC screening. Patients attending clinic appointments will continue to receive navigation until screened (Phase II) regardless of initial arm assignment. We hypothesize that those receiving education plus navigation will be more likely to attend clinic appointments (H1) and show higher rates of screening (H2) compared to those receiving education only. Phase I group assignment will be used as a control variable in analysis of screening follow-through in Phase II. Costs per screening achieved will be evaluated for each condition and the RE-AIM framework will be used to examine dissemination results. The novelty of our study design is the translational dissemination model that will allow us to assess the real-world application of an efficacious intervention previously tested in a randomized controlled trial. Copyright © 2016. Published by Elsevier Inc.

Screening of cognitive impairment in patients with Parkinson's disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised.

Science.gov (United States)

Sobreira, Emmanuelle; Pena-Pereira, Márcio A; Eckeli, Alan L; Sobreira-Neto, Manoel A; Chagas, Marcos H N; Foss, Maria P; Cholerton, Brenna; Zabetian, Cyrus P; Mata, Ignacio F; Tumas, Vitor

2015-11-01

The aim of the present study is to examine the accuracy of the Brazilian versions of the Montreal Cognitive Assessment (MoCA) and the Addenbrooke's Cognitive Examination-Revised (ACE-R) to screen for mild cognitive impairment (PDMCI) and dementia (PDD) in patients with Parkinson's disease (PD). Both scales were administered to a final convenience sample of 79 patients with PD. Patients were evaluated by a neurologist, a psychiatrist and a neuropsychologist using UPDRS, Hoehn and Yahr and Schwab and England scales, global deterioration scale, a psychiatric structured interview, Mattis Dementia Rating Scale and other cognitive tests. There were 32 patients with PDMCI and 17 patients with PDD. The MoCA and the ACE-R were able to discriminate patients with PDD from the others. Both scales showed to be useful to screen for dementia but not for mild cognitive impairment in patients with PD.

Screening of cognitive impairment in patients with Parkinson's disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised

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Emmanuelle Sobreira

2015-11-01

Full Text Available ABSTRACTObjective The aim of the present study is to examine the accuracy of the Brazilian versions of the Montreal Cognitive Assessment (MoCA and the Addenbrooke's Cognitive Examination-Revised (ACE-R to screen for mild cognitive impairment (PDMCI and dementia (PDD in patients with Parkinson's disease (PD.Method Both scales were administered to a final convenience sample of 79 patients with PD. Patients were evaluated by a neurologist, a psychiatrist and a neuropsychologist using UPDRS, Hoehn and Yahr and Schwab and England scales, global deterioration scale, a psychiatric structured interview, Mattis Dementia Rating Scale and other cognitive tests.Results There were 32 patients with PDMCI and 17 patients with PDD. The MoCA and the ACE-R were able to discriminate patients with PDD from the others.Conclusion Both scales showed to be useful to screen for dementia but not for mild cognitive impairment in patients with PD.

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 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.

Danish method study on cervical screening in women offered HPV vaccination as girls (Trial23)

DEFF Research Database (Denmark)

Thamsborg, Lise Holst; Andersen, Berit; Larsen, Lise Grupe

2018-01-01

arm) or present screening plus an HPV test (HPV arm). The study started 1 February 2017 and will run over three screening rounds corresponding to 7-8 years. ANALYSES: The primary endpoint is cervical intraepithelial neoplasia grade 3 or above. The trial is undertaken as a non-inferiority study......INTRODUCTION: The first birth cohorts of women offered human papillomavirus (HPV) vaccination as girls are now entering cervical screening. However, there is no international consensus on how to screen HPV vaccinated women. These women are better protected against cervical cancer and could...... vaccination as girls. METHODS: Trial23 is a method study embedded in the existing cervical screening programme in four out of five Danish regions. Without affecting the screening programme, women born in 1994 are randomised to present screening with liquid-based cytology every third year (present programme...

Impact of national cancer policies on cancer survival trends and socioeconomic inequalities in England, 1996-2013: population based study

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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

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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.

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…

Innovation in European Vocational Education and Training: Network Learning in England, Finland and Germany

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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

Understanding the challenges to implementing case management for people with dementia in primary care in England: a qualitative study using Normalization Process Theory.

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Bamford, Claire; Poole, Marie; Brittain, Katie; Chew-Graham, Carolyn; Fox, Chris; Iliffe, Steve; Manthorpe, Jill; Robinson, Louise

2014-11-08

Case management has been suggested as a way of improving the quality and cost-effectiveness of support for people with dementia. In this study we adapted and implemented a successful United States' model of case management in primary care in England. The results are reported elsewhere, but a key finding was that little case management took place. This paper reports the findings of the process evaluation which used Normalization Process Theory to understand the barriers to implementation. Ethnographic methods were used to explore the views and experiences of case management. Interviews with 49 stakeholders (patients, carers, case managers, health and social care professionals) were supplemented with observation of case managers during meetings and initial assessments with patients. Transcripts and field notes were analysed initially using the constant comparative approach and emerging themes were then mapped onto the framework of Normalization Process Theory. The primary focus during implementation was on the case managers as isolated individuals, with little attention being paid to the social or organizational context within which they worked. Barriers relating to each of the four main constructs of Normalization Process Theory were identified, with a lack of clarity over the scope and boundaries of the intervention (coherence); variable investment in the intervention (cognitive participation); a lack of resources, skills and training to deliver case management (collective action); and limited reflection and feedback on the case manager role (reflexive monitoring). Despite the intuitive appeal of case management to all stakeholders, there were multiple barriers to implementation in primary care in England including: difficulties in embedding case managers within existing well-established community networks; the challenges of protecting time for case management; and case managers' inability to identify, and act on, emerging patient and carer needs (an essential, but

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.

Experimental study on image quality when using screens in mammography

International Nuclear Information System (INIS)

Maurer, H.J.; Goos, F.

1979-01-01

1) Different types of screens and X-ray films have been investigated using a Kodak mamma-phantom I.T.O. 745 and compared with conventional non screen industrial film radiography. 2) Dosisreduction by using screens depends on the used film/screen system. It is possible to reach a relation of 1:10. 3) The information depends on type of screen and of type of film. Therefore, it is possible to reach the information of non screen industrial film radiographs. 4) A suitable film/screen system allows without loss of any diagnostic information to replace non screen industrial films needing a high exposure dosis by a film/screen system needing decreased dosis. (orig.) [de

Screen-film mammography versus full-field digital mammography in a population-based screening program: The Sogn and Fjordane study

International Nuclear Information System (INIS)

Juel, Inger-Marie; Johannessen, Gunnar; Skaane, Per; Roth Hoff, Solveig; Hofvind, Solveig

2010-01-01

Background: Studies comparing analog and digital mammography in breast cancer screening have shown conflicting results. Little is known about the use of digital photon-counting detectors. Purpose: To retrospectively compare performance indicators in screen-film (SFM) and full-field digital mammography (FFDM) using a photon-counting detector in a population-based screening program. Material and Methods: The Norwegian Social Science Data Services approved the study, which was part of the Norwegian Breast Cancer Screening Program. The program invites women aged 50-69 years to two-view mammography biannually. The study period was January 2005 to June 2006 for SFM and August 2006 to December 2007 for FFDM. Independent double reading was performed using a five-point rating scale for probability of cancer. Recalls due to abnormal mammography were retrospectively reviewed by an expert panel. Performance indicators for the two techniques were compared. Attendance rate was 83.6% (7442/8901) for SFM and 82.0% (6932/8451) for FFDM. Results: The recall rate due to abnormal mammography, cancer detection rate and positive predictive value did not differ significantly between SFM and FFDM: recall 2.3% (174/7442) versus 2.4% (168/6932), cancer detection 0.39% (29/7442) versus 0.48% (33/6932), positive predictive value 16.7% (29/174) versus 19.6% (33/168), respectively (P>0.05 for all). The recall rate due to technically inadequate mammograms was 0.3% (19/7442) for SFM and 0.01% (1/6932) for FFDM. In the retrospective review, a significantly higher proportion of calcifications and asymmetric density were categorized as normal or definitively benign in FFDM compared with SFM. The average glandular dose was 2.17 mGy for SFM and 1.25 mGy for FFDM. Conclusion: Performance indicators show that FFDM using photon-counting detector is suitable for breast cancer screening. The lower radiation dose and lower recalls due to technically inadequate mammograms are of importance in mammography

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.

Liberal Conservatism, Vocationalism and Further Education in England

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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...

Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 11-13 weeks gestation.

Science.gov (United States)

O'Gorman, Neil; Wright, David; Syngelaki, Argyro; Akolekar, Ranjit; Wright, Alan; Poon, Leona C; Nicolaides, Kypros H

2016-01-01

Preeclampsia affects approximately 3% of all pregnancies and is a major cause of maternal and perinatal morbidity and death. In the last decade, extensive research has been devoted to early screening for preeclampsia with the aim of reducing the prevalence of the disease through pharmacologic intervention in the high-risk group starting from the first trimester of pregnancy. The purpose of this study was to develop a model for preeclampsia based on maternal demographic characteristics and medical history (maternal factors) and biomarkers. The data for this study were derived from prospective screening for adverse obstetric outcomes in women who attended for their routine first hospital visit at 11-13 weeks gestation in 2 maternity hospitals in England. We screened 35,948 singleton pregnancies that included 1058 pregnancies (2.9%) that experienced preeclampsia. Bayes theorem was used to combine the a priori risk from maternal factors with various combinations of uterine artery pulsatility index, mean arterial pressure, serum pregnancy-associated plasma protein-A, and placental growth factor multiple of the median values. Five-fold cross validation was used to assess the performance of screening for preeclampsia that delivered at preeclampsia) and ≥37 weeks gestation (term-preeclampsia) by models that combined maternal factors with individual biomarkers and their combination with screening by maternal factors alone. In pregnancies that experienced preeclampsia, the values of uterine artery pulsatility index and mean arterial pressure were increased, and the values of serum pregnancy-associated plasma protein-A and placental growth factor were decreased. For all biomarkers, the deviation from normal was greater for early than late preeclampsia; therefore, the performance of screening was related inversely to the gestational age at which delivery became necessary for maternal and/or fetal indications. Combined screening by maternal factors, uterine artery pulsatility

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.

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...

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.

Science.gov (United States)

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.

Observed and Predicted Risk of Breast Cancer Death in Randomized Trials on Breast Cancer Screening.

Science.gov (United States)

Autier, Philippe; Boniol, Mathieu; Smans, Michel; Sullivan, Richard; Boyle, Peter

2016-01-01

The role of breast screening in breast cancer mortality declines is debated. Screening impacts cancer mortality through decreasing the number of advanced cancers with poor diagnosis, while cancer treatment works through decreasing the case-fatality rate. Hence, reductions in cancer death rates thanks to screening should directly reflect reductions in advanced cancer rates. We verified whether in breast screening trials, the observed reductions in the risk of breast cancer death could be predicted from reductions of advanced breast cancer rates. The Greater New York Health Insurance Plan trial (HIP) is the only breast screening trial that reported stage-specific cancer fatality for the screening and for the control group separately. The Swedish Two-County trial (TCT)) reported size-specific fatalities for cancer patients in both screening and control groups. We computed predicted numbers of breast cancer deaths, from which we calculated predicted relative risks (RR) and (95% confidence intervals). The Age trial in England performed its own calculations of predicted relative risk. The observed and predicted RR of breast cancer death were 0.72 (0.56-0.94) and 0.98 (0.77-1.24) in the HIP trial, and 0.79 (0.78-1.01) and 0.90 (0.80-1.01) in the Age trial. In the TCT, the observed RR was 0.73 (0.62-0.87), while the predicted RR was 0.89 (0.75-1.05) if overdiagnosis was assumed to be negligible and 0.83 (0.70-0.97) if extra cancers were excluded. In breast screening trials, factors other than screening have contributed to reductions in the risk of breast cancer death most probably by reducing the fatality of advanced cancers in screening groups. These factors were the better management of breast cancer patients and the underreporting of breast cancer as the underlying cause of death. Breast screening trials should publish stage-specific fatalities observed in each group.

A retrospective study of the performance of radiographers in interpreting screening mammograms

International Nuclear Information System (INIS)

Moran, S.; Warren-Forward, H.

2011-01-01

Purpose: This paper provides data on the continued success of radiographers in reviewing mammograms with similar accuracy to screen readers. Method: The participants consisted of 7 radiographers and 2 current official screen readers. Two hundred and fifty sets of mammograms from 2003 were used in this study. Each participant reviewed each set of mammograms as a Rescreen or Recall. Patient outcomes were assessed by following up the results of any histology or pathology tests in 2003 or the 2005/2006 screening results. Results: The screen reader's sensitivities ranged from 79% to 93% and the specificities ranged from 82% to 84%. The radiographer values ranged from 57% to 97% and 63% to 80% respectively. Conclusion: The sensitivity and specificity values attained by some radiographers were equivalent to those of both the screen readers. Accuracy rates of the radiographers suggest that screen reading by selected and appropriately trained radiographers should be achievable in Australia.

Campylobacter epidemiology: a descriptive study reviewing 1 million cases in England and Wales between 1989 and 2011.

Science.gov (United States)

Nichols, Gordon L; Richardson, Judith F; Sheppard, Samuel K; Lane, Chris; Sarran, Christophe

2012-01-01

To review Campylobacter cases in England and Wales over 2 decades and examine the main factors/mechanisms driving the changing epidemiology. A descriptive study of Campylobacter patients between 1989 and 2011. Cases over 3 years were linked anonymously to postcode, population density, deprivation indices and census data. Cases over 5 years were anonymously linked to local weather exposure estimates. Patients were from general practice, hospital and environmental health investigations through primary diagnostic laboratories across England and Wales. There were 1 109 406 cases. Description of changes in Campylobacter epidemiology over 23 years and how the main drivers may influence these. There was an increase in Campylobacter cases over the past 23 years, with the largest increase in people over 50 years. Changes in the underlying population have contributed to this, including the impacts of population increases after World War I, World War II and the 'baby boom' of the 1960s. A recent increase in risk or ascertainment within this population has caused an increase in cases in all age groups from 2004 to 2011. The seasonal increase in cases between weeks 18 (Early May) and 22 (Early June) was consistent across ages, years and regions and was most marked in children and in more rural regions. Campylobacter prevalence by week in each region correlated with temperature 2 weeks before. There were higher prevalences in areas with a low population density, low deprivation and lower percentage of people of ethnic origin. Data from sero-phage and multilocus sequence typing show a few common types and many uncommon types. The drivers/mechanisms influencing seasonality, age distribution, population density, socioeconomic and long-term differences are diverse and their relative contributions remain to be established. Surveillance and typing provide insights into Campylobacter epidemiology and sources of infection, providing a sound basis for targeted interventions.

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...

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

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....

Role of Magnetic Resonance Imaging in Prostate Cancer Screening: A Pilot Study Within the Göteborg Randomised Screening Trial

Science.gov (United States)

Bergdahl, Anna Grenabo; Wilderäng, Ulrica; Aus, Gunnar; Carlsson, Sigrid; Damber, Jan-Erik; Frånlund, Maria; Geterud, Kjell; Khatami, Ali; Socratous, Andreas; Stranne, Johan; Hellström, Mikael; Hugosson, Jonas

2016-01-01

Background Magnetic resonance imaging (MRI) and targeted biopsies (TB) have shown potential to more accurately detect significant prostate cancer (PC) compared to prostate-specific antigen (PSA) and systematic biopsies (SB). Objective To compare sequential screening (PSA + MRI) with conventional PSA screening. Design, Setting and Participants Of 384 attendees in the 10th screening round of the Göteborg randomised screening trial, 124 men, median age 69.5, had a PSA of ≥1.8 ng/ml and underwent a prebiopsy MRI. Men with suspicious lesions on MRI and/or PSA ≥3.0 ng/ml were referred for biopsy. SB was performed blinded to MRI results and TB was performed in men with tumour-suspicious findings on MRI. Three screening strategies were compared (PSA≥3.0+SB; PSA≥3.0+MRI+TB and PSA≥1.8+MRI+TB). Outcome Measurements and Statistical Analysis Cancer detection rates, sensitivity and specificity were calculated per screening strategy and compared using McNemar´s test. Results and Limitations In total, 28 PC were detected, of which 20 were diagnosed in biopsy-naïve men. Both PSA≥3.0+MRI and PSA≥1.8+MRI significantly increased specificity compared with PSA≥3.0+SB (0.92 and 0.79 vs. 0.52; p=3.0+MRI (0.73 vs. 0.46, p=0.008). The detection rate of significant cancer was higher with PSA≥1.8+MRI compared to PSA≥3.0+SB (5.9 vs. 4.0%), while the detection rate of insignificant cancer was lowered by PSA≥3.0+MRI (0.3 vs. 1.2%). The primary limitation of this study is the small sample of men. Conclusion A screening strategy with a lowered PSA cut-off followed by TB in MRI-positive men seems to increase the detection of significant cancers while improving specificity. If replicated, these results may contribute to a paradigm shift in future screening. Patient Summary Major concerns in prostate-specific antigen screening are overdiagnosis and underdiagnosis. We evaluated whether prostate magnetic resonance imaging could improve the balance of benefits to harm in

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

Automated docking screens: a feasibility study.

Science.gov (United States)

Irwin, John J; Shoichet, Brian K; Mysinger, Michael M; Huang, Niu; Colizzi, Francesco; Wassam, Pascal; Cao, Yiqun

2009-09-24

Molecular docking is the most practical approach to leverage protein structure for ligand discovery, but the technique retains important liabilities that make it challenging to deploy on a large scale. We have therefore created an expert system, DOCK Blaster, to investigate the feasibility of full automation. The method requires a PDB code, sometimes with a ligand structure, and from that alone can launch a full screen of large libraries. A critical feature is self-assessment, which estimates the anticipated reliability of the automated screening results using pose fidelity and enrichment. Against common benchmarks, DOCK Blaster recapitulates the crystal ligand pose within 2 A rmsd 50-60% of the time; inferior to an expert, but respectrable. Half the time the ligand also ranked among the top 5% of 100 physically matched decoys chosen on the fly. Further tests were undertaken culminating in a study of 7755 eligible PDB structures. In 1398 cases, the redocked ligand ranked in the top 5% of 100 property-matched decoys while also posing within 2 A rmsd, suggesting that unsupervised prospective docking is viable. DOCK Blaster is available at http://blaster.docking.org .

Performance of systematic and non-systematic ('opportunistic') screening mammography: a comparative study from Denmark

DEFF Research Database (Denmark)

Bihrmann, Kristine; Jensen, Allan; Olsen, Anne Helene

2008-01-01

screening were calculated. RESULTS: Defining BI-RADS(trade mark) 4-5 as a positive screening outcome, the overall sensitivity of opportunistic screening was 33.6% and the specificity was 99.1%. Using BI-RADS(trade mark) 3-5 as positive, the sensitivity was 37.4% and the specificity was 97.9%. Organized...... screening (which was not categorized according to BI-RADS(trade mark)) had an overall sensitivity of 67.2% and a specificity of 98.4%. CONCLUSION: Our study showed a considerably higher sensitivity in organized screening than in opportunistic screening, while the specificity was fairly similar in the two...

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.

"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

Digital mammography in a screening programme and its implications for pathology: a comparative study.

LENUS (Irish Health Repository)

Feeley, Linda

2011-03-01

Most studies comparing full-field digital mammography (FFDM) with conventional screen-film mammography (SFM) have been radiology-based. The pathological implications of FFDM have received little attention in the literature, especially in the context of screening programmes. The primary objective of this retrospective study is to compare FFDM with SFM in a population-based screening programme with regard to a number of pathological parameters.

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

Science.gov (United States)

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.

Clinical negligence in hospitals in France and England.

Science.gov (United States)

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.

Accuracy of Assignment of Atlantic Salmon (Salmo salar L.) to Rivers and Regions in Scotland and Northeast England Based on Single Nucleotide Polymorphism (SNP) Markers

Science.gov (United States)

Gilbey, John; Cauwelier, Eef; Coulson, Mark W.; Stradmeyer, Lee; Sampayo, James N.; Armstrong, Anja; Verspoor, Eric; Corrigan, Laura; Shelley, Jonathan; Middlemas, Stuart

2016-01-01

Understanding the habitat use patterns of migratory fish, such as Atlantic salmon (Salmo salar L.), and the natural and anthropogenic impacts on them, is aided by the ability to identify individuals to their stock of origin. Presented here are the results of an analysis of informative single nucleotide polymorphic (SNP) markers for detecting genetic structuring in Atlantic salmon in Scotland and NE England and their ability to allow accurate genetic stock identification. 3,787 fish from 147 sites covering 27 rivers were screened at 5,568 SNP markers. In order to identify a cost-effective subset of SNPs, they were ranked according to their ability to differentiate between fish from different rivers. A panel of 288 SNPs was used to examine both individual assignments and mixed stock fisheries and eighteen assignment units were defined. The results improved greatly on previously available methods and, for the first time, fish caught in the marine environment can be confidently assigned to geographically coherent units within Scotland and NE England, including individual rivers. As such, this SNP panel has the potential to aid understanding of the various influences acting upon Atlantic salmon on their marine migrations, be they natural environmental variations and/or anthropogenic impacts, such as mixed stock fisheries and interactions with marine power generation installations. PMID:27723810

Does population screening for Chlamydia trachomatis raise anxiety among those tested? Findings from a population based chlamydia screening study.

Science.gov (United States)

Campbell, Rona; Mills, Nicola; Sanford, Emma; Graham, Anna; Low, Nicola; Peters, Tim J

2006-04-25

The advent of urine testing for Chlamydia trachomatis has raised the possibility of large-scale screening for this sexually transmitted infection, which is now the most common in the United Kingdom. The purpose of this study was to investigate the effect of an invitation to be screened for chlamydia and of receiving a negative result on levels of anxiety, depression and self-esteem. 19,773 men and women aged 16 to 39 years, selected at random from 27 general practices in two large city areas (Bristol and Birmingham) were invited by post to send home-collected urine samples or vulvo-vaginal swabs for chlamydia testing. Questionnaires enquiring about anxiety, depression and self-esteem were sent to random samples of those offered screening: one month before the dispatch of invitations; when participants returned samples; and after receiving a negative result. Home screening was associated with an overall reduction in anxiety scores. An invitation to participate did not increase anxiety levels. Anxiety scores in men were lower after receiving the invitation than at baseline. Amongst women anxiety was reduced after receipt of negative test results. Neither depression nor self-esteem scores were affected by screening. Postal screening for chlamydia does not appear to have a negative impact on overall psychological well-being and can lead to a decrease in anxiety levels among respondents. There is, however, a clear difference between men and women in when this reduction occurs.

Does population screening for Chlamydia trachomatis raise anxiety among those tested? Findings from a population based chlamydia screening study

Directory of Open Access Journals (Sweden)

Low Nicola

2006-04-01

Full Text Available Abstract Background The advent of urine testing for Chlamydia trachomatis has raised the possibility of large-scale screening for this sexually transmitted infection, which is now the most common in the United Kingdom. The purpose of this study was to investigate the effect of an invitation to be screened for chlamydia and of receiving a negative result on levels of anxiety, depression and self-esteem. Methods 19,773 men and women aged 16 to 39 years, selected at random from 27 general practices in two large city areas (Bristol and Birmingham were invited by post to send home-collected urine samples or vulvo-vaginal swabs for chlamydia testing. Questionnaires enquiring about anxiety, depression and self-esteem were sent to random samples of those offered screening: one month before the dispatch of invitations; when participants returned samples; and after receiving a negative result. Results Home screening was associated with an overall reduction in anxiety scores. An invitation to participate did not increase anxiety levels. Anxiety scores in men were lower after receiving the invitation than at baseline. Amongst women anxiety was reduced after receipt of negative test results. Neither depression nor self-esteem scores were affected by screening. Conclusion Postal screening for chlamydia does not appear to have a negative impact on overall psychological well-being and can lead to a decrease in anxiety levels among respondents. There is, however, a clear difference between men and women in when this reduction occurs.

Lessons Learned From A Study Of Genomics-Based Carrier Screening For Reproductive Decision Making.

Science.gov (United States)

Wilfond, Benjamin S; Kauffman, Tia L; Jarvik, Gail P; Reiss, Jacob A; Richards, C Sue; McMullen, Carmit; Gilmore, Marian; Himes, Patricia; Kraft, Stephanie A; Porter, Kathryn M; Schneider, Jennifer L; Punj, Sumit; Leo, Michael C; Dickerson, John F; Lynch, Frances L; Clarke, Elizabeth; Rope, Alan F; Lutz, Kevin; Goddard, Katrina A B

2018-05-01

Genomics-based carrier screening is one of many opportunities to use genomic information to inform medical decision making, but clinicians, health care delivery systems, and payers need to determine whether to offer screening and how to do so in an efficient, ethical way. To shed light on this issue, we conducted a study in the period 2014-17 to inform the design of clinical screening programs and guide further health services research. Many of our results have been published elsewhere; this article summarizes the lessons we learned from that study and offers policy insights. Our experience can inform understanding of the potential impact of expanded carrier screening services on health system workflows and workforces-impacts that depend on the details of the screening approach. We found limited patient or health system harms from expanded screening. We also found that some patients valued the information they learned from the process. Future policy discussions should consider the value of offering such expanded carrier screening in health delivery systems with limited resources.

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.

Breast cancer screening: An outpatient clinic study

Directory of Open Access Journals (Sweden)

Mustafa Girgin

2017-03-01

Conclusion: A multidisciplinary cancer screening program should be maintained. With such a process, the aim is to reduce the morbidity and mortality of the disease without adversely affecting the health conditions of asymptomatic individuals based on the screening. Success is brought about by the combination of individual features. [Arch Clin Exp Surg 2017; 6(1.000: 23-27

Screening of Potential Lead Molecule as Novel MurE Inhibitor: Virtual Screening, Molecular Dynamics and In Vitro Studies.

Science.gov (United States)

Zaveri, Kunal; Kiranmayi, Patnala

2017-01-01

The prevalence of multi-drug resistance S. aureus is one of the most challenging tasks for the treatment of nosocomial infections. Proteins and enzymes of peptidoglycan biosynthesis pathway are one among the well-studied targets, but many of the enzymes are unexplored as targets. MurE is one such enzyme featured to be a promising target. As MurE plays an important role in ligating the L-lys to stem peptide at third position that is crucial for peptidoglycan synthesis. To screen the potential MurE inhibitor by in silico approach and evaluate the best potential lead molecule by in vitro methods. In the current study, we have employed structure based virtual screening targeting the active site of MurE, followed by Molecular dynamics and in vitro studies. Virtual screening resulted in successful screening of potential lead molecule ((2R)-2-[[1-[(2R)- 2-(benzyloxycarbonylamino) propanoyl] piperidine-4-carbonyl]amino]-5-guanidino-pentan). The molecular dynamics of the MurE and Lead molecule complex emphasizes that lead molecule has shown stable interactions with active site residues Asp 406 and with Glu 460. In vitro studies demonstrate that the lead molecule shows antibacterial activity close to standard antibiotic Vancomycin and higher than that of Ampicillin, Streptomycin and Rifampicin. The MIC of lead molecule at 50μg/mL was observed to be 3.75 μg/mL, MBC being bactericidal with value of 6.25 μg/mL, cytotoxicity showing 34.44% and IC50 of 40.06μg/mL. These results suggest ((2R)-2-[[1-[(2R)-2-(benzyloxycarbonylamino) propanoyl] piperidine-4-carbonyl]amino]-5-guanidino-pentan) as a promising lead molecule for developing a MurE inhibitor against treatment of S. aureus infections. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

15-year followup of a population based prostate cancer screening study.

Science.gov (United States)

Kjellman, Anders; Akre, Olof; Norming, Ulf; Törnblom, Magnus; Gustafsson, Ove

2009-04-01

We evaluated long-term survival in attendees and nonattendees of a 1-time screening for prostate cancer. A total of 2,400 men 55 to 70 years old in 1988 were randomly selected and invited to a screening for prostate cancer. Of the invited men 1,782 (74%) attended. Screening attendees were examined with digital rectal examination, transrectal ultrasound and prostate specific antigen analysis. When cancer was suspected, prostate biopsies were taken. A total of 65 men with prostate cancer were detected by this procedure. The entire source population comprising 27,204 men, including 618 nonattendees (26%), was followed for prostate cancer diagnosis and survival for 15 years. Incidence rate ratios were calculated using Poisson regression models. We found no effect of this screening procedure on the risk of death from prostate cancer and other causes of death (incidence rate ratio 1.10, 95% CI 0.83-1.46 and 0.98, 95% CI 0.92-1.05, respectively) when comparing all invited men with the source population. However, attending the screening program was associated with a significantly decreased risk of death from causes other than prostate cancer (vs source population incidence rate ratio 0.82, 95% CI 0.76-0.90). In contrast, the corresponding incidence rate ratio in nonattendees was 1.53 (95% CI 1.37-1.71). We found no evidence of a beneficial effect of this specific screening procedure but strong evidence of a difference in overall survival in screening attendees and nonattendees. These findings should be considered when interpreting previous and upcoming studies of the effect of screening programs.

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...

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.

Overdiagnosis in organised mammography screening in Denmark. A comparative study

DEFF Research Database (Denmark)

Jørgensen, Karsten J; Zahl, Per-Henrik; Gøtzsche, Peter C

2009-01-01

% of the Danish population has been offered organised mammography screening over a long time-period. METHODS: We collected incidence rates of carcinoma in situ and invasive breast cancer in areas with and without screening over 13 years with screening (1991-2003), and 20 years before its introduction (1971...... an overdiagnosis of 35% when we compared unadjusted incidence rates for the screened and non-screened areas, but after compensating for a small decline in incidence in older, previously screened women. Our adjusted Poisson regression analysis indicated a relative risk of 1.40 (95% CI: 1.35-1.45) for the whole...... screening period, and a potential compensatory drop in older women of 0.90 (95% CI: 0.88-0.96), yielding an overdiagnosis of 33%, which we consider the most reliable estimate. The drop in previously screened women was only present in one of the two screened regions and was small in absolute numbers...

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

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

MULTISCAN--a Scandinavian multicenter second trimester obstetric ultrasound and serum screening study

DEFF Research Database (Denmark)

Jørgensen, F S; Valentin, L; Salvesen, K A

1999-01-01

AIM: To study the detection rates of second trimester ultrasound screening for neural tube defects (NTD), abdominal wall defects (AWD) and Down's syndrome (DS) in low risk populations at tertiary centers, and to compare the ultrasound screening detection rates with those that were obtainable by b...

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.

Does breast screening offer a survival benefit? A retrospective comparative study of oncological outcomes of screen-detected and symptomatic early stage breast cancer cases.

Science.gov (United States)

Újhelyi, M; Pukancsik, D; Kelemen, P; Kovács, E; Kenessey, I; Udvarhelyi, N; Bak, M; Kovács, T; Mátrai, Z

2016-12-01

Mammography screening reduces breast cancer mortality by up to 32%. However, some recent studies have questioned the impact of non-palpable breast cancer detection on mortality reduction. The aim of this study was to analyse the clinicopathological and long-term follow-up data of early stage screened and symptomatic breast cancer patients. The institutional prospectively led database was systematically analysed for breast cancer cases diagnosed via the mammography screening program from 2002 to 2009. As a control group, symptomatic early stage breast cancer patients were collected randomly from the same database and matched for age and follow-up period. All medical records were reviewed retrospectively. Data from 298 breast cancer patients were collected from 47,718 mammography screenings. In addition, 331 symptomatic breast cancer patients were randomly selected. The screened group presented a significantly lower median tumour size (P screened group (P screened group did not exhibit better overall (P = 0.717) or disease-free survival (P = 0.081) compared to the symptomatic group. Our results do not suggest that mammography screening does not reduce breast cancer mortality but the mammography screening did not bring any significant improvement in patient overall or disease-free survival for the early stage breast cancer patients compared to the symptomatic group. The drawback of symptomatic early stage tumours compared to non-palpable tumours could be equalized by modern multimodality oncology treatments. Copyright © 2016 Elsevier Ltd, BASO ~ the Association for Cancer Surgery, and the European Society of Surgical Oncology. 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…

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...

Newborn Screening for Sickle Cell Disease in Liberia: A Pilot Study.

Science.gov (United States)

Tubman, Venée N; Marshall, Roseda; Jallah, Wilhemina; Guo, Dongjing; Ma, Clement; Ohene-Frempong, Kwaku; London, Wendy B; Heeney, Matthew M

2016-04-01

In malaria-endemic countries in West Africa, sickle cell disease (SCD) contributes to childhood mortality. Historically, Liberia had regions wherein hemoglobin S and beta-thalassemia trait were mutually exclusive. Data on hemoglobinopathies in the Monrovia, the capital, are outdated and do not reflect urban migration. Updating the epidemiology of SCD is necessary to plan a public health and clinical agenda. Neither newborn screening (NBS) nor screening tools were available in country. This pilot study aimed to determine the feasibility of NBS using a South-South partnership and define the incidence of sickle cell trait (SCT) and SCD in Monrovia. This descriptive epidemiologic feasibility study collected dried blood spots from 2,785 consecutive newborns delivered at a hospital in Monrovia. Samples were analyzed by isoelectric focusing at a regional reference laboratory. Infants with SCD were referred for preventive care. SCT occurred in 10.31% of infants screened. SCD occurred in 33 infants screened [1.19% (95% confidence interval [CI]: 0.79-1.59%)] (FS: 28/33, FSB: 2/33, FSA: 2/33, FSX: 1/33). There were no infants with FSC phenotype observed. Nonsickling hemoglobin phenotypes "FC" and "F" were each present in three infants screened. Seventy-six percent of infants with SCD were brought to care, demonstrating the feasibility of our approach. The incidence of SCD and other hemoglobinopathies remains high in Liberia. Additional studies are needed to clarify sickle genotypes and identify the contribution of silent beta-thalassemia alleles. By developing regional partnerships, countries similar to Liberia can acquire current data to inform NBS as an important public health initiative toward improving child health. © 2016 Wiley Periodicals, Inc.

In Vivo RNAi-Based Screens: Studies in Model Organisms

Directory of Open Access Journals (Sweden)

Miki Yamamoto-Hino

2013-11-01

Full Text Available RNA interference (RNAi is a technique widely used for gene silencing in organisms and cultured cells, and depends on sequence homology between double-stranded RNA (dsRNA and target mRNA molecules. Numerous cell-based genome-wide screens have successfully identified novel genes involved in various biological processes, including signal transduction, cell viability/death, and cell morphology. However, cell-based screens cannot address cellular processes such as development, behavior, and immunity. Drosophila and Caenorhabditis elegans are two model organisms whose whole bodies and individual body parts have been subjected to RNAi-based genome-wide screening. Moreover, Drosophila RNAi allows the manipulation of gene function in a spatiotemporal manner when it is implemented using the Gal4/UAS system. Using this inducible RNAi technique, various large-scale screens have been performed in Drosophila, demonstrating that the method is straightforward and valuable. However, accumulated results reveal that the results of RNAi-based screens have relatively high levels of error, such as false positives and negatives. Here, we review in vivo RNAi screens in Drosophila and the methods that could be used to remove ambiguity from screening results.

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.

A Danish nationwide questionnaire study of hepatitis B virus screening before immunosuppressive therapy

DEFF Research Database (Denmark)

Bunyoz, Kristine Ifigenia; Krarup, Henrik; Weis, Nina

2017-01-01

INTRODUCTION: Difficulty in identifying patients who are at risk for hepatitis B virus (HBV) reactivation makes it import-ant to screen for HBV before initiating immunosuppressive therapy. The aim of this study was to investigate screening procedures for HBV infection before initiation of immunos......INTRODUCTION: Difficulty in identifying patients who are at risk for hepatitis B virus (HBV) reactivation makes it import-ant to screen for HBV before initiating immunosuppressive therapy. The aim of this study was to investigate screening procedures for HBV infection before initiation...... of immunosuppressive therapy and to explore HBV treatment strategies. METHODS: All Danish units of haematology, oncology, dermatology, rheumatology and gastroenterology using immunosuppressive agents were invited to fill out a questionnaire for The Danish Database for Hepatitis B and C. RESULTS: A total of 28 (53...

Screen-based sedentary behaviours in Italian school children: the ZOOM8 study

Directory of Open Access Journals (Sweden)

Myriam Galfo

2014-07-01

Full Text Available Normal 0 14 Background: screen-based sedentary behaviours likely have a negative impact on many aspects of youth health and development. The purpose of this study was to describe the screen-based sedentary behaviours and to examine factors associated in a sample of Italian school children. Methods: 2129 children, aged 8-9 years, from the three main geographical areas of Italy were involved. Body weight and height were measured. Screen-based sedentary behaviours were evaluated using a parent-reported questionnaire that included items about the time spent watching television (TV and using computer/playstation and other electronic games. Pearson’s chi-square test and logistic regression analysis were conducted to study possible associated factors.Results: more time was spent in screen-based sedentary activities during non-school days rather than on school days. More males than females watched television more than the recommended 2 hours a day and spent the same time using computer (PC, playstation and other electronic games.  The presence of a TV in the child’s bedroom was significantly associated with geographical area, and inversely associated with mother’s education. Moreover, children with a TV in the bedroom had higher odds of being overweight/obese and watching TV more than 2 hours a day than those without a TV. According to multiple logistic regression gender, mother’s age and mother’s education were predictors of the total screen time.Conclusions: Italian children spent a significant amount of time in screen-based sedentary behaviours, exceeding media recommendations. In addition gender, mother’s age and mother’s education were predictors of the total screen time.

"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...

Understanding the role of embarrassment in gynaecological screening: a qualitative study from the ASPIRE cervical cancer screening project in Uganda.

Science.gov (United States)

Teng, Flora F; Mitchell, Sheona M; Sekikubo, Musa; Biryabarema, Christine; Byamugisha, Josaphat K; Steinberg, Malcolm; Money, Deborah M; Ogilvie, Gina S

2014-04-11

To define embarrassment and develop an understanding of the role of embarrassment in relation to cervical cancer screening and self-collected human papillomavirus (HPV) DNA testing in Uganda. Cross-sectional, qualitative study using semistructured one-to-one interviews and focus groups. 6 key-informant health workers and 16 local women, purposively sampled. Key informant inclusion criteria: Ugandan members of the project team. Focus group inclusion criteria: woman age 30-69 years, Luganda or Swahili speaking, living or working in the target Ugandan community. unwillingness to sign informed consent. Primary and tertiary low-resource setting in Kampala, Uganda. In Luganda, embarrassment relating to cervical cancer is described in two forms. 'Community embarrassment' describes discomfort based on how a person may be perceived by others. 'Personal embarrassment' relates to shyness or discomfort with her own genitalia. Community embarrassment was described in themes relating to place of study recruitment, amount of privacy in dwellings, personal relationship with health workers, handling of the vaginal swab and misunderstanding of HPV self-collection as HIV testing. Themes of personal embarrassment related to lack of knowledge, age and novelty of the self-collection swab. Overall, embarrassment was a barrier to screening at the outset and diminished over time through education and knowledge. Fatalism regarding cervical cancer diagnosis, worry about results and stigma associated with a cervical cancer diagnosis were other psychosocial barriers described. Overcoming psychosocial barriers to screening can include peer-to-peer education, drama and media campaigns. Embarrassment and other psychosocial barriers may play a large role at the onset of a screening programme, but over time as education and knowledge increase, and the social norms around screening evolve, its role diminishes. The role of peer-to-peer education and community authorities on healthcare cannot be

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...

Utilizing a 'systems' approach to improve the management of waste from healthcare facilities: best practice case studies from England and Wales.

Science.gov (United States)

Tudor, Terry L; Woolridge, Anne C; Bates, Margaret P; Phillips, Paul S; Butler, Sharon; Jones, Keith

2008-06-01

Changes in environmental legislation and standards governing healthcare waste, such as the Hazardous Waste Regulations are expected to have a significant impact on healthcare waste quantities and costs in England and Wales. This paper presents findings from two award winning case study organizations, the Cardiff and Vale NHS Trust and the Cornwall NHS Trust on 'systems' they have employed for minimizing waste. The results suggest the need for the development and implementation of a holistic range of systems in order to develop best practice, including waste minimization strategies, key performance indicators, and staff training and awareness. The implications for the sharing of best practice from the two case studies are also discussed.

A study on client needs regarding FDG-PET for cancer screening

International Nuclear Information System (INIS)

Yamane, Tomohiko; Yoshiya, Kazuhiko; Nagata, Takeshi; Ito, Shinichi; Ito, Satoshi; Mezaki, Yukio; Uchida, Hideo

2006-01-01

We researched client needs regarding FDG-PET for cancer screening. The study included 1,527 individuals who underwent FDG-PET for cancer screening at our hospital. An interview sheet was distributed after injecting FDG. Clients listed the organs that required examination and the symptoms causing them anxiety. Results indicated that 9.8% of the clients listed organs for which FDG-PET would not be useful in detecting cancer. This study suggested that there exists a gap between client needs and FDG-PET utility; hence we need improved methods of providing correct information to clients. (author)

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)

Screening history in women with cervical cancer in a Danish population-based screening program

DEFF Research Database (Denmark)

Kirschner, Benny; Poll, Susanne; Rygaard, Carsten

2011-01-01

The aim of this study was to explore the screening histories of all cervical cancers in a Danish screening population. The intention was to decide suboptimal sides of the screening program and to evaluate the significance of routine screening in the development of cervical cancer.......The aim of this study was to explore the screening histories of all cervical cancers in a Danish screening population. The intention was to decide suboptimal sides of the screening program and to evaluate the significance of routine screening in the development of cervical cancer....