WorldWideScience

Sample records for uk case studies

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

    Science.gov (United States)

    Taha, Nashrawan; Cox, Andrew

    2016-01-01

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

  2. Online modelling of water distribution systems: a UK case study

    Directory of Open Access Journals (Sweden)

    J. Machell

    2010-03-01

    Full Text Available Hydraulic simulation models of water distribution networks are routinely used for operational investigations and network design purposes. However, their full potential is often never realised because, in the majority of cases, they have been calibrated with data collected manually from the field during a single historic time period and, as such, reflect the network operational conditions that were prevalent at that time, and they are then applied as part of a reactive, desktop investigation. In order to use a hydraulic model to assist proactive distribution network management its element asset information must be up to date and it should be able to access current network information to drive simulations. Historically this advance has been restricted by the high cost of collecting and transferring the necessary field measurements. However, recent innovation and cost reductions associated with data transfer is resulting in collection of data from increasing numbers of sensors in water supply systems, and automatic transfer of the data to point of use. This means engineers potentially have access to a constant stream of current network data that enables a new era of "on-line" modelling that can be used to continually assess standards of service compliance for pressure and reduce the impact of network events, such as mains bursts, on customers. A case study is presented here that shows how an online modelling system can give timely warning of changes from normal network operation, providing capacity to minimise customer impact.

  3. Investigating employee resistance to Lean transformation: UK case study.

    OpenAIRE

    Bruce, J.; Scott, Philip; Roberts, Martyn

    2011-01-01

    Lean is a business process transformation approach that eliminates ‘wastes’ – activities that generate no value for the customer. Lean originated from the production line but is widely implemented in the service sector. This study investigates human and social factors in a Lean transformation in a ‘knowledge worker’ environment. We identify a paradox: a successful Lean programme in the service sector develops staff who are educated and empowered and thus potential opponents to future business...

  4. Innovative Solutions for Companies to Reduce Gender Gaps (UK Study Case)

    OpenAIRE

    Andrei ANGHELUTA; Larisa MIHOREANU; Carmen COSTEA

    2016-01-01

    For many years the gender gap has been a complex reality having economic implications and social decisiveness. No matter the percentage recently decreased, we still confront with social discriminations. In this paper we focused on the UK labour market so we developed a case study for a logistics company, using classification of the employees in different pay bands. Based on this study we created a state of the art human resource tool that can be applied worldwide and that help firms to analys...

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

    Science.gov (United States)

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

    2012-02-01

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

  6. Innovative Solutions for Companies to Reduce Gender Gaps (UK Study Case

    Directory of Open Access Journals (Sweden)

    Andrei ANGHELUTA

    2016-06-01

    Full Text Available For many years the gender gap has been a complex reality having economic implications and social decisiveness. No matter the percentage recently decreased, we still confront with social discriminations. In this paper we focused on the UK labour market so we developed a case study for a logistics company, using classification of the employees in different pay bands. Based on this study we created a state of the art human resource tool that can be applied worldwide and that help firms to analyse the root causes and to reduce the gender gap.

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

    Science.gov (United States)

    Banks, Vanessa; Cooper, Anthony

    2016-04-01

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

  8. A case-control study assessing bone mineral density in severe haemophilia A in the UK.

    Science.gov (United States)

    Wells, A J; McLaughlin, P; Simmonds, J V; Prouse, P J; Prelevic, G; Gill, S; Chowdary, P

    2015-01-01

    It has been shown that bone mineral density (BMD) may be lower in patients with haemophilia (PWH). A comparison to control subjects is required to thoroughly assess current BMD in PWH in the UK. The objective of this study was to test the hypothesis that BMD is lower in PWH than in controls, and in patients with more severely affected joints or lower activity levels. In this case-control study, 37 patients with severe haemophilia A were recruited from two haemophilia centres in the UK. A group of 37 age, gender and ethnicity-matched control participants were recruited. All participants had a bone density scan, a musculoskeletal assessment, a blood test for vitamin D and completed a functional activity questionnaire. Of the case group, 5% had osteoporosis and 24% had BMD lower than expected for age. No control participants had osteoporosis, 3% had osteopenia and 14% had BMD lower than expected for age. Ninety one per cent of case participants and 92% of control participants had reduced 25(OH)D levels. Case participants had significantly lower BMD than control participants, and case participants with more severely affected joints, lower activity levels, HIV, history of hepatitis C or lower BMI had significantly lower BMD. Patients with severe haemophilia have a higher risk of low BMD than men without haemophilia. Patients with more severely affected joints and lower activity levels have lower BMD. It remains unclear whether patients with low BMD reached adequate peak bone mass. Low vitamin D may be present in the majority of PWH. © 2014 John Wiley & Sons Ltd.

  9. Reflections on Tutoring Ancient Greek Philosophy: A Case Study of Teaching First-Year Undergraduates in the UK

    Science.gov (United States)

    Vázquez, Daniel

    2014-01-01

    This is a case study of my reflections on teaching a first-year undergraduate tutorial on Ancient Greek Philosophy in the UK. This study draws upon the notion of reflective practice as an essential feature of teaching, in this case applied to Higher Education. My aim is to show how a critical engagement with my teaching practices and the overall…

  10. Development of a sustainability reporting scheme for biofuels: A UK case study

    International Nuclear Information System (INIS)

    Chalmers, Jessica; Archer, Greg

    2011-01-01

    In 2008, the UK launched the first regulatory sustainability reporting scheme for biofuels. The development of the scheme, managed by the Low Carbon Vehicle Partnership for the Department for Transport, involved extensive stakeholder engagement. The scheme has significantly increased understanding by policy-makers, the biofuels industry and its supply chains on how to monitor and manage the sustainability risks of biofuels and increase their greenhouse-gas benefits. It is providing a practical model for similar developments globally. To receive certificates in order to meet volume obligations under the Renewable Transport Fuel Obligation (RTFO), suppliers must provide a monthly carbon and sustainability report on individual batches of renewable fuels they supply into the UK. The Renewable Fuels Agency produces aggregate monthly reports of overall performance and quarterly updates of individual supplier performance. This scheme is an important first step to assist the biofuels industry to demonstrate its environmental credentials and justify the subsidies received. The paper provides a case study of the development of the scheme, its initial outcomes and outstanding challenges.

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

    Science.gov (United States)

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

    2018-02-27

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

  12. A 10-year case study on the changing determinants of university student satisfaction in the UK.

    Directory of Open Access Journals (Sweden)

    Adrian Burgess

    Full Text Available Higher Education (HE, once the prerogative of a tiny elite, is now accessible to larger numbers of people around the world than ever before yet despite the fact that an understanding of student satisfaction has never been more important for today's universities, the concept remains poorly understood. Here we use published data from the UK's National Student Survey (NSS, representing data from 2.3 million full-time students collected from 2007 to 2016, as a case study of the benefits and limitations of measuring student satisfaction that might have applicability for other countries, particularly those that, like the UK, have experienced significant growth in student numbers. The analyses showed that the factor structure of the NSS remained generally stable and that the ability of the NSS to discriminate between different subjects at different universities actually improved over the ten-year sample period. The best predictors of overall satisfaction were 'Teaching Quality' and 'Organisation & Management', with 'Assessment & Feedback' having relatively weak predictive ability, despite the sector's tangible efforts to improve on this metric. The tripling of student fees in 2012 for English students (but not the rest of the UK was used as a 'natural experiment' to investigate the sensitivity of student satisfaction ratings to the real economic costs of HE. The tuition fee increase had no identifiable negative effect, with student satisfaction steadily improving throughout the decade. Although the NSS was never designed to measure perceived value-for-money, its insensitivity to major changes in the economic costs of HE to the individual suggest that the conventional concept of student satisfaction is incomplete. As such we propose that the concept of student satisfaction: (i needs to be widened to take into account the broader economic benefits to the individual student by including measures of perceived value-for-money and (ii should measure students

  13. A 10-year case study on the changing determinants of university student satisfaction in the UK.

    Science.gov (United States)

    Burgess, Adrian; Senior, Carl; Moores, Elisabeth

    2018-01-01

    Higher Education (HE), once the prerogative of a tiny elite, is now accessible to larger numbers of people around the world than ever before yet despite the fact that an understanding of student satisfaction has never been more important for today's universities, the concept remains poorly understood. Here we use published data from the UK's National Student Survey (NSS), representing data from 2.3 million full-time students collected from 2007 to 2016, as a case study of the benefits and limitations of measuring student satisfaction that might have applicability for other countries, particularly those that, like the UK, have experienced significant growth in student numbers. The analyses showed that the factor structure of the NSS remained generally stable and that the ability of the NSS to discriminate between different subjects at different universities actually improved over the ten-year sample period. The best predictors of overall satisfaction were 'Teaching Quality' and 'Organisation & Management', with 'Assessment & Feedback' having relatively weak predictive ability, despite the sector's tangible efforts to improve on this metric. The tripling of student fees in 2012 for English students (but not the rest of the UK) was used as a 'natural experiment' to investigate the sensitivity of student satisfaction ratings to the real economic costs of HE. The tuition fee increase had no identifiable negative effect, with student satisfaction steadily improving throughout the decade. Although the NSS was never designed to measure perceived value-for-money, its insensitivity to major changes in the economic costs of HE to the individual suggest that the conventional concept of student satisfaction is incomplete. As such we propose that the concept of student satisfaction: (i) needs to be widened to take into account the broader economic benefits to the individual student by including measures of perceived value-for-money and (ii) should measure students' level of

  14. Adaptation of the landscape for biodiversity to climate change : terrestrial case studies Limburg (NL), Kent and Hampshire (UK)

    NARCIS (Netherlands)

    Rooij, van S.A.M.; Baveco, J.M.; Bugter, R.J.F.; Eupen, van M.; Opdam, P.F.M.; Steingröver, E.G.; Taylor, S.; Steenwijk, van H.

    2007-01-01

    This study is part of the BRANCH project, aimed at assessing the impact of climate change on species and habitats and formulating strategies for adaptation. It focuses on the local scale in three terrestrial case studies, Limburg (NL) and in Kent and Hampshire (UK). We developed and tested: (a) a

  15. Understanding general practice: a conceptual framework developed from case studies in the UK NHS.

    Science.gov (United States)

    Checkland, Kath

    2007-01-01

    General practice in the UK is undergoing a period of rapid and profound change. Traditionally, research into the effects of change on general practice has tended to regard GPs as individuals or as members of a professional group. To understand the impact of change, general practices should also be considered as organisations. To use the organisational studies literature to build a conceptual framework of general practice organisations, and to test and develop this empirically using case studies of change in practice. This study used the implementation of National Service Frameworks (NSFs) and the new General Medical Services (GMS) contract as incidents of change. In-depth, qualitative case studies. The design was iterative: each case study was followed by a review of the theoretical ideas. The final conceptual framework was the result of the dynamic interplay between theory and empirical evidence. Five general practices in England, selected using purposeful sampling. Semi-structured interviews with all clinical and managerial personnel in each practice, participant and nonparticipant observation, and examination of documents. A conceptual framework was developed that can be used to understand how and why practices respond to change. This framework enabled understanding of observed reactions to the introduction of NSFs and the new GMS contract. Important factors for generating responses to change included the story that the practice members told about their practice, beliefs about what counted as legitimate work, the role played by the manager, and previous experiences of change. Viewing general practices as small organisations has generated insights into factors that influence responses to change. Change tends to occur from the bottom up and is determined by beliefs about organisational reality. The conceptual framework suggests some questions that can be asked of practices to explain this internal reality.

  16. Severe Maternal Sepsis in the UK, 2011–2012: A National Case-Control Study

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    Acosta, Colleen D.; Kurinczuk, Jennifer J.; Lucas, D. Nuala; Tuffnell, Derek J.; Sellers, Susan; Knight, Marian

    2014-01-01

    Background In light of increasing rates and severity of sepsis worldwide, this study aimed to estimate the incidence of, and describe the causative organisms, sources of infection, and risk factors for, severe maternal sepsis in the UK. Methods and Findings A prospective case-control study included 365 confirmed cases of severe maternal sepsis and 757 controls from all UK obstetrician-led maternity units from June 1, 2011, to May 31, 2012. Incidence of severe sepsis was 4.7 (95% CI 4.2–5.2) per 10,000 maternities; 71 (19.5%) women developed septic shock; and five (1.4%) women died. Genital tract infection (31.0%) and the organism Escherichia coli (21.1%) were most common. Women had significantly increased adjusted odds ratios (aORs) of severe sepsis if they were black or other ethnic minority (aOR = 1.82; 95% CI 1.82–2.51), were primiparous (aOR = 1.60; 95% CI 1.17–2.20), had a pre-existing medical problem (aOR = 1.40; 95% CI 1.01–1.94), had febrile illness or were taking antibiotics in the 2 wk prior to presentation (aOR = 12.07; 95% CI 8.11–17.97), or had an operative vaginal delivery (aOR = 2.49; 95% CI 1.32–4.70), pre-labour cesarean (aOR = 3.83; 95% CI 2.24–6.56), or cesarean after labour onset (aOR = 8.06; 95% CI 4.65–13.97). Median time between delivery and sepsis was 3 d (interquartile range = 1–7 d). Multiple pregnancy (aOR = 5.75; 95% CI 1.54–21.45) and infection with group A streptococcus (aOR = 4.84; 2.17–10.78) were associated with progression to septic shock; for 16 (50%) women with a group A streptococcal infection there was anyone with suspected sepsis. Signs of severe sepsis in peripartum women, particularly with confirmed or suspected group A streptococcal infection, should be regarded as an obstetric emergency. Please see later in the article for the Editors' Summary PMID:25003759

  17. Severe maternal sepsis in the UK, 2011-2012: a national case-control study.

    Science.gov (United States)

    Acosta, Colleen D; Kurinczuk, Jennifer J; Lucas, D Nuala; Tuffnell, Derek J; Sellers, Susan; Knight, Marian

    2014-07-01

    In light of increasing rates and severity of sepsis worldwide, this study aimed to estimate the incidence of, and describe the causative organisms, sources of infection, and risk factors for, severe maternal sepsis in the UK. A prospective case-control study included 365 confirmed cases of severe maternal sepsis and 757 controls from all UK obstetrician-led maternity units from June 1, 2011, to May 31, 2012. Incidence of severe sepsis was 4.7 (95% CI 4.2-5.2) per 10,000 maternities; 71 (19.5%) women developed septic shock; and five (1.4%) women died. Genital tract infection (31.0%) and the organism Escherichia coli (21.1%) were most common. Women had significantly increased adjusted odds ratios (aORs) of severe sepsis if they were black or other ethnic minority (aOR = 1.82; 95% CI 1.82-2.51), were primiparous (aOR = 1.60; 95% CI 1.17-2.20), had a pre-existing medical problem (aOR = 1.40; 95% CI 1.01-1.94), had febrile illness or were taking antibiotics in the 2 wk prior to presentation (aOR = 12.07; 95% CI 8.11-17.97), or had an operative vaginal delivery (aOR = 2.49; 95% CI 1.32-4.70), pre-labour cesarean (aOR = 3.83; 95% CI 2.24-6.56), or cesarean after labour onset (aOR = 8.06; 95% CI 4.65-13.97). Median time between delivery and sepsis was 3 d (interquartile range = 1-7 d). Multiple pregnancy (aOR = 5.75; 95% CI 1.54-21.45) and infection with group A streptococcus (aOR = 4.84; 2.17-10.78) were associated with progression to septic shock; for 16 (50%) women with a group A streptococcal infection there was anyone with suspected sepsis. Signs of severe sepsis in peripartum women, particularly with confirmed or suspected group A streptococcal infection, should be regarded as an obstetric emergency. Please see later in the article for the Editors' Summary.

  18. Establishing and sustaining research partnerships in Africa: a case study of the UK-Africa Academic Partnership on Chronic Disease

    NARCIS (Netherlands)

    de-Graft Aikins, Ama; Arhinful, Daniel K.; Pitchforth, Emma; Ogedegbe, Gbenga; Allotey, Pascale; Agyemang, Charles

    2012-01-01

    This paper examines the challenges and opportunities in establishing and sustaining north-south research partnerships in Africa through a case study of the UK-Africa Academic Partnership on Chronic Disease. Established in 2006 with seed funding from the British Academy, the partnership aimed to

  19. Private Finance Initiative (PFI for Road Projects in UK: Current Practice with a Case Study

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    Rifat Akbiyikli

    2011-05-01

    Full Text Available The long-term sustainable provision of new and high quality maintained road stock is vitally important, especially in times of economic constraint such as Europe is currently experiencing. The Private Finance Initiative (PFI is one method of financing such large-scale, capital intensive projects. An important aspect of this form of financing projects is that the risks are borne not only by the sponsors but are shared by different types of investors such as equity holders, debt providers, and quasi-equity investors. Consequently, a comprehensive and heuristic risk management process is essential for the success of the project. The proposition made within this paper is that the PFI mechanism provides a Value-for-Money and effective mechanism to achieve this. The structure of this PFI finance and investment on a particular road project therefore enables all project stakeholders to take a long-term perspective. This long-term perspective is reflected in the mechanism of a case study of UK – Class A trunk roads which are examined in detail. This paper presents a novel solution to a modern dilemma.

  20. DNA barcoding for biosecurity: case studies from the UK plant protection program.

    Science.gov (United States)

    Hodgetts, Jennifer; Ostojá-Starzewski, Jozef C; Prior, Thomas; Lawson, Rebecca; Hall, Jayne; Boonham, Neil

    2016-11-01

    Since its conception, DNA barcoding has seen a rapid uptake within the research community. Nevertheless, as with many new scientific tools, progression towards the point of routine deployment within diagnostic laboratories has been slow. In this paper, we discuss the application of DNA barcoding in the Defra plant health diagnostic laboratories, where DNA barcoding is used primarily for the identification of invertebrate pests. We present a series of case studies that demonstrate the successful application of DNA barcoding but also reveal some potential limitations to expanded use. The regulated plant pest, Bursephalenchus xylophilus, and one of its vectors, Monochamus alternatus, were found in dining chairs. Some traded wood products are potentially high risk, allowing the movement of longhorn beetles; Trichoferus campestris, Leptura quadrifasciata, and Trichoferus holosericeus were found in a wooden cutlery tray, a railway sleeper, and a dining chair, respectively. An outbreak of Meloidogyne fallax was identified in Allium ampeloprasum and in three weed species. Reference sequences for UK native psyllids were generated to enable the development of rapid diagnostics to be used for monitoring following the release of Aphalara itadori as a biological control agent for Fallopia japonica.

  1. Identifying 'unhealthy' food advertising on television: a case study applying the UK Nutrient Profile model.

    Science.gov (United States)

    Jenkin, Gabrielle; Wilson, Nick; Hermanson, Nicole

    2009-05-01

    To evaluate the feasibility of the UK Nutrient Profile (NP) model for identifying 'unhealthy' food advertisements using a case study of New Zealand television advertisements. Four weeks of weekday television from 15.30 hours to 18.30 hours was videotaped from a state-owned (free-to-air) television channel popular with children. Food advertisements were identified and their nutritional information collected in accordance with the requirements of the NP model. Nutrient information was obtained from a variety of sources including food labels, company websites and a national nutritional database. From the 60 h sample of weekday afternoon television, there were 1893 advertisements, of which 483 were for food products or retailers. After applying the NP model, 66 % of these were classified as advertising high-fat, high-salt and high-sugar (HFSS) foods; 28 % were classified as advertising non-HFSS foods; and the remaining 2 % were unclassifiable. More than half (53 %) of the HFSS food advertisements were for 'mixed meal' items promoted by major fast-food franchises. The advertising of non-HFSS food was sparse, covering a narrow range of food groups, with no advertisements for fresh fruit or vegetables. Despite the NP model having some design limitations in classifying real-world televised food advertisements, it was easily applied to this sample and could clearly identify HFSS products. Policy makers who do not wish to completely restrict food advertising to children outright should consider using this NP model for regulating food advertising.

  2. Ethnic variations in severe maternal morbidity in the UK- a case control study.

    Directory of Open Access Journals (Sweden)

    Manisha Nair

    Full Text Available Previous studies showed a higher risk of maternal morbidity amongst black and other minority ethnic (BME groups, but were unable to investigate whether this excess risk was concentrated within specific BME groups in the UK. Our aim was to analyse the specific risks and to investigate reasons for any disparity.Unmatched case-control analysis using data from the United Kingdom Obstetric Surveillance System (UKOSS, February 2005-January 2013. Cases were 1,753 women who experienced severe morbidity during the peripartum period. Controls were 3,310 women who delivered immediately before the cases in the same hospital. Multivariable logistic regression modelling was used to adjust for known confounders and to understand their effects.Compared with white European women, the odds of severe maternal morbidity were 83% higher among black African women (adjusted odds ratio (aOR = 1.83; 95% Confidence Interval (CI = 1.39-2.40, 80% higher among black Caribbean (aOR = 1.80; 95% CI = 1.14-2.82, 74% higher in Bangladeshi (aOR = 1.74; 95% CI = 1.05-2.88, 56% higher in other non-whites (non-Asian (aOR = 1.56; 95% CI = 1.05-2.33 and 43% higher among Pakistani women (aOR = 1.43; 95% CI = 1.07-1.92. There was no evidence of substantial confounding. Anaemia in current pregnancy, previous pregnancy problems, inadequate utilisation of antenatal care, pre-existing medical conditions, parity>3, and being younger and older were independent risk factors but, the odds of severe maternal morbidity did not differ by socioeconomic status, between smokers and non-smokers or by BMI.This national study demonstrates an increased risk of severe maternal morbidity among women of ethnic minority backgrounds which could not be explained by known risk factors for severe maternal morbidity.

  3. Severe maternal sepsis in the UK, 2011-2012: a national case-control study.

    Directory of Open Access Journals (Sweden)

    Colleen D Acosta

    2014-07-01

    Full Text Available In light of increasing rates and severity of sepsis worldwide, this study aimed to estimate the incidence of, and describe the causative organisms, sources of infection, and risk factors for, severe maternal sepsis in the UK.A prospective case-control study included 365 confirmed cases of severe maternal sepsis and 757 controls from all UK obstetrician-led maternity units from June 1, 2011, to May 31, 2012. Incidence of severe sepsis was 4.7 (95% CI 4.2-5.2 per 10,000 maternities; 71 (19.5% women developed septic shock; and five (1.4% women died. Genital tract infection (31.0% and the organism Escherichia coli (21.1% were most common. Women had significantly increased adjusted odds ratios (aORs of severe sepsis if they were black or other ethnic minority (aOR = 1.82; 95% CI 1.82-2.51, were primiparous (aOR = 1.60; 95% CI 1.17-2.20, had a pre-existing medical problem (aOR = 1.40; 95% CI 1.01-1.94, had febrile illness or were taking antibiotics in the 2 wk prior to presentation (aOR = 12.07; 95% CI 8.11-17.97, or had an operative vaginal delivery (aOR = 2.49; 95% CI 1.32-4.70, pre-labour cesarean (aOR = 3.83; 95% CI 2.24-6.56, or cesarean after labour onset (aOR = 8.06; 95% CI 4.65-13.97. Median time between delivery and sepsis was 3 d (interquartile range = 1-7 d. Multiple pregnancy (aOR = 5.75; 95% CI 1.54-21.45 and infection with group A streptococcus (aOR = 4.84; 2.17-10.78 were associated with progression to septic shock; for 16 (50% women with a group A streptococcal infection there was <2 h-and for 24 (75% women, <9 h-between the first sign of systemic inflammatory response syndrome and a diagnosis of severe sepsis. A limitation of this study was the proportion of women with sepsis without an identified organism or infection source (16.4%.For each maternal sepsis death, approximately 50 women have life-threatening morbidity from sepsis. Follow-up to ensure infection is eradicated is important. The

  4. Information vs Engagement in parliamentary websites – a case study of Brazil and the UK

    Directory of Open Access Journals (Sweden)

    Cristiane Brum Bernardes

    Full Text Available Abstract Parliamentary websites have become the main window of parliament to the outside world. More than a gimmick, they are an essential element in the promotion of a relationship between parliament and citizens. This paper develops a comparative analysis of the websites of the lower chambers of the Brazilian and the British parliaments, respectively the Chamber of Deputies and the House of Commons. We structure this analysis around three dimensions: 1 information about the institution; 2 information about parliamentary activity; and 3 tools to promote engagement with the public. The choice of two very different case studies enables us to consider more clearly the specific purposes of these parliamentary websites. We consider in particular if these parliaments' institutional differences affect their websites. The websites' analysis is complemented by semi-structured elite interviews with parliamentary staff who manage the services provided by these websites. Our analysis shows that both websites achieve much higher levels of complexity in the information area than in engagement. But it also shows that the Brazilian parliament website includes far more tools designed for public interaction than its UK counterpart. The indexes and interviews show that both institutions are highly committed to disseminating data and information to citizens. This is seen as a path towards achieving higher accountability and improving knowledge about parliamentary processes and, consequently, improving public image and levels of trust. Whilst there is a strong focus on the provision of information, there is still little evidence of enabling citizen participation in the legislative process. This is partly due to a tension between conceptions of representative democracy and those of participatory democracy. The articulation between these different types of democracy still has a long way to be resolved, although parliaments are slowly introducing participatory tools.

  5. Supporting newly qualified nurse transition: A case study in a UK hospital.

    Science.gov (United States)

    Whitehead, Bill; Owen, Patricia; Henshaw, Lorraine; Beddingham, Elaine; Simmons, Maxine

    2016-01-01

    Nurse education in the United Kingdom (UK) has been university based since the mid-1990s but despite careful preparation and assessment of student nurses it has been considered necessary to provide a period of additional support for newly qualified nurses (NQNs) to help them settle into their new role and responsibilities. Preceptorship is the process of supporting NQNs over the transition from student to registered nurse (RN) and it is recognised that this can be a difficult time for NQNs. A systematic review was conducted as part of this project and has been published in an earlier edition of Nurse Education Today (Whitehead et al, 2013). This suggests that preceptorship is a positive and essential experience for NQNs. Lincoln and Guba's Naturalistic Inquiry (1985) was used. A qualitative case study method was developed and consisted of a multi-stage approach including semi-structured interviews with key personnel; documentary analysis of preceptorship material; and focus groups with key actors. Ethical approval was attained for the project. The aim was to interpret the social phenomena and to produce an evidence based tool to improve preceptorship. Findings are grouped under the headings indicated by the research design. In addition a further 11 themes emerged, including: the need for specific time for preceptors and preceptees; formal recognition of the role and a culture of support; selection and preparation of preceptors and the management structure to support preceptorship. The findings indicate that there are a range of factors which are reported to affect the successful transition from student to NQN. Based on these factors recommendations are made for practice and for further research. Practice recommendations: to provide supported preceptorship following the recommendations of the research findings. to concentrate on enhancing preceptorship as preceptorship in any form is better than none. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. LSS, a problem solving skill for graduates and SMEs: Case Study of investigation in a UK Business School curriculum

    OpenAIRE

    Shokri, Alireza; Nabhani, Farhad

    2015-01-01

    Purpose - This research aims to investigate the feasibility of a systematic Lean Six Sigma (LSS) education through the curriculum of business schools to respond to the existing gap between the graduate’s expectation of employability and skill requirements by the Small and Medium Sized Enterprises (SMEs).\\ud \\ud Design/approach/methodology - One UK business school has been used as a case study to conduct an extensive module and programme review followed by a semi-structured interview with the ...

  7. Receptionist input to quality and safety in repeat prescribing in UK general practice: ethnographic case study.

    Science.gov (United States)

    Swinglehurst, Deborah; Greenhalgh, Trisha; Russell, Jill; Myall, Michelle

    2011-11-03

    To describe, explore, and compare organisational routines for repeat prescribing in general practice to identify contributors and barriers to safety and quality. Ethnographic case study. Four urban UK general practices with diverse organisational characteristics using electronic patient records that supported semi-automation of repeat prescribing. 395 hours of ethnographic observation of staff (25 doctors, 16 nurses, 4 healthcare assistants, 6 managers, and 56 reception or administrative staff), and 28 documents and other artefacts relating to repeat prescribing locally and nationally. Potential threats to patient safety and characteristics of good practice. Observation of how doctors, receptionists, and other administrative staff contributed to, and collaborated on, the repeat prescribing routine. Analysis included mapping prescribing routines, building a rich description of organisational practices, and drawing these together through narrative synthesis. This was informed by a sociological model of how organisational routines shape and are shaped by information and communications technologies. Results Repeat prescribing was a complex, technology-supported social practice requiring collaboration between clinical and administrative staff, with important implications for patient safety. More than half of requests for repeat prescriptions were classed as "exceptions" by receptionists (most commonly because the drug, dose, or timing differed from what was on the electronic repeat list). They managed these exceptions by making situated judgments that enabled them (sometimes but not always) to bridge the gap between the idealised assumptions about tasks, roles, and interactions that were built into the electronic patient record and formal protocols, and the actual repeat prescribing routine as it played out in practice. This work was creative and demanded both explicit and tacit knowledge. Clinicians were often unaware of this input and it did not feature in policy

  8. The design briefing process matters: a case study on telehealthcare device providers in the UK.

    Science.gov (United States)

    Yang, Fan; Renda, Gianni

    2018-01-23

    The telehealthcare sector has been expanding steadily in the UK. However, confusing, complex and unwieldy designs of telehealthcare devices are at best, less effective than they could be, at worst, they are potentially dangerous to the users. This study investigated the factors within the new product development process that hindered satisfactory product design outcomes, through working collaboratively with a leading provider based in the UK. This study identified that there are too many costly late-stage design changes; a critical and persistent problem area ripe for improvement. The findings from analyzing 30 recent devices, interviewing key stakeholders and observing on-going projects further revealed that one major cause of the issue was poor practice in defining and communicating the product design criteria and requirements. Addressing the characteristics of the telehealthcare industry, such as multiple design commissioners and frequent deployment of design subcontracts, this paper argues that undertaking a robust process of creating the product design brief is the key to improving the outcomes of telehealthcare device design, particularly for the small and medium-sized enterprises dominating the sector. Implications for rehabilitation Product design criteria and requirements are frequently ill-defined and ineffectively communicated to the designers within the processes of developing new telehealthcare devices. The absence of a (robust) process of creating the design brief is the root cause of the identified issues in defining and communicating the design task. Deploying a formal process of creating the product design brief is particularly important for the telehealthcare sector.

  9. Market Impact of Foot-and-Mouth Disease Control Strategies: A UK Case Study

    Directory of Open Access Journals (Sweden)

    Siyi Feng

    2017-09-01

    Full Text Available Foot-and-mouth disease (FMD poses a serious threat to the agricultural sector due to its highly contagious nature. Outbreaks of FMD can lead to substantial disruptions to livestock markets due to loss of production and access to international markets. In a previously FMD-free country, the use of vaccination to augment control of an FMD outbreak is increasingly being recognized as an alternative control strategy to direct slaughtering [stamping-out (SO]. The choice of control strategy has implications on production, trade, and hence prices of the sector. Specific choice of eradication strategies depends on their costs and benefits. Economic impact assessments are often based on benefit–cost framework, which provide detailed information on the changes in profit for a farm or budget implications for a government (1. However, this framework cannot capture price effects caused by changes in production due to culling of animals; access to international markets; and consumers’ reaction. These three impacts combine to affect equilibrium within commodity markets (2. This paper provides assessment of sectoral level impacts of the eradication choices of FMD outbreaks, which are typically not available from benefit–cost framework, in the context of the UK. The FAPRI-UK model, a partial equilibrium model of the agricultural sector, is utilized to investigate market outcomes of different control strategies (namely SO and vaccinate-to-die in the case of FMD outbreaks. The outputs from the simulations of the EXODIS epidemiological model (number of animals culled/vaccinated and duration of outbreak are used as inputs within the economic model to capture the overall price impact of the animal destruction, export ban, and consumers’ response.

  10. Case studies of hydrogen sulphide occupational exposure incidents in the UK.

    Science.gov (United States)

    Jones, Kate

    2014-12-15

    The UK Health and Safety Executive has investigated several incidents of workplace accidents involving hydrogen sulphide exposure in recent years. Biological monitoring has been used in some incidents to determine the cause of unconsciousness resulting from these incidents and as a supporting evidence in regulatory enforcement. This paper reports on three case incidents and discusses the use of biological monitoring in such cases. Biological monitoring has a role in identifying hydrogen sulphide exposure in incidents, whether these are occupational or in the wider environment. Sample type, time of collection and sample storage are important factors in the applicability of this technique. For non-fatal incidents, multiple urine samples are recommended at two or more time points between the incident and 15 h post-exposure. For routine occupational monitoring, post-shift samples should be adequate. Due to endogenous levels of urinary thiosulphate, it is likely that exposures in excess of 12 ppm for 30 min (or 360 ppm/min equivalent) would be detectable using biological monitoring. This is within the Acute Exposure Guideline Level 2 (the level of the chemical in air at or above which there may be irreversible or other serious long-lasting effects or impaired ability to escape) for hydrogen sulphide. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

  11. The UK Netball Superleague: A case study of franchising in elite women's sport organisations

    OpenAIRE

    Mansfield, L; Killick, L

    2012-01-01

    This is an Author's Accepted Manuscript of an article published in European Sport Management Quarterly, 12(5), 545 - 567, 2012, copyright Taylor & Francis, available online at: http://www.tandfonline.com/10.1080/16184742.2012.734525. This paper draws on theories of franchising in examining the emergence of the UK Netball Superleague (UK NSL) in 2005. The focus of the paper is to explore the development of an empowered franchise framework as part of England Netball's elite performance strat...

  12. UK investments in global infectious disease research 1997-2010: a case study.

    Science.gov (United States)

    Head, Michael G; Fitchett, Joseph R; Cooke, Mary K; Wurie, Fatima B; Hayward, Andrew C; Atun, Rifat

    2013-01-01

    Infectious diseases account for 15 million deaths per year worldwide, and disproportionately affect young people, elderly people, and the poorest sections of society. We aimed to describe the investments awarded to UK institutions for infectious disease research. We systematically searched databases and websites for information on research studies from funding institutions and created a comprehensive database of infectious disease research projects for the period 1997-2010. We categorised studies and funding by disease, cross-cutting theme, and by a research and development value chain describing the type of science. Regression analyses were reported with Spearman's rank correlation coefficient to establish the relation between research investment, mortality, and disease burden as measured by disability-adjusted life years (DALYs). We identified 6170 funded studies, with a total research investment of UK£2·6 billion. Studies with a clear global health component represented 35·6% of all funding (£927 million). By disease, HIV received £461 million (17·7%), malaria £346 million (13·3%), tuberculosis £149 million (5·7%), influenza £80 million (3·1%), and hepatitis C £60 million (2·3%). We compared funding with disease burden (DALYs and mortality) to show low levels of investment relative to burden for gastrointestinal infections (£254 million, 9·7%), some neglected tropical diseases (£184 million, 7·1%), and antimicrobial resistance (£96 million, 3·7%). Virology was the highest funded category (£1 billion, 38·4%). Leading funding sources were the Wellcome Trust (£688 million, 26·4%) and the Medical Research Council (£673 million, 25·8%). Research funding has to be aligned with prevailing and projected global infectious disease burden. Funding agencies and industry need to openly document their research investments to redress any inequities in resource allocation. None. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2014-06-01

    Since 2003, over 2000 cases of lymphogranuloma venereum (LGV) have been diagnosed in the U.K. in men who have sex with men (MSM). Most cases present with proctitis, but there are limited data on how to differentiate clinically between LGV and other pathology. We analysed the clinical presentations of rectal LGV in MSM to identify clinical characteristics predictive of LGV proctitis and produced a clinical prediction model. A prospective multicentre case-control study was conducted at six U.K. hospitals from 2008 to 2010. Cases of rectal LGV were compared with controls with rectal symptoms but without LGV. Data from 98 LGV cases and 81 controls were collected from patients and clinicians using computer-assisted self-interviews and clinical report forms. Univariate and multivariate logistic regression was used to compare symptoms and signs. Clinical prediction models for LGV were compared using receiver operating curves. Tenesmus, constipation, anal discharge and weight loss were significantly more common in cases than controls. In multivariate analysis, tenesmus and constipation alone were suggestive of LGV (OR 2.98, 95% CI 0.99 to 8.98 and 2.87, 95% CI 1.01 to 8.15, respectively) and that tenesmus alone or in combination with constipation was a significant predictor of LGV (OR 6.97, 95% CI 2.71 to 17.92). The best clinical prediction was having one or more of tenesmus, constipation and exudate on proctoscopy, with a sensitivity of 77% and specificity of 65%. This study indicates that tenesmus alone or in combination with constipation makes a diagnosis of LGV in MSM presenting with rectal symptoms more likely. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

    Science.gov (United States)

    Williams, Allan P. O.

    2009-01-01

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

  15. Comparing the Sustainability of Local and Global Food Chains: A Case Study of Cheese Products in Switzerland and the UK

    Directory of Open Access Journals (Sweden)

    Emilia Schmitt

    2016-04-01

    Full Text Available Local food has recently gained popularity under the assumption that it is more sustainable than food from distant locations. However, evidence is still lacking to fully support this assumption. The goal of this study is to compare local and global food chains in five dimensions of sustainability (environmental, economic, social, ethical and health, covering all stages of the chain. In particular, four cheese supply chains are compared in detail: a local (L’Etivaz and global (Le Gruyère case in Switzerland and a local (Single Gloucester and global (Cheddar case in the UK. A multi-dimensional perspective is adopted to compare their sustainability performance. Eight attributes of performance (affordability, creation and distribution of added value, information and communication, consumer behaviour, resource use, biodiversity, nutrition and animal welfare are used to frame the comparative analysis. The results suggest that local cheese performs better in the field of added value creation and distribution, animal welfare and biodiversity. Global chains, by contrast, perform better in terms of affordability and efficiency and some environmental indicators. This analysis needed to be expressed in qualitative terms rather than quantified indicators and it has been especially useful to identify the critical issues and trade-offs that hinder sustainability at different scales. Cheese supply chains in Switzerland and the UK also often present hybrid arrangements in term of local and global scales. Comparison is therefore most meaningful when presented on a local (farmhouse/global (creamery continuum.

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

    Science.gov (United States)

    Hart, Angie; Northmore, Simon

    2011-01-01

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

  17. Wine Argentinean Export Chain: A Case Study in the UK Market

    OpenAIRE

    Cetrangolo, Hugo; Briz, Julian

    2008-01-01

    International wine market is becoming one of the more dynamic in beverages sector. This paper is a summary of the research developed during 2004-2006 at the UPM with Argentinean exporters. The selection of UK market was due to the high degree of competition between international wines: European, American, Australian and others. Secondary information was collected from EU and Argentina publication and data bases. Primary information was obtained through face to face interviews with the main st...

  18. Urban river design and aesthetics: A river restoration case study from the UK

    OpenAIRE

    Prior, Jonathan

    2016-01-01

    This paper analyses the restoration of an urbanized section of the River Skerne where it flows through a suburb of Darlington, England; a project which was one of the first comprehensive urban river restorations undertaken in the UK. It is shown how aesthetic values were central to the identification of the River Skerne as a site for restoration, the production of restoration objectives, and a design vision of urban river renewal via restoration. Secondly, the means by which these aesthetic v...

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

    Science.gov (United States)

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

    2015-07-01

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

  20. A cost-effectiveness analysis of radon protection methods in domestic properties: a comparative case study in Brixworth, Northamptonshire, UK

    International Nuclear Information System (INIS)

    Coskeran, Thomas; Denman, Antony; Phillips, Paul; Tornberg, Roger

    2006-01-01

    Building regulations in the UK have since 1992 required that radon-proof membranes be installed in new domestic properties to protect residents against the adverse effects of radon. This study compares the cost-effectiveness of the current regulatory regime with an alternative that would entail new properties being tested for radon after construction, and being remediated if necessary. The alternative regime is found to be more cost-effective for a sample of properties in Brixworth, Northamptonshire, UK. For this regime, the central estimate of cost per quality-adjusted life-year gained, the measure of cost-effectiveness used, is Pounds 2869 compared to Pounds 6182 for installing membranes, results suggesting a case for re-examining the current regulations on radon protection in new properties. Pilot studies will, however, be needed to consider how different means of protecting residents of new properties against radon might operate in practice and to provide improved evidence on their relative cost-effectiveness

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

    Science.gov (United States)

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

    2012-09-01

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

  2. Establishing and sustaining research partnerships in Africa: a case study of the UK-Africa Academic Partnership on Chronic Disease

    Directory of Open Access Journals (Sweden)

    de-Graft Aikins Ama

    2012-08-01

    Full Text Available Abstract This paper examines the challenges and opportunities in establishing and sustaining north–south research partnerships in Africa through a case study of the UK-Africa Academic Partnership on Chronic Disease. Established in 2006 with seed funding from the British Academy, the partnership aimed to bring together multidisciplinary chronic disease researchers based in the UK and Africa to collaborate on research, inform policymaking, train and support postgraduates and create a platform for research dissemination. We review the partnership’s achievements and challenges, applying established criteria for developing successful partnerships. During the funded period we achieved major success in creating a platform for research dissemination through international meetings and publications. Other goals, such as engaging in collaborative research and training postgraduates, were not as successfully realised. Enabling factors included trust and respect between core working group members, a shared commitment to achieving partnership goals, and the collective ability to develop creative strategies to overcome funding challenges. Barriers included limited funding, administrative support, and framework for monitoring and evaluating some goals. Chronic disease research partnerships in low-income regions operate within health research, practice, funding and policy environments that prioritise infectious diseases and other pressing public health and developmental challenges. Their long-term sustainability will therefore depend on integrated funding systems that provide a crucial capacity building bridge. Beyond the specific challenges of chronic disease research, we identify social capital, measurable goals, administrative support, creativity and innovation and funding as five key ingredients that are essential for sustaining research partnerships.

  3. Establishing and sustaining research partnerships in Africa: a case study of the UK-Africa Academic Partnership on Chronic Disease

    Science.gov (United States)

    2012-01-01

    This paper examines the challenges and opportunities in establishing and sustaining north–south research partnerships in Africa through a case study of the UK-Africa Academic Partnership on Chronic Disease. Established in 2006 with seed funding from the British Academy, the partnership aimed to bring together multidisciplinary chronic disease researchers based in the UK and Africa to collaborate on research, inform policymaking, train and support postgraduates and create a platform for research dissemination. We review the partnership’s achievements and challenges, applying established criteria for developing successful partnerships. During the funded period we achieved major success in creating a platform for research dissemination through international meetings and publications. Other goals, such as engaging in collaborative research and training postgraduates, were not as successfully realised. Enabling factors included trust and respect between core working group members, a shared commitment to achieving partnership goals, and the collective ability to develop creative strategies to overcome funding challenges. Barriers included limited funding, administrative support, and framework for monitoring and evaluating some goals. Chronic disease research partnerships in low-income regions operate within health research, practice, funding and policy environments that prioritise infectious diseases and other pressing public health and developmental challenges. Their long-term sustainability will therefore depend on integrated funding systems that provide a crucial capacity building bridge. Beyond the specific challenges of chronic disease research, we identify social capital, measurable goals, administrative support, creativity and innovation and funding as five key ingredients that are essential for sustaining research partnerships. PMID:22897937

  4. Real-time flood inundation forecasting and mapping for key railway infrastructure: a UK case study

    Directory of Open Access Journals (Sweden)

    Murphy Alexandra T.

    2016-01-01

    Full Text Available Flooding events that impede railway infrastructure can cause severe travel delays for the general public and large fines in delayed minutes for the rail industry. Early warnings of flood inundation can give more time to implement mitigation measures which help reduce cancellations, delays and fines. Initial work is reported on the development of a real-time flood inundation forecasting and mapping system for the Cowley Bridge track area near Exeter, UK. This location is on one of the main access routes to South West England and has suffered major floods in the past resulting in significant transport impacts. Flood forecasting systems in the UK mainly forecast river level/flow rather than extent and depth of flood inundation. Here, the development of a chain of coupled models is discussed that link rainfall to river flow, river level and flood extent for the rail track area relating to Cowley Bridge. Historical events are identified to test model performance in predicting inundation of railway infrastructure. The modelling system will operate alongside a series of in-situ sensors chosen to enhance the flood mapping forecasting system. Sensor data will support offline model calibration/verification and real-time data assimilation as well as monitoring flood conditions to inform track closure decisions.

  5. A 10 year case study on the changing determinants of University student satisfaction in the UK

    OpenAIRE

    Burgess, Adrian P; Senior, Carl; Moores, Elisabeth

    2018-01-01

    Higher Education (HE), once the prerogative of a tiny elite, is now accessible to larger numbers of people around the world than ever before yet despite the fact that an understanding of student satisfaction has never been more important for today’s universities, the concept remains poorly understood. Here we use published data from the UK’s National Student Survey (NSS), representing data from 2.3 million full-time students collected from 2007 to 2016, as a case study of the benefits and lim...

  6. Measuring flood footprint of a regional economy - A case study for the UK flooding

    Science.gov (United States)

    Guan, D.

    2013-12-01

    Analysis of the urban economy and society is central to understanding the broad impacts of flooding and to identify cost-effective adaptation and mitigation measures. Assessments of the flooding impacts on cities have traditionally focused on the initial impact on people and assets. These initial estimates (so-called ';direct damage') are useful both in understanding the immediate implications of damage, and in marshalling the pools of capital and supplies required for re-building after an event. Since different economies as well as societies are coupled, especially under the current economic crisis, any small-scale damage may be multiplied and cascaded throughout wider economic systems and social networks. The direct and indirect damage is currently not evaluated well and could be captured by quantification of what we call the flood footprint. Flooding in one location can impact the whole UK economy. Neglecting these knock-on costs (i.e. the true footprint of the flood) means we might be ignoring the economic benefits and beneficiaries of flood risk management interventions. In 2007, for example, floods cost the economy about £3.2 bn directly, but the wider effect might actually add another 50% to 250% to that. Flood footprint is a measure of the exclusive total socioeconomic impact that is directly and indirectly caused by a flood event to the flooding region and wider economic systems and social networks. We adopt the UK 2012 flooding. An input-output basic dynamic inequalities (BDI) model is used to assess the impact of the floodings on the level of a Yorkshire economy, accounting for interactions between industries through demand and supply of intermediate consumption goods with a circular flow. After the disaster the economy will be unbalanced. The recovery process finishes when the economy is completely balance, i.e., when labour production capacity equals demands and production and all the variables reach pre-disaster levels. The analysis is carried out

  7. Advertising Appeals and Cultural Values in Social Media Commercials in UK, Brasil and India: Case Study of Nokia and Samsung

    OpenAIRE

    Han Nguyen

    2014-01-01

    The objectives of this study is to investigate the impact of culture on advertising appeals in mobile phone industry via social media channel in UK, Brazil and India. Content analysis on Samsung and Nokia commercials in YouTube is conducted. The result indicates that the advertising appeals are both congruent and incongruent with cultural dimensions in UK, Brazil and India. The result suggests that Hofstede and value paradoxes might be the tools to predict the relationshi...

  8. The application of the triple bottom line approach to sustainability assessment: The case study of the UK automotive supply chain

    International Nuclear Information System (INIS)

    Azevedo, S.; Barros, M.

    2017-01-01

    Purpose: The objective of this paper is to assess the level of sustainability of the UK automotive supply chain considering simultaneously the three dimensions of sustainability (economic, social and environmental) representing the Triple Bottom Line (TBL) approach. Design/methodology/approach: The assessment of the automotive SC’ sustainability is based on the framework proposed by Salvado, Azevedo, Matias and Ferreira (2011) and uses the Simple Additive Weighting (SAW) method to aggregate economic, environmental and social indicators into a unique index. A case study on the UK automotive industry is used and the data do perform this study is collected from the sustainability reports of the UK’ automotive companies. Findings and Originality/value: The proposed framework represents an important benchmarking tool, offering managers the possibility for assessing the sustainability behaviour of its supply chain and compare it with other supply chains. Once identified the dimension of sustainability where the company or the supply chain is worst performer managers can work closer to their supply chain’ partners in order to improve the performance of those dimension of sustainability. Research limitations/implications: One limitation of the suggested approach is related to the ambiguity of the sustainability’ indicators selection and the definition of weights for each sustainability dimension. Practical implications: The assessment of the SC sustainability by using the suggested framework to compute a SC sustainability index offers managers an opportunity for assessing the level of sustainability of each individual company and the corresponding SC in a very easy way. It also represents an opportunity for improving company performance. In this way managers can use the information on the sustainability index to help adjust their company's behaviour and improve their economic, social and environmental performance. Originality/value: The proposed framework

  9. The application of the triple bottom line approach to sustainability assessment: The case study of the UK automotive supply chain

    Energy Technology Data Exchange (ETDEWEB)

    Azevedo, S.; Barros, M.

    2017-07-01

    Purpose: The objective of this paper is to assess the level of sustainability of the UK automotive supply chain considering simultaneously the three dimensions of sustainability (economic, social and environmental) representing the Triple Bottom Line (TBL) approach. Design/methodology/approach: The assessment of the automotive SC’ sustainability is based on the framework proposed by Salvado, Azevedo, Matias and Ferreira (2011) and uses the Simple Additive Weighting (SAW) method to aggregate economic, environmental and social indicators into a unique index. A case study on the UK automotive industry is used and the data do perform this study is collected from the sustainability reports of the UK’ automotive companies. Findings and Originality/value: The proposed framework represents an important benchmarking tool, offering managers the possibility for assessing the sustainability behaviour of its supply chain and compare it with other supply chains. Once identified the dimension of sustainability where the company or the supply chain is worst performer managers can work closer to their supply chain’ partners in order to improve the performance of those dimension of sustainability. Research limitations/implications: One limitation of the suggested approach is related to the ambiguity of the sustainability’ indicators selection and the definition of weights for each sustainability dimension. Practical implications: The assessment of the SC sustainability by using the suggested framework to compute a SC sustainability index offers managers an opportunity for assessing the level of sustainability of each individual company and the corresponding SC in a very easy way. It also represents an opportunity for improving company performance. In this way managers can use the information on the sustainability index to help adjust their company's behaviour and improve their economic, social and environmental performance. Originality/value: The proposed framework

  10. Incidence and Risk Factors for Placenta Accreta/Increta/Percreta in the UK: A National Case-Control Study

    Science.gov (United States)

    Fitzpatrick, Kathryn E.; Sellers, Susan; Spark, Patsy; Kurinczuk, Jennifer J.; Brocklehurst, Peter; Knight, Marian

    2012-01-01

    Background Placenta accreta/increta/percreta is associated with major pregnancy complications and is thought to be becoming more common. The aims of this study were to estimate the incidence of placenta accreta/increta/percreta in the UK and to investigate and quantify the associated risk factors. Methods A national case-control study using the UK Obstetric Surveillance System was undertaken, including 134 women diagnosed with placenta accreta/increta/percreta between May 2010 and April 2011 and 256 control women. Results The estimated incidence of placenta accreta/increta/percreta was 1.7 per 10,000 maternities overall; 577 per 10,000 in women with both a previous caesarean delivery and placenta praevia. Women who had a previous caesarean delivery (adjusted odds ratio (aOR) 14.41, 95%CI 5.63–36.85), other previous uterine surgery (aOR 3.40, 95%CI 1.30–8.91), an IVF pregnancy (aOR 32.13, 95%CI 2.03–509.23) and placenta praevia diagnosed antepartum (aOR 65.02, 95%CI 16.58–254.96) had raised odds of having placenta accreta/increta/percreta. There was also a raised odds of placenta accreta/increta/percreta associated with older maternal age in women without a previous caesarean delivery (aOR 1.30, 95%CI 1.13–1.50 for every one year increase in age). Conclusions Women with both a prior caesarean delivery and placenta praevia have a high incidence of placenta accreta/increta/percreta. There is a need to maintain a high index of suspicion of abnormal placental invasion in such women and preparations for delivery should be made accordingly. PMID:23300807

  11. Incidence and risk factors for placenta accreta/increta/percreta in the UK: a national case-control study.

    Directory of Open Access Journals (Sweden)

    Kathryn E Fitzpatrick

    Full Text Available Placenta accreta/increta/percreta is associated with major pregnancy complications and is thought to be becoming more common. The aims of this study were to estimate the incidence of placenta accreta/increta/percreta in the UK and to investigate and quantify the associated risk factors.A national case-control study using the UK Obstetric Surveillance System was undertaken, including 134 women diagnosed with placenta accreta/increta/percreta between May 2010 and April 2011 and 256 control women.The estimated incidence of placenta accreta/increta/percreta was 1.7 per 10,000 maternities overall; 577 per 10,000 in women with both a previous caesarean delivery and placenta praevia. Women who had a previous caesarean delivery (adjusted odds ratio (aOR 14.41, 95%CI 5.63-36.85, other previous uterine surgery (aOR 3.40, 95%CI 1.30-8.91, an IVF pregnancy (aOR 32.13, 95%CI 2.03-509.23 and placenta praevia diagnosed antepartum (aOR 65.02, 95%CI 16.58-254.96 had raised odds of having placenta accreta/increta/percreta. There was also a raised odds of placenta accreta/increta/percreta associated with older maternal age in women without a previous caesarean delivery (aOR 1.30, 95%CI 1.13-1.50 for every one year increase in age.Women with both a prior caesarean delivery and placenta praevia have a high incidence of placenta accreta/increta/percreta. There is a need to maintain a high index of suspicion of abnormal placental invasion in such women and preparations for delivery should be made accordingly.

  12. The application of the triple bottom line approach to sustainability assessment: The case study of the UK automotive supply chain

    Directory of Open Access Journals (Sweden)

    Susana Azevedo

    2017-05-01

    Full Text Available Purpose: The objective of this paper is to assess the level of sustainability of the UK automotive supply chain considering simultaneously the three dimensions of sustainability (economic, social and environmental representing the Triple Bottom Line (TBL approach. Design/methodology/approach: The assessment of the automotive SC’ sustainability is based on the framework proposed by Salvado, Azevedo, Matias and Ferreira (2011 and uses the Simple Additive Weighting (SAW method to aggregate economic, environmental and social indicators into a unique index. A case study on the UK automotive industry is used and the data do perform this study is collected from the sustainability reports of the UK’ automotive companies. Findings and Originality/value: The proposed framework represents an important benchmarking tool, offering managers the possibility for assessing the sustainability behaviour of its supply chain and compare it with other supply chains. Once identified the dimension of sustainability where the company or the supply chain is worst performer managers can work closer to their supply chain’ partners in order to improve the performance of those dimension of sustainability. Research limitations/implications: One limitation of the suggested approach is related to the ambiguity of the sustainability’ indicators selection and the definition of weights for each sustainability dimension. Practical implications: The assessment of the SC sustainability by using the suggested framework to compute a SC sustainability index offers managers an opportunity for assessing the level of sustainability of each individual company and the corresponding SC in a very easy way. It also represents an opportunity for improving company performance. In this way managers can use the information on the sustainability index to help adjust their company's behaviour and improve their economic, social and environmental performance. Originality/value: The proposed

  13. The Dart estuary, Devon, UK: a case study of chemical dynamics and pollutant mobility

    Directory of Open Access Journals (Sweden)

    2007-01-01

    Full Text Available Water, sediments and gill and digestive gland tissues of adult common shore crab (Carcinus maenas, collected at Noss Marina, Sandquay (Britannia Royal Naval College, the Dartmouth Pier, Warfleet Cove and Sugary Cove in the Dart estuary, Devon, UK, were analysed for major, minor and trace elements in spring 2004. Total acid-available measurements analysed included the truly dissolved component and acid-available sediments. Trace metal concentrations are associated largely with particulate and micro-particulate/colloidal phases, the latter being able to pass through standard filter papers. Wide ranges of chemical concentrations were found in the water, sediments and tissues at all the locations. In the water column, 48% of the variance is linked to the sea-salt component (Cl, Na, K, Ca, Mg, B, Li and Sr and the sediment-associated acid-available fractions are linked to Fe-rich lithogenous materials (Ba, Co, Cu, Fe, Mn, V and Zn. In the sediments, trace elements of Cd, Co, Cr, Fe, Pb, Mn, Ni and V are correlated with the sea salts and associated with the fraction of fine sediments within the total sediment. In the gills and the digestive gland tissues of crabs, high concentrations of Al, Cu and Fe are found and there are correlations between acid-available trace metals of Cu, Cr, Fe, Mn, Ni, Sr and Zn. The relationships between trace metal contaminants, their site-specific concentrations, their temporal and spatial variability and the effects of human activities, such as moorland/agriculture with historic mining and recreational activities in the lower Dart estuary, are discussed.

  14. Out-of-home food outlets and area deprivation: case study in Glasgow, UK

    Directory of Open Access Journals (Sweden)

    Cummins Steven

    2005-10-01

    Full Text Available Abstract Background There is a popular belief that out-of-home eating outlets, which typically serve energy dense food, may be more commonly found in more deprived areas and that this may contribute to higher rates of obesity and related diseases in such areas. Methods We obtained a list of all 1301 out-of-home eating outlets in Glasgow, UK, in 2003 and mapped these at unit postcode level. We categorised them into quintiles of area deprivation using the 2004 Scottish Index of Multiple Deprivation and computed mean density of types of outlet (restaurants, fast food restaurants, cafes and takeaways, and all types combined, per 1000 population. We also estimated odds ratios for the presence of any outlets in small areas within the quintiles. Results The density of outlets, and the likelihood of having any outlets, was highest in the second most affluent quintile (Q2 and lowest in the second most deprived quintile (Q4. Mean outlets per 1,000 were 4.02 in Q2, 1.20 in Q4 and 2.03 in Q5. With Q2 as the reference, Odds Ratios for having any outlets were 0.52 (CI 0.32–0.84 in Q1, 0.50 (CI 0.31 – 0.80 in Q4 and 0.61 (CI 0.38 – 0.98 in Q5. Outlets were located in the City Centre, West End, and along arterial roads. Conclusion In Glasgow those living in poorer areas are not more likely to be exposed to out-of-home eating outlets in their neighbourhoods. Health improvement policies need to be based on empirical evidence about the location of fast food outlets in specific national and local contexts, rather than on popular 'factoids'.

  15. Manchester iStent study: early results from a prospective UK case series.

    Science.gov (United States)

    Patel, Ilesh; de Klerk, Timothy A; Au, Leon

    2013-01-01

    To evaluate the 6-month efficacy and safety of the iStent microtrabecular bypass stent in patients with open-angle glaucoma. A prospective, uncontrolled, interventional case series. Forty-four eyes with open-angle glaucoma were reported. All subjects underwent ab interno implantation of a single iStent together with (n = 40) or without (n = 4) cataract surgery. Patients were assessed at postoperative week 1, months 1 and 3, and quarterly, thereafter. Data collected included visual acuity, intraocular pressure measurement using Goldmann tonometry, number of glaucoma medications, and number and type of complications. The mean age of the sample was 76.8 years. The mean duration since glaucoma diagnosis was 5.3 years (standard deviation 2.9 years). The mean visual acuity was 0.53 logMAR at baseline that improved to 0.23 at 6 months postoperatively. The mean baseline intraocular pressure was 21.1 mmHg, and this decreased significantly to 16.7 mmHg at 6 months (P control. © 2013 The Authors. Clinical and Experimental Ophthalmology © 2013 Royal Australian and New Zealand College of Ophthalmologists.

  16. An investigation into international business collaboration in higher education organisations: a case study of international partnerships in four UK leading universities

    OpenAIRE

    Ayoubi, R; Al-Habaibeh, A

    2006-01-01

    Purpose - The purpose of this paper is to develop a comparative analysis of the main objectives of international institutional partnerships in four UK leading universities. Based on the presented case studies, the paper outlines a model for objectives and implementation of international partnership. Design/methodology/approach - Using a multiple case study approach, the paper employs three sources of data: templates of international partnerships, actual agreements of international partnership...

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

    Science.gov (United States)

    Ragavan, Shamini K.

    2014-01-01

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

  18. Health protection: communicable disease, public health and infection control educational programmes--a case study from the UK.

    Science.gov (United States)

    El-Ansari, W; Privett, S

    2005-04-01

    The health protection (HP) landscape is changing. Issues related to infectious diseases in the context of global health are receiving the attention of world leaders and policy makers. In the UK, the national health policies resonate with such transformations, presenting a range of opportunities and challenges. The opportunities include the formation of a new national organisation dedicated to protecting the people's health and reducing the impact of infectious disease, the Health Protection Agency. The opportunities also include the opening of non-medical specialists's pathways in public health. The challenges represent the limited number of centres offering infection control education; the hospital focus and bias of the courses; new, resurgent and emerging infections; globalisation and travel; bacterial resistance; vaccine safety and coverage; bioterrorism; global response capacity; and visa restrictions. Within this context, this paper presents a case study of a HP educational programme at a British university in the south of England. It outlines the course design and philosophy, participants, recruitment, aims, descriptions and learning outcomes. A range of teething problems associated with the initiation and running of such programmes is considered. These include aspects related to the university, features associated with the modules, characteristics of the students, and other interconnected larger scale international issues. Some suggestions for the way forward are presented. Collectively, attention to the suggested measures can ensure that the processes that teaching programmes embrace to refine their content and delivery will equip tomorrow's professionals with the requisite HP knowledge and skills.

  19. Can Consumers Understand Sustainability through Seafood Eco-Labels? A U.S. and UK Case Study

    Directory of Open Access Journals (Sweden)

    Alexis Gutierrez

    2014-11-01

    Full Text Available In the United States and the United Kingdom, over the last decade major retail chains have increasingly publicized their efforts to supply sustainably sourced and eco-labelled seafood. Debate exists over the extent of consumer demand for this product. Seafood eco-labels purportedly resolve the information asymmetry between producer and consumer, allowing consumers who care about sustainability to easily find and purchase these products. This paper discusses the idealized model of seafood eco-labelling in promoting sustainability and presents results of US and UK case studies based on consumer interviews and surveys, which found that consumers had often seen one or more seafood eco-labels. Two well-established eco-labels, dolphin-safe and organic, drove these rates of sustainable seafood awareness. These rates are interpreted in the context of consumer’s understanding of sustainable. The Sustainable Seafood Movement’s efforts to increase the supply of eco-labelled seafood and elaborate corporate buying policies for sustainable seafood are influencing consumer’s recognition and purchase of certified sustainable seafood products. However, eco-labels are a means to communicate messages about sustainable fisheries to consumers, not an end. Efforts to educate consumers about eco-labels should be a component of ocean literacy efforts, which educate the public about the need for sustainable fisheries.

  20. How Does Paying for Ecosystem Services Contribute to Sustainable Development? Evidence from Case Study Research in Germany and the UK

    Directory of Open Access Journals (Sweden)

    Kristin Nicolaus

    2014-05-01

    Full Text Available Payments for ecosystem services (PES are currently being discussed as one of the most promising tools in environmental and sustainability governance. However, much criticism has been voiced against overly optimistic assumptions of PES’ management potential towards sustainability. Several contributions to the debate show that PES fail both in reducing poverty and strengthening social justice. Additionally, they neglect problems of deliberation in decision-making, as well as the legitimacy of the applied environmental practices. Our empirical investigation on participatory and deliberative structures in already existing PES initiated by non-state actors contributes to the latter body of research. Based on the assumption that playing an active part in scheme design facilitates the consideration of justice and fairness, our case studies from Germany and the UK. present interesting results on the involvement of conflicting interests and their argumentation in the design process. Summing up these findings, we conclude that paying for ES rarely contributes to sustainable development in and of itself, but deliberatively designed schemes provide a formal setting to take aspects of justice into account.

  1. Environmental impacts of food waste: Learnings and challenges from a case study on UK

    DEFF Research Database (Denmark)

    Tonini, Davide; Albizzati, Paola Federica; Astrup, Thomas Fruergaard

    2018-01-01

    by four sectors of the food supply chain in United Kingdom, namely processing, wholesale and retail, food service, and households. The impacts were quantified for ten environmental impact categories, from Global Warming to Water Depletion, including indirect land use change impacts due to demand for land......Food waste, particularly when avoidable, incurs loss of resources and considerable environmental impacts due to the multiple processes involved in the life cycle. This study applies a bottom-up life cycle assessment method to quantify the environmental impacts of the avoidable food waste generated...

  2. Environmental impacts of food waste: Learnings and challenges from a case study on UK

    DEFF Research Database (Denmark)

    Tonini, Davide; Albizzati, Paola Federica; Astrup, Thomas Fruergaard

    2018-01-01

    Food waste, particularly when avoidable, incurs loss of resources and considerable environmental impacts due to the multiple processes involved in the life cycle. This study applies a bottom-up life cycle assessment method to quantify the environmental impacts of the avoidable food waste generate...... highlight the challenges related to modelling and methodological choices. Particularly, food production datasets should be chosen and used carefully, to avoid double counting and overestimation of the final impacts.......Food waste, particularly when avoidable, incurs loss of resources and considerable environmental impacts due to the multiple processes involved in the life cycle. This study applies a bottom-up life cycle assessment method to quantify the environmental impacts of the avoidable food waste generated...... by four sectors of the food supply chain in United Kingdom, namely processing, wholesale and retail, food service, and households. The impacts were quantified for ten environmental impact categories, from Global Warming to Water Depletion, including indirect land use change impacts due to demand for land...

  3. Handling uncertainty in bioenergy policy design – A case study analysis of UK and German bioelectricity policy instruments

    International Nuclear Information System (INIS)

    Purkus, Alexandra; Röder, Mirjam; Gawel, Erik; Thrän, Daniela; Thornley, Patricia

    2015-01-01

    In designing policies to promote bioenergy, policy makers face challenges concerning uncertainties about the sustainability of bioenergy pathways (including greenhouse gas balances), technology and resource costs, or future energy market framework conditions. New information becomes available with time, but policy adjustments can involve high levels of adaptation costs. To enable an effective steering of technology choices and innovation, policies have to strike a balance between creating a consistent institutional framework, which establishes planning security for investors, and sufficient flexibility to adapt to new information. This paper examines implications of economic theory for handling cost and benefit uncertainty in bioelectricity policy design, focussing on choices between price and quantity instruments, technology differentiation, and policy adjustment. Findings are applied to two case studies, the UK's Renewables Obligation and the German feed-in tariff/feed-in premium scheme. Case study results show the trade-offs that are involved in instrument choice and design – depending on political priorities and a country's specific context, different options can prove more adequate. Combining market-based remuneration with sustainability criteria results in strong incentives for bioenergy producers to search for low-cost solutions; whereas cost-based price instruments with centrally steered technology and feedstock choices offer higher planning security for investors and more direct control for policy makers over what pathways are implemented. Independent of the choice of instrument type and technology differentiation mechanism, findings emphasise the importance of a careful policy design, which determines the exact balance between performance criteria such as cost control, incentive intensity, planning security and adaptive efficiency. - Highlights: • Bioelectricity policy design must deal with simultaneous cost and benefit uncertainty.

  4. Social determinants of male health: a case study of Leeds, UK.

    Science.gov (United States)

    White, Alan; Seims, Amanda; Cameron, Ian; Taylor, Tim

    2018-01-19

    The social determinants of health have a disproportionate impact on mortality in men. A study into the state of health of the male population in Leeds was undertaken to guide public health commissioning decisions. This paper reports on the data relating to the social lives of men. A cross-sectional study was undertaken, comprising descriptive analysis of data relating to educational attainment, housing, employment (including benefit claimants), marital status and relationships. Data was considered for the whole city and localised at the Middle Super Output Area (MSOA) level and mapped against the Index of Deprivation. Boys' educational attainment was found to be lagging behind girls' from their earliest assessments (Early Years Foundation Stage Profile, 46% vs. 60%, P = 0.00) to GCSEs (53% vs. 63%, P = 0.00), leaving many men with no qualifications. There were 68% more men than women identified as being unemployed, with more men claiming benefits. Men living in social housing are more likely to be housed in high-rise flats. Almost 50% of men aged 16-64 are single, with 2254 lone fathers. There appears to be a lack of sex/gender analysis of current cross city data. In areas of deprivation a complex picture of multiple social problems emerges, with marked gender differences in the social determinants of health, with males seeming to be more negatively affected. There is a need for more focused planning for reaching out and targeting boys and men in the most deprived inner city areas, so that greater efficiency in service delivery can be obtained.

  5. Environmental impacts of food waste: Learnings and challenges from a case study on UK.

    Science.gov (United States)

    Tonini, Davide; Albizzati, Paola Federica; Astrup, Thomas Fruergaard

    2018-06-01

    Food waste, particularly when avoidable, incurs loss of resources and considerable environmental impacts due to the multiple processes involved in the life cycle. This study applies a bottom-up life cycle assessment method to quantify the environmental impacts of the avoidable food waste generated by four sectors of the food supply chain in United Kingdom, namely processing, wholesale and retail, food service, and households. The impacts were quantified for ten environmental impact categories, from Global Warming to Water Depletion, including indirect land use change impacts due to demand for land. The Global Warming impact of the avoidable food waste was quantified between 2000 and 3600 kg CO 2 -eq. t -1 . The range reflected the different compositions of the waste in each sector. Prominent contributors to the impact, across all the environmental categories assessed, were land use changes and food production. Food preparation, for households and food service sectors, also provided an important contribution to the Global Warming impacts, while waste management partly mitigated the overall impacts by incurring significant savings when landfilling was replaced with anaerobic digestion and incineration. To further improve these results, it is recommended to focus future efforts on providing improved data regarding the breakdown of specific food products within the mixed waste, indirect land use change effects, and the share of food waste undergoing cooking. Learning from this and previous studies, we highlight the challenges related to modelling and methodological choices. Particularly, food production datasets should be chosen and used carefully, to avoid double counting and overestimation of the final impacts. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Enhancing local distinctiveness fosters public acceptance of tidal energy: A UK case study

    International Nuclear Information System (INIS)

    Devine-Wright, Patrick

    2011-01-01

    Tidal energy has the technical potential to form part of a low carbon electricity sector, however, its 'social potential' is less clear, as few empirical studies of public beliefs and responses have been conducted to date. This research addressed this gap by investigating a tidal energy convertor in Northern Ireland, said to be the first grid-connected device of its kind in the world. Data was collected from 313 residents of two nearby villages using mixed methods, guided by a conceptual framework that avoided 'NIMBY' assumptions and instead drew on place theory. Findings indicated strong support for the project, arising from beliefs that the project enhanced local distinctiveness by 'putting the area on the map worldwide'; appeared visually familiar and helped tackle climate change. These positive beliefs outweighed concerns about outcome and process aspects, which were preponderant in one of the two villages. The project was interpreted to have few positive local economic outcomes, to potentially threaten local livelihoods and local ecology. Moreover, residents expressed cynicism about consultation procedures, and reported low levels of behavioural engagement. Implications of the findings for the literature on public acceptance of renewable energy, and for the emerging marine energy sector specifically, are discussed.

  7. Challenge of improving postoperative pain management: case studies of three acute pain services in the UK National Health Service.

    Science.gov (United States)

    Powell, A E; Davies, H T O; Bannister, J; Macrae, W A

    2009-06-01

    Previous national survey research has shown significant deficits in routine postoperative pain management in the UK. This study used an organizational change perspective to explore in detail the organizational challenges faced by three acute pain services in improving postoperative pain management. Case studies were conducted comprising documentary review and semi-structured interviews (71) with anaesthetists, surgeons, nurses, other health professionals, and managers working in and around three broadly typical acute pain services. Although the precise details differed to some degree, the three acute pain services all faced the same broad range of inter-related challenges identified in the organizational change literature (i.e. structural, political, cultural, educational, emotional, and physical/technological challenges). The services were largely isolated from wider organizational objectives and activities and struggled to engage other health professionals in improving postoperative pain management against a background of limited resources, turbulent organizational change, and inter- and intra-professional politics. Despite considerable efforts they struggled to address these challenges effectively. The literature on organizational change and quality improvement in health care suggests that it is only by addressing the multiple challenges in a comprehensive way across all levels of the organization and health-care system that sustained improvements in patient care can be secured. This helps to explain why the hard work and commitment of acute pain services over the years have not always resulted in significant improvements in routine postoperative pain management for all surgical patients. Using this literature and adopting a whole-organization quality improvement approach tailored to local circumstances may produce a step-change in the quality of routine postoperative pain management.

  8. Resilience and Social Justice as the Basis for Urban Food System Reform - A Case Study of Bristol, U.K.

    OpenAIRE

    Wilson, Mark

    2014-01-01

    This paper considers the contribution of urban agriculture to the local food system and the role of the city council in this system. Using an interdisciplinary mixed method approach, the study explores local stakeholders’ perspectives of these aspects in the city of Bristol, UK. The findings were viewed through the lenses of two conceptual frameworks, resilience and social justice. The results reveal that urban agriculture increases resilience through building community, maintaining a diverse...

  9. THE EFFICACY OF MOTORCYCLE TRAINING TO REDUCE SELF-REPORTED NEGATIVE BEHAVIOUR AND ATTITUDE (CASE STUDY IN UK AND INDONESIA

    Directory of Open Access Journals (Sweden)

    Winna Justiana Sirait

    2014-01-01

    Full Text Available Motorcyclists are vulnerable road users because of their particular combination of physical vulnerability. Motorcyclists’ training and licensing system have already implemented in so many countries in the world particularly developed countries. In the other hand, there are countries, particularly developing countries, where motorcyclists are less regulated in term of licensing, enforcement, and insurance. Therefore the objective of this research are to analyses the behavior and attitude of motorcyclists in Yorkshire and Humber Region (UK and Jakarta (Indonesia, and to analyses the efficacy of motorcycle training in UK to influence the self-reported negative behavior and attitude of motorcyclists. Motorcycle Rider Behavior Questionnaire (MRBQ and Motorcyclists Attitude Questionnaire (MAQ are used to conduct this study. The Mann Whitney test is used to evaluate the significance different of the mean score, which obtained from the survey in each country (UK and Indonesia. Mean score computation showed that Yorkshire and Humber Region’s respondents have better mean score than Jakarta’s respondents. However Mann Whitney test showed that the mean score different is not significant for speed violation factor in MRBQ and drink driving and speeding factor in MAQ. Keywords: motorcyclist, motorcycle training, Motorcycle Rider Behavior Questionnaire (MRBQ, Motorcyclist Attitude Questionnaire (MAQ.

  10. Emissions associated with meeting the future global wheat demand: A case study of UK production under climate change constraints

    International Nuclear Information System (INIS)

    Röder, Mirjam; Thornley, Patricia; Campbell, Grant; Bows-Larkin, Alice

    2014-01-01

    Highlights: • Conflicts between adapting to climate change, food security and reducing emissions. • Climate change likely to limit wheat production in the southern hemisphere. • Climate change yield benefits marginally increase emissions per unit of product. • Improved yield will result in higher total production emissions. • Production-based inventories discourage an increase in production. - Abstract: Climate change, population growth and socio-structural changes will make meeting future food demands extremely challenging. As wheat is a globally traded food commodity central to the food security of many nations, this paper uses it as an example to explore the impact of climate change on global food supply and quantify the resulting greenhouse gas emissions. Published data on projected wheat production is used to analyse how global production can be increased to match projected demand. The results show that the largest projected wheat demand increases are in areas most likely to suffer severe climate change impacts, but that global demand could be met if northern hemisphere producers exploit climate change benefits to increase production and narrow their yield gaps. Life cycle assessment of different climate change scenarios shows that in the case of one of the most important wheat producers (the UK) it may be possible to improve yields with an increase of only 0.6% in the emission intensity per unit of wheat produced in a 2 °C scenario. However, UK production would need to rise substantially, increasing total UK wheat production emissions by 26%. This demonstrates how national emission inventories and associated targets do not incentivise minimisation of global greenhouse gas emissions while meeting increased food demands, highlighting a triad of challenges: meeting the rising demand for food, adapting to climate change and reducing emissions

  11. Resource use in a low-input organic vegetable food supply system in UK - a case study

    DEFF Research Database (Denmark)

    Østergård, Hanne; Markussen, Mads V.; Kulak, Michal

    Until now the demand for food has been met by the use of abundant and cheap fossil fuels; however, we need to reconsider our modes of production to avoid a global environmental crisis. Food production systems should increasingly rely on renewable inputs and increase their stability by reducing...... dependency on external inputs. We apply the emergy approach to evaluate resource use efficiency of a food supply system in the UK. The main questions for this study were how much the system contributes to society by taking advantage of local renewable flows, and how much it depends on input from society....

  12. Small area mapping of domestic radon, smoking prevalence and lung cancer incidence – A case study in Northamptonshire, UK

    International Nuclear Information System (INIS)

    Denman, Antony R.; Rogers, Stephen; Ali, Akeem; Sinclair, John; Phillips, Paul S.; Crockett, Robin G.M.; Groves-Kirkby, Christopher J.

    2015-01-01

    Smoking and radon both cause lung cancer, and together the risk is significantly higher. UK public health campaigns continue to reduce smoking prevalence, and other initiatives identify houses with raised radon (radon-222) levels and encourage remedial action. Smoking prevalence and radon levels in the UK have been mapped at Primary Care Trust level. This paper extends that work, using a commercial socio-demographic database to estimate smoking prevalence at the postcode sector level, and to predict the population characteristics at postcode sector level for 87 postcode sectors in Northamptonshire. Likely smoking prevalence in each postcode sector is then modelled from estimates of the smoking prevalence in the different socio-economic groups used by the database. Mapping estimated smoking prevalence, radon potential and average lung cancer incidence for each postcode sector suggested that there was little correlation between smoking prevalence and radon levels, as radon potential was generally lower in urban areas in Northamptonshire, where the estimates of smoking prevalence were highest. However, the analysis demonstrated some sectors where both radon potential and smoking prevalence were moderately raised. This study showed the potential of this methodology to map estimated smoking prevalence and radon levels to inform locally targeted public health campaigns to reduce lung cancer incidence. - Highlights: • We use a commercial socio-demographic database to estimate smoking prevalence in small areas in Northamptonshire, UK. • We map the estimated smoking prevalence and average domestic radon levels in these small areas. • We estimate annual average lung cancer incidence in these small areas. • The methodology is useful to evaluate and plan localised public health campaigns to reduce lung cancer incidence.

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

    Science.gov (United States)

    Kohn, Eli

    2012-01-01

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

  14. Intramuscular Olanzapine – a UK case series of early cases

    Directory of Open Access Journals (Sweden)

    Taylor Mark

    2007-04-01

    Full Text Available Abstract Background Clinical trials assessing efficacy and safety of Intramuscular (IM Olanzapine in acute schizophrenia and acute mania have previously been undertaken in studies required for drug registration in patients who were required to give informed consent. These patients may have less severe forms of psychosis than patients treated in routine practice. Data derived from naturalistic practice following the launch of IM olanzapine may be helpful for clinicians in assessing efficacy and safety of IM olanzapine. The PANSS-EC scale used in the clinical studies may represent a tool that could be used in routine clinical practice. Case presentation We report on an early unselected case series of 7 patients who received IM olanzapine in routine clinical practice settings in the UK. In this case series, olanzapine IM was generally effective, and no adverse events were reported. Adjunctive benzodiazepines were given concomitantly in 1 of the 7 subjects. This is relevant as concomitant benzodiazepines are not recommended for a minimum of 1 hour post IM olanzapine administration. PANSS-EC data was collected in 2 of the 7 subjects. Conclusion Although patients had greater severity of psychosis than clinical trial patients there were no unexpected findings. In addition the PANSS-EC scale is a scale that may be useful in assessing the efficacy of IM antipsychotics in routine clinical practice.

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

    Science.gov (United States)

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

    2009-08-01

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

  16. Representations of minimum unit pricing for alcohol in UK newspapers: a case study of a public health policy debate.

    Science.gov (United States)

    Patterson, Chris; Katikireddi, Srinivasa Vittal; Wood, Karen; Hilton, Shona

    2015-03-01

    Mass media influence public acceptability, and hence feasibility, of public health interventions. This study investigates newsprint constructions of the alcohol problem and minimum unit pricing (MUP). Quantitative content analysis of 901 articles about MUP published in 10 UK and Scottish newspapers between 2005 and 2012. MUP was a high-profile issue, particularly in Scottish publications. Reporting increased steadily between 2008 and 2012, matching the growing status of the debate. The alcohol problem was widely acknowledged, often associated with youths, and portrayed as driven by cheap alcohol, supermarkets and drinking culture. Over-consumption was presented as a threat to health and social order. Appraisals of MUP were neutral, with supportiveness increasing slightly over time. Arguments focused on health impacts more frequently than more emotive perspectives or business interests. Health charities and the NHS were cited slightly more frequently than alcohol industry representatives. Emphases on efficacy, evidence and experts are positive signs for evidence-based policymaking. The high profile of MUP, along with growing support within articles, could reflect growing appetite for action on the alcohol problem. Representations of the problem as structurally driven might engender support for legislative solutions, although cultural explanations remain common. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health.

  17. Perspectives on econometric modelling to inform policy: a UK qualitative case study of minimum unit pricing of alcohol.

    Science.gov (United States)

    Katikireddi, Srinivasa V; Bond, Lyndal; Hilton, Shona

    2014-06-01

    Novel policy interventions may lack evaluation-based evidence. Considerations to introduce minimum unit pricing (MUP) of alcohol in the UK were informed by econometric modelling (the 'Sheffield model'). We aim to investigate policy stakeholders' views of the utility of modelling studies for public health policy. In-depth qualitative interviews with 36 individuals involved in MUP policy debates (purposively sampled to include civil servants, politicians, academics, advocates and industry-related actors) were conducted and thematically analysed. Interviewees felt familiar with modelling studies and often displayed detailed understandings of the Sheffield model. Despite this, many were uneasy about the extent to which the Sheffield model could be relied on for informing policymaking and preferred traditional evaluations. A tension was identified between this preference for post hoc evaluations and a desire for evidence derived from local data, with modelling seen to offer high external validity. MUP critics expressed concern that the Sheffield model did not adequately capture the 'real life' world of the alcohol market, which was conceptualized as a complex and, to some extent, inherently unpredictable system. Communication of modelling results was considered intrinsically difficult but presenting an appropriate picture of the uncertainties inherent in modelling was viewed as desirable. There was general enthusiasm for increased use of econometric modelling to inform future policymaking but an appreciation that such evidence should only form one input into the process. Modelling studies are valued by policymakers as they provide contextually relevant evidence for novel policies, but tensions exist with views of traditional evaluation-based evidence. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association.

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

    Science.gov (United States)

    Gallagher-Brett, Angela; Canning, John

    2011-01-01

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

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

    Science.gov (United States)

    Graham, Carroll; Regan, Julie-Anne

    2016-01-01

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

  20. Electricity Consumption Risk Map - The use of Urban Climate Mapping for smarter analysis: Case study for Birmingham, UK.

    Science.gov (United States)

    Antunes Azevedo, Juliana; Burghardt, René; Chapman, Lee; Katzchner, Lutz; Muller, Catherine L.

    2015-04-01

    Climate is a key driving factor in energy consumption. However, income, vegetation, building mass structure, topography also impact on the amount of energy consumption. In a changing climate, increased temperatures are likely to lead to increased electricity consumption, affecting demand, distribution and generation. Furthermore, as the world population becomes more urbanized, increasing numbers of people will need to deal with not only increased temperatures from climate change, but also from the unintentional modification of the urban climate in the form of urban heat islands. Hence, climate and climate change needs to be taken into account for future urban planning aspects to increase the climate and energy resilience of the community and decrease the future social and economic costs. Geographical Information Systems provide a means to create urban climate maps as part of the urban planning process. Geostatistical analyses linking these maps with demographic and social data, enables a geo-statistical analysis to identify linkages to high-risk groups of the community and vulnerable areas of town and cities. Presently, the climatope classification is oriented towards thermal aspects and the ventilation quality (roughness) of the urban areas but can also be adapted to take into account other structural "environmental factors". This study aims to use the climatope approach to predict areas of potential high electricity consumption in Birmingham, UK. Several datasets were used to produce an average surface temperature map, vegetation map, land use map, topography map, building height map, built-up area roughness calculations, an average air temperature map and a domestic electricity consumption map. From the correlations obtained between the layers it is possible to average the importance of each factor and create a map for domestic electricity consumption to understand the influence of environmental aspects on spatial energy consumption. Based on these results city

  1. Accuracy of Electronic Health Record Data for Identifying Stroke Cases in Large-Scale Epidemiological Studies: A Systematic Review from the UK Biobank Stroke Outcomes Group.

    Directory of Open Access Journals (Sweden)

    Rebecca Woodfield

    Full Text Available Long-term follow-up of population-based prospective studies is often achieved through linkages to coded regional or national health care data. Our knowledge of the accuracy of such data is incomplete. To inform methods for identifying stroke cases in UK Biobank (a prospective study of 503,000 UK adults recruited in middle-age, we systematically evaluated the accuracy of these data for stroke and its main pathological types (ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, determining the optimum codes for case identification.We sought studies published from 1990-November 2013, which compared coded data from death certificates, hospital admissions or primary care with a reference standard for stroke or its pathological types. We extracted information on a range of study characteristics and assessed study quality with the Quality Assessment of Diagnostic Studies tool (QUADAS-2. To assess accuracy, we extracted data on positive predictive values (PPV and-where available-on sensitivity, specificity, and negative predictive values (NPV.37 of 39 eligible studies assessed accuracy of International Classification of Diseases (ICD-coded hospital or death certificate data. They varied widely in their settings, methods, reporting, quality, and in the choice and accuracy of codes. Although PPVs for stroke and its pathological types ranged from 6-97%, appropriately selected, stroke-specific codes (rather than broad cerebrovascular codes consistently produced PPVs >70%, and in several studies >90%. The few studies with data on sensitivity, specificity and NPV showed higher sensitivity of hospital versus death certificate data for stroke, with specificity and NPV consistently >96%. Few studies assessed either primary care data or combinations of data sources.Particular stroke-specific codes can yield high PPVs (>90% for stroke/stroke types. Inclusion of primary care data and combining data sources should improve accuracy in large

  2. The importance of brand in the industrial purchase decision : a case study of the UK tractor market

    NARCIS (Netherlands)

    Walley, K.; Custance, P.; Taylor, S.; Lindgreen, A.; Hingley, M.

    2007-01-01

    Abstract: Purpose – With brands being an important source of competitive advantage, knowledge of branding is needed to inform their management. After reviewing the literature, the article aims to report the findings of a case study that investigated the role of branding in the industrial purchase of

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

    Science.gov (United States)

    Brewerton, Gary

    2014-01-01

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

  4. Reducing poverty and inequality through tax-benefit reform and the minimum wage: the UK as a case-study

    OpenAIRE

    Atkinson, AB; Leventi, C; Nolan, B; Sutherland, H; Tasseva, I

    2017-01-01

    Atkinson’s book Inequality: What Can Be Done? (Harvard University Press, 2015) sets out a range of concrete proposals aimed at reducing income inequality, which cover a very broad span but include major changes to the income tax and social transfers system and the minimum wage. These are framed with specific reference to the UK but have much broader relevance in demonstrating how substantial the impact on inequality of such measures could be. This paper assesses the first-round effects of the...

  5. Effects of peatland drainage on water quality: a case study of the shallow blanket bogs of Exmoor, UK

    Science.gov (United States)

    Grand-Clement, E.; Luscombe, D.; Le Feuvre, N.; Smith, D.; Anderson, K.; Brazier, R. E.

    2012-04-01

    Peatlands are widely represented in the South West of England (i.e. Exmoor, Dartmoor and Bodmin moors), but their existence is currently under threat due to both climate change and the impact of historical human activities. Peat cutting and intensive drainage for agricultural reclamation in the 19th and 20th century, have modified the hydrological behaviour of these shallow peats and dried out the upper layers, causing oxidation, erosion and vegetation change. Such anthropogenic impacts directly affect the storage of carbon, but also the provision of other ecosystem services, such as the supply of drinking water, and the support of specific and rare habitats. Blocking drainage ditches to restore the hydrological behaviour of peatlands has mostly been undertaken in the North of England, but to date, little is still known about the consequences of such management approaches on the overall Carbon stocks. The need to monitor restoration of peatlands in the South West of England arises due to the specific characteristics of the peat - it is often shallower than more northerly peat and dominated by Purple Moor Grass. In addition, and in part because of the shallowness of the resource, the peat has been damaged differently, often with very dense networks of hand-cut ditches which behave as highly efficient drainage networks. Most importantly, their location at the southernmost margin of the UK peatlands' geographical extent makes them extremely vulnerable to climate change, and so it is hypothesised that monitoring of these peatlands may provide an 'early warning system' for climatic impacts that affect more northerly sites in years to come. This study focuses upon the current impact of peatland degradation on water quality on Exmoor. Our experimental approach employs detailed, high resolution monitoring of selected ditches that are representative of damaged conditions on Exmoor, from small- (30 x 30cm ditches) through medium- (50x50cm), large- (1-2m ditches) and finally

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

    Science.gov (United States)

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

    2018-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Reeder FD

    2017-02-01

    Full Text Available Francesca D Reeder,1 Nusrat Husain,2 Abdul Rhouma,3 Peter M Haddad,2 Tariq Munshi,4 Farooq Naeem,4 Davit Khachatryan,4 Imran B Chaudhry2 1School of Medicine, 2Neurosciences and Psychiatry Unit, University of Manchester, Manchester, 3Early Intervention Service, Lancashire Care NHS Foundation Trust, Preston, UK; 4Queen’s University, Kingston, Ontario, Canada Aim: There is evidence that childhood trauma is a risk factor for the development of psychosis and it is recommended that childhood trauma is inquired about in all patients presenting with psychosis. This study aimed to determine the prevalence of childhood trauma in patients in the UK Early Intervention Service based on a case note review.Methods: This is a retrospective case note study of 296 patients in an UK Early Intervention Service. Trauma history obtained on service entry was reviewed and trauma experienced categorized. Results were analyzed using crosstab and frequency analysis.Results: The mean age of the sample was 24 years, 70% were male, 66% were White, and 23% Asian (ethnicity not documented in 11% of the sample. Approximately 60% of patients reported childhood trauma, 21% reported no childhood trauma, and data were not recorded for the remaining 19%. Among those reporting trauma, the prevalence of most frequently reported traumas were: severe or repeated disruption (21%, parental mental illness (19%, bullying (18%, absence of a parent (13%, and ‘other’ trauma (24% – the majority of which were victimization events. Sixty-six percent of those reporting trauma had experienced multiple forms of trauma.Conclusion: A high prevalence of childhood trauma (particularly trauma related to the home environment or family unit was reported. This is consistent with other studies reporting on trauma and psychosis. The main weakness of the study is a lack of a control group reporting experience of childhood trauma in those without psychosis. Guidelines recommend that all patients with

  8. Studies on urokinase (UK) therapy of thromboembolic diseases

    International Nuclear Information System (INIS)

    Wakayama, Ryuji; Satake, Kisaburo; Hisamatsu, Tokugoro; Fukase, Masaichi

    1974-01-01

    In order to determine the urokinase (UK) concentration in blood, a radioimmunoassay method was developed, in which a radioactive material labeled with 125 I-Na was used. In this method, the movement of UK in blood and the relationship between the UK concentration and fibrinolytic activity were studied with the following results: 1) The concentration of UK in normal human blood was found to be 6.84 +- 2.53 PKU early in the morning with an apparent daily rythmic fluctuation in concentration. 2) With an intravenous drip of 20,000 to 30,000 PKU, the UK concentration increased 6 to 8 PKU/ml above the early morning value, then in one to two hours it returned to the previous value once again. In some of the cases, a slight, transient decrease occurred. 3) Following the UK drip, UK concentration in the blood and fibrinolytic activity varied in a parallel fashion. Plasminogen and antiplasmin levels were not altered by administration of only 20,000 to 30,000 PKU of UK. Fibrinogen was lowered, but the fluctuation was within the physiological range. (S. Oyama)

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

    Science.gov (United States)

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

    2015-08-01

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

  10. Applying the ecosystem service concept to air quality management in the UK: a case study for ammonia

    DEFF Research Database (Denmark)

    Smart, James Christopher Rudd; Hicks, Kevin; Morrissey, Tim

    2011-01-01

    in magnitude to those for human health impacts. The ecosystem service approach thus offers the potential to provide a holistic appraisal of the effects of emission reductions, and could therefore make a valuable contribution to future air quality management. However, improvements in data collection...... feasibility of using an ecosystem services approach to appraise alternative scenarios for controlling agricultural ammonia emissions in the UK. The effect of ammonia emission reductions on ecosystems service delivery was assessed using an impact pathway approach. A ‘weakest link’ analysis identified...... that economic valuation of impacts on many key ecosystem services was constrained by inadequate dose–response relationships to predict physical changes in service flows and/or by an inability to produce economic valuations of the predicted physical changes. For effects on biodiversity, both the timescale...

  11. Understanding how and why health is integrated into foreign policy - a case study of health is global, a UK Government Strategy 2008–2013

    Science.gov (United States)

    2013-01-01

    Background Over the past decade, global health issues have become more prominent in foreign policies at the national level. The process to develop state level global health strategies is arguably a form of global health diplomacy (GHD). Despite an increase in the volume of secondary research and analysis in this area, little primary research, particularly that which draws directly on the perspectives of those involved in these processes, has been conducted. This study seeks to fill this knowledge gap through an empirical case study of Health is Global: A UK Government Strategy 2008–2013. It aims to build understanding about how and why health is integrated into foreign policy and derive lessons of potential relevance to other nations interested in developing whole-of-government global health strategies. Methods The major element of the study consisted of an in-depth investigation and analysis of the UK global health strategy. Document analysis and twenty interviews were conducted. Data was organized and described using an adapted version of Walt and Gilson’s policy analysis triangle. A general inductive approach was used to identify themes in the data, which were then analysed and interpreted using Fidler’s health and foreign policy conceptualizations and Kingdon’s multiples streams model of the policymaking process. Results The primary reason that the UK decided to focus more on global health is self-interest - to protect national and international security and economic interests. Investing in global health was also seen as a way to enhance the UK’s international reputation. A focus on global health to primarily benefit other nations and improve global health per se was a prevalent through weaker theme. A well organized, credible policy community played a critical role in the process and a policy entrepreneur with expertise in both international relations and health helped catalyze attention and action on global health when the time was right. Support

  12. Fluoride in drinking water and risk of hip fracture in the UK: a case-control study.

    Science.gov (United States)

    Hillier, S; Cooper, C; Kellingray, S; Russell, G; Hughes, H; Coggon, D

    2000-01-22

    Although the benefits of water fluoridation for dental health are widely accepted, concerns remain about possible adverse effects, particularly effects on bone. Several investigators have suggested increased rates of hip fracture in places with high concentrations of fluoride in drinking water, but this finding has not been consistent, possibly because of unrecognised confounding effects. We did a case-control study of men and women aged 50 years and older from the English county of Cleveland, and compared patients with hip fracture with community controls. Current addresses were ascertained for all participants; for those who agreed to an interview and who passed a mental test, more detailed information was obtained about lifetime residential history and exposure to other known and suspected risk factors for hip fracture. Exposures to fluoride in water were estimated from the residential histories and from information provided by water suppliers. Analysis was by logistic regression. 914 cases and 1196 controls were identified, of whom 514 and 527, respectively, were interviewed. Among those interviewed, hip fracture was strongly associated with low body-mass index (p for trend water ranged from 0.15 to 1.79 ppm. Current residence in Hartlepool was a good indicator for high lifetime exposure to fluoride. After adjustment for potential confounders, the odds ratio associated with an average lifetime exposure to fluoride > or =0.9 ppm was 1.0 [95% CI 0.7-1.5]. There is a low risk of hip fracture for people ingesting fluoride in drinking water at concentrations of about 1 ppm. This low risk should not be a reason for withholding fluoridation of water supplies.

  13. Genetic and environmental risk factors for rheumatoid arthritis in a UK African ancestry population: the GENRA case-control study.

    Science.gov (United States)

    Traylor, Matthew; Curtis, Charles; Patel, Hamel; Breen, Gerome; Hyuck Lee, Sang; Xu, Xiaohui; Newhouse, Stephen; Dobson, Richard; Steer, Sophia; Cope, Andrew P; Markus, Hugh S; Lewis, Cathryn M; Scott, Ian C

    2017-08-01

    To evaluate whether genetic and environmental factors associated with RA in European and Asian ancestry populations are also associated with RA in African ancestry individuals. A case-control study was undertaken in 197 RA cases and 868 controls of African ancestry (Black African, Black Caribbean or Black British ethnicity) from South London. Smoking and alcohol consumption data at RA diagnosis was captured. Genotyping was undertaken (Multi-Ethnic Genotyping Array) and human leukocyte antigen (HLA) alleles imputed. The following European/Asian RA susceptibility factors were tested: 99 genome-wide loci combined into a genetic risk score; HLA region [20 haplotypes; shared epitope (SE)]; smoking; and alcohol consumption. The SE was tested for its association with radiological erosions. Logistic regression models were used, including ancestry-informative principal components, to control for admixture. European/Asian susceptibility loci were associated with RA in African ancestry individuals. The genetic risk score provided an odds ratio (OR) for RA of 1.53 (95% CI: 1.31, 1.79; P = 1.3 × 10 - 7 ). HLA haplotype ORs in European and African ancestry individuals were highly correlated ( r = 0.83, 95% CI: 0.56, 0.94; P = 1.1 × 10 - 4 ). Ever-smoking increased (OR = 2.36, 95% CI: 1.46, 3.82; P = 4.6 × 10 - 4 ) and drinking alcohol reduced (OR = 0.34, 95% CI: 0.20, 0.56; P = 2.7 × 10 - 5 ) RA risk in African ancestry individuals. The SE was associated with erosions (OR = 2.61, 95% CI: 1.36, 5.01; P = 3.9 × 10 - 3 ). Gene-environment RA risk factors identified in European/Asian ancestry populations are relevant in African ancestry individuals. As modern statistical methods facilitate analysing ancestrally diverse populations, future genetic studies should incorporate African ancestry individuals to ensure their implications for precision medicine are universally applicable. © The Author 2017. Published by Oxford University Press on behalf of the British Society for

  14. Towards a Theory and Practice of Religious Literacy: A Case Study of Religion and Belief Engagement in a UK University

    Directory of Open Access Journals (Sweden)

    Adam Dinham

    2017-12-01

    Full Text Available This article reports on research undertaken in 2011–2012 into the role of religion and belief in one British university. In this indicative qualitative case study, we observed six important features in relation to religion and belief: a clear divide in attitudes to the place of religion and belief between operations and curriculum; a lack of knowledge and understanding of the religious landscape within the institution; differing and localized responses to religion and belief within and between departments; variation in the approaches of different academic disciplines; very strong desire to promote a good student experience, which included a recognition that some students identify as religious; and that religious and non-religious perspectives are widely conceived of as binary, meaning either ‘secular’ or religious. We conclude that these findings demonstrate, at this institution, a struggle to think and act strategically and consistently on religion and belief, and suggest that, because of their influential educational positions, this reflects and reproduces muddled thinking and acting about religion and belief in wider society.

  15. Three-dimensional geological modelling of anthropogenic deposits at small urban sites: a case study from Sheepcote Valley, Brighton, UK.

    Science.gov (United States)

    Tame, C; Cundy, A B; Royse, K R; Smith, M; Moles, N R

    2013-11-15

    Improvements in computing speed and capacity and the increasing collection and digitisation of geological data now allow geoscientists to produce meaningful 3D spatial models of the shallow subsurface in many large urban areas, to predict ground conditions and reduce risk and uncertainty in urban planning. It is not yet clear how useful this 3D modelling approach is at smaller urban scales, where poorly characterised anthropogenic deposits (artificial/made ground and fill) form the dominant subsurface material and where the availability of borehole and other geological data is less comprehensive. This is important as it is these smaller urban sites, with complex site history, which frequently form the focus of urban regeneration and redevelopment schemes. This paper examines the extent to which the 3D modelling approach previously utilised at large urban scales can be extended to smaller less well-characterised urban sites, using a historic landfill site in Sheepcote Valley, Brighton, UK as a case study. Two 3D models were generated and compared using GSI3D™ software, one using borehole data only, one combining borehole data with local geological maps and results from a desk study (involving collation of available site data, including ground contour plans). These models clearly delimit the overall subsurface geology at the site, and allow visualisation and modelling of the anthropogenic deposits present. Shallow geophysical data collected from the site partially validate the 3D modelled data, and can improve GSI3D™ outputs where boundaries of anthropogenic deposits may not be clearly defined by surface, contour or borehole data. Attribution of geotechnical and geochemical properties to the 3D model is problematic without intrusive investigations and sampling. However, combining available borehole data, shallow geophysical methods and site histories may allow attribution of generic fill properties, and consequent reduction of urban development risk and

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

    Science.gov (United States)

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

    2016-04-01

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

  17. Season of infectious mononucleosis as a risk factor for multiple sclerosis: A UK primary care case-control study.

    Science.gov (United States)

    Downham, Christina; Visser, Elizabeth; Vickers, Mark; Counsell, Carl

    2017-10-01

    Infectious mononucleosis (IM) and vitamin D deficiency are both risk factors for multiple sclerosis (MS). We wished to establish if IM in the winter months when vitamin D levels are low may be a greater risk factor for MS than IM in the summer months. We identified all patients with MS diagnosed aged 16-60 in a large primary care database in the United Kingdom and matched each by age, sex, general practice and observation period with up to six controls. We identified a coded diagnosis of IM prior to the index date (date of diagnosis). Logistic regression was used to calculate the odds ratio for prior IM exposure in cases versus controls and for winter versus summer exposure in cases and controls with prior IM exposure. Based on 9247 cases and 55,033 matched controls (246 and 846 with prior IM respectively), IM was associated with the development of MS (OR 1.77, 95%CI 1.53-2.05) but there was no evidence that IM in the winter as opposed to summer was associated with developing MS (OR 1.09, 95%CI 0.72-1.66). We found no evidence that the season of IM influences the risk of subsequent MS. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Tian, Mei; Lowe, John

    2013-01-01

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

  19. Neuroscience and Values: A Case Study Illustrating Developments in Policy, Training and Research in the UK and Internationally**

    Science.gov (United States)

    Fulford, K. W. M

    2011-01-01

    In the current climate of dramatic advances in the neurosciences, it has been widely assumed that the diagnosis of mental disorder is a matter exclusively for value-free science. Starting from a detailed case history, this paper describes how, to the contrary, values come into the diagnosis of mental disorders, directly through the criteria at the heart of psychiatry’s most scientifically grounded classification, the American Psychiatric Association’s DSM (Diagnostic and Statistical Manual). Various possible interpretations of the prominence of values in psychiatric diagnosis are outlined. Drawing on work in the Oxford analytic tradition of philosophy, it is shown that, properly understood, the prominence of psychiatric diagnostic values reflects the necessary engagement of psychiatry with the diversity of individual human values. This interpretation opens up psychiatric diagnostic assessment to the resources of a new skills-based approach to working with complex and conflicting values (also derived from analytic philosophy) called ‘values-based practice.’ Developments in values-based practice in training, policy and research in mental health are briefly outlined. The paper concludes with an indication of how the integration of values-based with evidence-based approaches provides the basis for psychiatric practice in the twenty-first century that is both science-based and person-centred. PMID:21694963

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

    Science.gov (United States)

    Dove, Jane

    2012-01-01

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

  1. Generic performance assessment for a deep repository for low and intermediate level waste in the UK - a case study in assessing radiological impacts on the natural environment

    International Nuclear Information System (INIS)

    Jones, S.R.; Patton, D.; Copplestone D.; Norris, S.; O'Sullivan, P.

    2003-01-01

    Concentrations of radionuclides in soil and surface water, taken from a generic performance assessment of a repository for low and intermediate level radioactive waste, assumed to be located in the UK, have been used as the basis for a case study in assessing radiological impacts on the natural environment. Simplified descriptions of the terrestrial and aquatic ecosystem types likely to be impacted have been developed. A scoping assessment has identified 226 Ra, 210 Po, 234 U, 230 Th and 238 U as having the highest potential for impact, with doses from internally incorporated alpha emitters as being potentially of particular importance. These nuclides, together with 36 Cl and 129 I (which have proved to be of importance in radiological risk assessments for humans) were included in a more detailed dose assessment. A basic methodology for dose assessment of ecosystems is described, and has been applied for the defined impacted ecosystems. Paucity of published data on concentration factors prevented a more detailed assessment for terrestrial ecosystems. For the aquatic ecosystem, a more detailed assessment was possible and highest calculated absorbed dose rates (weighted for the likely higher biological effectiveness of alpha radiation were about 6.5 μGy h -1 . We conclude that harm to the impacted ecosystems is unlikely and make the observation that the lack of concentration factor or transfer factor data for a sufficiently wide range of species, ecosystems and nuclides appears to be the principal obstacle to establishing a comprehensive framework for the application of radiological protection to ecosystems

  2. Interaction, Co-creation and Participation in PSM Literature, Policy and Strategy: A Comparative Case Study Analysis of Flanders, the Netherlands, France and the UK

    Directory of Open Access Journals (Sweden)

    Anne-Sofie Vanhaeght

    2015-12-01

    Full Text Available The article critically evaluates whether there is a (mismatch between ideas on audience involvement in public service media (PSM theory and the translation thereof in public broadcasters’ policy and strategy documents. The literature section theoretically frames this discussion, first, discussing five objectives of PSM and audience involvement. Subsequently, it studies how the BBC (UK, France Télévisions (France, VRT (Flanders, and NPO (the Netherlands have to (policy and intend to (strategy involve their audiences. These cases have been selected with an eye on including both better-funded (BBC, FTV and smaller public broadcasters (VRT, NPO, as well as different media systems. For the analysis, the method of goal-means tree analysis is adopted, a type of qualitative document analysis that can be deployed to uncover goal-means relationships in policy and strategy texts. The main argument is that, rather than a mismatch, some of the questionable, normative assumptions made in theories concerning audience involvement and PSM are also present in the PSM policy and strategy texts.

  3. The 'Green' concern in e-learning development findings from a university case study in the UK

    DEFF Research Database (Denmark)

    Lin, Chih-Cheng; Ma, Zheng; Gerstlberger, Wolfgang

    2012-01-01

    Purpose: the paper tries to address the question of whether universities concern 'Green' during e-learning development. Methodology: acase study approach is chosen for establishing empirical evidence and describing the phenomenon. Findings: the paper found that the green concern did not appear...... at the initial stage of e-learning strategy although there is green output - reusable resource at the e-learning delivery stage. However, the diversity of cost is still a critical concern for the e-learning adoption. Originality/value: this paper shows the missing awareness of green concern in the e...

  4. Dependency of Businesses on Flows of Ecosystem Services: A Case Study from the County of Dorset, UK

    Directory of Open Access Journals (Sweden)

    Stephen C. L. Watson

    2018-04-01

    Full Text Available Although it is widely assumed that business activity is dependent on flows of ecosystem services (ES, little evidence is available with which to evaluate this contention. To address this knowledge gap, we conducted a questionnaire survey of business dependencies on twenty-six different ES in the English county of Dorset, where the environment supports a significant component of the local economy. Responses were received from 212 businesses across twenty-eight sectors. While virtually all businesses (98% were familiar with the concept of ES, dependency on ES was highly divided with 50% of businesses surveyed claiming no dependence on any ES flows. The highest businesses dependencies reported in this study were for regulating services with the ES of water quality and waste water treatment being of particular importance to businesses. The results however, advised that greater efforts are needed in highlighting the indirect benefits provided by Dorset’s ecosystems, with eight business sectors (58% of respondents claiming no or little dependence on supporting and habitat services including the ES of biodiversity, habitats for species and maintenance of genetic diversity. Many businesses also indicated little or no dependence on the globally important ES of pollination and soil condition, which may reflect a lack of awareness of dependencies occurring upstream of their value chains. At the sector level, businesses directly involved in protecting, extracting, or manufacturing raw materials were found to be more dependent on provisioning, regulatory and supporting ES than those operating in the service sector who favored cultural ES. These results highlight the value of assessing business dependencies on ES flows, which could usefully inform environmental management and accounting systems and improve monitoring of business performance, and thereby contribute to achievement of sustainability goals.

  5. Culture confirmation of tuberculosis cases in Birmingham, UK.

    Science.gov (United States)

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

    2013-10-01

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

  6. Risk factors for rectal lymphogranuloma venereum in gay men: results of a multicentre case-control study in the U.K.

    Science.gov (United States)

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

    2014-06-01

    To identify risk factors for rectal lymphogranuloma venereum (rLGV) in men who have sex with men (MSM). A case-control study at 6 U.K. hospitals compared MSM with rLGV (cases) with rLGV-negative controls: MSM without potential rLGV symptoms (CGa) and separately, MSM with such symptoms (CGs). Between 2008 and 2010, there were 90 rLGV cases, 74 CGa and 69 CGs recruited. Lifestyles and sexual behaviours in the previous 3 months were reported using internet-based computer-assisted self-interviews. Logistic regression was used to investigate factors associated with rLGV. Cases were significantly more likely to be HIV-positive (89%) compared with CGa (46%) and CGs (64%). Independent behavioural risks for rLGV were: unprotected receptive anal intercourse (adjusted OR (AOR)10.7, 95% CI 3.5 to 32.8), fisting another (AOR=6.7, CI 1.8 to 25.3), sex under the influence of gamma-hydroxybutyrate (AOR=3.1, CI 1.3 to 7.4) and anonymous sexual contacts (AOR=2.7, CI 1.2 to 6.3), compared with CGa; unprotected insertive anal intercourse (AOR=4.7, CI 2.0 to 10.9) and rectal douching (AOR=2.9 CI 1.3 to 6.6), compared with CGs. An incubation period from exposure to symptoms of 30 days was indicated. Unprotected receptive anal intercourse is a key risk factor for rectal LGV with the likelihood that rectal-to-rectal transmission is facilitated where insertive anal sex also occurs. The association between HIV and rLGV appears linked to HIV-positive men seeking unprotected sex with others with the same HIV status, sexual and drug interests. Such men should be targeted for frequent STI screening and interventions to minimise associated risks. 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.

  7. Investigating the impact of media on demand for wildlife: A case study of Harry Potter and the UK trade in owls.

    Science.gov (United States)

    Megias, Diane A; Anderson, Sean C; Smith, Robert J; Veríssimo, Diogo

    2017-01-01

    In recent decades, a substantial number of popular press articles have described an increase in demand for certain species in the pet trade due to films such as "Finding Nemo", "Ninja turtles", and "Harry Potter". Nevertheless, such assertions are largely supported only by anecdotal evidence. Given the role of the wildlife trade in the spread of pathogens and zoonosis, the introduction of invasive species, the overexploitation of biodiversity, and the neglect of animal welfare, it is crucial to understand what factors drive demand for a species. Here, we investigate the effect the movie industry may have on wildlife trade by examining the relationship between the "Harry Potter" cultural phenomenon and the trade in owls within the United Kingdom (UK). We gathered data from the UK box office, book sales, and newspaper mentions, and examined their relationship with data from three independent sources reflecting the legal ownership of owls in the UK, which is likely to involve several thousands of animals. Additionally, we conducted a questionnaire survey with UK animal sanctuaries to study the presumed mass abandonment of pet owls when the film series ended. Counter to common assertions, we find no evidence that the "Harry Potter" phenomenon increased the legal trade in owls within the UK, even when possible time-lag effects were taken into account. Only one indicator, the number of movie tickets sold, showed a weak but contradictory relationship with demand for owls, with a recorded drop of 13% (95% CI: 3-27%) per 1 SD in tickets sold in the original analysis but an increase of 4% (95% CI: 0-8%) with a one-year lag. In addition, our results suggest that the end of the Harry Potter series did not have a noticeable impact on the number of owls abandoned in UK wildlife sanctuaries, as only two of the 46 animal sanctuaries we contacted independently stated they had seen an increase in owls received and believed this was due to the Harry Potter series. We highlight the

  8. Investigating the impact of media on demand for wildlife: A case study of Harry Potter and the UK trade in owls.

    Directory of Open Access Journals (Sweden)

    Diane A Megias

    Full Text Available In recent decades, a substantial number of popular press articles have described an increase in demand for certain species in the pet trade due to films such as "Finding Nemo", "Ninja turtles", and "Harry Potter". Nevertheless, such assertions are largely supported only by anecdotal evidence. Given the role of the wildlife trade in the spread of pathogens and zoonosis, the introduction of invasive species, the overexploitation of biodiversity, and the neglect of animal welfare, it is crucial to understand what factors drive demand for a species. Here, we investigate the effect the movie industry may have on wildlife trade by examining the relationship between the "Harry Potter" cultural phenomenon and the trade in owls within the United Kingdom (UK. We gathered data from the UK box office, book sales, and newspaper mentions, and examined their relationship with data from three independent sources reflecting the legal ownership of owls in the UK, which is likely to involve several thousands of animals. Additionally, we conducted a questionnaire survey with UK animal sanctuaries to study the presumed mass abandonment of pet owls when the film series ended. Counter to common assertions, we find no evidence that the "Harry Potter" phenomenon increased the legal trade in owls within the UK, even when possible time-lag effects were taken into account. Only one indicator, the number of movie tickets sold, showed a weak but contradictory relationship with demand for owls, with a recorded drop of 13% (95% CI: 3-27% per 1 SD in tickets sold in the original analysis but an increase of 4% (95% CI: 0-8% with a one-year lag. In addition, our results suggest that the end of the Harry Potter series did not have a noticeable impact on the number of owls abandoned in UK wildlife sanctuaries, as only two of the 46 animal sanctuaries we contacted independently stated they had seen an increase in owls received and believed this was due to the Harry Potter series. We

  9. Three-dimensional modelling for assessment of far-field impact of tidal stream turbine: A case study at the Anglesey Coast, Wales, UK

    Science.gov (United States)

    Li, Xiaorong; Li, Ming; Wolf, Judith

    2017-04-01

    which the developed model is tested; based on a combination of laboratory measured data and CFD simulated results. The developed turbine simulation system is then applied to the Anglesey coast, North Wales, UK for a case study. The validation study suggests that the developed turbine simulation system is able to accurately simulate both hydrodynamics and wave dynamics in the turbine wake. The case study with 18 turbines (diameter is 15 m) modelled individually in the waterway between the north-west Anglesey and the Skerries reveals impacts of the turbine farm on free surface elevation, flow field, turbulence kinetic energy (TKE), surface waves, bottom shear stress and suspended sediment transport. The wake is observable up to 4.5 km downstream of the device farm. Flow near the bed in the wake is accelerated, leading to enhanced bottom shear stress. The device farm has a strong influence on TKE and hence the vertical mixing of suspended sediment in the wake. Further, the eastwards directed residual sediment transport along the north coast of Anglesey is found to be weakened by the turbine farm.

  10. The contribution of geology and groundwater studies to city-scale ground heat network strategies: A case study from Cardiff, UK

    Science.gov (United States)

    Boon, David; Farr, Gareth; Patton, Ashley; Kendall, Rhian; James, Laura; Abesser, Corinna; Busby, Jonathan; Schofield, David; White, Debbie; Gooddy, Daren; James, David; Williams, Bernie; Tucker, David; Knowles, Steve; Harcombe, Gareth

    2016-04-01

    The development of integrated heat network strategies involving exploitation of the shallow subsurface requires knowledge of ground conditions at the feasibility stage, and throughout the life of the system. We describe an approach to the assessment of ground constraints and energy opportunities in data-rich urban areas. Geological and hydrogeological investigations have formed a core component of the strategy development for sustainable thermal use of the subsurface in Cardiff, UK. We present findings from a 12 month project titled 'Ground Heat Network at a City Scale', which was co-funded by NERC/BGS and the UK Government through the InnovateUK Energy Catalyst grant in 2015-16. The project examined the technical feasibility of extracting low grade waste heat from a shallow gravel aquifer using a cluster of open loop ground source heat pumps. Heat demand mapping was carried out separately. The ground condition assessment approach involved the following steps: (1) city-wide baseline groundwater temperature mapping in 2014 with seasonal monitoring for at least 12 months prior to heat pump installation (Patton et al 2015); (2) desk top and field-based investigation of the aquifer system to determine groundwater levels, likely flow directions, sustainable pumping yields, water chemistry, and boundary conditions; (3) creation of a 3D geological framework model with physical property testing and model attribution; (4) use steps 1-3 to develop conceptual ground models and production of maps and GIS data layers to support scenario planning, and initial heat network concept designs; (5) heat flow modelling in FEFLOW software to analyse sustainability and predict potential thermal breakthrough in higher risk areas; (6) installation of a shallow open loop GSHP research observatory with real-time monitoring of groundwater bodies to provide data for heat flow model validation and feedback for system control. In conclusion, early ground condition modelling and subsurface

  11. Practical experience of ustekinumab in the treatment of psoriasis: experience from a multicentre, retrospective case cohort study across the U.K. and Ireland.

    LENUS (Irish Health Repository)

    2012-02-01

    Background There are limited data on the use of ustekinumab outside of clinical trials. Objectives To assess the efficacy and safety of ustekinumab in patients with severe psoriasis attending 10 dermatology centres in the U.K. and Ireland. Methods A retrospective case-note review of 129 patients with psoriasis treated with ustekinumab. Results Baseline Psoriasis Area and Severity Index (PASI) was 22.9 +\\/- 10.1 (mean +\\/- SD). After 16 weeks of treatment with ustekinumab PASI 75 (75% reduction in PASI) was observed in 63.0% (n = 80\\/127) of patients, although four patients required concomitant therapy at the 16-week time point. Previous biologic use did show a small, non-significant trend towards treatment failure. A PASI 75 response was seen in 29.4% (n = 5\\/17) of individuals weighing 90-100 kg and treated with the standard 45 mg ustekinumab dose compared with PASI 75 of 70.3%, 71.4%, 75.0% and 55.6% for weight groups < 80, 80-90, 100-110 and > 110 kg, respectively (P = 0.024). Ustekinumab therapy was well tolerated; serious adverse events were observed in 2.3% (n = 3\\/129) of patients. Conclusions Ustekinumab is a novel biologic agent for psoriasis. When used in everyday clinical practice it demonstrates high levels of short-term therapeutic efficacy with an acceptable short-term safety profile.

  12. Cooperation under the RES Directive - Case study on a joint project: An offshore wind park in the North Sea (cooperation between the Netherlands, Belgium, UK, and Luxembourg)

    DEFF Research Database (Denmark)

    Kitzing, Lena; Nysten, Jana; Gephart, Malte

    .The joint project consists of a 1000 MW offshore wind park located on Dutch territory, to beconnected to an offshore hub on Belgian territory. Belgium, the Netherlands and the UK will togetherundertake the joint project and share the production and the RES benefits. Belgium will be the drivingforce...... of the joint project, organising the necessary negotiations and initiatives. The country will alsoassume most risks related to the development of the wind park. Therefore, we assume that the jointproject will be shared in the following way: 40% to Belgium, 30% to the Netherlands, and 30% tothe UK. We further...

  13. Vertical Deformation Monitoring of the Suspension Bridge Tower Using GNSS: A Case Study of the Forth Road Bridge in the UK

    Directory of Open Access Journals (Sweden)

    Qusen Chen

    2018-02-01

    Full Text Available The vertical deformation monitoring of a suspension bridge tower is of paramount importance to maintain the operational safety since nearly all forces are eventually transferred as the vertical stress on the tower. This paper analyses the components affecting the vertical deformation and attempts to reveal its deformation mechanism. Firstly, we designed a strategy for high-precision GNSS data processing aiming at facilitating deformation extraction and analysis. Then, 33 months of vertical deformation time series of the southern tower of the Forth Road Bridge (FRB in the UK were processed, and the accurate subsidence and the parameters of seasonal signals were estimated based on a classic function model that has been widely studied to analyse GNSS coordinate time series. We found that the subsidence rate is about 4.7 mm/year, with 0.1 mm uncertainty. Meanwhile, a 15-month meteorological dataset was utilised with a thermal expansion model (TEM to explain the effects of seasonal signals on tower deformation. The amplitude of the annual signals correlated quite well that obtained by the TEM, with the consistency reaching 98.9%, demonstrating that the thermal effect contributes significantly to the annual signals. The amplitude of daily signals displays poor consistency with the ambient temperature data. However, the phase variation tendencies between the daily signals of the vertical deformation and the ambient temperature are highly consistent after February 2016. Finally, the potential contribution of the North Atlantic Drift (NAD to the characteristics of annual and daily signals is discussed because of the special geographical location of the FRB. Meanwhile, this paper emphasizes the importance of collecting more detailed meteorological and other loading data for the investigation of the vertical deformation mechanism of the bridge towers over time with the support of GNSS.

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

    Directory of Open Access Journals (Sweden)

    Janet Richardson

    2012-04-01

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

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

    Science.gov (United States)

    Jain, Yashraj

    2016-01-01

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

  16. Developing leadership interventions for black and minority ethnic staff: A case study of the National Health Service (NHS) in the U.K.

    Science.gov (United States)

    Kalra, V S; Abel, P; Esmail, A

    2009-01-01

    The National Health Service (NHS) is the largest employer in the U.K. but, despite decades of equal opportunities legislation, its senior management workforce does not reflect the diversity of either the wider NHS workforce or the U.K. population. The aim of the paper is to consider the range of management interventions available to organisations like the NHS to deliver change in the area of promotion of Black and minority ethnic staff. Intervention programmes in a range of public and private organisations are reviewed and the nature of barriers to promotion and the range of interventions to overcome these are explored. The paper uses the paradigm of institutional racism to examine the ways in which the NHS discriminates against certain sections of its workforce. The methods used include a literature review combined with key stakeholder interviews. A comparative dimension which involved a review of research on leadership initiatives in the U.S.A. was also undertaken. The literature review found that there were a range of initiatives which could be implemented by public organisations such as the NHS to increase the presence of Black and Minority Ethnic (BME) staff in senior management positions. Most of these interventions were largely focused on the individual. Much more progress on institutional or organisational change needed to be made before the NHS could be perceived as a model employer in this area. The literature review also indicated that there is little published research on such initiatives within other European Union countries. The paper is targeted at both policy makers and human resource officers responsible for equality and diversity issues within large organisations, who have a remit to improve the career pathways of staff. The analysis provided offers a set of critical tools and interventions that have not hitherto been well examined in the U.K. context.

  17. Second study of UK nuclear test participants

    International Nuclear Information System (INIS)

    Darby, S.; Doll, R.; Kendall, G.

    1994-01-01

    A second epidemiological analysis of mortality and cancer incidence in UK participants in the UK atmospheric nuclear tests and associated experimental programmes has provided broadly reassuring results. Overall death rates in test participants are lower than those in the general population and similar to those in a closely matched control group. Observations in the extended period of follow-up suggest that the excess of multiple myeloma seen in the first analysis was a chance finding. The extended follow-up does not provide any new evidence to support the finding of apparent excess of leukaemia found in the first analysis. However, the possibility that test participation may have caused a small risk of leukaemia in the early years after the tests cannot be ruled out. (author)

  18. Studies project development off U.K

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This paper reports that capital spending on U.K. Continental Shelf (UKCS) oil and gas development in 1992-94 will reach about $36 billion, Arthur Andersen Petroleum Services (AAPS) predicts. Expenditures during the 3 year period would be about 55% more than capital spending for UKCS development in 1989-91 AAPS noted. Another industry forecast, by Grampian Regional Council, Aberdeen, estimates more than 90 new fields could be developed on the UKCS during the next 20 years

  19. UK Nuclear Science Forum. Progress report: Data studies during 2000

    International Nuclear Information System (INIS)

    Nichols, A.L.

    2001-06-01

    The UK Nuclear Science Forum (UKNSF) now meets once per year to discuss issues of direct relevance to forum members, and to review nuclear data for application in the UK nuclear industry. Links are also maintained through the year, mainly through e-mail and the normal postal system. Work of immediate interest includes the measurement and evaluation of decay data (e.g., half-lives and gamma-ray emission probabilities), fission yields and thermal neutron cross sections; all known UK studies in 2000 are summarised in this document. Specific applications and international links of relevance in the field of nuclear data are also described

  20. New use of low-dose aspirin and risk of colorectal cancer by stage at diagnosis: a nested case-control study in UK general practice.

    Science.gov (United States)

    García Rodríguez, Luis A; Soriano-Gabarró, Montse; Bromley, Susan; Lanas, Angel; Cea Soriano, Lucía

    2017-09-07

    Evidence from clinical trial populations suggests low-dose aspirin reduces the risk of colorectal cancer (CRC). Part of this reduction in risk might be due to protection against metastatic disease. We investigated the risk of CRC among new-users of low-dose aspirin (75-300 mg), including risk by stage at diagnosis. Using The Health Improvement Network, we conducted a cohort study with nested case-control analysis. Two cohorts (N = 170,336 each) aged 40-89 years from 2000 to 2009 and free of cancer were identified: i) new-users of low-dose aspirin, ii) non-users of low-dose aspirin, at start of follow-up, matched by age, sex and previous primary care practitioner visits. Patients were followed for up to 12 years to identify incident CRC. 10,000 frequency-matched controls were selected by incidence density sampling where the odds ratio is an unbiased estimator of the incidence rate ratio (RR). RRs with 95% confidence intervals were calculated. Low-dose aspirin use was classified 'as-treated' independent from baseline exposure status to account for changes in exposure during follow-up. Current users of low-dose aspirin (use on the index date or in the previous 90 days) had a significantly reduced risk of CRC, RR 0.66 (95% CI 0.60-0.74). The reduction in risk was apparent across all age groups, and was unrelated to dose, indication, gender, CRC location or case-fatality status. Reduced risks occurred throughout treatment duration and with all low-dose aspirin doses. RRs by aspirin indication were 0.71 (0·63-0·79) and 0.60 (0.53-0.68) for primary and secondary cardiovascular protection, respectively. Among cases with staging information (n = 1421), RRs for current use of low-dose aspirin were 0.94 (0.66-1.33) for Dukes Stage A CRC, 0.54 (0.42-0.68) for Dukes B, 0.71 (0.56-0.91) for Dukes C, and 0.60 (0.48-0.74) for Dukes D. After 5 years' therapy, the RR for Dukes Stage A CRC was 0.53 (0.24-1.19). Patients starting low-dose aspirin therapy have a reduced

  1. The Potential Role of Social Capital in the Willingness to be a Deceased Organ Donor: A Case Study of UK Polish Migrants.

    Science.gov (United States)

    Sharp, C; Randhawa, G

    2016-04-01

    In the United Kingdom, the demand for transplantable organs exceeds supply, leaving many patients on the active transplant waiting list with the majority on dialysis as the kidney is the most commonly transplanted organ. This is a marked issue across black, Asian, and minority ethnic communities. This article uses the Polish migrant community as a case study for making new theoretical insights into the willingness to become an organ donor in a host country using social capital theory. There were 31 participants who took part in interviews and small group discussions. Grounded theory methodology was used as the study explored the relationships between deceased organ donation, religion, and Mauss's gift-exchange theory and the notion of social capital arose as an emergent theme from the study. Elements of social capital were explored with participants such as social networks, civil engagement, trust, and reciprocity. Polish social networks were found to be small and the formation of networks to be influenced by English language skills. Participants were willing to donate organs to others inside and outside of their social networks in the United Kingdom and wanted to help a patient in need and influenced by the overall migrant experience in the United Kingdom and whether they felt a sense of belonging. Overall, participants had mixed experiences and views about trust in the National Health Service. Through a discussion of the results using a communitarian social capital, cognitive and structural social capital lens, and collective-action theory, it is concluded that an interplay of these social capital theories can reframe debates within organ donation such as reciprocity policies, the relevancy of altruism, and the role of migration experiences and networks in the willingness to donate organs posthumously in a host country. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. A case-control study of surgical site infection following operative fixation of fractures of the ankle in a large U.K. trauma unit.

    Science.gov (United States)

    Korim, M T; Payne, R; Bhatia, M

    2014-05-01

    Most of the literature on surgical site infections following the surgical treatment of fractures of the ankle is based on small series of patients, focusing on diabetics or the elderly. None have described post-operative functional scores in those patients who develop an infection. We performed an age- and gender-matched case-control study to identify patient- and surgery-related risk factors for surgical site infection following open reduction and internal fixation of a fracture of the ankle. Logistic regression analysis was used to identify significant risk factors for infection and to calculate odds ratios (OR). Function was assessed using the Olerud and Molander Ankle Score. The incidence of infection was 4% (29/717) and 1.1% (8/717) were deep infections. The median ankle score was significantly lower in the infection group compared with the control group (60 vs 90, Mann-Whitney test p fractures (OR = 4, p = 0.048) were significant risk factors for infection. A low incidence of infection following open reduction and internal fixation of fractures of the ankle was observed. Both superficial and deep infections result in lower functional scores.

  3. Hydrogeochemical modelling of fluid–rock interactions triggered by seawater injection into oil reservoirs: Case study Miller field (UK North Sea)

    International Nuclear Information System (INIS)

    Fu, Yunjiao; Berk, Wolfgang van; Schulz, Hans-Martin

    2012-01-01

    A hydrogeochemical model is presented and applied to quantitatively elucidate interdependent reactions among minerals and formation water–seawater mixtures at elevated levels of CO 2 partial pressure. These hydrogeochemical reactions (including scale formation) occur within reservoir aquifers and wells and are driven by seawater injection. The model relies on chemical equilibrium thermodynamics and reproduces the compositional development of the produced water (formation water–seawater mixtures) of the Miller field, UK North Sea. This composition of the produced water deviates from its calculated composition, which could result solely from mixing of both the end members (formation water and seawater). This indicates the effect of hydrogeochemical reactions leading to the formation and/or the dissolution of mineral phases. A fairly good match between the modelled and measured chemical composition of produced water indicates that hydrogeochemical interactions achieve near-equilibrium conditions within the residence time of formation water–seawater mixtures at reservoir conditions. Hence the model enables identification of minerals (including scale minerals), to quantitatively reproduce and to predict their dissolution and/or formation. The modelling results indicate that admixing of seawater into formation water triggers the precipitation of Sr–Barite solid solution, CaSO 4 phases and dolomite. In contrast, calcite and microcrystalline quartz are dissolved along the seawater flow path from the injection well towards the production well. Depending on the fraction of seawater admixed, interdependent reactions induce profound modifications to the aquifer mineral phase assemblage. At low levels of seawater admixture, Ba–Sr sulfate solid solution is precipitated and coupled to concurrent dissolution of calcite and microcrystalline quartz. Massive dissolution of calcite and the formation of CaSO 4 phases and dolomite are triggered by intense seawater admixture

  4. Revitalization and ITS Impact on Public. Space Organization A Case Study of Manchester in UK, Lyon in France and Łódź in Poland

    Directory of Open Access Journals (Sweden)

    Jarosław Kazimierczak

    2014-05-01

    Full Text Available Process of deindustrialization of downtowns in most of well-developed Western European countries has been undertaken since 1960’s while in post-socialist countries just from last 25 years, after political and economic transitions in Central and Eastern Europe.  As far as urban structure is concerned, a new type of inner-city sites has appeared as a consequence of the collapse of industrial activities in second half of 20th century.  In vast majority of cases newly developed morhological units (e.g. run-down post-industrial have been unavailable to the public. As a reult, “classical” public space organization of European cities has been significantly changed. However, revitalization of post-industrial urban areas creates opportunities to reorganize public space according to current inhabitants and other urban space users’ needs. All transitions undertaken as a part of re-developement of brownfields sites are focused on impovements in physical and functional dimension of urban space quality to increase the standard of living condition. According to the concept of smat cities it is relaeted to “smart living” in sustainable urban environment. As a matter of fact, post-socialist cities in Central and Eastern Europe where interval of central planning was present in second half of 20th century and “classical” capitalist cites of Western Europe represent different patterns of public space transitions due to distinct historical development process of central space. In the paper a comparative study of Manchester, Lyon and Łódź is presented. The aim of the research is to indicate the reorganization of historically shaped public space structre in central space of analyzed cities after revitalization of post-industrial urban areas and new central space creation.

  5. Turning the tide : tidal power in the UK

    OpenAIRE

    Sustainable Development Commission

    2007-01-01

    Contents: Turning the tide : tidal power in the UK -- Executive summary -- Tidal power in the UK : research report 1 : UK tidal resource assessment -- Tidal power in the UK : research report 2 : tidal technologies overview -- Tidal power in the UK : research report 3 : Severn barrage proposals -- Tidal power in the UK : research report 4 : Severn non-barrage options -- Tidal power in the UK : research report 5 : UK case studies. Summarised in the Welsh language version of the executive ...

  6. Digital channels diminish SME barriers: the case of the UK

    OpenAIRE

    Stankovska, Ivana; Josimovski, Saso; Edwards, Christopher

    2016-01-01

    This article investigates the usage of digital channels by UK small- and medium-sized enterprises (SMEs) and assesses the impact caused on their strategic marketing position. The research is based on statistical analysis of 66 surveyed SMEs in the context of the digital era. Despite indications from the relevant literature about the reluctance of SMEs to adopt advances in technological communication, the research reported indicates a high level of usage of digital channels, ...

  7. "If There Is a Job Description I Don't Think I've Read One": A Case Study of Programme Leadership in a UK Pre-1992 University

    Science.gov (United States)

    Mitchell, Rafael

    2015-01-01

    This paper reports on an exploratory study of the role of programme leaders (PLs) in a pre-1992 university, based on interviews with PLs (7) and a survey of taught Masters students (54) in a single school. The study elicits PLs' activities, most of which might be categorised as managerial and administrative, with leadership required…

  8. The Adoption and Diffusion of eLearning in UK Universities: \\ud A Comparative Case Study Using Giddens’s Theory of Structuration

    OpenAIRE

    Singh, Gurmak; Hardaker, Glenn

    2011-01-01

    This exploratory study identifies the factors that influence the adoption and diffusion of instructional technology at five prominent universities in the United Kingdom. The study examines the organisational factors that enable and inhibit organisational adoption and diffusion of innovation. Five diverse approaches to adoption and diffusions of instructional technology were examined; top-down, integrated top-down and bottom, research driven and project driven approach. The paper argues that s...

  9. Customers, accounting and strategy: the case of a UK SME

    OpenAIRE

    Pitcher, GS

    2016-01-01

    This paper illustrates that the linking of Customer Relationship Management, Customer Profitability Analysis and Portfolio Management can make a positive impact on the development of strategy in a SME. The integration of marketing and financial systems, inculcating a customer focused culture and encouraging and facilitating cross-functional interaction enabled the collection, dissemination and review of customer related information to become part of the organisational routines. The case study...

  10. Can premium tariffs for micro-generation and small scale renewable heat help the fuel poor, and if so, how? Case studies of innovative finance for community energy schemes in the UK

    International Nuclear Information System (INIS)

    Saunders, R.W.; Gross, R.J.K.; Wade, J.

    2012-01-01

    In the UK, the introduction of micro-generation Feed in Tariffs (FiTs) and a proposed Renewable Heat Incentive (RHI) for domestic and small scale schemes have re-energised the market for investment in domestic scale renewable energy. These incentives may provide financial opportunities for those with capital to spend but for the record numbers with low incomes in ‘fuel poverty’, these benefits may seem out of reach. This paper shows that with appropriate financial intermediaries it is possible for renewable energy incentives to be used to alleviate fuel poverty. Simple financial analysis demonstrates the theoretical potential of FiTs to help those in fuel poverty. Two case studies of renewable energy projects in low income areas investigate how the incentives may be used in practice, what barriers exist and what success factors are evident. The analysis shows that local energy organisations (LEOs) are key if the poor are to access benefits from premium tariff schemes. Low interest finance mechanisms, good information sharing and community involvement are found as key success factors. - Highlights: ► This paper researches the potential for FiTs and RHIs to help those in fuel poverty. ► Simple financial modelling shows the potential benefit of FiTs to the fuel poor. ► Original case study research investigates how these benefits can be realised. ► The action of local energy organisations (LEOs) is important to optimise outcomes. ► Financing and dynamics between the community and LEOs are key to success.

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

    Farragher, Tracey M; Shickle, Darren

    2018-01-01

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

  13. PLAB and UK graduates’ performance on MRCP(UK) and MRCGP examinations: data linkage study

    Science.gov (United States)

    Wakeford, Richard

    2014-01-01

    Objectives To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence. Design Data linkage of GMC PLAB performance data with data from the Royal Colleges of Physicians and the Royal College of General Practitioners on performance of PLAB graduates and UK graduates at the MRCP(UK) and MRCGP examinations. Setting Doctors in training for internal medicine or general practice in the United Kingdom. Participants 7829, 5135, and 4387 PLAB graduates on their first attempt at MRCP(UK) Part 1, Part 2, and PACES assessments from 2001 to 2012 compared with 18 532, 14 094, and 14 376 UK graduates taking the same assessments; 3160 PLAB1 graduates making their first attempt at the MRCGP AKT during 2007-12 compared with 14 235 UK graduates; and 1411 PLAB2 graduates making their first attempt at the MRCGP CSA during 2010-12 compared with 6935 UK graduates. Main outcome measures Performance at MRCP(UK) Part 1, Part 2, and PACES assessments, and MRCGP AKT and CSA assessments in relation to performance on PLAB1 and PLAB2 assessments, as well as to International English Language Testing System (IELTS) scores. MRCP(UK), MRCGP, and PLAB results were analysed as marks relative to the pass mark at the first attempt. Results PLAB1 marks were a valid predictor of MRCP(UK) Part 1, MRCP(UK) Part 2, and MRCGP AKT (r=0.521, 0.390, and 0.490; all PIELTS scores correlated significantly with later performance, multiple regression showing that the effect of PLAB1 (β=0.496) was much stronger than the effect of IELTS (β=0.086). Changes to PLAB pass marks that would result in international medical graduate and UK medical graduate equivalence were assessed in two

  14. PLAB and UK graduates' performance on MRCP(UK) and MRCGP examinations: data linkage study.

    Science.gov (United States)

    McManus, I C; Wakeford, Richard

    2014-04-17

    To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence. Data linkage of GMC PLAB performance data with data from the Royal Colleges of Physicians and the Royal College of General Practitioners on performance of PLAB graduates and UK graduates at the MRCP(UK) and MRCGP examinations. Doctors in training for internal medicine or general practice in the United Kingdom. 7829, 5135, and 4387 PLAB graduates on their first attempt at MRCP(UK) Part 1, Part 2, and PACES assessments from 2001 to 2012 compared with 18,532, 14,094, and 14,376 UK graduates taking the same assessments; 3160 PLAB1 graduates making their first attempt at the MRCGP AKT during 2007-12 compared with 14,235 UK graduates; and 1411 PLAB2 graduates making their first attempt at the MRCGP CSA during 2010-12 compared with 6935 UK graduates. Performance at MRCP(UK) Part 1, Part 2, and PACES assessments, and MRCGP AKT and CSA assessments in relation to performance on PLAB1 and PLAB2 assessments, as well as to International English Language Testing System (IELTS) scores. MRCP(UK), MRCGP, and PLAB results were analysed as marks relative to the pass mark at the first attempt. PLAB1 marks were a valid predictor of MRCP(UK) Part 1, MRCP(UK) Part 2, and MRCGP AKT (r=0.521, 0.390, and 0.490; all PIELTS scores correlated significantly with later performance, multiple regression showing that the effect of PLAB1 (β=0.496) was much stronger than the effect of IELTS (β=0.086). Changes to PLAB pass marks that would result in international medical graduate and UK medical graduate equivalence were assessed in two ways. Method 1 adjusted PLAB pass marks to equate median performance of PLAB

  15. The UK Smoke Constituents Testing Study. Summary of Results and Comparison with Other Studies

    Directory of Open Access Journals (Sweden)

    Gregg E

    2014-12-01

    Full Text Available At the request of the UK Department of Health, samples of 25 commercial UK cigarette brands were provided to LGC Ltd a for smoke analysis. The brands reflected a high market share (58% in July 2001 and included a wide range of blend and product styles manufactured and imported into the UK.= 0.76, suggesting a minor role of other design features on constituents yield variability. This was confirmed by the application of multiple regression analysis to the data. A subset of five brands, retested at another laboratory, gave between-laboratory differences in mean constituent yields of as much as 2.5-fold. Consideration of these results, other likely sources of analytical variation in this study and a review of other studies, clearly indicates that any tolerance values to be associated with individual smoke constituent measurements will be greater than those for NFDPM, and in some cases, much greater. Consistent with the reported results from other large studies it is concluded that, under ISO smoking conditions, smoke constituent yields are largely predictable, if NFDPM and CO yields are known, for a standard cigarette. Given these observations and the likely limitations of analytical determination, the need for routine measurement of smoke constituent yields, other than NFDPM, nicotine or CO, on standard cigarettes, is questionable.

  16. UK methods for studying fuel management in water moderated reactors

    International Nuclear Information System (INIS)

    Fayers, F.J.

    1970-10-01

    Current UK methods for studying fuel management and for predicting the reactor physics performance for both light and heavy water moderated power reactors are reviewed. Brief descriptions are given of the less costly computer codes used for initial assessment studies, and also the more elaborate programs associated with detailed evaluation are discussed. Some of the considerations influencing the accuracy of predictions are included with examples of various types of experimental confirmation. (author)

  17. CASE STUDY

    African Journals Online (AJOL)

    2011-06-02

    Jun 2, 2011 ... immunosuppression associated with HIV/AIDS puts them at a higher risk of developing oesophageal cancer. 47. CASE STUDY. A 49-year-old man was diagnosed as HIV infected, with a CD4 count of 60 cells/µl. He was started on an antiretroviral treatment regimen comprising zidovudine, lamivudine and ...

  18. Location of existing Case Studies on Open Education

    OpenAIRE

    Burke, Siobhan

    2014-01-01

    Members of the Open Education Special Interest Group have collected a selection of short case studies on Open Education. View all of the case studies at http://repository.alt.ac.uk/view/divisions/CaseStudies/ Location of existing Case Studies on Open Education: The following lists aims to capture and amalgamate the various different case study sources which have been created and developed within the UK around experiences of Open Educational Resources.

  19. The case for a new energy research, development and promotion policy for the UK

    International Nuclear Information System (INIS)

    Jamasb, Tooraj; Nuttall, William J.; Pollitt, Michael

    2008-01-01

    This paper is a critical assessment of the current balance of efforts towards energy research and development (R and D) and the promotion of low-carbon electricity technologies in the UK. We review the UK's main technological options and their estimated cost ranges in the medium term. We contrast the energy R and D spending with the current and expected future cost of renewable promotion policies and point out the high cost of carbon saving through existing renewable promotion arrangements. We also note that liberalisation of the electricity sector has had significant implications for the landscape of energy R and D in the UK. We argue that there is a need for reappraisal of the soundness and balance of the energy R and D and renewable capacity deployment efforts towards new energy technologies. We suggest that the cost-effectiveness of UK deployment policies needs to be more closely analysed as associated costs are non-trivial and expected to rise. We also make a case for considering increasing the current low level of energy R and D expenditure. Much of energy R and D is a public good and we should consider whether the current organisation of R and D effort is fit for purpose. We argue that it is important to build and maintain the research capability in the UK in order to absorb spillovers of technological progress elsewhere in the world. Against this background, the recent signs that an energy R and D renaissance could be underway are therefore positive and welcome

  20. International Students' Perceptions of Service Quality in the UK Banking Sector: An Exploratory Study

    Science.gov (United States)

    Bond, Christopher; Hsu, Marc Ting-Chun

    2011-01-01

    This study reviews and evaluates international students' perceptions of UK banks. The specific research objectives were to identify international students' expectations and perceptions of service quality from UK banks and to assess the quality GAP or dissonance between these. A total of 297 international students studying in the UK responded to…

  1. The UK Biobank sample handling and storage validation studies.

    Science.gov (United States)

    Peakman, Tim C; Elliott, Paul

    2008-04-01

    and aims UK Biobank is a large prospective study in the United Kingdom to investigate the role of genetic factors, environmental exposures and lifestyle in the causes of major diseases of late and middle age. It involves the collection of blood and urine from 500 000 individuals aged between 40 and 69 years. How the samples are collected, processed and stored will have a major impact on the future scientific usefulness of the UK Biobank resource. A series of validation studies was recommended to test the robustness of the draft sample handling and storage protocol. Samples of blood and urine were collected from 40 healthy volunteers and either processed immediately according to the protocol or maintained at specified temperatures (4 degrees C for all tubes with the exception of vacutainers containing acid citrate dextrose that were maintained at 18 degrees C) for 12, 24 or 36 h prior to processing. A further sample was maintained for 24 h at 4 degrees C, processed and the aliquots frozen at -80 degrees C for 20 days and then thawed under controlled conditions. The stability of the samples was compared for the different times in a wide variety of assays. The samples maintained at 4 degrees C were stable for at least 24 h after collection for a wide range of assays. Small but significant changes were observed in metabonomic studies in samples maintained at 4 degrees C for 36 h. There was no degradation of the samples for a range of biochemical assays after short-term freezing and thawing under controlled conditions. Whole blood maintained at 18 degrees C for 24 h in vacutainers containing acid citrate dextrose is suitable for viral immortalization techniques. The validation studies reported in this supplement provide justification for the sample handling and storage procedures adopted in the UK Biobank project.

  2. Researching primary engineering education: UK perspectives, an exploratory study

    Science.gov (United States)

    Clark, Robin; Andrews, Jane

    2010-10-01

    This paper draws attention to the findings of an exploratory study that critically identified and analysed relevant perceptions of elementary level engineering education within the UK. Utilising an approach based upon grounded theory methodology, 30 participants including teachers, representatives of government bodies and non-profit providers of primary level engineering initiatives were interviewed. Three main concepts were identified during the analysis of findings, each relevant to primary engineering education. These were pedagogic issues, exposure to engineering within the curriculum and children's interest. The paper concludes that the opportunity to make a real difference to children's education by stimulating their engineering imagination suggests this subject area is of particular value.

  3. Casing study

    Energy Technology Data Exchange (ETDEWEB)

    Roche, P.

    2000-12-01

    An unorthodox method of casing drilling used by Tesco Corporation at a gas well in Wyoming to drill deeper using casings as drillpipe is discussed. The process involves either rotating the casing as drill string or using a downhole mud motor to rotate the bit. In this instance, the surface hole and the production hole were casing-drilled to a record 8,312 feet by rotating the casing. The 8 1/2-inch surface hole was drilled with 7-inch casing to 1,200 feet using a Tesco underreamer and a polycrystalline pilot bit; drilling and cementing was completed in 12 1/2 hours. The 6 1/4-inch production hole was drilled with 4 1/2-inch casing and the bottomhole assembly was retrieved after 191 hours rotating. This case was the first in which the entire well was casing-drilled from surface to TD. Penetration rate compared favorably with conventional methods: 12 1/2 hours for casing-drilling to 18.9 hours for conventional drilling, despite the fact that the casing-drilling technology is still in its infancy. It is suggested that casing-drilling has the potential to eliminate the need for the drillpipe entirely. If these expectations were to be realised, casing-drilling could be one of the most radical drilling changes in the history of the oil and gas industry. 1 photo.

  4. Health status of UK care home residents: a cohort study.

    Science.gov (United States)

    Gordon, Adam Lee; Franklin, Matthew; Bradshaw, Lucy; Logan, Pip; Elliott, Rachel; Gladman, John R F

    2014-01-01

    UK care home residents are often poorly served by existing healthcare arrangements. Published descriptions of residents' health status have been limited by lack of detail and use of data derived from surveys drawn from social, rather than health, care records. to describe in detail the health status and healthcare resource use of UK care home residents a 180-day longitudinal cohort study of 227 residents across 11 UK care homes, 5 nursing and 6 residential, selected to be representative for nursing/residential status and dementia registration. Barthel index (BI), Mini-mental state examination (MMSE), Neuropsychiatric index (NPI), Mini-nutritional index (MNA), EuroQoL-5D (EQ-5D), 12-item General Health Questionnaire (GHQ-12), diagnoses and medications were recorded at baseline and BI, NPI, GHQ-12 and EQ-5D at follow-up after 180 days. National Health Service (NHS) resource use data were collected from databases of local healthcare providers. out of a total of 323, 227 residents were recruited. The median BI was 9 (IQR: 2.5-15.5), MMSE 13 (4-22) and number of medications 8 (5.5-10.5). The mean number of diagnoses per resident was 6.2 (SD: 4). Thirty per cent were malnourished, 66% had evidence of behavioural disturbance. Residents had contact with the NHS on average once per month. residents from both residential and nursing settings are dependent, cognitively impaired, have mild frequent behavioural symptoms, multimorbidity, polypharmacy and frequently use NHS resources. Effective care for such a cohort requires broad expertise from multiple disciplines delivered in a co-ordinated and managed way.

  5. Experimental asbestos studies in the UK: 1912-1950.

    Science.gov (United States)

    Greenberg, Morris

    2017-11-01

    The asbestos industry originated in the UK in the 1870s. By 1898, asbestos had many applications and was reported to be one of the four leading causes of severe occupational disease. In 1912, the UK government sponsored an experimental study that reported that exposure to asbestos produced no more than a modicum of pulmonary fibrosis in guinea pigs. In the 1930s, the newly established Medical Research Council, with assistance from industry, sponsored a study of the effects of exposing animals to asbestos by injection (intratracheal and subcutaneous) and by inhalation in the factory environment. Government reports, publications, and contemporary records obtained by legal discovery have been reviewed in the context of the stage of scientific development and the history of the times. Experimenters were engaged in a learning process during the 1912-1950 period, and their reports of the effects of asbestos were inconsistent. Pathologists who studied the effects of asbestos experimentally, at whole animal, tissue and cellular levels, advanced experimental methodology and mechanistic knowledge. In the hands of public relations experts, however, research was exploited to preserve an industry and perpetuate preventable diseases, a practice that continues to this day. © 2017 Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2015-01-01

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

  7. PLAB and UK graduates' performance on MRCP(UK) and MRCGP examinations: data linkage study

    OpenAIRE

    McManus, I. C.; Wakeford, R.

    2014-01-01

    OBJECTIVES: To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence. DESIGN: Data linkage of GMC PLAB performance data with data from the Royal Colleges of Phys...

  8. CASE STUDY

    African Journals Online (AJOL)

    HIV infection has several oral manifestations, including oral candidiasis and oral hairy leucoplakia. Occasionally unusual presentations requiring rigorous investigations are seen, and in these cases the diagnosis sometimes remains a dilemma owing to limited investigation facilities.1-3 We present the case of a patient who.

  9. Governing transitions: Cases and insights from two periods in the history of the UK gas industry

    International Nuclear Information System (INIS)

    Arapostathis, Stathis; Carlsson-Hyslop, Anna; Pearson, Peter J G; Thornton, Judith; Gradillas, Maria; Laczay, Scott; Wallis, Suzanne

    2013-01-01

    The paper aims to inform historically the analyses of future sociotechnical transition pathways in the electricity sector, particularly those developed by the Transition Pathways to a Low Carbon Economy project. It also aims to inform the theoretical approach to transitions by focusing on key decisions at ‘branching points’ that led to transitions in the UK gas energy services regime, which occurred under different governance patterns. The first historical case study covers the market-led transformation of the manufactured gas regime from 1877 to 1914, which developed the end-uses of gas beyond lighting to include cooking, and extended access to working class consumers. The second case study covers the period from 1948 to 1977, historically reconstructing the transition from town gas to natural gas. This state-led and coordinated conversion to natural gas was preceded by a period of destabilisation of the manufactured gas regime, the co-existence of several niche technologies and the hybridisation of the key actors and technological infrastructures of the incumbent regime. Comparing the cases provides insights for future energy service transitions by addressing the significance of power, trust and networking in the decision making processes involved in the governance of energy transitions. - Highlights: ► Historical work is useful in understanding socio-technical energy transitions. ► Different governance modes have led to transitions with different characteristics. ► Gas regimes operating under market and state ‘logics’ took decisions differently. ► Decisions at key branching points led to path dependency, affecting later decisions. ► Agency, governance and trust were important elements in the transitions analysed.

  10. Private power financing: a case study

    International Nuclear Information System (INIS)

    Stocker, Albert

    1991-01-01

    The Public Utility Regulatory Power Act (PURPA) in the USA and the UK's Electricity Act passed in 1989 are discussed and the first UK private power project is considered. A case study is presented, and covers the questions of when to approach the bank; banker versus investment bank; project fundamentals; the sponsor and the management team; the strength of the key project agreements; syndication of the project debt; and bank support during construction and operation. (author)

  11. case study

    African Journals Online (AJOL)

    Elton

    particularly in patients who commence ART with low CD4 counts and established opportunistic infections. IRIS results from a pathological inflammatory response to pre-existing infective, host or other antigens, alive or dead, causing clinical deterioration in HIV-infected patients after initiating ART.1 A case definition for IRIS ...

  12. CASE STUDY

    African Journals Online (AJOL)

    2010-09-01

    Sep 1, 2010 ... of the two diseases surgery can be successful, recovery can be similar to that .... lymphocytes predominated in 68% of cases, and that there was an .... using ferritin is the fact that it acts as an acute-phase reactant and will be ...

  13. Towards Corporate Shared Value in Retail Sector: A Comparative Study over Grocery and Banking Between Italy and the UK

    Directory of Open Access Journals (Sweden)

    Elena Candelo

    2015-10-01

    Full Text Available The research investigates the extent to which Banking and Grocery retailers use Corporate Social Responsibility (CSR in accordance to evolving consumers’ expectations and build a strategic model of Corporate Shared Value (CSV to strive for economic and social returns simultaneously. The paper adopts a qualitative approach, based on the comparative case study methodology by investigating a sample of twelve Banking and Grocery retailers in Italy and the UK. Differences and similarities in CSR as new strategic model among countries and retail sectors emerge, with UK companies from both the sectors showing the most formalized integration of CSR within their business strategy. The chance for both Italian and UK retail companies is to adopt the best practices emerging from the case studies to turn their CSR programs into a strategic business model of CSV that will allow a stronger retailer-consumer relationship based on social improvements and a reinforcement of their brand image.

  14. Which Frail Older People Are Dehydrated? The UK DRIE Study.

    Science.gov (United States)

    Hooper, Lee; Bunn, Diane K; Downing, Alice; Jimoh, Florence O; Groves, Joyce; Free, Carol; Cowap, Vicky; Potter, John F; Hunter, Paul R; Shepstone, Lee

    2016-10-01

    Water-loss dehydration in older people is associated with increased mortality and disability. We aimed to assess the prevalence of dehydration in older people living in UK long-term care and associated cognitive, functional, and health characteristics. The Dehydration Recognition In our Elders (DRIE) cohort study included people aged 65 or older living in long-term care without heart or renal failure. In a cross-sectional baseline analysis, we assessed serum osmolality, previously suggested dehydration risk factors, general health, markers of continence, cognitive and functional health, nutrition status, and medications. Univariate linear regression was used to assess relationships between participant characteristics and serum osmolality, then associated characteristics entered into stepwise backwards multivariate linear regression. DRIE included 188 residents (mean age 86 years, 66% women) of whom 20% were dehydrated (serum osmolality >300 mOsm/kg). Linear and logistic regression suggested that renal, cognitive, and diabetic status were consistently associated with serum osmolality and odds of dehydration, while potassium-sparing diuretics, sex, number of recent health contacts, and bladder incontinence were sometimes associated. Thirst was not associated with hydration status. DRIE found high prevalence of dehydration in older people living in UK long-term care, reinforcing the proposed association between cognitive and renal function and hydration. Dehydration is associated with increased mortality and disability in older people, but trials to assess effects of interventions to support healthy fluid intakes in older people living in residential care are needed to enable us to formally assess causal direction and any health benefits of increasing fluid intakes. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

    Science.gov (United States)

    Rey Vicario, D.; Holman, I.

    2016-12-01

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

  16. Modelling the potential to achieve deep carbon emission cuts in existing UK social housing: The case of Peabody

    International Nuclear Information System (INIS)

    Reeves, Andrew; Taylor, Simon; Fleming, Paul

    2010-01-01

    As part of the UK's effort to combat climate change, deep cuts in carbon emissions will be required from existing housing over the coming decades. The viability of achieving such emission cuts for the UK social housing sector has been explored through a case study of Peabody, a housing association operating in London. Various approaches to stock refurbishment were modelled for Peabody's existing stock up to the year 2030, incorporating insulation, communal heating and micro-generation technologies. Outputs were evaluated under four future socio-economic scenarios. The results indicate that the Greater London Authority's target of a 60% carbon emission cut by 2025 can be achieved if extensive stock refurbishment is coupled with a background of wider societal efforts to reduce carbon emissions. The two key external requirements identified are a significant reduction in the carbon intensity of grid electricity and a stabilisation or reduction in householder demand for energy. A target of achieving zero net carbon emissions across Peabody stock by 2030 can only be achieved if grid electricity becomes available from entirely zero-carbon sources. These results imply that stronger action is needed from both social landlords and Government to enable deep emission cuts to be achieved in UK social housing.

  17. Case Study: Testing with Case Studies

    Science.gov (United States)

    Herreid, Clyde Freeman

    2015-01-01

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

  18. Study into solar thermal electricity export opportunities for the UK

    International Nuclear Information System (INIS)

    1996-01-01

    The overall objectives of the project described in this report were: to provide an assessment of the world-wide opportunities currently available for the development of high temperature solar thermal (H-TSTh) technology; to identify United Kingdom companies and expertise which could benefit from the exploitation of export markets for H-TSTh; to estimate the potential benefits to the UK of such exploitation; and to review the current status of H-TSTh technology. Despite limited involvement at present, it is concluded that the UK would be well placed with respect to longer term market opportunities if current developments by UK companies in fixed bowl technology and Stirling engines for dish Stirling system are successful. Opportunities also exist for turbine supply, civil contractors, insurance, finance and operation, but discussions with relevant UK companies has revealed only limited interest. (Author)

  19. The Benefits of Part-Time Undergraduate Study and UK Higher Education Policy: A Literature Review

    Science.gov (United States)

    Bennion, Alice; Scesa, Anna; Williams, Ruth

    2011-01-01

    Part-time study in the UK is significant: nearly 40 per cent of higher education students study part-time. This article reports on a literature review that sought to understand the economic and social benefits of part-time study in the UK. It concludes that there are substantial and wide-ranging benefits from studying part-time. The article also…

  20. Antimicrobial susceptibility of methicillin-resistant Staphylococcus pseudintermedius isolated from veterinary clinical cases in the UK.

    Science.gov (United States)

    Maluping, R P; Paul, N C; Moodley, A

    2014-01-01

    Staphylococcus pseudintermedius is a leading aetiologic agent of pyoderma and other body tissue infections in dogs and cats. In recent years, an increased prevalence of methicillin-resistant S. pseudintermedius (MRSP) has been reported. Isolation of MRSP in serious infections poses a major therapeutic challenge as strains are often resistant to all forms of systemic antibiotic used to treat S. pseudintermedius -related infections. This study investigates the occurrence of MRSP from a total of 7183 clinical samples submitted to the authors' laboratories over a 15-month period. Identification was based on standard microbiological identification methods, and by S. pseudintermedius-specific nuc polymerase chain reaction (PCR). Methicillin resistance was confirmed by PBP2a latex agglutination and mecA PCR. Susceptibility against non-beta-lactam antibiotics was carried out using a disc-diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. In addition, susceptibility to pradofloxacin--a new veterinary fluoroquinolone--was also investigated. SCCmec types were determined by multiplex PCR. Staphylococcus pseudintermedius was isolated from 391 (5%) samples and 20 were confirmed as MRSP from cases of pyoderma, otitis, wound infections, urinary tract infection and mastitis in dogs only. All 20 isolates were resistant to clindamycin and sulphamethoxazole/trimethoprim. Nineteen were resistant to chloramphenicol, enrofloxacin, gentamicin, marbofloxacin and pradofloxacin; additionally, seven isolates were resistant to tetracycline. Fifteen isolates carried SCCmec type II-III, four isolates had type V and one harboured type IV. To date, only a few scientific papers on clinical MRSP strains isolated from the UK have been published, thus the results from this study would provide additional baseline data for further investigations.

  1. A Descriptive Study of Professional Staff, and Their Careers, in Australian and UK Universities

    Science.gov (United States)

    Gander, Michelle

    2018-01-01

    Professional staff total approximately 23% of staff in universities in the UK, which in 2014/15 was the equivalent of 95,870 individuals (hesa.ac.uk). With their increasing span of responsibility, it is surprising that there has been little research into the careers of these staff. This study, part of a larger careers study, highlights some key…

  2. Cross Functional Working and Concurrent Engineering – a UK Study

    Directory of Open Access Journals (Sweden)

    H. Williams

    2000-01-01

    Full Text Available This paper reports on the preliminary results of an investigative study into the implementation of concurrent engineering applied to new product development. Concurrent (or Simultaneous engineering is the term commonly given to creating new products using multi-disciplined teams of marketing, design, manufacturing and support functions together with supplier and customers. Such techniques have produced robust, low cost quality products in short concept to market times compared to traditional ones. The research investigated design management practice and performance in a number of organisations across a range of industrial sectors in the UK by means of a questionnaire survey. The results identify the current use of a variety of design practices and methodologies such as different organisational structures, the extent of cross-functional working, the use of design and phase reviews and the use of different technologies. They indicate that companies implementing CE are more successful in time to market performance than those who don’t implement CE. Factors most influencing the successful adoption of CE are design and phase reviews, and, to a lesser extent, the use of multifunctional teams and supplier partnerships.

  3. Gene–obesogenic environment interactions in the UK Biobank study

    Science.gov (United States)

    Tyrrell, Jessica; Wood, Andrew R; Ames, Ryan M; Yaghootkar, Hanieh; Beaumont, Robin N; Jones, Samuel E; Tuke, Marcus A; Ruth, Katherine S; Freathy, Rachel M; Davey Smith, George; Joost, Stéphane; Guessous, Idris; Murray, Anna; Strachan, David P; Kutalik, Zoltán; Weedon, Michael N; Frayling, Timothy M

    2017-01-01

    Abstract Background: Previous studies have suggested that modern obesogenic environments accentuate the genetic risk of obesity. However, these studies have proven controversial as to which, if any, measures of the environment accentuate genetic susceptibility to high body mass index (BMI). Methods: We used up to 120 000 adults from the UK Biobank study to test the hypothesis that high-risk obesogenic environments and behaviours accentuate genetic susceptibility to obesity. We used BMI as the outcome and a 69-variant genetic risk score (GRS) for obesity and 12 measures of the obesogenic environment as exposures. These measures included Townsend deprivation index (TDI) as a measure of socio-economic position, TV watching, a ‘Westernized’ diet and physical activity. We performed several negative control tests, including randomly selecting groups of different average BMIs, using a simulated environment and including sun-protection use as an environment. Results: We found gene–environment interactions with TDI (Pinteraction = 3 × 10–10), self-reported TV watching (Pinteraction = 7 × 10–5) and self-reported physical activity (Pinteraction = 5 × 10–6). Within the group of 50% living in the most relatively deprived situations, carrying 10 additional BMI-raising alleles was associated with approximately 3.8 kg extra weight in someone 1.73 m tall. In contrast, within the group of 50% living in the least deprivation, carrying 10 additional BMI-raising alleles was associated with approximately 2.9 kg extra weight. The interactions were weaker, but present, with the negative controls, including sun-protection use, indicating that residual confounding is likely. Conclusions: Our findings suggest that the obesogenic environment accentuates the risk of obesity in genetically susceptible adults. Of the factors we tested, relative social deprivation best captures the aspects of the obesogenic environment responsible. PMID:28073954

  4. UK National Audit of Sexual History-taking: case-notes audit.

    Science.gov (United States)

    Carne, C; McClean, H; Bhaduri, S; Gokhale, R; Sethi, G; Daniels, D

    2009-05-01

    A national audit of sexual history-taking was conducted in genitourinary medicine clinics in the UK in 2008. Data were aggregated by region and clinic, allowing practice to be compared between regions, as well as to national averages and against national Guidelines. In this paper the case-notes of 4121 patients were audited. A high proportion of the case-notes were deemed to be completely legible. In other respects there is considerable inter-regional variation in the adherence to national Guidelines. Interventions are especially required to improve documentation of practice in discussing condom use, HIV risk assessment, offer of a chaperone and assessment for hepatitis B vaccination and hepatitis C testing, and issues concerning sexual contacts.

  5. Optimising case detection within UK electronic health records : use of multiple linked databases for detecting liver injury

    NARCIS (Netherlands)

    Wing, Kevin; Bhaskaran, Krishnan; Smeeth, Liam; van Staa, Tjeerd P|info:eu-repo/dai/nl/304827762; Klungel, Olaf H|info:eu-repo/dai/nl/181447649; Reynolds, Robert F; Douglas, Ian

    2016-01-01

    OBJECTIVES: We aimed to create a 'multidatabase' algorithm for identification of cholestatic liver injury using multiple linked UK databases, before (1) assessing the improvement in case ascertainment compared to using a single database and (2) developing a new single-database case-definition

  6. Similarities of Variant Creutzfeldt-Jakob Disease Strain in Mother and Son in Spain to UK Reference Case.

    Science.gov (United States)

    Diack, Abigail B; Boyle, Aileen; Ritchie, Diane; Plinston, Chris; Kisielewski, Dorothy; de Pedro-Cuesta, Jesús; Rábano, Alberto; Will, Robert G; Manson, Jean C

    2017-09-01

    We investigated transmission characteristics of variant Creutzfeldt-Jakob disease in a mother and son from Spain. Despite differences in patient age and disease manifestations, we found the same strain properties in these patients as in UK vCJD cases. A single strain of agent appears to be responsible for all vCJD cases to date.

  7. CASE STUDY CRITIQUE; UPPER CLINCH CASE STUDY

    Science.gov (United States)

    Case study critique: Upper Clinch case study (from Research on Methods for Integrating Ecological Economics and Ecological Risk Assessment: A Trade-off Weighted Index Approach to Integrating Economics and Ecological Risk Assessment). This critique answers the questions: 1) does ...

  8. An exploratory study of information sources and key findings on UK cocaine-related deaths.

    Science.gov (United States)

    Corkery, John M; Claridge, Hugh; Goodair, Christine; Schifano, Fabrizio

    2017-08-01

    Cocaine-related deaths have increased since the early 1990s in Europe, including the UK. Being multi-factorial, they are difficult to define, detect and record. The European Monitoring Centre for Drugs and Drug Addiction commissioned research to: describe trends reported to Special Mortality Registries and General Mortality Registers; provide demographic and drug-use characteristic information of cases; and establish how deaths are identified and classified. A questionnaire was developed and piloted amongst all European Monitoring Centre for Drugs and Drug Addiction Focal Point experts/Special Mortality Registries: 19 (63%) responded; nine countries provided aggregated data. UK General Mortality Registers use cause of death and toxicology to identify cocaine-related deaths. Categorisation is based on International Classification of Diseases codes. Special Mortality Registries use toxicology, autopsy, evidence and cause of death. The cocaine metabolites commonly screened for are: benzoylecgonine, ecgonine methyl ester, cocaethylene and ecgonine. The 2000s saw a generally accelerating upward trend in cases, followed by a decline in 2009. The UK recorded 2700-2900 deaths during 1998-2012. UK Special Mortality Registry data (2005-2009) indicate: 25-44 year-olds account for 74% of deaths; mean age=34 (range 15-81) years; 84% male. Cocaine overdoses account for two-thirds of cases; cocaine alone being mentioned/implicated in 23% in the UK. Opioids are involved in most (58%) cocaine overdose cases.

  9. Sociocultural factors in public acceptance: comparative risk studies involving France, the USA and the UK

    Energy Technology Data Exchange (ETDEWEB)

    Poumadere, M.; Mays, C.

    1995-12-31

    Examples are given of two types of comparative study that explore the sociocultural factors that shape public attitudes. In the first, public perceptions of nuclear power were assessed by answers to a questionnaire on a broad range of factors by 1500 people in France and the USA. A degree of homogeniety was observed in the responses from France and the USA. Strikingly, both populations agreed in their evaluation of the health risk represented by nuclear power plant. Thus the apparently greater acceptance of nuclear power in France does not seem to be associated with a lesser perception of risk. However, presented with the statement ``We can trust the experts and engineers who build, operate and regulate nuclear power`` 66% of the French agreed compared to only 43% of the Americans. These results reflect two different types of relationship between society and authority. In the second study the approach to gaining public trust and acceptance in the siting of nuclear waste research facilities was compared between the UK and France. Striking differences were found. In this case, too, an explanation can be put forward in terms of the sociocultural variables which influence institutional decision making, particularly in the role and form given to authority. (UK).

  10. Sun safety in construction: a U.K. intervention study.

    Science.gov (United States)

    Houdmont, J; Madgwick, P; Randall, R

    2016-01-01

    Interventions to promote sun safety in the U.K. construction sector are warranted given the high incidence of skin cancer attributable to sun exposure relative to other occupational groups. To evaluate change in sun safety knowledge and practices among construction workers in response to an educational intervention. A baseline questionnaire was administered, followed by a bespoke sector-specific DVD-based intervention. At 12-month follow-up, participants completed a further questionnaire. Analyses were conducted on a sample of 120 workers (intervention group, n = 70; comparison group, n = 50). At follow-up, the proportion of intervention group participants that reported correct sun safety knowledge was not significantly greater than at baseline. However, the intervention group demonstrated significant positive change on 9 out of 10 behavioural measures, the greatest change being use of a shade/cover when working in the sun followed by regularly checking skin for moles or unusual changes. Exposure to this intervention was linked to some specific positive changes in construction workers' self-reported sun safety practices. These findings highlight the potential for educational interventions to contribute to tackling skin cancer in the UK construction sector. The findings support the development of bespoke educational interventions for other high-risk outdoor worker groups. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Performance of gout definitions for genetic epidemiological studies: analysis of UK Biobank.

    Science.gov (United States)

    Cadzow, Murray; Merriman, Tony R; Dalbeth, Nicola

    2017-08-09

    Many different combinations of available data have been used to identify gout cases in large genetic studies. The aim of this study was to determine the performance of case definitions of gout using the limited items available in multipurpose cohorts for population-based genetic studies. This research was conducted using the UK Biobank Resource. Data, including genome-wide genotypes, were available for 105,421 European participants aged 40-69 years without kidney disease. Gout definitions and combinations of these definitions were identified from previous epidemiological studies. These definitions were tested for association with 30 urate-associated single-nucleotide polymorphisms (SNPs) by logistic regression, adjusted for age, sex, waist circumference, and ratio of waist circumference to height. Heritability estimates under an additive model were generated using GCTA version 1.26.0 and PLINK version 1.90b3.32 by partitioning the genome. There were 2066 (1.96%) cases defined by self-report of gout, 1652 (1.57%) defined by urate-lowering therapy (ULT) use, 382 (0.36%) defined by hospital diagnosis, 1861 (1.76%) defined by hospital diagnosis or gout-specific medications and 2295 (2.18%) defined by self-report of gout or ULT use. Association with gout at experiment-wide significance (P genetic epidemiological studies of gout.

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

    Science.gov (United States)

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

    2015-05-01

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

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

    Science.gov (United States)

    Evans, Catrin; Stevenson, Keith

    2011-06-13

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

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

    Directory of Open Access Journals (Sweden)

    Stevenson Keith

    2011-06-01

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

  15. UK chemical nuclear data committee progress report: data studies during 1989

    International Nuclear Information System (INIS)

    Nichols, A.L.

    1990-01-01

    Basic nuclear data requirements for industrial application are monitored by the UK Chemical Nuclear Data Committee (UKCNDC), covering half-lives, decay data, fission yields and the content of computerised data files. While the UKCNDC Request List was reviewed at the end of 1989 to reveal new and continued requirements, funding problems have increased during the year. Difficulties in the UK nuclear power industry are reflected in the decline in experimental studies, although evaluation efforts have been maintained. (author)

  16. The management and outcomes of placenta accreta, increta, and percreta in the UK: a population-based descriptive study.

    Science.gov (United States)

    Fitzpatrick, K E; Sellers, S; Spark, P; Kurinczuk, J J; Brocklehurst, P; Knight, M

    2014-01-01

    To describe the management and outcomes of placenta accreta, increta, and percreta in the UK. A population-based descriptive study using the UK Obstetric Surveillance System (UKOSS). All 221 UK hospitals with obstetrician-led maternity units. All women diagnosed with placenta accreta, increta, and percreta in the UK between May 2010 and April 2011. Prospective case identification through the monthly mailing of UKOSS. Median estimated blood loss, transfusion requirements. A cohort of 134 women were identified with placenta accreta, increta, or percreta: 50% (66/133) were suspected to have this condition antenatally. In women with a final diagnosis of placenta increta or percreta, antenatal diagnosis was associated with reduced levels of haemorrhage (median estimated blood loss 2750 versus 6100 ml, P = 0.008) and a reduced need for blood transfusion (59 versus 94%, P = 0.014), possibly because antenatally diagnosed women were more likely to have preventative therapies for haemorrhage (74 versus 52%, P = 0.007), and were less likely to have an attempt made to remove their placenta (59 versus 93%, P accreta, increta, or percreta who have no attempt to remove any of their placenta, with the aim of conserving their uterus, or prior to hysterectomy, have reduced levels of haemorrhage and a reduced need for blood transfusion, supporting the recommendation of this practice. © 2013 RCOG.

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

    International Nuclear Information System (INIS)

    Bassi, Andrea; Howard, Robert; Geneletti, Davide; Ferrari, Simone

    2012-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Bassi, Andrea, E-mail: ab395@bath.co.uk [University of Bath, Faculty of Engineering and Design, Claverton Down, Bath BA2 7AY (United Kingdom); Howard, Robert, E-mail: robhoward@constcom.demon.co.uk [Construction Communications, 8 Cotton& #x27; s Field, Dry Drayton, Cambridge CB23 8DG (United Kingdom); Geneletti, Davide, E-mail: davide.geneletti@ing.unitn.it [Sustainability Science Program, Harvard University, 79 JFK Street, Cambridge, MA 02138 (United States); Dept. of Civil and Environmental Engineering, University of Trento, Via Mesiano, 77 38123 Trento (Italy); Ferrari, Simone, E-mail: simone.ferrari@polimi.it [Dept. BEST, Building Environment Science and Technology, Politecnico di Milano, Via Bonardi, 3 20133 Milano (Italy)

    2012-04-15

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

  19. The industrial application requirement for biotech inventions in light of recent EPO & UK case law:

    DEFF Research Database (Denmark)

    Minssen, Timo; Nilsson, David

    2012-01-01

    In this study we illuminate and discuss the most recent developments in respect of the interpretation of the “industrial application” requirement with respect to gene and protein related inventions in Europe. The analysis will focus on the relevant provisions of the EPC and decisional practice from...... the European Patent Organisation (“EPO”), particularly decisions from the Technical Board of Appeal 3.3.08 (the “Board”). To get a glimpse of the national dimension, we will also look at the first patent judgment from the "new" UK Supreme Court, i.e. the groundbreaking decision in HGS v Eli Lilly, In the final...... discussion, we will elaborate on two issues in particular; (i) determine which types of qualities an invention should have in order to meet the industrial application requirement in the first place; and (ii) what type of evidence an applicant is expected to present in respect of (potential) applications...

  20. Project management case studies

    CERN Document Server

    Kerzner, Harold R

    2013-01-01

    A new edition of the most popular book of project management case studies, expanded to include more than 100 cases plus a ""super case"" on the Iridium Project Case studies are an important part of project management education and training. This Fourth Edition of Harold Kerzner''s Project Management Case Studies features a number of new cases covering value measurement in project management. Also included is the well-received ""super case,"" which covers all aspects of project management and may be used as a capstone for a course. This new edition:Contains 100-plus case studies drawn from re

  1. Case Study Research Methodology

    Directory of Open Access Journals (Sweden)

    Mark Widdowson

    2011-01-01

    Full Text Available Commenting on the lack of case studies published in modern psychotherapy publications, the author reviews the strengths of case study methodology and responds to common criticisms, before providing a summary of types of case studies including clinical, experimental and naturalistic. Suggestions are included for developing systematic case studies and brief descriptions are given of a range of research resources relating to outcome and process measures. Examples of a pragmatic case study design and a hermeneutic single-case efficacy design are given and the paper concludes with some ethical considerations and an exhortation to the TA community to engage more widely in case study research.

  2. Career choices for cardiology: cohort studies of UK medical graduates

    Science.gov (United States)

    2013-01-01

    Background Cardiology is one of the most popular of the hospital medical specialties in the UK. It is also a highly competitive specialty in respect of the availability of higher specialty training posts. Our aims are to describe doctors’ early intentions about seeking careers in cardiology, to report on when decisions about seeking a career in cardiology are made, to compare differences between men and women doctors in the choice of cardiology, and to compare early career choices with later specialty destinations. Methods Questionnaire surveys were sent to all UK medical graduates in selected qualification years from 1974–2009, at 1, 3, 5, 7 and 10 years after graduation. Results One year after graduation, the percentage of doctors specifying cardiology as their first choice of long-term career rose from the mid-1990s from 2.4% (1993 cohort) to 4.2% (2005 cohort) but then fell back to 2.7% (2009 cohort). Men were more likely to give cardiology as their first choice than women (eg 4.1% of men and 1.9% of women in the 2009 cohort). The percentage of doctors who gave cardiology as their first choice of career declined between years one and five after qualification: the fall was more marked for women. 34% of respondents who specified cardiology as their sole first choice of career one year post-graduation were later working in cardiology. 24% of doctors practising as cardiologists several years after qualification had given cardiology as their sole first choice in year one. The doctors’ ‘domestic circumstances’ were a relatively unimportant influence on specialty choice for aspiring cardiologists, while ‘enthusiasm/commitment’, ‘financial prospects’, ‘experiences of the job so far’ and ‘a particular teacher/department’ were important. Conclusions Cardiology grew as a first preference one year after graduation to 2005 but is now falling. It consistently attracts a higher percentage of men than women doctors. The correspondence between early

  3. The UK Childhood Cancer Study: Maternal occupational exposures and childhood leukaemia and lymphoma

    International Nuclear Information System (INIS)

    McKinney, P. A.; Raji, O. Y.; Van Tongeren, M.; Feltbower, R. G.

    2008-01-01

    Risks of childhood leukaemia and lymphoma were investigated for specific work-related exposures of mothers in the UK Childhood Cancer Study. Interviews with parents of 1881 leukaemia and lymphoma cases (0-14 years) and 3742 controls collected job histories recording exposure to eight specific agents. Exposure was (1) self-reported and (2) reviewed, based mainly on exposure probability and exposure level. Completeness, consistency and sufficiency evaluated data quality. Of all job exposures which were self-reported as exposed, 33% cases and 34% controls remained classified as exposed after review, with the remainder designated as partially exposed or unexposed. No review of underreporting of exposure was made. Data quality was 'good' for 26% of cases and 24% of controls. For self-reported exposure, significant risks of acute lymphoblastic leukaemia (ALL) were observed for solvents and petrol in all time windows. For reviewed exposure, solvents remained significant for ALL during pregnancy and post-natality. Restricting analyses to good-quality information removed all significant results. Refinement of exposure assessment revealed misclassification of self-reported exposures and data quality influenced risk assessment. Maternal exposure to solvents should further be investigated. These findings must invoke caution in the interpretation of risks reliant on self-reported occupational data. (authors)

  4. Comprehensive sequence analysis of nine Usher syndrome genes in the UK National Collaborative Usher Study.

    Science.gov (United States)

    Le Quesne Stabej, Polona; Saihan, Zubin; Rangesh, Nell; Steele-Stallard, Heather B; Ambrose, John; Coffey, Alison; Emmerson, Jenny; Haralambous, Elene; Hughes, Yasmin; Steel, Karen P; Luxon, Linda M; Webster, Andrew R; Bitner-Glindzicz, Maria

    2012-01-01

    Usher syndrome (USH) is an autosomal recessive disorder comprising retinitis pigmentosa, hearing loss and, in some cases, vestibular dysfunction. It is clinically and genetically heterogeneous with three distinctive clinical types (I-III) and nine Usher genes identified. This study is a comprehensive clinical and genetic analysis of 172 Usher patients and evaluates the contribution of digenic inheritance. The genes MYO7A, USH1C, CDH23, PCDH15, USH1G, USH2A, GPR98, WHRN, CLRN1 and the candidate gene SLC4A7 were sequenced in 172 UK Usher patients, regardless of clinical type. No subject had definite mutations (nonsense, frameshift or consensus splice site mutations) in two different USH genes. Novel missense variants were classified UV1-4 (unclassified variant): UV4 is 'probably pathogenic', based on control frequency A being the most common USH1 mutation in the cohort). USH2A was responsible for 79.3% of USH2 families and GPR98 for only 6.6%. No mutations were found in USH1G, WHRN or SLC4A7. One or two pathogenic/likely pathogenic variants were identified in 86% of cases. No convincing cases of digenic inheritance were found. It is concluded that digenic inheritance does not make a significant contribution to Usher syndrome; the observation of multiple variants in different genes is likely to reflect polymorphic variation, rather than digenic effects.

  5. A comparative study of stakeholder participation in the cleanup of radioactive wastes in the US, Japan and UK

    International Nuclear Information System (INIS)

    Lawless, W.F.; Angjellari-Dajci, Fjorentina; Mito, Akiyoshi; Whitton, John

    2011-01-01

    We review case studies of stakeholder participation in the environmental cleanup of radioactive wastes in the United States, Japan and United Kingdom (e.g., [21,26,27,66,78]). Citizen participation programs in these three countries are at different stages: mature in the US, starting in Japan, and becoming operational in the UK. The US issue at the US Department of Energy's (DOE) Savannah River Site (SRS) in South Carolina (SC) had been focused on citizens encouraging Federal (DOE; US Environmental Protection Agency, or EPA; and the US Nuclear Regulatory Commission, or NRC) and State (SC's Department of Health and Environmental Compliance, or DHEC) agencies to pursue 'Plug-in-RODs' at SRS to simplify the regulations to accelerate closing seepage basins at SRS. In Japan, the Reprocessing of spent fuel and deep geological disposal of vitrified high-level waste have been among Japan's priorities. A reprocessing plant in Rokkasho, Aomori Prefecture is expected to commence operations in October 2010. The search of a site for a deep geological disposal facility has been ongoing since 2002. But the direct engagement of stakeholders has not occurred in Japan. Indirectly, stakeholders attempt to exert influence on decision-making with social movements, local elections, and litigation. In the UK, the issue is gaining effective citizen participation with the UK's Nuclear Decommissioning Authority (NDA). We hope that the case studies from these countries may improve citizen participation. (author)

  6. Bed-sharing in the absence of hazardous circumstances: is there a risk of sudden infant death syndrome? An analysis from two case-control studies conducted in the UK.

    Directory of Open Access Journals (Sweden)

    Peter S Blair

    Full Text Available The risk of sudden infant death syndrome (SIDS among infants who co-sleep in the absence of hazardous circumstances is unclear and needs to be quantified.Combined individual-analysis of two population-based case-control studies of SIDS infants and controls comparable for age and time of last sleep.Parents of 400 SIDS infants and 1386 controls provided information from five English health regions between 1993-6 (population: 17.7 million and one of these regions between 2003-6 (population:4.9 million.Over a third of SIDS infants (36% were found co-sleeping with an adult at the time of death compared to 15% of control infants after the reference sleep (multivariate OR = 3.9 [95% CI: 2.7-5.6]. The multivariable risk associated with co-sleeping on a sofa (OR = 18.3 [95% CI: 7.1-47.4] or next to a parent who drank more than two units of alcohol (OR = 18.3 [95% CI: 7.7-43.5] was very high and significant for infants of all ages. The risk associated with co-sleeping next to someone who smoked was significant for infants under 3 months old (OR = 8.9 [95% CI: 5.3-15.1] but not for older infants (OR = 1.4 [95% CI: 0.7-2.8]. The multivariable risk associated with bed-sharing in the absence of these hazards was not significant overall (OR = 1.1 [95% CI: 0.6-2.0], for infants less than 3 months old (OR = 1.6 [95% CI: 0.96-2.7], and was in the direction of protection for older infants (OR = 0.1 [95% CI: 0.01-0.5]. Dummy use was associated with a lower risk of SIDS only among co-sleepers and prone sleeping was a higher risk only among infants sleeping alone.These findings support a public health strategy that underlines specific hazardous co-sleeping environments parents should avoid. Sofa-sharing is not a safe alternative to bed-sharing and bed-sharing should be avoided if parents consume alcohol, smoke or take drugs or if the infant is pre-term.

  7. A Pirate too Needs to be Heard: Procedural Compromises in Online Copyright Infringement Cases in the UK

    Directory of Open Access Journals (Sweden)

    Poorna Mysoor

    2014-08-01

    Full Text Available Online copyright infringement is one of the toughest challenges the content industry has faced in the twenty first century. Article 8(3 of the Information Society Directive, implemented under section 97A of the UK Copyright, Designs and Patents Act, 1988, provides an injunctive remedy in response to such online infringement. Given the elusive nature of the website operators and the sheer number of their users, rights owners have turned to the Internet Service Providers (ISPs to implement the injunctions granted under section 97A to block websites with infringing content. In their battle to keep pace with online infringers, the UK courts have permitted significant compromises to the procedures while granting these injunctive blocking orders. One of the pioneers in this line of cases in the UK is the Pirate Bay case (TPB case, which ruled as a matter of law that the procedure under Section 97A does not require the alleged infringers to be made parties to those proceedings. TPB case also marks the trend of the ISPs consenting to an order of injunction, and not defending the proceedings. This has resulted in the absence of any adverse party in the proceedings under section 97A. This threatens the basic tenets of procedural fairness and propriety, having adverse consequences on both the substantive and procedural aspects, evident in the cases that followed TPB case. This article examines the aspects of the judgment in TPB case that led to these procedural compromises, whether it had any basis in the pre-existing case law, what the nature of an injunction under section 97A is and how the subsequent line of cases have followed TPB case as a precedent. It further explores the adverse consequences of the procedural compromises and whether any safeguards are available against such compromises.

  8. Marketing of new Technologies: The case of Renewable Energies in the UK

    DEFF Research Database (Denmark)

    Brem, Alexander; Muehlmann, F.; Sarmiento, T.

    2011-01-01

    The market in the UK for renewable energy is arguably at a very critical phase in its development. Key drivers for current policy include energy security, climate change and energy prices, added to which the UK has agreed specific targets with other EU countries to help meet these challenges....... The paper includes a general overview of worldwide energy demand and a comprehensive overview of renewable energy alternatives. Based on that, it describes the development of the UK renewables marketplace with a market overview including a summary of selected key organisations currently operating. Finally......, this paper recapitulates the key findings of our quantitative research, based on a survey of 65 organisations operating in the market, into the state of the UK market, including a view on the trends and outlook for the future. Finally, the paper offers some concluding remarks which state, among others...

  9. Investigation of nurses' intention to leave: a study of a sample of UK nurses.

    Science.gov (United States)

    Robson, Andrew; Robson, Fiona

    2016-01-01

    The purpose of this paper is to provide an evaluation of the key antecedents of leave intention demonstrated by nurses employed in UK National Health Service (NHS). Survey assessment of a sample of 433 nurses employed within the NHS was undertaken, potential relationships relating to both affective commitment and leave intention and work-place experiences assessed through leader-member exchange (LMX) and perceived organisational support (POS) have been evaluated quantitatively, using confirmatory factor analysis (CFA) and structural equations modelling (SEM). The study indicates that both LMX and POS act as direct antecedents to nurses' leave intention. Additionally, both LMX and POS in combination, significantly effect employees' affective commitment, the latter further impacting on employee leave intention. This would suggest that both LMX and POS have a significant role to play in employee leave intention that is partially mediated by affective commitment, further analysis confirming this to be the case. Research limitations/implications - The sample of nurses is large in absolute terms, permitting the CFA/SEM analysis undertaken, although the data represented only two NHS trusts, hence generalisation across the NHS should be done so cautiously. Various other drivers of leave intention, personal and organisational, have not been assessed here. The implications of these results are that to safeguard nurse retention, appropriate line manager engagement is crucial, but this requires organisational support that is recognised by the employees, especially to enhance their levels of affective commitment. This is given by providing NHS-based assessment of the role of both POS and LMX in the realisation of both affective commitment and desire to remain with their current organisations amongst members of the UK nursing profession.

  10. DOES BRAND EXTENSION IMPACT PARENT BRAND: A CASE OF JOHNSON, UK

    Directory of Open Access Journals (Sweden)

    Muhammad Shakil AHMAD

    2011-01-01

    Full Text Available Purpose of study: The main purpose of this study is to check the impact ofbrand extensions on brand image. For this purpose Johnson is selected asparent brand for current research. The targeted brand extensions areJohnson shampoo, Johnson’s isotonic drinks, Johnson’s sports wear andJohnson’s suntan lotion. Research Methodology: sample was selected fromBradford, UK. Sample consists of graduate students including males as wellas female. Total sample size is 60 and data was collected through selfadministered questionnaires. For each brand 15 respondents were selected.Convenient sampling was selected as sampling technique. Results: Resultsshow that Johnson’s have high brand awareness and perceived quality.While there is negative correlation results for brand fit on brand image forthose product extensions which are not in same brand category i.e.Johnson’s sportswear and Johnson’s isotonic drinks. Conclusion: It isconcluded from study results that launching new product in same parentbrand category have high chance of success while in different category isrisk.

  11. Overseas trained nurses' perception of UK nurses' caring attitudes: a qualitative study.

    Science.gov (United States)

    Alexis, Obrey

    2009-08-01

    The aim of this study was to explore overseas nurses' perception of their nursing colleagues' caring attitudes in the National Health Service (NHS) in the UK. A qualitative phenomenological approach using semi-structured interviews was used to obtain data from 12 overseas nurses. The interview transcripts were transcribed verbatim and analysed using van Manen thematic approach. Although many themes emerged following thematic analysis, this study will report the findings of three themes such as empathy, understanding and caring perspectives, emotional impact and lack of teamwork. In conclusion, this study provides an insight and it increases our understanding of overseas nurses' perceptions of their nursing colleagues' caring attitudes in the NHS in the UK. This paper concludes by indicating that teamwork, being empathetic, understanding and reducing emotional labour for overseas nurses could lead to a more satisfied working environment for overseas nurses in the NHS in the UK.

  12. Do Ends Justify Means? Feminist Economics Perspectives on the Business Case for Gender Equality in the UK Labour Market

    OpenAIRE

    Thomson, Emily

    2013-01-01

    This paper intends to explore a feminist economics perspective on business case arguments for gender equality in the UK labour market, where there are significant inequalities between men and women. Policy discourse on gender equality has moved from one which emphasises ‘equal opportunities’ and notions of fairness and equal treatment to one which focuses on increasing economic efficiency in the wider economy and viewing female employees as a competitive advantage for individual firms. Develo...

  13. The UK Paediatric Ocular Trauma Study 2 (POTS2): demographics and mechanisms of injuries.

    Science.gov (United States)

    Sii, Freda; Barry, Robert J; Abbott, Joseph; Blanch, Richard J; MacEwen, Caroline J; Shah, Peter

    2018-01-01

    Pediatric ocular trauma is an important cause of visual morbidity worldwide, accounting for up to one-third of all ocular trauma admissions. It has long-term implications for those affected and significant economic consequences for healthcare providers. It has been estimated that 90% of all ocular trauma is preventable. Targeted strategies are required to reduce the incidence and the severity of pediatric ocular trauma; this requires an understanding of the epidemiology and characteristics of these injuries and the children involved. Prospective, observational study of pediatric ocular trauma cases presenting to UK-based ophthalmologists over a 1-year period; reporting cards were distributed by the British Ophthalmological Surveillance Unit, and clinicians were asked to report incidents of acute orbital and ocular trauma in children aged ≤16 years requiring inpatient or day-case admission. A validated, standardized questionnaire was sent to reporting ophthalmologists to collect data on the demographics and circumstances of injury. Median age at presentation was 7.7 years, with boys more than twice as likely to be affected than girls (M:F =2.1:1.0). Almost 50% of injuries occurred at home, with 25% occurring in school or nursery. A total of 67% of injuries occurred during play, and 31% involved a sharp implement. Pediatric ocular trauma remains an important public health problem. At least three-quarters of all injuries are preventable through measures, including education of children and responsible adults, restricting access to sharp implements, improving adult supervision, and appropriate use of eye protection.

  14. Reduction in tuberculosis incidence in the UK from 2011 to 2015: a population-based study.

    Science.gov (United States)

    Thomas, H Lucy; Harris, Ross J; Muzyamba, Morris C; Davidson, Jennifer A; Lalor, Maeve K; Campbell, Colin N J; Anderson, Sarah R; Zenner, Dominik

    2018-04-19

    Following nearly two decades of increasing tuberculosis in the UK, TB incidence decreased by 32% from 2011 to 2015. Explaining this reduction is crucial to informing ongoing TB control efforts. We stratified TB cases notified in the UK and TB cases averted in the UK through pre-entry screening (PES) between 2011 and 2015 by country of birth and time since arrival. We used population estimates and migration data to establish denominators, and calculated incidence rate ratios (IRRs) between 2011 and 2015. We calculated the contribution of changing migrant population sizes, PES and changes in TB rates to the reduction in TB notifications. TB IRRs fell in all non-EU migrant and UK-born populations between 2011 and 2015 (0.61; 95%  CI 0.59 to 0.64 and 0.78; 0.73 to 0.83 respectively), with the greatest decrease in recent non-EU migrants (0.54; 0.48 to 0.61). 61.9% of the reduction in TB notifications was attributable to decreases in TB rates, 33.4% to a fall in the number of recent/mid-term non-EU migrants and 11.4% to PES. A small increase in notifications in EU-born migrants offset the reduction by 6.6%. Large decreases in TB rates in almost all populations accounted for the majority of the reduction in TB notifications, providing evidence of the impact of recent interventions to improve UK TB control. The particularly large decrease in TB rates in recent non-EU migrants provides evidence of the effectiveness of screening interventions that target this population. These findings will inform ongoing improvements to TB control. © 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.

  15. The Use of Case Studies in OR Teaching

    Science.gov (United States)

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

    2016-01-01

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

  16. Uptake of novel statistical methods for early-phase clinical studies in the UK public sector.

    Science.gov (United States)

    Jaki, Thomas

    2013-04-01

    In recent years, the success rate of confirmatory studies has been poor resulting in more emphasis on the conduct of exploratory studies. As one possibility to improve decision-making during the early stages of development, adaptive and Bayesian methods have been recommended. To investigate the current practice in designing early-phase studies in UK public sector research institutions and the use of adaptive and Bayesian methods in particular and to determine factors that hinder the penetration of methodological advances into practice. A questionnaire was sent to all UK clinical trials units (CTUs) to gauge their involvement in early-phase studies and to learn about the designs used in these studies. Follow-up visits to units conducting early-phase studies with round-table discussions around the methods used and the obstacles faced when using adaptive methods were undertaken. More than half of the CTUs are involved in early-phase studies, but conservatism in the methods used in these studies is present. Reasons for novel methodology not being used include a lack of expertise, incompatible funding and unit structure, and a lack of software. Information is collected from UK CTUs, which undertake a large portion (but not all) publicly funded trials. The use of adaptive and Bayesian methods for early-phase clinical studies in the UK public sector is at present limited. Various different initiatives aim to support and facilitate the use of these methods, however, so that an increased use of these methods can be anticipated in the future.

  17. Challenges of University Adjustment in the UK: A Study of East Asian Master's Degree Students

    Science.gov (United States)

    Wu, Wenli; Hammond, Michael

    2011-01-01

    This paper reports on the adjustment of East Asian Master's level students who came to study at a campus-based university in the UK during 2004-05. International students face challenges in respect to language proficiency, academic expectations and social participation. In this longitudinal study the experiences of a group of students from East…

  18. 451 Case studies Cardiac

    African Journals Online (AJOL)

    Marinda

    Case Studies. 29 ... A case of a 26-year-old ASA I physical status male undergoing septoplasty had an abrupt ... myocardial infarction, severe hypertensive crisis, cerebral .... or no formal management is required in an ASA I patient.8 One.

  19. E-cigarettes, a safer alternative for teenagers? A UK focus group study of teenagers' views

    OpenAIRE

    Hilton, Shona; Weishaar, Heide; Sweeting, Helen; Trevisan, Filippo; Katikireddi, Srinivasa Vital

    2016-01-01

    Objective: Concerns exist that e-cigarettes may be a gateway to traditional cigarettes and/or (re)normalise teenage smoking. This qualitative study explores how teenagers in the UK currently perceive e-cigarettes and how and why they do or do not use them.\\ud \\ud Design: 16 focus groups were conducted across the UK between November 2014 and February 2015, with 83 teenagers aged 14–17. All discussions were digitally recorded, transcribed verbatim, imported into NVivo 10 and thematically analys...

  20. A study of radon levels in NHS premises in affected areas around the UK

    International Nuclear Information System (INIS)

    Denman, A.R.; Lewis, G.T.R.; Brennen, S.E.

    2002-01-01

    Radon gas contributes a significant fraction of the natural background radiation dose, and in some areas raised levels are found in buildings, both homes and the workplace. Different UK Action Levels apply to homes and the workplace, because of the diurnal variation of radon. This study reviews the results for a number of hospitals throughout England and Wales, and suggests that the likelihood of finding raised radon levels is similar in the workplace and homes in the same area. Radon measurements and consequent remediation of any raised levels are appropriate in all workplaces in radon Affected Areas with over 5% of houses above the UK domestic Action Level of 200 Bq m -3

  1. Inherited Family Firms and Management Practices: The Case for Modernising the UK's Inheritance Tax

    OpenAIRE

    [multiple or corporate authorship].

    2006-01-01

    What role does hereditary family management play in the long-standing poor managerial performance of UK firms? We address this question using a new survey of the management practices of over 730 medium-sized manufacturing firms in France, Germany, the UK and the United States undertaken jointly by the Centre for Economic Performance and McKinsey & Company. • Analysis of the data reveals that firms that are family-owned but not managed by family members are typically well managed. An example i...

  2. Experiencing transformation: the case of Jordanian nurse immigrating to the UK.

    Science.gov (United States)

    Al-Hamdan, Zaid M; Al-Nawafleh, Ahmad H; Bawadi, Hala A; James, Veronica; Matiti, Milika; Hagerty, Bonnie M

    2015-08-01

    This study explored how Jordanian nurses experienced the transition from home to host country to illuminate the elements of transformation. Much research has been conducted on topics such as the current international nursing shortage and the recruitment of nurses from various countries. International nurses have unique needs with regard to adapting to new host cultures and workplaces; furthermore, the literature has revealed little evidence of nurses' professional and personal experiences related to migration. A qualitative study was conducted, collecting data via individual interviews. Twenty-five face-to-face and telephone interviews with Jordanian migrant nurses. This study showed that living and working in a host country changes the personal, social and professional attributes of migrant nurses. When nurses migrate, they encounter opportunities and significant challenges in their professional and personal lives. Although Jordanian nurses contributed their knowledge and skills to the UK healthcare system, they encountered enormous professional adaptation demands. Work setting discrepancies between source and host country are likely a major element behind the required nursing profession alteration. nurses' lives are transformed in terms of their personal and social networks in the host country. Social transformation is an integral and inseparable part of engagement with professional organisation(s) in the host community. Professional integration likely has far-reaching effects and consequences involving not only the individual but also their home and host country families and their professional networks. To provide high-quality nursing care, we must learn about the transformation experience, expand our sense of who we are and gain a degree of control over how we perform our nursing roles when we move away from our home. © 2015 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Grant, Aimee

    2016-02-01

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

  4. Use of mineral magnetic concentration data as a particle size proxy: a case study using marine, estuarine and fluvial sediments in the Carmarthen Bay area, South Wales, U.K.

    Science.gov (United States)

    Booth, C A; Walden, J; Neal, A; Smith, J P

    2005-07-15

    Compositional (non-magnetic) data can correlate strongly with particle size, which deems it appropriate as a particle size proxy and, therefore, a reliable means of normalising analytical data for particle size effects. Previous studies suggest magnetic concentration parameters represent an alternative means of normalising for these effects and, given the speed, low-cost and sensitivity of the measurements may, therefore, offer some advantages over other compositional signals. In this work, contemporary sediments from a range of depositional environments have been analysed with regard to their mineral magnetic concentration and textural characteristics, to observe if the strength and nature of the relationship identified in previous studies is universal. Our data shows magnetic parameters (chi(LF), chi(ARM) and SIRM) possess contrasting relationships with standard textural parameters for sediment samples collected from marine (Carmarthen Bay), estuarine (Gwendraeth Estuary) and fluvial (Rivers Gwendraeth Fach and Gwendraeth Fawr) settings. Magnetic concentrations of sediments from both the marine and estuarine environments are highly influenced by the magnetic contribution of finer particle sizes; Gwendraeth Fawr River sediments are influenced by the magnetic contribution of coarser particle sizes, while sediments from the Gwendraeth Fach River are not influenced significantly by any variations in textural properties. These results indicate mineral magnetic measurements have considerable potential as a particle size proxy for particular sedimentary environments, which in certain instances could be useful for geochemical, sediment transport, and sediment provenance studies. However, the data also highlight the importance of fully determining the nature of the relationship between sediment particle size and magnetic properties before applying mineral magnetic data as a particle size proxy.

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

    Science.gov (United States)

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

    2018-04-01

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

  6. Occupational Stress in UK Higher Education Institutions: A Comparative Study of All Staff Categories

    Science.gov (United States)

    Tytherleigh, M. Y.; Webb, C.; Cooper, C. L.; Ricketts, C.

    2005-01-01

    The higher education sector in the UK continues to experience significant change. This includes restructuring, use of short-term contracts, external scrutiny and accountability, and major reductions in funding. In line with this, reports of stress at work in higher education institutions have also increased. The study reported here was carried out…

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

    Science.gov (United States)

    Morrice, Linda

    2009-01-01

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

  8. Price Wars in Two-Sided Markets : The Case of the UK Quality Newspapers

    NARCIS (Netherlands)

    Behringer, S.; Filistrucchi, L.

    2009-01-01

    This paper investigates the price war in the UK quality newspaper industry in the 1990s. We build a model of the newspaper market which encompasses demand for differentiated products on both, the readers and advertisers side of the market, and profi…t maximization by four competing oligopolistic

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

    Science.gov (United States)

    Jewson, Nick; Felstead, Alan; Green, Francis

    2015-01-01

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

  10. Scientists' coping strategies in an evolving research system: the case of life scientists in the UK

    NARCIS (Netherlands)

    Morris, Norma; Rip, Arie

    2006-01-01

    Scientists in academia have struggled to adjust to a policy climate of uncertain funding and loss of freedom from direction and control. How UK life scientists have negotiated this challenge, and with what consequences for their research and the research system, is the empirical entrance point of

  11. The case for the UK nuclear power industry and the implications of its closure

    International Nuclear Information System (INIS)

    Locke, D.H.; Caley, J.R.

    1987-04-01

    The Chernobyl accident has produced calls for a moratorium on further nuclear power development and construction in the UK or, in the extreme, a phasing out of existing nuclear power stations. Some suggestions as to how to counteract these demands have been collected using published information wherever possible. (author)

  12. Stakeholder Choices in Adaptation and Public Finance Planning for Coastal Hazard Mitigation in a Changing World: Highlights from Case Studies in Santos, Brazil, Broward County, FL, US and Selsey, UK (The METROPOLE Project)

    Science.gov (United States)

    Muller-Karger, F. E.; Merrill, S.; Pelling, M.; Marengo, J. A.; Reynolds, C. J.; Langbehn, K.; Paterson, S.; Nunes, L. H.; Kartez, J.; Lockman, J. T.

    2016-12-01

    Better integration of the human dimensions (values, beliefs, cultural identity, place, risk perceptions, communications, decision making) with scientific, technical, and economic data is required to advance effective municipal planning for adaptation to changes that can be expected to occur based on a changing climate. The international METROPOLE project offers practical insights and a path forward for coastal communities around the world with results from applied research carried out by social scientists, natural scientists, and practitioners working in coastal municipalities in Brazil, the United Kingdom, and the United States. Decision makers were interviewed to assess the Adaptive Capacity of their communities, and stakeholders were engaged in workshops to discuss the risks due to projected sea level rise (SLR) in terms of impacts and costs to property. The team investigated the social, cultural, and governance factors that shape decision making. Municipal leaders and local experts selected the SLR scenarios and adaptation options to be modelled using COAST, a state-of-the-art tool. The visualizations and risk maps integrated scientific and local economic data, and illustrated the potential impacts on 10,000 properties in each study area. Stakeholders voted on parameters to determine the cost-benefit ratio of potential adaptation options. Stakeholder priorities for local adaption planning, agreement with the need for increased fees/taxes, and acceptability of possible public finance mechanisms were evaluated with pre- and post-workshop surveys. The research identified similar patterns of adaptation "priorities" and new insight into how stakeholders consider public finance mechanisms for local action, in the context of "fiscal benefits and burdens." The research suggests implications for small towns, land-use policy changes, implementing adaptation options which deliver short and long-term benefits, and, for state and local governments to develop finance policy

  13. Impact of omalizumab on treatment of severe allergic asthma in UK clinical practice: a UK multicentre observational study (the APEX II study).

    Science.gov (United States)

    Niven, Robert M; Saralaya, Dinesh; Chaudhuri, Rekha; Masoli, Matthew; Clifton, Ian; Mansur, Adel H; Hacking, Victoria; McLain-Smith, Susan; Menzies-Gow, Andrew

    2016-08-09

    To describe the impact of omalizumab on asthma management in patients treated as part of normal clinical practice in the UK National Health Service (NHS). A non-interventional, mixed methodology study, combining retrospective and prospective data collection for 12 months pre-omalizumab and post-omalizumab initiation, respectively. Data were collected in 22 UK NHS centres, including specialist centres and district general hospitals in the UK. 258 adult patients (aged ≥16 years; 65% women) with severe persistent allergic asthma treated with omalizumab were recruited, of whom 218 (84.5%) completed the study. The primary outcome measure was change in mean daily dose of oral corticosteroids (OCS) between the 12-month pre-omalizumab and post-omalizumab initiation periods. A priori secondary outcome measures included response to treatment, changes in OCS dosing, asthma exacerbations, lung function, employment/education, patient-reported outcomes and hospital resource utilisation. The response rate to omalizumab at 16 weeks was 82.4%. Comparing pre-omalizumab and post-omalizumab periods, the mean (95% CIs) daily dose of OCS decreased by 1.61 (-2.41 to -0.80) mg/patient/day (pomalizumab period. The mean number of A&E visits, inpatient hospitalisations, outpatient visits (excluding for omalizumab) and number of bed days/patient decreased significantly (pomalizumab period. These data support the beneficial effects of omalizumab on asthma-related outcomes, quality of life and resource utilisation in unselected patients treated in 'real-world' clinical practice. 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/

  14. Dementia ascertainment using existing data in UK longitudinal and cohort studies: a systematic review of methodology.

    Science.gov (United States)

    Sibbett, Ruth A; Russ, Tom C; Deary, Ian J; Starr, John M

    2017-07-03

    Studies investigating the risk factors for or causation of dementia must consider subjects prior to disease onset. To overcome the limitations of prospective studies and self-reported recall of information, the use of existing data is key. This review provides a narrative account of dementia ascertainment methods using sources of existing data. The literature search was performed using: MEDLINE, EMBASE, PsychInfo and Web of Science. Included articles reported a UK-based study of dementia in which cases were ascertained using existing data. Existing data included that which was routinely collected and that which was collected for previous research. After removing duplicates, abstracts were screened and the remaining articles were included for full-text review. A quality tool was used to evaluate the description of the ascertainment methodology. Of the 3545 abstracts screened, 360 articles were selected for full-text review. 47 articles were included for final consideration. Data sources for ascertainment included: death records, national datasets, research databases and hospital records among others. 36 articles used existing data alone for ascertainment, of which 27 used only a single data source. The most frequently used source was a research database. Quality scores ranged from 7/16 to 16/16. Quality scores were better for articles with dementia ascertainment as an outcome. Some papers performed validation studies of dementia ascertainment and most indicated that observed rates of dementia were lower than expected. We identified a lack of consistency in dementia ascertainment methodology using existing data. With no data source identified as a "gold-standard", we suggest the use of multiple sources. Where possible, studies should access records with evidence to confirm the diagnosis. Studies should also calculate the dementia ascertainment rate for the population being studied to enable a comparison with an expected rate.

  15. [Case and studies].

    Science.gov (United States)

    Schubert, András

    2015-11-15

    Case studies and case reports form an important and ever growing part of scientific and scholarly literature. The paper deals with the share and citation rate of these publication types on different fields of research. In general, evidence seems to support the opinion that an excessive number of such publications may negatively influence the impact factor of the journal. In the literature of scientometrics, case studies (at least the presence of the term "case study" in the titles of the papers) have a moderate share, but their citation rate is practically equal to that of other publication types.

  16. The (mis)management of migrant nurses in the UK: a sociological study.

    Science.gov (United States)

    Adhikari, Radha; Melia, Kath M

    2015-04-01

    To examine Nepali migrant nurses' professional life in the UK. In the late 1990 s the UK experienced an acute nursing shortage. Within a decade over 1000 Nepali nurses migrated to the UK. A multi-sited ethnographic approach was chosen for this study. Between 2006 and 2009, 21 in-depth interviews with Nepali nurses were conducted in the UK using snowballing sampling. Nepali migrant nurses are highly qualified and experienced in specialised areas such as critical care, management and education. However, these nurses end up working in the long-term care sector, providing personal care for elderly people - an area commonly described by migrant nurses as British Bottom Care (BBC). This means that migrant nurses lack career choices and professional development opportunities, causing them frustration and lack of job satisfaction. International nurse migration is an inevitable part of globalisation in health. Nurse managers and policy makers need to explore ways to make better use of the talents of the migrant workforce. We offer a management strategy to bring policies for the migrant workforce into line with the wider workforce plans by supporting nurses in finding jobs relevant to their expertise and providing career pathways. © 2013 John Wiley & Sons Ltd.

  17. Strategic energy planning within local authorities in the UK: A study of the city of Leeds

    International Nuclear Information System (INIS)

    Bale, Catherine S.E.; Foxon, Timothy J.; Hannon, Matthew J.; Gale, William F.

    2012-01-01

    This paper considers the development of a strategic energy body in a local authority in the UK and looks at the perceived need for, and possible roles of, such a body. Historically, energy provision and management has not usually been a strategic priority for UK local authorities. Yet energy considerations are implicit in key local authority responsibilities such as transport, waste management, planning, and the provision of housing services. In addition, recent UK central government policies support the move to localism and provide incentives for low-carbon energy generation. A study was undertaken to assess the potential (including both the perceived benefits and actual capacity to deliver) for Leeds City Council to develop a strategic body to execute delivery of city-level energy decision-making. We examine the perceived benefits to a range of main stakeholders, using data drawn from interviews with managers responsible for low-carbon and renewable energy projects across the city. Through participant observation we explore the capacity of a local authority to deliver a strategic energy body, and we briefly examine the possible forms of delivery. We conclude with recommendations for national policy that would enable the development of strategic energy bodies across local governments in the UK. - Highlights: ► Strategic energy planning is currently not a priority for UK local authorities. ► We present an empirical study of strategic energy planning in local authorities. ► Results from stakeholder interviews suggest support for a strategic energy body. ► We identify the capacity barriers to implementing a strategic energy body. ► We make recommendations for ways forward and support needed from national policy.

  18. Everyday life in a UK retirement village: a mixed-methods study

    OpenAIRE

    Liddle, Jennifer

    2016-01-01

    This study focuses on the experiences of older people living in a UK purpose-built retirement community – Denham Garden Village (DGV). The aim was to understand more about everyday life in this particular environmental context including how the environment and organisation of the village related to residents’ everyday experiences. Using a mixed methods approach, the study draws on quantitative survey data from the Longitudinal study of Ageing in a Retirement Community (LARC) and combines this...

  19. UK victims of trafficking

    Directory of Open Access Journals (Sweden)

    Bob Burgoyne

    2006-05-01

    Full Text Available Analysis of court cases shows how hard it is forvictims of trafficking to win the right to remain in the UK. Case law is inconsistent and more research and data collection are urgently needed.

  20. Trends in 30-day mortality rate and case mix for paediatric cardiac surgery in the UK between 2000 and 2010.

    Science.gov (United States)

    Brown, Katherine L; Crowe, Sonya; Franklin, Rodney; McLean, Andrew; Cunningham, David; Barron, David; Tsang, Victor; Pagel, Christina; Utley, Martin

    2015-01-01

    To explore changes over time in the 30-day mortality rate for paediatric cardiac surgery and to understand the role of attendant changes in the case mix. Included were: all mandatory submissions to the National Institute of Cardiovascular Outcomes Research (NICOR) relating to UK cardiac surgery in patients aged case mix indicators, in 10 consecutive time periods, from 2000 to 2010. Comparisons were made between two 5-year eras of: 30-day mortality, period prevalence and mean age for 30 groups of specific operations. 30-day mortality for an episode of surgical management. Our analysis includes 36 641 surgical episodes with an increase from 2283 episodes in 2000 to 3939 in 2009 (pcase mix became more complex in terms of the percentage of patients case mix complexity, and compares well with international benchmarks. Definitive repair is now more likely at a younger age for selected infants with congenital heart defects.

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

    Science.gov (United States)

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

    2014-01-01

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

  2. A Case Analysis on the Adequacy of Work-Life Balance Practices in UK Small- and Medium-Sized Enterprises

    Directory of Open Access Journals (Sweden)

    Babatunde Akanji

    2017-09-01

    Full Text Available Objective: The purpose of this study is to examine whether work-life balance (WLB practices are satisfactorily provided in UK small and medium-sized enterprises (SMEs and the impact of the availability of these work-life policies on turnover intentions. A review of extant literature reveals scarce knowledge in this area of research and this study presents a rudimentary effort to fill this gap. Research Design & Methods: Using qualitative design, the data set comprised of in-depth interviews with thirty-six employees working in small and medium-sized UK convenience stores and supermarkets with less than ninety employees. Findings: Informal nature of human resource management policies emerged from the findings as one of the constraining forces impeding work-life agendas in SMEs and causing low staff retention in UK. Although other themes were found to contribute to retention challenges, however, these additional reasons were not independent, but all considered integrated. Implications & Recommendations: Consequently, the practical implication of devising ways to overcome WLB and retention deficiencies in this context were also explored. Contribution & Value Added: The originality of this work lies in studying the importance of WLB practices to some of these grass root businesses that make up a large proportion of the economy in the UK. As the limitation of this study is that it is wholly qualitative in nature, it is suggested that future research should rely on quantitative designs that provides more internally valid tests via computational techniques.

  3. The Mediterranean diet and risk of colorectal cancer in the UK Women's Cohort Study.

    Science.gov (United States)

    Jones, Petra; Cade, Janet E; Evans, Charlotte E L; Hancock, Neil; Greenwood, Darren C

    2017-12-01

    Evidence from epidemiological studies investigating associations between adherence to the Mediterranean diet and colorectal cancer is inconsistent. The aim of this study is to assess in the UK Women's Cohort Study whether adherence to the Mediterranean dietary pattern is associated with reduced incidence of cancers of the colon and rectum. A total of 35 372 women were followed for a median of 17.4 years. A 10-component score indicating adherence to the Mediterranean diet was generated for each cohort participant, using a 217-item food frequency questionnaire. The Mediterranean diet score ranged from 0 for minimal adherence to 10 for maximal adherence. Cox proportional hazards regression was used to provide adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for colon and rectal cancer risk. A total of 465 incident colorectal cancer cases were documented. In the multivariable adjusted model, the test for trend was positive (HR = 0.88, 95% CI: 0.78 to 0.99; Ptrend = 0.03) for a 2-point increment in the Mediterranean diet score. For rectal cancer, a 2-point increment in the Mediterranean diet score resulted in an HR (95% CI) of 0.69 (0.56 to 0.86), whereas a 62% linear reduced risk (HR 0.38; 95% CI: 0.20 to 0.74; Ptrend Mediterranean dietary pattern may have a lower risk of colorectal cancer, especially rectal cancer. © The Author 2017; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association

  4. An Economic Analysis of the UK Pet Dog Market and Animal Welfare: The case of the UK pet dog overpopulation problem

    OpenAIRE

    Siettou, Christina

    2015-01-01

    Pets are an important part of our society as they have become ‘part of the family’. However, one of the most important problems regarding the pet dog population is the great number of strays and their management. The annual stray survey conducted on behalf of Dogs Trust, one of the leading dog welfare organizations in the UK, has revealed that each year there are more than 100,000 stray dogs in the UK. To date, their management remains a problem only addressed by Local Authorities. \\ud \\ud Th...

  5. Septic Systems Case Studies

    Science.gov (United States)

    A collection of septic systems case studies to help community planners, elected officials, health department staff, state officials, and interested citizens explore alternatives for managing their decentralized wastewater treatment systems.

  6. HYDROGEOLOGIC CASE STUDIES

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  7. A Psychobiographical Case Study

    African Journals Online (AJOL)

    man, and cancer fighter. This psychobiographical case study entailed a psychosocial-historical ... does not draw more attention as a research method, as this approach has .... of the applied Levinsonian theory to the life of Jobs against the ...

  8. The Determinants of Corporate Cash Holdings- An Empirical study from UK Firms

    OpenAIRE

    GUO, YI

    2013-01-01

    Cash holding is most important financial decision in the company management strategy. In this dissertation, the determinants of corporate cash holdings in UK non-financial publicly traded firms over the period from 2003 to 2012 are investigated. Our study finds that growth opportunities and cash flow and cash flow variability are positively associated with the level of corporate cash holdings, while firm size, leverage, net working capital, bank debt and dividend payment have negative impact ...

  9. A Comparative Study of Primary School Teachers’ Views about Dyslexia in the UK and Greece

    OpenAIRE

    Kostopoulou, Rodopi

    2013-01-01

    The present study is a comparative research on primary teachers’ understanding of dyslexia in the UK and Greece. More specifically, aim of the research was to investigate primary teachers’ knowledge about dyslexia, their attitudes towards students with dyslexia, the procedures they follow for the identification of dyslexic students and the way teachers respond to their learning and emotional needs, in both countries. The sample consisted of six primary teachers (three English and three Greek)...

  10. How UK internet websites portray breast milk expression and breast pumps: a qualitative study of content

    OpenAIRE

    McInnes, Rhona J; Arbuckle, Alix; Hoddinott, Pat

    2015-01-01

    Background Exclusive breastfeeding for six months is recommended but few parents achieve this; particularly younger and less well-educated mothers. Many parents introduce infant formula milk to manage feeding but describe a desire to express breastmilk alongside a lack of support or information. The Internet is highlighted as a key resource. This study aimed to examine UK websites on expressing breastmilk to identify key messages and how information is provided. Methods We used search terms i...

  11. Market Potential Analysis of Finland and the UK; Business case – “Sidebar business proposition”, Case Company: Orion Automotive

    OpenAIRE

    Ivanova, Kristina

    2015-01-01

    The purpose of the study was to explore a new market area for the case company Orion Automotive, which is primarily operating in the Netherlands, and to find out suitable ways of reaching more potential customers there. Both, theoretical and empirical parts were included in this thesis. First includes analysis of macro-environmental factors – PEST and SWOT and also vital concepts related to the study. For the empirical part, desk research and previous research for Orion Company were used for ...

  12. Qualitative Case Study Guidelines

    Science.gov (United States)

    2013-11-01

    Introduction to Sociological Methods. 2nd ed. New York, McGraw-Hill 14. Denzin , N. K. and Lincoln , Y. S. (2011) The SAGE Handbook of Qualitative...The Art of Science. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage 19. GAO (1990) Case Study...Rinehart & Winston 39. Stake, R. E. (1994) Case Studies. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage

  13. Seismic risk control of nuclear power plants using seismic protection systems in stable continental regions: The UK case

    Energy Technology Data Exchange (ETDEWEB)

    Medel-Vera, Carlos, E-mail: cbmedel@uc.cl; Ji, Tianjian, E-mail: tianjian.ji@manchester.ac.uk

    2016-10-15

    Highlights: • Strategies to reduce seismic risk for nuclear power stations in the UK are analysed. • Efficiency of devices to reduce risk: viscous-based higher than hysteretic-based. • Scenario-based incremental dynamic analysis is introduced for use in nuclear stations. • Surfaces of seismic unacceptable performance for nuclear stations are proposed. - Abstract: This article analyses three different strategies on the use of seismic protection systems (SPS) for nuclear power plants (NPPs) in the UK. Such strategies are based on the experience reported elsewhere of seismically protected nuclear reactor buildings in other stable continental regions. Analyses are conducted using an example of application based on a 1000 MW Pressurised Water Reactor building located in a representative UK nuclear site. The efficiency of the SPS is probabilistically assessed to achieve possible risk reduction for both rock and soil sites in comparison with conventionally constructed NPPs. Further analyses are conducted to study how the reduction of risk changes when all controlling scenarios of the site are included. This is done by introducing a scenario-based incremental dynamic analysis aimed at the generation of surfaces for unacceptable performance of NPPs as a function of earthquake magnitude (M{sub w}) and distance-to-site (R{sub epi}). General guidelines are proposed to potentially use SPS in future NPPs in the UK. Such recommendations can be used by the British nuclear industry in the future development of 12 new reactors to be built in the next two decades to generate 16 GWe of new nuclear capacity.

  14. A levels and intelligence as predictors of medical careers in UK doctors: 20 year prospective study

    Science.gov (United States)

    McManus, I C; Smithers, Eleni; Partridge, Philippa; Keeling, A; Fleming, Peter R

    2003-01-01

    Objective To assess whether A level grades (achievement) and intelligence (ability) predict doctors' careers. Design Prospective cohort study with follow up after 20 years by postal questionnaire. Setting A UK medical school in London. Participants 511 doctors who had entered Westminster Medical School as clinical students between 1975 and 1982 were followed up in January 2002. Main outcome measures Time taken to reach different career grades in hospital or general practice, postgraduate qualifications obtained (membership/fellowships, diplomas, higher academic degrees), number of research publications, and measures of stress and burnout related to A level grades and intelligence (result of AH5 intelligence test) at entry to clinical school. General health questionnaire, Maslach burnout inventory, and questionnaire on satisfaction with career at follow up. Results 47 (9%) doctors were no longer on the Medical Register. They had lower A level grades than those who were still on the register (P < 0.001). A levels also predicted performance in undergraduate training, performance in postregistration house officer posts, and time to achieve membership qualifications (Cox regression, P < 0.001; b=0.376, SE=0.098, exp(b)=1.457). Intelligence did not independently predict dropping off the register, career outcome, or other measures. A levels did not predict diploma or higher academic qualifications, research publications, or stress or burnout. Diplomas, higher academic degrees, and research publications did, however, significantly correlate with personality measures. Conclusions Results of achievement tests, in this case A level grades, which are particularly used for selection of students in the United Kingdom, have long term predictive validity for undergraduate and postgraduate careers. In contrast, a test of ability or aptitude (AH5) was of little predictive validity for subsequent medical careers. PMID:12869457

  15. Improving thermal performance of an existing UK district heat network: a case for temperature optimization

    DEFF Research Database (Denmark)

    Tunzi, Michele; Boukhanouf, Rabah; Li, Hongwei

    2018-01-01

    This paper presents results of a research study into improving energy performance of small-scale district heat network through water supply and return temperature optimization technique. The case study involves establishing the baseline heat demand of the estate’s buildings, benchmarking...... the existing heat network operating parameters, and defining the optimum supply and return temperature. A stepwise temperature optimization technique of plate radiators heat emitters was applied to control the buildings indoor thermal comfort using night set back temperature strategy of 21/18 °C....... It was established that the heat network return temperature could be lowered from the current measured average of 55 °C to 35.6 °C, resulting in overall reduction of heat distribution losses and fuel consumption of 10% and 9% respectively. Hence, the study demonstrates the potential of operating existing heat...

  16. UK health performance: findings of the Global Burden of Disease Study 2010.

    Science.gov (United States)

    Murray, Christopher J L; Richards, Michael A; Newton, John N; Fenton, Kevin A; Anderson, H Ross; Atkinson, Charles; Bennett, Derrick; Bernabé, Eduardo; Blencowe, Hannah; Bourne, Rupert; Braithwaite, Tasanee; Brayne, Carol; Bruce, Nigel G; Brugha, Traolach S; Burney, Peter; Dherani, Mukesh; Dolk, Helen; Edmond, Karen; Ezzati, Majid; Flaxman, Abraham D; Fleming, Tom D; Freedman, Greg; Gunnell, David; Hay, Roderick J; Hutchings, Sally J; Ohno, Summer Lockett; Lozano, Rafael; Lyons, Ronan A; Marcenes, Wagner; Naghavi, Mohsen; Newton, Charles R; Pearce, Neil; Pope, Dan; Rushton, Lesley; Salomon, Joshua A; Shibuya, Kenji; Vos, Theo; Wang, Haidong; Williams, Hywel C; Woolf, Anthony D; Lopez, Alan D; Davis, Adrian

    2013-03-23

    The UK has had universal free health care and public health programmes for more than six decades. Several policy initiatives and structural reforms of the health system have been undertaken. Health expenditure has increased substantially since 1990, albeit from relatively low levels compared with other countries. We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) to examine the patterns of health loss in the UK, the leading preventable risks that explain some of these patterns, and how UK outcomes compare with a set of comparable countries in the European Union and elsewhere in 1990 and 2010. We used results of GBD 2010 for 1990 and 2010 for the UK and 18 other comparator nations (the original 15 members of the European Union, Australia, Canada, Norway, and the USA; henceforth EU15+). We present analyses of trends and relative performance for mortality, causes of death, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE). We present results for 259 diseases and injuries and for 67 risk factors or clusters of risk factors relevant to the UK. We assessed the UK's rank for age-standardised YLLs and DALYs for their leading causes compared with EU15+ in 1990 and 2010. We estimated 95% uncertainty intervals (UIs) for all measures. For both mortality and disability, overall health has improved substantially in absolute terms in the UK from 1990 to 2010. Life expectancy in the UK increased by 4·2 years (95% UI 4·2-4·3) from 1990 to 2010. However, the UK performed significantly worse than the EU15+ for age-standardised death rates, age-standardised YLL rates, and life expectancy in 1990, and its relative position had worsened by 2010. Although in most age groups, there have been reductions in age-specific mortality, for men aged 30-34 years, mortality rates have hardly changed (reduction of 3·7%, 95% UI 2·7-4·9). In terms of premature

  17. How is Telemedicine perceived? A qualitative study of perspectives from the UK and India

    Science.gov (United States)

    2011-01-01

    Background Improvements in communication and information technologies have allowed for the globalisation of health services, especially the provision of health services from other countries, such as the use of telemedicine. This has led countries to evaluate their position on whether and to what extent they should open their health systems to trade. This often takes place from the context of multi-lateral trade agreements (under the auspices of the World Trade Organisation), which is misplaced as a significant amount of trade takes place regionally or bi-laterally. We report here the results of a qualitative study assessing stakeholders' views on the potential for a bi-lateral trade relationship between India and the UK, where India acts as an exporter and the UK as an importer of telemedicine services. Methods 19 semi-structured interviews were carried out with stakeholders from India and the UK. The themes discussed include prospects on the viability of a bi-lateral relationship between the UK and India on telemedicine, current activities and operations, barriers, benefits and risks. Results The participants in general believed there were good prospects for telemedicine trade, and that this could bring benefits to "importing" countries in terms of cost-savings and faster delivery of care and to "exporting" countries in the form of foreign exchange and quality improvement. However, there were some concerns regarding quality of care, regulation, accreditation and data security. Conclusions There is potential for trade in this type of health services to succeed and bring about important benefits to the countries involved. However, issues around data security and accreditation need to be taken into consideration. Countries may wish to consider entering bi-lateral agreements, as they provide more potential to address the concerns and capitalise on the benefits. Finally, this paper concludes that more data should be collected, both on the volume of telemedicine trade

  18. Early career choices and successful career progression in surgery in the UK: prospective cohort studies

    Directory of Open Access Journals (Sweden)

    Richards Jennifer MJ

    2010-11-01

    Full Text Available Abstract Background Changes to the structure of medical training worldwide require doctors to decide on their career specialty at an increasingly early stage after graduation. We studied trends in career choices for surgery, and the eventual career destinations, of UK graduates who declared an early preference for surgery. Methods Postal questionnaires were sent, at regular time intervals after qualification, to all medical qualifiers from all UK medical schools in selected qualification years between 1974 and 2005. They were sent in the first year after qualification, at year three and five years after qualification, and at longer time intervals thereafter. Results Responses were received from 27 749 of 38 280 doctors (73% at year one, 23 468 of 33151 (71% at year three, and 17 689 of 24 870 (71% at year five. Early career preferences showed that surgery has become more popular over the past two decades. Looking forward from early career choice, 60% of respondents (64% of men, 48% of women with a first preference for a surgical specialty at year one eventually worked in surgery (p Conclusions Surgery is a popular specialty choice in the UK. The great majority of doctors who progressed in a surgical career made an early and definitive decision to do so.

  19. Non- medical prescribing in Australasia and the UK: the case of podiatry.

    Science.gov (United States)

    Borthwick, Alan M; Short, Anthony J; Nancarrow, Susan A; Boyce, Rosalie

    2010-01-05

    The last decade has witnessed a rapid transformation in the role boundaries of the allied health professions, enabled through the creation of new roles and the expansion of existing, traditional roles. A strategy of health care 'modernisation' has encompassed calls for the redrawing of professional boundaries and identities, linked with demands for greater workforce flexibility. Several tasks and roles previously within the exclusive domain of medicine have been delegated to, or assumed by, allied health professionals, as the workforce is reshaped to meet the challenges posed by changing demographic, social and political contexts. The prescribing of medicines by non-medically qualified healthcare professionals, and in particular the podiatry profession, reflects these changes. Using a range of key primary documentary sources derived from published material in the public domain and unpublished material in private possession, this paper traces the development of contemporary UK and Australasian podiatric prescribing, access, supply and administration of medicines. Documentary sources include material from legislative, health policy, regulatory and professional bodies (including both State and Federal sources in Australia). Tracing a chronological, comparative, socio-historical account of the emergence and development of 'prescribing' in podiatry in both Australasia and the UK enables an analysis of the impact of health policy reforms on the use of, and access to, medicines by podiatrists. The advent of neo-liberal healthcare policies, coupled with demands for workforce flexibility and role transfer within a climate of demographic, economic and social change has enabled allied health professionals to undertake an expanding number of tasks involving the sale, supply, administration and prescription of medicines. As a challenge to medical dominance, these changes, although driven by wider healthcare policy, have met with resistance. As anticipated in the theory of

  20. A Case Analysis on the Adequacy of Work-Life Balance Practices in UK Small- and Medium-Sized Enterprises

    OpenAIRE

    Babatunde Akanji

    2017-01-01

    Objective: The purpose of this study is to examine whether work-life balance (WLB) practices are satisfactorily provided in UK small and medium-sized enterprises (SMEs) and the impact of the availability of these work-life policies on turnover intentions. A review of extant literature reveals scarce knowledge in this area of research and this study presents a rudimentary effort to fill this gap. Research Design & Methods: Using qualitative design, the data set comprised of in-depth interv...

  1. The UK Quality and Outcomes Framework pay-for-performance scheme and spirometry: rewarding quality or just quantity? A cross-sectional study in Rotherham, UK

    Directory of Open Access Journals (Sweden)

    South Gail

    2009-06-01

    Full Text Available Abstract Background Accurate spirometry is important in the management of COPD. The UK Quality and Outcomes Framework pay-for-performance scheme for general practitioners includes spirometry related indicators within its COPD domain. It is not known whether high achievement against QOF spirometry indicators is associated with spirometry to BTS standards. Methods Data were obtained from the records of 3,217 patients randomly sampled from 5,649 patients with COPD in 38 general practices in Rotherham, UK. Severity of airflow obstruction was categorised by FEV1 (% predicted according to NICE guidelines. This was compared with clinician recorded COPD severity. The proportion of patients whose spirometry met BTS standards was calculated in each practice using a random sub-sample of 761 patients. The Spearman rank correlation between practice level QOF spirometry achievement and performance against BTS spirometry standards was calculated. Results Spirometry as assessed by clinical records was to BTS standards in 31% of cases (range at practice level 0% to 74%. The categorisation of airflow obstruction according to the most recent spirometry results did not agree well with the clinical categorisation of COPD recorded in the notes (Cohen's kappa = 0.34, 0.30 – 0.38. 12% of patients on COPD registers had FEV1 (% predicted results recorded that did not support the diagnosis of COPD. There was no association between quality, as measured by adherence to BTS spirometry standards, and either QOF COPD9 achievement (Spearman's rho = -0.11, or QOF COPD10 achievement (rho = 0.01. Conclusion The UK Quality and Outcomes Framework currently assesses the quantity, but not the quality of spirometry.

  2. The impact of citrate introduction at UK syringe exchange programmes: a retrospective cohort study in Cheshire and Merseyside, UK

    Directory of Open Access Journals (Sweden)

    Wareing Michelle

    2007-12-01

    Full Text Available Abstract Background In 2003, it became legal in the UK for syringe exchange programmes (SEPs to provide citrate to injecting drug users to solubilise heroin. Little work has been undertaken on the effect of policy change on SEP function. Here, we examine whether the introduction of citrate in Cheshire and Merseyside SEPs has altered the number of heroin/crack injectors accessing SEPs, the frequency at which heroin/crack injectors visited SEPs and the number of syringes dispensed. Methods Eleven SEPs in Cheshire and Merseyside commenced citrate provision in 2003. SEP-specific data for the six months before and six months after citrate was introduced were extracted from routine monitoring systems relating to heroin and crack injectors. Analyses compared all individuals attending pre and post citrate and matched analyses only those individuals attending in both periods (defined as 'longitudinal attenders'. Non-parametric tests were used throughout. Results Neither new (first seen in either six months period nor established clients visited SEPs more frequently post citrate. New clients collected significantly less syringes per visit post citrate, than pre citrate (14.5,10.0; z = 1.992, P Conclusion The introduction of citrate did not negatively affect SEP attendance. 'Longitudinal attenders' visited SEPs more frequently post citrate, providing staff with greater opportunity for intervention and referral. As the number of syringes they collected each visit remained unchanged the total number of clean syringes made available to this group of injectors increased very slightly between the pre and post citrate periods. However, new clients collected significantly less syringes post citrate than pre citrate, possibly due to staff concerns regarding the amount of citrate (and thus syringes to dispense safely to new clients. These concerns should not be allowed to negatively impact on the number of syringes dispensed.

  3. Objectivist case study research

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner; Fachner, Jörg

    2016-01-01

    be achieved through the use of objectivist case study research. The strength of the case study design is that it allows for uncovering or suggesting causal relationships in real-life settings through an intensive and rich collection of data. According to Hilliard (1993), the opposite applies for extensive......In order to comprehend the impact of music therapy or music therapy processes, a researcher might look for an approach where the topic under investigation can be understood within a broader context. This calls for a rich inclusion of data and consequently a limited number of participants and may...... designs, in which a small amount of data is gathered on a large number of subjects. With the richness of data, the intensive design is ―the primary pragmatic reason for engaging in single-case or small N research‖ (p. 374) and for working from an idiographic rather than a nomothetic perspective....

  4. Non- medical prescribing in Australasia and the UK: the case of podiatry

    Directory of Open Access Journals (Sweden)

    Nancarrow Susan A

    2010-01-01

    Full Text Available Abstract Background The last decade has witnessed a rapid transformation in the role boundaries of the allied health professions, enabled through the creation of new roles and the expansion of existing, traditional roles. A strategy of health care 'modernisation' has encompassed calls for the redrawing of professional boundaries and identities, linked with demands for greater workforce flexibility. Several tasks and roles previously within the exclusive domain of medicine have been delegated to, or assumed by, allied health professionals, as the workforce is reshaped to meet the challenges posed by changing demographic, social and political contexts. The prescribing of medicines by non-medically qualified healthcare professionals, and in particular the podiatry profession, reflects these changes. Methods Using a range of key primary documentary sources derived from published material in the public domain and unpublished material in private possession, this paper traces the development of contemporary UK and Australasian podiatric prescribing, access, supply and administration of medicines. Documentary sources include material from legislative, health policy, regulatory and professional bodies (including both State and Federal sources in Australia. Results Tracing a chronological, comparative, socio-historical account of the emergence and development of 'prescribing' in podiatry in both Australasia and the UK enables an analysis of the impact of health policy reforms on the use of, and access to, medicines by podiatrists. The advent of neo-liberal healthcare policies, coupled with demands for workforce flexibility and role transfer within a climate of demographic, economic and social change has enabled allied health professionals to undertake an expanding number of tasks involving the sale, supply, administration and prescription of medicines. Conclusion As a challenge to medical dominance, these changes, although driven by wider healthcare

  5. Facilitating Public Access to the Arts: Applying the Motivation, Opportunity, and Ability Framework to the Case of the UK Royal Opera House

    Directory of Open Access Journals (Sweden)

    Hyunsun Catherine Yoon

    2017-07-01

    Full Text Available In recent years, arts organizations in the UK have faced challenging times due to severe funding cuts from government and depressed box office sales during the recession. In the UK’s current cultural policy, ‘social impacts’ of the arts are highly emphasized and state interventions are intensified both in terms of finance and legitimacy. What is necessary for arts organizations to produce social impacts is their active provision of ‘deliberate extra activities’, which are generally conducted in the form of education, community, participation or outreach programs. The Royal Opera House (ROH case study provides an apt example of how to exercise these activities effectively to deliver social impacts. Based on Rothchild’s theoretical Motivation, Opportunity, and Ability (MOA framework, this study aims to find out how the UK Royal Opera House stimulated motivation among arts audiences and facilitated opportunities for them, thereby allowed them to translate motivation into action. The results show that the ROH implemented several specific strategies: ‘interest triggerings,’ ‘value creation and transmission,’ relationship building and management,’ and education. These strategies can motivate potential arts consumers to be familiar with classic arts, which lowers psychological barriers and stimulates intrinsic motivation to satisfy long-lasting and self-sustaining cultural needs.

  6. An assessment of partition and transmutation against UK requirements for radioactive waste management: supporting studies

    International Nuclear Information System (INIS)

    Cummings, R.; Crookshanks, C.E.; McAdams, R.; Rogers, J.M.; Sims, H.E.; Smith-Briggs, J.L.

    1996-06-01

    A study of partition and transmutation (P and T) has recently been reported: An Assessment of Partition and Transmutation Against UK Requirements for Radioactive Waste Management (DOE/RAS/96.007). The prospects were assessed for real safety or financial gains being made through the future use of partition and transmutation within the United Kingdom in radioactive waste management. The assessment was made by AEA Technology, on behalf of the Department of the Environment. The assessment was partly based on the results of a number of studies described here. (Author)

  7. Case Studies - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.

  8. Nuclear forensics case studies

    International Nuclear Information System (INIS)

    Fedchenko, Vitaly

    2016-01-01

    The objective of this presentation is to share three case studies from the Institute of Transuranium Elements (ITU) which describe the application of nuclear forensics to events where nuclear and other radioactive material was found to be out of regulatory control

  9. SCA12 case study

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Genetics; Volume 88; Issue 1. Utilizing linkage disequilibrium information from Indian Genome Variation Database for mapping mutations: SCA12 case study. Samira Bahl Ikhlak Ahmed The Indian Genome Variation Consortium Mitali Mukerji. Research Article Volume 88 Issue 1 April 2009 pp 55- ...

  10. national Case study

    African Journals Online (AJOL)

    This national case study reports on the development of a national network, ... system under the new policy), tends to be limited by content on problems and ... 20 credit programme; and within two Post Graduate Certificate of Education contexts, ...... descriptive with an issues focus (empirical) towards awareness production to.

  11. Liverpool Telecare Pilot: case studies

    Directory of Open Access Journals (Sweden)

    Nigel Barnes

    2006-09-01

    Full Text Available Telecare services use information and communications technology (ICT to support the provision of care to people in their own homes. This paper describes a pilot telecare service employed by Liverpool (UK City Council to support a sample of their frail and elderly social services users. The pilot has been running for over two years and has been deployed for 21 individuals in Liverpool. In this paper we present the pilot system and provide real example cases which help to illustrate the benefits of such a system.

  12. MRI case studies

    International Nuclear Information System (INIS)

    Huggett, S.; Barber, J.

    1989-01-01

    Three case studies are presented to show the value of magnetic resonance imaging used in conjunction with other imaging techniques. In each case MRI proved a vital diagnostic tool and superior to CT in showing firstly the haematoma in a patient with aphasia and right-sided weakness, secondly the size of the disc herniation in a patient with severe leg and ankle pains and thirdly the existence of a metastatic lesion in a patient with a previous history of breast cancer. 11 figs

  13. Optical Coherence Tomography in the UK Biobank Study - Rapid Automated Analysis of Retinal Thickness for Large Population-Based Studies.

    Directory of Open Access Journals (Sweden)

    Pearse A Keane

    Full Text Available To describe an approach to the use of optical coherence tomography (OCT imaging in large, population-based studies, including methods for OCT image acquisition, storage, and the remote, rapid, automated analysis of retinal thickness.In UK Biobank, OCT images were acquired between 2009 and 2010 using a commercially available "spectral domain" OCT device (3D OCT-1000, Topcon. Images were obtained using a raster scan protocol, 6 mm x 6 mm in area, and consisting of 128 B-scans. OCT image sets were stored on UK Biobank servers in a central repository, adjacent to high performance computers. Rapid, automated analysis of retinal thickness was performed using custom image segmentation software developed by the Topcon Advanced Biomedical Imaging Laboratory (TABIL. This software employs dual-scale gradient information to allow for automated segmentation of nine intraretinal boundaries in a rapid fashion.67,321 participants (134,642 eyes in UK Biobank underwent OCT imaging of both eyes as part of the ocular module. 134,611 images were successfully processed with 31 images failing segmentation analysis due to corrupted OCT files or withdrawal of subject consent for UKBB study participation. Average time taken to call up an image from the database and complete segmentation analysis was approximately 120 seconds per data set per login, and analysis of the entire dataset was completed in approximately 28 days.We report an approach to the rapid, automated measurement of retinal thickness from nearly 140,000 OCT image sets from the UK Biobank. In the near future, these measurements will be publically available for utilization by researchers around the world, and thus for correlation with the wealth of other data collected in UK Biobank. The automated analysis approaches we describe may be of utility for future large population-based epidemiological studies, clinical trials, and screening programs that employ OCT imaging.

  14. Are chiropractors in the uk primary healthcare or primary contact practitioners?: a mixed methods study

    Directory of Open Access Journals (Sweden)

    Jones-Harris Amanda R

    2010-10-01

    Full Text Available Abstract Background One of the debates regarding the role of chiropractors is whether or not they should be considered as primary healthcare practitioners. Primary care is often used to describe chiropractic but without any definition of what is meant by the term. Primary healthcare itself has many definitions and this adds to the problem. Existing research literature, based mostly in the USA, suggests that the use of the title "primary healthcare professional" by chiropractors is central to the identity of the profession. It has also been suggested that the concept of primary care is misused by chiropractors because they have not examined the concept in detail and thus do not understand it. For the sake of quality of patient care and for the legitimacy of the profession, chiropractors in the UK need to agree on their healthcare role. This study aimed to examine the opinions of chiropractors towards the use of the term primary healthcare when applied to chiropractic practice within the UK. Methods A sequential study of exploratory design was used; this model is characterised by an initial phase of qualitative data collection and analysis that precedes and informs the quantitative phase of data collection and analysis. In this study, interviews with members of chiropractic teaching faculty were used to inform the development of a questionnaire used to survey the opinions of chiropractors in the UK. Results There was a general consensus of opinion that chiropractors are primary contact practitioners, who work in a primary healthcare setting and that to be able to fulfil this healthcare role, chiropractors must be able to diagnose patients and refer when required. Participants did not feel that chiropractors are able to treat all of the most common medical conditions that present in a primary healthcare setting. Conclusions The findings of this study suggest that chiropractors in the UK view their role as one of a primary contact healthcare

  15. Depleted uranium: A study of its uses in the UK and disposal issues

    Energy Technology Data Exchange (ETDEWEB)

    Russ, Bob

    2002-03-01

    Full text: The Environment Agency recently published a contract R and D report, by John Jackson of Alan Martin Associates, on depleted uranium (DU). The report documents a scoping study on the uses of DU; the civil non-nuclear applications for DU were a particular focus of the scoping study. The study was commissioned following a series of DU related incidents, including the crash of the Korean Airlines' Boeing 747 at Stansted in late 1999. There had also been an assertion in the Guardian (21 August 2000) that as much as 50 tonnes of DU is lying in UK scrapyards. The report confirms that the quantities referred to in the Guardian are groundless. The report provides information and guidance to the Agency's staff who regulate radioactive substances in England and Wales. The report does not attempt to review the health effects of DU (separate health studies have been carried out by the Royal Society and others). A range of non-nuclear uses of DU are identified in the report: Transportable shielded containers for radioactive sources, Aircraft counterbalance weights, Piling equipment (civil engineering), Radiation shielding (hospitals, universities, etc), Armour piercing ammunition, Uranium catalysts, and Ceramic glazes. The report concludes that there is, in total, less than 50 tonnes of DU in use in the UK outside of military and nuclear applications. The report identifies the aircraft salvage and recycling industry as having a significant risk of DU being lost from regulatory control. (Awareness and vigilance need to be maintained; in February 2001 in Ohio, USA, 53 tonnes of aluminium ingots from an aircraft recycling operation were found to be contaminated with DU from counterweights that had not been segregated prior to smelting.) The report highlights the absence of a UK disposal route for substantial quantities of DU. The BNFL site at Drigg cannot accept DU because in its undiluted state it is categorised as intermediate level waste. Whilst redundant DU

  16. International study for an international career: a survey of the motivations and aspirations of international students in the UK

    OpenAIRE

    Packwood, Helen; Findlay, Allan; McCollum, David

    2015-01-01

    There are currently 435,000 international students studying in UK Universities. This paper investigates the forces driving student mobility and the relationship between student migration and future mobility plans. The research, based on a survey of over 3000 international students and interviews with senior staff in International Offices at ten UK Universities confirms the importance of understanding international student mobility as part of wider mobility trajectories.

  17. Depleted uranium. A study of its uses within the UK and disposal issues

    International Nuclear Information System (INIS)

    Jackson, J.H.

    2001-01-01

    A number of events during recent years have triggered a need for the Environment Agency to confirm its understanding of the various uses to which depleted uranium (DU) has been and is being put, where it may be found in the UK, and the disposal consequences. A scoping study has been performed of DU usage in the UK; it is not an exhaustive study and it does not examine any health issues. By far the largest quantities of DU are to be found in the nuclear fuel cycle but the main focus of this report is to examine the uses of DU outside this area. An indication is provided of the most likely premises where DU is to be found and these are principally in the aircraft, ammunitions production, non-destructive testing, radioactive source supply industries, in hospitals and, to a lesser extent, in research and teaching establishments. The study reveals that accounting for DU varies in the UK depending on the application, user organisation and location. Areas to improve control are recommended, particularly in the application of the Radioactive Substances Act 1993 and in the formalised and more systematic exchange of information between the Environment Agency and the Department of Trade and Industry about holders, inventories and locations of DU. In regard to the civil aircraft industry, it is suggested that there should be improved provision of information passing with an aircraft either for resale or, more particularly, for scrapping in view of the fact that more older aircraft containing DU may be coming to the end of their lifespan. A way forward may be for the regulating bodies to jointly discuss with the industry the issues and perhaps the provision of guidance. Because of the international character of this issue, resolution may prove difficult. It is also suggested that the awareness of the amount of DU in linacs and teletherapy machines in hospitals could be improved, an aspect which may be of growing importance in view of the apparent gradual reduction of the use of

  18. Case study - Czechoslovakia

    International Nuclear Information System (INIS)

    Kovar, P.

    1986-01-01

    In the lecture Case Study - Czechoslovakia with the sub-title 'Unified System of Personnel Preparation for Nuclear Programme in Czechoslovakia' the actual status and the current experience of NPP personnel training and preparation in Czechoslovakia are introduced. The above mentioned training system is presented and demonstrated by the story of a proxy person who is going to become shift engineer in a nuclear power plant in Czechoslovakia. (orig./HP)

  19. Case Studies - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2010-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.  Created: 10/15/2010 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  20. Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study.

    Science.gov (United States)

    Woolf, Katherine; Rich, Antonia; Viney, Rowena; Needleman, Sarah; Griffin, Ann

    2016-11-25

    Explore trainee doctors' experiences of postgraduate training and perceptions of fairness in relation to ethnicity and country of primary medical qualification. Qualitative semistructured focus group and interview study. Postgraduate training in England (London, Yorkshire and Humber, Kent Surrey and Sussex) and Wales. 137 participants (96 trainees, 41 trainers) were purposively sampled from a framework comprising: doctors from all stages of training in general practice, medicine, obstetrics and gynaecology, psychiatry, radiology, surgery or foundation, in 4 geographical areas, from white and black and minority ethnic (BME) backgrounds, who qualified in the UK and abroad. Most trainees described difficult experiences, but BME UK graduates (UKGs) and international medical graduates (IMGs) could face additional difficulties that affected their learning and performance. Relationships with senior doctors were crucial to learning but bias was perceived to make these relationships more problematic for BME UKGs and IMGs. IMGs also had to deal with cultural differences and lack of trust from seniors, often looking to IMG peers for support instead. Workplace-based assessment and recruitment were considered vulnerable to bias whereas examinations were typically considered more rigorous. In a system where success in recruitment and assessments determines where in the country you can get a job, and where work-life balance is often poor, UK BME and international graduates in our sample were more likely to face separation from family and support outside of work, and reported more stress, anxiety or burnout that hindered their learning and performance. A culture in which difficulties are a sign of weakness made seeking support and additional training stigmatising. BME UKGs and IMGs can face additional difficulties in training which may impede learning and performance. Non-stigmatising interventions should focus on trainee-trainer relationships at work and organisational changes to

  1. Domestic violence teaching in UK medical schools: a cross-sectional study.

    Science.gov (United States)

    Potter, Lucy C; Feder, Gene

    2017-10-06

    Domestic violence and abuse (DVA) is a leading contributor to the physical and mental ill health of women. Recent international guidance recommends that undergraduate medical curricula should include DVA. We do not know what is currently taught about DVA to medical students in the UK. Recent international guidance recommends that undergraduate medical curricula should include DVA METHOD: Teaching leads from all UK medical schools (n = 34) were invited to participate in an 18-item online survey about what DVA education is provided, their views of this provision and any feedback provided by students. Descriptive statistics were used to analyse the data. A total of 25 out of 34 medical schools participated in the survey (74%). All respondents felt that there should be formal teaching on DVA in the medical curriculum. Eighty-four per cent of respondents reported that there was some formal teaching in their medical school, and 90% of these reported that it was mandatory. Of those who delivered some teaching, 52% reported that the provision was 0-2 hours in total. Most commonly content was delivered in year 4. DVA teaching was delivered in different modules, by different methods and delivered by a range of different providers. Seventy-five per cent of respondents reported that they felt the provision at their medical school was inadequate or not enough. Barriers to providing DVA education identified included time constraints, failure to perceive it as a medical problem and the assumption that it will be covered elsewhere. Most medical students in the UK receive a small amount of teaching on DVA towards the end of the curriculum. This is perceived as inadequate. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  2. Lifestyle factors affecting fruit and vegetable consumption in the UK Women's Cohort Study.

    Science.gov (United States)

    Pollard, J; Greenwood, D; Kirk, S; Cade, J

    2001-08-01

    The UK Women's Cohort Study (UKWCS) was originally set up to look at morbidity and mortality data on subjects with a wide range of dietary intakes including vegans, lacto-ovo vegetarians, non-red meat eaters and red meat eaters. The aim of the present study was to investigate factors that affect fruit and vegetable consumption within this particular cohort of women. Females of ages 35-69 years, taking part in the UK Women's Cohort Study (N=35 367), provided health and lifestyle information including a 217-item food frequency questionnaire. In multiple logistic regression, the strongest predictors of a higher reported level of fruit and vegetable consumption were being a vegetarian or vegan, taking vitamin or mineral supplements, being married, educated to A-level or degree level and belonging to a higher socio-economic group. Conversely, smokers were found to be only half as likely as non-smokers to be high fruit and vegetable consumers. These lifestyle distinctions among three levels of reported fruit and vegetable consumption are relevant to the future targeting of health promotion strategies. Copyright 2000 Academic Press.

  3. Research priorities for respiratory nursing: a UK-wide Delphi study

    Science.gov (United States)

    Pilkington, Melissa; Hodson, Matthew; Welch, Lindsay; Yorke, Janelle

    2018-01-01

    Respiratory nurses make a significant contribution to the delivery of respiratory healthcare, but there is a dearth of nurse-led, practice-focused, published research. Using a modified three-round Delphi, this study sought to identify research priorities for respiratory nursing to inform a national research strategy. Study information and the survey link were sent electronically to members of UK professional respiratory organisations. Round 1 had 78 items across 16 topics, informed by a systematic literature review. Respondents suggested additional items which were content analysed to inform Round 2. Respondents rated all items and ranked the topics in all rounds. To ensure rigour, rounds had an explicit focus with pre-determined criteria for consensus (70%). In total, 363 responses were received across Rounds 1, 2 and 3 (n=183, 95 and 85, respectively). The top five research priorities were: 1) “Patient understanding of asthma control”; 2) “The clinical and cost-effectiveness of respiratory nurse interventions”; 3) “The impact of nurse-led clinics on patient care”; 4) “Inhaler technique”; and 5) two topics jointly scored: “Prevention of exacerbations” and “Symptom management”. With potential international significance, this is the first UK study to identify research priorities for respiratory nursing, providing direction for those planning or undertaking research. PMID:29692999

  4. Organisational perspectives on addressing differential attainment in postgraduate medical education: a qualitative study in the UK.

    Science.gov (United States)

    Woolf, Katherine; Viney, Rowena; Rich, Antonia; Jayaweera, Hirosha; Griffin, Ann

    2018-03-09

    To explore how representatives from organisations with responsibility for doctors in training perceive risks to the educational progression of UK medical graduates from black and minority ethnic groups (BME UKGs), and graduates of non-UK medical schools (international medical graduates (IMGs)). To identify the barriers to and facilitators of change. Qualitative semistructured individual and group interview study. Postgraduate medical education in the UK. Individuals with roles in examinations and/or curriculum design from UK medical Royal Colleges. Employees of NHS Employers. Representatives from 11 medical Royal Colleges (n=29) and NHS Employers (n=2) took part (55% medically qualified, 61% male, 71% white British/Irish, 23% Asian/Asian British, 6% missing ethnicity). Risks were perceived as significant, although more so for IMGs than for BME UKGs. Participants based significance ratings on evidence obtained largely through personal experience. A lack of evidence led to downgrading of significance. Participants were pessimistic about effecting change, two main barriers being sensitivities around race and the isolation of interventions. Participants felt that organisations should acknowledge problems, but felt concerned about being transparent without a solution; and talking about race with trainees was felt to be difficult. Participants mentioned 63 schemes aiming to address differential attainment, but these were typically local or specialty-specific, were not aimed at BME UKGs and were largely unevaluated. Participants felt that national change was needed, but only felt empowered to effect change locally or within their specialty. Representatives from organisations responsible for training doctors perceived the risks faced by BME UKGs and IMGs as significant but difficult to change. Strategies to help organisations address these risks include: increased openness to discussing race (including ethnic differences in attainment among UKGs); better sharing of

  5. A scoping study: demand side measures on the UK electrical system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    The study is intended to eventually bring about a number of improvements in the UK electrical system, particularly in regard to Demand Side Management (DSM). Among the benefits envisaged are (a) increased security of supply when the network is under stress; (b) reduction in costs; (c) simpler outage management; (d) carbon saving and (e) increased energy efficiency. So far, these potential benefits have attracted little attention in the residential and small business sectors of the market: suggested reasons for this are listed. Taking into account the experience of other countries, three options are presented for a UK DSM programme: they are (i) customer initiated; (ii) supplier initiated and (iii) distributor initiated. At present, all the suggested options need further study and to aid the development for small customers, five possible initiatives are suggested. This final report (95 pages) includes a detailed description of the research required and a tender process for a customer-initiated programme. The report was prepared by KEMA Limited under contract to the DTI.

  6. A scoping study: demand side measures on the UK electrical system

    International Nuclear Information System (INIS)

    2005-01-01

    The study is intended to eventually bring about a number of improvements in the UK electrical system, particularly in regard to Demand Side Management (DSM). Among the benefits envisaged are (a) increased security of supply when the network is under stress; (b) reduction in costs; (c) simpler outage management; (d) carbon saving and (e) increased energy efficiency. So far, these potential benefits have attracted little attention in the residential and small business sectors of the market: suggested reasons for this are listed. Taking into account the experience of other countries, three options are presented for a UK DSM programme: they are (i) customer initiated; (ii) supplier initiated and (iii) distributor initiated. At present, all the suggested options need further study and to aid the development for small customers, five possible initiatives are suggested. This final report (95 pages) includes a detailed description of the research required and a tender process for a customer-initiated programme. The report was prepared by KEMA Limited under contract to the DTI

  7. Understanding the culture of antimicrobial prescribing in agriculture: a qualitative study of UK pig veterinary surgeons

    Science.gov (United States)

    Coyne, L. A.; Latham, S. M.; Williams, N. J.; Dawson, S.; Donald, I. J.; Pearson, R. B.; Smith, R. F.; Pinchbeck, G. L.

    2016-01-01

    Objectives The use of antimicrobials in food-producing animals has been linked with the emergence of antimicrobial resistance in bacterial populations, with consequences for animal and public health. This study explored the underpinning drivers, motivators and reasoning behind prescribing decisions made by veterinary surgeons working in the UK pig industry. Methods A qualitative interview study was conducted with 21 veterinary surgeons purposively selected from all UK pig veterinary surgeons. Thematic analysis was used to analyse transcripts. Results Ensuring optimum pig health and welfare was described as a driver for antimicrobial use by many veterinary surgeons and was considered a professional and moral obligation. Veterinary surgeons also exhibited a strong sense of social responsibility over the need to ensure that antimicrobial use was responsible. A close relationship between management practices, health and economics was evident, with improvements in management commonly identified as being potential routes to reduce antimicrobial usage; however, these were not always considered economically viable. The relationship with clients was identified as being a source of professional stress for practitioners due to pressure from farmers requesting antimicrobial prescriptions, and concern over poor compliance of antimicrobial administration by some farmers. Conclusions The drivers behind prescribing decisions by veterinary surgeons were complex and diverse. A combination of education, improving communication between veterinary surgeons and farmers, and changes in regulations, in farm management and in consumer/retailer demands may all be needed to ensure that antimicrobial prescribing is optimal and to achieve significant reductions in use. PMID:27516473

  8. Case Study - Alpha

    Directory of Open Access Journals (Sweden)

    Stephen Leybourne

    2016-11-01

    Full Text Available This case study was developed from an actual scenario by Dr. Steve Leybourne of Boston University.  The case documents the historical evolution of an organization, and has been used successfully in courses dealing with organizational and cultural change, and the utilization of ‘soft skills’ in project-based management. This is a short case, ideal for classroom use and discussion.  The issues are easily accessible to students, and there is a single wide ranging question that allows for the inclusion of many issues surrounding strategic decision-making, and behavioural and cultural change. Alpha was one of the earlier companies in the USA to invest in large, edge-of-town superstores, with plentiful free vehicle parking, selling food and related household products. Alpha was created in the 1950s as a subsidiary of a major publicly quoted retail group.  It started business by opening a string of very large discount stores in converted industrial and warehouse premises in the south of the United States. In the early days shoppers were offered a limited range of very competitively priced products. When Alpha went public in 1981 it was the fourth largest food retailer in the US, selling an ever-widening range of food and non-food products.  Its success continued to be based on high volume, low margins and good value for money, under the slogan of ‘Alpha Price.’

  9. Career choices for public health: cohort studies of graduates from UK medical schools.

    Science.gov (United States)

    Goldacre, Michael J; Laxton, Louise; Lambert, Trevor W; Webster, Premila

    2011-12-01

    The aim of this paper is to describe UK-trained doctors' early intentions about seeking careers in public health and their eventual speciality destinations. Analysis of longitudinal studies of medical graduates from all UK medical schools in selected year-of-qualification cohorts from 1974 to 2008; data collected by postal questionnaires at various times after qualifying; and selection, for this paper, of doctors who expressed an early preference for a career in public health and/or who eventually practised in it. Of all doctors eventually practising in public health, for whom we had early choices, public health had been the unreserved first choice of 8% (10/125) in their first post-qualification year, 27% (33/122) in their third year and 59% (51/86) in their fifth year. Including first choices for public health 'tied' with an equal preference for a different speciality, and doctors' second and third choices for public health, 19% (24/125) of practising public health doctors had considered public health as a possible career in their first post-graduation year, 41% (50/122) in the third and 83% (71/86) in the fifth year. Comparisons with other specialities show that doctors in public health chose their speciality relatively late after qualification.

  10. NOx trade. Case studies

    International Nuclear Information System (INIS)

    Jantzen, J.

    2002-01-01

    Some of the questions with respect to the trade of nitrogen oxides that businesses in the Netherlands have to deal with are dealt with: should a business buy or sell rights for NOx emission; which measures must be taken to reduce NOx emission; how much must be invested; and how to deal with uncertainties with regard to prices. Simulations were carried out with the MOSES model to find the answers to those questions. Results of some case studies are presented, focusing on the chemical sector in the Netherlands. Finally, the financial (dis)advantages of NOx trade and the related uncertainties for a single enterprise are discussed [nl

  11. OBSESSIONS: CASE REPORT STUDY

    Directory of Open Access Journals (Sweden)

    Miloš Židanik

    2004-01-01

    Full Text Available Background. Obsessions are one of the most refractory psychiatric disorders. The therapeutic guidelines include a psychopharmacotherapy and the use of behavioural and supportive psychotherapy.Methods. This case report study presents a patient with a homicide obsessions at the forefront and narcissistic personality disorder in background. The use of analytical oriented psychotherapy, which helped to resolve axis-1 symptoms, is described.Conclusions. In the therapy of patients it is important to have the knowledge about the national therapeutic guidelines and critical distance toward them as well. Which therapy to use should be decided by the individual patient’s needs.

  12. UK ignores treaty obligations

    International Nuclear Information System (INIS)

    Roche, P.

    1995-01-01

    A detailed critique is offered of United Kingdom (UK) political policy with respect to the Non-Proliferation Treaty, an interim agreement valid while nuclear disarmament was supposed to occur, by a representative of Greenpeace, the anti-nuclear campaigning group. The author argues that the civil and military nuclear programmes are still firmly linked, and emphasises his opinions by quoting examples of how UK politicians have broken treaty obligations in order to pursue their own political, and in some cases financial, goals. It is argued that the treaty has failed to force nuclear countries to disarm because of its promoted civil nuclear power programmes. (U.K.)

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

    Science.gov (United States)

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

    2017-08-01

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

  14. Exploring trust in online health information: a study of user experiences of patients.co.uk.

    Science.gov (United States)

    Cunningham, Anna; Johnson, Frances

    2016-12-01

    This feature has been co-authored by Anna Cunningham and her supervisor Frances Johnson. It is based on the research Anna conducted for her dissertation, which she completed as part of her MA in Library and Information Management at Manchester Metropolitan University. The study explored how people assess the trustworthiness of online health information, and the participants were asked to talk aloud whilst viewing information on the consumer health information website patients.co.uk. The study confirmed that their assessment was based on the information usefulness and credibility as well as identifying the factors relating to information quality and website design that helped to form these judgements. A. M. © 2016 Health Libraries Group.

  15. Cross-Cultural Study of Information Processing Biases in Chronic Fatigue Syndrome: Comparison of Dutch and UK Chronic Fatigue Patients.

    Science.gov (United States)

    Hughes, Alicia M; Hirsch, Colette R; Nikolaus, Stephanie; Chalder, Trudie; Knoop, Hans; Moss-Morris, Rona

    2018-02-01

    This study aims to replicate a UK study, with a Dutch sample to explore whether attention and interpretation biases and general attentional control deficits in chronic fatigue syndrome (CFS) are similar across populations and cultures. Thirty eight Dutch CFS participants were compared to 52 CFS and 51 healthy participants recruited from the UK. Participants completed self-report measures of symptoms, functioning, and mood, as well as three experimental tasks (i) visual-probe task measuring attentional bias to illness (somatic symptoms and disability) versus neutral words, (ii) interpretive bias task measuring positive versus somatic interpretations of ambiguous information, and (iii) the Attention Network Test measuring general attentional control. Compared to controls, Dutch and UK participants with CFS showed a significant attentional bias for illness-related words and were significantly more likely to interpret ambiguous information in a somatic way. These effects were not moderated by attentional control. There were no significant differences between the Dutch and UK CFS groups on attentional bias, interpretation bias, or attentional control scores. This study replicated the main findings of the UK study, with a Dutch CFS population, indicating that across these two cultures, people with CFS demonstrate biases in how somatic information is attended to and interpreted. These illness-specific biases appear to be unrelated to general attentional control deficits.

  16. Poor uptake of primary healthcare registration among recent entrants to the UK: a retrospective cohort study

    Science.gov (United States)

    Stagg, Helen R; Jones, Jane; Bickler, Graham

    2012-01-01

    Objectives Uptake of healthcare among migrants is a complex and controversial topic; there are multiple recognised barriers to accessing primary care. Delays in presentation to healthcare services may result in a greater burden on costly emergency care, as well as increased public health risks. This study aimed to explore some of the factors influencing registration of new entrants with general practitioners (GPs). Design Retrospective cohort study. Setting Port health screening at Heathrow and Gatwick airports, primary care. Participants 252 559 new entrants to the UK, whose entry was documented by the port health tuberculosis screening processes at Heathrow and Gatwick. 191 had insufficient information for record linkage. Primary outcome measure Registration with a GP practice within the UK, as measured through record linkage with the Personal Demographics Service (PDS) database. Results Only 32.5% of 252 368 individuals were linked to the PDS, suggesting low levels of registration in the study population. Women were more likely to register than men, with a RR ratio of 1.44 (95% CI 1.41 to 1.46). Compared with those from Europe, individuals of nationalities from the Americas (0.43 (0.39 to 0.47)) and Africa (0.74 (0.69 to 0.79)) were less likely to register. Similarly, students (0.83 (0.81 to 0.85)), long-stay visitors (0.82 (0.77 to 0.87)) and asylum seekers (0.46 (0.42 to 0.51)) were less likely to register with a GP than other migrant groups. Conclusions Levels of registration with GPs within this selected group of new entrants, as measured through record linkage, are low. Migrant groups with the lowest proportion registered are likely to be those with the highest health needs. The UK would benefit from a targeted approach to identify the migrants least likely to register for healthcare and to promote access among both users and service providers. PMID:22869094

  17. Vaginal birth after caesarean section prediction models: a UK comparative observational study.

    Science.gov (United States)

    Mone, Fionnuala; Harrity, Conor; Mackie, Adam; Segurado, Ricardo; Toner, Brenda; McCormick, Timothy R; Currie, Aoife; McAuliffe, Fionnuala M

    2015-10-01

    Primarily, to assess the performance of three statistical models in predicting successful vaginal birth in patients attempting a trial of labour after one previous lower segment caesarean section (TOLAC). The statistically most reliable models were subsequently subjected to validation testing in a local antenatal population. A retrospective observational study was performed with study data collected from the Northern Ireland Maternity Service Database (NIMATs). The study population included all women that underwent a TOLAC (n=385) from 2010 to 2012 in a regional UK obstetric unit. Data was collected from the Northern Ireland Maternity Service Database (NIMATs). Area under the curve (AUC) and correlation analysis was performed. Of the three prediction models evaluated, AUC calculations for the Smith et al., Grobman et al. and Troyer and Parisi Models were 0.74, 0.72 and 0.65, respectively. Using the Smith et al. model, 52% of women had a low risk of caesarean section (CS) (predicted VBAC >72%) and 20% had a high risk of CS (predicted VBAC <60%), of whom 20% and 63% had delivery by CS. The fit between observed and predicted outcome in this study cohort using the Smith et al. and Grobman et al. models were greatest (Chi-square test, p=0.228 and 0.904), validating both within the population. The Smith et al. and Grobman et al. models could potentially be utilized within the UK to provide women with an informed choice when deciding on mode of delivery after a previous CS. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

  18. Food allergy, a summary of eight cases in the UK criminal and civil courts: effective last resort for vulnerable consumers?

    Science.gov (United States)

    Gowland, M Hazel; Walker, Michael J

    2015-08-15

    Food allergy has a forensic context. The authors describe eight cases in the UK courts involving fatalities, personal injury or criminal non-compliance with food law from mainly 'grey' literature sources. The potentially severe consequences for people with food allergy of contraventions of labelling law have led to enforcement action up to criminal prosecution for what might otherwise be regarded as 'trivial' non-compliance. The authors suggest there should be central collation of such cases. Non-compliances should be followed up in a more rapid and robust manner. Evidence of fraud in the catering supply chain supports recent calls for zero tolerance of food fraud. Businesses must guard against gaps in allergen management, for which there are readily available sources of training and guidance, but also against fraudulent substitution in the supply chain, about which training and guidance should be developed. New allergen labelling legislation and case law appear to place responsibility on food businesses even for the forensically problematic area of allergen cross-contamination. The courts can be an effective last resort for vulnerable consumers; however, there is evidence of knowledge and skill gaps in both the investigation and prosecution of potentially serious incidents of food allergen mismanagement and mislabelling. Thorough investigation of food allergy deaths is required with a tenacious and skilled approach, including early realisation that samples of the food and/or stomach contents from a post mortem examination should be retained and analysed. The supply chain must be rigorously examined to find out where adulteration or contamination with the fatal allergen occurred. © 2014 Society of Chemical Industry.

  19. Maternal employment and child socio-emotional behaviour in the UK: longitudinal evidence from the UK Millennium Cohort Study.

    Science.gov (United States)

    McMunn, Anne; Kelly, Yvonne; Cable, Noriko; Bartley, Mel

    2012-07-01

    Mothers of young children are increasingly combining paid work with childrearing. Empirical evidence on the effects of maternal employment on children is contradictory and little work has considered the impact of maternal employment within the context of the employment patterns of both parents. Data on parental employment across three sweeps (when children were in infancy, age 3 and age 5 y) of the Millennium Cohort Study, a large nationally representative prospective birth cohort study, were used to investigate the relation between parental employment and child socio-emotional behaviour at age 5 years independent of maternal education, maternal depression or household income. The cumulative effect of maternal employment across the early years was investigated. The impact of maternal employment in the first year of life was separately examined as a potentially 'sensitive period'. There was no evidence of detrimental effects of maternal employment in the early years on subsequent child socio-emotional behaviour. There were significant gender differences in the effects of parental employment on behavioural outcomes. The most beneficial working arrangement for both girls and boys was that in which both mothers and fathers were present in the household and in paid work independent of maternal educational attainment and household income. No detrimental effects of maternal employment in the early years were seen. There were important gender differences in relationships between parental working arrangements and child socio-emotional outcomes.

  20. Separating civil and military nuclear programmes in the UK and France; a feasibility study

    International Nuclear Information System (INIS)

    Hart, David

    1987-01-01

    In recent years there has been considerable concern shown by the general public and the trade unions over the connection between the civil and military nuclear programmes. This paper is the result of research to determine the feasibility of separating the two in the UK and France. The result of the study is that it is technically and economically feasible to adopt a policy of separation. The costs are not overwhelming, rather the difficulty lies in assessing the intangible benefits of such a programme, and in overcoming any political impediments to its adoption. The major political fear is that adopting a separation programme would put that nation at a disadvantage with respect to other nuclear weapon states. (author)

  1. Provision of medical student teaching in UK general practices: a cross-sectional questionnaire study

    Science.gov (United States)

    Harding, Alex; Rosenthal, Joe; Al-Seaidy, Marwa; Gray, Denis Pereira; McKinley, Robert K

    2015-01-01

    Background Health care is increasingly provided in general practice. To meet this demand, the English Department of Health recommends that 50% of all medical students should train for general practice after qualification. Currently 19% of medical students express general practice as their first career choice. Undergraduate exposure to general practice positively influences future career choice. Appropriate undergraduate exposure to general practice is therefore highly relevant to workforce planning Aim This study seeks to quantify current exposure of medical students to general practice and compare it with past provision and also with postgraduate provision. Design and setting A cross-sectional questionnaire in the UK. Method A questionnaire regarding provision of undergraduate teaching was sent to the general practice teaching leads in all UK medical schools. Information was gathered on the amount of undergraduate teaching, how this was supported financially, and whether there was an integrated department of general practice. The data were then compared with results from previous studies of teaching provision. The provision of postgraduate teaching in general practice was also examined. Results General practice teaching for medical students increased from teaching in 1968 to 13.0% by 2008; since then, the percentage has plateaued. The total amount of general practice teaching per student has fallen by 2 weeks since 2002. Medical schools providing financial data delivered 14.6% of the clinical curriculum and received 7.1% of clinical teaching funding. The number of departments of general practice has halved since 2002. Provision of postgraduate teaching has tripled since 2000. Conclusion Current levels of undergraduate teaching in general practice are too low to fulfil future workforce requirements and may be falling. Financial support for current teaching is disproportionately low and the mechanism counterproductive. Central intervention may be required to solve

  2. Understanding the culture of antimicrobial prescribing in agriculture: a qualitative study of UK pig veterinary surgeons.

    Science.gov (United States)

    Coyne, L A; Latham, S M; Williams, N J; Dawson, S; Donald, I J; Pearson, R B; Smith, R F; Pinchbeck, G L

    2016-11-01

    The use of antimicrobials in food-producing animals has been linked with the emergence of antimicrobial resistance in bacterial populations, with consequences for animal and public health. This study explored the underpinning drivers, motivators and reasoning behind prescribing decisions made by veterinary surgeons working in the UK pig industry. A qualitative interview study was conducted with 21 veterinary surgeons purposively selected from all UK pig veterinary surgeons. Thematic analysis was used to analyse transcripts. Ensuring optimum pig health and welfare was described as a driver for antimicrobial use by many veterinary surgeons and was considered a professional and moral obligation. Veterinary surgeons also exhibited a strong sense of social responsibility over the need to ensure that antimicrobial use was responsible. A close relationship between management practices, health and economics was evident, with improvements in management commonly identified as being potential routes to reduce antimicrobial usage; however, these were not always considered economically viable. The relationship with clients was identified as being a source of professional stress for practitioners due to pressure from farmers requesting antimicrobial prescriptions, and concern over poor compliance of antimicrobial administration by some farmers. The drivers behind prescribing decisions by veterinary surgeons were complex and diverse. A combination of education, improving communication between veterinary surgeons and farmers, and changes in regulations, in farm management and in consumer/retailer demands may all be needed to ensure that antimicrobial prescribing is optimal and to achieve significant reductions in use. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

  3. UK military doctors; stigma, mental health and help-seeking: a comparative cohort study.

    Science.gov (United States)

    Jones, Norman; Whybrow, D; Coetzee, R

    2018-03-09

    Studies suggest that medical doctors can suffer from substantial levels of mental ill-health. Little is known about military doctors' mental health and well-being; we therefore assessed attitudes to mental health, self-stigma, psychological distress and help-seeking among UK Armed Forces doctors. Six hundred and seventy-eight military doctors (response rate 59%) completed an anonymous online survey. Comparisons were made with serving and ex-military personnel (n=1448, response rate 84.5%) participating in a mental health-related help-seeking survey. Basic sociodemographic data were gathered, and participants completed measures of mental health-related stigmatisation, perceived barriers to care and the 12-Item General Health Questionnaire. All participants were asked if in the last three years they had experienced stress, emotional, mental health, alcohol, family or relationship problems, and whether they had sought help from formal sources. Military doctors reported fewer mental disorder symptoms than the comparison groups. They endorsed higher levels of stigmatising beliefs, negative attitudes to mental healthcare, desire to self-manage and self-stigmatisation than each of the comparison groups. They were most concerned about potential negative effects of and peer perceptions about receiving a mental disorder diagnosis. Military doctors reporting historical and current relationship, and alcohol or mental health problems were significantly and substantially less likely to seek help than the comparison groups. Although there are a number of study limitations, outcomes suggest that UK military doctors report lower levels of mental disorder symptoms, higher levels of stigmatising beliefs and a lower propensity to seek formal support than other military reference groups. © 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.

  4. US/UK Sensor-To-Shooter Multinational C4 Interoperability Study Force-On-Force Effectiveness Methodology

    National Research Council Canada - National Science Library

    Bailey, Timothy J

    2000-01-01

    .... This methodology has been successfully applied to Army, joint, and multinational studies. The latest of these studies, the US/UK Sensor-To-Shooter Multinational C4 Interoperability Study Force-On-Force Analysis, was an effort to measure the value...

  5. Exploring the impact of early life factors on inequalities in risk of overweight in UK children: findings from the UK Millennium Cohort Study.

    Science.gov (United States)

    Massion, Samuel; Wickham, Sophie; Pearce, Anna; Barr, Ben; Law, Catherine; Taylor-Robinson, David

    2016-08-01

    Overweight and obesity in childhood are socially patterned, with higher prevalence in more disadvantaged populations, but it is unclear to what extent early life factors attenuate the social inequalities found in childhood overweight/obesity. We estimated relative risks (RRs) for being overweight (combining with obesity) at age 11 in 11 764 children from the UK Millennium Cohort Study (MCS) according to socio-economic circumstances (SEC). Early life risk factors were explored to assess if they attenuated associations between SECs and overweight. 28.84% of children were overweight at 11 years. Children of mothers with no academic qualifications were more likely to be overweight (RR 1.72, 95% CI 1.48 to 2.01) compared to children of mothers with degrees and higher degrees. Controlling for prenatal, perinatal, and early life characteristics (particularly maternal pre-pregnancy overweight and maternal smoking during pregnancy) reduced the RR for overweight to 1.44, 95% CI 1.23 to 1.69 in the group with the lowest academic qualifications compared to the highest. We observed a clear social gradient in overweight 11-year-old children using a representative UK sample. Moreover, we identified specific early life risk factors, including maternal smoking during pregnancy and maternal pre-pregnancy overweight, that partially account for the social inequalities found in childhood overweight. Policies to support mothers to maintain a healthy weight, breastfeed and abstain from smoking during pregnancy are important to improve maternal and child health outcomes, and our study provides some evidence that they may also help to address the continuing rise in inequalities in childhood overweight. 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/

  6. Tricuspid valve dysplasia: A retrospective study of clinical features and outcome in dogs in the UK

    Directory of Open Access Journals (Sweden)

    Xavier Navarro-Cubas

    2017-12-01

    Full Text Available The objective of this study was to determine the demographic, clinical and survival characteristics and to identify risk factors for mortality due to tricuspid valve dysplasia in UK dogs. Records of client-owned dogs diagnosed with tricuspid valve dysplasia at a referral centre were retrospectively reviewed. Only dogs diagnosed with tricuspid valve dysplasia based on the presence of a right-sided heart murmur identified prior to one year of age, and confirmed with Doppler echocardiography, were included. Dogs with concomitant cardiac diseases, pulmonary hypertension and/or trivial tricuspid regurgitation were excluded. Analysed data included signalment, reason for presentation, clinical signs, electrocardiographic and echocardiographic features, survival status and cause of death. Survival times and risk factors for mortality were evaluated using Kaplan-Meier curves and Cox regression. Eighteen dogs met inclusion criteria. Border collies were over-represented (p= 0.014. Dogs were most frequently referred for investigation of heart murmur. The most common arrhythmia was atrial fibrillation (n=3. Median survival time from diagnosis of tricuspid valve dysplasia was 2775 days (range 1-3696 days; 95% CI 1542.41-4007.59 and from onset of right-sided congestive heart failure was 181 days (range 1-2130 days; 95% CI 0-455.59. Syncope was the sole risk factor for cardiac death. In this population of UK dogs, tricuspid valve dysplasia was uncommon but, when severe, frequently led to right-sided congestive heart failure. Prognosis was favourable for mild and moderate tricuspid dysplasia. Survival time was reduced with right-sided congestive heart failure but varied widely. Risk of cardiac death was significantly increased if syncope had occurred.

  7. E-cigarettes, a safer alternative for teenagers? A UK focus group study of teenagers' views.

    Science.gov (United States)

    Hilton, Shona; Weishaar, Heide; Sweeting, Helen; Trevisan, Filippo; Katikireddi, Srinivasa Vittal

    2016-11-16

    Concerns exist that e-cigarettes may be a gateway to traditional cigarettes and/or (re)normalise teenage smoking. This qualitative study explores how teenagers in the UK currently perceive e-cigarettes and how and why they do or do not use them. 16 focus groups were conducted across the UK between November 2014 and February 2015, with 83 teenagers aged 14-17. All discussions were digitally recorded, transcribed verbatim, imported into NVivo 10 and thematically analysed. Teenagers generally agreed that e-cigarettes are useful products for smokers, including teenage smokers, to quit or reduce traditional cigarette use. Concerns were expressed about lack of information on their precise ingredients and any unknown risks for users and bystanders. However, teenagers typically viewed e-cigarettes as substantially less harmful than traditional cigarettes. They perceived e-cigarettes as attractive, with products described as 'fun' and having 'great flavourings'. Seeing websites or social media featuring e-cigarettes, especially YouTube 'vaping tricks', prompted some experimentation and imitation. E-cigarettes were used in a variety of situations, including at parties or when they could not smoke traditional cigarettes. A very few participants suggested covert use was a possibility and that e-cigarettes might help maintain a fledgling nicotine habit. Teenagers support the use of e-cigarettes as smoking cessation aids for established adult smokers. However, they engage with these products differently from adults, with the novel hypothesis that covert use could potentially reinforce traditional cigarette smoking requiring further investigation. Policy responses should more clearly meet the needs of young people, as well as helping established adult smokers. 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/.

  8. Women in senior post-graduate medicine career roles in the UK: a qualitative study.

    Science.gov (United States)

    Curtis, Anthony; Eley, Lizzie; Gray, Selena; Irish, Bill

    2016-01-01

    This qualitative study sought to elicit the views, experiences, career journeys and aspirations of women in senior post-graduate medical education roles to identify steps needed to help support career progression. In-depth semi-structured telephone interviews. UK. Purposive sample of 12 women in a variety of senior leadership roles in post-graduate medical education in the UK. Self reported motivating influences, factors that helped and hindered progress, key branch points, and key educational factors and social support impacting on participants' career in postgraduate medicine. Respondents often reported that career journeys were serendipitous, rather than planned, formal or well structured. Senior women leaders reported having a high internal locus of control, with very high levels of commitment to the NHS. All reported significant levels of drive, although the majority indicated that they were not ambitious in the sense of a strong drive for money, prestige, recognition or power. They perceived that there was an under-representation of women in senior leadership positions and that high-quality female mentorship was particularly important in redressing this imbalance. Social support, such a spouse or other significant family member, was particularly valued as reaffirming and supporting women's chosen career ambition. Factors that were considered to have hindered career progression included low self-confidence and self-efficacy, the so-called glass ceiling and perceived self-limiting cultural influences. Factors indirectly linked to gender such as part-time versus working full time were reportedly influential in being overlooked for senior leadership roles. Implications of these findings are discussed in the paper. Social support, mentorship and role modelling are all perceived as highly important in redressing perceived gender imbalances in careers in post-graduate medical education.

  9. Goiania incident case study

    International Nuclear Information System (INIS)

    Petterson, J.S.

    1988-06-01

    The reasons for wanting to document this case study and present the findings are simple. According to USDOE technical risk assessments (and our own initial work on the Hanford socioeconomic study), the likelihood of a major accident involving exposure to radioactive materials in the process of site characterization, construction, operation, and closure of a high-level waste repository is extremely remote. Most would agree, however, that there is a relatively high probability that a minor accident involving radiological contamination will occur sometime during the lifetime of the repository -- for example, during transport, at an MRS site or at the permanent site itself during repacking and deposition. Thus, one of the major concerns of the Yucca Mountain Socioeconomic Study is the potential impact of a relatively minor radiation-related accident. A large number of potential impact of a relatively minor radiation-related accident. A large number of potential accident scenarios have been under consideration (such as a transportation or other surface accident which results in a significant decline in tourism, the number of conventions, or the selection of Nevada as a retirement residence). The results of the work in Goiania make it clear, however, that such a significant shift in established social patterns and trends is not likely to occur as a direct outcome of a single nuclear-related accident (even, perhaps, a relatively major one), but rather, are likely to occur as a result of the enduring social interpretations of such an accident -- that is, as a result of the process of understanding, communicating, and socially sustaining a particular set of associations with respect to the initial incident

  10. Cross-Cultural Study of Information Processing Biases in Chronic Fatigue Syndrome: Comparison of Dutch and UK Chronic Fatigue Patients

    NARCIS (Netherlands)

    Hughes, Alicia M.; Hirsch, Colette R.; Nikolaus, Stephanie; Chalder, Trudie; Knoop, Hans; Moss-Morris, Rona

    2018-01-01

    This study aims to replicate a UK study, with a Dutch sample to explore whether attention and interpretation biases and general attentional control deficits in chronic fatigue syndrome (CFS) are similar across populations and cultures. Thirty eight Dutch CFS participants were compared to 52 CFS and

  11. FMCT verification: Case studies

    International Nuclear Information System (INIS)

    Hui Zhang

    2001-01-01

    Full text: How to manage the trade-off between the need for transparency and the concern about the disclosure of sensitive information would be a key issue during the negotiations of FMCT verification provision. This paper will explore the general concerns on FMCT verification; and demonstrate what verification measures might be applied to those reprocessing and enrichment plants. A primary goal of an FMCT will be to have the five declared nuclear weapon states and the three that operate unsafeguarded nuclear facilities become parties. One focus in negotiating the FMCT will be verification. Appropriate verification measures should be applied in each case. Most importantly, FMCT verification would focus, in the first instance, on these states' fissile material production facilities. After the FMCT enters into force, all these facilities should be declared. Some would continue operating to produce civil nuclear power or to produce fissile material for non- explosive military uses. The verification measures necessary for these operating facilities would be essentially IAEA safeguards, as currently being applied to non-nuclear weapon states under the NPT. However, some production facilities would be declared and shut down. Thus, one important task of the FMCT verifications will be to confirm the status of these closed facilities. As case studies, this paper will focus on the verification of those shutdown facilities. The FMCT verification system for former military facilities would have to differ in some ways from traditional IAEA safeguards. For example, there could be concerns about the potential loss of sensitive information at these facilities or at collocated facilities. Eventually, some safeguards measures such as environmental sampling might be seen as too intrusive. Thus, effective but less intrusive verification measures may be needed. Some sensitive nuclear facilities would be subject for the first time to international inspections, which could raise concerns

  12. In vitro studies with UK-18,892, a new aminoglycoside antibiotic.

    Science.gov (United States)

    Jevons, S; Cheeseman, H E; Brammer, K W

    1978-09-01

    The antibacterial activity of UK-18,892, a new semisynthetic aminoglycoside, was examined against aminoglycoside-susceptible and aminoglycoside-resistant clinical isolates of gram-negative bacilli and Staphylococcus aureus. UK-18,892 had a similar degree of activity to those of amikacin and kanamycin A against aminoglycoside-susceptible bacteria but was less potent than gentamicin against all isolates except Providencia spp. UK-18,892 was highly active against aminoglycoside-resistant bacteria, inhibiting 93% of the 268 isolates examined at 12.5 mug/ml. Amikacin was similarly active, whereas gentamicin inhibited only 14% of these isolates at 12.5 mug/ml.

  13. UK-based, multisite, prospective cohort study of small bowel obstruction in acute surgical services: National Audit of Small Bowel Obstruction (NASBO) protocol.

    Science.gov (United States)

    Lee, Matthew J; Sayers, Adele E; Drake, Thomas M; Hollyman, Marianne; Bradburn, Mike; Hind, Daniel; Wilson, Timothy R; Fearnhead, Nicola S

    2017-10-05

    Small bowel obstruction (SBO) is a common indication for emergency laparotomy in the UK, which is associated with a 90-day mortality rate of 13%. There are currently no UK clinical guidelines for the management of this condition. The aim of this multicentre prospective cohort study is to describe the burden, variation in management and associated outcomes of SBO in the UK adult population. UK hospitals providing emergency general surgery are eligible to participate. This study has three components: (1) a clinical preference questionnaire to be completed by consultants providing emergency general surgical care to assesses preferences in diagnostics and therapeutic approaches, including laparoscopy and nutritional interventions; (2) site resource profile questionnaire to indicate ease of access to diagnostic services, operating theatres, nutritional support teams and postoperative support including intensive care; (3) prospective cohort study of all cases of SBO admitted during an 8-week period at participating trusts. Data on diagnostics, operative and nutritional interventions, and in-hospital mortality and morbidity will be captured, followed by data validation. This will be conducted as a national audit of practice in conjunction with trainee research collaboratives, with support from patient representatives, surgeons, anaesthetists, gastroenterologists and a clinical trials unit. Site-specific reports will be provided to each participant site as well as an overall report to be disseminated through specialist societies. Results will be published in a formal project report endorsed by stakeholders, and in peer-reviewed scientific reports. Key findings will be debated at a focused national meeting with a view to quality improvement initiatives. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Impacts of energy legislation on organizational motivation: a case study

    OpenAIRE

    Roberts, C.; Bobrova, Y.; Marjanovic-Halburd, L.

    2017-01-01

    In an attempt to reduce operational energy use in non-domestic buildings and mitigate climate change, the UK government has introduced Energy Savings Opportunity Scheme (ESOS) legislation to motivate large organizations to implement energy-efficiency (EE) measures. However, evidence suggests that an organization’s behaviour with regard to EE measures does not follow rational cost minimization, demonstrating potential ESOS weakness. A case study is presented that assesses whether ESOS can lead...

  15. Final report on case studies

    DEFF Research Database (Denmark)

    Ljungberg, Daniel; McKelvey, Maureen; Lassen, Astrid Heidemann

    2012-01-01

    Case study as a research design means investigating a single or multiple instance(s) or setting(s) (i.e. a case) and its entire context to explain a phenomenon and its processes. This is achieved through detailed understanding, usually comprised of multiple sources of information. In this way, case...... studies attempt to provide as a complete an understanding of a (complex) phenomenon as possible. Within the AEGIS project, survey and case study research are complementary. They are complementary in the sense that the former can provide more generalizable evidence on a phenomenon in terms of cross......-sectional data, while the latter can provide more in-depth (qualitative) understanding on specific issues. In systematically examining the case studies, however, this report goes beyond a typical single case study. Here we provide a synthesis of 86 case studies. Multiple case studies, following similar focus...

  16. 425 Case study

    African Journals Online (AJOL)

    Marinda

    Anaesthesia management of acute aortic dissection type B in ... of a severe, constant abdominal and chest pain radiating to the ... Continuous spinal anaesthesia was induced ... these cases surgical intervention is critical.1,2 Type B of AAD is.

  17. Diagnosis and management of polycystic ovary syndrome in the UK (2004-2014): a retrospective cohort study.

    Science.gov (United States)

    Ding, Tao; Baio, Gianluca; Hardiman, Paul J; Petersen, Irene; Sammon, Cormac

    2016-07-11

    To estimate the incidence and prevalence of polycystic ovary syndrome (PCOS) in UK primary care and investigate prescribing patterns before and after a PCOS diagnosis. Retrospective cohort study. UK primary care (2004-2014). Women aged 15-45 years. The incidence and prevalence of diagnosed PCOS and probable PCOS (ie, those without a confirmed diagnosis but with at least 2 PCOS features recorded within 3 years). Among women with diagnosed or probable PCOS, the prevalence of prescribing of drugs typically used to treat PCOS was calculated prior to and in the 24 months after the diagnosis of PCOS. We identified 7233 women with PCOS diagnoses and 7057 women with records suggestive of probable PCOS, corresponding to incidence rates of 0.93 and 0.91 per 1000 person-years at risk (PYAR) and an overall rate of 1.84 per 1000 PYAR. Women aged 20-24 years and women living in deprived areas had the highest incidence of PCOS. The prevalence of PCOS in 2014 was ∼2%. The proportion of women with a prescription in the 24 months after their PCOS index date varied by drug type: 10.2% metformin, 15.2% combined oral contraceptives, 18.8% acne-related treatments, 1.93% clomiphene, 1.0% spironolactone, 0.28% cyproterone and 3.11% eflornithine. Acne-related treatments were more commonly used to treat probable (28.3%) than diagnosed (12.3%) cases, while metformin was prescribed much more commonly in diagnosed cases. In conclusion, compared to rates estimated in community samples, the incidence and prevalence of women presenting in primary care with PCOS diagnoses and features are low, indicating that PCOS is an under-recognised condition. Although considerable variation is observed in treatments prescribed to women with PCOS, the treatments initiated following a confirmed diagnosis generally reflect the long-term prognostic concerns raised in PCOS consensuses. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please

  18. Cancer-associated autoantibodies to MUC1 and MUC4--a blinded case–control study of colorectal cancer in UK collaborative trial of ovarian cancer screening

    DEFF Research Database (Denmark)

    Pedersen, Johannes W; Gentry-Maharaj, Aleksandra; Nøstdal, Alexander

    2014-01-01

    of colorectal cancer diagnosis and healthy controls. Subsequently, the selected biomarkers were evaluated in a blinded nested case–control study using stored serum samples from among the 50,640 women randomized to the multimodal arm of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), where......, at 95% specificity. IgA to MUC4 glycoforms were unable to discriminate between cases and controls in the UKCTOCS sera. Additional analysis was undertaken by combining the data of MUC1-STn and MUC1-Core3 with previously generated data on autoantibodies to p53 peptides, which increased the sensitivity...

  19. How appropriate are the English language test requirements for non-UK-trained nurses? A qualitative study of spoken communication in UK hospitals.

    Science.gov (United States)

    Sedgwick, Carole; Garner, Mark

    2017-06-01

    Non-native speakers of English who hold nursing qualifications from outside the UK are required to provide evidence of English language competence by achieving a minimum overall score of Band 7 on the International English Language Testing System (IELTS) academic test. To describe the English language required to deal with the daily demands of nursing in the UK. To compare these abilities with the stipulated levels on the language test. A tracking study was conducted with 4 nurses, and focus groups with 11 further nurses. The transcripts of the interviews and focus groups were analysed thematically for recurrent themes. These findings were then compared with the requirements of the IELTS spoken test. The study was conducted outside the participants' working shifts in busy London hospitals. The participants in the tracking study were selected opportunistically;all were trained in non-English speaking countries. Snowball sampling was used for the focus groups, of whom 4 were non-native and 7 native speakers of English. In the tracking study, each of the 4 nurses was interviewed on four occasions, outside the workplace, and as close to the end of a shift as possible. They were asked to recount their spoken interactions during the course of their shift. The participants in the focus groups were asked to describe their typical interactions with patients, family members, doctors, and nursing colleagues. They were prompted to recall specific instances of frequently-occurring communication problems. All interactions were audio-recorded, with the participants' permission,and transcribed. Nurses are at the centre of communication for patient care. They have to use appropriate registers to communicate with a range of health professionals, patients and their families. They must elicit information, calm and reassure, instruct, check procedures, ask for and give opinions,agree and disagree. Politeness strategies are needed to avoid threats to face. They participate in medical

  20. Institutional limits to the internalization of work systems : A comparative study of three Japanese multinational companies in the UK

    NARCIS (Netherlands)

    Saka, A

    2002-01-01

    This study adopts a multilevel comparative approach to investigating the degree to which Japanese work systems are implemented and internalized in the UK business system. The focus is on the limits to accepting the continuous improvement schemes of Japanese multinational corporations. The article

  1. Comparative study on fashion & textile design higher education system, Pakistan vs UK

    Science.gov (United States)

    Hameed, Umer; Umer, Saima

    2017-10-01

    of higher education and it also highlight the different pathway that leads to the different type of man power in this domain. Presented research will focus on the study of different modules of textile & Apparel Design Higher Education in Pakistan & UK. Its relation and comparison will be an important area of study. Research work document the Educational modules, its implementation and impact on industry. Afterwards this data was used for comparative study between higher education systems in Textile & Fashion Design

  2. Study of tidal power projects in the UK, with the exception of the Severn barrage

    International Nuclear Information System (INIS)

    Shaw, T.L.

    1997-01-01

    Several estuaries in the UK could be equipped with barrages and tidal power plants and several projects were proposed and studied from the end of the 1960's and 1989, until the electric power industry was privatized. Five projects revealed to be more promising than others: the Conwy estuary in the north of Wales, for which the feasibility study concluded that there was no serious environmental constraints on the project; Duddon, a little bit more in the north, which appears to be not economically interesting; Loughor, in the south of Wales, a small size project for which no advanced ecological consequences studies were carried out; Mersey, near Liverpool, the most important project (700 MW) which stands a good chance of being realized; the Wyre estuary, between Duddon and Mersey, for which the cost seems to be prohibitive. The economical conditions which started in the 1980's are largely responsible for the stand-by of any of these projects. The tide power kWh production cost continues to be viewed as two times more expensive than it would be with a classical power plant. Of course, this cost takes into account the actions for environmental protection. (J.S.)

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

    Science.gov (United States)

    Hourd, P C; Williams, D J

    2008-07-01

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

  4. Gender Implications of UK Welfare Reform and Government Equality Duties: Evidence from Qualitative Studies

    Directory of Open Access Journals (Sweden)

    Fran Bennett

    2013-12-01

    Full Text Available The UK coalition government is bound by equality duties to have regard to the impact of its policies on various groups, including women. This article investigates how far this legislative commitment is influencing debates about current welfare reforms, especially plans for ‘universal credit’ (a new means-tested benefit. The authors draw on findings from recent studies of within-household distribution from a gender perspective, including their own qualitative research. A major aim of this research was to facilitate more nuanced analysis of the effects of welfare reforms in terms of gender roles and relationships within the household. This article therefore examines how far findings from qualitative studies, in conjunction with the key principles they develop for assessing the gender impact of welfare reforms, can be used to examine ‘universal credit’; and to what extent these influenced the UK government’s proposals and analysis in the light of its commitment to equality duties. Los derechos de igualdad obligan al gobierno de coalición del Reino Unido a tener en cuenta el impacto de sus políticas sobre varios grupos, incluidas las mujeres. En este artículo se investiga hasta qué punto este compromiso legislativo está influyendo en los debates sobre las reformas de bienestar actuales, especialmente los planes de “crédito universal” (un nuevo beneficio de ingreso. Los autores se basan en los resultados de estudios recientes sobre la distribución dentro de los hogares desde una perspectiva de género, incluida su propia investigación cualitativa. Un objetivo principal de esta investigación era el de facilitar un análisis más matizado de los efectos de las reformas de bienestar en términos de roles y relaciones de género dentro del hogar. Por tanto, este artículo examina hasta qué punto los resultados de estudios cualitativos, en relación con los principios fundamentales que se desarrollan para evaluar el impacto de g

  5. Height, body mass index, and socioeconomic status: mendelian randomisation study in UK Biobank.

    Science.gov (United States)

    Tyrrell, Jessica; Jones, Samuel E; Beaumont, Robin; Astley, Christina M; Lovell, Rebecca; Yaghootkar, Hanieh; Tuke, Marcus; Ruth, Katherine S; Freathy, Rachel M; Hirschhorn, Joel N; Wood, Andrew R; Murray, Anna; Weedon, Michael N; Frayling, Timothy M

    2016-03-08

    To determine whether height and body mass index (BMI) have a causal role in five measures of socioeconomic status. Mendelian randomisation study to test for causal effects of differences in stature and BMI on five measures of socioeconomic status. Mendelian randomisation exploits the fact that genotypes are randomly assigned at conception and thus not confounded by non-genetic factors. UK Biobank. 119,669 men and women of British ancestry, aged between 37 and 73 years. Age completed full time education, degree level education, job class, annual household income, and Townsend deprivation index. In the UK Biobank study, shorter stature and higher BMI were observationally associated with several measures of lower socioeconomic status. The associations between shorter stature and lower socioeconomic status tended to be stronger in men, and the associations between higher BMI and lower socioeconomic status tended to be stronger in women. For example, a 1 standard deviation (SD) higher BMI was associated with a £210 (€276; $300; 95% confidence interval £84 to £420; P=6 × 10(-3)) lower annual household income in men and a £1890 (£1680 to £2100; P=6 × 10(-15)) lower annual household income in women. Genetic analysis provided evidence that these associations were partly causal. A genetically determined 1 SD (6.3 cm) taller stature caused a 0.06 (0.02 to 0.09) year older age of completing full time education (P=0.01), a 1.12 (1.07 to 1.18) times higher odds of working in a skilled profession (P=6 × 10(-7)), and a £1130 (£680 to £1580) higher annual household income (P=4 × 10(-8)). Associations were stronger in men. A genetically determined 1 SD higher BMI (4.6 kg/m(2)) caused a £2940 (£1680 to £4200; P=1 × 10(-5)) lower annual household income and a 0.10 (0.04 to 0.16) SD (P=0.001) higher level of deprivation in women only. These data support evidence that height and BMI play an important partial role in determining several aspects of a person

  6. Height, body mass index, and socioeconomic status: mendelian randomisation study in UK Biobank

    Science.gov (United States)

    Tyrrell, Jessica; Jones, Samuel E; Beaumont, Robin; Astley, Christina M; Lovell, Rebecca; Yaghootkar, Hanieh; Tuke, Marcus; Ruth, Katherine S; Freathy, Rachel M; Hirschhorn, Joel N; Wood, Andrew R; Murray, Anna; Weedon, Michael N

    2016-01-01

    Objective To determine whether height and body mass index (BMI) have a causal role in five measures of socioeconomic status. Design Mendelian randomisation study to test for causal effects of differences in stature and BMI on five measures of socioeconomic status. Mendelian randomisation exploits the fact that genotypes are randomly assigned at conception and thus not confounded by non-genetic factors. Setting UK Biobank. Participants 119 669 men and women of British ancestry, aged between 37 and 73 years. Main outcome measures Age completed full time education, degree level education, job class, annual household income, and Townsend deprivation index. Results In the UK Biobank study, shorter stature and higher BMI were observationally associated with several measures of lower socioeconomic status. The associations between shorter stature and lower socioeconomic status tended to be stronger in men, and the associations between higher BMI and lower socioeconomic status tended to be stronger in women. For example, a 1 standard deviation (SD) higher BMI was associated with a £210 (€276; $300; 95% confidence interval £84 to £420; P=6×10−3) lower annual household income in men and a £1890 (£1680 to £2100; P=6×10−15) lower annual household income in women. Genetic analysis provided evidence that these associations were partly causal. A genetically determined 1 SD (6.3 cm) taller stature caused a 0.06 (0.02 to 0.09) year older age of completing full time education (P=0.01), a 1.12 (1.07 to 1.18) times higher odds of working in a skilled profession (P=6×10−7), and a £1130 (£680 to £1580) higher annual household income (P=4×10−8). Associations were stronger in men. A genetically determined 1 SD higher BMI (4.6 kg/m2) caused a £2940 (£1680 to £4200; P=1×10−5) lower annual household income and a 0.10 (0.04 to 0.16) SD (P=0.001) higher level of deprivation in women only. Conclusions These data support evidence that height and BMI play an

  7. Rising burden of gout in the UK but continuing suboptimal management: a nationwide population study

    Science.gov (United States)

    Kuo, Chang-Fu; Grainge, Matthew J; Mallen, Christian; Zhang, Weiya; Doherty, Michael

    2015-01-01

    Objectives To describe trends in the epidemiology of gout and patterns of urate-lowering treatment (ULT) in the UK general population from 1997 to 2012. Methods We used the Clinical Practice Research Datalink to estimate the prevalence and incidence of gout for each calendar year from 1997 to 2012. We also investigated the pattern of gout management for both prevalent and incident gout patients. Results In 2012, the prevalence of gout was 2.49% (95% CI 2.48% to 2.51%) and the incidence was 1.77 (95% CI 1.73 to 1.81) per 1000 person-years. Prevalence and incidence both were significantly higher in 2012 than in 1997, with a 63.9% increase in prevalence and 29.6% increase in incidence over this period. Regions with highest prevalence and incidence were the North East and Wales. Among prevalent gout patients in 2012, only 48.48% (95% CI 48.08% to 48.89%) were being consulted specifically for gout or treated with ULT and of these 37.63% (95% CI 37.28% to 38.99%) received ULT. In addition, only 18.6% (95% CI 17.6% to 19.6%) of incident gout patients received ULT within 6 months and 27.3% (95% CI 26.1% to 28.5%) within 12 months of diagnosis. The management of prevalent and incident gout patients remained essentially the same during the study period, although the percentage of adherent patients improved from 28.28% (95% CI 27.33% to 29.26%) in 1997 to 39.66% (95% CI 39.11% to 40.22%) in 2012. Conclusions In recent years, both the prevalence and incidence of gout have increased significantly in the UK. Suboptimal use of ULT has not changed between 1997 and 2012. Patient adherence has improved during the study period, but it remains poor. PMID:24431399

  8. Incidence of and risk factors for Motor Neurone Disease in UK women: a prospective study

    Directory of Open Access Journals (Sweden)

    Doyle Pat

    2012-05-01

    Full Text Available Abstract Background Motor neuron disease (MND is a severe neurodegenerative disease with largely unknown etiology. Most epidemiological studies are hampered by small sample sizes and/or the retrospective collection of information on behavioural and lifestyle factors. Methods 1.3 million women from the UK Million Women Study, aged 56 years on average at recruitment, were followed up for incident and/or fatal MND using NHS hospital admission and mortality data. Adjusted relative risks were calculated using Cox regression models. Findings During follow-up for an average of 9·2 years, 752 women had a new diagnosis of MND. Age-specific rates increased with age, from 1·9 (95% CI 1·3 – 2·7 to 12·5 (95% CI 10·2 – 15·3 per 100,000 women aged 50–54 to 70–74, respectively, giving a cumulative risk of diagnosis with the disease of 1·74 per 1000 women between the ages of 50 and 75 years. There was no significant variation in risk of MND with region of residence, socio-economic status, education, height, alcohol use, parity, use of oral contraceptives or hormone replacement therapy. Ever-smokers had about a 20% greater risk than never smokers (RR 1·19 95% CI 1·02 to 1·38, p = 0·03. There was a statistically significant reduction in risk of MND with increasing body mass index (pfor trend = 0·009: obese women (body mass index, 30 kg/m2 or more had a 20% lower risk than women of normal body mass index (20 to 2(RR 0·78 95% CI 0·65-0·94; p = 0·03. This effect persisted after exclusion of the first three years of follow-up. Interpretation MND incidence in UK women rises rapidly with age, and an estimated 1 in 575 women are likely to be affected between the ages of 50 and 75 years. Smoking slightly increases the risk of MND, and adiposity in middle age is associated with a lower risk of the disease.

  9. Access to food retail outlets in County Durham, UK: a pragmatic cross-sectional study.

    Science.gov (United States)

    Mills, Susanna; Wright, Tim

    2015-02-26

    Strong links exist between deprivation, obesity, and dietary quality. Increasing interest has focussed on the concept of access to food and so-called food deserts, defined by a policy working group of the UK Low Income Project Team in 1995 as "areas of relative exclusion where people experience physical and economic barriers to accessing healthy food". We aimed to establish the accessibility of food retail outlets in County Durham, a county in north-east England, UK, considering physical access, affordability, and food range and quality. In a pragmatic cross-sectional study in County Durham, we used information from town surveys and food business databases to locate and identify food retail outlets. The prevalence of deprivation, obesity, retail outlets, takeaway outlets, and ratio of retail to takeaway outlets was mapped, to establish local food access, and any associations with deprivation and obesity. The times taken to travel from residences to supermarkets using private car and public transport were also measured. 400 members of the community participated in eight focus groups and commissioned on-street surveys. Focus group transcripts were reviewed alongside the on-street survey responses to identify key issues. Most residents shopped at least weekly for food (n=368, 92%), used a supermarket for their main food shop (372, 93%), travelled for up to 15 min (340, 85%), and used a car for transport (188, 47%). Many survey respondents indicated high levels of satisfaction with food retail outlets (average rating 8·7 out of 10 for agreement with the statement "Overall I am satisfied with the shop where I do my main food shopping"), although financial constraints and transport inconvenience were identified as barriers. Difficulties with food shopping were more widely described in focus groups, and many individuals felt that local shopping provision had declined, with an emergent excess of takeaway outlets. Food retail access was reduced for the disabled, full

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

    Science.gov (United States)

    McKenna, Caoimhe; Law, Catherine; Pearce, Anna

    2017-03-09

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

  11. Facilitating professional liaison in collaborative care for depression in UK primary care; a qualitative study utilising normalisation process theory.

    Science.gov (United States)

    Coupe, Nia; Anderson, Emma; Gask, Linda; Sykes, Paul; Richards, David A; Chew-Graham, Carolyn

    2014-05-01

    Collaborative care (CC) is an organisational framework which facilitates the delivery of a mental health intervention to patients by case managers in collaboration with more senior health professionals (supervisors and GPs), and is effective for the management of depression in primary care. However, there remains limited evidence on how to successfully implement this collaborative approach in UK primary care. This study aimed to explore to what extent CC impacts on professional working relationships, and if CC for depression could be implemented as routine in the primary care setting. This qualitative study explored perspectives of the 6 case managers (CMs), 5 supervisors (trial research team members) and 15 general practitioners (GPs) from practices participating in a randomised controlled trial of CC for depression. Interviews were transcribed verbatim and data was analysed using a two-step approach using an initial thematic analysis, and a secondary analysis using the Normalisation Process Theory concepts of coherence, cognitive participation, collective action and reflexive monitoring with respect to the implementation of CC in primary care. Supervisors and CMs demonstrated coherence in their understanding of CC, and consequently reported good levels of cognitive participation and collective action regarding delivering and supervising the intervention. GPs interviewed showed limited understanding of the CC framework, and reported limited collaboration with CMs: barriers to collaboration were identified. All participants identified the potential or experienced benefits of a collaborative approach to depression management and were able to discuss ways in which collaboration can be facilitated. Primary care professionals in this study valued the potential for collaboration, but GPs' understanding of CC and organisational barriers hindered opportunities for communication. Further work is needed to address these organisational barriers in order to facilitate

  12. A qualitative study of the impact of the UK 'bedroom tax'.

    Science.gov (United States)

    Moffatt, S; Lawson, S; Patterson, R; Holding, E; Dennison, A; Sowden, S; Brown, J

    2016-06-01

    The implementation of the 'Removal of the Spare Room Subsidy' in April 2013, commonly known as the 'bedroom tax', affects an estimated 660 000 working age social housing tenants in the UK, reducing weekly incomes by £12-£22. This study aimed to examine the impact of this tax on health and wellbeing in a North East England community in which 68.5% of residents live in social housing. Qualitative study using interviews and a focus group with 38 social housing tenants and 12 service providers. Income reduction affected purchasing power for essentials, particularly food and utilities. Participants recounted negative impacts on mental health, family relationships and community networks. The hardship and debt that people experienced adversely affected their social relationships and ability to carry out normal social roles. Residents and service providers highlighted negative impacts on the neighbourhood, as well as added pressure on already strained local services. The bedroom tax has increased poverty and had broad-ranging adverse effects on health, wellbeing and social relationships within this community. These findings strengthen the arguments for revoking this tax. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health.

  13. Has publication of the results of the ORACLE Children Study changed practice in the UK?

    Science.gov (United States)

    Kenyon, S; Pike, K; Jones, D; Brocklehurst, P; Marlow, N; Salt, A; Taylor, D

    2010-10-01

      To investigate whether publication of the results of the ORACLE Children's Study, a 7-year follow-up of the ORACLE trial, changed practice with regard to the routine prescription of antibiotics to women with preterm rupture of membranes or spontaneous preterm labour (intact membranes).   A comparative questionnaire survey of clinical practice in November 2007 (before publication) and March 2009 (after publication).   Lead obstetricians for labour wards of all maternity units in the UK.   Self-administered questionnaires requested information about the routine prescription of antibiotics to women with either preterm rupture of membranes or spontaneous preterm labour (intact membranes).   Change in practice for prescription of antibiotics.   The response rate was 166/214 (78%) in 2007 and 158/209 (76%) in 2009. In total, 120 maternity units responded on both occasions. For women with preterm rupture of membranes, 162/214 (98%) in 2007 and 151/158 (96%) in 2009 maternity units reported that they prescribed antibiotics, with the majority using erythromycin (98%). For women with spontaneous preterm labour (intact membranes), 35/166 (21%) in 2007 and 25/158 (16%) in 2009 maternity units reported that they routinely prescribed antibiotics. The findings from units who responded on both occasions are similar.   There has been little change in the reported prescription of antibiotics to women with either preterm rupture of membranes or spontaneous preterm labour following publication of the ORACLE Children's Study. This suggests that current practice may require updated guidance.

  14. Puberty timing associated with diabetes, cardiovascular disease and also diverse health outcomes in men and women: the UK Biobank study.

    Science.gov (United States)

    Day, Felix R; Elks, Cathy E; Murray, Anna; Ong, Ken K; Perry, John R B

    2015-06-18

    Early puberty timing is associated with higher risks for type 2 diabetes (T2D) and cardiovascular disease in women and therefore represents a potential target for early preventive interventions. We characterised the range of diseases and other adverse health outcomes associated with early or late puberty timing in men and women in the very large UK Biobank study. Recalled puberty timing and past/current diseases were self-reported by questionnaire. We limited analyses to individuals of White ethnicity (250,037 women; 197,714 men) and to disease outcomes with at least 500 cases (~ 0.2% prevalence) and we applied stringent correction for multiple testing (corrected threshold P puberty timing was associated with higher risks for angina, hypertension and T2D. Furthermore, compared to the median/average group, earlier or later puberty timing in women or men was associated with higher risks for 48 adverse outcomes, across a range of cancers, cardio-metabolic, gynaecological/obstetric, gastrointestinal, musculoskeletal, and neuro-cognitive categories. Notably, both early and late menarche were associated with higher risks for early natural menopause in women. Puberty timing in both men and women appears to have a profound impact on later health.

  15. Cultural responses to pain in UK children of primary school age: a mixed-methods study.

    Science.gov (United States)

    Azize, Pary M; Endacott, Ruth; Cattani, Allegra; Humphreys, Ann

    2014-06-01

    Pain-measurement tools are often criticized for not addressing the influence of culture and ethnicity on pain. This study examined how children who speak English as a primary or additional language discuss pain. Two methods were used in six focus group interviews with 34 children aged 4-7 years: (i) use of drawings from the Pediatric Pain Inventory to capture the language used by children to describe pain; and (ii) observation of the children's placing of pain drawings on red/amber/green paper to denote perceived severity of pain. The findings demonstrated that children with English as an additional language used less elaborate language when talking about pain, but tended to talk about the pictures prior to deciding where they should be placed. For these children, there was a positive significant relationship between language, age, and length of stay in the UK. The children's placement of pain drawings varied according to language background, sex, and age. The findings emphasize the need for sufficient time to assess pain adequately in children who do not speak English as a first language. © 2013 Wiley Publishing Asia Pty Ltd.

  16. Depression in primary care patients with coronary heart disease: baseline findings from the UPBEAT UK study.

    Directory of Open Access Journals (Sweden)

    Paul Walters

    Full Text Available An association between depression and coronary heart disease is now accepted but there has been little primary care research on this topic. The UPBEAT-UK studies are centred on a cohort of primary patients with coronary heart disease assessed every six months for up to four years. The aim of this research was to determine the prevalence and associations of depression in this cohort at baseline.Participants with coronary heart disease were recruited from general practice registers and assessed for cardiac symptoms, depression, quality of life and social problems.803 people participated. 42% had a documented history of myocardial infarction, 54% a diagnosis of ischaemic heart disease or angina. 44% still experienced chest pain. 7% had an ICD-10 defined depressive disorder. Factors independently associated with this diagnosis were problems living alone (OR 5.49, 95% CI 2.11-13.30, problems carrying out usual activities (OR 3.71, 95% CI 1.93-7.14, experiencing chest pain (OR 3.27, 95% CI 1.58-6.76, other pains or discomfort (OR 3.39, 95% CI 1.42-8.10, younger age (OR 0.95 per year 95% CI 0.92-0.98.Problems living alone, chest pain and disability are important predictors of depression in this population.

  17. Children's views on research without prior consent in emergency situations: a UK qualitative study.

    Science.gov (United States)

    Roper, Louise; Sherratt, Frances C; Young, Bridget; McNamara, Paul; Dawson, Angus; Appleton, Richard; Crawley, Esther; Frith, Lucy; Gamble, Carrol; Woolfall, Kerry

    2018-06-09

    We explored children's views on research without prior consent (RWPC) and sought to identify ways of involving children in research discussions. Qualitative interview study. Participants were recruited through a UK children's hospital and online advertising. 16 children aged 7-15 years with a diagnosis of asthma (n=14) or anaphylaxis (n=2) with recent (<12 months) experience of emergency care. Children were keen to be included in medical research and viewed RWPC as acceptable in emergency situations if trial interventions were judged safe. Children trusted that doctors would know about their trial participation and act in their best interests. All felt that children should be informed about the research following their recovery and involved in discussions with a clinician or their parent(s) about the use of data already collected as well as continued participation in the trial (if applicable). Participants suggested methods to inform children about their trial participation including an animation. Children supported, and were keen to be involved in, clinical trials in emergency situations. We present guidance and an animation that practitioners and parents might use to involve children in trial discussions following their recovery. © 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.

  18. What is the impact of giant cell arteritis on patients’ lives? A UK qualitative study

    Science.gov (United States)

    Liddle, Jennifer; Bartlam, Roisin; Mallen, Christian D; Mackie, Sarah L; Prior, James A; Helliwell, Toby; Richardson, Jane C

    2017-01-01

    Objectives Clinical management of giant cell arteritis (GCA) involves balancing the risks and burdens arising from the disease with those arising from treatment, but there is little research on the nature of those burdens. We aimed to explore the impact of giant cell arteritis (GCA) and its treatment on patients’ lives. Methods UK patients with GCA participated in semi-structured telephone interviews. Inductive thematic analysis was employed. Results 24 participants were recruited (age: 65–92 years, time since diagnosis: 2 months to >6 years). The overarching themes from analysis were: ongoing symptoms of the disease and its treatment; and ‘life-changing’ impacts. The overall impact of GCA on patients’ lives arose from a changing combination of symptoms, side effects, adaptations to everyday life and impacts on sense of normality. Important factors contributing to loss of normality were glucocorticoid-related treatment burdens and fear about possible future loss of vision. Conclusions The impact of GCA in patients’ everyday lives can be substantial, multifaceted and ongoing despite apparent control of disease activity. The findings of this study will help doctors better understand patient priorities, legitimise patients’ experiences of GCA and work with patients to set realistic treatment goals and plan adaptations to their everyday lives. PMID:28838902

  19. Costs of a healthy diet: analysis from the UK Women's Cohort Study.

    Science.gov (United States)

    Cade, J; Upmeier, H; Calvert, C; Greenwood, D

    1999-12-01

    To investigate the direct and indirect cost differences associated with eating a 'healthy' or 'unhealthy' diet. Analysis of data from a baseline postal questionnaire for the UK Women's Cohort Study, including a detailed food frequency questionnaire (FFQ), supplemented by a telephone interview on a sub-sample. The first 15,191 women who responded to the questionnaire, aged 35-69 years with similar numbers of meat eaters, fish eaters and vegetarians. A healthy diet indicator (hdi), with values from 0 (lowest) to 8 (highest) was developed based on the WHO dietary recommendations. Direct monetary cost of the diet was calculated using prices from the 1995 National Food Survey and the Tesco home shopping catalogue. Women in the healthy diet group were almost four times as likely to be vegetarian and have a higher educational level. For direct costs, the difference between the most extreme hdi groups was 1.48 day-1 (equivalent to 540 year-1), with fruit and vegetable expenditure being the main items making a healthy diet more expensive. Forty-nine per cent of the food budget was spent on fruit and vegetables in hdi group 8 compared to 29% in hdi group 0. Interestingly, 52% of those questioned in both extreme hdi groups did not think that it was difficult to eat healthily. To achieve a particularly healthy diet independent predictive factors were spending more money, being a vegetarian, having a higher energy intake, having a lower body mass index (BMI) and being older.

  20. A cohort mortality study of lead-exposed workers in the USA, Finland and the UK.

    Science.gov (United States)

    Steenland, Kyle; Barry, Vaughn; Anttila, Ahti; Sallmén, Markku; McElvenny, Damien; Todd, A C; Straif, Kurt

    2017-11-01

    To investigate further whether inorganic lead is a carcinogen among adults, or associated with increased blood pressure and kidney damage, via a large mortality study. We conducted internal analyses via Cox regression of mortality in three cohorts of lead-exposed workers with blood lead (BL) data (USA, Finland, UK), including over 88 000 workers and over 14 000 deaths. Our exposure metric was maximum BL. We also conducted external analyses using country-specific background rates. The combined cohort had a median BL of 26 µg/dL, a mean first-year BL test of 1990 and was 96% male. Fifty per cent had more than one BL test (mean 7). Significant (p40 µg/dL; for bladder, lung and larynx cancer; and for COPD. In a small subsample of the US cohort (n=115) who were interviewed, we found no association between smoking and BL. We found strong positive mortality trends, with increasing BL level, for several outcomes in internal analysis. Many of these outcomes are associated with smoking, for which we had no data. A borderline trend was found for brain cancer, not associated with smoking. © 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.

  1. Restoration of a wild grey partridge shoot: a major development in the Sussex study, UK

    Directory of Open Access Journals (Sweden)

    Ewald, J. A.

    2012-01-01

    Full Text Available The scientific basis of wild grey partridge management has been known for a generation. This includes controlling nest predators, providing nesting cover, having sufficient insect food for chicks and appropriate rates of shooting. More recently, measures such as providing food for adult birds and habitats for protection from birds of prey have also been considered important. Habitat provision can be expensive, but in the UK costs can be partially recovered through governmental agri–environment schemes. The landowner still needs to pay for the essential gamekeeper. Since 2003/04, one part of the Game & Wildlife Conservation Trust’s (GWCT Sussex Study area has put these principles of environmental management into practice with the aim of restoring a wild grey partridge shoot to this part of Southern England. Results have been impressive, with the spring pair density increasing from 0.3 pairs/100 ha in 2003 to nearly 20 pairs/100 ha in 2010 on an area of just over 10 km2. Over the past two years a wild grey partridge shoot has taken place, and the landowner and his team have gained national recognition for their conservation work.

  2. Parasagittal fractures of the proximal phalanx in Thoroughbred racehorses in the UK: Outcome of repaired fractures in 113 cases (2007-2011).

    Science.gov (United States)

    Smith, M R W; Corletto, F C; Wright, I M

    2017-11-01

    Thirty years have elapsed since the last published review of outcome following fracture of the proximal phalanx in Thoroughbred racehorses in the UK and contemporary results are needed to be able to advise of expected outcome. Collect and analyse outcome data following repair of fractures of the proximal phalanx in Thoroughbred racehorses in the UK. Retrospective case series. Case records of all Thoroughbred racehorses admitted to Newmarket Equine Hospital for evaluation of a parasagittal fracture of the proximal phalanx during a 5 years period were reviewed. Follow-up data regarding racing careers was collected for horses that underwent repair. Following exclusion of outliers, cases with incomplete data sets and comminuted fractures, mixed effect logistic regression was used to identify variables affecting returning to racing and odds ratios and confidence intervals calculated. Of 113 repaired cases, fracture configurations included short incomplete parasagittal (n = 12), long incomplete parasagittal (n = 86), complete parasagittal (n = 12) and comminuted (n = 3). A total of 54 (48%) cases raced after surgery. Horses that fractured at 2 years of age had increased odds of racing following surgery than those older than 2 years of age (OR 1.34; 95% CI 1.13-1.59, P = 0.002). Horses sustaining short incomplete parasagittal fractures had increased odds of racing following surgery compared with those with complete parasagittal fractures (OR 2.62; 95% CI 1.36-5.07, P = 0.006). No horses with comminuted fractures returned to racing. Data are relevant only to Thoroughbred racehorses in the UK. Approximately half of the cases in this series raced following surgical repair. More 2-year-old horses raced following surgery, but this likely reflects horses, specifically older horses, passing out of training from unrelated factors. Fracture configuration affects odds of racing, which is relevant to owners when deciding on treatment. © 2017 EVJ Ltd.

  3. Emotion, Engagement, and Case Studies

    Science.gov (United States)

    Herreid, Clyde Freeman; Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric

    2014-01-01

    Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

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

    Directory of Open Access Journals (Sweden)

    Macdonald Clare

    2008-02-01

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

  5. Mental health consequences of overstretch in the UK Armed Forces, 2007-09: a population-based cohort study.

    Science.gov (United States)

    Rona, Roberto J; Jones, Margaret; Keeling, Mary; Hull, Lisa; Wessely, Simon; Fear, Nicola T

    2014-12-01

    Concerns have been raised about the effect of tour length on the mental health of the UK armed forces. In 2007, we reported that cumulative length of deployment was associated with mental illness in military personnel. Our findings provided empirical evidence to support the UK advisory policy for tour length, known as the Harmony Guidelines. If fully implemented, these guidelines could aid prevention of mental illnesses. We aimed to reassess the association between cumulative length of deployment and number of deployments with mental illness in the UK forces. Our analysis was based on data from a representative study of the military for UK regular personnel who had completed a questionnaire between Nov 2, 2007, and Sept 24, 2009, and were deployed in the 3 years before questionnaire completion. Study outcomes were presence of possible post-traumatic stress disorder (PTSD), psychological distress, multiple physical symptoms, alcohol misuse, problems at home during and after deployment, and relationship or family problems. The key independent factors were deployment for 13 months or more, and months and number of deployments in the past 3 years. 8278 regulars responded to the questionnaire, of whom 3982 (48%) had been deployed in the 3 years before questionnaire completion. Deployment for 13 months or more decreased from 22% in March, 2005, (median March 8, 2005 [IQR Oct 10, 2004 to April 28, 2005]), to 12% in May, 2008, (May 17, 2008, [Feb 14, 2008, to Dec 5, 2008]). We noted an association between cumulative time deployed as a continuous variable and a score of 40 or more on the PTSD checklist (p=0·002), presence of psychological distress (p=0·018), and multiple physical symptoms (p=0·030; table 2). Furthermore, 13 months or more of deployment was associated with multiple physical symptoms (adjusted odds ratio [OR] 2·15, 95% CI 1·39-3·32), a PTSD checklist score of 40 or more (2·02, 1·31-3·12), and problems at home, but not a PTSD checklist score of 50 or

  6. Have health inequalities changed during childhood in the New Labour generation? Findings from the UK Millennium Cohort Study.

    Science.gov (United States)

    Rougeaux, Emeline; Hope, Steven; Law, Catherine; Pearce, Anna

    2017-01-11

    To examine how population-level socioeconomic health inequalities developed during childhood, for children born at the turn of the 21st century and who grew up with major initiatives to tackle health inequalities (under the New Labour Government). The UK. Singleton children in the Millennium Cohort Study at ages 3 (n=15 381), 5 (n=15 041), 7 (n=13 681) and 11 (n=13 112) years. Relative (prevalence ratios (PR)) and absolute health inequalities (prevalence differences (PD)) were estimated in longitudinal models by socioeconomic circumstances (SEC; using highest maternal academic attainment, ranging from 'no academic qualifications' to 'degree' (baseline)). Three health outcomes were examined: overweight (including obesity), limiting long-standing illness (LLSI), and socio-emotional difficulties (SED). Relative and absolute inequalities in overweight, across the social gradient, emerged by age 5 and increased with age. By age 11, children with mothers who had no academic qualifications were considerably more likely to be overweight as compared with those with degree-educated mothers (PR=1.6 (95% CI 1.4 to 1.8), PD=12.9% (9.1% to 16.8%)). For LLSI, inequalities emerged by age 7 and remained at 11, but only for children whose mothers had no academic qualifications (PR=1.7 (1.3 to 2.3), PD=4.8% (2% to 7.5%)). Inequalities in SED (observed across the social gradient and at all ages) declined between 3 and 11, although remained large at 11 (eg, PR=2.4 (1.9 to 2.9), PD=13.4% (10.2% to 16.7%) comparing children whose mothers had no academic qualifications with those of degree-educated mothers). Although health inequalities have been well documented in cross-sectional and trend data in the UK, it is less clear how they develop during childhood. We found that relative and absolute health inequalities persisted, and in some cases widened, for a cohort of children born at the turn of the century. Further research examining and comparing the pathways through which SECs

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

    Science.gov (United States)

    Ngaage, Millie; Agius, Mark

    2016-09-01

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

  8. Clinical decision making in a high-risk primary care environment: a qualitative study in the UK.

    Science.gov (United States)

    Balla, John; Heneghan, Carl; Thompson, Matthew; Balla, Margaret

    2012-01-01

    Examine clinical reasoning and decision making in an out of hours (OOH) primary care setting to gain insights into how general practitioners (GPs) make clinical decisions and manage risk in this environment. Semi-structured interviews using open-ended questions. A 2-month qualitative interview study conducted in Oxfordshire, UK. 21 GPs working in OOH primary care. The most powerful themes to emerge related to dealing with urgent potentially high-risk cases, keeping patients safe and responding to their needs, while trying to keep patients out of hospital and the concept of 'fire fighting'. There were a number of well-defined characteristics that GPs reported making presentations easy or difficult to deal with. Severely ill patients were straightforward, while the older people, with complex multisystem diseases, were often difficult. GPs stopped collecting clinical information and came to clinical decisions when high-risk disease and severe illness requiring hospital attention has been excluded; they had responded directly to the patient's needs and there was a reliable safety net in place. Learning points that GPs identified as important for trainees in the OOH setting included the importance of developing rapport in spite of time pressures, learning to deal with uncertainty and learning about common presentations with a focus on critical cues to exclude severe illness. The findings support suggestions that improvements in primary care OOH could be achieved by including automated and regular timely feedback system for GPs and individual peer and expert clinician support for GPs with regular meetings to discuss recent cases. In addition, trainee support and mentoring to focus on clinical skills, knowledge and risk management issues specific to OOH is currently required. Investigating the stopping rules used for diagnostic closure may provide new insights into the root causes of clinical error in such a high-risk setting.

  9. Building theories from case study research: the progressive case study

    NARCIS (Netherlands)

    Steenhuis, H.J.; de Bruijn, E.J.

    2006-01-01

    Meredith (1998) argues for more case and field research studies in the field of operations management. Based on a literature review, we discuss several existing approaches to case studies and their characteristics. These approaches include; the Grounded Theory approach which proposes no prior

  10. Case note: ECHR (Animal Defenders International v UK: App no 48876/08: Political Advertising Bans and Freedom of Expression)

    NARCIS (Netherlands)

    Ó Fathaigh, R.

    2013-01-01

    In Animal Defenders International v UK, the 17-judge Grand Chamber of the European Court of Human Rights ruled that the UK’s ban on political advertising on television, as applied to an animal rights organisation, did not violate freedom of expression. The Court divided nine votes to eight, with the

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

    Science.gov (United States)

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

    2010-01-01

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

  12. Theory Testing Using Case Studies

    DEFF Research Database (Denmark)

    Møller, Ann-Kristina Løkke; Dissing Sørensen, Pernille

    2014-01-01

    The appropriateness of case studies as a tool for theory testing is still a controversial issue, and discussions about the weaknesses of such research designs have previously taken precedence over those about its strengths. The purpose of the paper is to examine and revive the approach of theory...... testing using case studies, including the associated research goal, analysis, and generalisability. We argue that research designs for theory testing using case studies differ from theorybuilding case study research designs because different research projects serve different purposes and follow different...... research paths....

  13. Multiple and multidimensional transitions from trainee to trained doctor: a qualitative longitudinal study in the UK.

    Science.gov (United States)

    Gordon, Lisi; Jindal-Snape, Divya; Morrison, Jill; Muldoon, Janine; Needham, Gillian; Siebert, Sabina; Rees, Charlotte

    2017-12-01

    To explore trainee doctors' experiences of the transition to trained doctor, we answer three questions: (1) What multiple and multidimensional transitions (MMTs) are experienced as participants move from trainee to trained doctor? (2) What facilitates and hinders doctors' successful transition experiences? (3) What is the impact of MMTs on trained doctors? A qualitative longitudinal study underpinned by MMT theory. Four training areas (health boards) in the UK. 20 doctors, 19 higher-stage trainees within 6 months of completing their postgraduate training and 1 staff grade, associate specialist or specialty doctor, were recruited to the 9-month longitudinal audio-diary (LAD) study. All completed an entrance interview, 18 completed LADs and 18 completed exit interviews. Data were analysed cross-sectionally and longitudinally using thematic Framework Analysis. Participants experienced a multiplicity of expected and unexpected, positive and negative work-related transitions (eg, new roles) and home-related transitions (eg, moving home) during their trainee-trained doctor transition. Factors facilitating or inhibiting successful transitions were identified at various levels: individual (eg, living arrangements), interpersonal (eg, presence of supportive relationships), systemic (eg, mentoring opportunities) and macro (eg, the curriculum provided by Medical Royal Colleges). Various impacts of transitions were also identified at each of these four levels: individual (eg, stress), interpersonal (eg, trainees' children spending more time in childcare), systemic (eg, spending less time with patients) and macro (eg, delayed start in trainees' new roles). Priority should be given to developing supportive relationships (both formal and informal) to help trainees transition into their trained doctor roles, as well as providing more opportunities for learning. Further longitudinal qualitative research is now needed with a longer study duration to explore transition journeys for

  14. Professionalism dilemmas, moral distress and the healthcare student: insights from two online UK-wide questionnaire studies

    OpenAIRE

    Monrouxe, Lynn V; Rees, Charlotte E; Dennis, Ian; Wells, Stephanie E

    2015-01-01

    Objective To understand the prevalence of healthcare students? witnessing or participating in something that they think unethical (professionalism dilemmas) during workplace learning and examine whether differences exist in moral distress intensity resulting from these experiences according to gender and the frequency of occurrence. Design Two cross-sectional online questionnaires of UK medical (study 1) and nursing, dentistry, physiotherapy and pharmacy students (study 2) concerning professi...

  15. Do disordered eating behaviours in girls vary by school characteristics? A UK cohort study.

    Science.gov (United States)

    Bould, Helen; De Stavola, Bianca; Lewis, Glyn; Micali, Nadia

    2018-03-15

    Previous research on eating disorders, disordered eating behaviours, and whether their prevalence varies across schools, has produced inconsistent results. Our previous work using Swedish record-linkage data found that rates of diagnosed eating disorders vary between schools, with higher proportions of girls and higher proportions of highly educated parents within a school being associated with greater numbers of diagnosed eating disorders. We aimed to extend these findings to a UK population-based sample and hypothesised that a similar association would be evident when studying disordered eating behaviours. We used data from the Avon Longitudinal Study of Parents and Children to test the hypothesis that prevalence of self- and parent-reported disordered eating behaviours (binge eating, purging, fasting, restrictive eating, and fear of weight gain), and body dissatisfaction cluster by school. We had complete data on body dissatisfaction, school attended, and other possible risk factors for 2146 girls in 263 schools at age 14 and on disordered eating behaviours for 1769 girls in 273 schools at age 16. We used multilevel logistic regression modelling to assess whether prevalence varied between and within schools, and logistic regression to investigate the association between specific school characteristics and prevalence of disordered eating behaviours and body dissatisfaction. At age 14, there was no evidence for body dissatisfaction clustering by school, or for specific school characteristics being associated with body dissatisfaction. At age 16, there was no evidence for clustering, but higher rates of disordered eating behaviours were associated with attending all-girl schools and lower levels with attending schools with higher academic results. We found no evidence for clustering of disordered eating behaviours in individual schools, possibly because of the small cluster sizes. However, we found evidence for higher levels of disordered eating behaviours in 16

  16. The economic burden of cancer in the UK: a study of survivors treated with curative intent.

    Science.gov (United States)

    Marti, Joachim; Hall, Peter S; Hamilton, Patrick; Hulme, Claire T; Jones, Helen; Velikova, Galina; Ashley, Laura; Wright, Penny

    2016-01-01

    We aim to describe the economic burden of UK cancer survivorship for breast, colorectal and prostate cancer patients treated with curative intent, 1 year post-diagnosis. Patient-level data were collected over a 3-month period 12-15 months post-diagnosis to estimate the monthly societal costs incurred by cancer survivors. Self-reported resource utilisation data were obtained via the electronic Patient-reported Outcomes from Cancer Survivors system and included community-based health and social care, medications, travel costs and informal care. Hospital costs were retrieved through data linkage. Multivariate regression analysis was used to examine cost predictors. Overall, 298 patients were included in the analysis, including 136 breast cancer, 83 colorectal cancer and 79 prostate cancer patients. The average monthly societal cost was $ US 409 (95%CI: $ US 316-$ US 502) [mean: £ 260, 95%CI: £ 198-£ 322] and was incurred by 92% of patients. This was divided into costs to the National Health Service (mean: $ US 279, 95%CI: $ US 207-$ US 351) [mean: £ 177, 95%CI: £ 131-£ 224], patients' out-of-pocket (OOP) expenses (mean: $ US 40, 95%CI: $ US 15-$ US 65) [mean: £ 25, 95%CI: £ 9-£ 42] and the cost of informal care (mean: $ US 110, 95%CI: $ US 57-$ US 162) [mean: £ 70, 95%CI: £ 38-£ 102]. The distribution of costs was skewed with a small number of patients incurring very high costs. Multivariate analyses showed higher societal costs for breast cancer patients. Significant predictors of OOP costs included age and socioeconomic deprivation. This study found the economic burden of cancer survivorship is unevenly distributed in the population and that cancer survivors may still incur substantial costs over 1 year post-diagnosis. In addition, this study illustrates the feasibility of using an innovative online data collection platform to collect patient-reported resource utilisation information. Copyright © 2015 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

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

    2015-11-01

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

  18. A UK population-based study of the relationship between mental disorder and victimisation

    NARCIS (Netherlands)

    Hart, C.; Vet, R. de; Moran, P.; Hatch, S.L.; Dean, K.

    2012-01-01

    PURPOSE: To establish the prevalence of victimisation in a UK population-based sample and to investigate the association between mental disorder and victimisation in both cross-sectional and prospective manner, whilst adjusting for potential confounds. METHODS: Data from the National Child

  19. Theory, Practice and Policy: A Longitudinal Study of University Knowledge Exchange in the UK

    Science.gov (United States)

    Zhang, Qiantao

    2018-01-01

    This article examines the progress of university knowledge exchange in the United Kingdom over a decade, linking theory, practice and policy. As indicated by the literature, the performance of university knowledge exchange is influenced by institutional and locational characteristics. Data on 133 UK universities between 2003-2004 and 2012-2013 are…

  20. The impact of climate change on tourism in Germany, the UK and Ireland: a simulation study

    NARCIS (Netherlands)

    Hamilton, Jacqueline; Tol, Richard

    2007-01-01

    We downscale the results of a global tourism simulation model at a national resolution to a regional resolution. We use this to investigate the impact of climate change on the regions of Germany, Ireland and the UK. Because of climate change, tourists from all three countries would spend more

  1. International Student Migration: A Comparison of UK and Indian Students' Motivations for Studying Abroad

    Science.gov (United States)

    King, Russell; Sondhi, Gunjan

    2018-01-01

    This paper breaks new ground in its comparative analysis of two international student migration (ISM) streams, one from the Global South to the Global North (India to developed Anglophone countries), and the other within the Global North (UK to North America, Europe and Australia). These two ISM movements reflect different positionalities within…

  2. Theory testing using case studies

    DEFF Research Database (Denmark)

    Dissing Sørensen, Pernille; Løkke Nielsen, Ann-Kristina

    2006-01-01

    on the strengths of theory-testing case studies. We specify research paths associated with theory testing in case studies and present a coherent argument for the logic of theoretical development and refinement using case studies. We emphasize different uses of rival explanations and their implications for research...... design. Finally, we discuss the epistemological logic, i.e., the value to larger research programmes, of such studies and, following Lakatos, conclude that the value of theory-testing case studies lies beyond naïve falsification and in their contribution to developing research programmes in a progressive......Case studies may have different research goals. One such goal is the testing of small-scale and middle-range theories. Theory testing refers to the critical examination, observation, and evaluation of the 'why' and 'how' of a specified phenomenon in a particular setting. In this paper, we focus...

  3. Fuzzy-Set Case Studies

    Science.gov (United States)

    Mikkelsen, Kim Sass

    2017-01-01

    Contemporary case studies rely on verbal arguments and set theory to build or evaluate theoretical claims. While existing procedures excel in the use of qualitative information (information about kind), they ignore quantitative information (information about degree) at central points of the analysis. Effectively, contemporary case studies rely on…

  4. Methodology for the case studies

    NARCIS (Netherlands)

    Smits, M.J.W.; Woltjer, G.B.

    2017-01-01

    This document is about the methodology and selection of the case studies. It is meant as a guideline for the case studies, and together with the other reports in this work package can be a source of inform ation for policy officers, interest groups and researchers evaluating or performing impact

  5. Family employment and child socioemotional behaviour: longitudinal findings from the UK Millennium Cohort Study.

    Science.gov (United States)

    Hope, Steven; Pearce, Anna; Whitehead, Margaret; Law, Catherine

    2014-10-01

    Levels of paid employment in two parent and lone parent families have increased in the UK but evidence of its impact on child socioemotional behaviour is limited and inconsistent. We conducted a longitudinal analysis using the first four sweeps of the Millennium Cohort Study (9 months, 3 years, 5 years and 7 years) to investigate the influence of family employment trajectories in the early years on socioemotional behaviour at 7 years, unadjusted and adjusted for covariates. In addition, mothers' employment was investigated separately. Children from families where no parent was employed for one or more sweeps were at a greater risk of socioemotional problem behaviour compared with those where a parent was continuously employed, even after adjustment for covariates. Children of mothers who were non-employed for one or more sweeps were at greater risk of problem behaviour compared with mothers who were employed at all sweeps. Adjustment for covariates fully attenuated the excess risk for children whose mothers had moved into employment by the time they were 7 years. In contrast, the elevated risk associated with continuous non-employment and a single transition out of employment was attenuated after adjustment for early covariates, fathers' employment, household income and mothers' psychological distress at 7 years, but remained significant. Family and mothers' employment were associated with a lower risk of problem behaviour for children in middle childhood, in part explained by sociodemographic characteristics of families and the apparent psychological and socioeconomic benefits of employment. Results for mothers' transitions in or out of the labour market suggest that child problem behaviour is influenced by current status, over and above diverse earlier experiences of employment and non-employment. 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.

  6. Mortality in first-contact psychosis patients in the U.K.: a cohort study.

    Science.gov (United States)

    Dutta, R; Murray, R M; Allardyce, J; Jones, P B; Boydell, J E

    2012-08-01

    The excess mortality following first-contact psychosis is well recognized. However, the causes of death in a complete incidence cohort and mortality patterns over time compared with the general population are unknown. All 2723 patients who presented for the first time with psychosis in three defined catchment areas of the U.K. in London (1965-2004, n=2056), Nottingham (1997-1999, n=203) and Dumfries and Galloway (1979-1998, n=464) were traced after a mean of 11.5 years follow-up and death certificates were obtained. Data analysis was by indirect standardization. The overall standardized mortality ratio (SMR) for first-contact psychosis was 184 [95% confidence interval (CI) 167-202]. Most deaths (84.2%, 374/444) were from natural causes, although suicide had the highest SMR (1165, 95% CI 873-1524). Diseases of the respiratory system and infectious diseases had the highest SMR of the natural causes of death (232, 95% CI 183-291). The risk of death from diseases of the circulatory system was also elevated compared with the general population (SMR 139, 95% CI 117-164) whereas there was no such difference for neoplasms (SMR 111, 95% CI 86-141). There was strong evidence that the mortality gap compared with the general population for all causes of death (p<0.001) and all natural causes (p=0.01) increased over the four decades of the study. There was weak evidence that cardiovascular deaths may be increasing relative to the general population (p=0.07). People with first-contact psychosis have an overall mortality risk that is nearly double that of the general population. Most excess deaths are from natural causes. The widening of the mortality gap over the last four decades should be of concern to all clinicians involved in delivering healthcare.

  7. Public attitudes towards pricing policies to change health-related behaviours: a UK focus group study.

    Science.gov (United States)

    Somerville, Claire; Marteau, Theresa M; Kinmonth, Ann Louise; Cohn, Simon

    2015-12-01

    Evidence supports the use of pricing interventions in achieving healthier behaviour at population level. The public acceptability of this strategy continues to be debated throughout Europe, Australasia and USA. We examined public attitudes towards, and beliefs about the acceptability of pricing policies to change health-related behaviours in the UK. The study explores what underlies ideas of acceptability, and in particular those values and beliefs that potentially compete with the evidence presented by policy-makers. Twelve focus group discussions were held in the London area using a common protocol with visual and textual stimuli. Over 300,000 words of verbatim transcript were inductively coded and analyzed, and themes extracted using a constant comparative method. Attitudes towards pricing policies to change three behaviours (smoking, and excessive consumption of alcohol and food) to improve health outcomes, were unfavourable and acceptability was low. Three sets of beliefs appeared to underpin these attitudes: (i) pricing makes no difference to behaviour; (ii) government raises prices to generate income, not to achieve healthier behaviour and (iii) government is not trustworthy. These beliefs were evident in discussions of all types of health-related behaviour. The low acceptability of pricing interventions to achieve healthier behaviours in populations was linked among these responders to a set of beliefs indicating low trust in government. Acceptability might be increased if evidence regarding effectiveness came from trusted sources seen as independent of government and was supported by public involvement and hypothecated taxation. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association.

  8. Family employment and child socioemotional behaviour: longitudinal findings from the UK Millennium Cohort Study

    Science.gov (United States)

    Hope, Steven; Pearce, Anna; Whitehead, Margaret; Law, Catherine

    2014-01-01

    Background Levels of paid employment in two parent and lone parent families have increased in the UK but evidence of its impact on child socioemotional behaviour is limited and inconsistent. Methods We conducted a longitudinal analysis using the first four sweeps of the Millennium Cohort Study (9 months, 3 years, 5 years and 7 years) to investigate the influence of family employment trajectories in the early years on socioemotional behaviour at 7 years, unadjusted and adjusted for covariates. In addition, mothers’ employment was investigated separately. Results Children from families where no parent was employed for one or more sweeps were at a greater risk of socioemotional problem behaviour compared with those where a parent was continuously employed, even after adjustment for covariates. Children of mothers who were non-employed for one or more sweeps were at greater risk of problem behaviour compared with mothers who were employed at all sweeps. Adjustment for covariates fully attenuated the excess risk for children whose mothers had moved into employment by the time they were 7 years. In contrast, the elevated risk associated with continuous non-employment and a single transition out of employment was attenuated after adjustment for early covariates, fathers’ employment, household income and mothers’ psychological distress at 7 years, but remained significant. Conclusions Family and mothers’ employment were associated with a lower risk of problem behaviour for children in middle childhood, in part explained by sociodemographic characteristics of families and the apparent psychological and socioeconomic benefits of employment. Results for mothers’ transitions in or out of the labour market suggest that child problem behaviour is influenced by current status, over and above diverse earlier experiences of employment and non-employment. PMID:24889054

  9. Bereaved parents' experience of stillbirth in UK hospitals: a qualitative interview study.

    Science.gov (United States)

    Downe, Soo; Schmidt, Ellie; Kingdon, Carol; Heazell, Alexander E P

    2013-01-01

    To obtain the views of bereaved parents about their interactions with healthcare staff when their baby died just before or during labour. Qualitative in-depth interview study, following an earlier national survey. All interviews took place during 2011, either face-to-face or on the telephone. Data analysis was informed by the constant comparative technique from grounded theory. Every National Health Service (NHS) region in the UK was represented. Bereaved parents who had completed an e-questionnaire, via the website of Sands (Stillbirth and Neonatal Death Society). Of the 304 survey respondents who gave provisional consent, 29 families were approached to take part, based on maximum variation sampling and data saturation. 22 families (n=25) participated. Births took place between 2002 and 2010. Specific practices were identified that were particularly helpful to the parents. Respondents talked about their interactions with hospital staff as having profound effects on their capacity to cope, both during labour and in the longer term. The data generated three key themes: 'enduring and multiple loss': 'making irretrievable moments precious'; and the 'best care possible to the worst imaginable'. The overall synthesis of findings is encapsulated in the meta-theme 'One chance to get it right.' This pertains to the parents and family themselves, clinical and support staff who care for them directly, and the NHS organisations that indirectly provide the resources and governance procedures that may (or may not) foster a caring ethos. Positive memories and outcomes following stillbirth depend as much on genuinely caring staff attitudes and behaviours as on high-quality clinical procedures. All staff who encounter parents in this situation need to see each meeting as their one chance to get it right.

  10. Integrating Art and Creative Practices into a Programme of Support for Nigerian Students Studying in UK Higher Education Institutions

    Directory of Open Access Journals (Sweden)

    Elizabeth Achinewhu-Nworgu

    2017-05-01

    Full Text Available This scoping paper explores the experiences of overseas students from Nigeria studying in Higher Education Institutions (HEIs in the United Kingdom. It considers the context for these students and some of the particular pressures and challenges they experience in making the transition from education in Nigeria to achieving academic success and adapting to life as a student in the UK. With reference to the work of Professor Claudio-Rafael Vásquez-Martínez, at the outset of a collaborative project to explore these issues further, this paper considers whether the use of painting and other creative practices could assist these students in managing the transition more effectively and ultimately in succeeding in their academic studies. For the present study, qualitative data was gathered using interviews with Nigerian students who came to study in the UK with the assistance of a London-based organisation, Focus Learning Support Ltd, which assists Nigerian students in their applications to UK HEIs, and which supports them throughout their studies.

  11. Case study - Argentina

    International Nuclear Information System (INIS)

    Diaz, E.

    1986-01-01

    Antecedents and experience of nuclear activities in Argentina; the Atomic Energy Commission (CNEA). First development and research activities. Research reactors and radioisotopes plants. Health physics and safety regulations. - Feasibility studies for the first nuclear power plant. Awarding the first plant CNA I (Atucha I). Relevant data related to the different project stages. Plant performance. - Feasibility study for the second nuclear power plant. Awarding the second plant CNE (Central Nuclear Embalse). Relevant data related to established targets. Differences compared with the first station targets. Local participation. Plant performance. (orig./GL)

  12. Effects of residents' tourism development expectation and tourism impacts perception on their attitude towards tourism in natural tourist destination: A Comparative study between China's Jiuzhaigou and the UK's New Forest National Parks

    OpenAIRE

    Cheng, S.; Zhang, J.; Xu, Feifei; Liang, Y.

    2010-01-01

    Local residents' perception of tourism impacts in tourist destinations has been found to affect their attitude towards tourism; however, there have been relatively few studies on the influence of residents' tourism development expectation on their attitude towards tourism. With the utilization of SPSS16.0 software, this paper, taking China's Jiuzhaigou and the UK's New Forest National Parks as case study areas, makes a comparative study on the influence of local residents' tourism development...

  13. How do workplaces, working practices and colleagues affect UK doctors' career decisions? A qualitative study of junior doctors' career decision making in the UK.

    Science.gov (United States)

    Spooner, Sharon; Pearson, Emma; Gibson, Jonathan; Checkland, Kath

    2017-10-25

    This study draws on an in-depth investigation of factors that influenced the career decisions of junior doctors. Junior doctors in the UK can choose to enter specialty training (ST) programmes within 2 years of becoming doctors. Their specialty choices contribute to shaping the balance of the future medical workforce, with views on general practice (GP) careers of particular interest because of current recruitment difficulties. This paper examines how experiences of medical work and perceptions about specialty training shape junior doctors' career decisions. Twenty doctors in the second year of a Foundation Training Programme in England were recruited. Purposive sampling was used to achieve a diverse sample from respondents to an online survey. Narrative interviewing techniques encouraged doctors to reflect on how experiences during medical school and in medical workplaces had influenced their preferences and perceptions of different specialties. They also spoke about personal aspirations, work priorities and their wider future.Junior doctors' decisions were informed by knowledge about the requirements of ST programmes and direct observation of the pressures under which ST doctors worked. When they encountered negative attitudes towards a specialty they had intended to choose, some became defensive while others kept silent. Achievement of an acceptable work-life balance was a central objective that could override other preferences.Events linked with specific specialties influenced doctors' attitudes towards them. For example, findings confirmed that while early, positive experiences of GP work could increase its attractiveness, negative experiences in GP settings had the opposite effect. Junior doctors' preferences and perceptions about medical work are influenced by multiple intrinsic and extrinsic factors and experiences. This paper highlights the importance of understanding how perceptions are formed and preferences are developed, as a basis for generating

  14. How do workplaces, working practices and colleagues affect UK doctors’ career decisions? A qualitative study of junior doctors’ career decision making in the UK

    Science.gov (United States)

    Pearson, Emma; Gibson, Jonathan; Checkland, Kath

    2017-01-01

    Objectives This study draws on an in-depth investigation of factors that influenced the career decisions of junior doctors. Setting Junior doctors in the UK can choose to enter specialty training (ST) programmes within 2 years of becoming doctors. Their specialty choices contribute to shaping the balance of the future medical workforce, with views on general practice (GP) careers of particular interest because of current recruitment difficulties. This paper examines how experiences of medical work and perceptions about specialty training shape junior doctors’ career decisions. Participants Twenty doctors in the second year of a Foundation Training Programme in England were recruited. Purposive sampling was used to achieve a diverse sample from respondents to an online survey. Results Narrative interviewing techniques encouraged doctors to reflect on how experiences during medical school and in medical workplaces had influenced their preferences and perceptions of different specialties. They also spoke about personal aspirations, work priorities and their wider future. Junior doctors’ decisions were informed by knowledge about the requirements of ST programmes and direct observation of the pressures under which ST doctors worked. When they encountered negative attitudes towards a specialty they had intended to choose, some became defensive while others kept silent. Achievement of an acceptable work-life balance was a central objective that could override other preferences. Events linked with specific specialties influenced doctors’ attitudes towards them. For example, findings confirmed that while early, positive experiences of GP work could increase its attractiveness, negative experiences in GP settings had the opposite effect. Conclusions Junior doctors’ preferences and perceptions about medical work are influenced by multiple intrinsic and extrinsic factors and experiences. This paper highlights the importance of understanding how perceptions are formed

  15. Mental health morbidity among people subject to immigration detention in the UK: a feasibility study.

    Science.gov (United States)

    Sen, P; Arugnanaseelan, J; Connell, E; Katona, C; Khan, A A; Moran, P; Robjant, K; Slade, K; Tan, J; Widyaratna, K; Youd, J; Forrester, A

    2017-06-22

    The UK has one of the largest systems of immigration detention in Europe.. Those detained include asylum-seekers and foreign national prisoners, groups with a higher prevalence of mental health vulnerabilities compared with the general population. In light of little published research on the mental health status of detainees in immigration removal centres (IRCs), the primary aim of this study was to explore whether it was feasible to conduct psychiatric research in such a setting. A secondary aim was to compare the mental health of those seeking asylum with the rest of the detainees. Cross-sectional study with simple random sampling followed by opportunistic sampling. Exclusion criteria included inadequate knowledge of English and European Union nationality. Six validated tools were used to screen for mental health disorders including developmental disorders like Personality Disorder, Attention Deficit Hyperactivity Disorder (ADHD), Autistic Spectrum Disorder (ASD) and Intellectual Disability, as well as for needs assessment. These were the MINI v6, SAPAS, AQ-10, ASRS, LDSQ and CANFOR. Demographic data were obtained using a participant demographic sheet. Researchers were trained in the use of the screening battery and inter-rater reliability assessed by joint ratings. A total of 101 subjects were interviewed. Overall response rate was 39%. The most prevalent screened mental disorder was depression (52.5%), followed by personality disorder (34.7%) and post-traumatic stress disorder (20.8%). 21.8% were at moderate to high suicidal risk. 14.9 and 13.9% screened positive for ASD and ADHD, respectively. The greatest unmet needs were in the areas of intimate relationships (76.2%), psychological distress (72.3%) and sexual expression (71.3%). Overall presence of mental disorder was comparable with levels found in prisons. The numbers in each group were too small to carry out any further analysis. It is feasible to undertake a psychiatric morbidity survey in an IRC

  16. Cleavages and co-operation in the UK alcohol industry: A qualitative study

    Directory of Open Access Journals (Sweden)

    Holden Chris

    2012-06-01

    Full Text Available Abstract Background It is widely believed that corporate actors exert substantial influence on the making of public health policy, including in the alcohol field. However, the industry is far from being monolithic, comprising a range of producers and retailers with varying and diverse interests. With a focus on contemporary debates concerning the minimum pricing of alcohol in the UK, this study examined the differing interests of actors within the alcohol industry, the cleavages which emerged between them on this issue and how this impacted on their ability to organise themselves collectively to influence the policy process. We conducted 35 semi-structured interviews between June and November 2010 with respondents from all sectors of the industry as well as a range of non-industry actors who had knowledge of the alcohol policy process, including former Ministers, Members of the UK Parliament and the Scottish Parliament, civil servants, members of civil society organisations and professionals. Methods The paper draws on an analysis of publicly available documents and 35 semi-structured interviews with respondents from the alcohol industry (on- and off-trade including retailers, producers of wines, spirits and beers and trade associations and a range of non-industry actors with knowledge of the alcohol policy process (including former Ministers, Members of Parliament and of the Scottish Parliament, civil servants, members of civil society organisations and professional groups. Interviews were recorded, transcribed and analysed using Nvivo qualitative analysis software. Processes of triangulation between data sources and different types of respondent sought to ensure we gained as accurate a picture as possible of industry participation in the policy process. Results Divergences of interest were evident between producers and retailers and within the retail sector between the on and off trade. Divisions within the alcohol industry, however, existed

  17. Summer Thermal Comfort and Self-Shading Geometries in Passivhaus Dwellings: A Pilot Study Using Future UK Climates

    Directory of Open Access Journals (Sweden)

    Yahya Lavafpour

    2015-08-01

    Full Text Available This study uses numerical thermal simulation to investigate the potential use of building geometry to eliminate or reduce current and future thermal discomfort overheating risk in UK Passivhaus dwellings. The study focused on the optimum inclination of a south façade to make use of the building shape to self-protect itself. Dynamic simulation modelling software was used to test a range of different inclined façades with regards to their effectiveness in reducing overheating risk. The research found that implementing a tilted façade could completely eliminate the risk of overheating for current UK climates, but with some consequences for natural ventilation and daylighting. Future overheating was significantly reduced by the tilted façade. However, geometric considerations could not eradicate completely the risk of thermal discomfort overheating, particularly by the 2080s.

  18. Case Study: Shiraz Women

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    Bijan Khajehnoori

    2011-04-01

    Full Text Available This study investigated the relationship between lifestyle which seems as a scale of globalization process with body image. Required data was collected by systematic random sampling among 508 women in Shiraz. Based on existing theories and studies theoretical framework has constituted based on Giddens theory. Six hypotheses have been established. For collecting information, survey method and self reported questionnaire were used. In data analysis and explanation, multiple regression and unilateral dispersion analyses were used. The result showed that among effective factors on body image, modern musical lifestyle, religious' lifestyle, leisure lifestyle and participative lifestyle explained 23 percent of variations of body image. Among these variables, only religious lifestyle had negative relationship with body image and other variables had positive relationship with dependant variable.

  19. Centrifugal compressor case study

    Energy Technology Data Exchange (ETDEWEB)

    Eckert, B.

    2010-10-15

    Three centrifugal compressors at a pipeline station were retrofitted with higher head impellers in 2008. The owners of the station experienced vibration problems over the following 2 years that caused transmitter and position failures that were assumed to be flow-induced pulsations. A vibration and pulsation analysis indicated that the shell mode piping vibration excited by the blade pass pulsation was responsible for the failures. This study outlined factors that contributed to the vibration problem. Interferences between the compressor and shell mode piping natural frequencies were predicted, and potential excitation sources were examined. The study demonstrated how centrifugal vibration analyses can be used during the design phase to avoid costly adjustments. Recommendations included the addition of stiffeners to alter the shell modes, and the addition of constrained layer damping material to reduce resonant responses. 2 refs., 1 tab., 12 figs.

  20. Case study: Tourism marketing

    OpenAIRE

    Kennell, James

    2014-01-01

    Tourism can be a challenging subject for students because it is both dynamic and susceptible to economic turbulence and shifts in trends. Tourism: A Modern Synthesis is an essential textbook for tourism students looking for a clear and comprehensive introduction to their studies which helps overcome these challenges. The authors apply a strong business approach to the subject reflecting developments in the teaching and content of modern courses and the text covers both key principles and cont...

  1. Transition from clinician to academic: an interview study of the experiences of UK and Australian Registered Nurses.

    Science.gov (United States)

    Logan, Patricia A; Gallimore, David; Jordan, Sue

    2016-03-01

    The aim of this study was to explore and compare the experiences of nurses in Australia and the UK as they moved from clinical practice into higher education institutions. When nurse education moved from hospitals into higher education institutions, the roles and career pathways of nurse educators changed. The design method used in this study was qualitative interview study. Semi-structured interviews were undertaken with 14 nurse educators, seven in Australia and seven in the UK, in 2011-2012. Thematic analysis of the transcripts was undertaken and triangulated with automated content and thematic analysis by Leximancer© software. Nurse academics in Australia and the UK voiced similar enthusiasms and concerns. These coalesced around four emergent themes: adapting to change, external pressures, teaching and progress up the academic ladder. The Leximancer© analysis for both sites ranked 'research' as the primary theme, linked with 'time', 'University' and 'nursing' on both sites. Respondents were aware of the importance of research to career progression in universities, but most prioritized their teaching and clinical commitments for the sake of their organizations. Most respondents were supported in their doctoral studies, but the absence of postdoctoral research teams, mentors and role models was striking. Additional support is needed to ensure that nurse academics are able to pursue research beyond doctoral level. © 2015 John Wiley & Sons Ltd.

  2. Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK: a prospective study

    Directory of Open Access Journals (Sweden)

    O'Brien Karen

    2009-03-01

    Full Text Available Abstract Background More women are requesting Emergency Hormonal Contraception (EHC at pharmacies where screening for Chlamydia trachomatis is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK. Methods Six Primary Care Trusts (PCTs that had contracted with pharmacies to provide free EHC, requested the largest EHC providers (≥ 40 doses annually to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate. Results 33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718 of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348/2904 EHC clients (46.4% who had been offered screening accepted a screening kit. 264 (17.6% of those who accepted a kit returned a sample, of whom 24 (9.1% were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015. Conclusion Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group.

  3. Identifying critical success factors for designing selection processes into postgraduate specialty training: the case of UK general practice.

    Science.gov (United States)

    Plint, Simon; Patterson, Fiona

    2010-06-01

    The UK national recruitment process into general practice training has been developed over several years, with incremental introduction of stages which have been piloted and validated. Previously independent processes, which encouraged multiple applications and produced inconsistent outcomes, have been replaced by a robust national process which has high reliability and predictive validity, and is perceived to be fair by candidates and allocates applicants equitably across the country. Best selection practice involves a job analysis which identifies required competencies, then designs reliable assessment methods to measure them, and over the long term ensures that the process has predictive validity against future performance. The general practitioner recruitment process introduced machine markable short listing assessments for the first time in the UK postgraduate recruitment context, and also adopted selection centre workplace simulations. The key success factors have been identified as corporate commitment to the goal of a national process, with gradual convergence maintaining locus of control rather than the imposition of change without perceived legitimate authority.

  4. Financial Strain, Parental Smoking, and the Great Recession: An Analysis of the UK Millennium Cohort Study.

    Science.gov (United States)

    McKenna, Caoimhe S; Law, Catherine; Pearce, Anna

    2017-11-07

    has focused on parents. We used longitudinal data from the UK Millennium Cohort Study, between 2008 and 2012, to examine the association between FS and parental smoking. We show that parents who experienced increased FS, over the period of the "Great Recession," were more likely to continue using tobacco or to relapse. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

  5. Land use implications of future energy system trajectories—The case of the UK 2050 Carbon Plan

    International Nuclear Information System (INIS)

    Konadu, D. Dennis; Mourão, Zenaida Sobral; Allwood, Julian M.; Richards, Keith S.; Kopec, Grant; McMahon, Richard; Fenner, Richard

    2015-01-01

    The UK's 2008 Climate Change Act sets a legally binding target for reducing territorial greenhouse gas emissions by 80% by 2050, relative to 1990 levels. Four pathways to achieve this target have been developed by the Department of Energy and Climate Change, with all pathways requiring increased us of bioenergy. A significant amount of this could be indigenously sourced from crops, but will increased domestic production of energy crops conflict with other agricultural priorities? To address this question, a coupled analysis of the UK energy system and land use has been developed. The two systems are connected by the production of bioenergy, and are projected forwards in time under the energy pathways, accounting for various constraints on land use for agriculture and ecosystem services. The results show different combinations of crop yield and compositions for the pathways lead to the appropriation of between 7% and 61% of UK's agricultural land for bioenergy production. This could result in competition for land for food production and other land uses, as well as indirect land use change in other countries due to an increase in bioenergy imports. Consequently, the potential role of bioenergy in achieving UK emissions reduction targets may face significant deployment challenges. - Highlights: • The Carbon Plan could result in significant land use change for bioenergy by 2050. • Higher Nuclear; less efficiency pathway has the highest land use change impact. • Higher Renewables; more energy efficiency pathway has the lowest land use change impact. • Transport decarbonisation via biofuels has the highest land use change impacts. • At current deployment rate only Higher Renewables pathway projections is achievable.

  6. A Proposal for a UK Ethics Council for Animal Policy: The Case for Putting Ethics Back into Policy Making

    Directory of Open Access Journals (Sweden)

    Steven P. McCulloch

    2018-06-01

    Full Text Available Substantial controversy is a consistent feature of UK animal health and welfare policy. BSE,~foot and mouth disease, bovine TB and badger culling, large indoor dairies, and wild animals in circuses are examples. Such policy issues are inherently normative; they include a substantial moral dimension. This paper reviews UK animal welfare advisory bodies such as the Animal Health and Welfare Board of England, the Farm Animal Welfare Committee and the Animals in Science Committee. These bodies play a key advisory role, but do not have adequate expertise in ethics to inform the moral dimension of policy. We propose an “Ethics Council for Animal Policy” to inform the UK government on policy that significantly impacts sentient species. We review existing Councils (e.g., the Nuffield Council on Bioethics and The Netherlands Council on Animal Affairs and examine some widely used ethical frameworks (e.g., Banner’s principles and the ethical matrix. The Ethics Council for Animal Policy should be independent from government and members should have substantial expertise in ethics and related disciplines. A pluralistic six-stage ethical framework is proposed: (i Problematisation of the policy issue, (ii utilitarian analysis, (iii animal rights analysis, (iv virtue-based analysis, (v animal welfare ethic analysis, and (vi integrated ethical analysis. The~paper concludes that an Ethics Council for Animal Policy is necessary for just and democratic policy making in all societies that use sentient nonhuman species.

  7. A Proposal for a UK Ethics Council for Animal Policy: The Case for Putting Ethics Back into Policy Making.

    Science.gov (United States)

    McCulloch, Steven P; Reiss, Michael J

    2018-06-07

    Substantial controversy is a consistent feature of UK animal health and welfare policy. BSE, foot and mouth disease, bovine TB and badger culling, large indoor dairies, and wild animals in circuses are examples. Such policy issues are inherently normative; they include a substantial moral dimension. This paper reviews UK animal welfare advisory bodies such as the Animal Health and Welfare Board of England, the Farm Animal Welfare Council and the Animals in Science Committee. These bodies play a key advisory role, but do not have adequate expertise in ethics to inform the moral dimension of policy. We propose an "Ethics Council for Animal Policy" to inform the UK government on policy that significantly impacts sentient species. We review existing Councils (e.g., the Nuffield Council on Bioethics and The Netherlands Council on Animal Affairs) and examine some widely used ethical frameworks (e.g., Banner's principles and the ethical matrix). The Ethics Council for Animal Policy should be independent from government and members should have substantial expertise in ethics and related disciplines. A pluralistic six-stage ethical framework is proposed: (i) Problematisation of the policy issue, (ii) utilitarian analysis, (iii) animal rights analysis, (iv) virtue-based analysis, (v) animal welfare ethic analysis, and (vi) integrated ethical analysis. The paper concludes that an Ethics Council for Animal Policy is necessary for just and democratic policy making in all societies that use sentient nonhuman species.

  8. Case Study: Derechos Digitales

    Directory of Open Access Journals (Sweden)

    Cameron Neylon

    2017-10-01

    Full Text Available Derechos Digitales is a Latin American advocacy and research network focussed on freedom on the internet, privacy and copyright reform. For the pilot project a specific IDRC funded project was the notional focus of study. However in practice the effort for considering data sharing was aimed at being organisation wide. The organisation already shares reports and other resources (particularly images and infographics by default. While open data was described as being “in the DNA of the organisation” there was little practice across the network of sharing preliminary and in-process materials. Some aspects of data collection on research projects, particularly to do with copyright and legal issues, have significant privacy issues and as the organisation focuses on privacy as one of its advocacy areas this is taken very seriously. Many materials from research projects are not placed online at all. Derechos Digitales run distributed projects and this creates challenges for consistent management. Alongside this the main contact at DD changed during the course of the pilot. This exchange exemplified the challenges of maintaining organisational systems and awareness through a personnel change.

  9. Case study: Khoramdareh County

    Directory of Open Access Journals (Sweden)

    Vahid Riahi Riahi

    2016-10-01

    Full Text Available Environmental sustainability of rural settlements based on a systematic viewpoint may be defined as a realization of sustainable development in different social, economic and environmental aspects of rural areas. Achieving this goal requires that we pay more attention to effective elements and factors through a set of sustainability indices. This research was meant to analyze sustainable factors of rural settlement in three dimensions: environmental, social and economic context using multi-criteria decision analysis and explanation of the relationships between its active and effective factors in the rural area of the Khorramdarreh County in the province of Zanjan. The research method used is the descriptive analytic approach. Data from 287 households were sampled randomly from a total of 1143 households in the four villages including: Rahmat Abad, Alvand, Baghdareh and, Sukhariz (out of 15 villages in the Khorramdarreh County. In the process of doing this research and after calculating the weights, the difference in the sustainability of environmental, social, economic and physical aspects in rural areas of this county have been determined. Data was collected using library and field research through questionnaires. Data analysis was performed by the One-Sample t Test and the Vikur and path analysis techniques, using statistical software SPSS. The findings show that environmental sustainability in the study area is half desirable. Among the different aspects of environmental sustainability, the most effective factors are physical, economic, social and environmental aspects, respectively. Little attention of policy-making –system to socio-cultural and environmental aspects, especially in practice, and rapid and unplanned utilization of production resources are the most important factors affecting this situation in two given dimensions. Although, in programmed documents the planning system agents emphasize on the socio-cultural sustainability

  10. Exposure to phthalic acid, phthalate diesters and phthalate monoesters from foodstuffs: UK total diet study results.

    Science.gov (United States)

    Bradley, Emma L; Burden, Richard A; Bentayeb, Karim; Driffield, Malcolm; Harmer, Nick; Mortimer, David N; Speck, Dennis R; Ticha, Jana; Castle, Laurence

    2013-01-01

    Phthalates are ubiquitous in the environment and thus exposure to these compounds can occur in various forms. Foods are one source of such exposure. There are only a limited number of studies that describe the levels of phthalates (diesters, monoesters and phthalic acid) in foods and assess the exposure from this source. In this study the levels of selected phthalate diesters, phthalate monoesters and phthalic acid in total diet study (TDS) samples are determined and the resulting exposure estimated. The methodology for the determination of phthalic acid and nine phthalate monoesters (mono-isopropyl phthalate, mono-n-butyl phthalate, mono-isobutyl phthalate, mono-benzyl phthalate, mono-cyclohexyl phthalate, mono-n-pentyl phthalate, mono-(2-ethylhexyl) phthalate, mono-n-octyl phthalate and mono-isononyl phthalate) in foods is described. In this method phthalate monoesters and phthalic acid are extracted from the foodstuffs with a mixture of acidified acetonitrile and dichloromethane. The method uses isotope-labelled phthalic acid and phthalate monoester internal standards and is appropriate for quantitative determination in the concentration range of 5-100 µg kg⁻¹. The method was validated in-house and its broad applicability demonstrated by the analysis of high-fat, high-carbohydrate and high-protein foodstuffs as well as combinations of all three major food constituents. The methodology used for 15 major phthalate diesters has been reported elsewhere. Phthalic acid was the most prevalent phthalate, being detected in 17 food groups. The highest concentration measured was di-(2-ethylhexyl) phthalate in fish (789 µg kg⁻¹). Low levels of mono-n-butyl phthalate and mono-(2-ethylhexyl) phthalate were detected in several of the TDS animal-based food groups and the highest concentrations measured corresponded with the most abundant diesters (di-n-butyl phthalate and di-(2-ethylhexyl) phthalate). The UK Committee on Toxicity of Chemicals in Food, Consumer Products

  11. Cost reductions on a titanium dioxide plant identified by a process integration study at Tioxide UK Ltd

    Energy Technology Data Exchange (ETDEWEB)

    1985-08-01

    The purpose of a process integration study is to determine the minimum practical amount of energy required to operate a process and to identify the most appropriate investment strategy which will realise the maximum energy cost savings consistent with a particular company's financial and operating criteria. The process integration method involves the rigorous application of thermodynamics and cost accounting, tempered by practical plant engineering and operability considerations. Tioxide UK Ltd is part of Tioxide Group plc and operates two UK sites for the production of titanium dioxide pigment. The site in question, Greatham works near Hartlepool, produces pigment via the chloride route. The energy costs at Greatham works can amount to pound5 - 6 million/year depending on production levels. (author).

  12. A prospective study of social difficulties, acculturation and persistent depression in Pakistani women living in the UK.

    Science.gov (United States)

    Chaudhry, N; Husain, N; Tomenson, B; Creed, F

    2012-06-01

    The reasons for the high prevalence of depressive disorders in women of Pakistani origin living in the UK are not clear. The aim of this study was to determine the relative importance of life events, chronic social difficulties and acculturation in a population-based sample of British Pakistani women. A cross-sectional and prospective cohort study of 18- to 65-year-old Pakistani women in UK was carried out. The Schedule for Clinical Assessment in Neuropsychiatry for diagnosis, the Life Events and Difficulties Schedule for social stress and an acculturation questionnaire were used. Depressive disorder at baseline was associated with older age, social isolation and marked difficulties involving health and close relationships. Depressive disorder at follow-up was associated with severity of depression at baseline, difficulties in close relationships and two aspects of acculturation, especially less acculturation in relation to use of the English language. Lack of acculturation, especially less familiarity with the English language, is an independent predictor of persistence of depression in Pakistani women in UK. This needs to be taken into consideration when planning treatment, which also needs to address the personal difficulties associated with persistent depression. The implication of this work is that women of Pakistani origin with depression should be encouraged to receive help in the use of English as one part of treatment that may prevent relapse.

  13. Consumption of Image-Related Luxury Products: An Exploratory Study of Chinese Students in the UK

    OpenAIRE

    Liang, Jiajia

    2013-01-01

    Abstract The aim of this research is to explore UK’s Chinese students’ perceptions of luxury products, and their motivations of purchasing image-related luxury goods. Literature consists of five parts namely: the research context of Chinese students in the UK, the various definitions of “luxury” from different academics, the effect of gender on luxury consumption categories, consumer motivations of purchasing image-related luxury products, and culture value influence. A framework of luxur...

  14. Materiality and external assurance in corporate sustainability reporting: An exploratory study of UK house builders

    OpenAIRE

    Jones, Peter; Comfort, Daphne; Hillier, David

    2015-01-01

    This paper provides a preliminary examination of the extent to which the UK’s leading house builders are embracing the concept of materiality and commissioning independent external assurance as part of their sustainability reporting processes and to offer some wider reflections on materiality and external assurance in sustainability reporting.\\ud \\ud The paper begins with a review of the characteristics of materiality and external assurance and a brief outline of house building in the UK and ...

  15. The University of the Third Age in the UK: An Interpretive and Critical Study

    Science.gov (United States)

    Huang, Chin-Shan

    2006-01-01

    The idea of the University of the Third Age (U3A) in the UK was originated from France. However, the British formed their own model of U3As, which is different from that of French U3As. What are the reasons that the British U3As developed in a different way? The purpose of this article is to interpret and criticize in-depth the reasons why British…

  16. Five Strategic Imperatives for Interdisciplinary Study in Mass Communications/Media Studies in the U.S. and U.K.

    Science.gov (United States)

    Petrausch, Robert J.

    2005-01-01

    Interdisciplinary study can allow students to share ideas with scholars in allied fields and broaden their knowledge of global issues. Mass communication/media studies programs in the U.S. and U.K. can serve as models to lead students into successful learning through interdisciplinary study. This paper outlines five strategic imperatives for the…

  17. A study on the annual equivalent doses received by cardiologists in a UK hospital

    International Nuclear Information System (INIS)

    Fong, R.Y.L.; Ryan, E.; Alonso-Arrizabalaga, S.

    2001-01-01

    A dose assessment study was carried out to determine the likely annual equivalent doses received by various parts of a cardiologist's body. High sensitivity GR-200 thermoluminescent dosemeters were attached to cardiologists' foreheads, little fingers, wrists, elbows, knees and ankles. Three common cardiology procedures were investigated, namely, percutaneous transluminal coronary angioplasty (PTCA), permanent pacemaker insertion (PPM) and left heart catheterisation (LHC). Dose monitoring was done on a case-by-case basis. Data on ten cases of each procedure were gathered. The projected annual equivalent doses were computed by averaging the ten doses measured at each site for each examination type and finding out from the cardiologists how many cases of PTCA, PPM and LHC they do in a year. Results in this study show that for the lens of the eye, the projected annual equivalent dose is below 10 mSv and for the other body parts, it is below 100 mSv per year. The study demonstrated that the methodology used can help to optimise radiation protection in diagnostic radiology. (author)

  18. Prostate-specific antigen (PSA) testing of men in UK general practice: a 10-year longitudinal cohort study.

    Science.gov (United States)

    Young, Grace J; Harrison, Sean; Turner, Emma L; Walsh, Eleanor I; Oliver, Steven E; Ben-Shlomo, Yoav; Evans, Simon; Lane, J Athene; Neal, David E; Hamdy, Freddie C; Donovan, Jenny L; Martin, Richard M; Metcalfe, Chris

    2017-10-30

    Cross-sectional studies suggest that around 6% of men undergo prostate-specific antigen (PSA) testing each year in UK general practice (GP). This longitudinal study aims to determine the cumulative testing pattern of men over a 10-year period and whether this testing can be considered equivalent to screening for prostate cancer (PCa). Patient-level data on PSA tests, biopsies and PCa diagnoses were obtained from the UK Clinical Practice Research Datalink (CPRD) for the years 2002 to 2011. The cumulative risks of PSA testing and of being diagnosed with PCa were estimated for the 10-year study period. Associations of a man's age, region and index of multiple deprivation with the cumulative risk of PSA testing and PCa diagnosis were investigated. Rates of biopsy and diagnosis, following a high test result, were compared with those from the programme of PSA testing in the Prostate Testing for Cancer and Treatment (ProtecT) study. The 10-year risk of exposure to at least one PSA test in men aged 45 to 69 years in UK GP was 39.2% (95% CI 39.0 to 39.4%). The age-specific risks ranged from 25.2% for men aged 45-49 years to 53.0% for men aged 65-69 years (p for trend PSA level ≥3, a test in UK GP was less likely to result in a biopsy (6%) and/or diagnosis of PCa (15%) compared with ProtecT study participants (85% and 34%, respectively). A high proportion of men aged 45-69 years undergo PSA tests in UK GP: 39% over a 10-year period. A high proportion of these tests appear to be for the investigation of lower urinary tract symptoms and not screening for PCa. ISRCTN20141297,NCT02044172. © 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.

  19. Chlorinated organophosphate and “legacy” brominated flame retardants in UK waste soft furnishings: A preliminary study

    Directory of Open Access Journals (Sweden)

    William A. Stubbings

    2016-12-01

    Full Text Available The Furniture and Furnishings (Fire Safety Regulations 1988 is the major driver for the use of chemical flame retardants (FRs in soft furnishings marketed in the UK. While these regulations specify the level of flame retardancy required, they do not specify how such levels should be achieved. Consequently, it remains unclear which FRs are present in UK soft furnishings. This is important not only to help assess what FRs we may be exposed to currently, but which FRs are currently entering the waste stream with concomitant potential for release into the environment. To address this data gap, concentrations of polybrominated diphenyl ethers (PBDEs, hexabromocyclododecane (HBCDD and a range of chlorinated organophosphate flame retardants (OPFRs were measured in samples of domestic and office waste soft furnishings products entering the UK waste stream in 2011 and 2012. This preliminary study measured the FR content of: carpets (n = 4, curtains (n = 7, mattress fabrics (n = 2, furniture foam (n = 9, and furniture upholstery textiles (n = 10. Polybrominated diphenyl ethers (PBDEs and hexabromocyclododecane (HBCDD were not found at significant concentrations (below detection limits in most samples in any of the twenty two analysed products. In contrast, 7 of the 9 furniture foam samples were treated with tris(2-chloroisopropylphosphate (TCIPP at a mean concentration of 1.9% w/w, with another single foam sample containing tris(1,3-dichloroisopropylphosphate (TDCIPP and tris(2-chloroethylphosphate (TCEP at 1.1 and 0.5% respectively. By comparison, PBDE concentrations are within the range reported previously for UK indoor dust [18], rather than the percent by weight levels required to impart flame retardancy.

  20. Perspectives on clinical leadership: a qualitative study exploring the views of senior healthcare leaders in the UK

    Science.gov (United States)

    Mohanna, Kay; Cowpe, Jenny

    2014-01-01

    Introduction Clinicians are being asked to play a major role leading the NHS. While much is written on about clinical leadership, little research in the medical literature has examined perceptions of the term or mapped the perceived attributes required for success. Objective To capture the views of senior UK healthcare leaders regarding their perception of the term `clinical leadership' and the cultural backdrop in which it is being espoused. Setting UK Healthcare sector Participants Senior UK Healthcare leaders Methods Twenty senior healthcare leaders including a former Health Minister, NHS Executives, NHS Strategic Health Authority, PCT and Acute Trust chief executives and medical directors, Medical Deans and other key actors in the UK medical leadership arena were interviewed between 2010 and 2011 using a semi-structured interview technique. Using grounded theory, themes were identified and subsequently analysed in an attempt to answer the broad questions posed. Main outcome measures Not applicable for a qualitative research project Results A number of themes emerged from this qualitative study. First, there was evidence of changing attitudes among doctors, particularly trainees, towards becoming involved in clinical leadership. However, there was unease over the ambiguity of the term ‘clinical leadership’ and the implications for the future. There was, however, broad agreement as to the perceived attributes and skills required for success in healthcare leadership. Conclusions Clinical leadership is often perceived to be doctor centric and ‘Healthcare Leadership’ may be a more inclusive term. An understanding of the historical medico-political context of the leadership debate is required by all healthcare leaders to fully understand the challenges of changing healthcare culture. Whilst the broad attributes deemed essential for success as a healthcare leaders are not new, significant effort and investment, including a physical Healthcare Academy, are

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

    Science.gov (United States)

    McMahon, Kendra

    2012-01-01

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

  2. The BRACELET Study: surveys of mortality in UK neonatal and paediatric intensive care trials

    Directory of Open Access Journals (Sweden)

    Platt Martin

    2010-05-01

    Full Text Available Abstract Background The subject of death and bereavement in the context of randomised controlled trials in neonatal or paediatric intensive care is under-researched. The objectives of this phase of the Bereavement and RAndomised ControlLEd Trials (BRACELET Study were to determine trial activity in UK neonatal and paediatric intensive care (2002-06; numbers of deaths before hospital discharge; and variation in mortality across intensive care units and trials and to determine whether bereavement support policies were available within trials. These are essential prerequisites to considering the implications of future policies and practice subsequent to bereavement following a child's enrolment in a trial. Methods The units survey involved neonatal units providing level 2 or 3 care, and paediatric units providing level II care or above; the trials survey involved trials where allocation was randomized and interventions were delivered to intensive care patients, or to parents but designed to affect patient outcomes. Results Information was available from 191/220 (87% neonatal units (149 level 2 or 3 care; and 28/32 (88% paediatric units. 90/177 (51% eligible responding units participated in one or more trial (76 neonatal, 14 paediatric and 54 neonatal units and 6 paediatric units witnessed at least one death. 50 trials were identified (36 neonatal, 14 paediatric. 3,137 babies were enrolled in neonatal trials, 210 children in paediatric trials. Deaths ranged 0-278 (median [IQR interquartile range] 2 [1, 14.5] per neonatal trial, 0-4 (median [IQR] 1 [0, 2.5] per paediatric trial. 534 (16% participants died post-enrolment: 522 (17% in neonatal trials, 12 (6% in paediatric trials. Trial participants ranged 1-236 (median [IQR] 21.5 [8, 39.8] per neonatal unit, 1-53 (median [IQR] 11.5 [2.3, 33.8] per paediatric unit. Deaths ranged 0-37 (median [IQR] 3.5 [0.3, 8.8] per neonatal unit, 0-7 (median [IQR] 0.5 [0, 1.8] per paediatric unit. Three trials had a

  3. How UK internet websites portray breast milk expression and breast pumps: a qualitative study of content.

    Science.gov (United States)

    McInnes, Rhona J; Arbuckle, Alix; Hoddinott, Pat

    2015-04-02

    Exclusive breastfeeding for six months is recommended but few parents achieve this; particularly younger and less well-educated mothers. Many parents introduce infant formula milk to manage feeding but describe a desire to express breastmilk alongside a lack of support or information. The Internet is highlighted as a key resource. This study aimed to examine UK websites on expressing breastmilk to identify key messages and how information is provided. We used search terms in Google to identify websites with information rich content on expressing breastmilk and breast pumps. Ten sites were purposively selected at two time points in 2013 and 2014 to represent 3 categories: commercial, NHS or 3(rd) sector (voluntary or not for profit). Each site was reviewed by two researchers, data and reflective analytical notes were uploaded into NVivo and thematic data analysis undertaken. Sites varied considerably in their design, use of images, videos, audio files, product placement and marketing opportunities. Three key themes emerged: depiction of expressing; reasons to express; and recommendations about expressing. Inconsistent and conflicting information was common within and between sites. Expressing was portrayed as similar to, but easier than, breastfeeding although at the same time difficult and requiring to be learned. Expressed breastmilk is promoted by mainly commercial sites as immediately available, although pumps were also presented as needing to be concealed, not heard or seen. Health benefits were the overarching reason for expressing. Although predicated on separation from the baby, commercial sites identified this as a positive choice while other sites focused on separation due to circumstance. Commercial sites emphasised restrictions related to breastfeeding, lack of sleep and bonding with the father and wider family. Non-commercial sites emphasised hand expression, with some not mentioning breast pumps. Practical information about starting expressing in

  4. Local Skills Case Study. Research Report

    Science.gov (United States)

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

    2017-01-01

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

  5. Case studies of uncommon headaches.

    Science.gov (United States)

    Evans, Randolph W

    2006-05-01

    The following interesting and uncommon headache disorders are presented through case studies: exploding head syndrome, hypnic headache, neck-tongue syndrome, "Alice in Wonderland" syndrome, nummular headache, red ear syndrome, burning mouth syndrome, spontaneous intracranial hypotension syndrome, and cardiac cephalalgia.

  6. HYDROGEOLOGIC CASE STUDIES (DENVER PRESENTATION)

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  7. HYDROGEOLOGIC CASE STUDIES (CHICAGO, IL)

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  8. Hydrogeologic Case Studies (Seattle, WA)

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  9. a case study ondo state

    African Journals Online (AJOL)

    user

    the design of a Government Cloud (G-Cloud) network for Ondo State Government which will ... network for a developing economy; a case study of ... France is one of those countries that favour .... Arequipa city. .... Where region 0 = Akure, 1 =.

  10. 'Demand pull' government policies to support Product-Service System activity: The case of Energy Service Companies in the UK

    OpenAIRE

    Hannon, MJ; Foxon, TJ; Gale, WF

    2015-01-01

    Product-Service Systems (PSSs) constitute a family of service-based business models designed to satisfy our societal needs in an economically and environmentally sustainable manner. To date however PSS application has remained niche due to a variety of critical barriers. This paper explores how ‘demand pull’ national government policies could support PSS activity by addressing these barriers and cultivating market demand. Lessons are drawn from a case study of how regulatory, economic incenti...

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

    Science.gov (United States)

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

    2017-07-13

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

  12. Implementation of food safety management systems in the UK

    OpenAIRE

    Mensah, L. D.; Julien, D.

    2011-01-01

    This paper reports the first stage of work being undertaken to understand the factors that have impacted on the current state of food safety in the UK food manufacturing sector. The paper first explores developments in international food safety regulation in general and in particular, the UK. Using a survey and case study methodology, the paper examines the response of food manufacturing enterprises to food safety regulation, and uses statistical techniques to investigate th...

  13. Characterisation: Challenges and Opportunities - A UK Perspective

    International Nuclear Information System (INIS)

    Emptage, Matthew; Loudon, David; Mcleod, Richard; Milburn, Helen

    2016-01-01

    Characterisation plays a very important role in the nuclear industry supporting: the development and implementation of decommissioning strategies/plans (and the optimisation of associated costs through reduction in technical risks); regulatory compliance demonstration; waste prevention/minimisation; evaluation and optimisation of worker radiation doses; and maintaining public confidence. Recognising these important drivers, the UK regulators are working with the UK Nuclear Decommissioning Authority (NDA) to undertake a review of characterisation practice in the UK nuclear (decommissioning) industry. The objective of the characterisation review is to understand the current characterisation challenges and to determine strategic and tactical opportunities (including sharing of standards and guidance, capabilities, learning from experience, good practice, research and development, training, quality assurance) to optimise characterisation practice. The work is being undertaken through review of nuclear operator's characterisation practice, with input from the NDA, the UK regulators, nuclear operators and representatives from the supply chain, and through consideration of good practice case studies. To support this, a catalogue of relevant national/international guidance documents is also be compiled. Finally a workshop with representatives from all parties has taken place to consider the findings and establish a common understanding of challenges and opportunities and to start to consider how they can be addressed. The review is establishing a collective (UK regulator's, NDA; nuclear operator's and supply chain) understanding of opportunities to improve characterisation practice in the UK. The characterisation review process is described and early results are presented and discussed. Subsequent work in 2016 will be required to prioritise the opportunities and to build a consensus to facilitate development and implementation of an improvement plan. The aim

  14. Development of a Generic Environmental Safety Case for the Disposal of Higher Activity Wastes in the UK

    International Nuclear Information System (INIS)

    Bailey, Lucy; Hicks, Tim

    2016-01-01

    The UK generic ESC demonstrates safe disposal of higher activity wastes, by providing: • A demonstration of how environmental safety can be achieved by a variety of disposal concepts based on systems of multiple engineered and natural barriers, providing multiple safety functions; • An understanding of expected barrier performance and how conditions in a disposal system will evolve, based on research findings presented in RWM’s knowledge base; • An approach to safety assessment based on multiple lines of reasoning, involving both qualitative and quantitative analysis; • Complementary insight modelling and total system modelling used to develop understanding of how different components of the engineered and natural barrier system contribute to safety

  15. Comprehensive sequence analysis of nine Usher syndrome genes in the UK National Collaborative Usher Study

    OpenAIRE

    Le Quesne Stabej, Polona; Saihan, Zubin; Rangesh, Nell; Steele-Stallard, Heather B; Ambrose, John; Coffey, Alison; Emmerson, Jenny; Haralambous, Elene; Hughes, Yasmin; Steel, Karen P; Luxon, Linda M; Webster, Andrew R; Bitner-Glindzicz, Maria

    2011-01-01

    Background Usher syndrome (USH) is an autosomal recessive disorder comprising retinitis pigmentosa, hearing loss and, in some cases, vestibular dysfunction. It is clinically and genetically heterogeneous with three distinctive clinical types (I?III) and nine Usher genes identified. This study is a comprehensive clinical and genetic analysis of 172 Usher patients and evaluates the contribution of digenic inheritance. Methods The genes MYO7A, USH1C, CDH23, PCDH15, USH1G, USH2A, GPR98, WHRN, CLR...

  16. Obtaining antibiotics online from within the UK: a cross-sectional study

    Science.gov (United States)

    Boyd, Sara Elizabeth; Moore, Luke Stephen Prockter; Gilchrist, Mark; Costelloe, Ceire; Castro-Sánchez, Enrique; Franklin, Bryony Dean; Holmes, Alison Helen

    2017-01-01

    Background: Improved antibiotic stewardship (AS) and reduced prescribing in primary care, with a parallel increase in personal internet use, could lead citizens to obtain antibiotics from alternative sources online. Objectives: A cross-sectional analysis was performed to: (i) determine the quality and legality of online pharmacies selling antibiotics to the UK public; (ii) describe processes for obtaining antibiotics online from within the UK; and (iii) identify resulting AS and patient safety issues. Methods: Searches were conducted for ‘buy antibiotics online’ using Google and Yahoo. For each search engine, data from the first 10 web sites with unique URL addresses were reviewed. Analysis was conducted on evidence of appropriate pharmacy registration, prescription requirement, whether antibiotic choice was ‘prescriber-driven’ or ‘consumer-driven’, and whether specific information was required (allergies, comorbidities, pregnancy) or given (adverse effects) prior to purchase. Results: Twenty unique URL addresses were analysed in detail. Online pharmacies evidencing their location in the UK (n = 5; 25%) required a prescription before antibiotic purchase, and were appropriately registered. Online pharmacies unclear about the location they were operating from (n = 10; 50%) had variable prescription requirements, and no evidence of appropriate registration. Nine (45%) online pharmacies did not require a prescription prior to purchase. For 16 (80%) online pharmacies, decisions were initially consumer-driven for antibiotic choice, dose and quantity. Conclusions: Wide variation exists among online pharmacies in relation to antibiotic practices, highlighting considerable patient safety and AS issues. Improved education, legislation, regulation and new best practice stewardship guidelines are urgently needed for online antibiotic suppliers. PMID:28333179

  17. Comparative Study on Urban Planning Inspection System in the UK and China

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    The urban-rural planning inspector system of China is hierarchical supervision over local governments from the Central Government in respect of town and country development. The comparative analysis on planning inspection system of the UK may provide experience in seeking solutions to the problems occurring in the system of China. The planning inspector system of China can be improved in six aspects such as establishing the legal status, setting up the planning inspection agency, completing the personnel management system, enhancing the legal binding force, building the internal and external supervision channel, supplementing the relieve function, and establishing the coordination mechanism of various internal supervisions.

  18. UK and European Union public and charitable funding from 2008 to 2013 for bacteriology and antibiotic research in the UK: an observational study.

    Science.gov (United States)

    Bragginton, Eilis C; Piddock, Laura J V

    2014-09-01

    Since the 1990s, the number of new antibacterial drugs has plummeted and the number of antibiotic-resistant infections has risen, which has decreased the effective treatment of many disorders, including sepsis. We aimed to assess whether funding for bacteriology and antibiotic research to UK researchers had increased in response to this global crisis. We systematically searched websites and databases of agencies that fund research in the UK to identify publicly and charitably funded projects from financial years 2008 to 2013 within the specialties of bacteriology and antibiotic research. We created a database to identify the projects funded. Grants awarded in euros were converted to pounds sterling (€1=£0·86). We identified 609 projects within the specialty of bacteriology, 196 (32·2%) of which were on antibiotics. Of £13 846·1 million of available research funding, £269·2 million (1·9%) was awarded to bacteriology projects and £95·0 million (0·7%) was awarded for research on antibiotics. Additionally, £181·4 million in European Union (EU) funding was awarded to antibiotic research consortia including researchers based within the UK, including two EU Innovative Medicines Initiative awards, totalling £85·2 million. To increase awareness of who funds antibiotic research and to facilitate priority setting and funding decisions, funding organisations need to be aware of the breadth and depth of present funding as a baseline by which funding from 2014 onwards can be measured and so that informed decisions about the future level of funding can be made. To resolve the crisis of antibiotic resistance, present levels of funding are inadequate and should be increased substantially. British Society for Antimicrobial Chemotherapy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Assessing occupational and domestic ELF magnetic field exposure in the UK Adult Brain Tumour Study: Results of a feasibility study

    International Nuclear Information System (INIS)

    Van Tongeren, M.; Mee, T.; Whatmough, P.; Broad, L.; Mashlanyj, M.; Allen, S.; Muir, K.; McKinney, P.

    2004-01-01

    The feasibility of measuring exposure to extremely low frequency magnetic fields (ELF MF) in the UK Adult Brain Tumour Study (UKABTS) was examined. During the study, 81 individuals and 30 companies were approached with 79 individuals and 25 companies agreeing to participate. Exposure data were collected using EMDEX II dosemeters worn by the participants for 3-4 consecutive days. Data were collected over a total of 321 d, including non-occupational periods. The results showed occupational exposure to be the main determinant of overall exposure. Moderate to strong correlations were found between arithmetic mean exposure and all other metrics with the possible exception of maximum exposure. Significant differences in exposure were found between job categories with large variability in certain categories. Highest average exposures were found for security officers (arithmetic mean, AM: 0.78 μT), secretaries (AM: 0.48 μT) and dentists (AM: 0.42 μT). Welding and working near high-voltage power lines were associated with elevated exposure. In summary, acceptably precise measures of ELF MF exposure are feasible at relatively moderate cost. The results were used to develop a protocol for data collection from subjects in the UKABTS. (authors)

  20. Magazine Publishing Innovation: Two Case Studies on Managing Creativity

    Directory of Open Access Journals (Sweden)

    Simon Das

    2016-06-01

    Full Text Available This paper aims to highlight a link between publishing business innovation and how editors manage creativity in the digital era. Examining the changing industrial and historical business context for the U.K. magazine publishing industry, two case studies are analyzed as representatives of different ends of the publishing company spectrum (one a newly launched magazine published by a major, the other an independent ‘magazine’ website start-up. Qualitative data analysis on publishing innovation and managing creativity is presented as a springboard for further research on magazine media management.

  1. Macroeconomic effects of efficiency policies for energy-intensive industries: the case of the UK Climate Change Agreements, 2000-2010

    International Nuclear Information System (INIS)

    Barker, T.; Foxon, T.

    2007-01-01

    This paper reports a study modeling the UK Climate Change Agreements (CCAs) and related energy-efficiency policies for energy-intensive industrial sectors. Bottom-up estimates of the effects of these policies are introduced into the energy-demand equations of a top-down dynamic econometric model of the UK economy with fifty industrial sectors, MDM-E3. This allowed estimation of the effects of the reduced energy use for the outputs from the sectors, i.e. the reductions in unit costs of the energy-intensive industries, on the demand for their outputs (both in the UK and in the export markets). The model is solved as a counterfactual 2000-2005 and as a projection 2005-2010 in a series of scenarios to allow estimation of the effects of the policies on inflation and growth, as well as on overall energy demand and CO 2 emissions. The system-wide final energy reductions is estimated to be 4.2 mtoe, or 2.6%, of total final demand for energy by 2010, including a rebound effect of 19%, with negligible effects on inflation and a slight increase in economic growth through improved international competitiveness. (author)

  2. Chronic disease and independence in old age: A case study

    International Nuclear Information System (INIS)

    Reeves, Pauline J.

    2006-01-01

    This report uses case study methodology to examine the issue of long-term care of the elderly in the United Kingdom, including where that care should take place. The report will examine the difficulties inherent in maintaining independent living for the elderly (in particular the danger and cost of falls). The case study presented is that of an elderly female patient who had suffered from chronic rheumatoid arthritis for over 10 years. She was admitted to hospital several times from December 2003 to January 2004. The discussion of her case is set in the context of the sociology of ageing; long-term care of the elderly and the UK National Service Frameworks, of which standard six relates to falls in the elderly. The report will also consider the problems in deciding whether it is necessary to terminate independent living for an individual

  3. Comparison of attitudes and beliefs regarding the causes of low back pain between UK students and International students studying at Sheffield Hallam University

    Directory of Open Access Journals (Sweden)

    Yousef Shanib

    2017-02-01

    Full Text Available Background & Aim Low Back Pain (LBP is a widespread problem. Very few past studies which focus on the attitudes and beliefs regarding the causes of LBP of UK and international students exist. This study compares attitudes and beliefs regarding the causes of low back pain between UK students and International students studying at Sheffield Hallam University. Methods The study involved 12 participants (6 UK and 6 international students studying at Sheffield Hallam University. Data was collected by conducting face to face semi structured, recorded interviews. Interviews were later transcribed verbatim. In order to analyse the data obtained, thematic analysis was carried out, using themes found in data transcriptions. Results Four main themes were identified from the data obtained from interviews. These were; personal health and medical related, work related, everyday day life and culture related and government policy and law related. Main themes identified consisted of other smaller themes. Conclusion Attitudes and beliefs belonging to UK and international students at Sheffield Hallam University are related to four main themes; personal health and medical, work, everyday day life and culture and government policy and law. The study identified differences in attitudes and beliefs between UK and International students. As students are the next generation of employees, the study could aid in increasing knowledge of causes of LBP of students in the UK and Internationally, therefore preventing low back pain incidences in the future.

  4. Risk Identification in the Early Design Stage Using Thermal Simulations—A Case Study

    Directory of Open Access Journals (Sweden)

    Seyed Masoud Sajjadian

    2018-01-01

    Full Text Available The likely increasing temperature predicted by UK Climate Impacts Program (UKCIP underlines the risk of overheating and potential increase in cooling loads in most of UK dwellings. This could also increase the possibility of failure in building performance evaluation methods and add even more uncertainty to the decision-making process in a low-carbon building design process. This paper uses a 55-unit residential unit project in Cardiff, UK as a case study to evaluate the potential of thermal simulations to identify risk in the early design stage. Overheating, increase in energy loads, carbon emissions, and thermal bridges are considered as potential risks in this study. DesignBuilder (DesignBuilder Software Ltd., Stroud, UK was the dynamic thermal simulation software used in this research. Simulations compare results in the present, 2050, and 2080 time slices and quantifies the overall cooling and heating loads required to keep the operative temperature within the comfort zone. Overall carbon emissions are also calculated and a considerable reduction in the future is predicted. Further analysis was taken by THERM (Lawrence Berkeley National Laboratory, Berkeley, CA, USA and Psi THERM (Passivate, London, UK to evaluate the thermal bridge risk in most common junctions of the case study and the results reveal the potential of thermal assessment methods to improve design details before the start of construction stage.

  5. Challenges in collecting clinical samples for research from pregnant women of South Asian origin: evidence from a UK study.

    Science.gov (United States)

    Neelotpol, Sharmind; Hay, Alastair W M; Jolly, A Jim; Woolridge, Mike W

    2016-08-31

    To recruit South Asian pregnant women, living in the UK, into a clinicoepidemiological study for the collection of lifestyle survey data and antenatal blood and to retain the women for the later collection of cord blood and meconium samples from their babies for biochemical analysis. A longitudinal study recruiting pregnant women of South Asian and Caucasian origin living in the UK. Recruitment of the participants, collection of clinical samples and survey data took place at the 2 sites within a single UK Northern Hospital Trust. Pregnant women of South Asian origin (study group, n=98) and of Caucasian origin (comparison group, n=38) living in Leeds, UK. Among the participants approached, 81% agreed to take part in the study while a 'direct approach' method was followed. The retention rate of the participants was a remarkable 93.4%. The main challenges in recruiting the ethnic minority participants were their cultural and religious conservativeness, language barrier, lack of interest and feeling of extra 'stress' in taking part in research. The chief investigator developed an innovative participant retention method, associated with the women's cultural and religious practices. The method proved useful in retaining the participants for about 5 months and in enabling successful collection of clinical samples from the same mother-baby pairs. The collection of clinical samples and lifestyle data exceeded the calculated sample size required to give the study sufficient power. The numbers of samples obtained were: maternal blood (n=171), cord blood (n=38), meconium (n=176), lifestyle questionnaire data (n=136) and postnatal records (n=136). Recruitment and retention of participants, according to the calculated sample size, ensured sufficient power and success for a clinicoepidemiological study. Results suggest that development of trust and confidence between the participant and the researcher is the key to the success of a clinical and epidemiological study involving

  6. Teaching Case: Enterprise Architecture Specification Case Study

    Science.gov (United States)

    Steenkamp, Annette Lerine; Alawdah, Amal; Almasri, Osama; Gai, Keke; Khattab, Nidal; Swaby, Carval; Abaas, Ramy

    2013-01-01

    A graduate course in enterprise architecture had a team project component in which a real-world business case, provided by an industry sponsor, formed the basis of the project charter and the architecture statement of work. The paper aims to share the team project experience on developing the architecture specifications based on the business case…

  7. A study of grandparents and grandchildren as visitors to museums and art galleries in the UK

    Directory of Open Access Journals (Sweden)

    Ela Beaumont

    2005-11-01

    Full Text Available This paper discusses one aspect of a major research project funded by the Arts and Humanities Research Council of family group visitors to museums and galleries in the UK. Grandparents visiting with their grandchildren are a little understood phenomenon in terms of visitor research and this paper aims to address that balance. The research project focuses on three art galleries and museums in the UK where 44 sets of grandparents were interviewed during the initial stages of the research. Findings have shown a number of interesting facets, some of which are presented in this paper. Grandparents are motivated to visit the museum with their grandchildren in the main because they are seeking an entertaining visit, a day out that is also educational and linked to school projects. They are likely to be the children’s primary carers as parents are out to work and the destination might not link with their own interests but those of the parents. They have social roles to play in their grandchildren’s lives. They often seek activity or workshops in the museum/art gallery that will be of benefit for their grandchildren and encourage them to explore the activities provided. These and other aspects are discussed within the paper. We conclude by suggesting how the findings can be used to inform more sophisticated approaches to ‘family friendly’ initiatives in museums and art galleries.

  8. Coal mining and agriculture: a study in environmental impact assessment. [On agriculture in UK

    Energy Technology Data Exchange (ETDEWEB)

    Selman, P.H.

    1986-03-01

    Coal mining activities in the U.K. are reported to be extending into areas of comparatively unspoilt countryside. Despite reductions in the National Coal Board's programme of future expansion, it is considered that the scale of impact of new mining activities on agriculture is still likely to be significant. The major impact will be associated with land alienation, but a wide range of other adverse effects will also be encountered. In view of the controversy likely to accompany new mining proposals, it is recommended that methods of environmental impact assessment (EIA) should be adopted. The nature and components of EIA are reviewed, and a framework appropriate to mining-agriculture conflicts is advanced. This approach is more closely examined In relation to recent developments in Leicestershire, U.K. It is found that the magnitude of agricultural impact is small in national terms, but may be severe at the local and - if mining activities become geographically concentrated - even at the sub-regional level. Systematic scrutiny of major coaling proposals by EIA will therefore become essential. (115 refs.)

  9. Theory Testing Using Case Studies

    DEFF Research Database (Denmark)

    Sørensen, Pernille Dissing; Løkke, Ann-Kristina

    2006-01-01

    design. Finally, we discuss the epistemological logic, i.e., the value to larger research programmes, of such studies and, following Lakatos, conclude that the value of theory-testing case studies lies beyond naïve falsification and in their contribution to developing research programmes in a progressive...

  10. Clinical features, microbiology and surgical outcomes of infective endocarditis: a 13-year study from a UK tertiary cardiothoracic referral centre.

    Science.gov (United States)

    Marks, D J B; Hyams, C; Koo, C Y; Pavlou, M; Robbins, J; Koo, C S; Rodger, G; Huggett, J F; Yap, J; Macrae, M B; Swanton, R H; Zumla, A I; Miller, R F

    2015-03-01

    Infective endocarditis (IE) causes substantial morbidity and mortality. Patient and pathogen profiles, as well as microbiological and operative strategies, continue to evolve. The impact of these changes requires evaluation to inform optimum management and identify individuals at high risk of early mortality. Identification of clinical and microbiological features, and surgical outcomes, among patients presenting to a UK tertiary cardiothoracic centre for surgical management of IE between 1998 and 2010. Retrospective observational cohort study. Clinical, biochemical, microbiological and echocardiographic data were identified from clinical records. Principal outcomes were all-cause 28-day mortality and duration of post-operative admission. Patients (n = 336) were predominantly male (75.0%); median age 52 years (IQR = 41-67). Most cases involved the aortic (56.0%) or mitral (53.9%) valves. Microbiological diagnoses, obtained in 288 (85.7%) patients, included streptococci (45.2%); staphylococci (34.5%); Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella (HACEK) organisms (3.0%); and fungi (1.8%); 11.3% had polymicrobial infection. Valve replacement in 308 (91.7%) patients included mechanical prostheses (69.8%), xenografts (24.0%) and homografts (6.2%). Early mortality was 12.2%, but fell progressively during the study (P = 0.02), as did median duration of post-operative admission (33.5 to 10.5 days; P = 0.0003). Multivariable analysis showed previous cardiothoracic surgery (OR = 3.85, P = 0.03), neutrophil count (OR = 2.27, P = 0.05), albumin (OR = 0.94, P = 0.04) and urea (OR = 2.63, P < 0.001) predicted early mortality. This study demonstrates reduced post-operative early mortality and duration of hospital admission for IE patients over the past 13 years. Biomarkers (previous cardiothoracic surgery, neutrophil count, albumin and urea), predictive of early post-operative mortality, require prospective evaluation to refine algorithms, further improve

  11. Case Study of 'moral injury' : Format Dutch Case Studies Project

    NARCIS (Netherlands)

    Korver, Sjaak; Walton, Martin N.; van Loenen, Guus

    2017-01-01

    The case study ‘Moral Injury’ traces care provided by a chaplain in a mental health institution to a former military marksman named Hans. Hans was in care at a specialized unit for military veterans with traumas. He sought contact with a chaplain “to set things right with God” and wanted the

  12. Get a Life? The Impact of the European Working Time Directive: The Case of UK Senior Doctors.

    Science.gov (United States)

    Dolton, Peter J; Kidd, Michael P; Fooken, Jonas

    2015-10-01

    This paper seeks to identify the effect of the implementation of the European Working Time Directive on the working hours of UK doctors. The Labour Force Survey is used to compare the working hours of doctors with a variety of control groups before and after the implementation of the directive. The controls include those unconstrained by the directive and doctor counterparts working in Europe. We use differences-in-differences and matching methods to estimate the impact of this natural experiment, distinguishing between the anticipation and enactment of the European Working Time Directive. We find that the legislation reduced the hours of senior doctors by around 8 hours in total including the component attributable to anticipation effects and allowing for (exogenously set) rising wages. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

  13. Exposing the faults: the geological case against the plans by UK NIREX to dispose of radioactive waste

    International Nuclear Information System (INIS)

    Richardson, P.J.

    1989-01-01

    NIREX has given the strong impression throughout is recent public consultation exercise connected with underground disposal of low and intermediate level waste that the problem is one of public and political acceptability, rather than one of a technical nature. This is not the place in which to list the considerable failings of this latest attempt. Nevertheless, the results of the consultation process show quite clearly that it has no mandate from the British public to develop a single, national deep repository for the burial of radioactive waste. There is considerable opposition to this method of managing radioactive waste and a quite reasonable suspicion of the claims by NIREX concerning the supposed integrity and safety of this deep burial option. This report gives substance to those suspicions and spells out in detail the significant areas of uncertainty in the concept of effective geological containment of hazardous radioactive elements, which remain dangerous for tens of thousands of years. Because the science of geology is essentially retrospective rather than predictive, NIREX's plans for a single, national, deep 'repository' depend heavily upon a wide range of assumptions about the geological and hydrogeological regimes in certain areas of the United Kingdom (UK). This report demonstrates that these assumptions are based on a limited understanding of UK geology and on unvalidated and simplistic theoretical models of geological processes, the performance of which can never be directly tested over the long time-scales involved. An extensive public relations exercise cannot hide the unavoidable technical uncertainties associated with burying radioactive waste. Dumping radioactive waste is foolhardy and irresponsible in the face of these unknowns. NIREX's proposals offer no guarantees for the safe and effective containment of radioactivity. They are deeply flawed. This report exposes the faults. (author)

  14. The case for a new capacity mechanism in the UK electricity market-Lessons from Australia and New Zealand

    International Nuclear Information System (INIS)

    Carstairs, Jamie; Pope, Ian

    2011-01-01

    The UK Government plans a capacity mechanism to ensure sufficient reserves as the share of intermittent generation increases. This article reviews the use of last resort capacity mechanisms in two other energy-only markets, Australia and New Zealand. The Australian National Electricity Market has infrequent price spikes up to A$12,500 ( Pounds 7800)/MWh. Option contracts have supported significant investment in peak capacity. The system operator also has an ability to contract reserve up to 9 months before projected shortfalls. Reserve has been contracted on two occasions but never dispatched. The New Zealand electricity market includes a reserve energy scheme which allows the system operator to contract and dispatch reserve capacity. One plant has been contracted under the scheme. The plant is currently offered into the market at NZ$5000 ( Pounds 2300)/MWh. In both markets there have been concerns that reserve schemes could reduce the frequency of high prices and damage price signals for peak investment. Following a Ministerial review in 2009 the New Zealand scheme is being closed down and the plant is for sale. The Australian scheme is to be closed down in 2013. This experience raises concerns about the possible impact of a new capacity mechanism in Great Britain. - Highlights: → The UK is considering a capacity mechanism targeted at new generation and dispatched as a last resort. → Australia and New Zealand are shutting down reserve schemes due to impact on investment incentives. → This shows that energy only markets can deliver sufficient reserves without a capacity mechanism. → An optimal response may be to ensure price signals are strong enough to ensure necessary investment. → If price signals are too weak a market wide response would be preferable to a targeted mechanism.

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

    Science.gov (United States)

    Robson, Andrew; Robson, Fiona

    2015-01-01

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

  16. eCompetence Case Studies

    DEFF Research Database (Denmark)

    Jensen, Helle Bækkelund

    2006-01-01

    In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches.......In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches....

  17. Neighbourhood walkability and incidence of hypertension: Findings from the study of 429,334 UK Biobank participants.

    Science.gov (United States)

    Sarkar, Chinmoy; Webster, Chris; Gallacher, John

    2018-04-01

    With an estimated one billion hypertension cases worldwide, the role of the built environment in its prevention and control is still uncertain. The present study aims to examine the associations between neighbourhood walkability and hypertension in a large and diverse population-based cohort. We examined the association between neighbourhood walkability and blood pressure outcomes for N = 429,334 participants drawn from the UK Biobank and aged 38-73 years. Neighbourhood walkability was objectively modelled from detailed building footprint-level data within multi-scale functional neighbourhoods (1.0-, 1.5- and 2.0-kilometer street catchments of geocoded dwelling). A series of linear and modified Poisson regression models were employed to examine the association between walkability and outcomes of diastolic blood pressure (DBP in mmHg), systolic blood pressure (SBP in mmHg) and prevalent hypertension adjusting for socio-demographic, lifestyle and related physical environmental covariates. We also examined the relationship between walkability and change in blood pressure for a sub-sample of participants with follow-up data and tested for interaction effects of age, sex, employment status, neighbourhood SES, residential density and green exposure. Neighbourhood walkability within one-kilometer street catchment was beneficially associated with all the three blood pressure outcomes, independent of all other factors. Each interquartile increment in walkability was associated with the lower blood pressure outcomes of DBP (β = -0.358, 95% CI: -0.42, -0.29 mmHg), SBP (β = -0.833, 95% CI: -0.95, -0.72 mmHg) as well as reduced hypertension risk (RR = 0.970, 95% CI: 0.96, 0.98). The results remained consistent across spatial and temporal scales and were sensitive to sub-groups, with pronounced protective effects among female participants, those aged between 50 and 60 years, in employment, residing in deprived, high density and greener areas. This large

  18. Case Study on Logistics Performance

    Directory of Open Access Journals (Sweden)

    Shahryar Sorooshian

    2013-05-01

    Full Text Available The paper presents research carried out at a medium‐size manufacturing organization in east Asia. The study tries to highlight the importance of supply chain management; specifically, our aim for this study is to understand logistics and performance measurement in the logistics and supply chain, and we include a theoretical discussion of online data collected and a case study of the logistic performance of a real organization. The study also examines the performance of the selected company, identifies the problems and provides recommendations for improvements. This study can be a guide for business advisers and those interested in analysing company performance, especially from a logistics viewpoint. We also suggest the methodology of this case study for those who want to have a better understanding of a business environment before starting their own business, or for benchmarking practice during strategic planning.

  19. How to Establish and Follow up a Large Prospective Cohort Study in the 21st Century - Lessons from UK COSMOS

    Science.gov (United States)

    Toledano, Mireille B.; Smith, Rachel B.; Brook, James P.; Douglass, Margaret; Elliott, Paul

    2015-01-01

    Large-scale prospective cohort studies are invaluable in epidemiology, but they are increasingly difficult and costly to establish and follow-up. More efficient methods for recruitment, data collection and follow-up are essential if such studies are to remain feasible with limited public and research funds. Here, we discuss how these challenges were addressed in the UK COSMOS cohort study where fixed budget and limited time frame necessitated new approaches to consent and recruitment between 2009-2012. Web-based e-consent and data collection should be considered in large scale observational studies, as they offer a streamlined experience which benefits both participants and researchers and save costs. Commercial providers of register and marketing data, smartphones, apps, email, social media, and the internet offer innovative possibilities for identifying, recruiting and following up cohorts. Using examples from UK COSMOS, this article sets out the dos and don’ts for today's cohort studies and provides a guide on how best to take advantage of new technologies and innovative methods to simplify logistics and minimise costs. Thus a more streamlined experience to the benefit of both research participants and researchers becomes achievable. PMID:26147611

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

    Science.gov (United States)

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

    2012-09-01

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

  1. BioFleet case studies

    International Nuclear Information System (INIS)

    2007-01-01

    These six case studies examined the use of different biodiesel blends as fuel supply sources for businesses in British Columbia (BC). In the first case study, 6 municipalities participated in a pilot program designed to compare the performance of biodiesel and diesel fuels. Each municipality operated 2 base vehicles running on conventional diesel along with 2 similar vehicles which used biodiesel. Real time emissions tests and analyses of the vehicles using biodiesel were also conducted by 2 of the participating municipalities. All municipalities participating in the study agreed to purchase significant volumes of biodiesel. The second case study described a pilot study conducted by the City of Vancouver's equipment services branch in 2004. As a result of the study, the city now has over 530 types of equipment that use biodiesel. The third case study described a program designed by TSI Terminals in Vancouver to assess the emission reduction impact of using biodiesel at its port facility. Six different pieces of equipment were used to confirm that biodiesel could be used throughout the terminal. Test results confirmed that biodiesel blends could be used to reduce emissions. Overall emissions were reduced by 30 per cent. The fourth case study described a waste renderer that used a fleet of 36 trucks to deliver raw products to its plants. The company made the decision to use only biodiesel for its entire fleet of trucks. Since July 2005, the company has logged over 1.7 million km using biodiesel blends. The fifth case study described a salmon hatchery that switched from diesel to biodiesel in order to reduce emissions. The biodiesel blends are used to fuel the hatchery's 2 diesel generators. The hatchery has reduced emissions of greenhouse gases (GHGs) by an estimated 1800 tonnes annually. The sixth case study described how the Township of Langley has started using biodiesel for its entire fleet of of approximately 250 pieces of equipment. The township has not

  2. Resource utilisation, costs and clinical outcomes in non-institutionalised patients with Alzheimer’s disease: 18-month UK results from the GERAS observational study

    OpenAIRE

    Alan Lenox-Smith; Catherine Reed; Jeremie Lebrec; Mark Belger; Roy W. Jones

    2016-01-01

    Abstract Background Alzheimer’s disease (AD), the commonest cause of dementia, represents a significant cost to UK society. This analysis describes resource utilisation, costs and clinical outcomes in non-institutionalised patients with AD in the UK. Methods The GERAS prospective observational study assessed societal costs associated with AD for patients and caregivers over 18 months, stratified according to baseline disease severity (mild, moderate, or moderately severe/severe [MS/S]). All p...

  3. Retail price and point of sale display of tobacco in the UK: a descriptive study of small retailers.

    Directory of Open Access Journals (Sweden)

    Dionysis Spanopoulos

    Full Text Available Since the implementation of the 2002 Tobacco Advertising and Promotion Act, point-of-sale (PoS tobacco displays are one of few remaining means of communication between the tobacco industry and customers in the UK. This study aimed to explore the characteristics of tobacco displays in a UK city, and particularly to assess the tobacco prices and promotional offers, types and pack sizes on display.Digital pictures of PoS displays were taken in 117 small retail shops in Nottingham in mid 2010. Data were analysed using Windows Photo Gallery software and SPSS version 16.Just over half (52% of cigarette packs on display were packs of 20, and 43% packs of 10. Cigarette prices differed substantially between brands, ranging from £4.19 to £6.85 for 20-packs, and from £2.12 to £3.59 for 10-packs. Forty four percent of cigarette packs and 40% of RYO (Roll-Your-Own tobacco pouches, almost exclusively lower priced brands, were displayed with a pricemark, implying a promotional price offer. Eighty percent of 20-pack cigarette brand or brand variants on sale were priced below the EU-defined Most Popular Price Category (MPPC for the UK in 2010; 45% were priced below the Weighted Average Price (WAP, which replaced the MPPC in 2011.PoS displays communicate value by displaying a high proportion of lower cost brands, and smaller and hence lower-cost packs, and by displaying price discounts on packs. The MPPC substantially overestimated the prices at which most 20-cigarette packs were available. Removal of PoS displays will prevent this means of price marketing but our study also suggests that minimum pricing of 20-pack cigarettes, prohibition of sale of cigarettes in packs less than 20, and plain packaging to prevent pricemarking are necessary if price is to be used effectively as a tobacco control measure.

  4. Retail price and point of sale display of tobacco in the UK: a descriptive study of small retailers.

    Science.gov (United States)

    Spanopoulos, Dionysis; Ratschen, Elena; McNeill, Ann; Britton, John

    2012-01-01

    Since the implementation of the 2002 Tobacco Advertising and Promotion Act, point-of-sale (PoS) tobacco displays are one of few remaining means of communication between the tobacco industry and customers in the UK. This study aimed to explore the characteristics of tobacco displays in a UK city, and particularly to assess the tobacco prices and promotional offers, types and pack sizes on display. Digital pictures of PoS displays were taken in 117 small retail shops in Nottingham in mid 2010. Data were analysed using Windows Photo Gallery software and SPSS version 16. Just over half (52%) of cigarette packs on display were packs of 20, and 43% packs of 10. Cigarette prices differed substantially between brands, ranging from £4.19 to £6.85 for 20-packs, and from £2.12 to £3.59 for 10-packs. Forty four percent of cigarette packs and 40% of RYO (Roll-Your-Own) tobacco pouches, almost exclusively lower priced brands, were displayed with a pricemark, implying a promotional price offer. Eighty percent of 20-pack cigarette brand or brand variants on sale were priced below the EU-defined Most Popular Price Category (MPPC) for the UK in 2010; 45% were priced below the Weighted Average Price (WAP), which replaced the MPPC in 2011. PoS displays communicate value by displaying a high proportion of lower cost brands, and smaller and hence lower-cost packs, and by displaying price discounts on packs. The MPPC substantially overestimated the prices at which most 20-cigarette packs were available. Removal of PoS displays will prevent this means of price marketing but our study also suggests that minimum pricing of 20-pack cigarettes, prohibition of sale of cigarettes in packs less than 20, and plain packaging to prevent pricemarking are necessary if price is to be used effectively as a tobacco control measure.

  5. Do personality traits assessed on medical school admission predict exit performance? A UK-wide longitudinal cohort study.

    Science.gov (United States)

    MacKenzie, R K; Dowell, J; Ayansina, D; Cleland, J A

    2017-05-01

    Traditional methods of assessing personality traits in medical school selection have been heavily criticised. To address this at the point of selection, "non-cognitive" tests were included in the UK Clinical Aptitude Test, the most widely-used aptitude test in UK medical education (UKCAT: http://www.ukcat.ac.uk/ ). We examined the predictive validity of these non-cognitive traits with performance during and on exit from medical school. We sampled all students graduating in 2013 from the 30 UKCAT consortium medical schools. Analysis included: candidate demographics, UKCAT non-cognitive scores, medical school performance data-the Educational Performance Measure (EPM) and national exit situational judgement test (SJT) outcomes. We examined the relationships between these variables and SJT and EPM scores. Multilevel modelling was used to assess the relationships adjusting for confounders. The 3343 students who had taken the UKCAT non-cognitive tests and had both EPM and SJT data were entered into the analysis. There were four types of non-cognitive test: (1) libertariancommunitarian, (2) NACE-narcissism, aloofness, confidence and empathy, (3) MEARS-self-esteem, optimism, control, self-discipline, emotional-nondefensiveness (END) and faking, (4) an abridged version of 1 and 2 combined. Multilevel regression showed that, after correcting for demographic factors, END predicted SJT and EPM decile. Aloofness and empathy in NACE were predictive of SJT score. This is the first large-scale study examining the relationship between performance on non-cognitive selection tests and medical school exit assessments. The predictive validity of these tests was limited, and the relationships revealed do not fit neatly with theoretical expectations. This study does not support their use in selection.

  6. A comparative study of radiation safety practices at selected hospitals in the UK and USA

    International Nuclear Information System (INIS)

    White, D.R.; Showalter, C.K.; Hamilton, D.R.

    1984-01-01

    The radiation safety practices in a group of 25 UK and USA hospitals have recently been assessed. This took the form of detailed inspections of some 62 medical radiation departments, including Diagnostic X-ray, Radiotherapy, Nuclear Medicine and Pathology/Research (Radionuclide) Departments. Empirical expressions called ''Radiation Safety Indices'' were devised to evaluate the incidence of personal doses and radiological incidents occurring from 1977-82 and to characterise the safety facilities, procedures, supervision and educational techniques in each department. An outline is given of national legislative material and voluntary codes of conduct, together with the results of the departmental inspections. The computed indices are presented graphically and an analysis given of apparent national trends. (author)

  7. Cost effectiveness of drug eluting coronary artery stenting in a UK setting: cost-utility study.

    Science.gov (United States)

    Bagust, A; Grayson, A D; Palmer, N D; Perry, R A; Walley, T

    2006-01-01

    To assess the cost effectiveness of drug eluting stents (DES) compared with conventional stents for treatment of symptomatic coronary artery disease in the UK. Cost-utility analysis of audit based patient subgroups by means of a simple economic model. Tertiary care. 12 month audit data for 2884 patients receiving percutaneous coronary intervention with stenting at the Cardiothoracic Centre Liverpool between January 2000 and December 2002. Risk of repeat revascularisation within 12 months of index procedure and reduction in risk from use of DES. Economic modelling was used to estimate the cost-utility ratio and threshold price premium. Four factors were identified for patients undergoing elective surgery (n = 1951) and two for non-elective surgery (n = 933) to predict risk of repeat revascularisation within 12 months. Most patients fell within the subgroup with lowest risk (57% of the elective surgery group with 5.6% risk and 91% of the non-elective surgery group with 9.9% risk). Modelled cost-utility ratios were acceptable for only one group of high risk patients undergoing non-elective surgery (only one patient in audit data). Restricting the number of DES for each patient improved results marginally: 4% of stents could then be drug eluting on economic grounds. The threshold price premium justifying 90% substitution of conventional stents was estimated to be 112 pound sterling (212 USD, 162 pound sterling) (sirolimus stents) or 89 pound sterling (167 USD, 130 pound sterling) (paclitaxel stents). At current UK prices, DES are not cost effective compared with conventional stents except for a small minority of patients. Although the technology is clearly effective, general substitution is not justified unless the price premium falls substantially.

  8. Preparation to care for confused older patients in general hospitals: a study of UK health professionals.

    Science.gov (United States)

    Griffiths, Amanda; Knight, Alec; Harwood, Rowan; Gladman, John R F

    2014-07-01

    in the UK, two-thirds of patients in general hospitals are older than 70, of whom half have dementia or delirium or both. Our objective was to explore doctors, nurses and allied health professionals' perceptions of their preparation to care for confused older patients on general hospital wards. : using a quota sampling strategy across 11 medical, geriatric and orthopaedic wards in a British teaching hospital, we conducted 60 semi-structured interviews with doctors, nurses and allied healthcare professionals and analysed the data using the Consensual Qualitative Research approach. : there was consensus among participants that education, induction and in-service training left them inadequately prepared and under-confident to care for confused older patients. Many doctors reported initial assessments of confused older patients as difficult. They admitted inadequate knowledge of mental health disorders, including the diagnostic features of delirium and dementia. Handling agitation and aggression were considered top priorities for training, particularly for nurses. Multidisciplinary team meetings were highly valued but were reported as too infrequent. Participants valued specialist input but reported difficulties gaining such support. Communication with confused patients was regarded as particularly challenging, both in terms of patients making their needs known, and staff conveying information to patients. Participants reported emotional and behavioural responses including frustration, stress, empathy, avoidance and low job satisfaction. : our findings indicate that a revision of training across healthcare professions in the UK is required, and that increased specialist support should be provided, so that the workforce is properly prepared to care for older patients with cognitive problems. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society.

  9. Case Studies in Sports Nutrition.

    Science.gov (United States)

    Clark, Nancy

    1988-01-01

    This article presents case studies of two athletes who wanted to affect a change in their body weight in order to enhance athletic performance. Each athlete's problem and the nutrition approach used to solve it are discussed. Caloric values of fast foods are listed. (JL)

  10. Shea case study Burkina Faso

    NARCIS (Netherlands)

    S. Drost (Sarah); J.C.A.C. van Wijk (Jeroen); S.R. Vellema (Sietze)

    2012-01-01

    textabstractThis shea case study is part of a larger Partnerships Resource Centre (PrC) project elaborated in tandem with two Dutch non-governmental organisations (NGOs); ICCO and Oxfam Novib. The endeavour of this ‘action research’ project is to combine the expert knowledge of development

  11. The reflexive case study method

    DEFF Research Database (Denmark)

    Rittenhofer, Iris

    2015-01-01

    This paper extends the international business research on small to medium-sized enterprises (SME) at the nexus of globalization. Based on a conceptual synthesis across disciplines and theoretical perspectives, it offers management research a reflexive method for case study research of postnational...

  12. Cancer through black eyes - The views of UK based black men towards cancer: A constructivist grounded theory study.

    Science.gov (United States)

    Mulugeta, Betselot; Williamson, Susan; Monks, Rob; Hack, Thomas; Beaver, Kinta

    2017-08-01

    Little is known about black African (BA) and black African-Caribbean (BAC) men's views towards cancer; yet culture and acculturation can contribute to the way in which people understand, explain and develop their attitudes towards cancer. Hence, cancer prevention and early detection strategies may not be sensitive to United Kingdom (UK)-based black men's views, affecting their awareness of risk factors and early detection services. This study explored the views of UK-based BA and BAC men towards cancer. In collaboration with black community organisations based in four major cities in the UK, 25 participants were recruited using convenience and theoretical sampling methods. Data were collected using 33 semi-structured interviews, and analysed using grounded theory analytic procedures. One core category (cancer through black eyes) and seven sub-categories emerged; 'cultural views', 'religious beliefs', 'avoiding Babylon', 'alienation', 'suspicious mind', 'advertisements and information influence very little', and 'gap in service provision (bridging the gap)'. Participants' views towards cancer were linked to socially constructed perspectives, linked with cultural and religious beliefs, and shaped by what being a black male means in society. Risk factors such as smoking and obesity had different meanings and symbolisation through black eyes. There were macro- and micro-level similarities and differences between BA and BAC men. Cancer services and related public-health campaigns aimed at black men need to understand cancer through black eyes. Public health campaigns based solely on the clinical meaning of cancer are incongruent with black men's understandings of cancer, and therefore ineffective at reducing health inequality. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Comparing human papillomavirus vaccine concerns on Twitter: a cross-sectional study of users in Australia, Canada and the UK.

    Science.gov (United States)

    Shapiro, Gilla K; Surian, Didi; Dunn, Adam G; Perry, Ryan; Kelaher, Margaret

    2017-10-05

    Opposition to human papillomavirus (HPV) vaccination is common on social media and has the potential to impact vaccine coverage. This study aims to conduct an international comparison of the proportions of tweets about HPV vaccines that express concerns, the types of concerns expressed and the social connections among users posting about HPV vaccines in Australia, Canada and the UK. Using a cross-sectional design, an international comparison of English language tweets about HPV vaccines and social connections among Twitter users posting about HPV vaccines between January 2014 and April 2016 was conducted. The Health Belief Model, one of the most widely used theories in health psychology, was used as the basis for coding the types of HPV vaccine concerns expressed on Twitter. The content of tweets and the social connections between users who posted tweets about HPV vaccines from Australia, Canada and the UK. 16 789 Twitter users who posted 43 852 tweets about HPV vaccines. The proportions of tweets expressing concern, the type of concern expressed and the proportions of local and international social connections between users. Tweets expressing concerns about HPV vaccines made up 14.9% of tweets in Canada, 19.4% in Australia and 22.6% in the UK. The types of concerns expressed were similar across the three countries, with concerns related to 'perceived barriers' being the most common. Users expressing concerns about HPV vaccines in each of the three countries had a relatively high proportion of international followers also expressing concerns. The proportions and types of HPV vaccine concerns expressed on Twitter were similar across the three countries. Twitter users who mostly expressed concerns about HPV vaccines were better connected to international users who shared their concerns compared with users who did not express concerns about HPV vaccines. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  14. UK Mission to CERN

    CERN Multimedia

    2004-01-01

    At the end of June, nine experts from UK industry visited CERN to study techniques for developing distributed computing systems and to look at some specific applications. In a packed three-day programme, almost 40 CERN experts presented a comprehensive survey of achievements.

  15. Field studies to determine acceptable levels of contamination at former UK nuclear testing sites, Maralinga and Emu in Australia

    International Nuclear Information System (INIS)

    Davy, D.R.

    1988-01-01

    The Maralinga and Emu regions of South Australia were used between 1953 and 1961 for the UK nuclear weapon development program. Two types of trials were conducted - the major trials involved the detonation of fission weapons and the minor trials dealt with weapon design and operational safety. In 1986, as a result of the findings of the Royal Commission on Nuclear Testing in Australia, the UK and Australian governments agreed to set up a Technical Assessment Group (TAG) with one American, two Australian and two British members to review the Maralinga-Emu situation. TAG was to advise on a series of clean-up options and their associated costs and examine land-use options ranging from unrestricted use by the traditional Aboriginal land owners to options involving various degrees of administrative and physical control. In its interim report, presented in May 1986, TAG observed that the existing data base was inadequate and suggested a series of field and laboratory studies that would partly correct this situation. Six of these studies were concerned with redefining the existing levels of contamination and establishing acceptable levels of contamination for a range of land-use options. This paper discusses the rationale, organisational support, scope and experimental protocol adopted for each of the six studies

  16. Mitigation potential of horizontal ground coupled heat pumps for current and future climatic conditions: UK environmental modelling and monitoring studies

    Science.gov (United States)

    García González, Raquel; Verhoef, Anne; Vidale, Pier Luigi; Gan, Guohui; Wu, Yupeng; Hughes, Andrew; Mansour, Majdi; Blyth, Eleanor; Finch, Jon; Main, Bruce

    2010-05-01

    An increased uptake of alternative low or non-CO2 emitting energy sources is one of the key priorities for policy makers to mitigate the effects of environmental change. Relatively little work has been undertaken on the mitigation potential of Ground Coupled Heat Pumps (GCHPs) despite the fact that a GCHP could significantly reduce CO2 emissions from heating systems. It is predicted that under climate change the most probable scenario is for UK temperatures to increase and for winter rainfall to become more abundant; the latter is likely to cause a general rise in groundwater levels. Summer rainfall may reduce considerably, while vegetation type and density may change. Furthermore, recent studies underline the likelihood of an increase in the number of heat waves. Under such a scenario, GCHPs will increasingly be used for cooling as well as heating. These factors will affect long-term performance of horizontal GCHP systems and hence their economic viability and mitigation potential during their life span ( 50 years). The seasonal temperature differences encountered in soil are harnessed by GCHPs to provide heating in the winter and cooling in the summer. The performance of a GCHP system will depend on technical factors (heat exchanger (HE) type, length, depth, and spacing of pipes), but also it will be determined to a large extent by interactions between the below-ground parts of the system and the environment (atmospheric conditions, vegetation and soil characteristics). Depending on the balance between extraction and rejection of heat from and to the ground, the soil temperature in the neighbourhood of the HE may fall or rise. The GROMIT project (GROund coupled heat pumps MITigation potential), funded by the Natural Environment Research Council (UK), is a multi-disciplinary research project, in collaboration with EarthEnergy Ltd., which aims to quantify the CO2 mitigation potential of horizontal GCHPs. It considers changing environmental conditions and combines

  17. Economic burden of advanced melanoma in France, Germany and the UK: a retrospective observational study (Melanoma Burden-of-Illness Study).

    Science.gov (United States)

    Grange, Florent; Mohr, Peter; Harries, Mark; Ehness, Rainer; Benjamin, Laure; Siakpere, Obukohwo; Barth, Janina; Stapelkamp, Ceilidh; Pfersch, Sylvie; McLeod, Lori D; Kaye, James A; Wolowacz, Sorrel; Kontoudis, Ilias

    2017-12-01

    The aim of this study was to estimate the cost-of-illness associated with completely resected stage IIIB/IIIC melanoma with macroscopic lymph node involvement, overall and by disease phase, in France, Germany and the UK. This retrospective observational study included patients aged older than or equal to 18 years first diagnosed with stage IIIB/IIIC cutaneous melanoma between 1 January 2009 and 31 December 2011. Data were obtained from medical records and a patient survey. Direct costs, indirect costs and patient out-of-pocket expenses were estimated in euros (€) (and British pounds, £) by collecting resource use and multiplying by country-specific unit costs. National annual costs were estimated using national disease prevalence from the European cancer registry and other published data. Forty-nine centres provided data on 558 patients (58.2% aged <65 years, 53.6% stage IIIB disease at diagnosis). The mean follow-up duration was 27 months (France), 26 months (Germany) and 22 months (UK). The mean total direct cost per patient during follow-up was €23 582 in France, €32 058 in Germany and €37 970 (£31 123) in the UK. The largest cost drivers were melanoma drugs [mean €14 004, €21 269, €29 750 (£24 385), respectively] and hospitalization/emergency treatment [mean: €6634, €6950, €3449 (£2827), respectively]. The total mean indirect costs per patient were €129 (France), €4,441 (Germany) and €1712 (£1427) (UK). Estimates for annual national direct cost were €13.1 million (France), €30.2 million (Germany) and €27.8 (£22.8) million (UK). The economic burden of stage IIIB/IIIC melanoma with macroscopic lymph node involvement was substantial in all three countries. Total direct costs were the highest during the period with distant metastasis/terminal illness.

  18. Homegrown Terror: The United Kingdom as a Case Study

    Science.gov (United States)

    2007-06-01

    mediation can disadvantage vulnerable groups, such as women, within a community. I’m concerned about how much choice the weaker party would have in...case of the Muslim population of the UK, has resulted in the acculturation or creation of a youth culture that is further economically disadvantaged ...Mark, and Griffith, Phoebe. (2005) “The European inclusion index, is Europe ready for the globalisation of people?” FPC.Org. http://fpc.org.uk/fsblob

  19. Higher education provision using systems thinking approach - case studies

    Science.gov (United States)

    Dhukaram, Anandhi Vivekanandan; Sgouropoulou, Cleo; Feldman, Gerald; Amini, Ardavan

    2018-01-01

    The purpose of this paper is to highlight the complexities involved in higher education provision and how systems thinking and socio-technical systems (STS) thinking approach can be used to understand the education ecosystem. Systems thinking perspective is provided using two case studies: the development of European Learner Mobility (EuroLM) service and the delivery of Enterprise System Management (ESM) course at the Birmingham City University, UK. The case studies present how systems thinking using STS approaches like applied organisational change and Cognitive Work Analysis can be used to capture a conceptual model of the education system for understanding the interactions and relationships between the people, technology, processes and the organisations. Using systems thinking perspective, EuroLM has developed a set of technical standards addressed to the European systems developers and ESM delivery ensures that students communicate and collaborate.

  20. Prediction of cervical cancer incidence in England, UK, up to 2040, under four scenarios: a modelling study.

    Science.gov (United States)

    Castanon, Alejandra; Landy, Rebecca; Pesola, Francesca; Windridge, Peter; Sasieni, Peter

    2018-01-01

    In the next 25 years, the epidemiology of cervical cancer in England, UK, will change: human papillomavirus (HPV) screening will be the primary test for cervical cancer. Additionally, the proportion of women screened regularly is decreasing and women who received the HPV vaccine are due to attend screening for the first time. Therefore, we aimed to estimate how vaccination against HPV, changes to the screening test, and falling screening coverage will affect cervical cancer incidence in England up to 2040. We did a data modelling study that combined results from population modelling of incidence trends, observable data from the individual level with use of a generalised linear model, and microsimulation of unobservable disease states. We estimated age-specific absolute risks of cervical cancer in the absence of screening (derived from individual level data). We used an age period cohort model to estimate birth cohort effects. We multiplied the absolute risks by the age cohort effects to provide absolute risks of cervical cancer for unscreened women in different birth cohorts. We obtained relative risks (RRs) of cervical cancer by screening history (never screened, regularly screened, or lapsed attender) using data from a population-based case-control study for unvaccinated women, and using a microsimulation model for vaccinated women. RRs of primary HPV screening were relative to cytology. We used the proportion of women in each 5-year age group (25-29 years to 75-79 years) and 5-year period (2016-20 to 2036-40) who have a combination of screening and vaccination history, and weighted to estimate the population incidence. The primary outcome was the number of cases and rates per 100 000 women under four scenarios: no changes to current screening coverage or vaccine uptake and HPV primary testing from 2019 (status quo), changing the year in which HPV primary testing is introduced, introduction of the nine-valent vaccine, and changes to cervical screening coverage

  1. The hazards of using ionising radiation for non-malignant conditions - a case study

    International Nuclear Information System (INIS)

    Morton, Tracy

    1989-01-01

    A case study is presented in which a patient received low dose radiotherapy at seven months for a non-malignant cavernous haemangioma on the upper chest. She subsequently developed three separate malignancies before the age of 40 years: a thyroid carcinoma, a breast carcinoma and a basal cell carcinoma of the skin on the upper chest. This case illustrates the hazards of using ionizing radiation for the treatment of non-malignant conditions. (U.K.)

  2. Interprofessional Education (IPE and Pharmacy in the UK. A Study on IPE Activities across Different Schools of Pharmacy

    Directory of Open Access Journals (Sweden)

    Nilesh Patel

    2016-09-01

    Full Text Available Interprofessional education (IPE has been recognised internationally as a way to improve healthcare professional interactions and team working in order to enhance patient care. Since pharmacists are increasingly part of multi-professional healthcare teams and are expanding their clinical roles, many pharmacy regulators have stipulated IPE must be included in educational curricula. This study aimed to examine how different Schools of Pharmacy (SOPs in the UK implement IPE within their pharmacy course. Information about IPE was mainly obtained through interviews with staff from various SOPs. Nine telephone interviews were conducted which were analysed using a thematic analysis approach in order to derive common categories. These were identified as students, activities, barriers and facilitators and benefits of IPE. It was found that teaching methods used for IPE varied across SOPs. No standard strategy to deliver IPE was identified. Students were thought to value the IPE experience, especially the interaction with other professionals. The main barriers to implementing IPE arose from limited financial and organisational support. In general, many SOPs in the UK are undertaking IPE but challenges remain in establishing it as a routine part of the course, something which seems to echo difficulties in implementation of IPE both nationally and internationally.

  3. Assessment of environmental co-benefits of energy system decarbonisation - the case of UK air quality using Remote Sensing and Model simulations

    Science.gov (United States)

    Sobral Mourao, Z.; Konadu, D. D.; Damoah, R.

    2016-12-01

    The UK has a binding obligation to reduce GHG emission by 80% (based on 1990 levels) by 2050. Meeting this target requires extensive decarbonisation of the UK energy system. Different pathways that achieve this target at the lowest system costs are being explored at different levels of policy and decisions on future energy infrastructure. Whilst benefits of decarbonisation are mainly focused on the impacts on climate change, there are other potential environmental and health impacts such as air-quality. In particular, a decrease in fossil fuel use by directly substituting current systems with low-carbon technologies could lead to significant reductions in the concentrations of SO2, NOX, CO and other atmospheric pollutants. So far, the proposed decarbonisation pathways tend to target the electricity sector first, followed by a transition in transport and heating technologies and use. However, the spatial dimension of where short term changes in the energy sector occur in relation to high density population areas is not taken into account when defining the energy transition strategies. This may lead to limited short-term improvements in air quality within urban areas, where use of fossil fuels for heating and transport is the main contribution to overall atmospheric pollutant levels. It is therefore imperative to explore decarbonisation strategies that prioritise transition in sectors of the energy system that produce immediate improvements in air quality in key regions of the UK. This study aims to use a combination of Remote Sensing observations and atmospheric chemistry/transport modelling approaches to estimate and map the atmospheric pollutants impact of the traditional approach of decarbonising electricity first compared to a slower transition in the electricity sector, but faster change in end use sectors (heating and transport). This would provide an additional standard to compare future energy system pathways beyond the traditional metrics of cost and GHG

  4. Institutional total energy case studies

    Energy Technology Data Exchange (ETDEWEB)

    Wulfinghoff, D.

    1979-07-01

    Profiles of three total energy systems in institutional settings are provided in this report. The plants are those of Franciscan Hospital, a 384-bed facility in Rock Island, Illinois; Franklin Foundation Hospital, a 100-bed hospital in Franklin, Louisiana; and the North American Air Defense Command Cheyenne Mountain Complex, a military installation near Colorado Springs, Colorado. The case studies include descriptions of plant components and configurations, operation and maintenance procedures, reliability, relationships to public utilities, staffing, economic efficiency, and factors contributing to success.

  5. Stochastic efficiency: five case studies

    International Nuclear Information System (INIS)

    Proesmans, Karel; Broeck, Christian Van den

    2015-01-01

    Stochastic efficiency is evaluated in five case studies: driven Brownian motion, effusion with a thermo-chemical and thermo-velocity gradient, a quantum dot and a model for information to work conversion. The salient features of stochastic efficiency, including the maximum of the large deviation function at the reversible efficiency, are reproduced. The approach to and extrapolation into the asymptotic time regime are documented. (paper)

  6. Antiepileptic drugs during pregnancy in primary care: a UK population based study.

    Directory of Open Access Journals (Sweden)

    Shuk-Li Man

    Full Text Available Antiepileptic drugs (AEDs are commonly prescribed for epilepsy and bipolar disorder but little is known about their use in pregnancy. We examined secular trends in AED prescribing in pregnancy and pregnancy as a determinant for stopping AED prescribing.We identified 174,055 pregnancies from The Health Improvement Network UK primary care database. Secular trends in AED prescribing during pregnancy were examined between 1994 and 2009. We used Cox's regression analyses to compare time to discontinuation of AED prescriptions between pregnant and non-pregnant women and to identify predictors of discontinuation of AEDs in pregnancy.Prescribing of carbamazepine and sodium valproate have declined since 1994 despite being the most commonly prescribed AEDs in pregnancy up to 2004. Prescribing of lamotrigine in pregnancy has steadily increased and has been the most popular AED prescribed in pregnancy since 2004. Pregnant women with epilepsy were twice as likely to stop receiving AEDs (Hazard Ratio (HR 2.00, 95% Confidence Interval (CI 1.62-2.47 when compared to non-pregnant women and for women with bipolar disorder this was even higher (HR 3.07, 95% CI 2.04-4.62. For pregnant women with epilepsy, those receiving AEDs less regularly before pregnancy were more likely to stop receiving AEDs in pregnancy.Lamotrigine has been increasingly prescribed in pregnancy over older AEDs namely carbamazepine and sodium valproate. Pregnancy is a strong determinant for the discontinuation of AED prescribing particularly for women with bipolar disorder.

  7. Geoengineering, climate change scepticism and the 'moral hazard' argument: an experimental study of UK public perceptions.

    Science.gov (United States)

    Corner, Adam; Pidgeon, Nick

    2014-12-28

    Many commentators have expressed concerns that researching and/or developing geoengineering technologies may undermine support for existing climate policies-the so-called moral hazard argument. This argument plays a central role in policy debates about geoengineering. However, there has not yet been a systematic investigation of how members of the public view the moral hazard argument, or whether it impacts on people's beliefs about geoengineering and climate change. In this paper, we describe an online experiment with a representative sample of the UK public, in which participants read one of two arguments (either endorsing or rejecting the idea that geoengineering poses a moral hazard). The argument endorsing the idea of geoengineering as a moral hazard was perceived as more convincing overall. However, people with more sceptical views and those who endorsed 'self-enhancing' values were more likely to agree that the prospect of geoengineering would reduce their motivation to make changes in their own behaviour in response to climate change. The findings suggest that geoengineering is likely to pose a moral hazard for some people more than others, and the implications for engaging the public are discussed.

  8. Perspectives on management education: an exploratory study of UK and Portuguese medical students.

    Science.gov (United States)

    Martins, Henrique M G; Detmer, Don E; Rubery, Eileen

    2005-09-01

    Healthcare management is becoming extremely important and large health organizations face increasing demands for leadership and system change. The role of doctors is pivotal but their relationship with management issues and practice has been a matter of long-lasting debate. The aim of this research was to establish opinions of medical students and other medical educational stakeholders on the value and structure of a management and leadership course in medical school. A survey of undergraduate medical students from two medical schools (n = 268) was carried out, and quantitative and qualitative data were analysed and compared with opinions collected from interviews with hospital managers and clinical professors. Portuguese medical students attributed higher relevance to leadership/management education than their UK counterparts. For both groups, such a course would be best: (1) situated in the clinical years, (2) optional and (3) one term/semester long. Main topics desired were 'Managing people/team management'; 'National Health Service'; 'Doctors and Leadership', 'Costs/prices and resource management'. In conclusion, leadership/management education is perceived as relevant but its inclusion in the medical curriculum as well as its content needs careful consideration. Education in informatics and knowledge management would also provide a positive contribution to professional development but is scarcely appreciated at present.

  9. A longitudinal study of fallow dynamics in the UK Continental Shelf (UKCS)

    International Nuclear Information System (INIS)

    Kemp, Alexander G.; Kasim, Sola A.

    2007-01-01

    This paper identifies the causes of and solutions to the problems posed by the fallow assets' phenomenon in the UK Continental Shelf (UKCS). Using data available in the public domain, including the Fifth Fallow Release, the province's assets were grouped into two broad cross-sections of fallow and non-fallow assets, with further sub-divisions. The dependent variable of interest was the median fallow duration of the assets. Fallow duration was measured in two ways, namely those relating to censored and uncensored data. An empirical panel econometric model was formulated, estimated and simulated to establish the principal causal factors and the effective remedial policy measures. The model estimation results provide evidence that the interactive effects of the key influencing variables are stronger than their individual effects. Thus, the combined effects of reserves and distance from infrastructure have a greater weight on the fallow spell than their individual effects. Several policy simulation runs established that, contrary to some theoretical propositions (a) stronger rather than weaker government intervention, on occasion, is preferable, and (b) price is not a central determinant of investment timing

  10. Case Study: Guidelines for Producing Videos to Accompany Flipped Cases

    Science.gov (United States)

    Prud'homme-Généreux, Annie; Schiller, Nancy A.; Wild, John H.; Herreid, Clyde Freeman

    2017-01-01

    Three years ago, the "National Center for Case Study Teaching in Science" (NCCSTS) was inspired to merge the case study and flipped classroom approaches. The resulting project aimed to create the materials required to teach a flipped course in introductory biology by assigning videos as homework and case studies in the classroom. Three…

  11. CAREM X INPRO case study

    International Nuclear Information System (INIS)

    Florido, P.C.; Brasnarof, D.; Delmastro, D.; Azpitarte, O.E.

    2004-01-01

    In order to assess and compare the performance of innovative nuclear energy systems INPRO has defined a set of basic principles, user requirements and criteria to be met in different areas (economics, sustainability and environment, safety, waste management and proliferation). This paper illustrates the use of INPRO methodology to a particular reactor system. Argentina is performing CAREM X Nuclear System Case Study based on CAREM nuclear reactor and Once Through Fuel Cycle, using SIGMA for enriched uranium production, and a deep geological repository for final disposal of high level waste after surface intermediate storage in horizontal natural convection silos, to verify INPRO (International Project on Innovative Nuclear Reactors and Fuel Cycles) methodology. 6 aspects have been considered: 1) enrichment based on Sigma enrichment plant (gas diffusion technology), 2) conversion to UO 2 , 3) fuel manufacturing, 4) CAREM-300 based reactor technology, 5) intermediate spent fuel storage, and 6) deep geological repository of spent fuels. Projections show that developing countries could play a crucial role in the deployment of nuclear energy, in the next fifty years. This case study will be highly useful for checking INPRO methodology for this scenario. In this paper, the preliminary findings of the Case Study are presented, including proposals to improve the INPRO methodology

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

    Science.gov (United States)

    Reap, Elisabeth

    2015-01-01

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

  13. Job satisfaction of therapy radiographers in the UK: Results of a phase I qualitative study

    Energy Technology Data Exchange (ETDEWEB)

    Probst, Heidi [Sheffield Hallam University, Faculty of Health and Wellbeing, Collegiate Crescent Campus, Robert Winston Building, 11-15 Broomhall Road, Sheffield, S10 2BP (United Kingdom)], E-mail: h.probst@shu.ac.uk; Griffiths, Sue [Leeds Teaching Hospitals NHS Trust (United Kingdom)

    2009-05-15

    Background: Department of Health (DoH) vacancy data for radiography have been consistently higher than other allied health professions. In radiotherapy there has been ongoing concern about recruitment and retention. It is therefore useful to consider what elements of the job and the work environment influence job satisfaction and intentions to leave in therapy radiographers (therapists), in order to stem any future losses from the profession. Aim: To identify and explore the current and developing roles and responsibilities of therapists and the impact of these factors on job satisfaction. Design: An interpretive study utilising unstructured interviews with qualified practitioners was undertaken across three radiotherapy centres in England. A Grounded Theory approach was utilised within a case study design. Setting and participants: Three radiotherapy centres were the focus of this phase I study. Centres were geographically close but with historically different vacancy rates (based on the DoH vacancy data). A total of 18 therapists across a range of grades and experience participated in the one to one interviews. Results: From the interviews, factors which influence job satisfaction fall under three main headings: job design, leadership and organisational governance, and stress or burnout. A preliminary model is proposed to explain how job satisfaction changes with level of responsibility (which is primarily linked to job design and opportunities for autonomy) and job-tenure. Leadership and aspects of organisational governance (such as perceived fairness in application of departmental policies) and stress or burnout appear to moderate job satisfaction and leaving intentions. Conclusion: This study provides some preliminary qualitative data to help managers design retention strategies. These strategies should initially focus on job redesign, development of appropriate leadership qualities in those within supervisory roles and minimising opportunities for stress and

  14. Job satisfaction of therapy radiographers in the UK: Results of a phase I qualitative study

    International Nuclear Information System (INIS)

    Probst, Heidi; Griffiths, Sue

    2009-01-01

    Background: Department of Health (DoH) vacancy data for radiography have been consistently higher than other allied health professions. In radiotherapy there has been ongoing concern about recruitment and retention. It is therefore useful to consider what elements of the job and the work environment influence job satisfaction and intentions to leave in therapy radiographers (therapists), in order to stem any future losses from the profession. Aim: To identify and explore the current and developing roles and responsibilities of therapists and the impact of these factors on job satisfaction. Design: An interpretive study utilising unstructured interviews with qualified practitioners was undertaken across three radiotherapy centres in England. A Grounded Theory approach was utilised within a case study design. Setting and participants: Three radiotherapy centres were the focus of this phase I study. Centres were geographically close but with historically different vacancy rates (based on the DoH vacancy data). A total of 18 therapists across a range of grades and experience participated in the one to one interviews. Results: From the interviews, factors which influence job satisfaction fall under three main headings: job design, leadership and organisational governance, and stress or burnout. A preliminary model is proposed to explain how job satisfaction changes with level of responsibility (which is primarily linked to job design and opportunities for autonomy) and job-tenure. Leadership and aspects of organisational governance (such as perceived fairness in application of departmental policies) and stress or burnout appear to moderate job satisfaction and leaving intentions. Conclusion: This study provides some preliminary qualitative data to help managers design retention strategies. These strategies should initially focus on job redesign, development of appropriate leadership qualities in those within supervisory roles and minimising opportunities for stress and

  15. A non-fatal case of hantavirus cardiopulmonary syndrome imported into the UK (ex Panama), July 2014

    OpenAIRE

    Atkinson, Barry; Jameson, Lisa J.; Bovill, Bego?a A.; Aarons, Emma J.; Clewlow, Jodie; Lumley, Sarah; Latham, Jennie; Jenkins, Megan H.; MacGowan, Alasdair P.; Simpson, Andrew J.; Ahmed, Javeed; Brooks, Timothy J.; Hewson, Roger

    2015-01-01

    Highlights ? Detection of hantavirus cardiopulmonary syndrome imported into Europe. ? Additional evidence that Choclo hantavirus is currently circulating and causing human disease in Panama. ? Novel diagnostic and sequencing assays for identifying cases of Choclo hantavirus infection.

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

    Science.gov (United States)

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

    2016-11-16

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

  17. Prevalence of pain medication prescriptions in France, Germany, and the UK - a cross-sectional study including 4,270,142 patients.

    Science.gov (United States)

    Jacob, Louis; Kostev, Karel

    2018-01-01

    The goal of the present study was to analyze the prevalence of pain medication prescriptions in general practices in France, Germany, and the UK. This study included all patients aged ≥18 years followed in 2016 in general practitioner practices in France, Germany and the UK. The primary outcome was the prevalence of patients receiving prescriptions for pain medications in France, Germany, and the UK in 2016. The following drugs were included in the analysis: anti-inflammatory and antirheumatic products, non-steroids and analgesics including opioids, antimigraine preparations, and other analgesics and antipyretics. Demographic variables included age and gender. This study included 4,270,142 patients. The prevalences of pain medication prescriptions were 57.3% in France, 29.6% in Germany, and 21.7% in the UK. Although this prevalence generally remained consistent between age groups in France (54.3%-60.3%), it increased with age in Germany (18-30 years: 23.8%; >70 years: 35.8%) and in the UK (18-30 years: 9.3%; >70 years: 43.8%). Finally, the prevalence of pain medication prescriptions was higher in women than in men in all three countries. Paracetamol was prescribed to 82.3% and 60.1% of patients receiving pain medication in France and the UK, respectively, whereas ibuprofen was prescribed to 46.5% of individuals in Germany. The prevalence of pain medication prescriptions was higher in France than in Germany and the UK. Further research is needed to gain a better understanding of the differences in the prescription patterns between these three European countries.

  18. A case study of Impetigo

    Directory of Open Access Journals (Sweden)

    Mansouri P

    1993-05-01

    Full Text Available This is a report of a case study on 234 patients with impetigo who referred to Razi Dermatology Hospital from April to November, 1989. Treatment was started immediately after obtaining direct smear and performing culture and antibiotic sensitivity test. The most common organism responsible for impetigo was the coagulase-positive staphylococcus (71%. In 13.7% of the cases, the coagulase-negative staphylococcus was grown on culture media, but none of the cultures showed streptococcus as the main organism. Treatment was started with oral penicillin V, oral erythromycin, benzathine penicillin G injection, oral cephalexin, and topical fuccidin. Clinical and bacteriological evaluation after 3-7 days showed that it is preferable to use oral cephalexin instead of other protocols such as oral erythromycin, which has previously been the drug of choice for impetigo. In addition, topical fuccidin with a 75% curative rate was the first drug for treatment, with the same effect as the oral cephalexin

  19. Beware of the dog? An observational study of dog-related musculoskeletal injury in the UK.

    Science.gov (United States)

    Willmott, H; Greenheld, N; Goddard, R

    2012-05-01

    Although owning a dog confers numerous health benefits, dogs can cause falls resulting in musculoskeletal injury and fractures. We conducted a prospective observational study over a two-month period to investigate the incidence and epidemiology of dog-related musculoskeletal injury. All patients attending the Emergency Department, trauma ward or fracture clinic were asked whether their injury was caused by a dog. Thirty-seven patients were identified. There were 26 fractures, 10 soft-tissue injuries and one head injury. Seventeen patients were admitted to the hospital and sixteen cases required an operation. Older people were statistically more likely to sustain a fracture (p=0.0003) or require hospital admission (p=0.02). Mechanisms of injury are discussed and can be classified into direct or indirectly caused by the dog. The most common injury mechanism was being pulled over by a dog on a lead. Injury avoidance strategies are discussed. We conclude that dogs are a potential hazard, particularly to the elderly and the morbidity associated with these injuries may offset the health benefits conferred by dog ownership. Copyright © 2012. Published by Elsevier Ltd.

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

    Science.gov (United States)

    Hunt, D; Churchill, R

    2013-08-01

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

  1. Transformational change in healthcare: an examination of four case studies.

    Science.gov (United States)

    Charlesworth, Kate; Jamieson, Maggie; Davey, Rachel; Butler, Colin D

    2016-04-01

    Objectives Healthcare leaders around the world are calling for radical, transformational change of our health and care systems. This will be a difficult and complex task. In this article, we examine case studies in which transformational change has been achieved, and seek to learn from these experiences. Methods We used the case study method to investigate examples of transformational change in healthcare. The case studies were identified from preliminary doctoral research into the transition towards future sustainable health and social care systems. Evidence was collected from multiple sources, key features of each case study were displayed in a matrix and thematic analysis was conducted. The results are presented in narrative form. Results Four case studies were selected: two from the US, one from Australia and one from the UK. The notable features are discussed for each case study. There were many common factors: a well communicated vision, innovative redesign, extensive consultation and engagement with staff and patients, performance management, automated information management and high-quality leadership. Conclusions Although there were some notable differences between the case studies, overall the characteristics of success were similar and collectively provide a blueprint for transformational change in healthcare. What is known about the topic? Healthcare leaders around the world are calling for radical redesign of our systems in order to meet the challenges of modern society. What does this paper add? There are some remarkable examples of transformational change in healthcare. The key factors in success are similar across the case studies. What are the implications for practitioners? Collectively, these key factors can guide future attempts at transformational change in healthcare.

  2. Herpes zoster as a risk factor for stroke and TIA: a retrospective cohort study in the UK.

    Science.gov (United States)

    Breuer, Judith; Pacou, Maud; Gautier, Aline; Brown, Martin M

    2014-07-08

    Stroke and TIA are recognized complications of acute herpes zoster (HZ). Herein, we evaluate HZ as a risk factor for cerebrovascular disease (stroke and TIA) and myocardial infarction (MI) in a UK population cohort. A retrospective cohort of 106,601 HZ cases and 213,202 controls, matched for age, sex, and general practice, was identified from the THIN (The Health Improvement Network) general practice database. Cox proportional hazard models were used to examine the risks of stroke, TIA, and MI in cases and controls, adjusted for vascular risk factors, including body mass index >30 kg/m(2), smoking, cholesterol >6.2 mmol/L, hypertension, diabetes, ischemic heart disease, atrial fibrillation, intermittent arterial claudication, carotid stenosis, and valvular heart disease, over 24 (median 6.3) years after HZ infection. Risk factors for vascular disease were significantly increased in cases of HZ compared with controls. Adjusted hazard ratios for TIA and MI but not stroke were increased in all patients with HZ (adjusted hazard ratios [95% confidence intervals]: 1.15 [1.09-1.21] and 1.10 [1.05-1.16], respectively). However, stroke, TIA, and MI were increased in cases whose HZ occurred when they were younger than 40 years (adjusted hazard ratios [95% confidence intervals]: 1.74 [1.13-2.66], 2.42 [1.34-4.36], and 1.49 [1.04-2.15], respectively). Subjects younger than 40 years were significantly less likely to be asked about vascular risk factors compared with older patients (p TIA, and MI in subjects affected before the age of 40 years. In older subjects, better ascertainment of vascular risk factors and earlier intervention may explain the reduction in risk of stroke after HZ infection. © 2014 American Academy of Neurology.

  3. Local environmental quality positively predicts breastfeeding in the UK's Millennium Cohort Study.

    Science.gov (United States)

    Brown, Laura J; Sear, Rebecca

    2017-01-01

    Background and Objectives: Breastfeeding is an important form of parental investment with clear health benefits. Despite this, rates remain low in the UK; understanding variation can therefore help improve interventions. Life history theory suggests that environmental quality may pattern maternal investment, including breastfeeding. We analyse a nationally representative dataset to test two predictions: (i) higher local environmental quality predicts higher likelihood of breastfeeding initiation and longer duration; (ii) higher socioeconomic status (SES) provides a buffer against the adverse influences of low local environmental quality. Methodology: We ran factor analysis on a wide range of local-level environmental variables. Two summary measures of local environmental quality were generated by this analysis-one 'objective' (based on an independent assessor's neighbourhood scores) and one 'subjective' (based on respondent's scores). We used mixed-effects regression techniques to test our hypotheses. Results: Higher objective, but not subjective, local environmental quality predicts higher likelihood of starting and maintaining breastfeeding over and above individual SES and area-level measures of environmental quality. Higher individual SES is protective, with women from high-income households having relatively high breastfeeding initiation rates and those with high status jobs being more likely to maintain breastfeeding, even in poor environmental conditions. Conclusions and Implications: Environmental quality is often vaguely measured; here we present a thorough investigation of environmental quality at the local level, controlling for individual- and area-level measures. Our findings support a shift in focus away from individual factors and towards altering the landscape of women's decision making contexts when considering behaviours relevant to public health.

  4. Mortality rates and causes of death in children with epilepsy prescribed antiepileptic drugs: a retrospective cohort study using the UK General Practice Research Database.

    Science.gov (United States)

    Ackers, Ruth; Besag, Frank M C; Hughes, Elaine; Squier, Waney; Murray, Macey L; Wong, Ian C K

    2011-05-01

    Patients with epilepsy, including children, have an increased risk of mortality compared with the general population. Antiepileptic drugs (AEDs) were the most frequent class of drugs reported in a study looking at fatal suspected adverse drug reactions in children in the UK. The objective of the study was to identify cases and causes of death in a paediatric patient cohort prescribed AEDs with an associated epilepsy diagnosis. This was a retrospective cohort study supplemented with general practitioner-completed questionnaires, post-mortem reports and death certificates. The setting was UK primary care practices contributing to the General Practice Research Database. Participants were children and adolescents aged 0-18 years prescribed AEDs between 1993 and 2005. Causality assessment was undertaken by a consensus panel comprising paediatric specialists in neuropathology, neurology, neuropsychiatry, paediatric epilepsy, pharmacoepidemiology and pharmacy to determine crude mortality rate (CMR) and standardized mortality ratios (SMRs), and the likelihood of an association between AED(s) and the event of death. There were 6190 subjects in the cohort (contributing 26,890 person-years of data), of whom 151 died. Median age at death was 8.0 years. CMR was 56.2 per 10,000 person-years and the SMR was 22.4 (95% CI 18.9, 26.2). The majority of deceased subjects had severe underlying disorders. Death was attributable to epilepsy in 18 subjects; in 9 the cause of death was sudden unexpected death in epilepsy (SUDEP) [3.3 per 10 000 person-years (95% CI 1.5, 6.4)]. AEDs were probably (n = 2) or possibly (n = 3) associated causally with death in five subjects. Two status epilepticus deaths were associated causally with AED withdrawal. Children prescribed AEDs have an increased risk of mortality relative to the general population. Most of the deaths were in children with serious underlying disorders. A small number of SUDEP cases were identified. AEDs are not a major

  5. Is the Relationship between Common Mental Disorder and Adiposity Bidirectional? Prospective Analyses of a UK General Population-Based Study.

    Science.gov (United States)

    Fezeu, Léopold K; Batty, G David; Batty, David G; Gale, Catharine R; Kivimaki, Mika; Hercberg, Serge; Czernichow, Sebastien

    2015-01-01

    The direction of the association between mental health and adiposity is poorly understood. Our objective was to empirically examine this link in a UK study. This is a prospective cohort study of 3 388 people (men) aged ≥ 18 years at study induction who participated in both the UK Health and Lifestyle Survey at baseline (HALS-1, 1984/1985) and the re-survey (HALS-2, 1991/1992). At both survey examinations, body mass index, waist circumference and self-reported common mental disorder (the 30-item General Health Questionnaire, GHQ) were measured. Logistic regression models were used to compute odds ratios (OR) and accompanying 95% confidence intervals (CI) for the associations between (1) baseline common mental disorder (QHQ score > 4) and subsequent general and abdominal obesity and (2) baseline general and abdominal obesity and re-survey common mental disorders. After controlling for a range of covariates, participants with common mental disorder at baseline experienced greater odds of subsequently becoming overweight (women, OR: 1.30, 1.03 - 1.64; men, 1.05, 0.81 - 1.38) and obese (women, 1.26, 0.82 - 1.94; men, OR: 2.10, 1.23 - 3.55) than those who were free of common mental disorder. Similarly, having baseline common mental health disorder was also related to a greater risk of developing moderate (1.57, 1.21 - 2.04) and severe (1.48, 1.09 - 2.01) abdominal obesity (women only). Baseline general or abdominal obesity was not associated with the risk of future common mental disorder. These findings of the present study suggest that the direction of association between common mental disorders and adiposity is from common mental disorder to increased future risk of adiposity as opposed to the converse.

  6. Reliability of digital ulcer definitions as proposed by the UK Scleroderma Study Group: A challenge for clinical trial design.

    Science.gov (United States)

    Hughes, Michael; Tracey, Andrew; Bhushan, Monica; Chakravarty, Kuntal; Denton, Christopher P; Dubey, Shirish; Guiducci, Serena; Muir, Lindsay; Ong, Voon; Parker, Louise; Pauling, John D; Prabu, Athiveeraramapandian; Rogers, Christine; Roberts, Christopher; Herrick, Ariane L

    2018-06-01

    The reliability of clinician grading of systemic sclerosis-related digital ulcers has been reported to be poor to moderate at best, which has important implications for clinical trial design. The aim of this study was to examine the reliability of new proposed UK Scleroderma Study Group digital ulcer definitions among UK clinicians with an interest in systemic sclerosis. Raters graded (through a custom-built interface) 90 images (80 unique and 10 repeat) of a range of digital lesions collected from patients with systemic sclerosis. Lesions were graded on an ordinal scale of severity: 'no ulcer', 'healed ulcer' or 'digital ulcer'. A total of 23 clinicians - 18 rheumatologists, 3 dermatologists, 1 hand surgeon and 1 specialist rheumatology nurse - completed the study. A total of 2070 (1840 unique + 230 repeat) image gradings were obtained. For intra-rater reliability, across all images, the overall weighted kappa coefficient was high (0.71) and was moderate (0.55) when averaged across individual raters. Overall inter-rater reliability was poor (0.15). Although our proposed digital ulcer definitions had high intra-rater reliability, the overall inter-rater reliability was poor. Our study highlights the challenges of digital ulcer assessment by clinicians with an interest in systemic sclerosis and provides a number of useful insights for future clinical trial design. Further research is warranted to improve the reliability of digital ulcer definition/rating as an outcome measure in clinical trials, including examining the role for objective measurement techniques, and the development of digital ulcer patient-reported outcome measures.

  7. Social representation of "hearing loss": cross-cultural exploratory study in India, Iran, Portugal, and the UK.

    Science.gov (United States)

    Manchaiah, Vinaya; Danermark, Berth; Ahmadi, Tayebeh; Tomé, David; Zhao, Fei; Li, Qiang; Krishna, Rajalakshmi; Germundsson, Per

    2015-01-01

    Hearing loss is one of the most common chronic conditions in older adults. In audiology literature, several studies have examined the attitudes and behavior of people with hearing loss; however, not much is known about the manner in which society in general views and perceives hearing loss. This exploratory study was aimed at understanding the social representation of hearing loss (among the general public) in the countries of India, Iran, Portugal, and the UK. We also compared these social representations. The study involved a cross-sectional design, and participants were recruited using the snowball sampling method. A total of 404 people from four countries participated in the study. Data were collected using a free-association task where participants were asked to produce up to five words or phrases that came to mind while thinking about hearing loss. In addition, they were also asked to indicate if each word they presented had positive, neutral, or negative associations in their view. Data were analyzed using various qualitative and quantitative methods. The most frequently occurring categories were: assessment and management; causes of hearing loss; communication difficulties; disability; hearing ability or disability; hearing instruments; negative mental state; the attitudes of others; and sound and acoustics of the environment. Some categories were reported with similar frequency in most countries (eg, causes of hearing loss, communication difficulties, and negative mental state), whereas others differed among countries. Participants in India reported significantly more positive and fewer negative associations when compared to participants from Iran, Portugal, and the UK. However, there was no statistical difference among neutral responses reported among these countries. Also, more differences were noted among these countries than similarities. These findings provide useful insights into the public perception of hearing loss that may prove useful in public

  8. Social representation of “hearing loss”: cross-cultural exploratory study in India, Iran, Portugal, and the UK

    Science.gov (United States)

    Manchaiah, Vinaya; Danermark, Berth; Ahmadi, Tayebeh; Tomé, David; Zhao, Fei; Li, Qiang; Krishna, Rajalakshmi; Germundsson, Per

    2015-01-01

    Background Hearing loss is one of the most common chronic conditions in older adults. In audiology literature, several studies have examined the attitudes and behavior of people with hearing loss; however, not much is known about the manner in which society in general views and perceives hearing loss. This exploratory study was aimed at understanding the social representation of hearing loss (among the general public) in the countries of India, Iran, Portugal, and the UK. We also compared these social representations. Materials and methods The study involved a cross-sectional design, and participants were recruited using the snowball sampling method. A total of 404 people from four countries participated in the study. Data were collected using a free-association task where participants were asked to produce up to five words or phrases that came to mind while thinking about hearing loss. In addition, they were also asked to indicate if each word they presented had positive, neutral, or negative associations in their view. Data were analyzed using various qualitative and quantitative methods. Results The most frequently occurring categories were: assessment and management; causes of hearing loss; communication difficulties; disability; hearing ability or disability; hearing instruments; negative mental state; the attitudes of others; and sound and acoustics of the environment. Some categories were reported with similar frequency in most countries (eg, causes of hearing loss, communication difficulties, and negative mental state), whereas others differed among countries. Participants in India reported significantly more positive and fewer negative associations when compared to participants from Iran, Portugal, and the UK. However, there was no statistical difference among neutral responses reported among these countries. Also, more differences were noted among these countries than similarities. Conclusion These findings provide useful insights into the public

  9. Cost of illness of oral lichen planus in a U.K. population--a pilot study.

    Science.gov (United States)

    Ni Riordain, Richeal; Christou, Joanna; Pinder, Denise; Squires, Vanessa; Hodgson, Tim

    2016-05-01

    To assess the economic burden of oral lichen planus (OLP) from the perspective of the healthcare provider in a U.K. population. This prevalence-based cost-of-illness analysis was carried out via a cross-sectional study conducted in the Oral Medicine Unit of the Eastman Dental Hospital. This study was conducted in three phases - phase 1 involved framing of the cost-of-illness analysis, development of the cost inventory and design of the patient questionnaire for ease of data collection. Data collected from patients were inputted during phase 2, and costings were determined. The final phase consisted of the calculation of the cost of illness of OLP. One hundred patients were enrolled in the study, 30 males and 70 females, with an average age of 59.9 years (±13.4 years). The average OLP patient, based on our cohort, attends the oral medicine unit 2.64 times per year, their general medical practitioner 1.13 times annually, their general dental practitioner 0.82 times in a year and fills on average 3.37 prescriptions annually. This leads to an average annual cost of £398.58 (€541.16) per patient per year from the perspective of the healthcare provider. The annual average cost of OLP to the healthcare provider in the U.K. is substantial. The prevalence-based cost-of-illness data generated in this study will facilitate comparison with other chronic oral mucosal diseases and with chronic diseases managed in allied medical specialties. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Operational radiation protection in UK mining

    International Nuclear Information System (INIS)

    O'Riordan, M.C.

    1977-01-01

    The radiological conditions of the mining industry (coal-national, coal-private, non-coal) in the UK are described. From the point of view of radiological protection, non-coal miners have the highest occupational exposure of any group in the UK in relation to a recommended limit. From the point of view of general health and safety in non-coal mining, however, the situation does not look no serious. This is illustrated as follows. The US epidemiological study of uranium miners yields, on extrapolation, a risk estimate of some 0.3 deaths annually from lung cancer per 1000 miners exposed to 100 WLM. On the other hand, accident statistics for non-coal mines in the UK yield an estimate of two deaths annually per 1000 miners. Further perspective is given to the problem by the incidence of lung cancer among adult males within the UK, that is, 1.5 cases annually per 1000 persons. Narrow concern for the radiological safety of miners must therefore be tempered with broader concern for the other hazards they face

  11. Retrospective case note review of chronic spontaneous urticaria outcomes and adverse effects in patients treated with omalizumab or ciclosporin in UK secondary care.

    Science.gov (United States)

    Savic, Sinisa; Marsland, Alexander; McKay, David; Ardern-Jones, Michael R; Leslie, Tabi; Somenzi, Olivier; Baldock, Laura; Grattan, Clive

    2015-01-01

    Omalizumab is approved in the UK as add-on treatment for chronic spontaneous urticaria (CSU) in patients with inadequate response to H1-antihistamines. Ciclosporin is an established but unlicensed 3rd line option for CSU. Two parallel retrospective observational studies were conducted to describe outcomes of treatment and adverse events with omalizumab or ciclosporin for CSU treatment. Data from UK specialist centres prescribing omalizumab (five centres) or ciclosporin (three centres) in CSU patients were collected from hospital records by clinical staff and pooled for analysis. Forty-six patients prescribed omalizumab and 72 patients prescribed ciclosporin were included. Twenty-two (48%) omalizumab-treated patients had paired Urticaria Activity Scores (UAS7), showing a 25.4 point improvement during treatment (P making causality assignment difficult, whereas those for ciclosporin were consistent with its known adverse effect profile. Validated patient-reported measures of disease severity and quality of life should be used routinely in CSU management. Based on clinician comments and DLQI scores, symptoms and quality of life showed a greater improvement in the omalizumab-treated cohort than in the ciclosporin-treated cohort.

  12. What is the cost of a healthy diet? Using diet data from the UK Women's Cohort Study.

    Science.gov (United States)

    Morris, Michelle A; Hulme, Claire; Clarke, Graham P; Edwards, Kimberley L; Cade, Janet E

    2014-11-01

    A healthy diet is important to promote health and well-being while preventing chronic disease. However, the monetary cost of consuming such a diet can be a perceived barrier. This study will investigate the cost of consuming a range of dietary patterns. A cross-sectional analysis, where cost of diet was assigned to dietary intakes recorded using a Food Frequency Questionnaire. A mean daily diet cost was calculated for seven data-driven dietary patterns. These dietary patterns were given a healthiness score according to how well they comply with the UK Department of Health's Eatwell Plate guidelines. This study involved ∼35 000 women recruited in the 1990s into the UK Women's Cohort Study. A significant positive association was observed between diet cost and healthiness of the diet (p for trend >0.001). The healthiest dietary pattern was double the price of the least healthy, £6.63/day and £3.29/day, respectively. Dietary diversity, described by the patterns, was also shown to be associated with increased cost. Those with higher education and a professional or managerial occupation were more likely to consume a healthier diet. A healthy diet is more expensive to the consumer than a less healthy one. In order to promote health through diet and reduce potential inequalities in health, it seems sensible that healthier food choices should be made more accessible to all. 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.

  13. Genome-wide association study of cognitive functions and educational attainment in UK Biobank (N=112 151)

    Science.gov (United States)

    Davies, G; Marioni, R E; Liewald, D C; Hill, W D; Hagenaars, S P; Harris, S E; Ritchie, S J; Luciano, M; Fawns-Ritchie, C; Lyall, D; Cullen, B; Cox, S R; Hayward, C; Porteous, D J; Evans, J; McIntosh, A M; Gallacher, J; Craddock, N; Pell, J P; Smith, D J; Gale, C R; Deary, I J

    2016-01-01

    People's differences in cognitive functions are partly heritable and are associated with important life outcomes. Previous genome-wide association (GWA) studies of cognitive functions have found evidence for polygenic effects yet, to date, there are few replicated genetic associations. Here we use data from the UK Biobank sample to investigate the genetic contributions to variation in tests of three cognitive functions and in educational attainment. GWA analyses were performed for verbal–numerical reasoning (N=36 035), memory (N=112 067), reaction time (N=111 483) and for the attainment of a college or a university degree (N=111 114). We report genome-wide significant single-nucleotide polymorphism (SNP)-based associations in 20 genomic regions, and significant gene-based findings in 46 regions. These include findings in the ATXN2, CYP2DG, APBA1 and CADM2 genes. We report replication of these hits in published GWA studies of cognitive function, educational attainment and childhood intelligence. There is also replication, in UK Biobank, of SNP hits reported previously in GWA studies of educational attainment and cognitive function. GCTA-GREML analyses, using common SNPs (minor allele frequency>0.01), indicated significant SNP-based heritabilities of 31% (s.e.m.=1.8%) for verbal–numerical reasoning, 5% (s.e.m.=0.6%) for memory, 11% (s.e.m.=0.6%) for reaction time and 21% (s.e.m.=0.6%) for educational attainment. Polygenic score analyses indicate that up to 5% of the variance in cognitive test scores can be predicted in an independent cohort. The genomic regions identified include several novel loci, some of which have been associated with intracranial volume, neurodegeneration, Alzheimer's disease and schizophrenia. PMID:27046643

  14. Establishing the reliability and validity of the Zagazig Depression Scale in a UK student population: an online pilot study

    Directory of Open Access Journals (Sweden)

    Challenor Emily C

    2010-12-01

    Full Text Available Abstract Background It is thought that depressive disorders will be the second leading cause of disability worldwide by 2020. Recently, there is a steady increase in the number of university students diagnosed and treated as depression patients. It can be assumed that depression is a serious mental health problem for university students because it affects all age groups of the students either younger or older equally. The current study aims to establish the reliability and validity of the Zagazig Depression scale in a UK sample. Methods The study was a cross-sectional online survey. A sample of 133 out of 275 undergraduate students from a range of UK Universities in the academic year 2008-2009, aged 20.3 ± 6.3 years old were recruited. A modified back translated version of Zagazig Depression scale was used. In order to validate the Zagazig Depression scale, participants were asked to complete the Patient Health Questionnaire. Statistical analysis includes Kappa analysis, Cronbach's alpha, Spearman's correlation analysis, and Confirmatory Factor analysis. Results Using the recommended cut-off of Zagazig Depression scale for possible minor depression it was found that 30.3% of the students have depression and higher percentage was identified according to the Patient Health Questionnaire (37.4%. Females were more depressed. The mean ZDS score was 8.3 ± 4.2. Rates of depression increase as students get older. The reliability of The ZDS was satisfactory (Cronbach's alpha was .894. For validity, ZDS score was strongly associated with PHQ, with no significant difference (p-value > 0.05, with strong positive correlation (r = +.8, p-value Conclusion The strong, significant correlation between the PHQ and ZDS, along with high internal consistency of the ZDS as a whole provides evidence that ZDS is a reliable measure of depressive symptoms and is promising for the use of the translated ZDS in a large-scale cross-culture study.

  15. Establishing the reliability and validity of the Zagazig Depression Scale in a UK student population: an online pilot study.

    Science.gov (United States)

    Ibrahim, Ahmed K; Kelly, Shona J; Challenor, Emily C; Glazebrook, Cris

    2010-12-10

    It is thought that depressive disorders will be the second leading cause of disability worldwide by 2020. Recently, there is a steady increase in the number of university students diagnosed and treated as depression patients. It can be assumed that depression is a serious mental health problem for university students because it affects all age groups of the students either younger or older equally. The current study aims to establish the reliability and validity of the Zagazig Depression scale in a UK sample. The study was a cross-sectional online survey. A sample of 133 out of 275 undergraduate students from a range of UK Universities in the academic year 2008-2009, aged 20.3 ± 6.3 years old were recruited. A modified back translated version of Zagazig Depression scale was used. In order to validate the Zagazig Depression scale, participants were asked to complete the Patient Health Questionnaire. Statistical analysis includes Kappa analysis, Cronbach's alpha, Spearman's correlation analysis, and Confirmatory Factor analysis. Using the recommended cut-off of Zagazig Depression scale for possible minor depression it was found that 30.3% of the students have depression and higher percentage was identified according to the Patient Health Questionnaire (37.4%). Females were more depressed. The mean ZDS score was 8.3 ± 4.2. Rates of depression increase as students get older. The reliability of The ZDS was satisfactory (Cronbach's alpha was .894). For validity, ZDS score was strongly associated with PHQ, with no significant difference (p-value > 0.05), with strong positive correlation (r = +.8, p-value depressive symptoms and is promising for the use of the translated ZDS in a large-scale cross-culture study.

  16. Occult hepatitis B virus coinfection in HIV-positive African migrants to the UK: a point prevalence study.

    Science.gov (United States)

    Chadwick, D; Doyle, T; Ellis, S; Price, D; Abbas, I; Valappil, M; Geretti, A M

    2014-03-01

    Occult (surface antigen-negative/DNA-positive) hepatitis B virus (HBV) infection is common in areas of the world where HBV is endemic. The main objectives of this study were to determine the prevalence of occult HBV infection in HIV-infected African migrants to the UK and to determine factors associated with occult coinfection. This anonymized point-prevalence study identified Africans attending three HIV clinics, focussing on patients naïve to antiretroviral therapy (ART). Stored blood samples were tested for HBV DNA. Prevalence was calculated in the entire cohort, as well as in subpopulations. Risk factors for occult HBV coinfection were identified using logistic regression analysis. Among 335 HIV-positive African migrants, the prevalence of occult HBV coinfection was 4.5% [95% confidence interval (CI) 2.8-7.4%] overall, and 6.5% (95% CI 3.9-10.6%) and 0.8% (95% CI 0.2-4.6%) in ART-naïve and ART-experienced patients, respectively. Among ART-naïve anti-HBV core (anti-HBc)-positive patients, the prevalence was 16.4% (95% CI 8.3-25.6%). The strongest predictor of occult coinfection was anti-HBc positivity [odds ratio (OR) 7.4; 95% CI 2.0-27.6]. Median HBV DNA and ALT levels were 54 IU/mL [interquartile range (IQR) 33-513 IU/mL] and 22 U/L (IQR 13-27 U/L), respectively. Occult HBV coinfection remains under-diagnosed in African HIV-infected patients in the UK. Given the range of HBV DNA levels observed, further studies are warranted to determine its clinical significance and to guide screening strategies and ART selection in these patients. © 2013 British HIV Association.

  17. MULTIPLE PERSONALITY: CASE REPORT STUDY

    Directory of Open Access Journals (Sweden)

    Miloš Židanik

    2004-07-01

    Full Text Available Background. Multiple personality disorder is characterised by splited individual ego-states and splited professional community arguing whether this disorder actually exists or not.Methods. In this case report study a supportive psychodynamic psychotherapy of a patient with multiple personality disorder is presented, that lasted for 4.5 years and resulted in ego-reintegration.Conclusions. The spliting between different ego-states is powered by unneutralised aggression with the possibility of hetero- and autoaggressive behaviour. Therefore the patient in the analytically oriented psychotherapeutic process is at high risk and a safe therapeutic (e. g. in-patient setting has to be provided.

  18. Overview of the Case Studies

    DEFF Research Database (Denmark)

    Cameron, Ian; Gani, Rafiqul

    2011-01-01

    A series of case studies are used to illustrate many of the underlying modelling principles within the book. To facilitate this, the ICAS-MoT modelling tool has been used. A wide range of application areas have been chosen to ensure that the principal concepts of effective and efficient modelling...... are exercised. Conceptual frameworks for single and multiscale problems are given and explained. The importance of the steps is also explained, through annotated schematic diagrams. The important issues around workflow and data flow are given in diagrammatic form....

  19. A comparative study of vocational education and occupational safety and health training in China and the UK.

    Science.gov (United States)

    Nie, Baisheng; Huang, Xin; Xue, Fei; Chen, Jiang; Liu, Xiaobing; Meng, Yangyang; Huang, Jinxin

    2018-06-01

    In order to enhance Chinese workers' occupational safety awareness, it is essential to learn from developed countries' experiences. This article investigates thoroughly occupational safety and health (OSH) in China and the UK; moreover, the article performs a comparison of Chinese and British OSH training-related laws, regulations and education system. The following conclusions are drawn: China's work safety continues to improve, but there is still a large gap compared with the UK. In China a relatively complete vocational education and training (VET) system has been established. However, there exist some defects in OSH. In the UK, the employer will not only pay attention to employees' physiological health, but also to their mental health. The UK's VET is characterized by classification and grading management, which helps integrate OSH into the whole education system. China can learn from the UK in the development of policies, VET and OSH training.

  20. Hospital Waste Management - Case Study

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    Beatriz Edra

    2017-07-01

    Full Text Available The importance of waste management in hospitals is indisputable in preserving the environment and protecting public health, but management models are rarely discussed. This study presents the legal and conceptual frameworks of good waste management practices applicable to hospitals and associated indicators. As a case study, the overall performance of Hospital Centre of São João, in Porto, was analysed based on published reports. Data on the production of waste in their different typologies were collected from 2010 to 2016, enabling a correlation of the waste production with the kg/bed/day indicator. The aim of this study was to gather data and discuss trends in a real scenario of evolution over a six-year period in order to contribute to a future research proposal on indicators that can be used as reference for benchmarking the construction of methodological guides for hospital waste management.

  1. A field study of the uptake of 35S and 14C into crops characteristic of the UK diet

    International Nuclear Information System (INIS)

    Kluczewski, S.M.; Bell, J.N.B.; Nair, S.

    1986-02-01

    The uptake of 35 S and 14 C into crops characteristic of the UK diet was studied. Four common types of green vegetable, six common types of root vegetable and perennial ryegrass were grown in a garden plot in the environs of Hinkley Point Nuclear Power Station and the 35 S and 14 C contents of the crops were measured. Also measured were the corresponding air concentrations over the plot averaged over a range of time periods between sowing and harvesting. The results were analysed in terms of air to crop transfer factors for 35 S and 14 C and the implications of these for dose calculations were assessed for both collective dose and for a hypothetical critical group consuming a range of foods produced in situ. (author)

  2. Qualitative Case Study Research as Empirical Inquiry

    Science.gov (United States)

    Ellinger, Andrea D.; McWhorter, Rochell

    2016-01-01

    This article introduces the concept of qualitative case study research as empirical inquiry. It defines and distinguishes what a case study is, the purposes, intentions, and types of case studies. It then describes how to determine if a qualitative case study is the preferred approach for conducting research. It overviews the essential steps in…

  3. Preventing childhood obesity during infancy in UK primary care: a mixed-methods study of HCPs' knowledge, beliefs and practice

    Directory of Open Access Journals (Sweden)

    Swift Judy A

    2011-06-01

    Full Text Available Abstract Background There is a strong rationale for intervening in early childhood to prevent obesity. Over a quarter of infants gain weight more rapidly than desirable during the first six months of life putting them at greater risk of obesity in childhood. However, little is known about UK healthcare professionals' (HCPs approach to primary prevention. This study explored obesity-related knowledge of UK HCPs and the beliefs and current practice of general practitioners (GPs and practice nurses in relation to identifying infants at risk of developing childhood obesity. Method Survey of UK HCPs (GPs, practice nurses, health visitors, nursery, community and children's nurses. HCPs (n = 116 rated their confidence in providing infant feeding advice and completed the Obesity Risk Knowledge Scale (ORK-10. Semi-structured interviews with a sub-set of 12 GPs and 6 practice nurses were audio recorded, taped and transcribed verbatim. Thematic analysis was applied using an interpretative, inductive approach. Results GPs were less confident about giving advice about infant feeding than health visitors (p = 0.001 and nursery nurses (p = 0.009 but more knowledgeable about the health risks of obesity (p Six main themes emerged from the interviews: 1 Attribution of childhood obesity to family environment, 2 Infant feeding advice as the health visitor's role, 3 Professional reliance on anecdotal or experiential knowledge about infant feeding, 4 Difficulties with recognition of, or lack of concern for, infants "at risk" of becoming obese, 5 Prioritising relationship with parent over best practice in infant feeding and 6 Lack of shared understanding for dealing with early years' obesity. Conclusions Intervention is needed to improve health visitors and nursery nurses' knowledge of obesity risk and GPs and practice nurses' capacity to identify and manage infants' at risk of developing childhood obesity. GPs value strategies that maintain relationships with

  4. A pilot randomised controlled study of the mental health first aid eLearning course with UK medical students.

    Science.gov (United States)

    Davies, E Bethan; Beever, Emmeline; Glazebrook, Cris

    2018-03-21

    Medical students face many barriers to seeking out professional help for their mental health, including stigma relating to mental illness, and often prefer to seek support and advice from fellow students. Improving medical students' mental health literacy and abilities to support someone experiencing a mental health problem could reduce barriers to help seeking and improve mental health in this population. Mental Health First Aid (MHFA) is an evidence-based intervention designed to improve mental health literacy and ability to respond to someone with a mental health problem. This pilot randomised controlled trial aims to evaluate the MHFA eLearning course in UK medical students. Fifty-five medical students were randomised to receive six weeks access to the MHFA eLearning course (n = 27) or to a no-access control group (n = 28). Both groups completed baseline (pre-randomisation) and follow-up (six weeks post-randomisation) online questionnaires measuring recognition of a mental health problem, mental health first aid intentions, confidence to help a friend experiencing a mental health problem, and stigmatising attitudes. Course feedback was gathered at follow-up. More participants were lost follow-up in the MHFA group (51.9%) compared to control (21.4%). Both intention-to-treat (ITT) and non-ITT analyses showed that the MHFA intervention improved mental health first aid intentions (p = first aid actions at follow-up (p = .006). Feedback about the MHFA course was generally positive, with participants stating it helped improve their knowledge and confidence to help someone. This pilot study demonstrated the potential for the MHFA eLearning course to improve UK medical students' mental health first aid skills, confidence to help a friend and stigmatising attitudes. It could be useful in supporting their own and others' mental health while studying and in their future healthcare careers. Retrospectively registered ( ISRCTN11219848 ).

  5. Do television and electronic games predict children's psychosocial adjustment? Longitudinal research using the UK Millennium Cohort Study.

    Science.gov (United States)

    Parkes, Alison; Sweeting, Helen; Wight, Daniel; Henderson, Marion

    2013-05-01

    Screen entertainment for young children has been associated with several aspects of psychosocial adjustment. Most research is from North America a