Quality of coroner's post-mortems in a UK hospital.

Science.gov (United States)

Al Mahdy, Husayn

2014-01-01

The aim of this paper was, principally, to look at the coroner's post-mortem report quality regarding adult medical patients admitted to an English hospital; and to compare results with Royal College of Pathologists guidelines. Hospital clinical notes of adult medical patients dying in 2011 and who were referred to the coroner's office to determine the cause of death were scrutinised. Their clinical care was also reviewed. There needs to be a comprehensive approach to coroner's post-mortems such as routinely taking histological and microbiological specimens. Acute adult medical patient care needs to improve. Steps should be taken to ensure that comprehensive coroner's post-mortems are performed throughout the UK, including with routine histological and microbiological specimens examination. Additionally, closer collaboration between clinicians and pathologists needs to occur to improve emergency adult medical patient clinical care. The study highlights inadequacies in coroner's pathology services.

The development and evaluation of options for improving future U.K. blood component labelling--outcome of the 2013 U.K. hospital survey.

Science.gov (United States)

Nightingale, M J; Brazier, A M; McArthur, K; Jones, J; Cardigan, R; Lodge, L; Maclennan, S

2014-04-01

U.K. blood component labels have evolved to accommodate a plethora of information. Concern has, however, been expressed that current U.K. labelling is too 'cluttered', detracting from the clarity of critical information. This prompted a holistic review of labelling and available information technology (IT) with the aim of improving the situation. A survey was circulated requiring U.K. hospital participants to rank each item of information on the label according to its 'criticality' and assess three novel 'future' and one 'transition' prototype labels. Prototypes were based on applicable regulatory standards, best practice guidance, international benchmark data and U.K. expert input. The prototypes support steps towards 'full face' label printing and utilise 2D and quick response (QR) barcodes. Two-hundred eleven completed surveys were received identifying 110 contributing hospitals with 41% from clinical staff, 37% from transfusion laboratory staff and 22% from transfusion practitioners. There was excellent agreement between the three groups on the critical information, i.e., blood group, expiry date, blood component name, unique donation identification number (DIN) and blood component volume but far less on the other information, especially the various warning messages. Of the 'future' labels, option 3 (closest to the current 'quadrant model') was most popular. Option 1, with its additional inverted section replicating critical information was least popular and prompted significant safety concerns. The prototype labels correctly identified the critical items of information and extensive comments confirmed that this was more prominently and clearly displayed. Laboratory staff commented that the transition label was essential to enable IT systems to be adapted. © 2014 The Authors. Transfusion Medicine © 2014 British Blood Transfusion Society.

The accuracy of surface-contamination measurements; survey of UK hospitals, 1986

International Nuclear Information System (INIS)

Woods, M.J.

1987-01-01

In response to a number of concerns expressed at both national and international levels, the National Physical Laboratory (NPL) conducted a survey of UK hospitals and associated Regional Radiation Protection Services. Sources of surface contamination were distributed and participants were requested to measure these and interpret the relevant responses in terms of emission and activity per unit area. The analysis of the returns demonstrates that the vast majority of results was significantly in error and that the quality of radiation protection may be impaired. (author)

Solution of the Chandler-Gibson equations for a three-body test problem

International Nuclear Information System (INIS)

Gibson, A.G.; Waters, A.J.; Berthold, G.H.; Chandler, C.

1991-01-01

The Chandler-Gibson (CG) N-body equations are tested by considering the problem of three nonrelativistic particles moving on a line and interacting through attractive delta-function potentials. In particular, the input Born and overlap matrix-valued functions are evaluated analytically, and the CG equations are solved using a B-spline collocation method. The computed scattering matrix elements are within 0.5% of the known exact solutions, and the corresponding scattering probabilities are within 0.001% of the exact probabilities, both below and above the 3-body breakup threshold. These results establish that the CG method is practical, as well as theoretically correct, and may be a valuable approach for solving certain more complicated N-body scattering problems

Development of consensus guidance to facilitate service redesign around pharmacist prescribing in UK hospital practice.

Science.gov (United States)

Tonna, Antonella; McCaig, Dorothy; Diack, Lesley; West, Bernice; Stewart, Derek

2014-10-01

The last decade has seen a drive towards non-medical prescribing in the United Kingdom (UK). However, there is a dearth of any published literature on applying the principles of service redesign to support pharmacist prescribing in any sphere of practice. To develop consensus guidance to facilitate service redesign around pharmacist prescribing. UK hospital practice. The Delphi technique was used to measure consensus of a panel of expert opinion holders in Scotland. Individuals with key strategic and operational roles in implementing initiatives of pharmacy practice and medicines management were recruited as experts. An electronic questionnaire consisting of 30 statements related to pharmacist prescribing service redesign was developed. These were presented as five-point Likert scales with illustrative quotes. Consensus, defined as 70 % of panel members agreeing (ranked strongly agree/agree) with each statement. Responses were obtained from 35/40 (87.5 %) experts in round one and 29 (72.5 %) in round two. Consensus in round one was achieved for 27/30 of statements relating to aspects of generic 'service development' (e.g. succession planning, multidisciplinary working, quality evaluation, practice development and outcome measures) and 'pharmacist prescribing role development' (e.g. education and future orientation of service). Issues of disagreement were around targeting of pharmacist prescribing to clinical specialities and financial remuneration for prescribing in the hospital setting. Consensus guidance has been developed to facilitate service redesign around hospital pharmacist prescribing.

Comparison of 201Tl solution sources in UK hospitals, 2001

International Nuclear Information System (INIS)

Baker, M.; Woods, M.

2001-01-01

During recent years, concerns have been raised within the nuclear medicine field about the accuracy of activity measurements for 201 Tl. And indeed, NPL calibrations repeatedly indicated that the level of impurities present in such samples and the significant amount of activity adsorbed onto the glass wall of the container could produce erroneous results. In addition, the standard P6 vials, in which 201 Tl solution had been previously supplied, were recently replaced with the new ''10R Type 1 plus'' Schott vials. To assess the magnitude of these effects on the accuracy of clinical measurements of the activity of 201 Tl, an intercomparison exercise was conducted between the National Physical Laboratory (NPL), Nycomed-Amersham (NA) and the UK hospital physics community. The majority of the 273 reported results were within the ± 10 % limit of accuracy that hospitals aim to achieve for diagnosis, biased high. The tendency to overestimate the activity was more evident for syringe measurements. The exercise also revealed that the adsorption losses experienced with P6 vials had been solved by the introduction of the 10R vials, but individual calibrators need to be recalibrated for this new container. (author)

Plasminogen activator inhibitor-1 released from activated platelets plays a key role in thrombolysis resistance. Studies with thrombi generated in the Chandler loop

NARCIS (Netherlands)

Stringer, H. A.; van Swieten, P.; Heijnen, H. F.; Sixma, J. J.; Pannekoek, H.

1994-01-01

To investigate the potential role of plasminogen activator inhibitor-1 (PAI-1), which is released from the alpha-granules of activated platelets, in thrombolysis resistance, we employed a model (the "Chandler loop") that mimics the formation of arterial thrombi in vivo and that can be manipulated in

Pregnancy outcomes of women with HIV in a district general hospital in the UK.

Science.gov (United States)

Carey, L; Desouza, C; Moorcroft, A; Elgalib, A

2018-03-12

The aim of this study was to describe the obstetrical and virological outcomes in HIV-infected pregnant women who delivered at a district general hospital in south London in the period from 2008 to 2014. Our review identified 137 pregnancies; most (60%, 63/105) of them were unplanned. The commonest mode of delivery was spontaneous vaginal delivery (SVD) (42%, 48/114) followed by emergency Caesarean section (32%, 36/114). Gestational age at delivery was ≥37 weeks in most (84%, 91/106) of the cases. Maternal HIV VL at or closest to delivery was undetectable (1000 copies/mL in 73% (94/129), 90% (116/129) and 6% (8/129) of the pregnancies, respectively. None of the infants were infected with HIV making the rate of MTCT of HIV 0% (zero). Our study shows that favourable virological and obstetrical outcomes of HIV-infected pregnant women are achievable in non-tertiary HIV treatment centres. Impact Statement What is already known on this subject: Prevention of mother-to-child transmission (MTCT) of HIV has been one of the major public health successes in the last decades. This success was evident by the reduction of MTCT of HIV in the UK from 25.6% in the 1993 to only 0.46% in 2011. Furthermore, many reports from individual providers, mainly from tertiary centres, of HIV care in the UK also showed very low rates MTCT of HIV. What the results of this study add: Our study shows that favourable virological and obstetrical outcomes of HIV-infected pregnant women are achievable in non-tertiary HIV treatment centres. The MTCT of HIV rate in our hospital was zero in the period from 2008 to 2014. What the implications are of these findings for clinical practice and/or further research: Staff caring for pregnant HIV positive women in general hospitals and small-to-medium HIV clinics should liaise closely with each other and utilise the skill-mix within their hospital in order to provide a quality care that is similar to what is achieved in large teaching centres; however, a

Non-invasive ventilation (NIV) in the clinical management of acute COPD in 233 UK hospitals: results from the RCP/BTS 2003 National COPD Audit.

Science.gov (United States)

Kaul, Sundeep; Pearson, Michael; Coutts, Ian; Lowe, Derek; Roberts, Michael

2009-06-01

Non-invasive ventilation (NIV) is a clinically proven, cost-effective intervention for acidotic exacerbations of COPD that is recommended by UK national guidelines. This study examines the extent to which these recommendations are being followed in the UK. Between August and October 2003 a national audit of COPD exacerbations was conducted by the Royal College of Physicians and the British Thoracic Society. 233 (94%) UK hospitals submitted data for 7,529 prospectively recruited acute COPD admissions, documenting process of care and outcomes from a retrospective case note audit. They also completed a resources and organisation of care proforma. Nineteen hospitals (8%) reported they did not offer NIV. There was no access to NIV in 92 (39%) intensive care units in 88 (36%), high-dependency units or on general wards of 85 (34%) hospitals. In 74 (30%) NIV was available on all 3 sites. A low pH (hospital mortality (26% v 14%) and at 90 days (37% v 24%) and longer hospital stays (median 9 v 7 days) than those not receiving NIV. Hospitals with least usage of NIV had similar mortality rates to those using NIV more often. A comprehensive NIV service is not available in many hospitals admitting patients with acute respiratory failure secondary to COPD. Access to acute NIV is inadequate and does not conform with NICE and BTS guidelines. These observational audit data do not demonstrate benefits of NIV on survival when compared to conventional management, contrary to results from randomised trials. Reasons for this are unclear but unmeasured confounding factors and poor patient selection for NIV are likely explanations.

Fighting lung cancer in the developed world - a model of care in a UK hospital

International Nuclear Information System (INIS)

Baig, I.M.; Milroy, R.

2010-01-01

To highlight the initial management approach for Lung Cancer in a UK Hospital with the aim of translating the principles of such methodology to a developing country, such as Pakistan. A descriptive observational study was carried out at Stobhill Hospital , Glasgow, UK. The investigator (IMB) observed the Lung Cancer Service, attending the weekly 'New patients Clinic', 'Results Clinic', and 'Multidisciplinary team (MDT) meetings'. The process observations and the factual data describing the details of the service were recorded on a pre designed proforma. Observations relating to two aspects of this service (Results Clinic and MDT) are included in this report. The methodology of communicating results of lung cancer investigations to patients in a pre-planned and staged manner at a dedicated 'Results Clinic' was identified as a useful approach. A format of communication was consistently followed. The MDT consisted of a Respiratory Physician, Clinical Oncologist, Thoracic Surgeon, Radiologist, Pathologist and Palliative Care Specialist. Each patient's case was discussed on an individual basis and the team developed a consensus regarding diagnosis, staging of the disease, further need for diagnostic procedures and treatment options, bearing in mind the patient's performance status, co-morbidity and their wishes. This approach has improved the initial part of the lung cancer patient journey and components of this approach could easily be transferred to a developing country (JPMA 60:93; 2010). (author)

A survey of doctors at a UK teaching hospital to assess understanding of recent changes to consent law.

Science.gov (United States)

O'Brien, J W; Natarajan, M; Shaikh, I

2017-06-01

The UK Supreme Court recently ruled that when consenting patients for treatments or procedures, clinicians must also discuss any associated material risks. We surveyed medical staff at a large UK teaching hospital in order to ascertain knowledge of consent law and current understanding of this change. Email survey sent to medical staff in all specialities at Norfolk and Norwich University Hospital in February 2016. 245 responses (141 Consultants and 104 junior doctors, response rate 32%). 82% consent patients for procedures at least monthly and 23% daily. 31% were not familiar with the concept of material risk. 35% were familiar with the recent change in consent law, 41% were not. 18% were "very uncertain" and 64% "a little uncertain" that their consenting process meets current legal requirements. >92% think that landmark cases and changes in law should be discussed through professional bodies and circulated better locally. The majority were not familiar with the concept of material risk and recent legal changes. A majority were not confident that their practice meets current requirements, suggesting that recent changes in consent law may not be widely understood at this hospital. We suggest more guidance and education may be necessary than is currently available. Increased understanding of recent changes to consent law will reduce the risk taken by NHS trusts and offer patients a service compliant with Supreme Court guidance.

Patterns of hospital admission with epistaxis for 26,725 patients over an 18-year period in Wales, UK

Science.gov (United States)

Fishpool, SJC; Tomkinson, A

2012-01-01

INTRODUCTION Epistaxis is the one of the most common otorhinolaryngology emergencies. This study examined the age and sex distribution of all patients admitted with epistaxis to National Health Service (NHS) hospitals in Wales, UK, over a period of 18 years and 9 months. METHODS The Patient Episode Database for Wales was examined for all patient admissions with a diagnosis of epistaxis between April 1991 and December 2009. The age and sex of these patients was recorded and the proportion of the underlying population affected was calculated by comparing admission rates to the population data derived from the 1991 and 2001 national population censuses for Wales. RESULTS A total of 26,725 patients were admitted to NHS hospitals in Wales with epistaxis over the period studied. The proportion of the population admitted with epistaxis increased from the age of 40 onwards. For all ages except patients in the 10–14 years group, a higher proportion of the male population was admitted with epistaxis than the comparable female population. This discrepancy was most pronounced between the ages of 15 and 49 years, with the female-to-male ratio of hospital admissions with epistaxis being 0.55. These ages (15 and 49 years) approximate the average age of menarche and menopause respectively in the UK. CONCLUSIONS Women of menstrual age have fewer hospital admissions with epistaxis. This may be due to oestrogens providing protection to the nasal vasculature (as they do to other areas of the vascular tree). PMID:23131225

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.

Retrospective audit of the acute management of stroke in two district general hospitals in the uk.

Science.gov (United States)

Faluyi, O O; Omodara, J A; Tay, K H; Muhiddin, K

2008-06-01

There is some evidence to suggest that the standard of acute medical care provided to patients with cerebrovascular disease is a major determinant of the eventual outcome. Consequently, the Royal College of Physicians (RCP) of London issues periodic guidelines to assist healthcare providers in the management of patients presenting with stroke. An audit of the acute management of stroke in two hospitals belonging to the same health care trust in the UK. Retrospective review of 98 randomly selected case-notes of patients managed for cerebrovascular disease in two acute hospitals in the UK between April and June 2004. The pertinent guidelines of RCP (London) are highlighted while audit targets were set at 70%. 84% of patients presenting with cerebrovascular disease had a stroke rather than a TIA, anterior circulation strokes were commonest. All patients with stroke were admitted while those with TIAs were discharged on the same day but most patients with TIA were not followed up by Stroke specialists. Most CT-imaging of the head was done after 24 hours delaying the commencement of anti-platelets for patients with ischaemic stroke or neurosurgical referral for haemorrhagic stroke. Furthermore, there was a low rate of referral for carotid ultrasound in patients with anterior circulation strokes. Anti-platelets and statins were commenced for most patients with ischaemic stroke while diabetes was well controlled in most of them. However, ACE-inhibitors and diuretics such as indapamide were under-utilized for secondary prevention in such patients. Warfarin anti-coagulation was underutilized in patients with ischaemic stroke who had underlying chronic atrial fibrillation. While there was significant multi-disciplinary team input, dysphagia and physiotherapy assessments were delayed. Similarly, occupational therapy input and psychological assesment were omitted from the care of most patients. Hospital service provision for the management of cerebrovascular disease needs to

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)

HSMR : Comparing Death Rates Across UK Hospitals

NARCIS (Netherlands)

Ben Teeuwen; Thuy Ngo; Frans Nauta

2011-01-01

The Hospital Standardized Mortality Ratio (HSMR) is a measurement tool that shows hospitals’ death rates. The HSMR compares deaths that occur in hospitals with death ratios that one would normally expect based on patients’ diseases. It is used as a benchmark for adjusted hospital death rates. These

Budget impact model of Mydrane®, a new intracameral injectable used for intra-operative mydriasis, from a UK hospital perspective.

Science.gov (United States)

Davey, Keith; Chang, Bernard; Purslow, Christine; Clay, Emilie; Vataire, Anne-Lise

2018-04-19

During cataract surgery, maintaining an adequate degree of mydriasis throughout the entire operation is critical to allow for visualisation of the capsulorhexis and the crystalline lens. Good anaesthesia is also essential for safe intraocular surgery. Mydrane® is a new injectable intracameral solution containing two mydriatics (tropicamide 0.02% and phenylephrine 0.31%) and one anaesthetic (lidocaine 1%) that was developed as an alternative to the conventional topical pre-operative mydriatics used in cataract surgery. This study aimed to estimate the budget impact across a one year time frame using Mydrane® instead of topical dilating eye drops, for a UK hospital performing 3,000 cataract operations a year. A budget impact model (BIM) was developed to compare the economic outcomes associated with the use of Mydrane® versus topical drops (tropicamide 0.5% and phenylephrine 10%) in patients undergoing cataract surgery in a UK hospital. The outcomes of interest included costs and resource use (e.g. clinician time, mydriasis failures, operating room time, number of patients per vial of therapy etc.) associated with management of mydriasis in patients undergoing cataract surgery. All model inputs considered the UK hospital perspective without social or geographical variables. Deterministic sensitivity analyses were also performed to assess the model uncertainty. Introduction of Mydrane® is associated with a cost saving of £6,251 over 3,000 cataract surgeries in one year. The acquisition costs of the Mydrane® (£18,000 by year vs. £3,330 for eye drops) were balanced by substantial reductions in mainly nurses' costs and time, plus a smaller contribution from savings in surgeons' costs (£20,511) and lower costs associated with auxiliary dilation (£410 due to avoidance of additional dilation methods). Results of the sensitivity analyses confirmed the robustness of the model to the variation of inputs. Except for the duration of one session of eye drop instillation

Winter excess in hospital admissions, in-patient mortality and length of acute hospital stay in stroke: a hospital database study over six seasonal years in Norfolk, UK.

Science.gov (United States)

Myint, Phyo K; Vowler, Sarah L; Woodhouse, Peter R; Redmayne, Oliver; Fulcher, Robert A

2007-01-01

Several studies have examined the incidence and mortality of stroke in relation to season. However, the evidence is conflicting partly due to variation in the populations (community vs. hospital-based), and in climatic conditions between studies. Moreover, they may not have been able to take into account the age, sex and stroke type of the study population. We hypothesized that the age, sex and type of stroke are major determinants of the presence or absence of winter excess in morbidity and mortality associated with stroke. We analyzed a hospital-based stroke register from Norfolk, UK to examine our prior hypothesis. Using Curwen's method, we performed stratified sex-specific analyses by (1) seasonal year and (2) quartiles of patients' age and stroke subtype and calculated the winter excess for the number of admissions, in-patient deaths and length of acute hospital stay. There were 5,481 patients (men=45%). Their ages ranged from 17 to 105 years (median=78 years). There appeared to be winter excess in hospital admissions, deaths and length of acute hospital stay overall accounting for 3/100,000 extra admissions (winter excess index of 3.4% in men and 7.6% in women) and 1/100,000 deaths (winter excess index of 4.7 and 8.6% in women) due to stroke in winter compared to non-winter periods. Older patients with non-haemorrhagic stroke mainly contribute to this excess. If our findings are replicated throughout England and Wales, it is estimated that there are 1,700 excess admissions, 600 excess in-patient deaths and 24,500 extra acute hospital bed days each winter, related to stroke within the current population of approximately 60 million. Further research should be focused on the determinants of winter excess in morbidity and mortality associated with stroke. This may subsequently reduce the morbidity and mortality by providing effective preventive strategies in future. (c) 2007 S. Karger AG, Basel.

Hospital catering systems and their impact on the sensorial profile of foods provided to older patients in the UK.

Science.gov (United States)

Mavrommatis, Yiannis; Moynihan, Paula J; Gosney, Margot A; Methven, Lisa

2011-08-01

Impaired sensorial perception is very common in older people and low sensorial quality of foods is associated with decreased appetite and dietary intake. Hospital undernutrition in older patients could be linked to sensorial quality of hospital food if the quality were low or inappropriate for older people. The aim of this study was to examine changes in the sensorial quality of different foods that occur as a result of the food journey (i.e. freezing, regeneration, etc.) in the most common hospital catering systems in the UK. A trained sensory panel assessed sensorial descriptors of certain foods with and without the hospital food journey as it occurs in the in-house and cook/freeze systems. The results showed effects of the food journey on a small number of sensorial descriptors related to flavour, appearance and mouthfeel. The majority of these effects were due to temperature changes, which caused accumulation of condensation. A daily variation in sensorial descriptors was also detected and in some cases it was greater than the effect of the food journey. This study has shown that changes occur in the sensory quality of meals due to hospital food journeys, however these changes were small and are not expected to substantially contribute to acceptability or have a major role in hospital malnutrition. Copyright © 2011 Elsevier Ltd. All rights reserved.

Psychotropic prescribing in seriously violent men with schizophrenia or personality disorder in a UK high security hospital.

Science.gov (United States)

Stone-Brown, Keir; Naji, Mahmood; Francioni, Alex; Myers, Kyle; Samarendra, Harsh; Mushtaq-Chaudhry, Haseeb; Heslop, Stephen; Sengupta, Samrat; Ross, Callum C; Larkin, Fintan; Das, Mrigendra

2016-02-01

To analyze antipsychotic prescribing patterns in a UK high security hospital (HSH) that treats seriously violent men with either schizophrenia or personality disorder and examine how different groups consented to treatment and prescribing for metabolic conditions. We hypothesized that there would be high prevalence of antipsychotic polypharmacy, and high-dose antipsychotic and clozapine prescribing. HSHs treat seriously violent, mentally disordered offenders, and the extant literature on prescribing patterns in forensic settings is sparse. Prescribing and clinical data on all 189 patients in a UK HSH were collected from the hospital's databases. Data were analyzed using SPSS. The population was split into the following groups: schizophrenia spectrum disorder (SSD-only), personality disorder (PD-only), and comorbid schizophrenia spectrum disorder and PD. The majority (93.7%) of all patients were prescribed at least one antipsychotic, and (27.5%) were on clozapine. Polypharmacy was prevalent in 22.2% and high-dose antipsychotic in 27.5%. Patients on clozapine were more likely to be prescribed antidiabetic, statins, or antihypertensive medication. Patients in the PD-only group were more likely to be deemed to have the capacity to consent to treatment and be prescribed clozapine in contrast to the SSD-only group. Rates of clozapine and high-dose antipsychotic prescribing were higher than in other psychiatric settings, while polypharmacy prescribing rates were lower. Higher clozapine prescribing rates may be a function of a treatment-resistant and aggressive population. A higher proportion of PD-only patients consented to treatment and received clozapine compared with in-house SSD-only as well as other psychiatric settings. Implications of the findings are discussed.

Management of hip fractures in older people in Beijing: a retrospective audit and comparison with evidence-based guidelines and practice in the UK.

Science.gov (United States)

Tian, M; Gong, X; Rath, S; Wei, J; Yan, L L; Lamb, S E; Lindley, R I; Sherrington, C; Willett, K; Norton, R

2016-02-01

Despite the high burden of hip fracture in China, there is limited information on its management. This study investigated the management of hip fractures in a Beijing tertiary hospital and compared practice with that in 180 hospitals in the UK. The findings show a significant gap exists between the countries. The purpose of this study was to determine if the management of older people with hip fractures in a Beijing tertiary hospital is comparable with the UK best practice guidelines for hip fracture management and the UK National Hip Fracture Database 2012, obtained from 180 hospitals. A retrospective audit was undertaken in a large tertiary care hospital in Beijing. Data were compared with the National Hip Fracture Database 2012 collected in 180 hospitals in the UK on the proportion of patients managed according to the UK Blue Book standards. Sixty-six percent of patients were admitted to an orthopaedic ward within 24 h of fracture, while 100 % of patients in the UK were admitted to an orthopaedic ward within 24 h of arrival to an accident and emergency department. Only 8 % of patients received surgery within 48 h of admission compared with 83 % in the UK; 10 % received no surgery compared with 2.5 % in the UK; and 27 % received orthogeriatrician assessment compared with 70 % in the UK. New pressure ulcers developed in 2 % of patients compared with 3.7 % of those in the UK; whereas, 0.3 % of patients were assessed for osteoporosis treatment and 3.8 % received falls assessment, and comparable figures for the UK were 94 and 92 %, respectively. Significant gaps exist in hip fracture management in the Beijing hospital compared with the best practice achieved in 180 UK hospitals, highlighting the need to implement and evaluate proactive strategies to increase the uptake of best practice hip fracture care in China.

Designing an Error Resolution Checklist for a Shared Manned-Unmanned Environment

Science.gov (United States)

2010-06-01

to many people who contributed to the successful completion of this thesis. First, a special thank you to Missy Cummings, my research advisor ...Management Using Treemaps. Proceedings of the Project Management Institute Research Conference. London, UK. Chandler, D. (2009). Robo -forklift keeps

HRM practices and knowledge processes outcomes: empirical evidence from a quasi-experiment on UK SMEs in the tourism hospitality and leisure sector

OpenAIRE

Andreas Georgiadis; Christos N. Pitelis

2008-01-01

This paper presents empirical evidence of the relationship between human resources practices and the effectiveness of a firm to capitalise on investment in knowledge as measured by the returns to innovation and business development expenditure. The empirical design is based on exploiting a natural experiment provided by a policy intervention that offers human resources-related support to small and medium sized enterprises in the UK Tourism Hospitality and Leisure sector. Our findings suggest ...

UK medical tourists in Thailand: they are not who you think they are.

Science.gov (United States)

Noree, Thinakorn; Hanefeld, Johanna; Smith, Richard

2014-05-06

Travel for medical treatment is an aspect of globalization and health that is comparatively less understood. Little is known about volume, characteristic and motivation of medical tourists, limiting understanding of effects on health systems and patients. Thailand is amongst a handful of countries that have positioned themselves as medical tourism destination. This paper examines in unprecedented detail volume and characteristics of medical tourists who travel from the UK to Thailand for treatment. As part of a wider medical tourism study, authors gained access to over 4000 patient records from the five largest private hospitals in Thailand. These included information on country of origin, gender, age, arrival month, hospitalization, diagnosis, procedures, length of stay, medical expenditure and type of payment. Patient records were analysed to understand who travels and findings were triangulated with data from the UK International Passenger Survey (IPS). 104,830 medical tourists visited these hospitals in Thailand in 2010. While patients originate all over the world, UK medical tourists represent the largest group amongst Europeans. The majority UK medical tourists (60%) have comparatively small, elective procedures, costing less than USD 500. A significant minority of patients travel for more serious orthopedic and cardiothoracic procedures. Data of individual patient records from Thailand shows a higher number of UK patients traveled to Thailand than indicated by the IPS. Thailand is attracting a large number of medical tourists including larger numbers of UK patients than previously estimated. However, as many patients travel for comparatively minor procedures treatment may not be their primary motivation for travel. The small but significant proportion of older UK residents traveling for complex procedures may point to challenges within the NHS.

Deficiencies in provision of integrated multidisciplinary podiatry care for patients with inflammatory arthritis: a UK district general hospital experience.

Science.gov (United States)

Juarez, M; Price, E; Collins, D; Williamson, L

2010-01-01

Foot problems are highly prevalent in inflammatory arthritis (IA), especially rheumatoid arthritis (RA). Chronic inflammation can lead to permanent structural changes, deformity and disability. Early podiatry intervention in RA improves long term outcomes. National guidelines recommend that patients should be treated by a multidisciplinary team with dedicated podiatry services. In clinical practice funding constraints limit availability of these services. To assess prevalence of foot problems and quality and availability of foot care services at a UK district general hospital. 1200 IA patients in Swindon (Wiltshire, UK) were invited to complete an anonymised questionnaire regarding access to foot care services and education/information on foot problems. 448 patients. Prevalence of foot problems: 68%. Only 31% of patients had access to appropriate foot specialist. 24% had received foot assessment within 3 months of diagnosis of IA and 17% yearly review thereafter. Despite high prevalence of foot problems in our population we identified significant deficiencies in provision of integrated multidisciplinary podiatry care. The data we present could be used by others to support business cases to obtain funding to improve the links between rheumatology and podiatry services. Copyright 2010 Elsevier Ltd. All rights reserved.

Inside 'bed management': ethnographic insights from the vantage point of UK hospital nurses.

Science.gov (United States)

Allen, Davina

2015-03-01

In the face of unprecedented financial and demographic challenges, optimising acute bed utilisation by the proactive management of patient flows is a pressing policy concern in high-income countries. Despite the growing literature on this topic, bed management has received scant sociological attention. Drawing on practice-based approaches, this article deploys ethnographic data to examine bed management from the perspective of UK hospital nurses. While the nursing contribution to bed management is recognised formally in their widespread employment in patient access and discharge liaison roles, nurses at all levels in the study site were enrolled in this organisational priority. Rather than the rational, centrally controlled processes promulgated by policymakers, bed management emerges as a predominantly distributed activity, described here as match-making. An example of micro-level rationing, for the most part, match-making was not informed by explicit criteria nor did it hinge on clearly identifiable decisions to grant or deny access. Rather it was embedded in the everyday practices and situated rationalities through which nurses accomplished the accommodations necessary to balance demand with resources. © 2014 Foundation for the Sociology of Health & Illness.

What factors influence UK medical students’ choice of foundation school?

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Miah S

2017-04-01

Full Text Available Saiful Miah,1,2 Karl H Pang,3 Wayne Rebello,4 Zoe Rubakumar,4 Victoria Fung,5 Suresh Venugopal,6 Hena Begum4 1Division of Surgery and Interventional science, University College London, London, UK; 2Department of Urology, Charing Cross Hospital Imperial College Healthcare NHS Trust, London, UK; 3Academic Urology Unit, University of Sheffield, Sheffield, UK; 4Medical School, University of Sheffield, Sheffield, UK; 5Department of Plastic Surgery, Royal Hallamshire Hospital, Sheffield, UK; 6Department of Urology, Chesterfield Royal Infirmary, Chesterfield, UK Background: We aimed to identify the factors influencing UK medical student applicants’ choice of foundation school. We also explored the factors that doctors currently approaching the end of their 2-year program believe should be considered. Methods: A cross-sectional study was conducted during the 2013–2014 academic year. An online questionnaire was distributed to 2092 final-year medical students from nine UK medical schools and 84 foundation year-2 (FY2 doctors from eight foundation schools. Participants were asked to rank their top 3 from a list of 12 factors that could potentially influence choice of foundation school on a 5-point Likert scale. Collated categorical data from the two groups were compared using a chi-square test with Yates correction. Results: Geographic location was overwhelmingly the most important factor for medical students and FY2 doctors with 97.2% and 98.8% in agreement, respectively. Social relationships played a pivotal role for medical student applicants. Clinical specialties within the rotations were of less importance to medical students, in comparison to location and social relationships. In contrast, FY2 doctors placed a significantly greater importance on the specialties undertaken in their 2-year training program, when compared to medical students (chi-square; p=0.0001. Conclusion: UK medical schools should make their foundation program applicants aware

Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation

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Benning, Amirta; Ghaleb, Maisoon; Suokas, Anu; Dixon-Woods, Mary; Dawson, Jeremy; Barber, Nick; Franklin, Bryony Dean; Girling, Alan; Hemming, Karla; Carmalt, Martin; Rudge, Gavin; Naicker, Thirumalai; Nwulu, Ugochi; Choudhury, Sopna

2011-01-01

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (Porganisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296

Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation.

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Benning, Amirta; Ghaleb, Maisoon; Suokas, Anu; Dixon-Woods, Mary; Dawson, Jeremy; Barber, Nick; Franklin, Bryony Dean; Girling, Alan; Hemming, Karla; Carmalt, Martin; Rudge, Gavin; Naicker, Thirumalai; Nwulu, Ugochi; Choudhury, Sopna; Lilford, Richard

2011-02-03

To conduct an independent evaluation of the first phase of the Health Foundation's Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Mixed method evaluation involving five substudies, before and after design. NHS hospitals in the United Kingdom. Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. The SPI1 was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration--monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)--there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for "difference in difference" 2

Hospital autopsy: Endangered or extinct?

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Turnbull, Angus; Osborn, Michael; Nicholas, Nick

2015-08-01

To determine the hospital autopsy rate for the UK in 2013. A study of data from a 'Freedom of Information' request to all (n=186) acute NHS Trusts within England (n=160), NHS Boards in Scotland (n=14) and Wales (n=7) and Social Care Trusts in Northern Ireland (n=5). Hospital autopsy rates were calculated from the number of hospital autopsies performed in 2013 as a percentage of total inpatient deaths in the Trust that year. The UK response rate was 99% (n=184), yielding a mean autopsy rate of 0.69%. The mean rates were 0.51% (England), 2.13% (Scotland), 0.65% (Wales) and 0.46% (Northern Ireland). 23% (n=38) of all included respondents had a rate of 0% and 86% (n=143) a rate less than 1%. The decline in hospital autopsy has continued relentlessly and, for better or for worse, the practice is on the verge of extinction in the UK. The study highlights to health professionals and policy makers the magnitude of this decline. Further research should investigate the impact of this on patient safety, clinical audit, public health and medical education. 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.

Delivering a quality-assured fracture liaison service in a UK teaching hospital-is it achievable?

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Shipman, K E; Stammers, J; Doyle, A; Gittoes, N

2016-10-01

To determine whether new national guidance on the specifications of a fracture liaison service are realistically deliverable, 1 year of data on the performance of such a service were audited. Audit targets were mostly met. This audit demonstrates that these standards are deliverable in a real world setting. UK service specifications for a fracture liaison service (FLS) have been produced (National Osteoporosis Society, NOS) to promote effective commissioning and delivery of the highest quality care to patients with fragility fractures. How deliverable these standards are has not as yet been methodically reported. Our FLS was modelled on the ten NOS standards; performance was audited after 1 year to determine whether these standards could be delivered and to describe the lessons learnt. Performance was audited against the NOS FLS Service Standards, with management based on the Fracture Risk Assessment Tool (FRAX®), the four-item Falls Risk Assessment Tool (FRAT), National Institute for Health and Care Excellence (NICE) and the National Osteoporosis Guideline Groups (NOGG) guidance. Data were recorded prospectively on a database. The FLS commenced in May 2014, was fully operational in August 2014 and data were captured from 1 September 2014 to 1 September 2015. The FLS detected 1773 patients and standards were largely achieved. Most, 94 %, patients were seen within 6 weeks, 533 DXA requests were generated, 804 outpatient FRAT assessments were recorded (134 required falls intervention) and 773 patients had bone treatments started. On follow-up at 3 months, between 78-79 % were still taking medication. Preliminary evaluation of a FLS implemented according to UK NOS standards demonstrates that the model is practical to apply to a large teaching hospital population. Collection and review of outcome and cost effectiveness data is required to determine the performance of this model in comparison with existing models.

Radiation safety in the nuclear medicine department: impact of the UK Ionising Radiations Regulations

International Nuclear Information System (INIS)

Harding, L.K.

1987-01-01

The new 1985 regulations and guidance on radiation protection in the U.K. are discussed in relation to the needs for controlled areas in the nuclear medicine department and patient wards, admittance to hospital to comply with legislation, classification of workers, patient waiting rooms, handling flood sources, pregnancy and breast feeding. (U.K.)

TRANSITIONING BEYOND UNDERGRADUATE HOSPITALITY EDUCATION; A DIALOGIC ANALYSIS OF FINAL YEAR HOSPITALITY STUDENTS’ NARRATIVES OF EMPLOYABILITY

OpenAIRE

Hine, Catherine

2017-01-01

Employability has become a key consideration for graduates, and society. Increasingly the trajectory of individuals at age 18 involves the completion of an undergraduate level degree qualification. This thesis presents a sociologically grounded study into the dialogic construction of employability in final year hospitality students and recent hospitality graduates. Drawing on a nationwide sample of UK based hospitality graduates, as they transition beyond undergraduate level higher educati...

Malnutrition in the UK: policies to address the problem.

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Elia, M; Russell, C A; Stratton, R J

2010-11-01

In 2007, the estimated cost of disease-related malnutrition in the UK was in excess of £13×109. At any point in time, only about 2% of over 3 million individuals at risk of malnutrition were in hospital, 5% in care homes and the remainder in the community (2-3% in sheltered housing). Some government statistics (England) grossly underestimated the prevalence of malnutrition on admission and discharge from hospital (1000-3000 annually between 1998 and 2008), which is less than 1% of the prevalence (about 3 million in 2007-2008) established by national surveys using criteria based on the 'Malnutrition Universal Screening Tool' ('MUST'). The incidence of malnutrition-related deaths in hospitals, according to government statistics (242 deaths in England in 2007), was also policies have reduced the number of hospital and care home beds and encouraged care closer to home. Such policies have raised issues about education and training of the homecare workforce, including 6 million insufficiently supported informal carers (10% of the population), the commissioning process, and difficulties in implementing nutritional policies in a widely distributed population. The four devolved nations in the UK (England, Scotland, Northern Ireland and Wales) have developed their own healthcare polices to deal with malnutrition. These generally aim to span across all care settings and various government departments in a co-ordinated manner, but their effectiveness remains to be properly evaluated.

A comparison of patients' perceptions and an audit of health promotion practice within a UK hospital

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Cook Gary A

2007-09-01

Full Text Available Abstract Background UK hospitals are required to monitor the health promotion services they provide for patients. We compared the use of audit and patient questionnaires as appropriate tools for monitoring whether patients are screened for modifiable risk factors (smoking, alcohol use, obesity, diet, and physical activity, whether staff correctly identify risk factor presence and deliver health promotion when a risk factor is identified. Methods We sent a questionnaire post-discharge to 322 hospitalised adult patients discharged alive between January and March 2006, and audited their hospital case notes for evidence of screening for risk factors, identification of risk factors, and delivery of health promotion to change risk factors. Agreement between the audit and questionnaire findings was assessed by Kappa statistic. Results There was little relationship between what was written in the case notes and what patients thought had happened. Agreement between the audit and questionnaire for screening of risk factors was at best fair. For the delivery of health promotion agreement was moderate for alcohol, poor for exercise, and no different from chance for smoking and diet. Agreement on identifying risk factors was very good for obesity, good for smoking, and moderate for alcohol misuse. The identification of diet quality and level of physical activity was too low in the audit to allow statistical comparison with self-reported diet and activity. Conclusion A direct comparison of data gathered in the audit and patient questionnaires provides a comprehensive picture of health promotion practice within hospitals. Poor screening agreement is likely to be due to errors in patients' recall of screening activities. Audit is therefore the preferred method for evaluating screening of risk factors, but further insight into screening practice can be gained by using the questionnaire in conjunction with audit. If a patient does not recognise that they received

Determination of risk identification process employed by NHS for a PFI hospital project in the UK

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F. E. Mohamed Ghazali

2009-12-01

Full Text Available Long-term concession contracts associated with Private Finance Initiative (PFI projects, such as National Health Service (NHS hospitals, are subject to substantial risks, which may not only emerge from project activities such as design and construction, but also from global issues beyond the control of project parties, such as commercial, legal and political risks. Therefore, the principal parties involved must manage risks effectively and efficiently, as early as the project initiation stage, in order to ensure a successful delivery. The aim of this paper is to examine the risk identification process of the NHS PFI hospital in the UK, as a case study, in order to determine the techniques used in risk identification, and their significance, based on estimated probabilities of occurrence. These objectives were achieved through interviews with key personnel within the NHS Trust involved. Results found the sole technique used in risk identification to be brainstorming, through which more than thirty risks were identified and classified under six risk categories: planning, pre-commissioning, design, land purchasing, construction and operation. Thirteen risks were identified as significant based on their estimated probability of occurrence had the project been developed via public procurement. The results of this research will enable public sector clients like the NHS Trust to not only identify the significant risks, which will allow them to focus more attention on developing appropriate mitigation strategies and contingency plans, but also to improve its risk identification process through the use of other techniques in order to support findings from the brainstorming process.

Frequency of medical and dental x-ray examinations in the UK. 1997/98

International Nuclear Information System (INIS)

Tanner, R.; Wall, B.; Shrimpton, P.

2000-12-01

A survey has been performed to assess the numbers of all types of radiological x-ray examination conducted in the UK during the period from April 1997 to March 1998. The survey covers all diagnostic and interventional procedures using x-rays for medical and dental purposes, both within and outside the National Health Service (NHS), but excludes a detailed analysis of magnetic resonance imaging (MRI), ultrasound and nuclear medicine. This is the first such national survey conducted by NRPB since 1983. The results provide a current picture of the pattern of medical x-ray imaging practice in the UK and will allow revised estimates to be made of the collective dose to the population from these procedures. The survey has utilised detailed information available from radiology management systems at a selected sample of 38 English NHS trusts. The different classifications of x-ray procedure have been re-arranged into 62 standardised categories based on anatomical location and whether they were conventional, computed tomography (CT) or interventional procedures. Extrapolation of the sample data to the whole of England was carried out using broad NHS radiology statistics (KH12 returns) for the period of the survey from the Department of Health. Additional data have been obtained covering NHS radiology practice in Wales and Northern Ireland and also for x-ray imaging practice outside NHS hospitals such as that performed in independent hospitals and by dentists and chiropractors. Results are presented giving the annual numbers and relative frequencies of x-ray examinations in the 62 categories and the contributions from radiology practice outside NHS hospitals and from the whole of the UK. Altogether, about 41.5 million medical and dental x-ray examinations were conducted in the UK in 1997/98, corresponding to 704 examinations per 1000 inhabitants. The increase since 1983 for medical examinations conducted in NHS hospitals has just kept pace with the increase in population

Educational challenges faced by international medical graduates in the UK

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Hashim A

2017-06-01

Full Text Available Ahmed Hashim Gastroenterology Department, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK Introduction: International medical graduates (IMGs in the UK constitute approximately one-quarter of the total number of doctors registered in the General Medical Council (GMC. The transition of IMGs into the health care system in the UK is accompanied by significant sociocultural and educational challenges. This study aims to explore the views of IMGs in medical training on the educational challenges they face.Methods: This study was conducted in the Kent, Surrey and Sussex region in 2015. All IMGs who work in medical (physicianly training programs were included. Data were collected through a questionnaire and semi-structured interviews. Thematic approach was used to analyze the qualitative data.Results: Of the total 61 IMGs included, 17 responded to the survey and 3 were interviewed. The common educational barriers faced by IMGs were related to lack of appreciation of the values and structure of the National Health Service (NHS, ethical and medicolegal issues, receiving feedback from colleagues and the different learning strategies in the UK. IMGs suggested introduction of a mandatory dedicated induction program in the form of formal teaching sessions. They also believed that a supervised shadowing period prior in the first job in the UK would be beneficial. Further assessment areas should be incorporated into the prequalifying examinations to address specific educational needs such as NHS structure and hospital policies. Other measures such as buddying schemes with senior IMGs and educating NHS staff on different needs of IMGs should also be considered.Conclusion: This study highlighted important educational challenges faced by IMGs and generated relevant solutions. However, the opinions of the supervisors and other health care professionals need to be explored. Keywords: international medical graduates, IMG, educational barriers

The frequency of asthma exacerbations and healthcare utilization in patients with asthma from the UK and USA.

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Suruki, Robert Y; Daugherty, Jonas B; Boudiaf, Nada; Albers, Frank C

2017-04-27

Asthma exacerbations are frequent in patients with severe disease. This report describes results from two retrospective cohort studies describing exacerbation frequency and risk, emergency department (ED)/hospital re-admissions, and asthma-related costs by asthma severity in the US and UK. Patients with asthma in the US-based Clinformatics™ DataMart Multiplan IMPACT (2010-2011; WEUSKOP7048) and the UK-based Clinical Practice Research Datalink (2009-2011; WEUSKOP7092) databases were categorized by disease severity (Global Initiative for Asthma [GINA]; Step and exacerbation history) during the 12 months pre-asthma medical code (index date). Outcomes included: frequency of exacerbations (asthma-related ED visit, hospitalization, or oral corticosteroid use with an asthma medical code recorded within ±2 weeks) 12 months post-index, asthma-related ED visits/hospitalization, and asthma-related costs 30 days post-index. Risk of a subsequent exacerbation was determined by proportional hazard model. Of the 222,817 and 211,807 patients with asthma included from the US and UK databases, respectively, 12.5 and 8.4% experienced ≥1 exacerbation during the follow-up period. Exacerbation frequency increased with disease severity. Among the 5,167 and 2,904 patients with an asthma-related ED visit/hospitalization in the US and UK databases, respectively, 9.2 and 4.7% had asthma-related re-admissions within 30 days. Asthma-related re-admission rates and costs increased with disease severity, approximately doubling between GINA Step 1 and 5 and in patients with ≥2 versus <2 exacerbations in the previous year. Risk of a subsequent exacerbation increased 32-35% for an exacerbation requiring ED visit/hospitalization versus oral corticosteroids. Increased disease severity was associated with higher exacerbation frequency, ED/hospitalization re-admission, costs and risk of subsequent exacerbation, indicating that these patients require high-intensity post-exacerbation management.

Contracts and supply assurance in the UK health care market.

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Fenn, P; Rickman, N; McGuire, A

1994-07-01

We present a formal model of the relationship between a health care purchaser and a provider drawing on the recent experience of explicit contracting in the UK health sector. Specifically we model the contractual relationships emerging between District Health Authorities, who are presently the dominant health care purchasers, and the providers of hospital care. The comparative static analysis implies that the transaction cost of using non-local hospitals, the expected patient demand, the extent of excess capacity in local hospitals, and the proportion of that excess capacity expected to be lost to competitive purchasers, are all important determinants of the choice of contract.

Aflibercept treatment for neovascular AMD beyond the first year: consensus recommendations by a UK expert roundtable panel, 2017 update

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Patel PJ

2017-11-01

Full Text Available Praveen J Patel,1 Helen Devonport,2 Sobha Sivaprasad,1 Adam H Ross,3 Gavin Walters,4 Richard P Gale,5 Andrew J Lotery,6 Sajjad Mahmood,7 James S Talks,8 Jackie Napier9 1National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; 2The Ophthalmology Department, Bradford Royal Infirmary, Bradford, UK; 3The Ophthalmology Department, Bristol Eye Hospital, Bristol, UK; 4Department of Ophthalmology, Harrogate District Hospital, Harrogate, UK; 5The Ophthalmology Department, The York Hospital and Department of Health Sciences, University of York, York, UK; 6Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; 7Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; 8Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK; 9Medical Affairs, Bayer plc, Reading, Berkshire, UK Abstract: National recommendations on continued administration of aflibercept solution for injection after the first year of treatment for neovascular age-related macular degeneration (nAMD have been developed by an expert panel of UK retina specialists, based on clinician experience and treatment outcomes seen in year 2. The 2017 update reiterates that the treatment goal is to maintain or improve the macular structural and functional gains achieved in year 1 while attempting to reduce or minimize the treatment burden, recognizing the need for ongoing treatment. At the end of year 1 (ie, the decision visit at month 11, two treatment options should be considered: do not extend the treatment interval and maintain fixed 8-weekly dosing, or extend the treatment interval using a treat-and-extend regimen up to a maximum 12 weeks. Criteria for considering not extending the treatment interval are persistent macular fluid with stable

Surgical simulators in urological training--views of UK Training Programme Directors.

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Forster, James A; Browning, Anthony J; Paul, Alan B; Biyani, C Shekhar

2012-09-01

What's known on the subject? and What does the study add? The role of surgical simulators is currently being debated in urological and other surgical specialties. Simulators are not presently implemented in the UK urology training curriculum. The availability of simulators and the opinions of Training Programme Directors' (TPD) on their role have not been described. In the present questionnaire-based survey, the trainees of most, but not all, UK TPDs had access to laparoscopic simulators, and that all responding TPDs thought that simulators improved laparoscopic training. We hope that the present study will be a positive step towards making an agreement to formally introduce simulators into the UK urology training curriculum. To discuss the current situation on the use of simulators in surgical training. To determine the views of UK Urology Training Programme Directors (TPDs) on the availability and use of simulators in Urology at present, and to discuss the role that simulators may have in future training. An online-questionnaire survey was distributed to all UK Urology TPDs. In all, 16 of 21 TPDs responded. All 16 thought that laparoscopic simulators improved the quality of laparoscopic training. The trainees of 13 TPDs had access to a laparoscopic simulator (either in their own hospital or another hospital in the deanery). Most TPDs thought that trainees should use simulators in their free time, in quiet time during work hours, or in teaching sessions (rather than incorporated into the weekly timetable). We feel that the current apprentice-style method of training in urological surgery is out-dated. We think that all TPDs and trainees should have access to a simulator, and that a formal competency based simulation training programme should be incorporated into the urology training curriculum, with trainees reaching a minimum proficiency on a simulator before undertaking surgical procedures. © 2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.

The future of UK/Irish surgery: A European solution.

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Varzgalis, M; Kerin, M J; Sweeney, K J

2015-11-01

The United Kingdom (UK) and Republic of Ireland (ROI) hospital systems are dependent on junior doctors for their functionality however it is increasingly difficult to recruit UK/ROI trained doctors to fill these posts. Directive 2005/36/EC, which came into force in 2007, is the principal European legislation on the recognition of equivalence of professional qualifications across Europe. European trained doctors are therefore attractive candidates for junior doctor posts. However, although their training is recognised as equivalent by the Irish Medical Council (IMC) and General Medical Council (GMC) they are not being appointed to equivalent posts by the Health Service Executive (HSE) or National Health Service (NHS). With the influence of European Union (EU) centralisation, modification of UK/ROI consultant grade is imminent, possibly to pyramidal structure of the Continental European model with clearer lines of corporate responsibility. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Early risk assessment for viral haemorrhagic fever: experience at the Hospital for Tropical Diseases, London, UK.

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Woodrow, Charles J; Eziefula, Alice C; Agranoff, Dan; Scott, Geoffrey M; Watson, Julie; Chiodini, Peter L; Lockwood, Diana N J; Grant, Alison D

2007-01-01

To implement a policy of systematic screening for viral haemorrhagic fever (VHF) among travellers returning from African countries with fever, commencing at initial clinical contact. A protocol based on UK Advisory Committee on Dangerous Pathogens guidance was developed collaboratively by medical, nursing and laboratory staff. Audit was carried out to quantify resource demands and effects on time to diagnose malaria, the main differential diagnosis. A protocol is now implemented for all patients presenting to HTD with fever, with clear guidelines for interaction with clinical and laboratory staff at each stage. The protocol required moderate amounts of clinical and laboratory staff time and resulted in some additional hospital admissions. The time to a diagnosis of malaria increased from a median of 90 (range 50-125) min in patients without VHF risk to a median of 140 (range 101-225) min (p=0.0025) in those assessed as at risk. Although all acute medical services need to have robust procedures for early detection of patients with serious transmissible conditions, few implement such a policy. Our protocol requires increased human and other resources but has no important impact on the rapidity of diagnosis of malaria, and is now embedded in local practice.

Building new hospitals: a UK infection control perspective.

Science.gov (United States)

Stockley, J M; Constantine, C E; Orr, K E

2006-03-01

Infection control input is vital throughout the planning, design and building stages of a new hospital project, and must continue through the commissioning (and decommissioning) process, evaluation and putting the facility into full clinical service. Many hospitals continue to experience problems months or years after occupying the new premises; some of these could have been avoided by infection control involvement earlier in the project. The importance of infection control must be recognized by the chief executive of the hospital trust and project teams overseeing the development. Clinical user groups and contractors must also be made aware of infection control issues. It is vital that good working relationships are built up between the infection control team (ICT) and all these parties. ICTs need the authority to influence the process. This may require their specific recognition by the Private Finance Initiative National Unit, the Department of Health or other relevant authorities. ICTs need training in how to read design plans, how to write effective specifications, and in other areas with which they may be unfamiliar. The importance of documentation and record keeping is paramount. External or independent validation of processes should be available, particularly in commissioning processes. Building design in relation to infection control needs stricter national regulations, allowing ICTs to focus on more local usage issues. Further research is needed to provide evidence regarding the relationship between building design and the prevalence of infection.

Bereaved parents' experience of stillbirth in UK hospitals: a qualitative interview study.

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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.

Impact of recurrent Clostridium difficile infection: hospitalization and patient quality of life.

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Wilcox, Mark H; Ahir, Harblas; Coia, John E; Dodgson, Andrew; Hopkins, Susan; Llewelyn, Martin J; Settle, Chris; Mclain-Smith, Susan; Marcella, Stephen W

2017-09-01

Data quantifying outcomes of recurrent Clostridium difficile infection (rCDI) are lacking. We sought to determine the UK hospital resource use and health-related quality of life (HRQoL) associated with rCDI hospitalizations. A non-interventional study in six UK acute hospitals collected retrospective clinical and resource use data from medical records of 64 adults hospitalized for rCDI and 64 matched inpatient controls with a first episode only (f)CDI. Patients were observed from the index event (date rCDI/fCDI confirmed) for 28 days (or death, if sooner); UK-specific reference costs were applied. HRQoL was assessed prospectively in a separate cohort of 30 patients hospitalized with CDI, who completed the EQ-5D-3L questionnaire during their illness. The median total management cost (post-index) was £7539 and £6294 for rCDI and fCDI, respectively (cost difference, P = 0.075); median length of stay was 21 days and 15.5 days, respectively (P = 0.269). The median cost difference between matched rCDI and fCDI cases was £689 (IQR=£1873-£3954). Subgroup analysis demonstrated the highest median costs (£8542/patient) in severe rCDI cases. CDI management costs were driven primarily by hospital length of stay, which accounted for >85% of costs in both groups. Mean EQ-5D index values were 46% lower in CDI patients compared with UK population values (0.42 and 0.78, respectively); EQ visual analogue scale scores were 38% lower (47.82 and 77.3, respectively). CDI has considerable impact on patients and healthcare resources. This multicentre study provides a contemporaneous estimate of the real-world UK costs associated with rCDI management, which are substantial and comparable to fCDI costs. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

UK medical students’ perceptions, attitudes, and interest toward medical leadership and clinician managers

Directory of Open Access Journals (Sweden)

Rouhani MJ

2018-02-01

Full Text Available Maral J Rouhani,1 Eleanor J Burleigh,2 Chloe Hobbis,2 Charlotte Dunford,1 Nadir I Osman,3 Christine Gan,1 Norma B Gibbons,1 Hashim U Ahmed,1,4 Saiful Miah1,5 1Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK; 2Medical School, University of Sheffield, Sheffield, UK; 3Department of Urology, Royal Hallamshire Hospital, Sheffield, UK; 4Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK; 5Division of Surgery and Interventional Science, University College London, London, UK Background: We aimed to determine UK medical students’ perceptions and attitudes and interest toward medical leadership and clinician managers. Methods: A cross-sectional study was conducted during the academic year 2015–2016. An online questionnaire was distributed to 2,349 final-year students from 10 UK medical schools. Participants were asked to complete a 5-point Likert scale on their current perceptions, attitudes, and interest toward medical leadership and clinician managers. They were also asked to self-rate their leadership competences set by the Medical Leadership Competency Framework and to rate the quality of management and leadership training they received from their medical school. Results: In total, we received 114 complete responses. Only 7.9% of respondents were in agreement (strongly agree or agree when asked whether they felt they were well informed about what a managerial position in medicine entails. When asked whether clinicians should influence managerial decisions within a clinical setting, 94.7% of respondents were in agreement with the statement. About 85% of respondents were in agreement that it is important for clinicians to have managerial or leadership responsibilities, with 63.2% of students in agreement that they would have liked more management or leadership training during medical school. Over half the respondents rated their management and leadership

Diabetes UK Position Statement. Competency frameworks in diabetes.

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

2015-05-01

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

Development and validation of risk models to predict outcomes following in-hospital cardiac arrest attended by a hospital-based resuscitation team.

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Harrison, David A; Patel, Krishna; Nixon, Edel; Soar, Jasmeet; Smith, Gary B; Gwinnutt, Carl; Nolan, Jerry P; Rowan, Kathryn M

2014-08-01

The National Cardiac Arrest Audit (NCAA) is the UK national clinical audit for in-hospital cardiac arrest. To make fair comparisons among health care providers, clinical indicators require case mix adjustment using a validated risk model. The aim of this study was to develop and validate risk models to predict outcomes following in-hospital cardiac arrest attended by a hospital-based resuscitation team in UK hospitals. Risk models for two outcomes-return of spontaneous circulation (ROSC) for greater than 20min and survival to hospital discharge-were developed and validated using data for in-hospital cardiac arrests between April 2011 and March 2013. For each outcome, a full model was fitted and then simplified by testing for non-linearity, combining categories and stepwise reduction. Finally, interactions between predictors were considered. Models were assessed for discrimination, calibration and accuracy. 22,479 in-hospital cardiac arrests in 143 hospitals were included (14,688 development, 7791 validation). The final risk model for ROSC>20min included: age (non-linear), sex, prior length of stay in hospital, reason for attendance, location of arrest, presenting rhythm, and interactions between presenting rhythm and location of arrest. The model for hospital survival included the same predictors, excluding sex. Both models had acceptable performance across the range of measures, although discrimination for hospital mortality exceeded that for ROSC>20min (c index 0.81 versus 0.72). Validated risk models for ROSC>20min and hospital survival following in-hospital cardiac arrest have been developed. These models will strengthen comparative reporting in NCAA and support local quality improvement. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Development and validation of risk models to predict outcomes following in-hospital cardiac arrest attended by a hospital-based resuscitation team☆

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Harrison, David A.; Patel, Krishna; Nixon, Edel; Soar, Jasmeet; Smith, Gary B.; Gwinnutt, Carl; Nolan, Jerry P.; Rowan, Kathryn M.

2014-01-01

Aim The National Cardiac Arrest Audit (NCAA) is the UK national clinical audit for in-hospital cardiac arrest. To make fair comparisons among health care providers, clinical indicators require case mix adjustment using a validated risk model. The aim of this study was to develop and validate risk models to predict outcomes following in-hospital cardiac arrest attended by a hospital-based resuscitation team in UK hospitals. Methods Risk models for two outcomes—return of spontaneous circulation (ROSC) for greater than 20 min and survival to hospital discharge—were developed and validated using data for in-hospital cardiac arrests between April 2011 and March 2013. For each outcome, a full model was fitted and then simplified by testing for non-linearity, combining categories and stepwise reduction. Finally, interactions between predictors were considered. Models were assessed for discrimination, calibration and accuracy. Results 22,479 in-hospital cardiac arrests in 143 hospitals were included (14,688 development, 7791 validation). The final risk model for ROSC > 20 min included: age (non-linear), sex, prior length of stay in hospital, reason for attendance, location of arrest, presenting rhythm, and interactions between presenting rhythm and location of arrest. The model for hospital survival included the same predictors, excluding sex. Both models had acceptable performance across the range of measures, although discrimination for hospital mortality exceeded that for ROSC > 20 min (c index 0.81 versus 0.72). Conclusions Validated risk models for ROSC > 20 min and hospital survival following in-hospital cardiac arrest have been developed. These models will strengthen comparative reporting in NCAA and support local quality improvement. PMID:24830872

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

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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/

An evaluation of the benefits to a UK Health Care Trust working in a partnership with a hospital in Northern Uganda: International partnership working in mental health.

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Hague, Ben; Sills, Jenny; Thompson, Andrew R

2015-12-22

Despite the worthy intentions of international health partnerships between high-income countries and countries with developing economies, the tangible benefits are rarely evaluated, limiting the assessment of the achievements of such collaborations. The present study used longitudinal qualitative methods to examine the individual and organisational benefits of a partnership between a National Health Service (NHS) mental health Trust in the United Kingdom and a mental health referral hospital in Northern Uganda. Benefits to UK staff and organisational development were benchmarked against an existing framework of healthcare competencies. Partnership involvement was beneficial to UK staff, by increasing awareness of diversity, and in enhancing ability to work flexibly and as a team. There were clear benefits expressed with regards to the partnership having the potential to enhance organisational reputation and staff morale. The findings from this study demonstrate that international partnerships are experienced as being of tangible value for healthcare staff from high-income countries, providing opportunities for the development of recognised healthcare competencies. In this study there was also some evidence that staff involvement might also provide wider organisational benefits.

Malnutrition in healthcare institutions: a review of the prevalence of under-nutrition in hospitals and care homes since 1994 in England.

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Ray, Sumantra; Laur, Celia; Golubic, Rajna

2014-10-01

One in four hospital patients in the UK are estimated to be affected by 'hospital malnutrition' (under-nutrition). There is a need for robust epidemiological data relating to the frequency, distribution and determinants of this clinical problem of public health importance. This review aims to undertake a narrative synthesis of data on the descriptive epidemiology of under-nutrition, and to address some of the methodological limitations. A methodical review of literature was undertaken, tracking the reported prevalence and incidence of under-nutrition in hospital, in the UK, since 1994. The 16 articles retrieved and reviewed demonstrate that nutrition in hospital is a long standing problem in UK hospitals and care homes. The existing literature is comprised mainly of cross-sectional surveys describing the prevalence of under-nutrition in hospital which ranges from 11 to 45%. There is considerable heterogeneity in the published literature on hospital malnutrition (under-nutrition) and very few studies either measure or have estimated incidence. Under-nutrition in hospital continues to be under-addressed, yet a major public health problem in the UK. Defining the descriptive epidemiology of this problem is one of the first steps towards understanding its aetiology or planning and evaluating appropriate prevention or treatment strategies. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Benchmarking of venous thromboembolism prophylaxis practice with ENT.UK guidelines.

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Al-Qahtani, Ali S

2017-05-01

The aim of this study was to benchmark our guidelines of prevention of venous thromboembolism (VTE) in ENT surgical population against ENT.UK guidelines, and also to encourage healthcare providers to utilize benchmarking as an effective method of improving performance. The study design is prospective descriptive analysis. The setting of this study is tertiary referral centre (Assir Central Hospital, Abha, Saudi Arabia). In this study, we are benchmarking our practice guidelines of the prevention of VTE in the ENT surgical population against that of ENT.UK guidelines to mitigate any gaps. ENT guidelines 2010 were downloaded from the ENT.UK Website. Our guidelines were compared with the possibilities that either our performance meets or fall short of ENT.UK guidelines. Immediate corrective actions will take place if there is quality chasm between the two guidelines. ENT.UK guidelines are evidence-based and updated which may serve as role-model for adoption and benchmarking. Our guidelines were accordingly amended to contain all factors required in providing a quality service to ENT surgical patients. While not given appropriate attention, benchmarking is a useful tool in improving quality of health care. It allows learning from others' practices and experiences, and works towards closing any quality gaps. In addition, benchmarking clinical outcomes is critical for quality improvement and informing decisions concerning service provision. It is recommended to be included on the list of quality improvement methods of healthcare services.

PACS and diagnostic imaging service delivery-A UK perspective

International Nuclear Information System (INIS)

Sutton, Laurence N.

2011-01-01

This review sets out the current position with regard to the implementation of PACS throughout the United Kingdom and the impact this has had on improving patient care. In December 2007 England had implemented full hospital-wide PACS in all hospitals: a major achievement in the relatively short time period of three years. The different approaches used by each country of the UK to achieve full national PACS are described in addition to the current issues with the sharing of images and reports across different healthcare organisations with regard to technical solutions, clinical safety and governance. The review gives insight into the changing methods of service delivery to address increasing demand pressures on diagnostic imaging services and how the national PACS implementation, specifically in England, has made a significant contribution to measures to improve efficiencies. The role of Teleradiology is discussed in the context of supporting local patient services rather than undermining them and the concept of cross-healthcare reporting 'Grids' is described. Finally, in the summary it is recognised that the vast wealth of knowledge accumulated during the national implementations has placed the UK in a strong position to facilitate full national data sharing across all healthcare organisations to improve patient care.

Implementation of IRR99 and IRMER2000 in UK hospitals

International Nuclear Information System (INIS)

Beddoe, A.; Temperton, D.; Rafiqi, E.; Larkin, E.; Jones, T.

2004-01-01

(ME)R must be clearly established. This paper examines the implications of implementing IRR99 and IR(ME)R2000 in hospitals and medical practices in the UK for both diagnostic and therapeutic procedures. The costs of this implementation have been significant, both in terms of increased work, and therefore staffing costs, and increased bureaucracy, but the benefits in terms of reduced medical exposure (from diagnostic sources) have also been clearly achieved. Although fewer patients are inappropriately exposed and more radiographs are actually reported, would the resources expended to achieve these improvements have been better spent on other more pressing public health and medical issues? Copyright (2004) Australasian Radiation Protection Society Inc

National Audit of Seizure management in Hospitals (NASH): results of the national audit of adult epilepsy in the UK.

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Dixon, Peter A; Kirkham, Jamie J; Marson, Anthony G; Pearson, Mike G

2015-03-31

About 100,000 people present to hospitals each year in England with an epileptic seizure. How they are managed is unknown; thus, the National Audit of Seizure management in Hospitals (NASH) set out to assess prior care, management of the acute event and follow-up of these patients. This paper describes the data from the second audit conducted in 2013. 154 emergency departments (EDs) across the UK. Data from 4544 attendances (median age of 45 years, 57% men) showed that 61% had a prior diagnosis of epilepsy, 12% other neurological problems and 22% were first seizure cases. Each ED identified 30 consecutive adult cases presenting due to a seizure. Details were recorded of the patient's prior care, management at hospital and onward referral to neurological specialists onto an online database. Descriptive results are reported at national level. Of those with epilepsy, 498 (18%) were on no antiepileptic drug therapy and 1330 (48%) were on monotherapy. Assessments were often incomplete and witness histories were sought in only 759 (75%) of first seizure patients, 58% were seen by a senior doctor and 57% were admitted. For first seizure patients, advice on further seizure management was given to 264 (27%) and only 55% were referred to a neurologist or epilepsy specialist. For each variable, there was wide variability among sites that was not explicable. For the sites who partook in both audits, there was a trend towards better care in 2013, but this was small and dwarfed by the intersite variability. These results have parallels with the Sentinel Audit of Stroke performed a decade earlier. There is wide intersite variability in care covering the entire care pathway, and a need for better organised and accessible care for these patients. 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.

Use of Performance Measures to Evaluate, Document Competence and Deterioration of Advanced Surgical Skills Exposure for Trauma (ASSET) Surgical Skills

Science.gov (United States)

2015-03-01

Sharon Henry1, Stacy Shackelford4. 1Shock Trauma Anesthesiology Research, University of Maryland Baltimore; 2The Alfred Hospital and Swinburne...Bethesda USA, The Alfred Hospital and Swinburne University, Melbourne, Australia • 6) THE ASSETS OF ASSET: IMPROVING SURGICAL PERFROMANCE...ACTIVITY 820 CHANDLER STREET FORT DETRICK MD 21702-5014 January 15, 2015 SUBJECT: BA 150077- "Refreshing Combat Surgical Skills for Vascular Control

The Availability of Advanced Airway Equipment and Experience with Videolaryngoscopy in the UK: Two UK Surveys

Directory of Open Access Journals (Sweden)

Rachel L. Gill

2015-01-01

Full Text Available Fibreoptic intubation, high frequency jet ventilation, and videolaryngoscopy form part of the Royal College of Anaesthetists compulsory higher airway training module. Curriculum delivery requires equipment availability and competent trainers. We sought to establish (1 availability of advanced airway equipment in UK hospitals (Survey I and (2 if those interested in airway management (Difficult Airway Society (DAS members had access to videolaryngoscopes, their basic skill levels and teaching competence with these devices and if they believed that videolaryngoscopy was replacing conventional or fibreoptic laryngoscopy (Survey II. Data was obtained from 212 hospitals (73.1% and 554 DAS members (27.6%. Most hospitals (202, 99% owned a fiberscope, 119 (57.5% had a videolaryngoscope, yet only 62 (29.5% had high frequency jet ventilators. DAS members had variable access to videolaryngoscopes with Airtraq 319 (59.6% and Glidescope 176 (32.9% being the most common. More DAS members were happy to teach or use videolaryngoscopes in a difficult airway than those who had used them more than ten times. The majority rated Macintosh laryngoscopy as the most important airway skill. Members rated fibreoptic intubation and videolaryngoscopy skills equally. Our surveys demonstrate widespread availability of fibreoptic scopes, limited availability of videolaryngoscopes, and limited numbers of experienced videolaryngoscope tutors.

Food hygiene training in the UK: time for a radical re-think?

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MacAuslan, E

2001-12-01

Training food handlers in the hospitality industry has been recommended by various organisations as a means of improving food handling practices and thus the safety of food for consumers. It is nearly 20 years since the first examinations for basic level food hygiene certificates were made available to food handlers in the UK. Since then little has changed in the syllabuses and in the way the questions are worded. However, the range of languages spoken by food handlers working in the UK has increased substantially since more employers are recruiting those who speak English as a second language. Training can be an unwelcome expense for managers where there is a high turnover of employees, especially amongst those for whom English is not a first language. To improve practical implementation of food hygiene theory it is time to develop a radical strategy concerning the way training is targeted and delivered in the UK, and perhaps Europe.

"Folk" Understandings of Quality in UK Higher Hospitality Education

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Wood, Roy

2015-01-01

Purpose: The purpose of this paper is to provide an overview of the evolution of "folk" understandings of quality in higher hospitality education and the consequent implications of these understandings for current quality concerns in the field. Design/methodology/approach: The paper combines a historical survey of the stated topic…

Food work and feeding assistance on hospital wards.

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Heaven, Ben; Bamford, Claire; May, Carl; Moynihan, Paula

2013-05-01

Approximately 60 per cent of UK patients aged 65 years or older are at risk of malnutrition or their situation worsening while in hospital. We report the results of a qualitative study embedded in research to prevent malnutrition in older people in hospital (the mappmal study). Our aim was to understand and describe processes that promote or inhibit nutrition in hospital. Throughout 2009 we examined meal services at four UK hospital sites across two regional locations, focusing on older patients admitted with dementia, for stroke or for fractured neck of femur. Data were collected through semi-structured interviews with National Health Service staff (n = 54), stakeholders (n = 6), and a focus group with former patients and carers (n = 5). We identified ward-based food work as a technical and interpersonal challenge in narratives around malnutrition. Food work constituted two overlapping spheres of activity: interpersonal engagement through feeding assistance and reassurance and the arrangement of resources that facilitate meals such as the preparation of food trolleys. Our analysis is framed by the literature on emotional labour, dirty work and the professionalisation of nursing. We demonstrate how food work is overlooked by being conceptualised as common sense and as one of the most mundane and elementary tasks in hospitals. © 2012 The Authors. Sociology of Health & Illness © 2012 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

Hospital networks and the dispersal of hospital-acquired pathogens by patient transfer.

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Tjibbe Donker

Full Text Available Hospital-acquired infections (HAI are often seen as preventable incidents that result from unsafe practices or poor hospital hygiene. This however ignores the fact that transmissibility is not only a property of the causative organisms but also of the hosts who can translocate bacteria when moving between hospitals. In an epidemiological sense, hospitals become connected through the patients they share. We here postulate that the degree of hospital connectedness crucially influences the rates of infections caused by hospital-acquired bacteria. To test this hypothesis, we mapped the movement of patients based on the UK-NHS Hospital Episode Statistics and observed that the proportion of patients admitted to a hospital after a recent episode in another hospital correlates with the hospital-specific incidence rate of MRSA bacteraemia as recorded by mandatory reporting. We observed a positive correlation between hospital connectedness and MRSA bacteraemia incidence rate that is significant for all financial years since 2001 except for 2008-09. All years combined, this correlation is positive and significantly different from zero (partial correlation coefficient r = 0.33 (0.28 to 0.38. When comparing the referral pattern for English hospitals with referral patterns observed in the Netherlands, we predict that English hospitals more likely see a swifter and more sustained spread of HAIs. Our results indicate that hospitals cannot be viewed as individual units but rather should be viewed as connected elements of larger modular networks. Our findings stress the importance of cooperative effects that will have a bearing on the planning of health care systems, patient management and hospital infection control.

Factor structure of the Essen Climate Evaluation Schema measure of social climate in a UK medium-security setting.

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Milsom, Sophia A; Freestone, Mark; Duller, Rachel; Bouman, Marisa; Taylor, Celia

2014-04-01

Social climate has an influence on a number of treatment-related factors, including service users' behaviour, staff morale and treatment outcomes. Reliable assessment of social climate is, therefore, beneficial within forensic mental health settings. The Essen Climate Evaluation Schema (EssenCES) has been validated in forensic mental health services in the UK and Germany. Preliminary normative data have been produced for UK high-security national health services and German medium-security and high-security services. We aim to validate the use of the EssenCES scale (English version) and provide preliminary normative data in UK medium-security hospital settings. The EssenCES scale was completed in a medium-security mental health service as part of a service-wide audit. A total of 89 patients and 112 staff completed the EssenCES. The three-factor structure of the EssenCES and its internal construct validity were maintained within the sample. Scores from this medium-security hospital sample were significantly higher than those from earlier high-security hospital data, with three exceptions--'patient cohesion' according to the patients and 'therapeutic hold' according to staff and patients. Our data support the use of the EssenCES scale as a valid measure for assessing social climate within medium-security hospital settings. Significant differences between the means of high-security and medium-security service samples imply that degree of security is a relevant factor affecting the ward climate and that in monitoring quality of secure services, it is likely to be important to apply different scores to reflect standards. Copyright © 2013 John Wiley & Sons, Ltd.

A BEME systematic review of UK undergraduate medical education in the general practice setting: BEME Guide No. 32.

Science.gov (United States)

Park, Sophie; Khan, Nada F; Hampshire, Mandy; Knox, Richard; Malpass, Alice; Thomas, James; Anagnostelis, Betsy; Newman, Mark; Bower, Peter; Rosenthal, Joe; Murray, Elizabeth; Iliffe, Steve; Heneghan, Carl; Band, Amanda; Georgieva, Zoya

2015-05-06

General practice is increasingly used as a learning environment in undergraduate medical education in the UK. The aim of this project was to identify, summarise and synthesise research about undergraduate medical education in general practice in the UK. We systematically identified studies of undergraduate medical education within a general practice setting in the UK from 1990 onwards. All papers were summarised in a descriptive report and categorised into two in-depth syntheses: a quantitative and a qualitative in-depth review. 169 papers were identified, representing research from 26 UK medical schools. The in-depth review of quantitative papers (n = 7) showed that medical students learned clinical skills as well or better in general practice settings. Students receive more teaching, and clerk and examine more patients in the general practice setting than in hospital. Patient satisfaction and enablement are similar whether a student is present or not in a consultation, however, patients experience lower relational empathy. Two main thematic groups emerged from the qualitative in-depth review (n = 10): the interpersonal interactions within the teaching consultation and the socio-cultural spaces of learning which shape these interactions. The GP has a role as a broker of the interactions between patients and students. General practice is a socio-cultural and developmental learning space for students, who need to negotiate the competing cultures between hospital and general practice. Lastly, patients are transient members of the learning community, and their role requires careful facilitation. General practice is as good, if not better, than hospital delivery of teaching of clinical skills. Our meta-ethnography has produced rich understandings of the complex relationships shaping possibilities for student and patient active participation in learning.

Doses to patients from medical X-ray examinations in the UK. 2000 review

CERN Document Server

Hart, D; Wall, B F

2002-01-01

In 1992 NRPB established a National Collation Centre for measurements of doses to patients made by x-ray departments throughout the UK. This report is the second in a series of five-yearly reviews of the national patient dose database and analyses the information collected during the period January 1996 to December 2000. It includes the results of 28,000 entrance surface dose (ESD) measurements and 13,000 dose-area product (DAP) measurements for single radiographs, and 140,000 DAP measurements and 128,000 records of the fluoroscopy time for complete examinations, collected from 371 hospitals throughout the UK. Information on the patient dose distributions and exposure conditions for over 30 types of examination and radiograph is presented. National reference doses based on the rounded third quartile values of these dose distributions are recommended and are seen to be about 20% lower than corresponding values in the previous (1995) review. They have approximately halved since the original UK national referenc...

UK surplus source disposal programme - 16097

International Nuclear Information System (INIS)

John, Gordon H.; Reeves, Nigel; Nisbet, Amy C.; Garnett, Andrew; Williams, Clive R.

2009-01-01

The UK Surplus Source Disposal Programme (SSDP), managed by the Environment Agency, was designed to remove redundant radioactive sources from the public domain. The UK Government Department for Environment, Food and Rural Affairs (Defra) was concerned that disused sources were being retained by hospitals, universities and businesses, posing a risk to public health and the environment. AMEC provided a range of technical and administrative services to support the SSDP. A questionnaire was issued to registered source holders and the submitted returns compiled to assess the scale of the project. A member of AMEC staff was seconded to the Environment Agency to provide technical support and liaise directly with source holders during funding applications, which would cover disposal costs. Funding for disposal of different sources was partially based on a sliding scale of risk as determined by the IAEA hazard categorisation system. This funding was also sector dependent. The SSDP was subsequently expanded to include the disposal of luminised aircraft instruments from aviation museums across the UK. These museums often hold significant radiological inventories, with many items being unused and in a poor state of repair. These instruments were fully characterised on site by assessing surface dose rate, dimensions, source integrity and potential contamination issues. Calculations using the Microshield computer code allowed gamma radiation measurements to be converted into total activity estimates for each source. More than 11,000 sources were disposed of under the programme from across the medical, industrial, museum and academic sectors. The total activity disposed of was more than 8.5 E+14 Bq, and the project was delivered under budget. (authors)

A cross-sectional survey of cardiovascular health and lifestyle habits of hospital staff in the UK: Do we look after ourselves?

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Mittal, Tarun K; Cleghorn, Christine L; Cade, Janet E; Barr, Suzanne; Grove, Tim; Bassett, Paul; Wood, David A; Kotseva, Kornelia

2018-03-01

Background A high prevalence of stress-related disorders is well known among healthcare professionals. We set out to assess the prevalence of cardiovascular risk factors and compliance with national dietary and physical activity recommendations in NHS staff in the UK with comparison between clinical and non-clinical staff, and national surveys. Design A multi-centre cross-sectional study. Methods A web-based questionnaire was developed to include anonymised data on demographics, job role, cardiovascular risk factors and diseases, dietary habits, physical activity and barriers towards healthy lifestyle. This was distributed to staff in four NHS hospitals via emails. Results A total of 1158 staff completed the survey (response rate 13%) with equal distribution between the clinical and non-clinical groups. Most staff were aged 26-60 years and 79% were women. Half of the staff were either overweight or obese (51%) with no difference between the groups ( P = 0.176), but there was a lower prevalence of cardiovascular risk factors compared to the general population. The survey revealed a low compliance (17%) with the recommended intake of five-a-day portions of fruit and vegetables, and that of moderate or vigorous physical activity (56%), with no difference between the clinical and non-clinical staff ( P = 0.6). However, more clinical staff were exceeding the alcohol recommendations ( P = 0.02). Lack of fitness facilities and managerial support, coupled with long working hours, were the main reported barriers to a healthy lifestyle. Conclusions In this survey of UK NHS staff, half were found to be overweight or obese with a lower prevalence of cardiovascular risk factors compared to the general population. There was a low compliance with the five-a-day fruit and vegetables recommendation and physical activity guidelines, with no difference between the clinical and non-clinical staff.

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

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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

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

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

Science.gov (United States)

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

2017-12-01

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

Impact of supply problems of preservative-free glaucoma medications on patients and hospital staff.

Science.gov (United States)

Shah, Shima; Theodossiades, Julia; Chapman, Kristin; Murdoch, Ian

2015-03-01

Glaucoma is a chronic ocular disease, which is usually managed with long-term daily medical therapy, in the form of eye drops. Patients who are intolerant to preservatives in topical medicines require preservative-free versions. From early 2011 patients attending Moorfields Eye Hospital, London, UK, started to report recurring problems with the supply of the following preservative-free glaucoma medications: Timolol 0.25% (Timoptol 0.25%, MSD UK); Dorzolamide (Trusopt, MSD UK); Dorzolamide and Timolol 0.5% (Cosopt, MSD UK). This study investigates the impact of the supply problems of these medications at Moorfields Eye Hospital from a patient, administrative and clinical perspective. Information was sought by interviewing both patients and hospital staff, and by a retrospective case note review between April 2010 and May 2013. Many hospital roles, both administrative and clinical, were involved in attempting to resolve the impact of the supply problems. All staff reported a considerable increase in their workload. At the peak of the problem, the glaucoma secretaries received about 150 enquiries per week. A review of 83 sets of patient notes, retrieved from a random sample of 125 patients, showed that 22% encountered a supply problem. Of these, more than one-third attended Moorfields Eye Hospital Accident & Emergency (A&E) for repeat supplies and 89% eventually had their medication changed. In telephone interviews with 39 of a random sample of 50 patients (a subset of the 83 notes retrieved), 59% of the interviewees reported a supply problem. Of these, one-third attended Moorfields Eye Hospital A&E for repeat supplies and half eventually required an alternative medication. Some patients reported going to considerable lengths to obtain ongoing supplies in the community. This study shows that medication supply problems can have a major impact on patients and hospital services. Supply problems occur across many fields of medicine and with increasing frequency. The

Community Hospitals in Selected High Income Countries: A Scoping Review of Approaches and Models

Directory of Open Access Journals (Sweden)

Eleanor M Winpenny

2016-11-01

Full Text Available Background: There is no single definition of a community hospital in the UK, despite its long history. We sought to understand the nature and scope of service provision in community hospitals, within the UK and other high-income countries. Methods: We undertook a scoping review of literature on community hospitals published from 2005 to 2014. Data were extracted on features of the hospital model and the services provided, with results presented as a narrative synthesis. Results: 75 studies were included from ten countries. Community hospitals provide a wide range of services, with wide diversity of provision appearing to reflect local needs. Community hospitals are staffed by a mixture of general practitioners (GPs, nurses, allied health professionals and healthcare assistants. We found many examples of collaborative working arrangements between community hospitals and other health care organisations, including colocation of services, shared workforce with primary care and close collaboration with acute specialists. Conclusions: Community hospitals are able to provide a diverse range of services, responding to geographical and health system contexts. Their collaborative nature may be particularly important in the design of future models of care delivery, where emphasis is placed on integration of care with a key focus on patient-centred care.

The example of the UK SHOT haemovigilance system

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Perla Eleftheriou

2014-12-01

Full Text Available SHOT (Serious Hazards of Transfusion scheme is the UK’s National confidential haemovigilance system, and was set up in 1996. It is an independent, confidential, professionally led haemovigilance scheme. Initially the reporting was voluntary but now required by several professional bodies. SHOT publishes annual reports with recommendations and circulates to all relevant organizations including the 4 UK Blood services, Departments of Health in England, Wales, Scotland and Northern Ireland, all relevant professional bodies and reporting hospitals. Over the 17 years of reporting, the evidence gathered has prompted changes in transfusion practice from the selection and management of donors to changes in hospital practice, better education and training. Acute transfusion reactions and transfusion-associated circulatory overload carry the highest risk for morbidity and death. Greatest risk to patients remain errors in the process at the point of blood sampling, in the laboratory and at bedside administration. SHOT’s objectives are to use findings to improve standards of hospital transfusion practice, to educate users on transfusion hazards and prevention, to aid production of clinical guidelines in blood transfusion and to inform national policy on transfusion safety. MHRA is the UK competent authority to which serious adverse reactions and events have to be reported annually. Overall the most common adverse incidents are caused by errors, resulting in the transfusion of an incorrect component or one that does not meet the specific requirements of the patient (e.g. not irradiated or not appropriately antigen matched. TACO (transfusion associated circulatory overload accounts for most deaths and major morbidity reported to SHOT but is overall underreported. Transfusions are not always given appropriately. This may be due to wrong haemoglobin results, failure to assess patients appropriately, or avoidable use of emergency O RhD negative units because

Trick questions: cosmopolitan hospitality

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Eleanor Byrne

2013-08-01

Full Text Available Byrne’s paper consists of two parallel texts. The first explores the limits of cosmopolitanism in practice, taking as its subject the Life in the UK Citizenship Test, inaugurated under the Labour Government in 2005. It argues that the test exemplifies the predicament of all attempts at cosmopolitan hospitality as unconditional welcoming, through a discussion of the relation between questioning and welcoming the stranger. Establishing the relationship between cosmopolitanism and hospitality as envisaged in Derrida’s reading of Kant it asks what kind of cosmopolitan hospitality is either possible or desirable by exploring what Derrida calls the ‘perversions’ inherent in the structures of hospitality. It focuses on the concept of the ‘trick questions’ that the state asks the foreigner observed by Derrida in his reading of The Apology of Socrates; questions that seem to invite answers but foreclose the possibilities of a free response. The second text asks how this logic that Derrida identifies can be pushed or coaxed into new ways of addressing the perceived threats of ‘unconditional’ hospitality through a reading of ‘unconditional hospitality’ as queer in the work of Tove Jansson.

A quality control exercise of radionuclide calibrators among Belgian hospitals

International Nuclear Information System (INIS)

Reher, D.F.G.; Merlo, P.

1990-01-01

On the initiative of the Belgian Association of Hospital Physicists, eleven Belgian hospitals participated in a quality control of radionuclide calibrators conducted in collaboration with the Central Bureau for Nuclear Measurements of the Commission of the European Communities. For practical reasons the nuclide 57 Co was chosen. The results from 20 different radionuclide calibrators show a fair agreement with a similar comparison carried out in 1980 in the UK. (orig.)

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

Exploring gender differences in the working lives of UK hospital consultants.

Science.gov (United States)

Jefferson, Laura; Bloor, Karen; Spilsbury, Karen

2015-05-01

Internationally, increasing numbers of women are practising medicine. Gender differences in doctors' working hours, specialty choices and communication styles are well documented, but studies often neglect contextual factors such as the role of socialised gender expectations on behaviours in the workplace and the medical profession. These may be important as recent studies have reported gender differences in doctors' activity rates that cannot be explained by specialty or contracted hours, suggesting other sources of variation. This study sought to explore the working lives of hospital doctors and how their work is negotiated according to gender and context. Gender differences in the day-to-day work of hospital specialists (consultants) in the NHS were investigated using a qualitative approach, including observation and interview methods. Data were analysed inductively using qualitative observation and interview methods. Two NHS hospital trusts in England. Data were collected from 13 participants working in a variety of specialties and in a range of clinical and non-clinical settings. Various behaviours, attitudes and experiences were explored, such as doctor-patient communication, interactions with colleagues and workload. Influences at both individual and situational levels, appear to affect differentially the work of male and female doctors. Female consultants described awareness of the impact of behaviours on relationships with colleagues, and their interactions appeared to be more carefully performed. Nurses and other colleagues tend to demonstrate less cooperation with female consultants. Gender differences also exist in patient communication, feelings of work-family conflict and barriers to career progression. These variations in hospital consultants' work may have implications for both the quantity and quality of care provided by male and female consultants. This is timely and of importance to the medical workforce as the gender composition approaches

Hirsch Index Value and Variability Related to General Surgery in a UK Deanery.

Science.gov (United States)

Abdelrahman, Tarig; Brown, Josephine; Wheat, Jenny; Thomas, Charlotte; Lewis, Wyn

2016-01-01

The Hirsch Index (h-index) is often used to assess research impact, and on average a social science senior lecturer will have an h-index of 2.29, yet its validity within the context of UK General Surgery (GS) is unknown. The aim of this study was to calculate the h-indices of a cohort of GS consultants in a UK Deanery to assess its relative validity. Individual h-indices and total publication (TP) counts were obtained for GS consultants via the Scopus and Web of Science (WoS) Internet search engines. Assessment of construct validity and reliability of these 2 measures of the h-index was undertaken. All hospitals in a single UK National Health Service Deanery were included (14 general hospitals). All 136 GS consultants from the Deanery were included. Median h-index (Scopus) was 5 (0-52) and TP 15 (0-369), and strong correlation was found between h-index and TP (ρ = 0.932, p Scopus and WoS h-index also significant (intraclass correlation coefficient = 0.973 [95% CI: 0.962-0.981], p Scopus 12 vs 7 vs 4 [p 2.29 in 57.4% of consultants. No subspecialty differences were apparent in median h-indices (p = 0.792) and TP (p = 0.903). h-Index is a valid GS research productivity metric with over half of consultants performing at levels equivalent to social science Senior Lecturers. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

UK Transfusion Laboratory Collaborative: minimum standards for staff qualifications, training, competency and the use of information technology in hospital transfusion laboratories 2014.

Science.gov (United States)

Chaffe, B; Glencross, H; Jones, J; Staves, J; Capps-Jenner, A; Mistry, H; Bolton-Maggs, P; McQuade, M; Asher, D

2014-12-01

The SHOT Adverse Incident Reporting Scheme has consistently reported an unacceptably high level of errors originating in the laboratory setting. In 2006 an initiative was launched in conjunction with the IBMS, SHOT, RCPath, BBTS, UK NEQAS, the NHSE NBTC and the equivalents in Scotland, Wales and Northern Ireland that led to the formation of the UK TLC. The UK TLC in considering the nature and spread of the errors documented by SHOT concluded that a significant proportion of these errors were most likely to be related to either the use of information technology or staff education, staffing levels, skill mix, training and competency issues. In the absence of any formal guidance on these matters, the UK TLC developed a series of recommendations using the results of two laboratory surveys conducted in 2007 and 2008.

The burden of chronic obstructive pulmonary disease associated with maintenance monotherapy in the UK

Directory of Open Access Journals (Sweden)

Edwards SC

2016-11-01

Full Text Available Susan C Edwards,1 Sian E Fairbrother,2 Anna Scowcroft,3 Gavin Chiu,4 Andrew Ternouth,3 Brian J Lipworth5 1Department of Market Access Pricing & Outcomes Research, 2Department of Medical Affairs - Respiratory, 3Department of Market Access, 4Department of Prescription Medicine - Respiratory, Boehringer Ingelheim, Bracknell, UK; 5Asthma and Allergy Research Group, Division of Cardiovascular and Diabetes Medicine, Scottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK Background: This study characterized a cohort of chronic obstructive pulmonary disease (COPD patients on maintenance bronchodilator monotherapy for ≥6 months to establish their disease burden, measured by health care utilization.Methods: Data were extracted from the UK Clinical Practice Research Datalink and linked to Hospital Episode Statistics. The monotherapy period spanned the first prescription of a long-acting β2-adrenergic agonist or a long-acting muscarinic antagonist until the end of the study (December 31, 2013 or until step up to dual/triple therapy, for example, addition of another long-acting bronchodilator, an inhaled corticosteroid, or both. A minimum of four consecutive prescriptions and 6 months on continuous monotherapy were required. Patients <50 years old at first COPD diagnosis or with another significant respiratory disease before starting monotherapy were excluded. Disease burden was evaluated by measuring patients’ rate of face-to-face interactions with a health care professional (HCP, COPD-related exacerbations, hospitalizations, and referrals.Results: A cohort of 8,811 COPD patients (95% Global initiative for chronic Obstructive Lung Disease stage A/B on maintenance monotherapy was identified between 2002 and 2013; 45% of these patients were still on monotherapy by the end of the study. Median time from first COPD diagnosis to first monotherapy prescription was 56 days, while the median time on

Smoking habits and attitudes toward tobacco bans among United Kingdom hospital staff and students.

Science.gov (United States)

Lewis, K E; Shin, D; Davies, G

2011-08-01

A group of United Kingdom (UK) hospitals. To estimate the current smoking habits of health care professionals (HCPs) in a country with active tobacco control measures, and to record their attitudes to national and hospital tobacco bans. A cross-sectional survey of 500 HCPs. HCPs reported a lower rate of current smoking (7%) than the general population (24%). Doctors (2.6%) and medical students (3.8%) were less likely to be current smokers than both nurses (8.7%) and allied health professionals (10.9%, P smoking in health care premises. A higher proportion of UK doctors (69%) than nurses (52%) favoured a complete ban (odds ratio 2.01, 95% confidence interval 1.14-3.56). Self-reported smoking patterns in UK health professionals are lower than previously and compared to other industrialised and developing countries. Support for bans is very high, but differences remain in behaviour and especially attitudes to local bans according to professional status, although this gap is also narrowing.

Does the private sector receive an excessive return from investments in health care infrastructure projects? Evidence from the UK.

Science.gov (United States)

Vecchi, Veronica; Hellowell, Mark; Gatti, Stefano

2013-05-01

This paper is concerned with the cost-efficiency of Private Finance Initiatives (PFIs) in the delivery of hospital facilities in the UK. We outline a methodology for identifying the "fair" return on equity, based on the Weighted Average Cost of Capital (WACC) of each investor. We apply this method to assess the expected returns on a sample of 77 contracts signed between 1997 and 2011 by health care provider organisations in the UK. We show that expected returns are in general in excess of the WACC benchmarks. The findings highlight significant problems in current procurement practices and the methodologies by which bids are assessed. To minimise the financial impact of hospital investments on health care systems, a regulatory regime must ensure that expected returns are set at the "fair" rate. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

UK energy policy ambition and UK energy modelling-fit for purpose?

International Nuclear Information System (INIS)

Strachan, Neil

2011-01-01

Aiming to lead amongst other G20 countries, the UK government has classified the twin energy policy priorities of decarbonisation and security of supply as a 'centennial challenge'. This viewpoint discusses the UK's capacity for energy modelling and scenario building as a critical underpinning of iterative decision making to meet these policy ambitions. From a nadir, over the last decade UK modelling expertise has been steadily built up. However extreme challenges remain in the level and consistency of funding of core model teams - critical to ensure a full scope of energy model types and hence insights, and in developing new state-of-the-art models to address evolving uncertainties. Meeting this challenge will facilitate a broad scope of types and geographical scale of UK's analytical tools to responsively deliver the evidence base for a range of public and private sector decision makers, and ensure that the UK contributes to global efforts to advance the field of energy-economic modelling. - Research highlights: → Energy modelling capacity is a critical underpinning for iterative energy policy making. → Full scope of energy models and analytical approaches is required. → Extreme challenges remain in consistent and sustainable funding of energy modelling teams. → National governments that lead in global energy policy also need to invest in modelling capacity.

Solar energy: a UK assessment

Energy Technology Data Exchange (ETDEWEB)

1976-01-01

A panel convened by UK-ISES to analyze all aspects of solar energy systems and to assess the potential for solar energy utilization and research and development needs in the UK and for export is reported. Topics covered include: solar energy in relation to other energy sources; international solar energy research and development program; the physical nature of solar energy and its availability in the UK and other countries; thermal collection, storage, and low-temperature applications; solar energy and architecture; solar thermal power systems; solar cells; agricultural and biological systems; photochemical systems; social, legal, and political considerations with particular reference to the UK; and future policy on solar research and development for the UK. (WDM)

Neglected roots of regionalism? The Commissioners for the special areas and grants to hospital services in the 1930s.

Science.gov (United States)

Mohan, J

1997-08-01

The inter-war years in the UK were notable for debates about the extent to which an extension of state intervention in hospital provision was desirable and necessary, and about the limits to and future of the voluntary hospital system which relied largely on various forms of private charity. These themes were intertwined in the UK's 'Special Areas', locations recognized as having suffered adversely from the inter-war depression, with consequent effects on their ability to finance desirable investments in social infrastructures. Grant aid was offered to hospitals in these locations under the terms of the Special Areas legislation of 1934, but there were extensive debates about the principle and practice of such subsidies to hospital development. This paper reviews these debates and considers whether the measures taken by the Commissioners can be seen as neglected antecedents of the regionalism detected in British hospital policy by several commentators.

Prevalence, Nature, Severity and Risk Factors for Prescribing Errors in Hospital Inpatients: Prospective Study in 20 UK Hospitals.

Science.gov (United States)

Ashcroft, Darren M; Lewis, Penny J; Tully, Mary P; Farragher, Tracey M; Taylor, David; Wass, Valerie; Williams, Steven D; Dornan, Tim

2015-09-01

It has been suggested that doctors in their first year of post-graduate training make a disproportionate number of prescribing errors. This study aimed to compare the prevalence of prescribing errors made by first-year post-graduate doctors with that of errors by senior doctors and non-medical prescribers and to investigate the predictors of potentially serious prescribing errors. Pharmacists in 20 hospitals over 7 prospectively selected days collected data on the number of medication orders checked, the grade of prescriber and details of any prescribing errors. Logistic regression models (adjusted for clustering by hospital) identified factors predicting the likelihood of prescribing erroneously and the severity of prescribing errors. Pharmacists reviewed 26,019 patients and 124,260 medication orders; 11,235 prescribing errors were detected in 10,986 orders. The mean error rate was 8.8 % (95 % confidence interval [CI] 8.6-9.1) errors per 100 medication orders. Rates of errors for all doctors in training were significantly higher than rates for medical consultants. Doctors who were 1 year (odds ratio [OR] 2.13; 95 % CI 1.80-2.52) or 2 years in training (OR 2.23; 95 % CI 1.89-2.65) were more than twice as likely to prescribe erroneously. Prescribing errors were 70 % (OR 1.70; 95 % CI 1.61-1.80) more likely to occur at the time of hospital admission than when medication orders were issued during the hospital stay. No significant differences in severity of error were observed between grades of prescriber. Potentially serious errors were more likely to be associated with prescriptions for parenteral administration, especially for cardiovascular or endocrine disorders. The problem of prescribing errors in hospitals is substantial and not solely a problem of the most junior medical prescribers, particularly for those errors most likely to cause significant patient harm. Interventions are needed to target these high-risk errors by all grades of staff and hence

A comparative review of the effectiveness of radon remediation programmes in hospitals, schools and homes in Northamptonshire, UK

International Nuclear Information System (INIS)

Denman, A.R.; Phillips, P.S.; Tornberg, R.

2000-01-01

are found and remediated. The total cost of each programme per man-sievert saved annually was estimated to be pound 195,400 for NHS, pound 20,400 for Schools, and currently pound 144,200 for houses, dropping to pound 27,000 if all houses are remediated. Comparisons between the programmes in schools, hospitals and domestic properties, show that it is most cost effective to conduct radon remediation in schools in a radon Affected Area. It is almost as cost effective to remediate domestic properties in the same area, but only if all householders can be encouraged to undertake any necessary remediation. In the UK with only 10% of such households having so far organised remediation, a review of current strategy is required. The exemption of remediation work from VAT would be a simple means of reducing costs, and demonstrating government commitment to reducing radon health risks. Despite this the domestic programme is already achieving a greater reduction in collective dose. It may be appropriate to consider a graduated approach to radon mitigation, with schools being remediated over a wider area than either domestic properties or the over-ground workplace. (author)

Management of patient dose in radiology in the UK

International Nuclear Information System (INIS)

Martin, C. J.

2011-01-01

Programmes to manage patient dose in radiology are becoming a higher priority as the number of imaging examinations and the proportion of higher dose computed tomography (CT) and complex interventional procedures all continue to rise. Such programmes have a number of components and their implementation in UK hospitals, which have been developing such programmes over two decades, is described. As part of any programme to manage patient doses, elements should be in place for both justification and optimisation. The system for justification needs to be robust in order to minimise the number of unnecessary procedures and requires the provision of training in radiation protection for medical and other staff to ensure that they understand the risks. Optimisation of X-ray techniques requires performance tests on equipment at installation and regularly thereafter, linked to surveys of patient doses. Confirming the performance of the available options on fluoroscopy and CT equipment is essential and the information obtained should be available to radiographers and radiologists, so they can make informed choices in developing imaging protocols. Patient doses should be compared with diagnostic reference levels set in terms of measured dose quantities to allow the identification of equipment that is giving higher doses. Taking the next step of analysing results to determine the reasons for high doses is crucial and requires a link with the equipment performance tests and an understanding of the underlying physics. Medical physics services play an important role at the hub of the dose management programme for carrying out tests, organising surveys, making recommendations on optimisation strategies and training other staff in radiation protection, performance testing and dose reduction. Programmes for management of patient doses in UK hospitals were first set up in the late 1980's by medical physicists and have been developed since that time to keep pace with the developments in

ONLINE PROACTIVE REVIEWS

DEFF Research Database (Denmark)

Kolbæk, Ditte

of business and different geographical regions and countries. The gathering of data includes ethical considerations consisting of informed consent from the researched people, confidentiality, anonymity and considerations regarding the formal power distance between the researcher and the researched people......-based research: putting a stake in the ground’, Journal of Learning Sciences, vol. 13 no.1, pp. 1–14.Bateson, G. (1972). Steps to an ecology of mind. New York, NY: Chandler Publishing Co.Bohm, D. (1996), On Dialogue, Routledge, London, UK.Brinkmann, Svend and Tanggaard, Lene (2010), Kvalitative Metoder, en...

An evaluation of paediatric medicines reconciliation at hospital discharge into the community

OpenAIRE

Huynh, Chi; Wong, Ian Chi Kei; Tomlin, Stephen; Halford, Ellisha; Jani, Yogini; Ghaleb, Maisoon

2016-01-01

OBJECTIVE: A UK national survey of primary care physicians has indicated that the medication information on hospital discharge summary was incomplete or inaccurate most of the time. Internationally, studies have shown that hospital pharmacist's interventions reduce these discrepancies in the adult population. There have been no published studies on the incidence and severity of the discrepancies of the medication prescribed for children specifically at discharge to date. The objectives of thi...

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 ...

Uses of the Twins UK genetic database.

Science.gov (United States)

Spector, Tim D

2007-11-01

Tim Spector is a Professor of Genetic Epidemiology at King's College London and Director of the Twin Research and Genetic Epidemiology Unit at St Thomas' Hospital, London. Professor Spector graduated from St Bartholomew's Hospital Medical School, London, in 1982. After working in General Medicine, he completed a MSc in Epidemiology, and his MD degree at the University of London in 1989. He founded the UK Twins Registry of 10,000 twins in 1993, which is one of the largest collections of genotype and phenotype information on twins worldwide, whose breadth of research has expanded to cover a wide range of common complex traits many of which were previously thought to be mainly due to aging and the environment. He has published over 350 research articles on common diseases. He has written several original articles on the genetics of a wide range of diseases and traits including back pain, acne, inflammation, obesity, memory, musical ability and sexuality. He is the principal investigator of the EU Euroclot and Treat OA study, and a partner in five others. He has written several books, focusing on osteoporosis and genetics and, in 2003, he published a popular book on genetics: Your Genes Unzipped.

Nuclear skills and education training in the UK through the Dalton nuclear institute

International Nuclear Information System (INIS)

Richard Clegg

2006-01-01

The UK demand for nuclear skills and research requirements is showing signs of a significant upturn. More capacity is being needed to support the UK's national programmes on clean-up and decommissioning, keeping the nuclear option open, and longer term advanced reactors technology. In response to this, The University of Manchester has launched the Dalton Nuclear Institute. The Institute is working with government and industry to strengthen and develop the UK's strategic nuclear skills base in the university sector. The Institute's scope covers the broad entirety of the UK's nuclear requirements spanning reactors, fuel cycles, decommissioning, disposal, social policy and regulation, and with connections into nuclear medicine and fusion. The rational behind the setting up of the Dalton Nuclear Institute including its research and education strategies are explained below, together with a description of the areas of current strength and the areas where major university investment is being targeted to uplift UK capacity and infrastructure. A big driver is also to forge links with other world leading centres internationally that will complement Manchester's in house capability. In the UK, the Dalton Nuclear Institute is working in partnership with Nexia Solutions and the NDA (Nuclear Decommissioning Authority) to match the Institute's plans with end-user industry and sector requirements. A key driver is to maximize the utilisation of the UK's specialist research facilities, notably the new Sellafield Technology Centre in West Cumbria. Discussions are underway with Nexia Solutions and the NDA to grant academic access for the Dalton Nuclear Institute and its collaborators to the Sellafield Technology Centre, to utilize it along the lines akin to a 'teaching hospital' model. The paper also explains the steps Dalton has taken by setting up and leading a consortium with ten other higher education providers in the UK, to launch a national programme for postgraduate

Management of COPD in the UK primary-care setting: an analysis of real-life prescribing patterns

Directory of Open Access Journals (Sweden)

Price D

2014-08-01

Full Text Available David Price,1 Daniel West,2 Guy Brusselle,3–5 Kevin Gruffydd-Jones,6 Rupert Jones,7 Marc Miravitlles,8 Andrea Rossi,9 Catherine Hutton,2 Valerie L Ashton,2 Rebecca Stewart,2 Katsiaryna Bichel2 1Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK; 2Research in Real-Life Ltd, Cambridge, UK; 3Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium; 4Department of Epidemiology, 5Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, the Netherlands; 6Box Surgery, Wiltshire, UK; 7Centre for Clinical Trials and Health Research – Translational and Stratified Medicine, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth UK; 8Department of Pneumology, Hospital Universitari Vall d'Hebron, Ciber de Enfermedades Respiratorias (CIBERES, Barcelona, Spain; 9Pulmonary Unit, Cardiovascular and Thoracic Department, University and General Hospital, Verona, Italy Background: Despite the availability of national and international guidelines, evidence suggests that chronic obstructive pulmonary disease (COPD treatment is not always prescribed according to recommendations. This study evaluated the current management of patients with COPD using a large UK primary-care database. Methods: This analysis used electronic patient records and patient-completed questionnaires from the Optimum Patient Care Research Database. Data on current management were analyzed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD group and presence or absence of a concomitant asthma diagnosis, in patients with a COPD diagnosis at ≥35 years of age and with spirometry results supportive of the COPD diagnosis. Results: A total of 24,957 patients were analyzed, of whom 13,557 (54.3% had moderate airflow limitation (GOLD Stage 2 COPD. The proportion of patients not receiving pharmacologic treatment for COPD was 17.0% in the total COPD population and 17.7% in the GOLD Stage 2 subset. Approximately

Enhanced recovery from surgery in the UK: an audit of the enhanced recovery partnership programme 2009-2012.

Science.gov (United States)

Simpson, J C; Moonesinghe, S R; Grocott, M P W; Kuper, M; McMeeking, A; Oliver, C M; Galsworthy, M J; Mythen, M G

2015-10-01

The UK Department of Health Enhanced Recovery Partnership Programme collected data on 24 513 surgical patients in the UK from 2009-2012. Enhanced Recovery is an approach to major elective surgery aimed at minimizing perioperative stress for the patient. Previous studies have shown Enhanced Recovery to be associated with reduced hospital length of stay and perioperative morbidity. In this national clinical audit, National Health Service hospitals in the UK were invited to submit patient-level data. The data regarding length of stay and compliance with each element of Enhanced Recovery protocols for colorectal, orthopaedic, urological and gynaecological surgery patients were analysed. The relationship between Enhanced Recovery protocol compliance and length of stay was measured. From 16 267 patients from 61 hospital trusts, three out of four surgical specialties showed Enhanced Recovery, compliance being weakly associated with shorter length of stay (correlation coefficients -0.18, -0.14, -0.25 in colorectal, orthopaedics and gynaecology respectively). At a cut-off of 80% compliance, good compliance was associated with two, one and three day reductions in median length of stay respectively in colorectal, orthopaedic and urological surgeries, with no saving in gynaecology. This study is the largest assessment of the relationship between Enhanced Recovery protocol compliance and outcome in four surgical specialties. The data suggest that higher compliance with an Enhanced Recovery protocol has a weak association with shorter length of stay. This suggests that changes in process, resulting from highly protocolised pathways, may be as important in reducing perioperative length of stay as any individual element of Enhanced Recovery protocols in isolation. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

UK retail marketing survey 94

International Nuclear Information System (INIS)

Anon.

1994-01-01

This document draws together data on the United Kingdom (UK) petroleum market up to the end of 1993. Lists include suppliers of petrol to the UK market listed by brand name, a regional breakdown of petrol and derv outlets, UK outlets which retail derv. Average retail prices for motor spirit and derv per litre are given as are sites fitted with Vapour Recovery equipment. Other tables shown indicate various companies' share of the market in terms of the percentage of petrol sites, including supermarkets. The volumes of motor spirit and derv delivered to retail and commercial customers between 1984 and 1993 is also given. (UK)

Innovative UK Approaches to Acquisition Management

Science.gov (United States)

2009-05-01

Financial and Operational Imperatives Size of UK armed forces UK Industry ? Political influence PFI / PPP Increased Scrutiny - NAO “ Commercialisation “ of the...acquisition KNOWLEDGE (EXPERIENCE – Lessons learned) KNOWLEDGE (Training) KNOWLEDGE ( Education ) OPTIMAL OPERATIONAL PERFORMANCE Operational Capability UK

Polar motion as boundary condition in an adaptive Kalman filter approach for the determination of period and damping of the Chandler oscillation

Science.gov (United States)

Seitz, F.; Kirschner, S.; Neubersch, D.

2012-12-01

Earth rotation has been monitored using space geodetic techniques since many decades. The geophysical interpretation of observed time series of Earth rotation parameters (ERP) polar motion and length-of-day is commonly based on numerical models that describe and balance variations of angular momentum in various subsystems of the Earth. Naturally, models are dependent on geometrical, rheological and physical parameters. Many of these are weakly determined from other models or observations. In our study we present an adaptive Kalman filter approach for the improvement of parameters of the dynamic Earth system model DyMEG which acts as a simulator of ERP. In particular we focus on the improvement of the pole tide Love number k2. In the frame of a sensitivity analysis k2 has been identified as one of the most crucial parameters of DyMEG since it directly influences the modeled Chandler oscillation. At the same time k2 is one of the most uncertain parameters in the model. Our simulations with DyMEG cover a period of 60 years after which a steady state of k2 is reached. The estimate for k2, accounting for the anelastic response of the Earth's mantle and the ocean, is 0.3531 + 0.0030i. We demonstrate that the application of the improved parameter k2 in DyMEG leads to significantly better results for polar motion than the original value taken from the Conventions of the International Earth Rotation and Reference Systems Service (IERS).

The UK biomass industry

International Nuclear Information System (INIS)

Billins, P.

1998-01-01

A brief review is given of the development of the biomass industry in the UK. Topics covered include poultry litter generation of electricity, gasification plants fuelled by short-rotation coppice, on-farm anaerobic digestion and specialized combustion systems, e.g. straw, wood and other agricultural wastes. (UK)

Report on primate supply for biomedical scientific work in the UK. EUPREN UK Working Party.

Science.gov (United States)

Owen, S; Thomas, C; West, P; Wolfensohn, S; Wood, M

1997-10-01

A Working Party of the UK group of European Primate Resources Network (EUPREN) considered primate supply for scientific work in the UK. Through a questionnaire, which achieved a very good response, it obtained details of primate use, sources and breeding in the UK and it put forward options to ensure that animal welfare is the best possible whilst ensuring continued supply. The questionnaire showed that contract research laboratories and pharmaceutical companies use about 80% of the 4233 primates used annually at the moment, with the rest accounted for by academic establishments and public sector laboratories. Fifty-four per cent are cynomolgus macaques (Macaca fascicularis), of which nearly 90% are captive-bred outside the European Union (EU), the remainder being bred in the UK. Nearly 90% of cynomolgus macaques are used by only five institutions. Thirty-seven per cent of primates used are marmosets (Callithrix jacchus jacchus), all of which are bred in the UK. Most of the rest are rhesus macaques (Macaca mulatta), about half of which are captive-bred outside the EU, the other half being bred in the UK. Overall primate use has increased from about 3000 per year in 1990 and users predict that requirements for all species except baboons (Papio sp.) will be maintained or increase. Marmoset breeding in the UK is already closely matched to use, and it could be increased reasonably easily if necessary. Some of the existing breeding centres of macaques in the UK would be prepared to consider expanding to supply others, although investment and imported breeding stock would be needed and it is likely that a large investment would be needed to breed a significant fraction of the macaque use in the UK. A further problem is that the users of only about 10% of the cynomolgus macaques said that they could replace this species by rhesus macaques, which are easier to breed in the UK. The questionnaire showed that much of the use of macaques would be transferred to other countries

Viral Co-Infections in Pediatric Patients Hospitalized with Lower Tract Acute Respiratory Infections.

Science.gov (United States)

Cebey-López, Miriam; Herberg, Jethro; Pardo-Seco, Jacobo; Gómez-Carballa, Alberto; Martinón-Torres, Nazareth; Salas, Antonio; Martinón-Sánchez, José María; Gormley, Stuart; Sumner, Edward; Fink, Colin; Martinón-Torres, Federico

2015-01-01

Molecular techniques can often reveal a broader range of pathogens in respiratory infections. We aim to investigate the prevalence and age pattern of viral co-infection in children hospitalized with lower tract acute respiratory infection (LT-ARI), using molecular techniques. A nested polymerase chain reaction approach was used to detect Influenza (A, B), metapneumovirus, respiratory syncytial virus (RSV), parainfluenza (1-4), rhinovirus, adenovirus (A-F), bocavirus and coronaviruses (NL63, 229E, OC43) in respiratory samples of children with acute respiratory infection prospectively admitted to any of the GENDRES network hospitals between 2011-2013. The results were corroborated in an independent cohort collected in the UK. A total of 204 and 97 nasopharyngeal samples were collected in the GENDRES and UK cohorts, respectively. In both cohorts, RSV was the most frequent pathogen (52.9% and 36.1% of the cohorts, respectively). Co-infection with multiple viruses was found in 92 samples (45.1%) and 29 samples (29.9%), respectively; this was most frequent in the 12-24 months age group. The most frequently observed co-infection patterns were RSV-Rhinovirus (23 patients, 11.3%, GENDRES cohort) and RSV-bocavirus / bocavirus-influenza (5 patients, 5.2%, UK cohort). The presence of more than one virus in pediatric patients admitted to hospital with LT-ARI is very frequent and seems to peak at 12-24 months of age. The clinical significance of these findings is unclear but should warrant further analysis.

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

Science.gov (United States)

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

2017-12-01

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

Coding accuracy for Parkinson's disease hospital admissions: implications for healthcare planning in the UK.

Science.gov (United States)

Muzerengi, S; Rick, C; Begaj, I; Ives, N; Evison, F; Woolley, R L; Clarke, C E

2017-05-01

Hospital Episode Statistics data are used for healthcare planning and hospital reimbursements. Reliability of these data is dependent on the accuracy of individual hospitals reporting Secondary Uses Service (SUS) which includes hospitalisation. The number and coding accuracy for Parkinson's disease hospital admissions at a tertiary centre in Birmingham was assessed. Retrospective, routine-data-based study. A retrospective electronic database search for all Parkinson's disease patients admitted to the tertiary hospital over a 4-year period (2009-2013) was performed on the SUS database using International Classification of Disease codes, and on the local inpatient electronic prescription database, Prescription and Information Communications System, using medication prescriptions. Capture-recapture methods were used to estimate the number of patients and admissions missed by both databases. From the two databases, between July 2009 and June 2013, 1068 patients with Parkinson's disease accounted for 1999 admissions. During these admissions, the Parkinson's disease was coded as a primary or secondary diagnosis. Ninety-one percent of these admissions were recorded on the SUS database. Capture-recapture methods estimated that the number of Parkinson's disease patients admitted during this period was 1127 patients (95% confidence interval: 1107-1146). A supplementary search of both SUS and Prescription and Information Communications System was undertaken using the hospital numbers of these 1068 patients. This identified another 479 admissions. SUS database under-estimated Parkinson's disease admissions by 27% during the study period. The accuracy of disease coding is critical for healthcare policy planning and must be improved. If the under-reporting of Parkinson's disease admissions on the SUS database is repeated nationally, expenditure on Parkinson's disease admissions in England is under-estimated by approximately £61 million per year. Copyright © 2016 The Royal

The evidence-based practice profiles of academic and clinical staff involved in pre-registration nursing students' education: a cross sectional survey of US and UK staff.

Science.gov (United States)

Upton, Penney; Scurlock-Evans, Laura; Williamson, Kathleen; Rouse, Joanne; Upton, Dominic

2015-01-01

Competency in evidence-based practice (EBP) is a requirement for graduate nurses. Despite a growing body of research exploring the EBP profiles of students, little research has explored the EBP profiles of nurse educators. To explore: the differences/similarities in the EBP profiles of US and UK clinical and academic faculty; the barriers nurse educators experience when teaching EBP; the impact of postgraduate education on EBP profile and; what nurse educators perceive "success" in implementing and teaching EBP to be. A cross-sectional online survey design was employed. Two Universities delivering undergraduate nursing education in the US and UK, in partnership with large hospital systems, small community hospitals, community settings, and independent sector health organisations. Eighty-one nurse educators working in academic and clinical contexts in the US and UK (US academic=12, US clinical=17, UK academic=9, UK clinical=43) were recruited opportunistically. Participants were emailed a weblink to an online survey, comprising demographic questions, the Evidence-Based Practice Questionnaire and open-ended questions about EBP barriers, facilitators and successes. Quantitative results indicated that academic faculty scored significantly higher on knowledge and skills of EBP, than clinical faculty, but revealed no other significant differences on EBP use or attitudes, or between US and UK professionals. Participants with postgraduate training scored significantly higher on EBP knowledge/skills, but not EBP attitudes or use. Qualitative findings identified key themes relating to EBP barriers and facilitators, including: Evidence-, organisational-, and teaching-related issues. Perceptions of successes in EBP were also described. Nurse educators working in the UK and US face similar EBP barriers to teaching and implementation, but view it positively and use it frequently. Clinical staff may require extra support to maintain their EBP knowledge and skills in

Impact of hospital mergers on staff job satisfaction: a quantitative study

OpenAIRE

Lim, Ka Keat

2014-01-01

Background Hospital mergers began in the UK in the late 1990s to deal with underperformance. Despite their prevalence, there is a lack of research on how such organizational changes affect the staff morale. This study aims to assess the impact of NHS hospital mergers between financial years 2009/10 and 2011/12 on staff job satisfaction and to identify factors contributing to satisfaction. Methods Data on staff job satisfaction were obtained from the annual NHS Staff Survey. A list of mergers ...

Hewitt launches Research Councils UK

CERN Multimedia

2002-01-01

"Trade and Industry Secretary Patricia Hewitt today launched 'Research Councils UK' - a new strategic partnership that will champion research in science, engineering and technology across the UK" (1 page).

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.)

UK 2009-2010 repeat station report

Directory of Open Access Journals (Sweden)

Thomas J.G. Shanahan

2013-03-01

Full Text Available The British Geological Survey is responsible for conducting the UK geomagnetic repeat station programme. Measurements made at the UK repeat station sites are used in conjunction with the three UK magnetic observatories: Hartland, Eskdalemuir and Lerwick, to produce a regional model of the local field each year. The UK network of repeat stations comprises 41 stations which are occupied at approximately 3-4 year intervals. Practices for conducting repeat station measurements continue to evolve as advances are made in survey instrumentation and as the usage of the data continues to change. Here, a summary of the 2009 and 2010 UK repeat station surveys is presented, highlighting the measurement process and techniques, density of network, reduction process and recent results.

Nurses and opioids: results of a bi-national survey on mental models regarding opioid administration in hospitals

Directory of Open Access Journals (Sweden)

Guest C

2017-03-01

Full Text Available Charlotte Guest,1 Fabian Sobotka,2 Athina Karavasopoulou,3 Stephen Ward,3 Carsten Bantel4,5 1Pain Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; 2Division of Epidemiology and Biometry, Department of Health Services Research, Faculty 6, Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany; 3Pain Service, Barts Health, St Bartholomew’s Hospital, London, UK; 4Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Oldenburg University, Klinikum Oldenburg Campus, Oldenburg, Germany; 5Department of Surgery and Cancer, Anaesthetics Section, Imperial College London, Chelsea and Westminster Hospital Campus, London, UK Objective: Pain remains insufficiently treated in hospitals. Increasing evidence suggests human factors contribute to this, due to nurses failing to administer opioids. This behavior might be the consequence of nurses’ mental models about opioids. As personal experience and conceptions shape these models, the aim of this prospective survey was to identify model-influencing factors. Material and methods: A questionnaire was developed comprising of 14 statements concerning ideations about opioids and seven questions concerning demographics, indicators of adult learning, and strength of religious beliefs. Latent variables that may underlie nurses’ mental models were identified using undirected graphical dependence models. Representative items of latent variables were employed for ordinal regression analysis. Questionnaires were distributed to 1,379 nurses in two London, UK, hospitals (n=580 and one German (n=799 hospital between September 2014 and February 2015. Results: A total of 511 (37.1% questionnaires were returned. Mean (standard deviation age of participants were 37 (11 years; 83.5% participants were female; 45.2% worked in critical care; and 51.5% had more than 10 years experience. Of the nurses, 84% were not scared of opioids, 87

Radiation protection in hospitals

International Nuclear Information System (INIS)

MOuld, R.F.

1985-01-01

A book on radiation protection in hospitals has been written to cater for readers with different backgrounds, training and needs by providing an elementary radiation physics text in Part I and an advanced, comprehensive Part II relating to specific medical applications of X-rays and of radioactivity. Part I includes information on basic radiation physics, radiation risk, radiation absorption and attenuation, radiation measurement, radiation shielding and classification of radiation workers. Part II includes information on radiation protection in external beam radiotherapy, interstitial source radiotherapy, intracavitary radiotherapy, radioactive iodine-131 radiotherapy, nuclear medicine diagnostics and diagnostic radiology. (U.K.)

Examining the relationship between anxiety and depression and exacerbations of COPD which result in hospital admission: a systematic review

Directory of Open Access Journals (Sweden)

Pooler A

2014-03-01

Full Text Available Alison Pooler,1,2 Roger Beech21School of Nursing and Midwifery, Clinical Education Centre, University Hospital of North Staffordshire NHS Trust, Stoke-on-Trent, UK; 2Health Services Research, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK Objectives: Exacerbations of chronic obstructive pulmonary disease (COPD are the third largest cause of emergency hospital admissions in the UK. This systematic literature review explored the relationship between the hospitalization rates and the COPD comorbidities, anxiety, and depression.Methods: The Centre for Research Dissemination's framework for systematic reviews was followed using search terms relating to COPD, anxiety, depression, and hospital admission. Papers identified were assessed for relevance and quality, using a suitable Critical Appraisal Skills Programme tool and Mixed Methods Assessment Tool.Results: Twenty quantitative studies indicated that anxiety and depression led to a statistically significant increase in the likelihood of COPD patients being hospitalized. These comorbidities also led to an increased length of stay and a greater risk of mortality postdischarge. Other significant factors included lower Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise scores, female gender, lower socioeconomic status, poorer patient perceived quality of life, increased severity of lung function, and less improvement in dyspnea from admission to discharge. It was also highlighted that only 27%–33% of those with depression were being treated for it. Four qualitative studies revealed that patients saw anxiety and depression as a major factor that affected their ability to cope with and self-manage their condition.Implications: Findings from the systematic review have highlighted a need for better recognition and treatment of anxiety and depression amongst individuals with COPD. Ongoing research will develop and test strategies for promoting better management

UK Announces Intention to Join ESO

Science.gov (United States)

2000-11-01

Summary The Particle Physics and Astronomy Research Council (PPARC) , the UK's strategic science investment agency, today announced that the government of the United Kingdom is making funds available that provide a baseline for this country to join the European Southern Observatory (ESO) . The ESO Director General, Dr. Catherine Cesarsky , and the ESO Community warmly welcome this move towards fuller integration in European astronomy. "With the UK as a potential member country of ESO, our joint opportunities for front-line research and technology will grow significantly", she said. "This announcement is a clear sign of confidence in ESO's abilities, most recently demonstrated with the construction and operation of the unique Very Large Telescope (VLT) on Paranal. Together we will look forward with confidence towards new, exciting projects in ground-based astronomy." It was decided earlier this year to place the 4-m UK Visible and Infrared Survey Telescope (VISTA) at Paranal, cf. ESO Press Release 03/00. Following negotiations between ESO and PPARC, a detailed proposal for the associated UK/ESO Agreement with the various entry modalities will now be presented to the ESO Council for approval. Before this Agreement can enter into force, the ESO Convention and associated protocols must also be ratified by the UK Parliament. Research and key technologies According to the PPARC press release, increased funding for science, announced by the UK government today, will enable UK astronomers to prepare for the next generation of telescopes and expand their current telescope portfolio through membership of the European Southern Observatory (ESO). The uplift to its baseline budget will enable PPARC to enter into final negotiations for UK membership of the ESO. This will ensure that UK astronomers, together with their colleagues in the ESO member states, are actively involved in global scale preparations for the next generation of astronomy facilities. among these are ALMA

UK Royal Navy WWII Logbooks

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — In 2006, the UK and NOAA's Climate Database Modernization Program (CDMP) funded the imaging of approximately 8,000 Royal Navy logbooks in the UK National Archives...

A Cyber Security Risk Assessment of Hospital Infrastructure including TLS/SSL and other Threats

OpenAIRE

Millar, Stuart

2016-01-01

Cyber threats traditionally target governments, financial institutions and businesses. However, of growing concern is the threat to healthcare organizations. This study conducts a cyber security risk assessment of a theoretical hospital environment, to include TLS/SSL, which is an encryption protocol for network communications, plus other physical, logical and human threats. Despite significant budgets in the UK for the NHS, the spend on cyber security appears worryingly low and many hospital...

How to govern physician-hospital exchanges: contractual and relational issues in Belgian hospitals.

Science.gov (United States)

Trybou, Jeroen; Gemmel, Paul; Annemans, Lieven

2014-07-01

exchange, stimulating an integrated hospital-physician relationship. Unfortunately, the fragmented payment framework characterized by unaligned incentives is perceived as an obstacle to realize effective collaboration. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Pub Culture in the U.K.

Institute of Scientific and Technical Information of China (English)

孙鑫

2015-01-01

In the U.K., pubs can be seen everywhere. They play an important role in the British society. How pubs came into being in the U.K.? Why is pub culture formed and what makes it prosperous? What effects does pub culture make on British society both in the past and in the present? Does any British character be shown in pub culture in the U.K.? In this paper, I will give a brief in-troduction of pub culture's history and development in the U.K.. Besides, the above questions will be explored and analyzed one by one.

No Ifs, No Butts: Compliance with Smoking Cessation in Secondary Care Guidance (NICE PH48 by Providers of Cancer Therapies (Radiotherapy and Chemotherapy in the UK

Directory of Open Access Journals (Sweden)

Daniel Hutton

2016-12-01

Full Text Available Background: Legislation preventing smoking in public places was introduced in England in July 2007. Since then, smoke-free policies have been extended to the majority of hospitals including those providing cancer therapies. Whilst studies have been conducted on the impact and effectiveness of hospital smoke-free policy in the UK and other countries, there have not been any studies with a focus on cancer care providers. Cancer patients are a priority group for smoking cessation and support and this study aimed to examine implementation of the National Institute Clinical Excellence (NICE guidance (PH48 in acute cancer care trusts in the UK. Methods: Participants were recruited from UK radiotherapy and chemotherapy departments (total 80 sites, 65 organisations and asked to complete a 15 min online questionnaire exploring the implementation of NICE guidance at their hospital site. Results: Considerable variability in implementation of the NICE guidance was observed. A total of 79.1% trusts were smoke-free in theory; however, only 18.6% were described as smoke-free in practice. Areas of improvement were identified in information and support for patients and staff including in Nicotine Replacement Therapy (NRT provision, staff training and clarity on e-cigarette policies. Conclusions: While some trusts have effective smoke-free policies and provide valuable cessation support services for patients, improvements are required to ensure that all sites fully adopt the NICE guidance.

UK doctors’ views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis

Science.gov (United States)

Clarke, Rachel T; Pitcher, Alex; Lambert, Trevor W; Goldacre, Michael J

2014-01-01

Objectives To report on what doctors at very different levels of seniority wrote, in their own words, about their concerns about the European Working Time Directive (EWTD) and its implementation in the National Health Service (NHS). Design All medical school graduates from 1993, 2005 and 2009 were surveyed by post and email in 2010. Setting The UK. Methods Using qualitative methods, we analysed free-text responses made in 2010, towards the end of the first year of full EWTD implementation, of three cohorts of the UK medical graduates (graduates of 1993, 2005 and 2009), surveyed as part of the UK Medical Careers Research Group's schedule of multipurpose longitudinal surveys of doctors. Results Of 2459 respondents who gave free-text comments, 279 (11%) made unprompted reference to the EWTD; 270 of the 279 comments were broadly critical. Key themes to emerge included frequent dissociation between rotas and actual hours worked, adverse effects on training opportunities and quality, concerns about patient safety, lowering of morale and job satisfaction, and attempts reportedly made in some hospitals to persuade junior doctors to collude in the inaccurate reporting of compliance. Conclusions Further work is needed to determine whether problems perceived with the EWTD, when they occur, are attributable to the EWTD itself, and shortened working hours, or to the way that it has been implemented in some hospitals. PMID:24503304

UK doctors' views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis.

Science.gov (United States)

Clarke, Rachel T; Pitcher, Alex; Lambert, Trevor W; Goldacre, Michael J

2014-02-06

To report on what doctors at very different levels of seniority wrote, in their own words, about their concerns about the European Working Time Directive (EWTD) and its implementation in the National Health Service (NHS). All medical school graduates from 1993, 2005 and 2009 were surveyed by post and email in 2010. The UK. Using qualitative methods, we analysed free-text responses made in 2010, towards the end of the first year of full EWTD implementation, of three cohorts of the UK medical graduates (graduates of 1993, 2005 and 2009), surveyed as part of the UK Medical Careers Research Group's schedule of multipurpose longitudinal surveys of doctors. Of 2459 respondents who gave free-text comments, 279 (11%) made unprompted reference to the EWTD; 270 of the 279 comments were broadly critical. Key themes to emerge included frequent dissociation between rotas and actual hours worked, adverse effects on training opportunities and quality, concerns about patient safety, lowering of morale and job satisfaction, and attempts reportedly made in some hospitals to persuade junior doctors to collude in the inaccurate reporting of compliance. Further work is needed to determine whether problems perceived with the EWTD, when they occur, are attributable to the EWTD itself, and shortened working hours, or to the way that it has been implemented in some hospitals.

Pre-hospital care after a seizure: Evidence base and United Kingdom management guidelines.

Science.gov (United States)

Osborne, Andrew; Taylor, Louise; Reuber, Markus; Grünewald, Richard A; Parkinson, Martin; Dickson, Jon M

2015-01-01

Seizures are a common presentation to pre-hospital emergency services and they generate significant healthcare costs. This article summarises the United Kingdom (UK) Ambulance Service guidelines for the management of seizures and explores the extent to which these guidelines are evidence-based. Summary of the Clinical Practice Guidelines of the UK Joint Royal Colleges Ambulance Liaison Committee relating to the management of seizures. Review of the literature relating to pre-hospital management of seizure emergencies. Much standard practice relating to the emergency out of hospital management of patients with seizures is drawn from generic Advanced Life Support (ALS) guidelines although many patients do not need ALS during or after a seizure and the benefit of many ALS interventions in seizure patients remains to be established. The majority of studies identified pertain to medical treatment of status epilepticus. These papers show that benzodiazepines are safe and effective but it is not possible to draw definitive conclusions about the best medication or the optimal route of administration. The evidence base for current pre-hospital guidelines for seizure emergencies is incomplete. A large proportion of patients are transported to hospital after a seizure but many of these may be suitable for home management. However, there is very little research into alternative care pathways or criteria that could be used to help paramedics avoid transport to hospital. More research is needed to improve care for people after a seizure and to improve the cost-effectiveness of the healthcare systems within which they are treated. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

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

The impact of smokefree legislation in Scotland: results from the Scottish ITC Scotland/UK longitudinal surveys

Science.gov (United States)

Hassan, Louise M.; Higbee, Cheryl; Boudreau, Christian; Fong, Geoffrey T.; Borland, Ron; Cummings, K. Michael; Yan, Mi; Thompson, Mary E.; Hastings, Gerard

2009-01-01

Background: To evaluate how Scotland's smokefree law impacted self-reported secondhand smoke (SHS) exposure in hospitality venues, workplaces and in people's homes. In addition, we examine changes in support for the law, pub and restaurant patronage, smoking cessation indicators and whether any observed changes varied by socioeconomic status. Methods: A quasi-experimental longitudinal telephone survey of nationally representative samples of smokers and non-smokers interviewed before the Scottish law (February to March 2006) and 1 year later after the law (March 2007) in Scotland (n = 705 smokers and n = 417 non-smokers) and the rest of the UK (n = 1027 smokers and n = 447 non-smokers) where smoking in public places was not regulated at the time. Results: Dramatic declines in the observance of smoking in pubs, restaurants and workplaces were found in Scotland relative to the rest of the UK. The change in the percent of smokers reporting a smokefree home and number of cigarettes smoked inside the home in the evening was comparable in Scotland and the rest of the UK. Support for smokefree policies increased to a greater extent in Scotland than in the rest of the UK. Self-reported frequency of going to pubs and restaurants was generally comparable between Scotland and the rest of the UK; however, non-smokers in Scotland were more likely to frequent pubs more often. No differences in smoking cessation indicators were observed between countries. Conclusion: The Scottish smokefree law has been successful in decreasing secondhand smoke exposure while causing none of the hypothesized negative outcomes. PMID:19151105

Clozapine: an effective treatment for seriously violent and psychopathic men with antisocial personality disorder in a UK high-security hospital.

Science.gov (United States)

Brown, Darcy; Larkin, Fintan; Sengupta, Samrat; Romero-Ureclay, Jose L; Ross, Callum C; Gupta, Nitin; Vinestock, Morris; Das, Mrigendra

2014-10-01

A number of studies have demonstrated the anti-aggressive properties of clozapine in schizophrenia and its positive effect in borderline personality disorder. There is no published literature on the treatment of antisocial personality disorder (ASPD) with clozapine. We present a case series of 7 patients with primary ASPD and high psychopathic traits treated with clozapine, having a significant history of serious violence and currently detained in a UK based high-security hospital. A retrospective review of case notes was carried out to formulate Clinical Global Impression (CGI) scores and record incidents of violence and aggression. Effect on specific symptom domains (cognitive-perceptual, impulsive-behavioural dyscontrol, affective dysregulation) was also noted. Metabolic parameters and serum clozapine levels were also sampled. All 7 patients showed significant improvement on clozapine. It was shown to benefit all symptom domains, especially impulsive behavioral dyscontrol and anger. The number of violent incidents committed by 6 of the 7 patients reduced significantly, and all patients' risk of violence reduced. Clozapine serum levels for 6 of the 7 patients were in the range 150-350 ng/mL. Clozapine is of benefit in reducing the clinical severity of ASPD. It improved all symptom domains, especially impulsive-behavioral dyscontrol and anger, and reduced levels of aggression and violence, especially at lower doses (serum levels <350 ng/m). To our knowledge, this is the first account of clozapine treatment in patients with ASPD and high psychopathy.

The vascular surgery workforce: a survey of consultant vascular surgeons in the UK, 2014.

Science.gov (United States)

Harkin, D W; Beard, J D; Shearman, C P; Wyatt, M G

2015-04-01

The purpose of this study was to describe the demographics, training, and practice characteristics of consultant vascular surgeons across the UK to provide an assessment of current, and inform future prediction of workforce needs. A questionnaire was developed using a modified Delphi process to generate questionnaire items. The questionnaire was emailed to all consultant vascular surgeons (n = 450) in the UK who were members of the Vascular Society of Great Britain & Ireland. 352 consultant vascular surgeons from 95 hospital trusts across the UK completed the survey (78% response rate). The mean age was 50.6 years old, the majority (62%) were mid-career, but 24% were above the age of 55. Currently, 92% are men and only 8% women. 93% work full-time, with 60% working >50 hours, and 21% working >60 hours per week. The average team was 5 to 6 (range 2-10) vascular surgeons, with 23% working in a large team of ≥8. 17% still work in small teams of ≤3. Over 90% of consultant vascular surgeons perform the major index vascular surgery procedures (aneurysm repair, carotid endarterectomy, infra-inguinal bypass, amputation). While 84% perform standard endovascular abdominal aortic aneurysm repair (EVAR), <50% perform more complex endovascular aortic therapy. The majority of vascular surgeons "like their job" (85%) and are "satisfied" (69%) with their job. 34% of consultant vascular surgeons indicated they were "extremely likely" to retire within the next 10 years. This study provides the first detailed analysis of the new specialty of vascular surgery as practiced in the UK. There is a need to plan for a significant expansion in the consultant vascular surgeon workforce in the UK over the next 10 years to maintain the status quo. Copyright © 2014 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Introducing wood pellet fuel to the UK

Energy Technology Data Exchange (ETDEWEB)

Cotton, R A; Giffard, A

2001-07-01

Technical and non-technical issues affecting the introduction of wood pellet-fired heating to the UK were investigated with the aim of helping to establish a wood pellet industry in the UK. The project examined the growth and status of the industry in continental Europe and North America, reviewed relevant UK standards and legislation, identified markets for pellet heating in the UK, organised workshops and seminars to demonstrate pellet burning appliances, carried out a trial pelletisation of a range of biomass fuels, helped to set up demonstration installations of pellet-fired appliances, undertook a promotional campaign for wood pellet fuel and compiled resource directories for pellet fuel and pellet burning appliances in the UK. The work was completed in three phases - review, identification and commercialisation. Project outputs include UK voluntary standards for wood pellet fuel and combustion appliances, and a database of individuals with an interest in wood pellet fuel.

UK experience of planning the nuclear contribution to the UK power programme

International Nuclear Information System (INIS)

Catchpole, S.; Jenkin, F.P.

1977-01-01

The paper outlines U.K. experience in planning nuclear programmes. It examines the factors which have determined the size of such programmes together with those factors which have influenced their implementation. The paper also discusses the role which the utility has played in the deployment of nuclear power in the U.K. At present, nuclear energy can only be utilised on a large scale via the electricity route and the forecasting of electricity demand is therefore a key element in determining the size of the nuclear programme. Other important issues which affect the nuclear contribution are: national fuel policies, discontinuities in price and availability of imported fossil fuels, plant capital costs, fuel price relativities, plant siting, rate of introduction of new nuclear systems, manufacturer's capability, public attitudes towards nuclear power and financing. These issues are dealt with in some detail including their relative importance in the U.K. The paper also discusses the contribution of the various nuclear bodies in the U.K. in securing the implementation of the nuclear programmes. From the inception of nuclear power in the U.K., it has been recognised that a major utility has a central role to play not only in commercial operation but also in the procurement of plant and materials. As explained in the paper this ''informed buyer'' approach, which is being increasingly adopted by other major utilities, calls for an organisation and technical infrastructure far more complex than is the case for fossil plants. The requirements of safety, which is unambiguously the responsibility of the utility, and of high availability of plant operation demand a rigorous approach to design, quality assurance, project management, construction and operation. To this must be added sound research and development and staff training facilities. The paper explains how experience in these vital areas has been built up

IEA PVPS Task 1 - UK Expert. Final report

Energy Technology Data Exchange (ETDEWEB)

Gunning, R.

2003-07-01

The paper relates to work carried out under contract to the UK Renewable Energy Programme, and describes the terms of reference of the UK representation in the IEA PVPS Task 1 which provides a forum for exchange of information on photovoltaic (PV) technology between 21 participating countries. The main benefit derived by the UK is access to international expertise in PV technology. Using information obtained from participation in Task 1, the UK produces a National Survey Report which reports on developments in PV technology in the UK over the previous 12 months. The report covers installed capacity, prices, budgets and costs: it is freely available on the UK PVPS website. The newsletter PV Power, is prepared and distributed biannually - 18 issues have been published by mid-2003. IT Power is currently the UK representative on the IEA PVPS Task 1.

Brachytherapy, diagnostic radiology, mammographic radiology and ophthalmic applicators. An assessment of current and future needs in the UK and the role of NPL

International Nuclear Information System (INIS)

Angliss, R.; Bass, G.; Sander, T.

2001-01-01

Several UK hospitals were visited by NPL staff to discuss the current practises and future developments in brachytherapy, diagnostic and mammographic radiology and ophthalmic applicators. The results of the discussions are presented here, including NPL's role in each of these areas is discussed. (author)

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)

Identification of the benefits, enablers and barriers to integrating junior pharmacists into the ward team within one UK-based hospital

Directory of Open Access Journals (Sweden)

Hung MY

2017-11-01

Full Text Available Man Yui Hung,1 David John Wright,2 Jeanette Blacklock,2 Richard John Needle1,2 1Pharmacy Department, Colchester Hospital University NHS Foundation Trust, Colchester, 2School of Pharmacy, University of East Anglia, Norwich, UK Introduction: A high nurse-vacancy rate combined with high numbers of applications for junior pharmacist roles resulted in Colchester Hospital University National Health System Foundation Trust trial employing junior pharmacists into traditional nursing posts with the aim of integrating pharmacists into the ward team and enhancing local medicines optimization. The aim of the evaluation was to describe the implementation process and practice of the integrated care pharmacists (ICPs in order to inform future innovations of a similar nature.Methods: Four band 6 ward-based ICPs were employed on two wards funded within current ward staffing expenditure. With ethical committee approval, interviews were undertaken with the ICPs and focus groups with ward nurses, senior ward nurses and members of the medical team. Data were analyzed thematically to identify service benefits, barriers and enablers. Routine ward performance data were obtained from the two ICP wards and two wards selected as comparators. Appropriate statistical tests were performed to identify differences in performance.Results: Four ICPs were interviewed, and focus groups were undertaken with three junior nurses, four senior nurses and three medical practitioners. Service enablers were continuous ward time, undertaking drug administration, positive feedback and use of effective communication methods. Barriers were planning, funding model, career development, and interprofessional working and social isolation. ICPs were believed to save nurse time and improve medicines safety. The proportion of patients receiving medicine reconciliation within 24 hours increased significantly in the ICP wards. All ICPs had resigned from their role within 12 months.Discussion: It was

Assessment of the Penta-XT radiography table at Mansfield General Hospital

International Nuclear Information System (INIS)

1984-07-01

A DHSS assessment report, prepared by Mansfield General Hospital, is presented for a Penta-XT radiographic table. The table has a fully floating table top with longitudinal and lateral movement and a variable height which has proved to be very acceptable to both staff and patients utilising the equipment. Details of operational experience and reliability are given. (U.K.)

CPR and the RCP (1). Training of doctors in NHS hospitals.

Science.gov (United States)

Wheatly, S; Redmond, A D

1993-10-01

Six years after the Royal College of Physicians published its report, most hospitals in the UK with acute coronary beds fail to train or test their doctors adequately in the skills of cardiopulmonary resuscitation. Doctors want more training, and consultants try to give it, but there is a lack of funds for this basic yet critical task.

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

Science.gov (United States)

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

2014-01-01

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

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

Science.gov (United States)

Fung, Fai; Lowe, Jason

2016-04-01

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

Nuclear power and the UK

International Nuclear Information System (INIS)

Murphy, St.

2009-01-01

This series of slides describes the policy of the UK government concerning nuclear power. In January 2008 the UK Government published the White Paper on the Future of Nuclear Power. The White Paper concluded that new nuclear power stations should have a role to play in this country's future energy mix. The role of the Government is neither to build nuclear power plants nor to finance them. The White Paper set out the facilitative actions the Government planned to take to reduce regulatory and planning risks associated with investing in new nuclear power stations. The White Paper followed a lengthy period of consultation where the UK Government sought a wide variety of views from stakeholders and the public across the country on the future of nuclear power. In total energy companies will need to invest in around 30-35 GW of new electricity generating capacity over the next two decades. This is equivalent to about one-third of our existing capacity. The first plants are expected to enter into service by 2018 or sooner. The Office for Nuclear Development (OND) has been created to facilitate new nuclear investment in the UK while the Nuclear Development Forum (NDF) has been established to lock in momentum to secure the long-term future of nuclear power generation in the UK. (A.C.)

Ecological assessment of the direct and indirect effects of routine rotavirus vaccination in Merseyside, UK using data from multiple health systems: a study protocol.

Science.gov (United States)

Hungerford, Daniel; Vivancos, Roberto; French, Neil; Iturriza-Gomara, Miren; Cunliffe, Nigel

2014-11-25

Rotavirus is the most common cause of severe gastroenteritis in infants and young children worldwide. Currently 67 countries include rotavirus vaccine in childhood immunisation programmes, but uptake in Western Europe has been slow. In July 2013, rotavirus vaccine was introduced into the UK's routine childhood immunisation programme. Prior to vaccine introduction in the UK, rotavirus was estimated to result in 750,000 diarrhoea episodes and 80,000 general practice (GP) consultations each year, together with 45% and 20% of hospital admissions and emergency department attendances for acute gastroenteritis, in children under 5 years of age. This paper describes a protocol for an ecological study that will assess rotavirus vaccine impact in the UK, to inform rotavirus immunisation policy in the UK and in other Western European countries. In Merseyside, UK, we will conduct an ecological study using a 'before and after' approach to examine changes in gastroenteritis and rotavirus incidence following the introduction of rotavirus vaccination. Data will be collected on mortality, hospital admissions, nosocomial infection, emergency department attendances, GP consultations and community health consultations to capture all healthcare providers in the region. We will assess both the direct and indirect effects of the vaccine on the study population. Comparisons of outcome indicator rates will be made in relation to vaccine uptake and socioeconomic status. The study has been approved by NHS Research Ethics Committee, South Central-Berkshire REC Reference: 14/SC/1140. Study outputs will be disseminated through scientific conferences and peer-reviewed publications. The study will demonstrate the impact of rotavirus vaccination on the burden of disease from a complete health system perspective. It will identify key areas that require improved data collection tools to maximise the usefulness of this surveillance approach and will provide a template for vaccine evaluations using

Support needs and experiences of family members of wounded, injured or sick UK service personnel.

Science.gov (United States)

Verey, Anna; Keeling, M; Thandi, G; Stevelink, S; Fear, N

2017-12-01

When a service person has been wounded, injured or sick (WIS), family members may provide care during their recovery in an unpaid capacity. This may occur in diverse environments including hospitals, inpatient rehabilitation centres, in the community and at home. Thirty-seven family members of WIS personnel were interviewed regarding their support needs, family relationships and use of UK support services. Semistructured, in-depth telephone interviews were used, with data analysis undertaken using a thematic approach. 'Family member involvement' was the main theme under which four subthemes were situated: 'continuity of support', 'proactive signposting and initiating contact', 'psychoeducation and counselling' and 'higher risk groups'. Family members felt they might benefit from direct, consistent and continuous care regardless of the WIS person's injury or engagement type, and whether the WIS person was being treated in a hospital, rehabilitative centre or at home. The findings of this study suggest that family members of WIS personnel value proactive, direct and sustained communication from support service providers. We suggest that families of UK service personnel may benefit from family care coordinators, who could provide continuous and consistent care to family members of WIS personnel. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The relationship between UK hospital nurse staffing and emotional exhaustion and job dissatisfaction.

Science.gov (United States)

Sheward, Louisa; Hunt, Jennifer; Hagen, Suzanne; Macleod, Margaret; Ball, Jane

2005-01-01

To explore the relationship between nurse outcomes (dissatisfaction and emotional exhaustion) and nurse workload, nurse characteristics and hospital variables. Concern about the impact of restructuring of nurse staffing, and reports of nurse shortages, on nurse and patient outcomes led to the research being reported on in this article. A questionnaire survey of registered nurses in Scotland and England. A questionnaire survey of the hospitals in which these nurses worked. Respondents in the two countries were similar in terms of demographic, work and employment characteristics. Significant relationships were found using the combined English and Scottish data between nurse patient ratios and (1) emotional exhaustion and (2) dissatisfaction with current job reported by nurses. Increasing numbers of patients to nurses was associated with increasing risk of emotional exhaustion and dissatisfaction with current job.

Improving post-hospital medication management in a Danish municipality

DEFF Research Database (Denmark)

Kollerup, Mette Geil; Curtis, Tine; Schantz Laursen, Birgitte

2018-01-01

implementation rate, which involved 31 out of the 38 patients in the target group. CONCLUSION: For patients with complex care needs, post-hospital medication management may be improved by a reconsideration of the activity-based funding of home healthcare, a recognition of the importance of organising work......AIMS AND OBJECTIVES: This study evaluates an intervention developed to improve patient safety in post-hospital medication management carried out by visiting nurses working in a municipality in Denmark. The intervention consisted of three elements: an initial inter-disciplinary home visit by nurses...... management is identified as the most challenging component of a discharge from the hospital to the home, in which discrepancies have been found in up to 94% of medication lists. DESIGN: A process evaluation inspired by the UK Medical Research Council's guidance. METHODS: The process evaluation was conducted...

Sustainability in the UK construction minerals industry

OpenAIRE

Mitchell, Clive

2015-01-01

Sustainability in the UK construction minerals industry Clive Mitchell, Industrial Minerals Specialist, British Geological Survey, Nottingham, UK Email: Sustainability is not just about environmental protection it also concerns biodiversity, community relations, competence, employment, geodiversity, health and safety, resource efficiency, restoration and stakeholder accountability. The UK construction minerals industry aims to supply essential materials in a sustainabl...

The future of UK gas producers

International Nuclear Information System (INIS)

Hallas, P.A.

1991-01-01

Traditionally, an oil company wishing to develop UK gas reserves almost always faced a protracted gas sales negotiation with British Gas. British Gas then had an effective monopoly in the resale of that gas to final consumers. This traditional pattern is now in a process of fundamental change, as a result of recent UK gas market re-regulation and the emergence of a new large scale opportunity to sell gas for power generation. The impact of these changes is still not very well understood outside a relatively small group of gas specialists but is likely to be significant for British Gas, consumers and UK gas producers. This paper outlines the background to the recent changes, the possible future of UK gas marketing and the likely impact on gas producers in the North Sea

UK manufacturers construction joint venture

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-07-01

This report examines the legal and commercial framework for UK manufacturers to collaborate in a construction venture for a small combustion/steam cycle power plant fueled with biomass. The integration of technology and project plan, the working capital and capitalisation, financial aspects, the market plan, turnkey packages, joint venture entities, and collaboration are discussed. (UK)

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.

Career Choices and Career Progression of Junior Doctors in Dermatology: Surveys of UK Medical Graduates.

Science.gov (United States)

Barat, Atena; Goldacre, Michael J; Lambert, Trevor W

2018-01-01

To report UK-trained doctors' career choices for dermatology, career destinations, and factors influencing career pathways. Multicohort multipurpose longitudinal surveys of UK-trained doctors who graduated between 1974 and 2015. In all, 40,412 doctors (58% of graduates) responded in year 1, 31,466 (64%) in year 3, and 24,970 (67%) in year 5. One year after graduation, 1.7% of women and 0.6% of men made dermatology their first choice but by five years after graduation the respective figures were 1.0% and 0.7%. Compared to their predecessors, its popularity fell more substantially from years 1 to 5 among recent graduates (2005-15), particularly for women (from 2.1% in year 1 to 0.8% in year 5) compared with a fall from 0.8% to 0.5% among men. The most important factor influencing dermatology choice was "hours/working conditions": in year one, 69% regarded this as important compared with 31% of those choosing other hospital physician specialties. Only 18% of respondents who chose dermatology at year 1 eventually worked in it; however, almost all practising dermatologists (94%), 10 years after qualifying, had made their future career decision by year 5. Dermatology is popular among female UK graduates. Most dermatologists made their career decision late but decisively.

Implications of sustainability constraints on UK bioenergy development: Assessing optimistic and precautionary approaches with UK MARKAL

International Nuclear Information System (INIS)

McDowall, Will; Anandarajah, Gabrial; Dodds, Paul E.; Tomei, Julia

2012-01-01

Bioenergy is an important renewable energy resource. However, assessments of the future of bioenergy are beset with uncertainty and contested values, suggesting that a precautionary approach to bioenergy resource development may be warranted. This paper uses UK MARKAL to examine the implications of adopting a precautionary approach to bioenergy development in the UK. The paper reports a detailed review of UK bioenergy resources and sustainability constraints, and develops precautionary and optimistic resource scenarios. The paper then examines the implications of these scenarios using the energy systems model MARKAL, finding that a precautionary approach adds to the cost of decarbonisation, but does not significantly alter the optimal technology mix. In particular, biomass and co-firing CCS emerge as optimal technologies across scenarios. The question of UK land availability for bioenergy production is highlighted within the paper. With less land available for bioenergy production, the costs of decarbonisation will rise; whereas if more land is available for bioenergy, then less land is available for either food production or ecosystem conservation. This paper quantifies one side of this trade-off, by estimating the additional costs incurred when UK land availability for bioenergy production is constrained. - Highlights: ► We assess UK bioenergy resources under optimistic and precautionary approaches. ► Using MARKAL, we find that sustainability constraints add to decarbonisation costs. ► Preferred use of bioenergy is similar in optimistic and precautionary cases. ► Best use of bioenergy is heat and power, not transport, if CCS is available. ► The marginal value of additional land availability to the energy system is high.

Organs and organisations: Situating ethics in organ donation after circulatory death in the UK.

Science.gov (United States)

Cooper, Jessie

2018-05-25

Controlled organ donation after circulatory death (DCD) has recently been revived in the UK, as part of attempts to increase organ donation rates. The re-introduction of DCD has subsequently become the focus of bioethical controversy, since it necessitates intervening in the care of dying patients to obtain quality donor organs. Transplant policy responses to these concerns have generated new legal and ethical guidelines to address uncertainties around DCD, producing claims that the UK has overcome' the ethical challenge of DCD. In contrast, by drawing on Lynch's call to 'respecify' ethics, this paper argues that ethics in DCD cannot be reduced to abstract directives for practice, but, instead, are composed and dealt with as an organisational problem. To do this, I utilise data from an ethnographic study examining the production of the 'minority ethnic organ donor' within UK organ donation settings; in particular, the data pertains to a case hospital which was in the process of developing a DCD programme during the period of fieldwork. Findings show that the ethics of DCD are encountered as practical sets of problems, constructed in relation to particular institutional locales. I describe how these issues are worked-around by creating conditions to make DCD organisationally possible, and through the animation of standard procedures into acceptable forms of practice. I argue that ethics in DCD go far beyond normative bioethical principles, to encompass concerns around: the reputation of hospital Trusts, public perceptions of organ donation, the welfare of potential donor families, and challenges to the work of health professionals caring for dying patients. The paper enriches understanding of ethics in science and medicine by showing how ethics are assembled and negotiated as a practical-organisational concern, and calls for further examination of how DCD gets constructed as a potential problem and is made to happen in practice. Crown Copyright © 2018. Published by

Indoor air quality: a UK perspective

International Nuclear Information System (INIS)

Wadge, A.

1995-01-01

Outdoor air quality has generally improved in the UK over the last 2 decades but during this period changing conditions within the home have tended to reduce ventilation and increase the opportunity for accumulation of undesirable levels of indoor air pollutants. Information obtained from laboratory and epidemiological studies suggest that indoor air pollutants are an important cause of avoidable morbidity and mortality in the UK. This paper reviews the major indoor air pollutants of concern in the UK and considers some of the special issues relevant to indoor environment. (author) 3 figs., 37 refs

Prospects for UK fuel cells component suppliers

Energy Technology Data Exchange (ETDEWEB)

Wilcox, C.; Tunnicliffe, M.

2002-07-01

This report examines the capabilities of the UK fuel cell industry in meeting the expected increase in demand, and aims to identify all UK suppliers of fuel cell components, evaluate their products and match them to fuel cell markets, and identify components where the UK is in a competitive position. Component areas are addressed along with the need to reduce costs and ensure efficient production. The well established supplier base in the UK is noted, and the car engine manufacturing base and fuel supply companies are considered. The different strengths of UK suppliers of the various types of fuel cells are listed. The future industry structure, the opportunities and dangers for business posed by fuel cells, the investment in cleaner technologies by the large fuel companies, opportunities for catalyst suppliers, and the residential combined heat and power and portable electronics battery markets are discussed.

New Ross Community Hospital, Hospital Road, New Ross, Wexford.

LENUS (Irish Health Repository)

El-Khuffash, A

2011-03-01

Extracorporeal membrane oxygenation (ECMO) is a complex technique for providing life support in neonatal respiratory failure. T UK Collaborative ECMO trial demonstrated cost-effectiveness and substantial improvements in neurological morbidity and mortality. Currently, infants requiring ECMO in Ireland are referred to one of various centres in the UK and Scandinavia. We aimed to review the number of infants referred from Ireland for respiratory ECMO. All infants with a non-cardiac condition referred from Ireland for ECMO were reviewed for diagnosis and outcomes. Eleven infants required ECMO between June 2006 and January 2009 and were referred to the Scandinavian team for ECMO transport although one infant improved and did not require ECMO following the arrival of the team. Four infants died: one infant died prior to arrival of the ECMO team, 3 infants had fatal diagnoses and one infant with congenital diaphragmatic hernia received pre-op ECMO. The median (inter-quartile range) gestational age was 39.7 (38.3-40.7) weeks and birth weight of 3.7 (3.2-4.0) kg. The median age at the decision to transfer for ECMO was 13h (4-123) and the team arrived at 23 h (12-132). All infants had a normal cranial ultrasound and echo prior to ECMO and 2 infants had an abnormal MRI post-ECMO. The time on ECMO was 9 days (3-17) and total length of hospital stay was 32 d (23-36). There were no pre-ECMO clinical or biochemical

The mental health of the UK Armed Forces: where facts meet fiction

Science.gov (United States)

Hunt, Elizabeth J. F.; Wessely, Simon; Jones, Norman; Rona, Roberto J.; Greenberg, Neil

2014-01-01

A substantial amount of research has been conducted into the mental health of the UK military in recent years. This article summarises the results of the various studies and offers possible explanations for differences in findings between the UK and other allied nations. Post-traumatic stress disorder (PTSD) rates are perhaps surprisingly low amongst British forces, with prevalence rates of around 4% in personnel who have deployed, rising to 6% in combat troops, despite the high tempo of operations in recent years. The rates in personnel currently on operations are consistently lower than these. Explanations for the lower PTSD prevalence in British troops include variations in combat exposures, demographic differences, higher leader to enlisted soldier ratios, shorter operational tour lengths and differences in access to long-term health care between countries. Delayed-onset PTSD was recently found to be more common than previously supposed, accounting for nearly half of all PTSD cases; however, many of these had sub-syndromal PTSD predating the onset of the full disorder. Rates of common mental health disorders in UK troops are similar or higher to those of the general population, and overall operational deployments are not associated with an increase in mental health problems in UK regular forces. However, there does appear to be a correlation between both deployment and increased alcohol misuse and post-deployment violence in combat troops. Unlike for regular forces, there is an overall association between deployment and mental health problems in Reservists. There have been growing concerns regarding mild traumatic brain injury, though this appears to be low in British troops with an overall prevalence of 4.4% in comparison with 15% in the US military. The current strategies for detection and treatment of mental health problems in British forces are also described. The stance of the UK military is that psychological welfare of troops is primarily a chain of

The mental health of the UK Armed Forces: where facts meet fiction

Directory of Open Access Journals (Sweden)

Elizabeth J. F. Hunt

2014-08-01

Full Text Available A substantial amount of research has been conducted into the mental health of the UK military in recent years. This article summarises the results of the various studies and offers possible explanations for differences in findings between the UK and other allied nations. Post-traumatic stress disorder (PTSD rates are perhaps surprisingly low amongst British forces, with prevalence rates of around 4% in personnel who have deployed, rising to 6% in combat troops, despite the high tempo of operations in recent years. The rates in personnel currently on operations are consistently lower than these. Explanations for the lower PTSD prevalence in British troops include variations in combat exposures, demographic differences, higher leader to enlisted soldier ratios, shorter operational tour lengths and differences in access to long-term health care between countries. Delayed-onset PTSD was recently found to be more common than previously supposed, accounting for nearly half of all PTSD cases; however, many of these had sub-syndromal PTSD predating the onset of the full disorder. Rates of common mental health disorders in UK troops are similar or higher to those of the general population, and overall operational deployments are not associated with an increase in mental health problems in UK regular forces. However, there does appear to be a correlation between both deployment and increased alcohol misuse and post-deployment violence in combat troops. Unlike for regular forces, there is an overall association between deployment and mental health problems in Reservists. There have been growing concerns regarding mild traumatic brain injury, though this appears to be low in British troops with an overall prevalence of 4.4% in comparison with 15% in the US military. The current strategies for detection and treatment of mental health problems in British forces are also described. The stance of the UK military is that psychological welfare of troops is

Selected Abstracts of the 3rd Edition of Transport of High Risk Infants; Oxford (UK); August 31st-September 2nd, 2017

OpenAIRE

--- Various Authors

2017-01-01

Selected Abstracts of the 3rd Edition of Transport of High Risk Infants; Oxford (UK); August 31st-September 2nd, 2017ABS 1. MORTALITY RATE IN 23-30 WEEKS PRE­MATURE BORN IN LEVEL 2 HOSPITAL IN COMPARISON TO THOSE BORN IN TERTIARY-CARE HOSPITAL • J.P. Doray, J.L. DorayABS 2. THE QUEBEC AEROMEDICAL EXPERIENCE: EVACUATION OF NEONATES FROM AREAS IN EXTREME WEATHER CONDITIONS – IN­NOVATIONS IN SAFETY AND EFFICIENCY • É. Notebaert, J. Provencher, R. Bernier, S. Côté, S. KindABS 3. NASAL HIGH FLOW S...

The economic cost of stroke-associated pneumonia in a UK setting.

Science.gov (United States)

Ali, A N; Howe, J; Majid, A; Redgrave, J; Pownall, S; Abdelhafiz, A H

2018-04-01

Introduction Stroke-associated pneumonia (SAP) is common, however, data on the economic impact of SAP are scarce. This study aimed to prospectively evaluate the impact of SAP on acute stroke care costs in a UK setting. Methods Prospective cohort study of 213 consecutive patients with stroke (196 ischemic, 17 hemorrhagic) was admitted to a UK hospital over 1 year. Socio demographic and clinical characteristics were recorded along with all treatments and rehabilitation activity. Patients were classified as having SAP if they fulfilled criteria for "probable" or "definite" respiratory tract infection according to the Centres for Disease Control and Prevention definition, within the first seven days following stroke. Resource use was calculated using a "bottom up" approach of cumulative unit costs. Univariate and multivariate regression analyses were used to establish independent predictors of direct costs. Results Probable or definite SAP occurred in 13.2% (28/213) of patients. Patients with SAP experienced greater inpatient stays (31 days vs. 9 days, p ≤ 0.001) and higher in-hospital mortality (29.2% vs. 10.2%, p = 0.007). Mean (SD) acute care costs per patient was £7035 (6767), but costs were significantly greater for patients with SAP than without [£14,371 (9484) versus £6,103 (5,735); p ≤ 0.001]. SAP was an independent predictor of costs along with increasing stroke severity (NIHSS) and age. Occurrence of SAP resulted in an adjusted incremental additional cost of £5817 (95% CI 4945-6689; p = 0.001) per patient. Conclusions SAP increased acute care costs for stroke by approximately 80%. This provides further impetus for research aimed at reducing SAP, and will inform cost-effectiveness analyses of potential therapeutic strategies.

Mapping heat wave risk in the UK: Proactive planning for the 2050s

Science.gov (United States)

Oven, Katie; Reaney, Sim; Ohlemüller, Ralf; Nodwell, Sarah; Curtis, Sarah; Riva, Mylène; Dunn, Christine; Val, Dimitri; Burkhard, Roland

2010-05-01

Climate change projections suggest an increased frequency of heat waves in the UK over the coming decades. Such extreme events pose a serious threat to human health and are likely to impact upon health and social care systems and the infrastructures supporting them. This stress will result from both increased demands upon healthcare services and the ability of the infrastructure to cope, such as sufficient climate control in hospitals. Certain sectors of the population, such as older people, have an increased susceptibility to heat waves and hence are the focus of this research. There is no universal definition of a heat wave, reflecting the acclimatisation of a population. Based on a review of the literature, this research therefore sets out a series of working definitions of a heat wave in the UK context from a human health perspective. Drawing on these definitions, the UK heat wave hazard was mapped for the 2050s (2040-2069) using daily minimum and maximum temperature data derived from the UKCP09 Weather Generator at 50 km resolution. The analysis was undertaken for the three different greenhouse gas emissions scenarios within UKCP09 (low, medium and high). Hot spots of increased heat wave risk were identified and comparisons made between the various model outputs. These data were then combined with demographic forecasts for the 2050s enabling the identification of areas with an ageing population. Results are presented showing the scale of the projected change in heat wave risk across the UK and the location of older people. These results will be used in proactive planning to help policymakers and practitioners respond more appropriately to the needs of vulnerable populations in the coming decades. Key words: climate change; heat wave; risk mapping; vulnerability; risk reduction.

The Unfair Commercial Practices Directive in the UK

NARCIS (Netherlands)

M. Koutsias (Marios); C. Willett (Chris)

2013-01-01

markdownabstract__Abstract__ This article shows that the UK has blended preventive and traditional UK criminal enforcement techniques to implement the UCPD; these techniques have been 'Europeanised' by the UCPD unfairness concepts; and the UCPD may also cause UK private law to be Europeanised in

A postal survey of quality assurance in nuclear medicine imaging in the UK during 1988

International Nuclear Information System (INIS)

Williams, E.D.; Harding, L.K.; McKillop, J.H.

1989-01-01

A questionnaire was sent to all the estimated 200 hospital departments providing nuclear medicine imaging services in the UK. Replies were received from 162 (81%). The questionnaire was brief, but covered a wide range of aspects of a nuclear medicine service. While all responses showed departments to have some quality control procedures in operation, they were often not used correctly. In most departments there appears to be scope for improvement so that departmental managers can monitor more closely the quality of service provided. (author)

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.

Statement about UK referendum on the EU

CERN Multimedia

2016-01-01

Dear Colleagues, Many people have expressed their concerns about the consequences of the 23 June vote in the UK for CERN, and for the UK’s relationship with CERN. CERN is an intergovernmental organisation subject to its own treaty. We are not part of the European Union, and several of our Member States, including Switzerland, in which we are headquartered, are not EU Members. Britain’s membership of CERN is not affected by the UK electorate’s vote to leave the European Union. We look forward to continuing the very constructive relationship we have shared with the UK, one of our founding members, long into the future. CERN was founded on the principle of international collaboration, and our success over the years is built on that. We will continue to work proactively to encourage ever-greater international collaboration in particle physics, and to help ensure that the UK continues to play a very active role. UK nationals remain eligible for all categories of employment at CERN, a...

UK nuclear terrorism insurance arrangements: an overview

International Nuclear Information System (INIS)

Tetley, M. G.

2004-01-01

The risk of terrorism in the UK is not new, but since the New York World Trade Centre attacks in 2001, the potential scale of any terrorist attack has required a considerable reassessment. With UK foreign policy closely aligned to that of the USA, the UK security services now consider it is simply a matter of when and no longer if the UK is attacked. For insurers of any type this fact would cause concern; for insurers involved in high profile and potentially catastrophic loss targets such as nuclear power plants, any attack could have a severe impact on solvency and shareholder's funds. This paper's objective is to describe the terrorism insurance arrangements put in place in the U.K. both before and after the September 2001 attacks. These arrangements have been designed both to safeguard insurers' solvency and to ensure that the nuclear industry and general public can continue to be reassured by the availability of insurance should an attack ever occur.(author)

The future of the UK gas network

International Nuclear Information System (INIS)

Dodds, Paul E.; McDowall, Will

2013-01-01

The UK has an extensive natural gas pipeline network supplying 84% of homes. Previous studies of decarbonisation pathways using the UK MARKAL energy system model have concluded that the low-pressure gas networks should be mostly abandoned by 2050, yet most of the iron pipes near buildings are currently being replaced early for safety reasons. Our study suggests that this programme will not lock-in the use of gas in the long-term. We examine potential future uses of the gas network in the UK energy system using an improved version of UK MARKAL that introduces a number of decarbonisation options for the gas network including bio-methane, hydrogen injection to the natural gas and conversion of the network to deliver hydrogen. We conclude that hydrogen conversion is the only gas decarbonisation option that might enable the gas networks to continue supplying energy to most buildings in the long-term, from a cost-optimal perspective. There is an opportunity for the government to adopt a long-term strategy for the gas distribution networks that either curtails the iron mains replacement programme or alters it to prepare the network for hydrogen conversion; both options could substantially reduce the long-term cost of supplying heat to UK buildings. - Highlights: • We examine the long-term future of the UK gas pipe networks using the UK MARKAL model. • The iron mains replacement programme will not lead to gas infrastructure lock-in. • Bio-methane and hydrogen injection have only a small role in our future scenarios. • The most cost-optimal strategy might be to convert the networks to deliver hydrogen. • Adopting a long-term gas strategy could reduce the cost of providing heat in the UK

Cost-effectiveness of an aprepitant regimen for prevention of chemotherapy-induced nausea and vomiting in patients with breast cancer in the UK

Directory of Open Access Journals (Sweden)

Humphreys S

2013-08-01

Full Text Available Samantha Humphreys,1 James Pellissier,2 Alison Jones3 1Market Access Department, Merck Sharp and Dohme Ltd, Hoddesdon, Hertfordshire, UK; 2Health Economic Statistics, Merck Research Laboratories, Upper Gwynedd, PA, USA; 3Department of Medical Oncology, University College Hospital, London, UK Purpose: Prevention of chemotherapy-induced nausea and vomiting (CINV remains an important goal for patients receiving chemotherapy. The objective of this study was to define, from the UK payer perspective, the cost-effectiveness of an antiemetic regimen using aprepitant, a selective neurokinin-1 receptor antagonist, for patients receiving chemotherapy for breast cancer. Methods: A decision-analytic model was developed to compare an aprepitant regimen (aprepitant, ondansetron, and dexamethasone with a standard UK antiemetic regimen (ondansetron, dexamethasone, and metoclopramide for expected costs and health outcomes after single-day adjuvant chemotherapy for breast cancer. The model was populated with results from patients with breast cancer participating in a randomized trial of CINV preventative therapy for cycle 1 of single-day chemotherapy. Results: During 5 days after chemotherapy, 64% of patients receiving the aprepitant regimen and 47% of those receiving the UK comparator regimen had a complete response to antiemetic therapy (no emesis and no rescue antiemetic therapy. A mean of £37.11 (78% of the cost of aprepitant was offset by reduced health care resource utilization costs. The predicted gain in quality-adjusted lifeyears (QALYs with the aprepitant regimen was 0.0048. The incremental cost effectiveness ratio (ICER with aprepitant, relative to the UK comparator, was £10,847/QALY, which is well below the threshold commonly accepted in the UK of £20,000–£30,000/QALY. Conclusion: The results of this study suggest that aprepitant is cost-effective for preventing CINV associated with chemotherapy for patients with breast cancer in the UK health

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.

Computer modelling of the UK wind energy resource: UK wind speed data package and user manual

Energy Technology Data Exchange (ETDEWEB)

Burch, S F; Ravenscroft, F

1993-12-31

A software package has been developed for IBM-PC or true compatibles. It is designed to provide easy access to the results of a programme of work to estimate the UK wind energy resource. Mean wind speed maps and quantitative resource estimates were obtained using the NOABL mesoscale (1 km resolution) numerical model for the prediction of wind flow over complex terrain. NOABL was used in conjunction with digitised terrain data and wind data from surface meteorological stations for a ten year period (1975-1984) to provide digital UK maps of mean wind speed at 10m, 25m and 45m above ground level. Also included in the derivation of these maps was the use of the Engineering Science Data Unit (ESDU) method to model the effect on wind speed of the abrupt change in surface roughness that occurs at the coast. With the wind speed software package, the user is able to obtain a display of the modelled wind speed at 10m, 25m and 45m above ground level for any location in the UK. The required co-ordinates are simply supplied by the user, and the package displays the selected wind speed. This user manual summarises the methodology used in the generation of these UK maps and shows computer generated plots of the 25m wind speeds in 200 x 200 km regions covering the whole UK. The uncertainties inherent in the derivation of these maps are also described, and notes given on their practical usage. The present study indicated that 23% of the UK land area had speeds over 6 m/s, with many hill sites having 10m speeds over 10 m/s. It is concluded that these `first order` resource estimates represent a substantial improvement over the presently available `zero order` estimates. (18 figures, 3 tables, 6 references). (author)

Research reactor fuel transport in the U.K

Energy Technology Data Exchange (ETDEWEB)

Panter, R [U.K. Atomic Energy Authority, Harwell (United Kingdom)

1983-09-01

This paper describes the containers currently used for transport of fresh or spent fuel elements for Research and Materials Test Reactors in the U.K., their status, operating procedures and some of the practical difficulties. In the U.K., MTR fuel cycle work is almost entirely the responsibility of the U.K. Atomic Energy Authority.

Prehospital critical care for out-of-hospital cardiac arrest: An observational study examining survival and a stakeholder-focused cost analysis.

Science.gov (United States)

von Vopelius-Feldt, Johannes; Powell, Jane; Morris, Richard; Benger, Jonathan

2016-12-07

Survival rates from out-of-hospital cardiac arrest (OHCA) remain low, despite remarkable efforts to improve care. A number of ambulance services in the United Kingdom (UK) have developed prehospital critical care teams (CCTs) which attend critically ill patients, including OHCA. However, current scientific evidence describing CCTs attending OHCA is sparse and research to date has not demonstrated clear benefits from this model of care. This prospective, observational study will describe the effect of CCTs on survival from OHCA, when compared to advanced-life-support (ALS), the current standard of prehospital care in the UK. In addition, we will describe the association between individual critical care interventions and survival, and also the costs of CCTs for OHCA. To examine the effect of CCTs on survival from OHCA, we will use routine Utstein variables data already collected in a number of UK ambulance trusts. We will use propensity score matching to adjust for imbalances between the CCT and ALS groups. The primary outcome will be survival to hospital discharge, with the secondary outcome of survival to hospital admission. We will record the critical care interventions delivered during CCT attendance at OHCA. We will describe frequencies and aim to use multiple logistic regression to examine possible associations with survival. Finally, we will undertake a stakeholder-focused cost analysis of CCTs for OHCA. This will utilise a previously published Emergency Medical Services (EMS) cost analysis toolkit and will take into account the costs incurred from use of a helicopter and the proportion of these costs currently covered by charities in the UK. Prehospital critical care for OHCA is not universally available in many EMS. In the UK, it is variable and largely funded through public donations to charities. If this study demonstrates benefit from CCTs at an acceptable cost to the public or EMS commissioners, it will provide a rationale to increase funding and service

Nuclear prospects in the UK

International Nuclear Information System (INIS)

Hawley, Robert

1993-01-01

During the late 1980s and early 1990s the UK government decided to privatise the UK electricity supply industry. In order to introduce competition into the generation side of the business it was decided that the large generating boards - the Central Electricity Generating Board (CEGB) and in Scotland, the South of Scotland Electricity Board and North of Scotland Hydro Board, - should be split up into smaller companies. In England and Wales two companies were proposed. The larger company National Power would include the nuclear generating business in England and Wales, the smaller company, Power Gen would use fossil generation only. Scotland was also to have two companies, Scottish Power - including Scotland's nuclear stations - and Scottish Hydro. But these were troubled times for the UK nuclear industry. A lot of misinformation was being issued by its opponents, in particular about decommissioning and fuel reprocessing costs. Looking back I can see there were reasons for that. Both National Power and Scottish Power wanted to be absolutely certain that they got the best possible deal and that every imaginable, and unimaginable, cost that may ever arise would be taken care of. This attitude resulted in the estimate of huge liabilities and 'unprecedented guarantees' that the then Secretary of State for Energy in the UK, could not accept

The use of irradiated food for immuno-suppressed hospital patients

International Nuclear Information System (INIS)

Pryke, D.C.

1994-01-01

The treatment of leukaemia and other forms of haematological malignancies involves destruction of the bone marrow followed by bone-marrow transplant. This results in patients becoming severely immuno-suppressed. Other diseases result in a similar condition, most notably Acquired Immuno-Deficiency Syndrome (AIDS). Irradiation using radioactive sources or machines has been proposed as a method for preparing foods for immuno-suppressed patients and other high risk groups. Doses of around 30 kGy ensure a total sterility whilst a dose of 10 kGy (the recommended maximum for food available to the general public) results in a significant reduction in the number of pathogenic microorganisms. Irradiation has a number of advantages over other processing methods, in particular that flavour, texture and nutritional changes are limited. This is important as patients are often in a compromised state and need clinical assistance in returning to normal eating habits. In recognition of the potential of irradiated foods for hospital patients this use has been specifically exempted from regulatory control in the UK. This paper reviews the experience in the UK of irradiation-sterilized foods in hospitals. It was found that for practical reasons use is currently restricted. The future prospects for food irradiated at non-sterilized doses are also considered. It is concluded that as well as providing greater choice for consumers (high risk and the general public as a whole) irradiated foods could extend and improved the diets of immuno-suppressed hospital patients; this could be an important factor in recovery. (author)

UK creates new funding super-body

Science.gov (United States)

2017-06-01

The UK government has passed its higher-education and research bill, which includes the creation of UK Research and Innovation (UKRI) - a new umbrella organization that will oversee the country’s seven research councils such as the Science and Technology Facilities Council and the Engineering and Physical Sciences Research Council.

Career Choices and Career Progression of Junior Doctors in Dermatology: Surveys of UK Medical Graduates

Directory of Open Access Journals (Sweden)

Atena Barat

2018-01-01

Full Text Available Objective. To report UK-trained doctors’ career choices for dermatology, career destinations, and factors influencing career pathways. Methods. Multicohort multipurpose longitudinal surveys of UK-trained doctors who graduated between 1974 and 2015. Results. In all, 40,412 doctors (58% of graduates responded in year 1, 31,466 (64% in year 3, and 24,970 (67% in year 5. One year after graduation, 1.7% of women and 0.6% of men made dermatology their first choice but by five years after graduation the respective figures were 1.0% and 0.7%. Compared to their predecessors, its popularity fell more substantially from years 1 to 5 among recent graduates (2005–15, particularly for women (from 2.1% in year 1 to 0.8% in year 5 compared with a fall from 0.8% to 0.5% among men. The most important factor influencing dermatology choice was “hours/working conditions”: in year one, 69% regarded this as important compared with 31% of those choosing other hospital physician specialties. Only 18% of respondents who chose dermatology at year 1 eventually worked in it; however, almost all practising dermatologists (94%, 10 years after qualifying, had made their future career decision by year 5. Conclusion. Dermatology is popular among female UK graduates. Most dermatologists made their career decision late but decisively.

UK nuclear installations

International Nuclear Information System (INIS)

Gronow, W.S.

Regulations and conditions for the commissioning of nuclear power plants in the UK, their siting, licence conditions, design safety assessment, inspection during construction and conditions for safety in operation are listed. (J.P.)

UK Chemical Nuclear Data Committee request list - 1990

International Nuclear Information System (INIS)

Nichols, A.L.

1990-03-01

The 1986 UK request list for chemical nuclear data has been reviewed in detail by members of the UK Chemical Nuclear Data Committee. New requirements for data measurements and evaluations have been identified, and specific requests have been withdrawn. A new UK request list has evolved, and is given in the form of tabulations covering measurements and evaluations. (author)

Strategy for energy policy in the UK

International Nuclear Information System (INIS)

Stone, T.

2012-01-01

UK Energy Policy is leading the world in showing how governments can effectively respond to the now widely accepted challenges of security of supply, low-carbon generation and pragmatic implementation. Confidence in the UK as place to invest in new nuclear is very high-there are already 3 developers who have between them already invested over 1 billion, 5 sites are planned to be developed and between 10 and 12 new reactors are planned to be built. To be clear, this is by far the largest commitment to new nuclear in the Western World and swamps in other countries. This achievement is a combination of vision, continuity, political consensus and a group of ministers and officials who are clear in the goals for the long-term sustain ability of an energy policy that will dramatically affect the lives of many generations to come. Recognising the multi-generational obligations and consequences of government policy's key to ensuring that this investment continues, together with the maintenance of the trust that investors have developed in the management of energy policy by the UK government. There is no doubt in the commitment of the UK government to delivering the safe, secure and low-carbon energy future of the UK. The opportunities for businesses and high-quality job creation are undoubted-all that now has to happen is for developers, reactor vendors, construction companies and communities to show how they can together deliver the cheapest form of low-carbon base load to time and to cost and to the benefit of local communities and the UK economy. the world is watching for the UK to show how it can be done. (Author)

Mechanisms, patterns and outcomes of paediatric polytrauma in a UK major trauma centre.

Science.gov (United States)

Naqvi, G; Johansson, G; Yip, G; Rehm, A; Carrothers, A; Stöhr, K

2017-01-01

Introduction Paediatric trauma is a significant burden to healthcare worldwide and accounts for a large proportion of deaths in the UK. Methods This retrospective study examined the epidemiological data from a major trauma centre in the UK between January 2012 and December 2014, reviewing all cases of moderate to severe trauma in children. Patients were included if aged ≤16 years and if they had an abbreviated injury scale score of ≥2 in one or more body region. Results A total of 213 patients were included in the study, with a mean age of 7.8 years (standard deviation [SD]: 5.2 years). The most common cause of injury was vehicle related incidents (46%). The median length of hospital stay was 5 days (interquartile range [IQR]: 4-10 days). Approximately half (52%) of the patients had to stay in the intensive care unit, for a median of 1 day (IQR: 0-2 days). The mortality rate was 6.6%. The mean injury severity score was 19 (SD: 10). Pearson's correlation coefficient showed a positive correlation for injury severity score with length of stay in hospital (p<0.001). Conclusions There is significant variation in mechanism of injury, severity and pattern of paediatric trauma across age groups. A multidisciplinary team approach is imperative, and patients should be managed in specialist centres to optimise their care and eventual functional recovery. Head injury remained the most common, with significant mortality in all age groups. Rib fractures and pelvic fractures should be considered a marker for the severity of injury, and should alert doctors to look for other associated injuries.

Update on Radioactive Waste Management in the UK

International Nuclear Information System (INIS)

Dalton, John; McCall, Ann

2003-01-01

This paper provides a brief background to the current position in the United Kingdom (UK) and provides an update on the various developments and initiatives within the field of radioactive waste management that have been taking place during 2002/03. These include: The UK Government's Department of Trade and Industry (DTi) review of UK energy policy; The UK Government's (Department of Environment, Food and Rural Affairs (Defra) and Devolved Administrations*) consultation program; The UK Government's DTi White Paper, 'Managing the Nuclear Legacy: A Strategy for Action'; Proposals for improved regulation of Intermediate Level Waste (ILW) conditioning and packaging. These various initiatives relate, in Nirex's opinion, to the three sectors of the industry and this paper will provide a comment on these initiatives in light of the lessons that Nirex has learnt from past events and suggest some conclusions for the future

The future of learning disabilities nursing in the UK.

Science.gov (United States)

Clapham, Anthony

2014-07-02

This article appraises the report Strengthening the Commitment, which is a UK-wide review of learning disabilities nursing by the UK's four chief nursing officers. Strengthening the Commitment has strategic importance in reviewing progress in the care of people with learning disabilities in the UK. It also has a role in helping to guide future strategies and initiatives addressing the continuing health inequalities experienced by people with learning disabilities throughout the UK.

Double income tax between UK and US, 1914-1945 – Impact on UK multinationals

OpenAIRE

Izawa, Ryo

2015-01-01

Tax rates on business income in many countries increased enormously during World War I and stayed at a much higher level than before the war. Particularly, the UK multinationals with subsidiaries based elsewhere other than the Empire suffered from the situation because the UK did not provide a foreign tax relief until 1945, when a tax treaty with US was signed. The aim of this paper is to clarify the historical premises of establishment of the tax treaty in 1945. The major premise of this pap...

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

Radiation safety culture in the UK medical sector: a top to bottom strategy

International Nuclear Information System (INIS)

Chapple, Claire-Louise; Bradley, Andy; Murray, Maria; Orr, Phil; Reay, Jill; Riley, Peter; Rogers, Andy; Sandhu, Navneet; Thurston, Jim

2017-01-01

UK professional bodies have established a number of sectorial working parties to provide guidance on the improvement of radiation safety (RS) culture in the workplace. The medical sector provides unique challenges in this regard, and the remit of the medical group was to review the current state of RS culture and to develop a framework for improvement. The review of current RS culture was based on measurable indicators, including data from regulatory inspections, personal monitoring data and incident data. An online survey to capture the RS-related views and experience of hospital staff at all levels was carried out, and the responses provided a wealth of information on RS awareness and implementation across the country. The framework for improving RS culture includes both 'top-down' initiatives to engage management and regulators, and 'bottom-up' initiatives relating to engagement and training of different staff groups. A 'Ten-point Assessment' on what constitutes a good approach to medical RS culture has been proposed, which provides a tool for management to assess RS culture in the workplace and has potential use in regulatory inspections in the UK. (authors)

Indian Diaspora In The UK

Directory of Open Access Journals (Sweden)

L. V. Kulik

2017-01-01

Full Text Available The author traces the history of formation of the Indian diaspora in the UK, evaluates the key trends that characterize the current state of diaspora. The article highlights the level of involvement and participation of diaspora in the evolution of the bilateral relations, as well as the influence of diaspora over home and foreign policy in the UK and India. The diaspora today is not just a unique vibrant connection between the two countries, it has also become a factor of influence over domestic, social and economic affairs in both the UK and India. There is a growing number of Indians among British statesmen and politicians. Indians occupy significant posts in various sectors in Britain, including business and finance. This contributes to strengthening of economic ties between the two countries, particularly important considering Britain’s forthcoming exit from the EU. As to internal political matters, though potential issues exist (those include, for instance, the possible transfer from India into Britain of problematic inter-caste relations, India’s criticism over unbalanced approach to teaching colonial history in British schools, the Indian diaspora due to its’ inherent tolerance and moderation generally plays a stabilizing role in the UK, especially on the background of radicalization of other ethnic communities. For the new India the diaspora today is not just an important source of financing, competences and know-how, it is also a significant lobbying and soft-power instrument. This article is part of a broader research, related to the contemporary relations between the United Kingdom and India. Indian diaspora in the UK is an integral part of the unique centuries-long history that connects the two countries. It is poised to remain a strong factor contributing to interdependence and cooperation between Britain and India in the XXI century.

UK-born ethnic minority women and their experiences of feeding their newborn infant.

Science.gov (United States)

Twamley, Katherine; Puthussery, Shuby; Harding, Seeromanie; Baron, Maurina; Macfarlane, Alison

2011-10-01

to explore the factors that impact on UK-born ethnic minority women's experiences of and decisions around feeding their infant. in-depth semi-structured interviews. 34 UK-born women of Black African, Black Caribbean, Pakistani, Bangladeshi, Indian and Irish parentage and 30 health-care professionals. women and health-care professionals were recruited primarily from hospitals serving large numbers of ethnic minority women in London and Birmingham. despite being aware of the benefits of exclusive breast feeding, many women chose to feed their infant with formula. The main barriers to breast feeding were the perceived difficulties of breast feeding, a family preference for formula feed, and embarrassment about breast feeding in front of others. Reports from women of South Asian parentage, particularly those who lived with an extended family, suggested that their intentions to breast feed were compromised by the context of their family life. The lack of privacy in these households and grandparental pressure appeared to be key issues. Unlike other participants, Irish women reported an intention to feed their infant with formula before giving birth. The key facilitators to breast feeding were the self-confidence and determination of women and the supportive role of health-care professionals. these findings point to common but also culturally specific mechanisms that may hinder both the initiation and maintenance of breast feeding in UK-born ethnic minority women. They signal potential benefits from the inclusion of family members in breast-feeding support programmes. Copyright © 2010 Elsevier Ltd. All rights reserved.

Spatially Explicit Analysis of Water Footprints in the UK

Directory of Open Access Journals (Sweden)

John Barrett

2010-12-01

Full Text Available The Water Footprint, as an indicator of water consumption has become increasingly popular for analyzing environmental issues associated with the use of water resources in the global supply chain of consumer goods. This is particularly relevant for countries like the UK, which increasingly rely on products produced elsewhere in the world and thus impose pressures on foreign water resources. Existing studies calculating water footprints are mostly based on process analysis, and results are mainly available at the national level. The current paper assesses the domestic and foreign water requirements for UK final consumption by applying an environmentally extended multi-regional input-output model in combination with geo-demographic consumer segmentation data. This approach allows us to calculate water footprints (both direct and indirect for different products as well as different geographies within the UK. We distinguished between production and consumption footprints where the former is the total water consumed from the UK domestic water resources by the production activities in the UK and the latter is the total water consumed from both domestic and global water resources to satisfy the UK domestic final consumption. The results show that the production water footprint is 439 m3/cap/year, 85% of which is for the final consumption in the UK itself. The average consumption water footprint of the UK is more than three times bigger than the UK production water footprint in 2006. About half of the UK consumption water footprints were associated with imports from Non-OECD countries (many of which are water-scarce, while around 19% were from EU-OECD countries, and only 3% from Non-EU-OECD countries. We find that the water footprint differs considerably across sub-national geographies in the UK, and the differences are as big as 273 m3/cap/year for the internal water footprint and 802 m3/cap/year for the external water footprint. Our results suggest

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

The regulatory framework in the UK

International Nuclear Information System (INIS)

O'Sullivan, R.

1984-01-01

The subject is covered in sections, headed: basic regulatory requirements covering the transport of radioactive material in the UK; responsibility for safety (competent authority; provision of regulations; implementation of regulations (international and national); design of transport flask; safety case; testing; assessment; approval certificate; compliance assurance; administration); advice and information on the regulatory safety standards. (U.K.)

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.

Gas prices in the UK: markets and insecurity supply

International Nuclear Information System (INIS)

Wright, P.

2006-01-01

In this article, Professor P. Wright argues that the high and volatile gas price experienced by UK consumers over the last 3 years are the result of the extend of liberalization in the UK - which has made UK prices much more sensitive to insecurities of supply. Businesses pay the cost of this, straightaway, while the strategies which gas companies have used to respond to heightened price risks means domestic consumers also bear the cost of higher supply-markups. The prospect of high levels of demand in bad winters then just adds to price risk and its associated costs. The implication of this analysis is that it is illogical for the UK's regulator and government to blame the UK's high prices on the slow progress of liberalization in the rest of Europe - greater liberalization in Europe might simply replicate the UK's price difficulties throughout Europe

The UK gas market in transition to competition

International Nuclear Information System (INIS)

Helm, D.

1997-01-01

Virtually every aspect of the UK gas market is currently experiencing rapid change and major uncertainties. The fast-track to full competition in 1998 requires a new customer-handling infrastructure, new rules and new marketing strategies.The introduction of competition in the UK is proving more complex than most of its architects assumed. The UK provides considerable evidence not only on market design but also the management of the transitional process. The path from a state-owned monopoly through privatisation to competition is overviewed, and some of the lessons are considered which other countries (and the European Commission) contemplating reforms may glean from the UK experience. (R.P.)

Patient‐friendly hospital environments: exploring the patients’ perspective

Science.gov (United States)

Douglas, Calbert H.; Douglas, Mary R.

2004-01-01

Abstract Objective  To investigate the perceptions and attitudes of patients to the built environments of NHS Trust hospitals, in order to inform design excellence so as to make future hospitals places and spaces responsive to patient needs. Design  An exploratory study of patients perceptions based on qualitative semi‐structured personal interviews. Setting and participants  Fifty one‐to‐one interviews held with hospital in‐patients across the four directorates of surgery, medicine, care of the elderly and maternity at Salford Royal Hospitals NHS Trust, Salford, UK. Results  The research found that there was much similarity in the priorities, issues and concerns raised by patients in each of the four directorates. Patients perceived the built environment of the hospital as a supportive environment. Their accounts in each area pointed to the significance of the factors that immediately impacted on them and their families. Patients identified having a need for personal space, a homely welcoming atmosphere, a supportive environment, good physical design, access to external areas and provision of facilities for recreation and leisure. Responses suggest that patient attitudes and perceptions to the built environment of hospital facilities relates to whether the hospital provides a welcoming homely space for themselves and their visitors that promotes health and wellbeing. Conclusions  The findings have important implications for capital development teams, clinical staff, managers and NHS Estates personnel. Although the study has immediate relevance for Salford Royal Hospitals Trust, findings and recommendations reported provide NHS Estates and other relevant stakeholders with evidence‐based knowledge and understanding of patients’ perceptions and expectations of and preferences for particular facilities and estates provision in NHS hospitals. PMID:14982500

Development opportunities for the UK offshore wind industry

International Nuclear Information System (INIS)

1999-01-01

This report summarises the results of a study investigating the UK's ability to compete for the construction of offshore wind farms. The European offshore wind farm market is examined, and the UK offshore construction equipment and wind farm construction methods are analysed, and recommendations for a purpose build or modified construction vessel are presented. The appendix gives UK construction companies addresses and contact names

The Evolution of Enterprise Organization Designs

OpenAIRE

Jay R. Galbraith

2012-01-01

This article extends Alfred Chandler's seminal ideas about strategy and organizational structure, and it predicts the next stage of organizational evolution. Chandler described the evolution of vertical integration and diversification strategies for which the functional and multidivisional structures are appropriate. He also explained how the dominant structure at any point in time is a concatenation or accumulation of all previous strategies and structures. I extend Chandler's ideas by descr...

The UK and British Gas: Any future for Norwegian gas

International Nuclear Information System (INIS)

Jungles, P.

1996-01-01

The paper deals with the UK natural gas market and the future for Norwegian gas in the UK. The role of the British Gas in the domestic and European markets is discussed. Topics are: The UK gas supply market; the UK upstream gas market and the Interconnector; the European market, competition and deregulation; the prospects for Norwegian gas

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

Science.gov (United States)

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

2017-08-01

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

Cancer Research UK | IDRC - International Development Research ...

International Development Research Centre (IDRC) Digital Library (Canada)

Cancer Research UK. Cancer Research UK. https://www.cancerresearchuk.org/. The Economics of Tobacco Control Research Initiative. The Economics of Tobacco Control Research Initiative funds innovative fiscal policy research supporting tobacco control in low and middle-income countries. View more. The Economics ...

E-cigarette regulation and policy: UK vapers' perspectives.

Science.gov (United States)

Farrimond, Hannah

2016-06-01

The rapid increase in use of electronic cigarettes (e-cigarettes) has created an international policy dilemma concerning how to use these products. This study assesses the types of beliefs that e-cigarette users in the United Kingdom may hold concerning regulation. Qualitative thematic analysis of written answers to open-ended questions. United Kingdom, questionnaire conducted by post, 44% recruited from online forums and 56% non-online. Fifty-five UK vapers, 55% male, mean age 46 years, 84% sole users of e-cigarettes, 95% vaping daily. Open-ended questions on regulatory and policy options. 'Protecting youth' was seen as a fundamental regulatory requirement which should be achieved through childproofing, age limits, no advertising aimed at children and health warnings about addictiveness of nicotine, but not the restriction of flavours. There was little support for regulating e-cigarettes as medicines or limiting the strength of nicotine liquids. In terms of public use, participants argued against a blanket ban on public vaping given perceptions of a lack of scientific evidence of harm. However, they supported the principle of autonomy, that individuals and organizations have the right to restrict vaping. Some participants suggested banning vaping in places such as schools, hospitals or around food, in line with current smoking norms. Vapers' regulatory positions were accompanied by political concerns about the use (and misuse) of scientific evidence. With regard to regulation of e-cigarettes, issues that are salient to UK vapers may include the need for youth protection, regulation as medicines, strength of e-liquids, bans on public vaping and concerns about the misuse of scientific evidence. © 2016 Society for the Study of Addiction.

A review of the UK fast reactor programme

International Nuclear Information System (INIS)

Picker, C.; Ainsworth, K.F.

1998-01-01

The general position with regard to nuclear power and fast reactors in the UK during 1996 is described. The main UK Government-funded fast reactor research and development programme was concluded in 1993, to be replaced by a smaller programme which is mainly funded and managed by British Nuclear Fuels plc. The main focus of this programme sustains the UK participation in the European Fast Reactor (EFR) collaboration and the broader international links built-up over the previous decades. The status of fast reactor studies made in the UK in 1996 is outlined and, with respect to the Prototype Fast Reactor at Dounreay, a report of progress with the closure studies, fuel reprocessing and decommissioning activities is provided. (author)

Experiencing Work: Supporting the Undergraduate Hospitality, Tourism and Cruise Management Student on an Overseas Work Placement

Science.gov (United States)

Gibson, Philip; Busby, Graham

2009-01-01

This paper reports on a funded research project into the experiences of tourism, hospitality and cruise management students on internship outside the UK as part of their British university degree between 2007 and 2009. The research reflected on the perceptions of students, course managers, placement officers and members of university placement…

Fossil resource trade balances. Emerging trends for the UK

International Nuclear Information System (INIS)

Papathanasopoulou, Eleni; Jackson, Tim

2008-01-01

The aim of this paper is to examine the extent to which the UK can be classified as a net importer of fossil resources and a creator of pollution havens abroad between 1968 and 2000. Using input-output techniques and a derived Resource Flow Classification System, both the physical trade balance (PTB) and pollution trade balance (UTB) associated with fossil resource use are computed. The PTB shows that between 1968 and the early 1980's the UK is presented as a net importer of direct fossil resource flows. Between 1984 and 2000, the UK is identified as a net exporter of direct fossil resources. These trends are primarily explained by the UK's discovery and commercial production of North Sea oil and gas fields in the late 1970s. On the other hand, the UTB shows that over the whole period the indirect used flows attributable to the UK's exports are higher than those attributable to its imports. These findings suggest that the UK did not create pollution havens abroad from the use of fossil resources between 1968 and 2000. However, it is noticeable in both cases that from 1995 the UK's position as a net exporter has been decreasing considerably. Maturing North Sea oil and gas fields set against increasing demands for fossil fuels and imported goods is signalling a return to the UK's pre-1984 dependence on direct imported fossil resources and the possible creation of pollution havens abroad. Knowledge of these trends contributes to the evidence base for the UK's changing import and export structure and the potential environmental repercussions at home and abroad. (author)

Fossil resource trade balances. Emerging trends for the UK

Energy Technology Data Exchange (ETDEWEB)

Papathanasopoulou, Eleni; Jackson, Tim [Centre for Environmental Strategy, University of Surrey, Guildford, Surrey, GU2 7TH (United Kingdom)

2008-06-15

The aim of this paper is to examine the extent to which the UK can be classified as a net importer of fossil resources and a creator of pollution havens abroad between 1968 and 2000. Using input-output techniques and a derived Resource Flow Classification System, both the physical trade balance (PTB) and pollution trade balance (UTB) associated with fossil resource use are computed. The PTB shows that between 1968 and the early 1980's the UK is presented as a net importer of direct fossil resource flows. Between 1984 and 2000, the UK is identified as a net exporter of direct fossil resources. These trends are primarily explained by the UK's discovery and commercial production of North Sea oil and gas fields in the late 1970s. On the other hand, the UTB shows that over the whole period the indirect used flows attributable to the UK's exports are higher than those attributable to its imports. These findings suggest that the UK did not create pollution havens abroad from the use of fossil resources between 1968 and 2000. However, it is noticeable in both cases that from 1995 the UK's position as a net exporter has been decreasing considerably. Maturing North Sea oil and gas fields set against increasing demands for fossil fuels and imported goods is signalling a return to the UK's pre-1984 dependence on direct imported fossil resources and the possible creation of pollution havens abroad. Knowledge of these trends contributes to the evidence base for the UK's changing import and export structure and the potential environmental repercussions at home and abroad. (author)

An educational conference in a general hospital.

Science.gov (United States)

Caldwell, Gordon

2011-12-01

Western Sussex Hospitals National Health Service (NHS) Trust comprises the District General Hospitals of Worthing and Chichester. Both hospitals have successful postgraduate medical education centres, providing training for junior doctors and continuing professional development for senior doctors. Until now, there have been limited multi-professional teaching and learning activities available. The two hospitals have recently merged. The education executive felt that workplace learning had become undervalued since the implementation of Modernising Medical Careers in the UK. The executive wanted to provide a multi-professional conference on Workplace Learning, both to support the merger and to promote the value of workplace and multi-professional learning. The conference topic covering the 'how' of workplace learning was innovative. Many educational conferences concentrate on the organisation and evaluation of classroom learning, rather than on how learning can be facilitated in the workplace during ordinary working practice. It was also innovative to ensure that the presenters were representative of the multi-professional workforce. The presentations were limited to 8 minutes each to promote high-impact short presentations. The talks were recorded for publishing on the trust's intranet and the internet. A committed team in a district general hospital can provide a high-quality educational conference with wide appeal. Local health care professionals can produce short high-impact presentations. The use of modern information technology and audio-visual systems can make the presentations available to both local and worldwide audiences. © Blackwell Publishing Ltd 2011.

Decision-tree model for health economic comparison of two long-acting somatostatin receptor ligand devices in France, Germany, and the UK.

Science.gov (United States)

Marty, Rémi; Roze, Stéphane; Kurth, Hannah

2012-01-01

Long-acting somatostatin receptor ligands (SRL) with product-specific formulation and means of administration are injected periodically in patients with acromegaly and neuroendocrine tumors. A simple decision-tree model aimed at comparing cost savings with ready-to-use Somatuline Autogel(®) (lanreotide) and Sandostatin LAR(®) (octreotide) for the UK, France, and Germany. The drivers of cost savings studied were the reduction of time to administer as well as a reduced baseline risk of clogging during product administration reported for Somatuline Autogel(®). The decision-tree model assumed two settings for SRL administration, ie, by either hospital-based or community-based nurses. In the case of clogging, the first dose was assumed to be lost and a second injection performed. Successful injection depended on the probability of clogging. Direct medical costs were included. A set of scenarios were run, varying the cost drivers, such as the baseline risk of clogging, SRL administration time, and percentage of patients injected during a hospital stay. Costs per successful injection were less for Somatuline Autogel(®)/Depot, ranging from Euros (EUR) 13-45, EUR 52-108, and EUR 127-151, respectively, for France, Germany, and the UK. The prices for both long-acting SRL were the same in France, and cost savings came to 100% from differences other than drug prices. For Germany and the UK, the proportion of savings due to less clogging and shorter administration time was estimated to be around 32% and 20%, respectively. Based on low and high country-specific patient cohort size estimations of individuals eligible for SRL treatment among the patient population with acromegaly and neuroendocrine tumors, annual savings were estimated to be up to EUR 2,000,000 for France, EUR 6,000,000 for Germany, and EUR 7,000,000 for the UK. This model suggests that increasing usage of the Somatuline device for injection of SRL might lead to substantial savings for health care providers

Hospital competition, GP fundholders and waiting times in the UK internal market: the case of elective surgery.

Science.gov (United States)

Xavier, Ana

2003-03-01

In this paper I model the demand for and supply of elective surgery using a modified Hotelling framework in which time, money, and distance are determinants of the demand for hospital care. Hospitals compete with each other in terms of the waiting time and consequently treat a certain number of patients. The basic model of hospital competition is then extended to incorporate the general practitioner (GP) fundholding scheme whereby the GPs are allocated a budget with which to buy care for their patients. Waiting time increases when production of care becomes more expensive, when the benefit obtained from treatment increases, when the unit cost of distance decreases, and when the importance given to time as a performance indicator decreases. The higher the money price the lower the waiting time. Finally, the money price paid by the GP fundholders is greater than that paid by the Health Authorities and greater than the hospitals marginal cost of production. As a consequence, fundholding patients pay a zero time price while non-fundholding patients experiment a positive waiting time.

Young people's experiences of managing Type 1 diabetes at university: a national study of UK university students.

Science.gov (United States)

Kellett, J; Sampson, M; Swords, F; Murphy, H R; Clark, A; Howe, A; Price, C; Datta, V; Myint, K S

2018-04-23

Little is known about the challenges of transitioning from school to university for young people with Type 1 diabetes. In a national survey, we investigated the impact of entering and attending university on diabetes self-care in students with Type 1 diabetes in all UK universities. Some 1865 current UK university students aged 18-24 years with Type 1 diabetes, were invited to complete a structured questionnaire. The association between demographic variables and diabetes variables was assessed using logistic regression models. In total, 584 (31%) students from 64 hospitals and 37 university medical practices completed the questionnaire. Some 62% had maintained routine diabetes care with their home team, whereas 32% moved to the university provider. Since starting university, 63% reported harder diabetes management and 44% reported higher HbA 1c levels than before university. At university, 52% had frequent hypoglycaemia, 9.6% reported one or more episodes of severe hypoglycaemia and 26% experienced diabetes-related hospital admissions. Female students and those who changed healthcare provider were approximately twice as likely to report poor glycaemic control, emergency hospital admissions and frequent hypoglycaemia. Females were more likely than males to report stress [odds ratio (OR) 4.78, 95% confidence interval (CI) 3.19-7.16], illness (OR 3.48, 95% CI 2.06-5.87) and weight management issues (OR 3.19, 95% CI 1.99-5.11) as barriers to self-care. Despite these difficulties, 91% of respondents never or rarely contacted university support services about their diabetes. The study quantifies the high level of risk experienced by students with Type 1 diabetes during the transition to university, in particular, female students and those moving to a new university healthcare provider. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Influence on UK Nuclear Regulation from the Fukushima Daiichi Accident

International Nuclear Information System (INIS)

Savage, R.

2016-01-01

This paper provides an overview of the UKs response to the Fukushima Daiichi Accident and highlights the influence that this has had on UK nuclear regulation since March 2011. ONR’s Incident Suite was staffed from the first day of the accident and remained active on a 24 hours basis for over two weeks. The purpose was to provide advice to the UK government specifically prompt assurance of why this accident couldn’t take place in the UK and practical advice in relation to the 17,000 UK nationals in Japan at that time. In the early phase of the accident ONR took part in international cooperation with the US, Canadian and French regulators in order to determine the actual technical status of the Fukushima Daiichi power plant units. The UK Secretary of State requested that the ONR Chief Inspector identify any lessons to be learnt by the UK nuclear industry and in doing so cooperate and coordinate with international colleagues. The Interim report was produced (May 2011) this focused on civil NPP’s, provided background to radiation, technology and regulations. This report compared the Japan situation with the UK and identified 11 conclusions and 26 recommendations.

UK114, a YjgF/Yer057p/UK114 family protein highly conserved from bacteria to mammals, is localized in rat liver peroxisomes

International Nuclear Information System (INIS)

Antonenkov, Vasily D.; Ohlmeier, Steffen; Sormunen, Raija T.; Hiltunen, J. Kalervo

2007-01-01

Mammalian UK114 belongs to a highly conserved family of proteins with unknown functions. Although it is believed that UK114 is a cytosolic or mitochondrial protein there is no detailed study of its intracellular localization. Using analytical subcellular fractionation, electron microscopic colloidal gold technique, and two-dimensional gel electrophoresis of peroxisomal matrix proteins combined with mass spectrometric analysis we show here that a large portion of UK114 is present in rat liver peroxisomes. The peroxisomal UK114 is a soluble matrix protein and it is not inducible by the peroxisomal proliferator clofibrate. The data predict involvement of UK114 in peroxisomal metabolism

Prevalence of supporting limb laminitis in a UK equine practice and referral hospital setting between 2005 and 2013: implications for future epidemiological studies.

Science.gov (United States)

Wylie, C E; Newton, J R; Bathe, A P; Payne, R J

2015-01-17

The electronic patient records of all equine patients of Rossdales Equine Practice between January 1, 2005 and November 1, 2013 were reviewed to determine the number of cases of supporting limb laminitis (SLL) in a large equine practice and referral hospital setting in the UK and to discuss the implications for future epidemiological studies. The clinical notes were searched electronically for a combination of 'laminitis AND (contralateral OR supporting OR overload OR weight bearing)'. The prevalence of SLL within each identified denominator population and the corresponding 95% CI were calculated. SLL developed in nine horses, one donkey and one pony. Thoroughbreds were the most commonly affected breed (72.7 per cent, CI 46.4 to 99.1 per cent), aged 2-14 years (median six years), and only mares (n=9) and stallions (n=2) were represented. SLL was not restricted to horses that were non-weightbearing lame, it developed within 4-100 days after injury (median 14.5 days) and occurred most commonly in a forelimb (54.6 per cent, CI 25.1 to 84.0 per cent). During the same time frame, a total of 65,327 horses were registered with Rossdales Equine Practice, resulting in an overall practice prevalence of SLL of 0.02 per cent (CI 0.01 to 0.03 per cent). Future epidemiological studies to investigate risk factors for SLL prevention will, therefore, be a logistical challenge. British Veterinary Association.

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

Directory of Open Access Journals (Sweden)

Manisha Nair

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

Sharps injuries in UK health care: a review of injury rates, viral transmission and potential efficacy of safety devices.

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Elder, Alexander; Paterson, Caron

2006-12-01

To review the literature on sharps injuries and occupational bloodborne virus transmission in health care in the UK and the worldwide evidence for injury prevention of sharps safety devices. Literature review by online database and Internet resource search. Twenty-four relevant publications were identified regarding UK reported sharps injury rates. UK studies showed as much as a 10-fold difference between injuries reported through standard reporting systems (0.78-5.15 per 100 person-years) and rates estimated from retrospective questionnaires of clinical populations (30-284 per 100 person-years). National surveillance data from England, Wales and Northern Ireland gives a rate of 1.43 known hepatitis C virus or human immunodeficiency virus (HIV) transmissions to health care workers per annum. When extrapolated, this suggests an approximate rate of 0.009 such viral transmissions per 1000 hospital beds per annum. Risk of infection from sources with no risk factors is extremely small (less than one in one million for HIV transmission based on Scottish data). Thirty-one studies on the efficacy of sharps safety devices showed evidence of a reduction in injuries, with the greatest reductions achieved by blunt suture needles and safety cannulae. Although injuries remain common, confirmed viral transmission in the UK has been relatively rare. The degree of under-reporting of sharps injuries may be as much as 10-fold. Safety-engineered devices are likely to be effective at injury reduction.

The Transatlantic Essay Contest and the Planning Principles of the North African Campaign

Science.gov (United States)

2013-05-23

1941), 97. 50Dwight David Eisenhower and Alfred D. Chandler , The Papers of Dwight David Eisenhower: The War Years I (Baltimore; London: the Johns...Eisenhower Library, 1943. Eisenhower, Dwight David, and Alfred D. Chandler . The Papers of Dwight David Eisenhower: The War Years I. V vols. Baltimore...laid the blame for the plan’s poor chances of success at the feet of the Combined Chiefs. 55Ibid. 56Eisenhower and Chandler , The Papers of Dwight

Evaluating Courses of Actions at the Strategic Planning Level

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2013-03-01

Normann and Ramirez 1993). • American business historian, Alfred D. Chandler in 1962, defines strategy as “the determination of the basic long...goals” ( Chandler 1962). The planning makes us prepare a better future. It helps to formulate methods or means to achieve a desired objective or goal in...Jossey-Bass, 1995. Chandler , A.D. Strategy and Structure. Cambridge, MA: MIT Press, 1962. Evered, Roger. "So What is Strategy?" Long Range Planning 16

Eisenhower’s Pursuit of Strategy: The Importance of Understanding the Influence of Leadership Styles on Strategic Decision Makers

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2013-05-23

343. 28Alfred D. Chandler , The Papers of Dwight David Eisenhower The War Years: III, 1604-1606. 7...Whatever the conditions in other Theaters of War, the one here that we must never forget is the enemy’s 82Alfred D. Chandler , The Papers of Dwight...David Eisenhower The War Years: III, 1661-1663. 83Alfred D. Chandler Jr., The Papers of Dwight David Eisenhower The War Years: III (Baltimore, MD: The

Cost viability of 3D printed house in UK

Science.gov (United States)

Tobi, A. L. Mohd; Omar, S. A.; Yehia, Z.; Al-Ojaili, S.; Hashim, A.; Orhan, O.

2018-03-01

UK has been facing housing crisis due to the rising price of the property on sale. This paper will look into the viability of 3D printing technology as an alternative way for house construction on UK. The analysis will be carried out based on the data until the year of 2014 due to limited resources availability. Details cost breakdown on average size house construction cost in UK were analysed and relate to the cost viability of 3D printing technology in reducing the house price in UK. It is found that the 3D printing generates saving of up to around 35% out of total house price in UK. This cost saving comes from the 3D printed construction of walls and foundations for material and labour cost.

Nuclear and renewable energies, master cards of UK

International Nuclear Information System (INIS)

Anon.

2007-01-01

UK's greenhouse gas emissions have increased in 2004 and 2005 and the country is no longer self-sufficient with respect to energy supplies. In front of global warming and energy security threats, UK is reconsidering its energy policy. Based on low carbon solutions, the UK energy economy tries to valorize renewable energies: recovery of methane, combined combustion of biomass and fossil fuels, development of offshore wind and wave power, etc. One reason is also for UK to locally recover part of its lost autonomy thanks to energy decentralization. Since 2006, public hearings have been launched to consider a renewal of the present nuclear park, a development of offshore gas storage and LNG terminal facilities and a promotion of cogeneration systems. (J.S.)

Is the UK triple-A?

OpenAIRE

Polito, Vito; Wickens, Michael R.

2013-01-01

The immediate background to this paper is the downgrade of the U.K.'s credit rating in February 2013, the market's view that this should have occurred earlier and the emphasis in fiscal policy on reducing debt rather than recovery from recession. We propose a measure of the U.K. sovereign credit rating based on an open economy macroeconomic model that is simple to compute and easily automated. Whether based on an ad hoc debt-GDP limit or a DSGE model of an open economy, our measure downgrades...

Determinants of the cost of capital for privately financed hospital projects in the UK.

Science.gov (United States)

Colla, Paolo; Hellowell, Mark; Vecchi, Veronica; Gatti, Stefano

2015-11-01

Many governments make use of private finance contracts to deliver healthcare infrastructure. Previous work has shown that the rate of return to investors in these markets often exceeds the efficient level. Our focus is on the factors that influence that return. We examine the effect of macroeconomic, project- and firm-level variables using a detailed sample of 84 UK private finance initiative (PFI) contracts signed between 1997 and 2010. Of the above variables, macroeconomic conditions and lead sponsor size are related to the investor return. However, our results show a remarkable degree of stability in the return to investors over the 14-year period. We find evidence of a 'prevailing norm' that is robust to project- and firm-level variation. The sustainability of excess returns over a long period is indicative of a concentrated market structure. We argue that policymakers should consider new mechanisms for increasing competition in the equity market, while ensuring that authorities have the specialist resources required to negotiate efficient contract prices. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

UK nuclear medicine survey, 1989/90

International Nuclear Information System (INIS)

Elliott, A.T.; Shields, R.A.

1993-01-01

A postal survey of UK nuclear medicine departments was carried out to obtain information on activity during the year 1989/90. A rise of 14% in the number of administrations of radiopharmaceuticals was found compared to 1982: a rise of 22% in imaging studies was offset by a 30% decrease in the number of nonimaging investigations. The estimated total number of administrations in the UK was 430 000. (author)

The cost of pressure ulcers in the UK.

Science.gov (United States)

Bennett, Gerry; Dealey, Carol; Posnett, John

2004-05-01

To estimate the annual cost of treating pressure ulcers in the UK. Costs were derived from a bottom-up methodology, based on the daily resources required to deliver protocols of care reflecting good clinical practice. Health and social care system in the UK. Patients developing a pressure ulcer. A bottom-up costing approach is used to estimate treatment cost per episode of care and per patient for ulcers of different grades and level of complications. Also, total treatment cost to the health and social care system in the UK. The cost of treating a pressure ulcer varies from pound 1,064 (Grade 1) to pound 10,551 (Grade 4). Costs increase with ulcer grade because the time to heal is longer and because the incidence of complications is higher in more severe cases. The total cost in the UK is pound 1.4- pound 2.1 billion annually (4% of total NHS expenditure). Most of this cost is nurse time. Pressure ulcers represent a very significant cost burden in the UK. Without concerted effort this cost is likely to increase in the future as the population ages. To the extent that pressure ulcers are avoidable, pressure damage may be indicative of clinical negligence and there is evidence that litigation could soon become a significant threat to healthcare providers in the UK, as it is in the USA.

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

Science.gov (United States)

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

2018-01-01

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

Regulation of nuclear power in the UK after Chernobyl

International Nuclear Information System (INIS)

Ryder, E.A.

1987-01-01

The essential philosophy underlying safe nuclear power in the UK is to establish a safe design and then monitor the manufacture, construction, commissioning, operation and maintenance to ensure that the safe design intent is not violated either deliberately or unintentionally. In the UK any commercial nuclear installation must have a nuclear site licence. The Nuclear Installations Inspectorate (NII) is the agency responsible for granting licences and ensuring the safe design and operation of the installation by the licensee. The way in which the NII does this for the 27 licensed sites that it regulates in the UK is explained. This covers plant assessment and site inspection. Following the accident at Chernobyl the NII reviewed the way in which it regulates nuclear power in the UK. Some changes in specific areas were recommended but no changes in the general philosophy were considered necessary. (UK)

The UK commercial demonstration fast reactor design

International Nuclear Information System (INIS)

Holmes, J.A.G.

1987-01-01

The paper on the UK Commercial Demonstration Fast Reactor design was presented to the seminar on 'European Commercial Fast Reactor Programme, London 1987. The design is discussed under the topic headings:- primary circuit, intermediate heat exchangers and pumps, fuel and core, refuelling, steam generators, and nuclear island layout. (U.K.)

A UK perspective on recycling

International Nuclear Information System (INIS)

Williams, T.

1991-01-01

The United Kingdom, through the recycling of depleted uranium from Magnox reactors into Advanced Gas-cooled Reactor (AGR) fuel, has already recycled significant quantities of reprocessed material in reactors owned by Nuclear Electric plc and Scottish Nuclear Limited. This AGR fuel has been satisfactorily irradiated and discharged over a decade or more, and will be reprocessed in the new Thermal Oxide Reprocessing Plant (THORP), currently under construction in the UK. British Nuclear Fuels plc (BNFL) and the UK Atomic Energy Authority (UKAEA) have also been exploiting the potential of plutonium recycled in mixed oxide (MOX) fuel, which they have been making since 1963. All of the UK nuclear companies are committed to further recycling of Magnox depleted uranium during the 1990s, and it is anticipated that oxide recycling will also become firmly established during the next decade. British Nuclear Fuels and Urenco Ltd, as the providers of fuel cycle services, are developing an infrastructure to close the fuel cycle for oxide nuclear fuel, using both the uranium and plutonium arising from reprocessing. (author)

Systematic literature review of hospital medication administration errors in children

Directory of Open Access Journals (Sweden)

Ameer A

2015-11-01

Full Text Available Ahmed Ameer,1 Soraya Dhillon,1 Mark J Peters,2 Maisoon Ghaleb11Department of Pharmacy, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; 2Paediatric Intensive Care Unit, Great Ormond Street Hospital, London, UK Objective: Medication administration is the last step in the medication process. It can act as a safety net to prevent unintended harm to patients if detected. However, medication administration errors (MAEs during this process have been documented and thought to be preventable. In pediatric medicine, doses are usually administered based on the child's weight or body surface area. This in turn increases the risk of drug miscalculations and therefore MAEs. The aim of this review is to report MAEs occurring in pediatric inpatients. Methods: Twelve bibliographic databases were searched for studies published between January 2000 and February 2015 using “medication administration errors”, “hospital”, and “children” related terminologies. Handsearching of relevant publications was also carried out. A second reviewer screened articles for eligibility and quality in accordance with the inclusion/exclusion criteria. Key findings: A total of 44 studies were systematically reviewed. MAEs were generally defined as a deviation of dose given from that prescribed; this included omitted doses and administration at the wrong time. Hospital MAEs in children accounted for a mean of 50% of all reported medication error reports (n=12,588. It was also identified in a mean of 29% of doses observed (n=8,894. The most prevalent type of MAEs related to preparation, infusion rate, dose, and time. This review has identified five types of interventions to reduce hospital MAEs in children: barcode medicine administration, electronic prescribing, education, use of smart pumps, and standard concentration. Conclusion: This review has identified a wide variation in the prevalence of hospital MAEs in children. This is attributed to

Regulation of fuel cycle facilities in the UK

International Nuclear Information System (INIS)

Ascroft-Hutton, H.W.

2001-01-01

The UK has facilities for the production of uranium hexafluoride, its enrichment, conversion into fuel and for the subsequent reprocessing of irradiated fuel and closure of the fuel cycle. All of these facilities must be licensed under UK legislation. HM Nuclear Installations Inspectorate has delegated powers to issue the licence and to attach any conditions it considers necessary in the interests of safety. The fuel cycle facilities in the UK have been licensed since 1971. This paper describes briefly the UK nuclear regulatory framework and the fuel cycle facilities involved. It considers the regulatory practices adopted together with similarities and differences between regulation of fuel cycle facilities and power reactors. The safety issues associated with the fuel cycle are discussed and NII's regulatory strategy for these facilities is set out. (author)

Ammonia emission factors for UK agriculture

Science.gov (United States)

Misselbrook, T. H.; Van Der Weerden, T. J.; Pain, B. F.; Jarvis, S. C.; Chambers, B. J.; Smith, K. A.; Phillips, V. R.; Demmers, T. G. M.

Ammonia (NH 3) emission inventories are required for modelling atmospheric NH 3 transport and estimating downwind deposition. A recent inventory for UK agriculture, estimating emission as 197 kt NH 3-N yr -1, was constructed using 1993 statistical and census data for the UK. This paper describes the derivation of the UK-based emission factors used in the calculation of that emission for a range of livestock classes, farm practices and fertiliser applications to agricultural land. Some emission factors have been updated where more recent information has become available. Some of the largest emission factors derived for each farming practice include 16.9 g NH 3-N dairy cow -1 d -1 for grazing, 148.8 g NH 3-N liveweight unit -1 yr -1 for housed broilers and 4.8 g NH 3-N m -2 d -1 for storage of solid pig and poultry waste as manure heaps. Emissions for land spreading of all livestock waste were 59% of the total ammoniacal nitrogen (TAN) applied as a high dry matter content slurry and 76% of TAN applied as farm yard manure. An updated estimate of emission from UK agriculture, using updated emission factors together with 1997 statistical and census data, is presented, giving a total of 226 kt NH 3-N per year.

Increasing antimicrobial resistance in clinical isolates of Staphylococcus intermedius group bacteria and emergence of MRSP in the UK.

Science.gov (United States)

Beever, L; Bond, R; Graham, P A; Jackson, B; Lloyd, D H; Loeffler, A

2015-02-14

Frequencies of antimicrobial resistance were determined amongst 14,555 clinical Staphylococcus intermedius group (SIG) isolates from UK dogs and cats to estimate resistance trends and quantify the occurrence of meticillin-resistant Staphylococcus pseudintermedius (MRSP). Reports from two diagnostic laboratories (13,313 general submissions, 1242 referral centre only submissions) were analysed retrospectively (2003/2006-2012). MRSP were defined by phenotypic resistance to meticillin and concurrent broad β-lactam resistance; a subset was confirmed genetically (SIG-specific nuc and mecA). Trends were analysed by Cochran-Armitage test. Resistance remained below 10 per cent for cefalexin, amoxicillin-clavulanic acid and the fluoroquinolones. Increasing resistance trends were seen in both laboratories for ampicillin/amoxicillin (both PResistance to cefalexin increased over time in referral hospital isolates (Presistance to important antimicrobials was identified overtime and the emergence of MRSP from UK clinical cases was confirmed. Attention to responsible use of antibacterial therapy in small animal practice is urgently needed. British Veterinary Association.

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.

Geothermal heat pumps - gaining ground in the UK and worldwide

International Nuclear Information System (INIS)

Curtis, Robin

2001-01-01

This 2001 edition of the guide to UK renewable energy companies examines the geothermal heat pump sector, and discusses the technology involved, installations of geothermal heat pumps, the activity in the UK market with increased interest in UK geothermal heat pump products from abroad, and developments in the building sector. The UK government's increased support for the industry including its sponsorship of the Affordable Warmth programme, and the future potential of ground source systems are discussed

Gas prices in the UK: markets and insecurity of supply

International Nuclear Information System (INIS)

Wright, P.

2006-01-01

In this article Professor Philip Wright argues that the high and volatile gas prices experienced by UK consumers over the last 3 years are the result of the extent of liberalization in the UK which has made UK prices much more sensitive to insecurities of supply. Businesses pay the cost of this, straightaway, while the strategies which gas companies have used to respond to heightened price risks means domestic consumers also bear the cost of higher supply-markups. The prospect of high levels of demand in bad winters then just adds to price risk and its associated costs. The implication of this analysis is that it is illogical for the UK's regulator and government to blame the UK's high prices on the slow progress of liberalization in the rest of Europe - greater liberalization in Europe might simply replicate the UK's price difficulties throughout Europe. (author)

Radiation Safety Culture in the UK Medical Sector: A Top to Bottom Strategy.

Science.gov (United States)

Chapple, Claire-Louise; Bradley, Andy; Murray, Maria; Orr, Phil; Reay, Jill; Riley, Peter; Rogers, Andy; Sandhu, Navneet; Thurston, Jim

2017-04-01

UK professional bodies have established a number of sectorial working parties to provide guidance on the improvement of radiation safety (RS) culture in the workplace. The medical sector provides unique challenges in this regard, and the remit of the medical group was to review the current state of RS culture and to develop a framework for improvement. The review of current RS culture was based on measurable indicators, including data from regulatory inspections, personal monitoring data and incident data. An online survey to capture the RS-related views and experience of hospital staff at all levels was carried out, and the responses provided a wealth of information on RS awareness and implementation across the country. The framework for improving RS culture includes both 'top-down' initiatives to engage management and regulators, and 'bottom-up' initiatives relating to engagement and training of different staff groups. A 'Ten-point Assessment' on what constitutes a good approach to medical RS culture has been proposed, which provides a tool for management to assess RS culture in the workplace and has potential use in regulatory inspections in the UK. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Learning the law: practical proposals for UK medical education.

Science.gov (United States)

Margetts, J K

2016-02-01

Ongoing serious breaches in medical professionalism might be avoided if UK doctors rethink their approach to law. UK medical education has a role in creating a climate of change by re-examining how law is taught to medical students. Adopting a more insightful approach in the UK to the impact of The Human Rights Act and learning to manipulate legal concepts, such as conflict of interest, need to be taught to medical students now if UK doctors are to manage complex decision-making in the NHS of the future. The literature is reviewed from a unique personal perspective of a doctor and lawyer, and practical proposals for developing medical education in law in the UK are suggested. 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/

Suppliers of petrol to the UK retail market - end 1994

International Nuclear Information System (INIS)

Anon.

1995-01-01

Suppliers of petrol to the UK retail market (as at 31.12.94) are tabulated, with brand names and company names, areas of operation, and total numbers of retail petrol outlets displaying brand names, self-service sites, company-owned sites and outlets retailing Derv given. Statistics resulting from a retail marketing survey (1995) are listed and cover UK petrol sites from 1985-1994; motorway brands; a regional breakdown of petrol and derv outlets; UK outlets retailing derv; average UK prices for petrol and derv per litre; percentage of petrol sites per company (1994); number of company petrol sites as a percentage of total; number of outlets at hypermarkets/supermarkets; and vapour recovery sites. (UK)

CONSERVATION MANAGEMENT AND LEGISLATION THE UK EXPERIENCE

Directory of Open Access Journals (Sweden)

SIBLEY P. J.

2003-04-01

Full Text Available Underpinning the conservation management of Austropotamobius pallipes in the UK is the process of monitoring and reporting crayfish distribution. Should the current trend in the decline of A. pallipes continue, the species could be virtually extinct in mainland Britain within 30 years (SIBLEY, 2003. Conversely, if the increase in the distribution of non-indigenous crayfish species (NICS continues at its current rate, the distribution (by 10 km squares of these species could double within 15 years. These forward projections are based on a number of possibly unreliable assumptions; they illustrate however the magnitude of the challenge facing those concerned with the conservation of A. pallipes in the UK at this time. Recent work in crayfish conservation management in the UK has yielded guidance in several areas including monitoring, habitat enhancement and a re-introduction protocol for A. pallipes (KEMP and HILEY, 2003. Similarly, scientific research continues to inform our understanding of the movement and behaviour of NICS and explores new methods for the potential management of these species. In addition, the protection afforded to A. pallipes by current legislation is key to the long-term survival prospects of the species, albeit with a probable fragmented distribution, across the British Isles and continental Europe. Legal provisions in the UK derive in part from European instructions (e.g. EC Habitats and Species Directive and also from national legislation (e.g. Salmon and Freshwater Fisheries Act (1975 and the Wildlife and Countryside Act (1981. Also, a raft of “quasi-legislation” exists which requires responsible organisations in the UK to implement the white-clawed crayfish biodiversity action plan (BAP. Altogether these provisions constitute a considerable volume of legal protection for crayfish and provide the legal framework on which UK management policy and practice are based.

Tobacco imagery on prime time UK television.

Science.gov (United States)

Lyons, Ailsa; McNeill, Ann; Britton, John

2014-05-01

Smoking in films is a common and well documented cause of youth smoking experimentation and uptake and hence a significant health hazard. The extent of exposure of young people to tobacco imagery in television programming has to date been far less investigated. We have therefore measured the extent to which tobacco content occurs in prime time UK television, and estimated exposure of UK youth. The occurrence of tobacco, categorised as actual tobacco use, implied tobacco use, tobacco paraphernalia, other reference to tobacco, tobacco brand appearances or any of these, occurring in all prime time broadcasting on the five most popularly viewed UK television stations during 3 separate weeks in 2010 were measured by 1-minute interval coding. Youth exposure to tobacco content in the UK was estimated using media viewing figures. Actual tobacco use, predominantly cigarette smoking, occurred in 73 of 613 (12%) programmes, particularly in feature films and reality TV. Brand appearances were rare, occurring in only 18 programmes, of which 12 were news or other factual genres, and 6 were episodes of the same British soap opera. Tobacco occurred with similar frequency before as after 21:00, the UK watershed for programmes suitable for youth. The estimated number of incidences of exposure of the audience aged less than 18 years for any tobacco, actual tobacco use and tobacco branding were 59 million, 16 million and 3 million, respectively on average per week. Television programming is a source of significant exposure of youth to tobacco imagery, before and after the watershed. Tobacco branding is particularly common in Coronation Street, a soap opera popular among youth audiences. More stringent controls on tobacco in prime time television therefore have the potential to reduce the uptake of youth smoking in the UK.

Tobacco imagery on prime time UK television

Science.gov (United States)

Lyons, Ailsa; McNeill, Ann; Britton, John

2014-01-01

Background Smoking in films is a common and well documented cause of youth smoking experimentation and uptake and hence a significant health hazard. The extent of exposure of young people to tobacco imagery in television programming has to date been far less investigated. We have therefore measured the extent to which tobacco content occurs in prime time UK television, and estimated exposure of UK youth. Methods The occurrence of tobacco, categorised as actual tobacco use, implied tobacco use, tobacco paraphernalia, other reference to tobacco, tobacco brand appearances or any of these, occurring in all prime time broadcasting on the five most popularly viewed UK television stations during 3 separate weeks in 2010 were measured by 1-minute interval coding. Youth exposure to tobacco content in the UK was estimated using media viewing figures. Findings Actual tobacco use, predominantly cigarette smoking, occurred in 73 of 613 (12%) programmes, particularly in feature films and reality TV. Brand appearances were rare, occurring in only 18 programmes, of which 12 were news or other factual genres, and 6 were episodes of the same British soap opera. Tobacco occurred with similar frequency before as after 21:00, the UK watershed for programmes suitable for youth. The estimated number of incidences of exposure of the audience aged less than 18 years for any tobacco, actual tobacco use and tobacco branding were 59 million, 16 million and 3 million, respectively on average per week. Conclusions Television programming is a source of significant exposure of youth to tobacco imagery, before and after the watershed. Tobacco branding is particularly common in Coronation Street, a soap opera popular among youth audiences. More stringent controls on tobacco in prime time television therefore have the potential to reduce the uptake of youth smoking in the UK. PMID:23479113

Financing nuclear power in the U.K

International Nuclear Information System (INIS)

Bonner, F.E.

1979-01-01

In the United Kingdom the Central Electricity Generating Board (CEGB) are responsible for bulk supplies of electricity to the 12 Area Boards responsible for retailing in England and Wales. As such, the Board are responsible for over 90% of total generation in the UK and are therefore the body principally concerned with the financing of nuclear power growth. The author first looks at the problem of financing nuclear power from the point of view of the CEGB. Thereafter the situation in the UK is dealt with more generally and in that section reference is also made to the total call on the UK's resources involved in financing energy growth in general and nuclear power in particular. (author)

Exercise portrayal in children’s television programs: analysis of the UK and Irish programming

Directory of Open Access Journals (Sweden)

Scully P

2016-09-01

Full Text Available Paul Scully,1 Orlaith Reid,1 Alan P Macken,1–3 Mark Healy,4 Jean Saunders,4 Des Leddin,3,5 Walter Cullen,3 Colum P Dunne,3 Clodagh S O’Gorman1–3,5 1The Children’s Ark, University Hospital Limerick, Limerick, 2National Children’s Research Centre, Dublin, 3Centre for Interventions in Infection, Inflammation & Immunity (4i, Graduate Entry Medical School, 4C-Star, University of Limerick, Limerick, Ireland; 5Department of Medicine, Dalhousie University, Halifax, Canada Background: Television watching is obesogenic due to its sedentary nature and programming content, which influences children. Few studies have examined exercise placement within children-specific programming. This study aimed to investigate the frequency and type of exercise placement in children-specific television broadcasts and to compare placements on the UK and Irish television channels.Methods: Content analysis for five weekdays’ worth of children-specific television broadcasting totaling 82.5 hours on both the UK (British Broadcasting Corporation and Irish (Radió Teilifís Éireann television channels was performed. For the purposes of comparing the UK and Irish placements, analysis was restricted to programming broadcast between 6 am and 11.30 am. Exercise placements were coded based on type of activity, activity context, activity motivating factors and outcome, and characters involved.Results: A total of 780 cues were recorded during the total recording period. A wide variety of sports were depicted, but dancing-related cues were most commonly seen (n=163, 23.3%, with the majority of cues being of mild (n=365, 65.9% or moderate (n=172, 31.0% intensity. The majority of cues were associated with a positive outcome (n=404, 61.4%, and social motivations were most commonly seen (n=289, 30.3%. The Irish and the UK portrayals were broadly similar.Conclusion: This study highlights the wide variety of sports portrayed and the active effort undertaken by television

Understanding the occupational and organizational boundaries to safe hospital discharge.

Science.gov (United States)

Waring, Justin; Marshall, Fiona; Bishop, Simon

2015-01-01

Safe hospital discharge relies upon communication and coordination across multiple occupational and organizational boundaries. Our aim was to understand how these boundaries can exacerbate health system complexity and represent latent sociocultural threats to safe discharge. An ethnographic study was conducted in two local health and social care systems (health economies) in England, focusing on two clinical areas: stroke and hip fracture patients. Data collection involved 345 hours of observations and 220 semi-structured interviews with health and social care professionals, patients and their lay carers. Hospital discharge involves a dynamic network of interactions between heterogeneous health and social care actors, each characterized by divergent ways of organizing discharge activities; cultures of collaboration and interaction and understanding of what discharge involves and how it contributes to patient recovery. These interrelated dimensions elaborate the occupational and organisational boundaries that can influence communication and coordination in hospital discharge. Hospital discharge relies upon the coordination of multiple actors working across occupational and organizational boundaries. Attention to the sociocultural boundaries that influence communication and coordination can help inform interventions that might support enhanced discharge safety. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Networking Hospital ePrescribing: A Systemic View of Digitalization of Medicines' Use in England.

Science.gov (United States)

Lichtner, Valentina; Hibberd, Ralph; Cornford, Tony

2016-01-01

Medicine management is at the core of hospital care and digitalization of prescribing and administration of medicines is often the focus of attention of health IT programs. This may be conveyed to the public in terms of the elimination of paper-based drug charts and increased readability of doctors' prescriptions. Based on analysis of documents about hospital medicines supply and use (including systems' implementation) in the UK, in this conceptual paper electronic prescribing and administration are repositioned as only one aspect of an important wider transformation in medicine management in hospital settings, involving, for example, procurement, dispensing, auditing, waste management, research and safety vigilance. Approaching digitalization from a systemic perspective has the potential to uncover the wider implications of this transformation for patients, the organization and the wider health care system.

Graduates of different UK medical schools show substantial differences in performance on MRCP(UK Part 1, Part 2 and PACES examinations

Directory of Open Access Journals (Sweden)

Mollon Jennifer

2008-02-01

Full Text Available Abstract Background The UK General Medical Council has emphasized the lack of evidence on whether graduates from different UK medical schools perform differently in their clinical careers. Here we assess the performance of UK graduates who have taken MRCP(UK Part 1 and Part 2, which are multiple-choice assessments, and PACES, an assessment using real and simulated patients of clinical examination skills and communication skills, and we explore the reasons for the differences between medical schools. Method We perform a retrospective analysis of the performance of 5827 doctors graduating in UK medical schools taking the Part 1, Part 2 or PACES for the first time between 2003/2 and 2005/3, and 22453 candidates taking Part 1 from 1989/1 to 2005/3. Results Graduates of UK medical schools performed differently in the MRCP(UK examination between 2003/2 and 2005/3. Part 1 and 2 performance of Oxford, Cambridge and Newcastle-upon-Tyne graduates was significantly better than average, and the performance of Liverpool, Dundee, Belfast and Aberdeen graduates was significantly worse than average. In the PACES (clinical examination, Oxford graduates performed significantly above average, and Dundee, Liverpool and London graduates significantly below average. About 60% of medical school variance was explained by differences in pre-admission qualifications, although the remaining variance was still significant, with graduates from Leicester, Oxford, Birmingham, Newcastle-upon-Tyne and London overperforming at Part 1, and graduates from Southampton, Dundee, Aberdeen, Liverpool and Belfast underperforming relative to pre-admission qualifications. The ranking of schools at Part 1 in 2003/2 to 2005/3 correlated 0.723, 0.654, 0.618 and 0.493 with performance in 1999–2001, 1996–1998, 1993–1995 and 1989–1992, respectively. Conclusion Candidates from different UK medical schools perform differently in all three parts of the MRCP(UK examination, with the

Modelling UK energy demand to 2000

International Nuclear Information System (INIS)

Thomas, S.D.

1980-01-01

A recent long-term demand forecast for the UK was made by Cheshire and Surrey. (SPRU Occasional Paper Series No.5, Science Policy Research Unit, Univ. Of Sussex, 1978.) Although they adopted a sectoral approach their study leaves some questions unanswered. Do they succeed in their aim of making all their assumptions fully explicit. How sensitive are their estimates to changes in assumptions and policies. Are important problems and 'turning points' fully identified in the period up to and immediately beyond their time horizon of 2000. The author addresses these questions by using a computer model based on the study by Cheshire and Surrey. This article is a shortened version of the report, S.D. Thomas, 'Modelling UK Energy Demand to 2000', Operational Research, Univ. of Sussex, Brighton, UK, 1979, in which full details of the author's model are given. Copies are available from the author. (author)

Modelling UK energy demand to 2000

Energy Technology Data Exchange (ETDEWEB)

Thomas, S D [Sussex Univ., Brighton (UK)

1980-03-01

A recent long-term demand forecast for the UK was made by Cheshire and Surrey. (SPRU Occasional Paper Series No.5, Science Policy Research Unit, Univ. Of Sussex, 1978.) Although they adopted a sectoral approach their study leaves some questions unanswered. Do they succeed in their aim of making all their assumptions fully explicit. How sensitive are their estimates to changes in assumptions and policies. Are important problems and 'turning points' fully identified in the period up to and immediately beyond their time horizon of 2000. The author addresses these questions by using a computer model based on the study by Cheshire and Surrey. This article is a shortened version of the report, S.D. Thomas, 'Modelling UK Energy Demand to 2000', Operational Research, Univ. of Sussex, Brighton, UK, 1979, in which full details of the author's model are given. Copies are available from the author.

Long-term mercury dynamics in UK soils

International Nuclear Information System (INIS)

Tipping, E.; Wadsworth, R.A.; Norris, D.A.; Hall, J.R.; Ilyin, I.

2011-01-01

A model assuming first-order losses by evasion and leaching was used to evaluate Hg dynamics in UK soils since 1850. Temporal deposition patterns of Hg were constructed from literature information. Inverse modelling indicated that 30% of 898 rural sites receive Hg only from the global circulation, while in 51% of cases local deposition exceeds global. Average estimated deposition is 16 μg Hg m -2 a -1 to rural soils, 19 μg Hg m -2 a -1 to rural and non-rural soils combined. UK soils currently hold 2490 tonnes of reactive Hg, of which 2140 tonnes are due to anthropogenic deposition, mostly local in origin. Topsoil currently releases 5.1 tonnes of Hg 0 per annum to the atmosphere, about 50% more than the anthropogenic flux. Sorptive retention of Hg in the lower soil exerts a strong control on surface water Hg concentrations. Following decreases in inputs, soil Hg concentrations are predicted to decline over hundreds of years. - Highlights: → Spatial data for mercury in UK soils can be related to past atmospheric deposition. → The residence time of Hg (c. 400 years) depends on gaseous evasion and leaching. → UK soils currently contribute more Hg 0 to the atmosphere than human activities. → Sorption of Hg by deeper soil is a strong control on surface water concentrations. - Atmospherically-deposited anthropogenic mercury, mostly of local origin, has accumulated in UK soils, and is now a significant source of Hg 0 to the global circulation.

Globalisation of Researcher Mobility within the UK Higher Education: Explaining the Presence of Overseas Academics in the UK Academia

Science.gov (United States)

Khattab, Nabil; Fenton, Steve

2016-01-01

In this paper, we argue that the power structure that lies within the UK elite universities dictates a division of labour through which the inflows of overseas academics into the UK academic labour markets are skewed towards these elite academic institutions where they are employed primarily in research-only posts. These posts, are less valued and…

Food advertising during children's television in Canada and the UK.

Science.gov (United States)

Adams, J; Hennessy-Priest, K; Ingimarsdóttir, S; Sheeshka, J; Ostbye, T; White, M

2009-09-01

Television advertisements for less healthy foods are thought to contribute to overweight and obesity in children. In the UK, new regulations on television food advertising to children came into effect in April 2007. These prohibit advertisements for "less healthy" foods during or around programmes "of particular appeal to" (OPAT) children. In Canada, self-regulated codes of practice on television food advertising to children were recently strengthened. To document the nutritional content of food advertised and number of advertisements OPAT children broadcast in the UK and central Canada before the introduction of the new UK regulations. All food advertisements broadcast on four popular channels in Canada and the three terrestrial commercial channels in the UK during 1 week in 2006 were identified and linked to relevant nutritional data. Food advertisements OPAT children and for "less healthy" products were identified using the criteria in the UK regulations. 2315 food related advertisements broadcast in Canada and 1365 broadcast in the UK were included. 52-61% were for "less healthy" products; 5-11% were OPAT children. Around 5% of food advertisements would have been prohibited under the new UK regulations. There were few differences in the nutritional content of food described in advertisements that were and were not OPAT children. There was little evidence that food described in advertisements OPAT children were any less healthy than those that were not. Few food advertisements are likely to be prohibited by the new UK regulations.

UK Government: New postgraduate scheme - Dorothy Hodgkin awards

CERN Multimedia

2003-01-01

The UK Prime Minister today announced a new GBP10m initiative, the Dorothy Hodgkin Postgraduate Awards, which will allow over 100 PhD students from India, China, Hong Kong, Russia and the developing world to study in top UK universities (1 page).

Nutritional Knowledge of UK Coaches

Directory of Open Access Journals (Sweden)

Emma Cockburn

2014-04-01

Full Text Available Athletes obtain nutritional information from their coaches, yet their competency in this area is lacking. Currently, no research exists in the UK which has a different coach education system to many other countries. Therefore, the aim of this study was to evaluate the sports nutrition knowledge of UK coaching certificate (UKCC level 2 and 3, hockey and netball qualified coaches. All coaches (n = 163 completed a sports nutrition questionnaire to identify: (a if they provided nutritional advice; (b their level of sport nutrition knowledge; and (c factors that may have contributed to their level of knowledge. Over half the coaches provided advice to their athletes (n = 93, 57.1%, even though they were not competent to do so. Coaches responded correctly to 60.3 ± 10.5% of all knowledge questions with no differences between those providing advice and those who did not (p > 0.05. Those coaches who had undertaken formal nutrition training achieved higher scores than those who had not (p < 0.05. In conclusion, UK sports coaches would benefit from continued professional development in sports nutrition to enhance their coaching practice.

UK review of radio science, 1984-1986. Ionosphere and magnetosphere

International Nuclear Information System (INIS)

Rishbeth, H.; Jones, D.

1986-12-01

The paper contains the United Kingdom (U.K.) review of Radio Science, 1984-1986, covering ionospheric and magnetospheric science. This is the current UK contribution towards an international review published by the International Union of Radio Science (URSI). The UK review is divided into topics prescribed by URSI and covers work that is actually published within the period October 1983 - Sept. 1986, also as prescribed by URSI. The topics discussed in the review include: incoherent and coherent scatter, probing the magnetosphere, plasma instabilities, ionospheric modification, composition, ionization and chemistry and ionospheric dynamics. (U.K.)

Kyoto commitments: CHP will help the UK

International Nuclear Information System (INIS)

Knowles, Michael

1998-01-01

In order to meet the United Kingdom's targets for carbon dioxide emissions reduction, agreed at the Kyoto Summit, the UK Government is promoting the use of combined heat and power (CHP) plants. Such schemes need to offer over 70% efficiency, have on-site or nearby heat uses, and allow flexibility for the export of electricity where this is appropriate. Electricity trading arrangements will need to be re-organised in line with similar commodities, in order to facilitate and promote the growth of CHP and renewable energy schemes. Financial incentives and regulation of electricity prices will also contribute to the promotion of CHP schemes, ultimately leading to reduced CO 2 pollution as a result of the growth in the UK's CHP capacity. (UK)

Guide to UK renewable energy companies 2001. 6. ed.

International Nuclear Information System (INIS)

2001-01-01

This 2001 edition of the guide to UK renewable companies and equipment and service providers presents summaries of the different industry sectors covering wind power, photovoltaics, solar water heating, geothermal heat pump, hydroelectric power, marine current and wave technology, bioenergy, power generation from landfill gas, energy from waste, and cogeneration. A UK company classification listing and index is provided along with listing of UK organisations and companies and an index of advertisers

Blood inventory management: hospital best practice.

Science.gov (United States)

Stanger, Sebastian H W; Yates, Nicola; Wilding, Richard; Cotton, Sue

2012-04-01

Blood is a perishable product, and hence good management of inventories is crucial. Blood inventory management is a trade-off between shortage and wastage. The challenge is to keep enough stock to ensure a 100% supply of blood while keeping time expiry losses at a minimum. This article focuses on inventory management of red blood cells in hospital transfusion laboratories to derive principles of best practice and makes recommendations that will ensure losses due to time expiry are kept to a minimum. The literature was reviewed to identify available models for perishable inventory management. Historical data from the UK blood supply chain was analyzed to identify hospitals with good inventory management practice and low wastage levels. Transfusion laboratory managers in the selected hospitals were interviewed in 7 case studies with the aim of identifying drivers for low wastage and good inventory management practice. The findings from the case studies were compared with the literature. The extant literature asserts that the drivers for good inventory performance are the use of complex inventory models and algorithms. This study has found this not to be the case. Instead, good performance is driven by the quality of transfusion laboratory staff, who must be skilled, regularly trained, and experienced. Electronic crossmatching, transparency of the inventory, and simple management procedures also facilitate good performance. Copyright © 2012 Elsevier Inc. All rights reserved.

Questions raised over future of UK research council

Science.gov (United States)

Banks, Michael

2010-02-01

Five senior physicists have written to the UK science minister, Lord Drayson, about the "dismal future" for researchers in the country in the wake of a £40m shortfall in the budget of the Science and Technology Facilities Council (STFC). The physicists, who chair the STFC's five advisory panels, have also called for structural reforms to be made to the council. They warn that unless the government takes action to reverse the situation, the UK will be "perceived as an untrustworthy partner in global projects" and predict that a brain drain of the best UK scientists to positions overseas will ensue.

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.

Using Constraints from Satellite Gravimetry to Study Meteorological Excitations of the Chandler Wobble for an Earth Model with Frequency-dependent Responses

Science.gov (United States)

Chen, W.; Li, J.; Ray, J.; Cheng, M.; Chen, J.; Wilson, C. R.

2015-12-01

What maintain(s) the damping Chandler wobble (CW) is still under debate though meteorological excitations are now more preferred. However, controversial results have been obtained: Gross [2000] and Gross et al. [2003] suggested oceanic processes are more efficient to excite the CW than atmospheric ones during 1980 - 2000. Brzezinski and Nastula [2002] concluded that their contributions are almost the same, and they can only provide ~80% of the power needed to maintain the CW observed during 1985 - 1996. Polar motion excitations involve not only the perturbations within the Earth system (namely, mass redistributions and motions of relative to the mantle), but also the Earth's responses to those perturbations (namely, the rheology of the Earth). Chen et al. [2013a] developed an improved theory for polar motion excitation taking into account the Earth's frequency-dependent responses, of which the polar motion transfer functions are ~10% higher than those of previous theories around the CW band. Chen et al. [2013b] compared the geophysical excitations derived from various global atmospheric, oceanic and hydrological models (NCEP, ECCO, ERA40, ERAinterim and ECMWF operational products), and found significant and broad-band discrepancies for models released by different institutes. In addition, the atmosphere, ocean and hydrology models are usually developed in a somewhat independent manner and thus the global (atmospheric, oceanic and hydrological) mass is not conserved [e.g., Yan and Chao, 2012]. Therefore, the matter-term excitations estimated from those models are problematic. In one word, it is unlikely to obtain reliable conclusions on meteorological excitations of CW on the basis of the original meteorological models. Satellite gravimetry can measure mass transportations caused by atmospheric, oceanic and hydrological processes much more accurately than those provided by the original meteorological models, and can force the global (atmospheric, oceanic and

The impact of overactive bladder on mental health, work productivity and health-related quality of life in the UK and Sweden: results from EpiLUTS.

Science.gov (United States)

Coyne, Karin S; Sexton, Chris C; Kopp, Zoe S; Ebel-Bitoun, Caty; Milsom, Ian; Chapple, Chris

2011-11-01

• To examine the prevalence and burden of overactive bladder (OAB) with bother in the UK and Sweden compared to OAB without bother and no/minimal OAB/lower urinary tract (LUTS) symptoms, respectively. • A cross-sectional population-representative survey was conducted via the Internet in the UK, Sweden and USA. • Participants rated the frequency and bother of OAB and LUTS. Patient outcomes included the Overactive Bladder Questionnaire Short Form, Patient Perception of Bladder Condition, Short Form-12, Hospital Anxiety and Depression Scale-Anxiety and Hospital Anxiety and Depression Scale-Depression, as well as questions about treatment seeking and work productivity. • OAB was defined as urgency at least sometimes or the presence of urinary urgency incontinence. Three subgroups were compared: no/minimal symptoms, OAB without bother and OAB with bother. • Analyses were conducted by gender and country using general linear and logistic regression models to examine bothersome OAB and treatment seeking. • Survey response was 59.2%; 10,000 people (4724 men and 5276 women) participated. • The prevalence of OAB with bother at least 'somewhat' was 10.9% and 14.6% for men in the UK and Sweden, and 22.5% and 33.7% for women in the UK and Sweden, respectively. • Men and women with bothersome OAB were significantly more likely to seek treatment, report the lowest levels of health-related quality of life and work productivity and the highest levels of anxiety and depression compared to those with no/minimal symptoms and OAB without bother. • Greater symptom severity of urgency, urgency urinary incontinence, frequency, nocturia, and increasing levels of anxiety were strongly predictive of OAB bother in both men and women. • Predictors of treatment seeking included frequency, bother as a result of urgency, and lower levels of depressive symptoms in men, and frequency, nocturia and urgency in women. • OAB is common in the UK and Sweden, and women are more

The role of bioenergy in the UK's energy future formulation and modelling of long-term UK bioenergy scenarios

International Nuclear Information System (INIS)

Jablonski, Sophie; Bauen, Ausilio; Strachan, Neil; Brand, Christian

2010-01-01

This paper explores the prospects and policy implications for bioenergy to contribute to a long-term sustainable UK energy system. The UK MARKAL technology-focused energy systems dynamic cost optimisation model - which has been used to quantify the costs and benefits of alternative energy strategies in UK policy making - is enhanced with detailed representation of bio-energy chains and end-uses. This provides an important advance in linking bioenergy expert-knowledge with a whole system modelling approach, in order to better understand the potential role of bioenergy in an evolving energy system. The new BIOSYS-MARKAL model is used to run four scenarios constructed along the pillars of UK energy policy objectives (low carbon and energy security). The results are analysed in terms of bioenergy resources use and bioenergy pathways penetration in different end use sectors. The main findings suggest that the complexity of different bioenergy pathways may have been overlooked in previous modelling exercises. A range of bioenergy pathways - notably bio-heat and biofuels for transport - may have a much wider potential role to play. The extent to which this potential is fulfilled will be further determined by resources availability, and market segment constraints, as well as policy measures to improve deployment. (author)

Do UK Institutional Shareholders Monitor their Investee Firms?

NARCIS (Netherlands)

Goergen, M.; Renneboog, L.D.R.; Zhang, C.

2008-01-01

As institutional investors are the largest shareholders in most listed UK firms, one expects them to monitor the firms they invest in. However, there is mounting empirical evidence which suggests that they do not perform any monitoring. This paper provides a new test on whether UK institutional

"Big Society" in the UK: A Policy Review

Science.gov (United States)

Evans, Kathy

2011-01-01

Alongside the UK Coalition Government's historic public spending cuts, the "Big Society" has become a major narrative in UK political discourse. This article reviews key features of Big Society policies against their aims of rebalancing the economy and mending "Broken Britain", with particular reference to their implications…

UK strategy for nuclear industry LLW - 16393

International Nuclear Information System (INIS)

Clark, Matthew; Fisher, Joanne

2009-01-01

In March 2007 the UK Government and devolved administrations (for Scotland, Wales and Northern Ireland, from here on referred to as 'Government') published their policy for the management of solid low level waste ('the Policy'). The Policy sets out a number of core principles for the management of low level waste (LLW) and charges the Nuclear Decommissioning Authority with developing a UK-wide strategy in the case of LLW from nuclear sites. The UK Nuclear Industry LLW Strategy has been developed within the framework of the principles set out in the policy. A key factor in the development of this strategy has been the strategic partnership the NDA shares with the Low Level Waste Repository near Drigg (LLWR), who now have a role in developing strategy as well as delivering an optimised waste management service at the LLWR. The strategy aims to support continued hazard reduction and decommissioning by ensuring uninterrupted capability and capacity for the management and disposal of LLW in the UK. The continued availability of a disposal route for LLW is considered vital by both the nuclear industry and non-nuclear industry low level waste producers. Given that the UK will generate significantly more low level waste (∼ 3.1 million m 3 ) than there is capacity at the LLWR (∼0.75 million m 3 ), developing alternative effective ways to manage LLW is critical. The waste management hierarchy is central to the strategy, which includes strategic goals at all levels of the hierarchy to improve its application across the industry. (authors)

Long-term mercury dynamics in UK soils

Energy Technology Data Exchange (ETDEWEB)

Tipping, E., E-mail: et@ceh.ac.uk [Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LA1 4AP (United Kingdom); Wadsworth, R.A. [Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LA1 4AP (United Kingdom); Norris, D.A.; Hall, J.R. [Centre for Ecology and Hydrology, Environment Centre Wales, Deiniol Road, Bangor, Gwynedd LL57 2UW (United Kingdom); Ilyin, I. [Meteorological Synthesizing Centre - East, Krasina pereulok, 16/1, 123056 Moscow (Russian Federation)

2011-12-15

A model assuming first-order losses by evasion and leaching was used to evaluate Hg dynamics in UK soils since 1850. Temporal deposition patterns of Hg were constructed from literature information. Inverse modelling indicated that 30% of 898 rural sites receive Hg only from the global circulation, while in 51% of cases local deposition exceeds global. Average estimated deposition is 16 {mu}g Hg m{sup -2} a{sup -1} to rural soils, 19 {mu}g Hg m{sup -2} a{sup -1} to rural and non-rural soils combined. UK soils currently hold 2490 tonnes of reactive Hg, of which 2140 tonnes are due to anthropogenic deposition, mostly local in origin. Topsoil currently releases 5.1 tonnes of Hg{sup 0} per annum to the atmosphere, about 50% more than the anthropogenic flux. Sorptive retention of Hg in the lower soil exerts a strong control on surface water Hg concentrations. Following decreases in inputs, soil Hg concentrations are predicted to decline over hundreds of years. - Highlights: > Spatial data for mercury in UK soils can be related to past atmospheric deposition. > The residence time of Hg (c. 400 years) depends on gaseous evasion and leaching. > UK soils currently contribute more Hg{sup 0} to the atmosphere than human activities. > Sorption of Hg by deeper soil is a strong control on surface water concentrations. - Atmospherically-deposited anthropogenic mercury, mostly of local origin, has accumulated in UK soils, and is now a significant source of Hg{sup 0} to the global circulation.

History of UK contribution to astronautics: Politics and government

Science.gov (United States)

Hicks CB, Colin

2009-12-01

In all developed countries, once it emerged from the amateur era, Space (and especially rocketry) moved on the public agenda because of its potential significance for both the civil and military policies of governments (coupled with its appetite for new money). In the UK the policy treatment of Space broadly paralleled that in other countries until the post-Empire trauma, the burn-out of the White-Hot Technological revolution of Harold Wilson, and the financial crises of the 1970s exhausted the public appetite for large scale publicly funded projects in high technology. The culmination for Space of these pressures came in 1986-1987 when the UK rejected the emerging international consensus and, almost alone, stayed outside the manned space commitments which developed into the International Space Station. In this paper, Colin Hicks will review the UK political developments which led up to the 1986-1987 decision and how the politics and organisation of UK space activity have developed since then to the point where in 2008 a major government review of the UK involvement in manned space was commissioned.

Economic Effects of Migration from Poland to the UK

Directory of Open Access Journals (Sweden)

Mihaela Simionescu

2017-08-01

Full Text Available Considering that large numbers of the EU-8 immigrants was a strong argument for the Brexit, the objective of this paper is to assess some economic effects of migration from Poland to the UK for both countries. Intensive emigration of the Poles to the UK since 2004 negatively affected Poland’s economic growth in the long run, but it also reduced tensions at the labour market by decreasing the unemployment rate. On the other hand, the increase in Polish immigrants in the UK did not significantly affect economic growth and unemployment rate in the destination country in the short run in the period 2004-2015. A significance influence was observed only in the long run, when the UK economic growth decreased, but the pressures on the labour market significantly reduced. From these empirical findings, some policy recommendations are required for both countries: for Poland, migration policies to promote the return of migrants and more efficient utilization of labour force, while for the UK – shaping a more flexible labour market.

Energy UK 2011? Give us just a little more time

Energy Technology Data Exchange (ETDEWEB)

Darkwa, K.; O`Callaghan, P.W. [Nottingham Trent University, Nottingham (United Kingdom). Faculty of Environmental Studies

1995-04-01

The article analyses the trends from `published proved` fossil reserves, consumption and lives, both in the UK and globally. Despite fears of global warming, and the 1988 Toronto Protocol, energy consumption rates globally have increased 25% over the past two decades. And although they fluctuate, UK rates have not declined significantly. In the absence of imports UK indigenous fossil fuels will be depleted in 2011. The UK has vast reserves of coal, shale oil and peat, but is currently unable to complete with cheap imported fuel. The authors urge continuous review of the economic, political and social factors. 1 fig., 1 tab.

Environmental tobacco smoke in hospitality venues in Greece.

Science.gov (United States)

Vardavas, Constantine I; Kondilis, Barbara; Travers, Mark J; Petsetaki, Elisabeth; Tountas, Yiannis; Kafatos, Anthony G

2007-10-23

Exposure to environmental tobacco smoke is a major threat to public health. Greece, having the highest smoking prevalence in the European Union is seriously affected by passive smoking. The purpose of this study was to measure environmental tobacco smoke (ETS) exposure in the non smoking areas of hospitality venues and offices in Greece and to compare the levels of exposure to levels in the US, UK and Ireland before and after the implementation of a smoking ban. Experimental measurements of particulate matter 2.5 microm (PM2.5), performed during a cross sectional study of 49 hospitality venues and offices in Athens and Crete, Greece during February - March 2006. Levels of ETS ranged from 19 microg/m3 to 612 microg/m3, differing according to the place of measurement. The average exposure in hospitality venues was 268 microg/m3 with ETS levels found to be highest in restaurants with a mean value of 298 microg/m3 followed by bars and cafes with 271 microg/m3. ETS levels were 76% lower in venues in which smoking was not observed compared to all other venues (p hospitality venues while levels in Ireland with a total smoking ban are 89% lower and smoke-free communities in the US are 91 - 96% lower than levels in Greece. Designated non-smoking areas of hospitality venues in Greece are significantly more polluted with ETS than outdoor air and similar venues in Europe and the United States. The implementation of a total indoor smoking ban in hospitality venues has been shown to have a positive effect on workers and patrons' health. The necessity of such legislation in Greece is thus warranted.

A Point of View on the UK Energy Policy

International Nuclear Information System (INIS)

Lescoeur, Bruno

2017-02-01

The United Kingdom chose to leave the European Union at a crucial moment for the Energy Union, and in a period when the necessity of leading a coherent energy transition is strongly shared by EU countries. In the light of this conjunction of events, this study analyses the determining factors of the UK energy policy. The industrial revolution started in England, a country endowed with abundant coal supplies but also with robust policies and the right technical, economic and social conditions for making the most out of these natural resources. Likewise, the UK developed effective domestic and foreign policies in the first half of the 20. century and successfully managed the second industrial revolution, which was based on the use of oil and electricity. The UK energy system has gone through significant changes over the past forty years, with the gradual phase out of coal, the development of oil and gas production in the North Sea, the transformation of the electricity system, the re-building of a credible nuclear strategy and the rise of a low-carbon economy. These changes have been implemented at a reasonable cost, at least compared to the cost incurred by the other EU energy systems. The consistency and stability of the UK energy policies are striking, and one must admit that they are driven by a great sense of pragmatism. They are developed through trial and error and their results are openly debated and confronted to the three objectives of having secure, affordable and sustainable energy supplies. There is no doubt about who is the main beneficiary from these policies: it should always be the UK national community. Its interests are well-defended, government after government, and this national focus is probably the main reason why the UK energy policy appears to be very consistent. The EU has often tried to replicate the UK initiatives in the field of energy, but probably without taking proper account of the specificities of the UK context

Manejo quirúrgico del angiofibroma nasofaríngeo juvenil

Directory of Open Access Journals (Sweden)

Juan Oré

2007-09-01

Full Text Available Objetivos: Describir el manejo quirúrgico del angiofibroma nasofaríngeo juvenil, tanto en el abordaje como en la anestesia, evidenciar el grado de compromiso y estadio de los casos intervenidos y determinar las complicaciones y recurrencias del angiofibroma juvenil usando un abordaje Le Fort I. Diseño: Estudio descriptivo retrospectivo. Lugar: Servicio de Cirugía de Cabeza y Cuello, Hospital Dos de Mayo, hospital docente. Participantes: Pacientes con resultado anatomopatológico de angiofibroma juvenil. Intervenciones: Se revisó los casos de intervención quirúrgica de angiofibroma juvenil, confirmado por anatomía patológica entre enero de 1993 hasta diciembre de 2006. Principales medidas de resultados: Resultados quirúrgicos, pérdida sanguínea, complicaciones. Resultados: Se intervino 29 casos en el periodo en estudio, todos varones, con un promedio de edad de 19,2 años y rango de edad entre 13 y 27 años. Procedían principalmente de Lima (34% y Cajamarca (17%. Presentamos 90% de casos catalogados como Chandler III, 7% como Chandler IV y 3% como Chandler II. Todos fueron sometidos a tratamiento quirúrgico, con intubación submentoniana; en 28 pacientes se realizó un abordaje Le Fort I, con osteosíntesis con miniplacas y tornillos de titanio. Se realizó una embolización preoperatorio, al optar por un abordaje transpalatino. El valor promedio de hemoglobina preoperatorio fue 13,6 g% y en el postoperatorio, 10,5 g%. El promedio de pérdida sanguínea fue 1 019 mL, en un rango de entre 300 y 4 500 mL. Se transfundió en promedio 2,3 paquetes globulares por paciente; tres pacientes no requirieron transfusión alguna. No se presentaron complicaciones en el periodo postoperatorio. Conclusiones: El tratamiento quirúrgico es de elección para el tratamiento del angiofibroma juvenil en todos sus estadíos. Debido al amplio campo quirúrgico del abordaje Le Fort I y la escasa recurrencia presentada, postulamos este abordaje como el m

New Dimensions for Manufacturing: A UK Strategy for Nanotechnology

National Research Council Canada - National Science Library

Taylor, John M

2002-01-01

... R&D for nanotechnology. This report, of the UK Advisory Group on Nanotechnology Applications, examines the growth of nanotechnology, its potential implications for industry in the UK, and proposes the elements of a strategy...

What's in a name? Nominative determinism in the UK dental workforce.

Science.gov (United States)

Sleigh, J

2016-12-16

Background Nominative determinism describes the theory that people are more likely to pursue careers that are connected to their names. Compelling research has been carried out across the medical professions that provides strong evidence for this phenomenon, but as yet its applicability to the UK dental workforce remains unknown.Aim The aim of this study was to establish the prevalence of dentally-related surnames in the UK dental workforce (dentists and dental care professionals) and compare this to the UK population.Results Dentistry may provide a surprising counter-example to prevailing theories of nominative determinism, as UK dentists are significantly less likely than the UK general population to have dentally-related surnames. This new phenomenon of 'nominative antideterminism' was not observed in the dental care professional (DCP) cohort, for whom the prevalence of dentally-related surnames was similar to that in the wider UK population.

UK medical selection: lottery or meritocracy?

Science.gov (United States)

Harris, Benjamin H L; Walsh, Jason L; Lammy, Simon

2015-02-01

From senior school through to consultancy, a plethora of assessments shape medical careers. Multiple methods of assessment are used to discriminate between applicants. Medical selection in the UK appears to be moving increasingly towards non-knowledge-based testing at all career stages. We review the evidence for non-knowledge-based tests and discuss their perceived benefits. We raise the question: is the current use of non-knowledge-based tests within the UK at risk of undermining more robust measures of medical school and postgraduate performance? © 2015 Royal College of Physicians.

Is Communications a Strategic Activity in UK Education?

Science.gov (United States)

Chapleo, Chris

2006-01-01

This qualitative exploratory paper investigates whether communications/public relations is regarded by opinion formers in UK education as a strategic business activity or a tactical marketing tool. It is based upon depth interviews with 16 senior managers with strategic roles in UK higher or further education, or Government bodies, conducted…

The IB Diploma and UK University Degree Qualifications

Science.gov (United States)

Frank-Gemmill, Gerda

2013-01-01

In recent years the International Baccalaureate (IB) Diploma has become widely accepted as a university-entry qualification in the UK, but there has been little quantitative research into the achievements of IB students at degree level. This study investigates IB students from one selective independent school who entered UK universities between…

Nuclear power and public acceptance in the UK

International Nuclear Information System (INIS)

Baker, J.W.

1985-01-01

The subject is covered in sections: introduction; UK nuclear experience (experience of the Central Electricity Generating Board; impartial assessment); Sizewell inquiry (into proposal to construct a PWR based plant as Sizewell B; inquiry process; ground covered; economics and safety; project management); public acceptance (sociological studies); long-term programme. (U.K.)

Educating nurses to care for military veterans in civilian hospitals: An integrated literature review.

Science.gov (United States)

Cooper, Linda; Andrew, Sharon; Fossey, Matt

2016-12-01

In the UK, military veterans will receive care by civilian nurses in civilian hospitals. We propose that the nurses providing this care require an understanding of the unique experiences and specific health needs of veterans to deliver evidence-based care. To conduct an integrative review of published literature to explore how nursing programmes prepare nurses to care for the military veteran population in civilian hospitals. A systematic search was undertaken of a range of electronic databases, Google Scholar and hand searching of Military and Veteran health journals. Papers that focused on education of civilian nurses about veteran health and included primary research or description of practice-based innovations were included in the review. The search generated sixteen papers that were focused on nurse education in higher education institutions. Several papers focused on simulation as a teaching method for veteran-specific health issues or curriculum developments with educational innovations such as online courses. Six papers focusing in continuing professional education of nurses in the clinical setting were included as supplementary information. All papers reviewed were US focused and dated between January 2011 and September 2015. Our search concluded that there is a gap in knowledge in this subject area within a UK context, therefore our review includes UK background information to support the US findings. Civilian nurses need educational preparation to understand the specific needs of veterans. Educational institutions in the US have responded to nationwide initiatives to undertake that preparation. More empirical studies need to be undertaken to develop, test and evaluate educational innovations for preparing students and nurses delivering care to military veteran in civilian healthcare settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Phase 1 implementation of nutrition screening in a Dublin acute teaching hospital

LENUS (Irish Health Repository)

2014-01-01

Nutrition Screening Week results from 2010 and 2011 indicated that one in three to four patients admitted to Irish Hospitals are at risk of disease-related malnutrition, 74-75% of whom are at high risk1. Nutrition screening tools are used to screen for malnutrition risk. One such tool, the Malnutrition Universal Screening Tool (MUST)2 is a practical, easy to use tool that often takes ≤5 minutes to complete. MUST has been validated across care settings and across patient populations, and has been recommended for use in Irish Hospitals by the Department of Health and Children as part of standard care3. The National Institute for Health and Clinical Excellence in the UK has demonstrated significant financial savings associated with the use of routine nutrition screening, in part due to reduced length of hospital stay4. The Irish Society for Clinical Nutrition and Metabolism (IrSPEN) has also demonstrated this5

Overexpression of antibiotic resistance genes in hospital effluents over time.

Science.gov (United States)

Rowe, Will P M; Baker-Austin, Craig; Verner-Jeffreys, David W; Ryan, Jim J; Micallef, Christianne; Maskell, Duncan J; Pearce, Gareth P

2017-06-01

Effluents contain a diverse abundance of antibiotic resistance genes that augment the resistome of receiving aquatic environments. However, uncertainty remains regarding their temporal persistence, transcription and response to anthropogenic factors, such as antibiotic usage. We present a spatiotemporal study within a river catchment (River Cam, UK) that aims to determine the contribution of antibiotic resistance gene-containing effluents originating from sites of varying antibiotic usage to the receiving environment. Gene abundance in effluents (municipal hospital and dairy farm) was compared against background samples of the receiving aquatic environment (i.e. the catchment source) to determine the resistome contribution of effluents. We used metagenomics and metatranscriptomics to correlate DNA and RNA abundance and identified differentially regulated gene transcripts. We found that mean antibiotic resistance gene and transcript abundances were correlated for both hospital ( ρ  = 0.9, two-tailed P  hospital effluent samples. High β-lactam resistance gene transcript abundance was related to hospital antibiotic usage over time and hospital effluents contained antibiotic residues. We conclude that effluents contribute high levels of antibiotic resistance genes to the aquatic environment; these genes are expressed at significant levels and are possibly related to the level of antibiotic usage at the effluent source. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

UK Hazard Assessment for a Laki-type Volcanic Eruption

Science.gov (United States)

Witham, Claire; Felton, Chris; Daud, Sophie; Aspinall, Willy; Braban, Christine; Loughlin, Sue; Hort, Matthew; Schmidt, Anja; Vieno, Massimo

2014-05-01

Following the impacts of the Eyjafjallajokull eruption in 2010, two types of volcanic eruption have been added to the UK Government's National Risk Register for Civil Emergencies. One of these, a large gas-rich volcanic eruption, was identified as a high impact natural hazard, one of the three highest priority natural hazards faced by the UK. This eruption scenario is typified by the Laki eruption in Iceland in 1783-1784. The Civil Contingency Secretariat (CCS) of the UK's Cabinet Office, responsible for Civil Protection in the UK, has since been working on quantifying the risk and better understanding its potential impacts. This involves cross-cutting work across UK Government departments and the wider scientific community in order to identify the capabilities needed to respond to an effusive eruption, to exercise the response and develop increased resilience where possible. As part of its current work, CCS has been working closely with the UK Met Office and other UK agencies and academics (represented by the co-authors and others) to generate and assess the impacts of a 'reasonable worst case scenario', which can be used for decision making and preparation in advance of an eruption. Information from the literature and the findings of an expert elicitation have been synthesised to determine appropriate eruption source term parameters and associated uncertainties. This scenario is then being used to create a limited ensemble of model simulations of the dispersion and chemical conversion of the emissions of volcanic gases during such an eruption. The UK Met Office's NAME Lagrangian dispersion model and the Centre for Ecology and Hydrology's EMEP4UK Eulerian model are both being used. Modelling outputs will address the likelihood of near-surface concentrations of sulphur and halogen species being above specified health thresholds. Concentrations at aviation relevant altitudes will also be evaluated, as well as the effects of acid deposition of volcanic species on

Financing small scale wind energy projects in the UK

International Nuclear Information System (INIS)

Mitchell, Catherine

1993-01-01

This paper shows how wind energy projects in the UK have obtained finance. It attempts to list the financing options open to small scale developments and to note any likely problems which may occur. (UK)

The interpretability of doctor identification badges in UK hospitals: a survey of nurses and patients.

Science.gov (United States)

Hickerton, Bethan C; Fitzgerald, Daniel John; Perry, Elizabeth; De Bolla, Alan R

2014-07-01

Hospital badges have multiple important purposes, but their essential role remains the clear identification of the bearer, including their professional status. The modernisation of medical careers in the National Health Service has changed terminology dramatically, resulting in a plethora of new job titles emerging among both doctors and nurses. To determine whether the new or old terminology allowed clearer identification of medical doctors by patients and nurses. We replicated 11 identification badges used in the Royal Cornwall Hospital and Wrexham Maelor Hospital, both current and before the introduction of new medical training terminology. Data were collected from 114 patients and 67 nurses, by asking them to (1) identify which name badges represented doctors and (2) rank them in order of seniority. Only 11% of patients and 60% of nurses identified a 'Foundation Year 1 Trainee' as a qualified medical doctor. Indeed, only 'General Practice Vocational Trainee' and 'Consultant' were both readily identifiable as qualified doctors to both patients and nurses. Ranking was also a problem, with only 19% of patients and 45% of nurses able to correctly grade medical doctors using the current terminology. The old terminology allowed more accurate identification by nurses, with over 80% successfully ranking and marking the title appropriately. Current terminology is a source of confusion to both patients and members of the immediate medical care team, with nurses unable to correctly identify medical doctors. Our study indicates that a review of terminology is necessary to ensure patients, and staff, are able to communicate effectively. 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.

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.

Patient dose measurement and dose reduction in East Anglia (UK)

International Nuclear Information System (INIS)

Wade, J.P.; Goldstone, K.E.; Dendy, P.P.

1995-01-01

At the end of 1990 a programme of patient dose measurements was introduced as part of the quality assurance service already provided for X ray departments throughout the East Anglian Health Region (UK). Thermoluminescence dosemeters (TLDs) were used to measure over 1200 skin entrance surface doses for four common radiographic views in 33 hospitals in both the NHS and private sector. The four views were chosen to cover a wide range of equipment and techniques. The data collected have enabled Regional reference doses to be set which, for all views considered, fall below the National Radiological Protection Board (NRPB) Reference levels. In departments which exceeded reference levels, techniques were reviewed, improvements suggested and doses re-measured, in accordance with the recommended procedure for patient dose audit. A significant finding was that, given appropriate controls, X ray departments in the private sector could achieve the same acceptably low doses as NHS departments. (Author)

The impact of energy price shocks on the UK economy

International Nuclear Information System (INIS)

2007-01-01

This report describes the results of six scenarios considering the impact of energy price shocks on the UK economy. The six scenarios considered are: UK aggregate energy price scenario; pan-Europe aggregate energy price; global aggregate energy price; UK temporary gas price; UK permanent gas price; crude (Brent) oil price. As expected, shocks to aggregate energy prices cause the largest macroeconomic and energy demand effects (in terms of growth rate volatility). Shocks to gas prices produce a greater growth volatility for macroeconomic and energy demand than shocks to oil prices. In general terms, shocks specific to the UK market tend to produce more growth rate volatility than wider ranging price shocks (global or pan-European). All of the price shocks considered have a recursive effect on the main indicators, which tend to stabilise around the baseline level in the long run. The report summarises the results obtained in the different scenarios

UK Citizens Lack Simple, Objective Knowledge of the European Union

DEFF Research Database (Denmark)

Manners, Ian James

2017-01-01

214); ‘A direct European tax will be created’ (EBS 214); ‘National citizenship will disappear’ (EBS 214); and ‘Most of the European budget is spent on administrative and personnel costs’ (EB65) UK respondents were far more likely to answer incorrectly that these were true. This is likely the result...... of disinformation in UK politics and media. The data suggests that not only are UK respondents unable to answer simple questions about the EU, but that they are relatively more likely to answer incorrectly rather than admit they did not know, reflecting disinformation about the EU in the UK. This lack of simple...

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.

Survey of employment in the UK wind energy industry

International Nuclear Information System (INIS)

Jenkins, G.

1997-01-01

A survey of employment in the UK wind energy industry has been carried out. It related to the financial years 1993-4 and 1994-5. A questionnaire was sent to all organisations working in wind energy in the UK. Some 249 replies were received. The paper reports on the findings regarding overall employment in the industry, employment in the major sectors of the industry, jobs by type of organisation, the major employers, the location of jobs, and the overall impact on employment in the UK economy. (Author)

Perspectives of nuclear power in the UK - the view of a utility

International Nuclear Information System (INIS)

Golby, P.

2007-01-01

Nuclear energy is back on the agenda in UK due to the discussion about climate change and security of supply. First, the UK has to face up to the challenges of reducing its greenhouse gas emissions. The UK Government has adopted a clear leadership position on climate change internationally. Second, UK is facing some fundamental questions about the future security of the energy supplies. The decline of UKs' gas reserves in the North Sea is bringing to an end the years in which the UK could afford to be relatively relaxed energy and energy policy almost took care of itself. We are expecting the next major milestone with the UK Government due to publish an 'Energy Withe Paper'. Alongside that document they are also due to launch a new consultation on nuclear power and whether it should have a role in the UK market. For investment in nuclear to be a credible economic option for investors a number of issues will need to be addressed by the UK Government. These issues include the public and political acceptance, the management of the waste by the Government, and an efficient regulatory and licensing framework for new plants. Two words should be addressed to the UK Government at the moment - urgency and partnership. Urgency - because we desperately need to see progress on energy policy over the next 12 months. It is 5 minutes to midnight and the clock is ticking. Partnership - because investors are ready to make the necessary investments but we need in the UK the long-term policy framework that will underpin and support the scale of the investment we need to see. (orig.)

A review of the UK fast reactor programme

International Nuclear Information System (INIS)

Picker, C.; Ainsworth, K.F.

1996-01-01

The general position with regard to nuclear power and fast reactors in UK during 1995 is described. The status of fast reactor studies made in UK is outlined and a description and statement regarding the conclusions of the programme of studies associated with the closure of the Prototype Fast Reactor is included. (author)

A review of the UK fast reactor programme

Energy Technology Data Exchange (ETDEWEB)

Picker, C [AEA Technolgy plc, Risley, Warrington, Cheshire (United Kingdom); Ainsworth, K F [British Nuclear Fuels plc, Sellafield, Cumbria (United Kingdom)

1996-07-01

The general position with regard to nuclear power and fast reactors in UK during 1995 is described. The status of fast reactor studies made in UK is outlined and a description and statement regarding the conclusions of the programme of studies associated with the closure of the Prototype Fast Reactor is included. (author)

Stress among UK Academics: Identifying Who Copes Best

Science.gov (United States)

Darabi, Mitra; Macaskill, Ann; Reidy, Lisa

2017-01-01

This article examined levels of stress and associated coping strategies among UK academics. Adopting a positive psychology approach, the influence of the character strengths of hope, optimism, gratitude and self-efficacy on stress, subjective well-being (SWB), and mental health was examined in 216 academics in a UK university. The study explored…

LLW disposal wasteform preparation in the UK: the role of high force compaction

Energy Technology Data Exchange (ETDEWEB)

Johnson, L. F.; Fearnley, I. G. [British Nuclear Fuels Ltd., Sellafield (United Kingdom)

1991-07-01

British Nuclear Fuels plc (BNFL) owns and operates the principal UK solid low level radioactive waste (LLW) disposal site. The site is located at Drigg in West Cumbria some 6 km to the south east of BNFL's Sellafield reprocessing complex. Sellafield is the major UK generator of LLW, accounting for about 85% of estimated future arisings of raw (untreated, unpackaged) waste. Non-Sellafield consignors to the Drigg site include other BNFL production establishments, nuclear power stations, sites of UKAEA, Ministry of Defence facilities, hospitals, universities, radioisotope production sites and various other industrial organisations. In September 1987, BNFL announced a major upgrade of operations at the Drigg site aimed at improving management practices, the efficiency of space utilisation and enhancing the visual impact of disposal operations. During 1989 a review of plans for compaction and containerisation of Sellafield waste identified that residual voidage in ISO freight containers could be significant even after the introduction of compaction. Subsequent studies which examined a range of compaction and packaging options concluded that the preferred scheme centred on the use of high force compaction (HFC) of compactable waste, and grouting to take up readily accessible voidage in the wasteform. The paper describes the emergence of high force compaction as the preferred scheme for wasteform preparation and subsequent benefits against the background of the overall development of Low Level Waste disposal operations at Drigg.

LLW disposal wasteform preparation in the UK: the role of high force compaction

International Nuclear Information System (INIS)

Johnson, L. F.; Fearnley, I. G.

1991-01-01

British Nuclear Fuels plc (BNFL) owns and operates the principal UK solid low level radioactive waste (LLW) disposal site. The site is located at Drigg in West Cumbria some 6 km to the south east of BNFL's Sellafield reprocessing complex. Sellafield is the major UK generator of LLW, accounting for about 85% of estimated future arisings of raw (untreated, unpackaged) waste. Non-Sellafield consignors to the Drigg site include other BNFL production establishments, nuclear power stations, sites of UKAEA, Ministry of Defence facilities, hospitals, universities, radioisotope production sites and various other industrial organisations. In September 1987, BNFL announced a major upgrade of operations at the Drigg site aimed at improving management practices, the efficiency of space utilisation and enhancing the visual impact of disposal operations. During 1989 a review of plans for compaction and containerisation of Sellafield waste identified that residual voidage in ISO freight containers could be significant even after the introduction of compaction. Subsequent studies which examined a range of compaction and packaging options concluded that the preferred scheme centred on the use of high force compaction (HFC) of compactable waste, and grouting to take up readily accessible voidage in the wasteform. The paper describes the emergence of high force compaction as the preferred scheme for wasteform preparation and subsequent benefits against the background of the overall development of Low Level Waste disposal operations at Drigg

Sizewell: UK power demand

International Nuclear Information System (INIS)

Anon.

1986-01-01

The Sizewell Inquiry was about whether the next power stations to be built in the UK should be nuclear or coal and, if nuclear, PWRs or AGRs. During the period of the Inquiry forecasts of demand for electricity were low. Now, however, it seems that the forecast demand is much increased. This uncertainty in demand and the wide regional variations are examined in some detail. Facts and figures on electricity sales (area by area) are presented. Also the minutes of supply lost per consumer per year. These show that security of supply is also a problem. It is also shown that the way electricity is used has changed. Whilst electricity generation has been changing to large-scale, centralised power stations the demand patterns may make smaller scale, quickly-constructed units more sensible. The questions considered at the Sizewell Inquiry may, indeed, no longer be the right ones. (UK)

The Continental Market Seen from the UK

International Nuclear Information System (INIS)

Romieu, Michel

1998-01-01

In this presentation, the Chairman of a French gas company (Elf) comments on the evolution of the Continental gas market from a British point of view. He first discusses the differences between the US, British and Continental gas markets, recalls the provisions of the European Gas Directive and states why a fully competitive system is a long-term prospect in Continental Europe. Seen from the UK, the provisions of the EU directive may appear modest. Due to the long transportation, British gas companies may find it hard to compete on the gas market of Continental Europe. When Inter connector, the gas pipeline connecting the gas markets in UK and the Continent, begins operation, there will be a flow of gas from the UK to the Continent according to already signed contracts. But there may be contractual flows both ways. Gas prices will level off between the UK and Northern Europe, at least for the industry. The continental markets will change gradually, the Gas Directive and the Inter connector will help the move towards a more competitive gas industry, but the fundamentals will not change: low gas prices for the next few years, competition between the big three exporters to Continental Europe, and long-term contracts that will extend beyond 2005

The Vocal Euro-outsider: The UK in a Two-speed Europe

DEFF Research Database (Denmark)

Adler-Nissen, Rebecca

2016-01-01

The EU is divided between member states that have adopted the euro and those that have not. This article looks at the issue of differentiated integration with particular reference to eurozone integration and the euro-outsiders. I explore the recent public debate in the UK on euro......-outsiderness, comparing this with debates in Denmark. The article highlights some striking differences between the UK and Denmark when it comes to the actual management of euro-outsiderness in Brussels as well as some of the dilemmas facing euro-outsiders such as the UK, Denmark, Sweden and Poland as the EU struggles...... to exit its crises. Finally, I discuss the future of two-speed European integration and the UK's possible exit from the EU. The UK cannot escape the dilemma of favouring either influence or autonomy; whether the UK remains in or leaves the EU, it will need to allow the eurozone to proceed in order...

Analysing UK real estate market forecast disagreement

OpenAIRE

McAllister, Patrick; Newell, G.; Matysiak, George

2005-01-01

Given the significance of forecasting in real estate investment decisions, this paper investigates forecast uncertainty and disagreement in real estate market forecasts. Using the Investment Property Forum (IPF) quarterly survey amongst UK independent real estate forecasters, these real estate forecasts are compared with actual real estate performance to assess a number of real estate forecasting issues in the UK over 1999-2004, including real estate forecast error, bias and consensus. The re...

Organisation of the disposal of radioactive sources from Scottish hospitals

International Nuclear Information System (INIS)

Corrigall, R S; Martin, C J; Watson, I

2004-01-01

An amnesty for disposal of sealed radioactive sources from Scottish hospitals has been funded by the Scottish Executive to address problems arising from accumulation of sources. The contract was awarded to a company involved in radioactive source recycling. Coordination of uplifts from several hospitals allowed considerable financial savings to be made, so source amnesties could offer monetary advantages to Health and Education Departments elsewhere in the UK, as well as alleviating the problem from security and storage of sources that are no longer required. The sources originated in 14 hospitals, but were uplifted from five pick-up points. There were a total of 246 sources with 167 of these being caesium-137. The total activity was 16.2 TBq with one large 16.1 TBq blood irradiator source and the activities of all the other sources adding up to 167 GBq. This paper describes organisation of the collection. Options for achieving compliance with the Radioactive Substances Act 1993 are discussed, although in the event, special authorisations were obtained for each hospital. Arrangements for transport of the sources and source security were drawn up including emergency procedures for dealing with foreseeable incidents. The police provided secure overnight storage for the loaded truck and assistance in directing and monitoring progress of the load

The UK shielding Forum. Best Practice through consensus

International Nuclear Information System (INIS)

Hobson, J.; Gunston, K.; Gunston, K.

2000-01-01

The UK national shielding Forum has been established to represent all key industry groups in the UK (including the Nuclear Installations Inspectorate (NII), the national regulatory authority). The Forum's aim is to increase awareness and confidence in the range of professional practice within the UK shielding community, with a view to having a coherent and dynamic role within the international shielding community. In the past, no comprehensive representative body covering the whole UK nuclear industry has existed, and the different industry shielding groups have developed local ways of working to address their particular requirements. Inevitably, there are common issues arising from these requirements which benefit from a wider consensus. As a result of the formation of the Forum (initiated by the NII and subsequently chaired by BNFL as an industry key player), expertise, experience and best working practice are now being actively shared between shielding professionals, and there has been a strong and successful drive to achieving consensus on key issues, which is also reflected in the increasing quality of industry-regulator relationships. (author)

Automated Mobility Transitions: Governing Processes in the UK

Directory of Open Access Journals (Sweden)

Debbie Hopkins

2018-03-01

Full Text Available Contemporary systems of mobility are undergoing a transition towards automation. In the UK, this transition is being led by (often new partnerships between incumbent manufacturers and new entrants, in collaboration with national governments, local/regional councils, and research institutions. This paper first offers a framework for analyzing the governance of the transition, adapting ideas from the Transition Management (TM perspective, and then applies the framework to ongoing automated vehicle transition dynamics in the UK. The empirical analysis suggests that the UK has adopted a reasonably comprehensive approach to the governing of automated vehicle innovation but that this approach cannot be characterized as sufficiently inclusive, democratic, diverse and open. The lack of inclusivity, democracy, diversity and openness is symptomatic of the post-political character of how the UK’s automated mobility transition is being governed. The paper ends with a call for a reconfiguration of the automated vehicle transition in the UK and beyond, so that much more space is created for dissent and for reflexive and comprehensive big picture thinking on (automated mobility futures.

UK parliamentary debate analysis: bombing ISIL in Syria.

Science.gov (United States)

Rashed, Haifa

2016-01-01

This paper examines the arguments presented for and against the UK government's motion for the UK to intervene militarily in Syria in the House of Commons debate on ISIL in Syria that took place on 2 December 2015. It considers what the most common arguments were in favour of and in opposition to the motion as well as which arguments were given the most emphasis, in order to understand the prime justifications given that led to the decision to approve the motion. It suggests that due to the shadow of the 2003 Iraq war, politicians in the debate placed a considerable emphasis on the legal justification for military intervention. It argues that the focus on the national security of the UK and its allies in this particular debate seems to contrast with previous military interventions where humanitarian motives were more widely stated. This paper calls for further comparative research of parliamentary debates in order to track such changes in the rhetoric used by UK politicians to defend their support for military intervention.

Metal Recycling in the UK - a decade of developments

International Nuclear Information System (INIS)

Robinson, Joe

2014-01-01

In the last 10 years, metal recycling in the UK has developed from a rarely used technique to a cornerstone of the UK national LLW strategy. The paper will explore the drivers for developing the metal recycling supply chain, policy and legislative developments, key milestones, and consider issues with market development both in its initial slow phases and now in a rapidly developing mode. The paper will contrast some of the initial inertia and blockers in the UK with the now-proven benefits of the approach, including financial, environmental and ethical. (author)

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.

UK wants more revenue from North Sea oil

Energy Technology Data Exchange (ETDEWEB)

1973-03-09

The first report from the Committee of Public Accounts of the UK Parliament on North Sea gas and oil has revealed a situation under which the UK Exchequer apparently does not receive cash intake comparable to the Exchequers of other oil producing countries. So important are these findings that some of them are presented so that the industry at large, and particularly those engaged in North Sea exploration and production, will be aware of the UK situation. Recomendations are made that the government should take action substantially to improve the effective tax yield from operations on the continental shelf, and should consider among other methods the possibility of imposing a system of quantity taxation.

In the loop Large Hadron Collider project - UK engineering firms

CERN Document Server

Wilks, N

2004-01-01

This paper presents the latest measures being taken to boost the level of UK engineering firms' involvement in research at CERN (Centre for Nuclear Research), including its 27 km circular Large Hadron Collider (LHC) project. Virtually all of the components on this complex project have had to be custom-made, usually in the form of collaboration. It is part of these collaborations that some UK firms have proved they can shine. However, despite the proven capabilities, the financial return continues to be less than the government's funding. Each of the 20 CERN member states provides funds in proportion to its GDP and the UK is the second largest financial contributor. UK firms become price-competitive where a contract calls for a degree of customisation or product development, project management and tight quality control. Development of the Particle Physics Grid, for dissemination and analysis of data from the LHC, continues to provide major supply opportunities for UK manufacturers.

The UK-DALE dataset, domestic appliance-level electricity demand and whole-house demand from five UK homes.

Science.gov (United States)

Kelly, Jack; Knottenbelt, William

2015-01-01

Many countries are rolling out smart electricity meters. These measure a home's total power demand. However, research into consumer behaviour suggests that consumers are best able to improve their energy efficiency when provided with itemised, appliance-by-appliance consumption information. Energy disaggregation is a computational technique for estimating appliance-by-appliance energy consumption from a whole-house meter signal. To conduct research on disaggregation algorithms, researchers require data describing not just the aggregate demand per building but also the 'ground truth' demand of individual appliances. In this context, we present UK-DALE: an open-access dataset from the UK recording Domestic Appliance-Level Electricity at a sample rate of 16 kHz for the whole-house and at 1/6 Hz for individual appliances. This is the first open access UK dataset at this temporal resolution. We recorded from five houses, one of which was recorded for 655 days, the longest duration we are aware of for any energy dataset at this sample rate. We also describe the low-cost, open-source, wireless system we built for collecting our dataset.

"UK today" Tallinnas / Tuuli Oder

Index Scriptorium Estoniae

Oder, Tuuli, 1958-

2001-01-01

Vabariikliku inglise keele olümpiaadi raames toimus Tallinnas viktoriini "UK today" lõppvoor. Osalesid 22 kooli kaheliikmelised võistkonnad. Viktoriini tulemused koolide lõikes ja küsimused õigete vastustega

How do food bloggers and PR practitioners in the hospitality sector view their relationships? A UK perspective / ¿Cómo ven su relación los bloggers de alimentos y los profesionales de relaciones públicas en el sector de la hostelería? Desde Reino Unido

Directory of Open Access Journals (Sweden)

Liz Yeomans

2014-10-01

Full Text Available Bloggers are increasingly viewed by public relations practitioners as important influencers within the online media environment, yet research that explores relationships between bloggers and PR practitioners, particularly in the UK, is relatively limited. This paper reports on findings from a small-scale, in depth qualitative study of food blogger-practitioner relationships within the hospitality sector in the UK. The study explored why bloggers write about their restaurant experiences and how they view their relationships with PR professionals; while PR practitioners were questioned about their relationships with bloggers and the influence bloggers are having on PR clients’ reputations. In keeping with previous research, this study found that the practitioner-blogger relationship is complex. The PR practitioners interviewed within the hospitality sector viewed restaurant review bloggers as highly influential to their clients’ reputations and view the relationship as one that is built on mutual interests and trust. However, bloggers do not perceive the relationship in this light and are sceptical of PR practitioners’ motives. While bloggers had different motivations for blogging, they shared a common passion for blogging and a drive to provide reliable information and objective advice to their readers. Concerns within the blogging community were highlighted in regard to accepting incentives (free meals from PR practitioners, and how this can be damaging to bloggers’ reputations. While some bloggers claim to resist PR practitioners’ attempts to influence their blog content, other bloggers take an active role in building relationships with PR practitioners. It is argued that both parties are engaged in ‘identity work’ in order to protect their respective identities and practices and that emotion management plays a part in the practitioner-blogger relationship.

Why nuclear power failed the market test in the UK

International Nuclear Information System (INIS)

Chesshire, J.

1992-01-01

The Conservative Party's manifesto for the general election of May 1987 contained two pledges of relevance to the UK electricity supply industry (ESI). These were to privatize the industry; and to continue to support the development of civil nuclear power in the private sector. As anticipated by some independent commentators, in the event these objectives proved incompatible. The costs of nuclear power have long been a vexed issue and UK nuclear costs have been higher than those in many other countries. While most of the UK ESI has now been privatized, nuclear generation remains in the public sector. This article seeks to explore the reasons for this fundamental and politically embarrassing policy reversal, a rarity under three successive Conservative administrations since 1979. It would be incorrect to argue that private ownership and nuclear power are inherently incompatible. Rather the specific - competitive - form of privatization proposed for the UK failed to provide sufficient guarantees for the London capital market. Thus, at least in this specific case, nuclear power failed the market test. The implications of this for the UK nuclear industry have been profound. As a result, the UK case has wider international lessons as the pressures for privatization, liberalization and greater cost transparency bear down upon electric utilities in other countries. (author)

UK Chemical Nuclear Data Committee progress report

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)

Worldwide open access: UK leadership?

Directory of Open Access Journals (Sweden)

Stevan Harnad

2013-03-01

Full Text Available The web is destined to become humankind's cognitive commons, where digital knowledge is jointly created and freely shared. The UK has been a leader in the global movement toward open access (OA to research but recently its leadership has been derailed by the joint influence of the publishing industry lobby from without and well-intentioned but premature and unhelpful over-reaching from within the OA movement itself. The result has been the extremely counterproductive ‘Finch Report’ followed by a new draft of the Research Councils UK (RCUK OA mandate, downgrading the role of cost-free OA self-archiving of research publications (‘green OA’ in favor of paying subscription publishers over and above subscriptions, out of scarce research funds, in exchange for making single articles OA (‘hybrid gold OA’. The motivation of the new policy is to reform publication and to gain certain re-use rights (CC-BY, but the likely effect would be researcher resistance, very little OA and a waste of research funds. There is still time to fix the RCUK mandate and restore the UK's leadership by taking a few very specific steps to clarify and strengthen the green component by adding a mechanism for monitoring and verifying compliance, with consequences for non-compliance, along lines also being adopted in the EC and the US.

Public health research in the UK: a report with a European perspective.

Science.gov (United States)

McCarthy, Mark; Dyakova, Mariana; Clarke, Aileen

2014-06-01

Public health research is of growing interest within Europe. Bibliometric research shows the UK with a high absolute output of public health publications, although lower per capita than Nordic countries. UK contributed to a European Union (EU) project PHIRE to assess public health research and innovation. UK health research structures, and programmes funded in 2010, were determined from internet search. Expert informants were asked to comment on national uptake of eight projects EU collaborative health projects. The Faculty of Public Health and the UK Society for Social Medicine discussed the findings at a meeting with stakeholders. Health research in UK is funded by research councils, the National Health Service (NHS) and independent foundations. Reviews and reports on public health research have encouraged diversified funding. There were 15 programmes and calls in 2010. The UK participated in all eight EU projects, and there was uptake of results for four. Strategic coordination between public health researchers and practitioners, and the UK research councils, ministries of health and medical charities would strengthen research for policy and practice. With growing expertise and capacity across other EU countries, the UK should take more active leadership in European collaboration. © The Author 2013, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.

Resilience improvements to UK nuclear power plants

International Nuclear Information System (INIS)

Pepper, Kevin

2015-01-01

Following the events at Fukushima, the Office for Nuclear Regulation (ONR), the UK nuclear safety regulator, undertook a series of reviews into the resilience of UK nuclear power plants to severe events. These reviews highlighted a number of areas in relation to electrical infrastructure where it considered licensees should review their arrangements, considering both onsite and offsite infrastructure as well as the ability to recover following a complete loss of site infrastructure. In response, UK licensees have been exploring four parallel approaches to improving the resilience for each of their sites. Firstly, through modifications on-site such as enhancements to the installed diesel generators and related systems. Secondly through improvements to the resilience of essential instrumentation to Station Black Out events. Thirdly, through the provision of off-site backup equipment that can be deployed to any site following a severe event. Finally, the provision of event qualified connection points on site to enable timely restoration of long term essential electrical supplies and cooling to key systems. This last item gives a central focus to the issues of switchboard availability and the resilience of the whole network to large potentially common cause internal and external hazards. This paper will discuss the electrically related findings of the ONR reviews, explore the reasoning behind those decisions, and describe the approaches being taken by UK licensees. (authors)

U.K. policy responses to international influences - nuclear power

International Nuclear Information System (INIS)

Jones, P.M.S.

1978-01-01

An account is given of U.K. participation in international discussions directed towards the safe development and application of nuclear power. Particular attention is given to the International Fuel Cycle Evaluation (INFCE), which is stated to be looking at the whole question of proliferation and the merits and disadvantages of a range of alternative fuel cycles and nuclear power strategies. A summary is also given of U.K. participation in work on radiological protection (through the I.C.R.P.) and radioactive waste disposal. International cooperation in research and development is mentioned. Public involvement in policy making is also discussed briefly. (U.K.)

U.K. nuclear data progress report January-December 1986

International Nuclear Information System (INIS)

Sene, M.R.; Cookson, J.A.

1987-06-01

The paper is the United Kingdom Nuclear Data (UKND) progress report, and summarises nuclear data research in the UK between January and December 1986. The contents of the report contains nuclear data work presented by:- UKAEA Harwell, UKAEA Winfrith, National Physical Laboratory, and the Universities of Birmingham, Edinburgh and Oxford. Included in these contributions are collaborative studies involving institutions in Holland, Italy, West Germany and the United States. The report also contains contributions on Chemical Nuclear Data, as well as the summaries of three invited lectures presented at the 19th UK Nuclear Data Form, Harwell Laboratory, 1986. (U.K.)

Design adaptation to the local context - Example of the UK EPR

International Nuclear Information System (INIS)

Dupuis, Joseph

2014-01-01

The Chief Executive Officer of SOFINEL, Joseph Dupuis, explained how the EPR design was adapted to the UK context and, in particular, the main modifications that were implemented to conform with UK specific regulations. He also presented the cultural and/or technical differences that had to be taken into account for managing the UK EPR project

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

Science.gov (United States)

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

2017-01-01

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

Staffing UK University Campuses Overseas: Lessons from MNE Practice

Science.gov (United States)

Salt, John; Wood, Peter

2014-01-01

This article suggests that as their internal labor markets become more multinational in scope, UK universities may acquire similar staffing characteristics to commercial multinational enterprises (MNEs). Comparing evidence from four UK universities with several surveys of MNEs it concludes that, although there are broad similarities in the…

To explore preferences and willingness to pay for attributes regarding stoma appliances amongst patients in the UK, France and Germany.

Science.gov (United States)

Nafees, Beenish; Lloyd, Andrew; Elkin, Eric; Porret, Terri

2015-04-01

To explore patient preferences regarding stoma appliances in the UK, France and Germany and to estimate willingness to pay (WTP) for attributes of stoma appliances. A discrete choice (DCE) survey was developed based on published literature, attributes of current available appliances and qualitative interviews with patients from the UK (N = 3), France (N = 2) and Germany (N = 2). Members from a patient panel in the UK, France and Germany were asked to participate in the DCE survey and to fill out two quality of life (QoL) questionnaires. Data were analyzed using the conditional logit model whereby the coefficients obtained from the model provided an estimate of the (log) odds ratios (ORs) of preference for attributes. WTP was estimated for each level of a given identified attribute. Seven key attributes were identified for the DCE survey: comfort and elastic flexibility, skin problems, early detection of leakage, leakage, filter performance, service/help after hospital discharge and out-of-pocket cost. A total of 415 participants (166 patients in UK, 99 in France, and 150 in Germany) completed the questionnaires. All attributes were significant predictors of choice. The two most important drivers of preference were the attributes comfort and elastic flexibility and skin problems which resulted in high WTP values. Appliances which were able to detect episodes of leakage were also of high importance to participants' appliances. The results show the importance of different attributes of stoma appliances for patients. Improving comfort and elastic flexibility, and risk of skin problems were the most important aspects of appliances. The WTP values indicate the value people place on improvement in each attribute of appliances.

UK school visit: Alfriston School for girls

CERN Multimedia

Sophie Louise Hetherton

2014-01-01

Pupils with learning disabilities from Alfriston School in the UK visited the CMS detector last week. This visit was funded by the UK's Science and Technologies Facilities Council (STFC) as part of a grant awarded to support activities that will help to build the girls’ self-esteem and interest in physics.   Alfriston School students at CMS. On Friday, 10 October, pupils from Alfriston School – a UK secondary school catering for girls with a wide range of special educational needs and disabilities – paid a special visit to CERN. Dave Waterman, a science teacher at the school, recently received a Public Engagement Small Award from the STFC, which enabled the group of girls and accompanying teachers to travel to Switzerland and visit CERN. The awards form part of a project to boost the girls’ confidence and interest in physics. The aim is to create enthusiastic role models with first-hand experience of science who can inspire their peers back hom...

UK Minister enthusiastic after visit to CERN

CERN Multimedia

2008-01-01

ON Tuesday 5 August the UK Secretary of State for Innovation, Universities and Skills, John Denham, came to CERN. The UK continues its strong links with CERN.The Minister was welcomed on arrival at CERN by Robert Aymar, the Director-General, and senior British scientists. Following a short presentation, he began a comprehensive tour of the Laboratory with a visit to both the LHC at point 5 and the CMS experiment. After lunch the Minister’s busy schedule continued, completing his overview of the main areas of UK participation at CERN. As soon as he had signed the guest book, he was whisked off to visit the LHCb experiment, the LHC computing grid project (LCG) and the ATLAS control room. However, the last item on his itinerary was perhaps the most illuminating. Meeting a diverse group of British scientists, from technical and summer students to staff members with more than 30 years of experience, the Minister had the opportunity...

The alcohol industry, charities and policy influence in the UK

Science.gov (United States)

Lyness, Sarah M

2014-01-01

Background: Charities exist to pursue a public benefit, whereas corporations serve the interests of their shareholders. The alcohol industry uses corporate social responsibility activities to further its interests in influencing alcohol policy. Many charities also seek to influence alcohol and other policy. The aim of this study was to explore relationships between the alcohol industry and charities in the UK and whether these relationships may be used as a method of influencing alcohol policy. Methods: The charity regulator websites for England and Wales and for Scotland were the main data sources used to identify charities involved in UK alcohol policy making processes and/or funded by the alcohol industry. Results: Five charities were identified that both receive alcohol industry funding and are active in UK alcohol policy processes: Drinkaware; the Robertson Trust; British Institute of Innkeeping; Mentor UK and Addaction. The latter two are the sole remaining non-industry non-governmental members of the controversial responsibility deal alcohol network, from which all other public health interests have resigned. Conclusion: This study raises questions about the extent to which the alcohol industry is using UK charities as vehicles to further their own interests in UK alcohol policy. Mechanisms of industry influence in alcohol policy making globally is an important target for further investigations designed to assist the implementation of evidenced-based policies. PMID:24913316

Care adjustments for people with learning disabilities in hospitals.

Science.gov (United States)

Blair, Jim

2011-12-01

Health inequalities start early in life for people with learning disabilities. In the UK, they can arise from various barriers that people experience when trying to access care that should be appropriate, timely and effective. Inequalities in health care are likely to result in many NHS organisations breaching their legal responsibilities, as outlined in the Disability Discrimination Acts 1995 and 2005, the Equality Act 2010 and the Mental Capacity Act 2005 (Emerson and Baines 2010). This article seeks to help nurses, healthcare professionals and hospital managers ensure that better services are delivered by encouraging them to explore how reasonable adjustments can improve outcomes for people with learning disabilities.

The use of an exclusion-based risk-assessment model for venous thrombosis improves uptake of appropriate thromboprophylaxis in hospitalized medical patients.

Science.gov (United States)

Bagot, C; Gohil, S; Perrott, R; Barsam, S; Patel, R K; Arya, R

2010-08-01

Venous thromboembolism is a common condition in hospitalized medical patients. Numerous studies have demonstrated that low molecular weight heparin significantly reduces this risk but, despite this, the use of thromboprophylaxis remains poor. To evaluate the use of an exclusion based risk-assessment model (RAM) for venous thrombosis in improving the uptake of appropriate thromboprophylaxis in hospitalized medical patients. A survey with a subsequent audit cycle of three separate audits over 36 months. 497 hospitalized patients with acute medical conditions on general medical wards were audited at a secondary care centre in London, UK. The survey and subsequent audits were performed by reviewing the notes and medication charts of medical patients, prior to the launch of the RAM and at 12, 28 and 36 months following its introduction. Prior to launching the RAM, 49% of hospitalized medical patients received appropriate thromboprophylaxis. This did not change 12 months after the RAM was introduced but increased significantly to 71% following formal education of the health care professionals involved in thromboprophylaxis prescription. This improvement was maintained as demonstrated by a subsequent audit 8 months later (75.9%). The introduction of a simple exclusion-based RAM for venous thrombosis in medical patients significantly improved delivery of thromboprophylaxis. The successful uptake of the RAM appears to have been dependent on direct education of those health carers involved in its use. A similar exclusion-based model used nationally could have a significant impact on the burden of VTE currently experienced in the UK.

Incremental Validity of WISC-IV[superscript UK] Factor Index Scores with a Referred Irish Sample: Predicting Performance on the WIAT-II[superscript UK

Science.gov (United States)

Canivez, Gary L.; Watkins, Marley W.; James, Trevor; Good, Rebecca; James, Kate

2014-01-01

Background: Subtest and factor scores have typically provided little incremental predictive validity beyond the omnibus IQ score. Aims: This study examined the incremental validity of Wechsler Intelligence Scale for Children-Fourth UK Edition (WISC-IV[superscript UK]; Wechsler, 2004a, "Wechsler Intelligence Scale for Children-Fourth UK…

Environmental tobacco smoke in hospitality venues in Greece

Directory of Open Access Journals (Sweden)

Tountas Yiannis

2007-10-01

Full Text Available Abstract Background Exposure to environmental tobacco smoke is a major threat to public health. Greece, having the highest smoking prevalence in the European Union is seriously affected by passive smoking. The purpose of this study was to measure environmental tobacco smoke (ETS exposure in the non smoking areas of hospitality venues and offices in Greece and to compare the levels of exposure to levels in the US, UK and Ireland before and after the implementation of a smoking ban. Methods Experimental measurements of particulate matter 2.5 μm (PM2.5, performed during a cross sectional study of 49 hospitality venues and offices in Athens and Crete, Greece during February – March 2006. Results Levels of ETS ranged from 19 μg/m3 to 612 μg/m3, differing according to the place of measurement. The average exposure in hospitality venues was 268 μg/m3 with ETS levels found to be highest in restaurants with a mean value of 298 μg/m3 followed by bars and cafes with 271 μg/m3. ETS levels were 76% lower in venues in which smoking was not observed compared to all other venues (p Conclusion Designated non-smoking areas of hospitality venues in Greece are significantly more polluted with ETS than outdoor air and similar venues in Europe and the United States. The implementation of a total indoor smoking ban in hospitality venues has been shown to have a positive effect on workers and patrons' health. The necessity of such legislation in Greece is thus warranted.

The Use of Social Media by UK Local Resilience Forums

OpenAIRE

Meaton, Julia; Stringer, Lisa

2014-01-01

The potential uses of social media in the field of emergency preparedness, resilience and response (EPRR) are varied and interesting. The UK government have produced guidance documents for its use in the UK EPRR field but evidence of use is poorly documented and appears sporadic. This paper presents the results of a survey of Local Resilience Forums (LRF) in the UK on their use and engagement with social media. The findings suggest that the level of application of social media strategies as e...

Field Artillery and the Combined Arms Team: A Case for the Continued Relevance of American Fire Support

Science.gov (United States)

2015-05-23

97 Alfred D. Chandler , ed., The Papers of Dwight David Eisenhower, the War Years: II (Baltimore: The John Hopkins Press, 1970), 1111-12...Observer on Guadalcanal.” Field Artillery Journal (August 1943): 563-68. Chandler , Alfred D., ed. The Papers of Dwight David Eisenhower, the War Years

China’s Emerging Capabilities in Energy Technology Innovation and Development

Science.gov (United States)

2015-01-22

44(4): 823-30. Chandler , Alfred D. and Takashi Hikino (1997). The Large Industrial Enterprise and the Dynamics of Modern Growth. Big Business...and the Wealth of Nations. A. D. Chandler , F. Amatori and T. Hikino. Cambrige Cambridge University Press. Deutch, John and Edward S. Steinfeld

Are UK undergraduate Forensic Science degrees fit for purpose?

Science.gov (United States)

Welsh, Charles; Hannis, Marc

2011-09-01

In October 2009 Skills for Justice published the social research paper 'Fit for purpose?: Research into the provision of Forensic Science degree programmes in UK Higher Education Institutions.' The research engaged employers representing 95% of UK Forensic Science providers and 79% of UK universities offering Forensic Science or Crime Scene degree programmes. In addition to this, the research collected the views of 430 students studying these degrees. In 2008 there were approximately 9000 people working in the Forensic Science sector in the UK. The research found that the numbers of students studying Forensic Science or Crime Scene degrees in the UK have more than doubled since 2002-03, from 2191 in to 5664 in 2007-08. Over the same period there were twice as many females as males studying for these degrees. The research concluded that Forensic Science degree programmes offered by UK universities were of a good quality and they provided the student with a positive learning experience but the content was not relevant for Forensic Science employers. This echoed similar research by the former Government Department for Innovation, Universities and Skills on graduates from wider science, technology, engineering and mathematics degree programmes. The research also found that 75% of students studying Forensic Science or Crime Scene degrees expected to have a career in the Forensic Science sector, meaning that ensuring these courses are relevant for employers is a key challenge for universities. This paper reflects on the original research and discusses the implications in light of recent government policy. Copyright © 2011 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.

Undergraduate teaching in UK general practice: a geographical snapshot.

Science.gov (United States)

Derbyshire, Helen; Rees, Eliot; Gay, Simon P; McKinley, Robert K

2014-06-01

Learning in general practice is an essential component of undergraduate medical education; currently, on average, 13% of clinical placements in the UK are in general practice. However, whether general practice can sustainably deliver more undergraduate placements is uncertain. To identify the geographical distribution of undergraduate teaching practices and their distance from the host medical school. National survey of all medical schools in the UK. All 33 UK medical schools were invited to provide the postcodes of their undergraduate teaching practices. These were collated, de-duplicated, and mapped. The distance in kilometres and journey times by car and public transport between each medical school and its teaching practices was estimated using Transport Direct (www.transportdirect.info). The postcodes of every practice in the UK were obtained from the UK's health departments. All 33 UK medical schools responded; 4392 practices contributed to teaching, with a median (minimum-maximum) of 142 (17-385) practices per school. The median (minimum-maximum) distance between a school and a teaching practice was 28 km (0-1421 km), 41 (0:00-23:26) minutes' travel by car and 1 hour 12 (0:00-17:29) minutes' travel by public transport. All teaching practices were accessible by public transport in one school and 90-99% were in a further four schools; 24 schools had >20% of practices that were inaccessible by public transport. The 4392 undergraduate teaching general practices are widely distributed and potentially any practice, no matter how isolated, could contribute to undergraduate education. However, this is, at the price of a considerable travel burden. © British Journal of General Practice 2014.

Oral health and orofacial pain in people with dementia admitted to acute hospital wards: observational cohort study.

Science.gov (United States)

van de Rijt, Liza J M; Weijenberg, Roxane A F; Feast, Alexandra R; Vickerstaff, Victoria; Lobbezoo, Frank; Sampson, Elizabeth L

2018-05-23

Orofacial pain in people with dementia is difficult to detect, and often under-treated. Our aim was to investigate the prevalence of orofacial pain in people with dementia in acute hospitals in the UK. Secondary aims were to examine oral health status and explore associations between orofacial pain and oral health factors. This cross-sectional observational study was carried out in two UK hospitals. Using the Orofacial Pain Scale in Non-Verbal Individuals (OPS-NVI) to identify orofacial pain, 101 participants with dementia, admitted to acute medical wards, were observed for at least 3 min during rest and chewing. Verbal participants were then asked about presence of orofacial pain, using self-report pain scales. Finally, a brief oral assessment was performed. Orofacial pain, assessed with the OPS-NVI, was present in 11.9% (95% C.I. 5.9, 18.8) of participants at rest and 21.9% (95% C.I. 14.6, 31.3) whilst chewing. Participants who were no longer able to self-report pain were significantly more likely to experience orofacial pain. Oral health in both dentate and edentate participants was poor. Brush frequency, indication of chewing quality, consistency of the food, presence of extra-oral abnormalities, person who performed mouth care, and oral hygiene in dentate participants were significant predictors for the presence of orofacial pain. Improving oral care in acute hospital patients with dementia, particularly those who cannot self-report pain, may significantly reduce pain and suffering in this population.

Network analysis of patient flow in two UK acute care hospitals identifies key sub-networks for A&E performance.

Science.gov (United States)

Bean, Daniel M; Stringer, Clive; Beeknoo, Neeraj; Teo, James; Dobson, Richard J B

2017-01-01

The topology of the patient flow network in a hospital is complex, comprising hundreds of overlapping patient journeys, and is a determinant of operational efficiency. To understand the network architecture of patient flow, we performed a data-driven network analysis of patient flow through two acute hospital sites of King's College Hospital NHS Foundation Trust. Administration databases were queried for all intra-hospital patient transfers in an 18-month period and modelled as a dynamic weighted directed graph. A 'core' subnetwork containing only 13-17% of all edges channelled 83-90% of the patient flow, while an 'ephemeral' network constituted the remainder. Unsupervised cluster analysis and differential network analysis identified sub-networks where traffic is most associated with A&E performance. Increased flow to clinical decision units was associated with the best A&E performance in both sites. The component analysis also detected a weekend effect on patient transfers which was not associated with performance. We have performed the first data-driven hypothesis-free analysis of patient flow which can enhance understanding of whole healthcare systems. Such analysis can drive transformation in healthcare as it has in industries such as manufacturing.

The UK-DALE dataset, domestic appliance-level electricity demand and whole-house demand from five UK homes

Science.gov (United States)

Kelly, Jack; Knottenbelt, William

2015-03-01

Many countries are rolling out smart electricity meters. These measure a home’s total power demand. However, research into consumer behaviour suggests that consumers are best able to improve their energy efficiency when provided with itemised, appliance-by-appliance consumption information. Energy disaggregation is a computational technique for estimating appliance-by-appliance energy consumption from a whole-house meter signal. To conduct research on disaggregation algorithms, researchers require data describing not just the aggregate demand per building but also the ‘ground truth’ demand of individual appliances. In this context, we present UK-DALE: an open-access dataset from the UK recording Domestic Appliance-Level Electricity at a sample rate of 16 kHz for the whole-house and at 1/6 Hz for individual appliances. This is the first open access UK dataset at this temporal resolution. We recorded from five houses, one of which was recorded for 655 days, the longest duration we are aware of for any energy dataset at this sample rate. We also describe the low-cost, open-source, wireless system we built for collecting our dataset.

Curbing UK impacts on global biodiversity: an agenda for action

Energy Technology Data Exchange (ETDEWEB)

Smith, Steve [Scott Wilson Ltd (United Kingdom); Craeynest, Lies [WWF (United Kingdom); Bass, Steve

2008-05-15

Stemming the tide of biodiversity loss is a global issue with national implications. The UK has set up initiatives to reduce its impacts on biodiversity worldwide — but as a government review found in 2006, these have yet to add up to a comprehensive strategy. How can the gaps be filled? New research suggests that action on a number of fronts is key. Many UK policies and practices clearly affect biodiversity even though they do not directly address it. For instance, UK imports such as coffee, cocoa and sugar are linked to biodiversity loss. By integrating relevant mainstream concerns such as trade and exploitation of natural resources into an overall strategy, the UK government could better demonstrate its commitment to reducing biodiversity loss significantly by the target date of 2010.

Antimicrobial resistance in gram-positive pathogens isolated in the UK between October 1996 and January 1997.

Science.gov (United States)

Andrews, J; Ashby, J; Jevons, G; Lines, N; Wise, R

1999-05-01

Antimicrobial resistance in gram-positive pathogens from 30 centres in the UK (ten Teaching, ten Associate Teaching and ten District General Hospitals) was studied over a 4 month period between October 1996 and January 1997. High-level resistance (HLR) and low-level resistance (LLR) to penicillin amongst pneumococci was 3.3% and 3.4%, respectively. However, considerable variation in resistance rates was observed depending on geographical location (LLR range 0-15.4% and HLR range 0-30.8%). Considerable variation in resistance rates was also observed for Staphylococcus aureus to methicillin, with rates ranging from 0% to 56.7% depending on locality. Using conventional MIC methodology, none of the isolates of S. aureus was considered as having reduced sensitivity to vancomycin. However, eight isolates grew on Brain Heart Infusion Agar containing vancomycin (4 mg/L) after prolonged incubation and are therefore worthy of further investigation by electron microscopy. With Enterococcus faecalis, resistance rates were similar between the three types of hospital and only four isolates were considered resistant to glycopeptide antibiotics (one vanA and three vanB phenotype).

The UK education of overseas students in speech and language therapy.

Science.gov (United States)

Marshall, J; Goldbart, J; Phillips, J; Evans, R

2001-01-01

Informal evidence suggests that many overseas speech and language therapists (SLTs) either do not return to their home country on qualification or do not work as SLTs in the public sector. Many factors may contribute to this situation. However, concern that it may result in part from a poor match between UK SLT education and the demands of the role in other countries, led the Royal College of Speech and Language Therapists (RCSLT) to fund a study of overseas SLT students' experiences of UK qualifying courses. The study involved questionnaires and interviews with current students and those qualifying since May 1994. The focus of this paper is the respondents' experiences of studying and working in the UK, their views of the advantages and disadvantages of working in their home countries and the UK and supportive strategies that UK universities and other agencies might adopt. Implications of the findings are discussed.

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.

A multicentre randomised controlled trial of day hospital-based falls prevention programme for a screened population of community-dwelling older people at high risk of falls

OpenAIRE

Conroy, Simon; Kendrick, Denise; Harwood, Rowan; Gladman, John; Coupland, Carol; Sach, Tracey; Drummond, Avril; Youde, Jane; Edmans, Judi; Masud, Tahir

2010-01-01

Objective: to determine the clinical effectiveness of a day hospital-delivered multifactorial falls prevention programme, for community-dwelling older people at high risk of future falls identified through a screening process. Design: multicentre randomised controlled trial. Setting: eight general practices and three day hospitals based in the East Midlands, UK. Participants: three hundred and sixty-four participants, mean age 79 years, with a median of three falls risk factors per person at ...

Incidence, treatment and recurrence of endometriosis in a UK-based population analysis using data from The Health Improvement Network and the Hospital Episode Statistics database.

Science.gov (United States)

Cea Soriano, Lucia; López-Garcia, Esther; Schulze-Rath, Renate; Garcia Rodríguez, Luis A

2017-10-01

This retrospective study used medical records from The Health Improvement Network (THIN) and Hospital Episode Statistics (HES) database to evaluate endometriosis (incidence, treatment and need for recurrent invasive procedures) in the general UK population. Women aged 12-54 years between January 2000 and December 2010, with a Read code for endometriosis, were identified in THIN. Cases were validated by manual review of free-text comments in medical records and responses to physician questionnaires. False-negative cases were identified among women with Read codes for hysterectomy or dysmenorrhea. Prescriptions of medical therapies for endometriosis were identified in THIN. Cases of single and recurrent invasive procedures were identified in women with medical records in both THIN and HES. Overall, 5087 women had a Read code for endometriosis, corresponding to an incidence of 1.02 (95% confidence interval [CI]: 0.99-1.05) per 1000 person-years. After case validation, the estimate was 1.46 (95% CI: 1.43-1.50) per 1000 person-years. Medical therapy was prescribed to 55.5% of women with endometriosis in the first year after diagnosis. In total, 48.3% of women received invasive treatment during the study period; approximately one-fifth of these women required further invasive treatment, mainly in the 3 years after the index procedure. Using Read codes as the only method to identify women with endometriosis underestimates incidence. Over half of women with recorded endometriosis are prescribed medical therapy in the first year after diagnosis. Women with diagnosed endometriosis are at risk of requiring recurrent invasive procedures.

Establishing a legal service for major trauma patients at a major trauma centre in the UK.

Science.gov (United States)

Seligman, William H; Thompson, Julian; Thould, Hannah E; Tan, Charlotte; Dinsmore, Andrew; Lockey, David J

2017-09-01

Major trauma causes unanticipated critical illness and patients have often made few arrangements for what are sudden and life-changing circumstances. This can lead to financial, housing, insurance, legal and employment issues for patients and their families.A UK law firm worked with the major trauma services to develop a free and comprehensive legal service for major trauma patients and their families at a major trauma centre (MTC) in the UK. In 2013, a legal service was established at North Bristol NHS Trust. Referrals are made by trauma nurse practitioners and it operates within a strict ethical framework. A retrospective analysis of the activity of this legal service between September 2013 and October 2015 was undertaken. 66 major trauma patients were seen by the legal teams at the MTC. 535 hours of free legal advice were provided on non-compensation issues-an average of 8 hours per patient. This initiative confirms a demand for the early availability of legal advice for major trauma patients to address a range of non-compensation issues as well as for identification of potential compensation claims. The availability of advice at the MTC is convenient for relatives who may be spending the majority of their time with injured relatives in hospital. More data are needed to establish the rehabilitation and health effects of receiving non-compensation advice after major injury; however, the utilisation of this service suggests that it should be considered at the UK MTCs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

Science.gov (United States)

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

2016-08-29

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

The UK MT-3 ballooning test in the Battelle NRU loop

International Nuclear Information System (INIS)

Gibson, I.H.; Coddington, P.; Healey, T.; Mann, C.A.

1982-04-01

The ballooning response of PWR fuel rods under postulated LOCA conditions has been the subject of intensive investigations. The UK MT-3 ballooning test was a co-operative international exercise which was technically very successful. This report describes the pre-test planning and calculations carried out in the UK and then describes in some detail the thermal hydraulic and clad deformation results. (U.K.)

The UK Ecosystem for Fostering Innovation in the Earth & Space Sciences

Science.gov (United States)

Lee, V. E.

2015-12-01

The UK national government supports an ecosystem of government-funded organisations that carry a specific remit for innovation. By specifically cultivating the commercialisation of research where appropriate, the UK demonstrates a forward-thinking and coordinated approach to deriving economic and societal impact from scientific research activities. This presentation provides an overview of innovation activities at government-backed organisations that support the Earth and space science communities. At the broadest and highest levels, the UK has a whole-of-government approach to fostering innovation. The government also has a designated innovation agency - Innovate UK - which works with people, companies, and partner organisations to find and drive the science & technology innovations that will grow the UK economy. A primary source of scientific funding to UK-based researchers comes from the Research Councils UK (RCUK), which has seven constituent Research Councils. Along with funding activities that support basic research, innovation is supported through a variety of activities. The National Environmental Research Council (NERC), the UK's leading public funder for Earth & environmental science, has brought to market a wide variety of ideas and innovations, including by helping to register patents, negotiating licensing deals, and setting up spin-out companies or joint ventures with commercial organisations. Case studies of NERC commercialization successes will be given, as well as an overview of mechanisms by which NERC supports innovation. These include 'Pathfinder' awards that help enable researchers to develop a greater understanding of the commercial aspects and possibilities of their research. Complementary 'Follow-on Fund' awards provide proof-of-concept funding to support the commercialisation of ideas arising from NERC-funded research. Early-career researchers are also eligible for NERC's Environment Young Entrepreneurs Scheme. Innovation activity, like

UK strategy for radioactive discharges 2001-2020. Consultation document

International Nuclear Information System (INIS)

2000-06-01

This consultation draft of a strategy for radioactive discharges describes how the United Kingdom (UK) will implement the agreements reached at the 1998 Ministerial meeting of the OSPAR Commission, with regard to radioactive substances. It also provides a policy base for future reviews of discharge authorisations by the regulatory bodies and for strategic planning by the nuclear operators. The strategy sets a framework for radioactive discharges from UK installations over the next twenty years. Its aims are: progressive and substantial reductions in radioactive discharges from the UK as a whole and from each of the main sectors responsible for such discharges; progressive reduction of human exposure to ionising radiation resulting from radioactive discharges, so that no member of the general public in the UK will be exposed to a dose of more than 0.02 mSv a year, as a result of authorised radioactive discharges made from 2020 onwards; progressive reductions in concentrations of radionuclides in the marine environment resulting from radioactive discharges, such that by 2020 they add close to zero to historic levels. The scope of the UK strategy encompasses radioactive discharges from nuclear licensed sites, defence activities and other nuclear and non-nuclear sources of radioactive discharges. It covers both liquid and aerial discharges, although it is assumed that in general liquid discharges will have the largest and most measurable effects in the marine environment

Comparison of the carbon footprint of different patient diets in a Spanish hospital.

Science.gov (United States)

Vidal, Rosario; Moliner, Enrique; Pikula, Andrej; Mena-Nieto, Angel; Ortega, Agustín

2015-01-01

Mitigating climate change requires management strategies to reduce greenhouse gas emissions in any sector, including the health system. Carbon footprint calculations should play a key role in quantifying and communicating these emissions. Food is among the categories with low accuracy because the carbon footprint for food is still under development. We aimed to quantify the carbon footprint of different diets. Average carbon footprint for a normal diet was based on detailed composition data in Juan Ramón Jiménez Hospital (Huelva, Spain). In addition, the carbon footprints of 17 other therapeutic diets were estimated using a streamlined variation of each diet published by Benidorm Clinical Hospital (Spain). The carbon footprint was calculated for 18 hospital diets for a variety of patients. The reference menu corresponds to the normal diet provided to patients who do not have special dietary requirements. This menu has a low carbon footprint of 5.083 CO₂ eq/day. Hospital diets contribute to the carbon footprint of a hospital. The type of diet has a significant impact on the greenhouse gas emissions. A Mediterranean diet is associated with lower environmental impact than diets with more meat, in particular red meat. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Cost-effectiveness of omega-3 fatty acid supplements in parenteral nutrition therapy in hospitals: a discrete event simulation model.

Science.gov (United States)

Pradelli, Lorenzo; Eandi, Mario; Povero, Massimiliano; Mayer, Konstantin; Muscaritoli, Maurizio; Heller, Axel R; Fries-Schaffner, Eva

2014-10-01

A recent meta-analysis showed that supplementation of omega-3 fatty acids in parenteral nutrition (PN) regimens is associated with a statistically and clinically significant reduction in infection rate, and length of hospital stay (LOS) in medical and surgical patients admitted to the ICU and in surgical patients not admitted to the ICU. The objective of this present study was to evaluate the cost-effectiveness of the addition of omega-3 fatty acids to standard PN regimens in four European countries (Italy, France, Germany and the UK) from the healthcare provider perspective. Using a discrete event simulation scheme, a patient-level simulation model was developed, based on outcomes from the Italian ICU patient population and published literature. Comparative efficacy data for PN regimens containing omega-3 fatty acids versus standard PN regimens was taken from the meta-analysis of published randomised clinical trials (n = 23 studies with a total of 1502 patients), and hospital LOS reduction was further processed in order to split the reduction in ICU stay from that in-ward stays for patients admitted to the ICU. Country-specific cost data was obtained for Italian, French, German and UK healthcare systems. Clinical outcomes included in the model were death rates, nosocomial infection rates, and ICU/hospital LOS. Probabilistic and deterministic sensitivity analyses were undertaken to test the reliability of results. PN regimens containing omega-3 fatty acids were more effective on average than standard PN both in ICU and in non-ICU patients in the four countries considered, reducing infection rates and overall LOS, and resulting in a lower total cost per patient. Overall costs for patients receiving PN regimens containing omega-3 fatty acids were between €14 144 to €19 825 per ICU patient and €5484 to €14 232 per non-ICU patient, translating into savings of between €3972 and €4897 per ICU patient and savings of between €561 and €1762 per non

Bayesian analysis of genetic association across tree-structured routine healthcare data in the UK Biobank

DEFF Research Database (Denmark)

Cortes, Adrian; Dendrou, Calliope A; Motyer, Allan

2017-01-01

Genetic discovery from the multitude of phenotypes extractable from routine healthcare data can transform understanding of the human phenome and accelerate progress toward precision medicine. However, a critical question when analyzing high-dimensional and heterogeneous data is how best...... to interrogate increasingly specific subphenotypes while retaining statistical power to detect genetic associations. Here we develop and employ a new Bayesian analysis framework that exploits the hierarchical structure of diagnosis classifications to analyze genetic variants against UK Biobank disease phenotypes...... derived from self-reporting and hospital episode statistics. Our method displays a more than 20% increase in power to detect genetic effects over other approaches and identifies new associations between classical human leukocyte antigen (HLA) alleles and common immune-mediated diseases (IMDs). By applying...

Views of senior UK doctors about working in medicine: questionnaire survey.

Science.gov (United States)

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

2014-11-01

We surveyed the UK medical qualifiers of 1993. We asked closed questions about their careers; and invited them to give us comments, if they wished, about any aspect of their work. Our aim in this paper is to report on the topics that this senior cohort of UK-trained doctors who work in UK medicine raised with us. Questionnaire survey. 3479 contactable UK-trained medical graduates of 1993. UK. Comments made by doctors about their work, and their views about medical careers and training in the UK. Postal and email questionnaires. Response rate was 72% (2507); 2252 were working in UK medicine, 816 (36%) of whom provided comments. Positive comments outweighed negative in the areas of their own job satisfaction and satisfaction with their training. However, 23% of doctors who commented expressed dissatisfaction with aspects of junior doctors' training, the impact of working time regulations, and with the requirement for doctors to make earlier career decisions than in the past about their choice of specialty. Some doctors were concerned about government health service policy; others were dissatisfied with the availability of family-friendly/part-time work, and we are concerned about attitudes to gender and work-life balance. Though satisfied with their own training and their current position, many senior doctors felt that changes to working hours and postgraduate training had reduced the level of experience gained by newer graduates. They were also concerned about government policy interventions.

The Search for a Cold War Grand Strategy: NSC 68 & 162

Science.gov (United States)

2014-05-22

Harper Collins Publishers, 1990. Chandler , Alfred D., Jr., and Louis Galamos Jr. The Papers of Dwight D. Eisenhower. Baltimore, MD, 1970. Cutler...76Alfred D. Chandler Jr., and Louis Galamos Jr., The Papers of Dwight D. Eisenhower (Baltimore, MD, 1970), Vol. 11, 1312; Vol. 8, 1609. 77Ibid

What is the prognosis of nitrogen losses from UK soils?

Science.gov (United States)

Burt, T. P.; Worrall, F.; Whelan, M.; Howden, N. J.

2009-12-01

The UK’s high population density, intensive agriculture and relative short, unimpeded rivers mean that the UK is a known “hotspot” of fluvial nitrogen flux. Furthermore, it is known that the fluvial flux of nitrogen from the UK is increasing. This study estimates the release of nitrate from the UK terrestrial biosphere to understand this rising fluvial flux and i to assess the in-stream losses of nitrate, thusgiving an assessment of the fluvial component of the total nitrogen budget of UK. The approach taken by the study is to use an export coefficient model coupled with a description of mineralisation and immobilisation of nitrogen within soil reserves. The study applies the modelling approach to the whole of the UK from 1925 to 2007 using long term records of: land use (including - agricultural, forestry and urban uses); livestock; human population and atmospheric deposition. The study shows that: i) The flux of nitrate from the UK soils varied from 420 to 1463 Ktonnes N/yr with two peaks in the period since 1925, one in 1944 and one in 1967, the first is caused by mineralisation of soil organic matter following large-scale land use change in the Second World War, and the second is a multifactorial response to land use change and intensification. ii) The current trend in the release from soils is downward whilst the current fluvial flux at the tidal limit is upwards. With the current trends fluvial flux at the tidal limit will be greater than release from the soils of the UK, i.e. there will be net gain across the fluvial network. This apparent gain can be explained by the breakthrough of high nitrate groundwater into surface waters.

The Age of BLood Evaluation (ABLE) randomised controlled trial: description of the UK-funded arm of the international trial, the UK cost-utility analysis and secondary analyses exploring factors associated with health-related quality of life and health-care costs during the 12-month follow-up.

Science.gov (United States)

Walsh, Timothy S; Stanworth, Simon; Boyd, Julia; Hope, David; Hemmatapour, Sue; Burrows, Helen; Campbell, Helen; Pizzo, Elena; Swart, Nicholas; Morris, Stephen

2017-10-01

At present, red blood cells (RBCs) are stored for up to 42 days prior to transfusion. The relative effectiveness and safety of different RBC storage times prior to transfusion is uncertain. To assess the clinical effectiveness and cost-effectiveness of transfusing fresher RBCs (stored for ≤ 7 days) compared with current standard-aged RBCs in critically ill patients requiring blood transfusions. The international Age of BLood Evaluation (ABLE) trial was a multicentre, randomised, blinded trial undertaken in Canada, the UK, the Netherlands and France. The UK trial was funded to contribute patients to the international trial and undertake a UK-specific health economic evaluation. Twenty intensive care units (ICUs) in the UK, as part of 64 international centres. Critically ill patients aged ≥ 18 years (≥ 16 years in Scotland) expected to require mechanical ventilation for ≥ 48 hours and requiring a first RBC transfusion during the first 7 days in the ICU. All decisions to transfuse RBCs were made by clinicians. One patient group received exclusively fresh RBCs stored for ≤ 7 days whenever transfusion was required from randomisation until hospital discharge. The other group received standard-issue RBCs throughout their hospital stay. The primary outcome was 90-day mortality. Secondary outcomes included development of organ dysfunction, new thrombosis, infections and transfusion reactions. The primary economic evaluation was a cost-utility analysis. The international trial took place between March 2009 and October 2014 (UK recruitment took place between January 2012 and October 2014). In total, 1211 patients were assigned to receive fresh blood and 1219 patients to receive standard-aged blood. RBCs were stored for a mean of 6.1 days [standard deviation (SD) ± 4.9 days] in the group allocated to receive fresh blood and 22.0 days (SD ± 8.4 days) in the group allocated to receive standard-aged blood. Patients received a mean of 4.3 RBC units

Market mechanisms and the management of health care. The UK model and experience.

Science.gov (United States)

Lapsley, I

1997-01-01

Examines recent reforms of the UK's National Health Service (NHS), and explores the pressures for change in the pursuit of an efficient NHS and the conflicts which this causes in an organization which was based on the aim of equity. In particular, addresses the "false revolutions" of managerial change introduced after the Griffiths Report (1983) and the accounting changes introduced in the wake of the Griffiths proposals. Evidence shows that these intended revolutions were limited in impact. The result of these failures has been the introduction of the "real revolution"--the internal market in health care. This is a radical change in both the NHS management arrangements and in service delivery, with the division of the NHS into purchasers (health authorities and GP fund holders) and providers (hospital and community services, whether provided by private, voluntary or state-owned facilities.

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)

Leadership and management in UK medical school curricula.

Science.gov (United States)

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

2016-10-10

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

UK's promising future with change of nuclear fortune

Energy Technology Data Exchange (ETDEWEB)

Shepherd, John [nuclear 24, London (United Kingdom)

2014-02-15

In January 2014, Toshiba became the latest overseas company to set its sights on building new nuclear reactor units in the UK - announcing that it had secured agreements to see it take a majority 60 percent stake in NuGeneration Limited (NuGen). That makes a total of 11 new units planned or proposed in the UK to date. Whatever the future holds for nuclear in the UK, there is a long road ahead. Main aspects and developments during the past eight years are summarised and explained by the author. (orig.)

Implementation of the basic safety standards directive in the UK

International Nuclear Information System (INIS)

Bines, W.

2003-01-01

Implementation of the European Council BSS Directive 96/29/Euratom in the UK is not achieved through any one piece of legislation (though the majority of the provisions are implemented by the Ionising Radiations Regulations 1999) but by a mosaic of provisions, supported by codes of practice, non-statutory guidance and administrative arrangements. The paper describes some of the features of UK occupational radiation protection and the reason for the apparent differences between the UK and other EU Member States in their approach to agreeing the precise provisions of European legislation. (author)

UK-18,892: resistance to modification by aminoglycoside-inactivating enzymes.

Science.gov (United States)

Andrews, R J; Brammer, K W; Cheeseman, H E; Jevons, S

1978-12-01

UK-18,892, a new semisynthetic aminoglycoside, was active against bacteria possessing aminoglycoside-inactivating enzymes, with the exception of some known to possess AAC(6') or AAD(4') enzymes. This activity has been rationalized by using cell-free extracts of bacteria containing known inactivating enzymes, where it was shown that UK-18,892 was not a substrate for the APH(3'), AAD(2''), AAC(3), and AAC(2') enzymes. It was also demonstrated that UK-18,892 protected mice against lethal infections caused by organisms possessing aminoglycoside-inactivating enzymes.

The UK Earth System Model project

Science.gov (United States)

Tang, Yongming

2016-04-01

In this talk we will describe the development and current status of the UK Earth System Model (UKESM). This project is a NERC/Met Office collaboration and has two objectives; to develop and apply a world-leading Earth System Model, and to grow a community of UK Earth System Model scientists. We are building numerical models that include all the key components of the global climate system, and contain the important process interactions between global biogeochemistry, atmospheric chemistry and the physical climate system. UKESM will be used to make key CMIP6 simulations as well as long-time (e.g. millennium) simulations, large ensemble experiments and investigating a range of future carbon emission scenarios.

Risk-adjusted survival for adults following in-hospital cardiac arrest by day of week and time of day: observational cohort study

Science.gov (United States)

Robinson, Emily J; Power, Geraldine S; Nolan, Jerry; Soar, Jasmeet; Spearpoint, Ken; Gwinnutt, Carl; Rowan, Kathryn M

2016-01-01

Background Internationally, hospital survival is lower for patients admitted at weekends and at night. Data from the UK National Cardiac Arrest Audit (NCAA) indicate that crude hospital survival was worse after in-hospital cardiac arrest (IHCA) at night versus day, and at weekends versus weekdays, despite similar frequency of events. Objective To describe IHCA demographics during three day/time periods—weekday daytime (Monday to Friday, 08:00 to 19:59), weekend daytime (Saturday and Sunday, 08:00 to 19:59) and night-time (Monday to Sunday, 20:00 to 07:59)—and to compare the associated rates of return of spontaneous circulation (ROSC) for >20 min (ROSC>20 min) and survival to hospital discharge, adjusted for risk using previously developed NCAA risk models. To consider whether any observed difference could be attributed to differences in the case mix of patients resident in hospital and/or the administered care. Methods We performed a prospectively defined analysis of NCAA data from 27 700 patients aged ≥16 years receiving chest compressions and/or defibrillation and attended by a hospital-based resuscitation team in response to a resuscitation (2222) call in 146 UK acute hospitals. Results Risk-adjusted outcomes (OR (95% CI)) were worse (p20 min 0.88 (0.81 to 0.95); hospital survival 0.72 (0.64 to 0.80)), and night-time (ROSC>20 min 0.72 (0.68 to 0.76); hospital survival 0.58 (0.54 to 0.63)) compared with weekday daytime. The effects were stronger for non-shockable than shockable rhythms, but there was no significant interaction between day/time of arrest and age, or day/time of arrest and arrest location. While many daytime IHCAs involved procedures, restricting the analyses to IHCAs in medical admissions with an arrest location of ward produced results that are broadly in line with the primary analyses. Conclusions IHCAs attended by the hospital-based resuscitation team during nights and weekends have substantially worse outcomes than during

Universities and Economic Development Activities: A UK Regional Comparison

Science.gov (United States)

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

2011-01-01

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

Ratings of Severity of Life Events by Ninth-Grade Students.

Science.gov (United States)

Hutton, Jerry B.; And Others

1987-01-01

Special education, basic, and honors ninth-grade students (n=60) rated the severity of stress for each of the life events on the Source of Stress Inventory (Chandler, 1981). There was a significant positive relationship between the Chandler rankings (teachers and mental health workers) and the student rankings. (Author/NB)

UK Tax Update

Energy Technology Data Exchange (ETDEWEB)

Deakin, John F.

1998-07-01

The presentation deals with the North Sea fiscal regime, a modern system for corporation tax payments, transfer pricing, general anti-avoidance rule for direct taxes, treaty refunds, deductibility of interest for corporation tax, UK/US double taxation convention, and plain and simple tax legislation. Part of the background for the presentation was the fact that in England a new Labour Government had replaced the Conservatives and the new Chancellor had announced a review of the North Sea fiscal regime.

Restart: The Resurgence of Computer Science in UK Schools

Science.gov (United States)

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

2014-01-01

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

The UK national response plan: An 'all-risk' approach

International Nuclear Information System (INIS)

Englefield, C.

2001-01-01

Full text: The UK has been using and regulating radioactive materials for many years. The law, and the regulatory systems to implement it have developed over time, to meet the perceived need. More recently, the threat of inadvertent movements of, and illicit trafficking in radioactive materials has become apparent. This relatively new challenge cannot be met by a single U.K. law enforcement body. There will be Police and security services interest in any cases that arise of deliberate trafficking in fissile materials, and there will be statutory concerns for Customs and Excise. At the operational level, they do not have radioanalytical services and radiation protection support immediately available, as the frequency of occurrence of such incidents is extremely low. However, the typical case is an inadvertent movement. These usually involve orphaned sources, where none of the above law enforcement bodies have a statutory locus. In such cases, it is the UK environment agencies that take the lead (as regulators of radioactive substances), together with Health and Safety Executive as regulators of radiation safety. However they do not have all the statutory powers needed to intervene. This is in contrast to the position in some other countries. The UK paper at the International Conference of Regulators in Buenos Aires in December 2000 described the UK's co-ordination work to create synergies between law enforcement bodies and potentially affected industry groups. This was described as an 'All Risk Approach'. This is seen as the best way to manage an effective response to the challenge, given that the legislation cannot at present provide all the necessary powers. This new paper will describe the UK Response Plan and how it is designed to cover all risk: radiological and socio-economic. It will also describe how the Plan is being tested and validated as a project. The plan draws on UK Emergency Planning policy, as well as IAEA guidance on the Prevention, Detection and

Implementing statistical equating for MRCP(UK) Parts 1 and 2.

Science.gov (United States)

McManus, I C; Chis, Liliana; Fox, Ray; Waller, Derek; Tang, Peter

2014-09-26

The MRCP(UK) exam, in 2008 and 2010, changed the standard-setting of its Part 1 and Part 2 examinations from a hybrid Angoff/Hofstee method to statistical equating using Item Response Theory, the reference group being UK graduates. The present paper considers the implementation of the change, the question of whether the pass rate increased amongst non-UK candidates, any possible role of Differential Item Functioning (DIF), and changes in examination predictive validity after the change. Analysis of data of MRCP(UK) Part 1 exam from 2003 to 2013 and Part 2 exam from 2005 to 2013. Inspection suggested that Part 1 pass rates were stable after the introduction of statistical equating, but showed greater annual variation probably due to stronger candidates taking the examination earlier. Pass rates seemed to have increased in non-UK graduates after equating was introduced, but was not associated with any changes in DIF after statistical equating. Statistical modelling of the pass rates for non-UK graduates found that pass rates, in both Part 1 and Part 2, were increasing year on year, with the changes probably beginning before the introduction of equating. The predictive validity of Part 1 for Part 2 was higher with statistical equating than with the previous hybrid Angoff/Hofstee method, confirming the utility of IRT-based statistical equating. Statistical equating was successfully introduced into the MRCP(UK) Part 1 and Part 2 written examinations, resulting in higher predictive validity than the previous Angoff/Hofstee standard setting. Concerns about an artefactual increase in pass rates for non-UK candidates after equating were shown not to be well-founded. Most likely the changes resulted from a genuine increase in candidate ability, albeit for reasons which remain unclear, coupled with a cognitive illusion giving the impression of a step-change immediately after equating began. Statistical equating provides a robust standard-setting method, with a better

What is Bobath? A survey of UK stroke physiotherapists' perceptions of the content of the Bobath concept to treat postural control and mobility problems after stroke

OpenAIRE

Tyson, Sarah F.; Connell, L. A.; Busse, M. E.; Lennon, S.

2009-01-01

Objective. The aim of this study was to identify which interventions used to treat postural control and mobility are considered part of the Bobath concept (BC). Design. Hospital-based UK stroke physiotherapists identified interventions which they perceived to be part of the BC from a pre-published list of interventions used to treat postural control and mobility problems. Interventions that >75% of participants felt were part of the BC were classified as 'definitely Bobath'. Interventions ...

Perinatal mental health service provision in Switzerland and in the UK.

Science.gov (United States)

Amiel Castro, Rita T; Schroeder, Katrin; Pinard, Claudia; Blöchlinger, Patricia; Künzli, Hansjörg; Riecher-Rössler, Anita; Kammerer, Martin

2015-01-01

The epidemiology of maternal perinatal-psychiatric disorders as well as their effect on the baby is well recognised. Increasingly well researched specialised treatment methods can reduce maternal morbidity, positively affect mother-baby bonding and empower women's confidence as a mother. Here, we aimed to compare guidelines and the structure of perinatal-psychiatric service delivery in the United Kingdom and in Switzerland from the government's perspective. Swiss cantons provided information regarding guidelines and structure of service delivery in 2000. A subsequent survey using the same questionnaire was carried out in 2007. In the UK, similar information was accessed through published reports from 2000-2012. Guidelines for perinatal psychiatry exist in the UK, whereas in Switzerland in 2000 none of the 26 cantons had guidelines, and in 2007 only one canton did. Joint mother-baby admissions on general psychiatric wards were offered by 92% of the Swiss cantons. In the UK, pregnant women and joint mother-baby admissions are only advised onto specialised perinatal-psychiatric units. In Switzerland, in 2007, three specialised units (max. 24 beds) were in place corresponding to 1 unit per 2.5 million people, while in the UK there were 22 mother-baby units (168 beds) in 2012 (1 unit per 2.8 million). In the UK, less than 50% of trusts provided specialised perinatal-psychiatric health care. The main difference between the UK and Switzerland was the absence of guidelines, regular assessment and plans for future development of perinatal psychiatry in Switzerland. There are still geographical differences in the provision of perinatal-psychiatric services in the UK.

Fuelling expectations: A policy-promise lock-in of UK biofuel policy

International Nuclear Information System (INIS)

Berti, Pietro; Levidow, Les

2014-01-01

Controversy over EU-wide biofuel policy resonated within the UK, fuelling policy disagreements among UK public authorities. They disagreed over how to protect a space for future second-generation biofuels, which were expected to overcome harm from first-generation biofuels. The UK government defended rising targets for available biofuels as a necessary stimulus for industry to help fulfil the UK's EU obligations and eventually develop second-generation biofuels. By contrast, Parliamentary Select Committees opposed biofuel targets on grounds that these would instead lock-in first-generation biofuels, thus delaying or pre-empting second-generation biofuels. Those disagreements can be explained by different institutional responsibilities and reputational stakes towards ‘promise-requirement cycles’, whereby techno-optimistic promises generate future requirements for the actors involved. The UK government's stance illustrates a ‘policy-promise lock-in’, a dilemma whereby promised support is a requirement for credibility towards technology innovators and thus technoscientific development – but may delay the redirection of support from incumbent to preferable emerging technologies. Thus the sociology of expectations – previously applied to technological expectations from technology innovators – can be extended to analyse public authorities. - Highlights: • Controversy over EU-wide biofuel policy resonated within the UK. • At issue was how to stimulate future 2nd-generation biofuels. • The government defended targets for 1st-generation as necessary to stimulate industry. • Parliamentary Committees opposed biofuel targets as locking in 1st-generation. • The UK government′s stance illustrates a ‘policy-promise lock-in’

Financing the UK power sector: Is the money available?

International Nuclear Information System (INIS)

Blyth, William; McCarthy, Rory; Gross, Robert

2015-01-01

The UK power generation sector faces a major new round of investment: the coincidence of asset retiring and ambitious goals for decarbonisation is not unique, but is particularly acute in the UK. The UK government has put in place a raft of new policies that seek to promote new, low carbon investment and ensure security of supply. The traditional channel for financing the sector has been through large utility companies, but this now looks challenging for various reasons. The UK therefore offers an interesting case study on several counts; the scale of the challenge, effectiveness of new policies, and the availability of alternative finance. We find that the link between the finance sector and the electricity sector is not ‘broken’, but the flow of money to the sector is threatened by the current weakness of the utilities’ business model. This paper compares estimates of the scale of investment required in the UK with historical investment rates. It summarises contemporary finance industry views of conditions and trends, and potential policy interventions that might be needed to bridge the investment gap. The potential for channelling institutional investor funds directly into energy assets is reviewed. - Highlights: • Power investment need to scale up compared to historical trends, but is achievable. • Traditionally, low-cost finance has been through bonds and shares of large utilities. • Utilities are suffering high debt, reduced demand, and suppressed prices. • Policy interventions to scale-up investment are reviewed.

U.K. nuclear data progress report for the period April 1975 to March 1976

International Nuclear Information System (INIS)

Gayther, D.B.

1976-08-01

The Progress Report describes the activities of the UK Nuclear Data Committee, lists the UK data in a CINDA type index, and reports briefly on each UK activity under the organization concerned (AERE Harwell, AEE Winfrith, NPL, AWRE Aldermaston, University of Aston in Birmingham, University of Edinburgh, University of London Reactor Centre). (U.K.)

Scope for energy improvement for hospital imaging services in the USA.

Science.gov (United States)

Esmaeili, Amin; Twomey, Janet M; Overcash, Michael R; Soltani, Seyed A; McGuire, Charles; Ali, Kamran

2015-04-01

To aid radiologists by measuring the carbon footprint of CT scans by quantifying in-hospital and out-of-hospital energy use and to assess public health impacts. The study followed a standard life cycle assessment protocol to measure energy from a CT scan then expanding to all hospital electrical energy related to CT usage. In addition, all the fuel energy used to generate electricity and to manufacture the CT consumables was measured. The study was conducted at two hospitals. The entire life cycle energy for a CT scan was 24-34 kWh of natural resource energy per scan. The actual active patient scan energy that produces the images is only about 1.6% of this total life cycle energy. This large multiplier to get total CT energy is a previously undocumented environmental response to the direct radiology order for a patient CT scan. The CT in-hospital energy related to idle periods, where the machine is on but no patients are being scanned and is 14-30-fold higher than the energy used for the CT image. The in-hospital electrical energy of a CT scan makes up only about 25% of the total energy footprint. The rest is generated outside the hospital: 54-62% for generation and transmission of the electricity, while 13-22% is for all the energy to make the consumables. Different CT scanners have some influences on the results and could help guide purchase of CT equipment. The transparent, detailed life cycle approach allows the data from this study to be used by radiologists to examine details of both direct and of unseen energy impacts of CT scans. The public health (outside-the-hospital) impact (including the patients receiving a CT) needs to be measured and included. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Adverse incidents resulting in exposure to body fluids at a UK dental teaching hospital over a 6-year period

Directory of Open Access Journals (Sweden)

Hughes A

2012-10-01

Full Text Available A Hughes,1 L Davies,1 R Hale,1 JE Gallagher21Kings College Hospital NHS Foundation Trust, 2King's College London Dental Institute, London, United KingdomBackground: The safety and protection of patients and health care workers is of paramount importance in dentistry, and this includes students in training who provide clinical care. Given the nature of dental care, adverse incidents can and do occur, exposing health care workers to body fluids and putting them at risk of infection, including contracting a blood-borne virus. The aim of this research was to analyze trends in the volume, rate, nature, management, and outcome of adverse incidents reported at one dental teaching hospital from 2005 to 2010.Methods: Descriptive analysis of trends in the volume, rate, nature, management, and outcome of adverse incidents reported at one dental teaching hospital over a six-year period was undertaken in relation to the level of outpatient and day surgery activity.Results: In total, 287 incidents were reported over a six-year period, which amounted to 0.039% of outpatient or day surgery appointments. Nearly three quarters of all the incidents (n = 208, 72% took place during treatment or whilst clearing away after the appointment. The most frequent incidents were associated with administration of local anesthetic (n = 63, 22%, followed by burs used in dental hand pieces (n = 51, 18%.Conclusion: This research confirms that adverse incidents are a feature of dental hospitals and reports the common sources. The importance of accurate and consistent reporting of data to ensure that these issues are monitored to inform action and reduce risks to staff, students, and patients are highlighted.Keywords: risk management, blood-borne virus, dental hospital, body fluids exposure, adverse event reporting

Stress among UK academics : identifying who copes best?

OpenAIRE

Darabi, Mitra; Macaskill, Ann; Reidy, Lisa

2016-01-01

This paper examined the levels of stress and coping strategies among UK academics. Adopting a positive psychology approach, the influence of the character strengths of hope, optimism, gratitude and self-efficacy, on stress, subjective well-being (SWB), and mental health (GHQ) was examined in 216 academics in a UK university. The study explored the relationship between coping styles and work-coping variables of sense of coherence and work locus of control and stress. No significant differences...

A national survey of services for the prevention and management of falls in the UK

Directory of Open Access Journals (Sweden)

Potter Rachel

2008-11-01

Full Text Available Abstract Background The National Health Service (NHS was tasked in 2001 with developing service provision to prevent falls in older people. We carried out a national survey to provide a description of health and social care funded UK fallers services, and to benchmark progress against current practice guidelines. Methods Cascade approach to sampling, followed by telephone survey with senior member of the fall service. Characteristics of the service were assessed using an internationally agreed taxonomy. Reported service provision was compared against benchmarks set by the National Institute for Health and Clinical Excellence (NICE. Results We identified 303 clinics across the UK. 231 (76% were willing to participate. The majority of services were based in acute or community hospitals, with only a few in primary care or emergency departments. Access to services was, in the majority of cases, by health professional referral. Most services undertook a multi-factorial assessment. The content and quality of these assessments varied substantially. Services varied extensively in the way that interventions were delivered, and particular concern is raised about interventions for vision, home hazard modification, medication review and bone health. Conclusion The most common type of service provision was a multi-factorial assessment and intervention. There were a wide range of service models, but for a substantial number of services, delivery appears to fall below recommended NICE guidance.

The UK solar water heating industry: a period of development and growth

International Nuclear Information System (INIS)

Blower, John

2001-01-01

This 2001 edition of the guide to UK renewable energy companies examines the solar water heating sector in the UK and presents an illustration of the layout of a typical solar water heating system. The rising demand for solar water heating and growth in sales especially in the export market are noted. Developments within the UK solar water heating manufacturing industry are considered, and details are given of design and development in innovative policy infrastructure, and the SHINE 21 project supported by the EU's ADAPT programme and the UK Department of Trade and Industry involving collaboration between the solar water heating and plumbing industries. Developments in the new build sectors including in-roof solar collector products and the increasing number of solar water heating systems installed in UK houses are discussed along with the promising future for the market

Addressing the knowledge gap: sexual violence and harassment in the UK Armed Forces

OpenAIRE

Godier, Lauren; Fossey, Matt

2017-01-01

Despite media interest in alleged sexual violence and harassment in the UK military, there remains a paucity of UK-based peer-reviewed research in this area. Ministry of Defence and service-specific reports support the suggestion that UK service personnel may be at risk of experiencing sexual harassment. These reports however highlight a reluctance by service personnel to report sexual harassment through official channels. In this article, we discuss the paucity of UK-based research pertainin...

Breastfeeding practice in the UK: midwives' perspectives.

Science.gov (United States)

Furber, Christine M; Thomson, Ann M

2008-01-01

Despite breastfeeding prevalence increasing, many mothers in developed countries are dissatisfied with care provided by midwives. However, a paucity of research exists related to midwives' experiences of supporting breastfeeding mothers. This study explored the experiences of English midwives' during their breastfeeding support role. A qualitative study using grounded theory principles was used. Data were collected using in-depth interviews and analysed using constant comparative techniques. The setting was two maternity hospitals in the North of England, UK. Thirty midwives who cared for normal, healthy babies participated. Volunteers were recruited using theoretical sampling techniques. The core category that emerged is called 'surviving baby feeding' and relates to midwives' experiences when supporting mothers. The results reported in this paper refer to one category called 'doing well with feeding' which has three main themes: (1) communicating sensitively, (2) facilitating breastfeeding, and (3) reducing conflicting advice. Participating midwives reported practice that suggests that they valued breastfeeding, attempted to provide realistic information and advice, and tried to minimise confusion for mothers. However, some midwives used an authoritative manner when conversing with mothers. English midwives' reported practice demonstrates that these midwives appreciated that breastfeeding mothers required specific support. However, breastfeeding education that encourages midwives to develop effective skills in ascertaining mother's needs, but also encourages mothers to effectively participate in their care, should be provided. Further research is needed to clarify breastfeeding mothers' expectations and needs.

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

UK-China review of opportunities for landfill gas (LFG) technology transfer

Energy Technology Data Exchange (ETDEWEB)

NONE

2004-07-01

This report presents the results of a project to identify opportunities to transfer UK skills with regard to landfill gas (LFG) technologies to China and other countries looking to develop LFG as a commercially viable clean energy source. The aim of the project was to develop all aspects of LFG extraction and utilisation techniques. The project involved: examining current Chinese waste disposal practices; identifying key technologies and methods for maximising LFG recovery; considering end use options and methods to optimise gas use; assessing the environmental benefits; and identifying potential opportunities for UK industry. The report consider: barriers to the development of LFG; waste disposal and landfill design in China; China's experience of LFG use; UN Development Programme (UNDP) and Global Environmental Forum (GEF) LFG demonstration projects in China; environmental regulation and controls in China; LFG technology in the UK; support for renewable energy in China and the UK; design and operational needs in China from a UK perspective; technology needs, barriers and opportunities; and recommendations for action and future work.

Comments on the article "Changing attitudes towards the care of children in hospital: a new assessment of the influence of the work of Bowlby and Robertson in the UK, 1940-1970" by Frank C.P. van der Horst and Rene van der Veer (Attachment and Human Development Vol 11, No 2, March 2009, 119-142).

Science.gov (United States)

Lindsay, Mary

2009-11-01

The authors give an impressive list of references, but these do not reflect the situation in the UK; most of those looking after children in hospital did not write about what they did or read about what others did. Children in hospital saw little or nothing of their parents, and once they had 'settled' the doctors and nurses were unaware of their distress. John Bowlby's interest in maternal deprivation led him to appoint James Robertson as his research assistant, to observe responses of young children to loss of maternal care on admission to hospital. They formulated the theoretical framework of the three stages through which the children went; protest, despair, and detachment constituting a developmental interference. Robertson was so concerned when nobody would listen that in 1952 he made the film 'A Two Year Old Goes to Hospital', which upset children's doctors and nurses. It also probably contributed to the government setting up in 1957 a Committee chaired by Sir Harry Platt to consider the Welfare of Children in Hospital. 'Going to Hospital with Mother' was made by Robertson in 1958. With Dermod MacCarthy he showed the films to the Committee, who accepted the suggestions in Robertson's Memorandum which included unrestricted visiting and mothers being admitted with their young children. The Report, known as the Platt Report, was published in 1959. Robertson could then show his films publicly, campaign in the media and encourage the pressure group NAWCH (the National Association for the Welfare of Children in Hospital) who were successful in getting many of the Committee's recommendations implemented, to the benefit of all children in hospital.

Essentials for profitable coalbed methane production in the UK

Energy Technology Data Exchange (ETDEWEB)

Creel, J.C.; Rollins, J.B. [Cawley, Gillespie & Associates, Inc. (United Kingdom)

1995-12-31

The UK coalbed methane industry is now poised for a continuation of its growth. For this potential growth to be realized, coalbed methane production must be profitable for producers. Commercial viability of coalbed methane production in the UK depends on th fulfilment of essential technical, regulatory, and economic conditions. Technically, coalbed methane reservoirs must have an adequate thickness of permeable gas saturated coal. The regulatory environment must offer favorable treatment regarding taxation, royalties, and policies on well spacing, wellsite locations, and market accessibility. Economically, gas prices and initial capital costs must be sufficiently favorable to yield an acceptable rate of return. If these essential conditions can be fulfilled, UK coalbed methane production can be expected to be a commercially viable industry. 6 refs., 6 figs., 2 tabs.

Examining Brexit through the GPA’s Lens:What next for UK public procurement reform?

OpenAIRE

Telles, Pedro; Sanchez Graells, Albert

2017-01-01

The United Kingdom has formally begun leaving the European Union (so-called Brexit). This has immersed the UK Government and EU Institutions in negotiations to disentangle the UK from EU law by the end of March 2019, and to devise a new legal framework for UK-EU trade. The UK will also have to adjust its trading arrangements with the rest of the world. In this context, public procurement regulation is broadly seen as an area where, ‘unshackled by EU law’, the UK would be able to turn to a lig...

Oil and gas operational and policy issues in the UK

International Nuclear Information System (INIS)

Howard, D.

1992-01-01

The method of arriving at monthly values under Schedule 3 OTA 1975 applies to all oil which can include LPG and condensate as well as crude oil and gas. The majority of crude oil is now sold spot and in 1987 the method of arriving at monthly values was amended better to reflect this aspect of the crude oil market. The UK gas market was such that the proceeds of sale of large amounts of natural gas were exempt from PRT under Section 10 OTA 1975 and very little gas was disposed of other than at arms length to British Gas. British Gas no longer buys virtually all gas produced from the UK Continental Shelf and neither does it sell all the gas used by UK customers. The use of natural gas to generate electricity has opened up a new market for UK landed gas. How do these changes affect gas valuation.?. (Author)

Globalisation and Transnational Teachers: South African Teacher Migration to the UK

Directory of Open Access Journals (Sweden)

Sadhana Manik

2006-06-01

Full Text Available The globalisation of the world markets has paved the way for the movement of people with scarce skills such as teachers across national boundaries with relative ease. This paper focuses on the migration of teachers from South Africa to the UK using a qualitative, ethnographic approach. It argues that there are socio-cultural complexities in the transnational migration of SA teachers. It begins by identifying the reasons for teachers exiting the SA teaching fraternity to work in schools in London in the UK. Teachers’ experiences in the UK schools are then explored. The study revealed that teachers leaving SA had multiple reasons for going abroad. The migration of teachers from SA to the UK was influenced by the declining economic status of teaching as a profession in SA, and global labour market conditions. The majority of the migrant teachers who were interviewed had an existing social network in the UK, either friends or relatives. However, the gravity of teaching in a foreign country without next of kin took its toll and teachers spoke at length of the loneliness of being apart from immediate family. An overwhelming majority of migrant teachers experienced a culture shock in UK classrooms, especially discipline problems. Migrant teachers felt powerless, as UK policies tend to protect children, even if they misbehaved in the classroom. The paper concludes by highlighting the commodification of teachers; those who are able to trade their skills in a global market in return for socio-economic and career gains. The arrival of this breed of teacher is also facilitated by what D. Harvey terms the “time-space compression” of global society.

As UK inches towards Chinese reactor project, China sets sights on new world markets

International Nuclear Information System (INIS)

Shepherd, John

2017-01-01

Early in January, as many of us in Europe were getting back into the routine of returning to work following the festive period, a new chapter in the history of nuclear energy was already starting to be written in the UK. The UK government asked the country's nuclear regulators, the Office for Nuclear Regulation (ONR) and the Environment Agency, to start a generic design assessment (GDA) of what is now known as the 'UK HPR1000 reactor' - which is set to be the first deployment of Chinese reactor technology outside China. If the UK HPR1000 is eventually built in the UK, which would be at a designated site adjacent to the country's former Bradwell nuclear power plant in Essex, on the eastern coast, the project will not only be a first for the use of Chinese nuclear technology in any other country, it will ironically make UK ties with France stronger - at a time when the UK is preparing to break away from the European Union.

Outsourcing the law firm library: the UK experience

OpenAIRE

Brown, Fiona

2017-01-01

Since 2009, a number of large and leading UK law firms have outsourced their in-house law library and research service to outsource service providers. Integreon, the leading provider of these services in the UK, commenced operations in Australia in 2011. Since that time, a number of other providers of outsourced law library and legal research services have attracted a number of top-tier Australian law firms as clients. These outsource providers are not currently providing law library and lega...

The UK Bribery Act: Business Integrity and Whistleblowers

OpenAIRE

Carr, I

2012-01-01

This article’s main focus is the extent to which the U.K. Bribery Act 2010 and the Guidance Document prepared by the Secretary of State, address- ing the procedures that commercial organizations can put into place to prevent bribery, include whistleblower protection. The article also exam- ines provisions for whistleblower protection in the four anti-corruption conventions that the U.K. has ratified in order to provide the context for a discussion of whistleblower protection in the Bribery Ac...

UK money demand 1873-2001

DEFF Research Database (Denmark)

Nielsen, Heino Bohn

2007-01-01

This paper performs a multivariate cointegration analysis of UK money demand 1873-2001, and illustrates how a long-run time series analysis may be conducted on a data set characterized by turbulent episodes and institutional changes. We suggest accounting for the effects of the two world wars...

UK position paper on sodium fires

Energy Technology Data Exchange (ETDEWEB)

Vaughan, G J [National Nuclear Corporation Ltd., Risley, Warrington, Cheshire (United Kingdom); Glass, D [United Kingdom Atomic Energy Authority, Dounreay Nuclear Power Development Establishment, Thurso, Caithness (United Kingdom); Newman, R N [Central Electricity Generating Board, Berekely Nuclear Laboratory, Berkeley, Gloucestershire (United Kingdom); Ramsdale, S A [United Kingdom Atomic Energy Authority, Safety and Reliability Directorate, Culcheth, Cheshire (United Kingdom); Snelling, K W [United Kingdom Atomic Energy Authority, Atomic Energy Establishment, Winfrith, Dorchester, Dorset (United Kingdom)

1989-07-01

The UK has over several years developed a philosophy for the prevention, mitigation and extinguishment of sodium fires. The systems which were developed for PFR have been continuously revised and modified and from these considerations systems were proposed for CDFR. The latest phases of this development are described with reference to the CDFR plant. The current analytical and experimental work on fires, aerosols and sodium concrete reactions is also discussed. The UK are developing codes to analyse the effects of a sodium fire in a building and to model aerosol behaviour following a fire. Experimental work on small scale fires, aerosol behaviour, filtration devices and sodium concrete reaction is being carried out on a laboratory scale. Techniques for aerosol measurement and characterisation have also been developed and used both In the laboratory and large scale tests. Larger scale tests of sodium fire extinguishment techniques have also been performed. Currently a programme of tests (SOFA) of large scale fires in the open to investigate the chemical and physical changes in the aerosol and its dispersion in the atmosphere are just beginning. The UK studies are intended to both assist in the development of prevention and mitigation systems for design base and beyond design base accidents in any building which contains sodium (or sodium potassium alloy) and also to provide methods for assessing the risks from such accidents. (author)

UK position paper on sodium fires

International Nuclear Information System (INIS)

Vaughan, G.J.; Glass, D.; Newman, R.N.; Ramsdale, S.A.; Snelling, K.W.

1989-01-01

The UK has over several years developed a philosophy for the prevention, mitigation and extinguishment of sodium fires. The systems which were developed for PFR have been continuously revised and modified and from these considerations systems were proposed for CDFR. The latest phases of this development are described with reference to the CDFR plant. The current analytical and experimental work on fires, aerosols and sodium concrete reactions is also discussed. The UK are developing codes to analyse the effects of a sodium fire in a building and to model aerosol behaviour following a fire. Experimental work on small scale fires, aerosol behaviour, filtration devices and sodium concrete reaction is being carried out on a laboratory scale. Techniques for aerosol measurement and characterisation have also been developed and used both In the laboratory and large scale tests. Larger scale tests of sodium fire extinguishment techniques have also been performed. Currently a programme of tests (SOFA) of large scale fires in the open to investigate the chemical and physical changes in the aerosol and its dispersion in the atmosphere are just beginning. The UK studies are intended to both assist in the development of prevention and mitigation systems for design base and beyond design base accidents in any building which contains sodium (or sodium potassium alloy) and also to provide methods for assessing the risks from such accidents. (author)

The Macalister archive: records from the Queen's Hospital, Sidcup, 1917-1921.

Science.gov (United States)

Bamji, A N

1993-04-01

The Queen's Hospital opened in 1917 to care for soldiers receiving facial injuries in Western Front trenches, usually as a result of a gunshot wound. Some 8000 patients were treated by the medical teams of the UK, the Dominions and the USA. The wartime records were removed by their respective sections in 1921, but Queen Mary's Hospital has recently reacquired those of the New Zealand section, rescued from imminent destruction by Professor A.D. Macalister, late Dean of the Dental School at Dunedin, and kindly donated by him. There are 282 sets of case-notes containing typescript summaries, clinical photographs and radiographs, drawings, 77 watercolor paintings and a life-size wax model of head and upper torso illustrating some of the surgical techniques. The archive is a fine example of medical illustration 75 years ago, and provides invaluable detail on the plastic surgery and dental reconstructive methods that were developed at Sidcup.

Sector review of UK higher education energy consumption

International Nuclear Information System (INIS)

Ward, Ian; Ogbonna, Anthony; Altan, Hasim

2008-01-01

The UK education and education-related services are said to be one of the fastest-growing export earners in recent years and are known to have had significant impacts at the micro- and macro-levels of the UK. This review looks at energy consumption of this fast growing sector. It concentrates on the energy consumption patterns of the funded higher education institutions in the UK. The findings indicate energy consumption in the sector has been on the increase in the 6 years up to 2006; rising by about 2.7% above the 2001 consumption levels. This increase is, however, not evenly spread across the entire sector. The high energy-consuming institutions appear to be increasing their net consumption, relative to other institutions. Gross internal area, staff and research student full-time equivalent were found to have highest correlation with energy consumption across the sector and may be used as proxy indicators for energy consumption as well as the targets of interventions

Evolving trauma and orthopedics training in the UK.

Science.gov (United States)

Inaparthy, Praveen K; Sayana, Murali K; Maffulli, Nicola

2013-01-01

The ever-growing population of the UK has resulted in increasing demands on its healthcare service. Changes have been introduced in the UK medical training system to avoid loss of training time and make it more focused and productive. Modernizing medical careers (MMC) was introduced in 2005. This promised to reduce the training period for a safe trauma specialist, in trauma and orthopedics, to 10 years. At around the same time, the European Working Time Directive (EWTD) was introduced to reduce the working hours for junior doctors in training, to improve patient safety and also work-life balance of junior doctors. Introduction of the assessment tools from Orthopedic Competency assessment project (OCAP) will help tailor the training according to the needs of the trainee. The aim of this article is to review the changes in the UK orthopedic surgical training over the past two decades. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Oral hygiene and mouth care for older people in acute hospitals: part 1.

Science.gov (United States)

Steel, Ben J

2017-10-31

The oral health of older people in acute hospitals has rarely been studied. Hospital admission provides a prime opportunity for identification and rectification of problems, and oral health promotion. This two-part article explores oral hygiene and mouth care provision for older adults in acute hospitals. The first article presents the findings of a literature review exploring oral and dental disease in older adults, the importance of good oral health and mouth care, and the current situation. Searches of electronic databases and the websites of relevant professional health service bodies in the UK were undertaken to identify articles and guidelines. The literature shows a high prevalence of oro-dental disease in this population, with many known detrimental effects, combined with suboptimal oral hygiene and mouth care provision in acute hospitals. Several guidelines exist, although the emphasis on oral health is weaker than other aspects of hospital care. Older adults admitted to acute hospitals have a high burden of oro-dental disease and oral and mouth care needs, but care provision tends to be suboptimal. The literature is growing, but this area is still relatively neglected. Great potential exists to develop oral and mouth care in this context. The second part of this article explores clinical recommendations. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Failure Mode and Effects Analysis: views of hospital staff in the UK.

Science.gov (United States)

Shebl, Nada; Franklin, Bryony; Barber, Nick; Burnett, Susan; Parand, Anam

2012-01-01

To explore health care professionals' experiences and perceptions of Failure Mode and Effects Analysis (FMEA), a team-based, prospective risk analysis technique. Semi-structured interviews were conducted with 21 operational leads (20 pharmacists, one nurse) in medicines management teams of hospitals participating in a national quality improvement programme. Interviews were transcribed, coded and emergent themes identified using framework analysis. Themes identified included perceptions and experiences of participants with FMEA, validity and reliability issues, and FMEA's use in practice. FMEA was considered to be a structured but subjective process that helps health care professionals get together to identify high risk areas of care. Both positive and negative opinions were expressed, with the majority of interviewees expressing positive views towards FMEA in relation to its structured nature and the use of a multidisciplinary team. Other participants criticised FMEA for being subjective and lacking validity. Most likely to restrict its widespread use were its time consuming nature and its perceived lack of validity and reliability. FMEA is a subjective but systematic tool that helps identify high risk areas, but its time consuming nature, difficulty with the scores and perceived lack of validity and reliability may limit its widespread use.

East Lancashire Hospital Trust creates an open culture paving the way for service improvement 'Below ten thousand'.

Science.gov (United States)

Tomlinson, Robert

2018-05-01

Reacting to a never event is difficult and often embarrassing for staff involved. East Lancashire Hospitals NHS Trust has demonstrated that treating staff with respect after a never event, creates an open culture that encourages problem solving and service improvement. The approach has allowed learning to be shared and paved the way for the trust to be the first in the UK to launch the patient centric behavioural noise reduction strategy 'Below ten thousand'.

The UK Human Genome Mapping Project online computing service.

Science.gov (United States)

Rysavy, F R; Bishop, M J; Gibbs, G P; Williams, G W

1992-04-01

This paper presents an overview of computing and networking facilities developed by the Medical Research Council to provide online computing support to the Human Genome Mapping Project (HGMP) in the UK. The facility is connected to a number of other computing facilities in various centres of genetics and molecular biology research excellence, either directly via high-speed links or through national and international wide-area networks. The paper describes the design and implementation of the current system, a 'client/server' network of Sun, IBM, DEC and Apple servers, gateways and workstations. A short outline of online computing services currently delivered by this system to the UK human genetics research community is also provided. More information about the services and their availability could be obtained by a direct approach to the UK HGMP-RC.

Evaluating the UK's carbon budget using a dense network of tall-tower observations

Science.gov (United States)

White, E.; Rigby, M. L.; Manning, A.; Lunt, M. F.; Ganesan, A.; O'Doherty, S.; Stavert, A.; Stanley, K. M.; Williams, M. D.; Smallman, T. L.; Comyn-Platt, E.; Levy, P. E.

2017-12-01

The UK has committed to reducing greenhouse gas (GHG) emissions to 80% of 1990 levels by 2050. Evaluating the UK's GHG emissions, and in particular those of carbon dioxide, is imperative to the UK's ability to track progress towards these goals. Making top-down estimates of regional carbon dioxide emissions is challenging due to the rapid temporal variability in the biogenic flux, and the co-location of anthropogenic and biogenic sources and sinks. We present a hierarchical Bayesian inverse modelling framework, which is able to estimate a yearly total (anthropogenic and biogenic) carbon dioxide budget for the UK. Using observations from a high-density GHG monitoring network, combined with high temporal resolution prior information and a Lagrangian atmospheric transport model (NAME, developed by the UK Met Office), we derive a net positive flux for the UK of 0.39 Pg/yr in 2014. We will compare the outcome of inversions that used prior information from two different biosphere models, CARDAMOM and JULES. This comparison helps to understand more about the biogenic processes contributing to the UK's carbon dioxide budget, limitations with different modelling approaches and the sensitivity of the inversion framework to the choice of prior. A better understanding of how the biogenic flux changes throughout the year can, in turn, help to improve the UK's anthropogenic carbon dioxide inventory by identifying times in the year when the anthropogenic signal may be possible to detect.

16th UK Workshop on Computational Intelligence

CERN Document Server

Gegov, Alexander; Jayne, Chrisina; Shen, Qiang

2017-01-01

The book is a timely report on advanced methods and applications of computational intelligence systems. It covers a long list of interconnected research areas, such as fuzzy systems, neural networks, evolutionary computation, evolving systems and machine learning. The individual chapters are based on peer-reviewed contributions presented at the 16th Annual UK Workshop on Computational Intelligence, held on September 7-9, 2016, in Lancaster, UK. The book puts a special emphasis on novels methods and reports on their use in a wide range of applications areas, thus providing both academics and professionals with a comprehensive and timely overview of new trends in computational intelligence.

Continuous subcutaneous insulin infusion (CSII) therapy at Derby Teaching Hospitals: sustained benefits in glucose control.

Science.gov (United States)

Anyanwagu, U; Olaoye, H; Jennings, P; Ashton-Cleary, S; Sugunendran, S; Hughes, D; Idris, I; Wilmot, E G

2017-08-01

In the short term, continuous subcutaneous insulin infusion (CSII) has been associated with improved glycaemic control, reduced hypoglycaemia and improved quality of life (QOL). However, limited data are available on its long-term benefits, particularly in the UK. We aimed to assess the impact of CSII on longer term outcomes. Patient-level data were obtained for CSII users at Derby Teaching Hospitals, UK. Patient confidence and satisfaction questionnaires using the Likert scale were used to assess confidence in self-management. Comparative statistics were conducted using Pearson's chi-square and Student's t-tests. Some 258 CSII users were identified (60.1% female, mean age 43.9 ± 13.4 years). Overall, there was significant decrease in HbA 1c from 78 mmol/mol (9.3 ± 2.0%) at baseline, to 69 mmol/mol (8.5 ± 1.3%) at 6 months [mean difference (md): -0.64; 95% confidence interval (95% CI): -0.91 to -0.37; P quality of care received in the insulin pump service. CSII therapy led to a sustained long-term improvement in glycaemic control in addition to a reduction in self-reported hypoglycaemia. © 2017 Diabetes UK.

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

Consultant input in acute medical admissions and patient outcomes in hospitals in England: a multivariate analysis.

Science.gov (United States)

Bell, Derek; Lambourne, Adrian; Percival, Frances; Laverty, Anthony A; Ward, David K

2013-01-01

Recent recommendations for physicians in the UK outline key aspects of care that should improve patient outcomes and experience in acute hospital care. Included in these recommendations are Consultant patterns of work to improve timeliness of clinical review and improve continuity of care. This study used a contemporaneous validated survey compared with clinical outcomes derived from Hospital Episode Statistics, between April 2009 and March 2010 from 91 acute hospital sites in England to evaluate systems of consultant cover for acute medical admissions. Clinical outcomes studied included adjusted case fatality rates (aCFR), including the ratio of weekend to weekday mortality, length of stay and readmission rates. Hospitals that had an admitting Consultant presence within the Acute Medicine Unit (AMU, or equivalent) for a minimum of 4 hours per day (65% of study group) had a lower aCFR compared with hospitals that had Consultant presence for less than 4 hours per day (p40 acute medical admissions per day had a lower aCFR compared to hospitals with fewer than 40 admissions per day (pstudy is the first large study to explore the potential relationships between systems of providing acute medical care and clinical outcomes. The results show an association between well-designed systems of Consultant working practices, which promote increased patient contact, and improved patient outcomes in the acute hospital setting.

The Anatomy of International Students' Acculturation in UK Universities

Science.gov (United States)

Gbadamosi, Ayantunji

2018-01-01

The diversity of the student population in the United Kingdom's higher education sector evokes a vision of the world as a global village. The effect of this diversity on the UK economy has been considerable. Nevertheless, the research attention given to how overseas students can become integrated into UK culture remains inadequate. This…

As UK inches towards Chinese reactor project, China sets sights on new world markets

Energy Technology Data Exchange (ETDEWEB)

Shepherd, John [nuclear 24, St George' s Redditch (United Kingdom)

2017-02-15

Early in January, as many of us in Europe were getting back into the routine of returning to work following the festive period, a new chapter in the history of nuclear energy was already starting to be written in the UK. The UK government asked the country's nuclear regulators, the Office for Nuclear Regulation (ONR) and the Environment Agency, to start a generic design assessment (GDA) of what is now known as the 'UK HPR1000 reactor' - which is set to be the first deployment of Chinese reactor technology outside China. If the UK HPR1000 is eventually built in the UK, which would be at a designated site adjacent to the country's former Bradwell nuclear power plant in Essex, on the eastern coast, the project will not only be a first for the use of Chinese nuclear technology in any other country, it will ironically make UK ties with France stronger - at a time when the UK is preparing to break away from the European Union.

Wpływ wysiłku fizycznego na funkcję układu oddechowego w twardzinie układowej

OpenAIRE

Stanisław Sierakowski; Ewa Gińdzieńska-Sieśkiewicz; Maciej Kaczmarski; Zenon Siergiejko; Grzegorz Siergiejko; Piotr Siergiejko; Justyna Fryc

2010-01-01

Cel: Powikłania ze strony układu oddechowego stanowią główną przyczynę zgonów pacjentów z twardziną układową (TU). Tętniczenadciśnienie płucne i śródmiąższowa choroba płuc stanowią najistotniejszez nich. Pacjenci są jednak często zdiagnozowani dopierow późnym okresie choroby, dlatego też istotne jest opracowaniemetody diagnostycznej do wczesnego wykrywania tych powikłań.Celem pracy była ocena wpływu wysiłku fizycznego na zmiany parametrówoddechowych. Materiały i metody: Badania przeprowadzono...

Management of achalasia in the UK, do we need new guidelines?

Directory of Open Access Journals (Sweden)

Jihene El Kafsi

2016-12-01

Conclusion: Diagnosis and management of achalasia within the UK is relatively standardised, although there remains limited access to HRM. Discussion at benign MDTs however is poor and follow-up differs widely. UK guidelines may help to make these more uniform.

Has Economics become an Elite Subject for Elite UK Universities?

Science.gov (United States)

Johnston, James; Reeves, Alan; Talbot, Steven

2014-01-01

The decline in the number of UK universities offering undergraduate degree programmes in subjects such as sciences, mathematics, modern languages and humanities has been well documented and is now of real concern. It appears that economics may be going through a decline in new (post-1992) UK universities with many economics programmes having been…

The Prevalence of Intellectual Disability in a Major UK Prison

Science.gov (United States)

Hayes, Susan; Shackell, Phil; Mottram, Pat; Lancaster, Rachel

2007-01-01

Over-representation of people with learning disability in prisons has been demonstrated in many Western jurisdictions. This was the first comprehensive research in a UK prison. The research used a random 10% sample of a prison population (n = 140). A semi-structured interview, the Wechsler Adult Intelligence Scale-III (UK version) and the Vineland…

Health professional perspectives on lifestyle behaviour change in the paediatric hospital setting: a qualitative study.

Science.gov (United States)

Elwell, Laura; Powell, Jane; Wordsworth, Sharon; Cummins, Carole

2014-03-13

Research exists examining the challenges of delivering lifestyle behaviour change initiatives in practice. However, at present much of this research has been conducted with primary care health professionals, or in acute adult hospital settings. The purpose of this study was to identify barriers and facilitators associated with implementing routine lifestyle behaviour change brief advice into practice in an acute children's hospital. Thirty-three health professionals (nurses, junior doctors, allied health professionals and clinical support staff) from inpatient and outpatient departments at a UK children's hospital were interviewed about their attitudes and beliefs towards supporting lifestyle behaviour change in hospital patients and their families. Responses were analysed using thematic framework analysis. Health professionals identified a range of barriers and facilitators to supporting lifestyle behaviour change in a children's hospital. These included (1) personal experience of effectiveness, (2) constraints associated with the hospital environment, (3) appropriateness of advice delivery given the patient's condition and care pathway and (4) job role priorities, and (5) perceived benefits of the advice given. Delivery of lifestyle behaviour change advice was often seen as an educational activity, rather than a behaviour change activity. Factors underpinning the successful delivery of routine lifestyle behaviour change support must be understood if this is to be implemented effectively in paediatric acute settings. This study reveals key areas where paediatric health professionals may need further support and training to achieve successful implementation.

Indications for Caesarean sections in a rural hospital in the Highlands of Papua New Guinea.

Science.gov (United States)

Mark, Terence B; Radcliffe, Jim; Laman, Moses

2014-07-01

We retrospectively documented indications for Caesarean sections in a rural district level hospital in the highlands of Papua New Guinea. Over a 53-month study period, 745 Caesarean sections were performed. Prolonged labour, previous history of Caesarean section, cephalopelvic disproportion, malpresentation and fetal distress accounted for over 88% of Caesarean sections performed. In older mothers (aged >30 years), antepartum haemorrhage (Fisher exact test, P = 0.05) and multiple indications (P = 0.001) were leading reasons for Caesarean sections while cephalopelvic disproportion (P = 0.005) was the leading indication in younger mothers. Further prospective studies incorporating perinatal and maternal mortality rates are required to optimise the value of Caesarean sections at district level hospitals in Papua New Guinea. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Impact of hospital mergers on staff job satisfaction: a quantitative study.

Science.gov (United States)

Lim, Ka Keat

2014-12-12

Hospital mergers began in the UK in the late 1990s to deal with underperformance. Despite their prevalence, there is a lack of research on how such organizational changes affect the staff morale. This study aims to assess the impact of NHS hospital mergers between financial years 2009/10 and 2011/12 on staff job satisfaction and to identify factors contributing to satisfaction. Data on staff job satisfaction were obtained from the annual NHS Staff Survey. A list of mergers was compiled using data provided by the Cooperation and Competition Panel and the Department of Health. Other sources of data included the NHS Hospital Estates and Facilities Statistics, the NHS 'Quarter' publication, official reports from health service regulators, individual hospitals' annual accounts, data from the NHS Information Centre and the NHS Recurrent Revenue Allocations Exposition Book. Only full mergers of acute and mental health hospitals were analyzed. Propensity scores were generated using observable factors likely to affect merger decision to select three comparable hospitals for every constituent hospital in a merger to act as a control group. A difference-in-difference was estimated between baseline (3 years before merger approval) and each subsequent year up to 4 years post-merger, controlling for work environment, drivers of job satisfaction, data year, type of hospital and occupation group. There were nine mergers during the study period. Only job satisfaction scores 1 to 2 years before (0.03 to 0.04 point) and 1 year after merger approval (0.06 point) were higher (P job clarity ratings would increase job satisfaction scores. Higher job satisfaction scores were also associated with being classified as medical, dental, management or administrative staff and working in a mental health trust. Hospital mergers have a small, transient positive impact on staff job satisfaction in the year immediately before and after merger approval. Continuous staff support and management of

'Being a conduit' between hospital and home: stakeholders' views and perceptions of a nurse-led Palliative Care Discharge Facilitator Service in an acute hospital setting.

Science.gov (United States)

Venkatasalu, Munikumar Ramasamy; Clarke, Amanda; Atkinson, Joanne

2015-06-01

To explore and critically examine stakeholders' views and perceptions concerning the nurse-led Palliative Care Discharge Service in an acute hospital setting and to inform sustainability, service development and future service configuration. The drive in policy and practice is to enable individuals to achieve their preferred place of care during their last days of life. However, most people in UK die in acute hospital settings against their wishes. To facilitate individuals' preferred place of care, a large acute hospital in northeast England implemented a pilot project to establish a nurse-led Macmillan Palliative Care Discharge Facilitator Service. A pluralistic evaluation design using qualitative methods was used to seek stakeholders' views and perceptions of this service. In total, 12 participants (five bereaved carers and seven health professionals) participated in the evaluation. Semi-structured interviews were conducted with bereaved carers who used this service for their relatives. A focus group and an individual interview were undertaken with health professionals who had used the service since its inception. Individual interviews were also conducted with the Discharge Facilitator and service manager. Analysis of all data was guided by Framework Analysis. Four key themes emerged relating to the role of the Discharge Facilitator Service: achieving preferred place of care; the Discharge Facilitator as the 'conduit' between hospital and community settings; delays in hospital discharge and stakeholders' perceptions of the way forward for the service. The Discharge Facilitator Service acted as a reliable resource and support for facilitating the fast-tracking of end-of-life patients to their preferred place of care. Future planning for hospital-based palliative care discharge facilitating services need to consider incorporating strategies that include: increased profile of the service, expansion of service provision and the Discharge Facilitator's earlier

Saturated and trans-fatty acids in UK takeaway food.

Science.gov (United States)

Davies, Ian Glynn; Blackham, Toni; Jaworowska, Agnieszka; Taylor, Catherine; Ashton, Matthew; Stevenson, Leonard

2016-01-01

The aim of the study was to analyze the saturated fatty acid (SFA) and trans-fatty acid (TFA) contents of popular takeaway foods in the UK (including English, pizza, Chinese, Indian and kebab cuisine). Samples of meals were analyzed by an accredited public analyst laboratory for SFA and TFA. The meals were highly variable for SFA and TFA. English and Pizza meals had the highest median amount of SFA with 35.7 g/meal; Kebab meals were high in TFA with up to 5.2 g/meal. When compared to UK dietary reference values, some meals exceeded SFA and TFA recommendations from just one meal. Takeaway food would be an obvious target to reduce SFA and TFA contents and increase the potential of meeting UK recommendations. Strategies such as reformulation and smaller takeaway portion sizes warrant investigation.

Uniforms, status and professional boundaries in hospital.

Science.gov (United States)

Timmons, Stephen; East, Linda

2011-11-01

Despite their comparative neglect analytically, uniforms play a key role in the delineation of occupational boundaries and the formation of professional identity in healthcare. This paper analyses a change to the system of uniforms in one UK hospital, where management have required all professions (with the exception of doctors) to wear the same 'corporate' uniform. Focus groups were conducted with the professionals and patients. We analyse this initiative as a kind of McDonaldisation, seeking to create a new 'corporate' worker whose allegiance is principally to the organisation, rather than a profession. Our findings show how important uniforms are to their wearers, both in terms of the defence of professional boundaries and status, as well as the construction of professional identity. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

Students and Sex Work in the UK: Providers and Purchasers

Science.gov (United States)

Roberts, Ron; Jones, Amy; Sanders, Teela

2013-01-01

Available evidence suggests that changes in the funding of UK higher education in recent years have been accompanied by an increased student presence in the sex industry, ostensibly for financial reasons and to make ends meet. The current study comprises a sample of students ("N" = 200) drawn from several universities in the UK. Data…

Teaching Astronomy in UK Schools

Science.gov (United States)

Roche, Paul; Roberts, Sarah; Newsam, Andy; Barclay, Charles

2012-01-01

This article attempts to summarise the good, bad and (occasionally) ugly aspects of teaching astronomy in UK schools. It covers the most common problems reported by teachers when asked about covering the astronomy/space topics in school. Particular focus is given to the GCSE Astronomy qualification offered by Edexcel (which is currently the…

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...

Risk-adjusted survival for adults following in-hospital cardiac arrest by day of week and time of day: observational cohort study.

Science.gov (United States)

Robinson, Emily J; Smith, Gary B; Power, Geraldine S; Harrison, David A; Nolan, Jerry; Soar, Jasmeet; Spearpoint, Ken; Gwinnutt, Carl; Rowan, Kathryn M

2016-11-01

Internationally, hospital survival is lower for patients admitted at weekends and at night. Data from the UK National Cardiac Arrest Audit (NCAA) indicate that crude hospital survival was worse after in-hospital cardiac arrest (IHCA) at night versus day, and at weekends versus weekdays, despite similar frequency of events. To describe IHCA demographics during three day/time periods-weekday daytime (Monday to Friday, 08:00 to 19:59), weekend daytime (Saturday and Sunday, 08:00 to 19:59) and night-time (Monday to Sunday, 20:00 to 07:59)-and to compare the associated rates of return of spontaneous circulation (ROSC) for >20 min (ROSC>20 min) and survival to hospital discharge, adjusted for risk using previously developed NCAA risk models. To consider whether any observed difference could be attributed to differences in the case mix of patients resident in hospital and/or the administered care. We performed a prospectively defined analysis of NCAA data from 27 700 patients aged ≥16 years receiving chest compressions and/or defibrillation and attended by a hospital-based resuscitation team in response to a resuscitation (2222) call in 146 UK acute hospitals. Risk-adjusted outcomes (OR (95% CI)) were worse (p20 min 0.88 (0.81 to 0.95); hospital survival 0.72 (0.64 to 0.80)), and night-time (ROSC>20 min 0.72 (0.68 to 0.76); hospital survival 0.58 (0.54 to 0.63)) compared with weekday daytime. The effects were stronger for non-shockable than shockable rhythms, but there was no significant interaction between day/time of arrest and age, or day/time of arrest and arrest location. While many daytime IHCAs involved procedures, restricting the analyses to IHCAs in medical admissions with an arrest location of ward produced results that are broadly in line with the primary analyses. IHCAs attended by the hospital-based resuscitation team during nights and weekends have substantially worse outcomes than during weekday daytimes. Organisational or care differences at

Interval between onset of psoriasis and psoriatic arthritis comparing the UK Clinical Practice Research Datalink with a hospital-based cohort.

Science.gov (United States)

Tillett, William; Charlton, Rachel; Nightingale, Alison; Snowball, Julia; Green, Amelia; Smith, Catherine; Shaddick, Gavin; McHugh, Neil

2017-12-01

To describe the time interval between the onset of psoriasis and PsA in the UK primary care setting and compare with a large, well-classified secondary care cohort. Patients with PsA and/or psoriasis were identified in the UK Clinical Practice Research Datalink (CPRD). The secondary care cohort comprised patients from the Bath PsA longitudinal observational cohort study. For incident PsA patients in the CPRD who also had a record of psoriasis, the time interval between PsA diagnosis and first psoriasis record was calculated. Comparisons were made with the time interval between diagnoses in the Bath cohort. There were 5272 eligible PsA patients in the CPRD and 815 in the Bath cohort. In both cohorts, the majority of patients (82.3 and 61.3%, respectively) had psoriasis before their PsA diagnosis or within the same calendar year (10.5 and 23.8%), with only a minority receiving their PsA diagnosis first (7.1 and 14.8%). Excluding those who presented with arthritis before psoriasis, the median time between diagnoses was 8 years [interquartile range (IQR) 2-15] in the CPRD and 7 years (IQR 0-20) in the Bath cohort. In the CPRD, 60.1 and 75.1% received their PsA diagnosis within 10 and 15 years of their psoriasis diagnosis, respectively; this was comparable with 57.2 and 67.7% in the Bath cohort. A similar distribution for the time interval between psoriasis and arthritis was observed in the CPRD and secondary care cohort. These data can inform screening strategies and support the validity of data from each cohort. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

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

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...

Mobile phone collection, reuse and recycling in the UK

International Nuclear Information System (INIS)

Ongondo, F.O.; Williams, I.D.

2011-01-01

Highlights: → We characterized the key features of the voluntary UK mobile phone takeback network via a survey. → We identified 3 flows: information; product (handsets and accessories); and incentives. → There has been a significant rise in the number of UK takeback schemes since 1997. → Most returned handsets are low quality; little data exists on quantities of mobile phones collected. → Takeback schemes increasingly divert EoL mobile phones from landfill and enable reuse/recycling. - Abstract: Mobile phones are the most ubiquitous electronic product on the globe. They have relatively short lifecycles and because of their (perceived) in-built obsolescence, discarded mobile phones represent a significant and growing problem with respect to waste electrical and electronic equipment (WEEE). An emerging and increasingly important issue for industry is the shortage of key metals, especially the types of metals found in mobile phones, and hence the primary aim of this timely study was to assess and evaluate the voluntary mobile phone takeback network in the UK. The study has characterised the information, product and incentives flows in the voluntary UK mobile phone takeback network and reviewed the merits and demerits of the incentives offered. A survey of the activities of the voluntary mobile phone takeback schemes was undertaken in 2008 to: identify and evaluate the takeback schemes operating in the UK; determine the target groups from whom handsets are collected; and assess the collection, promotion and advertising methods used by the schemes. In addition, the survey sought to identify and critically evaluate the incentives offered by the takeback schemes, evaluate their ease and convenience of use; and determine the types, qualities and quantities of mobile phones they collect. The study has established that the UK voluntary mobile phone takeback network can be characterised as three distinctive flows: information flow; product flow (handsets and related

Some UK experience and practice in the packaging and transport of irradiated fuel

International Nuclear Information System (INIS)

Edney, C.J.; Rutter, R.L.

1977-01-01

The origin and growth of irradiated fuel transport within and to the U.K. is described and the role of the organisations presently carrying out transport operations is explained. An explanation of the relevant U.K. regulations and laws affecting irradiated fuel transport and the role of the controlling body, the Department of the Environment is given. An explanation is given of the technical requirements for the transport of irradiated Magnox fuel and of the type of flask used, and the transport arrangements, both within the U.K. and to the U.K., from overseas is discussed. The technical requirements for the transport of C.A.G.R. fuel are outlined and the flask and transport arrangements are discussed. The transport requirements of oxide fuel from water reactors is outlined and the flask and shipping arrangements under which this fuel is brought to the U.K. from overseas is explained. The shipping arrangements are explained with particular reference to current international and national requirements. The requirements of the transport of M.T.R. fuel are discussed and the flask type explained. The expected future expansion of the transport of irradiated fuel within and to the U.K. is outlined and the proposed operating methods are briefly discussed. A summary is given of the U.K. experience and the lessons to be drawn from that experience

Developing wind energy for the UK

Energy Technology Data Exchange (ETDEWEB)

Rand, Marcus [Open Univ., Milton Keynes (GB). Faculty of Technology

1990-01-01

There is now emerging a consensus that the sensitive development of renewable sources of energy, and in particular wind energy, is going to be of major environmental significance for the UK. Primarily, renewable sources of energy can act as a means of combating the Greenhouse Effect and of reducing the other environmental impacts of conventional energy technology, including the build-up of radioactive waste and the damaging emissions from fossil fuelled power stations. The UK has a large natural potential for harnessing energy from the wind (between 20% and 200% of our current electrical requirements). This potential is beginning to be tapped. Wind energy is now in a position where it can take advantage of the profound changes taking place in the form of the privatisation of the Electricity Supply Industry. In other countries wind energy has developed successfully. (author).

MNCs in Denmark and the UK

DEFF Research Database (Denmark)

Navrbjerg, Steen Erik; Marginson, Paul

2016-01-01

Multinational companies (MNCs) have more opportunities than ever to forum shop and choose between different market systems - including different industrial relations (IR) systems. When an MNC choose to engage in a certain country, it also becomes an actor in the country's labor market system. MNCs...... are often quite large companies, and hence they can become significant players, potentially affecting the existing balances between the social partners. The question is whether MNCs adapt to the host country's labor market system (host country effect) - or if they seek in various ways to change the host...... to determine the employment relations. Quite the opposite to the UK, where trade unions are weak and where collective bargaining is far less widespread. Further analyses show that MNCs originating from liberal market economies (especially the US) acts differently in the two countries; in the UK they tend...

Graphite core design in UK reactors

International Nuclear Information System (INIS)

Davies, M.W.

1996-01-01

The cores in the first power producing Magnox reactors in the UK were designed with only a limited amount of information available regarding the anisotropic dimensional change behaviour of Pile Grade graphite. As more information was gained it was necessary to make modifications to the design, some minor, some major. As the cores being built became larger, and with the switch to the Advanced Gas-cooled Reactor (AGR) with its much higher power density, additional problems had to be overcome such as increased dimensional change and radiolytic oxidation by the carbon dioxide coolant. For the AGRs a more isotropic graphite was required, with a lower initial open pore volume and higher strength. Gilsocarbon graphite was developed and was selected for all the AGRs built in the UK. Methane bearing coolants are used to limit radiolytic oxidation. (author). 5 figs

Local policies for DSM: the UK's home energy conservation act

International Nuclear Information System (INIS)

Jones, E.; Leach, M.

2000-01-01

Residential energy use accounts for approximately 28 per cent of total primary energy use in the UK, with consumption in this sector forecast to increase due partly to expanding numbers of households. Finding ways to reduce residential energy consumption must form a key part of the climate change strategies of the UK and all developed countries. In 1995, an innovative piece of legislation was passed in the UK, devolving residential energy efficiency responsibility to local government. Under 'The Home Energy Conservation Act' (HECA), local authorities are obliged to consider the energy efficiency of private as well as public housing stock. Authorities were given a duty to produce a strategy for improving residential energy efficiency in their area by 30 per cent in the next 10-15 years. This paper describes the enormous variation in the quality of local authorities' strategies and discusses reasons for this variation. Based on a nationwide survey of HECA lead officers, it considers the opportunities and constraints facing local authorities, and what has been achieved to-date under the Act. It also examines how HECA fits into the UK's national energy policy and explains the roles of other institutions across the public, private and voluntary sector in facilitating implementation of the Act. Finally, the paper considers how other countries can learn from the UK's HECA experience and can use the Act as a template to apply the principle of subsidiarity to this area of environmental policy. (Author)

Regulation, proportionality and discharges of radioactive wastes: UK perspective

International Nuclear Information System (INIS)

Morley, Bob; Butler, Gregg; Mc Glynn, Grace

2008-01-01

In recent years, the UK Government and the Regulators have made a commitment to further improve the operation of the regulatory regime and to its operating within the principles of proportionality, transparency, consistency and accountability which underpin the Government's approach to regulation in general. Particular emphasis was to be placed upon ensuring that there is greater consistency in the treatment of risk and hazard; proportionate and cost effective delivery of public, worker and environmental protection; and an open and transparently applied regulatory system. It is noteworthy that with regard to radiation protection, there are different limits for public doses and workforce doses, with the latter 15 times greater. Allowable doses for medical patients are higher still. This discrepancy raises a question in itself. This presentation focuses on the practical application of the regulatory regime with particular regard to environmental discharges and disposals. Under the Radioactive Substances Act 1993, Operators within the UK nuclear industry are required to employ Best Practicable Means (BPM) to control and minimise radioactive discharges to ensure that doses from discharges are As Low As Reasonably Achievable (ALARA). Scientific assessments to date indicate that there are no expectations of environmental harm from discharges at Sellafield (and hence likewise at other UK nuclear sites where the discharges are lower), even where those discharges have historically been up to two orders of magnitude higher than current levels. Current discharges result in doses which are a small fraction of those received by the UK population due to natural background radiation. In addition, there is no proven environmental harm from foreseeable future discharges from Sellafield or other UK nuclear sites. This is supported by independent work which illustrates that the public collective dose from Sellafield discharges is almost all delivered at risks of less that one in a

Renewable energy policy in the UK 1990-2003

International Nuclear Information System (INIS)

Mitchell, Catherine; Connor, Peter

2004-01-01

The UK's renewable energy policy has been characterised by opportunism, cost-limiting caps and continuous adjustments resulting from a lack of clarity of goals. Renewable electricity has had a specific delivery mechanism in place since 1990. The Non-Fossil Fuel Obligation (NFFO) did not deliver deployment; did not create mentors; did not promote diversity; was focussed on electricity and was generally beneficial only to large companies. A new support mechanism, the Renewable Obligation, began in April 2002. This may result in more deployment than the NFFO, but is also beneficial to electricity-generating technologies and large, established companies only. The UK Government published a visionary energy policy in early 2003 placing the UK on a path to cutting carbon dioxide emissions by 60% in 2050. This paper argues that unless the Government 'learns' from it's past results, mistakes and difficulties, clarifies the reasons for supporting renewable energy and then follows through with a focussed policy aimed at delivery, diversity and the creation of mentors, it is likely to be no more successful than the previous 13 years of renewable policy

Tidal Power in the UK and Worldwide to Reduce Greenhouse Gas Emissions

Directory of Open Access Journals (Sweden)

T. J. Hammons

2011-05-01

Full Text Available This paper discusses the role of Tidal Power in the UK in fulfilling the UK's requirements for reducing greenhouse gas emissions. Generating electricity from tidal range of the Severn Estuary has the potential to generate some 5% of UK electricity from a renewable indigenous resource. The paper focuses primarily on the proposed Severn Barrage considering potential benefits, conditions for sustainable development, energy policy context and compliance with environment legislation. UK tidal resource is reviewed: stream resource (that is KE contained in fast-flowing tidal currents, and tidal range resource (that refers to gravitation potential energy. The top tidal range and tidal stream sites in the UK with the resource (in TWh/year are indicated. A feasibility study for Tidal Range development in the Mersey Estuary is also summarised and other schemes including the Loughor Estuary (Wales, Duddon Estuary (located on the Cumbrian coast and the Thames Estuary proposals are reported. Also given is a strategic overview of the Severn Estuary resource, electric output and characteristics, carbon emissions (carbon payback and carbon reduction potential and physical implications of a barrage.

Environmental aspects of large-scale wind-power systems in the UK

Science.gov (United States)

Robson, A.

1984-11-01

Environmental issues relating to the introduction of large, MW-scale wind turbines at land-based sites in the UK are discussed. Noise, television interference, hazards to bird life, and visual effects are considered. Areas of uncertainty are identified, but enough is known from experience elsewhere in the world to enable the first UK machines to be introduced in a safe and environementally acceptable manner. Research to establish siting criteria more clearly, and significantly increase the potential wind-energy resource is mentioned. Studies of the comparative risk of energy systems are shown to be overpessimistic for UK wind turbines.

WorldSkills UK Training Managers: Midas Touch or Fool’s Gold?

Directory of Open Access Journals (Sweden)

Stephanie Wilde

2015-08-01

Full Text Available This article focuses on the role of training managers (TMs in UK participation in WorldSkills Competitions (WSC. The TM role is outlined, according to the perceptions of the TMs, and there is analysis of the benefits to them of participation, as well as the barriers they face, and the benefits and barriers available to participating further education colleges and employers. The article is based on analysis of semi-structured interviews with almost the full cohort of UK TMs preparing competitors for WorldSkills Brazil 2015, and concludes with reflections on the vision and purposes of UK WorldSkills participation.

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.

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

Science.gov (United States)

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

2017-12-01

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

Energy, the UK and the European Community

International Nuclear Information System (INIS)

Lucas, N.

1982-01-01

The emphasis of effort in European energy policy should be placed on external relations rather than internal regulation. The divergence of the interests of the United States and Europe in energy policy will no longer allow Europe to depend on US initiative. The temporary relaxation of world oil markets has engendered unrealistic complacency. The European Community must develop its important role as a means whereby the member states can formulate common initiatives to press within international institutions. Strong presentation of interests externally has to be complemented by internal adaptation. The Community has at the moment few means of influencing the form and nature of energy investment. This paper proposes a fund of the order of Pound1 bn per annum to be used for the promotion of projects whose intrinsic benefits are not fully translated into commercial advantage and which need political stimulus. Such a Fund might be, but need not necessarily be, financed by a small levy on imported oil. The UK should present more aggressively the considerable benefits which accrue to the Community from UK resources. There is perhaps an opportunity to take a more extrovert view of the relationship between the UK and the continental gas transport systems. (author)

Measuring and monitoring fuel poverty in the UK: National and regional perspectives

International Nuclear Information System (INIS)

Liddell, Christine; Morris, Chris; McKenzie, S.J.P.; Rae, Gordon

2012-01-01

Throughout the industrialised world, fuel poverty is the most commonly accepted term with which to describe a household's inability to afford basic standards of heat, power and light. Whilst the term gained widespread acceptance with the publication of the UK's Fuel Poverty Strategy in 2001, little is known about the origins of the term itself. This paper traces the earliest formulations of the concept, focusing particularly on the 10% needs to spend threshold which was adopted in 1991 and remains in place some 20 years later. This paper argues that understanding more about the origins of this threshold yields a more critical understanding of why fuel poverty targets in the UK have not been reached, and enables a more informed approach to setting realistic targets for the future. It also provides an opportunity to explore regional disparities in UK fuel poverty prevalence, highlighting the extent to which rigid adherence to a 10% threshold has created an unstable regional mosaic of over-estimation and under-estimation. - Highlights: ► We highlight the origins of the 10% threshold used to define fuel poverty in the UK. ► This sheds new light on why fuel poverty targets in the UK have not been reached. ► It also helps interpret regional disparities in UK fuel poverty prevalence. ► The threshold has created an unstable mosaic of over- and under-estimation.

SCOPS and COWS--'worming it out of UK farmers'.

Science.gov (United States)

Taylor, M A

2012-05-04

Infections with gastrointestinal roundworms are an important cause of production losses in sheep and cattle. Worm control is a vital part of health and production management in sheep flocks and cattle herds in the UK, and good control is highly dependent on effective anthelmintics. Unfortunately, a direct and unavoidable consequence of using anthelmintics to control worm populations is selection for individuals that are resistant to the chemicals used. If left unchecked, anthelmintic resistance (AR) could prove to be one of the biggest challenges to sheep and cattle production and animal welfare within the UK. As a consequence of increasing reports of AR in sheep, a working group, "SCOPS" (sustainable control of parasites in sheep) was formed in 2003 with representatives from the UK sheep industry to promote practical guidelines for sheep farmers and their advisors. This led to the production of guidelines for 'sustainable worm control strategies for sheep' intended for veterinarians and sheep advisors, plus ongoing promotional literature aimed at farmers. Whilst there is some evidence of emerging resistance in roundworms of cattle, it appears to still be at a very low level in the UK. However the potential presence of such AR in cattle worms has been seen as a timely warning, which if ignored, could lead to a not dissimilar AR situation to that seen in sheep, and in other cattle areas around the world. Reports of AR in UK cattle nematodes have generally been limited to a small number of anecdotal reports of treatment failure with some macrocyclic lactone (ML) products, especially those formulated as pour-on preparations, and invariably involving the dose-limiting species, Cooperia oncophora. As a consequence of these observations, guidelines have been produced similar to those for sheep, for sustainable worm control strategies for cattle "COWS" (control of worms sustainably), and were launched in May 2010. Uptake and effectiveness of SCOPS recommendations are

Vascular access in lipoprotein apheresis: a retrospective analysis from the UK's largest lipoprotein apheresis centre.

Science.gov (United States)

Doherty, Daniel J; Pottle, Alison; Malietzis, George; Hakim, Nadey; Barbir, Mahmoud; Crane, Jeremy S

2018-01-01

Lipoprotein apheresis (LA) has proven to be an effective, safe and life-saving therapy. Vascular access is needed to facilitate this treatment but has recognised complications. Despite consistency in treatment indication and duration there are no guidelines in place. The aim of this study is to characterise vascular access practice at the UK's largest LA centre and forward suggestions for future approaches. A retrospective analysis of vascular access strategies was undertaken in all patients who received LA treatment in the low-density lipoprotein (LDL) Apheresis Unit at Harefield Hospital (Middlesex, UK) from November 2000 to March 2016. Fifty-three former and current patients underwent 4260 LA treatments. Peripheral vein cannulation represented 79% of initial vascular access strategies with arteriovenous (AV) fistula use accounting for 15%. Last used method of vascular access was peripheral vein cannulation in 57% versus AV fistula in 32%. Total AV fistula failure rate was 37%. Peripheral vein cannulation remains the most common method to facilitate LA. Practice trends indicate a move towards AV fistula creation; the favoured approach receiving support from the expert body in this area. AV fistula failure rate is high and of great concern, therefore we suggest the implementation of upper limb ultrasound vascular mapping in all patients who meet treatment eligibility criteria. We encourage close ties between apheresis units and specialist surgical centres to facilitate patient counselling and monitoring. Further prospective data regarding fistula failure is needed in this expanding treatment field.

Variations in mortality after emergency laparotomy: the first report of the UK Emergency Laparotomy Network.

Science.gov (United States)

Saunders, D I; Murray, D; Pichel, A C; Varley, S; Peden, C J

2012-09-01

Emergency laparotomy is a common intra-abdominal procedure. Outcomes are generally recognized to be poor, but there is a paucity of hard UK data, and reports have mainly been confined to single-centre studies. Clinicians were invited to join an 'Emergency Laparotomy Network' and to collect prospective non-risk-adjusted outcome data from a large number of NHS Trusts providing emergency surgical care. Data concerning what were considered to be key aspects of perioperative care, including thirty-day mortality, were collected over a 3 month period. Data from 1853 patients were collected from 35 NHS hospitals. The unadjusted 30 day mortality was 14.9% for all patients and 24.4% in patients aged 80 or over. There was a wide variation between units in terms of the proportion of cases subject to key interventions that may affect outcomes. The presence of a consultant surgeon in theatre varied between 40.6% and 100% of cases, while a consultant anaesthetist was present in theatre for 25-100% of cases. Goal-directed fluid management was used in 0-63% of cases. Between 0% and 68.9% of the patients returned to the ward (level one) after surgery, and between 9.7% and 87.5% were admitted to intensive care (level three). Mortality rates varied from 3.6% to 41.7%. This study confirms that emergency laparotomy in the UK carries a high mortality. The variation in clinical management and outcomes indicates the need for a national quality improvement programme.

A retrospective study comparing the accuracy of prehistology diagnosis and surgical excision of malignant melanomas by general practitioners and hospital specialists.

Science.gov (United States)

Bakhai, M; Hopster, D; Wakeel, R

2010-01-01

A retrospective study was carried out to compare the overall standard of surgical excision of malignant melanomas (MMs) between general practitioners (GPs) and hospital specialists before and after the introduction of the UK melanoma guidelines between 1989 and 2006. In total, 213 melanoma excision reports were examined and surgical excision margins recorded. The results showed a significant difference in the rate of adequate surgical excision margins (at all levels of Breslow thickness) between GPs and hospital specialists, with hospital specialists excising melanomas with safe surgical excision margins at a significantly higher rate compared with GPs. Since the introduction of the guidelines in 2002, GPs showed a significant improvement in the completeness of melanoma excision but remained poor at prehistology diagnosis and in particular at taking adequate excision margins. Implementation of the guidelines has not produced significant improvements in adequacy of excision margins in both primary and secondary care. The results show that hospital specialists maintained a high standard of prehistological diagnosis and completeness of excision throughout the time of the study, performing at a significantly higher standard compared with GPs. Our conclusions concur with the UK melanoma guidelines and the National Institute for Health and Clinical Excellence guidelines, which suggest that lesions suspicious for melanoma should be urgently referred to a dermatologist or plastic surgeon for surgical excision and should not be surgically excised in primary care, particularly if lesions have a Breslow thickness > 2 mm. We suggest that the new guidelines need to be more aggressively implemented in primary care and guidance introduced to improve the accuracy of diagnosis, with better training provided for GPs.

Nutritional knowledge of UK coaches.

Science.gov (United States)

Cockburn, Emma; Fortune, Alistair; Briggs, Marc; Rumbold, Penny

2014-04-10

Athletes obtain nutritional information from their coaches, yet their competency in this area is lacking. Currently, no research exists in the UK which has a different coach education system to many other countries. Therefore, the aim of this study was to evaluate the sports nutrition knowledge of UK coaching certificate (UKCC) level 2 and 3, hockey and netball qualified coaches. All coaches (n = 163) completed a sports nutrition questionnaire to identify: (a) if they provided nutritional advice; (b) their level of sport nutrition knowledge; and (c) factors that may have contributed to their level of knowledge. Over half the coaches provided advice to their athletes (n = 93, 57.1%), even though they were not competent to do so. Coaches responded correctly to 60.3 ± 10.5% of all knowledge questions with no differences between those providing advice and those who did not (p > 0.05). Those coaches who had undertaken formal nutrition training achieved higher scores than those who had not (p sports coaches would benefit from continued professional development in sports nutrition to enhance their coaching practice.

Laparoscopic hand-assisted pancreaticoduodenectomy: initial UK experience.

Science.gov (United States)

Ammori, B J

2004-04-01

By and large, the limited world experience with laparoscopic pancreaticoduodenectomy (PD) has been unfavorable, but the laparoscopic hand-assisted approach to PD has recently shown promising results. We report the first successful UK experience with laparoscopic hand-assisted PD (LHAPD). A 62-year-old man who presented with painless obstructive jaundice was found at endoscopy, to have an ampullary tumor. Preoperative biopsy specimens confirmed the diagnosis of an adenocarcinoma, and CT showed no evidence of either vascular involvement or metastatic disease. A staging laparoscopy showed no intraabdominal metastases, and an LHAPD was performed using a Gelport. The intraoperative course was uneventful. Two units of blood were transfused intraoperatively, but no postoperative blood transfusion was required. The operative time was 11 h (plus a 30-min break). The patients postoperative recovery was uneventful except for superficial pressure sores over the buttocks and elbows. The patient resumed oral fluid and dietary intake on the 1st and 3rd postoperative days, respectively, and was discharged from hospital on the 9th postoperative day. Histology demonstrated an ampullary adenocarcinoma with clear resection margins and involvement of two of the 13 lymph nodes examined. At 2-month follow-up, the patient remains well and is receiving adjuvant chemotherapy. LHAPD achieves good oncological clearance and can be performed safely in selected patients. The early promising results with this approach will undoubtedly encourage wider adoption of this procedure and are likely to widen the selection criteria.

Integration and dispersal in the UK

Directory of Open Access Journals (Sweden)

David Griffiths

2005-05-01

Full Text Available It is often suggested that Refugee Community-based Organisations (RCOs play a key role in assisting refugee adaptation and integration in the UK. But what happens when the reception policy for asylum seekers and refugees is fundamentally changed?

The UK's Surplus Source Disposal Programme: successful management of a national radioactive legacy

International Nuclear Information System (INIS)

Williams, Clive; Burns, Philip; Wakerley, Malcolm; Watson, Isabelle; Cook, Marianne; Moloney, Barry

2010-01-01

Between 2004 and 2009, the Surplus Source Disposal Programme (SSDP) arranged and subsidised the safe disposal or recycling of more than 11 000 unwanted radioactive items containing in total more than 8.5 x 10 14 Bq of activity, from some 500 sites throughout the United Kingdom. Sources were removed principally from universities, schools and colleges, museums, and hospitals. SSDP was funded by the UK Government and managed by the Environment Agency. The programme was delivered at a total cost of Pounds 7.14 million, nearly Pounds 2 million less than its initial budget. This was a big success for health and safety, the environment, business and the public purse. Current legislative requirements under the High Activity Sealed Sources Directive, which came into effect during 2005, will prevent a build-up of high activity surplus sources in future. Continuing vigilance may be needed to avoid a build-up of lower activity disused sources. (note)

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

Policy Options to Address Crucial Communication Gaps in the Incident Command System

Science.gov (United States)

2012-09-01

knife and study their husbands’ necks. Anything can happen.12 Raymond Chandler , Red Wind, A. CHAPTER INTRODUCTION This chapter describes the...Santa Barbara, moving southward towards Ventura, 12 Raymond Chandler , “Red Wind.” Available at http...front of the Alfred P. Murrah Federal Building. Government and other responders were on the scene minutes after a massive truck bomb destroyed a federal

Prevention of meticillin-resistant Staphylococcus aureus bloodstream infections in European hospitals: moving beyond policies.

Science.gov (United States)

Borg, M A; Hulscher, M; Scicluna, E A; Richards, J; Azanowsky, J-M; Xuereb, D; Huis, A; Moro, M L; Maltezou, H C; Frank, U

2014-08-01

There is evidence that meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia can be reduced with improved infection control and antibiotic stewardship. To survey infection control and antibiotic stewardship practices within European hospitals and to identify initiatives that correlate with reduced MRSA prevalence. Online questionnaires were sent to European hospitals about their surveillance, hand hygiene, intravenous device management, admission screening, isolation, antibiotic prescribing, hospital demographics and MRSA blood culture isolates during 2010. In all, 269 replies were received from hospitals in 29 European countries. Lower MRSA prevalence showed significant association with presence of incidence surveillance, performance of root cause analysis, mandatory training requirements for hand hygiene, accountability measures for persistent non-compliance, and multi-stakeholder teamwork in antibiotic prescribing. Presence of policies on intravenous catheter insertion and management showed no variation between different MRSA prevalence groups. However, low-prevalence hospitals reported more competency assessment programmes in insertion and maintenance of peripheral and central venous catheters. Hospitals from the UK and Ireland reported the highest uptake of infection control and antibiotic stewardship practices that were significantly associated with low MRSA prevalence, whereas Southern European hospitals exhibited the lowest. In multiple regression analysis, isolation of high-risk patients, performance of root cause analysis, obligatory training for nurses in hand hygiene, and undertaking joint ward rounds including microbiologists and infectious disease physicians remained significantly associated with lower MRSA prevalence. Proactive infection control and antibiotic stewardship initiatives that instilled accountability, ownership, teamwork, and validated competence among healthcare workers were associated with improved MRSA outcomes. Copyright �

An Analysis of Gender Diversity in Urology in the UK and Ireland.

Science.gov (United States)

O'Connor, E M; Nason, G J; Manecksha, R P

2017-12-18

Traditionally, surgery and certain surgical sub-specialities in particular have been predominantly male orientated. In recent years, there has been an increased proportion of female medical graduates which will ultimately have an effect on speciality choices. The aim of this study was to assess the gender diversity among urologists in the UK and Ireland. The total number and gender breakdown of consultant urologists and trainees in the UK and Ireland was obtained from the British Association of Urological Surgeons (BAUS) and the Irish Society of Urology (ISU) membership offices. The total number and gender breakdown of medical school entrants and graduates in 2015 was obtained from the six medical schools in the Republic of Ireland. There are a total of 1,012 consultant urologists in the UK and Ireland. In the UK, 141 (14.6%) are female compared to four (8.2%) in Ireland, p= 0.531. There was a significant increase in the number of females between consultant urologists and trainees in both the UK (p=0.0001) and Ireland (p=0.015). In recent years, there has been a significant change in the percentage of female trainees in the UK and Ireland (22.8% (n=75) in 2011 vs 31.7% (n=93) in 2014, p=0.019. Between the six medical schools in Ireland, there were significantly more female entrants (n=726, 56.5%) than female graduates (n=521, 51.2%) in 2015, p=0.013.There has been a significant shift in gender diversity in urology in the UK and Ireland. Efforts to increase diversity should be pursued to attract further trainees to urology.

Comparative genome analysis of the high pathogenicity Salmonella Typhimurium strain UK-1.

Directory of Open Access Journals (Sweden)

Yingqin Luo

Full Text Available Salmonella enterica serovar Typhimurium, a gram-negative facultative rod-shaped bacterium causing salmonellosis and foodborne disease, is one of the most common isolated Salmonella serovars in both developed and developing nations. Several S. Typhimurium genomes have been completed and many more genome-sequencing projects are underway. Comparative genome analysis of the multiple strains leads to a better understanding of the evolution of S. Typhimurium and its pathogenesis. S. Typhimurium strain UK-1 (belongs to phage type 1 is highly virulent when orally administered to mice and chickens and efficiently colonizes lymphoid tissues of these species. These characteristics make this strain a good choice for use in vaccine development. In fact, UK-1 has been used as the parent strain for a number of nonrecombinant and recombinant vaccine strains, including several commercial vaccines for poultry. In this study, we conducted a thorough comparative genome analysis of the UK-1 strain with other S. Typhimurium strains and examined the phenotypic impact of several genomic differences. Whole genomic comparison highlights an extremely close relationship between the UK-1 strain and other S. Typhimurium strains; however, many interesting genetic and genomic variations specific to UK-1 were explored. In particular, the deletion of a UK-1-specific gene that is highly similar to the gene encoding the T3SS effector protein NleC exhibited a significant decrease in oral virulence in BALB/c mice. The complete genetic complements in UK-1, especially those elements that contribute to virulence or aid in determining the diversity within bacterial species, provide key information in evaluating the functional characterization of important genetic determinants and for development of vaccines.

Health effects of adopting low greenhouse gas emission diets in the UK

Science.gov (United States)

Milner, James; Green, Rosemary; Dangour, Alan D; Haines, Andy; Chalabi, Zaid; Spadaro, Joseph; Markandya, Anil; Wilkinson, Paul

2015-01-01

Objective Dietary changes which improve health are also likely to be beneficial for the environment by reducing emissions of greenhouse gases (GHG). However, previous analyses have not accounted for the potential acceptability of low GHG diets to the general public. This study attempted to quantify the health effects associated with adopting low GHG emission diets in the UK. Design Epidemiological modelling study. Setting UK. Participants UK population. Intervention Adoption of diets optimised to achieve the WHO nutritional recommendations and reduce GHG emissions while remaining as close as possible to existing dietary patterns. Main outcome Changes in years of life lost due to coronary heart disease, stroke, several cancers and type II diabetes, quantified using life tables. Results If the average UK dietary intake were optimised to comply with the WHO recommendations, we estimate an incidental reduction of 17% in GHG emissions. Such a dietary pattern would be broadly similar to the current UK average. Our model suggests that it would save almost 7 million years of life lost prematurely in the UK over the next 30 years and increase average life expectancy by over 8 months. Diets that result in additional GHG emission reductions could achieve further net health benefits. For emission reductions greater than 40%, improvements in some health outcomes may decrease and acceptability will diminish. Conclusions There are large potential benefits to health from adopting diets with lower associated GHG emissions in the UK. Most of these benefits can be achieved without drastic changes to existing dietary patterns. However, to reduce emissions by more than 40%, major dietary changes that limit both acceptability and the benefits to health are required. PMID:25929258

An Analysis of Gender Diversity in Urology in the UK and Ireland

LENUS (Irish Health Repository)

E M O’Connor, E M

2017-11-01

Traditionally, surgery and certain surgical sub-specialities in particular have been predominantly male orientated. In recent years, there has been an increased proportion of female medical graduates which will ultimately have an effect on speciality choices. The aim of this study was to assess the gender diversity among urologists in the UK and Ireland. The total number and gender breakdown of consultant urologists and trainees in the UK and Ireland was obtained from the British Association of Urological Surgeons (BAUS) and the Irish Society of Urology (ISU) membership offices. The total number and gender breakdown of medical school entrants and graduates in 2015 was obtained from the six medical schools in the Republic of Ireland. There are a total of 1,012 consultant urologists in the UK and Ireland. In the UK, 141 (14.6%) are female compared to four (8.2%) in Ireland, p= 0.531. There was a significant increase in the number of females between consultant urologists and trainees in both the UK (p=0.0001) and Ireland (p=0.015). In recent years, there has been a significant change in the percentage of female trainees in the UK and Ireland (22.8% (n=75) in 2011 vs 31.7% (n=93) in 2014, p=0.019. Between the six medical schools in Ireland, there were significantly more female entrants (n=726, 56.5%) than female graduates (n=521, 51.2%) in 2015, p=0.013.There has been a significant shift in gender diversity in urology in the UK and Ireland. Efforts to increase diversity should be pursued to attract further trainees to urology.

Promotion of an indigenous manufacturing industry in the UK

International Nuclear Information System (INIS)

Anderson, C.

1998-01-01

Of the large European wind energy markets, that of the UK is uniquely dominated by imported technology. An indigenous manufacturing base is desirable for strategic reasons, and to create employment and export opportunities. Analysis of the wind energy policies of other countries indicates the factors required to stimulate local manufacture. This paper examines how UK wind energy policy may be shaped for this purpose, taking account of the lessons learned under NFFO/SRO, and elsewhere in Europe. (Author)

KONSOLIDOVANÉ ÚČETNÍ VÝKAZY PODLE UK GAAP

OpenAIRE

Nesvadbová, Klára

2015-01-01

This diploma thesis deals with the preparation of consolidated financial statements in accordance with UK GAAP rules after the reform, with effect from 1 January 2015. The subject of investigation is primarily a process of preparation of consolidated financial statements in the UK, especially the full consolidation method and the equity method. The fundamental standard upon which this work is based is FRS 102. The work should also, on the practical examples, compare the process of preparation...

Prospects for local community wind energy projects in the UK

International Nuclear Information System (INIS)

Taylor, Derek; Open Univ., Milton Keynes

1993-01-01

This paper examines the prospects for local community wind energy projects in the UK. After explaining the advantages of such projects compared to purely commercial developments, the scale and funding for the projects are discussed. It is argued that such projects are beneficial both financially to individual members and also to the local rural economies particularly in deprived regions. (UK)

Establishing biomass heating in the UK: phase 2

International Nuclear Information System (INIS)

2000-01-01

The Biomass Heat Working Group, first set up in 1995, was taken on by British BioGen in 1996. Over the summer of 1996 British BioGen, supported by DTI, worked with the group to produce 'A Strategy to Develop the UK Market for Biomass Heating Installations'. In the spring of 1997 British BioGen agreed a two-year programme with ETSU (for the DTI) to 'Establish Biomass Heating in the UK'. The DTI's New and Renewable Energy Programme has supported this two-year programme which aims to bring together industry stakeholders and assist in the development of a significant biomass heat market in the UK. Overall we believe the project has been successful in its aim to increase the volume of biomass heating enquiries and enable greater use of the industry 'knowledge base'. Throughout the duration of the project a number of new biomass heating systems have been installed, including Shenstone Lodge School, Boughton Pumping Station and Elvendon Priory. In addition, an efficient system of information exchange has been established for customers and industry. British BioGen believe that the benefits of this system will be a crucial factor in achieving bioenergy industry targets of 2MWt for domestic heating, 2MWt for industrial and commercial heating and 2MWt for CHP by the end of 2001. The remainder of this summary offers highlights of the activities undertaken within the project, outlines the conclusions of the project and makes brief recommendations for further actions to assist the further deployment of biomass heating in the UK. (author)

Performance in the FRCR (UK) Part 2B examination: Analysis of factors associated with success

International Nuclear Information System (INIS)

Hawtin, K.E.; Williams, H.R.T.; McKnight, L.; Booth, T.C.

2014-01-01

Aim: To assess factors that influence pass rates and examination scores in the Fellowship of the Royal College of Radiologists (FRCR) 2B examination. Materials and methods: 2238 attempts at the FRCR 2B examination were evaluated between Spring 2006 and Spring 2010. Pass rates and examination scores were analysed by gender and ethnicity, and the influence of factors such as radiology training (UK versus non-UK), sitting (Spring versus Autumn), and the presence of an undergraduate or postgraduate degree were examined. Results: 1571 candidates made 2238 examination attempts, with an overall pass rate of 59.4% (63.1% at first attempt). 66.2% entrants were male; 48.8% attempts were by candidates from a UK radiology training scheme. UK candidates were significantly more likely to pass than non-UK candidates (p < 0.0001). White candidates were more likely to pass at first or second attempt than non-white candidates (p < 0.0001), but when restricted to UK entrants ethnicity did not influence success at first attempt. Overall, females were more successful than males (p < 0.001). Presence of an undergraduate (p = 0.19) or postgraduate (p = 0.80) degree did not affect pass rate at first attempt for UK candidates. However, logistic regression demonstrated that the only significant factor influencing pass rates at first attempt was whether radiology training was undertaken in the UK (p < 0.0001). A trend towards increased pass rates in autumn sittings was seen (p = 0.06), but ethnicity (p = 0.99) and gender (p = 0.41) were not significant factors. Conclusion: The FRCR 2B examination is non-discriminatory for UK candidates with respect to gender and ethnicity. Poorer performance of non-UK trained candidates is a consistent outcome in the literature. - Highlights: • Factors influencing pass rates and scores in FRCR 2B examination were assessed. • UK candidates are more likely to pass than non-UK candidates. • There is no effect of gender or ethnicity on UK

Nuclear merchant ship propulsion. The present status in the UK

International Nuclear Information System (INIS)

Kinsey, R.P.

1976-01-01

The latest report of the Nuclear Ship Stearing Group which deals with three important aspects; economic assessments, international safety and operating procedures for nuclear ships, and the industrial capability of the UK shipbuilding and nuclear industries, is discussed. The integral design concept for a pressurised water reactor for use as a marine reactor is considered. The operational safety aspects of such reactors and of the attendant refuelling facilities are discussed. U.K. capability in the whole nuclear merchant ship propulsion project is considered; reference being made to the design and construction of small PWR reactors, the development, design and supply of the nuclear propulsion unit, financial aspects, and the requirement for cooperation between industrial interests and governmental research units. (U.K.)

Measuring patient safety in a UK dental hospital: development of a dental clinical effectiveness dashboard.

Science.gov (United States)

Pemberton, M N; Ashley, M P; Shaw, A; Dickson, S; Saksena, A

2014-10-01

Patient safety is an important marker of quality for any healthcare organisation. In 2008, the British Government white paper entitled High quality care for all, resulting from a review led by Lord Darzi, identified patient safety as a key component of quality and discussed how it might be measured, analysed and acted upon. National and local clinically curated metrics were suggested, which could be displayed via a 'clinical dashboard'. This paper explains the development of a clinical effectiveness dashboard focused on patient safety in an English dental hospital and how it has helped us identify relevant patient safety issues in secondary dental care.

Qualitative Investigation of the Wellness Recovery Action Plan in a UK NHS Crisis Care Setting.

Science.gov (United States)

Ashman, Michael; Halliday, Vanessa; Cunnane, Joseph G

2017-07-01

Crisis theory suggests that in addition to presenting a threat to mental well-being, crises are also opportunities where successful interventions can lead to successful outcomes. UK mental health crisis teams aim to reduce hospital admission by treating people at home and by building resilience and supporting learning from crisis, yet data on repeat crisis episodes suggest this could be improved. This qualitative study sought to explore the Wellness Recovery Action Plan (WRAP) as a means of supporting resilience-building and maximising the opportunity potential of crisis. The following themes emerged: The meaning of crisis; Engaging with the WRAP process; WRAP and self-management; and Changes and transformations. This research suggests that WRAP has potential in supporting recovery from crisis, revealing insights into the nature of crisis which can inform the further development of crisis services.

Evaluating the UK and Dutch defined benefit policies using the holistic balance sheet framework

NARCIS (Netherlands)

Chen, Z.; Pelsser, A.; Ponds, E.H.M.

This paper compares the UK and Dutch occupational defined-benefit pension policies using the holistic balance sheet (HBS) framework. The UK DB pension system differs from the Dutch one in terms of the steering tools and adjustment mechanisms. In addition to the sponsor guarantee, the UK system has

Construct Validity of the WISC-IV[superscript UK] with a Large Referred Irish Sample

Science.gov (United States)

Watkins, Marley W.; Canivez, Gary L.; James, Trevor; James, Kate; Good, Rebecca

2013-01-01

Irish educational psychologists frequently use the Wechsler Intelligence Scale for Children-Fourth U.K. Edition (WISC-IV[superscript UK]) in clinical assessments of children with learning difficulties. Unfortunately, reliability and validity studies of the WISC-IV[superscript UK] have not yet been reported. This study examined the construct…

The impact of the customer relationship management on organizational productivity, customer trust and satisfaction by using the structural equation model: A study in the Iranian hospitals.

Science.gov (United States)